The effect of amiodarone on cardiac rhythm after cardiopulmonary bypass in patients with atrial fibrillation.

BACKGROUND AND AIM OF THE STUDY: The intraoperative use of amiodarone in patients with atrial fibrillation (AF) undergoing valvular heart surgery was unclear. Hence, a randomized clinical trial was designed to evaluate the effect of amiodarone on cardiac recovery and rhythm following mitral valve surgery. METHODS: A total of 120 elective mitral valve replacement patients with AF received either amiodarone (5 mg/kg) or the same volume of saline during cardiopulmonary bypass (CPB), in a randomized manner. Cardiac recovery was assessed by the heart auto re-beat ratio, the time from reperfusion to heart beat, the post-reperfusion rhythm, pacemaker use, and vasoactive drug use. RESULTS: A higher heart auto re-beat ratio, higher sinus rhythm ratio, lower electric defibrillation ratio and less dopamine usage were found in the amiodarone treatment group. However, the proportion of temporary pacemaker use was lower in the control group. CONCLUSION: Amiodarone had a good effect on cardiac recovery and the rhythm of AF patients after CPB.

Parthenolide promotes the repair of spinal cord injury by modulating M1/M2 polarization via the NF-κB and STAT 1/3 signaling pathway.

Spinal cord injury (SCI) is a severe neurological disease; however, there is no effective treatment for spinal cord injury. Neuroinflammation involves the activation of resident microglia and the infiltration of macrophages is the major pathogenesis of SCI secondary injury and considered to be the therapeutic target of SCI. Parthenolide (PN) has been reported to exert anti-inflammatory effects in fever, migraines, arthritis, and superficial inflammation; however, the role of PN in SCI therapeutics has not been clarified. In this study, we showed that PN could improve the functional recovery of spinal cord in mice as revealed by increased BMS scores and decreased cavity of spinal cord injury in vivo. Immunofluorescence staining experiments confirmed that PN could promote axonal regeneration, increase myelin reconstitution, reduce chondroitin sulfate formation, inhibit scar hyperplasia, suppress the activation of A1 neurotoxic reactive astrocytes and facilitate shift from M1 to M2 polarization of microglia/macrophages. To verify how PN exerts its effects on microglia/macrophages polarization, we performed the mechanism study in vitro in microglia cell line BV-2. PN could significantly reduce M1 polarization in BV2 cells and partially rescue the decrease in the expression of M2 phenotype markers of microglia/macrophage induced by LPS, but no significant effect on M2 polarization stimulated with IL-4 was observed. Further study demonstrated PN inhibited NF-κB signal pathway directly or indirectly, and suppressed activation of signal transducer and activator of transcription 1 or 3 (STAT1/3) via reducing the expression of HDAC1 and subsequently increasing the levels of STAT1/3 acetylation. Overall, our study illustrated that PN may be a promising strategy for traumatic SCI.