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The impact of reverse left ventricular remodeling (r-LVR) on clinical outcomes after surgical correction of anomalous left coronary artery from the pulmonary artery (ALCAPA) remains unclear. This study aims to examine the prognostic significance of r-LVR in patients with ALCAPA after surgery. We prospectively identified 61 patients undergoing surgical correction for ALCAPA; 54 patients had adequate echocardiographic image quality with quantitative biplane analysis performed both at baseline and at 30-day postoperative follow-up. Postoperative r-LVR was defined as a reduction of ≥ 10% in left ventricular end-diastolic volume index during follow-up. Cox proportional-hazards regression was used to investigate the independent association of r-LVR and all-cause mortality. Among 54 patients (age: 21.2 ± 7 months; 37% females), r-LVR occurred in 35 patients (64.8%) after surgery. Compared to patients with r-LVR, patients without r-LVR had significantly higher level of N-terminal pro B-type natriuretic peptide (NT-proBNP) [2176 (711, 4219) vs 998 (623, 2145) P < 0.001] and lower survival rate (47.3% vs 82.9%, HR = 5.72 [1.96 to 17.20], P < 0.001) at 1-year follow-up. NT-proBNP (OR = 2.27 [1.67 to 18.3], P = 0.02) was an independent predictor of r-LVR in multivariate analysis. Moreover, r-LVR was significantly associated with a lower rate of all-cause mortality (HR = 0.27 [0.08 to 0.98], P = 0.03) in multivariate analysis, even after adjustment for clinical and echocardiographic variables. R-LVR occurred in more than half of patients with ALCAPA undergoing surgical correction and it was associated with better clinical outcomes. NT-proBNP is an independent predictor of r-LVR.
Assuntos
Artéria Coronária Esquerda Anormal/cirurgia , Remodelação Ventricular , Estudos de Casos e Controles , Pré-Escolar , Ecocardiografia/métodos , Feminino , Humanos , Lactente , Masculino , Peptídeo Natriurético Encefálico , Fragmentos de Peptídeos , Complicações Pós-Operatórias/etiologia , Estudos Prospectivos , Artéria PulmonarRESUMO
Shone's syndrome is a rare congenital heart disease that includes 4 cardiovascular anomalies: supravalvular mitral ring, parachute mitral valve, subaortic stenosis, and coarctation of the aorta. Early diagnosis and treatment result in better outcomes. Echocardiography plays an important role in the diagnosis and is the optimal examination for detecting this disease. Pressure gradients are often unreliable and inaccurate; thus, careful anatomical observation of the left ventricular inflow and outflow tracts, particularly the mitral valve, is vital for accurate diagnosis and planning appropriate management. Herein, we describe 9 cases of Shone's syndrome, diagnosed with echocardiography and treated surgically.
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Coartação Aórtica , Cardiopatias Congênitas , Estenose da Valva Mitral , Coartação Aórtica/diagnóstico por imagem , Ecocardiografia , Cardiopatias Congênitas/diagnóstico por imagem , Humanos , Estenose da Valva Mitral/diagnóstico por imagem , SíndromeRESUMO
To explore the main target and signal pathway of Simiao Yongan Decoction in the treatment of psoriatic arthritis(PsA) by network pharmacology, so as to reveal the intervention mechanism of Simiao Yongan Decoction in the treatment of psoriatic arthritis. The platform of pharmacology technology of traditional Chinese medicine system(TCMSP) was used to predict and screen the active ingredients of Simiao Yongan Decoction, and GeneCards database was searched to obtain the disease target related to the psoriatic arthritis. Protein interaction network model was constructed with STRING platform; drug-component-target-disease network map was constructed with Cytoscape Software; Wayne Diagram of common target of Simiao Yongan Decoction and psoriasis arthritis was drawn with the help of ClusterProfiler R Software. At the same time, the genetic ontology(GO) enrichment analysis and the Kyoto encyclopedia of genes and genomes(KEGG) pathway analysis were conducted. Through database analysis, 1 128 targets related to 70 main active components of Simiao Yongan Decoction and psoriatic arthritis were selected. On this basis, the interaction network between Simiao Yongan Decoction and psoriatic arthritis was constructed, and 38 common targets were screened out. By GO and KEGG enrichment analysis, 135 signal pathways related to the main components of Simiao Yongan Decoction were selected. It was found that Simiao Yong-an Decoction may play a role in the treatment of psoriatic arthritis through antiviral effect, anti-inflammatory repair, protection of vascular endothelial cells, regulation of immunity and other multiple targets. The mechanism of Simiao Yongan Decoction in the treatment of psoriatic arthritis from multi-component, multi-target and multi-pathway was revealed, which provided a research direction for screening its subsequent clinical effect evaluation indexes.
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Artrite Psoriásica , Medicamentos de Ervas Chinesas , Células Endoteliais , Humanos , Medicina Tradicional Chinesa , Mapas de Interação de ProteínasRESUMO
Occupational pneumoconiosis refers to a group of occupational pulmonary diseases,which is mainly characterized by diffuse fibrosis of lung tissue caused by inhalation of different pathogenic productive dust and retention in the lungs during occupational activities for a long period of time. According to the classification and catalogue of occupational diseases in China,it is mainly classified into 12 categories,such as silicosis,coal worker's pneumoconiosis,asbestos lung. At present,it is the most serious and most common occupational disease in China. The pathogenesis of pneumoconiosis is not clear,and there is still no effective therapy. In the past three years,it is found that traditional Chinese medicine is effective in the treatment of pneumoconiosis. Through collection of medical records,the regularity of the prescriptions used in the treatment of pneumoconiosis were analyzed and summarized. According to the traditional Chinese medicine theory,the clinical characteristics of recurrent cough,phlegm and asthma in patients with pneumoconiosis could be included in the categories of cough,wheezing,lung distension. Professor Ma Guiqin believes that the basic pathogenesis of pneumoconiosis is depression of the atmosphere,deficiency of the kidney,internal obstruction of phlegm,and adverse cardinality. According to its pathogenesis,the commonly used prescriptions,namely Shengxian Decoction,Jinshui Liujun Jian,Xiaochaihu Decoction,Sini Powder,Guomin Jian and syndrome differentiation-based modified medicines were expounded. In addition, " throat is the gateway to the lung and stomach",Professor Ma also believes that the prevention of pneumoconiosis should start with the throat,so as to curb the exacerbation or recurrence of the disease. Through clinical observation,if traditional Chinese medicine is properly used,and pathogenesis and syndrome differentiation-based treatment is provided,traditional Chinese medicine can relieve the clinical symptoms,and improve the exercise tolerance and the quality of life of patients with pneumoconiosis.
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Medicina Tradicional Chinesa , Pneumoconiose/terapia , China , Minas de Carvão , Humanos , Qualidade de VidaRESUMO
As a topical plaster developed by modern pharmaceutical technology based on traditional Tibetan medicine,Cheezheng Xiaotong Tiegao has functions of promoting blood circulation,relieving swelling and relieving pain. Since its introduction in 1993,it has been widely used in the treatment of various types of acute and chronic musculoskeletal pain and various types of spinal,joint and soft tissue diseases. In order to better standardize the clinical application and improve the clinical efficacy of Cheezheng Xiaotong Tiegao,the research and development work of the Experts consensus statement on Cheezheng Xiaotong Tiegao in clinical practice was officially launched on October 19,2017,upon approval from China Association of Chinese Medicine. In this paper,main R&D process and related technical links for the experts consensus on Cheezheng Xiaotong Tiegao would be summarized,which will help the various medical workers understand,master and apply more accurately,and also provide reference for the development of experts consensus on clinical application of other topical Chinese medicines.
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Medicina Tradicional Tibetana , Manejo da Dor , Administração Tópica , China , Consenso , Humanos , DorRESUMO
Three new compounds 1-glyceryl 9(ß), 10(α), 11(ß)-trihydroxy-12(Z)-octadecenoate, 2'S-20-O-p-hydroxyphenylpropionyloxy-20-hyd-roxyarachidic acid glycerol ester (2), 3-O-α-l-arabinopyranosyl-(1â6)-ß-d-glucopyranoside of ethyl (3S)-hydroxybutanoate (3), as well as a new natural product (4) were isolated from the fruits of Solanum virginianum L. The structures of 26 compounds were determined by comprehensive spectroscopic analyses, NMR calculation, chemical methods, and comparisons of spectroscopic data. Compounds 2 and 16 exhibited good anti-inflammatory activity in the LPS-induced RAW 264.7 inflammatory model with IC50 values of 16.75 ± 1.54 and 22.43 ± 2.01 µM, respectively.
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BACKGROUND: Recent studies have demonstrated that microRNAs (miRNAs) play an essential role in the regulation of allergic rhinitis (AR), but the underlying mechanism is still unclear. OBJECTIVE: This case-control study aimed to measure the expression levels of serum miRNAs in children with AR, to evaluate their potential as diagnostic markers, and investigate the association between miRNAs and IL-4, total nasal symptom score (TNSS), and specific IgE (Artemisia). METHODS: Twenty allergic rhinitis patients and 20 healthy controls were included. The expression levels of serum miR-18a-5p, miR-142-5p, miR-155-5p, and miR-3687 were measured using quantitative real-time polymerase chain reaction. Serum cytokine levels were measured using IL-4 enzyme-linked immunosorbent assay kits. Nasal symptoms were assessed using the TNSS. A receiver operating characteristic (ROC) curve was used to test the diagnostic ability of the study parameters. RESULTS: The AR case group had a higher serum expression of miR-142-5p, miR-155-5p, and IL-4 than did the control group. However, there were no significant differences in the serum miR-18a-5p and miR-3687 expression levels between the two groups. We found that serum miR-142-5p and miR-155-5p levels were positively correlated with the expression of specific IgE (Artemisia). TNSS did not correlate with miR-142-5p or miR-155-5p levels. In addition, no significant correlation was identified between miR-142-5p and IL-4 expression, whereas miR-155-5p was positively correlated with IL-4 expression. The receiver operating characteristic curve did not look promising. The AUC was around 0.7 and it was not high enough for diagnostic tool. CONCLUSION: The expression levels of serum miR-142-5p and miR-155-5p were upregulated in children with AR; however, they were insufficient as diagnostic tools for AR. MiR-155-5p may be involved in T helper type 2 cell-mediated immune response.
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MicroRNAs , Rinite Alérgica , Humanos , Criança , Interleucina-4 , Estudos de Casos e Controles , MicroRNAs/genética , Rinite Alérgica/diagnóstico , Rinite Alérgica/genética , Imunoglobulina ERESUMO
BACKGROUND: Congenital vascular rings may often cause unexplained respiratory symptoms in infants and young children. Their diagnosis and treatment are often delayed. Few studies of vascular rings have been reported in China. The aim of this study was to describe the clinical presentation, diagnosis and surgical management of infants and children with congenital vascular rings. METHODS: Clinical histories, physical examinations, investigations, image studies and surgical interventions were retrospectively evaluated in 7 children (age range: 2 months-4 years, mean 7 months) with congenital vascular rings. Chest radiography was performed in all patients. Echocardiography and computed tomography (CT) with 3-dimensional (3D) reconstructions were performed in 6 patients. Esophagography, cardiac catheterization and angiography, and bronchoscopy were performed in 1, 1 and 4 children, respectively. RESULTS: Six of the 7 patients had respiratory symptoms, including recurrent cough, stridor and wheeze. Age at onset of symptoms ranged from 1 month to 11 months. Chest X-ray showed nothing important on the vascular rings, besides bronchitis and pneumonia. Contrast-enhanced CT diagnosed vascular rings in 6 patients. Four patients had double aortic arches, two had balanced arches and two were right arch dominant. One patient had a right aortic arch with left ligament and 1 patient had a pulmonary artery sling. Echocardiography failed to diagnose vascular rings in 2 patients. The esophagogram of 1 patient showed esophageal compression. Bronchoscopy of 4 patients showed compression of the distal trachea. Five of the 7 patients underwent surgical division of the vascular rings. Surgical observation confirmed the CT findings in each patient. CONCLUSIONS: Patients, especially infants or young children, with recurrent respiratory symptoms such as chronic cough, stridor and wheeze, should be examined for the possible presence of congenital vascular rings. Contrast-enhanced CT can clearly show the anatomy of vascular rings. As a noninvasive technique, echocardiography is helpful for diagnosis. Early surgical management in symptomatic patients is effective.
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Aorta Torácica/anormalidades , Pré-Escolar , Tosse/etiologia , Ecocardiografia , Feminino , Humanos , Lactente , Masculino , Sons Respiratórios/etiologia , Estudos Retrospectivos , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVE: To obtain normal range of coronary artery diameter with body surface area (BSA) dynamic changes in normal children at different age. METHOD: The left main coronary artery (LCA), left anterior descending artery (LAD), left circumflex artery (LCX) and the right coronary artery (RCA) diameter were measured in 400 normal subjects from Chinese population aged 0 d to 18 years [(6.43 ± 4.45) years], using HP Sonos 5500 color Doppler ultrasonic system, according to the standard method of measuring the coronary artery diameter. RESULT: (1) The diameters of LCA, LAD, LCX and RCA in different age groups (0 d-12 months, -3 years, -6 years, -9 years, -12 years, -18 years) had significant differences (F = 61.688, 51.343, 46.375, 50.192, P < 0.01,all groups mean differences had significant differences, there was significant difference between every two groups, P < 0.05), there were no significant differences between male and female subjects (P > 0.05). (2) The correlation analyses showed that the diameter of LCA, LAD, LCX and RCA had significant linear correlations with age, height, weight and BSA (r ranged from 0.71 to 0.85, P < 0.01 ). (3) The regression analyses were respectively performed on the diameters of LCA, LAD, LCX and RCA with BSA to establish seven regression models. The coefficients were compared for each model, the best model was chosen to create a Z score calculator, tracing out the Z value curve, through clinical practice,we chose Z score within ± 2 as the coronary artery diameter's normal range for Chinese children. CONCLUSION: Coronary artery diameter's Z score curve is effective and reliable, it provide objective basis for clinicians and sonographers to accurately and quickly diagnose the anomalies in diameter of coronary artery.
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Vasos Coronários/diagnóstico por imagem , Vasos Coronários/crescimento & desenvolvimento , Ecocardiografia Doppler/métodos , Adolescente , Fatores Etários , Aorta/diagnóstico por imagem , Estatura , Superfície Corporal , Peso Corporal , Criança , Desenvolvimento Infantil/fisiologia , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Síndrome de Linfonodos Mucocutâneos/diagnóstico por imagem , Valores de Referência , Análise de Regressão , Estudos de Validação como AssuntoRESUMO
OBJECTIVE: To investigate the expression of matrix metalloproteinase-1 (MMP-1), E26 transformation-specific-1 (Ets-1) in laryngeal carcinoma and to discuss their relevance and the roles in carcinogenesis and development of laryngeal carcinoma. METHOD: Immunohistochemical technique was used to detect the expression of MMP-1 and Ets-1 protein in 34 tissues of laryngeal carcinoma and 34 para-carcinoma tissues, 15 cases of vocal cord polyps, and the use of the pathological image analysis software, we analysis the results of immunohistochemical semi-quantitatively. RESULT: (1) The expression of MMP-1 and Ets-1 protein in laryngeal carcinoma tissues is obviously higher than that in para-carcinoma and in vocal cord polyps respectively (P < 0.05). There is no significant difference between the expression of para-carcinoma and vocal cord polyps(P > 0.05). (2) The expression of MMP-1, Ets-1 protein isn't related to patients' age and sex, tumor size,clinical classification (P > 0.05), but related to pathological grade, clinical stage and lymph nodes metastasis (P < 0.05). (3) There is a positive correlation between the expression of MMP-1 and Ets-1 in laryngeal carcinoma. CONCLUSION: Overexpression of MMP-1 and Ets-1 was observed in laryngeal carcinoma. The high expression of MMP-1 and Ets-1 may contribute to the carcinogenesis and development of laryngeal carcinoma,which is a important value to judge the malignant degree and progress of laryngeal carcinoma.