BACKGROUND Despite sharing similar pathogenic factors,cancer and coronary heart disease(CHD)occur in comparable populations at similar ages and possess similar susceptibility factors.Consequently,it is increasingly co...BACKGROUND Despite sharing similar pathogenic factors,cancer and coronary heart disease(CHD)occur in comparable populations at similar ages and possess similar susceptibility factors.Consequently,it is increasingly commonplace for patients to experience the simultaneous occurrence of cancer and CHD,a trend that is steadily rising.AIM To determine the impacts of continuing care on lung cancer patients with CHD following percutaneous coronary intervention(PCI).METHODS There were 94 lung cancer patients with CHD following PCI who were randomly assigned to the intervention group(n=38)and the control group(n=41).In the intervention group,continuing care was provided,while in the control group,routine care was provided.An evaluation of cardiac and pulmonary function,medication compliance,a 6-min walk test,and patient quality of life was performed.RESULTS Differences between the two groups were significant in left ventricular ejection fraction,6-min walk test,oxygen uptake,quality of life and medication compliance(P<0.05).In comparison with the control group,the enhancement in the intervention group was more significant.The intervention group had more patients with high medication compliance than the control group,with a statistically significant difference(P<0.05).CONCLUSION After undergoing PCI,lung patients with CHD could benefit from continued care in terms of cardiac and pulmonary function,medications compliance,and quality of life.展开更多
Objective: To treat the patients with type 2 diabetes mellitus complicated with coronary heart disease, to explore the clinical efficacy and mechanism of conventional western medicine combined with Yiqi Yangyin Huoxue...Objective: To treat the patients with type 2 diabetes mellitus complicated with coronary heart disease, to explore the clinical efficacy and mechanism of conventional western medicine combined with Yiqi Yangyin Huoxue herbs, and to detect the level of serum fibroblast growth factor-21 (FGF-21) and Ghrelin. Changes and significance. Methods: A randomized control method was used to collect 100 patients with type 2 diabetes mellitus complicated with coronary heart disease who were diagnosed and treated in our hospital from March 2015 to March 2018.They were randomly divided into two groups according to the random number table method: 50 patients separately. The patients in the control group were treated with conventional western medicine and basic treatment;the observation group was treated with the addition and subtraction of traditional Chinese medicine formulas on the basis of the control group;the clinical curative effect was evaluated after two months of treatment, and the treatment efficiency and scores of traditional Chinese medicine symptoms were observed in the two groups. Basic laboratory indicators were improved, and serum levels of FGF-21 and Ghrelin in patients were measured and the difference between the results of the tests was compared with the condition and efficacy. Results: After treatment, the total effective rate of the observation group (86.0%) was significantly higher than that of the control group (68.0%) (P<0.05), suggesting that the combination of Chinese and Western medicine treatment can significantly improve the clinical efficacy;before treatment,there is no difference between the two groups of Chinese medicine symptom scores (P>0.05). After treatment, the symptom scores of the two groups were significantly improved after treatment (P<0.05). The observation group was better among the two groups (P<0.05).After treatment, the basic biochemical indicators were improved. The observation group was better than the control group (P<0.05);Serum FGF-21 levels were significantly lower in both groups after treatment (P<0.05), and Ghrelin levels were significantly increased. There was a statistically significant difference between the two groups (P<0.05). Conclusion: The use of conventional western medicine in combination with Yiqi Yangyin Huoxue Chinese medicine for the treatment of type 2 diabetes mellitus patients with coronary heart disease can significantly improve the clinical efficacy, effectively promote the improvement of symptoms, and can be used in clinical work through serum FGF-21, Ghrelin levels combined detection of the value of Abnormal changes to predict the severity of type 2 diabetes mellitus with coronary heart disease severity and treatment effect should be widely used in clinical diagnosis and treatment.展开更多
This report introduced and summarized the nursing care experience for a senior patient with lung cancer and developed programmed cell death protein 1(PD-1)immunotherapy-related myocarditis combined with coronary heart...This report introduced and summarized the nursing care experience for a senior patient with lung cancer and developed programmed cell death protein 1(PD-1)immunotherapy-related myocarditis combined with coronary heart disease(CHD)after receiving said treatment.In this case,immune myocarditis with CHD occurred shortly after implementing the PD-1 immunotherapy,yet the patient presented no clinical symptoms.Frequent nursing attention and close observation are so required for monitoring the patient’s status and updating the physicians for a swift control of the myocarditis.For this case,nursing care procedures vital for the successful recovery of the patient included condition observation,position management,pre-and postcoronary angiography care,infection prevention,hemorrhage prevention,venous access port maintenance,pain care,trachea care,psychological care,diet care,environment management,and health education.After receiving effective,successful treatment and care,the patient was discharged after 13 days of treatment with generally satisfying overall conditions.展开更多
A 69-year-old woman with angina had a lesion in the left lower lobe on chest film. Angiography revealed coronary artery disease in three vessels. Combined off pump coronary artery bypass grafting (CABG) and left low...A 69-year-old woman with angina had a lesion in the left lower lobe on chest film. Angiography revealed coronary artery disease in three vessels. Combined off pump coronary artery bypass grafting (CABG) and left lower lobectomy were performed through median sternotomy. This approach avoids complications due to staged operations and cardiopulmonary bypass (CPB). This report shows that simultaneous off pump CABG and pulmonary operations can be performed safely in patients with coronary artery disease (CAD) associated with lung cancer.展开更多
AIM: To investigate the role of [breast and ovarian cancer susceptibility 1(BRCA1)-associated RING domain 1(BARD1)]/BRCA1 E3-ubiquitin ligase complex in governing the stability of mutant liver X receptor-(LXR-α...AIM: To investigate the role of [breast and ovarian cancer susceptibility 1(BRCA1)-associated RING domain 1(BARD1)]/BRCA1 E3-ubiquitin ligase complex in governing the stability of mutant liver X receptor-(LXR-α) protein in coronary heart disease(CHD) subjects.METHODS: The expression analysis of various genes was carried out by quantitative real time polymerase chain reaction and western blotting within blood mononuclear cells of human CHD subjects at various stages of coronary occlusion and their corresponding normal healthy counterparts.Immunoprecipitation experiments were performed to establish protein interactions between LXR-αand BARD1.Peripheral blood mononuclear cells were cultured and exposed to Vitamin D3 and Cisplatin to validate the degradation of mutant LXR-αprotein in CHD subjects by BARD1/BRCA1 complex.RESULTS: The expression of mutant LXR-αprotein in CHD subjects was found to decrease gradually with the severity of coronary occlusion exhibiting a strong negative correlation,r =-0.975 at P 【 0.001.Further,the expression of BARD1 and BRCA1 also increased with the disease severity,r = 0.895 and 0.873 respectively(P 【 0.001).Immunoprecipitation studies established that BARD1/BRCA1 complex degrades mutant LXR-αvia ubiquitination.The absence of functional LXR-αprotein resulted in increased expression of inflammatory cytokines such as interleukin(IL)-6,IL-8 and interferon-and decreased expression of ABCA1(ATP-binding cassette A1)(r = 0.932,0.949,0.918 and-0.902 with respect to Gensini score;P 【 0.001).Additionally,cell culture experiments proved that Vitamin D3 could prevent the degradation of mutant LXR-αand restore its functional activity to some extent.CONCLUSION: Mutant LXR-αprotein in CHD subjects is degraded by BARD1/BRCA1 complex and Vitamin D3 can rescue and restore its function.展开更多
Case 1 was a 49-year-old woman who visited with a dry cough. She had an underlying disease of lung adenocarcinoma and received cancer immunotherapy because of an ALK-positive response and several cancer chemotherapies...Case 1 was a 49-year-old woman who visited with a dry cough. She had an underlying disease of lung adenocarcinoma and received cancer immunotherapy because of an ALK-positive response and several cancer chemotherapies. The clinical effect was a complete response. Chest CT was performed because of continuous dry cough, and a new tumor shadow was recognized in the lingula portion of the left upper lobe. We performed CT-guided lung biopsy and could aspirate pus-fluid. The culture test for acid-fast bacilli was positive and the causative microorganism was identified as Mycobacterium avium by the DDH method. The final diagnosis was pulmonary abscess due to M. avium. Treatment using combined chemotherapy including CAM was performed and a good clinical response was obtained. Case 2 was a 67-year-old man who had a past history of surgical resection of lung adenocarcinoma eight and two years ago and received several cancer chemotherapies and radiation therapy. Because a new nodular shadow appeared in the right middle lobe one year ago and showed strong positivity on PET/CT, surgical resection was performed with the suspected recurrence of lung cancer. Subsequently, the histological diagnosis was epithelioid granuloma and a culture test of acid-fast bacilli was positive, with the identification of Mycobacterium intracellulare by the DDH method. Combined chemotherapy was not performed because the lesion was completely resected. Afterwards, a new nodular shadow appeared in the left lower lobe again and bronchoscopy was performed. Because M. intracellulare was isolated from the local specimen, we diagnosed the patient with recurrence of pulmonary MAC disease and combined chemotherapy including CAM was performed for one year. Finally, the nodular lesion disappeared. It is difficult to differentiate pulmonary MAC disease from lung cancer. Therefore, careful follow-up of patients with lung cancer while keeping in mind the possible complication of pulmonary MAC disease is necessary.展开更多
Non-alcoholic fatty liver disease(NAFLD)has emerged as a public health problem of epidemic proportions worldwide.Accumulating clinical and epidemiological evidence indicates that NAFLD is not only associated with live...Non-alcoholic fatty liver disease(NAFLD)has emerged as a public health problem of epidemic proportions worldwide.Accumulating clinical and epidemiological evidence indicates that NAFLD is not only associated with liver-related morbidity and mortality but also with an increased risk of coronary heart disease(CHD),abnormalities of cardiac function and structure(e.g.,left ventricular dysfunction and hypertrophy,and heart failure),valvular heart disease(e.g.,aortic valve sclerosis)and arrhythmias(e.g.,atrial fibrillation).Experimental evidence suggests that NAFLD itself,especially in its more severe forms,exacerbates systemic/hepatic insulin resistance,causes atherogenic dyslipidemia,and releases a variety of pro-inflammatory,pro-coagulant and pro-fibrogenic mediators that may play important roles in the pathophysiology of cardiac and arrhythmic complications.Collectively,these findings suggest that patients with NAFLD may benefit from more intensive surveillance and early treatment interventions to decrease the risk for CHD and other cardiac/arrhythmic complications.The purpose of this clinical review is to summarize the rapidly expanding body of evidence that supports a strong association between NAFLD and cardiovascular,cardiac and arrhythmic complications,to briefly examine the putative biological mechanisms underlying this association,and to discuss some of the current treatment options that may influence both NAFLD and its related cardiac and arrhythmic complications.展开更多
Hydrostatic pulmonary edema is as an abnormal in-crease in extravascular water secondary to elevatedpressure in the pulmonary circulation, due to conges-tive heart failure or intravascular volume overload.Diagnosis of...Hydrostatic pulmonary edema is as an abnormal in-crease in extravascular water secondary to elevatedpressure in the pulmonary circulation, due to conges-tive heart failure or intravascular volume overload.Diagnosis of hydrostatic pulmonary edema is usuallybased on clinical signs associated to conventional ra-diography findings. Interpretation of radiologic signsof cardiogenic pulmonary edema are often question-able and subject. For a bedside prompt evaluation,lung ultrasound(LUS) may assess pulmonary conges-tion through the evaluation of vertical reverberationartifacts, known as B-lines. These artifacts are relatedto multiple minimal acoustic interfaces between smallwater-rich structures and alveolar air, as it happens incase of thickened interlobular septa due to increase of extravascular lung water. The number, diffusion and in-tensity of B lines correlates with both the radiologic andinvasive estimate of extravascular lung water. The inte-gration of conventional chest radiograph with LUS canbe very helpful to obtain the correct diagnosis. Com-puted tomography(CT) is of limited use in the work upof cardiogenic pulmonary edema, due to its high cost,little use in the emergencies and radiation exposure.However, a deep knowledge of CT signs of pulmonaryedema is crucial when other similar pulmonary condi-tions may occasionally be in the differential diagnosis.展开更多
Objective:To establish a rat model of transfusion-related acute lung injury(TRALI)with coronary heart disease(CHD),and to analyze the safety of blood transfusion through oxygen balance.Methods:Forty-five 10-day-old ma...Objective:To establish a rat model of transfusion-related acute lung injury(TRALI)with coronary heart disease(CHD),and to analyze the safety of blood transfusion through oxygen balance.Methods:Forty-five 10-day-old male Wistar rats were purchased,and 35 of them were fed with high-fat diet to establish coronary heart disease rat models,and then 20 of them were selected to establish rat models of transfusion-related acute lung injury with coronary heart disease(model group,10 rats),positive acute lung injury group(positive group,5 rats)and negative acute lung injury group(negative group,5 rats),and the lung histomorphology,pathological score and wet/dry weight ratio were compared.Then,another 15 rats with coronary heart disease were selected and infused with mutant Hb,rHb1.1 and rHb2.0 with the same osmotic pressure through femoral vein catheterization,respectively,and were divided into mutant Hb group,rHb1.1 group and rHb2.0 group,with 5 rats in each group,and 5 healthy rats were combined as control group.The MAP,HR and blood gas values of mesenteric artery of rats were compared at 0,30,60 and 90 min after infusion.Results:(1)Rats in the model group and the positive group showed symptoms such as irregular and shallow breathing,increased oral and nasal secretions,and audible wheezing,which were consistent with the symptoms of acute lung injury.Comparison of lung histological score and lung tissue wet/dry ratio in three groups:There was no significant difference in lung histological score and lung tissue wet/dry ratio(P>0.05),but they were higher than those in the negative group(P<0.05).(2)During hemoglobin infusion,the MAP of mutant Hb group,rHb1.1 group and rHb2.0 group was higher than that of the control group,while the pH and PaCO2were lower than those of the control group(P<0.05),and there was no significant difference in QSMA(P>0.05).In the mutant Hb group,MAP returned to normal at 30-60 min after infusion(P>0.05),but MAP increased again at 90 min after infusion(P<0.05),and QSMA increased significantly at 60 min after transfusion(P<0.05).The pH value was lower than the normal value and the PaCO2was higher than the normal value within 90 min of infusion(P<0.05),and the HCO3-level returned to normal after 30 min of infusion(P>0.05).In rHb 1.1 group,MAP returned to normal,QSMA remained at normal level(P>0.05),and pH,PaCO2and HCO3-returned to normal after 60 min of infusion(P>0.05);In rHb 2.0 group,the levels of MAP,pH,PaCO2and HCO3-returned to normal after 30 min of infusion(P>0.05),and QSMA remained normal during infusion(P>0.05).Conclusion:The rat model of transfusion-relatted acute lung injury with coronary heart disease can be successfully established by injecting LPS into the rat model of coronary heart disease,and the infusion of recombinant hemoglobin can improve the balance of blood supply in rats,in which the infusion of rHb2.0 can better correct the metabolic acidosis.展开更多
目的:运用网络药理学分析方法探究黄芪治疗糖尿病合并冠心病的可能性作用靶点以及其作用机制。方法:借助TCMSP平台及Uniprot数据库检索筛选黄芪的活性成分及其相应靶点;在GeneCards数据库、OMIM数据库中检索糖尿病合并冠心病的疾病靶点...目的:运用网络药理学分析方法探究黄芪治疗糖尿病合并冠心病的可能性作用靶点以及其作用机制。方法:借助TCMSP平台及Uniprot数据库检索筛选黄芪的活性成分及其相应靶点;在GeneCards数据库、OMIM数据库中检索糖尿病合并冠心病的疾病靶点,通过Cytoscape 3.9.1得到黄芪-活性成分-靶基因的可视化网络图;将疾病与药物对应靶点共同提交Venny2.1.0生成相交靶点,并通过蛋白质相互作用(STRING)平台构建蛋白质相互作用(PPI)网络。基于Metascape 3.9.1数据库进行GO富集分析和KEGG通路富集分析明确可能涉及到的生物进程及信号通路。最后应用分子对接技术对上述猜想进行粗浅验证。结果:共获取黄芪的关键化合物17个,对应靶点195个,疾病相关靶点3815个,导入Venny2.1.0中生成163个交集靶点。富集分析结果表明:黄芪治疗糖尿病合并冠心病主要涉及激素反应(response to hormone)、细胞有机循环化合物反应(cellular response to organic cyclic compound)、细胞脂质反应(cellular response to lipid)、无机物反应(response to inorganic substance)等生物进程;可能涉及到癌症通路(Pathways in cancer)、脂质及动脉硬化通路(Lipid and atheroscierosis)、糖尿病并发症中的AGE-RAGE信号通路(AGE-RAGE signaling pathway in diabetic complications)、P13K-AKT信号通路(P13K-AKt signaling pathway)等信号通路。分子对接结果提示药物活性分子与核心靶点有较好的结合。结论:该研究揭示了黄芪在机体内可能参与抑制胰岛素抵抗、糖脂代谢调控等众多生物进程,以多成分、多靶点、多通路实现对糖尿病合并冠心病的治疗作用。展开更多
文摘BACKGROUND Despite sharing similar pathogenic factors,cancer and coronary heart disease(CHD)occur in comparable populations at similar ages and possess similar susceptibility factors.Consequently,it is increasingly commonplace for patients to experience the simultaneous occurrence of cancer and CHD,a trend that is steadily rising.AIM To determine the impacts of continuing care on lung cancer patients with CHD following percutaneous coronary intervention(PCI).METHODS There were 94 lung cancer patients with CHD following PCI who were randomly assigned to the intervention group(n=38)and the control group(n=41).In the intervention group,continuing care was provided,while in the control group,routine care was provided.An evaluation of cardiac and pulmonary function,medication compliance,a 6-min walk test,and patient quality of life was performed.RESULTS Differences between the two groups were significant in left ventricular ejection fraction,6-min walk test,oxygen uptake,quality of life and medication compliance(P<0.05).In comparison with the control group,the enhancement in the intervention group was more significant.The intervention group had more patients with high medication compliance than the control group,with a statistically significant difference(P<0.05).CONCLUSION After undergoing PCI,lung patients with CHD could benefit from continued care in terms of cardiac and pulmonary function,medications compliance,and quality of life.
文摘Objective: To treat the patients with type 2 diabetes mellitus complicated with coronary heart disease, to explore the clinical efficacy and mechanism of conventional western medicine combined with Yiqi Yangyin Huoxue herbs, and to detect the level of serum fibroblast growth factor-21 (FGF-21) and Ghrelin. Changes and significance. Methods: A randomized control method was used to collect 100 patients with type 2 diabetes mellitus complicated with coronary heart disease who were diagnosed and treated in our hospital from March 2015 to March 2018.They were randomly divided into two groups according to the random number table method: 50 patients separately. The patients in the control group were treated with conventional western medicine and basic treatment;the observation group was treated with the addition and subtraction of traditional Chinese medicine formulas on the basis of the control group;the clinical curative effect was evaluated after two months of treatment, and the treatment efficiency and scores of traditional Chinese medicine symptoms were observed in the two groups. Basic laboratory indicators were improved, and serum levels of FGF-21 and Ghrelin in patients were measured and the difference between the results of the tests was compared with the condition and efficacy. Results: After treatment, the total effective rate of the observation group (86.0%) was significantly higher than that of the control group (68.0%) (P<0.05), suggesting that the combination of Chinese and Western medicine treatment can significantly improve the clinical efficacy;before treatment,there is no difference between the two groups of Chinese medicine symptom scores (P>0.05). After treatment, the symptom scores of the two groups were significantly improved after treatment (P<0.05). The observation group was better among the two groups (P<0.05).After treatment, the basic biochemical indicators were improved. The observation group was better than the control group (P<0.05);Serum FGF-21 levels were significantly lower in both groups after treatment (P<0.05), and Ghrelin levels were significantly increased. There was a statistically significant difference between the two groups (P<0.05). Conclusion: The use of conventional western medicine in combination with Yiqi Yangyin Huoxue Chinese medicine for the treatment of type 2 diabetes mellitus patients with coronary heart disease can significantly improve the clinical efficacy, effectively promote the improvement of symptoms, and can be used in clinical work through serum FGF-21, Ghrelin levels combined detection of the value of Abnormal changes to predict the severity of type 2 diabetes mellitus with coronary heart disease severity and treatment effect should be widely used in clinical diagnosis and treatment.
文摘This report introduced and summarized the nursing care experience for a senior patient with lung cancer and developed programmed cell death protein 1(PD-1)immunotherapy-related myocarditis combined with coronary heart disease(CHD)after receiving said treatment.In this case,immune myocarditis with CHD occurred shortly after implementing the PD-1 immunotherapy,yet the patient presented no clinical symptoms.Frequent nursing attention and close observation are so required for monitoring the patient’s status and updating the physicians for a swift control of the myocarditis.For this case,nursing care procedures vital for the successful recovery of the patient included condition observation,position management,pre-and postcoronary angiography care,infection prevention,hemorrhage prevention,venous access port maintenance,pain care,trachea care,psychological care,diet care,environment management,and health education.After receiving effective,successful treatment and care,the patient was discharged after 13 days of treatment with generally satisfying overall conditions.
文摘A 69-year-old woman with angina had a lesion in the left lower lobe on chest film. Angiography revealed coronary artery disease in three vessels. Combined off pump coronary artery bypass grafting (CABG) and left lower lobectomy were performed through median sternotomy. This approach avoids complications due to staged operations and cardiopulmonary bypass (CPB). This report shows that simultaneous off pump CABG and pulmonary operations can be performed safely in patients with coronary artery disease (CAD) associated with lung cancer.
基金Supported by Indian Council of Medical Research,New Delhi,India
文摘AIM: To investigate the role of [breast and ovarian cancer susceptibility 1(BRCA1)-associated RING domain 1(BARD1)]/BRCA1 E3-ubiquitin ligase complex in governing the stability of mutant liver X receptor-(LXR-α) protein in coronary heart disease(CHD) subjects.METHODS: The expression analysis of various genes was carried out by quantitative real time polymerase chain reaction and western blotting within blood mononuclear cells of human CHD subjects at various stages of coronary occlusion and their corresponding normal healthy counterparts.Immunoprecipitation experiments were performed to establish protein interactions between LXR-αand BARD1.Peripheral blood mononuclear cells were cultured and exposed to Vitamin D3 and Cisplatin to validate the degradation of mutant LXR-αprotein in CHD subjects by BARD1/BRCA1 complex.RESULTS: The expression of mutant LXR-αprotein in CHD subjects was found to decrease gradually with the severity of coronary occlusion exhibiting a strong negative correlation,r =-0.975 at P 【 0.001.Further,the expression of BARD1 and BRCA1 also increased with the disease severity,r = 0.895 and 0.873 respectively(P 【 0.001).Immunoprecipitation studies established that BARD1/BRCA1 complex degrades mutant LXR-αvia ubiquitination.The absence of functional LXR-αprotein resulted in increased expression of inflammatory cytokines such as interleukin(IL)-6,IL-8 and interferon-and decreased expression of ABCA1(ATP-binding cassette A1)(r = 0.932,0.949,0.918 and-0.902 with respect to Gensini score;P 【 0.001).Additionally,cell culture experiments proved that Vitamin D3 could prevent the degradation of mutant LXR-αand restore its functional activity to some extent.CONCLUSION: Mutant LXR-αprotein in CHD subjects is degraded by BARD1/BRCA1 complex and Vitamin D3 can rescue and restore its function.
文摘Case 1 was a 49-year-old woman who visited with a dry cough. She had an underlying disease of lung adenocarcinoma and received cancer immunotherapy because of an ALK-positive response and several cancer chemotherapies. The clinical effect was a complete response. Chest CT was performed because of continuous dry cough, and a new tumor shadow was recognized in the lingula portion of the left upper lobe. We performed CT-guided lung biopsy and could aspirate pus-fluid. The culture test for acid-fast bacilli was positive and the causative microorganism was identified as Mycobacterium avium by the DDH method. The final diagnosis was pulmonary abscess due to M. avium. Treatment using combined chemotherapy including CAM was performed and a good clinical response was obtained. Case 2 was a 67-year-old man who had a past history of surgical resection of lung adenocarcinoma eight and two years ago and received several cancer chemotherapies and radiation therapy. Because a new nodular shadow appeared in the right middle lobe one year ago and showed strong positivity on PET/CT, surgical resection was performed with the suspected recurrence of lung cancer. Subsequently, the histological diagnosis was epithelioid granuloma and a culture test of acid-fast bacilli was positive, with the identification of Mycobacterium intracellulare by the DDH method. Combined chemotherapy was not performed because the lesion was completely resected. Afterwards, a new nodular shadow appeared in the left lower lobe again and bronchoscopy was performed. Because M. intracellulare was isolated from the local specimen, we diagnosed the patient with recurrence of pulmonary MAC disease and combined chemotherapy including CAM was performed for one year. Finally, the nodular lesion disappeared. It is difficult to differentiate pulmonary MAC disease from lung cancer. Therefore, careful follow-up of patients with lung cancer while keeping in mind the possible complication of pulmonary MAC disease is necessary.
基金Supported by(in part)the Southampton National Institute for Health Research Biomedical Research Centre(Byrne CD)grants from the School of Medicine of the Verona University(Targher GT)
文摘Non-alcoholic fatty liver disease(NAFLD)has emerged as a public health problem of epidemic proportions worldwide.Accumulating clinical and epidemiological evidence indicates that NAFLD is not only associated with liver-related morbidity and mortality but also with an increased risk of coronary heart disease(CHD),abnormalities of cardiac function and structure(e.g.,left ventricular dysfunction and hypertrophy,and heart failure),valvular heart disease(e.g.,aortic valve sclerosis)and arrhythmias(e.g.,atrial fibrillation).Experimental evidence suggests that NAFLD itself,especially in its more severe forms,exacerbates systemic/hepatic insulin resistance,causes atherogenic dyslipidemia,and releases a variety of pro-inflammatory,pro-coagulant and pro-fibrogenic mediators that may play important roles in the pathophysiology of cardiac and arrhythmic complications.Collectively,these findings suggest that patients with NAFLD may benefit from more intensive surveillance and early treatment interventions to decrease the risk for CHD and other cardiac/arrhythmic complications.The purpose of this clinical review is to summarize the rapidly expanding body of evidence that supports a strong association between NAFLD and cardiovascular,cardiac and arrhythmic complications,to briefly examine the putative biological mechanisms underlying this association,and to discuss some of the current treatment options that may influence both NAFLD and its related cardiac and arrhythmic complications.
文摘Hydrostatic pulmonary edema is as an abnormal in-crease in extravascular water secondary to elevatedpressure in the pulmonary circulation, due to conges-tive heart failure or intravascular volume overload.Diagnosis of hydrostatic pulmonary edema is usuallybased on clinical signs associated to conventional ra-diography findings. Interpretation of radiologic signsof cardiogenic pulmonary edema are often question-able and subject. For a bedside prompt evaluation,lung ultrasound(LUS) may assess pulmonary conges-tion through the evaluation of vertical reverberationartifacts, known as B-lines. These artifacts are relatedto multiple minimal acoustic interfaces between smallwater-rich structures and alveolar air, as it happens incase of thickened interlobular septa due to increase of extravascular lung water. The number, diffusion and in-tensity of B lines correlates with both the radiologic andinvasive estimate of extravascular lung water. The inte-gration of conventional chest radiograph with LUS canbe very helpful to obtain the correct diagnosis. Com-puted tomography(CT) is of limited use in the work upof cardiogenic pulmonary edema, due to its high cost,little use in the emergencies and radiation exposure.However, a deep knowledge of CT signs of pulmonaryedema is crucial when other similar pulmonary condi-tions may occasionally be in the differential diagnosis.
文摘Objective:To establish a rat model of transfusion-related acute lung injury(TRALI)with coronary heart disease(CHD),and to analyze the safety of blood transfusion through oxygen balance.Methods:Forty-five 10-day-old male Wistar rats were purchased,and 35 of them were fed with high-fat diet to establish coronary heart disease rat models,and then 20 of them were selected to establish rat models of transfusion-related acute lung injury with coronary heart disease(model group,10 rats),positive acute lung injury group(positive group,5 rats)and negative acute lung injury group(negative group,5 rats),and the lung histomorphology,pathological score and wet/dry weight ratio were compared.Then,another 15 rats with coronary heart disease were selected and infused with mutant Hb,rHb1.1 and rHb2.0 with the same osmotic pressure through femoral vein catheterization,respectively,and were divided into mutant Hb group,rHb1.1 group and rHb2.0 group,with 5 rats in each group,and 5 healthy rats were combined as control group.The MAP,HR and blood gas values of mesenteric artery of rats were compared at 0,30,60 and 90 min after infusion.Results:(1)Rats in the model group and the positive group showed symptoms such as irregular and shallow breathing,increased oral and nasal secretions,and audible wheezing,which were consistent with the symptoms of acute lung injury.Comparison of lung histological score and lung tissue wet/dry ratio in three groups:There was no significant difference in lung histological score and lung tissue wet/dry ratio(P>0.05),but they were higher than those in the negative group(P<0.05).(2)During hemoglobin infusion,the MAP of mutant Hb group,rHb1.1 group and rHb2.0 group was higher than that of the control group,while the pH and PaCO2were lower than those of the control group(P<0.05),and there was no significant difference in QSMA(P>0.05).In the mutant Hb group,MAP returned to normal at 30-60 min after infusion(P>0.05),but MAP increased again at 90 min after infusion(P<0.05),and QSMA increased significantly at 60 min after transfusion(P<0.05).The pH value was lower than the normal value and the PaCO2was higher than the normal value within 90 min of infusion(P<0.05),and the HCO3-level returned to normal after 30 min of infusion(P>0.05).In rHb 1.1 group,MAP returned to normal,QSMA remained at normal level(P>0.05),and pH,PaCO2and HCO3-returned to normal after 60 min of infusion(P>0.05);In rHb 2.0 group,the levels of MAP,pH,PaCO2and HCO3-returned to normal after 30 min of infusion(P>0.05),and QSMA remained normal during infusion(P>0.05).Conclusion:The rat model of transfusion-relatted acute lung injury with coronary heart disease can be successfully established by injecting LPS into the rat model of coronary heart disease,and the infusion of recombinant hemoglobin can improve the balance of blood supply in rats,in which the infusion of rHb2.0 can better correct the metabolic acidosis.
文摘目的:运用网络药理学分析方法探究黄芪治疗糖尿病合并冠心病的可能性作用靶点以及其作用机制。方法:借助TCMSP平台及Uniprot数据库检索筛选黄芪的活性成分及其相应靶点;在GeneCards数据库、OMIM数据库中检索糖尿病合并冠心病的疾病靶点,通过Cytoscape 3.9.1得到黄芪-活性成分-靶基因的可视化网络图;将疾病与药物对应靶点共同提交Venny2.1.0生成相交靶点,并通过蛋白质相互作用(STRING)平台构建蛋白质相互作用(PPI)网络。基于Metascape 3.9.1数据库进行GO富集分析和KEGG通路富集分析明确可能涉及到的生物进程及信号通路。最后应用分子对接技术对上述猜想进行粗浅验证。结果:共获取黄芪的关键化合物17个,对应靶点195个,疾病相关靶点3815个,导入Venny2.1.0中生成163个交集靶点。富集分析结果表明:黄芪治疗糖尿病合并冠心病主要涉及激素反应(response to hormone)、细胞有机循环化合物反应(cellular response to organic cyclic compound)、细胞脂质反应(cellular response to lipid)、无机物反应(response to inorganic substance)等生物进程;可能涉及到癌症通路(Pathways in cancer)、脂质及动脉硬化通路(Lipid and atheroscierosis)、糖尿病并发症中的AGE-RAGE信号通路(AGE-RAGE signaling pathway in diabetic complications)、P13K-AKT信号通路(P13K-AKt signaling pathway)等信号通路。分子对接结果提示药物活性分子与核心靶点有较好的结合。结论:该研究揭示了黄芪在机体内可能参与抑制胰岛素抵抗、糖脂代谢调控等众多生物进程,以多成分、多靶点、多通路实现对糖尿病合并冠心病的治疗作用。