ABSTRACT Objective: To evaluate objective treatment efficacy and safety, and subjective patient-reported outcomes in patients with complex ureteral strictures (US) undergoing minimally invasive lingual mucosal graft ureteroplasty (LMGU). Materials and Methods: We prospectively enrolled patients underwent robotic or laparoscopic LMGU between May 2020 and July 2022. Clinical success was defined as symptom-free and no radiographic evidence of re-obstruction. Patient-reported outcomes, including health-related quality of life (HRQoL), mental health status and oral health-related quality of life (OHRQoL), were longitudinally evaluated before surgery, 6 and 12 months postoperatively. Results: Overall, 41 consecutive patients were included. All procedures were performed successfully with 32 patients in robotic approach and 9 in laparoscopic. Forty (97.56%) patients achieved clinical success during the median follow-up of 29 (range 15-41) months. Although patients with complex US experienced poor baseline HRQoL, there was a remarkable improvement following LMGU. Specifically, the 6-month and 12-month postoperative scores were significantly improved compared to the baseline (p < 0.05) in most domains. Twenty-eight (68.3%) and 31 (75.6%) patients had anxiety and depression symptoms before surgery, respectively. However, no significant decrease in the incidence of these symptoms was observed postoperatively. Moreover, there was no significant deterioration of OHRQoL at 6 months and 12 months postoperatively when compared to the baseline. Conclusions: LMGU is a safe and efficient procedure for complex ureteral reconstruction that significantly improves patient-reported HRQoL without compromising OHRQoL. Assessing patients’ quality of life enables us to monitor postoperative recovery and progress, which should be considered as one of the criteria for surgical success. Objective safety patientreported patient reported (US . (LMGU) Methods 202 2022 symptomfree symptom free reobstruction. reobstruction re obstruction. obstruction re-obstruction Patientreported Patient healthrelated related , (HRQoL) OHRQoL, (OHRQoL) surgery 1 Results Overall 4 included 3 97.56% 9756 97 56 (97.56% followup follow up 2 range 1541 15 15-41 Specifically 6month month 12month p 0.05 005 0 05 domains Twentyeight Twenty eight 68.3% 683 68 (68.3% 75.6% 756 75 (75.6% respectively However Moreover Conclusions progress (LMGU 20 (HRQoL (OHRQoL 97.56 975 5 (97.56 154 15-4 0.0 00 68.3 (68.3 75.6 7 (75.6 97.5 (97.5 15- 0. 68. (68. 75. (75. 97. (97. (68 (75 (97 (6 (7 (9 (

ABSTRACT To explore the functions of Txnip and its mechanism in adipocyte differentiation, the preadipocytes were isolated from subcutaneous adipose tissue of three-day-old piglets and induced into adipogenic differentiation. The expression of Txnip and ChREBP was silenced, and the Txnip overexpression was achieved in the cells with transfection of the recombinant lentivirus strategies. Txnip silencing promoted the differentiation of porcine preadipocytes and PPARγ expression, and a PPARγ inhibitor reduced this facilitation. Instead, Txnip overexpression exerted a suppressive effect on the cell differentiation and PPARγ expression, and the PPARγ agonist offset this inhibition. High glucose stimulated the preadipocyte differentiation and expressions of ChREBP and Txnip. In contrast, Txnip expression was reduced by ChREBP silencing, suggesting glucose-regulated Txnip expression through the mediation of ChREBP. Moreover, the expressions of ChREBP and Glut4 induced by high glucose and glucose uptake of the cells were reduced by Txnip-overexpression, but increased by Txnip silencing, while these changes of Txnip did not alter their expressions under low glucose. Collectively, Txnip could be an inhibitor of porcine preadipocyte differentiation, which attenuated the adipogenesis through the negative feedback regulation on PPARγ. Txnip impaired the induction of glucose on the preadipocyte differentiation through decreasing Glut4 expression and glucose uptake and subsequent decrease of the expression and transcriptional activity of ChREBP.

Abstract Introduction: The objective of this study was to investigate the effect of mivacurium in the application of fast-track anesthesia for transthoracic device closure of ventricular septal defects (VSDs) in children. Methods: The data of 108 children who underwent transthoracic device closure of VSDs from December 2018 to June 2020 were recorded and analyzed. All children were divided into group M (mivacurium group, n=55) and group C (cisatracurium group, n=53) according to the different muscle relaxant drug used. Results: No statistically significant differences in general preoperative data, intraoperative hemodynamic changes, or the incidence of adverse reactions were noted between the two groups (P>0.05). However, the intubation condition rating of children in group M was better than that in group C. The onset time, duration of clinical action and recovery index of the muscle relaxant, postoperative mechanical ventilation duration, and length of intensive care unit stay in group M were significantly lower than those in group C (P<0.05). Conclusion: It is safe and feasible to use mivacurium as a muscle relaxant in children undergoing fast-track cardiac anesthesia during transthoracic device closure of VSDs.

Abstract Megalobrama Amblycephala is an important fishery resource. The processing of Megalobrama Amblycephala often generates many underutilized leftovers including bone which contents abundant active calcium. This study investigated the optimization for extraction conditions of active calcium from Megalobrama Amblycephala bone. The active calcium was extracted from Megalobrama Amblycephala bone using citric acid and malic acid. The response surface methodology was applied to optimize the extraction technology parameters including extraction temperature, extraction time and ratio of citric acid and malic acid. Results showed that, the optimal conditions of extracting active calcium from Megalobrama Amblycephala bone were as follows: extraction temperature, 113 °C, extraction time, 0.8 h, ratio of citric acid and malic acid, 2: 1. Under these conditions, the yield of active calcium was 90.11%. This study has provided a reference for efficiently obtaining of active calcium and utilization of Megalobrama Amblycephala bone resource.

Abstract Nowadays brown rice (BR) and germinated brown rice (GBR) have aroused great interest of consumers, due to the higher nutrition compared with polished rice. In this study, the nutritional and bioactive compositions of BR and GBR samples prepared by 6 early indica rice cultivars and 12 middle indica rice cultivars from three producing areas were investigated. The free amino acid (215.75 mg/100 g), γ-aminobutyric acid (18.04 mg/100 g) and ferulic acid (195.9 μg/ g) content in early indica rice cultivars after germinated were significantly higher (P < 0.05) than those of other cultivars. In addition, principal component analysis and orthogonal partial least squares discriminant analysis models were able to identify BR and GBR, quercetin and p-coumaric acid were the most differential metabolites of all tested rice samples after germinated. The results provided the potential of early indica rice on functional food processing.

Resumo Fundamento: A fração de ejeção (FE) tem sido utilizada em análises fenotípicas e na tomada de decisões sobre o tratamento de insuficiência cardíaca (IC). Assim, a FE tornou-se parte fundamental da prática clínica diária. Objetivo: Este estudo tem como objetivo investigar características, preditores e desfechos associados a alterações da FE em pacientes com diferentes tipos de IC grave. Métodos: Foram incluídos neste estudo 626 pacientes com IC grave e classe III–IV da New York Heart Association (NYHA). Os pacientes foram classificados em três grupos de acordo com as alterações da FE, ou seja, FE aumentada (FE-A), definida como aumento da FE ≥10%, FE diminuída (FE-D), definida como diminuição da FE ≥10%, e FE estável (FE-E), definida como alteração da FE <10%. Valores p inferiores a 0,05 foram considerados significativos. Resultados: Dos 377 pacientes com IC grave, 23,3% apresentaram FE-A, 59,5% apresentaram FE-E e 17,2% apresentaram FE-D. Os resultados mostraram ainda 68,2% de insuficiência cardíaca com fração de ejeção reduzida (ICFEr) no grupo FE-A e 64,6% de insuficiência cardíaca com fração de ejeção preservada (ICFEp) no grupo FE-D. Os preditores de FE-A identificados foram faixa etária mais jovem, ausência de diabetes e fração de ejeção do ventrículo esquerdo (FEVE) menor. Já os preditores de FE-D encontrados foram ausência de fibrilação atrial, baixos níveis de ácido úrico e maior FEVE. Em um seguimento mediano de 40 meses, 44,8% dos pacientes foram vítimas de morte por todas as causas. Conclusão: Na IC grave, a ICFEr apresentou maior percentual no grupo FE-A e a ICFEp foi mais comum no grupo FE-D.

Abstract Background: Ejection fraction (EF) has been used in phenotype analyses and to make treatment decisions regarding heart failure (HF). Thus, EF has become a fundamental part of daily clinical practice. Objective: This study aims to investigate the characteristics, predictors, and outcomes associated with EF changes in patients with different types of severe HF. Methods: A total of 626 severe HF patients with New York Heart Association (NYHA) class III–IV were enrolled in this study. The patients were classified into three groups according to EF changes, namely, increased EF (EF-I), defined as an EF increase ≥10%, decreased EF (EF-D), defined as an EF decrease ≥10%, and stable EF (EF-S), defined as an EF change <10%. A p-value lower than 0.05 was considered significant. Results: Out of 377 severe HF patients, 23.3% presented EF-I, 59.5% presented EF-S, and 17.2% presented EF-D. The results further showed 68.2% of heart failure with reduced ejection fraction (HFrEF) in the EF-I group and 64.6% of heart failure with preserved ejection fraction (HFpEF) in the EF-D group. The predictors of EF-I included younger age, absence of diabetes, and lower left ventricular ejection fraction (LVEF). The predictors of EF-D were absence of atrial fibrillation, lower uric acid level, and higher LVEF. Within a median follow-up of 40 months, 44.8% of patients suffered from all-cause death. Conclusion: In severe HF, HFrEF presented the highest percentage in the EF-I group, and HFpEF was most common in the EF-D group.

Mixed liquor circulates ceaselessly in the closed-loop corridor in an oxidation ditch (OD), which is significantly different from other wastewater treatment processes. The internal recirculation ratio (IRR), i.e., the ratio between circulation flow rate (Q CC) and influent flow rate (QJ, and the circulatory period (T), i.e. the time consumed for the mixed liquor to complete one lap in the circular corridor, was used to quantify the internal recirculation characteristics of the OD system. In order to elucidate the characteristics and applicability of IRR and T, this study obtained the numerical relationship between IRR and T by formula derivation. It also discusses the factors influencing IRR and analyses the applications of IRR and T. The results showed that IRR = Q CC/Q In = HRT/T = HRT · IRF (HRT = hydraulic retention time of the mixed liquor in the circular corridor; IRF = internal recirculation frequency). Moreover, three kinds of parameters had an effect on IRR: Q In; reactor dimensions, i.e., length (Lmid), width (ß), and height (H) of the circular corridor; and horizontal velocity of the mixed liquor in the circular corridor (v). Q In changed IRR by altering HRT. However, B, H, Lmid, and v changed IRR by altering IRF and T. Furthermore, the same IRR corresponded to many different HRT and IRF. Therefore, when Q In and Q CC varied in the OD system, using HRT and IRF to evaluate the variation of Q In and Q CC, respectively, was better than using IRR to evaluate their synthetical variation. IRF and T were useful for directly and precisely characterizing the circulation speed and circulation flow rate in the circular corridor, while IRR was more useful for evaluating the dilution effect of reflux on influent.

This study aimed to investigate the clinical characteristics, prognosis, and factors for survival of patients who underwent early-start peritoneal dialysis (PD) within 24 h after catheter insertion three years after PD. This study was conducted from January 1, 2013 to December 31, 2017. All adult patients who were diagnosed with end-stage renal disease (ESRD) and underwent PD for the first time within 24 h after catheter insertion in our hospital were included. All patients with PD were followed-up until they withdrew from PD, switching to hemodialysis, were transferred to other medical centers, underwent renal transplantation, died or were lost to follow-up, or continued to undergo dialysis until the end of the study period. The follow-up observation lasted three years. The number of eligible patients was 110, and switching to hemodialysis and death were the main reasons for patients to withdraw from PD. The 1-, 2-, and 3-year technical survival rates of patients were 89.1, 79.1, and 79.1% respectively, while the 1-, 2- and 3-year survival rates were 90, 81.8, and 81.8%, respectively. The Charlson comorbidity index, age, hemoglobin, serum albumin, diabetic nephropathy, chronic glomerulonephritis, and hypertensive renal damage were independent risk factors that affected the prognosis of PD patients. Under the condition of ensuring the quality of the PD catheter insertion, early-start PD within 24 h after catheter insertion is a safe treatment approach for ESRD patients.

Abstract Objective This study aimed to determine the differences in learning style preferences among bachelor degree nursing students at Central South University and associate degree nursing students at the Vocational Health School in China. Methods This study was a cross-sectional survey using the Chinese version of the VARK questionnaire to assess preferred learning styles: 159 enrolled bachelor degree nursing students and 199 enrolled associate degree nursing students completed the questionnaire with a response rate of 96.8%. Results The bachelor degree nursing students tend to prefer a multimodal learning style (58.49%), which significantly differed from that of associate degree nursing students (45.77%). The kinaesthetic modality was the predominant unimodal learning style among the bachelor degree and associate degree nursing students (18.20% and 33.67%), and the read-write modality was the least popular modality (2.5% and 4.02%). Conclusion There are both differences and similarities between the learning style preferences of bachelor degree and associate degree nursing students. Educational background is one of the most critical factors that influence the learning style preference of nursing students. This finding may be necessary and beneficial for carrying out future curricula reform. In addition, further comprehensive research should be conducted to examine the relationships between learning style preferences and academic performance, as well as learning style preferences and teaching methods.

Abstract Objective This study aimed to determine the differences in learning style preferences among bachelor degree nursing students at Central South University and associate degree nursing students at the Vocational Health School in China. Methods This study was a cross-sectional survey using the Chinese version of the VARK questionnaire to assess preferred learning styles: 159 enrolled bachelor degree nursing students and 199 enrolled associate degree nursing students completed the questionnaire with a response rate of 96.8%. Results The bachelor degree nursing students tend to prefer a multimodal learning style (58.49%), which significantly differed from that of associate degree nursing students (45.77%). The kinaesthetic modality was the predominant unimodal learning style among the bachelor degree and associate degree nursing students (18.20% and 33.67%), and the read-write modality was the least popular modality (2.5% and 4.02%). Conclusion There are both differences and similarities between the learning style preferences of bachelor degree and associate degree nursing students. Educational background is one of the most critical factors that influence the learning style preference of nursing students. This finding may be necessary and beneficial for carrying out future curricula reform. In addition, further comprehensive research should be conducted to examine the relationships between learning style preferences and academic performance, as well as learning style preferences and teaching methods.

ABSTRACT Dolichomitriopsis diversiformis is an endemic and threatened moss in eastern Asia. In vitro culture and light microscopic observation were employed to study its developmental process from spore germination to the formation of young gametophyte, as well as effects of light and temperature on its spore germination and protonemal development. Microscopic observations revealed that its spores were positively photoblastic with exosporous germination, and sporelings were classified as the bryum-type. Light and dark conditions were compared to understand their effects on spore germination. In 24 h continuous illumination, all spores germinated in both 20 ℃ and 25 ℃. In contrast, in darkness at 20 ℃ from one to 30 days, spores did not germinate. However, when dark-cultured spores transferred to continuous light, they started to geminate in 48 hours. In addition, effects of 20 ℃ and 25 ℃ on sporeling were compared. In a continuous light condition, sporelings grew longer and developed more protonema branches in the 20 ℃ treatment than in the 25 ℃ treatment. It was interesting that a phenomenon of slow and hysteretic spore germination and protonematal development was observed in natural light and room temperature (5-10℃). These observations suggest that spore germination and sporeling development is regulated by light and temperature.

Objetivo: Este estudo tem como objetivo apresentar a patologia do enxerto no momento da coleta e do impacto na sobrevida a longo prazo. Métodos: Os remanescentes de pontes de safena de 66 pacientes consecutivos com doença arterial coronária que receberam uma cirurgia de revascularização coronariana foram investigados patologicamente, e os fatores de risco preditivos e a sobrevivência foram analisados. Resultados: Alterações degenerativas da artéria medial, com ou sem proliferação da íntima estavam presentes em 36,8%, 37,8% e 35,6% de pontes da artéria torácica interna esquerda (ATIE), artéria radial e veia safena. Houve dois (3,0%) óbitos hospitalares e nove (14,1%) óbitos tardios. A regressão logística multinomial revelou que alterações patológicas na ATIE, dislipidemia, história de angioplastia/stent implantação coronariana transluminal percutânea e Y-enxerto foram significativos fatores de risco preditivos que influenciam negativamente a sobrevivência a longo prazo dos pacientes. Análise de sobrevida de Kaplan- Meier revelou que a sobrevivência a longo prazo de pacientes com alterações patológicas da ATIE foi significativamente reduzida em comparação com aqueles sem (74,1% vs. 91,4%, P=0,002), considerando que não foram observadas diferenças na sobrevivência de longo prazo entre pacientes com e sem alterações patológicas dos enxertos da artéria radial ou de veia safena. Conclusão: As alterações patológicas podem se desenvolver na revascularização no momento da coleta. As modificações ultraestruturais sutis e as expressões de reguladores do tônus vascular podem ser responsáveis pela patência tardia do enxerto. As alterações patológicas da ATIE no momento da coleta, em vez do enxerto da artéria radial ou da veia safena, podem afetar significativamente a sobrevida de longo prazo. Manobra não traumática da ATIE na coleta, bom controle da dislipidemia e para evitar uso de enxertos compostos pode ser útil na manutenção da arquitetura dos enxertos.

Objective: This study aims to present the graft pathology at the time of harvest and its impact on long-term survival. Methods: The remnants of the bypass grafts from 66 consecutive patients with coronary artery disease receiving a coronary artery bypass grafting were investigated pathologically, and pertinent predictive risk factors and survival were analyzed. Results: Medial degenerative changes with or without intimal proliferation were present in 36.8%, 37.8% and 35.6% of left internal mammary artery (IMA), radial artery and saphenous vein grafts. There were 2 (3.0%) hospital deaths and 9 (14.1%) late deaths. Multinomial logistic regression revealed left IMA pathological changes, dyslipidemia, history of percutaneous transluminal coronary angioplasty/stent deployment and Y-graft were significant predictive risk factors negatively influencing the patients’ long-term survival. Kaplan-Meier survival analysis revealed that the long-term survival of patients with left IMA pathological changes were significantly reduced compared with those without (74.1% vs. 91.4%, P=0.002); whereas no differences were noted in long-term survivals between patients with and without pathological changes of the radial arterial or saphenous vein grafts. Conclusion: Pathological changes may be seen in the bypass graft at the time of harvest. The subtle ultrastructural modifications and the expressions of vascular tone regulators might be responsible for late graft patency. The pathological changes of the left IMA at the time of harvest rather than those of the radial artery or saphenous vein graft affect significantly longterm survival. Non-traumatic maneuver of left IMA harvest, well-controlled dyslipidemia and avoidance of using composite grafts can be helpful in maintaining the architecture of the grafts.

Disturbances of the microcirculation and abnormal hemorheological properties are important factors that play an important role in disseminated intravascular coagulation (DIC) and result in organ dysfunction or failure. In the present study, we established an animal model of DIC using intravenous Dextran 500 in rats, and used exogenous normal lymph corresponding to 1/15 of whole blood volume for injection through the left jugular vein. We found that normal lymph could improve the blood pressure and survival time of rats with DIC. The results regarding the mesenteric microcirculation showed that the abnormality of the diameter of mesenteric microvessels and micro-blood flow speed in the DIC+lymph group was significantly less than in the DIC+saline group. Whole blood viscosity, relative viscosity, plasma viscosity, hematocrit (Hct), erythrocyte sedimentation rate (ESR), and electrophoresis time of erythrocytes were significantly increased in the DIC+saline group compared to the control group. The electrophoretic length and migration of erythrocytes from the DIC+saline and DIC+lymph groups were significantly slower than the control group. Blood relative viscosity, Hct, ESR, and electrophoretic time of erythrocytes were significantly increased in the DIC+lymph group compared to the control group. Whole blood viscosity, relative viscosity and reduced viscosity were significantly lower in the DIC+lymph group than in the DIC+saline group, and erythrocyte deformability index was also significantly higher than in the DIC+saline and control groups. These results suggest that exogenous normal lymph could markedly improve the acute microcirculation disturbance and the abnormal hemorheological properties in rats with DIC induced by Dextran 500.

The role of myogenic enhancer transcription factor 2a (MEF2A) in avian muscle during fetal development is unknown. In this work, we cloned the duck MEF2A cDNA sequence (GenBank accession no. HM460752) and examined its developmental expression profiles in cardiac muscle, non-vascular smooth muscle and skeletal muscle. Duck MEF2A cDNA comprised 1479 bp encoding 492 amino acid residues. In silico analysis showed that MEF2A contained MADS (MCM1, AGAMOUS, DEFICIENS and SRF -serum response factor), MEF2 and mitogen-activated protein kinase (MAPK) transcription domains with high homology to related proteins in other species. Modified sites in these domains were conserved among species and several variants were found. Quantitative PCR showed that MEF2A was expressed in all three muscles at each developmental stage examined, with the expression in smooth muscle being higher than in the other muscles. These results indicate that the conserved domains of duck MEF2A, including the MADS and MEF2 domains, are important for MEF2A transcription factor function. The expression of MEF2A in duck smooth muscle and cardiac muscle suggests that MEF2A plays a role in these two tissues.

OBJETIVOS: Fator transformador de crescimento (TGF) -β/ Smad como via de sinalização em casos de dissecção aórtica e indivíduos normais não foi descrito anteriormente. O presente estudo foi elaborado para avaliar as expressões TGF-β/Smad como via de sinalização nos pacientes com dissecção aguda da aorta, em comparação com que nos pacientes com aneurisma da aorta torácica e com doença arterial coronariana, e (ou) com indivíduos saudáveis. MÉTODOS: Pacientes cirúrgicos consecutivos para o tipo A de dissecção aguda da aorta (20 pacientes), aneurisma da aorta (nove pacientes) ou doença arterial coronária (20 pacientes) foram selecionados para este estudo. Amostras de sangue (4 ml) foram obtidas a partir do cateter arterial radial direito após heparinização sistêmica antes do início da circulação extracorpórea na sala de cirurgia. Vinte e um voluntários jovens e saudáveis, sem problemas de saúde subjacentes que doaram amostras de sangue venoso do antebraço (4 ml) foram tomados como controle. Os espécimes cirúrgicos de tecidos aórtico foram obtidos imediatamente após terem sido cortados durante as operações da substituição da aorta nos pacientes com dissecção aórtica ou aneurisma da aorta. Em pacientes que foram submetidos à cirurgia de revascularização miocárdica, os tecidos da aorta minúsculos foram obtidos quando os orifícios da anastomose proximal na parede anterior da aorta ascendente foram feitos. Os tecidos da aorta foram para a RNA, proteínas ou preparações sobrenadantes até a detecção de TGF-β1 mRNA pela reação de transcrição reversa quantitativa em tempo real em cadeia da polimerase, de TGF-β1, receptor I de TGF-β, Smad2/3, Smad4 e Smad7 por Western Blot, e de TGF-β1 pelo teste de ELISA, respectivamente. Em particular, as correlações lineares dos tons de cinza relativo entre diferentes proteínas de cada grupo, e aquelas correlações entre os quantitativos TGF-β1 pelo teste de ELISA e o intervalo de tempo desde o início da cirurgia ou as dimensões máximas da aorta do grupo de dissecção da aorta foram avaliados. RESULTADOS: Reação de transcrição reversa quantitativa em tempo real em cadeia da polimerase mostrou que o mRNA TGF-β1 foi supra-regulado em todos os grupos cirúrgicos (1,59 ± 0,33 vs 1,45 ± 0,34 vs 1,48 ± 0,48, P> 0,05). Western blot revelou que as expressões de TGF-β1, receptor I de TGF-β, Smad 2/3, Smad4 e Smad7 foram positivos nos tecidos da aorta de todos os três grupos investigados. Dos tons de cinza quantitativa relativa, uma correlação inversa significativa foi observada entre TGF-β1 e Smad 2/3 (Y = 1,6417 +-0.8552X, r = -0,759, P <0,0001), e uma estreita correlação direta entre Smad4 e Smad7 (Y = 0,5905X + 0,2805, r = 0,781, P <0,0001) no Grupo de dissecção da aorta. No Grupo de Aneurisma da Aorta, Smad4 e Smad7 estavam também estreitamente correlacionados (Y = 0,1642 + 0.5228X, r = 0,727, P = 0,026), e no Grupo de Coronariopatias, TGF-β1 e Smad7 estavam muito significativamente correlacionados (Y = 0.5301X + 0,5758, r = 0,917, P = 0,004). Por meio do teste de ELISA, o nível de TGF-β1 do tecido aórtico foi menor na dissecção aórtica do que no aneurisma da aorta e nos grupos de doença arterial coronariana sem significância estatística (319,52 ± 129,21 proteína pg/mg vs 324,09 ± 49,70 pg/mg de proteína vs 304,15 ± 29,39 proteína pg/mg, P> 0,05). Os níveis de plasma TGF-β1 foram 1.158,30 ± 11,54 pg/ml, 1.170,27 ± 8,26 pg/ml, 1225,00 ± 174,42 pg/mL e 1.160,25 ± 13,01 pg/mL nos quatro grupos, respectivamente, mostrando diferenças significativas entre grupos (P <0,05). Nenhuma correlação significativa foi encontrada entre a aorta ou níveis plasmáticos de TGF-β1 e o intervalo de tempo desde o início da cirurgia ou as dimensões máximas da aorta nos pacientes do grupo de dissecção da aorta. CONCLUSÕES: A dissecção aórtica, aneurisma da aorta e arterosclerose podem estar associadas a uma via de sinalização TGF-β/Smad elevada, com dissecção aórtica exibindo uma suprarregulação menos proeminente. Isso poderia ter implicações para a ativação do sinal a jusante, presumivelmente, traduzindo-se em degradação da matriz na condição de dissecção da aorta, em comparação com deposição de matriz no aneurisma da aorta e doença arterial coronariana

OBJECTIVES: Transforming growth factor (TGF)-β/Smad signaling pathway in aortic dissection patients and normal subjects has not been previously described. The present study was designed to evaluate the TGF-β/Smad signaling expressions in the patients with acute type A aortic dissection in comparison with those in the patients with thoracic aortic aneurysm and with coronary artery disease, and (or) the healthy subjects. METHODS: Consecutive surgical patients for acute type A aortic dissection (20 patients), aortic aneurysm (nine patients) or coronary artery disease (20 patients) were selected into this study. Blood samples (4 ml) were obtained from the right radial arterial indwelling catheter after systemic heparinization prior to the start of cardiopulmonary bypass in the operating room. Twenty-one young healthy volunteers without underlying health issues who donated forearm venous blood samples (4 ml) were taken as control. The surgical specimens of the aortic tissues were obtained immediately after they were severed during the operations of the replacement of the aorta in the patients with aortic dissection or aortic aneurysm. In patients receiving coronary artery bypass grafting, the tiny aortic tissues were taken when the punch holes of the proximal anastomosis on the anterior wall of the ascending aorta were made. The aortic tissues were for RNA, protein, or supernatant preparations until detection of TGF-β1 mRNA by quantitative real-time reverse transcription polymerase chain reaction, of TGF-β1, TGF-β receptor I, Smad2/3, Smad4 and Smad7 by Western blot, and of TGF-β1 by enzyme-linked immunosorbent assay, respectively. In particular, the linear correlations of the relative grayscales between different proteins of each group, and those correlations between the quantitative TGF-β1 by enzyme-linked immunosorbent assay and the time interval from the onset to surgery or the maximal dimensions of the aorta of the aortic dissection group were assessed. RESULTS: Quantitative real-time reverse transcription polymerase chain reaction showed that TGF-β1 mRNA were upregulated in all surgical groups (1.59 ± 0.33 vs. 1.45 ± 0.34 vs. 1.48 ± 0.48, P > 0.05). Western blot revealed that the expressions of TGF-β1, TGF-β receptor I, Smad2/3, Smad4 and Smad7 were positive in the aortic tissues of all three investigated groups. Of the quantitative relative grayscales, a significant reverse correlation was noted between TGF-β1 and Smad2/3 (Y = -0.8552X + 1.6417, r = -0.759, P < 0.0001), and a close direct correlation between Smad4 and Smad7 (Y = 0.5905X + 0.2805, r = 0.781, P < 0.0001) in the Aortic Dissection Group. In the Aortic Aneurysm Group, Smad4 and Smad7 were also closely correlated (Y = 0.5228X + 0.1642, r = 0.727, P = 0.026), and in the Coronary Artery Disease Group, TGF-β1 and Smad7 were much significantly correlated (Y = 0.5301X + 0.5758, r = 0.917, P = 0.004). By enzyme-linked immunosorbent assay, TGF-β1 level of the aortic tissue was lower in the aortic dissection than in the aortic aneurysm and coronary artery disease groups with no statistical significance (319.52 ± 129.21 pg/mg protein vs. 324.09 ± 49.70 pg/mg protein vs. 304.15 ± 29.39 pg/mg protein, P > 0.05). The plasma TGF-β1 levels were 1158.30 ± 11.54 pg/ ml, 1170.27 ± 8.26 pg/ml, 1225.00 ± 174.42 pg/mL and 1160.25 ± 13.01 pg/mL in the four groups, respectively, showing significant intergroup differences (P < 0.05). No significant correlation was found between the aortic or plasma TGF-β1 levels and the time interval from the onset to surgery or the maximal dimensions of the aorta in the patients of the aortic dissection group. CONCLUSIONS: Aortic dissection, aortic aneurysm and atheroslerosis might be associated with an enhanced TGF β/Smad signaling function, with aortic dissection exhibiting a less prominent upregulation. It might have implications for downstream signal activation presumably translating into matrix degradation in the condition of aortic dissection in comparison to matrix deposition in aortic aneurysm and coronary artery disease