BACKGROUND： Coronary microembolization （CME） is a serious complication following percutaneous coronary intervention （PCI） in patients with acute coronary syndromes. The use of metoprolol before PCI can significan...BACKGROUND： Coronary microembolization （CME） is a serious complication following percutaneous coronary intervention （PCI） in patients with acute coronary syndromes. The use of metoprolol before PCI can significantly protect ischemic myocardium from myocardial damage, but the function of metoprolol in the treatment of CME is not entirely clear. This study was to explore the effect and significance of metoprolol on myocardial apoptosis and caspase-3 activation after CME in rats. METHODS： Thirty rats were randomly divided into three groups including sham-operation （control group）, CME plus saline （CME group）, CME plus metoprolol （metoprolol group）, 10 rats for each group. The CME group was induced by injecting 3 000 polyethylene microspheres （42 tJm） into the left ventricle during a 10-second occlusion of the ascending aorta; the control group was injected with physiological saline instead of microembolization ball; the metoprolol or saline group was given three intravenous bolus injections before CME. Echocardiography, TUNEL staining, and Western blotting were used to evaluate cardiac function, proportion of apoptotic cells and activation of caspase-3 respectively at 6 hours after operation. RESULTS： Echocardiographic parameters displayed that the metoprolol group improved cardiac function significantly compared with the CME group （P〈0.05）. The myocardial apoptotic rate of the CME group as well as the contents of activated caspase-3 increased significantly （P〈0.05）, both of which were ameliorated significantly by metoprolol treatment （P〈0.05）. CONCLUSIONS： This study demonstrates that metoprolol can protect the myocardium during CME in rats by inhibiting apoptosis and improving cardiac function. These results suggest that the inhibition of apoptosis can be a potential therapeutic strategy for the treatment of CME.展开更多
BACKGROUND Coronavirus disease 2019(COVID-19)is a major public health emergency with obvious characteristics of human-to-human transmission,and there are infective asymptomatic carriers.Early identification and proper...BACKGROUND Coronavirus disease 2019(COVID-19)is a major public health emergency with obvious characteristics of human-to-human transmission,and there are infective asymptomatic carriers.Early identification and proper management of patients with COVID-19 are important.Features in chest computed tomography(CT)can facilitate identifying newly infected individuals.However,CT findings of some lung contusions are similar to those of COVID-19,as shown in the present case.CASE SUMMARY A 46-year-old woman was admitted to hospital for backache and foot pain caused by a fall injury 1 d before hospitalization.She was suspected of having COVID-19,since there was a confirmed COVID-19 case near her residence.But she had no fever,cough,chest tightness,difficult breathing,nausea,vomiting,or diarrhea,etc.On physical examination,the lower posterior chest of both sides showed dullness on percussion and moist rales at the end of inspiration on auscultation.The white blood cell count and lymphocyte count were 10.88×109/L and 1.04×109/L,respectively.CT performed on February 7,2020 revealed that both lungs were scattered with patchy ground-glass opacity.The patient was diagnosed with pulmonary contusion with thoracic spinal fracture(T12),calcaneal fracture,and pelvic fracture.On day 9 after conservative treatment,her condition was alleviated.On review of the chest CT,the previous shadows were significantly reduced.CONCLUSION Differential diagnosis of lung contusion and COVID-19 must be emphasized.Both conditions require effective prompt actions,especially COVID-19.展开更多
基金supported by a grant from the National Natural Science Foundation of China(30760262/C030313)
文摘BACKGROUND： Coronary microembolization （CME） is a serious complication following percutaneous coronary intervention （PCI） in patients with acute coronary syndromes. The use of metoprolol before PCI can significantly protect ischemic myocardium from myocardial damage, but the function of metoprolol in the treatment of CME is not entirely clear. This study was to explore the effect and significance of metoprolol on myocardial apoptosis and caspase-3 activation after CME in rats. METHODS： Thirty rats were randomly divided into three groups including sham-operation （control group）, CME plus saline （CME group）, CME plus metoprolol （metoprolol group）, 10 rats for each group. The CME group was induced by injecting 3 000 polyethylene microspheres （42 tJm） into the left ventricle during a 10-second occlusion of the ascending aorta; the control group was injected with physiological saline instead of microembolization ball; the metoprolol or saline group was given three intravenous bolus injections before CME. Echocardiography, TUNEL staining, and Western blotting were used to evaluate cardiac function, proportion of apoptotic cells and activation of caspase-3 respectively at 6 hours after operation. RESULTS： Echocardiographic parameters displayed that the metoprolol group improved cardiac function significantly compared with the CME group （P〈0.05）. The myocardial apoptotic rate of the CME group as well as the contents of activated caspase-3 increased significantly （P〈0.05）, both of which were ameliorated significantly by metoprolol treatment （P〈0.05）. CONCLUSIONS： This study demonstrates that metoprolol can protect the myocardium during CME in rats by inhibiting apoptosis and improving cardiac function. These results suggest that the inhibition of apoptosis can be a potential therapeutic strategy for the treatment of CME.
文摘BACKGROUND Coronavirus disease 2019(COVID-19)is a major public health emergency with obvious characteristics of human-to-human transmission,and there are infective asymptomatic carriers.Early identification and proper management of patients with COVID-19 are important.Features in chest computed tomography(CT)can facilitate identifying newly infected individuals.However,CT findings of some lung contusions are similar to those of COVID-19,as shown in the present case.CASE SUMMARY A 46-year-old woman was admitted to hospital for backache and foot pain caused by a fall injury 1 d before hospitalization.She was suspected of having COVID-19,since there was a confirmed COVID-19 case near her residence.But she had no fever,cough,chest tightness,difficult breathing,nausea,vomiting,or diarrhea,etc.On physical examination,the lower posterior chest of both sides showed dullness on percussion and moist rales at the end of inspiration on auscultation.The white blood cell count and lymphocyte count were 10.88×109/L and 1.04×109/L,respectively.CT performed on February 7,2020 revealed that both lungs were scattered with patchy ground-glass opacity.The patient was diagnosed with pulmonary contusion with thoracic spinal fracture(T12),calcaneal fracture,and pelvic fracture.On day 9 after conservative treatment,her condition was alleviated.On review of the chest CT,the previous shadows were significantly reduced.CONCLUSION Differential diagnosis of lung contusion and COVID-19 must be emphasized.Both conditions require effective prompt actions,especially COVID-19.
