Arteries ; surgery ; Arteriosclerosis Obliterans ; surgery ; Bioprosthesis ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation ; instrumentation ; Humans ; Lower Extremity ; blood supply ; surgery

BACKGROUND:Both of acupuncture and mesenchymal stem cel transplantation have therapeutic effects on cerebral palsy. OBJECTIVE:To explore the therapentic effect of acupuncture combined with placenta derived mesenchymal stem cel s on rat cerebral palsy. METHODS:Thirty-five Wistar rats were equivalently randomized into five groups, including control group, model group, acupuncture group, transplantation group and combination group. Rat models of cerebral palsy were prepared in al groups except the control group. At 7 days after modeling, in the transplantation group, 10μL placenta derived mesenchymal stem cel s were transplanted into the right cerebral cortex and striatum of rats;rats in theacupuncture group were given acupuncture at Shuigou (DU26), Dazhui (DU14), Baihui (DU20), Guanyuan (RN4) and Qihai (RN6) points;rats in the combination group given acupuncture and transplantation treatment as described above;the model and control groups received no treatment. Then, after 7-day intervention, the body mass, neurological function and pathological changes of rat brain tissues were measured and observed, respectively. . RESULTS AND CONCLUSION:The order of the growth rate of body mass was as fol ows:control group>combination group>acupuncture and transplantation groups>model group, and al groups had significant differences except the two groups of acupuncture and transplantation (P<0.05);findings from holding tract, foot error and water finding in maze tests showed the neurological function was best in the control group, fol owed by the combination group, as wel as acupuncture and transplantation groups, and the worst in the model group. Al groups had significant differences except acupuncture and transplantation groups (P<0.05). Besides, in the model group, cel s in the brain and hippocampus decreased, arranging disorderly with fuzzy structure, and inflammatory cel s appeared;pathological changes in the other groups were in between control group and model group, Additional y, brain tissues in the combination group exlibited better pathological changes than those in the acupuncture and transplantation groups, which were similar with the normal brain tissues. To conclude, acupuncture, placenta derived mesenchymal stem cel s transplantation, or their combination can improve neurological function in rats with cerebral palsy, especial y the combination treatment.

Objective To study the suitable dose of intracoronary adenosine (AD) on fractional flow reserve (FFR) measurement in Chinese patients with angiographic coronary artery disease. Methods FFR was measured in 32 patients with 40 moderate coronary stenosis. Boluses of intracoronary AD at increasing doses of 60μg (A1), 80μg (A2), 100μg (A3) and 120μg (A4) were randomly administered. FFR values, symptoms, systemic effects and development of atrioventricular block were recorded. Results FFR value decreased significantly by 8.99%(A1), 11.24%(A2), 13.48%(A3) and 13.48%(A4) compared with the baseline distal coronary pressure/aortic pressure (0.891±0.044, all P<0.001). A3 and A4 showed significantly lower FFR values than A1 (t=6.331、6.343, all P < 0.001),A2 (t=2.974、3.058, P=0.005、0.004). Positive rates of an FFR of<0.75 were 30.0%(n=12), 32.5%(n=13), 35.0%(n=14) and 35.0%(n=14) in A1, A2, A3 and A4. A total of 13 patients(40.6%) reported at least one side effects. Conclusions This study suggests a dose-response relationship for intracoronary AD on the measurement of FFR in Chinese patients with angiographic coronary artery disease. The suitable dose of bolus of intracoronary AD is 100μg.

BACKGROUND:Acupuncture is proved to have therapeutic effect on cerebral palsy of immature rats.
OBJECTIVE:To discuss the possible effect on cerebral amino acids and neurotransmitters in immature rats with cerebral palsy by using fire-needle.
METHODS:Cerebral palsy models were established in 45 Wistar rats aged 1 week by left common carotid artery ligation and randomly assigned into model, acupuncture and positive groups (n=15 per group). The other five rats were defined as controls, without any management. At 3 days, positive group rats were oral y administrated with brain enzyme solution, and acupuncture group given fire-needle treatment at points of Neiguan (P 6), Yongquan (K 1), Quchi (LI 11) and Baihui (Du 20) for 21 days. Hanging test, inclined plane test and Y maze test were performed 1 hour after the last treatment, and the cerebral cortex and hippocampus were extracted and homogenized after execution. Lelves of acethl choline, norepinephrine, 5-hydroxytryptamine, glutamic acid andγ-aminobutyric acid were recruited, and morphology of hippocampus was observed by pathological section.
RESULTS AND CONCLUSION:(1) Within 21-day treatment, positive and acupuncture treatment rats were more active than model group. Compared with the control group, the body mass in the model group was significantly decreased (P<0.05);compared with the model group, the body mass in the positive and fire-needle groups were significantly increased (P<0.05), while it showed no significant difference between latter two groups. (2) The hanging time of model group rats was significantly shorter than that of control group (P<0.05), and significantly lengthened in the positive and fire-needle groups compared with the model group (P<0.05). Compared with the control rats, the error numbers of model group rats were significantly increased (P<0.05), and conversely, significantly decreased in the positive and fire-needle groups (P<0.05). (3) In the model group, the levels of norepinephrine, 5-hydroxytryptamine andγ-aminobutyric acid were significantly decreased, while glutamic acid significantly increased compared with the control group (P<0.05);compare with the model group, the positive and fire-needle group rats held significantly increased levels of norepinephrine, 5-hydroxytryptamine andγ-aminobutyric acid and decrease of glutamic acid (P<0.05). (4) Hematoxylin-eosin staining showed that in the mode group, there were abundant neurons damaged, cel volume reduced, nucleus pycnosis and unclear border with nucleus;both positive and fire-needle groups could improve neuron structure induced by cerebral ischemia. (5) In conclusion, fire-needle can treat cerebral palsy effectively.

Objective To compare safety and feasibility using radial versus femoral access during cardiac catheterization of patients who had previously undergone coronary artery bypass graft ( CABG) surgery. Methods We retrospectively evaluated 116 consecutive patients who underwent graft intervention via the transradial (TRA group, n = 46) or transfemoral approach (TFA group, n = 70), and observed the baseline clinical characteristics, angiography characteristics and complications between the 2 groups. Results The baseline clinical characteristics between the 2 groups were similar ( all P > 0. 05) . No significant difference was observed in angiography characteristics and procedural parameters including operation time, radiation exposure and puncture time between the 2 groups (all P > 0. 05). There was no significant difference in major adverse cardiac events during hospitalization. PCI to graft vessels were all successful and procedural success rates were similar between the 2 groups (P = 0. 669). Vascular access site complications were significantly lower ( P = 0. 03) in the TRA group. No access site complication was recorded in the TRA group. 7 cases (10. 0% ) with complications were recorded in the TFA group including 1 case of major bleeding (1. 4% ), 3 cases of minor bleeding (4. 3% ), 2 cases of local hematorna (2. 9% ) and 1 case of A-V fistula formation. Conclusions In contrast to the transfemoral route, the rate of major vascular complications was negligible using the transradial approach.

Objective To investigate the method and value of adjustable interatrial fistulization in the operation of congenital heart disease(CHD) accompany with severe pulmonary arterial hypertension(PH).Methods Twenty-seven patients(19 male,8 females) accompany with severe PH were entered the study,age ranged from 4 to 14 years old,weight from 13.7 to 42.0 kilogram.The enrolled diseases included 11 cases of atrial septal defect(ASD),10 cases of ventricular septal defect(VSD),4 cases of patent ductus arteriosus(PDA),and 2 cases of Ebstein syndrome accompany with severe tricuspid insufficiency.All patients were diagnosed as CHD accompany with severe PH(bidirectional shunt)which was the contraindications for routine operation before operation through chest X-ray,electrocardiography,ultrasonic cardiography,cardiac catheteri-zation and cardiac angiography.Results With adjustable interatrial fistulization and treatment to the abnormalities,14 fistulaes were closed immediately after operation,7 fistulaes were closed 2 days after operation,3 fistulaes were closed 3 days and 1 fistulae was closed 4 days after operation and accompanied with empyema discharged initiatively.One fistula was never closed,1 case died from low cardiac output symptom.The effective rate was 92.6%,closed to that of routine operations.Conclusion Adjustable interatrial fistulization is an easy procedure,and it can decrease the danger of PH post-operation effectively and provide operation opportunity for those patients with CHD approaching terminal stage.

Objective To evaluate the safety and effectiveness of different anesthesia methods in performing percutaneous radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC). Methods The clinical data of 102 HCC patients, who were admitted to authors’ hospital during the period from January 2010 to October 2014 to receive percutaneous RFA, were retrospective analyzed. According to the anesthesia method used for RFA, the patients were divided into 3 groups. Group A: control of breathing and general intravenous anesthesia; group B: general intravenous anesthesia with spontaneous breathing; group C: local anesthesia with monitoring. The vital signs, perioperative adverse reactions and procedure-related complications were analyzed. Results The operation time of group A and B was longer than that of group C (P<0.02); the time of waking up after the operation in group A was longer than that in group B (P<0.03). During the performance of RFA the patient’s vital signs in group A and B were more stable than those in group C (P<0.01);during the performance of RFA the blood oxygen saturation in patients of both group A and B remained above 95%(from the placement of oxygen masks to the end of operation), although the blood oxygen saturation of group B was lower than that of group A (P<0.05), and the blood oxygen saturation of group C was lower than that of both group A and B (P<0.01). The incidences of adverse reactions such as involuntary limb activity, tears, need of anesthesia machine-assisted respiration, etc. in group A were significantly lower than those in group B and C (P<0.01). The postoperative complications such as subcutaneous emphysema, pneumothorax or need of thoracic drainage in group B and C were significantly higher than those in group A (P<0.05). Conclusion General intravenous anesthesia can reduce the operation time of RFA for HCC, which can create a safe and comfortable surgical environment for patients. The use of general intravenous anesthesia together with the control of breathing is the safest method with lower incidence of perioperative adverse reactions and procedure-related complications; it might be a relatively optimal anesthesia method for RFA of HCC.

Objective:To investigate the effects of exogenous BMSCs transplantation at different time points on the treatment of traumatic brain injury in rats. Methods: Male 3-week-old SD rats were taken,BMSCs was isolated and cultured in vitro to 3 genera-tions. Fifty healthy female SD rats were randomly divided into 5 groups,10 rats in each group:control group,brain trauma model group, early treatment group,middle treatment group,late treatment group. A traumatic brain injury model was made by using cortical trauma instrument in rats,after the establishment,the treatment group:early treatment group(1 day),middle treatment group(28 days),late treatment group model(56 days),were given BMSCs (1×106ml-1) intervention treatment,the control group and model group were given equal dose of normal saline. In addition,40 rats were tested by water maze,and each group was divided into four points:6 d,7 d, 8 d and 9 d after injury,the spatial memory ability of rats was detected. All the experimental groups were sacrificed at 14 days after treatment. Morphological changes of brain tissue were observed by HE staining;the expression of LC-3 and Beclin-1 protein was detected by Western blot. Results: The brain trauma model group was compared with the control group,the shape of neuronal cell bodies appears to change,a clear gap was seen between the cells,and necrotic neurons appeared. Compared with the brain trauma model group,the morphological changes of neurons were alleviated,and the expression of protein was obviously weakened in the early stage of traumatic brain injury (1 d) and the medium term group (28 d) (P＜0. 05). BMSCs was not effective in the treatment of advanced traumatic brain injury (56 d). Conclusion: In the early and middle stage of traumatic brain injury in rats,the transplantation of BMSCs may alleviate the extent of traumatic brain injury to some extent,and the effect of late treatment is not obvious.

BACKGROUND:Meta-analysis results have shown that Duhuojisheng Decoction can improve the symptoms and relieve the pain of patients with knee osteoarthritis, but the mechanism and pathway are not very clear.OBJECTIVE:To further verify the curative effect of Duhuojisheng Decoction for primary knee osteoarthritis in macaca fascicularis. METHODS: Under natural conditions, 6 clean young macaca fascicularis (aged 3-5 years, normal group) and 6 elderly macaca fascicularis (aged more than 20 years, model group) were selected from 24 macaca fascicularis. The models of primary knee osteoarthritis were established in the model group,then aged animals were randomly divided into control and intervention(given the treatment of Duhuojisheng Decoction) groups. The number of whole blood leukocytes, C-reactive protein, erythrocyte sedimentation rate, properties of the joint fluid and expression level of tumor necrosis factor-α were compared between the control and intervention groups. RESULTS AND CONCLUSION: The aged macaca fascicularis was characterized by a typical osteoarthritis similar to human. Treatment with Duhuojisheng Decoction significantly down-regulated the expression level of tumor necrosis factor-α and significantly reduced the levels of whole blood leukocytes, and C-reactive protein. Our results suggest that the aged macaca fascicularis model of primary knee osteoarthritis is an effective animal model to simulate the occurrence and development of human primary knee osteoarthritis.Duhuojisheng decoction alleviates the progression of primary knee osteoarthritis probably by inhibiting the expression level of tumor necrosis factor-α and decreasing the levels of inflammatory factors in the articular cartilage. Additionally, the levels of whole blood leukocytes and C-reactive protein are important parameters for the prediction of curative effects.

Objective To investigate the roles and significances of MMP-2 and MMP-9 in diffuse proliferative lupus nephritis by repeated renal biopsy.Methods Seventeen patients diagnosed by renal biopsy as WHO typeⅣlupus nephritis were analyzed by immunohistochemistry staining for MMP-2 and MMP-9. Double staining for MMP-2 and MT1-MMP,MMP-9 and CD68 were also performed.Patients had repeated renal biopsy after followed up for 2.5 years.The relationship between expressions of gelatinases and pathological activity index and clinical data were studied.Results MMP-2 immunoreactivity was detected in normal controls and was increased in diffuse proliferative lupus nephritis.MMP-9 staining,which was almost negative in normal giomeruli,was increased much more significantly in diffuse proliferative lupus nephritis. The immunoreactivity of MMP-2 and MMP-9 was positive in MT1-MMP staining and CD68-positive macrophages, respectively.The expression of MMP-2 and MMP-9 was reduced by 70% and 62% in 10 patients whose clinical condition was partially alleviated,while the expressions in 7 patients whose clinical condition was not alleviated,were only reduced by 27% and 32%.The staining for MMP-2 and MMP-9 were correlated with activity index of lupus nephritis and proteinuria.Conclusion Up-regulation of gelatinases expression in diffuse proliferate lupus nephritis is correlated to activity index of the disease.