Clinical characteristics of community-acquired pneumonia in children caused by mycoplasma pneumoniae with or without myocardial damage:A single-center retrospective study

BACKGROUND Mycoplasma pneumoniae(MP)is a prevalent pathogen that causes respiratory infections in children and adolescents.AIM To assess the differences in the clinical features of MP-associated communityacquired pneumonia(CAP)in children who presented with mild or severe mycoplasma pneumoniae pneumonia(MPP);to identify the incidence of myocardial damage between the two groups.METHODS This work is a retrospective study.We identified children between 2 mo and 16 years of age with clinical and radiological findings consistent with CAP.We admitted patients to the inpatient department of the Second Hospital of Jilin University,Changchun,China,from January 2019 to December 2019.RESULTS A total of 409 hospitalized patients were diagnosed with MPP.Among them were 214(52.3%)males and 195(47.7%)females.The duration of fever and cough was the longest in severe MPP cases.Similarly,plasma levels of highly sensitive Creactive protein(t=-2.834,P<0.05),alanine transaminase(t=-2.511,P<0.05),aspartate aminotransferase(t=-2.939,P<0.05),and lactate dehydrogenase(LDH)(t=-2.939,P<0.05)were all elevated in severe MPP cases compared with mild MPP cases,and these elevations were statistically significant(P<0.05).Conversely,the neutrophil percentage was significantly lower in severe MPP cases than in mild MPP cases.The incidence of myocardial damage was significantly higher in severe MPP cases than in mild MPP cases(χ^(2)=157.078,P<0.05).CONCLUSION Mycoplasma pneumoniae is the main cause of CAP.The incidence of myocardial damage was higher and statistically significant in severe MPP cases than in mild MPP cases.

Clinical significance of TnI, hs-CRP and NT-proBNP in the diagnosis of myocardial damage in uremia patients

Objective:To study the clinical significance of troponinI(TnI),high sensitivity C reactive protein(hs-CRP)and N-terminal pro-brain natriuretic peptide(NT-proBNP)in the diagnosis of myocardial damage in uremia patients.Methods:114 uremia patients treated in our hospital from January 2017 to February 2019 were selected.According to whether myocardial damage occurred,patients were divided into two groups including uremia group(63 cases)anduremia myocardial damage group(51 cases).50 hospitalized patients with non-chronic kidney disease and non-cardiovascular disease in our hospital were selected as control group.The levels of TnI,hs-CRP and NT-proBNP in 1,3 and 7 days after admission were detected and compared.Meanwhile,the ecg indexes of left?ventricular?ejection?fraction(LVEF)and Thickness of the posterior wall of the left ventricle(LVPWd)were recorded and compared.Person correlation was used to analyze the correlation between the levels of TnI,hs-CRP,NT-proBNP and ecg indexes including LVEF and LVPWd.COX regression analysis was used to analyze the independent riskfactors affecting the clinical prognosis of uremia patients.Results:The levels of TnI,hs-CRP,NT-proBNP in the three groups were significantly different on 1,3,7 days after admission.The levels of the three indexes(TnI,hs-CRP,NT-proBNP)in uremia combined with myocardial damage group and uremia group were decreased with treatment.However,the levels of the three indexes(TnI,hs-CRP,NT-proBNP)in uremia combined with myocardial damage group were the highest(P<0.05).Compared with the other two groups,the LVEF of uremia combined with myocardial damage group was the lowest,while the LVPWd was the thickest,showing a significant difference(P<0.05).There was negativecorrelation between LVEF and TnI,hs-CRP,NT-proBNP levels.However,LVPWd was positively correlated with TnI,hs-CRP and NT-proBNP levels(P<0.05).COX regression analysis showed that TnI,hs-CRP,NT-proBNP levels,LVEF and LVPWd were the independent factors affecting the clinical prognosis of uremia patients Conclusion:The level of TnI,hs-CRP,NT-proBNP was dynamic change in the onset and treatment process in uremia combined with myocardial damage patients,which could be used for early diagnosis of uremia combined with myocardial damage.

Role of peroxisome proliferator-activated receptor a activation in acute myocardial damage induced by isoproterenol in rats

Background Peroxisome proliferator-activated receptor （PPAR） a is one of the subtypes of PPARs. It regulates metabolism of lipid and lipoprotein, as well as glucose homeostasis. In addition, PPARa influences cellular proliferation, inflammation, differentiation and apoptosis, which plays a vital role in cardiovascular diseases. The purpose of this study was to investigate the role and mechanisms of PPARa activation in relation to acute myocardial damage induced by isoproterenol in rats. Methods Thirty male Wister rats were randomly divided into control group, isoproterenol （Iso） injured group and fenofibrate （FF） treatment group. Acute myocardial damage caused by isoproterenol intraperitoneal injection induced ischemia was established. We determined the levels of creatine kinase （CK） and lactic dehydrogenase （LDH） in serum as well as the concentrations of free fatty acids （FFA） in serum and myocardium. The mRNA expressions of PPARa, muscular type carnitine palmitransferase （M-CPT-I） and medium chain lipid acetyl coenzyme A dehydrogenase （MCAD） were analyzed by reverse transcription-polymerase chain reaction （RT-PCR）. Results Compared with the control group, the levels of serum CK and LDH were significantly increased after FF and Iso treatments. Moreover, the concentrations of FFA in both serum and myocardium were obviously increased in the Iso group and FF group, while the mRNAexpressions of PPARa, M-CPT-I and MCAD declined, respectively （P〈0.01）. When compared with the Iso group, significant decreases in serum CK and LDH were observed in the FF group. The concentrations of FFA both in serum and myocardial tissue were markedly decreased in the FF group, while the expressions of PPARa, M-CPT-I and MCAD mRNA were increased （vs Iso, P〈0.01）. Conclusions The utilization of FFA was reduced in isoproterenol induced acute myocardial damage. PPARa activation by its activator fenofibrate may play a key role in energy metabolism in acute myocardial damage induced by isoproterenol in rats.

Preventive effect of Fangshuan capsule on PCI-induced myocardial damage and vascular endothelial injury in patients with unstable angina pectoris

Objective To observe the prevention of Fangshuan Capsule(FC)on percutaneous coronary intervention(PCI)induced myocardial damage and vascular endothelial injury in patients with unstable angina pectoris(UAP).Methods Totally 100 UAP patients undergoing PCI were assigned to the control group and the

The research status of Asprosin and its application prospect in the protection of myocardial injury

Asprosin is a newly discovered protein hormone that promotes appetite,regulates glucose homeostasis,increases insulin resistance and has potential myocardial protection.Myocardium is vulnerable to oxidative stress injury caused by factors such as high glucose,anti-tumor drugs,ischemia reperfusion and so on,and currently there is a lack of effective preventive measures.It has been reported in the literature that Asprosin has a unique protective effect on myocardium,but the protective mechanism of Asprosin is not clear.In this paper,the general situation and functions of Asprosin,as well as the protective mechanism of Asprosin on myocardium were reviewed,in order to provide reference for the application of Asprosin in the treatment of cardio-related diseases.

COVID-19 Related Organ Damage

Coronavirus particles contain four main structural proteins. These are the spike (S), membrane (M), envelope (E), and nucleocapsid (N) proteins, all of which are encoded within the 3’ end of the viral genome. The S protein (~150 kDa) utilizes an N-terminal signal sequence to gain access to the ER, and is heavily N-linked glycosylated. In view of the increase in death due to COVID-19 (coronavirus disease), it is important to investigate the potential effects the coronavirus on different organs. A literature search was performed from Elsevier, Pubmed, Springer, and Hindawi, and literature is reviewed using customized search strategies. The search strategy included the following terms Cardiovascular effect, Neurological effect, and kidney. Myocardial damage is a common occurrence in patients with COVID-19 disease hospitalisation. This is characterized by a rise in troponin. Vascular endothelial damage in both small and mid-sized pulmonary vessels was noted together with Disseminated intravascular coagulation (DIC), Deep vein thrombosis (DVT), and Pulmonary embolism (PE), resulting in pulmonary infarction. Liver damage in patients with coronavirus infections might be directly caused by the viral infection of liver cells. Neuronal pathway is an important vehicle for neurotropic viruses to enter the CNS (Central Nervous system). Recent research studies show that apoptosis is implicated in a variety of ocular disorders, including glaucoma, retinitis pigmentosa, cataract development, retinoblastoma, retinal ischemia, diabetic retinopathy, and ocular murine glaucoma. The more the understanding about this new virus and its occurrence, the better the ability of people to cope with it. It’s far hoped that we will conquer COVID-19 soon with the invention of powerful vaccines, pills, and remedies.

Hepatic ischemia-reperfusion syndrome and its effect on the cardiovascular system: The role of treprostinil, a synthetic prostacyclin analog

Hepatic ischemia-reperfusion syndrome has been the subject of intensive study and experimentation in recent decades since it is responsible for the outcome of several clinical entities,such as major hepatic resections and liver transplantation.In addition to the organ’s post reperfusion injury,this syndrome appears to play a central role in the dysfunction of distant tissues and systems.Thus,continuous research should be directed toward finding effective therapeutic options to improve the outcome and reduce the postoperative morbidity and mortality rates.Treprostinil is a synthetic analog of prostaglandin I2,and its experimental administration has shown encouraging results.It has already been approved by the Food and Drug Administration in the United States for pulmonary arterial hypertension and has been used in liver transplantation,where preliminary encouraging results showed its safety and feasibility by using continuous intravenous administration at a dose of 5 ng/kg/min.Treprostinil improves renal and hepatic function,diminishes hepatic oxidative stress and lipid peroxidation,reduces hepatictoll-like receptor 9 and inflammation,inhibits hepatic apoptosis and restores hepatic adenosine triphosphate(ATP)levels and ATP synthases,which is necessary for functional maintenance of mitochondria.Treprostinil exhibits vasodilatory properties and antiplatelet activity and regulates proinflam-matory cytokines;therefore,it can potentially minimize ischemia-reperfusion injury.Additionally,it may have beneficial effects on cardiovascular parameters,and much current research interest is concentrated on this compound.

Coxsackievirus A6 was the most common enterovirus serotype causing hand,foot,and mouth disease in Shiyan City,central China

BACKGROUND Hand,foot,and mouth disease(HFMD)has become one of the most common infectious diseases in China.Before 2016,the primary causal serotypes were enterovirus A71(EV-A71)and coxsackievirus A16(CV-A16).Following the introduction of EV-A71 vaccines in China since 2016,the situation could change.CV-A6 has recently replaced EV-A71 and CV-A16 in some areas of China.However,the epidemiological characteristics of central China remain unknown.AIM To investigate the clinical symptoms and pathogen spectrum of HFMD in Shiyan City,central China,in recent years.METHODS The epidemiological,clinical,and laboratory data from HFMD cases reported to the Shiyan Center for Disease Control and Prevention between January 2016 and December 2020 were analyzed.196 throat swab specimens were collected from hospitalized HFMD patients between January 2018 and December 2020.To detect and genotype enteroviruses,real-time reverse transcription-polymerase chain reaction and sequencing of the 5'-untranslated region were used.In Shiyan,168 laboratory-confirmed HFMD cases were studied using a logistic regression model to determine the effect of predominant enterovirus serotypes.Based on the logistic regression model,the least absolute shrinkage and selection operator model was used to analyze the correlation between CV-A6 infection and various clinical characteristics in HFMD patients in Shiyan.RESULTS From 2016 to 2020,35840 HFMD cases were reported in Shiyan.The number of cases decreased by 48.4%from 2016 to 2017.Approximately 1.58-fold increases were found in 2018 and 2019 when compared to the previous year,respectively.In 2020,a decrease of about 85.5%was reported when compared to 2019.The most common serotypes shifted from EV-A71 and CV-A16(about 60%-80%in 2016 and 2018)to others(more than 80.0%in 2017,2019,and 2020).EV-A71 lost its dominance in 2017 in Shiyan.Among 196 confirmed HFMD cases,85.7%tested positive for enterovirus,with CV-A6 being the most common serotype(121/168,72.0%).The positive rates for CV-A16 and CVA10 were 4.8%and 3.0%,respectively.There was no EV-A71 discovered.Infection with CV-A6 was linked to fever,myocardial damage,increased creatine kinase MB isoenzyme,and lactate dehydrogenase levels.CONCLUSION CV-A6 was the most common enterovirus serotype in Shiyan City,replacing EV-A71 and CV-A16 as the HFMD pathogen.Developing vaccines against CV-A6 or multiple pathogens,as well as rising CV-A6 surveillance,will help prevent HFMD in central China.

Comprehensive Left Ventricular Mechanics Analysis by Speckle Tracking Echocardiography in COVID-19

Background: Cardiac involvement and the consequences of inflammation induced by SARS-CoV2 infection could have catastrophic long-term consequences. Left ventricular mechanics could identify a specific pattern of myocardial fiber damage in patients infected with COVID-19. To our knowledge there are no publications referring to the global description of ventricular mechanics in patients with COVID-19. Objective: To describe left ventricular mechanics in hospitalized patients with COVID-19. Methods: In this cross-sectional study, we included 40 hospitalized patients with confirmed diagnostic of COVID-19, from April 11, 2020, to September 6, 2020. Demographic and laboratory data, clinical and echocardiographic characteristics were collected, as well as events during hospitalization. Left ventricular deformation was analyzed and reported. Results: Subclinical dysfunction was observed in 82.5% (left ventricular longitudinal strain [LVGLS] -17.05% and global circumferential strain [GCS] -18.6%) of the patients, likewise, the mean twist and apical rotation were preserved, and even increased as part of the compensating mechanism to maintain the ejection fraction. Conclusion: In patients hospitalized with COVID-19, despite having a normal left ventricular ejection fraction, subclinical myocardial damage was found, manifested by a decrease in Global Longitudinal Strain (GLS) and Global Circumferential Strain (GCS). This behavior is similar to that of cardiomyopathies in the early stage of the disease, and given the pathophysiological mechanisms involved in the disease, its long-term consequences should be monitored and evaluated.

Level of Cardiac Biomarkers in Immediate Post-Operative Period after Off-Pump CABG and Its Comparison with On-Pump CABG: A Prospective Analytical Study

Background: Coronary artery bypass grafting (CABG) is an important modality of treatment for ischemic heart disease. Both off-pump and on-pump CABG have direct effect on the level cardiac biomarkers in the perioperative period. The use of cardiopulmonary bypass (CPB) and aortic cross-clamping may cause additive myocardial damage leading to further elevation of blood markers. The present study is aimed at measuring and comparing the cardiac biomarker levels in immediate post-operative period after on-pump CABG (ONCAB) and off-pump CABG (OPCAB). Methods: All the patients who underwent CABG from January 2015 to June 2016 on elective or emergency basis at Nilratan Sircar Medical College & Hospital have been included in the study. Total 106 patients were operated for CABG of which 75 patients were operated for OPCAB and 31 patients were operated for ONCAB. For the comparison of data the blood markers Troponin-T (Trop-T) and Creatine Kinase-MB (CK-MB) are measured during anesthesia before surgery, post-operatively after 1 hour, post-operatively after 4 hours and post-operatively after 20 hours. All recorded data are analyzed using standard statistical methods. Results: We found the markers are elevated immediately after surgery and gradually come down within 24 hours after surgery in both OPCAB and ONCAB groups. The elevation is more after ONCAB than OPCAB group in immediate post-operative period but the difference is not significant after 20 hours of surgery. Conclusion: Elevated levels of cardiac biomarkers in the immediate post-operative period indicate myocardial damage during surgery, especially after ONCAB in comparison to OPCAB. This may attribute to the better hemodynamic stability in the immediate post-operative period after OPCAB than ONCAB assuming comparable and adequate revascularization in patients of both groups. The avoidance of CPB and cross-clamp may explain better myocardial functioning immediately after OPCAB. But after 20 hours, the level of cardiac markers is comparable in both groups indicating little difference in post-operative recovery and long-term prognosis.

Antioxidative Effects of Rubidate on Ischemic Myocardium in Mice

Rubidate is a phenolic compound. The present investigation was designed to establishwhether rubidate protects the heart muscle against tlie deleterious effects of ttie oxygen free radicals pro-deced by isoproterenol (ISO)-indiJced myocardial ischemia in mice. ISO treatment (30 mg ·kg-1 subcuta-neous injection once daily for 2 days) caused widespread and severe myocardial cell damage- decreased my-ocardial glutathione peroxidase (GSH-Px) , superoxide dismutase (SOD) activities and increased myocardialmalondialdehyde I MDA) content. Rubidate pretreatment 500 mg· kg-1 , 2000 mg· kg-1 x 7d protected GSH-Px, SOD activity in the tiearts of ISO-treated mice. Rubidate 2000 mg . kg` diminished MDA production.However, rubidate 500 mg·kg-1 did not show such an effect. This study demonstrated that rubidate inhibitedIipid peroxidation (LPO, expressed by malondialdehyde formation) , scavenged.O2 and H2O2.It may beconcluded that rubidate exhibits an antioxidative activity via scavenging free radicals.