Objective    To evaluate the efficiency and safety of intraprocedural valve-in-valve deployment for treatment of aortic regurgitation following transcatheter aortic valve replacement (TAVR). Methods    Consecutive patients (n=333) who diagnosed with severe aortic stenosis and underwent TAVR in Zhongshan Hospital affiliated to Fudan University from October 3rd, 2010 to April 21st, 2021 were included. There were 208 males and 125 females aged 76.0±7.0 years. There were 316 patients underwent simple TAVR (simple TAVR group) and 17 patients underwent intraprocedural valve-in-valve deployment following TAVR (valve-in-valve group). Their clinical and echocardiographic outcomes were evaluated and compared. Results    There was no significant difference between the two groups of patients at postoperative 30 d and 1 year in all-cause mortality (4.4% vs. 0, P=1.000; 6.3% vs. 0, P=1.000), incidence of pacemaker implantation (10.4% vs. 17.6%, P=1.000; 11.8% vs. 17.6%, P=1.000), incidence of ischemic stroke (1.3% vs. 0, P=1.000; 1.3%  vs. 0, P=1.000), mean trans-aortic pressure gradient (11.4±6.4 mm Hg vs. 8.9±4.9 mm Hg, P=0.099; 10.5±7.6 mm Hg vs. 11.2±5.2 mm Hg, P=0.432), left ventricular ejection fraction (62.0%±9.0% vs. 57.0%±12.0%, P=0.189; 63.0%±7.0% vs. 60.0%±8.0%, P=0.170), and incidence of mitral valve dysfunction (0.6% vs. 5.9%, P=1.000; 0.6% vs. 5.9%, P=1.000). Conclusion    It is feasible to treat perivalvular leakage with valve-in-valve technology in the procedure of TAVR, and the short and medium-term effects are satisfied.

Objective:To observe the effects of Shexiang Wulong pill on serum interleukin-1 (IL-1), transforming growth factor-β(TGF-β1), matrix metalloproteinase-3 (MMP3), matrix tissue inhibitors of metalloproteinase 1(TIMP-1) in patients with knee osteoarthritis (KOA) expression.Methods:Using prospective cohort study method, the subjects were KOA patients from Department of Rheumatology and Immunology clinic of North China University of Science and Technology Affiliated Hospital from March 2016 to June 2018.According to random number table The patients were divided into two groups: the treatment group (treated with shexiangwulong pill) with 46 cases and the control group (Kanggu Zengsheng tablet) with 46 cases.The treatment group was treated with Shexiang Wulong pill, 30 capsules per time, twice a day; the control group was treated with Kanggu Zengsheng tablet, four tablets per time, twice a day.The treatment period was 8 weeks.The levels of IL-1, TGF-β1, MMP3 and TIMP-1 in the serum of the patients in the treatment group and the control group were measured by enzyme-linked immunosorbent assay, and the differences of relevant indexes between the two groups were statistically analyzed.Results:Forty-six cases were completed in the treatment group and 44 cases were completed in the control group.After treatment with Shexiang Wulong pill and Kanggu Zengsheng tablet, the levels of IL-1 were (30.99±2.80) μg/L, (32.90±2.84) μg/L in the treatment group and the control group, resectively( t=3.21, P<0.001). There was no significant difference of TGF-β1 levels between the treatment group((214.87±17.30) μg/L) and the control group ((208.85±15.53) μg/L, ( t=1.73, P=0.08). The levels of TIMP-1 were (139.60±6.79) μg/L, (135.09±6.16) μg/L in the treatment group and the control group, resectively( t=3.29, P<0.001). The levels of MMP3 were (1.19±0.10) μg/L, (1.23±0.06) μg/L in the treatment group and the control group, resectively ( t=2.28, P=0.03). The rate of TIMP1/MMP3 were 111.04±8.81, 118.46±12.06 in the treatment group and the control group, resectively( t=3.34, P<0.001). Conclusion:Shexiang Wulong pill can decrease the levels of IL-1 and MMP-3, and increase the levels of TGF-β1, TIMP-1, and the rate of TIMP1/MMP3, so as to protect the articular cartilage and improve the knee joint function in patients with KOA.

Objective: To study the clinical significance of serum calcitonin in the diagnosis and treatment of medullary thyroid carcinoma and to analyze its cost-benefit. Methods: One hundred and forty one patients with medullary thyroid carcinoma who undertook calcitonin test and frozen pathological examination were enrolled in this study from Oct 2012 to Mar 2018. Using the method of χ² test, the positive rate of calcitonin test and frozen pathological examination in diagnosis of medullary thyroid carcinoma(MTC) were compared. Firstly, we compared the correct checkout cost of calcitonin test and that of frozen pathological examination (total number of patients×cost of examination/the correctly detected number of patients) . Secondly, we calculated whether calcitonin test help patients save money(average cost of treatment in hospital for MTC×number of patients who were evaluated to be candidate for surgery-cost of calcitonin test×total number of patients)/total number of patients. Results: 139 patients were positive in calcitonin test among 141 patients, and the positive rate was 98.58%. 91 patients were positive in frozen pathological examination, and the positive rate was 64.54% (χ²=97.821, P<0.000 1) . Cost-benefit analysis showed that the correct checkout cost of calcitonin test and frozen pathological examination were 71.01 yuan and 426.10 yuan, also,1 371 938.64 yuan could be saved totally and 9 730.06 yuan could be saved per patient because of calcitonin test. Conclusion Serum calcitonin test had a significant effect on the diagnosis and treatment of medullary thyroid carcinoma and was economical and practical.

Objective To evaluate the clinical outcomes of hemodialysis patients after superficial femoral artery - superficial femoral vein arteriovenous graft (AVG). Methods Hemodialysis patients with mid - thigh superficial femoral artery - superficial femoral vein AVG from August 2015 to March 2018 in department of vascular surgery, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine were enrolled. Their clinical outcomes and complications after operation were analyzed retrospectively. Patency rates were measured by Kaplan - Meier survival curve. Results A total of 18 cases were enrolled. The success rate of the operation was 100％without complication. Follow - up time was (22.00 ± 11.77) months with 100％ follow - up rate. The 6 months -, 12 months -, 24 months - primary patency rates were 83.3％±8.8％, 48.5％±12.1％, 24.2％± 13.5％, respectively; secondly patency rates were 100.0％, 100.0％, 87.5％±11.7％. There were 1 case of seroma, 1 case of puncture site infection, 11 cases of stenosis and 5 cases thrombosis during follow-up, while no heart failure, ischemia or pseudoaneurysm. Conclusion Mid - thigh AVG has low infection rate and high patency rate, so it can be as the first choice for the lower extremity AVG in hemodialysis patients.

Objective To summarize the experiences of aneurysmorrhaphy for arteriovenous fistula aneurysms with acute thrombosis in hemodialysis patients.Methods There were 7 cases of arteriovenous fistula with acute thrombosis from Nov 2015 to Feb 2017 at our department of vascular surgery,Longhua Hospital.Results In all cases thrombosis was secondary to proximal stenosis or occlusion.The stenosis and occlusion were corrected with embolectomy and aneurysmorrhaphy.The proximal part of the cephalic vein was translocated to the basilic vein in 1 case,axillary vein in 2 cases;autologous vein graft in 1 case;resection of the occlusion,end-to-end anastomosis in 1 case;autogenous patch in 1 case.No perioperative complications occurred.The operation site was cannulated within one month after operation in all cases.Patients were followed up for 7 months to 23 months,all cases were patent.Conclusions Aneurysmorrhaphy is effective,reliable and safe for arteriovenous fistula aneurysms with acute thrombosis in hemodialysis patients.

A reliable UPLC-MS method was developed for the simultaneous determination of 4 chemicals (Sudan Ⅰ, tetrabromobisphenol A, tris ( 1, 3-dichloroisopropyl ) phosphate and tris ( chlorisopropyl ) Phosphate) in children products. The samples were ultrasonic extracted with acetonitrile, and then the four chemicals were separated on a C18 column in 3 min. Results showed that the limit of quantification of the method was between 5 and 500μg/kg. The calibration curves were linear within 2-3 orders of magnitude with typical correlation coefficient above 0 . 9995 . The recoveries ranged from 83 . 7% to 97 . 8% with three addition levels. The sensitivity, recovery and selectivity of the method could fully meet the requirements of practical work.

AIM:We investigated how AT 1-R stimulated by mechanical stresses induces cardiac fibrosis .METHODS:We produced in vivo cardiac pressure overload model in angiotensinogen knockout ( ATG-/-) mice and in vitro mechanically-stretched cell model in cultured neonatal cardiac cells of ATG-/-mice both lack the participation of Ang II .RESULTS: Pressure overload for 4 weeks in ATG-/-mice induced myocardial hypertrophy accompanied by the significant interstitial fibrosis , however , the TGF-β, a key regulatory factor of fibrosis, was not significantly increased in these ATG-/-mice.Meanwhile, the inhibitor for AT1-R significantly inhibited mechani-cal stress-induced cardiac fibrosis in these ATG-/-models whereas inhibition of TGF-βdid not.CONCLUSION:The results showed that mechanical stress-induced fibrotic responses through AT 1-R required the phosphorylation of Smad 2 but not the involvement of TGF-β.

Objective To compare dose distribution in gamma knife radiotherapy plan, conformal radiotherapy(CRT)plan and intensity modulated radiotherapy(MRT)plan for patients with small mass in lung, and evaluate their characters. Methods Fourteen patients with small mass in lung participated in the study. Gamma knife radiotherapy plan(plan 1), CRT plan(plan 2)and IMRT plan(plan 3)were made for each mass. The planning target volume(PTV)and the dose include 95% PTV were consistent.Conformal index(CI), homogeneity index(HI), lung V5 ,V10 ,V20 ,V30 and the max dose of esophagus and spinal cord were analyzed. Paired samples t-test was used for comparison between each two plans. Results The CI of the plan 1,2 and 3 were 0. 58,0. 46 and 0. 63, respectively. CI of the plan 1 ＞ that of the plan 2 (t= -3.95,P =0.000),plan 3 ＞ plan 2(t = -6.01 ,P =0.000),plan 1 =plan 3(t =1.64,P =0.116);HI of the plan 1,2 and 3 were 1.66,1.10 and 1.07 respectively. HI of the plan 1 ＞ plan 2 ,plan 1 ＞ plan 3(t= -20.52,21.41 respectively, both P=0. 000),plan 2 = plan 3(t= -1.08,P=0.294). The wholelung V5 ,V10 ,V20 and V30 were 10.0% ,5.6% ,2. 4% and 1.2%, respectively, in plan 1 ;20. 2% ,13. 4%,6. 9% ,3.0%, respectively, in plan 3; and 26. 5%, 18. 0%, 11.4% and 4. 6%, respectively, in plan 2.The V5, V10, V20 and V 30 of the plan 1 ＜ in plan 2(t = 9. 68,8. 41,5. 45,5. 14, all P = 0. 000), the V5,V10,V20 and V30 of the plan 1 ＜ in plan 3(t=7.58,8.95,6. 15,4.78, respectively, all P=0.000),the V5 ,V10, V20andV30 oftheplan2 ＞ inplan3(t =9. 71,5. 91,4. 13,3.91, respectively, allP =0.000).The max dose of esophagus in plan 1 ,2 and 3 were 24.93 ± 21.54, 31.90 ± 18. 75, 29. 19 ± 23.09 Gy,respectively, plan 1 ＜ plan 2(t = -2. 71 ,P=0.013),plan 1 = plan 3(t = - 1.49,P =0. 152),plan 2 =plan 3(t = 1.35, P = 0. 193). The max dose of spinal cord in plan 1,2 and 3 were 12.07 ± 10. 67,17.70 ±11.35 and 8.92 :± 10. 04 Gy, respectively, plan 2 ＞ plan 1 ＞plan 3(t = -2. 38,2. 29,4. 83,P=0. 1027,0.033,0.000);All three plans of each mass meet the needs that the max dose of the esophagus≤60 Gy and the max dose of spinal cord ≤40 Gy. Conclusions The dose of the normal lung was lower, but the HI and the max dose of spinal cord were higher in Gamma knife radiotherapy plan than those in the CRT and the IMRT plan of the small mass in lung.

OBJECTIVE: To establish the kanamycin-induced deafness model in SD rats, and to investigate the expression and significance of transmembrane protease, serine 3 (TMPRSS3) in the cochlea following kanamycin ototoxicity. METHODS: A total of 40 male SD rats were randomly divided into 4 groups. The experimental rats received intramuscular kanamycin sulfate for 3, 7, and 14 consecutive days, and the control group were treated with normal saline for 14 days. Auditory brainstem responses (ABR) were obtained before and after the kanamycin administration. The expression of TMPRSS3 in the cochlea was identified and detected by immunohistochemistry and Western blot. RESULTS: Kanamycin-induced deafness model in the SD rats was successfully established. ABR thresholds were increased and the expression of TMPRSS3 in the cochlea was reduced after the kanamycin injection (P<0.01). CONCLUSION TMPRSS3 may play an important role in normal cochlea function and involve in the process of aminoglycoside antibiotics induced deafness.
Animals ; Anti-Bacterial Agents ; toxicity ; Cochlea ; drug effects ; metabolism ; Deafness ; chemically induced ; metabolism ; Disease Models, Animal ; Evoked Potentials, Auditory, Brain Stem ; physiology ; Kanamycin ; toxicity ; Male ; Membrane Proteins ; metabolism ; Rats ; Rats, Sprague-Dawley ; Serine Endopeptidases ; metabolism

OBJECTIVE: To observe the expression of proteinase transmembrane protease, serine 3 (TMPRSS3) in mouse cochlea, and to investigate the significance of TMPRSS3 in the inner ear. METHODS: The protein expression of TMPRSS3 in C57/BL mouse cochlea was identified and detected by immunohistochemistry and immunofluorescence. Different cochlear tissues, such as spiral ganglion neurons, corti organ, stria vascularis and so on, were separated to detect the gene expression of TMPRSS3 by real-time fluorescence quantitative polymerase chain reaction (qPCR). The cochlear tissues with different ages were collected and the expression of TMPRSS3 mRNA was detected by qPCR. RESULTS: TMPRSS3 was mainly expressed in the spiral ganglion neurons, and there was TMPRSS3 mRNA in the cochlea in groups with different age. The expression level of TMPRSS3 mRNA was much weaker. CONCLUSION The distribution of TMPRSS3 was observed in many regions of the mouse cochlea, but mainly in the spiral ganglion neurons. This indicates that TMPRSS3 may be involved in the physiological functional regulation of the spiral ganglion neurons.
Animals ; Cochlea ; metabolism ; Female ; Male ; Membrane Proteins ; genetics ; metabolism ; Mice ; Mice, Inbred C57BL ; RNA, Messenger ; genetics ; metabolism ; Serine Proteases ; genetics ; metabolism