LncRNA MCM3AP-AS1 serves as a competing endogenous RNA of miR-218 to upregulate GLUT1 in papillary thyroid carcinoma

ABSTRACT Objective: MCM3AP-AS1 has been characterized as an oncogenic long non-coding RNA (lncRNA) in several cancers including papillary thyroid cancer (PTC), but its role in PTC has not been fully elucidated. Considering the critical role of lncRNAs in cancer biology, further functional analysis of MCM3AP-AS1 in PTC may provide novel insights into PTC management. Subjects and methods: Paired tumor and non-tumor tissues were collected from 63 papillary thyroid carcinoma (PTC) patients. Expression levels of MCM3AP-AS1 , miR-218 and GLUT1 in tissue samples were analyzed by qRT-PCR. Cell transfection was performed to explore the interactions among MCM3AP-AS1 , miR-218 and GLUT1 . Cell proliferation assay was performed to evaluate the effects of MCM3AP-AS1 and miR-218 on cell proliferation. Results: MCM3AP-AS1 accumulated to high levels in PTC tissues and was affected by clinical stage. MCM3AP-AS1 showed a positive correlation with GLUT1 across PTC tissues. RNA interaction prediction showed that MCM3AP-AS1 could bind to miR-218 , which can directly target GLUT1 . MCM3AP-AS1 and miR-218 showed no regulatory role regulating the expression of each other, but overexpression of MCM3AP-AS1 upregulated GLUT1 and enhanced cell proliferation. In contrast, overexpression of miR-218 downregulated GLUT1 and attenuated cell proliferation. In addition, miR-218 suppressed the role of MCM3AP-AS1 in regulating the expression of GLUT1 and cell proliferation. Conclusions: MCM3AP-AS1 may serve as a competing endogenous RNA of miR-218 to upregulate GLUT1 in PTC, thereby promoting cell proliferation. The MCM3AP-AS1/miR-218/GLUT1 pathway characterized in the present study might serve as a potential target to treat PTC.

Sexual assault and associated factors among middle school students in one city of Sichuan Province / 中国学校卫生

Objective@#To understand the current situation and influencing factors of sexual assault among middle school students, and to provide a basis for promoting healthy psychosocial environment for children and adolescents.@*Methods@#A questionnaire survey was conducted among 1 471 middle school students in one city of Sichuan Province from April to May 2020 using multi stage stratified cluster sampling.@*Results@#The proportion of middle school students who have been raped, indecent assault and sexual assault was 1.6%, 3.7% and 9.4%, respectively. About 23.8% of them had suffered two or more types of sexual assault; 75.1 % to 82.1% of sexual assault occurred between the ages of 9 and 15. Between 36.3% and 62.3% of sexual assault subjects were acquaintances of the same generation. Pornography exposure was the same risk factor for the three types of sexual assault (rape: OR= 9.93, 95%CI =3.09-27.57; sexual obscenity: OR=7.83, 95%CI =3.95-15.53; sexual harassment: OR=5.22, 95%CI= 3.52- 7.73, P <0.01). Low gender identity was the same risk factor for both suffering sexual obscenity and sexual harassment (sexual obscenity: OR=2.37, 95%CI =1.31-4.29; sexual harassment: OR=1.73, 95%CI=1.16-2.58, P <0.01). The long term absence of mothers was a risk factor for suffering sexual rape among middle school students ( OR=3.10, 95%CI =1.31-7.30), as well as father s sex education was a risk factor for suffering sexual obscenity among middle school students ( OR=2.52, 95%CI = 1.26 - 5.03 )( P <0.01).@*Conclusion@#Pornography exposure is the same risk factor for all types of sexual assault among middle school students. Low gender identity is the same risk factor for indecent assault and sexual harassment. Sexual education capabilities of families and schools should be improved, and attention should be paid to the gender identity and sexual mental health of middle school students.

Association between circadian rhythm disorder with depressive and anxiety symptoms of college students in Jinzhou City / 中国学校卫生

Objective@#To explore the association between circadian rhythm with depressive and anxiety symptoms of college students in Jinzhou City, to provide a theoretical basis for targeted depression and anxiety prevention among college students.@*Methods@#A total of 1 938 college students were selected by convenient sampling method from November to December 2020 for questionnaire survey. The relationship between circadian rhythm and depression and anxiety symptoms was analyzed by using questionnaire,survey including Self Rating Depression Scale (SDS), Self Rating Anxiety Scale (SAS) and Munich Chronotype Questionnaire (MCTQ).@*Results@#There were significant differences in the distribution of depressive symptoms in different majors, smoking, drinking and physical exercise ( χ 2=46.80, 5.88, 5.76, 12.23, P <0.05). There were significant differences in the distribution of anxiety symptoms in different majors, smoking and drinking ( χ 2=9.41, 5.80, 5.56, P <0.05). Stratified analysis showed that the depressive symptoms of different chronotype were statistically varied by age, gender, professional, grade, registered residence, body mass index, smoking, drinking, and sports( χ 2=8.16, 14.42, 12.25, 6.19, 10.99, 15.29, 17.41, 15.63, 7.47, 9.59, 10.51 , P <0.05). The anxiety symptoms of different chronotype were statistically different in age (21 years) and smoking (no), ( χ 2= 8.34 , 7.16, P <0.05). Spearman rank correlation showed that the corrected Mid sleep on Free Days Corrected for Sleep Debt on Work Days (MSFsc) was positively correlated with the standard scores of depression and anxiety ( r s=0.10, 0.09), and social jet lag was positively correlated with the standard scores of depression and anxiety ( r s=0.09, 0.05)( P <0.05). After controlling for age, major, smoking and drinking, binary Logistic regression showed that mean sleep length was inversely correlated with depressive symptoms ( OR =0.82), and weekly insomnia frequency was positively correlated with depressive symptoms ( OR=1.14 ).Early type and intermediate type of chronotypes were negatively correlated with depression ( OR =0.66,0.57). Intermediate type of chronotype was negatively correlated with anxiety symptoms ( OR =0.65).@*Conclusion@#Circadian rhythm is related to depressive and anxiety symptoms,among which the average sleep length, early rise and intermediate sleep patterns are negatively related to depression symptoms, and intermediate sleep patterns and anxiety symptoms, suggesting that circadian rhythm disorder may affect depression and anxiety symptoms.

A case of acute carbon monoxide poisoning with secondary intestinal obstruction and thrombosis / 中华劳动卫生职业病杂志

Acute carbon monoxide poisoning can cause multiple organ damage due to hypoxia. In severe cases, it can be life-threatening and has a high fatality rate. Intestinal obstruction and thrombosis are rare complications of carbon monoxide poisoning. A case of carbon monoxide poisoning was reported. In addition to the central nervous system lesion, intestinal obstruction and lower limb thrombosis were also found. In the treatment of carbon monoxide poisoning patients, the clinician was able to treat the common complications, attention should be paid to gastrointestinal tract, thrombotic disease and other rare complications, so as to avoid missed diagnosis.

Feasibility and safety of right ventricular endomyocardial biopsy via the right internal jugular vein approach / 中华心血管病杂志

Objective: To evaluate the feasibility and safety of right ventricular endomyocardial biopsy (EMB) via the right internal jugular vein approach. Methods: It was a retrospective and descriptive study. A total of 272 patients, who underwent right ventricular EMB from December 2014 to June 2020 in Fuwai Hospital and Peking Union Medical College Hospital were enrolled. The preliminary diagnosis included suspected myocarditis, myocardiopathy, unexplained heart failure etc after exclusion of coronary heart disease. Clinical characteristics including age, sex, height, weight, NYHA functional class, NT-proBNP, chest radiography, echocardiography, and hemodynamics parameters were collected at baseline. EMB was performed via right internal jugular vein approach under the biplane fluoroscopic guidance. Success rate was calculated in this study. Complications related to operation were recorded according the following definitions. Major complications included death, urgent cardiac surgery, advanced cardiac life support, pericardiocentesis in cardiac tamponade, permanent complete atrioventricular block requiring permanent pacing etc. Minor complications included pericardial effusion without pericardiocentesis, temporary (lasting less than 24 hours) or permanent right bundle-branch block, temporary Mobitz type Ⅱ atrioventricular block (AV block) with AV conduction 2∶1 requiring medical treatment with atropine, or additive temporary pacing, non-sustained ventricular tachycardia with long runs of more than 10 ventricular complexes, and an episode of atrial fibrillation lasting less than 12 hours or cardioversion of atrial fibrillation. Other complications included tricuspid anterior chorda rupture and new onset tricuspid regurgitation after EMB. Results: In this study, right ventricular EMB were performed successfully in 270 patients, the total success rate was 99.3% (270/272), and EMB were failed in 2 (0.7%) patients. Age of the enrolled patients was (42.7±16.9) years, and there were 164 (60.3%) males. Major complication including cardiac tamponade requiring pericardiocentesis occurred in 2 (0.7%) patients. Minor complications such as small amount pericardial effusion occurred in 18 (6.6%) patients, tricuspid anterior chorda rupture occurred in 1 (0.4%) patient. No patient died, or requiring permanent pacing, or requiring emergency cardiac surgery. The complication rate was 9.3% (13/140), 7.8% (7/90), and 2.4% (1/42) in operators with 1, 2, and 3 years' experience. Conclusions: EMB via the right jugular vein approach under fluoroscopic guidance is a simple, safe and feasible procedure. The complication rates decrease significantly with increasing operator experience.

Feasibility of the determination of plasma vardenafil level in rat by performance liquid chromatography-tandem mass spectrometry / 中华心血管病杂志

Objective: To develope and validate a reliable and sensitive liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for determination of vardenafil concentration in plasma of rat. Methods: Plasma samples of normal Sprague-Dawley rats were collected. A Phenomenex Synergi Polar-RP 80A column (2.0 mm×50 mm, 4 µm) was used. Column temperature was set at 30 ℃. Mobile phase A was 0.1% formic acid in water; mobile phase B was 0.1% formic acid in acetonitrile. The flow rate was 0.4 ml/minutes. Quantitative determination was performed by electrospray ionization, operating in positive ion multiple reaction monitoring (MRM) mode. Cisapride was used as the internal standard. The feasibility of the method was evaluated by examining its specificity, linearity and quantitative range, precision and accuracy, matrix effects, and stability. Results: Under the selected chromatographic and mass spectrometry conditions, the monitoring ions of vardenafil and internal standard were mass-to-charge ratio（m/z) 489.3/151.2 and 466.4/234.2, the retention times of vardenafil and internal standard were 2.62 and 2.80 minutes, respectively, and the peak shape was satisfactory. The method has good linearity in the concentration range of 0.2-200 ng/ml. The intra-batch precision (%CV) and accuracy (%DEV) of vardenafil were 1.5%-9.7% and -6.8%-6.6%, respectively. The inter-batch precision and accuracy of vardenafil were 3.1% -8.4% and -3.7%-4.6%, respectively. In this sample processing method, the extraction recovery rate of vardenafil was obtained at range of 88.2%-104.6%, which met the requirements for the investigation of extraction recovery rate. In this sample processing method, the normalized matrix factor of each quality control concentration of vardenafil was 1.04, 0.85, and 1.04, and the coefficient of variation (%CV) was in the range of 1.7%-10.7%, which met the requirements for the investigation of matrix effects. Variations of short-term stability, long-term stability, and stability of 4 freeze-thaw cycles of vardenafil was within ±15%, and the coefficient of variation were within 5%. Conclusion: The high performance liquid chromatography-tandem mass spectrometry method established in this study is feasible for the measurement of concentration of vardenafil in rat plasma and this method has good specificity and high accuracy, and can be used to detect the concentration of vardenafil in rat plasma.

Downregulation of miR-4772-3p promotes enhanced regulatory T cell capacity in malignant pleural effusion by elevating Helios levels / 中华医学杂志(英文版)

BACKGROUND@#Malignant pleural effusion (MPE) is a complicated condition of patients with advanced tumors. Further dissecting the microenvironment of infiltrated immune cells and malignant cells are warranted to understand the immune-evasion mechanisms of tumor development and progression.@*METHODS@#The possible involvement of microRNAs (miRNAs) in malignant pleural fluid was investigated using small RNA sequencing. Regulatory T cell (Treg) markers (CD4, CD25, forkhead box P3), and Helios (also known as IKAROS Family Zinc Finger 2 [IKZF2]) were detected using flow cytometry. The expression levels of IKZF2 and miR-4772-3p were measured using quantitative real-time reverse transcription polymerase chain reaction. The interaction between miR-4772-3p and Helios was determined using dual-luciferase reporter assays. The effects of miR-4772-3p on Helios expression were evaluated using an in vitro system. Correlation assays between miR-4772-3p and functional molecules of Tregs were performed.@*RESULTS@#Compared with non-malignant controls, patients with non-small cell lung cancer had an increased Tregs frequency with Helios expression in the MPE and peripheral blood mononuclear cells. The verified downregulation of miR-4772-3p was inversely related to the Helios Tregs frequency and Helios expression in the MPE. Overexpression of miR-4772-3p could inhibit Helios expression in in vitro experiments. However, ectopic expression of Helios in induced Tregs reversed the effects induced by miR-4772-3p overexpression. Additionally, miR-4772-3p could regulate Helios expression by directly targeting IKZF2 mRNA.@*CONCLUSION@#Downregulation of miR-4772-3p, by targeting Helios, contributes to enhanced Tregs activities in the MPE microenvironment.

Downregulation of miR-4772-3p promotes enhanced regulatory T cell capacity in malignant pleural effusion by elevating Helios levels / 中华医学杂志(英文版)

Background@#Malignant pleural effusion (MPE) is a complicated condition of patients with advanced tumors. Further dissecting the microenvironment of infiltrated immune cells and malignant cells are warranted to understand the immune-evasion mechanisms of tumor development and progression.@*Methods@#The possible involvement of microRNAs (miRNAs) in malignant pleural fluid was investigated using small RNA sequencing. Regulatory T cell (Treg) markers (CD4, CD25, forkhead box P3), and Helios (also known as IKAROS Family Zinc Finger 2 [IKZF2]) were detected using flow cytometry. The expression levels of IKZF2 and miR-4772-3p were measured using quantitative real-time reverse transcription polymerase chain reaction. The interaction between miR-4772-3p and Helios was determined using dual-luciferase reporter assays. The effects of miR-4772-3p on Helios expression were evaluated using an in vitro system. Correlation assays between miR-4772-3p and functional molecules of Tregs were performed.@*Results@#Compared with non-malignant controls, patients with non-small cell lung cancer had an increased Tregs frequency with Helios expression in the MPE and peripheral blood mononuclear cells. The verified downregulation of miR-4772-3p was inversely related to the Helios+ Tregs frequency and Helios expression in the MPE. Overexpression of miR-4772-3p could inhibit Helios expression in in vitro experiments. However, ectopic expression of Helios in induced Tregs reversed the effects induced by miR-4772-3p overexpression. Additionally, miR-4772-3p could regulate Helios expression by directly targeting IKZF2 mRNA.@*Conclusion@#Downregulation of miR-4772-3p, by targeting Helios, contributes to enhanced Tregs activities in the MPE microenvironment.

Protective effect and mechanism of extracts and main components from stem and leaves of Salvia miltiorrhiza on HUVECS / 中草药

Objective: To investigate the protective effects of the extracts and active components from stems and leaves of Salvia miltiorrhiza on oxidative stress and high glucose-injured human umbilical endothelial cells (HUVECs). Methods: The models of oxidative stress and high glucose injury in HUVECs were established. The ethanol extract of S. miltiorrhiza stems and leaves (CJ), ethanol extract of S. miltiorrhiza roots (CG), water extract of S. miltiorrhiza stems and leaves (SJ), water extract of S. miltiorrhiza roots (SG), rosmarinic acid, salvianolic acid B, rutin, isoquercitrin, cryptotanshinone, aminoguanidine and VC were administrated to cells. MTT were used to observe the cell viability. The levels of glutathione peroxidase (GSH-Px), catalase (CAT), nitric oxide (NO), endothelin (ET-1), ICAM-1 and TNF-α were detected. Result:s Compared with the control group, H2O2 decreased the levels of GSH-Px, CAT and NO (P < 0.01) and increased the level of ET-1 (P < 0.01), glucose increased the levels of ICAM-1 and TNF-α (P < 0.01) and decreased the level of NO (P < 0.01). Compared with the model group, the levels of GSH-Px, CAT and NO in CJ, CG, SJ and SG groups were increased, and the levels of ET-1, ICAM-1 and TNF-α were decreased (P < 0.05, P < 0.01). VC, rosmarinic acid, salvianolic acid B and rutin high and medium dose groups, and isoquercitrin, cryptotanshinone high dose group significantly increased the levels of GSH-Px, CAT and NO (P < 0.05, P < 0.01) and decreased the level of ET-1 (P < 0.05, P < 0.01). ICAM-1 levels were significantly decreased in the high dose groups of salvianolic acid B, isoquercitrin and rutin as well as in the high and medium dose groups of rosmarinic acid (P < 0.01). In addition to the aminoguanidine group, the levels of TNF-α of other groups were significantly lower than the model group (P < 0.05, P < 0.01). Except the aminoguanidine group and isoquercetin low dose group, the levels of NO of other groups were significantly higher than the model group (P < 0.05, P < 0.01). Conclusion: In certain concentration range of alcohol extract and water extract of stems, leaves and roots of S. miltiorrhiza, rosmarinic acid, salvianolic acid B, rutin and isoquercitrin have protective effects on HUVECs injured by H2O2 and glucose. And the mechanisms are related to inhibition of intercellular adhesion molecule expression and regulation of NO and TNF-α production. This study will provide reference for the discovery and transformation of the resource value of non-medicinal stems and leaves produced during the production of S. miltiorrhiza.

Hypoxia promotes proliferation of nucleus pulposus-derived mesenchymal stem cells in rats / 基础医学与临床

Objective To investigate the effect of hypoxia on the proliferation of nucleus pulposus-derived mesen-chymal stem cells ( NPMSCs) in vitro and explore its possible mechanism .Methods NPMSCs were isolated from nucleus pulposus of Sprague-Dawley rats.Cellular morphology was observed and expression of CD 11b, CD45, CD73, CD90 and CD105 was detected using flow cytometry .The third generation NPMSCs were cultured under nor-moxia (20%O2) and hypoxia (2%O2) for 14 days.Cell viability was determined by the annexin-V-FITC/propidi-um iodide doublestaining assay and cell proliferation was measured by MTT assay .The expressions of hypoxia-in-ducible factor-1α( HIF-1α) , glucose transporter 1( GLUT-1) , vascular endothelial growth factor ( VEGF) , silent information regulator protein 1( SIRT1) and silent information regulator protein 6 ( SIRT6) at the mRNA level were examined by semi-quantitative reverse transcription polymerase chain reaction ( RT-qPCR ).Results NPMSCs formed sunflower-like colony and the third passage NPMSCs became homogeneous and exhibited spindle -like mor-phology .Meanwhile , high expression level of stem cell-related positive antigen molecules and low expression levels of negative antigen molecules .Hypoxia promoted proliferation of NPMSCs and promoted gene expression of HIF-1α, GLUT-1, VEGF, SIRT1 and SIRT6 significantly(P<0.05).Conclusions Hypoxia has a significant impact on the proliferation of NPMSCs and SIRT 1, SIRT6 mediated HIF-1αpathway is potentially involved in the mechanism .

Exploring Patterns and Trends with Selected Cancer Rates Reported by China National Cancer Registry: Alternative Perspectives and Findings.

Background: National cancer registration reports provide huge potential for identifying patterns and trends of policy, research, prevention and treatment significance. Yet given the range of factors involved in cancer onset, case identification, progression and reporting, pin-pointing this complexity requires systematic thinking and varied strategies of data analysis. Methods: The study extracts data about incidence rates (IRs) and mortality rates (MRs) of lung, stomach, colorectal and liver cancers for 2004, 2006 and 2009 from relevant China National Cancer Registry (CNCR) reports and analyzes the data using line-graphs, ratios and logistic growth modeling. Results: The study shows that: a) all line graphs of age-specific IRs and MRs of the 4 cancers characterized typical S-shape with substantial differences in terms of smoothness, height and proximity; b) MR lines mimicked and located below the corresponding (of the same cancer, population group and year of reporting) IR lines for almost all the age groups except 1 to 2 oldest ones; c) colorectal cancer witnessed the lowest MR/IR ratios on average followed by gastric and lung cancers and all such ratios featured an increasing trend along the age spectrum; d) urban vs. rural ratios in IRs or MRs showed an increasing trend along the age axis for 3 out of the 4 cancers but a typical v-shaped curves for stomach cancer; e) the lines of recent vs. early ratios in cumulative IRs or MRs for urban areas located apparently closer than that for rural areas; f) all the age-specific IRs and MRs fitted very well with logistic growth models (goodness of fit> 0.91) and the integrations and ages when the models reached 5%, 50% or 95% of their highest values yielded interesting features. Conclusion: The study provides useful perspectives for analyzing age-specific IRs and MRs and reveals a number of interesting patterns and trends with cancer counts reported by CNCR.

Effects of ambrisentan in treatment of pulmonary arterial hypertension: a pilot study with 15 patients / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the preliminary efficacy and safety of ambrisentan, a selective endothelin receptor antagonist, in patients with pulmonary arterial hypertension (PAH).</p><p><b>METHODS</b>A total of 15 patients with PAH, including 10 patients with idiopathic PAH and 5 patients with associated connective-tissue disease, received 2.5 mg or 5 mg of ambrisentan once daily for 12 weeks. Before and after 12 weeks treatment, 6-minute walk test (6-MWD), WHO functional classification (WHO FC) and N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured.</p><p><b>RESULTS</b>After 12 weeks treatment, the 6-MWD was significantly increased [(376.5 ± 108.2) m vs.(460.3 ± 95.7) m, P = 0.021] and the systolic pulmonary artery was significantly decreased [(85.0 ± 33.3) mm Hg (1 mm Hg = 0.133 kPa)vs. (70.5 ± 30.5) mm Hg,P = 0.015] and NT-proBNP was significantly reduced [892.0 (99.0-2245.0) ng/L vs. 205.0 (56.0-534.0) ng/L, P = 0.026] than before treatment. WHO FC was improved in 4 patients after 12 weeks treatment. No patient was withdrawn from this study for safety reasons.</p><p><b>CONCLUSIONS</b>Ambrisentan treatment can effectively improve the exercise capacity, and reduce systolic pulmonary artery pressure and NT-proBNP in PAH patients. Ambrisentan use is safe and could be well tolerated in Chinese PAH patients.</p>

Chronic effects of 100 mg/2 hours recombinant tissue-type plasminogen activator therapy regimen for patients with acute pulmonary thromboembolism / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of 100 mg/2 hours recombinant tissue-type plasminogen activator (rt-PA) regimen for treating patients with acute pulmonary thromboembolism (PE) by observing long-term clinical outcome including recurrent pulmonary embolism, chronic thromboembolic pulmonary hypertension (CTEPH) and other complications.</p><p><b>METHODS</b>Data of 43 consecutive patients with acute high-risk and intermediate-risk PE treated with intravenous rt-PA (100 mg/2 hours) were prospectively analyzed. Median follow-up post-thrombolysis was (15.6 ± 11.4) months. The endpoints of the study were PE recurrence, death related to PE and onset CTEPH.</p><p><b>RESULTS</b>After rt-PA therapy, pulse pressure increased [(46.7 ± 9.5) mm Hg(1 mm Hg = 0.133 kPa)vs. (41.9 ± 11.3) mm Hg, P = 0.007], heart rate and respiratory rate decreased [(84.2 ± 14.7) bpm vs.(93.3 ± 17.7) bpm, P < 0.001; (20.2 ± 2.4) bpm vs. (23.2 ± 4.1) bpm, P < 0.001, respectively], tricuspid annular plane systolic excursion increased [(18.7 ± 3.1) mm vs. (15.9 ± 3.9) mm, P < 0.001] and right ventricle transverse diameter [(34.0 ± 3.6) mm vs. (36.8 ± 4.4) mm, P < 0.001]. PO2, SO2 and P(A-a)O2 improved [ (87.9 ± 17.8) mm Hg vs. (73.4 ± 20.1) mm Hg, P < 0.001; 96.6% ± 2.4% vs. 92.5% ± 6.3%, P < 0.001; 29.9 (12.3, 55.1) mm Hg vs. 52.1(31.5, 76.3) mm Hg, P = 0.014, respectively], D-dimer and NT-proBNP levels significant reduced (P < 0.001). Mortality rate related to PE was 6.9% (4/43) and there was no patient developed CTEPH during follow up.</p><p><b>CONCLUSION</b>The 100 mg/2 hours rt-PA regimen is effective to treat acute PE patients and could improve right heart function and outcome in patients with acute PE.</p>

Clinical characteristics of 161 Chinese patients with idiopathic pulmonary arterial hypertension / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the clinical characteristics of patients with idiopathic pulmonary arterial hypertension (IPAH) in China.</p><p><b>METHODS</b>A total of 161 patients diagnosed as IPAH in Shanghai Pulmonary Hospital from June 2008 to June 2010 were retrospective analyzed.</p><p><b>RESULTS</b>The mean diagnostic age was (33 ± 15) years old and 70.2% patients were female. The median duration from symptoms onset to diagnostic right heart catheterization was 12 months. Incidence of NYHA class III to IV was 56.5% at diagnosis and the mean six minutes walk distance was limited to (398 ± 108) meters. Incidence of mild obstructive, restrictive and diffusing impairment in pulmonary function test was 7.8%, 42.2% and 82.2% patients with IPAH, respectively. Right heart catheterization demonstrated severe elevated mean pulmonary arterial pressure [(63 ± 17) mm Hg (1 mm Hg = 0.133 kPa)] and pulmonary vascular resistance index [(25 ± 12) Wood U/m(2)] in this patient cohort. The response rate of acute pulmonary vasoreactivity testing was 8.7% in this cohort. Compared with non-responders, responders to acute pulmonary vasoreactivity testing were younger and with less severe pulmonary hypertension. Among non-responders, 89% patients were treated by one specific anti-pulmonary arterial hypertension drug and 27% patients received combined anti-pulmonary arterial hypertension medications.</p><p><b>CONCLUSIONS</b>Young female was predominantly involved in patients with IPAH in China. The diagnosis of IPAH is often made at advanced disease stage and majority patients with IPAH received specific anti-pulmonary arterial hypertension therapies in this patient cohort.</p>

Association of nicotinic acetylcholine receptor subunit alpha-4 polymorphisms with smoking behaviors in Chinese male smokers / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>It has been reported that the nicotinic acetylcholine receptor subunit α4 gene (CHRNA4) might be associated with smoking behaviors in the previous studies. Up to now, there are few reports on the relationship between CHRNA4 and smoking initiation. In this study, we tried to explore the role of two polymorphisms in CHRNA4 (rs1044396 and rs1044397) in smoking initiation and nicotine dependence in Chinese male smokers.</p><p><b>METHODS</b>Nine hundred and sixty-six Chinese male lifetime nonsmokers and smokers were assessed by the Fagerström test for nicotine dependence (FTND), smoking quantity (SQ) and the heaviness of smoking index (HSI). All subjects were divided into four groups based on their tobacco use history and the FTND scores. The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was performed to find two polymorphisms of CHRNA4 in these subjects.</p><p><b>RESULTS</b>The χ(2) test showed that rs1044396 was significantly associated with smoking initiation (χ(2) = 4.65, P = 0.031), while both rs1044396 and rs1044397 were significantly associated with nicotine dependence (χ(2) = 5.42, P = 0.020; χ(2) = 7.58, P = 0.005). Furthermore, the T-G (3.9%) haplotype of rs1044396-rs1044397 showed significant association with smoking initiation (χ(2) = 6.30, P = 0.012) and the C-G haplotype (58.9%) remained positive association with nicotine dependence (χ(2) = 8.64, P = 0.003) after Bonferroni correction. The C-G haplotype also significantly increased the HSI (P = 0.002) and FTND scores (P = 0.001) after Bonferroni correction.</p><p><b>CONCLUSION</b>These findings suggest that CHRNA4 may be associated with smoking initiation and the C-G haplotype of rs1044396-rs1044397 might increase the vulnerability to nicotine dependence in Chinese male smokers.</p>

Clinic diagnosis and treatment of patients with Cantrell syndrome / 中华心血管病杂志

<p><b>OBJECTIVE</b>To analyze the diagnostic feature, treatment and prognosis of patients with Cantrell syndrome.</p><p><b>METHODS</b>Clinical manifestation, diagnosis, operation and follow-up data of 5 patients with Cantrell syndrome were summarized in this retrospective analysis.</p><p><b>RESULTS</b>The age of the 5 patients was 7 days-76 years, definite diagnosis was made in 3 cases and 2 cases presented feature of incomplete Cantrell syndrome. Three patients with full Cantrell syndrome were correctly diagnosed before operation and confirmed by operation. One patient with incomplete Cantrell syndrome (two-vessel stenosis) received bypass surgery. Another asymptomatic patient with incomplete Cantrell syndrome (apical diverticulum of the left ventricle) does not need operation and is under observation. During follow-up, 1 patient died at 60 months after operation and the remaining 4 patients are alive and well.</p><p><b>CONCLUSIONS</b>With the development of modern imaging technology, it becomes easy to make correct diagnose Cantrell syndrome before operation. Prognosis is fine post timely operation and related intervention.</p>

Clinical characteristics and survival of patients with pulmonary veno-occlusive disease / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the clinical presentation, diagnosis, treatment and outcome of patients with pulmonary veno-occlusive disease (PVOD).</p><p><b>METHODS</b>Data from patients diagnosed as PVOD from May 2008 to May 2011 in Shanghai Pulmonary Hospital, Tongji University were retrospectively reviewed.</p><p><b>RESULTS</b>During this period, 5 patients [4 female, aged from 12 to 42 (22 ± 12) years old] were diagnosed as PVOD. The durations from symptoms onset to PVOD diagnosis was 2 to 50 (16 ± 20) months and four of them were previously diagnosed as idiopathic pulmonary arterial hypertension. All patients at the time of PVOD diagnosis had a severely impaired WHO pulmonary hypertension functional class (3 in class III and 2 in class IV). Furthermore, all patients characterized by a typical sign of centrilobular ground-glass opacities in high-resolution computed tomography, a markedly reduction of diffusing capacity of the lung for carbon monoxide [(38 ± 12)% of predicted value] in pulmonary functional test and severely compromised cardio-pulmonary hemodynamics identified by right heart catheterization. All patients received conventional and pulmonary arterial hypertension specific therapies, and then followed-up regularly. Up to now, 4 out of 5 patients died due to refractory right heart failure. The durations from symptoms onset to death and from PVOD establish to death were 5 - 65 (27 ± 26) months and 1 - 16 (9 ± 9) months, respectively.</p><p><b>CONCLUSIONS</b>PVOD is a rare and malignant cardio-pulmonary disorder that often be misdiagnosed as idiopathic pulmonary arterial hypertension. Given the poor responses to modern pulmonary arterial hypertension specific therapies, lung transplantation remains the treatment of choice.</p>

Determination of pulmonary vascular resistance by improved right heart catheter in rat / 中华心血管病杂志

<p><b>OBJECTIVE</b>To establish an easy and repeatable method for determination of pulmonary vascular resistance in normal and pulmonary arterial hypertension (PAH) rats.</p><p><b>METHODS</b>Forty-five Sprague-Dawley rats were randomly assigned into three groups: control group, low dose monocrotaline (MCT) group (50 mg/kg) and high dose MCT group (60 mg/kg). Rats in PAH groups received single subcutaneous injection of MCT. We measured pulmonary artery pressure by right heart catheterization using an improved hand-made PE-50 catheter. Cardiac output was calculated through thermodilution method. Pulmonary vascular resistance equals the mean pulmonary artery pressure divided by cardiac output.</p><p><b>RESULTS</b>The total percentages of success to detect pulmonary artery pressure, cardiac output and pulmonary vascular resistance were 98%, 100% and 96% respectively in 3 groups. Twenty-one days after MCT injection, mean pulmonary artery pressure significantly increased in MCT group compared to control group [(43.1 ± 0.8), (54.8 ± 2.2) vs. (17.4 ± 1.0) mm Hg (1 mm Hg = 0.133 kPa), P < 0.001], and the mPAP was also significantly higher in high dose MCT group than in low dose MCT group (P < 0.001). Cardiac output was significantly lower in PAH rats than in control rats [(77.5 ± 6.9), (71.0 ± 6.7) vs. (126.8 ± 3.9) ml/min, P < 0.001]. Pulmonary vascular resistance was significantly increased in PAH rats compared with control rats [(0.56 ± 0.06), (0.76 ± 0.08) vs. (0.13 ± 0.01) mm Hg×min(-1)×ml(-1), P < 0.001]. There were significant differences in both MCT-treated groups (P = 0.01).</p><p><b>CONCLUSIONS</b>Pulmonary vascular resistance in rats could be reliably detected using the improved hand-made PE-50 right heart catheter.</p>

The efficacy and safety of bosentan therapy for Chinese patients with idiopathic pulmonary arterial hypertension: an open-label, prospective multicenter study / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the efficacy, safety and tolerance of bosentan, a dual endothelin receptor antagonist, in Chinese patients with idiopathic pulmonary arterial hypertension (IPAH).</p><p><b>METHODS</b>Totally 79 IPAH patients (hemodynamic criteria confirmed by right heart catheterization) were included in this open-label, prospective multicenter study. Patients received 62.5 mg of bosentan twice daily for the first 4 weeks, and then up-titrated to 125 mg twice daily for another 12 weeks. The primary end point was the change in exercise capacity showed by six-minute walk distance (6MWD) from baseline to 16 weeks. Secondary end points included the change in World Health Organization (WHO) functional class, Borg dyspnoea scale and systolic pulmonary artery pressure measured by echocardiography.</p><p><b>RESULTS</b>The 6MWD increased from (343.7 ± 93.7) meters at baseline to (397.5 ± 104.4) meters after 16 weeks (P < 0.01), WHO functional class and Borg dyspnoea scale were also significantly improved after 16 weeks therapy compared to baseline levels (all P < 0.01). Furthermore, the systolic pulmonary artery pressure was significantly decreased from (97.8 ± 25.2) mm Hg (1 mm Hg = 0.133 kPa) to (92.8 ± 29.5) mm Hg (P < 0.05) after 16 weeks bosentan treatment. There was no patient withdrawal from this study for safety consideration.</p><p><b>CONCLUSION</b>Bosentan therapy is well tolerated and can improve the exercise capacity and WHO functional class in Chinese IPAH patients.</p>

Clinical efficacy of intravenous L-carnitine in patients with right-sided heart failure induced by pulmonary arterial hypertension / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the efficacy of L-carnitine in patients with right-sided heart failure induced by pulmonary arterial hypertension (PAH).</p><p><b>METHODS</b>A total of 66 pulmonary arterial hypertension patients (14 idiopathic, 36 congenital heart disease associated and 16 connective-tissue disease associated PAH, WHO heart functional class III, n = 38 or IV, n = 28) were enrolled in this study and divided into control group (26 cases) and L-carnitine group (40 cases). All patients received conventional treatment according to guideline for treatment of right-sided heart failure. The patients in L-carnitine group received 5 g/d L-carnitine intravenously for seven days. Six-minute walking distance, WHO heart functional class, physical examination, and serum markers were evaluated at baseline and 7 days after enrollment.</p><p><b>RESULTS</b>Compared to the baseline, six-minute walking distance was significantly increased (75 m vs. 45 m, P < 0.05), WHO heart functional class significantly improved (improved 2 classes in 16 patients, improved 1 class in 13, no improved in 6, worsen in 5 vs. 3, 8, 9, 6 respectively in the control, P = 0.04), BNP level significant decreased (58.16 ng/L vs. 33.29 ng/L, P = 0.01) and systolic blood pressure significantly increased [8.1 mm Hg vs. 2.4 mm Hg (1 mm Hg = 0.133 kPa), P = 0.03] in L-carnitine group compared with those in control group. No patient was withdrawn from this study for safety reasons.</p><p><b>CONCLUSIONS</b>L-carnitine could improve short-term exercise capacity and WHO heart functional class in right-sided heart failure patients induced by PAH.</p>