目的探讨脑卒中早期上肢肌动图信号与上肢上臂肌痉挛发生的关系及其风险预测模型。方法选取2019-06—2021-06北京康复医院收治脑卒中患者196例,根据患者是否发生上肢屈肌痉挛分为痉挛组和非痉挛组,比较2组患者早期上肢肌动图信号变化和...目的探讨脑卒中早期上肢肌动图信号与上肢上臂肌痉挛发生的关系及其风险预测模型。方法选取2019-06—2021-06北京康复医院收治脑卒中患者196例,根据患者是否发生上肢屈肌痉挛分为痉挛组和非痉挛组,比较2组患者早期上肢肌动图信号变化和临床资料变化,多因素Logistic回归分析脑卒中合并上肢上臂肌痉挛发生的危险因素并建立风险预测模型,该模型的区分度用受试者工作特征曲线(ROC)评估,拟合度采用Hosmer-Lemeshow test。结果痉挛组上肢肱二头肌的伸展iEMG、协同收缩率和肱三头肌协同收缩率均高于非痉挛组(P<0.001),肱二头肌屈曲iEMG和肱三头肌的屈曲iEMG、伸展i EMG均低于非痉挛组(P<0.001),男性、年龄<60岁、卒中病程≥3个月、颅内手术史、疼痛、大面积病变和美国国立卫生院卒中量表(NIHSS)评分≥13分患者占比均高于非痉挛组(P<0.05)。男性、年龄<60岁、卒中病程≥3个月、疼痛和NIHSS评分≥13分是脑卒中患者上肢上臂肌痉挛的独立危险因素,低、中、高风险脑卒中患者上肢上臂肌痉挛发生率分别为5.38%、38.24%、85.71%,差异有统计意义(χ^(2)=79.023,P<0.001),建立的脑卒中患者上肢上臂肌痉挛风险预测ROC曲线下面积(AUC)为0.901(95%CI:0.835~0.967,P<0.001),Hosmer-Lemeshow test P=0.168。结论脑卒中合并上肢屈肌痉挛患者早期上臂功能下降,性别、年龄、卒中病程、疼痛以及NIHSS评分是其独立危险因素,建立的风险预测模型的预测效能高。展开更多
Actins are a small family of ubiquitous proteins that are essential cytoskeletal components and are highly conserved during evolution. Actins are usually divided into two classes, the cytoplasmic and muscle actins, wh...Actins are a small family of ubiquitous proteins that are essential cytoskeletal components and are highly conserved during evolution. Actins are usually divided into two classes, the cytoplasmic and muscle actins, which have different functional roles. Here we systematically analyzed the actin genes in the genome of the primitive chordate amphioxus （Branchiostoma floridae）. We found that amphioxus contains more than 30 actin genes, many of which are linked. Phylogenetic analysis suggests the amphioxus actin genes have clearly undergone extensive expansion through tandem duplications. The actin genes＇ structure also varies a lot, containing 2 to 7 exons. We also cloned two muscle type of actin genes from the amphioxus （B. belcheri） and compared their expression patterns during early development. The slight difference in their expression suggests functional diversification of these actin genes. Our results shed light on the evolution both of actin genes themselves and their functional roles in chordate development.展开更多
Background Recurrence of takotsubo cardiomyopathy （TTC） is a well-known complication. However, current literature lists only a few isolated cases. We aimed to determine the incidence and clinical significance of rec...Background Recurrence of takotsubo cardiomyopathy （TTC） is a well-known complication. However, current literature lists only a few isolated cases. We aimed to determine the incidence and clinical significance of recurrent TTC. Methods ＆ Results Our institutional database constituted a collective of 114 patients diagnosed with TTC since 2003. Close follow-up of these patients revealed a recurrence of TTC in seven of these （6.1%）. The time interval between the index event and its recurrence varied between six months and six years. Arterial hypertension was more revealed in the recurrence group of TTC compared to non-recurrence group, （P = 0.02）. Chronic obstructive pulmo- nary disease and/or asthma was more diagnosed in the recurrence group, （P = 0.04）. Clinical events like fight ventficular involvement, TTC related complications such as life-threatening arrhythmias, pulmonary congestion and in hospital death were observed more frequently in the recurrent episode. Over a mean follow-up of one year the mortality rate was similar in both groups. Conclusions Recurrence of TTC within six years after index event is not an uncommon phenomenon. In the event of right ventricular involvement in the relapse phase, it might be associated with a higher complication rate. TTC recurrence should be the first differential diagnosis in patients with a past history of TTC.展开更多
Objectives To establish a cost-effective and reproducible procedure for induction of chronic left ventricular aneurysm （LVA） in rabbits. Methods Acute myocardial infarction （AMI） was induced in 35 rabbits via conc...Objectives To establish a cost-effective and reproducible procedure for induction of chronic left ventricular aneurysm （LVA） in rabbits. Methods Acute myocardial infarction （AMI） was induced in 35 rabbits via concomitant ligation of the left anterior descending （LAD） coronary artery and the circumflex （Cx） branch at the middle portion. Development of AMI was co n-firmed by ST segment elevation and akinesis of the occluded area. Echocardiography, pathological evaluation, and agar i n-tra-chamber casting were utilized to validate the formation of LVA four weeks after the surgery. Left ventricular end systolic pressure （LVESP） and diastolic pressure （LVEDP） were measured before, immediately after and four weeks after ligation. D i-mensions of the ventricular chamber, thickness of the interventricular septum （IVS） and the left ventricular posterior wall （LVPW） left ventricular end diastolic volume （LVEDV） and systolic volume （LVESV）, and ejection fraction （EF） were recorded by echo-cardiography. Results Thirty one （88.6%） rabbits survived myocardial infarction and 26 of them developed aneurysm （83.9%）. The mean area of aneurysm was 33.4% ＆#177; 2.4% of the left ventricle. LVEF markedly decreased after LVA formation, whereas LVEDV, LVESV and the thickness of IVS as well as the dimension of ventricular chamber from apex to mitral valve annulus significantly increased. LVESP immediately dropped after ligation and recovered to a small extent after LVA formation. LVEDP progressively increased after ligation till LVA formation. Areas in the left ventricle （LV） that underwent fibrosis included the apex, anterior wall and lateral wall but not IVS. Agar intra-chamber cast showed that the bulging of LV wall was prominent in the area of aneurysm. Conclusions Ligation of LAD and Cx at the middle portion could induce develo pment of LVA at a mean area ratio of 33.4%＆#177;2.4%which involves the apex, anterior wall and lateral wall of the LV.展开更多
To the Editor The interesting report by Redfors, et aL[1] in the June issue of the Journal of Geriatric Cardiology, about an 88-year-old woman who presented with chest pain, found on echocardiography （ECHO） to have...To the Editor The interesting report by Redfors, et aL[1] in the June issue of the Journal of Geriatric Cardiology, about an 88-year-old woman who presented with chest pain, found on echocardiography （ECHO） to have transient left ventricular apical akinesis with a hypercontractile base, and an occluded first diagonal coronary branch with suspected acute plaque rupture, on coronary angiography, treated with a percutaneous coronary intervention, for which the authors concluded that the observed extent of akinesis was disproportionally large for the occluded coronary lesion, letting them to deduce that the acute myocardial infarction （AMI） caused the episode of Takotsubo syndrome （TTS）, reminds me of a similar case of an AMI due to stent thrombosis and a resultant associated TTS.展开更多
文摘目的探讨脑卒中早期上肢肌动图信号与上肢上臂肌痉挛发生的关系及其风险预测模型。方法选取2019-06—2021-06北京康复医院收治脑卒中患者196例,根据患者是否发生上肢屈肌痉挛分为痉挛组和非痉挛组,比较2组患者早期上肢肌动图信号变化和临床资料变化,多因素Logistic回归分析脑卒中合并上肢上臂肌痉挛发生的危险因素并建立风险预测模型,该模型的区分度用受试者工作特征曲线(ROC)评估,拟合度采用Hosmer-Lemeshow test。结果痉挛组上肢肱二头肌的伸展iEMG、协同收缩率和肱三头肌协同收缩率均高于非痉挛组(P<0.001),肱二头肌屈曲iEMG和肱三头肌的屈曲iEMG、伸展i EMG均低于非痉挛组(P<0.001),男性、年龄<60岁、卒中病程≥3个月、颅内手术史、疼痛、大面积病变和美国国立卫生院卒中量表(NIHSS)评分≥13分患者占比均高于非痉挛组(P<0.05)。男性、年龄<60岁、卒中病程≥3个月、疼痛和NIHSS评分≥13分是脑卒中患者上肢上臂肌痉挛的独立危险因素,低、中、高风险脑卒中患者上肢上臂肌痉挛发生率分别为5.38%、38.24%、85.71%,差异有统计意义(χ^(2)=79.023,P<0.001),建立的脑卒中患者上肢上臂肌痉挛风险预测ROC曲线下面积(AUC)为0.901(95%CI:0.835~0.967,P<0.001),Hosmer-Lemeshow test P=0.168。结论脑卒中合并上肢屈肌痉挛患者早期上臂功能下降,性别、年龄、卒中病程、疼痛以及NIHSS评分是其独立危险因素,建立的风险预测模型的预测效能高。
基金supported by grants from the National Natural Science Foundation of China (30425011 30530380)the Innovation Project of Chinese Academy of Sciences (KSCX2-YW-R-090)~~
文摘Actins are a small family of ubiquitous proteins that are essential cytoskeletal components and are highly conserved during evolution. Actins are usually divided into two classes, the cytoplasmic and muscle actins, which have different functional roles. Here we systematically analyzed the actin genes in the genome of the primitive chordate amphioxus （Branchiostoma floridae）. We found that amphioxus contains more than 30 actin genes, many of which are linked. Phylogenetic analysis suggests the amphioxus actin genes have clearly undergone extensive expansion through tandem duplications. The actin genes＇ structure also varies a lot, containing 2 to 7 exons. We also cloned two muscle type of actin genes from the amphioxus （B. belcheri） and compared their expression patterns during early development. The slight difference in their expression suggests functional diversification of these actin genes. Our results shed light on the evolution both of actin genes themselves and their functional roles in chordate development.
文摘Background Recurrence of takotsubo cardiomyopathy （TTC） is a well-known complication. However, current literature lists only a few isolated cases. We aimed to determine the incidence and clinical significance of recurrent TTC. Methods ＆ Results Our institutional database constituted a collective of 114 patients diagnosed with TTC since 2003. Close follow-up of these patients revealed a recurrence of TTC in seven of these （6.1%）. The time interval between the index event and its recurrence varied between six months and six years. Arterial hypertension was more revealed in the recurrence group of TTC compared to non-recurrence group, （P = 0.02）. Chronic obstructive pulmo- nary disease and/or asthma was more diagnosed in the recurrence group, （P = 0.04）. Clinical events like fight ventficular involvement, TTC related complications such as life-threatening arrhythmias, pulmonary congestion and in hospital death were observed more frequently in the recurrent episode. Over a mean follow-up of one year the mortality rate was similar in both groups. Conclusions Recurrence of TTC within six years after index event is not an uncommon phenomenon. In the event of right ventricular involvement in the relapse phase, it might be associated with a higher complication rate. TTC recurrence should be the first differential diagnosis in patients with a past history of TTC.
文摘Objectives To establish a cost-effective and reproducible procedure for induction of chronic left ventricular aneurysm （LVA） in rabbits. Methods Acute myocardial infarction （AMI） was induced in 35 rabbits via concomitant ligation of the left anterior descending （LAD） coronary artery and the circumflex （Cx） branch at the middle portion. Development of AMI was co n-firmed by ST segment elevation and akinesis of the occluded area. Echocardiography, pathological evaluation, and agar i n-tra-chamber casting were utilized to validate the formation of LVA four weeks after the surgery. Left ventricular end systolic pressure （LVESP） and diastolic pressure （LVEDP） were measured before, immediately after and four weeks after ligation. D i-mensions of the ventricular chamber, thickness of the interventricular septum （IVS） and the left ventricular posterior wall （LVPW） left ventricular end diastolic volume （LVEDV） and systolic volume （LVESV）, and ejection fraction （EF） were recorded by echo-cardiography. Results Thirty one （88.6%） rabbits survived myocardial infarction and 26 of them developed aneurysm （83.9%）. The mean area of aneurysm was 33.4% ＆#177; 2.4% of the left ventricle. LVEF markedly decreased after LVA formation, whereas LVEDV, LVESV and the thickness of IVS as well as the dimension of ventricular chamber from apex to mitral valve annulus significantly increased. LVESP immediately dropped after ligation and recovered to a small extent after LVA formation. LVEDP progressively increased after ligation till LVA formation. Areas in the left ventricle （LV） that underwent fibrosis included the apex, anterior wall and lateral wall but not IVS. Agar intra-chamber cast showed that the bulging of LV wall was prominent in the area of aneurysm. Conclusions Ligation of LAD and Cx at the middle portion could induce develo pment of LVA at a mean area ratio of 33.4%＆#177;2.4%which involves the apex, anterior wall and lateral wall of the LV.
文摘To the Editor The interesting report by Redfors, et aL[1] in the June issue of the Journal of Geriatric Cardiology, about an 88-year-old woman who presented with chest pain, found on echocardiography （ECHO） to have transient left ventricular apical akinesis with a hypercontractile base, and an occluded first diagonal coronary branch with suspected acute plaque rupture, on coronary angiography, treated with a percutaneous coronary intervention, for which the authors concluded that the observed extent of akinesis was disproportionally large for the occluded coronary lesion, letting them to deduce that the acute myocardial infarction （AMI） caused the episode of Takotsubo syndrome （TTS）, reminds me of a similar case of an AMI due to stent thrombosis and a resultant associated TTS.
基金supported by National Basic Research Development Program of China(No.2012CB26611)the National Natural Science Foundation of China(No.31260247)+2 种基金the Science and Technology Research Project of Xinjiang Production and Construction CorpsChina(No.2012BA0212010GG34)
