Abstract: Objective To investigate the effect of autologous bone marrow mesenchymal stem cells (MSCs) transplantation on cardiac function and their proliferation and differentiation in the post-infarct myocardium in rabbits. Methods Twenty New Zealand rabbits were randomly divided into two groups, the autologous bone marrow mesenchymal stem cells group (MSCs group,n=10) and control group (n=10). Myocardial infarct model was set up by ligation of the left anterior descending (LAD), two weeks after establishment of the infarct model,either 400μl of cell suspension (total cells 1×106) labled by 1,1’-dioctadecyl3,3,3’,3’-tetramethyl indocarbocyanine perchlorate (Dil) or a comparable volume of L-DMEM medium were autologously transplanted into several different points of the periphery of the scar respectively. To evaluate the heart function, echocardiography were performed before modeling,two weeks after modeling, 2 and 4 weeks after the cells transplantation for asurements of left ventricular end systolic diameter (LVESD) and left ventricular end diastolic diameter (LVEDD), tocalculate left ventricular eject fraction(LVEF) and left ventricular fractional shortening (LVFS). Meanwhile the myocardial contrast echocardiography (MCE) were performed for evaluating the blood perfusion of the post-infarct myocardium. Eight weeks after the transplantation, the animalswere undergoing euthanasia, specimens were acquired for pathology. Results Echocardiography indicated that:The LVEF and LVFS between two groups were fundamentally the same before modeling,two weeks after modeling respectively (0.72±0.08 vs. 0.71±0.04,0.56±0.11 vs. 0.55±0.09; 0.35±0.06 vs. 0.35±0.04, 0.24±0.08 vs. 0.23±0.03, Pgt;0.05), but those were improved significantly in group MSCs when compared with control group at two weeks and four weeks after the cells transplantation(0.71±0.05 vs. 0.60±0.05，0.72±0.07 vs. 0.62±0.08 and 0.34±0.03 vs. 0.29±0.01， 0.35±0.06 vs. 0.27±0.05 respectively,Plt;0.05). There were no differences in LVESD and LVEDD between two groups in any time points(Pgt;0.05). MCE showed the blood perfusion of the infarct myocardium were improved two and four weeks after the cell transplantation. Pathology indicated that Dil positive cells were survived in MSCs transplanted hearts, stained positively for αsarcomeric actin and desmin eight weeks after cell transplantation, HE slides indicated that the capillary density in all the cells transplanted hearts were much higher when compared with control group (38.6±7.6/mm2 vs. 21.4±3.9/mm2，Plt;0.05). ConclusionMSCs can differentiate into cardiomyocytes, improve myocardial perfusion and cardiac function when transplanted into ischemic myocardium.
ObjectiveTo explore the therapeutic effects of different surgical strategies on women with mechanical valve dysfunction during pregnancy.MethodsA total of 11 patients with mechanical valve dysfunction during pregnancy who underwent surgeries in our hospital from 2007 to 2017 were retrospectively included. The average age was 27.5±3.7 years. The prognosis of patients was analyzed according to the gestational weeks, cardiac function and the severity of mechanical valve dysfunction.ResultsNo death occurred. Three of them suffered subtotal hysterectomy during the surgery because of uncontrolled bleeding, and the others recovered without complications. Among the 5 patients with pregnancies <28 weeks, 1 patient was found intrauterine death before hospital admission, 2 suffered fetal loss 5 days after the cardiac surgery, and the other 2 patients continued their gestations until deliveries. Among the other 6 patients with pregnancies >28 weeks, 1 fetus died because of intracranial hemorrhage, and the other 5 survived without embryopathy or foetopathy.ConclusionGestation week, cardiac function and severity of mechanical valve dysfunction may be taken into account when making a treatment regimen for women with dysfunctional valve prostheses during pregnancy.
Postoperative cognitive dysfunction (POCD) is a common and important complication after cardiac surgery. The pathological reactions caused by cardiac surgery, such as traumatic stress reaction, inflammation, hemodynamics disorders, and blood coagulation dysfunction, by triggering central inflammation, ischemia, hypoxia and ischemia-reperfusion injury and other mechanisms, leading to brain function-impairment, causing the development of POCD. According to the above mechanisms, taking corresponding protective measures, reducing the development of POCD, and improving the quality of life after cardiac surgery are of great importance.
ObjectiveTo investigate the effect of virtual scene simulation training combined with midium frequency impulse electrotherapy on upper limb function and daily living ability of hemiplegia patients.MethodsFrom March to October 2019, 50 hemiplegic patients were recruited and randomly assigned to the trial group and the control group, with 25 patients in each group. The control group was given routine rehabilitation training, while the trial group was given virtual scene simulation training and medium frequency impulse electrotherapy on the basis of routine rehabilitation training. The Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Simple Test for Evaluating Hand Function (STEF), and Modified Barthel Index (MBI) were used to assess patients’ upper limb function and daily living ability before treatment and after 8 weeks of treatment.ResultsBefore treatment, the FMA-UE, STEF, and MBI scores of the trial group vs. the control group were 22.88±5.18 vs. 23.44±6.26, 40.12±4.82 vs. 41.44±4.54, and 51.40±7.29 vs. 48.60±7.00, respectively, and none of the between-group differences was statistically significant (P>0.05); after 8 weeks of treatment, the FMA-UE, STEF, and MBI scores of the two groups were 39.48±6.35 vs. 33.52±6.53, 59.08±7.54 vs. 52.52±5.83, and 71.00±8.78 vs. 62.40±9.37, respectively, and all of the between-group differences were statistically significant (P<0.05). After 8 weeks of treatment, the FMA-UE, STEF and MBI scores of the two groups of patients were significantly improved compared with those before treatment (P<0.05), and the improvement of each score of the trial group was significantlybetter than that of the control group (P<0.05). No stroke recurrence, electric burn, or other adverse reactions occurred in the two groups after treatment. ConclusionVirtual scene simulation training combined with midium frequency impulse electrotherapy can effectively improve the upper limb function of patients with hemiplegia and improve their quality of life.
ObjectiveTo review the advances of the role of mitochondrial dysfunction in the spinal cord injury (SCI) and its relevant treatments. MethodsFocusing on various mechanisms of mitochondrial dysfunction, recent relevant literature at home and abroad was identified to summarize the therapeutic strategies for SCI. ResultsMitochondrial dysfunction is mainly manifested in abnormalities in mitochondrial energy metabolism, mitochondrial oxidative stress, mitochondrial-mediated apoptosis, mitophagy, mitochondrial permeability transition, and mitochondrial biogenesis, playing a vital role in the development of SCI. Drug that enhanced mitochondrial function have been proved beneficial for the treatment of SCI. ConclusionMitochondrial dysfunction can serve as a potential therapeutic target for SCI, providing ideas and basis for the development of SCI therapeutic candidates in the future.
Objective To study the effect of recombinant growth hormone (rhGH) on improvement of liver function and liver regeneration in animal and patients after hepatectomy. Methods The liver cirrhosis model of SD species mouse was set up, then the mouse were randomly divided into experiment group and control group, then 30%-40% liver of all the models were resected, rhGH was used by hypodermic injection (0.2-0.4ml/100g) in experimental group, and the equal dose of N.S. were given in control group every day. Then liver function, arterial blood ketone body ratio(AKBR), and the regenerated liver/body weight ratio (RL/W) were determined, histopathology of the cirrhosis with microscope and electron microscope and the mitotic index (MI) of liver cell on 7, 14 and 28th day after operation were observed. Clinically,39 hepatectomized patients were randomly divided into experiment group and control group, liver function, PA， Glu, RI and AKBR were measured preoperatively and on 1, 7,14th day after operation. Postoperative clinical course were also compared between the two groups. Results In the animal experiment group, as compared with the control group, AKBR was obviously higher (P＜0.01), seruim level of total protein and PA were increased faster (P＜0.05), and RL/W was higher. The mitotic index of liver cell was increased faster on 14th day, the numbers of regenerated liver cell with double nucleus and rough endoplasmic reticulum were higher in 14 and 28th day. In the clinical experiment group, as compared with the control group, serum total bilirubin, alanine aminotransferase and aspartate aminotransferase were lower on 7 and 14th postoperative day (P＜0.05). Serum albumin, PA, Glu, RI and AKBR were higher on 7, 14th postoperative day (P＜0.05). Conclusion Both experimental and clinical study show that the rhGH can promote liver regeneration and improve liver function after hepatectomy.
ObjectiveTo investigate the changes and clinical significance of cardiac structure and function evaluation by cardiac magnetic resonance imaging (CMR) for patients with pectus excavatum deformity at preoperation.
MethodsWe retrospectively analyzed 54 patients (24 children and 30 adults) who underwent pectus excavatum surgery from June 2012 to June 2014. There were 48 males and 6 females at age of 7-33 (19.08±5.17) years. All the patients underwent CMR using 1.5 Tesla scanner for evaluation of compressing and displacement of the heart. The major and minor dimensions of right ventricle were measured. The right ventricle end-diastole volume (RVEDV), right ventricle end-systolic volume (RVESV), and right ventricle ejection fraction (RVEF) were also recorded and analyzed.
ResultsThe heart compression and displacement occurred in 83.3% of the children group and 90.0% of the adults group. The extent of heart displacement in the adults was more serious than that in the children (76.86%±13.30% vs. 67.99%±8.15%, P<0.05). The structure of right ventricle were striking distorted because right atrum or right ventricule below valve ring was compressed locally, with the major dimension of right ventricle obviously increased, and the minor dimension of right ventricle obviously decreased. The indices of right ventricle major dimension and right ventricle minor dimension were 61.14±0.44 mm/m2 and 14.82±2.52 mm/m2 in the children, 49.54±15.40 mm/m2 and 18.90 ±3.14 mm/m2 in the adults. The RVEDV and RVESV were significantly higher in the adults than those in the children (139.09±29.08 ml vs. 121.50±31.27 ml; 73.61±16.05 ml vs. 64.92±19.28 ml; P<0.05). RVEF was similar between the children and the adults (45.29%±4.14% vs. 46.30±6.09%). The patients' symptoms disappeared after correction of pectus excavatum.
ConclusionCMR is an useful method for evaluating right ventricular structure and functions in patients with cardiac compression and distortion by pectus excavatum before operation, which can bring strong indications for pectus excavatum repair surgery.
Objective To investigate the changes and roles of myocardial adenosine triphosphate enzyme(ATPase) in the mechanism of cardiac dysfunction after blunt chest trauma（BCT）. Methods Thirtysix rabbits were divided into 6 groups with random number table, control group, 2 h group, 4 h group, 8 h group, 12 h group and 24 h group, 6 in each group. The models of BCT were established with BIMⅡ biological impact machine, catheterization technique was used through the right jugular artery into the left ventricle measure its pressure. The hemodynamics and the activities of ATPase in myocardial cell plasm, homogenate and mitochondria were measured at preinjury(control group), 2 h, 4 h, 8 h, 12 h and 24 h postinjury. Results Left ventricular endsystolic pressure(LVESP), the maximal ascending rate of left intraventricular pressure(+dp/dtmax), isovolemec pressure(IP) and the maximal physiological velocity(Vpm) decreased significantly at 2 h group after BCT(Plt;0.05）, and recovered to preinjury level in 4 h, 8 h and 12 h group during 4-12 h after BCT; isovolumic relaxation phase left ventricular pressure descending time constant (T). Left ventricular enddiastolic pressure(LVEDP) and the maximal descending rate of left intraventricular pressure(-dp/dtmax) were significantly higher （Plt;0.05, 0.01）. The activity of ATPase in homogenate, mitochondria and cell plasm decreased significantly at 2 h group and 4 h group after BCT（Plt;0.05, 001, respectively）, and 8 h group and 12 h group recovered after BCT. There was negative correlations between [CM(159mm]LVEDP and -dp/dtmax and the decrease of the activity of Na+-K+-ATPase in homogenate（r=-0.674, -0.691, Plt;0.05）, the Ca2+-ATPase in homogenate（r=-0.613,-0.642, Plt;0.05）, the Na+-K+-ATPase in mitochondria（r=-0.622,-0.616, Plt;0.05）,the Ca2+-ATPase in myocardial cell plasm（r=-0.672,-0.658, Plt;0.05）, the Na+-K+-ATPase in myocardial cell plasm（r=-0.627,-0.632,Plt;0.05）,and the Mg2+-ATPase in myocardial cell plasm（r=-0.677,-0.661, Plt;0.05）. Conclusion The left ventricular function is impaired obviously after BCT, especially in diastolic phase. The decrease of the activity of ATPase in myocardial cells may be one of the reasons of cardiac dysfunction after BCT.
Objective To investigate the effect of edgetoedge mitral valve plasty on left ventricular diastolic function and in order to find the validity and safety of this procedure. Methods From Feb. 2006 to Dec. 2007, thirty cases with mitral regurgitation were divided into two groups. Quadrangular resection was performed on fifteen cases with posterior proplapse in control group, and edgetoedge mitral valve plasty was performed on fifteen cases with anterior or bileaflet proplapse in experimental group, and ring annuloplasty(Medtronic ring) was used in both groups. The hemodynamics were monitored and recorded with SwanGanz catheter at the time of postoperation，2 h, 4 h, 6 h and 12 h after operation. Left ventricular diastolic function was also evaluated with echocardiography using color Doppler and tissue Doppler imaging in the patients with sinus rhythm. The ratio of the peak E velocity and A velocity(E/A), the ratio of the early diastolic peak flow velocity to the early diastolic mitral valve annular movement velocity(E/Em), and the ratio of early diastolic mitral valve annular movement velocity to late diastolic mitral valve annular movement velocity（Em/Am）were measured before operation and 1 week after operation respectively. Results Mitralvalve area were significantly reduced at 1 week after operation compared with that before operation in both groups (control group 3.63±1.06 cm2 vs. 7.18±2.41 cm2, experimental group 3.44±1.02 cm2 vs. 6.51±3.06 cm2, Plt;0.05）; and mitral regurgitant grade were significantly reduced at 1 week after operation in both groups as well(control group 0.53±0.64 cm2 vs.3.60±0.51 cm2, experimental group 0.67±0.82 cm2 vs.3.40±0.63 cm2, Plt;0.05). However, there was no significant difference for mitral valve area and mitral regurgitant grade between two groups before and after operation（Pgt;0.05）. In experimental group, there were no significant change of evaluations of E/A,E/Em and Em/Am before and after operation（E/A 1.28±0.36 vs. 1.95±1.06,E/Em 8.79±2.16 vs. 8.13±3.02, Em/Am 1.39±0.38 vs. 1.31±041，Pgt;0.05). There was no significant change of pulmonary artery wedge pressure (PAWP) before and after operation between two groups（13.60±4.37 mm Hg vs.12.20±3.53 mm Hg, Pgt;0.05）. Conclusion Edgetoedge mitral valve plasty technique is available and has no significant influence on left ventricular diastolic function, and a doubleorifice mitral valve has similar hemodynamic change compared with a physiological mitral valve.
ObjectiveTo establish a normal reference value range of specific thyroid function in pregnant women corresponding to Beckman reagent in Chengdu.MethodsWe randomly selected 120 non-pregnant women and 445 pregnant women who underwent routine examinations at the First Affiliated Hospital of Chengdu Medical College from November 2016 to June 2017; tested for free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH) in serum; used SPSS 24.0 to calculate the bilateral limit of each index (Section 2.5, 97. 5 Quot); established the normal range of Beckman reagent.ResultsThe reference ranges of FT3, FT4, and TSH in the first, second, and third trimester of pregnancy were 4.41–6.33, 4.17–6.12, and 3.86–6.39 pmol/L; 7.64–14.63, 6.62–13.69, and 6.62–12.51 pmol/L; 0.21–3.62, 0.16–4.35, and 0.89–4.88 mU/L; respectively. There was no significant difference in serum TSH between the first and second trimester (P>0.05), and neither between the first and second trimesters and the controls in serum FT3 (P>0.05). The differences in serum FT3, FT4, and TSH among the rest of trimesters, and between each trimester and the normal control group were statistically significant (P<0.05). There was a significant correlation between TSH and FT4 in the early and middle stages of pregnancy (r=–0.277, –0.392, P<0.01).ConclusionThe reference value of FT3, FT4, and TSH in pregnant women with Beckman reagent was significantly different from that in non-pregnant women.
