Abstract: Objective To evaluate if cardiac function and myocardial perfusion in acute ischemia myocardial transplanted by autologous bone mesenchymal stem cells (MSC) can be improved. Methods Sixteen New Zealand rabbits were studied.The left anterior descending coronary artery under the first diagonally branch was ligated to result in acute myocardial ischemia models,the sixteen models were divided into two groups with randomed number table. Control group(n=8): 0.6ml αminimum essential medium was injected into myocardium; transplanted group (n=8): 0.6ml medium of autologous MSC marked with 5-bromium,2-deoxy-uridine (BrdU) was injected into myocardium. Echocardiography were erformed to measure left ventricular ejection fraction(LVEF),as well as the displacement and strain of apex segment of left ventricle pre-ichemia,beforeand 4 weeks after treatment; the target myocardial tissues were harvested 4 weeks after treatment,double immunohistochemistry staining of anti-BrdU and anti-troponin T(TnT) were used to evaluate the survival and differentiation of implanted MSC; immunohistochemistry staining of anti-CD146 endothelium factor were used to evaluate the density of capillary vessels in treated myocardium. Results Double immunohistochemistry staining showed that positive cells were found in transplanted group and not found in control group. Anti-CD146 immunohistochemistry staining showed density of capillary vessels of transplanted group was significantly more than that of control group(Plt;0.05) ; LVEF,displacement and strain of cardiac apex of transplanted group improved significantly more than those of control group(Plt;0.05). Conclusion Transplanted to acute myocardium ischemia models of rabbits, MSC can differentiate into myocardium-like cells in myocardial microenvironment,and improve global and part cardiac systolic function and then improving perfusion of ischemia myocardium.
Objective To investigate the protective effect of the exosome on the organ damage induced by ische-mia-reperfusion (I/R) so as to provide a new way for the treatment of I/R damage. Methods The literature related to the treatment of I/R damage was reviewed and analyzed. Results The exosome volume is small and it is present in blood, cerebrospinal fluid, and urine, which has the function to cross the blood-brain barrier, and protect the heart, brain and other organs after I/R damage. Conclusion Exosome is a new material for the treatment of I/R organ injury, and it is important to understand the protective effect and possible mechanism.
Objective To evaluate the effectiveness and safety of sarpogrelate hydrochloride for patients with peripheral arterial disease (PAD). Methods The randomized controlled trials (RCTs) on PAD treated by sarpogrelate hydrochloride were identified from CBM (1978 to September 2011), CNKI (1979 to May 2011), PubMed (1950 to May 2011), EMbase (1970 to May 2011) and The Cochrane Library (Issue 3, 2011). According to the criteria of the Cochrane Handbook, two reviewers independently screened the studies, extracted and cross-checked the data, and assessed the methodological quality. Then meta-analysis was conducted by using RevMan 5.0 software. Results Nine RCTs involving 522 patients and 532 limbs were included, with low methodological quality in most trials. The results of meta-analyses indicated that compared with the conventional treatment, sarpogrelate hydrochloride could reduce the area of ulcers (MD= –3.22, 95%CI –3.99 to –2.45), and it could increase the ankle-brachial index (SMD=0.49, 95%CI 0.07 to 0.91), blood flow of dorsalis pedis artery (MD=0.16, 95%CI 0.09 to 0.23) and pain-free walking distance (MD=200.87, 95%CI 3.39 to 398.36). Five trials reported the adverse effects of sarpogrelate hydrochloride, most of which were mild gastrointestinal symptoms. Conclusion Based on the review, sarpogrelate hydrochloride may have positive effect on patients with PAD. However, the evidence is not b enough due to the general low methodological quality, so the reliable conclusion has to be drawn with more high quality studies in future.
Objective To study the effect of Kupffer cell on the liver ischemia/reperfusion injury.Methods The literature in recent years on the liver ischemia/reperfusin injury were reviewed.Results The activated kupffer cell can generate and release a variety of soluble toxic mediators, affect the liver microcirculation directly or indirectly. Conclusion Kupffer cell have important effect on liver ischemia/reperfusion injury.
Objective To analyze the influencing factors of hemorrhagic transformation (HT) after intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) in patients with acute ischemic stroke (AIS). Methods AIS patients hospitalized in the Department of Neurology of the First Affiliated Hospital of Zhengzhou University between June 2017 and June 2020 and receiving rt-PA intravenous thrombolysis were selected. Patients were divided into two groups according to whether they had HT, HT group and non-HT group. General data such as patient’s age, sex, past history, score of National Institute of Health Stroke Scale (NIHSS) before thrombolysis, and related biochemical examination indicators were collected, to analyze the difference between the patients with HT or not, and analyze the related factors affecting the HT of AIS patients after intravenous thrombolysis. Results A total of patients 323 were included. Among them, 46 cases (14.2%) had HT, and 277 cases (85.8%) had no-HT. Except for serum free triiodothyronine (FT3), atrial fibrillation, hypertension, cerebral infarction area, NIHSS score before thrombolysis, uric acid, blood glucose before thrombolysis, white blood cell count, albumin level, alanine aminotransferase, aspartate aminotransferase / alanine aminotransferase and C-reactive protein (P<0.05), there was no significant difference in other indexes between the two groups (P>0.05). Logistic regression analysis showed that NIHSS score≥13 before thrombolysis, aspartate aminotransferase / alanine aminotransferase, blood glucose before thrombolysis≥12.74 mmol/L, low FT3 level, massive cerebral infarction, and atrial fibrillation were independent risk factors for HT after thrombolysis in AIS. Conclusions FT3 and aspartate aminotransferase / alanine aminotransferase levels may be good biomarkers for predicting HT after intravenous thrombolysis. For patients with reduced albumin and uric acid levels, supplementation of exogenous uric acid and albumin may help reduce the risk of HT after AIS thrombolysis.
Objective To explore the change tendency of hypoxia-inducible factor-1α (HIF-1α) and extracellular signal-regulated kinase 1/2 (ERK1/2) in fetal rat cerebral cortex neurons cultured in vitro after hypoxia-ischemia reperfusion andto investigate their mutual relationship. Methods Cortical neurons obtained from cerebral cortex of 15 pregnant SD rats at16-18 days of gestation underwent primary culture. The primary neurons 5 days after culture were adopted to establ ish model of oxygen and glucose deprivation (OGD). The experiment was divided into 4 groups: the experimental group 1, culture medium was changed to neuron complete medium containing glucose after the preparation of OGD model to form reperfusion, and the neurons were observed 0, 2, 4, 8, 12 and 24 hours after reperfusion; the control group 1, the neurons were treated with normal medium; the experimental group 2, the neurons were pretreated with U0126 followed by the preparation of OGD model, and the neurons were observed 4 and 8 hours after reperfusion; the control group 2, the neurons were pretreated with DMSO, and other treatments were the same as the experimental group 2. Expressions of HIF-1α, VEGF protein, ERK1/2 and p-ERK1/2 were detected by Western blot. Expression and distribution of p-ERK1/2 and HIF-1α protein were detected by SABC immunocytochemistry method. Results Compl icated synaptic connections between cortical neurons processes were observed 5 days after culture. The expression of HIF-1α and VEGF were increased gradually, peaked at 8 hours, and decreased gradually after 12 hours in the experimental group 1, and there were significant differences between the experimental group 1 and the control group 1 (P lt; 0.05). There was no significant difference between the experimental group 1 and the control group 1 in terms of ERK1/2 protein expression (P gt; 0.05). The p-ERK1/2 protein expression in the experimental group 1 started to increase at 2 hours peaked at 4 hours, and started to decrease at 8 hours, showing significant differences compared with the control group 1 (P lt; 0.01). In the experimental group 2, the p-ERK1/2 protein decreased, and HIF-1αand VEGF protein expression subsequentlydecreased, showing significant differences compared with the control group 2 (P lt; 0.05). There was no significant difference between the experimental group 2 and the control group 2 in terms of ERK1/2 protein expression at each time point (P gt; 0.05). Immunocytochemistry staining showed that p-ERK1/2 and HIF-1α expression decreased, and the yellow-brown staining of the neurons was reduced. Conclusion Expressions of HIF-1α and its target-gene VEGF protein in the cortex neurons after OGD reperfusion are time-dependent. Their expressions decrease when ERK1/2 signal ing pathway is inhibited, indicating the pathway plays an important role in the regulation of HIF-1α and VEGF induced by OGD of cortical neurons
Objective To summarize the experience of emergency coronary artery bypass grafting(CABG) on serious myocardium ischemia in early post CABG. Methods Between 1998 and 2002, emergency redo CABG was performed in 13 patients with serious early post operative myocardium ischemia. The causes included vein graft embolize(4 cases),uncompleted revascularize(3 cases), graft spasm(1 case) and anastomose stenosis or occlusion (5 cases). The grafts was 1 3(1.8±0.9) during redo CABG. Results There were 6 deaths, the mortality was 46%. The mean follow up was 31 months. There was no recurrence of angina. NYHA function was Ⅰ Ⅱ. Conclusion Emergency CABG is an important method in saving the patients with severe myocardium ischemia in early post CABG. The perioperative prevention and early treatment should be emphasized.
OBJECTIVE: To investigate the clinical effects of revascularization in lower extremity for severe ischemia. METHODS: Fifty-six lower limbs with severe ischemia in 49 patients were evaluated retrospectively, who underwent surgical intervention from January of 1995 to December of 2000. By arteriography, the actual anatomic distributions of occlusive disease included infrarenal aorta-bicommon iliac arteries, abdominal aorta-bicommon iliac arteries, iliac artery, and femoral artery or femoropopliteal artery. The indication for surgery was disabling claudication, rest pain and gangrene. Fourteen limbs in 12 cases received arterialization of femoral venous system by artificial venous-arterial fistula. Artificial vascular grafts were implanted in 33 limbs of 28 cases, endarterectomy and patch profundaplasty were performed in 5 limbs of 5 cases, and primary amputation was carried out in 4 cases. RESULTS: During 38 months follow-up in average, 4 limbs were amputated within 52 revascularizated limbs, and accumulated amputation rate was 14.3%. Patency rate was 68.4% in arterial revascularization limbs (26/38 limbs), and limb survival rate was 94.7%(36/38 limbs) by procedure of artificial vascular grafts, endarterectomy and patch profundaplasty. Limb survival rate in procedure of artificial venous-arterial fistula was 85.7%(12/14 limbs). CONCLUSION: In treatment of severe lower extremity ischemia, the effective revascularization can be achieved by artificial vascular bypass, endarterectomy and patch profundaplasty, or arterialization of femoral venous system. Options in the surgical management should depend on individual. Arteriography is essential for revascularization and properly planning a practicable surgical approach.
ObjectiveTo investigate the effect and significance of early coronary artery bypass graft (CABG) on the expression level of ionophorous protein at infracted border zone (IBZ) in dog with acute myocardial infarction. MethodsThe anterior descending coronary artery of all thirty healthy mongrel dogs were ligated into myocardial infarction model, whose successful criteria was that the regional myocardium supplied by ligated coronary artery became darker. Coronary artery bypass surgery performed at different time points after myocardial infarction (in the 1st week, the 2nd week, the 4th week, the 6th week respectively) was as an experimental group. While myocardial infarction without coronary artery bypass surgery was set up as a control group. Myocardial tissue without ligation of coronary artery was as a normal group. After 8 weeks, myocardial specimens were cut out in the experimental group and the control group. The local expression levels of ionophorous proteins such as Cav1.2, Kv4.3 and KchIP2 mRNA were detected by means of reverse transcription- polymerase chain reaction (RT-PCR) at normal myocardium and IBZ of the experimental group and the control group. ResultsFour dogs in every experimental group and all dogs in the control group survived to the end of the study. Three myocardial ion channel proteins expression in the control group were lower than those of the normal group or the experimental group significantly (P<0.01). Cav1.2 mRNA expression in the experimental group in the 4th week or the 6th week was lower than that in the normal group significantly (P<0.05). Kv4.3 and KchIP2 mRNA expression in the experimental group in the 4th week or the 6th week were lower than those in the normal group and the experimental group significantly in the 1st week or the 2nd week (P<0.05). ConclusionEarly CABG surgery for acute myocardial infarction could lessen the changes of expression level of ionophorous protein at infracted border zone (IBZ) of dog with acute myocardial infarction. Especially, CABG surgery among two weeks could improve expression level of ionophorous protein, and reduce the effect of ischemia for ionophorous protein and myocardial electrophysiology at IBZ.
ObjectiveTo compare the myocardial protective effect of HTK solution and St.ThomasⅡ(STH) solution in immature rabbit myocardium at different cardiac arrest time. MethodsAccording to cardioplegia and cardiac arrest time, 32 immature New Zealand white rabbits (aged 2-3 weeks) were randomly divided into four groups. A group SO (8 rabbits) underwent 1 hour cardiac arrest with STH solution, a group ST (8 rabbits) underwent 2 hours cardiac arrest with STH solution, a group HO (8 rabbits) underwent 1 hour cardiac arrest with HTK solution, a group Ht (8 rabbits) underwent 2 hours cardiac arrest with HTK solution. Compare the myocardial protective effect of HTK and STH solution in immature myocardium at different cardiac arrest time. ResultsThe Langendorff models were successfully established in 30 cases (8 cases in the group SO and HO, 7 cases in the group ST and HT). There were no statistical differences in hemodynamics and myocardial enzyme (CK-MB, LDH) (P > 0.05), but HTK solution reduced the activity of nitric oxide synthase (NOS) and content of malonaldehyde (MDA) and NO, maintained high activity of superoxide dismutase (SOD) and Ca2+-ATPase (P < 0.05), performed more effective myocardial protection for immature myocardium. ConclusionHTK solution has more effective myocardial protection for immature myocardium than STH solution does, but STH solution still has good outcomes within short cardiac arrest time (1h).