Publications by authors named "Zhigong Zhang"

8 Publications

  • Page 1 of 1

TMSB4 Overexpression Enhances the Potency of Marrow Mesenchymal Stromal Cells for Myocardial Repair.

Front Cell Dev Biol 2021 9;9:670913. Epub 2021 Jun 9.

Department of the Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.

Objective: The actin-sequestering proteins, thymosin beta-4 (Tβ4) and hypoxia-inducible factor (HIF)-1α, are known to be associated with angiogenesis after myocardial infarction (MI). Herein, we aimed to identify the mechanism of HIF-1α induction by Tβ4 and investigate the effects of bone marrow mesenchymal stromal cells (BMMSCs) transfected with the Tβ4 gene () in a rat model of MI.

Methods: Rat BMMSCs were isolated, cultured, and transfected with the gene by using the lentivirus-mediated method. Rats with surgically induced MI were randomly divided into three groups ( = 9/group); after 1 week, the rats were injected at the heart infarcted border zone with TMSB4-overexpressed BMMSCs (BMMSC-TMSB4 ), wild-type BMMSCs that expressed normal levels of TMSB4 (BMMSC-TMSB4 ), or medium (MI). The fourth group of animals ( = 9) underwent all surgical procedures necessary for MI induction except for the ligation step (Sham). Four weeks after the injection, heart function was measured using transthoracic echocardiography. Infarct size was calculated by TTC staining, and collagen volume was measured by Masson staining. Angiogenesis in the infarcted heart area was evaluated by CD31 immunofluorescence histochemistry. experiments were carried out to observe the effect of exogenous Tβ4 on HIF-1α and explore the various possible mechanism(s).

Results: experiments showed that vascular density 4 weeks after treatment was about twofold higher in BMMSC-TMSB4 -treated animals than in BMMSC-TMSB4 -treated animals ( < 0.05). The cardiac function and infarct size significantly improved in both cell-treatment groups compared to controls. Notably, the cardiac function and infarct size were most prominent in BMMSC-TMSB4 -treated animals (both < 0.05). HIF-1α and phosphorylated HIF-1α (p-HIF-1α) were significantly enhanced by exogenous Tβ4, which was nonetheless blocked by the factor-inhibiting HIF (FIH) promoter (YC-1). The expression of prolyl hydroxylase domain proteins (PHD) was decreased upon treatment with Tβ4 and further decreased with the combined treatment of Tβ4 and FG-4497 (a specific PHD inhibitor).

Conclusion: TMSB4-transfected BMMSCs might significantly improve recovery from myocardial ischemia and promote the generation of HIF-1α and p-HIF-1α the AKT pathway, and inhibit the degradation of HIF-1α the PHD and FIH pathways.
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June 2021

Atherectomy plus drug-coated balloon versus drug-coated balloon only for treatment of femoropopliteal artery lesions: A systematic review and meta-analysis.

Vascular 2021 Jan 21:1708538120985732. Epub 2021 Jan 21.

Department of Vascular Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China.

Objectives: To compare the safety and efficiency of atherectomy plus drug-coated balloon with drug-coated balloon only for the treatment of femoropopliteal artery lesions.

Methods: This systematic review and meta-analysis was performed and reported following the requirement of the PRISMA. EMBASE, MEDLINE, and Cochrane library were queried from January 2000 to June 2020 to identify eligible literature. The modified Downs and Black checklist was used to assess the quality of included studies. Outcome measures included bail-out stenting, distal embolization, perforation, hematoma, primary patency at 12 months, target lesion revascularization at 12 months, leg amputation at 12 months, and mortality at 12 months. We used DerSimonian and Laird random-effects model to pool the dichotomous data on risk ratio (RR) with 95% confidence intervals (CIs) from each study to obtain an overall estimate for major outcomes. Subgroup analysis and sensitivity analyses were conducted.

Results: Six studies (two randomized controlled trials and four retrospective cohort studies) with 470 patients were included. Atherectomy plus drug-coated balloon group was associated with lower rates of bail-out stenting (RR: 0.49, 95%CI: 0.34-0.71,  < 0.001). There was no significant difference between two groups in terms of distal embolization (RR: 2.06, 95%CI: 0.51-8.38,  = 0.31), perforation (RR: 2.04, 95%CI: 0.43-9.71,  = 0.37), hematoma (RR: 1.75, 95%CI: 0.43-7.09,  = 0.43), primary patency at 12 months (1.09, 95%CI: 0.98-1.21,  = 0.12), target lesion revascularization at 12 months (RR: 0.68, 95%CI: 0.41-1.14,  = 0.15), leg amputations at 12 months (RR: 0.54, 95%CI: 0.13-2.23,  = 0.39), mortality at 12 months (RR: 2.18, 95%CI: 0.71-6.64,  = 0.17). Sensitivity analysis had no effect on our findings.

Conclusions: The combination of atherectomy and drug-coated balloon was safe and effective in the treatment of femoropopliteal artery lesions, with lower incidence of bail-out stenting compared with drug-coated balloon only.
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January 2021

Surgical Outcomes And Postoperative Descending Aorta Morphologic Remodeling After Thoracic Endovascular Aortic Repair For Acute And Chronic Type B Aortic Dissection.

Clin Interv Aging 2019 6;14:1925-1935. Epub 2019 Nov 6.

Department of Vascular and Thyroid Surgery, Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Anhui 230022, People's Republic of China.

Background: This study aims to investigate the descending aortic morphological alterations caused by pathological changes in acute and chronic Type B aortic dissection (TBAD) and morphological remodeling after thoracic endovascular aortic repair (TEVAR).

Patients And Methods: From February 2012 to January 2016, 86 TBAD patients undergoing TEVAR were divided into an acute group (n=63) and a chronic group (n=23). The areas of the true, false and maximal lumen and descending aorta morphological parameters, including the taper ratio (TR), oversizing ratio (OR), mismatch ratio (MR), radius of curvature (RoC) and tortuosity index (TI), were evaluated. Follow-ups were performed postoperatively before discharge, at 1 and 6 months, and yearly thereafter.

Results: Before TEVAR, the TR (0.57 (0.49) vs 0.74 (0.60); < 0.05), OR (2.75 ± 1.89 vs 3.96 ± 2.27; < 0.05) and TI (1.22 (1.19) vs 1.41 ± 0.17; < 0.05) were significantly higher in the chronic group than in the acute group. The TEVAR technical success rate was 100%. No differences were found in 30-day and >30-day mortality between the two groups. Pathology-specific devices, such as tapered stent grafts and distal bare stents, were used more frequently in the chronic group than in the acute group (47.8% vs 23.8%, 0.03; 43.5% vs 12.7%, = 0.002, respectively). The OR and TI changes that occurred after TEVAR were significantly higher in the chronic group than in the acute group (1.80 ± 0.86 vs 2.98 ± 1.85, = 0.028; 0.00 ± 0.09 vs 0.09 ± 0.10, < 0.001, respectively).

Conclusion: TEVAR is a safe and effective therapy for acute and chronic TBAD. Compared to acute TBAD, chronic TBAD resulted in an adverse preoperative descending aorta morphology. Pathology-specific devices may be a feasible treatment option for endovascular repair of chronic TBAD. A larger series of cases with longer follow-up are needed to draw definitive conclusions.
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March 2020

The potential role of carbon nanoparticles-assisted biopsy for sentinel lymph nodes of incidental thyroid carcinoma.

Gland Surg 2019 Aug;8(4):370-377

Department of Burn and Plastic Surgery, Xiangtan Central Hospital, Xiangtan 411100, China.

Background: Some thyroid cancers are found after thyroidectomy for benign lesions, implying additional surgery and treatments. This work aimed to investigate the role of intraoperative sentinel lymph node biopsy (SLNB) for diagnosis of incidental thyroid carcinoma.

Methods: This was a retrospective study of 541 consecutive patients who underwent thyroid surgery between 02/2012 and 02/2014 at the Hunan Provincial People's Hospital. All patients were diagnosed with thyroid benign lesions preoperatively and intraoperatively. Among them, 375 underwent successful intraoperative SLNB using carbon nanoparticles (CNs).

Results: The preoperative diagnoses were nodular goiter (n=472), Hashimoto's disease with nodules (n=24), hyperthyroidism with nodules (n=16), and thyroid cysts with obstructive symptoms (n=29). In the SLNB group, SLN metastasis of thyroid microcarcinoma was confirmed in 21/392 cases (5.4%). These 21 patients received radical surgical treatment for thyroid carcinoma during the initial operation. In the no-SLNB group (n=149), seven patients (4.7%) were finally diagnosed with thyroid microcarcinoma. Six patients had to undergo a second surgery.

Conclusions: Intraoperative SLNB could help diagnose differentiated thyroid microcarcinoma that may be missed preoperatively and intraoperatively. This could prevent the need for a second surgery since the intraoperative frozen section examination of the SLNs can reveal metastasis from thyroid cancer.
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August 2019

Endovascular repair of type B aortic dissection with the restrictive bare stent technique: morphologic changes, technique details, and outcomes.

Ther Clin Risk Manag 2018 12;14:1993-2002. Epub 2018 Oct 12.

Department of Vascular Surgery, Fourth Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.

Purpose: The aim of this study was to present our experience and assess the morphologic changes of the descending aorta after the restrictive bare stent (RBS) technique in the treatment of type B aortic dissection (TBAD).

Patients And Methods: A retrospective study was conducted of 22 consecutive patients with TBAD who underwent RBS treatment between February 2012 and June 2016. Indications for the RBS procedure included radiological evidence of true lumen (TL) compression or collapse and/or tortuosity index (TI) of the descending aorta >1.4. Technique success, descending aorta morphology, and clinical outcomes were evaluated.

Results: The technical success rate was 100%. Patients treated with the RBS technique were often accompanied by TL collapse (45.5%) or TI >1.4 (59.1%). One-month postoperative computed tomography angiography showed that the taper ratio, oversizing ratio of the stent graft, and TI values were significantly decreased compared with preoperative computed tomography angiography values (<0.05). The 30-day mortality rate was 0%. In total 95.2% had a thrombosed false lumen in the segment of aortic coverage, and TL diameters were increased in 40.3%±11% (mean ± SD) and 37.5%±17.9% of patients in the thoracic and abdominal segments, respectively. During the follow-up from 16 to 64 months (33±19 months), no distal stent graft-induced new entry, endoleak, and paraplegia were observed. One patient died from rupture of a chronic TBAD with aneurysm degeneration.

Conclusion: Mid-term outcomes showed RBS to be a flexible and feasible approach to repair TBAD. RBS corrects the descending aorta morphology and promotes TL expansion in most patients, but the rupture of chronic TBAD with aneurysm degeneration was not prevented in all patients.
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October 2018

Subxiphoid pneumonectomy: the new frontier?

J Thorac Dis 2018 Jul;10(7):4464-4471

Thoracic Surgery, Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge, UK.

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July 2018

Evaluation of the clinical value of carbon nanoparticles as lymph node tracer in differentiated thyroid carcinoma requiring reoperation.

Int J Clin Oncol 2016 Feb 17;21(1):68-74. Epub 2015 Jun 17.

Department of Breast and Thyroid Surgery, Hunan Provincial People's Hospital, Changsha, 410005, People's Republic of China.

Background: The incidence of parathyroid injury in patients with differentiated thyroid carcinoma (DTC) who underwent reoperation is significantly higher than that incurred from the initial surgery. The aim of this study was to investigate the clinical value of carbon nanoparticles (CN) as tracers for lymph nodes to guide cervical lymph node dissection and protect the parathyroid during reoperation for DTC.

Methods: Our study recruited 116 patients with DTC who previously underwent thyroidectomy and later received remedial surgical treatment at the Department of Breast and Thyroid Surgery, Hunan Provincial People's Hospital, China, between February 2011 and February 2014. Those patients were randomly divided into the experimental group (the CN group) with 64 cases and the control group with 52 cases. Carbon nanoparticle suspension (CNS, 0.1-0.3 ml) was intraoperatively injected into the residual thyroid or enlarged lymph nodes in the CN group; in the control group, CNS was not applied intraoperatively. The differences in identification of the parathyroid glands, the number of lymph nodes resected intraoperatively, and the incidence of common complications after thyroidectomy in both groups were recorded and analyzed.

Results: The accuracy of identification of the parathyroid in the CN group and control group was 92.2 % and 28.8 %, respectively, and the identification rate of three glands or more in both groups was 75 % and 36.5 %, respectively; those differences were statistically significant between the two groups (P < 0.05). There was also a significant difference between the two groups in the number of lymph nodes removed in the central and lateral cervical compartments (P < 0.05). There was no increase in common complications after the second surgery compared with the previous surgery; in addition, there was a decline in the incidence of transient hypoparathyroidism (HPT) (P < 0.05).

Conclusions: By tracing the thyroid and cervical regional lymph nodes with carbon nanoparticles, the parathyroid glands can be easily identified and protected to reduce the complications of transient hypoparathyroidism resulting from reoperation for residual or missed DTC. Carbon nanoparticle tracers also facilitate radical resection of lymph nodes at the central and lateral compartments of the neck.
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February 2016

Ischemic preconditioning provides no additive clinical value in liver resection of cirrhotic and non-cirrhotic patients under portal triad clamping: a prospective randomized controlled trial.

Clin Res Hepatol Gastroenterol 2014 Sep 29;38(4):467-74. Epub 2014 Apr 29.

Department of Hepatobiliary Surgery of the First Affiliated Hospital of Anhui Medical University, Hefei, China. Electronic address:

Background And Objective: The clinical value of ischemic preconditioning (IP) on patients undergoing hepatectomy under portal triad clamping (PTC) is uncertain, especially for patients with liver cirrhosis. Hence, we conducted a prospective randomized controlled trial to test whether IP could protect liver against ischemic reperfusion (IR) injury after hepatectomy under PTC.

Method: One hundred patients, including 67 with cirrhosis, undergoing hepatectomy with PTC were randomly divided into IP and control groups. Liver function tests at postoperative days 1, 3, and 7 as well as postoperative morbidity, mortality, and duration of hospitalization were compared between the two groups.

Results: The general clinical characteristics between both groups were comparable. The duration of the operation, the amount of intraoperative blood loss, and the need and amount of perioperative blood transfusion were similar in both groups. The postoperative levels of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, and albumin were not statistically different between the two groups. In addition, the morbidity and mortality rates and the duration of hospitalization were similar in both groups.

Conclusions: IP did not improve liver tolerance to IR injury after hepatectomy under PTC. Therefore, the clinical use of IP cannot be recommended as a standard procedure before PTC.
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September 2014