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急性心肌梗死合并室间隔穿孔早期死亡相关因素分析

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中华心血管病杂志 2018年第12期46卷 981-986页

作者：倪宇晴唐建军台适唐亮胡信群方臻飞潘宏伟黄河刘厂辉曾高峰周胜华中南大学湘雅二医院心血管内科长沙410011 湖南省人民医院心血管内科湘潭市中心医院心血管内科南华大学附属第一医院心血管内科南华大学附属第二医院心血管内科

目的分析急性心肌梗死(AMI)合并室间隔穿孔(VSR)患者的临床特点,评估影响室间隔穿孔患者早期死亡的相关危险因素。方法回顾性分析2007年12月到2017年5月由湘雅二医院、湖南省人民医院、南华大学附属第一医院、南华大学附属第二医院、湘... 详细信息

目的分析急性心肌梗死(AMI)合并室间隔穿孔(VSR)患者的临床特点,评估影响室间隔穿孔患者早期死亡的相关危险因素。方法回顾性分析2007年12月到2017年5月由湘雅二医院、湖南省人民医院、南华大学附属第一医院、南华大学附属第二医院、湘潭市中心医院5家医院确诊的AMI合并VSR患者96例,其中男50例,女46例,年龄43~90(66.2±10.7)岁,收集患者年龄、性别、合并症、心肌梗死史、吸烟史、胸痛发作至就诊时间、AMI后急诊经皮冠状动脉介入治疗或溶栓、Killip分级、心电图、超声心动图、冠状动脉造影等临床资料。根据是否发生院内死亡分为院内死亡组(n=32)和院内存活组(n=64),探讨影响AMI合并VSR院内死亡的相关因素;再根据患者存活时间分为早期死亡组(存活≤2周,n=50)和非早期死亡组(存活 >2周,n=46),采用logistic多元回归分析早期死亡的独立危险因素。结果71例收集到VSR穿孔部位的患者中,64.0%(32/50)前壁AMI的VSR部位为心尖部或前间隔近心尖部室间隔穿孔,57.1%(12/21)非前壁AMI的VSR部位为后间隔和基底段。与院内存活组比较,院内死亡组患者多为高龄[(69.6±11.3)岁比(64.6±10.1)岁,P=0.031]、不合并室壁瘤形成[71.9%(23/32)比37.5%(24/64),P=0.001]和前壁心肌梗死[84.4%(27/32)比62.5%(40/64),P=0.028]。早期死亡组(存活≤2周)与非早期死亡组(存活 >2周)比较,年龄、性别、合并心绞痛/心肌梗死病史、Killip分级≥Ⅲ级、合并室壁瘤形成等差异有统计学意义(P<0.05)。logistic回归分析显示,女性(OR=5.11,95%CI1.19~22.00,P=0.012)、无心绞痛/心肌梗死史(OR=23.34,95%CI3.44~158.37,P=0.001)、Killip分级≥Ⅲ级(OR=5.35,95%CI1.26~22.66,P=0.019)、不合并室壁瘤(OR=6.30,95%CI1.67~23.73,P=0.005)为早期死亡的独立危险因素。结论女性、无心绞痛/心肌梗死史、Killip分级≥Ⅲ级、不合并室壁瘤为AMI合并VSR患者早期死亡的独立危险因素。

关键词：心肌梗死室间隔破裂死亡危险因素

先天性心脏病复合畸形介入治疗19例临床分析

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疑难病杂志 2015年第4期14卷 343-345页

作者：申国璋沈向前方臻飞唐建军湖南省长沙市第四医院心内一科 410006 中南大学湘雅二医院心内科长沙410011

目的探讨先天性心脏病（CHD）复合畸形介入治疗的疗效和安全性。方法 CHD复合畸形患者19例,男11例,女8例,年龄5～36（15.2±10.7）岁,体质量25.6～55.8（32.2±26.1）kg;其中房间隔缺损（ASD）合并动脉导管未闭（PDA）5例,ASD合并肺动... 详细信息

目的探讨先天性心脏病（CHD）复合畸形介入治疗的疗效和安全性。方法 CHD复合畸形患者19例,男11例,女8例,年龄5～36（15.2±10.7）岁,体质量25.6～55.8（32.2±26.1）kg;其中房间隔缺损（ASD）合并动脉导管未闭（PDA）5例,ASD合并肺动脉瓣狭窄（PS）6例,ASD合并室间隔缺损（VSD）3例,VSD合并PS 3例,PDA合并PS 1例,PDA合并B型预激综合征1例。介入治疗顺序为：PS球囊扩张术、VSD封堵术、PDA封堵术、ASD封堵术;PDA合并预激综合征先行射频消融治疗,再行PDA封堵术。结果 19例患者均一次性介入治疗成功,术中无严重并发症发生,术后造影和心脏彩超证实无明显残余分流,封堵器固定良好。10例合并PS患者的跨肺动脉瓣压差由术前的（50.6±17.2）mm Hg降至术后的（21.2±9.5）mm Hg（t=6.28,P〈0.01）。ASD合并其他畸形患者14例,均采用ASD封堵器,封堵器直径平均为（20.6±10.5）mm;PDA合并其他畸形患者6例,2例选用弹簧圈封堵,其余4例患者选用PDA封堵器,平均直径为（7.1±2.5）mm;VSD合并其他畸形患者6例,膜周部4例,并膜部瘤形成2例,均采用对称型VSD封堵器,封堵器直径平均为（9.5±3.2）mm。结论严格掌握适应证,制定合理的操作策略,CHD复合畸形介入治疗的疗效肯定,安全可行。

关键词：心脏缺损,先天性心脏导管插入术复合畸形介入治疗

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经导管主动脉瓣置换术后瓣周漏尝试封堵一例

华西医学 2020年第4期35卷 484-488页

作者：苏文黄亿源台适唐建军方臻飞中南大学湘雅二医院心血管内科长沙410000

患者为75岁老年女性,因"反复胸痛、气促5年余,晕厥3次"入院。CT提示主动脉瓣严重狭窄,二叶瓣,严重钙化,入院后接受经导管主动脉瓣置换术治疗。植入瓣膜后患者出现明显瓣周漏,考虑因钙化团块之间形成的三角区域使得瓣膜扩张不全;术中行... 详细信息

患者为75岁老年女性,因"反复胸痛、气促5年余,晕厥3次"入院。CT提示主动脉瓣严重狭窄,二叶瓣,严重钙化,入院后接受经导管主动脉瓣置换术治疗。植入瓣膜后患者出现明显瓣周漏,考虑因钙化团块之间形成的三角区域使得瓣膜扩张不全;术中行瓣周漏封堵术,尝试穿过瓣膜支架网眼进行封堵;封堵后发生了罕见的输送器嵌顿事件,尝试通过提拉技术拔出嵌顿的输送器,导致瓣膜脱出,最终患者转入外科行开胸手术。

关键词：经导管主动脉瓣置换瓣周漏封堵主动脉瓣钙化

急诊经导管主动脉瓣置换术的疗效初探:一项多中心研究

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中华心血管病杂志 2022年第7期50卷 698-704页

作者：周政张龙岩杨剑尚小珂李捷潘文志姜正明方臻飞李飞吴永健宋光远中国医学科学院北京协和医学院国家心血管病中心阜外医院心内科北京100037 武汉亚洲心脏病医院心内科武汉430022 第四军医大学西京医院心外科西安710032 华中科技大学同济医学院附属协和医院心外科武汉430022 广东省人民医院心内科广州510000 上海复旦大学附属中山医院心内科上海200032 郑州大学第一附属医院心内科郑州450052 中南大学湘雅二医院心内科长沙410011 第四军医大学西京医院心内科西安710032

目的:初步探讨急诊经导管主动脉瓣置换术(TAVR)的有效性及安全性。方法:该研究为回顾性研究。入选2017年5月至2020年12月于中国医学科学院阜外医院、广东省人民医院、华中科技大学同济医学院附属协和医院、第四军医大学西京医院、上海... 详细信息

目的:初步探讨急诊经导管主动脉瓣置换术(TAVR)的有效性及安全性。方法:该研究为回顾性研究。入选2017年5月至2020年12月于中国医学科学院阜外医院、广东省人民医院、华中科技大学同济医学院附属协和医院、第四军医大学西京医院、上海复旦大学附属中山医院、武汉亚洲心脏病医院、郑州大学第一附属医院、中南大学湘雅二医院8家中心行急诊TAVR的患者。收集机械循环辅助装置(MCS)使用情况及手术前后实验室检验[N末端B型利钠肽原(NT-proBNP)]及超声心动图检查结果(平均主动脉瓣跨瓣压差、左心室射血分数)。主要终点事件为全因死亡,次要终点事件为卒中、大出血、主要血管并发症、心肌梗死、永久起搏器置入、急性肾损伤。计算器械置入成功率,器械置入成功指患者存活,单个人工主动脉瓣置入位置合适且术后平均主动脉瓣跨瓣压差<20 mmHg(1 mmHg=0.133 kPa)或主动脉瓣峰值流速<3 m/s,同时无中度及以上人工主动脉瓣膜反流。采用Kaplan-Meier生存曲线法估计患者随访期间生存率。结果:共纳入48例患者,年龄(72.5±8.1)岁,其中男性34例(70.8%)。器械置入成功率为91.7%(44/48)。全部患者的术后平均主动脉瓣跨瓣压差较术前降低[(12.3±6.4)mmHg比(60.2±23.8)mmHg,P<0.0001],左心室射血分数升高[(41.5±11.7)%比(31.0±11.3)%,P<0.0001],NT-proBNP下降[3492.0(1638.8,7165.5)ng/L比12418.5(6693.8,35000.0)ng/L,P<0.0001]。入选患者的院内全因死亡率为8.3%(4/48),住院期间卒中发生率为2.1%(1/48),大出血发生率为6.3%(3/48),主要血管并发症发生率为10.4%(5/48),心肌梗死发生率为4.2%(2/48),永久起搏器置入率为6.3%(3/48),急性肾损伤发生率为12.5%(6/48)。20例患者应用了MCS,使用率达41.7%。中位随访时间196 d,随访期间全因死亡1例(因胰腺癌全身转移),新增心肌梗死2例,置入永久起搏器1例。术后30 d、1年及2年的生存率分别为91.7%(44/48)、89.6%(43/48)、89.6%(43/48)。结论:对于急危重症状态的失代偿性主动脉瓣重度狭窄患者,急诊TAVR可能是一种安全有效的治疗手段。

关键词：主动脉瓣狭窄经导管主动脉瓣置换术急诊预后

Outcome of percutaneous closure of congenital heart defects with the CERATM Occluder:a new nano-structured TiN/Ti coating on nitinol cardiac occluder multi-center clinical trial of Chinese Registry

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Outcome of percutaneous closure of congenital heart defects ...

疫情流行期间心力衰竭与新型冠状病毒肺炎患者临床及影像学特征的比较

中华医学会第十七次全国儿科学术大会

作者： Yumei Xie1,Zhiwei Zhang1,Yufen Li1,Junjie Li1,zhenfei fang 1,Jijun Shi 1,Shushui Wang1,Shuguang Lin1 1.Departements of Pediatric Cardiology,Guangdong General Hospital,Guangdong Cardiovascular Institute, Guangzhou,China 2.Second Xiangya Hospital of Central South University,Changsha,China

Objectives The aim of this study was to evaluate safety and efficacy of the Cera family of occluders coated with bioceramic TiN for percutaneous closure of PDA,ASD,and VSD in the Chinese Registry. Methods Between June 2008 and April 2009,Implantation of percutaneous devices was attempted in enrolled patients in 11 Chinese *** were randomized to either a Cera

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中华心血管病杂志 2020年第6期48卷 467-471页

作者：朱兆伟唐建军柴湘平方臻飞刘启明胡信群许丹焰唐亮台适伍玉枝周胜华中南大学湘雅二医院心内科长沙410011 中南大学湘雅二医院急诊科长沙410011 中南大学湘雅二医院放射科长沙410011

目的对比心力衰竭及新型冠状病毒肺炎(COVID-19)患者临床及肺部影像学特征,总结二者的鉴别要点。方法本研究为回顾性研究。纳入中南大学湘雅二医院于2019年12月1日至2020年2月15日间收治的心力衰竭及COVID-19患者,排除病例资料不全者,... 详细信息

目的对比心力衰竭及新型冠状病毒肺炎(COVID-19)患者临床及肺部影像学特征,总结二者的鉴别要点。方法本研究为回顾性研究。纳入中南大学湘雅二医院于2019年12月1日至2020年2月15日间收治的心力衰竭及COVID-19患者,排除病例资料不全者,共纳入心力衰竭患者7例,COVID-19患者12例。比较两组的基线临床特征(包括性别、年龄、病史、实验室检查等)及肺部CT影像学特征。结果两组间年龄、性别差异无统计学意义(P均>0.05),COVID-19组流行病学接触史、发热或呼吸道症状比例明显高于心力衰竭组(12/12比0,P<0.001;12/12比4/7,P=0.013);合并心血管基础疾病、心功能受损比例则明显少于心力衰竭组(2/12比7/7,P<0.001;0比7/7,P<0.001)。影像学方面,两组患者都可有磨玻璃影及小叶间隔增厚的特点。但与COVID-19组比较,心力衰竭患者肺部病变呈中央型及阶梯状的比例(4/7比1/12,P=0.04)及小肺静脉扩张比例更高(3/7比0,P=0.013),且经有效抗心力衰竭治疗后肺部病变会快速改善。此外,COVID-19患者肺部病变呈圆形或类圆形的比例高于心力衰竭患者(9/12比2/7,P=0.048)。结论COVID-19患者具有流行病学接触史,发热和呼吸道症状明显。在肺部CT影像学表现上,二者有相似之处,但病变分布特点、病变形态和肺静脉扩张情况有不同之处。

关键词：新型冠状病毒肺炎心力衰竭肺部CT

Polyamines and antioxidant defense system are associated with cold tolerance in centipedegrass

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Frontiers of Agricultural Science and Engineering 2018年第1期5卷 129-138页

作者： Jingjing CHEN Junyang fang zhenfei GUO Shaoyun LU College of Life Sciences Guangdong Engineering Research Center for Grassland Science/State Key Laboratory for Conservation and Utilization of Subtropical Agro-Bioresources South China Agricultural University Key Laboratory of Tropical Fruit Biology of Ministry of Agriculture/South Subtropical Crops Research Institute Chinese Academy of Tropical Agricultural Science College of Grassland Science Nanjing Agricultural University

Physiological responses to low temperature were analyzed in a chilling-tolerant centipedegrass(Eremochloa ophiuroides) accession, Shao Guan(SG), in comparison to the commercial cultivar, Common. Lower levels of ion leakage and higher chlorophyll(Chl)concentration were observed in SG than in Common during chilling stress. The maximum photochemical efficiency, the actual photosystem Ⅱ(PSII) efficiency,photochemical quenching efficiency, and net photosynthetic rate were decreased during chilling stress in both genotypes, with higher levels of these parameters shown by SG than Common. In addition, higher activities of superoxide dismutase(SOD), catalase(CAT), ascorbateperoxidase(APX) and glutathione reductase(GR), and higher concentrations of ascorbic acid(AsA) and glutathione(GSH) were observed in SG than in ***, higher concentrations of putrescine(Put),spermidine(Spd), and spermine(Spm) were observed in SG than in Common. Correlation analysis indicated that SOD, CAT, APX and GR activities, and As A and GSH concentrations showed high correlation to Put, while APX,GR, and As A concentrations were correlated to *** Put or Spd increased antioxidant enzyme activities and chilling tolerance. The results suggested that polyamine-regulated antioxidants are important for chilling tolerance in centipedegrass and protect plants against chilling induced oxidative damage.

关键词： antioxidants centipedegrass chilling photosynthesis polyamines

Lamin-like Proteins Negatively Regulate Plant Immunity through NAC WITH TRANSMEMBRANE MOTIF1-LIKE9 and NONEXPRESSOR OF PR 3ENES1 in Arabidopsis thaliana

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Molecular Plant 2017年第10期10卷 1334-1348页

作者： Tongtong Guo Xuegao Mao Hui Zhang Yu Zhang Mengdi Fu zhenfei Sun Peng Kuai Yonggen Lou Yuda fang National Key Laboratory of Plant Molecular Genetics CAS Center for Excellence in Molecular Plant Sciences Institute of Plant Physiology and Ecology Shanghai Institutes for Biological Sciences Chinese Academy of Sciences Shanghai 200032 China University of the Chinese Academy of Sciences Beijing 100049 China State Key Laboratory of Rice Biology Institute of Insect Sciences Zhejiang University Hangzhou 310058 China

Nuclear lamins are involved in multiple biological processes in metazoan cells. The proteins of the CROWDED NUCLEI （CRWN） family are considered lamin-like candidates in Arabidopsis, although the functions of these proteins are largely unknown. In this article we show that crwnl crwn2 double mutant displays an enhanced resistance against virulent bacterial pathogens, and both virulent bacteria and salicylic acid （SA） induce transcription of CRWN1 gene as well as proteasome-mediated degradation of CRWN1 protein. We also show that CRWN1 interacts with NAC WITH TRANSMEMBRANE MOTIF1 -LIKE9 （NTL9）, a NAC transcription factor involved in plant immunity. The interaction between CRWN1 and NTL9 enhances the binding of NTL9 to the promoter of the PATHOGENESIS-RELATED1 （PR1） gene, and inhibits PR1 expression. Further genetic experiments indicated that the defense-related phenotypes of crwnl crwn2 double mutant are dependent on NONEXPRESSOR OF PR GENES1 （NPR1）, a transcriptional cofactor of PRI. These findings revealed a regulatory network composed of lamin-like protein CRWN1, NTL9, and NPR1 for the regulation of PR1 expression.

关键词： lamin CRWN NTL9 NPR1 plant immunity

Genome-wide profiling of histone H3 lysine 27 trimethylation and its modification in response to chilling stress in grapevine leaves

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Horticultural Plant Journal 2023年第3期9卷 496-508页

作者： zhenfei Zhu Qingyun Li Duncan Kiragu Gichuki Yujun Hou Yuanshuang Liu Huimin Zhou Chen Xu Linchuan fang Linzhong Gong Beibei Zheng Wei Duan Peige Fan Qingfeng Wang Haiping Xin Key Laboratory of Plant Germplasm Enhancement and Specialty Agriculture Core Botanical Gardens/Wuhan Botanical GardenChinese Academy of SciencesWuhanHubei430074China Sino-Africa Joint Research Center Chinese Academy of SciencesWuhanHubei430074China Key Laboratory of Plant Resources Institute of BotanyChinese Academy of ScienceBeijing100093China Institute of Fruit and Tea Hubei Academy of Agricultural SciencesWuhanHubei430064China University of Chinese Academy of Sciences Beijing100049China Wuhan Academy of Agricultural Sciences WuhanHubei430074China

Histone H3 lysine 27 trimethylation(H3K27me3) is a histone modification associated with transcriptional repression. However, insights into the genome-wide pattern of H3K27me3 in grapevines are limited. Here, anti-H3K27 chromatin immunoprecipitation(ChIP), high-throughput sequencing, and transcriptome analysis were performed using leaves of Vitis amurensis. The leaves were treated at 4°C for 2 h and 24 h and used to investigate changes in H3K27me3 under chilling treatment. The results show that H3K27me3 is well-distributed both in gene regions(-50%) and in the intergenic region(-50%) in the grapevine genome(Vitis vinifera ‘Pinot Noir PN40024'). H3K27me3 was found to be localized in8 368 annotated gene regions in all detected samples(leaves at normal temperature and under chilling treatments) and mainly enriched in gene bodies with the adjacent promoter and downstream areas. The short-term chilling treatments(4°C for 2 h) induced 2 793 gains and 305losses in H3K27me3 modification. Subsequently, 97.3% of the alterations were restored to original levels after 24 h treatment. The ChIP-qPCR for five differential peaks showed similar results to the data for ChIP-seq, indicating that the chilling-induced H3K27me3 modification is *** analysis of transcriptome and ChIP-seq results showed that the expression of H3K27me3 target genes was significantly lower than those of non-target genes, indicating transcriptional repression of H3K27me3 in grapevine leaves. Furthermore, histone methylation alterations were detected in 82 genes and were related to either repression or activation of their expression during chilling stress. The findings provide the genome-wide H3K27me3 patterns in grapevines and shed light on uncovering its regulation in chilling stress responses.

关键词： Vitis amurensis Histone modification H3K27me3 Chilling stress