Gait stride-to-stride variability and foot clearance pattern analysis in Idiopathic Parkinson’s Disease and Vascular Parkinsonism

The literature on gait analysis in Vascular Parkinsonism (VaP), addressing issues such as variability, foot clearance patterns, and the effect of levodopa, is scarce. This study investigates whether spatiotemporal, foot clearance and stride-to-stride variability analysis can discriminate VaP, and responsiveness to levodopa.Fifteen healthy subjects, 15 Idiopathic Parkinson's Disease (IPD) patients and 15 VaP patients, were assessed in two phases: before (Off-state), and one hour after (On-state) the acute administration of a suprathreshold (1.5 times the usual) levodopa dose. Participants were asked to walk a 30-meter continuous course at a self-selected walking speed while wearing foot-worn inertial sensors. For each gait variable, mean, coefficient of variation (CV), and standard deviations SD1 and SD2 obtained by Poincaré analysis were calculated. General linear models (GLMs) were used to identify group differences. Patients were subject to neuropsychological evaluation (MoCA test) and Brain MRI.VaP patients presented lower mean stride velocity, stride length, lift-off and strike angle, and height of maximum toe (later swing) (p < .05), and higher %gait cycle in double support, with only the latter unresponsive to levodopa. VaP patients also presented higher CV, significantly reduced after levodopa. Yet, all VaP versus IPD differences lost significance when accounting for mean stride length as a covariate.In conclusion, VaP patients presented a unique gait with reduced degrees of foot clearance, probably correlated to vascular lesioning in dopaminergic/non-dopaminergic cortical and subcortical non-dopaminergic networks, still amenable to benefit from levodopa. The dependency of gait and foot clearance and variability deficits from stride length deserves future clarification.     

血管钠肽、 C型钠尿肽和心房钠尿肽舒血管作用的对比

本实验采用离体血管灌流方法,观察和比较血管钠肽（ＶＮＰ）,Ｃ型钠尿肽（ＣＮＰ）和心房钠尿肽（ＡＮＰ）对大鼠肺动脉,腹主动脉和腹腔静脉的舒张作用。．结果表明,ＶＮＰ,ＣＮＰ和ＡＮＰ对离体大鼠的保留内皮与去内皮的肺动脉,腹主动脉和腹腔静脉均有浓度依赖性舒张作用。     

心房钠尿肽对内毒素血症大鼠肺动脉和主动脉舒缩的影响

目的:探讨心房钠尿肽(ANP)对内毒素血症大鼠(ETR)肺动脉和主动脉内皮和平滑肌细胞的调节作用.方法:24只雄性SD大鼠随机分为对照组,模型组(LPS组),治疗组(ANP组).各组分别静脉注射生理盐水、2 mg/kg的LPS和2 mg/kg LPS与2μg/kg的ANP,4 h后处死动物分离肺动脉、主动脉,进行离体血管务体外灌注实验.结果:LPS组、ANP治疗组主动脉环和LPS组肺动脉环对去甲肾上腺素(NE)引起的收缩作用在NE低浓度时较对照组减弱(P＜0.01),在较高浓度时较对照组均明显增强(P＜0.01);主动脉环ANP治疗组与LPS组无显著差异(P＞0.05);肺动脉环ANP治疗组与对照组相比无显著差异(P＞0.05).ANP可明显改善ETR离体主动脉和肺动脉对乙酰胆碱(ACh)的舒张反应(P＜0.01),ANP可提高ETR离体主动脉和主动脉环对硝普钠(SNP)引起的舒张反应的敏感性(P＜0.01).结论:ANP对ETR肺动脉和主动脉内皮和平滑肌细胞可能存在调节作用.     

Evolution of the membrane guanylate cyclase transduction system

Almost four decades of research in the field of membrane guanylate cyclases is discussed in this review. Primarily, it focuses on the chronological development of the field, recognizes major contributions of the original investigators, corrects certain misplaced facts, and projects its future trend.     

Cyclic stretch induces the release of growth promoting factors from cultured neonatal cardiomyocytes and cardiac fibroblasts

Growth factors and hormones may play an autocrine/paracrine role in mechanical stress-induced cardiac hypertrophy. Using an in vitro model of mechanical stress, i.e. stretch of cardiomyocytes and cardiac fibroblasts, we tested the involvement of growth factors and hormones in this process.We found that conditioned medium (CM) derived from 4 h cyclicly (1 Hz) stretched cardiomyocytes increased the rate of protein synthesis in static cardiomyocytes by 8 ± 3%. Moreover, CM derived from 2 h stretched fibroblasts increased the rate of protein synthesis in static fibroblasts as well as in static cardiomyocytes by 8 ± 2 and 6 ± 2%, respectively. Analysis of CM using size-exclusion HPLC showed that cardiomyocytes and fibroblasts released at least three factors with MW 10 kD, their quantities being time-dependently increased by stretch. Subsequent analyses using immunoassays revealed that cardiomyocytes released atrial natriuretic peptide (ANP) and transforming growth factor-beta1 (TGF₁) being increased by 45 ± 17 and 21 ± 4% upon 4 h of stretch, respectively. Fibroblasts released TGF₁ and very low quantity of endothelin-1 (ET-1). The release of TGF₁ was significantly increased by 18 ± 4% after 24 h of stretch in fibroblasts. Both cell types released no detectable amount of angiotensin II (Ang II).In conclusion, upon cyclic stretch cardiomyocytes and fibroblasts secrete growth factors and hormones which induce growth responses in cardiomyocytes and fibroblasts in an autocrine/paracrine way. TGF secreted by cardiomyocytes and fibroblasts, and ANP secreted by cardiomyocytes are likely candidates. We found no evidence for the involvement of Ang II and ET-1 in autocrine/paracrine mechanisms between cardiac cell types.     

Potassium ion channels and human disease: phenotypes to drug targets?

A significant difficulty faced by the pharmaceutical industry is the initial identification and selection of macromolecular targets upon which de novo drug discovery programs can be initiated. A drug target should have several characteristics: known biological function; robust assay systems for in vitro characterization and high-throughput screening; and be specifically modified by and accessible to small molecular weight compounds in vivo. Ion channels have many of these attributes and can be viewed as suitable targets for small molecule drugs. Potassium (K⁺) ion channels form a large and diverse gene family responsible for critical functions in numerous cell types, tissues and organs. Recent discoveries, facilitated by genomics technologies combined with advanced biophysical characterization methods, have identified novel K⁺ channels that are involved in important physiologic processes, or mutated in human inherited disease. These findings, coupled with a rapidly growing body of information regarding modulatory channel subunits and high resolution channel structures, are providing the critical information necessary for validation of K⁺ channels as drug targets.     

The complete sequence and expression patterns of the atrial myosin heavy chain in the developing chick

We have earlier reported partial cloning of a cDNA of a chick atrial myosin heavy chain (MHC) gene, CCSV2 and its expression pattern in embryonic chick hearts (Oana et al (1995) Eur J Cell Biol 67, 42-49). In this study, five overlapping cDNA clones (including CCSV2) which together encode the entire open reading frame of the chick atrial MHC gene were characterized, and both the entire nucleotide sequence consisting of 5825 bases and the deduced amino acid sequence consisting of 1931 amino acids determined. Reinvestigation of the nucleotide sequence of the previously reported and presumably different chick atrial specific MHC cDNA clone, AMHC1 (Yutzey et al (1994) Development 120, 871-883), revealed that our clone and AMHC1 encoded the same MHC. The chick atrial MHC gene was strongly expressed in developing chick atria from a very early stage (Hamburger and Hamilton stage 9, 29-33 h) to the adult stage. This gene was also expressed, although weakly, in the ventricle, somite (the precursor to skeletal muscle) and skeletal muscle during embryonic stages but not in adults.     

LenkeⅡ型青少年特发性脊柱侧凸患者内固定冠状面失衡的相关因素分析

目的:探讨Lenke II型青少年特发性脊柱侧凸患者内固定冠状面失衡相关因素分析。方法:选取我院骨科已确诊为Lenke II青少年特发性脊柱侧凸患者60例,根据术前脊柱柔韧度、risser分级水平、支具支持治疗、椎体融合数、内固定系统选择等多方面影响因素对内固定后冠状面失平衡情况发生率进行分析评估,其数据结果应用统计学软件SPSS 17.0处理。结果:对术后患者评估比较,多种因素均可影响内固定后冠状面失平衡情况发生,表现为:脊柱柔韧度低、risser分级高、长时间支具佩戴、延长融合椎体范围、先进钉棒系统方案选择均可明显提高术后疗效,降低内固定后冠状面失平衡情况发生率(P0.05),其结果均有统计学意义。结论:临床上通过对患者脊柱柔韧度、risser分级情况评估来判断脊柱成熟度,并在术后积极支具辅助治疗,选用钉棒固定系统并延长融合椎体节段,可明显降低内固定后冠状面失平衡情况发生,提高远期随访疗效。     

去自主神经效应对环肺静脉消融房颤疗效的影响

目的：探讨去自主神经效应对环肺静脉消融(CPVA)治疗心房颤动(房颤)的远期成功率的影响。方法：选择104 例药物治疗无 效的、有临床症状的阵发性房颤患者作为研究对象,所有患者均接受CPVA 术。分别于术前、术后进行动态心电图检查,术后每3 个月复查一次动态心电。随访房颤消融成功率(术后3个月无房颤被定义为无复发);并记录动态心电心率变异性(HRV)以反映自 主神经功能。结果：本组研究共104 例患者完成了CPVA术,平均手术次数为(1.35术次数为。变次,成功率为77.9%,共随访(24.27 次数为。变异性个月。根据术后是否发生房颤,将患者分为成功组(81例)和复发组(23 例),所有患者CPVA术后的时域和频域各项 参数均显著降低(P<0.01),两组术后心率变异性(HRV) 各项参数均较术前明显降低,成功组患者的SNDD、SDANN、rMSSD、 PNN50、HF、TF、LF、VLF 较对照组患者呈现不同程度的降低。结论：CPVA术可使心房出现去自主神经效应,进而增加去神经化 效应,有利于提高其治疗房颤的远期成功率。     

New-onset atrial fibrillation in sepsis is associated with increased morbidity and mortality

BackgroundThe development of new-onset atrial fibrillation in sepsis has been associated with adverse outcomes.MethodsA systematic literature search was conducted to retrieve articles that investigated the association of new-onset atrial fibrillation in patients diagnosed with sepsis. The primary outcome of interest was the pooled risk ratio (RR) of in-hospital mortality in patients with new-onset atrial fibrillation and sepsis.ResultsSix studies included 3100 patients with new-onset atrial fibrillation in sepsis and 36,900 patients without new-onset atrial fibrillation in sepsis. The pooled RR for in-hospital mortality was 1.45 (95 % CI 1.32–1.60, p < 0.00001, I^2 =24 %). New-onset atrial fibrillation was also associated with increased ICU mortality, ICU and in-hospital length of stay and stroke. New-onset atrial fibrillation occurred more in the elderly, those with a prior history of cardiovascular and respiratory disease, and those with increased severity of illness.ConclusionProspective randomised trials are needed to clarify the significance of new-onset atrial fibrillation in sepsis, optimal treatment strategies for these patients, and the benefit of systemic anticoagulation. Physicians should be aware that new-onset atrial fibrillation in sepsis is not merely an observed temporary arrhythmia but a marker of poor prognosis and should be managed accordingly.