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Passive activity enhances residual control ability in patients with complete spinal cord injury

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Neural Regeneration research 2025年第8期20卷 2337-2347页

作者： Yanqing Xiao Mingming Gao Zejia He Jia Zheng Hongming Bai Jia-Sheng Rao Guiyun Song Wei Song Xiaoguang Li Beijing Key Laboratory for Biomaterials and Neural Regeneration Beijing Advanced Innovation Center for Biomedical EngineeringSchool of Biological Science and Medical EngineeringBeihang UniversityBeijingChina Department of Rehabilitation Evaluation China Rehabilitation Research CenterBeijingChina cardiac Center Beijing Children’s HospitalCapital Medical UniversityBeijingChina The State Key Laboratory of Virtual Reality Technology and Systems Beihang UniversityBeijingChina Department of Rehabilitation Engineering China Rehabilitation Science InstituteBeijingChina

Patients with complete spinal cord injury retain the potential for volitional muscle activity in muscles located below the spinal injury ***,because of prolonged inactivity,initial attempts to activate these muscles may not effectively engage any of the remaining neurons in the descending pathway.A previous study unexpectedly found that a brief clinical round of passive activity significantly increased volitional muscle activation,as measured by surface *** this study,we further explored the effect of passive activity on surface electromyographic signals during volitional control tasks among individuals with complete spinal cord *** patients with chronic complete thoracic spinal cord injury were *** electromyography data from eight major leg muscles were acquired and compared before and after the passive activity *** results indicated that the passive activity led to an increased number of activated volitional muscles and an increased frequency of *** the cumulative root mean square of surface electromyography amplitude for volitional control of movement showed a slight increase after passive activity,the difference was not statistically *** findings suggest that brief passive activity may enhance the ability to initiate volitional muscle activity during surface electromyography tasks and underscore the potential of passive activity for improving residual motor control among patients with motor complete spinal cord injury.

关键词： complete spinal cord injury cycle training epidural electrical stimulation motor training passive activity physiological state spinal cord circuit surface electromyography volitional control task

Association of renal function with cardiac reverse remodeling and long-term outcome in heart failure patients following cardiac resynchronization therapy

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Chinese Medical Journal 2014年第23期127卷 4036-4042页

作者： Cai Chi Hua Wei Ding Ligang Wang Jing Chen Keping Yang Xinwei Liu Zhimin Zhang Shu centre of arrhythmia Diagnosis and Treatment Fuwai Hospital Chinese Academy of Medical Sciences & Peking Union Medical College Beijing 100037 China

Background Renal insufficiency （RI） is significantly associated with clinical prognosis in patients with heart failure （HF）,but direct evidences on the relation between renal function and clinical outcome in patients receiving cardiac resynchronization therapy （CRT） are *** aim of the current study was to systematically evaluate the association of baseline and 6-month renal function with cardiac reverse remodeling and long-term outcome after *** We retrospectively evaluated 190 consecutive patients who underwent CRT at Fuwai Hospital from January 2008 to April *** function tests,echocardiographic measurement,and clinical parameters at baseline and after 6 months of CRT were *** endpoint events included all-cause mortality,cardiac transplantation,and unplanned hospitalizations for *** At baseline,compared with normal renal function or mild RI （estimated glomerular filtration rate （eGFR）〉-60 ml·min-1·1.73 m-2）,moderate-to-severe RI （eGFR 〈60 ml·min-1·1.73 m-2） exerted a negative influence on cardiac reverse remodeling *** 6-month follow-up,114 （60.0%） patients were classified as responders and showed significant renal function improvement,whereas renal function deteriorated in non-responders and subsequently 41 （25.6%） patients developed worsening renal function （WRF）.During the mean follow-up of （24.3±17.1） months,both patients with baseline eGFR 〈60 ml·min^-1·1.73 m^-2 and those with WRF experienced worse event-free survival （P 〈0.01,respectively）.Conclusions：This analysis identified that baseline eGFR as well as WRF after CRT were found to be independent determinants of the combined endpoints of all-cause mortality and HF-related hospitalizations in CRT recipients.

关键词： heart failure renal insufficiency cardiac resynchronization therapy clinical outcome

Potential predictors of non-response and super-response to cardiac resynchronization therapy

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Chinese Medical Journal 2011年第9期124卷 1338-1341页

作者： QIAO Qing DING Li-gang HUA Wei CHEN Ke-ping WANG Fang-zheng ZHANG Shu centre of arrhythmia Diagnosis and Treatment Fuwai HospitalChinese Academy of Medical Sciences Peking Union Medical College Beijing 100037 China

Background Although cardiac resynchronization therapy （CRT） is already an established treatment, the characteristics of patients who have an excellent response to CRT and those who get no benefit remain to be determined. The purpose of this study was to search for potential predictors of both non-response and super-response to *** Seventy-six consecutive patients who received CRT treatment were divided into group A （non-responders）,group C （super-responders） and group B （responders exclusive of super-responders）. Student＇s t test, Mann-Whitney test, Logistic regression and receiver operating characteristic curve were employed to identify potential predictors among the patients＇ demographic characteristics, clinical features, several electrocardiographic parameters before and after CRT implantation, and their pre-implant echocardiographic *** Group A had the lowest 3-month left ventricular ejection fraction （LVEF）. Group C had the smallest pre-implant left ventricular end-diastolic dimension （LVEDD）, the shortest post-implant QRS duration, the smallest 3-month LVEDD and the highest 3-month LVEF. In addition, there was a trend of gradual change in percent of left bundle branch block,severity of pre-implant mitral regurgitation, pre-implant QRS dispersion, post-implant QRS duration as well as post-implant QRS dispersion from group A to group B and from group B to group C. Multivariable Logistic analysis revealed that only pre-implant LVEDD could predict CRT super-response. A pre-implant LVEDD of 68.5 mm was the cut-off value that identified super-responders with 87.5% sensitivity and 79.7% specificity. A pre-implant LVEDD of 62.5mm identified super-responders with 50.0% sensitivity and 89.8% *** Predictors of a CRT non-response remain unclear at present. But it is credible that patients with a smaller left ventricle would have a better chance to become super-responders to CRT.

关键词： cardiac resynchronization therapy non-response super-response predictor

The influence of metabolic syndrome on atrial fibrillation recurrence: five-year outcomes after a single cryoballoon ablation procedure

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Journal of Geriatric Cardiology 2021年第12期18卷 1019-1028页

作者： Yu XIA Xiao-Feng LI Jun LIU Miao YU Pi-Hua FANG Shu ZHANG State Key Laboratory of Cardiovascular Disease Cardiac Arrhythmia CenterFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

BACKGROUND Metabolic syndrome(MetS)has been reported as a risk factor of atrial fibrillation(AF)recurrence after radi-ofrequency catheter *** study aimed to investigate the long-term influence of MetS on paroxysmal AF recurrence after a single cryoballoon ablation procedure,which was scarcely investigated yet in Chinese *** In total,137 paroxysmal AF patients who had successfully completed a single cryoballoon ablation procedure at Fuwai Hospital,Beijing,China from December 2013 to October 2015 were *** for patients with AF recurrence,all patients were followed up for no less than five *** predictors of AF recurrence were determined by Cox propor-tional hazards regression *** Among 137 paroxysmal AF patients,91 patients(66.4%)had successfully achieved overall five-year follow-up after a single cryoballoon ablation procedure,and 44 patients(32.1%)had *** with MetS had a significant lower incidence of freedom from AF recurrence than those without MetS(50.0%vs.74.2%,log-rank P<0.01)during the five-year ***(HR=1.95,95%CI:1.069−3.551,P=0.030)was an independent predictor of AF recurrence after adjusting for multiple *** the second year post cryoballoon ablation procedure,the recurrence rate of AF gradually increased in patients with MetS,in con-trast,decreased recurrence rate of AF in patients without *** MetS is an independent predictor for five-year AF recurrence after a single cryoballoon ablation procedure in paroxysmal AF *** therapy of AF and MetS may improve the long-term outcomes of AF patients.

关键词： balloon fibrillation atrial

Acute and Chronic Changes and Predictive Value of Tpeak-Tend lor Ventricular arrhythmia Risk in cardiac Resynchronization Therapy Patients

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Chinese Medical Journal 2016年第18期129卷 2204-2211页

作者： Cong Xue Wei Hua Chi Cai Li-Gang Ding Zhi-Min Liu Xiao-Han Fan Yun-Zi Zhao Shu Zhang cardiac arrhythmia Center State Key Laboratory of Cardiovascular Disease Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 China

Background： Prolongation of the Tpeak-Tend （TpTe） interval as a measurement of transmural dispersion of repolarization （TDR） is an independent risk factor for chronic heart failure mortality, However, the cardiac resynchronization therapy＇s （CRT） effect on TDR is controversial. Therefore, this study aimed to evaluate CRTs acute and chronic effects on repolarization dispersion. Furthermore, we aimed to investigate the relationship between TpTe changes and ventricular arrbythmia. Methods： The study group consisted of 101 patients treated with CRT-defibrillator （CRT-D）. According to whether TpTe was shortened, patients were grouped at immediate and l-year follow-up after CRT, respectively. The echocardiogram index and ventricular arrhythmia were observed and compared in these subgroups. Results： For all patients, TpTe slightly increased immediately after CRT-D implantation, and then decreased at the l -year follow-up （from 107 ± 23 to 110 ± 21 rns within 24 h, to 94 ± 24 ms at 1-year follow-up, F 19.366, P 〈 0.001）. No significant difference in the left ventricular reverse remodeling and ventricular tachycardia/ventricular fibrillation （VT/VF） episodes between the TpTe immediately shortened and TpTe immediately nonshortened groups. However, patients in the TpTe at l-year shorten had a higher rate of the lelt ventricular （LV） reverse remodeling （65% vs. 44%, Z2 = 4.495, P - 0.038） and less VT/VF episodes （log-rank test, X2 - 10.207, P = 0.001 ） compared with TpTe I-year nonshortened group. TpTe immediately alter CRT-D independently predicted VT/VF episodes at l-year follow-up （hazard ratio [HR], 1.030; P = 0.001 ）. Conclusions： Patients with TpTe shortened at l -year after CRT had a higher rate of LV reverse remodeling and less VT/VF episodes. The acute changes of TpTe after CRT have minimal value on mechanical reverse remodeling and ventricular arrhythmia.

关键词： cardiac Resynchronization Therapy Dispersion of Repolarization Tpeak-Tend Interva

Ultrasound-guided stellate ganglion blockade: an appealing tactic for cardiac electrical storm

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Journal of Geriatric Cardiology 2023年第5期20卷 376-382页

作者： Zi-Hao LAI Li-Hui ZHENG Yan YAO arrhythmia Center Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

Ventricular arrhythmia(VA)is a life-threatening cardiac *** VA occurs three times or more within 24 h and interventions are required,it is defined as an electrical storm(ES)characterized by refractoriness and recurrence.[1]For patients with implantable cardioverter defibrillator(ICD),the notion is redefined as no fewer than three appropriate and separate(at least 5 min for each interval)ICD interventions given within 24 h.

关键词： cardiac storm electrical

Pacemaker implantation in a patient with brugada and sick sinus syndrome

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World Journal of Cardiology 2013年第3期5卷 65-67页

作者： Bjarke Risgaard Henning Bundgaard Reza Jabbari Stig HaunsФ Bo Gregers Winkel Jacob Tfelt-Hansen The Danish National research Foundation centre for cardiac arrhythmia University of Copenhagen Laboratory of Molecular Cardiology Department of Cardiology The Heart Centre Copenhagen University Hospital Rigshospitalet

Brugada syndrome (BrS) is a rare and inherited primary arrhythmic syndrome characterized by ST-segment elevations in the right precordial leads (V1 -V3 ) with an increased risk of sudden cardiac death (SCD). arrhythmias in BrS are often nocturne, and brady-arrhythmias are often seen in patients with loss-of-function mutations in SCN5A . In this case-report we present a 75-year old woman referred to our outpatient clinic for inherited cardiac diseases for a familial clinical work-up. Since childhood she had suffered from dizziness, absence seizures, and countless Syncope's. In 2004 sick sinus syndrome was suspected and she wastreated with implantation of a pacemaker (PM) at another institution. An inherited cardiac disease was one day suddenly suspected, as the patient had a 61-year old brother who was diagnosed with symptomatic BrS, and treated with an implantable cardioverter defibrillator (ICD) after aborted SCD. A mutation screening revealed a SCN5A [S231CfsX251 (c.692-693delCA )] loss-of-function mutation not previously reported, and as a part of the cascade screening in relatives she was therefore referred to our clinic. In the 7 year period after PM implantation she had experienced no cardiac symptoms, although her electrocardiogram changes now were consistent with a BrS type 1 pattern. A genetic test confirmed that she had the same mutation in SCN5A as her brother. In this case-report we present a loss-of function mutation in SCN5A not previously associated with BrS nor presented in healthy controls. Sinus node dysfunction has previously been documented in patients with symptomatic BrS, which suggests it is not a rare concomitant. The only accepted treatment of BrS is today implantation of an ICD. In the future studies should evaluate if PM in some cases of symptomatic BrS can be used instead of ICDs in patients with a loss-of-function SCN5A

关键词： Brugada syndrome Pacemaker arrhythmias Sudden cardiac death

Curcumin Reduces cardiac Fibrosis by Inhibiting Myofibroblast Differentiation and Decreasing Transforming Growth Factor β1 and Matrix Metalloproteinase 9/Tissue Inhibitor of Metalloproteinase 1

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Chinese Journal of Integrative Medicine 2017年第5期23卷 362-369页

作者： MA Jin MA Shi-yu DING Chun-hua cardiac Electrophysiology research Lab Guangdong Provincial Academy of Chinese Medical Sciences Guangzhou 510006 China Department of Critical Care Medicine Guangdong Provincial Hospital of Chinese Medicine Guangzhou 510006 China arrhythmia Center Guangdong Provincial Hospital of Chinese Medicine Guangzhou 510006 China

Objective： To study the effect of curcumin on fibroblasts in rats with cardiac fibrosis. Methods： The rats were randomly divided into 4 groups（n=12 in each group）： the normal control, isoproterenol（ISO）, ISO combined with low-dose curcumin（ISO＋Cur-L）, and ISO combined with high-dose curcumin（ISO＋Cur-H） groups. ISO＋Cur-L and ISO＋Cur-H groups were treated with curcumin（150 or 300 mg·kg-1·day-1） for 28 days. The primary culture of rat cardiac fibroblast was processed by trypsin digestion method in vitro. The 3rd to 5th generation were used for experiment. Western blot method was used to test the expression of collagen type Ⅰ/Ⅲ, α-smooth muscle actin（α-SMA）, transforming growth factor（TGF）-β1, matrix metalloproteinase（MMP）-9 and tissue inhibitor of metalloproteinase（TIMP）-1. 3-（4,5-Dimethylthiazol-2-yl）-2,5-diphenyltetr-azolium bromide（MTT） assay was applied to test the proliferation of fibroblast. Result： Curcumin significantly decreased interstitial and perivascular myocardial collagen deposition and cardiac weight index with reducing protein expression of collagen type Ⅰ/Ⅲ in hearts（P〈0.05）. In addition, curcumin directly inhibited angiotensin（Ang） Ⅱ-induced fibroblast proliferation and collagen type Ⅰ/Ⅲ expression in cardiac fibroblasts（P〈0.05）. Curcumin also inhibited fibrosis by inhibiting myofibroblast differentiation, decreased TGF-β1, MMP-9 and TIMP-1 expression（P〈0.05） but had no effects on Smad3 in Ang Ⅱ incubated cardiac fibroblasts. Conclusions： Curcumin reduces cardiac fibrosis in rats and Ang Ⅱ-induced fibroblast proliferation by inhibiting myofibroblast differentiation, decreasing collagen synthesis and accelerating collagen degradation through reduction of TGF-β1, MMPs/TIMPs. The present findings also provided novel insights into the role of curcumin as an anti-fibrotic agent for the treatment of cardiac fibrosis.

关键词： curcumin fibrosis myofibroblast transforming growth factor matrix metalloproteinase

cardiac resynchronization therapy for chronic heart failure in China： guideline and practice

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Chinese Medical Journal 2010年第17期123卷 2293-2294页

作者： HUA Wei cardiac arrhythmia Center Department of Cardiology Fu Wai Hospital and Cardiovascular Institute Peking Union Medical College and Chinese Academy of Medical Sciences Beijing 100037 China

The value of cardiac resynchronization therapy （CRT）in chronic heart failure has been well recognized around the world. Multi-center clinical trials have confirmed that CRT not only can improve cardiac function and quality of life, but also reduce mortality and improve the prognosis in patients with advanced heart failure and ventricular dyssynchrony.

关键词：钙调蛋白结合蛋白质类光刺激磷蛋白磷酸酶类生活质量心力衰竭预后中国准则