Tricuspid regurgitation(TR)is a common heart valve disease.According to the pathogenesis,TR can be divided into primary(organic)and secondary(functional)regurgitation,of which functional TR accounts for more than 90%.Patients with severe TR have poor prognosis and poor drug treatment,and surgery(valvuloplasty)is the main treatment.At present,transcatheter edge-to-edge tricuspid valve repair(T-TEER)has become an essential program of transcatheter treatment for TR,providing minimally invasive treatment for TR patients who cannot undergo surgery or are at high risk of surgery.T-TEER reduces the degree of regurgitation by clamping leaflets,and is currently in the early stage of research and development exploration and clinical validation,mainly for functional TR.T-TEER devices have also made significant progress(TriClip,PASCAL),and Chinese-made novel-designed T-TEER devices are also undergoing clinical trials(DragonFly-TTM,SQ-Kyrin-TTM,NeoBlazarTM).This paper reviews the current applications and research progress of T-TEER.

Transcatheter aortic valve replacement(TAVR)is currently one of the main therapeutic strategies for aortic valve disease.Preoperative imaging assessment is crucial for operation project planning and prevention of procedure-associated complications.Different from planar image reconstruction,3D printing technology can accurately depict the anatomical structure of the aortic root.It enables further assessment of operative risk and therapeutic strategy through in vitro simulation,especially for assessing the risk of coronary artery obstruction and planning interventional procedures.Here,we report on two patients who underwent a 3D printing aortic root anatomical simulation model,followed an by in vitro balloon dilatation/valve implantation test,to evaluate the risk of coronary artery obstruction suggested by CT angiography planar image reconstruction before TAVR.

Objective:To explore the clinical efficacy of immunoadsorption in highly sensitized kidney transplant (KT) candidates.Methods:From September 2019 to April 2023, the relevant clinical data were retrospectively reviewed for 26 highly sensitized KT recipients. Protein A immunoadsorption desensitization therapy was offered after KT. The effect of immunosorbent on reducing anti-human leukocyte antigen (HLA) antibodies was summarized. And operative success rate and postoperative complication incidence were calculated.Results:The mean number of treatment session was (10.76±5.53). The highest level of HLA-Ⅰ antibody mean fluorescence intensity (MFI) dropped from (17 921±4 442) to (7 333±6 434) with a decline of 59% and HLA-Ⅱ antibody MFI decreased from (21 135±5 245) to (10 989±7 627) with a decline of 48%. The differences were statistically significant (both P<0.001). All kidneys were harvested from cadavers. The complications were acute antibody mediated rejection (7 cases), perioperative pulmonary infection (3 cases) and myelosuppression (2 cases). The average follow-up period was (30.8±12.6) month. The graft survival rate was 88.5% (23/26) and the recipient survival rate 100% (26/26) . Conclusions:Immunoadsorption therapy can effectively reduce HLA antibody in highly sensitized KT candidates, thereby increasing the probability of successful KT. In terms of safety, immunosorbent therapy may boost the potential risks of infection and myelosuppression. It requires heightened attention.

Objective To retrospectively analyze the ultra-fast track anesthesia(UFTA)methods and perioperative anesthesia management experiences of transcatheter mitral valve edge-to-edge repair(TEER)in the treatment of functional mitral regurgitant.Methods In this retrospective study,patients underwent the TEER procedure and received UFTA in Fuwai Yunnan Hospital,from May 2022 to September 2022 for heart failure combined with moderate to severe or severe functional mitral regurgitant were included.Baseline,preoperative complications,cardial function and anesthesia classification,amino-terminal probrain natriuretic peptide(NT-proBNP),ultrasound examination results,surgery time,extubation time,intraoperative anesthetic and vasoactive drug,complications related to TEER and UFTA,perioperative,and postoperative 30-day and one-year follow-up data were collected.All perioperative clinical data were recorded and analyzed.Results A total of 30 patients were enrolled,11 patients(36.7％)were female,mean age was(63.6±6.1)years,NYHA classification IV 14 patients(46.7％),left ventricular ejection fraction(LVEF)(36.0±8.1)％,the end-diastolic volume of the left ventricle(66.0±8.2)mm,mitral regurgitation 4+14 patients(56.7％),3+17 patients(43.3％),NT-proBNP(1 934.1±1 973.5)pg/ml,1 patient(3.3％)used high-dose vasoactive drugs during surgery.All patients did not experience nausea,vomiting,delirium,respiratory depression,perioperative transesophageal echocardiography-related gastrointestinal bleeding,pericardial effusion,cerebrovascular accidents,emergency surgery or secondary intervention,or other serious adverse events within 24 hours after surgery.No 30-day all-cause death occurred;the mean postoperative hospital stay was(7.4±2.8)days.All patients completed one-year follow-up,LVEF(37.6±11.1)％,the end-diastolic volume of the left ventricle(63.2±8.6)mm,mitral regurgitation 2+7 patients(23.3％),1+23 patients(76.7％),NT-proBNP(1 949.2±2 576.6)pg/ml.Conclusions Ultra-fast track anesthesia can be safely applied to TEER in treating functional mitral regurgitant patients.

In this study, we investigated the anti-inflammatory effect and mechanism of tilianin in lipopolysaccharide (LPS)-induced RAW264.7 cells. The cell viability was detected by cell counting kit-8 (CCK-8) assay. The content of tumor necrosis factor α (TNF-α) and interleukin-6 (IL-6) were detected by enzyme-linked immuno sorbent assay (ELISA) kits. The content of nitric oxide (NO) was assayed by Griess reagent method. The level of intracellular reactive oxygen species (ROS) was detected by 2',7'-dichlorodihydrofluorescein diacetate (DCFH-DA) fluorescent probe. The protein levels of Toll like receptor 4 (TLR4), myeloid differentiation primary response gene 88 (Myd88), nuclear factors κB p65 (NF-κB p65), phosphorylated nuclear factor κB p65 (p-NF-κB p65), nuclear factor κB inhibitory protein α (IκBα) and phosphorylation nuclear factor κB inhibitory protein α (p-IκBα) were detected by Western blot. The mRNA and protein levels of NLRP3, pro-IL-1β, pro-IL-18 and pro-caspase-1 were detected by qRT-PCR and Western blot. Immunofluorescence staining was used to detect the nuclear translocation of NF-κB p65. The effect of tilianin on the TLR4/Myd88/NF-κB signaling pathway was further validated by using the TLR4 signaling inhibitor restatorvid (TAK242). The results showed that tilianin significantly reduced the levels of TNF-α, IL-6 and NO in the supernatant of RAW264.7 cells and decreased the content of intracellular ROS. Tilianin reduced the levels of TLR4, Myd88, p-NF-κB p65 and p-IκBα protein and nuclear translocation of NF-κB p65. Tilianin could reduce the protein levels of NLRP3, pro-IL-1β, pro-IL-18 and pro-caspase-1. Tilianin significantly inhibited the mRNA levels of NLRP3 and pro-IL-1β. The above research results indicated that tilianin could significantly alleviate the LPS-induced inflammatory response in RAW264.7 cells and its mechanism might be related to downregulate the TLR4/Myd88/NF-κB signaling pathway to inhibit NLRP3 inflammasome.

Objective To investigate the protective effect of HMS5552 on pancreatic islet β-cell injury in diabetic rats and study the mechanism.Methods A total of 40 SD rats were fed with high-sugar and high-fat diet for 8 weeks combined with intraperitoneal injection of streptozotocin(STZ)to induce type 2 diabetic rat models.The successful model rats were divided into model group(0.9％NaCl by gavage)and experimental group(30 mg·kg-1 HMS5552 by gavage).The other 20 normal rats served as the normal group(0.9％NaCl was given by gavage).Hematoxylin-eosin(HE)staining was used to detect the pathological changes of pancreatic islets.The INS-1 cells were divided into blank group(normal cultured),model group(high-sugar and high-fat culture medium)and experimental-L,-M,-H groups(high-sugar and high-fat culture medium+0.3,3.0 and 30.0 μmol·L-1 HMS5552).The viability of INS-1 cells was detected by cell counting kit-8(CCK-8)method,the apoptosis of INS-1 cells was detected by Annexin V/PI method,the mRNA expression level of B cell lymphocytoma 2(Bcl-2)was detected by real-time fluorescence quantitative polymerase chain reaction(RT-qPCR)method;the expression level of phosphoinositide 3-kinase/protein kinase B(PI3K/AKT)pathway and apoptosis protein was detected by western blotting.Results HE staining showed that the pathological damage of pancreas in the experimental group rats was significantly less than that in the model group.The cell viability of the blank group,model group and experimental-L,-M,-H groups were(99.67±2.40)％,(48.18±4.18)％,(61.74±4.78)％,(70.74±6.36)％and(78.30±4.68)％,respectively;apoptosis rates were(10.40±4.66)％,(48.60±3.27)％,(35.90±4.45)％,(28.07±5.35)％and(18.30±3.04)％,respectively;the relative expression levels of Bcl-2 mRNA were 1.00±0.03,0.32±0.04,0.59±0.05,0.62±0.04 and 0.72±0.12,respectively;phosphorylated PI3K(p-PI3K)/PI3K ratios were 1.00±0.00,0.34±0.05,0.46±0.02,0.64±0.01 and 0.81±0.01,respectively;phosphorylated AKT(p-AKT)/AKT ratios were 1.00±0.00,0.28±0.12,0.63±0.02,0.74±0.06 and 0.87±0.09,respectively.The above indexes in the model group compared with the blank group,the differences between the above indexes of the experimental-L,-M,-H groups and the model group were statistically significant(P＜0.05,P＜0.01).Conclusion HMS5552 can improve glucose metabolism in diabetic rats and protect pancreatic β-cells by regulating the expression of PI3K/AKT signaling pathway.

Objective To investigate the protective effect of HMS5552 on pancreatic islet β-cell injury in diabetic rats and study the mechanism.Methods A total of 40 SD rats were fed with high-sugar and high-fat diet for 8 weeks combined with intraperitoneal injection of streptozotocin(STZ)to induce type 2 diabetic rat models.The successful model rats were divided into model group(0.9％NaCl by gavage)and experimental group(30 mg·kg-1 HMS5552 by gavage).The other 20 normal rats served as the normal group(0.9％NaCl was given by gavage).Hematoxylin-eosin(HE)staining was used to detect the pathological changes of pancreatic islets.The INS-1 cells were divided into blank group(normal cultured),model group(high-sugar and high-fat culture medium)and experimental-L,-M,-H groups(high-sugar and high-fat culture medium+0.3,3.0 and 30.0 μmol·L-1 HMS5552).The viability of INS-1 cells was detected by cell counting kit-8(CCK-8)method,the apoptosis of INS-1 cells was detected by Annexin V/PI method,the mRNA expression level of B cell lymphocytoma 2(Bcl-2)was detected by real-time fluorescence quantitative polymerase chain reaction(RT-qPCR)method;the expression level of phosphoinositide 3-kinase/protein kinase B(PI3K/AKT)pathway and apoptosis protein was detected by western blotting.Results HE staining showed that the pathological damage of pancreas in the experimental group rats was significantly less than that in the model group.The cell viability of the blank group,model group and experimental-L,-M,-H groups were(99.67±2.40)％,(48.18±4.18)％,(61.74±4.78)％,(70.74±6.36)％and(78.30±4.68)％,respectively;apoptosis rates were(10.40±4.66)％,(48.60±3.27)％,(35.90±4.45)％,(28.07±5.35)％and(18.30±3.04)％,respectively;the relative expression levels of Bcl-2 mRNA were 1.00±0.03,0.32±0.04,0.59±0.05,0.62±0.04 and 0.72±0.12,respectively;phosphorylated PI3K(p-PI3K)/PI3K ratios were 1.00±0.00,0.34±0.05,0.46±0.02,0.64±0.01 and 0.81±0.01,respectively;phosphorylated AKT(p-AKT)/AKT ratios were 1.00±0.00,0.28±0.12,0.63±0.02,0.74±0.06 and 0.87±0.09,respectively.The above indexes in the model group compared with the blank group,the differences between the above indexes of the experimental-L,-M,-H groups and the model group were statistically significant(P＜0.05,P＜0.01).Conclusion HMS5552 can improve glucose metabolism in diabetic rats and protect pancreatic β-cells by regulating the expression of PI3K/AKT signaling pathway.

Objective: Data for 2016 from cancer registries were used to estimate cancer incidence and mortality in China in 2016. Methods: According to the quality control process of the National Central Cancer Registry, the data from 683 cancer registries submitted by each province were evaluated, and the data of 487 cancer registries were qualified and included in the final analysis. Age-specific incidence and mortality rates were calculated by area (urban/rural), sex, age and cancer site, combined with national population data to estimate cancer incidence and mortality in China in 2016. Chinese population census in 2000 and Segi's population were used for age-standardized incidence and mortality rates. Results: Total population covered by 487 cancer registries was 381 565 422 (192 628 370 in urban and 188 937 052 in rural areas). The percentages of morphologically verified (MV%) and death certificate-only cases (DCO%) accounted for 68.31% and 1.40%, respectively, and the mortality to incidence ratio was 0.61. It was estimated about 4 064 000 new cases occurred in China in 2016, with the crude incidence rate being 293.91/100 000 (the rates of males and females were 315.52/100 000 and 271.23/100 000), age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 190.76/100 000 and 186.46/100 000, with the cumulative incidence rate (0-74 years old) being 21.42%. The crude incidence and ASIRC were 314.74/100 000 and 196.38/100 000 in urban areas, whereas in rural areas, they were 265.90/100 000 and 182.21/100 000, respectively. It was estimated about 2 413 500 cancer deaths occurred in China in 2016, the crude mortality rate was 174.55/100 000 (216.16/100 000 in males and 130.88/100 000 in females), the age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 106.00/100 000 and 105.19/100 000, and the cumulative mortality rate (0-74 years old) was 11.85%. The crude mortality and ASMRC were 180.31/100 000 and 104.44/100 000 in urban areas, whereas in rural areas, they were 166.81/100 000 and 108.01/100 000, respectively. The most common cancer cases include lung, colorectal, stomach, liver and female breast cancers. The top five cancers accounted for about 57.27% of all cancer cases. The most common cancer deaths included lung, liver, stomach, colorectal and esophageal cancers. The top five cancers accounted for about 69.25% of all cancer deaths. Conclusions: The burden of cancer shows a continuous increasing trend in China. Regional and gender differences in cancer burden are obvious. The cancer patterns still show the coexistence of cancer patterns in developed countries and developing countries. The situation of cancer prevention and control is still serious in China.
Male ; Humans ; Female ; Infant, Newborn ; Infant ; Child, Preschool ; Child ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Aged ; Urban Population ; Breast Neoplasms ; Esophageal Neoplasms ; Rural Population ; China/epidemiology* ; Registries ; Incidence ; Colorectal Neoplasms

The aim of this study is to investigate the effects of Gynostemma pentaphyllum dried with two different methods(air drying and heating) on inflammation in acute lung injury(ALI) mice in vivo and in vitro. Lipopolysaccharide(LPS) was sprayed into the airway of wild type C57BL/6J male mice to establish the model, and the drug was injected into the tail vein 24 h after modeling. Lung function, lung tissue wet/dry weight(W/D) ratio, the total protein concentration, interleukin 6(IL-6), IL-1β, and tumor necrosis factor-α(TNF-α) in the bronchoalveolar lavage fluid(BALF), and pathological changes of the lung tissue were used to evaluate the effects of different gypenosides on ALI mice. The results showed that total gypenosides(YGGPs) and the gypenosides substituted with one or two glycosyl(GPs_(1-2)) in the air-dried sample improved the lung function, significantly lowered the levels of IL-1β and TNF-α in BALF, and alleviated the lung inflammation of ALI mice. Moreover, GPs_(1-2) had a more significant effect on inhibiting NO release in RAW264.7 cells. This study showed that different drying methods affected the anti-inflammatory activity of G. pentaphyllum, and the rare saponins in the air-dried sample without heating had better anti-inflammatory activity.
Male ; Mice ; Animals ; Tumor Necrosis Factor-alpha/metabolism* ; Gynostemma ; Mice, Inbred C57BL ; Lung ; Anti-Inflammatory Agents/metabolism* ; Interleukin-6/metabolism* ; Interleukin-1beta/metabolism* ; Lipopolysaccharides/pharmacology*

Mitral regurgitation(MR)is a common valvular heart disease in China,the prevalence of which increases with age,and most patients present with a wide range of cardiac or non-cardiac comorbidities.Transcatheter mitral valve edge-to-edge repair(TEER)has become a guideline-recommended,safe and effective treatment option for patients with severe primary or secondary mitral regurgitation.With the rapid development of TEER technology in China,relevant devices have been developed and approved for clinical trials,including the self-designed and manufactured JensClip system,which adopts a unique slider locking design to realize the innovation of mitral clip locking mode.Here we reported a case of JensClip device in treatment of a patient with degenerative mitral regurgitation(DMR).