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Pyrazines are important flavor components and healthy active components in Baijiu, which including tetramethylpyrazine (TTMP). During the brewing process, the traceability of microbial communities and the content distribution characteristics of TTMP are important for improving the quality and style characteristics of compound-flavored Baijiu (CFB). However, the traceability analysis of microorganisms in fermented grains (FG)-used in the production of CFB-lacks quantitative and systematic evaluation. In this study, the microbial communities and TTMP content of Jiuqu (JQ), Liangpei (LP), FG, and pit mud (CP) used in CFB production were characterized; further, coordinate and discriminant analyses were employed to determine differences in microbial communities. Additionally, traceability and correlation analyses were performed to reveal the origin of microbial communities in FG. The source, content, and distribution characteristics of TTMP based on the brewing process have also been discussed. The results showed that most of the bacterial and fungal communities at different levels of FG came from other sources, and the microorganisms of Cladosporium, Acetobacter, Aspergillus, Methanosarcina, and Bacillus were considered have a osculating correlations with TTMP content of FG. Taken together, this study provides insights into the origin of microbial communities in FG and the distribution characteristics of TTMP based on the CFB brewing process. The current findings are conducive for optimizing the fermentation process and improving the quality and style characteristics of CFB.
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Porcine reproductive and respiratory syndrome virus (PRRSV) is a pathogen that causes severe abortions in sows and high piglet mortality, resulting in huge economic losses to the pig industry worldwide. The emerging and novel PRRSV isolates are clinically and biologically important, as there are likely recombination and pathogenic differences among PRRSV genomes. Furthermore, the NADC34-like strain has become a major epidemic strain in some parts of China, but the characterization and pathogenicity of the latest strain in Inner Mongolia have not been reported in detail. In this study, an NADC34-like strain (CHNMGKL1-2304) from Tongliao City, Inner Mongolia was successfully isolated and characterized, and confirmed the pathogenicity in pigs. The phylogenetic tree showed that this strain belonged to sublineage 1.5 and had high homology with the strain JS2021NADC34. There is no recombination between CHNMGKL1-2304 and any other domestic strains. Animal experiments show that the CHNMGKL1-2304 strain is moderately virulent to piglets, which show persistent fever, weight loss and high morbidity but no mortality. The presence of PRRSV nucleic acids was detected in both blood, tissues, nasal and fecal swabs. In addition, obvious pathological changes and positive signals were observed in lung, lymph node, liver and spleen tissues when subjected to hematoxylin-eosin (HE) staining and immunohistochemistry (IHC). This report can provide a basis for epidemiological investigations and subsequent studies of PRRSV.
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Genoma Viral , Filogenia , Síndrome Respiratória e Reprodutiva Suína , Vírus da Síndrome Respiratória e Reprodutiva Suína , Animais , Suínos , Vírus da Síndrome Respiratória e Reprodutiva Suína/genética , Vírus da Síndrome Respiratória e Reprodutiva Suína/patogenicidade , Vírus da Síndrome Respiratória e Reprodutiva Suína/isolamento & purificação , Vírus da Síndrome Respiratória e Reprodutiva Suína/classificação , China , Síndrome Respiratória e Reprodutiva Suína/virologia , Síndrome Respiratória e Reprodutiva Suína/patologia , Virulência , Evolução MolecularRESUMO
This study aims to elucidate the effects of Platelet-rich plasma (PRP) in fibrosis development in intrauterine adhesion (IUA), and the associated underlying mechanisms are also explored, which are expected to be a potential therapeutic scheme for IUA. In this research, PRP was obtained and prepared from the peripheral venous blood of rats. A rat model was induced by mechanical injury. Further, PRP was directly injected into the uterus for treatment. The appearance and shape of the uterus were assessed based on the tissues harvested. The fibrosis biomarker levels were analyzed. The transforming growth factor beta 1 (TGF-ß1) and Mothers against decapentaplegic homolog 7 (Smad7) levels, the phosphorylation of Smad2 (p-Smad2), and the phosphorylation of Smad3 (p-Smad3) were analyzed, and the molecular mechanism was investigated by rescue experiments. It was found that PRP improved the appearance and shape of the uterus in IUA and increased endometrial thickness and gland numbers. The administration of PRP resulted in a decrease in the expressions of fibrosis markers including collagen I, α-SMA, and fibronectin. Furthermore, PRP increased Smad7 levels and decreased TGF-ß1 levels, p-Smad2, and p-Smad3. Meanwhile, administration of TGF-ß1 activator reversed the therapeutic effects of PRP in IUA. Collectively, the intrauterine infusion of PRP can promote endometrial damage recovery and improve endometrial fibrosis via the TGF-ß1/Smad pathway. Hence, PRP can be a potential therapeutic strategy for IUA.
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Fibrose , Plasma Rico em Plaquetas , Ratos Sprague-Dawley , Transdução de Sinais , Fator de Crescimento Transformador beta1 , Doenças Uterinas , Útero , Animais , Feminino , Fator de Crescimento Transformador beta1/metabolismo , Ratos , Aderências Teciduais/metabolismo , Doenças Uterinas/terapia , Doenças Uterinas/metabolismo , Transdução de Sinais/efeitos dos fármacos , Útero/metabolismo , Modelos Animais de Doenças , Proteínas Smad/metabolismo , Proteína Smad2/metabolismo , Proteína Smad3/metabolismoRESUMO
The microbial composition and volatile components of fermented grains (FG) and pit mud (PM) are crucial for the quality and flavor of compound-flavor baijiu (CFB). The physicochemical indices, culturable microorganisms, microbial communities, and volatile components of FG and PM were analyzed and correlated in our research. Considering FG and PM, amplicon sequencing was used to analyze the microbial community and the volatile components were detected by headspace solid-phase microextraction-gas chromatography-mass spectrometry (HS-SPME). For FG, redundancy analysis and correlation perfume Circos were used to clarify the correlations between the dominant microbial community and volatile components. The results showed that Aspergillus, Pichia, and Rhizopus were the main fungal microflora in FG and PM, whereas Lactobacillus and Bacillus were the dominant bacteria in FG, and Methanosarcina and Clostridium sensu stricto 12 were the dominant bacteria in the PM. The microbial community and volatile compounds in the CB sampled from the bottom layers of the FG were greatly affected by those in the PM. There were 32 common volatile components in CB and PM. For FG, most of the volatile components were highly correlated with Lactobacillus, Bacillus, Aspergillus, Pichia, and Monascus, which includes alcohols, acids and esters. This study reveals correlations between microbial composition, volatile components, and the interplay of FG and PM, which are conducive to optimizing the fermentation process and improving the quality of CFB base.
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This paper analyzes the physical layer security performance of hybrid automatic repeat request (HARQ) systems with the assistance of an intelligent reflecting surface (IRS) and aims to reveal the primary factors that enhance PLS. First, closed-form expressions for the connection outage probability (COP) and secrecy outage probability (SOP) in HARQ with chase combining (HARQ-CC) are acquired using the generalized-K (KG) distribution. Then, these two critical metrics are derived while adopting HARQ with incremental redundancy (HARQ-IR), resorting to the mixture gamma (MG) distribution and the Mellin transform. Diversity and coding gain are also addressed through an asymptotic analysis of the COP and SOP. Finally, an evaluation of the numerical results demonstrates that a greater gain in the main channel and the wiretap channel can be produced by increasing the number of meta-surfaces rather than increasing the maximum transmission number, except for the higher signal-to-noise (SNR) region of HARQ-IR where the latter is preferred. This finding provides a significant guidance for the joint configuration of IRS and HARQ to achieve secure communication.
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By connecting multiple short, local low-density parity-check (LDPC) codes with a global parity check, the globally coupled (GC) LDPC code can attain high performances with low complexities. The typical design of a local code is a quasi-cyclic (QC) LDPC for which the code length is proportional to the size of circulant permutation matrix (CPM). The greatest common divisor (GCD)-based full-length row multiplier (FLRM) matrix is constrained by a lower bound of CPM size to avoid six length cycles. In this paper, we find a new lower bound for the CPM size and propose an algorithm to determine the minimum CPM size and the corresponding FLRM matrix. Based on the new lower bound, two methods are proposed to construct the GC-QC-LDPC code of grith 8 based on the GCD based FLRM matrix. With the proposed algorithm, the CPM size can be 45% less than that given by sufficient condition of girth 8. Compared with the conventional GC-LDPC construction, the codes constructed with the proposed method have improved performance and are more flexible in code length and code rate design.
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The reconstruction of sparsely sampled projection data will generate obvious streaking artifacts, resulting in image quality degradation and affecting medical diagnosis results. Wavelet transform can effectively decompose directional components of image, so the artifact features and edge details with high directionality can be better detected in the wavelet domain. Therefore, a hybrid domain method based on wavelet transform is proposed in this paper for the sparse-view CT reconstruction. The reconstruction model combines wavelet, spatial, and radon domains to restore the projection consistency and enhance image details. In addition, the global distribution of artifacts requires the network to have a large receptive field, so that a multi-level wavelet transform network (MWCNN) is applied to the hybrid domain model. Wavelet transform is used in the encoding part of the network to reduce the size of feature maps instead of pooling operation and inverse wavelet transform is deployed in the decoding part to recover image details. The proposed method can achieve PSNR of 41.049 dB and SSIM of 0.958 with 120 projections of three angular intervals, and obtain the highest values in this paper. Through the results of numerical analysis and reconstructed images, it shows that the hybrid domain method is superior to the single-domain methods. At the same time, the multi-level wavelet transform model is more suitable for CT reconstruction than the single-level wavelet transform.
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Processamento de Imagem Assistida por Computador , Análise de Ondaletas , Algoritmos , Artefatos , Processamento de Imagem Assistida por Computador/métodos , Imagens de Fantasmas , Tomografia Computadorizada por Raios XRESUMO
The future 6G mobile communication network will support an unprecedented amount of Internet of Things (IoT) devices, which will boost the demand for low cost terminals under the principle of green communication. One of the critical issues for low cost terminals is the sampling rate of analog-to-digital converters (ADCs) at the receivers. A high sampling rate of the ADC gives rise to a high energy consumption and high hardware cost for the terminal. In the conventional multi-user OFDM systems, all users have to sample the received signal with a sampling rate that is larger than or equal to the Nyquist rate, despite only a small fraction of the bandwidth (number of subcarriers) is allocated to each user. This paper proposes a low sampling rate receiver design for multi-antenna multi-user OFDM systems. With the aid of zero-forcing precoding, the sampling rate of the receiver can be reduced to 1/K of the Nyquist rate, where K is the number of users. The simulation results show that with a significant reduction in sampling rate, performance loss is insignificant and acceptable in terms of bit error rate, mutual information and peak-to-average power ratio.
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Limited-view Computed Tomography (CT) can be used to efficaciously reduce radiation dose in clinical diagnosis, it is also adopted when encountering inevitable mechanical and physical limitation in industrial inspection. Nevertheless, limited-view CT leads to severe artifacts in its imaging, which turns out to be a major issue in the low dose protocol. Thus, how to exploit the limited prior information to obtain high-quality CT images becomes a crucial issue. We notice that almost all existing methods solely focus on a single CT image while neglecting the solid fact that, the scanned objects are always highly spatially correlated. Consequently, there lies bountiful spatial information between these acquired consecutive CT images, which is still largely left to be exploited. In this paper, we propose a novel hybrid-domain structure composed of fully convolutional networks that groundbreakingly explores the three-dimensional neighborhood and works in a "coarse-to-fine" manner. We first conduct data completion in the Radon domain, and transform the obtained full-view Radon data into images through FBP. Subsequently, we employ the spatial correlation between continuous CT images to productively restore them and then refine the image texture to finally receive the ideal high-quality CT images, achieving PSNR of 40.209 and SSIM of 0.943. Besides, unlike other current limited-view CT reconstruction methods, we adopt FBP (and implement it on GPUs) instead of SART-TV to significantly accelerate the overall procedure and realize it in an end-to-end manner.
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Algoritmos , Processamento de Imagem Assistida por Computador , Artefatos , Processamento de Imagem Assistida por Computador/métodos , Imagens de Fantasmas , Doses de Radiação , Tomografia Computadorizada por Raios X/métodosRESUMO
Sparse-view CT reconstruction is a fundamental task in computed tomography to overcome undesired artifacts and recover the details of textual structure in degraded CT images. Recently, many deep learning-based networks have achieved desirable performances compared to iterative reconstruction algorithms. However, the performance of these methods may severely deteriorate when the degradation strength of the test image is not consistent with that of the training dataset. In addition, these methods do not pay enough attention to the characteristics of different degradation levels, so solely extending the training dataset with multiple degraded images is also not effective. Although training plentiful models in terms of each degradation level can mitigate this problem, extensive parameter storage is involved. Accordingly, in this paper, we focused on sparse-view CT reconstruction for multiple degradation levels. We propose a single degradation-aware deep learning framework to predict clear CT images by understanding the disparity of degradation in both the frequency domain and image domain. The dual-domain procedure can perform particular operations at different degradation levels in frequency component recovery and spatial details reconstruction. The peak signal-to-noise ratio (PSNR), structural similarity (SSIM) and visual results demonstrate that our method outperformed the classical deep learning-based reconstruction methods in terms of effectiveness and scalability.
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Aprendizado Profundo , Processamento de Imagem Assistida por Computador , Artefatos , Processamento de Imagem Assistida por Computador/métodos , Razão Sinal-Ruído , Tomografia Computadorizada por Raios XRESUMO
Accurate estimation of channel log-likelihood ratio (LLR) is crucial to the decoding of modern channel codes like turbo, low-density parity-check (LDPC), and polar codes. Under an additive white Gaussian noise (AWGN) channel, the calculation of LLR is relatively straightforward since the closed-form expression for the channel likelihood function can be perfectly known to the receiver. However, it would be much more complicated for heterogeneous networks where the global noise (i.e., noise plus interference) may be dominated by non-Gaussian interference with an unknown distribution. Although the LLR can still be calculated by approximating the distribution of global noise as Gaussian, it will cause performance loss due to the non-Gaussian nature of global noise. To address this problem, we propose to use bi-Gaussian (BG) distribution to approximate the unknown distribution of global noise, for which the two parameters of BG distribution can easily be estimated from the second and fourth moments of the overall received signals without any knowledge of interfering channel state information (CSI) or signaling format information. Simulation results indicate that the proposed BG approximation can effectively improve the word error rate (WER) performance. The gain of BG approximation over Gaussian approximation depends heavily on the interference structure. For the scenario of a single BSPK interferer with a 5 dB interference-to-noise ratio (INR), we observed a gain of about 0.6 dB. The improved LLR estimation can also accelerate the convergence of iterative decoding, thus involving a lower overall decoding complexity. In general, the overall decoding complexity can be reduced by 25 to 50%.
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In this paper, we studied the secure transmission of a hybrid automatic repeat request with chase combining (HARQ-CC) system, under the existence of multiple eavesdroppers and limited latency. First, we analyzed some critical performance metrics, including connection outage probability (COP), secrecy outage probability (SOP) and effective secrecy throughput (EST). Then, to maximize the EST, three optimization problems of rate adaption were discussed: (i) optimizing the code rate with a given secrecy redundancy rate by a parameterized closed-form solution; (ii) optimizing the secrecy redundancy rate with a given code rate by a fixed-point method; (iii) optimizing both code rate and secrecy redundancy rate by an iterative optimization algorithm. We also considered COP and SOP constraints among the problems while corresponding solutions were deduced. Finally, numerical and simulated results verified our conclusions that the approximated SOP matches well with Monte-Carlo simulation for a strict reliable constraint, and that the optimized transmitting rate enhances EST efficiently with multiple eavesdroppers and retransmissions. Moreover, the influence of the number of eavesdroppers on secrecy performance was analyzed. Briefly, secrecy performance inevitably deteriorates with increasing number of eavesdroppers due to raised information leakage.
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BACKGROUND: This work was designed to explore the roles of PIM-1 in the development of cervical cancer. METHODS: There were 90 paired cervical tumor samples and the non-tumor adjacent tissue. The levels of PIM-1 in different samples were examined using quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) methods. The potential diagnostic value of PIM-1 was analyzed by the receiver operating characteristic (ROC) curve; furthermore, the expression of EGFR in tumor samples was detected, and Pearson's correlation analysis was performed to analyze the relationship between the expression of PIM-1 and EGFR. Finally, cervical cancer cell line Hela cells were cultured and treated by PIM-1 siRNA, and MTT assay and Pi/Annexin V assay were performed to explore the effects of PIM-1 siRNA on the growth and apoptosis ability of the Hela cells. RESULTS: PIM-1 was significantly up-regulated in cervical cancer tissue compared to adjacent tissue, and the expression of PIM-1 in patients with cervical cancer is positively associated with the size and metastasis of the tumor. ROC analysis showed PIM-1 is a sensitive biomarker for the diagnosis of cervical cancer. Furthermore, EGFR was over-expressed in cervical cancer tumor tissues, and the levels of PIM-1 and EGFR in cervical cancer tissue were positively correlated. Finally, PIM-1 siRNA dramatically inhibited the viability and promoted the apoptosis of the Hela cells. CONCLUSION: Our findings prove that PIM-1 may function as an oncogene in cervical cancer and can regulate the EGFR signaling in cervical cancer.
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Oncogenes/genética , Proteínas Proto-Oncogênicas c-pim-1/metabolismo , Neoplasias do Colo do Útero/genética , Receptores ErbB/metabolismo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transdução de Sinais , TransfecçãoRESUMO
BACKGROUND: Evidence has been shown that circular RNAs (circRNAs) play a vital role during the development of ovarian cancer. However, the mechanism by which circEXOC6B regulates tumorigenesis of ovarian cancer remains unknown. Thus, this study aimed to investigate the role of circEXOC6B during the progression of ovarian cancer. MATERIALS AND METHODS: The dual-luciferase reporter system assay was used to determine the interaction between circEXOC6B, miR-421 and RUS1 in ovarian cancer, respectively. CCK8 and colony formatting were used to evaluate cell proliferation. Meanwhile, the expressions of RSU1, PINCH1 and ILK in SKOV3 cells were detected with Western blot. RESULTS: Downregulation of circEXOC6B markedly promoted the proliferation and invasion in A2780 cells. In contrast, upregulation of circEXOC6B significantly inhibited the proliferation and invasion in SKOV3 cells. Moreover, overexpression of circEXOC6B obviously induced the apoptosis of SKOV3 cells. Furthermore, luciferase reporter assay identified that miR-421 was the potential miRNA binding of circEXOC6B, and RUS1 was the potential binding target of miR-421. Mechanism analysis indicated that upregulation of circEXOC6B increased the level of RUS1 by acting as a competitive "sponge" of miR-421. CONCLUSION: In this study, we found that circEXOC6B suppressed the growth of ovarian cancer cells through upregulating RSU1 partially via sponging miR-421. Therefore, circEXOC6B might be a potential target for the treatment of ovarian cancer.
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Cooperative routing is one of the most widely used technologies for improving the energy efficiency and energy balance of wireless multi-hop networks. However, the end-to-end energy cost and network lifetime are greatly restricted if the cooperative transmission model is not designed properly. The main aim of this paper is to explore a two-stage cooperative routing scheme to further improve the energy efficiency and prolong the network lifetime. A two-stage cooperative (TSC) transmission model is firstly designed in which the core helper is introduced to determine the helper set for cooperation. Then, the two-stage link cost is formulated where x, the weight of residual energy, is introduced to be adjusted for different design goals. By selecting the optimal helper set, the two-stage link cost of each link can be optimized. Finally, based on the designed TSC transmission model and the optimized two-stage link cost, a distributed two-stage cooperative routing (TSCR) scheme is further proposed to minimize the end-to-end cooperative routing cost. Simulation results evaluate the effect of x on the different performance metrics. When x equals 0, TSCR can achieve the shortest end-to-end transmission delay and highest energy efficiency, while a larger x can achieve a longer network lifetime. Furthermore, simulation results also show that the proposed TSCR scheme can effectively improve both the energy efficiency and network lifetime compared with the existing schemes.
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Signal molecules are stimulators of multiple quroum-sensing virulence and biofilm formation. Small molecule analogues have been suspected as a potent inhibitor in therapeutic strategy. Herein, we synthesized a series of small molecule compounds from the 2, 8-bit derivatives of quinoline by Suzuki coupling reaction. We found that these compounds have the biofilm inhibitory effect in normal condition instead of phosphate limitation state. Furthermore, lacZ reporter strain assay and rhamnolipids as well as pyocyanin experiments showed that these compounds did not affect las and pqs system but reduced the expression of rhl. All these results suggest that quinoline derivatives can be treated as potent inhibitors against biofilm and reduce virulence through the rhl system. This research will be useful in designing new quorum sensing inhibitors to attenuate the infection of bacteria.
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Antibacterianos/farmacologia , Biofilmes/efeitos dos fármacos , Pseudomonas aeruginosa/efeitos dos fármacos , Quinolinas/farmacologia , Virulência/efeitos dos fármacos , Óperon Lac , Pseudomonas aeruginosa/patogenicidade , Quinolinas/química , Percepção de QuorumRESUMO
This paper proposes a distributed joint source-channel coding (DJSCC) scheme using polar-like codes. In the proposed scheme, each distributed source encodes source message with a quasi-uniform systematic polar code (QSPC) or a punctured QSPC, and only transmits parity bits over its independent channel. These systematic codes play the role of both source compression and error protection. For the infinite code-length, we show that the proposed scheme approaches the information-theoretical limit by the technique of joint source-channel polarization with side information. For the finite code-length, the simulation results verify that the proposed scheme outperforms the distributed separate source-channel coding (DSSCC) scheme using polar codes and the DJSCC scheme using classic systematic polar codes.
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L-gulono-gamma-lactone oxidase (GULO) catalyzes the final step in vertebrate vitamin C biosynthesis. Vitamin C-incapable vertebrates lack the GULO gene. Gene structure and phylogenetic analyses showed that vertebrate GULO genes are 64-95% identical at the amino acid level and consist of 11 conserved exons. GULO pseudogenes have multiple indel mutations and premature stop codons in higher primates, guinea pigs, and some bats. No GULO-like sequences were identified in teleost fishes. During animal GULO evolution, exon F was subdivided into F1 and F2. Additional GULO retropseudogenes were identified in dogs, cats, and giant pandas. GULO-flanking genome regions acquired frequent segment translocations and inversions during vertebrate evolution. Purifying selection was detected across vertebrate GULO genes (d(N)/d(S) = 0.069), except for some positively selected sites identified in sharks and frogs. These positive sites demonstrated little functional significance when mapped onto the three-dimensional GULO protein structure. Vertebrate GULO genes are conserved except for those that are lost.
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Ácido Ascórbico/biossíntese , Sequência Conservada/genética , Evolução Molecular , L-Gulonolactona Oxidase/genética , Vertebrados/genética , Animais , Sequência de Bases , Gatos , Cães , Éxons/genética , Genoma/genética , Humanos , Íntrons/genética , Modelos Moleculares , Dados de Sequência Molecular , Filogenia , Pseudogenes/genética , Seleção Genética , Homologia de Sequência do Ácido Nucleico , Inversão de Sequência , Translocação GenéticaRESUMO
Our aim was to evaluate the safety and effectiveness of extracorporeal cardiac shock wave therapy (CSWT) for the patients with coronary heart disease (CHD) using a randomized, double-blind, controlled clinical trial design. Twenty-five patients with CHD were enrolled in this study. Fourteen of the patients were randomized into the CSWT group and 11 into the control group. We applied the CSWT procedure to each patient by using nine shock treatments during 3 months, but the shock wave (SW) energy was only applied to the patients in the CSWT group and not to the patients in the control group. Technetium-99m sestamibi myocardial perfusion, fluorine-18 fluorodeoxyglucose myocardial metabolism single-photon emission computed tomography (SPECT), and two-dimensional echocardiography were performed to identify segments of myocardial ischemia, myocardial viability, and ejection fraction before and after CSWT. We also followed the patients to evaluate adverse effects. After CSWT, the New York Heart Association class, the Canadian Cardiovascular Society angina scale, nitroglycerin dosage, myocardial perfusion and myocardial metabolic imaging scores of dual-isotope SPECT in the CSWT group were reduced significantly (P = 0.019, 0.027, 0.039, 0.000, 0.001, respectively), and the Seattle Angina Questionnaire scale, 6-min walking test, and left ventricular ejection fraction were increased significantly (P = 0.021, 0.024, 0.016, respectively) compared with those before the SW treatment. All of the parameters in the control group did not change significantly after the treatment (all P > 0.05). No serious adverse effects of CSWT were observed. Cardiac shock wave therapy is a safe and effective treatment for CHD patients.
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Doença das Coronárias/terapia , Ondas de Choque de Alta Energia/uso terapêutico , Idoso , Distribuição de Qui-Quadrado , China , Doença das Coronárias/diagnóstico , Doença das Coronárias/fisiopatologia , Método Duplo-Cego , Feminino , Fluordesoxiglucose F18 , Ondas de Choque de Alta Energia/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Imagem de Perfusão do Miocárdio/métodos , Valor Preditivo dos Testes , Compostos Radiofarmacêuticos , Inquéritos e Questionários , Tecnécio Tc 99m Sestamibi , Fatores de Tempo , Tomografia Computadorizada de Emissão de Fóton Único , Resultado do TratamentoRESUMO
OBJECTIVE: To evaluate the feasibility, safety and efficiency of extracorporeal cardiac shock wave therapy (CSWT) in patients with ischemic heart failure. METHODS: Fifty patients with ischemic heart failure and left ventricular ejection fraction (LVEF) < 50% were randomized to CSWT (shots/spot at 0.09 mJ/mm(2) for 9 spots, 9 times within 3 month) or control group. Dual isotope simultaneous acquisition single-photon emission computed tomography with (99)Tc(m)-sestamibi/(18)F-fluorodeoxyglucose ((99)Tc(m)-MIBI/(18)F-FDG) was performed before randomization and at 1 month after CSWT/control to locate and evaluate viable myocardium region. Canadian cardiovascular society (CCS) class sores, NYHA, Seattle Angina Questionnaire (SAQ), 6-min walk test (6 MWT), left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDD) and the dosage of nitroglycerin use were compared between two groups at each time point. RESULTS: All patients completed the study protocol without procedural complications. At 1 month, patients in CSWT group experienced improvement in NYHA (P < 0.01), CCS (P < 0.01), SAQ (P = 0.021), 6 MWT (P = 0.012) and dosage of nitroglycerin use (P < 0.01) compared to baseline. LVEF [45.0 (39.0, 48.0) vs. 47.0 (42.0, 50.0) P = 0.001], LVEDD [58.0 (56.0, 59.0) vs. 56.0 (55.0, 58.0) P = 0.002], summed perfused score [23.0 (20.5, 24.5) vs. 20.0 (18.0, 22.0) P < 0.01] and metabolic score [25.0 (23.0, 26.0) vs. 24.0 (21.5, 25.0) P = 0.028] were also improved in CSWT group. All these parameters remained unchanged in control group between baseline and at 1 month. CSWT was independent factor for improved cardiac function, quality of life and echocardiography parameters after adjusting for known factors which might affect outcome. CONCLUSION: CSWT could improve symptom, cardiac function, quality of life and exercise tolerance in patients with ischemic heart failure, CSWT might serve as a new, non-invasive, safe and efficient therapy for these patients.