查看更多>>摘要：Background:Visceral adipose tissue-derived serine protease inhibitor(vaspin),a secretory adipokine,protects against insulin resis-tance.Recent studies have demonstrated that serum vaspin levels are decreased in patients with coronary artery disease and that vaspin protects against myocardial ischemia-reperfusion injury and atherosclerosis.However,it remains unclear whether vaspin exerts specific effects on pathological cardiac hypertrophy.Methods:An in vivo study was conducted using a cardiac hypertrophy model established by subcutaneous injection of isoproterenol(ISO)in C57BU6 and vaspin-ko mice.Rapamycin was administered intraperitoneally to mice,for further study.H9c2 cells and neonatal rat ventricular myocytes(NRVMs)were treated with ISO to induce hypertrophy.Human vaspin fusion protein,the proteasome inhibitor MG132,and chloroquine diphosphate were used for further mechanistic studies.Results:Here,we provide the first evidence that vaspin knockdown results in markedly exaggerated cardiac hypertrophy,fibrosis,and cardiomyocyte senescence in mice treated with ISO.Conversely,the administration of exogenous recombinant human vaspin protected NRVMs in vitro against ISO-induced hypertrophy and senescence.Furthermore,vaspin significantly potentiated the ISO-induced de-crease in autophagy.Both rapamycin and chloroquine diphosphate regulated autophagy in vivo and in vitro,respectively,and participated in vaspin-mediated cardioprotection.Moreover,the PI3K-AKT-mTOR pathway plays a critical role in vaspin-mediated autophagy in car-diac tissues and NRVMs.Our data showed that vaspin downregulated the p85 and p110 subunits of PI3K by linking p85 and p110 to NEDD4L-mediated ubiquitination degradation.Conclusion:Our results show,for the first time,that vaspin functions as a critical regulator that alleviates pathological cardiac hypertro-phy by regulating autophagy-dependent myocardial senescence,providing potential preventive and therapeutic targets for pathological cardiac hypertrophy.
查看更多>>摘要：Background:Post-cardiac arrest syndrome involves systemic inflammation,which causes subsequent neurological impairments.We investigated the influence of targeted temperature management(TTM)therapy in patients with out-of-hospital cardiac arrest(OHCA)after retum of spontaneous circulation(ROSC)by observing the changes in circulating CD14+ monocytes and the expression of human leuko-cyte antigen D-related(HLA-DR)and programmed cell death ligand 1(PD-L1)in CD14+ monocytes.Methods:Adult patients admitted to the emergency department of Beijing Chao-Yang Hospital after OHCA between January 2017 and March 2018 were included in this study.Thirty control subjects,10 patients with OHCA,and 37 patients with OHCA who received 72 hours of TTM therapy were enrolled.Peripheral blood samples of patients in the OHCA and TTM groups were collected on Days 1 and 3(D1 and D3)after ROSC and evaluated for HLA-DR and PD-L1 expression on CD14+ monocytes using flow cytometry.Results:Compared with control subjects,the percentage of circulating CD14+ monocytes,HLA-DR+/CD14+monocyte ratios,and mean fluorescence intensity were significantly decreased in patients with OHCA.After ROSC,HLA-DR expression in CD14+monocytes in the TTM group was lower than that in patients with OHCA.However,there were no significant differences in the percentage of PD-L1+/CD14+ monocytes or the mean fluorescence intensity between patients with OHCA and healthy volunteers.Conclusion:After ROSC,circulating CD14+ monocytes and HLA-DR+/CD14+ monocyte ratios decreased significantly in patients with OHCA.Human leukocyte antigen D-related expression in CD14+ monocytes was lower in patients treated with TTM.
查看更多>>摘要：Background:Studies on myocardial infarction(MI)based on large medical databases have become popular in recent years.The influ-ence of the National Inpatient Sample(NIS),the largest collection of administrative healthcare data across the United States,on the field of MI has not been well investigated.This study aimed to quantify the contribution of NIS to MI research using bibliometric methods.Methods:We searched the Web of Science Core Collection database to identify publications on MI using NIS from 2000 to 2022.Bibliometric indicators,such as the number of publications,citations,and Hirsch index(H-index),were summarized by years,authors,organizations,and journals.VOSviewer and CiteSpace software were used to analyze the keywords and trends of the hot spots.Results:A total of 342 articles on MI based on NIS were included.A significant growth in outputs related to MI using the NIS from 2000 to 2020 was observed.The publications were mainly from the United States.The Mayo Clinic was the most prolific institution and had the most citations and the highest H-index.The American Journal of Cardiology ranked first among journals with the highest number of pub-lications,citations,and H-index.Mortality and healthcare management are the main focuses of this field.Personalized risks and care are receiving increased attention.Conclusion:This study suggests that NIS significantly contributes to high-quality output in MI research.More efforts are needed to im-prove the impact of knowledge gained from the NIS on MI.
查看更多>>摘要：Background:Proprotein convertase subtilisin/kexin 9(PSCK9)inhibitors have been beneficial for many patients with hyperlipidemia.The objective of this study was to investigate the benefit of PSCK9 inhibitors in patients with acute coronary syndrome(ACS).Methods:We systematically searched PubMed,EMBASE,and Cochrane Clinical Trials(published before January 2023;no language restriction)to compare the treatment of patients with ACS using PCSK9 inhibitors and placebo.The primary end points were major ad-verse cardiovascular events,nonfatal myocardial infarction,cardiogenic death,stroke,hospitalization for recurrent ACS,and coronary re-vascularization.Fixed-or random-effects models were used to assess the aggregated data.Results:Of the 1686 identified studies,5 were eligible and included in our analysis(of a total of 38,005 participants,18,609 cases were placed in the PCSK9 inhibitor treatment group and 19,396 cases in the placebo group).Compared with the placebo group,PCSK9 inhib-itors significantly reduced the major adverse cardiovascular events(odds ratio[OR]:0.83;95％confidence interval[Cl]:0.77-0.88;P＜0.00001)for patients following ACS.The incidence of nonfatal myocardial infarction(relative risk:0.80;95％Cl:0.74-0.87;P＜0.00001),cardiovascular death(OR:0.96;95％Cl:0.83-1.10;P=0.56),stroke(OR:0.74;95％Cl:0.63-0.88;P=0.0007),hospi-talization for recurrent ACS(OR:0.57;95％Cl:0.40-0.83;P=0.003),or coronary revascularization(OR:0.82;95％Cl:0.76-0.88;P＜0.00001)all demonstrated a significant decrease in the comparison between the 2 groups.Conclusion:This meta-analysis demonstrated that treatment with PCSK9 inhibitors in patients with ACS reduced the probability of mul-tiple cardiovascular events and improved patient prognosis.
查看更多>>摘要：Training of emergency physicians through an emergency medicine residency program takes 5 years,that is,3 years in junior residency and 2 years in senior residency.Throughout this period,residents will be exposed to a variety of educational methodologies and meet a spec-trum of faculty,supervisors,and teachers,who will have different personalities,styles,and approaches to teaching and nurturing them.It is important to ensure the maintenance of psychological safety for these residents throughout their training journey and into the future years of practice s an emergency physician.Communications,interactions(which involve questioning),and presentations will be an important part of this training program.This article looks at two modes of questioning:advocacy inquiry and circular questioning,which can be applied as appropriate.These two methods are examples in which faculty may consider adopting in their many interactions,follow-up,feedback,tutorials,facilitation,partnerships,and counseling sessions with residents.These two techniques offer options to maintain psychological safety,which can facilitate learners shar-ing and opening up.It can be included in the faculty's armamentarium of questioning techniques and applied where applicable.
查看更多>>摘要：Background:Mitral valve perforation refers to the occurrence of cracks or openings in the structure of the mitral valve,allowing blood to escape through these gaps.Typically,this is caused by infective endocarditis and the most common site is the anterior leaflet.However,it is crucial to explore other potential causes of valve damage,particularly when conventional risk factors are not apparent.Case presentation:We present a case of a middle-aged male patient who developed mitral valve perforation because of aortic valve regurgitation in the absence of infective endocarditis.Conclusion:Exploring such rare cases contributes to a deeper understanding of valvular diseases and enhances clinical decision mak-ing for effective management.
查看更多>>摘要：Background:Chylous ascites(CA),an emulsion rich in triglycerides,is a rare type of ascites,especially after cardiac surgery.Also,there are few reports of the occurrence of CA after mitral valve replacement,aortic valve replacement,tricuspid valvuloplasty,and coronary artery bypass grafting.Case presentation:We report the case of a 53-year-old man who underwent surgery for a diagnosis of mitral incompetence,aortic incompetence,tricuspid incompetence,and coronary atherosclerotic heart disease.Fifteen days after surgery,3000 mL of milky-yellow ascites appeared in the abdominal cavity,diagnosed as CA by laboratory examination.The ascites gradually disappeared after being drained,and the patients improved.The curative was objective,but the exact cause is not clear.Conclusion:Although CA is rare,it may occur during the surgical intervention in cardiac surgery.
万方数据
维普
NETL
NSTL