BACKGROUND Accurate condition assessment is critical for improving the prognosis of neonatal respiratory distress syndrome(RDS),but current assessment methods for RDS pose a cumulative risk of harm to neonates.Thus,a ...BACKGROUND Accurate condition assessment is critical for improving the prognosis of neonatal respiratory distress syndrome(RDS),but current assessment methods for RDS pose a cumulative risk of harm to neonates.Thus,a less harmful method for assessing the health of neonates with RDS is needed.AIM To analyze the relationships between pulmonary ultrasonography and respiratory distress scores,oxygenation index,and chest X-ray grade of neonatal RDS to identify predictors of neonatal RDS severity.METHODS This retrospective study analyzed the medical information of 73 neonates with RDS admitted to the neonatal intensive care unit of Liupanshui Maternal and Child Care Service Center between April and December 2022.The pulmonary ultrasonography score,respiratory distress score,oxygenation index,and chest Xray grade of each newborn before and after treatment were collected.Spearman correlation analysis was performed to determine the relationships among these values and neonatal RDS severity.RESULTS The pulmonary ultrasonography score,respiratory distress score,oxygenation index,and chest X-ray RDS grade of the neonates were significantly lower after treatment than before treatment(P<0.05).Spearman correlation analysis showed that before and after treatment,the pulmonary ultrasonography score of neonates with RDS was positively correlated with the respiratory distress score,oxygenation index,and chest X-ray grade(ρ=0.429–0.859,P<0.05).Receiver operating characteristic curve analysis indicated that pulmonary ultrasonography screening effectively predicted the severity of neonatal RDS(area under the curve=0.805–1.000,P<0.05).CONCLUSION The pulmonary ultrasonography score was significantly associated with the neonatal RDS score,oxygenation index,and chest X-ray grade.The pulmonary ultrasonography score was an effective predictor of neonatal RDS severity.展开更多
Fulminant myocarditis(FM)is an uncommon syndrome characterized by sudden and severe hemodynamic compromise secondary to acute myocardial inflammation,often presenting as profound cardiogenic shock,life-threatening ven...Fulminant myocarditis(FM)is an uncommon syndrome characterized by sudden and severe hemodynamic compromise secondary to acute myocardial inflammation,often presenting as profound cardiogenic shock,life-threatening ventricular arrhythmias and/or electrical storm.FM may be refractory to conventional therapies and require mechanical circulatory support(MCS).The immune system has been recognized as playing a pivotal role in the pathophysiology of myocarditis,leading to an increased focus on immunosuppressive treatment strategies.Recent data have highlighted not only the fact that FM has significantly worse outcomes than non-FM,but that prognosis and management strategies of FM are heavily dependent on histological subtype,placing greater emphasis on the role of endomyocardial biopsy in diagnosis.The impact of subtype on severity and prognosis will likewise influence how aggressively the myocarditis is managed,including whether MCS is warranted.Many patients with refractory cardiogenic shock secondary to FM end up requiring MCS,with venoarterial extracorporeal membrane oxygenation demonstrating favorable survival rates,particularly when initiated prior to the development of multiorgan failure.Among the challenges facing the field are the need to more precisely identify immunopathophysiological pathways in order to develop targeted therapies,and the need to better optimize the timing and management of MCS to minimize complications and maximize outcomes.展开更多
Regenerative capacity is weak after central nervous system injury because of the absence of an enhancing microenvironment and presence of an inhibitory microenvironment for neuronal and axonal repair. In addition to t...Regenerative capacity is weak after central nervous system injury because of the absence of an enhancing microenvironment and presence of an inhibitory microenvironment for neuronal and axonal repair. In addition to the Nogo receptor（Ng R）, the paired immunoglobulin-like receptor B（Pir B） is a recently discovered coreceptor of Nogo, myelin-associated glycoprotein, and myelin oligodendrocyte glycoprotein. Concurrent blocking of Ng R and Pir B almost completely eliminates the inhibitory effect of myelin-associated inhibitory molecules on axonal regeneration. Pir B participates in a key pathological process of the nervous system, specifically axonal regeneration inhibition. Pir B is an inhibitory receptor similar to Ng R, but their effects are not identical. This study summarizes the structure, distribution, relationship with common nervous system diseases, and known mechanisms of Pir B, and concludes that Pir B is also distributed in cells of the immune and hematopoietic systems. Further investigations are needed to determine if immunomodulation and blood cell migration involve inhibition of axonal regeneration.展开更多
The Chinese medicine Extractum trametes robiniophila murr(ETRM)is the extract of a type of fungus.Recent studies have suggested that ETRM efficiently improves the effacement of podocyte foot processes in adriamycin(AD...The Chinese medicine Extractum trametes robiniophila murr(ETRM)is the extract of a type of fungus.Recent studies have suggested that ETRM efficiently improves the effacement of podocyte foot processes in adriamycin(ADR)-induced nephrotic rats.In the present study,we aimed to assess whether ETRM modulated the actin rearrangements of podocytes and involved signaling molecules,includingα-actinin-4 and nephrin.Podocytes were treated with ADR(0.5μmol/L),ADR(0.5μmol/L)+dexamethasone(Dex)(1μmol/L),ADR(0.5μmol/L)+ETRM(10 mg/mL).The F-actin in the podocytes was stained by fluorescent phallotoxins and observed by confocal microscopy.The expression levels ofα-actinin-4 and nephrin were tested by real-time PCR and Western blotting analysis.The administration of ETRM could significantly prevent ADR-treated podocytes from actin rearrangement.Both ETRM and Dex could stabilize podocyte actin cytoskeletons.Moreover,α-actinin-4 might act as a potential target for ETRM functionality in podocyte actin rearrangements.However,pretreatment with ETRM could not inhibit the up-regulation of nephrin as a result of ADR treatment.ETRM could improve the cytoskeleton stability in ADR-induced actin rearrangement of podocytes via regulatingα-actinin-4 expression.展开更多
Background Pregnant women with heart disease are at high risk. Studies of risk factors of these patients are of great significance to improve maternal and fetal outcomes. In this paper, we try to discuss the main risk...Background Pregnant women with heart disease are at high risk. Studies of risk factors of these patients are of great significance to improve maternal and fetal outcomes. In this paper, we try to discuss the main risk factors of cardiac events in pregnant women with heart disease and to establish a risk assessment system. Methods A retrospective analysis was carried out for pregnancies in 1741 women with heart disease who delivered in Shanghai Obstetrical Cardiology Intensive Care Center between January 1993 and September 2010. A Logistic regression model was used to identify independent risk factors of cardiac events and calculate the risk index in pregnant women with heart disease. Results The composition of heart disease in pregnant women was arrhythmia （n=662, 38.00%）, congenital heart disease （CHD; n=529, 30.40%）, cardiomyopathy （n=327, 18.80%）, rheumatic heart disease （RHD; n=151, 8.70%）, and cardiopathy induced by pre-eclampsia （n=53, 3.00%）. Main cardiac events were heart failure （n=110, 6.32%）, symptomatic arrhythmia needing medication （n=43, 2.47%）, cardiac arrest （n=2, 0.11%）, syncope （n=3, 0.17%）, and maternal death （n=10, 0.57%）. Six independent risk factors to predict cardiac events in pregnant women with heart disease were cardiac events before pregnancy （heart failure, severe arrhythmia, cardiac shock, etc., P=0.000）, New York Heart Association （NYHA） class 〉11 （m=0.000）, oxygen saturation 〈90% （P=0.018）, pulmonary artery hypertention （PAH） 〉50 mmHg （P=0.025）, cyanotic heart disease without surgical correction （P=-0.015）, and reduced left ventricular systolic function （ejection fraction 〈40%, P=0.003）. Every risk factor was calculated as 1 score. The incidence of cardiac events in patients with scores 0, 1, 2, 3, and 〉4 was 2.10%, 31.61 %, 61.25%, 68.97%, and 100.00% respectively. Conclusions Pregnancy with heart disease could lead to undesirable pregnancy outcomes. The risk of cardiac events in pregnant women with heart disease could be assessed by risk index.展开更多
Granulocyte colony-stimulating factor(GM-CSF),produced by CD4^(+)T cells,has recently been implicated in the pathogenesis of inflammatory diseases,such as multiple sclerosis and juvenile arthritis.However,the role of ...Granulocyte colony-stimulating factor(GM-CSF),produced by CD4^(+)T cells,has recently been implicated in the pathogenesis of inflammatory diseases,such as multiple sclerosis and juvenile arthritis.However,the role of GM-CSF-producing CD4^(+)T cells in sepsis remains unknown.This study reports peripheral changes in GM-CSF-producing CD4^(+)T cells in septic patients and the possible underlying mechanism by which GM-CSF influences the outcome of sepsis.Forty-three septic patients,20 SIRS patients,and 20 healthy controls were enrolled in this study and followed for 28 days to assess mortality.We measured the peripheral frequency of GM-CSF^(+)CD4^(+)T cells and recorded their associated relationship with disease progression.Our data demonstrated that peripheral GM-CSF-producing CD4^(+)T cells were significantly higher in septic patients than in both SIRS patients and healthy controls.These cells exhibit a memory phenotype and impaired IFN-γ-secreting capacity in sepsis patients.Using a receiver operating curve analysis with 8.01%as a cut-off point,the percentage of GM-CSF^(+)CD4^(+)T cells could predict the outcome of septic patients.Combined with the increase in GM-CSF-producing CD4^(+)T cells,inflammatory cytokines IL-1βand IL-6 were also upregulated.Using an in vitro neutrophil model,we found that GM-CSF inhibited C3aR expression,while inducing IL-8 production.Furthermore,this effect was transferrable in plasma from sepsis patients and was attenuated by inhibition of GM-CSF using an anti-GM-CSF antibody.These results indicate that GM-CSF-producing CD4^(+)T cells may serve as a marker of sepsis severity.Thus,targeting GM-CSF overproduction may benefit sepsis patients.展开更多
Background As the Shanghai Obstetrical Cardiology Intensive Care Center, our hospital has accumulated a large number of clinical data of pregnant women with heart disease. This paper is a retrospective analysis of 114...Background As the Shanghai Obstetrical Cardiology Intensive Care Center, our hospital has accumulated a large number of clinical data of pregnant women with heart disease. This paper is a retrospective analysis of 1142 pregnancies in women with heart disease so as to evaluate the maternal and fetal outcomes of these patients.Methods A retrospective analysis was carried out for pregnancies in 1142 women with heart disease who delivered in Shanghai Obstetrical Cardiology Intensive Care Center between 1993 and 2007.Results In this study, main heart diseases in pregnancy were arrhythmia （n=359, 31.4%）, congenital heart disease （CHD; n=291,25.5%）, and myocarditis and its sequelae （n=284, 24.9%）; based on the functional classification criteria of New York Heart Association （NYHA）, more than half （n=678, 59.4%） of patients were classified NYHA Class Ⅰ; pregnant women in NHYA Class Ⅰ-Ⅱ （n=951, 83.3%） commonly had arrhythmia, myocarditis and its sequelae, while those in NHYA Class Ⅲ-Ⅳ （n=191, 16.7%） mainly had CHD, rheumatic heart disease （RHD）, cardiopathy induced by hypertensive disorders complicating pregnancy, and peripartum cardiomyopathy （PPCM）. Cardiac failure occurred in 97 （8.5%）patients, and 8 （0.7%） maternal deaths and 12 （1.1%） perinatal deaths were reported in this study. Compared with those in NHYA Class Ⅰ-Ⅱ, women in NHYA Class Ⅲ-Ⅳ had a significantly lower gestational age at birth （P 〈0.05）, lower birth weight （P 〈0.01）, and higher incidence of preterm delivery, small for gestational age and perinatal death （P 〈0.01）. The incidence of cardiac failure in pregnant women with cardiopathy induced by hypertensive disorders complicating pregnancy and PPCM was relatively high, with a rate of 80% and 52.2%, respectively. After cardiac operation, 131（90.3%） women were in classified NHYA Class Ⅰ-Ⅱ and 14 （9.7%） in NHYA Class Ⅲ-Ⅳ.Conclusions Arrhythmia is the type of heart disease that has a highest incidence in patients with heart disease in pregnancy, while main types of heart disease that impair cardiac function are CHD and RHD; cardiac failure is more frequently caused by cardiopathy induced by hypertensive disorders complicating pregnancy and PPCM; impaired cardiac function increases perinatal morbidity; cardiac surgery before pregnancy could improve the cardiac function.展开更多
Introduction For critically ill patients with unstable hemodynamics,goal‑directed therapy for arterial blood pressure is needed with continuous daily bedside monitoring.The prevalence of hypertension in Chinese adults...Introduction For critically ill patients with unstable hemodynamics,goal‑directed therapy for arterial blood pressure is needed with continuous daily bedside monitoring.The prevalence of hypertension in Chinese adults is 25.2%,of which 1–2%of patients may experience a hypertensive emergency,with a mortality rate of 6.9%in the acute phase.The mortality and readmission rates within 90 days of onset are as high as 11%.[1]Furthermore,the mortality rate for patients who experience hypertensive emergencies can reach 50%within 12 months of the incident.[2]The incidence of perioperative hypertension in patients undergoing cardiac surgery is approximately 50%,with this figure dropping to 25%for non-cardiac surgery.Surgery may increase the incidence of perioperative cardio-cerebrovascular adverse events by 3–5%.[3]展开更多
Background Parkinson’s disease(PD)is the second most common neurodegenerative disease.The pathologic characteristic feature is the loss of dopaminergic neurons in the substantia nigra(SN).However,the biochemical mech...Background Parkinson’s disease(PD)is the second most common neurodegenerative disease.The pathologic characteristic feature is the loss of dopaminergic neurons in the substantia nigra(SN).However,the biochemical mechanisms are unclear.A large number of studies have shown that oxidative damage is the primary cause of PD.Hence,antioxidants could become a suitable option to treat PD.The thioredoxin(Trx)system represents a useful,potentially disease-relevant oxidation-reduction system.Thioredoxin reductase 1(TR1)is a significant component of the Trx system.Methods The overexpression lentivirus(LV)or LV-TR1 in the TR1-A53T model of PD by the stereotactic brain,and successful overexpression of LV or LV-TR1 in the MPP^(+)-induced cellular model by LV or LV-TR1 transfection.Results We confirmed that interleukin-7 mRNA levels increased in MPP^(+)compared to that in the control and MPP^(+)-TR1 groups using quantitative polymerase chain reaction.Theγ-H_(2)AX level was increased in the Tg-A53T group compared to that in the TR1-A53T group by western blotting.The expression of Na^(+)-K^(+)-ATP was decreased in the MPP^(+)group compared to that in the control and MPP^(+)-TR1 groups by high content screening.Tg-A53T(the C57BL/6 mice transferred with mutant human a-syn);TR1-A53T(A53T mice which were injected TR1-LV 2µl in SNc on two sides with minipump).The mice were fed for 10 months.control(the N2a cells cultivated with DMEM);MPP^(+)(the N2a cells dealt with MPP^(+)(1 mM)48 h),MPP^(+)-LV(the N2a cells over-expressed LV for 24 h then dealt with MPP^(+)(1 mM)48 h).MPP^(+)-TR1(the N2a cell over-expressed TR1-LV for 24 h then dealt with MPP^(+)(1 mM)48 h).From the Kyoto Encyclopedia of Genes and Genomes(KEGG)analysis,we confirmed that the overexpression of TR1 in SN pars compacta cells decreased oxidative stress,apoptosis,DNA damage,and inflammatory response and increased NADPH,Na^(+)-K^(+)-ATP,and immune response in this PD model.Conclusions Our study shows that overexpressed TR1 can be developed as a neuroprotective agent for PD.Therefore,our findings demonstrate a new targeted protein for the treatment of PD.展开更多
基金Guizhou Provincial Science and Technology Department,Technology Achievement Application and Industrialization Plan,Applied Fundamental Research,No.Qianke Synthetic Fruit[2022]004.
文摘BACKGROUND Accurate condition assessment is critical for improving the prognosis of neonatal respiratory distress syndrome(RDS),but current assessment methods for RDS pose a cumulative risk of harm to neonates.Thus,a less harmful method for assessing the health of neonates with RDS is needed.AIM To analyze the relationships between pulmonary ultrasonography and respiratory distress scores,oxygenation index,and chest X-ray grade of neonatal RDS to identify predictors of neonatal RDS severity.METHODS This retrospective study analyzed the medical information of 73 neonates with RDS admitted to the neonatal intensive care unit of Liupanshui Maternal and Child Care Service Center between April and December 2022.The pulmonary ultrasonography score,respiratory distress score,oxygenation index,and chest Xray grade of each newborn before and after treatment were collected.Spearman correlation analysis was performed to determine the relationships among these values and neonatal RDS severity.RESULTS The pulmonary ultrasonography score,respiratory distress score,oxygenation index,and chest X-ray RDS grade of the neonates were significantly lower after treatment than before treatment(P<0.05).Spearman correlation analysis showed that before and after treatment,the pulmonary ultrasonography score of neonates with RDS was positively correlated with the respiratory distress score,oxygenation index,and chest X-ray grade(ρ=0.429–0.859,P<0.05).Receiver operating characteristic curve analysis indicated that pulmonary ultrasonography screening effectively predicted the severity of neonatal RDS(area under the curve=0.805–1.000,P<0.05).CONCLUSION The pulmonary ultrasonography score was significantly associated with the neonatal RDS score,oxygenation index,and chest X-ray grade.The pulmonary ultrasonography score was an effective predictor of neonatal RDS severity.
文摘Fulminant myocarditis(FM)is an uncommon syndrome characterized by sudden and severe hemodynamic compromise secondary to acute myocardial inflammation,often presenting as profound cardiogenic shock,life-threatening ventricular arrhythmias and/or electrical storm.FM may be refractory to conventional therapies and require mechanical circulatory support(MCS).The immune system has been recognized as playing a pivotal role in the pathophysiology of myocarditis,leading to an increased focus on immunosuppressive treatment strategies.Recent data have highlighted not only the fact that FM has significantly worse outcomes than non-FM,but that prognosis and management strategies of FM are heavily dependent on histological subtype,placing greater emphasis on the role of endomyocardial biopsy in diagnosis.The impact of subtype on severity and prognosis will likewise influence how aggressively the myocarditis is managed,including whether MCS is warranted.Many patients with refractory cardiogenic shock secondary to FM end up requiring MCS,with venoarterial extracorporeal membrane oxygenation demonstrating favorable survival rates,particularly when initiated prior to the development of multiorgan failure.Among the challenges facing the field are the need to more precisely identify immunopathophysiological pathways in order to develop targeted therapies,and the need to better optimize the timing and management of MCS to minimize complications and maximize outcomes.
基金supported by the National Natural Science Foundation of China,No.81170577
文摘Regenerative capacity is weak after central nervous system injury because of the absence of an enhancing microenvironment and presence of an inhibitory microenvironment for neuronal and axonal repair. In addition to the Nogo receptor（Ng R）, the paired immunoglobulin-like receptor B（Pir B） is a recently discovered coreceptor of Nogo, myelin-associated glycoprotein, and myelin oligodendrocyte glycoprotein. Concurrent blocking of Ng R and Pir B almost completely eliminates the inhibitory effect of myelin-associated inhibitory molecules on axonal regeneration. Pir B participates in a key pathological process of the nervous system, specifically axonal regeneration inhibition. Pir B is an inhibitory receptor similar to Ng R, but their effects are not identical. This study summarizes the structure, distribution, relationship with common nervous system diseases, and known mechanisms of Pir B, and concludes that Pir B is also distributed in cells of the immune and hematopoietic systems. Further investigations are needed to determine if immunomodulation and blood cell migration involve inhibition of axonal regeneration.
基金The National Natural Science Foundation of China(Grant No.81660130)the Natural Science Foundation of Gansu Province,China(Grant No.18JR3RA045).
文摘The Chinese medicine Extractum trametes robiniophila murr(ETRM)is the extract of a type of fungus.Recent studies have suggested that ETRM efficiently improves the effacement of podocyte foot processes in adriamycin(ADR)-induced nephrotic rats.In the present study,we aimed to assess whether ETRM modulated the actin rearrangements of podocytes and involved signaling molecules,includingα-actinin-4 and nephrin.Podocytes were treated with ADR(0.5μmol/L),ADR(0.5μmol/L)+dexamethasone(Dex)(1μmol/L),ADR(0.5μmol/L)+ETRM(10 mg/mL).The F-actin in the podocytes was stained by fluorescent phallotoxins and observed by confocal microscopy.The expression levels ofα-actinin-4 and nephrin were tested by real-time PCR and Western blotting analysis.The administration of ETRM could significantly prevent ADR-treated podocytes from actin rearrangement.Both ETRM and Dex could stabilize podocyte actin cytoskeletons.Moreover,α-actinin-4 might act as a potential target for ETRM functionality in podocyte actin rearrangements.However,pretreatment with ETRM could not inhibit the up-regulation of nephrin as a result of ADR treatment.ETRM could improve the cytoskeleton stability in ADR-induced actin rearrangement of podocytes via regulatingα-actinin-4 expression.
文摘Background Pregnant women with heart disease are at high risk. Studies of risk factors of these patients are of great significance to improve maternal and fetal outcomes. In this paper, we try to discuss the main risk factors of cardiac events in pregnant women with heart disease and to establish a risk assessment system. Methods A retrospective analysis was carried out for pregnancies in 1741 women with heart disease who delivered in Shanghai Obstetrical Cardiology Intensive Care Center between January 1993 and September 2010. A Logistic regression model was used to identify independent risk factors of cardiac events and calculate the risk index in pregnant women with heart disease. Results The composition of heart disease in pregnant women was arrhythmia （n=662, 38.00%）, congenital heart disease （CHD; n=529, 30.40%）, cardiomyopathy （n=327, 18.80%）, rheumatic heart disease （RHD; n=151, 8.70%）, and cardiopathy induced by pre-eclampsia （n=53, 3.00%）. Main cardiac events were heart failure （n=110, 6.32%）, symptomatic arrhythmia needing medication （n=43, 2.47%）, cardiac arrest （n=2, 0.11%）, syncope （n=3, 0.17%）, and maternal death （n=10, 0.57%）. Six independent risk factors to predict cardiac events in pregnant women with heart disease were cardiac events before pregnancy （heart failure, severe arrhythmia, cardiac shock, etc., P=0.000）, New York Heart Association （NYHA） class 〉11 （m=0.000）, oxygen saturation 〈90% （P=0.018）, pulmonary artery hypertention （PAH） 〉50 mmHg （P=0.025）, cyanotic heart disease without surgical correction （P=-0.015）, and reduced left ventricular systolic function （ejection fraction 〈40%, P=0.003）. Every risk factor was calculated as 1 score. The incidence of cardiac events in patients with scores 0, 1, 2, 3, and 〉4 was 2.10%, 31.61 %, 61.25%, 68.97%, and 100.00% respectively. Conclusions Pregnancy with heart disease could lead to undesirable pregnancy outcomes. The risk of cardiac events in pregnant women with heart disease could be assessed by risk index.
基金supported by the National Natural Science Foundation of China[grant number 81400626]the National Natural Science Foundation for innovation group[grant number 81721002].
文摘Granulocyte colony-stimulating factor(GM-CSF),produced by CD4^(+)T cells,has recently been implicated in the pathogenesis of inflammatory diseases,such as multiple sclerosis and juvenile arthritis.However,the role of GM-CSF-producing CD4^(+)T cells in sepsis remains unknown.This study reports peripheral changes in GM-CSF-producing CD4^(+)T cells in septic patients and the possible underlying mechanism by which GM-CSF influences the outcome of sepsis.Forty-three septic patients,20 SIRS patients,and 20 healthy controls were enrolled in this study and followed for 28 days to assess mortality.We measured the peripheral frequency of GM-CSF^(+)CD4^(+)T cells and recorded their associated relationship with disease progression.Our data demonstrated that peripheral GM-CSF-producing CD4^(+)T cells were significantly higher in septic patients than in both SIRS patients and healthy controls.These cells exhibit a memory phenotype and impaired IFN-γ-secreting capacity in sepsis patients.Using a receiver operating curve analysis with 8.01%as a cut-off point,the percentage of GM-CSF^(+)CD4^(+)T cells could predict the outcome of septic patients.Combined with the increase in GM-CSF-producing CD4^(+)T cells,inflammatory cytokines IL-1βand IL-6 were also upregulated.Using an in vitro neutrophil model,we found that GM-CSF inhibited C3aR expression,while inducing IL-8 production.Furthermore,this effect was transferrable in plasma from sepsis patients and was attenuated by inhibition of GM-CSF using an anti-GM-CSF antibody.These results indicate that GM-CSF-producing CD4^(+)T cells may serve as a marker of sepsis severity.Thus,targeting GM-CSF overproduction may benefit sepsis patients.
文摘Background As the Shanghai Obstetrical Cardiology Intensive Care Center, our hospital has accumulated a large number of clinical data of pregnant women with heart disease. This paper is a retrospective analysis of 1142 pregnancies in women with heart disease so as to evaluate the maternal and fetal outcomes of these patients.Methods A retrospective analysis was carried out for pregnancies in 1142 women with heart disease who delivered in Shanghai Obstetrical Cardiology Intensive Care Center between 1993 and 2007.Results In this study, main heart diseases in pregnancy were arrhythmia （n=359, 31.4%）, congenital heart disease （CHD; n=291,25.5%）, and myocarditis and its sequelae （n=284, 24.9%）; based on the functional classification criteria of New York Heart Association （NYHA）, more than half （n=678, 59.4%） of patients were classified NYHA Class Ⅰ; pregnant women in NHYA Class Ⅰ-Ⅱ （n=951, 83.3%） commonly had arrhythmia, myocarditis and its sequelae, while those in NHYA Class Ⅲ-Ⅳ （n=191, 16.7%） mainly had CHD, rheumatic heart disease （RHD）, cardiopathy induced by hypertensive disorders complicating pregnancy, and peripartum cardiomyopathy （PPCM）. Cardiac failure occurred in 97 （8.5%）patients, and 8 （0.7%） maternal deaths and 12 （1.1%） perinatal deaths were reported in this study. Compared with those in NHYA Class Ⅰ-Ⅱ, women in NHYA Class Ⅲ-Ⅳ had a significantly lower gestational age at birth （P 〈0.05）, lower birth weight （P 〈0.01）, and higher incidence of preterm delivery, small for gestational age and perinatal death （P 〈0.01）. The incidence of cardiac failure in pregnant women with cardiopathy induced by hypertensive disorders complicating pregnancy and PPCM was relatively high, with a rate of 80% and 52.2%, respectively. After cardiac operation, 131（90.3%） women were in classified NHYA Class Ⅰ-Ⅱ and 14 （9.7%） in NHYA Class Ⅲ-Ⅳ.Conclusions Arrhythmia is the type of heart disease that has a highest incidence in patients with heart disease in pregnancy, while main types of heart disease that impair cardiac function are CHD and RHD; cardiac failure is more frequently caused by cardiopathy induced by hypertensive disorders complicating pregnancy and PPCM; impaired cardiac function increases perinatal morbidity; cardiac surgery before pregnancy could improve the cardiac function.
基金This study was supported by grants from the National Natural Science Foundation of China(Grant Numbers:82172152,81873944,82241044,81971869,82172154).
文摘Introduction For critically ill patients with unstable hemodynamics,goal‑directed therapy for arterial blood pressure is needed with continuous daily bedside monitoring.The prevalence of hypertension in Chinese adults is 25.2%,of which 1–2%of patients may experience a hypertensive emergency,with a mortality rate of 6.9%in the acute phase.The mortality and readmission rates within 90 days of onset are as high as 11%.[1]Furthermore,the mortality rate for patients who experience hypertensive emergencies can reach 50%within 12 months of the incident.[2]The incidence of perioperative hypertension in patients undergoing cardiac surgery is approximately 50%,with this figure dropping to 25%for non-cardiac surgery.Surgery may increase the incidence of perioperative cardio-cerebrovascular adverse events by 3–5%.[3]
基金supported by the Cuiying Science and technology Innovation Project(CY2021-MS-B07)Cuiying studentsp scientific research and cultivation program(CYXZ2020-34)Natural Science Foundation of Gansu Province(22JR5RA987)
文摘Background Parkinson’s disease(PD)is the second most common neurodegenerative disease.The pathologic characteristic feature is the loss of dopaminergic neurons in the substantia nigra(SN).However,the biochemical mechanisms are unclear.A large number of studies have shown that oxidative damage is the primary cause of PD.Hence,antioxidants could become a suitable option to treat PD.The thioredoxin(Trx)system represents a useful,potentially disease-relevant oxidation-reduction system.Thioredoxin reductase 1(TR1)is a significant component of the Trx system.Methods The overexpression lentivirus(LV)or LV-TR1 in the TR1-A53T model of PD by the stereotactic brain,and successful overexpression of LV or LV-TR1 in the MPP^(+)-induced cellular model by LV or LV-TR1 transfection.Results We confirmed that interleukin-7 mRNA levels increased in MPP^(+)compared to that in the control and MPP^(+)-TR1 groups using quantitative polymerase chain reaction.Theγ-H_(2)AX level was increased in the Tg-A53T group compared to that in the TR1-A53T group by western blotting.The expression of Na^(+)-K^(+)-ATP was decreased in the MPP^(+)group compared to that in the control and MPP^(+)-TR1 groups by high content screening.Tg-A53T(the C57BL/6 mice transferred with mutant human a-syn);TR1-A53T(A53T mice which were injected TR1-LV 2µl in SNc on two sides with minipump).The mice were fed for 10 months.control(the N2a cells cultivated with DMEM);MPP^(+)(the N2a cells dealt with MPP^(+)(1 mM)48 h),MPP^(+)-LV(the N2a cells over-expressed LV for 24 h then dealt with MPP^(+)(1 mM)48 h).MPP^(+)-TR1(the N2a cell over-expressed TR1-LV for 24 h then dealt with MPP^(+)(1 mM)48 h).From the Kyoto Encyclopedia of Genes and Genomes(KEGG)analysis,we confirmed that the overexpression of TR1 in SN pars compacta cells decreased oxidative stress,apoptosis,DNA damage,and inflammatory response and increased NADPH,Na^(+)-K^(+)-ATP,and immune response in this PD model.Conclusions Our study shows that overexpressed TR1 can be developed as a neuroprotective agent for PD.Therefore,our findings demonstrate a new targeted protein for the treatment of PD.
