Which is the best prosthesis in an isolated or combined tricuspid valve replacement?

OBJECTIVES: The debate concerning the optimal choice of tricuspid position continues. We compared the long-term results of mechanical and biological prostheses in patients who underwent isolated or combined tricuspid valve replacement, at 2 major cardiac surgical centres in central China. METHODS: From January 1999 to December 2018, 338 patients underwent tricuspid valve replacement. Patients were divided into an isolated group or a combined group according to whether their surgery was combined with a left heart valve surgery. Mechanical tricuspid valve replacement was performed in 142 patients (isolated group: 41 vs combined group: 101), and 196 patients underwent bioprosthetic tricuspid valve replacement (isolated group: 145 vs combined group: 51). Operative results, long-term survival and tricuspid valve-related events were compared. RESULTS: Early mortality in the combined group was higher (n = 6, 4%) than that in the isolated group (n = 3, 2%), but no significant difference was observed between the mechanical and biological subgroups. In the isolated group, there was a higher event-free rate in the biological subgroup than in the mechanical subgroup (P = 0.042) and a similar result was also observed for patients without Ebstein's anomaly (P = 0.039). In the combined group, no significant difference was observed (P = 0.98). Survival rates were similar between the mechanical and biological subgroups in both the isolated (P = 0.54) and combined (P = 0.81) groups. Mechanical valves in isolated tricuspid valve replacement were more prone to valve thrombosis and bleeding. CONCLUSIONS: Every decision regarding tricuspid valve prostheses should be individualized, but biological prostheses may be an optimal choice for patients, especially for patients without Ebstein's anomaly, in isolated tricuspid valve replacement.

Secretion of adipocytes and macrophages under conditions of inflammation and/or insulin resistance and effect of adipocytes on preadipocytes under these conditions.

The purpose of the present study was to examine changes in preadipocytes following the coculture of preadipocytes and adipocytes and the effects on the secretion of adipocytes and macrophages following induction of inflammation and insulin resistance. Mature adipocytes and RAW264.7 macrophages were treated with lipopolysaccharide and insulin to establish models of inflammation and insulin resistance, respectively. The mRNA expression levels of IL-6, MCP-1, and TNF-α in all adipocyte treatment groups were significantly greater compared with the control, and that of adiponectin was less (P<0.05). In the RAW264.7 macrophages, the mRNA expression levels of IL-6 and TNF-α were greater than those in the control group (P<0.05). Moreover, the results of this study confirmed that adipocytes and macrophages increased the secretion of inflammatory factors under conditions of induced inflammation and insulin resistance. In addition, 3T3-L1 adipocytes inhibited the proliferation and differentiation of preadipocytes when cocultured with adipocytes under conditions of inflammation and/or insulin resistance, and the phenotype of preadipocytes did not change.

[Effects of on-pump beating-heart coronary artery bypass grafting for left-main patients].

OBJECTIVE: To explore the value of on-pump beating-heart coronary artery bypass grafting (OnP-BH CABG) for left-main patients with coronary heart disease through a comparative study with conventional coronary artery bypass grafting (CCABG). METHODS: The clinical data were retrospectively analyzed for 66 patients of OnP-BH and 48 control cases undergoing CCABG from January 2009 to January 2012 at Department of Cardiac Surgery, People's Hospital of Zhengzhou University. RESULTS: OnP-BH group had a better clinical outcome than CCABG group. There were obvious statistical difference in cardiopulmonary bypass (CPB) time, mean ventilation time, intensive care unit stay and recovery time of plasma cardiac troponin I (OnP-BH group vs CCABG group:(89 ± 25) vs (117 ± 28) min, (15 ± 14) vs (27 ± 19) h, (57 ± 27) vs (79 ± 34) h, (6.2 ± 1.8) vs (7.0 ± 2.4) d, all P < 0.05). The data of preoperative cTnI showed no significant difference between two groups (P > 0.05) .However, after CPB, significant intergroup difference existed in the level of cTnI (µg/L) OnP-BH group vs CCABG group: (0.5 h after CPB: (0.132 ± 0.022) vs (0.265 ± 0.014) , 1 h after CPB: (0.341 ± 0.027) vs (0.572 ± 0.046) , 1 h after operation: (0.641 ± 0.036) vs (0.932 ± 0.047) , 6 h after operation: (1.212 ± 0.765) vs (1.627 ± 0.542) and 24 h after operation: (1.496 ± 0.263) vs (1.734 ± 0.328) , all P < 0.05). CONCLUSIONS: On-pump beating-heart coronary artery bypass grafting is a feasible surgical approach for left-main patients. And it has a low risk and causes less myocardial damage.

Adsorbable organic halogens generation and reduction during degradation of phenol by UV radiation/sodium hypochlorite.

The degradation of phenol by UV radiation/sodium hypochlorite (UV/NaClO) was investigated. The degradation processes were analyzed by a UV-visible spectrometer, total organic carbon analyzer, and gas chromatography-mass spectroscopy. The experimental results indicate that phenol can be photodegraded by UV/NaClO effectively. However, adsorbable organic halogens (AOX) were produced during the degradation process. Analysis of the mechanism of degradation indicates that the decrease in pH value would increase the formation of AOX. Also, dissolved oxygen greatly increased the rate of phenol degradation and reduced the formation of AOX. Therefore, appropriate conditions could increase degradation and inhibit chlorination. Adjusting the pH value and increasing the amount of oxygen were effective methods.

Di-µ-chlorido-bis-{chlorido[2-(2-furyl-methyl-imino-meth-yl)pyridine-κN,N']nickel(II)}.

The title dinuclear nickel(II) complex, [Ni(2)Cl(4)(C(11)H(10)N(2)O)(2)], lies on a centre of symmetry located at the centroid of the four-membered ring formed by the two Ni atoms and the bridging chloride ions. The Ni(II) atom is five-coordinated in a square-pyramidal geometry by the imine and pyridine N atoms of the Schiff base ligand, and by one terminal and two bridging Cl atoms. The Ni⋯Ni distance is 3.506 (2) Å. The O atom of the furan substituent in the ligand unit is not involved in coordination to the Ni atom.

Bis[2-(butyl-imino-meth-yl)-4-chloro-phenolato]iron(II).

In the title compound, [Fe(C(11)H(13)ClNO)(2)], the Fe(II) atom is four-coordinated in a square-planar geometry by the O and N atoms of two 2-(butyl-imino-meth-yl)-4-chloro-phenolate Schiff base ligands.

Bis{(E)-2,4-diiodo-6-[(2-morpholinoeth-yl)imino-meth-yl]phenolato}nickel(II).

In the title mononuclear nickel(II) complex, [Ni(C(13)H(15)I(2)N(2)O(2))(2)], the Ni(II) atom is four-coordinated in a tetra-hedral geometry by the imine N and phenolate O atoms of the two Schiff base ligands. The O and N atoms of the morpholine substituent in the ligand are not involved in coordination to the Ni atom.

Bis[(E)-4-chloro-2-(cyclo-hexyl-imino-meth-yl)phenolato]nickel(II).

In the title mononuclear nickel(II) complex, [Ni(C(13)H(15)ClNO)(2)], the Ni(II) atom is four-coordinated in a tetra-hedral geometry by the N and O atoms of the two Schiff base ligands.

Bis[(E)-4-chloro-2-(2-furylmethyl-imino-meth-yl)phenolato]iron(II).

The Fe atom of the title compound, [Fe(C(12)H(9)ClNO(2))(2)], lies on a crystallographic twofold rotation axis. The Fe(II) atom is four-coordinated in a tetra-hedral geometry by the O and N atoms of the two Schiff base ligands. The O atom of the furan substituent in the ligand unit is not involved in coordination to the Fe atom.

Ethyl 3-(2,4-difluoro-phen-oxy)-2-(4-methoxy-phen-yl)acrylate.

In the title mol-ecule, C(18)H(16)F(2)O(4), the two benzene rings form a dihedral angle of 55.2 (2)°. In the crystal structure, weak inter-molecular C-H⋯O hydrogen bonds link the mol-ecules into chains propagating along the c axis.

Ethyl 2-(4-chloro-phen-yl)-3-(3,5-dimethoxy-phen-oxy)acrylate.

The title compound, C(19)H(19)ClO(5), displays a dihedral angle of 74.7 (3)° between the mean planes of the 4-chloro-phenyl and phenol rings.