[Effects of cardiac resynchronization therapy in patients with advanced congestive heart failure evaluated by real-time 3-dimensional echocardiography].

OBJECTIVE: To quantitatively assess the effects of cardiac resynchronization therapy (CRT) in patients with advanced congestive heart failure by real-time 3-dimensional(3D) echocardiography (RT-3DE). METHODS: Eighteen patients with advanced congestive heart failure underwent CRT with New York Heart association(NYHA) class III and IV and wide QRS complex (>120 ms) were included (17 dilated cardiomyopathy and 1 ischemic cardiomyopathy). Before CRT and 8 months after CRT, the clinical and RT-3DE parameters and outcome were analyzed. RESULTS: The biventricular pacemaker was successfully implanted in 17 patients (94.4%). Compared with before CRT, NYHA class of patients decreased by 1.5 class (P < 0.01), left ventricular ejection fraction increased by 25% (P < 0.01), left ventricular end systolic volume decreased by 38% (P < 0.01), left ventricular systolic dyssynchrony index (SDI) improved significantly (14.2% before CRT vs. 9.8% after CRT, P < 0.01 ) post CRT. Change in SDI and change in LVEF was positively correlated (r = 0.62, P < 0.01) . The procedure complications and outcome during and after CRT included coronary sinus dissection (n = 1), left ventricular lead dislodgement (n = 1), phrenic nerve stimulation (n = 1), sudden cardiac death (n = 1). Three non-response patients were complicated with atrial fibrillation, nonspecific intraventricular block and dilated cardiomyopathy with postero-lateral scar tissue. CONCLUSIONS: CRT could improve the cardiac function, correct the mechanical desynchronization and reverse left ventricular remodeling in patients with congestive heart failure, and SDI quantification by RT-3DE could predict increase of LVEF after CRT, however, there were complications related to the implantation procedure and possibilities of non-response.

Synergistic inhibitory effect of selenium, iron, and humic acid on cadmium uptake in rice (Oryza sativa L.) seedlings in hydroponic culture.

Selenium (Se), iron (Fe), and humic acid (HA) are beneficial fertilizers that inhibit cadmium (Cd) uptake in crops and are crucial for agricultural yields as well as human health. However, the joined effect of Se, Fe, and HA on Cd uptake in rice are still poorly understood. Therefore, a hydroponic culture experiment was established to evaluate the combined effect of Se (Se4+ or Se6+), Fe, and HA on the biomass, Cd uptake, and Cd translocation of/in rice seedlings. Compared to Se6+ application, Se4+ application in most treatments resulted in lower Cd translocations from roots to shoots, leading to a significant decrease in shoot Cd concentrations. Compared to the treatments with Se4+ or Fe2+ application, joined application of Se4+ and Fe2+ inhibited Cd uptake in shoots by decreasing Cd adsorption onto (iron plaque) and uptake by roots, and alleviating Cd translocation from root to shoot. Compared to the treatments with Se6+ or Fe2+ application, joined application of Se6+ and Fe2+ inhibited Cd uptake in shoots by sequestering (retaining) Cd onto root surface (iron plaque). HA inhibited Cd uptake in all treatments by decreasing the bioavailability of Cd in the nutrient solution through complexation. The simultaneous application of Se, Fe, and HA decreased the shoot Cd concentrations the most, followed by the combined application of two fertilizers and their individual application; the mean shoot Cd concentration in the Fe-SeIV-HA2 treatment was the lowest among all the treatments, at only 11.39 % of those in the control treatments. The 3-way ANOVA results indicated that the Cd concentrations in shoots were significantly affected by Se, Fe, HA, and certain of their interactions (Fe×Se and Se×HA) (p< 0.05). The above findings suggest that the joined application of Se, Fe, and HA ameliorated Cd uptake mainly by inhibiting Cd adsorption onto (iron plaque) and uptake by roots and the translocation from roots to shoots (Fe×Se4+), retaining (sequestering) Cd in iron plaque (Fe×Se6+), and decreasing Cd availability in nutrient solution (HA).

Specific alterations in gut microbiota are associated with prognosis of Budd-Chiari syndrome.

Gut microbiota is associated with liver diseases. However, gut microbial characteristics of Budd-Chiari syndrome (B-CS) have not been reported. Here, by MiSeq sequencing, gut microbial alterations were characterized among 37 health controls, 20 liver cirrhosis (LC) patients, 31 initial B-CS patients (B-CS group), 33 stability patients after BCS treatment (stability group) and 23 recurrent patients after BCS treatment (recurrence group). Gut microbial diversity was increased in B-CS versus LC. Bacterial community of B-CS clustered with controls but separated from LC. Operational taxonomic units (OTUs) 421, 502 (Clostridium IV) and 141 (Megasphaera) were unique to B-CS. Genera Escherichia/Shigella and Clostridium XI were decreased in B-CS versus controls. Moreover, nine genera, mainly including Bacteroides and Megamonas, were enriched in B-CS versus LC. Notably, Megamonas could distinguish B-CS from LC with areas under the curve (AUCs) of 0.7904. Microbial function prediction revealed that L-amino acid transport system activity was decreased in B-CS versus both LC and controls. Furthermore, OTUs 27 (Clostridium XI), 137 (Clostridium XIVb) and 40 (Bacteroides) were associated with B-CS stability. Importantly, genus Clostridium XI was enriched in stability group versus both recurrence group and B-CS group. Also, PRPP glutamine biosynthesis was reduced in stability group versus recurrence group, but was enriched in stability group versus B-CS group. In conclusion, specific microbial alterations associated with diagnosis and prognosis were detected in B-CS patients. Correction of gut microbial alterations may be a potential strategy for B-CS prevention and treatment.

Immunologic protection of anti-tetrodotoxin vaccines against lethal activities of oral tetrodotoxin challenge in mice.

Tetrodotoxin (TTX) is a high toxic small molecular neurotoxin. Haptenic vaccine for TTX was investigated and the carrier proteins were compared. TTX was conjugated to Tachypleus tridentatus hemocyanin (TTH) and tetanus toxoid (TT) via formaldehyde to form the artificial antigen TTX-TTH and TTX-TT. BALB/c mice were immunized with the artificial antigen, the TTX-specific antibody response were detected. The immunized animals were intragastrically challenged with increasing doses of TTX repeatedly. The mice which exposed to TTX in doses of 600, 630, 800, 1200, 1500, 2000 and 2400 microg/kg survived at rates of 100, 100, 90, 90, 80, 50 and 20%, with a LD(50) value of 2020 microg/kg for TTH-TTX vaccine, and of 100%, 90.9%, 90.9%, 90.9%, 63.6%, 27.3% and 0%, with a LD(50) value of 1410 microg/kg for TT-TTX vaccine, respectively. All control mice inoculated with carrier protein TTH or TT uniformly died of a dose of 600 microg/kg TTX i.g. challenge. Animals immunized with vaccines could antagonize repeated TTX challenge, half of them surviving about 6 mg/kg, and a few being able to bear a maximal accumulative dose as high as approximate 9 mg/kg of TTX challenges within eight months. The TTH-TTX vaccine was of the more excellent in protective effect from TTX oral intoxication, mainly resulted from the higher antibody affinity than that from TT-TTX vaccine. The present study for the first time demonstrated that the anti-TTX experimental vaccines would high effectively protect animal from multiple, oral TTX intoxication. Immunoprophylaxis would be the hopeful means against TTX poisoning.

Toxin-neutralizing effect and activity-quality relationship for mice tetrodotoxin-specific polyclonal antibodies.

The polyclonal antibodies specific for tetrodotoxin (TTX) were prepared from mice and their capacity of neutralizing TTX was investigated so as to explore the possibility of developing TTX antitoxin. Haptenic TTX was conjugated to Tachypleus tridentatus hemocyanin (TTH) chemically to form artificial antigen TTX-TTH. BALB/c mice were immunized with TTX-TTH and ascites were induced by intraperitoneal administration of Freund's adjuvant. Twenty strains of TTX-specific ascites antibody with apparent affinity varying from 10(-4) to 10(-7)M were obtained. KM mice were challenged with lethal doses (1LD = 14.0 microg/kg, i.p.) of TTX neutralized by antibodies to evaluate the power of antitoxin. The potential of TTX-neutralizing of the antibodies was approved by the increase in survival animal challenged by lethal doses of TTX pre-incubated in vitro or neutralized in vivo with TTX specific antibodies. The highest protection was observed with all animals survived challenge of 1.5 x LD TTX neutralized in vitro, and antibody administration 4 days prior to 1.3 x LD TTX challenge in vivo neutralization. The protective efficiency was antibody quality factor dependent and with the highest detoxifying immunological equivalent as high as 1 300 microg (TTX)/L(ascites) approximately, while the antibody apparent affinity being at the order of 10(-6) to 10(-7)M. These results suggested that chemical vaccine for haptenic TTX could successfully raise high humoral immune response and the antibodies could neutralize TTX effectively both in vitro and in vivo, antibody therapy would be the hopeful means for detoxification of TTX.

Evaluation of right ventricular function by Doppler tissue imaging of the tricuspid annulus in patients with acquired immune deficiency syndrome.

Chronic heart disease contributes to the mortality of patients with AIDS. Although studies of left ventricular function in patients with acquired immune deficiency syndrome (AIDS) have been conducted, studies of right ventricular function are rare. The present study aimed to characterize the tricuspid annulus movement and evaluate the right ventricular function of patients with AIDS by tissue Doppler imaging. Tissue Doppler echocardiography was performed on 106 patients with AIDS and 64 controls. Tricuspid annulus movements were detected from the apical four-chamber view and the apical right heart two-chamber view. The peak diastolic early period velocity (Ve), peak diastolic later period velocity (Va) and peak systolic velocity (Vs) were measured at the anterior, posterior and lateral walls and also at the interventricular septum. Mean values were calculated, as well as the Tei index of the lateral site. Compared with the values in the control group, the Vs and Va of the AIDS group decreased at all sites with the exception of the lateral wall, whereas the Ve decreased at all sites of the tricuspid annulus (P<0.05). The Tei index was higher in the AIDS group than in the control (P<0.05). The results obtained in the present study show that the function of the right ventricle decreases in patients with AIDS, which is indicative of susceptibility to right ventricular dysfunction.

Long-term use of first-line highly active antiretroviral therapy is not associated with carotid artery stiffness in human immunodeficiency virus-positive patients.

OBJECTIVE: To evaluate whether or not highly active antiretroviral therapy is associated with carotid artery stiffness in human immunodeficiency virus-positive patients in Henan Province, China. METHOD: Fifty human immunodeficiency virus-positive patients with at least a 5-year history of highly active antiretroviral therapy use and 50 human immunodeficiency virus-positive patients without a history of highly active antiretroviral therapy use were enrolled in this study. Carotid artery intima-media thickness and stiffness were determined by quantitative inter-media thickness and quantitative artery stiffness, respectively. RESULTS: No statistically significant difference in carotid artery intima-media thickness and stiffness was observed between groups. A significant association between human immunodeficiency virus infection time and carotid artery stiffness was observed, but no significant association between human immunodeficiency virus infection time and intima-media thickness was found. No significant association between intima-media thickness, stiffness, and CD4(+) and CD8(+) T-cell counts were observed. CONCLUSION: The first-line highly active antiretroviral therapy currently used in China is not associated with carotid artery stiffness in human immunodeficiency virus-positive patients with good highly active antiretroviral therapy compliance. Human immunodeficiency virus may play a role in the development of atherosclerosis.

Long-term use of first-line highly active antiretroviral therapy is not associated with carotid artery stiffness in human immunodeficiency virus-positive patients

Objective: To evaluate whether or not highly active antiretroviral therapy is associated with carotid artery stiffness in human immunodeficiency virus-positive patients in Henan Province, China. Method: Fifty human immunodeficiency virus-positive patients with at least a 5-year history of highly active antiretroviral therapy use and 50 human immunodeficiency virus-positive patients without a history of highly active antiretroviral therapy use were enrolled in this study. Carotid artery intima-media thickness and stiffness were determined by quantitative inter-media thickness and quantitative artery stiffness, respectively. Results: No statistically significant difference in carotid artery intima-media thickness and stiffness was observed between groups. A significant association between human immunodeficiency virus infection time and carotid artery stiffness was observed, but no significant association between human immunodeficiency virus infection time and intima-media thickness was found. No significant association between intima-media thickness, stiffness, and CD4+ and CD8+ T-cell counts were observed. Conclusion: The first-line highly active antiretroviral therapy currently used in China is not associated with carotid artery stiffness in human immunodeficiency virus-positive patients with good highly active antiretroviral therapy compliance. Human immunodeficiency virus may play a role in the development of atherosclerosis. .

Influence of carrier proteins on the immunologic response to haptenic antitetrodotoxin vaccine.

Tetrodotoxin (TTX) is a haptenic, highly toxic neurotoxin with no specific antidote available yet. Anti-TTX vaccine is being studied for antitoxin development. The effectiveness of the carrier protein in eliciting TTX-specific antibody response was comparatively studied. TTX was conjugated to Tachypleus tridentatus hemocyanin (TTH), Limulus polyphemus hemocyanin (LPH), tetanus toxoid (TT), diphtheria toxoid (DT), and bovine serum albumin (BSA) chemically to form artificial antigens TTH-TTX, LPH-TTX, TT-TTX, DT-TTX, and BSA-TTX, respectively, with which BALB/c mice were immunized, and the antibody response and antitoxic efficacy were detected. The serum anti-TTX antibody response and antitoxic efficacy varied markedly with adopted carrier protein. TTH-TTX elicited the best and BSA-TTX the worst TTX-specific antibody response. The proportion of the immunized mice surviving a 3x lethal dose (LD) dose of TTX challenge was 92%, 75%, 42%, 8%, and 0% for TTH-, TT-, LPH-, DT-, and BSA-TTX conjugates, respectively. The rank order of total efficacy of carrier protein for both anti-TTX antibody response and antitoxic effect was TTH > TT > LPH > DT > BSA. As a result of formaldehyde treatment in coupling of TTX carriers, the relative immunogenicity of TTX vs carrier, that is, the ratio of TTX- to carrier-specific antibody response, evidently varied with respective carrier adopted, in a rank order of TT > BSA > TTH > DT > LPH. The results suggest that the carrier protein used in haptenic TTX vaccine is greatly important in eliciting potent anti-TTX antibody, and both TTH and TT are the preferred carriers for development of excellent experimental TTX vaccine.