ABSTRACT
Hypertrophic cardiomyopathy(HCM)is the second commonest form of heart muscle disease affecting children and adolescents and is a leading cause of sudden death in young athletes. The aetiology of HCM is heterogeneous in the paediatric population,and includes inborn errors of metabolism,neuromuscular disorders and malformation syndromes.However,most cases of apparently idiopathic HCM in childhood are caused by mutations in cardiac sarcomere protein genes. Hypertrophic obstructive cardiomyopathy(HOCM) is not uncommon in children who don't respond to drug treatment;for such children,surgical treatment is the only solution.Previous routine surgical methods include modified Konno operation,modified extended Morrow operation and interventional alcohol ablation or radiofrequency ablation for pediatric patients. At present,the reports and large-scale clinical experience are rare.
ABSTRACT
<p><b>BACKGROUND</b>As an acute phase protein, α1-antitrypsin (AAT) has been extensively studied in acute coronary syndrome, but it is unclear whether a relationship exists between AAT and stable angina pectoris (SAP). The purpose of the present study was to investigate the association between AAT plasma levels and SAP.</p><p><b>METHODS</b>Overall, 103 SAP patients diagnosed by coronary angiography and clinical manifestations and 118 control subjects matched for age and gender were enrolled in this case-control study. Plasma levels of AAT, high-sensitivity C-reactive protein (hsCRP), lipid profiles and other clinical parameters were assayed for all participants. The severity of coronary lesions was evaluated based on the Gensini score (GS) assessed by coronary angiography.</p><p><b>RESULTS</b>Positively correlated with the GS (r = 0.564, P < 0.001), the plasma AAT level in the SAP group was significantly higher than that in the control group (142.08 ± 19.61 mg/dl vs. 125.50 ± 19.67 mg/dl, P < 0.001). The plasma AAT level was an independent predictor for both SAP (odds ratio [OR] = 1.037, 95% confidence interval [CI]: 1.020-1.054, P < 0.001) and a high GS (OR = 1.087, 95% CI: 1.051-1.124, P < 0.001) in a multivariate logistic regression model. In the receiver operating characteristic curve analysis, plasma AAT level was found to have a larger area under the curve (AUC) for predicting a high GS (AUC = 0.858, 95% CI: 0.788-0.929, P < 0.001) than that of hsCRP (AUC = 0.665, 95% CI: 0.557-0.773, P = 0.006; Z = 2.9363, P < 0.001), with an optimal cut-off value of 137.85 mg/dl (sensitivity: 94.3%, specificity: 68.2%).</p><p><b>CONCLUSIONS</b>Plasma AAT levels correlate with both the presence and severity of coronary stenosis in patients with SAP, suggesting that it could be a potential predictive marker of severe stenosis in SAP patients.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Angina Pectoris , Blood , Diagnostic Imaging , Angina, Stable , Blood , Diagnostic Imaging , Case-Control Studies , Coronary Angiography , alpha 1-Antitrypsin , BloodABSTRACT
<p><b>OBJECTIVE</b>To investigate the impact of the establishment of chest pain center (CPC) model based on the pre-hospital real-time tele-12-lead electrocardiogram on the door-to-balloon (D-to-B) time and short-term outcome after primary percutaneous coronary intervention (PPCI) of patients with ST-segment elevated myocardial infarction (STEMI).</p><p><b>METHODS</b>A regular CPC was established with pre-hospital transmitted real-time 12-lead electrocardiogram system for pre-hospital diagnosis of STEMI and enabled the STEMI patients to bypass the emergency room and directly treated in the catheter lab to shorten the D-to-B time. The mean D-to-B time, the short-term outcome and medical costs were compared in PPCI patients before (93 cases, group A) and after (149 cases, group B) the establishment of CPC.</p><p><b>RESULTS</b>After the establishment of CPC, the annual mean D-to-B time was significantly shortened [(127 ± 79) min in group A vs.(72 ± 23 )min in group B, P < 0.01], the shortest monthly mean D-to-B time was remarkably reduced in group B than in group A [(56 ± 11) min vs. (73 ± 14) min, P < 0.01]. The annual ratio of D-to-B below 90 minutes was significantly increased from 62.4% (58/93) in group A to 91.9% (137/149) in group B (P < 0.05) . The in-hospital mortality rate tended to be lower and the incidence of heart failure during hospitalization was significantly reduced in group B compared with group A [3.4% (5/149) vs. 6.5% (6/93), P > 0.05; 14.1% (21/149) vs. 24.7% (23/93), P < 0.05]. The length of hospital stay was slightly shortened from (8.98 ± 4.89) days to (7.79 ± 5.43) days (P > 0.05). Corrected mean medical cost went down by 9.4% (P < 0.05).</p><p><b>CONCLUSION</b>The establishment of CPC may significantly shorten the D-to-B time, improve the short-term outcome and reduce the hospitalization cost for PPCI patients with STEMI.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Angioplasty, Balloon, Coronary , Chest Pain , Therapeutics , Myocardial Infarction , Therapeutics , Percutaneous Coronary Intervention , Prognosis , Time FactorsABSTRACT
Objective To solve the danger and difficulty in transferring seriously injured victims. Methods The operating principle, construction design, electronic control system and software program flowchart of a robot transfer arm for victim-transfer were introduced.Results and Conclusion The victim didn not have to change their body posture during transfer. The procedure is very simple.A push at only one key is enough,without secondary injury.
ABSTRACT
The promoter of NAR gene in Magnaporthe grisea was isolated and sequenced. The promoter sequences contained the "TATA" box, the "CAAT" box, and binding sites for fungal regulatory proteins. Programs that predict promoter sequences indicated that promoter sequence lies between locations 430 and 857 of the NAR promoter fragment. GFP expression under the NAR promoter and NAR transcript analysis revealed that this promoter is activated primarily at the mycelial stage in the rice blast fungus and could be used to express native or extrinsic genes in the mycelia of the rice blast fungus.