ABSTRACT
BACKGROUND: Colchicine has been approved to reduce cardiovascular risk in patients with coronary heart disease on the basis of its potential benefits demonstrated in the COLCOT (Colchicine-Optical Coherence Tomography Trial) and LoDoCo2 studies. Nevertheless, there are limited data available about the specific impact of colchicine on coronary plaques. METHODS: This was a prospective, single-center, randomized, double-blind clinical trial. From May 3, 2021, until August 31, 2022, a total of 128 patients with acute coronary syndrome aged 18 to 80 years with lipid-rich plaque (lipid pool arc >90°) detected by optical coherence tomography were included. The subjects were randomly assigned in a 1:1 ratio to receive either colchicine (0.5 mg once daily) or placebo for 12 months. The primary end point was the change in the minimal fibrous cap thickness from baseline to the 12-month follow-up. RESULTS: Among 128 patients, 52 in the colchicine group and 52 in the placebo group completed the study. The mean age of the 128 patients was 58.0±9.8 years, and 25.0% were female. Compared with placebo, colchicine therapy significantly increased the minimal fibrous cap thickness (51.9 [95% CI, 32.8 to 71.0] µm versus 87.2 [95% CI, 69.9 to 104.5] µm; difference, 34.2 [95% CI, 9.7 to 58.6] µm; P=0.006), and reduced average lipid arc (-25.2° [95% CI, -30.6° to -19.9°] versus -35.7° [95% CI, -40.5° to -30.8°]; difference, -10.5° [95% CI, -17.7° to -3.4°]; P=0.004), mean angular extension of macrophages (-8.9° [95% CI, -13.3° to -4.6°] versus -14.0° [95% CI, -18.0° to -10.0°]; difference, -6.0° [95% CI, -11.8° to -0.2°]; P=0.044), high-sensitivity C-reactive protein level (geometric mean ratio, 0.6 [95% CI, 0.4 to 1.0] versus 0.3 [95% CI, 0.2 to 0.5]; difference, 0.5 [95% CI, 0.3 to 1.0]; P=0.046), interleukin-6 level (geometric mean ratio, 0.8 [95% CI, 0.6 to 1.1] versus 0.5 [95% CI, 0.4 to 0.7]; difference, 0.6 [95% CI, 0.4 to 0.9]; P=0.025), and myeloperoxidase level (geometric mean ratio, 1.0 [95% CI, 0.8 to 1.2] versus 0.8 [95% CI, 0.7 to 0.9]; difference, 0.8 [95% CI, 0.6 to 1.0]; P=0.047). CONCLUSIONS: Our findings suggested that colchicine resulted in favorable effects on coronary plaque stabilization at optical coherence tomography in patients with acute coronary syndrome. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04848857.
ABSTRACT
BACKGROUND: Allopurinol, a xanthine inhibitor that lowers uric acid concentration, has been proven to reduce inflammation and oxidative stress in patients with cardiovascular disease. However, it is unknown whether these beneficial effects translate into favorable plaque modiï¬cation in acute coronary syndromes (ACS). This study aimed to investigate whether allopurinol could improve coronary plaque stabilization using coronary computed tomography angiography (CCTA). METHODS: This was a prospective, single-center, randomized, double-blind clinical trial began in March 2019. A total of 162 ACS patients aged 18-80 years with a blood level of high-sensitivity C-reactive protein (hsCRP) â> â2 âmg/L were included. The subjects were randomly assigned in a 1:1 ratio to receive either allopurinol sustained-release capsules (at a dose of 0.25 âg once daily) or placebo for 12 months. The plaque analysis was performed at CCTA. The primary efficacy endpoint was the change in low-attenuation plaque volume (LAPV) from baseline to the 12-month follow-up. RESULTS: Among 162 patients, 54 in allopurinol group and 51 in placebo group completed the study. The median follow-up duration was 14 months in both groups. Compared with placebo, allopurinol therapy did not signiï¬cantly alter LAPV (-13.4 â± â3.7 â% vs. -17.8 â± â3.6 â%, p â= â0.390), intermediate attenuation plaque volume (-16.1 â± â3.0 â% vs. -16.2 â± â2.9 â%, p â= â0.992), dense calciï¬ed plaque volume (12.2 â± â13.7 â% vs. 9.7 â± â13.0 â%, p â= â0.894), total atheroma volume (-15.2 â± â3.2 â% vs. -16.4 â± â3.1 â%, p â= â0.785), remodeling index (2.0 â± â3.9 â% vs. 5.4 â± â3.8 â%, p â= â0.536) or hsCRP levels (-73.6 [-91.6-17.9] % vs. -81.2 [-95.4-47.7] %, p â= â0.286). CONCLUSIONS: Our ï¬ndings suggest that allopurinol does not improve atherosclerotic plaque stability or inï¬ammation in ACS.
Subject(s)
Acute Coronary Syndrome , Allopurinol , Plaque, Atherosclerotic , Humans , Acute Coronary Syndrome/diagnostic imaging , Acute Coronary Syndrome/drug therapy , Allopurinol/therapeutic use , C-Reactive Protein , Coronary Angiography/methods , Inflammation , Predictive Value of Tests , Prospective Studies , Adolescent , Young Adult , Adult , Middle Aged , Aged , Aged, 80 and overABSTRACT
ABSTRACT: Colchicine reduces atherothrombotic cardiovascular events in coronary artery disease because of its anti-inflammatory effect. However, the effects of the other anti-inflammatory drugs in coronary artery disease remain unclear. This study included 132 patients aged 18-80 years who completed the planned percutaneous coronary interventions and were treated with aggressive secondary prevention strategies for 4 weeks. The subjects were randomly assigned to 1 of the following treatment groups for 4 weeks: (1) control: no additional intervention; (2) colchicine: 0.5 mg once a day; (3) tranilast: 0.1 g thrice a day; or (4) oridonin: 0.5 g thrice a day. The primary outcome was the percentage change in high-sensitivity C-reactive protein (hsCRP) levels at the end of 4 weeks. In total, 109 patients completed the study. The mean age was 58.33 years, 81 (74.31%) were male, and 28 (25.69%) were female. The percentage changes in hsCRP after 4 weeks of treatment were -11.62%, -48.28%, -21.60%, and -7.81%, in the control, colchicine, tranilast, and the oridonin groups, respectively. Compared with the control group, only the colchicine group showed significantly greater reduction in hsCRP levels ( P = 0.022). In targeted proteomic analysis, proteins associated with neutrophil activation (azurocidin, myeloperoxidase, and myeloblastin), platelet aggregation (glycoprotein VI), and endothelial damage (galectin-3) were reduced with colchicine therapy. These results show that of 3 anti-inflammatory drugs only colchicine could reduce hsCRP in patients after percutaneous coronary interventions.
Subject(s)
Coronary Artery Disease , Diterpenes, Kaurane , Percutaneous Coronary Intervention , ortho-Aminobenzoates , Humans , Male , Female , Middle Aged , C-Reactive Protein/metabolism , Coronary Artery Disease/drug therapy , Pilot Projects , Proteomics , Anti-Inflammatory Agents/adverse effects , Colchicine/adverse effects , Percutaneous Coronary Intervention/adverse effects , Treatment OutcomeABSTRACT
AIMS: To survey the types of Electronic Nursing Records used and to explore nurses' perceptions in the hospitals in Henan Province, China. BACKGROUND: There are few studies about status of electronic nursing documents from nurses' view. METHOD: A cross-sectional study of 3,586 nurses using a web-based questionnaire was conducted. RESULTS: Approximately 98% of the nurses were college graduates or had higher degrees, with 46% of the nurses managed more than nine beds per nurse each day. About 27% spent more than two hours daily writing records with a further 38% spending between 1 and 2 hr. However, only 52% realized professional nursing records should be archived and fewer than 80% knew the importance and significance of preserving fundamental nursing records. CONCLUSION: Although nurses' educational level in Henan is high, the younger age of them (i.e., less experience) and heavy workload may lead to inferior quality of ENR. Nurses' awareness of the importance and legal significance of documents needs improvement. IMPLICATION FOR NURSING MANAGEMENT: Our results may provide detailed evidence of the time consuming as well as nurses' knowledge of, abilities in, and opinions about record-keeping in developed countries and bring potential clinical implications for the nursing managers worldwide.
Subject(s)
Electronic Health Records/standards , Nurses/psychology , Perception , Adult , Attitude of Health Personnel , China , Cross-Sectional Studies , Documentation/methods , Documentation/standards , Electronic Health Records/trends , Female , Humans , Male , Middle Aged , Nurses/trends , Surveys and Questionnaires , Workload/standardsABSTRACT
The nuclear factor-κB (NF-κB) pathway plays an important role in cell proliferation, survival, early viral response, cytokine secretion, and pro-inflammatory. Hepatitis C virus (HCV) can hijack and interact with the NF-κB signaling pathway and affect disease outcomes. This paper describes the interaction between NF-κB protein family, signaling pathway, HCV viral protein and host NF-κB signaling pathway, and its effect on HCV infection. In the future, further study is expected to be done in this aspect to provide new strategies for the screening of HCV high-susceptibility population as well as prevention.
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OBJECTIVE@#To investigate the effects of central nucleus of amygdala (CeA) lesion on the initiation and expression of sodium appetite in sodium-deficient rats.@*METHODS@#Three groups of SD rats (n=6 in each group) were treated with bilateral CeA lesion, sham lesion or no lesion. After the recovery, the rats were fed with low-sodium diets for 14 days to establish a sodium-deficient rat model. The double-bottle selection in single cage test was used to observe the intake of 0.3 mol/L NaCl and DW in 5 timepoint with 24 hours in sodium-deficient rats. Immunofluorescence staining of aldosterone-sensitive neurons in the nucleus tractus solitarii (NTS)was used to investigate the effect of CeA lesion or not on the activity of aldosterone-sensitive neurons in rats with or without sodium deficiency.@*RESULTS@#After fed with low-sodium diet for14 days, the volume and preference rate of 0.3 mol/L NaCl intake of the rats within 24 h were significantly increased compared with those before low-sodium diet (P<0.01). The intake volume and the preference rate of 0.3 mol/L NaCl in CeA lesion rats were significantly decreased than those in CeA sham lesion rats and normal rats in the sodium-deficient condition (P<0.01). The CeA lesion had no effects on the activity of aldosterone-sensitive neurons in NTS in rats with low-sodium diet.@*CONCLUSION@#Low-sodium diet induces an increase in the expression of sodium appetite in rats. CeA lesions inhibit the behavioral expression of sodium appetite in sodium-deficient rats but have no effects on the initiation of sodium appetite in rats with sodium-deficient rats.
Subject(s)
Animals , Rats , Amygdala , Pathology , Appetite , Diet, Sodium-Restricted , Neurons , Rats, Sprague-Dawley , Sodium , Sodium, Dietary , PharmacologyABSTRACT
<p><b>OBJECTIVE</b>To investigate the pathogenesis of globozoospermia, fertilization ability of round-headed sperm, and the application value of assisted oocyte activation in intracytoplasmic sperm injection (ICSI) for the wives of glohozoospermia men.</p><p><b>METHODS</b>We collected oocytes from the wives of 2 globozoospermia patients and randomly divided them into two groups after ICSI to receive calcium ionophore A23187-activation and conventional treatment, respectively. We reviewed the relevant literature published at home and abroad, and discussed the etiology of globozoospermia, fertilization ability of round-headed sperm, and treatment options for this disease.</p><p><b>RESULTS</b>Quality embryos were obtained in the A23187-activation group while no fertilized oocytes, oocyte cleavage, quality embryos, or blastular formation were found in the conventional treatment group. Both women achieved pregnancy and gave birth to healthy neonates after transfer of the quality embryos from the A23187-activation group.</p><p><b>CONCLUSION</b>Calcium ionophore A23187 can be applied to ICSI for the wives of globozoospermia men and bring about desirable clinical outcomes. Meanwhile, attention should be paid to its safety.</p>
Subject(s)
Female , Humans , Male , Pregnancy , Calcimycin , Therapeutic Uses , Calcium Ionophores , Therapeutic Uses , Infertility, Male , Drug Therapy , Oocytes , Sperm Injections, Intracytoplasmic , Spermatozoa , Congenital AbnormalitiesABSTRACT
<p><b>OBJECTIVE</b>To study the safety of the novel high nitrogen nickel-free austenitic stainless steel bare metal stents (BMS) in a recognized porcine coronary model and to select a better grid structure of it.</p><p><b>METHODS</b>Three types of stents were randomly implanted in different coronary arteries of the same pig: 316 L stainless steel BMS (316 L-BMS) (n=12), novel high nitrogen nickel-free stents Grid A (NF-A-BMS) (n=12) and novel high nitrogen nickel-free stents Grid B (NF-B-BMS) (n=12). In total, eighteen animals underwent successful random placement of 36 oversized stents in the coronary arteries. Coronary angiography was performed after 36 d of stents implantation. Nine animals were respectively sacrificed after 14 d and 36 d for histomorphologic analysis.</p><p><b>RESULTS</b>Quantitative coronary angiography (QCA) showed similar luminal loss (LL) in the three groups: (0.21 ± 0.17) mm for 316 L-BMS, (0.16 ± 0.12) mm for NF-A-BMS, (0.24 ± 0.15) mm for NF-B-BMS (P>0.05). Histomorphomeric analysis after 15 d and 36 d revealed that there was also no significant difference among the three groups in neointimal area (NA) with similar injury scores respectively. High magnification histomorphologic examination showed similar inflammation scores in the three groups, but NF-A-BMS group had poorer endothelialization scores compared with NF-B-BMS group, 2.00 ± 0.63 vs. 2.83 ± 0.41 (P=0.015) at 15 d, which also could be proved by the scanning electron microscope. However, the difference could not been observed at 36 d.</p><p><b>CONCLUSION</b>The novel NF-BMS showed similar safety as 316 L-BMS during the short-term study. NF-B-BMS had better endothelialization than NF-A-BMS and this may owe to the specific strut units.</p>
Subject(s)
Animals , Coronary Vessels , Nickel , Nitrogen , Random Allocation , Stainless Steel , Chemistry , Stents , Swine , Swine, MiniatureABSTRACT
The sensor of the taste is the taste bud. The signals originated from the taste buds are transmitted to the central nervous system through the gustatory taste nerves. The chorda tympani nerve (innervating the taste buds of the anterior tongue) and glossopharyngeal nerve (innervating the taste buds of the posterior tongue) are the two primary gustatory nerves. The injuries of gustatory nerves cause their innervating taste buds atrophy, degenerate and disappear. The related taste function is also impaired. The impaired taste function can be restored after the gustatory nerves regeneration. The rat model of cross-regeneration of gustatory nerves is an important platform for research in the plasticity of the central nervous system. The animal behavioral responses and the electrophysiological properties of the gustatory nerves have changed a lot after the cross-regeneration of the gustatory nerves. The effects of the injury, regeneration and cross-regeneration of the gustatory nerves on the taste function in the animals will be discussed in this review. The prospective studies on the animal model of cross-regeneration of gustatory nerves are also discussed in this review. The study on the injury, regeneration and cross-regeneration of the gustatory nerves not only benefits the understanding of mechanism for neural plasticity in gustatory nervous system, but also will provide theoretical basis and new ideas for seeking methods and techniques to cure dysgeusia.
Subject(s)
Animals , Rats , Chorda Tympani Nerve , Physiology , Glossopharyngeal Nerve , Physiology , Nerve Regeneration , Neuronal Plasticity , Taste , Physiology , Taste Buds , Physiology , TongueABSTRACT
A portable ECG monitor is introduced in the paper, which has a temporary intravenous and transesophageal fixable rate pacing function. During the PSVT attack, the tachyarrythmia can be stopped by the transesophageal cardiac pacing while the ECG signals are monitored. The instrument has some advantages such as small size, low price and good practicality. It is worth while introducing and popularizing it to all hospitals.