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1.
Journal of Army Medical University ; (semimonthly): 768-774, 2024.
Article in Chinese | WPRIM | ID: wpr-1017590

ABSTRACT

Objective To observe the incidence of pericardial tamponade(PT)after left atrial appendage closure(LAAC)in patients with non-valvular atrial fibrillation(NVAF),and to explore its related factors and outcomes.Methods NVAF patients who were hospitalized and treated with LAAC in Department of Cardiology of our hospital from August 2014 to March 2023 were selected for the study.The general clinical data,preoperative transthoracic echocardiography and transesophageal echocardiography data,results of routine preoperative laboratory tests,intraoperative data and follow-up data of the patients were collected through the hospital medical record management system.The enrolled patients were classified into the non-PT group(n=8)and the PT group(n =1184)according to whether PT occurred after LAAC or not.The incidence of PT,related risk factors and outcomes were statistically analyzed.Results This study included 639 males(53.6%)and 553 females(46.4%),with an average age of 68.1±9.65 years.The CHA2 DS2-VASc score was 4.51±1.72,and the HAS-BLED score was 3.36±1.09.PT occurred in 8 cases(0.67%),among them,6 cases occurred 1 to 33 h after LAAC,and 2 cases occurred on day 19 and day 27 after LAAC.As for the results of transesophageal echocardiography(TEE)and LAA angiography,compared with the non-PT group,the PT group had the significantly larger maximum caliber of the LAA(P=0.025,P=0.015),smaller maximum depth of the LAA(P=0.028,P=0.031),and lower success rate of one-time placement of the occluder(P=0.031);The occluder compression rate of the PT group was significantly greater than that of the non-PT group(P=0.046).Multivariate analysis showed that larger maximum diameter of LAA,smaller average effective depth of LAA and larger compression rate of occluder were the main risk factors for PT.All the 8 PT patients were cured by stopping antithrombotic drugs,pericardiocentesis or surgical drainage.During a mean follow-up of 39±27 months,there were no device-related thrombosis(DRT),ischemic stroke,systemic embolism and other complications in the PT group.Conclusion The incidence of PT after LAAC is low,which is related to the large diameter of LAA,the relatively insufficient depth of the LAA and the large compression rate of the occlude.PT can be cured by stopping antithrombotic drugs and pericardiocentesis/surgical drainage.

2.
Article in Chinese | WPRIM | ID: wpr-1030924

ABSTRACT

Objective To explore the causal relationship among 731 types of immune cells and breast cancer. Methods Genome-wide association data for immune cells and breast cancer were used. Mendelian randomization analysis was performed using the inverse variance weighting (IVW) and weighted median (WM) methods, and sensitivity analysis was conducted to assess heterogeneity and pleiotropy. Results A total of 19 immune cell phenotypes were identified to potentially have a causal association with breast cancer, using IVW as the main analysis method (P>0.05) and correcting P values using the false discovery rate method at a significance level of 0.05, excluding reverse causality. Of these, eight and 11 immune phenotypes may increase and decrease the risk of breast cancer, respectively. Conclusion This study explored the causal relationship between immune cells and breast cancer. Results show that certain immune cell phenotypes could serve as predictive markers for the early diagnosis of breast cancer and the development of new immunotherapeutic strategies.

3.
Chongqing Medicine ; (36): 211-213,216, 2018.
Article in Chinese | WPRIM | ID: wpr-691775

ABSTRACT

Objective To investigate the interventional therapy effect of combination application of thrombus aspiration and intracoronary injection of tirofiban for treating heavy thrombosis burden of infarction related vessel in the patients with acute anterior myocardial infarction.Methods The patients with acute anterior myocardial infarction undergone direct primary percutaneous coronary intervention in the hospital were retrospectively analyzed.The group A received simple thrombus aspiration during transcutaneous PCI and the group B received the combination treatment of thrombus aspiration and intracoronary injection of tirofiban in direct PCI.Results The patients with myocardial perfusion grade less than 3 during thrombolysis during myocardial infarction(TIMI) in the group B were significantly less than those in the group A(P<0.05).The cardiac magnetic resonance imaging(MRI) results indicated that the area of myocardial infarction in the group B was smaller than that in the group A(P<0.05).The color echocardiography results showed that the left ventricular diastolic volume(LVDV) and left ventricular ejection fraction(LVEF) in the group B were significantly better than those in the group A(P<0.05).Conclnsion The combination application of thrombus aspiration and intracoronary injection of tirofiban is safe and effective in direct PCI.

4.
Herald of Medicine ; (12): 1393-1396, 2018.
Article in Chinese | WPRIM | ID: wpr-701036

ABSTRACT

Objective To establish the chromatographic conditions of isochlorogenic acid A and isochlorogenic acid C in vernonia anthelmintica. Methods By changing the mobile phase,flow rate,column temperature and other chromatographic conditions,the best chromatographic conditions was we pursued to established. Results The linear relationship between the concentration of isochlorogenic acid A and the peak area was between 5. 825-69. 9 μg·mL-1, and the concentration of isochlorogenic acid C,was between 5.15-61.80 μg·mL-1and the peak area was good . The sample recovery rates of the two groups were 98.70%-101.92%(RSD=1.04%,n=9)、95.99%-102.52%(RSD=1.90%,n=9). Conclusion The method is simple,rapid, accurate and reliable for the determination of isochlorogenic acid A and isochlorogenic acid C in Vernonia anthelmintica and also for the quality control of the raw material.

5.
Article in Chinese | WPRIM | ID: wpr-809018

ABSTRACT

The etiology and pathogenesis of sleep obstructive apnea hypopnea syndrome (OSAHS) is not yet definitive, evidence shows that the dysfunction of pharyngeal nerve and the atonia of the muscle innervated by these nerve could play an important role in the progress of OSAHS. Dopamine is a neurotransmitter in the central nervous system which significantly affects the sleep-awake regulation. So far mounting evidence shows that dopamine has a potential role in the modulation of hypoglossal nucleus. The progress of dopamine in obstructive sleep apnea hypopnea syndrome is reviewed in this article.

6.
Chongqing Medicine ; (36): 2646-2648, 2015.
Article in Chinese | WPRIM | ID: wpr-465332

ABSTRACT

Objective To investigate the effective therapic methods of the perioperative vasovagal reflex(RV)in patients with atrial arrhythmias(AAs)underwent by catheter ablation .Methods The clinical data in the patients with atrial arrhythmias(AAs) complicated by vasovagal reflex(RV)were retrospectively analyzed during the perioperative procedure of catheter ablation guided by three dimensional mapping system CARTO ;the clinical data were compared between patients with RV and without RV .Results A total of 535 patients with AAs underwent catheter ablation guided by three dimensional mapping system were collected from Janu‐ary 2010 to December 2012 ,and 35 cases of intraoperative RV were found .Compared by patients without RV ,the patients with RV had more elderly cases and the cases of hypertension ,coronary heart disease and diabetes .The RV occurrence was also associated with the fasting ,painful stimuli ,operation time and skill .Conclusion The perioperative RV often is occurred in the cases of high risk and have the precipitating factors ,and the good prognosis could be obtained by the detect and treatment as early as possible .

7.
Chongqing Medicine ; (36): 3443-3444,3448, 2014.
Article in Chinese | WPRIM | ID: wpr-599496

ABSTRACT

Objective To investigate the efficacy and safety of radiofrequency catheter ablation for treating epicardial accessory pathway .Methods 8 patients with unsuccessful endocardial ablation of accessory pathway were mapped within coronary venous si-nus or middle cardiac vein and the radiofrequency catheter ablation was performed by the temperature control electrode .Results Ablation in 8 cases was successfully performed within coronary sinus or middle cardiac vein .There were no complications in all pa-tients .Conclusion Radiofrequency catheter ablation of epicardial accessory pathway within coronary sinus and middle cardiac vein is safe and effective .

8.
Chongqing Medicine ; (36): 823-825, 2014.
Article in Chinese | WPRIM | ID: wpr-444977

ABSTRACT

Objective To systematically evaluate the clinical outcomes of patients with multivessel diseases treated by fractional flow reserve (FFR) guided percutaneous coronary intervention (PCI) or other forms of treatment .Methods Some keywords inclu-ding FFR or fractional flow reserve ,percutaneous coronary intervention or PCI ,multivessel coronary artery disease were used to search randomized control trails(RCT) ,which compared outcomes of patients with multivessel disease treated by FFR guided PCI with other forms of treatment ,in Chinese and English database including CNKI ,VIP ,Wanfang ,Pubmed ,EMBASE and the web of science .The quality of included studies was evaluated by Jadad quality score and all the data was analyzed by stata 10 .0 .Results A total of 7 english literatures accumulating 2024 cases in experimental group and 7 284 cases in control group were included in this study .Compared with other forms of treatment ,patients with multivessel diseases treated by FFR-guided PCI had significantly low-er risk of myocardial infarction (RR=0 .72 ,P=0 .008) .Although the risk of death and major adverse cardiovascular events were al-so be reduced ,there were no statistically significant difference .Conclusion FFR-guided PCI is an effective treatment for multivessel disease ,but it is still needs further verification for the application in Chinese population .

9.
Article in Chinese | WPRIM | ID: wpr-562539

ABSTRACT

Objective To investigate the potassium currents of the cardiac pacemaking cells induced and differentiated from rat mesenchymal stem cells (MSCs) modified by HCN4 gene. Methods Identified cardiac pacemaking cells were adopted as the experiment group, and the sinoatrial node cells of original infant rat cultured in the same period were regarded as the control group. Whole cell patch was used to measure the action potential of the pacemaking cells and sinoatrial node cells. Results Action potential of automatic depolarization at dilatation was recorded in both the differentiated cardiac pacemaking cells and sinoatrial node cells. There was no significant difference on amplitudes of resting potential, amplitudes and cycle of action potential [(-50?2.8) vs (-55?5.5),(-60?2.5) vs (-65?2.5),(240?57) ms vs (250?60) ms], but the field potential was much lower in cardiac pacemaking cells than the control group[(-30?2.5) vs (-55?5.5),P

10.
Article in Chinese | WPRIM | ID: wpr-678307

ABSTRACT

Objective To investigate the effects of ischemia reperfusion on the morphological changes of sinoatrial node(SAN) cells in rabbits in vivo . Methods Ninety healthy adult rabbits were randomly divided into 3 groups with 10 rabbits in control and every subgroup: control group [a suture passed under the root section of right coronary artery(RCA) without ligation], ischemia group(occluding the root section of RCA for 10, 30, 60 and 120 min respectively), ischemia reperfusion group(10, 30, 60 and 120 min ischemia after respectively followed by 4 hours′ reperfusion). Results ① Compared with control group, abnormal structure of SAN cells was not seen in 10 min ischemia group and 10 min ischemia reperfusion group with light microscopy, except slight mitochondrial swelling of SAN cells in former group with electron microscopy. ② There were morphological changes of SAN cells in 7, 6 and 8 rabbits in 30, 60 and 120 min ischemia group, presenting mainly as cellular swelling, karyopyknosis, and focal necrosis under a light microscope, and mitochodrial swelling, cristae disorganization or break under an electron microscope. The most severe cellular damages were found in 120 min ischemia group. ③ In ischemia reperfusion group, there were morphological abnormalities of SAN cells in 6, 8 and 7 rabbits in 30, 60 and 120 min ischemia reperfusion groups. The morphologic changes were similar to those in ischemia group, but injury degree was more severe than that in ischemia group with the same ischemic time. Conclusion Ischemia and ischemia reperfusion can induce morphological changes of SAN cells in a time dependent manner in rabbits in vivo , and the injury degree is more severe in ischemia reperfusion group than that in ischemia group with the same ischemic time.

11.
Article in Chinese | WPRIM | ID: wpr-678408

ABSTRACT

Objective To study the effect of ischemia reperfusion(IR) on electrophysiological function of sinoatrial node(SAN) in rabbits. Methods Ninety healthy adult rabbits were divided randomly into control group, ischemia groups (I) 10(I10 min), 30(I30 min), 60(I60 min) and 120 min(I120 min) and IR groups (10, 30, 60 and 120 min ischemia followed by 4 h reperfusion respectively)(I10 minR4 h, I30 minR4 h, I60 minR4 h and I120 minR4 h). There were 10 rabbits in the control group and each subgroup. IR injury model of SAN was established by occluding and loosening the start section of right coronary artery(RCA). The changes of AA interval and arrhythmia were recorded by electrocardiography and cardiac chamber electrography synchronously. Results ① There was no significant difference in AA interval between different time points in the control group. ② Sinus arrest(SA), sinus bradycardia with arrhythmia(SB), or atrial tachyarrhythmia(AT) were found in 51 rabbits (63.75%) out of 80 rabbits in I and IR groups in ischemic period. The incidence rate of arrhythmia increased in a time dependent manner. The AA intervals also increased by at least 40 ms in 54 rabbits (67.5%). ③ Sinus or atrial arrhythmia during ischemic period was found in 26 out of the 40 rabbits in IR group, but 15 returned normal after reperfusion. ④ Increased AA intervals were found in 27 out of the 40 rabbits in IR group during ischemic period. Most of them recovered to pre occlusion level within 10 min after reperfusion, but the AA intervals prolonged again in I60 minR4 h and I120 minR4 h groups as the reperfusion elongated. Conclusion ① These findings suggest that about 2/3 of the rabbit sinus node arteries may stem from right coronary artery. ② Electrophysiological changes due to ischemia of SAN resemble the electrocardiogram of sick sinoatrial node syndrome. ③ Reperfusion arrhythmia can be induced by reperfusion after a long time of ischemia.

12.
Article in Chinese | WPRIM | ID: wpr-678839

ABSTRACT

Objective To evaluate the therapeutic efficacy and safety of transcatheter closure of atrial septal defect (ASD) and patent ductus arteriosus (PDA) using Amplatzer occluder. Methods Routine cardiac catheterization and angiography were performed in 50 patients (23 male, 27 female, age ranging from 3 to 64 years old), including 19 cases of ASD and 31 cases of PDA under local or general anesthesia. After balloon sizing of the ASD, the optimal Amplazter septal occluder (ASO) was transmitted into the left atrial, and the left and right disks were released in turn. The Amplatzer occluder was completely released after transthoracic echocardiography confirmed that there was no residual shunts or new onset mitral valve regurgitation. The Amplatzer duct occluder (ADO) size was selected according to the narrowest point of PDA measured by angiography, and the occluder was released after the repeated angiography showed no residual shunts. Results ① The mean diameter of the ASD measured by balloon was 13-31 (23?6) mm and the diameter of ASO was (17-40) mm. The immediate closure rate was 100%. ② Angiography confirmed that closure of the ductus using ADO was achieved in 30 patients, and closure of the large size (12 mm) was achieved in 1 case of PDA patient using ASO (17 mm). No complications were encountered. Conclusion Transcatheter closure of ASD and PDA using Amplatzer device, with the advantages of simple operation, confirmative occlusion efficacy, minimal invasiveness, wide indications, and less complications, has a bright future of clinical application.

13.
Article in Chinese | WPRIM | ID: wpr-678956

ABSTRACT

Objective To evaluate the immediate and short term therapeutic efficacy of percutaneous transluminal septal myocardial ablation (PTSMA) in patients with hypertrophic obstructive cardiomyopathy (HOCM) and to investigate the prevention of the related complications. Methods PTSMA was conducted in 3 patients with HOCM refractory to medication. The immediate effect was evaluated by pressure monitor, but the follow up effect by observation of the clinical symptoms and ultrasonic cardiogram. Results The left ventricular outflow tract gradients triggered by ventricular premature beats decreased from 143 mmHg (ranging from 70 to 180 mmHg) to 53 mmHg (ranging from 30 to 80 mmHg). Complete atrioventricular block (Ⅲ?AVB) with atrioventricular node rhythm was found in 1 case, and complete right branch bundle block (CRBBB) in another one. Follow up of the 3 cases at 6 months after operation revealed remarkable improvement of the patients' cardiac function (NYHA), disappearance of angina pectoris, and obvious attenuation of ventricular septal hypertrophy and SAM (systolic anterior motion of mitral) phenomenon. Conclusion PTSMA is an effective method with satisfactory short term effect for the patients with HOCM refractory to medication.

14.
Article in Chinese | WPRIM | ID: wpr-566671

ABSTRACT

Objective To explore the feasibility and reliability to build a sinoatrial node damage model in canine induced by formaldehyde wet dressing.Methods Twenty dogs were randomly divided into 4 groups(5 in each group) by means of random number table:2-hour,24-hour,1-week and 4-week groups after wet dressing.The sinoatrial node area of canine was damaged by wet dressing with 20% formaldehyde.Sinus node function was measured before,2 h after wet dressing and corresponding times of each group.Electrocardiogram(ECG) of body surface were recorded synchronically.Results Average wet dressing time was 6.2?2.6(3 to 12)min.Five dogs showed significantly decrease of heart rate(HR)(140?11 vs 89?6 beat/min,P

15.
Article in Chinese | WPRIM | ID: wpr-555535

ABSTRACT

6 months (n=12), control group, without AF (n=8). Atrial muscle samples of the left and right atrial appendage were cut off during heart valve replacement. Expressions of Cx40 and Cx43 were detected by immunoblotting and immunohistologic analyses. Results ①No obvious change of Cx43 and Cx40 in the left and right atrium of each patient in each group was measured. ②Compared with that in the control group, the level of Cx40 was decreased signficantly in GroupⅠ (P

16.
Article in Chinese | WPRIM | ID: wpr-556338

ABSTRACT

Objective To explore the regularity of dynamic morphologic changes of the sinoatrial node (SAN) cells of rabbits after the constitution was damaged by formaldehyde wet dressing. Methods Sixty rabbits were randomly divided into 6 groups (n=10 in each group): the control group and 5 experimental groups observed at 2 h, 1, 2, 3, and 4 weeks respectively after the operation. The SAN constitution of rabbits was damaged by 20% formaldehyde wet dressing. The constitutions of SAN were cut quickly at 2 h after wet dressing in the control group and at the corresponding time points in other experimental groups respectively. The specimens were made for light microscopical and electron microscopical observations. The apoptosis of SAN cells was detected by TUNEL method. Results Compared with those in the control group, SAN cells in all experimental groups were damaged at various degrees observed by light microscopy and electron microscopy. Distinct cell tumefaction, soak of grain cells, cytoclasis, hyperplasia of collagen fibers, and other pathological changes were detected. Electron microscopical observation showed distinct pathological changes of the super-micro construction of cells. Apoptosis was not detected in the control group, but various degrees of apoptosis in all experiment groups. The apoptotic rates in all experimental groups were significant as compared with that in the control group (P

17.
Article in Chinese | WPRIM | ID: wpr-561522

ABSTRACT

Objective To develop new methods to cultivate, retrieve and purify mouse mesenchymal stem cells (mMSCs). Methods Bone marrow was collected from 2-month-old Kunming mice by flushing femurs and tibias with complete medium of DMEM-LG. Cells were plated in a Petri dish. After 24 hours, non-adherent cells were removed by two to three washes with PBS, adherent cells were further cultured in complete medium and retrieved by trypsinisation with 0.25% trypsin for 5 min at 37 ℃. The treated adherent cells were cultivated with 3?dilution for further generations. CD11b-negative cells were retrieved from the collected adherent cells of 3rd generation by using immunomagnetic microbeads, and continued to be cultured in complete medium. After the cultured cells were retrieved, their morphology and their ability of osteoblastic differentiation and adipocytic differentiation were examined. Results Most of mMSCs from 1st generation were of shuttle shape, some of irregular shape. After treatment with magnetic microbeads and several generations, mMSCs were of spindle, star and irregular shape. These cells were of rich cytoplasma, clear nucleolus, and grew in parallel or vortex. The cultured adherent cells from the first and subsequent generations had plenty of CD11b-positive blooding-making cells. After 20-day osteoblastic induction, mMSCs differentiated into bone cells, which showed orange phosphate in extracellular matrix by Alizarin red S staining. mMSCs could differentiate into lipocytes. The size of cells increased along with fat-developing induction period. These cells showed many orange fatty follicles with O Red Oil dyeing. Conclusion Pure mMSCs can not be retrieved by either adhering method or generation cultivation method separately. The combined methods of adhering, immunomagnetic microbeads, and serial subcultivation is effective in vitro in retrieve mMSCs.

18.
Chinese Medical Journal ; (24): 465-468, 2003.
Article in English | WPRIM | ID: wpr-324449

ABSTRACT

<p><b>OBJECTIVE</b>To establish a reliable approach to primary culture and identification of sinoatrial node (SAN) cells.</p><p><b>METHODS</b>The SAN cells were cultured from SAN tissue removed from neonatal Wistar rats and purified with differential attachment and 5'-bromodeoxyuridine (BrdU) treatment. The obtained cells were morphologically observed with inverted microscopy and transmission electron microscopy. Its action potential was recorded using electrophysiological methods.</p><p><b>RESULTS</b>Three distinctly different cells were observed in the cultured SAN cells: spindle, triangle and irregular. Of these, the spindle cells comprised the greatest proportion, with their shape, structure and electrophysiological characteristics consistent with those of the pacemaker cells of SAN. The triangle cells were similar in features to the similarly shaped myocytes located in the atrial myocardium.</p><p><b>CONCLUSIONS</b>The culture method of differential attachment combined with BrdU treatment is a reliable approach to growing SAN cells. Of the cells cultured from SAN, the spindle cells appear to function as pacemaker cells.</p>


Subject(s)
Animals , Female , Male , Rats , Animals, Newborn , Cells, Cultured , Microscopy, Electron , Rats, Wistar , Sinoatrial Node , Cell Biology , Physiology
19.
Article in Chinese | WPRIM | ID: wpr-567846

ABSTRACT

Objective To investigate the effect of calcium/calmodulin-dependent protein kinaseⅡ (CaMK[KG-*6]Ⅱ) inhibitor,KN93 on calcium overloading of atrial muscle cells in neonatal rats and detect the expression of CaMK[KG-*6]Ⅱ. Methods The atrial muscle cells from neonatal rats were primarily cultured for 96 h and then divided into 6 group,control,calcium overloading group,KN93 group (0.5 ?mol/L),low-,moderate-and high-dose of KN93+ calcium overloading group. A model of calcium overloading for atrial muscle cells was established by using calcium ionophore (ionomycin,1.0 ?mol/L). For the later 3 groups,KN93 at doses of 0.25,0.5 and 1.0 ?mol/L was added into the culture medium for 30 min followed by 1.0 ?mol/L ionomycin treatment for another 30 min. The identification of ?-actin was performed by immunofluorescence staining. In the present of Fluo-3/AM (an indicator of calcium),intracellular calcium and the expression of CaMK[KG-*6]Ⅱ were detected under the intervention of KN93 with laser cofocal microscopy and Western blotting respectively. Results More than 90% of cultured cells were positive to ?-actin antibody. Compared with the control group,the fluorescence intensity of intracellular Ca2+ was increased significantly by ionomycin (660.16?108.47 vs 376.12?57.57,P

20.
Article in Chinese | WPRIM | ID: wpr-554014

ABSTRACT

0.05), and HC lead ECG was more useful than Wilson lead when applied to localize the right free wall and right-anteroseptal accessory pathway (P

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