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NAD(P)H: quinone oxidoreductase 1 (NQO1) is a flavin protease highly expressed in various cancer cells. NQO1 catalyzes a futile redox cycle in substrates, leading to substantial reactive oxygen species (ROS) production. This ROS generation results in extensive DNA damage and elevated poly (ADP-ribose) polymerase 1 (PARP1)-mediated consumption of nicotinamide adenine dinucleotide (NAD+), ultimately causing cell death. Nicotinamide phosphoribosyltransferase (NAMPT), the rate-limiting enzyme in the NAD+ salvage synthesis pathway, emerges as a critical target in cancer therapy. The concurrent inhibition of NQO1 and NAMPT triggers hyperactivation of PARP1 and intensive NAD+ depletion. In this study, we designed, synthesized, and assessed a novel series of proqodine A derivatives targeting both NQO1 and NAMPT. Among these, compound T8 demonstrated potent antitumor properties. Specifically, T8 selectively inhibited the proliferation of MCF-7 cells and induced apoptosis through mechanisms dependent on both NQO1 and NAMPT. This discovery offers a promising new molecular entity for advancing anticancer research.
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Humains , NAD/métabolisme , Lignée cellulaire tumorale , Espèces réactives de l'oxygène/métabolisme , Nicotinamide phosphoribosyltransferase/métabolisme , Cytokines/métabolisme , Quinones , OxidoreductasesRésumé
Objectives:The aim of this study was to assess the influence of graft anastomosis strategies of radial artery on the flow characteristics and early patency in coronary artery bypass grafting(CABG). Methods:Present study enrolled 99 patients(92 males,7 females,aged[57.2±8.7]years),who underwent isolated CABG using a radial artery(RA)graft from January 2019 to December 2021 in our department.The RA was proximally anastomosed to the aorta in 79 patients(group 1)and to another graft as a composite graft in 20 patients(group 2).The intraoperative flow characteristics were evaluated with the transit time flow measurement(TTFM),and the graft patency was assessed by computed tomography coronary angiograms perioperatively and at 1year after operation respectively. Results:Baseline characteristics were similar between the two groups(all P>0.05).There was no perioperative death.Incidence of minimally invasive cardiac surgery for CABG(MICS CABG)and mean flow(MF)of RA grafts were both higher in group 2 than in group 1(all P<0.05).Perioperative RA graft failure rate was 24.2%(n=24),which tended to be lower in group 2 than in group 1(10.0%vs.27.8%,P=0.096).CT angiography showed that RA graft failure reduced to 16.1%at one year after operation.Compared to patency group,patients with failure RA grafts perioperatively had higher pulse index(PI)and lower intraoperative MF(all P<0.05).Patients with failure RA grafts at one year after operation had higher PI and more bypassed to the right coronary artery(RCA)target territories of RA grafts(all P<0.05). Conclusions:RA proximal anastomosis to the aorta or to another graft dose not affect the perioperative patency in CABG.Some RA graft that failed perioperatively might recanalize at one year after operation.High intraoperative PI and bypassed to RCA of RA grafts may be predictors of graft failure at one year after operation.
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Objective:To report the use of right internal mammary artery (RIMA) in coronary artery bypass grafting (CABG) in our center, summarize the purpose and configuration of RIMA graft in CABG.Methods:All clinical data of coronary artery bypass grafting patients in our center performed in the past 6 years were collected and analyzed retrospectively. Those patients were divided into RIMA group and non-RIMA group according to the use of RIMA. Propensity score matching had been performed before these data was compared. Surgical technique of use of RIMA was summarized.Results:1 537 CABG had been performed from January 1st, 2016 to October 31st, 2021 in our center. Of which, 128 cases were allocated to RIMA group. After propensity score matching having been performed, there was no difference in baseline data between the RIMA group and the non-RIMA group (128 cases), and the RIMA group had more grafts and arterial grafts than the non-RIMA group. The postoperative drainage volume in the RIMA group was more than that of the non-RIMA group. However, there was no statistical significance in difference of transfusion between two groups. Also, there was no difference in postoperative mechanical ventilation time, ICU time and length of stay postoperatively. The postoperative complications were similar between two groups. Postoperative patency rate of the RIMA graft was as high as 95.2%. The target vessels of RIMA included left anterior descending branch (45 cases), diagonal branch (19 cases), intermediate branch (12 cases). obtuse marginal or circumflex branch (16 cases), posterior descending branch (5 cases) and right coronary trunk (18 cases). 41 RIMA used as free grafts, 87 used as in situ grafts, of which 19 RIMA need lengthened by other graft vessels.Conclusion:The patency rate of RIMA graft is high and the application of RIMA do not increase the surgical risk significantly. However, there are versatile contour of RIMA grafts. It can be used as artery graft in selected patients.
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Objective: To explore the role of nonalcoholic fatty liver disease (NAFLD) in the development of hepatocellular carcinoma (HCC) in patients with prior hepatitis B virus infection (HBsAg-negative and anti-HBC-positive). Methods: 1605 hospitalized patients who were first diagnosed with HCC at Nanfang Hospital between 2015 to 2017 were retrospectively studied. Patients who developed HCC on the basis of active HBV infection (HBsAg-positive, anti-HBc positive) were used as control. Multivariate logistic regression model was used to analyze the relationship between NAFLD and HCC in patients with prior hepatitis B virus infection. Results: Among HCC patients with both HBsAg and anti-HCV negative, the proportion of prior HBV infection accounted for 86.7%. NAFLD prevalence was higher in patients with HCC based on prior HBV infection than active HBV infection (19.7% vs. 8.5%, P < 0.001). After adjusting for gender, age, hypertension, alanine aminotransferase, and liver cirrhosis, patients with HCC based on prior HBV infection were more likely to develop NAFLD (OR: 2.29, 95% CI: 1.40-3.74), and this phenomenon was observed only in patients with non-cirrhosis (OR: 5.26, 95% CI: 2.53-10.96) and aged≥50 years (OR: 2.36, 95% CI: 1.33-4.20). Conclusion: NAFLD may be a risk factor for HCC in a previously infected patients with HBV, especially in non-cirrhotic and population aged≥50 years.
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Humains , Adulte d'âge moyen , Carcinome hépatocellulaire/épidémiologie , Hépatite B/épidémiologie , Antigènes de surface du virus de l'hépatite B , Virus de l'hépatite B , Tumeurs du foie/épidémiologie , Stéatose hépatique non alcoolique/épidémiologie , Études rétrospectives , Facteurs de risqueRésumé
Objective:To analyze and compare difference of ultrasonic blood flow of left internal mammary artery(LIMA) and right internal mammary artery(RIMA)as graft to left anterior descending artery(LAD) in patients undergoing off-pump coronary artery bypass grafting(OPCABG).Methods:From October 2017 to October 2019, a total of 363 patients who underwent OPCAB including 329 patients in LIMA-LAD group and 34 patients in RIMA-LAD group, were included in this study. Transthoracic ultrasound examination on IMA was performed before OPCABG. The blood flow , the value of PI(pulsation index) and diastolic flow(DF) of LIMA and RIMA to left anterior descending were measured and recorded by intraoperative TTFM. Patients underwent coronary artery CT examinations at 1 week after OPCABG to discover the patency of grafts.Results:The pre-operative diameter of RIMA was larger and the blood flow and pulsation index of RIMA was better than that of LIMA before OPCABG( P<0.001). But there was no significant difference in the flow, pulsation index and DF value of graft between the two groups after IMA were anastomosed to LAD( P>0.05). In situ skeletonized graft of RIMA did not show the advantage of increased blood flow. Compared with the preoperative parameters of flow of internal mammary artery, both the left and right grafts of IMA were significantly better in blood flow and pulsation index( P<0.001). Considering the remarkable difference in age between the two groups, Flow, PI and DF were compared again after propensity score matching, and there was still no statistical difference between the two groups( P>0.05). A total of 313 patients in LIMA-LAD group completed coronary CTA examination one week after surgery, among which 4 grafts had different degrees of problems. A total of 34 patients in RIMA-LAD group completed coronary CTA examination, one case indicated that the CTA imaging in distal segment was not clear, and the other results had no obvious abnormality. There was no significant difference in postoperative rate of coronary CTA completion( P=0.381) and rate of graft failure( P=0.405) between the two groups. Conclusion:Compared with the preoperative parameters of blood flow of internal mammary artery, both the left and right IMA grafts are significantly better in flow and pulsation index. The pre-operative diameter of RIMA is larger and the blood flow and pulsation index of RIMA is better than that of LIMA before OPCABG. But there is no significant difference in the flow, pulsation index and DF value of graft between the two groups after IMA are anastomosed to LAD. In situ skeletonized graft of RIMA do not show the advantage of increased blood flow.
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BACKGROUND@#Andersson lesions (ALs) are not uncommon in ankylosing spondylitis (AS). Plain radiography (PR) is widely used for the diagnosis of ALs. However, in our practice, there were some ALs in AS patients that could not be detected on plain radiographs. This study aimed to propose the concept of occult ALs and evaluate the prevalence and radiographic characteristics of the occult ALs in AS patients.@*METHODS@#A total of 496 consecutive AS patients were admitted in the Affiliated Drum Tower Hospital, Medical School of Nanjing University between April 2003 and November 2019 and they were retrospectively reviewed. The AS patients with ALs who met the following criteria were included for the investigation of occult ALs: (1) with pre-operative plain radiographs of the whole-spine and (2) availability of pre-operative computed tomography (CT) and/or magnetic resonance imaging (MRI) of the whole-spine. The occult ALs were defined as the ALs which were undetectable on plain radiographs but could be detected by CT and/or MRI. The extensive ALs involved the whole discovertebral junction or manifested as destructive lesions throughout the vertebral body. Independent-samples t test was used to compare the age between the patients with only occult ALs and those with only detectable ALs. Chi-square or Fisher exact test was applied to compare the types, distribution, and radiographic characteristics between detectable and occult ALs as appropriate.@*RESULTS@#Ninety-two AS patients with a mean age of 44.4 ± 10.1 years were included for the investigation of occult ALs. Twenty-three patients had occult ALs and the incidence was 25% (23/92). Fifteen extensive ALs were occult, and the proportion of extensive ALs was significantly higher in detectable ALs (97% vs. 44%, χ2 = 43.66, P < 0.001). As assessed by PR, the proportions of osteolytic destruction with reactive sclerosis (0 vs. 100%, χ2 = 111.00, P < 0.001), angular kyphosis of the affected discovertebral units or vertebral body (0 vs. 22%, χ2 = 8.86, P = 0.003), formation of an osseous bridge at the intervertebral space adjacent to ALs caused by the ossification of the anterior longitudinal ligament (38% vs. 86%, χ2 = 25.91, P < 0.001), and an abnormal height of the affected intervertebral space were all significantly lower in occult ALs (9% vs. 84%, χ2 = 60.41, P < 0.001).@*CONCLUSIONS@#Occult ALs presented with more subtle radiographic changes. Occult ALs should not be neglected, especially in the case of extensive occult ALs, because the stability of the spine might be severely impaired by these lesions.
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Adulte , Humains , Adulte d'âge moyen , Cyphose/imagerie diagnostique , Imagerie par résonance magnétique , Radiographie , Études rétrospectives , Rachis/imagerie diagnostique , Pelvispondylite rhumatismale/imagerie diagnostiqueRésumé
Objective:To explore the intervention effect of Wenxin granule on endoplasmic reticulum stress apoptosis pathway and its related mechanism in rats with myocardial infarction. Method:Ligating the left anterior descending coronary artery to establish the rat model, the rats were randomly divided into 5 groups, namely sham group, model group, betaloc group and low, high-dose Wenxin granule groups,10 in each group. The sham group and the model group were given 10 mL∙kg<sup>-1</sup>∙d<sup>-1</sup> deionized water, the low, high-dose modified Wenxin groups were given 1.35, 2.7 g∙kg<sup>-1</sup>∙d<sup>-1</sup> aqueous solution respectively, and the betaloc group was given 2.25 mg∙kg<sup>-1</sup>∙d<sup>-1</sup> aqueous solution. After 14 days,the catheter method was used to detect the cardiac hemodynamics and hematoxylin-eosin staining (HE) was used to observe the pathological morphological changes. The levels of endoplasmic reticulum stress protein glucose regulatory protein 78(GRP78), protein kinase R like endoplasmic reticulum kinase(PERK), phosphorylated activated PERK(p-PERK), activated transcription factor 6 (ATF6), nuclear transcription factor X cassette binding protein(XBP1) and apoptosis protein C/EBP homologous protein(CHOP), B cell lymphoma/leukemia-2(Bcl-2) and Bcl-2 associated X protein(Bax) were detected by Western blot. Deoxyribonucleotide end-transferase-mediated notch end labeling (TUNEL) was also used to detect the myocardial cell apoptosis. Result:Compared with control group, the levels of the maximum ascending rate of left ventricular pressure(+dp/dt<sub>max</sub>), the maximum descending rate of left ventricular pressure(-dp/dt<sub>max</sub>) and the left ventricular systolic blood pressure(LVSP) were decreased significantly(<italic>P</italic><0.05),but the level of the left ventricular end diastolic blood pressure (LVEDP) was significantly increased(<italic>P</italic><0.05). The expressions of GRP78, p-PERK, PERK, ATF6, XBP1, CHOP, Bax and apoptosis index were increased significantly (<italic>P</italic><0.05,<italic>P</italic><0.01), while Bcl-2/Bax and Bcl-2 were decreased significantly(<italic>P</italic><0.01) in model group. Compared with the model group, the levels of -dp/dt<sub>max</sub> and Bcl-2 were increased significantly (<italic>P</italic><0.05),while the level of the apoptosis index was decreased significantly(<italic>P</italic><0.01) in low-dose Wenxin granule group. In high-dose Wenxin granule group, the levels of +dp/dt<sub>max</sub> and -dp/dt<sub>max</sub> were increased significantly(<italic>P</italic><0.05,<italic>P</italic><0.01), the levels of endoplasmic reticulum stress pathway protein GRP78, p-PERK, PERK, ATF6, XBP1,apoptosis-related protein CHOP, Bax and apoptosis index were decreased significantly(<italic>P</italic><0.01), but Bcl-2 and Bcl-2/Bax were increased significantly (<italic>P</italic><0.01). Conclusion:Wenxin granule has effect in inhibiting excessive endoplasmic reticulum stress, reducing myocardial cell apoptosis and improving cardiac hemodynamics. Its molecular mechanism may be related to decrease the levels of GRP78, PERK, p-PERK, ATF6, XBP1, CHOP, Bax and increasing the expression of Bcl-2.
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Objective:To observate the changing trend of flow of in-situ bilateral internal mammary artery as grafts during perioperative period in patients undergoing coronary artery bypass grafting(CABG), and to compare the parameters of flow between LIMA and RIMA.Methods:A total of 57 patients , 50 males and 7 femails, mean aged(57.8±10.1) years, underwent bilateral IMA CABG in our hospital from August 2016 to January 2019. Transthoracic ultrasound of IMA examination was performed before CABG. The blood flow, the PI(pulsation index) and other parameters were measured and recorded by intraoperative TTFM.Results:There was no significant difference of the average diameter and PI between LIMA and RIMA, but the preoperative flow of RIMA is higher( P=0.026) in our study. There was no significant difference of the average flow and PI between LIMA and RIMA recorded by TTFM( P>0.05), but the higher diastolic flow(DF) in LIMA grafts( P=0.022) compared with RIMA grafts may be associated with the different target sites( P<0.05). Compared with the preoperative flow and PI of IMA, the intraoperative flow and PI of both LIMA and RIMA grafts were better( P<0.001). Conclusion:Compared with the preoperative flow of IMA, both flow of LIMA and RIMA are better. In spite of the targets exist difference , there are no significant difference of the average flow and PI between LIMA graft and RIMA graft recorded by TTFM.
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Objective:To study the effect of Yupingfeng San (YPFS) on the expressions of GATA binding protein 3 (GATA3) and forkhead transcription factor3 (Foxp3) in ovalbumin (OVA)-induced lung tissue of allergic rhinitis (AR) mice, and explore the mechanism of YPFS on AR. Method:The allergic rhinitismice model was established by intraperitoneally injecting with OVA and Al (OH)3, and challenged with OVA intranasally. The mice were divided into four groups: normal,model,chloretadine(3 mg·kg-1) and YPFS(6.5 g·kg-1) group, the corresponding drugs were orally administrated for three weeks. At the end of administration,the infiltration of inflammatory cells, such as mast cells, eosinophils and neutrophils in nasal mucosa, were observed by htoxylin eosin (HE) staining. The serum concentrations of OVA-specific IgE and cytokines [interleukin-4(IL-4), IL-5 and γ-interferon (INF-γ)] were determined by enzyme-linked immune sorbent assay (ELISA). The expressions of GATA3 and Foxp3 proteins in nasal mucosa tissue were detected by Western blot. Result:The AR mice had such symptoms as scratching, sneezing and running nose. Nasal mucosa section by HE staining showed significant desquamation of AR mouse nasal mucosa cilia, obvious tissue stromal edema, telangiectasia, and a large number of eosinophilic cells, lymphocytes, plasma cells infiltration. YPFS obviously improved nasal symptoms of allergic rhinitis mice. Nasal mucosa epithelial structure was complete and arranged evenly, with no obvious tissue clearance edema and vasodilation, and inflammatory cell infiltration was significantly reduced. Compared with normal group, the levels of OVA specific IgE, IL-4 and IL-5 in peripheral blood of AR model group were significantly higher(P<0.01), and the INF-γ level was significantly lower (P<0.01). Compared with AR model group, the administration of chloretadine and YPFS can significantly reduce the level of OVA specific IgE and IL-4, IL-5, and increase the level of INF-γ in AR mice peripheral blood (P<0.05, P<0.01). Western blot results showed that compared with normal group, GATA3 protein expression was significantly increased, while Foxp3 protein expression was significantly decreased in AR model group (P<0.05, P<0.01). Compared with AR model group, YPFS inhibited GATA3, and promoted Foxp3 protein expression (P<0.01). Conclusion:YPFS has an effect in alleviating OVA-induced allergic rhinitis.YPFS may modulate the immune response by regulating the balance of Th2/Treg cells.
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OBJECTIVE@#To investigate and analyze the relationship between intraoperative graft flow measurements and the early mid-term outcomes after off-pump coronary artery bypass grafting (OPCAB).@*METHODS@#Patients who underwent isolated OPCAB in the Department of Cardiac Surgery of Peking University People's Hospital from January 2013 to June 2016 were included. Perioperative characteristics, graft flow measurements and postoperative follow-up outcomes were retrospectively collected. Comparison was made between flow measurements of grafts and the early mid-term outcomes. Flow measurements of grafts included the mean flow (MF) and the pulsatility index (PI). The early outcomes included peri-operative myocardial infarction (PMI), use of an intra-aortic balloon pump (IABP), reoperation for all causes, new-onset atrial fibrillation and in-hospital or 30-day mortality.@*RESULTS@#A total of 463 patients were included in the study. Mean age was (62.80±8.36) years, and 24.8% were females. The total number of grafts was 1 435, which averaged 3.10 grafts per patient. The MF and PI were separately (32.34±14.45) mL/min and 2.87±0.92. Of all the patients, 23(5%) had PMI, and 11 used IABP. Observed in-hospital or 30-day mortality was 0.86% (4 patients). Compared with non-PMI group, the MF was lower and the PI was higher in the PMI group (P<0.05). However, the differences of other early outcomes had no statistical significance between the PMI group and the non-PMI group. The lower MF (Wald=5.684, P=0.017, 95%CI: 0.894-0.989) and the higher PI (Wald=9.040, P=0.003, 95%CI: 1.252-2.903) were risk factors of PMI in multivariable Logistic regression modeling. The longest follow-up time was 37 months, and 7 patients died. The differences of graft flow measurements between the surviving group and the nonsurvivors had no statistical significance, but overall mid-term survival was lower in patients with poor left internal mammary artery (LIMA) to left anterior descending artery (LAD) graft flow (MF<10 mL/min; OR=9.6, P<0.05).@*CONCLUSION@#Intraoperative graft flow parameters during OPCAB can predict the early mid-term outcomes. The lower MF and the higher PI should increase the rate of PMI. A lower flow of LIMA to LAD graft (<10 mL/min) should increase the rate of midterm mortality, but further research will be needed to confirm and explore the findings.
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Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Pontage aortocoronarien , Pontage coronarien à coeur battant , Artères mammaires , Études rétrospectives , Résultat thérapeutiqueRésumé
[Abstract] Objective To investigate the protective effects of hypoxic preconditioning (HPC) on cardiomyocytes after hypoxia/reoxygenation (H/R) by activating AMP-activated protein kinase (AMPK). Methods The primary cardiomyocytes were prepared from neonatal SD rats. The model of H/R of cardiomyocytes was established and randomly divided into control group, H/R group, HPC group, H/R+A-769662 (AMPK agonist) group and HPC+compound C (AMPK inhibitor) group. The survival rate of cardiomyocytes was detected by chromatometry with Cell Counting Kit-8 (CCK-8); the reactive oxygen species (ROS) and ATP contents in the cells were detected respectively by dihydroethidium (DHE) dyeing and ATP Detection Assay Kit measured by fluorescence microplate reader; the phosphorylation level of AMPK and activation level of caspase-3 were detected by Western blotting; the concentration of free Ca2+ in cardiomyocytes was detected by Fluo-3AM dyeing using laser scanning confocal microscopy; the apoptotic rate of cardiomyocytes was detected by TUNEL staining. Results CCK-8 assay showed that compared with H/R group, the survival rate of cardiomyocytes in HPC group and H/R+A-769662 group increased obviously (P0.05); compared with H/ R group, the AMPK phosphorylation levels elevated significantly in HPC group and H/R+A-769662 group respectively (P<0.05, P<0.01). Meanwhile, the activation levels of caspase-3 in H/R group and HPC+compound C group were increased obviously compared with that in control group (P<0.01), but in HPC group and H/R+A-769662 group were significantly lower than that in H/R group (P<0.01, P<0.05). The results of Fluo-3AM staining showed that compared with control group, the concentrations of intracellular free Ca2+ increased obviously in H/R group and HPC+compound C group (P<0.01); the concentrations of free Ca2+ in cardiomyocytes of HPC group and H/R+A-769662 group were less than that in H/R group (P<0.01), while the concentrations of free Ca2+ in HPC+compound C group much more increased than in HPC group (P<0.01). The results of TUNEL staining showed that compared with H/R group, the apoptotic rate of cardiomyocytes decreased obviously in HPC group and H/R+A-769662 group (P<0.01, P<0.05); while compared with HPC group, the apoptotic rate of cardiomyocytes increased significantly in HPC+compound C group (P<0.05). Conclusions H/R may lead to the increase of ROS production, the decrease of ATP contents, and increase the levels of free Ca2+ in cardiomyocytes, and thus activate caspase-3, lead to apoptosis eventually. While HPC may reduce the production of ROS by activating AMPK to ensure the energy supply of cardiomyocytes after H/R treatment, prevent apoptosis of cardiomyocytes, and then reduce the H/R injury to cardiomyocytes.
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Objective Few studies are reported on the factors influencing the selection of the surgical access for adenocarci-noma of the esophagogastric junction (AEG). This study aimed to investigate the factors influencing the selection of the surgical access for CT type-ⅡAEG. Methods We retrospectively analyzed 118 cases of CT type-ⅡAEG surgically treated in the Second Affiliated Hospital of Zhengzhou University and Henan Tumor Hospital from January 2015 to January 2017,92 via the abdominal access and the other 26 via the thoracoabdominal access. We performed univariate and multivariate logistic regression analyses on the factors that might influence the surgical approaches,such as gender,body mass index (BMI),degrees of the epigastric angle,pathological classifica-tion,and clinical stages. Results Logistic regression analysis showed that the degree of the epigastric angle was an independent fac-tor influencing the selection of the access of AEG (OR=0.250,95% CI: 0.098-0.639) (P<0.05). Conclusion In the surgical treatment of CT type-ⅡAEG,the abdominal access is preferable for patients with the epigastric angle> 90 degrees and the thoracoab-dominal access is recommended for those with the epigastric angle≤90 degrees.
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The aim of this paper was to study the curative effect of Huotan Jiedu Tongluo (HTJDTL) decoction on a rabbit model with early atherosclerosis (AS),and furtherly to explore whether it could inhibit the BH4/eNOS uncoupling ROS or not. Twenty-four Japanese white rabbits were randomly divided into sham operation group, model group, HTJDTL decoction group and atorvastatin group. Rabbit models with early atherosclerosis were established by high fat diet, nitrogen drying and carotid artery balloon injury. The rabbits were sacrificed at 7th days after balloon injury and several parameters were measured. The pathological morphology of the common carotid artery was observed by HE staining. The blood lipids were detected by peroxidase method. The ratio of vascular eNOS dimer and monomer was measured by Western blot. The ELISA and biochemical technology were respectively used for testing BH4 and ROS levels in serum. The results showed that compared with the sham operation group, the model group had mild stenosis of the common carotid artery lumen, uneven intimal hyperplasia, lipid deposition in the intima and media, and obvious hyperplasia of the adventitia with inflammatory cell infiltration. The HTJDTL decoction could significantly inhibit the intimal hyperplasia compared with the model group, meanwhile, reduce the lipid deposition of the media and the infiltration of the adventitial cells. Compared with the sham operation group, the blood lipids and ROS of the model animals significantly increased, but BH4 and the ratio of eNOS dimer/monomer decreased. Compared with the model group, HTJDTL decoction significantly reduced the TC, ox-LDL and ROS levels, and also up-regulated eNOS dimer/monomer ratio, but it increased BH4 trend without statistical difference. According to the results, it was found that HTJDTL decoction couldsignificantly prevent and improve the vascular remodeling of rabbits model with early atherosclerosis. The mechanism of decoction may largely be related to the inhibition of BH4/eNOS uncoupling and the reduction of oxidative stress.
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Animaux , Lapins , Athérosclérose , Traitement médicamenteux , Artères carotides , Anatomopathologie , Médicaments issus de plantes chinoises , Pharmacologie , Nitric oxide synthase type III , Métabolisme , Stress oxydatif , Répartition aléatoire , Transduction du signalRésumé
Objective To study the value of parameters of Transit-Time Flow Measurement(TTFM) as predictor and judge for one-year after coronary artery bypass transplantation in patency rate of vessel grafts .Methods Parameters of quantity of blood flow and the value of PI( pulsation index) were measured and recorded by intraoperative TTFM in CABG .One-year of follow-ing up, coronary artery CT or coronary angiography examination were accomplished.Results Our study include artery grafts 46(including LIMA grafts 44, RIMA graft 1 and radial artery graft 1) with the patency rate of grafts 91.3% for one-year after CABG, and vein grafts 48 with the patency rate of grafts 66.7% .There exists statistically significant difference between above two groups(P<0.001).High PI is independent risk factor(P =0.037) in patency rate of vessel grafts for one-year after CABG by binary logistics regression analysis but no other parameters have the statistical significance (P>0.05) .The results from logistic regression were summarized using the area under the ROC curve(AUC) .The pulsation index has been found hav-ing moderate judgment ability(P=0.016) for the dysfunction of grafts after CABG for one-year with optimal cut-off value of 2. 45.Conclusion Intraoperative high value of PI is the independent risk factor in patency rate of vessel grafts for one-year after CABG.
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Objectives: To observe the impact of cannulation strategies on veno-arterial extracorporeal membrane oxygenation (VA-ECMO) complications. Methods: A total of 37 patients with refractory heart failure (HF) treated in our hospital from 2007 to 2016 were enrolled. All patients received VA-ECMO with ipsilateral femoral artery and vein cannulation and they were divided into 2 groups: Direct cannulation group, patients received open surgery for femoral artery and vein cannulation directly, based on downstream leg ischemia condition, ARROW sheath was used in ECMO pipeline to establish collateral circulation, n=21 and "Chimney technique" group, patients received femoral vessel cannulation as a graft of 8 mm Dacron artificial vessel was end-to-side anastomosed to the host femoral artery, then was connected to the host femoral vein directly, n=16. Prior ECMO clinical condition, time of cannulation, duration of VA-ECMO, the mean amounts of daily bleeding and transfusion, downstream leg ischemia condition and in-hospital mortality were observed and compared between 2 groups. Results: Compared with Direct cannulation group, "Chimney technique" group showed the longer time of cannulation (83.54±13.2) min vs (67.33±22.4) min, P<0.05, less patients with downstream leg ischemia (6.2% vs 23.8%), less amounts of daily bleeding (210.78±180.22) ml vs (560.76±220.23) ml and transfusion (3.11±1.65) U vs (6.37±2.44) U, all P<0.01; the in-hospital mortality was similar between 2 groups (62.5% vs 61.9%), P>0.05. Conclusions: "Chimney technique" of VA-ECMO improved the downstream leg ischemia and bleeding, while the in-hospital mortality was similar to direct cannulation in relevant patients.
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Objective To discuss the clinical effect and safety of the unilateral C2 pedicle screw-plate(C2PSP)combined with contralateral C2 laminar screw-rod(C2LSR)for atlanto-axial joint and occipital cervical fixation.Methods 11 patients were treated by internal fixation with pedicle screw plate system combined with contralateral C2 laminar screw rod system.The cause of atlantoaxial instability was fresh type Ⅱ odontoid fracture in 5 patients,old odontoid fracture in 3 patients,occipitalization mal-formation in 2 patients,atlantoaxial instability in 2 patients.6 patients had small pedicle of the vertebral arch,2 patients had a high-riding vertebral artery(VA),2 patients had an asymmetrical VA,1 patient re-ceived a revision operation.9 patients performed C1-2 fixation,2 patients performed occipito-cervical fixa-tion.1 patient of irreducible atlantoaxial dislocation also performed anterior atlantoaxial joint release before posterior Fixation.All patients performed bone grafting to achieve a further occipito-cervical fusion or at-lantoaxial fusion.Before and after the operation,the neurologic function was scored according JOA scale. The X-ray and CT-scan also performed at regular intervals to evaluate cervical alignment and the fusion. Results All cases were complete reposition without vertebral artery,spinal cord or never root injuried.All patients were followed up for 6-32 months ( mean 16 months ),clinical symptom were improved visibly. The mean postoperative JOA scores was 14.9(13-16).The postoperative JOA score improvement rate was 76%-92%,and its mean value was 83%.All patients achieved bone fusion approved by CT scan after six months of operation.The reduction maintained well and the internal fixation was well positioned.Conclu-sion It will be an effective and safe way to achieve atlantoaxial fusion by posterior unilateral C2 pedicle screwing combined with contralateral C2 laminar screwing,but this study had not including clinical com-parative study.
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The long- and short-term outcomes in 21 patients with right colon cancer after right hemicolectomy and multivisceral resection surgery were investigated. Short-term therapeutic effects and long-term survival rate were retrospectively analyzed in patients with right colon cancer. These individuals underwent right hemicolectomy in combination with multivisceral resections including pancreatic head, duodenum, kidney, liver, gallbladder, and abdominal wall at the Department of General Surgery in the Henan Tumor Hospital between January 2003 and August 2014. The patients had an average age of 58.9 years (range: 39-78). Three patients had metastatic invasion only to the duodenum; meanwhile 18 patients had invasion to the duodenum and other adjacent organs. The median survival time was 41 months (95% CI: 6.972-75.028) with one death in the perioperative period. No patients lost follow-up. One-, 3-, and 5-year survival rate was 75%, 56%, and 43%, respectively. It was concluded that indications for surgery should be tightly controlled. Favorable clinical outcomes of right hemicolectomy and multivisceral resection surgery were demonstrated for patients with right colon cancer at the T4 stage.
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<p><b>OBJECTIVE</b>To describe the long-term survival of off-pump coronary artery bypass grafting (CABG) and to analysis the risk factors of operative mortality and long-term survival.</p><p><b>METHODS</b>From January 2001 to December 2012, 2 831 patients undergoing off-pump CABG in Peking University People's Hospital, 2 099 cases (74.1%) of them were male, the average age was (63±9) years. The perioperative data was retrospectively collected. Binary Logistic regression was used to find the risk factors which affect the operative mortality. Follow-up evaluation was completed regularly. Kaplan-Meier survival curve, Log-rank test and Cox regression model were used to find out factors which affect the long-term result.</p><p><b>RESULTS</b>Totally 2 831 patients underwent isolating off-pump CABG, in whom 45 patients died perioperative, 2 786 patients discharged successfully. Binary Logistic regression showed that sex (female) (χ2=4.4, OR=2.307, P=0.035), peripheral vascular disease (χ2=17.4, OR=6.616, P=0.000), New York Heart Association (NYHA) class grade≥3 (χ2=10.5, OR=3.491, P=0.001), ejection fraction≤40% (χ2=16.9, OR=5.230, P=0.000), emergency surgery (χ2=11.9, OR=5.127, P=0.001) are risk factors of operative mortality. The follow-up time was (74±44) months. Totally 107 patients were lost from follow-up, 109 patients died in follow-up. The survival rate at 1, 3, 5 , 8 and 10 years was 97.2%, 95.5%, 94.3%, 93.6%, 92.1%, respectively. Univariate analysis showed that age (>65 years), hypertension, renal insufficiency, peripheral vascular disease, history of myocardial infarction, NYHA class grade≥3 and emergency surgery were risk factors of the long-term survival (χ2=8.150 to 88.241, P<0.05). Cox regression analysis showed that age (>65 years) (χ2=12.1, RR=2.295, P=0.000), renal insufficiency (χ2=12.3, RR=3.160, P=0.000), peripheral vascular disease (χ2=42.5, RR=5.626, P=0.000), NYHA class grade≥3 (χ2=9.1, RR=1.994, P=0.002) and emergency surgery (χ2=5.5, RR=2.247, P=0.019) were independent risk factors that affect the long-term survival.</p><p><b>CONCLUSIONS</b>Sex (female), peripheral vascular disease, NYHA class grade≥3, ejection fraction≤40%, emergency surgery are risk factors of operative mortality. Age (>65 years), renal insufficiency, peripheral vascular disease, NYHA class grade≥3 and emergency surgery are independent risk factors that affect the long-term survival. Off-pump CABG has favorable perioperative and long-term outcome, and it definitely is a very safe and effective technique for coronary artery revascularization.</p>
Sujets)
Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Maladies cardiovasculaires , Pontage coronarien à coeur battant , Mortalité , Maladie des artères coronaires , Chirurgie générale , Estimation de Kaplan-Meier , Modèles logistiques , Infarctus du myocarde , Maladies vasculaires périphériques , Études rétrospectives , Facteurs de risque , Résultat thérapeutiqueRésumé
The long- and short-term outcomes in 21 patients with right colon cancer after right hemicolectomy and multivisceral resection surgery were investigated. Short-term therapeutic effects and long-term survival rate were retrospectively analyzed in patients with right colon cancer. These individuals underwent right hemicolectomy in combination with multivisceral resections including pancreatic head, duodenum, kidney, liver, gallbladder, and abdominal wall at the Department of General Surgery in the Henan Tumor Hospital between January 2003 and August 2014. The patients had an average age of 58.9 years (range: 39-78). Three patients had metastatic invasion only to the duodenum; meanwhile 18 patients had invasion to the duodenum and other adjacent organs. The median survival time was 41 months (95% CI: 6.972-75.028) with one death in the perioperative period. No patients lost follow-up. One-, 3-, and 5-year survival rate was 75%, 56%, and 43%, respectively. It was concluded that indications for surgery should be tightly controlled. Favorable clinical outcomes of right hemicolectomy and multivisceral resection surgery were demonstrated for patients with right colon cancer at the T4 stage.
Sujets)
Adulte , Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Tumeurs du côlon , Chirurgie générale , Procédures de chirurgie digestive , MéthodesRésumé
Objective:To explore the prognosis and risk factors for conversion from off-pump coronary artery bypass grafting (OPCABG) to coronary bypass grafting (CABG) during surgery. Methods: We retrospectively analyzed 2613 patients with elective OPCAB in our hospital from 2001 to 2012, there were 62 (2.37%) patients converted to CABG during the operation as Conversion group, the rest 2551 patients were set as Non-conversion group. The peril-operative baseline clinical data and prognosis condition were compared between 2 groups. The risk factors causing the in-operative conversion were studied with binary logistic regression analysis. Results: The total conversion rate was 2.37%, including 42 patients of hemodynamic instability, 6 with dififculty of target vessel exposure, 9 with malignant arrhythmia, 3 with graft occlusion and 2 patients with other reasons. Compared with Non-conversion group, the Conversion group had increased post-operative drainage and ventilation time, higher rates of second thoracotomy for stop bleeding and higher peril-operative mortality. Binary logistic regression analysis indicated that chronic obstructive pulmonary disease, previous history of CABG, NYHA class≥3, LVEF≤40%and left main disease were the independent risk factors for in-operative conversion. Conclusion: Conversion from OPCAB to CABG during the operation would be result in signiifcantly higher morbidity and mortality in relevant patients.