Arrhythmia onsets triggered by acute myocardial ischemia are not mediated by lysophosphoglycerides accumulation in ventricular myocardium.

Lysophosphoglycerides (LPLs) have been reported to accumulate in myocardium and serve as a cause of arrhythmias in acute myocardial ischemia. However, in this study we found that LPLs level in the ventricular myocardium was decreased by the onset of acute myocardial ischemia in vivo in rats. Decreasing of LPLs level in left ventricular myocardium, but not right, was observed within 26 min of left myocardial ischemia, regardless of whether arrhythmias were triggered. Lower LPLs level in the ventricular myocardium was also observed in aconitine-simulated ventricular fibrillation (P < 0.0001) and ouabain-simulated III° atrioventricular block (P < 0.0001). Shot-lasting electric shock, e.g., ≤ 40 s, decreased LPLs level, while long-lasting, e.g., 5 min, increased it (fold change = 2.27, P = 0.0008). LPLs accumulation was observed in long-lasting myocardial ischemia, e.g., 4 h (fold change = 1.20, P = 0.0012), when caspase3 activity was elevated (P = 0.0012), indicating increased cell death, but not coincided with higher frequent arrhythmias. In postmortem human ventricular myocardium, differences of LPLs level in left ventricular myocardium was not observed among coronary artery disease- and other heart diseases-caused sudden death and non-heart disease caused death. LPLs level manifested a remarkable increasing from postmortem 12 h on in rats, thus abolishing the potential for serving as biomarkers of sudden cardiac death. Token together, in this study we found that LPLs in ventricular myocardium were initially decreased by the onset of ischemia, LPLs accumulation do not confer arrhythmogenesis during acute myocardial ischemia. It is necessary to reassess the roles of LPLs in myocardial infarction.

Xylazine Poisoning in Clinical and Forensic Practice: Analysis Method, Characteristics, Mechanism and Future Challenges.

Xylazine abuse is emerging globally, while the identification of xylazine lethal cases poses a great challenge in clinical and forensic practice. The non-specific symptoms delay the diagnosis and treatment of xylazine poisoning, the pathological changes and lethal concentration of xylazine in body fluid and organs of fatal xylazine poisoning cases are seldom reported and the other toxins detected in such cases complicate the role of xylazine in the cause of death. Therefore, we carefully reviewed related updated information on xylazine, summarized the knowledge from clinical and forensic perspectives and can thus provide a reference in such cases and throw light on further study in the field of xylazine poisoning.

Effect of metformin and exenatide on pregnancy rate and pregnancy outcomes in overweight or obese infertility PCOS women: long-term follow-up of an RCT.

PURPOSE: The majority of Polycystic ovary syndrome (PCOS) are overweight or obese with increased infertility and high risk of pregnancy complications. We aim to compare efficacy of metformin and exenatide on spontaneous pregnancy rate, overall pregnancy rate after assisted reproductive technology treatment (ART) and pregnancy outcomes in overweight or obese infertility PCOS. METHODS: In this long-term follow-up study, 160 overweight or obese infertility Chinese PCOS were randomized to exenatide or metformin treatment for 12 weeks. Afterward, all were treated with metformin alone until pregnancy confirmed and followed until delivery. If patients failed spontaneous pregnancy during the second 12 weeks, ART could be offered until end of 64 weeks. The primary outcome was spontaneous pregnancy rate. RESULTS: At week 24, 29.2% of women in exenatide group conceived spontaneously while 14.7% in metformin group (p = 0.03). At week 64, total pregnancy rates were 79.2% in exenatide group and 76% in metformin group without significant difference (p = 0.65). Between two groups, there was no significant difference of pregnancy outcomes (p > 0.05). A stepwise logistic regression showed that spontaneous pregnancy was positively associated with body weight reduction and HOMA-IR improvement in either group. CONCLUSION: In overweight or obese infertility Chinese PCOS, 12 weeks pregestational exenatide treatment resulted in more spontaneous pregnancy likely due to greater weight reduction and improvement of insulin resistance compared with metformin treatment without obvious benefit on overall pregnancy rate after ART or pregnancy outcomes of successful conceived women. TRIAL REGISTRATION: This clinical trial was registered at Chinese Clinical Trials Registry (ChiCTR-IIR-16008084) on 13/3/2016.

Investigation and analysis of pain after dental implantation and its influencing factors.

OBJECTIVE: This study investigated and analyzed the pain degree after dental implantation and its influencing factors, and provided a scientific basis for reducing post-surgical pain in patients. METHODS: A total of 137 patients who underwent dental implantation between June 2018 to December 2019 were selected as the research subjects. Their pain intensity immediately after surgery, 24 h after surgery, and 72 h after surgery were evaluated respectively by a numerical rating scale (NRS), and the factors that affected the postoperative pain were analyzed by univariate and multivariate logistic regression analysis. RESULTS: The pain intensity of patients at 24 h after dental implantation was more serious than immediately after operation and 72 h after operation (P<0.05). The results of univariate and multivariate logistic regression analysis showed that the duration of surgery and whether analgesic drug was taken postoperatively were used in the regression model (P<0.05), which are independent risk factors for the occurrence of pain 24 h after surgery. CONCLUSION: The pain degree of most patients after oral implantation is mild, and the most obvious pain reaction is 24 h after operation. The use of postoperative analgesics can effectively relieve the pain of patients, and the long duration of surgery is one of the key factors leading to postoperative pain.

The curative effect of ultrasonic subgingival curettage combined with Xipayi gingival rinse on patients with chronic periodontitis.

OBJECTIVES: We explored and analyzed the effect and masticatory function of ultrasonic subgingival curettage combined with rinsing and gargling of Xipayi gingival rinse on patients with moderate to severe chronic periodontitis. METHODS: We selected 98 patients with moderate to severe chronic periodontitis admitted to our hospital, and randomly divided them into observation group and control group (n=49 in each group). The control group was treated with ultrasonic subgingival curettage. The observation group received ultrasonic subgingival curettage with Xipayi gingival rinse, and continued to use-Xipayi gingival rinse for 4 weeks. The changes of periodontal index, inflammatory degree of gingival crevicular fluid, occlusal and masticatory efficiency before and after treatment were compared. RESULTS: The periodontal indexes and the degree of inflammatory factors in gingival crevicular fluid of the two groups post-treatment decreased critically than those of pre-treatment (P<0.05), and the periodontal index and the degree of inflammatory factors in gingival crevicular fluid of the observation group was remarkably lower than those of the control group (P<0.05). The occlusal time and the balance of occlusal force of the two groups decreased significantly post-treatment compared with those of pre-treatment (P<0.05), and the indexes in observation group were dramatically lower than those in control group (P<0.05). The standard deviation of masticatory efficiency in the two groups decreased remarkably post-treatment than that of pre-treatment (P<0.05), and the index in observation group was obviously lower than that in control group (P<0.05). CONCLUSION: The combined therapy of ultrasonic subgingival curettage and Xipayi gingival rinse can effectively cure moderate to severe chronic periodontitis. Through this treatment, patients can improve periodontal condition and inhibit periodontal inflammation. Meanwhile, patients can improve the stability of occlusion and increase the bite force, thus improving the chewing efficiency. Therefore, the application of this method is worthy of clinical application.

A comparison of the effects of two orthodontic techniques in the orthodontic treatment of sagittal skeletal patterns.

OBJECTIVE: To compare the differences in the amount of dental root resorption (DRR) measured using different orthodontic techniques in the orthodontic treatment of patients with different sagittal skeletal patterns. METHODS: Ninety-three patients undergoing orthodontic treatment were randomly divided into group A (n=46) and group B (n=47). Group A was treated with bracketless invisible orthodontics and group B was treated using the self-ligating fixed orthodontic technique. Cone beam computed tomography (CBCT) was used to measure the amount of DRR in the patients with different sagittal skeletal patterns receiving the orthodontic treatment. RESULTS: After the treatment, the amounts of DRR in the maxillary and mandibular canines in both groups were lower than they were in the other 4 tooth positions (P < 0.05). The amount of DRR in the maxillary and mandibular canines in the patients with skeletal class I in both groups was lower than it was at the other four tooth positions (P < 0.05). The amount of DRR in the maxillary central incisors and maxillary canines in the patients with skeletal class II in group A was higher than it was in group B, but the amount of DRR in the mandibular canines in group A was lower than it was in group B (P < 0.05). The amounts of DRR at the six tooth positions in the patients with skeletal class III in group A were higher than the amounts in group B (P < 0.05). CONCLUSION: DRR occurs in patients with different sagittal skeletal patterns undergoing the two orthodontic techniques in the orthodontic treatment, but there are differences in the amount of DRR among the patients with different sagittal skeletal patterns receiving the orthodontic treatment. Clinically, the orthodontic method should be selected based on the type of patient.

Circulating zinc-α2-glycoprotein is reduced in women with polycystic ovary syndrome, but can be increased by exenatide or metformin treatment.

The study was to investigate circulating zinc-α2-glycoprotein (ZAG) concentrations in women with PCOS, and changes in ZAG levels after exenatide or metformin treatment. One hundred eighty-two women with polycystic ovary syndrome (PCOS) who met the 2003 Rotterdam diagnostic criteria and 150 controls without PCOS were recruited. We partitioned women with PCOS into groups according to body mass index or blood glucose concentrations, determined serum ZAG, anthropometric parameters, metabolic and endocrine indicators, and inflammatory markers, and statistically analyzed the results. Eighty-two overweight/obese subjects of the recruited women with PCOS were then randomly assigned to groups administered either 12 weeks of exenatide injection (10 µg b.i.d.) or oral metformin (1,000 mg b.i.d.). Circulating ZAG levels were determined after 12 weeks of treatment. The results showed that circulating ZAG was significantly lower in PCOS women than in healthy women (p < 0.01). Overweight/obese women and those with higher blood glucose levels had lower circulating ZAG. After 12 weeks of exenatide or metformin treatment, there were significant increases (p < 0.01) in circulating ZAG in both treatment groups (the exenatide baseline level was 46.54 ± 2.38 ng/mL vs. 56.41 ± 2.02 ng/mL after treatment, p < 0.01; metformin baseline was 47.81 ± 2.14 ng/mL vs. 55.67 ± 2.01 ng/mL after treatment, p < 0.01), however there was no statistical difference between the 2 treatments (p > 0.05). Circulating ZAG is closely related to PCOS and could be an important adipokine involved in the occurrence and development of PCOS. ZAG might possibly be applicable as a new observational indicator in the treatment of PCOS.

Efficacy of exenatide on weight loss, metabolic parameters and pregnancy in overweight/obese polycystic ovary syndrome.

CONTEXT: Weight loss remains one of the most important arms in obese patients with polycystic ovary syndrome (PCOS). Further studies are needed to identify the best treatment. OBJECTIVE: To evaluate the effects of exenatide (EXE) on reproductive and metabolic function in overweight/obese (OW/OB) PCOS. DESIGN: This is a 24-week open-label prospective, randomized, clinical study. PATIENTS AND MEASUREMENTS: This study randomized 176 OW/OB women diagnosed with PCOS to receive either EXE 10 µg BID (n = 88) or metformin (MET) 1000 mg BID (n = 88) for the first 12 weeks. Then all patients were treated with MET alone during the second 12 weeks. We observed metabolic parameters at 0 and 12 weeks, and then tracked the rate of pregnancy during the second 12 weeks. RESULTS: After the first 12 weeks of intervention, compared with MET, subjects who received EXE had significantly decreased weight (4.29 ± 1.29 kg vs 2.28 ± 0.55 kg, P < .001) and total fat% (4.67 ± 0.09% vs 1.11 ± 0.32%, P < .001), improved the homeostasis model of assessment for insulin resistance (1.30 ± 0.58 vs 0.59 ± 0.12, P < .001) and increased the menstrual frequency ratio (0.62 ± 0.12 vs 0.37 ± 0.01, P < .001). During the second 12 weeks, the rate of natural pregnancy of EXE-treated patients was significantly higher than MET-treated patients (43.60% vs 18.70%, P < .05). CONCLUSIONS: Short-term EXE therapy was linked to significant weight loss and central adiposity reduction, which may further explain the improvements in insulin resistance, inflammatory marker and menstrual cycle, which may contribute to increasing pregnancy rates in OW/OB women with PCOS.