1.Clinical efficacy of total thoracoscopic mitral valve surgery combined with beating-heart tricuspid valvuloplasty under the concept of enhanced recovery after surgery
Lijian HUANG ; Sicong LI ; Xiaomao LONG ; Wei JIANG ; Kequan WEI
Journal of Chinese Physician 2025;27(8):1147-1152
Objective:To evaluate the clinical efficacy of total thoracoscopic mitral valve surgery combined with beating-heart tricuspid valvuloplasty under the concept of enhanced recovery after surgery (ERAS).Methods:Clinical data from the People′s Hospital of Guangxi Zhuang Autonomous Region from January 2012 to January 2024 were collected and analyzed retrospectively. Patients were divided into the non-ERAS group (total thoracoscopic mitral valve surgery combined with beating-heart tricuspid annuloplasty without ERAS intervention) and the ERAS group (the same surgical procedures under the concept of ERAS). Propensity score matching (PSM) was used to reduce selection bias. Differences in perioperative blood transfusion, 24-hour postoperative drainage volume, incidence of severe postoperative complications [such as low cardiac output syndrome, liver failure, renal failure, stroke (ischemic/hemorrhagic), perivalvular leakage, re-thoracotomy during hospitalization, etc.], surgery and hospitalization-related indicators (operation time, cardiopulmonary bypass time, aortic cross-clamp time, length of hospital stay, etc.), and echocardiographic results at 1 month after surgery [mitral valve peak pressure difference, mitral valve peak flow velocity, mitral valve pressure half-time (PHT), tricuspid regurgitation area, right ventricular diameter, right atrial diameter] were compared between the two matched groups.Results:After PSM, the selection bias of covariates in the two groups was corrected. There were no statistically significant differences in operation time, cardiopulmonary bypass time, or aortic cross-clamp time between the two groups (all P>0.05). The ICU monitoring time, ventilator use time, and postoperative hospital stay in the ERAS group were significantly shorter than those in the non-ERAS group, with statistically significant differences (all P<0.05). There were no statistically significant differences in 24-hour postoperative drainage volume, perioperative red blood cell transfusion volume, plasma transfusion volume, or total hospitalization cost between the two groups (all P>0.05). Both the ERAS group and the non-ERAS group had 1 case of re-thoracotomy for hemostasis, and the non-ERAS group had 1 case of perivalvular leakage, with no statistically significant differences between the groups ( P>0.05). Echocardiographic results at 1 month after surgery showed that in the ERAS group, tricuspid regurgitation area, right atrial diameter, and right ventricular diameter were significantly improved compared with those before surgery (all P<0.05); in the non-ERAS group, tricuspid regurgitation area was improved compared with that before surgery, with a statistically significant difference ( P<0.05). There were statistically significant differences in the right ventricular diameter and right atrial diameter between the two groups one month after surgery (all P<0.05). Conclusions:Total thoracoscopic mitral valve surgery combined with beating-heart tricuspid valvuloplasty under the intervention of the ERAS concept is safe and effective, but further confirmation from more large-sample clinical studies is needed.
2.Clinical efficacy of total thoracoscopic mitral valve surgery combined with beating-heart tricuspid valvuloplasty under the concept of enhanced recovery after surgery
Lijian HUANG ; Sicong LI ; Xiaomao LONG ; Wei JIANG ; Kequan WEI
Journal of Chinese Physician 2025;27(8):1147-1152
Objective:To evaluate the clinical efficacy of total thoracoscopic mitral valve surgery combined with beating-heart tricuspid valvuloplasty under the concept of enhanced recovery after surgery (ERAS).Methods:Clinical data from the People′s Hospital of Guangxi Zhuang Autonomous Region from January 2012 to January 2024 were collected and analyzed retrospectively. Patients were divided into the non-ERAS group (total thoracoscopic mitral valve surgery combined with beating-heart tricuspid annuloplasty without ERAS intervention) and the ERAS group (the same surgical procedures under the concept of ERAS). Propensity score matching (PSM) was used to reduce selection bias. Differences in perioperative blood transfusion, 24-hour postoperative drainage volume, incidence of severe postoperative complications [such as low cardiac output syndrome, liver failure, renal failure, stroke (ischemic/hemorrhagic), perivalvular leakage, re-thoracotomy during hospitalization, etc.], surgery and hospitalization-related indicators (operation time, cardiopulmonary bypass time, aortic cross-clamp time, length of hospital stay, etc.), and echocardiographic results at 1 month after surgery [mitral valve peak pressure difference, mitral valve peak flow velocity, mitral valve pressure half-time (PHT), tricuspid regurgitation area, right ventricular diameter, right atrial diameter] were compared between the two matched groups.Results:After PSM, the selection bias of covariates in the two groups was corrected. There were no statistically significant differences in operation time, cardiopulmonary bypass time, or aortic cross-clamp time between the two groups (all P>0.05). The ICU monitoring time, ventilator use time, and postoperative hospital stay in the ERAS group were significantly shorter than those in the non-ERAS group, with statistically significant differences (all P<0.05). There were no statistically significant differences in 24-hour postoperative drainage volume, perioperative red blood cell transfusion volume, plasma transfusion volume, or total hospitalization cost between the two groups (all P>0.05). Both the ERAS group and the non-ERAS group had 1 case of re-thoracotomy for hemostasis, and the non-ERAS group had 1 case of perivalvular leakage, with no statistically significant differences between the groups ( P>0.05). Echocardiographic results at 1 month after surgery showed that in the ERAS group, tricuspid regurgitation area, right atrial diameter, and right ventricular diameter were significantly improved compared with those before surgery (all P<0.05); in the non-ERAS group, tricuspid regurgitation area was improved compared with that before surgery, with a statistically significant difference ( P<0.05). There were statistically significant differences in the right ventricular diameter and right atrial diameter between the two groups one month after surgery (all P<0.05). Conclusions:Total thoracoscopic mitral valve surgery combined with beating-heart tricuspid valvuloplasty under the intervention of the ERAS concept is safe and effective, but further confirmation from more large-sample clinical studies is needed.
3.Analysis of the efficacy of adjustable pericardial soft annulus plasty in the treatment of functional tricuspid regurgitation secondary to rheumatic heart disease
Sicong LI ; Xiaomao LONG ; Wei JIANG ; Kequan WEI ; Ze ZHANG ; Hui CHEN ; Songtao LIU ; Xiaohui GUAN
Chinese Journal of Thoracic and Cardiovascular Surgery 2024;40(2):65-71
Objective:To compare the surgical efficacy of pericardial soft ring tricuspid valvuloplasty with DeVega and artificial valvuloplasty.Methods:227 patients undergoing tricuspid valvuloplasty due to rheumatic heart disease complicated with functional tricuspid valve insufficiency were retrospectively analyzed and divided into 3 groups according to tricuspid valvuloplasty dynamic cohort(pericardial ring group, 89 cases; the artificial flap ring group, 61 cases, and the DeVega group, 77 cases) were matched 1∶1 for propensity score(match A: pericardial ring group and artificial flap ring group; match B: pericardial ring group and DeVega group), the successful matching was included in follow-up and data collection, and cases with incomplete case data during follow-up were removed from the study cohort in pairs according to matching conditions. The results of follow-up 1 month, 6 months and 24 months after surgery were compared.Results:1 month after operation: the tricuspid valve regurgitant in all groups was significantly reduced or even disappeared compared with that before operation, and the right atrium and right ventricle were also smaller than that before operation, with statistical significance( P<0.05). 6 months after surgery: There was no statistical significance in the area of tricuspid regurgitation and right atrial/indoor diameter between all groups compared with the results one month after surgery( P>0.05), and there was no statistical significance in the recurrence rate of tricuspid regurgitation between all groups( P>0.05). 24 months after surgery: There were no significant differences in the recurrence rate of tricuspid regurgitation, area of tricuspid regurgitation and right atrial/indoor diameter between the two groups in matching A( P>0.05). There was no statistical significance in the right atrial/indoor diameter between the matched pericardial ring group and the Devega group, but the tricuspid valve regurgentation area of the Devega group at 24 months after surgery was higher than that of the Devega group at 1 month after surgery, and the difference was statistically significant( P<0.05). The regurgitation area and recurrence rate of tricuspid valve were significantly higher than those of pericardium-TVP group( P<0.05). Conclusion:Pericardial soft ring tricuspid valvuloplasty can effectively correct functional tricuspid valvuloplasty and reverse right heart remodeling, which is an effective tricuspid valvuloplasty.
4.Safety and effectiveness of proximal aortic repair versus total arch replacement for the treatment of acute type A aortic dissection: A systematic review and meta-analysis
Dazhi LI ; Xiangwei LI ; Feng PANG ; Jinlong LUO ; Xin DENG ; Ze ZHANG ; Xinhong HE ; Kequan WEI
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2023;30(04):605-613
Objective To evaluate the effectiveness and safety of proximal aortic repair (PAR) versus total arch replacement (TAR) for treatment of acute type A aortic dissection (ATAAD). Methods An electronic search was conducted for clinical controlled studies on PAR versus TAR for patients with ATAAD published in Medline via PubMed, EMbase, The Cochrane Library, Web of Science, Wanfang Database and CNKI since their inception up to April 30, 2022. The quality of each study included was assessed by 2 evaluators and the necessary data were extracted. STATA 16 software was used to perform statistical analysis of the available data. Results A total of 28 cohort studies involving 7 923 patients with ATAAD were included in this meta-analysis, of whom 5 710 patients received PAR and 2 213 patients underwent TAR, and 96.43% of the studies (27/28) were rated as high quality. The meta-analysis results showed that: (1) patients who underwent PAR had lower incidences of 30 d mortality [RR=0.62, 95%CI (0.50, 0.77), P<0.001], in-hospital mortality [RR=0.64, 95%CI (0.54, 0.77), P<0.001], and neurologic deficiency after surgery [RR=0.84, 95%CI (0.72, 0.98), P=0.032] than those who received TAR; (2) the cardiopulmonary bypass time [WMD=–52.07, 95%CI (–74.19, –29.94), P<0.001], circulatory arrest time [WMD=–10.14, 95%CI (–15.02, –5.26), P<0.001], and operation time [WMD=–101.68, 95%CI (–178.63, –24.73), P<0.001] were significantly shorter in PAR than those in TAR; (3) there was no statistical difference in mortality after discharge, rate of over 5-year survival, renal failure after surgery and re-intervention, volume of red blood cells transfusion and fresh-frozen plasma transfusion, or hospital stay between two surgical procedures. Conclusion Compared with TAR, PAR has a shorter operation time and lower early and in-hospital mortality, but there is no difference in long-term outcomes or complications between the two procedures for patients with ATAAD.
5.Investigation of the efficacy and the mechanism of Jasminoside in ulcerative colitis mice
Yan XU ; Siquan LI ; Zhanhui YE ; Youhong LONG ; Shu XU ; Biyao ZHOU ; Kequan CHEN
Chinese Journal of Inflammatory Bowel Diseases 2023;07(3):272-277
Objective:To investigate the efficacy and mechanism of Jasminoside in dextran sodium sulfate (DSS) -induced ulcerative colitis (UC) mice.Methods:Eighteen C57BL/6 mice were randomly divided into control group, UC group and UC+Jasminoside group, with six mice in each group. The mice in UC group and UC+Jasminoside group freely drank 3%DSS solution for 7 days to induce UC mouse model. The mice in control group freely drank the water without DSS. During the modeling period, the mice in the UC+Jasminoside group were given Jasminoside at a dose of 20 mg/ (kg·d) by gavage for 7 consecutive days, meanwhile the mice in control group and UC group were given equal volumes of distilled water by gavage. The change of body weight and disease activity index (DAI) of the mice were observed daily, and the length of the colon was measured 7 days after the intervention. HE staining was used to observe the inflammatory changes of the colon, and Western blot was used to measure the expression of anti-apoptotic proteins (Bcl-2 and Bcl-xl), caveolin-1 (CAV-1), inducible nitric oxide synthase (iNOS), tight junction proteins (Occludin and Claudin-1). The differences in the above indicators among the mice in three groups were analyzed statistically.Results:All the mice survived. Compared with the control group, the body weight was lower, DAI score was higher, colon was shorter, whose differences were all statistically significant (all P<0.05), and inflammatory infiltration of colon tissue was more severe in mice of UC group. Compared with the UC group, body weight was higher, DAI score was lower, colon was longer, whose differences were all statistically significant (all P<0.05), and inflammatory infiltration of colon tissue was alleviated in mice of UC+Jasminoside group. Western blot results showed that compared with control group, the expression of Bcl-2, Bcl-xl, CAV-1, Occludin and Claudin-1 was significantly lower and the expression of iNOS was significantly higher in the colon tissues of mice in UC group, and the differences were statistically significant (all P<0.05). The expression of Bcl-2, Bcl-xl, CAV-1, Occludin and Claudin-1 in the colon tissues of mice in UC+Jasminoside group was significantly higher than those in UC group, while the expression of iNOS was lower, and the differences were statistically significant (all P<0.05) . Conclusion:Jasminoside can alleviate the symptoms of UC model mice, and its mechanism of action may be related to upregulating the expression of anti-apoptotic proteins and protecting the intestinal mucosal barrier through CAV-1/iNOS pathway.
6.Engineering and process management-based design of Comprehensive Biotechnology Experiment course.
Changbin GONG ; Fei CAO ; Honghua JIA ; Kequan CHEN ; Ganlu LI ; Bingfang HE
Chinese Journal of Biotechnology 2023;39(2):769-779
Based on the demand of enterprise talents and the characteristics of manufacturing process management in biotechnology, in order to make the students acquire the ability to solve complex engineering problems in the production process, we developed a "Comprehensive Biotechnology Experiment" course, where two-step enzymatic production of l-aspartate and l-alanine were the key processes. In this course, we drew lessons from the site management of the production enterprise, performed the experimental operation mode of four shifts and three operations. The content of this course includes principles, methods and experimental techniques of several core curricula and the site management mode of enterprises. As to the evaluation, the summary of the experimental staff's handover records and the content of teamwork were examined and scored. Through teaching practice and continuous improvement, we developed a complete experimental teaching process and assessment mechanism. Overall, the Comprehensive Biotechnology Experiment course achieved good teaching effect, which may serve as a reference to promote the development of experimental teaching of biotechnology.
Humans
;
Biotechnology
;
Curriculum
;
Students
7.Investigation of the efficacy and the mechanism of Jasminoside in ulcerative colitis mice
Yan XU ; Siquan LI ; Zhanhui YE ; Youhong LONG ; Shu XU ; Biyao ZHOU ; Kequan CHEN
Chinese Journal of Inflammatory Bowel Diseases 2023;07(3):272-277
Objective:To investigate the efficacy and mechanism of Jasminoside in dextran sodium sulfate (DSS) -induced ulcerative colitis (UC) mice.Methods:Eighteen C57BL/6 mice were randomly divided into control group, UC group and UC+Jasminoside group, with six mice in each group. The mice in UC group and UC+Jasminoside group freely drank 3%DSS solution for 7 days to induce UC mouse model. The mice in control group freely drank the water without DSS. During the modeling period, the mice in the UC+Jasminoside group were given Jasminoside at a dose of 20 mg/ (kg·d) by gavage for 7 consecutive days, meanwhile the mice in control group and UC group were given equal volumes of distilled water by gavage. The change of body weight and disease activity index (DAI) of the mice were observed daily, and the length of the colon was measured 7 days after the intervention. HE staining was used to observe the inflammatory changes of the colon, and Western blot was used to measure the expression of anti-apoptotic proteins (Bcl-2 and Bcl-xl), caveolin-1 (CAV-1), inducible nitric oxide synthase (iNOS), tight junction proteins (Occludin and Claudin-1). The differences in the above indicators among the mice in three groups were analyzed statistically.Results:All the mice survived. Compared with the control group, the body weight was lower, DAI score was higher, colon was shorter, whose differences were all statistically significant (all P<0.05), and inflammatory infiltration of colon tissue was more severe in mice of UC group. Compared with the UC group, body weight was higher, DAI score was lower, colon was longer, whose differences were all statistically significant (all P<0.05), and inflammatory infiltration of colon tissue was alleviated in mice of UC+Jasminoside group. Western blot results showed that compared with control group, the expression of Bcl-2, Bcl-xl, CAV-1, Occludin and Claudin-1 was significantly lower and the expression of iNOS was significantly higher in the colon tissues of mice in UC group, and the differences were statistically significant (all P<0.05). The expression of Bcl-2, Bcl-xl, CAV-1, Occludin and Claudin-1 in the colon tissues of mice in UC+Jasminoside group was significantly higher than those in UC group, while the expression of iNOS was lower, and the differences were statistically significant (all P<0.05) . Conclusion:Jasminoside can alleviate the symptoms of UC model mice, and its mechanism of action may be related to upregulating the expression of anti-apoptotic proteins and protecting the intestinal mucosal barrier through CAV-1/iNOS pathway.
8.Chemical genomics reveals inhibition of breast cancer lung metastasis by Ponatinib via c-Jun.
Wei SHAO ; Shasha LI ; Lu LI ; Kequan LIN ; Xinhong LIU ; Haiyan WANG ; Huili WANG ; Dong WANG
Protein & Cell 2019;10(3):161-177
Metastasis is the leading cause of human cancer deaths. Unfortunately, no approved drugs are available for anti-metastatic treatment. In our study, high-throughput sequencing-based high-throughput screening (HTS) and a breast cancer lung metastasis (BCLM)-associated gene signature were combined to discover anti-metastatic drugs. After screening of thousands of compounds, we identified Ponatinib as a BCLM inhibitor. Ponatinib significantly inhibited the migration and mammosphere formation of breast cancer cells in vitro and blocked BCLM in multiple mouse models. Mechanistically, Ponatinib represses the expression of BCLM-associated genes mainly through the ERK/c-Jun signaling pathway by inhibiting the transcription of JUN and accelerating the degradation of c-Jun protein. Notably, JUN expression levels were positively correlated with BCLM-associated gene expression and lung metastases in breast cancer patients. Collectively, we established a novel approach for the discovery of anti-metastatic drugs, identified Ponatinib as a new drug to inhibit BCLM and revealed c-Jun as a crucial factor and potential drug target for BCLM. Our study may facilitate the therapeutic treatment of BCLM as well as other metastases.
9.A Retrospective Study:High Intensity Focused Ultrasound (HIFU) Associated A Microbubble-enhancing Contrast (“SonoVue”) Therapy for Uterine Fibroids with Pelvic Operation History
Hong JIANG ; Shuang LUO ; Min HE ; Lian ZHANG ; Kequan LI ; Jia HE
Journal of Kunming Medical University 2013;(9):58-62,88
Objective To evaluate the feasibility of high intensity focused ultrasound (HIFU) associated microbubble-enhancing contrast (“SonoVue”) therapeutic ablation of uterine fibroids in patients with pelvic operation history. Methods A total of 100 patients with uterine fibroid from October 2010 to December 2012 in Suining Central Hospital of Sichuan were treated with HIFU associated SonoVue. Among them, 50 patients had pelvic operation history. The no-perfused volume, median fractional ablation, ablation power rate, ablation dose, treatment time and adverse reaction were recorded. Results There was no statistical significance between patients with operation history and without in no-perfused volume and ablation does. The ablation power was lower in patients with operation than without. The treatment time and room time were longer in patients with operation than without. The adverse reactions were higher in patients with operation than without, especially skin pain and lower abdominal pain ( <0.05) . According to short- and long-term follow-up results, no major complications were observed in any patients. Conclusion Pelvic operation history increases the difficulty in treatment of HIFU ablation uterine fibroids. HIFU associated contrast agent SonoVue ablation can be considered a safe and feasible approach to the management of uterine fibroids in patients with pelvic operation history after grasping the indications and contraindications.
10.A novel bone marrow transplantation strategy for donor-specific tolerance induction after heart transplantation
Kequan GUO ; Xu MENG ; Yuanlong YU ; Jie HAN ; Haiming JIANG ; Xiaojun XU ; Xiaojun LU ; Yixin JIA ; Junmeng ZHENG ; Haibo ZHANG ; Yan LI ; Tie ZHENG ; Chunlei XU ; Wen ZENG ; Jiangang WANG ; Yongqiang CUI ; Tiange LUO ; Jun WANG ; Susumu IKEHARA
Chinese Journal of Organ Transplantation 2011;32(1):32-35
Objective To investigate a new strategy of bone marrow transplantation (BMT) for donor-specific tolerance induction after heart transplantation. Methods Donor bone marrow cells (BMCs)were harvested simultaneously with donor cardiac graft using modified perfusion method (PM) ,then stored in a -80 ℃ refrigerator after filtration and centrifugation. Whole BMCs (IBM-BMT) (monocytes 1.2 ×107/kg,CD34+ cells 2.38× 105/kg) in host iliac bones were injected into the bone marrow cavity 40 days after heart transplantation. Preconditoning regimens that consisted of fludarabine, antithymoctye globin and total lymphoid irradiation were performed 3 days before BMT. Tacrolimus (Tac) was administrated intravenously after BMT or orally in conjunction with mycophenolate mofetil (MMF) 3 weeks later.Cyclosporine and MMF were orally administrated 6 weeks later. Donor chimerism was detected using short tandem repeats-polymerase chain reaction in monocytes from peripheral blood at the 2nd,4th, 8th or 12th week after BMT or BMCs at the 4th, 8th or 12th week after BMT. Intramyocardium electrocardiography examination or endomyocardial biopsy was performed weekly or monthly respectively. Mixed lymphocyte reactions (MLR) were performed 3 months after BMT. Results Donor chimerism in monocytes in peripheral blood or BMCs in iliac bones measured at the 1 st,2nd and 3rd month after BMT was 26.3%, 19.1%,4.8% ,and 46.3%, 24.4%, 7.6%, respectively. After 3-month follow-up, there was no rejection confirmed by endomyocardial biopsy or intramyocardium electrocardiography. Echocardiography revealed that the diastolic and systolic function of the cardiac graft was maintained well 3 months after BMT. MLR revealed donor-specific hyporesponsiveness while immunocompetence was preserved to third-party antigens. Conclusion These findings indicate that the two-stage BMT strategy is a safe and feasible method for the induction of donor-specific tolerance via stable mixed chimerism and needs to be further confirmed after a long-term observation.

Result Analysis
Print
Save
E-mail