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Huang ZN, Wang J, Wang ZY, Min LY, Ni HL, Han YL, Tian YY, Cui YZ, Han JX, Cheng XF. SR9009 attenuates inflammation-related NPMSC pyroptosis and IVDD through NR1D1/NLRP3/IL-1β pathway. iScience 2024; 27:109733. [PMID: 38689641 PMCID: PMC11059531 DOI: 10.1016/j.isci.2024.109733] [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: 05/30/2023] [Revised: 01/29/2024] [Accepted: 04/09/2024] [Indexed: 05/02/2024] Open
Abstract
Intervertebral disc is a highly rhythmical tissue. As a key factor linking biorhythm and inflammatory response, the shielding effect of NR1D1 in the process of intervertebral disc degeneration remains unclear. Here, we first confirmed that NR1D1 in the nucleus pulposus tissue presents periodic rhythmic changes and decreases in expression with intervertebral disc degeneration. Second, when NR1D1 was activated by SR9009 in vitro, NLRP3 inflammasome assembly and IL-1β production were inhibited, while ECM synthesis was increased. Finally, the vivo experiments further confirmed that the activation of NR1D1 can delay the process of disc degeneration to a certain extent. Mechanistically, we demonstrate that NR1D1 can bind to IL-1β and NLRP3 promoters, and that the NR1D1/NLRP3/IL-1β pathway is involved in this process. Our results demonstrate that the activation of NR1D1 can effectively reduce IL-1β secretion, alleviate LPS-induced NPMSC pyroptosis, and protect ECM degeneration.
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Affiliation(s)
- Ze-Nan Huang
- Department of Orthopedics, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 200072, Shandong Province, China
| | - Jing Wang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Shandong First Medical University, Jinan 200072, Shandong Province, China
| | - Ze-yu Wang
- Department of Spine Surgery, Affiliated Nanjing Jiangbei Hospital of Xinglin College, Nantong University, Nanjing 210019, Jiangsu Province, China
| | - Ling-yuan Min
- Research Center of Translational Medicine, Central Hospital Affiliated to Shandong First Medical University, Jinan 200072, Shandong Province, China
| | - Hai-Ling Ni
- Department of Orthopedics, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 200072, Shandong Province, China
| | - Yan-Ling Han
- Medical Experimental Research Center, Yangzhou University, Yangzhou 225001, Jiangsu Province, China
| | - You-yue Tian
- Department of Pharmacy, University of South China, Hengyang 421001, Hunan Province, China
| | - Ya-Zhou Cui
- Department of Orthopedic Surgery, The First Affiliated Hospital of Shandong First Medical University, Jinan 200072, Shandong Province, China
| | - Jing-Xiang Han
- Department of Orthopedics, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 200072, Shandong Province, China
| | - Xiao-Fei Cheng
- Department of Orthopaedic Surgery, Shanghai Key Laboratory of Orthopedic Implants, Shanghai Ninth People’s Hospital affiliated to Shanghai JiaoTong University School of Medicine, Shanghai 200011, China
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Zhao JC, Feng MX, Su M, Han YL, Xue F, Tang YJ, Zhang AA, Tang JY, Gao YJ. [Clinical analysis of 18 children with aggressive mature B-cell lymphoma after liver transplantation]. Zhonghua Er Ke Za Zhi 2024; 62:553-558. [PMID: 38763878 DOI: 10.3760/cma.j.cn112140-20230928-00233] [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: 05/21/2024]
Abstract
Objective: To summarize the clinical characteristics, prognostic factors and treatment outcomes of childhood aggressive mature B-cell lymphoma after liver transplantation. Methods: This retrospective study included 18 children with newly diagnosed aggressive mature B-cell lymphoma after liver transplantation and treated from June 2018 to June 2022 in the Department of Hematology and Oncology of Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine. Clinical characteristics, treatment and outcomes of patients at last evaluation were analyzed. Overall survival (OS) and event free survival (EFS) rates were calculated by Kaplan-Meier method and Log-Rank analysis was performed to find factors of poor prognosis. Results: Among all 18 patients, there were 6 males and 12 females, and the age of onset was 40 (35, 54) months. The interval from transplant to tumor diagnosis was 21 (17, 35) months and 5 patients had early onset disease (<1 year since transplant). Seventeen patients had abdominal lesions. Diarrhea, vomiting and abdominal masses were the main clinical manifestations. All patients were Epstein-Barr virus (EBV) related posttransplant lymphoproliferative disorders (PTLD). One patient received individualized therapy due to critical sick at diagnosis, and the remaining 17 patients received CP (cyclophosphamide, methylprednisolone plus rituximab) and/or modified EPOCH (prednisone, etoposide, doxorubicin, vincristine, cyclophosphamide plus rituximab) regimens. Of all 18 patients, 15 cases got complete response, 2 cases got partial response, 1 patient died of severe infection. The 2-year OS and EFS rates of 18 patients were (94±5)% and (83±8)%, respectively. None of age, gender or early onset disease had effect on OS and EFS rates in univariate analysis (all P>0.05). Conclusions: The symptoms of PTLD were atypical. Close surveillance of EBV-DNA for patients after liver transplantation was crucial to early stage PTLD diagnosis. CP or modified EPOCH regimen was efficient for pediatric patients with aggressive mature B cell lymphoma after liver transplantation.
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Affiliation(s)
- J C Zhao
- Department of Hematology and Oncology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - M X Feng
- Department of Liver Surgery and Liver Transplantation, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - M Su
- Department of Hematology and Oncology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - Y L Han
- Department of Hematology and Oncology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - F Xue
- Department of Liver Surgery and Liver Transplantation, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - Y J Tang
- Department of Hematology and Oncology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - A A Zhang
- Department of Hematology and Oncology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - J Y Tang
- Department of Hematology and Oncology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - Y J Gao
- Department of Hematology and Oncology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
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Yan HB, Han YL. [Improving the prognosis of critical myocardial infarct patients: still a long way to go]. Zhonghua Xin Xue Guan Bing Za Zhi 2024; 52:227-230. [PMID: 38514326 DOI: 10.3760/cma.j.cn112148-20240108-00017] [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: 03/23/2024]
Affiliation(s)
- H B Yan
- Coronary Heart Disease Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100037, China
| | - Y L Han
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
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4
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Xu DL, Han YL, Zhang SY. [Keeping pace with the times, enhancing standardized diagnosis and treatment capabilities for heart failure]. Zhonghua Xin Xue Guan Bing Za Zhi 2024; 52:231-234. [PMID: 38514327 DOI: 10.3760/cma.j.cn112148-20240122-00054] [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: 03/23/2024]
Affiliation(s)
- D L Xu
- Department of Cadiovascular Medicine, Nanfang Hospital, State Key Laboratory Organ Failure Research, Southern Medical University, Guangzhou 510515, China
| | - Y L Han
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - S Y Zhang
- Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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Luo SQ, Gao SQ, Fei MX, Xue-Wang, Yan-Sun, Ran-Zhao, Han YL, Wang HD, Zhou ML. Ligation of cervical lymphatic vessels decelerates blood clearance and worsens outcomes after experimental subarachnoid hemorrhage. Brain Res 2024; 1837:148855. [PMID: 38471644 DOI: 10.1016/j.brainres.2024.148855] [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: 12/21/2023] [Revised: 02/28/2024] [Accepted: 03/08/2024] [Indexed: 03/14/2024]
Abstract
Subarachnoid hemorrhage (SAH) is characterized by the extravasation of blood into the subarachnoid space, in which erythrocyte lysis is the primary contributor to cell death and brain injuries. New evidence has indicated that meningeal lymphatic vessels (mLVs) are essential in guiding fluid and macromolecular waste from cerebrospinal fluid (CSF) into deep cervical lymph nodes (dCLNs). However, the role of mLVs in clearing erythrocytes after SAH has not been completely elucidated. Hence, we conducted a cross-species study. Autologous blood was injected into the subarachnoid space of rabbits and rats to induce SAH. Erythrocytes in the CSF were measured with/without deep cervical lymph vessels (dCLVs) ligation. Additionally, prior to inducing SAH, we administered rats with vascular endothelial growth factor C (VEGF-C), which is essential for meningeal lymphangiogenesis and maintaining integrity and survival of lymphatic vessels. The results showed that the blood clearance rate was significantly lower after dCLVs ligation in both the rat and rabbit models. DCLVs ligation aggravated neuroinflammation, neuronal damage, brain edema, and behavioral impairment after SAH. Conversely, the treatment of VEGF-C enhanced meningeal lymphatic drainage of erythrocytes and improved outcomes in SAH. In summary, our research highlights the indispensable role of the meningeal lymphatic pathway in the clearance of blood and mediating consequences after SAH.
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Affiliation(s)
- Shi-Qiao Luo
- Department of Neurosurgery, Affiliated Jinling Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Sheng-Qing Gao
- Department of Neurosurgery, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, People's Republic of China
| | - Mao-Xing Fei
- Department of Neurosurgery, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, People's Republic of China
| | - Xue-Wang
- Department of Neurosurgery, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, People's Republic of China
| | - Yan-Sun
- Department of Neurosurgery, Affiliated Jinling Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Ran-Zhao
- Department of Neurosurgery, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, People's Republic of China
| | - Yan-Ling Han
- Department of Neurosurgery, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, People's Republic of China
| | - Han-Dong Wang
- Department of Neurosurgery, Affiliated Jinling Hospital, Nanjing Medical University, Nanjing, People's Republic of China; Department of Neurosurgery, Affiliated BenQ Hospital, Nanjing Medical University, Nanjing, People's Republic of China.
| | - Meng-Liang Zhou
- Department of Neurosurgery, Affiliated Jinling Hospital, Nanjing Medical University, Nanjing, People's Republic of China; Department of Neurosurgery, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, People's Republic of China.
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6
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Han YL. [Promoting self-reliance and self-strengthening in science and technology, and closely relying on innovation to improve the level of prevention and treatment of cardiovascular diseases in China]. Zhonghua Xin Xue Guan Bing Za Zhi 2024; 52:1-2. [PMID: 38220449 DOI: 10.3760/cma.j.cn112148-20231120-00448] [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: 01/16/2024]
Affiliation(s)
- Y L Han
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
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Gao SQ, Wang X, Li T, Gao CC, Han YL, Qiu JY, Miao SH, Sun Y, Zhao R, Zheng XB, Zhou ML. Astrocyte-derived hepcidin aggravates neuronal iron accumulation after subarachnoid hemorrhage by decreasing neuronal ferroportin1. Free Radic Biol Med 2024; 210:318-332. [PMID: 38052274 DOI: 10.1016/j.freeradbiomed.2023.11.036] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/27/2023] [Accepted: 11/28/2023] [Indexed: 12/07/2023]
Abstract
Iron accumulation is one of the most essential pathological events after subarachnoid hemorrhage (SAH). Ferroportin1 (FPN1) is the only transmembrane protein responsible for exporting iron. Hepcidin, as the major regulator of FPN1, is responsible for its degradation. Our study investigated how the interaction between FPN1 and hepcidin contributes to iron accumulation after SAH. We found that iron accumulation aggravated after SAH, along with decreased FPN1 in neurons and increased hepcidin in astrocytes. After knocking down hepcidin in astrocytes, the neuronal FPN1 significantly elevated, thus attenuating iron accumulation. After SAH, p-Smad1/5 and Smad4 tended to translocate into the nucleus. Moreover, Smad4 combined more fragments of the promoter region of Hamp after OxyHb stimulation. By knocking down Smad1/5 or Smad4 in astrocytes, FPN1 level restored and iron overload attenuated, leading to alleviated neuronal cell death and improved neurological function. However, the protective role disappeared after recombinant hepcidin administration. Therefore, our study suggests that owing to the nuclear translocation of transcription factors p-Smad1/5 and Smad4, astrocyte-derived hepcidin increased significantly after SAH, leading to a decreased level of neuronal FPN1, aggravation of iron accumulation, and worse neurological outcome.
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Affiliation(s)
- Sheng-Qing Gao
- Department of Neurosurgery, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Xue Wang
- Department of Neurosurgery, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Tao Li
- Department of Neurosurgery, Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Chao-Chao Gao
- Department of Neurosurgery, Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Yan-Ling Han
- Department of Neurosurgery, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Jia-Yin Qiu
- Department of Neurosurgery, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Shu-Hao Miao
- Department of Neurosurgery, Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Yan Sun
- Department of Neurosurgery, Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Ran Zhao
- Department of Neurosurgery, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Xiao-Bo Zheng
- Jinling Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, China
| | - Meng-Liang Zhou
- Department of Neurosurgery, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
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8
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Han YL, Li Y. [Emergency coronary intervention treatment for acute myocardial infarction: reach back on the past 40 years]. Zhonghua Xin Xue Guan Bing Za Zhi 2023; 51:1207-1211. [PMID: 38123202 DOI: 10.3760/cma.j.cn112148-20230814-00074] [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: 12/23/2023]
Affiliation(s)
- Y L Han
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Y Li
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
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9
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Li Y, Han YL. [Interpretation of 2023 ESC Guidelines for the management of acute coronary syndromes]. Zhonghua Xin Xue Guan Bing Za Zhi 2023; 51:1263-1267. [PMID: 38123210 DOI: 10.3760/cma.j.cn112148-20230920-00175] [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: 12/23/2023]
Affiliation(s)
- Y Li
- State Key Laboratory of Frigid Zone Cardiovascular Disease, Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Y L Han
- State Key Laboratory of Frigid Zone Cardiovascular Disease, Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
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Liu ZZ, Yan CH, Han YL. [Current status of cardiovascular translational medicine research: from high throughput multi omics to integrative bioinformatics]. Zhonghua Xin Xue Guan Bing Za Zhi 2023; 51:1121-1123. [PMID: 37963744 DOI: 10.3760/cma.j.cn112148-20230920-00177] [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: 11/16/2023]
Affiliation(s)
- Z Z Liu
- State Key Laboratory of Frigid Zone Cardiovascular Diseases, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - C H Yan
- State Key Laboratory of Frigid Zone Cardiovascular Diseases, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Y L Han
- State Key Laboratory of Frigid Zone Cardiovascular Diseases, General Hospital of Northern Theater Command, Shenyang 110016, China
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Huang ZN, Wang ZY, Cheng XF, Huang ZZ, Han YL, Cui YZ, Liu B, Tian W. Melatonin alleviates oxidative stress-induced injury to nucleus pulposus-derived mesenchymal stem cells through activating PI3K/Akt pathway. J Orthop Translat 2023; 43:66-84. [PMID: 38089645 PMCID: PMC10711395 DOI: 10.1016/j.jot.2023.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 08/23/2023] [Revised: 09/23/2023] [Accepted: 10/10/2023] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND The changes in the microenvironment of degenerative intervertebral discs cause oxidative stress injury and excessive apoptosis of intervertebral disc endogenous stem cells. The purpose of this study was to explore the possible mechanism of the protective effect of melatonin on oxidative stress injury in NPMSCs induced by H2O2. METHODS The Cell Counting Kit-8 assay was used to evaluate the cytotoxicity of hydrogen peroxide and the protective effects of melatonin. ROS content was detected by 2'7'-dichlorofluorescin diacetate (DCFH-DA). Mitochondrial membrane potential (MMP) was detected by the JC-1assay. Transferase mediated d-UTP Nick end labeling (TUNEL) and Annexin V/PI double staining were used to determine the apoptosis rate. Additionally, apoptosis-associated proteins and PI3K/Akt signaling pathway-related proteins were evaluated by immunofluorescence, immunoblotting and PCR. ECMs were evaluated by RT‒PCR and immunofluorescence. In vivo, X-ray, Magnetic resonance imaging (MRI) and Histological analyses were used to evaluate the protective effect of melatonin. RESULTS Melatonin had an obvious protective effect on NPMSCs treated with 0-10 μM melatonin for 24 h. In addition, melatonin also had obvious protective effects on mitochondrial dysfunction, decreased membrane potential and cell senescence induced by H2O2. More importantly, melatonin could significantly reduce the apoptosis of nucleus pulposus mesenchymal stem cells induced by H2O2 by regulating the expression of apoptosis-related proteins and decreasing the rate of apoptosis. After treatment with melatonin, the PI3K/Akt pathway was significantly activated in nucleus pulposus mesenchymal stem cells, while the protective effect was significantly weakened after PI3K-IN-1 treatment. In vivo, the results of X-ray, MRI and histological analyses showed that therapy with melatonin could partially reduce the degree of intervertebral disc degeneration. CONCLUSION Our research demonstrated that melatonin can effectively alleviate the excessive apoptosis and mitochondrial dysfunction of nucleus pulposus mesenchymal stem cells induced by oxidative stress via the PI3K/Akt pathway, which provides a novel idea for the therapy of intervertebral disc degeneration. THE TRANSLATIONAL POTENTIAL OF THIS ARTICLE This study indicates that melatonin can effectively alleviate the excessive apoptosis and mitochondrial dysfunction of NPMSCs through activating the PI3K/Akt pathway. Melatonin might serve as a promising candidate for the prevention and treatment of Intervertebral disc degeneration disease (IVDD) in the future.
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Affiliation(s)
- Ze-Nan Huang
- Department of Orthopedics, Shandong First Medical University & Shandong Academy of Medical Science, Shandong, 200072, China
- Department of Spine Surgery, Beijing Jishuitan Hospital, The Fourth Clinical Hospital Affiliated to Peking University, No. 37 Xinjiekou East, Road, Beijing, 100035, China
| | - Ze-Yu Wang
- Department of Orthopedics, The Affiliated BenQ Hospital of Nanjing Medical University, 210019, Nanjing, Jiangsu Province, China
| | - Xiao-Fei Cheng
- Department of Orthopedic Surgery, Shanghai Key Laboratory of Orthopedics Implants, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, China
| | - Zhao-Zhang Huang
- Taixing Medical Center, Taixing People's Hospital, Taixing, 225400, Jiangsu Province, China
| | - Yan-Ling Han
- Medical Experimental Research Center, Yangzhou University, Yangzhou, 225001, China
| | - Ya-Zhou Cui
- Department of Orthopedics, Shandong First Medical University & Shandong Academy of Medical Science, Shandong, 200072, China
| | - Bo Liu
- Department of Spine Surgery, Beijing Jishuitan Hospital, The Fourth Clinical Hospital Affiliated to Peking University, No. 37 Xinjiekou East, Road, Beijing, 100035, China
| | - Wei Tian
- Department of Spine Surgery, Beijing Jishuitan Hospital, The Fourth Clinical Hospital Affiliated to Peking University, No. 37 Xinjiekou East, Road, Beijing, 100035, China
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Wang H, Yang JF, Han YL. [Challenges and future directions in heart failure with preserved ejection fraction]. Zhonghua Xin Xue Guan Bing Za Zhi 2023; 51:1028-1032. [PMID: 37859354 DOI: 10.3760/cma.j.cn112148-20230725-00023] [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: 10/21/2023]
Affiliation(s)
- H Wang
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - J F Yang
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Y L Han
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
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Guan SY, Liang ZY, Qiu MH, Liu HW, Xu K, Ma YY, Wang B, Jing QM, Han YL. [Efficacy and safety of extracorporeal membrane oxygenation-supported percutaneous coronary intervention in chronic coronary total occlusion patients with reduced left ventricular ejection fraction]. Zhonghua Xin Xue Guan Bing Za Zhi 2023; 51:984-989. [PMID: 37709716 DOI: 10.3760/cma.j.cn112148-20230808-00060] [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: 09/16/2023]
Abstract
Objective: To investigate the feasibility and safety of extracorporeal membrane oxygenation (ECMO)-supported percutaneous coronary intervention (PCI) in chronic coronary total occlusion (CTO) patients with reduced left ventricular ejection fraction (LVEF). Methods: The CTO patients with LVEF≤35% and undergoing CTO-PCI assisted by ECMO in the General Hospital of Northern Theater Command from December 2018 to March 2022 were enrolled in this study. The post-procedure complications, changes of LVEF from pre-procedure to post-procedure during hospitalization, and the incidence of all-cause mortality and changes of LVEF after discharge were assessed. Results: A total of 17 patients aged (59.4±11.8) years were included. There were 14 males. The pre-procedure LVEF of these patients were (29.00±4.08)%. Coronary angiography results showed that there were 29 CTO lesions in these 17 patients. There was 1 in left main coronary artery, 7 in left anterior descending artery, 11 in left circumflex artery, and 10 in right coronary artery. ECMO was implanted in all patients before procedure. Among 25 CTO lesions attempted to cross, 24 CTO were successfully implanted with stents. All patients underwent successful PCI for at least one CTO lesion. The number of drug-eluting stents implantation per patient were 4.6±1.3. After procedure, there were 8 patients with hemoglobin decreased>20 g/L, and 1 patient with ECMO-access-site related bleeding. The LVEF value at a median duration of 2.5 (2.0-5.5) days after procedure significantly increased to (38.73±7.01)% (P<0.001 vs. baseline). There were no in-hospital deaths. Patients were followed up for 360 (120, 394) days after discharge, 3 patients died (3/17). The LVEF value was (41.80±7.32)% at 155 (100, 308) days after discharge, which was significantly higher than the baseline value (P<0.001). Conclusion: The results of present study demonstrate that it is feasible, efficient and safe to perform ECMO)-supported CTO-PCI in CTO patients with reduced LVEF.
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Affiliation(s)
- S Y Guan
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Z Y Liang
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - M H Qiu
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - H W Liu
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - K Xu
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Y Y Ma
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - B Wang
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Q M Jing
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Y L Han
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
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Xu K, Han YL. [Transcatheter interventional therapy for heart valve disease: applications and challenges]. Zhonghua Yi Xue Za Zhi 2023; 103:1805-1808. [PMID: 37357183 DOI: 10.3760/cma.j.cn112137-20221215-02660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Heart valve disease (HVD) is one of the most common cardiovascular diseases, and its incidence increases gradually with the aging of population. Surgery has long been the main solution to treat HVD. In recent years, the transcatheter interventional therapy of HVD has made great progress with the continuous technology innovation and improvement of devices. This article mainly describes the applications and challenges of transcatheter interventional therapy in aortic valve, mitral valve, tricuspid valve and pulmonary valve.
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Affiliation(s)
- K Xu
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Y L Han
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
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Li WF, Xu LJ, Han YL, Li LH. [Study on the status of turnover intention and its influencing factors of 382 hemato-oncology nurses]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2023; 41:408-413. [PMID: 37400399 DOI: 10.3760/cma.j.cn121094-20220424-00220] [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: 07/05/2023]
Abstract
Objective: To explore the status of turnover intention and its influencing factors of hemato-oncology nurses. Methods: From September to November 2021, the convenience sampling method was used to select 382 hemato-oncology nurses from 8 tertiary grade A general hospitals in Shandong Province. The general information questionnaire, the Chinese Nurses' Work Stressor Scale, the Psychological Capital Questionnaire and the Turnover Intention Questionnaire were used to investigate the general situation, occupational stress, psychological capital and turnover intention of the objects. The correlations between the turnover intention, occupational stress and psychological capital of the objects were analyze by Pearson correlation. And the multiple linear regression was used to analyze the influencing factors of turnover intention. A structural equation model was used to analyze the effect path of occupational stress and psychological capital on turnover intention. Results: The total turnover intention score of hemato-oncology nurses was (14.25±4.03), with the average item score of (2.38±0.67). The occupational stress score of hemato-oncology nurses was (71.57±14.43), and the psychological capital score was (91.96±15.29). The results of correlation analysis showed that the turnover intention of hemato-oncology nurses was positively correlated with occupational stress, and was negatively correlated with psychological capital (r=0.599, -0.489, P<0.001). Multiple linear regression analysis showed that married (β=-0.141), psychological capital (β=-0.156) and occupational stress (β=0.493) were the influencing factors of turnover intention of hemato-oncology nurses (P<0.05). The path analysis of structural equation model showed that the direct effect of occupational stress on turnover intention of hemato-oncology nurses was 0.522, and the intermediary effect of psychological capital on turnover intention was 0.143 (95%CI: 0.013-0.312, P<0.05), accounting for 21.5% of the total effect. Conclusion: The turnover intention of hemato-oncology nurses is at a high level, hospital and administrators should focus on the psychological state of unmarried nurses. By improving the psychological capital of nurses, to reduce occupational stress and turnover intention.
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Affiliation(s)
- W F Li
- Department of Hematology, Qilu Hospital of Shandong Univeisity, Jinan 250012, China
| | - L J Xu
- Department of Hematology, Qilu Hospital of Shandong Univeisity, Jinan 250012, China
| | - Y L Han
- Department of Hematology, Qilu Hospital of Shandong Univeisity, Jinan 250012, China
| | - L H Li
- Department of Hematology, Qilu Hospital of Shandong Univeisity, Jinan 250012, China
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Han YL. [Carrying on the past heritage and opening up the new journey: chief editor's celebrating words for the 50 th anniversary of the Chinese Journal of Cardiology]. Zhonghua Xin Xue Guan Bing Za Zhi 2023; 51:333-334. [PMID: 37057321 DOI: 10.3760/cma.j.cn112148-20230209-00078] [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: 04/15/2023]
Affiliation(s)
- Y L Han
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
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Miao SH, Gao SQ, Li HX, Zhuang YS, Wang X, Li T, Gao CC, Han YL, Qiu JY, Zhou ML. Increased NOX2 expression in astrocytes leads to eNOS uncoupling through dihydrofolate reductase in endothelial cells after subarachnoid hemorrhage. Front Mol Neurosci 2023; 16:1121944. [PMID: 37063365 PMCID: PMC10097896 DOI: 10.3389/fnmol.2023.1121944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 03/13/2023] [Indexed: 04/03/2023] Open
Abstract
IntroductionEndothelial nitric oxide synthase (eNOS) uncoupling plays a significant role in acute vasoconstriction during early brain injury (EBI) after subarachnoid hemorrhage (SAH). Astrocytes in the neurovascular unit extend their foot processes around endothelia. In our study, we tested the hypothesis that increased nicotinamide adenine dinucleotide phosphate oxidase 2 (NOX2) expression in astrocytes after SAH leads to eNOS uncoupling.MethodsWe utilized laser speckle contrast imaging for monitoring cortical blood flow changes in mice, nitric oxide (NO) kits to measure the level of NO, and a co-culture system to study the effect of astrocytes on endothelial cells. Moreover, the protein levels were assessed by Western blot and immunofluorescence staining. We used CCK-8 to measure the viability of astrocytes and endothelial cells, and we used the H2O2 kit to measure the H2O2 released from astrocytes. We used GSK2795039 as an inhibitor of NOX2, whereas lentivirus and adeno-associated virus were used for dihydrofolate reductase (DHFR) knockdown in vivo and in vitro.ResultsThe expression of NOX2 and the release of H2O2 in astrocytes are increased, which was accompanied by a decrease in endothelial DHFR 12 h after SAH. Moreover, the eNOS monomer/dimer ratio increased, leading to a decrease in NO and acute cerebral ischemia. All of the above were significantly alleviated after the administration of GSK2795039. However, after knocking down DHFR both in vivo and in vitro, the protective effect of GSK2795039 was greatly reversed.DiscussionThe increased level of NOX2 in astrocytes contributes to decreased DHFR in endothelial cells, thus aggravating eNOS uncoupling, which is an essential mechanism underlying acute vasoconstriction after SAH.
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Affiliation(s)
- Shu-Hao Miao
- Department of Neurosurgery, Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Sheng-Qing Gao
- Department of Neurosurgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Hui-Xin Li
- Department of Gynecology, Women’s Hospital of Nanjing Medical University, Nanjing, China
| | - Yun-Song Zhuang
- Department of Neurosurgery, Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Xue Wang
- Department of Neurosurgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Tao Li
- Department of Neurosurgery, Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Chao-Chao Gao
- Department of Neurosurgery, Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Yan-Ling Han
- Department of Neurosurgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Jia-Yin Qiu
- Department of Neurosurgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Meng-Liang Zhou
- Department of Neurosurgery, Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, Nanjing, China
- *Correspondence: Meng-Liang Zhou,
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Zhuang YS, Wang X, Gao SQ, Miao SH, Li T, Gao CC, Han YL, Qiu JY, Zhou ML, Wang HD. Neuroprotective mechanisms of OXCT1 via the SIRT3-SOD2 pathway after traumatic brain injury. Brain Res 2023; 1808:148324. [PMID: 36921750 DOI: 10.1016/j.brainres.2023.148324] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/01/2023] [Accepted: 03/09/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Ketones are not only utilized to produce energy but also play a neuroprotective role in many neurodegenerative diseases. However, whether this process has an impact on secondary brain damage after traumatic brain injury (TBI) remains unknown. OXCT1 (3-Oxoacid CoA-Transferase 1) is the rate-limiting enzyme in the intra-neuronal utilization of ketones. In this study, we investigated whether reduced expression of OXCT1 after TBI could impact neuroprotective mechanisms and exacerbate neurological dysfunction. MATERIALS AND METHODS Experimental TBI was induced by a modified version of the weight drop model, it is a model of severe head trauma. Expression of OXCT1 in the injured hippocampus of mice was measured at different time points using immunoblotting assays. The release of abnormal mitochondrial cytochrome c from neurons of the mouse injured lateral hippocampus was measured 1 week after TBI using immunoblotting assays. Neuronal death was assessed by Nissl staining and the level of reactive oxygen species (ROS) within the neurons of the injured lateral hippocampus was assessed by Dihydroethidium staining. Results OXCT1 was overexpressed in hippocampal neurons by injection of adeno-associated virus into the lateral ventricle. OXCT1 expression levels decreased significantly 1 week post-TBI. After comparing the data obtained from different groups of mice, OXCT1 was found to significantly increase the expression of SIRT3 and reduce the proportion of acetylated SOD2, thus decreasing the production of ROS in the injured hippocampal neurons, reducing neuronal death, and improving cognitive function. Conclusions OXCT1 has a critical previously unappreciated protective role in neurological impairment following TBI via the SIR3-SOD2 pathway. These findings highlight the potential of OXCT1 as a simple treatment for patients with TBI.
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Affiliation(s)
- Yun-Song Zhuang
- Department of Neurosurgery, Affiliated Jinling Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Xue Wang
- Department of Neurosurgery, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, People's Republic of China
| | - Sheng-Qing Gao
- Department of Neurosurgery, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, People's Republic of China
| | - Shu-Hao Miao
- Department of Neurosurgery, Affiliated Jinling Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Tao Li
- Department of Neurosurgery, Affiliated Jinling Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Chao-Chao Gao
- Department of Neurosurgery, Affiliated Jinling Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Yan-Ling Han
- Department of Neurosurgery, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, People's Republic of China
| | - Jia-Yin Qiu
- Department of Neurosurgery, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, People's Republic of China
| | - Meng-Liang Zhou
- Department of Neurosurgery, Affiliated Jinling Hospital, Nanjing Medical University, Nanjing, People's Republic of China.
| | - Han-Dong Wang
- Department of Neurosurgery, Affiliated Jinling Hospital, Nanjing Medical University, Nanjing, People's Republic of China; Department of Neurosurgery, Benq Medical Center, Nanjing Medical University, People's Republic of China.
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19
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Zhou TN, Li MC, Wang YS, Liu HW, Jing QM, Wang XZ, Han YL. [Clinical characteristics and prognostic analysis of female patients with Stanford type B aortic dissection]. Zhonghua Xin Xue Guan Bing Za Zhi 2023; 51:172-179. [PMID: 36789597 DOI: 10.3760/cma.j.cn112148-20221012-00797] [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: 02/16/2023]
Abstract
Objective: To explore the clinical characteristics and prognostic factors of female patients with Stanford type B aortic dissection. Methods: This is a single-centre retrospective study. Consecutive patients diagnosed with Stanford type B aortic dissection in General Hospital of Northern Theater Command from June 2002 to August 2021 were enrolled, and grouped based on sex. According to the general clinical conditions and complications of aortic dissection tear, patients were treated with thoracic endovascular aortic repair, surgery, or optimal medication. The clinical characteristics and aortic imaging data of the patients at different stages were collected, adverse events including all-cause deaths, stroke, and occurrence of aortic-related adverse events were obtained during hospitalization and within 30 days and at 1 and 5 years after discharge. According to the time of death, death was classified as in-hospital death, out-of-hospital death, and in-hospital death was divided into preoperative death, intraoperative death and postoperative death. According to the cause of death, death was classified as aortic death, cardiac death and other causes of death. Aortic-related adverse events within 30 days after discharge included new paraplegia, post-luminal repair syndrome, and aortic death; long-term (≥1 year after discharge) aortic-related adverse events included aortic death, recurrent aortic dissection, endoleak and distal ulcer events. The clinical characteristics, short-term and long-term prognosis was compared between the groups. Logistic regression analysis was used to explore the association between different clinical factors and all-cause mortality within 30 days in female and male groups separately. Results: A total of 1 094 patients with Stanford type B aortic dissection were enrolled, mean age was (53.9±12.1) years, and 861 (78.7%) were male and 233 (21.3%) were female. (1) Clinical characteristics: compared with male patients, female patients were featured with older average age, higher proportion of aged≥60 years old, back pain, anemia, optimal medication treatment, and higher cholesterol level; while lower proportion of smoking and drinking history, body mass index, calcium antagonists use, creatine kinase level, and white blood cell count (all P<0.05). However, there was no significant difference in dissection tear and clinical stage, history of coronary heart disease, diabetes, hypertension, and cerebrovascular disease between female and male patients (all P>0.05). (2) Follow-up result: compared with male patients, female patients had a higher rate of 30-day death [6.9% (16/233) vs. 3.8% (33/861), P=0.047], in-hospital death (5.6% (13/233) vs. 2.7% (23/861), P=0.027), preoperative death (3.9% (9/233) vs. 1.5% (12/861), P=0.023) and aorta death (6.0% (14/233) vs. 3.1% (27/861), P=0.041). The 1-year and 5-year follow-up results demonstrated that there were no significant differences in death, cerebrovascular disease, and aorta-related adverse events between the two groups (all P>0.05). (3) Prognostic factors: the results of the univariate logistic regression analysis showed that body mass index>24 kg/m2 (HR=1.087, 95%CI 1.029-1.149, P=0.013), history of anemia (HR=2.987, 95%CI 1.054-8.468, P=0.032), hypertension (HR=1.094, 95%CI 1.047-1.143, P=0.040) and troponin-T>0.05 μg/L (HR=5.818, 95%CI 1.611-21.018, P=0.003)were associated with an increased risk of all-cause mortality within 30 days in female patients. Conclusions: Female patients with Stanford type B aortic dissection have specific clinical characteristics, such as older age at presentation, higher rates of anemia and combined back pain, and higher total cholesterol levels. The risk of death within 1 month is higher in female patients than in male patients, which may be associated with body mass index, hypertension, anemia and troponin-T, but the long-term prognosis for both female and male patients is comparable.
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Affiliation(s)
- T N Zhou
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - M C Li
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Y S Wang
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - H W Liu
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Q M Jing
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - X Z Wang
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Y L Han
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
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20
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Yan HB, Han YL. [Interventional strategy for left main artery disease: comprehensive evaluation, shared decision-making, and procedural considerations]. Zhonghua Xin Xue Guan Bing Za Zhi 2023; 51:103-105. [PMID: 36789588 DOI: 10.3760/cma.j.cn112148-20221230-01023] [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: 02/16/2023]
Affiliation(s)
- H B Yan
- Coronary Heart Disease Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100037, China
| | - Y L Han
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
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Tan WEICHIEHTAN, Chew PCHEW, Tsui LAMTSUI, Tan TAN, Duplyakov DUPLYAKOV, Hammoudeh HAMMOUDEH, Zhang B, Li Y, Xu K, Ong JONG, Firman D, Gamra GAMRA, Almahmeed ALMAHMEED, Dalal DALAL, Tan TAN, Steg STEG, Nguyen NNGUYEN, Ako AKO, Suwaidi ALSUWAIDI, Chan CHAN, Sobhy SOBHY, Shehab SHEHAB, Buddhari BUDDHARI, Wang ZL, Fong YEANYIPFONG, Karadag KARADAG, Kim KIM, Baber BABER, Chin TANGCHIN, Han YL. [2021 Asian Pacific Society of Cardiology Consensus Recommendations on the use of P2Y12 receptor antagonists in the Asia-Pacific Region: Special populations]. Zhonghua Xin Xue Guan Bing Za Zhi 2023; 51:19-31. [PMID: 36655238 DOI: 10.3760/cma.j.cn112148-20220729-00588] [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: 01/20/2023]
Affiliation(s)
| | - P C H E W Chew
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | | | - T A N Tan
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore
| | | | | | - B Zhang
- Department of Cardiology, First Affiliated Hospital, Dalian Medical University, Dalian 116000, China
| | - Y Li
- Department of Cardiology, General Hospital of Northern Theatre Command, Shenyang 110840, China
| | - K Xu
- Department of Cardiology, General Hospital of Northern Theatre Command, Shenyang 110840, China
| | - J O N G Ong
- Heart Specialist International, Mount Elizabeth Novena Hospital, Singapore Tan Tock Seng Hospital, Singapore
| | - Doni Firman
- Harapan Kita National Cardiovascular Center/Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia Harapan Kita, Jakarta, Indonesia
| | - G A M R A Gamra
- Cardiology Department, Fattouma Bourguiba University Hospital and University of Monastir, Monastir, Tunisia
| | | | - D A L A L Dalal
- Centre for Cardiac Sciences, Kokilaben Dhirubhai Ambani Hospital, Mumbai, India
| | - T A N Tan
- Kwong Wah Hospital, Hong Kong, China
| | - S T E G Steg
- Department of Cardiology, Hôpital Bichat, Paris, France
| | | | - A K O Ako
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | | | | | | | - S H E H A B Shehab
- College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates
| | | | - Z L Wang
- Department of Cardiology, General Hospital of Northern Theatre Command, Shenyang 110840, China
| | | | | | - K I M Kim
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - B A B E R Baber
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, US
| | | | - Y L Han
- Department of Cardiology, General Hospital of Northern Theatre Command, Shenyang 110840, China
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Wang X, Deng HJ, Gao SQ, Li T, Gao CC, Han YL, Zhuang YS, Qiu JY, Miao SH, Zhou ML. Dobutamine promotes the clearance of erythrocytes from the brain to cervical lymph nodes after subarachnoid hemorrhage in mice. Front Pharmacol 2023; 13:1061457. [PMID: 36703738 PMCID: PMC9871238 DOI: 10.3389/fphar.2022.1061457] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 12/22/2022] [Indexed: 01/11/2023] Open
Abstract
Background: Erythrocytes and their breakdown products in the subarachnoid space (SAS) are the main contributors to the pathogenesis of subarachnoid hemorrhage (SAH). Dobutamine is a potent β1-adrenoreceptor agonist that can increase cardiac output, thus improving blood perfusion and arterial pulsation in the brain. In this study, we investigated whether the administration of dobutamine promoted the clearance of red blood cells (RBCs) and their degraded products via meningeal lymphatic vessels (mLVs), thus alleviating neurological deficits in the early stage post-SAH. Materials and methods: Experimental SAH was induced by injecting autologous arterial blood into the prechiasmatic cistern in male C57BL/6 mice. Evans blue was injected into the cisterna magna, and dobutamine was administered by inserting a femoral venous catheter. RBCs in the deep cervical lymphatic nodes (dCLNs) were evaluated by hematoxylin-eosin staining, and the hemoglobin content in dCLNs was detected by Drabkin's reagent. The accumulation of RBCs in the dura mater was examined by immunofluorescence staining, neuronal death was evaluated by Nissl staining, and apoptotic cell death was evaluated by TUNEL staining. The Morris water maze test was used to examine the cognitive function of mice after SAH. Results: RBCs appeared in dCLNs as early as 3 h post-SAH, and the hemoglobin in dCLNs peaked at 12 h after SAH. Dobutamine significantly promoted cerebrospinal fluid (CSF) drainage from the SAS to dCLNs and obviously reduced the RBC residue in mLVs, leading to a decrease in neuronal death and an improvement in cognitive function after SAH. Conclusion: Dobutamine administration significantly promoted RBC drainage from cerebrospinal fluid in the SAS via mLVs into dCLNs, ultimately relieving neuronal death and improving cognitive function.
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Affiliation(s)
- Xue Wang
- Department of Neurosurgery, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Hong-Ji Deng
- Department of Neurosurgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Sheng-Qing Gao
- Department of Neurosurgery, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Tao Li
- Department of Neurosurgery, Affiliated Jinling Hospital, Nanjing Medical University, Nanjing, China
| | - Chao-Chao Gao
- Department of Neurosurgery, Affiliated Jinling Hospital, Nanjing Medical University, Nanjing, China
| | - Yan-Ling Han
- Department of Neurosurgery, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yun-Song Zhuang
- Department of Neurosurgery, Affiliated Jinling Hospital, Nanjing Medical University, Nanjing, China
| | - Jia-Yin Qiu
- Department of Neurosurgery, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Shu-Hao Miao
- Department of Neurosurgery, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Meng-Liang Zhou
- Department of Neurosurgery, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China,*Correspondence: Meng-Liang Zhou,
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Wang ZL, Han YL. [Interpretation on the new sections and some update points of 2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death]. Zhonghua Xin Xue Guan Bing Za Zhi 2022; 50:1229-1232. [PMID: 36517445 DOI: 10.3760/cma.j.cn112148-20221010-00782] [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: 06/17/2023]
Affiliation(s)
- Z L Wang
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110840, China
| | - Y L Han
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110840, China
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Gao SQ, Shi JJ, Xue-Wang, Miao SH, Li T, Gao CC, Han YL, Qiu JY, Zhuang YS, Zhou ML. Endothelial NOX4 aggravates eNOS uncoupling by decreasing dihydrofolate reductase after subarachnoid hemorrhage. Free Radic Biol Med 2022; 193:499-510. [PMID: 36336227 DOI: 10.1016/j.freeradbiomed.2022.10.318] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/14/2022] [Accepted: 10/29/2022] [Indexed: 11/06/2022]
Abstract
Endothelial malfunction is a major contributor to early or delayed vasospasm after subarachnoid hemorrhage (SAH). As a representative form of endothelial dysfunction, endothelial nitric oxide synthase (eNOS) uncoupling leads to a reduction in nitric oxide (NO) generated by endothelial cells. In this study, we investigated how the interaction between endothelial NOX4 (nicotinamide adenine dinucleotide phosphate oxidase 4) and DHFR (dihydrofolate reductase) contributes to eNOS uncoupling after SAH. Setanaxib and the adeno-associated virus (AAV) targeting brain vascular endothelia were injected through the tail vein and the expression and localization of proteins were examined by western blot and immunofluorescence staining. The NO content was measured using the NO assay kit, and laser speckle contrast imaging was used to assess cortical perfusion. ROS (reactive oxygen species) level was detected by DHE (dihydroethidium) staining, DCFH-DA (2',7'-dichlorofluorescin diacetate) staining and H2O2 (hydrogen peroxide) measurement. The Garcia score was employed to examine neurological function. Setanaxib is widely used for its preferential inhibition for NOX1/4 over other NOX isoforms. After endothelial NOX4 was inhibited by Setanaxib in a mouse model of SAH, the endothelial DHFR level was significantly elevated, which attenuated eNOS uncoupling, increased cortical perfusion, and improved the neurological function. The protective role of inhibiting endothelial NOX4, however, disappeared after knocking down endothelial DHFR. Our results suggest that endothelial DHFR decreased significantly because of the elevated level of endothelial NOX4, which aggravated eNOS uncoupling after SAH, leading to decreased cortical perfusion and worse neurological outcome.
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Affiliation(s)
- Sheng-Qing Gao
- Department of Neurosurgery, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, People's Republic of China
| | - Jia-Jun Shi
- Department of General Surgery, Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing, People's Republic of China
| | - Xue-Wang
- Department of Neurosurgery, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, People's Republic of China
| | - Shu-Hao Miao
- Department of Neurosurgery, Affiliated Jinling Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Tao Li
- Department of Neurosurgery, Affiliated Jinling Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Chao-Chao Gao
- Department of Neurosurgery, Affiliated Jinling Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Yan-Ling Han
- Department of Neurosurgery, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, People's Republic of China
| | - Jia-Yin Qiu
- Department of Neurosurgery, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, People's Republic of China
| | - Yun-Song Zhuang
- Department of Neurosurgery, Affiliated Jinling Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Meng-Liang Zhou
- Department of Neurosurgery, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, People's Republic of China.
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Yang QS, Han YL, Cai JY, Gu S, Bai J, Ren H, Xu M, Zhang J, Zhang AA, Su M, Pan C, Wang Y, Tang JY, Gao YJ. [Analysis of 42 cases of childhood superior vena cava syndrome associated with mediastinal malignancy]. Zhonghua Er Ke Za Zhi 2022; 60:1026-1030. [PMID: 36207849 DOI: 10.3760/cma.j.cn112140-20220323-00239] [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: 06/16/2023]
Abstract
Objective: To summarize the clinical features, management and outcome of superior vena cava syndrome (SVCS) associated with mediastinal malignancy in children. Methods: Clinical data of 42 children of SVSC associated with mediastinal malignancy in Shanghai Children's Medical Center from January 2015 to December 2021 were collected and analyzed retrospectively. The clinical manifestations, pathological diagnosis, disease diagnosis process, and prognosis were summarized. Results: Among 42 children of SVCS associated with mediastinal malignancy, there were 31 males and 11 females. The age at diagnosis was 8.5 (1.9, 14.9) years. Cough and wheezing (33 cases, 79%), orthopnea (19 cases, 45%) and facial edema (18 cases, 43%) occurred most commonly. T-cell lymphoblastic lymphoma (T-LBL) was the most frequent pathological diagnosis (25 cases, 60%), followed by T-cell acute lymphoblastic leukemia (T-ALL) (7 cases, 17%), anaplastic large cell lymphoma (4 cases, 10%) and diffuse large B-cell lymphoma (2 cases, 5%), peripheral T-lymphoma, Hodgkin lymphoma, Ewing's sarcoma and germ cell tumor (1 case each). Pathological diagnosis was confirmed by bone marrow aspiration or thoracentesis in 14 cases, peripheral lymph node biopsy in 6 cases, and mediastinal biopsy in 22 cases. Twenty-seven cases (64%) had local anesthesia. Respiratory complications due to mediastinal mass developed in 3 of 15 cases who received general anesthesia. Of the 42 cases, 27 cases had sustained remission, 1 case survived with second-line therapy after recurrence, and 14 cases died (2 cases died of perioperative complications and 12 cases died of recurrence or progression of primary disease). The follow-up time was 36.7 (1.2, 76.1) months for 27 cases in continuous complete remission. The 3-year overall survival (OS) and events free survival (EFS) rates of 42 children were 59% (95%CI 44%-79%) and 58% (95%CI 44%-77%) respectively. Conclusions: SVCS associated with mediastinal malignancy in children is a life-threatening tumor emergency with high mortality. The most common primary disease is T-LBL. The most common clinical symptoms and signs are cough, wheezing, orthopnea and facial edema. Clinical management should be based on the premise of stable critical condition and confirm the pathological diagnosis through minimal invasive operation.
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Affiliation(s)
- Q S Yang
- Department of Hematology/Oncology,Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - Y L Han
- Department of Hematology/Oncology,Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - J Y Cai
- Department of Hematology/Oncology,Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - S Gu
- Department of General Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - J Bai
- Department of Anesthesiology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - H Ren
- Department of Critical Care Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - M Xu
- Department of General Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - J Zhang
- Department of Hematology/Oncology,Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - A A Zhang
- Department of Hematology/Oncology,Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - M Su
- Department of Hematology/Oncology,Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - C Pan
- Department of Hematology/Oncology,Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - Y Wang
- Department of Critical Care Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - J Y Tang
- Department of Hematology/Oncology,Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - Y J Gao
- Department of Hematology/Oncology,Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
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26
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Han YL. [Urgent need to optimize the management of acute aortic syndrome]. Zhonghua Xin Xue Guan Bing Za Zhi 2022; 50:737-738. [PMID: 35982002 DOI: 10.3760/cma.j.cn112148-20220704-00513] [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: 06/15/2023]
Affiliation(s)
- Y L Han
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
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27
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Wang ZL, Han YL. [Executive summary and interpretation on the update points of 2022 AHA/ACC/HFSA guideline for the management of heart failure]. Zhonghua Xin Xue Guan Bing Za Zhi 2022; 50:822-824. [PMID: 35982018 DOI: 10.3760/cma.j.cn112148-20220606-00442] [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: 06/15/2023]
Affiliation(s)
- Z L Wang
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110840, China
| | - Y L Han
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110840, China
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28
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Lou Y, Ma WJ, Wang ZJ, Yang N, Sun YJ, Liu YL, Lei RB, Zhao JX, Luo XF, Wang L, Chen YL, Han YL, Sun YX, Li YM, Cai J. [Writing protocols for the Chinese clinical practice guidelines of hypertension]. Zhonghua Xin Xue Guan Bing Za Zhi 2022; 50:671-675. [PMID: 35856223 DOI: 10.3760/cma.j.cn112148-20211126-01021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Y Lou
- Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - W J Ma
- Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Z J Wang
- Evidence-Based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - N Yang
- Evidence-Based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - Y J Sun
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - Y L Liu
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - R B Lei
- Pediatric Research Institute, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
| | - J X Zhao
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - X F Luo
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - L Wang
- Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Y L Chen
- Evidence-Based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - Y L Han
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110000, China
| | - Y X Sun
- Department of Cardiology, First Hospital of China Medical University, Shenyang 110000, China
| | - Y M Li
- Department of Cardiology, TEDA International Cardiovascular Hospital, Tianjin 300450, China
| | - J Cai
- Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing 100037, China
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29
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Li Y, Han YL. [Path of exploration for the optimal antithrombotic treatment strategy for patients with coronary heart disease]. Zhonghua Xin Xue Guan Bing Za Zhi 2022; 50:429-431. [PMID: 35589590 DOI: 10.3760/cma.j.cn112148-20220324-00206] [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: 06/15/2023]
Affiliation(s)
- Y Li
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Y L Han
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
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30
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Wang ZL, Han YL. [Simultaneous percutaneous closure of left atrial appendage and patent foramen ovale: more than enough is too much?]. Zhonghua Xin Xue Guan Bing Za Zhi 2022; 50:219-220. [PMID: 35340139 DOI: 10.3760/cma.j.cn112148-20210607-00479] [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: 06/14/2023]
Affiliation(s)
- Z L Wang
- Institute of Cardiovascular Diseases, General Hospital of Northern Theater Command, Shenyang 110840, China
| | - Y L Han
- Institute of Cardiovascular Diseases, General Hospital of Northern Theater Command, Shenyang 110840, China
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31
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Zhou SC, Xu K, Wang B, Wang G, Liang ZY, Li Y, Fang Y, Zheng LF, Wang YQ, Zhou WW, Jing QM, Han YL. [One-year follow-up results of atrial fibrillation patients who undergoing transcatheter aortic valve implantation]. Zhonghua Xin Xue Guan Bing Za Zhi 2022; 50:132-136. [PMID: 35172456 DOI: 10.3760/cma.j.cn112148-20211124-01016] [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: 06/14/2023]
Abstract
Objective: To investigate whether atrial fibrillation (AF) before transcatheter aortic valve implantation (TAVI) will affect the prognosis of patients post TAVI. Methods: This is a single center retrospective study. A total of 115 patients with severe aortic stenosis (AS) who were admitted to General Hospital of Northern Theater Command from May 2016 to November 2020 and successfully received TAVI treatment were included. According to absence or accompaniment of AF pre-TAVI, they were divided into AF group (21 cases) and non-AF group (94 cases). The patients were followed up for postoperative antithrombotic treatment and the occurrence of the net adverse clinical and cerebrovascular events (NACCE) at 12 months post TAVI, including cardiogenic death, readmission to hospital for heart failure, nonfatal myocardial infarction, ischemic stroke and severe bleeding (BARC levels 3-5). Univariate logistic regression was used to analyze the related factors of NACCE. Results: Among the 115 selected patients, age was (73.8±6.9) years, there were 63 males. And 21 cases (18.2%) were diagnosed as AFbefore TAVI. In terms of postoperative antithrombotic therapy, 48.9% (46/94) of the patients in the non-AF group received monotherapy and 47.9% (45/94) received dual antiplatelet therapy. In the AF group, 47.6% (10/21) received anticoagulants and 33.3% (7/21) received dual antiplatelet therapy. The proportion of patients in the AF group taking non-vitamin K antagonist oral anticoagulants (NOAC) was higher than that in the non-AF group (38.1% (8/21) vs. 2.1% (2/94), P<0.001). Patients in both groups were followed up to 12 months after TAVI. During the 12 months follow-up, the incidence of NACCE after TAVI was 14.3% (3/21) in the AF group, which was numerically higher than that in the non-AF group (6.4% (6/94)), but the difference was not statistically significant (P=0.441). The incidence of severe bleeding was significantly higher in the AF group than in the non-AF group (9.5% (2/21) vs. 0, P=0.032). Univariate logistic regression analysis showed that hypertension was associated with the risk of NACCE (OR=8.308, P=0.050), while AF was not associated with the risk of NACCE (P=0.235). Conclusion: The incidence of severe bleeding after TAVI is higher in patients with AF than in patients without AF prior TAVI, and there is a trend of increased risk of NACCE post TAVI in AF patients.
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Affiliation(s)
- S C Zhou
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - K Xu
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - B Wang
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - G Wang
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Z Y Liang
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Y Li
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Y Fang
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - L F Zheng
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Y Q Wang
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - W W Zhou
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Q M Jing
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Y L Han
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
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32
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Han YL. [Mission and responsibility of Chinese cardiovascular physicians in the new era]. Zhonghua Xin Xue Guan Bing Za Zhi 2022; 50:1-3. [PMID: 35045606 DOI: 10.3760/cma.j.cn112148-20211117-00991] [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: 06/14/2023]
Affiliation(s)
- Y L Han
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
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33
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Han YL, Li Y. [Progress in optimizing antiplatelet therapy after percutaneous coronary intervention in the year of 2021]. Zhonghua Xin Xue Guan Bing Za Zhi 2021; 49:1184-1186. [PMID: 34905894 DOI: 10.3760/cma.j.cn112148-20211027-00919] [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: 06/14/2023]
Affiliation(s)
- Y L Han
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Y Li
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
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Na K, Li MY, Qiu MH, Li J, Liu R, Li Y, Han YL. [The efficacy and safety of ticagrelor versus clopidogrel in elderly patients with acute coronary syndrome undergoing percutaneous coronary intervention]. Zhonghua Xin Xue Guan Bing Za Zhi 2021; 49:1117-1123. [PMID: 34775722 DOI: 10.3760/cma.j.cn112148-20201127-00943] [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 compare the efficacy and safety of ticagrelor and clopidogrel in elderly Chinese patients with acute coronary syndrome (ACS) underwent percutaneous coronary intervention (PCI) in the real world. Methods: This study is a post-hoc analysis of a single center, retrospective cohort study. Between March 2016 and March 2018, elderly (age≥65) ACS patients who underwent PCI in the General Hospital of Northern Theater Command were included in the study. The patients were grouped according to P2Y12 receptor inhibitor. The primary endpoints of this study were ischemic events during the 2-year follow-up, which were defined as the composite of cardiac death, myocardial or stroke. The secondary efficiency endpoints included all-cause death and BARC 2, 3, 5 bleeding events. Results: A total of 4 022 elderly (mean age: (71.5±5.3) years) ACS patients were included in this study. Based on the choice of P2Y12 receptor inhibitor, patients were divided into clopidogrel (n=3 201) and ticagrelor (n=821) groups. Incidences of ischemic events (3.2% (26/821) vs. 5.6% (179/3 201), P=0.005) at 2 years were significantly lower in ticagrelor group compared to clopidogrel group. BARC 2, 3, 5 bleeding events (1.7% (14/821) vs. 1.6% (52/3 201), P=0.818) were comparable between the two groups. The incidence of all-cause death (1.5% (12/821) vs. 4.1% (132/3 201), P=0.005) were also lower in the ticagrelor group compared to the clopidogrel group. Clinical outcomes were consistent after adjusting for confounding factors, the incidence of ischemic events (HR= 0.637, 95%CI 0.409-0.991, P=0.046) and all-cause mortality (HR=0.402, 95%CI 0.213-0.758, P=0.005) was significantly lower in the ticagrelor group compared with the clopidogrel group. Risk of BARC 2, 3, 5 bleeding events were similar between the two groups (HR=0.957, 95%CI 0.496-1.848, P=0.897). Conclusion: In real-world clinical practice, for elderly patients with ACS undergoing PCI, ticagrelor use might reduce the incidence of long-term ischemic events and all-cause death without increasing the risk of bleeding.
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Affiliation(s)
- K Na
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - M Y Li
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - M H Qiu
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - J Li
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - R Liu
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Y Li
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Y L Han
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
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35
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Qiu MH, Li Y, Xu K, Wang B, Liu HW, Zhou WW, Zhang J, Pei YF, Song Y, Han YL. [Key data elements for clinical management and outcomes of patients with coronary artery disease: definitions from Coronary Artery Disease and Creative Antithrombotic Clinical Research Collaboration (CardiaCare)]. Zhonghua Xin Xue Guan Bing Za Zhi 2021; 49:1082-1088. [PMID: 34775717 DOI: 10.3760/cma.j.cn112148-20210824-00726] [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 develop a set of data elements and standardized definitions of Coronary Artery Disease and Creative Antithrombotic Clinical Research Collaboration (CardiaCare), aiming to facilitate the exchange of disparate data sources, enhance the abilities to support multicenter researches, and subsequently ensure the databases use under standardized process and criteria. Methods: The Cardiacare writing committee members reviewed data elements and definitions from published guidelines, clinical trials, databases, and standardized documents, then determined the data elements and standardized definitions, which should be included in CardiaCare. The writing committee also considered the specific domestic clinical management strategies during the establishment of Cardiacare. The resulting documents provide a series of key data elements and standardized definitions used in the management of coronary artery disease patients. Key data elements from CardiaCare could be sorted by clinical management flowsheet and outcome from hospitalization to long-term follow-up. Results: The Cardiacare standardized set comprised 864 data elements from admission to post-hospital follow-up visit. There were 8 tables in the documents, including demographic and admission information (23 elements), medical history and risk factors (102 elements), clinical presentations and diagnosis (22 elements), diagnostic and laboratory tests (111 elements), interventional diagnosis and treatment (118 elements), pharmacological therapy (213 elements), clinical outcomes (161 elements), and special subpopulations (114 elements: 87 elements for transcatheter valve replacement and 27 elements with cardiac rehabilitation). Conclusions: The Cardiacare standardized data elements set could provide support for real-world clinical research in consecutive data collection and databases mining. A wider applicability in various settings of CardiaCare needs to be explored further.
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Affiliation(s)
- M H Qiu
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Y Li
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - K Xu
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - B Wang
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - H W Liu
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - W W Zhou
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - J Zhang
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Y F Pei
- Alibaba Health Information Technology, Beijing 100000, China
| | - Y Song
- Alibaba Health Information Technology, Beijing 100000, China
| | - Y L Han
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
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36
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Wang M, Mi Q, Yuan Q, Han YL, Wang JM, Luo CY, Pan C, Tang JY, Gao YJ. [Clinical analysis of 60 children with anaplastic large cell lymphoma in a single center]. Zhonghua Er Ke Za Zhi 2021; 59:824-829. [PMID: 34587677 DOI: 10.3760/cma.j.cn112140-20210208-00121] [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 summarize the clinical features, treatment outcome and prognostic factors of childhood anaplastic large cell lymphoma (ALCL). Methods: Clinical data of 60 newly diagnosed and biopsy-proven ALCL pediatric patients (≤18 years of age) at Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine from January 2010 to December 2018 were collected. All patients were treated with the Chinese Children Cancer Group-B cell-non-Hodgkin Lymphoma 2010 (CCCG-BNHL-2010) regimen. Overall survival (OS), event free survival (EFS) and progression free survival (PFS) rates were calculated by the Kaplan-Meier method. Univariate analysis was performed with Log-Rank test to find factors of poor prognosis. Results: Among 60 ALCL patients included in the current study, 39 were males and 21 females, the age of onset was 7.9 (1.2-16.7) years. Among all cases, 43 (72%) had B syndrome (any of the following: fever, drenching, weight loss). Forty-nine (82%) cases had lactate dehydrogenase (LDH) levels<2 times upper limit of normal (ULN) and 11 (18%) cases had LDH levels 2-<4 times ULN. The distribution of stages was stage Ⅰ,Ⅱ,Ⅲ, and Ⅳ in 2% (1/60), 5% (3/60), 92% (55/60), and 2% (1/60) of patients, respectively. Of 58 cases who had results of anaplastic lymphoma kinase (ALK) immunohistochemical staining, 53 (91%, 53/58) cases were positive. Visceral involvement was observed in 12 patients (20%). The 4-year OS and EFS rates were (88±4)% and (76±6)% for the entire group, respectively. Univariate analysis for gender, B symptoms, LDH level, ALK expression, clinical stage and visceral involvement showed that only LDH level correlated with an inferior OS rate (χ²=6.571, P=0.010) while not correlated with EFS rate. No independent risk factor for disease progression or recurrence was found by Logistic regression. Up to the last follow-up, 44 cases were continuously at complete remission state, and their follow-up time was 50 (13-119) months. Of 13 (23%) cases experienced disease progression or relapse, 3 cases abandoned treatment, 2 cases progressed to death, 8 cases received second line or salvage treatment (6 survived at last follow-up). For post progression or relapse cases, the 2-year OS and PFS rates were (60±16)% and (16±14)%, respectively. The treatment related death occurred in 3 cases (5%) and all of them were due to severe infection during the chemotherapy. Conclusions: The efficacy of CCCG-BNHL-2010 regimen in the treatment of children with ALCL was good. However, the safety needs to be improved as the treatment-related mortality in the present study was slightly higher. Efficient second line or salvage treatment can achieve cure in pediatric patients post progression or recurrence. LDH ≥2 times ULN was associated with worse prognosis.
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Affiliation(s)
- M Wang
- Department of Hematology/Oncology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - Q Mi
- Department of Hematology/Oncology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - Q Yuan
- Department of Hematology/Oncology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - Y L Han
- Department of Hematology/Oncology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - J M Wang
- Department of Hematology/Oncology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - C Y Luo
- Department of Hematology/Oncology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - C Pan
- Department of Hematology/Oncology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - J Y Tang
- Department of Hematology/Oncology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - Y J Gao
- Department of Hematology/Oncology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
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37
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Han YL. [Current status and challenges of interventional therapy for patients with complex high risk coronary artery disease]. Zhonghua Xin Xue Guan Bing Za Zhi 2021; 49:750-753. [PMID: 34404181 DOI: 10.3760/cma.j.cn112148-20210315-00233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
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38
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Zheng LF, Xu K, Wang B, Wang G, Liang ZY, Li Y, Fang Y, Wang YQ, Zhou WW, Jing QM, Han YL. [Perioperative serious complications in patients undergoing transcatheter aortic valve replacement: a single-center experience]. Zhonghua Xin Xue Guan Bing Za Zhi 2021; 49:764-769. [PMID: 34404184 DOI: 10.3760/cma.j.cn112148-20210422-00364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Objective: To observe the incidence of perioperative severe complications in aortic stenosis (AS) patients undergoing transcatheter aortic valve implantation (TAVR), and to explore the influence of the accumulated experience of the operators on the incidence of complications. Methods: This is a single-center retrospective study. Patients with AS who underwent TAVR from May 2016 to November 2020 in General Hospital of Northern Theater Command were included. The occurrence of severe complications during perioperative period was recorded. Severe complications included all-cause death, surgical transfer to thoracotomy, coronary artery occlusion, peripheral vascular approach complications, severe cerebrovascular events, moderate or above perivalvular leakage, valve displacement (implanted valve middle valve), pacemaker implantation, etc. In order to observe the influence of the accumulated experience of the operators on the occurrence of postoperative complications, the complications in each stage of the patients were counted and the bar chart was drawn with interval of every 30 patients. Results: A total of 119 patients were included, including 64 males and 55 females, the mean age was (73.9±6.9) years. The valve implantation was unsuccessful in 3 out of 119 patients (2.5%). There were 39 cases of severe complications during perioperative period, including 1 death (0.8%), 2 cases of thoracotomy (1.7%), 2 cases of coronary artery occlusion (1.7%), 8 cases of peripheral vascular approach complications (6.7%), and 1 case of new severe cerebrovascular event (0.8%), 3 cases of moderate or higher perivalvular leakage (2.5%), 8 cases of valve displacement leads to midvalvular implantation (6.7%), 14 cases of permanent pacemaker implantation due to new atrioventricular block (11.8%). The bar chart showed that the incidence of permanent pacemaker implantation and in-valve implantation did not significantly decrease with the accumulation of experience, while the incidence of other complications showed a decreasing trend after 30 cases. Conclusions: Most serious complications occurred in the early stage of TAVR in our center. The incidence of all cause death, coronary artery occlusion and peripheral vascular approach complications in the perioperative period post TAVR could be reduced in the TAVR center in the learning stage through the accumulation of procedure-related experience, but the incidence of pacemaker placement and the implanted valve within the valve dose not significantly decrease over time.
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Affiliation(s)
- L F Zheng
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - K Xu
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - B Wang
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - G Wang
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Z Y Liang
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Y Li
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Y Fang
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Y Q Wang
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - W W Zhou
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Q M Jing
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Y L Han
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
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Deng HJ, Deji Q, Zhaba W, Liu JQ, Gao SQ, Han YL, Zhou ML, Wang CX. A20 Establishes Negative Feedback With TRAF6/NF-κB and Attenuates Early Brain Injury After Experimental Subarachnoid Hemorrhage. Front Immunol 2021; 12:623256. [PMID: 34381441 PMCID: PMC8350325 DOI: 10.3389/fimmu.2021.623256] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 04/09/2021] [Indexed: 11/13/2022] Open
Abstract
Nuclear factor (NF)-κB-ty -50mediated neuroinflammation plays a crucial role in early brain injury (EBI) after subarachnoid hemorrhage (SAH). As an important negative feedback regulator of NF-κB, A20 is essential for inflammatory homeostasis. Herein, we tested the hypothesis that A20 attenuates EBI by establishing NF-κB-associated negative feedback after experimental SAH. In vivo and in vitro models of SAH were established. TPCA-1 and lentivirus were used for NF-κB inhibition and A20 silencing/overexpression, respectively. Cellular localization of A20 in the brain was determined via immunofluorescence. Western blotting and enzyme-linked immunosorbent assays were applied to observe the expression of members of the A20/tumor necrosis factor receptor-associated factor 6 (TRAF6)/NF-κB pathway and inflammatory cytokines (IL-6, IL-1β, TNF-α). Evans blue staining, TUNEL staining, Nissl staining, brain water content, and modified Garcia score were performed to evaluate the neuroprotective effect of A20. A20 expression by astrocytes, microglia, and neurons was increased at 24 h after SAH. A20 and inflammatory cytokine levels were decreased while TRAF6 expression was elevated after NF-κB inhibition. TRAF6, NF-κB, and inflammatory cytokine levels were increased after A20 silencing but suppressed with A20 overexpression. Also, Bcl-2, Bax, MMP-9, ZO-1 protein levels; Evans blue, TUNEL, and Nissl staining; brain water content; and modified Garcia score showed that A20 exerted a neuroprotective effect after SAH. A20 expression was regulated by NF-κB. In turn, increased A20 expression inhibited TRAF6 and NF-κB to reduce the subsequent inflammatory response. Our data also suggest that negative feedback regulation mechanism of the A20/TRAF6/NF-κB pathway and the neuroprotective role of A20 to attenuate EBI after SAH.
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Affiliation(s)
- Hong-Ji Deng
- Department of Neurosurgery, The First Affiliated Hospital, Guangxi Medical University, Nanning, China
| | - QuZhen Deji
- Department of Ophthalmology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - WangDui Zhaba
- Department of Neurosurgery, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Jia-Qiang Liu
- Department of Neurosurgery, Yijishan Hospital, Wannan Medical College, Wuhu, China
| | - Sheng-Qing Gao
- Department of Neurosurgery, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yan-Ling Han
- Department of Neurosurgery, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Meng-Liang Zhou
- Department of Neurosurgery, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Chun-Xi Wang
- Department of Neurosurgery, The First Affiliated Hospital, Guangxi Medical University, Nanning, China
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40
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Han YL, Li Y. [History and development of percutaneous coronary intervention for coronary heart disease in China]. Zhonghua Xin Xue Guan Bing Za Zhi 2021; 49:645-649. [PMID: 34256431 DOI: 10.3760/cma.j.cn112148-20210522-00440] [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)
- Y L Han
- Cardiovascular Research Institute and Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Y Li
- Cardiovascular Research Institute and Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
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41
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Liu XL, Gao CC, Qi M, Han YL, Zhou ML, Zheng LR. Expression of FOXO transcription factors in the brain following traumatic brain injury. Neurosci Lett 2021; 753:135882. [PMID: 33838260 DOI: 10.1016/j.neulet.2021.135882] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 12/28/2020] [Revised: 04/02/2021] [Accepted: 04/02/2021] [Indexed: 01/08/2023]
Abstract
Traumatic brain injury (TBI) is a substantial clinical and social problem worldwide, causing high morbidity and mortality along with significant economic and medical costs. Forkhead box O transcription factors (FOXOs) have been found to play a critical role in the regulation of cell functions, such as nutrient metabolism, programmed cell death, and tumor suppression. In the central nervous system, FOXOs are reported to be pivotal regulators of learning and memory, neurite outgrowth, and axonal degeneration. However, the role of FOXOs in TBI is still unknown. Here, we investigate changes in the expression of FOXOs in the acute stage following TBI. First, we evaluated the expression of FOXO proteins in the brains of humans after TBI. A TBI model was then established in mice, and the ipsilateral cerebral cortex was collected at 3 h, 6 h, 9 h, 12 h, 24 h, and 72 h post-TBI. The dynamic expression of Foxo proteins was observed. Neuron-specific localization of Foxos was detected by double immunofluorescence staining. Following TBI, FOXO proteins in the brains of humans were significantly increased. In mice, Foxo protein levels generally peaked at 24 h. By examining co-localization with neurons, the proportion of Foxo(+) neurons was found to increase following TBI and peak at 24 h. This study reveals the time-dependent and neuron-specific expression of Foxos following TBI in mice, providing insight to enhance understanding of the role of Foxos in TBI.
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Affiliation(s)
- Xi-Lin Liu
- Graduate School of Wannan Medical College, Wuhu, 241002, Anhui, China; Department of Pathology, School of Basic Medical Sciences, Wannan Medical College, Wuhu, 241002, Anhui, China
| | - Chao-Chao Gao
- Department of Neurosurgery, Jinling Hospital, Nanjing Medical University, Nanjing, 210002, Jiangsu, China
| | - Min Qi
- Department of Neurosurgery, Yijishan Hospital, Wannan Medical College, Wuhu, 241001, Anhui, China
| | - Yan-Ling Han
- Department of Neurosurgery, Jinling Hospital, Nanjing Medical University, Nanjing, 210002, Jiangsu, China; Department of Neurosurgery, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, 210002, Jiangsu, China
| | - Meng-Liang Zhou
- Department of Neurosurgery, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, 210002, Jiangsu, China.
| | - Lan-Rong Zheng
- Graduate School of Wannan Medical College, Wuhu, 241002, Anhui, China; Department of Pathology, School of Basic Medical Sciences, Wannan Medical College, Wuhu, 241002, Anhui, China.
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Liu HW, Han YL. [Recent advances in antithrombotic therapy for patients with coronary artery disease undergoing percutaneous coronary intervention]. Zhonghua Xin Xue Guan Bing Za Zhi 2021; 49:108-110. [PMID: 33611894 DOI: 10.3760/cma.j.cn112148-20201222-01010] [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)
- H W Liu
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Y L Han
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
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Wang G, Na K, Li Y, Jing QM, Wang XZ, Liu HW, Wang B, Xu K, Han YL. [Five-year clinical outcomes of the second generation biodegradable polymer sirolimus-eluting stent (EXCROSSAL) in treating patients with de novo coronary lesions]. Zhonghua Xin Xue Guan Bing Za Zhi 2021; 49:121-127. [PMID: 33611897 DOI: 10.3760/cma.j.cn112148-20200916-00740] [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 evaluate the five-year safety and efficacy of the second generation biodegradable polymer sirolimus-eluting stent (EXCROSSAL) in treating patients with de novo coronary artery diseases. Methods: Patients with coronary artery disease (CAD)who were implanted with EXTROSSAL stents in CREDIT Ⅱ and CREDIT Ⅲ study were included. CREDIT Ⅱ was a randomized trial, and CREDIT Ⅲ was a single-arm study. From November 2013 to December 2014, 833 CAD patients with de novo coronary lesions implanted with EXTROSSAL stents were selected from 33 centers in China. The primary outcome was 5-year target lesion failure (TLF), a composite of cardiac death, target vessel myocardial infarction and clinically indicated target lesion revascularization. Secondary endpoints was patient-oriented composite endpoint (PoCE), including all-cause death, all myocardial infarction, or any revascularization within 5 years post stenting and stent thrombosis according to Academic Research Consortium's (ARC) definition. Kaplan Meier method was used to calculate the incidence of TLF and PoCE within 5 years after operation. Univariate Cox regression analysis was used to analyze the impacts of diabetes, small vessel disease (vessel diameter ≤ 2.74 mm), lesion length ≥ 16.7 mm and multivessel disease on the incidence of TLF within 5 years after operation. Results: A total of 833 patients were included in this study including 579 males (69.5%), the age was (59.3±9.1) years. And 832 (99.9%) patients completed 5-year clinical follow-up. The incidence of TLF and PoCE in the 5-year follow-up were 10.6%(86/811) and 15.5%(126/811), respectively. Stent thrombosis occurred in 1.0%(8/811) of patients. Univariate Cox regression analysis showed that vessel diameter ≤ 2.74 mm (HR=3.20,95%CI 1.90-5.39,P<0.001), lesion length ≥ 16.7 mm (HR=1.88,95%CI 1.18-2.99,P=0.007) and multivessel disease (HR=2.44,95%CI 1.60-3.72,P<0.001) were related factors of TLF within 5 years after operation. Conclusion: EXCROSSAL stent is effective and safe in treating CAD patients with de novo coronary lesions, with low incidence of TLF and PoCE within 5 years after operation.
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Affiliation(s)
- G Wang
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - K Na
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Y Li
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Q M Jing
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - X Z Wang
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - H W Liu
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - B Wang
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - K Xu
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Y L Han
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
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Cheng H, Di G, Gao CC, He G, Wang X, Han YL, Sun LA, Zhou ML, Jiang X. FTY720 Reduces Endothelial Cell Apoptosis and Remodels Neurovascular Unit after Experimental Traumatic Brain Injury. Int J Med Sci 2021; 18:304-313. [PMID: 33390799 PMCID: PMC7757143 DOI: 10.7150/ijms.49066] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 06/03/2020] [Accepted: 11/05/2020] [Indexed: 12/21/2022] Open
Abstract
Traumatic brain injury (TBI) is a major cause of death and disability worldwide. A sequence of pathological processes occurred when there is TBI. Previous studies showed that sphingosine-1-phosphate receptor 1 (S1PR1) played a critical role in inflammatory response in the brain after TBI. Thus, the present study was designed to evaluate the effects of the S1PR1 modulator FTY720 on neurovascular unit (NVU) after experimental TBI in mice. The weight-drop TBI method was used to induce TBI. Western blot (WB) was performed to determine the levels of SIPR1, claudin-5 and occludin at different time points. FTY720 was intraperitoneally administered to mice after TBI was induced. The terminal deoxynucleotidyl transferase-dUTP nick end labeling (TUNEL) assay was used to assess endothelial cell apoptosis. Immunofluorescence and WB were performed to measure the expression of tight junction proteins: claudin-5 and occludin. Evans blue (EB) permeability assay and brain water content were applied to evaluate the blood-brain barrier (BBB) permeability and brain edema. Immunohistochemistry was performed to assess the activation of astrocytes and microglia. The results showed that FTY720 administration reduced endothelial cell apoptosis and improved BBB permeability. FTY720 also attenuated astrocytes and microglia activation. Furthermore, treatment with FTY720 not only improved neurological function, but also increased the survival rate of mice significantly. These findings suggest that FTY720 administration restored the structure of the NVU after experimental TBI by decreasing endothelial cell apoptosis and attenuating the activation of astrocytes. Moreover, FTY720 might reduce inflammation in the brain by reducing the activation of microglia in TBI mice.
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Affiliation(s)
- Hao Cheng
- Department of Neurosurgery, Yijishan Hospital, Wannan Medical College, Anhui, China
| | - Guangfu Di
- Department of Neurosurgery, Yijishan Hospital, Wannan Medical College, Anhui, China
| | - Chao-Chao Gao
- Department of Neurosurgery, Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, Jiangsu, China
| | - Guoyuan He
- Department of Neurosurgery, Yijishan Hospital, Wannan Medical College, Anhui, China
| | - Xue Wang
- Department of Neurosurgery, Jinling Hospital, School of Medicine, Nanjing University, Jiangsu, China
| | - Yan-Ling Han
- Department of Neurosurgery, Jinling Hospital, School of Medicine, Nanjing University, Jiangsu, China
| | - Le-An Sun
- Department of Neurosurgery, Yijishan Hospital, Wannan Medical College, Anhui, China
| | - Meng-Liang Zhou
- Department of Neurosurgery, Jinling Hospital, School of Medicine, Nanjing University, Jiangsu, China
| | - Xiaochun Jiang
- Department of Neurosurgery, Yijishan Hospital, Wannan Medical College, Anhui, China
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Zhaba WD, Deji QZ, Deng HJ, Han YL, Gao SQ, Liu XL, Zhou ML. Retinal hypoxia after experimental subarachnoid hemorrhage. Neurosci Lett 2020; 742:135554. [PMID: 33352284 DOI: 10.1016/j.neulet.2020.135554] [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] [Received: 08/31/2020] [Revised: 11/17/2020] [Accepted: 12/02/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND PURPOSE The patients who survive subarachnoid hemorrhage (SAH) often have long-term neurological complications. There are no reports about the pathological change of retina after SAH. METHODS An experimental model of SAH was established by injecting autologous blood into the prechiasmatic cistern of Sprague-Dawley rats. Hematoxylin and eosin (HE) staining was performed to show the alternation of morphology in retina after SAH. To detect the retinal new vessels (NVs), CD31 was labelled by immunofluorescence and immunohistochemistry. The time-course expressions of vascular endothelial growth factor (VEGF)-A and hypoxia-inducible factor-1α (HIF-1 α) was also revealed by Western blot analysis. RESULTS A clear reduction of retinal ganglion cells (RGCs) was noticed after SAH. The immunofluorescence and immunohistochemical staining of CD31 reveals a large number of NVs in RGC layer after SAH compared with the normal controls. The level of VEGF-A in the retina after SAH was increased and peaked at 12h and 14 d. The expression of HIF-1α in the retina increased as early as 3 h after SAH, reached a peak at 12 h after SAH. CONCLUSIONS The results showed that SAH induced the retina hypoxia resulting in the reduction of RGCs, increase of NVs and activation of NVs related HIF-1α/VEGF-A pathway.
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Affiliation(s)
- Wang-Dui Zhaba
- Department of Neurosurgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Qu-Zhen Deji
- Department of Ophthalmology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Hong-Ji Deng
- Department of Neurosurgery, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Yan-Ling Han
- Department of Neurosurgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Sheng-Qing Gao
- Department of Neurosurgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Xi-Lin Liu
- Graduate School of Wannan Medical College, Wuhu, Anhui, China
| | - Meng-Liang Zhou
- Department of Neurosurgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
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Mi RH, Dang HB, Chen L, Han YL, Wang MF, Zhang YL, Chen L, Li DB, Wei XD. [Clinical analysis of 12 cases of acute myeloid leukemia complicated with synchronous primary solid tumor]. Zhonghua Yi Xue Za Zhi 2020; 100:3323-3327. [PMID: 33202495 DOI: 10.3760/cma.j.cn112137-20200721-02178] [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 explore the clinical characteristics of acute myeloid leukemia (AML) complicated with simultaneous multiple primary cancer (SMPC). Methods: The data of 12 AML patients with SMPC hospitalized in the Affiliated Cancer Hospital of Zhengzhou University, the First Affiliated Hospital of Nanyang Medical College, the Xinhua District Hospital of Pingdingshan City and the First People's Hospital of Pingdingshan City from March 2014 to July 2019 were analyzed retrospectively, and their clinical features, treatment and prognosis were summarized. Results: Among the 12 patients, there were 6 males and 6 females, with a median age of 58 years (39-70 years). AML classification: according to French-American-British (FAB) classification, the 12 AML patients were classified as M0 1, M1 1, M2a 5, M2b 1, M3 2, M5 2; according to National Comprehensive Cancer Network (NCCN) prognosis stratified, low risk group 1 case, medium risk group 4 cases, high risk group 7 cases; classification of solid tumors: 3 cases of lung cancer, 1 case of breast cancer, 2 cases of gastric cancer, 3 cases of esophageal cancer, 1 case of rectal neuroendocrine tumor, 1 case of invasive hydatidiform mole and 1 case of sigmoid colon cancer. The median time interval for the diagnosis of two primary malignant tumors was 4 (from 2.6 to 5.6) months. Results of gene mutation detection: AML prognostic gene detection results: a total of 12 kinds of gene abnormalities including ASXL1, JAK2, TET2, U2AF1, ABCB1, FLT3-ITD, RUNX1, SETBPIT, TET2 (single nucleotide polymorphism, SNP), p53, IKZF1 and IDH2 were detected, and solid tumor related genes were detected: a total of 4 kinds of gene abnormalities including Her-2, EGFR, K-RAS and MSI were detected. Survival: among the 12 patients, 1 case was lost during follow-up, 2 cases were still in treatment, 3 cases ended treatment and the condition was stable, 6 cases died. The median overall survival of 12 patients was 12.5 (from 3.8 to 48.0) months. Conclusions: It is not clear whether there is a certain correlation between the simultaneous occurrence of AML and solid tumors. Patients with AML and synchronous solid tumors are not unusual. Both tumors should be treated aggressively at the same time.
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Affiliation(s)
- R H Mi
- Department of Hematology, the Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China
| | - H B Dang
- Department of Hematology, the First Affiliated Hospital of Nanyang Medical College, Nanyang 473000, China
| | - L Chen
- Department of Hematology, Xinhua District Hospital of Pingdingshan City, Pingdingshan 467000, China
| | - Y L Han
- Department of Hematology, Pingdingshan First People's Hospital, Pingdingshan 467000, China
| | - M F Wang
- Department of Hematology, Pingdingshan First People's Hospital, Pingdingshan 467000, China
| | - Y L Zhang
- Department of Hematology, the Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China
| | - L Chen
- Department of Hematology, the Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China
| | - D B Li
- Department of Hematology, the Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China
| | - X D Wei
- Department of Hematology, the Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China
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Tang JJ, Pan C, Gao YJ, Han YL, Hu WT, Zhang J, Zhou M, Tang JY. [Clinical analysis of 26 children with postoperative residual or recurrent fibrosarcoma]. Zhonghua Er Ke Za Zhi 2020; 58:668-673. [PMID: 32842388 DOI: 10.3760/cma.j.cn112140-20200217-00095] [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 long-term outcomes and prognostic factors of postoperative residual or recurrent fibrosarcoma in children. Methods: Clinical data of 26 patients continually admitted to Shanghai Children's Medical Center between April 2004 and February 2019 with postoperative residual or recurrent fibrosarcoma were analyzed retrospectively. All patients were treated with Shanghai Children's Medical Center-rhabdomyosarcoma-1999 (SCMC-RS-99) regimen and timely radical tumor resection. Before chemotherapy, according to the surgery and imaging examination, 26 patients were divided into 2 groups: postoperative residual group and postoperative recurrent group. Clinical features and long-term follow-up results of patients were summarized. Kaplan-Meier analysis was used to evaluate the overall survival (OS) and event-free survival (EFS) rates, Log-Rank test and Cox proportional hazards models were used for univariate and multivariate prognostic analysis of factors including age (<3 years or 3-18 years old), gender, primary tumor site, postoperative stage, disease status, ETS variant 6 (ETV6) gene and chemotherapy drugs. Results: Among 26 cases, 13 were male and 13 were female, 17 cases were in postoperative residual group and 9 cases were in postoperative recurrent group. Until the last follow-up at December 31, 2019, the median follow-up time was 73 months (ranged from 10 to 188 months).The 5-year OS and EFS rates were (86±7)% and (77±9)%. Univariate analysis showed that, the 5-year EFS rate of postoperative residual group was significantly higher than that of the postoperative recurrent group ((94±5)% vs.(63±16)%,χ(2)=5.106,P=0.024), the 5-year EFS rate of patients <3 years old was significantly higher than that of patients 3-18 years old ((94±5)% vs. (62±17)%, χ(2)=6.507, P=0.011). Gender (χ(2)=0.445), primary tumor site (χ(2)=0.258), postoperative stage (χ(2)=3.046), ETV6 gene (χ(2)=1.496), and whether doxorubicin-containing drugs in chemotherapy (χ(2)=1.692) did not exhibit significant impact on 5-EFS rate (all P>0.05). Age, postoperative stage and disease status were included in COX proportional risk model for multivariate analysis, which showed that age >3 years old (HR=8.95, 95%CI 0.73-109.50, P=0.086), stage Ⅲ-Ⅳ (HR=16.50, 95%CI 0.84-321.40, P=0.065) and postoperative recurrence (HR=10.60, 95%CI 0.84-134.30, P=0.068) had no significant impact on EFS rate. Conclusion: Children with postoperative residual or postoperative recurrent fibrosarcoma still had good remission rate and long-term survival, especially young children without recurrence have a significant survival advantage.
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Affiliation(s)
- J J Tang
- Department of Hematology and Oncology, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China (is working on the Department of Pediatrics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China)
| | - C Pan
- Department of Hematology and Oncology, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - Y J Gao
- Department of Hematology and Oncology, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China Tang
| | - Y L Han
- Department of Hematology and Oncology, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - W T Hu
- Department of Hematology and Oncology, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - J Zhang
- Department of Hematology and Oncology, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - M Zhou
- Department of Hematology and Oncology, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - J Y Tang
- Department of Hematology and Oncology, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
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Han YL, Li Y. [Pharmaco-invasive therapy is an effective reperfusion strategy for ST-segment elevation myocardial infarction]. Zhonghua Xin Xue Guan Bing Za Zhi 2020; 48:631-633. [PMID: 32847317 DOI: 10.3760/cma.j.cn112148-20200623-00508] [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)
- Y L Han
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Y Li
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
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Li J, Cheng L, Wang HY, Zhao X, Liang ZY, Han YL, Li Y. [Safety and efficacy of bivalirudin versus unfractionated heparin during perioperative period of percutaneous coronary intervention]. Zhonghua Xin Xue Guan Bing Za Zhi 2020; 48:648-654. [PMID: 32847320 DOI: 10.3760/cma.j.cn112148-20200717-00566] [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 safety and efficacy of bivalirudin versus unfractionated heparin during perioperative period of percutaneous coronary intervention(PCI) in real-world. Methods: A total of 13 097 serial patients who underwent PCI from January 2016 to November 2018 in the Northern Theater Command were enrolled in the present study. Patients were stratified as the bivalirudin group or the heparin group according to antithrombotic therapy during PCI. The primary efficiency endpoint was 30-day net adverse clinical event(NACE), defined as all-cause death, re-infarction, urgent target lesion revascularization (uTLR), stroke or any bleeding. The second efficiency endpoint was 30-day major cardiac and cerebral events (MACCE), defined as all-cause death, re-infarction, uTLR and stroke. Additional end points included the rates of stent thrombosis at 30 days. Propensity scores included clinical and demographic variables, with 1∶2 matching. Compared the incidence of events above between the two groups before and after matching. Results: Among the 13 097 included patients(age was (61±10) years old), 3 421 (26.1%) were female. And 2 734 patients were divided into the bivalirudin group, and 10 363 patients to the heparin group(5 468 after matching). Before propensity score matching, patients in bivalirudin group were older and received higher levels of CRUSADE score than heparin group. These patients were more likely to have hypertension and more with ST-segment elevation acute coronary syndromes(all P<0.05). After propensity score matching, the incidence of 30-day NACE(3.8%(103/2 734) vs.5.0%(271/5 468), P=0.015) and any bleeding (2.0%(54/2 734) vs. 2.8%(151/5 468), P=0.032) in the bivalirudin group were lower than that in the heparin group, but the incidence of MACCE (1.9%(51/2 734) vs. 2.3%(127/5 468), P=0.180) and stent thrombosis (0.1%(2/2 734) vs. 0.1%(3/5 468), P=1.000) were comparable between the two groups. Conclusion: The risk of bleeding and the incidence of NACE are significantly lower for patients using bivalirudin during perioperative period of PCI compared to heparin, without significant differences in ischemic events.
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Affiliation(s)
- J Li
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - L Cheng
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - H Y Wang
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - X Zhao
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Z Y Liang
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Y L Han
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Y Li
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110016, China
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50
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Han YL, Ma YY, Su GH, Li Y, Li Y, Liu DF, Song R, Li JY. [Efficacy and safety of alirocumab versus ezetimibe in high cardiovascular risk Chinese patients with hyperlipidemia: ODYSSEY EAST Study-Chinese sub-population analysis]. Zhonghua Xin Xue Guan Bing Za Zhi 2020; 48:593-599. [PMID: 32842270 DOI: 10.3760/cma.j.cn112148-20191216-00755] [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: 06/11/2023]
Abstract
Objective: To compare the efficacy and safety profile of alirocumab (PCSK9 inhibitor) versus ezetimibe on top of maximally tolerated statin dose in high cardiovascular risk Chinese patients with hyperlipidemia. Methods: The ODYSSEY EAST study was a randomized, double-blinded, double dummy, active-control, parallel group, multi-centers clinical trial, the Chinese sub-population included 456 patients with hyperlipidemia and high cardiovascular risk on maximally tolerated statin dose. Patients were randomized (2∶1) to receive the subcutaneous injection of alirocumab (75 mg Q2W; with dose up titration to 150 mg Q2W at week 12 if low-density lipoprotein cholesterol (LDL-C) was ≥1.81 mmol/L at week 8) or the oral administration of ezetimibe (10 mg daily) for 24 weeks. The primary endpoint was percentage change in calculated LDL-C from baseline to week 24. Key secondary efficacy endpoints included percentage change from baseline to week 12 or 24 in LDL-C (week 12) and other lipid parameters, including apolipoprotein (Apo) B, non-high-density lipoprotein cholesterol (non-HDL-C), TC, lipoprotein(a) (Lp(a)), HDL-C, fasting triglycerides (TG), and Apo A1, and the proportion of patients reaching LDL-C<1.81 mmol/L at week 24. Safety profile of therapeutic drugs was also assessed during the treatment period. Results: The mean age of 456 Chinese patients was (59.5±10.9) years, 341(74.8%) patients were male, 303 patients (66.4%) in alirocumab group and 153 patients (33.5%) in ezetimibe group. Demographic characteristics, disease characteristics, and lipid parameters at baseline were similar between the two groups. LDL-C was reduced more from baseline to week 12 and 24 in alirocumab group versus ezetimibe group, the difference of their least-squares mean (standard error) percent change were(-35.2±2.2)% and (-36.9±2.5)% (both P<0.001). At 12 weeks, alirocumab had significant reduction on Lp(a), Apo B, total cholesterol and non HDL-C, the difference of their least-squares mean (standard error) percent change were (-40.3±2.8)%, (-27.7±1.8)%, (-19.6±1.5)% and (-27.7±1.9)%, respectively (all P<0.001). At 24 weeks, the percent of patients who reached LDL-C<1.81 mmol/L and LDL-C<1.42 mmol/L was significantly higher in alirocumab group (85.3% and 70.5%) than in ezetimibe group (42.2% and 17.0%, both P<0.001), and alirocumab use was also associated with significant reduction on Lp(a), Apo B, total cholesterol and non HDL-C, the difference of their least-squares mean (standard error) percent change were (-37.2±2.8)%, (-29.1±2.0)%, (-21.6±1.6)% and (-29.6±2.2)%, respectively (all P<0.001). The incidence of treatment related adverse events was similar between the two treatment groups (223/302 patients (73.8%) in alirocumab group and 109/153 patients (71.2%) in ezetimibe group). Respiratory infection, urinary infection, dizziness and local injection-site reactions were the most frequently reported adverse events. Conclusions: In high cardiovascular risk patients with hyperlipidemia from China on maximally tolerated statin dose, the reduction of LDL-C induced by alirocumab is more significant than that induced by ezetimibe. Both treatments were generally safe during the observation period of study.
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Affiliation(s)
- Y L Han
- Department of Cardiology, General Hospital of Northern War Zone, Shenyang 110016, China
| | - Y Y Ma
- Department of Cardiology, General Hospital of Northern War Zone, Shenyang 110016, China
| | - G H Su
- Department of Cardiology, Jinan Central Hospital Affiliated to Shandong University, Jinan 250000, China
| | - Y Li
- Department of Cardiology, General Hospital of Northern War Zone, Shenyang 110016, China
| | - Y Li
- Medical, Sanofi (China) Investment Co., Ltd. Shanghai Branch, Shanghai 200040, China
| | - D F Liu
- R&D, Sanofi (China) Investment Co., Ltd. Shanghai Branch, Shanghai 200040, China
| | - R Song
- R&D, Sanofi (China) Investment Co., Ltd. Shanghai Branch, Shanghai 200040, China
| | - J Y Li
- R&D, Sanofi (China) Investment Co., Ltd. Shanghai Branch, Shanghai 200040, China
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