OBJECTIVES: To compare the efficacy of transcatheter tricuspid valve replacement (TTVR) using Lux-Valve and Lux-Valve Plus in patients with severe tricuspid regurgitation. METHODS: A total of 28 consecutive patients with severe tricuspid regurgitation who underwent TTVR with Lux-Valve (n=14) or Lux-Valve Plus (n=14) in the First Affiliated Hospital of the Air Force Medical University from August 2019 to November 2023 were enrolled. Transthoracic echocardiography was performed in all patients before and 6 months after the TTVR. The ultrasound indexes were compared before and 6 months after the TTVR in all patients and between Lux-Valve and Lux-Valve Plus groups. RESULTS: Compared with the Lux-Valve group, the Lux-Valve Plus group showed significantly reduced intraoperative bleeding and shorter postoperative hospital stays (both P<0.05). Six months after the TTVR, none of the patients exhibited more than a mild tricuspid valve regurgitation, and none of the patients had moderate or above perivalvular leakage except for one patient in the Lux-Valve Plus group who had a separation of the clamping member from the anterior tricuspid leaflet. The incidence of perivalvular leakage was significantly lower in the Lux-Valve Plus group (14.29%, 2/14) than in the Lux-Valve group (64.29%, 9/14, P<0.05). At 6 months after operation, the right chamber volume and right ventricle middle transverse diameter were reduced (both P<0.05); the peak blood flow velocity across the tricuspid valve, peak pressure gradient across the tricuspid valve, mean blood flow velocity of tricuspid valve, mean pressure gradient across the tricuspid valve and velocity time integral were increased in both groups (all P<0.05).Compared with the Lux-Valve group, the Lux-Valve Plus group showed higher left ventricular ejection fraction at 6 months postoperatively (P<0.05), while the rest of the indicators were not statistically different (all P>0.05). CONCLUSIONS The efficacy of using Lux-Valve and Lux-Valve Plus for TTVR in patients with severe tricuspid regurgitation is comparable. Six months after the TTVR, the right side of the heart has undergone reverse remodeling.While Lux-Valve Plus offers greater minimally invasive benefits, valve selection should consider device-specific characteristics and differences in individual patients.
Humans ; Tricuspid Valve Insufficiency/surgery* ; Male ; Female ; Heart Valve Prosthesis Implantation/methods* ; Middle Aged ; Aged ; Tricuspid Valve/surgery* ; Heart Valve Prosthesis ; Treatment Outcome ; Echocardiography ; Adult ; Cardiac Catheterization/methods*

OBJECTIVES: To investigate the application of transesophageal echocar-diography assessment for mitral valve in patients with atrial septal defects undergoing repair surgery. METHODS: The study group comprised of thirty-two adult patients with atrial septal defect who underwent thoracoscopic repair surgery at the First Affiliated Hospital of the Air Force Medical University from March to September 2022. Two-dimensional and real-time three-dimensional transesophageal ultrasonography of the mitral valve were performed after anesthesia. The parameters of the mitral valve structure at the late diastolic and late systolic stages were recorded, including anteroposterior and left-right annular diameters, anterior and posterior valves lengths, the vertical distance from the coaptation point of leaflet zone 2 during systole to the annular plane (mitral valve coaptation depth) and mitral valve coaptation length. Data from 32 patients with normal intracardiac structure and no mitral valve regurgitation (control group) were also collected and compared with those of the study group. Concurrent mitral valvoplasty was performed during the atrial septal defect repair surgery for 7 patients with significant mitral valve structural abnormalities and 2 patients with significantly increased mitral regurgitation after cardiac resuscitation. The study group was followed up with transthoracic echocardiography for 2 years postoperatively. RESULTS: In the study group, 26 (81.3%) patients had varying degrees of mitral valve morphological abnormalities. Among them, 10 (31.3%) patients had short mitral valve coaptation length or depth, 12 (37.5%) patients had closure point malposition, and 4 (12.5%) patients had different bulge of anterior and posterior leaflets. Compared with the control group, the study group had significantly smaller systolic and diastolic mitral left-right annular diameter, mitral posterior valves lengths, mitral coaptation length or depth (all P<0.05), a higher pulmonary systemic flow ratio (P<0.01), and a lower maximum blood flow velocity across the mitral valve (P<0.05). After 2 years of follow-up, among the 9 patients who underwent concurrent mitral valvoplasty, the mitral valve maintained no or little regurgitation, and the average mitral valve pressure difference was less than 5 mmHg (1 mmHg=0.133 kPa). Among the 23 patients without concurrent mitral valvoplasty, 2 patients had moderate regurgitation 1 year after surgery, with a pulmonary/systemic flow ratio larger than 2.8. CONCLUSIONS Patients with large atrial septal defects often have abnormal mitral valve structure. Therefore transesophageal echocardiography is recommended for mitral valve assessment during the surgery. If significant mitral valve structural abnormalities are detected, concurrent mitral valvoplasty is recommended.
Humans ; Heart Septal Defects, Atrial/diagnostic imaging* ; Echocardiography, Transesophageal/methods* ; Mitral Valve/surgery* ; Adult ; Female ; Male ; Middle Aged ; Mitral Valve Insufficiency/diagnostic imaging*

OBJECTIVES: To investigate the mechanism mediating the regulatory effect of miR-155-5p on proliferation of human submandibular gland epithelial cells (HSGECs) in primary Sjogren's syndrome (pSS). METHODS: Dual luciferase reporter assay was used to verify the targeting relationship between miR-155-5p and the PI3K/AKT pathway. In a HSGEC model of pSS induced by simulation with TRAIL and INF-γ, the effects of miR-155-inhibitor-NC or miR-155 inhibitor on cell viability, cell cycle, apoptosis and proliferation were evaluated using CKK8 assay, flow cytometry and colony formation assay. ELISA and RT-PCR were used to detect the expressions of inflammatory cytokines and miR-155-5p mRNA in the cells; Western blotting was performed to detect the expressions of proteins in the PI3K/AKT signaling pathway. RESULTS: Dual luciferase assay showed that miR-155-5p targets the PI3K/AKT pathway via PIK3R1 mRNA. The HSGEC model of pSS showed significantly decreased cell viability, cell clone formation ability and expressions IL-10 and IL-4 and increased cell apoptosis, cell percentage in G2 phase, expressions of TNF‑α, IL-6, miR-155-5p and PIK3R1 mRNA, p-PI3K/PI3K ratio, p-Akt/AKT ratio, and PIK3R1 protein expression. Treatment of the cell models with miR-155 inhibitor significantly increased the cell viability, G1 phase cell percentage, colony formation ability, and expressions of IL-10 and IL-4 levels, and obviously reduced cell apoptosis rate, G2 phase cell percentage, expressions of TNF-α, IL-6, miR-155-5p and PIK3R1 mRNA, p-PI3K/PI3K ratio, p-AKT/AKT ratio, and PIK3R1 protein expression. CONCLUSIONS In HSGEC model of pSS, inhibition of miR-155-5p can promote cell proliferation and reduced cell apoptosis by targeting PI3K1 mRNA to negatively regulate the overexpression of PI3K/AKT signaling pathway.
Humans ; MicroRNAs/genetics* ; Cell Proliferation ; Signal Transduction ; Proto-Oncogene Proteins c-akt/metabolism* ; Sjogren's Syndrome/pathology* ; Epithelial Cells/cytology* ; Submandibular Gland/cytology* ; Phosphatidylinositol 3-Kinases/metabolism* ; Apoptosis ; Class Ia Phosphatidylinositol 3-Kinase ; Cells, Cultured

Objective To investigate the differences in cortical activation and functional connectivity during speech under different cognitive loads in young individuals.Methods Twenty-one participants(mean age 21.9±1.33 years)were instructed to read short sentences embedded with color words under both congruent(where the color words matched the font color)and incongruent(where the color words did not match the font color)condi-tions.The color words required reading the font color instead of the word itself.Functional near-infrared spectros-copy(fNIRS)was utilized to analyze differences in cortical activation(changes in HbO concentration)and functional connectivity(Pearson correlation of HbO between brain regions)in the dorsolateral prefrontal cortex(DLPFC)and supplementary motor area(SMA)bilaterally.Results The fNIRS results revealed significant increase in HbO con-centration changes in the RDLPFC(t=3.4,P=0.003),LDLPFC(t=2.58,P=0.019),RSMA(t=3.59,P=0.002),and LSMA(t=4.06,P=0.001)under the incongruent condition compared to the congruent condition.Additionally,there was a significant enhancement in the correlation between RDLPFC and LDLPFC(t=2.44,P=0.025).However,the differences in correlation between left and right SMA,as well as between SMA and DLPFC,were not statistically significant(P＞0.05).Conclusion These findings suggest that during speech under incongru-ent conditions,increased cognitive load leads to elevated cortical activation in the DLPFC and SMA,along with in-creased functional connectivity between the left and right DLPFC.

Objective To investigate the effect of Schisandra chinensis polysaccharide(SCP)on mitochondrial autophagy in skeletal muscle in exercise-fatigue mice based on the nuclear factor erythroid 2-related factor 2(Nrf2)/antioxidant response element ARE pathway.Methods A fatigue mouse model was established by swimming training.Mice were assigned randomly to fatigue,SCP(20 mg/kg),Rhodiola rosea(8 mL/kg),inhibitor(30 mg/kg ML385),and SCP+inhibitor groups,with normal mice as the control group.Serum was separated and levels of lactic acid(LA),lactate dehydrogenase(LDH),blood urea nitrogen(BUN),and creatine kinase(CK)were detected.Liver tissue was also isolated and levels of malondialdehyde(MDA),hepatic glycogen(HG),and superoxide dismutase(SOD)were detected.Skeletal muscle tissues were isolated and muscle glycogen(MG),changes in skeletal muscle tissue in exercise fatigue,and mitochondrial morphology were detected.Gene expression levels of mitochondrial transcription factor A(TFAM)and nuclear respiratory factor-1(NRF-1),and Nrf2,quinone oxidoreductase 1(NQO1),heme oxygenase-1(HO-1),and LC3 protein expression levels were analyzed.Results HG,MG,SOD,TFAM mRNA,NRF-1 mRNA,Nrf2,NQO1,HO-1,and LC3 Ⅱ/LC3 Ⅰ were lower in the fatigue group than in the control group,while levels of LA,BUN,LDH,CK,and MDA were higher than in the control group(P＜0.05).HG,MG,SOD,TFAM mRNA,NRF-1 mRNA,Nrf2,NQO1,HO-1,and LC3 Ⅱ/LC3 Ⅰ levels were higher in the SCP and Rhodiola rosea groups than in the fatigue group,while LA,BUN,LDH,CK,and MDA levels were lower than in the fatigue group(P＜0.05).The above indexes were opposite in the inhibitor group(P＜0.05).Conclusions SCP promotes mitochondrial autophagy in skeletal muscle in exercise-fatigue mice by activating the Nrf2/ARE pathway,effectively exerting anti-fatigue effects.

Objective To investigate the differences in cortical activation and functional connectivity during speech under different cognitive loads in young individuals.Methods Twenty-one participants(mean age 21.9±1.33 years)were instructed to read short sentences embedded with color words under both congruent(where the color words matched the font color)and incongruent(where the color words did not match the font color)condi-tions.The color words required reading the font color instead of the word itself.Functional near-infrared spectros-copy(fNIRS)was utilized to analyze differences in cortical activation(changes in HbO concentration)and functional connectivity(Pearson correlation of HbO between brain regions)in the dorsolateral prefrontal cortex(DLPFC)and supplementary motor area(SMA)bilaterally.Results The fNIRS results revealed significant increase in HbO con-centration changes in the RDLPFC(t=3.4,P=0.003),LDLPFC(t=2.58,P=0.019),RSMA(t=3.59,P=0.002),and LSMA(t=4.06,P=0.001)under the incongruent condition compared to the congruent condition.Additionally,there was a significant enhancement in the correlation between RDLPFC and LDLPFC(t=2.44,P=0.025).However,the differences in correlation between left and right SMA,as well as between SMA and DLPFC,were not statistically significant(P＞0.05).Conclusion These findings suggest that during speech under incongru-ent conditions,increased cognitive load leads to elevated cortical activation in the DLPFC and SMA,along with in-creased functional connectivity between the left and right DLPFC.

Objective To investigate the effect of Schisandra chinensis polysaccharide(SCP)on mitochondrial autophagy in skeletal muscle in exercise-fatigue mice based on the nuclear factor erythroid 2-related factor 2(Nrf2)/antioxidant response element ARE pathway.Methods A fatigue mouse model was established by swimming training.Mice were assigned randomly to fatigue,SCP(20 mg/kg),Rhodiola rosea(8 mL/kg),inhibitor(30 mg/kg ML385),and SCP+inhibitor groups,with normal mice as the control group.Serum was separated and levels of lactic acid(LA),lactate dehydrogenase(LDH),blood urea nitrogen(BUN),and creatine kinase(CK)were detected.Liver tissue was also isolated and levels of malondialdehyde(MDA),hepatic glycogen(HG),and superoxide dismutase(SOD)were detected.Skeletal muscle tissues were isolated and muscle glycogen(MG),changes in skeletal muscle tissue in exercise fatigue,and mitochondrial morphology were detected.Gene expression levels of mitochondrial transcription factor A(TFAM)and nuclear respiratory factor-1(NRF-1),and Nrf2,quinone oxidoreductase 1(NQO1),heme oxygenase-1(HO-1),and LC3 protein expression levels were analyzed.Results HG,MG,SOD,TFAM mRNA,NRF-1 mRNA,Nrf2,NQO1,HO-1,and LC3 Ⅱ/LC3 Ⅰ were lower in the fatigue group than in the control group,while levels of LA,BUN,LDH,CK,and MDA were higher than in the control group(P＜0.05).HG,MG,SOD,TFAM mRNA,NRF-1 mRNA,Nrf2,NQO1,HO-1,and LC3 Ⅱ/LC3 Ⅰ levels were higher in the SCP and Rhodiola rosea groups than in the fatigue group,while LA,BUN,LDH,CK,and MDA levels were lower than in the fatigue group(P＜0.05).The above indexes were opposite in the inhibitor group(P＜0.05).Conclusions SCP promotes mitochondrial autophagy in skeletal muscle in exercise-fatigue mice by activating the Nrf2/ARE pathway,effectively exerting anti-fatigue effects.

Objective To explore the application of the integrated graded diagnosis,treatment and ambulance model based on circulation respiration abdomen motor speech (CRAMS) score in patients with multiple traumas. Methods From March 2023 to March 2024,160 patients with multiple traumas admitted to the department of emergency of Shanghai Sixth People's Hospital were selected as the research subjects. Based on a random number table,the patients were divided into an observation group and a control group,with 80 patients in each group. And the control group received routine emergency treatment,while the observation group was assessed by the intervention team using the CRAMS scoring scale to evaluate the condition,and then implemented an integrated graded diagnosis and treatment model based on the assessment results. The specific measures were as follows:establish an intervention team composed of 1 attending doctor from the emergency resuscitation room,1 head nurse specializing in trauma care,and 3 trauma specialty nurses. The attending doctor was responsible for diagnosing and treating the patient's condition;the head nurse specializes in assessing the patient using the CRAMS scoring scale;the trauma specialty nurses were tasked with implementing interventions for the patient. The CRAMS score,injuy seveity scoe (ISS),triage time,waiting time for treatment,treatment time,complication rate,and patient satisfaction rate were compared between the two groups before and after the intervention. Results There were no significant differences in CRAMS scores and ISS scores between the two groups before intervention. After intervention,the CRAMS score of the observation group was significantly higher than that of the control group (8.85±0.89 vs. 7.52±1.02,P<0.05),while the ISS score was significantly lower than that of the control group (15.98±2.98 vs. 20.77±3.02,P<0.05). The triage time,waiting time for treatment,and treatment time of the observation group were significantly shorter than those of the control group[triage time (minutes):3.25±0.62 vs. 5.89±1.02,waiting time for treatment (minutes):3.02±0.45 vs. 5.78±0.98,treatment time (minutes):45.85±5.23 vs. 65.22±6.41,all P<0.05]. Complication incidence of the observation group was significantly lower than that of the control group[3.75％ (3/80) vs. 12.50％ (10/80),P<0.05],while the satisfaction rate of the observation group was significantly higher than that of the control[93.75％ (75/80) vs. 77.50％ (62/80),P<005]. Conclusion The integrated graded diagnosis and rescue model based on CRAMS scores can improve the treatment efficiency of multiple trauma patients,improve their condition and prognosis,and enhance their satisfaction with treatment.

Objective:To explore the influence of simultaneous integrated boost intensity-modulated radiation therapy (SIB-IMRT) on tumor markers and quality of life after breast-conserving surgery for breast cancer.Methods:Patients after breast-conserving surgery for breast cancer in the Third People' s Hospital of Chengdu were selected from June 2015 to June 2018 as the study subjects. Fifty-five cases with conventional radiotherapy (CRT) were selected and included in control group, and 49 cases with SIB-IMRT were enrolled as observation group. The radiotherapy time and radiotherapy-related adverse reactions, serum tumor markers (β2-microglobulin (β2-MG), carbohydrate antigen 125 (CA125), tissue polypeptide specific antigen (TPS), carbohydrate antigen 153 (CA153)) before radiotherapy and at 6 months after radiotherapy, short-term solid tumor treatment effect at 6 months after radiotherapy and quality of life (progression-free survival (PFS), overall survival (OS)) after 5 years of follow-up were collected in both groups of patients. Measurement data were presented as xˉ± s by t test. Enumeration data were analyzed by χ2 test or Fisher test. Nonparametric rank sum test was used to compare the distribution of ranked data between groups. Results:The radiotherapy time in observation group was shorter than that in control group ((37.46±6.74) d vs (43.63±7.26) d), and the incidence of radiotherapy-related adverse reactions was lower than that in control group (14.29% (7/49) vs 32.73% (18/55))(Statistical values were 4.47 and 4.83, P values were <0.001 and 0.028). At 6 months after radiotherapy, the levels of β2-MG, CA125, TPS and CA153 in observation group were lower compared to control group ((1.25±0.21) mg/L vs (1.86±0.37) mg/L, (15.17±2.56) kU/L vs (18.81±3.13) kU/L, (9.43±1.58) μg/L vs (13.49±2.51) μg/L, (11.75±1.63) kU/L vs (15.46±3.07) kU/L) ( t=10.17, 6.44, 9.73, 7.56; all P<0.01), but there was no statistical significance in disease control rate between the two groups ( P>0.05). The observation group had higher objective remission rate (53.06%(26/49) vs 32.73%(18/55)), and the difference was statistically significant( χ2=4.39, P=0.036). After a 5-year follow-up, 44 patients in the observation group survived (89.80%, 44/49), with an OS of (57.92±11.21) months; 42 patients in the control group survived (76.36%, 42/55), with an OS of (54.05±10.14) months. There was no statistically significant difference between the two groups (both P>0.05). The PFS of the observation group patients was higher than that of the control group ((54.93±10.07) months compared to (50.76±9.95) months), and the difference was statistically significant ( t=2.12, P=0.036). Conclusion:Simultaneous integrated boost intensity-modulated radiation therapy for breast cancer patients undergoing breast-conserving surgery can reduce the levels of serum tumor markers, improve the breast aesthetics, and enhance the short-term and long-term quality of life of patients.