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1.
Huan Jing Ke Xue ; 40(10): 4310-4318, 2019 Oct 08.
Artigo em Chinês | MEDLINE | ID: mdl-31854797

RESUMO

Based on observational data for pollutants and meteorology, this study analyzed the pollution episode that occurred during Dec 17th to 23th in 2018 in Zhaoqing, Guangdong Province, China. Using the source apportionment model CMAQ-ISAM and the hybrid receptor model, the regional contributions to air pollution were examined. The results showed that low-pressure conditions had an adverse effect on the diffusion of pollutants during this pollution episode in Zhaoqing. Prior to the pollution episode, pollutants were mainly derived from Zhaoqing and Qingyuan, accounting for 19.2% and 10.7% of pollutants, respectively. As well as pollutants from Guangdong Province, long-distance transport of pollutants from Jiangxi, Hunan, Hubei, and Shaanxi accounted for approximately 64.5% of the total during the non-pollution period. During the polluted episode, major cities in Pearl River Delta and the eastern part of Guangdong Province contributed more pollutants as a surface high-pressure field moved southward. Zhaoqing, Foshan, Dongguan, Guangzhou, and Huizhou contributed 25.5%, 14.8%, 9.8%, 9.5%, and 5.3% of the pollutants, respectively. Cities in the eastern part of Guangdong Province including Heyuan, Meizhou, Shanwei, Jieyang, Shantou, and Chaozhou contributed 13.7% of the total pollutants. In addition, pollutants from Fujian, Jiangxi, and the Yangtze River Delta accounted for approximately 32.9%. Furthermore, pollutants transported under marine influences were one of the main causes of this pollution episode in Zhaoqing.

2.
Huan Jing Ke Xue ; 39(9): 3995-4001, 2018 Sep 08.
Artigo em Chinês | MEDLINE | ID: mdl-30188039

RESUMO

An emission inventory of atmospheric pollutants from crop residue burning in Guangdong for the period 2008-2016 was developed, based on crop yield data. Emissions of species of volatile organic compounds(VOCs)and corresponding ozone formation potential (OFP) in 2016 were also estimated. Results showed that emissions of atmospheric pollutants from crop residue burning in 2013-2016 were lower than in 2008-2012. This was mainly due to the policy of prohibiting open burning of straw and to improvement of rural living standards, which reduced the proportion of straw burning. In 2016, emissions of SO2, NOx, NH3, CH4, EC, OC, NMVOC, CO, and PM2.5 were 2443.7, 16187.9, 6943.8, 29174.4, 3625.5, 14830.7, 65612.6, 591613.9, and 49463.0 t, respectively. Rice straw burning was the main source of pollutants, accounting for about 68.55% of total pollutant emissions. The five municipalities with highest atmospheric pollutant emissions were Zhanjiang, Maoming, Meizhou, Zhaoqing, and Shaoguan, together accounting for about 58.63% of total emissions. The top 10 VOC species for mass-based emissions consisted of ethylene, acetaldehyde, formaldehyde, benzene, ethyne, propylene, ethane, toluene, propane, and propionaldehyde, together contributing 67.91% to total emissions. The top ten OFP-based VOC species were ethylene, formaldehyde, acetaldehyde, propylene, 1-butylene, propionaldehyde, toluene, acrolein, isoprene, and crotonaldehyde, accounting for 80.83% of total OFP.

3.
Huan Jing Ke Xue ; 39(1): 49-56, 2018 Jan 08.
Artigo em Chinês | MEDLINE | ID: mdl-29965665

RESUMO

To meet the requirements of regional air quality management (AQM), the Air Quality Subarea Management (AQSM) system was proposed. A case study was conducted for Guangdong Province. By using the method of air quality numerical simulation and satellite remote sensing inversion analysis, the key factors were selected from the meteorological simulation field, the pollutant concentration simulation field, and the satellite image interpretation to form the index system for AQSM. On this basis, a hierarchical cluster analysis method was used to divide Guangdong Province into three types of AQSM:Strict Control Subarea, Continuous Improvement Subarea, and Coordinated Development Subarea. It was shown that the Strict Control Subarea, Continuous Improvement Subarea, and Coordinated Development Subarea in Guangdong Province covered 16.3%, 28.0%, and 55.7%, respectively. The Strict Control Subarea in the Pearl River Delta, Eastern Guangdong, Western Guangdong, and Northern Guangdong accounted for 27.9%, 19.3%, 4.4%, and 12.5%, respectively, and the subarea should implement the most stringent AQM policies to promote air quality improvement. The Continuous Improvement Subarea in the Pearl River Delta, Eastern Guangdong, Western Guangdong, and Northern Guangdong accounted for 34.4%, 15.8%, 7.8%, and 34.5%, respectively, and the subarea should implement relatively strict AQM policies to ensure sustained and stable standards. The Coordinated Development Subarea in the Pearl River Delta, Eastern Guangdong, Western Guangdong, and Northern Guangdong accounted for 37.7%, 64.9%, 87.8%, and 53.0%, respectively, and the subarea could implement more liberal AQM policies to ensure relatively good air quality. In general, the strict AQM policies in Guangdong Province should be mainly concentrated in the Pearl River Delta region, followed by Northern Guangdong, Eastern Guangdong, and Western Guangdong in order.

4.
Huan Jing Ke Xue ; 39(8): 3485-3491, 2018 Aug 08.
Artigo em Chinês | MEDLINE | ID: mdl-29998652

RESUMO

Atmospheric environmental capacity is an important reference in environmental planning. To meet the PM2.5 standard, a new method is proposed to balance the capacity among cities of Guangdong, with screening of the most unfavorable meteorological year and combining it with the regional transportation calculated by the CAMx-PSAT module. Pollutant overloading and capacity scenarios were also calculated. The results showed that, under the constraints of the cities' annual PM2.5 ≤ 35 µg·m-3, the capacities of SO2, NOx, NH3, and PM2.5 in Guangdong were about 6.8×105 tons, 1.35×106 tons, 4.6×105 tons, and 5.1×105 tons, respectively. Based on the benchmark scenario, SO2 emissions in Guangdong were overloaded by 10%, and the emissions of NOx, NH3, and PM2.5 exceeded by 12%, 9%, and 20%, respectively, compared to those of the capacity scenario. Ranked by the number of overloaded species in Guangdong, the cities of Guangzhou, Foshan, Zhongshan, and Qingyuan were on top. When achieving the capacity scenario, the annual PM2.5 concentration in Guangdong was about 30 µg·m-3, which meets the national secondary ambient air quality standard.

5.
Int J Mol Med ; 42(2): 1199, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29749426

RESUMO

Subsequently to the publication of this article, the authors have realized that an address affiliation associated with certain of the authors had been omitted. The authors' affiliation information should have appeared as follows (the omitted address affiliation is featured in bold): Yi­Ying Yang1,2*, Xiu­Ting Sun1,2*, Zheng­Xun Li1,2, Wei­Yan Chen3, Xiang Wang4, Mei­Ling Liang5, Hui Shi1,2, Zhi­Sheng Yang1,2 and Wu­Tao Zeng1,2 1Department of Cardiology, The First Affiliated Hospital, Sun Yat­Sen University; 2Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, Guangdong 510080; 3Intensive Care Unit, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510260; 4Department of Cardiology, Laiwu City People's Hospital, Laiwu, Shandong 27110; 5Department of Cardiology, Sun Yat­Sen Cardiovascular Hospital, Shenzhen, Guangdong 518020, P.R. China *Contributed equally. The authors regret this error in the affiliations, and apologize for any inconvenience caused. [the original article was published in the International Journal of Molecular Medicine 41: 1283­1292, 2018; DOI: 10.3892/ijmm.2017.3322].

6.
Int J Mol Med ; 41(3): 1283-1292, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29286068

RESUMO

Angiotensin-(1-7) [Ang-(1-7)], a heptapeptide mainly generated from cleavage of AngⅠ and AngⅡ, possesses physiological and pharmacological properties, including anti­inflammatory and antidiabetic properties. Activation of the phosphoinositide 3-kinase and protein kinase B (PI3K̸Akt) signaling pathway has been confirmed to participate in cardioprotection against hyperglycaemia-induced injury. The aim of the present study was to test the hypothesis that Ang-(1-7) protects H9c2 cardiomyoblast cells against high glucose (HG)-induced injury by activating the PI3K̸Akt pathway. To examine this hypothesis, H9c2 cells were treated with 35 mmol/l (mM) glucose (HG) for 24 h to establish a HG-induced cardiomyocyte injury model. The cells were co-treated with 1 µmol/l (µM) Ang-(1-7) and 35 mM glucose. The findings of the present study demonstrated that exposure of H9c2 cells to HG for 24 h markedly induced injury, as evidenced by an increase in the percentage of apoptotic cells, generation of reactive oxygen species and level of inflammatory cytokines, as well as a decline in cell viability and mitochondrial luminosity. These injuries were significantly attenuated by co-treatment of the cells with Ang-(1-7) and HG. In addition, PI3K̸Akt phosphorylation was suppressed by HG treatment, but this effect was abolished when the H9c2 cells were co-treated with Ang-(1-7) and HG. Furthermore, the cardioprotection of Ang-(1-7) against HG-induced injury in H9c2 cardiomyoblasts was highly attenuated in the presence of either D-Ala7-Ang-(1-7) (A-779, an antagonist of the Mas receptor) or LY294002 (an inhibitor of PI3K̸Akt). In conclusion, the present study provided new evidence that Ang-(1-7) protects H9c2 cardiomyoblasts against HG-induced injury by activating the PI3K̸Akt signaling pathway.


Assuntos
Angiotensina I/farmacologia , Cardiotônicos/farmacologia , Hiperglicemia/patologia , Miócitos Cardíacos/enzimologia , Miócitos Cardíacos/patologia , Fragmentos de Peptídeos/farmacologia , Fosfatidilinositol 3-Quinases/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , Transdução de Sinais/efeitos dos fármacos , Animais , Apoptose/efeitos dos fármacos , Caspases/metabolismo , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Citoproteção/efeitos dos fármacos , Glucose/toxicidade , Inflamação/patologia , Potencial da Membrana Mitocondrial/efeitos dos fármacos , Miócitos Cardíacos/efeitos dos fármacos , Fosforilação/efeitos dos fármacos , Inibidores de Proteínas Quinases/farmacologia , Ratos , Espécies Reativas de Oxigênio/metabolismo
7.
Mol Med Rep ; 17(1): 1461-1468, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29257199

RESUMO

The transplantation of mesenchymal stem cells (MSCs) has been a reported method for alleviating atherosclerosis (AS). Because the availability of bone marrow­derived MSCs (BM­MSCs) is limited, the authors used this study to explore the use of a new type of MSC, human induced pluripotent stem cell­derived MSCs (iPSC­MSCs), to evaluate whether these cells could alleviate AS. iPSC­MSCs were intravenously administered to ApoE knock out mice fed on a high­fat diet (HFD) for 12 weeks. It was reported that systematically administering iPSC­MSCs clearly reduced the size of plaques. In addition, the numbers of macrophages and lipids in plaques were lower in the HFD + iPSC­MSCs group than in the HFD group. Furthermore, iPSC­MSCs attenuated AS­associated inflammation by decreasing the levels of inflammatory cytokines, such as tumor necrosis factor­α and interleukin­6, in serum. In addition, the expression of Notch1 was higher in the HFD group, and injecting iPSC­MSCs reversed this effect. In conclusion, the current study provides the first evidence indicating that iPSC­MSCs may be a new optional MSC­based strategy for treating AS.


Assuntos
Aterosclerose/terapia , Células-Tronco Pluripotentes Induzidas/citologia , Transplante de Células-Tronco Mesenquimais , Células-Tronco Mesenquimais/citologia , Animais , Aterosclerose/sangue , Aterosclerose/complicações , Aterosclerose/imunologia , Células Cultivadas , Citocinas/sangue , Citocinas/imunologia , Humanos , Células-Tronco Pluripotentes Induzidas/imunologia , Inflamação/sangue , Inflamação/complicações , Inflamação/imunologia , Inflamação/terapia , Masculino , Transplante de Células-Tronco Mesenquimais/métodos , Células-Tronco Mesenquimais/imunologia , Camundongos , Camundongos Endogâmicos C57BL
8.
Eur J Clin Pharmacol ; 72(11): 1327-1334, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27488389

RESUMO

PURPOSE: The aim of this study was to investigate whether any of the single-nucleotide polymorphisms (SNPs) in the POR gene were significantly associated with CYP activity and expression, and could contribute to the total variability in stable warfarin maintenance doses in Han Chinese. METHODS: A total of 408 patients treated at the First Affiliated Hospital of Sun Yat-Sen University were eligible for the study and had attained a stable warfarin maintenance dose at the start of the investigation. Demographics, warfarin maintenance doses, and concomitant medications were documented. Genomic DNA was extracted from peripheral blood samples and genotyped for ten SNPs (CYP 2C9*2 and *3, CYP4F2 rs2108622, VKORC1 -1639C>T, and potential POR genes of rs10239977, rs3815455, rs41301394, rs56256515, rs1057868, and rs2286823) using the Sequenom MassARRAY genotyping system. RESULTS: A predictive model of warfarin maintenance dose was established and indicated that age, gender, body surface area, aspirin use, CYP2C9*3, CYP4F2 rs2108622, VKORC1 -1639C>T, and POR*37 831-35C>T accounted for 42.4 % of dose variance in patients undergoing anticoagulant treatment. The contribution of POR*37 831-35C>T to warfarin dose variation was only 3.9 %. CONCLUSIONS: For the first time, the SNP POR*37 831-35C>T was confirmed as a minor but statistically significant factor associated with interindividual variation in warfarin maintenance dose in Han Chinese. The POR*37 gene polymorphism should be considered in future algorithms for faster and more reliable achievement of stable warfarin maintenance doses.


Assuntos
Anticoagulantes/administração & dosagem , Grupo com Ancestrais do Continente Asiático/genética , Sistema Enzimático do Citocromo P-450/genética , Modelos Biológicos , Varfarina/administração & dosagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticoagulantes/uso terapêutico , Relação Dose-Resposta a Droga , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Varfarina/uso terapêutico , Adulto Jovem
9.
J Am Heart Assoc ; 5(5)2016 05 20.
Artigo em Inglês | MEDLINE | ID: mdl-27207999

RESUMO

BACKGROUND: The safety and long-term outcome of systemic thrombolysis in patients receiving antiplatelet medications remain subjects of great clinical significance. The objective of this meta-analysis was to determine how prestroke antiplatelet therapy affects the risks and benefits of intravenous thrombolysis in patients with acute ischemic stroke. METHODS AND RESULTS: A dual-reviewer search was conducted in PubMed and EMBASE databases through November 2015, from which 19 studies involving a total of 108 588 patients with acute ischemic stroke were identified based on preset inclusion criteria. Information on study designs, patient characteristics, exposures, outcomes, and adjusting confounders was extracted, and estimates were combined by using random-effects models. The pooled crude estimates suggested that taking long-term antiplatelet medications was associated with higher odds of symptomatic intracranial hemorrhage (odds ratio [OR] 1.70, 95% CI 1.47-1.97) and death (OR 1.46, 95% CI 1.22-1.75) and lower odds of favorable functional outcomes (OR 0.86, 95% CI 0.80-0.93). However, the combined confounder-adjusted results only confirmed a relatively weak positive association between prior antiplatelet therapy and symptomatic intracranial hemorrhage (OR 1.21, 95% CI 1.02-1.44) and demonstrated no significant relationship between antiplatelet therapy and the other 2 outcomes (favorable outcome OR 1.09, 95% CI 0.96-1.24; death OR 1.02, 95% CI 0.98-1.07). Subgroup analyses revealed that the associations between prestroke antiplatelet therapy and outcomes were dependent on time and antiplatelet agents. CONCLUSIONS: Patients with acute ischemic stroke receiving long-term antiplatelet medications were associated with greater risks of developing symptomatic intracranial hemorrhage after systemic thrombolysis. However, the overall independent association between prestroke antiplatelet therapy and unfavorable outcomes or mortality was insignificant.


Assuntos
Isquemia Encefálica/tratamento farmacológico , Fibrinolíticos/uso terapêutico , Hemorragias Intracranianas/epidemiologia , Inibidores da Agregação de Plaquetas/uso terapêutico , Acidente Vascular Cerebral/tratamento farmacológico , Terapia Trombolítica/métodos , Ativador de Plasminogênio Tecidual/uso terapêutico , Administração Intravenosa , Isquemia Encefálica/complicações , Humanos , Hemorragias Intracranianas/induzido quimicamente , Razão de Chances , Fatores de Risco , Acidente Vascular Cerebral/etiologia
10.
Medicine (Baltimore) ; 95(12): e2949, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27015169

RESUMO

Digoxin has long been used for rate control in atrial fibrillation (AF); its safety remains controversial.We performed a literature search using MEDLINE (source PubMed, January 1, 1966, to July 31, 2015) and EMBASE (January 1, 1980, to July 31, 2015) with no restrictions. Studies that reported relative risk (RR) estimates with 95% confidence intervals (CIs) for the associations of interest were included. Pooled effect estimates were obtained by using random-effects meta-analysis.Twenty-two studies involving 586,594 patients were identified. Patients taking digoxin, as compared with those who took no digoxin, experienced an increased risk of death from any cause (RR: 1.29[95% CI 1.16-1.43]), even after reported adjustment for propensity scores (RR: 1.28[95% CI 1.18-1.39]). The risk of death was increased with patients with or without heart failure (RR: 1.12[95% CI 1.02-1.23] and RR: 1.26[95% CI 1.15-1.29], respectively), and patients taking or not taking beta blockers (RR: 1.17 [95% CI 1.06-1.30] and RR: 1.28 [95% CI 1.08-1.51], respectively). Digoxin use was also associated with increased risk of cardiovascular death (RR: 1.32 [95% CI 1.07-1.64]), arrhythmic death (RR: 1.38 [95% CI 1.07-1.79]), and stroke (RR: 1.20 [95% CI 1.004-1.44]). Digoxin treatment is associated with an absolute risk increase of 19 (95% CI 13-26) additional deaths from any cause per 1000 person-years.Digoxin use is associated with a significant increased risk for death from any cause in patients with AF. This finding suggests a need for reconsideration of present treatment recommendations on use of digoxin in AF.


Assuntos
Fibrilação Atrial/tratamento farmacológico , Digoxina/efeitos adversos , Digoxina/uso terapêutico , Fibrilação Atrial/mortalidade , Causas de Morte , Humanos , Risco , Taxa de Sobrevida
11.
J Am Coll Cardiol ; 66(20): 2173-2184, 2015 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-26564594

RESUMO

BACKGROUND: Large cohort studies provide conflicting evidence regarding the potential for oral macrolide antibiotics to increase the risk of serious cardiac events. OBJECTIVES: This study performed a meta-analysis to examine the link between macrolides and risk of sudden cardiac death (SCD) or ventricular tachyarrhythmias (VTA), cardiovascular death, and death from any cause. METHODS: We performed a search of published reports by using MEDLINE (January 1, 1966, to April 30, 2015) and EMBASE (January 1, 1980, to April 30, 2015) with no restrictions. Studies that reported relative risk (RR) estimates with 95% confidence intervals (CIs) for the associations of interest were included. RESULTS: Thirty-three studies involving 20,779,963 participants were identified. Patients taking macrolides, compared with those who took no macrolides, experienced an increased risk of developing SCD or VTA (RR: 2.42; 95% CI: 1.61 to 3.63), SCD (RR: 2.52; 95% CI: 1.91 to 3.31), and cardiovascular death (RR: 1.31; 95% CI: 1.06 to 1.62). No association was found between macrolides use and all-cause death or any cardiovascular events. The RRs associated with SCD or VTA were 3.40 for azithromycin, 2.16 for clarithromycin, and 3.61 for erythromycin, respectively. RRs for cardiovascular death were 1.54 for azithromycin and 1.48 for clarithromycin. No association was noted between roxithromycin and adverse cardiac outcomes. Treatment with macrolides is associated with an absolute risk increase of 118.1 additional SCDs or VTA, and 38.2 additional cardiovascular deaths per 1 million treatment courses. CONCLUSIONS: Administration of macrolide antibiotics is associated with increased risk for SCD or VTA and cardiovascular death but not increased all-cause mortality.


Assuntos
Antibacterianos/efeitos adversos , Morte Súbita Cardíaca/etiologia , Macrolídeos/efeitos adversos , Taquicardia Ventricular/etiologia , Causas de Morte , Morte Súbita Cardíaca/epidemiologia , Feminino , Humanos , Masculino , Fatores de Risco , Taquicardia Ventricular/epidemiologia
12.
Environ Sci Technol ; 49(19): 11670-8, 2015 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-26302450

RESUMO

Serious particulate matter (PM) pollution problems in many polluted regions of China have been frequently reported in recent years. Long-term exposure to ambient PM pollution is significantly associated with adverse health effects. Characterizing the long-term trends and variation in PM pollution is a basic requirement for evaluating long-term exposure and for guiding future policies to reduce the effects of air pollution on health. However, long-term, ground-based PM measurements are only available at a few fixed stations. In this study, an algorithm is developed and validated to estimate PM concentrations based on the satellite atmospheric optical depth with 1 km spatial resolution. The long-term trends of PM10 concentrations in the entire Pearl River Delta (PRD) region and different cities are quantified and discussed. From 2001 to 2013, the PM10 pollution of the entire PRD region was dominated by a decreasing trend of -0.15 ± 0.23 µg/m(3)·yr. This decreasing PM10 trend was apparent over 75% of the PRD area, with the most significant decreases observed in the center of the region. However, the remaining 25%, mostly located in the outskirts of the region, showed an increasing PM10 trend. This overall decreasing trend indicates the effectiveness of the control measures applied in the past decade for the primary pollutants.


Assuntos
Poluição do Ar/análise , Material Particulado/análise , Tecnologia de Sensoriamento Remoto/métodos , Algoritmos , China , Cidades , Monitoramento Ambiental/métodos , Reprodutibilidade dos Testes , Comunicações Via Satélite
13.
Stroke ; 46(1): 157-63, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25424480

RESUMO

BACKGROUND AND PURPOSE: Chronic kidney disease may increase the risk for ischemic stroke or systemic embolism in patients with nonvalular atrial fibrillation (AF). We conducted a meta-analysis to summarize all published studies to investigate the link between chronic kidney disease and risk of thromboembolic events in AF. METHODS: We performed a literature search using MEDLINE (source PubMed, 1966 to July, 2014) and EMBASE (1980 to July 2014) with no restrictions. Pooled effect estimates were obtained by using random-effects meta-analysis. RESULTS: Eighteen studies involving 538 479 patients and 41 719 incident thromboembolic events were identified. From the pooled analysis, AF patients with estimated glomerular filtration rate <60 mL/min compared with those with estimated glomerular filtration rate ≥60 mL/min experienced a significantly increased risk for developing thromboembolic events (relative risk, 1.62 [95% confidence interval, 1.40-1.87; P<0.001]). The annual rate of thromboembolic events increased by 0.41% (95% confidence interval, 0.17%-0.65%) for a 10 mL/min decrease in renal function. Addition of renal impairment to CHADS2 slightly improved the stroke risk stratification. CONCLUSIONS: Impaired renal function is an independent predictor of stroke or systemic embolism in patients with nonvalvular AF. Consideration of renal function may improve stroke risk stratification in patients with AF.


Assuntos
Fibrilação Atrial/complicações , Insuficiência Renal Crônica/complicações , Acidente Vascular Cerebral/etiologia , Tromboembolia/etiologia , Taxa de Filtração Glomerular , Humanos , Insuficiência Renal Crônica/fisiopatologia , Fatores de Risco , Índice de Gravidade de Doença
14.
Circ Arrhythm Electrophysiol ; 7(5): 807-15, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25146838

RESUMO

BACKGROUND: Data on sex difference in response to cardiac resynchronization therapy (CRT) remain controversial. We conducted a meta-analysis to summarize all published studies to determine whether sex-based differences in response to CRT exist. METHODS AND RESULTS: We performed a literature search using MEDLINE (source PubMed; January 1966 to March 2014) and EMBASE (January 1980 to March 2014) with no restrictions. Pooled effect estimates were obtained by using random-effects meta-analysis. Seventy-two studies involving 33 434 patients were identified. Overall, female patients had better outcomes from CRT compared with male patients, with a significant 33% reduction in the risk of death from any cause (hazard ratio, 0.67; 95% confidence interval, 0.61-0.74; P<0.001), 20% reduction in death or hospitalization for heart failure (hazard ratio, 0.80; 95% confidence interval, 0.71-0.90; P<0.001), 41% reduction in cardiac death (hazard ratio, 0.59; 95% confidence interval, 0.42-0.84; P<0.001), and 41% reduction in ventricular arrhythmias or sudden cardiac death (hazard ratio, 0.59; 95% confidence interval, 0.49-0.70; P<0.001). These more favorable responses to CRT in women were consistently associated with greater echocardiographic evidence of reverse cardiac remodeling in women than in men. CONCLUSIONS: Women obtained greater reductions in the risk of death from any cause, cardiac cause, death or hospitalization for heart failure, and ventricular arrhythmias or sudden cardiac death with CRT therapy compared with men, with consistently greater echocardiographic evidence of reverse cardiac remodeling in women than in men. Further studies are needed to investigate the exact reasons for these results and determine whether indications for CRT in women should be different from men.


Assuntos
Terapia de Ressincronização Cardíaca , Insuficiência Cardíaca/terapia , Terapia de Ressincronização Cardíaca/efeitos adversos , Terapia de Ressincronização Cardíaca/mortalidade , Morte Súbita Cardíaca/prevenção & controle , Feminino , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/mortalidade , Insuficiência Cardíaca/fisiopatologia , Hospitalização , Humanos , Estimativa de Kaplan-Meier , Masculino , Razão de Chances , Recuperação de Função Fisiológica , Fatores de Risco , Fatores Sexuais , Resultado do Tratamento , Remodelação Ventricular
15.
PLoS Med ; 10(9): e1001515, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24068896

RESUMO

BACKGROUND: Smoking is a well-established risk factor for atherosclerotic disease, but its role as an independent risk factor for venous thromboembolism (VTE) remains controversial. We conducted a meta-analysis to summarize all published prospective studies and case-control studies to update the risk for VTE in smokers and determine whether a dose-response relationship exists. METHODS AND FINDINGS: We performed a literature search using MEDLINE (source PubMed, January 1, 1966 to June 15, 2013) and EMBASE (January 1, 1980 to June 15, 2013) with no restrictions. Pooled effect estimates were obtained by using random-effects meta-analysis. Thirty-two observational studies involving 3,966,184 participants and 35,151 VTE events were identified. Compared with never smokers, the overall combined relative risks (RRs) for developing VTE were 1.17 (95% CI 1.09-1.25) for ever smokers, 1.23 (95% CI 1.14-1.33) for current smokers, and 1.10 (95% CI 1.03-1.17) for former smokers, respectively. The risk increased by 10.2% (95% CI 8.6%-11.8%) for every additional ten cigarettes per day smoked or by 6.1% (95% CI 3.8%-8.5%) for every additional ten pack-years. Analysis of 13 studies adjusted for body mass index (BMI) yielded a relatively higher RR (1.30; 95% CI 1.24-1.37) for current smokers. The population attributable fractions of VTE were 8.7% (95% CI 4.8%-12.3%) for ever smoking, 5.8% (95% CI 3.6%-8.2%) for current smoking, and 2.7% (95% CI 0.8%-4.5%) for former smoking. Smoking was associated with an absolute risk increase of 24.3 (95% CI 15.4-26.7) cases per 100,000 person-years. CONCLUSIONS: Cigarette smoking is associated with a slightly increased risk for VTE. BMI appears to be a confounding factor in the risk estimates. The relationship between VTE and smoking has clinical relevance with respect to individual screening, risk factor modification, and the primary and secondary prevention of VTE. Please see later in the article for the Editors' Summary.


Assuntos
Fumar/efeitos adversos , Tromboembolia Venosa/etiologia , Estudos de Casos e Controles , Estudos de Coortes , Heterogeneidade Genética , Humanos , Incidência , Fatores de Risco , Tromboembolia Venosa/epidemiologia
16.
Cardiovasc Ther ; 30(3): 152-61, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21167013

RESUMO

AIMS: We evaluated effects of the nonpeptide angiotensin (ANG)-(1-7) analog AVE 0991 (AVE) on cardiac function and remodeling as well as transforming growth factor-beta1 (TGF-ß1)/tumor necrosis factor-alpha (TNF-α) expression in myocardial infarction rat models. METHODS AND RESULTS: Sprague-Dawley rats underwent either sham surgery or coronary ligation. They were divided into four groups: sham, control, AVE, and AVE+A-779 [[D-Ala(7) ]-ANG-(1-7), a selective antagonist for the ANG-(1-7)] group. After 4 weeks of treatment, the AVE group displayed a significant elevation in left ventricular fractional shorting (LVFS) (25.5 ± 7.3% vs. 18.4 ± 3.3%, P < 0.05) and left ventricular ejection fraction (LVEF) (44.8 ± 7.6% vs. 32.7 ± 6.5%, P < 0.05) when compared to the control group, but no effects on the left ventricular end-diastolic and end-systolic diameters (LVDd and LVDs, respectively) were observed. In addition, we found that the myocyte diameter (18 ± 2 µm vs. 22 ± 4 µm, P < 0.05), infarct size (42.6 ± 3.6% vs. 50.9 ± 4.4%, P < 0.001) and collagen volume fraction (CVF) (16.4 ± 2.2% vs. 25.3 ± 3.2%, P < 0.001) were significantly reduced in the AVE group when compared to the control group. There were no differences in LVFS, LVEF, myocyte diameter, and infarct size between the control and AVE+A-779 groups. AVE also markedly attenuated the increased mRNA expression of collagen I (P < 0.001) and collagen III (P < 0.001) and inhibited the overexpression of TGF-ß1 (P < 0.05) and TNF-α (P < 0.05) compared to the control group. CONCLUSION: AVE could improve cardiac function and attenuate ventricular remodeling in MI rat models. It may involve the inhibition of inflammatory factors TGF-ß1/TNF-α overexpression and the action on the specific receptor Mas of ANG-(1-7).


Assuntos
Cardiotônicos/farmacologia , Imidazóis/farmacologia , Infarto do Miocárdio/tratamento farmacológico , Miocárdio/patologia , Função Ventricular Esquerda/efeitos dos fármacos , Remodelação Ventricular/efeitos dos fármacos , Angiotensina II/análogos & derivados , Angiotensina II/farmacologia , Animais , Cardiomegalia/patologia , Cardiomegalia/fisiopatologia , Cardiomegalia/prevenção & controle , Colágeno/genética , Colágeno/metabolismo , Modelos Animais de Doenças , Hemodinâmica/efeitos dos fármacos , Masculino , Contração Miocárdica/efeitos dos fármacos , Infarto do Miocárdio/genética , Infarto do Miocárdio/metabolismo , Infarto do Miocárdio/patologia , Infarto do Miocárdio/fisiopatologia , Miocárdio/metabolismo , Fragmentos de Peptídeos/farmacologia , Proteínas Proto-Oncogênicas/efeitos dos fármacos , Proteínas Proto-Oncogênicas/metabolismo , Ratos , Ratos Sprague-Dawley , Receptores Acoplados a Proteínas-G/efeitos dos fármacos , Receptores Acoplados a Proteínas-G/metabolismo , Transdução de Sinais/efeitos dos fármacos , Volume Sistólico/efeitos dos fármacos , Fator de Crescimento Transformador beta1/genética , Fator de Crescimento Transformador beta1/metabolismo , Fator de Necrose Tumoral alfa/genética , Fator de Necrose Tumoral alfa/metabolismo
17.
Zhonghua Xin Xue Guan Bing Za Zhi ; 38(6): 531-8, 2010 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-21033136

RESUMO

OBJECTIVE: To explore the effects of Angiotensin (ANG)-(1-7) on postangioplasty fibrotic remodeling and the involvement of TGF-beta/Smad signaling pathway in this process. METHODS: Thirty two healthy New Zealand white rabbits were randomly divided into 4 groups: sham group, control group, ANG-(1-7) group and ANG-(1-7) + A-779 group. Rabbits underwent angioplasty in the abdominal aorta or sham surgery. Subsequently, an osmotic minipump was implanted for saline, ANG-(1-7) (576 microg x kg(-1) x d(-1)) or ANG-(1-7) + A-779 (576 microg x kg(-1) x d(-1)) delivery. Before and after 4 weeks treatment, the levels of ANG II in plasma were measured by ELISA. At week 4, angiography and histomorphometric analysis were performed, mRNA levels of collagen I and III were assayed by RT-PCR and protein levels of TGF-beta1 and Smad2 in local vessel were assayed by Western blot. RESULTS: Following 4 weeks treatment, ANG-(1-7) and ANG-(1-7) + A-779 group displayed a significant elevation in lumen diameter [(4.11 +/- 0.10) mm and (3.34 +/- 0.11) mm vs. (2.88 +/- 0.08) mm, P < 0.05, respectively] and reduction in neointimal thickness [(208 +/- 17) microm and (407 +/- 25) microm vs. (448 +/- 15) microm, P < 0.05, respectively], neointimal area [(0.27 +/- 0.09) mm2 and (0.38 +/- 0.01) mm2 vs. (0.41 +/- 0.02) mm2, P < 0.05, respectively] and restenosis rate [(28.1 +/- 2.7)% and (36.8 +/- 2.2)% vs. (40.1 +/- 2.7)%, P < 0.05, respectively] compared with control group. Collagen I, III mRNA and TGF-beta1, Smad2 protein levels were significantly elevated in control group, ANG-(1-7) group and ANG-(1-7) +A-779 group compared to sham group (P < 0.01 or P < 0.05) and reduced in ANG-(1-7) group compared to control group (all P < 0.05). Co-treatment with A-779 reversed the inhibitory action of ANG-(1-7). Plasma levels of ANG II postangioplasty were similar in control and ANG-(1-7) group and both were significantly higher than preoperation levels. CONCLUSION: ANG-(1-7) attenuates postangioplasty collagen synthesis in rabbits possibly through down-regulating the expression of TGF-beta1 and inhibiting the activation of Smad2 pathway.


Assuntos
Angiotensina I/farmacologia , Aorta Abdominal/efeitos dos fármacos , Fibrose/metabolismo , Músculo Liso Vascular/metabolismo , Fragmentos de Peptídeos/farmacologia , Animais , Aorta Abdominal/metabolismo , Aorta Abdominal/patologia , Colágeno Tipo I/metabolismo , Colágeno Tipo III/metabolismo , Coelhos , Transdução de Sinais , Proteína Smad2/metabolismo , Fator de Crescimento Transformador beta1/metabolismo
18.
Br J Clin Pharmacol ; 70(2): 234-40, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20653676

RESUMO

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT * Genetic polymorphisms of VKORC1 and CYP2C9 are known to influence warfarin dosage. * Recent studies among Caucasians showed that polymorphisms of CYP4F2 also play a role in warfarin pharmacogenetics. * The contribution of CYP4F2 variants to the variability inwarfarin dose requirement in Chinese subjects remains to be investigated. WHAT THIS STUDY ADDS * This research was to study the effect of CYP4F2 variants on warfarin requirements in the Han Chinese population. * This study developed a multiple regression model including CYP2C9, VKORC1 3673G>A, CYP4F2 genotypes and age, weight, combination use of amiodarone which could explain 56.1% of the individual variability in warfarin dose CYP4F2 could explain 4% of the variance in warfarin dose. * We found that one novel genotypic polymorphism 5417G>T for Asp36Tyr, which was identified as an important marker of warfarin resistance, was absent in the Han Chinese population in our study. AIMS The objective of this study was to assess the effect of the CYP4F2 on the daily stable warfarin dose requirement in Han Chinese patients with mechanical heart valve replacement (MHVR). METHODS From March 2007 to November 2008, 222 Han Chinese MHVR patients were recruited in our study. VKORC1 3673G>A, 5417G>T, CYP2C9*3 and CYP4F2 rs2108622 were genotyped by using the polymerase chain reaction restriction fragment length polymorphism method (PCR-RFLP). Polymorphisms of VKORC1 9041G>A were detected by direct sequencing. Multiple linear regression analysis was used to investigate the contribution of CYP4F2. RESULTS The CYP4F2 rs2108622 CT/TT group took a significantly higher stable warfarin dose (3.2 mg day(-1)) than the CC group (2.9 mg day(-1), 95% CI 0.2, 1.0, P= 0.033). The multiple linear regression model included VKORC1 3673G>A, CYP2C9, CYP4F2 genotypes and clinical characteristics. The model could explain 56.1% of the variance in stable warfarin dose in Han Chinese patients with MHVR. CYP4F2 contributed about 4% to the variance in the warfarin dose. There was no variation in the SNPs of VKORC1 5417G>T. CONCLUSION CYP4F2 is a minor significant factor of individual variability in the stable warfarin dose in Han Chinese patients with MHVR. The effect of CYP2C9 and VKORC1 genotypes on variability in the stable warfarin dose had also been confirmed.


Assuntos
Anticoagulantes/administração & dosagem , Sistema Enzimático do Citocromo P-450/genética , Genótipo , Implante de Prótese de Valva Cardíaca , Varfarina/administração & dosagem , Adulto , Alelos , Hidrocarboneto de Aril Hidroxilases/genética , Grupo com Ancestrais do Continente Asiático/genética , China , Citocromo P-450 CYP2C9 , Família 4 do Citocromo P450 , Relação Dose-Resposta a Droga , Feminino , Frequência do Gene , Valvas Cardíacas/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Oxigenases de Função Mista/genética , Polimorfismo Genético , Polimorfismo de Fragmento de Restrição , Análise de Sequência de DNA , Vitamina K Epóxido Redutases
19.
Biochem Biophys Res Commun ; 389(1): 138-44, 2009 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-19715669

RESUMO

OBJECTIVE: Angiotensin-(1-7) [ANG-(1-7)] has been reported to attenuate neointimal formation after vascular injury and stent implantation in rats, but the mechanism remains mostly unresolved. Interestingly, the levels of circulating transforming growth factor-beta1 (TGF-beta1) after myocardial infarction were suppressed by ANG-(1-7), which suggests a possible downstream target for the anti-remodeling action of ANG-(1-7). Our study focused on the effects of ANG-(1-7) on vascular remodeling, including neointimal formation and collagen synthesis, and determining whether or not these effects were dependent upon the TGF-beta signaling pathway. METHODS: Thirty-two New Zealand white rabbits underwent sham surgery or angioplasty in abdominal aorta. The animals were divided into four groups, which were sham, control, ANG-(1-7), and ANG-(1-7)+A-779. Subsequently, an osmotic minipump was implanted to deliver saline, ANG-(1-7) (576 microg kg(-1)d(-1)) or ANG-(1-7)+A-779 (576 microg kg(-1)d(-1)) for 4 weeks. RESULTS: The ANG-(1-7) group displayed a significant reduction in neointimal thickness (207.51+/-16.70 microm vs. 448.08+/-15.30 microm, P<0.001), neointimal area (0.266+/-0.009 mm(2) vs. 0.408+/-0.002 mm(2), P<0.001), and restenosis rate (28.13+/-2.74% vs. 40.13+/-2.74%, P<0.001) when compared to the control group. ANG-(1-7) also inhibited collagen synthesis by significantly decreasing the mRNA expression of Collagen I and Collagen III (vs. CONTROL GROUP: 0.2190+/-0.0036 vs. 0.3852+/-0.0212, P<0.001 and 1.1328+/-0.0554 vs. 1.7378+/-0.1164, P<0.001, respectively). Furthermore, the expression of TGF-beta1 and phosphor-Smad2 (p-Smad2) were significantly suppressed by ANG-(1-7) (vs. CONTROL GROUP: 1.21+/-0.07 vs. 1.54+/-0.08, P<0.001 and 0.31+/-0.01 vs. 0.43+/-0.02, P<0.001, respectively), but no effect on p38 phosphorylation was observed. [d-Ala(7)]-ANG-(1-7) (A-779), showed a tendency to attenuate the anti-remodeling effects of ANG-(1-7). CONCLUSION: ANG-(1-7) decreases the amount of vascular remodeling, including a reduction in neointimal formation and collagen synthesis, after angioplasty in rabbits. The responsible mechanism may function through the possible down-regulation of TGF-beta1 levels and inhibition of the Smad2 pathway.


Assuntos
Aorta Abdominal/efeitos dos fármacos , Aorta Abdominal/cirurgia , Regeneração/efeitos dos fármacos , Proteína Smad2/metabolismo , Fator de Crescimento Transformador beta/metabolismo , Túnica Íntima/efeitos dos fármacos , Angioplastia , Animais , Aorta Abdominal/fisiologia , Pressão Sanguínea/efeitos dos fármacos , Colágeno Tipo I/biossíntese , Colágeno Tipo III/biossíntese , Frequência Cardíaca/efeitos dos fármacos , Coelhos , Ratos , Proteína Smad2/antagonistas & inibidores , Fator de Crescimento Transformador beta/antagonistas & inibidores , Túnica Íntima/fisiologia , Túnica Íntima/cirurgia
20.
Nanomedicine (Lond) ; 2(3): 333-44, 2007 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17716178

RESUMO

AIMS: Paclitaxel is one of the most effective antiproliferative agents and it has been applied in the development of drug-eluting stents. There are difficulties, however, in using paclitaxel in clinical applications owing to its poor solubility and side effects. We have synthesized nanoparticles of biodegradable polymers for the effective and sustainable delivery of paclitaxel and other antiproliferative agents for restenosis treatment. METHODS & RESULTS: Paclitaxel-loaded poly(lactic-co-glycolic acid) (PLGA) nanoparticles were prepared by a modified solvent extraction/evaporation method with D-alpha-tocopheryl polyethylene glycol 1000 succinate (TPGS) or polyvinyl alcohol (PVA) as an emulsifier. Drug-loaded nanoparticles were characterized for size and size distribution, surface morphology, surface charge, drug-encapsulation efficiency and in vitro drug-release kinetics. Cellular uptake of fluorescent nanoparticles was investigated in vitro in coronary artery smooth muscle cells and in vivo in the carotid arteries of rabbits. The antiproliferative effects of the nanoparticle formulations were assessed in vitro in close comparison with Taxol((R)). Both the PVA- and TPGS-emulsified nanoparticles have similar size and size distribution, surface morphology and dispersion stability and showed great advantages over paclitaxel in in vitro cellular uptake and cytotoxicity than Taxol. The TPGS-emulsified nanoparticle formulation has higher drug-encapsulation efficiency, cellular uptake and cytotoxicity than the PVA-emulsified nanoparticle formulation. IC(50) in 24-h culture with coronary artery smooth muscle cells is 748 ng/ml for paclitaxel, 708 ng/ml for PVA-emulsified nanoparticles and 474 ng/ml for TPGS-emulsified nanoparticles, respectively. CONCLUSION: TPGS-emulsified PLGA nanoparticles have great potential for the effective and sustainable delivery of antiproliferative agents and for the development of nanoparticle-coated stents, which may become the third generation of cardiovascular stents.


Assuntos
Preparações de Ação Retardada/administração & dosagem , Preparações de Ação Retardada/química , Oclusão de Enxerto Vascular/patologia , Oclusão de Enxerto Vascular/prevenção & controle , Ácido Láctico/química , Nanopartículas/uso terapêutico , Ácido Poliglicólico/química , Polímeros/química , Vitamina E/administração & dosagem , Animais , Portadores de Fármacos/química , Composição de Medicamentos/métodos , Emulsões/química , Nanomedicina/métodos , Nanopartículas/química , Nanopartículas/ultraestrutura , Tamanho da Partícula , Copolímero de Ácido Poliláctico e Ácido Poliglicólico , Coelhos , Resultado do Tratamento , Vitamina E/química
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