This study was to discuss the relationship among the change in the activity of Bombyx mori carboxylesterase （BmCarE） in the midguts, the differential expression of BmCarE gene （bmcare） in the midguts, and the abil...This study was to discuss the relationship among the change in the activity of Bombyx mori carboxylesterase （BmCarE） in the midguts, the differential expression of BmCarE gene （bmcare） in the midguts, and the ability of Bombyx mori resistant to densonucleosis virus （BmDNV）, and to elucidate the molecular mechanism of resistance to BmDNV-Z. With two silkworm strains, HUABA, which is susceptible to BmDNV-Z, and BC8 （a near isogenic line of HUABA）, which is completely resistant to the same virus, as materials, the activity of BmCarE in the midgut was determined by Bio-Tek Synergy, and the differential expression of bmcare between the two strains was investigated by real-time fluorescence quantitative PCR, both at 12, 36, and 72 h post oral inoculation of the two strains with virus （hereafter referred as inoculation）. While the activity of BmCarE in the midguts of BC8 inoculation group at 12 h post inoculation was higher than that in the BC8 control group, the HUABA inoculated group, and the HUABA control group by 3.28, 2.26, and 3.02 times, respectively, with the difference being highly significant （P 〈 0.01）, there was no statistical difference among the other groups. The relative expression level of bmcare in the midguts of BC8 inoculation group at 12 h post inoculation was higher than that in the BC8 control group, the HUABA inoculation group, and the HUABA control group by 17.714, 21.76, and 15.09 times, respectively, with the difference being highly significant （P 〈 0.01）, and there was no statistical difference among other groups. The elevation of BmCarE activity and expression level of bmcare in the resistant strain at 12 h post inoculation may relate to the resistant gene （nsd/nsd） and the stimulation of BmDNV-Z. The molecular basis for the elevation of BmCarE activity in the resistant strain BC8 may be the change in the expression level of bmcare.展开更多
Background Non-valvular atrial fibrillation is associated with an increased risk of ischemic stroke; however, the appropriate intensity of anticoagulation therapy for Chinese patients has not been determined. The purp...Background Non-valvular atrial fibrillation is associated with an increased risk of ischemic stroke; however, the appropriate intensity of anticoagulation therapy for Chinese patients has not been determined. The purpose of this study was to compare the safety and the efficacy of standard-intensity warfarin therapy, low-intensity warfarin therapy, and aspirin therapy for the prevention of ischemic events in Chinese patients with non-valvular atrial fibrillation （NVAF）. Methods A total of 786 patients from 75 Chinese hospitals were enrolled in this study and randomized into three therapy groups： standard-intensity warfarin （international normalized ratio （INR） 2.1 to 2.5） group, low-intensity warfarin （INR 1.6 to 2.0） group and aspirin （200 mg per day） group. All patients were evaluated by physicians at 1,3, 6, 9, 12, 15, 18, 21 and 24 months after randomization to obtain a patient questionnaire, physical examination and related laboratory tests. Results The annual event rates of ischemic stroke, transient ischemic attack （TIA） or systemic thromboembolism were 2.6%, 3.1% and 6.9% in the standard-intensity warfarin, low-intensity warfarin and aspirin groups, respectively （P=0.027）. Thromboembolic event rates in both warfarin groups were significantly lower than that in the aspirin group （P=0.018, P=0.044）, and there was no significant difference between the two warfarin groups. Severe hemorrhagic events occurred in 15 patients, 7 （2.6%） in the standard-intensity warfarin group, 7 （2.4%） in the low-intensity warfarin group and 1 （0.4%） in the aspirin group. The severe hemorrhagic event rates in the warfarin groups were higher than that in the aspirin group, but the difference did not reach statistical significance （P=0.101）. The mild hemorrhagic and total hemorrhagic event rates in the warfarin groups （whether in the standard-intensity warfarin group or low-intensity warfarin group） were much higher than that in the aspirin group with the annual event rates of total hemorrhages of 10.2%, 7.6% and 2.2%, respectively, in the 3 groups （P=0.001）. Furthermore, there was no significant difference in all cause mortality among the three study groups. Conclusion In Chinese patients with NVAF, the warfarin therapy （INR 1.6-2.5） for the prevention of thromboembolic events was superior to aspirin.展开更多
Background Ventricular tachycardia （VT） and ventricular fibrillation are the main reasons causing sudden cardiac death.This study aimed to investigate the effects of nifekalant hydrochloride （NIF） on QT dispersion...Background Ventricular tachycardia （VT） and ventricular fibrillation are the main reasons causing sudden cardiac death.This study aimed to investigate the effects of nifekalant hydrochloride （NIF） on QT dispersion （QTd） in treating VT.Methods A total of 16 consecutive patients suffered sustained VT was included and then randomly divided into two groups according to the administration duration of NIF.In long-time group （group L）, patients were injected with NIF continuously for at least 12 hours after a bolus dose.The patients in short-time group （group S） were injected with NIF just for 1 hour.Results There were 7 of all 10 episodes of VT which were terminated by NIF, including 4 episodes in group L were stopped over 1 hour after continuous infusion of NIF.One patient suffered from torsade de pointes.Electrocardiography analysis indicated that QTd was significantly decreased 12 hours after stopping of infusing NIF compared with that when VT stopped （（45.4±22.1） ms vs.（73.4±33.2） ms, P 〈0.01）, and the corrected QTd （QTcd） decreased too （（47.8±22.9） ms vs.（78.3±36.5） ms, P 〈0.01 ）.There was a positive correlation between the increase in QTd and dose of administrating NIF （P 〈0.01）, so was QTcd （P 〈0.01）.Conclusions More administration of NIF indicates higher terminating rate of VT and more QTd prolongation.However,the safety is acceptable if several important issues were noticed in using NIF, such as serum potassium concentration,stopping side-effect related agents, and carefully observing clinical responses.展开更多
Background N-terminal pro β-type natriuretic peptide （NT pro BNP） has been shown to predict the prognosis and could guide the treatment of heart failure. We aimed to investigate the values of NT pro BNP in predicti...Background N-terminal pro β-type natriuretic peptide （NT pro BNP） has been shown to predict the prognosis and could guide the treatment of heart failure. We aimed to investigate the values of NT pro BNP in predicting the clinical response to cardiac resynchronization therapy （CRT）. Methods A total of 44 patients with chronic heart failure （34 male and 10 female, mean age of （58±13） years, New York Heart Association （NYHA） class 3.3±0.5, QRS duration （150±14） milliseconds） who underwent successful implantation of a CRT system were enrolled in this study. Pharmacotherapy remained stable during the first 3 months of follow-up. Plasma levels of NT pro BNP were evaluated before and 3 months after implantation. Clinical, echocardiographic and exercise parameters were monitored at each clinical visit after CRT implantation. Receiver operating characteristic analysis and a paired ttest were performed to analyze the data. Results After a mean of （16.3±5.5） months of follow-up, 11 nonresponders were identified. CRT resulted in a significant reduction in NT pro BNP （（1.70±1.28） vs （1.07±0.88） pmol/ml, P 〈0.001） in responders. Percentage change in NT pro BNP level （△BNP%） was a statistically significant predictor of long term clinical improvement at 3 months of follow-up. Conclusions △BNP% from baseline to 3 months of follow-up is a predictor of long term response to CRT. NT pro BNP may be a simple method for monitoring the effects of CRT.展开更多
Background P-wave dispersion （PWD） is a useful predictor of paroxysmal atrial fibrillation （AF）. The effect of cardiac resynchronization therapy （CRT） on PWD and the prognostic implications of the improvement in...Background P-wave dispersion （PWD） is a useful predictor of paroxysmal atrial fibrillation （AF）. The effect of cardiac resynchronization therapy （CRT） on PWD and the prognostic implications of the improvement in PWD remain undefined. The aim of the study was to explore the clinical significance of the improvement of PWD after CRT. Methods Electrocardiographic studies were performed before and three months after CRT in 81 patients （57 men and 24 women; age （60.5±11.2） years） with standard CRT indication but no history of AF. A significant improvement of PWD （PWD responder） was defined as a relative decrease 〉20% from baseline PWD. The primary endpoints were new-onset AF detected by electrocardiogram （ECG） or CRT. Results After （30.6±7.5） months of follow-up, PWD responders （n=43） had a significantly lower incidence of AF than did PWD nonresponders, 12% vs. 29% （P 〈0.001）. In Cox proportional hazard analysis, PWD responders was the only predictor of lower risk of new-onset AF （HR 0.33, 95% confidence interval 0.12-0.96, P=0.033）. Conclusion Improvement of P-wave dispersion after CRT was associated with a lower incidence of AF, which may be related to the significant improvement in left ventricular systolic function and the reverse modeling of the left atrium.展开更多
Background Using tissue Doppler imaging and conventional echocardiographic technique, we examined the cardiac function and synchronicity in individuals with isolated right bundle branch block （RBBB） or left bundle b...Background Using tissue Doppler imaging and conventional echocardiographic technique, we examined the cardiac function and synchronicity in individuals with isolated right bundle branch block （RBBB） or left bundle branch block （LBBB） and assessed the relationship between QRS duration and synchronicity.展开更多
Background The impact of home monitoring system in the early detection of ventricular arrhythmia and inappropriate shock in daily work is not clear. The aim of this study was to investigate the impact of home monitori...Background The impact of home monitoring system in the early detection of ventricular arrhythmia and inappropriate shock in daily work is not clear. The aim of this study was to investigate the impact of home monitoring system on the early detection of ventricular arrhythmia and inappropriate shock in daily clinical practice. Methods Cases of implantable cardioverter defibrillator （ICD） implantation with or without the home monitoring system from June 2010 to October 2011 at our center were reviewed. Follow-up was scheduled after implantation. Data relating to the home monitoring ICD were retrieved using a remote transmitter system. Data relating to the other devices were obtained during scheduled follow-up or unscheduled visits. Results Our study involved 69 patients （mean age （68.4＋17.6） years, 64.3% males, 26 in the home monitoring group vs. 43 in the non-home monitoring group）. In all, 561 ventricular arrhythmia episodes were detected in 17 patients （39.5%） in the non-home monitoring group： 495 episodes were ventricular tachycardia and 66 episodes were ventricular fibrillation; among these, 476 episodes of ventricular tachycardia and 45 episodes of ventricular fibrillation were appropriately diagnosed （96.1% and 68.2%, respectively）. In the home monitoring group, 389 ventricular arrhythmia episodes were transmitted by the home monitoring system in nine patients （34.6%）： 348 ventricular tachycardia episodes and 41 ventricular fibrillation episodes. Device detection was appropriate in 348 ventricular tachycardia episodes （100.0%） and 36 ventricular fibrillation episodes （87.8%）. The home monitoring group showed a higher appropriate detection rate of ventricular tachycardia （P 〈0.01） and ventricular fibrillation （P=0.02）. The proportion of inappropriate shock was comparable in the two groups （6/11 in the non-home monitoring group vs. 1/7 in the home monitoring group; m=0.08）. Conclusions The home monitoring ICD was able to provide information relating to inappropriate detection and shock earlier than conventional devices. It proved to be a reliable tool and has a strong potential to provide greater reaction time in the case of inappropriate shock.展开更多
基金This work was supported by High Technology Research and Development Program of China （2005CB121000） Natural Science Foundation of Jiangsu Province, China （BK2006074）.
文摘This study was to discuss the relationship among the change in the activity of Bombyx mori carboxylesterase （BmCarE） in the midguts, the differential expression of BmCarE gene （bmcare） in the midguts, and the ability of Bombyx mori resistant to densonucleosis virus （BmDNV）, and to elucidate the molecular mechanism of resistance to BmDNV-Z. With two silkworm strains, HUABA, which is susceptible to BmDNV-Z, and BC8 （a near isogenic line of HUABA）, which is completely resistant to the same virus, as materials, the activity of BmCarE in the midgut was determined by Bio-Tek Synergy, and the differential expression of bmcare between the two strains was investigated by real-time fluorescence quantitative PCR, both at 12, 36, and 72 h post oral inoculation of the two strains with virus （hereafter referred as inoculation）. While the activity of BmCarE in the midguts of BC8 inoculation group at 12 h post inoculation was higher than that in the BC8 control group, the HUABA inoculated group, and the HUABA control group by 3.28, 2.26, and 3.02 times, respectively, with the difference being highly significant （P 〈 0.01）, there was no statistical difference among the other groups. The relative expression level of bmcare in the midguts of BC8 inoculation group at 12 h post inoculation was higher than that in the BC8 control group, the HUABA inoculation group, and the HUABA control group by 17.714, 21.76, and 15.09 times, respectively, with the difference being highly significant （P 〈 0.01）, and there was no statistical difference among other groups. The elevation of BmCarE activity and expression level of bmcare in the resistant strain at 12 h post inoculation may relate to the resistant gene （nsd/nsd） and the stimulation of BmDNV-Z. The molecular basis for the elevation of BmCarE activity in the resistant strain BC8 may be the change in the expression level of bmcare.
文摘Background Non-valvular atrial fibrillation is associated with an increased risk of ischemic stroke; however, the appropriate intensity of anticoagulation therapy for Chinese patients has not been determined. The purpose of this study was to compare the safety and the efficacy of standard-intensity warfarin therapy, low-intensity warfarin therapy, and aspirin therapy for the prevention of ischemic events in Chinese patients with non-valvular atrial fibrillation （NVAF）. Methods A total of 786 patients from 75 Chinese hospitals were enrolled in this study and randomized into three therapy groups： standard-intensity warfarin （international normalized ratio （INR） 2.1 to 2.5） group, low-intensity warfarin （INR 1.6 to 2.0） group and aspirin （200 mg per day） group. All patients were evaluated by physicians at 1,3, 6, 9, 12, 15, 18, 21 and 24 months after randomization to obtain a patient questionnaire, physical examination and related laboratory tests. Results The annual event rates of ischemic stroke, transient ischemic attack （TIA） or systemic thromboembolism were 2.6%, 3.1% and 6.9% in the standard-intensity warfarin, low-intensity warfarin and aspirin groups, respectively （P=0.027）. Thromboembolic event rates in both warfarin groups were significantly lower than that in the aspirin group （P=0.018, P=0.044）, and there was no significant difference between the two warfarin groups. Severe hemorrhagic events occurred in 15 patients, 7 （2.6%） in the standard-intensity warfarin group, 7 （2.4%） in the low-intensity warfarin group and 1 （0.4%） in the aspirin group. The severe hemorrhagic event rates in the warfarin groups were higher than that in the aspirin group, but the difference did not reach statistical significance （P=0.101）. The mild hemorrhagic and total hemorrhagic event rates in the warfarin groups （whether in the standard-intensity warfarin group or low-intensity warfarin group） were much higher than that in the aspirin group with the annual event rates of total hemorrhages of 10.2%, 7.6% and 2.2%, respectively, in the 3 groups （P=0.001）. Furthermore, there was no significant difference in all cause mortality among the three study groups. Conclusion In Chinese patients with NVAF, the warfarin therapy （INR 1.6-2.5） for the prevention of thromboembolic events was superior to aspirin.
文摘Background Ventricular tachycardia （VT） and ventricular fibrillation are the main reasons causing sudden cardiac death.This study aimed to investigate the effects of nifekalant hydrochloride （NIF） on QT dispersion （QTd） in treating VT.Methods A total of 16 consecutive patients suffered sustained VT was included and then randomly divided into two groups according to the administration duration of NIF.In long-time group （group L）, patients were injected with NIF continuously for at least 12 hours after a bolus dose.The patients in short-time group （group S） were injected with NIF just for 1 hour.Results There were 7 of all 10 episodes of VT which were terminated by NIF, including 4 episodes in group L were stopped over 1 hour after continuous infusion of NIF.One patient suffered from torsade de pointes.Electrocardiography analysis indicated that QTd was significantly decreased 12 hours after stopping of infusing NIF compared with that when VT stopped （（45.4±22.1） ms vs.（73.4±33.2） ms, P 〈0.01）, and the corrected QTd （QTcd） decreased too （（47.8±22.9） ms vs.（78.3±36.5） ms, P 〈0.01 ）.There was a positive correlation between the increase in QTd and dose of administrating NIF （P 〈0.01）, so was QTcd （P 〈0.01）.Conclusions More administration of NIF indicates higher terminating rate of VT and more QTd prolongation.However,the safety is acceptable if several important issues were noticed in using NIF, such as serum potassium concentration,stopping side-effect related agents, and carefully observing clinical responses.
基金This project was supported by a grant from the National Natural Science Foundation of China （No. 30770860）.
文摘Background N-terminal pro β-type natriuretic peptide （NT pro BNP） has been shown to predict the prognosis and could guide the treatment of heart failure. We aimed to investigate the values of NT pro BNP in predicting the clinical response to cardiac resynchronization therapy （CRT）. Methods A total of 44 patients with chronic heart failure （34 male and 10 female, mean age of （58±13） years, New York Heart Association （NYHA） class 3.3±0.5, QRS duration （150±14） milliseconds） who underwent successful implantation of a CRT system were enrolled in this study. Pharmacotherapy remained stable during the first 3 months of follow-up. Plasma levels of NT pro BNP were evaluated before and 3 months after implantation. Clinical, echocardiographic and exercise parameters were monitored at each clinical visit after CRT implantation. Receiver operating characteristic analysis and a paired ttest were performed to analyze the data. Results After a mean of （16.3±5.5） months of follow-up, 11 nonresponders were identified. CRT resulted in a significant reduction in NT pro BNP （（1.70±1.28） vs （1.07±0.88） pmol/ml, P 〈0.001） in responders. Percentage change in NT pro BNP level （△BNP%） was a statistically significant predictor of long term clinical improvement at 3 months of follow-up. Conclusions △BNP% from baseline to 3 months of follow-up is a predictor of long term response to CRT. NT pro BNP may be a simple method for monitoring the effects of CRT.
文摘Background P-wave dispersion （PWD） is a useful predictor of paroxysmal atrial fibrillation （AF）. The effect of cardiac resynchronization therapy （CRT） on PWD and the prognostic implications of the improvement in PWD remain undefined. The aim of the study was to explore the clinical significance of the improvement of PWD after CRT. Methods Electrocardiographic studies were performed before and three months after CRT in 81 patients （57 men and 24 women; age （60.5±11.2） years） with standard CRT indication but no history of AF. A significant improvement of PWD （PWD responder） was defined as a relative decrease 〉20% from baseline PWD. The primary endpoints were new-onset AF detected by electrocardiogram （ECG） or CRT. Results After （30.6±7.5） months of follow-up, PWD responders （n=43） had a significantly lower incidence of AF than did PWD nonresponders, 12% vs. 29% （P 〈0.001）. In Cox proportional hazard analysis, PWD responders was the only predictor of lower risk of new-onset AF （HR 0.33, 95% confidence interval 0.12-0.96, P=0.033）. Conclusion Improvement of P-wave dispersion after CRT was associated with a lower incidence of AF, which may be related to the significant improvement in left ventricular systolic function and the reverse modeling of the left atrium.
文摘Background Using tissue Doppler imaging and conventional echocardiographic technique, we examined the cardiac function and synchronicity in individuals with isolated right bundle branch block （RBBB） or left bundle branch block （LBBB） and assessed the relationship between QRS duration and synchronicity.
文摘Background The impact of home monitoring system in the early detection of ventricular arrhythmia and inappropriate shock in daily work is not clear. The aim of this study was to investigate the impact of home monitoring system on the early detection of ventricular arrhythmia and inappropriate shock in daily clinical practice. Methods Cases of implantable cardioverter defibrillator （ICD） implantation with or without the home monitoring system from June 2010 to October 2011 at our center were reviewed. Follow-up was scheduled after implantation. Data relating to the home monitoring ICD were retrieved using a remote transmitter system. Data relating to the other devices were obtained during scheduled follow-up or unscheduled visits. Results Our study involved 69 patients （mean age （68.4＋17.6） years, 64.3% males, 26 in the home monitoring group vs. 43 in the non-home monitoring group）. In all, 561 ventricular arrhythmia episodes were detected in 17 patients （39.5%） in the non-home monitoring group： 495 episodes were ventricular tachycardia and 66 episodes were ventricular fibrillation; among these, 476 episodes of ventricular tachycardia and 45 episodes of ventricular fibrillation were appropriately diagnosed （96.1% and 68.2%, respectively）. In the home monitoring group, 389 ventricular arrhythmia episodes were transmitted by the home monitoring system in nine patients （34.6%）： 348 ventricular tachycardia episodes and 41 ventricular fibrillation episodes. Device detection was appropriate in 348 ventricular tachycardia episodes （100.0%） and 36 ventricular fibrillation episodes （87.8%）. The home monitoring group showed a higher appropriate detection rate of ventricular tachycardia （P 〈0.01） and ventricular fibrillation （P=0.02）. The proportion of inappropriate shock was comparable in the two groups （6/11 in the non-home monitoring group vs. 1/7 in the home monitoring group; m=0.08）. Conclusions The home monitoring ICD was able to provide information relating to inappropriate detection and shock earlier than conventional devices. It proved to be a reliable tool and has a strong potential to provide greater reaction time in the case of inappropriate shock.
