Objectives::The aim of this multicenter, prospective, single-arm pilot study (ClinicalTrials.gov number: NCT05040074) was to observe the procedural and 30-day results of the novel transcatheter mitral valve repair system, SQ-Kyrin ?-M Clip (Shenqi Medical, Shanghai, China), in patients with severe mitral regurgitation (MR). Methods::The heart team considered patients from 5 centers in China with clinically significant functional mitral regurgitation ≥3+ despite optimal medical therapy or degenerative mitral regurgitation ≥3+ with high surgical risk as candidates for transcatheter repair. All patients received transcatheter edge-to-edge mitral valve repair under general anesthesia. The primary outcome was technical success, which included all of the following measured at the exit from the catheterization laboratory: (1) absence of procedural mortality; (2) successful access, delivery, and retrieval of the device delivery system; (3) successful deployment and correct positioning of the first intended device; and (4) no emergency surgery or reintervention related to the device or access procedure. The secondary outcomes included all-cause mortality, serious adverse events, device success, and procedural success 30 d after the intervention.Results::From June 2021 to December 2021, 18 patients were enrolled in this study with age (75.7 ± 7.4) years. Fifteen patients had MR 4+, while 3 had MR 3+. Technical success was achieved in all patients, including 6 degenerative mitral regurgitation and 12 functional mitral regurgitation patients. There was no all-cause mortality at 30 d. One patient had single leaflet device attachment within 30 d, which was regarded as a serious adverse event, and the patient was successfully treated with reintervention by implanting another clip. Another patient’s transmitral gradient was 6 mmHg (>5 mmHg), with an effective orifice area of 2.57 cm 2 after the procedure. Sixteen patients had device success and procedural success at 30 d postoperation. Fourteen patients had MR 1+, 3 had MR 2+, and only 1 patient had MR 3 + 30 d after the procedure. Conclusions::The results of this feasibility study showed the efficacy and safety of the SQ-Kyrin ?-M device in the Chinese population with severe MR, laying a solid foundation for a subsequent large-scale confirmatory study.

Objectives::The aim of this multicenter, prospective, single-arm pilot study (ClinicalTrials.gov number: NCT05040074) was to observe the procedural and 30-day results of the novel transcatheter mitral valve repair system, SQ-Kyrin ?-M Clip (Shenqi Medical, Shanghai, China), in patients with severe mitral regurgitation (MR). Methods::The heart team considered patients from 5 centers in China with clinically significant functional mitral regurgitation ≥3+ despite optimal medical therapy or degenerative mitral regurgitation ≥3+ with high surgical risk as candidates for transcatheter repair. All patients received transcatheter edge-to-edge mitral valve repair under general anesthesia. The primary outcome was technical success, which included all of the following measured at the exit from the catheterization laboratory: (1) absence of procedural mortality; (2) successful access, delivery, and retrieval of the device delivery system; (3) successful deployment and correct positioning of the first intended device; and (4) no emergency surgery or reintervention related to the device or access procedure. The secondary outcomes included all-cause mortality, serious adverse events, device success, and procedural success 30 d after the intervention.Results::From June 2021 to December 2021, 18 patients were enrolled in this study with age (75.7 ± 7.4) years. Fifteen patients had MR 4+, while 3 had MR 3+. Technical success was achieved in all patients, including 6 degenerative mitral regurgitation and 12 functional mitral regurgitation patients. There was no all-cause mortality at 30 d. One patient had single leaflet device attachment within 30 d, which was regarded as a serious adverse event, and the patient was successfully treated with reintervention by implanting another clip. Another patient’s transmitral gradient was 6 mmHg (>5 mmHg), with an effective orifice area of 2.57 cm 2 after the procedure. Sixteen patients had device success and procedural success at 30 d postoperation. Fourteen patients had MR 1+, 3 had MR 2+, and only 1 patient had MR 3 + 30 d after the procedure. Conclusions::The results of this feasibility study showed the efficacy and safety of the SQ-Kyrin ?-M device in the Chinese population with severe MR, laying a solid foundation for a subsequent large-scale confirmatory study.

Objective To investigate the factors related to the occurrence of in-stent restenosis (ISR) after percutaneous coronary drug-eluting stent (DES) implantation. Methods A total of 258 consecutive patients with coronary angiography confirmed ISR that occurred at least one year after coronary sirolimus-eluting stent implantation, who were encountered at the Affiliated Ruijin Hospital of Shanghai Jiaotong University during the period from September 2010 to September 2014 , were collected as ISR group; and other 260 age-and sex-matched patients with no ISR at least one year after coronary sirolimus-eluting stent implantation, who were encountered at the same hospital and during the same period, were collected as the control group. The clinical characteristics, biochemical measurements, postoperative medications, left ventricular ejection fraction (LVEF), and coronary interventional features were determined;using multivariate logistic regression analysis the independent factors related to the occurrence of ISR were evaluated. Results Compared to the control group, in ISR group the history of previous myocardial infarction , presence of diabetes mellitus and cigarette smokers were more often seen; serum levels of high-sensitivity C-reactive protein(hs-CRP), glycosylated hemoglobin, low-density lipoprotein cholesterol (LDL-C)and apoliprotein B in ISR group were significantly increased (P<0.05), while LVEF was decreased (P<0.05). Although the number of coronary lesions and the site of stent implantation were quite similar in both groups , the stents used in ISR group were smaller and longer (P<0.05), and bifurcation stenting procedure was more employed in ISR group (P<0.05). Multivariate Logistic regression analysis revealed that the history of previous myocardial infarction, diabetes, cigarette smoking, elevated serum hs-CRP and LDL-C levels, and longer stent length were independent risk factors for the occurrence of ISR, whereas stent diameter and LVEF bore a negative correlation with ISR. Conclusion The occurrence of ISR after coronary sirolimus-eluting stent implantation is related to multiple clinical and coronary angiographic and interventional factors. Effective control of risk factors of coronary heart disease and improvement of left ventricular function play an important role in preventing ISR, especially for the patients who has small vessel disease, and in whom longer stents are employed and bifurcation stenting procedure is carried out.

BACKGROUNDCollaterals to occluded infarct-related coronary arteries (IRA) have been observed after the onset of acute ST-elevation myocardial infarction (STEMI). We sought to investigate the impact of early coronary collateralization, as evidenced by angiography, on myocardial reperfusion and outcomes after primary percutaneous coronary intervention (PCI).

METHODSAcute procedural results, ST-segment resolution (STR), enzymatic infarct size, echocardiographic left ventricular function, and major adverse cardiac events (MACE) at 6-month follow-up were assessed in 389 patients with STEMI undergoing primary PCI for occluded IRA (TIMI flow grade 0 or 1) within 12 hours of symptom-onset. Angiographic coronary collateralization to the occluded IRA at first contrast injection was graded according to the Rentrop scoring system.

RESULTSLow (Rentrop score of 0 or 1) and high (Rentrop score of 2 or 3) coronary collateralization was detected in 329 and 60 patients, respectively. Patients with high collateralization more commonly had prior stable angina and right coronary artery occlusion, but less often had left anterior descending artery occlusion. At baseline, these patients presented with less extent of ST-segment elevation and lower serum levels of creatine kinase myocardial band (CK-MB) and cardiac troponin I (cTnI). Procedural success rate, STR, corrected TIMI flame count, and area under the curve of CK-MB and cTnI measurements after the procedure were similar between patients with high collateralization and those with low collateralization (for all comparisons P > 0.05). There were no differences in left ventricular ejection fraction and rates of MACE at 6 months according to baseline angiographic collaterals to occluded IRA.

CONCLUSIONSIn patients with acute STEMI undergoing primary PCI within 12 hours of symptom-onset, coronary collateralization to the occluded IRA was influenced by clinical and angiographic features. Early recruitment of collaterals limits infarct size at baseline, but has no significant impact on myocardial reperfusion after the procedure and subsequent left ventricular function and clinical outcomes.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Angioplasty, Balloon, Coronary ; Coronary Angiography ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; diagnostic imaging ; therapy ; Treatment Outcome ; Young Adult

Objective To study the sleep improvement function of DHA-PC.Methods The mice were randomly divid-ed into control, vehicle, DHA+Lecithin (60+200 mg/kg) and DHA-PC(50,100,200 mg/kg) groups.Ten mice were enrolled in each group .The mice of control were administered with normal food , the vehicle group was orally given normal saline at the dosage of 0.2 ml/10 g, while both DHA-PC and DHA+Lecithin were orally given corresponding drugs at the dosage of 0.2 ml/10 g.All the groups were treated for 30 days except control group .The direct sleep-inducing test, the test of lengthening sleep time induced by pentobarbital sodium , the test of pentobarbital sodium subthreshold-hypnosis and the test of barbital sodium sleep latency were conducted to observe the inductive effect of DHA -PC.Results Neither the effect on mice body mass nor directly-induced sleep was observed .DHA-PC (50,100, and 200 mg/kg) could prolong sleep time to (56.2 ±13.7),(57.9 ±25.4) and(64.1 ±18.4) min, respectively,compared to vehicle(32.9 ±10.8)min (P<0.05).DHA+Lecithin could not prolong sleep time (38.6 ±11.7)min compared to (32.9 ±10.8)min of vehicle.There was significant difference compared with DHA-PC at the dosage of 200 mg/kg (64.1 ±18.4)min (P<0.05).DHA-PC (200 mg/kg) enhanced pentobarbital sodium subthreshold-hypnosis (70%) compared to vehicle (10%) (P<0.05),so did DHA+Lecithin (60%) compared to vehicle (10%) (P<0.05).Both DHA-PC (200 mg/kg)[(22.9 ±4.1)min ] and DHA+Lecithin [(19.5 ±2.7) min ]could shorten sleep latency compared to vehicle (31.3 ±6.9) min(P<0.01), and the sleep latency of DHA +Lecithin (19.5 ±2.7) min was shorter than that of DHA-PC(50,100 mg/kg).Conclusion DHA-PC has some effect some sleep improvement in mice .

Objective To explore the effects of expression of thioredoxin-2(Trx-2) suppressed by small interference RNA(SiRNA) in A549 cells exposed to hyperoxia on expression of nicotinamide adenine dinucleotide(NADH) dehydrogenase subunit 1(ND1)and cytochrome C oxidase Ⅰ(COX Ⅰ). Methods A549 cells were gained by serial subcultivation in vitro and transfered with synthetic Trx-2 sequence-specific SiRNA and then were randomly divided into air group without interference,hyperoxia group without interference,air group after interference,and hyperoxia group after interference.After exposure to oxygen or room air for 12,24 and 48 h,expressions of Trx-2,ND1 and COX Ⅰ mRNA of these cells were detected by reverse transcription-polymerase chain reaction (RT-PCR),and Trx-2 protein was detected by Western blot. Results (1)Sequence-specific SiRNAtargeting Trx-2 could significantly down-regulate its expression in A549 cells.(2)Trx-2 mRNA levds inhyperoxia group without interference at 24 h was higher than those in air group without interference(0.7799±0.1249 VS 0.4424±Ⅰ.1140,P<0.05).Th-2 mRNA levels in hyperoxia group after ireedcrence at 24 hand 48 h were 0.2774±0.0174 and 0.2587±0.0069,lower than those in air group after interference andhyperoxia group without interference (P<0.05).(3)ND1 mRNA levels in hyperoxia group without interference at 24 h was 0.6609±0.0368,lower than those in air group without interference(0.8898±0.1049)(P<0.05).ND1 mRNA levels in hyperoxia group after interference at 12 h was 0.8848±0.0135,higher than those in air group after imederence(P<0.05).ND1 mRNA levels in hypemxia group afterinterference at 48 h was 0.3808±0.0937,lower than those in air group after imerference and hyperoxiagroup without interference(P<0.05).(4)COXI mRNA levels in hypemxia group without inteference at 12,24 and 48 h were 1.7313±0.4331,2.1929±0.6722 and 2.0754±0.2584,higher than those in air group witheUt interference,respectively (P<0.05). Conclusions ND1 and COXⅠ participate in thedevelopment of hyperoxia indUCed lung.injury,and Trx-2 is likely to have protective effect on mitochondria ofA549 cells in hyperoxia lung injury.

Objective To explore the relationship between CRP and glucose metabolism in advanced solid tumor patients. Methods 32 advanced stage malignant tumor patients with mild pain took celecoxib 200mg/qd orally, the plasma level of CRP, FBS, FINS, IR were measured before taking drug and 5 days later. Results CRP is well related with FINS, IR, P level, CRP[(8.17?1.76) mg/L vs (4.37?0.65) mg/L], P(876?123)pmol/L vs (621?145) pmol/L], FINS[(14.23?7.21) ?U/L vs (9.83?3.37) ?U/L] and IR [(3.2?1.01) vs (1.9?0.78)] all were improved significantly after taking celecoxib. Conclusion CRP has some relationship with abnormal glucose metabolism in advanced stage malignant tumor patients, taking celecoxib may improve this abnormal glucose metabolism.

[Objective] To explore the methods of avoiding hemolysis in preparing serum complements of guinea pigs. [Methods] In method 1, the serum of 8 guinea pigs was fixed first and then sheep red blood cells (SRBC) were added to the mixed serum for absorption. In method 2, SRBC was added to the serum of 8 guinea pigs respectively for absorption first and then the serum containing SRBC was mixed. After the experiment, macroscopic examination was carried out to observe the hemolysis and the optical density of the two kinds of mixture was detected at the wavelength of 540 nm. [ Results] In the serum complements of guinea pigs prepared by method 1, macroscopic hemolysis occurred; in the serum complements prepared by method 2, macroscopic hemolysis was not obvious and the optical density of the mixture was lower than that by method 1 ( P