Objective The prosthesis used for aortic valve replacement (AVR) may be too small in relation to the body size, thus causing valve prosthesis-patient mismatch (PPM) and abnormally high transvalvular pressure gradients. The aim of this study was to evaluate the prevalence of PPM and the impact of PPM on hemodynamic and early mortality after AVR. Methods A total of 292 patients ( 167 males, 125 females; mean age of ( 52.8 ± 14.6 ) years, with ranging 22 - 82 years) who underwent AVR between January 2007 and December 2009 were retrospectively evaluated. Etiologies were: rheumatic in 243 cases, degenerative in 36, congenitally bicuspid aortic valve in 8, and infective endocarditis in 5. Combined operations with AVR including mitral valve replacement ( 172 cases), mitral valve repair (56 cases), tricuspid valve repair (238 cases), and coronary artery bypass grafting (32 cases). The aortic valve prosthesis effective valve orifice area (EOA) was divided by the body surface area (BSA) to obtain the EOA index (EOAI). PPM was then defined as none or mild if EOAI was ＞0.85 cm2/m2, as moderate for 0.65 -0.85 cm2/m2 and as severe for ＜0.65 cm2/m2. The mean flow rate through aortic prostheses and mean transvalvular pressure gradients were measured by color Doppler after AVR. The prevalence of PPM was compared between the different type ( mechanical or bioprosthetic valve) and the different size ( ＞21 mm or ≤21 mm) of aortic valve prostheses. The effect of PPM on hemodynamic and early mortality after AVR was also studied. Results 219 patients received mechanical AVR and 73 bioprosthetic AVR. Moderate PPM occurs more frequently with bioprosthetic AVR (6.25% versus 48.22%, P ＜0. 01 ). Bigger than 21mm prostheses were used in 191 patients and ≤21 mm prostheses in 101 patients. The prevalence of PPM was 13.61% and 33.66% respectively ( P ＜ 0. 05 ). According to the EOAI of the aortic valve prostheses,all the 219 patients were divided into two group, PPM group and non-PPM group. The mean flow rate of aortic prostheses and mean transvalvular pressure gradients in PPM group was significantly higher than those in non-PPM group [(2.66 ± 0.87 ) m/s versus ( 1. 58 ± 0.47 ) m/s, ( 26.50 ± 6.25 ) mm Hg versus ( 16.75 ± 3.46 ) mm Hg, P ＜ 0. 01]. There were 9 deaths during early period of operation, and the total 30-day operative mortality was 3.08%. The postoperative early mortality of PPM group and non-PPM group was 6.67% and 2.16% respectively, and there were significantly difference between the two group ( P ＜ 0. 05 ). Conclusion Prosthesis-patient mismatch is common present after AVR, especially in patients with bioprostheses and small size valve prostheses. PPM has a negative impact on postoperative hemodynamic and early mortality. PPM results in higher transvalvular pressure gradients and higher early mortality.

A lack of the complete pig proteome has left a gap in our knowledge of the pig genome and has restricted the feasibility of using pigs as a biomedical model.In this study,we developed a tissue-based proteome map using 34 major normal pig tissues.A total of 5841 unknown protein iso-forms were identified and systematically characterized,including 2225 novel protein isoforms,669 protein isoforms from 460 genes symbolized beginning with LOC,and 2947 protein isoforms with-out clear NCBI annotation in the current pig reference genome.These newly identified protein iso-forms were functionally annotated through profiling the pig transcriptome with high-throughput RNA sequencing of the same pig tissues,further improving the genome annotation of the corre-sponding protein-coding genes.Combining the well-annotated genes that have parallel expression pattern and subcellular witness,we predicted the tissue-related subcellular locations and potential functions for these unknown proteins.Finally,we mined 3081 orthologous genes for 52.7％of unknown protein isoforms across multiple species,referring to 68 KEGG pathways as well as 23 disease signaling pathways.These findings provide valuable insights and a rich resource for enhancing studies of pig genomics and biology,as well as biomedical model application to human medicine.

ObjectiveTo explore the compatibility advantage of Scutellariae Radix-Coptidis Rhizoma in the prevention and treatment of neuroinflammation， and to elucidate the action characteristics and mechanism of the compatibility advantage based on Toll like receptor （TLR4）/myeloid differentiation factor 88 （MyD88）/nuclear factor kappaB （NF-κB） pathway. MethodRepresentative mouse microglia cells （BV2） in vitro were selected and divided into 8 groups： control group， model group， Scutellariae Radix-Coptidis Rhizoma group， Piracetam group， Scutellariae Radix group and Coptidis Rhizoma group. The BV2 cell inflammatory model was established by lipopolysaccharide （LPS）， and the cell activity was detected by cell counting kit-8 （CCK-8）. Cell morphology was observed under bright field. The production and release of pro-inflammatory factors in BV2 cells were determined by enzyme-linked immunosorbent assay （ELISA） and immunofluorescence assay， and the mRNA expressions of TLR4， MyD88 and NF-κB were detected by Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）. The nuclear translocation of NF-κB p65 was detected by immunofluorescence， and TLR4 signal transduction inhibitor （CLI-095） and NF-κB inhibitor （PDTC） were used to confirm the anti-neuroinflammation targets of Scutellariae Radix-Coptidis Rhizoma. ResultCompared with the conditions in the control group， most cells in LPS-induced model group were activated， and the contents of IL-6， TNF-α and IL-1β in culture medium and cells and the mRNA expressions of TLR4， MyD88， NF-κB p50 and NF-κB p65 were increased （P<0.01）， with obvious nuclear entry of NF-κB p65. Compared with the conditions in the model group， BV2 cell morphology was mostly recovered after pretreatment in Scutellariae Radix-Coptidis Rhizoma and Piracetam groups， and the levels of IL-6， TNF-α and IL-1β and the mRNA expressions of TLR4， MyD88， NF-κB p50 and NF-κB p65 were decreased （P<0.05， P<0.01）， with NF-κB p65 mostly observed in cytoplasm. Compared with the conditions in the model group， cell morphology was slightly recovered in Scutellariae Radix group and Coptidis Rhizoma group， and the levels of pro-inflammatory factors and mRNA expressions of TLR4， MyD88， NF-κB p50 and NF-κB p65 were reduced. In terms of inhibitory effect on pro-inflammatory factors， Scutellariae Radix group and Coptidis Rhizoma group were lower than Scutellariae Radix-Coptidis Rhizoma group （P<0.05）. Compared with the model group， the "Scutellariae Radix-Coptidis Rhizoma+CLI-095" group and "Scutellariae Radix-Coptidis Rhizoma+PDTC" group had lowered mRNA expressions of TLR4， MyD88， NF-κB p50 and NF-κB p65 （P<0.05， P<0.01）， and the transfer of NF-κB p65 into nucleus was obviously inhibited. ConclusionThe anti-neuroinflammation effect of Scutellariae Radix-Coptidis Rhizoma was significantly better than Scutellariae Radix or Coptidis Rhizom alone， and the anti-neuroinflammation advantage was closely related to the inhibition of activation of TLR4/MyD88/NF-κB signaling pathway in microglial cells. It was confirmed that TLR4， MyD88 and NF-κB were potential targets for Scutellariae Radix-Coptidis Rhizoma to exert the compatibility advantage.