Objective To discuss the methods of selecting different shapes occluder and to evaluate the feasibility,safety and efficacy of them in transcatheter closures of congenital ventricular septal defect (VSD) in children.Methods Transcatheter closures were performed in 226 children with congenital VSD,age ranging from 2 to 14 years(mean 5.62 years) under the guidance of transthoracic echocardiography(TTE) and fluoroscopy.There were 14 patients with intracristal VSD,209 patients with perimembranous VSD and 3 patients with muscular VSD.Left ventriculography and transthoracic echocardiography were performed repeatedly after the procedure to assess the effect of occlusion.The echocardiography and electrocardiography were scheduled before discharge,1,6 and 12 months for the follow-up.Results The occluders were deployed successfully in 211 patients.The successful rate was 93.4%.Thin waist shape occluders,were deployed in 7 patients;equal side shape occluders,were deployed in 191 patients;eccentric shape occluders were deployed in 12 patients,and muscular defect occluders were deployed in 1 patient.There were no complications encountered during or after closure.Conclusions It is very important in transcatheter closure of congenital in children to select different shape occluder according to pathologic characteristics.In general,equal side shape occluder is suita-ble for a large number of defect and it is easy for deployment.In some conditions,the other shape occluder may be necessary.

OBJECTIVETo evaluate the effect of Xuezhikang (XZK) on cardiac function and serum C-reactive protein (CRP) in patients with chronic heart failure (CHF).

METHODSSixty-eight CHF patients were randomly assigned to two groups, the control group (30 cases) treated with angiotensin converting enzyme inhibitor, beta-receptor inhibitor, digoxin and diuretic, and the treated group (38 cases) with the above treatment plus XZK for six months. The changes of cardiac function and serum CRP level were measured by echocardiography and enzyme-linked immunosorbent assay (ELISA) respectively before and after treatment.

RESULTSCompared with those before treatment, the NYHA cardiac function grade, the left ventricular dimension end diastole (LVDd), and the left ventricular dimension end systole (LVDs) decreased significantly (P < 0.05), and the ejection fraction (EF) and E/A ratio increased significantly in both groups after treatment (P < 0.05) , however, the decrement or increment was more significant in the treated group than that in the control group respectively (P < 0.05); the serum CRP level decreased significantly in the treated group after treatment and showed a level obviously lower than that in the control group (P < 0.05), which changed insignificantly after treatment.

CONCLUSIONXuezhikang could improve cardiac function and decrease serum CRP level at the same time.

Adrenergic beta-Antagonists ; therapeutic use ; Adult ; Aged ; Angiotensin-Converting Enzyme Inhibitors ; therapeutic use ; C-Reactive Protein ; metabolism ; Cholesterol ; blood ; Digoxin ; therapeutic use ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Heart Failure ; blood ; drug therapy ; physiopathology ; Humans ; Lipoproteins ; blood ; Male ; Middle Aged ; Phytotherapy ; Ventricular Function, Left ; drug effects

OBJECTIVETo investigate the association between serum cardiac troponin I (cTnI) and cardiac function/structure in patients with chronic heart failure.

METHODSOne hundred and twenty patients with decompensated chronic heart failure were included. The patients were divided into cTnI normal group (cTnIn; n = 80) and cTnI elevated group (cTnIe; n = 40). Systolic dimension of the left atrium (LAd), the maximal width of the left ventricle (LVd), the thickness of the interventricular septum (IVS) and posterior wall (LVPW) during diastole, left ventricle ejection fraction (LVEF), E and A wave velocities ratio (E/A) were determined. Bivariate correlation analysis was applied to show the correlation of serum cTnI level with above indices. Partial correlation analysis was performed followed by multivariate logistic regression.

RESULTSLAd and LVd dimensions were significantly higher (P < 0.05), IVS, LVPW, LVEF and E/A ratio were significantly lower (P < 0.05) in cTnIe group than in cTnIn group. Moreover, serum cTnI was positively correlated with LAd, LVd, and inversely correlated with IVS, LVPW, LVEF and E/A ratio (P < 0.05). The correlation persistent after adjusting with sex, history of heart failure, NYHA functional class and treatment. In multivariate modeling, cTnI was positively associated with LAd, LVd and the history of heart failure, and negatively related with the treatment with angiotensin-converting enzyme inhibitor.

CONCLUSIONSerum cTnI correlated with cardiac structure and function. Intensively serum cTnI monitoring and suitable therapy strategy may be helpful to attenuate the cardiac remodeling in patients with chronic heart failure.

Adult ; Chronic Disease ; Female ; Heart Failure ; blood ; physiopathology ; Humans ; Male ; Middle Aged ; Myocardium ; chemistry ; Troponin I ; blood ; Ventricular Remodeling

Melittin exhibits high antibacterial potency against drug-resistant bacteria. However, the clinical utility of melittin is limited by its serious hemolytic activity. Thus, the need for developing novel melittin analogues with high antimicrobial activity and low hemolytic activity has grown. We designed, synthesized, and evaluated 20 novel melittin analogues with varying hydrophobic, polar or positively charged amino acids. The results showed that 8 compounds had antimicrobial activity (MIC: 1-4 μg·mL^-1) against gram-positive pathogens equal to or better than that of melittin, and 16 compounds had low hemolytic activity (HC₅₀ ≥ 11.9 μg·mL^-1). Compounds 13 (MIC: 2-4 μg·mL^-1) and 15 (MIC: 1-2 μg·mL^-1) showed equal or better antimicrobial activity against both susceptible and resistant strains of Staphylococcus aureus and Enterococcus faecium compared to melittin (MIC: 4 μg·mL^-1). Compound 13 (HC₅₀: 24.0 ± 4.3 μg·mL^-1) displayed noticeably decreased hemolytic activity compared to melittin (HC₅₀: 5.3 ± 0.4 μg·mL^-1). This work established a base for further study on the structure-activity relationships and structure-toxicity relationships of melittin.

OBJECTIVETo confirm whether human MHC class I chain-related A (MICA) induces the amplification of V delta 1 gamma delta tumor-infiltrating lymphocytes (TILs) in vitro and to identify the cytotoxicity of MICA-reactive V delta 1 gamma delta TILs towards epithelial tumor cells.

METHODSMICA protein was prokaryoticly expressed and purified by molecular cloning technology. The purified recombined MICA (rMICA) was used to induce V delta 1 gamma delta T cells from tumor tissues in vitro and the cytotoxicity of these V delta 1 gamma delta TILs were tested by 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT).

RESULTSThe rMICA was expressed in prokaryocyte with pET30 as a vector. The immobilized rMICA protein could markedly induce the amplification of V delta 1 gamma delta T cells from tumor tissue in vitro. These V delta 1 gamma delta T cells showed strong cytolytic activities towards tumor cell lines expressing MICA.

CONCLUSIONThe MICA-reactive V delta 1 gamma delta T cell may be a candidate for adoptive cellular therapy of tumors.

Adult ; Aged ; Female ; HeLa Cells ; pathology ; Histocompatibility Antigens Class I ; biosynthesis ; genetics ; Humans ; Immunotherapy, Adoptive ; Lymphocytes, Tumor-Infiltrating ; immunology ; Male ; Membrane Proteins ; biosynthesis ; genetics ; Middle Aged ; Ovarian Neoplasms ; immunology ; Receptors, Antigen, T-Cell, gamma-delta ; immunology ; Recombinant Proteins ; biosynthesis ; genetics ; T-Lymphocytes, Cytotoxic

Abstract: To analyze the clinical, therapeutic and laboratory characteristics of disseminated cryptococcosis caused by Cryptococcus neoformans invading the blood stream in patient with liver cirrhosis and splenectomy. A 30-year-old male underwent splenectomy plus pericardial devascularization due to "splenomegaly and hypersplenism" in March in 2016. The patient had intermittent fever after operation for many times, and successively accompanied with back pain, left lower limb abscess and right hip pain. The highest body temperature was 39 ℃. CT and MRI revealed the lung lesion and multiple bone destruction. During that period, the effect of antibiotics was not good. On April 19th, 2017, Gram's stain, India ink stain, API 32C, Vitek 2 Compact, ribosomal ITS and IGS sequence analysis were performed to identify the strain isolated from the pus and blood stream. The serum of the patient was detected for cryptococcal antigen. Antifungal susceptibility test was used to determine drug sensitivity and minimum inhibitory concentration (MIC). The Cryptococcus neoformans isolated from fresh pus specimen showed a prominent, thick capsule after India ink stain. The colonies isolated from pus and blood stream were identified Cryptococcus neoformans using API 32C, Vitek 2 Compact, and sequence analysis of rDNA ITS and IGS. Cryptococcal capsule antigen was positive. The minimal inhibitory concentrations of 5-Flucytosine, amphotericin B, fluconazole, itriconazole, voriconazole against the isolate were <4 μg/mL, <0.5 μg/mL, 4 μg/mL, ≤0.25 μg/mL, 0.125 μg/mL respectively. The patient was initially treated with intravenous amphotericin B and flucytosine. After anti-Cryptococcus treatment for two months, the patient clinically improved, and the lesions were reduced on a follow-up CT scan. The patient made a full functional recovery after treatment for six months. Cryptococcosis has hidden onset, atypical clinical symptoms and lack of specificity. Blood stream is the main channel for Cryptococcus to spread and involve many organs of the whole body, including skin, bone and so on. Therefore, early use of blood culture to monitor blood flow dissemination, actively removing the primary focus and cutting off the infection route in time and carrying out effective anti-Cryptococcus treatment are conducive to the patient's early recovery.

OBJECTIVETo study the single nucleotide polymorphisms in genes associated with the high density lipoprotein (HDL) metabolism in Chinese population.

METHODSTwo hundred and nine normal Han ethnic subjects, aged 59+/-10 years, were recruited from 5 medical centers in western part of China. DNA was extracted by proteinase K digestion, phenol and chloroform extraction as well as isopropanol precipitation. The polymerase chain reaction (PCR)-restriction fragment length polymorphisms (RFLP) in conjunction with sequencing were employed to test the single nucleotide polymorphisms (SNPs) in ATP-binding cassette transporter (ABCA1), cholesteryl ester transfer protein (CETP) and lipoprotein lipase (LPL) genes.

RESULTSThe allelic frequencies of A and G of ABCA1 gene are 53.4% and 46.6%; of B2 and B1 allele of CETP, 41.0% and 59.0%; of HindIII (-) and (+) allele of LPL, 18.9% and 81.1%; and of PvuII(+) and (-) allele of LPL, 66.0% and 34.0%, respectively. All genotype frequencies fit well with the Hardy-Weinberg equilibrium; the significant linkage disequilibrium exists between LPL HindIII(+)and PvuII(+) polymorphisms. All of the RFLP in these genes result from the single nucleic substitution in fragment recognized by corresponding restriction enzymes.

CONCLUSIONThe genetic polymorphisms of ABCA1, LPL-HindIII and LPL-PvuII in Chinese Han ethnic population are significantly different from Caucasians residing in USA or Europe.

ATP Binding Cassette Transporter 1 ; ATP-Binding Cassette Transporters ; genetics ; Aged ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; China ; Cholesterol Ester Transfer Proteins ; genetics ; Female ; Gene Frequency ; Genotype ; Humans ; Linkage Disequilibrium ; Lipoprotein Lipase ; genetics ; Lipoproteins, HDL ; metabolism ; Male ; Middle Aged ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Polymorphism, Single Nucleotide ; Sequence Analysis, DNA

OBJECTIVETo evaluate medium-long term patency of below-knee bypass on patients who suffered from diabetic lower limb ischemia.

METHODSClinical and follow-up data of 51 patients was retrospectively analyzed who underwent 56 below-knee bypass because of diabetes from November 2001 to December 2006. There were 35 male and 16 female with an average age of 68 years. They endured 26 months ischemic time lag in average, and had suffered from diabetes for 11 years. All of the patients were performed bypass to below-knee (posterior tibial, anterior tibial or peroneal) arteries. Kaplan-meier method was applied. The subgroups of different operative methods and different out-flow vessels were compared by Log-rank tests.

RESULTSAn average follow-up time of 23 months was achieved, and lost-follow-up rate was 15%. The total 1- and 5-year primary patent rates were 68% and 54% respectively, secondary patent rate were 70% and 60% respectively, limb salvage rates were 69% and 65%, survival rates were 82% and 60%. One year (3 years) of patent rate(s) of operative method subgroups of femoral-popliteal-infrageniculate bypass with composite grafts, femoral/popliteal-infrageniculate bypass with artificial grafts and femoral/popliteal-infrageniculate bypass with autologous veins were 70% (50%), 33% (33%) and 70% (70%) respectively. One year (4 years) of patent rate(s) of out-flow vessel subgroups of posterior tibial artery, anterior tibial artery and peroneal artery were 65% (60%), 80% (53%) and 77% (66%) respectively. However, both subgroups did not show any statistic differences by log-rank tests.

CONCLUSIONSPartial or whole autologous veins as bypass grafts should be chosen when infrageniculate bypass is considered in diabetic patients. Considerable patent rates are acceptable no matter what kinds of out-flow vessels are chosen.

Aged ; Diabetic Angiopathies ; surgery ; Female ; Femoral Artery ; surgery ; Follow-Up Studies ; Humans ; Ischemia ; etiology ; surgery ; Lower Extremity ; blood supply ; Male ; Middle Aged ; Popliteal Artery ; surgery ; Retrospective Studies ; Saphenous Vein ; transplantation ; Tibial Arteries ; surgery ; Vascular Surgical Procedures ; methods

OBJECTIVETo detect Bartonella henselae IgG antibody among healthy people in Changping, Beijing.

METHODSUsing indirect enzyme linked immunosorbent assay (ELISA) and immunofluorescence antibody assay (IFA) to detect IgG antibody of Bartonella henselae among human beings.

RESULTSThe sensitivity and specificity of ELISA were 70.6% and 91.6% respectively, with the positive predictive value of serological test as 82.2%, and the negative predictive value as 84.9%, based on results of IFA. The positive rate was 34.5% among 357 healthy people on indirect ELISA but was 35.6% among 239 people with IFA.

CONCLUSIONThe results indicated that the indirect ELISA was a very quick, sensitive and available method for detecting Bartonella henselae in human beings, as well as a high positive percent age of Bartonella henselae among the healthy people of Changping Beijing.

Adolescent ; Adult ; Antibodies, Bacterial ; immunology ; Bartonella henselae ; immunology ; Enzyme-Linked Immunosorbent Assay ; methods ; Female ; Fluorescent Antibody Technique, Indirect ; methods ; Humans ; Immunoglobulin G ; immunology ; Male ; Middle Aged ; Young Adult

OBJECTIVETo compare the characteristics of interbody fusion achieved using hat type cervical intervertebral fusion cage (HCIFC) with those of an autologous tricortical iliac crest graft, Harms cage and Carbon cage in a goat cervical spine model.

METHODSThirty-two goats underwent C(3, 4) discectomy and fusion in which the following were used: Group 1, autologous tricortical iliac crest bone graft (8 goats); Group 2, Harms cage filled with autologous iliac crest graft (8 goats); Group 3, Carbon cage filled with autologous iliac bone (8 goats); Group 4, HCIFC filled with autologous iliac graft (8 goats). Radiography was performed pre- and postoperatively and after 1, 2, 4, 8, and 12 weeks. At the same time points, disc space height, intervertebral angle, and lordosis angle were measured. After 12 weeks, the goats were killed and fusion sites were harvested. Biomechanical testing was performed in flexion, extension, axial rotation, and lateral bending to determine the stiffness and range of motion. All cervical fusion specimens underwent histomorphological analysis.

RESULTSOne week after operation, the DSH, IVA and LA of HCIFC and Carbon cage were statistically greater than those of autologous iliac bone graft and Harms cage. Significantly higher values for disc space height, intervertebral angle and lordosis angle were shown in cage-treated goats than in those that received bone graft over a 12-week period. The stiffness of Harms cage in axial rotation and later bending were statistically greater than that of other groups. Radiographic and histomorphologic evaluation showed better fusion results in cage groups than in autologous bone group.

CONCLUSIONSHCIFC can provide a good intervertebral distractability and enough biomechanical stability for cervical fusion.

Animals ; Biomechanical Phenomena ; Bone Transplantation ; methods ; Cervical Vertebrae ; diagnostic imaging ; physiopathology ; surgery ; Goats ; Ilium ; transplantation ; Internal Fixators ; Male ; Materials Testing ; Radiography ; Random Allocation ; Spinal Fusion ; instrumentation ; methods ; Transplantation, Autologous