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BACKGROUND: In this study we investigated the impact of ABC stroke score on the recurrence of paroxysmal atrial fibrillation (PAF) following radiofrequency catheter ablation (RFCA). METHODS: A total of 132 patients with PAF who underwent RFCA from October 2018 to September 2019 were included in this study. During the first phase of this study the patients were categorized into two groups based on late recurrence of atrial fibrillation after RFCA. In the second phase, the patients were further divided into two groups based on whether their ABC stroke score was ≥ 6.5. RESULT: The univariate analysis indicated that the risk factors for late recurrence of PAF included early recurrence, ABC stroke score, CHA2DS2-VASc score, and NT-proBNP (P < 0.05). Cox multivariate regression analysis revealed that ABC stroke score (P = 0.006) and early recurrence (P = 0.000) were independent predictors of late recurrence, and ABC stroke score ≥ 6.5 was a risk for predicting recurrence of PAF after RFCA with a sensitivity of 66.7% and specificity of 65.7%. After the completion of the 1:1 matching, the univariate Cox analysis indicated that an elevated score of ABC stroke (≥ 6.5) was an independent predictor of late recurrence of PAF (HR = 2.687, 95% CI: 1.036-6.971, P = 0.042). However, using an ABC stroke score cut off at 6.4 predicted the recurrence of atrial tachyarrhythmia with 85% sensitivity and 58.5% specificity. CONCLUSION: An ABC stroke score ≥ 6.4 is a predictor for late recurrence of PAF after RFCA.
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Fibrilación Atrial , Ablación por Catéter , Recurrencia , Accidente Cerebrovascular , Humanos , Fibrilación Atrial/cirugía , Masculino , Femenino , Ablación por Catéter/efectos adversos , Persona de Mediana Edad , Accidente Cerebrovascular/etiología , Factores de Riesgo , Estudios Retrospectivos , Anciano , Medición de Riesgo/métodos , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/etiologíaRESUMEN
Pulmonary embolism caused by deep vein thrombosis (DVT) is a major contributor to maternal morbidity and mortality. There is still an unmet need for safe and effective treatment options for DVT during pregnancy. Recent research has shown that neutrophil extracellular trap (NET) formation plays a very vital role in thrombosis. We created nanoparticles surface-modified by neutrophil elastase (NE)-binding peptide that can target activated neutrophils specifically in vitro and in vivo. Prussian blue nanoparticles (PB NPs) designed in the core scavenges abnormally elevated reactive oxygen species (ROS) in the vascular microenvironment and acts as a photothermal agent to mediate photothermal therapy (PTT) to damage fibrin network structure. Based on the data we have included, this noninvasive therapeutic approach is considered safe for both mothers and the fetus. Furthermore, our findings indicate that this therapeutic approach has a significant alleviation effect on intrauterine growth restriction caused by maternal thrombosis.
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We compared the efficacy and complication rates of quantitative radiofrequency ablation guided by ablation index (RFCA-AI) with those of second-generation cryoballoon ablation (CBA-2). Consecutive patients (n = 230) with symptomatic atrial fibrillation (AF) undergoing a first ablation CBA-2 (92 patients) or RFCA-AI (138 patients) procedure were enrolled in this study. The late recurrence rate in the CBA-2 group was higher than that in the RFCA-AI group (P = .012). Subgroup analysis showed the same result in patients with paroxysmal AF (PAF) (P = .039), but no difference was found in patients with persistent AF (P = .21). The average operation duration in the CBA-2 group (85 [75-99.5] minutes) was shorter than that in the RFCA-AI group (100 [84.5-120] minutes) (P < .0001), but the average exposure time (17.36(13.87-22.49) vs 5.49(4.00-8.24) minutes) in the CBA-2 group and X-ray dose (223.25(149.15-336.95) vs 109.15(80.75-168.7) mGym) were significantly longer than those in RFCA-AI group (P < .0001). Multivariate logistic regression analysis showed that left atrial diameter (LAD), early recurrence, and methods of ablation (cryoballoon ablation) were independent risk factors for late recurrence after AF ablation. Early recurrence of AF and LAD were independent risk factors for predicting late recurrence after AF ablation.
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Fibrilación Atrial , Ablación por Catéter , Criocirugía , Humanos , Fibrilación Atrial/diagnóstico , Fibrilación Atrial/cirugía , Fibrilación Atrial/etiología , Resultado del Tratamiento , Criocirugía/efectos adversos , Criocirugía/métodos , Atrios Cardíacos/cirugía , Ablación por Catéter/efectos adversos , Ablación por Catéter/métodos , RecurrenciaRESUMEN
INTRODUCTION: To investigate the role of claudin-1 (CLDN1) in trophoblast invasion and endovascular trophoblast (enEVT) differentiation in early-onset preeclampsia (EOPE). METHODS: The expression and localization of CLDN1 in normal (n = 18) and EOPE (n = 20) placental tissues were detected by immunohistochemical (IHC) staining, quantitative real-time polymerase chain reaction (qRTâPCR) and Western blotting. Next, invasion, migration and tube formation assays were performed to explore the involvement of CLDN1 in trophoblast invasion and enEVT differentiation in trophoblast cell lines (HTR8/SVneo). Then, invasion and enEVT markers were analyzed via Western blotting and qRTâPCR, respectively. Finally, we established an EOPE mouse model to detect the Cldn1 protein level. RESULTS: CLDN1 expression was significantly decreased in EOPE placental tissues. Knockdown of CLDN1 suppressed HTR8/SVneo cell invasion, migration and the ability to penetrate the endothelial tube. Conversely, overexpression of CLDN1 promoted trophoblast invasion and the ability to invade the endothelial tube. Inhibition of CLDN1 decreased the protein expression of VIM and SNAIL along with downregulating IL1B and PECAM1 mRNA levels, while overexpression of CLDN1 gave the opposite results. In the EOPE mouse model, we found a decrease in Cldn1 expression in EOPE mouse placentas. DISCUSSION: These results suggest that the downregulation of CLDN1 in trophoblast cells is involved in the pathogenesis of early-onset preeclampsia by affecting trophoblast invasion and enEVT differentiation.
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Preeclampsia , Trofoblastos , Humanos , Animales , Ratones , Embarazo , Femenino , Trofoblastos/metabolismo , Placenta/metabolismo , Claudina-1/genética , Claudina-1/metabolismo , Regulación hacia Abajo , Preeclampsia/metabolismo , Movimiento Celular , Diferenciación CelularRESUMEN
Micro/nanoplastic (M/NP) contamination in food has become a global concern. Food-grade polypropylene (PP) nonwoven bags, which are widely used to filter food residues, are considered environmentally friendly and nontoxic. However, the emergence of M/NPs has forced us to re-examine the use of nonwoven bags in cooking as plastic contact with hot water leads to M/NP release. To evaluate the release characteristics of M/NPs, three food-grade PP nonwoven bags of different sizes were boiled in 500 mL water for 1 h. Micro-Fourier transform infrared spectroscopy and Raman spectrometer confirmed that the leachates were released from the nonwoven bags. After boiling once, a food-grade nonwoven bag can release 0.12-0.33 million MPs (>1 µm) and 17.6-30.6 billion NPs (<1 µm), equivalent to a mass of 2.25 - 6.47 mg. Number of M/NPs released is independent of nonwoven bag size; however, it decreases with increasing cooking times. M/NPs are primarily produced from easily breakable PP fibers, and they are not released into the water at once. Adult zebrafish (Danio rerio) were cultured in filtered distilled water without released M/NPs and in water containing 14.4 ± 0.8 mg L-1 released M/NPs for 2 and 14 days, respectively. To evaluate the toxicity of the released M/NPs on the gills and liver of zebrafish, several oxidative stress biomarkers (i.e., reactive oxygen species, glutathione, superoxide dismutase, catalase, and malonaldehyde) were measured. The ingestion of the released M/NPs by zebrafish induces oxidative stress in the gills and liver, depending on the exposure time. Food-grade plastics, such as nonwoven bags, should be used with caution in daily cooking because they release large amounts of M/NPs when heated, which can threaten human health.
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Microplásticos , Contaminantes Químicos del Agua , Animales , Humanos , Pez Cebra , Plásticos , Alimentos , Polipropilenos , Agua , Contaminantes Químicos del Agua/toxicidad , Contaminantes Químicos del Agua/análisisRESUMEN
Adsorption is an efficient and eco-friendly removal technique for small pristine microplastics in water. However, small pristine microplastics are not representative of those large microplastics in natural water with different aging levels. Whether the adsorption technique is effective in removing large aged microplastics from water remained unknown. To this end, the removal efficiency of large polyamide (PA) microplastics with different aging time by magnetic corncob biochar (MCCBC) was evaluated under different experimental conditions. After treated by heated-activated potassium persulfate, the physicochemical properties of PA have changed dramatically, as evidenced by rough surface, decreased particle size and crystallinity, and increased oxygen-containing functional groups, which enhanced with aging time. These changes promoted the combination of aged PA and MCCBC, thereby resulting in a higher removal efficiency of aged PA (~97 %) than that of pristine ones (~25 %). It is supposed that the adsorption process was a result of complexation, hydrophobic interaction, and electrostatic interaction. Increased ionic strength inhibited the removal of both pristine and aged PA, and neutral pH conditions favored PA removal. Furthermore, particle size played a great role in the removal of aged PA microplastics. When the particle size of aged PA was smaller than 75 µm, their removal efficiency was significantly increased (p < 0.01). The small PA microplastics were removed by adsorption, whereas the large ones were removed by magnetization. These research findings highlight magnetic biochar as promising technique for removing environmental microplastics.
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Polyvinyl chloride microplastics (PVC-MPs) are toxic to crops, resulting in economic losses during agricultural production. Owing to its strong adsorption capacity, biochar can effectively remove MPs from water. It is presumed that biochar can alleviate the phytotoxicity of PVC-MPs. To verify this hypothesis, the effects of different concentrations of corncob biochar (CCBC) on the phytotoxicity of PVC-MPs were investigated using hydroponic experiments. The results showed that PVC-MPs attached to lettuce roots substantially inhibited the growth and quality of lettuce. The tested CCBC adsorbed the PVC-MPs. At appropriate concentrations, CCBC alleviated the inhibitory effect of PVC-MPs on lettuce yield; however, it decreased some quality indicators. The single PVC-MPs induced oxidative damage to lettuce, as demonstrated by the increased hydrogen peroxide (H2O2) and malondialdehyde (MDA) content. Addition of CCBC considerably decreased the contents of H2O2 and MDA in the lettuce shoots but increased the H2O2 content in the roots. These findings indicate that CCBC may alleviate the adverse effects caused by PVC-MPs to the lettuce shoots but aggravate the toxic effects on the lettuce roots. This study provides a basis for understanding the removal of the phytotoxicity of MPs.
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Microplásticos , Contaminantes Químicos del Agua , Microplásticos/toxicidad , Plásticos , Cloruro de Polivinilo , Peróxido de Hidrógeno , Lactuca , Contaminantes Químicos del Agua/toxicidadRESUMEN
Ahead of Print article withdrawn by publisher.
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Croplands have become a hotspot for antibiotic and microplastic (MP) pollution. However, little is known regarding their combined effects on crops. In this study, the individual and combined effects of oxytetracycline (OTC) and three MPs (i.e., polypropylene (PP), polyamide (PA), and polyvinylchloride (PVC)) on cherry radish were investigated using pot experiments. Individually, OTC (50 mg kg-1), PA (2%, w/w), and PP (2%, w/w) induced negligible effects on cherry radish biomass and the root/shoot ratio. However, PVC (2%, w/w) significantly inhibited cherry radish growth; that is, its shoot and root fresh weight decreased by 46.2% and 81.1%, respectively. In the combined exposure groups, OTC alleviated the adverse effects of PVC on the cherry radish leaf number and shoot fresh weight. This was linked to that OTC increased the content of photosynthetic pigments. Superoxide dismutase activity in cherry radish roots was inhibited to different extents in all treatment groups except for the PA and PVC treatments. Malondialdehyde (MDA) content in cherry radish roots increased in all treatment groups, suggesting that both OTC and MPs caused oxidative damage to cherry radish root cells, therefore inhibiting cherry radish root growth. However, the presence of OTC non-significantly changed the effects of MPs on cherry radish roots. Irrespective of OTC presence, MPs induced a reduction in the root/shoot ratio of cherry radish, suggesting that the inhibitory effect of MPs on cherry radish roots was stronger than that on shoots. These findings contribute to the evaluation of the phytotoxicity of antibiotics and MPs in soil-vegetable systems.
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Oxitetraciclina , Raphanus , Antibacterianos/farmacología , Malondialdehído , Microplásticos , Nylons , Oxitetraciclina/toxicidad , Plásticos/toxicidad , Polipropilenos , Cloruro de Polivinilo , Suelo , Superóxido DismutasaRESUMEN
Objectives: The objectives of this study are to assess the efficacy of radiofrequency catheter ablation (RFCA) in patients with outflow tract (OT) ventricular premature complexes (VPCs) and to explore the electrocardiographic (ECG) features of initially successful procedures. Methods: Based on the outcome of ablation, 154 consecutive patients with OT-VPCs who underwent RFCA from January 2017 to December 2019 were divided into two groups. The rate of successful procedures and the ECG features were analyzed and compared between the two groups. Results: The highest success rate was found in patients with VPCs from the right ventricular outflow tract (RVOT), and the lowest success rate was evident among patients with complexes from both the RVOT and the left ventricular OT (LVOT). The patients with successful procedures (136) reflected a lower pseudo delta wave ratio (16.2% vs. 44.4%, P < 0.01), a smaller R-wave amplitude in lead V1 (V1) (0.23 ± 0.24 mV vs. 0.35 ± 0.44 mV, P < 0.05), shorter intrinsicoid deflection time in lead V2 (V2) (44.00 ± 18.33 ms vs. 57.41 ± 20.67 ms, P < 0.01), a shorter RS duration in V2 (93.67 ± 21.33 ms vs. 106.93 ± 18.76 ms, P < 0.01), and smaller R/S-waveratios in V2. Furthermore, multivariate analysis demonstrated that RS duration in V2 was above 109.17 ms and R/S ratio in V2 was above 0.28, forecasting a failed procedure. Conclusions: The ECG predictors of failed ablation were characterized by RS duration and R/S ratio in V2.
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Ablación por Catéter , Taquicardia Ventricular , Complejos Prematuros Ventriculares , Ablación por Catéter/efectos adversos , Electrocardiografía , Ventrículos Cardíacos/cirugía , Humanos , Complejos Prematuros Ventriculares/diagnóstico , Complejos Prematuros Ventriculares/etiología , Complejos Prematuros Ventriculares/cirugíaRESUMEN
BACKGROUND AND OBJECTIVE: Rivaroxaban is a novel oral anticoagulant widely used for thromboprophylaxis in patients with non-valvular atrial fibrillation (NVAF). The present study aimed to develop a population pharmacokinetic (PPK) model for rivaroxaban in Chinese patients with NVAF. METHODS: We performed a prospective multicenter study. The plasma concentration of rivaroxaban was directly detected by high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) and indirectly by rivaroxaban-calibrated chromogenic anti-Xa assay (STA®). Gene polymorphisms were detected by MassARRAY single nucleotide polymorphism genotyping technology. Nonlinear mixed-effects modeling was used to develop the PPK model for rivaroxaban in patients with NVAF, and we simulated the steady-state rivaroxaban exposures under different dosing strategies in different covariate levels. RESULTS: A total of 150 patients from five centers were recruited, including 263 plasma concentrations detected by HPLC-MS/MS, 2626 gene polymorphisms, and 131 plasma concentrations detected by anti-Xa assay. In our study, an oral one-compartment model was used to describe the pharmacokinetics of rivaroxaban in patients with NVAF. In the final model, the estimated apparent clearance (CL/F) and volume of distribution (V/F) were 5.79 L/h (relative standard error [RSE] 4.4%) and 51.5 L (RSE 5.0%), respectively. Covariates in the final model included creatinine clearance, total bilirubin, rs4728709, and body weight. The simulation results showed that in the 15 mg once-daily dosing regimen, in most instances the maximum plasma concentration at steady state (Cmax,ss) and trough plasma concentration at steady state (Cmin,ss) were in the target range for different covariate levels. When patients were administered rivaroxaban 15 or 20 mg once daily, the Cmax,ss and Cmin,ss in the different bodyweight levels were also in the target range. For patients with the ABCB1 rs4728709 mutation, the Cmin,ss in the 10, 15, and 20 mg once-daily dosing regimens were lower than the target range. The anti-Xa assay was highly linearly correlated with the HPLC-MS/MS method [y = 1.014x - 2.4648 (R2 = 0.97)]. CONCLUSIONS: Our study was the first multicenter PPK model for rivaroxaban in Chinese patients with NVAF (Alfalfa-RIVAAF-PPK). The study found that 15 mg once daily may be suitable as the principal rivaroxaban dose for Chinese patients with NVAF. For patients with the rs4728709 mutation, it may be necessary to examine insufficient anticoagulation. We found that the rivaroxaban-calibrated chromogenic anti-Xa assay and HPLC-MS/MS method were highly linearly correlated. Prospective studies with larger sample sizes and real-world studies are needed for further verification.
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Fibrilación Atrial , Tromboembolia Venosa , Anticoagulantes/farmacocinética , Fibrilación Atrial/tratamiento farmacológico , China , Inhibidores del Factor Xa/farmacocinética , Humanos , Estudios Prospectivos , Rivaroxabán/farmacocinética , Espectrometría de Masas en Tándem , Tromboembolia Venosa/tratamiento farmacológicoRESUMEN
At present, the question of whether radiofrequency ablation (RFA) combined with spironolactone can reduce the levels of plasma angiotensin II (AngII) and aldosterone (ALD) in patients with atrial fibrillation (AF) and reduce the recurrence of AF has not been reported. HYPOTHESIS: The present study evaluates the effect of spironolactone as an ALD antagonist on the short-term and long-term recurrence of AF after RFA. A total of 203 patients were enrolled in the present study, with 102 patients in the spironolactone therapy group (Group PVI/SP) and 101 patients in the control group (Group PVI alone). The AngII and ALD levels and the size of the left atrium in patients with AF were observed in order to evaluate the relationship between the combination therapy of spironolactone with RFA and the success rate in AF treatment. After therapy, the levels of AngII (52.8 vs. 64.3 pg/ml, p < .001), ALD (45.7 vs. 60.6 pg/ml, p = .016), and N-terminal of B-type natriuretic peptide (NT-proBNP) (73.5 vs. 110 pg/ml, p = .016), along with the size of the left atrium (35.8 vs. 37.2 mm, p = .007), were all significantly lower in Group PVI/SP compared with Group PVI alone. The cumulative AF-free survival rate was higher in Group PVI/SP than in Group PVI alone after treatment (85.3% vs.73.3%, p = .033). In RFA combined with spironolactone treatment, spironolactone can directly antagonize the effects of ALD and AngII and the recurrence of AF and improve left ventricular function.
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Fibrilación Atrial , Ablación por Catéter , Venas Pulmonares , Fibrilación Atrial/diagnóstico , Fibrilación Atrial/tratamiento farmacológico , Atrios Cardíacos , Humanos , Venas Pulmonares/cirugía , Recurrencia , Espironolactona/efectos adversos , Resultado del TratamientoRESUMEN
OBJECTIVE: This study aimed to investigate whether the enhanced endpoint of pulmonary vein isolation (PVI; intravenous injection of adenosine-triphosphate [ATP] + pacing capture + supplemental ablation) after initial PVI can reduce the long-term recurrence rate of atrial fibrillation (AF) after PVI. METHODS: Patients with paroxysmal or persistent AF undergoing catheter ablation treatment were enrolled in this study and divided into three groups according to the surgical endpoint: (1) group 1 (n = 92), in which patients were observed for 30 minutes after the initial PVI and pulmonary vein-left atrium (PV-LA) electrical conduction had not recovered; (2) group 2 (n = 99), in which patients were observed for 30 minutes after the initial PVI, then intravenously injected with ATP, and PV-LA electrical conduction had not recovered; and (3) group 3 (n = 102), in which patients were observed for 30 minutes after the initial PVI, then intravenously injected with ATP + treated with ablation line pacing, and the atrium could not be captured. RESULTS: Patients were followed up for 12 months after the operation. Twenty-eight patients in group 1 (30.4%), 19 patients in group 2 (19.2%), and 10 patients in group 3 (9.8%) developed a recurrence of AF. The difference between groups 1 and 3 was statistically significant (p < 0.001). At 12 months after the operation, the thickness of the left atrium, the posterior wall of the left ventricle, and the ventricular septum of the three groups of patients were significantly thinner than before the operation. Furthermore, the left ventricular ejection fraction had increased (p < 0.05 for all), and the pulmonary artery pressure had decreased (p < 0.001). CONCLUSION: For patients with paroxysmal AF or persistent AF, the enhanced endpoint of PVI after the initial PVI can reduce the long-term recurrence rate of AF after PVI.
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In the fault monitoring of rotating machinery, the vibration signal of the bearing and gear in a complex operating environment has poor stationarity and high noise. How to accurately and efficiently identify various fault categories is a major challenge in rotary fault diagnosis. Most of the existing methods only analyze the single channel vibration signal and do not comprehensively consider the multi-channel vibration signal. Therefore, this paper presents Refined Composite Multivariate Multiscale Fluctuation Dispersion Entropy (RCMMFDE), a method which extracts the recognition information of multi-channel signals with different scale factors, and the refined composite analysis ensures the recognition stability. The simulation results show that this method has the characteristics of low sensitivity to signal length and strong anti-noise ability. At the same time, combined with Joint Mutual Information Maximisation (JMIM) and support vector machine (SVM), RCMMFDE-JMIM-SVM fault diagnosis method has been proposed. This method uses RCMMFDE to extract the state characteristics of the multiple vibration signals of the rotary machine, and then uses the JMIM method to extract the sensitive characteristics. Finally, different states of the rotary machine are classified by SVM. The validity of the method is verified by the composite gear fault data set and bearing fault data set. The diagnostic accuracy of the method is 99.25% and 100.00%. The experimental results show that RCMMFDE-JMIM-SVM can effectively recognize multiple signals.
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BACKGROUND: Gallbladder cancer is a rare but highly malignant cancer, which often progresses to a metastatic stage when diagnosed because of its asymptomatic manifestation. In this study, we intended to analyze the prognostic value of metastatic gallbladder adenocarcinoma (GBA) with site-specific metastases. METHODS: Using the Surveillance, Epidemiology, and End Results (SEER) database, GBA patients diagnosed with metastases between 2010 and 2016 were selected to identify the prognosis according to the isolated metastatic sites, including liver, lung, bone, brain and distant lymph nodes (DL). Kaplan-Meier methods were used for survival comparisons and multivariable Cox regression models were constructed to find out independent factors that associated with survival. RESULTS: Data from 1526 eligible patients were extracted from the SEER database. Among the patients, 788 (51.6%) had isolated liver metastases, 80 (5.2%) had isolated distant nodal involvement, 45 (2.9%) had isolated lung metastases, 21 (1.4%) had isolated bone metastases, 2 (0.1%) had isolated brain metastases and 590 (38.7%) had multiple metastases. No significant survival difference was shown between patients with single or multisite metastases (P > 0.05). Patients with isolated lung or DL metastases had significant better survival outcomes than those with isolated bone metastases (P < 0.05). Multivariate analysis showed that performing surgery at primary site, receiving chemotherapy were associated with better OS and CSS for patients with isolated liver or DL metastases. CONCLUSIONS: The study showed that different metastatic sites affect survival outcomes in metastatic GBA patients. Highly selected subset of patients with liver or DL metastases might benefit from surgery at primary site.
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Adenocarcinoma , Neoplasias de la Vesícula Biliar , Adenocarcinoma/epidemiología , Adenocarcinoma/mortalidad , Adenocarcinoma/secundario , Anciano , Anciano de 80 o más Años , Femenino , Neoplasias de la Vesícula Biliar/epidemiología , Neoplasias de la Vesícula Biliar/mortalidad , Neoplasias de la Vesícula Biliar/patología , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia , Pronóstico , Programa de VERF/estadística & datos numéricos , Estados Unidos/epidemiologíaRESUMEN
BACKGROUND: Intrahepatic cholestasis of pregnancy (ICP) is a liver disorder that specifically occurs in pregnancy. Elevated levels of liver transaminases aspartate aminotransferase, alanine aminotransferase and serum bilirubin levels are common biochemical characteristics in ICP. The disorder is associated with an increased risk of premature delivery and stillbirth. The characterization of the potential microbiota in ICP could go a long way in the prevention and treatment of this pregnancy disease. METHODS: A total of 58 patients were recruited for our study: 27 ICP patients and 31 healthy pregnant subjects with no ICP. The V3 and V4 regions of the 16S rDNA collected from fecal samples of both diseased and control groups were amplified. 16S rRNA gene amplicon sequencing was then performed on gut microbiota. Sequencing data were analyzed and the correlation between components of microbiota and patient ICP status was found. Related metabolic pathways, relative abundance and significantly different operational taxonomic units (OTUs) between ICP and controls were also identified. RESULTS: Elevated levels of total bile acid, ALT, AST, Dbil and Tbil were recorded or observed in ICP subjects as compared to the control. Gut microbiota in pregnant women was dominated by four major phyla and 27 core genera. PCoA analysis results indicated that there was no significant clustering in Bray-Curtis distance matrices. Our results showed that there was a correlation between specific OTUs and measured clinical parameters of pregnant women. Comparison at the different taxonomy levels revealed high levels of abundance of Blautia and Citrobacter in ICP patients. At the family level, Enterobacteriaceae and Leuconostocaceae were higher in ICP patients. 638 KEGG Orthologs and 138 pathways significantly differed in the two groups. PLS-DA model with VIP plots indicated a total of eight genera and seven species were key taxa in ICP and control groups. CONCLUSIONS: Our research indicated that although there was no significant clustering by PCoA analysis, patients with ICP have increased rare bacteria at different phylogenetic levels. Our results also illustrated that all 638 KEGG Orthologs and 136 in 138 KEGG pathways were less abundant in ICP patients compared to the controls.
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Colestasis Intrahepática , Microbioma Gastrointestinal , Complicaciones del Embarazo , Femenino , Humanos , Filogenia , Embarazo , ARN Ribosómico 16S/genéticaRESUMEN
BACKGROUND: Amiodarone and propafenone are commonly used to maintain sinus rhythm in patients with atrial fibrillation (AF). However, it is not known which one is better in reducing early recurrence (ER) during the blanking period (the first three months after catheter ablation). OBJECTIVE: To compare the efficacy and safety of amiodarone and propafenone in reducing ER during the blanking period after radiofrequency catheter ablation (RFCA) in AF patients. MATERIALS AND METHODS: A total of 694 patients who underwent their first RFCA between May 2014 and May 2018 were enrolled in this retrospective study. Subsequently, 202 patients were excluded according to the exclusion criteria. The remaining 492 patients were divided into two groups based on the choice of antiarrhythmic drugs (AADs) (amiodarone or propafenone) in the blanking period. The primary outcomes were incidence of ER and AAD-associated adverse effects during the blanking period after RFCA. Propensity score matching (PSM) analyses were used to compare the outcomes of the two groups while controlling for confounders. RESULTS: Among the 492 patients who took AADs in the blanking period (187 amiodarone and 305 propafenone), PSM selected 135 unique pairs of patients with similar characteristics. Amiodarone was associated with a lower ER incidence rate (23.7% versus 48.9%, p < 0.001) and a similar rate of AAD-associated adverse effects (2.1% versus 1.5%, p = 0.652). Treatment with amiodarone in the blanking period was significantly associated with a lower ER incidence rate compared to treatment with propafenone (HR = 0.416, 95% CI 0.272-0.637, p < 0.001). CONCLUSIONS: Compared with propafenone, amiodarone was associated with a lower ER incidence rate, and they had similar rates of AAD-associated adverse effects. Treatment with amiodarone in the blanking period was shown to be more effective in reducing ER than propafenone.
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Amiodarona/administración & dosificación , Fibrilación Atrial/terapia , Ablación por Catéter , Propafenona/administración & dosificación , Anciano , Amiodarona/efectos adversos , Fibrilación Atrial/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Propafenona/efectos adversos , RecurrenciaRESUMEN
Fetal growth restriction (FGR) is a condition in which a newborn fails to achieve his or her prospective hereditary growth potential. This condition is associated with high newborn mortality, second only to that associated with premature birth. FGR is associated with maternal, fetal, and placental abnormalities. Although the placenta is considered to be an important organ for supplying nutrition for fetal growth, research on FGR is limited, and treatment through the placenta remains challenging, as neither proper uterine intervention nor its pathogenesis have been fully elucidated. Yes-associated protein (YAP), as the effector of the Hippo pathway, is widely known to regulate organ growth and cancer development. Therefore, the correlation of the placenta and YAP was investigated to elucidate the pathogenic mechanism of FGR. Placental samples from humans and mice were collected for histological and biomechanical analysis. After investigating the location and role of YAP in the placenta by immunohistochemistry, we observed that YAP and cytokeratin 7 have corresponding locations in human and mouse placentas. Moreover, phosphorylated YAP (p-YAP) was upregulated in FGR and gradually increased as gestational age increased during pregnancy. Cell function experiments and mRNA-Seq demonstrated impaired YAP activity mediated by extracellular signal-regulated kinase inhibition. Established FGR-like mice also recapitulated a number of the features of human FGR. The results of this study may help to elucidate the association of FGR development with YAP and provide an intrauterine target that may be helpful in alleviating placental dysfunction.
Asunto(s)
Proteínas Adaptadoras Transductoras de Señales/metabolismo , Movimiento Celular/fisiología , Factores de Transcripción/metabolismo , Trofoblastos/fisiología , Proteínas Adaptadoras Transductoras de Señales/genética , Animales , Línea Celular , Embrión de Mamíferos/efectos de los fármacos , Quinasas MAP Reguladas por Señal Extracelular/genética , Quinasas MAP Reguladas por Señal Extracelular/metabolismo , Femenino , Regulación de la Expresión Génica/efectos de los fármacos , Regulación de la Expresión Génica/fisiología , Humanos , Indazoles/farmacología , Ratones , Ratones Endogámicos C57BL , Fosforilación/efectos de los fármacos , Fosforilación/fisiología , Piperazinas/farmacología , Placenta , Embarazo , Factores de Transcripción/genética , Regulación hacia Arriba , Proteínas Señalizadoras YAPRESUMEN
This study aimed to evaluate the impact of the echocardiographic parameter ratio E/E' on the late recurrence of paroxysmal atrial fibrillation in patients after receiving radiofrequency catheter ablation.We retrospectively examined total of 288 paroxysmal atrial fibrillation (PAF) patients that underwent a preliminary radiofrequency catheter ablation (RFCA) in our hospital. During the first phase in this study, the patients were divided into 2 groups upon AF recurrence after RFCA: Recurrent group, nâ=â67 patients with rapid trial arrhythmia that lasted for more than 30âseconds at 3 months after RFCA and the Nonrecurrent group, nâ=â221. The clinical conditions were compared between the 2 groups. During the second phase of this study, based on the results in the first phase, the patients were divided into another 2 groups according to whether the ratio of E/E' ≥13 .45: Higher ratio of E/E' group, nâ=â55 and Lower ratio of E/E' group nâ=â233. The late AF recurrent rates were also compared between the 2 groups.During the first phase, the univariate analysis indicated that the risk factors(Pâ<â.05)for PAF late recurrence included early recurrence, E', and the ratio E/E'. The Cox multivariate analysis showed that the ratio of E/E' and early recurrence were the independent predictors for late PAF recurrence. The ratio of E/E' that was cut off at 13.45 also predicted atrial tachyarrhythmia recurrence with 40.3% sensitivity and 87.3% specificity. In the second phase, after completing the 1:1 matching, the Kaplan-Meier analysis indicated that the ratio of E/E' ≥ 13.45 was associated with further recurrences after RFCA (log-rank Pâ=â.009), compared to the patients with a ratio of E/E' < 13.45. The univariate Cox analysis indicated that an elevated ratio of E/E'(≥13.45) was the independent predictor for late PAF recurrence (HRâ=â3.322, 95%CI: 1.560-7.075, Pâ=â.002). However, the ratio of E/E' cut off at 13.25 predicted atrial tachyarrhythmia recurrence with 75% sensitivity and 62.2% specificity.The ratio of E/E' ≥ 13.25 is an important predictor of the late recurrence of paroxysmal atrial fibrillation (PAF) after radiofrequency catheter ablation (RFCA).