摘要
BACKGROUND:In the initial stage of multiple sclerosis,central immune cells activate and release a large number of inflammatory factors,causing white matter demyelination and even involving gray matter neurons.The equilibrium of differentiation between different subsets of CD4+ T cells plays an important role in the progression of experimental autoimmune encephalomyelitis.The previous results of the research group showed that the active ingredient astragalus glycoprotein in astragalus can regulate the immune response in experimental autoimmune encephalomyelitis mice,and whether it has a regulatory effect on the differentiation of T cell subsets has not been determined. OBJECTIVE:To explore the therapeutic effects and immune regulatory mechanisms of astragaloside IV on experimental autoimmune encephalomyelitis mice. METHODS:Female C57BL/6 mice were divided into the normal control group,experimental autoimmune encephalomyelitis disease model group,and astragaloside IV treatment group(n=8 per group).Myelin oligodendrocyte glycoprotein peptides 35-55 were used for experimental autoimmune encephalomyelitis model induction in the last two groups.On day 10 to 28 after immunization,the astragaloside IV treatment group was treated with 40 mg/kg per day astragaloside IV intragastrically.Body weight and clinical scores of mice in each group were recorded from the immunization day to the 28th day.On the 28th day after immunization,the mouse spinal cord was taken and made into frozen sections for hematoxylin-eosin staining and Lux fast blue staining to observe pathological changes in the spinal cord.Percentage of splenic T cell subsets was detected using flow cytometry.Western blot assay was used to determine the protein expression of interferon-γ,interleukin-17 and interleukin-6 in the spinal cord.Levels of interferon-γ,interleukin-17,interleukin-6 and interleukin-4 in supernatants of cultured splenocytes were determined by ELISA. RESULTS AND CONCLUSION:(1)Compared with the experimental autoimmune encephalomyelitis disease model group,astragaloside IV could reduce the degree of weight loss in experimental autoimmune encephalomyelitis mice(P<0.05),ameliorate clinical symptoms(P<0.05),inhibit the infiltration of inflammatory cells and alleviate myelin loss(P<0.01,P<0.05).(2)Compared with the experimental autoimmune encephalomyelitis disease model group,astragaloside IV could inhibit the proportion of CD4+T cell subsets expressing interferon-γ(P<0.001)and interleukin-17(P<0.001),but increase percentages of CD4+ interleukin-10+(P<0.001)and CD4+ transforming growth factor-β+(P<0.01)T cell subsets.(3)Astragaloside IV could inhibit the expression of interferon-γ(P<0.05,P<0.01),interleukin-17(P<0.05,P<0.05),and interleukin-6(P<0.05,P<0.05)in the spinal cord and spleen,and up-regulate the expression of interleukin-4(P<0.01)in spleen.(4)These findings confirm that astragaloside IV alleviates clinical symptoms in experimental autoimmune encephalomyelitis mice,which may be related to regulating the splenic T cell subsets,therefore,inhibiting the infiltration of inflammatory cells into the center and reducing the demyelination.
摘要
AIM:To investigate the influencing factors of abnormal telangiectasia secondary to diabetic retinopathy(DR).METHODS: Prospective studies. A total of 153 cases(240 eyes)with DR treated in our hospital from January 2021 to January 2023 were selected to analyze the risk factors of abnormal telangiectasia secondary to DR and its predictive efficacy.RESULTS: The patients were divided into dilated group(77 eyes of 40 cases)and non-dilated group(163 eyes of 113 cases)according to whether they had secondary abnormal telangiectasia. There were significant differences in diabetic macular edema, hard exudates grade and fasting blood glucose level between the two groups(P&#x003C;0.05). Logistic regression analysis showed that diabetic macular edema, high hard exudates grade and high blood glucose level were the risk factors for abnormal telangiectasia secondary to DR(P&#x003C;0.05).CONCLUSION: The occurrence of telangiectasia secondary to DR may be related to diabetic macular edema, grade 3 hard exudates and high blood glucose level.
摘要
Methods:From Jan 2019 to Nov 2021, 20 patients underwent 3D printed template assisted pre-fenestration of stent graft with reducing-diameter tie technique and branched stents for the EVAR at the three hospitals. The clinical data patients were collected and analyzed.Results:All the 20 cases underwent 3D printed template assisted pre-fenestration of stent graft according to the data of pre-operative the computed tomographic angiography (CTA). EVAR was successfully performed in all patients(included 2 cases with one fenestration,5 cases with 2 fenestration,10 cases with 3 fenestration and 3 cases with 4 fenestration). Fifty-four reinforced fenestrations (20 in right renal artery, 18 in left renal artery, 13 in superior mesenteric artery and 3 in celiac artery) were performed. During the follow-up period (mean 14.6 months), 1 case died, and the one-stage patency rate of splanchnic artery branch stent was 98.1%. Four patients had endoleak, 1 patient died of intracranial hemorrhage during postoperative period. None of patients had postoperative paraplegia or organ ischemia.Conclusions:3D printed template assisted pre-fenestration of stent graft with reducing-diameter tie technique is feasible for EVAR in the treatment of complex abdominal aortic aneurysms and dissections. The technique is capable to reinforce the blood supply of visceral arteries with satisfied short-term effectiveness.Ojective:To evaluate 3D printed template assisted pre-fenestration of stent graft with reducing-diameter tie technique and branched stents for the endovascular aortic aneurysm repair (EVAR).
摘要
Objective: To explore the effect and safety of pre-operative loading ticagrelor on myocardium reperfusion in patients with acute ST-elevation myocardial infarction (STEMI) during primary percutaneous coronary intervention (PCI). Methods: A total of 105 acute STEMI patients received PCI within 12-hour of onset were studied and they were divided into 2 groups: Ticagrelor group, the patients received pre-operative oral chewing ticagrelor 180 mg,n=58 and Clopidogrel group, the patients received pre-operative oral chewing clopidogrel 600 mg,n=47. The baseline feathers, operative TIMI and corrected TIMI frame count (CTFC), TIMI myocardial perfusion grade (TMPG), no-relfow/slow lfow conditions were compared between 2 groups. Results: The baseline feathers and pre-operative TIMI were similar between 2 groups, bothP>0.05. Compared with Clopidogrel group, Ticagrelor group showed increased ratios of TIMI 3 lfow (94.8% vs 80.9%) and TMPG (89.7% vs 72.3%), bothP0.05. Conclusion: Prior PCI loading ticagrelor may reduce no-relfow/slow lfow incidence, improve myocardium reperfusion safely and therefore, decrease MACE occurrence in acute STEMI patients.
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Objective: To investigate thoracic endovascular aortic repair (TEVAR) and “Chimney” technique for treating the involved left common carotid artery (LCCA) or left subclavian artery (LSA) in Standford B patients with aortic lesion and in-sufficient proximal anchoring area. Meanwhile, to explore the relationship between endoleaking condition and the location of lesion with the prognosis. Methods: A total of 32 relevant patients treated by TEVAR + “Chimney” technique in our hospital from 2011-09 to 2015-07 were retrospectively analyzed. Immediate post-operative image development of LCCA or LSA was observed; cerebral complications, severe upper limb ischemic symptoms and endoleaking conditions were recorded. The patients were followed-up for (3-46) months. Results: Thoracic aortic stent-graft placement was successfully carried out in all 32 patients. Immediate post-operative image development of LCCAor LSAwas favorable, no cerebral complications and no severe upper limb ischemic symptoms were observed. There were 7 patients suffered from endoleak at aortic arch including 6 with the lesion located at the greater curvature side and 1 at the small curvature side. During follow-up period, aortic stent-graft remained in a stable condition and the blood flow in “Chimney” stent was unobstructed. Endoleking condition was gradually reduced and disappeared in 5 patients, it was persisted in 2 patients. Conclusion: “Chimney” technique may prolong anchoring area and keep LCCA or LSA unobstructed, therefore expand the indication of TEVAR in a mini-invasive, safe and effective way. When aortic lesion located at the greater curvature side, the endoleaking probability could be increased.
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BACKGROUND:Restenosis after angioplasty severely limited the application and long-period therapeutic effects of percutaneous coronary intervention. Changes in smooth muscle cel phenotype and their proliferation are important mechanisms of restenosis after angioplasty. OBJECTIVE:To use bal oon in vivo transduction of osteopontin short hairpin RNA (OPN-shRNA), to inhibit osteopontin expression at the injured blood vessels of a rabbit model of experimental atherosclerosis, and to prevent restenosis after angioplasty. METHODS:A total of 20 rabbit models of atherosclerosis were established and randomly equal y assigned to empty plasmid group and OPN-shRNA plasmid group. The plasmid recombinant OPN-shRNA and empty plasmid were transferred to the ventral aorta by bal oon. RESULTS AND CONCLUSION:After bal oon dilatation, specific green fluorescence was detected in the layer of vascular smooth muscle in the two groups. Moreover, with prolonged time of transfection, fluorescence intensity gradual y decreased. Compared with the empty plasmid group, the expanded artery lumen area obviously increased in the OPN-shRNA plasmid group, and plaque burden evidently reduced. Results indicated that bal oon catheter used in regional blood vessels in rabbit models of atherosclerosis could successful y transduce OPN-shRNA plasmid. The restenosis of the expanded blood vessels lessened, and thrombus burden relieved. It is of great importance to prevent the occurrence of restenosis after angioplasty in rabbit models.
摘要
Objective To evaluate the influence of tirofiban on myocardial perfusion through percutaneous coronary intervention (PCI) and platelet activation in patients with acute myocardial infarction (AMI). Methods Eighty patients with acute myocardial infarction who underwent emergency PCI within 12 hours were randomly divided into 2 groups due to the random number table method: tirofiban group (40 patients) and control group (40 patients). The control group received conventional anticoagulant therapy (aspirin + low molecular weight heparin + clopidogrel). The tirofiban group additionally received intracoronary tirofiban hydrochloride injection of 10 μg/kg PCI during PCI, intravenous maintenance dose of 0. 15 after PCI 15 mins, the changes of platelet activation before and after treatment 7 days,the bleeding complications and major adverse cardiac events (MACE) within 30 days after PCI. Results The TMPG 3 perfusion percentage of tirofiban group (97.5% ,39/40) after PCI 15 minutes was significantly higher than that (80. 0%,32/40) of the control group( x2 = 4. 507,P ＜ 0. 05 ) ;The expression positive rate of platelet activation CD62P,CD63, MPA of the tirofiban group after treatment of 7 days were ( 1.7 ± 0. 7 ) %, ( 1.5 ± 0. 7 ) % and ( 11.7 ±3.8)% ,respectively,which were significantly lower than those of before treatment ([7.2 ± 2. 5]%, [6. 9 ±1.8]% and [22. 0 ± 7. 8] %, respectivley) and those of the control group after treatment of 7 days ( [2. 9 ±1.2]% ,[3.9 ±0.6]% and [16.2 ±4.2]% ,respectivley)(t =5.463,16. 468 and 5.025, Ps ＜0.01 );The incidence of cardiovascular events of the tirofiban group (0) was significantly lower than that of the control group ( 15.0%, 12/40 ) after treatment of 30 days ( x2 = 4. 504, P ＜ 0. 05 ); The incidence of bleeding complications was not significant between the 2 groups ( x2 = 0. 180, P ＞ 0. 05 ). Conclusion The application of tirofiban hydrochloride in intervention in acute myocardial infarction can improve myocardial perfusion, and further inhibiting platelet activation and reduce the incidence of major adverse cardiac events after PCI while does not increase the incidence of severe bleeding.