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Objectives: This study sought to describe our institutional experience of repeated percutaneous stellate ganglion blockade (R-SGB) as a treatment option for drug-refractory electrical storm in patients with nonischemic cardiomyopathy (NICM). Methods: This prospective observational study included 8 consecutive NICM patients who had drug-refractory electrical storm and underwent R-SGB between June 1, 2021 and January 31, 2022. Lidocaine (5 ml, 1%) was injected in the vicinity of the left stellate ganglion under the guidance of ultrasound, once per day for 7 days. Data including clinical characteristics, immediate and long-term outcomes, and procedure related complications were collected. Results: The mean age was (51.5±13.6) years. All patients were male. 5 patients were diagnosed as dilated cardiomyopathy, 2 patients as arrhythmogenic right ventricular cardiomyopathy and 1 patient as hypertrophic cardiomyopathy. The left ventricular ejection fraction was 37.8%±6.6%. After the treatment of R-SGB, 6 (75%) patients were free of electrical storm. 24 hours Holter monitoring showed significant reduction in ventricular tachycardia (VT) episodes from 43.0 (13.3, 276.3) to 1.0 (0.3, 34.0) on the first day following R-SGB (P<0.05) and 0.5 (0.0, 19.3) after whole R-SGB process (P<0.05). There were no procedure-related major complications. The mean follow-up was (4.8±1.1) months, and the median time of recurrent VT was 2 months. Conclusion: Minimally invasive R-SGB is a safe and effective method to treat electrical storm in patients with NICM.
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Humains , Mâle , Adulte , Adulte d'âge moyen , Sujet âgé , Femelle , Débit systolique , Ganglion cervicothoracique/chirurgie , Fonction ventriculaire gauche , Cardiomyopathies/complications , Tachycardie ventriculaire/thérapie , Résultat thérapeutique , Ablation par cathéterRésumé
During the development of therapeutic microRNAs (miRNAs or miRs), it is essential to define their pharmacological actions. Rather, miRNA research and therapy mainly use miRNA mimics synthesized in vitro. After experimental screening of unique recombinant miRNAs produced in vivo, three lead antiproliferative miRNAs against human NSCLC cells, miR-22-3p, miR-9-5p, and miR-218-5p, were revealed to target folate metabolism by bioinformatic analyses. Recombinant miR-22-3p, miR-9-5p, and miR-218-5p were shown to regulate key folate metabolic enzymes to inhibit folate metabolism and subsequently alter amino acid metabolome in NSCLC A549 and H1975 cells. Isotope tracing studies further confirmed the disruption of one-carbon transfer from serine to folate metabolites by all three miRNAs, inhibition of glucose uptake by miR-22-3p, and reduction of serine biosynthesis from glucose by miR-9-5p and -218-5p in NSCLC cells. With greater activities to interrupt NSCLC cell respiration, glycolysis, and colony formation than miR-9-5p and -218-5p, recombinant miR-22-3p was effective to reduce tumor growth in two NSCLC patient-derived xenograft mouse models without causing any toxicity. These results establish a common antifolate mechanism and differential actions on glucose uptake and metabolism for three lead anticancer miRNAs as well as antitumor efficacy for miR-22-3p nanomedicine, which shall provide insight into developing antimetabolite RNA therapies.
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Nuclear transporter importin-β1 is emerging as an attractive target by virtue of its prevalence in many cancers. However, the lack of druggable inhibitors restricts its therapeutic proof of concept. In the present work, we optimized a natural importin-β1 inhibitor DD1 to afford an improved analog DD1-Br with better tolerability (>25 folds) and oral bioavailability. DD1-Br inhibited the survival of castration-resistant prostate cancer (CRPC) cells with sub-nanomolar potency and completely prevented tumor growth in resistant CRPC models both in monotherapy (0.5 mg/kg) and in enzalutamide-combination therapy. Mechanistic study revealed that by targeting importin-β1, DD1-Br markedly inhibited the nuclear accumulation of multiple CRPC drivers, particularly AR-V7, a main contributor to enzalutamide resistance, leading to the integral suppression of downstream oncogenic signaling. This study provides a promising lead for CRPC and demonstrates the potential of overcoming drug resistance in advanced CRPC via targeting importin-β1.
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Objective: To investigate the acute and long-term outcome of catheter ablation for the treatment of ventricular tachycardia (VT) in patients with arrhythmogenic left ventricular cardiomyopathy (ALVC). Methods: This retrospective, cross-sectional study enrolled ALVC patients undergoing radiofrequency ablation for the treatment of VT at the First Affiliated Hospital of Nanjing Medical University from January 2011 to December 2018 and collected their clinical characteristics and intraoperative electrophysiological examination. Patients were followed up every 6 months after radiofrequency ablation until August 2021. Echocardiographic results and VT recurrence post radiofrequency ablation were analysed. Results: Totally 12 patients were enrolled (mean age: (42±15) years, 11 males(11/12)). The mean of left ventricular end diastolic diameter (LVDd) and left ventricular ejection fraction (LVEF) were (51±5)mm and (65±5)%, respectively. Twelve VTs were induced in 10 patients during the electrophysiological study, and the mean tachycardia cycle length was (293±65) ms. Three-dimensional substrate mapping revealed the diseased area at endocardial site in one patient, at epicardial sites in the other 11 patients (involved endocardial sites in 2 cases) with the basal part near the mitral annulus being the predilection for the substrate (10/11). After the catheter ablation at the endocardial and epicardial sites respectively, the complete procedure endpoint was achieved in all patients (VT cannot be induced post ablation). The median follow-up time was 65 (25, 123) months. One patient was lost to follow-up, and the other 11 patients survived without VT. No significant cardiac function deterioration was detected by the echocardiographic examination ((51±5)mm vs. (52±5)mm, P>0.05 for LVDd, (65±5)% vs. (60±6)%, P>0.05 for LVEF) at the end of follow-up. Conclusion: After radiofrequency ablation, the complete procedure endpoint is achieved in ALVC patients, and the catheter ablation provides long-term ventricular tachycardia control during the long-term follow-up.
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Adulte , Humains , Mâle , Adulte d'âge moyen , Cardiomyopathies , Ablation par cathéter , Études transversales , Études de suivi , Péricarde/chirurgie , Récidive , Études rétrospectives , Débit systolique , Tachycardie ventriculaire/chirurgie , Résultat thérapeutique , Fonction ventriculaire gaucheRésumé
Prostate cancer (PCa) patients who progress to metastatic castration-resistant PCa (mCRPC) mostly have poor outcomes due to the lack of effective therapies. Our recent study established the orphan nuclear receptor ROR
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We reviewed the data of 38 neonates who died of respiratory failure. Paraffin sections of the autopsy lung samples were examined with HE staining or immunolabeling for CD34, CD68 and CK to observe the development of the pulmonary vessels and detect potential pulmonary vascular diseases (PVDs). Five cases were identified to have PVDs, including pulmonary hypertensive vascular remodeling in 3 cases and alveolar capillary dysplasia in 2 cases. The result indicated that PVD was one of the important reasons for respiratory failure in these neonates.
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Humains , Nouveau-né , Mort , Poumon , Anatomopathologie , Maladies pulmonaires , Diagnostic , Persistance de la circulation foetale , Anatomopathologie , Alvéoles pulmonaires , Malformations , Anatomopathologie , Insuffisance respiratoire , Mortalité , Maladies vasculaires , Diagnostic , Remodelage vasculaireRésumé
<p><b>OBJECTIVE</b>To evaluate the clinical characteristics and long-term results of non-pulmonary veins (PV) trigger ablation in patients with paroxysmal atrial fibrillation (AF).</p><p><b>METHODS</b>Eighty-six patients [48 men, mean age (52.3 ± 10.2) years] were included in the study. Circumferential pulmonary vein antrum isolation guided by a 3-D mapping system was performed. Aggressive high right atrium programmed stimulation and burst pacing were made before and after isoproterenol infusion. Additional ablation was performed if other trigger foci were found or other sustained tachycardias could be induced.</p><p><b>RESULTS</b>PV triggers were observed in 59 patients (group I), and non-PV triggers were observed in 27 patients (group II), 12 non-PV triggers were identified during the first procedure. Among them, one was located in the roof of left atrium, 11 were originated from superior vena cava. After a mean follow-up of [37.1 ± 10.4 (range 15-60)] months, the AF recurrence rate was significantly higher in the Group II than in the Group I (55.5% vs. 20.3%, P = 0.001). The number of performed ablation was also significantly in group II than in group I higher difference (1.7 ± 0.8 vs. 1.1 ± 0.4, P < 0.001). In the group II, 15/15 (100%) patients had a repeated ablation procedure for AF recurrence, and 15 patients had new non-PV foci after isoproterenol infusion which were originated from the superior vena cava (n = 11) and coronary sinus (n = 2), respectively. After the second ablation procedure, AF recurrence was observed in three patients, two patients accepted third procedure, the non-PV triggers were located in left atrial septum and coronary sinus, and one patient accepted fourth procedure, the non-PV foci was located in left posterior wall.</p><p><b>CONCLUSIONS</b>Non-PV foci may occur at any age and the main area is located in the super vena cava, Non-PV serves as a major cause of AF recurrence after successful PVAI.</p>
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Adulte , Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Fibrillation auriculaire , Thérapeutique , Ablation par cathéter , Études de suivi , Veines pulmonaires , Récidive , Résultat thérapeutiqueRésumé
<p><b>OBJECTIVE</b>To report the single-center clinical experience of catheter ablation of epicardial accessory pathway associated with coronary sinus musculature.</p><p><b>METHODS</b>The data of 721 cases of left sided accessory pathway ablation were retrospectively analyzed. Ablation in the coronary sinus was performed in 17 (2.4 %) cases [11 males, mean age (37 ± 11) years].</p><p><b>RESULTS</b>Among the 17 cases, the accessory pathway was successfully ablated in middle cardiac vein and posterior lateral coronary sinus in 11 and 6 cases, respectively. Deverticulum of middle cardiac vein was seen in 2 cases. Mean time required to block the accessory pathway was (4.7 ± 2.7) s. An accessory pathway potential could be recorded at the target site in 10 out of 17 patients (59%). During a mean (21 ± 16) months follow up, only one patient experienced recurrence who was successfully cured by a second ablation session. No procedure related complication was reported.</p><p><b>CONCLUSION</b>About 2.4% of left accessory pathway may have epicardial connection locating at middle cardiac vein or lateral part of the coronary sinus and require epicardial ablation. The epicardial ablation is safe and effective, warrants an excellent long-term results.</p>
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Adulte , Femelle , Humains , Mâle , Adulte d'âge moyen , Jeune adulte , Ablation par cathéter , Sinus coronaire , Chirurgie générale , Études de suivi , Péricarde , Chirurgie générale , Études rétrospectivesRésumé
<p><b>OBJECTIVE</b>To evaluate the acute and long-term effects of catheter radiofrequency ablation for the treatment of ventricular arrhythmia storm (VAS) post implantable cardioverter-defibrillators (ICD) implantation.</p><p><b>METHODS</b>Acute and long-term effects of catheter radiofrequency ablation for the treatment of VAS post ICD implantation were retrospectively assessed in 11 patients from September 2008 to August 2011.</p><p><b>RESULTS</b>A total of 15 ablation procedures were performed in 11 patients. Six ablation procedures were performed through epicardial approach. In 9 patients, 20 types of ventricular tachycardia (VT) (including 20% hemodynamically unstable VT) were induced during the procedures [mean cycle length (384 ± 141) ms] and polymorphic ventricular tachycardia were induced in 7 patients. The average X-ray fluoroscopy time and procedural time were (26 ± 17) min and (189 ± 60) min, respectively. Complete success, partial success, and failure rates immediately post catheter radiofrequency ablation were 46.7% (7/15), 26.7% (4/15) and 26.7% (4/15), respectively. All patients are alive at follow-up[(2.45 ± 9.6) months after the last catheter ablation] and the complete success, partial success, and failure rates during follow-up were 72.7% (8/11), 9.1% (1/11) and 18.2% (2/11), respectively.</p><p><b>CONCLUSION</b>VAS can be effectively treated by catheter radiofrequency ablation in patients post ICD implantation.</p>
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Adulte , Sujet âgé , Humains , Mâle , Adulte d'âge moyen , Ablation par cathéter , Défibrillateurs implantables , Études de suivi , Études rétrospectives , Tachycardie ventriculaire , Chirurgie générale , Résultat thérapeutiqueRésumé
Objective To discuss the treatment and the clinical effect of endoscopic third ventriculostomy on severe obstructive hydrocephalus in premature infant.Methods Eleven patients were operated,ultrasound,CT and MRI showed severe obstructive hydrocephalus and cerebral spinal fluid absorption was normal.The technique was that endoscope was inserted through the foramen of Monro into the third ventricle,then perforating the floor of the third ventriculostomy.Comparison before and after surgery of ventricular system ultrasonic measurement about the change of lateral ventricle and the MRI and CT imaging changes were performed.The complications,operation effect and security were observed.The bailey baby scale and Peabody movement function scale was used to assess the patient's neurologic system status.Results The follow-up time was 6 months and 6 years after operation,an excellent operative result was got in 9 cases.The ventricular width of 1 patient was mild ventriculomegaly,but stayed stabilily.No change of ventricular width was found in 1 case.Additional shunt were needed in 1 case.No severe complications were found.The left and right lateral ventricle measured by ultrasonic before operation were (9.60 ± 3.52) mm and (8.63 ± 3.10) mm before operation,and (5.50 ± 2.20) mm and (4.90 ± 2.70) mm after operation.The 11 cases of lateral ventricle side edema were disappeared,the follow-up time in 9 cases were more than 12 months,obstructive hydrocephalus clinical symptoms were relieved.Conclusions Ventricular mirror operation significantly improve severe hydrocephalic short and longterm poor prognosis,it is a safe,effective and less complications of minimally invasive surgery.
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<p><b>OBJECTIVE</b>To explore the topographic distribution and long-term outcome of catheter ablation for focal atrial tachycardia (AT).</p><p><b>METHOD</b>The data of 207 patients who underwent electrophysiologic study for AT were retrospectively analyzed.</p><p><b>RESULTS</b>A total of 200 AT were identified in 185 patients. The most common site for AT was ostium of the coronary sinus (23.8%), followed by crista terminalis (20.5%), perinodal area (20.0%), cava vena (17.8%), annulus (13.0%), and appendage (10.3%). Eighty percent AT originated from the right atrium, 17.8% originated from the left atrium. AT originated from the left atrium was more common in male than in female (25.0% vs. 13.3%, P = 0.042), while AT originated from the right atrium was more common in female than in male (69.4% vs. 86.7%, P = 0.004). Among the 185 patients, acute success ablation rate was 93.5% (n = 173). The acute success rate in the conventional mapping group was lower than that in the three-dimensional mapping group (79.3% vs. 96.5%, P < 0.01). During a median of 36 months follow up, the AT recurred in 20 patients (success ablation rate 88.4%). Success ablation rate was similar between the conventional mapping group and the three-dimensional mapping group (P > 0.05).</p><p><b>CONCLUSIONS</b>Focal AT commonly originates from ostium of coronary sinus, crystal terminalis, perinodal area, and cava veins. There is a gender related difference in the distribution of focal AT. The radiofrequency catheter ablation yields a satisfying success rate and very low complication rate and could be the first line choice for treating ATs in experienced electrophysiological center.</p>
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Adolescent , Adulte , Sujet âgé , Enfant , Femelle , Humains , Mâle , Adulte d'âge moyen , Jeune adulte , Ablation par cathéter , Études rétrospectives , Tachycardie auriculaire ectopique , Anatomopathologie , Chirurgie généraleRésumé
<p><b>OBJECTIVE</b>To summarize the clinical characteristics of congenital ventricular aneurysm and diverticula in inland China.</p><p><b>METHODS</b>To identify the literature of congenital aneurysm and diverticula from Wanfang, China National Knowledge Infrastructure (CNKI) and PubMed databases, and to analyze the clinical characteristics of congenital aneurysm and diverticula from January of 2001 to December of 2009.</p><p><b>RESULTS</b>A total of 116 patients [78 men, 1 - 80 (33.5 ± 21.3) years old] with congenital aneurysm or diverticula were included in 109 articles. Twenty-five patients (13 men) were congenital ventricular aneurysm, including a family of 4 patients. Ninety-one patients (65 men) were congenital ventricular diverticula. One hundred patients were detected by echocardiography during medical examination, 34 patients combined with other cardiac anomalies, 4 of which with extracardiac structures. There were 8 patients with ventricular arrhythmia, 8 patients with thrombosis, 2 patients died of cardiac rupture, 4 patients died of sudden death, surgical operation was performed in 46 patients and 3 patients received ablation procedure. All patient did not receive implantable cardioverter defibrillator (ICD) implantation.</p><p><b>CONCLUSIONS</b>Congenital ventricular aneurysm or diverticulum is a rare cardiac malformation. Most congenital left ventricular aneurysms and diverticula are asymptomatic and detected by echocardiography. Congenital ventricular aneurysm or diverticulum may cause ventricular tachycardia, ventricular wall rupture, systemic embolization or sudden death, which had to be treated individually.</p>
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Adolescent , Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Enfant , Enfant d'âge préscolaire , Femelle , Humains , Nourrisson , Mâle , Adulte d'âge moyen , Jeune adulte , Chine , Épidémiologie , Diverticule , Diagnostic , Anévrysme cardiaque , Diagnostic , Cardiopathies congénitales , Diagnostic , Ventricules cardiaquesRésumé
<p><b>OBJECTIVE</b>To clone the gene human thioredoxin 1 (hTrx-1) expressing its protein in the E.coli expression system and to obtain its polyclonal antibody, and to study the protective effects of hTrx-1 on neonatal rats with endotoxemia.</p><p><b>METHODS</b>DNA encoding hTrx-1 from fetal liver cells was isolated by RT-PCR. The hTrx-1 was cloned to the prokaryotic expression plasmid PET-28a to induce its protein expression in the E.coli expression system. The purified hTrx-1 was injected into rats to prepare polyclonal antibody. Newborn Sprague-Dawley rats were randomly assigned to three groups: control, lipopolysaccharide (LPS) and hTrx-1 (n=12 each). The control and the LPS groups were intraperitoneally injected with normal saline and LPS (5 mg/kg), respectively. The hTrx-1 group received an intraperitoneal injection of hTrx-1 (10 mg/kg) 30 minutes before LPS injection. The mortality rate 24 hrs after injection was compared between the three groups.</p><p><b>RESULTS</b>The prokaryotic expression plasmid PET-28a-hTrx-1 was constructed. The hTrx-1 protein was expressed and purified. The polyclonal antibody of hTrx-1 with the titer of 1∶51200 was prepared. The mortality rate of the control, LPS and hTrx-1 groups was 0, 67% and 17%, respectively (χ2=14.400, P<0.01).</p><p><b>CONCLUSIONS</b>The polyclonal antibody of hTrx-1 is prepared successfully. The hTrx-1 protein has protective effects on neonatal rats with endotoxiamia.</p>
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Animaux , Humains , Mâle , Rats , Animaux nouveau-nés , Anticorps , Technique de Western , Endotoxémie , Test ELISA , Rat Sprague-Dawley , Protéines recombinantes , Allergie et immunologie , Thiorédoxines , Génétique , Allergie et immunologie , Utilisations thérapeutiquesRésumé
<p><b>BACKGROUND</b>Radiofrequency catheter ablation (RFCA) necessarily produces an area of myocardial necrosis. However, the difference of the extent of myocardial injury between circumferential pulmonary vein isolation (CPVI) and complex fractionated atrial electrograms (CFAE) ablation in patients with atrial fibrillation (AF) has not been investigated before.</p><p><b>METHODS</b>Twenty-nine consecutive male patients (n = 29) with either paroxysmal or persistent AF were selected for CPVI or CFAE ablation. The CPVI or CFAE ablation was performed with a three-dimensional electroanatomical mapping system (CARTO). Serum cardiac biomarkers, for example, cardiac troponin T (cTnT), aspartate transaminase (AST), lactate dehydrogenase (LDH), creatine kinase (CK), and creatine kinase myocardial bound (CKMB) were determined by the Elecsys STATE immunoassay. Cardiac structure and function were measured with echocardiography.</p><p><b>RESULTS</b>Echocardiography showed that there was no significant difference of atrioventricular structure or function parameters between the CPVI group and the CFAE ablation group. Serum cTnT showed a significant increase in the CFAE ablation group over the CPVI group at 12 and 24 hours after the procedure (P < 0.05, respectively), and then it was reduced to a normal level after 48 hours. Serum AST showed a significant increase in the CFAE ablation group over the CPVI group at post-procedure, 4 and 12 hours after the procedure (P < 0.05, respectively), and then it reached to a normal level after 24 hours. There was no significant difference in LDH, CK, or CKMB levels between the CFAE ablation group and the CPVI group at any time point (P > 0.05).</p><p><b>CONCLUSIONS</b>cTnT and AST other than LDH, total CK or CKMB activity significantly increased more in the CFAE ablation group than the CPVI group. However, the difference of the serum levels of cTnT, AST between two groups was temporary.</p>
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Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Aspartate aminotransferases , Sang , Fibrillation auriculaire , Métabolisme , Thérapeutique , Ablation par cathéter , Méthodes , Creatine kinase , Sang , Échocardiographie , Techniques électrophysiologiques cardiaques , Méthodes , Lésions traumatiques du coeur , Sang , Thérapeutique , L-Lactate dehydrogenase , Sang , Myocarde , Métabolisme , Veines pulmonairesRésumé
<p><b>OBJECTIVE</b>To study the effect of automated peripheral arteriovenous exchange transfusion for treatment of severe hyperbilirubinemia in neonates.</p><p><b>METHODS</b>Fifty-three neonates with severe hyperbilirubinemia underwent automated peripheral arteriovenous exchange transfusion, and the changes in the blood gas, electrolytes and some biochemical indices after the exchange transfusion were evaluated.</p><p><b>RESULTS</b>Treatment with the exchange transfusion resulted in a significant reduction in the total serum bilirubin with an exchange rate of 53.12% (P<0.01). The levels of serum kalium, calcium, magnesium, white blood cell count, platelets, and pH showed reductions while blood glucose exhibited a significant elevation changes after the transfusion (P<0.01), which all recovered the normal levels within 48 h. No obvious alterations occurred in the respiration, heart rate, blood pressure, or saturation of blood oxygen during the transfusion.</p><p><b>CONCLUSION</b>Automated peripheral arteriovenous exchange transfusion can rapidly reduce serum bilirubin levels in neonates with severe hyperbilirubinemia without obviously affecting the blood gas balance or blood electrolyte or glucose levels.</p>
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Femelle , Humains , Nouveau-né , Mâle , Exsanguinotransfusion , Méthodes , Hyperbilirubinémie néonatale , ThérapeutiqueRésumé
<p><b>OBJECTIVE</b>To evaluate the effects of N-acetylcysteine (NAC) on hypoxia-reoxygenation (H/R) injury induced apoptosis in neonatal rat cardiomyocytes.</p><p><b>METHODS</b>Neonatal rat cardiomyocytes were cultured for 48 h and then randomized into control group, H/R group and H/R + NAC group. Cardiomyocytes underwent hypoxia for 6 h, reoxygenation for 72 h in the absence (H/R group) or presence (H/R + NAC group) of NAC (100 micromol/L). Cell viability was assayed with trypan blue staining. Early stage of apoptosis was detected by flow cytometry with Annexin V, late stage of apoptosis was assessed by TUNEL staining. ROS in culture medium was assayed by Image-iT(TM) LIVE green reactive oxygen species detection kit.bcl2 and bax mRNA levels were determined by real-time quantitative PCR (RT-PCR). bcl2, bax, p38 and pp38 protein levels were measured by Western blot.</p><p><b>RESULTS</b>The percentage of viable cardiomyocytes (93.5%, 74.9%, 89.9%) was significantly reduced while percentage of early stage of apoptotic cardiomyocytes (6.5%, 25.2% and 11.1%) and late stage of apoptotic cardiomyocytes (3.5%, 33.5% and 13.5%) were significantly increased in H/R group compared to control group and these changes could be largely reversed by NAC (all P < 0.01). Significantly increased ROS generation in H/R group could also be attenuated by NAC (P < 0.01). The band density ratio of pp38 and p38 was significantly upregulated in H/R group (13.4 vs. 3.89), the mRNA and protein expressions of bcl2 were significantly lower and bax expressions were significantly higher in H/R group than those in control group and these changes could also be attenuated by NAC.</p><p><b>CONCLUSION</b>NAC significantly reduced apoptosis through inhibiting the phosphorylation of p38 signal pathway.</p>
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Animaux , Rats , Acétylcystéine , Pharmacologie , Animaux nouveau-nés , Apoptose , Mort cellulaire , Hypoxie cellulaire , Cellules cultivées , Hypoxie , Myocytes cardiaques , Biologie cellulaire , Métabolisme , Oxygène , Métabolisme , Rat Sprague-Dawley , Espèces réactives de l'oxygène , MétabolismeRésumé
<p><b>OBJECTIVE</b>To report a newborn infant who died of alveolar capillary dysplasia (ACD). The literature on about 20 cases of ACD was reviewed.</p><p><b>METHODS</b>A retrospective review of records of infants from Medline with a diagnosis of ACD was carried out.</p><p><b>RESULTS</b>The case was a newborn female infant who developed respiratory distress 5 hours after an uncomplicated delivery. She died at the fourth day after birth despite full ventilatory support. The lung autopsy provided a diagnosis of ACD. In the 21 infants, 7 were male and 14 were female; 19 infants were born full-term and 2 were born pre-term. The birth weight of 19 infants and Apgar score of 15 infants were normal; 16 infants developed progressing tachypnea and cyanosis within 24 hours of age, 5 developed cyanosis at 1 day to 19 days. Echocardiography demonstrated a right to left shunt in the hearts of all the 21 infants, and pulmonary hypertension in 20 infants. Twenty infants were treated with conventional mechanical ventilation, 7 infants with high-frequency oscillatory ventilation and 12 infants with extracorporeal membrane oxygenation (ECMO). Fourteen infants were also treated with inhaled nitric oxide therapy and 4 with exogenous surfactant. Diagnostic open lung biopsy was performed in 6 infants. The chest radiography showed normal findings in 3 infants, pneumothoraces in 9 infants, reticular markings, granular, patchy or diffuse opacity in lungs of 7 infants, and decreased pulmonary vascular markings in two infants. All the 21 infants died; 8 of them died within 10 days of age, 7 within 30 days of age, and one died at the age of 4 months who was the longest survivor. Fourteen infants were associated with congenital malformations, such as cardiovascular, gastrointestinal, and genitourinary systems, including one infant associated with chromosomal abnormalities, two infants of familial genetic predisposition.</p><p><b>CONCLUSIONS</b>At present, ACD is still a disease with poor prognosis, significant medical expenses and no specific treatment. When respiratory failure or persistent pulmonary hypertension (PPHN) is persistent after routine treatment in an infant, ACD should be highly suspected and conventional open-lung biopsy should be preformed to confirm the diagnosis.</p>
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Femelle , Humains , Nouveau-né , Mâle , Persistance de la circulation foetale , Diagnostic , Anatomopathologie , Alvéoles pulmonaires , Malformations , AnatomopathologieRésumé
<p><b>OBJECTIVE</b>To investigate the prevalence of Epsilon wave in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC).</p><p><b>METHODS</b>The epsilon wave was detected in 32 patients [24 men, mean age (42.3 +/- 13.3) years] with ARVC using three different electrocardiography (ECG) recording methods: standard twelve leads ECG (S-ECG), right precordial leads ECG (R-ECG) and Fontaine bipolar precordial leads ECG (F-ECG). The Epsilon wave was defined as wiggler, small spike wave and smooth potential between the end of the QRS complex and the beginning of the ST segment.</p><p><b>RESULTS</b>Epsilon wave was detected in 37.5%, 37.5% and 50.0% patients with ARVC by S-ECG, R-ECG and F-ECG respectively. The detection rates derived from the three recording methods were similar (P > 0.05). The Epsilon wave was only detectable by S-ECG in one case, by R-ECG in three cases, and by F-ECG in five cases. The detection rate of Epsilon wave was 50.0% by combined use of S-ECG and R-ECG (SR-ECG), 56.3% by combined use of S-ECG and F-ECG (SF-ECG), and 65.6% by combined use of the three recording methods (SRF-ECG). The detection rate was significantly higher by SF-ECG (56.3%) and SRF-ECG (65.6%) than by S-ECG alone (37.5%, all P < 0.05). Most Epsilon waves detected by the S-ECG, R-ECG and F-ECG were small spiked waves.</p><p><b>CONCLUSION</b>Combined use of S-ECG, F-ECG and R-ECG could increase the detection rate of Epsilon wave in patients with ARVC.</p>
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Adolescent , Adulte , Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Jeune adulte , Dysplasie ventriculaire droite arythmogène , Épidémiologie , Électrocardiographie , PrévalenceRésumé
<p><b>OBJECTIVE</b>To observe the effects of N-acetylcysteine (NAC) on aging in neonatal SD rat cardiomyocytes and explore related mechanisms.</p><p><b>METHODS</b>Cultured cardiomyocytes were randomized assigned to 6 groups: 1-day, 5-day, 10-day, 1-day + NAC (1 mmol/L), 5-day + NAC (1 mmol/L) and 10-day + NAC (1 mmol/L). Flow cytometry was used to examine cell cycle. Real-time quantitative PCR and Western blot were used to determine mRNA and protein expression of p16INK4a, p21WAF1 and Rb gene. beta-galactosidase staining kit was used to investigate beta-galactosidase activity.</p><p><b>RESULTS</b>Numbers of cardiomyocytes resided in G(0)/G(1) phase were significantly higher in the group of 5-day + NAC and 10-day + NAC compared with 5-day, 10-day, respectively (P < 0.05). The mRNA and protein expression of p16INK4a and p21WAF1 were also significantly higher in the group of 5-day + NAC and 10-day + NAC compared with 5-day, 10-day, respectively (P < 0.05 or P < 0.01). The mRNA and protein expression of Rb was significantly lower in the group of 5-day + NAC and 10-day + NAC compared with 5-day, 10-day, respectively (P < 0.01). beta-galactosidase activity was not affected by NAC in the 1-day + NAC group but was significantly higher in 5-day + NAC and 10-day + NAC groups compared with the 5-day, 10-day groups (all P < 0.05).</p><p><b>CONCLUSION</b>NAC could promote aging through upregulating the expression of p16INK4a and p21WAF1 and inhibiting Rb phosphorylation in neonatal SD rat cardiomyocytes.</p>
Sujets)
Animaux , Rats , Acétylcystéine , Pharmacologie , Cycle cellulaire , Cellules cultivées , Vieillissement de la cellule , Inhibiteur p16 de kinase cycline-dépendante , Métabolisme , Inhibiteur p21 de kinase cycline-dépendante , Métabolisme , Myocytes cardiaques , Métabolisme , ARN messager , Génétique , Rat Sprague-DawleyRésumé
<p><b>OBJECTIVE</b>To evaluate the safety and outcome of patients with acute myocardial infarction (AMI) transferred for primary percutaneous coronary intervention (PCI).</p><p><b>METHODS</b>Data from patients with ST elevation AMI urgently transferred from first admitted hospitals to our cath-lab to receive primary PCI were analyzed. According to time intervals from symptom onset to transfer, the patients were divided into early transfer (< 6 h, n = 26), delayed transfer (6 - 24 h, n = 39) and late transfer (24 h to 1 week, n = 18) group. The major cardiac events during transfer periods and one month after PCI were obtained and echocardiogram and left ventricular systolic functions were compared among groups.</p><p><b>RESULTS</b>There was no serious cardiac event during transfer period and all 83 patients received primary PCI with a mean transfer-to-balloon time about 180 minutes. Success rate of PCI was 92.3% in early transfer group, 89.7% in delayed transfer group, and 94.4% in late transfer group (P > 0.05). At one month follow-up after PCI, 0, 10.3% and 16.7% of patients developed heart failure in early, delayed transfer and late transfer group respectively (P > 0.05 vs. early), the LVEF of early transfer group (53.2% +/- 9.7%) was also significantly higher than delayed transfer group (48.6% +/- 8.2%, P < 0.05) and late transfer group (43.1% +/- 10.3%, P < 0.01).</p><p><b>CONCLUSIONS</b>Transfer patients with AMI for primary PCI is safe in the observed time intervals during acute phase. Early transferred patients are associated with better outcome at 1 month post PCI compared to delayed and late transferred AMI patients.</p>