ObjectiveTo explore the effect of expression of miRNA-21 on bone marrow mesenchymal stem cells (BMSCs).MethodsIn this study, flow cytometry was used to identify the surface-associated antigens of BMSCs. The 10 μmol/L 5-azacytidine was used to induce BMSCs to differentiate to cardiomyocyte-like cells. Immunofluorescence was used to detect the expression of troponin I (cTnI). The samples were assigned to 3 groups: a blank group, a miRNA-21 mimic group, and a negative control (NC) group. The proliferation of BMSCs was detected by methyl thiazolylte-trazolium (MTT), the apoptosis of BMSCs was analyzed by flow cytometry. Western-blotting was used to identify the expression of cTnI and myod in the BMSCs.ResultsThe proliferation of BMSCs was increased, because of the over expression of miRNA-21. But the apoptotic rate of the BMSCs was slower in the miRNA-21 group, on account of the expression of miRNA-21 was higher than that in the NC group and the CK group. The expression of cTnI in the miRNA-21 group was higher than that in the NC group or the CK group.ConclusionThe results suggest that the up-regulation of miRNA-21 enhances proliferation of BMSCs, reduces the apoptosis of BMSCs. miRNA-21 promotes the differentiation of BMSCs, which may pave the way for the treatment directed toward restoring miRNA-21 function for myocardial ischemia.
ObjectiveTo analyze the safety and follow-up results of on-pump coronary artery bypass grafting (CABG) for the treatment of multivessel diseases via left anterolateral minithoracotomy.MethodsFrom January 2018 to March 2020, a total of 30 patients including 18 males and 12 females with an average age of 61.3±7.5 years having multivessel coronary heart diseases were treated in our hospital with on-pump CABG via left anterolateral minithoracotomy. Among them, 14 patients had three-vessel diseases and 16 patients had two-vessel diseases.ResultsThere were 29 internal mammary artery-to-left anterior descending bypass grafts harvested in total while the rest were saphenous-vein bypass grafts. The average number of bypass vessels was 2.3±0.5. There was no perioperative death in the whole group, one patient underwent rethoracotomy due to hemorrhage, and one patient suffered acute renal insufficiency. The average time of postoperative tracheal intubation was 16.0±5.8 hours, and the postoperative ICU stay was 30.1±11.5 hours. Twenty five patients were followed up, including coronary CT angiography examinations at 6 months and 1 year after operation. Proximal anastomotic stenosis in one patient and distal anastomosis occlusion in one patient occurred.ConclusionOn-pump CABG via left anterolateral minithoracotomy is safe for appropriately selected patients.
ObjectiveTo evaluate the safety and medium-to-long-term efficacy of Maze procedure with cryoablation in conjunction with mitral valve surgery for atrial functional mitral regurgitation (AFMR). MethodsRetrospective collection of clinical data from patients undergoing surgical treatment for AFMR in the Department of Cardiovascular Surgery at General Hospital of the Northern Theater Command from June 2013 to February 2022. Patients were divided into an ablation group and a non-ablation group based on whether they underwent ablation. Propensity score matching analysis was performed on the two groups with 15 parameters as covariates. The safety and medium-to-long-term efficacy of the operation in the two groups were compared. ResultsA total of 167 patients with AFMR were included, 95 of whom underwent isolated mitral valve surgery (non-ablation group), and 72 of whom underwent Maze procedure with cryoablation in conjunction with mitral valve surgery (ablation group). A total of 72 pairs were successfully matched. The ablation group included 33 males and 39 females, with an average age of (59.39±6.38) years; the non-ablation group included 33 males and 39 females, with an average age of (60.94±8.95) years. Within an average follow-up of 4 years, 4 deaths occurred in the ablation group, and 13 in the non-ablation group. The duration of extracorporeal circulation [(152.14±35.24) min vs. (93.63±32.48) min] and aortic cross-clamping time [(81.22±20.30) min vs. (47.26±17.89) min] were significantly longer in the ablation group compared to the non-ablation group (P<0.001), but there was no statistical difference in the incidence of perioperative adverse events between the two groups (P>0.05). The diameters of the left atrium and left ventricle were significantly reduced in both groups compared to pre-operation (P<0.05); the postoperative diameter of the left atrium [(47.82±6.72) mm vs. (51.58±8.63) mm] and left ventricular end-diastolic diameter [(47.46±5.06) mm vs. (49.61±6.64) mm] in the ablation group were significantly smaller than those in the non-ablation group, with statistical differences (P<0.05). At each follow-up time point, the sinus rhythm conversion rate and drug-free rate in the ablation group were significantly higher than those in the non-ablation group (P<0.001). Kaplan-Meier analysis showed that the cumulative survival rate in the ablation group (2 years: 98.6% vs. 89.9%; 4 years: 91.7% vs. 87.7%; 6 years: 91.7% vs. 73.9%, 8 years: 91.7% vs. 67.2%; P=0.026) and the rate of freedom from rehospitalization for heart failure (2 years: 98.3% vs. 86.7%; 4 years: 95.8% vs. 82.8%; 6 years: 90.1% vs. 74.9%; 8 years: 81.1% vs. 57.2%; P=0.031) were significantly higher than the non-ablation group. ConclusionConcomitant cryoablation Maze procedure with mitral valve surgery in treating patients with AFMR is safe and has satisfactory results. It can effectively promote the recovery of sinus rhythm, reverse adverse cardiac remodeling, and reduce the incidence of medium-to-long-term adverse events.