• 【缬沙坦在心肌梗死后和心力衰竭患者中的应用。】 复制标题 收藏 收藏
    DOI:10.3317/jraas.2006.019 复制DOI
    作者列表:Liu PP,Maggioni A,Velazquez EJ
    BACKGROUND & AIMS: :Left ventricular (LV) dysfunction and/or heart failure (HF) are frequent complications of hypertension and myocardial infarction (MI), placing affected patients at increased risk of significant morbidity and premature death. Given that the renin-angiotensin-aldosterone system (RAAS) is activated and of pathophysiological importance in such patients, a strong therapeutic rationale exists to target the main effector mechanism (that is, angiotensin II [Ang II]) in order to lessen the associated morbidity and mortality burden. Angiotensin-converting enzyme (ACE) inhibitors have been shown to reduce mortality and LV dysfunction and to slow disease progression in patients with HF, including high-risk, post-MI patients. However, ACE inhibitors (ACE-Is) may not provide optimal long-term RAAS blockade (a finding that is associated with a worse prognosis) and many patients are unable to tolerate such therapy (because of troublesome dry cough, for example). In contrast, Ang II receptor blockers (ARBs) may block the RAAS more completely than ACE-Is and appear to be better tolerated. Several large-scale trials gave evaluated the efficacy of ARBs in patients with LV dysfunction and/or HF (including high-risk, post-MI patients), and have confirmed their utility as an efficacious and well-tolerated alternative to ACE-Is in this setting.
    背景与目标: : 左心室 (LV) 功能障碍和/或心力衰竭 (HF) 是高血压和心肌梗塞 (MI) 的常见并发症,使受影响的患者具有显着发病率和过早死亡的风险。鉴于肾素-血管紧张素-醛固酮系统 (RAAS) 在此类患者中被激活并且具有病理生理重要性,因此存在针对主要效应机制 (即血管紧张素II [Ang II]) 的强有力的治疗依据,以减轻相关的发病率和死亡率负担。血管紧张素转换酶 (ACE) 抑制剂已被证明可降低HF患者 (包括高危MI后患者) 的死亡率和LV功能障碍,并可减缓疾病进展。然而,ACE抑制剂 (ACE-Is) 可能无法提供最佳的长期RAAS阻断 (这一发现与更差的预后相关),并且许多患者无法耐受这种治疗 (例如,由于麻烦的干咳)。相比之下,Ang II受体阻滞剂 (arb) 可能比ACE-Is更完全地阻断RAAS,并且似乎具有更好的耐受性。几项大规模试验评估了ARBs在LV功能障碍和/或HF患者 (包括高危MI后患者) 中的疗效,并已证实其作为ACE-Is的有效且耐受性良好的替代方法在这种情况下。
  • 【氟硝西泮长期治疗导致继发性肾上腺功能衰竭。】 复制标题 收藏 收藏
    DOI:10.1111/j.1365-2265.2006.02622.x 复制DOI
    作者列表:Müssig K,Friess E,Wudy SA,Mörike K,Häring HU,Overkamp D
    BACKGROUND & AIMS: -2
    背景与目标: -2
  • 【未能启动: 促进iNKT细胞的细胞因子分泌。】 复制标题 收藏 收藏
    DOI:10.1016/j.immuni.2006.08.012 复制DOI
    作者列表:Locksley RM
    BACKGROUND & AIMS: :In this issue of Immunity, Bezbradica et al., (2006) uncover an unsuspected role for the cytokine GM-CSF in the thymic development of invariant NKT cells, a role that licenses these cells to secrete effector cytokines upon activation in the periphery.
    背景与目标: : 在本期《免疫》中,bezbratica等人 (2006) 揭示了细胞因子gm-csf在不变NKT细胞的胸腺发育中不可怀疑的作用,该作用允许这些细胞在外围激活时分泌效应细胞因子。
  • 【人暴发性肝衰竭中胱天蛋白酶的肝内激活。】 复制标题 收藏 收藏
    DOI:10.1111/j.1478-3231.2006.01300.x 复制DOI
    作者列表:Leifeld L,Nattermann J,Fielenbach M,Schmitz V,Sauerbruch T,Spengler U
    BACKGROUND & AIMS: BACKGROUND/AIMS:Apoptosis has been implicated in the pathogenesis of fulminant hepatic failure (FHF) potentially involving caspases. Thus far, apoptosis in FHF has mainly been studied in animal models while human data are sparse. METHODS:Caspases-3, -8 and -9 activities and Fas expression were analyzed in correlation to TdT-mediated dUTP nick end labelling (TUNEL) positive apoptotic cells in livers of patients with FHF (n=26), chronic liver disease (CLD) (n=60) and normal controls (NC) (n=10). RESULTS:Numbers of TUNEL-positive cells were higher in FHF than in CLD and NC (P<0.001) correlating to the intrahepatic activities of caspase-3. The highest caspase-3 activities were found in fulminant hepatitis B, significantly surpassing those in FHF of any other etiology. In fulminant hepatitis B, caspase-9 activity was also higher than in controls, while caspase-8 activation was not higher than in NC. Unlike caspase-3, caspases -8 and -9 activities were not correlated to the numbers of TUNEL positive cells. Fas expression was also the highest in FHF but did not differ between hepatitis B virus-FHF and other FHF. CONCLUSIONS:Our data indicate differential activation of intrahepatic caspases in FHF depending on the underlying etiology. Massive activation of caspases in fulminant hepatitis B confirms a pivotal role of apoptotic pathways in the pathogenesis of human fulminant hepatitis B.
    背景与目标:
  • 【成年先天性心脏病患者的亚临床甲状腺功能减退。】 复制标题 收藏 收藏
    DOI:10.1007/s00246-012-0571-6 复制DOI
    作者列表:Martínez-Quintana E,Rodríguez-González F,Nieto-Lago V
    BACKGROUND & AIMS: :Subclinical hypothyroidism usually is asymptomatic, but it can be associated with various adverse cardiologic outcomes. With the objective of gaining insight into the role of thyroid-stimulating hormone (TSH) in congenital heart abnormalities, this study measured serum TSH concentrations in different subtypes of grown-up congenital heart disease (GUCHD) patients. Serum TSH (reference range, 0.34-5.6 mIU/L), creatinine, cholesterol, C-reactive protein (CRP), N-terminal proB-type natriuretic peptide (NT-pro-BNP), and 24-h proteinuria were measured in 249 GUCHD patients. Of 24 GUCHD patients (9.6 %) with a TSH level higher than 5.6 mUI/L, nine were cyanotic (37.5 %) and seven (29.1 %) had Down syndrome. The GUCHD patients with serum TSH exceeding 5.6 mIU/L had a significantly higher level of serum NT-pro-BNP (195.1 [0.28; 5,280.3] vs 57.6 [0.00; 929.8]; p = 0.001) and CRP (0.30 [0.06; 1.87] vs 0.16 [0.00; 1.40]; p = 0.011] than those with a TSH level of 5.6 mIU/L or lower. No significant differences were found in serum creatinine, lipids, or 24-h proteinuria between the two groups. The T4 concentrations in the GUCHD patients with TSH exceeding 5.6 mIU/L were within the normal range (0.89 ± 0.23 ng/dL). In the multivariate analysis, cyanosis (odds ratio [OR], 6,399; 95 % confidence interval [CI] 2,296-17,830; p < 0.001), Down syndrome (OR, 6,208; 95 % CI, 1,963-19,636; p = 0.002), and NT-pro-BNP concentrations (OR, 1,001; 95 % CI, 1,000-1,002; p < 0.026) proved to be risk factors for TSH levels higher than 5.6 mIU/L. Because subclinical hypothyroidism entails a cardiovascular risk, the authors postulate that TSH screening should be included in the routine follow-up evaluation of GUCHD patients with cyanosis or Down syndrome.
    背景与目标: : 亚临床甲状腺功能减退通常是无症状的,但它可能与各种不良的心脏结局有关。为了深入了解促甲状腺激素 (TSH) 在先天性心脏异常中的作用,本研究测量了成年先天性心脏病 (GUCHD) 患者不同亚型的血清TSH浓度。在249例GUCHD患者中测量了血清TSH (参考范围,0.34-5.6 mIU/L),肌酐,胆固醇,C反应蛋白 (CRP),N末端proB型利钠肽 (NT-pro-BNP) 和24小时蛋白尿。在TSH水平高于5.6 mUI/L的24例GUCHD患者 (9.6% 例) 中,9例为紫绀 (37.5% 例),7例 (29.1% 例) 患有唐氏综合症。血清TSH超过5.6 mIU/L的GUCHD患者的血清NT-pro-BNP水平 (195.1 [0.28; 5,280.3] vs 57.6 [0.00; 929.8]; p = 0.001) 和CRP (0.30 [0.06; 1.87] vs 0.16 [0.00; 1.40]; p = 0.011] 与TSH水平为5.6 mIU/L或更低者比较,血清肌酐、血脂、或两组之间的24小时蛋白尿。TSH超过5.6 mIU/L的GUCHD患者的T4浓度在正常范围内 (0.89 ± 0.23 ng/dL)。在多变量分析中,发绀 (优势比 [or],6,399; 95% 置信区间 [CI] 2,296-17,830; p <0.001),唐氏综合征 (OR,6,208; 95% CI,1,963-19,636; p = 0.002) 和NT-pro-BNP浓度 (OR,1,001; 95% CI,1,000-1,002; p < 0.026) 被证明是TSH水平高于5.6 mIU/L的危险因素。由于亚临床甲状腺功能减退会带来心血管风险,因此作者假设TSH筛查应包括在患有发绀或唐氏综合症的GUCHD患者的常规随访评估中。
  • 【Cornelia de Lange综合征: 149患者的先天性心脏病。】 复制标题 收藏 收藏
    DOI:10.1016/j.medcli.2017.03.051 复制DOI
    作者列表:Ayerza Casas A,Puisac Uriol B,Teresa Rodrigo ME,Hernández Marcos M,Ramos Fuentes FJ,Pie Juste J
    BACKGROUND & AIMS: INTRODUCTION:Cornelia de Lange syndrome (CdLS) is produced by mutations in genes that encode regulatory or structural proteins of the cohesin complex. Congenital heart disease (CHD) is not a major criterion of the disease, but it affects many individuals. The objective of this study was to study the incidence and type of CHD in patients with CdLS. MATERIAL AND METHOD:Cardiological findings were evaluated in 149 patients with CdLS and their possible relationship with clinical and genetic variables. RESULTS:A percentage of 34.9 had CHD (septal defects 50%, pulmonary stenosis 27%, aortic coarctation 9.6%). The presence of CHD was related with neonatal hospitalisation (P=.04), hearing loss (P=.002), mortality (P=.09) and lower hyperactivity (P=.02), it being more frequent in HDAC8+ patients (60%), followed by NIPBL+ (33%) and SMC1A+ (28.5%). While septal defects predominate in NIPBL+, pulmonary stenosis is more common in HDAC8+. CONCLUSIONS:Patients with CdLS have a high incidence of CHD, which varies according to the affected gene, the most frequent findings being septal defects and pulmonary stenosis. Perform a cardiologic study in all these patients is suggested.
    背景与目标:
  • 【中药新极丸通过Akt/Nrf2途径保护心脏免受缺血/再灌注损伤。】 复制标题 收藏 收藏
    DOI:10.3892/mmr.2017.6732 复制DOI
    作者列表:Yuan Q,Chen R,Zheng X,Meng M,Kao Y,Liu J,Gan X,Shi M,Fu J,Jiang S,Yu H
    BACKGROUND & AIMS: :The cardioprotective drugs used for treatment against ischemia/reperfusion (MI/R) injury have been well evaluated and are considered inadequate. The Chinese herbal medicine formula, Xinji pill (XJP) has been used traditionally for the prevention and treatment of ischemic heart diseases for decades. In the present study, the cardioprotective effects of XJP against MI/R injury were assessed in vivo and its possible mechanism was examined. Male Sprague‑Dawley rats were selected for establishing an MI/R model, which was induced by ischemia for 30 min followed by 24 h reperfusion. Drugs and saline were administered intragastrically from day 14 prior to MI/R. Blood samples were collected for biochemical detection. The rats were then sacrificed and cardiac muscle tissues were harvested. The mRNA expression levels of antioxidant genes were measured by reverse transcription‑quantitative polymerase chain reaction and the protein levels were measured by western blotting. Pretreatment with XJP for 14 days protected the heart against I/R‑induced myocardial function disorder, protected against heart injury, as demonstrated by normalized serum levels of lactate dehydrogenase and creatine kinase, and suppressed oxidative stress. XJP markedly upregulated the expression of antioxidant genes, including superoxide dismutase, catalase, glutathione reductase and glutathione peroxidase, and promoted the protein expression of heme oxygenase‑1 and NFE2‑related factor 2 (Nrf2) in the heart tissues. Furthermore, Akt kinase was confirmed to be upstream of Nrf2 in the XJP treatment. LY294002, a specific inhibitor of Akt, significantly eliminated the cardioprotective effects of XJP. In conclusion, these results demonstrated that XJP exhibited notable cardioprotective properties, in which the Akt/Nrf2 signaling pathway may be involved.
    背景与目标: : 用于治疗缺血/再灌注 (MI/R) 损伤的心脏保护药物已得到很好的评估,被认为是不充分的。几十年来,中药配方新基丸 (XJP) 一直用于预防和治疗缺血性心脏病。在本研究中,在体内评估了XJP对MI/R损伤的心脏保护作用,并研究了其可能的机制。选择雄性sprague-dawley大鼠建立MI/R模型,该模型由缺血30分钟然后再灌注24小时诱导。从MI/R开始的第14天开始胃内给药和生理盐水。采集血样进行生化检测。然后处死大鼠并收获心肌组织。通过逆转录定量聚合酶链反应测量抗氧化基因的mRNA表达水平,并通过蛋白质印迹法测量蛋白质水平。用XJP预处理14天可以保护心脏免受I/r诱导的心肌功能障碍,防止心脏损伤,如乳酸脱氢酶和肌酸激酶的标准化血清水平所示,并抑制氧化应激。XJP显着上调了抗氧化基因的表达,包括超氧化物歧化酶,过氧化氢酶,谷胱甘肽还原酶和谷胱甘肽过氧化物酶,并促进了血红素氧合酶-1和NFE2相关因子2 (Nrf2) 在心脏组织中的蛋白表达。此外,在XJP治疗中,Akt激酶被证实是Nrf2的上游。LY294002是一种特殊的Akt抑制剂,显著消除了XJP的心脏保护作用。总之,这些结果表明XJP表现出显着的心脏保护特性,其中可能涉及Akt/Nrf2信号通路。
  • 【脊髓损伤个体生活方式与冠心病危险因素的纵向关联.】 复制标题 收藏 收藏
    DOI:10.1038/sc.2012.153 复制DOI
    作者列表:de Groot S,Post MW,Snoek GJ,Schuitemaker M,van der Woude LH
    BACKGROUND & AIMS: OBJECTIVE:To investigate: (1) the course of coronary heart disease risk factors (lipid profiles and body mass index (BMI)) in the first five years after discharge from inpatient spinal cord injury (SCI) rehabilitation and (2) the association between lifestyle (physical activity, self-care related to fitness, smoking, alcohol, body mass and low-fat diet) and coronary heart disease risk factors during that period. DESIGN:Prospective cohort study. PARTICIPANTS/METHODS:Individuals with SCI (N=130). Total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TG) and BMI were determined at discharge from inpatient rehabilitation and 1 and 5 years after discharge. Using multilevel regression models, the effects of lifestyle (drinking alcohol, smoking, active lifestyle and self-care) on the lipid profiles and BMI were determined. RESULTS:After correction for lesion and personal characteristics, no changes in lipid profiles in the five years after discharge were seen, whereas the BMI increased significantly with 1.8 kg m(-2). A high percentage was at risk of cardiovascular disease due to high BMI (63-75%) or HDL (66-95%). The individuals who indicated to maintain their fitness level as good as possible and the individuals with a low BMI showed better lipid profiles. Individuals with a more active lifestyle showed higher HDL levels. Individuals who avoid smoking showed a 1.5 kg m(-2) higher BMI. CONCLUSION:Lipid profiles seem to stabilize in the years after discharge from inpatient SCI rehabilitation, whereas the BMI increased. Lifestyle factors associated with a favorable lipid profile and BMI could be identified.
    背景与目标:
  • 【先天性心脏病的心脏T1标测: 用于测量心肌细胞外体积分数的推注与输注方案。】 复制标题 收藏 收藏
    DOI:10.1007/s10554-017-1191-2 复制DOI
    作者列表:Al-Wakeel-Marquard N,Rastin S,Muench F,O H-Ici D,Yilmaz S,Berger F,Kuehne T,Messroghli DR
    BACKGROUND & AIMS: :Myocardial extracellular volume fraction (ECV) reflecting diffuse myocardial fibrosis can be measured with T1 mapping cardiovascular magnetic resonance (CMR) before and after the application of a gadolinium-based extracellular contrast agent. The equilibrium between blood and myocardium contrast concentration required for ECV measurements can be obtained with a primed contrast infusion (equilibrium contrast-CMR). We hypothesized that equilibrium can also be achieved with a single contrast bolus to accurately measure diffuse myocardial fibrosis in patients with congenital heart disease (CHD). Healthy controls (n = 17; median age 24.0 years) and patients with CHD (n = 19; 25.0 years) were prospectively enrolled. Using modified Look-Locker inversion recovery T1 mapping before, 15 min after bolus injection, and during constant infusion of gadolinium-DOTA, T1 values were obtained for blood pool and myocardium of the left ventricle (LV), the interventricular septum (IVS), and the right ventricle (RV) in a single midventricular plane in short axis or in transverse orientation. ECV of LV, IVS and RV by bolus-only and bolus-infusion correlated significantly in CHD patients (r = 0.94, 0.95, and 0.74; p < 0.01, respectively) and healthy controls (r = 0.96, 0.89, and 0.64; p < 0.05, respectively). Bland-Altman plots revealed no significant bias between the techniques for any of the analyzed regions. ECV of LV and RV myocardium measured by bolus-only T1 mapping agrees well with bolus-infusion measurements in patients with CHD. The use of a bolus-only approach facilitates the integration of ECV measurements into existing CMR imaging protocols, allowing for assessment of diffuse myocardial fibrosis in CHD in clinical routine.
    背景与目标: : 反映弥漫性心肌纤维化的心肌细胞外体积分数 (ECV) 可以在施用基于g的细胞外造影剂之前和之后用T1映射心血管磁共振 (CMR) 测量。ECV测量所需的血液和心肌对比浓度之间的平衡可以通过灌注对比输注 (平衡对比-CMR) 获得。我们假设,通过单次对比推注也可以实现平衡,以准确测量先天性心脏病 (CHD) 患者的弥漫性心肌纤维化。前瞻性地纳入健康对照 (n   =   17; 中位年龄24.0岁) 和CHD患者 (n   =   19; 25.0岁)。在推注前,推注后15分钟以及在不断输注g-DOTA期间,使用改良的Look-Locker反转恢复T1映射,获得左心室 (LV),室间隔 (IVS) 的血池和心肌的T1值,和右心室 (RV) 在单个心室中平面中的短轴或横向方向。在CHD患者 (分别为r   =   0.94、0.95和0.74; P  <  0.01) 和健康对照组 (分别为r   =   0.96、0.89和0.64; P  <  0.05) 中,仅推注和推注LV、IVS和RV的ECV显著相关。Bland-Altman图显示,任何分析区域的技术之间都没有明显的偏差。通过仅推注T1映射测量的LV和RV心肌的ECV与冠心病患者的推注测量非常吻合。仅推注方法的使用有助于将ECV测量结果集成到现有的CMR成像协议中,从而可以在临床常规中评估CHD中的弥漫性心肌纤维化。
  • 【慢性心脏病患者的抑郁和焦虑: 风险和预测因素的年龄差异。】 复制标题 收藏 收藏
    DOI:10.1002/nur.4770130205 复制DOI
    作者列表:Nickel JT,Brown KJ,Smith BA
    BACKGROUND & AIMS: :Anxiety and depression for 399 survivors of a 1,102-member heart disease cohort were assessed 8 to 9 years post-hospitalization. Approximately one-third reported symptoms of emotional distress and one-fourth were on anti-anxiety drugs. Predictors of anxiety and depression were analyzed through logistic regression. Subjects age 65 and over were less likely than younger patients to report anxiety or depression and also reported less heart-associated disability, the strongest predictor of distress for both age groups. Other significant predictors included a previous history of distress, low income, female sex, and beta blocker use.
    背景与目标: : 住院后8至9年评估了一个由1,102名成员组成的心脏病队列的399幸存者的焦虑和抑郁。大约3分之1个报告的情绪困扰和4分之1症状是使用抗焦虑药物。通过logistic回归分析焦虑和抑郁的预测因子。与年轻患者相比,65岁及以上的受试者报告焦虑或抑郁的可能性较小,并且与心脏相关的残疾也较少,这是两个年龄组中困扰的最强预测指标。其他重要的预测因素包括以前的困扰史,低收入,女性性别和使用 β 受体阻滞剂。
  • 【中度至复杂先天性心脏病或肺动脉高压产妇的围产期结局和麻醉管理 *。】 复制标题 收藏 收藏
    DOI:10.1111/anae.12058 复制DOI
    作者列表:Maxwell BG,El-Sayed YY,Riley ET,Carvalho B
    BACKGROUND & AIMS: :We performed a retrospective cohort analysis of pregnancies among women with moderate to complex congenital heart disease or pulmonary hypertension over a 12-year period, resulting in a cohort of 107 cases in 65 women. Neuraxial analgesia or anaesthesia was provided in 84%, 89% and 95% of spontaneous vaginal, operative vaginal and caesarean deliveries, respectively. The caesarean delivery rate was 43% compared to our institution average of 27% over the same period (p = 0.02), and 38% had operative vaginal deliveries compared to a 10.5% institution rate (p < 0.01). Invasive monitoring was used in 28% of all deliveries. There were one maternal and two neonatal deaths. This study provides detailed anaesthetic and peripartum management of women with congenital heart disease, a patient population in whom evidence-based practice and data are largely lacking. We observed a predominance of neuraxial anaesthetic techniques, increased caesarean and operative delivery rates, and favourable maternal and neonatal outcomes. Multicentre studies and registries to compare anaesthetic and obstetric management strategies further and delineate risk factors for adverse outcomes are required.
    背景与目标: : 我们对12年的中度至复杂先天性心脏病或肺动脉高压妇女的妊娠进行了回顾性队列分析,结果在65名妇女中进行了107例病例的队列研究。分别在84%,89% 和95% 自发阴道,手术阴道和剖腹产时提供了神经镇痛或麻醉。与同期的机构平均27% 相比,剖腹产率43% (p = 0.02),与10.5% 机构相比,38% 进行了阴道分娩 (p <0.01)。侵入性监测用于28% 所有分娩。有1名产妇和2名新生儿死亡。这项研究提供了先天性心脏病妇女的详细麻醉和围产期管理,先天性心脏病是一个缺乏循证实践和数据的患者人群。我们观察到神经麻醉技术占主导地位,剖腹产和手术分娩率提高,孕产妇和新生儿结局良好。需要进行多中心研究和注册,以进一步比较麻醉和产科管理策略,并描述不良结局的风险因素。
  • 【TCDD抑制成年斑马鱼的心脏再生。】 复制标题 收藏 收藏
    DOI:10.1093/toxsci/kfs329 复制DOI
    作者列表:Hofsteen P,Mehta V,Kim MS,Peterson RE,Heideman W
    BACKGROUND & AIMS: :Normal adult zebrafish can completely regenerate lost myocardium following partial amputation of the ventricle apex. We report that 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) significantly impairs this regeneration. Adult male zebrafish were injected with vehicle (control) or TCDD (70ng/g, ip) 1 day prior to partial amputation of the ventricle apex. Gross observation and histological analysis of the amputated heart at 21 days postamputation revealed that TCDD-exposed fish had not progressed beyond the initial clot formation stage, whereas the vehicle control fish showed substantial recovery and almost complete resolution of the formed clot. In contrast, hearts that were not surgically wounded showed no signs of TCDD toxicity. Striking features in the TCDD-exposed hearts were the absence of the normal sheath of new tissue enveloping the wound and the absence of intense cell proliferation at the site of the wound. In addition, the patterns of collagen deposition at the wound site were different between the TCDD and vehicle groups. Because the receptor for TCDD is the aryl hydrocarbon receptor ligand-activated transcriptional regulator, we examined the effects of TCDD exposure on gene expression in the ventricle using DNA microarrays. Samples were collected just prior to amputation and at 6h and 7 days postamputation. TCDD-pretreated hearts had dysregulated expression of genes involved in heart function, tissue regeneration, cell growth, and extracellular matrix. Because embryonic, but not adult, hearts are major targets for TCDD-induced cardiotoxicity, we speculate that the need for embryonic-like cells in regeneration is connected with the effects of TCDD in inhibiting the response to wounding.
    背景与目标: : 正常成年斑马鱼可以在部分截肢心室尖后完全再生丢失的心肌。我们报告2,3,7,8-四氯二苯并-对-二恶英 (TCDD) 显著损害这种再生。成年雄性斑马鱼在脑室尖部分截肢前1天注射赋形剂 (对照) 或TCDD (70ng/g,ip)。截肢后21天对截肢心脏的总体观察和组织学分析表明,暴露于TCDD的鱼没有进展超过最初的凝块形成阶段,而媒介物对照鱼则显示出实质性的恢复和形成的凝块的几乎完全消退。相反,未手术受伤的心脏没有TCDD毒性的迹象。暴露于TCDD的心脏的显着特征是没有包裹伤口的新组织的正常鞘,并且在伤口部位没有强烈的细胞增殖。此外,TCDD组和媒介物组在伤口部位的胶原沉积模式也不同。由于TCDD的受体是芳基烃受体配体激活的转录调节因子,因此我们使用DNA微阵列检查了TCDD暴露对心室中基因表达的影响。在截肢前以及截肢后6小时和7天收集样本。TCDD预处理的心脏与心脏功能,组织再生,细胞生长和细胞外基质有关的基因表达异常。由于胚胎而不是成年心脏是TCDD诱导的心脏毒性的主要靶标,因此我们推测再生中对胚胎样细胞的需求与TCDD抑制对创伤的反应有关。
  • 【探索已发表的关于运动训练和体育锻炼的指导的横断面样本的方法学质量和临床实用性,以进行冠心病的二级预防。】 复制标题 收藏 收藏
    DOI:10.1186/s12872-017-0589-z 复制DOI
    作者列表:Abell B,Glasziou P,Hoffmann T
    BACKGROUND & AIMS: BACKGROUND:Clinicians are encouraged to use guidelines to assist in providing evidence-based secondary prevention to patients with coronary heart disease. However, the expanding number of publications providing guidance about exercise training may confuse cardiac rehabilitation clinicians. We therefore sought to explore the number, scope, publication characteristics, methodological quality, and clinical usefulness of published exercise-based cardiac rehabilitation guidance. METHODS:We included publications recommending physical activity, exercise or cardiac rehabilitation for patients with coronary heart disease. These included systematically developed clinical practice guidelines, as well as other publications intended to support clinician decision making, such as position papers or consensus statements. Publications were obtained via electronic searches of preventive cardiology societies, guideline databases and PubMed, to November 2016. Publication characteristics were extracted, and two independent assessors evaluated quality using the 23-item Appraisal of Guidelines Research and Evaluation II (AGREE) tool. RESULTS:Fifty-four international publications from 1994 to 2016 were identified. Most were found on preventive cardiology association websites (n = 35; 65%) and were freely accessible (n = 50; 93%). Thirty (56%) publications contained only broad recommendations for physical activity and cardiac rehabilitation referral, while 24 (44%) contained the necessary detailed exercise training recommendations. Many were labelled as "guidelines", however publications with other titles (e.g. scientific statements) were common (n = 24; 44%). This latter group of publications contained a significantly greater proportion of detailed exercise training recommendations than clinical guidelines (p = 0.017). Wide variation in quality also existed, with 'applicability' the worst scoring AGREE II domain for clinical guidelines (mean score 53%) and 'rigour of development' rated lowest for other guidance types (mean score 33%). CONCLUSIONS:While a large number of guidance documents provide recommendations for exercise-based cardiac rehabilitation, most have limitations in either methodological quality or clinical usefulness. The lack of rigorously developed guidelines which also contain necessary detail about exercise training remains a substantial problem for clinicians.
    背景与目标:
  • 【对三叶Menyanthes的抗炎研究与对大鼠肾衰竭的作用有关。】 复制标题 收藏 收藏
    DOI:10.1016/S0944-7113(11)80054-1 复制DOI
    作者列表:Tunón H,Bohlin L
    BACKGROUND & AIMS: :Menyanthes trifoliata L. is used in Swedish traditional medicine for the treatment of inflammatory diseases of the kidney, e.g. glomerulonephritis. Earlier studies have shown that MtL increases glomerular filtration rate after renal reperfusion ischemia. This activity was suggested to be PAF-inhibitory since MtL also inhibited PAF-induced exocytosis in vitro on human neutrophils (IC(50) = 0.16 mg/ml). The present study further characterizes the anti-inflammatory properties of a rhizome decoction of this plant. MtL inhibited carrageenan-induced rat paw edema (ID(50) ≈ 1.7 g/kg p.o.) and ethyl phenylpropiolate-induced rat ear edema (32% at 2.0 g/kg p.o.) in a dose-dependent manner. Further studies revealed that MtL inhibited both fMLP-induced exocytosis (IC(50) = 0.16 mg/ml) and elastase activity (IC(50) = 0.16 mg/ml). According to these results it is likely that the activity shown in the PAF-test is at least partly due to an inhibition of elastase. MtL showed only minor hemolytic properties at the concentrations used in the PAF- and fMLP-tests, suggesting that the cells in these tests are undamaged. The decoction also inhibited the biosynthesis of LTB(4) (IC(50) ≈ 0.73 mg/ml) and prostaglandins (IC(50) = 0.37 mg/ml) in vitro in a concentration-dependent way. However, at concentrations where the decoction is active in the LTB(4)-test, it also possesses hemolytic properties.
    背景与目标: : Menyanthes trifoliata L.在瑞典传统医学中用于治疗肾脏的炎症性疾病,例如肾小球肾炎。较早的研究表明,MtL会增加肾脏再灌注缺血后的肾小球滤过率。该活性被认为是PAF抑制的,因为MtL还抑制了PAF诱导的人嗜中性粒细胞的胞吐作用 (IC(50) = 0.16 mg/ml)。本研究进一步表征了该植物根茎汤的抗炎特性。MtL以剂量依赖性方式抑制角叉菜胶诱导的大鼠爪子水肿 (ID(50) ≈ 1.7g/kg p.o.) 和苯基丙醇酸乙酯诱导的大鼠耳水肿 (32% 2.0g/kg p.o.)。进一步的研究表明,MtL抑制fMLP诱导的胞吐作用 (IC(50) = 0.16 mg/ml) 和弹性蛋白酶活性 (IC(50) = 0.16 mg/ml)。根据这些结果,PAF测试中显示的活性可能至少部分归因于弹性蛋白酶的抑制。在PAF和fMLP测试中使用的浓度下,MtL仅显示出较小的溶血特性,这表明这些测试中的细胞未受损。该汤剂还以浓度依赖性方式抑制体外LTB(4) (IC(50) ≈ 0.73 mg/ml) 和前列腺素 (IC(50) = 0.37 mg/ml) 的生物合成。然而,在汤在LTB(4)-测试中具有活性的浓度下,它也具有溶血特性。
  • 【妊娠晚期二尖瓣腱索断裂引起的急性充血性心力衰竭。】 复制标题 收藏 收藏
    DOI:10.1111/j.1447-0756.2012.02014.x 复制DOI
    作者列表:Ohishi S,Nitta H,Chinen Y,Kinjo T,Masamoto H,Sakumoto K,Maeda T,Kuniyoshi Y,Aoki Y
    BACKGROUND & AIMS: :A 31-year-old woman complained of dyspnea and orthopnea at 38 weeks of gestation. A grade 3/6 pansystolic murmur was heard, and echocardiography revealed severe mitral regurgitation with a hyperechoic obstacle on the posterior mitral valve leaflet, consistent with a diagnosis of acute heart failure due to a ruptured chordae tendineae or an infectious endocarditis. An emergency cesarean section was performed under general anesthesia. A male infant was born weighing 2928 g with Apgar scores of 7 and 8 at 1 and 5 min, respectively. The patient was managed in the intensive care unit and underwent open-heart surgery for mitral valve repair on postpartum day 3. The two chordal tendineae appeared torn and frail, and a mitral annuloplasty was performed. No finding of infectious endocarditis was observed. Because it is a dramatic and life-threatening clinical situation, proper diagnosis and treatment in the intensive care unit assure a good outcome for both mother and fetus.
    背景与目标: : 一名31岁的妇女在妊娠38周时抱怨呼吸困难和正呼吸。听到了3/6级的全收缩期杂音,超声心动图显示严重的二尖瓣反流,二尖瓣后叶上有高回声障碍,这与由于腱索破裂或感染性心内膜炎引起的急性心力衰竭的诊断一致。在全身麻醉下进行紧急剖宫产。出生时体重为2928  g的男婴,分别在1和5  min时Apgar评分为7和8。该患者在重症监护病房接受治疗,并于产后第3天接受心脏直视手术进行二尖瓣修复。两个腱索出现撕裂和脆弱,并进行了二尖瓣环成形术。未发现感染性心内膜炎。由于这是一个戏剧性的,危及生命的临床情况,因此在重症监护病房中进行适当的诊断和治疗可确保母亲和胎儿的良好结局。

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