Objective To investigate the impact of COVID-19 infection on the early clinical outcomes of patients undergoing valve replacement. Methods Perioperative data of patients who underwent single valve replacement at the Second Affiliated Hospital of Chinese People's Liberation Army Medical University from January to February 2023 were consecutively collected. Based on COVID-19 infection status, patients were divided into a COVID-19 group and a non-COVID-19 group. The perioperative data were compared between the two groups. Results A total of 136 patients were included, comprising 53 males and 83 females, with a mean age of (53.4±10.2) years. There were 32 patients receiving aortic valve replacements, 102 mitral valve replacements, and 2 tricuspid valve replacements. The COVID-19 group comprised 70 patients, and the non-COVID-19 group included 66 patients. No statistical difference was observed in the incidence of postoperative complications between the two groups [9.09% (6/66) vs. 11.43% (8/70), P=0.654]. However, the COVID-19 group had longer postoperative mechanical ventilation duration [1 201.00 (1 003.75, 1 347.75) min vs. 913.50 (465.50, 1 251.00) min, P=0.001] and ICU stay [3 (2, 3) days vs. 2 (2, 3) days, P<0.001] compared to the non-COVID-19 group. Additionally, troponin I [4.76 (2.55, 7.93) ng/mL vs. 2.66 (1.19, 5.65) ng/mL, P=0.001] and brain natriuretic peptide [608.50 (249.75, 1 150.00) pg/mL vs. 192.00 (100.93, 314.75) pg/mL, P<0.001] levels were significantly higher in the COVID-19 group. Conclusion For patients with single valve disease undergoing elective surgery, short-term outcomes after recovery from COVID-19 infection are favorable, with no significant increase in in-hospital mortality or postoperative complication rates.

Objective By using optical coherence tomography (OCT) to evaluate the vascular neointimal hyperplasia and the stent strut coverage degree in patients with acute myocardial infarction (AMI) and in patients with stable angina (SA) one year after receiving drug-eluting stent (DES) implantation, and to compare the clinical results between the two groups. Methods A total of 39 patients, who received DES implantation due to coronary heart disease, including AMI (n=16, AMI group) and SA (n=23, SA group), during the period from March 2011 to July 2012, were enrolled in this study. One year after DES implantation, coronary angiography and OCT reexaminations were performed in all patients. The neointimal hyperplasia (NIH) thickness, NIH area, NIH volume, strut coverage and apposition rate were determined with OCT. The results were compared between the two groups. Results OCT measuring results showed that the mean NIH thickness of AMI group and SA group was ( 66 . 8 ± 20 . 7 ) mm and ( 121 . 6 ± 135 . 7 ) mm respectively (P=0.022); the NIH volume ratio were 5.66%±3.18% and 11.88%±8.22% respectively (P=0.005); the percentage of cross-section with NIH thickness over 100 μm was 22.56%±23.99% and 40.14%± 30.01% respectively (P=0.034); and the percentage of overall stent strut coverage was 89.27%±6.40% and 93.42%±7.03% respectively (P=0.007). All the above mentioned data of AMI group were obviously lower than those of SA group. Conclusion After DES implantation, the intimal repair, intimal hyperplasia and stent strut coverage in AMI patients are poorer.

BACKGROUNDCollaterals to occluded infarct-related coronary arteries (IRA) have been observed after the onset of acute ST-elevation myocardial infarction (STEMI). We sought to investigate the impact of early coronary collateralization, as evidenced by angiography, on myocardial reperfusion and outcomes after primary percutaneous coronary intervention (PCI).

METHODSAcute procedural results, ST-segment resolution (STR), enzymatic infarct size, echocardiographic left ventricular function, and major adverse cardiac events (MACE) at 6-month follow-up were assessed in 389 patients with STEMI undergoing primary PCI for occluded IRA (TIMI flow grade 0 or 1) within 12 hours of symptom-onset. Angiographic coronary collateralization to the occluded IRA at first contrast injection was graded according to the Rentrop scoring system.

RESULTSLow (Rentrop score of 0 or 1) and high (Rentrop score of 2 or 3) coronary collateralization was detected in 329 and 60 patients, respectively. Patients with high collateralization more commonly had prior stable angina and right coronary artery occlusion, but less often had left anterior descending artery occlusion. At baseline, these patients presented with less extent of ST-segment elevation and lower serum levels of creatine kinase myocardial band (CK-MB) and cardiac troponin I (cTnI). Procedural success rate, STR, corrected TIMI flame count, and area under the curve of CK-MB and cTnI measurements after the procedure were similar between patients with high collateralization and those with low collateralization (for all comparisons P > 0.05). There were no differences in left ventricular ejection fraction and rates of MACE at 6 months according to baseline angiographic collaterals to occluded IRA.

CONCLUSIONSIn patients with acute STEMI undergoing primary PCI within 12 hours of symptom-onset, coronary collateralization to the occluded IRA was influenced by clinical and angiographic features. Early recruitment of collaterals limits infarct size at baseline, but has no significant impact on myocardial reperfusion after the procedure and subsequent left ventricular function and clinical outcomes.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Angioplasty, Balloon, Coronary ; Coronary Angiography ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; diagnostic imaging ; therapy ; Treatment Outcome ; Young Adult

Objective To investigate the possible inhibition effect of a domestic novel drug-eluting balloon(DEB), such as controlling the vascular stenosis and reducing the intimal hyperplasia, on obstructive peripheral arterial disease (PAD) of lower extremity. Methods Male New Zealand rabbits (weighted 2.5-3.0 kg) were used for this study. Mustang bare metal stents (BMS) were separately implanted at both the proximal and distal site of abdominal aorta to establish the PAD models in rabbits. Bare balloon (PTA group) or drug-eluting balloon (DEB group) was separately used to dilate the stent segment of the aorta. The animals were sacrificed 28 days after the treatment. The aorta stent specimens were collected and sent for pathologic examination. Using Masson staining method the degree of intimal hyperplasia was estimated and the expression level of paclitaxel-targeted β-tubulin was determined with immunohistochemical method. The results were compared between the two groups. Results Morphologically, both the degree of intimal hyperplasia and the vascular stenosis rate in DEB group were significantly lower than those in PTA group. Meanwhile, immunohistochemical examination of paclitaxel-targeted β-tubulin indicated that its expression level in DEB group was obviously higher than that in PTA group. Conclusion This experimental study indicates that the domestic novel DEB has potential inhibition effect in respect of controlling the loss of lumen as well as reducing the intimal hyperplasia. This novel DEB carries excellent property, suggesting the possibility to use DEB in clinical treatment of PAD.

Objective To investigate the influence of diabetes mellitus (DM) on left ventricular(LV) remodeling in patients with acute ST-segment elevation myocardial infarction (STEMI) treated by primary percutaneous coronary intervention (PCI) within 12 hours of symptom onset. Methods Four hundred and fifty-one consecutive patients with acute STEMI treated by primary PCI were prospectively enrolled in the current study. Baseline, angiographic and PCI features and prevalence of LV remodeling at one-week during hospitalization and 6-month clinical follow-up by two-dimensional echocardiography were compared between 93 diabetic and 358 non-diabetic patients. Results Despite similar baseline clinical and angiographic characteristics, symptom-to-door time was longer (399±106 min vs. 321±116 min, P=0.006) and prevalence of multivessel disease was higher (65.6%vs. 51.7%, P=0.02) in diabetic patients. More patients in diabetic group had LV remodeling at 6-month clinical follow-up (29.0%vs. 17.3%, P=0.01), and DM was an independent predictor of LV remodeling (RR 2.1, 95%CI 1.31-4.79, P=0.02). The rate of rehospitalization due to heart failure did not differ between diabetic and non-diabetic patients (12.9%vs. 8.1%, P=0.15), however, more adverse events occurred in patients with LV remodeling comparing to those without LV remodeling (25.8% vs. 6.6%, P < 0.001). Conclusions Diabetic patients with STEMI often have an increased risk of LV remodeling after treated by primary PCI. Thus, comprehensive therapeutic strategy for diabetic patients presented with STEMI is required considering the poor prognosis of these patients with LV remodeling.

Objective To study the expression of receptor for advanced glycation end products ( RAGE ) in chronic adriamycin ( ADR )-induced cardiotoxicity mice . Method A mouse model of chronic cardiotoxicity was established by intraperitoneal injection of 5 mg/kg ADR once a week for continuous 3 weeks.Mice treated with the same volume of saline were used as control group (6 mice in each group).Echocardiography and histopathological examination were used to evaluate the myocardial injury , cardiac function and ventricular remodeling .The expression of RAGE in cardiac tissues was detected by immunohistochemical staining and Western blotting .Results Echocardiography indicated that ADR-treated mice had reduced left ventricular ejection fraction , while histopathological analysis of cardiac tissues showed obvious cardiac damage . RAGE protein in cardiac tissues was highly expressed in chronic ADR-induced cardiotoxicity mice .Conclusion RAGE is highly induced and may be involved in the cardiotoxicity after ADR treatment .

Objective To analyse and compare the effects and safety of early use (in emergency room, intravenous loading followed by infusion) with bolus injection during primary PCI of tirofiban, on post-procedural TIMI flow and 30d clinical outcomes. Methods Seven hundred and seven patients with acute STEMI treated by primary PCI in Ruijin hospital were retrospectively and enrolled screened. Among them, 86 patients with single bolus intra-coronary injection of tirofiban (25 μg/kg) during the procedure were served as observation group. Baseline, angiographic, PCI features and rate of major adverse cardiac events (MACE) at 30 d follow-up were compared with those received early intravenous infusion of tirofiban (10ug/kg bolus followed by 0.15μg/(kg·min) intravenous infusion)(control group, n=239). Results Compared with control group, patients in observation group were older[(63.8±11.4) vs. (57.9±8.8), P=0.01], had higher prevalence of hypertension (58.6%vs. 51.0%, P=0.005), multivessel disease (57.0%vs. 34.3%, P<0.001), and female in gender (40.7%vs. 25.1%, P=0.006). Post-procedural TIMI flow in culprit vessel and TMP grade were comparable between the two groups (P=0.66 and P=0.48, respectively). Reduction in TIMI minimal bleeding events were found in the observation group (2.3%vs. 9.6%, P=0.03). MACE free survival rate at 30d clinical follow-up was similar between the two groups (P=0.48). Conclusions Single bolus intra-coronary injection of tirofiban exerts similar effects in post-procedural TIMI flow, TMP grade in culprit vessel and 30d clinical outcomes compared with early use in emergency room with intra-venous loading and infusion, nevertheless, intra-coronary injection resulted in significantly reduced TIMI minimal bleeding events. Prospective, randomized clinical study is mandatory to prove our current results.

A 2 L tubular photobioreactor (PBR) was designed, and hydrogen production by Rhodospirillum rubrum uptake hydrogenase deficient mutant in this PBR under artificial illumination condition (including continuous illumination and light/dark cycle condition) and natural day/night cycle was investigated, respectively. Hydrogen production by R. rubrum uptake hydrogenase deficient mutant under artificial illumination lasts five days, and hydrogen yield under continuous illumination and light/dark cycle (12 h:12 h) reaches 5752 mL/PBR ? 158 mL/PBR and 5012 mL/PBR ? 202 mL/PBR, respectively. Under natural day/night cycle, hydrogen production lasts 6~10 days and the maximal hydrogen yield of R. rubrum reaches 2800 mL/PBR with the optimal light intensity of about 30000~40000 Lux. Hydrogen production under natural day/night cycle condition was lower than that under artificial illumination, however, it would be a promising technology of hydrogen production due to low cost and ease of operation of hydrogen production system.

Objective To explore the relationship between CRP and glucose metabolism in advanced solid tumor patients. Methods 32 advanced stage malignant tumor patients with mild pain took celecoxib 200mg/qd orally, the plasma level of CRP, FBS, FINS, IR were measured before taking drug and 5 days later. Results CRP is well related with FINS, IR, P level, CRP[(8.17?1.76) mg/L vs (4.37?0.65) mg/L], P(876?123)pmol/L vs (621?145) pmol/L], FINS[(14.23?7.21) ?U/L vs (9.83?3.37) ?U/L] and IR [(3.2?1.01) vs (1.9?0.78)] all were improved significantly after taking celecoxib. Conclusion CRP has some relationship with abnormal glucose metabolism in advanced stage malignant tumor patients, taking celecoxib may improve this abnormal glucose metabolism.