抗凝血活性海洋硫酸多糖HP1-1的结构研究

目的 对抗凝血活性海洋硫酸多糖HP1-1的结构进行研究。方法 通过高效液相色谱(HPLC)、高效凝胶渗透色谱(HPGPC)、傅里叶变换红外光谱(IR)以及气质联用色谱(GC-MS)和核磁共振波谱(NMR)方法,对抗凝血活性海洋硫酸多糖HP1-1的结构进行解析。结果 海洋硫酸多糖HP1-1的分子量为297 kDa,总糖和硫酸基含量分别为78.1%和12.3%;HP1-1主要由葡萄糖组成,含有少量半乳糖、阿拉伯糖和甘露糖;HP1-1糖链中含有→4)-Glcp-(1→、→3)-Glcp-(1→、→3,4)-Glcp-(1→、→4)-Arap-(1→、→3,4)-Galp-(1→和→3)-Galp-(1→,硫酸基位于→4)-Glcp-(1→的C-3位和→3)-Galp-(1→的C-4位。 结论 海洋多糖HP1-1是主要由葡萄糖组成的硫酸多糖,含有多种糖基连接方式,为独特结构序列的新颖海洋硫酸甘露阿拉伯半乳葡聚糖。     

Precision Medicine in Catecholaminergic Polymorphic Ventricular Tachycardia: JACC Focus Seminar 5/5

In this final of a 5-part Focus Seminar series on precision medicine, we focus on catecholaminergic polymorphic ventricular tachycardia (CPVT). This focus on CPVT allows us to take a “deep dive” and explore the full extent of the precision medicine opportunities for a single cardiovascular condition at a level that was not possible in the preceding articles. As a new paradigm presented in this article, it has become clear that CPVT can occur as either a typical or atypical form. Although there is a degree of overlap between the typical and atypical forms, it is notable that they arise due to different underlying genetic changes, likely exhibiting differing mechanisms of action, and presenting with different phenotypic features. The recognition of these differing forms of CPVT and their different etiologies and mechanisms is an important step toward implementing rapidly emerging precision medicine approaches that will tailor novel therapies to specific gene defects.     

Mode of Onset of Malignant Ventricular Arrhythmias in Idiopathic Ventricular Fibrillation

Mode of Onset of Idiopathic VF. Introduction : The mode of onset of malignant ventricular arrhythmias (ventricular tachycardia [VT] or ventricular fibrillation [VF] has been well described in patients with organic heart disease and in patients with the long QT syndromes. Less is known about the mode of onset of VF in patients with out-of-hospital VF who have no evidence of organic heart disease or identifiable etiology.
Methods and Results : We reviewed the ECGs of all our patients with Idiopathic VF. Documentation of the onset of spontaneous arrhythmias was available for 22 VK episodes in 9 patients (6 men and 3 women; age 41 ± 16 years). In all instances, spontaneous VF followed a rapid polymorphic VT, which was initiated by premature ventricular complexes (PVCs) with very short coupling intervals. The PVC initiating VF had a coupling interval of 302 ± 52 msec and a prematurity index of 0.4 ± 0.07. These PVCs occurred within 40 msec of the peak of the preceding T wave. Pause-dependent arrhythmias were never observed.
Concltision : Cardiac arrest among patients with idiopathic VF has a very distinctive mode of onset. Documentation of a polymorphic VT that is not pause dependent is of diagnostic value.     

Hemodialysis improves myocardial interstitial edema and left ventricular diastolic function in patients with end-stage renal disease: noninvasive assessment by ultrasonic tissue characterization

Congestive heart failure is the most common cause of mortality in patients with end-stage renal disease (ESRD). Ultrasonic tissue characterization with integrated backscatter offers a promising method for the noninvasive assessment of regional myocardial contractile performance and fibrosis. The aim of this study was to investigate the effect of hemodialysis (HD) on myocardial tissue characterization and left ventricular function in ESRD patients. We examined 26 patients with ESRD undergoing routine HD (age 63 ± 12 years, duration of HD 9.2 ± 3.2 years) and 30 patients with essential hypertension (HT; 60 ± 10 years). Routine echocardiographic parameters and the cyclic variation of ultrasonic integrated backscatter of the ventricular septum (CV-IBS) were measured. Left ventricular mass index was significantly larger in patients with ESRD than in those with HT (217 ± 56 vs 146 ± 45 g/m², P < 0.05). The indices for left ventricular diastolic function (E/A, the ratio of left ventricular peak early to late diastolic filling velocity; DT, the deceleration time of the early diastolic filling) and CV-IBS had deteriorated significantly in patients with ESRD before HD compared with those with HT (E/A, 0.6 ± 0.2 vs 0.9 ± 0.3, P < 0.05; DT, 228 ± 23 vs 184 ± 19 ms, P < 0.05; CV-IBS, 9.0 ± 1.3 vs 12.4 ± 0.9 dB, P < 0.05), possibly reflecting interstitial fibrosis. In patients with ESRD, HD reduced calculated left ventricular mass index by 19% (before HD, 217 ± 56 vs immediately after HD, 176 ± 45 g/m², P < 0.05) and CV-IBS by 19% (9.0 ± 1.3 vs 7.3 ± 1.1 dB, P < 0.05), that possibly reflected improvement of interstitial edema. HD also significantly improved indices for left ventricular diastolic function (E/A, 0.6 ± 0.2 vs 0.9 ± 0.2, P < 0.05; DT, 228 ± 23 vs 188 ± 21 ms, P < 0.05). HD improves myocardial interstitial edema and left ventricular diastolic function in patients with ESRD. Noninvasive assessment of ultrasonic tissue characterization is useful in defining the pathophysiological changes of ventricular myocardium in patients with ESRD. Received: December 17, 2001 / Accepted: April 19, 2002 Correspondence to O. Hirono     

A coxsackievirus B5‐associated aseptic meningitis outbreak in Shandong Province,China in 2009

In 2009, a major outbreak of aseptic meningitis was noted in Linyi city, Shandong province, China. From June to September 2009, a total of 2,104 cases were involved in this outbreak, and 98.6% of patients were <16 years of age. To determine the pathogen of the outbreak, 42 cerebrospinal fluid specimens collected from aseptic meningitis cases were tested for cell culture, and 17 (40.5%) enteroviruses were isolated and identified as Coxsackievirus B5 (CVB5). Homologous comparison indicated that these isolates had 0–7.7% nucleotide divergence with each other. Phylogenetic reconstruction showed global CVB5 could be separated into four genogroups, and all Linyi CVB5 isolates belonged to the genogroup C which had been circulating for recent 27 years in Asia and Europe. Interestingly, two distinct lineages were observed for the 17 isolates in the phylogenetic tree, indicating that at least two different transmission chains of CVB5 were responsible for this outbreak. This study showed that CVB5‐associated aseptic meningitis is an emerging concern in China. J. Med. Virol. 85:483–489, 2013. © 2012 Wiley Periodicals, Inc.     

Time-frequency characterization of atrial fibrillation from surface ECG based on Hilbert-Huang transform

In this paper, based on Hilbert-Huang transform (HHT), we develop a new non-invasive time-frequency analysis method to characterize the dynamic behaviour of atrial fibrillation (AF) from surface ECG. We first extract f waves from single-lead ECG records of AF patients using PCA analysis. To capture the non-stationary behaviours of AF signals at different time scales, we use HHT to find the Hilbert spectrum and instantaneous frequency (IF) distribution of residual signals from principal component analysis. Two important feature variables, namely mean IF (mIF) and index of frequency stability over time (IS), are derived from the IF distribution, and in combination will be able to effectively discriminate two different AF types: self-terminating and non-terminating termination. The proposed AF signal decomposition and analysis method will help us efficiently differentiate individual AF patients, advance our understanding of AF mechanisms, and provide useful guidelines for improving administration of AF patients, especially paroxysmal AF.     

Antimicrobial and physicochemical characterization of endodontic sealers after exposure to chlorhexidine digluconate

ObjectivesAssess the antibacterial, physical and chemical properties of AH Plus, BioRoot RCS and Pulp Canal Sealer (PCS) in contact with 2% chlorhexidine digluconate (CHX) used as final irrigant prior to root canal obturation.MethodsThe antimicrobial properties were investigated by direct contact tests for planktonic and biofilm growth of E. faecalis, S. mutans, S.epidermidis and S.aureus in vitro. The setting time, wettability, microhardness and surface roughness were also assessed. The sealers were studied in no contact, 1-minute (short-term) and continuous contact (long-term) with CHX. Chemical characterization of sealers was performed by scanning electron microscopy, X-ray diffraction analysis and Fourier-transform infrared spectroscopy after CHX or saline used as the last irrigant in an ex vivo tooth model and in endo training blocks.ResultsCHX increased the antibacterial activity of all the sealers investigated against planktonic bacteria and biofilms with PCS exerting the highest antimicrobial activity with and without the presence of CHX. The setting of AH Plus and BioRoot RCS was retarded, while for PCS accelerated in the presence of CHX. AH Plus and PCS were more hydrophilic after contact with CHX, whilst BioRoot RCS was hydrophobic in a time-dependent manner. The microhardness of sealers was compromised and the surface roughness increased after CHX exposure for AH Plus and BioRoot RCS, and decreased for PCS. CHX did not affect the sealers’ chemistry, but PCS that exhibited two extra phases.SignificanceCHX improved the antibacterial efficacy of endodontic sealers but further evidence is needed to confirm its suitability as a final irrigant prior to root canal obturation.     

血液环境下Biodentine与MTA的颜色稳定性研究

目的比较牙体牙髓治疗中常用的骨水泥材料Biodentine与三氧化矿物凝聚体(mineral trioxide aggregrate,MTA)在与血液接触条件下的颜色稳定性,并探讨其可能的变色原因。方法制备直径5 mm、高3 mm的Biodentine和MTA圆盘,将每种材料的24个圆盘随机分配到去离子水组和脱纤维羊血组中,浸泡1 d和7 d后进行后续检测。进行各类检测的3个时间点为:圆盘固化脱模后即刻、浸泡1 d和7 d后。检测指标如下:在同样光照环境下对圆盘进行拍照,直观比较两种材料的颜色变化;采用比色仪检测两种材料的色度;借助扫描电镜观察两种材料的表面形态;使用X射线能谱仪测量两种材料各元素含量。结果肉眼观察到与脱膜后即刻相比,在脱纤维羊血组浸泡1 d后仅MTA在明暗度上发生改变,脱纤维羊血组浸泡7 d后Biodentine与MTA颜色均加深变红,但MTA暗度明显增加。比色仪结果显示脱纤维羊血组MTA的7 d色差值ΔE(21.257±0.955)大于Biodentine的7 dΔE(5.833±0.501)(t=24.781,P<0.001);MTA材料自身变色随着与血液接触时间延长而加深,其7 dΔE与1 dΔE(6.233±0.888)相比,差异具有统计学意义(t=19.956,P<0.001);而Biodentine材料自身变色随时间延长则无统计学意义[7 dΔE与1 dΔE(6.790±0.831)相比,t=1.707,P=0.163]。扫描电镜结果表明:用脱纤维羊血浸泡7 d后,MTA表面孔隙率大于Biodentine,且MTA的晶体边缘相较Biodentine也更为圆钝。X射线能谱仪检测显示:在脱纤维羊血组浸泡7 d后MTA中氧元素含量下降、铋元素含量上升;与此同时Biodentine因阻射能力低未被检测出锆元素,但其他元素含量稳定。结论Biodentine在与血液接触条件下的颜色稳定性优于MTA,这主要与Biodentine表面孔隙率小、阻射剂成分稳定有关。     

Catecholaminergic Polymorphic Ventricular Tachycardia with QT Prolongation

The QT interval in patients with catecholaminergic polymorphic ventricular tachycardia (CPVT) is typically normal. However, CPVT patients are sometimes misdiagnosed as concealed long QT syndrome (LQTS), because patients with LQTS also manifest with syncope or sudden death following periods of exertion or extreme emotion. We report a CPVT patient with a pathogenic RyR2 mutation associated with a marked QT prolongation, which normalized after flecainide therapy.     

超声图像定量分析对子宫内膜癌的诊断价值

目的观察子宫内膜癌与非子宫内膜癌的子宫内膜超声图像回声强度的差异,探讨超声图像定量分析对子宫内膜癌的诊断价值。方法选择绝经后不规则阴道流血的患者84例和健康体检正常的绝经期妇女30例(健康组),通过联合应用彩色多普勒超声诊断仪与超声图像定量分析仪检测其子宫内膜回声强度定量指标,并检测子宫内膜厚度。84例患者同时进行病理学检查,根据病理结果分为内膜增生组(48例)、内膜癌组(36例),比较各组间灰阶值及分贝值的差异。结果内膜癌组的子宫内膜厚度、灰阶值及分贝值均高于内膜增生组和健康组(P均0.01),内膜增生组的子宫内膜厚度、灰阶值及分贝值均高于健康组(P0.05或0.01)。结论超声图像定量分析提供了超声影像的数字量化指标,结合子宫内膜厚度,为无创鉴别子宫内膜癌提供了得力手段。