Background Cardiovascular disease has become a major cause of death worldwide.Atherosclerosis is the pathological basis of many cardiovascular diseases.It is well established that hemodynamics also play an important r...Background Cardiovascular disease has become a major cause of death worldwide.Atherosclerosis is the pathological basis of many cardiovascular diseases.It is well established that hemodynamics also play an important role in endothelial cell mediated atherosclerotic development.In the process of inflammatory reaction,the damage of vascular endothelial cells is the initial link,and various factors can cause damage of endothelial cells.The change of shear stress is considered to be one of the important factors.In the body,vascular endothelial cells are constantly exposed to blood flow.Flow conditions critically regulate endothelial cell functions in the vasculature.Shear stress not only influences the endothelial cell morphology,migration,differentiation and proliferation,but also regulates the expression of proteins in the endothelial cells.Reduced shear stress resulting from disturbed blood flow can drive the development of vascular inflammatory lesions and promote the formation of atherosclerosis.In the present study,the objective of our study is the comprehensive identification of CX3CR1/NF-κB signaling pathway involved in low shear stress(LSS)-induced inflammation in HUVECs through protein profiling and cell function experiment.Methods Human umbilical vein endothelial cell was cultured onglass slides and placed in a parallel plate flow chamber.M199 culture medium was used for low laminar shear stress at 4.14 dyn/cm2,2 h for the testing group,CX3CR1 sh-RNA and NF-κB inhibitor PDTC are used to block the effects of CX3CR1 and P65.The expression levels of the protein were determined by western blot analysis.Mononuclear cell adhesion assays and scratch assays are used to detect cell adhesion and migration.Results Western blotting analyses revealed that compared with the controls,there is a significant increase in the expression of CX3CR1,nucleusP65,intercellular adhesion molecule-1(ICAM-1),vascular cell adhesion molecule-1(VCAM-1)and Interleukin-6(IL-6),while the expression of cytosolic P65 and IκB was significantly reduced in human umbilical vein endothelial cells(HUVECs)treated with LSS.CX3CR1 Sh-RNA was use to reveal its effect on LSS-induced inflammation.Further,specific NF-κB P65 inhibitors(PDTC)were used to reveal the downstream NF-κB P65 exclusively involved in LSS-induced inflammation in HUVECs,this effect can be abrogated by CX3CR1 sh-RNA and NF-κB inhibitors.Monocyte adhesion assay and scratch test revealed LSS promotes adhesion of monocytes and migration of cells,this effect can be abrogated by CX3CR1 sh-RNA and NF-κB inhibitors.LSS is involved in the expression of adhesion moleculesand chemokines,which are important for the initiation of endothelial inflammation-related atherosclerosis.Conclusions The activation of CX3CR1/NF-κB signaling pathway induced by low shear stress in endothelial cells may lead to the future therapeutic targets of atherosclerotic inflammation.展开更多
Background Minimally invasive cardiac surgery and closed chest cardiopulmonary bypass （CPB） techniques continue to evolve. Previous reports have demonstrated the benefits of fluoroscopy guided cannulation for endova...Background Minimally invasive cardiac surgery and closed chest cardiopulmonary bypass （CPB） techniques continue to evolve. Previous reports have demonstrated the benefits of fluoroscopy guided cannulation for endovascular CPB during port access cardiac surgery. However, few data are available on the role of transesophageal echocardiography （TEE） guided cannulation for peripheral CPB during robotic cardiac surgery. The purpose of this study was to evaluate TEE guided cannulation for peripheral CPB during robotic cardiac surgery. Methods We performed a retrospective analysis of intraoperative data of 129 consecutive patients underwent robotic cardiac surgical procedures requiring peripheral CPB from September 2007 to August 2011, which was established using femoral arterial inflow and kinetic venous drainage by way of the femoral vein and right internal jugular vein and a transthoracic aortic cross clamp. TEE was used to guide cannulation of the inferior vena cava （IVC）, superior vena cava （SVC）, and ascending aorta （AAO）. The success rate and the complication rate of TEE guided cannulation for peripheral CPB were evaluated and compared with the results of fluoroscopy guided cannulation in a historical control group. Results One hundred and twenty-nine consecutive patients underwent robotic cardiac surgical procedures requiring peripheral CPB. There were 67 female （51.9%） and 62 male （48.1%） patients, ranging in age from 13 to 70 years （mean （43.94 ± 13.82） years） and body surface area 1.32 to 2.39 m2 （mean （1.71± 0.20） m2）. Some 61 （47.3%） patients underwent mitral valve repair, 27 （20.9%） mitral valve replacement, 27 （20.9%） left atrial myxoma removal, and 14 （10.9%） ventricular septal defect repair. Of the 129 patients, TEE guided cannulation of the IVC or SVC was successful in all patients （100%）, and no puncture related complications occurred in all patients. Of the 129 patients, successful cannulation of the AAO was achieved in all patients （100%）, and aortic perforation occurred in 1 patient （0.78%） under TEE guidance. Of the 42 patients in the historical control group, successful cannulation occured in 39 patients （92.86%）, and major complications occurred in 3 patients （7.14%） under fluoroscopy guidance. TEE guided cannulation of the AAO significantly improved success rate （100% vs. 92.86%, P=0.014） and decreased complication rate （0.78% vs. 7.14%, P=0.046）.展开更多
基金supported by a project grant from the National Natural Science Foundation of China ( 31860261)
文摘Background Cardiovascular disease has become a major cause of death worldwide.Atherosclerosis is the pathological basis of many cardiovascular diseases.It is well established that hemodynamics also play an important role in endothelial cell mediated atherosclerotic development.In the process of inflammatory reaction,the damage of vascular endothelial cells is the initial link,and various factors can cause damage of endothelial cells.The change of shear stress is considered to be one of the important factors.In the body,vascular endothelial cells are constantly exposed to blood flow.Flow conditions critically regulate endothelial cell functions in the vasculature.Shear stress not only influences the endothelial cell morphology,migration,differentiation and proliferation,but also regulates the expression of proteins in the endothelial cells.Reduced shear stress resulting from disturbed blood flow can drive the development of vascular inflammatory lesions and promote the formation of atherosclerosis.In the present study,the objective of our study is the comprehensive identification of CX3CR1/NF-κB signaling pathway involved in low shear stress(LSS)-induced inflammation in HUVECs through protein profiling and cell function experiment.Methods Human umbilical vein endothelial cell was cultured onglass slides and placed in a parallel plate flow chamber.M199 culture medium was used for low laminar shear stress at 4.14 dyn/cm2,2 h for the testing group,CX3CR1 sh-RNA and NF-κB inhibitor PDTC are used to block the effects of CX3CR1 and P65.The expression levels of the protein were determined by western blot analysis.Mononuclear cell adhesion assays and scratch assays are used to detect cell adhesion and migration.Results Western blotting analyses revealed that compared with the controls,there is a significant increase in the expression of CX3CR1,nucleusP65,intercellular adhesion molecule-1(ICAM-1),vascular cell adhesion molecule-1(VCAM-1)and Interleukin-6(IL-6),while the expression of cytosolic P65 and IκB was significantly reduced in human umbilical vein endothelial cells(HUVECs)treated with LSS.CX3CR1 Sh-RNA was use to reveal its effect on LSS-induced inflammation.Further,specific NF-κB P65 inhibitors(PDTC)were used to reveal the downstream NF-κB P65 exclusively involved in LSS-induced inflammation in HUVECs,this effect can be abrogated by CX3CR1 sh-RNA and NF-κB inhibitors.Monocyte adhesion assay and scratch test revealed LSS promotes adhesion of monocytes and migration of cells,this effect can be abrogated by CX3CR1 sh-RNA and NF-κB inhibitors.LSS is involved in the expression of adhesion moleculesand chemokines,which are important for the initiation of endothelial inflammation-related atherosclerosis.Conclusions The activation of CX3CR1/NF-κB signaling pathway induced by low shear stress in endothelial cells may lead to the future therapeutic targets of atherosclerotic inflammation.
文摘Background Minimally invasive cardiac surgery and closed chest cardiopulmonary bypass （CPB） techniques continue to evolve. Previous reports have demonstrated the benefits of fluoroscopy guided cannulation for endovascular CPB during port access cardiac surgery. However, few data are available on the role of transesophageal echocardiography （TEE） guided cannulation for peripheral CPB during robotic cardiac surgery. The purpose of this study was to evaluate TEE guided cannulation for peripheral CPB during robotic cardiac surgery. Methods We performed a retrospective analysis of intraoperative data of 129 consecutive patients underwent robotic cardiac surgical procedures requiring peripheral CPB from September 2007 to August 2011, which was established using femoral arterial inflow and kinetic venous drainage by way of the femoral vein and right internal jugular vein and a transthoracic aortic cross clamp. TEE was used to guide cannulation of the inferior vena cava （IVC）, superior vena cava （SVC）, and ascending aorta （AAO）. The success rate and the complication rate of TEE guided cannulation for peripheral CPB were evaluated and compared with the results of fluoroscopy guided cannulation in a historical control group. Results One hundred and twenty-nine consecutive patients underwent robotic cardiac surgical procedures requiring peripheral CPB. There were 67 female （51.9%） and 62 male （48.1%） patients, ranging in age from 13 to 70 years （mean （43.94 ± 13.82） years） and body surface area 1.32 to 2.39 m2 （mean （1.71± 0.20） m2）. Some 61 （47.3%） patients underwent mitral valve repair, 27 （20.9%） mitral valve replacement, 27 （20.9%） left atrial myxoma removal, and 14 （10.9%） ventricular septal defect repair. Of the 129 patients, TEE guided cannulation of the IVC or SVC was successful in all patients （100%）, and no puncture related complications occurred in all patients. Of the 129 patients, successful cannulation of the AAO was achieved in all patients （100%）, and aortic perforation occurred in 1 patient （0.78%） under TEE guidance. Of the 42 patients in the historical control group, successful cannulation occured in 39 patients （92.86%）, and major complications occurred in 3 patients （7.14%） under fluoroscopy guidance. TEE guided cannulation of the AAO significantly improved success rate （100% vs. 92.86%, P=0.014） and decreased complication rate （0.78% vs. 7.14%, P=0.046）.
