Long-term outcome of EVAHEART I implantable ventricular assist device for the treatment of end stage heart failure: clinical 3-year follow-up results of 15 cases / 中华心血管病杂志

Objective: To evaluate the long-term efficacy and safety of the implantable ventricular assist system EVAHEART I in clinical use. Methods: Fifteen consecutive patients with end-stage heart failure who received left ventricular assist device therapy in Fuwai Hospital from January 2018 to December 2021 were enrolled in this study, their clinical data were retrospectively analyzed. Cardiac function, liver and kidney function, New York Heart Association (NYHA) classification, 6-minute walk distance and quality of life were evaluated before implantation and at 1, 6, 12, 24 and 36 months after device implantation. Drive cable infection, hemolysis, cerebrovascular events, mechanical failure, abnormally high-power consumption and abnormal pump flow were recorded during follow up. Results: All 15 patients were male, mean average age was (43.0±7.5) years, including 11 cases of dilated cardiomyopathy, 2 cases of ischemic cardiomyopathy, and 2 cases of valvular heart disease. All patients were hemodynamically stable on more than one intravenous vasoactive drugs, and 3 patients were supported by preoperative intra aortic balloon pump (IABP). Compared with before device implantation, left ventricular end-diastolic dimension (LVEDD) was significantly decreased ((80.93±6.69) mm vs. (63.73±6.31) mm, P<0.05), brain natriuretic peptide (BNP), total bilirubin and creatinine were also significantly decreased ((3 544.85±1 723.77) ng/L vs. (770.80±406.39) ng/L; (21.28±10.51) μmol/L vs. (17.39±7.68) μmol/L; (95.82±34.88) μmol/L vs. (77.32±43.81) μmol/L; P<0.05) at 1 week after device implantation. All patients in this group were in NYHA class Ⅳ before implantation, and 9 patients could recover to NYHA class Ⅲ, 3 to class Ⅱ, and 3 to class Ⅰ at 1 month after operation. All patients recovered to class Ⅰ-Ⅱ at 6 months after operation. The 6-minute walk distance, total quality of life and visual analogue scale were significantly increased and improved at 1 month after implantation compared with those before operation (P<0.05). All patients were implanted with EVAHEART I at speeds between 1 700-1 950 rpm, flow rates between 3.2-4.5 L/min, power consumption of 3-9 W. The 1-year, 2-year, and 3-year survival rates were 100%, 87%, and 80%, respectively. Three patients died of multiple organ failure at 412, 610, and 872 d after surgery, respectively. During long-term device carrying, 3 patients developed drive cable infection on 170, 220, and 475 d after surgery, respectively, and were cured by dressing change. One patient underwent heart transplantation at 155 d after surgery due to bacteremia. Three patients developed transient ischemic attack and 1 patient developed hemorrhagic stroke events, all cured without sequelae. Conclusion: EVAHEART I implantable left heart assist system can effectively treat critically ill patients with end-stage heart failure, can be carried for long-term life and significantly improve the survival rate, with clear clinical efficacy.

Clinical application value of transthoracic echocardiography during perioperative period in patients undergoing left ventricular assist device implantation / 中华心血管病杂志

Objective: To observe the changes of parameters derived from transthoracic echocardiography (TTE) before and after left ventricular assist device (LVAD) implantation, and to evaluate the clinical value of TTE in the perioperative period of LVAD implantation. Methods: This is a retrospective study. The data of patients who underwent LVAD implantation in Fuwai Hospital from January 2018 to December 2020 were analyzed retrospectively. The TTE parameters, N-terminal pro-B-type natriuretic peptide (NT-proBNP) and total bilirubin (TBil) before and 1 month after LVAD implantation were collected and analyzed. Results: A total of 12 male patients undergoing LVAD implantation were included in this study. The mean age was (43.3±8.6) years. The left atrial volume index ((41.4±12.8)ml/m2 vs. (74.9±30.7)ml/m2, P<0.001), left ventricular end-diastolic volume index ((152.1±35.3)ml/m2 vs. (205.5±35.7)ml/m2, P<0.001), left ventricular end-systolic volume index ((112.5±27.9)ml/m2 vs. (155.1±29.1)ml/m2, P<0.001), right atrial diameter index ((23.7±3.5)mm/m2 vs. (27.2±5.8)mm/m2, P=0.023), right ventricular internal diameter at end-diastole ((24.6±2.7)mm vs. (30.0±4.8)mm, P<0.001), tricuspid annular plane systolic excursion ((11.5±2.9)mm vs. (14.6±2.8)mm, P=0.007), systolic pulmonary arterial pressure ((29.2±4.8) mmHg vs. (55.1±19.3) mmHg, P<0.001, 1 mmHg=0.133 kPa) were significantly reduced at 1 month post LVAD implantation as compared to before LVAD implantation. The aortic sinus diameter ((33.8±4.7)mm vs. (31.6±5.1)mm, P=0.007), left ventricular ejection fraction ((26.3±3.0)% vs. (23.8±4.4)%, P=0.016), right ventricular fractional area change ((31.0±8.6)% vs. (23.8±5.5)%, P=0.004) at 1 month post LVAD implantation were significantly higher than before LVAD implantation. The degree of mitral and tricuspid regurgitation decreased, and the inspiratory collapse rate of inferior vena cava increased (all P<0.05). NT-proBNP ((1 418.4±812.6)ng/L vs. (5 097.5±3 940.4)ng/L, P=0.004) and TBil ((12.4±5.4)μmol/L vs. (27.5±14.0)μmol/L, P=0.001) decreased significantly at 1 month post LVAD implantation. Conclusions: TTE results show that LVAD could effectively relieve left ventricular load and improve right ventricular function. TTE can monitor the cardiac structural and functional changes during the perioperative period of LVAD implantation, and provide the imaging evidence for clinical evaluation of the therapeutic effect of LVAD.

A controlled study on the therapeutic effect of acupuncture and acupuncture combined with drugs on peripheral facial paralysis with normal result of facial nerve magnetic resonance examination / 中国针灸

OBJECTIVE@#To explore whether a combination of drugs is needed when acupuncture is used to treat peripheral facial paralysis with normal result of facial nerve magnetic resonance examination.@*METHODS@#A total of 48 normal facial nerve magnetic resonance examination of peripheral facial paralysis patients were randomly divided into an acupuncture combined with drugs group and an acupuncture group, 24 cases in each group. Acupuncture combined with prednisone were applied in the acupuncture combined with drugs group, and simple acupuncture was given in the acupuncture group. The acupuncture treatment methods were the same. Acupuncture mainly applied at Yifeng (TE 17), Quanliao (SI 18), Taiyang (EX-HN 5), Sibai (ST 2), Jiache (ST 6), Dicang (ST 4) on the affected side, Hegu (LI 4, opposite side) for 30 min a day, once every other day. Electroacupuncture was added at Yifeng (TE 17) and Quanliao (SI 18), Jiache (ST 6) and Dicang (ST 4) on the affected side after the acute phase until it was cured. Prednisone was taken orally once a day, with an initial dose of 30 mg, decrease 10 mg every 3 days for 9 days. After 3 and 8 weeks of treatment, the effect was observed by Portmann score.@*RESULTS@#After 3 and 8 weeks of treatment, the cured rates were 50.0% (12/24) and 83.3% (20/24) in the acupuncture group, which were slightly lower than 58.3% (14/24) and 87.5% (21/24) in the acupuncture combined with drugs group，there was no significant difference between the two groups (both >0.05); the course of treatment in the acupuncture group was (31.2±17.0) d, slightly longer than (29.5±12.8) d in the acupuncture combined with drugs group , but there was no significant difference between the two groups (>0.05).@*CONCLUSION@#Simple acupuncture treatment on peripheral facial paralysis with normal result of facial nerve magnetic resonance examination can achieve the same effect of acupuncture combined with drugs, and avoid drug-related adverse reactions.

The effective parts of liangxue tongyu prescription on cooling-blood and activating-blood and analysis of chemical constituents by HPLC-MS and GC-MS / 药学学报

In order to clarify material basis of effective parts of liangxue tongyu prescription, blood-heat and blood-stasis rat model induced by dry yeast was established. The changes of rectal temperature, blood viscosity and plasma viscosity were used to evaluate the cooling-blood and activating-blood effects of liangxue tongyu prescription and its parts. Compared with the model group, the extract from liangxue tongyu prescription, its volatile oil and n-butanol part could significantly reduce rectal temperature (P<0.01), and also reduce blood viscosity and plasma viscosity to various degrees (P<0.01 or P<0.05). So volatile oil and n-butanol part were primarily identified as effective parts of liangxue tongyu prescription. By using GC-MS with normalization method of area to analyze volatile oil of liangxue tongyu prescription, 70 compounds were identified, accounting for about 92.54%, mainly as β-asarone, paeonol, α-asarone and shyobunone. 42 compounds such as peony glycosides, tannins, and iridoid glycosides were identified by HPLC-MS techniques and standard comparison. The study determined the effective parts of liangxue tongyu prescription and clarified the chemical composition providing the foundation for further studies on material basis of liangxue tongyu prescription.

Consistency analysis of Keratograph and traditional methods to evaluate tear film function / 国际眼科杂志(Guoji Yanke Zazhi)

?AlM: To investigate repeatability and accuracy of a latest Keratograph for evaluating the tear film stability and to compare its measurements with that of traditional examination methods. ?METHODS: The results of noninvasive tear film break-up time ( Nl-BUT ) including the first tear film break-up time ( BUT-f ) and the average tear film break-up time ( BUT - ave ) were measured by Keratograph. The repeatability of the measurements was evaluated by coefficient of variation ( CV ) and intraclass correlation coefficient ( lCC) . Wilcoxon Signed-Rank test was used to compare Nl-BUT with fluorescein tear film break-up time ( FBUT) to confirm the correlation between Nl-BUT and FBUT, Schirmer l test values. Bland-Altman analysis was used to evaluate consistency. ?RESULTS: The study recruited 48 subjects ( 48 eyes ) (mean age 38. 7±15. 2 years). The CV and lCC of BUT-f were respectively 12. 6% and 0. 95, those of BUT-ave were 9. 8% and 0. 96. The value of BUT-f was lower than that of FBUT. The difference had statistical significance ( 6. 16±2. 46s vs 7. 46±1. 92s, P ?CONCLUSlON: Keratograph can provide Nl-BUT data that has a better repeatability and reliability, which has great application prospects in diagnosis and treatment of dry eye and refractive corneal surgery.

Characteristic and surgical treatment of cervicothoracic spine fracture / 中国骨伤

<p><b>OBJECTIVE</b>To discuss the clinical characteristic and surgical treatment of cervicothoracic spine fracture complicated with spine cord injury.</p><p><b>METHODS</b>Thirty-eight patients with cervicothoracic fracture and spine cord injury were retrospectively analyzed from January 1998 to January 2007. There were 29 males and 9 females with an average age of 36.4 years ranging from 18 to 58 years. All patient suffered from pain and limitation of motion on cervicothoracic junction. According to American Spinal Injury Association (ASIA) grades, 4 cases were in grade A, 13 cases in grade B, 10 cases in grade C, 7 cases in grade D and 4 cases in grade E. All patients were treated with anterior decompressed, bone graft and Zephir plate fixation in cervicothoracic spine.</p><p><b>RESULTS</b>All patients were followed up for 1 to 10 years, the mean followed up time was 4.5 years. And all patients got complete bone fusion within 4 to 6 months postoperatively. There were no pull-out and breakage of screws or plates. Spinal cord functional recovery improved on average 3.8 degree according AISA standard. Two patients appeared transient hoarse voice after surgery, the symptoms were alleviated from 3 to 6 months after operation. Seven patients were complicated with Horner syndrome preoperatively, and the symptoms were disappeared after operation.</p><p><b>CONCLUSION</b>The clinical situation of cervicothoracic spine fracture with spine cord injury is complicated. And anterior decompressed, bone graft and internal fixation performed on cervicothoracic spine fracture can achieve an efficient and safe clinical outcome.</p>

Suppression of vascular endothelial growth factor expression by vector-based small interfering RNA in human tongue squamous carcinoma cell line Tca8113 / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To assess suppression effects of vector-based small interfering RNA (siRNA) on vascular endothelial growth factor (VEGF) expression of human tongue squamous carcinoma cell line (Tca8113) in vitro.</p><p><b>METHODS</b>Two siRNA targeting VEGF constructed in eukaryotic expression vector (Pu-VEGF-siRNA1, Pu-VEGF-siRNA2), eukaryotic expression vector as the experiment control, all of which were transfected into Tca8113 cells with Lipofectamine 2000. Non-transfection cell was used as negative control. VEGF mRNA and protein were detected by reverse transcription polymerase chain reaction (RT-PCR), immunohistochemistry and enzyme linked immunosorbent assay (ELISA), respectively.</p><p><b>RESULTS</b>Compared to the experimental and negative controls, the expression of VEGF mRNA and protein were significantly decreased in the Pu-VEGF-siRNA1 group and Pu-VEGF-siRNA2 group. But there were no significant differences between two controls (P > 0.05).</p><p><b>CONCLUSION</b>Vector-based siRNAs targeting VEGF are efficient in down-regulating VEGF expression in Tca8113 cells.</p>

Antiangiogenic and antitumor effects of vascular endothelial growth factor small interfering RNA on Tca8113 human tongue squamous cell carcinoma xenografts in vivo / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To examine the antiangiogenic and antitumor effects of vector-based small interfering RNA (siRNA) targeting vascular endothelial growth factor (VEGF) on human tongue squamous cell carcinoma xenografts in vivo.</p><p><b>METHODS</b>Tca8113 human tongue cancer nude mice xenograft model was established, and subsequently divided into four groups randomly (5/group). Two siRNA targeting VEGF constructed in eukaryotic expression vector (PU-VEGF-siRNA1, PU-VEGF-siRNA2) were injected intratumor and peritumor with lipofectamine 2000, respectively. No siRNA vector injected and non-injected tumors were used as experimented and negative controlled, respectively. Animals were injected one time every 3 days for a total of 10 times. Three days after the last injection, the weigh and volume of tumors, and intratumor microvessel density (MVD) were measured. The expression of VEGF in xenograft tumors was detected by reverse transcription polymerase chain reaction (RT-PCR), Western blotting and immunohistochemistry. The cell apoptosis and cell cycle analysis of tumors were detected by Tunel and Flow cytometry, respectively.</p><p><b>RESULTS</b>Compared to the experimental and negative controls, the percentage of cells in the G(1) phase increased (P < 0.05), the expression of VEGF on both mRNA and protein level, the tumor weigh and volume, and MVD decreased in the PU-VEGF-siRNA2 group (P < 0.05), and more apoptosis was induced (P < 0.01). But significant differences were not noted between PU-VEGF-siRNA1 group and two controls (P > 0.05).</p><p><b>CONCLUSIONS</b>VEGF-siRNA can reduce VEGF expression, inhibit tumor growth and angiogenesis, and induce apoptosis in Tca8113 cell carcinoma in vivo. Different VEGF-siRNA may have different effect in vivo.</p>

Treatment of patients older than 60 years with symptomatic vertebrobasilar artery stenosis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Vertebrobasilar artery stenosis is an important cause of ischemic posterior circulation strokes. This study aimed at evaluating the safety and efficacy of treatment including conservative therapy alone and conservative plus endovascular therapy for elderly patients with symptomatic vertebrobasilar artery stenosis.</p><p><b>METHODS</b>Patients older than 60 years with symptomatic vertebrobasilar artery stenosis (> or = 50%) confirmed by cerebral angiography were enrolled. All of them were treated with medical therapy and some with additional stent-assisted angioplasty (the stenting subgroup). Their clinical, imaging, intervention and follow-up data were analyzed.</p><p><b>RESULTS</b>One hundred and seventeen consecutive elderly patients (100 men, mean age (68.1 +/- 5.1) years) were enrolled and followed up for a mean time of 28.4 months; 81.7% of them were symptomatically resolved or improved; a stroke rate of 5.1% and a stroke-related death rate of 1.7% were found among them during the hospitalization and follow-up. In the stenting subgroup, 78 balloon expandable stents were employed in the 70 patients with a technical success rate of 98.7% and the mean degree of stenosis was significantly reduced from (81.7 +/- 14.3)% before stenting to (8.3 +/- 4.2)% after stenting (P < 0.001). Four (5.7%) periprocedural strokes occurred, of whom two led to death within 30 days after the procedure. During the follow-up (mean 27.7 months), sixty of the surviving 68 patients in the stenting subgroup were symptomatically resolved or improved. Only one (1.5%) posterior circulation stroke occurred, while duplex ultrasound scan of 34 patients demonstrated 10 (29.4%) in-stent restenosis.</p><p><b>CONCLUSIONS</b>Appropriate utilization of conservative therapy alone and conservative plus endovascular therapy may improve short-term clinical outcomes for elderly patients with symptomatic vertebrobasilar artery stenosis. Furthermore, stent-assisted angioplasty is technically feasible and relatively safe in elderly patients.</p>

Management of elderly patients with symptomatic vertebrobasilar insufficiency / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the feasibility, safety and short-term efficacy of stent-assisted angioplasty and/or drug therapy for elderly patients with symptomatic vertebrobasilar insufficiency.</p><p><b>METHODS</b>Elderly patients (> or = 60 years old) with symptomatic vertebrobasilar stenosis (> or = 50%) demonstrated by cerebral angiography were treated with drug therapy and some with endovascular stenting further from April 2001 to June 2006. The clinical, imaging, intervention and follow-up data were collected and analyzed.</p><p><b>RESULTS</b>Eighty-one elderly patients were chosen for study, including 68 males and 13 females. The mean age is 70 years (60 - 87 years); stroke rate of 4.9% (4/81) and stroke-related mortality rate of 2.5% (2/81) were found in this group during hospitalization and follow-up (mean 28.1 months), and symptoms resolved or improved clinically in 66 (81.5%). Fifty-two balloon expandable stents were placed in 48 (59.3%) patients of this group with a technical success rate of 98.1% and the mean degree of stenosis was reduced from (82.4 +/- 13.1)% to (6.4 +/- 3.2)% (t = 22.4, P = 0.00).</p><p><b>CONCLUSIONS</b>Appropriate management including endovascular stenting and/or drug therapy may improve short-term outcomes of elderly patients with symptomatic vertebrobasilar insufficiency; meanwhile, stent-assisted angioplasty is technically feasible and relatively safe.</p>

Reconstruction of maxillary defects combination with pedicled buccal fat pad graft, temporalis myofascial flap and titanium mesh / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To study the feasibility of close and three-dimensional reconstruction of maxillary defects combination with pedicled buccal fat pad graft, temporalis myofascial flap and titanium mesh.</p><p><b>METHODS</b>Among 11 patients with maxillary tumors, 9 were malignant and 2 were benign. 8 cases underwent subtotal maxillectomy and 3 cases underwent total maxillectomy. Maxillary defects were closely reconstructed combination with pedicled buccal fat pad graft (BFP), temporalis myofascial flap (TMF) and titanium mesh to restore the profile of maxilla.</p><p><b>RESULTS</b>All flaps were alive with satisfactory function and aesthetic appearance. The uncovered BFP and the facial muscle surface of TMF epithelialized within 4-6 weeks. Their degree of mouth opening ranged from 2.5 to 4.0 cm and without nasal foods return. All patients had a good voice quality.</p><p><b>CONCLUSION</b>Making use of BFP, TMF and titanium mesh can restore the good contour and function of maxillary. It is an effective method of reconstruction of maxillary defects, and is easy to manipulate. It is worthy to popularization.</p>

Open-label and non-randomized study of therapeutic effect of amantadine monotherapy and concomitant amantadine with salvia miltiorrhiza compound or selegiline on early Parkinson's disease / 中国康复理论与实践

@# Objective To assess the clinical efficacy and safety of amantadine monotherapy and concomitant amantadine with salvia miltiorrhiza compound or selegiline of the treatment of Parkinson's disease.Methods The clinical trial was performed in the multicenter, open label study. Amantadine group: 35 cases, amantadine plus salvia miltiorrhiza compound group: 34 cases and amantadine plus selegiline group: 29 cases. The clinical efficacy had been assessed with modified Webster scale (WR) and motor dysfunction rating scale for Parkinson's disease (MDRSPD) with interval of two months for one year. The safety data included blood glucose, hepatic and renal function tests, blood and urine routine tests.Results The clinical improved rates were 42.9% (WR) and 37.1% (MDRSPD) in amantadine group, respectively. The clinical score was improved in 34.2% (WR) and 26.5% (MDRSPD) in amantadine plus salvia miltiorrhiza compound group, respectively. The clinical improvement was 51.1% (WR)and 48.3% (MDRSPD) in amantadine plus selegiline group, respectively. There were no significant differences among these three groups (t-test,P>0.05). The clinical marked efficacy rates in assessment of MDRSPD were 2.8% in amantadine group, 11.8% in amantadine plus salvia miltiorrhiza compound group and 27.6% in amantadine plus selegiline group, respectively. There was significant difference between amantadine group and amantadine plus selegiline group, but no significant difference between amantadine group and amantadine plus salvia miltiorrhiza compound group. The adverse event rates were 27.8% in amantadine group, 8.8% in amantadine plus salvia miltiorrhiza compound group and 31.0% in amantadine plus selegiline group, respectively. All these events were mild, of short duration and resolved without treatment. Conclusion There was some efficacy rate in all three groups. Comparing with amantadine group, there was higher marked efficacy rate in amantadine plus selegiline group.