Anastomosis, Surgical ; Anastomotic Leak/surgery* ; Drainage ; Gastrectomy ; Humans ; Suction

OBJECTIVE: To explore the value of transthoracic echocardiography (TTE) in transcatheter closure of atrial septal aneurysm (ASA) combined with secoundum-type atrial septal defect (ASD). METHODS: Fourteen patients (3 males and 11 females) who had ASA combined with secoundum-type ASD were diagnosed by TTE or transesophageal echocardiography. The ASA projected to the right atrium in all patients. The width of basilar part was 13 approximately 24 (18.5+/-3.9) mm, and the vertical extent was 7 approximately 11(9.7+/-1.8) mm. Ten patients combined with single hole ASD and 4 patients with multiple hole ASD. Blood shifting from the left atrium to the right atrium was displayed in color Doppler in all patients. All patients were treated by transcatheter closure under the guiding of X fluoroscopy and TTE, and examined with TTE during the follow-up. RESULTS: Transcatheter closure was successfully performed by 14 occluders in all patients. No residual shunt was detected immediately by TTE after the procedure in all patients. During the 6 approximately 12 month follow-up, no residual shunt or occluder shifting was found, the dimensions of the heart became normal in 11 patients (79%) and were significantly decreased in 4. CONCLUSION Transcatheter closure is feasible in patients with ASA combined with secoundum-type ASD, and extra attention must be paid to the specialty. TTE is very important in case selection before transcatheter closure, and it may be used to monitor and guide the procedure during transcatheter closure.
Adult ; Atrial Septum ; Balloon Occlusion ; methods ; Cardiac Catheterization ; Echocardiography ; Female ; Heart Aneurysm ; complications ; therapy ; Heart Septal Defects, Atrial ; complications ; therapy ; Humans ; Male ; Middle Aged ; Ultrasonography, Interventional ; Young Adult

Objective To evaluate the accuracy of dual-source CT coronary angiography (DSCTCA) for the depiction of functionally relevant coronary artery lesion ( FRCAL) , by using myocardial perfusion imaging (MPI) with single photon emission computed tomography(SPECT). Methods DSCTCA,99Tcm-MIBI SPECT myocardial perfusion imaging (MPI) and conventional coronary angiography (CCA) were performed in 59 patients with clinical suspected CAD . Coronary artery diameter narrowing of 50% or greater at DSCTCA was defined as stenosis and was compared with MPI findings. CCA was served as a reference standard for DSCTCA. Results (1) Agreement between DSCTCA and CCA was good (kapaa = 0.93 for patient-based analysis, Kappa = 0. 88 for vessel-based analysis) . (2) DSCTCA revealed stenoses in 86 segments corresponding to 60 arteries in 34 patients. (3) MPI revealed 19 reversible,21 partially reversible, and 5 fixed defects in 25 patients. (4) About 65.0% (39/60) of all the narrowed coronary arteries were determined to be FRCAL Sensitivity, specificity, accuracy, positive predictive values and negative predictive values, respectively, of DSCTCA in the detection of all MPI defects were 92.0%, 67.6%, 78.0%, 67. 6% and 92. 0% on a per-patient basis and 86. 7% , 89. 0% , 88. 6% , 65. 0% and 96. 6% on a perartery basis. (5) ROC analysis showed that predictive value of DSCTCA in FRCAL was similar with those of CCA (AUCs = 0. 80, 0. 82). Conclusions DSCTCA can evaluate FRCAL indirectly. When DSCTCA results are negative,it can help ruled out patients with FRCAL The positive DSCTCA results should combin MPI in predictor of myocardial ischemia.

Objective To evaluate the pharmacokinetics and safety of single micro dose in travenous temozolomidein Chinese health male volunteers or standard treatment in glioma patients.Methods 14 healthy subjects of phase 0 research were assigned to take a single microdose of 2 mg · m-2 intravenous temozolomide.24 glioma patients of phase Ⅰ research were assigned to take 150 mg · m-2 intravenous temozolomide.These rumconcentrations of temozolomide were assayed with LC-MS/MS.Results Fourteen healthy subjects pharmacokinetic parameters wereCmax (0.14 ± 0.03) μg · mL-1,tmax (80.40 ± 12.60) min,t1/2 (114.00±6.00) min,AUC0-24h (25.80 ±4.72) μg · mL-1 · min,AUC0-x (26.20 ±4.79) μg · mL-1 · min.Twenty-one glioma patients were included in the pharmacokinetic analysis,pharmacokinetic parameters were Cmax (7.92 ± 1.50) μg · mL-1,tmax (87.90 ± 5.38) min,t1/2 (108.00 ± 5.25) min,AUC0-24h (1530.00 ±270.00) μg · mL-1 · min,AUC0-∞ (1550.00 ±273.00) μg · mL-1 · min.All the 14 healthy volunteers and 24 glioma patients were included in the safety analysis.No adverse events were detected in health volunteers.6 gliomapatients experienced 7 adverse events related to temozolomide.There were no serious adverse events in two early clinical reseach.Conclusion Pharmacokinetic parameters of phase 0 research of intravenous temozolomide reflected the characteristics of the drug distribution and elimination in some extent.It is significative to follow-up clinical trials.

Objective To evaluated the pharmacokinetics and safety of single microdose imatinib mesylate in Chinese health volunteers.Methods Eight subjects were randomly assigned to take orally a single microdose of 4 mg imatinib mesylate.The serum concentrations of ima-tinib were assayed with LC-MS/MS.Results The following pharmaco-kinetic parameters were calculated by WinNolin 6.3 software.Cmax (12.70 ±6.61 ) ng · mL-1, tmax ( 1.94 ±0.94 ) h, AUC0-24 h (90.10 ±37.70)ng· mL-1· h, t1/2 ( 10.40 ± 5.01 ) h, CL/F (47.20 ±33.40)L· h-1, V/F ( 541.00 ± 128.00 ) L, MRT (7.21 ±1.30)h.No adverse events and serious adverse events were detected.Conclusion Pharm-acokinetic parameters of phase 0 research of imatinib mesylate reflected the characteristics of the drug distribution and elimination in some extent.It was significant to protect subjects in phase 0 research by taking microdose imatinib mesylate.

BACKGROUNDIn cardiology, it is controversial whether gender influences prognosis after acute myocardial infarction (MI). We examined the 30-day and 1-year prognosis for female patients with ST-elevation myocardial infarction (STEMI) in Liaoning province, and we analyzed factors that influenced these outcomes.

METHODSThis was a prospective, multicenter, observational study in which patient data were collected by questionnaire at the time of diagnosis and at approximately 30 days and 1 year later by telephone inquiries. Patients were diagnosed with STEMI between June 1, 2009 and June 1, 2010 at any of the 20 hospitals that gave treatment representative of current STEMI treatment in Liaoning Province. Unified follow-up questionnaire was used to visit the STEMI patients.

RESULTSWe analyzed data from a total of 1429 consecutive patients with STEMI in Liaoning province. Female patients were older (70.0 vs. 60.3, P < 0.001) and were less likely to receive emergency reperfusion therapy than male ones (39.2% vs. 58.0%, P < 0.001). Female gender was associated with higher unadjusted 30-day mortality rates (HR = 2.118, 95%CI: 1.572 - 2.854, P < 0.001) and higher unadjusted 1-year mortality rates (HR = 2.174, 95%CI: 1.659 - 2.848, P < 0.001). Multivariate Cox regression analysis showed that female gender was not an independent predictor of 30-day mortality rates (HR = 1.273, 95%CI: 0.929 - 1.745, P = 0.133) nor of 1-year mortality rates (HR = 1.112, 95%CI: 0.831 - 1.487, P = 0.475).

CONCLUSIONSWomen with STEMI appear to be at increased risk of 30-day and 1-year mortality compared with male STEMI patients, but this difference may be explained by older age and less frequent receipt of reperfusion therapy among the women.

Aged ; Aged, 80 and over ; China ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; mortality ; surgery ; Myocardial Reperfusion ; Proportional Hazards Models ; Prospective Studies ; Sex Factors ; Surveys and Questionnaires

Aim To investigate the effect of adenosine on the autophagy and proliferation of hepatocellular carcinoma cells, and improve the curative effect of a-denosine on hepatocellular carcinoma. Methods HepG2 cells were incubated with adenosine, CCK-8 method was used to study the changes of cell prolifera-tion,Western blot was used to study the expression of LC3-Ⅱ and LC3-Ⅰ, and MDC staining was used to observe the number of autophagosomes. Results HepG2 cells were incubated with adenosine(1.0~4.0 mmol·L-1) for 48 h,the proliferation of HepG2 cells were detected at the different time points (12,24,48 h),and the result showed the proliferation was signifi-cantly inhibited by adenosine (P < 0.01). HepG2 cells were incubated with adenosine (0.2,0.5,1.0, 2.0,4.0 mmol·L-1) for 24 h,the ratio of LC3-Ⅱ/LC3-Ⅰ decreased significantly in low concentration of adenosine group (0.2, 0.5 mmol·L-1, P <0.05;1.0 mmol·L-1,P<0.01),and the ratio of LC3-Ⅱ/LC3-Ⅰ increased significantly in higher concentration of adenosine group (4.0 mmol·L-1, P <0.05). HepG2 cells were incubated with adenosine(1.0 mmol·L-1) for 24 h, the ratio of LC3-Ⅱ/LC3-Ⅰ de-creased significantly at 6,12 and 24 h detecting point, the number of autophagosomes were reduced, the low-est ratio of LC3-Ⅱ/LC3-Ⅰ and autophagosomes were observed at 12 h detecting point(P<0.01). Conclu-sions Adenosine inhibits the proliferation of hepato-cellular carcinoma cells,the low concentration of aden-osine inhibits the autophagy,while the high concentra-tion of adenosine increases the autophagy, which is of great significance to reduce multi-drug resistance and improve the therapeutic effect of anti-hepatoma drugs.

Background In cardiology,it is controversial whether gender influences prognosis after acute myocardial infarction (MI).We examined the 30-day and 1-year prognosis for female patients with ST-elevation myocardial infarction (STEMI)in Liaoning province,and we analyzed factors that influenced these outcomes.Methods This was a prospective,multicenter,observational study in which patient data were collected by questionnaire at the time of diagnosis and at approximately 30 days and 1 year later by telephone inquiries.Patients were diagnosed with STEMI between June 1,2009 and June 1,2010 at any of the 20 hospitals that gave treatment representative of current STEMI treatment in Liaoning Province.Unified follow-up questionnaire was used to visit the STEMI patients.Results We analyzed data from a total of 1429 consecutive patients with STEMI in Liaoning province.Female patients were older (70.0 vs.60.3,P ＜0.001) and were less likely to receive emergency reperfusion therapy than male ones (39.2％ vs.58.0％,P ＜0.001).Female gender was associated with higher unadjusted 30-day mortality rates (HR=2.118,95％C/:1.572-2.854,P ＜0.001) and higher unadjusted 1-year mortality rates (HR=2.174,95％C/:1.659-2.848,P ＜0.001).Multivariate Cox regression analysis showed that female gender was not an independent predictor of 30-day mortality rates (HR=1.273,95％C/:0.929-1.745,P=0.133) nor of 1-year mortality rates (HR=1.112,95％C/:0.831-1.487,P=0.475).Conclusions Women with STEMI appear to be at increased risk of 30-day and 1-year mortality compared with male STEMI patients,but this difference may be explained by older age and less frequent receipt of reperfusion therapy among the women.

OBJECTIVE: To observe effects of (, TLZT) gel preparation on p53, miR-502-5p, NF-κBp65 in synovial tissue of knee osteoarthritis (KOA), and to explore mechanism of TLZT gel preparation in treating KOA. METHODS: Thirthy-six Wistar rats aged 8 weeks and weighed 200 to 220 g (meaned 208 g) were randomly divided into normal group, model group and traditional Chinese medicine (TCM) group, 12 rats in each group. KOA model was established by modified Hulth method. After 4 weeks of modeling, TCM group treated with TLZT gel preparation for external use, 3 times daily for 2 weeks;normal group and model group were fed normally without intervention. After treatment, morphological changes of specimens in each group were observed, changes of miR-502-5p in synovial tissue were detected by qPCR, and contents of p53, NF-κBp65, IL-1β, TNF-α, MMP-13 in synovial tissue were detected by qPCR and Western Blot respectively. RESULTS: (1)Morphological observation of specimens showed that the articular cartilage in model group was hyaline and uneven, the synovial membranes were hypertrophic and proliferative with a large number of inflammatory cells infiltrating, the joint fluid was thicker in texture;the articular cartilage in TCM group was more transparent and smooth, synovial hyperplasia was mild with a small amount of inflammatory cell infiltration, the texture of articular fluid was clear and sparse. (2) Compared with normal group, content of miR-502-5p of synovial tissue in model and TCM group were increased, mRNA and expression of p53 decreased, expression of NF-κBp65, IL-1β, TNF-α, MMP-13 increased. (3)Compared with model group, content of miR-502-5p in synovial tissue of TCM group decreased (<0.05), mRNA and protein expression of p53 increased (<0.05), mRNA and protein expression of NF-κBp65, IL-1β, TNF-α, MMP-13 decreased (<0.05). CONCLUSION Expression of p53, miR-502 -5p, NF -κBp65 in synovial tissue is closely related to synovial hyperplasia and inflammatory reaction, TLZT gel preparation may reduce proliferation and inflammatory reaction of KOA synovium by regulating the expression of p53, miR- 502-5p, NF-κBp65 in synovial tissues.
Animals ; Drugs, Chinese Herbal ; MicroRNAs ; Osteoarthritis, Knee ; Rats ; Rats, Wistar ; Synovial Membrane ; Tumor Suppressor Protein p53

We investigated the impact and predictive value of bladder function in patients with benign prostatic hyperplasia (BPH) on the efficacy of transurethral prostatectomy. Symptomatic, imaging, and urodynamic data of patients who underwent transurethral prostatectomy at West China Hospital of Sichuan University (Chengdu, China) from July 2019 to December 2021 were collected. Follow-up data included the quality of life (QoL), International Prostate Symptom Score (IPSS), and IPSS storage and voiding (IPSS-s and IPSS-v). Moreover, urinary creatinine (Cr), nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), and prostaglandin estradiol (PGE2) were measured in 30 patients with BPH and 30 healthy participants. Perioperative indicators were determined by subgroup analyses and receiver operating characteristic (ROC) curve analysis. Among the 313 patients with BPH included, patients with severe micturition problems had more improvements but higher micturition grades postoperatively than those with moderate symptoms. Similarly, good bladder sensation, compliance, and detrusor contractility (DC) were predictors of low postoperative IPSS and QoL. The urinary concentrations of BDNF/Cr, NGF/Cr, and PGE2/Cr in patients were significantly higher than those in healthy participants (all P < 0.001). After evaluation, only DC was significantly related to both urinary indicators and postoperative recovery of patients. Patients with good DC, as predicted by urinary indicators, had lower IPSS and IPSS-v than those with reduced DC at the 1st month postoperatively (both P < 0.05). In summary, patients with impaired bladder function had poor recovery. The combined levels of urinary BDNF/Cr, NGF/Cr, and PGE2/Cr in patients with BPH may be valid predictors of preoperative bladder function and postoperative recovery.