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OBJECTIVE@#To investigate the efficacy and safety of venetoclax (VEN) combined with demethylating agents (HMA) in the treatment of relapsed/refractory acute myeloid leukemia (R/R AML).@*METHODS@#The clinical data of 26 adult R/R AML patients who received the combination of VEN with azacitidine (AZA) or decitabine (DAC) in Huai'an Second People's Hospital from February 2019 to November 2021 were retrospectively analyzed. The treatment response, adverse events as well as survival were observed, and the factors of influencing the efficacy and survival were explored.@*RESULTS@#The overall response rate (ORR) of 26 patients was 57.7% (15 cases), including 13 cases of complete response (CR) and CR with incomplete count recovery (CRi) and 2 cases of partial response (PR). Among the 13 patients who got CR/CRi, 7 cases achieved CRm (minimal residual disease negative CR) and 6 cases did not, with statistically significant differences in overall survival (OS) and event-free survival (EFS) between the two groups (P=0.044, 0.036). The median OS of all the patients was 6.6 (0.5-15.6) months, and median EFS was 3.4 (0.5-9.9) months. There were 13 patients in the relapse group and refractory group, respectively, with response rate of 84.6% and 30.8% (P=0.015). The survival analysis showed that the relapse group had a better OS than the refractory group (P=0.026), but there was no significant difference in EFS (P=0.069). Sixteen patients who treated for 1-2 cycles and 10 patients who treated for more than 3 cycles achieved response rates of 37.5% and 90.0%, respectively (P=0.014), and patients treated for more cycles had superior OS and EFS (both P<0.01). Adverse effects were mainly bone marrow suppression, complicated by various degrees of infection, bleeding, and gastrointestinal discomfort was common, but these could be all tolerated by patients.@*CONCLUSION@#VEN combined with HMA is an effective salvage therapy for patients with R/R AML and is well tolerated by patients. Achieving minimal residual disease negativity is able to improve long-term survival of patients.
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Adulto , Humanos , Estudos Retrospectivos , Neoplasia Residual/tratamento farmacológico , Compostos Bicíclicos Heterocíclicos com Pontes/efeitos adversos , Recidiva , Leucemia Mieloide Aguda/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêuticoRESUMO
Objective: To investigate the clinical efficacy of fecal microbiota transplantation (FMT) for treating steroid-refractory gastrointestinal acute graft-versus-host disease (GI-aGVHD) . Methods: This analysis included 29 patients with hematology who developed steroid-refractory GI-aGVHD after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in Huaian Hospital Affiliated to Xuzhou Medical University from March 2017 to March 2022. Among them, 19 patients underwent FMT treatment (the FMT group) and 10 patients did not (the control group). The efficacy and safety of FMT were assessed, as well as the changes in intestinal microbiota abundance, lymphocyte subpopulation ratio, peripheral blood inflammatory cytokines, and GVHD biomarkers before and after FMT treatment. Results: ① Complete remission of clinical symptoms after FMT was achieved by 13 (68.4%) patients and 2 (20.0%) controls, with a statistically significant difference (P<0.05). Intestinal microbiota diversity increased and gradually recovered to normal levels after FMT and FMT-related infections did not occur. ②The proportion of CD3(+) and CD8(+) cells in the FMT group after treatment decreased compared with the control group, and the ratio of CD4(+), regulatory T cells (Treg), and CD4(+)/CD8(+) cells increased (all P< 0.05). The interleukin (IL) -6 concentration in the FMT group was lower than that in the control group [4.15 (1.91-5.71) ng/L vs 6.82 (2.40-8.91) ng/L, P=0.040], and the IL-10 concentration in the FMT group was higher than that in the control group [12.11 (5.69-20.36) ng/L vs 7.51 (4.10-9.58) ng/L, P=0.024]. Islet-derived protein 3α (REG3α) was significantly increased in patients with GI-aGVHD, and the REG3α level in the FMT group was lower than that in the control group after treatment [30.70 (10.50-105.00) μg/L vs 74.35 (33.50-139.50) μg/L, P=0.021]. Conclusion: FMT is a safe and effective method for the treatment of steroid-refractory GI-aGVHD by restoring intestinal microbiota diversity, regulating inflammatory cytokines, and upregulating Treg cells.
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Humanos , Transplante de Microbiota Fecal/métodos , Resultado do Tratamento , Doença Enxerto-Hospedeiro/etiologia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , EsteroidesRESUMO
OBJECTIVE@#To construct an acute myeloid leukemia cell line stably expressing CD123-CLL1 so as to provide an "in vitro" model for studying the role of CD123 and CLL-1 in leukemia and the treatment targeting CD123 and CLL-1.@*METHODS@#The recombinant plasmid of lentivirus was constructed by synthesizing CD123 and CLL-1 sequences and PCR homologous recombination. The lentivirus vector was packaged by three-plasmid packaging system. After collecting the supernatant of lentivirus, the virus titer was determined by quantitative PCR. K562 leukemia cells were collected and transtected with virus supernatant. Leukemia cell line stably expressing the target gene were screened by purinomycin. The expression levels of CD123 and CLL-1 were detected by RT-PCR and flow cytometry.@*RESULTS@#The lentiviral vector was successfully constructed, and identified by agarose gel electrophoresis and gene sequencing, then the virus titer of the supernatant was up to 5.81×10@*CONCLUSION@#Lentiviral vector expressing CD123-CLL1 has been successfully constructed, and K562 leukemia cell line stably expressing CD123 and CLL-1 has been successfully obtained.
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Humanos , Linhagem Celular Tumoral , Vetores Genéticos , Subunidade alfa de Receptor de Interleucina-3 , Células K562 , Lentivirus/genética , Leucemia Linfocítica Crônica de Células B/genética , Plasmídeos , TransfecçãoRESUMO
OBJECTIVE@#To evaluate the incidence and clinical characteristics of metabolic syndrome (MS) within one year after hematopoietic stem cell transplantation (HSCT) in order to screen the risk factors for HSCT-MS, provide early intervention and improve the long-term quality of survival of patients.@*METHODS@#The clinical follow-up data of 64 HSCT patients (survival time > 1 year) who received HSCT in our center from January 2007 to August 2018 were collected. Among them, 50 cases were allogeneic hematopoietic stem cell transplantation (allo-HSCT) and 14 cases were autologous hematopoietic stem cell transplantation (auto-HSCT). The changes of MS-related indexes and clinical characteristics before and 1, 3, 6 and 12 months after HSCT were analyzed retrospectively.@*RESULTS@#In allo-HSCT group, 14 cases were diagnosed as MS before operation, including high-density lipoprotein cholesterol (hypo-HDL-C)> hyper triglycerides(hyper-TG)> hyper fasting glucose(hyper-FBG)> abdominal obesity (AO) > hypertension. The preoperative diagnosis of MS in the auto-HSCT group was 5 cases, in the order of hyper-FBG> hyper-TG> AO> hypo-HDL-C> hypertension. Incidence of MS at 1, 3, 6 and 12 months after transplantation: 19, 26, 24 and 20 cases in the allo-HSCT group, respectively; auto-HSCT group were 7, 7, 6 and 6 cases, respectively. Hyper-TG and hypo-HDL-C were prominent in both groups.@*CONCLUSION@#The incidence of HSCT-MS is significantly higher within 1 year after HSCT. Regardless of allo-HSCT and auto-HSCT, the prevention and control of HSCT-MS is emphasized as an important guarantee to improve the long-term survival quality of HSCT patients.
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Humanos , Transplante de Células-Tronco Hematopoéticas , Células-Tronco Hematopoéticas , Síndrome Metabólica , Estudos Retrospectivos , Transplante HomólogoRESUMO
Objective To explore the effects of warming moxibustion on behavioristics and cell morphology in pruritus mice.Methods Forty C57BL/6J mice were randomly divided into control group,model group,treatment group Ⅰ and treatment group Ⅱ.Mice were injected subcutaneously with vanilloid on the back to establish itch model.Treatment group Ⅱ and group Ⅱ were given moxibustion treatment at Changqiang (GV1) and Shenque (CV8).After one week treatment,histamine was injected into the cheek to observe the itching behavior,and the skin of cheek and crissum was observed under the transmission electron microscope to explore the effects of moxibustion on cell morphology.Results Scratching behavior and the number of vacuole in the perianal cells among four groups were significantly different.Scratching behavior reduced in the treatment group Ⅰ (9.4 ± 1.7) and treatment group Ⅱ (8.3 ± 1.2) compared with the model group (11.6 ± 2.3).The number of vacuole were also reduced in the treatment group Ⅰ (17.33 ±5.51) and treatment group Ⅱ (5.67 ± 2.08) compared with the model group (30.00 ±9.17).In treatment group Ⅰ and Ⅱ,the number of vacuole in the perianal cells significantly reduced compared with ceils in the skin of cheek.Condusion Warming moxibustion has a potent depressant effect on histamine-induced scratching behavior and the decrease number of vacuole may be one of the mechanisms.
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<p><b>OBJECTIVE</b>To investigate the potential association between monocyte chemotactic protein 1(MCP-1)in plasma and acute aortic dissection(AAD).</p><p><b>METHODS</b>A total of 110 patients with Stanford type A AAD who had received emergent surgical treatment in Xiangya hospital from September 2011 to September 2014 were enrolled in as the study group;meanwhile,110 patients with simple hypertension who had received treatment in department of cardiology were chosen as the control group. The plasma level of MCP-1 was measured and then compared between these two groups.</p><p><b>RESULTS</b>The plasma level of MCP-1 in the study group was(257.79±86.52)pg/ml,which was significantly higher than that in control group [(136.57±48.84)pg/ml](P<0.001).</p><p><b>CONCLUSION</b>There may be a correlation between plasma MCP-1 level and AAD.</p>
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Humanos , Dissecção Aórtica , Aneurisma Aórtico , Quimiocina CCL2RESUMO
<p><b>OBJECTIVE</b>To investigate the correlation between blood flow assessed by CT perfusion imaging and characteristics of microvascular ultrastructure in non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>twenty-eight patients with non-small cell lung cancer proven surgically and pathologically underwent perfusion CT examination. The patients were divided into a hyper-perfusion group and a hypo-perfusion group by the median value of blood flow, and then the differences of microvascular ultrastructure in the two groups were analyzed.</p><p><b>RESULTS</b>The median BF value of the 28 patients was 36.40 ml×100 g(-1)×min(-1). Take this median value as the boundary, the group with hypo-perfusion showed a significantly lower BF value than the group with hyper-perfusion [(30.84 ± 4.79) ml×100 g(-1)×min(-1) vs. (49.67 ± 10.89) ml×100 g(-1)×min(-1), t = -5.925, P < 0.001]. The group with lymph node metastasis showed a significantly lower BF value than the group without lymph node metastasis [(30.78 ± 5.24) ml×100 g(-1)×min(-1) vs. (50.73 ± 11.16) ml×100 g(-1)×min(-1), t = 3.490, P = 0.015]. The maturity of microvessels of the hyper-perfusion group was higher than that of the hypo-perfusion group. Under the electron microscope, the microvessels in the hypo-perfusion group showed a more narrow lumen, poorer integrity of basement membrane, a more close relationship between cancer cells and microvascular wall, and cancer cells were more easily seen in the microvascular lumen.</p><p><b>CONCLUSION</b>The blood flow value of CT perfusion imaging may be related with the abnormal microvascular ultrastructure, and may be helpful to the prediction of metastasis risk in NSCLC.</p>
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Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Carcinoma Pulmonar de Células não Pequenas , Diagnóstico por Imagem , Metabolismo , Patologia , Seguimentos , Neoplasias Pulmonares , Diagnóstico por Imagem , Metabolismo , Patologia , Metástase Linfática , Microvasos , Diagnóstico por Imagem , Metástase Neoplásica , Imagem de Perfusão , Tomografia Computadorizada Espiral , Fator A de Crescimento do Endotélio Vascular , MetabolismoRESUMO
<p><b>OBJECTIVE</b>To investigate the proportion of Th22 cells in peripheral blood of patients with acute lymphoblastic leukemia (ALL) and evaluate its significance.</p><p><b>METHODS</b>The proportions of Th22 cells in peripheral blood of B-ALL and T-ALL patients before therapy (group 1), B-ALL and T-ALL patients in complete remission (ALL-CR, group 2) and healthy donors (group 3) were evaluated by flow cytometry. The cytokines IL-22, TGF-β, TNF-α and IL-6 in peripheral blood of each group were measured by enzyme-linked immunosorbent assay (ELISA). The levels of IL-22 mRNA in peripheral blood mononuclear cells of each group were examined by reverse transcription-PCR (RT-PCR).</p><p><b>RESULTS</b>The percentages of Th22 cells and the levels of IL-22, TNF-α, IL-6 and IL-22 mRNA in B-ALL and T-ALL patients before therapy were (0.44 ± 0.10)%, (10.9 ± 3.4) ng/L, (110.7 ± 26.5) ng/L, (60.2 ± 13.8) ng/L, 0.17 ± 0.04 and (0.46 ± 0.11)%, (11.2 ± 3.5) ng/L, (114.6 ± 27.0) ng/L, (58.7 ± 12.4) ng/L, 0.19 ± 0.04, respectively; Which in B-ALL and T-ALL patients in complete remission were(0.59 ± 0.15)%, (14.3 ± 4.1) ng/L, (142.5 ± 32.7) ng/L, (83.7 ± 18.9) ng/L, 0.25 ± 0.06 and(0.60 ± 0.15)%, (14.6 ± 4.3) ng/L, (140.4 ± 31.4) ng/L, (81.4 ± 18.2) ng/L, 0.26 ± 0.06, significantly lower than those in healthy donors \[(1.24 ± 0.31)%, (19.7 ± 6.6) ng/L, (238.3 ± 50.4) ng/L, (138.0 ± 27.1) ng/L, 0.49 ± 0.09\] (P < 0.01). The percentages of Th22 cells and the levels of IL-22, TNF-α, IL-6 and IL-22 mRNA in group l were lower than those in group 2 (P < 0.05), there was not significant difference between B-ALL and T-ALL (P > 0.05). But the levels of TGF-β in B-ALL and T-ALL patients before therapy \[(30.6 ± 8.2) ng/L, (31.4 ± 8.8) ng/L\] and in complete remission \[(24.2 ± 5.8) ng/L, (25.1 ± 6.1) ng/L\] were significantly higher than those in group 3\[(9.6 ± 2.8) ng/L\] (P < 0.01). However, the level of TGF-β in group 1 was higher than that of group 2 (P < 0.05), there was not significant difference between B-ALL and T-ALL (P > 0.05).</p><p><b>CONCLUSION</b>Both the number and function of Th22 cells reduced in ALL patients. Th22 cells might be negatively correlated with ALL progression. The lower levels of TNF-α and IL-6, and overexpression of TGF-β in ALL patients might suppress the differentiation of Th22 cells.</p>
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Adolescente , Adulto , Humanos , Pessoa de Meia-Idade , Adulto Jovem , Estudos de Casos e Controles , Interferon gama , Metabolismo , Interleucina-6 , Metabolismo , Interleucinas , Metabolismo , Leucócitos Mononucleares , Metabolismo , Leucemia-Linfoma Linfoblástico de Células T Precursoras , Sangue , RNA Mensageiro , Genética , Linfócitos T Auxiliares-Indutores , Metabolismo , Fator de Crescimento Transformador beta , Metabolismo , Fator de Necrose Tumoral alfa , MetabolismoRESUMO
<p><b>OBJECTIVE</b>To explore the mechanism of immunomodulatory activity of triptolide on primary immune thrombocytopenia (ITP)patients-derived plasmacytoid dendritic cells (pDCs).</p><p><b>METHODS</b>pDCs in peripheral blood of ITP patients before therapy (group 1), ITP patients in complete response (ITP-CR, group 2) and healthy donors (group 3) were sorted by flow cytometry, then incubated with triptolide at 0, 5, 10 or 30 µg/L. After 24 hours, we collected the supernatants and then detected the concentrations of IFN-α, IL-6 and TNF-α using ELISA. After 5 days, the cultured cells were collected and CD11c, CD80 and CD86 expressions of myeloid dendritic cells (mDCs) were analyzed by flow cytometry, the morphology of mDC was observed by light microscope and electron microscope.</p><p><b>RESULTS</b>After incubation with triptolide at 10 µg/L, the levels of IFN-α, IL-6 and TNF-α in group 1 \[(451.32 ± 85.77) ng/L, (105.68 ± 23.85) ng/L and (135.78 ± 30.62) ng/L\] and group 2 \[(391.71 ± 72.49) ng/L, (84.73 ± 17.77) ng/L and (108.16 ± 23.21) ng/L\] were significantly higher than those in group 3 \[(335.51 ± 67.54) ng/L, (73.62 ± 21.82) ng/L and (95.58 ± 32.85) ng/L\] (all P < 0.05); the levels of IFN-α, IL-6 and TNF-α in group 1 were significantly higher than those in group 2 (all P < 0.05) in a dose-dependent manner (P < 0.05). CD11c, CD80 and CD86 expressions of mDC in group1 and group 2 were significantly higher than those in group 3 (all P < 0.05); CD11c, CD80 and CD86 expressions of mDC in group 1 were significantly higher than those in group 2 (all P < 0.05) also in a dose-dependent manner (all P < 0.05). Triptolide could inhibit pDCs from differentiation into mDCs, the latter displayed more immature morphology than untreated-pDCs.</p><p><b>CONCLUSION</b>Triptolide could decrease the immune function of pDCs from ITP, inhibit pDCs from differentiation and maturation.</p>
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Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Estudos de Casos e Controles , Diferenciação Celular , Células Cultivadas , Células Dendríticas , Biologia Celular , Diterpenos , Farmacologia , Compostos de Epóxi , Farmacologia , Fenantrenos , Farmacologia , Trombocitopenia , Alergia e ImunologiaRESUMO
This study was purposed to explore the effect of specific small interfering RNA targeting at bcr-abl fusion gene and its combination with p27 gene clone on the proliferation, cell cycle and apoptosis of chronic myeloid leukemia (CML) cell line K562. CML cell line K562 was used as the study object. A 21nt siRNA targeting at the fusion site of b3:a2 mRNA in bcr-abl fusion gene was designed, synthesized and transfected into the K562 cells as RNA interference group. Northern blot was used to detect the bcr-abl fusion gene, Western blot was used to detect the expression of P210 protein and apoptosis-related protein BCL-xL after the transfection. Meanwhile, p27 gene was amplified from peripheral blood mononuclear cells by RT-PCR, and was confirmed to be correct by sequencing, then p27-pcDNA3.1 vector was constructed and transfected into K562 cell line by Lipofectin. After being selected with G418, p27-pcDNA3.1-K562 cell clone stably expressing p27 was isolated. P27 protein was identified by Western blot. Finally, siRNA and p27 gene clone were together applied to K562 cells, the cell survival rate was tested by MTT. The cell cycle and the apoptosis were tested by flow cytometry. The result showed that in contrast with the control group, the expression level of bcr-abl fusion gene was much lower in siRNA group, about 18.4% of K562 cells in siRNA group were apoptotic at 24 hours after siRNA transfection, and the expression of apoptosis-associated protein BCL-xL was greatly down-regulated. The expression of P27 protein could be detected by Western blot in p27-pcDNA3.1-K562 cells. The strong inhibition of cell proliferation was observed in p27-pcDNA3.1-K562 cells, as compared with control K562 cells. The count of p27-pcDNA3.1-K562 cells in G(0)/G(1) phase increased apparently, but that in S phase declined greatly. Cell cycle was arrested in G(0)/G(1) phase. After the combination of p27-pcDNA3.1-K562 cells with specific siRNA, the percentage of apoptosis obviously increased and cell survival rate significantly declined. It is concluded that the specific siRNA distinctly inhibits the expression of bcr-abl fusion gene, and can induce K562 cell apoptosis. The combination of specific siRNA with P27 gene clone displays a synergy of inhibition and pro-apoptosis effects to K562 cells.
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Humanos , Apoptose , Ciclo Celular , Proliferação de Células , Inibidor de Quinase Dependente de Ciclina p27 , Genética , Proteínas de Fusão bcr-abl , Genética , Células K562 , Interferência de RNA , RNA Interferente Pequeno , Genética , TransfecçãoRESUMO
<p><b>OBJECTIVE</b>To observe the effects of tetramethylpyrazine (TMP) on tissue factor (TF) expression induced by thrombin in human umbilical vein endothelium derived cell line ECV304.</p><p><b>METHODS</b>The changes in the total cellular procoagulant activity (PCA) of ECV304 cells exposed to thrombin were observed with one-stage clotting assay. TF mRNA expression in the exposed cells was examined using semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR).</p><p><b>RESULTS</b>ECV304 cells stimulated with increasing concentrations of thrombin (1.25-20 U/ml) showed a gradual increase of PCA (r=0.9602, P<0.01). The application of FVII-deficient plasma and the monoclonal antibody of TF confirmed that the PCA of the cells mediated by TF activity. TMP at 125-1000 microg/ml alone did not affect TF expression in ECV304 cells (P>0.20), TMP administered 30 min prior to thrombin exposure showed a significant concentration-dependent inhibitory effect on the increments of PCA (r=-0.9644, P<0.01) and TF mRNA expression (r=-0.9576, P<0.05) in ECV304 cells, and 1000 microg/ml TMP produced the strongest effect. In ECV304 cells stimulated with thrombin for 4, 6, 8, 10 and 12 h, TMP administration significantly inhibited the thrombin-induced PCA, and the effect was especially obvious at 8 h following thrombin exposure (P<0.05).</p><p><b>CONCLUSION</b>Thrombin induces TF expression in vascular endothelial cells, and this effect can be inhibited by TMP at the mRNA level.</p>
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Animais , Humanos , Linhagem Celular , Relação Dose-Resposta a Droga , Células Endoteliais , Biologia Celular , Metabolismo , Regulação da Expressão Gênica , Pirazinas , Farmacologia , RNA Mensageiro , Genética , Metabolismo , Trombina , Farmacologia , Tromboplastina , Genética , Metabolismo , Fatores de TempoRESUMO
OBJECTIVE@#To establish the hyperlipoidemia model and observe its effect on the expression of plasma vWF, PAl-1 and t-PA after endothelial cell injury caused by the model at different time in rats.@*METHODS@#Sixty male Sprague-Dawley rats weighing (200+/-20)g were randomly divided into 6 groups (n=10 in each): high flat composition for 7 weeks (Group A7), 8 weeks (Group A8)and 9 weeks(Group A9), common bait vessel feeding for 7 weeks(Group C7), 8 weeks(Group C8) and 9 weeks (Group C9). When it reached the setting time, the rats were put to death and the serum was separated to detect the blood-fat immediately. Meanwhile, the pathological sections of the rat aorta were made to observe the endothelial injury. The blood plasma was separated and the content of the blood plasma PAl-1, t-PA and vWF was detected by ELISA assay.@*RESULTS@#(1)TG, TC and LDL of the rats intragastrically administrated high flat composition were higher than those of the control group,and HDL increased with time at first, but lowered when longer than 9 weeks. (2) There were no lesions in the aortic endothelium in all rats of Group C through optical microscope,while different lesions in the aortic endothelium in all rats of Group A were observed. (3)In the 3 groups A, the plasma vWF and PAI-1 were gradually increasing with time while t-PA gradually decreased. (4) There was no significant difference of vWF between Group A7 and Group A8. PAI-I increased gradually with the aggravation of endotheliocytes in Group A; and t-PA decreased gradually with the aggravation of endothelium in Group A.@*CONCLUSION@#(1) As intragastric administration prolongs, the plasma lipid of rats keeps increasing with the aggravation of the endodermis injury. (2) PAI-1, t-PA and vWF are the molecular markers of vascular endothelial cell injury in rats. (3) PAI-l and t-PA are more sensitive than vWF in reflecting the endothelial cell injury in hyperlipemia early metaphase.
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Animais , Masculino , Ratos , Aorta , Patologia , Células Endoteliais , Patologia , Hiperlipidemias , Sangue , Patologia , Inibidor 1 de Ativador de Plasminogênio , Sangue , Distribuição Aleatória , Ratos Sprague-Dawley , Ativador de Plasminogênio Tecidual , Sangue , Fator de von Willebrand , MetabolismoRESUMO
OBJECTIVE@#To summarize the experience of mitral vavuloplasty for mitral insufficiency in 53 patients.@*METHODS@#Between January 2001 and September 2006,53 patients (31 males and 22 females) with mitral insufficiency underwent mitral valve repair at our hospital. The mean age was (23.8+/-10.4) years, and the mean weight was (43+/-12) kg,including 29 cases of mitral prolapse,17 congenital mitral insufficiency, 5 rheumatic mitral insufficiency,and 2 other etiology. All operations were performed under cardiopulmonary bypass,moderate hypothermia and under the surveillance of transesophagus echocardiography.@*RESULTS@#There were 2 early postoperative deaths,and another patient failed to repair and received valve replacement afterward. Postoperative echocardiography indicated that mitral insufficiency was completely corrected in 42 patients, and residual mitral regurginitation in the other 8 patients. During the follow-up with mean period 13.8 months,41 patients revealed 28 in NYHA classI,13 in Class II.@*CONCLUSION@#Mitral valve repair should be the preferred modes of surgical correction for regurgitate mitral valves. With proper vavuloplasty technique, patients with selective mitral insufficiency patients may achieve satisfactory effect.
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Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ponte Cardiopulmonar , Ecocardiografia Doppler em Cores , Seguimentos , Valva Mitral , Cirurgia Geral , Insuficiência da Valva Mitral , Cirurgia Geral , Prolapso da Valva Mitral , Cirurgia GeralRESUMO
OBJECTIVE@#To observe the changes of plasma von Willebrand factor (vWF) and soluble E-selectin (sE-selectin) in patients with coronary artery disease (CAD) and evaluate their clinic significance.@*METHODS@#The level of plasma vWF and sE-selectin of 60 cases with coronary artery disease were detected by enzyme-linked immunosorbent assay (ELISA) and 20 healthy persons acted as the control group. Risk factors for coronary artery disease were obtained by asking the medical history and the relation ship was analyzed with coronary artery disease.@*RESULTS@#The plasma vWF and sE-selectin levels of CAD patients were significantly higher than those of the control group (P = 0.017 and P < 0.001). There was no significant difference in plasma vWF levels between the acute myocardial infarction (AMI) group and the unstable angina pectoris (UA) group or the SA group (P = 0.210 and P = 0.194). The plasma vWF level of the SA group were higher than that of the UA group (P = 0.012). The plasma levels of sE-selectin of AMI group, and the UA group were higher than those of the SA group (P < 0.001 and P = 0.010). There were no significant differences between the SA group and the control group (P = 0.284) and between the AMI group and the UA group (P = 0.066).@*CONCLUSION@#The increased plasma vWF or sE-selectin level may be risk factors for CAD and they may be involved in the pathogenesis of CAD. The increase of plasma sE-selectin is correlated to the generation and development of CAD and it is important in the evaluation of clinical severity of CAD.