Gut microbiota and its metabolites in various human diseases have gradually become a research hotspot in the current medical community. And coronary artery disease is currently one of the most threatening clinical cardiovascular diseases in the world, so the use of gut microbiota and its metabolites in the development of its pathophysiology has also received more and more attention. Therefore, this paper reviews the effects of gut microbiota and its metabolites on coronary artery disease, as well as the research progress of intervening gut microbiota and its metabolites as therapeutic targets, hoping to expand the future research direction in this field and provide new ideas with treating coronary artery disease.
ObjectiveTo summarize our experience of surgical treatment for right pulmonary artery originated from the ascending aorta by using adult diameter artificial vascular and study the operative indication, design, method, and therapeutic efficacy. MethodsWe retrospectively analyzed clinical data of 11 patients with right pulmonary artery originated from ascending aorta in The Second Affiliated Hospital of Harbin Medical University from May 2008 through December 2013, who were treated by using adult diameter artificial vascular. The patients ranged from 4 months to 25 months old, weighted 4-15 kg. Among of them, 4 patients had persistent truncus arteriosus and 7 had aortopulmonary septal defect. All patients were complicated with moderate pulmonary hypertension. All the patients underwent one stage surgical repair under extracorporeal circulation and cardiac arrest. During the surgery, end to side anastomosis was done between the right pulmonary artery and 16-18 mm diameter artificial blood vessels. And artificial blood vessel was connected to the main pulmonary artery or right ventricle outflow tract incision from the aorta above. ResultsThe average operation time was 179-325 (224±68) min. The average cardiopulmonary bypass (CPB) time was 81-208 (117±54) min. The average aortic clamping time was 29-63(42±21) min. The mean residence time in ICU was 71-197 (109±42) hours. The average assisted mechanical ventilator time was 59-191 (91±26) hours. The average length of stay in hospital was 21-39 (28±11) days. Low cardiac output syndromes caused by pulmonary arterial hypertension occurred in 5 patients including 2 deaths and 3 patients with good recovery by reducing the pulmonary arterial pressure and peritoneal dialysis. The result of postoperative cardiac color ultrasound examination of 9 survival patients showed vascular prosthesis, no distortion, no stenosis of the anastomosis, deformity correction satisfaction. Nine patients were followed up for 3-60 months. The results of echocardiography showed no anastomosis and artificial vascular stenosis, and the pulmonary arterial pressure decreased significantly. ConclusionThe right pulmonary artery originated from the ascending aorta in children should be operated as soon as possible. Compared the adult diameter artificial vascular treatment for one stage repair of right pulmonary artery from the ascending aorta with other operation methods, both short-term and long-term effects are good. Postoperative low cardiac output syndrome is a common complication.
Objective To observe the rate of iris vessels exposure and analyze its relevant factors in normal full-term neonates. Methods A retrospective study. 1855 normal full term neonates, including 947 boys and 908 girls, were enrolled. The mean gestational age (GA) was (38.84±1.10) weeks and mean birth weight (BW) was (3 396.52±402.08) g. There were 1235 neonates from normal term vaginal delivery, 402 cases of cesarean delivery and 218 cases of forceps delivery. All neonates were examined with hand-held portable slit lamp biomicroscopy within 1 to 3 days after birth by two trained ophthalmologist respectively. Iris vessels exposure was defined as radial red blood vessels along iris fibers. Infants were divided into iris vessels exposure group and iris vessels unexposed group according to the findings of slit lamp biomicroscopy. 78 infants with iris vessels exposure were followed up for 42 days after birth till the iris vessels can’t be seen under microscope. The differences between the two groups were compared for gender, mode of delivery (MOD), GA, BW and body length (BL). Multiple logistic regressions were used to determine the factors related to iris vessels exposure. Results There were 298 neonates with iris vessels exposure among 1855 neonates and the rate was 16.1%. 1557 neonates (83.9%) had unexposed iris vessels. There were no different in gender (χ2=0.551) and MOD (χ2=3.036) between iris vessels exposure group and unexposed group (P>0.05), while the differences in GA (χ2=47.216), BW (t=4.603) and BL (t=3.936) between the two groups were statistically significant (P=0.000). Multiple logistic regression analysis revealed that only GA (β=−0.291, odds ratio=0.747, 95% confidence interval: 0.656 - 0.851, P=0.000) was correlated to iris vessels exposure significantly. The iris vessels couldn’t be seen in 77 of 78 infants with iris vessels exposure when followed up to 42 days. Conclusions The iris vessels exposure in normal full-term neonates is frequently observed. There is a significant inverse correlation between GA and iris vessels exposure.
ObjectiveTo construct a cationic microbubble (CMB), and investigate the enhancement of gene transfection efficiency and therapeutic effect of ultrasound-targeted microbubble destruction (UTMD) in vivo with CMB compared to definity MB (DMB).Methods In vitro, the CMB was prepared by the method of thin film hydration. The morphology, size, zeta potential, and gene-carrying capacity of CMB were compared with the DMB. In vivo, the firefly luciferase gene which was used as a reporter gene was targeted transfected into myocardium of 16 rats with CMB and DMB, respectively. The gene transfection efficiency and targeting were observed dynamically. Then, ischemia-reperfusion (I/R) model was performed on 64 rats. The models of 60 rats were successfully confirmed by using ultrasonography at 5 days after I/R. The rats were divided into 3 groups (n=20) randomly. The control group received DMB carrying empty plasmid for transfection; DMB group received DMB carrying AKT plasmid for transfection; and CMB group received CMB carrying AKT plasmid for transfection. The cardiac perfusion, cardiac function, infarct size, and infarct thickness were measured by ultrasonography and histological observations after treatment. In addition, the capillary and arteriolar densities were measured with immunohistochemical staining. The myocyte apoptosis was measured with TUNEL staining. The protein expressions of AKT, phospho-AKT (P-AKT), Survivin, and phospho-BAD (P-BAD) were measured by Western blot.ResultsThe size of CMB was uniformly. The zeta potential of CMB was significantly higher than that of DMB (t=28.680, P=0.000). The CMB bound more plasmid DNA than the DMB (P<0.05). The luciferase activity of myocardium were higher in CMB group than in DMB group bothin vitro and in vivo measurements (P<0.05). There was no significant difference between groups in the ratio of signal intensity in anterior wall to posterior wall, ejection fraction (EF), and fractional shortening (FS) at 5 days after I/R (P>0.05), but the above indexes were significant higher in CMB and DMB groups than in control group at 21 days after I/R (P<0.05). Besides, the above indexes were significant higher in CMB group than in DMB group at 21 days after I/R (P<0.05). The infarct size was the smallest and infarct thickness was the thickest in the CMB group, followed by DMB group, control group at 21 days after I/R. The capillary and arteriolar densities of CMB and DMB groups were significant higher than those of control group at 21 days after I/R (P<0.05). Besides, the capillary and arteriolar densities of CMB group were significant higher than those of DMB group (P<0.05). The apoptotic cells were the most in the control group, followed by DMB group, CMB group at 3 days after gene transfection, showing significant differences between groups (P<0.05). The protein expressions of AKT, P-AKT, Survivin, and P-BAD were significant higher in CMB and DMB groups than those in control group at 3 days after gene transfection (P<0.05). Besides, these protein expressions were significant higher in CMB group than those in DMB group (P<0.05).ConclusionThe DNA-carrying capacity and gene transfection efficiency are elevated by CMB, although its physicochemical property is the same as DMB. When ultrasound-targeted AKT gene transfection is used to treat myocardial I/R injury in rats, delivery of AKT with the CMB can result in higher transfection efficiency and greater cardiac functional improvements compared to the DMB.