Arterio-Arterial Fistula ; surgery ; Cardiac Catheterization ; Cardiac Surgical Procedures ; Catheterization ; Coronary Vessels ; Heart Ventricles ; Humans ; Male ; Middle Aged

Adult ; Angioplasty, Balloon ; methods ; Arteriovenous Malformations ; complications ; therapy ; Heart Septal Defects, Ventricular ; complications ; therapy ; Humans ; Jugular Veins ; Male ; Vena Cava, Inferior ; abnormalities

Objective To evaluate the clinical value of three-dimensional reconstruction and virtual hepatectomy for laparoscopic precise liver resection of right liver tumor.Methods 31 cases of right liver tumor from June 2012 to October 2015 at Department of Hepatobiliary Surgery in Affiliated Hospital of Nantong University,were analyzed retrospectively.Patients were divided into three dimensional reconstruction group (n =15) and control group (n =16),Operation time,bleeding volume during operation,postoperative complications and days of hospitalization after operation in two groups were observed.Results All operation was successfully performed with pure laparoscopic right liver tumor resection in three dimensional reconstruction group.In control group,1 case was completed by hand-assisted laparoscopic liver resection,1 case was converted to open operation,the remaining 14 cases underwent total laparoscopic right liver tumor resection.Operation time in 3-dimensional reconstruction group was (141 ± 36)min vs.(207 ± 66)min in control group,bleeding volume was (274 ±88)ml vs.(418 ± 189)ml,hospitalization after operation was (9 ± 3)days vs.(13 ±6)days (all P ＜0.05).Conclusions Preoperative three-dimensional reconstruction and virtual hepatectomy can ensure the localization of parenchyma tumor during the laparoscopic precise liver resection,clarifing the relationship between tumor operation section and peritumoral vascular or biliary ducts,fulfilling the idea of precise liver resection.

Objective To study the relationship between vascular endothelial growth factor (VEGF) expression and proliferation of hepatic blood vessel and fibrosis in hepatitis B (HB) patients. Methods The total RNA of VEGF was extracted from human liver tissues, and VEGF mRNA probe was acquired by RT-PCR. It was then labeled on hepatic tissues of 160 patients with HB and 10 healthy individuals (control group). Immunohistochemistry of VEGF was performed at the same time. Results The results of hybridization in situ showed that VEGF mRNA was negative in the control group. While in the HB groups, VEGF mRNA was located in the hepatic sinusoids, Disse′s space and hepatocyte cytoplast around the dilated sinusoids. Immunohistochemistry showed that VEGF was expressed in three patterns: the cytoplasm, sinusoid membrane, and sinusoidal endothelium. The expression strength and distribution range of VEGF were closely related with the grading and staging of HB, hepatic vascular inflammation, destruction, obstruction, proliferation and fibrosis. There was remarkable difference between different liver pathological changes (P

Objective To study three-dimensional reconstruction system (IQQA-Liver) in evaluation of resection volume and margin of hepatocellular carcinoma.Method Data of 51 hepatocellular carcinoma patients undergoing hepatectomy from March 2014 to October 2015 were analyzed retrospectively.All patients received preoperative ultrasound and CT/MIR evaluation.Three-dimensional reconstruction system (IQQA-Liver) was used to reconstruct tumor shape and location,the relationship between tumor and adjacent vessels or bile ducts.Then liver volume,liver resection volume,residual liver volume and surgical margin were calculated and compared with the actual resection liver values and actual margin.Results Images of three-dimensional reconstruction system (IQQA-Liver) were accurate,clear and directly perceived.In terms of the resection liver volume and resection margin,there was no significant difference between the predicted results and actual results [resection liver volume:(412.93 ± 471.26)cm3 vs.(487.02±529.01)cm3,t=0.75,P=0.46,resection margin:(13.72 ± 4.58) mm vs.(13.92 ±4.21)mm,t =0.23,P =0.82].The predicted resection liver volume was significantly correlated with the actual resection volume (r =0.91,P ＜ 0.01),the predicted resection margin was also correlated with the actual resection margin (r =0.89,P ＜ 0.01).Conclusion Three-dimensional reconstruction system (IQQALivcr) could accurately assess the resection volumc and margin of hepatocellular carcinoma.

We constructed plasmid pMTac to overexpress 3-ketosteroid-Δ1-dehydrogenase (KSDD) in Mycobacterium neoaurum JC-12 for improving androst-1,4-diene-3,17-dione (ADD) production. To construct pMTac, pACE promoter on pMF41 was replaced by tac promoter, and then four recombinants were constructed, which were M. neoaurum JC-12/pMF41-gfp, M. neoaurum JC-12/pMTac-gfp, M. neoaurum JC-12/pMF41-ksdd and M. neoaurum JC-12/pMTac-ksdd. Fluorescence detection results show that much more green fluorescent protein (GFP) was expressed in M. neoaurum JC-12/pMTac-ksdd than M. neoaurum JC-12/pMF41-ksdd. The activity of KSDD was 2.41 U/mg in M. neoaurum JC-12/pMTac-ksdd, 6.53-fold as that of M. neoaurum JC-12 and 4.36-fold as that of M. neoaurum JC-12/pMF41-ksdd. In shake flask fermentation, ADD production of M. neoaurum JC-12/pMTac-ksdd was 5.94 g/L, increased about 22.2% compared to the original strain M. neoaurum JC-12 and 12.7% to M. neoaurum JC-12/pMF41-ksdd. AD (4-androstene-3,17-dione) production of JC-12/pMTac-ksdd was 0.17 g/L, decreased 81.5% compared to M. neoaurum JC-12 and 71.2% to M neoaurum JC-12/pMF41-ksdd. In the 5 L fermenter, 20 g/L phytosterols was used as substrate, ADD production of M. neoaurum JC-12/pMTac-ksdd was improved to 10.28 g/L. pMTac is favorable for expressing KSDD in M. neoaurum JC-12, and overexpression of KSDD has beneficial effect on ADD producing, and it is the highest level ever reported using fermentation method in M. neoaurum.
Androstadienes ; metabolism ; Fermentation ; Industrial Microbiology ; Mycobacterium ; Oxidoreductases ; genetics ; metabolism ; Phytosterols ; metabolism ; Plasmids

OBJECTIVETo evaluate the safety and efficacy of transcatheter closure of ruptured aneurysm of the sinus of Valsalva (RAVS) using a domestic made small-waist ventricular septal defect occluder.

METHODSBetween September 2005 and December 2010, transcatheter closure of RAVS was randomly performed in 7 patients of (43.5 ± 13.0) years old using domestic made small-waist ventricular septal defect occluder in our department. RAVS was diagnosed by color Doppler echocardiography. The size of the small-waist double-disk occlude selected was 4 to 6 mm larger than the narrowest diameter of the opening of aneurysm. After establishment of the arteriovenous wire loop, the device was deployed by retrograde venous approach in all patients. All patients were followed up in terms of rhythm change, residual shunt, shape of occlude, and possible valve regurgitation by echocardiography for 6 to 12 months.

RESULTSAll RAVS were confirmed by aortography. Aortography showed rupture of right coronary sinus into the right ventricle in 6 patients and non-coronary sinus ruptured into right ventricle in another patient. The estimated size of the defect was 4 to 7 (5.0 ± 1.3) mm by aortogram. Ventricular septal defect was evidenced in 2 patients. All defects were successfully occluded without complication. Two patients with ventricular septal defect received combined percutaneous ventricular septal defect closure. After transcatheter RAVS occlusion, pulmonary artery systolic pressure decreased from (35.6 ± 12.7) mm Hg (1 mm Hg = 0.133 kPa) to (27.4 ± 6.2) mm Hg (P < 0.05), and mean pulmonary artery pressure decreased from (21.9 ± 8.0) mm Hg to (16.1 ± 5.3) mm Hg (P < 0.05). Cardiac murmur disappeared right after successful occlusion. Echocardiography detected a trace of residual shunt in one patient after occlusion which disappeared the next day. There was no aortic regurgitation, hemolysis and arrhythmia during hospitalization. There was no device embolization, infective endocarditis, right heart failure and death during the 6 to 12 months follow-up.

CONCLUSIONTranscatheter closure of RAVS with the domestic made small-waist ventricular septal defect occluder is safe and effective.

Adult ; Aged ; Aneurysm, Ruptured ; surgery ; Cardiac Catheterization ; instrumentation ; methods ; Female ; Heart Aneurysm ; Humans ; Male ; Middle Aged ; Septal Occluder Device ; Sinus of Valsalva ; pathology ; Treatment Outcome ; Young Adult

OBJECTIVETo explore the relationship between Pi-Wei Damp-Heat Syndrome (PWDHS) with expression of aquaporin (AQP) 3,4 gene in gastric mucosa and the effects of Qingre Huashi Recipe (QHR) on the expression.

METHODSSixty-eight patients with chronic superficial gastritis were differentiated into Pi-Wei Damp-Heat Syndrome group (PWDHS, n = 53, 19 cases with predominant Dampness, 14 cases with predominant Heat, 20 cases with Dampness equal to Heat) and Pi deficiency Syndrome group (PDS, n = 15). The PWDHS were treated with QHR. The expression of AQP 3,4 gene in the two groups were determined by fluorescence quantitative polymerase chain reaction (FQ-PCR).

RESULTSExpression of AQP 3 gene in PWDHS was higher than that in PDS and the healthy group, but the difference showed no statistical significance. Expression of AQP 4 gene in PWDHS was obvious higher than that in PDS and the healthy group (P <0.05 or P <0.01), but the difference of AQP 4 gene expression between PDS and the healthy group was insignificant. Comparison among various sub-types of PWDHS showed that the AQP 4 gene expression in the predominant dampness > dampness equal to heat> predominant heat. AQP 3,4 gene expression in PWDHS was significantly decreased after QHR treatment, especially in the cases with predominant dampness syndrome (P <0.01), approaching that in the healthy group and PDS.

CONCLUSIONAbnormal expression of AQP 3,4 gene may be one of the possible mechanisms of PWDHS pathogenesis, Chinese herbs could influence AQP 3,4 gene expression to play a key role in treatment.

Adult ; Aquaporin 3 ; Aquaporin 4 ; Aquaporins ; biosynthesis ; genetics ; Diagnosis, Differential ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Gastric Mucosa ; metabolism ; Gastritis ; drug therapy ; genetics ; metabolism ; Humans ; Male ; Medicine, Chinese Traditional ; Phytotherapy

Objective To investigate whether the left ventricular delayed contraction site determined by tissue Doppler imaging might be an optimal left ventricular lead position for improved outcomes of cardiac resynchronization therapy (CRT) in patients with non-ischemic cardiomyopathy. Methods Thirty-three patients subjected to CRT were selected, and all were performed conventional ultrasound cardiography and tissue Doppler examinations before operation. The left ventricular delayed contraction site was determined according to the interval between the onset of QRS and the peak systolic velocity. Retrograde coronary venography was performed during operation, and the left ventricular lead site was selected according to the left ventricular delayed contraction site determined by tissue Doppler examination before operation. The coronary sinus lead site was determined under the guidance of X ray of dorsaventral, lateral, right anterior oblique and left anterior oblique positions. Patients were divided into group A(n=20, the left ventricular lead site was in line with the delayed contraction site) and group B (n=13, the left ventricular lead site was not in line with the delayed contraction site). Results There was no significant difference in age, NYHA grading, left ventricular end-systolic volume(LVESV), left ventricular ejection fraction(LVEF), pulmonary arterial systolic pressure, QRS width and Ts-SD between the two groups before operation(P> 0.05). Six months after CRT, there was no significant difference in NYHA grading, LVESV and mitral regurgitation(MR) grading between the two groups(P>0.05), while the increase in LVEF and decrease in LVESV of group A were more significant than those of group B (P<0.01). Conclusion In patients with non-ischemic cardiomyopathy, CRT significantly improves left ventricular performance, and the more favourable outcomes are achieved in those pace at the delayed contraction site. Tissue Doppler imaging may help to guide the implant of left ventricular lead.

Objective To explore the relationship of vascular endothelial growth factor(VEGF),IFN-? and IL-4 and effect of Bude-sonide on their in asthmatic rats.Methods Thirty-six male SD rats were randomly divided into 3 groups:asthma group,Budesonide-treatment group and control group.On the first day of the experiment and the 8th day,the rat models of the asthma group and Budesonid treatment group were allergized by the OVA/Al(OH)3 through intraperitoneal injection,respectively.And starting from the 15th day,they were challenged by the OVA through atomization for 2 weeks.Control group was allergized and challenged by NS atomization.Budesonid treatment group was interfered in Budesonide inhalation before suscitation in 0.5 h.After 12 h the same inhal done was again in Budesonide group.Twenty-four hours after the last challenge,the rats in 3 groups were sacrificed,and blood and bronchoalveolar lavage fluid(BALF) were collected.The concentrations of IL-4,IFN-? and VEGF in serum and BALF were measured by enzyme-linked immunosorbent assay.Results The concentrations of IL-4 in serum and BALF in asthma group and Budesonide treatment group were significantly increased than those in control group(P