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BACKGROUND AND OBJECTIVE: Electrocardiographic imaging (ECGI) has emerged as a non-invasive approach to identify atrial fibrillation (AF) driver sources. This paper aims to collect and review the current research literature on the ECGI inverse problem, summarize the research progress, and propose potential research directions for the future. METHODS AND RESULTS: The effectiveness and feasibility of using ECGI to map AF driver sources may be influenced by several factors, such as inaccuracies in the atrial model due to heart movement or deformation, noise interference in high-density body surface potential (BSP), inconvenient and time-consuming BSP acquisition, errors in solving the inverse problem, and incomplete interpretation of the AF driving source information derived from the reconstructed epicardial potential. We review the current research progress on these factors and discuss possible improvement directions. Additionally, we highlight the limitations of ECGI itself, including the lack of a gold standard to validate the accuracy of ECGI technology in locating AF drivers and the challenges associated with guiding AF ablation based on post-processed epicardial potentials due to the intrinsic difference between epicardial and endocardial potentials. CONCLUSIONS: Before performing ablation, ECGI can provide operators with predictive information about the underlying locations of AF driver by non-invasively and globally mapping the biatrial electrical activity. In the future, endocardial catheter mapping technology may benefit from the use of ECGI to enhance the diagnosis and ablation of AF.
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Fibrilação Atrial , Ablação por Cateter , Humanos , Fibrilação Atrial/diagnóstico por imagem , Mapeamento Potencial de Superfície Corporal/métodos , Diagnóstico por Imagem , Eletrocardiografia/métodos , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/cirurgia , Ablação por Cateter/métodosRESUMO
Objective:To investigate the clinical effect of facial depression correction by using free anterolateral thigh adipofascial flap and human acellular dermal matrix.Methods:Nineteen facial depression patients (3 males and 16 females), age ranges from 16 to 56 years (average age: 29.1±10.37 years), caused by different reasons were selected in this research from Jan. 2008 to Dec. 2020. In the stage I operation, anterolateral thigh adipofascial flap was designed according to facial depression area and harvested to fill in the depression with vascular anastomosis; In the stage II operation, the human acellular dermal matrix was used to fill in the remained depression edge according to facial subunit.Results:All free anterolateral thigh adipofascial flap survived well. All patients revealed fascial subunit tissue atrophy of different degree in infraorbital, nasolabial sulcus and temporal areas which were repaired by using cellular dermal matrix and obtained satisfying effect during 1 to 8 years of follow-up with no obvious rejection. 18 of 19 patients showed flap hypertrophy and corrected by liposuction. All patients recovered well after 1 to 8 years of follow-up.Conclusions:Humana cellular dermal matrix could make up the limitations of treating fascial depression deformity when using anterolateral thigh adipofascial flap. The combination method of above approaches could obtain satisfying clinical effect, which is worthy of clinical promotion.
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Osteoarthritis (OA) is a prevalent joint disease with no effective treatment strategies. Aberrant mechanical stimuli was demonstrated to be an essential factor for OA pathogenesis. Although multiple studies have detected potential regulatory mechanisms underlying OA and have concentrated on developing novel treatment strategies, the epigenetic control of OA remains unclear. Histone demethylase JMJD3 has been reported to mediate multiple physiological and pathological processes, including cell differentiation, proliferation, autophagy, and apoptosis. However, the regulation of JMJD3 in aberrant force-related OA and its mediatory effect on disease progression are still unknown. In this work, we confirmed the upregulation of JMJD3 in aberrant force-induced cartilage injury in vitro and in vivo. Functionally, inhibition of JMJD3 by its inhibitor, GSK-J4, or downregulation of JMJD3 by adenovirus infection of sh-JMJD3 could alleviate the aberrant force-induced chondrocyte injury. Mechanistic investigation illustrated that aberrant force induces JMJD3 expression and then demethylates H3K27me3 at the NR4A1 promoter to promote its expression. Further experiments indicated that NR4A1 can regulate chondrocyte apoptosis, cartilage degeneration, extracellular matrix degradation, and inflammatory responses. In vivo, anterior cruciate ligament transection (ACLT) was performed to construct an OA model, and the therapeutic effect of GSK-J4 was validated. More importantly, we adopted a peptide-siRNA nanoplatform to deliver si-JMJD3 into articular cartilage, and the severity of joint degeneration was remarkably mitigated. Taken together, our findings demonstrated that JMJD3 is flow-responsive and epigenetically regulates OA progression. Our work provides evidences for JMJD3 inhibition as an innovative epigenetic therapy approach for joint diseases by utilizing p5RHH-siRNA nanocomplexes.
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Humanos , Cartilagem Articular/patologia , Condrócitos/metabolismo , Regulação para Baixo , Epigênese Genética , Histona Desmetilases com o Domínio Jumonji/metabolismo , Membro 1 do Grupo A da Subfamília 4 de Receptores Nucleares/metabolismo , Osteoartrite/patologia , RNA Interferente Pequeno/farmacologiaRESUMO
Objective:To assess systematically the effect of dance training on the cognitive functioning and emotional state of people with Parkinson′s disease.Methods:Randomized controlled trials (RCTs) of the effect of dance training on the cognition and emotional state of people with Parkinson′s disease were retrieved from the Pubmed, Embase, Cochrane Library, Web of Science, Science Direct, Ovid, CNKI, Wan fang and VIP databases. The period was from January 1995 to January 10, 2019. The literature was screened, collected and evaluated by two reviewers independently. The meta-analysis was conducted using version 5.3 of the Revman software.Results:Seven RCTs involving 167 patients were discovered. According to the meta-analysis, dance training significantly relieved depression [SMD=-0.75, 95%CI: -1.41 to -0.10]. It improved the average score on the Montreal Cognitive Assessment Scale [WMD=2.05, 95%CI: 0.87 to 3.23] and on the Frontal Assessment Battery [WMD=1.41, 95%CI: 0.49 to 2.33]. However, dance training could not effectively improve apathy.Conclusions:Current evidence shows that dance training can relieve depression and promote better cognitive functioning for people with Parkinson′s disease.
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Melanoma is a highly aggressive malignant skin tumor characterized by rapid growth and early metastasis. Surgical resection is currently still the main treatment. There are still some challenges in the early diagnosis and thorough surgical resection of melanoma, which affect the prognosis of patients. To date, great progress has been made in the application of fluorescent probes to the diagnosis and surgical resection of, as well as sentinel lymph node localization and resection in melanoma. Fluorescent probes have advantages of good chemical stability, less adverse effects, high specificity, high accuracy and visualization, and may provid new ideas for the diagnosis and treatment of melanoma.
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<p><b>OBJECTIVE</b>To explore the relationship between the time after thrombosis and the efficacy of combined ultrasound and microbubble treatment for rescuing the ischemic tissues.</p><p><b>METHODS</b>Rat models of thrombosis in the right common iliac artery were established and received combined ultrasound and microbubble treatment at 3, 6 and 12 h after thrombosis. The recanalization rate of the right common iliac artery was assessed using both 2-dimensional and Doppler ultrasound. The plateau acoustic intensity (AI) was quantified for estimating the skeletal microvascular blood volume, and skeletal muscle injury markers including myoglobin (Mb) and creatinine kinase (CK) were measured using ELISA. Postmortem TUNEL staining was used to detect the apoptotic rate of skeletal muscle cells in the hind limb of the rats.</p><p><b>RESULTS</b>Compared with those in 3 h group, the recanalization rate and AI were significantly lower, and the levels of Mb and CK and the apoptotic rate of the skeletal muscle cells were significantly higher in both 6 h group and 12 h group ( < 0.05). Compared with those in 6 h group, the rats receiving treatment at 12 h after thrombosis showed significantly lowered AI and increased Mb, CK and apoptotic rate of the skeletal muscle cells ( < 0.05).</p><p><b>CONCLUSIONS</b>The efficacy of combined ultrasound and microbubble treatment for rescuing ischemic tissues tends to be attenuated as the time after thrombosis prolongs in rats.</p>
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Objective To investigate the efficacy of microbubble-enhanced sonothrombolysis on platelet-rich thrombi (PRT) and erythrocyte-rich thrombi (ERT) in different ages.Methods PRT and ERT in different ages were prepared both in vitro and in vivo of common carotid artery in rats.All the participants were divided into 8 groups with 4 in vitro and another 4 in vivo experiment,including PRT 3 h,PRT 24 h,ERT 3 h,ERT 24h in vitro groups and PRT 3 h,PRT 24 h,ERT 3 h,ERT 24 h in vivo groups.Microbubble-enhanced sonothrombolysis was carried out in both in vitro and in vivo experiments,and the ultrasonic images were collected.The components of PRT and ERT were identified by histopathological examination.The percentage increase of luminal cross sectional area and lytic ratio in vitro,and the recanalization rate and mean blood flow velocity of common carotid artery in vivo were mainly analyzed.Results After sonothrombolysis,both in vitro and in vivo experiment showed there was no statistically significant difference of the percentage increase of luminal cross sectional area ([121.12 ± 13.21]% vs [130.09 ± 15.34]%),lytic ratio ([39.83± 7.09]% vs [42.14±5.17]%),recanalization rate (83.33% vs 91.67%) and blood flow velocity of common carotid artery ([0.21±0.02]m/s vs [0.22±0.01]m/s) between PRT 3 h group and ERT 3 h group (both P>0.05).PRT 24 h group compared with EPR 24 h group,PRT 24 h group compared with PRT 3 h group,as well as ERT 24 h group compared with ERT 3 h group,the percent increase of luminal cross sectional area,lytic ratio,recanalization rate and blood flow velocity of common carotid artery reduced (all P<0.05).Conclusion The efficacy of microbubble-enhanced sonothrombolysis on PRT and ERT in vitro and in vivo of of rat common carotid artery model decrease with the increase of thrombus age,especially for the PRT.
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Pharmacy education in Singapore adopts a patient-orientated approach. This article provides a general introduction to the education and practice of Pharmacy in Singapore through 3 major aspects,①Professional pharmacy degree;②Curriculum of the undergraduate and postgraduate pharmacy education;③Professional pharmacy practice and employment in Singapore.
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BACKGROUND:Autologous bone marrow mesenchymal stem cel transplantation for the treatment of cardiovascular disease has become one of the hotspots, but it is unclear whether the proliferation and directional differentiation of autologous bone marrow mesenchymal stem cels varies changes with age. OBJECTIVE: To explore the proliferation and differentiation changes of rat bone mesenchymal stem cels in different ages. METHODS:The bone marrow mesenchymal stem cels from Sprague-Dawley rats in different age groups were purified and cultured, and then examined by flow cytometry in terms of cel cycle. Meanwhile, neonatal rat cardiomyocytes were co-cultured with bone marrow mesenchymal stem cels. The morphologic changes of bone marrow mesenchymal stem cels and the protein expression of troponin T were detected with immunofluorescence technique. RESULTS AND CONCLUSION: The percentage of bone marrow mesenchymal stem cels in G0/G1 phase was increased with age; while the percentage of expression of troponin T proteins-positive bone marrow mesenchymal stem cels were decreased with age. These findings indicate that the proliferation and differentiation abilities of rat bone marrow mesenchymal stem cels descend with age.
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To investigate the synergistic effect of tetrandrine (TET) to the anti-Trichophyton mentagrophytes activity of econazole (ECZ) in vivo,animal model of dermatophytosis in guinea pig was established by inoculating Trichophyton mentagrophytes conidia.These 40 infected animals were divided into 4 groups randomly and from Day 5 after inoculation,they were treated with the following formulations once per day for successive 14 days: 1% econazole and 1% tetrandrine compound cream (1%ECZ+1%TET group),1% econazole cream (1%ECZ group),1%TET cream (1%TET group) and matrix cream (matrix group).The alterations in the skin lesions and the pathological changes were observed.From the 4~(th) day of drugs applying,the tendency of lesion score about 1%ECZ+1%TET group continued to decline.On the 14~(th) day of drugs applying,the lesion score decreased to 0.75.There was a similarity between 1%ECZ+1%TET group and 1%ECZ group in tendency of lesion score,but more reduction was appeared in 1%ECZ+1%TET group than in 1%ECZ group (mean 0.75 VS 2.00) with obviously statistical difference (P=0.037).The culture results of skin sections and the pathological changes in 1%ECZ+1%TET group were less than those of other 3 groups.It's predicted that there is a synergistic effect of tetrandrine to the anti-Trichophyton mentagrophytes of econazole in animal model of dermatophytosis in guinea pig.