Preliminary clinical experience of the novel transcatheter aortic valve system Prizvalve® for the treatment of severe aortic stenosis / 中华心血管病杂志

Objective: To evaluate the safety and efficacy of transcatheter aortic valve implantation (TAVI) with the novel Prizvalve® system in treating severe aortic stenosis. Methods: This is a single-center, prospective, single-arm, observational study. A total of 11 patients with severe aortic stenosis with high risk or inappropriate for conventional surgical aortic valve replacement (SAVR) were included, and TAVI was achieved with the Prizvalve® system between March 2021 and May 2021 in West China Hospital. Transthoracic echocardiography (TTE) was performed immediately after prosthesis implantation to evaluate mean transaortic gradient and maximal transaortic velocity. The device success rate was calculated, which was defined as (1) the device being delivered via the access, deployed, implanted and withdrawn, (2) mean transaortic gradient<20 mmHg (1 mmHg=0.133 kPa) or a maximal transaortic velocity<3 m/s post TAVI, and without severe aortic regurgitation or paravalvular leak post TAVI. TTE was performed at 30 days after the surgery, and all-cause mortality as well as the major cardiovascular adverse events (including acute myocardial infarction, disabling hemorrhagic or ischemic stroke) up to 30 days post TAVI were analyzed. Results: The age of 11 included patients were (78.1±6.3) years, with 8 males. A total of 10 patients were with NYHA functional class Ⅲ or Ⅳ. Devices were delivered via the access, deployed, implanted and withdrawn successfully in all patients. Post-implant mean transaortic gradient was (7.55±4.08) mmHg and maximal transaortic velocity was (1.78±0.44) m/s, and both decreased significantly as compared to baseline levels (both P<0.05). No severe aortic regurgitation or paravalvular leak was observed post TAVI. Device success was achieved in all the 11 patients. No patient died or experienced major cardiovascular adverse events up to 30 days post TAVI. Mean transaortic gradient was (9.45±5.07) mmHg and maximal transaortic velocity was (2.05±0.42) m/s at 30 days post TAVI, which were similar as the values measured immediately post TAVI (both P>0.05). Conclusions: TAVI with the Prizvalve® system is a feasible and relatively safe procedure for patients with severe aortic stenosis and at high risk or inappropriate for SAVR. Further clinical studies could be launched to obtain more clinical experience with Prizvalve® system.

Site-directed mutagenesis of the quorum-sensing transcriptional regulator SinR affects the biosynthesis of menaquinone in Bacillus subtilis.

BACKGROUND: Menaquinone (MK-7) is a highly valuable vitamin K2 produced by Bacillus subtilis. Common static metabolic engineering approaches for promoting the production of MK-7 have been studied previously. However, these approaches caused an accumulation of toxic substances and reduced product yield. Hence, dynamic regulation by the quorum sensing (QS) system is a promising method for achieving a balance between product synthesis and cell growth. RESULTS: In this study, the QS transcriptional regulator SinR, which plays a significant role in biofilm formation and MK production simultaneously, was selected, and its site-directed mutants were constructed. Among these mutants, sinR knock out strain (KO-SinR) increased the biofilm biomass by 2.8-fold compared to the wild-type. SinRquad maximized the yield of MK-7 (102.56 ± 2.84 mg/L). To decipher the mechanism of how this mutant regulates MK-7 synthesis and to find additional potential regulators that enhance MK-7 synthesis, RNA-seq was used to analyze expression changes in the QS system, biofilm formation, and MK-7 synthesis pathway. The results showed that the expressions of tapA, tasA and epsE were up-regulated 9.79-, 0.95-, and 4.42-fold, respectively. Therefore, SinRquad formed more wrinkly and smoother biofilms than BS168. The upregulated expressions of glpF, glpk, and glpD in this biofilm morphology facilitated the flow of glycerol through the biofilm. In addition, NADH dehydrogenases especially sdhA, sdhB, sdhC and glpD, increased 1.01-, 3.93-, 1.87-, and 1.11-fold, respectively. The increased expression levels of NADH dehydrogenases indicated that more electrons were produced for the electron transport system. Electrical hyperpolarization stimulated the synthesis of the electron transport chain components, such as cytochrome c and MK, to ensure the efficiency of electron transfer. Wrinkly and smooth biofilms formed a network of interconnected channels with a low resistance to liquid flow, which was beneficial for the uptake of glycerol, and facilitated the metabolic flux of four modules of the MK-7 synthesis pathway. CONCLUSIONS: In this study, we report for the first time that SinRquad has significant effects on MK-7 synthesis by forming wrinkly and smooth biofilms, upregulating the expression level of most NADH dehydrogenases, and providing higher membrane potential to stimulate the accumulation of the components in the electron transport system.

Valve in Valve transcatheter mitral valve replacement by a transvenous, transseptal access: A case report / 中国胸心血管外科临床杂志

@#Reoperation due to degenerated bioprostheses is an important factor of high-risk thoracic surgeries. In 2020 ACC/AHA guideline, Valve in Valve (ViV) was recommended for high-risk patient instead of surgical mitral valve replacement. This report described a 77-year-old male patient with a failed mitral bioprosthetic valve, evaluated at high risk of surgery, received a transvenous, transseptal transcatheter mitral valve replacement (TMVR). Tracheal intubation was removed at CCU 3 h after surgery without discomfort such as polypnea. The patient was transferred out of the CCU and discharged on the 3rd day. Compared with transapical access, transvenous transseptal access was less invasive, with shorter duration in CCU and hospitalization.

Effect and Mechanism of Arbuscular Mycorrhizal Fungi in Herbs / 中国实验方剂学杂志

Arbuscular mycorrhizal fungi （AMF） can establish mycorrhizal symbiosis system with most terrestrial plants，and play important roles in their growth and development. However，there is no systematic analysis and summarization of their roles in the growth, biosynthesis and accumulation of active substances of herbs，as well as stress-resistance mechanism. First，the main research methods of AMF were summarized in the paper，including the separation of AMF spores，morphological identification，chemical staining and molecular identification. The main morphological structures of some AMF were detailed in the table. In terms of growth promotion，AMF promoted the growth by prolonging mycelium，enhancing phosphatase secretion，organic acid，activation of soil and increasing absorption efficiency. In the aspect of biosynthesis and accumulation of flavonoids，terpenoids and other active substances in herbs，AMF improved the contents by regulating activities of signal substances and key enzymes involved in the metabolism of secondary products. In addition，AMF could alleviate a series of stresses caused by drought，heavy metal，high salt，high or low temperature by improving the activity of antioxidant enzymes，enhancing the ability of plants to scavenge free radicals，complexing toxic heavy metals，diluting high salt concentration，or inducing the expressions of key genes. Finally，the application prospects and in-depth study of AMF in the ecological planting of herbs were discussed, in order to provide reference for promoting relevant research.

Biosynthesis of Steroidal Saponins in Herbs / 中国实验方剂学杂志

Steroidal saponins are efficacious substances wildly existed in the herbs，and consist of glycosyl and steroid sapogenin. The biosynthesis pathways of steroidal saponins mainly include the cytosolic mevalonate （MVA） pathway and the plastidial methylerythritol 4-phosphate （MEP） pathway，with the MVA pathway as the main pathway. The key enzymes are involved in the biosynthetic pathway, including 3-hydroxy-3-methyl glutaryl coenzyme A reductase（HMGR），1-deoxy-D-xylulose 5-phosphate synthase（DXS），1-deoxy-D-xylulose-5-phosphatereduetoisomerase（DXR），farnesyl pyrophosphate synthase（FPS），squalene synthase（SS），squalene epoxidase（SE），cycloartenol synthase（CAS），cytochrome P450（CYP450），and steroidalglycosyltransferase（SGTase）. In the paper，the biosynthesis roadmap of steroidal saponins was optimized based on previous studies. According to a comprehensive analysis on studies of key enzymes for the past five years, genes, like HMGR，SS，CYP450 and UGT，were studied more，while other genes，like FPS，SE，CAS，were known less. In conclusion， current studies still focus on the primary stage，but lack direct evidence for the roles of key enzymes. This paper would provide a reference and theoretical support for subsequent studies.

An Investigation on the Molecular Characteristics and Intracellular Growth Ability among Environmental and Clinical Isolates of Legionella pneumophila in Sichuan Province, China / 生物医学与环境科学（英文）

OBJECTIVE@#To investigate the molecular characteristics and intracellular growth ability of Legionella pneumophila (L. pneumophila) strains from 1989 to 2016 in Sichuan Province, China.@*METHODS@#Seventy-nine isolates of L. pneumophila were collected from environmental and clinical sources, including cooling towers, hot springs, bath water, fountains, and patients, and identified with 16S rRNA gene analysis and serum agglutination assay. The isolates were then typed by Sequence-Based Typing (SBT), and Genotyping of forty-two LP1 strains were analyzed by means of multiple-locus VNTR analysis with 8 loci (MLVA-8). All strains were further analyzed for two virulence genes: Legionella vir homologue (lvh) and repeats in structural toxin (rtxA). The intracellular growth ability of 33 selected isolates was determined by examining their interaction with J774 cells.@*RESULTS@#All isolates were identified to L. pneumophila including 11 serogroups, among which the main serogroup were LP1, accounting for 54.43%. Thirty-three different sequence types (STs) from five main clonal groups and five singletons were identified, along with 8 different MLVA patterns. Both the lvh and rtxA loci were found in all 79 strains. Thirty isolates showed high intracellular growth ability in J774 cells.@*CONCLUSION@#L. pneumophila is a potential threat to public health, and effective control and prevention strategies are urgently needed.

Efficacy and safety of aspirin for venous thromboembolism after total knee arthroplasty / 中国组织工程研究

BACKGROUND: The best prevention strategy for venous thrombosis (VTE) is currently controversial, especially for patients with high risk of total knee arthroplasty. There are no fully safe, effective and inexpensive thrombus prevention drugs. OBJECTIVE: To study the efficacy and safety of aspirin in preventing venous thrombosis after total knee arthroplasty. METHODS: 300 patients undergoing primary unilateral total knee arthroplasty from September 2014 to December 2016 were randomly divided into two groups: conventional anticoagulation group and risk stratification group (n=150 per group), including 88 males and 212 females at the age of 49-85 years old. The conventional anticoagulation group received low molecular weight heparin for prevention and treatment. Risk stratification group was stratified according to the risk of venous thrombosis. 64 patients with low risk were treated with aspirin and 86 patients with high risk were treated with low molecular weight heparin. Complications were analyzed within 90 days after surgery, including deep venous thrombosis, pulmonary embolism, wound infection, bleeding and death. RESULTS AND CONCLUSION: (1) Complications occurred in 39 cases (13%) within 90 days after follow-up. The total incidence of symptomatic deep vein thrombosis complications was 2% in 6 cases, and 19 cases (6.33%) had wound complications. There were 3 cases (2%) of symptomatic deep vein thrombosis in conventional anticoagulation group and 3 cases (2%) in risk stratification group. (2) The incidence of symptomatic deep vein thrombosis, proximal deep vein thrombosis and distal deep vein thrombosis and pulmonary embolism were 1.56% (1 case), 1.56% (1 case), 4.68% (3 cases), and 0% respectively in patients treated with aspirin. The incidence of symptomatic deep vein thrombosis, proximal deep vein thrombosis and distal deep vein thrombosis and pulmonary embolism in patients receiving low molecular weight heparin were 2.12% (5 cases), 0.85% (2 cases), 5.08% (12 cases) and 0.42% (1 case), respectively. There was no significant difference between the two groups (P > 0.05). (3) There were 11 cases of wound complications in the conventional anticoagulation group and 8 cases in the risk stratification group (χ2 = 506, P = 0.318). (4) The incidences of wound-related complications (wound delayed healing, superficial wound infection and deep wound infection) were 1.56% (1 case), 0% and 1.56% (1 case) respectively in patients receiving aspirin, and 5.51% (13 cases), 1.27% (3 cases) and 0.42% (1 case) in patients receiving low molecular weight heparin. (5) Results suggested that aspirin and low molecular weight heparin can effectively prevent the occurrence of deep vein thrombosis. For low-risk patients, aspirin multi-mode thrombosis prevention is safe and effective.

Molecular cloning, expression analysis and subcellular localization of a Transparent Testa 12 ortholog in brown cotton (Gossypium hirsutum L.).

Transparent Testa 12 (TT12) is a kind of transmembrane transporter of proanthocyanidins (PAs), which belongs to a membrane-localized multidrug and toxin efflux (MATE) family, but the molecular basis of PAs transport is still poorly understood. Here, we cloned a full-length TT12 cDNA from the fiber of brown cotton (Gossypium hirsutum), named GhTT12 (GenBank accession No. KF240564), which comprised 1733 bp with an open reading frame (ORF) of 1503 bp and encoded a putative protein containing 500 amino acid residues with a typical MATE conserved domain. The GhTT12 gene had 96.8% similarity to AA genome in Gossypium arboretum. Quantitative RT-PCR analysis denoted that the relative expression of GhTT12 in brown cotton was 1-5 folds higher than that in white cotton. The mRNA level was the highest at 5 days post anthesis (DPA) and reduced gradually during the fiber development. Expressing GhTT12-fused green fluorescent protein (GFP) in Nicotiana tabacum showed that GhTT12-GFP was localized in the vacuole membrane. The content of PAs increased firstly and decreased afterwards, and reached the maximum at 15 DPA in brown cotton. But for white cotton, the content of PAs remained at a low level during the fiber development. We speculate that GhTT12 may participate in the transportation of PAs from the cytoplasmic matrix to the vacuole. Taken together, our data revealed that GhTT12 was functional as a PAs transmembrane transporter.

Relationship between intermedin and atrial fibrosis in patients of hypertension combined with atrial fibrillation / 生物医学工程学杂志

This study was aimed to evaluate the relationship between the changes of plasma intermedin (IMD) and atrial fibrosis in hypertensive patients with atrial fibrillation. During the period from 2010 to 2011, appropriate 150 subjects of out-patients (female 50%, male 50%) were selected in West China Hospital, Sichuan University, and were divided into three groups: the hypertension-only group, the hypertension combined with paroxysmal atrial fibrillation group and the hypertension combined with persistent atrial fibrillation group. Firstly, we collected the Physical examination results and medical history records of the patients. We then performed ultrasound cardiogram and blood biochemical tests on the patients. We also detected the plasma IMD and transforming growth factor β1 (TGF-β1) using ELISA. The results showed that compared with the hypertensive group, the plasma level of IMD, TGF-β1 and left atrium director (LAD) in the hypertensive combined with atrial fibrillation group were higher significantly. Compared with the paroxymal atrial fibrillation group, the levels of IMD, TGF-β1 and LAD were higher significantly in persistent atrial fibrillation group. Analysis of correlation and partial correlation showed that IMD was positively correlated with TGF-p1 (r=0.51, P<0. 001), IMD was positively correlated with LAD(r=0.59, P< 0.001), and TGF-β1 was positively correlated with LAD (r = 0.57, P < 0.001). The results suggest that IMD might suppress the pathophysiological process of atrial fibrillation.

Relations between fasting serum lipids and high-sensitivity C-reactive protein level in Chengdu residents / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the associations between fasting serum lipids and high-sensitivity C-reactive protein (hsCRP).</p><p><b>METHODS</b>Serum triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and hsCRP were measured in residents of Chengdu, China. Subjects with potential factors which might influence lipids and hsCRP were excluded, 580 subjects [mean age (62.3 ± 6.6) years; male: 58.7%] were finally recruited by random sampling methods.</p><p><b>RESULTS</b>There was a weak positive relationship between TG and hsCRP (r = 0.108, P = 0.01) and a weak negative relationship between HDL-C and hsCRP (r = -0.197, P < 0.001), this was also true in the sub-group with BMI < 24 kg/m(2) (r = 0.236, -0.140 respectively, all P < 0.001). In subjects with BMI < 24 kg/m(2), the hsCRP concentration was significantly higher in subjects with higher TG or lower HDL-C (all P < 0.05). hsCRP increased in proportion with the degree of dyslipidemia. After adjusting for gender, age, TC, LDL-C, fasting blood glucose, systolic blood pressure, diastolic blood pressure, history of hypertension and diabetes, smoking and alcohol drinking, logistic regression analysis showed that the odds ratio for increased hsCRP was 1.970 in subjects with either increased TG or lower HDL-C (P = 0.105) and 9.098 in subjects with both higher TG or lower HDL-C levels (P = 0.031). However, the observed relationship between TG, HDL-C and hsCRP in subjects with BMI < 24 kg/m(2) could not be observed in subjects with subjects with BMI > 24 kg/m(2) despite significant more cardiovascular risk factors in these subjects.</p><p><b>CONCLUSIONS</b>A weak positive correlation between TG and hsCRP as well as a weak negative correlation between HDL-C and hsCRP was evidenced in the whole cohort suggesting dyslipidemia might be related to enhanced inflammatory status. However, this relationship is not observed in subjects with BMI > 24 kg/m(2) despite existence of more cardiovascular risk factors in these subjects.</p>

Effect of aconite cake-separated moxibustion at Guanyuan (CV 4) and Mingmen (GV 4) on thyroid function in patients of Hashimoto's thyroiditis / 中国针灸

<p><b>OBJECTIVE</b>To explore the effects on thyroid function in patients of Hashimoto's thyroiditis treated with aconite cake-separated moxibustion and option the better therapeutic program.</p><p><b>METHODS</b>Eighty-five cases were randomly divided into a moxibustion group (42 cases) and a western medication group (43 cases). The moxibustion group was treated by aconite cake-separated moxibustion therapy with acupoints of two groups [(1) Danzhong (CV 17), Zhongwan (CV 12), Guanyuan (CV 4); (2) Dazhui (GV 14), Shenshu (BL 23), Mingmen (GV 4)] alternatively and oral administration of 25 microg Euthyrox everyday. The western medication group was oral administration of 25 microg Euthyrox everyday. Indices of thyroid function before and after treatment and clinical effect were compared between two groups.</p><p><b>RESULTS</b>The clinical total effective rate and effective rate of thyroid function were 25.0% (10/40), 87.5% (35/40) in moxibustion group respectively, 7.53% (3/40) and 57.5% (23/40) in western medication group, with significant differences between two groups (both P < 0.05). Content of serum free thyroxine index (FT4) increased significantly in the moxibustion group after treatment (P < 0.01); content of serum supersensitive thyrotropin (S-TSH) in the moxibustion group was lower than that of western medication group, and contents of serum FT4 and free triiodothyronine (FT3) were higher than those of western medication group, but with no significant differences (all P > 0.05).</p><p><b>CONCLUSION</b>Aconite cake-separated moxibustion at Guanyuan (CV 4) and Mingmen (GV 4) combined with oral administration of Euthyrox can improve clinical symptoms and thyroid function in patients of Hashimoto's thyroiditis, which is better than simple oral administration of Euthyrox.</p>

Expression of XIAP and survivin and its significance in diffuse large B-cell lymphoma / 肿瘤研究与临床

Objective To investigate the expression of XIAP and survivin and its significance in diffuse large B-cell lymphoma. Methods The expression of XIAP and survivin were detected by immunohistochemistry in 49 patients with diffuse large B-cell lymphomas. Results The positive rate of XIAP and survivin in cases of DLBCL were 40.8%(20/49) and 44.9%(22/49) respectively, which was higher than that of benign lymph node pathological changes (P ＜0.05). The expression of XIAP in DLBCL positively correlated with the expression of surviving (r =0.382, P =0.01). Moreover, the mean survival period in DLBCL expressing XIAP was shorter than the XIAP-negative group. Conclusion The up-regulation of expression of XIAP may play an important role in the development of DLBCL, and may cooperate with the expression of survivin in apoptosis pathway. Furthermore, the expression of XIAP might be a new unfavorable prognosis factor of DLBCL.

Therapeutic effect and side effect of treatment on hyperthyroid exophthalmos with the combination of acupuncture and medication / 中国针灸

<p><b>OBJECTIVE</b>To compare the therapeutic effect and side effect of the treatments on hyperthyroid exophthalmos with the combination of acupuncture and medication and with medication only.</p><p><b>METHODS</b>Fifty-two cases were randomly divided into an acupuncture and medication group (27 cases) and a medication group (25 cases). Acupuncture in combination of oral taking of Thiamazole and Euthyrox were adopted for the acupuncture and medication group. And acupoints such as Jingming (BL 1), Chengqi (ST 1) and Sizhukong (TE 23) etc. were selected. Western medication for oral taking was applied as the only treatment for the medication group. Objective eye syndrome marks, side effects and accidents were compared between two groups before and after treatment.</p><p><b>RESULTS</b>The improvement of the objective marks of eye syndrome in the acupuncture and medication group was better than that in the medication group (P < 0.01). There were 4 cases with hypoleucocytosis, 3 cases with rash and 3 cases with aggravated symptom of exophthalmos in the medication group during the treatment, while no case with side effects was observed in the acupuncture and medication group. However, 8 cases were found with hemorrhage and 8 with hematoma in the acupuncture and medication group.</p><p><b>CONCLUSION</b>Treatment with the combination of acupuncture and medication may not only enhance the therapeutic effect, but also reduce the side effects.</p>

Study on expression of NF-κB/p65 in nasal NK/T cell lymphomas / 中国医师杂志

Objective To investigate the expression of NF-κB/p65 in nasal NK/T cell lymphomas. Methods Immunohistochemis-try and TUNEL were used to study the expression of NF-KB/p65 and cell apoptosis in 23 nasal NK/T cell lymphoma samples and 14 benign lymph node lesions. Results The NF-KB/p65 positive rates were 43.5% (10/23). The expression of NF-κB/p65 was negative correlated with apoptotic index among 23 nasal NK/T cell lymphomas(P <0. 05). The mean survival period in patients expressed NF-KB/p65 was sig-nificantly shorter than that in negative group(P <0. 05). Conclusions Apoptosis inhibited by overexpression of NF-κB/p65 might be in-volved in the development of nasal NK/T cell lymphoma. NF-κB/p65 expression may be an unfavorable prognostic factor of nasal NK/T cell lymphoma.

Laboratory confirmation of the first influenza A (H1N1) imported case in Mainland China / 病毒学报

The clinical throat swab specimen of an imported suspected case of influenza A (H1N1) was detec ted with real-time PCR, RT-PCR and subsequently confirmed by gene sequencing. The presence of influ enza A (H1N1) virus confirmed the first case with A (H1N1) infection in Mainland China.

Thinking about syndrome differentiation-based treatment in clinical acupuncture and moxibustion / 中国针灸

At present, current situation of syndrome differentiation-based treatment in clinical acupuncture and moxibustion has brought about concern of scholars at home and abroad. Acu-moxibustion doctors on Japan point out that a great number of corrupt practice in clinical treatment, which should be paid to enough attention. Based on the question put forward by the Japanese doctor, this article points out the main existing problems and analyzes some opinions, for which people may hold different viewpoints. The "syndrome differentiation-based treatment" is embodied in the scientific and orderly application of "principles, methods, prescriptions, acupoints and techniques" in the clinical practice. To achieve the purpose of improving the therapeutic effect, the clinical techniques, action regularity, indications and influential factors, etc. should further be studied.

Effects of Acupoint Iontophoresis on Ultrastructure and Function of Heart of Rats / 中国康复理论与实践

@#ObjectiveTo research the protective mechanism of acupoint iontophoresis to the heart function.Methods46 SD rats were randomly divided into 5 groups. The methods of histology, transmission electron microscope and radioimmunoassay were used respectively to observe the influence of acupoint iontophoresis on rats' heart ultrastructure.ResultsAcupoint iontophoresis could prolong rats' exertion period, protect ultrastructure of heart and prevent it from abnormal accretion. Over training would cause unbalance secreting between endothelin (ET) and calcitoningene related peptide (CGRP), while acupoint iontophoresis could improve such situation.ConclusionThe rise of exercise induced fatigue is related to many factors; acupoint iontophoresis can protect cardiac muscle, improve heart function and prevent it from exercise induced fatigue via several ways.

Effect of acupoint transcutaneus electrical nerve stimulation on endurance training in rats / 中国康复理论与实践

@#Objective To observe effects of acupoint transcutaneus electrical nerve stimulation on endurance training of rats.Methods Rats were put in swimming groove, closed glass bottle and on movable platform, then examined exhausting time, enduring lack of oxygen time, movable platform fatigue time and avoirdupois change.Results Exhausting time, movable platform fatigue time, and enduring lack of oxygen time of experimental rats were increased (P <0.01); All of post experiment rats' avoirdupois rose obviously, but experimental group enhanced least.Conclusion The acupoint transcutaneus electrical nerve stimulation has integrated acupuncture with physical therapy and has features of safety, convenience, practicality and efficiency.