Objective:To investigate the relationship between the changes in extracellular vesicles (EVs) size distribution before and after cardiopulmonary bypass (CPB) cardiac surgery and postoperative coagulation function.Methods:A total of 103 patients undergoing cardiac surgery with CPB were enrolled. Venous blood samples were collected at preoperation, postoperative 12 h and 3 days. Additionally, 50 age- and gender-matched healthy volunteers served as a control group. EVs were isolated using gradient centrifugation, and their size distribution was assessed by dynamic light scattering (DLS). The relationship between EV size characteristics, including peak diameter, peak height, and interquartile range( IQR), and postoperative coagulation function was analyzed. Results:Compared to patients with normal postoperative coagulation function, those with postoperative coagulation dysfunction had lower size at peak and IQR, and significantly higher peak intensity. Logistic regression analysis indicated that elevated peak intensity and lower size at peak and IQR were risk factors for coagulation dysfunction. The area under the curve ( AUC) for diagnosing coagulation dysfunction with 12 h postoperative EVs peak intensity was 0.76, with a positive predictive value of 85% at the optimal cutoff of 8.2; the AUC for IQR was 0.84, with a sensitivity of 83%, specificity of 82%, and negative predictive value of 86% at the optimal cutoff of 125.05 nm. Conclusion:The size distribution of circulating EVs show a correlation with coagulation function after cardiac surgery with CPB and may serve as a novel biomarker to predict postoperative coagulation dysfunction.

Objective:To investigate the relationship between the changes in extracellular vesicles (EVs) size distribution before and after cardiopulmonary bypass (CPB) cardiac surgery and postoperative coagulation function.Methods:A total of 103 patients undergoing cardiac surgery with CPB were enrolled. Venous blood samples were collected at preoperation, postoperative 12 h and 3 days. Additionally, 50 age- and gender-matched healthy volunteers served as a control group. EVs were isolated using gradient centrifugation, and their size distribution was assessed by dynamic light scattering (DLS). The relationship between EV size characteristics, including peak diameter, peak height, and interquartile range( IQR), and postoperative coagulation function was analyzed. Results:Compared to patients with normal postoperative coagulation function, those with postoperative coagulation dysfunction had lower size at peak and IQR, and significantly higher peak intensity. Logistic regression analysis indicated that elevated peak intensity and lower size at peak and IQR were risk factors for coagulation dysfunction. The area under the curve ( AUC) for diagnosing coagulation dysfunction with 12 h postoperative EVs peak intensity was 0.76, with a positive predictive value of 85% at the optimal cutoff of 8.2; the AUC for IQR was 0.84, with a sensitivity of 83%, specificity of 82%, and negative predictive value of 86% at the optimal cutoff of 125.05 nm. Conclusion:The size distribution of circulating EVs show a correlation with coagulation function after cardiac surgery with CPB and may serve as a novel biomarker to predict postoperative coagulation dysfunction.

Aortic root enlargement or aortic annulus enlargement is one of the key strategies for managing the small aortic root or small aortic annulus. Surgeons may be conservative about the risks of this method, which has limited the application in clinical surgery. Recent large clinical studies have shown that aortic root enlargement does not increase the risk of surgery and is a safe surgical procedure. This article reviews the methods of aortic root enlargement surgery including new aortic root enlargement surgery-aortic root enlargement with replacement of the noncoronary sinus with a patch and clinical outcome, which aims to provide a guidance for clinical practice.

High density lipoprotein cholesterol ( HDL-C) has received extensive attention because of its cardiovascular protective effects.Recent studies showed that HDL could promote reverse cholesterol transport ( RCT ) , be anti-inflammatory and antioxidant, and induce angiogenesis. Apolipoptrotein A-I (apoA-I), the most abundant protein of HDL, plays a pivotal role in the HDL mediated-functional activities.Short peptides based on the amphiphilic alpha helix structure of apoA-I have been designed and aimed at imitating the function of apoA-I.The function and metabolism of these mimetic peptides depend on their amino acids component and sequence , and have been proved to exert protection in against cardiovascular disease , infection, inflammation and oxidative damage, metabolic syndrome and tumor.Clinical trials confirmed their benefits, but high cost put them out of the practical applications..

ObjectiveTo investigate the role of iNOS in the middle and late stage of pulmonary hypertension (PH) and the effect of L-Arginine(L-Arg) on these stage.MethodsThirty healthy male SD rats were randomly divided into five groups.All rats except those in control group were injected intraperitoneally (ip) with a single dose (50 mg/kg) of MCT to induce PH.Then the L3 and L5 groups were injected ip with 500 mg/kg L-Arg daily for 3 weeks and 5weeks respectively,the M3 and M5groups received a daily ip injection of the same amount of saline as L-Arg for 3 weeks and 5 weeks respectively; the same amount of saline was injected ip daily in control group for 5 weeks.Right ventricular systolic pressure(RVSP) was measured before lungs were excised for immunohistochemistry at the end of experiments. ResultsThe expressions of iNOS and elastin in M3 and M5 were higher compared to the control group,but L-Arg partly reduced the expressions of iNOS and elastin both at 3weeks and 5 weeks post-MCT.The reduction of eNOS expression in L3 and L5 groups were lower compared to M3 and M5 groups,but the eNOS expression in L3 and L5 groups were still lower than control group.ConclusionDuring the middle and late stage of PH,the expression of eNOS was decreased.The expression of iNOS was induced,which would produce numerous NO.However,these NO had no benefit on the development of PH.L-Arg could restore the balance of eNOS and iNOS,and could inhibit the development of PH,which may provide a new clues to explore the pathogenesis and treatment of PH.

Objective To search the way of prolonging xenograft survival of discordant cardiac xenotransplantation.Methods All animals were divided into groups A,B,C and D receiving the following combined therapies respectively:cobra venom factor (CVF) in group A,CVF and pentoxifylline (FTX) in group B,CVF and CCS (CsA,CTX,MP)in group C,CVF,PTX and CCS in group D.The recipients were given CVF 150 μg/kg(i.P) twice daily 1,4 days before transplantation;PTX 50 mg/kg daily(i.P)1 h before transplamtation,then 25 mg/kg(i.P)in an interval of 6 h until rejection thereafter;CsA 10mg/kg(i.p) daily one day and 1 h before transplantation until rejection;CTX 40 mg/kg(i.p) one day before transplantation,then 10 mg/kg(i.P)daily 1 h before transplantation until rejection thereafter;MP 10 mg/kg(i.v)1 h before transplantation,then 1 mg/kg(i.m) daily until rejection thereafter.The expression of vascular cell adhesion molecular-1 (VCAM-1) of vascular endothelial cells (EC) in cardiac xenografts was detected by using immunohistochemical staining method.Results The mean survival time of cardiac xenografts was 57.5 h (group A),77.38 h(group B),79.13 h (group C) and 98.75 h(group D),respectively.Twenty-four h after transplantation.VCAM-1 expression in the groups B and D was not upregulated,but slightly up-regulated in group C and obvious in group A.At rejection,the up-regulation of VCAM-1 expression was mildest in group D and most obvious in group A.and VCAM-1 expression in group B was milder than that in group C (P＜0.05).Conclusions CVF combined with PTX and CCS could significantly prolong the survival time of cardiac xenograft.PTX mainly protected EC and CCS mainly inhibit inflammatory cell infiltration.Combined use of them could complement and reinforce mutually.

Objective To investigate the effect of chronic liver injury on the expression of uridine diphosphate glucuronosyltransferase(UGT) 1A1 mRNA in mice. Methods Chronic liver injury model was induced by feeding CCl 4 in mice.Thirty mice were randomly divided into three groups:control group,experimental group 1(CCl 4 was given for 1 month),and experimental group 2(CCl 4 was given for 2 months).The liver function was tested;and the expression of UGT1A1 mRNA in the 3groups was analysed by RT-PCR. Results There was significant difference in the expression of UGT1A1 mRNA between the 3 groups(P

AIM:To investigate the mechanism of endothelium-derived microparticles(EMP)-induced endothelial dysfunction and the role of superoxide anion(O-?2) in EMP-induced endothelial dysfunction.METHODS:EMP were isolated from human umbilical vein endothelial cells stimulated with plasminogen activated inhibitor-1.(1) Cultured bovine aortic endothelial cells(BAEC) were divided into 3 groups and pretreated with nothing in group 1,EMP(1?108/L) in group 2,EMP(1?108/L) + L-nitroarginiemethylester(L-NAME,1 mmol/L) in group 3 for 30 min and A23187(5 ?mol/L) stimulated O-?2 generation was determined by superoxide dismutase(SOD)-inhibitable ferricytochrome C reduction.(2) Facialis arteries(60-150 microns) were isolated from C57BL/6 mice and divided into 4 groups.The vessels were pretreated with nothing in group 1,EMP(1?108/L) in group 2,EMP(1?108/L) + SOD(2?105 U/L) in group 3,EMP(1?108/L) + polyethylene glycolated-SOD(PEG-SOD,2?105 U/L) in group 4 for 10 min and acetylcholine(ACH)-induced vasodilation was measured.RESULTS:(1) EMP significantly increased O-?2 generation in BAEC culture,which was prevented about 50% by pretreating the BAEC with L-NAME.(2) EMP significantly impaired ACH-induced vasodilation.SOD could not restore EMP-impaired ACH-induced vasodilation and PEG-SOD showed partial restoration of vasodilation.CONCLUSION:These data indicate that at least some EMP-induced endothelial dysfunction occurs by inducing intracellular O-?2 generation.It may provide a theoretical evidences in finding a multiple treatment including removal of O-?2 in the future.