1.Effect of home-based exercise rehabilitation on cardiac structure and exercise capacity in patients with severe aortic stenosis after transcatheter aortic valve replacement
Zehan XIE ; Shouling MI ; Nianwei ZHOU ; Zhiyun SHEN ; Wei LI ; Xianhong SHU ; Limin LUO ; Xingguo ZHU ; Zhenglong XIAO ; Lei ZHUANG
Chinese Journal of Clinical Medicine 2025;32(5):827-834
Objective To explore the effects of home-based exercise rehabilitation on cardiac structure, valvular function, and exercise capacity in patients with severe aortic stenosis (AS) after transcatheter aortic valve replacement (TAVR). Methods 49 patients with severe AS who underwent TAVR at Zhongshan Hospital, Fudan University, from January 2024 to February 2025 were enrolled. They were divided into an exercise group (n=25) or a non-exercise group (n=24) based on participating or not in home-based rehabilitation after TAVR. The exercise group received 12 weeks of home-based exercise training (aerobic exercise plus resistance training every week); the non-exercise group received routine care. Transthoracic echocardiography (TTE) was used to assess cardiac structural parameters before discharge (T0) and after 12 weeks of exercise (T1). Functional outcomes including the 6-minute walk test (6MWT), Duke Activity Status Index (DASI), and Short Physical Performance Battery (SPPB) were compared between the two groups. A linear mixed-effects model was used to analyze the effect of home-based rehabilitation on echocardiographic parameters. Patients were stratified by baseline 6MWT (<240 m as low-function subgroup, ≥240 m as high-function subgroup) to compare exercise-related outcomes between subgroups. Results At T1, the exercise group had a longer 6MWT distance than the non-exercise group (P=0.012). The linear mixed-effects model showed that after 12 weeks of exercise, the left ventricular end-diastolic diameter (LVEDD) decreased in the exercise group but slightly increased in the non-exercise group, with a significant difference in changes over time between the two groups (Pinteraction=0.030). The exercise group also showed greater improvement in effective orifice area index (Pinteraction=0.028) and effective orifice area (Pinteraction=0.042) than the non-exercise group. Subgroup analysis revealed that in the low-function subgroup, the exercise group showed greater improvement in the 6MWT (Pinteraction=0.035) and the effective orifice area index (Pinteraction=0.046) compared to the non-exercise group; in the high-function subgroup, the exercise group showed greater improvement only in LVEDD compared to the non-exercise group (Pinteraction=0.046). Conclusions Home-based exercise rehabilitation improves exercise capacity, optimizes left ventricular remodeling, and enhances valvular function in patients with severe AS after TAVR, with greater benefits observed in patients with lower baseline 6MWT.
2.Progress and prospects of dental pulp stem cells in diabetes treatment
Ailan HUANG ; Peipei GUO ; Xiaoqing LU ; Jintao WU ; Zehan LI ; Xiuqing XU ; Juan WANG ; Lili ZHOU
STOMATOLOGY 2024;44(6):452-457
Diabetes mellitus(DM)stands as a chronic metabolic ailment predominantly characterized by elevated blood glucose lev-els,stemming from either a resistance to insulin or aberrations in insulin secretion.The ensuing persistent hyperglycemia,a direct con-sequence of pancreatic β-cell devastation,acts as a catalyst for a myriad of complications,inclusive of extensive neuropathies.The dis-ease has substantial prevalence and mortality rates,underscoring the gravity of its impact on public health.Dental pulp stem cells(DPSCs)are readily obtainable,and they exhibit a profound capacity for self-renewal,multi-lineage differentiation,and vigorous pro-liferation.Remarkably,DPSCs can differentiate into pancreatic β-cells,subsequently participate in insulin secretion and play a pivotal role in immune modulation.This has achieved notable advancements in the therapeutic domain,particularly in the treatment of chronic diseases.Furthermore,DPSCs harbor the potential to mitigate symptoms in patients afflicted with type 1 diabetes.They navigate this therapeutic pathway through mechanisms that involve suppressing autoimmunity,modulating inflammatory responses,and counteracting oxidative stress.This article meticulously reviews the biological characteristics inherent to DPSCs and explores their multifaceted thera-peutic potential in addressing DM and its associated complications.Through this endeavor,the article aims to contribute to the refine-ment and enhancement of DM management strategies.
3.Advances in the study on cytokines related to dental pulp regeneration
Minhui YAO ; Jintao WU ; Yu ZHOU ; Fengqing CHU ; Jiajia JIANG ; Yue CHEN ; Lili ZHOU ; Zehan LI
STOMATOLOGY 2023;43(3):282-288
With the development of molecular biology, biomaterials and tissue engineering, regenerative treatment of pulpal and periradicular diseases is facing new opportunities. At present, a large number of studies on dental pulp regeneration reveal that cytokines are essential for promoting migration, proliferation and osteogenic differentiation of dental pulp stem cells. In this paper, we review several kinds of cytokines related to dental pulp regeneration, and analyze their roles and regulatory mechanisms in dental pulp regeneration.
4.The regulatory effect of memantine on expression and synthesis of heat shock protein 70 gene in neonatal rat models with cerebral hypoxic ischemia.
Huijin CHEN ; Zhiwei LIU ; Zehan ZHOU ; Minhua JIANG ; Longhua QIAN ; Shengmei WU
Chinese Medical Journal 2003;116(4):558-564
OBJECTIVETo evaluate the neuroprotective effect of memantine, a non-competitive antagonist at the N-methyl-D-aspartate receptor, against hypoxic ischemia (HI) by exploring its regulation on the expression and synthesis of heat shock protein 70 (HSP70) gene in neonatal rat models with cerebral HI.
METHODSMemantine was intraperitoneally injected at a dose of 20 mg/kg in neonatal rat models either before (PRE group) or after (POST group) induction of HI. The expression and synthesis of the HSP70 gene and its corresponding product were determined by rapid competitive PCR and immunohistochemistry, respectively.
RESULTSThere was an increase in the expression of HSP70 mRNA two hours after induction of HI, which reached its peak at 48 hours, then decreased gradually. The same expression occurred at relatively low levels in the control group. Also, HSP70 synthesis was detected as early as 2h after HI, reached its peak between 48 and 72 hours, then declined over time. After memantine administration, the expression of the gene and its synthesis of the corresponding product decreased significantly during the time intervals 24 - 72 h for the gene and 48 - 72 h for the product compared to the HI group.
CONCLUSIONIt was shown that HI is very sensitive to the expression of the HSP70 gene and synthesis of its corresponding product, which could be regulated by memantine. The latter may have the ability to reduce brain damage; thus decreased HSP70 mRNA expression could be a marker for HI. It is suggested that memantine can be a promising agent for neuroprotection against HI, although an overall and objective assessment of memantine is required to see if it can be used on neonates clinically later on.
Animals ; Female ; Gene Expression Regulation ; drug effects ; HSP70 Heat-Shock Proteins ; biosynthesis ; genetics ; Hypoxia-Ischemia, Brain ; drug therapy ; metabolism ; Male ; Memantine ; pharmacology ; Neuroprotective Agents ; pharmacology ; Rats ; Rats, Sprague-Dawley
5.Pathological Research of Cerebral Protection of Memantine in Neonatal Rat Models with Hypoxic-ischemia
Huijin CHEN ; Zhongde ZHANG ; Zehan ZHOU
Chinese Journal of Perinatal Medicine 1998;0(03):-
Objective To investigate the cerebral protection of Memantine in neonatal rats with hypoxic ischemia. Methods Memantine was intraperitoneally injected at a dose of 20 mg/kg in neonatal rats of cerebral hypoxic ischemia (HI). Employing a quantized score system of cerebral pathology for hypoxic ischemia developed, the neuroprotective effect of Memantine was evaluated pathologically. Results There were significantly decreased scores in either PRE group (Memantine was given one hour before HI) or POST group (Memantine was given after HI immediately) comparing to HI group with higher score. Conclusion Memantine can improve cerebral hypoxic ischemic damage significantly, and be potentially valuable for the treatment of neonatal hypoxic ischemic brain damage.

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