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The characteristics of dissolved organic matter (DOM) serve as indicators of nitrate pollution in groundwater. However, the specific DOM components associated with nitrate in groundwater systems remain unclear. In this study, dual isotopes of nitrate, three-dimensional Excitation emission matrices (EEMs) and Fourier transform ion cyclotron resonance mass spectrometry (FT-ICR MS) were utilized to uncover the sources of nitrate and their associations with DOM characteristics. The predominant nitrate in the targeted aquifer was derived from soil organic nitrogen (mean 46.0%) and manure &sewage (mean 34.3%). The DOM in nitrate-contaminated groundwater (nitrate-nitrogen >20 mg/L) exhibited evident exogenous characteristics, with a bioavailable content 2.58 times greater than that of uncontaminated groundwater. Regarding the molecular characteristics, DOM molecules characterized by CHO + 3N, featuring lower molecular weights and H/C ratios, indicated potential for mineralization, while CHONS formulas indicated the exogenous features, providing the potential for accurate traceability. These findings provided insights at the molecular level into the characterization of DOM in nitrate-contaminated groundwater and offer scientific guidance for decision-making regarding the remediation of groundwater nitrate pollution.
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Monitoreo del Ambiente , Agua Subterránea , Nitratos , Contaminantes Químicos del Agua , Agua Subterránea/química , Nitratos/análisis , Contaminantes Químicos del Agua/análisis , Monitoreo del Ambiente/métodosRESUMEN
Dissolved organic matter (DOM) plays a crucial role in driving biogeochemical processes and determining water quality in shallow groundwater systems, where DOM could be susceptible to dynamic influences of surface water influx. This study employed fluorescence excitation-emission matrix (EEM) spectroscopy combined with principal component coefficients, parallel factor analysis (PARAFAC), co-occurrence network analysis and structural equation modeling (SEM) to examine changes of DOM fractions from surface water to shallow groundwater in a mesoscale lowland river basin. Combining stable isotope and hydrochemical parameters, except for surface water (SW), two groups of groundwater samples were defined, namely, deeply influenced by surface water (IGW) and groundwater nearly non-influenced by surface water (UGW), which were 50.34 % and 19.39 % recharged by surface water, respectively. According to principal component coefficients, reassembled EEM data of these categories highlighted variations of the tyrosine-like peak in DOM. EEMs coupled with PARAFAC extracted five components (C1-C5), i.e. C1, protein-like substances, C2 and C4, humic-like substances, and C3 and C5, microbial-related substances. The abundance of the protein-like was SW > IGW > UGW, while the order of the humic-like was opposite. The bacterial communities exhibited an obvious cluster across three regions, which hinted their sensitivity to variations in environmental conditions. Based on co-occurrence, SW represented the highest connectivity between bacterial OTUs and DOM fractions, followed by IGW and UGW. SEM revealed that microbial activities increased bioavailability of the humic-like in the SW and IGW, whereas microbial compositions promoted the evolution of humic-like substances in the UGW. Generally, these results could be conducive to discern dissimilarity in DOM fractions across surface water and shallow groundwater, and further trace their interactions in the river watershed.
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Agua Subterránea , Ríos , Agua Subterránea/química , Ríos/microbiología , Ríos/química , Microbiota , Monitoreo del Ambiente , Análisis de Componente Principal , Sustancias Húmicas/análisisAsunto(s)
Estenosis de la Válvula Aórtica , Reemplazo de la Válvula Aórtica Transcatéter , Humanos , Estudios Retrospectivos , Reemplazo de la Válvula Aórtica Transcatéter/efectos adversos , Medición de Riesgo , China , Pronóstico , Estenosis de la Válvula Aórtica/cirugía , Resultado del Tratamiento , Factores de Riesgo , Válvula AórticaAsunto(s)
Estenosis de la Válvula Aórtica , Implantación de Prótesis de Válvulas Cardíacas , Reemplazo de la Válvula Aórtica Transcatéter , Humanos , Válvula Aórtica/cirugía , Estudios Retrospectivos , Factores Sexuales , Resultado del Tratamiento , China , Estenosis de la Válvula Aórtica/cirugía , Factores de Riesgo , Medición de RiesgoRESUMEN
Background: The association between the risk of heart disease and tobacco smoking has been studied in previous work, but there are arguments among various population. We aimed to investigate the association between heart disease incidence and smoking status among older adults. Methods: A cross-sectional analysis was conducted with 10,891 older adults in the 2 most recent waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), 2011-2014 and 2014-2018. The data included individual weighting variables to ensure they were nationally representative. The parameters consisted of age, sex, body mass index (BMI), smoking status, and disease history was collected. Smoking measures included current/former/never status, pack-years and the time to first cigarette. Heart disease included coronary artery disease, arrhythmias, heart failure, valve diseases and other heart conditions. Respondents with missed values were excluded. Multivariable logistic regression analyses were performed. Results: Among the 10,006 respondents included in the analyses, 4,501 (44.9%) were men. The median age was 88 years old [interquartile range (IQR), 78-96]. A total of 6,713 respondents (67.1%) were nonsmokers, 1,695 respondents (16.9%) were former smokers, and 1,598 respondents (16.0%) were current smokers. The incidence of heart disease was significantly higher in smokers compared with nonsmokers (14.5% vs. 12.8%, P=0.018). Female smokers and those over 80 years old had higher morbidity than male smokers. After adjusting for sex, age, BMI, hypertension, diabetes, area of residency, alcohol status, and exercise status, smokers still had an increased risk of heart disease [odds ratio (OR) 1.29, 95% confidential interval (CI): 1.10-1.50, P=0.001]. The incidence of heart disease also increased with higher intensity of smoking for each additional pack-year (OR 1.01, 95% CI: 1.00-1.02, P=0.011). Conclusions: For elderly adults, current or former smoking was largely associated with heart disease incidence, especially in females and those over 80 years old. These variables could be considered for inclusion in future heart disease risk prediction models.
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Chlorophyll-a (Chl-a) is considered as an indicator of phytoplankton biomass dynamically reflecting the growth of algae. Therefore, determination of Chl-a threshold is of vital importance to the health of aquatic ecosystems and drinking water security. This research is aimed to investigate the spatial and temporal distributions of Chl-a and microcystin (MC) concentrations using Geographic Information System (GIS) and identify the Chl-a threshold in Lake Taihu based on available guideline values of MCs. Nearly, the same characteristics of spatiotemporal variation of Chl-a and MCs were observed in Lake Taihu. Overall, the lakewide distributions of Chl-a and MCs were highly variable over time and space. The Chl-a concentration in the winter and spring was relatively low, and gradually increasing in summer and autumn, with the maximum concentration observed in August. But the maximum MCs concentration appeared in October, 2 months lagging behind the Chl-a. The highest annual average Chl-a and MCs concentrations were observed in Zhushan Bay, Meiliang Bay, and Gonghu Bay in northwest of Lake Taihu, following by West Zone and Center Zone. Dongtaihu Bay, East Zone, and South Zone always present good water quality. Referring to the guideline value of MCs, the Chl-a threshold was determined as 10-15 mg·m-3 based on the linear regression correlation between Chl-a and MCs. The establishment of Chl-a threshold is useful for eutrophication control, water quality management, and drinking water utilities in developing water safety plans.
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Agua Potable , Lagos , Clorofila A , Microcistinas/análisis , Ecosistema , Monitoreo del Ambiente , Clorofila/análisis , Eutrofización , ChinaRESUMEN
BACKGROUND: Renal and liver dysfunctions are risk factors for mortality in patients with severe aortic stenosis (AS). Transcatheter aortic valve implantation (TAVI) has the potential to break the vicious cycle between AS and hepatorenal dysfunction by relieving aortic valve obstruction. HYPOTHESIS: A part of patients can derive hepatorenal function improvement from TAVI, and this noncardiac benefit improves the intermediate-term outcomes. METHODS: We developed this retrospective cohort study in 439 consecutive patients undergoing TAVI and described the dynamic hepatorenal function assessed by model for end-stage liver disease model for end-stage liver disease (MELD)-XI score in subgroups. The endpoint was 2-year all-cause mortality. RESULTS: Receiver-operating characteristic analysis showed that the baseline MELD-XI score of 10.71 was the cutoff point. A high MELD-XI score (>10.71) at baseline was an independent predictor of the 2-year mortality hazard ratio (HR: 2.65 [1.29-5.47], p = .008). After TAVI, patients with irreversible high MELD-XI scores had a higher risk of 2-year mortality than patients who improved from high to low MELD-XI scores (HR: 2.50 [1.06-5.91], p = .03). Factors associated with reversible MELD-XI scores improvement were low baseline MELD-XI scores (≤12.00, odds ratio [OR]: 2.02 [1.04-3.94], p = .04), high aortic valve peak velocity (≥5 m/s, OR: 2.17 [1.11-4.24], p = .02), and low body mass index (≤25 kg/m2 , OR: 2.73 [1.25-5.98], p = .01). CONCLUSION: High MELD-XI score at baseline is an independent predictor for 2-year mortality. Patients with hepatorenal function improvement after TAVI have better outcomes. For patients with irreversible hepatorenal dysfunction after TAVI, further optimization of the subsequent treatment after TAVI is needed to improve the outcomes.
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Estenosis de la Válvula Aórtica , Enfermedad Hepática en Estado Terminal , Reemplazo de la Válvula Aórtica Transcatéter , Humanos , Pronóstico , Reemplazo de la Válvula Aórtica Transcatéter/efectos adversos , Enfermedad Hepática en Estado Terminal/diagnóstico , Enfermedad Hepática en Estado Terminal/cirugía , Enfermedad Hepática en Estado Terminal/complicaciones , Resultado del Tratamiento , Estudios Retrospectivos , Alta del Paciente , Índice de Severidad de la Enfermedad , Factores de Riesgo , Estenosis de la Válvula Aórtica/complicaciones , Estenosis de la Válvula Aórtica/cirugíaRESUMEN
Fertile and uncontaminated soil with appropriate pH is crucial in terms of the agricultural sustainable development. Herein, a compound soil conditioner containing chitosan modified straw biochar (CBC), kitchen waste compost product-derived humic substance (HS), NPK compound fertiliser (NPK-CF) was prepared to simultaneously adjust acidic soil pH, improve fertility, and immobilize heavy metal. The results exhibited that the best Pb and NH4+ adsorption performance was obtained in CBC with chitosan:biochar of 1:5. Then, the acid soil pH was improved from 5.03 to 6.66 in the presence of CBC/HS (5:5) with 3% addition weight (the mass ratio of conditioner to soil). Meanwhile, compared with the control, the contents of organic matter, available nitrogen, and available phosphorus significantly increased by 52.4%, 92.6%, and 136.3%, respectively. Moreover, Pb was highly efficient immobilised by CBC, and the concentration of Pb in the soil was decreased by 55.2%. The optimal growth trend of ryegrass was obtained in the presence of 3% addition weight (the mass ratio of conditioner to soil) CBC/HS (CBC:HS = 5:5) combined with 60% of the recommended NPK-CF application weight, which was mainly contributed by the improvement of the soil microbial abundance and community structure diversity. The addition of CBC/HS could effectively reduce the addition of NPK-CF and contribute to simultaneous controlling nitrogen loss, releasing phosphorus, immobilising Pb, adjusting pH, improving soil quality and controlling nonpoint pollution.
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Quitosano , Metales Pesados , Contaminantes del Suelo , Suelo/química , Fertilizantes , Sustancias Húmicas , Contaminantes del Suelo/análisis , Plomo , Metales Pesados/química , Fósforo , NitrógenoRESUMEN
Urbanization has dramatically changed the quality and quantity of dissolved organic matter (DOM) fluxes in rivers, thereby affecting the diversity and lifestyle strategies of microbial communities. However, relationships between DOM molecular composition and microbial lifestyle strategies in effluent-dominated rivers are poorly understood. Herein, we investigated the variations in DOM structure and composition of an effluent-dominated river and further revealed how these changes alter the abundance and lifestyle strategies of microbial communities. Results demonstrated that macromolecular (MW > 35 kDa) humic-like substances constituted the major components of effluent-dominated riverine DOM. Also, due to the degradation of humic-like substances, the accumulation of protein-like substances was observed from upstream to downstream areas, corresponding to an apparent decrease in overall aromaticity. The abundance of bacterial, Actinobacteria, and eukaryotic was higher in the upstream and midstream areas but relatively lower in the downstream area. The response of bacterial and Actinobacteria communities to the changes in DOM composition was more prominent as compared to that of eukaryotic. Based on multivariate statistical analysis, the decrease in aromatic components (MW > 35 kDa) was mainly attributed to the degradation of Proteobacteria and Actinobacteria (K-strategists), resulting in a decrease in their relative abundance along the river course. Proteins and polysaccharides (15 kDa < MW < 35 kDa, MW < 6 kDa) were more easily utilized by Firmicutes and Bacteroidetes (r-strategists), leading to an increase in their relative abundance. With the decrease of macromolecular humic-like substances and the increase of protein-like substances, river microbial communities shifted from K-strategists to r-strategists. This work unveils the evolution of DOM in an effluent-dominated river and the influence of the degradation of macromolecular humic-like substances on r/K-strategists.
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Materia Orgánica Disuelta , Microbiota , Ríos/química , Sustancias Húmicas/análisis , Urbanización , Bacterias , Espectrometría de Fluorescencia/métodosRESUMEN
Staphylococcus aureus represents a notorious opportunistic pathogen causing various infections in biofilm nature, imposing remarkable therapeutic challenges worldwide. The catabolite control protein A (CcpA), a major regulator of carbon catabolite repression (CCR), has been recognized to modulate S. aureus biofilm formation, while the underlying mechanism remains to be fully elucidated. In this study, the reduced biofilm was firstly determined in the ccpA deletion mutant of S. aureus clinical isolate XN108 using both crystal violet staining and confocal laser scanning microscopy. RNA-seq analysis suggested that sak-encoding staphylokinase (Sak) was significantly upregulated in the mutant ∆ccpA, which was further confirmed by RT-qPCR. Consistently, the induced Sak production correlated the elevated promoter activity of sak and increased secretion in the supernatants, as demonstrated by Psak-lacZ reporter fusion expression and chromogenic detection, respectively. Notably, electrophoretic mobility shift assays showed that purified recombinant protein CcpA binds directly to the promoter region of sak, suggesting the direct negative control of sak expression by CcpA. Double isogenic deletion of ccpA and sak restored biofilm formation for mutant ∆ccpA, which could be diminished by trans-complemented sak. Furthermore, the exogenous addition of recombinant Sak inhibited biofilm formation for XN108 in a dose-dependent manner. Together, this study delineates a novel model of CcpA-controlled S. aureus biofilm through direct inhibition of sak expression, highlighting the multifaceted roles and multiple networks regulated by CcpA.
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BACKGROUND: It is unknown whether the sex difference whereby female transcatheter aortic valve replacement (TAVR) candidates had a lower risk profile, a higher incidence of in-hospital complications, but more favorable short- and long-term survival observed in tricuspid cohorts undergoing TAVR would persist in patients with bicuspid aortic valves (BAVs). OBJECTIVES: The aim of this study was to reexamine the impact of sex on outcomes following TAVR in patients with BAVs. METHODS: In this single-center study, patients with BAVs undergoing TAVR for severe aortic stenosis from 2012 to 2021 were retrospectively included. Baseline characteristics, aortic root anatomy, and in-hospital and 1-year valve hemodynamic status and survival were compared between sexes. RESULTS: A total of 510 patients with BAVs were included. At baseline, women presented with fewer comorbidities. Men had a greater proportion of Sievers type 1 BAV, higher calcium volumes (549.2 ± 408.4 mm3 vs 920.8 ± 654.3 mm3; P < 0.001), and larger aortic root structures. Women experienced more vascular complications (12.9% vs 4.9%; P = 0.002) and bleeding (11.1% vs 5.3%; P = 0.019) and higher residual gradients (16.9 ± 7.7 mm Hg vs 13.2 ± 6.4 mm Hg; P < 0.001), while men were more likely to undergo second valve implantations during index TAVR (6.3% vs 15.9%; P = 0.001). Death at 1 year was not significantly different between sexes (HR: 1.15; 95% CI: 0.56-2.35; P = 0.70). Bleeding (adjusted HR: 4.62; 95% CI: 1.51-14.12; P = 0.007) was the single independent predictor of 1-year death for women. CONCLUSIONS: In patients with BAVs undergoing TAVR, women presented with fewer comorbidities, while men had a greater proportion of type 1 BAV, more calcification, and larger aortic roots. In-hospital outcomes favored men, with fewer complications except for the need for second valve implantation, but 1-year survival was comparable between sexes.
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Estenosis de la Válvula Aórtica , Enfermedad de la Válvula Aórtica Bicúspide , Reemplazo de la Válvula Aórtica Transcatéter , Válvula Aórtica/diagnóstico por imagen , Válvula Aórtica/cirugía , Estenosis de la Válvula Aórtica/diagnóstico por imagen , Estenosis de la Válvula Aórtica/etiología , Estenosis de la Válvula Aórtica/cirugía , Femenino , Humanos , Masculino , Estudios Retrospectivos , Caracteres Sexuales , Reemplazo de la Válvula Aórtica Transcatéter/efectos adversos , Resultado del TratamientoRESUMEN
Objective: We sought to conduct a systematic review and meta-analysis of clinical adverse events in patients undergoing transcatheter aortic valve replacement (TAVR) with bicuspid aortic valve (BAV) vs. tricuspid aortic valve (TAV) anatomy and the efficacy of balloon-expandable (BE) vs. self-expanding (SE) valves in the BAV population. Comparisons aforementioned will be made stratified into early- and new-generation devices. Differences of prosthetic geometry on CT between patients with BAV and TAV were presented. In addition, BAV morphological presentations in included studies were summarized. Method: Observational studies and a randomized controlled trial of patients with BAV undergoing TAVR were included according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Results: A total of 43 studies were included in the final analysis. In patients undergoing TAVR, type 1 BAV was the most common phenotype and type 2 BAV accounted for the least. Significant higher risks of conversion to surgical aortic valve replacement (SAVR), the need of a second valve, a moderate or severe paravalvular leakage (PVL), device failure, acute kidney injury (AKI), and stroke were observed in patients with BAV than in patients with TAV during hospitalization. BAV had a higher risk of new permanent pacemaker implantation (PPI) both at hospitalization and a 30-day follow-up. Risk of 1-year mortality was significantly lower in patients with BAV than that with TAV [odds ratio (OR) = 0.85, 95% CI 0.75-0.97, p = 0.01]. BE transcatheter heart valves (THVs) had higher risks of annular rupture but a lower risk of the need of a second valve and a new PPI than SE THVs. Moreover, BE THV was less expanded and more elliptical in BAV than in TAV. In general, the rates of clinical adverse events were lower in new-generation THVs than in early-generation THVs in both BAV and TAV. Conclusions: Despite higher risks of conversion to SAVR, the need of a second valve, moderate or severe PVL, device failure, AKI, stroke, and new PPI, TAVR seems to be a viable option for selected patients with severe bicuspid aortic stenosis (AS), which demonstrated a potential benefit of 1-year survival, especially among lower surgical risk population using new-generation devices. Larger randomized studies are needed to guide patient selection and verified the durable performance of THVs in the BAV population.
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Burkholderia pseudomallei is the causal agent of melioidosis, a deadly tropical infectious disease that lacks a vaccine. On the basis of the attenuated Staphylococcus aureus RN4220-Δagr (RN), we engineered the RN4220-Δagr/pdhB-hcp1 strain (RN-Hcp1) to generate B. pseudomallei hemolysin-coregulated protein 1 (Hcp1)-loaded membrane vesicles (hcp1MVs). The immunization of BALB/c mice with hcp1MVs mixed with adjuvant by a three-dose regimen increased the serum specific IgG production. The serum levels of inflammatory factors, including TNF-α and IL-6, in hcp1MV-vaccinated mice were comparable with those in PBS-challenged mice. The partial adjuvant effect of staphylococcal MVs was observed with the elevation of specific antibody titer in hcp1MV-vaccinated mice relative to those that received the recombinant Hcp1 protein (rHcp1) or MVs derived from RN strain (ΔagrMVs). The hcp1MVs/adjuvant vaccine protected 70% of mice from lethal B. pseudomallei challenge. Immunization with hcp1MVs only protected 60% of mice, whereas vaccination with rHcp1 or ΔagrMVs conferred no protection. Moreover, mice that received hcp1MVs/adjuvant and hcp1MVs immunization had low serum TNF-α and IL-6 levels and no inflammatory infiltration in comparison with other groups. In addition, all surviving mice in hcp1MVs/adjuvant and hcp1MVs groups exhibited no culturable bacteria in their lungs, livers, and spleens five days postinfection. Overall, our data highlighted a new strategy for developing B. pseudomallei vaccine and showed that Hcp1-incorporated staphylococcal MV is a promising candidate for the prevention of acute melioidosis.
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Melioidosis , Animales , Ratones , Melioidosis/prevención & control , Proteínas Hemolisinas , Interleucina-6 , Factor de Necrosis Tumoral alfa , Anticuerpos Antibacterianos , Vacunas BacterianasRESUMEN
MicroRNAs (miRNAs) have been proven to serve as key post-transcriptional regulators, affecting diverse biological processes including osteogenic differentiation and bone formation. Recently, it has been reported that miR-146a-5p affects the activity of both osteoblasts and osteoclasts. However, the target genes of miR-146a-5p in these procedures remain unknown. Here we identify miR-146a-5p as a critical suppressor of osteoblastogenesis and bone formation. We found that miR-146a-5p knockout mice exhibit elevated bone formation and enhanced bone mass in vivo. Consistently, we also found that miR-146a-5p inhibited the osteoblast differentiation of bone marrow mesenchymal stem cells (BMSCs) in vitro. Importantly, we further demonstrated that miR-146a-5p directly targeted Sirt1 to inhibit osteoblast activity. Additionally, we showed that the expression of miR-146a-5p gradually increased in femurs with age not only in female mice but also in female patients, and miR-146a-5p deletion protected female mice from age-induced bone loss. These data suggested that miR-146a-5p has a crucial role in suppressing the bone formation and that inhibition of miR-146a-5p may be a strategy for ameliorating osteoporosis.
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Particulate organic matter (POM) includes humin and non-degradable residues, and the knowledge about its composition, evolution and environmental behavior is limited. The composition, evolution and its influence on dechlorination of the POM in landfill was studied. The results show that POM accounts for 27 %-57 % of the organic matter in landfill cell, which is mainly composed of protein-, fulvic- and humic-like components. Firmicutes and Proteobacteria were the main microorganisms driving the compositional evolution of POM during the landfilling process. The electron acceptance capacities (EAC) and electron donating capacities (EDC) of POM were in the range of 0.05-0.51 µmol/gC-1 and 0.13-0.66 µmol/gC-1, respectively, and the average EAC and EDC of POM in the intermediate and old stage of landfill were higher than those in the initial stage. The combined action of MR-1 and POM increased the degradation rate of PCP by 20 %-40 %, which was ascribed to the reduction capacities and electron transfer process of POM. POM derived from the intermediate and old stages promoted PCP dechlorination more effectively when compared with the initial stage due to its high electron transfer capacities (ETC), which are of great significance for soil in-situ bioremediation.
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Estenosis de la Válvula Aórtica/cirugía , Arritmias Cardíacas/terapia , Estimulación Cardíaca Artificial , Marcapaso Artificial , Reemplazo de la Válvula Aórtica Transcatéter/efectos adversos , Anciano , Anciano de 80 o más Años , Estenosis de la Válvula Aórtica/diagnóstico por imagen , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/etiología , Femenino , Prótesis Valvulares Cardíacas , Humanos , Masculino , Diseño de Prótesis , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Reemplazo de la Válvula Aórtica Transcatéter/instrumentación , Resultado del TratamientoRESUMEN
Long non-coding RNAs (lncRNAs) are emerging as important regulators of the processes involved in cancer development and progression. The molecular mechanism by which lncRNAs regulate the progression of osteosarcoma has not been clearly elucidated. The role of NR_136400, which is an uncharacterized lncRNA, has not been previously reported in osteosarcoma (OS). In the present study, we demonstrated that NR_136400 was downregulated in OS cells and that its downregulation promoted OS cell proliferation, apoptosis, and invasion. NR_136400 downregulation facilitated EMT by inhibiting the expression of E-cadherin and elevating the expression of ZEB1, Snail, and fibronectin. In vivo experiments using a xenograft tumor mouse model revealed that NR_136400 downregulation promoted tumor growth in OS. Mechanistic investigations demonstrated that NR_136400 competitively bound to miR-8081 and then upregulated the protein expression of TUSC5. Taken together, a newly identified regulatory mechanism of the lncRNA NR_136400/miR-8081/TUSC5 axis was systematically studied in OS, providing a promising target for therapeutic treatment.
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RATIONALE: Therapeutic or diagnostic thoracentesis is widely used in different clinical settings. Cardiac injury, a rare complication, could lead to fatal consequences. We describe a case of cardiac tamponade complicating thoracentesis that was recognized and rescued in a timely manner. PATIENT CONCERNS: A 42-year-old woman underwent blind thoracentesis due to excessive left pleural effusion after left pneumonectomy surgery. She suddenly lost consciousness and was in a state of shock a few minutes after needle insertion and fluid drainage. DIAGNOSIS: Bedside transthoracic echocardiography revealed pericardial effusion at a depth of 20âmm, and cardiac tamponade complicating thoracentesis was diagnosed. INTERVENTIONS: After draining 250 mL of non-coagulated blood by pericardiocentesis under transthoracic echocardiography guidance, a tube was placed for continuous drainage over the subsequent 36âhours. OUTCOMES: The patient's hemodynamic condition was stabilized hours after pericardiocentesis. The patient was discharged in good condition a few days later. LESSONS: Imaging assessment and guidance in the process of thoracentesis was indispensable, especially in a patient with altered intra-thoracic anatomy. Cardiac damage, as a life-threatening complication, should be considered once hemodynamic instability occurs during the procedure.
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Taponamiento Cardíaco/etiología , Neumonectomía/métodos , Toracocentesis/efectos adversos , Adulto , Taponamiento Cardíaco/diagnóstico por imagen , Taponamiento Cardíaco/cirugía , Drenaje/efectos adversos , Ecocardiografía/métodos , Femenino , Humanos , Pericardiocentesis/instrumentación , Derrame Pleural/cirugía , Procedimientos Quirúrgicos Torácicos/efectos adversos , Resultado del TratamientoRESUMEN
Pheochromocytoma crisis is a rare and possibly fatal emergency. Hypersecreted catecholamines may result in myocardial injury via its direct toxic effect on cardiomyocytes or mediating vasoconstriction which will reduce coronary blood flow in this special setting. Interestingly, several case studies have reported the occurrence of ST-segment elevation myocardial infarction in patients with pheochromocytoma crisis. However, no one found the angiographic evidence of occlusive thrombus in the infarct-related coronary artery. Additionally, pheochromocytoma can induce hypercoagulability and promote thrombosis, but spontaneous coronary thrombosis has never been reported in this condition. Here, we report an unusual case of pheochromocytoma crisis presenting with STEMI due to spontaneous coronary thrombosis.