An early-onset case of post-cardiac injury syndrome after coronary stenting

Dear editor,Post-cardiac injury syndrome(PCIS) refers to a group of syndromes characterized by inflammation of the pericardium, pleura, and lung parenchyma after various heart injuries, including cardiac surgery or trauma, acute myocardial infarction(AMI), radiofrequency catheter ablation, coronary intervention, pacemaker implantation and pericardiocentesis.[1-5]Although advanced PCIS is well understood after cardiac surgery and AMI, known as post-pericardiotomy syndrome and post-myocardial infarction syndrome,[6,7]early-onset cases of PCIS after coronary intervention are rarely reported in China.

Application of bedside continuous blood purification in patients with multiple organ dysfunction syndromes

BACKGROUND:The complications of systemic inflammatory response syndrome(SIRS)include acute lung injury,acute kidney injury,shock,and multiple organ dysfunction syndrome(MODS).In recent years,how to clear inflammatory mediators has become a hot topic in critical care medicine.Researchers hypothesize that continuous blood purification(CBP) can effectively eliminate a variety of inflammatory mediators which participate in the occurrence of MODS and adjust the immune imbalance.This study aimed to observe the effects of CBP in MODS patients.METHODS:In this retrospective clinical study,a total of 38 MODS patients,18 males and 20 females,were enrolled.After conventional therapy,all the patients received CBP.Biochemistry,blood gas analysis,oxygenation index,mean arterial blood pressure(MAP),acute physiology and chronic health evaluation(APACHE) II scores were monitored.RESULTS:After CBP,the vital signs of patients were rapidly stable,and electrolyte disorders and acid-base imbalance were corrected.Renal function,blood gas,oxygenation index were all improved.MAP was increased,and APACHE II score was significantly decreased.All patients had good tolerance,stable hemodynamics,and no obvious adverse reaction on CBP compared with pre-CBP.CONCLUSION:CBP can effectively clean toxins,correct electrolyte acid-base balance,and improve systemic inflammatory response syndrome and the organ function of MODS patients.

A Comparison of the Transradial and Transfemoral Approaches for the Angiography and Intervention in Patients with a History of Coronary Artery Bypass Surgery： In-hospital and 1-year Follow-up Results

Background:Percutaneous coronary intervention (PCI) through transradial approach (TRA) has shown to be safe and effective as transfemoral approach (TFA) among unselected patients.However,very few studies have compared the outcomes between TRA and TFA specifically in patients with a history of coronary artery bypass grafting surgery (CABG).Methods:A total of 404 post-CABG patients who had undergone angiography or PCI were included in the study.The primary endpoint was defined as angiographic success and procedure success.The secondary endpoint was defined as in-hospital net adverse clinical events (NACEs),which included all cause of death,myocardial infarction (MI),stroke,repeat revascularization,and major bleeding.Patients were followed-up for 1-year.Major adverse cardiovascular events (MACEs),which included death,MI,and repeat revascularization,at 1-year follow-up were also compared.Results:The angiographic success was reached by 97.4％ in the TRA group compared with 100％ in the TFA group (P =0.02).The procedure success was achieved in 99.1％ in the TRA group and 97.9％ in the TFA group (P =0.68).The incidence rates of in-hospital NACE (2.7％ vs.2.7％,P =1.00) and 1-year MACE (11.5％ vs.12.0％,P =0.88) were similar between TRA and TFA.Meanwhile,TRA was associated with a lower rate of Bleeding Academic Research Consortium ≥2 bleeding (P =0.02).In patients undergoing graft PCI,the procedure success was similar between TRA and TFA (100.0％ vs.98.7％,P =1.00).The procedure time (25.0 min vs.27.5 min,P =0.53) was also similar.No significant difference was detected between TRA and TFA in terms of in-hospital NACE (0 vs.0,P =1.00)and 1-year MACE (21.4％ vs.10.3％,P =0.19).Conclusions:Compared with TFA,TRA had lower angiographic success but had a similar procedure success in post-CABG patients.TRA was also associated with decreased bleeding and shortened hospital stay.

Impact of Body Mass Index on the Clinical Outcomes after Percutaneous Coronary Intervention in Patients ≥75 Years Old

Background：The impact of body mass index （BMI） on the clinical outcomes after percutaneous coronary intervention （PCI） in patients ≥75 years old remained unclear.Methods：A total of 1098 elderly patients undergoing PCI with stent implantation were recruited.Patients were divided into four groups by the value of BMI：Underweight （〈20.0 kg/m^2）,normal weight （20.0-24.9 kg/m^2）,overweight （25.0-29.9 kg/m^2） and obese （≥30.0 kg/m^2）.Major clinical outcomes after PCI were compared between the groups.The primary endpoint was defined as in-hospital major adverse cardiovascular events （MACEs）,which included death,myocardial infarction （MI） and target vessel revascularization.The secondary endpoint was defined as 1 year death.Logistic regression analysis was performed to adjust for the potential confounders.Results：Totally,1077 elderly patients with available BMIs were included in the analysis.Patients of underweight,normal weight,overweight and obese accounted for 5.6%,45.4%,41.5% and 7.5% of the population,respectively.Underweight patients were more likely to attract ST-segment elevation MI,and get accompanied with anemia or renal dysfunction.Meanwhile,they were less likely to achieve thrombolysis in MI 3 grade flow after PCI,and receive beta-blocker,angiotensin converting enzyme inhibitor or angiotensin receptor blocker after discharge.In underweight,normal weight,overweight and obese patients,in-hospital MACE were 1.7%,2.7%,3.8%,and 3.7% respectively （P =0.68）,and 1 year mortality rates were 5.0%,3.9%,5.1% and 3.7% （P =0.80）,without significant difference between the groups.Multivariate regression analysis showed that the value of BMI was not associated with in-hospital MACE in patients at 75 years old.Conclusions：The BMI ＂obese paradox＂ was not found in patients ≥75 years old.It was suggested that BMI may not be a sensitive predictor of adverse cardiovascular events in elderly patients.

Comparison of anti-inflammatory effects of Lonicerae Japonicae Flos and Lonicerae Flos based on network pharmacology

Objective:In Chinese herbal medicine(CHM)history,Lonicerae Japonicae Flos and Lonicerae Flos were used clinically as one drug,but now they are admitted as two herbal medicines in Chinese Pharmacopoeia(2010 edition).This study used network pharmacology to investigate whether the two can be used interchangeably for the treatment of inflammatory diseases in TCM clinical practice.Methods:Lonicerae Japonicae Flos and Lonicerae Flos were compared in the inflammation mechanism including core targets,Gene Ontology(GO),pathway and principle chemical components by the method of network pharmacology.Results:Lonicerae Japonicae Flos and Lonicerae Flos shared in six targets accounting for 66.7%of the entire core targets and more than half of the GO terms and pathways are similar.Organic acids are dominent compounds responsible for anti-inflammatory effects.Three of the compounds that bind to core targets including luteolin,quercetin and kaempferol,are shared in both herbs.Conclusion:Due to high similarity between Lonicerae Japonicae Flos and Lonicerae Flos,we believe that they can be used interchangeably for the inflammation in clinical treatment.

Velocity and Temperature of In-Flight Particles and Its Significance in Determining the Microstructure and Mechanical Properties of TBCs

The correlation between particle in-flight parameter, defect content and mechanical property of yttria-stabilized zirconia coating was systematically studied in the present work. The melting state of in-flight particle during spraying was simulated using computational fluid dynamics. The results suggested that, with the increase of velocity and temperature of in-flight particles in the plasma jet, the particles changed from partially melted state to fully melted one. As a result, the total defect content of as-sprayed coating gradually decreased, while elastic modulus and microhardness increased correspondingly. However, the fracture toughness of as-sprayed coating reached a maximum value when the total defect content reached approximately 9.1%.

Research on Quality Markers of Moutan Cortex: Quality Evaluation and Quality Standards of Moutan Cortex

Objective To identify the quality markers of Moutan Cortex（MC） and establish the quality evaluation methods for multi-component assay and fingerprinting of MC. Methods The chemical constituents in MC were identified by HPLC-QTOF-MS. UPLC was employed for the multi-component assay and fingerprinting of MC. Furthermore, text mining was carried out to review the biosynthesis pathways and pharmacological and pharmacokinetic studies related to MC, and in silico target fishing was conducted to construct compound-target networks for MC. Results Sixteen compounds were clearly identified in MC and their structures were confirmed through comparison with literature data. In addition, the biosynthetic pathways and component specificities of the identified compounds were summarized and confirmed by text mining.Pharmacological activities, including traditional usage and modern pharmacological studies were summarized. A total of 282 targets from Homo sapiens were fished for 13 compounds. In addition, pharmacokinetic studies of different compounds were synopsized. Finally, multi-component assay and fingerprint of MC were established. Conclusion Eight major components are selected as quality markers of MC, such as oxypaeoniflorin, apiopaeonoside, albiflorin, paeonolide, paeoniflorin, 1,2,3,4,6-penta-O-galloyl-β-D-glucose, mudanpioside C and paeonol. These eight quality markers are successfully applied to the quality evaluation of MC, and could be useful in improving the current quality standards of MC.

Small Lymphocytic Lymphoma/Chronic Lymphocytic Leukemia with Chromothripsis in an Old Woman

Cell karyotyping in patients with small lymphocytic lymphoma/chronic lymphocytic leukemia （SLL/CLL） is not easy to success, and small genomic lesions （〈5 Mb） are not routinely detected by this method. It is likely that a complete genomic characterization of CLL requires a combination of fluorescence in situ hybridization （FISH）, single nucleotide polymorphism （SNP） array profiling for comprehensive genome-wide analysis of acquired genomic copy number aberrations （aCNAs） and loss-of-heterozygosity （LOH） in dominant clones, and karyotyping for detection of balanced translocations, isochromosomes, and marker chromosomes. SNP array analysis can reveal chromothripsis, a phenomenon by which regions of the cancer genome are shattered and recombined to generate frequent oscillations between the lower and the higher DNA copy number states. This study provided cytogenetic findings in a CLL/SLL patient with v-myc avian myelocytomatosis viral oncogene homolog （C-MYC）-amplification by FISH, in which SNP arrays detected profound genomic upheaval due to chromothripsis that may lead to malignant transformation.