ABSTRACT
Rapid surface charge mapping of a solid surface remains a challenge. In this study, we present a novel microchip based on liquid crystals for assessing the surface charge distribution of a planar or soft surface. This chip enables rapid measurements of the local surface charge distribution of a charged surface. The chip consists of a micropillar array fabricated on a transparent indium tin oxide substrate, while the liquid crystal is used to fill in the gaps between the micropillar structures. When an object is placed on top of the chip, the local surface charge (or zeta potential) influences the orientation of the liquid crystal molecules, resulting in changes in the magnitude of transmitted light. By measuring the intensity of the transmitted light, the distribution of the surface charge can be accurately quantified. We calibrated the chip in a three-electrode configuration and demonstrated the validity of the chip for rapid surface charge mapping using a borosilicate glass slide. This chip offers noninvasive, rapid mapping of surface charges on charged surfaces, with no need for physical or chemical modifications, and has broad potential applications in biomedical research and advanced material design.
Subject(s)
Liquid Crystals , Surface Properties , Liquid Crystals/chemistry , Tin Compounds/chemistry , Electrodes , Biosensing TechniquesABSTRACT
Rapid and accurate analysis of micro/nano bio-objects (e.g., cells, biomolecules) is crucial in clinical diagnostics and drug discovery. While a traditional resistive pulse sensor can provide multiple kinds of information (size, count, surface charge, etc.) about analytes, it has low throughput. We present a unique bipolar pulse-width, multiplexing-based resistive pulse sensor for high-throughput analysis of microparticles. Signal multiplexing is enabled by exposing the central electrode at different locations inside the parallel sensing channels. Together with two common electrodes, the central electrode encodes the electrical signal from each sensing channel, generating specific bipolar template waveforms with different pulse widths. Only one DC source is needed as input, and only one combined electrical output is collected. The combined signal can be demodulated using correlation analysis and a unique iterative cancellation scheme. The accuracy of particle counting and sizing was validated using mixtures of various sized microparticles. Results showed errors of 2.6% and 6.1% in sizing and counting, respectively. We further demonstrated its accuracy for cell analysis using HeLa cells.
Subject(s)
Microfluidic Analytical Techniques , Microfluidics , Humans , HeLa Cells , Electrodes , Lab-On-A-Chip Devices , Microfluidic Analytical Techniques/methodsABSTRACT
The fast, accurate detection of biomolecules, ranging from nucleic acids and small molecules to proteins and cellular secretions, plays an essential role in various biomedical applications. These include disease diagnostics and prognostics, environmental monitoring, public health, and food safety. Aptamer recognition (DNA or RNA) has gained extensive attention for biomolecular detection due to its high selectivity, affinity, reproducibility, and robustness. Concurrently, biosensing with nanoparticles has been widely used for its high carrier capacity, stability and feasibility of incorporating optical and catalytic activity, and enhanced diffusivity. Biosensors based on aptamers and nanoparticles utilize the combination of their advantages and have become a promising technology for detecting of a wide variety of biomolecules with high sensitivity, reliability, specificity, and detection speed. Via various sensing mechanisms, target biomolecules have been quantified in terms of optical (e.g., colorimetric and fluorometric), magnetic, and electrical signals. In this review, we summarize the recent advances in and compare different aptamer-nanoparticle-based biosensors by nanoparticle types and detection mechanisms. We also share our views on the highlights and challenges of the different nanoparticle-aptamer-based biosensors.
Subject(s)
Aptamers, Nucleotide , Biosensing Techniques , Nanoparticles , Reproducibility of Results , DNAABSTRACT
Many cellular functions are regulated by cell surface charges, such as intercellular signaling and metabolism. Noninvasive measurement of surface charge distribution of a single cell plays a vital role in understanding cellular functions via cell membranes. We report a method for cell surface charge mapping via photoelectric interactions. A cell is placed on an array of microelectrodes fabricated on a transparent ITO (indium tin oxide) surface. An incident light irradiates the ITO surface from the backside. Because of the influence of the cell surface charge (or zeta potential), the photocurrent and the absorption of the incident light are changed, inducing a magnitude change of the reflected light. Hence, the cell surface charge distribution can be quantified by analyzing the reflected light intensity. This method does not need physical or chemical modification of the cell surface. We validated this method using charged microparticles (MPs) and two types of cells, i.e., human dermal fibroblast cells (HDFs) and human mesenchymal stem cells (hMSC). The measured average zeta potentials were in good agreement with the standard electrophoresis light scattering method.
Subject(s)
Light , Humans , Microelectrodes , Cell MembraneABSTRACT
Pancreatic exocrine insufficiency (PEI) refers to insufficient or non-synchronous secretion of trypsin caused by various reasons, resulting in dyspepsia and other symptoms. Intestinal microbiota is a large number of microbiota on the surface of intestinal mucosa. Its main functions include intestinal immune function, forming intestinal biological barrier and participating in the regulation of nutrition and metabolism. Due to aging, some elderly people often have unexplained chronic pancreatic insufficiency, which is often characterized by unexplained weight loss and malnutrition. Several studies have shown that the composition of intestinal microbiota changes significantly with age. This article focuses on aging and its related PEI and then reviews its possible effects on intestinal microbiota, in order to provide a reference basis for individualized prevention and treatment strategies according to the changes of pancreatic exocrine function and microbiota in the elderly.
ABSTRACT
This study aimed to prepare silk fibroin nanoparticles (SF-NPs) and assess the physicochemical properties and biocompatibility of the formulation. An optimized and simplified solvent displacement method was employed to obtain SF-NPs. Single-factor prescription screening, such as silk fibroin (SF) solution concentration, the ratio of SF solution to organic solvent, ultrasonication power and time, and different types of organic phases, was used to optimize the formulation. The characterization of the optimal formulation included particle size, polydispersity index (PDI), zeta potential, morphology, and stability. The in vitro cell compatibility of the nanoparticles was evaluated using CCK-8 and Calcein-AM/PI cell viability staining. The results showed that when SF concentration was 20 mg·mL-1, volume ratio of aqueous phase to acetone was 1∶6, ultrasonic power was 80 W and ultrasonic time was 3 min, the best SF-NPs was obtained. The nanoparticles prepared in this study exhibit a near-spherical shape, with a uniform size distribution, having an average size of 144.8 nm, a PDI of 0.174, and a zeta potential of -27.35 mV. Results from in vitro cell experiments demonstrate excellent cell compatibility of SF-NPs, showing the ability to promote cell proliferation. The SF-NPs which were successfully prepared in this study exhibit uniform particle size and excellent biocompatibility.
ABSTRACT
The great anti-epidemic spirit formed in the practice of fighting against the COVID-19 epidemic is a vivid embodiment of the national spirit and zeitgeist, an important part of the spiritual spectrum of the Communist Party of China, and an important content of professional ethics education for medical students in the new era. In the context of the new era, it is of great significance to integrate the great anti-epidemic spirit into the professional ethics education of medical students and explore its theoretical basis and existing problems. Based on the empirical investigation, this paper proposed the practical path of integrating the great anti-epidemic spirit into medical students’ professional ethics education from three dimensions:subject’s cognitive consciousness, school education practice, and hospital clinical training, to effectively exert the nurturing function of the great anti-epidemic spirit and improve the timeliness of professional ethics education for medical students.
ABSTRACT
Detection of small biomolecules is critical for understanding molecular mechanisms in biological systems and performing in vitro diagnosis in clinics. Current antibody based detection methods face large challenges in detecting small biomolecules at low concentrations. We report a new method for detecting small biomolecules based on molecular recognition and nanoparticle (NP) counting. Aptamer-functionalized NPs are attached to complementary sequence (CS)-conjugated microparticle (MP) carriers. In the presence of target small biomolecules at ultra low concentrations, NPs would be released from the MP carriers. Coupled with a resistive pulse sensor (RPS) using a micropore that counts the released NPs, this method can measure the concentrations of target biomolecules at low concentrations with high sensitivity and high throughput. Adenosine was used as a model to demonstrate the feasibility of this method. It is demonstrated that this method can detect a wide range of adenosine concentrations with a low detection limit of 0.168 nM, which is 10 times lower than that of the ELISA kit. With its simple structure, high sensitivity, and high reproducibility, this detection method holds great potential for the ultrasensitive detection of low abundance small biomolecules.
Subject(s)
Aptamers, Nucleotide , Biosensing Techniques , Metal Nanoparticles , Nanoparticles , Adenosine/analysis , Aptamers, Nucleotide/chemistry , Biosensing Techniques/methods , Metal Nanoparticles/chemistry , Nanoparticles/chemistry , Reproducibility of ResultsABSTRACT
Many bio-functions of cells can be regulated by their surface charge characteristics. Mapping surface charge density in a single cell's surface is vital to advance the understanding of cell behaviors. This article demonstrates a method of cell surface charge mapping via electrostatic cell-nanoparticle (NP) interactions. Fluorescent nanoparticles (NPs) were used as the marker to investigate single cells' surface charge distribution. The nanoparticles with opposite charges were electrostatically bonded to the cell surface; a stack of fluorescence distribution on a cell's surface at a series of vertical distances was imaged and analyzed. By establishing a relationship between fluorescent light intensity and number of nanoparticles, cells' surface charge distribution was quantified from the fluorescence distribution. Two types of cells, human umbilical vein endothelial cells (HUVECs) and HeLa cells, were tested. From the measured surface charge density of a group of single cells, the average zeta potentials of the two types of cells were obtained, which are in good agreement with the standard electrophoretic light scattering measurement. This method can be used for rapid surface charge mapping of single particles or cells, and can advance cell-surface-charge characterization applications in many biomedical fields.
Subject(s)
Cell Membrane/chemistry , Microscopy, Fluorescence/methods , Nanoparticles , HeLa Cells , Human Umbilical Vein Endothelial Cells , HumansABSTRACT
The enrichment and focusing of the nano-/submicroparticle (e.g., 150-1000 nm microvesicle shed from the plasma membrane) in the viscoelastic fluid has great potentials in the biomedical and clinical applications such as the disease diagnosis and the prognostic test for liquid biopsy. However, due to the small size and the resulting weak hydrodynamic force, the efficient manipulation of the nano-/submicroparticle by the passive viscoelastic microfluidic technology remains a major challenge. For instance, a typically long channel length is often required to achieve the focusing or the separation of the nano-/submicroparticle, which makes it difficult to be integrated in small chip area. In this work, a microchannel with gradually contracted cross-section and high aspect ratio (the ratio of the height to the average width of channel) is utilized to enhance the hydrodynamic force and change the force direction, eventually leading to the efficient enrichment of nano-/submicroparticles (500 and 860 nm) in a short channel length (2 cm). The influence of the flow rate, the particle size, the solid concentration, and the channel geometry on the enrichment of the nano-/submicroparticles are investigated. With simple structure, small footprint, easy operation, and good performance, the present device would be a promising platform for various lab-chip microvesicle-related biomedical research and disease diagnosis.
Subject(s)
Microfluidic Analytical Techniques , Microfluidics , Hydrodynamics , Particle SizeABSTRACT
Objective:To investigate the computed tomography (CT) features and diagnosis and treatment of emphysema pancreatitis (EP).Methods:The retrospective and descriptive study was conducted. The clinical and imaging data of 12 patients with EP who were admitted to Xuanwu Hospital of Capital Medical University from January 2017 to June 2020 were collected. There were 10 males and 2 females, aged from 25 to 71 years, with a median age of 42 years. All patients received CT examination. Step-up treatment or one-step surgical treatment was performed on patients according to their conditions. Observation indicators: (1) CT features; (2) bacteriological characteristics; (3) treatment and follow-up. Follow-up using outpatient examination was conducted at postoperative 1, 3, 6 months to detect survival of patients up to January 2021. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M (range). Count data were described as absolute numbers. Results:(1) CT features: 1 of the 12 patients underwent abdominal+pelvic CT plain scan, and 11 cases underwent abdominal+pelvic CT plain scan and enhanced scan of arterial and portal venous phase. CT examination of 12 patients showed diffuse enlargement of the pancreas, unclear borders and a large amount of exudation around the pancreas. Pancreatic necrotic tissues accounted for >30% of the total pancreatic volume; the Balthazar CT score was 10 (range, 8-10). Of the 12 patients, 5 cases showed that the exudation or necrosis involved bilateral prerenal fascia, 7 cases only involved the left prerenal fascia; the necrotic infection area of 11 patients formed obvious wraps. The distribution of pancreatic, peripancreatic infection and gas in 12 patients: 6 cases had pancreatic, peripancreatic infection and gas located in Ⅰ+Ⅱa area, 3 cases located in Ⅰ+Ⅱa+Ⅲ area, 2 cases located in Ⅰ+Ⅲ area, and 1 case located in Ⅰ area. There was gas in the pancreatic parenchyma in 12 patients, with fluid in the abdominal cavity and pelvic cavity. (2) Bacteriological characteristics: the culture results of peripancreatic necrotic issues in 12 patients were all positive for the pathogenic specimens, and 27 strains were cultured. Klebsiella pneumoniae was the most common in the culture of necrosis from 12 patients, followed by Escherichia coli and Enterococcus bacteria. Fungus was found in the culture of necrosis from 1 patient. Of the 12 patients, 5 had negative blood cultures and 7 had positive blood cultures. A total of 14 strains were cultured, with Klebsiella pneumoniae being the most common; fungus was found in the blood culture from 4 patients. (3) Treatment and follow-up: 1 patient underwent percutaneous catheter drainage, 7 underwent step-up surgical treatment, 4 underwent one-step surgical treatment; 11 patients undergoing surgical treatment received laparoscopic-assisted removal of pancreatic necrotic tissue, including 1 case with exploratory laparotomy due to abdominal hemorrhage. Of the 11 patients undergoing surgical treatment, 7 cases received the left retroperitoneal approach surgery (including 1 case combined with the upper abdominal median approach), 2 cases received the upper abdominal median transomental sac approach surgery, 1 case received the right retroperitoneal approach surgery, and 1 case received the left rectus abdominis approach surgery. The number of operations of all the 11 patients were (3.1±0.9)times, the number of step-up treatments was (3.6±0.8)times, and the number of one-step surgery was (2.3±0.5)times. Nine of 12 patients had organ dysfunction that lasted for more than 48 hours during the treatment, which received surgical treatment after organ support and anti-infection therapy. All the 12 patients were followed up for 6 months after operation, of which 9 cases were cured after treatment and 3 cases died including 1 case dying of bleeding and 2 cases dying of septic shock combined with multiple organ failure.Conclusions:Emphysema pancreatitis is complicated by pancreatic necrosis, which is characterized by pancreatic and peripancreatic gas accumulation on CT. Most patients with EP have organ failure. Surgery is an important treatment for EP.
ABSTRACT
Objective:To study the clinical application of laparoscopic combined with multi-video debridement in treatment of complicated infectious pancreatic necrosis (CIPN).Methods:The clinical data of 34 patients with CIPN who were treated at the Department of General Surgery, Xuanwu Hospital, Capital Medical University from August 2017 to December 2019 were retrospectively studied. Based on the different video methods used, these patients were divided into 3 groups: the laparoscopic combined with intraoperative ultrasound group, the laparoscopic combined with choledochoscopy group and the laparoscopic group. The number of operations, operation time, blood loss, postoperative complication rates, mortality rates and total length of hospital stay were compared.Results:There were 13 patients in the laparoscopic combined with intraoperative ultrasound group, with age of (56.4±13.4) years. There were 7 patients in the laparoscopic combined with choledochoscopy group, with age of (48.0±8.4) years. There were 14 patients in the laparoscopic group with age of (51.4±15.6) years. The number of operations of the laparoscopic combined with intraoperative ultrasound group, the laparoscopic combined with choledochoscopy group and the laparoscopic group were (2.2±1.1), (1.6±0.8), (2.9±1.4), respectively. The number of operations of the laparoscopic combined with choledochoscopy group were significantly less than that of the laparoscopic group ( P<0.05), but there were no significant differences among the other groups ( P>0.05). The operation time of the laparoscopic combined with intraoperative ultrasound group, the laparoscopic combined with choledochoscopy group and the laparoscopic group were (70.5±22.9) min, (65.7±19.9) min, (51.5±15.4) min, respectively. The operation time of the laparoscopic combined with intraoperative ultrasound group was significantly longer than that of the laparoscopic group ( P<0.05), but there were no significant differences among the other groups ( P>0.05). There were no differences in blood loss, postoperative complication rate, mortality rates and total lengths of hospital stay among the three groups ( P>0.05). Conclusion:Laparoscopic combined with multi-video debridement after making full use of the advantages of each of the video methods, can be used to improve treatment outcomes of patients with CIPN.
ABSTRACT
The outbreak of 2019-nCoV pneumonia (COVID-19) in the city of Wuhan, China has resulted in more than 70,000 laboratory confirmed cases, and recent studies showed that 2019-nCoV (SARS-CoV-2) could be of bat origin but involve other potential intermediate hosts. In this study, we assembled the genomes of coronaviruses identified in sick pangolins. The molecular and phylogenetic analyses showed that pangolin Coronaviruses (pangolin-CoV) are genetically related to both the 2019-nCoV and bat Coronaviruses but do not support the 2019-nCoV arose directly from the pangolin-CoV. Our study also suggested that pangolin be natural host of Betacoronavirus, with a potential to infect humans. Large surveillance of coronaviruses in pangolins could improve our understanding of the spectrum of coronaviruses in pangolins. Conservation of wildlife and limits of the exposures of humans to wildlife will be important to minimize the spillover risks of coronaviruses from wild animals to humans.
ABSTRACT
A novel method is reported to enhance the focusing of microparticle in the viscoelastic fluid. Gradually contracted geometry is designed in microchannel, which changes the distribution of the elastic lift force on the cross section. Additionally, it induces the viscous drag force and the Saffman lift force in the lateral direction. Under the combined effect of these forces, microparticles fast migrate to the center of the channel. In comparison to the channel with constant cross section, the present channel significantly enhances the particle's lateral migration, leading to efficient viscoelastic particle focusing in a short channel length. The influence of flow rate, channel length, particle size and fluid property on the particle focusing is also investigated. With simple structure, small footprint and perfect particle focusing performance, the present device has great potential in the particle focusing processes in various lab-on-a-chip applications.
Subject(s)
Microfluidic Analytical Techniques/instrumentation , Microfluidic Analytical Techniques/methods , Elasticity , Equipment Design , Lab-On-A-Chip Devices , Particle Size , ViscosityABSTRACT
Cell surface charge has been recognized as an important cellular property. We developed a microfluidic sensor based on resistive pulse sensing to assess surface charge and sizes of single cells suspended in a continuous flow. The device consists of two consecutive resistive pulse sensors (RPSs) with identical dimensions. Opposite electric fields were applied on the two RPSs. A charged cell in the RPSs was accelerated or decelerated by the electric fields and thus exhibited different transit times passing through the two RPSs. The cell surface charge is measured with zeta potential that can be quantified with the transit time difference. The transit time of each cell can be accurately detected with the width of pulses generated by the RPS, while the cell size can be calculated with the pulse magnitude at the same time. This device has the ability to detect surface charges and sizes of individual cells with high tolerance in cell types and testing solutions compared with traditional electrophoretic light scattering methods. Three different types of cells including HeLa cancer cells, human dermal fibroblast cells, and human umbilical vein endothelial cells (HUVECs) were tested with the sensor. Results showed a significant difference of zeta potentials between HeLa cells and fibroblasts or HUVECs. In addition, when HeLa cells were treated with various concentrations of glutamine, the effects on cancer cell surface charge were detected. Our results demonstrated the great potential of using our sensor for cell type sorting, cancer cell detection, and cell status analysis.
Subject(s)
Microfluidic Analytical Techniques/methods , Single-Cell Analysis/methods , HumansABSTRACT
Electrical stimulation (ES) has been recognized to play important roles in regulating cell behaviors. A microfluidic device was developed for the electrical stimulation of single cells and simultaneous recording of extracellular field potential (EFP). Each single cell was trapped onto an electrode surface by a constriction channel for ES testing and was then driven to the outlet by the pressure afterward. This design allows the application of ES on and detection of EFP of single cells continuously in a microfluidic channel. Human cardiomyocytes and primary rat cortex neurons were tested with specific ES with the device. Each cell's EFP signal was detected and analyzed during the ES process. Results have shown that after applying specific ES on the excitable single cells, the cells evoked electrical responses. In addition, increased secretion of glutamic acid was detected from the stimulated neurons. Altogether, these results indicated that the developed device can be used to continuously apply ES on and accurately determine cell responses of single cells with shorter probing time. The throughput of the measurement can achieve 1 cell per minute, which is higher than the traditional ES methods that need culturing cells or manually positioning the cells onto the electrode surface. Before and after the application of ES, the cell viability had no significant change. Such a device can be used to study the biological process of various types of cells under electrical stimulation.
ABSTRACT
We developed a device that can quickly apply versatile electrical stimulation (ES) signals to cells suspended in microfluidic channels and measure extracellular field potential simultaneously. The device could trap cells onto the surface of measurement electrodes for ES and push them to the downstream channel after ES by increasing pressure for continuous measurement. Cardiomyocytes, major functional cells in heart, together with human fibroblast cells and human umbilical vein endothelial cells, were tested with the device. Extracellular field potential signals generated from the cells were recorded. We found that under electrical stimulation, cardiomyocytes were triggered to alter their field potential, while non-excitable cells were not triggered. Hence this device can noninvasively distinguish electrically excitable cells from electrically non-excitable cells. Results have also shown that increased cardiomyocyte cell number led to increased magnitude and occurrence of the cell responses. This relationship could be used to detect the viable cells in a cardiac tissue. Application of variable ES signals on different cardiomyocyte clusters has shown that the application of ES clearly boosted cardiomyocytes electrical activities according to the stimulation frequency. In addition, we confirmed that the device can apply ES onto and detect the electrical responses from a mixed cell cluster; the responses from the mixed cluster is dependent on the ratio of cardiomyocytes. These results demonstrated that our device could be used as a tool to optimize ES conditions to facilitate the functional engineered cardiac tissue development.
Subject(s)
Lab-On-A-Chip Devices , Microfluidics , Myocytes, Cardiac/metabolism , Electric Stimulation/instrumentation , Electric Stimulation/methods , Electrodes , Humans , Myocytes, Cardiac/cytologyABSTRACT
A passive microfluidic device is reported for continuous microparticle enrichment. The microparticle is enriched based on the inertial effect in a microchannel with contracting-expanding structures on one side where microparticles/cells are subjected to the inertial lift force and the momentum-change-induced inertial force induced by highly curved streamlines. Under the combined effect of the two forces, yeast cells and microparticles of different sizes were continuously focused in the present device over a range of Reynolds numbers from 16.7 to 125. â¼68% of the particle-free liquid was separated from the sample at Re = 66.7, and â¼18 µL particle-free liquid was fast obtained within 10 s. Results also showed that the geometry of the contracting-expanding structure significantly influenced the lateral migration of the particle. Structures with a large angle induced strong inertial effect and weak disturbance effect of vortex on the particle, both of which enhanced the microparticle enrichment in microchannel. With simple structure, small footprint (18 × 0.35 mm), easy operation and cell-friendly property, the present device has great potential in biomedical applications, such as the enrichment of cells and the fast extraction of plasma from blood for disease diagnose and therapy.
Subject(s)
Cell Separation/instrumentation , Lab-On-A-Chip Devices , Microfluidic Analytical Techniques/instrumentation , Equipment Design , Microspheres , Particle Size , Yeasts/cytology , Yeasts/isolation & purificationABSTRACT
Objective To evaluate the cardiac hemodynamics and function before and after balloon pulmonary angioplasty ( BPA ) treatment in patients with chronic thromboembolic pulmonary hypertension ( CTEPH) using echocardiography ,and to discuss the clinical value of the treatment . Methods A total of 36 CT EPH patients with medium‐high risk stratification underwent BPA during the period of September 2016 to January 2019 in Beijing Chao‐Yang Hospital ,Capital M edical University were recruited . T he following conventional echocardiographic parameters including right ventricular basal diameter ( RVD ) ,left ventricular basal diameter ( LVD) ,right atrial diameter ( RAD) ,left atrial diameter ( LAD) ,main pulmonary artery diameter ( DM PA ) , left ventricular eccentricity index ( LVEI ) , left ventricular ejection fraction ( LVEF) and pulmonary artery systolic pressure ( PASP ) were recorded .Echocardiographic parameters of right ventricular ( RV ) function including tricuspid annular plane systolic excursion ( T APSE ) , right ventricular fractional area change ( RVFAC ) ,tissue Doppler – derived tricuspid lateral annular systolic velocity ( S′) ,RV index of myocardial performance ( RIM P ) and right ventricular free wall longitudinal strain ( GLS) were measured . T he patients were divided into 2 groups according to the threshold value of postoperative SPAP of 50 mmHg (group Ⅰ :SPAP ≤ 50 mmHg ,group Ⅱ :SPAP>50 mmHg) . Changes between each parameter before and after BPA were analyzed . Results ① T he frequency of BPA treatment for CT EPH patients ranged from 1 to 6 times . After BPA treatment ,SPAP decreased significantly ,and the measurements of RV function including T APSE ,RVFAC ,RIM P and GLS improved significantly ( all P <0 .05) . ②Patients in group Ⅰ showed significantly better RV function including T APSE ,RVFAC and GLS compared with group Ⅱ before BPA ( P <0 .05) . ③Univariate logistic regression showed that parameters of preoperative RV function T APSE , RVFAC and GLS had certain effects on the curative effect of interventional surgery . Conclusions Echocardiography can evaluate the hemodynamics and RV function in CT EPH patients with BPA .After BPA ,pulmonary artery pressure decreases and RV function improves to some extent ,suggesting that the treatment of BPA has certain clinical application and popularization value .
ABSTRACT
Objective@#To evaluate the cardiac hemodynamics and function before and after balloon pulmonary angioplasty (BPA) treatment in patients with chronic thromboembolic pulmonary hypertension (CTEPH) using echocardiography, and to discuss the clinical value of the treatment.@*Methods@#A total of 36 CTEPH patients with medium-high risk stratification underwent BPA during the period of September 2016 to January 2019 in Beijing Chao-Yang Hospital, Capital Medical University were recruited. The following conventional echocardiographic parameters including right ventricular basal diameter (RVD), left ventricular basal diameter (LVD), right atrial diameter (RAD), left atrial diameter (LAD), main pulmonary artery diameter (DMPA), left ventricular eccentricity index (LVEI), left ventricular ejection fraction (LVEF) and pulmonary artery systolic pressure (PASP) were recorded.Echocardiographic parameters of right ventricular (RV) function including tricuspid annular plane systolic excursion (TAPSE), right ventricular fractional area change (RVFAC), tissue Doppler–derived tricuspid lateral annular systolic velocity (S′), RV index of myocardial performance (RIMP) and right ventricular free wall longitudinal strain (GLS) were measured. The patients were divided into 2 groups according to the threshold value of postoperative SPAP of 50 mmHg (group Ⅰ: SPAP ≤ 50 mmHg, group Ⅱ: SPAP>50 mmHg). Changes between each parameter before and after BPA were analyzed.@*Results@#①The frequency of BPA treatment for CTEPH patients ranged from 1 to 6 times. After BPA treatment, SPAP decreased significantly, and the measurements of RV function including TAPSE, RVFAC, RIMP and GLS improved significantly (all P<0.05). ②Patients in group Ⅰ showed significantly better RV function including TAPSE, RVFAC and GLS compared with group Ⅱ before BPA (P<0.05). ③Univariate logistic regression showed that parameters of preoperative RV function TAPSE, RVFAC and GLS had certain effects on the curative effect of interventional surgery.@*Conclusions@#Echocardiography can evaluate the hemodynamics and RV function in CTEPH patients with BPA.After BPA, pulmonary artery pressure decreases and RV function improves to some extent, suggesting that the treatment of BPA has certain clinical application and popularization value.