Effects of percutaneous closure of atrial septal defects via the right internal jugular vein.

Background: Percutaneous atrial septal defect (ASD) closure is the preferred treatment for patients with suitable ASD anatomy. The safety and effectiveness of transcatheter closure have been established. However, reports on transesophageal echocardiography (TEE)-guided percutaneous closure of ASD via the right internal jugular vein (RIJV) are limited. The study aims to discuss the safety and effectiveness of percutaneous trans-jugular vein closure of ASD. Methods: We conducted a retrospective analysis of patients (n=103) with secondary ASD who underwent surgical treatment in the Department of Cardiovascular Surgery, the Second Hospital of Jilin University between July 2015 to July 2022. The article is a cross-sectional study. Clinical data, including age, gender, weight, defect diameter, tricuspid regurgitation, left atrial (LA) size, and the operation results, were collected and evaluated. Nonparametric rank sum tests were used to assess tricuspid regurgitation before and after surgery, while paired sample t-tests were used to compare LA size before and after surgery. Results: TEE-guided percutaneous closure of ASD via the RIJV was successfully performed in 97 out of 103 (94.2%) cases. The average procedure time was 34.48±13.06 min, and the mean age at the time of the procedure and ASD size were 36±18 years and 15.45±5.82 mm, respectively. On analyzing medical records and echocardiographic images, postoperative complications were found to occur in four (3.9%) patients. Among these, three patients had residual shunt as indicated by echocardiography during the operation, which subsequently disappeared at the three-month follow-up. One patient developed atrial fibrillation after surgery but returned to normal sinus rhythm with medication. Percutaneous closure of ASD via the RIJV was unsuccessful in 6 patients (5.8%), with 5 of them undergoing transthoracic ASD closure and achieving satisfactory results. One patient refused further surgical treatment. No pericardial effusion, thrombosis, atrioventricular block, or other complications were observed during the 3-month to 1-year follow-up period. Conclusions: ASD closure via the RIJV is a safe and effective therapeutic approach. The initial results are satisfactory, but further studies with large sample sizes and long-term follow-up are warranted to assess the long-term outcomes.

Enhancing Mechanical Performance of High-Lignin-Filled Polypropylene via Reactive Extrusion.

Polypropylene (PP) is one of the most extensively used commodity plastics. In terms of eco-friendliness, it is worth considering preparing high-lignin-filled PP. This study explores the incorporation of high lignin content, derived from acetic acid lignin (AAL) and Kraft lignin (KL), into PP through twin-screw extrusion and injection molding. The challenge lies in maintaining mechanical performance. A compatibilizer-specifically, maleic anhydride-grafted polypropylene (MAPP)-is employed to enhance lignin-PP compatibility by chemically bonding with lignin and physically associating with the PP phase. Results indicate that KL maintains better dispersity than AAL. Compatibilizers with a high maleic anhydride (MA) level (≥0.8 wt.%) and moderate melt flow index (MFI) in the range of 60-100 g 10 min⁻¹ prove favorable in constructing a reinforced PP/KL network. Optimizing with 40 wt.% lignin content and 10 parts per hundred (pph) of compatibilizer yields blends with mechanical performance comparable to neat PP, exhibiting a notable increase in modulus and heat deflection temperature (HDT). Furthermore, utilizing PP/lignin blends can lead to a 20% reduction in expenses and approximately 40% reduction in PP-induced greenhouse gas (GHG) emissions. This approach not only reduces PP costs but also adds value to lignin utilization in a sustainable and cost-effective manner.

Antimicrobial peptides for combating drug-resistant bacterial infections.

The problem of drug resistance due to long-term use of antibiotics has been a concern for years. As this problem grows worse, infections caused by multiple bacteria are expanding rapidly and are extremely detrimental to human health. Antimicrobial peptides (AMPs) are a good alternative to current antimicrobials with potent antimicrobial activity and unique antimicrobial mechanisms, which have advantages over traditional antibiotics in fighting against drug-resistant bacterial infections. Currently, researchers have conducted clinical investigations on AMPs for drug-resistant bacterial infections while integrating new technologies in the development of AMPs, such as changing amino acid structure of AMPs and using different delivery methods for AMPs. This article introduces the basic properties of AMPs, deliberates the mechanism of drug resistance in bacteria and the therapeutic mechanism of AMPs. The current disadvantages and advances of AMPs in combating drug-resistant bacterial infections are also discussed. This article provides important insights into the research and clinical application of new AMPs for drug-resistant bacterial infections.

Naringin attenuates renal interstitial fibrosis by regulating the TGF-ß/Smad signaling pathway and inflammation.

Interstitial fibrosis is a typical feature of all progressive renal diseases. The process of fibrosis is frequently coupled with the presence of pro-fibrotic factors and inflammation. Naringin is a dihydroflavone compound that has been previously reported to exhibit anti-fibrotic effects in the liver, where it prevents oxidative damage. In the present study, a rat model of renal interstitial fibrosis and fibrosis cell model were established to evaluate the effects of naringin on inflammatory proteins and fibrosis markers in kidney of rats and NRK-52E cells, and to elucidate the role of the TGF-ß/Smad signaling pathway in this mechanism. Compared with those in fibrotic NRK-52E cells that were stimulated by transforming growth factor-ß (TGF-ß), gene expression levels of α-smooth muscle actin (α-SMA), collagen 1 (COL1A1), collagen 3 (COL3A1), interleukin (IL)-1ß, IL-6 and tumor necrosis factor-α (TNF-α) were all found to be significantly decreased in fibrotic NRK-52E cells following treatment with naringin (50, 100 and 200 ng/ml). Results from the histopathological studies showed that naringin treatment preserved the renal tissue structure and reduced the degree of fibrosis in the kidney tissues of rats that underwent unilateral ureteral obstruction (UUO). In addition, naringin administration reduced the expression of α-SMA, COL1A1, COL3A1, IL-1ß, IL-6 and TNF-α in the kidneys of rats following UUO. The current study, using western blot analysis, indicated that naringin also downregulated the activation of Smad2/3 and the expression of Smad4, high-mobility group protein B1, activator protein-1, NF-κB and cyclooxygenase-2 whilst upregulating the expression of Smad7 in fibrotic NRK-52E cells and rats in the UUO group. In conclusion, naringin could antagonize renal interstitial fibrosis by regulating the TGF-ß/Smad pathway and the expression of inflammatory factors.

Cytotoxic oligophenols from the rhizome of Wikstroemia indica.

A new tricoumarin glycoside, triumbelletin-7-O-ß-d-glucoside (1) and a new biflavonoid, wikstroflavone A (2), together with two known compounds, wikstaiwanone A (3) and wikstaiwanone B (4), were isolated from the rhizome of Wikstroemia indica. The structures of new compounds were elucidated by extensive spectroscopic techniques (UV, IR, HRESIMS, 1D, 2D NMR and CD), in combination with quantum chemical calculations of 13C NMR and ECD spectra. All isolates were tested for their antineoplastic activities against cancer-derived cell lines HCT116, SW480, U87 and T98G. Compounds 2-4 exhibited moderate cytotoxic activities to the four cell lines. The flow cytometry assay and western blot analysis revealed that the cytotoxic effects were possibly attributed to the induced apoptotic cell death.

Multipath ultrasonic gas flow-meter based on multiple reference waves.

Several technologies can be used in ultrasonic gas flow-meters, such as transit-time, Doppler, cross-correlation and etc. In applications, the approach based on measuring transit-time has demonstrated its advantages and become more popular. Among those techniques which can be applied to determine time-of-flight (TOF) of ultrasonic waves, including threshold detection, cross correlation algorithm and other digital signal processing algorithms, cross correlation algorithm has more advantages when the received ultrasonic signal is severely disturbed by the noise. However, the reference wave for cross correlation computation has great influence on the precise measurement of TOF. In the applications of the multipath flow-meters, selection of the reference wave becomes even more complicated. Based on the analysis of the impact factors that will introduce noise and waveform distortion of ultrasonic waves, an averaging method is proposed to determine the reference wave in this paper. In the multipath ultrasonic gas flow-meter, the analysis of each path of ultrasound needs its own reference wave. In case study, a six-path ultrasonic gas flow-meter has been designed and tested with air flow through the pipeline. The results demonstrate that the flow rate accuracy and the repeatability of the TOF are significantly improved by using averaging reference wave, compared with that using random reference wave.

Three-Dimensional Printing of Reduction Template in the Contouring of Craniofacial Fibrous Dysplasia.

BACKGROUND: Contouring is a minimal invasive procedure to remove excess lesions and restore facial appearance of patients with craniofacial fibrous dysplasia; however, it is difficult to measure the amount of excess lesions. This study is to demonstrate the use of reduction template produced by three-dimensional printer in contouring procedure. METHODS: Computed tomography data were reconstructed into a three-dimensional model by Mimics software. The unaffected side was mirrored and superimposed on the affected side. Excess fibrous dysplasia lesions were calculated by Boolean operations. Lesions to be removed were separated and saved as stereolithography file. This model was further constructed in 3-matic package of Mimics software, and several holes were designed to indicate the variation in depth. Finally, the virtual model was exported into three-dimensional printer to produce physical template. RESULTS: With the direct guidance of three-dimensional reduction template, contouring procedure was performed easily and accurately. Good facial symmetry was achieved with reduced operative time and loss of bleeding. CONCLUSIONS: The application of reduction template produced by three-dimensional printer in contouring procedure improves the efficient and safety of surgery. Good outcomes are obtained without extra requirement in craniofacial surgery.

Rigid External Distractor Aided Conventional Le Fort III Osteotomy Advancement in Adult With Severe Midfacial Hypoplasia.

BACKGROUND: Management of severe midfacial hypoplasia is still a challenge for craniofacial team, adult patients with syndromic midfacial hypoplasia made the situation even worse. The authors present the clinical result in an adult patient with Crouzon syndrome treated by rigid external distractor aided conventional Le Fort III procedure. METHODS: A 26-year-old patient with Crouzon syndrome presented with severe midfacial hypoplasia, a negative overjet of -17 mm, exorbitism, airway obstruction, and masticatory problem, while chief complaint of the patient was abnormal appearance. After Le Fort III osteotomy, rigid external distractor and distraction hooks were fixed. With the aid of rigid external distractor, the midfacial mass was immediately advanced to a desired position, allograft bone grafted in the gaps, and microplate fixed. The device was removed 3 weeks later when the advanced midface was stable. RESULTS: Point A was advanced by 18.6 mm in horizontal and displaced superiorly 0.5 mm in vertical at the time of device removal. Point A moved backward 1.5 mm and upward 0.3 mm at 2-year follow-up. A good and balanced facial profile was obtained in a short treatment period. Airway obstruction symptoms and exorbitism were relieved. CONCLUSIONS: The midfacial advancement achieved by rigid external distractor aided conventional Le Fort III osteotomy is a stable, controllable, and timesaving procedure. This technique may become an important choice for adult patients with severe midfacial hypoplasia.

[Application of Le Fort â ¢ osteotomy with minimal invasive approach in the treatment of midfacial hypoplasia].

Objective: To describe a minimal invasive approach in the Le Fort Ⅲ osteotomy procedure. Methods: 33 cases with midfacial hypoplasia were treated by Le Fort Ⅲ osteotomy.Incisions were performed with minimal invasive approach,through lower eyelid,intraoral and upper eyelid crease or medial part of eyebrow instead of coronal incision.After the completion of osteotomy,distraction osteogenesis or orthognathic procedures were followed. Results: The midfacial segments achieved enough advancement without obvious relapse.Bleeding and operative time were reduced compared with coronal approach.No obvious scar was left. Conclusion: The Le Fort Ⅲ osteotomy procedure could be successfully performed through minimal approach with steady results and minimal scars.

[APPLICATION OF THREE-DIMENSIONAL CEPHALOMETRIC ANALYSIS IN ORTHOGNATHIC SURGERY].

OBJECTIVE: To establish a model of three-dimensional (3-D) cephalometric analysis to study dentomaxillofacial deformities. METHODS: Between January 2012 and October 2013, 15 patients with dentomaxillofacial deformities were treated using 3-D cephalometric analysis in orthognathic surgery plan. There were 7 males and 8 females with an average age of 23.6 years (range, 17-37 years), including 4 cases of mandibular protrusion with maxillary deficiency, 4 cases of maxillary protrusion with mandibular deficiency, 2 cases of long face syndrome, and 5 cases of facial asymmetry. CT images were reconstructed by Mimics software. The anatomical landmarks were located, the reference planes and analysis planes were defined and the 3-D coordinate was established. The distance and degree between landmarks and analysis planes which defined in the measure project were measured. RESULTS: Based on the 3-D CT quantitative analysis methods, cephalometric analysis project was defined in the 3-D coordinate. 3-D cephalometric analysis provided a convenient and precise method for the clinical measurement of dentomaxillofacial morphology, and reduce the time in preoperation analysis. CONCLUSION: The model of 3-D CT cephalometric analysis can provide precise information in the diagnosis and treatment planning of orthognathic surgery.

[Effects of rat allogeneic adipose-derived stem cells on the early neovascularization of autologous fat transplantation].

OBJECTIVE: To investigate the effects of allogeneic adipose-derived stem cells (ADSCs) of rat on the early neovascularization of autologous fat transplantation. METHODS: (1) Experiment 1. Adipose tissue was collected from both inguinal regions of two SD rats to isolate, culture, and purify ADSCs through collagen enzyme digestion, density gradient centrifugation, and adherence method. The fourth passage of cells were collected for morphologic observation, detection of expressions of surface markers CD34, CD49d, CD106, and CD45 of ADSCs with flow cytometer, identification of adipogenic and osteogenic differentiation, and determination of the cell proliferation ability with thiazolyl blue method. (2) Experiment 2. Another 30 SD rats were divided into allogeneic adipose granule (AG) group (A, n = 6), autologous AG group (B, n = 8), autologous ADSCs+autologous AG group (C, n = 8), and allogeneic ADSCs+autologous AG group (D, n = 8) according to the random number table. The fourth passage of ADSCs were obtained from adipose tissue from one side of inguinal region of SD rats in group C. Adipose tissue obtained from one side of inguinal region of SD rats of the other 3 groups was abandoned. The AG was prepared from another side of inguinal region of SD rats in the 4 groups. The mixture of 0.6 g AG from one rat and 1 mL DMEM/F12 nutrient solution was injected subcutaneously into the back of another rat in group A, and so on. Autologous AG was injected into its own body of the rats in group B. The mixture of 1 mL autologous ADSCs mixture which contains 3.0 × 106 cells per mililitre autologous ADSCs combined with autologous AG was injected into the rats in group C. The mixture of 1 mL allogeneic ADSCs mixture which contains 3.0 × 106 cells per mililitre ADSCs extractived from the former 2 rats in experiment 1 combined with autologous AG was injected into the rats in group D. At 7 days post transplantation, fat transplants were harvested for gross observation, measurement of wet weight, pathological observation, and assessment of cells with positive expression of CD31 with immunohistochemical method. Data were processed with one-way analysis of variance and SNK test. RESULTS: (1) The fourth passage of cells proliferated well showing fusiform shape similar to fibroblasts. These cells showed positive expression of CD34 and CD49d and weak positive expression of CD106 and CD45. They were able to differentiate into adipocytes and osteoblasts. These cells were identified as ADSCs. The fourth passage of cells grew faster than that of the tenth passage. (2) At 7 days post transplantation, no liquifying necrosis or infection was observed in the fat transplants of the rats in the 4 groups. Wet weight of the fat transplants in groups A and B was respectively (0.25 ± 0.04) and (0.26 ± 0.03) g, which were less than those of groups C and D [(0.36 ± 0.03) and (0.35 ± 0.04) g, with P values below 0.05]. HE staining showed that there were less fat cells and more fibroblasts in the transplants of group A, visible fibrous tissue around uneven shape of fat cells in the transplants of group B, and almost identical size and shape of fat cells and unobvious fibrous tissues were found in the transplants of groups C and D. The cells with positive expression of CD31 were distributed in fibrous tissues in larger number but less around fat cells in the transplants of group A, while more of these cells were observed surrounding fat cells in the transplants of group B. There were more cells with positive expression of CD31 distributed surrounding fat cells in the transplants of groups C and D than that in group B. The cells with positive expression of CD31 observed under 400 times field were more in number in groups C (20.5 ± 1.1) and D (22.1 ± 1.0) than in groups A (8.0 ± 3.6) and B (10.9 ± 1.7), with P values below 0.05. CONCLUSIONS: Allogeneic ADSCs combined with autologous AG can significantly improve the early vascularization of fat transplantation as well as autologous ADSCs combined with autologous AG.

[Quantitative analysis of craniofacial skeleton asymmetry by three-dimensional computed tomography].

OBJECTIVE: To present a method of quantitative diagnosis of craniofacial skeleton deformities based on three-dimensional computed tomography (3D CT). METHODS: 20 cases with facial asymmetric deformities underwent 3D CT and the 3D images were reconstructed by Mimics 10.0 (Belgium). Anatomical landmarks were located and the coordinate of the landmarks obtained. Axial images of 1 patient with Romberg disease was used as representative case. The differences in the distance between the right landmarks and the left were calculated and analyzed. RESULTS: The measurement results were not significantly different between two stages with an interval of 4 weeks ( P > 0.05), showing a reproducible resutls. The deviation of landmarks at facial midline increased gradually from upward to downward, reaching (2.63 +/- 0.54) mm at menton point. Paired landmarks showed asymmetry in three dimensions, especially gonion point on the left side, which was deviated 10.21 mm inward, 9.26 mm forward, 6.30 mm upward, compared to the opposite side. CONCLUSIONS: The method of 3D CT quantitative analysis can provide precise information in the diagnosis and treatment planning of facial asymmetry deformity.