Cardiac remodeling in patients with atrial fibrillation reversing bradycardia-induced cardiomyopathy:A case report

BACKGROUND Bradycardia-induced cardiomyopathy(BIC),which is a disease resulting from bradycardia,is characterized by cardiac chamber enlargement and diminished cardiac function.The correction of bradycardia can allow for significant improvements in both cardiac function and structure;however,this disease has been infrequently documented.In this case,we conducted a longitudinal followup of a patient who had been enduring BIC for more than 40 years to heighten awareness and prompt timely diagnosis and rational intervention.CASE SUMMARY A woman who presented with postactivity fatigue and dyspnea was diagnosed with bradycardia at the age of 7.Since she had no obvious symptoms,she did not receive any treatment to improve her bradycardia during the 42-year follow-up,except for the implantation of a temporary pacemaker during labor induction surgery.As time progressed,the patient's heart gradually expanded due to her low ventricular rate,and she was diagnosed with BIC.In 2014,the patient developed atrial fibrillation,her ventricular rate gradually increased,and her heart shape gradually returned to normal.This report describes the cardiac morphological changes caused by the heart rate changes in BIC patients older than 40 years,introduces another possible outcome of BIC,and emphasizes the importance of early intervention in treating BIC.CONCLUSION BIC can induce atrial fibrillation,causing an increased ventricular rate and leading to positive cardiac remodeling.

Identification of a novel mutation in the FGF10 gene in a Chinese family with obvious congenital lacrimal duct dysplasia in lacrimo-auriculo-dento-digital syndrome

AIM:To identify the pathogenic gene variant in a family with lacrimo-auriculo-dento-digital syndrome[LADD(MIM 149730)]showing congenital lacrimal duct dysplasia as the main clinical manifestation and lay the foundation for future research on the pathogenic gene.METHODS:Ophthalmological examinations,including slit-lamp biomicroscopy and lacrimal duct probing,and computed tomography dacryocystography(CT-DCG)were performed for all participants.The family pedigree was drawn,genetic features were analyzed,and the genomic DNA of the subjects was extracted.Pathogenic genes were screened via whole exome sequencing(WES)and confirmed using Sanger sequencing.RESULTS:Six patients belonged to this three-generation family,and their clinical manifestations included congenital nasolacrimal duct obstruction,congenital absence of lacrimal puncta and canaliculi,lacrimal fistulae,and limb deformities.This pattern indicates autosomal dominant inheritance.Diagnosis was based on the clinical characteristics of LADD syndrome,which presented in all the patients in this family.A novel frameshif t mutation in the FGF10 gene(NM_004465.1),c.234dup C(p.Trp79Leus*15),was identified in all patients via WES.The variant was confirmed by Sanger sequencing and classified as a“pathogenic mutation”according to the American College of Medical Genetics and Genomics(ACMG)variant interpretation guidelines.CONCLUSION:A novel frameshift mutation in the FGF10 gene is found in all patients.This finding helps this family with LADD syndrome receiving a more accurate clinical diagnosis and genetic counseling by extending the mutation range of the FGF10 gene.

Primary lacrimal sac lymphoma:a case-based retrospective study in a Chinese population

AIM:To determine the clinical characteristics,pathological types,tumor markers,treatments,and outcomes of Chinese patients with primary lacrimal sac lymphoma.METHODS:This case-based retrospective study analyzed 15 Chinese patients with primary lacrimal sac lymphoma.The clinical data collected included gender,age at diagnosis,symptoms,imaging examination results,pathologic diagnosis,pathogen identification,tumor markers,treatments,follow-up,and prognosis.Descriptive statistics were used to characterize the patients.Progression-free survival(PFS)was defined as the time from surgery to the last follow-up,first record of tumor recurrence,or death.RESULTS:There were 7 males and 8 females with unilateral primar y lacrimal sac lymphoma in the lef t eye(n=6)or right eye(n=9).The initial symptom in 13 patients was epiphora,and 2 patients had redness and swelling in the lacrimal sac area.All patients ultimately developed epiphora,and 12 had masses in the lacrimal sac area.Analysis of preoperative plasma tumor markers indicated 14 patients had elevated homocysteine,9 had elevatedβ2-microglobulin,and 2 had elevated lactate dehydrogenase(LDH);2 patients had elevations of all three markers,and 1 patient had no elevation of any marker.All patients underwent surgical resection and 12 patients received postoperative chemotherapy.The pathological types were DLBCL(n=8),MALT lymphoma(n=5),and NK/T-cell lymphoma,nasal type(n=2).The mean followup time was 25.8mo(range:4-41)and 2 patients died.Seven patients who underwent mass excision combined with dacryocystorhinostomy(DCR)had no postoperative epiphora.Eight patients who only underwent mass excision had varying degrees of postoperative epiphora.Preoperative LDH elevation and NK/T-cell lymphoma,nasal type were associated with poor prognoses.CONCLUSION:Early diagnosis and treatment can lead to a good prognosis for most patients with primary lacrimal sac lymphoma.Mass resection combined with DCR can reduce the occurrence of post-surgical epiphora.The pathology type and tumor marker status are associated with prognosis.

Olsen公式对高度近视合并白内障患者术后屈光力的预测性

目的:探讨Olsen公式对高度近视合并白内障患者术后屈光力的预测性。方法:回顾性分析自2016-10-10/2019-08-20于我院行白内障超声乳化联合人工晶状体(IOL)植入术的高度近视合并白内障患者65例101眼,根据眼轴长度(AL)进行分组,A组(26mm<AL≤28mm)17例29眼,B组(28mm<AL≤30mm)26例41眼,C组(AL>30mm)22例31眼。采用IOL Master自带的SRK/T、Haigis和Olsen公式计算术后理论屈光度(即所植入IOL度数对应的各公式的预测屈光度),并记录术后3mo实际屈光度,计算绝对屈光误差(MAE)。结果:三组患者采用Olsen公式对应的术后3mo MAE分别为0.15(0.04,0.22)、0.19(0.14,0.27)、0.26(0.115,0.455)D,无明显差异(P>0.05),且对于相同眼轴长度范围的患者,采用Olsen公式对应的术后3mo MAE最小。采用Bland-Altman法分析采用三种IOL屈光度计算公式对应的术后理论屈光度与术后3mo实际屈光度的一致性,结果表明,术后3mo实际屈光度与Olsen公式对应的术后理论屈光度最为接近,与SRK/T公式对应的术后理论屈光度一致性最差。结论:Olsen公式对高度近视合并白内障患者术后屈光力的预测准确性和稳定性优于SRK/T、Haigis公式,且Olsen公式受眼轴长度影响最小。

SFBR联合贝伐珠单抗对结肠癌脉管系统的影响

目的探讨单次近距离放疗(SFBR)联合贝伐珠单抗对结肠癌脉管系统的影响。方法复制小鼠结肠癌移植瘤模型,随机分为空白对照组、SFBR组、贝伐珠单抗组、SFBR联合贝伐珠单抗组(以下简称联合组)。治疗结束后第14天计算移植瘤的终体积和肿瘤生长抑制率。运用^(18)F-FDG microPET/CT测量肿瘤最大标准摄取值(SUV_(max)),评估肿瘤代谢活性。采用免疫组织化学法检测肿瘤组织的微血管密度(MVD)、淋巴管密度(LVD)、血管生成拟态密度(VMD)及肿瘤细胞Ki-67阳性表达率。利用流式细胞学技术检测肿瘤细胞凋亡率,评估肿瘤凋亡情况。结果联合组肿瘤组织中MVD、LVD、VMD低于SFBR组和贝伐珠单抗组(P<0.05),SUV_(max)、Ki-67表达水平低于SFBR组和贝伐珠单抗组(P<0.05);而联合组肿瘤抑制率、肿瘤细胞凋亡率高于SFBR组和贝伐珠单抗组(P<0.05)。结论SFBR联合贝伐珠单抗能降低结肠癌组织中MVD、LVD、VMD,从而有效抑制结肠癌的生长。

MicroRNA-34a promoting apoptosis of human lens epithelial cells through down-regulation of B-cell lymphoma-2 and silent information regulator

AIM： To investigate the role of micro RNA-34a（mi R-34a） in the induction of apoptosis of human lens epithelial（HLE-B3） cells. METHODS： The apoptosis of HLE-B3 cells was detected by Annexin V-PE apoptosis detection kit after the treatment with 200 μmol/L H2O2 for 24h and lentiviral mi R-34 a vector transfection. The expression of mi R-34 a in the cells was quantified by quantitative real time polymerase chain reaction（q RT-PCR） in response to H2O2 exposure and the vector transfection. The effects of overexpression of mi R-34 a on the expression of B-cell lymphoma-2（Bcl-2） and silent information regulator 1（SIRT1） was determined by q RT-PCR and Western blot. RESULTS： The expression of mi R-34 a was up-regulated by the treatment of H2O2 in HLE-B3 cells. The increased expression of mi R-34 a is accompanied with the cell apoptosis. Consistence with the H2O2 exposure,ectopic overexpression of mi R-34 a in HLE-B3 cells promoted cells apoptosis. Importantly the anti-apoptosis factors Bcl-2 and SIRT1 were reduced significantly by up-regulation of mi R-34 a in HLE-B3 cells.CONCLUSION： Mi R-34 a promotes the apoptosis of HLE-B3 cells by down-regulating Bcl-2 and SIRT1,suggesting that mi R-34 a may involve in the pathogenesis of cataract formation and targeting mi R-34 a may be a potentially therapeutic approach for treatment of cataract.

Femtosecond laser capsulotomy versus manual capsulotomy： a Meta-analysis

AIM：To perform a Meta-analysis on the precision and safety of femtosecond laser（FSL） capsulotomy compared with manual continuous curvilinear capsulotomy（CCC）.· METHODS：We searched PubMed,EMBASE,Web of Science,the Cochrane Library databases,and Clinical Trials.gov that maintained our inclusion criteria.Reference lists of retrieved articles were also reviewed.The effects of morphology of capsulorhexis and the tears of anterior capsule were calculated by using randomeffect models.· RESULTS：We identified 4 randomized and 7nonrandomized studies involving 2941 eyes.The diameter of capsulotomy and the rates of anterior capsule tear showed no statistically difference between FSL group and manual group（MD=0.03;95%CI,-0.03 to0.09,P=0.31）,and（OR=1.40;95%CI,0.28 to 6.97,P=0.68） respectively.In terms of the circularity of capsulotomy,FSL group had a more significant advantage than the manual CCC group（MD=0.09;95%CI,0.05 to 0.12,P〈0.001）.· CONCLUSION：Our Meta-analysis shows that FSL can perform a capsulotomy with more precision and higher reliability than manual CCC.The results in diameter of capsulotomy and the rate of anterior capsule tears was no significant difference between FSL and manual CCC groups.However in terms of circularity,the FSL was superior to the manual procedure.

Modeling in SolidWorks and analysis of temperature and thermal stress during construction of intake tower

With a focus on the intake tower of the Yanshan Reservoir, this paper discusses the method of modeling in the 3D CAD software SolidWorks and the interface processing between SolidWorks and the ANSYS code, which decreases the difficulty in modeling complicated models in ANSYS. In view of the function of the birth-death element and secondary development with APDL （ANSYS parametric design language）, a simulation analysis of the temperature field and thermal stress during the construction period of the intake tower was conveniently conducted. The results show that the temperature rise is about 29.934 ℃ over 3 or 4 days. The temperature differences between any two points are less than 24 ℃. The thermal stress increases with the temperature difference and reaches its maximum of 1.68 MPa at the interface between two concrete layers.

Effect of heat input on austenite microstructural evolution of simulated heat affected zone in 2205 duplex stainless steel

The effect of simulated welding thermal cycle on the microstructure and impact toughness of heat affected zone (HAZ) in 2205 duplex stainless steel was investigated by optical microscopy, scanning electron microscopy, transmission electron microscopy and room temperature impact test. The results show that the morphology and volume fraction of austenite change greatly with heat input. The amount of residual austenite and grain boundary austenite (GBA) decreases while Widmanstatten austenite (WA) laths and intergranular austenite increase with the increase in heat input. Only the fine equiaxed austenite exists in the HAZ when the heat input is increased up to 61.8 kJ/cm. WA laths nucleate initially either at the ferrite and GBA phase boundaries or directly in ferrite grains and begin to decompose into diamond-shaped austenite with the heat input larger than 25.2 kJ/cm. The impact toughness shows a non-monotonic variation, which is related to the increase in austenite fraction and the formation and the decomposition of WA laths.

Effect of rich air/fuel ratio and temperature on NO_x desorption of lean NO_x trap

An experimental and model-based study of the effect of rich air/fuel ratios(AFRs) and temperature on the NOx slip of a lean NOx trap(LNT) was conducted in a lean-burn gasoline engine with an LNT after-treatment system. The emissions of the engine test bench and the inlet temperature of the LNT were used as the major inlet boundary conditions of the LNT. The engine periodically operated between a constant lean AFR of 23 with alterable rich AFRs of 10, 11, 12, 13, and 14. A decrease in the rich AFR of the engine strengthened the desorption atmosphere in the LNT, an effect closely related to the number of reductants, and further heightened the NOx desorption of the LNT, but with a penalty in fuel consumption. To eliminate that penalty, the inlet boundary conditions of the LNT were varied by adjusting the inlet temperature within a range between 200℃ and 400℃. An increase in inlet temperature heightened the NOx desorption of the LNT, and a NOx breakthrough occurred after the inlet temperature exceeded 390℃. To control NOx breakthrough, the inlet temperature can be adjusted to offset the strong desorption atmosphere in the LNT commonly created by a rich AFR.