Combined myocardial deformation to predict cardiac resynchronization therapy response in nonischemic cardiomyopathy.

BACKGROUND: 20-30% of patients do not benefit from cardiac resynchronization therapy (CRT) when the established selection criteria were applied. We hypothesized that a combined assessment of mechanical dyssynchrony, myocardial deformation, and diastolic function would identify patients who would benefit most from CRT. METHOD: In 36 CRT patients, clinical evaluation and echocardiography were performed before and after CRT. Patients were classified into three subgroups according to their amount of response: echocardiographic responders, clinical responders, and nonresponders. Radial dyssynchrony and left ventricular (LV) global longitudinal, radial, and circumferential peak strain was assessed by speckle-tracking image. Diastolic function was quantified by conventional echocardiography. RESULT: In addition to left bundle branch block, nonspecific intraventricular conduction disturbance with intraventricular dyssynchrony could also improve LV remodeling. Echocardiographic responders had better global longitudinal strain, global circumferential peak strain, and global radial strain at baseline which significantly increased at 12-month follow-up. An improvement in estimates of LV filling pressure and a decrease in mitral regurgitation and left atrial dimensions were observed only in echocardiographic responders to CRT. Patients with clinical but without echocardiographic response showed a significant improvement in atrioventricular (AV) synchrony and a nonsignificant improvement in other parameters. The nonresponder group did not improve the AV and intraventricular dyssynchrony. CRT could not improve restrictive filling pattern with normal filling time. Overall, those patients with AV and intraventricular dyssynchrony and those with best contractile function and short diastolic filling time of restrictive filling pattern at baseline demonstrated the greatest benefit from CRT. CONCLUSIONS: Mechanical dyssynchrony, contractile function, and filling pattern are important determinants of the benefits in CRT.

[Inhibitory effect of total flavonoids of Malus hupehensis on hepatic fibrosis induced by Schistosoma japonicum in mice].

OBJECTIVE: To investigate the effects of total flavonoids of Malus hupehensis on hepatic fibrosis in mice induced by Schistosoma japonicum. METHODS: The mice model of hepatic fibrosis which infected by cercariae of S. japonicum were randomly divided into 6 groups: Group A as a blank control, Group B as a model, Group C as a positive control by complex liver soften tablet of turtle, Group D, E, F treated with a high dose of 114 mg/(kg x d), middle dose of 57 mg/(kg d), and low dose of 28.5 mg/(kg x d) of total flavonoids of Malus hupehensis, respectively. Every group had 10 mice. Each group of C, D, E, F was orally given praziquantel at a dose of 500 mg/(kg x d) for 2 d, on 42 d after the infection, and then administered with total flavonoids of Malus hupehensis for 60 d. Group A and B were orally given with sodium chloride. All the mice were killed at the end of the administration. Serum hyaluronic acid (HA), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were detected; hydroxyproline in liver tissues was detected; areas of egg granuloma and degrees of hepatic fibrosis were observed via HE and Masson staining. RESULTS: Compared with the blank control Group A, the egg granuloma appeared obviously, the collagen deposit and fibrosis occurred in liver tissues of Group B, C, D, E, F. The levels of ALT, AST, HA in sera and HYP in liver tissues were significantly higher (P < 0.05 or P < 0.01). However, the levels of ALT, AST, HA and HYP in the high, middle and low dose groups of total flavonoids were significantly lower than those in the model Group B (P < 0.05 or P < 0.01), the areas of egg granuloma, the collagen deposits and the degrees of hepatic fibrosis in Group C, D, E, F were significantly lower than those in the model Group B. CONCLUSION: The total flavonoids of Malus hupehensis have an obviously inhibitory effect on the hepatic fibrosis induced by Schistosomajaponicum infection.

Nup88 mRNA overexpression in colorectal cancers and relationship with p53.

OBJECTIVES: We measured nucleoporin 88 (Nup88) mRNA expression in primary colorectal cancers to investigate its relationship with clinicopathological features and p53. METHODS: The primary cancer tissues, adjacent noncancerous tissues and the proximal and distant margins of normal mucosa were collected from 73 colorectal cancer patients during surgery. Nup88 mRNA expression was measured on these fresh specimens and on colon cell lines HCT-116^{p53 + / + } and HCT-116^{p53 - / - } by RT-PCR while p53 mRNA and ß-actin as controls. Nup88 and p53 protein expression were then immunohistochemistrically examined in other 25 colorectal cancers specimens paraffin embedded and formalin fixed. RESULTS: Nup88 expression was higher in primary cancer tissues than in adjacent noncancerous tissues, and in the proximal and distant margins of normal mucosa. Overexpression of Nup88 mRNA was statistically associated with TNM stage (P=0.044), lymphatic metastasis (P=0.022), and cancer location (P=0.036), while not related to gender, age of patients and histological type, infiltration depth, and differentiation of cancers. The expression of Nup88 mRNA in the HCT-116^{p53 - / - } cell line was not significantly different from expression in the HCT-116^{p53 + / +}cell line. And there was no correlation between Nup88 and p53 protein expression (r=0.632, P=0.368). CONCLUSIONS: Nup88 mRNA was overexpressed in colorectal cancers and the overexpression was associated with cancer development and aggressiveness. Nup88 might be regard as essential contributor to nodal metastagenicity of colorectal cancer.

[Effect of ulinastatin on intestinal mucosal barrier function of rats with obstructive jaundice].

OBJECTIVE: To investigate the effect of ulinastatin on intestinal mucosal barrier function of rats with obstructive jaundice. METHODS: Seventy-two male SD rats were randomly divided into sham operation, obstructive jaundice, and ulinastatin treatment groups (groups A, B, and C, respectively). In groups B and C, the common bile duct was ligated to induce obstructive jaundice. The rats in group C were given intraperitoneal injection of ulinastatin at the daily dose of 40,000 IU/kg after the operation, while those in groups A and group B received equal amount of normal saline. At 3, 5, 7 and 10 days after the operation, the liver function and plasma endotoxin level were evaluated and measured, and bacterial culture of the mesenteric lymph nodes, liver and spleen was performed. The terminal ileum mucosa was observed under light microscope, and the intestinal villi and mucosal thinckness was examined with image analysis system. RESULTS: The indices relative to the liver function and plasma endotoxin level were higher at different time points of observation in group B than in group A (P<0.01), and were lower in group C than in group B (P<0.01). Plasma endotoxin level was similar between groups A and C 3 days after the operation (P>0.05). The rate of bacterial translocation was higher in group B than in group A and C (P<0.01, P<0.05), but comparable between groups A and C (P>0.05). Intestinal mucosal injury was observed in group B 3 days after operation, and aggravated with the passage of time. The injury was milder in group C. The intestinal villus length and mucosal thickness were greater in groups A and C than in group B (P<0.01 or P<0.05), but comparable between the former two groups 3 days after operation (P>0.05). CONCLUSION: In early stage of obstructive jaundice, the intestinal mucosal barrier may sustain injuries which aggravate with time; ulinastatin has significant effect in protecting the mucosal barrier function especially against early pathological changes.