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The diagnostic yield for computed tomography pulmonary angiography in patients with anticoagulation

World Journal of Emergency Medicine 2024年第4期15卷 251-255页

作者： Payush Chatta Brian Diep Jakrin Kewcharoen Daniel Rossie Cory Toomasian Purvi Parwani Dmitry Abramov Department of Medicine Division of CardiologyLoma Linda University Medical CenterLoma LindaCA 92374USA Department of Medicine Loma Linda University Medical CenterLoma LindaCA 92374USA Department of Emergency Medicine Loma Linda University Medical CenterLoma LindaCA 92374USA

BACKGROUND:Patients who present to the emergency department(ED)for suspected pulmonary embolism(PE)are often on active oral anticoagulation(AC).However,the diagnostic yield of computed tomography pulmonary angiography(CTPA)in screening for PE in patients who present on AC has not been well *** aim to investigate the diagnostic yield of CTPA in diagnosing PE depending on AC ***:We reviewed and analyzed the electronic medical records of patients who underwent CTPA for PE at a university hospital ED from June 1,2019,to March 25,*** outcome was the incidence of PE on CTPA depending on baseline AC status and indication for ***:Of 2,846 patients,242 were on AC for a history of venous thromboembolism(VTE),210 were on AC for other indications,and 2,394 were not on *** incidence of PE on CTPA was significantly lower in patients on AC for other indications(5.7%)when compared to patients on AC for prior VTE(24.3%)and patients not on AC at presentation(9.8%)(P<0.001).In multivariable analysis among the whole cohort,AC was associated with a positive CTPA(odds ratio[OR]0.26,95%confidence interval[CI]:0.15-0.45,P<0.001).CONCLUSION:The incidence of PE among patients undergoing CTPA in the ED is lower in patients previously on AC for indications other than VTE when compared to those not on AC or those on AC for history of *** status and indication for AC may affect pre-test probability of a positive CTPA,and AC status therefore warrants consideration as part of future diagnostic algorithms among patients with suspected PE.

关键词： Pulmonary embolism Computed tomography pulmonary angiography Emergency department Anticoagulation

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L-Ergothioneine ameliorates MPTP-induced Parkinson's disease in C57BL/6J mice by activating DJ-1

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Food Science and Human Wellness 2024年

作者： Xianshe Meng# Huawen Meng# Shuzeng Hou Zequn Yin Xuerui Wang Ke Gong Feng Zhang Qingshan Li Shuang Zhang Yuanli Chen Xiaoxiao Yang Zhiwei Zhao Chenzhong Liao Yajun Duan Department of cardiology the First Affiliated Hospital of USTC division of Life Sciences and Medicine University of Science and Technology of China Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes Hefei University of Technology

Parkinson’s disease (PD) is one of the most common neurodegenerative diseases. The loss of dopaminergic (DAergic) neurons in the substantia nigra and the decrease of dopamine (DA) levels accelerate the process of PD. L-Ergothioneine (EGT) is a natural antioxidant derived from microorganisms， especially in edible mushrooms. EGT can penetrate blood-brain barrier and its levels are significantly decreased in the plasma of PD patients. Therefore， we speculated that EGT could ameliorate PD， and determined its effect on PD development by using 1-methyl-4-phenyl-1，2，3，6-tetrahydropyridine (MPTP)-induced PD mouse models and neurotoxin 1-methyl-4-phenylpyridinium (MPP+)-induced cell models. Our results show that EGT alleviated MPTP-induced behavioral dysfunction in mice. Mechanistically， we innovatively revealed that EGT is a key regulator of DJ-1. EGT restored DA levels by activating the DJ-1-Nuclear receptor-related factor 1(Nurr1) axis. Furthermore， it reduced reactive oxygen species (ROS) levels by regulating the DJ-1-Nuclear factor erythroid 2-related factor 2 (Nrf2) pathway， which inhibited oxidative stress-induced DAergic neuronal apoptosis. Combined treatment with DJ-1-siRNA transfection revealed that blocking DJ-1 reversed EGT upregulated Nurr1 and Nrf2 expression in the nucleus， which significantly decreased the benefits of EGT. Taken together， our study suggests that EGT can ameliorate PD and be considered as a strategy for PD treatment.

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A Chinese Multi-Specialty Delphi Consensus to Optimize RAASi Usage and Hyperkalaemia Management in Patients with Chronic Kidney Disease and Heart Failure

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Chinese Medical Sciences Journal 2024年第2期39卷 79-90页

作者： Ming-Hui Zhao Wei Chen Hong Cheng Bi-Cheng Liu Zhi-Guo Mao Zhuang Tian Gang Xu Jing-Min Zhou Renal division Peking University First HospitalBeijing 100034China Department of Nephrology The First Affiliated HospitalSun Yat-Sen UniversityGuangzhou 510080China Department of Nephrology Capital Medical UniversityBeijing 100029China Department of Nephrology Southeast University Zhongda HospitalNanjing 210009China Department of Nephrology Shanghai Changzheng HospitalShanghai 200003China Department of cardiology Peking Union Medical College HospitalBeijing 100730China Renal division Tongji Medical College of Huazhong University of Science and TechnologyWuhan 430030China Department of cardiology Zhongshan HospitalFudan UniversityShanghai 200032China

Objective Variations are present in common clinical practices regarding best practice in managing hyperkalaemia(HK),there is therefore a need to establish a multi-specialty approach to optimal renin angiotension-aldosterone system inhibitors(RAASi)usage and HK management in patients with chronic kidney disease(CKD)&heart failure(HF).This study aimed to establish a multi-speciality approach to the optimal use of RAASi and the management of HK in patients with CKD and *** A steering expert group of cardiology and nephrology experts across China were convened to discuss challenges to HK management through a nominal group *** group then created a list of 41 statements for a consensus questionnaire,which was distributed for a further survey in extended panel group of cardiologists and nephrologists across *** was assessed using a modified Delphi technique,with agreement defined as"strong"(≥75%and<90%)and"very strong"(≥90%).The steering group,data collection,and analysis were aided by an independent *** A total of 150 responses from 21 provinces across China were recruited in the *** were comprised of an even split(n=75,50%)between cardiologists and *** 41 statements achieved the 75%consensus agreement threshold,of which 27 statements attained very strong consensus(≥90%agreement)and 14 attained strong consensus(agreement between 75%and 90%).Conclusion Based on the agreement levels from respondents,the steering group agreed a set of recommendations intended to improve patient outcomes in the use of RAASi therapy and HK management in China.

关键词： Sardiorenal syndrome chronic kidney failure heart failure hyperkalemia multidisciplinary communication RAASi

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Association between balloon atrial septostomy and prostaglandin E1 therapy until repair of transposition of the great arteries in neonates

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Pediatric Investigation 2024年第2期8卷 135-138页

作者： Samantha Gilg Sebastian Acosta Rohit S.Loomba Claire Rizk Gary E.Stapleton David Faraoni Fabio Savorgnan Department of Pediatrics Divisions of Critical Care Medicine and CardiologyTexas Children’s Hospital and Baylor College of MedicineHoustonTexasUSA Department of Pediatrics Division of CardiologyTexas Children’s Hospital and Baylor College of MedicineHoustonTexasUSA Department of Pediatrics The Heart InstituteAdvocate Children’s HospitalChicago Medical School and Rosalind Franklin University of Medicine and ScienceOak LawnIllinoisUSA Department of Anesthesiology Arthur S.Keats Division of Pediatric Cardiovascular AnesthesiaPerioperative and Pain MedicineTexas Children’s HospitalBaylor College of MedicineHoustonTexasUSA

The standard of care in the management of d-transposition of the great arteries(TGA)includes the arterial switch operation(ASO).1,2 Although some institutions have begun to publish the results of performing the ASO within the first few hours of life,most centers continue to"electively"delay ASO for several days to allow for a reduction in pulmonary vascular resistance and the stabilization of renal and liver function.1,2 The early initiation of prostaglandin E1(PGE)infusion to maintain ductal patency is a nearly universal component of therapy in order to maintain adequate arterial oxygen saturation and systemic oxygen delivery during the pre-operative period via intercirculatory mixing at the atrial septal and patent ductus arteriosus levels1,3.

关键词： balloon maintain stabilization

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SARS-CoV-2 variants are associated with different clinical courses in children with MIS-C

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World Journal of Pediatrics 2024年第2期20卷 143-152页

作者： Andres F.Moreno Rojas Emelia Bainto Helen Harvey Adriana H.Tremoulet Jane C.Burns Kirsten B.Dummer Department of Pediatrics Division of Pediatric CardiologyUniversity of California San Diegoand Rady Children’s Hospital3020 Children’s Way MC 5004San DiegoCA 92123USA Kawasaki Disease Research Center La JollaCAUSA Department of Pediatrics Division of Pediatric Critical CareUniversity of California San Diegoand Rady Children’s HospitalSan DiegoCAUSA Department of Pediatrics University of California San Diegoand Rady Children’s HospitalSan DiegoCAUSA

Background Recent infection with SARS‑CoV-2 in children has been associated with multisystem inflammatory syndrome in children(MIS-C).SARS‑CoV-2 has undergone different *** publications exist about specific variants and their correlation with the severity of *** This was a single-center,retrospective study including all patients admitted with MIS-C at Rady Children’s Hospital-San Diego between May 2020 and March *** epidemiologic data,including viral genomic information,were obtained from public ***,clinical presentation,laboratory values,and outcomes were obtained from electronic medical *** The analysis included 104 pediatric *** MIS-C waves were *** variants in San Diego during the first wave included clades 20A to *** the second wave,there were variants from clades 20A to C,20G,21C(Epsilon),20I(Alpha),and 20J(Gamma).The third wave had Delta strains(clades 21A,21I,and 21J),and the fourth had Omicron variants(clades 21K,21L,and 22C).MIS-C presented with similar symptoms and laboratory findings across all *** patients were admitted to the pediatric intensive care unit(PICU)(74%)and required inotropic support(63%)during the second *** of the patients required mechanical circulatory support,and only two required invasive ventilatory *** was no *** The various strains of SARS-CoV-2 triggered MIS-C with differing severities,with the second wave having a more severe clinical *** the differences in disease severity across variants were due to changes in the virus or other factors remains unknown.

关键词： Complications COVID-19 MIS-C SARS-CoV-2 variants

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Decoding the Cellular Trafficking of Prion-like Proteins in Neurodegenerative Diseases

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Neuroscience Bulletin 2024年第2期40卷 241-254页

作者： Chenjun Hu Yiqun Yan Yanhong Jin Jun Yang Yongmei Xi Zhen Zhong Department of Neurology of the Second Afliated Hospital and Department of Human Anatomy Histology and EmbryologyZhejiang University School of MedicineHangzhou 310058China Department of Physiology and Department of cardiology of the Second Afliated Hospital Zhejiang University School of MedicineHangzhou 310058China division of Human Reproduction and Developmental Genetics Women’s Hospital and Institute of GeneticsZhejiang University School of MedicineHangzhou 310006China

The accumulation and spread of prion-like proteins is a key feature of neurodegenerative diseases(NDs)such as Alzheimer’s disease,Parkinson's disease,or Amyotrophic Lateral *** a process known as‘seeding’,prion-like proteins such as amyloid beta,microtubule-associated protein tau,α-synuclein,silence superoxide dismutase 1,or transactive response DNA-binding protein 43 kDa,propagate their misfolded conformations by transforming their respective soluble monomers into *** and molecular evidence of prion-like propagation in NDs,the clinical relevance of their‘seeding’capacities,and their levels of contribution towards disease progression have been intensively studied over recent *** review unpacks the cyclic prion-like propagation in cells including factors of aggregate internalization,endo-lysosomal leaking,aggregate degradation,and *** on the importance of the role of prion-like protein aggregates in NDs,whether causal or consequent,are also *** lead to a greater understanding of ND pathogenesis and increased potential for therapeutic strategies.

关键词： Neurodegenerative diseases Prion-like propagation Seeding Endocytosis Endolyosomal leaking Degradation

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Massive inferior wall aneurysm presenting with ventricular tachycardia and refractory cardiomyopathy requiring multiple interventions:A case report

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World Journal of cardiology 2024年第6期16卷 363-369页

作者： Anderson Anuforo Jake Charlamb Dan Draytsel Mark Charlamb Department of Medicine SUNY Upstate Medical UniversitySyracuseNY 13210United States College of Medicine Norton College of MedicineSUNY Upstate Medical UniversitySyracuseNY 13210United States division of cardiology SUNY Upstate Medical UniversitySyracuseNY 13210United States

BACKGROUND Inferior wall left ventricular aneurysms are rare,they develop after transmural myocardial infarction(MI)and may be associated with poorer *** present a unique case of a large aneurysm of the inferior wall complicated by ventricular tachycardia(VT)and requiring surgical resection and mitral valve *** SUMMARY A 59-year-old male was admitted for VT one month after he had a delayed presentation for an inferior ST-segment elevation MI and was discovered to have a large true inferior wall aneurysm on echocardiography and confirmed on coronary computed tomography(CT)*** to the sustained VT,concern for aneurysm expansion,and persistent heart failure symptoms,the patient was referred for surgical resection of the aneurysm with patch repair,mitral valve replacement,and automated implantable cardioverter defibrillator insertion with significant improvement in functional and clinical *** Inferior wall aneurysms are rare and require close monitoring to identify electrical or contractile *** CT angiography can outline anatomic details and guide surgical intervention to ameliorate life-threatening complications and improve performance status.

关键词： Inferior wall aneurysm True aneurysm Ventricular tachycardia Electrophysiology Structural interventional cardiology Case report

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The lysine methyltransferase SMYD2 facilitates neointimal hyperplasia by regulating the HDAC3-SRF axis

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Acta Pharmaceutica Sinica B 2024年第2期14卷 712-728页

作者： Xiaoxuan Zhong Xiang Wei Yan Xu Xuehai Zhu Bo Huo Xian Guo Gaoke Feng Zihao Zhang Xin Feng Zemin Fang Yuxuan Luo Xin Yi Ding-Sheng Jiang division of Cardiovascular Surgery Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China Key Laboratory of Organ Transplantation Ministry of EducationNHC Key Laboratory of Organ TransplantationChinese Academy of Medical SciencesWuhan 430030China School of Life Science and Technology Key Laboratory of Developmental Genes and Human DiseaseSoutheast UniversityNanjing 210096China Department of cardiology Renmin Hospital of Wuhan UniversityWuhan 430060China

Coronary restenosis is an important cause of poor long-term prognosis in patients with coronary heart ***,we show that lysine methyltransferase SMYD2 expression in the nucleus is significantly elevated in serum-and PDGF-BB-induced vascular smooth muscle cells(VSMCs),and in tissues of carotid artery injury-induced neointimal ***2 overexpression in VSMCs(Smyd2-vTg)facilitates,but treatment with its specific inhibitor LLY-507 or SMYD2 knockdown significantly inhibits VSMC phenotypic switching and carotid artery injury-induced neointima formation in *** sequencing revealed that SMYD2 knockdown represses the expression of serum response factor(SRF)target genes and that SRF overexpression largely reverses the inhibitory effect of SMYD2 knockdown on VSMC ***3 directly interacts with and deacetylates SRF,which enhances SRF transcriptional activity in ***,SMYD2 promotes HDAC3 expression via tri-methylation of H3K36 at its ***966,a specific inhibitor of HDAC3,not only counteracts the pro-proliferation effect of SMYD2 overexpression on VSMCs,but also inhibits carotid artery injury-induced neointima formation in ***3 partially abolishes the inhibitory effect of SMYD2 knockdown on VSMC proliferation in a deacetylase activity-dependent *** results reveal that the SMYD2-HDAC3-SRF axis constitutes a novel and critical epigenetic mechanism that regulates VSMC phenotypic switching and neointimal hyperplasia.

关键词： Neointimaformation Histonemethylation Histoneacetylation SRFacetylation SMYD2 HDAC3 LLY-507 RGFP966

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Effect of early stepwise cardiopulmonary rehabilitation on function and quality of life in sepsis patients

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World Journal of Clinical Cases 2024年第4期12卷 729-736页

作者： Ming-Hui Zheng Wen-Jun Liu Juan Yang division of Cardiovascular First Ward Departments of Internal Medicine Liyuan HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430077Hubei ProvinceChina Department of Respiratory Medicine PuRen Hospital Affiliated to Wuhan University of Science and Technology/Respiratory MedicineWuhan 430000Hubei ProvinceChina Department of cardiology Huanggang Central HospitalHuanggang 438000Hubei ProvinceChina

BACKGROUND Sepsis,as a non-limiting host infection disease,can be accompanied by serious complications such as organ failure,which seriously threatens patient quality of *** To investigate the effect of early stepwise cardiopulmonary rehabilitation on cardiopulmonary function and quality of life in patients evacuated from mechanical ventilation with *** A total of 80 patients with sepsis who were hospitalized in our hospital from January 2021 to January 2022 were selected and divided into the observation group(n=40)and the control group(n=40)according to the random number table *** observation group was treated with early stepwise cardiopulmonary rehabilitation,and the control group was treated with a conventional treatment *** function indexes(central venous pressure,cardiac troponin I,B-type brain natriuretic peptide),lung function indicators(diaphragmatic mobility,changes in central venous oxygen saturation,oxygenation index),and quality of life(Quality of Life Evaluation Scale)were compared between the two groups after *** After treatment,the central venous pressure,diaphragm mobility,central venous oxygen saturation,oxygenation index,and Quality of Life Evaluation Scale scores in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The observation group was less than that of the control group for other parameters,and the differences were statistically significant(P<0.05).CONCLUSION Early stepwise cardiopulmonary rehabilitation can effectively enhance cardiac and pulmonary function and improve the quality of life in patients evacuated from mechanical ventilation with sepsis.

关键词： Stepwise cardiopulmonary rehabilitation Sepsis Evacuation of mechanical ventilation Cardiopulmonary function Quality of life

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Unveiling significant risk factors for intensive care unit-acquired weakness:Advancing preventive care

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World Journal of Clinical Cases 2024年第18期12卷 3288-3290页

作者： Chun-Yao Cheng Wen-Rui Hao Tzu-Hurng Cheng Department of Medical Education National Taiwan University HospitalTaipei 100225Taiwan division of cardiology Department of Internal MedicineShuang Ho HospitalMinistry of Health and WelfareTaipei Medical UniversityNew Taipei 23561Taiwan division of cardiology Department of Internal MedicineSchool of MedicineCollege of MedicineTaipei Medical UniversityTaipei 11002Taiwan Department of Biochemistry School of MedicineCollege of MedicineChina Medical UniversityTaichung 404333Taiwan

In this editorial,we discuss an article titled,“Significant risk factors for intensive care unit-acquired weakness:A processing strategy based on repeated machine learning,”published in a recent issue of the World Journal of Clinical *** care unit-acquired weakness(ICU-AW)is a debilitating condition that affects critically ill patients,with significant implications for patient outcomes and their quality of *** study explored the use of artificial intelligence and machine learning techniques to predict ICU-AW occurrence and identify key risk *** from a cohort of 1063 adult intensive care unit(ICU)patients were analyzed,with a particular emphasis on variables such as duration of ICU stay,duration of mechanical ventilation,doses of sedatives and vasopressors,and underlying comorbidities.A multilayer perceptron neural network model was developed,which exhibited a remarkable impressive prediction accuracy of 86.2%on the training set and 85.5%on the test *** study highlights the importance of early prediction and intervention in mitigating ICU-AW risk and improving patient outcomes.

关键词： Intensive care unit-acquired weakness Artificial intelligence Machine learning Neural network Risk factors Prediction Critical care

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