Objective: To investigate the efficacy and safety of percutaneous closure of ventricular septal rupture (VSR) after acute myocardial infarction (AMI) and the risk factors of all-cause mortality at 30 days after operation. Methods: This is a retrospective case series study. A total of 69 patients with post-AMI VSR, underwent percutaneous closure of VSR from October 2013 to May 2020 in Department of Cardiology of Henan Provincial People's Hospital and Department of Cardiology of Central China Fuwai Hospital, were included. Patients were divided into survival group (53 cases) and non-survival group (16 cases) according to the status at 30 days after operation. Clinical data were collected and analyzed during hospitalization. Telephone follow-up was performed 30 days after operation. The primary safety endpoint was occlusion failure and all-cause mortality at 30 days post operation. The secondary safety endpoint was the operation related or non-operation related complications. Efficacy endpoint included NYHA classification of cardiac function, index measured by right heart catheterization and echocardiography. Multivariate logistic regression was performed to analyze the risk factors of all-cause mortality at 30 days after operation. Results: A total of 69 patients, aged 67 (64, 71) years, including 42 women (60.9%), were enrolled in this study. All-cause death occurred in 16 patients (23.2%), including 13 in-hospital death and 3 death during follow-up. There were 4 cases of closure failure (5.8%). Among the 65 patients with successful closure, 12 (18.5%) experienced operation-related complications, among which 8 (12.3%) experienced valve injury. The mortality was significantly higher in patients with operation-related complications than that in patients without operation-related complications (41.7% (5/12) vs. 13.2% (7/53), P = 0.022). One case received percutaneous closure of VSR and PCI, this patient experienced new-onset AMI immediately post procedure and died thereafter (1.5%). One case (1.5%) developed multiple organ failure and 2 cases (3.1%) developed gastrointestinal bleeding post operation. All of the 65 patients with successful occlusion completed postoperative echocardiography, 56 patients completed cardiac function assessment at discharge, and 53 patients who survived up to 30 days post discharge completed clinical follow up by telephone. The NYHA cardiac function at discharge and 30 days after operation were significantly improved as compared to that before operation (P<0.001), the ratio of NYHA Ⅰ and Ⅱ patients was significantly higher post operation at these two time points as compared to baseline level (76.8% (43/56) vs. 23.1% (15/65), P<0.001, 77.4% (41/53) vs. 23.1% (15/65), P<0.001). The pulmonary circulation/systemic circulation blood flow ratio (Qp/Qs), pulmonary artery systolic pressure (PASP) and left ventricular end-diastolic diameter (LVDd) were decreased, aortic systolic pressure (ASP) and left ventricular ejection fraction (LVEF) were increased post operation (P<0.05). Multivariate logistic regression analysis showed that WBC>9.8×10⁹/L (OR=20.94, 95%CI 1.21-362.93, P=0.037) and NT-ProBNP>6 000 ng/L (OR=869.11, 95%CI 2.93-258 058.34, P=0.020) were the independent risk factors of mortality at 30 days. Conclusions: Percutaneous closure in VSR after AMI is safe and effective. The increase of WBC and NT-ProBNP are the independent risk factors of all-cause mortality at 30 days after operation.
Aftercare ; Female ; Hospital Mortality ; Humans ; Myocardial Infarction ; Patient Discharge ; Percutaneous Coronary Intervention ; Retrospective Studies ; Stroke Volume ; Ventricular Function, Left ; Ventricular Septal Rupture/surgery*

Objective: To investigate the effect of the Periplaneta Americana polypeptide on the angiogenesis. Method:Methylthiazolyldiphenyl-tetrazolium bromide (MTT) assay and cell scratch assay were used to observe effect of different concentration (6.25,12.5,25,50,100 mg·L^-1) of the Periplaneta Americana polypeptide, CⅡ-3 and skimmed cream on the proliferation and migration of human umbilical vein endothelial cells (HUVECs), and a normal group and a thalidomide group were also established in this study. The tubule formation assay was used to detect the effect of different concentration (25, 50, 100 mg·L^-1) of the Periplaneta Americana extracts on the formation of tubules in HUVECs cells. The adhesion between HepG2 cells and HUVECs cells was observed by cell adhesion assay. The expression of vascular endothelial growth factor (VEGF) proteins in HUVECs was detected by immunocytochemical staining and enzyme linked immunosorbent assay (ELISA). Result:MTT results showed that the Periplaneta Americana polypeptide could inhibit the proliferation of HUVECs in a dose-dependent manner (P<0.05). The effect of different concentrations of PAP-2 was better than that of PAP-1 and PAP-3 at 24, 48 72 h (P<0.05). However, the survival rate of HUVECs was significantly increased after treatment with different concentrations of CⅡ-3 and skimmed cream in a time-dose dependent manner. Cell wound scratch assay indicated that migration of HUVECs could be inhibited by Periplaneta Americana polypeptide in a dose-dependent manner (P<0.05), and the effect of PAP-2 was better than that of PAP-1 and PAP-3 (P<0.05). CⅡ-3 could inhibit migration HUVECs to some extent, but the higher the dose was, the weaker the inhibition effect was. Skimmed cream promoted migration of HUVECs in a dose-dependent manner. Tube formation assay revealed that Periplaneta Americana polypeptide could inhibit tube formation of HUVECs, and the inhibitory effect of PAP-2 was better than that of PAP-1 and PAP-3 (P<0.05). CⅡ-3 and skimmed cream promoted the tube formation of HUVECs to a certain extent. Intercellular adhesion assay stated clearly that Periplaneta Americana polypeptide could block the adhesion between HepG2 and HUVECs (P<0.05), and the effect of PAP-2 was better than that of PAP-1 and PAP-3 (P<0.05). However, CⅡ-3 and skimmed cream could promote the adhesion between HepG2 and HUVECs. Results of ELISA assay and immunocytochemical staining indicated that Periplaneta Americana polypeptide could down-regulate the expression of VEGF of HUVECs in a dose-dependent manner (P<0.05), in which effect of PAP-2 was better than that of PAP-1 and PAP-3 (P<0.05). However, CⅡ-3 and skimmed cream could up-regulate the expression of VEGF in HUVECs. Conclusion:The Periplaneta Americana polypeptide can inhibit the invasion, metastasis and tube formation of HUVECs, and down-regulate the expression of VEGF in HUVECs. The effect of Periplaneta Americana polypeptide is better than CⅡ-3 and skimmed cream, and the among the polypeptide, the effect of PAP-2 is superior to the other two.

Objective To investigate the feasibility of the endoscope-assisted styloidectomy.Methods Sixty patients with Eagle's syndrome undergoing the endoscope-assisted styloidectomy via postauricular incision,including 7 unilateral and 53 bilateral,between June 2010 and March 2013 were reviewed.Results The styloid processes in all patients were resected successfully via this approach,with the incision length range of 2.0 to 2.5 cm.The mean operative time was (21.3 ± 4.8) min (x-± s),for unilateral surgery and (48.5 ± 11.4) min for bilateral surgery.Fifty-four patients symptom showed complete remission of symptom,3 cases with decrease in symptom and other 3 cases with no significant relief of symptom after surgery.None case recurred for follow-up of 3 to 70 months.There were 3 sides with ear numbness after surgery for 3 months,and one case had transient facial paralysis and recovered after 3 months.Conclusions The endoscope-assisted styloidectomy via postauricular incision is effective and feasible.

OBJECTIVETo study the clinical outcomes of stage I testis teratoma, including pure teratoma, and to provide information on the treatment options for this disease.

METHODSWe retrospectively analyzed 27 cases of orchiectomy for stage I testis teratoma, excluding epidermoid cyst, and investigated its recurrence associated with treatment methods and clinicopathological factors.

RESULTSFour of the 27 cases relapsed, all in the orchiectomy group and confined to the retroperitoneal region, 3 with and the other 1 without risk factors, but with no death. No recurrence was found in those treated by orchiectomy followed by chemotherapy with bleomycin, etoposide and platinum (BEP). The total rate of recurrence was 15.8%. No severe side effects were observed in the 9 patients undergoing adjuvant BEP chemotherapy.

CONCLUSIONRisk factors may increase the recurrence rate of stage I testis teratoma, while postoperative adjuvant chemotherapy can reduce it, including that of pure teratoma, though surveillance policy remains the most popular option after orchiectomy.

Adolescent ; Adult ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; pathology ; Neoplasm Staging ; Retrospective Studies ; Teratoma ; pathology ; therapy ; Testicular Neoplasms ; pathology ; therapy ; Young Adult

Objective To study local and systemic immune response in an animal model treated with recombinant hIFN-α-2b-BCG instillation. Methods The MB49 orthotopic bladder cancer model in C57BL/6 mice was established and treated separately with rBCG, wild BCG, wild BCG combined with IFN-α-2b and PBS as the control. The changes of lymphocyte subgroups in peripheral blood were analyzed with FCM, and mTNF-α and mIL-12 in peripheral blood of mice were detected with ELISA.Immunohistochemistry was carried out to detect the local immune reaction, T cell subsets and FAS, in bladder cancer after being treated with rBCG or wBCG. Results The content of CD4+ T lymphocyte was up-regulated in the rBCG group. The CD4+/CD8+ ratio of 2. 63 was up-regulated than pretreatment, significantly different than that of wBCG group(P＜0.05). ELISA assay showed that BCG significantly up-regulated the level of mTNF-α and mIL-12 in serum of orthotopie murine bladder cancer mice. The mTNF-α 806 pg/ml, mIL-12 860 pg/ml in rBCG group, was not significantly higher than those in wBCG group and combination group. The immunocompetent cell numbers with CD3, CD4,CD8 phenotype increased significantly in the tumor tissue of BCG treated group than the control(P＜0.05). The results of CD4+ in rBCG group and the combination group, and CD8+ in rBCG group were significantly higher than that of the wBCG(P＜0.05). The expression of Fas in tumor tissues treated with intravesical BCG was increased(P＜0. 05). Conclusions The recombinant IFN-α-2b-BCG can retrieve the disproportion of systemic lymphocyte subgroups, and increases Th1-type factors and local Fas expression in orthotopic murine bladder cancer. The recombinant IFN-α-2b-BCG is effective in regulating local and systemic immune reaction in orthotopic murine bladder cancer model.

BACKGROUND AND OBJECTIVEHypopharyngeal carcinoma has a high risk for early regional lymphatic dissemination. However, reports about regional lymph node metastases, especially retropharyngeal lymph node metastases, are rare. This research explored the spread of hypopharyngeal carcinoma, especially metastases of the retropharyngeal lymph nodes by studying computed tomography (CT) and magnetic resonance imaging (MRI) images.

METHODSThe CT/MRI images of 88 patients with pathologically confirmed hypopharyngeal carcinomas that were performed at our hospital between August 2000 and March 2009 were analyzed retrospectively. The interrelations among local stage and lymph nodes in various regions were analyzed by Chi2 test and multivariate logistical regression.

RESULTSThe rate of regional lymph node metastasis for all patients was 73.9%, and the highest rates of positive lymph nodes were at levels IIa (61.4%), IIb (44.3%), and III (37.5%). Metastases to levels I, IV, V, and VI were rare, as were retropharyngeal lymph-node metastases, which were always combined with metastases at levels II and III. Univariate analysis showed that level-IV metastases correlated to metastases at levels Ib and III; retropharyngeal lymph node metastases were correlated to level IIb and bilateral cervical lymph node metastases. Multivariate analysis showed that level-VI metastases correlated to level IV and that retropharyngeal lymph-node metastases correlated to bilateral cervical lymph node metastases.

CONCLUSIONSRegional lymph node metastases in patients with hypopharyngeal carcinoma follow some regulations, and skip metastasis is rare. The highest rates of positive lymph nodes are at levels II and III. Bilateral lymph node metastases may be a risk factor for retropharyngeal lymph node metastases.

Adult ; Aged ; Carcinoma in Situ ; diagnosis ; diagnostic imaging ; pathology ; Carcinoma, Squamous Cell ; diagnosis ; diagnostic imaging ; pathology ; Female ; Humans ; Hypopharyngeal Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; Lymph Nodes ; diagnostic imaging ; Lymphatic Metastasis ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neck ; Neoplasm Staging ; Pharynx ; Retrospective Studies ; Tomography, X-Ray Computed

OBJECTIVETo investigate the antitumor effect of recombinant IFN-alpha-2b-BCG on mouse bladder cancer MB49 cells in vitro, and to explore its antitumor mechanisms.

METHODSMB49 cells were co-cultured with recombinant BCG or wild BCG, and than were examined by light and transmission electron microscopy. The cell growth was assessed by MTT assay, and apoptosis rate and MHC-I of the MB49 cells was detected by flow cytometry using AO and Hoechst33258 fluorescence immunostaining.

RESULTSThe hIFN-alpha-2b-BCG-treated tumor cells showed slow growth, detachment of some cells, and various degree of degeneration. Light microscopy revealed organelle disorganization, chromatin aggregation, nuclear pyknosis, and cytolysis in some cells. Cellular membrane bulged and some bubbles were seen under fluorescence microscope using AO staining. Hoechst33258 assay also depicted frequent apoptosis in the tumor cells. The MTT assay showed that rBCG more actively than the wild BCG inhibited the proliferation of MB49 cells. The apoptosis rate of the recombinant BCG group was 19.7% and 46.6% at the time point of 24 h and 48 h, respectively, significantly higher than 10.8% and 20.9%, respectively, in the wild BCG group. The results of flow cytometry indicated that both types of BCG enhanced the expression of MHC-I in the MB49 cells, but more effective in the recombinant BCG group.

CONCLUSIONThe recombinant hIFN-alpha-2b-BCG has more strong immuno-modulatory properties, anti-tumor effect on MB49 cells and induces apparent cytotoxicity in the bladder cancer cells in vitro.

Adjuvants, Immunologic ; pharmacology ; Animals ; Antineoplastic Agents ; pharmacology ; Apoptosis ; drug effects ; BCG Vaccine ; pharmacology ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cytotoxicity, Immunologic ; Histocompatibility Antigens Class I ; metabolism ; Interferon-alpha ; pharmacology ; Mice ; Recombinant Proteins ; pharmacology ; Urinary Bladder Neoplasms ; metabolism ; pathology

Background and Objective:Hypopharyngeal carcinoma has a high risk for early regional lymphatic dissemination.However.reports about regional lymph node metastases, especially retropharyngeal lymph node metastases,are rare.This research explored the spread of hypopharyngeal carcinoma, especially metastases of the retropharyngeal lymph nodes by studying computed tomography(CT) and magnetic resonance imaging (MRI) images. Methlods:The CT/MRI images of 88 patients with pathologically confirmed hypOpharyngeaI carcinomas that were performed at our hospital between August 2000 and March 2009 were analyzed retrospectively.The interrelations among local stage and lymph nodes in vanous regtons were analyzed by χ~2 test and multivariate logistical regression. ResulIts:The rate of regional lymph node metastasis for all patients was 73.9%.and the highest rates of positive lymph nodes were at levels 11 a(61.4%),11 b(44.3%),and Ⅲ (37.5%).Metastases to levels Ⅰ,Ⅳ,Ⅴ,and Ⅵ were rare,as were retropharyngeal lymph-node metastases,which were always combined with metastases at levels Ⅱ and Ⅲ.Univariate analysis showed that level-Ⅳ metastases correlated to metastases at levels Ⅰ b and Ⅲ:retropharyngeal lymph node metastases were correlated to level Ⅱ b and bilateral cervical lymph node metastases. Multivariate analysis showed that level-Vl metastases correlated to level Ⅳ and that retropharyngeal lymph-node metastases correlated to bilateral cervical lymph node metastases.Conclusions:Regional lymph node metastases in patients with hypopharyngeal carcinoma follow some regulations,and skip metastasis is rare.The highest rates of positive lymph nodes are at levels Ⅱ and Ⅲ.Bilateral lymph node metastases may be a risk factor for retropharyngeallymph node metastases.

Objective To investigate the myocardial damage in rats fed with corn from Keshan disease area added with bean puree. Methods Male Wistar rats were randomly divided into 3 groups according to their body weights, and fed with corn, corn from Keshan disease area added with bean puree, corn from non-endemic area. The GSH-Px activity of vena cardalis blood was examined in 1 and 3 months, rats were sacrificed after being fed for 6 months to examine the heart changes with HE stain. Results The three groups of GSH-Px activity were different in 1 and 3 months respectively(F=23.60,72.46, all P<0.01); GSH-Px activity was (181.58±22.15), (44.76±28.59)U/L in rats fed with corn, was (195.03±17.66), (30.38±3.35)U/L in those fed with corn added with bean puree from Keshan disease area, lower than the group fed with corn of non-endemic area[(340.90±95.42), (125.17±13.64)U/L, all P < 0.01]. But the difference of GSH-Px activity between simple corn group and corn adding bean puree groups of Keshan disease area was not obvious(P>0.05). Myocardial damage incidence of the three groups was 3/9,1/9,2/7. Difference among three groups did not have statistical significance(χ2=1.33, P> 0.05). Conclusions Only corn from Keshan disease area may induce myocardial damage pathology change. Adding bean puree into corn does not increase damage.

OBJECTIVETo determine the effect of acupuncture on chronic prostatitis.

METHODSWe retrieved all the case-control studies on acupuncture for chronic prostatitis before August 2007 in MEDLINE and CNKI databases, screened the eligible literature according to the selection and exclusion criteria, and performed meta-analyses of the included studies with the software Revman 4. 2.

RESULTSThirteen eligible reports were identified in this study, including 861 cases and 738 controls. The effectiveness and cure rates were significantly higher in the acupuncture therapy group than in the control, with pooled RR as 1.20 (95% CI, 1.14, 1.25; P < 0.01) and 1.85 (95% CI, 1.63, 2.11; P < 0.01), respectively.

CONCLUSIONAcupuncture therapy exhibited a definite effect in the treatment of chronic prostatitis.

Acupuncture Therapy ; Case-Control Studies ; Chronic Disease ; Humans ; Male ; Prostatitis ; therapy