Performance of heart rate adjusted heart rate variability for risk stratification of sudden cardiac death.

PURPOSE: As a non-invasive tool for the assessment of cardiovascular autonomic function, the predictive value of heart rate variability (HRV) for sudden cardiac death (SCD) risk stratification remains unclear. In this study, we investigated the performance of the individualized heart rate (HR) adjusted HRV (HRVI) for SCD risk stratification in subjects with diverse risks. METHODS: A total of 11 commonly used HRV metrics were analyzed in 192 subjects, including 88 healthy controls (low risk group), 82 hypertrophic cardiomyopathy (HCM) patients (medium risk group), and 22 SCD victims (high risk group). The relationship between HRV metrics and HR was examined with long-term and short-term analysis. The performance HRVI was evaluated by area under the receiver operating characteristic curve (AUC) and covariance of variation (CV). RESULTS: Most of the HRV metrics were exponentially decayed with the increase of HR, while the exponential power coefficients were significantly different among groups. The HRVI metrics discriminated low, medium and high risk subjects with a median AUC of 0.72[0.11], which was considerably higher than that of the traditional long-term (0.63[0.04]) and short-term (0.58[0.05]) HRV without adjustment. The average CV of the HRVI metrics was also significantly lower than traditional short-term HRV metrics (0.09 ± 0.02 vs. 0.24 ± 0.13, p < 0.01). CONCLUSIONS: Subjects with diverse risks of SCD had similar exponential decay relationship between HRV metrics and HR, but with different decaying rates. HRVI provides reliable and robust estimation for risk stratification of SCD.

Isolated fungus ball in a single cell of the left ethmoid roof: A case report.

BACKGROUND: Isolated fungus ball (FB) in a single cell of the left ethmoid roof is a very rare condition. CASE SUMMARY: We report the case of a 51-year-old female patient whose computed tomography presented a soft tissue mass filling in the left ethmoid roof cell. The patient did not complain of any specific sinonasal symptoms, such as nasal discharge, nasal obstruction, and loss of smell, apart from headache in the left retro-orbital region. CONCLUSION: The patient underwent functional endoscopic sinus surgery under general anesthesia, and the inflammatory material collected was histologically diagnosed as a rare case of a FB in a single cell of the left ethmoid roof.

Sulfitobacter maritimus sp. nov., isolated from coastal sediment.

A facultatively anaerobic bacterium, strain S0837T, was isolated from the marine sediment of Jingzi Wharf, Weihai, China. Cells of the novel strain were Gram-stain-negative, non-flagellated, non-gliding, non-pigmented and rod-shaped. Cells were around 0.3-0.5×1.0-1.4 µm in size and often appeared singly. Optimum growth occurred at 33 °C, with 2 % (w/v) NaCl and at pH 7.0-7.5. On the basis of the results of 16S rRNA gene sequences, stain S0837T had the closest relative with Sulfitobacter delicatus KCTC 32183T (98.0 %). Genome sequencing revealed a genome size of 3 785 026 bp, a G+C content of 59.8 mol% and several genes related with sulphur oxidation. The strain shared 98.0 % 16S rRNA sequence similarities with closely related type species and shared ANI value below 95-96 %, dDDH value of showed relatedness of 27.4, 25.2 and 25.2 % respectively with the closely related type species. Strain S0837T had ubiquinone-10 as the sole respiratory quinone, and possessed summed feature 8 (C18 : 1 ω7c/C18 : 1 ω6c) as the major fatty acid. The major polar lipids were phosphatidylglycerol, phosphatidylcholine and phosphatidylethanolamine. According to the results of the phenotypic, chemotaxonomic characterization, phylogenetic properties and genome analysis, strain S0837T should represent a novel species of the genus Sulfitobacter, for which the name Sulfitobacter maritimus sp. nov. is proposed. The type strain is S0837T (=MCCC 1K04635T=KCTC 72860T).

Automatic identification of compressions and ventilations during CPR based on the fuzzy c-means clustering and deep belief network.

BACKGROUND: A transthoracic impedance (TTI) signal is an important indicator of the quality of chest compressions (CCs) during cardiopulmonary resuscitation (CPR). We proposed an automatic detection algorithm including the wavelet decomposition, fuzzy c-means (FCM) clustering, and deep belief network (DBN) to identify the compression and ventilation waveforms for evaluating the quality of CPR. METHODS: TTI signals were collected from a cardiac arrest model that electrically induced cardiac arrest in pigs. All signals were denoised using the wavelet and morphology method. The potential compression and ventilation waveforms were marked using an algorithm with a multi-resolution window. The compressions and ventilations in these waveforms were identified and classified using the FCM clustering and DBN methods. RESULTS: Using the FCM clustering method, the positive predictive values (PPVs) for compressions and ventilations were 99.7% and 95.7%, respectively. The sensitivities of recognition were 99.8% for compressions and 95.1% for ventilations. The DBN approach exhibited similar PPV and sensitivity results to the FCM clustering method. The time cost was satisfactory using either of these techniques. CONCLUSIONS: Our findings suggest that FCM clustering and DBN can be utilized to effectively and accurately evaluate CPR quality, and provide information for improving the success rate of CPR. Our real-time algorithms using FCM clustering and DBN eliminated most distortions and noises effectively, and correctly identified the compression and ventilation waveforms with a low time cost.

Cellular senescence in recurrent tonsillitis and tonsillar hypertrophy in children.

OBJECTIVE: To observe the difference in cellular senescence patterns between recurrent tonsillitis and tonsillar hypertrophy. METHODS AND MATERIALS: Forty-three patients diagnosed with recurrent tonsillitis or tonsillar hypertrophy, based on medical history and symptoms, underwent tonsillectomy. The specimens were collected and examined using senescence ß-galactosidase staining for cellular senescence. Macrophages were detected by immunochemistry. RESULTS: Cellular senescence was found in both recurrent tonsillitis and tonsillar hypertrophy groups. The comparison of cellular senescence in microcompartments of tonsil tissue (germinal centre, mantle zone, subepithelial and intraepithelial) revealed a significant increase of senescent cells in germinal centres in tonsillar hypertrophy compared with that in tonsillar hypertrophy. The majority of senescent cells in both groups were CD68-positive. CONCLUSIONS: Different cellular senescence patterns were found between the two studied paediatric tonsillar diseases. Macrophage senescence may play a role in the pathogenesis of these diseases.

Association between heart rate variability indices and features of spontaneous ventricular tachyarrhythmias in mice.

Direct evidence is limited for the association between heart rate variability (HRV) indices and ventricular tachyarrhythmias (VTAs). While galectin-3 (Gal-3) is regarded as a causal factor for cardiac remodelling and a biomarker for arrhythmias, its regulation on VTAs and HVR is unknown. Using aged transgenic (TG) mice with cardiac overexpression of ß2 -adrenoceptors and spontaneous VTAs, we studied whether changes in HRV indices correlated with the severity of VTAs, and whether Gal-3 gene knockout (KO) in TG mice might limit VTA. Body-surface ECG was recorded (10-minute period) in 9- to 10-month-old mice of non-transgenic (nTG), TG and TG × Gal-3 knockout (TG/KO). Time-domain, frequency-domain and nonlinear-domain HRV indices were calculated using the R-R intervals extracted from ECG signals and compared with frequency of VTAs. TG and TG/KO mice developed frequent VTAs and showed significant changes in certain time-domain and nonlinear-domain HRV indices relative to nTG mice. The severity of VTAs in TG and TG/KO mice in combination, estimated by VTA counts and arrhythmia score, was significantly correlated with certain time-domain and nonlinear-domain HRV indices. In conclusion, significant changes in HRV indices were evident and correlated with the severity of spontaneous VTAs in TG mice. The frequency of VTA and HRV indices were largely comparable between TG and TG/KO mice. Deletion of Gal-3 in TG mice altered certain HRV indices implying influence by neuronally localized Gal-3 on autonomic nervous activity.

Epidemics and underlying factors of multiple-peak pattern on hand, foot and mouth disease inWenzhou, China.

Background: Several outbreaks of severe hand-foot-mouth disease (HFMD) in East Asia and Southwest Asia in recent years have had a serious impact on the countries. However, the factors that contribute to annual multiple-peak pattern of HFMD outbreaks, and how and when do these factors play the decisive role in the HFMD transmission is still unclear. METHODS: Based on the surveillance data of HFMD between 1 January 2010 to 31 December 2015 in Wenzhou, China, the daily modelfree basic reproduction number and its annual average were first estimated by incorporating incubation and infection information, then the annual model-based basic reproduction number was computed by the proposed kinetic model, and finally the potential impact factors of multiple-peak pattern are assessed through the global and time-varying sensitivity analyses. RESULTS: All annual model-based and model-free basic reproduction numbers were significantly higher than one. The school opening both in the spring and fall semester, meteorological e ect in the spring semester, and the interactions among them were strongly correlated with the annual model-based basic reproduction number, which were the main underlying factors on the annual multiple-peak pattern of HFMD outbreaks. CONCLUSIONS: School opening was primarily responsible for peaks of HFMD outbreaks and meteorological factors in the spring semester should also be highly concerned. The optimum timing for social distance implementation is at the beginning of every school semester and health education focusing on personal hygiene and good sanitation should be highlighted in the spring semester.

Rosiglitazone inhibits PM2.5-induced cytotoxicity in human lung epithelial A549 cells.

BACKGROUND: Exposure to fine particulate matter <2.5 µm in diameter (PM2.5) leads to global adverse health effects, including increases in morbidity and mortality of respiratory diseases. PM2.5 increases production of reactive oxygen species (ROS) in the lung, which further lead to oxidative stress, cell apoptosis and cell death. According to results of previous studies, oxidative stress and subsequent cell apoptosis can be reduced by peroxisome proliferator-activated receptor gamma (PPARγ) in various cell types, however, its role in oxidative stress-related cell apoptosis caused by PM2.5 in respiratory systems is unclear. METHODS: Human lung alveolar epithelial A549 cells were exposed to PM2.5 with or without rosiglitazone (an agonist of PPARγ) treatment. Cellular apoptosis and intracellular oxidative stress were determined by flow cytometry based on FITC Annexin V and DCFH-DA fluorescence, respectively. Western blot was conducted to determine the expression of Bax, Bcl2, PPARγ, P-ERK1/2, ERK1/2, P-STAT3, and STAT3. RESULTS: PPARγ was downregulated in PM2.5-treated A549 cells, and application of rosiglitazone reduced PM2.5-mediated ROS generation and cell apoptosis. In addition, our results indicated that rosiglitazone treatment suppressed PM2.5-induced ERK1/2 and STAT3 activation. CONCLUSIONS: Collectively, these data suggested that rosiglitazone protects against PM2.5-induced ROS production and cell apoptosis and represses activation of ERK1/2 and STAT3 signaling in A549 cells. Our results indicated that rosiglitazone is a potential therapeutic agent for PM2.5-induced lung diseases.

Traditional Chinese medicine Qiliqiangxin attenuates phenylephrine-induced cardiac hypertrophy via upregulating PPARγ and PGC-1α.

BACKGROUND: Clinical study has demonstrated that the traditional Chinese medicine Qiliqiangxin (QLQX) has protective effects on heart failure. Phenylephrine (PE) is an important inducing factor for cardiac hypertrophy and our previous studies have showed that QLQX attenuates PE-induced cardiac hypertrophy. Besides, QLQX protects against cardiac remodeling after myocardial infarction via activating PPARγ. However, whether QLQX prevents PE-induced cardiac hypertrophy through PPARγ and its coactivator PGC-1α is still unknown. METHODS: The effects of QLQX were investigated based on PE induced cardiac hypertrophy mouse models. Echocardiography and hematoxylin-eosin (HE) staining were used to determine cardiac function and cross-sectional area, respectively. Quantitative real time PCR (qRT-PCR) was used to determine ANP and BNP expressions. Based on primary neonatal rat ventricular cardiomyocytes (NRVMs) treated with PE, the cell size and expressions of ANP and BNP were determined by immunofluorescent staining and qRT-PCR, respectively. In addition, western blot was used to determine PPARγ and PGC-1α expressions. RESULTS: In present study, we confirmed that QLQX could significantly attenuate cardiac hypertrophy in mice treated with PE. Then we showed that PPARγ and PGC-1α were downregulated in PE-induced cardiac hypertrophy, and QLQX could block the decrease of PPARγ and PGC-1α both in vitro and in vivo. Importantly, we found that PPARγ inhibitors or PGC-1α siRNAs eliminated the protective effects of QLQX on PE-induced cardiac hypertrophy. CONCLUSIONS: Our study suggested that QLQX prevents from PE-induced cardiac hypertrophy by activating PPARγ and its coactivator PGC-1α.

Small RNAome sequencing delineates the small RNA landscape of pluripotent adult stem cells in the planarian Schmidtea mediterranea.

Small noncoding RNAs play a pivotal role in the regulation of gene expression, and are key regulators of animal development. Freshwater planarian exhibits an extraordinary ability to regenerate any missing body parts, representing an emerging model for studying mechanism underlying stem cell regulation and tissue regeneration. Here, we utilized next-generation sequencing (NGS) to identify small RNAs that are expressed in planarian adult stem cells, and are implicated in tissue regeneration. We profiled microRNAs (miRNAs), piwi-interacting RNA (piRNAs), small rDNA-derived RNAs (srRNAs) and endogenous interfering RNAs (endo-siRNAs) population from size 18-30 nt, measured the expression of 244 conserved miRNAs, and identified 41 novel miRNAs and 64 novel endo-siRNAs. Expression profiling analyses revealed that most piRNAs and srRNAs are up-regulated during regeneration, and that the most abundantly expressed srRNAs are from 5.8s and 28s rRNA. Furthermore, a target prediction method was adopted to investigate the anti-correlation of small RNAs and mRNA expression. We built up a gene regulatory network based on the genes that are targeted by dynamically changed small RNAs. These results expand the known small RNA repertoire in planarian, and provide valuable insights and a rich resource for understanding the small RNAs landscape in stem cell-mediated regeneration.