Fistula between the right pulmonary artery and the left atrium coexisting with a secundum-type atrial septal defect: An unusual case of cyanosis in a girl.

A fistula between the pulmonary artery (PA) and the left atrium (LA) is a rare congenital heart disease that usually presents with cyanosis, clubbing, and dyspnea, as well as the signs and symptoms of a right-to-left shunt. Herein, we report a 16-year-old girl with a fistula between the right PA and the LA. This type of fistula could lead to systemic desaturation. This patient also had an atrial septal defect of the secundum type and has been followed up without treatment. The clinical manifestations and treatment of fistulas located between the PA and LA are also reviewed in this report.

Double-chambered left ventricle: A rare case in a child.

Double-chambered left ventricle (DCLV) is an extremely rare congenital heart disease. In this condition, the left ventricle is divided into two chambers by a septum or muscle fiber with abnormal proliferation. A symptomatic boy was diagnosed with DCLV at our hospital. The patient was admitted with the major complaint of 8 years of cardiac murmur, which was discovered through physical examination, and 5 years of palpitations and shortness of breath. He has been followed up without treatment.

Survival of Patients with Primary Cardiac Tumors in an 11-Year Single Center Study.

BACKGROUND: Primary cardiac tumors are rare, but few studies have examined the relationship between risk factors and the prognosis. The aim of this study was to provide a survival analysis and risk factors for mortality in patients with primary cardiac tumors. METHODS: We retrospectively enrolled 71 patients diagnosed with primary cardiac tumors from June 2006 to November 2017 in our hospital. Patients' population characteristics, treatment information, pathology, and follow-up data were obtained and analyzed. RESULTS: Of the 71 patients, 60 cases were benign, and 11 cases were malignant. Sex, age, New York Heart Association classification, the percentage of peripheral embolism, and surgery had no significant difference between benign and malignant groups (P >.05), but the percentage of arrhythmia, leg edema, and mortality rate was higher in the malignant tumor group than in the benign tumor group (P <.05). Compared with the benign tumor group, the percentage of biatrial lesions in the malignant tumor group was significantly higher (P <.05). Moreover, Independent risk factors included the treatment choice, pathology type, and number of tumor lesions (P <.05). CONCLUSION: Our study suggests that conservative therapy, malignant cardiac tumor, and biatrial tumor lesion are independent risk factors for poor prognosis.

[Effects of psychological stress on xanthine oxidase expression, activity and related markers in adipose tissue of mice].

OBJECTIVE: To investigate the effects of psychological stress on xanthine oxidase (XO) expression, activity and related markers in adipose tissue of mice. METHODS: Twenty male Kunming mice were randomly divided into two groups (10 in each group), stress group and control group (10 in each group). Stress group were restrained in self-made restraint device for 2 hours per day for 14 days, then blood samples and white adipose tissues(WAT) were collected. The expression levels of XO and NADPH oxidase-4 (Nox-4) in WAT were detected by immunohistochemistry. The expression of XO, Nox-4, antioxidant proteins (manganese superoxide dismutase (Mn SOD), glutathione peroxidase (GSH-Px), and catalase (CAT)), adipocytokines (adiponectin (ADPN), monocyte chemotactic protein 1 (MCP-1), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α)) in WAT were further detected by quantitative PCR. Relative expressions of glucose metabolism (insulin receptor substrate-1(IRS-1) and glucose transporter type 4(GLUT-4)) and thrombin(tissue factor (TF) and plasminogen activator inhibitor 1 (PAI-1))were measured. XO activity and serum concentrations of (triglyceride (TG), total cholesterol (T-Cho), free fatty acid, (FFA), and uric acid (UA)) were detected by ELISA. RESULTS: XO expressed in stress mice inguinal WAT was deeper and more abundant than that of control group, mainly expressed in adipocytes. RT-PCR and ELISA results showed that the levels of XO mRNA, serum XO concentration and the activities of XO enzyme in WAT of stress group were significantly higher than those of control group(P ＜0.01). Compared with control group the concentrations of free fatty acid (FFA) and uric acid (UA) in stress group were increased significantly than in control group (P＜ 0.01). Nox-4 positive cells mainly expressed in adipocytes. The expression of Nox-4 in WAT of stress group was significantly higher(P ＜0.01); The levels of antioxidant proteins (Mn-SOD, GSH-Px, Catalase) in WAT of stress group were significantly lower (P＜ 0.01). WAT in stress group showed a large number of infiltration reactions and inflammatory changes of monocytes, neutrophils, eosinophils and plasma cells. Stress significantly decreased the expression of adiponectin in WAT, and significantly increased the expressions of MCP-1, IL-6 and TNF-α (P＜0.01). The levels of IRS-1 and GLUT-4 in WAT of stress mice were increased significantly (P＜ 0.01). The expressions of TF and PAI-1 in WAT of stress mice and blood concentrations were significantly higher (P＜0.01). CONCLUSION: Stress can induce excessive expressions of XO in adipose tissue, which eventaully can lead to adipose inflammation, glycometabolism and abnormal prothrombin.