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Objective@#To investigate the prevalence and association of hyperuricemia (HUA) and hypertriglyceridemic Waist (HTW) phenotype in children and adolescents aged 6-17 years in Inner Mongolia, providing a basis for the prevention and treatment of hyperuricemia in adolescents in Inner Mongolia.@*Methods@#A total of 2 175 students of primary, junior high, and senior high school students from eight counties (districts) in Inner Mongolia were chosen and received a questionnaire survey, physical examination, and laboratory test by used a multi stage stratified random sampling approach. The association between the HTW phenotype and HUA was analyzed using binary Logistic regression.@*Results@#The prevalence of the HTW phenotype was 2.1%, with boys(2.5%) higher than that of girls(1.6%) ( χ 2=14.50, P<0.05). The average SUA level of the participants was 308.00 (259.00, 371.00) mmol/L, with a statistically significant sex difference(Z=-9.87, P<0.05). The prevalence of HUA was 21.1%. The frequency of HUA in the HTW phenotype(44.4%) was higher than in other phenotypes, followed by enlarged waist (EW) phenotype. After controlling for associated variables, the EW phenotypes (OR=1.76，95%CI=1.26-2.47) and HTW phenotypes (OR=2.25, 95%CI=1.12-4.52) were associated with higher risk for HUA(P<0.05).@*Conclusion@#In Inner Mongolia, the prevalence of HUA in children and adolescents aged 6-17 years is high, and there shows a positive association between the HTW phenotype and hyperuricemia. For the prevention of hyperuricemia, more attention should be paid to children and adolescents with HTW phenotype.
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Objective@#To investigate the prevalence and association of hyperuricemia (HUA) and hypertriglyceridemic Waist (HTW) phenotype in children and adolescents aged 6-17 years in Inner Mongolia, providing a basis for the prevention and treatment of hyperuricemia in adolescents in Inner Mongolia.@*Methods@#A total of 2 175 students of primary, junior high, and senior high school students from eight counties (districts) in Inner Mongolia were chosen and received a questionnaire survey, physical examination, and laboratory test by used a multi stage stratified random sampling approach. The association between the HTW phenotype and HUA was analyzed using binary Logistic regression.@*Results@#The prevalence of the HTW phenotype was 2.1%, with boys(2.5%) higher than that of girls(1.6%) ( χ 2=14.50, P<0.05). The average SUA level of the participants was 308.00 (259.00, 371.00) mmol/L, with a statistically significant sex difference(Z=-9.87, P<0.05). The prevalence of HUA was 21.1%. The frequency of HUA in the HTW phenotype(44.4%) was higher than in other phenotypes, followed by enlarged waist (EW) phenotype. After controlling for associated variables, the EW phenotypes (OR=1.76，95%CI=1.26-2.47) and HTW phenotypes (OR=2.25, 95%CI=1.12-4.52) were associated with higher risk for HUA(P<0.05).@*Conclusion@#In Inner Mongolia, the prevalence of HUA in children and adolescents aged 6-17 years is high, and there shows a positive association between the HTW phenotype and hyperuricemia. For the prevention of hyperuricemia, more attention should be paid to children and adolescents with HTW phenotype.
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Objective: To investigate the efficacy and safety of left bundle branch pacing(LBBP) in patients after transcatheter aortic valve implantation (TAVI). Methods: This is a retrospective study. A total of 35 patients underwent TAVI and received pacemaker implantation from January 2018 to December 2020 in Beijing Fuwai Hospital were enrolled. Patients were divided into LBBP group (n=12) and right ventricular apex pacing (RVAP) group (n=23) according to the pacing position. The success rate of operation in LBBP group was calculated, and the occurrence of complications were observed, and the parameters of pacemaker were measured on the 3rd day and 1, 3 and 6 months after operation. The N-terminal pro-B-type natriuretic peptide (NT-proBNP), echocardiographic and ECG indexes were compared between the two groups on the 3rd day and 1, 3, and 6 months after pacemaker implantation. Result: A total of 35 patients were included, The age was (76.4±7.7) years, including 19 males (54.3%). The procedure time ((86.58±17.10)min vs. (68.74±9.18)min, P<0.001) and fluoroscopy duration ((20.08±4.44)min vs. (17.00±2.26)min, P<0.001) were significantly longer in LBBP group compared with RVAP group. The operation success rate of LBBP group was 11/12. There was no serious operation related complications such as pneumothorax, hemothorax, electrode dislocation, infection, and lower limb bleeding. The patients were followed up for 7.43 (5.21, 9.84) months. The programmed parameters of pacemaker were in the ideal range and stable during follow-up. At 3 and 6 months after operation, the left ventricular ejection fraction in LBBP group was higher than that in RVAP Group (at 3 months: (60.75±2.89)% vs. (57.35±3.33)%, P=0.004; at 6 months: (63.17±3.33)% vs. (56.17±3.97)%, P<0.001), NT-proBNP values was lower in LBBP group than that in RVAP Group (at 3 months: 822 (607, 1 150)ng/L vs. 1 052 (902, 1 536)ng/L, P=0.006; at 6 months: 440 (330,679)ng/L vs. 783 (588, 1 023)ng/L, P=0.001). At 1, 3 and 6 months after operation, the QRS duration was shorter in LBBP group than that in RVAP group (1 month: 99 (97, 107)ms vs. 126(124, 130)ms, P<0.001; 3 months: 98(96, 105)ms vs. 129(128, 133)ms, P<0.001; 6 months: 96(94, 104)ms vs. 130(128, 132)ms, P<0.001). Conclusions: For patients with permanent pacemaker indications after TAVI, LBBP is feasible, safe and reliable. It could improve the cardiac function in the short term, the long-term effect of LBBP needs to be further observed.
Subject(s)
Aged , Aged, 80 and over , Humans , Male , Bundle of His , Cardiac Pacing, Artificial/methods , Electrocardiography/methods , Fluoroscopy , Retrospective Studies , Stroke Volume , Transcatheter Aortic Valve Replacement/adverse effects , Treatment Outcome , Ventricular Function, LeftABSTRACT
Objective: To summarize the single center experience of transcatheter aortic valve replacement (TAVR) with a simplified operative protocol. Methods: Consecutive patients who underwent transfemoral TAVR (TF-TAVR) from July 2020 to December 2020 in Fuwai Hospital were retrospectively analyzed. We compared the baseline characteristic, procedure information, 30-day follow-up outcomes of the patients who underwent TF-TAVR without the simplified operative protocol (routine group) or with the simplified operative protocol (simplified protocol group). Results: 93 patients were collected, 42 patients belonging to routine group, 51 patients belonging to simplified protocol group. In simplified protocol group, there were 51 patients planned to use ultrasound-guided femoral access puncture, procedure was successful in all 51 patients (100%). There were 49 patients planned to use the radial artery as the secondary access, procedure was successful in 45 patients (92%). There were 48 patients planned to use the strategy of avoidance of urinary catheter, this strategy was achieved in 35 patients (73%). There were 12 patients planned to use the left ventricular guidewire to pace, procedure was successful in 11 patients (92%). There were no differences in baseline characteristics, major clinical endpoints and 30-day follow-up outcomes between the two groups. Meanwhile, the procedure time ((62.5±17.9)min vs. (78.3±16.7)min, P<0.001), operation room time ((133.7±25.1)min vs. (159.2±42.6)min, P<0.001), X-ray exposure time ((17.2±6.5)min vs. (20.2±7.7)min, P=0.027) were significantly shorten in simplified protocol group compared with the routine group. Conclusion: Our study results indicate that the simplified operative protocol of TF-TAVR is as effective and safe as the routine operative protocol, meanwhile using the simplified operative protocol can significantly increase the operative efficiency of TF-TAVR.
Subject(s)
Humans , Aortic Valve , Aortic Valve Stenosis/surgery , Femoral Artery/surgery , Retrospective Studies , Risk Factors , Time Factors , Transcatheter Aortic Valve Replacement/methods , Treatment OutcomeABSTRACT
OBJECTIVE@#To evaluate whether ultrafine particulates (UFPs) have direct deleterious effects on cardiac function through activating MAPK signaling.@*METHODS@#Langendorff-perfused Sprague-Dawley rat hearts were randomly divided into 2 groups (n=10/each group). In control group, the rat hearts were perfused with Tyrode's buffer for 40 min; in UFPs-treated group, the hearts were perfused with UFPs at a concentration of 12.5 mg/L. Cardiac function was determined by measuring left ventricular developed pressure (LVDP), left ventricular peak rate of contraction and relaxation (±dp/dtmax) and coronary flow (CF). The levels of malondialdehyde (MDA), superoxide dismutase (SOD), total anti-oxidant capacity (TAOC) were detected in order to evaluate cardiac oxidative stress via the thiobarbituric acid assay, water soluble tetrazolium salt assay and colorimetry, respectively. The expressions of p-p38 MAPK, p-ERKs and p-JNKs in the myocardium were observed using immunohistochemical staining and Western blots.@*RESULTS@#No significant changes in cardiac function were detected before and after the perfusion in control group while UFPs perfused hearts showed a decline in cardiac function in a time-dependent manner (all P < 0.05). In UFPs-treated group, LVDP, +dp/dtmax, -dp/dtmax and CF were statistically reduced from (82.6±2.1) mmHg, (1 624±113) mmHg/s, (1 565±116) mmHg/s, (12.0±0.2) mL/min to (56.8±4.4) mmHg, (1 066±177) mmHg/s, (1 082±134) mmHg/s, (8.7±0.3) mL/min (all P < 0.05), respectively. Furthermore, The comparison between the two groups observed that UFPs perfusion caused a significant decrease in cardiac function at 30 and 40 min compared with the control group (all P < 0.05). At the end of the perfusion, the level of MDA was increased from (0.98±0.14) nmol/L to (1.95±0.18) nmol/L, while SOD and TAOC were reduced from (12.50±1.87) U/mL and (6.83±1.16) U/mL to (6.50 ±1.04) U/mL and (3.67±0.82) U/mL (all P < 0.001) in UFPs group, respectively. In coincidence with these changes, immunohistochemistry and Western blots results showed that the levels of p-p38 MAPK, p-ERKs and p-JNKs in the myocardium significantly increased in UFPs group as compared with control group (all P < 0.05).@*CONCLUSION@#The results of this study demonstrated that the short-term exposure of UFPs to the isolated rat hearts has direct and acute toxic effects on cardiac function, probably related to attenuation of anti-oxidative capacity and activation of MAPK signaling pathways.
Subject(s)
Animals , Rats , Heart , Malondialdehyde/metabolism , Myocardium , Oxidative Stress , Rats, Sprague-DawleyABSTRACT
Objective: To investigate the safety and efficacy of left ventricular guidewire pacing during transcatheter aortic valve replacement (TAVR). Methods: This is a retrospective study. Thirteen patients, who underwent TAVR with left ventricular guidewire pacing from October 2019 to December 2019 in Fuwai Hospital, were included. Clinical data and operational procedure data of the patients were collected. Changes in blood pressure and electrocardiogram were observed during operations. Ascending aorta angiography was performed to evaluate the regurgitation of aortic valve after valve implantion. The incidence of major adverse cardiac events during hospitalization and at 3-months after discharge was recorded. Results: There were 7 male and 6 female patients in this cohort,and age was (73.8±8.3) years old. Among the 13 patients, 9 were tricuspid aortic valves, 3 were bicuspid aortic valves, and 1 was degenerated bioprosthetic surgical aortic valve. TAVR were successfully performed in all of the 13 cases using pacing through the left ventricular guidewire. During balloon dilation, the blood pressure decreased to below 60 mmHg (1 mmHg=0.133 kPa) after 180 beats/min pacing, and the valve release process was smooth and the position was stable. The results of aortography showed that there was no regurgitation in 7 cases, mild regurgitation in 5 cases and moderate regurgitation in 1 case. Three patients required temporary pacing during the procedure due to complete heart block, among whom 1 patient was implanted with permanent pacemaker during hospitalization, and the other 2 patients recovered within 24 hours after operation. In another case, there was no significant change of electrocardiogram during the operation, and complete heart block occurred 10 days after the operation, and treated with permanent pacemaker. The other 10 patients began to carry out bedside activities and rehabilitation training 24 hours after operation. There was no death, myocardial infarction, stroke and other major adverse cardiac events during hospitalization and at 3-month follow-up after discharge. Conclusion: Left ventricular guidewire pacing is a safe and effective strategy for TAVR.
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Aortic Valve/surgery , Aortic Valve Stenosis/surgery , Heart Valve Prosthesis , Retrospective Studies , Risk Factors , Transcatheter Aortic Valve Replacement , Treatment OutcomeABSTRACT
Objective: To explore the feasibility of the single-stage stent implantation following rotational atherectomy combined with transcatheter aortic valve replacement (TAVR) in treating patients with severe aortic stenosis(AS) and severe calcified coronary artery stenosis. Methods: Three patients who received single-stage stent implantation following rotational atherectomy combined with TAVR in Fuwai hospital from April to October 2019 were included in this retrospective analysis. Clinical and anatomical features (including echocardiography and aortic CT) of the patients were collected, efficacy and safety of this operation strategy were observed and 6 months follow up results were summarized. Results: Three patients (2 females, 66-80 years old) were included. The mean Society of Thoracic Surgeons (STS) risk score was 7.8%. The mean maximum velocity of aortic valve was 4.4 m/s, the mean transvalvular pressure gradient was 53.2 mmHg (1 mmHg=0.133 kPa), mean left ventricular ejection fraction (LVEF) was 48.6%. All three patients had severe calcified coronary artery stenosis: left anterior descending artery (LAD, n=2) and left main coronary artery (LM, n=1), requiring rotary grinding. The mean SYNTAX score was 20. All the procedures were performed through transfemoral access. After aortic valve crossing, all coronary lesions were successfully treated with stent implantation following rotational atherectomy, transfemoral TAVR was then immediately performed with a self-expandable Venus-A valve. One patient underwent"valve-in-valve"implantation due to the high-implantation position of the first valve. The procedures were completed without complications in all the three patients. The immediate effect was satisfactory. Echocardiography results showed that the mean maximum velocity of aortic valve was 2.1 m/s, mean gradient was 9.3 mmHg, and mean LVEF was 59% after the procedure. There was no death and revascularization during the 6 months follow-up. Conclusion: In patients with severe calcified coronary artery and severe AS with high risk of cardiac surgery, the single-stage stent implantation following rotational atherectomy combined with TAVR is feasible and results are satisfactory in this patient cohort.
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Objectives: To explore the clinical experience for a bridge therapy of percutaneous balloon aortic valvuloplasty (PBAV) in treating the patients with severe aortic stenosis (AS). Methods: A total of 37 patients with severe AS who were not suitable for surgical valvular replacement received PBAV in our hospital from 2011-03 to 2017-03 were retrospectively studied. The patient's mean age was (74±12) years, their clinical and anatomical features, efficacy and safety of operation were observed and the outcomes were evaluated by follow-up study. Results: Patients presented the high surgical risk and worse cardiac function, 50% of them had bicuspid leaflet morphology with severe calcification [HU850=(856.0±658.2) mm3]. Balloon size was chosen by the intra-operative supra-annular diameters; at 7 days after operation, aortic valve orifice area (AVOA) was increased from (0.37±0.10) cm2to (0.87±1.10) cm2, the mean trans-aortic valve gradient pressure decreased form (55.1±22.9) mmHg to (44.8±17.8) mmHg, P<0.001 and LVEF elevated form(35.8±14.3)% to(41.0±12.2)%,P<0.001.There were 4 patients died in hospital,1 received permanent pacemaker and 1 developed severe aortic valve regurgitation. The patients were followed-up for (16.5±11.1)months after operation, 13/37 (35.1%) patients were in transition to surgical or transcatheter aortic valve replacement (TAVR). Conclusions: PBAV may have good early clinical efficacy in severe AS patients who were not suitable for surgical valvular replacement and TAVR; PBAV could be expected to become a bridge therapy, smaller supra-annular diameter was safe and effective for patients having bicuspid leaflet with severe calcification.
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<p><b>OBJECTIVE</b>To analyze the clinical features of 6 children with Duchenne muscular dystrophy (DMD) and review related literature, and to provide a basis for early diagnosis and effective treatment of this disease.</p><p><b>METHODS</b>A retrospective analysis was performed on the clinical data of 6 children with DMD who were admitted to the First Affiliated Hospital of Nanjing Medical University from January 2010 to October 2015.</p><p><b>RESULTS</b>All the 6 cases were boys without a family history of DMD, and the age of diagnosis of DMD was 1.2-11.5 years. All patients had insidious onset and increases in alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, α-hydroxybutyrate dehydrogenase, creatine kinase (CK), and creatine kinase-MB, particularly CK, which was 3.3-107.2 times the normal level. Their gene detection results all showed DMD gene mutation. The gene detection results of two children's mothers showed that they carried the same mutant gene. The muscle biopsy in one case showed that the pathological changes confirmed the diagnosis of DMD. The level of CK in one case declined by 77.0% 5 days after umbilical cord blood mesenchymal stem cell transplantation.</p><p><b>CONCLUSIONS</b>For boys with abnormal serum enzyme levels and motor function, DMD should be highly suspected. It should be confirmed by CK and DMD gene detection as soon as possible. And the progression of the disease could be delayed by early intervention for protecting the remaining normal muscle fibers.</p>
Subject(s)
Child , Child, Preschool , Humans , Infant , Male , Cord Blood Stem Cell Transplantation , Creatine Kinase , Genetics , Dystrophin , Genetics , Muscular Dystrophy, Duchenne , Genetics , Therapeutics , Retrospective StudiesABSTRACT
Objective To study the value of combination detection of four markers in predicting the early recurrence and metastasis after hepatectomy.Methods Peripheral blood samples were obtained from 40 primary hepatocellular carcinoma and controls,Reverse transcription-polymerase chain reaction (RT-PCR) was used to detect AFP mRNA,h-TERT mRNA,CD44v6 mRNA and MAGE-1 mRNA in PBMC.Results The positive rate of AFP mRNA,h-TERT mRNA,CD44v6 mRNA,MAGE-1 mRNA was 50％,62.5％,55％,37.5％ in PHC patients.The positive expression rate of AFP mRNA and hTERT mRNA were 15％,30％ in patients with chronic active hepatitis,there was significant difference in the positive expression rate of two groups (respectively,~ =6.910,5.640,all P ＜ 0.05).There was no expression of the four markers in peripheral blood of healthy adults.Eight patients showed recurrence or metastasis in 9 PHC patients who has positive expression of the four markers,while none of patients who has no expression of any of four markers showed recurrence or metastasis.The difference among the groups was statistically significant (x2 =9.244,P ＜ 0.01).Conclusions The combinatorial detection of AFP mRNA,h-TERT mRNA,CD44v6 mRNA and MAGE mRNA expression increased the accuracy of predicting recurrence or metastasis of PHC patients in early postoperative phase.
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Objective To study the value of combination detection of four markers in predicting the early recurrence and metastasis after hepatectomy.Methods Peripheral blood samples were obtained from 40 primary hepatocellular carcinoma and controls,Reverse transcription-polymerase chain reaction (RT-PCR) was used to detect AFP mRNA,h-TERT mRNA,CD44v6 mRNA and MAGE-1 mRNA in PBMC.Results The positive rate of AFP mRNA,h-TERT mRNA,CD44v6 mRNA,MAGE-1 mRNA was 50％,62.5％,55％,37.5％ in PHC patients.The positive expression rate of AFP mRNA and hTERT mRNA were 15％,30％ in patients with chronic active hepatitis,there was significant difference in the positive expression rate of two groups (respectively,~ =6.910,5.640,all P ＜ 0.05).There was no expression of the four markers in peripheral blood of healthy adults.Eight patients showed recurrence or metastasis in 9 PHC patients who has positive expression of the four markers,while none of patients who has no expression of any of four markers showed recurrence or metastasis.The difference among the groups was statistically significant (x2 =9.244,P ＜ 0.01).Conclusions The combinatorial detection of AFP mRNA,h-TERT mRNA,CD44v6 mRNA and MAGE mRNA expression increased the accuracy of predicting recurrence or metastasis of PHC patients in early postoperative phase.
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The DNA structures could be altered or even damaged by exogeous or endogenous factors during cell proliferation. Failure of effective and timely repair will lead to cell cycle arrest or apoptosis. By taking the advantage of the quick proliferation of cancer cells, DNA damage induction, cell cycle arrest and apoptosis promotion have become important strategies for ant-cancer chemotherapy. Previous reports showed that an array of natural compounds inhibit cancer cell proliferation by inducing DNA damage, which have therapeutic potentials for anti-cancer drug research and development.
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Animals , Humans , Biological Products , Pharmacology , Therapeutic Uses , DNA Damage , Drugs, Chinese Herbal , Therapeutic Uses , Neoplasms , Drug TherapyABSTRACT
Objective To investigate the effect of intensive lipid-lowering therapy on the imbalance between inflammatory and anti-inflammatory responses in patients with acute coronary syndrome (ACS).Methods Observed serum levels of hs-CRP and IL-IO in 82 patients with ACS, 17 patients with stable angina, and 22 controls. Forty-one patients with ACS were randomized to take either atorvastatin 10 mg/d (standard lipid-lowering therapy) or atorvastatin 40 mg/d (intensive lipid-lowering therapy) for one month in addition to their routine anti-anginal treatment. Serum levels of hs-CRP, blood lipids, IL-10 were investigat-ed.IL-10 was measured by ELISA. Results The level of hs-CRP in patients with ACS [(11.10 ± 14.30)mg/L] was higher than that in patients with stable angina [(2.47 ± 2.72) mg/L]and controls [(2.34 ± 4.22)mg/L] (P all < 0.05 ). The level of IL- 10 was lower in ACS patients [( 3.94 ± 1.91 ) ng/L] compared with those who had stable angina [(6.31 ± 4.26) ng/L] and controls [(7.76 ± 2.82) ng/L], Pan <0.05. The level of hs-CRP in patients with ACS was decreased and IL-10 was increased after one month treatment with atorvastatin (P < 0.05).The effect of atorvastatin 40 mg/d was more effective than that of atorvastatin 10 mg/d.Conclusions Patients with ACS have higher level of hs-CRP and lower level of IL-10 than those with sta-ble angina. This finding suggests that imbalance of inflammatory and anti-inflammatory responses is related with aggravation of atherosclerotic disease. Intensive lipid-lowering therapy is more effective than standard lipid-lowering therapy on ameliorating the imbalance.
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Objective Previous studies indicated that activation of Toll-like receptor4 (TLR4) was involved in the progression and instability of atherosclerotic plaque.Anti-inflammatory effects were shown in statins. However,the mechanisms underlying these effects have not been well explored.We test the hypothesis that a por- tion of these anti-inflammatory effects are mediated by regulation of TLR4 expression.Methods One hundred twenty-one subjects (22 normal persons,17 patients with stable angina and 82 patients with ACS) were recruited. 41 patients with ACS were randomized to atorvastatin 10 mg/d or atorvastatin 40 mg/d on top of routine anti-anginal treatment.Serum level of hsCRP,blood lipids,TLR4 expression on CD_(14)~+ monocytes were measuered before and after one month treatment.TLR4 expression on CD_(14)~+ monocytes were quantified via flow-cytometry.Results hsCRP and TLR4 expression on CD_(14)~+ monocytes in patients with ACS were higher than patients with stable angina and normal persons(hsCRP,ACS:11.1?14.3 vs stable angina:2.5?2.7 mg/L vs normal:2.3?4.2 mg/L,P