Objective\ In order to assess and evaluate the clinical results of cold blood cardioplegia and intermittent cross clamping as myocardial preservation in coronary artery bypass grafting(CABG).\ Methods\ According to the management methods, 2 013 cases for elective, isolated CABG were divided into two groups at St.George’s Hospital, London.Cold blood cardioplegia group: 596 patients treated with cold blood cardioplegia, and hypothermic ventricular fibrillation group: 1 417 patients treated with intermitt...
OBJECTIVE: To construct a co-expressing vector of human bone morphogenetic protein 2 (BMP-2) and osteoprotegerin (OPG) and to determine the expression of BMP-2 and OPG in myoblast C2C12. METHODS: Using the isolated total RNA from osteosacoma cell line MG63 as a template, the cDNA encoding region of human OPG was amplified by reverse transcription-polymerase chain reaction (RT-PCT) method and cloned into sites EcoR 1 and BamH I of mammalian expressing vector pIRES2-EGFP, and the cDNA encoding region of human BMP-2 was cloned into endonucleases site BstX I. Then the recombinant plasmid pIRES2-BMP-2-OPG was transformed into C2C12 cell line, the expression of OPG and BMP-2 were determined by Western blot assay. RESULTS: The sequence of OPG cDNA obtained was the same as that reported, recombinant plasmid pIRES2-BMP-2-OPG was constructed successfully. Human OPG and BMP-2 co-expression cell line C2C12 was selected and confirmed by Western blot analysis. CONCLUSION: The co-expressing vector of OPG and BMP-2 is constructed and can expressed stably in myoblast C2C12. The co-expression of human OPG and BMP-2 may be logical approach for treatment of osteoporosis and bone metastasis.
Objective To observe the protective role of the ectogenesis zinc on the cells in rat flap with ischemia reperfusion injury and study the mechanisms. Methods A right low abdominal island flap was created in Wistar rats. Fortyeight rats were randomly divded into 3 groups (n=16):the control group, the ischemia reperfusion group and adding zinc ischemia reperfusion group.The content of malondialdehyde(MDA) and the activity of myeloperoxidase(MPO) were measured by thiobarbituric acid methods and colorimetry. The location of expression of MT was observed,and the image analysis was performed. The quantity of MT was represented by the integratial optical density. The ultrastructure changes of skin flap with ischemia reperfusion injury and the flap viability were observed. Results In the ischemia reperfusion injury flaps, the content of MDA and MPO show no statistically significant difference among the control group,IR group and the adding-zinc-IR group (P＞0.05). Compared with the control group at 1 h and 24 h of reperfusion, the level of MDA increased 62.2% and 136.4%(P＜0.01) in the IR group, which increased 11.3% and 33.2%(P＜0.01) in the adding-zinc-IR group. The activity of MPO increased 238.4% and 503.4%(P＜0.01)in the IR group when compared with the control group, and increased 17.9%and 24.1%(P＜0.05) when compared with the adding-zinc-IR group. In the ischemia reperfusion injury falps, the content of MT in the control group and the IR group is too minimal to measure. While the content ofMT in the adding-zinc-IR group is 45.30±7.60. At 1 h and 24 h of reperfusiion, the content of MT in the adding-zinc-IR group increased 41.5% and 44.9% (P＜0.01) compared with the IR group, and increased 119.9% and 234.6% (P＜0.01) compared with the control group. The flap viability is 100% in the control group, 19.65%±4.38% in the IR group, and 24.99%±5.12% in the adding-zinc-IR group, which increased 27.2% (P＜0.05) compared with IR group. Conclusion Many kinds of cells in skin flap with ischemiareperfusion injury can be protected by ectogenesis zinc and the flap viability increases significantly.
Transcatheter aortic valve replacement (TAVR) has become a common theraputic option for aortic stenosis, but the evidence for precise anatomy for TAVR is accumulating. This paper presents the case of an 71-year-old female patient who had an extremely high risk of coronary obstruction due to both coronary ostia lying too low. The patient underwent TAVR with the help of coronary protection successfully. During the procedure, the patient was protected with wires only for both coronaries. After deployment, angiofluoroscopy suggested that chimney stenting should be applied for left coronary. The whole procedure was unenventful and both coronaries were seen.
Abstract: Objective To evaluate myocardial protection effect of different myocardial protective strategies for patients undergoing double valve replacement （DVR） . Methods From Jun. 2005 to Dec. 2005, 32 patients with predominant aortic valve stenosis undergoing DVR in Xinqiao Hospital were included in this study. These patients were randomly divided into four groups with 8 patients in each group： （1） antegrade perfusion group：Cold-blood cardioplegia was delivered antegradely through aortic root, and mitral valve replacement （MVR）was performed. Then cold-blood cardioplegia was delivered antegradely through left and right coronary ostia, and aortic valve replacement （AVR） was performed； （2）retrograde perfusion group：Cold-blood cardioplegia was delivered retrogradely and intermittently through coronary sinus, and DVR was performed； （3）antegrade＋retrograde perfusion group：The route of cold-blood cardioplegic infusion was antegrade during MVR procedure first and then retrograde during AVR procedure；and （4）beating heart group：Oxygenated blood from cardiopulmonary bypass machine was delivered retrogradely and continuously through coronary sinus, and DVR was performed with beating heart. Early clinical outcomes were observed. Serum cardiac troponin I （cTnI） was measured by enzyme-linked immunosorbent assay（ELISA）. Serum creatine kinase-MB （CK-MB） and myocardial lactic acid release rate were measured by Hitachi7150 Automatic Chemistry Analyzer. Myocardial mitochondria malondialdehyde （MDA） level was measured through thiobarbituric acid reagent species analysis. Results All the 32 patients survived their surgery and were discharged successfully. Myocardial lactic acid release rate at 80 min after aortic cross-clamping, serum cTnI and CK-MB on the first postoperative day, myocardial mitochondria MDA levels of beating heart group were 13.59%±6.27%,（1.17±0.25） ng/ml, （56.43±16.50） U/L and（2.18±1.23） nmol/（ng.prot）respectively, all significantly lower than those of retrograde perfusion group ［（33.49%±8.29%, （1.82±0.58 ）ng/ml, （78.31±21.27） U/L （5.07±2.35） nmol/（ng.prot），P＜0.05］ and antegrade＋retrograde perfusion group［20.87%±7.22%, （1.49±0.23） ng/ml,（66.67±19.13） U/L,（4.34±1.73） nmol/（ng.prot），P＜0.05］, but not statistically different from those of antegrade perfusion group ［18.83%±5.97%, （1.41±0.32） ng/ml, （63.21±37.52） U/L, （3.46±1.62） nmol/ （ng.prot），P＞0.05］. Conclusion All the four myocardial protective strategies are effective myocardial protection methods for DVR patients. Continuous retrograde perfusion with beating heart and intermittent antegrade perfusion can provide better myocardial protection, and therefore are preferred for DVR patients. The combination of antegrade and retrograde perfusion is easy to administer and does not negatively influence surgical procedures. Retrograde perfusion is also effective as it takes only a short time.
Age-related macular degeneration (AMD) is an age-related neurodegenerative eye disease characterized by degeneration and progressive death of retinal pigment epithelium (RPE) and photoreceptor cells. In recent years, as a new treatment for AMD, stem cell therapy has attracted wide attention in the field of AMD, and has become a current research hotspot. Although stem cell therapy carries risks such as increased incidence of cancer and immune rejection, it significantly promotes damaged photoreceptor cells and retinal cells by differentiating into RPE cells and other retinal cell types, as well as secreting neurotrophic factors and extracellular vesicles. In particular, the development of embryonic stem cell-derived RPE cells, its cryopreservation technology and the advancement of plasmid, adeno-associated virus, Sendai virus and other delivery technologies have laid a solid foundation for stem cell therapy of AMD. As a new method to prevent retinal damage and photoreceptor degeneration, stem cell neuroprotective therapy has shown great potential, and with the continuous maturity and improvement of these technologies, stem cell therapy is expected to provide new ideas for the prevention and treatment of AMD in the future.