Patterning of the heart field in the chick

In human development, it is postulated based on histological sections, that the cardiogenic mesoderm rotates 180° with the pericardial cavity. This is also thought to be the case in mouse development where gene expression data suggests that the progenitors of the right ventricle and outflow tract invert their position with respect to the progenitors of the atria and left ventricle. However, the inversion in both cases is inferred and has never been shown directly. We have used 3D reconstructions and cell tracing in chick embryos to show that the cardiogenic mesoderm is organized such that the lateralmost cells are incorporated into the cardiac inflow (atria and left ventricle) while medially placed cells are incorporated into the cardiac outflow (right ventricle and outflow tract). This happens because the cardiogenic mesoderm is inverted. The inversion is concomitant with movement of the anterior intestinal portal which rolls caudally to form the foregut pocket. The bilateral cranial cardiogenic fields fold medially and ventrally and fuse. After heart looping the seam made by ventral fusion will become the greater curvature of the heart loop. The caudal border of the cardiogenic mesoderm which ends up dorsally coincides with the inner curvature. Physical ablation of selected areas of the cardiogenic mesoderm based on this new fate map confirmed these results and, in addition, showed that the right and left atria arise from the right and left heart fields. The inversion and the new fate map account for several unexplained observations and provide a unified concept of heart fields and heart tube formation for avians and mammals.     

Krp1 (Sarcosin) promotes lateral fusion of myofibril assembly intermediates in cultured mouse cardiomyocytes

Krp1, also called sarcosin, is a cardiac and skeletal muscle kelch repeat protein hypothesized to promote the assembly of myofibrils, the contractile organelles of striated muscles, through interaction with N-RAP and actin. To elucidate its role, endogenous Krp1 was studied in primary embryonic mouse cardiomyocytes. While immunofluorescence showed punctate Krp1 distribution throughout the cell, detergent extraction revealed a significant pool of Krp1 associated with cytoskeletal elements. Reduction of Krp1 expression with siRNA resulted in specific inhibition of myofibril accumulation with no effect on cell spreading. Immunostaining analysis and electron microscopy revealed that cardiomyocytes lacking Krp1 contained sarcomeric proteins with longitudinal periodicities similar to mature myofibrils, but fibrils remained thin and separated. These thin myofibrils were degraded by a scission mechanism distinct from the myofibril disassembly pathway observed during cell division in the developing heart. The data are consistent with a model in which Krp1 promotes lateral fusion of adjacent thin fibrils into mature, wide myofibrils and contribute insight into mechanisms of myofibrillogenesis and disassembly.     

Levels of apolipoprotein M are not associated with the risk of coronary heart disease in two independent case-control studies

Apolipoprotein M (apoM), a 25 kDa plasma protein belonging to the lipocalin protein family, is predominantly associated with HDL. Studies in mice have suggested apoM to be important for the formation of pre-beta-HDL and to increase cholesterol efflux from macrophage foam cells. Overexpression of human apoM in LDL receptor-deficient mice reduced the atherogenic effect of a cholesterol-rich diet. The aim of the present study was to investigate whether the apoM levels in man predict the risk for coronary heart disease (CHD). ApoM was measured in samples from two separate case-control studies. FINRISK '92 consisted of 255 individuals, of whom 80 developed CHD during follow-up and 175 were controls. The Copenhagen City Heart Study included 1,865 individuals, of whom 921 developed CHD during follow-up and 944 were controls. Correlation studies of apoM concentration with several analytes showed a marked positive correlation with HDL and total cholesterol as well as with apoA-I and apoB. There was no significant difference in mean apoM level between CHD and control subjects in either study. In conditional logistic regression analyses, apoM was not a predictor of CHD events, [odds ratio (95% CI) 0.97 (0.74-1.27) and 0.92 (0.84-1.02), respectively]. In conclusion, no association between apoM and CHD could be found in this study.     

卡维地洛加安体舒通治疗慢性充血性心力衰竭疗效观察

目的:观察卡维地洛加安体舒通治疗慢性充血性心力衰竭(CHF)的疗效。方法:将CHF患者63例随机分成观察组与对照组,在常规强心、利尿基础上,观察组加卡维地洛、安体舒通治疗。对照组加依那普利治疗。时间为三个月。结果:两组对CHF患者心功能均明显改善,总有效率观察组为80％,对照组为67％。观察组优于对照组,P<0.05。观察组不良反应轻,对照组有3例患者分别出现咳嗽、皮疹。结论:卡维地洛加安体舒通治疗CHF优于依那普利,且无明显不良反应。     

基于盒维数的心音信号分形特征研究

在传统盒维数的基础上,从尺度变化的角度,提出一种计算心音信号时域波形分形维数的新的二进盒维数算法,并给出了算法思想和估算方法;然后用该方法对正常心音和几种典型的病态心音的分形维数进行计算,并对其分形特征进行了研究．研究结果表明：心音信号具有明显的分形特征,分形维数能够反映心音信号的复杂程度,并且能够明显地区分正常心音和病态心音．     

Time domain baroreflex sensitivity assessment by joint analysis of spontaneous SBP and RR series

The sequences technique is frequently used for time domain assessment of the arterial-cardiac baroreceptor reflex sensitivity (BRS). The BRS is estimated by the slope between systolic blood pressure and RR interval values in baroreflex sequences (BSs) and an overall estimate is obtained by slope averaging. However, only 25% of all beats are in BSs with 60% of those located in 3-beat length segments. Also, in cases of BSs absence (usually associated with poor BRS function), the BRS cannot be quantified.Here, baroreflex events (BEs) are introduced and used with global/total slope estimators to improve BRS assessment. The performance of the novel method is evaluated using the EuroBaVar dataset. The events technique benefits from a higher number of beats: 50% of all beats are in BEs with more than 70% exceeding 3-beat length. It always provides a BRS estimate, even when BSs cannot be identified. When BSs are available, estimates from BEs and BSs are highly correlated. The estimates from BEs for the cases without BSs are lower than the estimates for the remaining cases, indicating poorer BRS function. The events technique also offers superior ability to discriminate lying from standing position in the EuroBaVar dataset (23/23 versus 18/23 for the sequences technique).     

人心型脂肪酸结合蛋白(H-FABP)的原核表达、纯化和冻干品的制备

目的：获得重组人心型脂肪酸结合蛋白,分析其活性及制备冻干品。方法：从GenBank中检索人源H-FABP CDs 序列,合成基因后构建原核表达载体pET-28a（+）-H-FABP。将表达载体转入E.coli BL21（DE3）,摸索pET-28a（+）-H-FABP最佳诱导条件,表达并纯化重组蛋白。使用检测试剂检测纯化后的重组H-FABP活性,研究最佳冻干方案并考察冻干品的稳定性。结果：经过优化诱导条件,重组H-FABP在BL21（DE3）中以可溶性蛋白形式表达。诱导条件为OD₆₀₀≈0.6,IPTG终浓度0.4mmol/L,30℃诱导4h。通过Ni²⁺亲和层析纯化可得到纯度大于95%的重组H-FABP蛋白。重组H-FABP冻干品可以在37℃稳定保存12d,25℃、4℃稳定保存至少4个月。结论：本项研究中的重组H-FABP表达体系成熟、蛋白活性高,冻干品稳定性好,为后续研究提供了稳定高效的生物原材料。     

慢性心力衰竭大鼠心肌毛细血管密度及血管内皮生长因子变化

目的观察慢性心力衰竭大鼠心肌毛细血管密度及血管内皮生长因子(VEGF)变化,探究冠脉微循环障碍的病理特点及病因机制.方法实验组(n=15)皮下注射异丙肾上腺素,对照组(n=10)皮下注射生理盐水,间隔24h,连续2次.12周后测定血液动力学;计算左心室重量/体重;HE染色、Masson染色分别观察左心室病理改变、胶原变化;西非单叶豆素组织化学染色结合图像分析确定心内膜下心肌毛细血管密度、心肌细胞密度、毛细血管密度与心肌细胞密度的比值(毛细血管/心肌细胞);观察心内膜下心肌VEGF免疫组织化学变化.结果同对照组比较,实验组左心室收缩、舒张功能下降(P<0.05);左心室重量/体重升高(P<0.001);心内膜下心肌散在坏死,胶原沉积;心内膜下心肌毛细血管密度、心肌细胞密度、毛细血管/心肌细胞下降(P<0.05);VEGF合成增加(P<0.001).结论慢性心力衰竭大鼠心内膜下心肌毛细血管分布稀疏;该区域毛细血管代偿性生成减少与心肌VEGF表达无关.     

Contemporary perspective on endogenous myocardial regeneration

Considering the complex nature of the adult heart, it is no wonder that innate regenerative processes, while maintaining adequate cardiac function, fall short in myocardial jeopardy. In spite of these enchaining limitations, cardiac rejuvenation occurs as well as restricted regeneration. In this review, the background as well as potential mechanisms of endogenous myocardial regeneration are summarized. We present and analyze the available evidence in three subsequent steps. First, we examine the experimental research data that provide insights into the mechanisms and origins of the replicating cardiac myocytes, including cell populations referred to as cardiac progenitor cells (i.e., c-kit+ cells). Second, we describe the role of clinical settings such as acute or chronic myocardial ischemia, as initiators of pathways of endogenous myocardial regeneration. Third, the hitherto conducted clinical studies that examined different approaches of initiating endogenous myocardial regeneration in failing human hearts are analyzed. In conclusion, we present the evidence in support of the notion that regaining cardiac function beyond cellular replacement of dysfunctional myocardium via initiation of innate regenerative pathways could create a new perspective and a paradigm change in heart failure therapeutics. Reinitiating cardiac morphogenesis by reintroducing developmental pathways in the adult failing heart might provide a feasible way of tissue regeneration. Based on our hypothesis “embryonic recall”, we present first supporting evidence on regenerative impulses in the myocardium, as induced by developmental processes.     

心力衰竭的物理诊断现状

心力衰竭是各种心脏疾病发展的终末阶段,及时准确的确诊心力衰竭、辨别其病情变化可进一步指导治疗及缩短住院时间,并为心力衰竭的预后评价提供参考依据。目前,确诊心力衰竭主要基于患者的临床症状、体征及各种影像学表现、生化指标等做出综合评价,而物理诊断是诊断心力衰竭不可或缺的依据。心脏彩超已应用于临床多年,可从多个层面评估左室充盈压,是初步评价心脏功能的便捷措施。核心脏病学可评估心脏交感神经支配的区域及激活模式,预测心力衰竭的发病率和死亡率。心脏磁共振可用于进行危险分层及确定是否适合手术/介入治疗。此外,心脏CT及心导管术也是用于评价心功能的常见物理检查方法。本文主要总结了目前各种诊断心力衰竭的物理诊断方法的最新进展,以进一步指导临床实践。