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Objective To compare the safety and efficacy between transcatheter intervention and surgical closure of para-valvular leakage(PVL)after valve replacement.Methods From May 2010 to May 2014,17 patients of paravalvular leakage af-ter valve replacement underwent interventional therapy and 11 patients underwent surgical closure.The perioperative charac-ters, mortality rate, complications and prognosis were compared between the patients underwent surgical procedure and tran-scatheter intervention.The average follow-up time was 13 months(1-36 months).Results The success rate of transcatheter intervention was 100%, while there were 2 in-hospital deaths in the surgical group(18%).Compared with surgical group, transcatheter intervention group has the benefit of shorter operation time[(84 ±36)min vs.(358 ±88)min](P<0.01),shor-ter hospitalization time[(11.9 ±12.1)d vs.(38.1 ±42.2)d](P<0.05), less transfusion[(1 029 ±455)ml vs.(1 438 ± 908)ml](P<0.05).There was no mechanical ventilation and ICU stay in the transcatheter intervention group.After tran-scatheter intervention, there was 7 residual shunt(47%)with an average shunt volume of(1.6 ±1.7)ml,which is remarkably reduced compared with pre-operation.In the surgical group, there was 1 case of residual shunt(9%).During the follow-up, there was no deaths in both groups, with improved heart function and no serious complications.Conclusion In the treatment of paravalvular leakage after valve replacement,transcatheter interventiontechnique has the advantages of simpler and safe ap-proach, less trauma, shorter time of hospitalization,faster post-operative recovery and lower treatment cost.This method is one of the new technology in the field of minimally invasive cardiac surgery in recent years.By improving operation skills,choosing individualized occluders and treatment of early hemolytic complications, the success rate and long-term effect of interventional therapy can get further improved.
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Objective To evaluate the efficacy of interventional therapy via apical approach in complex mitral valve paravalvular leakage (PVL).Methods From January 2014 to December 2016,interventional therapy by apical approach was used in 7 patients with mitral valve PVL after mechanical valve replacement.There were 5 male and 2 female with mean age of 42-64 (51.3 ± 7.1) years.Six patients had a history of previous infective endocarditis.There were 3 cases of NYHA heart function =Ⅲ,and 4 cases =Ⅳ.The period of time between interventional therapy and previous operation was 6.5-8 (3.6 ± 3.1) years,with mitral regurgitation volume:9.5-23.1 (13.3 ± 4.7)ml.Interventional therapy of small incision method via the left sixth intercostal was carried out in the catheterization laboratory or the hybrid operation room with the patient under general anesthesia.Follow-up evaluation included peri-operational mortality,complications,improvement of cardiac function,hemolysis and postoperative residual mitral regurgitation.Results The success rate of total operation was 100％.The average operation time was 90-300 (145.7 ± 71.8) min,and the DSA radiation time was 6-25 (12.1 ± 6.5)min,with average hospitalization time of 5-12 (10.2 ± 3.5)d.The main post-operative complications included 1 case of hemoptysis,1 case of hematuria and acute renal failure,and 2 cases of blood transfusion,with blood transfusion volume of 1 200 ml and 3 290 ml,respectively.During the follow-up,there was no death.Mitral regurgitation volume decreased to 0 -1.0(0.43 ± 0.45) ml (P ＜ 0.05).All patients had improved heart function in different degree and no serious complications.Conclusions Interventional therapy via apical approach in complex mitral valve PVL has the advantages of being a simpler and safer approach,less trauma,shorter time of hospitalization,faster post-operative recovery and lower treatment cost.Its disadvantages are high difficult operation,strict indications and high technical requirements for the surgeon.By improving operation skills,choosing individualized occluders and treatment of early hemolytic complications,the success rate and long-term effect of interventional therapy can get further improved.
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OBJECTIVE:To establish a method for determining the plasma concentration of paeoniflorin and phillyrin and phar-macokinetic study before and after intragastric administration of Qianliean granules. METHODS:LC-MS/MS method was adopted. The column was Waters C18 with mobile phase consisted of acetonitrile(A)-2 mmol/L ammonium acetate(containing 0.05% formic acid)(B)(0-9 min:15%A→50%A;9-11 min:50%A→90%A;11-17 min:90%A;17-19 min:90%A→15%A;19-20 min:15%A),at the flow rate of 0.6 ml/min;column temperature was 35 ℃ and the volume was 20 μl;quantitative ions were paeoniflorin m/z 525.2 → m/z 449.0,phillyrin m/z 552.3 → m/z 355.3. 7 SD male rats were docked to collect blood 0.5 ml from angular vein 0.25,0.5,0.75,1,1.5,2,3,4,6,8,10,12,24 h after administration Qianliean granule solution 1 g(medicinal materials)/kg to determine the blood concentration of drugs. DAS 2.1.1 software was employed to calculate pharmacokinetic parameters. RE-SULTS:The linear range of paeoniflorin and phillyri were 5.0-2500.0 μg/L(r=0.9979)and 2.0-2000.0 μg/L(r=0.9982),re-spectively;RSD of precision test was less than 5.5%(n=5);the method recovery were 96.0%-104.0% and 92.0%-107.0%,the extration recovery were 71.4%-83.5% and 81.5%-92.3% and RSD of stability test was less than 5.0%(n=3). The pharmacokinet-ic parameters of paeoniflorin and phillyrin were as follows as t1/2 of (2.206 ± 0.631) and (1.355 ± 0.317) h;cmax of (1504.069 ± 620.885) and (79.043 ± 15.568)μg/L;tmax of (1.000 ± 0.250) and (1.214 ± 0.267) h;AUC0-24 h of (4897.645 ± 2207.577) and (263.475±54.795)μg·h/L;CL of(5.025±2.773)and(76.253±13.986)L/(h·kg). CONCLUSIONS:The method is highly sensi-tive,exclusive,simple,accurate and reliable,and can be applied to study the pharmacokinetic characteristics of paeoniflorin and phillyrin in rats in vivo.
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OBJECTIVE:To study the influence of butylphthalide on the pharmacokinetics of aspirin in rats. METHODS:20 rats were randomly divided into control group(vegetable oil 0.4 ml/rat+aspirin 10 mg/kg)and trial group(butylphthalide 80 mg/kg+aspirin 10 mg/kg) intragastrically,once a day,for consecutive 10 days. Blood samples were collected before the last medication and 10,20,40,60,120,240,360,480,600 and 720 min after medication,0.2 ml each time. The blood concentration of drugs was determined by HPLC,and pharmacokinetics parameters were calculated by DAS 2.0 software. RESULTS:Main pharmacokinet-ic parameters of aspirin in control group vs. trial group were as follows as cmax of (28.68 ± 6.08) vs. (29.33 ± 4.25)μg/ml;t1/2 of (2.48±0.67)vs.(1.60±0.36)h;AUC0-720 min of(188.71±24.29)vs.(140.31±15.08)μg·h/ml;CL/F of(0.05±0.01)vs.(0.07± 0.01)L/(h·kg);there were significant differences in t1/2,AUC0-720 min and CL/F(P<0.05). CONCLUSIONS:Butylphthalide has no significant effect on the absorption and distribution of aspirin in rats,but can strengthen its metabolism and elimination.
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Objective To explore the current condition of psychological problems of patients in cardiology clinic. Methods A total of 347 patients in the cardiology clinic of Prof. HU Da-yi were screened by self-rating depression scale(SDS),Self-rating anxiety scale(SAS),Hamilton rating scale for depression(HRSD)and Hamilton anxiety scale(HAMA). Results The rates of patients with somatic disease only or with psychological disorder only were 52.4%and 12.7%, the rate of somatic disease accompanied with psychological disorder was 27.7%. For the patients with psychological problems, there were 31 cases with depression(8.9%),62 cases with anxiety(17.9%),and 28 cases(8.1%) suffering from mixed depression and anxiety the diagnosis of cardiovascular disease,functional disease or digestive disease was always used by doctors for the patients with psychological problems only,as they always did not accept the diagnosis of psychological disorder. Conclusions It is very common that patients in cardiology clinic department suffered from psychological problems. The patients with psychological disorder only were easily misdiagnosed as somatic disease especially cardiovascular disease.
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Objective To evaluate the relationships between the unstable coronary lesions and the levels of serum C-reactive protein(CRP) and urico-acid (UA).Methods 205 patients with primary diagnoses as coronary heart disease were examined by selective coronary angiography,and in the mean time ,the serum CRP and UA levels were measured.These patients were grouped the control,the unstable coronary lesion group and stable coronary lesion group according to the extent of coronary artery atherosclerosis stenosis.All data were undergone statistical analysis.Results The serum CRP level in unstable coronary lesion group was higher than that in stable coronary lesion group(P0 05).Conclusions The serum CRP level is significantly positive relation with the unstable coronary lesions.The serum UA level is not association with the unstable coronary lesions.
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OBJECTIVE:To study the pharmacokinetics and relative bioavailability of clindamycin phosphate capsules in healthy volunteers METHODS:A single oral dose of 300mg domestic clindamycin phosphate capsules or imported Dalacin C was given to 18 healthy male volunteers in an open randomized crossover study Clindamycin concentrations in plasma were determined by microbiologic assay The pharmacokinetic parmameters as well as relative bioavailability were calculated with 3p97 software and bioequivalence was analysed with NDST software RESULTS:The concentration-time curves of domestic clindamycin phosphate capsules or imported Dalacin C were well fitted for one-compartment open model The pharmacokinetic parameters of domestic and imported products were:Tmax(0 94?0 51) and(0 75?0 35)h;Cmax(3 86?0 62)?g/ml and (4 08?0 60)?g/ml;AUC0～12(14 88?3 64)?g/(ml?h)and(16 07?3 68)?g/(ml?h)respectively There were no significant differences in AUC0～12 and Cmax between two products CONCLUSION:The relative bioavailability of clindamycin phosphate capsules was(93 4?14 9)% compared with imported Dalacin C The results showed that the two formulations were bioequivalent
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OBJECTIVE： To prepare etoposide－ bovine serum albumin－ microspheres (VP－ BSA－ MS)and to study the distribution and pharmacokinetics of VP－ BSA－ MS in mice. METHODS: The drug concentrations in various tissues were determined by high－ performance liquid chromatograph (HPLC). RESULTS: The VP－ BSA－ MS was injected into mice and (47.88± 2.56 )％ of the total dosage was detected in lung tissue 15min after administration， the pharmacokinetical equation was C=149.0 897e－ 1.7 780t＋ 3.9 627e－ 0.0 398t — 153.0 524e－ 3.5 054t. CONCLUSION： The VP－ BSA－ MS showed remakable targeting action to the lung and the pharmacokinetic regularity could be discribed as two－ compartment model
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OBJECTIVE:To prepare etoposide-bovine serum albumin-microspheres (VP-BSA-MS)and to study the distribution and pharmacokinetics of VP-BSA-MS in mice. METHODS: The drug concentrations in various tissues were determined by high-performance liquid chromatograph (HPLC). RESULTS: The VP-BSA-MS was injected into mice and (47.88?2.56 )% of the total dosage was detected in lung tissue 15min after administration,the pharmacokinetical equation was C=149.0 897e-1.7 780t+3.9 627e-0.0 398t —153.0 524e-3.5 054t. CONCLUSION:The VP-BSA-MS showed remakable targeting action to the lung and the pharmacokinetic regularity could be discribed as two-compartment model