Long-term outcome of transcatheter repair of paravalvular leak post surgical mitral valve replacement / 中华心血管病杂志

Objective: To explore the long-term clinical efficacy of transcatheter repair of mitral paravalvular leak (PVL) post surgical mitral valve replacement. Methods: This study is a retrospective study. Patients who completed transcatheter repair of paravalvular leak after surgical mitral valve replacement at Shanghai Chest Hospital, Shanghai Jiaotong University School of Medicine from March 2010 to December 2018 were included. Technical success was defined as the occluder being stably implanted in the paravalvular leak site without affecting the function of the mitral valve and surrounding tissues; and there were no intervention-related complications, such as new hemolysis or aggravated hemolysis, and echocardiography confirmed mitral paravalvular regurgitation reduced by more than 1 grade. Patients were followed up at 30 days, 1, and 3 years after the intervention. The main endpoints were all-cause death and re-surgery due to interventional failure or serious complications. The occurrence of occluder-mediated hemolysis and chronic renal insufficiency was recorded, and patients were monitored with echocardiography during follow up. Results: A total of 75 patients were included, aged (54.3±22.9) years old, and 38 patients were males. All patients had decreased cardiac function and/or hemolysis before intervention. Procedural success was achieved in 54 patients (72.0%). Incidence of device-mediated hemolysis was 18.7% (14/75). During the follow-up period, all-cause death occurred in 7 patients (9.3%), and 3 were cardiac deaths.The 3-year event-free survival rate was 81.3% (61/75). The need for cardiac surgery was 9.3% (7/75): 3 cases due to severe device-mediated hemolysis, 2 cases due to prosthetic valve failure and 2 cases due to moderate to severe residual regurgitation. The echocardiography follow-up results showed that the position of the occluder was stable, there was no impact on the artificial valve function and surrounding structures, and the residual regurgitation was stable without progressive increase in event-free patients. Compared with pre-intervention, the left ventricular end systolic diameter ((33.9±7.4)mm vs. (38.3±8.9) mm, P=0.036), end diastolic diameter ((53.7±8.3) mm vs. (58.4±9.1) mm, P=0.045) and left atrial diameter (59.3 (44.5, 90.7) mm vs. 64.3 (44.8, 96.6) mm, P=0.049) were significantly reduced, pulmonary artery systolic pressure was also significantly decreased ((36.5±15.8) mmHg vs. (46.3±14.9) mmHg, P=0.022, 1 mmHg=0.133 kPa). There was no significant difference between 3 years and 1 year after transcatheter repair of mitral paravalvular leak post surgical mitral valve replacement (all P>0.05). Conclusion: Transcatheter repair of mitral paravalvular leak post surgical mitral valve replacement is an effective treatment option in selective patients.

Research progress on the modulation mechanism of electroacupuncture for learning and memory impairment after ischemic stroke / 中国针灸

Electroacupuncture may play a role in treatment of learning and memory impairment after ischemic stroke by regulating phosphatidylinositol-3-kinase (PI3K)/protein kinase B (Akt) signaling pathway, cyclic adenosine monophosphate (cAMP)-dependent protein kinase A (PKA)/cAMP response element binding protein (CREB) signaling pathway, nerve growth factor (NGF)/tyrosine kinase-A (TrkA) signaling pathway, Janus kinase 2 (JAK2)/signal transducer and activator of transcription 3 (STAT3) signaling pathway, Notch signaling pathway, erythropoietin-producing hepatocyte (Eph)/ephrin signaling pathway. The interactions among these pathways should be further explored in treatment of learning and memory impairment after ischemic stroke.

Research progress of obstructive sleep apnea hypopnea syndrome and ocular surface diseases / 国际眼科杂志(Guoji Yanke Zazhi)

Obstructive sleep apnea hypopnea syndrome(OSAHS)is a group of diseases which occurred in the upper respiratory tract with transient, recurrent, partial or complete obstruction during night sleep. It can affect the regulation of hemodynamics, endocrine systems and autonomic nerve, and then result in the reduction of body oxygen saturation, chronic hypoxia and hypercapnia. Beside being an independent risk factor for cardiovascular and cerebrovascular diseases, many studies have shown that it is also associated with ocular surface diseases in OSAHS, such as floppy eyelid syndrome, dry eye, keratoconus, etc., but there is still a lack of perfect systematic analysis. This paper reviews the relationship between OSAHS and relevant ocular surface diseases including pathogenesis,clinical manifestations and treatment progress, in order to reduce the ophthalmic complications of OSAHS patients in clinical diagnosis and treatment,and better improve the quality of life of patients.

Treatment of finger spasm after stroke with wheat grain moxibustion at Shixuan (EX-UE 11) combined with rehabilitation training: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the clinical effect of wheat grain moxibustion combined with rehabilitation training and simple rehabilitation training on finger spasm after stroke.@*METHODS@#A total of 80 patients with finger spasm after stroke were randomly divided into an observation group and a control group, 40 cases in each group. The control group was given routine rehabilitation training, once a day, 30 min each time. The observation group was given wheat grain moxibustion at Shixuan (EX-UE 11) on the basis of the control group, 8~10 moxibustion cones at each point, once a day. Both groups were treated for 6 days as one course of treatment for 4 courses. The motor function of the affected hand (Fugl-Meyer assessment [FMA] score) and muscle tension (modified Ashworth scale [MAS] grading), surface EMG indexes (wrist dorsiflexor muscle and flexor carpal metacarpal muscle mean square [RMS] value), hand muscle strength (neurological deficit score [NDS]) and daily living ability (modified Barthel index [MBI] score) were compared between the two groups before and after treatment, and clinical efficacy was evaluated.@*RESULTS@#After treatment, FMA and MBI scores in the 2 groups were increased compared with before treatment (P<0.05), and those in the observation group were higher than the control group (P<0.05). The RMS value of wrist dorsiflexor muscle and flexor carpal metacarpal muscle in relaxation and passive function testsand and NDS in the 2 groups were lower than those before treatment (P<0.05), and those in the observation group were lower than the control group (P<0.05). MAS grading in the 2 groups was improved compared with before treatment (P<0.05), and that in the observation group was better than the control group (P<0.05). The total effective rate of the observation group was 92.5% (37/40), which was higher than that of the control group (80.0%, 32/40, P<0.05).@*CONCLUSION@#Wheat grain moxibustion at Shixuan (EX-UE 11) combined with rehabilitation training can improve the hand motor function and daily living ability of patients with finger spasm after stroke, improve the degree of spasm and the function of wrist dorsiflexor muscle and flexor carpal metacarpal muscle, the clinical effect is better than simple rehabilitation training.

Molecular mechanism of astragaloside Ⅳ against atherosclerosis by regulating miR-17-5p and PCSK9/VLDLR signal pathway / 中国中药杂志

This study explores the regulatory effect of astragaloside Ⅳ on miR-17-5 p and its downstream proprotein convertase subtillisin/kexin type 9(PCSK9)/very low density lipoprotein receptor(VLDLR) signal pathway, aiming at elucidating the mechanism of astragaloside Ⅳ against atherosclerosis(AS). In cell experiment, oxidized low-density lipoprotein(ox-LDL) was used for endothelial cell injury modeling with vascular smooth muscle cells(VSMCs). Then cells were classified into the model group, miR-17-5 p inhibitor group, blank serum group, and astragaloside Ⅳ-containing serum group based on the invention. Afterward, cell viability and the expression of miR-17-5 p, VLDLR, and PCSK9 mRNA and protein in cells in each group were detected. In animal experiment, 15 C57 BL/6 mice were used as the control group, and 45 ApoE~(-/-) mice were classified into the model group, miR-17-5 p inhibitor group, and astragaloside Ⅳ group, with 15 mice in each group. After 8 weeks of intervention, the peripheral serum levels of interleukin-6(IL-6), interleukin-10(IL-10), and tumor necrosis factor-α(TNF-α), and the expression of miR-17-5 p, VLDLR, and PCSK9 mRNA in the aorta of mice were detected. The pathological changes of mice in each group were observed. According to the cell experiment, VSMC viability in the miR-17-5 p inhibitor group and the astragaloside Ⅳ-containing serum group was higher than that in the model group(P<0.05). The mRNA and protein expression of miR-17-5 p and VLDLR in VSMCs in the miR-17-5 p inhibitor group and the astragaloside Ⅳ-containing serum group was lower than that in the model group(P<0.05), but the mRNA and protein expression of PCSK9 was higher than that in the model group(P<0.05). As for the animal experiment, the levels of IL-6 and TNF-α in the peripheral serum of the miR-17-5 p inhibitor group and the astragaloside Ⅳ group were lower(P<0.05) and the serum level of IL-10 was higher(P<0.05) than that of the model group. The mRNA expression of miR-17-5 p and VLDLR in the aorta in the miR-17-5 p inhibitor group and the astragaloside Ⅳ group was lower(P<0.05), and PCSK9 mRNA expression was higher(P<0.05) than that in the model group. Pathological observation showed mild AS in the miR-17-5 p inhibitor group and the astragaloside Ⅳ group. In summary, astragaloside Ⅳ can prevent the occurrence and development of AS. The mechanism is that it performs targeted regulation of miR-17-5 p, further affecting the PCSK9/VLDLR signal pathway, inhibiting vascular inflammation, and thus alleviating endothelial cell injury.

Expression of Versican and Its Related Molecules in Patient with Multiple Myeloma and Its Clinical Significance / 中国实验血液学杂志

OBJECTIVE@#To investigate the expression and clinical significant of VCAN and its related molecules in patients with MM.@*METHODS@#Ficoll density gradient centrifugation method was used to speared the bone marrow mononuclear cell in 25 cases of MM before and after treatment, the relative mRNA expression of VCAN and their related molecules (FAK, FN, MK, and HAS) in bone marrow was detected by real-time quantitative PCR, and their protein expression was determined by Western bolt.@*RESULTS@#The expression of VCAN, FK and FN in the effective group after treatment was significantly lower than that before treatment (P＜0.05), however, the expression of MK and HAS showed no statistically significantly different before and after treatment (P＜0.05). The expression of VCAN of patients in non remission group was significantly higher than that in control group (P＜0.05). The expression of FAK and FN of patients in no remission group was significant increased as compared with the patients in newly diagnosed group (P＜0.05). The relative expression of VCAN mRNA in the patients at 3rd stage was significantly higher than those at the 1st stage (P＜0.05) and control group but showed no significant difference to the patients at 2nd stage (P＜0.05). The expression of VCAN and its related proteins (FAK, MK, FN) showed positively correlation in bone marrow mononuclear cells of MM patients (P＜0.05). The correlation between VCAN and HAS was not statistically significant (r=0.259，P＞0.05). Survival analysis showed that the relative expression of VCAN mRNA was associated with OS (P=0.049) and PFS (P=0.041) in MM patients.@*CONCLUSION@#VCAN and its related molecules are highly expressed in MM patients; VCAN may act as potential biomarker in the development of multiple myeloma.

Advance in Animal Models of Dysphagia (review) / 中国康复理论与实践

An appropriate animal model of dysphagia is important for research of the mechanism and treatment. Animal models of dysphagia mainly involve rodents, non-human primates and some other mammals, in which rats and mice are the most commonly used. The diseases mainly reproduced include stroke, amyotrophic lateral sclerosis, Parkinson's disease and oropharyngeal neuromuscular diseases, with dysphagia. The success of modeling mainly depends on the assessment of swallowing function, such as videofluoroscopic swallowing study and electrophysiological examination. No animal model can perfectly represent the clinical and pathological characteristics of dysphagia in humans now. With the development of targeted genetic modification and detection indicators, more reasonable dysphagia models would be reproduced.

Impact factors of in-stent restenosis following successful stent implantation for acquired severe pulmonary vein stenosis post atrial fibrillation ablation / 中华心血管病杂志

Objective: To investigate the influencing factors of in-stent restenosis (ISR) following successful stent implantation in patients with ablation-associated severe pulmonary vein stenosis (PVS) who undergo atrial fibrillation ablation. Methods: Data of patients who underwent pulmonary vein angiography to confirm PVS after radiofrequency ablation for atrial fibrillation (AF) and received pulmonary vein stenting at Shanghai Chest Hospital from March 2010 to December 2017 were retrospectively analysed. All patients were followed up for a long period of time (pulmonary vein contract-enhanced CT within 6 to 12 months after operation was performed, and pulmonary angiography was performed if CT indicated stenosis>50%). The incidence of ISR was recorded. According to angiography, the patients were divided into ISR group and non-ISR group. The clinical and intraoperative imaging characteristics and interventional data were compared between the two groups. Logistic regression was used to analyse the influencing factors of ISR. Results: A total of 47 patients ((47.1±12.2) years old) were enrolled in this study, including 28 males(59.6%). There were 19 cases in ISR group and 28 cases in non-ISR group. Compared with the non-ISR group, the ISR group received more pulmonary vein isolation ((2.8±0.9) vs. (1.8±1.3), P=0.02), and the interval between last ablation and stenting was longer ((19.4±9.6) vs. (13.0±12.4), P=0.03). The incidence of ISR in patients with stent diameter≤8 mm was significantly higher than those with stent diameter>8 mm (33.3%(20/60) vs. 8.1%(3/37), P<0.01). Logistic regression analysis found that the number of radiofrequency ablation>1 (OR=2.1, 95%CI 1.3-3.9, P=0.02), and the time from the last ablation to stent placement>12 months (OR=1.5, 95%CI 1.1-2.5, P=0.03), reference diameter of stenosed distal vessel (OR=0.7, 95%CI 0.5-0.9, P=0.04), post procedural minimal luminal diameter (OR=0.4, 95%CI 0.2-0.8, P=0.02) and stent diameter (OR=0.6, 95%CI 0.3-0.9, P=0.03) were independent factors of ISR. Conclusions: The greater number of radiofrequency ablations and the longer time from the last ablation to stent placement increase the risk of ISR. The larger reference diameter of the stenosed distal vessel, stent diameter and post procedural minimal luminal diameter are the protective factors of ISR.

Effect of acupuncture at " three points of ilioumbar" on lumbar function and pain in patients with iliopsoas muscle strain / 中国针灸

OBJECTIVE@#To compare the clinical effect of acupuncture at "three points of iliolumbar" combined with celecoxib and celecoxib alone in the treatment of iliopsoas muscle strain.@*METHODS@#A total of 60 patients with iliopsoas muscle strain were randomly divided into an observation group and a control group, 30 patients in each group. Celecoxib was given orally to both groups, 200 mg once a day for 3 days. On the basis of the above drugs, acupuncture was applied at (Extra), Wushu (GB 27), (Extra) in the observation group, once a day for 3 days. The Japanese Orthopaedic Association (JOA) score and visual analogue scale (VAS) score were observed and compared before and after treatment, and the content of 5-hydroxytryptamine (5-HT) in serum was detected by enzyme-linked immunosorbent assay (ELISA) before and after treatment in the two groups.@*RESULTS@#After treatment, the JOA scores in the two groups were increased (both <0.05), and the VAS scores and 5-HT contents were decreased (all <0.05). The increase of JOA score in the observation group was greater than that in the control group (<0.05), and the decrease of VAS score and 5-HT content in the observation group was greater than that in the control group (both <0.05).@*CONCLUSION@#Acupuncture at "three points of ilioumbar" combined with celecoxib in the treatment of iliopsoas muscle strain can improve lumbar function, relieve pain and reduce 5-HT content in serum, which is better than celecoxib alone.

MicroRNA as potential target for gene therapy of multiple myeloma-review / 中国实验血液学杂志

The studies in recent years have found that miRNA play an important role in various biological functions, such as cell differentiation, proliferation, apoptosis, migration, and survival. Many studies considered the abnormally expressed miRNA as significant regulator in the pathogenesis, progression and metastasis of malignant tumors. miRNA can function as oncogenes or tumor suppressors by regulating post-transcriptional factors effecting multi pathways and may even represent target for therapies. This review summarizes the current advancement about the roles of miRNA in the biology of multiple myeloma (MM), including focuses on miRNA signatures relevant to MM, functions of critical miRNA in the mechanisms and development of MM behind their deregulation, the role in the drug-resistance and perspective of their expression in MM.

Sustaining expression of B domain-deleted human factor VIII mediated by using lentiviral vectors in NOD/SCID mouse / 中国实验血液学杂志

Recently, gene therapy has been become a promising approach to cure hemophilia A, a most common recessive bleeding disease. The aim of this study was to determine the perspective of lentiviral vector in hemophilia A gene therapy in vitro and in NOD/SCID mice. Lentivirus transfer vector pXZ9/BDDFVIII containing human B-domain-deleted Factor VIII-IRES-eGFP coding sequence and mock control pXZ9 were constructed. Lentivirus was prepared by co-transfecting 3 plasmids into 293FT cells. 293FT, HLF, human bone marrow mesenchymal stem cells and Chang-liver cells were transfected with the prepared virus. Coagulant activity of human FVIII, human FVIII antigen, human FVIII mRNA transcription and genomic integration were assayed by ELISA, one-step method, RT-PCR and PCR after infection. Lentiviral particles were concentrated by ultracentrifugation and NOD/SCID mice were transfected via portal vein injection. Human FVIII antigen in mouse blood plasma was analyzed by ELISA. eGFP expression was observed by fluorescent microscopy and human FVIII transcription in mouse liver was analyzed by RT-PCR at one month after transduction. The results showed that the high titer of recombinant virus was prepared and used to efficiently transduce the target cells in vitro. At 72 h after transfection, high levels of FVIII activity and FVIII antigen were detected. Human FVIII gene transcription could be detected in the liver of NOD/SCID mice received lentiviral particles carrying FVIII gene. Mouse hepatocytes were transfected with recombinant lentivirus efficiently in vivo. Human FVIII level in mouse blood plasma reached to (49 ± 6) mU, (54 ± 8) mU and (23 ± 4) mU at 72 h, one week and one month after transfection respectively. It is concluded that the lentiviral particles carrying BDDhFVIII gene can high efficiently transfect the target cells both in vitro and in vivo, and the transfected target cells can secrete hFVIII efficiently. The sustained expression of human FVIII in NOD/SCID mice is observed after lentivirus transfection via portal vein injection.

Establishment and identification of mouse lymphoma cell line EL4 expressing red fluorescent protein / 中国实验血液学杂志

This study was purposed to construct a lentiviral vector encoding red fluorescent protein (DsRed) and transfect DsRed into EL4 cells for establishing mouse leukemia/lymphoma model expressing DsRed. The bicistronic SIN lentiviral transfer plasmid containing the genes encoding neo and internal ribosomal entry site-red fluorescent protein (IRES-DsRed) was constructed. Human embryonic kidney 293FT cells were co-transfected with the three plasmids by liposome method. The viral particles were collected and used to transfect EL4 cells, then the cells were selected by G418. The results showed that the plasmid pXZ208-neo-IRES-DsRed was constructed successfully, and the viral titer reached to 10(6) U/ml. EL4 cells were transfected by the viral solution efficiently. The transfected EL4 cells expressing DsRed survived in the final concentration 600 microg/ml of G418. The expression of DsRed in the transfected EL4 cells was demonstrated by fluorescence microscopy and flow cytometry. In conclusion, the EL4/DsRed cell line was established successfully.

Observation on therapeutic effect of acupuncture combined with medicine on Parkinson disease / 中国针灸

<p><b>OBJECTIVE</b>To observe therapeutic effect of acupuncture on Parkinson disease (PD).</p><p><b>METHODS</b>Sixty cases of PD were randomly divided into 2 groups, an acupuncture plus medication group and a medication group, 30 cases in each group. The acupuncture plus medication group were treated with acupuncture at Shenting (GV 24), Baihui (GV 20), Sishencong (EX-HN 1), etc. and oral administration of Madopa, and the medication group only with Madopa. Their therapeutic effect and scores of Parkinson disease function rating scale (modified UPDRS) were compared.</p><p><b>RESULTS</b>The total improvement rate of 80.0% in the acupuncture plus medication group was significantly higher than 60.0% in the medication group (P < 0.05); the decrease of cumulative score of UPDRS in the acupuncture plus medication group was better than that in the medication group (P < 0.05).</p><p><b>CONCLUSION</b>Acupuncture has a certain therapeutic effect on PD.</p>

Effects of volatile oil of Rhizoma zingiberis and other two kinds of volatile oil on percutaneous penetration of bullatine A via hairless mouse skin in vitro / 中国中药杂志

<p><b>OBJECTIVE</b>To investigate the effects of volatile oils of Rhizoma Acori Tatarinowii (RAT), Semen Myristicae (SM) and Pericarpium Citri Reticulatae (PCR) on percutaneous penetration of bullatine A via hairless mouse skin in vitro.</p><p><b>METHOD</b>By an improved Franz diffusion, the effects of three kinds of volatile oils on the percutaneous penetration of bullatine A were observed and compared with Azone, and the cumulative amount of bullatine A was determined by HPLC.</p><p><b>RESULT</b>The penetration enhancement ratios of bullatine A with 7% volatile oil RAT and SM, 5% volatile oil of PCR and 3% Azone were 6.52, 6.74, 2.18, 6.03, respectively.</p><p><b>CONCLUSION</b>The volatile oil of RAT, SM and PCR enhance permeation of bullatine A, effectively.</p>

Synthesis and antitumor activity of selenophosphocholine analogues containing tegafur / 药学学报

<p><b>AIM</b>To synthesize the selenophosphocholine analogues containing tegafur and test their antitumor activities.</p><p><b>METHODS</b>The cyclic glyceroselenophospholopid conjugate of tegafur was synthesized by the reaction of hexaethylphosphorous triamide with N1-(2-furanidyl)-N3-(hydroxyalkyl)-5-fluyorouracil and 1-O-hexadecyl glycerol as well as selenium in one-pot. Cyclic glyceroselenophospholopid conjugate of tegafur reacted with triethylamine to give title compounds.</p><p><b>RESULTS</b>Six new compounds have been synthesized. Their structures were confirmed by 1H NMR, 13P NMR and elemental analysis. Antitumor activity of the title compounds against PGA1 was tested.</p><p><b>CONCLUSION</b>The reaction of triethylamine with cyclic glyceroselenophospholopid conjugate of tegafur very readily occurred, which was finished within 2 h at room temperature. The opening-ring products of trans isomers showed antimutor activity against human uriaryl bladder cancer cell more effective than that of the tegafur.</p>