BACKGROUND: The restenosis occurs up to 20%-30% following metal coronary stent implantation. Under the support of the 863 program, the feasibility to treat coronary artery stenosis using a novel drug-eluting stent (DES) has been investigated to reduce restenosis. OBJECTIVE: A drug-eluting stent (rapamycin as drug mode) was implanted into porcine models of coronary stenosis. The safety and efficacy of the drug-eluting stent were observed and compared with bare-metal stent. DESIGN, TIME AND SETTING: A randomized controlled animal experiment was performed in the Fu Wai Hospital for Cardiovascular Disease between November 2003 and April 2004. MATERIALS: A novel bioinspired phospholipid copolymer was synthesized by free radical polymerization of stearyl methacrylate, β-hydroxypropyl methacrylateand 3-(trimethoxysilyl) propylmethacrylate. METHODS: Twenty-one pigs were randomly divided into 3 groups: bare-mental stent, drug-eluting stent, and polymer-coated stent. The treated stents pre-loaded onto a delivery system through the use of crimping instrument were implanted into pig's coronary artery, with 2 stents per pig. MAIN OUTCOME MEASURES: Determination of luminal diameter, luminal area, mean intimal thickness on and between the stents, neointimal area, percentage of luminal area restenosis, and damage index using an image analysis instrument. RESULTS: At 28 days after implantation, there was significant difference in mean intimal thickness on and between the stents, as well as neointimal area, between the DES and bare-metal stent groups (P < 0.05). The neointimal area was reduced by 44.87% in the DES group compared with the bare-metal stent group. No significant difference in percentage of luminal area restenosis was found between the DES and bare-metal stent groups, but P value equaled to 0.053, which was close to 0.05. In addition, no restenosis was found in the DES group. CONCLUSION: Rapamycin DES can markedly resist intravascular intimal hyperplasia and restenosis following stenting.

Objective:To investigate the effect and relationship of coronary microvascular dysfunction (CMD) on cardiac mechanical indices in patients with non-obstructive coronary artery disease(NOCAD) in the resting state.Methods:This study was a single-center retrospective study. Seventy-nine NOCAD patients who hospitalized in Qilu Hospital of Shandong University from July 2017 to March 2022 were recruited. All patients underwent conventional echocardiography examination and the examination of coronary flow velocity reserved by transthoracic Doppler echocardiography (TTDE-CFVR). Based on the results of TTDE-CFVR, patients were divided into CMD group (CFVR<2.5, 32 cases) and a control group (CFVR≥2.5, 47 cases). Clinical data, routine echocardiographic parameters, regional mechanical indices including regional myocardial work index(RWI) and regional longitudinal strain(RLS), global mechanical indices including left ventricular global longitudinal strain(GLS), global longitudinal strain in the endocardial layer(GLS-endo), global longitudinal strain in the epicardial layer(GLS-epi), left ventricular global work index(GWI), global contractive work(GCW), global waste work(GWW), global work efficiency(GWE) were compared between two groups. Binary logistic regression was used to analyze the risk factors of CMD. ROC curve was used to construct a prediction model for CMD.Results:There was no significant difference in sex ratio, BMI, smoking history, diabetes, hypertension and dyslipidemia between CMD group and control group. Age was significantly higher in the CMD group than in the control group. RWI, GWI, GCW, GWE and the absolute values of RLS, GLS, GLS-endo and GLS-epi were significantly lower in the CMD group than in the control group. Logistic regression analysis showed that the decrease of absolute value of GLS was an independent risk factor for the CMD( OR=1.335, 95% CI=1.041-1.713, P=0.023). ROC curve showed that myocardial strain-related indexes had a good decrease value for the CMD. Conclusions:For patients with NOCAD, the presence of CMD is associated with the decrease of left ventricular regional and global systolic function.

A novel bioinspired phospholipid copolymer has been synthesized by the radical polymerization of poly2-Methacryloyloxyethylphosphorylcholine (MPC), stearyl methacrylate (SMA), hydroxypropyl methacrylate (HPMA) and trimethoxysilylpropyl methacrylate (TSMA). Contact angle results indicated that the coating surface rearranged to get a more hydrophilic surface at the polymer/water interface. The membrane mimic phosphorylcholine coating surface could resist the platelet adhesion and prolong plasma recalcification time significantly. Rapamycin was used as model drugs to prepare drug-eluting coating. The animal experiments showed that this novel drug-eluting stent could effectively prevent the phenomena of restenosis.
Angioplasty, Balloon, Coronary ; instrumentation ; Animals ; Coated Materials, Biocompatible ; Coronary Restenosis ; prevention & control ; Drug-Eluting Stents ; Female ; Humans ; Male ; Materials Testing ; Methacrylates ; chemistry ; Phosphorylcholine ; analogs & derivatives ; chemistry ; Pilot Projects ; Polymers ; chemistry ; Prosthesis Design ; Random Allocation ; Sirolimus ; chemistry ; Swine ; Swine, Miniature

Objective:To explore the role of ductular reaction in assessing the efficacy of liver transplantation.Method:From January 2015 to December 2020, he relevant clinical data were retrospectively reviewed for 100 recipients and their corresponding donors at Shulan (Hangzhou) Hospital. They were assigned into two groups of hepatic steatosis (HS group, 65 cases) and non-hepatic steatosis (non-HS group, 35 cases) according to whether or not receiving steatosis donated liver. Furthermore, based upon the occurrence of early allograft dysfunction (EAD), the participants were categorized into two groups of EAD (33 cases) and non-EAD (67 cases). The degree of bile duct reaction ductular reaction was defined by the percentage of staining area occupied by cytokeratin 19 (CK19) -positive bile duct cells in immunohistochemical-stained specimens. Donor of ductular reaction were compared between HS/non-HS and EAD/non-EAD groups. The risk factors for EAD were identified by univariate and multivariate Logistic regression analysis. Subgroup analysis was conducted based upon the level of ductular reaction (DR number) in donors (DR=0.4 as a threshold) and whether or not donors exhibited steatosis. The impact of DR was examined on the incidence of EAD and survival post-liver transplantation in steatosis donors.Result:The level of DR was higher in steatosis donor than that in non-steatosis donor [ (0.59%±0.385%) vs. (0.32%±0.194%), P<0.01]. And it was higher in EAD group than that in non-EAD group [ (0.72%±0.449%) vs. (0.38%±0.226%), P<0.01]. Multivariate logistic regression analysis showed that a high level of ductular reaction was an independent risk factor for EAD post-liver transplantation in donor. Subgroup analysis revealed that receiving a steatosis donor with low ductular reaction (DR<0.4%) had comparable levels of EAD occurrence and overall survival rate to receiving a non-steatosis donor. Conclusion:Steatosis with low ductular reaction donor may be safely applied for liver transplantation. And assessing donor injury based upon ductular reaction can effectively expand the clinical application of steatosis donors.

Objective:To investigate the effect of N-acetylserotonin (NAS) on the retinal microglia polarization in retinal ischemia-reperfusion injury (RIRI) rats and explore its mechanism via nucleotide-bound oligomeric domain 1 (NOD1)/receptor interacting protein 2 (Rip2) pathway.Methods:Healthy male Sprague Dawley rats were randomly divided into Sham ( n=21), RIRI ( n=21) and NAS (injected intraperitoneally 30 min before and after modeling with NAS, 10 mg/kg, n=18) groups, using random number table. And the right eye was used experimental eye. The RIRI model of rats in RIRI group and NAS group was established by anterior chamber high intraocular pressure method. Rats in NAS group were intraperitoneally injected with 10 mg/kg NAS before and 30 min after modeling, respectively. The retinal morphology and the number of retinal ganglion cell (RGC) in each group were detected by hematoxylin-eosin staining and immunohistochemical staining. The effect of NAS on polarization of retinal microglia was detected by immunofluorescence staining. Transcriptome sequencing technology was used to screen out the differentially expressed genes between Sham and RIRI groups. Western blot and real-time quantitative polymerase chain reaction (RT-PCR) were used to examine the differentially expressed genes. Immunohistochemical staining, Western blot and RT-PCR were used to investigate the effect of NAS on the expression of NOD1 and Rip2 protein and mRNA in retinal tissue and microglia of rats. General linear regression analysis was performed to determine the correlation between the number difference of NOD1 + cells and the number difference of M1 and M2 microglia in retinal tissues of rats in NAS group and RIRI group. Results:A large number of RGC were observed in the retina of rats in Sham group. 24 h after modeling, compared with Sham group, the inner retinal thickness of rats in RIRI group was significantly increased and the number of RGC was significantly decreased. The thickness of inner retina in NAS group was significantly thinner and the number of RGC was significantly increased. Compared with Sham group, the number of retinal microglia of M1 and M2 in RIRI group was significantly increased. Compared with RIRI group, the number of M1 microglia decreased significantly and the number of M2 microglia increased significantly in NAS group. There was statistical significance in the number of M1 and M2 microglia in the retina of the three groups ( P<0.05). Transcriptome sequencing results showed that retinal NOD1 and Rip2 were important differential genes 24 h after modeling. The mRNA and protein relative expressions of NOD1 and Rip2 in retina of RIRI group were significantly higher than those of Sham group, with statistical significance ( P<0.05). The number of NOD1 + and Rip2 + cells and the relative expression of mRNA and protein in retinal microglia in RIRI group were significantly higher than those in Sham group, and NAS group was also significantly higher than that in Sham group, but lower than that in RIRI group, with statistical significance ( P<0.05). The number of Iba-1 +/NOD1 + and Iba-1 +/Rip2 + cells in retinal microglia in RIRI group was significantly increased compared with that in Sham group, and the number of Iba-1 +/Rip2 + cells in NAS group was significantly decreased compared with that in RIRI group, but still significantly higher than that in Sham group, with statistical significance ( P<0.05). Correlation analysis results showed that the difference of retinal NOD1 + and Rip2 + cells in NAS group and RIRI group was positively correlated with that of M1 microglia ( r=0.851, 0.895), and negatively correlated with that of M2 microglia ( r=-0.797, -0.819). The differences were statistically significant ( P<0.05). Conclusion:NAS can regulate the microglial polarization from M1 to M2 phenotype, the mechanism is correlated with the NOD1/Rip2 pathway.

Objective To investigate the prevalence of musculoskeletal disorders (MSD) in dentists and to analyze the risk factors of MSD to provide suggestions for preventing and reducing MSD in dentists. Methods Through stratified cluster random sampling, 373 dentists were selected from one Hospital of Stomatolagy and five general hospitals among Three-A hospitals in Wuhan as the research objects. The prevalence of MSD was surveyed using the Nordic musculoskeletal disorders standard questionnaire (NMQ) and Numerical Rating Scale (NRS) of pain measurement, and the risk factors of MSD was analyzed with binary Logistic regression. Results The total MSD annual prevalence rate of dentists was 93.3%, with a prevalence rate in neck, shoulder and back, waist and wrist at 78.3%, 70.0%, 56.0% and 36.2% respectively. Through Binary Logistic regression analysis, it was found that the risk factors associated with neck MSD were work fatigue（χ²=24.00，P=0.000）, neck hunching（χ²=23.55，P=0.000）, and shoulder side lift（χ²=24.52，P=0.000）. The risk factors associated with MSD in shoulder and back were work fatigue（χ²=34.64，P=0.000）, neck twisting（χ²=21.68，P=0.000） and wrist bending（χ²=45.87，P=0.000）. The risk factors associated with waist MSD were age（χ²=29.83，P=0.000）, majors（χ²=16.68，P=0.028）, work fatigue（χ²=21.08，P=0.000）, waist bending（χ²=22.88，P=0.000）. The risk factors associated with wrist MSD were gender（χ²=4.17，P=0.041）, majors（χ²=23.47，P=0.001）, working years（χ²=11.63，P=0.009）, physical activities（χ²=9.14，P=0.028）, number of patient visits per day（χ²=18.41，P=0.000）, bending and twisting（χ²=24.12，P=0.000）, wrist twisting（χ²=34.41，P=0.000）, and prevalence of microscope using（χ²=12.09，P=0.020）, while physical exercise was a protective factor for wrist MSD.The differences of the above-mentioned risk factors were statistically significant (P<0.05). Conclusion The prevalence of MSD in dentists is relatively high, and hospital management should strengthen organizational training to help dentists to realize the importance of adopting correct operating posture, a 5-minute breaks during work, prevent MSD at an early stage.

Objective:To investigate the efficacy of flexion-lateral curvature-supination reduction combined with primary anterior surgery for the treatment of lower cervical dislocation with unilateral facet inter-locking.Methods:A retrospective analysis was performed in the 32 patients who had been admitted to Department of Spine Surgery, Honghui Hospital for lower cervical dislocation with unilateral facet interlocking from November 2015 to October 2018. According to their treatments, they were divided into 2 groups. In the emergency group treated by flexion-lateral curvature-supination reduction combined with primary anterior surgery, there were 13 males and 3 females, aged from 24 to 63 years. In the traction group treated by cranial traction reduction combined with secondary anterior surgery, there were 12 males and 4 females, aged from 20 to 64 years. The operation time, intraoperative blood loss, hospital stay, bone graft fusion, American Spinal Injury Association (ASIA) grade and Japanese Orthopaedic Association (JOA) score were compared between the 2 groups.Results:There was no significant difference in the preoperative general data between the 2 groups, showing they were comparable ( P<0.05). All patients were followed up from 26 to 40 months. The hospital stay for the emergency group [(7.2±1.2) d] was significantly shorter than that for the traction group[(10.9±1.2) d] ( P<0.05). There was no significant difference in the operation time, blood loss, ASIA grade or JOA score between the 2 groups ( P>0.05). All patients achieved osseous fusion of intervertebral space. Conclusion:Compared with traditional methods, flexion-lateral curvature-supination reduction combined with primay anterior surgery shows no significant difference in the recovery of neurological function but leads to a shorter hospital stay.