1.The Application of Chimney Technique in Thoracic Endovascular Aortic Repair of Thoracic Aortic Lesions
Kaikai FAN ; Minxin WEI ; Qiang FU ; Zanxin WANG
Tianjin Medical Journal 2014;(4):384-386
Objective To evaluate the feasibility of strent-graft with Chimney technique in thoracic endovascular aortic repair (TEVAR) of thoracic aortic dissection left subclavian artery (LSA) disease and left common carotid artery (LCCA) disease without good landing zone. Methods A total of 21 patients with thoracic aortic diseases complicated by in-sufficient proximal anchoring area,who were presented in our hospital in recent years,were selected in this study. The clini-cal data were retrospectively analyzed. The thoracic aortic diseases included aortic dissection ( n=11), aortic pseudoaneurysm (n=2), aortic aneurysm(n=1) and penetrating ulcer(n=7). Among all 21 patients,lesion was located in distal to LSA in 18 pa-tients with distance to LSA anchoring less than15 mm,and the lesion was located between the LSA and LCCA in the rest 3 patients.Thoracic aortic stent-graft placement was carried out.The ostium of LSA was intentionally and completely cov-ered by thoracic aortic stent-graft and left subclavian artery or left internal carotid artery stent-graft placement was subse-quently performed. The patients were observed for symptoms of cerebral and upper limb ischemia. The postoperative com-plications such as endoleak and the patency of LSA were assessed with angiography. Results Thoracic aortic stent-graft placement was suceessfully carried out in all 21 patients. In addition,one“Chimney”stent was properly implanted in LSA or LICA in each patient. After the procedure,no complications of nervous system or severe ischemia of upper extremity was observed. Follow-up examinations between to 38 months after the treatment revealed that the aortic stent-graft remained in stable condition without type I endoleak. Meanwhile the blood flow in“chinney”stent was unobstructed. Conclusion Chimney technique can expand the applicability of TSGP with high tolerance. Chimney technique expand the applicability of TEVAR for patients with challenging anatomy. It is a safe,effective and microinvasive method to treat thoracic aortic lesions.
2.Evaluation of left ventricular diastolic function in patients with uremia by using vector flow mapping
Kaikai SHEN ; Zhenzhen WANG ; Ying DENG ; Hairu LI ; Jiawei TIAN
Chinese Journal of Ultrasonography 2015;24(11):942-947
Objective To assess the clinical application value of vector flow mapping (VFM) in evaluating the left ventricular diastolic function in patients with uremia.Methods Forty patients with uremia and forty healthy volunteers were enrolled.The quantitative parameters,including vorticity,sum total energy loss (sEL),average energy loss(aEL),and the alteration circulation were measured in the VFM imaging mode.Difference was evaluated between two groups at apical,mid and basal segments at different periods.E/e'was derived via dual-Doppler imaging technology.And correlationship was analyzed between vorticity,sEL,aEL,circulation and E/e',separately.Results ①At apex segment of isovolumetric relaxation time and at three segments of atrial systole,there were difference in vorticity,sEL,aEL between two groups (P <0.05).Circulation in rapid filling phase of anterior mitral valve and slow filling phase of posterior mitral valve were different[(15.94 ± 8.40) m2/s vs (8.36 ± 7.84) m2/s,(5.34 ± 5.24) m2/s vs (13.37 ± 10.42) m2/s,P <0.05].②In control group,vorticity,sEL and aEL were different in different segments of same phase or at different phases of same segment,and also did in the uremia group(P <0.01).③In uremia group,vorticity had a good correlation with E/e'at basal segment of rapid filling phase(r =0.34,P =0.046)and atrial systole(r =0.38,P =0.02).And sEL had a good correlation with E/e'at basal segment of rapid filling phase,isovolumetric relaxation time and at mid segment of rapid filling phase(r1 =0.44,P1 =0.008;r2 =0.48,P2 =0.003;r3 =0.50,P3 =0.002),and in time phase mentioned above,there were also the correlationship between aEL and E/e'(r1 =0.39,P1 =0.017;r2 =0.49,P2 =0.002;r3 =0.48,P3 =0.003).Conclusions VFM can be utilized to analyze left ventricular hemodynamics features of uremia patients and it may be a good supplement for assessing cardiac diastolic function.
3.Study of left ventricular diastolic function in hypertensive patients with different left ventricular geometric patterns by vector flow mapping
Hongfeng WANG ; Min REN ; Kaikai SHEN ; Hairu LI ; Jiawei TIAN
Chinese Journal of Ultrasonography 2016;25(11):926-931
Objective To assess the clinical application value of vector flow mapping (VFM) in evaluating the left ventricular diastolic function in hypertensive patients with different left ventricular geometric patterns.Methods One hundred and sixty-nine patients with hypertension and 50 healthy volunteers were enrolled.Hypertensive patients were divided into four groups with different ventricular configurations according to ASE guide line in 2005:normal geometry group,concentric remodeling group,concentric hypertrophy group and eccentric hypertrophy group.The quantitative parameters,including average energy loss(aEL) and circulation were measured.Difference was evaluated among five groups at apical,mid and basal segments and at different periods.The correlationship was analyzed between aEL,circulation and E/e',respectively.Results ① Compared to control group,aEL was higher in four hypertension groups at three segments of atrial systole(P <0.05).aEL in eccentric hypertrophy group was higher than those in control group,normal geometry group or concentric remodeling group at apical and mid segments of atrial systole,and higher than those in other hypertensive groups at basal segment (P < 0.05).In four hypertension groups,circulations in rapid filling phase of anterior mitral valve were lower than that in control group,but circulations in slow filling phase of posterior mitral valve were higher than that in control group(P <0.05).The circulation in slow filling phase of posterior mitral valve in concentric remodeling group was higher than that in normal geometry group,and that in eccentric hypertrophy group was higher than those in normal geometry group and concentric remodeling group(P <0.05).②When intra-group comparison,aEL were different in different segments of same phase or at different phases of same segment(P <0.05).③aEL had a good correlation with E/e'at basal segment of atrial systole in four hypertension groups(r =0.66,P <0.01).Conclusions VFM can be utilized to analyze left ventricular hemodynamics features of hypertensive patients with different left ventricular geometric patterns,it may be a good supplement for assessing cardiac diastolic function and reflect the extent of damage.
4.Influence of acrylamide on adult neurogenesis and expression of GSK3βin mouse
Kaikai LI ; Jiongfang XIE ; Jiutao WANG ; Lingzhen SONG ; Wei ZHANG ; Shulin CHEN ; Shanting ZHAO
Chinese Journal of Immunology 2015;(2):163-168
Objective:To investigate the influence of acrylamide ( ACR) on adult neurogenesis and expression of GSK 3βin mouse.Methods:Method Adult male Kunming mice were used and divided into two groups:control group and experimental poisoning groups,that were exposured to acrylamide by intraperitoneal injection.Brdu labeling and immunohistochemistry were used to investigate the proliferation of adult neural stem cells in the subgranular zone ( SGZ).BrdU/NeuN/GFAP triple labeling to investigate the survival and differentiation of newly generated cells.Detecting GSK3βexpression and distribution in Neuro-2a cells,the expression of GSK3βwas examined by using Western blot.Results:Compared with control mice ,lower number of BrdU-positive cells and less differentiated into neurons in ACR mice.Less neural stem cells survived ,but more glia cells were generated in the subgranular zone of acrylamide mice.Moreover,higher phosphorylated GSK 3β( Ser9 ) were detected in Neuro-2a cells and mouse dentate gyrus in ACR mice respectively .Conclusion:These results suggested that acrylamide inhibits neural stem cells proliferation and influences the survival and differentiation of newly generated cells.Acrylamide inhibits neurogenesis maybe through GSK 3βsignaling pathway.
5.Effect of histone deacetylase inhibitor LBH589 on proliferation, apoptosis and drug resistance of acute myeloid leukemia cell line HL60/ADM
Xuejie JIANG ; Qingxia ZHAO ; Zhixiang WANG ; Bingjie DING ; Kaikai HUANG ; Jieyu YE ; Fanyi MENG
Journal of Leukemia & Lymphoma 2014;23(4):199-203
Objective To investigate the effect of histone deacetylase inhibitor LBH589 on proliferation,apoptosis and drug resistance of chemoresistant acute myeloid leukemia cells HL60/ADM.Methods HL60/ADM cells were treated with LBH589.Proliferation,apoptosis and adriamycin IC50 were evaluated by MTT assay and AnnexinV-FITC/PI stain.The change in MRP1 expression and intercellular adriamycin accumulatiom were analyzed by flow cytometry.Results Effective proliferative inhibition and apoptotic induction in HL60/ADM cells were observed after treatment with 10-80 nmol/L LBH589 with maximal effect detected after treatment with 70 nmol/L LBH589 for 60 hours.However,inhibition ratio remain unchanged with the further increase of drug dose and incubation time (P > 0.05).Downregulation of MRP1 [(93.90±4.20) % vs (76.19±6.53) %],upregulation of adriamycin accumulation [(8.53±0.68) % vs (25.67±1.34) %] and decrease in adriamycin IC50 [(6.833±0.319) μg/ml vs (1.382±0.104) μg/ml] were induced by the treatment with 20 nmol/L LBH589 (P < 0.01),whose reversal fold was 4.9.The expression of acetylated histone 3 after treatment with LBH589 was higher than that before treatment (P < 0.01).However,relative p-Akt levels after treatment for 24 h and 48 h were 1.07±0.09 and 0.59±0.01,respectively,which were lower than that before treatment (2.03±0.12) (P < 0.01).Meanwhile,expression levels of p53 were 0.57±0.04 and 1.31±0.09,respectively,which were higher than that before treatment (0.21 ±0.02) (P < 0.01).Conclusion Treatment with LBH589 has the capability of inhibiting proliferation and inducing apoptosis,as well as increasing intercellular adriamycin accumulation and sensitivity through downregulation of MRP1 expression and inhibition of PI3K-Akt signaling pathway in HL60/ADM cells.
6.Clinical effect of three-dimensional radiotherapy combined with chemotherapy for esophageal squamous cell carcinoma:a study of 1257 patients
Andu ZHAND ; Jing HAN ; Chun HAN ; Jie KONG ; Lan WANG ; Jun ZHANG ; Kaikai HAO
Chinese Journal of Radiation Oncology 2017;26(5):517-521
Objective To compare the efficacy between three-dimensional radiotherapy (3DRT) combined with chemotherapy and radiotherapy alone for patients with esophageal squamous cell carcinoma.Methods A retrospective analysis was performed for 1257 patients with esophageal squamous cell carcinoma who were admitted to our hospital from July 2003 to June 2012 and met the inclusion criteria;362 patients were treated with 3DRT combined with chemotherapy (chemoradiotherapy group) and 895 patients were treated with radiotherapy alone (radiotherapy group).The short-term outcome, overall survival (OS) rate, and causes of death were analyzed.The Kaplan-Meier method was used to calculate survival rates, and the log-rank test was used for survival difference analysis and univariate prognostic analysis.Results The response rate was 99.1%(346/349) in the chemoradiotherapy group and 99.0%(813/821) in the radiotherapy group (P=0.397).The 1-, 3-, and 5-year OS rates were 74.0%,42.0%,and 32.9% in the chemoradiotherapy group and 65.9%,33.0%,and 23.3% in the radiotherapy group (P=0.000), and were 75.6%,43.5%,and 33.2% in the concurrent chemoradiotherapy group and 65.9%,33.0%,and 23.3% in the radiotherapy group (P=0.000).There were no significant differences in 1-, 3-, and 5-year OS rates between the concurrent chemoradiotherapy group and the sequential chemoradiotherapy group (P=0.583).The sequential chemoradiotherapy group had an insignificant increase in 1-, 3-, and 5-year OS rates compared with the radiotherapy group (P=0.065).Tumor recurrence and local control failure were the main causes of death, followed by distant metastasis.The chemoradiotherapy group had a significantly lower proportion of patients who died of local control failure than the radiotherapy group (7.4% vs.14.7%, P=0.003).Conclusions For patients with esophageal squamous cell carcinoma, chemoradiotherapy leads to significantly improved overall survival compared with radiotherapy alone;compared with radiotherapy alone, sequential chemoradiotherapy results in an increasing trend in OS rates, while concurrent chemoradiotherapy results in significantly increased OS rates.Chemoradiotherapy can reduce the deaths due to local control failure compared with radiotherapy alone.
7.Effect of subcellular localization of P21 on proliferation and apoptosis of HepG2 cells.
Rongyuan, QIU ; Songbai, WANG ; Xihua, FENG ; Feng, CHEN ; Kaikai, YANG ; Shengsong, HE
Journal of Huazhong University of Science and Technology (Medical Sciences) 2011;31(6):756-61
This study examined the effect of subcellular localization of P21 on the proliferation and apoptosis of HepG2 cells. The coding genes of the wild and the mutant P21 were amplified by mega primer PCR from the plasmid pCEP-WAF1 which contains human P21 cDNA in the nuclear localizational signal (NLS) sequence, and then inserted into the eukaryotic expression vector pDsRed1-C1. The recombinants were transfected into HepG2 cells. The transcription and expression of P21 were determined by RT-PCR and fluorescence microscopy. The cell proliferation was measured by MTT, and the cell cycle and apoptosis of HepG2 cells by flow cytometry. The results of restriction analysis, DNA sequencing and fluorescence microscopy confirmed the construction of the wild and the mutant P21 in the eukaryotic expression plasmid. The plasmid containing the mutant P21 was found to accelerate cell proliferation and the wild P21 plasmid to inhibit cell proliferation. Cell cycle analysis showed that the cell ratio of G(0)/G(1) in the wild type group was significantly increased as compared with that in the mutant type group, and cell apoptosis analysis revealed that the apoptosis rate in the wild type group was much higher than that in the mutant type group. It was concluded that the subcellular localization of P21 may contribute to the development of hepatic cancer.
8.Application of non-invasive left ventricular pressure-strain curve in evaluating left ventricular myocardial work in hemodialysis patients
Kaikai SHEN ; Haohui ZHU ; Xiao DING ; Rui XU ; Yisa WANG ; Jianjun YUAN
Chinese Journal of Ultrasonography 2020;29(6):505-510
Objective:The evaluate left ventricular myocardial work in maintenance hemodialysis (MHD) patients by non-invasive left ventricular pressure strain curve.Methods:Forty-eight patients undergoing maintenance hemodialysis were selected as the MHD group, and 33 healthy subjects were selected as the control group from Apr to Oct 2019 in Henan Provincial People′s Hospital. The differences of general clinical data, basic parameters of two-dimensional ultrasound including left ventricular end-diastolic diameter (LVDd), left ventricular end-systolic diameter (LVDs), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), stroke volume (SV), diastolic interventricular septal thickness (IVSd), left ventricular diastolic posterior wall thickness (LVPWd), left ventricular diastolic mass (LVDm), left ventricular systolic mass (LVSm), late diastolic tissue velocity (a′), early diastolic peak velocity/early diastolic tissue velocity (E/e′), A peak and cardiac output (CO), peak strain dispersion (PSD), and global work index (GWI), global work efficiency (GWE), global constructive work (GCW), global wasted work (GWW) and global long-axis strain (GLS) between two groups were compared, and the correlation between myocardial work parameters and conventional cardiac parameters was analyzed.Results:①In terms of comparison, LVDd, LVDs, LVEDV, LVESV, SV, IVSd, LVPWd, LVDm, LVSm, systolic blood pressure (SBP), diastolic blood pressure (DBP), a′, E/e′. A peak and CO of the MHD group were greater than those in the control group (all P<0.05), and e′ of the MHD group was lower ( P<0.05). ②In terms of comparison, PSD and GWW of the MHD group were greater than those of the control group (all P<0.05), while GLS and GWE of the MHD group was lower (all P<0.05). There were no statistically significant differences in GCW and GWI between two groups(all P>0.05). ③GWI was positively correlated with SBP, DBP and left ventricular ejection fraction (LVEF)( r1=0.442, P1=0.030; r2=0.477, P2=0.019; r3=0.431, P3=0.040), and negatively correlated with GLS and LVDs( r1=-0.576, P1=0.003; r2=-0.404, P2=0.050). GWW was positively correlated with GLS and PSD( r1=0.584, P1=0.003; r2=0.564, P2=0.004). GWE was positively correlated with LVEF( r=0.424, P=0.044), and negatively correlated with LVEDV, LVESV, PSD, GLS and LVDm( r1=-0.444, P1=0.034; r2=-0.490, P2=0.018; r3=-0.721, P3<0.001; r4=-0.738, P4<0.001; r5=-0.442, P5=0.035). GCW was positively correlated with LVEF and DBP( r1=0.494, P1=0.017; r2=0431, P2=0.035), and negatively correlated with GLS and LVDs( r1=-0.630, P1=0.001; r2=-0.419, P2=0.042). Conclusions:The non-invasive left ventricular pressure-strain curve combines blood pressure and strain. Compared with the GLS, it can accurately assess left ventricular myocardial work in maintenance hemodialysis patients and predict potential left ventricular function changes in maintenance hemodialysis patients.
9.Risk factors for prolonged postoperative ileus after radical colorectal cancer resection
Zhen TIAN ; Kaikai ZHANG ; Yunlong LI ; Yiqi WANG
Chinese Journal of General Surgery 2024;39(1):36-40
Objective:To investigate the prognostic factors for the risk of prolonged postoperative ileus (PPOI) after colorectal cancer resection.Methods:The clinical data of 896 patients undergoing radical colorectal cancer resection at Affiliated Hospital of Qingdao University between Jan 2016 and Dec 2022 were retrospectively analyzed. Patients were divided into PPOI group (59 cases) and non-PPOI group (837 cases) according to whether PPOI happened after surgery. Potential prognostic factors for the risk of developing PPOI were analyzed by univariate and multivariate Logistic regression. The receiver operating characteristic curve analysis was performed to assess the predictive power of potential prognosis factors.Results:Fifty-nine patients (6.5%) developed PPOI after radical colorectal cancer resection. Univariate and multifactorial logistic regression analyses showed that diabetes mellitus ( OR=2.360, P=0.018), preoperative albumin level <35 g/L ( OR=2.196, P=0.036), postoperative epidural analgesia ( OR=2.399, P=0.007), open surgery ( OR=3.413, P=0.001), and ICU hospitalization ≥ 48 h ( OR=6.134, P<0.001) were independent prognostic factors for PPOI. Combining the above prognostic factors to construct the receiver operating characteristic curve yielded an area under the curve of 0.806 (95% CI: 0.698-0.838), with an accuracy, sensitivity and specificity of 73.9%, 74.0%, 72.9%, respectively. Conclusion:Diabetes mellitus, preoperative albumin level, postoperative epidural analgesia, open surgery, and ICU hospitalization ≥ 48 h were risk factors for PPOI after radical colorectal cancer resection.
10.Recent advance in role of RNA binding protein in glioma
Jun ZHANG ; Kaikai WANG ; Shiguang ZHAO
Chinese Journal of Neuromedicine 2018;17(9):892-896
Glioblastoma (GBM) is one of the most common primary malignant intracranial tumors and has a poor prognosis despite the application of standard therapies-surgical resection,radiotherapy and chemotherapy.RNA-binding proteins (RBPs) are proteins that directly bound to RNA.They could regulate RNA splicing,polyadenylation,localization,stability and translation by creating functional units called ribonucleoprotein complexes (RNPs).RBPs play an important role in tumor progression including glioma.In this paper,we summarized the recent development of research of RBPs in glioma progress,especially the molecular mechanism of RBPs regulating RNA biological activity.