Role of real-time three-dimensional transesophageal echocardiograpny in mitral valve repair

Background and objective Pre-operative assessment of mitral valve(MV)anatomy is essential to surgical design in patientsundergoing MV repair.Although 2-dimensional(2D)echocardiography provides precise information regarding MV anatomy,RT-3DTEE could increase the understanding of MV apparatus and individual scallop identification.We aimed to investigate the value of RT-3DTEE in MV repair. Methods RT-3DTEE was performed in six patients with mitral valve prolapse(MVP) by using Philips IE33with X7-2t probe.Preoperative RT-3DTEE studies were compared with surgical findings in patients undergoing surgical mitral valverepair,and quantitative evaluation was performed by QLab 6.0 software before and after surgicalmitralvalve repair.Results RT-3DTEE could display dynamic morphology of MV,the location of prolapse,and spatial relation to the surrounding tissue.It couldprovide surgical views of the valves and the valvular apparatus.These resuIts were consistent with surgical findings.The quantitativeevahuation before and after surgical MV repair indicated that anterolateral to posteromedial diameter of annalus.anterior to posteriordiameter of annulus,perimeter of annullus.,and area of annalus in projectionplane were significantlv smaller after operation comparedwith those before operation(P＜0.05).The length of posterior leaflet,,the area of anterior and posterior leaflet,the maximal prolapseheight,the volume of leaflet prolapse and the length of coaptation in projection planewere significantly reduced after operation(P＜0.05).Conclusion RT-3DTEE is a unique new medality for rapid and accurate evaluation of mitral valve prolapse and miwal valverepair.     

术中联合胆道镜应用在胰管结石治疗中的疗效观察

目的探讨胆道镜取石及碎石在胰管结石手术中的应用价值。方法通过病例资料回顾性分析本院收治的胰管结石46例患者的临床资料,2例因合并胰头癌行胰十二指肠切除术(Whipple),1例行胰体尾部加脾切除术,1例行胰尾加脾切除、胰腺断端空肠吻合术(Pusetow),其中行胰管切开取石、疏通主胰管并联合胰肠Roux-en-Y吻合术,术中应用胆道镜取石及碎石治疗20例胰管结石患者(胆道镜联合手术组),并与期间仅行胰管切开取石、疏通主胰管并联合胰肠Roux-en-Y吻合术治疗10例胰管结石患者(常规手术组)以及仅行内镜下逆行性胰胆管造影(ERCP)联合体外震波碎石(ESWL)术治疗12例胰管结石患者(ERCP+ESWL组)在术中失血量、术后残石率、术后疼痛缓解率、腹泻缓解率、糖尿病缓解率方面进行比较。结果与常规手术组比较,胆道镜联合手术组及ERCP+ESWL组在术中失血量、术后残石率、术后疼痛缓解率方面差异有显著性(P<0.05);胆道镜联合手术组与ERCP+ESWL组比较,在术中失血量、术后残石率、术后疼痛缓解率、腹泻缓解率方面差异均有显著性(P<0.05),而在糖尿病缓解率方面,差异无显著性(P>0.05)。结论在胰管结石的治疗中,外科手术中联合应用胆道镜取石、碎石技术能显著减少结石残留率及术中出血量,并明显提高患者术后上腹部疼痛缓解率。     

白介素-2在主动脉夹层全弓置换术后多乳糜引流量患者中的应用研究

目的 探讨白介素-2应用于主动脉夹层全弓置换术后多乳糜引流量患者的安全性及有效性.方法 将41例主动脉夹层全弓置换术后的多乳糜引流量患者随机分为实验组(20例)和对照组(21例).并于术后5、7、9d上午10:00左右,在试验组纵隔引流管内注入白介素-2注射液400万U(加生理盐水20 mL),对照组注入等量的生理盐水.术后记录患者24 h引流量(5、7、9、11、15 d)、带引流管时间、住ICU时间和住院时间,并观察并发症发生情况.结果 术后两组引流量均逐渐减少,试验组各时间点引流量均少于对照组,两者相比,在术后7、9、11、15d差异有统计学意义(P＜0.05).试验组带引流管时间明显少于对照组(P＜0.05).两组术后发热、肺部感染及住ICU时间相比,差异无统计学意义(P＞0.05).试验组营养不良发生率及术后住院时间明显低于对照组(P＜0.05).结论 经纵隔引流管注入白介素-2能明显降低主动脉夹层全弓置换术后引流量,缩短住院时间,且不增加感染、营养不良等发生率.     

Improved electrical transport properties of an n-ZnO nanowire/p-diamond heterojunction

A heterojunction of n-ZnO nanowire (NW)/p-B-doped diamond (BDD) was fabricated. The rectifying behavior was observed with the turn on voltage of a low value (0.8 V). The forward current at 5 V is 12 times higher than that of a larger diameter n-ZnO nanorod (NR)/p-BDD heterojunction. The electrical transport behaviors for the comparison of n-ZnO NWs/p-BDD and n-ZnO NRs/p-BDD heterojunctions are investigated over various bias voltages. The carrier injection process mechanism for ZnO NWs/BDD is analyzed on the basis of the proposed equilibrium energy band diagrams. The ZnO NWs/BDD heterojunction displays improved I–V characteristics and relatively high performance for the electrical transport properties.

A heterojunction of n-ZnO nanowire/p-diamond was fabricated and exhibits improved electrical transport properties, which offer a promising design for developing optoelectronic nanodevices working at the nano-scale and with severe environments.     

An integrated pathway interaction network for the combination of four effective compounds from ShengMai preparations in the treatment of cardio-cerebral ischemic diseases

Aim:

SMXZF (a combination of ginsenoside Rb1, ginsenoside Rg1, schizandrin and DT-13) derived from Chinese traditional medicine formula ShengMai preparations) is capable of alleviating cerebral ischemia-reperfusion injury in mice. In this study we used network pharmacology approach to explore the mechanisms of SMXZF in the treatment of cardio-cerebral ischemic diseases.

Methods:

Based upon the chemical predictors, such as chemical structure, pharmacological information and systems biology functional data analysis, a target-pathway interaction network was constructed to identify potential pathways and targets of SMXZF in the treatment of cardio-cerebral ischemia. Furthermore, the most related pathways were verified in TNF-α-treated human vascular endothelial EA.hy926 cells and H2O2-treated rat PC12 cells.

Results:

Three signaling pathways including the NF-κB pathway, oxidative stress pathway and cytokine network pathway were demonstrated to be the main signaling pathways. The results from the gene ontology analysis were in accordance with these signaling pathways. The target proteins were found to be associated with other diseases such as vision, renal and metabolic diseases, although they exerted therapeutic actions on cardio-cerebral ischemic diseases. Furthermore, SMXZF not only dose-dependently inhibited the phosphorylation of NF-κB, p50, p65 and IKKα/β in TNF-α-treated EA.hy926 cells, but also regulated the Nrf2/HO-1 pathway in H2O2-treated PC12 cells.

Conclusion:

NF-κB signaling pathway, oxidative stress pathway and cytokine network pathway are mainly responsible for the therapeutic actions of SMXZF against cardio-cerebral ischemic diseases.     

The efficacy and safety of glucokinase activators for the treatment of type-2 diabetes mellitus: A protocol for systematic review and meta-analysis

Background:Glucokinase activators are a novel family of glucose-lowering agents used for the treatment of type-2 diabetes mellitus (T2DM). Glucokinase activators blind to GK activate the enzyme allosterically. Treatment with different GKAs has been shown to reduce fasting and postprandial glucose in patients with type 2 diabetes. We compared the efficacy/safety of glucokinase activators in T2DM patients through a meta-analysis.Methods:We searched PubMed, Excerpt Medica Database, and Cochrane Central Register of Controlled Trials databases for articles published before December 30, 2020. Two independent reviewers extracted the information from article. The quality of articles were assessed by 2 independent reviewers using the 5 items of scale proposed by Jadad. We computed the weighted mean difference and 95% confidence interval (CI) for a change from baseline to the study endpoint for glucokinase activators vs placebo. Egger test and Begg test were used to assess the possible publication bias caused by the tendency of published studies to be positive.Results:The present meta-analysis will compare the efficacy and safety of glucokinase activators and placebo for the treatment of T2DM.Conclusions:This meta-analysis will provide advanced evidence on the efficacy and safety of glucokinase activators for the treatment of T2DM.Ethics and dissemination:Ethical approval and patient consent are not required because this study is a literature-based study. This systematic review and meta-analysis will be published in a peer-reviewed journalPROSPERO registration number:CRD42021220364.     

Efficacy and safety of app-based remote warfarin management during COVID-19-related lockdown: a retrospective cohort study

Journal of Thrombosis and Thrombolysis - Patients undergoing percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) are at increased risk for thrombotic and bleeding...     

Surgical experiences with inflammatory arterial aneurysms due to Takayasu's arteritis

This report shows clinical manifestations and provides aspects of surgical strategy for inflammatory aneurysms due to Takayasu's arteritis. Fourteen cases of inflammatory aneurysms among 81 patients with Takayasu's arteritis who underwent surgery in our institute were reviewed. The patient group consisted of six males and eight females, ages from 20 to 61 (mean 39.6±3.5) years. Aneurysmal lesions were located in the ascending aorta or aortic arch (type I) in six (42.9%) patients and the thoracic and/or abdominal aorta (type II) in six patients (42.9%). Type III distribution was determined for two patients (14.3%). Operative procedures for aneurysms included aortic replacement using prosthetic graft (n=6), aneurysmorraphy (n=1), patch angioplasty (n=1), Hardy operation (n=1), aortic valve replacement (AVR) (n=2), and AVR associated with mesh wrapping or aneurysmorraphy (n=3). Operative mortality was 21.4% (three cases) at initial operation and late deaths were found in five cases. Causes of late deaths included rupture of suture aneurysms, rupture of the aortic aneurysm at other aortic lesions, and sudden death due to acute perivalvular leakage. Aggressive surgical approach prior to rupture is required for cases with progressive aortic dilatation even if inflammation signs appear to be controlled. Careful long-term follow-up using periodical angiogram or computed tomography are essential to the best prognosis in pre- and postoperative periods.     

Preferential occupancy of Eu3+ and energy transfer in Eu3+ doped Sr2V2O7, Sr9Gd(VO4)7 and Sr2V2O7/Sr9Gd(VO4)7 phosphors

The vanadate-based phosphors Sr₂V₂O₇:Eu³⁺ (SV:Eu³⁺), Sr₉Gd(VO₄)₇:Eu³⁺ (SGV:Eu³⁺) and Sr₉Gd(VO₄)₇/Sr₂V₂O₇:Eu³⁺ (SGV/SV:Eu³⁺) were obtained by solid-state reaction. The bond-energy method was used to investigate the site occupancy preference of Eu³⁺ based on the bond valence model. By comparing the change of bond energy when the Eu³⁺ ions are incorporated into the different Sr, V or Gd sites, we observed that Eu³⁺ doped in SV, SGV or SV/SGV would preferentially occupy the smaller energy variation sites, i.e., Sr4, Gd and Gd sites, respectively. The crystal structures of SGV and SV, the photoluminescence properties of SGV:Eu³⁺, SV, SGV/SV and SGV/SV:Eu, as well as their possible energy transfer mechanisms are proposed. Interesting tunable colours (including warm-white emission) of SGV/SV:Eu³⁺ can be obtained through changing the concentration of Eu³⁺ or changing the relative quantities of SGV to SV by increasing the calcination temperature. Its excitation bands consist of two types of O²⁻ → V⁵⁺ charge transfer (CT) bands with the peaks at about 325 and 350 nm respectively, as well as f–f transitions of Eu³⁺. The obtained warm-white emission consists of a broad photoluminescence band centred at about 530 nm, which originates from the O²⁻ → V⁵⁺ CT of SV, and a sharp characteristic spectrum (⁵D₀–⁷F₂) at about 615 and 621 nm.

The vanadate-based phosphors Sr₂V₂O₇:Eu³⁺ (SV:Eu³⁺), Sr₉Gd(VO₄)₇:Eu³⁺ (SGV:Eu³⁺) and Sr₉Gd(VO₄)₇/Sr₂V₂O₇:Eu³⁺ (SGV/SV:Eu³⁺) were obtained by solid-state reaction.