2021年 · 第44卷第03期

Time flies, and a year has passed since the first publication of the novel coronavirus pneumonia column in this journal in March 2020. Professor Liu Youning, the editor-in-chief essay column of this issue, combed and reviewed the anti-epidemic experience in the past year, analyzed some controversial views that have attracted attention, and the writing was smooth and clear, once again emphasizing the superiority of the "national prevention and control" policy. It is recommended to read.

Background and PurposeTo investigate the feasibility and accuracy of dynamic angiography-guided balloon pulmonary angioplasty (BPA).MethodsThirty-four patients undergoing BPA were included, 23 of whom were CTEPH patients, with a total of 175 target pulmonary arteries. Eleven patients underwent two-dimensional angiography guided by DSA (2D group), and 23 patients underwent reconstruction guided by Dyna CT angiography (3D group). Three-dimensional images of blood vessels were obtained by volume rendering (VR) method. With reference to this image, BPA treatment was continued under the guidance of three-dimensional vascular reconstruction technique. With Mann-WhitneyUThe surgical time and radiation exposure data were compared between the two groups.resultShorter operation time with Dyna CT angiographic reconstruction technique [(3.58 ± 0.61)vs(4.49 ± 0.91) h,P=0.002], the number of target vessels treated with a single BPA procedure was greater [(5.83 ± 2.33)vs(3.73 ± 1.10),P=0.008］。 Overall, the dose area product (DAP) was significantly higher in the 2D group than in the 3D group (13 901.82 ± 5 549.69vs4 682.82±1 950.64，P<0.001）。 The use of Dyna CT angiographic reconstruction technique to guide BPA can use a lower dose of contrast [(225.22 ± 48.70)vs(292.73 ± 76.82) ml,P=0.013], receiving less radiation exposure.conclusionIt is feasible and accurate to use Dyna CT angiography to guide the revascularization of BPA patients. In BPA surgery, dynamic angiographic image reconstruction helps to optimize the surgical procedure of BPA and reduce radiation exposure.

Background and PurposeLigustrazine (TMP) was isolated from traditional Chinese medicine Ligusticum chuanxiong and Japanese fermented food natto, and then synthesized artificially. It is clinically applied to the treatment of various cardiovascular diseases. The researchers evaluated the efficacy of TMP in pulmonary hypertension through clinical trials and animal models of pulmonary hypertension to explore its mechanism.MethodsThree rat models of pulmonary hypertension, including chronic hypoxic pulmonary hypertension (CHPH) rat model, monocrotaline-induced PH (MCT-PH) rat model and Sugen combined with hypoxia-induced PH (SuHx-PH) rat model, were treated with 100 mg · kg^-1• d^-1The therapeutic effect of ligustrazine on pulmonary hypertension was evaluated by small animal ultrasound, hemodynamics and pulmonary pathology. The heart and lung tissues and pulmonary arteries of animals were separated, and the effects and mechanisms of ligustrazine on isolated pulmonary circulation indexes and pulmonary artery diastolic effect were studied by pulmonary perfusion test and vascular tension test. Primary rat pulmonary artery smooth muscle cells were cultured, and the effects of ligustrazine on cellular calcium ion concentration and calcium channel protein were studied by immunoblotting, real-time fluorescence quantitative PCR and intracellular calcium ion concentration determination. Patients with PAH or CTEPH were recruited for a clinical study. On the basis of the original treatment, the treatment group was given oral TMP (100 mg, 3 times/d). After 16 weeks of treatment, the efficacy of TMP in patients with pulmonary hypertension was evaluated.resultPrevention and treatment TMP can significantly improve the hemodynamic indexes of three kinds of pulmonary hypertension rats, reduce the degree of pulmonary artery remodeling, and improve the right ventricular function of the model. On the one hand, its mechanism may be related to the fact that ligustrazine can inhibit calcium influx of pulmonary artery smooth muscle cells by activating pulmonary artery potassium channels, thus directly relaxing pulmonary artery blood vessels; On the other hand, ligustrazine can inhibit the proliferation and migration of pulmonary artery smooth muscle cells mediated by hypoxia by inhibiting HIF-1 α-TRPC1/6-SOCE signaling pathway. The results of clinical studies showed that treatment with ligustrazine for 16 weeks could significantly improve the 6-min walking distance of patients with pulmonary hypertension.conclusionThis study demonstrates the efficacy of TMP in the treatment of pulmonary hypertension, and it is expected to be a safe, effective and inexpensive new drug for the treatment of pulmonary hypertension.