RESUMEN
Objective: To investigate the relationship between the mechanical circulatory support (MCS) combined with immunomodulation and the prognosis of patients with fulminant myocarditis. Methods: This is a retrospective study. A total of 88 patients with fulminant myocarditis admitted to Dongguan Kanghua hospital from Aug. 2008 to Dec. 2020 were included. Medical histories, results of laboratory tests, treatment regimens and clinical outcomes of these patients during their hospitalization were collected from the medical record system. According to the treatment methods, the patients were divided into MCS+immunomodulation group (38 cases), MCS group (20 cases) and traditional treatment group (30 cases). Patients in the MCS+immunomodulation group received intra-aortic balloon pump (IABP) or IABP combined with extracorporeal membrane oxygenation (ECMO) and immunoglobulin or glucocorticoid. Patients in the MCS group only received mechanical circulatory support. Patients in the traditional treatment group received neither mechanical circulatory support nor immunomodulatory therapy, and only used vasoactive drugs and cardiotonic drugs. The in-hospital mortality and length of stay were compared among the three groups. Results: A total of 88 patients with fulminant myocarditis aged (35.0±10.8) years were included, and there were 46 males (52.3%). The mortality of MCS+immunomodulation group (7.9% (3/38) vs. 56.7% (17/30), P=0.001 2) and MCS group (30.0% (6/20) vs. 56.7% (17/30), P=0.002 8) were lower than that of traditional treatment group. Compared with the MCS group, the in-hospital mortality in the MCS+immunomodulation group was lower (P=0.005 4). The most common cause of death was multiple organ dysfunction syndrome (MODS). The constituent ratios of death in MCS+immunomodulation group, MCS group and traditional treatment group were 3/3, 4/6 and 12/17, respectively. The incidence of MODS in the MCS group (20% (4/20)) and the traditional treatment group (40% (12/30)) was significantly higher than that in the MCS+immunomodulation group (7.9% (3/38)) (both P<0.01). In discharged patients, the hospitalization time of MCS+immunomodulation group was shorter than that of traditional treatment group ((13.4±5.5)d vs. (18.5±7.4)d, P<0.05) and MCS group ((13.4±5.5)d vs. (16.9±8.5)d, P<0.05). Conclusion: MCS combined with immunomodulatory therapy is associated with lower in-hospital mortality and shorter hospital stay in patients with fulminant myocarditis.
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Adulto , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Corazón Auxiliar , Inmunomodulación , Miocarditis/terapia , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
<p><b>OBJECTIVE</b>To screen the differentially expressed miRNAs and their target genes in adipogenic differentiation of human bone marrow mesenchymal stem cells (hMSCs) to better understand the mechanism for regulating the balance between osteoblast and adipocyte differentiation.</p><p><b>METHODS</b>Cultured hMSCs were induced for adipogenic differentiation, and at 0, 7, 14, and 21 days of induction, the cells were examined for miRNA and mRNA expression profiles using miRNA chip and transcriptome sequencing (RNA-seq) techniques. Correlation analysis was carried out for the miRNAs and mRNAs of potential interest. The databases including TargetScan, PicTar and miRanda were used to predict the target genes of the differentially expressed miRNA.</p><p><b>RESULTS</b>The expression of miR-140-5p was down-regulated and leukemia inhibitory factor receptor (LIFR) expression increased progressively during adipogenic differentiation of hMSCs, showing a negative correlation between them. Target gene prediction using the 3 databases identified LIFR as the target gene of miR-140-5p.</p><p><b>CONCLUSION</b>miRNA-140-5p may play an important role by regulating its target gene LIFR during adipogenic differentiation of hMSCs.</p>
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Humanos , Adipocitos , Biología Celular , Adipogénesis , Diferenciación Celular , Células Cultivadas , Regulación hacia Abajo , Subunidad alfa del Receptor del Factor Inhibidor de Leucemia , Metabolismo , Células Madre Mesenquimatosas , Biología Celular , MicroARNs , Genética , Análisis de Secuencia por Matrices de Oligonucleótidos , Osteoblastos , Biología Celular , ARN Mensajero , TranscriptomaRESUMEN
OBJECTIVE@#To clone 5' untranslated region of human IPO8 gene and determine its transcription activity.@*METHODS@#We used 5' rapid amplification of cDNA ends (RACE) analysis to identify the IPO8 transcription start site (TSS), and amplified series truncated 5' UTR fragment containing transcription start site. The PCR productions were inserted into luciferase report vector pGL3- Basic. After confirmation by restriction enzyme digestion, the recombinant plasmids were cotransfected into Saos-2 cells with plasmid pRL-TK. The luciferase activities were measured by dual luciferase reporter system.@*RESULTS@#The IPO8 gene transcription start site was established. The electrophoresis analysis of restriction enzyme digestion and DNA sequencing verified the fragments were successfully amplified and inserted into pGL3-Basic. After the recombinant plasmids transfected, the highexpressions of luciferase were detected in Saos-2 cells.@*CONCLUSION@#The recombinant vector containing IPO8 promoter is constructed successfully, which provides a foundation for determining expressional regulation of IPO8 in the further study.
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Humanos , Clonación Molecular , ADN Complementario , Vectores Genéticos , Luciferasas , Plásmidos , Regiones Promotoras Genéticas , Transfección , beta Carioferinas , GenéticaRESUMEN
<p><b>OBJECTIVE</b>To explore the difference of serum adiponectin (APN) level in hypertensive patients of phlegm-dampness constitution (PDC) and in those of non-PDC, as well as its association with APN gene polymorphisms.</p><p><b>METHODS</b>Serum APN levels in 250 hypertensive patients (137 of PDC and 113 of non-PDC) were determined, and a correlation study was performed on 8 selected single nucleotide polymorphism (SNP) of APN gene.</p><p><b>RESULTS</b>Significant differences of serum APN levels were observed between PDC and non-PDC patients (5.07 +/- 0.35 microg/mL vs 6.41 +/- 0.39 microg/mL, P = 0.045). No significant difference in polymorphism distribution of the 8 SNP sites of APN genes was found between patients of different constitutions (P > 0.05). Serum APN level was significantly lower in PDC patients than in non-PDC patients in sites of APN gene rs1063537 (3224C/T) polymorphism TT genotype (2.580 +/- 1.029 microg/mL vs 6.011 +/- 0.945 microg/mL, P = 0.017) and CT genotype (5.113 +/- 0.968 microg/mL vs 7.812 +/- 0.161 microg/mL, P = 0.021), while that of CC genotype was insignificant between the two constitutions (5.426 +/- 0.591 microg/mL vs 6.130 +/- 0.668 microg/mL).</p><p><b>CONCLUSION</b>Serum APN level was significantly lower in hypertensive patients of PDC than in those of non-PDC. Moreover, the APN gene SNP3224 T allele carrier might be a hereditary feature of APN abnormity.</p>
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Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adiponectina , Sangre , Genética , Estudios de Casos y Controles , Hipertensión , Sangre , Genética , Medicina Tradicional China , Polimorfismo de Nucleótido SimpleRESUMEN
<p><b>OBJECTIVE</b>To investigate the relationship of insulin resistance and the polymorphisms of insulin receptor-related genes in essential hypertension patients of two different kinds of TCM constitution.</p><p><b>METHODS</b>Oral glucose tolerance test (OGTT) and insulin release test (InRT) were conducted in 217 essential hypertensive patients of either sluggish meticulous (SM) constitution (139 cases) or prosperous impetuous (PI) constitution (78 cases), and the polymorphism of three genes, including insulin-like growth factor-1 receptor (IGF-1R), insulin receptor substrate-1 (IRS-1) and 2 (IRS-2) genes were detected.</p><p><b>RESULTS</b>(1) OGTT, InRT and insulin resistance index (Homa-IR) were higher and insulin sensitive index (ISI) was lower in the patients of SM constitution than those in patients of PI constitution. (2) Significant difference of ISI and Homa-IR was shown in patients of both constitutions with genotype G of the 3 genes.</p><p><b>CONCLUSION</b>Decrease of insulin sensitivity and increase of insulin resistance are more obvious in hypertensive patients with genotype G of the 3 genes of SM constitution than in those of PI constitution. Therefore, the difference in constitution might be one of the genetic characteristics for insulin resistance in hypertensive patients.</p>