Feasibility and clinical benefits of the double-ProGlide technique for hemostasis after cryoballoon atrial fibrillation ablation with uninterrupted oral anticoagulants / 老年心脏病学杂志（英文版）

OBJECTIVE@#To access the efficacy and safety of the double-ProGlide technique for the femoral vein access-site closure in cryoballoon ablation with uninterrupted oral anticoagulants (OAC), and its impact on the electrophysiology laboratory time as well as hospital stay after the procedure in this observational study.@*METHODS@#Patients with atrial fibrillation undergoing cryoballoon ablation with uninterrupted OAC at Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China from May 2019 to May 2021 were enrolled in this study. From October 2020, double-ProGlide technique was consistently used for hemostasis (ProGlide group), and before that conventional manual compression was utilized (manual compression group). The occurrence of vascular and groin complications was accessed during the hospital stay and until the three-month follow-up.@*RESULTS@#A total of 140 participants (69.30% of male, mean age: 59.21 ± 10.29 years) were evaluated, 70 participants being in each group. Immediate hemostasis was achieved in all the patients with ProGlide closure. No major vascular complications were found in the ProGlide group while two major vascular complications were occurred in the manual compression group. The incidence of any groin complication was obviously higher in subjects with manual compression than patients with ProGlide devices (15.71% vs. 2.86%, P = 0.009). In addition, compared with the manual compression group, the ProGlide group was associated with significantly shorter total time in the electrophysiology laboratory [112.0 (93.3-128.8) min vs. 123.5 (107.3-158.3) min, P = 0.006], time from sheath removal until venous site hemostasis [3.8 (3.4-4.2) min vs. 8.0 (7.6-8.5) min, P < 0.001], bed rest time [8.0 (7.6-8.0) h vs. 14.1 (12.0-17.6) h, P < 0.001] and hospital stay after the procedure [13.8 (12.5-17.8) h vs. 38.0 (21.5-41.0) h, P < 0.001].@*CONCLUSIONS@#Utilization of the double-ProGlide technique for hemostasis after cryoballoon ablation with uninterrupted OAC is feasible and safe, which has the clinical benefit in reducing the total electrophysiology laboratory time and the hospital stay length after the procedure.

The effect of exogenous creatine phosphate on myocardial injury after percutaneous coronary intervention.

OBJECTIVE: To evaluate the effect of exogenous creatine phosphate (CP) on myocardial injury after percutaneous coronary intervention (PCI). METHOD: Four hundred patients were divided to receive conventional therapy (control group) or 3-day intravenous infusion of CP after PCI (CP group). Levels of creatine kinase MB (CK-MB) and troponin I (TnI) were measured before and on postprocedural day 3. RESULTS: Postprocedural CK-MB and TnI in the CP group were significantly increased compared to the control group. In the CP group, 8.0% and 5.0% of patients had an increase in CK-MB 1 to 3 times and >3 times, respectively, which were significantly lower than that of the control group (19.0% and 9.0%, respectively); 12.0% and 10.0% of patients had an increase in TnI 1 to 3 times and >3 times, respectively, which were significantly lower than that of the control group (21.0% and 18.0%, respectively). CONCLUSION: Exogenous CP was helpful to reduce myocardial injury after PCI.

Effect of BCL11A gene on transcription of γ-globin gene / 中国实验血液学杂志

This study was aimed to explore the effect of BCL11A gene on transcription of γ-globin gene in K562 cells. B-cell lymphoma/leukemia 11A (BCL11A) gene was silenced by small interfering RNA (siRNA) expression vectors in K562 cells (human erythroblastic leukemia cell line). Gamma-globin mRNA level in K562 cells was determined by RT-PCR. Association between the BCL11A gene and γ-globin gene transcription was explored by comparison of mRNA levels. The results indicated that the silence rate of the BCL11A gene in K562 cells by 4 siRNA expression vectors was 49.7%, 55.4%, 78.2%, and 84.1%, respectively. The siRNA expression vector with 84.1% silence rate was transfected into K562 cells, transcription level of γ-globin mRNA in K562 cells transfected with siRNA expression vector increased 2.4 times as compared with control K562 cells. It is concluded that level of γ-globin mRNA increases when the BCL11A gene is silenced. It indicates that the BCL11A gene may be a negative regulator for γ-globin gene expression.

Mutation analysis of UGT1A1 gene in patients with unconjugated hyperbilirubinemia / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To analyze potential mutations of uridine diphosphate glucuronosyltransferase 1A1 (UGT1A1) gene in patients with unconjugated hyperbilirubinemia, and to explore the correlation between the mutations and total serum bilirubin levels.</p><p><b>METHODS</b>Genomic DNA was extracted from peripheral blood samples of patients. Coding sequence and promoter region of the UGT1A1 gene were amplified. Mutations were identified through DNA sequencing.</p><p><b>RESULTS</b>Mutations of the UGT1A1 gene were found in 46 out of 61 patients with unconjugated hyperbilirubinemia. Five types of mutations were detected, with a decreasing order of 211G>A, TA insertion in the TATAA promoter element, 686C>A, 1091C>T and 1352C>T. Compared with those carrying a single homozygous mutation or compound heterozygous mutations, total serum bilirubin was higher in those carrying a homozygous mutation in combination with other heterozygous mutations (P< 0.05). Based on the UGT1A1 gene mutations and level of total serum bilirubin, 44 patients were diagnosed with Gilbert syndrome, and 2 were diagnosed with Crigler-Najjar syndrome type 2.</p><p><b>CONCLUSION</b>The level of total serum bilirubin is correlated with the number of UGT1A1 gene mutations as well as their heterozygous or homozygous status.</p>

Effects of trimetazidine therapy on left ventricular function after percutaneous coronary intervention / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the effects of trimetazidine therapy on left ventricular (LV) function after percutaneous coronary intervention (PCI).</p><p><b>METHODS</b>A total of 106 patients with unstable angina pectoris underwent successful elective PCI were randomly assigned to standard therapy group (control, n = 55) or trimetazidine group (n = 51, 60 mg trimetazidine loading dose prior to PCI followed by 20 mg Tid after PCI on top of standard therapy). cTnI level was measured before and at 16-18 hours after PCI. LV function was evaluated by echocardiography and major adverse cardiac events (MACE, including death, re-infarction and target vessel revascularization) at 12 months after PCI was compared between the two groups.</p><p><b>RESULTS</b>Post procedural cTnI level increased from [0.02 (0.01, 0.03)] µg/L at baseline to [0.11 (0.07, 0.13)] µg/L (P < 0.05) at 16-18 hours in the trimetazidine group, while [0.02(0.01, 0.03)] µg/L to [1.31(0.44, 2.31)] µg/L in the control group (P < 0.05). Post procedural cTnI level was significantly reduced in the trimetazidine group compared to the control group (P < 0.05). At 12 months follow-up, left ventricular ejection fraction in the trimetazidine group was significantly higher than in control group [(65.65 ± 3.94)% vs. (62.29 ± 3.06)%, P < 0.01] while incidence of MACE was similar between the two groups.</p><p><b>CONCLUSION</b>Trimetazidine can reduce the post-PCI cTnI release and improve left ventricular function after PCI in patients with unstable angina pectoris.</p>

Polymorphism in BP1 binding site upstream of β-globin gene in Chinese Han population / 中国实验血液学杂志

This study was aimed to analyze the BP1 binding site sequence upstream of β-globin gene in Chinese Han population, and to investigate polymorphism in the BP1 binding site upstream of β-globin gene, so as to provide the basis for exploration of relation between polymorphisms in the BP1 binding site and β-globin expression. Genomic DNA was extracted from peripheral leukocytes of 110 healthy individuals in Chinese Han population. Sequence of the BP1 binding site upstream of β-globin gene was amplified by polymerase chain reaction, the polymorphic variation in the BP1 binding site was determined by DNA sequencing. The results indicated that 2 polymorphism loci were found in the BP1 binding site upstream of β-globin gene, they were C/T at the -551 bp region and (AC)(n)(AT)(x)T(y) at the -530 bp region in Chinese Han population. Frequencies of C and T were 60.4% and 39.6% at position -551. Analysis of the (AC)(n)(AT)(x)T(y) polymorphism revealed 9 different genotypes: (AC)(2)(AT)(9)T(5), (AC)(2)(AT)(8)T(5), (AC)(2)(AT)(7)T(7), (AC)(3)(AT)(7)T(5), (AC)(2)(AT)(8)T(9), (AC)(3)(AT)(8)T(5), (AC)(2)(AT)(10)T(3), (AC)(2)(AT)(11)T(3), and (AC)(2)(AT)(7)T(5) at position -530. Frequencies of 9 (AC)(n)(AT)(x)T(y) polymorphisms were 33.2%, 29.1%, 24.1%, 5.4%, 3.2%, 1.8%, 1.4%, 0.9%, and 0.9% respectively. It is concluded that rich (AC)(n)(AT)(x)T(y) polymorphisms at the -530 bp region in the BP1 binding site upstream of β-globin gene are found in Chinese Han population. (AC)(2)(AT)(9)T(5), (AC)(2)(AT)(8)T(5), and (AC)(2)(AT)(7)T(7) are 3 major polymorphisms among Chinese Han population, and (AC)(3)(AT)(8)T(5) is a novel polymorphism at the -530 bp region. More studies should be done to explore relation between (AC)(n)(AT)(x)T(y) polymorphisms and β-globin expression.

Dynamic observation of cerebral vasoreactivity after carotid angioplasty and stenting / 中华神经医学杂志

Objective To explore the changes and influencing factors of cerebral vasoreactivity (CVR) in patients after carotid angioplasty and stenting (CAS). Methods Thirty-seven patients performed CAS, admitted to our hospital from July 2008 to September 2009, were finished the follow-up and chosen in our study; the breath-holding index (BHI) of the bilateral middle cerebral artery was measured using transcranial Doppler combined with breath holding test before thc operation, and 1 d and 3-10 months after the operation. Repeated measures design analysis of variance was employed to detect the BHI changes before and after the stenting; multiple regression was employed to analyze the influencing factors of BHI. Results BHI values after stenting were significantly higher than those before stenting on the stenotic side (P＜0.05). The follow-up BHI values were negatively correlated with those of tandem stenoses (β=-0.016, P=0.002) and positively correlated with the postoperative BHI values (β=1.030, P=0.000). Conclusion CAS can immediately improve CVR on the ipsilateral side and make it close to normalization gradually. Tandem stenoses are the independent risk factors of CVR.

Factors associated with cerebral microbleeds in patients with ischemic stroke / 中华神经医学杂志

Objective To investigate the clinical and neuroimaging features of cerebral microbleeds(CMBs)in patients with ischemic stroke. Methods MRI,including gradient-echo T2~*-weighted MRI,was performed in 85 patients with acute ischemic stroke.Their clinical information and imaging characteristics were analyzed. Results One hundred and twenty-four CMBs were noted in 26 patients(30.6%)with the number of CMBs ranged from 1 to 16 per patient.CMBs were more frequently presentcd in the cortical-subcortical region and thalamus-basal ganglia than in the cerebellum and brain stem legions.Some CMBs in the brain stem had related neurological symptoms and signs.CMBs,the age of the patient,the number of lacunar infarcts and the white matter changes were correlative(r=0.243,P=0.025;r=0.337,P=0.025;r=0.438,P=0.000).CMBs could be well demonstrated in the gradient-echo T2~*-weighted MRI and some larger ones could be demonstrated in the apin-echo T2~*-weighted MRI and DWI. Conclusion CMBs are the sighs for microangiopathy in the brain with advanced age,mutiple lacunar infartion and leukoaraiosis as its main prognosis factors.

Pharmacophore modeling of dual angiotensin II and endothelin A receptor antagonists / 药学学报

Three-dimensional pharmacophore models were generated for AT1 and ET(A) receptors based on highly selective AT1 and ET(A) antagonists using the program Catalyst/HipHop. Both the best pharmacophore model for selective AT1 antagonists (Hypo-AT(1)-7) and ETA antagonists (Hypo-ET(A)-1) were obtained through a careful validation process. All five features contained in Hypo-AT(1)-7 and Hypo-ET(A)-1 (hydrogen-bond acceptor (A), hydrophobic aliphatic (Z), negative ionizable (N), ring aromatic (R), and hydrophobic aromatic (Y)) seem to be essential for antagonists in terms of binding activity. Dual AT1 and ET(A) receptor antagonists (DARAs) can map to both Hypo-AT(1)-7 and Hypo-ET(A)-1, separately. Comparison of Hypo-AT(1)-7 and Hypo-ET(A)-1, not only AT1 and ET(A) antagonist pharmacophore models consist of essential features necessary for compounds to be highly active and selective toward their corresponding receptor, but also have something in common. The results in this study will act as a valuable tool for designing and researching structural relationship of novel dual AT1 and ET(A) receptor antagonists.

Evaluation of cerebral blood flow with spatial brain symmetry index in patients performed carotid artery stenting / 中华神经医学杂志

Objective To detect the spatial brain symmetry index (sBSI) changes, reflected the blood flow changes, before and after the carotid artery stenting (CAS). Methods Thirty one patients performed CAS were examined with electroencephalogram 1 d before and 3～5 d after the procedures. We analyzed the sBSI of EEG. The preoperative and postoperative degrees of stenosis were determined according to cerebral angiography. The sBSI changes were compared using paired analysis before and after the procedures. Correlation and regression analysis was processed between EEG sBSI improvement and both stenosis decrement and preoperative sBSI. Results The sBSI of 31 patients were significantly different before and after the stenting (P<0.05). No correlation between the sBSI improvement and the degree of stenosis reduction was found (P>0.05). The sBSI improvement was positively correlated with sBSI before stenting. Conclusions Electroencephalogram spatial brain symmetry index can be regarded as a safe and effective index to evaluate the improved effect of CAS in patients with carotid artery stenosis.

Study of the relationship between cardiovascular risk factors and severity of coronary artery disease in patients underwent coronary angiography / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the correlation between multiple cardiovascular risk factors and the extent and severity of angiographic coronary artery disease (CAD) in patients underwent coronary angiography.</p><p><b>METHODS</b>Nine hundred and twenty consecutive patients underwent coronary angiography were selected according to inclusion criteria. The extent and severity of angiographic CAD was diagnosed by: (1) whether or not CAD was diagnosed by angiography; (2) the number of diseased vessels; (3) The CAD Gensini cumulative index. Cardiovascular risk factors included were age, gender, hypertension, smoking status, type 2 diabetes mellitus, dyslipidemia, and high uric acid level. Analyses were achieved by univariate and multivariate analysis.</p><p><b>RESULTS</b>(1) Logistic regression analysis showed that high low-density lipoprotein was a prominent predictor of the extent and severity of angiographic CAD (OR = 2.816, 95% CI 1.903 - 4.167, P = 0.001). (2) High low-density lipoprotein was the most important risk factor in men, whereas smoking and high uric acid were the most important risk factors in women.</p><p><b>CONCLUSION</b>(1) It is very important to control risk factors in the intervention and prevention of CAD. (2) Distribution of risk factors and their severities vary in different genders, therefore the treatment of risk factors should be done differently.</p>