BACKGROUNDHemodynamic evaluation is crucial for the management of patients with pulmonary hypertention. Clinicians often prefer a rapid and non-invasive method. This study aimed to examine the feasibility of transthoracic echocardiography for the measurements of hemodynamic parameters in patients with pulmonary hypertension.

METHODSA prospective single-center study was conducted among 42 patients with pulmonary hypertension caused by different diseases. Transthoracic echocardiography and right-heart catheterization were performed within 24 hours. Pulmonary artery systolic, diastolic and mean pressure (PASP, PADP and PAMP), cardiac output (CO), and pulmonary capillary wedge pressure (PCWP) were measured by both methods. A linear correlation and a Bland-Altman analysis were performed to compare the two groups of hemodynamic parameters.

RESULTSA good correlation was found between invasive and non-invasive measurements for PASP (r = 0.96), PADP (r = 0.85), PAMP (r = 0.88), CO (r = 0.82), and PCWP (r = 0.81). Further agreement analysis done by the Bland-Altman method showed that bias and a 95% confidence interval for PASP, PADP, and CO were clinically acceptable while great discrepancies existed for PAMP and PCWP.

CONCLUSIONSThe non-invasive measurements by PASP, PADP, and CO in patients with pulmonary hypertension correlate well with the invasive determinations. Transthoracic echocardiography (TTE) was inappropriate for estimating PCWP and PAMP.

Adolescent ; Adult ; Cardiac Catheterization ; Cardiac Output ; Echocardiography ; Female ; Hemodynamics ; Humans ; Hypertension, Pulmonary ; physiopathology ; Male ; Middle Aged ; Prospective Studies ; Pulmonary Wedge Pressure

OBJECTIVETo determine the safety and efficacy of total percutaneous endovascular abdominal aortic aneurysm repair using the Perclose ProGlide suture-mediated closure system.

METHODSFrom May 2008 to April 2010, 36 abdominal aortic aneurysm patients were undergone total percutaneous endovascular repair. There were 30 male and 6 female patients with a mean age of 68 years. Endografts used included 3 Endurant endografts, 13 Talent endografts, and 20 Zenith endografts. Prior to insertion of the introducer sheath, two ProGlides were pre-set to 18 to 24 F access sites and one to 14 to 16 F access sites. At last, suture the arteriotomy by tying down knots of the ProGlide following removal of the sheath. Technical success, complications, and procedure and access closure times were evaluated. Follow-up protocol consisted of computed tomography angiograms performed at 3, 6, 9, 12 months, and annually thereafter.

RESULTSTwenty patients were operated under local anesthesia and 16 patients under general anesthesia. A total of 68 femoral arteries were closed with 128 devices. Thirty-eight vessels were with 2 devices, while 8 arteries required 3 devices and 2 arteries required 4 devices for hemostasis and an additional 20 vessels only required a single device. Sixty-three (63/68, 92.6%) vessels were closed successfully. Two vessels converted to open closure. Three vessels complicated with hematomas without surgical procedure. The mean follow-up was (12±3) months. There was one asymptomatic femoral artery dissection 3 months after operation.

CONCLUSIONSTotal percutaneous endovascular abdominal aortic aneurysm repair is safe and effective. But it should be performed at hybrid operating room where can convert to open procedure if necessary.

Aged ; Aged, 80 and over ; Aortic Aneurysm, Abdominal ; surgery ; Blood Vessel Prosthesis Implantation ; instrumentation ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Suture Techniques ; instrumentation ; Treatment Outcome

OBJECTIVETo describe the dental caries of 15-year-old adolescents in Hubei province, and to determine the influence of various social-behavioral risk factors on dental caries in the population.

METHODSThe survey employed a multistage, stratified, non-geometric proportional randomized sampling, representing adolescents aged 15-year-old in Hubei province. The epidemiological investigation of dental caries was made by clinical oral health examination. Oral health knowledge, attitude and behavior investigated by questionnaire.

RESULTSThe prevalence and mean DMFT in 1,080 15-year-old adolescents in Hubei province was 24.4% and 0.45, respectively. 11.4% of the adolescents brushed their teeth at least twice a day, 33.1% of the adolescents ever visited the dentists. A significant higher prevalence of dental caries was observed in girls (OR = 1.70). In addition, those who visit dentists and those who the scores of the consumption of sugar drink were high tended to have a higher prevalence of dental caries.

CONCLUSIONThe dental caries prevalence of adolescents in Hubei province is low, but oral health habit of adolescents seems poor. Gender and consumption of sugar drink may be risk factors of dental caries.

Adolescent ; Dental Caries ; Female ; Humans ; Male ; Oral Health ; Prevalence ; Risk Factors ; Surveys and Questionnaires

BACKGROUNDTo construct recombinant retroviral vector expressing HBcAg in eukaryotic cells.

METHODSThe HBV core gene fragment was amplified by using PCR from pADR which contains complement nucleotide sequence of HBV subtype adr and cloned into retroviral expression plasmid pLXSN, then transfected into packing cell (PT67) with lipofec AMINE. After 2-3 weeks selection with G418, large colonies were isolated and transferred to individual plates. Virus-containing medium was collected and used to infect NIH3T3, EL4 and mouse bone marrow derived dendritic cells(DC). DNA was extracted from infected cells and tested by PCR. Indirect immunofluorescence and FACS were used to detect the expression of HBcAg. Cell mediated immunity of immunized C57BL/6 mice with transduced DC was analyzed.

RESULTSThe insertion of HBV core gene fragment in the recombinant retroviral plasmid was confirmed by PCR as well as enzyme digestion with EcoR1 and BamH2. The viral titer reached 3 x 10(5) CFU/ml. The result of PCR showed that the HBV core gene had been integrated into the genome of infected NIH3T3 cells. Indirect immunofluorescence and FACS analysis showed that HBcAg had been expressed in these cells. HBcAg specific CTL responses could be generated in mice immunized with retrovirus transduced DC.

CONCLUSIONSHBV core gene had been integrated into eukaryotic cells with retroviral vector and target gene had been expressed efficiently. These results may have some impact on gene therapy of chronic hepatitis B.

3T3 Cells ; Animals ; Cloning, Molecular ; Dendritic Cells ; metabolism ; Eukaryotic Cells ; metabolism ; Genetic Vectors ; Hepatitis B Core Antigens ; biosynthesis ; genetics ; Hepatitis B virus ; genetics ; Humans ; Mice ; Recombination, Genetic ; genetics ; Retroviridae ; genetics ; Transfection

Objective To compare the effects and complications between neuroendoscope-assisted and conventional shunt methods in patients with hydrocephalus,Methods The data of 299 patients with hydrocephalus admitted to our hospital from June 2002 and June 2009 were analyzed.Among these patients,98 adopted neuroendscope:78 were performed ventriculoperitoneal shunt(EVPS)combined with endoscopic third ventriculostomy(ETV)and the other 20 with obstructive hydrocephalus were performed ETV only.The other 201 patients adopt conventional operation:VPS was employed in 196 and ventriculoatrial shunt was performed in 5.We compared shunt effectiveness by calculating the pre-and post-operative ventricular indexes,shunt failure rates and complication rates during the follow-up between the 2 groups.Results No difference in etiology of hydrocephalus or clinical characteristics between the 2 groups was found.Compared with the conventional shunt group,neuroendscope-assisted group enjoyed a longer operative time,a higher surgery cost,a lower clogging incidence rote and a higher precision rote of putting the tube(P<0.05).Conclusion Applying of neuroendoscope is a very good option in treating patients with various kinds of hydrocephalus with good long-term follow-up results.

Objective To investigate the effects of Rac1 gene silencing on cell cycle and apoptosis of Daoy cell line in medulloblastoma. Methods Daoy cells were divided into Rac1-shRNA group and empty plasmid control group; Daoy cells in the former group were transfected by using Rac1-shRNA plasmid (Rac1-shRNA). RT-PCR, Western blotting and flow cytometry were used to observe the changes of cycle and apoptosis of Daoy cells after Rac1 gene silencing. Results Rac1 mRNA and protein in medulloblastoma Daoy cell lines were highly expressed; cell cycle of Daoy cells with Rac1 gene silencing were blocked at G0-G1 phases and cell percentage of G0-G1 phases significantly increased to 80.9%±4.9%; however, the proportion of cells in the S phase reduced to 11.8%± 2.3%. The apoptosis rate of Rac1-shRNA plasmid group (36.7%±3.9%) was significantly different as compared with that of empty plasmid control group (8.5% ±0.9%) (P<0.05). Conclusion RNA-interfered Rac1 gene silencing can inhibit the proliferation of Daoy cells and promote their apoptosis, indicating that Rac1 may become a new target being able to inhibit the cell proliferation and promote the apoptosis of Daoy cells in medulloblastoma.

OBJECTIVETo evaluate immediate- and median-term outcomes from subintimal recanalization of superficial femoral arteries (SFA) chronic total occlusions (CTO) with the Outback LTD catheter.

METHODSFrom January 2010 to May 2011, 35 legs in 30 patients with CTO of the SFA and proximal popliteal artery were treated by Outback LTD catheter. There were 20 male and 10 female patients. The mean age of the patients was 68 years. Clinical presentation was severe intermittent claudication (Rutherford category 3, 10/35, 28.6%), rest pain (Rutherford category 4, 13/35, 37.1%), and minor ulceration (Rutherford category 5, 12/35, 34.3%). In all cases, the true lumen could not be entered by using standard antegrade catheter and guide wire techniques. Technical success, complications, procedure times, clinical outcomes and cumulative patency rates in follow-up were evaluated.

RESULTSMedian lesion length was (210 ± 15) mm. Recanalization of the arterial occlusion was successful in 34 of 35 treated lesions (97.1%). None of the 30 patients showed any procedure-related complications during or after treatment. The mean follow-up was (7.2 ± 0.3) months. Cumulative primary patency rates after 3, 6, and 12 months were 90.9%, 84.8% and 50.6%. Three minor toe amputations and one major below-the-knee amputation were observed in patients with critical limb ischemia.

CONCLUSIONSThe Outback LTD catheter is a safe and effective device to recanalize challenging superficial femoral arteries CTO. The technique could reduce radiation exposure time and raise the technique success rate.

Aged ; Aged, 80 and over ; Angioplasty, Balloon ; instrumentation ; methods ; Arterial Occlusive Diseases ; surgery ; Catheters ; Female ; Femoral Artery ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

BACKGROUNDNumerous Asian cases of avian influenza virus infection, especially the highly pathogenic strain H5N1, in humans have raised the concern that another influenza pandemic is close. However, there are no effective therapeutic drugs or preventative vaccines available. Hemagglutinin is the membrane glycoprotein of avian influenza virus responsible for receptor binding to human cells and the main immunogenic protein that elicits a strong immune response. Although this protein is of great importance to the study of pathogenesis and vaccine development, its expression and purification are difficult due to high levels of glycosylation.

METHODSIn this study, we expressed codon-optimized, full-length hemagglutinin 5 (H5) protein fused with a human IgG Fc tag (H5-Fc) in HEK293 cells. To enhance secretion of this protein, we also deleted the transmembrane domain and the intracellular domain of the H5 protein (H5DeltaTM-Fc). Purified proteins were obtained using a protein A column.

RESULTSELISA revealed that the yield of soluble H5DeltaTM-Fc protein in the supernatant was about 20 mg/L. Western blotting and fluorescence activated cell sorter (FACS) indicated that the purified H5 protein was correctly folded and biologically active.

CONCLUSIONPurification of H5 proteins from mammalian cells could be used for large-scale production of recombinant H5 protein for basic scientific research or the development of vaccines.

Cell Line ; Codon ; metabolism ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Hemagglutinin Glycoproteins, Influenza Virus ; genetics ; metabolism ; Humans ; Protein Folding ; Recombinant Proteins ; genetics ; metabolism

BACKGROUNDAn implantable cardioverter-defibrillator (ICD) has been suggested for heart failure patients for primary prevention of sudden cardiac death. However, few data have been reported on the application of ICD as primary prevention of sudden cardiac death in China. We evaluated the value of primary prevention ICD therapy in Chinese patients with heart failure.

METHODSThirty-four patients at an average age of (60.2 +/- 13.7) years seen in Peking Union Medical College Hospital were treated with ICD implantation for primary prevention of sudden cardiac death from November 2005 to July 2009. Single-chamber ICDs were implanted in 16 (47.0%) cases, and dual-chamber or cardiac resynchronization therapy defibrillators in 18 (53.0%) cases. The patients had an average left ventricular ejection fraction of (26.9 +/- 5.5)% (11% to 35%), of which 18 (53.0%) patients had ischemic cardiomyopathy and 16 (47.0%) patients had non-ischemic cardiomyopathy. All patients were followed up at three months after the implantation and every six months thereafter or when prompted by an ICD event.

RESULTSThere were five (14.7%) deaths, including two of heart failure and three with a non-cardiac course, during an average follow-up of (15.0 +/- 11.9) months. Forty-one ICD therapy events were recorded, including 19 (46.3%) appropriate ICD therapies in six patients and 22 (53.7%) inappropriate ICD therapies in four patients with single chamber leads. Inappropriate ICD therapies were mainly due to supraventricular tachyarrhythmias, especially atrial fibrillation. Patients with ischemic cardiomyopathy and non-ischemic cardiomyopathy did not differ in the incidence of either appropriate or inappropriate therapy.

CONCLUSIONSICD for primary prevention of sudden cardiac death in China prevents patients from arrhythmia death. Relatively high incidence of inappropriate therapies highlights the importance of an atrial lead.

Aged ; Death, Sudden, Cardiac ; prevention & control ; Defibrillators, Implantable ; adverse effects ; Female ; Heart Failure ; mortality ; therapy ; Humans ; Male ; Middle Aged ; Treatment Outcome

BACKGROUNDSevere bilateral carotid stenosis caused by atherosclerosis has not been unusual in the elderly. Such patients have high stroke risk. Many studies show that carotid artery stenting (CAS) is an alternative to treat unilateral carotid stenosis. However, the optimal procedural strategy of bilateral carotid stenosis remains unclear. The purpose of our study was to evaluate the safety of simultaneous bilateral carotid artery stenting (SBCAS) compared with unilateral carotid artery stenting (UCAS).

METHODSIn this single-center retrospective study, we analyzed 234 consecutive patients who underwent carotid stenting from January 2005 to December 2009. Thirty-nine patients (16.7%) of them underwent SBCAS, and the others (n = 195) underwent UCAS. Indication for CAS was defined as carotid artery diameter reduction > 60% (symptomatic) or > 80% (asymptomatic). Six-month and 30-day hemodynamic depression (HD), hyperperfusion syndrome (HPS), stroke, death and myocardial infarction (MI) after carotid stenting were assessed.

RESULTSSBCAS group had no more HD and HPS compared with UCAS group at 30 days (HD: 28.2% vs. 20.0%, P = 0.396; HPS: 2.6% vs. 2.1%, P = 0.262). Moreover, there was no statistically significant difference between SBCAS group and UCAS group in major stroke, death, MI and their combinations within 30 days (major stroke: 0 vs. 3.6%, P = 0.604; death: 2.6% vs. 1.5%, P = 0.520; MI: 2.6% vs. 0.5%, P = 0.306; and their combinations: 5.1% vs. 4.6%, P = 1.000) and 6 months (major stroke: 0 vs. 3.6%, P = 0.604; death: 5.1% vs. 2.1%, P = 0.262; MI: 5.1% vs.1.0%, P = 0.130 and their combinations: 7.7% vs. 5.1%, P = 0.459).

CONCLUSIONSThe patients undergoing SBCAS had no more events than those undergoing UCAS in 30-day and 6-month follow-up. Our finding suggests that SBCAS appears to be as safe as UCAS.

Aged ; Angioplasty, Balloon ; adverse effects ; Carotid Stenosis ; physiopathology ; therapy ; Female ; Hemodynamics ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; Retrospective Studies ; Stents ; adverse effects ; Time Factors