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Ma QM, Tang WB, Li XJ, Chang F, Yin X, Chen ZH, Wu GH, Xia CD, Li XL, Wang DY, Chu ZG, Zhang Y, Wang L, Wu CL, Tong YL, Cui P, Guo GH, Zhu ZH, Huang SY, Chang L, Liu R, Liu YJ, Wang YS, Liu XB, Shen T, Zhu F. [Multicenter retrospect analysis of early clinical features and analysis of risk factors on prognosis of elderly patients with severe burns]. Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi 2024; 40:249-257. [PMID: 38548395 DOI: 10.3760/cma.j.cn501225-20230808-00042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
Objective: To investigate the early clinical characteristics of elderly patients with severe burns and the risk factors on prognosis. Methods: This study was a retrospective case series study. Clinical data of 124 elderly patients with severe burns who met the inclusion criteria and were admitted to the 12 hospitals from January 2015 to December 2020 were collected, including 4 patients from the Fourth People's Hospital of Dalian, 5 patients from Fujian Medical University Union Hospital, 22 patients from Guangzhou Red Cross Hospital of Jinan University, 5 patients from Heilongjiang Provincial Hospital, 27 patients from the First Affiliated Hospital of Naval Medical University, 9 patients from the First Affiliated Hospital of Nanchang University, 10 patients from Affiliated Hospital of Nantong University, 9 patients from Tongren Hospital of Wuhan University & Wuhan Third Hospital, 12 patients from the 924th Hospital of PLA, 6 patients from Zhangjiagang First People's Hospital, 4 patients from Taizhou Hospital of Zhejiang Province, and 11 patients from Zhengzhou First People's Hospital. The patients' overall clinical characteristics, such as gender, age, body mass index, total burn area, full-thickness burn area, inhalation injury, causative factors, whether combined with underlying medical diseases, and admission time after injury were recorded. According to the survival outcome within 28 days after injury, the patients were divided into survival group (89 cases) and death group (35 cases). The following data of patients were compared between the two groups, including the basic data and injuries (the same as the overall clinical characteristics ahead); the coagulation indexes within the first 24 hours of injury such as prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time, D-dimer, fibrinogen degradation product (FDP), international normalized ratio (INR), and fibrinogen; the blood routine indexes within the first 24 hours of injury such as white blood cell count, platelet count, neutrophil-to-lymphocyte ratio, monocyte count, red blood cell count, hemoglobin, and hematocrit; the organ function indexes within the first 24 hours of injury such as direct bilirubin, total bilirubin, urea, serum creatinine, aspartate aminotransferase, alanine aminotransferase, total protein, albumin, globulin, blood glucose, triglyceride, total cholesterol, alkaline phosphatase, creatine kinase, electrolyte indexes (potassium, sodium, chlorine, calcium, magnesium, and phosphorus in blood), uric acid, myoglobin, and brain natriuretic peptide; the infection and blood gas indexes within the first 24 hours of injury such as procalcitonin, C-reactive protein, pH value, oxygenation index, base excess, and lactate; treatment such as whether conducted with mechanical ventilation, whether conducted with continuous renal replacement therapy, whether conducted with anticoagulation therapy, whether applied with vasoactive drugs, and fluid resuscitation. The analysis was conducted to screen the independent risk factors for the mortality within 28 days after injury in elderly patients with severe burns. Results: Among 124 patients, there were 82 males and 42 females, aged 60-97 years, with body mass index of 23.44 (21.09, 25.95) kg/m2, total burn area of 54.00% (42.00%, 75.00%) total body surface area (TBSA), and full-thickness burn area of 25.00% (10.00%, 40.00%) TBSA. The patients were mainly combined with moderate to severe inhalation injury and caused by flame burns. There were 43 cases with underlying medical diseases. The majority of patients were admitted to the hospital within 8 hours after injury. There were statistically significant differences between patients in the 2 groups in terms of age, total burn area, full-thickness burn area, and inhalation injury, and PT, APTT, D-dimer, FDP, INR, white blood cell count, platelet count, urea, serum creatinine, blood glucose, blood sodium, uric acid, myoglobin, and urine volume within the first 24 hours of injury (with Z values of 2.37, 5.49, 5.26, 5.97, 2.18, 1.95, 2.68, 2.68, 2.51, 2.82, 2.14, 3.40, 5.31, 3.41, 2.35, 3.81, 2.16, and -3.82, respectively, P<0.05); there were statistically significant differences between two groups of patients in whether conducted with mechanical ventilation and whether applied with vasoactive drugs (with χ2 values of 9.44 and 28.50, respectively, P<0.05). Age, total burn area, full-thickness burn area, serum creatinine within the first 24 hours of injury, and APTT within the first 24 hours of injury were the independent risk factors for the mortality within 28 days after injury in elderly patients with severe burns (with odds ratios of 1.17, 1.10, 1.10, 1.09, and 1.27, 95% confidence intervals of 1.03-1.40, 1.04-1.21, 1.05-1.19, 1.05-1.17, and 1.07-1.69, respectively, P<0.05). Conclusions: The elderly patients with severe burns had the injuries mainly from flame burns, often accompanied by moderate to severe inhalation injury and enhanced inflammatory response, elevated blood glucose levels, activated fibrinolysis, and impaired organ function in the early stage, which are associated with their prognosis. Age, total burn area, full-thickness burn area, and serum creatinine and APTT within the first 24 hours of injury are the independent risk factors for death within 28 days after injury in this population.
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Affiliation(s)
- Q M Ma
- Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China Department of Critical Care Medicine, Shanghai East Hospital Affiliated to Tongji University, Shanghai 200120, China
| | - W B Tang
- Department of Burns and Plastic Surgery, Guangzhou Red Cross Hospital of Jinan University, Guangzhou 510220, China
| | - X J Li
- Department of Burns and Plastic Surgery, Guangzhou Red Cross Hospital of Jinan University, Guangzhou 510220, China
| | - F Chang
- Department of Burns and Plastic Surgery, Zhangjiagang First People's Hospital, Zhangjiagang 215600, China
| | - X Yin
- Department of Burns and Plastic Surgery, Zhangjiagang First People's Hospital, Zhangjiagang 215600, China
| | - Z H Chen
- Department of Burns, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - G H Wu
- Department of Burns, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - C D Xia
- Department of Burns, Zhengzhou First People's Hospital, Zhengzhou 450004, China
| | - X L Li
- Department of Burns, Zhengzhou First People's Hospital, Zhengzhou 450004, China
| | - D Y Wang
- Department of Burns, Tongren Hospital of Wuhan University & Wuhan Third Hospital, Wuhan 430060, China
| | - Z G Chu
- Department of Burns, Tongren Hospital of Wuhan University & Wuhan Third Hospital, Wuhan 430060, China
| | - Y Zhang
- Department of Burns and Plastic Surgery, Affiliated Hospital of Nantong University, Nantong 226001, China
| | - L Wang
- Department of Burns and Plastic Surgery, Affiliated Hospital of Nantong University, Nantong 226001, China
| | - C L Wu
- Department of Burns, Taizhou Hospital of Zhejiang Province, Linhai 317000, China
| | - Y L Tong
- Department of Burns and Plastic Surgery, the 924th Hospital of PLA, Guilin 541002, China
| | - P Cui
- Department of Burns and Plastic Surgery, the 924th Hospital of PLA, Guilin 541002, China
| | - G H Guo
- Medical Center of Burn Plastic and Wound Repair, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - Z H Zhu
- Medical Center of Burn Plastic and Wound Repair, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - S Y Huang
- Medical Center of Burn Plastic and Wound Repair, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - L Chang
- Department of Burns and Plastic Surgery, the Fourth People's Hospital of Dalian, Dalian 116031, China
| | - R Liu
- Department of Burns, Heilongjiang Provincial Hospital, Harbin 150036, China
| | - Y J Liu
- Department of Burns, Heilongjiang Provincial Hospital, Harbin 150036, China
| | - Y S Wang
- Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - X B Liu
- Department of Critical Care Medicine, Shanghai East Hospital Affiliated to Tongji University, Shanghai 200120, China
| | - T Shen
- Department of Critical Care Medicine, Shanghai East Hospital Affiliated to Tongji University, Shanghai 200120, China
| | - F Zhu
- Department of Critical Care Medicine, Shanghai East Hospital Affiliated to Tongji University, Shanghai 200120, China
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Cui HJ, Chen JM, Wang SS, Cen JZ, Xu G, Wen SS, Liu XB, Zhuang J. [Diagnosis and surgical treatment of high-risk anomalous aortic origin of coronary artery]. Zhonghua Wai Ke Za Zhi 2024; 62:242-247. [PMID: 38291641 DOI: 10.3760/cma.j.cn112139-20230721-00021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Objective: To analyze the diagnosis and surgical treatment of high-risk anomalous aortic origin of coronary artery (AAOCA). Methods: This is a retrospective case series study. From January 2016 to July 2023, 24 cases of high-risk AAOCA underwent surgical treatment in Department of Cardiac Surgery, Guangdong Provincial People's Hospital. There were 18 males and 6 females, operatively aged (M (IQR)) 13 (26) years (range: 0.3 to 57.0 years). They were confirmed by cardiac ultrasound and cardiac CT, all of which had anomalous coronary running between the aorta and the pulmonary artery. There were 15 cases of the right coronary artery from the left aortic sinus of Valsalva, 6 cases of left coronary artery from the right aortic sinus of Valsalva, 3 cases of the sigle coronary artery. Only 3 patients had no obvious related symptoms (2 cases were complicated with a positive exercise stress test and 1 case with other intracardiac malformations), 21 cases had a history of chest tightness, chest pain, or syncope after exercise. Three patients suffered syncope after exercise and underwent cardiopulmonary resuscitation (2 cases were treated with an extracorporeal membrane oxygenerator (ECMO)). The gap from the first symptom to the diagnosis was 4.0 (11.5) months (range: 0.2 to 84.0 months). The detection rate of coronary artery abnormalities suggested by the first cardiac ultrasound was only 37.5% (9/24). Seven patients were complicated with other cardiac diseases (4 cases with congenital heart defects, 2 cases with coronary atherosclerotic heart disease, 1 case with mitral valve disease). Results: All 24 patients underwent surgical treatment (23 cases underwent abnormal coronary artery unroofing, 1 case underwent coronary artery bypass grafting), and 5 patients underwent other intracardiac malformation correction at the same time. There were no death or surgery related complications in the hospital for 30 days after the operation. A patient with preoperative extracorporeal cardiopulmonary resuscitation was continuously assisted by ECMO after emergency AAOCA correction and had complications such as limb ischemia necrosis and renal dysfunction after the operation. During the follow-up of 2.2 (3.3) years (range: 1 month to 7.2 years), one patient who previously underwent percutaneous transluminal coronary angioplasty with a stent implant experienced significant postoperative symptomatic relief, and the other discharged patients had no related symptoms. Conclusions: The accurate rate of initial diagnosis for high-risk AAOCA is still low, but the risk of cardiovascular accidents is high. For sports-related chest pain and other symptoms, more attention should be paid to the detection of AAOCA, especially for adolescents. Exercise stress testing can be helpful in evaluating the cardiovascular risk of asymptomatic AAOCA. Instant surgical treatment can achieve satisfactory curative effects.
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Affiliation(s)
- H J Cui
- Department of Cardiac Surgery, Guangdong Provincial People's Hospital, Guangdong Cardiocvascular Diseases Institute, Guangzhou 510080, China
| | - J M Chen
- Department of Cardiac Surgery, Guangdong Provincial People's Hospital, Guangdong Cardiocvascular Diseases Institute, Guangzhou 510080, China
| | - S S Wang
- Department of Pediatric Cardiology, Guangdong Provincial People's Hospital, Guangdong Cardiocvascular Diseases Institute, Guangzhou 510080, China
| | - J Z Cen
- Department of Cardiac Surgery, Guangdong Provincial People's Hospital, Guangdong Cardiocvascular Diseases Institute, Guangzhou 510080, China
| | - G Xu
- Department of Cardiac Surgery, Guangdong Provincial People's Hospital, Guangdong Cardiocvascular Diseases Institute, Guangzhou 510080, China
| | - S S Wen
- Department of Cardiac Surgery, Guangdong Provincial People's Hospital, Guangdong Cardiocvascular Diseases Institute, Guangzhou 510080, China
| | - X B Liu
- Department of Cardiac Surgery, Guangdong Provincial People's Hospital, Guangdong Cardiocvascular Diseases Institute, Guangzhou 510080, China
| | - J Zhuang
- Department of Cardiac Surgery, Guangdong Provincial People's Hospital, Guangdong Cardiocvascular Diseases Institute, Guangzhou 510080, China
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Liu XB. [Intravascular imaging to guide coronary intervention: when and what]. Zhonghua Xin Xue Guan Bing Za Zhi 2024; 52:123-127. [PMID: 38326062 DOI: 10.3760/cma.j.cn112148-20231030-00394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Affiliation(s)
- X B Liu
- Department of Cardiology, Tongji Hospital, Tongji University, Shanghai 200065, China
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Li ZX, Liu XB, Li Y, Liang GH, Wang ZF, Zheng Y, Sun HB, Wang W, Song T, Xing WQ. [Application value of CT examination of lymph node short diameter in evaluating cardia-left gastric lymph node metastasis in thoracic esophageal squamous cell carcinoma]. Zhonghua Zhong Liu Za Zhi 2023; 45:962-966. [PMID: 37968082 DOI: 10.3760/cma.j.cn112152-20220313-00173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
Objective: To investigate the application value of computed tomography (CT) examination of lymph node short diameter in evaluating cardia-left gastric lymph node metastasis in thoracic esophageal squamous cell carcinoma (ESCC). Methods: A total of 477 patients with primary thoracic ESCC who underwent surgical treatment in the Affiliated Cancer Hospital of Zhengzhou University from January 2013 to December 2017 were collected. All of them underwent McKeown esophagectomy plus complete two-field or three-field lymph node dissection. Picture archiving and communication system were used to measure the largest cardia-left gastric lymph node short diameter in preoperative CT images. The postoperative pathological diagnosis results of cardia-left gastric lymph node were used as the gold standard. Receiver operating characteristic (ROC) curve was used to evaluate the efficacy of CT lymph node short diameter in detecting the metastasis of cardia-left gastric lymph node in thoracic ESCC, and determine the optimal cut-off value. Results: The median short diameter of the largest cardia-left gastric lymph node was 4.1 mm in 477 patients, and the largest cardia-left gastric lymph node short diameter was less than 3 mm in 155 cases (32.5%). Sixty-eight patients had cardia-left gastric lymph node metastases, of which 38 had paracardial node metastases and 41 had left gastric node metastases. The lymph node ratios of paracardial node and left gastric node were 4.0% (60/1 511) and 3.3% (62/1 887), respectively. ROC curve analysis showed that the area under the curve of CT lymph node short diameter for evaluating cardia-left gastric lymph node metastasis was 0.941 (95% CI: 0.904-0.977; P<0.05). The optimal cut-off value of CT examination of the cardia-left gastric lymph node short diameter was 6 mm, and the corresponding sensitivity, specificity and accuracy were 85.3%, 91.7%, and 90.8%, respectively. Conclusion: CT examination of lymph node short diameter can be a good evaluation of cardia-left gastric lymph node metastasis in thoracic ESCC, and the optimal cut-off value is 6 mm.
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Affiliation(s)
- Z X Li
- Department of Thoracic Surgery, the Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China
| | - X B Liu
- Department of Thoracic Surgery, the Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China
| | - Y Li
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - G H Liang
- Department of Thoracic Surgery, the Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China
| | - Z F Wang
- Department of Thoracic Surgery, the Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China
| | - Y Zheng
- Department of Thoracic Surgery, the Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China
| | - H B Sun
- Department of Thoracic Surgery, the Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China
| | - W Wang
- Department of Thoracic Surgery, the Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China
| | - T Song
- Department of Imaging, the Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China
| | - W Q Xing
- Department of Thoracic Surgery, the Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China
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Wang JA, Liu XB, Zhu QF, Pu ZX, Hu P, Wang LH, Lin XP, Jiang JB, Ren KD. [Novel transcatheter intervention on calcific aortic valve stenosis using shockwave technique: two case reports]. Zhonghua Xin Xue Guan Bing Za Zhi 2023; 51:859-862. [PMID: 37583335 DOI: 10.3760/cma.j.cn112148-20230616-00356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Affiliation(s)
- J A Wang
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009 China
| | - X B Liu
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009 China
| | - Q F Zhu
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009 China
| | - Z X Pu
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009 China
| | - P Hu
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009 China
| | - L H Wang
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009 China
| | - X P Lin
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009 China
| | - J B Jiang
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009 China
| | - K D Ren
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009 China
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Wang JA, Liu XB, Pu ZX, Ren KD, Lin XP, Zhu QF, Wang LH, Hu P. [Tricuspid transcatheter edge-to-edge repair with 2 years of follow-up: a case report]. Zhonghua Xin Xue Guan Bing Za Zhi 2023; 51:662-664. [PMID: 37312486 DOI: 10.3760/cma.j.cn112148-20230304-00120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- J A Wang
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - X B Liu
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Z X Pu
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - K D Ren
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - X P Lin
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Q F Zhu
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - L H Wang
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - P Hu
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
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Ma QM, Wang YS, Hou WJ, Liu XB, Shen T, Zhu F. [Visual analysis of the current research status and development of burn-related coagulation dysfunction]. Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi 2023; 39:356-363. [PMID: 37805739 DOI: 10.3760/cma.j.cn501225-20220616-00237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/09/2023]
Abstract
Objective: To conduct a visual analysis of the literature on burn-related coagulation dysfunction and to explore the current research status, evolution process, hot topics, and future research trends in burn-related coagulation dysfunction at home and abroad. Methods: The bibliometrics method was used. The literature on burn-related coagulation dysfunction which were published in Web of Science and China National Knowledge Internet databases from January 1, 1950 to May 1, 2022, and met the inclusion criteria were retrieved for publication volume analysis. The literature on burn-related coagulation dysfunction were retrieved as above in the core collection of Web of Science and China National Knowledge Internet databases, and CiteSpace 5.8.R3 software was used to perform co-occurrence analysis, cluster analysis, and literature co-citation analysis of key words. Results: A total of 501 and 235 literature on burn-related coagulation dysfunction were retrieved from Web of Science database and China National Knowledge Internet database, respectively. The literature on burn-related coagulation dysfunction emerged from 1975 and 1950, respectively, in China and abroad, which were gradually increased later. The frequency and centrality of Chinese key words such as , , were high in 235 literature in China National Knowledge Internet database, and the frequency and centrality of key words such as burn, coagulation, and deep vein thrombosis were high in 340 literature in the core collection of Web of Science database. In China National Knowledge Internet database, the top 6 Chinese key words in terms of burst intensity were , , , , , , and the first 3 among which were burst key words in the early stage; and in the core collection of Web of Science database, the key words with higher burst intensity were disseminated intravascular coagulation and pulmonary embolism, which were the burst key words in the early stage. The representative clustering labels in China National Knowledge Internet database were #0 , #1 , and #2 , etc., and the representative clustering labels in the core collection of Web of Science database were #0 risk, #1 surgical patient, and #2 sepsis. Early researches in China National Knowledge Internet database and the core collection of Web of Science database focused on the presence of burn-related coagulation dysfunction itself, while the late researches focused on the relationship between burn-related coagulation dysfunction and inflammation, immunity, coagulation in general, and wounds. From 2010 onwards, there were a large number of core cited literature in the core collection of Web of Science database, and the prevention and treatment of vein thromboembolism was the most popular research direction in recent years. The researches on optimization and standardization of diagnostic methods and the overall mechanism of burn-related coagulation dysfunction would be the main research directions in the future. Conclusions: The research hotspots and evolution processes of burn-related coagulation dysfunction at home and abroad have both similarities and differences, and the current research hotspot is the relationship between coagulation and inflammation, immunity. With researches increasingly deepening, the researches on optimization and standardization of diagnostic methods and the overall mechanism of burn-related coagulation dysfunction will be the main research directions in the future.
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Affiliation(s)
- Q M Ma
- Intensive Care Unit of Burns and Trauma, the First Affiliated Hospital, Naval Medical University, Shanghai 200433, China
| | - Y S Wang
- Intensive Care Unit of Burns and Trauma, the First Affiliated Hospital, Naval Medical University, Shanghai 200433, China
| | - W J Hou
- Intensive Care Unit of Burns and Trauma, the First Affiliated Hospital, Naval Medical University, Shanghai 200433, China
| | - X B Liu
- Intensive Care Unit of Burns and Trauma, the First Affiliated Hospital, Naval Medical University, Shanghai 200433, China
| | - T Shen
- Intensive Care Unit of Burns and Trauma, the First Affiliated Hospital, Naval Medical University, Shanghai 200433, China
| | - F Zhu
- Intensive Care Unit of Burns and Trauma, the First Affiliated Hospital, Naval Medical University, Shanghai 200433, China
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Yun XL, Liu XB, Cheng ZC, Ji YR, Guo YM, Yuan JM, Nie W. Determination and prediction of standardized ileal amino acid digestibility of wheat in broilers. Poult Sci 2023; 102:102383. [PMID: 36529100 PMCID: PMC9792556 DOI: 10.1016/j.psj.2022.102383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/16/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022] Open
Abstract
This experiment evaluated the standard ileal digestibility (SID) of amino acids (AA) in 8 different sources of wheat fed to broilers and established prediction equations based on the chemical properties of wheat. A total of five hundred forty 1-day-old broilers were tested in 2 stages (from d 10 to 13 and from d 25 to 28). On d 13, 324 broilers were randomly assigned to 9 diets (6 replicate cages, 6 broilers per cage); on d 28, 216 broilers were randomly assigned to 9 diets (6 replicate cages, 4 broilers per cage). The 9 experimental diets included 8 test diets and 1 nitrogen-free diet. Titanium dioxide was added as an exogenous indicator at 0.5% of the diet. In 8 wheat samples, the mean values of total amino acids (TAA), dispensable amino acids (DAA), and indispensable amino acids (IAA) were 12.16% (CV 13.70%), 7.97% (CV 15.49%), and 4.20% (CV 11.47%). On d 13, the lowest SID of AA was Lys (86.71%), and the highest was Pro (97.98%). On d 28, the lowest SID of AA was His (81.31%), and the highest was Pro (96.83%). There was an effect of wheat source on the SID of AA except for Trp (P < 0.05); the broiler age had an effect on the SID of AA except for Tyr (P < 0.05); the SID of most AA were higher at d 13 compared to d 28. At d 13, the SID of AA was correlated with CP, NDF, and ST (P < 0.05). At d 28, the SID of AA was correlated with EE, Ash, ADF, and NDF (P < 0.05). The R2 value of stepwise regression equations to predict the SID of AA at d 13 was highest for Leu (R2 = 0.972), lowest for Asp (R2 = 0.785); at d 28 was highest for Gly (R2 = 0.995), lowest for His (R2 = 0.678). In conclusion, this experiment showed that the chemical properties of wheat can be used to establish accurate equations for predicting the SID of AA. This made it more efficient to obtain the SID of AA for wheat.
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Affiliation(s)
- X L Yun
- State Key Laboratory of Animal Nutrition, College of Animal Science and Technology, China Agricultural University, Beijing 100193, China
| | - X B Liu
- State Key Laboratory of Animal Nutrition, College of Animal Science and Technology, China Agricultural University, Beijing 100193, China
| | - Z C Cheng
- State Key Laboratory of Animal Nutrition, College of Animal Science and Technology, China Agricultural University, Beijing 100193, China
| | - Y R Ji
- State Key Laboratory of Animal Nutrition, College of Animal Science and Technology, China Agricultural University, Beijing 100193, China
| | - Y M Guo
- State Key Laboratory of Animal Nutrition, College of Animal Science and Technology, China Agricultural University, Beijing 100193, China
| | - J M Yuan
- State Key Laboratory of Animal Nutrition, College of Animal Science and Technology, China Agricultural University, Beijing 100193, China
| | - W Nie
- State Key Laboratory of Animal Nutrition, College of Animal Science and Technology, China Agricultural University, Beijing 100193, China.
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Wang SS, Li JM, Hu P, Guo YC, Liu XB, Wang JA, Chen H. Circulating Irisin Level as a Biomarker for Pure Aortic Stenosis and Aortic Valve Calcification. J Cardiovasc Transl Res 2022; 16:443-452. [PMID: 36223050 PMCID: PMC10151307 DOI: 10.1007/s12265-022-10327-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 09/26/2022] [Indexed: 11/25/2022]
Abstract
Irisin, a myokine mainly secreted by skeletal and cardiac muscles, is actively involved in cardiovascular diseases. However, whether irisin is associated with aortic stenosis remains unknown. Two hundred ninety-three severe AS patients who underwent transcatheter aortic valve implantation were enrolled and followed-up for 35 months on average. Enzyme-linked immunosorbent assay (ELISA) was applied to measure circulating irisin levels. Patients were divided into two groups based on the median plasma irisin level. We found that high plasma irisin levels were independently associated with pure aortic stenosis (PAS) after adjusting for age, body mass index, history of peripheral vascular disease, and creatinine (OR = 3.015, 95% CI 1.775-5.119, P < 0.001). ROC curve analysis showed a significant predictive value of irisin for PAS (AUC = 0.647, 95% CI 0.583-0.711, P < 0.001). The severity of aortic valve calcification was negatively associated with plasma irisin levels (P < 0.05). In conclusion, irisin is an independent predictor for PAS and is negatively associated with the severity of aortic valve calcification.
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Affiliation(s)
- Shan-Shan Wang
- Department of Cardiology, Second Affiliated Hospital, Zhejiang Provincial Key Lab of Cardiovascular Disease Diagnosis and Treatment, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China
| | - Jia-Min Li
- Department of Cardiology, Second Affiliated Hospital, Zhejiang Provincial Key Lab of Cardiovascular Disease Diagnosis and Treatment, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China
| | - Po Hu
- Department of Cardiology, Second Affiliated Hospital, Zhejiang Provincial Key Lab of Cardiovascular Disease Diagnosis and Treatment, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China
| | - Yu-Chao Guo
- Department of Cardiology, Second Affiliated Hospital, Zhejiang Provincial Key Lab of Cardiovascular Disease Diagnosis and Treatment, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China
| | - Xian-Bao Liu
- Department of Cardiology, Second Affiliated Hospital, Zhejiang Provincial Key Lab of Cardiovascular Disease Diagnosis and Treatment, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China
| | - Jian-An Wang
- Department of Cardiology, Second Affiliated Hospital, Zhejiang Provincial Key Lab of Cardiovascular Disease Diagnosis and Treatment, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China
| | - Han Chen
- Department of Cardiology, Second Affiliated Hospital, Zhejiang Provincial Key Lab of Cardiovascular Disease Diagnosis and Treatment, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China.
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10
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Li S, Yao TQ, Wang HF, Wen XW, Lin H, Gao ZH, Zhang Q, Mo Y, Tang D, Cheng Y, Liu XB, Shen JH. [Two-dimensional equivalent mechanical modeling and finite element analysis of normal female pelvic floor system]. Zhonghua Yi Xue Za Zhi 2022; 102:2189-2195. [PMID: 35872583 DOI: 10.3760/cma.j.cn112137-20211108-02478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To construct the geometric model of the pelvic floor by a two-dimensional equivalent mechanics method, and to explore the effect of the shape and position of pelvic floor organs and tissues on the biomechanical properties of the pelvic floor under different abdominal pressure. Methods: A 28-year-old healthy and symmetrical married infertile female volunteer was included. The pelvic floor tissue was scanned in the supine position using a 3.0T magnetic resonance scanner (Philips Company, Holland). Based on the method of magnetic resonance imaging (MRI) two-dimensional parameter measurement and computer aided design, the geometric model and finite element model of the female pelvic floor were established, and the biomechanical characteristics of the pelvic floor support system under different abdominal pressure were analyzed. Results: In this study, four different working conditions of the pelvic floor force were simulated under 60, 99, 168, and 208 cmH2O (1 cmH2O=0.098 kPa) abdominal pressure loads. The trend was as follows: under the abdominal pressure load, the retrograde flexion of the uterus occurred, the cervical, the middle and upper vaginal segment and the levator anus muscle had the characteristic change of mechanical axial direction pointing to the sacrum and coccyx, and the deformation of the levator anus muscle in the horizontal direction was greater than that in the vertical direction. With the increase of the abdominal pressure, the maximum stress values of the pelvic floor whole system of healthy subjects under four different working conditions were 0.194 3, 0.389 6, 0.557 1, and 0.627 5 MPa, respectively, and the maximum displacement values were 10, 14, 21 and 25 mm, respectively. The maximum stress values of the cervical and vaginal middle and upper segment were 0.111 7, 0.161 8, 0.250 6, and 0.304 1 MPa, respectively, and the maximum displacement values were 3, 6, 9, and 11 mm, respectively. The maximum stress of the perineal body was 0.063 4, 0.119 6, 0.235 2, and 0.288 0 MPa, and the maximum displacement was 1, 2, 4, and 5 mm. The maximum stress values of the levator anus muscle were 0.194 3, 0.389 6, 0.557 1, and 0.627 5 MPa, and the maximum displacement values were 2, 4, 7, and 8 mm, respectively. The maximum stress and maximum displacement of pelvic organs increased with the increase of the abdominal pressure under different working conditions. The stress axial relationship of normal female pelvic floor was that the middle and upper segment of uterus and vagina mainly acted on the sacrococcyx and the levator anus muscle, and the lower vaginal segment acts on the perineal body. Conclusions: The two-dimensional equivalent mechanical modeling and finite element analysis of the female pelvic floor system can accurately reflect the biomechanical characteristics of the female pelvic floor, and the resultant stress direction of the pelvic organs points to the sacrum and coccyx. The sacrum and coccyx, levator anus and perineal body play important stress supporting roles in the pelvic floor system.
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Affiliation(s)
- S Li
- Department of Urology, the First Affiliated Hospital of Kunming Medical University, Kunming 650093, China
| | - T Q Yao
- School of Mechanical and Electric Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - H F Wang
- Department of Urology, the First Affiliated Hospital of Kunming Medical University, Kunming 650093, China
| | - X W Wen
- Department of Urology, the First Affiliated Hospital of Kunming Medical University, Kunming 650093, China
| | - H Lin
- Department of Urology, the First Affiliated Hospital of Kunming Medical University, Kunming 650093, China
| | - Z H Gao
- Department of Urology, the First Affiliated Hospital of Kunming Medical University, Kunming 650093, China
| | - Q Zhang
- Department of Urology, the First Affiliated Hospital of Kunming Medical University, Kunming 650093, China
| | - Y Mo
- Department of Urology, the First Affiliated Hospital of Kunming Medical University, Kunming 650093, China
| | - D Tang
- Department of Urology, the First Affiliated Hospital of Kunming Medical University, Kunming 650093, China
| | - Y Cheng
- Department of Urology, the First Affiliated Hospital of Kunming Medical University, Kunming 650093, China
| | - X B Liu
- School of Mechanical and Electric Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - J H Shen
- Department of Urology, the First Affiliated Hospital of Kunming Medical University, Kunming 650093, China
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11
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Yin X, Zhou WF, Hou WJ, Fan MZ, Wu GS, Liu XB, Ma QM, Wang YS, Zhu F. [Effects of non-muscle myosin Ⅱ silenced bone marrow-derived mesenchymal stem cells transplantation on lung extracellular matrix in rats after endotoxin/lipopolysaccharide-induced acute lung injury]. Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi 2022; 38:422-433. [PMID: 35599418 DOI: 10.3760/cma.j.cn501225-20220212-00024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To investigate the effects of non-muscle myosin Ⅱ (NMⅡ) gene silenced bone marrow-derived mesenchymal stem cells (BMMSCs) on pulmonary extracellular matrix (ECM) and fibrosis in rats with acute lung injury (ALI) induced by endotoxin/lipopolysaccharide (LPS). Methods: The experimental research methods were adopted. Cells from femur and tibial bone marrow cavity of four one-week-old male Sprague-Dawley rats were identified as BMMSCs by flow cytometry, and the third passage of BMMSCs were used in the following experiments. The cells were divided into NMⅡ silenced group transfected with pHBLV-U6-ZsGreen-Puro plasmid containing small interference RNA sequence of NMⅡ gene, vector group transfected with empty plasmid, and blank control group without any treatment, and the protein expression of NMⅡ at 72 h after intervention was detected by Western blotting (n=3). The morphology of cells was observed by an inverted phase contrast microscope and cells labeled with chloromethylbenzoine (CM-DiⅠ) in vitro were observed by an inverted fluorescence microscope. Twenty 4-week-old male Sprague-Dawley rats were divided into blank control group, ALI alone group, ALI+BMMSC group, and ALI+NMⅡ silenced BMMSC group according to the random number table, with 5 rats in each group. Rats in blank control group were not treated, and rats in the other 3 groups were given LPS to induce ALI. Immediately after modeling, rats in ALI alone group were injected with 1 mL normal saline via tail vein, rats in ALI+BMMSC group and ALI+NMⅡ silenced BMMSC group were injected with 1×107/mL BMMSCs and NMⅡ gene silenced BMMSCs of 1 mL labelled with CM-DiⅠ via tail vein, and rats in blank control group were injected with 1 mL normal saline via tail vein at the same time point, respectively. At 24 h after intervention, the lung tissue was collected to observe intrapulmonary homing of the BMMSCs by an inverted fluorescence microscope. Lung tissue was collected at 24 h, in 1 week, and in 2 weeks after intervention to observe pulmonary inflammation by hematoxylin eosin staining and to observe pulmonary fibrosis by Masson staining, and the pulmonary fibrosis in 2 weeks after intervention was scored by modified Ashcroft score (n=5). The content of α-smooth muscle actin (α-SMA), matrix metalloproteinase 2 (MMP-2), and MMP-9 was detected by immunohistochemistry in 2 weeks after intervention (n=3), the activity of superoxide dismutase (SOD), malondialdehyde, myeloperoxidase (MPO) was detected by enzyme-linked immunosorbent assay at 24 h after intervention (n=3), and the protein expressions of CD11b and epidermal growth factor like module containing mucin like hormone receptor 1 (EMR1) in 1 week after intervention were detected by immunofluorescence staining (n=3). Data were statistically analyzed with one-way analysis of variance, Bonferroni method, and Kruskal-Wallis H test. Results: At 72 h after intervention, the NMⅡprotein expression of cells in NMⅡ silenced group was significantly lower than those in blank control group and vector group (with P values <0.01). BMMSCs were in long spindle shape and grew in cluster shaped like vortexes, which were labelled with CM-DiⅠ successfully in vitro. At 24 h after intervention, cell homing in lung of rats in ALI+NMⅡ silenced BMMSC group was more pronounced than that in ALI+BMMSC group, while no CM-DiⅠ-labelled BMMSCs were observed in lung of rats in blank control group and ALI alone group. There was no obvious inflammatory cell infiltration in lung tissue of rats in blank control group at all time points, while inflammatory cell infiltration in lung tissue of rats in ALI+BMMSC group and ALI+NMⅡ silenced BMMSC group was significantly less than that in ALI alone group at 24 h after intervention, and alveolar wall turned to be thinner and a small amount of congestion in local lung tissue appeared in rats of the two groups in 1 week and 2 weeks after intervention. In 1 week and 2 weeks after intervention, collagen fiber deposition in lung tissue of rats in ALI alone group, ALI+BMMSC group, and ALI+NMⅡ silenced BMMSC group was significantly aggravated compared with that in blank control group, while collagen fiber deposition in lung tissue of rats in ALI+BMMSC group and ALI+NMⅡ silenced BMMSC group was significantly improved compared with that in ALI alone group. In 2 weeks after intervention, modified Ashcroft scores for pulmonary fibrosis of rats in ALI alone group, ALI+BMMSC group, and ALI+NMⅡ silenced BMMSC group were 2.36±0.22, 1.62±0.16, 1.06±0.26, respectively, significantly higher than 0.30±0.21 in blank control group (P<0.01). Modified Ashcroft scores for pulmonary fibrosis of rats in ALI+BMMSC group and ALI+NMⅡ silenced BMMSC group were significantly lower than that in ALI alone group (P<0.01), and modified Ashcroft score for pulmonary fibrosis of rats in ALI+NMⅡ silenced BMMSC group was significantly lower than that in ALI+BMMSC group (P<0.01). In 2 weeks after intervention, the content of α-SMA in lung tissue of rats in ALI+BMMSC group and ALI+NMⅡ silenced BMMSC group were significantly decreased compared with that in ALI alone group (P<0.05 or P<0.01). The content of MMP-2 in lung tissue of rats in the 4 groups was similar (P>0.05). The content of MMP-9 in lung tissue of rats in ALI alone group was significantly increased compared with that in blank control group (P<0.01), and the content of MMP-9 in lung tissue of rats in ALI+BMMSC group and ALI+NMⅡ silenced BMMSC group was significantly decreased compared with that in ALI alone group (P<0.01). At 24 h after intervention, the activity of malondialdehyde, SOD, and MPO in lung tissue of rats in ALI alone group, ALI+BMMSC group, and ALI+NMⅡ silenced BMMSC group were significantly increased compared with that in blank control group (P<0.01), the activity of malondialdehyde in lung tissue of rats in ALI+NMⅡ silenced BMMSC group and the activity of SOD in lung tissue of rats in ALI+BMMSC group and ALI+NMⅡ silenced BMMSC group were significantly increased compared with that in ALI alone group (P<0.05 or P<0.01), and the activity of SOD in lung tissue of rats in ALI+NMⅡ silenced BMMSC group was significantly decreased compared with that in ALI+BMMSC group (P<0.01). The activity of MPO in lung tissue of rats in ALI+BMMSC group and ALI+NMⅡ silenced BMMSC group was significantly decreased compared with that in ALI alone group (P<0.01), and the activity of MPO in lung tissue of rats in ALI+NMⅡ silenced BMMSC group was significantly decreased compared with that in ALI+BMMSC group (P<0.01). In 1 week after intervention, the protein expression of CD11b in lung tissue of rats in ALI+NMⅡ silenced BMMSC group was significantly increased compared with those in the other three groups (P<0.05 or P<0.01), while the protein expressions of EMR1 in lung tissue of rats in the four groups were similar (P>0.05). Conclusions: Transplantation of NMⅡ gene silenced BMMSCs can significantly improve the activity of ECM components in the lung tissue in LPS-induced ALI rats, remodel its integrity, and enhance its antioxidant capacity, and alleviate lung injury and pulmonary fibrosis.
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Affiliation(s)
- X Yin
- Department of Burns and Plastic Surgery, Zhangjiagang First People's Hospital (the Affiliated Zhangjiagang Hospital of Soochow University), Suzhou 215600, China
| | - W F Zhou
- Department of Burns, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - W J Hou
- Department of Burns, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - M Z Fan
- Department of Burns, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - G S Wu
- Department of Burns, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - X B Liu
- Department of Burns, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - Q M Ma
- Department of Burns, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - Y S Wang
- Department of Burns, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - F Zhu
- Department of Burns, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
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12
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Hu P, Chen H, Wang LH, Jiang JB, Li JM, Tang MY, Guo YC, Zhu QF, Pu ZX, Lin XP, Ng S, Liu XB, Wang JA. Elevated N-terminal pro C-type natriuretic peptide is associated with mortality in patients undergoing transcatheter aortic valve replacement. BMC Cardiovasc Disord 2022; 22:164. [PMID: 35413789 PMCID: PMC9004019 DOI: 10.1186/s12872-022-02615-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 04/01/2022] [Indexed: 12/02/2022] Open
Abstract
Background Unlike N-terminal pro-B-type natriuretic peptide (NT-proBNP), which have been extensively studied, little is known about the role of N-terminal pro-C-type natriuretic peptide (NT-proCNP) for predicting survival post transcatheter aortic valve replacement (TAVR). Methods A total of 309 patients were included in the analysis. Patients were grouped into quartiles (Q1–4) according to the baseline NT-proCNP value. Blood for NT-proCNP analysis was obtained prior to TAVR procedure. The primary endpoint was mortality after a median follow-up of 32 months. Multivariable Cox proportional hazards regression models analyzed prognostic factors. The predictive capability was compared between NT-proBNP and NT-proCNP using receiver operator curve (ROC) analysis. Results A total of 309 subjects with the mean age of 76.8 ± 6.3 years, among whom 58.6% were male, were included in the analysis. A total of 58 (18.8%) patients died during follow-up. Cox multivariable analyses indicated society of thoracic surgeons (STS)-score was a strong independent predictor for mortality (hazard ratio (HR) 1.08, 95% confidential interval (CI) 1.05–1.12, P < 0.001). Elevated NT-proCNP was associated with a higher risk of cardiovascular mortality (HR 1.02, 95% CI 1.00–1.03, P = 0.025) and All-cause mortality (HR 1.01, 95% CI 1.00–1.03, P = 0.027), whereas NT-proBNP showed a small effect size on mortality. ROC analysis indicated that NT-proCNP was superior to NT-proBNP for TAVR risk evaluation in patients with left ventricular ejection fraction (LVEF) < 50% [(Area under the curve (AUC)-values of 0.79 (0.69; 0.87) vs. 0.59 (0.48; 0.69), P = 0.0453]. Conclusions NT-proCNP and STS-Score were the independent prognostic factors of mortality among TAVR patients. Furthermore, NT-proCNP was superior to NT-proBNP for TAVR risk evaluation in patients with LVEF < 50%. Trial registration NCT02803294, 16/06/2016. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-022-02615-8.
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Affiliation(s)
- Po Hu
- Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, China
| | - Han Chen
- Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, China
| | - Li-Han Wang
- Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, China
| | - Ju-Bo Jiang
- Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, China
| | - Jia-Min Li
- Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, 310009, Zhejiang, China
| | - Meng-Yao Tang
- Renal Division, Brigham and Women's Hospital, Boston, MA, USA.,Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Yu-Chao Guo
- Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, China
| | - Qi-Feng Zhu
- Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, China
| | - Zhao-Xia Pu
- Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, China.,Department of Echocardiography, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, China
| | - Xin-Ping Lin
- Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, China.,Department of Echocardiography, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, China
| | - Stella Ng
- Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, 310009, Zhejiang, China
| | - Xian-Bao Liu
- Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, China. .,Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, 310009, Zhejiang, China.
| | - Jian-An Wang
- Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, China. .,Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, 310009, Zhejiang, China.
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13
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Ding HR, Qian J, Tong J, Tang JN, Lin H, Chu JP, Zhu GQ, Chen F, Liu XB. HSP90 pathway in intermediate mononuclear cells causes plaque erosion via induction of neutrophil hyper-responsiveness. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Aim
To explore the function(s) of HSP90 in intermediate monocyte-mediated plaque erosion.
Materials and methods
We used single-cell RNA sequencing to map cardiac immune response composition in patients with plaque rupture and plaque erosion. By focusing our analyses on CD14 positive monocytes, we obtained a higher resolution identification of the immune cell subsets in patients experiencing plaque erosion and rupture. We interpreted our findings with analyses using gene ontology (GO) enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) databases and by performing receiver operating characteristic (ROC) curve analysis.
Results
Single-cell sequencing analysis of mononuclear cells in the peripheral blood of five ACS patients experiencing plaque erosion and rupture confirmed that CD14 positive monocytes were the main immune cells leading to ACS. Interestingly, our results suggested a significant increase in the proportion of atypical monocytes (C4 subsets) in patients with plaque rupture, which was a novel finding. This increase may be caused by increased migration of atypical monocytes into a plaque during plaque rupture. We found that intermediate monocyte activation was most obvious in patients with plaque erosion (C1, C10, and C11), and the proportion of C1 subgroup monocytes (FCGR3B/CMTM2 double strong positive; subsequently defined as intermediate monocytes) was very high. To further explore the role of C1 subgroup intermediate monocytes in plaque erosion, GO and KEGG pathway analyses were performed. GO analysis indicated that C1 subgroup intermediate monocytes are highly involved in neutrophil metabolism. Because neutrophils are the main effector cells that induce plaque erosion, we reasonably infer that intermediate monocytes can induce plaque erosion. KEGG pathway analysis indicated that all subtypes of HSP90 were highly expressed in C1 subgroup intermediate monocytes. We thus collected peripheral blood from ACS patients with plaque rupture (n=150) and plaque erosion (n=150) for mononuclear cell transcriptomics and intracellular proteomics analysis. ROC curve analysis demonstrated that the area under the curve for HSP90-based prediction was 0.86, indicating that HSP90 could be used to predict if patients would experience plaque erosion.
Conclusion
Activation of intermediate mononuclear HSP90 expression may be the crucial event that induces neutrophil hyper-responsiveness and leads to plaque erosion.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): China,Shanghai Science and Technology Commission
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Affiliation(s)
- H R Ding
- Tongji Hospital affiliated to Tongji University, Department of Cardiology, Shanghai, China
| | - J Qian
- Tongji Hospital affiliated to Tongji University, Department of Cardiology, Shanghai, China
| | - J Tong
- Tongji Hospital affiliated to Tongji University, Department of Cardiology, Shanghai, China
| | - J N Tang
- Tongji Hospital affiliated to Tongji University, Department of Cardiology, Shanghai, China
| | - H Lin
- Tongji Hospital affiliated to Tongji University, Department of Cardiology, Shanghai, China
| | - J P Chu
- Tongji Hospital affiliated to Tongji University, Department of Cardiology, Shanghai, China
| | - G Q Zhu
- Tongji Hospital affiliated to Tongji University, Department of Cardiology, Shanghai, China
| | - F Chen
- Tongji Hospital affiliated to Tongji University, Department of Cardiology, Shanghai, China
| | - X B Liu
- Tongji Hospital affiliated to Tongji University, Department of Cardiology, Shanghai, China
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Zhang ZH, Lu XW, Qin JB, Zhao Z, Wang RH, Ye KC, Li WM, Yin MY, Liu XB. [ In situ semiconductor laser fenestration of type A aortic dissection during thoracic endovascular aortic repair]. Zhonghua Yi Xue Za Zhi 2021; 101:2328-2332. [PMID: 34333950 DOI: 10.3760/cma.j.cn112137-20201222-03426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the feasibility, efficacy and safety of semiconductor laser in situ fenestration of type A aortic dissection during thoracic endovascular aortic repair. Methods: The clinical data of 68 patients with type A aortic dissection treated by semiconductor laser in situ fenestration from June 2016 to January 2020 in Department of Vascular Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiaotong University were analyzed retrospectively. Of the patients, 45 were male, 23 were female, the mean age was (52±14) years. The technical success rate and complication rates were assessed. Results: The technical success rate of 68 patients was 92.6% (63/68), only 5 patients failed due to the complex aortic arch type, 3 patients underwent chimney stent implantation, 2 patients underwent artificial vessel bypass. During the perioperative period, 1 patient died due to severe pulmonary infection, 4 patients developed neurological symptoms such as cerebral infarction after surgery, and the remaining patients had no related complications. Postoperative CTA follow-up indicated that the primary intercalation rupture was completely closed, and the main and branch stents were patency, 8 (8.8%) type Ⅰ leakage were occurred. Conclusion: It showed that in situ semiconductor laser fenestration is a feasible, effective and safe method to treat type A aortic dissection.
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Affiliation(s)
- Z H Zhang
- Department of Vascular Surgery, the Affiliated Central Hospital of Qingdao University, Qingdao 266042, China
| | - X W Lu
- Department of Vascular Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai JiaoTong University, School of Medicine, Shanghai 200011, China
| | - J B Qin
- Department of Vascular Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai JiaoTong University, School of Medicine, Shanghai 200011, China
| | - Z Zhao
- Department of Vascular Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai JiaoTong University, School of Medicine, Shanghai 200011, China
| | - R H Wang
- Department of Vascular Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai JiaoTong University, School of Medicine, Shanghai 200011, China
| | - K C Ye
- Department of Vascular Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai JiaoTong University, School of Medicine, Shanghai 200011, China
| | - W M Li
- Department of Vascular Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai JiaoTong University, School of Medicine, Shanghai 200011, China
| | - M Y Yin
- Department of Vascular Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai JiaoTong University, School of Medicine, Shanghai 200011, China
| | - X B Liu
- Department of Vascular Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai JiaoTong University, School of Medicine, Shanghai 200011, China
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15
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Li W, Niu YL, Zhao Z, Ren HY, Li GC, Liu XB, Gao Y, Wang J, Lu L, Liu QY. [Meteorological factors and related lag effects on scrub typhus in southwestern Yunnan]. Zhonghua Liu Xing Bing Xue Za Zhi 2021; 42:1235-1239. [PMID: 34814537 DOI: 10.3760/cma.j.cn112338-20200828-01106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Objective: To analyze the influence and related lag effects of meteorological factors on scrub typhus (ST) in southwestern Yunnan, to provide a reference for the corresponding prevention and treatment measures. Methods: Data on ST and meteorology in Yunnan province from 2007 to 2018 were collected. A distributed lag nonlinear model was conducted to study the cumulative lag effects of temperature, relative humidity, and rainfall on ST. Results: From 2007-2018, a total of 19 975 ST cases were reported in southwestern Yunnan. Weekly mean temperature, mean relative humidity, and the risk of ST all showed J-shaped curves. The cumulative risk of ST increased with mean temperature >23 ℃, mean relative humidity >80%, and cumulative rainfall between 20 and 60 mm or over 100 mm, weekly. Taking the median value as the reference, higher temperature (22.27 ℃, 23.45 ℃), relative humidity (80.14%, 84.38%) and rainfall (37.17 mm, 74.42 mm) all increased the risk of disease while lower temperature (11.22 ℃,14.83 ℃), relative humidity (53.18%,65.36%) and rainfall (0.00 mm,0.55 mm) showed opposite effects. The temperature-lag effect lasted for 10 and 16 weeks, respectively, with ST's risk the highest during the week of exposure. Humidity-lag effects usually last for 10 and 17 weeks. The lag effect of rainfall lasted for 25 weeks, while the disease's risk was the highest in the 4th week. Conclusion: Factors as temperature, relative humidity, and precipitation showed nonlinear and lag effects on ST. High temperature, high relative humidity, and an appropriate amount of rainfalls increase the risk of ST. The authorities of public health should implement effective prevention and control measures according to meteorological conditions.
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Affiliation(s)
- W Li
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Y L Niu
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China Beijing Center for Disease Prevention and Control, Beijing 100013, China
| | - Z Zhao
- Department of Epidemiology, School of Public Health, Shandong University, Ji'nan 250012, China
| | - H Y Ren
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China
| | - G C Li
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - X B Liu
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Y Gao
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - J Wang
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - L Lu
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Q Y Liu
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
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16
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Fan JQ, Liu XB, Guo YC, Wang LH, Lin XP, Gao F, Zhu QF, He W, Chen YW, Chen HL, Wang JA. [Next-day discharge after minimalist transcatheter aortic valve replacement: a case report]. Zhonghua Xin Xue Guan Bing Za Zhi 2021; 49:510-512. [PMID: 34034387 DOI: 10.3760/cma.j.cn112148-20210402-00300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- J Q Fan
- Department of Cardiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - X B Liu
- Department of Cardiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Y C Guo
- Department of Cardiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - L H Wang
- Department of Cardiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - X P Lin
- Department of Cardiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - F Gao
- Department of Cardiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Q F Zhu
- Department of Cardiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - W He
- Department of Cardiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Y W Chen
- Department of Cardiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - H L Chen
- Department of Cardiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - J A Wang
- Department of Cardiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
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17
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Lin XP, Zhu QF, Liu XB, Wang JA. [Current status and progress of transcatheter mitral regurgitation interventional therapy]. Zhonghua Xin Xue Guan Bing Za Zhi 2021; 49:425-431. [PMID: 34034376 DOI: 10.3760/cma.j.cn112148-20210211-00148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- X P Lin
- Department of Cardiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Q F Zhu
- Department of Cardiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - X B Liu
- Department of Cardiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - J A Wang
- Department of Cardiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
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18
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Liu XB, Gao ZY, Jin S, Gao B, Wang MS, Wu T, Li SB, Tong Q, Zhang JC. [Comparative study on metagenomics of esophageal flora in elderly and middle-aged esophageal squamous cell carcinoma patients]. Zhonghua Yu Fang Yi Xue Za Zhi 2021; 55:371-378. [PMID: 33730830 DOI: 10.3760/cma.j.cn112150-20200707-00984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the flora characteristics and differences of esophageal tissues between elderly esophageal squamous cell carcinoma (ESCC) patients and young and middle-aged ESCC patients, so as to assist in studying the potential biomarkers of elderly ESCC patients. Methods: In this study, a retrospective study was adopted. 72 ESCC patients diagnosed in Taihe Hospital, Shiyan City, Hubei Province from July 2018 to July 2019 were selected, including 49 patients in the elderly group (≥ 60 years old, 40 males and 9 females), 23 patients in the young and middle-aged group (<60 years old, 21 males and 2 females). In the same period, 20 healthy persons without abnormal gastroscopy in endoscopy center were selected as the control group (aged 35-78 years old, median age 57 years old, 16 males and 4 females). The genomic DNA was extracted from the affected esophageal tissues of patients with ESCC and the middle esophageal samples of the control group. The V4 hypervariable region of bacterial 16SrRNA gene sequence was amplified. Illumina HiSeq sequencing technology was adopted. The flora characteristics of elderly, young and middle-aged ESCC patients was compared and analyzed. QIIME and Rstudio software were used to analyze the sequence data, and nonparametric Kruskal-Wallis test or Wilcoxon rank sum test were used for statistical methods. Results: Shannon index [5.17 (4.53, 5.95) vs. 4.79 (3.74, 5.97)], Simpson index [0.94 (0.91, 0.96) vs. 0.92 (0.83, 0.96)] and Chao1 index [343.55 (259.76, 570.59) vs. 329.16 (268.88, 648.00)] were similar in flora of two groups, and there was no significant difference (Z=-0.791, -1.057, -0.380, all P>0.05). There was no significant difference in β-diversity between the elderly group and the young and middle-aged group (PC1=19.14%, PC2=6.95%, PPC1=0.67, PPC2=0.42). At the phyla level, the top 5 phyla in abundance were as follows: Firmicutes, Bacteroidetes, Proteobacteria, Actinobacteria and Fusobacteria in the young and middle-aged group, while the top 5 phyla in abundance were as follows: Firmicutes, Bacteroidetes, Proteobacteria, Fusobacteria and Actinobacteria in the elderly group; the significant difference between the two groups was Fusobacteria (Q=0.596, P<0.05). At the genus level, the top 5 genera in the young and middle-aged group in abundance were as follows: Prevotella, Bacteroides, Streptococcus, Selenomonas and Veillonella. In the elderly group, Prevotella, Bacteroides, Streptococcus, Selenomonas and Haemophilus were the top 5 in abundance, and there were significant difference in Fusobacterium between the two groups (Q=0.938, P<0.05). PICRUSt function prediction showed that the abundance of Aminoacyl.tRNA.biosynthesis, Nucleotide.excision.repair, RNA.polymerase, Ribosome, Clavulanic.acid.biosynthesis, Photosynthesis and Photosynthesis. proteins in the elderly group were lower than those in the young and middle-aged group (all Q=0.734, P<0.05). Conclusion: There is no significant difference in α-diversity and β-diversity between elderly ESCC patients and young and middle-aged patients, but the abundance of Fusobacterium flora increased.
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Affiliation(s)
- X B Liu
- Department of Gastroenterology, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China Hubei Key Laboratory of Embryonic Stem Cell Research, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China
| | - Z Y Gao
- Department of Oncology, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China
| | - S Jin
- Department of Gastroenterology, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China
| | - B Gao
- Department of Laboratory, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China
| | - M S Wang
- Department of Gastroenterology, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China
| | - T Wu
- Department of Gastroenterology, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China
| | - S B Li
- Department of Gastroenterology, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China
| | - Q Tong
- Department of Gastroenterology, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China
| | - J C Zhang
- Department of Laboratory, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China
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19
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Li HH, Liu XB, Kong MJ, Gao F, Wang LH, Lin XP, Hu YH, Jiang J, Pu ZX, Zhao J, Zhou QJ, Wen CJ, Wang JA. [A case report of Impella-assisted treatment for severe aortic regurgitation during the perioperative period of transcatheter aortic valve replacement]. Zhonghua Xin Xue Guan Bing Za Zhi 2021; 49:179-181. [PMID: 33611906 DOI: 10.3760/cma.j.cn112148-20200309-00177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- H H Li
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - X B Liu
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - M J Kong
- Department of Cardiac Surgery, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - F Gao
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - L H Wang
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - X P Lin
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Y H Hu
- Department of Intensive Care Unit, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - J Jiang
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Z X Pu
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - J Zhao
- Department of Anesthesiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Q J Zhou
- Department of Radiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - C J Wen
- Department of Cardiovascular Intervention Center, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - J A Wang
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
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20
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Jiang JB, Liu XB, Gao F, Fan JJ, Lin XP, Pu ZX, Kong MJ, Dong AQ, Xu Y, Zhou QJ, Wang JA. [A case report of transcatheter aortic valve replacement for severe aortic regurgitation in a patient with Behcet disease]. Zhonghua Xin Xue Guan Bing Za Zhi 2021; 49:71-73. [PMID: 33429490 DOI: 10.3760/cma.j.cn112148-20200225-00127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- J B Jiang
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - X B Liu
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - F Gao
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - J J Fan
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - X P Lin
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Z X Pu
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - M J Kong
- Department of Cardiac Surgery, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - A Q Dong
- Department of Cardiac Surgery, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Y Xu
- Department of Anesthesiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Q J Zhou
- Department of Radiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - J A Wang
- Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
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21
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Chiam PTL, Hayashida K, Watanabe Y, Yin WH, Kao HL, Lee MKY, Posas FE, Chandavimol M, Buddhari W, Dy TC, Nguyen NQ, Kim WJ, Chang K, Lin MS, Lam YY, Pham HM, Yahaya SA, Ho KW, Pan W, Liu XB, Wang J, Kim HS, Chen M. Sex differences in patients undergoing transcatheter aortic valve replacement in Asia. Open Heart 2021; 8:openhrt-2020-001541. [PMID: 33419935 PMCID: PMC7798412 DOI: 10.1136/openhrt-2020-001541] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 12/12/2020] [Accepted: 12/14/2020] [Indexed: 02/05/2023] Open
Abstract
Objectives Transcatheter aortic valve replacement (TAVR) is increasingly performed. Physically small Asians have smaller aortic root and peripheral vessel anatomy. The influence of gender of Asian patients undergoing TAVR is unknown and may affect outcomes. The aim of this study was to assess sex differences in Asian patients undergoing TAVR. Methods Patients undergoing TAVR from eight countries were enrolled. In this retrospective analysis, we examined differences in characteristics, 30-day clinical outcomes and 1-year survival between female and male Asian patients. Results Eight hundred and seventy-three patients (54.4% women) were included. Women were older, smaller and had less coronary artery and lung disease but tended to have higher logistic EuroSCOREs. Smaller prostheses were used more often in women. Major vascular complications occurred more frequently in women (5.5% vs 1.8%, p<0.01); however, 30-day stroke and mortality (women vs men: 1.5% vs 1.6%, p=0.95% and 4.3% vs 3.4%, p=0.48) were similar. Functional status improvement was significant and comparable between the sexes. Conduction disturbance and permanent pacemaker requirements (11.2% vs 9.0%, p=0.52) were also similar as was 1-year survival (women vs men: 85.6% vs 88.2%, p=0.25). The only predictors of 30-day mortality were major vascular injury in women and age in men. Conclusions Asian women had significantly smaller stature and anatomy with some differences in clinical profiles. Despite more frequent major vascular complications, women had similar 30-day stroke or mortality rates. Functional status improvement was significant and comparable between the sexes. Conduction disturbance and permanent pacemaker requirements were similar as was 1-year survival.
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Affiliation(s)
- Paul T L Chiam
- The Heart and Vascular Centre, Mount Elizabeth Medical Centre, Singapore
| | - Kentaro Hayashida
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Yusuke Watanabe
- Department of Cardiology, Teikyo University Hospital, Tokyo, Japan
| | - Wei-Hsian Yin
- Division of Cardiology, Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan
| | - Hsien-Li Kao
- Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Michael K Y Lee
- Department of Cardiology, Queen Elizabeth Hospital, Hong Kong, Hong Kong
| | | | | | | | - Timothy C Dy
- Heart Institute, Chinese General Hospital and Medical Centre, Manila, Philippines
| | - Ngoc Quang Nguyen
- Department of Cardiology, Vietnam National Heart Institute, Hanoi, Vietnam
| | - Won Jang Kim
- Department of Cardiology, CHA Bundang Medical Centre, Seoul, Republic of Korea
| | - Kiyuk Chang
- Cardiology, The Catholic University of Korea Seoul St. Mary's Hospital, Seoul, Republic of Korea
| | - Mao-Shin Lin
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yat-Yin Lam
- Hong Kong Asia Heart Centre, Canossa Hospital, Hong Kong, Hong Kong
| | - Hung Manh Pham
- Department of Cardiology, Vietnam National Heart Institute, Hanoi, Vietnam
| | | | - Kay Woon Ho
- Department of Cardiology, National Heart Centre Singapore, Singapore
| | - Wenzhi Pan
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xian-Bao Liu
- Department of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jian'an Wang
- Cardiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Hyo Soo Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Mao Chen
- Department of Cardiology, Sichuan University West China Hospital, Chengdu, China
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22
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Liu XB, Fan JQ, Xu YM, Guo YC, Li C, Xu JG, Wang JA. Myocardial infarction detected by a smartwatch after transcatheter aortic valve replacement during the COVID-19 pandemic. World J Emerg Med 2021; 12:247-248. [PMID: 34141046 DOI: 10.5847/wjem.j.1920-8642.2021.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Xian-Bao Liu
- Department of Cardiology, the Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China.,Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Jia-Qi Fan
- Department of Cardiology, the Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Ye-Ming Xu
- Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Yu-Chao Guo
- Department of Cardiology, the Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Cheng Li
- Department of Cardiology, the Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Jian-Guo Xu
- Department of Electrocardiography, the Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Jian-An Wang
- Department of Cardiology, the Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China.,Zhejiang University School of Medicine, Hangzhou 310058, China
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23
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Lv F, Pan XH, Fan JQ, Wang LH, Yang DD, Lin XP, Li HJ, Zhu QF, Liu XB, Wang JA. A case of a successful post-transcatheter aortic valve replacement His bundle pacing. World J Emerg Med 2021; 12:157-159. [PMID: 33728011 DOI: 10.5847/wjem.j.1920-8642.2021.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Fei Lv
- Department of Cardiology, the Second Affi liated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Xiao-Hong Pan
- Department of Cardiology, the Second Affi liated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Jia-Qi Fan
- Department of Cardiology, the Second Affi liated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Li-Han Wang
- Department of Cardiology, the Second Affi liated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Dan-Dan Yang
- Department of Cardiology, the Second Affi liated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Xin-Ping Lin
- Department of Cardiology, the Second Affi liated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Hua-Jun Li
- Department of Cardiology, the Second Affi liated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Qi-Feng Zhu
- Department of Cardiology, the Second Affi liated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Xian-Bao Liu
- Department of Cardiology, the Second Affi liated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Jian-An Wang
- Department of Cardiology, the Second Affi liated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
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Tang CQ, Xu L, Liu XB, Xu DY, Wu GS, Du TJ, Cheng DS, Zhu SH, Xiao SC. [One case of atypical septic shock with acute pulmonary edema in a patient with extensive burn]. Zhonghua Shao Shang Za Zhi 2020; 36:1075-1077. [PMID: 33238692 DOI: 10.3760/cma.j.cn501120-20190828-00365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A 25-year-old man with extensive burn due to industrial dust explosion was admitted to the First Affiliated Hospital of Naval Medical University on 16th October, 2018. Four days after the first skin grafting and vacuum sealing drainage surgery, the patient developed signs of uncontrolled severe inflammation and shock. However, several atypical manifestations interfered the diagnosis of septic shock. After giving emergency treatment including fluid resuscitation, broad-spectrum antibiotics, and administration of vasopressor agents, the patient's condition was alleviated, but quickly relapsed and deteriorated, with acute pulmonary edema appeared in the evening of the same day. Finally, the condition was reversed by completely removing the negative pressure devices on upper limbs and thorough dressing change. This case suggests that the diagnosis and treatment of infection in patients with extensive burn need comprehensive analysis. Timely intervention of the wound is the key to control the exacerbation of sepsis. In addition, the possibility of pulmonary edema in patients with sepsis should be on high alert.
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Affiliation(s)
- C Q Tang
- Center of Burns and Trauma, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - L Xu
- Center of Burns and Trauma, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - X B Liu
- Center of Burns and Trauma, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - D Y Xu
- Center of Burns and Trauma, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - G S Wu
- Center of Burns and Trauma, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - T J Du
- Center of Burns and Trauma, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - D S Cheng
- Center of Burns and Trauma, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - S H Zhu
- Center of Burns and Trauma, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - S C Xiao
- Center of Burns and Trauma, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
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25
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Liu XB, Jia ZX, Xia SJ, He L, Lu SX, Guo XY, Li SN, Liu N, Jiang CX, Sang CH, Tang RB, Long DY, Yu RH, Bai R, Wu JH, Du X, Dong JZ, Ma CS. [The thromboembolism risk of low-risk atrial fibrillation patients with different clinical characteristics]. Zhonghua Xin Xue Guan Bing Za Zhi 2020; 48:735-739. [PMID: 32957755 DOI: 10.3760/cma.j.cn112148-20200306-00164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: This study explored the thromboembolism risk of low-risk atrial fibrillation (AF) patients (CHA2DS2-VASc score of 0 or 1 for male and 1 or 2 for female) with different clinical characteristics to provide the basis for anticoagulation decision-making in these patients. Methods: We prospectively enrolled consecutive 2 862 nonvalvular low-risk AF patients between August 2011 to December 2018 in China-AF (China Atrial Fibrillation Registry) Study, their CHA2DS2-VASc score was 0 or 1 for male and 1 or 2 for female. According to their age, sex, presence or absence of hypertension, diabetes mellitus, congestive heart failure, and vascular disease at the time of enrolling, patients were divided into CHA2DS2-VASc score 0 score group, 1 score group, and 2 score group. Patients were followed up every 6 months by outpatient clinic visit or telephone interview. The outcome was a thromboembolic event, including ischemic stroke and systemic embolism. Univariate Cox regression analysis was used to compare the thromboembolism risk between the patients with different risk factors and CHA2DS2-VASc score 0 group. Results: A total of 2 862 low-risk atrial fibrillation patients were enrolled in this study. 915 patients (32.0%) were female, and age was (55.0±10.7) years old. There were 933 patients (32.6%) in CHA2DS2-VASc score 0 group, 1 401 patients (49.0%) in score 1 group and 528 patients (18.5%) in score 2 group. During follow-up (median 1.5 years, 5 811.82 person-years), 33 cases of thromboembolic events were recorded, the annual rate of thromboembolism was 0.57% (95%CI 0.40%~0.80%). The number of thromboembolic events in patients with CHA2DS2-VASc score 0, 1 and 2 were 8, 11 and 14, respectively, and the annual thromboembolism event rates were 0.40% (95%CI 0.20%-0.81%), 0.39% (95%CI 0.22%-0.71%) and 1.34% (95%CI 0.80%-2.27%), respectively. The risk of thromboembolism of CHA2DS2-VASc score 2 group (HR=3.53, 95%CI 1.48-8.44; P=0.005), especially female patients aged 65-74 years in CHA2DS2-VASc score 2 group (HR=2.67, 95%CI 1.63-4.38; P<0.000) was significantly higher than that in patients of CHA2DS2-VASc score 0 group. Conclusion: Low-Risk Atrial Fibrillation patients with CHA2DS2-VASc score 2, especially female patients aged 65-74 years old with CHA2DS2-VASc score 2 are at higher risk of thromboembolism in low-risk AF patients. For such patients, intensified oral anticoagulant therapy might be helpful to reduce the risk of thrombolism.
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Affiliation(s)
- X B Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing 100029, China
| | - Z X Jia
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing 100029, China
| | - S J Xia
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing 100029, China
| | - L He
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing 100029, China
| | - S X Lu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing 100029, China
| | - X Y Guo
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing 100029, China
| | - S N Li
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing 100029, China
| | - N Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing 100029, China
| | - C X Jiang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing 100029, China
| | - C H Sang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing 100029, China
| | - R B Tang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing 100029, China
| | - D Y Long
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing 100029, China
| | - R H Yu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing 100029, China
| | - R Bai
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing 100029, China
| | - J H Wu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing 100029, China
| | - X Du
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing 100029, China
| | - J Z Dong
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing 100029, China
| | - C S Ma
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing 100029, China
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Hou MM, Mao XW, Liu XB, Liu YQ, Bi XY, Hou XJ. Novel c.971A>G mutation in the HTRA1 gene in a Chinese family with CARASIL. J BIOL REG HOMEOS AG 2020; 34:1407-1410. [PMID: 32895092 DOI: 10.23812/19-480-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- M M Hou
- Department of Neurology, Shanghai Changhai Hospital affiliated to Second Military Medical University, People's Republic of China
| | - X W Mao
- Department of Neurology, Shanghai Changhai Hospital affiliated to Second Military Medical University, People's Republic of China
| | - X B Liu
- Department of Neurology, Shanghai Changhai Hospital affiliated to Second Military Medical University, People's Republic of China
| | - Y Q Liu
- Department of Neurology, Shanghai Changhai Hospital affiliated to Second Military Medical University, People's Republic of China
| | - X Y Bi
- Department of Neurology, Shanghai Changhai Hospital affiliated to Second Military Medical University, People's Republic of China
| | - X J Hou
- Department of Neurology, Shanghai Changhai Hospital affiliated to Second Military Medical University, People's Republic of China
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Liu XB, Xia H, Wang G, Zhang W, Hu Y, Zhang J. Propofol relieves oxidative stress response of cerebral ischemiareperfusion injury through SIRT1 signaling pathway. J BIOL REG HOMEOS AG 2020; 34:435-443. [PMID: 32529818 DOI: 10.23812/20-65-a-36] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This study explored the effects of propofol on the cognitive function and expressions of superoxide dismutase (SOD) and malondialdehyde (MDA) through the silent information regulator 1 (SIRT1) signaling pathway during cerebral ischemia-reperfusion (I/R) injury. C57BL/6J mice were used and divided into Sham group, I/R group (I/R model established via ligation of artery) and Treated group (peritoneal injection of propofol) according to different treatments. The memory ability of mice was evaluated using Morris water maze test, and the motor coordination was assessed using Rota rod test and oblique beam walking test. The brain tissues were prepared into embedded sections, and then the pathological changes in brain neurons were detected via hematoxylin-eosin (HE) staining, and the changes in apoptosis of brain tissues were detected via flow cytometry. Moreover, after the mice were anesthetized and sacrificed, the brain tissues were isolated and whole blood was collected. Then the changes in SIRT1 protein were determined using Western blotting, and the changes in MDA and SOD activity were determined through biochemical assays. The results of Morris water maze test and elevated plus-maze test revealed that transfer latency time (TLT) was significantly prolonged, and escape latency time (ELT) was significantly shortened in the I/R group compared with those in Sham group (*P<0.05), indicating memory impairment after cerebral I/R injury. TLT was shortened, and ELT was significantly prolonged in the Treated group compared with those in I/R group (#P<0.05). In Rota rod test, the falling down time was obviously shorter in the I/R group than in the Sham group (*P<0.05), while it was obviously longer in the Treated group than that in the I/R group (#P<0.05). Compared with the Sham group, the I/R group had neurological impairment, manifested as the evident increase in motor performance score (*P<0.05), and the motor performance score in the Treated group was evidently lower than that in the I/R group (#P<0.05). The apoptosis was markedly enhanced in the I/R group (*P<0.05), while it was markedly weakened in the Treated group (#P<0.05) compared with that in the Sham group. In addition, the results of Western blotting showed that the expression of SIRT1 was evidently higher in I the /R group than that in the Sham group, while it evidently declined after treatment with propofol (#P<0.05).
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Affiliation(s)
- X B Liu
- Department of Anesthesiology, Beijing Jishuitan Hospital, Beijing, China
| | - H Xia
- Department of Anesthesiology, Dongfang Hospital Beijing University of Chinese Medicine, Beijing, China
| | - G Wang
- Department of Anesthesiology, Beijing Jishuitan Hospital, Beijing, China
| | - W Zhang
- Department of Anesthesiology, Beijing Jishuitan Hospital, Beijing, China
| | - Y Hu
- Department of Anesthesiology, Beijing Jishuitan Hospital, Beijing, China
| | - J Zhang
- Department of Anesthesiology, Dongzhimen Hospital Beijing University of Chinese Medicine, Beijing, China
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Jiang J, Tian NL, Cui HB, Li CL, Liu XB, Dong L, Sun Y, Chen XM, Chen SL, Xu B, Wang JA. Post-dilatation improves stent apposition in patients with ST-segment elevation myocardial infarction receiving primary percutaneous intervention: A multicenter, randomized controlled trial using optical coherence tomography. World J Emerg Med 2020; 11:87-92. [PMID: 32076473 DOI: 10.5847/wjem.j.1920-8642.2020.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Stent failure is more likely in the lipid rich and thrombus laden culprit lesions underlying ST-segment elevation myocardial infarction (STEMI). This study assessed the effectiveness of post-dilatation in primary percutaneous coronary intervention (pPCI) for acute STEMI. METHODS The multi-center POST-STEMI trial enrolled 41 consecutive STEMI patients with symptom onset <12 hours undergoing manual thrombus aspiration and Promus Element stent implantation. Patients were randomly assigned to control group (n=20) or post-dilatation group (n=21) in which a non-compliant balloon was inflated to >16 atm pressure. Strut apposition and coverage were evaluated by optical coherence tomography (OCT) after intracoronary verapamil administration via thrombus aspiration catheter, post pPCI and at 7-month follow-up. The primary endpoint was rate of incomplete strut apposition (ISA) at 7 months after pPCI. RESULTS There were similar baseline characteristics except for stent length (21.9 [SD 6.5] mm vs. 26.0 [SD 5.8] mm, respectively, P=0.03). In post-dilatation vs. control group, ISA rate was lower (2.5% vs. 4.5%, P=0.04) immediately after pPCI without affecting final TIMI flow 3 rate (95.2% vs. 95.0%, P>0.05) or corrected TIMI frame counts (22.6±9.4 vs. 22.0±9.7, P>0.05); and at 7-month follow-up (0.7% vs. 1.8%, P<0.0001), the primary study endpoint, with similar strut coverage (98.5% vs. 98.4%, P=0.63) and 1-year rate of major adverse cardiovascular events (MACE). CONCLUSION In STEMI patients, post-dilatation after stent implantation and thrombus aspiration improved strut apposition up to 7 months without affecting coronary blood flow or 1-year MACE rate. Larger and longer term studies are warranted to further assess safety (ClinicalTrials.gov identifier: NCT02121223).
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Affiliation(s)
- Jun Jiang
- Department of Cardiology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Nai-Liang Tian
- Department of Cardiology, Nanjing First Hospital, Nanjing, China
| | - Han-Bin Cui
- Department of Cardiology, Ningbo First Hospital, Ningbo, China
| | - Chang-Ling Li
- Department of Cardiology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xian-Bao Liu
- Department of Cardiology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Liang Dong
- Department of Cardiology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Yong Sun
- Department of Cardiology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xiao-Min Chen
- Department of Cardiology, Ningbo First Hospital, Ningbo, China
| | - Shao-Liang Chen
- Department of Cardiology, Nanjing First Hospital, Nanjing, China
| | - Bo Xu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Beijing, China
| | - Jian-An Wang
- Department of Cardiology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
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Ren KD, Pu ZX, Yu L, Gao F, Wang LH, Ng S, Jiang JB, Li HJ, Xu Y, He W, Yan M, Liu XB, Wang JA. The first two cases of transcatheter mitral valve repair with ARTO system in Asia. World J Emerg Med 2020; 11:33-36. [PMID: 31893001 DOI: 10.5847/wjem.j.1920-8642.2020.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND MAVERIC (Mitral Valve Repair Clinical Trial) validates the safety and efficacy of the ARTO system. We here report the first two successful cases of utilizing the ARTO system in patients with symptomatic heart failure (HF) with functional mitral regurgitation (FMR) in Asia. METHODS Two patients, aged 70 and 63, had severe HF with FMR. Transesophageal echocardiography confirmed that the left ventricular ejection fractions were less than 50% with severe mitral regurgitation (MR) in both patients. Optimizing drug treatment could not mitigate their symptoms. Therefore, we used the ARTO system to repair the mitral valve for these patients on March 5 and 6, 2019, respectively. RESULTS Mitral valve repairs using the ARTO system were successfully performed under general anaesthesia for these two patients. MR was decreased immediately after the procedures in both patients. The 30-day and 3-month transthoracic echocardiography (TTE) revealed a moderate to severe MR in both patients, and the New York Heart Association (NYHA) scales were also partially improved. CONCLUSION The first two cases in Asia indicate that the ARTO system is feasible for patients with heart failure with FMR, and the patient selection appears to be crucial.
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Affiliation(s)
- Kai-da Ren
- Cardiovascular Department, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Zhao-Xia Pu
- Cardiovascular Department, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Lei Yu
- Cardiovascular Department, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Feng Gao
- Cardiovascular Department, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Li-Han Wang
- Cardiovascular Department, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Stella Ng
- Cardiovascular Department, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Ju-Bo Jiang
- Cardiovascular Department, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Hua-Jun Li
- Cardiovascular Department, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Yong Xu
- Cardiovascular Department, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Wei He
- Cardiovascular Department, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Min Yan
- Cardiovascular Department, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Xian-Bao Liu
- Cardiovascular Department, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Jian-An Wang
- Cardiovascular Department, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
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Wang JA, Liu XB, Lin XP, Jiang JB, Jiang J, Pu ZX, Wang LH, Li HJ, Lv F. Alcohol septal ablation for the treatment of hypertrophic obstructive cardiomyopathy in a patient with prior transcatheter aortic valve replacement. Cardiol Plus 2020. [DOI: 10.4103/cp.cp_12_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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31
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Man K, Lo CM, Liu XB. M2 macrophages on tumour growth and metastasis in hepatocellular carcinoma. Hong Kong Med J 2019; 25 Suppl 9:35-39. [PMID: 31889034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Affiliation(s)
- K Man
- Department of Surgery, The University of Hong Kong
| | - C M Lo
- Department of Surgery, The University of Hong Kong
| | - X B Liu
- Department of Surgery, The University of Hong Kong
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Wang HF, Jiang YZ, Ren LQ, Liu XB, Zhang HX, Hu XM. [The Role of Soluble HLA-G in the Vertical Transmission of Toxoplasma gondii]. Mol Biol (Mosk) 2019; 53:303-310. [PMID: 31099780 DOI: 10.1134/s0026898419020162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 07/17/2018] [Indexed: 11/23/2022]
Abstract
Soluble human leukocyte antigen G (sHLA-G) plays a key role in pregnancy through interaction with decidual natural killer (dNK) cell inhibitory receptors at the maternal-fetal interface. To demonstrate the possible role of sHLA-G during the pregnancy with Toxoplasma gondii infection, we compared the concentration of a murine functional homolog of sHLA-G, Qa-2, in T. gondii infected and non-infected pregnant C57BL/6 mice, and that of sHLA-G in BeWo culture supernatant. In addition, the levels of KIR2DL4 expressed on human dNK cells and NKG2A in pregnant mice were evaluated. We showed that T. gondii infection result in significant increase in the level of Qa-2 and NKG2A in pregnant mice. sHLA-G and KIR2DL4 in human samples were also significantly upregulated under the condition of T. gondii infection. The further treatment with sHLA-G antibody could reduce the expression level of KIR2DL4 which was upregulated by T. gondii infection. In summary, sHLA-G could upregulate the expression level of KIR2DL4 which lead to excessive immunological tolerance, and further contributed to T. gondii immunity escaping and affecting fetus via vertical transmission which may lead to adverse outcomes.
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Affiliation(s)
- H F Wang
- Department of Immunology, Binzhou Medical University, Yantai, Shandong Province, 264003 China.,Department of Immunology, Shandong College of Traditional Chinese Medicine, Yantai, Shandong Province, 264003 China
| | - Y Z Jiang
- Department of Immunology, Binzhou Medical University, Yantai, Shandong Province, 264003 China
| | - L Q Ren
- Medical and Pharmaceutical Research Center, Binzhou Medical University, Yantai, Shandong Province, 264003 China
| | - X B Liu
- Department of Immunology, Binzhou Medical University, Yantai, Shandong Province, 264003 China
| | - H X Zhang
- Department of Immunology, Binzhou Medical University, Yantai, Shandong Province, 264003 China
| | - X M Hu
- Department of Immunology, Binzhou Medical University, Yantai, Shandong Province, 264003 China.,Medical and Pharmaceutical Research Center, Binzhou Medical University, Yantai, Shandong Province, 264003 China.,
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Wang Y, Liu XB, Cao J, Hu JH. [Effects of clinical medicine on salt sensitivity hypertension: a systematic review and meta-analysis]. Zhonghua Yi Xue Za Zhi 2019; 99:2367-2374. [PMID: 31434418 DOI: 10.3760/cma.j.issn.0376-2491.2019.30.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Objective: To assess the effects of clinical medicine on salt sensitive hypertension. Methods: The PubMed, EMBASE, Cochrane Library, CBM, WanFang Data, VIP and CNKI databases were searched to collect randomized controlled trials (RCTs) on clinical medicine in treating salt sensitive hypertension from inception to December 2018. Two reviewers independently screened the literature, extracted data, and another investigator assessed the risk of bias included in the study. Then meta-analysis was performed using RevMan 5.3 software. Results: A total of 16 RCTs studies involving 1 355 patients were included. Meta-analysis showed that angiotensin-converting enzyme inhibitors (ACEIs) combined with diuretics could effectively reduce 24 h systolic blood pressure variability [mean difference (MD)=4.45, 95%CI: 3.47-5.43, P<0.001] and 24 h diastolic blood pressure variability (MD=3.71, 95%CI:2.83-4.59, P<0.001) in salt-sensitive hypertension patients. Angiotensin Ⅱ receptor antagonists (ARBs) combined with diuretics had no antihypertensive effect on salt-sensitive hypertension patients. Indapamide alone can reduce systolic blood pressure (MD=-14.70, 95%CI:-18.57--10.83, P<0.001) and diastolic blood pressure (MD=-8.73, 95%CI:-11.57--5.89, P<0.001). The use of ACEIs alone in salt-sensitive hypertension patients can not reduce systolic pressure (MD=2.20, 95%CI:-1.48-5.88, P=0.240) and diastolic pressure (MD=2.95, 95%CI: 1.37~4.54, P<0.001). Amlodipine combined with metformin had therapeutic effect on salt-sensitive hypertension (RR=1.23, 95%CI: 1.14~1.33, P<0.001). Conclusions: ACEIs combined with diuretics can effectively reduce blood pressure variability in salt-sensitive hypertensive patients. The use of amlodipine in combination with metformin and indapamide alone have antihypertensive effect in salt-sensitive hypertensive patients.
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Affiliation(s)
- Y Wang
- Public Health School, Gansu University of Chinese Medicine, Lanzhou 730000, China
| | - X B Liu
- Public Health School, Gansu University of Chinese Medicine, Lanzhou 730000, China
| | - J Cao
- Public Health School, Gansu University of Chinese Medicine, Lanzhou 730000, China
| | - J H Hu
- Research and Experiment Center of Gansu University of Chinese Medicine, Lanzhou 730000, China
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Liu JF, Liu XB, Wang Z, Shi ZH, Cao BJ, Jiang T, Zhang SW. [Gastrectomy with either wedge resection of the pancreas or pancreaticosplenectomy for adenocarcinoma of the esophagogastric junction invading the pancreas: a comparison study]. Zhonghua Wai Ke Za Zhi 2019; 57:452-456. [PMID: 31142071 DOI: 10.3760/cma.j.issn.0529-5815.2019.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To compare the outcomes of gastrectomy with either wedge resection of the pancreas or pancreaticosplenectomy for adenocarcinoma of the esophagogastric junction (AEG) invading pancreas. Methods: From May 2005 to December 2015, a total of 64 patients with AEG invading pancreas underwent gastrectomy with either wedge resection of pancreas (n=25) or pancreaticosplenectomy (n=39) at Department of Thoracic Surgery, Fourth Hospital, Hebei Medical University. There were 53 males and 11 females, with a mean age of 60.2 years (range: 39 to 77 years). According to the AJCC esophageal cancer staging system, 8(th) edition, there were 27 patients in phase T4N0M0, 18 in phase T4bN1M0, 9 in phase T4bN2M0 and 10 in phase T4bN3M0. Follow-up was carried out every 6 months. The t-test for the measurement data and the χ(2) test, Fisher exact test or Wilcoxon ran-sum test for the enumeration data were used between the two groups. Survival curves were generated using the Kaplan-Meier method, and compared using the Log-rank test. Multivariate analysis was undertaken using the Cox proportional hazard model (forward stepwise regression). Results: In 39 patients who underwent pancreaticosplenectomy, incision infection occurred in 5 patients, anastomotic leak, peritoneal infection, lung infarction each occurred in 1 patient. There was 1 respiratory failure and 1 peritoneal infection in 25 patients undergoing wedge resection of the pancreas. There were no significant difference in the incidence of postoperative complications between the 2 groups (8/39 vs. 2/25, P=0.292), and no postoperative death in the study. Fifty-seven patients were followed up, with a follow-up rate of 89.1%. The 5-year overall survival rate was 32.3% in patients who underwent simultaneous gastrectomy and pancreaticosplenectomy, compared to 0 in those who underwent gastrectomy and wedge resection of the pancreas (χ(2)=4.484, P=0.034). The 5-year overall survival rate for patients who undergoing adjuvant chemotherapy was 32.3%, compared to 17.2% in whom underwent surgery alone (χ(2)=4.186, P=0.041). Conclusions: Survival benefit from R0 resection by simultaneous gastrectomy and pancreaticosplenectomy for AEG invading the pancreas can be achieved. Adjuvant chemotherapy is necessary for these patients.
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Affiliation(s)
- J F Liu
- Department of Thoracic Surgery, Fourth Hospital, Hebei Medical University, Shijiazhuang 050011, China
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He YX, Fan JQ, Zhu QF, Zhou QJ, Jiang JB, Wang LH, Ng S, Liu XB, Wang JA. Ascending aortic dilatation rate after transcatheter aortic valve replacement in patients with bicuspid and tricuspid aortic stenosis: A multidetector computed tomography follow-up study. World J Emerg Med 2019; 10:197-204. [PMID: 31534592 DOI: 10.5847/wjem.j.1920-8642.2019.04.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Current data is lacking about the progression of ascending aortic dilatation after transcatheter aortic valve replacement (TAVR) in aortic stenosis (AS) patients with bicuspid aortic valve (BAV) and tricuspid aortic valve (TAV). This study aims to assess the ascending aortic dilatation rate (mm/year) after TAVR in patients with BAV versus TAV using a multidetector computed tomography (MDCT) follow-up and to determine the predictors of ascending aortic dilatation rate. METHODS Severe AS patients undergoing TAVR from March 2013 to March 2018 at our center with MDCT follow-ups were included. BAV and TAV were identified using baseline MDCT. Baseline and follow-up MDCT images were analyzed, and the diameters of ascending aorta were measured. Study end point is ascending aortic dilatation rate (mm/year). Furthermore, factors predicting ascending aortic dilatation rate were also investigated. RESULTS Two hundred and eight patients were included, comprised of 86 BAV and 122 TAV patients. Five, 4, 3, 2, and 1-year MDCT follow-ups were achieved in 7, 9, 30, 46, and 116 patients. The ascending aortic diameter was significantly increased after TAVR in both BAV group (43.7±4.4 mm vs. 44.0±4.5 mm; P<0.001) and TAV group (39.1±4.8 mm vs. 39.7±5.1 mm; P<0.001). However, no difference of ascending aortic dilatation rate was found between BAV and TAV group (0.2±0.8 mm/year vs. 0.3±0.8 mm/year, P=0.592). Multivariate linear regression revealed paravalvular leakage (PVL) grade was independently associated with ascending aortic dilatation rate in the whole population and BAV group, but not TAV group. No aortic events occurred during follow-ups. CONCLUSION Ascending aortic size continues to grow after TAVR in BAV patients, but the dilatation rate is mild and comparable to that of TAV patients. PVL grade is associated with ascending aortic dilatation rate in BAV patients post-TAVR.
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Affiliation(s)
- Yu-Xin He
- Department of Cardiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Jia-Qi Fan
- Department of Cardiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Qi-Feng Zhu
- Department of Cardiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Qi-Jing Zhou
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Ju-Bo Jiang
- Department of Cardiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Li-Han Wang
- Department of Cardiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Stella Ng
- Department of Cardiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Xian-Bao Liu
- Department of Cardiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Jian-An Wang
- Department of Cardiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
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Wang LH, Pu ZX, Kong MJ, Jiang JB, Ren KD, Gao F, Lin XP, Yu L, He W, Yan M, Liu XB, Wang JA. The first four cases of successful NeoChord procedure in mainland China. World J Emerg Med 2019; 10:133-137. [PMID: 31171942 DOI: 10.5847/wjem.j.1920-8642.2019.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Transapical off-pump NeoChord procedure is a novel minimally invasive surgical repair of degenerative mitral regurgitation (MR). Here, we report the first four cases of NeoChord procedure in patients with mitral valve prolapse in mainland China. METHODS Four patients, aged 86, 84, 80 and 60 years, with severe MR due to posterior middle scallop prolapse (P2), underwent transapical off-pump artificial chordae implantation on April 9 and 10, 2019. The procedure was performed by left mini-thoracotomy under general anaesthesia and guided by 2D and 3D dimensional transoesophageal echocardiography (TEE). RESULTS Mitral valve repair via NeoChord procedure was successfully performed with implantation of 3 artificial chordae in the first patient and 3, 2, and 3 artificial chordae in the following patients, respectively. Intraoperative TEE and pre-discharge transthoracic echocardiography (TTE) showed only mild to moderate MR of these four patients and no postoperative complications were noted. There were no changes of TTE finding between one-month follow-up and pre-discharge. CONCLUSION The successful NeoChord procedures in four Chinese indicate that the valve repair using the NeoChord system for Chinese population is feasible.
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Affiliation(s)
- Li-Han Wang
- Cardiovascular Department, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Zhao-Xia Pu
- Cardiovascular Department, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Min-Jian Kong
- Cardiovascular Department, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Ju-Bo Jiang
- Cardiovascular Department, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Kai-da Ren
- Cardiovascular Department, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Feng Gao
- Cardiovascular Department, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Xin-Ping Lin
- Cardiovascular Department, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Lei Yu
- Cardiovascular Department, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Wei He
- Cardiovascular Department, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Min Yan
- Cardiovascular Department, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Xian-Bao Liu
- Cardiovascular Department, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Jian-An Wang
- Cardiovascular Department, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
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Tang CQ, Li JQ, Xu DY, Liu XB, Hou WJ, Lyu KY, Xiao SC, Xia ZF. [Comparison of machine learning method and logistic regression model in prediction of acute kidney injury in severely burned patients]. Zhonghua Shao Shang Za Zhi 2018; 34:343-348. [PMID: 29961290 DOI: 10.3760/cma.j.issn.1009-2587.2018.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To build risk prediction models for acute kidney injury (AKI) in severely burned patients, and to compare the prediction performance of machine learning method and logistic regression model. Methods: The clinical data of 157 severely burned patients in August 2nd Kunshan factory aluminum dust explosion accident conforming to the inclusion criteria were collected. Patients suffering AKI within 90 days after admission were enrolled in group AKI, while the others were enrolled in non-AKI group. Single factor analysis was used to choose independent factors associated with AKI, including sex, age, admission time, features of basic injuries, initial score on admission, treatment condition, and mortality on post injury days 30, 60, and 90. Data were processed with Mann-Whitney U test, chi-square test, and Fisher's exact test. Variables with P<0.1 in single factor analysis and those with possible clinical significance were brought into the establishment of prediction model. Logistic regression and XGBoost machine learning algorithm were used to build the prediction model of AKI. The area under receiver operating characteristic curve (AUC) was calculated, and the sensitivity and specificity for optimal threshold value were also calculated for each model. Nonparametric resampling test was used to compare the significance of difference of AUC of the two models. Results: (1) Eighty-nine (56.7%) patients developed AKI within 90 days from admission. Compared with 68 patients in non-AKI group, 89 patients in group AKI were older (Z=-2.203, P<0.05), with larger total burn area and full-thickness burn area (Z=-5.200, -6.297, P<0.01), worse acute physical and chronic health evaluation (APACHE) Ⅱ score, abbreviated burn severity index score, and sequential organ failure assessment (SOFA) score on admission (Z=-7.485, -4.739, -4.590, P<0.01), higher occurrence rate of sepsis (χ(2)=33.087, P<0.01), higher rates of accepting tracheotomy, mechanical ventilation, and continuous renal replacement therapy (χ(2)=12.373, 17.201, 43.763, P<0.01), larger first excision area (Z=-2.191, P<0.05), and higher mortality on post injury days 30, 60, and 90 (χ(2)=7.483, 37.259, 45.533, P<0.01). There were no statistically significant differences in sex, open decompression, admission time, 24-hour fluid volume after admission, 48-hour fluid volume after admission, the first 24-hour urine volume, the second 24 hour urine volume, the first excision time, and inhalation injury (χ(2)=0.529, 3.318, Z=-1.746, -0.016, -1.199, -1.824, -0.625, -1.747, P>0.05). The rates of deep vein catheterization of patients in the two groups were both 100%. (2) There were twenty possible prediction variables for preliminary establishment of model according to the difference results of single factor analysis and clinical significance of variables. (3) The logistic regression prediction model had three variables: APACHE Ⅱ score [odds ratio (OR)=1.36, 95% confidence interval (CI)=1.20-1.53, P<0.001], sepsis (OR=2.63, 95% CI=0.90-7.66, P>0.05), and the first 24-hour urine volume (OR=0.71, 95% CI=0.50-1.01, P>0.05). The AUC of the logistic regression prediction model was 0.875 (95% CI=0.821-0.930), with the specificity and sensitivity of optimal threshold value 84.4% and 77.7%, respectively. (4) XGBoost machine learning model had seven main predictive variables: APACHE Ⅱ score, full-thickness burn area, 24-hour fluid volume after admission, sepsis, the first 24-hour urine volume, SOFA score, and 48-hour fluid volume after admission. The AUC of machine learning model was 0.920 (95% CI=0.879-0.962), higher than that of logistic regression model (P<0.001), with the specificity and sensitivity of optimal threshold value 89.7% and 82.0%, respectively. Conclusions: Sepsis and fluid resuscitation are two important predictive variables that can be intervened for AKI in severely burned patients. Machine learning method has a better performance and can provide more accurate prediction for individuals than logistic regression prediction model, and therefore has good clinical application prospect.
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Affiliation(s)
- C Q Tang
- Burn Institute of PLA, Department of Burn Surgery, the First Affiliated Hospital, Naval Military Medical University, Shanghai 200433, China
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Jaiswal S, Liu XB, Wei QC, Sun YH, Wang LH, Song LG, Yang DD, Wang JA. Effect of corticosteroids on atrial fibrillation after catheter ablation: a meta-analysis . J Zhejiang Univ Sci B 2018; 19:57-64. [PMID: 29308608 DOI: 10.1631/jzus.b1600529] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The purpose of this meta-analysis was to explore the effect of corticosteroids on atrial fibrillation (AF) following catheter ablation. METHODS We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials for published articles describing the effect of corticosteroids in preventing AF recurrence after catheter ablation. Data on study and patient were extracted. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated by use of a random-effect model, and P values of <0.05 were considered significant. RESULTS Two randomized controlled trials (RCTs) and three cohort studies involving 846 patients were included in this meta-analysis. Within one month of catheter ablation, corticosteroid use was associated with a declined risk of recurrence of AF in RCT (RR 0.57, 95% CI 0.39 to 0.85, P=0.005), but without significant effect in cohort studies (RR 1.01, 95% CI 0.79 to 1.30, P=0.94). After three months of catheter ablation, corticosteroids did not have a significant effect in the prevention of late recurrence of AF in either RCT (RR 0.78, 95% CI 0.38 to 1.59, P=0.49) or cohort studies (RR 0.96, 95% CI 0.70 to 1.31, P=0.78). CONCLUSIONS Our meta-analysis suggested that periprocedural administration of corticosteroids of catheter ablation was associated with reduction of early but not late recurrence of AF.
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Affiliation(s)
- Sanjay Jaiswal
- Department of Cardiology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
| | - Xian-Bao Liu
- Department of Cardiology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
| | - Qu-Cheng Wei
- Department of Cardiology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
| | - Ying-Hao Sun
- Department of Cardiology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
| | - Li-Han Wang
- Department of Cardiology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
| | - Liu-Guang Song
- Department of Cardiology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
| | - Dan-Dan Yang
- Department of Cardiology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
| | - Jian-An Wang
- Department of Cardiology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
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Li HH, Bao ZX, Liu XB, Zhu SH. [Advances in the research of application of artificial intelligence in burn field]. Zhonghua Shao Shang Za Zhi 2018; 34:246-248. [PMID: 29690744 DOI: 10.3760/cma.j.issn.1009-2587.2018.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Artificial intelligence has been able to automatically learn and judge large-scale data to some extent. Based on database of a large amount of burn data and in-depth learning, artificial intelligence can assist burn surgeons to evaluate burn surface, diagnose burn depth, guide fluid supply during shock stage, and predict prognosis, with high accuracy. With the development of technology, artificial intelligence can provide more accurate information for burn surgeons to make clinical diagnosis and treatment strategies.
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Affiliation(s)
- H H Li
- Department of Burn Surgery, Institute of Burns, the first affiliated Hospital of Naval Medical University, Shanghai 200433, China
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Shen J, Zhang N, Lin YN, Xiang P, Liu XB, Shan PF, Hu XY, Zhu W, Tang YL, Webster KA, Cai R, Schally AV, Wang J, Yu H. Regulation of Vascular Calcification by Growth Hormone-Releasing Hormone and Its Agonists. Circ Res 2018; 122:1395-1408. [PMID: 29618597 DOI: 10.1161/circresaha.117.312418] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
RATIONALE Vascular calcification (VC) is a marker of the severity of atherosclerotic disease. Hormones play important roles in regulating calcification; estrogen and parathyroid hormones exert opposing effects, the former alleviating VC and the latter exacerbating it. To date no treatment strategies have been developed to regulate clinical VC. OBJECTIVE The objective of this study was to investigate the effect of growth hormone-releasing hormone (GHRH) and its agonist (GHRH-A) on the blocking of VC in a mouse model. METHODS AND RESULTS Young adult osteoprotegerin-deficient mice were given daily subcutaneous injections of GHRH-A (MR409) for 4 weeks. Significant reductions in calcification of the aortas of MR409-treated mice were paralleled by markedly lower alkaline phosphatase activity and a dramatic reduction in the expression of transcription factors, including the osteogenic marker gene Runx2 and its downstream factors, osteonectin and osteocalcin. The mechanism of action of GHRH-A was dissected in smooth muscle cells isolated from human and mouse aortas. Calcification of smooth muscle cells induced by osteogenic medium was inhibited in the presence of GHRH or MR409, as evidenced by reduced alkaline phosphatase activity and Runx2 expression. Inhibition of calcification by MR409 was partially reversed by MIA602, a GHRH antagonist, or a GHRH receptor-selective small interfering RNA. Treatment with MR409 induced elevated cytosolic cAMP and its target, protein kinase A which in turn blocked nicotinamide adenine dinucleotide phosphate oxidase activity and reduced production of reactive oxygen species, thus blocking the phosphorylation of nuclear factor κB (p65), a key intermediate in the ligand of receptor activator for nuclear factor-κ B-Runx2/alkaline phosphatase osteogenesis program. A protein kinase A-selective small interfering RNA or the chemical inhibitor H89 abolished these beneficial effects of MR409. CONCLUSIONS GHRH-A controls osteogenesis in smooth muscle cells by targeting cross talk between protein kinase A and nuclear factor κB (p65) and through the suppression of reactive oxygen species production that induces the Runx2 gene and alkaline phosphatase. Inflammation-mediated osteogenesis is thereby blocked. GHRH-A may represent a new pharmacological strategy to regulate VC.
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Affiliation(s)
- Jian Shen
- From the Departments of Cardiology (J.S., N.Z., Y.-N.L., P.P.X., X.-b.L., X.-y.H., W.Z., J.W., H.Y.)
- Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, PR China (J.S., N.Z., Y.-N.L., P.P.X., X.-b.L., X.-y.H., W.Z., J.W., H.Y.)
| | - Ning Zhang
- From the Departments of Cardiology (J.S., N.Z., Y.-N.L., P.P.X., X.-b.L., X.-y.H., W.Z., J.W., H.Y.)
- Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, PR China (J.S., N.Z., Y.-N.L., P.P.X., X.-b.L., X.-y.H., W.Z., J.W., H.Y.)
| | - Yi-Nuo Lin
- From the Departments of Cardiology (J.S., N.Z., Y.-N.L., P.P.X., X.-b.L., X.-y.H., W.Z., J.W., H.Y.)
- Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, PR China (J.S., N.Z., Y.-N.L., P.P.X., X.-b.L., X.-y.H., W.Z., J.W., H.Y.)
| | - PingPing Xiang
- From the Departments of Cardiology (J.S., N.Z., Y.-N.L., P.P.X., X.-b.L., X.-y.H., W.Z., J.W., H.Y.)
- Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, PR China (J.S., N.Z., Y.-N.L., P.P.X., X.-b.L., X.-y.H., W.Z., J.W., H.Y.)
| | - Xian-Bao Liu
- From the Departments of Cardiology (J.S., N.Z., Y.-N.L., P.P.X., X.-b.L., X.-y.H., W.Z., J.W., H.Y.)
- Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, PR China (J.S., N.Z., Y.-N.L., P.P.X., X.-b.L., X.-y.H., W.Z., J.W., H.Y.)
| | | | - Xin-Yang Hu
- From the Departments of Cardiology (J.S., N.Z., Y.-N.L., P.P.X., X.-b.L., X.-y.H., W.Z., J.W., H.Y.)
- Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, PR China (J.S., N.Z., Y.-N.L., P.P.X., X.-b.L., X.-y.H., W.Z., J.W., H.Y.)
| | - Wei Zhu
- From the Departments of Cardiology (J.S., N.Z., Y.-N.L., P.P.X., X.-b.L., X.-y.H., W.Z., J.W., H.Y.)
- Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, PR China (J.S., N.Z., Y.-N.L., P.P.X., X.-b.L., X.-y.H., W.Z., J.W., H.Y.)
| | - Yao-Liang Tang
- Vascular Biology Center, Georgia Regents University, Augusta (Y.-l.T.)
| | - Keith A Webster
- Department of Molecular and Cellular Pharmacology and the Vascular Biology Institute (K.A.W., R.C., A.V.S.)
| | - Renzhi Cai
- Department of Molecular and Cellular Pharmacology and the Vascular Biology Institute (K.A.W., R.C., A.V.S.)
- Divisions of Hematology/Oncology, Department of Medicine (R.C., A.V.S.)
- Miller School of Medicine, University of Miami, FL; and Endocrine, Polypeptide and Cancer Institute, Veterans Affairs Medical Center, Miami, FL (R.C., A.V.S.)
| | - Andrew V Schally
- Department of Molecular and Cellular Pharmacology and the Vascular Biology Institute (K.A.W., R.C., A.V.S.)
- Divisions of Hematology/Oncology, Department of Medicine (R.C., A.V.S.)
- Miller School of Medicine, University of Miami, FL; and Endocrine, Polypeptide and Cancer Institute, Veterans Affairs Medical Center, Miami, FL (R.C., A.V.S.)
| | - Jian'an Wang
- From the Departments of Cardiology (J.S., N.Z., Y.-N.L., P.P.X., X.-b.L., X.-y.H., W.Z., J.W., H.Y.)
- Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, PR China (J.S., N.Z., Y.-N.L., P.P.X., X.-b.L., X.-y.H., W.Z., J.W., H.Y.)
| | - Hong Yu
- From the Departments of Cardiology (J.S., N.Z., Y.-N.L., P.P.X., X.-b.L., X.-y.H., W.Z., J.W., H.Y.)
- Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China; Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, PR China (J.S., N.Z., Y.-N.L., P.P.X., X.-b.L., X.-y.H., W.Z., J.W., H.Y.)
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Liu XB, He YX, Liu CH, Wang LH, Gao F, Yu L, Dong AQ, Kong MJ, Chen JF, Xu Y, Zhou QJ, Yan M, Wang JA. First-in-man implantation of the retrievable and repositionable VenusA-Plus valve. World J Emerg Med 2018; 9:64-66. [PMID: 29290898 DOI: 10.5847/wjem.j.1920-8642.2018.01.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND No retrievable and repositionable second generation transcatheter aortic valve is available in China. Here, we report the first-in-man implantation of the retrievable and repositionable VenusA-Plus valve. METHODS A 76-year-old patient with symptomatic severe aortic stenosis and high surgical risk (STS 13.8%) was recommended for transcatheter aortic valve replacement (TAVR) by heart valve team. Type 0 bicuspid aortic valve with asymmetric calcification was identified by dual source computed tomography, and the unfavorable anatomies increased the possibility of malposition and paravalvular leakage during TAVR. Therefore, we used the retrievable and repositionable VenusA-Plus valve for the patient. RESULTS Transfemoral TAVR was performed under local anesthesia with sedation, and a 26mm VenusA-Plus valve was successfully implanted. No transvalvular pressure gradient and trace paravalvular leakage were found. CONCLUSION The successful first-in-man implantation indicates the retrievable and repositionable VenusA-Plus valve is feasible in complicated TAVR cases such as bicuspid aortic valve.
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Affiliation(s)
- Xian-Bao Liu
- Department of Cardiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yu-Xin He
- Department of Cardiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chun-Hui Liu
- Department of Cardiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Li-Han Wang
- Department of Cardiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Feng Gao
- Department of Cardiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lei Yu
- Department of Cardiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ai-Qiang Dong
- Department of Cardiovascular Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Min-Jian Kong
- Department of Cardiovascular Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ji-Fang Chen
- Department of Cardiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yong Xu
- Department of Anesthesiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qi-Jing Zhou
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Min Yan
- Department of Anesthesiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jian-An Wang
- Department of Cardiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Song G, Jilaihawi H, Wang M, Chen M, Wang J, Wang W, Feng Y, Liu X, Zhang R, Kong X, Xu B, Sievert H, Gao R, Yang Y, Wu Y. Severe Symptomatic Bicuspid and Tricuspid Aortic Stenosis in China: Characteristics and Outcomes of Transcatheter Aortic Valve Replacement with the Venus-A Valve. Structural Heart 2017. [DOI: 10.1080/24748706.2017.1398437] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Guangyuan Song
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Hasan Jilaihawi
- Heart Valve Center, NYU Langone Health, New York, New York, USA
| | - Moyang Wang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Mao Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Jian’an Wang
- Department of Cardiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
| | - Wei Wang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Yuan Feng
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - XianBao Liu
- Department of Cardiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
| | - Ruiyan Zhang
- Department of Cardiology, Affiliated Ruijin Hospital of Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China
| | - Xiangqing Kong
- Department of Cardiology, The First Affiliated Hospital with NanJing Medical University, Nanjing, People’s Republic of China
| | - Bo Xu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Horst Sievert
- Department of Cardiology, CardioVascular Center, Frankfurt, Germany
| | - Runling Gao
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - YueJin Yang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Yongjian Wu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
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Song GY, Wang MY, Wang Y, Liu XB, Feng Y, Kong XQ, Wu YJ. [Effect of transcatheter aortic valve replacement using Venus-A valve for treating patients with severe aortic stenosis]. Zhonghua Xin Xue Guan Bing Za Zhi 2017; 45:843-847. [PMID: 29081172 DOI: 10.3760/cma.j.issn.0253-3758.2017.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the effect of transcatheter aortic valve replacement(TAVR) using Venus-A valve for treating patients with severe aortic stenosis. Methods: In this prospective study, 101 consecutive severe aortic stenosis patients with high surgical risk(Society of Thoracic Surgeon(STS) score ≥4%) or at prohibitive surgical risk were enrolled from 5 academic cardiovascular centers in China(Fuwai hospital, the second affiliated hospital of Zhejiang university school of medicine, West China hospital of Sichuan university, the first affiliated hospital of Nanjing medical university, Ruijin hospital of Shanghai Jiaotong university school of medicine) from September 2012 to January 2015, and Venus-A valves were used in TAVR for these patients. The primary endpoints were death from any cause and major stroke in 1 year. The secondary endpoints included efficacy and safety of TAVR in 1 year. Results: TAVR success rate was 97.9%(98/101), and 3 patients were transferred to receive surgical AVR. There were 85 patients using 1 Venus-A valve, and 13 patients underwent valve-in-valve implantation using 2 Venus-A valves. There were 1 case(1.0%) of stroke, 2 cases(2.0%)of acute myocardial infarction, 5 cases(5.0%) of pericardial effusion, 6 cases(5.9%) of severe vascular complication, and 2 cases(2.0%) of death after 7 days of TAVR. Meanwhile, aortic pressure gradient derived from echocardiography was significantly reduced when compared with pre-procedure level(11(8, 15) mmHg (1 mmHg=0.133 kPa) vs. 59(45, 71)mmHg, P<0.01), and there was no aortic root rupture or leaflets thrombosis. Rate of NYHA functional class ≤Ⅱ improvements were observed at 6 months follow-up when compared with pre-procedure(94.4%(84/89)vs. 21.3%(21/89), P<0.01). The primary endpoint was 7.9%(8/11), and the incidence of all cause death and stroke was 5.9%(6/101) and 2.0%(2/101) respectively at 1 year after the procedure. Kaplan-Meier survival analysis showed that cumulative survival rate was 94.1% at 1 year after the procedure. Conclusion: TAVR using Venus-A valve for treating patients with severe aortic stenosis is effective and safe in the early and medium term post procedure.
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Affiliation(s)
- G Y Song
- Coronary Intervention Center, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
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He W, Huang RR, Shi QY, Liu XB, Wang JA, Yan M. Bispectral index-guided sedation in transfemoral transcatheter aortic valve implantation: a retrospective control study. J Zhejiang Univ Sci B 2017; 18:353-359. [PMID: 28378573 DOI: 10.1631/jzus.b1600522] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Transcatheter aortic valve implantation (TAVI) is a minimally invasive therapy for elderly patients with severe aortic valve stenosis who were refused surgical aortic valve replacement because of the high perioperative risk. Traditionally, this procedure has been done under general anesthesia, but more recently local anesthesia and sedation have become popular. This research assessed the effectiveness of transfemoral TAVI under bispectral index (BIS)-guided sedation. METHODS In this single-center retrospective control analysis, clinical data, including demographic characteristics, echocardiography, periprocedural data, and main complications, were collected and assessed in 113 patients undergoing TAVI through the femoral artery under general anesthesia (GA group, n=36) and under BIS-guided sedation (SED group, n=77). RESULTS The demographic characteristics and echocardiographic parameters between the two groups were similar (P>0.05). Two (2.6%) of patients were moved from BIS-guided sedation to general anesthesia for surgical reasons. Procedures were significantly shorter in the SED group than in the GA group ((127.10±44.43) min vs. (165.90±71.62) min, P=0.004). Patients in the SED group lost less blood and received significantly fewer red blood cells and catecholamines than those in the GA group (5.19% vs. 22.22%, P=0.017 and 67.53% vs. 97.22%, P<0.001). The length of hospital stay was significantly shorter and there were fewer pulmonary complications in the SED group than in the GA group. Thirty-day mortality was similar between the two groups. CONCLUSIONS BIS-guided sedation is a feasible and safe approach for transfemoral TAVI. The anesthesiologist should choose the best anesthetic method according to the team's experience.
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Affiliation(s)
- Wei He
- Department of Anesthesia, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Rong-Rong Huang
- Department of Anesthesia, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Qing-Yu Shi
- Department of Anesthesia, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Xian-Bao Liu
- Department of Cardiology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Jian-An Wang
- Department of Cardiology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Min Yan
- Department of Anesthesia, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
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Lu JX, Liu XB, Chen J, Hu YC, Yun CF, Li WD, Wang R, Yang YH, Mao DQ, Piao JH, Yang XG, Yang LC. [The vitamin D nutritional status in Chinese urban women of child-bearing age from 2010 to 2012]. Zhonghua Yu Fang Yi Xue Za Zhi 2017; 51:112-116. [PMID: 28219147 DOI: 10.3760/cma.j.issn.0253-9624.2017.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the vitamin D nutritional status in Chinese women of child-bearing age by analyzing serum 25-hydroxyvitamin D level in 2010-2012. Methods: Data were obtained from the China Nutrition and Health Survey in 2010-2012. Using cluster sampling and proportional stratified random sampling, 1 514 women of child-bearing age (18-44 years old) from 34 metropolis and 41 small and medium-sized cities were included in this study. Demographic information was collected by questionnaire and serum 25-hydroxyvitamin D concentration was determined by radioimmunoassay, in accordance with the 2010 Institute of Medicine of the National Academies standards. We compared differences in vitamin D levels, specifically serious deficiency, lack of deficiency, insufficiency, and excess. Results: The overall serum 25-hydroxyvitamin D level of Chinese urban women of child-bearing age (P(50) (P(25)-P(75))) was 20.1 (15.1-26.3) ng/ml; minorities had a significantly higher serum 25-hydroxyvitamin D level of 22.0 (15.9-27.5) ng/ml compared with women of Han nationality (19.8 (14.9-26.2) ng/ml) (χ(2)=7.02, P=0.008). The proportions of women with serious deficiency, lack of deficiency, insufficiency, and excess vitamin D were 11.6% (n=175), 37.9% (n=574), 35.1% (n=531), and 0.3% (n=5), respectively. Only 15.1% (n=229) of women of child-bearing age had normal vitamin D nutritional status. No significant differences in vitamin D nutritional status were observed according to age, body mass index, city, nationality, educational level, marital status, or household income per capita (P>0.05). Conclusion: Most Chinese urban women of child-bearing age have poor vitamin D levels and require vitamin D supplementation.
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Affiliation(s)
- J X Lu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention; Key Laboratory of Trace Element Nutrition, National Health and Family Planning Commission, Beijing 100050, China
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Han JL, He LY, Cui M, Zhang YZ, Liu XB, Xu XY, Wang YP, Wang FF, Wang GS, Niu J, Zhang FC, Mi L, Guo LJ, Gao W. [Feasibility and value of index of microcirculatory resistance in patients with acute myocardial infarction after primary percutaneous coronary intervention]. Zhonghua Yi Xue Za Zhi 2017; 97:2261-2265. [PMID: 28780839 DOI: 10.3760/cma.j.issn.0376-2491.2017.29.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the feasibility of detecting index of microcirculatory resistance (IMR) and the relationship between IMR and left ventricular (LV) systolic function after acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI). Methods: The patients with first AMI received primary PCI in Peking University Third Hospital were enrolled from January 2014 to March 2016. IMR were measured immediately after PCI by using pressure/temperature wire. The relationship between IMR and left ventricular ejection fraction (LVEF) assessed by echocardiography at first day and 6 months after admission was evaluated. Results: Twenty-eight patients with anterior wall AMI were enrolled, with an average age (56±13) years. The success rate of IMR detection was 100%. The mean IMR was (33±18 )mmHg·s. There was no complication related to intravenous adenosine triphosphate (ATP) (140 μg· kg(-1)· min(-1)). The IMR was negatively correlated with TIMI blood flow grade after primary PCI (r=-0.386, P=0.043), and positively correlated with female gender, CK peak value and TnT peak value (r=0.430, P=0.022; r=0.431, P=0.025; r=0.434, P=0.024). After 6 months of follow-up, no adverse cardiovascular events (including cardiac death, nonfatal myocardial infarction, malignant arrhythmia, unplanned revascularization, hospitalization for unstable angina pectoris and severe heart failure requiring hospitalization) occurred. LVEF increased significantly compared with the first day after PCI (0.54±0.08 vs 0.47±0.06, P=0.001), and IMR was negatively correlated with LVEF after 6 months (r=-0.477, P=0.014). Multivariable linear regression analysis showed that CK peak and IMR were predictors of LVEF after six months ( β=-0.595, t=-3.814, P=0.01; β=-0.352, t=-2.26, P=0.036). Conclusions: Immediate detection of IMR in patients with anterior wall AMI after PCI is safe and feasible. The immediate IMR after PCI reflects the extent of myocardial necrosis and myocardial perfusion, and is a predictor of LVEF at 6 months after PCI.
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Affiliation(s)
- J L Han
- Department of Cardiology, Peking University Third Hospital; Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptide, Ministry of Health; Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing 100191, China
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Gao JH, Li LP, Wang J, Liu XB, Wu HX, Li J, Li J, Liu QY. [Progress of research in relation to the impact of climate change on children's health status]. Zhonghua Liu Xing Bing Xue Za Zhi 2017; 38:832-836. [PMID: 28647992 DOI: 10.3760/cma.j.issn.0254-6450.2017.06.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Along with global warming, climate change has become one of the biggest public health challenges. The unique metabolism, behavior, physiology and development in children, will make them suffer more from the climate change. In the present review, we summarized the progress and situation of studies on the associations between climate change and children's health also trying to provide adaptation and mitigation strategies. The purpose of this study was to offer scientific evidence for prevention and control on the adverse effects as injuries, diseases and deaths among children that resulted from the changes of climate.
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Affiliation(s)
- J H Gao
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - L P Li
- Injury Prevention Research Center, Shantou University Medical College, Shantou 515041, China
| | - J Wang
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - X B Liu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - H X Wu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - J Li
- Department of Epidemiology, School of Public Health, Shandong University, Jinan 250012, China; State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - J Li
- Changping District Centre for Disease Control and Prevention, Beijing 102200, China; State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Q Y Liu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
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Abstract
Heart failure (HF) represents the most common endpoint of most cardiovascular diseases (CVDs) which are the leading causes of death around the world. Despite the advances in treating CVDs, the prevalence of HF continues to increase. It is believed that better results of prognosis are obtained from prevention rather than additional treatment for HF. Therefore, it is reasonable to prevent the development of CVDs or other complications to HF. Most types of HF are attributed to contractile dysfunction, cardiac hypertrophy or remodeling, and ischemic injuries. SIRT3 is a mitochondrial nicotinamide adenine dinucleotide (NAD+)-dependent deacetylase whose substrates vary from metabolic biogenesis-associated proteins to stress-responsive proteins. In recent years, a number of studies have highlighted the cardio-protective role of SIRT3 and, as such, efforts have been made to induce over-expression or increased activity of this protein. In this review, we provide an overview of the roles of SIRT3 in cardiac hypertrophy induced by pressure overload or agonists and cardiomyocytes ischemic injuries. Moreover, we will introduce the application of SIRT3 agonists in the prevention of cardiac hypertrophy and ischemia reperfusion injury.
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Affiliation(s)
- De-Xing Hu
- Department of Cardiology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China.,Provincial Key Laboratory of Cardiovascular Research of Zhejiang Province, Hangzhou 310009, China.,Department of Cardiology, Ningbo Medical Center Lihuili Eastern Hospital, Ningbo 315100, China
| | - Xian-Bao Liu
- Department of Cardiology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China.,Provincial Key Laboratory of Cardiovascular Research of Zhejiang Province, Hangzhou 310009, China
| | - Wen-Chao Song
- Department of Cardiology, Ningbo Medical Center Lihuili Eastern Hospital, Ningbo 315100, China
| | - Jian-An Wang
- Department of Cardiology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China.,Provincial Key Laboratory of Cardiovascular Research of Zhejiang Province, Hangzhou 310009, China
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Zhang Y, Liu XB, Yang LC, Chen J, Wang R, Yang XG, Piao JH, Mao DQ. [Study on vitamin A nutritional status of 6- to 17-year-old urban children and adolescents between 2010 and 2012 in China]. Zhonghua Yu Fang Yi Xue Za Zhi 2017; 51:117-120. [PMID: 28219148 DOI: 10.3760/cma.j.issn.0253-9624.2017.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the vitamin A nutritional status of 6- to 17-year-old urban children and adolescents by analyzing serum retinol level, between 2010 and 2012 in China. Methods: Data were obtained from the China Nutrition and Health Survey in 2010-2012. Using multi-stage stratified sampling and the population proportional stratified random sampling method, 6 617 children aged 6-17 years from 32 metropolis and 41 middle-sized and small cities of China were selected. The questionnaire survey was used to collect demographic information. Blood samples were analyzed using high-performance liquid chromatography to determine serum retinol concentration, and the World Health Organization guidelines were used to evaluate the nutritional status of vitamin A. Vitamin A levels, vitamin A deficiency, and marginal vitamin A deficiency in children with different characteristics were compared. Results: A total of 3 785 cases with valid samples were obtained. The overall mean serum retinol concentration level was (1.49±0.71) μmol/L; the mean serum retinol concentration was (1.55±0.69) μmol/L for metropolis and (1.49±0.75) μmol/L for middle-sized and small cities (P>0.05). The mean serum retinol concentration was (1.52±0.78) μmol/L for boys and (1.47±0.68) μmol/L for girls (P>0.05). The mean serum retinol concentration level was (1.46±0.70) μmol/L for 6- to 11-year-old children and (1.54±0.65) μmol/L for 12- to 17-year-old children (P<0.05). The total vitamin A deficiency rate and marginal vitamin A deficiency rate was 7.69% (291/3 785) and 18.57% (703/3 785), respectively. The vitamin A deficiency rate was 8.00% (36/450) for metropolis and 7.64% (65/3 335) for middle-sized and small cities; 8.12% (155/1 908) for boys and 7.25% (136/1 877) for girls; and 8.04% (171/2 115) for 6- to 11-year-old children and 7.18% (120/1 670) for 12- to 17-year-old children. No significant differences were observed for region, sex, or age (P>0.05). The marginal vitamin A deficiency rate was 19.11% (86/450) for metropolis and 18.50% (617/3 335) for middle-sized and small cities; 18.19% (347/1 908) for boys and 18.97% (356/1 877) for girls, with no significant differences observed (P>0.05). The marginal vitamin A deficiency rate was 16.54% (350/2 115) for 6- to 11-year-old children and 21.13% (353/1 670) for 12- to 17-year-old children (P<0.05). Conclusion: The vitamin A nutritional status of 6- to 17-year-old Chinese urban children and adolescents between 2010 and 2012 has improved, and the gap between cities is narrowing. However, vitamin A deficiency overall remains high, especially in younger children, and requires specific attention.
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Affiliation(s)
- Y Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention; Key Laboratory of Trace Element Nutrition, National Health and Family Planning Commission, Beijing 100050, China
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Su ZY, Ye Q, Liu XB, Chen YZ, Zhan H, Xu SY. Dexmedetomidine mitigates isoflurane-induced neurodegeneration in fetal rats during the second trimester of pregnancy. Neural Regen Res 2017; 12:1329-1337. [PMID: 28966649 PMCID: PMC5607829 DOI: 10.4103/1673-5374.213554] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Dexmedetomidine has significant neuroprotective effects. However, whether its protective effects can reduce neurotoxicity caused by isoflurane in fetal brain during the second trimester of pregnancy remains unclear. In this study, timed-pregnancy rats at gestational day 14 spontaneously inhaled 1.5% isoflurane for 4 hours, and were intraperitoneally injected with dexmedetomidine at dosages of 5, 10, 20, and 20 μg/kg 15 minutes before inhalation and after inhalation for 2 hours. Our results demonstrate that 4 hours after inhaling isoflurane, 20 μg/kg dexmedetomidine visibly mitigated isoflurane-induced neuronal apoptosis, reversed downregulation of brain-derived neurotrophic factor expression, and lessened decreased spatial learning and memory ability in adulthood in the fetal rats. Altogether, these findings indicate that dexmedetomidine can reduce neurodegeneration induced by isoflurane in fetal rats during the second trimester of pregnancy. Further, brain-derived neurotrophic factor participates in this process.
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Affiliation(s)
- Zhi-Yuan Su
- Department of Anesthesia, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Qing Ye
- Department of Anesthesia, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Xian-Bao Liu
- Department of Anesthesia, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Yu-Zhong Chen
- Department of Anesthesia, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Hong Zhan
- Department of Anesthesia, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Shi-Yuan Xu
- Department of Anesthesia, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong Province, China
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