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Objective: In this study, we aimed to investigate the potential interaction of apatinib and buspirone and underlying mechanism. Methods: UPLC‐MS/MS assay was applied to determine the concentrations of buspirone and its main metabolites (1‐PP and 6‐OH buspirone) after incubated with liver microsomes. Moreover, the connection of in vitro and in vivo was further determined. Sprague Dawley rats were randomly divided into two groups: group A (20 mg/kg buspirone) and group B (buspirone vs 40 mg/kg apatinib). Tail vein blood was collected and subjected to the UPLC‐MS/MS detection. Key findings: Apatinib inhibited the generations of 1‐PP and 6‐OH buspirone dose‐dependently with IC50 of 1.76 and 2.23 μm in RLMs, and 1.51 and 1.48 μm in HLMs, respectively. There was a mixed mechanism underlying such an inhibition effect. In rat, AUC(0–t), AUC(0–∞), Tmax and Cmax of buspirone and 6‐OH buspirone increased significantly while co‐administering with apatinib, but Vz/F and CLz/F decreased obviously while comparing group A with group B. Conclusions: Apatinib suppresses the CYP450 based metabolism of buspirone in a mixed mechanism and boosted the blood exposure of prototype drug and 6‐OH buspirone dramatically. Therefore, extra caution should be taken when combining apatinib with buspirone in clinic. [ABSTRACT FROM AUTHOR]

OBJECTIVES Conventional surgical closure has been considered the gold standard for the treatment of perimembranous ventricular septal defects (PVSDs) in infants for many years, but it requires a cardiopulmonary bypass and midline sternotomy which can lead to both physical and psychological trauma in the future. An intraoperative device closure can be performed with the advantages of reduced invasion, faster recovery and so on. We evaluate the safety and feasibility of intraoperative device closure of PVSDs in infants in comparison with surgical closure. METHODS One hundred eighty-six infants with a PVSD were enrolled in our study. Among them, 97 patients were treated by surgical closure and 89 were treated by intraoperative device closure. The success rates, complications, length of hospital stay and costs were measured. RESULTS The success rate was similar (P = 0.228) in the two groups: 87/89 patients (97.8%) in the device group versus 97/97 patients (100%) in the surgical group. Complication needs management was required in one patient of the device group (1.1%) and in two patients of the surgical group (2.0%) (P = 1.000). Minor complications were observed in 7/87 patients (8.0%) of the device group versus 15/99 patients (15.2%) of the surgical group (P < 0.001). Both groups were similarly effective in reducing the left ventricular end-diastolic dimension, pulmonary arterial pressure and cardiothoracic rate. The procedure time, inpatient stay and intensive care unit stay are shorter in the device group; the total cost was similar for both groups. CONCLUSIONS Intraoperative device closure of PVSDs under real-time transoesophageal echocardiography guidance is safe and feasible without CPB. Under the right conditions, intraoperative device closure can be a good alternative to surgical closure for the treatment of PVSDs in infants. [ABSTRACT FROM PUBLISHER]

Monoclonal antibodies have been developed which specifically recognize protein modified by 7β,8α-dihydroxy-9α,10α-epoxy-7,8,9,10-tetrahydrobenzo[a]pyrene (BPDE-I). These antibodies have been characterized as to sensitivity and specificity by an enzyme-linked immunosorbent assay. They react with BPDE-I-modified proteins and do not cross-react with non-modified protein. All the antibodies have higher sensitivity toward BPDE-I-tetraols than to BPDE-I-modified protein. They cross-react with BPDE-I-deoxyguanosine, BPDE-I-DNA and BPDE-II-rabbit serum albumin. Because of the high antibody sensitivity for tetraols, an immunoassay was developed for quantitating DNA and protein adducts based on release of tetraols from modified samples. This approach was validated using radiolabeled BPDE-I modified DNA and protein. [ABSTRACT FROM PUBLISHER]

OBJECTIVE The study aims to evaluate the safety and feasibility of intra-operative device closure of atrial septal defect with transthoracic minimal invasion. METHODS From May 2006 to June 2009, 252 patients with secundum-type atrial septal defect closure were enrolled in our institution. The patients were divided into two groups, with 182 patients in group I with intra-operative device closure and 72 in group II with surgical closure. In group I, the patients’ age ranged from 3 months to 62 years (mean ± standard deviation, 19.0 ± 16.7 years). This approach involved a transthoracic minimal invasion that was performed after full evaluation of the atrial septal defect by transthoracic echocardiography, deploying the device through the delivery sheath to occlude the atrial septal defect. RESULTS In group I, 180 patients were occluded successfully under this approach. The size of the occluder device implanted ranged from 6 to 48 mm. Minor complications occurred, which included transient arrhythmias (n = 23) and pleural effusion (n = 15). Two patients with postoperative cardiac arrest were successfully cardiopulmonary resuscitated. Another two patients with occluder dislodged back into the right atrium were turned to surgical repair with cardiopulmonary bypass on the postoperative day. In group II, all patients were occluded successfully, and almost all patients needed blood transfusion and suffered from various minor complications. All discharged patients were followed up for 1–5 years. During this period, we found no recurrence, no thrombosis, even no device failure. In our comparative studies, group II had significantly longer intensive care unit (ICU) stay and hospital stay than group I (p < 0.05). The cost for group I was less than group II (p < 0.05). CONCLUSIONS Intra-operative device closure of atrial septal defect with transthoracic minimal invasion is a safe and feasible technique. It had the advantages of cost savings, yielding better cosmetic results, and leaving less trauma than surgical closure. [ABSTRACT FROM AUTHOR]