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Photodynamic therapy (PDT) is a rapidly growing discipline that is expected to become an encouraging noninvasive therapeutic strategy for cancer treatment. In the PDT process, an efficient intersystem crossing (ISC) process for photosensitizers from the singlet excited state (S1) to the triplet excited state (T1) is critical for the formation of cytotoxic reactive oxygen species and improvement of PDT performance. Thermally activated delayed fluorescence (TADF) molecules featuring an extremely small singlet-triplet energy gap and an efficient ISC process represent an enormous breakthrough for the PDT process. Consequently, the development of advanced TADF photosensitizers has become increasingly crucial and pressing. The most recent developments in TADF photosensitizers aimed at enhancing PDT efficiency for bio-applications are presented in this review. TADF photosensitizers with water dispersibility, targeting ability, activatable ability, and two-photon excitation properties are highlighted. Furthermore, the future challenges and perspectives of TADF photosensitizers in PDT are proposed.
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Neoplasias , Fotoquimioterapia , Fármacos Fotossensibilizantes , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/química , Fármacos Fotossensibilizantes/uso terapêutico , Fármacos Fotossensibilizantes/farmacologia , Humanos , Neoplasias/tratamento farmacológico , Espécies Reativas de Oxigênio/metabolismo , Fluorescência , Corantes Fluorescentes/químicaRESUMO
BACKGROUND: Posteroseptal accessory pathways (APs) associated with coronary sinus (CS) diverticulum present a rare and challenge for ablation. This study aimed to compare the safety and efficacy of conventional approach and three-dimensional (3D) mapping system in the catheter ablation. METHODS AND RESULTS: This was a retrospective study of all patients (from January 2013 to July 2022) who underwent catheter ablation of posteroseptal AP associated with CS diverticula in our center. Patients who underwent catheter ablation using the traditional fluoroscopy method were included in the conventional method group (n = 13). Patients who underwent catheter ablation using the 3D mapping method were included in the 3D mapping group (n = 11). Clinical characteristics, ablation procedure, and outcomes were recorded and analyzed between the two groups. Out of 669 patients with posteroseptal APs, 24 of them (3.6%) were associated with CS diverticula. All patients in both groups successfully completed the electrophysiological study. In the conventional method group, two patients experienced complications (one patient with pericardial effusion and the other patient with femoral arterial hematoma), and two patients had recurrence. However, no patients suffered from complications or recurrence during follow-up. The procedure time and fluoroscopy time in the conventional method group were significantly longer than those in the 3D mapping method group. CONCLUSIONS: The utilization of 3D mapping led to reduced fluoroscopy time, shorter procedure duration, enhanced acute success rates, and decreased incidence of complications.
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Feixe Acessório Atrioventricular , Ablação por Cateter , Seio Coronário , Divertículo , Cardiopatias Congênitas , Humanos , Seio Coronário/diagnóstico por imagem , Seio Coronário/cirurgia , Estudos Retrospectivos , Eletrocardiografia/métodos , Feixe Acessório Atrioventricular/diagnóstico por imagem , Feixe Acessório Atrioventricular/cirurgia , Cardiopatias Congênitas/cirurgia , Ablação por Cateter/métodos , Divertículo/complicações , Divertículo/diagnóstico por imagem , Divertículo/cirurgiaRESUMO
BACKGROUND: The temporary pacing lead routinely is placed into right ventricular (RV), which pose a risk of dislocation and cardiac perforation. OBJECTIVE: We aim to evaluate the effectiveness and safety of temporary transvenous cardiac pacing (TTCP) leads placement into the coronary sinus vein (CSV) in patients with sick sinus syndrome (SSS). METHODS: We investigated patients with SSS who underwent TTCP lead placement into the CSV under the guidance of X-ray between January 2013 and May 2023. Patients were randomly divided into two groups: RV group (n = 33) and CSV group (n = 22). The ordinary passive bipolar electrodes were applied in both groups. In RV groups, electrodes were placed into RV. In CSV group, electrodes were placed into CSV. We evaluated the operation duration, fluoroscopic exposure, first-attempt success rate of leads placement, pacing threshold, success rate of leads placement, rate of leads displacement, and complications. RESULTS: Compared with that in RV group, the procedure time, fluoroscopic exposure was significantly prolonged, while the first-attempt success rate of lead placement was obviously increased in CSV group (both p < .05). Compared with that in RV group, the rate of leads displacement is lower in CSV group (both p < .05). There were three patients occurred cardiac perforation in RV group, but no cardiac perforation was reported in CSV group (p > .05). CONCLUSION: TTCP leads placement into the CSV is an effective and safe strategy in patients with SSS. It indicates a high rate of pacing effectiveness with low device replacement and complication rates.
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Seio Coronário , Marca-Passo Artificial , Humanos , Seio Coronário/diagnóstico por imagem , Estimulação Cardíaca Artificial/efeitos adversos , Estimulação Cardíaca Artificial/métodos , Síndrome do Nó Sinusal/terapia , EletrocardiografiaRESUMO
BACKGROUND: This study aimed to assess the public knowledge regarding Alzheimer's Disease (AD) in Zhuhai, China, focusing on identifying knowledge gaps and the influence of demographic and health factors. METHODS: A cross-sectional study was conducted in Zhuhai, China, from October to November 2022. A total of 1986 residents from 18 communities were selected employing stratified multi-stage equi-proportional sampling. Questionnaires covering general information and the Alzheimer's Disease Knowledge Scale (ADKS) were investigated face-to-face. Ordinal multiclass logistic regression was applied to assess the relationship between AD awareness and demographic and health characteristics. RESULTS: The average ADKS score was 18.5 (SD = 3.36) in Zhuhai. The lowest awareness rates were observed in the "Symptoms" and "Caregiving" subdomains of ADKS, with rates of 51.01% and 43.78%, respectively. The correct rates for the 30 ADKS questions ranged from 16.62 to 92.6%, showing a bimodal pattern with clusters around 80% and 20%. Women (OR = 1.203, 95% CI: 1.009-1.435), individuals aged 60 years or older (OR = 2.073, 95% CI: 1.467-2.932), those living in urban areas (OR = 1.361, 95% CI: 1.117-1.662), higher average monthly household income per capita (OR = 1.641, 95% CI: 1.297-2.082), and without any neurological or mental disorders (OR = 1.810, 95% CI: 1.323-2.478) were more likely to have higher levels of awareness about Alzheimer's disease. CONCLUSIONS: Adults in Zhuhai show a limited knowledge of AD, particularly in the 'Symptoms' and 'Caregiving' subdomains. Upcoming health campaigns must focus on bridging the knowledge gaps in different subdomains of AD, especially among subgroups with lower awareness, as identified in our study.
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Doença de Alzheimer , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Estudos Transversais , China/epidemiologia , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Adulto , Inquéritos e Questionários , Adulto JovemRESUMO
BACKGROUND: To discuss the current status of reproductive concerns and its correlation with fear of recurrence and level of family support in patients of childbearing age with gynecologic malignancies. METHODS: A convenient sampling method was used to enroll 188 patients with gynecologic malignancies in Nanjing Maternity and Child Health Care Hospital, Nanjing Drum Tower Hospital, General Hospital of Ningxia Medical University, and Haian Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine from September 2022 to April 2023. Patients were assessed using general information questionnaire, Reproductive Concerns After Cancer Scale (RCAC), Fear of Cancer Recurrence Inventory (FCRI) questionnaire, and Perceived Social Support-Family (PSS-FA) Scale. RESULTS: Among patients of childbearing age with gynecologic malignancies, the total RCAC score was (54.35 ± 7.52), indicating a moderate level of reproductive concerns. Patients scored (20.98 ± 4.51) on FCRI, implying a moderate level of fear of recurrence. The PSS-FA score was (9.57 ± 2.76), denoting a moderate level of family support. The total score and each dimensional score of RCAC were positively correlated with FCRI total score (P < 0.05), and negatively correlated with PSS-FA total score (P < 0.05). Fear of recurrence, family support level, number of children, educational background, treatment modality, and fertility intention were influencing factors for reproductive concerns in patients of childbearing age with gynecologic malignancies (all P < 0.05). CONCLUSION: The reproductive concerns, fear of recurrence and family support are all at moderate levels in patients of childbearing age with gynecologic malignancies, and reproductive concerns are positively correlated with fear of recurrence and negatively correlated with family support.
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Apoio Familiar , Medo , Neoplasias dos Genitais Femininos , Recidiva Local de Neoplasia , Adolescente , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Adulto Jovem , China/epidemiologia , Medo/psicologia , Neoplasias dos Genitais Femininos/psicologia , Recidiva Local de Neoplasia/psicologia , Inquéritos e QuestionáriosRESUMO
Hypertrophic obstructive cardiomyopathy (HOCM) is a hereditary cardiac disorder characterized primarily by septal hypertrophy and left ventricular outflow tract obstruction. Traditional therapeutic modalities, such as medications and surgeries, do not yield satisfactory outcomes in a subset of patients. The advancements have been made in novel treatments, including new drugs and percutaneous intramyocardial septal radiofrequency ablation (PIMSRA), still need further observation to obtain long-term efficacy and safety. In recent years, stereotactic body radiation therapy (SBRT) has emerged as an innovative non-invasive approach for treating HOCM. Studies indicate that SBRT allows for precise targeting of the hypertrophied septal region, causing both direct and indirect damage to targeted myocardial cells. This can alleviate left ventricular outflow tract obstruction and myocardial ischemia, fulfilling the therapeutic objective. For those with HOCM who neither respond well to medications nor are surgical candidates, SBRT offers a potential new therapeutic alternative. However, the latent risks of radiation therapy persist, such as the onset of radiation-induced heart disease (RIHD). The preliminary investigations guarantee the safety and feasibility of SBRT in HOCM management, an increased volume of clinical studies and prolonged follow-up data are essential to evaluate its real efficacy and potential hazards. In addition, research regarding the therapeutic mechanisms of SBRT for HOCM, optimal dosages and treatment durations, indications and contraindications, prevention of complications, and enhancing the precision of radiation therapy, still needs to be further exploration, to determine the best therapeutic strategies.
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Cardiomiopatia Hipertrófica , Cardiopatias , Radiocirurgia , Obstrução da Via de Saída Ventricular Esquerda , Humanos , Cardiomiopatia Hipertrófica/radioterapia , Miócitos CardíacosRESUMO
It is challenging to achieve stable and efficient radical emissions under ambient conditions. Herein, we present a rational design strategy to protect photoinduced carbonyl free radical emission through electrostatic interaction and spin delocalization effects. The host-guest system is constructed from tricarbonyl-substituted benzene molecules and a series of imidazolium ionic liquids as the guest and host, respectively, whereby the carbonyl anion radical emission can be in situ generated under the light irradiation and further stabilized by electrostatic interaction. More importantly, the anion species and the alkyl chain length of imidazolium ionic liquids show a noticeable effect on luminescence efficiency, with the highest radical emission efficiency is as high as 53.3 % after optimizing the imidazole ionic liquid's structure, which is about four times higher than the polymer-protected radical system. Theoretical calculations confirm the synergistic effect of strong electrostatic interactions and that the spin delocalization effect significantly stabilizes the radical emission. Moreover, such a radical emission system also could be integrated with a fluorescent dye to induce multi-color or even white light emission with reversible temperature-responsive characteristics. The radical emission system can also be used to detect different amine compounds on the basis of the emission changes and photoactivation time.
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The development of efficient sensors for detecting water content in organic solvents is highly desirable for various cases in the chemical industry. Relevant sensors based on luminescent materials are promising due to their superior sensitivity and visualization. However, reported luminescent probes are either aggregation-caused quenching-type molecules, which present an emission quenching effect in high water content, or aggregation induced emission-type luminogens, which exhibit weak emission in organic solvents. This factor narrows the targeted water-content sensing range. Herein, we developed a series of indoline-based donor-acceptor-donor luminogens involving twist intramolecular charge transfer and an aggregation-induced emission effect, which exhibited a unique "on-off-on" emission behavior in tetrahydrofuran with the continuous increase of water content from 0% to 99%. Simultaneously, the emission wavelength underwent a process of first red-shift and then blue-shift. Three-dimensional working curves based upon the log value of wavelength and emission intensity ratio versus water content in tetrahydrofuran were established with two-stage characteristics, aiming to visually detect a wide range of water content in organic solvents. Such a sensing method offers extra sensitivity, convenience, and accuracy.
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Corantes Fluorescentes , Água , Corantes Fluorescentes/química , Furanos , Solventes/química , Espectrometria de Fluorescência , Água/químicaRESUMO
BACKGROUND: Exposure to tobacco imagery in films can result in tobacco use among adolescents and young adults. Efforts have been made to limit tobacco imagery in films in China. Our study investigates the level and trend of tobacco imagery in popular films in China from 2001 to 2020. METHODS: The running time of the 20 top-grossing films in China annually from 2001 to 2020 was divided into 5 min intervals, and those containing tobacco imagery were coded for the following aspects: country of origin, presence of warning, presence of minors and the presence of tobacco brands. RESULTS: We coded 9423 five-minute intervals across 400 films. Tobacco imagery occurred in 1344 intervals across 239 films. There was a declining trend in the proportion of films (r=-0.515, p=0.022) and the proportion of intervals (r=-0.004, p<0.001) with tobacco imagery over time. None of the films with tobacco imagery contained a warning for their audience against smoking. Chinese films contained more tobacco imagery than international films, and tobacco imagery related to minors and tobacco brands were present despite regulations. CONCLUSION: Tobacco imagery remains in films in China. The relevant authorities and film producers should ban films with tobacco imagery in China; for example, they should ban films with tobacco imagery from participating in awards, add warnings to films with tobacco imagery and give films containing tobacco imagery a default 'R' classification.
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A 37-year-old man was admitted to our hospital with paroxysmal palpitation for half year. A previous electrogram showed a narrow complex tachycardia. Electrophysiologic study (EPS) found a concealed left-sided free wall pathway accessory. In addition, a transseptal approach was used for radiofrequency ablation. After successful ablation, EPS induced a wide complex tachycardia and a narrow complex tachycardia. The wide complex tachycardia was diagnosed as a right-sided Mahaim fiber atriofascicular accessory pathway, and the narrow complex tachycardia was diagnosed as atypical atrioventricular nodal reentrant tachycardia (AVNRT). Then, the right-sided Mahaim fiber atriofascicular accessory pathway and atypical AVNRT were successfully ablated. Herein, we report a rare case of a concealed left-sided accessory pathway combined with a right atriofascicular Mahaim fiber and atypical AVNRT.
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Feixe Acessório Atrioventricular , Ablação por Cateter , Taquicardia por Reentrada no Nó Atrioventricular , Masculino , Humanos , Adulto , Taquicardia por Reentrada no Nó Atrioventricular/complicações , Taquicardia por Reentrada no Nó Atrioventricular/diagnóstico , Taquicardia por Reentrada no Nó Atrioventricular/cirurgia , Feixe Acessório Atrioventricular/complicações , Feixe Acessório Atrioventricular/cirurgia , Eletrocardiografia , Fascículo Atrioventricular , Taquicardia/cirurgiaRESUMO
A 54-year-old man had a dual-chamber pacemaker implantation 9 years ago because of sick sinus syndrome at a different facility. The patient did not undergo any evaluation of his pacemaker for a long time with cardiologist. The patient was admitted to another hospital manifesting dyspnea and palpitation with atrial fibrillation for 1 month, and he was diagnosed with ventricular lead perforation. For further treatment, he was referred to our hospital, and an elective replacement indicator (ERI) of the battery state and a malpositioned ventricular lead into the middle cardiac vein were found. Finally, the pacing lead was left in the primary place and the pacemaker was replaced.
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Fibrilação Atrial , Seio Coronário , Marca-Passo Artificial , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/etiologia , Estimulação Cardíaca Artificial , Seio Coronário/diagnóstico por imagem , Erros de Diagnóstico , Eletrocardiografia/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Marca-Passo Artificial/efeitos adversosRESUMO
BACKGROUND: It is difficult to insert cardiac pacing leads in patient with tricuspid valve surgery (TVS). The aim of this study was to evaluate safety and effectiveness of a novel technique applied for bedside temporary pacemaker placement (TPP) in patients with TVS. METHODS: We investigated patients with TVS who required bedside TPP without X-ray guidance in cardiac intensive care unit between January 2019 and March 2022. They were divided into Novel pre-shaped group (N = 21) and Control group (routine pre-shaped group, N = 26). The ordinary bipolar electrodes were applied in both groups. In Novel pre-shaped group, electrodes were reshaped by a novel technique with three-curve with anterior tip method, while electrodes were shaped by traditional strategy in Control group. We evaluated the operation duration, first-attempt success rate of the lead placement, pacing threshold, success rate of lead placement, the rate of leads displacement, and complications. RESULTS: Compared with that in Control group, the procedure time was significantly shortened and the first-attempt success rate of lead placement was obviously increased in Novel pre-shaped group (both p < 0.05). Although there was a slight reduction in complications in Novel pre-shaped group when compared with that in Control group. However, there were no statistical significance in pacing threshold, the success rate of lead placement, the rate of leads displacement, and complications when compared between two groups. CONCLUSIONS: We propose a novel technique, three-curve with anterior tip method, is a feasible and effective bedside method to insert emergency temporary pacing leads in patients with TVS.
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Estimulação Cardíaca Artificial , Marca-Passo Artificial , Humanos , Estimulação Cardíaca Artificial/métodos , Valva Tricúspide/diagnóstico por imagem , Valva Tricúspide/cirurgia , Raios X , EletrocardiografiaRESUMO
Endothelium-dependent relaxation (EDR) is an initial key step leading to various vascular complications in patients with diabetes. However, the underlying mechanism of EDR impairment in diabetes is not fully understood. Present study defined the role of high-mobility group protein (HMGB1) in EDR related to diabetes. Serum level of HMGB1 was increased in diabetic patients and in db/db mice. Serum HMGB1 level was also positively correlated with HbA1c and negatively correlated with nitric oxide (NO) in diabetic patients. Results from wire myograph showed that recombinant HMGB1 (rHMGB1) was capable of impairing EDR of aortas from wild-type (WT) mice by an eNOS-dependent mechanism. Consistently, HMGB1 inhibitor glycyrrhizin acid (GA) decreased the serum level of HMGB1 and rescued EDR impairment partly in db/db mice. Furthermore, rHMGB1 mediated EDR impairment was abolished in aortas of TLR4-/- mice. In addition, high-glucose-induced HMGB1 upregulation and secretion in endothelial cells. In conclusion, HMGB1 contributes to the EDR impairment through TLR4/eNOS pathway in the setting of diabetes. GA as the HMGB1 inhibitor could attenuate EDR impairment in an animal model of diabetes.
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Diabetes Mellitus/metabolismo , Células Endoteliais/metabolismo , Endotélio Vascular/metabolismo , Proteína HMGB1/metabolismo , Óxido Nítrico Sintase Tipo III/metabolismo , Transdução de Sinais/fisiologia , Receptor 4 Toll-Like/metabolismo , Animais , Aorta/metabolismo , Diabetes Mellitus Experimental/metabolismo , Modelos Animais de Doenças , Feminino , Humanos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Óxido Nítrico/metabolismo , Regulação para Cima/fisiologiaRESUMO
OBJECTIVE: Abnormal proliferation and migration of vascular smooth muscle cells (VSMCs) are related to in-stent-restenosis (ISR) following percutaneous coronary intervention (PCI). Osteoprotegerin (OPG) has been implicated in various vascular diseases. However, the effects of OPG on ISR and the underlying mechanism remained elusive. We here investigated the association between OPG and ISR, and to demonstrate the role and potential mechanisms of OPG in neointimal hyperplasia. APPROACH AND RESULTS: From 2962 patients who received coronary angiography and follow-up coronary angiography at approximately one year, 291 patients were diagnosed with ISR, and another 291 gender- and age- matched patients without ISR were selected as controls. Serum OPG levels were significantly increased in patients with ISR. Multivariable logistic regression analysis indicated that OPG level was independently associated with the increased risk of ISR. In a mouse femoral artery wire injury model, upregulated OPG was evidenced in vascular tissue after injury. OPG deletion attenuated the vascular injury-induced neointimal hyperplasia and related gene expression in mice. OPG promoted neointimal hyperplasia and human aortic smooth muscle cell (hASMC) proliferation and migration through activation of yes-associated protein (YAP), a major downstream effector of the Hippo signaling pathway, whereas knockdown or inhibition of YAP in hASMCs blunted OPG-induced above effects. Moreover, we found that OPG, as a ligand for integrin αVß3, mediated phosphorylation of focal adhesion kinase (FAK) and actin cytoskeleton reorganization, resulting in YAP dephosphorylation in hASMCs. OPG-dependent YAP and VSMC activation was prevented by treatment with αVß3-blocking antibodies and inhibitors of FAK and actin stress fibers. CONCLUSIONS: Increased serum OPG levels are associated with increased risk of ISR following PCI and OPG could promote neointimal hyperplasia in response to injury through integrin αVß3 mediated FAK and YAP activation, indicating OPG/YAP inhibition might serve as an attractive novel target for the prevention of ISR after PCI.
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Reestenose Coronária/complicações , Proteína-Tirosina Quinases de Adesão Focal/metabolismo , Integrina alfaVbeta3/metabolismo , Neointima/complicações , Neointima/patologia , Osteoprotegerina/metabolismo , Transdução de Sinais , Stents/efeitos adversos , Citoesqueleto de Actina/efeitos dos fármacos , Citoesqueleto de Actina/metabolismo , Idoso , Animais , Movimento Celular , Proliferação de Células , Reestenose Coronária/sangue , Progressão da Doença , Feminino , Artéria Femoral/metabolismo , Artéria Femoral/patologia , Humanos , Hiperplasia , Incidência , Modelos Logísticos , Masculino , Camundongos Endogâmicos C57BL , Análise Multivariada , Músculo Liso Vascular/patologia , Miócitos de Músculo Liso/patologia , Neointima/sangue , Osteoprotegerina/sangue , Osteoprotegerina/deficiência , Fosforilação/efeitos dos fármacos , Índice de Gravidade de Doença , Regulação para Cima , Verteporfina/farmacologiaRESUMO
Organic luminogens constitute promising prototypes for various optoelectronic applications. Since gaining distinct color emissions normally requires the alternation of the conjugated backbone, big issues remain in material synthetic cost and skeleton compatibility while pursuing full-color luminescence. Upon a facile one-step coupling, three simple but smart perchalcogenated (O, S, and Se) arenes are synthesized. They exhibit strong luminescent tricolor primaries (i.e., blue, green, and red, respectively) in the solid state with a superior quantum yield up to >40% (5-10 times higher than that in corresponding solutions). The properties originate from a fluorescence-phosphorescence-phosphorescence triple-channel emission effect, which is regulated by S and Se heavy atoms-dependent intersystem crossing upon molecular packing, as well as Se-Se atom interaction-caused energy splittings. Consequently, full-color luminescence, including a typical white-light luminescence with a Commission Internationale de I'Eclairage coordinate of (0.30, 0.35), is realized by complementarily incorporating these tricolor luminescent materials in the film. Moreover, mechanochromic luminescent color conversions are also observed to achieve the fine-tuning of the luminescent tints. This strategy can be smart to address full-color luminescence on the same molecular skeleton, showing better material compatibility as an alternative to the traditional multiple-luminophore engineering.
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PURPOSE: The association between occupational radiation exposure and endothelium-dependent vasodilation (EDV) remains unclear. This study evaluated the association between radiation exposure and EDV among fluoroscopy-guided interventional procedure specialists and explored the possible mechanisms. MATERIALS AND METHODS: Brachial flow-mediated dilation was compared in 21 interventional cardiologists (the radiation group) and 15 noninterventional cardiologists (the nonradiation group). Animal radiation experiments were also performed to observe the impact of radiation on EDV. RESULTS: Flow-mediated dilation in both the left (radiation group, 3.63% vs. nonradiation group, 6.77%; P < .001) and right brachial arteries (5.36% vs. 7.33%, respectively; P = .04) and serum nitric oxide (NO) level (343.69 vs. 427.09 µmol/L, respectively; P = .02) were significantly reduced in the radiation group compared to those in the nonradiation group. EDV was significantly impaired in acetylcholine concentrations of 3 × 10-6 mol/L and 10-5 mol/L (60.09% vs.74.79%, respectively; P = .03; and 62.73% vs. 80.56%, respectively; P = .002), and reactive oxygen species levels in the aorta intima and media layers were significantly increased in mice after a single x-ray exposure, which could be partly rescued by pretreatment with folic acid (P < .05). CONCLUSIONS: Radiation exposure can lead to impairment of flow-mediated vasodilation in human or EDV in mice. In mice acutely exposed to radiation, folic acid alleviated radiation-induced EDV impairment by possible reduction of reactive oxidative species.
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Aorta/efeitos da radiação , Artéria Braquial/efeitos da radiação , Exposição Ocupacional/efeitos adversos , Saúde Ocupacional , Doses de Radiação , Exposição à Radiação/efeitos adversos , Radiografia Intervencionista/efeitos adversos , Radiologistas , Vasodilatação/efeitos da radiação , Adulto , Animais , Antioxidantes/farmacologia , Aorta/efeitos dos fármacos , Aorta/metabolismo , Aorta/fisiopatologia , Artéria Braquial/metabolismo , Artéria Braquial/fisiopatologia , Estudos de Casos e Controles , Feminino , Ácido Fólico/farmacologia , Humanos , Masculino , Camundongos , Pessoa de Meia-Idade , Óxido Nítrico/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Espécies Reativas de Oxigênio/metabolismoRESUMO
BACKGROUND: Hypothyroidism is known to be associated with adverse clinical outcomes in heart failure. The association between hypothyroidism and cardiac resynchronization therapy outcomes in patients with severe heart failure is not clear. METHODS: The study included 1316 patients who received cardiac resynchronization therapy between 2002 and 2015. Baseline demographics and cardiac resynchronization therapy outcomes, including left ventricular ejection fraction, New York Heart Association class, appropriate implantable cardioverter-defibrillator therapy, and all-cause mortality, were collected from the electronic health record. RESULTS: Of the study cohort, 350 patients (26.6%) were classified as the hypothyroidism group. The median duration of follow-up was 3.6 years (interquartile range, 1.7-6.2 years). Hypothyroidism was not associated with a higher risk of all-cause mortality in patients receiving CRT for heart failure. The risk of appropriate implantable cardioverter-defibrillator therapy significantly increased in association with increased baseline thyroid-stimulating hormone level in the entire cohort (hazard ratio, 1.23 per 5mIU/L increase; 95% CI, 1.01-1.5; P = 0.04) as well as in the hypothyroid group (hazard ratio, 1.44 per 5mIU/L increase; 95% CI, 1.13-1.84; P = 0.004). CONCLUSIONS: CRT improves cardiac function in hypothyroid patients. The ventricular arrhythmic events requiring ICD therapies are associated with baseline TSH level, which might be considered as an important biomarker to stratify the risk of sudden death for patients with heart failure and hypothyroidism.
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Terapia de Ressincronização Cardíaca , Cardioversão Elétrica , Insuficiência Cardíaca/terapia , Hipotireoidismo/complicações , Idoso , Idoso de 80 Anos ou mais , Terapia de Ressincronização Cardíaca/efeitos adversos , Terapia de Ressincronização Cardíaca/mortalidade , Dispositivos de Terapia de Ressincronização Cardíaca , Desfibriladores Implantáveis , Cardioversão Elétrica/efeitos adversos , Cardioversão Elétrica/instrumentação , Cardioversão Elétrica/mortalidade , Feminino , Insuficiência Cardíaca/complicações , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/mortalidade , Humanos , Hipotireoidismo/diagnóstico , Hipotireoidismo/mortalidade , Masculino , Pessoa de Meia-Idade , Recuperação de Função Fisiológica , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do TratamentoRESUMO
The performance of the second-generation cryoballoon has been greatly improved compared to the first-generation.But it has not reduced the incidence of phrenic nerve injury, and even increased the incidence of this complication during ablation of the right inferior pulmonary vein. Two cases of phrenic nerve injury occurred when right inferior pulmonary vein was ablated with the second-generation cryoballoon in Department of Cardiovascular Medicine, Second Xiangya Hospital, Central South University. Based on literature review, the possible causes for phrenic nerve injury in our report were summarized to provide helpful information for operators aiming to reduce the occurrence of this complication related to the second-generation cryoballoon.
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Fibrilação Atrial , Ablação por Cateter , Veias Pulmonares , Criocirurgia , Humanos , Nervo Frênico , Resultado do TratamentoRESUMO
OBJECTIVES: To analyze the risk factors for recurrence of paroxysmal atrial fibrillation (PAF) after the second-generation of cryoballoon ablation (CBA). METHODS: A total of 67 patients with PAF, who underwent CBA treatment from March 2017 to June 2018, were selected from the Department of Cardiology, Second Xiangya Hospital of Central South University. The incidence rate of early recurrence (within 3 months) and late recurrence (after 3 months) in patients with PAF were analyzed retrospectively and the risk factors for recurrence were discussed. RESULTS: Among the 67 patients, 40 were males (59.7%). The patients were at 34-84 (58.91±10.49) years old and followed up for 4-15 (9.04±4.66) months. Fifteen (22.4%) patients suffered early recurrence, and 16 (23.9%) patients suffered late recurrence. Among the 16 patients with late recurrence, 12 suffered early recurrence. The results of univariate analysis showed that there were significant differences between the early recurrence group and the non-early recurrence group in the freezing temperature of right inferior pulmonary vein at 30 s and right superior pulmonary vein at 60 s, the nadir freezing temperature of right inferior pulmonary vein and the width of left inferior pulmonary vein (all P<0.05); there were significant differences between the late recurrence group and the non-late recurrence group in the left atrial diameter, early recurrence and the nadir temperature of left superior pulmonary vein (all P<0.05). Multivariate analysis found that the freezing temperature of right superior pulmonary vein at 60 s was an independent risk factor for early recurrence (OR=1.108, 95% CI 1.002 to 1.225, P=0.046); and early recurrence was an independent risk factor for late recurrence (OR=24.94, 95% CI 7.85 to 41.91, P=0.020). CONCLUSIONS: Freezing temperature of right superior pulmonary vein at 60 s is an independent risk factor of early recurrence, and early recurrence is an independent risk factor of late recurrence after the second-generation cryoballon ablation for PAF.
Assuntos
Fibrilação Atrial , Ablação por Cateter , Adulto , Idoso , Idoso de 80 Anos ou mais , Criocirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Veias Pulmonares , Recidiva , Estudos Retrospectivos , Fatores de Risco , Resultado do TratamentoRESUMO
The fact that the lifetime of photoluminescence is often difficult to access because of the weakness of the emission signals, seriously limits the possibility to gain local bioimaging information in time-resolved luminescence probing. We aim to provide a solution to this problem by creating a general photophysical strategy based on the use of molecular probes designed for single-luminophore dual thermally activated delayed fluorescence (TADF). The structural and conformational design makes the dual TADF strong in both diluted solution and in an aggregated state, thereby reducing sensitivity to oxygen quenching and enabling a unique dual-channel time-resolved imaging capability. As the two TADF signals show mutual complementarity during probing, a dual-channel means that lifetime mapping is established to reduce the time-resolved imaging distortion by 30-40 %. Consequently, the leading intracellular local imaging information is serialized and integrated, which allows comparison to any single time-resolved signal, and leads to a significant improvement of the probing capacity.