Deep hypothermic circulatory arrest (HCA), which causes perioperative complications, is the foundation of surgical treatment for acute type A aortic dissection (AAAD). To extensively replace the ...dissected aorta and avoid the negative impacts of HCA, we developed an "aorta-clamp" technique and examined its efficacy in repairing AAAD.
From November 2014 to August 2016, we recruited 59 consecutive patients (51.3±10.9 years) with AAAD into this study. We performed total arch replacement combined with an elephant trunk implantation using the "aorta-clamp" technique under a 30 °C HCA with continual bilateral antegrade cerebral perfusion.
The average HCA time was 4.9±1.0 min. Twenty-three patients had increased serum creatinine (sCr) before surgery, suggesting an AAAD-associated acute kidney injury (AKI). The sCr level returned to normal in five patients after operation and in 15 before discharge. Six patients (10.2%) with preoperative AKI required postoperative dialysis, and two of these patients (3.4%) died of multiple organ failure. Two patients (3.4%) required re-exploration due to bleeding. One patient (1.7%) exhibited temporary neurologic deficits. There were no late deaths. Computed tomography (CT) examination confirmed the patency of the anastomotic sites and thrombus obliteration of the residual false lumen.
Using the "aorta-clamp" technique with continual bilateral antegrade cerebral perfusion, total arch replacement combined with an elephant trunk implantation can be performed under five minutes of mild (30 °C) HCA. Our data suggest that this technique for the surgical repair of AAAD is a safe, feasible and effective surgical approach with satisfactory early outcomes.
Background:
The patient-tailored SyncAV algorithm shortens the QRS duration (QRSd) beyond what conventional biventricular (BiV) pacing can. However, evidence of the ability of SyncAV to improve the ...cardiac resynchronization therapy (CRT) response is lacking. The aim of this study was to evaluate the impact of CRT enhanced by SyncAV on echocardiographic and clinical responses.
Methods and Results:
Consecutive heart failure (HF) patients from three centers treated with a quadripolar CRT system (Abbott) were enrolled. The total of 122 patients were divided into BiV+SyncAV (
n
= 68) and BiV groups (
n
= 54) according to whether they underwent CRT with or without SyncAV. Electrocardiographic, echocardiographic, and clinical data were assessed at baseline and during follow-up. Echocardiographic response to CRT was defined as a ≥15% decrease in left ventricular end-systolic volume (LVESV), and clinical response was defined as a NYHA class reduction of ≥1. At the 6-month follow-up, the baseline QRSd and LVESV decreased more significantly in the BiV+SyncAV than in the BiV group (QRSd −36.25 ± 16.33 vs. −22.72 ± 18.75 ms,
P
< 0.001; LVESV −54.19 ± 38.87 vs. −25.37 ± 36.48 ml,
P
< 0.001). Compared to the BiV group, more patients in the BiV+SyncAV group were classified as echocardiographic (82.35 vs. 64.81%;
P
= 0.036) and clinical responders (83.82 vs. 66.67%;
P
= 0.033). During follow-up, no deaths due to HF deterioration or severe procedure related complications occurred.
Conclusion:
Compared to BiV pacing, BiV combined with SyncAV leads to a more significant reduction in QRSd and improves LV remodeling and long-term outcomes in HF patients treated with CRT.
In this work, a novel core-shell structure material, NiFe layered double hydroxide (NiFe LDH) loaded on SiO2 microspheres (SiO2@NiFe LDH), was synthesized by a one-step hydrothermal method, and the ...spontaneous electrostatic self-assembly process. The morphology, structure, and microwave absorption properties of SiO2@NiFe LDH nanocomposites with different NiFe element ratios were systematically investigated. The results show that the sample of SiO2@NiFe LDH-3 nanocomposite has excellent microwave absorption properties. It exhibits broadband effective absorption bandwidth (RL < −10 dB) of 8.24 GHz (from 9.76 GHz to 18.0 GHz) and the reflection loss is −53.78 dB at the matched thickness of 6.95 mm. It is expected that this SiO2@NiFe-LDH core-shell structural material can be used as a promising non-precious, metal-based material microwave absorber to eliminate electromagnetic wave contamination.
Progressive dilatation is responsible for significant mortality and morbidity in patients with thoracic aortic aneurysms (TAAs). Studies have shown that the development and progression of TAAs are ...closely related to immune regulatory pathways and genes. Therefore, it is important to understand the immune regulatory mechanisms and biomarkers of TAA dilatation.
Systematic bioinformatics analysis was applied, including linear models for microarray data (LIMMA) differential expression analyses, principal component analysis (PCA), immunocyte identification, and genetic function enrichment analysis.
Our results showed that both aortic intima-media (AMed) and outer aortic adventitia (AAdv) tissues were closely associated with T cell activation during the process of tricuspid aortic valve (TAV)-associated TAA dilation. Additionally, the degree of infiltration of resting memory CD4+ T cells was linked to both AAdv and AMed vascular dilation. The core regulators PPTRC, IL1B, CD4, CD3G, and IL2RA were also identified and are closely related to resting memory CD4+ T cell infiltration in this pathological process.
The candidate genes PPTRC, IL1B, CD4, CD3G, and IL2RA were involved in the regulation of resting memory CD4 T cell tissue infiltration, which is closely related to the process of AAdv and AMed vascular dilation in TAV patients.
A PAL gene designated as
JcPAL1
was cloned from
J. curcas
L. The full-length is 2336 bp in size with one intron and two exons, encoding a polypeptide of 713 amino acids. Its 5′-upstream region is ...rich in putative cis-elements including not only PAL typical TATA box, L-box and transcriptional initiation site (TIS) but also light responding motifs. Expression pattern analysis indicated that
JcPAL1
were expressed in all tissues, most highly in flowers. When Treated with ABA, GA3, high and low temperature, expression of
JcPAL1
were induced. Recombinant JcPAL1 has a pH optimum at 8.7 and a temperature optimum at 60°C in 100 mM Tris–HCl buffer. The
Km
and
Kcat
values are 0.125 mM and 1.73 S
−1
for
l
-phenylalanine, and 1.312 mM and 0.109 S
−1
for
l
-tyrosine, respectively. These findings suggested that
JcPAL1
might involve in the
J. curcas
responding to various stresses and
l
-Phe should be its true physiological substrate. This study is essential prior to uncover whether and how the PAL initiated phenylpropanoid metabolic networks functioning in the defense responses of
J. curcas
.
Based on the load-sensing control principle, a novel type of electronic load sensing hydraulic system was developed. Taking a two-loads system for example, the design and analysis of the novel ...hydraulic system principle was completed and an electronic control system was accomplished using TTC60 controller. A preliminary experimental study was completed. The experimental studies show that the new system can not only achieve the traditional load-sensing control function, but also improve the level of electronic control system.
The best solution to the polysaccharide ultrasonic extraction of auricularia is as follows. With aqueous conditions of solid-liquid ratio of 1∶60, 4h extraction time, 40w ultrasonic power, 70°C ...extraction temperature, extract twice to measure the auricularia polysaccharide extraction rate as 14.95%. Then elute the auricularia polysaccharide with DEAE-Cellulose 52 chromatographic column to get auricularia polysaccharide component AAP -1 which is then separated by Sephadex G-200 gel chromatographic column to get mono component. Set up the swimming training model with increasing intensity. Feed the mouse witsh AAP-1 solution. The result shows that a certain dose of AAP-1 taken can increase the contents of muscle glycogen and liver glycogen and maintain a constant blood sugar. The exhaustion time of the mouse can be elongated and the survival time in anoxic condition will be significantly prolonged. The above shows that auricularia polysaccharide has the function of anti-exercise fatigue.
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