Safety and efficacy of pulse-induced contour cardiac output monitoring in elderly patients with coronary artery disease and severe heart failure at coronary care units.

Background: The optimal treatment for elderly patients with severe heart failure depends on the accurate assessment of their hemodynamic status. Due to its less invasive nature, the safety and efficacy of invasive pulse-induced contour cardiac output (PiCCO)-based hemodynamic monitoring remains uncertain. Methods: This was a prospective observational study. Between January 2016 and July 2020, 190 elderly patients with severe heart failure were consecutively enrolled. The PiCCO group (89 patients) and non-invasive hemodynamic monitoring group (101 patients) were observed. Hospital stays results were evaluated. Results: No significant difference in clinical data (P > 0.05) or the incidence of 1-month mortality (16.0 vs. 35.0%, P = 0.141) were observed between groups. The coronary care unit (CCU) stay was shorter in the PiCCO group than in the non-invasive group (40.0 vs. 43.0%, P = 0.049). Indicators such as low Extravascular Lung Water Index (EVLWI), high Body Mass Index (BMI), low Pulmonary Artery Pressure (PAP), and high Left Ventricular Ejection Time (LVET), were associated with favorable clinical results. Conclusion: Early invasive PiCCO monitoring is safe in critically ill elderly patients with severe heart failure. The hospital stay was reduced using PiCCO monitoring. These encouraging PiCCO results favor its use in elderly patients with severe heart failure at CCUs.

Effects of Virtual Reality on Balance for Patients with Parkinson's Disease: A Meta-analysis / 中国康复理论与实践

Objective:To evaluate the effect of virtual reality (VR) on comprehensive balance for patients with Parkinson's disease (PD). Methods:The databases of Web of Science, PubMed, Cochrane Library, EMBASE, Scopus, VIP, Wanfang Data and CNKI were retrieved to collect randomized controlled trials about VR intervention for PD patients, from establishment to November, 2020. Two researchers independently screened the literature, extracted the data and evaluated the quality of the literature, and then used Review Manager 5.3 software for meta-analysis. Results:A total of 24 documents were included. Compared with the control group, VR intervention might improve the static balance (SMD = -0.49, 95%CI -0.64 to -0.35, P < 0.001) of PD patients. Simple VR intervention might improve the Berg Balance Scale score (SMD = 0.83, 95%CI 0.43 to 1.23, P < 0.001) for PD patients, while combination of VR intervention might improve the Berg Balance Scale score (SMD = 0.75, 95%CI 0.53 to 0.96, P < 0.001) and Timed 'Up and Go' Test time (SMD = -0.87, 95%CI -1.52 to -0.22, P = 0.008) for PD patients; however, simple VR intervention might do little in improving Timed 'Up and Go' Test time (SMD = -0.36, 95%CI -0.74 to 0.03, P = 0.07). Conclusions:VR can improve the comprehensive balance for PD patients, especially combine with conventional or balance training.

Mesenchymal stem cells release membrane microparticles in the process of apoptosis / 中国实验血液学杂志

Though mesenchymal stem cells (MSC) have been clinically used to repair a variety of damaged tissues, the underlying mechanisms remain elusively as the majority of the ex vivo expanded MSC die shortly after transplantation. To explore the mechanism in which the death cells play tissue repair effect, apoptosis of rat bone marrow MSC was induced by culturing cells in the conditions of hypoxia or/and serum-free medium, and the subcellular structures in the supernatants were analyzed. The results showed that apoptosis occurred in the presence of either hypoxia or serum-free condition as well, and the apoptotic proportion reached up to (17.44 ± 2.15) after the cells were treated by hypoxia plus serum free culture for 72 hours. The flow cytometric analysis of the sub-cellular substances harvested by ultracentrifugation of the supernatants found that the MSC released substantial amount of membrane microparticles into the supernatants, which expressed CD29, CD44A and Annexin-V-binding phosphatidylserine. It is concluded that the MSC can release membrane microparticles after induction, the amount of these membrane microparticles was around 15-fold of the parent cell numbers. The membrane microparticles is the mediators in the cross-talk between the transplanted cells and their surrounding tissues. This study provides some novel information for the mechanisms of MSC therapy.

Mesenchymal stem cells exist in the compact bones from four species of mammals / 中国实验血液学杂志

The biological properties of cultured mesenchymal stem cells (MSC) have been intensively investigated, while there is still a paucity of information about the definite in vivo sites that harbor these stem cells due to the lack of specific surface markers. Previous data have demonstrated that human and murine MSC can be isolated from the compact bones. To investigate if it is the case for other species, the femurs from Wistar rats, Beagles, C57 mice and New Zealand rabbits were collected, minced and digested with collagenase type I. The digested bone fragments were seeded into the medium for human bone marrow culture after removal of the suspended cells in the digestion. The results showed that the fibroblast-like cells were observed to migrate from the bone fragments after several days of culture, and they gradually formed an adherent confluent layer. The adherent cells could be passaged and expressed homogenously the mesenchymal cell marker vimentin. Differentiation assays showed that these cells had the capacity to differentiate into osteoblasts and adipocytes. In conclusion, the results here provide new information for the further investigations on the in vivo biological features of MSC in the context of the simplicity of the compact bone structure.

Association of CT image changes and prognosis in gastrointestinal stromal tumor after targeted therapy / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the association between CT image changes and the prognosis in gastrointestinal stromal tumors (GIST) after targeted therapy.</p><p><b>METHODS</b>A total of 35 patients with GIST were treated by imatinib mesylate from April 2003 to June 2008. The longest diameter (LD) and mean enhanced CT values (HU) of tumors were measured on axial images. The CT classifying (number, location, liver metastasis, hemorrhage,cystic degeneration) and quantitative indices (pre- and 2-6 months post-treatment LD, HU, and their change rate) were compared between those with and without progress in two years.</p><p><b>RESULTS</b>During follow-up (median:285 months) 13 cases had tumor progress. The progress rate was higher in the group with extensive tumor involvement (> or = 5 lesions and > or = 2 parts), and that without hemorrhage demonstrated. The mean change rate was -14.29% (range, -67%, 11%) for LD and -12.25% (range, -55%, 39%) for HU in non-progressive group, while the mean change rate was 15.09%(range, -45%, 191%) for LD and 9.91% (-27%, 135%) for HU in progressive group. The differences were significantly different (P<0.01). The accuracies of predicting 2-year progress by LD and HU change rates were moderate, with area under ROC curve being 0.790 and 0.797, respectively.</p><p><b>CONCLUSIONS</b>The 2-year progress rate of GIST after targeted therapy is higher in extensively involved tumors. Higher decrease rates of LD and HU predict less 2-year progress, which possess moderate prediction accuracy and can be used as valuable indicators in the evaluation of targeted therapy for GIST.</p>

Myocardial involvement in 2494 patients with systemic lupus erythematosus / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the clinical characteristics and related pathogenetic factors in systemic lupus erythematosus (SLE) patients with myocardial involvement.</p><p><b>METHODS</b>Clinic data and myocardial involvements were analyzed in 2494 SLE patients who admitted to our hospital from 1997 to 2007.</p><p><b>RESULTS</b>Myocardial involvements were seen in 13 out of 2494 SLE patients (0.52%). Dyspnea of various degrees and left ventricular systolic dysfunction are frequently found in these patients with myocardial involvements. Glucocorticoid therapy significantly increased left ventricular ejection fraction (LVEF, 37.7% +/- 5.8% vs. 40.9% +/- 7.1%, P = 0.002). Significant associations were found between anti-rRNP antibody and LVEF (r = 0.843, P = 0.001) as well as between cardiac troponin I (cTnI) and left ventricular end diastolic diameter (LVEDD) (r = 0.656, P = 0.036).</p><p><b>CONCLUSIONS</b>Myocardium is rarely affected in patients with SLE in this cohort. Echocardiography is a valuable method for detecting cardiac abnormalities in patients with SLE. Glucocorticoid therapy could improve cardiac function in SLE patients with cardiac involvement and serological factors are related to cardiac functions.</p>