[Single center experience of transcatheter aortic valve replacement with a simplified operative protocol]

Objective: To summarize the single center experience of transcatheter aortic valve replacement (TAVR) with a simplified operative protocol. Methods: Consecutive patients who underwent transfemoral TAVR (TF-TAVR) from July 2020 to December 2020 in Fuwai Hospital were retrospectively analyzed. We compared the baseline characteristic, procedure information, 30-day follow-up outcomes of the patients who underwent TF-TAVR without the simplified operative protocol (routine group) or with the simplified operative protocol (simplified protocol group). Results: 93 patients were collected, 42 patients belonging to routine group, 51 patients belonging to simplified protocol group. In simplified protocol group, there were 51 patients planned to use ultrasound-guided femoral access puncture, procedure was successful in all 51 patients (100%). There were 49 patients planned to use the radial artery as the secondary access, procedure was successful in 45 patients (92%). There were 48 patients planned to use the strategy of avoidance of urinary catheter, this strategy was achieved in 35 patients (73%). There were 12 patients planned to use the left ventricular guidewire to pace, procedure was successful in 11 patients (92%). There were no differences in baseline characteristics, major clinical endpoints and 30-day follow-up outcomes between the two groups. Meanwhile, the procedure time ((62.5±17.9)min vs. (78.3±16.7)min, P<0.001), operation room time ((133.7±25.1)min vs. (159.2±42.6)min, P<0.001), X-ray exposure time ((17.2±6.5)min vs. (20.2±7.7)min, P=0.027) were significantly shorten in simplified protocol group compared with the routine group. Conclusion: Our study results indicate that the simplified operative protocol of TF-TAVR is as effective and safe as the routine operative protocol, meanwhile using the simplified operative protocol can significantly increase the operative efficiency of TF-TAVR.

PAX8 is a potential marker for the diagnosis of primary epithelial ovarian cancer

The present study aimed to investigate the clinical significance of paired-box 8 (PAX8) in primary epithelial ovarian cancer (PEOC). Using immunohistochemical (IHC) staining, the expression of PAX8 in 60 patients with PEOC, 20 patients with ovarian benign lesions and 10 patients with metastatic ovarian cancer (MOC), was examined based on the clinicopathological profiles of the patients. The correlation between PAX8 expression and the clinicopathological parameters or prognosis of patients was statistically analyzed. PAX8 was revealed to be highly expressed in PEOC, but not in MOC, as indicated by IHC staining. The rate of positivity of PAX8 in PEOC was 92% (57/60) with no significant difference of PAX8 expression found between the various pathological types of PEOC (P=0.871). The rate of positivity of PAX8 in ovarian benign tumors was 85%, demonstrating no significant difference in comparison with that of PEOC (P=0.761). PAX8 staining and statistical analysis revealed that the higher the grade of PEOC, the less the cancer cell had differentiated (P=0.033) and the more the cancer had advanced according to International Federation of Gynaecological Oncologists (FIGO) staging (P=0.003). Survival rate statistics showed that PEOC patients with higher PAX8 expression exhibited a shorter postoperative survival rate (P=0.009). PAX8 was specifically expressed in PEOC, and its expression level was associated with the degree of cancer cell differentiation, FIGO stage, and survival rate, indicating that PAX8 is a potential marker for the diagnosis of PEOC.

Thin-section computed tomography-histopathologic comparisons of pulmonary focal interstitial fibrosis, atypical adenomatous hyperplasia, adenocarcinoma in situ, and minimally invasive adenocarcinoma with pure ground-glass opacity

OBJECTIVE

To retrospectively compare focal interstitial fibrosis (FIF), atypical adenomatous hyperplasia (AAH), adenocarcinoma in situ (AIS), and minimally invasive adenocarcinoma (MIA) with pure ground-glass opacity (GGO) using thin-section computed tomography (CT).

MATERIALS AND METHODS

Sixty pathologically confirmed cases were reviewed including 7 cases of FIF, 17 of AAH, 23of AIS, and 13 of MIA. All nodules kept pure ground glass appearances before surgical resection and their last time of thin-section CT imaging data before operation were collected. Differences of patient demographics and CT features were compared among these four types of lesions.

RESULTS

FIF occurred more frequently in males and smokers while the others occurred more frequently in female nonsmokers. Nodule size was significant larger in MIA (P<0.001, cut-off value=7.5mm). Nodule shape (P=0.045), margin characteristics (P<0.001), the presence of pleural indentation (P=0.032), and vascular ingress (P<0.001) were significant factors that differentiated the 4 groups. A concave margin was only demonstrated in a high proportion of FIF at 85.7% (P=0.002). There were no significant differences (all P>0.05) in age, malignant history, attenuation value, location, and presence of bubble-like lucency.

CONCLUSION

A nodule size >7.5mm increases the possibility of MIA. A concave margin could be useful for differentiation of FIF from the other malignant or pre-malignant GGO nodules. The presence of spiculation or pleural indentation may preclude the diagnosis of AAH.

Study on lymph node metastasis correlated to lymphangiogenesis, lymphatic vessel invasion, and lymph node micrometastasis in gastric cancer

BACKGROUND

This study aimed to evaluate the clinical significance of lymphangiogenesis, lymph vessel invasion (LVI), and lymph node (LN) micrometastasis (LNMM) in patients with gastric cancer.

METHODS

The influences of the expression levels of LVI, lymph vessel density (LVD) by D2-40 immunohistochemical (IHC) staining (n=68), LNMM (including CK 20 and CK pan immunostainings, n=51) on the clinicopathologic profiles and the prognosis were analyzed.

RESULTS

The higher positive rate of LVI-IHC was related to deeper invasion (P=0.044), later TNM stage (P=0.003), and more extensive LN metastasis (LNM, P=0.000). The level of LVD was significantly associated with venous invasion (P=0.037), later TNM stage (P=0.020), positive LVI-HE (P=0.040), positive LVI-IHC status (P=0.001), and severer LNM (P=0.001). Better prognosis in LVI negative group than LVI positive group has been identified. The survival rate of the group with LVD≥15/field was significantly lower than that in the group with LVD≤14/field (P=0.032). Invasion depth, N stage, LNM, blood vessel invasion, or LVI was respectively an independent prognostic factor to 3-y survival rate. The incidence of patients with LNM and metastasized LNs increased respectively from 74.5% (38/51) by HE staining to 88.2% (45/51) by CK immunostaining and from 32.0% (253/791) to 41.5% (328/791) (P=0.001). The increment of LNMM was correlated to larger tumor diameter (P=0.001), deeper invasion (P=0.018), LNM (P=0.001) and later TNM stage (P=0.012), positive LVI (P=0.04). Meanwhile, the evaluation on LNMM revealed the migration of LN stage (N(0)→N(1) in seven patients, N(1)→N(2) in six patients, and N(2)→N(3) in one patient), and TNM stage (I(b)→II in four patients, II→III(a) in 4 patients, III(a)→III(b) in 3 patients, and III(b)→IV in one patient). Survival analysis demonstrated that better prognosis in patients without LNM and/or LNMM.

CONCLUSION

Our immunohistochemical analyses using antibodies of D2-40 and CK, including both CK 20 and CK pan, detected a higher incidence of LVIs and LNMs in gastric cancer specimens. This study shows close correlations among lymphangiogenesis related factors, such as LVI, LVD, and LNMM, and patients' prognosis after surgery. Therefore, immunohistochemical evaluations of these factors could be used for the accurate determination of tumor aggressiveness.

[Protective mechanism of tianmacuzhi granules in brain]

OBJECTIVE

To provide pharmacological evidence for the protective effects of Tianmacuzhi Granules (TMC) in mouse brain in a ischemia--reperfusion model.

METHOD

Receptor binding test of NMDA receptor and M receptor in brain, GPx activity determination in brain and liver effected by different dose of TMC were performed.

RESULT

TMC could reduce the NMDA receptor activity, increase the M receptor activity and GPx activity of cerebral cortex and hippocampus tissues significantly.

CONCLUSION

TMC might antagonize ischemia-reperfusion injury of brain by reducing the glutamate neurotoxicity and increasing the function of cholinergic nerve and effects of anti-peroxidization in brain.

[Effect of tianma cuzhi keli (TMCZKL) on contents of transmitter amino acids of brain tissue in the mouse repetitious cerebral ischemia reperfusion]

OBJECTIVE

To research the mechanism of protective action of TMCZKL on brain,

METHOD

Contents of transmitter amino acids in cortex and hippocampus before and after administration of TMCZKL were measured in mice of repetitious cerebral ischemia reperfusion.

RESULT

The three doses of TMCZKL raised the content of glutamic acid in cortex and hippocampus the content of aspartic acid in hippocampus and decreased GABA content in cortex significantly.

CONCLUSION

TMCZKL might antagonize ischemic injury through regulating contents of transmitter amino acids and sustain the dynamic equilibrium of EAA and IAA.

[Protective effect of xinxin capsule on learning and memory impairment in mice]

OBJECTIVE

To investigate the effect of Xinxin Capsule on the scopolamine or ethanol induced impairment of learning and memory retention in mice.

METHOD

Step-through and Morris Water-maze methods, wer used to the protective effect of Xinxin Capsule(0.4, 0.8, 1.6 g.kg-1, ig, 16 d) on the scopolamine or ethanol induced impairment of learning and memory retention in mice.

RESULT

The Capsule(0.8, 1.6 g.kg-1, ig,) can turn over the Scope so as to induce the impairment of learning, and the Capsule((0.4, 0.8, 1.6 g.kg-1, ig) can improve the ethanol induced impairment of memory retention in mice.

CONCLUSION

Xinxin Capsule helps regain as well as impair the learning and memory retention in mice.

[Effects of 6,7-dimethoxycoumarin on experimental arrhythmia]

By using the arrhythmic animal models, the effect of 6,7-dimethoxycoumarin (DMOC) on arrhythmia was investigated. The arrhythmia in anaesthetized rat were induced by iv aconitine 20 micrograms.kg-1 or CaCl2 5 mg.kg-1. The arrhythmia in anesthetized guinea pigs was induced by iv ouabain 3.6 micrograms.kg-1.min-1. Procainamide (PA) was used as a positive control. DMOC (33-500 mg.kg-1, ig) and PA (100-800 mg.kg-1, ig) in anaesthetized rats could delay the time of onset of arrhythmia induced by aconitine. The ED50 of DMOC and PA for postponing the occurrence of ventricular extrasystole (VE) were 88 mg.kg-1 (95% confidence interval was 43-165 mg.kg-1) and 183 mg.kg-1 (95% confidence interval was 109-304 mg.kg-1), respectively. The results suggested that the anti-arrhythmia potency of DMOC was higher than that of PA (P < 0.01).