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

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

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

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

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

OBJECTIVETo evaluate the initial and long-term results of endovascular aneurysm repair (EVAR) in high-surgical-risk abdominal aortic aneurysm (AAA) patients.

METHODSFrom July 1997 to July 2011, 120 consecutive high-surgical-risk patients with AAA who were treated electively using a bifurcated aortic endograft were entered in a registry. There were 96 male and 24 female patients, aged from 52 to 95 years with a mean of 74 years. Follow-up protocol consisted of computed tomography angiograms or ultrasound performed at 3, 6, 9, 12 months, and annually thereafter. The main goal was evaluation of the operative mortality and the long-term survival of these patients. Secondary goals were determination of the frequency of secondary operations, the outcome of the aneurysm sac, and primary and secondary patency rates after aortic endograft placement.

RESULTSMean aneurysm diameter was (57 ± 8) mm. Thirty-seven patients were operated under local anesthesia and eighty-three under general anesthesia. Five type I endoleaks, twenty-five type II endoleaks and one type III endoleak occurred during the perioperative period. The technical success rate was 95%. Operative mortality was 2.5%. The survival rates at 1-, 3- and 5-year were 92%, 75% and 43% respectively. The mean follow up was (36 ± 3) months. Primary and secondary patency rates at 3 year were respectively 97% and 100%. Secondary intervention rate was 10% (12/120) at 5 year. The reasons included endoleaks for 7 patients, stent-grafts fracture for 2 patients, stent-grafts migration for 2 patients and stent-graft thrombosis for 1 patients.

CONCLUSIONSInitial and long-term results with endograft repair of AAA in high-surgical-risk patients were satisfactory. These results appear to justify endovascular repair for this patient population.

Aged ; Aged, 80 and over ; Aortic Aneurysm, Abdominal ; surgery ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation ; methods ; Female ; Humans ; Male ; Middle Aged ; Stents ; Treatment Outcome

OBJECTIVETo describe observation of availability of catheter-directed foam sclerotherapy for the great saphenous vein varicosis.

METHODSA selective series of 30 patients of vein varicosis were treated with foam sclerotherapy using a standard technique for foam delivery from April 2008 to August 2008. Patients were treated with 1% polidocanol foam through a catheter, which was inserted percutaneously over a guidewire in the great saphenous vein (GSV). All successfully treated patients were examined by colour duplex two weeks after the procedure.

RESULTSThirty patients with an insufficiency reflux of the GSV were treated with the catheter-directed foam sclerotherapy. Primary technical success was achieved in all the patients. The concentrations (1.0%) and doses (6 to 8 ml) of polidocanol was mainly we used. Five patients experienced transient scotomas and developed segmental phlebitis of a collateral vein. The intervention was well tolerated in all patients without the occurrence of serious side effects. In 27 of the 30 treated patients (90%), a closure of the GSV was found at control visits 2 weeks, 3 months after treatment.

CONCLUSIONThe use of an endovascular catheter inserted percutaneously over a guidewire is feasible in most patients and has resulted in high primary occlusion rates.

Adult ; Aged ; Aged, 80 and over ; Catheterization, Peripheral ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Saphenous Vein ; Sclerosing Solutions ; administration & dosage ; therapeutic use ; Sclerotherapy ; methods ; Treatment Outcome ; Varicose Veins ; therapy

Objective To investigate the morphology and classification of the atypical azygos venous system,and to provide reference for diagnosis and treatment of mediastinal and thoracic vascular diseases.Methods Thirty cadavers were perfused with 10%formalin solution, and immersed in the solution for one month before dissection.The vertebral levels of termination and diameters of the azygos,hemiazygos and accessory hemiazygos veins were examined.Results There were 24 cases of classical azygos venous system,which contained the azygos, hemiazygos and accessory hemiazygos veins.And there were 6 cases of atypical azygos venous system,which were further divided into 4 sub-groups.Namely,type a(2 cases)which showed an inverted"Y"shape;type b(2 cases)which was single column with hemiazygos and ac-cessory hemiazygos veins absent;type c(1 case)which showed an accessory hemiazygos vein draining into the left brachiocephalic vein;and type d(1 case)with azygos vein and double superior vena cava variation.Diameters of termination of the azygos,hemiazygos and accessory hemiazygos veins were(10.39 ±1.98)mm,(8.51 ±2.28)mm,and(6.29 ±1.56)mm,respectively.The vertebral levels of termination of the azygos,hemiazygos and accessory hemiazygos veins were T 4(83.3%),T7to T10,T4to T8respectively.Conclusion All morphometrical diameters and their termination levels can be used during preoperative CT evaluations before planning invasive mediastinal procedures.The re-sults of this study could be helpful in mediastinal surgery,mediastinoscopy and the surgery of the deformations of the vertebral column in the thoracic cavity.