A systematic review of guidelines for dual antiplatelet therapy in coronary artery bypass graft.

BACKGROUND: In most situations, many patients undergoing coronary artery bypass graft (CABG) are on dual antiplatelet therapy (DAPT), which is also required after CABG. The adjustment of antiplatelet strategy remains controversial. In this study, we systematically review current guidelines, seeking consensus and controversies to facilitate clinical practice. METHODS AND RESULTS: Guidelines are searched in PubMed, Embase, ECRI Guidelines Trust and websites of guidelines organizations and professional society. Guidelines with recommendations of DAPT for patients undergo CABG are included. Two reviewers appraised guidelines with the Appraisal of Guidelines for Research and Evaluation II (AGREE II). Relevant recommendations are extracted and summarized. A total of 14 guidelines meeting inclusion criteria are selected, with average AGREE II scores from 44% to 86%. Most guidelines score high in domains other than 'applicability'. Many guidelines are not detailed enough in reporting considerations behind recommendations. Current guidelines are consistent on the management of antiplatelet strategy before elective CABG and using DAPT after surgery for preventing graft vessel occlusion. Evidence is still lacking in urgent CABG and resumption of the previous DAPT after surgery. CONCLUSIONS: Current guidelines on DAPT in CABG are generally satisfying. Suspending P2Y12 inhibitors while aspirin continued before elective CABG is recommended, as well as 12 months of DAPT following CABG. More evidence is needed to guide antiplatelet therapy in urgent CABG and to prove the benefits of resuming previous DAPT.

Identification and expression analysis of a new invertebrate lysozyme in Kuruma shrimp (Marsupenaeus japonicus).

Lysozyme is an important component of the innate immunity system against invading pathogens. An invertebrate (i-type) lysozyme from the hepatopancreas of Kuruma shrimp Marsupenaeus japonicus (Mj-ilys) was identified. The full-length cDNA of Mj-ilys was 580bp with a 429 bp open reading frame encoding a 142 amino acid polypeptide. The encoded polypeptide was predicted to have a 17 amino acid signal peptide, and a 125 amino acid mature protein with a theoretical mass of 14.099 kDa and an isoelectric point (pI) of 4.18. A Destabilase conserved domain was predicted in Mj-ilys amino acid sequences which may be stable by 10 cysteine residues forming 5 disulfide bonds. Mj-ilys may loss the muramidase and isopeptidase activities due to the lack of the key catalytic residues. Mj-ilys had high homologous of 80-82% with i-type lysozymes of penaeid shrimps. It was first grouped with other i-type lysozyme of shrimps and crabs in a phylogenetic tree predicted by the Neighbor-Joining method. Mj-ilys mRNA was expressed mainly in hepatopancreas and almost undetectable in other tissues. The mRNA expression of Mj-ilys were all found from fertilized eggs to post-larvae of 17 days (PL17), and its expression exhibited significant differences among each developmental stage. After white spot syndrome virus (WSSV) challenge (3.6 × 10(8) virions/µl), the time-dependent expression pattern of Mj-ilys in hepatopancreas and gills showed significantly different. These results indicated that Mj-ilys is potentially involved in the ontogenesis and immune defense in Kuruma shrimp.

Identification and expression analysis of a novel stylicin antimicrobial peptide from Kuruma shrimp (Marsupenaeus japonicus).

Antimicrobial peptides (AMPs) are important components of the innate immune system and function as the first line of defense against invading pathogens. In current study we identified, cloned and characterized a novel stylicin AMP from Kuruma shrimp Marsupenaeus japonicus (Mj-sty). The full-length cDNA of Mj-sty was 428 bp with an open reading frame of 315 bp that encoded 104 amino acids. The theoretical molecular mass of mature Mj-sty was 8.693 kDa with an isoelectric point (pI) of 4.79. A proline-rich N-terminal region and a C-terminal region contained 13 cysteine residues were identified. Genomic sequence analysis with respect to its cDNA showed that Mj-sty was organized into two exons interrupted by one intron. Tissue-specific expression revealed that Mj-sty was mainly transcribed in gills and hemocytes. Expression of Mj-sty in early developmental stages demonstrated that Mj-sty mRNA were present from fertilized eggs to post-larvae of 17 days (PL17), and the expression levels showed a significant variation in different developmental stages. After challenge of white spot syndrome virus (WSSV), the time-dependent expression pattern of Mj-sty in both gills and hepatopancrease showed down-regulation at the early hours of infection, subsequently up-regulation and down-regulation, and then up-regulation at the end hours to almost the half of the controls. The results indicate that Mj-sty is potentially involved in the ontogenesis and immune responses against WSSV.

Anion-dependent assembly of four sensitized near-infrared luminescent heteronuclear Zn(II)-Yb(III) Schiff base complexes from a trinuclear Zn(II) complex.

Four anion-dependent 0D Zn(II)-Yb(III) heterometallic Schiff base complexes, [YbZn2L2(OAc)4]·ClO4 (2), YbZnL2(NO3)3 (3), [(YbL)2(H2O)Cl(OAc)]2·[ZnCl4]2 (4), and YbZnL(OAc)4 (5), were assembled through central metal substitution or reconstruction from homotrinuclear Zn(II) complex {[(Zn(OAc)(H2O)L]2Zn}(ClO4)2·4H2O [1; HL = 2-ethoxy-6-[(pyridin-2-ylmethylimino)methyl]phenol] with different Yb(III)X3 salts [X = ClO4 (2), NO3 (3), Cl (4), and OAc (5)], in which the Zn(II)-sensitized near-infrared luminescent performances in the four complexes 2-5 are closely related to their structural models.

Strategy of pacemaker and electrode replacement for superior vena cava stenosis.

Cardiac implantable devices are commonly used for superior vena cava stenosis, but there have been few reports of electrode replacement in the stenosed superior vena cava. A 73-year-old man was diagnosed with second-degree type II atrioventricular block and a permanent dual-chamber, rate-modulated pacing pacemaker was implanted 10 years previously. Because of depletion of the pacemaker battery and an increase in the ventricular pacing threshold, replacement of the pacemaker and ventricular electrode was required. During the operation, we found that the patient had severe superior vena cava stenosis on angiography, and this caused obstruction when a common guidewire was used to pass through the superior vena cava. After attempting various methods, we successfully passed through the vascular stenosis with a super slide guidewire and a long sheath, and completed replacement of the pacemaker and ventricular electrode. We summarize the related literature of superior vena cava stenosis related to a cardiac implantable device, and discuss the replacement strategy of this complication and other treatment options.

Therapeutic strategy of central vein perforation accompanied by a mediastinal lesion after catheterization.

Central vein perforation associated with a mediastinal lesion is a rare complication of catheterization. A 50-year-old woman was diagnosed with chronic kidney disease and required hemodialysis treatment. The patient developed central vein injury during attempted placement of a double-channel catheter. A computed tomographic scan and venography showed that the catheter had punctured the mediastinum from the central vein. After comprehensive assessment and multidisciplinary consultation, percutaneous catheter thrombin injection with follow-up balloon dilatation under fluoroscopy guidance successfully fixed the perforation. We summarize the therapeutic strategy of this complication and other treatment options, and discuss the related literature of central vein injury.

Construction of four low-dimensional NIR-luminescence-tunable Yb(III) complexes.

Four low-dimensional ytterbium(iii)-organic compounds through hydrothermal reactions of quinoline-2,3-dicarboxylic acid (2,3-H2qldc) and oxalic acid (H2ox) with Yb2O3, namely, [Yb(2,3-qldc)(ox)1/2(H2O)3·(H2O)4]n (1), [Yb(2,3-qldc)(ox)1/2(H2O)2·(H2O)2]n (2), [Yb(2,3-Hqldc)(ox)(H2O)2·(H2O)]n (3) and [Yb(2,3-Hqldc)(ox)(H2O)·(H2O)2]n (4), were first synthesized and characterized by elemental analysis (EA), infrared spectroscopy (IR), thermogravimetric analysis (TG), and single-crystal X-ray diffraction. When the reactant ratio of 2,3-H2qldc : H2ox : Yb2O3 is 2 : 1 : 1, 1-D chain-like complex 1 with three coordinated water molecules around the Yb(iii) ion was obtained in mixed solvents of H2O and CH3OH (v : v = 10 : 1) at 70 °C, and with the increase of temperature to 100 °C, the same reactants gave 2-D 6(3) topological layer-like complex 2 with two coordinated water molecules in the coordination sphere of the Yb(iii) ion. However, when the reactant ratio was changed to 1 : 1 : 1, two 2-D 6(3) topological layer-like complexes 3 (70 °C) and 4 (100 °C) were obtained at different temperatures, in which the coordination water molecules in 3 and 4 are two and one, respectively. Obviously, these results reveal that the reaction temperature and reactant ratios play critical roles in the structural direction of these low-dimensional compounds. Interestingly, with the gradual loss of coordination water molecules to the Yb(iii) ion, the near infrared (NIR) emission of four Yb(iii)-based compounds 1-4 can be gradually strengthened with increasing order of 1 < 3 < 2 < 4, indicating that these ytterbium(iii) complexes have tunable near infrared luminescence.

Interaction of toxin-1 and T lymphocytes in toxic shock syndrome.

Toxic shock syndrome (TSS) is a potentially fatal illness caused by infection with the bacterium Staphylococcus aureus. TSS toxin-1 (TSST-1) contains a T-cell epitope with specificity for human V-beta-2. Binding of TSST-1 to the human major histocompatibility complex and T cell receptors activates T cells and triggers the secretion of high amounts of inflammatory cytokines, leading to TSS and potentially death. During this process, CD4+ T cells are inhibited by TSST-1, while regulatory T cells are increased. This suggests a protective immune response by the body in TSS. Thus, TSST-1 can trigger both, an inflammatory response that attacks the body and a protective response. In this review, we discuss the interaction between TSST-1 and T lymphocytes in TSS.

Temperature-/solvent-dependent low-dimensional compounds based on quinoline-2,3-dicarboxylic acid: structures and fluorescent properties.

A series of 0-D, 1-D, and 2-D metal-organic compounds through reactions of quinoline-2,3-dicarboxylic acid (2,3-H(2)qldc) with transition metal salts MCl(2), namely, M(2,3-Hqldc)(2)(H(2)O)(2) (M = Co(1), Zn(4) and Cd(7)), [M(3-qlc)(2)(H(2)O)(2)](n) (M = Co(2), Zn(5) and Cd(8)), M(2-qldc-3-OCH(3))(2)(CH(3)OH)(2) (M = Co(3) and Zn(6)) and [Cd(2,3-qldc-OCH(3))(µ(2)-Cl)](2n) (9) (where, 3-Hqlc = quinoline-3-carboxylic acid and 2-qldc-3-OCH(3) = 3-(methoxycarbonyl)quinoline-2-carboxylic acid), were synthesized and characterized by elemental analysis, IR, thermogravimetric analysis (TG), and single-crystal X-ray diffraction. When the temperature ranged from room temperature to 70 °C, three isomorphous mononuclear complexes 1, 4 and 7 were obtained in H(2)O/H(2)O + CH(3)OH. As the temperature rose further to above 90 °C, due to the decomposition of 2-position carboxyl group in ligand 2,3-H(2)qldc, the same reactions, respectively, produced three isomorphous 2-D layer-like structures 2, 5 and 8 with 4(4) topology in water. By contrast, when the mixed solvent of H(2)O + CH(3)OH at a 1 : 1 ratio (v/v) was applied, the three above-mentioned reactions respectively gave compounds 3, 6 and 9 with the 3-position esterification of 2,3-H(2)qldc. Compounds 3 and 6 are mononuclear and isomorphous, while complex 9 has a 1-D double-stranded chain-like structure connected by two µ(2)-Cl bridges. Obviously, these results reveal that the reaction temperature and solvent play a critical role in structural direction of these low-dimensional compounds. Meanwhile, the photoluminescent property of the selected compounds is also investigated.