Impact of first contact hospital on timing of treatment for patients with acute ST-elevation myocardial infarction / 中华全科医师杂志

Clinical data of 655 patients with acute ST-elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) in Luoyang Central Hospital during January 2017 to March 2020 were analyzed retrospectively. There were 425 cases who first visited PCI-capable hospital (PCI hospital group) and 230 cases who were transferred to PCI-capable hospital (transfer group). Compared with PCI hospital group, STEMI patients in the transfer group had a shorter first diagnosis time [2.0 (0.8, 4.2)h vs. 2.5(1.2, 4.1)h, Z=3.66, P<0.01], longer time from first medical contact to the balloon through (FMC2B) [175 (113, 344) min vs. 75 (57, 112) min, Z=-8.92, P<0.01], longer total ischemic time [5.4 (3.5, 9.8) h vs. 3.9 (2.4, 6.0) h, Z=-5.43, P<0.01]. There was no significant difference in the time from PCI hospital entry to balloon passage (DTB) between the two groups [43(29, 103) min vs. 46 (61, 94) min, Z=-0.56, P=0.573]. The compliance rate of FMC2B time<120 min in the transfer group was only 25.9% (50/193). However, the different first-visit hospital had no significant effect on the risk of heart failure ( OR=0.54, 95 %CI:0.16-1.79, P=0.311) and risk of death ( OR=1.14, 95 %CI:0.20-6.36, P=0.885). The results suggest that STEMI patients referred to PCI hospitals have considerable time delay, and the rate of compliance with FMC2B time<120 min is low.

Glycoltic metabolism gene changes in left and right ventricles in experimental rat pulmonary arterial hypertension model / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore potential divergent glycolytic metabolism gene changes between left and right ventricle in the monocmtaline (MCT) induced pulmonary arterial hypertension (PAH) rat model.</p><p><b>METHODS</b>PAH was induced by a single subcutaneous injection of MCT (50 mg/kg) in rats. Control rats were injected with normal saline. MCT-PAH rats were randomly divided into MCT-2week, MCT-3week and MCT-4week groups (MCT-2w, 3w, 4w). At the end of study, the hemodynamics and right ventricular hypertrophy were compared among groups. The expression levels of proliferating cell nuclear antigen (PCNA) and TdT-mediated dUTP nick end labeling (TUNEL) in left and right ventricular cells were compared. The glycolytic key candidate genes expression was screened between two ventricles.</p><p><b>RESULTS</b>After three to four weeks MCT injection, mean pulmonary arterial pressure, right ventricular systolic pressure and right ventricular hypertrophy index were all significantly increased compared to control group (all P < 0.05). Both left and right ventricular morphology and structure changes were observed in all PAH rats and were similar between left and right ventricular cells. Left and right ventricular cells increased while apoptotic cells decreased in proportion to the duration post MCT injection and the PCNA positive cells in the right ventricle were higher than in the left ventricle in rats post 3 and 4 weeks MCT injection (P < 0.05). The HK1, HK2, PDHα1 and LDHA mRNA expression in the left ventricle and LDHA mRNA expression were significantly upregulated after 4 weeks MCT injection compared to control rats (all P < 0.05). Moreover, HK1 mRNA expression in the left ventricle was significantly higher in the MCT-PAH-4w group than in MCT-PAH-3w group (P < 0.05). Immunohistochemistry analysis evidenced increasing HK1 positive cells in both left and right ventricle in proportion to MCT injection time and positive HK1 cells were significantly higher in the right ventricle than in left ventricle of MCT-PAH-3w and MCT-PAH-4w rats. Furthermore, the HK1 protein expression in left ventricular tissue form MCT-PAH-4w group and in right ventricular tissue from MCT-PAH-3w and MCT-PAH-4w groups were also significantly upregulated compared to control group (P < 0.05).</p><p><b>CONCLUSIONS</b>Energy metabolic shift occurs both in the left and right ventricles in this PAH model. Upregulated HK1 expression appeares earlier in right ventricle compared to left ventricle. Interference on right ventricular glycolysis may be a potential novel therapy target of PAH.</p>

Somnogenic effects of L-stepholidine in mice / 中国药理学通报

Aim To set up a highly effective and automatic mouse sleep-wake bioassay system,and evaluate the system through analysis of the somnogenic effects of L-stepholidine(SPD),targeting at dopamine D1/D2 receptors in mice.Methods The animals were housed in an insulated and soundproof recording chamber maintained at a constant temperature and humidity on an automatically controlled 12 h light/12 h dark cycle.The electroencephalogram and electromyogram were recorded continuously for 48 hours and analyzed by SleepSign software.Saline was administered ip to the mice at 21:00 on the first day,and SPD was given on the next day at the same hour.The vigilance state was analyzed based on the polygraphic recordings by the same software.Results The system has been demonstrated to be highly efficient and stable in recording and reliable in analyzing sleep-wake behavior in mice.With the aid of the sleep bioassay system,we found that SPD significantly increased the total time spent in sleep during dark period,and prolonged durations of non-rapid eye movement sleep episodes,with a concomitant reduction in amount and EEG power density of wakefulness.SPD rendered no effect on rapid eye movement sleep.Conclusion Through the reliable mouse sleep bioassay system,we found that SPD promotes non-rapid eye movement sleep but not rapid eye movement sleep in mice.