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It is universally acknowledged that ligands can improve the reaction activity to simplify the reaction operating conditions and enrich the applicability of the reaction. Therefore, we developed N-octylglycine ligand-accelerated Pd-catalyzed ortho-arylation of benzoic acids under mild conditions with just 6 h; moreover, this N-octylglycine ligand was successfully implemented to carboxyl-directed Pd-catalyzed ß-C(sp3)-H arylation and ortho-arylation of phenylacetic acids under mild conditions.
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BACKGROUND: Leadless pacemakers are a recent technological advancement. It has many advantages, but there are still a few serious complications. CASE PRESENTATION: This article reports the case of a patient with an endocardial tear and dissection caused by contact with the tip of the Micra cup during surgery and summarises the relevant data. CONCLUSIONS: This case report details the occurrence and management of the incident and provides some guidance for future clinical management.
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Marca-Passo Artificial , Humanos , Resultado do Tratamento , Desenho de EquipamentoRESUMO
BACKGROUND International studies have shown that use of a subcutaneous implantable cardioverter defibrillator (S-ICD) could reduce lead-related complications while maintaining adequate defibrillation performance; however, data from the Chinese population or other Asian groups are limited. MATERIAL AND METHODS SCOPE is a prospective, multicenter, observational cohort study. Two hundred patients with primary prevention indication for sudden cardiac death (SCD), who are candidates for S-ICD, will be enrolled. From the same population, another 200 patients who are candidates for transvenous implantable cardioverter defibrillator (TV-ICD) will be enrolled after being matched for age, sex, SCD high-risk etiology (ischemic cardiomyopathy, and non-ischemic cardiomyopathy, ion channel disease, and other) and atrial fibrillation in a 1: 1 ratio with enrolled S-ICD patients. All the patients will be followed for 18 months under standard of care. RESULTS The primary endpoint is proportion of patients free from inappropriate shock (IAS) at 18 months in the S-ICD group. The lower 95% confidence bound of the proportion will be compared with a performance goal of 90.3%, which was derived from the previous meta-analysis. The comparisons between S-ICD and TV-ICD on IAS, appropriate shock, and complications will be used as secondary endpoints without formal assumptions. CONCLUSIONS This is the first prospective multicenter study focusing on the long-term performance of S-ICD in a Chinese population. By comparing with the data derived from international historical studies and a matched TV-ICD group, data from SCOPE will allow for the assessment of S-ICD in the Chinese population in a contemporary real-world implantation level and programming techniques, which will help us to further modify the device implantation and programming protocol in this specific population in the future.
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Fibrilação Atrial , Cardiomiopatias , Desfibriladores Implantáveis , Humanos , Estudos Prospectivos , Resultado do Tratamento , Morte Súbita Cardíaca/prevenção & controle , Morte Súbita Cardíaca/epidemiologia , Prevenção Primária , ChinaRESUMO
Classical shadows are a powerful method for learning many properties of quantum states in a sample-efficient manner, by making use of randomized measurements. Here we study the sample complexity of learning the expectation value of Pauli operators via "shallow shadows," a recently proposed version of classical shadows in which the randomization step is effected by a local unitary circuit of variable depth t. We show that the shadow norm (the quantity controlling the sample complexity) is expressed in terms of properties of the Heisenberg time evolution of operators under the randomizing ("twirling") circuit-namely the evolution of the weight distribution characterizing the number of sites on which an operator acts nontrivially. For spatially contiguous Pauli operators of weight k, this entails a competition between two processes: operator spreading (whereby the support of an operator grows over time, increasing its weight) and operator relaxation (whereby the bulk of the operator develops an equilibrium density of identity operators, decreasing its weight). From this simple picture we derive (i) an upper bound on the shadow norm which, for depth tâ¼log(k), guarantees an exponential gain in sample complexity over the t=0 protocol in any spatial dimension, and (ii) quantitative results in one dimension within a mean-field approximation, including a universal subleading correction to the optimal depth, found to be in excellent agreement with infinite matrix product state numerical simulations. Our Letter connects fundamental ideas in quantum many-body dynamics to applications in quantum information science, and paves the way to highly optimized protocols for learning different properties of quantum states.
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We investigate prospects of employing the linear cross entropy to experimentally access measurement-induced phase transitions without requiring any postselection of quantum trajectories. For two random circuits that are identical in the bulk but with different initial states, the linear cross entropy χ between the bulk measurement outcome distributions in the two circuits acts as an order parameter, and can be used to distinguish the volume law from area law phases. In the volume law phase (and in the thermodynamic limit) the bulk measurements cannot distinguish between the two different initial states, and χ=1. In the area law phase χ<1. For circuits with Clifford gates, we provide numerical evidence that χ can be sampled to accuracy ϵ from O(1/ϵ^{2}) trajectories, by running the first circuit on a quantum simulator without postselection, aided by a classical simulation of the second. We also find that for weak depolarizing noise the signature of the measurement-induced phase transitions is still present for intermediate system sizes. In our protocol we have the freedom of choosing initial states such that the "classical" side can be simulated efficiently, while simulating the "quantum" side is still classically hard.
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Benchmarking , Entropia , Termodinâmica , Simulação por Computador , Transição de FaseRESUMO
A quantum spin liquid is an exotic quantum state of matter in which spins are highly entangled and remain disordered down to zero temperature. Such a state of matter is potentially relevant to high-temperature superconductivity and quantum-information applications, and experimental identification of a quantum spin liquid state is of fundamental importance for our understanding of quantum matter. Theoretical studies have proposed various quantum-spin-liquid ground states, most of which are characterized by exotic spin excitations with fractional quantum numbers (termed 'spinons'). Here we report neutron scattering measurements of the triangular-lattice antiferromagnet YbMgGaO4 that reveal broad spin excitations covering a wide region of the Brillouin zone. The observed diffusive spin excitation persists at the lowest measured energy and shows a clear upper excitation edge, consistent with the particle-hole excitation of a spinon Fermi surface. Our results therefore point to the existence of a quantum spin liquid state with a spinon Fermi surface in YbMgGaO4, which has a perfect spin-1/2 triangular lattice as in the original proposal of quantum spin liquids.
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BACKGROUND: Atrial fibrillation (AF) is a very common type of cardiac arrhythmia that threatens public health. Aging is an independent AF risk factor. However, the mechanism of age-related AF remains unclear. METHODS: A total of 36 Beagle dogs were selected and divided into three groups (12 in each group): two groups were 9-year-old aged dogs, and one group was 4-year-old adult dogs. Electrophysiological testing was employed to determine if modeling is successful. Patch-clamp technique was employed to measure the If current. The expression of protein and mRNA related to If current were also tested. Collagen deposition was observed with the use of Masson staining. RESULTS: Aging resulted in a higher collagen deposition percentage in the left atrium. The hyperpolarization-activated cyclic nucleotide-gated (HCN)2 and HCN4 expressions were increased in the atria and pulmonary veins but decreased in the sinus node of the aged group. Moreover, in the aged group, the left atrium mRNA expressions of Kcnd2 (Potassium voltage-gated channel subfamily D member 2), Kcnh2, Kcnq1, Kcnj2, Kcnj11, and CACNA1H were significantly downregulated. The aged AF group also demonstrated sustained AF and significant changes in electrophysiological characteristics. The If current demonstrated an increased amplitude and was easier to activate in the aged AF group than in younger group. Finally, AF occurrence exacerbated aging-induced cardiac fibrosis, thereby aggravating the above-listed symptoms. CONCLUSION: With age, the increase in atrial fibrosis affected the expression of the ion channels, thereby modulating the If current. Moreover, AF also further exacerbated the degree of atrial fibrosis.
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Fibrilação Atrial , Envelhecimento/fisiologia , Animais , Colágeno/metabolismo , Colágeno/farmacologia , Cães , Eletrocardiografia , Fibrose , Átrios do Coração , Humanos , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , RNA Mensageiro/farmacologiaRESUMO
This study aimed to determine the pooled incidence, risk factors, and clinical prognosis of tricuspid regurgitation (TR) deterioration after implantation of a cardiac implantable electronic device (CIED). The study was designed as a meta-analysis of randomized controlled trials and observational studies. Patients with indications for CIEDs were selected as participants and CIED implantation was the intervention. PubMed, EMBASE, the Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, and China Science and Technology Journal Database were searched systematically to identify studies. Thirty-seven studies with 8,144 patients were included. The pooled incidence of TR deterioration of at least one grade was 25.1% (95% confidence interval [CI], 20.9-29.3; Z = 11.60; p < 0.01; I2 = 94.8%, p < 0.01). Compared with TR incidence after permanent pacemaker implantation, that after implantable cardioverter-defibrillator implantation did not significantly increase (22.68% v 29.18%; odds ratio [OR], 0.615; 95% CI, 0.271-1.339; Z =1.16; p = 0.246). The pooled incidence of TR deterioration of at least two grades was 9.4% (95% CI, 6.6-12.1; Z = 6.72; p < 0.01; I2 = 86.0%, p < 0.01). Lead interference (OR, 8.704; 95% CI,4.450-17.028; Z= 6.32; p < 0.001) and pacemaker implantation time (OR, 1.153; 95% CI, 1.082-1.229; Z = 4.37; p < 0.001) were risk factors for worsening TR. Baseline atrial fibrillation, age, baseline mild TR, and left ventricular ejection fraction were not associated with TR. All-cause mortality (>one year after pacemaker implantation) was higher in patients with TR deterioration (hazard ratio, 1.598; 95% CI, 1.275-2.002; Z = 4.07; p < 0.01; I2 = 0%). TR is a common complication after CIED implantation. Lead interference and pacemaker implantation time were risk factors for TR worsening. Compared with patients without TR deterioration after pacemaker implantation, patients with TR deterioration had a poorer prognosis.
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Desfibriladores Implantáveis , Marca-Passo Artificial , Insuficiência da Valva Tricúspide , Desfibriladores Implantáveis/efeitos adversos , Eletrônica , Humanos , Incidência , Marca-Passo Artificial/efeitos adversos , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Volume Sistólico , Insuficiência da Valva Tricúspide/diagnóstico , Insuficiência da Valva Tricúspide/epidemiologia , Insuficiência da Valva Tricúspide/etiologia , Função Ventricular EsquerdaRESUMO
OBJECTIVE: The outbreak of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2) has caused more than 26 million cases of Corona virus disease (COVID-19) in the world so far. To control the spread of the disease, screening large numbers of suspected cases for appropriate quarantine and treatment are a priority. Pathogenic laboratory testing is typically the gold standard, but it bears the burden of significant false negativity, adding to the urgent need of alternative diagnostic methods to combat the disease. Based on COVID-19 radiographic changes in CT images, this study hypothesized that artificial intelligence methods might be able to extract specific graphical features of COVID-19 and provide a clinical diagnosis ahead of the pathogenic test, thus saving critical time for disease control. METHODS: We collected 1065 CT images of pathogen-confirmed COVID-19 cases along with those previously diagnosed with typical viral pneumonia. We modified the inception transfer-learning model to establish the algorithm, followed by internal and external validation. RESULTS: The internal validation achieved a total accuracy of 89.5% with a specificity of 0.88 and sensitivity of 0.87. The external testing dataset showed a total accuracy of 79.3% with a specificity of 0.83 and sensitivity of 0.67. In addition, in 54 COVID-19 images, the first two nucleic acid test results were negative, and 46 were predicted as COVID-19 positive by the algorithm, with an accuracy of 85.2%. CONCLUSION: These results demonstrate the proof-of-principle for using artificial intelligence to extract radiological features for timely and accurate COVID-19 diagnosis. KEY POINTS: ⢠The study evaluated the diagnostic performance of a deep learning algorithm using CT images to screen for COVID-19 during the influenza season. ⢠As a screening method, our model achieved a relatively high sensitivity on internal and external CT image datasets. ⢠The model was used to distinguish between COVID-19 and other typical viral pneumonia, both of which have quite similar radiologic characteristics.
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COVID-19 , Aprendizado Profundo , Algoritmos , Inteligência Artificial , Teste para COVID-19 , Humanos , SARS-CoV-2 , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: Leadless pacemakers provide safe and effective pacing options for patients with device-related infections. This study was aimed at observing and evaluating the safety and feasibility of extracting an infected pacemaker device followed by the implantation of a leadless pacemaker in the same location for patients without systemic infection. METHODS: Between December 2019 and September 2020, following a well-planned re-implantation strategy, pacemaker electrodes were removed from patients with device infection and leadless pacemakers were immediately implanted at our center. The patients were then followed up for up to 10 months to assess the safety and practicality of the procedure. RESULTS: Pacemaker electrode removal and immediate leadless pacemaker implantation were successfully achieved in eight patients with pocket infection. After a minimum follow-up period of 1 month and a maximum follow-up of 10 months, the pacing parameters for the patients remained stable and there was no infection at the original capsular bag or in the leadless pacemaker. CONCLUSION: Direct implantation of a leadless pacemaker is safe and feasible for patients with local infection of the pacing system after removal of the electrode as an alternative to a bridge period with a temporary pacemaker. This strategy may be a better option for pacing-dependent patients.
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Marca-Passo Artificial , Desenho de Prótese , Implantação de Prótese/métodos , Infecções Relacionadas à Prótese/terapia , Idoso , Remoção de Dispositivo , Estudos de Viabilidade , Feminino , Humanos , Masculino , Segurança do PacienteRESUMO
This study aims to evaluate four pacemaker pocket cleaning methods for preventing implantation-related infections. This single-center trial prospectively randomized 910 patients undergoing first-time pacemaker implantation or replacement into four pocket cleaning methods: hemocoagulase (group A, n = 228), gentamicin (group B, n = 228), hemocoagulase plus gentamicin (group C, n = 227), and normal saline (group D, n = 227). Before implanting the pacemaker battery, the pockets were cleaned with gauze presoaked in the respective cleaning solutions. Then, these patients were followed up to monitor the occurrence of infections for 1 month after implantation. Twelve implantation-related infections occurred in 910 patients (1.32%): four patients from group A (1.75%), three patients from group B (1.32%), two patients from group C (0.88%), and three patients from group D (1.32%) (P > .05). Furthermore, two patients developed bloodstream infections (0.22%), and both of these patients were associated with pocket infection (one patient was from group A, while the other patient was from group C, respectively). No cases of infective endocarditis occurred. The differences in the number of infections in these study groups were not statistically significant. The application of hemocoagulase, gentamicin, hemocoagulase plus gentamicin, or normal saline on the presoaked gauze before implantation was equally effective in preventing pocket-associated infections.
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Marca-Passo Artificial , Infecções Relacionadas à Prótese/prevenção & controle , Infecção da Ferida Cirúrgica/prevenção & controle , Idoso , Antibacterianos/farmacologia , Batroxobina/farmacologia , Feminino , Gentamicinas/farmacologia , Humanos , Masculino , Estudos Prospectivos , Solução Salina/farmacologiaRESUMO
BACKGROUND Imbalanced cardiac autonomic control and cardiac receptors redistribution contribute to the arrhythmogenic substrate under the myocardial infarction (MI) condition. Stimulating the auricular branch of vagus nerve (AB-VNS) has been proven to reduce post-infarction ventricular arrhythmia (VAs), but its potential mechanisms were largely unknown. This study aimed to investigate whether long-term intermittent low-intensity AB-VNS could produce a protective effect on modulating autonomic activities and abnormal redistribution of autonomic nerve efferent receptors in a MI canine model. MATERIAL AND METHODS Twelve healthy beagle dogs underwent ligation of the left anterior descending coronary artery to establish a MI model and were randomized into 2 groups: an AB-VNS group, (AB-VNS for 4 weeks) and a control group (sham stimulation for 4 weeks). Dynamic electrocardiogram recording, neural recording, catecholamine concentration, and histological studies were conducted subsequently. RESULTS Compared to the control group, the AB-VNS group had significantly suppressed post-infarction VAs, reduced low frequency (LF) power and increased high frequency (HF) power. In the AB-VNS group, with the progression of reduced cardiac sympathetic activities and augmented cardiac parasympathetic activities, the catecholamine concentration in heart tissue declined in the peripheral infarction area and right ventricle (RV); tyrosine hydroxylase (TH)-positive neurons decreased in the inferior cardiac sympathetic nerve, and choline acetyltransferase (ChAT)-positive neurons increased in the cervical vagus nerve. Expression of TrkA and P75NGFR were reduced in the peripheral MI (peri-MI) and non-MI area with AB-VNS. The mRNA expression of adrenergic and nicotinic receptors (ß1-AR, ß3-AR, and CHRNA7) significantly declined in the peri-MI and non-MI area of the AB-VNS group. CONCLUSIONS Chronic intermittent low-intensity AB-VNS effectively suppressed post-infarction VAs by potentially rebalancing extracardiac intrathoracic autonomic activities, reducing excessive cardiac sympathetic denervation, and attenuating the heterogeneities of cardiac efferent nerve receptors distribution.
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Arritmias Cardíacas/prevenção & controle , Estimulação do Nervo Vago/métodos , Nervo Vago/fisiologia , Animais , Arritmias Cardíacas/fisiopatologia , Modelos Animais de Doenças , Cães , Eletrocardiografia Ambulatorial/métodos , Coração/fisiopatologia , Insuficiência Cardíaca/fisiopatologia , Masculino , Infarto do Miocárdio/fisiopatologia , Nervo Vago/metabolismoRESUMO
BACKGROUND: This study explored the relationships between the low-/high-density lipoprotein cholesterol ratio (LDL-C/HDL-C) and other clinical indicators and ischaemic stroke (IS) in patients with non-valvular atrial fibrillation (NVAF) in Xinjiang. The findings could provide a theoretical and therapeutic basis for NVAF patients. METHODS: NVAF patients who were admitted to 10 medical centres across Xinjiang were divided into stroke (798 patients) and control (2671 patients) groups according to the occurrence of first acute IS. Univariate and multivariate logistic regression analysis were used to examine the independent risk factors for IS in NVAF patients. Factor analysis and principal component regression analysis were used to analyse the main factors influencing IS. Receiver operating characteristic (ROC) curve analysis was used to evaluate the discriminatory ability of LDL-C/HDL-C for predicting the occurrence of IS. RESULTS: The stroke group had an average age of 71.64 ± 9.96 years and included 305 females (38.22%). The control group had a mean age of 67.30 ± 12.01 years and included 825 females (30.89%). Multivariate logistic regression showed that the risk of IS in the highest LDL-C/HDL-C quartile (≥2.73) was 16.23-fold that of the lowest quartile (< 1.22); IS risk was 2.27-fold higher in obese patients than in normal-weight subjects; IS risk was 3.15-fold higher in smoking patients than in non-smoking patients. The area under the ROC curve of LDL-C/HDL-C was 0.76, the optimal critical value was 2.33, the sensitivity was 63.53%, and the specificity was 76.34%. Principal component regression analysis showed that LDL-C/HDL-C, age, smoking, drinking, LDL-C and hypertension were risk factors for IS in NVAF patients. CONCLUSIONS: LDL-C/HDL-C > 1.22, smoking, BMI ≥24 kg/m2 and CHA2DS2-VASc score were independent risk factors for IS in NVAF patients; LDL-C/HDL-C was the main risk factor.
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Fibrilação Atrial/epidemiologia , AVC Isquêmico/epidemiologia , Obesidade/epidemiologia , Idoso , Fibrilação Atrial/sangue , Fibrilação Atrial/complicações , Fibrilação Atrial/patologia , Estudos de Casos e Controles , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Feminino , Humanos , AVC Isquêmico/sangue , AVC Isquêmico/complicações , AVC Isquêmico/patologia , Masculino , Obesidade/sangue , Obesidade/complicações , Obesidade/patologia , Fatores de RiscoRESUMO
BACKGROUND: Atrial fibrillation (AF), for which age is an independent risk factor, is the most common persistent arrhythmia. Monocyte chemoattractant protein-1-induced protein (MCPIP), a transcription factor that induces a series of inflammation and cell death procedures, has been indicated to cause cardiomyocyte death in ischemic cardiomyopathy. The objective of this research was to investigate the relationship between age-related AF and MCPIP. METHODS: A total of 1,084 participants were included in this study, including 542 AF patients and 542 non-AF controls. Their medical histories were collected and analyzed. Moreover, blood samples were collected, and ELISA tests for expression of the inflammatory factor MCPIP and the fibrosis biomarkers pro-collagen type III N-terminal peptide (PIIINP) and type I collagen C-terminal telopeptide (ICTP) were conducted. Finally, a correlation analysis of these inflammatory factors and biomarkers was performed based on the ELISA results. RESULTS: We compared the echocardiography results of AF patients and found that the left ventricular ejection fraction and left atrial appendage velocity decreased with age (p < 0.05). Moreover, ELISA analysis of these samples showed that the expression of MCPIP was the highest in elderly patients with AF (p < 0.05), and there was no significant difference in expression between adult AF patients and elderly controls (p > 0.05). Finally, the correlation analysis demonstrated that the expressions of MCPIP, PIIINP, and ICTP were positively correlated in the elderly AF patient group, the adult AF group, and the elderly control group (p < 0.05). CONCLUSION: MCPIP expression was higher in age-related AF than in the other patient groups and it was associated with AF-induced fibrosis.
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Fibrilação Atrial/sangue , Quimiocina CCL2/sangue , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Estudos de Casos e Controles , China , Ensaio de Imunoadsorção Enzimática , Feminino , Fibrose/sangue , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND Myocardial infarction (MI) is the main cause of heart failure (HF), and sympathetic nerve activity is associated with prognosis chronic heart failure. Renal sympathetic denervation (RDN) is noted for its powerful effect on the inhibition of sympathetic nerve activity. This study investigated the effect of RDN on heart failure in dogs after myocardial infarction. MATERIAL AND METHODS The experimental animals were randomized into 2 groups: the MI group (n=12) and the sham operation group (n=6). In the MI group we established an MI model by permanently ligating the left anterior descending branch. After 4 weeks, the MI dogs were randomly divided into 2 groups: the MI+RDN group (MI+renal sympathetic denervation, n=6) and the simple MI group (n=6). Animals in the MI+RDN group underwent both surgical and chemical renal denervation. RESULTS Compared with sham operation group, left ventricular fraction shortening (LVFS) and left ventricular ejection fraction (LVEF) were significantly reduced in the simple MI group, while the reduction was partly reversed in the MI+RDN group. RDN reduced sympathetic nerve activity and release of B-type natriuretic peptide (BNP) and Angiotensin II (AngII) in the MI+ RDN group but not in the simple MI group. CONCLUSIONS Canine renal sympathetic denervation prevents myocardial malignant remodeling by lowering the activity of the systemic sympathetic nerve and inhibiting renin-angiotensin-aldosterone system (RASS) activation, providing a new target and method for the treatment of heart failure.
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Rim/inervação , Infarto do Miocárdio/patologia , Simpatectomia/métodos , Angiotensina II , Animais , Pressão Sanguínea , Denervação , Modelos Animais de Doenças , Cães , Ecocardiografia , Feminino , Coração/fisiopatologia , Insuficiência Cardíaca/fisiopatologia , Rim/patologia , Masculino , Miocárdio/patologia , Artéria Renal/patologia , Sistema Renina-Angiotensina/fisiologia , Sistema Nervoso Simpático/fisiopatologia , Função Ventricular Esquerda/fisiologiaRESUMO
BACKGROUND: The epidemiological characteristics of sudden cardiac death (SCD) in the autonomous region of Xinjiang Uygur have been largely unknown. This study aimed to evaluate the incidence and demographic risk factors of SCD in Xinjiang, China. METHODS: This retrospective study reviewed medical records from 11 regions in Xinjiang with different geography (north and south of the Tian Shan mountain range), gross domestic product, and ethnicity (Han, Uyghur, Kazakh, and Hui). SCD was defined as unexpected death due to cardiac reasons within 1 hour after the onset of acute symptoms, including sudden death, unexpected death, and nonviolent death. Monitoring was conducted throughout 2015. Demographic and mortality data were recorded and age-adjusted standardized risk ratio (SRR) was analyzed. RESULTS: Among 3,224,103 residents, there were 13,308 all-cause deaths and 1244 events of SCD (784 men and 460 women; overall incidence 38.6 per 100,000 residents). SCD was associated with age (χ2 = 2105.3), but not geography. Men had an increased risk of SCD compared with women (SRR: 1.75, 95% CI: 1.10-2.79). The risk of SCD was highest in residents of the Uyghur (SRR: 1.59, 95% CI: 1.05-2.42) and Kazakh (SRR: 1.92, 95% CI: 1.29-2.87) compared with those of the Han. Poor economic development was associated with elevated risk of SCD (SRR: 1.55, 95% CI: 1.02-2.38). CONCLUSION: SCD is an important public health issue in China. Our understanding of the demographic differences on SCD in Xinjiang, China may improve the risk stratification and management to reduce the incidence and lethality of SCD.
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Diversidade Cultural , Morte Súbita Cardíaca/etnologia , Etnicidade/estatística & dados numéricos , Adolescente , Adulto , Causas de Morte/tendências , China/epidemiologia , Desenvolvimento Econômico/estatística & dados numéricos , Feminino , Produto Interno Bruto/estatística & dados numéricos , Humanos , Incidência , Masculino , Prontuários Médicos , Pessoa de Meia-Idade , Razão de Chances , Estudos Retrospectivos , Fatores de Risco , Adulto JovemRESUMO
Personalized content retrieval service has become a major information service that consumes a large portion of mobile Internet traffic. Joint content recommendation and delivery is a promising design philosophy that could effectively improve the overall user experience with personalized content retrieval services. Existing research mostly focused on a push-type design paradigm called proactive caching, which, however, has multiple inherent drawbacks such as high device cost and low energy efficiency. This paper proposes a novel, interactive joint content recommendation and delivery system as an alternative to overcome the drawbacks of proactive caching systems. We present several optimal and heuristic algorithms for the proposed system and analyze the system performance in terms of user interest and transmission outage probability. Some theoretical performance bounds of the system are also derived. The effectiveness of the proposed system and algorithms is validated by simulation results.
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BACKGROUND The cardiac autonomic nervous system plays an essential role in epicardial ganglionated plexi (GP) regulation of atrial fibrillation onset and progression. To date, the activity of GP and the function of the cardiac autonomic nervous system are not well understood. The aim of this study was to determine alterations in epicardial GP cholinergic nerve, adrenergic nerve, and nerve growth factor expression using rapid atrial pacing to induce atrial fibrillation in canines. MATERIAL AND METHODS Nine healthy adult beagles were divided into two groups: the pacing experimental group (n=6) and the sham-operation control group (n=3). For the pacing group, high frequency pacing of the left atrial appendage was performed for eight hours. In the control group, electrodes were implanted without rapid atrial pacing. Immunocytochemistry was used to identify neurons positively expressing tyrosine hydroxylase, choline acetyl transferase, nerve growth factor and neurturin. RESULTS After successfully establishing a rapid atrial pacing of the left atrial appendage induced atrial fibrillation model, we found that expression of choline acetyl transferase, tyrosine hydroxylase, nerve growth factor, and neurturin was significantly higher in the rapid atrial pacing group than the control group (p<0.05). CONCLUSIONS In our model, incremental excitability of both the adrenergic and cholinergic nerves led to frequent incidents of atrial fibrillation, which were possibly due to an imbalance of autonomic nerve factors in the epicardial GP during acute atrial fibrillation.
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Fibrilação Atrial/fisiopatologia , Gânglios Autônomos/fisiopatologia , Animais , Sistema Nervoso Autônomo/fisiopatologia , Vias Autônomas/fisiopatologia , Estimulação Cardíaca Artificial/métodos , Colina O-Acetiltransferase/análise , Cães , Mapeamento Epicárdico , Átrios do Coração/fisiopatologia , Fator de Crescimento Neural/análise , Neurturina/análise , Tirosina 3-Mono-Oxigenase/análiseRESUMO
BACKGROUND: Ivabradine is an inhibitor of mixed Na+-K+ current that could combine with HCN channels to reduce the transmembrane velocity of funny current (If), heart rate, and cardiac efficiency, and thus be used for the treatment of cardiovascular diseases such as chronic heart failure. As an ion channel blocker, Ivabradine is also a potential antiarrhythmic agent. MATERIAL/METHODS: Twelve aging dogs (8-10 years old) underwent rapid atrial pacing for 2 months to induce age-related AF in this study. The dogs were randomly divided into the Ivabradine group and aging-AF group. The effects of Ivabradine on the electrophysiological parameters, including the effective refractory period (ERP) of the pulmonary veins and atrium, duration of AF, and inducing rate of AF, were investigated. RESULTS: As compared to the aging-AF group, the ERPs of the left superior pulmonary vein (139.00±4.18 ms vs. 129.00±4.08 ms, P=0.005) and left auricle (135.00±3.53 ms vs. 122.00±4.47 ms, P=0.001) were significantly increased, while the duration of AF (46.60±5.07 s vs. 205.40±1.14 s, P=0.001) and inducing rate of AF (25% vs. 60%, P=0.001) were significantly decreased. CONCLUSIONS: Ivabradine could effectively reduce the inducing rate of AF, and thus be used as an upstream drug for the prevention of age-related AF.
Assuntos
Envelhecimento/fisiologia , Antiarrítmicos/uso terapêutico , Fibrilação Atrial/tratamento farmacológico , Benzazepinas/uso terapêutico , Canais Disparados por Nucleotídeos Cíclicos Ativados por Hiperpolarização/antagonistas & inibidores , Período Refratário Eletrofisiológico/efeitos dos fármacos , Nó Sinoatrial/efeitos dos fármacos , Animais , Antiarrítmicos/farmacologia , Fibrilação Atrial/etiologia , Fibrilação Atrial/fisiopatologia , Benzazepinas/farmacologia , Estimulação Cardíaca Artificial/efeitos adversos , Modelos Animais de Doenças , Cães , Avaliação Pré-Clínica de Medicamentos , Feminino , Átrios do Coração/efeitos dos fármacos , Átrios do Coração/fisiopatologia , Ivabradina , Masculino , Veias Pulmonares/efeitos dos fármacos , Veias Pulmonares/fisiopatologiaRESUMO
BACKGROUND: Dilated cardiomyopathy (DCM) is characterized by left ventricular enlargement, systolic dysfunction, and heart failure. Both genetic and non-genetic factors have been linked to DCM pathogenesis. Familial DCM (FDCM) accounts for 20%-50% of all DCM cases, highlighting the importance of genetics in pathogenesis. Indeed, more than 40 DCM-associated genes have been identified, including the gene encoding cardiac troponin T type-2 (TNNT2). We examined polymorphisms of the TNNT2 gene in idiopathic DCM (IDCM) patients of Kazak and Han ethnicity compared with healthy Kazak and Han controls. MATERIAL AND METHODS: Peripheral blood samples were collected from 180 patients with IDCM (90 Kazak and 90 Han), and 180 healthy controls (90 Kazak and 90 Han). PCR was used to amplify 15 exons and nearby introns of the TNNT2 gene. The amplified products were sequenced and compared to the standard sequence in PubMed by BLAST and CHROMAS software, to identify mutation sites. RESULTS: Results from Kazak and Han IDCM patients were complied for Hardy-Weinberg equilibrium analysis. There was a significant difference in the genotype distribution (χ2=6.67, P=0.015) and allele frequency (χ2=5.71, P=0.017) between Kazaks with IDCM and Kazak controls of SNP rs3729547. There was also a difference in the genotype distribution (χ2=6.62, P=0.036) and allele frequency (χ2=4.91, P=0.018) between Han with IDCM and Han controls. The TNNT2 gene polymorphism loci rs3729547 may be associated with the IDCM onset in Kazak and Han patients (OR=2.5, 95% CI: 1.233~5.068). CONCLUSIONS: The TNNT2 polymorphisms might play an important role in susceptibility to DCM in Xinjiang Kazak and Han patients.