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Chen Y, Chen Y, Lin W, Fu L, Liu H, Pu S, Chen H, Yi H, Xue Y. Impact of hyperuricemia and chronic kidney disease on the prevalence and mortality of cardiovascular disease in cancer survivors. Cancer Med 2024; 13:e7180. [PMID: 38686569 PMCID: PMC11058684 DOI: 10.1002/cam4.7180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/30/2023] [Accepted: 01/12/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND The risks of cardiovascular disease (CVD) and CVD mortality are prevalent among cancer survivors (CS) population. The 2022 ESC Guidelines on cardio-oncology have recommended that modifying cardiovascular risk factors (CVRF) could potentially improve long-term outcomes in CS. OBJECTIVES To identify the independent and joint chronic kidney disease (CKD) associations of hyperuricemia with the incidence of CVD and mortality outcomes among CS. METHODS Utilizing data from the US National Health and Nutrition Examination Survey spanning 2005-2018, we assessed the risk of CVD through weighted multivariable logistic regression and restricted cubic spline (RCS) regression. Additionally, all-cause and CVD-related mortality were evaluated using weighted multivariable Cox regression and Kaplan-Meier analysis. Subgroup analysis was conducted to further elucidate the interplay between hyperuricemia, CKD, and mortality within the CS population. RESULTS A total of 3276 CS participants were enrolled in this study. Results showed that hyperuricemia was positively related to the incidence of CVD (OR [95% CI] = 1.86 [1.24, 2.81], p = 0.004). RCS analysis further demonstrated that uric acid levels ≥345 μmol/L positively correlated with CVD incidence (p value for nonlinearity = 0.0013). However, the association between hyperuricemia and CVD mortality, as well as all-cause mortality did not reach statistical significance in the fully adjusted model (HR = 1.48, 95% CI: 0.92-2.39, p = 0.11; HR = 1.11, 95% CI:0.92, 1.34, p = 0.28, respectively). Among CS participants with CKD, hyperuricemia could increase risks of all-cause (HR [95% CI] = 1.39 [1.08, 1.11], p = 0.02) and CVD mortality (HR [95% CI] =2.17 [1.29, 3.66], p = 0.004) after adjusting for sex, age, and ethnicity. CONCLUSIONS In the CS population, hyperuricemia was positively associated with the incidence of CVD. In addition, CKD might be an intermediate variable among the CS population that mediated the effects of hyperuricemia on mortality.
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Affiliation(s)
- Yanlin Chen
- Department of Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhouChina
| | - Yuhan Chen
- Department of Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhouChina
| | - Weidong Lin
- Department of Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhouChina
| | - Lu Fu
- Department of Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhouChina
| | - Huiyi Liu
- Department of Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhouChina
| | - Sijia Pu
- School of MedicineSouth China University of TechnologyGuangzhouChina
| | - Haowei Chen
- The Second School of Clinical MedicineSouthern Medical UniversityGuangzhouChina
| | - Hong Yi
- Department of Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhouChina
| | - Yumei Xue
- Department of Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhouChina
- School of MedicineSouth China University of TechnologyGuangzhouChina
- The Second School of Clinical MedicineSouthern Medical UniversityGuangzhouChina
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Wei HQ, Liu F, Xue Y, Wu S, Zhan X. A case report of entrapment of PentaRay catheter in the mechanical mitral valve: a known complication experienced anew. Eur Heart J Case Rep 2024; 8:ytae194. [PMID: 38707525 PMCID: PMC11065343 DOI: 10.1093/ehjcr/ytae194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 04/09/2024] [Accepted: 04/12/2024] [Indexed: 05/07/2024]
Abstract
Background Complex atrial tachycardia (AT) is commonly observed in patients with cardiac surgery. High-density mapping is widely adopted for catheter ablation of complex AT in patients with cardiac surgery. Several case reports have described that PentaRay mapping catheter can be trapped in the mechanical valve and sheared off and successful retrieval of the spline by a snare system. We described a rare case in which PentaRay mapping catheter spline was successfully retrieved from the distal anterior tibial artery by direct syringe suction via the diagnostic catheter following entrapment in the mechanical mitral valve (MV) and rupture of the spline. Case summary A 70-year-old female with mechanical bileaflet MV underwent catheter ablation for AT. During mapping in left atrium, the catheter was entrapped in mechanical MV and sheared off. We attempted to release the entrapped the spline by advancing the ablation catheter towards the stuck disc and pushing on the hinge portion of the disc with the catheter tip. The stuck and closed disc was opened, and the deeply entrapped spline was released. However, the entrapped PentaRay spline floated through the Valsalva sinus and strayed into the distal left anterior tibial artery. Fortunately, we successfully retrieved the spline from the distal anterior tibial artery by direct syringe suction instead of a snare system. Discussion The possibility of the entrapment and subsequent rupture of the spline should always be considered during mapping the site close to mechanical valve. A rapid retrieval of embolized material should be carried out. If the spline strays into the distal and small artery in which the snare system is difficult to advance, a direct syringe suction via the diagnostic catheter may be attempted.
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Affiliation(s)
- Hui-Qiang Wei
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106 Zhongshan 2nd Road, Yuexiu District, 510000 Guangzhou, China
| | - Fangzhou Liu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106 Zhongshan 2nd Road, Yuexiu District, 510000 Guangzhou, China
| | - Yumei Xue
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106 Zhongshan 2nd Road, Yuexiu District, 510000 Guangzhou, China
| | - Shulin Wu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106 Zhongshan 2nd Road, Yuexiu District, 510000 Guangzhou, China
| | - Xianzhang Zhan
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106 Zhongshan 2nd Road, Yuexiu District, 510000 Guangzhou, China
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Luo X, Xue C, Chen J, Xue Y, Feng SM. [Comparison of the clinical efficacy of all-inside arthroscopic lateral ligament augmentation procedure and Broström procedure for the treatment of chronic lateral rotational ankle instability]. Zhonghua Wai Ke Za Zhi 2024; 62:581-590. [PMID: 38682630 DOI: 10.3760/cma.j.cn112139-20240105-00009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
Objective: To compare the clinical efficacy of patients with chronic lateral rotational ankle instability(CLRAI) after all-inside arthroscopic lateral ligament augmentation procedure and Broström procedure. Methods: This is a retrospective cohort study. The clinical and imaging data of 106 CLRAI patients were collected at the Xuzhou Central Hospital from January 2021 to December 2022. The patients included 55 males and 51 females with an age of (32.6±8.2) years (range: 16 to 50 years). All patients were treated under all-inside arthroscopic, and were divided into Broström-Gould surgery group (n=54) and Broström surgery group (n=52) according to different ligament repair methods. At 3, 6, and 12 months after surgery, ankle inversion stress tests and anterior drawer tests were used to examine the stability of the ankle joint and observe gait. The American Orthopedic Foot and Ankle Society ankle hindfoot scale (AOFAS-AH) and Karlsson ankle function score (KAFS) were used to assess ankle function; Tegner score was used to assess the patient's level of exercise; the foot and ankle outcome score(FAOS)(including score of symptoms,pain,function, daily living,function, sports and recreational activities (sport); quality of life (QOL)) was used to assess the patient's daily activity ability. Comparisons of data were made using independent sample t test, repeated measures analysis of variance, LSD multiple comparison method, χ2 test or Mann-Whitney U test. Results: All operations were successfully accomplished. All incisions healed by first intention, without evidence of postoperative complications of implant rejection, ligation reaction, and nerve and vessel injury. All patients were followed up at 3, 6, and 12 months after surgery. Ankle varus stress test and anterior drawer test were negative. No evidence supporting lateral ankle instability was obtained. All patients eventually regained normal gait. No patients underwent revision surgery. Repeated measurement analysis of variance showed that AOFAS-AH, Tegner, KAFS and FAOS scores in the Brostrom-Gould group and the Brostrom group were significantly higher than those before surgery (P<0.01). The change trends of Tegner score and FAOS-sport score were significantly different between the two groups (F=18.839, P<0.01; F=8.169, P=0.005). Multiple comparisons revealed that at 3-, 6-and 12-month follow-up, the Tegner scores ((3 months: 3.7±0.5 vs. 3.3±0.5, t=-3.980, P<0.01; 6 months: 4.4±0.6 vs. 3.8±0.7, t=-4.792,P<0.01;12 months: 5.8±0.9 vs. 5.1±1.0, t=-3.889,P<0.01)), sport scores ((3 months: 82.5±3.7 vs. 79.3±3.8, LSD-t=-4.316, P<0.01; 6 months: 88.5±4.9 vs. 85.7±3.8, LSD-t=-3.312,P=0.001;12 months: 90.1±4.3 vs. 88.2±5.1, LSD-t=-2.112,P=0.037)) in the Broström-Gould surgery group were higher than those in the Broström surgery group, with statistical significances. Conclusions: Both Broström-Gould and Broström procedures under all-inside arthroscopic can make ankle stability and improve ankle function in the treatment of CLRAI. However, the former maybe shorten the time to return to exercise and achieve higher motor function.
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Affiliation(s)
- X Luo
- Department of Orthopedics, the Xuzhou Clinical College of Xuzhou Medical University,Xuzhou Central Hospital, Xuzhou 221009, China
| | - C Xue
- Department of Orthopedics, the Xuzhou Clinical College of Xuzhou Medical University,Xuzhou Central Hospital, Xuzhou 221009, China
| | - J Chen
- Department of Orthopedics, the Xuzhou Clinical College of Xuzhou Medical University,Xuzhou Central Hospital, Xuzhou 221009, China
| | - Y Xue
- Department of Orthopedics, the Xuzhou Clinical College of Xuzhou Medical University,Xuzhou Central Hospital, Xuzhou 221009, China
| | - S M Feng
- Department of Orthopedics, the Xuzhou Clinical College of Xuzhou Medical University,Xuzhou Central Hospital, Xuzhou 221009, China
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Wang YM, Xue Y, Zhao JH, Pan J, Zou DH, Cui NH, Zhang W, Wang QZ, Li ZZ, Zhou YQ, Hu KJ. [Strolling through the glorious years of Alveolar Surgery, bravely stepping onto the path of practice and innovation]. Zhonghua Kou Qiang Yi Xue Za Zhi 2024; 59:301-311. [PMID: 38548586 DOI: 10.3760/cma.j.cn112144-20231221-00301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
This article summarizes and organizes relevant publications in journals, along with a review of medical history, systematically summarizing the development process of dental alveolar surgery in China. The initial establishment phase (1935-1952) marked the starting point of Chinese Alveolar Surgery. Despite the impact of wars, it laid the foundation for subsequent research and practice. During the early development phase (1953-1966), the "Chinese Journal of Stomatology" was founded, which promoted the development of Alveolar Surgery. Research focused on tooth extraction methods and complications. Tooth Transplantation and Preprosthetic Surgery gradually began to take off. The stagnant phase (1967-1977) occurred due to the interruption of international exchanges, leading to an almost complete halt in the development of Alveolar Surgery. Entering the rapid catch-up phase (1978-1985), Alveolar Surgery scholars in China began striving to overcome the stagnation of the previous decade. While some progress was made, no significant innovative achievements emerged. In the scientific development phase (1986-2010), clinical research, basic experiments, and paper writing in modern Chinese Alveolar Surgery began to adhere to scientific standards with the rise of experimental medicine. The exploration and innovation stage (2011-2023) is the current development phase, during which Chinese Aveolar Surgery has reached its peak, making substantial progress in technology, clinical practices, and basic research, gradually reaching or even surpassing international advanced levels. Looking back at the development history in China, we can find the wisdom and hard work of the older generation of Alveolar Surgery scholars. However, contemporary challenges and issues, such as standardizing technology, promoting clinical practices, and talent cultivation, need to be addressed by present-day Alveolar Surgery professionals as they forge ahead.
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Affiliation(s)
- Y M Wang
- Department of Oral Surgery, School of Stomatology, The Fourth Military Medical University, State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseas, Xi'an 710032, China
| | - Y Xue
- Department of Oral Surgery, School of Stomatology, The Fourth Military Medical University, State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseas, Xi'an 710032, China
| | - J H Zhao
- Department of Oral Surgery, State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - J Pan
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University & State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Chengdu 610041, China
| | - D H Zou
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine & College of Stomatology, Shanghai Jiao Tong University & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai 200011, China
| | - N H Cui
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - W Zhang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - Q Z Wang
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University & State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Chengdu 610041, China
| | - Z Z Li
- Department of Oral Surgery, State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Y Q Zhou
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine & College of Stomatology, Shanghai Jiao Tong University & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai 200011, China
| | - K J Hu
- Xi'an Medcial University, School of Stomatology, The Third Affiliated Hospital, Xi'an 710065, China
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Lee S, Xue Y, Petricca J, Kremic L, Xiao MZX, Pivetta B, Ladha KS, Wijeysundera DN, Diep C. The impact of pre-operative depression on pain outcomes after major surgery: a systematic review and meta-analysis. Anaesthesia 2024; 79:423-434. [PMID: 38050423 DOI: 10.1111/anae.16188] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2023] [Indexed: 12/06/2023]
Abstract
Symptoms of depression are common among patients before surgery. Depression may be associated with worse postoperative pain and other pain-related outcomes. This review aimed to characterise the impact of pre-operative depression on postoperative pain outcomes. We conducted a systematic review of observational studies that reported an association between pre-operative depression and pain outcomes after major surgery. Multilevel random effects meta-analyses were conducted to pool standardised mean differences and 95%CI for postoperative pain scores in patients with depression compared with those without depression, at different time intervals. A meta-analysis was performed for studies reporting change in pain scores from the pre-operative period to any time-point after surgery. Sixty studies (n = 501,962) were included in the overall review, of which 18 were eligible for meta-analysis. Pre-operative depression was associated with greater pain scores at < 72 h (standardised mean difference 0.97 (95%CI 0.37-1.56), p = 0.009, I2 = 41%; moderate certainty) and > 6 months (standardised mean difference 0.45 (95%CI 0.23-0.68), p < 0.001, I2 = 78%; low certainty) after surgery, but not at 3-6 months after surgery (standardised mean difference 0.54 (95%CI -0.06-1.15), p = 0.07, I2 = 83%; very low certainty). The change in pain scores from pre-operative baseline to 1-2 years after surgery was similar between patients with and without pre-operative depression (standardised mean difference 0.13 (95%CI -0.06-0.32), p = 0.15, I2 = 54%; very low certainty). Overall, pre-existing depression before surgery was associated with worse pain severity postoperatively. Our findings highlight the importance of incorporating psychological care into current postoperative pain management approaches in patients with depression.
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Affiliation(s)
- S Lee
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Y Xue
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - J Petricca
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - L Kremic
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - M Z X Xiao
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Canada
| | - B Pivetta
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Canada
| | - K S Ladha
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Canada
- Department of Anesthesia, St Michael's Hospital, Toronto, Canada
| | - D N Wijeysundera
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Canada
- Department of Anesthesia, St Michael's Hospital, Toronto, Canada
| | - C Diep
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Canada
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Dong YT, Guan J, Yang BY, Yierfulati G, Xue Y, Chen XJ. [The long-term efficacy of metformin in megestrol acetate-based fertility-sparing treatment for patients with endometrial atypical hyperplasia and endometrioid endometrial cancer]. Zhonghua Yi Xue Za Zhi 2024; 104:729-735. [PMID: 38462352 DOI: 10.3760/cma.j.cn112137-20231016-00768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Objective: To assess the long-term efficacy of metformin in megestrol acetate (MA)-based fertility-sparing treatment for patients with endometrial atypical hyperplasia (EAH) and endometrioid endometrial cancer (EEC). Methods: The randomized controlled trail study was conducted from October 2013 to October 2017 in the Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China. Patients with EAH or EEC were firstly stratified according to pathology, and randomized to receive MA (160 mg orally, daily) plus metformin (500 mg orally, three times a day) or MA (160 mg orally, daily). Baseline data between two groups of patients were compared. Estimates of time to complete remission (CR) and recurrence-free survival (RFS) were calculated using the Kaplan-Meier method. Cox proportional-hazards regression model was used to estimate hazard ratios (HR) of related factors for recurrence-free survival. Quantitative data were represented by M (Q1, Q3). Results: A total of 150 patients were included, and 76 patients were allocated to receive MA plus metformin with the age of 32.5 (28.0, 36.0), while 74 patients received MA alone with the age of 32.0 (28.0, 36.0). By the end of follow-up period, 96.7% (n=145) of patients achieved complete remission, with a median follow-up time of 57.7 (26.7, 70.5) months. The median CR time for the MA plus metformin group and the MA alone group were 6.3 (3.5, 8.3) months and 6.8 (4.0, 9.3) months, respectively (P=0.193), with 2-year cumulative CR rate of 98.6% and 98.5%, respectively (P=0.879). The median time of RFS was 28.1 (12.5, 57.3) months for the MA plus metformin group and 33.3 (14.1, 62.5) months for the MA alone group (P=0.213), with a cumulative RFS rate of 61.9% and 65.8%, respectively (P=0.560). In the subgroup of non-obese (body mass index<28 kg/m2) patients with EAH, the median RFS times were 25.7 (7.6, 60.3) months and 47.3 (17.5, 64.8) months for the MA plus metformin group and the MA alone group, respectively (P=0.033), with a cumulative RFS rate of 57.5% and 80.6%, respectively (P=0.029). According to Cox proportional hazards regression analysis, undergoing assisted reproductive treatment (HR=2.358, 95%CI: 1.069-5.204, P=0.034) was identified as an independent risk factor for recurrence-free survival after complete remission of endometrial lesions. Conclusion: The long-term follow-up outcome indicates that there is no significant difference in CR time and RFS time between MA plus metformin therapy and MA alone therapy for patients with EAH or EEC.
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Affiliation(s)
- Y T Dong
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200092, China
| | - J Guan
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200092, China
| | - B Y Yang
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200092, China
| | - Gulinazi Yierfulati
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200092, China
| | - Y Xue
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200092, China
| | - X J Chen
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200092, China
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Chen X, Luo G, Li H, Zheng J, Zhang Q, Liao H, Zhan X, Wei W, Liang Y, Deng H, Fang X, Wu S, Xue Y, Liu Y. High prevalence and distinctive clinical features of LMNA-associated atrioventricular block in young patients. Am Heart J 2024; 269:8-14. [PMID: 38048861 DOI: 10.1016/j.ahj.2023.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/21/2023] [Accepted: 11/24/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND AND AIMS Atrioventricular block (AVB) is a degenerative disease and more commonly encountered in elderly patients, but unusual and often of unknown etiology in young patients. This study aimed to investigate the potential contributions of genetic variations to AVB of unknown reasons in young patients. METHODS We enrolled 41 patients aged <55 years with high-degree AVB of unknown etiology whose clinical and genetic data were collected. RESULTS Genetic variants were identified in 20 (20/41, 48.8%) patients, 11 (11/20, 55%) of whom had LMNA variants including 3 pathogenic (c.961C > T, c.936+1G > T and c.646C > T), 4 likely pathogenic (c.1489-1G > C, c.265C > A, c.1609-2A > G and c.1129C > T) and 3 of uncertain significance (c.1158-3C > G, c.776A > G and c.674G > T). Compared to those without LMNA variants, patients with LMNA variants demonstrated a later age at onset of AVB (41.45 ± 9.89 years vs 32.93 ± 12.07 years, P = .043), had more prevalent family history of cardiac events (81.8% vs 16.7%, P < .000), suffered more frequently atrial (81.8% vs 10.0%, P < .000) and ventricular (72.7% vs 10.0%, P < .000) arrhythmias, and were more significantly associated with enlargement of left atrium (39.91 ± 7.83 mm vs 34.30 ± 7.54 mm, P = .043) and left ventricle (53.27 ± 8.53 mm vs 47.77 ± 6.66 mm, P = .036). CONCLUSIONS Our findings provide insights into the genetic etiology of AVB in young patients. LMNA variants are predominant in genotype positive patients and relevant to distinctive phenotypic properties.
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Affiliation(s)
- Xin Chen
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Guanhao Luo
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Hezhi Li
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Jianhong Zheng
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Qianhuan Zhang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Hongtao Liao
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xianzhang Zhan
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Wei Wei
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yuanhong Liang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Hai Deng
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xianhong Fang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Shulin Wu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yumei Xue
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yang Liu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
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Pu S, Liu H, Deng H, Xue Y, Lin W. A case report of right bundle branch block and junctional beats during ablation at the right ventricle outflow tract: metallic occluder's unanticipated effect. Eur Heart J Case Rep 2024; 8:ytae054. [PMID: 38362062 PMCID: PMC10868540 DOI: 10.1093/ehjcr/ytae054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 01/22/2024] [Accepted: 01/24/2024] [Indexed: 02/17/2024]
Abstract
Background Previously, ablation at the outflow tract was considered to be safe and rarely affected the His-Purkinje system due to their spatial distance. However, we have reported a case of right bundle branch block (RBBB) and junctional beats that were recorded during radiofrequency catheter ablation in a patient who had a history of peri-membranous ventricular septal defect (pmVSD) closure and the implantation of a metallic occluder. Case summary A 16-year-old girl with a metallic occluder for peri-membranous ventricular septum defect underwent an ablation procedure for premature ventricular complexes. During the ablation at the right ventricular outflow tract (RVOT), RBBB and junctional beats were recorded. His bundle potentials and the high-frequency potential generated by electrical interference were observed when mapping the margin of the occluder. To ensure safety, we attempted ablation at the right coronary cusp in the left ventricular outflow tract, which eventually proved to be successful, presenting an alternative ablation strategy. Conclusion This is a rare report of RBBB and junctional beats observed during ablation at RVOT in a patient with pmVSD and a metallic occluder. The observed damage to the His-Purkinje system may be attributed to uncontrolled radiofrequency energy heating up caused by the metallic device. This case emphasizes the importance of thorough electroanatomic and activation mapping prior to starting the ablation procedure, especially in complicated cases. Furthermore, it suggests that ablation at a relatively remote position is both feasible and relatively safe for patients with occluder devices.
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Affiliation(s)
- Sijia Pu
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Rd, Guangzhou 510080, China
- School of Medicine, South China University of Technology, Guangzhou 510006, China
| | - Huiyi Liu
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Rd, Guangzhou 510080, China
| | - Hai Deng
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Rd, Guangzhou 510080, China
| | - Yumei Xue
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Rd, Guangzhou 510080, China
- School of Medicine, South China University of Technology, Guangzhou 510006, China
| | - Weidong Lin
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Rd, Guangzhou 510080, China
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9
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Yu S, Zeng L, Rao F, Deng C, Zhang M, Xiao H, Xiao F, Xue Y, Wu S, Du Z, Wei W. High hydrostatic pressure participates in atrial fibrosis through the p300/p53/Smad3 pathway. FASEB J 2024; 38:e23324. [PMID: 38019188 DOI: 10.1096/fj.202300473rr] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 10/01/2023] [Accepted: 11/07/2023] [Indexed: 11/30/2023]
Abstract
As an independent risk factor of atrial fibrillation (AF), hypertension (HTN) can induce atrial fibrosis through cyclic stretch and hydrostatic pressure. The mechanism by which high hydrostatic pressure promotes atrial fibrosis is unclear yet. p300 and p53/Smad3 play important roles in the process of atrial fibrosis. This study investigated whether high hydrostatic pressure promotes atrial fibrosis by activating the p300/p53/Smad3 pathway. Biochemical experiments were used to study the expression of p300/p53/Smad3 pathway in left atrial appendage (LAA) tissues of patients with sinus rhythm (SR), AF, AF + HTN, and C57/BL6 mice, hypertensive C57/BL6 mice and atrial fibroblasts of mice. To investigate the roles of p300 and p53 in the process of atrial fibrosis, p300 and p53 in mice atrial fibroblasts were knocked in or knocked down, respectively. The expression of p300/p53/Smad3 and fibrotic factors was higher in patients with AF and AF + HTN than those with SR only. The expressions of p300/p53/Smad3 and fibrotic factors increased in hypertensive mice. Curcumin (Cur) and knocking down of p300 reversed the expressions of these factors. 40 mmHg hydrostatic pressure/overexpression of p300 upregulated the expressions of p300/p53/Smad3 and fibrotic factors in mice LAA fibroblasts. While Cur or knocking down p300 reversed these changes. Knocking down/overexpression of p53, the expressions of p53/Smad3 and fibrotic factors also decreased/increased, correspondingly. High hydrostatic pressure promotes atrial fibrosis by activating the p300/p53/Smad3 pathway, which further increases the susceptibility to AF.
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Affiliation(s)
- Shenghuan Yu
- Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P.R. China
| | - Long Zeng
- Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P.R. China
| | - Fang Rao
- Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P.R. China
- Research Center of Medical Sciences, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P. R. China
| | - Chunyu Deng
- Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P.R. China
- Research Center of Medical Sciences, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P. R. China
| | - Mengzhen Zhang
- Research Center of Medical Sciences, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P. R. China
| | - Haiyin Xiao
- Research Center of Medical Sciences, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P. R. China
| | - Feifei Xiao
- Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P.R. China
| | - Yumei Xue
- Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P.R. China
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P.R. China
| | - Shulin Wu
- Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P.R. China
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P.R. China
| | - Zhimin Du
- Dongguan Tungwah Songshan Lake Hospital, Dongguan, P.R. China
| | - Wei Wei
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P.R. China
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10
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Pu S, Liu F, Chen Y, Luo C, Li P, Chen Y, Fu L, Liu H, Ye X, Wu S, Xue Y, Lin W. 'Single-shot' pulmonary vein isolation using a novel lotos pulsed field ablation catheter: a pre-clinical evaluation of feasibility, safety, and 30-day efficacy. Europace 2023; 26:euad362. [PMID: 38109928 PMCID: PMC10757452 DOI: 10.1093/europace/euad362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/25/2023] [Accepted: 12/08/2023] [Indexed: 12/20/2023] Open
Abstract
AIMS Pulsed field ablation (PFA) is emerging as a non-thermal, tissue-specific technique for pulmonary vein isolation (PVI) in atrial fibrillation therapy. This pre-clinical study aims to investigate the feasibility and safety of PVI using a novel PFA system including a nanosecond-scale PFA generator, a novel lotos PFA catheter, and a customized 12 Fr steerable sheath. METHODS AND RESULTS A total of 11 Yorkshire swine were included in this study, with 4 in the acute cohort and 7 in the chronic cohort. Under general anaesthesia, transseptal puncture and pulmonary vein (PV) angiography was initially performed. The PFA catheter was navigated to position at the right and left PV antrum after the electroanatomic reconstruction of the left atrium. Biphasic PFA applications were performed on PVs in both the spindle-shaped and the lotos-shaped poses. Pulmonary vein isolation and PFA-associated safety were assessed 30 min after ablation in both cohorts and 30 days later in the chronic cohort. Detailed necropsy and histopathology were performed. Additional intracardiac echocardiography and coronary angiogram were evaluated for safety. All target PVs (n = 20) were successfully isolated on the first attempt. No spasm of coronary artery or microbubble was seen during the procedure. Eleven of 12 PVs (91.6%) remained in isolation at the 30-day invasive study. No evidence of PV stenosis was observed in any targets. However, transient diaphragm capture occurred in 17.6%. Histopathological examinations showed no evidence of collateral injury. CONCLUSION This study provides scientific evidence demonstrating the safety and efficacy of the novel PFA catheter and system for single-shot PVI, which shows great potential.
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Affiliation(s)
- Sijia Pu
- School of Medicine, South China University of Technology, Guangzhou, China
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Rd, Guangzhou 510080, China
| | - Fangzhou Liu
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Rd, Guangzhou 510080, China
| | - Yuhan Chen
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Rd, Guangzhou 510080, China
| | - Cihua Luo
- Insight Medtech Co., Ltd, Shenzhen, China
| | - Peng Li
- Insight Medtech Co., Ltd, Shenzhen, China
| | - Yanlin Chen
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Rd, Guangzhou 510080, China
| | - Lu Fu
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Rd, Guangzhou 510080, China
| | - Huiyi Liu
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Rd, Guangzhou 510080, China
| | - Xingdong Ye
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Rd, Guangzhou 510080, China
| | - Shulin Wu
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Rd, Guangzhou 510080, China
| | - Yumei Xue
- School of Medicine, South China University of Technology, Guangzhou, China
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Rd, Guangzhou 510080, China
| | - Weidong Lin
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Rd, Guangzhou 510080, China
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11
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Lai Y, He J, Gao X, Peng D, Zhou H, Xu Y, Luo X, Yang H, Zhang M, Deng C, Wu S, Xue Y, Zhou F, Rao F. Involvement of plasminogen activator inhibitor-1 in p300/p53-mediated age-related atrial fibrosis. PeerJ 2023; 11:e16545. [PMID: 38107584 PMCID: PMC10722982 DOI: 10.7717/peerj.16545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/08/2023] [Indexed: 12/19/2023] Open
Abstract
Plasminogen activator inhibitor-1 (PAI-1), a key regulator of the fibrinolytic system, is also intimately involved in the fibrosis. Although PAI-1 may be involved in the occurrence of atrial fibrillation (AF) and thrombosis in the elderly, but whether it participated in aging-related atrial fibrosis and the detailed mechanism is still unclear. We compared the transcriptomics data of young (passage 4) versus senescent (passage 14) human atrial fibroblasts and found that PAI-1 was closely related to aging-related fibrosis. Aged mice and senescent human and mouse atrial fibroblasts underwent electrophysiological and biochemical studies. We found that p300, p53, and PAI-1 protein expressions were increased in the atrial tissue of aged mice and senescent human and mouse atrial fibroblasts. Curcumin or C646 (p300 inhibitor), or p300 knockdown inhibited the expression of PAI-1 contributing to reduced atrial fibroblasts senescence, atrial fibrosis, and the AF inducibility. Furthermore, p53 knockdown decreased the protein expression of PAI-1 and p21 in senescent human and mouse atrial fibroblasts. Our results suggest that p300/p53/PAI-1 signaling pathway participates in the mechanism of atrial fibrosis induced by aging, which provides new sights into the treatment of elderly AF.
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Affiliation(s)
- Yingyu Lai
- Medical Research Institute, Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
- Department of Pharmacy, The People’s Hospital of Hezhou, Hezhou, Guangxi, China
| | - Jintao He
- School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
| | - Xiaoyan Gao
- Medical Research Institute, Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Dewei Peng
- Medical Research Institute, Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Huishan Zhou
- Medical Research Institute, Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Yuwen Xu
- Medical Research Institute, Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Xueshan Luo
- Medical Research Institute, Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Hui Yang
- Medical Research Institute, Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Mengzhen Zhang
- Medical Research Institute, Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Chunyu Deng
- Medical Research Institute, Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Shulin Wu
- Medical Research Institute, Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Yumei Xue
- Medical Research Institute, Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Feng Zhou
- Department of Neurology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, China
| | - Fang Rao
- Medical Research Institute, Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
- School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
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12
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Wang XW, Xu LL, Lyu WS, Sun XF, Wang YG, Xue Y. [Culler-Jones syndrome caused by a new mutated GLI2 gene: a case report]. Zhonghua Nei Ke Za Zhi 2023; 62:1472-1475. [PMID: 38044075 DOI: 10.3760/cma.j.cn112138-20230322-00167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Affiliation(s)
- X W Wang
- Department of Endocrinology, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - L L Xu
- Department of Endocrinology, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - W S Lyu
- Department of Endocrinology, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - X F Sun
- Department of Endocrinology, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - Y G Wang
- Department of Endocrinology, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - Y Xue
- Department of Endocrinology, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
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13
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Chen Y, Lin W, Fu L, Liu H, Jin S, Ye X, Pu S, Xue Y. Muscle quality index and cardiovascular disease among US population-findings from NHANES 2011-2014. BMC Public Health 2023; 23:2388. [PMID: 38041010 PMCID: PMC10691039 DOI: 10.1186/s12889-023-17303-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 11/22/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the United States. However, current evidence on the association between muscle quality and CVD is limited. This study investigates the potential association between the muscle quality index (MQI) and the prevalence of CVD and CVD-related mortality. METHODS Participants were selected from the National Health and Nutrition Examination Survey (NHANES) 2011-2014. Data on mortality and causes of death were obtained from the National Death Index (NDI) records through December 31, 2019. Statistical analysis used in this study, including weighted multivariable linear and logistic regression, cox regression and Kaplan-Meier (K-M) analysis, to estimate the association between MQI and all-cause mortality as well as CVD mortality. In addition, subgroup analysis was used to estimate the association between MQI and CVD subtypes, such as heart attack, coronary heart disease, angina, congestive heart failure, and stroke. RESULTS A total of 5,053 participants were included in the final analysis. Weighted multivariable linear regression models revealed that a lower MQI.total level was independently associated with an increased risk of CVD development in model 3, with t value =-3.48, 95%CI: (-0.24, -0.06), P = 0.002. During 5,053 person-years of 6.92 years of follow-up, there were 29 deaths from CVD. Still, the association between MQI.total and CVD mortality, as well as all-cause mortality did not reach statistical significance in the fully adjusted model (HR = 0.58, 95% CI: 0.21-1.62, P = 0.30; HR = 0.91, 95% CI:0.65,1.28, P = 0.59, respectively). Subgroup analysis confirmed that MQI.total was negatively associated with congestive heart failure (OR = 0.35, 95% CI = 0.18,0.68, P = 0.01). CONCLUSION This study highlights the potential of MQI as a measure of muscle quality, its negative correlation with congestive heart failure (CHF). However, MQI was not very useful for predicting the health outcomes such as CVD and mortality. Therefore, more attention should be paid to the early recognition of muscle weakness progression in CHF. Further studies are needed to explore more effective indicator to evaluate the association between muscle quality and health outcomes.
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Affiliation(s)
- Yanlin Chen
- Department of Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - Weidong Lin
- Department of Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - Lu Fu
- Department of Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - Huiyi Liu
- Department of Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - Shuyu Jin
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, China
| | - Xingdong Ye
- Department of Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - Sijia Pu
- School of Medicine, South China University of Technology, Guangzhou, 510006, China
| | - Yumei Xue
- Department of Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China.
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, China.
- School of Medicine, South China University of Technology, Guangzhou, 510006, China.
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14
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Zhang L, Xue Y, Yuan C, Du X, Wang X, Guo L, Li B. Decreased SIRT1 mRNA expression in peripheral blood mononuclear cells from patients with neuromyelitis optica spectrum disorders. Acta Neurol Belg 2023; 123:2287-2294. [PMID: 37294424 DOI: 10.1007/s13760-023-02300-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 05/31/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Sirtuin (SIRT)1, as a molecular link between immunity and metabolic pathways, is a key immune response regulator. The significance of SIRT1 in peripheral blood mononuclear cells (PBMCs) of neuromyelitis optica spectrum disorder (NMOSD) has not been investigated. Here, we aimed to evaluate the SIRT1 mRNA level in PBMCs of patients with NMOSD and its clinical relevance and explore the potential mechanism of SIRT1 action. METHODS A total of 65 patients with NMOSD and 60 normal controls from North China were enrolled. Using real-time fluorescence quantitative-polymerase chain reaction, mRNA levels were detected in PBMCs, and protein levels were detected using western blotting. RESULTS Compared to the healthy controls and chronic-phase patients with NMOSD, SIRT1 mRNA and protein levels in PBMCs of NMOSD patients with acute attack were significantly downregulated (p < 0.0001). ∆EDSS scores (EDSS scores in the acute phase-EDSS scores before the recent attack) were higher in NMOSD patients with low SIRT1 mRNA level than in patients with high SIRT1 expression (p = 0.042). SIRT1 mRNA level in patients with acute-phase NMSOD was positively correlated with lymphocyte and monocyte counts and negatively correlated with neutrophil counts and the neutrophil-to-lymphocyte ratio. Furthermore, the transcription factor FOXP3 mRNA level was significantly positively correlated with the SIRT1 mRNA level in PBMCs of patients with acute-phase NMOSD. CONCLUSIONS Our study indicated that SIRT1 mRNA expression was downregulated in the PBMCs of patients with acute-phase NMOSD, and its level was correlated with the clinical parameters of the patients, suggesting a potential role of SIRT1 in NMOSD.
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Affiliation(s)
- Lu Zhang
- Department of Neurology, The Second Hospital of Hebei Medical University, No. 215, Hepingxi Road, Shijiazhuang, 050000, China
- Key Laboratory of Neurology of Hebei Province, Shijiazhuang, China
| | - Yumei Xue
- Department of Neurology, The Second Hospital of Hebei Medical University, No. 215, Hepingxi Road, Shijiazhuang, 050000, China
- Key Laboratory of Neurology of Hebei Province, Shijiazhuang, China
- Department of Pharmacy, Shijiazhuang People's Hospital, Shijiazhuang, China
| | - Congcong Yuan
- Department of Neurology, The Second Hospital of Hebei Medical University, No. 215, Hepingxi Road, Shijiazhuang, 050000, China
- Key Laboratory of Neurology of Hebei Province, Shijiazhuang, China
- Department of Neurology, Baoding First Central Hospital, Baoding, China
| | - Xiaochen Du
- Department of Neurology, The Second Hospital of Hebei Medical University, No. 215, Hepingxi Road, Shijiazhuang, 050000, China
- Key Laboratory of Neurology of Hebei Province, Shijiazhuang, China
| | - Xuan Wang
- Department of Neurology, The Second Hospital of Hebei Medical University, No. 215, Hepingxi Road, Shijiazhuang, 050000, China
- Key Laboratory of Neurology of Hebei Province, Shijiazhuang, China
| | - Li Guo
- Department of Neurology, The Second Hospital of Hebei Medical University, No. 215, Hepingxi Road, Shijiazhuang, 050000, China.
- Key Laboratory of Neurology of Hebei Province, Shijiazhuang, China.
| | - Bin Li
- Department of Neurology, The Second Hospital of Hebei Medical University, No. 215, Hepingxi Road, Shijiazhuang, 050000, China.
- Key Laboratory of Neurology of Hebei Province, Shijiazhuang, China.
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15
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Wei HQ, Chen W, Luo S, Liao Z, Fang X, Liao H, Sun Q, Guo XG, Yang JD, Liang JJ, Wu S, Xue Y, Ma J, Zhan X. Comparison of strategies for catheter ablation of left posterior fascicular ventricular tachycardia. Europace 2023; 25:euad339. [PMID: 37971899 PMCID: PMC10653165 DOI: 10.1093/europace/euad339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023] Open
Abstract
AIMS Traditional ablation strategies including targeting the earliest Purkinje potential (PP) during left posterior fascicular (LPF) ventricular tachycardia (VT) or linear ablation at the middle segment of LPF during sinus rhythm are commonly used for the treatment of LPF-VT. Catheter ablation for LPF-VT targeting fragmented antegrade Purkinje (FAP) potential during sinus rhythm is a novel approach. We aimed to compare safety and efficacy of different ablation strategies (FAP ablation vs. traditional ablation) for the treatment of LPF-VT. METHODS AND RESULTS Consecutive patients with electrocardiographically documented LPF-VT referred for catheter ablation received either FAP ablation approach or traditional ablation approach. Electrophysiological characteristics, procedural complications, and long-term clinical outcome were assessed. A total of 189 consecutive patients who underwent catheter ablation for LPF-VT were included. Fragmented antegrade Purkinje ablation was attempted in 95 patients, and traditional ablation was attempted in 94 patients. Acute ablation success with elimination of LPF-VT was achieved in all patients. Left posterior fascicular block occurred in 11 of 95 (11.6%) patients in the FAP group compared with 75 of 94 (79.8%) patients in the traditional group (P < 0.001). Fragmented antegrade Purkinje ablation was associated with significant shorter procedure time (94 ± 26 vs. 117 ± 23 min, P = 0.03) and fewer radiofrequency energy applications (4.1 ± 2.4 vs. 6.3 ± 3.5, P = 0.003) compared with the traditional group. One complete atrioventricular block and one left bundle branch block were seen in the traditional group. Over mean follow-up of 65 months, 89 (93.7%) patients in the FAP group and 81 (86.2%) patients in the traditional group remained free of recurrent VT off antiarrhythmic drugs (P = 0.157). CONCLUSION Left posterior fascicular-ventricular tachycardia ablation utilizing FAP and traditional ablation approaches resulted in similar acute and long-term procedural outcomes. Serious His-Purkinje injury did occur infrequently during traditional ablation. The use of FAP ablation approach was associated with shorter procedure time and fewer radiofrequency energy applications, especially for non-inducible patients.
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Affiliation(s)
- Hui-Qiang Wei
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 102 Zhongshan 2nd Rd, Yuexiu District, 510010 Guangzhou, China
| | - Wanwen Chen
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 102 Zhongshan 2nd Rd, Yuexiu District, 510010 Guangzhou, China
| | - Sini Luo
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 102 Zhongshan 2nd Rd, Yuexiu District, 510010 Guangzhou, China
| | - Zili Liao
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 102 Zhongshan 2nd Rd, Yuexiu District, 510010 Guangzhou, China
| | - Xianhong Fang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 102 Zhongshan 2nd Rd, Yuexiu District, 510010 Guangzhou, China
| | - Hongtao Liao
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 102 Zhongshan 2nd Rd, Yuexiu District, 510010 Guangzhou, China
| | - Qi Sun
- Arrhythmia Center, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, No.167 Beilishi Rd. Xicheng District, 100037 Beijing, China
| | - Xiao-Gang Guo
- Arrhythmia Center, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, No.167 Beilishi Rd. Xicheng District, 100037 Beijing, China
| | - Jian-Du Yang
- Arrhythmia Center, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, No.167 Beilishi Rd. Xicheng District, 100037 Beijing, China
| | - Jackson J Liang
- Division of Cardiovascular Medicine, Cardiac Arrhythmia Service, University of Michigan Health System, Ann Arbor, MI, USA
| | - Shulin Wu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 102 Zhongshan 2nd Rd, Yuexiu District, 510010 Guangzhou, China
| | - Yumei Xue
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 102 Zhongshan 2nd Rd, Yuexiu District, 510010 Guangzhou, China
| | - Jian Ma
- Arrhythmia Center, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, No.167 Beilishi Rd. Xicheng District, 100037 Beijing, China
| | - Xianzhang Zhan
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 102 Zhongshan 2nd Rd, Yuexiu District, 510010 Guangzhou, China
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Fu L, Xue Y. High density mapping of complex atrial tachycardia in patients after cardiac surgery. Pacing Clin Electrophysiol 2023; 46:1341-1347. [PMID: 37846820 DOI: 10.1111/pace.14841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 09/21/2023] [Accepted: 10/01/2023] [Indexed: 10/18/2023]
Abstract
To provide an overview of the current application of high-density mapping (HDM) in the mechanism of complex atrial tachycardias (ATs). Complex ATs are frequently scar-related, after history of previous cardiac surgery and large scars. These scar-related ATs are difficult to manage medically and frequently recur after electrical cardioversion. HDM technologies have enabled rigorous elucidation of AT mechanisms in patients post cardiac surgery. This article showed the application of HDM technology in complex ATs from the mechanisms of complex ATs, the development of HDM technology, and the identification of scars or critical isthmus from HDM. HDM-guided approach is highly effective for identifying the ATs mechanism and critical isthmus.
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Affiliation(s)
- Lu Fu
- Department of Cardiology, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
| | - Yumei Xue
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Clinical Pharmacology, Research Center of Medical Sciences, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
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Shao WY, Dong YT, Lyu QY, Liao JB, Xue Y, Chen XJ. [Fertility-preserving treatment outcomes in endometrial cancer and atypical hyperplasia patients with different molecular profiles]. Zhonghua Fu Chan Ke Za Zhi 2023; 58:742-754. [PMID: 37849255 DOI: 10.3760/cma.j.cn112141-20230719-00011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
Objective: To investigate the impact of molecular classification and key oncogenes on the oncologic outcomes in patients with endometrial carcinoma (EC) and atypical endometrial hyperplasia (AEH) receiving fertility-preserving treatment. Methods: Patients with EC and AEH undergoing progestin-based fertility-preserving treatment and receiving molecular classification as well as key oncogenes test at Obstetrics and Gynecology Hospital, Fudan University from January 2021 to March 2023 were reviewed. Hysteroscopic lesion resection and endometrial biopsy were performed before initiating hormone therapy and every 3 months during the treatment to evaluate the efficacy. The risk factors which had impact on the treatment outcomes in EC and AEH patients were further analyzed. Results: Of the 171 patients analyzed, the median age was 32 years, including 86 patients with EC and 85 patients with AEH. The distribution of molecular classification was as follows: 157 cases (91.8%) were classified as having no specific molecular profile (NSMP); 9 cases (5.3%), mismatch repair deficient (MMR-d); 3 cases (1.8%), POLE-mutated; 2 cases (1.2%), p53 abnormal. No difference was found in the cumulative 40-week complete response (CR) rate between the patients having NSMP or MMR-d (61.6% vs 60.0%; P=0.593), while the patients having MMR-d had increased risk than those having NSMP to have recurrence after CR (50.0% vs 14.4%; P=0.005). Multi-variant analysis showed PTEN gene multi-loci mutation (HR=0.413, 95%CI: 0.259-0.658; P<0.001) and PIK3CA gene mutation (HR=0.499, 95%CI: 0.310-0.804; P=0.004) were associated with a lower cumulative 40-week CR rate, and progestin-insensitivity (HR=3.825, 95%CI: 1.570-9.317; P=0.003) and MMR-d (HR=9.014, 95%CI: 1.734-46.873; P=0.009) were independent risk factors of recurrence in EC and AEH patients. Conclusions: No difference in cumulative 40-week CR rate is found in the patients having NSMP or MMR-d who received progestin-based fertility-preserving treatment, where the use of hysteroscopy during the treatment might be the reason, while those having MMR-d have a higher risk of recurrence after CR. Oncogene mutation of PTEN or PIK3CA gene might be associated with a lower response to progestin treatment. The molecular profiles help predict the fertility-preserving treatment outcomes in EC and AEH patients.
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Affiliation(s)
- W Y Shao
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200092, China
| | - Y T Dong
- Clinical Medical College, Fudan University, Shanghai 200032, China
| | - Q Y Lyu
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200092, China
| | - J B Liao
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200092, China
| | - Y Xue
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200092, China
| | - X J Chen
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200092, China
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Xue Y, Yang X, Zhang H, Zhang T, Chen W, Chang X, Wang Y. [Protective effect of recombinant Schistosoma japonicum cystatin against acute kidney injury associated with acute liver failure in mice]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2023; 35:331-339. [PMID: 37926467 DOI: 10.16250/j.32.1374.2023067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
OBJECTIVE To evaluate the protective effect of recombinant Schistosoma japonicum cystatin (rSj-Cys) against acute kidney injury induced by acute liver failure and unravel the underlying mechanism, so as to provide insights into the clinical therapy of acute kidney injury. METHODS Twenty-four male C57BL/6J mice at ages of 6 to 8 weeks were randomly divided into the normal control group, rSj-Cys control group, lipopolysaccharide (LPS)/D-galactosamine (D-GaIN) model group and LPS/D-GaIN + rSj-Cys treatment group, of 6 mice each group. Mice in the LPS/D-GaIN group and LPS/D-GaIN + rSj-Cys group were intraperitoneally injected with LPS (10 μg/kg) and D-GaIN (700 mg/kg), and mice in the LPS/D-GaIN + rSj-Cys group were additionally administered with rSj-Cys (1.25 mg/kg) by intraperitoneal injection 30 min post-modeling, while mice in the rSj-Cys group were intraperitoneally injected with rSj-Cys (1.25 mg/kg), and mice in the normal control group were injected with the normal volume of PBS. All mice were sacrificed 6 h post-modeling, and mouse serum and kidney samples were collected. Serum creatinine (Cr) and urea nitrogen (BUN) levels were measured, and the pathological changes of mouse kidney specimens were examined using hematoxylin-eosin (HE) staining. Serum tumor necrosis factor (TNF)-α and interleukin (IL)-6 levels were detected using enzyme-linked immunosorbent assay (ELISA), and the expression of inflammatory factors and pyroptosis-related proteins was quantified in mouse kidney specimens using immunohistochemistry. In addition, the expression of pyroptosis-related proteins and nuclear factor-kappa B (NF-κB) signaling pathway-associated proteins was determined in mouse kidney specimens using Western blotting assay. RESULTS HE staining showed no remarkable abnormality in the mouse kidney structure in the normal control group and the rSj-Cys control group, and renal tubular injury was found in LPS/D-GaIN group, while the renal tubular injury was alleviated in LPS/D-GaIN+rSj-Cys treatment group. There were significant differences in serum levels of Cr (F = 46.33, P < 0.001), BUN (F = 128.60, P < 0.001), TNF-α (F = 102.00, P < 0.001) and IL-6 (F = 202.10, P < 0.001) among the four groups, and lower serum Cr [(85.35 ± 32.05) μmol/L], BUN [(11.90 ± 2.76) mmol/L], TNF-α [(158.27 ± 15.83) pg/mL] and IL-6 levels [(56.72 ± 4.37) pg/mL] were detected in the in LPS/D-GaIN + rSj-Cys group than in the LPS/D-GaIN group (all P values < 0.01). Immunohistochemical staining detected significant differences in TNF-α (F = 24.16, P < 0.001) and IL-10 (F = 15.07, P < 0.01) expression among the four groups, and lower TNF-α [(106.50 ± 16.57)%] and higher IL-10 expression [(91.83 ± 5.23)%] was detected in the LPS/D-GaIN + rSj-Cys group than in the LPS/D-GaIN group (both P values < 0.01). Western blotting and immunohistochemistry detected significant differences in the protein expression of pyroptosis-related proteins NOD-like receptor thermal protein domain associated protein 3 (NLRP3) (F = 24.57 and 30.72, both P values < 0.001), IL-1β (F = 19.24 and 22.59, both P values < 0.001) and IL-18 (F = 16.60 and 19.30, both P values < 0.001) in kidney samples among the four groups, and lower NLRP3, IL-1β and IL-18 expression was quantified in the LPS/D-GaIN + rSj-Cys treatment group than in the LPS/D-GaIN group (P values < 0.05). In addition, there were significant differences in the protein expression of NF-κB signaling pathway-associated proteins p-NF-κB p-P65/NF-κB p65 (F = 71.88, P < 0.001), Toll-like receptor (TLR)-4 (F = 45.49, P < 0.001) and p-IκB/IκB (F = 60.87, P < 0.001) in mouse kidney samples among the four groups, and lower expression of three NF-κB signaling pathway-associated proteins was determined in the LPS/D-GaIN + rSj-Cys treatment group than in the LPS/D-GaIN group (all P values < 0.01). CONCLUSIONS rSj-Cys may present a protective effect against acute kidney injury caused by acute liver failure through inhibiting inflammation and pyroptosis and downregulating the NF-κB signaling pathway.
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Affiliation(s)
- Y Xue
- Department of Microbiology and Immunology, Shanxi Medical University, Jinzhong, Shanxi 030600, China
| | - X Yang
- Department of Microbiology and Parasitology, Bengbu Medical College, Anhui Provincial Key Laboratory of Infection and Immunology, China
| | - H Zhang
- Department of Pathology and Physiology, Shanxi Medical University, China
| | - T Zhang
- Department of Microbiology and Immunology, Shanxi Medical University, Jinzhong, Shanxi 030600, China
| | - W Chen
- Department of Microbiology and Immunology, Shanxi Medical University, Jinzhong, Shanxi 030600, China
| | - X Chang
- Department of Microbiology and Immunology, Shanxi Medical University, Jinzhong, Shanxi 030600, China
| | - Y Wang
- Department of Microbiology and Immunology, Shanxi Medical University, Jinzhong, Shanxi 030600, China
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Luo Y, Chen X, Zhang Y, Zhang Q, Liu F, Luo G, Wu S, Xue Y, Deng H, Jiang F, Chen Z, Liu Y, Liao H. Nomogram for predicting cardiac death and heart transplantation in arrhythmogenic right ventricular cardiomyopathy. ESC Heart Fail 2023; 10:3028-3037. [PMID: 37563882 PMCID: PMC10567630 DOI: 10.1002/ehf2.14432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 04/23/2023] [Accepted: 05/24/2023] [Indexed: 08/12/2023] Open
Abstract
AIMS In this study, we aimed to develop and validate a competing risk nomogram for predicting cardiac death and heart transplantation (HT) in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). METHODS We retrospectively enrolled 149 consecutive patients with ARVC diagnosed at our institution between 2008 and 2022. Cox proportional hazards model was primarily used to identify variables associated with cardiac death and HT. On the basis of these indicators, a competing risk nomogram was developed to predict the 1, 3, and 5 year probabilities of cardiac death and HT. The area under the receiver operating characteristic curve (AUC), Harrell's C-index, and calibration curves were used to evaluate and internally validate the performance of the model. Decision curve analysis was performed to assess the clinical utility of the nomogram. RESULT Of the 149 patients with ARVC, the mean age was 38.77 ± 15.94 years, and most of the patients were men (67.11%, 100/149). Fourteen patients experienced cardiac death and nine underwent HT, during a median follow-up period of 5.8 years (interquartile range, 0.62-5.56 years). Multivariable COX analysis revealed that extent of TWI in the anterior and inferior leads (P = 0.0057), right atrial diameter on transthoracic echocardiography (P = 0.0498), RVEF (P = 0.1036), and LVEF (P < 0.001) all showed statistical significance. The 1-, 3-, and 5-year cumulative incidence of cardiac death and HT were 3.35%, 8.05%, and 11.4%, respectively. The area under the receiver operating characteristic curve of the nomogram for predicting cardiac death and HT at 1, 3, and 5 years after diagnosis of ARVC were 0.860, 0.935, and 0.956. The value of Harrell's C-index is 0.9273 (95% confidence interval 0.8954-0.9590; P < 0.001), indicating that the model had good discriminative ability in internal validation. Decision curve analysis revealed that our model was clinically useful within the entire range of potential treatment thresholds in most cases. The cumulative incidence of the primary outcomes was significantly different between the three risk groups according to nomogram-derived scores (P < 0.001). CONCLUSIONS On the basis of a retrospective review of patients with ARVC at a single centre, we developed a novel nomogram for predicting the risk of cardiac death and HT after ARVC diagnosis. This competing risk nomogram based on four readily available clinical parameters (right atrial diameter, right and left ventricular ejection fraction, and T-wave inversion) is a potentially useful tool for individualized prognostic assessment in patients with ARVC.
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Affiliation(s)
- Yiju Luo
- Guangdong Cardiovascular Institute, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
| | - Xin Chen
- Guangdong Cardiovascular Institute, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
| | - Yuhua Zhang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
| | - Qianhuan Zhang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
| | - Fangzhou Liu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
| | - Guanhao Luo
- Guangdong Cardiovascular Institute, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
| | - Shulin Wu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
| | - Yumei Xue
- Guangdong Cardiovascular Institute, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
| | - Hai Deng
- Guangdong Cardiovascular Institute, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
| | - Fengyu Jiang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
| | - Zien Chen
- Guangdong Cardiovascular Institute, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
| | - Yang Liu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
| | - Hongtao Liao
- Guangdong Cardiovascular Institute, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
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Jiang C, Ma C, Chen S, Chen S, Jiang C, Jiang R, Ju W, Long D, Li D, Li J, Liu Q, Ma W, Pu X, Wang R, Wang Y, Yi F, Zou C, Zhang J, Zhang X, Zhao Y, Zei PC, Biase LD, Chang D, Cai H, Chen L, Chen M, Fu G, Fu H, Fan J, Gui C, Jiang T, Liu S, Li X, Li Y, Shu M, Wang Y, Xu J, Xie R, Xia Y, Xue Y, Yang P, Yuan Y, Zhong J, Zhu W. Chinese expert consensus on the construction of the fluoroless cardiac electrophysiology laboratory and related techniques. Pacing Clin Electrophysiol 2023; 46:1035-1048. [PMID: 37573146 DOI: 10.1111/pace.14782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/17/2023] [Accepted: 06/25/2023] [Indexed: 08/14/2023]
Abstract
Transcatheter radiofrequency ablation has been widely introduced for the treatment of tachyarrhythmias. The demand for catheter ablation continues to grow rapidly as the level of recommendation for catheter ablation. Traditional catheter ablation is performed under the guidance of X-rays. X-rays can help display the heart contour and catheter position, but the radiobiological effects caused by ionizing radiation and the occupational injuries worn caused by medical staff wearing heavy protective equipment cannot be ignored. Three-dimensional mapping system and intracardiac echocardiography can provide detailed anatomical and electrical information during cardiac electrophysiological study and ablation procedure, and can also greatly reduce or avoid the use of X-rays. In recent years, fluoroless catheter ablation technique has been well demonstrated for most arrhythmic diseases. Several centers have reported performing procedures in a purposefully designed fluoroless electrophysiology catheterization laboratory (EP Lab) without fixed digital subtraction angiography equipment. In view of the lack of relevant standardized configurations and operating procedures, this expert task force has written this consensus statement in combination with relevant research and experience from China and abroad, with the aim of providing guidance for hospitals (institutions) and physicians intending to build a fluoroless cardiac EP Lab, implement relevant technologies, promote the standardized construction of the fluoroless cardiac EP Lab.
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Affiliation(s)
- Chenyang Jiang
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Changsheng Ma
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Songwen Chen
- Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Shiquan Chen
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Chenxi Jiang
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Ruhong Jiang
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Weizhu Ju
- Jiangsu Province Hospital, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Deyong Long
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Ding Li
- Peking University People's Hospital, Beijing, China
| | - Jia Li
- The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Qiang Liu
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Wei Ma
- Tianjin Chest Hospital, Tianjin, China
| | - Xiaobo Pu
- West China Hospital, Sichuan University, Chengdu, China
| | - Rui Wang
- First Hospital of Shanxi Medical University, Taiyuan, China
| | - Yuegang Wang
- Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Fu Yi
- Xijing Hospital, The First Affiliated Hospital of Air Force Medical University, Xian, China
| | - Cao Zou
- The First Affiliated Hospital, Soochow University, Suzhou, China
| | - Jidong Zhang
- The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xi Zhang
- The First People's Hospital of Yunnan Province, Kunming, China
| | - Yujie Zhao
- The seventh People's Hospital of Zhenzhou, Zhengzhou, China
| | - Paul C Zei
- Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Luigi Di Biase
- Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, USA
| | - Dong Chang
- Xiamen Cardiovascular Hospital, Xiamen University, Xiamen, China
| | - Heng Cai
- Tianjin Medical University General Hospital, Tianjin, China
| | | | - Minglong Chen
- Jiangsu Province Hospital, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Guosheng Fu
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Hua Fu
- West China Hospital, Sichuan University, Chengdu, China
| | - Jie Fan
- The First People's Hospital of Yunnan Province, Kunming, China
| | - Chun Gui
- The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Tingbo Jiang
- The First Affiliated Hospital, Soochow University, Suzhou, China
| | - Shaowen Liu
- Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Xuebin Li
- Peking University People's Hospital, Beijing, China
| | - Yigang Li
- Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Maoqin Shu
- Southwest Hospital, The First Affiliated Hospital of Army Medical University, Chongqing, China
| | - Yan Wang
- Tongji Hospital, Tongji Medical College of HUST, Wuhan, China
| | - Jian Xu
- The First Affiliated Hospital of USTC, Anhui Provincial Hospital, Hefei, China
| | - Ruiqin Xie
- The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yunlong Xia
- The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yumei Xue
- Guangdong Provincial People's Hospital, Guangzhou, China
| | - Pingzhen Yang
- Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yiqiang Yuan
- Henan Provincial Chest Hospital, Zhengzhou, China
| | - Jingquan Zhong
- Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Wenqing Zhu
- Zhongshan Hospital, Fudan University, Shanghai, China
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Liao Z, Dai S, Nie Z, Song X, Huang X, Wang J, Yang F, Liu X, Du Z, Wei H, Liu F, Zhan X, Xue Y, Yang P, Ma J, Ouyang F, Ge J, Wu S. Reappraisal and New Observations on Idiopathic Ventricular Arrhythmias Ablated From the Noncoronary Aortic Sinus. JACC Clin Electrophysiol 2023; 9:1279-1291. [PMID: 36951815 DOI: 10.1016/j.jacep.2023.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/27/2023] [Accepted: 01/31/2023] [Indexed: 03/24/2023]
Abstract
BACKGROUND The electrophysiological characteristics of idiopathic ventricular arrhythmias (VAs) from the noncoronary sinus (NCS) have not been fully described. OBJECTIVES This study sought to investigate electrophysiological characteristics and catheter ablation in patients with idiopathic NCS-VA. METHODS This study comprised 11 patients undergoing radiofrequency (RF) catheter ablation for idiopathic NCS-VA. Angiography was performed to confirm the origin in the aortic sinus before RF ablation. RESULTS Clinical arrhythmias presented left bundle block/inferior axis morphology in all patients. QRS morphology of R' and R/s' pattern was dominantly found in lead III. Mapping in the right ventricle demonstrated the earliest ventricular activation (EVA) site at the His Bundle region, whereas mapping in the NCS demonstrated that the EVA preceded the activation at the His Bundle region by 12.1 ± 7.9 milliseconds. All VAs were successfully ablated in <2.5 seconds within the NCS with 1 RF application. The successful ablation site was at the nadir of NCS in 10 patients, and near the junction of NCS and the right coronary sinus in the remaining one. A discrete potential can be observed at the EVA site within the NCS in 10 patients (91%); however, an excellent pace mapping at the EVA site was obtained in only 2 patients. Junctional beats did not occur during RF application in all 11 patients. There were no complications or clinical recurrence during a mean follow-up of 26.0 ± 9.8 months. CONCLUSIONS NCS-VA presents a peculiar electrocardiogram. A discrete potential can be mapped within the NCS during VA and sinus rhythm, and can be used in guiding ablation.
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Affiliation(s)
- Zili Liao
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People's Republic of China
| | - Shimo Dai
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Shanghai, People's Republic of China
| | - Zhenning Nie
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Shanghai, People's Republic of China
| | - Xudong Song
- Department of Cardiology, Laboratory of Heart Center, Zhujiang Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Xingfu Huang
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Jing Wang
- State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People's Republic of China
| | - Fei Yang
- Department of Cardiology, the Third People's Hospital, Huizhou, People's Republic of China
| | - Xu Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Zhongpeng Du
- Department of Cardiology, Laboratory of Heart Center, Zhujiang Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Huiqiang Wei
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People's Republic of China
| | - Fangzhou Liu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People's Republic of China
| | - Xianzhang Zhan
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People's Republic of China
| | - Yumei Xue
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People's Republic of China.
| | - Pingzhen Yang
- Department of Cardiology, Laboratory of Heart Center, Zhujiang Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Jian Ma
- State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People's Republic of China
| | - Feifan Ouyang
- Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany/Hongkong Asian Medical Group, Hong Kong, China.
| | - Junbo Ge
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Shanghai, People's Republic of China
| | - Shulin Wu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People's Republic of China
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Zhang X, Huang J, Weng F, Wen Y, Wang X, Jiang J, Xue Y, Li K. Adherence to Atrial Fibrillation Better Care (ABC) Pathway Management of Chinese Community Elderly Patients with Atrial Fibrillation: A Cross-Sectional Study. Patient Prefer Adherence 2023; 17:1813-1823. [PMID: 37520064 PMCID: PMC10386861 DOI: 10.2147/ppa.s417384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 07/08/2023] [Indexed: 08/01/2023] Open
Abstract
Background Investigating adherence to the Atrial Fibrillation Better Care (ABC) pathway management and identifying gaps between the real world and established guidelines can lead to better integrated management of AF. Current data on adherence to ABC pathway management among community elderly patients with atrial fibrillation (AF) in Chinese communities is limited. Aim To investigate the adherence to ABC pathway management among community elderly patients with AF in China. Methods In this cross-sectional study, data were collected from the 2020 National Basic Public Health Service Program database that includes health examination information for all residents >65 years of age in Yuexiu, Guangzhou, Guangdong Province. Demographic and clinical characteristics data from 197 community AF patients were obtained. Results Among the 197 AF patients, 103 (52.3%) were male, 117 (59.4%) were ≥75 years of age, 127 (64.5%) had a senior middle school education or above, 84.3% were married, and 195 (99.0%) had medical insurance. The most common comorbidities were hypertension (72.1%, 142/197), dyslipidaemia (28.4%, 56/197), CAD (28.9%, 57/197), and diabetes (24.9%, 49/197). In terms of the ABC management pathway, 21.8% (43/197), 82.7% (163/197), and 31.5% (62/197) of AF patients were classified into the A-adherent group, B-adherent group, and C-adherent group, respectively. The level of adherence to ABC pathway management was very low (9.1%, 18/197) and independently associated with age and multimorbidity. Conclusion The level of adherence to ABC pathway management in community elderly patients with AF was unsatisfactory. Further research is warranted to improve the integrated management of AF.
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Affiliation(s)
- Xiaomin Zhang
- School of Nursing, Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Jun Huang
- Department of Geriatrics, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China
| | - Fan Weng
- Yuexiu District Center for Disease Control and Prevention, Guangzhou, People’s Republic of China
| | - Yanting Wen
- Yuexiu District Center for Disease Control and Prevention, Guangzhou, People’s Republic of China
| | - Xiaoxia Wang
- Department of Geriatrics, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China
| | - Junrong Jiang
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangzhou, People’s Republic of China
| | - Yumei Xue
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangzhou, People’s Republic of China
| | - Kun Li
- School of Nursing, Sun Yat-Sen University, Guangzhou, People’s Republic of China
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Xue Y, Zhang L, Guo R, Shao X, Shi M, Yuan C, Li X, Li B. miR-485 regulates Th17 generation and pathogenesis in experimental autoimmune encephalomyelitis through targeting STAT3. J Neuroimmunol 2023; 379:578100. [PMID: 37187004 DOI: 10.1016/j.jneuroim.2023.578100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 04/28/2023] [Accepted: 05/03/2023] [Indexed: 05/17/2023]
Abstract
Experimental autoimmune encephalomyelitis (EAE) is an induced autoimmune disease widely used as an animal model for multiple sclerosis, which is mainly characterized by demyelination, axonal loss, as well as neurodegeneration of central nervous system (CNS). T-helper (Th) 17 cell that generate interleukin-17 (IL-17) plays a key role in its pathogenesis. Their activity and differentiation are tightly regulated by some cytokines and transcription factors. Certain microRNAs (miRNAs) are involved in the pathogenesis of various autoimmune disorders, including EAE. Our research detected a novel miRNA that can regulate EAE. According to the results, during EAE, the expression of miR-485 notably lowered, and STAT3 was significantly increased. It was discovered that miR-485 knockdown in vivo upregulated Th17-associated cytokines and aggravated EAE, while the overexpressed miR-485 down-regulated Th17-associated cytokines and mitigated EAE. The up-regulation of miRNA-485 in vitro inhibited Th17-associated cytokines expression within EAE CD4+ T cells. Furthermore, as revealed by target prediction and dual-luciferase reporter assays, miR-485 directly targets STAT3, a gene that encodes a protein responsible for Th17 generation. Overall, miR-485 exert vital functions in Th17 generation and EAE pathogenesis.
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Affiliation(s)
- Yumei Xue
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China; Key Laboratory of Neurology (Hebei Medical University), Ministry of Education, China; Key Laboratory of Neurology of Hebei Province, Shijiazhuang, China
| | - Lu Zhang
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China; Key Laboratory of Neurology (Hebei Medical University), Ministry of Education, China; Key Laboratory of Neurology of Hebei Province, Shijiazhuang, China
| | - Ruoyi Guo
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China; Key Laboratory of Neurology (Hebei Medical University), Ministry of Education, China; Key Laboratory of Neurology of Hebei Province, Shijiazhuang, China
| | - Xi Shao
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China; Key Laboratory of Neurology (Hebei Medical University), Ministry of Education, China; Key Laboratory of Neurology of Hebei Province, Shijiazhuang, China
| | - Mengya Shi
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China; Key Laboratory of Neurology (Hebei Medical University), Ministry of Education, China; Key Laboratory of Neurology of Hebei Province, Shijiazhuang, China
| | - Congcong Yuan
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China; Key Laboratory of Neurology (Hebei Medical University), Ministry of Education, China; Key Laboratory of Neurology of Hebei Province, Shijiazhuang, China; Department of Neurology, Baoding First Central Hospital, Baoding, China
| | - Xiaobing Li
- Department of Pharmacy, Shijiazhuang People's Hospital, Shijiazhuang, China
| | - Bin Li
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China; Key Laboratory of Neurology (Hebei Medical University), Ministry of Education, China; Key Laboratory of Neurology of Hebei Province, Shijiazhuang, China.
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Jiang J, Huang J, Deng H, Liao H, Fang X, Zhan X, Wu S, Xue Y. Current status and time trends of lipid and use of statins among older adults in China-real world data from primary community health institutions. Front Public Health 2023; 11:1138411. [PMID: 37181715 PMCID: PMC10169566 DOI: 10.3389/fpubh.2023.1138411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 04/05/2023] [Indexed: 05/16/2023] Open
Abstract
Background Elevated serum total cholesterol and low-density lipoprotein cholesterol (LDL-C) levels are established risk factors for cardiovascular diseases, a leading cause of death in China, especially in aged population. We sought to assess the latest levels of serum lipids, prevalence of dyslipidemia and achievement of LDL-C lowering targets among Chinese aged population. Methods The data was obtained from the annual health check and medical records in primary community health institutions of Yuexiu District, Guangzhou, Southern China. A sample of approximately 135,000 participants provides comprehensive estimates of the status of cholesterol level and statins use in older adults in China. Clinical characteristics were compared by different age grades, genders and years. Independent risk factors associated with statin use were determined by stepwise logistic regression analysis. Results The mean levels of TC, HDL-C, LDL-C, TG were 5.39, 1.45, 3.10, and 1.60 mmol/L, respectively, while the prevalence of high TC, high TG, high LDL-C, and low HDL-C were 21.99, 15.52, 13.26, and 11.92%, respectively. Although statin use showed an increasing trend in both participants > 75 years and ≤75 years of age, the achievement of treatment goals fluctuated between 40.94 and 48.47%, and even seemed to have a downward trend. Stepwise multiple logistic regression analysis further indicated that age, medical insurance, ability of self-care, hypertension, stroke, CAD, and high LDL-C were shown to be associated with statins use (P < 0.05). Those aged ≤75 years old seemed to be less likely to use statin, and those without medical insurance or ability of self-care seemed to be less likely to use statin, too. Patients with hypertension, stroke, CAD and high LDL-C were more inclined to use statins. Conclusion Chinese aged population currently experienced high serum lipid levels and prevalence of dyslipidemia. Although an increasing trend was shown in the proportion of high CVD risk and statin use, the achievement of treatment goals seemed to have a downward trend. Improvement of lipid management is necessary in order to reduce the burden of ASCVD in China.
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Affiliation(s)
- Junrong Jiang
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Jun Huang
- Department of Geriatrics, Guangdong Provincial People’s Hospital, Institute of Geriatrics, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Hai Deng
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Hongtao Liao
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xianhong Fang
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xianzhang Zhan
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Shulin Wu
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yumei Xue
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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Varotsos C, Golitsyn G, Xue Y, Efstathiou M, Sarlis N, Voronova T. On the relation between rain, clouds, and cosmic rays. Remote Sensing Letters 2023; 14:301-312. [DOI: 10.1080/2150704x.2023.2190468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 03/08/2023] [Indexed: 06/16/2023]
Affiliation(s)
- C.A. Varotsos
- Climate Research Group, Division of Environmental Physics and Meteorology, Faculty of Physics, National and Kapodistrian University of Athens, Athens, Greece
| | - G.S. Golitsyn
- Obukhov Institute of Atmospheric Physics, Russian Academy of Sciences, Moscow, Russia
| | - Y. Xue
- School of Environment Science and Spatial Informatics, University of Mining and Technology, Xuzhou, Jiangsu, PR China
- Department of Electronics, Computing and Mathematics, College of Science and Engineering, University of Derby, Derby, UK
| | - M. Efstathiou
- Climate Research Group, Division of Environmental Physics and Meteorology, Faculty of Physics, National and Kapodistrian University of Athens, Athens, Greece
| | - N. Sarlis
- Section of Condensed Matter Physics, Department of Physics, National and Kapodistrian University of Athens, Zografos, Greece
| | - T. Voronova
- Climate Research Group, Division of Environmental Physics and Meteorology, Faculty of Physics, National and Kapodistrian University of Athens, Athens, Greece
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Jiang J, Deng H, Liao H, Fang X, Zhan X, Wei W, Wu S, Xue Y. An Artificial Intelligence-Enabled ECG Algorithm for Predicting the Risk of Recurrence in Patients with Paroxysmal Atrial Fibrillation after Catheter Ablation. J Clin Med 2023; 12:jcm12051933. [PMID: 36902719 PMCID: PMC10003633 DOI: 10.3390/jcm12051933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/06/2023] [Accepted: 02/13/2023] [Indexed: 03/05/2023] Open
Abstract
Background: Catheter ablation (CA) is an important treatment strategy to reduce the burden and complications of atrial fibrillation (AF). This study aims to predict the risk of recurrence in patients with paroxysmal AF (pAF) after CA by an artificial intelligence (AI)-enabled electrocardiography (ECG) algorithm. Methods and Results: 1618 ≥ 18 years old patients with pAF who underwent CA in Guangdong Provincial People's Hospital from 1 January 2012 to 31 May 2019 were enrolled in this study. All patients underwent pulmonary vein isolation (PVI) by experienced operators. Baseline clinical features were recorded in detail before the operation and standard follow-up (≥12 months) was conducted. The convolutional neural network (CNN) was trained and validated by 12-lead ECGs within 30 days before CA to predict the risk of recurrence. A receiver operating characteristic curve (ROC) was created for the testing and validation sets, and the predictive performance of AI-enabled ECG was assessed by the area under the curve (AUC). After training and internal validation, the AUC of the AI algorithm was 0.84 (95% CI: 0.78-0.89), with a sensitivity, specificity, accuracy, precision and balanced F Score (F1 score) of 72.3%, 95.0%, 92.0%, 69.1% and 0.707, respectively. Compared with current prognostic models (APPLE, BASE-AF2, CAAP-AF, DR-FLASH and MB-LATER), the performance of the AI algorithm was better (p < 0.01). Conclusions: The AI-enabled ECG algorithm seemed to be an effective method to predict the risk of recurrence in patients with pAF after CA. This is of great clinical significance in decision-making for personalized ablation strategies and postoperative treatment plans in patients with pAF.
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Jin S, Lin W, Fang X, Liao H, Zhan X, Fu L, Jiang J, Ye X, Liu H, Chen Y, Pu S, Wu S, Deng H, Xue Y. High-Power, Short-Duration Ablation under the Guidance of Relatively Low Ablation Index Values for Paroxysmal Atrial Fibrillation: Long-Term Outcomes and Characteristics of Recurrent Atrial Arrhythmias. J Clin Med 2023; 12:jcm12030971. [PMID: 36769620 PMCID: PMC9917927 DOI: 10.3390/jcm12030971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate the difference in effectiveness and safety of high-power, short-duration (HPSD) radiofrequency catheter ablation (RFA) guided by relatively low ablation index (AI) values and conventional RFA in paroxysmal atrial fibrillation (PAF) patients. METHODS The HPSD RFA strategy (40-50 W, AI 350-400 for anterior, 320-350 for posterior wall; n = 547) was compared with the conventional RFA strategy (25-40 W, without AI; n = 396) in PAF patients who underwent their first ablation. Propensity-score matching analyses were used to compare the outcomes of the two groups while controlling for confounders. RESULTS After using propensity-score matching analysis, the HPSD group showed a higher early recurrence rate (22.727% vs. 13.636%, p = 0.003), similar late recurrence rate, and comparable safety (p = 0.604) compared with the conventional group. For late recurrent atrial arrhythmia types, the rate of regular atrial tachycardia was significantly higher in the HPSD group (p = 0.013). Additionally, the rate of chronic pulmonary vein reconnection and non-pulmonary vein triggers during repeat procedures was similar in both groups. CONCLUSIONS For PAF patients, compared with the conventional RFA strategy, the HPSD RFA strategy at relatively low AI settings had a higher early recurrence rate, similar long-term success rate, and comparable safety.
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Affiliation(s)
- Shuyu Jin
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China
- Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Weidong Lin
- Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Xianhong Fang
- Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Hongtao Liao
- Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Xianzhang Zhan
- Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Lu Fu
- Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Junrong Jiang
- Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Xingdong Ye
- Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Huiyi Liu
- Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Yanlin Chen
- Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Sijia Pu
- Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
- School of Medicine, South China University of Technology, Guangzhou 510006, China
| | - Shulin Wu
- Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Hai Deng
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China
- Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
- Correspondence: (H.D.); (Y.X.)
| | - Yumei Xue
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China
- Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
- Correspondence: (H.D.); (Y.X.)
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Wei HQ, Liao Z, Liang Y, Fang X, Liao H, Deng H, Wei W, Huang Y, Liu Y, Liu F, Lin W, Liang JJ, Xue Y, Wu S, Zhan X. Electrophysiological characteristics and long-term outcome of substrate-based catheter ablation for left posterior fascicular ventricular tachycardia targeting fragmented antegrade Purkinje potentials during sinus rhythm. Europace 2023; 25:1008-1014. [PMID: 36610066 PMCID: PMC10062339 DOI: 10.1093/europace/euac265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 12/12/2022] [Indexed: 01/09/2023] Open
Abstract
AIMS The aim of this study was to investigate the electrophysiological characteristics and long-term outcome of patients undergoing substrate-based ablation of left posterior fascicular ventricular tachycardia (LPF-VT) guided by targeting of fragmented antegrade Purkinje potentials (FAPs) during sinus rhythm. METHODS AND RESULTS This study retrospectively analysed 50 consecutive patients referred for ablation. Substrate mapping during sinus rhythm was performed to identify the FAP that was targeted by ablation. FAPs were recorded in 48 of 50 (96%) patients during sinus rhythm. The distribution of FAPs was located at the proximal segment of posterior septal left ventricle (LV) in two (4.2%) patients, middle segment in 33 (68.8%) patients, and distal segment in 13 (27.1%) patients. In 32 of 48 (66.7%) patients, the FAP displayed a continuous multicomponent fragmented electrogram, while a fragmented, split, and uncoupled electrogram was recorded in 16 (33.3%) patients. Entrainment attempts at FAP region were performed successfully in seven patients, demonstrating concealed fusion and the critical isthmus of LPF-VT. Catheter ablation targeting at the FAPs successfully terminated the LPF-VT in all 48 patients in whom they were seen. Left posterior fascicular (LPF) block occurred in four (8%) patients after ablation. During a median follow-up period of 61.2 ± 16.8 months, 47 of 50 (94%) patients remained free from recurrent LPF-VT. CONCLUSION Ablation of LPF-VT targeting FAP during sinus rhythm results in excellent long-term clinical outcome. FAPs were commonly located at the middle segment of posterior septal LV. Region with FAPs during sinus rhythm was predictive of critical site for re-entry.
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Affiliation(s)
- Hui-Qiang Wei
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No.106 Zhongshan 2nd Road, Yuexiu District, 510000 Guangzhou, China
| | - Zili Liao
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No.106 Zhongshan 2nd Road, Yuexiu District, 510000 Guangzhou, China
| | - Yuanhong Liang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No.106 Zhongshan 2nd Road, Yuexiu District, 510000 Guangzhou, China
| | - Xianhong Fang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No.106 Zhongshan 2nd Road, Yuexiu District, 510000 Guangzhou, China
| | - Hongtao Liao
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No.106 Zhongshan 2nd Road, Yuexiu District, 510000 Guangzhou, China
| | - Hai Deng
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No.106 Zhongshan 2nd Road, Yuexiu District, 510000 Guangzhou, China
| | - Wei Wei
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No.106 Zhongshan 2nd Road, Yuexiu District, 510000 Guangzhou, China
| | - Yingjie Huang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No.106 Zhongshan 2nd Road, Yuexiu District, 510000 Guangzhou, China
| | - Yang Liu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No.106 Zhongshan 2nd Road, Yuexiu District, 510000 Guangzhou, China
| | - Fangzhou Liu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No.106 Zhongshan 2nd Road, Yuexiu District, 510000 Guangzhou, China
| | - Weidong Lin
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No.106 Zhongshan 2nd Road, Yuexiu District, 510000 Guangzhou, China
| | - Jackson J Liang
- Division of Cardiovascular Medicine, Cardiac Arrhythmia Service, University of Michigan Health System, Ann Arbor, MI, USA
| | - Yumei Xue
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No.106 Zhongshan 2nd Road, Yuexiu District, 510000 Guangzhou, China
| | - Shulin Wu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No.106 Zhongshan 2nd Road, Yuexiu District, 510000 Guangzhou, China
| | - Xianzhang Zhan
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No.106 Zhongshan 2nd Road, Yuexiu District, 510000 Guangzhou, China
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Qi Y, Jia JY, Gu QH, Zheng ZF, Li LN, Li D, Jia ZH, Xue Y, Yan TK. [Long-term efficacy of low-dose rituximab treatment in patients with primary membranous nephropathy]. Zhonghua Yi Xue Za Zhi 2022; 102:3201-3206. [PMID: 36319174 DOI: 10.3760/cma.j.cn112137-20220716-01555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To explore the long-term efficacy of low-dose rituximab (RTX) treatment in patients with primary membranous nephropathy (PMN). Methods: Patients with biopsy-proven PMN who received low-dose RTX as initial or second-line regimen from August 2018 to May 2020 in the Department of Nephrology, Tianjin Medical University General Hospital were respectively enrolled. The clinical parameters of patients were urinary protein>3.5 g/24 h, serum albumin<30 g/L and estimated glomerular filtration rate (eGFR)>20 ml·min-1·(1.73 m2)-1. The treatment response of patients with PMN was observed during follow-up, and the remission rate of patients with urinary protein<8 g/24 h or ≥8 g/24 h, anti-PLA2R antibody<150 RU/ml or ≥150 RU/ml, eGFR≥ 60 ml·min-1·(1.73 m2)-1 or<60 ml·min-1·(1.73 m2)-1 were analyzed, respectively. Results: A total of 40 patients were enrolled, including 26 males and 14 females, aged (53±15) years. There were 14 patients received RTX as initial treatment and 26 patients as second-line therapy. The total median dose of RTX in the first course was 800 (425, 1 075) mg. The overall remission rate at the 1st, 3rd, 6th, 12th and 24th months were 12.5% (5/40), 17.5% (7/40), 47.5% (19/40), 57.5% (23/40), 60% (24/40), respectively. The median overall response time was 6.0 (3.0, 7.5) months. Two cases relapsed. Patients with remission (n=24) had a higher level of baseline eGFR [(93.9±28.0) vs (62.4±28.1) ml·min-1·(1.73 m2)-1, P=0.001), and a lower level of both urinary protein [5.9 (5.0, 6.5) vs 11.7 (8.6, 15.5) g/24 h, P<0.001] and anti-PLA2R antibody level [73 (29, 132) vs 453 (182, 950) RU/ml, P=0.004] than those without remission (n=16) 24 month after treatment. There was no statistically significant difference in the remission rate between initial and second-line treatment (P=0.101). Moreover, patients had a higher remission rate in urinary protein<8 g/24 h group (21/26 vs 3/14, P<0.001), anti-PLA2R antibody<150 RU/ml group (16/19 vs 5/16, P=0.002) and eGFR ≥ 60 ml·min-1·(1.73 m2)-1 group (22/29 vs 2/11, P=0.003). Conclusions: Low-dose RTX treatment in PMN is effective during long-term follow-up, and has a lower recurrence rate. The results also suggest that it is more suitable for patients with baseline urinary protein<8 g/24 h, anti-PLA2R antibody<150 RU/ml and eGFR≥ 60 ml·min-1·(1.73 m2)-1.
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Affiliation(s)
- Y Qi
- Department of Nephrology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - J Y Jia
- Department of Nephrology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Q H Gu
- Department of Nephrology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Z F Zheng
- Department of Nephrology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - L N Li
- Department of Nephrology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - D Li
- Department of Nephrology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Z H Jia
- Department of Nephrology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Y Xue
- Department of Nephrology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - T K Yan
- Department of Nephrology, Tianjin Medical University General Hospital, Tianjin 300052, China
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Qiu S, Sun Z, Li X, Li J, Huang X, Liu M, Bin J, Liao Y, Xiu J, Zha D, Xue Y, Wang L, Wang Y. A novel and effective ECG method to differentiate right from left ventricular outflow tract arrhythmias: Angle-corrected V2S. Front Cardiovasc Med 2022; 9:868634. [PMID: 36312235 PMCID: PMC9606339 DOI: 10.3389/fcvm.2022.868634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 09/16/2022] [Indexed: 11/13/2022] Open
Abstract
Background and aims Standard 12-lead electrocardiogram (ECG) patterns combined with the anatomical cardiac long-axis angle revealed by chest X-ray can prevent the influence of cardiac rotation, physical shape, and lead position, so it may be an ideal means to predict the origin of the outflow tract (OT) ventricular arrhythmias (OTVAs) for ablation procedures. The study explores the value of this strategy in identifying the origin of OTVA. Methods This study was conducted using a retrospective cohort and a prospective cohort of consecutive patients at two centers. The anatomical cardiac long-axis angle was calculated by measuring the angle between the cardiac long-axis (a line joining the apex to the midpoint of the mitral annulus) and the horizontal plane on a chest X-ray. The V2S angle was calculated as the V2S amplitude times the angle. We ultimately enrolled 147 patients with symptomatic OTVAs who underwent successful radiofrequency catheter ablation (RFCA) (98 women (66.7%); mean age 46.9 ± 14.7 years; 126 right ventricular OT (RVOT) origins, 21 left ventricular OT (LVOT) origins) as a development cohort. The new algorithm was validated in 48 prospective patients (12 men (25.0%); mean age 48.0 ± 15.8 years; 36 RVOT, 12 LVOT origins). Results Patients with RVOT VAs had greater V2S, long-axis angle, and V2S angle than patients with LVOT VA (all P < 0.001). The cut-off V2S angle obtained by receiver operating characteristic (ROC) curve analysis was 58.28 mV° for the prediction of RVOT origin (sensitivity: 85.7%; specificity: 95.2%; positive predictive value: 99.1%; negative predictive value: 52.6%). The AUC achieved using the V2S angle was 0.888 (P < 0.001), which was the highest among all indexes (V2S/V3R: 0.887 (P < 0.016); TZ index: 0.858 (P < 0.001); V1-2 SRd: 0.876 (P < 0.001); V3 transition: 0.651 (P < 0.001)). In the prospective cohort, the V2S angle had a high overall accuracy of 93.8% and decreased the procedure time (P = 0.002). Conclusion V2S angle can be a novel measure that can be used to accurately differentiate RVOT from LVOT origins. It could help decrease ablation duration and radiation exposure.
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Affiliation(s)
- Shifeng Qiu
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China,Guangdong Provincial Key Laboratory of Shock and Microcirculation, Nanfang Hospital, Southern Medical University, Guangzhou, China,State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zhuhua Sun
- Department of Health Management, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Xinzhong Li
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China,Guangdong Provincial Key Laboratory of Shock and Microcirculation, Nanfang Hospital, Southern Medical University, Guangzhou, China,State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jianyong Li
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China,Guangdong Provincial Key Laboratory of Shock and Microcirculation, Nanfang Hospital, Southern Medical University, Guangzhou, China,State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiaobo Huang
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China,Guangdong Provincial Key Laboratory of Shock and Microcirculation, Nanfang Hospital, Southern Medical University, Guangzhou, China,State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Menghui Liu
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China,Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China
| | - Jianping Bin
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China,Guangdong Provincial Key Laboratory of Shock and Microcirculation, Nanfang Hospital, Southern Medical University, Guangzhou, China,State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yulin Liao
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China,Guangdong Provincial Key Laboratory of Shock and Microcirculation, Nanfang Hospital, Southern Medical University, Guangzhou, China,State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jiancheng Xiu
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China,Guangdong Provincial Key Laboratory of Shock and Microcirculation, Nanfang Hospital, Southern Medical University, Guangzhou, China,State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Daogang Zha
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China,Guangdong Provincial Key Laboratory of Shock and Microcirculation, Nanfang Hospital, Southern Medical University, Guangzhou, China,State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yumei Xue
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China,Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China,Yumei Xue,
| | - Lichun Wang
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China,Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China,Lichun Wang,
| | - Yuegang Wang
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China,Guangdong Provincial Key Laboratory of Shock and Microcirculation, Nanfang Hospital, Southern Medical University, Guangzhou, China,State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China,*Correspondence: Yuegang Wang,
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Wei HQ, Xue Y, Wu S, Fang X. Case report: Three-dimensional printing as an educational tool for optimal lead positioning to left bundle branch pacing. Front Cardiovasc Med 2022; 9:973480. [PMID: 36186972 PMCID: PMC9520357 DOI: 10.3389/fcvm.2022.973480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
Left bundle branch pacing (LBBP) has been widely adopted as a physiological pacing approach. However, LBBP fails to achieve in some cases because it is difficult to maintain the orientation of the lead tip perpendicular to the interventricular septum (IVS). Three-dimensional (3D) printing technology has emerged as a promising tool for modeling and teaching cardiovascular interventions. Seeking confirmation of optimal lead placement relative to the IVS, we used 3D printing technology to generate a 3D printed heart from a selected patient with successful and proven LBBP. Our model successfully illustrated that the lead tip was perpendicular to the IVS. Application of the 3D technology has potential to help the early-operator understand the optimal lead placement relative to IVS and diminish the learning-curve.
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Wang J, Mi J, Liang Y, Wu XQ, Zhang JX, Liu YP, Wang L, Xue Y, Shi YC, Gong WP. [Transcriptomic analysis of tuberculosis peptide-based vaccine MP3RT in humanized mice]. Zhonghua Jie He He Hu Xi Za Zhi 2022; 45:894-903. [PMID: 36097927 DOI: 10.3760/cma.j.cn112147-20220112-00045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To identify the differentially expressed genes (DEGs) induced by tuberculosis peptide-based vaccine MP3RT in a humanized mouse model using transcriptomics technology. Methods: This study was conducted from August 2019 to February 2022. We used edgeR software to screen DEGs with a fold change greater than or equal to 1.5 and a P value less than 0.05 as screening conditions. Gene ontology (GO), Kyoto encyclopedia of genes and genomes (KEGG), and protein interaction network analyses were performed on the screened DEGs. Then, these DEGs were verified by RT-qPCR and statistically analyzed by GraphPad Prism 8 software. Results: A total of 367 DEGs (214 up-regulated and 153 down-regulated) were identified by transcriptomics. Bioinformatics analysis showed that the GO enrichment of the DEGs mentioned above significantly focused on cell metabolism, growth, apoptosis, inflammation, and other terms. In contrast, the KEGG enrichment significantly focused on inflammatory pathways such as the MAPK signaling pathway. Protein interaction network analysis showed that protein Abl1 had the highest aggregation, the highest aggregation coefficient, and the best connectivity. RT-qPCR results showed that gene expressions of cpne4 (t=2.48, P=0.048 0), h2-q10 (t=2.95, P=0.025 6), mef2c (t=2.87, P=0.028 4), cr2 (t=3.23, P=0.178), ablim1 (t=2.91, P=0.033 5), dll1 (t=2.70, P=0.027 3) and ms4a2 (t=3.03, P=0.019 2) genes in the MP3RT group were significantly up-regulated than those in the PBS group, while gene expressions of cd163l1 (t=2.56, P=0.043 0), il1r1 (t=2.91, P=0.022 7) and cd34 (t=2.42, P=0.046 2) genes in the MP3RT group were significantly down-regulated than those in the PBS group. Conclusions: The MP3RT vaccine induced 367 DEGs in humanized mice, which were associated with metabolic and immune responses. Furthermore, we found that p38 MAPK and JNK/MAPK signaling pathways played an important role in the molecular mechanism of the MP3RT vaccine.
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Affiliation(s)
- J Wang
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, the Eighth Medical Center of PLA General Hospital, Beijing 100091, China
| | - J Mi
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, the Eighth Medical Center of PLA General Hospital, Beijing 100091, China
| | - Y Liang
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, the Eighth Medical Center of PLA General Hospital, Beijing 100091, China
| | - X Q Wu
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, the Eighth Medical Center of PLA General Hospital, Beijing 100091, China
| | - J X Zhang
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, the Eighth Medical Center of PLA General Hospital, Beijing 100091, China
| | - Y P Liu
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, the Eighth Medical Center of PLA General Hospital, Beijing 100091, China
| | - L Wang
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, the Eighth Medical Center of PLA General Hospital, Beijing 100091, China
| | - Y Xue
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, the Eighth Medical Center of PLA General Hospital, Beijing 100091, China
| | - Y C Shi
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, the Eighth Medical Center of PLA General Hospital, Beijing 100091, China
| | - W P Gong
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, the Eighth Medical Center of PLA General Hospital, Beijing 100091, China
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Feng F, Ning Y, Xue Y, Friedl V, Hann D, Gibb B, Bergamaschi A, Guler G, Hazen K, Scott A, Phillips T, McCarthy E, Ellison C, Malta R, Nguyen A, Lopez V, Cavet R, Chowdhury S, Volkmuth W, Levy S. 69MO 5-Hydroxymethycytosine analysis reveals stable epigenetic changes in tumor tissue that enable cfDNA cancer predictions. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Xue Y, Lyu C, Taylor A, van Ee A, Kiemen A, Choi Y, Lee C, Wirtz D, Garza L, Reddy S. 759 Mechanical tension mobilizes Lgr6+ epidermal stem cells to drive skin growth. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Chen Y, Fu L, Pu S, Xue Y. Systemic lupus erythematosus increases risk of incident atrial fibrillation: A systematic review and meta-analysis. Int J Rheum Dis 2022; 25:1097-1106. [PMID: 35906745 DOI: 10.1111/1756-185x.14403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/08/2022] [Accepted: 07/13/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVES Patients with systemic lupus erythematosus (SLE) might have increased risk of atrial fibrillation (AF) as a result of initiating chronic and systematic inflammation. However, the prevalence of AF in patients with SLE have not been well quantified. The aim of this systematic review and meta-analysis was to collect and identify available clinical data to explore this possible correlation. METHODS Articles were searched based on electronic databases (PubMed, Scopus, ScienceDirect, Cochrane Library, Web of Science). Review Manager 5.4 was used to perform meta-analysis of all selected studies and subgroup analyses (pooled separately by geographical distribution). Pooled risk ratio (RR) and 95% confidence intervals (95% CI) were calculated by random-effect model or fix-effect model. RESULTS Six cohort studies were involved in this meta-analysis, including 311 844 participants, 78 134 cases of SLE and 347 883 non-SLE controls. Pooled studies indicated increased risk of AF development in patients with SLE compared to participants without SLE (I2 = 96%, RR = 1.85; 95% CI: 1.23-2.79; P = .003). Four clinical trials including only European/ American populations were analyzed in subgroups. Heterogeneity analysis showed that I2 = 9% and there was an increase in the risk of AF development in European/ American patients with SLE (RR = 1.79; 95% CI: 1.61-1.98; P < .001), while in 2 Korean studies, the heterogeneity was 98% and there was no correlation between AF and SLE (RR = 1.81, 95% CI: 0.39-8.43). Five clinical studies were involved in subgroup analysis after excluding the Beak study, with I2 = 96% and they suggested that SLE increased the risk of AF development (RR = 2.13, 95% CI: 1.42-3.21, P = .002). CONCLUSION This meta-analysis suggested that SLE may be a risk factor for AF development and the results may vary with geographic distribution.
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Affiliation(s)
- Yanlin Chen
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Lu Fu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Sijia Pu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yumei Xue
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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Gong S, Wang B, Xue Y, Sun Q, Wang J, Kuai J, Liu F, Cheng J. NiCoO2 and polypyrrole decorated three-dimensional carbon nanofiber network with coaxial cable-like structure for high-performance supercapacitors. J Colloid Interface Sci 2022; 628:343-355. [DOI: 10.1016/j.jcis.2022.07.134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 01/17/2023]
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Tung R, Xue Y, Chen M, Jiang C, Shatz DY, Besser SA, Hu H, Chung FP, Nakahara S, Kim YH, Satomi K, Shen L, Liang E, Liao H, Gu K, Jiang R, Jiang J, Hori Y, Choi JI, Ueda A, Komatsu Y, Kazawa S, Soejima K, Chen SA, Nogami A, Yao Y. First-Line Catheter Ablation of Monomorphic Ventricular Tachycardia in Cardiomyopathy Concurrent With Defibrillator Implantation: The PAUSE-SCD Randomized Trial. Circulation 2022; 145:1839-1849. [PMID: 35507499 DOI: 10.1161/circulation.122.060039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND Catheter ablation as first-line therapy for ventricular tachycardia (VT) at the time of implantable cardioverter defibrillator (ICD) implantation has not been adopted into clinical guidelines. Also, there is an unmet clinical need to prospectively examine the role of VT ablation in patients with nonischemic cardiomyopathy, an increasingly prevalent population that is referred for advanced therapies globally. METHODS We conducted an international, multicenter, randomized controlled trial enrolling 180 patients with cardiomyopathy and monomorphic VT with an indication for ICD implantation to assess the role of early, first-line ablation therapy. A total of 121 patients were randomly assigned (1:1) to ablation plus an ICD versus conventional medical therapy plus an ICD. Patients who refused ICD (n=47) were followed in a prospective registry after stand-alone ablation treatment. The primary outcome was a composite end point of VT recurrence, cardiovascular hospitalization, or death. RESULTS Randomly assigned patients had a mean age of 55 years (interquartile range, 46-64) and left ventricular ejection fraction of 40% (interquartile range, 30%-49%); 81% were male. The underlying heart disease was ischemic cardiomyopathy in 35%, nonischemic cardiomyopathy in 30%, and arrhythmogenic cardiomyopathy in 35%. Ablation was performed a median of 2 days before ICD implantation (interquartile range, 5 days before to 14 days after). At 31 months, the primary outcome occurred in 49.3% of the ablation group and 65.5% in the control group (hazard ratio, 0.58 [95% CI, 0.35-0.96]; P=0.04). The observed difference was driven by a reduction in VT recurrence in the ablation arm (hazard ratio, 0.51 [95%CI, 0.29-0.90]; P=0.02). A statistically significant reduction in both ICD shocks (10.0% versus 24.6%; P=0.03) and antitachycardia pacing (16.2% versus 32.8%; P=0.04) was observed in patients who underwent ablation compared with control. No differences in cardiovascular hospitalization (32.0% versus. 33.7%; hazard ratio, 0.82 [95% CI, 0.43-1.56]; P=0.55) or mortality (8.9% versus 8.8%; hazard ratio, 1.40 [95% CI, 0.38-5.22]; P=0.62]) were observed. Ablation-related complications occurred in 8.3% of patients. CONCLUSIONS Among patients with cardiomyopathy of varied causes, early catheter ablation performed at the time of ICD implantation significantly reduced the composite primary outcome of VT recurrence, cardiovascular hospitalization, or death. These findings were driven by a reduction in ICD therapies. REGISTRATION URL: https://www. CLINICALTRIALS gov; Unique identifier: NCT02848781.
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Affiliation(s)
- Roderick Tung
- The University of Chicago, Center for Arrhythmia Care, Pritzker School of Medicine, IL (R.T., D.Y.S., S.A.B.)
- Guangdong Provincial People's Hospital, China (R.T., Y.X., H.L.)
- Department of Cardiology, Sir Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China (R.T.)
| | - Yumei Xue
- Guangdong Provincial People's Hospital, China (R.T., Y.X., H.L.)
| | - Minglong Chen
- The First Affiliated Hospital of Nanjing Medical University, China (M.C., K.G.)
| | - Chenyang Jiang
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China (C.J., R.J.)
| | - Dalise Y Shatz
- The University of Chicago, Center for Arrhythmia Care, Pritzker School of Medicine, IL (R.T., D.Y.S., S.A.B.)
| | - Stephanie A Besser
- The University of Chicago, Center for Arrhythmia Care, Pritzker School of Medicine, IL (R.T., D.Y.S., S.A.B.)
| | - Hongde Hu
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu (H.H., J.J.)
| | - Fa-Po Chung
- Taipei Veterans General Hospital, National Yang Ming Chiao Tung University, Taiwan (F.-P.C.)
| | - Shiro Nakahara
- Dokkyo Medical University Saitama Medical Center, Japan (S.N., Y.H.)
| | - Young-Hoon Kim
- Division of Cardiology, Department of Internal Medicine, Korea University Medical Center, Seoul, Korea (Y.-H.K., J.-I.C.)
| | | | - Lishui Shen
- Fuwai Hospital, Arrhythmia Center, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing (L.S., E.L., Y.Y.)
| | - Er'peng Liang
- Fuwai Hospital, Arrhythmia Center, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing (L.S., E.L., Y.Y.)
| | - Hongtao Liao
- Guangdong Provincial People's Hospital, China (R.T., Y.X., H.L.)
| | - Kai Gu
- The First Affiliated Hospital of Nanjing Medical University, China (M.C., K.G.)
| | - Ruhong Jiang
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China (C.J., R.J.)
| | - Jian Jiang
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu (H.H., J.J.)
| | - Yuichi Hori
- Dokkyo Medical University Saitama Medical Center, Japan (S.N., Y.H.)
| | - Jong-Il Choi
- Division of Cardiology, Department of Internal Medicine, Korea University Medical Center, Seoul, Korea (Y.-H.K., J.-I.C.)
| | - Akiko Ueda
- Division of Advanced Arrhythmia Management, Kyorin University Hospital, Japan (A.U.)
| | - Yuki Komatsu
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Japan (Y.K., A.N.)
| | | | - Kyoko Soejima
- Department of Cardiovascular Medicine, Kyorin University Hospital, Japan (K.S.)
| | - Shih-Ann Chen
- Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan (S.-A.C.)
| | - Akihiko Nogami
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Japan (Y.K., A.N.)
| | - Yan Yao
- Fuwai Hospital, Arrhythmia Center, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing (L.S., E.L., Y.Y.)
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Jiang J, Deng H, Liao H, Fang X, Zhan X, Wu S, Xue Y. Development and Validation of a Deep-Learning Model to Detect CRP Level from the Electrocardiogram. Front Physiol 2022; 13:864747. [PMID: 35707008 PMCID: PMC9189881 DOI: 10.3389/fphys.2022.864747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 05/11/2022] [Indexed: 11/13/2022] Open
Abstract
Background: C-reactive protein (CRP), as a non-specific inflammatory marker, is a predictor of the occurrence and prognosis of various arrhythmias. It is still unknown whether electrocardiographic features are altered in patients with inflammation. Objectives: To evaluate the performance of a deep learning model in detection of CRP levels from the ECG in patients with sinus rhythm. Methods: The study population came from an epidemiological survey of heart disease in Guangzhou. 12,315 ECGs of 11,480 patients with sinus rhythm were included. CRP > 5mg/L was defined as high CRP level. A convolutional neural network was trained and validated to detect CRP levels from 12 leads ECGs. The performance of the model was evaluated by calculating the area under the curve (AUC), accuracy, sensitivity, specificity, and balanced F Score (F1 score). Results: Overweight, smoking, hypertension and diabetes were more common in the High CRP group (p < 0.05). Although the ECG features were within the normal ranges in both groups, the high CRP group had faster heart rate, longer QTc interval and narrower QRS width. After training and validating the deep learning model, the AUC of the validation set was 0.86 (95% CI: 0.85-0.88) with sensitivity, specificity of 89.7 and 69.6%, while the AUC of the testing set was 0.85 (95% CI: 0.84-0.87) with sensitivity, specificity of 90.7 and 67.6%. Conclusion: An AI-enabled ECG algorithm was developed to detect CRP levels in patients with sinus rhythm. This study proved the existence of inflammation-related changes in cardiac electrophysiological signals and provided a noninvasive approach to screen patients with inflammatory status by detecting CRP levels.
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Affiliation(s)
- Junrong Jiang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Hai Deng
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Hongtao Liao
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xianhong Fang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xianzhang Zhan
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Shulin Wu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yumei Xue
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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He S, Zhao F, Liu X, Liu F, Xue Y, Liao H, Zhan X, Lin W, Zheng M, Jiang J, Li H, Ma X, Wu S, Deng H. Prevalence of congenital heart disease among school children in Qinghai Province. BMC Pediatr 2022; 22:331. [PMID: 35672682 PMCID: PMC9175385 DOI: 10.1186/s12887-022-03364-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 05/10/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives This study aimed to investigate the prevalence of congenital heart disease (CHD) among school children in Qinghai province, a high-altitude region in China. Methods A cross-sectional study was conducted among school-aged children in 2019. All subjects completed a survey with a structure questionnaire and underwent CHD screening. CHD was screened by standard physical examination and further confirmed by echocardiography. Multivariate logistic regression were used to estimate the association of CHD prevalence with gender, nationality, and altitude. Results A total of 43,562 children aged 3–19 years participated in the study. The mean (SD) age was 11.2 (3.3) years. 49.7% were boys, and 80.0% were of Tibetan. CHD was identified in 293 children, with an overall prevalence of 6.73 ‰. Among them, 239 were unrecognized CHD, yielding a prevalence of 5.49 ‰. Atrial septal defect accounted for 51.9% of the CHD, followed by patent ductus arteriosus (31.1%), ventricular septal defect (9.9%). The CHD prevalence was significantly higher in female (8 ‰), Han race (18 ‰), children lived in Qumalai county (13 ‰), and children lived in a higher altitude (13 ‰). Female had greater prevalence of total CHD, atrial septal defect, and patent ductus arteriosus, but insignificant difference was observed in ventricular septal defect prvalence than male. In multivariable logistic regression analyses, female (OR, 1.48; 95% CI, 1.17–1.87, P = 0.001), Han population (OR, 3.28; 95% CI, 1.67–6.42, P = 0.001), and higher altitudes (OR, 2.28; 95% CI, 1.74–3.00, P < 0.001) were shown to be independently association with CHD prevalence. Conclusions The prevalence of CHD in Qinghai province was 6.73 ‰. Altitude elevation, female, and Han population were independently association with CHD prevalence.
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Affiliation(s)
- Shangfei He
- Qinghai Province Cardio Cerebrovascular Disease Specialist Hospital, No.7 of Zhuanchang Road, Xining City, 810012, Qinghai Province, China.,Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Science, No.106 of Zhongshan Second Road, Guangzhou City, 510080, Guangdong Province, China
| | - Fengqing Zhao
- Qinghai Province Cardio Cerebrovascular Disease Specialist Hospital, No.7 of Zhuanchang Road, Xining City, 810012, Qinghai Province, China
| | - Xudong Liu
- School of Public Health, Sun Yat-Sen University, No.74 of Zhongshan Second Road, Guangzhou City, 510080, Guangdong Province, China
| | - Fangzhou Liu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Science, No.106 of Zhongshan Second Road, Guangzhou City, 510080, Guangdong Province, China
| | - Yumei Xue
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Science, No.106 of Zhongshan Second Road, Guangzhou City, 510080, Guangdong Province, China
| | - Hongtao Liao
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Science, No.106 of Zhongshan Second Road, Guangzhou City, 510080, Guangdong Province, China
| | - Xianzhang Zhan
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Science, No.106 of Zhongshan Second Road, Guangzhou City, 510080, Guangdong Province, China
| | - Weidong Lin
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Science, No.106 of Zhongshan Second Road, Guangzhou City, 510080, Guangdong Province, China
| | - Murui Zheng
- Guangzhou Center for Disease Control and Prevention. , No.23 of Jiaochang Road, Guangzhou City, 510120, Guangdong Province, China
| | - Junrong Jiang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Science, No.106 of Zhongshan Second Road, Guangzhou City, 510080, Guangdong Province, China
| | - Huoxing Li
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Science, No.106 of Zhongshan Second Road, Guangzhou City, 510080, Guangdong Province, China
| | - Xiaofeng Ma
- Qinghai Province Cardio Cerebrovascular Disease Specialist Hospital, No.7 of Zhuanchang Road, Xining City, 810012, Qinghai Province, China.
| | - Shulin Wu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Science, No.106 of Zhongshan Second Road, Guangzhou City, 510080, Guangdong Province, China.
| | - Hai Deng
- Qinghai Province Cardio Cerebrovascular Disease Specialist Hospital, No.7 of Zhuanchang Road, Xining City, 810012, Qinghai Province, China. .,Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Science, No.106 of Zhongshan Second Road, Guangzhou City, 510080, Guangdong Province, China. .,Southern Medical University, No.1023-1063 of Shatai South Road, Guangzhou City, 510515, Guangdong Province, China.
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Sun XY, Xue Y, Wang YP, Huang J, Lin RF, Kang MY, Fang YJ. [Clinical phenotype and genotype of Gaucher disease in 14 children]. Zhonghua Er Ke Za Zhi 2022; 60:527-532. [PMID: 35658357 DOI: 10.3760/cma.j.cn112140-20220228-00159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To analyze the clinical and genetical characteristics of children with Gaucher disease and to explore the relationship between genotype and phenotype. Methods: In this retrospective study, the clinical data of 14 children with Gaucher disease diagnosed in Children's Hospital of Nanjing Medical University from August 2016 to October 2021 were analyzed. Their general conditions, clinical manifestations, laboratory tests and gene variations were collected, followed by the analysis of the clinical phenotypes and genotypes. Results: Among 14 children diagnosed with Gaucher disease, 9 were males and 5 were females, with the age of diagnosis ranging from 0.7 to 15.8 years. There were 10 patients with type 1 Gaucher disease, 2 patients with type 2, and 2 patients with type 3. The most common clinical manifestations were splenomegaly, thrombocytopenia (14 cases), hepatomegaly (8 cases) and anemia (8 cases). There were 6 patients with growth retardation, and 5 patients lag in height compared with their peers. Bone abnormalities were revealed by magnetic resonance imaging in 7 type 1 Gaucher disease patients, but only 1 patient experienced bone pain. Patients with type 2 and type 3 Gaucher disease also presented with convulsions, nystagmus and hearing loss. Gaucher cells were found in bone marrow smears in 12 patients. The glucocerebrosidase gene variations identified in 13 patients were heterozygous and in 1 type 1 patient was homozygous of L483P. L483P variation accounted for 33%(10/30) of the variation alleles, followed by V414L, D448H and R159W. The variation alleles were L483P and L422R, F252I and L483P in 2 children with severe neurological manifestations of Gaucher disease. A novel variation c.22A>G was detected. Conclusions: Splenomegaly and thrombocytopenia are the main clinical presentations of Gaucher disease in children and bone lesions revealed by radiologic imaging appear prior to the occurrence of bone diseases, type 2 and type 3 Gaucher disease also present growth retardation and neurological manifestation. The most frequent variant allele is L483P, which are detected in all 3 subtypes of Gaucher disease. The L422R, F252I gene variants correlated with the neuronopathic phenotype.
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Affiliation(s)
- X Y Sun
- Department of Hematological Oncology, Children's Hospital of Nanjing Medical University, Nanjing 210008, China
| | - Y Xue
- Department of Hematological Oncology, Children's Hospital of Nanjing Medical University, Nanjing 210008, China
| | - Y P Wang
- Department of Hematological Oncology, Children's Hospital of Nanjing Medical University, Nanjing 210008, China
| | - J Huang
- Department of Hematological Oncology, Children's Hospital of Nanjing Medical University, Nanjing 210008, China
| | - R F Lin
- Department of Hematological Oncology, Children's Hospital of Nanjing Medical University, Nanjing 210008, China
| | - M Y Kang
- Department of Hematological Oncology, Children's Hospital of Nanjing Medical University, Nanjing 210008, China
| | - Y J Fang
- Department of Hematological Oncology, Children's Hospital of Nanjing Medical University, Nanjing 210008, China
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Mcgrath M, Xue Y, Dillen C, Oldfield L, Assad-garcia N, Zaveri J, Singh N, Baracco L, Taylor L, Vashee S, Frieman M. SARS-CoV-2 Variant Spike and accessory gene mutations alter pathogenesis.. [PMID: 35677080 PMCID: PMC9176647 DOI: 10.1101/2022.05.31.494211] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The ongoing COVID-19 pandemic is a major public health crisis. Despite the development and deployment of vaccines against SARS-CoV-2, the pandemic persists. The continued spread of the virus is largely driven by the emergence of viral variants, which can evade the current vaccines through mutations in the Spike protein. Although these differences in Spike are important in terms of transmission and vaccine responses, these variants possess mutations in the other parts of their genome which may affect pathogenesis. Of particular interest to us are the mutations present in the accessory genes, which have been shown to contribute to pathogenesis in the host through innate immune signaling, among other effects on host machinery. To examine the effects of accessory protein mutations and other non-spike mutations on SARS-CoV-2 pathogenesis, we synthesized viruses where the WA1 Spike is replaced by each variant spike genes in a SARS-CoV-2/WA-1 infectious clone. We then characterized the in vitro and in vivo replication of these viruses and compared them to the full variant viruses. Our work has revealed that non-spike mutations in variants can contribute to replication of SARS-CoV-2 and pathogenesis in the host and can lead to attenuating phenotypes in circulating variants of concern. This work suggests that while Spike mutations may enhance receptor binding and entry into cells, mutations in accessory proteins may lead to less clinical disease, extended time toward knowing an infection exists in a person and thus increased time for transmission to occur.
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Yu MR, Yang GH, Liu GH, Zeng YT, Xue Y, Ma QW, Zeng FY. [Factor analysis of effective platelet-producing ability of fetal liver-derived cells]. Zhonghua Nei Ke Za Zhi 2022; 61:664-672. [PMID: 35673747 DOI: 10.3760/cma.j.cn112138-20220318-00190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To study the different factors affecting platelet production post transplantation of hematopoietic stem cells (HSCs) isolated from different sources in order to explore novel options for treating platelet depletion following HSCs transplantation. Methods: HSCs and their downstream derivatives including myeloid and lymphoid cells (i.e., collective of mononuclear cells (MNCs)), were isolated from E14.5 fetal liver (FL) and bone marrow (BM) of 8-week-old mice by Ficoll separation technique. These cells were subsequently transplanted into the tibia bone marrow cavity of recipient mice post lethal myeloablative treatment in order to construct the FL-MNCs and BM-MNCs transplantation mouse model. Routine blood indices were examined in these recipient mice. The chimeric rate of donor cells in recipient peripheral blood cells were determined by flow cytometry. Different groups of cells involved in platelet reconstruction were analyzed. CD41+megakaryocytes were sorted from fetal liver or bone marrow using magnetic beads, which were then induced to differentiate into platelets in an in vitro assay. Quantitative RT-PCR was used to detect the expression of platelet-related genes in CD41+megakaryocytes from the two sources. Results: Both the FL-MNCs and the BM-MNCs transplantation groups resumed normal hematopoiesis at the 4th week after transplantation, and the blood cells of the recipient mice were largely replaced by the donor cells. Compared with the mice transplanted with BM-MNCs, the platelet level of mice transplanted with FL-MNCs recovered faster and were maintained at a higher level. At week 4, the PLT level of the FL-MNCs group was (1.45±0.37)×1012/L, and of the BM-MNCs group was (1.22±0.24)×1012/L, P<0.05. The FL-MNCs contain a higher proportion of hematopoietic stem cells (Lin-Sca-1+c-Kit+)(7.60%±1.40%) compared to the BM-MNCs (1.10%±0.46%), P<0.01; the proportion of the megakaryocyte progenitor cells (Lin-Sca-1-c-Kit+CD41+CD150+) and mature megakaryocyte cells (CD41+CD42b+), also differ significantly between the FL-MNCs (3.05%±0.22%, 1.60%±0.06%, respectively) and the BM-MNCs (0.15%±0.02%, 0.87%±0.11%, respectively) groups, both P<0.01. In vitro functional studies showed that FL-MNCs-CD41+megakaryocytes could produce proplatelet-like cells more quickly after induction, with proplatelet-like cells formation on day 3 and significant platelet-like particle formation on day 5, in contrast to bone marrow-derived BM-MNCs-CD41+megakaryocytes that failed to form proplatelet-like cell on day 5. In addition, FL-MNCs-CD41+cells expressed higher levels of platelet-related genes, Mpl (3.25-fold), Fog1 (3-fold), and Gata1 (1.5-fold) (P<0.05). Conclusion: Compared with the BM-MNCs group, the FL-MNCs transplantation group appears to have a more efficient platelet implantation effect in the HSCs transplantation recipient in vivo, as well as a higher platelet differentiation rate in vitro. This might be related to a higher proportion of megakaryocytes and higher expression levels of genes such as Mpl, Fog1, and Gata1 that could be important for platelet formation in FL-MNCs-CD41+cells. Further exploration of the specific functions of these genes and the characteristics of the different proportions of the donor cells will provide valuable clues for the future treatment of platelets reconstitution after HSCs transplantation clinically.
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Affiliation(s)
- M R Yu
- Shanghai Institute of Medical Genetics, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200040, China
| | - G H Yang
- Shanghai Institute of Medical Genetics, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200040, China
| | - G H Liu
- Shanghai Institute of Medical Genetics, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200040, China
| | - Y T Zeng
- Shanghai Institute of Medical Genetics, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200040, China
| | - Y Xue
- Shanghai Institute of Medical Genetics, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200040, China Department of Histoembryology, Genetics & Development, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China NHC Key Laboratory of Medical Embryogenesis and Developmental Molecular Biology, Shanghai Key Laboratory of Embryo and Reproduction Engineering, Shanghai 200040, China
| | - Q W Ma
- Shanghai Institute of Medical Genetics, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200040, China NHC Key Laboratory of Medical Embryogenesis and Developmental Molecular Biology, Shanghai Key Laboratory of Embryo and Reproduction Engineering, Shanghai 200040, China
| | - F Y Zeng
- Shanghai Institute of Medical Genetics, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200040, China Department of Histoembryology, Genetics & Development, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China NHC Key Laboratory of Medical Embryogenesis and Developmental Molecular Biology, Shanghai Key Laboratory of Embryo and Reproduction Engineering, Shanghai 200040, China
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Tung R, Xue Y, Chen M, Jiang C, Shatz DY, Besser S, Hu H, Chung FP, Nakahara S, Kim YH, Satomi K, Shen L, Liang E, Liao H, Gu K, Jiang R, Jiang J, Hori Y, Choi JI, Ueda A, Komatsu Y, Kazawa S, Soejima K, Chen SA, Nogami A, Yao Y. First-Line Catheter Ablation of Monomorphic Ventricular Tachycardia in Cardiomyopathy Concurrent with Defibrillator Implantation: The PAUSE-SCD Randomized Trial. Circulation 2022; 145:1839-1849. [PMID: 35507499 DOI: 10.1161/circulationaha.122.060039] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background: Catheter ablation as first-line therapy for ventricular tachycardia (VT) at the time of implantable cardioverter defibrillator (ICD) implantation has not been adopted into clinical guidelines. Also, there is an unmet clinical need to prospectively examine the role of VT ablation in patients with non-ischemic cardiomyopathy (NICM), an increasingly prevalent population referred for advanced therapies globally. Methods: We conducted an international, multi-center, randomized controlled trial enrolling 180 patients with cardiomyopathy and monomorphic VT with an indication for implantable cardioverter defibrillator (ICD) implantation to assess the role of early, first-line ablation therapy. A total of 121 patients were randomized (1:1) to ablation + an ICD versus conventional medical therapy + an ICD. Patients who refused ICD (n=47) were followed in a prospective registry after stand-alone ablation treatment. The primary outcome was a composite endpoint of VT recurrence, cardiovascular hospitalization, or death. Results: Randomized patients had a mean age of 55 years old (IQR 46-64) and left ventricular ejection fraction of 40 % (IQR 30-49 %); 81 % were male. The underlying heart disease was ischemic cardiomyopathy (ICM) in 35 %, NICM in 30 %, and arrhythmogenic cardiomyopathy (ARVC) in 35 %. Ablation was performed a median of 2 days prior to ICD implantation (IQR 5 days prior to 14 days after). At 31-months, the primary outcome occurred in 49.3 %of the ablation group and 65.5 % in the control group (HR 0.58, 95 % CI, 0.35-0.96; P=0.04). The observed difference was driven by a reduction in VT recurrence in the ablation arm (HR 0.51 [95 %CI, 0.29-0.90 ]; P=0.02). A statistically significant reduction in both ICD shocks (10.0 vs 24.6 %; p=0.03) and anti-tachycardia pacing (16.2 % vs 32.8 %; p=0.04) was observed in patients who underwent ablation compared with control. No differences in cardiovascular hospitalization (32.0 % vs. 33.7 %; HR 0.82 [95 % CI, 0.43-1.56 ]; P=0.55) or mortality (8.9% vs 8.8 %, HR 1.40 [95 %CI, 0.38-5.22 ]; P=0.62]) were observed. Ablation-related complications occurred in 8.3 % of patients. Conclusions: Among patients with cardiomyopathy of varied etiologies, early catheter ablation performed at the time of ICD implantation significantly reduced the composite primary outcome of VT recurrence, cardiovascular hospitalization, or death. These findings were driven by a reduction in ICD therapies.
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Affiliation(s)
- Roderick Tung
- The University of Chicago, Center for Arrhythmia Care, Pritzker School of Medicine, Chicago, IL; Guangdong Provincial People's Hospital, China; Department of Cardiology, Sir Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yumei Xue
- Guangdong Provincial People's Hospital, China
| | - Minglong Chen
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Chenyang Jiang
- Department of Cardiology, Sir Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Dalise Y Shatz
- The University of Chicago, Center for Arrhythmia Care, Pritzker School of Medicine, Chicago, IL
| | - Stephanie Besser
- The University of Chicago, Center for Arrhythmia Care, Pritzker School of Medicine, Chicago, IL
| | - Hongde Hu
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Fa-Po Chung
- Taipei Veterans General Hospital, National Yang Ming Chiao Tung University, Taiwan
| | | | - Young-Hoon Kim
- Department of Cardiology, Korea University Medicine, Seoul, South Korea
| | | | - Lishui Shen
- Fuwai Hospital, Arrhythmia Center, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Erpeng Liang
- Fuwai Hospital, Arrhythmia Center, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | | | - Kai Gu
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Ruhong Jiang
- Department of Cardiology, Sir Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jian Jiang
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Yuichi Hori
- Dokkyo Medical University Saitama Medical Center, Japan
| | - Jong-Il Choi
- Department of Cardiology, Korea University Medicine, Seoul, South Korea
| | - Akiko Ueda
- Division of Advanced Arrhythmia Management, Kyorin University Hospital, Japan
| | - Yuki Komatsu
- Department of Cardiology, University of Tsukuba, Japan
| | | | - Kyoko Soejima
- Division of Advanced Arrhythmia Management, Kyorin University Hospital, Japan
| | - Shih-Ann Chen
- Taipei Veterans General Hospital, National Yang Ming Chiao Tung University, Taiwan
| | | | - Yan Yao
- Fuwai Hospital, Arrhythmia Center, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
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Jiayuan Z, Xiang-Zi J, Li-Na M, Jin-Wei Y, Xue Y. Effects of Mindfulness-Based Tai Chi Chuan on Physical Performance and Cognitive Function among Cognitive Frailty Older Adults: A Six-Month Follow-Up of a Randomized Controlled Trial. J Prev Alzheimers Dis 2022; 9:104-112. [PMID: 35098980 DOI: 10.14283/jpad.2021.40] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To assess the effectiveness of a mindfulness-based Tai Chi Chuan on physical performance and cognitive function among cognitive frailty older adults. DESIGN A single-blind,three-arm randomized controlled trial. SETTING Three communities in Daqing, China. PARTICIPANTS The study sample comprised 93 men and women aged 65 years or older who were able to walk more than 10 m without helping tools, scored 0.5 on Clinical Dementia Rating (CDR) and absence of concurrent dementia, identified pre-frailty (scored 1-2 on Fried Frailty Criteria) and frailty older adults (scored 3-5 on Fried Frailty Criteria). INTERVENTION Subjects were randomly allocated to three groups: Group1, which received mindfulness intervention (formal and informal mindfulness practices); Group 2, which received Tai-Chi Chuan intervention; Group 3, which received MTCC intervention. MEASUREMENTS The primary outcomes was cognitive frailty rate(measured by Fried Frailty Criteria and Clinical Dementia Rating-CDR) , the secondary outcome were cognitive function (measured by Min-Mental State Examination-MMES) and physical level (measured by Short physical performance battery- SPPB, Timed up and Go test-TUG and the 30-second Chair test). They were all assessed at Time 1-baseline, Time 2-after the end of 6-month intervention and the follow up (Time 3-half year after the end of 6-month intervention). RESULTS The baseline characteristics did not differ among the groups.Improvements in the cognitive function (MMES), physical performance (SPPB, TUG, 30-second Chair test) were significantly difference between time-group interaction (p<.05). The rate of CF was significantly different among groups at 6-month follow-up period (χ2=6.37, p<.05). A lower prevalence of frailty and better cognitive function and physical performance were found in the Group 3 compared with other two groups at the follow-up period (p<.05). CONCLUSIONS MTCC seems to be effectively reverse CF, improving the cognitive and physical function among older adults, suggesting that MTCC is a preferably intervention option in community older adults with cognitive frailty.
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Affiliation(s)
- Z Jiayuan
- Meng Li-Na, No.39 Xinyang Street, Harbin Medical University, Daqing, Heilongjiang Province, China, Tel: 86-18604586122,
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Huang J, Liu Y, Huang S, Ke G, Chen X, Gong B, Wei W, Xue Y, Deng H, Wu S. Research output of artificial intelligence in arrhythmia from 2004 to 2021: a bibliometric analysis. J Thorac Dis 2022; 14:1411-1427. [PMID: 35693591 PMCID: PMC9186255 DOI: 10.21037/jtd-21-1767] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 03/24/2022] [Indexed: 11/29/2022]
Abstract
Background With the advancement in machine learning (ML) and artificial neural networks as well as the development of portable electrocardiogram devices, artificial intelligence (AI) has been increasing in popularity over the years. In this study, we aimed to provide an overview of the research regarding the utilization of AI techniques to improve the diagnosis of arrhythmia. Methods We extracted data published 2004 to 2021 from Web of Science database. The online analytic platform, Literature Metrology (http://bibliometric.com), was used to analyze publication trends, including information about journals, authors, institutions, collaborations between countries, citations, and keywords. Results Keywords, such as deep learning, electrocardiogram (ECG), and convolutional neural network, have been increasing in frequency over the years. The analysis outcomes demonstrated that topics associated with AI, robotic prosthesis, and big data analysis for arrhythmia have become increasingly popular since 2016. Our study also found that atrial fibrillation (AF) and ventricular arrhythmia were the two ECG signal sharing the most interest. Conclusions The utility of deep learning in diagnostics and the prognostication of arrhythmia has been gaining traction over the years, covering areas from electrocardiogram detection to atrial arrhythmogenesis model construction. Our study revealed the trend of topics from 2004 to 2021, which may help researchers to monitor future trends.
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Affiliation(s)
- Junlin Huang
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Cardiovascular Institute, Guangzhou, China
| | - Yang Liu
- Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Cardiovascular Institute, Guangzhou, China
| | - Shuping Huang
- Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Cardiovascular Institute, Guangzhou, China
| | - Guibao Ke
- Department of Nephrology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Nephrology, Affiliated Hospital/Clinical Medical College of Chengdu University, Chengdu, China
| | - Xin Chen
- Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Cardiovascular Institute, Guangzhou, China
| | - Bei Gong
- Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Cardiovascular Institute, Guangzhou, China
| | - Wei Wei
- Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Cardiovascular Institute, Guangzhou, China
| | - Yumei Xue
- Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Cardiovascular Institute, Guangzhou, China
| | - Hai Deng
- Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Cardiovascular Institute, Guangzhou, China
| | - Shulin Wu
- Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Cardiovascular Institute, Guangzhou, China
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Jiang LD, Ma LL, Xue Y, Pan X, He L, Zhao Y. [Recommendations of diagnosis and treatment of Takayasu's arteritis in China]. Zhonghua Nei Ke Za Zhi 2022; 61:517-524. [PMID: 35488601 DOI: 10.3760/cma.j.cn112138-20211120-00831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Takayasu's arteritis (TAK) mainly involves the aorta and its major branches, which is characterized as a chronic, progressive and inflammatory disease. China belongs to one of the regions with a high prevalence of TAK referring to its global distribution. However, it is insufficient for the spread and update of standardized diagnosis and treatment of TAK. Based on the evidence and guidelines from China and other countries, Chinese Rheumatology Association developed the standardized diagnosis and treatment of TAK in China. The purpose is to standardize the methods for diagnosis of TAK, assessment of disease activity and disease severity, strategies of internal treatment and timing of surgical intervention, and further leading to protect the function of important organs and improve the disease prognosis.
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Affiliation(s)
- L D Jiang
- Department of Rheumatology, Zhongshan Hospital, Fudan University, Evidence-Based Medicine Center, Fudan University, Shanghai 200032, China
| | - L L Ma
- Department of Rheumatology, Zhongshan Hospital, Fudan University, Evidence-Based Medicine Center, Fudan University, Shanghai 200032, China
| | - Y Xue
- Department of Rheumatology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - X Pan
- Department of Hematology and Rheumatology, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi 832008, China
| | - L He
- Department of Rheumatology and Immunology, First Affiliated Hospital of Xi'an JiaoTong University, Xi'an 710061, China
| | - Yan Zhao
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, National Clinical Research Center for Dermatologic and Immunologic Diseases, State Key Laboratory of Complex Severe and Rare Diseases, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing 100730, China
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Varotsos CA, Mkrtchyan FA, Soldatov VY, Xue Y. Capabilities on Remote Microwave Technologies to Assess the State of Water Systems. Water Air Soil Pollut 2022; 233:114. [DOI: 10.1007/s11270-022-05560-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/17/2022] [Indexed: 06/16/2023]
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48
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Bridge J, Fu L, Lin W, Xue Y, Lip GYH, Zheng Y. Artificial intelligence to detect abnormal heart rhythm from scanned electrocardiogram tracings. J Arrhythm 2022; 38:425-431. [PMID: 35785392 PMCID: PMC9237304 DOI: 10.1002/joa3.12707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 03/03/2022] [Accepted: 03/19/2022] [Indexed: 11/17/2022] Open
Abstract
Background Electrocardiogram (ECG) interpretation is an integral part of the clinical ECG workflow; however, this process is often time‐consuming and labor‐intensive. We aim to develop a rapid, inexpensive means to detect abnormal ECGs using artificial intelligence (AI) from scanned ECG printouts. Methods The study included 1172 12‐lead ECG scans performed in 1172 individuals from a community in Guangzhou, China; 878 (74.9%) were diagnosed with sinus rhythm, and the remaining 294 (25.1%) with abnormal rhythms. A deep learning model consisting of a convolutional neural network based on InceptionV3 and a fully connected layer followed by a GEV activation was trained to classify scanned tracings as either normal or abnormal. Results In a hold‐out testing set, the model achieved a area under curve (AUC), sensitivity, specificity, PPV, and NPV of 0.932 (95% confidence interval [CI]: 0.890, 0.976), 0.816 (95% CI: 0.657, 0.923), 0.993 (95% CI: 0.959, 1.0), 0.969 (95% CI: 0.838, 0.999), and 0.950 (95% CI: 0.90, 0.980) respectively, when using a probability threshold of 0.5. When compared with a physiological expert, these results show comparable performance with a statistically significant increase in specificity and a non‐significant decrease in sensitivity at the 95% level. Conclusions We have developed a rapid, inexpensive, accurate means to detect abnormal ECGs using AI. Easy and accurate identification of such “abnormal” ECGs could allow the mass automated review of ECGs in community settings where abnormal ones could be flagged using AI for detailed clinical review by healthcare professionals.
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Affiliation(s)
- Joshua Bridge
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences University of Liverpool Liverpool UK
| | - Lu Fu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital Guangdong Academy of Medical Sciences Guangzhou China
| | - Weidong Lin
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital Guangdong Academy of Medical Sciences Guangzhou China
| | - Yumei Xue
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital Guangdong Academy of Medical Sciences Guangzhou China
| | - Gregory Y. H. Lip
- Liverpool Centre for Cardiovascular Science University of Liverpool and Liverpool Heart & Chest Hospital Liverpool UK
| | - Yalin Zheng
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences University of Liverpool Liverpool UK
- Liverpool Centre for Cardiovascular Science University of Liverpool and Liverpool Heart & Chest Hospital Liverpool UK
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Begum H, Xue Y, Bolton JS, Horoshenkov KV. The acoustical absorption by air-saturated aerogel powders. J Acoust Soc Am 2022; 151:1502. [PMID: 35364908 DOI: 10.1121/10.0009635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 02/07/2022] [Indexed: 06/14/2023]
Abstract
The acoustical behavior of air-saturated aerogel powders in the audible frequency range is not well understood. It is not clear, for example, which physical processes control the acoustic absorption and/or attenuation in a very light, loose granular mix in which the grain diameter is on the order of a micron. The originality of this work is the use of a Biot-type poro-elastic model to fit accurately the measured absorption coefficients of two aerogel powders with particle diameters in the range 1-40 μm. It is shown that these materials behave like a viscoelastic layer and their absorption coefficient depends strongly on the root mean square sound pressure in the incident wave. Furthermore, it was found that the loss factor controlling the energy dissipation due to the vibration of the elastic frame is a key model parameter. The value of this parameter decreased progressively with the frequency and sound pressure. In contrast, other fitted parameters in the Biot-type poro-elastic model, e.g., the stiffness of the elastic frame and pore size, were found to be relatively independent of the frequency and amplitude of the incident wave. It is shown that these materials absorb acoustic waves very efficiently around the frequencies of the frame resonance.
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Affiliation(s)
- H Begum
- Department of Mechanical Engineering, The University of Sheffield, S1 3JD, United Kingdom
| | - Y Xue
- Midea Corporate Research Center, Foshan, Guangdong 528311, China
| | - J S Bolton
- Ray W. Herrick Laboratories, School of Mechanical Engineering, Purdue University, 177 South Russell Street, West Lafayette, Indiana 47907-2099, USA
| | - K V Horoshenkov
- Department of Mechanical Engineering, The University of Sheffield, S1 3JD, United Kingdom
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Fu Z, Liao Z, Zhang J, Zhan X, Lin W, Liu FZ, Su X, Deng H, Fang X, Liao H, Wang H, Wu S, Xue Y, Ouyang F. Experimental Findings and Clinical-Pathologic Correlation of Radiofrequency Catheter Ablation at the Left Ventricle Para-Hisian Region. Front Cardiovasc Med 2022; 8:793903. [PMID: 35155606 PMCID: PMC8829110 DOI: 10.3389/fcvm.2021.793903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/22/2021] [Indexed: 11/28/2022] Open
Abstract
Background Catheter ablation target at the site with large His activation in the left ventricle poses a high risk of atrioventricular (AV) block. We aimed to identify far-field (FF) and near-field (NF) His activation at left upper septum (LUS). Methods Three-D mapping of the aortic root and left ventricle was performed in 12 dogs. Two sites located at either the base or apex of the triangle interposed between the hinges of the the noncornary coronary cusp (NCC) - right coronary cusp (RCC) were chosen for a single radiofrequency (RF) application. Bipolar and unipolar pacing with different outputs at both sites was attempted to discern NF and FF His activation. Results The sites chosen for NF and FF ablation were located at the base and apex of the triangle, which were 8.03 ± 1.18 mm (group 1) and 3.42 ± 0.61 mm (group 2) away from the RCC-NCC junction. Lower A/V ratios were found in group 1. Pacing could not differentiate NF from FF His activation. In group 1, ablation resulted in III degree AV block in all 6 dogs, whereas neither PR prolongation nor AV block occurred in group 2. Pathologic examination of group 1 showed complete/partial necrosis of the His bundle (HB) and left bundle branch in all 6 dogs. In group 2, no necrosis of the HB was seen in the 6/6 dogs. Conclusion Anatomical localization in the triangle of RCC-NCC junction can help differentiate NF from FF His activation.
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Affiliation(s)
- Zuyi Fu
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Zili Liao
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Jinlin Zhang
- Department of Cardiology, Wuhan Asian Heart Hospital, Wuhan, China
| | - Xianzhang Zhan
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Weidong Lin
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Fang Zhou Liu
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xi Su
- Department of Cardiology, Wuhan Asian Heart Hospital, Wuhan, China
| | - Hai Deng
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xianhong Fang
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Hongtao Liao
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Hongyue Wang
- Department of Pathology, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shulin Wu
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yumei Xue
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Southern Medical University, Guangzhou, China
- Yumei Xue
| | - Feifan Ouyang
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Department of Cardiology, Wuhan Asian Heart Hospital, Wuhan, China
- Universitäres Herz- und Gefäßzentrum, University Hospital Eppendorf, Hamburg, Germany
- *Correspondence: Feifan Ouyang
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