Correlation between 25 element contents in mane hair in riding horses and atrioventricular block

The influence of atrioventricular block (AV-block) on the trace elemental status in a horse hair was studied. The particle-induced X-ray emission (PIXE) method has provided a reliable, rapid, easy, and relatively inexpensive diagnostic method. Twenty-five elements (Al, Br, Ca, Cl, Co, Cu, Cr, Fe, Hg, K, Mg, Mn, Na, Nb, Ni, P, Pb, Rb, S, Se, Si, Ti, Y, and Zn) in mane hair and serum were measured by the PIXE method. A horse hair with first- and second-degree AV-block contained significantly greater amounts of Br, Ca, Sr, and Zn than those of horses without electrocardiographic abnormalities, whereas there was no significant differences in the elemental contents of the serum of the both groups. Those results in contents of a horse hair suggest that the evaluation of the degree of ionic imbalance by this method might be used to predict the susceptibility of a horse to heart disease much before symptoms appear.     

比较常温和亚低温下连续血液透析治疗瓣膜病术后心源性休克的效果及对患者心功能、心衰指标和炎性因子的影响

摘要 目的：比较常温和亚低温下连续血液透析治疗瓣膜病术后心源性休克的效果及对患者心功能、心衰指标和炎性因子的影响。方法：选取我院2020年1月到2022年12月收治的90例瓣膜病术后心源性休克患者,分为观察组与对照组,各45例。对照组患者采取常温下连续血液透析治疗,观察组患者采取亚低温下连续血液透析治疗,对比两组患者术后引流量、血液净化时间、呼吸机辅助时间、ICU入住时间以及死亡、心律失常、感染发生情况,对比两组患者治疗前后左心室射血分数（LVEF）、左心室收缩末期容积（LVESV）、左心室舒张末期容积（LVEDV）心功能指标,BNP（B型利钠肽）、超敏C反应蛋白（hs-CRP）、血肌酐（Cr）心衰实验室指标,炎症因子表法水平。结果：两组患者心律失常、感染发生率对比无差异（P＞0.05）,观察组术后引流量、呼吸机辅助时间ICU入住时间、血液净化时间及死亡率较对照组低（P＜0.05）;治疗前两组患者LVESV、LVEF、LVEDV对比无明显差异（P＞0.05）,治疗后两组患者LVEF均升高,且观察组较对照组高,LVESV、LVEDV水平降低,观察组较对照组低（P＜0.05）;治疗前两组患者BNP、hs-CRP、Cr相关心衰实验室指标对比无差异（P＞0.05）,治疗后两组患者BNP、hs-CRP、Cr相关心衰实验室指标均降低,观察组低于对照组（P＜0.05）;治疗前两组患者白细胞介素-6（IL-6）、白细胞介素-1（IL-1）、肿瘤坏死因子-α（TNF-α）炎性因子水平对比无差异（P＞0.05）,治疗后水平均降低,且观察组较对照组低（P＜0.05）。结论：对瓣膜病术后心源性休克患者采取亚低温下血液净化治疗与常温下血液透析治疗相比能欧进一步减少患者术后引流量、血液净化时间,促进患者早日康复的同时能够降低患者死亡率,同时采取亚低温下血液透析治疗能够进一步改善患者心功能,减轻心衰情况,降低患者机体炎症因子水平。     

老年瓣膜病患者瓣膜置换术术后死亡原因分析

目的:分析老年瓣膜病在瓣膜置换术后的死亡原因,为降低术后死亡率提供科学依据。方法:回顾分析我院以瓣膜置换术治疗的329例老年瓣膜病变患者的资料,对比分析生存患者和死亡患者之间的差异,总结瓣膜置换术后患者死亡的危险因素。结果:心脏瓣膜置换术后死亡率8.51%,单因素分析发现年龄、心功能分级、置换瓣膜数、LAD、LVEF、LVEDD、CPB时间、主动脉阻断时间、置换瓣膜数目与术后死亡有关联(P0.05),Logistic回归分析发现高龄、心功能差、LVEED、CPB为死亡独立危险因素(P0.05)。结论:高龄、心功能差、LVEED过度增大、CPB过长均是瓣膜置换术后的老年瓣膜病患者死亡的独立危险因素,建议临床在诊治中加以警惕。     

Coronary sinus cannulation predicts atrioventricular nodal reentry as mechanism of supraventricular tachycardia

IntroductionCommon clinical teaching, for invasive electrophysiology, is that if the first year fellow cannulates the coronary sinus (CS) in his first attempt, the arrhythmia is more likely to be atrioventricular nodal reentry tachycardia (AVNRT). This general perception has not yet been clinically tested. We evaluated this theory in prospective patients undergoing an electrophysiological study (EPS) for paroxysmal supraventricular tachycardia (PSVT).MethodsCohort study. CS ease of cannulation (CSCS) was graded as: 1) 1st year fellow cannulates in first attempt; 2) 1st year fellow needs more than one attempt or maneuver to cannulate the CS; 3) staff physician cannulates in first attempt after the fellow was unsuccessful; 4) staff physician requires more than one maneuver to cannulate the CS; 5) staff physician judges that the cannulation process was extremely difficult.ResultsOf the 1361 patients undergoing EPS in our institution, 165 were selected. Age was 49 ± 15 years. AVNRT occurred in 77.6%, atrioventricular reentry tachycardia (AVRT) in 15.1% and atrial tachycardia (AT) in 7.3% of cases. The CSCS = 1 was more prevalent in AVNRT, 89% versus 68% AVRT and 58.3% of AT (P = 0.0005). Patients with CSCS = 1 have a higher chance of the PSVT being AVNRT (odds ratio: 4.41; 95CI: 1.84–10.56; P = 0.0009).ConclusionThe CSCS predicts the likelihood of the induced PSVT being AVNRT as compared to AVRT and AT. More studies are required to try to associate this finding to clinical patient characteristics to create a score for PSVT mechanism prediction.     

Hearts and bones: shared regulatory mechanisms in heart valve, cartilage, tendon, and bone development

The atrioventricular heart valve leaflets and chordae tendineae are composed of diverse cell lineages and highly organized extracellular matrices that share characteristics with cartilage and tendon cell types in the limb buds and somites. During embryonic chicken valvulogenesis, aggrecan and sox9, characteristic of cartilage cells, are observed in the AV valve leaflets, in contrast to tendon-associated genes scleraxis and tenascin, present in the chordae tendineae. In the limb buds and somites, cartilage cell lineage differentiation is regulated by BMP2, while FGF4 controls tendon cell fate. The ability of BMP2 and FGF4 to induce similar patterns of gene expression in heart valve precursor cells was examined. In multiple assays of cells from prefused endocardial cushions, BMP2 is sufficient to activate Smad1/5/8 phosphorylation and induce sox9 and aggrecan expression, while FGF4 treatment increases phosphorylated MAPK (dpERK) signaling and promotes expression of scleraxis and tenascin. However, these treatments do not alter differentiated lineage gene expression in valve progenitors from fused cushions of older embryos. Together, these studies define regulatory pathways of AV valve progenitor cell diversification into leaflets and chordae tendineae that share inductive interactions and differentiation phenotypes with cartilage and tendon cell lineages.     

ICD discrimination of SVT versus VT with 1:1 V-A conduction: A review of the literature

Inappropriate ICD shocks are associated with increased mortality. They also impair patients'' quality of life, increase hospitalizations, and raise health-care costs. Nearly 80% of inappropriate ICD shocks are caused by supraventricular tachycardia. Here we report the case of a patient who received a single-lead dual-chamber sensing ICD for primary prevention of sudden cardiac death and experienced inappropriate ICD shocks. V-A time, electrogram morphology, and response to antitachycardia pacing suggested atrioventricular nodal reentry tachycardia, which was confirmed in an electrophysiology study. Inspired by this case, we performed a literature review to discuss mechanisms for discrimination of supraventricular tachycardia with 1:1 A:V relationship from ventricular tachycardia with 1:1 retrograde conduction.     

一次性可调压限压式灌肠器的实验研究

目的：研究一次性可调压限压式灌肠器的性能。方法：建立模型,测定模拟体内环境下灌肠治疗时肠管各点的压力和灌肠器可调压限压阀开启时的压力是否一致。结果：测定模拟肠管各点压力与灌肠器的可调压限压阀开启时压力一致。结论：一次性可调压限压式灌肠器的性能达到设计要求,操作简便,具有科学性、稳定性、安全性,值得推广。     

Heart-targeted overexpression of Nip3a in zebrafish embryos causes abnormal heart development and cardiac dysfunction

We transiently expressed a proapoptotic protein, Nip3a, by a heart-specific BMP4 promoter in zebrafish embryos and generated two variants of embryos with abnormal heart phenotypes (A and B). Embryos with phenotype A heart defects showed hypoplastic or elongated ventricles, elongated or enlarged atriums with no normal cardiac looping resulting a significant longer SV-BA distance, and bradycardia at 48 h post-fertilization (hpf). Embryos with phenotype B heart defects showed an enlarged fluid-filled pericardium, severe hypoplasia, non-contracting ventricles, and elongated or enlarged slowly beating atriums with no normal looping. Histological sections further revealed the absence of a proper atrioventricular boundary and no endocardial cells lining this region in both 48- and 72-hpf Nip3a-overexpressing embryos, implicating defective endocardial cushion formation. These phenotypes are reminiscent of atrioventricular canal defects in humans. In addition, induced apoptotic myocardium cells were clustered in the presumptive atrioventricular boundary as well as in the adjacent ventricle and atrium of 48- and 72-hpf Nip3a-overexpressing embryos. Nip3a expression was readily detected in 80% epiboly BMP4-Nip3a-injected embryos, and defects in heart development were observed in both the linear heart tube and subsequent chamber formation stages. These results showed that myocyte apoptosis is a universal pathogenic factor for congenital heart failure using zebrafish as a model organism.