三维超声心动图评价不同年龄段和性别主动脉瓣二叶畸形

目的:三维超声心动图评估不同年龄段和性别主动脉瓣二叶畸形(bicuspid aortic valve malformation,BAV)的应用价值。方法:超声心动图检测我院2012年6月至2014年9月70例BAV患者,根据年龄段分为4组,≤20岁年龄组7例,21-40岁年龄组14例,41-60岁年龄组30例,≥60岁年龄组19例;根据性别分为2组,男性42例,女性28例。测量不同病例分组的主动脉窦部及升部内径、室间隔厚度、左心功能及左房横径,比较主动脉瓣狭窄、关闭不全、钙化及脱垂四个合并症发生率。结果:在心脏结构指标方面,年龄段分组室间隔厚度≥60岁年龄组12.37±1.64 mm高于≤20岁年龄组10.43±2.22 mm和21-40岁年龄组11.00±1.92 mm;左房横径41-60岁年龄组38.73±7.95 mm和≥60岁年龄组40.05±9.71 mm高于≤20岁年龄组29.86±1.86 mm。性别分组左心功能女性64.18±6.04%高于男性58.71±11.28%。在合并症发生率方面年龄段分组主动脉瓣狭窄41-60岁年龄组80%、≥60岁年龄组84%高于21-40岁年龄组50%,性别分组狭窄男性81%大于女性54%,关闭不全女性79%大于男性50%。结论:三维超声心动图诊断BAV可获得更加全面、具体、直观的诊断信息,BAV的超声表现与患者年龄段和性别密切相关。     

细胞内铜/锌超氧化物歧化酶在人胸主动脉夹层的表达研究

目的:探讨细胞内铜/锌超氧化物岐化酶(copper zinc superoxide dismutase,Cu/Zn-SOD,SOD-1)在人胸主动脉夹层(humanthoracic aortic dissection,hTAD)中的表达情况及其在hTAD中的可能作用。方法:蛋白质印迹法(Western blot,WB)检测SOD-1在TAD和正常人胸主动脉(NA)中膜组织中的表达情况,免疫组织化学染色(immunohistochemistry,IHC)验证SOD-1在动脉壁中的表达和定位。结果:蛋白质印迹和免疫组化染色均显示SOD-1在TAD组表达量较NA组减低(P<0.05);免疫组化染色进一步显示,SOD-1主要位于主动脉壁中膜平滑肌细胞的胞质内,其在夹层主动脉壁中膜撕开处表达缺失。结论:SOD-1在TAD中表达量减少,可能由于参与氧化应激引起的脂质过氧化和炎症反应,以及细胞外基质(extracellular matrix,ECM)的降解等机制所致。     

Vasodilator effects of peptides derived from egg white proteins

The aim of this work was to investigate the effect of several peptides, identified before and after simulated gastrointestinal digestion of an egg white hydrolysate, on the vascular function, in rat aorta. The sequences IVF, RADHPFL and YAEERYPIL (0.1 mM) induced vasodilatation in intact aortic rings, with the maximum percentage of dilation corresponding to RADHPFL (40.5 ± 7.0%). Two of the end products of the gastrointestinal digestion, RADHP and YPI, also showed vasodilator activity with degrees of relaxation higher than 50%. However, all these peptides failed to induce relaxation in endothelium-denuded aortic rings. The relaxation induced by RADHP was concentration-dependent and it was partially blocked by the nitric oxide synthase inhibitor l-NAME (100 μM) and by the B₁ bradykinin receptor antagonist Des-HOE 140 (30 nM), thus showing that it was mediated by NO production through the activation of B₁ bradykinin receptors. These findings suggest that these peptides could reduce the vascular resistance and could be used as functional food ingredients in the prevention and treatment of hypertension.     

The motif of SPARC that inhibits DNA synthesis is not a nuclear localization signal

SPARC (secreted protein acidic and rich in cysteine), although primarily known as a secreted, matricellular protein, has also been identified in urothelial cell nuclei. Many biological activities, including inhibition of cell adhesion and repression of DNA synthesis, have been ascribed to SPARC, but the influence of its intracellular localization on each of these activities is unknown. When exposed by epitope retrieval and nuclear matrix unmasking techniques, endogenous SPARC was found to localize strongly to the nuclei and the nuclear matrix of cultured urothelial cells. Live-cell time-lapse imaging revealed that exogenous fluorescently labeled recombinant (r) SPARC was taken up from medium over a 16 h period and accumulated inside cells. Two variants of rSPARC with alterations in its putative nuclear localization signal (NLS) were generated to investigate the existence and effects of the NLS. These variants demonstrated similar biophysical characteristics as the wild-type protein. Visualization by a variety of techniques, including live-cell imaging, deconvolution microscopy, and cell fractionation, all concurred that exogenous rSPARC was not able to localize to cell nuclei, but instead accumulated as perinuclear clusters. Localization of the rSPARC NLS variants was no different than wild-type, arguing against the presence of an active NLS in rSPARC. Imaging experiments showed that only permeabilized, dead cells avidly took up rSPARC into their nuclei. The rSPARC(no NLS) variant proved ineffective at inhibiting DNA synthesis, whereas the rSPARC(strong NLS) variant was a more potent inhibitor of DNA synthesis than was wild-type rSPARC. The motif of SPARC that inhibits the synthesis of urothelial cell DNA is therefore not a nuclear localization signal, but its manipulation holds therapeutic potential to generate a "Super-SPARC" that can quiesce proliferative tissues.     

Differential expression of TRAIL and its receptors relative to calcification in AAA

Abdominal aortic aneurysm (AAA) is commonly associated with atherosclerosis. Human AAA tissue displays cells undergoing all stages of apoptosis. Tumour necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL) induces apoptosis in tumour cells but not in normal cells. It has death receptors and decoy receptors. An inhibitor of TRAIL, osteoprotegerin (OPG), is involved in osteogenesis and vascular calcification. We investigated TRAIL and its receptors in AAA compared within normal aorta (NA). Both qualitative and quantitative analyses of calcification in AAA walls were determined using Von Kossa staining and pre-operation computer tomography (CT) scans. There was a significant difference in calcification level at different locations in the AAA wall (p <0.05). Apoptosis was confirmed in AAA by TUNEL assay. A significant difference in TRAIL and its receptor expression was observed between normal aortae and AAA (p<0.05). Significant differences were also observed between tissues displaying different extents of calcification for TRAIL mRNA (p<0.05) by RT-PCR examination and OPG protein (p<0.01) by protein blotting examination. We propose that this pattern of expression of TRAIL and its receptors may contribute to AAA formation and calcification in the AAA wall.     

彩色双功能超声在诊断肢体假性动脉瘤中应用价值(附16例分析)

目的评价彩色双功能超声在检查创伤性肢体假性动脉瘤中的诊断价值。方法利用高频线阵探头对16例(17个)肢体假性动脉瘤患者进行检查,并与血管造影进行对比分析。结果16例肢体假性动脉瘤首先经超声检查诊断,所有病例假性动脉瘤体内均有红蓝相间的“来和去”特征性彩色血流图像,6例行血管造影检查,结果与超声诊断完全相符。诊断符合率为100%。11例手术切除,其中10例与超声检查结果相符,1例合并桡动脉漏超声未能检出。超声诊断符合率为92%。结论彩色多普勒超声诊断创伤性肢体假性动脉瘤在临床上具有重要的诊断价值。     

Aortic root dynamics and surgery: from craft to science

Since the fifteenth century beginning with Leonardo da Vinci's studies, the precise structure and functional dynamics of the aortic root throughout the cardiac cycle continues to elude investigators. The last five decades of experimental work have contributed substantially to our current understanding of aortic root dynamics. In this article, we review and summarize the relevant structural analyses, using radiopaque markers and sonomicrometric crystals, concerning aortic root three-dimensional deformations and describe aortic root dynamics in detail throughout the cardiac cycle. We then compare data between different studies and discuss the mechanisms responsible for the modes of aortic root deformation, including the haemodynamics, anatomical and temporal determinants of those deformations. These modes of aortic root deformation are closely coupled to maximize ejection, optimize transvalvular ejection haemodynamics and-perhaps most importantly-reduce stress on the aortic valve cusps by optimal diastolic load sharing and minimizing transvalvular turbulence throughout the cardiac cycle. This more comprehensive understanding of aortic root mechanics and physiology will contribute to improved medical and surgical treatment methods, enhanced therapeutic decision making and better post-intervention care of patients. With a better understanding of aortic root physiology, future research on aortic valve repair and replacement should take into account the integrated structural and functional asymmetry of aortic root dynamics to minimize stress on the aortic cusps in order to prevent premature structural valve deterioration.     

Heart valve macro- and microstructure

Each heart valve is composed of different structures of which each one has its own histological profile. Although the aortic and the pulmonary valves as well as the mitral and the tricuspid valves show similarities in their architecture, they are individually designed to ensure optimal function with regard to their role in the cardiac cycle.In this article, we systematically describe the structural elements of the four heart valves by different anatomical, light- and electron-microscopic techniques that have been presented. Without the demand of completeness, we describe main structural features that are in our opinion of importance in understanding heart valve performance. These features will also have important implications in the treatment of heart valve disease. They will increase the knowledge in the design of valve substitutes or partial substitutes and may participate to improve reconstructive techniques. In addition, understanding heart valve macro- and microstructure may also be of benefit in heart valve engineering techniques.     

Interaction of angio-associated migratory cell protein with the TPα and TPβ isoforms of the human thromboxane A₂ receptor

In humans, thromboxane (TX) A₂ signals through the TPα and TPβ isoforms of its G-protein coupled TXA₂ receptor (TP) to mediate a host of (patho)physiologic responses. Herein, angio-associated migratory cell protein (AAMP) was identified as a novel interacting partner of both TPα and TPβ through an interaction dependent on common (residues 312-328) and unique (residues 366-392 of TPβ) sequences within their carboxyl-terminal (C)-tail domains. While the interaction was constitutive in mammalian cells, agonist-stimulation of TPα/TPβ led to a transient dissociation of AAMP from immune complexes which coincided with a transient redistribution of AAMP from its localization in an intracellular fibrous network. Although the GTPase RhoA is a downstream effector of both AAMP and the TPs, AAMP did not influence TP-mediated RhoA or vice versa. Small interfering RNA (siRNA)-mediated disruption of AAMP expression decreased migration of primary human coronary artery smooth muscle cells (1° hCoASMCs). Moreover, siRNA-disruption of AAMP significantly impaired 1° hCoASMC migration in the presence of the TXA₂ mimetic U46619 but did not affect VEGF-mediated cell migration. Given their roles within the vasculature, the identification of a specific interaction between TPα/TPβ and AAMP is likely to have substantial functional implications for vascular pathologies in which they are both implicated.