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Objective: The feasibility of the conduction system pacing (CSP) upgrade as an alternative modality to the traditional biventricular pacing (BiVP) upgrade in patients with pacemaker-induced cardiomyopathy (PICM) remains uncertain. This study sought to compare two modalities of CSP (His bundle pacing (HBP) and left bundle branch pacing (LBBP)) with BiVP and no upgrades in patients with pacing-induced cardiomyopathy. Methods: This retrospective analysis comprised consecutive patients who underwent either BiVP or CSP upgrade for PICM at the cardiac department from 2017 to 2021. Patients with a follow-up period exceeding 12 months were considered for the final analysis. Results: The final group of patients who underwent upgrades included 48 individuals: 11 with BiVP upgrades, 24 with HBP upgrades, and 13 with LBBP upgrades. Compared to the baseline data, there were significant improvements in cardiac performance at the last follow-up. After the upgrade, the QRS duration (127.81 ± 31.89 vs 177.08 ± 34.35 ms, p < 0.001), NYHA class (2.28 ± 0.70 vs 3.04 ± 0.54, p < 0.05), left ventricular end-diastolic diameter (LVEDD) (54.08 ± 4.80 vs 57.50 ± 4.85 mm, p < 0.05), and left ventricular ejection fraction (LVEF) (44.46% ± 6.39% vs 33.15% ± 5.25%, p < 0.001) were improved. There was a noticeable improvement in LVEF in the CSP group (32.15% ± 3.22% vs 44.95% ± 3.99% (p < 0.001)) and the BiVP group (33.90% ± 3.09% vs 40.83% ± 2.99% (p < 0.001)). The changes in QRS duration were more evident in CSP than in BiVP (56.65 ± 11.71 vs 34.67 ± 13.32, p < 0.001). Similarly, the changes in LVEF (12.8 ± 3.66 vs 6.93 ± 3.04, p < 0.001) and LVEDD (5.80 ± 1.71 vs 3.16 ± 1.35, p < 0.001) were greater in CSP than in BiVP. The changes in LVEDD (p = 0.549) and LVEF (p = 0.570) were similar in the LBBP and HBP groups. The threshold in LBBP was also lower than that in HBP (1.01 ± 0.43 vs 1.33 ± 0.32 V, p = 0.019). Conclusion: The improvement of clinical outcomes in CSP was more significant than in BiVP. CSP may be an alternative therapy to CRT for patients with PICM. LBBP would be a better choice than HBP due to its lower thresholds.
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The article was to study the effect of local photodynamics therapy combined with carbon dioxide lattice laser - "light needles" for the treatment of basal cell carcinoma (BCC). 5-Aminolevulinic acid (5-ALA) cubic liquid crystal using glyceryl monostearate (GMO) as the substrate was prepared. The cytotoxicity of 5-ALA cubic liquid crystal combined with light needles in vitro were evaluated. The pharmacodynamics study of 5-ALA cubic liquid crystal combined with light needles of high or low energy for BCC was carried out based on the pathological changes, tumor volume, vascular endothelial growth factor (VEGF) expression and the recurrence rate, which has been approved by the Ethics Committee of Beijing Institute of Radiation Medicine. The cubic liquid crystal was isotropic with the lattice of PN3M. The cytotoxicity of 5-ALA cubic liquid crystal combined with light needles was much higher than that of 5-ALA or light needles alone. Compared with light needles or photodynamic therapy alone, 5-ALA cubic liquid crystal combined with light needles of high energy could prevent the BCC metastasis and of low energy could inhibit BCC growth. It demonstrated the obvious therapeutical effects for BCC. 5-ALA cubic liquid crystal combined with light needles can effectively treat BCC, which provides a new choice for clinical BCC treatment.
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Objective To investigate the therapeutic effect of curcumin in situ hydrogels for treatment of vaginal candidiasis. Methods In situ hydrogels were prepared using poloxamer 407 and 188 as the gel matrix.Gelation temperature,gelation time and rheological characteristics were determined.Mice models with vaginal candidiasis were established.The animals were divided into six groups:the healthy mice group,the model group,the positive control group(ketoconazole cream),curcumin-loaded in situ hydrogels of 0.025,0.10 and 0.20 g/ml.Before treatment and after the fourth and eighth treatments,the vaginal smears were collected and Gram-stained.The vagina washings fluid of mice were collected to determine DNA of Lactobacillus.On 8thday,the mice were sacrificed and the vaginal tissues were excised for pathological detection.Results The gelation temperature and time of in situ hydrogels were 29℃and 2′30″,respectively.Rheological profiles demonstrated that it showed good retention effect in vivo.Compared with the model group, curcumin hydrogels of 0.025,0.10 and 0.20 g/ml could inhibit the growth of Candida albicans,inhibit vaginal mucosal edema,inflam?matory hyperplasia,and decrease the expression of inflammatory factors including TNF-α(P<0.01)and IL-1β(P<0.01).Howev?er,curcumin hydrogels could not influence the growth of lactobacillus in the vagina.It indicated that curcumin hydrogels did not de?pend on lactobacillus to treat fungal vaginitis.Conclusion Curcumin in situ hydrogels could inhibit candidiasis growth,decrease ede?ma of vaginal mucosa and inflammatory hyperplasia,and reduce the expression of inflammatory factors.It provides a novel choice for the treatment of clinical vaginal candidiasis.
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Objective To demonstrate the therapeutic effect of curcumin hydrogel combined with photodynamics on acne. Methods Sieving and ultrasound/high pressure homogenization were used to prepare curcumin micropowder.Curcumin-loaded hydro?gel was prepared with Poloxamer 407 and its rheological characteristics were evaluated.The antibacterial activity of curcumin hydrogel irritated with 657 nm laser was assayed by a hole-punching method.Acne model on rabbit ears war established.Fifteen New Zealand white rabbits were randomly divided into five groups:the model group,tretinoin cream group,illumination group,curcumin hydrogel group,and curcumin hydrogel/illumination group.The therapeutic effects on acne were evaluated by the morphological and histopatho?logical examination.Results The micropowdered curcumin prepared with ultrasound/high pressure homogenization had smaller size and more uniform distribution(size range:5-20 μm.)than the sieving-prepared curcumin micro-powders(10-45 μm).The prepared hydrogels being a pseudoplastic fluid had the properties of gelatin.The antibacterial effect of curcumin hydrogel/illumination was bet?ter than that of curcumin hydrogel.The inhibition zone diameters were(9.4±0.92)and(12.57±1.12)mm for the curcumin hydrogel and the curcumin hadrogel/illumination groups,respectively.The therapeutic effect for the treatment of acne on the rabbit ears with ac?ne was better in the curcumin hydrogel/illumination group than in both the illumination and the curcumin hydrogel groups. Conclu?sion Curcumin hydrogel combined with photodynamic therapy showed better therapeutic efficacy on acne treatment.It provides an ideal choice for acne treatment.
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Objective To compare the improvement effect of three physical techniques on the transdermal absorption of sinapine thiocyanate(ST)in vitro, including microneedles, sonophoresis and iontophoresis, and to evaluate the mechanism and rules of physcial techniques on the transdermal absorption of poorly transdermal absorbed drugs. Methods In vitro transdermal experiment was carried out under the circumstances of microneedles, sonophoresis or iontophoresis, using the modified Franz diffusion pool. The 2 mg/ml ST solution was adopted as the donor solution, and the SD rats′ abdomen skin was used as the model skin. Sampling was carried out at the predetermined time points and each sample was analyzed by HPLC. Cumulative transdermal amount and steady transdermal absorption rate were calculated. Pathological slides were made after the skins were treated with microneedles, sonophoresis and iontophoresis for 12 h. The structure changes were observed to evaluate the transdermal improvement mechanism of different technologies. Results Accumulated transdermal amount of ST was little without any techniques. The transdermal improvement effect of different technologies was as follows: Microneedles>sonophoresis>iontophoresis. A substantial hole formed on the skin by microneedles to promote ST transdermal absorption obviously. Sonophoresis disrupted the tight structure of skin and improved the transdermal absorption of drugs easily. The effect of iontophresis on skin structure was little. Conclusion This study provides experimental evidence for choice of different techniques to improve transdermal absorption.