Zhi-Yun Xu

Changhai Hospital, Shanghai, Shanghai, Shanghai Shi, China

Are you Zhi-Yun Xu?

Claim your profile

Publications (87)81.17 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Objectives: The optimal surgical strategy for acute type A aortic dissection (ATAAD) is still controversial because of the inconsistent or even conflicting results of proximal aortic repair (PR) versus extensive aortic repair (ER) on early and late prognostic outcomes. This meta-analysis pooled data from all available studies of PR versus ER to get a summarized conclusion. Methods: Studies were identified by searching the Medline, EMBASE and Cochrane databases. Early and late prognostic outcomes of interest were evaluated with meta-analysis. Fixed- or random-effect models were used according to the significance of heterogeneity. Robustness of pooled estimates and the source of heterogeneity were assessed via sensitivity analyses and meta-regression, respectively. Publication bias was evaluated by the funnel plot and Egger's test. Results: Nine studies with a total of 1872 patients were included for the meta-analysis. Pooled results indicated that, when compared with the ER procedure, PR was associated with lower early mortality [risk ratio (RR) = 0.69, 95% confidence interval (CI) 0.54-0.90, P = 0.005] but higher incidence of postoperative aortic events including reoperation of the distal aorta (RR = 3.14, 95% CI 1.74-5.67, P < 0.001). PR and ER demonstrated analogous prognosis on long-term mortality (HR = 1.02, 95% CI 0.51-2.06, P = 0.96) and the incidences of early postoperative renal failure (RR = 0.75, 95% CI 0.49-1.14, P = 0.17) and stroke (RR = 0.73, 95% CI 0.30-1.78, P = 0.50). All the pooled results were robust to sensitivity analysis. Heterogeneity was insignificant except for the meta-analysis of late mortality. Conclusions: Performing a less aggressive initial surgical procedure of PR in ATAAD patients would have lower early mortality but elevated incidence rates of late aortic reintervention, when compared with ER. Other prognostic results of the two surgical strategies including long-term mortality were similar for both.
    No preview · Article · Oct 2015 · European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To elucidate the mechanisms of Brahma-related gene 1 (Brg1) involvement in the pathophysiologic processes of aortic dissection. Methods: Seventeen dissecting, 4 dilated, and 10 healthy human aorta samples were collected. Expression of Brg1 in the medium of aorta was evaluated by quantitative real-time polymerase chain reaction, Western blot, and immunohistochemical staining, respectively. The regulation effect of Brg1 on proliferation and migration of human aortic smooth muscle cells (HASMCs) was analyzed in 3 ways: using cell counting, a migration chamber, and a wound scratch assay. A polymerase chain reaction array was used for screening potential target genes of Brg1. A chromatin immunoprecipitation assay was adopted for direct deoxyribonucleic acid-protein binding detection. Results: Expression levels of Brg1 were increased in aortic dissection and aortic dilation patients. In vitro results indicated that overexpression of Brg1 inhibited proliferation and migration of HASMCs. The candidate proliferation- and migration-related Brg1 target gene found was Ras-related associated with diabetes (RRAD), expression levels of which were enhanced in dissecting aortic specimens. The direct regulation effect of Brg1 on RRAD was verified by chromatin immunoprecipitation assay results. Furthermore, down-regulating RRAD significantly alleviated the suppression effects of Brg1 on proliferation and migration of HASMCs. Conclusions: Our study illustrated that Brg1 inhibited the proliferation and migration capacity of HASMCs, via the mechanism of direct up-regulation of RRAD, thus playing an important role in the pathophysiologic processes of aortic dissection.
    No preview · Article · Sep 2015 · The Journal of thoracic and cardiovascular surgery
  • Lv Wang · Fang-Lin Lu · Chong Wang · Meng-Wei Tan · Zhi-Yun Xu
    [Show abstract] [Hide abstract]
    ABSTRACT: Objectives: The Society of Thoracic Surgeons 2008 cardiac surgery risk models have been developed for heart valve surgery with and without coronary artery bypass grafting. The aim of our study was to evaluate the performance of Society of Thoracic Surgeons 2008 cardiac risk models in Chinese patients undergoing single valve surgery and the predicted mortality rates of those undergoing multiple valve surgery derived from the Society of Thoracic Surgeons 2008 risk models. Methods: A total of 12,170 patients underwent heart valve surgery from January 2008 to December 2011. Combined congenital heart surgery and aortal surgery cases were excluded. A relatively small number of valve surgery combinations were excluded. The final research population included the following isolated heart valve surgery types: aortic valve replacement, mitral valve replacement, and mitral valve repair. The following combined valve surgery types were included: mitral valve replacement plus tricuspid valve repair, mitral valve replacement plus aortic valve replacement, and mitral valve replacement plus aortic valve replacement and tricuspid valve repair. Evaluation was performed by using the Hosmer-Lemeshow test and C-statistics. Results: Data from 9846 patients were analyzed. The Society of Thoracic Surgeons 2008 cardiac risk models showed reasonable discrimination and poor calibration (C-statistic, 0.712; P = .00006 in Hosmer-Lemeshow test). Society of Thoracic Surgeons 2008 models had better discrimination (C-statistic, 0.734) and calibration (P = .5805) in patients undergoing isolated valve surgery than in patients undergoing multiple valve surgery (C-statistic, 0.694; P = .00002 in Hosmer-Lemeshow test). Estimates derived from the Society of Thoracic Surgeons 2008 models exceeded the mortality rates of multiple valve surgery (observed/expected ratios of 1.44 for multiple valve surgery and 1.17 for single valve surgery). Conclusions: The Society of Thoracic Surgeons 2008 cardiac surgery risk models performed well when predicting the mortality for Chinese patients undergoing valve surgery. The Society of Thoracic Surgeons 2008 models were suitable for single valve surgery in a Chinese population; estimates of mortality for multiple valve surgery derived from the Society of Thoracic Surgeons 2008 models were less accurate.
    No preview · Article · Jul 2014 · Journal of Thoracic and Cardiovascular Surgery
  • [Show abstract] [Hide abstract]
    ABSTRACT: Intra-aortic balloon pump (IABP) in heart valve surgical patients is associated with a higher mortality than coronary artery bypass grafting (CABG). The study aim was to analyze the early outcome of heart valve surgical patients requiring IABP support, and to assess the risk factors for early mortality. Among a cohort of 5,786 patients undergoing heart valve replacement without CABG, 81 (1.4%) required IABP support. Data from these latter patients were collected and analyzed retrospectively, and univariate and multivariate logistic regression were applied to identify risk factors for early mortality in patients requiring IABP support. IABP was inserted in 30 patients intraoperatively, and in 51 patients postoperatively. The overall mortality was 50.6%. Mortality in the intraoperative IABP subgroup was significantly lower than in the postoperative IABP subgroup (26.7% versus 64.7%, p = 0.001). The independent risk factors for early mortality were: age increasing by 10 years (OR 1.906, 95% CI: 1.165-3.116, p = 0.010) and pulmonary hypertension (OR 4.153, 95% CI: 1.380-12.499, p = 0.011). Intraoperative IABP insertion (OR 0.297, 95% CI: 0.100-0.876, p = 0.028) was identified as a protective factor compared to postoperative insertion. The mortality of patients requiring IABP support after heart valve replacement was high. The efficacy of intraoperative IABP insertion was better than a postoperative mandatory use. Clearly, more attention should be paid to older patients or those with pulmonary hypertension, who may benefit less from IABP.
    No preview · Article · Jul 2014 · The Journal of heart valve disease
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Since 2000, transcatheter pulmonary valve replacement has steadily advanced. However, the available prosthetic valves are restricted to bioprosthesis which have defects like poor durability. Polymeric heart valve is thought as a promising alternative to bioprosthesis. In this study, we introduced a novel polymeric transcatheter pulmonary valve and evaluated its feasibility and safety in sheep by a hybrid approach. Methods We designed a novel polymeric trileaflet transcatheter pulmonary valve with a balloon-expandable stent, and the valve leaflets were made of 0.1-mm expanded polytetrafluoroethylene (ePTFE) coated with phosphorylcholine. We chose glutaraldehyde-treated bovine pericardium valves as control. Pulmonary valve stents were implanted in situ by a hybrid transapical approach in 10 healthy sheep (8 for polymeric valve and 2 for bovine pericardium valve), weighing an average of 22.5±2.0 kg. Angiography and cardiac catheter examination were performed after implantation to assess immediate valvular functionality. After 4-week follow-up, angiography, echocardiography, computed tomography, and cardiac catheter examination were used to assess early valvular function. One randomly selected sheep with polymeric valve was euthanized and the explanted valved stent was analyzed macroscopically and microscopically. Findings Implantation was successful in 9 sheep. Angiography at implantation showed all 9 prosthetic valves demonstrated orthotopic position and normal functionality. All 9 sheep survived at 4-week follow-up. Four-week follow-up revealed no evidence of valve stent dislocation or deformation and normal valvular and cardiac functionality. The cardiac catheter examination showed the peak-peak transvalvular pressure gradient of the polymeric valves was 11.9±5.0 mmHg, while that of two bovine pericardium valves were 11 and 17 mmHg. Gross morphology demonstrated good opening and closure characteristics. No thrombus or calcification was seen macroscopically. Conclusions This design of the novel ePTFE transcatheter pulmonary valve is safe and effective to deploy in sheep by hybrid approach, and the early valvular functionality is good.
    Preview · Article · Jun 2014 · PLoS ONE
  • [Show abstract] [Hide abstract]
    ABSTRACT: Inconsistent results regarding the relations between consumption of dairy products and the risk of esophageal squamous cell carcinoma (ESCC) have been reported. In this report, we summarized the evidence by a meta-analysis of observational studies. Eligible studies published up to January 31, 2013 were retrieved via both computer searches and a manual review of references. Random-effects models were used to calculate the summary relative risk (SRR) based on high versus low and dose-response analysis. A total of 19 studies with 4315 ESCC cases were included in this meta-analysis. Overall, there were no significant associations between intakes of total dairy products, milk, cheese and butter and ESCC for the highest versus lowest intake categories (total dairy products: SRR 1.03, 95% confidence interval [CI]: 0.60-1.77; milk: SRR 0.93, 95% CI: 0.74-1.16; cheese: SRR 0.84, 95% CI: 0.61-1.15; butter: SRR 1.77, 95% CI 0.85-3.75). A significant inverse association was found for yogurt consumption (SRR 0.73, 95% CI: 0.54-0.98). There was high heterogeneity among studies on total dairy products, milk and butter; however, little or no heterogeneity was observed among studies on cheese and yogurt. No associations between consumption of milk, dairy products, butter or cheese and risk of ESCC were found, while yogurt consumption may have a protective effect. However, these associations may be subject to high levels of heterogeneity or confounding, and further efforts should be made to confirm these findings.
    No preview · Article · Mar 2014 · Asia-Pacific Journal of Clinical Oncology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Valve calcification involves transdifferentiation of valve interstitial cells (VICs) into osteoblasts. Twist-related protein 1 (TWIST1) has been established as a negative regulator of osteoblast differentiation in both mouse and human mesenchymal stem cells, but its function in human aortic VICs is unknown. In our study, we determined the mechanism of TWIST1 action in regulating osteoblastic transdifferentiation of human aortic VICs. Human calcified and noncalcified aortic valves were examined for TWIST1 expression. Human aortic VICs were isolated and cultured. The data showed that calcified aortic valves express lower levels of TWIST1. In vitro experiments showed that TWIST1 overexpression inhibited the transdifferentiation of VICs into osteoblasts by decreasing the expression of runt-related transcription factor 2 (RUNX2) and its downstream osteoblastic markers. Through chromatin immunoprecipitation and dual luciferase assays, we found that TWIST1 repressed the expression of RUNX2 by directly binding to an E-box located at -820 bp of the RUNX2 P2 promoter region and inhibiting its activity. Our study results suggest that TWIST1 could play an important role in preventing human aortic valve calcification by negatively regulating osteoblastic transdifferentiation of human aortic VICs through direct inhibition of RUNX2.
    No preview · Article · Mar 2014 · The Journal of thoracic and cardiovascular surgery
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective Valve calcification involves transdifferentiation of valve interstitial cells (VICs) into osteoblasts. Twist1 has been established as a negative regulator of osteoblast differentiation in both mouse and human mesenchymal stem cells, but its function in human aortic VICs is unknown. In this study, we aimed to determine the mechanism of TWIST1 action in regulating osteoblastic transdifferentiation of human aortic VICs. Methods and Results Human calcified and non-calcified aortic valves were examined for the expression of TWIST1. Data showed that calcified aortic valves expressed lower levels of TWIST1. Human aortic VICs were isolated and cultured. In vitro experiments showed that TWIST1 overexpression inhibited the transdifferentiation of VICs into osteoblasts by decreasing the expression of RUNX2 and its downstream osteoblastic markers. Through chromatin immunoprecipitation and dual luciferase assays, we found that TWIST1 repressed the expression of RUNX2 by directly binding to an E-box located at -820bp of the RUNX2 P2 promoter region and inhibiting its activity. Conclusion Our study suggests that TWIST1 may play an important role in preventing human aortic valve calcification by negatively regulating osteoblastic transdifferentiation of human aortic VICs through direct inhibition of RUNX2.
    No preview · Article · Jan 2014
  • Ben Zhang · Yang Liu · Tong-Yi Xu · Pu-Xi Xiong · Lin Han · Zhi-Yun Xu
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective To discuss the diagnosis, surgical treatment, and prognosis of primary malignant cardiac tumors. Methods and Results The clinical data of 13 patients with primary malignant cardiac tumors, who were surgically treated from January, 1999 to May, 2012, were retrospectively analyzed. The 13 patients accounted for 9. 22% (13/141) of patients with cardiac tumors who were surgically treated during the corresponding period. The diagnoses of the 13 cases were all comfirmed by echocardiography. Median sternotomy was performed in 12 cases and left anterolateral thoracotomy in 1. Complete resection of tumor was performed in 8 cases, subtotal resection in 1, and only biopsy in 4. The tumors arose from the right atrium in 3 cases, right ventricle in 3, left atrium in 4, left ventricle in 1, and right atrium combined with right ventricle in 2 cases. Pathological diagnoses included angiosarcoma in 3 cases, rha bdomyosarcoma in 3, mesenchymal sarcoma in 3, leiomyosarcoma in 2, undifferentiated sarcoma in 1, and fibromyxoid sarcoma in 1. There was no operative or in-hospital death, and all the patients were followed up after surgery. The median survival time of the entire group was 17. 5 months (range, 1-76 months). The median survival time of the patients who underwent a complete or subtotal surgical excision was 18. 5 months compared with 8 months for those who underwent only biopsy. Conclusion Malignant primary cardiac tumors are often found in the right heart. Echocardiography is the most important diagnostic method. The prognosis of malignant primary cardiac tumors is very poor. Surgical excision remains an effective method to improve the prognosis.
    No preview · Article · Nov 2013 · Academic Journal of Second Military Medical University
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective To explore the surgical procedure and prognosis for elderly patients with early stage non-small-cell lung carcinoma (NSCLC). Methods The clinical data of 113 elderly patients with early stage NSCLC, who were treated in Changhai Hospital between January 2010 and December 2012, were retrospectively analyzed. The clinical features, treatments, surgical approaches, surgical procedures, and surgical outcomes were analyzed. Results Sixty-four patients received surgical treatment and others were transferred to internal treatment. There were significant differences in performance status (PS) and lung function (FEVi % and VC%) between the surgical patients and non-surgical patients (P = 0. 001, P = 0. 046, P = 0. 038). Of the 64 patients undergoing surgical treatment, 47 (73. 4%) received video-assisted thoracic surgery (VATS) and 17 (26.6%) received open thoractomy. Fifty-six patients underwent lobectomy, 8 underwent limited resection, and none had pneumonectomy. Among VATS patients, two (4. 0%) of the 47 patients were converted to thoractomy. The overall complication rate was 18. 8% (12/64), the complication rate of the VATS group was significantly different from that of thoractomy group (6. 0% vs 41. 0%, P < 0. 05). Univariate and multivariate logistic regression analysis revealed that conventional open chest surgery was the independent risk factor for post-surgical complications in elderly NSCLC patients (P = 0. 01,P = 0. 03). Only one patient died after surgery. Conclusion Elderly NSCLC patients should not be denied for pulmonary resection if their performance status and lung function allow. VATS approach lobectomy can effectively reduce post-operation complications and decrease perioperative risks. Conversion to an open procedure should be considered in case of lymph node adhesions. Pneumonectomy should be avoided for elderly NSCLC patients.
    No preview · Article · Sep 2013 · Academic Journal of Second Military Medical University
  • [Show abstract] [Hide abstract]
    ABSTRACT: To establish a neonatal rat model of thoracic aortic dissection by treating pregnant rats with semicarbazide. Methods Implantable capsule osmotic pump with different concentrations of semicarbazide (5, 10, 15, 20, 25, 30, 35, 40 mg/[kg • d])or normal saline were implanted into the abdomen of rats on day 14 of pregnancy. The thoracic aortas of 21 day fetus and neonatal rats were collected. H-E staining was applied to examine the pathological changes under microscope, and the formation of thoracic aortic dissection was analyzed. Results Various degrees of thoracic aortic dissections were observed in neonatal rats after the mother rats were given different concentrations of semicarbazide. At a lowest semicarbazide release rate of 25 mg/kg per day, all the neonatal rats survived and had a high incidence of thoracic aortic dissection. Conclusion A neonatal rat model of thoracic aortic dissection has been successfully established, paving a way for further researches.
    No preview · Article · Sep 2013 · Academic Journal of Second Military Medical University
  • [Show abstract] [Hide abstract]
    ABSTRACT: To explore the expressions of Beclinl and microtubule-associated protein 1 light chain 3(1X3) in type A aortic dissection (AD) tissue and to discuss the relevance. Methods Twenty surgical AD specimens were used in this study, and 10 normal control specimens were obtained from autopsy. Immuno-histochemical staining and Western blotting analysis were performed to evaluate the locations and expressions of Beclinl and LC3 proteins. Results It was found that Beclinl and LC3 proteins were mainly located in the vascular smooth muscle cells of the AD tissues, and the expressions in the AD tissues were signicantly higher than those in the control group (P<0. 05). Conclusion Autophagy is activated in the vascular smooth muscle cells of AD tissues, which may play an important role in the development and progression of thoracic aortic dissection.
    No preview · Article · Sep 2013 · Academic Journal of Second Military Medical University
  • Bai-Ling Li · Da-Hai Du · Guan-Xin Zhang · Zhi-Yun Xu
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective To construct a small interfering RNA (siRNA) vector targeting ΔNp63α and investigate ΔNp63α gene interference on the proliferation and apoptosis of human esophageal squamous carcinoma Eca109 cell line. Methods Adeno-associated virus (AAV)-ΔNp63αshRNA driven by H1 promoter was constructed and was used to infect Eca109 cells. AAV-Null and normal cell lines were utilized in the control group and blank control group, respectively. The influence of siRNA interference of ΔNp6α expression on the growth, proliferation, tumorigenic efficiency and apoptosis of Eca109 cells were analyzed in vitro and in vivo. Results Compared with the two control groups, the specific siRNA targeting ΔNp63α gene significantly down-regulated the expression of ΔNp63α protein levels in Eca109 cells (all P<0.05). The growth of Eca109 cells infected with AAV-ΔNp63αshRNA was significantly lower than those in the two control groups (all P<0.05). Cell cycle analysis showed the proliferation index (PI) of AAV-ΔNp63αshRNA infected cell line was significantly lower compared with the two control groups (all P<0.01). In vivo experiment exhibited that AAV-ΔNp63αshRNA infected cells resulted in a lower tumor weight in nude mice compared with the cells in the two control groups (all P<0.05). In addition, the apoptosis index (AI) of AAV-ΔNp63αshRNA infected cells were significantly higher than those of the other cell lines (P<0.05). Conclusion AAV- mediated expression of shRNA can significantly reduce ΔNp63α expression in Eca109 cells, slowing down the proliferation, promoting the apoptosis, and subsequently inhibiting the growth of tumor.
    No preview · Article · Aug 2013 · Academic Journal of Second Military Medical University
  • Jin-Long Wu · Tao Yan · Liang-Jian Zou · Hao Tang · Zhi-Yun Xu

    No preview · Article · Jun 2013 · Academic Journal of Second Military Medical University
  • Xue-Wen Liao · Li Li · Lin Han · Fang-Lin Lu · Zhi-Yun Xu · Bing Xu · Hong Meng

    No preview · Article · Jun 2013 · Academic Journal of Second Military Medical University
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: There are debates regarding the optimal approach for AAAD involving the aortic root. We described a modified reinforced aortic root reconstruction approach for treating AAAD involving the aortic root. A total of 161 patients with AAAD involving the aortic root were treated by our modified reinforced aortic root reconstruction approach from January 1998 to December 2008. Key features of our modified approach were placement of an autologous pericardial patch in the false lumen, lining of the sinotubular junction lumen with a polyester vascular ring, and wrapping of the vessel with Teflon strips. Outcome measures included post-operative mortality, survival, complications, and level of aortic regurgitation. A total of 161 patients were included in the study (mean age: 43.3 1 15.5 years). The mean duration of follow-up was 5.1 1 2.96 years (2-12 years). A total of 10 (6.2%) and 11 (6.8%) patients died during hospitalization and during follow-up, respectively. Thirty-one (19.3%) patients experienced postoperative complications. The 1-, 3-, 5-, and 10-year survival rates were 99.3%, 98%, 93.8%, and 75.5%, respectively. There were no instances of recurrent aortic dissection, aortic aneurysm, or pseudoaneurysm during the entire study period. The severity of aortic regurgitation dramatically decreased immediately after surgery (from 28.6% to 0% grade 3-4) and thereafter slightly increased (from 0% to 7.2% at 5 years and 9.1% at 10 years). This modified reinforced aortic root reconstruction was feasible, safe and durable/effective, as indicated by its low mortality, low postoperative complications and high survival rate.
    Preview · Article · Jun 2013 · Brazilian Journal of Cardiovascular Surgery
  • Lei Jin · Chong Wang · Bai-Ling Li · Xi-Long Lang · Lin Han · Zhi-Yun Xu
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective To assess the performance of the European System for Cardiac Operative Risk Evaluation II (EuroSCORE I) in predicating in-hospital mortality among Chinese patients undergoing heart valve surgery at our center. Methods From January 2006 to December 2011, 3 479 consecutive patients who underwent heart valve surgery at our center were enrolled in this study and they were scored by the original EuroSCORE(addtive EuroSCORE and logistic EuroSCORE) and EuroSCORE II model. The actual mortality rate of patients was compared with those of the predicted ones. The performances of the original EuroSCORE and EuroSCORE II model were assessed by the Hosmer-Lemeshow (H-L) test. The discrimination validity of prediction was tested by calculating the area under the receiver operating characteristic (ROC) curve. Results There were 112 in-hospital deaths among the 3 479 patients, with an in-hospitalmortality rate of 3. 2%, compared to the predicted mortality rates of 3. 84% by the additive EuroSCORE (H-L: P = 0. 013, suggesting a higher prediction),3. 33% by the logistic EuroSCORE (H-L: P= 0. 08, suggesting good consistency), and 2.52% by the EuroSCORE II (H-L: P<0. 0001, suggesting a lower prediction). EuroSCORE II showed a good calibration in predicting in-hospital mortality for patients undergoing single valve surgery (H-L: P = 0. 103, area under the ROC curve of 0. 792) and a poor calibration for patients undergoing multiple valve surgery (H-L: P<0. 0001, area under the ROC curve of 0. 605). The discriminative powers of the predictions by additive EuroSCORE, logistic EuroSCORE, andEuroSCORE I were poor for the entire cohort, with the areas under the ROC curve being 0.684, 0. 673, and 0. 685, respectively. Conclusion EuroSCORE II has abetter accuracy for predicting mortality of patients undergoing single valve surgery, but not for those undergoing multiple valve surgery, which should be considered in clinical practice.
    No preview · Article · May 2013 · Academic Journal of Second Military Medical University
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective To primary culture human aortic valvular interstitial cells (hVICs), establish their in vitro calcification model, and to induce hVICs differentiation to osteogenesis and to observe the phenotype changes. Methods hVICs were digested from native valves and used for experiments after 3-7 passages. The cells were cultured in osteogenic media or in normal media. One week later the calcified nodules were stained and measured by von Kossa. The activity of alkaline phosphatase (ALP) was examined by spectrophotometer, immunofluorescence staining was used to detect the phenotype protein of hVICs, and real-time PCR and Western blotting analysis were used to examine the osteogenesis associated factors to assess the calcification model of hVICs. Results The calcified nodules were found 7 days after osteogenic induction. The calcified nodules in the experimental group were significantly more than that in the control group (51. 20±14. 31/well vs 3. 60±1. 82/ well, P<0. 05). The activity of ALP was significantly increased after osteogenic induction compared with the control group (increased by about 4 folds, P<0. 05), with increased contractile phenotype crsmooth muscle actin (crSMA). Real-time PCR and Western blotting results indicated that the expressions of Runx2, osteocalcin, and osteopontin in the experiment group were significantly higher than those in the control group (P<0. 05), so was the expression of phosphorylated Smad1/5/8(P<0. 05). Conclusion We have successfully established the in vitrr calcification modll of hVICs, with hVICs in an activated state; and the phenotype shifts to contraction and ossification, which provide a reliable cell modll for the future study.
    No preview · Article · May 2013 · Academic Journal of Second Military Medical University

  • No preview · Article · May 2013 · Academic Journal of Second Military Medical University
  • Lv Wang · Qing-Qi Han · Fan Qiao · Chong Wang · Xi-Wu Zhang · Lin Han · Zhi-Yun Xu
    [Show abstract] [Hide abstract]
    ABSTRACT: Objectives: The EuroSCORE II is an updated version of the EuroSCORE. This multicentre study validated the EuroSCORE II and logistic EuroSCORE in Chinese patients who underwent heart valve surgery. Methods: A total of 11 170 adult patients underwent heart valve surgery from January 2008 to December 2011. Model discrimination and calibration were assessed for both EuroSCORE II and logistic EuroSCORE. The patients were divided into three subgroups according to the weight of the procedures, and the performance of EuroSCORE II for each group was assessed. A correlation analysis was performed for operative complications and EuroSCORE II. Results: The in-hospital mortality of this series was 2.02% (226 of 11 170), and the predicted mortality rate was 2.62±5.75% by EuroSCORE II and 2.55±6.51% by logistic EuroSCORE (LES). The C-statistics of EuroSCORE II and LES were 0.72 [95% confidence interval (CI) 0.69-0.75] and 0.67 (95% CI 0.63-0.70), respectively. Both models failed the Hosmer-Lemeshow goodness-of-fit test, with a P<0.05. According to the weight of the procedure, the isolated non-CABG subgroup had the best discrimination (C-statistics: 0.76 in the non-CABG group, 0.67 in the 2 procedures group and 0.73 in the 3+ procedures group). The complication ratio was strongly related to the EuroSCORE II-predicted mortality (Pearson correlation coefficient: 0.90 for ARDS, 0.97 for acute renal failure, 0.97 for prolonged ventilation and 0.94 for a prolonged ICU stay). Conclusions: EuroSCORE II was an improvement upon its original logistic model for Chinese patients who underwent heart valve surgery, particularly for a single-valve procedure. The EuroSCORE II-predicted mortality correlated with the operative complications.
    No preview · Article · May 2013 · European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery

Publication Stats

329 Citations
81.17 Total Impact Points

Institutions

  • 2003-2015
    • Changhai Hospital, Shanghai
      Shanghai, Shanghai Shi, China
  • 2006-2014
    • Second Military Medical University, Shanghai
      Shanghai, Shanghai Shi, China
  • 2008
    • Red Cross
      Washington, Washington, D.C., United States