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OBJECTIVE：To explore t he mechanism of Xinmaikang improving atherosclerosis （AS）in rabbits. METHODS ：A total of 50 male Zealand rabbits were randomly divided into sham operation group ，model group ，simvastatin group [positive control ， 2.60 mg/（kg·d）] and Xinmaikang low-dose and high-dose groups [ 0.21，0.84 g/（kg·d）]，with 10 rabbits in each group. Rabbits in sham operation group were fed with ordinary diet ，and only femoral artery was separated and ligated ，and abdominal aortic endothelium was not strained ；the other groups were given high-fat diet and received abdominal aortic intimal balloon injury to induce AS model. Ten weeks after operation ，sham operation group and model group were given intragastric administration of normal saline ，and administration groups were given corresponding drug solution intragastrically （normal saline as solvent ）with the volume of 100 mL，once a day ，for consecutive 12 weeks. After last administration ，the pathological changes of abdominal aorta and inner wall in rabbits were observed in each group. The serum contents of triglyceride （TG），total cholesterol （TC），low density lipoprotein cholesterol （LDL-C），high density lipoprotein cholesterol （HDL-C），interleukin-6（IL-6）and IL- 1β were detected，and the contents and protein expression of Toll-like receptor 4（TLR4）and nuclear factor-κB p65（NF-κB p65）in abdominal aortic tissue were determined. RESULTS ：Compared with sham operation group ，the intima of abdominal aorta in model group was rich in lipids ，the thickness of vessel wall and plaque area were increased obviously ，and there was obvious vascular endothelial injury. The contents of TG ，TC，LDL-C，IL-6 and IL- 1β in serum，the contents and protein expression of TLR 4 and NF-κB p65 in abdominal aorta tissue were significantly increased ，while the content of HDL-C was decreased significantly （P＜0.05 or P＜ 0.01）. Compared with model group ，the lesion of rabbit abdominal aorta were alleviated ，and no obvious damage was found on the inner wall. The contents of TG ，TC，LDL-C，IL-6，IL-1β of Xinmaikang high-dose group and simvastatin group as well as the content of NF-κB p65 and protein expression of TLR4 and cnd- NF-κB p65 were improved significantly （P＜0.05 or P＜0.01）. CONCLUSIONS：Xinmaikang can improve AS in rabbits ， and its mechanism may be assicated with inhibiting the expression of TLR 4，NF-κB p65 and inhibiting inflammatory response.
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Objective:To investigate the relationship between serum 25 hydroxyvitamin-D3, soluble advanced glycation end product receptor (sRAGE), nucleotide binding oligomerization domain like receptor 3 (NLRP3) mRNA and cognitive impairment in hypertensive intracerebral hemorrhage (HICH).Methods:143 patients with HICH treated in the Affiliated Hospital of Guangdong Medical University from July 2016 to July 2019 were selected as the research objects. Among the 143 patients with HICH, there were 68 patients with cognitive impairment (cognitive impairment group) and 75 patients without cognitive impairment (control group). The age, gender, amount of intracerebral hemorrhage, bleeding site, blood pressure, blood glucose and blood lipid of the two groups were counted, and the mRNA levels of 25 hydroxyvitamin-D3, sRAGE and NLRP3 were detected. Multivariate logistic regression analysis was used to analyze the risk factors of cognitive impairment in patients with HICH.Results:There were no significant differences in age, gender, smoking, education, bleeding site, diabetes rate, triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol (HDL-C) between cognitive dysfunction group and control group ( P>0.05); There were significant differences in bleeding volume and neurological function defect score (NIHSS) score between cognitive impairment group and control group ( P<0.05); The level of 25 hydroxyvitamin-D3 in cognitive impairment group was lower than that in control group ( P<0.05), and the expression level of NLRP3 mRNA was higher than that in control group ( P<0.05). There was no significant difference in sRAGE between the two groups ( P>0.05); Logistic regression analysis showed that the decrease of 25-hydroxyvitamin-D3 level, the increase of bleeding volume and NIHSS score were independent risk factors for cognitive impairment in HICH patients ( P<0.05). Conclusions:Decreased serum 25 hydroxyvitamin-D3 levels may increase the risk of cognitive impairment in patients with HICH.
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Objective:To explore the effect of extracorporeal membrane oxygenation(ECMO)upon supporting during bilateral lung transplantation(BLTx)for different primary diseases.Methods:The clinical data were retrospectively analyzed for 139 cases of BLTx. They were divided into non-ECMO and ECMO groups. The perieoperative data of two groups were compared.Results:BLTx was successfully performed in all patients. As compared with non-ECMO group, operative duration, mechanical ventilation time and ICU hospitalization time were significantly prolonged in ECMO group ( P<0.05). The proportion of patients with different primary diseases was statistically significant different between two groups( P<0.01). ECMO was employed intraoperatively in all IPAH patients. ECMO proportion was higher in idiopathic pulmonary fibrosis(IPF)patients but lower in chronic obstructive pulmonary disease(COPD)counterparts( P<0.05). In terms of cardiac function indices, patients with a moderate/severe elevation of pulmonary artery pressure had a higher proportion of ECMO application( P<0.001). Moreover, the application of ECMO increased with the severity of tricuspid regurgitation and pulmonary vascular resistance(PVR)( P<0.05). Conclusions:It is both safe and feasible to apply ECMO during BLTx. ECMO support should be given a high priority during BLTx for patients with primary diseases such as IPAH, IPF, severe preoperative PAP, tricuspid regurgitation and PVR. On the other hand, ECMO is sufficient as an alternative choice for COPD patients.
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Objective To investigate the effects of Xinkang recipe on myocardial collagen metabolism in rats with doxorubi-cin-induced heart failure.Methods Male SD rats were randomly divided into sham operation group(sham group),model group, Xinkang group and captopril group.The rat model of heart failure was established by intraperitoneal injection of doxorubi-cin.Distilled water,Xinkang decoction and captopril were respectively administrated to rats by gavage for 35 d.The indexes of ventricular remodeling and cardiac function were measured.Myocardial fibrosis was assessed by Masson's trichrome stai-ning.The expression levels of collagen Ⅰ,collagen Ⅲ,TGF-β1,IκB and p56 were detected in myocardial tissues by Western blotting.Myocardial protein and mRNA levels of matrix metalloproteinase-2(MMP-2),MMP-9,and tissue inhibitor of matrix metalloproteinase-1(TIMP-1)and TIMP-2 were detected by Western blotting and RT-qPCR,respectively.Results The expres-sion levels of collagenⅠand collagen Ⅲ protein,the collagen volume fraction(CVF),and the expression levels of TGF-β1 and p56 protein were significantly increased(P< 0.01),and the expression level of IκB protein was significantly decreased in the model group as compared with the sham group(P<0.05 for all).The myocardial protein and mRNA levels of MMP-2,MMP-9, TIMP-1,and TIMP-2 were significantly higher in the model group than in sham group(P<0.05 or P<0.01).The cardiac out-put(CO),left ventricular fractional shortening(FS),and left ventricular ejection fraction(LVEF)were significantly lower while the left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV),and left ventricular mass index (LVMI)were significantly higher in model group than in sham group(P<0.01).Compared with the model group,the expres-sion levels of collagen Ⅰand collagen Ⅲ protein,the CVF and the TGF-β1 and p56 expression levels were significantly decreased and the IκB protein expression was significantly increased in Xinkang and the captopril groups(P<0.05).The myocardial pro-tein and mRNA levels of MMP-2,MMP-9,TIMP-1,and TIMP-2 were significantly lower in Xinkang and captopril groups than in control group(P<0.05 or P<0.01).CO,FS,and LVEF were significantly higher while LVEDV,LVESV,and LVMI were significantly lower in Xinkang and captopril groups than in model group(P<0.01).Conclusion Xinkang recipe can reduce col-lagen deposition in the myocardia of rats with doxorubicin-induced heart failure,attenuate left ventricular remodeling,and im-prove cardiac function,which is associated with the inhibition of the NF-κB-mediated upregulation of TGF-β1.
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Objective: To observe the effect of bisoprolol on cardiac function in heart failure (HF) rats and to explore the mechanism. Methods: The experimental rats were divided into 6 groups: Control group, with normal healthy rats, Sham group, the rats received intraperitoneal injection of normal saline; chronic heart failure (CHF) model was successfully established in 40 rats and divided into 4 groups: CHF group, CHF+bisoprolol (Bis) group, CHF+captopril (Cap) group and CHF+Bis and Cap group.n=10 in each group. The cardiac function was observed among different groups; plasma BNP level was measured by ELISA, myocardial miR-25-3p expression was examined by RT-PCR, protein expressions of SERCA2a and phospholamban (PLB) were detected by Western blot analysis and SERCA2a activity was determined by inorganic phosphorus method. Results: Compared with Control group, CHF group showed decreased cardiac output (CO), left ventricular fractional shortening (LVFS), left ventricular ejection fraction (LVEF), reduced expression of cardiac SERCA2a, PLB, the ratio of SERCA2a/PLB and SERCA2a activity; while increased plasma BNP and miR-25-3p expression, allP<0.01. Compared with CHF group, CHF+Bis, CHF+Cap and CHF+Bis and Cap groups had increased CO, LVFS, LVEF, elevated expression of cardiac SERCA2a, PLB, the ratio of SERCA2a/PLB and SERCA2a activity; while decreased plasma BNP and miR-25-3p expression, allP<0.05.Conclusion: Bisoprolol could improve cardiac function in HF rats, which might be related to down regulating myocardial miR-25-3p expression, up regulating myocardial protein expressions of SERCA2a, PLB and enhancing SERCA2a activity.
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Objective To investigate the effects of bisoprolol on myocardial SERCA2a activity in rats with heart fail-ure.Methods Male SD rats were randomly divided into normal control group (control group), sham operation group ( sham group ) , model group , bisoprolol group ( Bis group ) , captopril group ( Cap group ) and bisoprolol plus captopril group[(Bis+Cap)group], heart failure rat model was induced by intraperitoneal injections of doxorubicin .Distilled water, bisoprolol, captopril or bisoprolol plus captopril were administrated by gastrogavage for 35 days, respectively. Indices of cardiac function and plasma levels of B-type natriuretic peptide ( BNP) were measured , myocardial expres-sion of miR-25-3p was detected by Stem-loop RT-qPCR, myocardial levels of SERCA2a and phospholamban (PLB) were detected by Western blot , myocardial SERCA2a activity was determined by the inorganic phosphorus method . Results Cardiac function in model group decreased significantly while plasma levels of BNP were significantly higher than those of control group ( P<0.01 ) .Myocardial expression of miR-25-3p in model group was significantly higher while myocardial levels of SERCA 2a and PLB,SERCA2a activity were significantly lower than those of con-trol group(P<0.01).Cardiac function in Bis group , Cap group and Bis +Cap group improved significantly while plasma levels of BNP were significantly lower than those of model group ( P<0.01 ) .Myocardial expression of miR-25-3p in Bis group, Cap group and Bis +Cap group were significantly lower while myocardial levels of SERCA2a and PLB were significantly higher than those in model group (P<0.01).The SERCA2a/PLB ratio and SERCA2a activity in Bis group and Bis +Cap group were significantly higher than those of model group ( P<0.05 ) .Conclu-sions Bisoprolol therapy improves cardiac function in rats with heart failure , which may be related to inhibition of myocardial miR-25-3p, increasing myocardial SERCA2a and PLB levels, enhancing SERCA2a activity.
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Objective To explore the effect of Xinkang Tablets on myocardial apoptosis index,collagen volume fraction and sarcoplasmic reticulum Ca2+-ATPase activity of rats with adriamycin-induced heart failure.Methods The chronic heart failure (CHF) SD rat model was established by intraperitoneal injection of doxorubicin.After successful modeling,the rats with CHF were randomly divided into 5 groups,namely model group,western medicine group,and low-,middle-and high-dose of Chinese medicine groups,10 rats in each group.The rats in the above groups were given intragastric administration of distilled water,22.5 μg/kg of Digoxin mixed suspension,9,18,36 g/kg of XinkangTablets,respectively,in the volume of 10 mL/kg of distilled water dilution,once a day,for 5 continuous weeks.Another the same batch of 10 SD rats were randomly allocated to the sham operation group,and were treated with intragastric administration of the same volume of distilled water.And then the apoptotic rate of myocardial cells was measured by TUNEL method,the collagen volume fraction (CVF) was measured after Masson staining,and the sarcoplasmic reticulum Ca2+-ATPase activity was determined by inorganic phosphate assay.Results Compared with the sham operation group,the apoptotic rate of myocardial cells and CVF in the model group were increased(P ＜ 0.01),indicating that the myocardial remodeling occurred in rats with CHF.Compared with the model Group,the apoptotic rate of western medicine group and three Chinese medicine groups was significantly decreased(P ＜ 0.01),suggesting that Digoxin and Xinkang Tablets can relieve apoptosis to certain extent.The CVF in Digoxin group and middle-and high-dose of Chinese medicine groups were lower than those in the model Group (P＜ 0.05 or P＜ 0.01),indicating that Digoxin and Xinkang Tablets can delay the myocardial fibrosis.Last but not least,the SERCA2a activities in the middle-and high-dose of Chinese medicine groups were higher than those in the model group (P ＜ 0.05 or P ＜ 0.01),suggesting that Xinkang Tablets may relieve myocardial remodeling and improve cardiac function through the regulation of SERCA2a activity.Conclusion Xinkang Tablets decrease the apoptotic rate and myocardial cell volume fraction probably through the regulation of SERCA2a activity,which may play a role in counteracting apoptosis and myocardial fibrosis,and ultimately delay the remodeling of the myocardium.
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ABSTRACT:Objective To investigate the effects of Xiefei Lishui recipe on left ventricle remodeling in rats with heart failure.Methods Heart failure rat model was induced by intraperitoneal injections of doxorubicin. Rats were randomly divided into sham operation group (sham group),model group,traditional Chinese medicine group (TCM group),captopril group,and digoxin group.Distilled water,TCM [22 g/(kg · d)],captopril [19 mg/(kg·d)],and digoxin [32μg/(kg·d)]were administered by gastrogavage in rats in different groups for 35 days,respectively.Indices of ventricle remodeling and cardiac function,plasma levels of B-type natriuretic peptide (BNP),rennin (REN),angiotensin Ⅱ(AngⅡ)and aldosterone (ALD)were measured.Cardiomyocyte apoptosis index and collagen volume fraction (CVF)were analyzed.We also assayed myocardial mRNA expressions of MMP-2/9 and TIMP-1/2,and their tissue inhibiting factors TIMP-1 and TIMP-2.Results Compared with those in sham group,in model group cardiac function was significantly decreased,which could be significantly increased by TCM or captopril or digoxin,indices of cardiac remodeling were significantly increased,which could be significantly decreased by TCM or captopril (P<0.01 or P<0.05).Plasma levels of BNP,REN,AngⅡ and ALD,cardiomyocyte apoptosis index and CVF in model group were significantly increased,could be significantly decreased by TCM or captopril (P<0.01 or P<0.05).Myocardial mRNA expressions of MMP-2,MMP-9,TIMP-1 and TIMP-2 in model group were significantly upregulated compared with those in sham group, which could be significantly downregulated by TCM (P<0.01 or P<0.05).Conclusion Xiefei Lishui recipe can attenuate left ventricle remodeling and improve cardiac function in rats with heart failure, which may be related to downregulating myocardial mRNA expressions of MMP-2 ,MMP-9 ,TIMP-1 and TIMP-2 in the left ventricle as well as inhibiting cardiomyocyte apoptosis and myocardial fibrosis.
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Objective To explore the key points of anaesthetic management of bilateral lung transplantation treating severe idiopathic pulmonary arterial hypertension.Methods Clinical data of 20 cases with severe IPAH treated by bilateral lung transplantation were analyzed retrospectively, 2 males and 18 females, ASA physical status Ⅲ or Ⅳ.The hemodynamic changes were observed at various points (30 min after double lung ventilation, 15 min after ECMO, during one-lung ventilation, 30 min after pulmonary artery block, at the opening of pulmonary artery and at the end of surgery) and pre-and post-operative changes of cardiovascular morphology were analyzed with heart ultrasound.Results Compared with 30 min after double lung ventilation, PaO2 and SVV were significantly increased and PAP, PAWP and PaCO2 were decreased 15 min after extracorporeal membrance oxygenation (ECMO) (P<0.05).PAP and PAWP were significant higher and SVV was lower 30 min after pulmonary artery block than 15 min after ECMO (P<0.05).Opening of pulmonary artery had significantly increased SVV and reduced PAP and PAWP compared with pulmonary artery block (P<0.05).ECMO was removed in 4 cases at end of the surgery.The remaining 16 cases assisted by ECMO were transferred to ICU, 3 cases underwent thoracotomy for exploration and hemostasis 1 day after the operation while 13 cases suffered from different degrees of left heart dysfunction postoperatively, 4 of which had acute heart failure.Of the 4 cases, 2 were treated by right femoral vein-right femoral artery bypass (V-A ECMO bypass) and 2 underwent right femoral vein-right internal jugular vein bypass (V-V ECMO bypass).Moreover, 3 cases performed tracheotomy 5 days, 6 days and 13 days day after the operation, respectively.All the patients were cured and discharged.Their cardiovascular morphology was improved.Conclusion The key successful factors of IPAH treated by bilateral lung transplantation are to improving perioperative heart function, keeping stable hemodynamics during induction of anesthesia and the operation and using ECMO properly and postoperative support.
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AIM:To investigate the effects of Xinkang recipe on myocardial miR-25-3p expression and sarco-plasmic reticulum calcium ATPase 2a ( SERCA2a) activity in heart failure rats .METHODS:Male SD rats were randomly divided into normal group , sham group , model group , Xinkang recipe group ( Xinkang group ) , and captopril group .The heart failure rat model was induced by intraperitoneal injection of doxorubicin .Distilled water , Xinkang recipe and capto-pril were administrated by gastric gavage for 35 d, respectively .The indexes of cardiac function and plasma level of brain natriuretic peptide (BNP) were measured.The SERCA2a activity was determined by the inorganic phosphorus method . The myocardial protein expression of SERCA 2a and phospholamban ( PLB) was detected by Western blot .The myocardial expression of miR-25-3p was detected by stem-loop RT-qPCR.RESULTS:Cardiac output (CO), left ventricular fraction-al shortening ( LVFS) and left ventricular ejection fraction ( LVEF) in Xinkang group and captopril group were significantly higher while the plasma levels of BNP were significantly lower than those in model group (P<0.01).The myocardial ex-pression levels of miR-25-3p in Xinkang group and captopril group were significantly lower while the myocardial protein le -vels of SERCA2a and PLB were significantly higher than those in model group (P<0.01).The SERCA2a/PLB ratio and SERCA2a activity in Xinkang group were significantly higher than those in model group (P<0.05), and no significant change was observed between captopril group and model group .CONCLUSION:Xinkang recipe therapy may improve car-diac function in heart failure rats , which may be related to inhibiting the expression of miR-25-3p, increasing the SER-CA2a/PLB ratio and enhancing SERCA 2a activity in the myocardium .
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Objective To investigate the changes of the N-acetylaspartate(NAA) concentrations in different brain regions and executive function skills in alcohol dependence,and to study the relationship between NAA levels and cognitive functions in subjects.Methods 49 male,non-smoking,alcohol-dependent patients and 45 healthy control subjects were measured with Proton 1H Magnetic resonance spectroscopy (MRS) and Wisconsin Card Sorting Test (WCST).Results Alcoholics had lower NAA/Cr ratios in prefrontal grey matter(GM) (1.59± 0.13) and white matter(WM) (1.58±0.12) regions and performed poorly on executive function tests compared to controls (P＜0.001).NAA/Cr in left prefrontal regions positively correlated with certain parameters of EF testing (number of correct responses 30.37± 3.73,perseverative errors 11.49± 3.39,random errors 6.18± 2.64,categories completed 2.08± 1.59)in alcoholic group (P＜0.01).NAA/Cr in prefrontal WM regions correlated with certain parameters of EF testing in alcoholic group (number of correct responses r=0.379,categories completed r=0.433,P＜ 0.05).Conclusion Long-term,chronic alcoholism will damage neuronal viability and cognitive functions,which suggests that NAA concentrations can reflect the extent of damage of cognitive functions with decreased levels reflecting neuronal loss.
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The regional medical information system calls for regional information resources and hospital-level information resources be interconnected and intercommunicated.To meet this requirement,a HL7 CDA-based solution was proposed based on analysis of the current hospital information resources management.An information resources service portal was built to harmonize the management of both new and old resources,and the hierarchy management based on information granularity.The technical implementation of the system is compliant with the SOA architecture and health information standards.This ensures the interconnection and intercommunication between inner information and outer one,and uses information resources in an efficient,reasonable and safe manner.