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BACKGROUND: This study aimed to assess the public knowledge regarding Alzheimer's Disease (AD) in Zhuhai, China, focusing on identifying knowledge gaps and the influence of demographic and health factors. METHODS: A cross-sectional study was conducted in Zhuhai, China, from October to November 2022. A total of 1986 residents from 18 communities were selected employing stratified multi-stage equi-proportional sampling. Questionnaires covering general information and the Alzheimer's Disease Knowledge Scale (ADKS) were investigated face-to-face. Ordinal multiclass logistic regression was applied to assess the relationship between AD awareness and demographic and health characteristics. RESULTS: The average ADKS score was 18.5 (SD = 3.36) in Zhuhai. The lowest awareness rates were observed in the "Symptoms" and "Caregiving" subdomains of ADKS, with rates of 51.01% and 43.78%, respectively. The correct rates for the 30 ADKS questions ranged from 16.62 to 92.6%, showing a bimodal pattern with clusters around 80% and 20%. Women (OR = 1.203, 95% CI: 1.009-1.435), individuals aged 60 years or older (OR = 2.073, 95% CI: 1.467-2.932), those living in urban areas (OR = 1.361, 95% CI: 1.117-1.662), higher average monthly household income per capita (OR = 1.641, 95% CI: 1.297-2.082), and without any neurological or mental disorders (OR = 1.810, 95% CI: 1.323-2.478) were more likely to have higher levels of awareness about Alzheimer's disease. CONCLUSIONS: Adults in Zhuhai show a limited knowledge of AD, particularly in the 'Symptoms' and 'Caregiving' subdomains. Upcoming health campaigns must focus on bridging the knowledge gaps in different subdomains of AD, especially among subgroups with lower awareness, as identified in our study.
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Enfermedad de Alzheimer , Conocimientos, Actitudes y Práctica en Salud , Humanos , Estudios Transversales , China/epidemiología , Masculino , Femenino , Persona de Mediana Edad , Anciano , Adulto , Encuestas y Cuestionarios , Adulto JovenRESUMEN
This study aims to identify the level and trend of alcohol imagery in popular films in China from 2001 to 2020. We divided the running time of the annual 20 top-grossing films in China into 5-min intervals and coded those containing alcohol imagery, the presence of warnings, whether the imagery was related to minors and alcohol brands. Results showed that alcohol imagery occurred in 90.75% (363/400) of the films and 25.26% (2380/9423) of the intervals; these proportions remained stable over time. No film containing alcohol imagery had warnings, alcohol imagery related to minors appeared each year, and 103 alcohol brands were present in 185 intervals across 93 of the 400 films. Chinese films contained more alcohol imagery than international films. National policies are required to restrict alcohol imagery in films and to reduce the availability of such films for viewing by young people.
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Películas Cinematográficas , China , Humanos , Películas Cinematográficas/estadística & datos numéricos , Bebidas Alcohólicas , Consumo de Bebidas Alcohólicas/epidemiología , AdolescenteRESUMEN
BACKGROUND: To discuss the current status of reproductive concerns and its correlation with fear of recurrence and level of family support in patients of childbearing age with gynecologic malignancies. METHODS: A convenient sampling method was used to enroll 188 patients with gynecologic malignancies in Nanjing Maternity and Child Health Care Hospital, Nanjing Drum Tower Hospital, General Hospital of Ningxia Medical University, and Haian Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine from September 2022 to April 2023. Patients were assessed using general information questionnaire, Reproductive Concerns After Cancer Scale (RCAC), Fear of Cancer Recurrence Inventory (FCRI) questionnaire, and Perceived Social Support-Family (PSS-FA) Scale. RESULTS: Among patients of childbearing age with gynecologic malignancies, the total RCAC score was (54.35 ± 7.52), indicating a moderate level of reproductive concerns. Patients scored (20.98 ± 4.51) on FCRI, implying a moderate level of fear of recurrence. The PSS-FA score was (9.57 ± 2.76), denoting a moderate level of family support. The total score and each dimensional score of RCAC were positively correlated with FCRI total score (P < 0.05), and negatively correlated with PSS-FA total score (P < 0.05). Fear of recurrence, family support level, number of children, educational background, treatment modality, and fertility intention were influencing factors for reproductive concerns in patients of childbearing age with gynecologic malignancies (all P < 0.05). CONCLUSION: The reproductive concerns, fear of recurrence and family support are all at moderate levels in patients of childbearing age with gynecologic malignancies, and reproductive concerns are positively correlated with fear of recurrence and negatively correlated with family support.
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Apoyo Familiar , Miedo , Neoplasias de los Genitales Femeninos , Recurrencia Local de Neoplasia , Adolescente , Adulto , Femenino , Humanos , Persona de Mediana Edad , Adulto Joven , China/epidemiología , Miedo/psicología , Neoplasias de los Genitales Femeninos/psicología , Recurrencia Local de Neoplasia/psicología , Encuestas y CuestionariosRESUMEN
To reveal the mechanism of CO gas generation and adsorption in coal gangue slits at the microscopic level, a new composite kaolinite-coal-kaolinite (KCK) slit model was constructed by combining the Hongqingliang (HQL) coal molecular model and the Bish kaolinite model to characterize the crack structure of the gangue. It is compared with the kaolinite model (TriK) commonly used in gangue research. Molecular dynamics was used to study the production of CO in different oxygen environments and variation in the adsorption amount, adsorption sites and diffusion coefficient in the temperature range from 293.15 K to 333.15 K. The results indicate that CO mainly comes from the decomposition of ether and phenol in organic structures, and the lower the oxygen concentration, the lesser the CO production time. The KCK model has a higher average adsorption capacity and weaker diffusion capacity mainly due to the additional adsorption sites provided by the carbon-containing structural layer, and CO is mainly adsorbed near the oxygen-containing functional groups. Although kaolinite exhibits bonding adsorption on the Al-O plane, its adsorption site is limited to the surface. The slit model with the carbon structure can better reflect the complex conditions of gas motion in the gangue, thus providing a reference to determine the spontaneous combustion conditions of the gangue hill via the index gas.
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Photodynamic therapy (PDT) is a rapidly growing discipline that is expected to become an encouraging noninvasive therapeutic strategy for cancer treatment. In the PDT process, an efficient intersystem crossing (ISC) process for photosensitizers from the singlet excited state (S1) to the triplet excited state (T1) is critical for the formation of cytotoxic reactive oxygen species and improvement of PDT performance. Thermally activated delayed fluorescence (TADF) molecules featuring an extremely small singlet-triplet energy gap and an efficient ISC process represent an enormous breakthrough for the PDT process. Consequently, the development of advanced TADF photosensitizers has become increasingly crucial and pressing. The most recent developments in TADF photosensitizers aimed at enhancing PDT efficiency for bio-applications are presented in this review. TADF photosensitizers with water dispersibility, targeting ability, activatable ability, and two-photon excitation properties are highlighted. Furthermore, the future challenges and perspectives of TADF photosensitizers in PDT are proposed.
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Neoplasias , Fotoquimioterapia , Fármacos Fotosensibilizantes , Fotoquimioterapia/métodos , Fármacos Fotosensibilizantes/química , Fármacos Fotosensibilizantes/uso terapéutico , Fármacos Fotosensibilizantes/farmacología , Humanos , Neoplasias/tratamiento farmacológico , Especies Reactivas de Oxígeno/metabolismo , Fluorescencia , Colorantes Fluorescentes/químicaRESUMEN
BACKGROUND: This study aimed to assess the safety and effectiveness of a novel technique for catheter ablation in patients with premature ventricular contraction (PVC) from the free wall of tricuspid annulus (TV). HYPOTHESIS: We hypothesized that the novel technique is more efficacious than the traditional approach. METHODS: We retrospectively investigated 59 consecutive patients with PVC originating from the free wall of TV between January 2013 and November 2021. The patients were divided into two groups: the reversed S-curve technique group (RST, n = 26) and the reversed C-curve technique group (RCT, n = 33). The RST under the support of a steerable sheath was used in RST group, while the RCT under the support of a nonsteerable sheath was used in the RCT group. Systematic mapping and radiofrequency ablation were preferentially performed under the valve in all patients. RESULTS: Compared to the RCT group, total procedural time and fluoroscopic exposure time were significantly shorter in RST group. Two patients experienced cardiac tamponade in the RCT group, while no complications were observed in RST group (p = .498). The success rate was significantly higher in RST group compared to RCT group (81.9% vs. 100%, p = .029). Three patients in RCT group failed to ablate during the operation but were successfully ablated using the novel method. During regular follow-up, no patients in the RST group had a recurrence, while three patients in the RCT group did (p = .274). CONCLUSIONS: It suggests that the reserved S-curve technique, supported by a steerable sheath, is a feasible and effective method for ablating PVC originating from the free wall of TV.
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Ablación por Catéter , Complejos Prematuros Ventriculares , Humanos , Complejos Prematuros Ventriculares/diagnóstico , Complejos Prematuros Ventriculares/cirugía , Estudios Retrospectivos , Ablación por Catéter/efectos adversos , Ablación por Catéter/métodos , Catéteres , Resultado del TratamientoRESUMEN
BACKGROUND: The temporary pacing lead routinely is placed into right ventricular (RV), which pose a risk of dislocation and cardiac perforation. OBJECTIVE: We aim to evaluate the effectiveness and safety of temporary transvenous cardiac pacing (TTCP) leads placement into the coronary sinus vein (CSV) in patients with sick sinus syndrome (SSS). METHODS: We investigated patients with SSS who underwent TTCP lead placement into the CSV under the guidance of X-ray between January 2013 and May 2023. Patients were randomly divided into two groups: RV group (n = 33) and CSV group (n = 22). The ordinary passive bipolar electrodes were applied in both groups. In RV groups, electrodes were placed into RV. In CSV group, electrodes were placed into CSV. We evaluated the operation duration, fluoroscopic exposure, first-attempt success rate of leads placement, pacing threshold, success rate of leads placement, rate of leads displacement, and complications. RESULTS: Compared with that in RV group, the procedure time, fluoroscopic exposure was significantly prolonged, while the first-attempt success rate of lead placement was obviously increased in CSV group (both p < .05). Compared with that in RV group, the rate of leads displacement is lower in CSV group (both p < .05). There were three patients occurred cardiac perforation in RV group, but no cardiac perforation was reported in CSV group (p > .05). CONCLUSION: TTCP leads placement into the CSV is an effective and safe strategy in patients with SSS. It indicates a high rate of pacing effectiveness with low device replacement and complication rates.
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Seno Coronario , Marcapaso Artificial , Humanos , Seno Coronario/diagnóstico por imagen , Estimulación Cardíaca Artificial/efectos adversos , Estimulación Cardíaca Artificial/métodos , Síndrome del Seno Enfermo/terapia , ElectrocardiografíaRESUMEN
BACKGROUND: Posteroseptal accessory pathways (APs) associated with coronary sinus (CS) diverticulum present a rare and challenge for ablation. This study aimed to compare the safety and efficacy of conventional approach and three-dimensional (3D) mapping system in the catheter ablation. METHODS AND RESULTS: This was a retrospective study of all patients (from January 2013 to July 2022) who underwent catheter ablation of posteroseptal AP associated with CS diverticula in our center. Patients who underwent catheter ablation using the traditional fluoroscopy method were included in the conventional method group (n = 13). Patients who underwent catheter ablation using the 3D mapping method were included in the 3D mapping group (n = 11). Clinical characteristics, ablation procedure, and outcomes were recorded and analyzed between the two groups. Out of 669 patients with posteroseptal APs, 24 of them (3.6%) were associated with CS diverticula. All patients in both groups successfully completed the electrophysiological study. In the conventional method group, two patients experienced complications (one patient with pericardial effusion and the other patient with femoral arterial hematoma), and two patients had recurrence. However, no patients suffered from complications or recurrence during follow-up. The procedure time and fluoroscopy time in the conventional method group were significantly longer than those in the 3D mapping method group. CONCLUSIONS: The utilization of 3D mapping led to reduced fluoroscopy time, shorter procedure duration, enhanced acute success rates, and decreased incidence of complications.
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Fascículo Atrioventricular Accesorio , Ablación por Catéter , Seno Coronario , Divertículo , Cardiopatías Congénitas , Humanos , Seno Coronario/diagnóstico por imagen , Seno Coronario/cirugía , Estudios Retrospectivos , Electrocardiografía/métodos , Fascículo Atrioventricular Accesorio/diagnóstico por imagen , Fascículo Atrioventricular Accesorio/cirugía , Cardiopatías Congénitas/cirugía , Ablación por Catéter/métodos , Divertículo/complicaciones , Divertículo/diagnóstico por imagen , Divertículo/cirugíaRESUMEN
In this study, we simulated the actual landfill disposal process using accelerated carbonization experiments, based on the leaching characteristics of heavy metals from "alkaline" fly ash, and used the LandSim-HELP coupling model to assess the environmental risk of the leaching. The results showed that the leaching data of "alkaline" fly ash before carbonization showed the illusion of admission to landfill with only a small amount of chemical addition or even without curing/stabilization. The leached concentrations of Zn and Cd from "alkaline" fly ash after carbonation were significantly higher. The risk assessment of the leakage of heavy metals in the case of a single artificial composite liner system showed that the exposure concentrations of Pb, Zn, and Cd in samples exceeded Standard for groundwater quality (GB/T 14848-2017) the Class III permissible limits after carbonation; exposure risk for Cd was exceeded in all samples. However, although the use of a double-layer artificial composite liner to improve the level of impermeability effectively reduced the risk of Cd leaching, so that none of the non-carcinogenic risks exceeded the standard, the carcinogenic risk of Cd in the carbonized samples exceeded the factor of 1.1-4.5 of the acceptable hazard quotient, and the contamination characteristics of the alkaline fly ash still need to be kept in view.
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Metales Pesados , Eliminación de Residuos , Ceniza del Carbón , Cadmio , Incineración , Medición de Riesgo , Instalaciones de Eliminación de Residuos , Carbono , Material Particulado , Eliminación de Residuos/métodosRESUMEN
PURPOSE: Recent years have seen a clear link established between elevated ferritin levels and COVID-19 prognosis. However, the impact of heightened ferritin levels on the prognosis of individuals with severe ischemic heart disease remains uncertain. METHODS: We utilized the MIMIC IV database to identify a cohort of ischemic heart disease patients who underwent serum ferritin testing. We conducted regression analyses, employed the overlap propensity score weighting model, and utilized the restricted cubic splines model to comprehensively investigate the associations between serum ferritin levels and clinical outcomes. RESULTS: Our cohort included 1173 patients with diagnosed ischemic heart disease, categorized into high and low serum ferritin groups. After meticulous adjustment for confounding factors in a fully adjusted model, the hazard ratios (HRs) for 90-day and 1-year mortality were 1.63 (95% CI: 1.27-2.09) and 1.49 (95% CI: 1.19-1.86), respectively, in the high-ferritin group compared to the low-ferritin group. Subsequent analyses with propensity score weighting confirmed these results. Remarkably, restricted cubic spline analysis revealed an almost linear relationship between log-transformed serum ferritin levels and the risk of both 90-day and 1-year all-cause mortality. Moreover, incorporating ferritin into conventional severity of illness scores significantly improved the area under the curve for both 90-day and 1-year mortality. CONCLUSIONS: This study provides compelling evidence regarding the prognostic significance of serum ferritin in predicting 90-day and one-year mortality rates among patients diagnosed with ischemic heart disease.
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Background: Alzheimer's disease (AD) is a major cause of disability and mortality in older adults. This study aimed to investigate the association of AD with education and genetic factors. Methods: We conducted a prospective cohort study using data from the UK Biobank. Genetic risk was assessed using a polygenic risk score for AD. The educational level was categorized as either low, intermediate, or high. AD was defined using the International Classification of Diseases and Related Health Problems, 10th revision. Logistic regression models were used to investigate the independent and combined effects of genetic factors and educational levels on the risk of AD. Results: We included 318,535 participants in this study (age: 56.53 ± 8.09 years; male: 44.81%). Compared with a low genetic risk, a high genetic risk was associated with a significantly greater risk of AD (OR = 7.09, 95% CI: 6.09-8.26). A high educational level was associated with a 30% lower risk of AD compared with a low educational level (OR = 0.70, 95% CI: 0.60-0.81). Combining genetic risk and education categories, individuals with a low genetic risk and high educational level had a more than 90% (OR = 0.09, 95% CI: 0.05-0.16) lower risk of AD compared to those with a high genetic risk and low educational level. There was no significant interaction between genetic risk and educational level regarding AD risk (p for interaction = 0.359). Conclusion: Education counteracts the genetic risk of AD, without an interaction effect. Increasing education to reduce the incidence of AD is of same importance across individuals with different genetic risk.
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Enfermedad de Alzheimer , Masculino , Humanos , Anciano , Persona de Mediana Edad , Enfermedad de Alzheimer/epidemiología , Enfermedad de Alzheimer/genética , Estudios Prospectivos , Escolaridad , Factores de Riesgo , Modelos LogísticosRESUMEN
Aims: There is still no non-invasive septal reduction therapy for patients with hypertrophic obstructive cardiomyopathy (HOCM). This study aimed to investigate the feasibility, safety, and efficacy of stereotactic body radiotherapy (SBRT) in patients with drug-refractory symptomatic HOCM. Methods and results: The radiation target of ventricular septum was determined by multiple anatomical imaging. Stereotactic body radiotherapy was performed with standard techniques. Patients were treated with a single fraction of 25â Gy, followed up at 1, 3, 6, and 12â months by clinical visit. Five patients were enrolled and completed the 12â months follow-up. The mean radioablation time was 21.6â min, and the mean target volume was 10.5â cm3. All five patients survived and showed improvements in symptoms after SBRT. At 12â months post-SBRT, the echocardiography-derived left ventricular outflow tract gradient decreased from 88â mmHg (range, 63-105) to 52â mmHg (range, 36-66) at rest and from 101â mmHg (range, 72-121) to 74â mmHg (range, 65-100) after Valsalva. The end-diastolic thickness of the targeted septum reduced from 23.7â mm (range, 20.3-29) to 22.4â mm (range, 19.7-26.5); 6â min walking distance increased from 190.4â m (range, 50-370) to 412.0â m (range, 320-480). All patients presented with new fibrosis in the irradiated septum area. No radiation-related complications were observed during SBRT and up to 12â months post procedure. Conclusion: The current study suggests that SBRT might be a feasible radioablation therapeutic option for patients with drug-refractory symptomatic HOCM. Trial registration: ClinicalTrials.gov Identifier: NCT04686487.
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It is challenging to achieve stable and efficient radical emissions under ambient conditions. Herein, we present a rational design strategy to protect photoinduced carbonyl free radical emission through electrostatic interaction and spin delocalization effects. The host-guest system is constructed from tricarbonyl-substituted benzene molecules and a series of imidazolium ionic liquids as the guest and host, respectively, whereby the carbonyl anion radical emission can be in situ generated under the light irradiation and further stabilized by electrostatic interaction. More importantly, the anion species and the alkyl chain length of imidazolium ionic liquids show a noticeable effect on luminescence efficiency, with the highest radical emission efficiency is as high as 53.3 % after optimizing the imidazole ionic liquid's structure, which is about four times higher than the polymer-protected radical system. Theoretical calculations confirm the synergistic effect of strong electrostatic interactions and that the spin delocalization effect significantly stabilizes the radical emission. Moreover, such a radical emission system also could be integrated with a fluorescent dye to induce multi-color or even white light emission with reversible temperature-responsive characteristics. The radical emission system can also be used to detect different amine compounds on the basis of the emission changes and photoactivation time.
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BACKGROUND: Vasovagal syncope (VVS) is the leading cause of syncope. The most frequent mechanism is that of a cardioinhibitory response, vasodepressor response, or mixture of both. Neural stimulation that negates or overcomes the effects of vagal tone may be used as a treatment strategy for VVS. METHODS: Six male canines were studied. Stimulation (10-Hz, 2 ms pulse duration, 2 min duration) of the cervical vagus (CV), thoracic vagus (TV), and stellate ganglia (SG) was performed using needle electrodes at 3 V, 5 V, and 10 V output. SG stimulation at an output of 10 V overlaying TV stimulation at the same output was performed. Heart rate (HR), blood pressure (BP), and cardiac output (CO) were measured before, during, and after stimulation. RESULTS: Right cervical vagal stimulation was associated with significant hemodynamic changes. HR, SBP, and DBP were reduced (107 ± 16 vs. 78 ± 15 bpm [P < 0.0001], 116 ± 24 vs. 107 ± 28 mmHg [P = 0.002] and 71 ± 18 vs. 58 ± 20 mmHg [P < 0.0001]), respectively, while left cervical vagal stimulation had minimal changes. CV stimulation was associated with greater hemodynamic changes than TV stimulation. Left and right SG stimulation significantly increased systolic blood pressure (SBP), diastolic blood pressure (DBP), and HR at 5 V and 10 V, which could be observed within 30 s after stimulation. An output-dependent increase in hemodynamic parameters was seen with both left and right SG stimulation. No difference between left and right SG stimulation was seen. SG stimulation overlay significantly increased HR, BP, and CO from baseline vagal stimulation bilaterally. CONCLUSIONS: Stellate ganglia stimulation leads to increased HR and BP despite significant vagal stimulation. This may be exploited therapeutically in the management of vasovagal syncope.
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BACKGROUND: Evidence indicates that certain healthy lifestyle factors are associated with non-alcoholic fatty liver disease (NAFLD). However, little is known about the effect of combined healthy lifestyle factors. OBJECTIVE: To assess the association of combined healthy lifestyle factors with the incidence of NAFLD. METHODS: This cohort study was conducted in Changsha, Hunan Province, China. The healthy lifestyles factors studied were not being a current smoker, having a healthy diet, engaging in physical activity, having a normal body mass index (BMI) and engaging in non-sedentary behavior. NAFLD was diagnosed based on abdominal ultrasonography. Logistic regression models were conducted to investigate the associations being studied. RESULTS: Of the 5411 participants, 1280 participants had NAFLD, with a prevalence of 23.7% at baseline. The incidence of NAFLD among participants without NAFLD at baseline was found to be 7.2% over a mean follow-up of 1.1 years. Compared with participants with 0-1 low-risk factors, the OR of NAFLD was 0.50 (95% CI: 0.29-0.82, p = 0.008) for those with at least 4 low-risk factors. Similar associations were observed in subgroup analyses and sensitivity analyses. CONCLUSION: This study suggests that a combined healthy lifestyle pattern may considerably decrease the risk of NAFLD in Chinese government employees.
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Enfermedad del Hígado Graso no Alcohólico , Humanos , Enfermedad del Hígado Graso no Alcohólico/etiología , Estudios de Cohortes , Estudios Prospectivos , Empleados de Gobierno , Factores de Riesgo , Estilo de Vida Saludable , China/epidemiologíaRESUMEN
BACKGROUND: Depression is a common complication after myocardial infarction (MI) that can seriously affect the prognosis of MI. PURPOSE: To investigate whether formononetin could ameliorate MI injury and depressive behaviours in a mouse model of MI with depression and elucidate its underlying molecular mechanisms. METHODS: Haemodynamic measurements (systolic blood pressure (SYS), the maximum rate of rise of LV pressure (± dp/dtmax)) and behavior tests (tail suspension test, sucrose preference test, forced swimming test) were used to evaluate the effects of formononetin on male C57BL/6N mice after left anterior descending (LAD) coronary artery ligation and chronic unpredictable stress. RT-qPCR, immunohistochemistry, immunofluorescence analysis, western blotting, molecular docking technology, surface plasmon resonance and gene-directed mutagenesis were used to clarify the underlying mechanism. RESULTS: Formononetin significantly suppressed the depressive behaviours and improved cardiac dysfunction in MI with depression mice model. Formononetin inhibited M1 polarization in macrophages/microglia, while promoting M2 polarization. Importantly, elevated serum IL-6 and IL-17A levels were found in patient with MI, and the patient serum induced M1 microglial polarization; however, formononetin reversed the polarization. Further mechanistic studies showed that formononetin inhibited GSK-3ß activity and downstream Notch1 and C/EBPα signaling pathways. Covalent molecular docking showed that formononetin bound to Cys199 of GSK-3ß and it has a high affinity for GSK-3ß. When Cys199 was mutation, the inhibitory effect of formononetin on GSK-3ß activity and M1 polarization in macrophages/microglia were also partly blocked. CONCLUSIONS: Our results firstly uncovered that formononetin improved cardiac function and suppressed depressive behaviours in mice after MI with depression by targeting GSK-3ß to regulate macrophage/microglial polarization. More importantly, IL-6 and IL-17A produced after MI may cause neuroinflammation, which might be the key factors for depression. Formononetin may be a potential drug for treating MI with depression.
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Microglía , Infarto del Miocardio , Ratones , Masculino , Animales , Microglía/metabolismo , Glucógeno Sintasa Quinasa 3 beta/metabolismo , Interleucina-17/metabolismo , Depresión/tratamiento farmacológico , Depresión/etiología , Interleucina-6/metabolismo , Simulación del Acoplamiento Molecular , Ratones Endogámicos C57BL , Infarto del Miocardio/complicaciones , Infarto del Miocardio/tratamiento farmacológico , Infarto del Miocardio/metabolismo , Macrófagos/metabolismoRESUMEN
Hypertrophic obstructive cardiomyopathy (HOCM) is a hereditary cardiac disorder characterized primarily by septal hypertrophy and left ventricular outflow tract obstruction. Traditional therapeutic modalities, such as medications and surgeries, do not yield satisfactory outcomes in a subset of patients. The advancements have been made in novel treatments, including new drugs and percutaneous intramyocardial septal radiofrequency ablation (PIMSRA), still need further observation to obtain long-term efficacy and safety. In recent years, stereotactic body radiation therapy (SBRT) has emerged as an innovative non-invasive approach for treating HOCM. Studies indicate that SBRT allows for precise targeting of the hypertrophied septal region, causing both direct and indirect damage to targeted myocardial cells. This can alleviate left ventricular outflow tract obstruction and myocardial ischemia, fulfilling the therapeutic objective. For those with HOCM who neither respond well to medications nor are surgical candidates, SBRT offers a potential new therapeutic alternative. However, the latent risks of radiation therapy persist, such as the onset of radiation-induced heart disease (RIHD). The preliminary investigations guarantee the safety and feasibility of SBRT in HOCM management, an increased volume of clinical studies and prolonged follow-up data are essential to evaluate its real efficacy and potential hazards. In addition, research regarding the therapeutic mechanisms of SBRT for HOCM, optimal dosages and treatment durations, indications and contraindications, prevention of complications, and enhancing the precision of radiation therapy, still needs to be further exploration, to determine the best therapeutic strategies.
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Cardiomiopatía Hipertrófica , Cardiopatías , Radiocirugia , Obstrucción del Flujo de Salida Ventricular Izquierda , Humanos , Cardiomiopatía Hipertrófica/radioterapia , Miocitos CardíacosRESUMEN
A 71-year-old female with a dual-chamber pacemaker presented to our hospital complaining of repeated chest pain. She was diagnosed with unstable angina. On day 7, the patient suddenly suffered cardiopulmonary arrest due to an inferior ST segment elevation myocardial infarction (STEMI). Pacemaker lost capture was suspected and was later confirmed by a pacemaker check with a high pacing threshold and a low sensing parameter. Emergency coronary angiography revealed that a large filling defect remained due to an extensive thrombus in the proximal left circumflex (LCX) with thrombolysis in myocardial infarction (TIMI) grade 2 flow, and then a repeat thrombus aspiration was performed. After reperfusion, the parameters of the right ventricular lead were gradually returned. We conclude that the loss of the right ventricular lead pacing occurred in this case of acute coronary syndrome (ACS) induced by an LCX thrombus due to an LCX supplying the right ventricular septal.
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Objectives: Evidence has shown that nocturnal sleep duration is associated with the risk of hyperuricemia, yet the findings are inconsistent. Thus, we aimed at exploring the association between nocturnal sleep duration and the risk of hyperuricemia in Chinese government employees. Methods: A total of 10,321 government employees aged 20-60 years were collected from the Cohort Study on Chronic Diseases among Government Employees in Hunan Province, China. Sleep duration was self-reported. And serum uric acid levels >420 µmol/L in men and >360 µmol/L in women were considered hyperuricemia. The association between nocturnal sleep duration and hyperuricemia risk was examined utilizing multivariate logistic regression models. To further examine the connection between nocturnal sleep duration and serum uric acid levels, multiple linear regression analyses were utilized. Results: The prevalence of hyperuricemia was 17.2%. The results of logistic regression demonstrated that, in contrast to participants whose sleep duration was 7-8 h, those who slept for <7 h had an elevated risk of hyperuricemia (OR = 1.343, 95%CI: 1.126, 1.601). Further stratified analysis revealed that this association was still observed in those without obesity (OR = 1.365; 95%CI: 1.127, 1.655), hypertension (OR = 1.290, 95%CI: 1.054, 1.578), or diabetes mellitus (OR = 1.361, 95%CI: 1.136, 1.631). Multiple linear regression showed that shorter sleep duration (< 7 h) was positively correlated with serum uric acid levels. In comparison to individuals who slept for 7-8 h, those with sleep duration of fewer than 7 h had serum uric acid levels that were 7.231 µmol/L (95% CI: 2.875, 11.588) higher. Conclusion: Short nocturnal sleep duration (< 7 h) was associated with a higher risk of hyperuricemia, especially in participants without obesity, hypertension, or diabetes mellitus. Besides, short nocturnal sleep duration was related to greater uric acid levels.