RESUMEN
Probabilistic Boolean networks (PBNs) are extensions of Boolean networks (BNs), and both have been widely used to model biological systems. In this paper, we study the long-range correlations of PBNs based on their corresponding Markov chains. PBN states are quantified by the deviation of their steady-state distributions. The results demonstrate that, compared with BNs, PBNs can exhibit these dynamics over a wider and higher noise range. In addition, the constituent BNs significantly impact the generation of 1/f dynamics of PBNs, and PBNs with homogeneous steady-state distributions tend to sustain the 1/f dynamics over a wider noise range.
Asunto(s)
Modelos Biológicos , Probabilidad , Biología de Sistemas/métodos , Simulación por Computador , Redes Reguladoras de Genes/genética , Cadenas de Markov , Proteínas Proto-Oncogénicas/genética , Proteínas Wnt/genética , Proteína Wnt-5aRESUMEN
BACKGROUND: Pulmonary thromboendarterectomy (PTE) has evolved as a treatment of choice for chronic thromboembolic pulmonary hypertension (CTEPH). This study aimed to characterize if pulmonary oligemia maneuver (POM) can alleviate pulmonary artery injury during PTE procedure. METHODS: A total of 112 cases of CTEPH admitted to Beijing Anzhen Hospital from March 2002 to August 2011 received PTE procedure. They were retrospectively classified as non-POM group (group A, n = 55) or POM group (group B, n = 57). Members from group B received POM during rewarming period, whereas members from group A did not. RESULTS: There were three (5.45%) early deaths in group A, no death in group B (0) (Fisher's exact test, P = 0.118). Six patients in group A needed extracorporeal membrane oxygenation (ECMO) as life support after the PTE procedure, no patients in group B needed ECMO (Fisher's exact test, P = 0.013). The patients in group B had a shorter intubation and ICU stay, lower mean pulmonary arterial pressure (mPAP) and pulmonary vascular resistance (PVR), higher partial pressure of oxygen in artery (PaO2) and arterial oxygen saturation (SaO2) and less medical expenditure than patients in group A. With a mean follow-up time of (58.3 ± 30.6) months, two patients in group A and one patient in group B died. The difference of the actuarial survival after the procedure between the two groups did not reach statistical significance. Three months post the PTE procedure, the difference of residual occluded pulmonary segment between the two groups did not reach statistical significance (P = 0.393). CONCLUSION: POM can alleviate pulmonary artery injury, shorten ICU stay and intubation time, and lower down the rate of ECMO after PTE procedure.
Asunto(s)
Endarterectomía/efectos adversos , Endarterectomía/métodos , Hipertensión Pulmonar/etiología , Hipertensión Pulmonar/prevención & control , Arteria Pulmonar/lesiones , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
OBJECTIVE: To describe the clinical features of obstructive sleep apnea-hypopnea syndrome (OSAHS) in hospitalized pulmonary thromboembolism (PTE) patients, and to explore its impact on the severity of disease and management among patients with PTE. METHODS: Demographic and clinical characteristics of 28 PTE patients complicated with OSAHS admitted to this hospital from January 2002 to December 2010 were analyzed. A total of 30 PTE patients without OSAHS served as a control group. RESULTS: PTE patients with OSAHS had a significantly lower age of onset of disease [(55 ± 11) yr vs (66 ± 11) yr, t = 3.230, P < 0.01], an increased body mass index (BMI) [(30.1 ± 2.8) kg/m(2) vs (26.1 ± 3.1) kg/m(2), t = -4.161, P < 0.001] and a higher smoking index [(19 ± 6) packs/yr vs (8 ± 4) packs/yr, t = -1.713, P < 0.05] when compared with PTE patients without OSAHS. PaO2 [(70 ± 8) mm Hg vs (79 ± 6) mm Hg, 1 mm Hg = 0.133 kPa, t = 4.233, P < 0.05] and involved lung segments [(8 ± 4) vs (5 ± 3), t = -2.496, P < 0.05] in PTE patients with OSAHS were more severe than those in PTE patients without OSAHS. All patients received anticoagulation and/or thrombolysis treatment, and continuous positive airway pressure (CPAP) ventilation was used in some PTE patients with OSAHS. CONCLUSION: PTE patients with OSAHS had a significantly earlier age of onset of disease and more severe conditions than PTE patients without OSAHS. Treatments including anticoagulation and CPAP should be used in these patients.
Asunto(s)
Embolia Pulmonar/complicaciones , Apnea Obstructiva del Sueño/complicaciones , Adulto , Edad de Inicio , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/terapia , Estudios Retrospectivos , Apnea Obstructiva del Sueño/diagnóstico , Apnea Obstructiva del Sueño/terapia , FumarRESUMEN
OBJECTIVE: The study objectives were to characterize the prognostic perspectives of pulmonary artery sarcoma and to investigate the effect of distal embolectomy on the prognosis of surgical treatment of pulmonary artery sarcoma. METHODS: Nine patients with pulmonary artery sarcoma were surgically treated at Anzhen Hospital, and the data were retrospectively reviewed. Five patients underwent only pulmonary artery sarcoma resection, and 4 patients underwent both pulmonary artery sarcoma resection and distal embolectomy. RESULTS: There was no in-hospital mortality. Four patients had lung ischemia-reperfusion injury, 3 of whom recovered with the support of extended ventilation and positive end-expiratory pressure, and 1 of whom recovered with extracorporeal membrane oxygenation support. During the follow-up, 5 patients who did not undergo distal embolectomy died 6 to 29 months after the procedure, with a median survival time of 10 months. Of the 4 patients undergoing distal embolectomy, 3 died 30, 37, and 43 months after the procedure, and 1 is still alive 39 months after the procedure. All 8 deaths were due to local or systemic recurrence. The patients who underwent distal embolectomy lived longer than the patients who did not undergo distal embolectomy (log-rank test, x(2) = 7.914, P = .005). CONCLUSIONS: Radical surgical resection provides the only chance of survival for patients with pulmonary artery sarcoma, and distal embolectomy may further extend survival for these patients.
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Arteria Pulmonar/cirugía , Sarcoma/cirugía , Neoplasias Vasculares/cirugía , Adulto , Anciano , Embolectomía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Células Neoplásicas Circulantes , Complicaciones Posoperatorias , Sarcoma/diagnóstico , Sarcoma/patología , Neoplasias Vasculares/diagnóstico , Neoplasias Vasculares/patologíaRESUMEN
OBJECTIVE: To retrospectively evaluate the effects of pulmonary thromboendarterectomy (PTE) on chronic thromboembolic pulmonary hypertension (CTEPH). METHODS: Sixty-two cases of CTEPH operated with PTE from October 2002 to September 2008 at Anzhen Hospital were retrospectively reviewed and were assigned into either proximal CTEPH group (n = 46) or distal CTEPH group (n = 16). RESULT: No early death was reported. 15 had residual pulmonary hypertension and 23 had pulmonary reperfusion injury postoperatively. And reperfusion injury was recovered with the support of ventilation or ECMO. Between pre and post-procedure, the pulmonary artery systolic pressure changed from 91 +/- 38 mm Hg to 53 +/- 21 mm Hg, the pulmonary vascular resistance from 916 +/- 548 dynxsxcm(-5) to 368 +/- 302 dynxsxcm(-5) (t = 6.896, P = 0.0001), and the arterial partial pressure of oxygen (PaO(2)) from 51 +/- 7 mm Hg to 90 +/- 7 mm Hg and the arterial oxygen saturation (SaO(2)) from 87.0% +/- 3.9% to 96.1% +/- 3.3%, P < 0.05. With the follow-up of (24.8 +/- 14.6) months (cumulative follow-up was 121.6 patient-years), there was no late death and 38 were in NYHA functional class I, 20 class II, 2 class III and 2 class IV. According to Kaplan-Meier actuarial curve, the freedom from reembolism at 3 years was 96.7% +/- 2.8%. The linear bleeding rate related to anticoagulation was 2.47% patient-years, and the linear thromboembolic rate related to anticoagulation is 1.64% patient-years. CONCLUSION: The early and mid-long term survival rate of PTE procedure on CTEPH is acceptable and the complication rate related to anticoagulation with warfarin is relatively low.
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Endarterectomía/métodos , Hipertensión Pulmonar/mortalidad , Hipertensión Pulmonar/cirugía , Adulto , Anciano , Femenino , Estudios de Seguimiento , Humanos , Hipertensión Pulmonar/etiología , Lesión Pulmonar , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Tasa de Supervivencia , Resultado del TratamientoRESUMEN
OBJECTIVE: To investigate the role of matrix metalloproteinases (MMPs) and extracellular matrix metalloproteinase inducer (EMMPRIN) in the pathogenesis of acute lung injury induced by hyperoxia. METHODS: Fifty four mice were exposed in sealed cages to >98% oxygen (for 24-72 hours), and another 18 mice to room air. The severity of lung injury was assessed, and the expression of mRNA and protein of MMP-2, MMP-9 and EMMPRIN in lung tissue, after exposure for 24, 48 and 72 hours of hyperoxia were studied by reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry. RESULTS: Hyperoxia caused acute lung injury; this was accompanied by increased expression of an upregulation of MMP-2, MMP-9 and EMMPRIN mRNA and protein in lung tissues. CONCLUSION: Hyperoxia causes acute lung injury in mice; increases in MMP-2, MMP-9 and EMMPRIN may play an important role in the development of hyperoxia induced lung injury in mice.