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cardiovascular response to nanosecond pulses is milder in percutaneous ablation of hepatocellular carcinoma compared with microsecond pulses

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Hepatobiliary & Pancreatic Diseases International 2025年第1期24卷 114-116页

作者： Hai-Ying Kong Qian-Hui Jin Xin-Hua Chen Dan-Xia Xu Qi-Yu Zhao Xiong-Xin Zhang R James Swanson Tian-An Jiang Department of Anesthesiology The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China division of Hepatobiliary Pancreatic Surgery Department of SurgeryThe First Hospital of JiaxingJiaxing University College of MedicineJiaxing 314000China Key Laboratory of Pulsed Power Translational medicine of Zhejiang Province Hangzhou 310003China Department of Ultrasound medicine The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China Anatomy Department Liberty University College of Osteopathic MedicineLynchburgVAUSA

To the Editor:Irreversible electroporation(IRE)is a promising ablative technique for hepatobiliary *** has unique advantages,including no detrimental heat sink effect[1]and no injury of the surrounding tissues[2].For lesions in complex areas,bile duct[3],and large blood vessels[4],IRE has been developed as an alternative to thermal ablation such as radiofrequency and *** IRE tumor ablative technique combines cell biology and pulsed high-voltage *** high-voltage,high-frequency and transient pulses can create irreversible electroporation in the phospholipid bilayer of the cell membrane and nuclear envelope,resulting in cell *** with radiofrequency ablation and microwave ablation[5],IRE does not cause damage to important vessels and *** has some unique shortcomings in delivering high currents,which has limited its clinical applications in the *** animal and clinical studies,side effects including muscle contraction,procedural hypertension,and arrhythmia are frequently reported[6].However,during the ablation process,if the pulse is synchronized with the heart rhythm,the risk of arrhythmia is *** muscle relaxant eliminates muscle ***,arrhythmia[7],hypertension[8],and myocardial infarction[9]are potential risks requiring proper *** adverse events are mostly moderate and self-limiting,but they may have serious consequences for patients with coronary artery *** to the potential risks,patients with a history of cardiovascular disease are not recommended for IRE treatment.

关键词： microwave consequences ablation

Revascularization strategies for patients with myocardial infarction and multi-vessel disease: A critical appraisal of the current evidence

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Journal of Geriatric Cardiology 2019年第9期16卷 717-723页

作者： Muhammad O Zaman Mohammad K Mojadidi Islam Y Elgendy division of cardiovascular medicine Department of Medicine University of Florida College of Medicine Gainesville Florida USA division of cardiovascular medicine Department of Medicine Virginia Commonwealth University Richmond Virginia USA division of cardiovascular medicine Massachusetts General Hospital and Harvard Medical School Boston MA USA

Approximately half of patients presenting with myocardial infarction are found to have non-infarct related multi-vessel severe coronary artery disease. Various observational studies and randomized controlled trials have been conducted to assess if revascularization of non-infarct related artery is associated with better clinical outcomes. In this review, the authors discuss the various revascularization strategies in patients with multi-vessel disease who present with myocardial infarction.

关键词： Coronary artery disease Mortality Myocardial Infarction Percutaneous coronary intervention

Gender differences,outcomes and trends among nonagenarian with atrial fibrillation:insight from National Inpatient Sample database

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Journal of Geriatric Cardiology 2021年第2期18卷 114-122页

作者： Dinesh Voruganti Ghanshyam Shantha Sushma Dugyala Alexander Bolton Ala Mohsen Subodh Devabhaktuni Hakan Paydak Jawahar L Mehta division of cardiovascular medicine University of Arkansas for Medical SciencesArkansasUSA division of cardiovascular medicine Wake Forest Medical CenterNorth CarolinaUSA division of Internal medicine University of AlabamaAlabamaUSA Department of Internal medicine Unity Point HealthIowaUSA division of cardiovascular medicine Louisiana State UniversityLouisianaUSA

BACKGROUND Nonagenarians(NG),individuals aged≥90 years,constitute an increasing proportion of hospitalizations presenting with atrial fibrillation(AF).However,not much is known about demographics,clinical outcomes,and trends of ***,we analyzed data about hospitalizations and clinical outcomes among NGs with AF over ten years from 2005 to 2014 using a publically available database,the National Inpatient *** All hospitalizations and major outcomes of subjects≥90 years with a primary diagnosis of AF(ICD-9-CM code 427.31)over a ten-year period were assessed in this study by multivariate logistic regression *** There were more females than males(176,268 females,51,384 males)in this *** number of hospitalizations for AF among NG increased by 50%(17,295 in 2005 to 25,830 in 2014).Males were more likely to undergo cardioversion(6.14%of males vs.5.06%of females,P<0.0001).Over this period,in-hospital mortality declined from 3.21%in 2005 to 2.38%in 2014(P=0.0041),with higher in-hospital mortality in males(3.23%in males vs.2.76%in females,P=0.0138),mean length of hospitalization decreased from 4.53 days to 4.13 days(P<0.0001),the prevalence of congestive heart failure fell from 0.48%to 0.23%(P=0.0257),and the use of anticoagulation increased from 6.09%to 14.54%(P<0.0001).In a multivariate analysis,hospital admission on the weekend,Elixhauser comorbidity index,CHA2DS2VASc score,acute respiratory failure,and the length of hospital stay were associated with a higher risk of in-hospital *** From 2005 to 2014,AF-related hospitalizations among NGs increased,more so in in females population,mortality trends improved,rates of anticoagulation increased,and cardioversions *** the decreasing trend of in-hospital mortality since 2005,the relatively high mortality rate in males warrants further studies.

关键词： mortality fibrillation analysis.

Enhancing postoperative pain control by surgically-initiated rectus sheath block in abdominal aortic aneurysm open repair: A case report

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World Journal of Clinical Cases 2025年第6期13卷 41-47页

作者： Kuan-Hua Chen Ming-Yuan Kang Yi-Ting Chang Sheng-Yang Huang Yung-Szu Wu Center for cardiovascular Disease Taichung Veterans General HospitalTaichung 407219TaiwanChina Department of Anesthesiology Taichung Veterans General HospitalTaichung 407219TaiwanChina division of Pediatric Surgery Department of SurgeryTaichung Veterans General HospitalTaichung 407219TaiwanChina School of medicine National Yang Ming Chiao Tung UniversityTaipei 112304TaiwanChina Department of Post-Baccalaureate medicine National Chung Hsing UniversityTaichung 402202TaiwanChina

BACKGROUND Abdominal aortic aneurysm(AAA)repair often involves significant postoperative pain,traditionally managed with systemic opioids,which can cause undesirable side *** case report explores the novel use of a surgically-initiated rectus sheath block with a catheter-over-needle assembly for pain management in AAA *** SUMMARY A 67-year-old female with hypertension and previous aortic dissection underwent elective open repair of an infrarenal AAA,which had grown from 3.4 cm to 4.3 cm over 14 months.A rectus sheath block was initiated surgically for postoperative pain *** patient reported low pain scores and did not require systemic intravenous opioids,enabling early ambulation and discharge on postoperative day seven without *** preventing complications of systemic opi-oids,the method indicating a promising direction for postoperative pain management in major vascular *** Surgically-initiated rectus sheath block as a valuable tool for managing postoperative pain in AAA repair.

关键词： Abdominal aortic aneurysm Postoperative pain management Rectus sheath block Surgical anesthesia Opioid-sparing techniques Case report

Arrhythmogenic mechanisms in ryanodine receptor channelopathies

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Science China(Life Sciences) 2015年第1期58卷 54-58页

作者： ZHAO Yan-Ting VALDIVIA Carmen R. GURROLA Georgina B. HERNNDEZ Jonathan J. VALDIVIA Héctor H. Center for Arrhythmia Research Department of Internal MedicineCardiovascular DivisionUniversity of Michigan

Ryanodine receptors(Ry Rs) are the calcium release channels of sarcoplasmic reticulum(SR) that provide the majority of calcium ions(Ca2+) necessary to induce contraction of cardiac and skeletal muscle *** their intracellular environment,Ry R channels are regulated by a variety of cytosolic and luminal factors so that their output signal(Ca2+) induces finely-graded cell contraction without igniting cellular processes that may lead to aberrant electrical activity(ventricular arrhythmias) or cellular *** importance of Ry R dysfunction has been recently highlighted with the demonstration that point mutations in RYR2,the gene encoding for the cardiac isoform of the Ry R(Ry R2),are associated with catecholaminergic polymorphic ventricular tachycardia(CPVT),an arrhythmogenic syndrome characterized by the development of adrenergically-mediated ventricular tachycardia in individuals with an apparently normal *** we summarize the state of the field in regards to the main arrhythmogenic mechanisms triggered by Ry R2 channels harboring mutations linked to *** CPVT mutations characterized to date endow Ry R2 channels with a gain of function,resulting in hyperactive channels that release Ca2+ spontaneously,especially during *** spontaneous Ca2+ release is extruded by the electrogenic Na+/Ca2+ exchanger,which depolarizes the external membrane(delayed afterdepolarization or DAD) and may trigger untimely action ***,a rare set of CPVT mutations yield Ry R2 channels that are intrinsically hypo-active and hypo-responsive to stimuli,and it is unclear whether these channels release Ca2+ spontaneously during *** discuss novel cellular mechanisms that appear more suitable to explain ventricular arrhythmias due to Ry R2 loss-of-function mutations.

关键词： ryanodine receptors CPVT sarcoplasmic reticulum cardiac arrhythmias

Mediator Complex Dependent Regulation of Cardiac Development and Disease

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Genomics, Proteomics & Bioinformatics 2013年第3期11卷 151-157页

作者： Chad E. Grueter division of cardiovascular medicine Department of Internal Medicine University of Iowa Carver College of Medicine

cardiovascular disease （CVD） is a leading cause of morbidity and mortality. The risk factors for CVD include environmental and genetic components. Human mutations in genes involved in most aspects of cardiovascular function have been identified, many of which are involved in transcriptional regulation. The Mediator complex serves as a pivotal transcriptional reg- ulator that functions to integrate diverse cellular signals by multiple mechanisms including recruit- ing RNA polymerase II, chromatin modifying proteins and non-coding RNAs to promoters in a context dependent manner. This review discusses components of the Mediator complex and the contribution of the Mediator complex to normal and pathological cardiac development and func- tion. Enhanced understanding of the role of this core transcriptional regulatory complex in the heart will help us gain further insights into CVD.

关键词： Mediator complexCardiac disease Transcription Development

Effect of herpesvirus infection on pancreatic duct cell secretion

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World Journal of Gastroenterology 2005年第38期11卷 5997-6002页

作者： Péter Hegyi Balázs rdg Zoltán Rakonczai Jr Tamás Takács János Lonovics Annamária Szabolcs Réka Sári András Tóth Julius G Papp András Varró Mária K Kovács Mike A Gray Barry E Argent Zsolt Boldogki First Department of medicine Department of Biology division of cardiovascular Pharmacology School of Cell and Molecular Biosciences

AIM： To examine the effect of acute infection caused by herpesvirus （pseudorabies virus, PRV） on pancreatic ductal secretion. METHODS： The virulent Ba-DupGreen （BDG） and non- virulent Ka-RREp01acgfp （KEG） genetically modified strains of PRV were used in this study and both of them contain the gene for green fluorescent protein （GFP）. Small intra/ interlobular ducts were infected with BDG virus （10^7 PFU/mL for 6 h） or with KEG virus （10^10 PFU/mL for 6 h）, while non-infected ducts were incubated only with the culture media. The ducts were then cultured for a further 18 h. The rate of HCO3 secretion [base efflux -λ（B）] was determined from the buffering capacity of the cells and the initial rate of intracellular acidification （1） after sudden blockage of basolateral base loaders with dihydro-4,4,- diisothiocyanatostilbene-2,2,-disulfonic acid （500 μmol/L） and amiloride （200 μmol/L）, and （2） after alkali loading the ducts by exposure to NH4Cl. All the experiments were performed in HCO3-buffered Ringer solution at 37 ℃ （n = 5 ducts for each experimental condition）. Viral structural proteins were visualized by immunohistochemistry. Virallyencoded GFP and immunofluorescence signals were recorded by a confocal laser scanning microscope.RESULTS： The BDG virus infected the majority of accessible cells of the duct as judged by the appearance of GFP and viral anUgens in the ductal cells. KEG virus caused a similarly high efficiency of infection. After blockage of basolateral base loaders, BDG infection significantly elevated -λB-） 24 h after the infection, compared to the non-infected group. However, KEG infection did not modify -λB-）. After alkali loading the ducts, -λB-） was significantly elevated in the BDG group compared to the control group 24 h after the infection. As we found with the inhibitor stop method, no change was observed in the group KEG compared to the non-infected group. CONCLUSION： Incubation with the BDG or KEG strains of PRV results in an effective i

关键词： Pancreas Hypersecretion Ductal cells Infection Pseudorabies virus

Translational initiatives in thrombolytic therapy

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Frontiers of medicine 2017年第1期11卷 1-19页

作者： Melvin E. Klegerman Department of lnWrnal medicine Division of Cardiovascular Medicine University of Texas Health Science Center at Houston (UTHealth) Houston TX 77054 USA

Once thrombi have formed as part of the pathology defining myocardial infarction, ischemic stroke, peripheral arterial disease, deep venous thrombosis or other embolic disorders, the only clinically meaningful thrombolytic agents available for reversing the thrombogenic process are various plasminogen activators. These agents are enzymes that reverse fibrin polymerization underlying the coagulation process by converting endogenous plasminogen to plasmin, which cleaves the fibrin network to form increasingly smaller protein fragments, a process known as fibrinolysis. For the most part, the major clinically used thrombolytics, tissue plasminogen activator, urokinase and streptokinase, as well as the experimentally investigated agent staphylokinase, are the products of recombinant DNA technology, which permits molecular optimization of clinical efficacy. In all cases of molecular optimization and targeting, however, the primary challenge of thrombolytic therapy remains hemorrhagic side effects, which are especially devastating when they occur intracerebrally. Currently, the best strategy to ameliorate this adverse effect is nanoparticulate encapsulation or complexation, and many strategies of this sort are being actively pursued. This review summarizes the variety of targeted and untargeted thrombolytic formulations that have been investigated in preclinical studies.

关键词： thrombolytics nanomedicine plasminogen activators

Lactic control of tumor growth:a new role for an old metabolite

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Signal Transduction and Targeted Therapy 2023年第9期8卷 3890-3891页

作者： Carolina E.Hagberg division of cardiovascular medicine Department of Medicine SolnaKarolinska InstitutetStockholmSweden and 2 Center for Molecular MedicineKarolinska InstitutetStockholmSweden

In a recent study published in Nature,Liu and co-workers show that high lactate production by tumor cells promotes premature mitotic escape and further cell proliferation by facilitating the binding of Ubiquitin Conjugating Enzyme E2 C(UBE2C)to the anaphase promoting complex(APC/C).1 This is important as it suggests cancer metabolism not only to be a consequence of tumor growth,but also one of its *** its initial discovery over 200 years ago,lactate has sustained the interest of a wide range of research fields due to its significance as energy fuel,redox buffer and signaling molecule.2 High quantities of lactate are produced through glycolysis in muscle during exercise,through bacterial lactic acid fermentation,and perhaps most famously,by rapidly growing tumor cells.

关键词： metabolism sustained consequence