1.The protective role of hypothermic protective solution during surgey for the tetralogy of Fallot
Chinese Journal of Thoracic and Cardiovascular Surgery 2010;26(4):252-255
Objective The incidence of acute pulmonary injury occurred after cardiopulmonary bypass for fallot tetrad has been high. The severity of pulmonary ischemia-reperfusion has been found to be reduced with ulinastatin (UTI) in the animal models and clinical practice. We evaluated the effect of pulmonary artery perfusion with a hypothermic protective solution containing ulinastatin on the inflammatory response in the lung during cardiopulmonary bypass. Methods 30 children with tetralogy of Fallot (TOF) were randomly assigned into control group and protective group, 15 cases in each group. Patients would be excluded if they had signs of infections, such as the white blood cell count was over 12000 per microliter, the temperature was above 38 centi-degree and the c-reaction protein was more than 8 mg/L. Operation with routine approaches was performed in the control group and the pulmonary artery was infused with 4℃ protective solution in the protective group while the heart stoped beating. Plasma tumor necrosis factor α (TNF-α) 、CD11b and Myeloperoxidase (MPO) were measured intraoperatively and postoperatively. Blood gas、pulmonary function and clinic index of the patients were also monitored. Results The level of TNF-α was lower in the protective group as compared with that in the control group immediately and 3 hours after closing the sternum [(11.15±2.47) pg/ml vs. (14.21 ±5.55) pg/ml, P<0.05; (12.01 ±2.69) pg/ml vs. (15.94 ±4.86)pg/ml,P <0.01]. The MFI of CD11b was lower in the protective group as compared with that in the control group at 3 and 6 hoursafter closing the sternum (126.23±36.05 vs. 156.98±48.34, P<0.05; 137.27±38.85 vs. 173.27±67.43, P<0.05). The level of MPO was lower in protective group as compared with that in the control group at 3 hours, 6 hours and 24hours after closing the sternum [(156.52±17.57)U/L vs.(178.45±35.68)U/L, P<0.05; (178.28±23.63) U/L vs.(224.66±49.66)U/L, P<0.01;(130.52±57.50)U/L vs. (96.50±14.49)U/L, P<0.05]. The duration of mechanical ventilation was significantly shorter in the protective group than that in the control group (17.60±6.39 vs. 23.70±8.51,P<0.05). Alveolar-arterial oxygen pressure difference (A-aDO2, calculated as [FiO2×713-5/4×PaCO2]-PaO2) in the protective group was less than that in the control group at 3 and 6 hours after closing the sternum [(120.92±33.08)mm Hg vs. (145.52±39.38)mmHg, P<0.05;(74.76±40.16)mm Hg vs. (112.50±44.16)mmHg, P<0.01]. Dynamic compliance (Cdyn) in protective group was lower than that in control group at 3 and 6 hours after closing the sternum [(0.59±0.11)ml·cmH2O-1·kg-1 vs. (0.46±0.17)ml·cmH2O-1·kg-1, P<0.05;(0.67±0.09)ml·cmH2O-1·kg-1vs. (0.53±0.18)ml·cmH2O-1·kg-1,P<0.05). Conclusion Perfusion with hypothermic protective solution containing UTI to the pulmonary artery during cardiopulmonary bypass may reduce the inflammatory responses substantially in the lung after bypass and had a role in the lung protection.
2.Relationship of conotruncal anomalies and chromosome 22q11.2 deletion
International Journal of Pediatrics 2011;38(6):612-616
Congenital cardiovascular anomalies are present in approximately 80% of children with 22q11.2 deletion syndrome.Three genes in chromosome 22q11.2 ( TBX1,CRKL,and ERK2 ) have been identified whose haploinsufficiency causes anomalies of 22q11.2 deletion.The most common diseases are conotruncal anomalies,which include tetralogy of Fallot ( TOF),pulmonary atresia with ventricular septum defect (PA-VSD),truncus arteriosus,and interrupted aortic arch.In major phenotypes,a high prevalence of the deletion is noted in patients with TOF with pulmonary atresia,TOF associated with pulmonary atresia and major aortopumonary collateral arteries,persistent truncus arteriosus,and type B interruption of aortic arch.In minor phenotypes,right aortic arch,aberrant subclavian artery,and major aortopulmonary collateral arteries are frequently associated with cardiovascular anomalies associated with 22q11.2 deletion.In conclusion,conotruncal anomaly associated with aortic arch and branch anomalies should increase the suspicion of 22q11.2 deletion.
3.Effects of TSA on Cerebral ischemia/reperfusion injury via JAK/STAT signal pathway in rats
Zhen JIA ; Zewei ZHANG ; Qiang GAO
Chinese Journal of Emergency Medicine 2014;23(2):174-177
Objective To investigate the protective effect of trichostatin-A (TSA) on cerebral ischemia/reperfusion injury via Janus kinase/signal transducer and activator of transcription (JAK/STAT) signal pathway.Methods 36 male SD rats were randomly (random number) divided into 3 groups:shamoperated group,ischemia/reperfusion (I/R) group and TSA group.Rat model of middle cerebral artery occlusion/reperfusion (MCAO) was established using a modified filament method.No occlusion was applicated to the sham-operated group.TSA group was injected with TSA 0.05 mg/kg via penile vein,20 minutes before operation.Reperfusion was carried out 24 hours after modeling.Longa 5 score was used to assess the neurological function,and TTC staining was applied to calculate the percentage of cerebral infarction area,The expression of JAK2 and p-JAK2 proteins was detected by Elisa.Results The low expression of JAK2 was observed in each group,and there was no statistical difference between groups (P =0.266).Compared with I/R group,TSA group had lower score in cerebral ischemia-reperfusion injury assessment (P=0.019),smaller area of cerebral infarction (P <0.01),reduced expression of p-JAK2 (P =0.009),all of which were of significant difference.Condusions TSA can reduce the cerebral ischemia/reperfusion injury via JAK/STAT signal pathway by down regulating p-JAK2 expression.
4.EFFECT OF STEAM-HEATED PROCEDURE ON IMMUNOGENICITY OF MAJOR SOYBEAN ANTIGENIC PROTEINS IN WHOLE FAT SOYBEAN
Zewei SUN ; Guixin QIN ; Qinghua ZHANG
Acta Nutrimenta Sinica 2004;0(06):-
Objective: To study the effect of steam-heated procedure on immunogenicity of major antigenic proteins in soybean. Method: Twelve newborn calves were randomly divided into 3 groups (Group A, B and C). Each group of the calves were fed on the diets containing raw soybean flour, heated soybean flour and whole milk, respectively. The glycicin, ?-conglycinin and neighbor collection as antigens, antibodies specific to soy allergens were detected by ELISA. Results: (1) The weight gain was A
5.Nine cases of children with ventricular septal defect performed super minimally invasive trans intercostal device closure
Zewei ZHANG ; Weiwei TU ; Qiang GAO
Journal of Chinese Physician 2015;17(2):166-168
Objective To introduce the super minimally invasive transintercostal device closure of ventricular septal defect (VSD) and summarize it's therapeutic effect.Methods Nine patiens with VSD from August 2014 to December 2014 in our hospital were enrolled,which performed super minimally invasive transintercostal device closure of VSD.All patients were followed up prudently post-operation.Echocardiography was scheduled according to the protocol.Results All cases were successfully occluded.There was no death case in the peri-operation period and severe complications after operation.Conclusions The super minimally invasive transintercostal device closure of VSD is safe and reliable.
6.The effect of diltiazern on patency rate of arteriovenous anastomosis in rat and how it works
Qiang GAO ; Changjiang YU ; Zewei ZHANG
Chinese Journal of Thoracic and Cardiovascular Surgery 2014;30(10):622-623,631
Objective This study was designed to study the effect of Diltiazem on patency rate of arteriovenous anastomosis in rat and how it works.Methods 24 SD rats were divided into control group and experimental group,12 rats in each group.Experimental group rats were gavaged with Diltiazem after vascular anastomosis.Control group rats were gavaged with water.By comparing the patency rate and the thickness of artery to make sure whether Diltiazem will affect the patency rate.;By comparing the clotting time,prothrombin time,artial thromboplastin time,and serum thromboxane B2 levels to explore the pathway of diltiazem.Results The patency rate was 75% in the experimental group and 25% in control group.Compared with the control group,experimental group venous blood vessels in the film segment was significantly thicker,clotting time was prolonged,TXB2 levels in blood was decreased,the differences were statistically significant(P < 0.05).There were no significant difference in prothrombin time and partial thromboplastin between two groups (P > 0.05).Conclusion Diltiazem can inhibit the secretion of TXB2,antagonize the effct of antiplatelet,and increase the patency rate of vascular anastomosis in rats.
7.The clinical significance of calcitonin gene related peptide(CGRP) level and gene sequence in congenital heart disease with pulmonary hypertension
Zewei ZHANG ; Jing YE ; Jianhua LI ; Lijun JIANG ; Zhan GAO
Chinese Journal of Emergency Medicine 2006;0(03):-
Objective To investigate the clinical significance of CGRP level and gene sequence in congenital heart disease(CHD)with pulmonary hypertension.Methods The level of serum CGRP was tested by radioimmunoassy in 36 children with left to right shunt CHD,including 29 children with different severity of pulmonany hypertension(PH).Echo cardiography pulse wave Doppler tested the ratio of the pulmonary and systemic arterial pressure.The exon 5 in CGRP gene was directly sequenced in these patients. Results There were significant differences in serum levels of CGRP between the patients with mild PH and control group.The levels of serum CGRP were significantly decreased in patients with moderate or severe PH.There was significant negative line correlation between the levels of CGRP and pulmonary pressure.Base mutation were not found in the exon 5 in CGRP gene.Conclusion The CGRP might be involved in the pathophysiologic process of pulmonary hypertension in CHD.There is no gene expression polymorphism in encode sequence in CHD patients with pulmonary hypertension.
8.Respiratory syncyital virus infection in the early period after open-heart surgery in pediatric patients: impacts on the postoperative course and treatment outcome
Jiajie FAN ; Linhua TAN ; Zewei ZHANG ; Xiongkai ZHU
Chinese Journal of Emergency Medicine 2009;18(11):1198-1202
Objective To summzarize the impacts of respiratory syncytial virus (RSV) infection in the early period(< 72 h) on the postoperative course after open-heart surgery in pediatric patients, and to discuss the expe-riences on therapeutic strategies. Method From March 2005 to March 2008, 39 patients diagnosed to be RSV in-fection confmned by RSV antigen test were prospectively enrolled into RSV-infeetion group. Anoth.er 39 patients were randomly 1 : 1 matched with age and same type of congenital heart disease (CHD) during the same period who also underwent open-heart surgery without RSV infection (nonRSV-infection group) as control group. The medical records of these patients were retrospectivdy reviewed. The duration of mechanical ventilation (MV), length of ICU stay and hospital stay were compared between the two groups with Paired Student's t test. Meanwhile Fisher' s exact test was used to compare the differences in noninvasive positive pressure ventilation, incidence rate of re-intubafion and severe postoperative complications between groups. Patients in both groups were further divided into subgroups aceonting to differences in age, cyanosis and pulmonary arterial pressure in order to identify the dif-ferent impacts of RSV infection in patients in different settings. Results All the patients were survived and dis-charged home. RSV infection significantly prolonged the duration of MV, ICU and hospital stay (all P < 0. 05).In addition, it significantly increased the incidence of pulmonary atelectasis (P < 0.05). In patients under 6 months old, RSV infection resulted in prolongation of MV, ICU and hospital stay (all P <0.05); furthermore, it significantly increased the incidence of complications of low cardiac output syndrome and bacteria co-infection (both P = 0.05). In patients over 24 months, RSV infection had no significant impacts in all the parameters which are compared between the two groups. In patients with cyanotic CHD, RSV infection significantly prolonged the duration of MV, ICU stay and hospital stay (all P < 0.05). In patients with cyanotic CHD, RSV infection significantly prolonged the duration of ICU stay and hospital stay (P <0.05). In patients with pulmonary hyper-tension, RSV infection significantly prolonged the duration of MV, ICU and hospital stay(all P <0.05), and in-creased the incidence rate of concomitant infection (P < 0.05). However, in patients without pulmonary hyper-tension, RSV infection only significantly increased the length of hospital stay (P < 0.05). Conclusions RSV in-fection in the early period after open-heart surgery in pediatric patients has significant adverse impacts on the post-operative course, especially in those patients under 6 months old, patients with pumonary hypertension or cyanotic CHD. Early diagnosis, and effective circulatory and respiratory support,alone with antivirus results in a satisfied outcome.
9.Study on Anti-tumor Activities & Tumor Radio-sensitivity of 17a?-D-Homo-Ethynylestradiol-3-Acetate
Zewei ZHOU ; Liang'An ZHANG ; Xiu SHEN ; Al ET ;
Journal of Medical Research 2006;0(08):-
Objective The paper reports anti-tumor activities and tumor radio-sensitivity research of the novel Estrogen compound 17a?-D-Homo Ethynylestradiol-3-Acetate to U_ 14 and S_ 180 sarcomas;and overall test high-activity and low toxicity traits of 17a?-D-Homo Ethynylestradiol-3-Acetate by the indexes of thymus gland,spleen,etc.Methods The mouse cervical cancer U_ 14 was selected and implanted in IRM-2 mice for anti-tumor assay,and sarcoma S_ 180 was selected for tumor radio-sensitivity assay,the drug was administered to all mice by i.v.way.Results 17a?-D-Homo Ethynylestradiol-3-Acetate has obvious anti-tumor activity to U_ 14 tumor,the best inhibitory rates is U_ 14 64.3%,and17a?-D-Homo Ethynylestradiol-3-Acetate has hardly any influence to hematogenous system(spleen index),immune system(thymus index);Nevertheless,the positive control drug CCP has obvious damage to spleen index and thymus index(P
10.Clinical features and correlation between radiographic parameters and incidence of calcaneal spur
Qing ZHANG ; Nan JIANG ; Weiran HU ; Zewei YU ; Xiang ZHANG ; Bin YU
Chinese Journal of Orthopaedic Trauma 2016;18(6):487-492
Objective To analyze the clinical features and the correlation between radiographic parameters and incidence of calcaneal spur in the patients from Nanfang Hospital,Southern Medical University,China.Methods Three experienced observers independently used the image acquisition and transmission system (PACS) to collect the data of lateral and axial X-ray images of calcaneus or ankle joint in neutral position from the patients with calcaneal spur and normal controls who had undergone radiological examination in Nanfang Hospital,Southern Medical University from July 2014 through December 2015.Ten radiological parameters of the foot (B(o)hler angle,Gissane angle,calcaneal inclination angle,talocalcaneal angle,talus horizontal angle,posterior facet inclination angle,calcaneal length,height of the posterior facet,absolute foot height,and calcaneal width) were measured in both the patients and normal controls.The location,morphology and length of calcaneal spurs were compared between genders,sides and age groups.Results A total of 216 parpatients were included in the study.Female patients were more than male ones,simple plantar spurs more than simple achilles tendon ones,type B spurs more than type A ones,the length of achilles tendon spurs larger than that of plantar ones,female plantar spurs more than males ones,and the length of right foot plantar spurs larger than that of left foot ones.All the differences above were statistically significant (P < 0.05).There were no significant differences in the location,morphology or length of calcaneal spurs between the age group of ≤ 60 years old and the age group of > 60 years old (P > 0.05).The incidence of calcaneal spur were significantly correlated to Gissane angle (P =0.000,OR =0.944,95% CI 0.917-0.973),posterior facet inclination angle (P=0.017,OR=0.957,95% CI 0.924-0.992) and height of the posterior facet (P =0.007,OR =0.933,95% CI O.886-0.981).Conclusions Calcaneal spur favored more females than males.Plantar spurs were more common than Achilles ones.Plantar spurs of Type B were more common than those of Type A.Achilles spurs were longer than plantar ones.More females suffered plantar spur than males.Right foot spurs were longer than left foot ones.Age had no significant influence on the spur characteristics.The incidence of spur might have been related to the Gissane angle,posterior facet inclination angle and height of the posterior facet of the foot.