Risk Prediction for Arrhythmias by Heart Rate Deceleration Runs in Patients with Chronic Obstructive Pulmonary Disease.

Purpose: Chronic obstructive pulmonary disease (COPD) is associated with increased incidence of arrhythmias, which has been attributed to autonomic dysregulation. Detection of autonomic function may facilitate stratification of COPD patients with respect to their risk of development of arrhythmias. Patients and Methods: A total of 151 COPD patients and 45 non-COPD patients were included in this study. Heart rate deceleration runs (DRs) were detected by dynamic electrocardiogram (ECG); DRs successively occurring in 2, 4, or 8 cardiac cycles were denoted as DR2, DR4, and DR8, respectively. Indicators of arrhythmias including isolated premature atrial contractions (PAC), supraventricular tachycardia (SVT), isolated premature ventricular contractions (PVC), and ventricular tachycardia (VT) were recorded. Occurrence of SVT or PAC ≥70/day was considered positive for supraventricular arrhythmias, while positive ventricular arrhythmias category (PVAC) was defined as occurrence of VT or PVC ≥10/hour. Results: Compared with non-COPD individuals, COPD patients were associated with increased number of PAC, PVC, higher incidence of PAC >70/d, SVT, PVAC, and decreased DRs (DR2, DR4, DR8) (P<0.05). In COPD patients, DRs showed a negative correlation with the incidence of PAC, PVC, SVT, and PVAC (P<0.05). In receiver operating characteristic curve analysis, all the DRs were found to be significant predictors of PAC >70/d, SVT, and PVAC. The predictive power of DRs was significantly different from one another with the order ranged as DR4>DR8>DR2 for PAC >70/d, DR8>DR4>DR2 for SVT, and DR8>DR4>DR2 for PVAC. Conclusion: Our study provides evidence of significant autonomic dysregulation in COPD patients. DRs may serve as a marker of the risk of arrhythmias in COPD patients.

Serum iron and A(2)DS(2) score in stroke-associated pneumonia.

To evaluate the efficacy of serum biomarkers such as iron, procalcitonin (PCT), C-reactive protein (CRP) and A(2)DS(2) scores at hospital admission to predict the onset and severity of stroke-associated pneumonia (SAP), 101 patients with acute stroke were selected and divided into the control and SAP group. Compared with control group, no significant differences were discovered in age, sex, vascular risk factors including hypertension, diabetes and hyperlipidemia, chronic lung disease of SAP group, while a significantly higher level was found in incidence of dysphagia, NIHSS score, A(2)DS(2) score, CURB-65 score, serum iron, serum ferritin, PCT and CRP (P < 0.01). The receiver operating characteristic curve showed that serum iron, serum ferritin, PCT, CRP, A(2)DS(2) score and CURB-65 score had relatively high values in the SAP prediction (all P < 0.01, all AUC > 0.5). When combined ferritin, PCT, and A(2)DS(2) scores and other indicators with CRP for SAP prediction, the model had a larger area under the curve (AUC) and higher specificity than individual prediction models. Spearman regression analysis presented that serum iron, serum ferritin and A(2)DS(2) score were highly correlated with CURB-65 score (P < 0.01). It was suggested that Serum iron and A(2)DS(2) score measured at admission were effective indicators in SAP prediction which could be used for SAP screening and severity prediction. Besides, the specificity in SAP prediction could be improved when Serum iron and A(2)DS(2) score combined with CRP.

Aging reduces the expression of lung CINC and MCP-1 mRNA in a P. aeruginosa rat model of infection.

We investigated dynamic changes of inflammatory cell infiltration and expression of cytokine-induced neutrophil chemoattractant (CINC) and monocyte chemoattractant protein-1 (MCP-1) mRNA in aged rats with Pseudomonas aeruginosa pulmonary infection. Disease manifestation and lung tissue pathology (lesion dispersion, inflammatory reactions, tissue edema and bleeding) were more severe in aged rats than young rats. At various time points, lung tissue polymorphonuclear neutrophil and mononuclear macrophage numbers were lower in the aged group than the young group (P < 0.05), and at 24 h there was no difference in mononuclear macrophage numbers. After inoculation with P. aeruginosa, CINC and MCP-1 mRNA expression increased in both groups, but the peak lagged in old rats compared with young. Thus, aging can reduce the expression of CINC and MCP-1 mRNA in lung tissues, and reduce the infiltration of neutrophils and monocyte-macrophages induced by CINC and MCP-1. This might lead to increased risk of pneumonia in elderly patients.

Age-specific Mycoplasma pneumoniae pneumonia-associated myocardial damage in children.

OBJECTIVE: To measure Mycoplasma pneumoniae pneumonia (MPP)-associated myocardial damage in different age groups of children with pneumonia. METHODS: Children aged 0-14 years with pneumonia and myocardial damage (serum creatine kinase isoenzyme-MB [CK-MB] concentration >25 U/l) were enrolled in the study. The children were classified as Mycoplasma pneumoniae immunoglobulin M positive (M. pneumoniae IgM+) or negative (M. pneumoniae IgM-) based on a serological test. Children were stratified into four age groups in order to analyse age-specific MPP-associated myocardial damage. RESULTS: The incidence of fever was significantly higher in children who were M. pneumoniae IgM+ compared with M. pneumoniae IgM- children. The median serum CK-MB concentration was significantly higher in children who were M. pneumoniae IgM+ compared with those who were M. pneumoniae IgM-. Children who were M. pneumoniae IgM+ in the 13-36 months and 72 months-14 years age groups had significantly higher median serum CK-MB concentrations than those who were M. pneumoniae IgM- in the same age group. CONCLUSIONS: M. pneumoniae infection was associated with greater myocardial damage in children aged 13-36 months and 72 months-14 years. This suggests age-specific immune responses to M. pneumoniae.

Transplanted bone marrow stromal cells improve cognitive dysfunction due to aging hypoperfusion in rats.

BACKGROUND: Aging is an important risk factor for vascular dementia, and D-galactose (D-gal) injection can simulate the pathology of aging. Two-vessel occlusion of common carotid arteries (2VO) is the most popular model for vascular dementia. This study was aimed to investigate the possibility of D-gal injection plus 2VO simulating cognitive impairment of aging vascular dementia; and whether transplanted bone marrow stromal cells (BMSCs) can improve the cognitive function induced by D-gal injection plus 2VO. METHODS: Totally 30 male Sprague-Dawley rats were divided into 5 groups equivalently: control group, D-gal group, D-gal + 2VO group, D-gal + 2VO + saline water group, and D-gal + 2VO + BMSCs group. Aging hypoperfusion rats were created by subcutaneous injection of D-gal and occlusion of two common carotid arteries. BMSCs or saline water was stereotactically transplanted into the subventricular zone as treatment vehicles at 24 hours post operation. Two-way repeat analysis of variance (ANOVA) was used for significance analysis of 5 groups at 6 weeks post transplantation; moreover, Tamhane's test (equal variance not assumed) and least significant difference (LSD) test (equal variance assumed) were used for pairwise comparison in Morris water maze (MWM). RESULTS: Transplanted BMSCs distributed around the lateral ventricles and acquired the phenotypes of neurons and astrocytes. In terms of swimming path distance and escape latency in MWM, D-gal + 2VO + BMSC group showed significant improvement than the D-gal + 2VO group but was still obviously worse than the control group (both P < 0.05). There was no significant difference in swimming speed for all 5 groups. CONCLUSIONS: D-gal plus 2VO induces cognitive dysfunction. The engrafted BMSCs exhibit the beneficial effect on cognitive function via promotion interactively with host brain.