心脏血管三角的应用解剖学研究

目的:探讨心脏血管三角的形态学特点,为心脏手术提供形态学资料。方法:取正常成人心脏60例,10%甲醛溶液固定;取新鲜成人心脏10例,制作出心脏的血管铸型标本。定点解剖显示左冠状动脉及其分支的形态、位置、数目、直径及角度,心大静脉的形态、位置,进行观测。比较前室间支、左旋支与心大静脉围成的三角的特点。结果:左冠状动脉起始处与终末处的外径分别为4．18±1．36mm、4．79±1．53mm,主干长度8．99±1．26mm;左旋支、前室间支起始处的外径分别为3．30±1．02mm、3．31±1．03mm;左冠状动脉分别与前室间支、左旋支形成的夹角为173°±5．3°,117°±4．6°。对角支起于心血管三角的上角,有1-3支不等,其起始处的外径为1．78±0．32mm,长度为20．12±0．42mm。心大静脉与前室间动脉、左旋支呈深、浅相交,静脉行于动脉表面占56%、静脉行于动脉深面占44%。心大静脉、前室间支、左旋支两两相交形成心血管三角的三角与三边,其夹角分别为41．97°±11．9°, 65．05°±14．5°,70．17°±16．5°,前室间支的起始处与心大静脉相交处的距离23．04±5．36mm,旋支的起始处与心大静脉相交处的距离15．24±4．23mm,心大静脉横跨前室间支与左旋支的距离为26．28±6．31mm。结论:前室间支、左旋支与心大静脉在左心室前上部围成一闭合、开放、半闭合半开放、山峰四型血管三角。三血管以不同的角度两两相交,三角形的形状可分为A、B、C类。三角形内有数目不等的对角支及左心室前支,对角支分为Ⅰ、Ⅱ、Ⅲ型。左冠状动脉介入治疗,心二尖瓣,主动脉瓣置换应充分考虑心血管三角的形态特点,尽可能避免血管的损伤。     

Recruitment of stem cells by hepatocyte growth factor via intracoronary gene transfection in the postinfarction heart failure

We aim to study the amelioration effect of adenovirus5-mediated human hepatocyte growth factor gene transfer on postinfarction heart failure in swine model. Twelve Suzhong young swine were randomly divided into 2 groups of 6 pigs each: Ad5-HGF group and mock-vector Ad5 group. Four weeks after ligation of the left anterior descending coronary artery, Ad5-HGF was intracoronarily transferred into the myocardium. Simultaneously, gate cardiac perfusion imaging was performed to evaluate the heart function. Three weeks later, gate cardiac perfusion imaging was performed again, then the hearts were removed and sectioned for immunohistochemical examination to illustrate the effects of Ad5-HGF on infarcted myocardium. The expression of HGF was examined by ELISA. The results were: (1) compared with the mock-vector Ad5 group, high expression of human HGF was observed in the myocardium of Ad5-HGF group; (2) in the Ad5-HGF group, the number of CD117 cells co-expressing c-Met per mm2 was significantly larger; (3) the improvement in LVEF was greater in the Ad5-HGF group than in the mock-vector Ad5 group. We concluded that: (1) high expression of human HGF was observed in the myocardium through intracoronary gene transfection; (2) HGF can improve the mobilization of CD117 /c-Met stem cells into ischemic myocardium. The amelioration effect of HGF on postinfarction heart failure could not be limited to stimulating angiogenesis, anti-apoptosis, anti-fibrosis, but was also involved in the recruitment of stem cells into myocardium.     

Remote sensing monitoring upon the grass production in China

Using MODIS remote sensing data and ground truth data, a thorough investigation was conducted to monitor the productivity of grasslands in China for the year 2005. The Normalized Difference Vegetation Index (NDVI) was first computed from the MODIS data. Then the data from the NDVI images were used to correlate with the grass yield data from the ground sampling campaigns. Six regional models were accordingly established from the correlation for estimation of grass production in the six main types of steppe in China. The main results from the estimation could be summarized as follows: (1) High grass productivity in 2005 was obtained in the following 3 regions: the grassland covering Hulunbuir, Xilinhaote, and the western Daxing'anling, the region including the eastern Qinghai, the northwestern Sichuan and the mid-southern Gansu, and the northwestern Xinjiang region. (2) Total hay output from the grasslands in China amounted to 294213.86 thousand tons in 2005 with an average yield of 829.67 kg/hm2. (3) The following 7 provinces were the largest grass producers in China: Inner Mongolia, Qinghai, Xinjiang, Sichuan, Tibet, Heilongjiang and Gansu. For example, Inner Mongolia produced 60370.82 thousand tons of hay in 2005, and hence became the No. 1 grass producer of China. (4) Among the steppe types, the following 5 had the largest grass production: Alpine meadow, Temperate steppe, Low-land meadow, Temperate meadow steppe and Montane meadow with total production accounting for 62.2% in China. (5) Grass production of the entire China in August 2005 remained at the same level as that in August 2004. However, the situations of major grassland provinces were different: grass production in both Qinghai and Gansu in 2005 increased to 9.02% and 3.63%, respectively, when compared with that in 2004. The grass production in Inner Mongolia decreased by 3%, while the production in Tibet, Xinjiang and Sichuan remains unchanged when compared with that in 2004. These results were very important for grassland administration, pasture grazing and grassland ecosystem studies in China.     

Probing behavior of the tea green leafhopper on different tea plant cultivars

The probing behaviors of the tea green leafhopper, Empoasca vitis (Gothe), on 9 tea cultivars were studied using video-text Direct Current-Electrical Penetration Graph, i.e., DC-EPG. The following 7 types of waveforms produced by the leafhopper stylet probing were determined: A, stylet pathway formation; S, salivation when stylets pierce into and stay in phloems; C, active ingestion before stylets reach phloems; E and F, passive ingestion in phloems; R, the insect resting with its stylet inserted into the leaf tissue and NP without probing. The 9 tested tea cultivars were categorized into 3 groups by the cluster analysis according to the number of probes per insect, waveform durations, or duration per probe of various waveforms on different tea cultivars. Waveforms S, E and F correlated to the main feeding activity of the leafhopper and may provide valuable information on predicting the resis-tance level of the tea plants to the leafhopper. The resistance level of the 9 tea cultivars to the leafhopper was ranked based on the durations of waveforms S, E and F, as well as the duration per probe including various waveforms. The ranking order of the resis-tance was: Longjingchangye > Hangdan > Zhenghedabaicha > Qianmei 601 > Hongyafoshuo > Zhongcha 102 > Zhongcha 302 > Longjing 43 > Anjibaicha, which corresponded to the resistance level determined by the population density (infestation) of the leaf-hopper on the 9 tea cultivars in the tea fields. Our study suggests that this simple and convenient DC-EPG technique might have great potential as a reliable tool to predict the resistance of tea cultivars to the tea leafhopper.     

Expression of heat shock proteins in myocardium of patients with atrial fibrillation

Atrial fibrillation (AF) is the most common sustained arrhythmia. Because heat shock proteins (Hsp) can protect cells from stress, we compared the levels of Hsp60, Hsp72, Hsc73, and Hsp27 in atrial myocardium from 17 patients with AF (8 paroxysmal and 9 persistent) and 7 controls in sinus rhythm (SR). Hsp60, Hsp72, and Hsc73 levels were not significantly different among the 3 groups. Hsp27 expression was slightly higher in paroxysmal AF than in SR and in persistent AF, and a borderline significant difference (P = 0.064) was seen between the paroxysmal and persistent AF subgroups. Hsp60 levels in the moderate, severe, and profound myolysis groups were significantly lower than the light myolysis group, but no differences were found in other Hsps. In summary, the data indicate that expression of Hsp27 and Hsc73 may be associated with different stages of AF and that Hsp60 also may be associated with the degree of atrial myolysis.     

Detection of mercury(II) by DNA templated gold nanoclusters based on forming thymidine–Hg2+–thymidine duplexes

We have successfully synthesized gold nanoclusters (AuNCs) templated with DNA (5′‐CCCCCCCCCCCCTTTTTT‐3′), and subsequently employed the fluorescent DNA‐AuNCs as a novel probe for sensitive detections of mercury ions (Hg²⁺). Basically, the procedure is due to the formation of thymidine–Hg²⁺–thymidine duplexes between DNA‐AuNCs and Hg²⁺, thus leading to aggregations of DNA‐AuNCs described here occurring, and facilitating their fluorescence decrease. Significantly, this decrease of fluorescent signals permitted sensitive detection of Hg²⁺ in a linear range of 0.1–100 µmol L^?1, with a detection limit of 0.083 µmol L^?1 at a signal‐to‐noise ratio of 3. Additionally, the practicality of this probe for assaying Hg²⁺ in human urine and lake water samples was further validated, and showed various advantages including simplicity, selectivity, sensitivity and low cost, demonstrating its potential to broaden ways for assaying Hg²⁺ in real samples. Copyright © 2014 John Wiley & Sons, Ltd.     

The autophagy gene Wdr45/Wipi4 regulates learning and memory function and axonal homeostasis

WDR45/WIPI4, encoding a WD40 repeat-containing PtdIns(3)P binding protein, is essential for the basal autophagy pathway. Mutations in WDR45 cause the neurodegenerative disease β-propeller protein-associated neurodegeneration (BPAN), a subtype of NBIA. We generated CNS-specific Wdr45 knockout mice, which exhibit poor motor coordination, greatly impaired learning and memory, and extensive axon swelling with numerous axon spheroids. Autophagic flux is defective and SQSTM1 (sequestosome-1)/p62 and ubiquitin-positive protein aggregates accumulate in neurons and swollen axons. Nes-Wdr45^fl/Y mice recapitulate some hallmarks of BPAN, including cognitive impairment and defective axonal homeostasis, providing a model for revealing the disease pathogenesis of BPAN and also for investigating the possible role of autophagy in axon maintenance.     

The Cost-Effectiveness of Low-Cost Essential Antihypertensive Medicines for Hypertension Control in China: A Modelling Study

Background

Hypertension is China’s leading cardiovascular disease risk factor. Improved hypertension control in China would result in result in enormous health gains in the world’s largest population. A computer simulation model projected the cost-effectiveness of hypertension treatment in Chinese adults, assuming a range of essential medicines list drug costs.

Methods and Findings

The Cardiovascular Disease Policy Model-China, a Markov-style computer simulation model, simulated hypertension screening, essential medicines program implementation, hypertension control program administration, drug treatment and monitoring costs, disease-related costs, and quality-adjusted life years (QALYs) gained by preventing cardiovascular disease or lost because of drug side effects in untreated hypertensive adults aged 35–84 y over 2015–2025. Cost-effectiveness was assessed in cardiovascular disease patients (secondary prevention) and for two blood pressure ranges in primary prevention (stage one, 140–159/90–99 mm Hg; stage two, ≥160/≥100 mm Hg). Treatment of isolated systolic hypertension and combined systolic and diastolic hypertension were modeled as a reduction in systolic blood pressure; treatment of isolated diastolic hypertension was modeled as a reduction in diastolic blood pressure. One-way and probabilistic sensitivity analyses explored ranges of antihypertensive drug effectiveness and costs, monitoring frequency, medication adherence, side effect severity, background hypertension prevalence, antihypertensive medication treatment, case fatality, incidence and prevalence, and cardiovascular disease treatment costs. Median antihypertensive costs from Shanghai and Yunnan province were entered into the model in order to estimate the effects of very low and high drug prices. Incremental cost-effectiveness ratios less than the per capita gross domestic product of China (11,900 international dollars [Int$] in 2015) were considered cost-effective. Treating hypertensive adults with prior cardiovascular disease for secondary prevention was projected to be cost saving in the main simulation and 100% of probabilistic simulation results. Treating all hypertension for primary and secondary prevention would prevent about 800,000 cardiovascular disease events annually (95% uncertainty interval, 0.6 to 1.0 million) and was borderline cost-effective incremental to treating only cardiovascular disease and stage two patients (2015 Int$13,000 per QALY gained [95% uncertainty interval, Int$10,000 to Int$18,000]). Of all one-way sensitivity analyses, assuming adherence to taking medications as low as 25%, high Shanghai drug costs, or low medication efficacy led to the most unfavorable results (treating all hypertension, about Int$47,000, Int$37,000, and Int$27,000 per QALY were gained, respectively). The strengths of this study were the use of a recent Chinese national health survey, vital statistics, health care costs, and cohort study outcomes data as model inputs and reliance on clinical-trial-based estimates of coronary heart disease and stroke risk reduction due to antihypertensive medication treatment. The limitations of the study were the use of several sources of data, limited clinical trial evidence for medication effectiveness and harms in the youngest and oldest age groups, lack of information about geographic and ethnic subgroups, lack of specific information about indirect costs borne by patients, and uncertainty about the future epidemiology of cardiovascular diseases in China.

Conclusions

Expanded hypertension treatment has the potential to prevent about 800,000 cardiovascular disease events annually and be borderline cost-effective in China, provided low-cost essential antihypertensive medicines programs can be implemented.