BACKGROUND: This study was undertaken to determine the effect of mesenchymal stem cells (MSCs) engraftment on vascular endothelial cell growth factor (VEGF) in lung tissue, plasma and extravascular lung water at early stage of smoke inhalation injury. METHODS: A rabbit smoke inhalation injury model was established using a home-made smoke inhalation injury generator, and rabbits were divided into two groups randomly: a control group (S group, n=32) and a MSCs treatment group (M group,n=32). 10 ml PBS was injected via the ear marginal vein immediately at injury into the S group. Third generation MSCs with a concentration of 1×107/10 ml PBS were injected via the ear marginal vein immediately at injury into the M group. VEGF in peripheral blood and lung tissue were measured at 0 (baseline), 2, 4 and 6 hours after injection respectively and analyzed. The right lungs of rabbits were taken to measure lung water mass fraction. RESULTS: In the lung tissue, VEGF decreased gradually in the S group (P<0.05) and signifi cantly decreased in the M group (P<0.05), but it increased more signifi cantly than the values at the corresponding time points (P<0.05). In peripheral blood, VEGF increased gradually in the S group (P<0.05) and markedly increased in the M group (P<0.05), but it decreased more signifi cantly than the values at corresponding time points (P<0.05). CONCLUSION: MSCs engraftment to smoke inhalation injury could increase VEGF in lung tissue, decrease VEGF in plasma and reduce extravascular lung water, indicating its protective effect on smoke inhalation injury.

China ; Heart Transplantation ; methods ; Humans

OBJECTIVETo study the effect of bone marrow-derived mesenchymal stem cells (MSC) transplantation on the major inflammatory cytokines content in peripheral blood, lung water mass fraction, and lung tissue injury in rabbits with smoke inhalation injury.

METHODSSixteen adult New Zealand big ear rabbits were subjected to smoke inhalation injury and then were divided into pure injury group (PI, n = 8) and MSC transplantation group (MT, n = 8) according to the random number table. Via ear marginal vein, rabbits in PI group were injected with 10 mL phosphate buffered saline (PBS); rabbits in MT group were injected with 10 mL PBS containing the third passage MSC (1 x 10⁷ cell) isolated from marrow of healthy young New Zealand big ear rabbit. Another 8 rabbits were enrolled as normal control group (NC). Rabbits in NC group were injected with 10 mL PBS via ear marginal vein without smoke inhalation injury. Blood was harvested from rabbits in PI and MT groups at post injury hour (PIH) 2, 4, 6. Contents of TNF-α, IL-1β, IL-6, and IL-10 in serum were determined with ELISA. At PIH 24, left lung was harvested for morphology and histopathology observation; the right lung tissue was obtained to measure and calculate lung water mass fraction. Blood and lung tissue of rabbits in NC group were harvested and determined in the same way. Data were processed with t test.

RESULTS(1) Serum contents of TNF-α in PI and MT groups at each time point were obviously higher than that in NC group (t = 2.43 - 9.57, P < 0.05 or P < 0.01). Serum contents of IL-1β and IL-6 in PI group at each time point were obviously higher than those in NC group (t = 8.49 - 19.80, P values all below 0.01). Serum content of IL-1β in MT group at each time point was close to that in NC group (t = 0.11 - 0.92, P values all above 0.05). Serum content of IL-6 in MT group at PIH 2 was close to that in NC group (t = 2.12, P > 0.05), but that of MT group increased significantly at PIH 4 and 6 (t = 2.83, P values all below 0.05). Serum contents of TNF-α, IL-1β, and IL-6 in MT group at each time point were obviously lower than those in PI group (t = 2.35 - 12.45, P < 0.05 or P < 0.01). (2) Serum content of IL-10 in MT group at PIH 2, 4, and 6 was respectively (13.0 ± 3.6), (11.6 ± 8.5), (15.2 ± 4.4) pg/mL, and they were higher than those in PI group [(5.5 ± 3.4), (5.0 ± 1.7), (7.9 ± 3.5) pg/mL, with t value respectively 4.28, 2.15, 3.67, P values all below 0.01]. Serum contents of IL-10 in PI and MT groups were obviously higher than that in NC group (t = 2.46-8.14, P < 0.05 or P < 0.01). (3) Lung tissue injury in MT group was alleviated markedly as compared with that in PI group. (4) At PIH 24, lung water mass fraction in MT group was (69 ± 7)%, which was obviously lower than that in PI group [(87 ± 6)%, t = 5.49, P < 0.01]. Compared with that in NC group [(48 ± 3)%], lung water mass fraction in PI and MT groups were increased obviously (with t value respectively 16.93 and 7.22, P values all below 0.01).

CONCLUSIONSMSC transplantation can decrease pro-inflammatory cytokines, increase anti-inflammatory cytokines, decrease lung water mass fraction, ameliorate systemic inflammatory response, and protect lung tissue in rabbits with smoke inhalation injury.

Animals ; Bone Marrow Cells ; cytology ; Inflammation ; Interleukin-10 ; blood ; Interleukin-6 ; blood ; Lung Injury ; blood ; surgery ; Mesenchymal Stem Cell Transplantation ; Rabbits ; Smoke Inhalation Injury ; blood ; surgery ; Tumor Necrosis Factor-alpha ; blood

Objective To investigate the characteristics of infecting pathogens,their changes and antimicrobial susceptibilities on CAPD related peritonitis in our peritoneal dialysis(PD) center in the past 15 years.Methods Two hundred and six CAPD related peritonitis episodes in 145 patients from 2000 to 2005 were analyzed and compared with 109 episodes from 1991 to 2000.The causative pathogens,their antimicrobial susceptibilities and outcomes on CAPD related peritonitis from the two periods were retrospectively reviewed and compared.Results Culture negative rate decreased from 60.6% in 1990 s to 47.6% in the last five years (P=0.031 ).Among culture positive peritonitis episodes,the incidence of gram positive bacteria (GPB) peritonitis increased from 25.6% to 39.8% (P=0.059).This was mainly due to a significant increase in coagulase-neagative staphylococcus peritonitis,which significantly increased from 4.7% to 26.9% (P=0.01).Gram negative bacteria (GNB) peritonitis decreased slightly (44.2% vs 34.3%,P=0.322).The incidence of Klebsiella pneumoniae peritonitis significantly decreased (14.0% vs 3.7%,P=0.023),while Pseudomonas aeruginosa and Escherichis coli peritonitis rates slightly increased (4.7% vs 9.3%,P = 0.338;7% vs 18.7%,P=0.072).The decrease of fungal peritonitis rate was not significant (30.2% vs 17.6%,P= 0.123).The comparison of clinical outcomes showed an improvement of total recovery rate from 68.8% in 1990 s to 73.9% for 2000-2005 (P=0.09).The catheter removal rate decreased from 19.2% to 14.3% (P=0.238),and the mortality from 10.1% to 5.4% (P=0.118).In both periods,fungal peritonitis had the poorest results,which all the patients either withdrew from PD or died.Conclusions Compared with that in 1990 s,the culture positive rate for CAPD related peritonitis in 2000-2005 has been greatly improved.Coagulase-negative staphylococcus is the most common causative pathogen.The mortality and catheter removal rate have been markedly reduced in the last five years.Fungal peritonitis is the most important reason for patients' dropout.

Objective To investigate the efficacy and safety of Urinary kallidinogenase(UK)combined with butylphthalide in patients with acute cardioembolic stroke(ACS).Methods A retrospective collection was performed for ACS patients diagnosed and treated in Hangzhou First People's Hospital from May 2022 to April 2023.According to the treatment protocol,ACS patients were divided into UK group and Butylphthalide+UK group.The clinical efficacy,neurological function,serum indexes(Hcy,NT-proBNP and VEGF)and prognosis of the two groups were compared after 2 weeks of treatment.Results A total of 86 ACS patients were included in the study,including 43 in the UK group and 43 in the Butylphthalide+UK group.After treatment,the total effective rate of treatment in the Butylphthalide+UK group was significantly higher than that in the UK group(P<0.05),and there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).In addition,the expression levels of Hcy and NT-proBNP in ACS patients in the Butylphthalide+UK group were significantly lower than those in the UK group(P<0.05),while the expression levels of VEGF were significantly higher than those in the UK group(P<0.05).The NIHSS score and mRS score of ACS patients in the Butylphthalide+UK group were significantly lower than those in the UK group(P<0.05).The rate of collateral circulation establishment in the Butylphthalide+UK group was significantly higher than that in the UK group(P<0.05).Conclusion Butaphthalide combined with UK has significant efficacy and high safety in ACS patients,which may be achieved by regulating the expression levels of serum Hcy,NT-proBNP and VEGF,thereby improving neurological function and promoting the establishment of collateral circulation.

Objective To assess the diagnostic accuracy of 64-slice computed tomography coronary angiography (64-SCTCA) in individuals with suspected coronary artery disease (CAD). Methods The study enrolled 285 individuals undergoing 64-SCTCA with calcium scoring and thereafter invasive coronary angiography (CAG) within 4 weeks for suspected CAD. Pretest probability of having obstructive CAD was determined using the Duke clinical score, which was estimated by type of chest discomfort, age, gender,and traditional risk factors and stratified into 3 levels of probability: low ( ≤ 30%, n = 80), intermediate (31% to 70%, n =92), and high ( ≥71%, n = 113). CAD was defined as the presence of at least one vessel of ≥50% coronary stenosis on CAG. Results The patient-based diagnostic accuracy of 64-SCTCA for detecting CAD according to CAG revealed a sensitivity of 81.2%, a specificity of 93.3%, a positive predictive value of 68.0% and negative predictive value of 96.6%. The CAD prevalence in the low,intermediate and high risk groups according to Duke probability was 46.3%, 72.8% and 82.3%,respectively. The sensitivity and positive predictive value were lower in the low probability group than those in the intermediate and high probability groups. For those with coronary artery Agatston calcium score ＞400, the diagnostic accuracy was linked with a higher sensitivity but lower specificity. The diagnostic value of 64-SCTCA for proximal and mid-segment of coronary artery was superior to that for distal segment. Conclusions 64-SCTCA is mainly indicated in individuals with an intermediate probability of having CAD. The diagnostic value of 64-SCTCA could be affected by coronary artery calcium, lesion location and vessel diameter.

AIM To investigate the flavor technology for Jiannaoning Mixture based on electronic tongue combined with preference index.METHODS Artificial sensory evaluation method was employed to screen the type of flavor agents,electronic tongue was applied to screening the consumption of flavor agents,and double-bottle preference test was adopted in the analysis of effects of rat gender and body weight on taste sensitivity,after which acceleration test was conducted.RESULTS Sucrose,stevioside and xylitol were taken as flavor agents,whose optimal consumptions were 15%,0.08%and 15%,respectively.Male rats demonstrated stable taste perception with the body weights of 220-280 g,and 0.08%stevioside displayed the best flavoring effect.After placed under accelerated condition for 3 months,the preparation exhibited stable appearance,pH value and contents of lobetyolin,salvianolic acid B,schizandrin,ruscogenin.CONCLUSION This stable and reliable method can provide reference for improving the terrible tastes of Jiannaoning Mixture and other oral liquid preparations of traditional Chinese medicines.

BACKGROUNDAlthough heart transplantation (HTx) has become a standard therapy for end-stage heart diseases, experience with pediatric HTx is limited in China. In this article, we will try to provide the experience with indications, complications, perioperative management, immunosuppressive therapy, and survival for pediatric HTx based on our clinical work.

METHODSThis is a retrospective chart review of the pediatric patients undergoing HTx at Department of Cardiovascular Surgery of Union Hospital from September 2008 to December 2014. We summarized the indications, surgical variables, postoperative complications, and survival for these patients.

RESULTSNineteen pediatric patients presented for HTx at Union Hospital of Tongji Medical College, of whom 10 were male. The age at the time of transplantation ranged from 3 months to 18 years (median 15 years). Patient weight ranged from 5.2 kg to 57.0 kg (median 38.0 kg). Pretransplant diagnosis included cardiomyopathy (14 cases), complex congenital heart disease (3 cases), and tumor (2 cases). All recipients received ABO-compatible donor hearts. Postoperative complications occurred in 12 patients, including cardiac dysfunction, arrhythmia, pulmonary infection, renal dysfunction, and rejection. Two of them experienced cardiac failure and required extracorporeal membrane oxygenation. The immunosuppression regimen was comprised of prednisone, a calcineurin inhibitor, and mycophenolate. All patients recovered with New York Heart Association (NYHA) Class I-II cardiac function and were discharged. Only one patient suffered sudden death 19 months after transplantation.

CONCLUSIONOrthotopic HTx is a promising therapeutic option with satisfying survival for the pediatric population in China with end-stage heart disease.

Adolescent ; Child ; China ; Female ; Heart Transplantation ; statistics & numerical data ; Humans ; Immunosuppressive Agents ; therapeutic use ; Infant ; Male ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo observe the mechanical properties of decellularized porcine aortic valve, and to explore the effects of precoating methods of biological scaffold on histocompatibility.

METHODSFresh porcine aortic valves were decellularized using trypsin, TritonX-100 and nuclease. Treated valves were evaluated by light microscopy, scanning electron microscopy (SEM) and mechanical test. Three groups of scaffold were precoated with phosphate buffered saline (PBS), poly-L-lysine (PLL) and fetal bovine serum (FBS) respectively. Myofibroblasts were seeded onto each scaffold. Light and electron microscopic observation was performed and MTT test was used to examine efficiency of cell attachment.

RESULTSHE stain and SEM showed that cells were almost absent in the treated leaflet. The wave-like collagen together with the whole three-dimensional structure was maintained. Compared with normal valves, the Max-load, Max-stress and elastic modulus decreased while the Max-strain increased (P<0.05). The result of MTT test showed more cells were attached on the valves treated with FBS compared to the other two groups. Histological investigations also confirm that the high degree of cell attachment on the valves precoated with FBS (F=129.26, P=0.000).

CONCLUSIONSEnzyme combined with detergent and nucleases can remove cells from porcine aortic valves. Meanwhile the mechanical properties of these valves may be altered. Precoating porcine aortic valve with FBS is an effective method to improve cell attachment, growth and increasing.

Animals ; Aortic Valve ; cytology ; drug effects ; physiology ; Biomechanical Phenomena ; Bioprosthesis ; Cell Adhesion ; Cell Proliferation ; Cells, Cultured ; Coated Materials, Biocompatible ; chemistry ; pharmacology ; Fibroblasts ; cytology ; Heart Valve Prosthesis ; Rats ; Swine ; Tissue Engineering ; methods ; Tissue Scaffolds ; chemistry

OBJECTIVETo evaluate the efficacy of using small interfering RNA targeting TF as a therapy for vein graft failure.

METHODSExternal jugular vein to carotid artery interposition vein grafts, which were applied to a low flow condition, were made in 120 Sprague-Dawley rats weighing 260 to 300 g. These rats were randomly divided into 4 groups, 30 rats each group. Group A was atelocollagen-TF Stealth Select RNAi group. Group B was atelocollagen-TF Stealth RNAi group. Group C was atelocollagen group. Group D was control group. Small interfering RNA mixed with atelocollagen was administrated to the external wall of grafted veins. The TF protein expression of vein grafts was analyzed by Western blot at 1, 3, 7, 14, and 28 d postoperatively, and by immunochemistry at 3 d postoperatively. The proliferation index was determined at 14 d postoperatively. Neointimal hyperplasia was evaluated at 28 d postoperatively. BLOCK-iT fluorescent oligo was used to confirm its stability and successful transfer into the vein graft wall at 3 and 7 d postoperatively for another group (n=12).

RESULTSFluorescence of BLOCK-iT fluorescent oligo could be detected in the graft wall even at 7 d postoperatively. Knockdown of the TF expression was achieved by perivascular application of siRNA using atelocollagen. Compared with control group, the intima thickness at 28 d after grafting was significantly reduced (P < 0.05). This phenomenon was preceded by significant reduction of cell proliferation in siRNA-treated grafts at 14 d postoperatively (P < 0.05).

CONCLUSIONThe expression of TF in vein grafts can be effectively inhibited by specific siRNAs using a atelocollagen-based nonviral delivery approach in vivo, so that the neointimal thickening can be prevented. Transplants;

Animals ; Collagen ; pharmacology ; Drug Carriers ; pharmacology ; Female ; Hyperplasia ; prevention & control ; Jugular Veins ; pathology ; transplantation ; Male ; RNA Interference ; RNA, Small Interfering ; pharmacology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Thromboplastin ; genetics ; metabolism ; Tunica Intima ; pathology