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1.

Background

Pump speed optimization in patients implanted with a ventricular assist device represents a major challenge during the follow-up period. We present our findings on whether combined invasive hemodynamic ramp tests and cardiopulmonary exercise testing (CPX) can help optimize patient management.

Methods

Eighteen patients implanted with a HeartMate 3 (HM3) device underwent ramp tests with right heart catheterization (including central venous pressure [CVP], pulmonary artery pressure, pulmonary capillary wedge pressure [PCWP], and blood pressure) and echocardiography. Data were recorded at up to 4 speed settings. Speed changes were in steps of 200 revolutions/min (rpm). Evaluation of functional capacity by CPX was conducted according to the modified Bruce protocol.

Results

Only 30% of patients had normal PCWPs at their original rpm settings. In going from lowest to highest speeds, cardiac output improved by 0.25 ± 0.35 L/min/step (total change, 1.28 ± 0.3 L/min), and PCWP decreased by 1.9 ± 0.73 mm Hg/step (total change, 6 ± 1.6 mm Hg). CVP and systolic blood pressure did not change significantly with rpm. The rpm assessment was adjusted based on test results to achieve CVPs and PCWPs as close to normal limits as possible, which was feasible in all patients. On CPX, all patients demonstrated good performance (peak VO2, 16.8 ± 3.5 mL/kg/min).

Conclusion

Hemodynamic ramp testing provides an objective means of optimizing rpm, and has the potential to provide good exercise tolerance.  相似文献   
2.
目的 探讨胶质瘤中MKK7和c-Jun磷酸化(p-c-Jun)的表达及意义,分析两者表达的相关性。方法 选取弥漫型星形细胞瘤(15例)、少突胶质细胞瘤(5例)、间变性星形细胞瘤(11例)、间变性少突胶质细胞瘤(8例)、胶质母细胞瘤(53例)及其瘤旁正常脑组织(25例)共117例,采用免疫组织化学法检测MKK7、c-Jun及p-c-Jun的表达。体外培养神经胶质瘤细胞株U87,用脂质体转染MKK4-siRNA、MKK7-siRNA和对照siRNA,48 h后Western blot检测MKK7、c-Jun及p-c-Jun的表达水平。结果 胶质母细胞瘤中p-c-Jun及MKK7的表达均明显高于其他组织学类型胶质瘤及胶质母细胞瘤瘤旁正常脑组织中的表达(P=0.000, P=0.000)。随着胶质瘤WHO分级的升高,p-c-Jun及MKK7的表达增高,且与WHO分级呈明显正相关(r=0.494, P=0.000; r=0.606, P=0.000)。胶质瘤及胶质母细胞瘤瘤旁正常脑组织中MKK7与p-c-Jun的表达存在正相关关系(r=0.387, P=0.000)。沉默神经胶质瘤细胞株U87 MKK7表达抑制了c-Jun磷酸化水平。结论 MKK7可以通过调控JNK/c-Jun活性进而促进胶质母细胞瘤的发生。  相似文献   
3.
We performed a caffeine (N-3-methyl-13C) breath test (CafeBT) to determine whether it can be employed to identify caffeine metabolism-associated single nucleotide polymorphisms. The study included 130 healthy adults (mean age: 21.9 years). Saliva was collected using an Oragene®•DNA saliva collection kit. Breath samples were collected from the subjects. The subjects orally ingested 100 mg 13C-caffeine dissolved in distilled water. Subsequently, breath samples were collected in bags every 10 min for a total of 90 min. An analysis of 13CO2 in the expired breath was performed by infrared spectroscopy, and the sum of Δ13CO2 over 90 min (S90m) was calculated. DNA from saliva samples was genotyped using TaqMan® SNP Genotyping for the following genes: cytochrome P4501A2: rs762551, rs2472297, aryl-hydrocarbon receptor (rs4410790), and adenosine A2A receptor (rs5751876). All subjects had the genotype CC in rs2472297 alleles. No significant difference was observed in S90m among the genotypes of rs762551 and rs5751876; however, a significant difference was found in S90m among the genotypes of rs4410790 (C > T). Our findings suggest that the N-3 demethylation of caffeine is dependent on the rs4410790 allele and that CafeBT may be used to determine rs4410790 genotypes.  相似文献   
4.
Radiation-induced bystander effects (RIBEs) are detected in cells that are not irradiated but receive signals from treated cells. The present study explored these bystander effects in a U87MG multicellular tumour spheroid model. A medium transfer technique was employed to induce the bystander effect, and colony formation assay was used to evaluate the effect. Relative changes in expression of BAX, BCL2, JNK and ERK genes were analysed using RT-PCR to investigate the RIBE mechanism. A significant decrease in plating efficiency was observed for both bystander and irradiated cells. The survival fraction was calculated for bystander cells to be 69.48% and for irradiated cells to be 34.68%. There was no change in pro-apoptotic BAX relative expression, but anti-apoptotic BCL2 showed downregulation in both irradiated and bystander cells. Pro-apoptotic JNK in bystander samples and ERK in irradiated samples were upregulated. The clonogenic survival data suggests that there was a classic RIBE in U87MG spheroids exposed to 4 Gy of X-rays, using a medium transfer technique. Changes in the expression of pro- and anti-apoptotic genes indicate involvement of both intrinsic apoptotic and MAPK pathways in inducing these effects.  相似文献   
5.
The brain is highly enriched in long chain polyunsaturated fatty acids (LC-PUFAs) that display immunomodulatory properties in the brain. At the periphery, the modulation of inflammation by LC-PUFAs occurs through lipid mediators called oxylipins which have anti-inflammatory and pro-resolving activities when derived from n-3 LC-PUFAs and pro-inflammatory activities when derived from n-6 LC-PUFAs. However, whether a diet rich in LC-PUFAs modulates oxylipins and neuroinflammation in the brain has been poorly investigated. In this study, the effect of a dietary n-3 LC-PUFA supplementation on oxylipin profile and neuroinflammation in the brain was analyzed. Mice were given diets deficient or supplemented in n-3 LC-PUFAs for a 2-month period starting at post-natal day 21, followed by a peripheral administration of lipopolysaccharide (LPS) at adulthood. We first showed that dietary n-3 LC-PUFA supplementation induced n-3 LC-PUFA enrichment in the hippocampus and subsequently an increase in n-3 PUFA-derived oxylipins and a decrease in n-6 PUFA-derived oxylipins. In response to LPS, n-3 LC-PUFA deficient mice presented a pro-inflammatory oxylipin profile whereas n-3 LC-PUFA supplemented mice displayed an anti-inflammatory oxylipin profile in the hippocampus. Accordingly, the expression of cyclooxygenase-2 and 5-lipoxygenase, the enzymes implicated in pro- and anti-inflammatory oxylipin synthesis, was induced by LPS in both diets. In addition, LPS-induced pro-inflammatory cytokine increase was reduced by dietary n-3 LC-PUFA supplementation. These results indicate that brain n-3 LC-PUFAs increase by dietary means and promote the synthesis of anti-inflammatory derived bioactive oxylipins. As neuroinflammation plays a key role in all brain injuries and many neurodegenerative disorders, the present data suggest that dietary habits may be an important regulator of brain cytokine production in these contexts.  相似文献   
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目的 探讨乙酰辅酶A羧化酶1(ACC1)对人胶质瘤细胞系U87细胞增殖、迁移及侵袭的作用。 方法 Western blotting检测人胶质瘤细胞系U87、U251及U373中ACC1的表达;构建ACC1过表达质粒载体,将过表达ACC1质粒载体瞬时转染至U87细胞中;Western blotting检测转染后U87细胞中ACC1表达情况;MTT实验检测过表达ACC1对U87细胞增殖的影响;Transwell迁移和侵袭实验分别检测过表达ACC1对U87细胞迁移和侵袭的影响;划痕实验检测过表达ACC1对U87细胞划痕愈合能力的影响;Western blotting检测相关蛋白表达变化。 结果 与人胶质瘤细胞系U251和U373相比,U87细胞中ACC1表达较低;ACC1过表达抑制U87细胞增殖(P<0.01);ACC1过表达抑制U87细胞迁移、侵袭和划痕愈合能力(P<0.01);ACC1过表达迁移和侵袭相关蛋白波形蛋白(vimentin)、纤维连接蛋白(fibronectin)和尿激酶型纤溶酶原激活剂(uPA)表达下调(P<0.01),凋亡抑制蛋白Bcl-2和细胞周期蛋白(cyclin) B、cyclin D表达下调(P<0.01),p-STAT3蛋白表达下调(P<0.01),细胞周期蛋白P21表达上调(P<0.01)。 结论 过表达ACC1可能通过抑制STAT3活性,抑制人胶质瘤细胞的增殖、迁移和侵袭。  相似文献   
10.
目的:探讨n-3多不饱和脂肪酸( n-3PUFAs)对大鼠结直肠癌的影响及与脂质代谢相关基因的研究。方法选取60只SPF级SD大鼠,将大鼠随机分为实验组与对照组,每组各30例。以N-甲基-N-亚硝基脲( MNU)经灌肠方式诱导大鼠大肠癌模型。同时,于建立模型1周前,对照组喂养含葵花籽油饲料(n-6PUFAs),实验组喂养含鱼油饲料(n-3PUFAs),直至16周。处死大鼠并解剖,寻找原发肿瘤并观察周围淋巴结转移情况。将可疑组织进行HE染色,行常规病理学检查。采用气象色谱方法测定无病变结肠组织n-3PUFAs含量。采用RT-PCR方法检测脂质代谢关键调控基因:脂肪酸合成酶( FAS)、环氧合酶2( COX-2)、5-脂氧合酶(5-LOX)和过氧化物酶增殖活化受体( PPARβ及PPARγ)的mRNA表达。结果实验组的肿瘤发生率低于对验组的肿瘤发生率( P<0.05)。实验组无病变结肠组织n-3 PUFAs含量高于对照组( P<0.01)。实验组FAS、COX-2、5-LOX和PPARβmRNA的表达低于对照组( P<0.05或P<0.01) ,实验组PPARγmRNA的表达高于对照组( P<0.01)。结论 n-3PUFA通过影响脂质代谢关键调控基因的表达,起到抗肿瘤的作用。  相似文献   
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