ObjectiveTo compare the clinical efficacy of small incision with traditional thoractomy for aortic valve replacement.MethodsWe retrospectively analyzed the clinical data of 78 patients with heart valve replacement in our hospital between May 2014 and June 2016. The patients were divided into a small incision group and an open chest group with 39 patients in each group. In the small incision group, 18 males and 21 females, aged 56.4±10.8 years, underwent cardiac surgery with a small incision. And in the open chest group, 17 males and 22 females, aged 57.1±9.7 years, underwent cardiac surgery by thoracotomy.ResultsThe extracorporeal circulation time, aortic cross clamping time of the small incision group were longer than those of the open chest group (P<0.05). But the amount of intraoperative blood transfusion and postoperative 24 h drainage volume of the small incision group were significantly less than those of the open chest group (P<0.05). Postoperative mechanical ventilation time, and postoperative hospitalization time of the small incision group were significantly shorter than those of the open chest group (P<0.05). Pain score of the small incision group was significantly lower than that of the open chest group significantly (P<0.05). There was no statistical difference in complications rate between the two groups after 6 months (P>0.05).ConclusionCompared with traditional open chest cardiac surgery, small incision cardiac surgery is effective and safe, and is worth popularizing in clinic.
Objective To examine the relationship between ratio of proliferating cell nuclear antigen (PCNA)/apoptosis and biology of hepatocellular carcinoma. Methods Thirty five cases of hepatocellular carcinoma were studied with TUNEL and immunohistochemistry. Results Positive rate of apoptosis in grade Ⅰ, Ⅱ, Ⅲand Ⅳ was 1.37%,0.70%, 0.67% and 0.25% respectively. Positive rate of PCNA in grade Ⅰ, Ⅱ, Ⅲ and Ⅳ was 17%, 19%, 75% and 80%. Ratio of PCNA/apoptosis in grade Ⅰ,Ⅱ,Ⅲ and Ⅳ was 19.04, 75.51, 138.01 and 345.52. Conclusion Ratio of PCNA/apoptosis is correlated with histological classification.
ObjectiveTo investigate the regulatory effect of long chain non-coding RNA (lncRNA) metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) adsorbing microRNA-124 (miR-124) on osteogenic differentiation of mesenchymal stem cells (MSCs).MethodsC3H10T1/2 cells derived from mouse embryos were cultured in vitro, then randomly divided into control group (group A), lncRNA MALAT1 no-load plasmid group (group B), lncRNA MALAT1 overexpression plasmid group (group C), lncRNA MALAT1 small interfering RNA (siRNA) group (group D), and lncRNA MALAT1 siRNA negative control group (group E). The cells were transfected into plasmids and siRNA, then induced to differentiate into osteoblasts. Alkaline phosphatase (ALP) and alizarin red staining were used to detect the osteogenic differentiation of cells in each group, real-time fluorescence quantitative (qRT-PCR) analysis was used to detect the expressions of lncRNA MALAT, miR-124, and osteogenesis-related genes such as Runt-related transcription factor 2 (Runx2), osteopontin (OPN), and osteocalcin (OCN) in each group. Double luciferase reporter gene was used to detect the targeting regulation of lncRNA MALAT1 to miR-124.ResultsThe relative contents of ALP positive cells, mineralized nodule, and the relative mRNA expressions of lncRNA MALAT1, Runx2, OPN, and OCN in group C were significantly higher than those in other groups (P<0.05), while in group D significantly lower than in other groups (P<0.05); the relative expression of miR-124 in group C was significantly lower than that in other groups(P<0.05), while in group D significantly higher than in other groups (P<0.05). There was no significant difference in these indexes between groups A, B, and E (P>0.05). The results of double luciferase reporter gene assay showed that lncRNA MALAT1 targeting down-regulated the expression of miR-124.ConclusionLncRNA MALAT1 can targeting down-regulate the expression of miR-124 and promote the osteogenic differentiation of MSCs.
ObjectiveTo analyze systematic reviews (SRs) and meta-analyses on the efficacy of pharmacological interventions in the prevention of contrast-induced acute kidney injury (CI-AKI) after percutaneous coronary intervention (PCI). MethodsWe searched the PubMed, The Cochrane Library, EMbase, CNKI, CBM, WanFang Data, and VIP databases to identify SRs and meta-analyses on the pharmacological interventions aimed at preventing CI-AKI after PCI from inception of the databases to February 2022. Two researchers independently screened the literature and extracted data. The PRISMA statement, AMSTAR 2 tool, and GRADE system were adopted to evaluate the reporting quality, methodological quality, and evidence quality of the findings of the included SRs and meta-analyses. ResultsA total of 14 SRs and meta-analyses were identified. Among the drugs used were statins, N-acetylcysteine, sodium bicarbonate, Dan-hong injection, vitamins, salvianolate, adenosine antagonists, nicorandil, allopurinol, alprostadil, furosemide, trimetazidine, probucol, and brain natriuretic peptide. Most of the studies had relatively comprehensive coverage of the items, with the PRISMA scores ranging from 18 to 24.5. The main issues of reporting quality were protocol and registration, search, and funding. The methodological quality of the SRs and meta-analyses was generally low. Items 2 and 7 were the key items with poor scores, and the non-critical items with poor scores were items 3, 10, and 16. All drugs, except furosemide, decreased the incidence of CI-AKI. The quality of evidence ranged from medium to very low according to GRADE. Conclusion Most of the single drugs or drugs combined with hydration show the potential to prevent CI-AKI, however, the overall methodological quality of the included studies is relatively low, and the strength of evidence is generally low.
ObjectiveTo systematically review the correlation between the triglyceride-glucose index (TyG index) and pulse wave velocity (PWV) and explore the relationship between the TyG index and arterial stiffness (AS). MethodsThe PubMed, Embase, Web of Science, CBM, WanFang Data, and CNKI databases were searched to collect observational studies on the correlation between the TyG index and AS from inception to January 14, 2024. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias in the included studies. Meta-analysis was performed using RevMan 5.4 software. ResultsA total of 16 studies were included. The results of the meta-analysis showed that when the TyG index was used as a continuous variable to evaluate its correlation with AS based on brachial-ankle pulse wave velocity (baPWV) as the outcome parameter, individuals with high TyG index had higher baPWV compared to those with low TyG index (OR=1.48, 95%CI 1.27 to 1.72, P<0.001). Similar correlations were observed when the TyG index was used as a categorical variable to evaluate its correlation with AS (OR=1.85, 95%CI 1.67 to 2.04, P<0.001). When carotid-femoral pulse wave velocity (cfPWV) was used as the outcome parameter, individuals with high TyG index had higher cfPWV compared to those with low TyG index when the TyG index was used as a continuous variable (OR=1.47, 95%CI 1.11 to 1.95, P=0.008). Similar correlations were observed when the TyG index was used as a categorical variable to evaluate its correlation with AS (OR=1.34, 95%CI 1.21 to 1.48, P<0.001). Subgroup analysis results showed that when the TyG index was used as a continuous variable, the correlation between the TyG index and baPWV was independent of gender, age, participant characteristics, and study type. When the TyG index was used as a categorical variable, the correlation between the TyG index and baPWV was independent of age and participant characteristics. Using high baPWV to define AS, when the TyG index was used as a continuous variable to evaluate its impact on AS, individuals with high TyG index had a higher likelihood of AS compared to those with low TyG index (OR=1.51, 95%CI 1.36 to 1.67, P<0.001). Similar correlations were observed when the TyG index was used as a categorical variable to evaluate its correlation with AS (OR=1.81, 95%CI 1.48 to 2.21, P<0.001). Using high cfPWV to define AS, when the TyG index was used as a continuous variable to evaluate its impact on arterial stiffness, individuals with a high TyG index had a higher likelihood of AS compared to those with a low TyG index (OR=1.30, 95%CI 1.10 to 1.53, P=0.02). Similar correlations were observed when the TyG index was used as a categorical variable to evaluate its correlation with AS (OR=1.60, 95%CI 1.33 to 1.92, P<0.001). Subgroup analysis results showed that when the TyG index was used as a continuous variable, the correlation between the TyG index and AS was independent of gender, participant characteristics, age, hypertension, and diabetes. When the TyG index was used as a categorical variable, the correlation between the TyG index and AS was independent of gender, participant characteristics, age, and hypertension. ConclusionThere is a strong correlation between the TyG index and PWV, with a higher TyG index associated with increased PWV and greater risk of AS. The TyG index can serve as a simple alternative marker for early diagnosis of AS and guide clinical intervention. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
Objective To investigate the method of single umbilical port laparoscopic cholecystectomy and its feasibility. Methods The clinical data of 46 patients receiving single port umbilical laparoscopic cholecystectomy in this hospital from December 2008 to February 2009 were analyzed retrospectively. Results Fourty-six cases were operated successfully with ordinary laparoscopic instruments by single umbilical port laparoscopic cholecystectomy, all without drainage placed. Operative time was from 40 to 130 min, average 52.3 min; bleeding was from 10 to 150 ml, average 40.6 ml. No complications, such as biliary leakage, hemorrhage, umbilical hernia and infection of incisional wound happened. Postoperative abdominal wall scar was not obvious, 1-4 d hospitalization, from 2 weeks to 3 months following-up without disconnecting of incision. Conclusions The single umbilical port laparoscopic cholecystectomy is safe and feasible, with little abdominal wall scar, but difficult to perform, so it can be applied in hospitals with related conditions as improvements of laparoscopic cholecystectomy.
Objective To explore the operative safety of HIV-infected patients with colorectal cancer in different degrees of immunodeficiency. Methods A total of 56 patients, including 26 cases of HIV positive (HIV-positive group) and 28 cases of HIV negative (HIV-negative group), who underwent radical operation for colorectal cancer between January 2012 and December 2015, were enrolled in our study. We divided HIV-positive patients into three groups according to CD4+ T cells count in peripheral venous blood before 1 day (D0) of the surgery (HIV-positive Ⅰgroup with CD4+ T cells count >500/μL, HIV-positive Ⅱgroup with CD 4+ T cells count among 200–500/μL, and HIV-positive Ⅲ group with CD4+ T cells count <200/μL). Non-infective patients were enrolled in HIV-negative group. Leukocyte count, neutrophil percentage, lymphocyte percentage, CD 4+ T cells subsets count, and CD8+ T cells subsets count of the 4 groups in different time points were tested. In addition, we compared postoperative complications, carcinoembryonic antigen (CEA), and postoperative survival rate between the HIV-positive group and the HIV-negative group. Results In 56 cases, there were 26 cases of HIV-positive patients (including 10 cases of HIV-positive Ⅰ group, 8 cases of HIV-positive Ⅱ group and 10 cases of HIV-positive Ⅲ group). Variance results about repeated measurement data showed that, variation of leukocyte count, neutrophil percentage, lymphocyte percentage, and CD8+ T cells count among 4 groups after surgery had no statistical significance (P>0.05), in addition there was no significant on time effect and interactive effect of time and group (P>0.05). CD4+ T cells count in the 4 groups showed a trend from decline to rising with time going, and the time effect had statistical significance (P<0.05). The speed and amplitude of decline and recovery of CD4+ T cells count were different among groups, and the group effect had statistical significance (P<0.05). CEA showed a trend of decline after surgery in both HIV-positive group and HIV-negative group, and the time effect had statistical significance (P<0.05), but the group effect and interactive effect of time and group had no statistical significance (P>0.05). No statistically significant differences in amount of blood loss, duration of surgery, postoperative stay, nor complication rate (including incision infection, pulmonary infection, and opportunistic infections after surgery) were found between the HIV-positive group and the HIV-negative group (P>0.05). The overall survival situation of the HIV-positive group and the HIV-negative group had no statistical significance (P>0.05). Conclusions Radical operation for HIV-infected patients with colorectal cancer has an impact of " first inhibition and recovery” on cellular immunity over a period of time. Incidence of postoperative complications and survival rates are similar in HIV-positive patients and HIV-negative patients. In a word, it’s safe to have radical operation for colorectal cancer in HIV-positive patients under the proper perioperative treatment.
Objective To systematically review the angiographic predictors of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Methods The PubMed, EMbase, Cochrane Library, Web of Science, CBM, WanFang Data, and CNKI databases were electronically searched to collect observational studies on the angiographic predictors of CTO-PCI from inception to December 18, 2022. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was performed using RevMan 5.4 software. Results A total of 36 studies were included. The results of meta-analysis showed that the angiographic predictors of CTO-PCI included calcification (OR=1.92, 95%CI 1.49 to 2.47, P<0.01), occlusion length≥20mm (OR=1.80, 95%CI 1.26 to 2.57, P<0.01), bending>45° (OR=2.19, 95%CI 1.56 to 3.08, P<0.01), blunt stump (OR=1.53, 95%CI 1.08 to 2.16, P<0.01), ostial lesions (OR=2.27, 95%CI 1.34 to 3.85, P<0.01), proximal cap ambiguity (OR=2.27, 95%CI 1.40 to 3.68, P<0.01), side branch at proximal cap (OR=1.65, 95%CI 1.27 to 2.16, P<0.01), and J-CTO score≥3 (OR=2.53, 95%CI 1.53 to 4.16, P<0.01). Conclusion Current evidence indicates that calcification, occlusion length ≥20mm, bending>45°, blunt stump, ostial lesions, proximal cap ambiguity, side branch at proximal cap, and J-CTO score≥3 are the angiographic predictors of CTO-PCI. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
Objective To investigate the cognition degree and clinical use of new COPD classification system of 2011 GOLD in respiratory specialists, and further analyze the reasons of failing to clinical use. Methods Respiratory specialists from 42 hospitals in Chongqing were investigated through questionnaire survey. The questionnaire contains two parts. The first part contains nine questions about the knowledge of 2011 GOLD new COPD classification system and its clinical use. The second part contains six questions about the reasons of failing to clinical use of the COPD classification system. Results A total of 204 valid questionnaires were recovered. More than 90% respiratory specialists had understood the new COPD classification system with different degree, and believed it is suitable for clinical use. More than twothirds respiratory specialists knew well the ways about CAT and mMRC, but only 24% specialists were using these ways. The main reasons of failing to clinical use were as follows: 60% specialists believed the pulmonary function test can evaluate the COPD classification, and 66. 7% specialists were limited by short visit time. The cognition degree and clinical use of the new COPD classification systemin the specialists from third grade A class hospitals was better than those from the other hospitals. But the difference was not significant among specialists with different professional title.Conclusion Respiratory specialists in Chongqing knew well about the new COPD classification systemin 2011 GOLD, but did not use it widely in clinical works due to the complicated operation of the new COPD classification system.