Table of Content

25 June 2021, Volume 16 Issue 03 Previous Issue    Next Issue

For Selected:

Download Citations EndNote Ris BibTeX

Toggle Thumbnails

Original article

Select

The learning curve of remote magnetic navigation-guided ablation for idiopathic ventricular arrhythmias LI Xiang, JIN Qi, PAN Wenqi, JIA Kangni, ZHANG Ning, LIN Changjian, LING Tianyou, CHEN Kang, XIE Yucai, WU Liqun 2021, 16 (03):  167-171.  DOI: 10.16138/j.1673-6087.2021.03.006 Abstract ( 157 )   HTML ( 3 )   PDF (646KB) ( 53 )   Objectives To determine the learning curve of remote magnetic navigation (RMN)-guided ablation for idiopathic ventricular arrhythmias (IVA) and its implications on the outcomes of the procedures. Methods A total of 249 IVA patients undergoing catheter ablation with RMN were divided into two groups: right ventricle (RV) and left ventricle (LV) group regarding to the initially mapping from RV or LV. Procedural outcomes and complications were compared between two groups. The learning curve was determined by plotting procedure time of the consequentially performed procedures in RV group patients. These patients were then divided equally into 3 phases (P1, P2, P3) to determine the effect of learning curve on procedure outcomes. Results The acute success rate reached 91% and complication rate was only 0.4%. The procedure time, mapping time, ablation time and X-ray time of LV group was significantly higher than RV group (P<0.05), but no significant difference was detected in the complication rate of the two groups(P=0.313 3). The procedure time of RV group patients decreased significantly along the learning curve. Compared with P2 and P1, the procedure time of P3 was decreased by 24% (P<0.01) and 41% (P<0.000 1) respectively. The X-ray time was relatively low [(3.8±4.1) min] at the very beginning and dropped significantly along the learning curve [(1.3±1.0) min, P<0.001]. Conclusions It takes rather short term to establish the learning curve of RMN-guided IVA with low rate of complication. The radiation exposure for both patient and operator is low during the establishment of learning curve and could be further reduced later on. Figures and Tables | References | Related Articles | Metrics

Select

Follistatin like protein 1 mitigates oxidized low-density lipoprotein-stimulated phenotypic transformation of mouse vascular smooth muscle cell XIAO Fan, ZHA Qing, LIU Ya, YANG Ling, YE Jiawen, LIU Yan 2021, 16 (03):  172-177.  DOI: 10.16138/j.1673-6087.2021.03.007 Abstract ( 188 )   HTML ( 3 )   PDF (810KB) ( 114 )   Objective To investigate the effect of follistatin like protein 1(FSTL1) on oxidized low-density lipoprotein (Ox-LDL)-stimulated the phenotypic transformation of mouse vascular smooth muscle cell (VSMC). Methods Firstly, under Ox-LDL-stimulating, the expression of FSTL1 in VSMC was detected. Secondly, Western blotting was used to detect the signature proteins, α-smooth muscle actin(α-SMA) and osteopontin(OPN). Finally, the proliferation of VSMC was verified by proliferation experiments under the influence of Ox-LDL and FSTL1. Results Comparing to the normal group, the expression of FSTL1 was lower in the abnormal vessel regions, which was filled with Ox-LDL（0.223±0.010 vs. 0.097±0.019, P<0.01）. VSMC was stimulated by Ox-LDL at 0, 12.5, 25 and 50 mg/L for 24 h respectively and the expression level of FSTL1 detected by Western blotting was 1.330±0.055, 0.905±0.027, 0.753±0.037 and 0.243±0.016 accordingly. It showed that the lowest expression level of FSTL1 was observed when Ox-LDL concentration increased to 50 mg/L (F=260.600, P<0.000 1). The expression of FSTL1 was 1.383±0.033, 0.782±0.047, 0.381±0.022 and 0.230±0.017 after 50 mg/L Ox-LDL stimulating VSMC for 0, 6, 12 and 24 h respectively, in which the expression of FSTL1 was the lowest when Ox-LDL induced 24 h(F=151.000, P<0.000 1). In addition, Ox-LDL stimulation reduced the expression of α-SMA(1.303±0.030 vs. 0.493±0.069, P<0.01) and SIRT1(0.993±0.044 vs. 0.613±0.030, P<0.01), while increasing the expression of OPN(1.001±0.031 vs. 2.698±0.001, P<0.01). However, the expression of OPN, α-SMA and SIRT1 showed opposite trend when VSMC was stimulated with both FSTL1 and Ox-LDL（OPN 2.698±0.002 vs. 1.590±0.001, P<0.05; α-SMA 0.493±0.062 vs. 0.653±0.015, P<0.05; SIRT1 0.613±0.030 vs. 1.231±0.011, P<0.05）. Compared with Ox-LDL+FSTL1+DMSO group, VSMC in Ox-LDL+FSTL1+SIRT1 inhibitor group showed reduced α-SMA(0.530±0.033 vs. 0.283±0.032, P<0.01) and SIRT1(1.056±0.020 vs. 0.207±0.021, P<0.01), and increased OPN(1.643±0.047 vs. 3.533±0.100, P<0.01). The proliferation of VSMC was enhanced by Ox-LDL stimulation（0.870±0.010 vs. 1.890±0.020, P<0.01）, while FSTL1 reduced this proliferation（1.890±0.021 vs. 1.200±0.023, P<0.05） via SIRT1（1.280±0.033 vs. 2.030±0.092, P<0.01）. Conclusions Ox-LDL reduced the expression of FSTL1. FSTL1 could mitigate Ox-LDL-stimulated proliferation via SIRT1 effectively. Figures and Tables | References | Related Articles | Metrics

Select

Clinical observation of the combination therapy of azacitidine and venetoclax in newly diagnosed, elderly patients with acute myeloid leukemia HUANG Lei, YE Chenjing, WU Chao, XU Wenbin, YU Qing, LI Junmin, YAN Hua 2021, 16 (03):  178-182.  DOI: 10.16138/j.1673-6087.2021.03.008 Abstract ( 295 )   HTML ( 4 )   PDF (477KB) ( 79 )   Objective To observe the clinical efficacy and safety of azacitidine combined with venetoclax in the treatment of newly diagnosed, elderly patients with acute myeloid leukemia (AML). Methods Fourteen elderly patients admitted in Ruijin Hospital from March 2018 to September 2020, who were newly diagnosed with AML and not suitable for intensive chemotherapy, were enrolled and a retrospective analysis was conducted. All patients received 75 mg/m2 azacitidine subcutaneously from day 1 to day 7, and venetoclax orally once a day, total 28 d(the first cause of venetoclax treatment: 100 mg in day 1, 200 mg in day 2, 400 mg from day 3 to day 28). The primary end points were composite complete remission rate (CR+CRi), overall response rate (ORR), time to first response(CR/CRi ) and duration of response (DOR), and the secondary end points were overall survival(OS) and safety. Results The median follow-up time was 12.5 (2.0-24.0) months, the composite complete remission rate (CR+CRi) was 71%, ORR was 79%, the median time to first response was 1.1 (1.0-2.1) months, the median DOR was 16.0 months [95% confidence interval (CI): 4.0-not reached(NR)], and the median OS was 14.0 months (95% CI: 4.0-NR). Among 12 patients with median and high danger of poor cytogenetics, 8 patients (67%) achieved CR+CRi, the median DOR was 9.0 months (95% CI: 2.0-NR), and the median OS was 11.0 months (95% CI: 2.0-NR). Among 10 patients with CR + CRi, 8 patients(80%) achieved MRD<0.01% at least in one assessment, the median DOR was 17.0 months (95% CI: 4.0-NR) and the median OS did not reach (95% CI: 6.0-NR）。All patients showed cytopenia in different degree, including neutropenia of grade 3 or above (100%), thrombocytopenia (7 cases, 50%), febrile neutropenia (6 cases, 43%) and anemia (5 cases, 36%). The other common events occurred in gastrointestinal tract, which were all controllable response of grade 1-2. One patient showed tumor lysis syndrome. Most patients were tolerant to treatment. Conclusions The preliminary results show that the combination therapy of azacitidine and venetoclax is effective and safe, which provides a treatment option for elderly, untreated AML patients who are not suitable for intensive chemotherapy. Figures and Tables | References | Related Articles | Metrics

Select

Relationship between vasopressin and prognosis in the patients with critical condition LI Yanxiu, ZHU Enze, ZHOU Chunlei, LIU Yun, ZUO Xiangrong, LI Jinghang, CAO Quan 2021, 16 (03):  183-187.  DOI: 10.16138/j.1673-6087.2021.03.009 Abstract ( 165 )   HTML ( 3 )   PDF (461KB) ( 58 )   Objective To investigate the effect of vasopressin on the prognosis in the patients with critical condition. Methods The basic information and clinical data of the patients in critical condition in American intensive care database Medical Information Mart for Intensive Care-Ⅲ(MIMIC-Ⅲ) were retrospectively analyzed. The influence of vasopressin on the prognosis of the patients in critical condition was investigated by propensity score matching method and Cox multivariate regression analysis. Results A total of 57 785 patients in critical condition were selected from the MIMIC-Ⅲ database, in which 2 171 were treated with vasopressin. Propensity matching method was used to match 1∶1 between the patients treated with vasopressin and the patients treated without vasopressin. A total of 1 168 patients were successfully matched. The mortality of in-hospital, 30 d, 1-year and long-term in the group using vasopressin were higher than the group treated without vasopressin after matching, and the time staying in hospital and intensive care unit (ICU) were significantly longer in the vasopressin group after matching. Cox multivariate regression analysis showed that using vasopressin was an independent risk factor for increased in-hospital mortality[hazard ratio(HR)=2.44, 95% confidence interval(CI): 2.147-2.772, P<0.001], 30 d mortality (HR=2.205, 95% CI:1.940-2.505, P<0.001), 1-year mortality (HR=1.999, 95% CI: 1.781-2.242, P<0.001) and long-term mortality (HR=1.891, 95% CI: 1.698-2.107, P<0.001). Conclusions This study used propensity score matching method and Cox multivariate regression analysis to conduct a large sample retrospective study, and showed that the using vasopressin is an independent risk factor for the prognosis of the patients with critical condition. Figures and Tables | References | Related Articles | Metrics

Select

Risk factors of asymptomatic erosive esophagitis SUN Chao, YAO Weiyan, HUANG Jia, ZHU Ying, TANG Yuming 2021, 16 (03):  188-192.  DOI: 10.16138/j.1673-6087.2021.03.010 Abstract ( 176 )   HTML ( 3 )   PDF (560KB) ( 46 )   Objective To explore the prevalence, risk factors, prognosis, and management of asymptomatic erosive esophagitis(AEE). Methods A total of 5 184 asymptomatic individuals who underwent gastroscopy for routine health checkup were included in our study. 475 (9.2%) patients with EE devoid of gastroesophageal reflux disease(GERD) symptoms were selected as AEE group. A total of 950 age- and gender-matched subjects with negative endoscopic findings were selected as healthy control group. The clinical data between the two groups were compared. The independent risk factors, prognosis, and treatment of AEE were analyzed. Results A higher body mass index (BMI) [odds ratio（OR）=1.101, P=0.001], fatty liver（OR=1.635, P=0.013）, hiatus hernia（OR=2.302, P=0.039）, and higher gamma-glutamyl transferase (GGT)(OR=1.008, P=0.013) were independent risk factors for AEE. A total of 140 patients were followed up after they were diagnosed with AEE. Regardless of treatment, improved esophagitis occurred in about 2/3 AEE patients（82.4% vs 65.3%）. However, the proportion of subjects with improved esophagitis was much higher in the proton pump inhibitor(PPI) treatment group than that in the non-treatment group. Conclusions Higher BMI, fatty liver, hiatus hernia, and higher GGT are independent risk factors for AEE. The prognosis of AEE is good and PPI treatment could improve AEE. Figures and Tables | References | Related Articles | Metrics

Select

Imaging characteristics of malignant solitary pulmonary nodule in 908 cases LI Yong, WU Pengliang, FANG Zhenfei, ZHOU Jin, TANG Wei 2021, 16 (03):  193-196.  DOI: 10.16138/j.1673-6087.2021.03.011 Abstract ( 144 )   HTML ( 2 )   PDF (456KB) ( 58 )   Objective To analyze the imaging characteristics of malignant solitary pulmonary nodule (SPN). Methods Totally 908 cases of SPN were collected. The imaging features of SPN were analyzed, including tumor microvascular CT sign, vascular convergence, lobulation sign and spiculation. Results In 908 SPN cases, 825 were malignant and 83 were benign. The detection rates of tumor microvascular CT sign, vascular convergence and spiculation were higher in malignant SPN than those in benign SPN (P<0.001). The detection rates of these features were different when malignant SPN were divided into three groups according to different SPN density(P<0.001), and they increased following SPN density increasing (P<0.001). In addition, the detection rates of these features were different when malignant SPN were divided into three groups according to the invasion depth of adenocarcinoma (P<0.001), and they also increased following the deepening of infiltration (P<0.001). Conclusions Tumor microvascular CT signs play an important role in the diagnosis of pure ground glass nodules and part of solid nodules, while vascular convergence, lobulation sign and spiculation are more valuable in qualitative diagnosis of solid nodules. These imaging features also show the diagnostic value in benign and malignant SPN. Figures and Tables | References | Related Articles | Metrics

Select

Effect of chloroquine on type Ⅱ alveolar cell injury caused by lipopolysaccharide ZHU Yingying, ZHANG Jiaojiao, SUN Junnan, WANG Hairong 2021, 16 (03):  197-201.  DOI: 10.16138/j.1673-6087.2021.03.012 Abstract ( 170 )   HTML ( 2 )   PDF (581KB) ( 46 )   Objective To explore the effect of chloroquine (CQ) on lipopolysaccharide (LPS)-induced damage to alveolar type Ⅱ(AT2) cell. Methods Different concentrations of LPS and CQ were used to treat AT2 cells separately, and cell counting kit-8(CCK-8) was used to detect cell viability to screen the concentration of LPS and CQ. After that, the AT2 cells were divided into 4 groups based on different treatment, including control (without treatment), LPS, CQ and LPS+CQ groups. The expression of cleaved caspase 3, Bcl-2, Bax and the phosphorylation level of Akt were detected by Western blotting after each group of cells were processed. After that, LY294002, the signaling pathway inhibitor of phosphatidylinositol-3-kinase(PI3K)/Akt, was added in the cells which were treated by LPS and CQ successively(LPS+CQ+LY294002 group), and the protein expression of cleaved caspase 3, Bcl-2 and Bax was detected by Western blotting in this group. Results The LPS in the concentration of 1, 10 and 50 mg/L was kept for 24 h. The activity of AT2 decreased significantly (P<0.05) when the LPS concentration was increased to 50 mg/L, so LPS in this concentration was used to stimulate AT2. AT2 cell viability did not change significantly (P>0.05) when they were treated with 0.5 μmol/L and 5 μmol/L CQ for 4 h. However, AT2 cell viability began to decrease and showed a concentration-dependent manner when the CQ concentration increased to 10 μmol/L. According to the cell response to CQ in different concentration, 5 μmol/L CQ was chosen to treat the cells. After stimulation with 50 mg/L LPS, the expression of cleaved caspase 3 in the cell increased, and the Bcl-2/Bax ratio and the phosphorylation of Akt decreased. After adding 5 μmol/L CQ, the cleaved caspase 3 dropped, and Bcl-2/Bax ratio and Akt protein phosphorylation rise significantly. After the PI3K inhibitor LY294002 was added, the effect of CQ was eliminated, which showed the Bcl-2/Bax ratio decreased, and the expression of cleaved caspase 3 increased. Conclusions CQ(5 μmol/L) could inhibit cell mitochondrial apoptosis by activating the PI3K/Akt signaling pathway, and alleviate the damage of AT2 cells induced by LPS. Figures and Tables | References | Related Articles | Metrics