Objective To introduce the studies on gene therapy for peripheral arterial disease(PAD) using plasmid DNA encoding human hepatocyte growth factor(HGF) gene. Methods Recent articles including preclinical and clinical studies were reviewed. Results Intramuscular injection of human HGF plasmid DNA into rat, rabbit, dog and diabetic hindlimb ischemic models, resulted in a significant increase in capillary density, blood flow and blood pressure. but no influence on tumor growth in mice. A clinical trial wasperformed in ischemic limbs of 6 critical limb ischemic patients, the result showed that no side effect caused by gene transfer was detected in all 6 patients.The pain scale and long diameter of ischemic ulcers were reduced. Conclusion Intramuscular injection of naked HGF plasmid DNA could be a safe and potential treatment for PAD.
ObjectiveTo systematically compare the incidence, microbiological profile, and outcomes of infective endocarditis (IE) following transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR). MethodsA systematic literature search was conducted in the CNKI, Wanfang, VIP, SinoMed, PubMed, the Cochrane Library, Embase, and Web of Science databases for relevant studies published from their inception to August 2025. Two reviewers independently screened the literature, extracted data, and assessed the quality of the included studies. The quality of cohort studies was evaluated using the modified Newcastle-Ottawa Scale (NOS), and randomized controlled trials (RCTs) were assessed using the Cochrane Risk of Bias tool 2 (RoB 2). A meta-analysis was performed using Stata 19.0. ResultsA total of 12 cohort studies and 1 RCT, encompassing over 200 000 patients, were included. The modified NOS scores for all cohort studies were ≥7 points, and the RCT was rated as having a low overall risk of bias. The overall incidence of IE was significantly lower after TAVR than that after SAVR [RR=0.73, 95%CI (0.59, 0.90), P<0.01]. However, early IE (within 12 months) occurred more frequently following TAVR, though the difference was not statistically significant [RR=1.23, 95%CI (0.87, 1.75), P=0.24]. Reoperation for IE was markedly less common in the TAVR group [RR=0.31, 95%CI (0.20, 0.47), P<0.01]. There were no significant differences in in-hospital mortality or 1-year mortality between the two groups. Regarding the microbiological profile, no significant differences were observed in the distribution of Staphylococcus aureus, coagulase-negative staphylococci, Streptococcus spp., and Enterococcus spp. (P>0.01). ConclusionTAVR is associated with a lower overall risk of IE but a higher risk of early IE compared to SAVR. Although reoperation is less common in TAVR patients, mortality rates are comparable. The microbiological etiology is consistent between procedures.
ObjectiveTo systematically review the short term and long term efficacy of early surgery for infective endocarditis (IE) patients. MethodsWe searched PubMed, EMbase, The Cochrane Library, CBM, WanFang Data and CNKI databases for cohort studies concerning the efficacy of early surgery for IE patients from inception to October 2014. Two reviewers independently screened literature, extracted data and assessed the risk bias of included studies. Then meta-analysis was performed by using RevMan 5.3 software. ResultsSixteen cohort studies including 8 141 patients were included. The results of meta-analysis showed that early surgery could reduce the short term mortality (OR=0.57, 95%CI 0.42 to 0.77, P=0.000 4) and long term mortality (OR=0.57, 95%CI 0.43 to 0.77, P=0.000 7) in IE patients. Subgroup analysis showed that early surgery could significantly reduce the short term mortality and long term mortality in patients with native valve endocarditis (NVE). ConclusionEarly surgery can reduce IE patients' short term mortality and long term mortality. Due to the limited quality and quantity of the included studies, more large-scale high-quality studies are needed to verify the above conclusion.
Acute lung injury is one of the common and serious complications of acute aortic dissection, and it greatly affects the recovery of patients. Old age, overweight, hypoxemia, smoking history, hypotension, extensive involvement of dissection and pleural effusion are possible risk factors for the acute lung injury before operation. In addition, deep hypothermia circulatory arrest and blood product infusion can further aggravate the acute lung injury during operation. In this paper, researches on risk factors, prediction model, prevention and treatment of acute aortic dissection with acute lung injury were reviewed, in order to provide assistance for clinical diagnosis and treatment.
Objective To analyze the risk factors and prognosis of acute gastrointestinal injury (AGI) early after acute type A aortic dissection (ATAAD) repair, and develop the Nomogram prediction model of AGI. Methods The patients who underwent ATAAD cardiopulmonary bypass surgery in our hospital from 2016 to 2021 were collected and divided into an AGI group and a non-AGI group. The clinical data of the two groups were compared. A Nomogram prediction model was established by using R language. Results A total of 188 patients were enrolled, including 166 males and 22 females, aged 22-70 (49.70±9.96) years. Through multivariate logistic regression analysis, the aortic dissection (AD) risk score, poor perfusion of superior mesenteric artery (SMA), duration of aortic occlusion and intraoperative infusion of red blood cells were the predictors for AGI (P<0.05). There were statistical differences in the ventilator-assisted duration, ICU stay time, liver dysfunction, renal insufficiency, parenteral nutrition, nosocomial infection and death within 30 days after the operation between the two groups (P<0.05). The Nomogram prediction model was established by using the prediction factors, and the C index was 0.888. Through internal verification, the C index was 0.848. The receiver operating characteristic curve was used to evaluate the discrimination of the model, and the area under the curve was 0.888. Conclusion The AD risk score after ATAAD, poor perfusion of SMA, duration of aortic occlusion and intraoperative infusion of red blood cells are independent predictors for AGI. The Nomogram model has good prediction ability.