Large Lipomatous Hypertrophy of the Interventricular Septum

We present the case of a 58-year-old woman who had large lipomatous hypertrophy of the interventricular septum, a condition that is reported very infrequently. Preoperative cardiac magnetic resonance images revealed an inhomogeneous, infiltrating mass that was suppressed in fat-suppression mode. The extensive mass was causing right ventricular dysfunction, so we excised it through a right ventricular approach. The findings on histologic analysis of the mass were consistent with lipomatous hypertrophy. The patient died of septic shock on the 28th postoperative day. In addition to the patient''s case, we discuss the characteristics and diagnosis of this rare entity.     

寿胎丸对脂多糖诱导的人绒毛外滋养细胞氧化应激及焦亡的调节作用

目的 探讨寿胎丸在脂多糖（LPS）诱导的人绒毛外滋养细胞（HTR-8/SVneo）损伤中的作用及其对细胞损伤中氧化应激和焦亡的调控，为寿胎丸安胎的作用机制研究提供新的方向。方法 采用LPS（100 μg?L^-1）诱导HTR-8/SVneo细胞损伤建立细胞模型，设置空白组、模型组、寿胎丸组（10%寿胎丸含药血清）、抗氧化剂组（1 mmol·L^-1 NAC）、NOD样受体热蛋白结构域3（NLRP3）抑制剂组（50 μmol·L^-1MCC950）。分别采用细胞增殖与活性检测（CCK-8）试剂盒检测细胞活性情况；Hochest 33342/PI双荧光染色和流式细胞术观察细胞死亡情况；酶联免疫吸附测定法（ELISA）检测细胞上清液中白细胞介素-18（IL-18）、白细胞介素-1β（IL-1β）、丙二醛（MDA）、超氧化物歧化酶（SOD）释放情况；DCFH-DA探针检测细胞内活性氧（ROS）含量；蛋白免疫印迹法（Western blot）检测NLRP3、胱天蛋白酶（Caspase）-1、消化道皮肤素D（GSDMD）、IL-1β蛋白的表达；实时荧光定量聚合酶链式反应（Real-time PCR）检测NLRP3、Caspase-1 mRNA的表达。结果 与空白组比较，模型组细胞活力显著降低（P<0.01），细胞上清液中炎症因子IL-1β、IL-18含量显著增加（P<0.01），氧化应激因子ROS、MDA含量升高，SOD活性显著降低（P<0.01），NLRP3、Caspase-1、GSDMD、IL-1β蛋白和NLRP3、Caspase-1 mRNA表达显著上调（P<0.01）；与模型组比较，寿胎丸组、NAC组及MCC950组细胞活力显著升高（P<0.01），寿胎丸组和NAC组MDA、ROS活性降低，SOD活性显著升高（P<0.01），寿胎丸组和MCC950组细胞上清液中IL-1β、IL-18含量减少（P<0.01），细胞内NLRP3、Caspase-1、GSDMD、IL-1β蛋白和NLRP3、Caspase-1、IL-1β mRNA表达均明显降低（P<0.05，P<0.01）。结论 寿胎丸可通过抑制氧化应激和细胞焦亡减轻LPS诱导的HTR-8/SVneo细胞损伤，这可能是寿胎丸防治复发性流产，发挥安胎作用的机制之一。     

Successful treatment of massive thrombosis in different locations with prolonged thrombolytic therapy: A life-saving intervention

Venous thrombosis is recognized as one of the most important complications of nephrotic syndrome (NS). In patients with NS, venous thrombosis may develop in the renal veins, the deep veins of the lower limb, and the inferior vena cava. Here, we describe a case report of an NS patient with multiple venous thrombosis in the right renal vein, the left iliac vein, the vena cava inferior, the right atrium, and the pulmonary arteries. Moreover, we describe the successful treatment of multiple venous thrombosis with prolonged thrombolytic treatment in spite of an increased risk of bleeding due to renal biopsy.     

Diversity of γδ T-cell antigens

In the last two decades, it has become clear that γδ T cells recognize a diverse array of antigens including self and foreign, large and small, and peptidic and non-peptidic molecules. In this respect, γδ antigens as a whole resemble more the antigens recognized by antibodies than those recognized by αβ T cells. Because of this antigenic diversity, no single mechanism—such as the major histocompatibility complex (MHC) restriction of αβ T cells—is likely to provide a basis for all observed T-cell antigen receptor (TCR)-dependent γδ T-cell responses. Furthermore, available evidence suggests that many individual γδ T cells are poly-specific, probably using different modes of ligand recognition in their responses to unrelated antigens. While posing a unique challenge in the maintenance of self-tolerance, this broad reactivity pattern might enable multiple overlapping uses of γδ T-cell populations, and thus generate a more efficient immune response.     

IMMUNOGENICITY OF HEPATITIS A VACCINE IN CHILDREN WITH CANCER

This study evaluated the immuned response of the hepatitis A vaccine in children with cancer who were receiving chemotherapy. Twenty-eight patients with lymphomas or solid tumors and who had negative serology for hepatitis A were enrolled. The median age was 4.7 years (range 2–16). The patients received 1440 IU hepatitis A vaccine at 0 and 6 months. Seroconversion rates at the first and seventh months were 60% (n = 17/28 patients) and 89% (n = 24/27 patients). No adverse effects were observed. The hepatitis A vaccine was found to be effective and safe in children with cancer.     

Matrix Metalloproteinase‐2 and ‐9 Levels in Patients with Dilated Ascending Aorta and Bicuspid Aortic Valve

Background: Predictors of aortic dilatation are not well‐described in patients with bicuspid aortic valve (BAV). Changes in extracellular matrix composition in the aortic wall may play an important role. Our study aimed to examine the relationship between ascending aortic dilatation and biochemical markers for collagen metabolism, such as matrix metalloproteinase‐2 (MMP‐2) and matrix metalloproteinase‐9 (MMP‐9) levels in patients with BAV. Methods: All patients underwent cardiac echocardiography using a standard protocol, and aortic measurements were made in end‐diastole. One hundred twelve BAV patients with no or mild valvular impairment were recruited and grouped according to the aortic dimensions corrected for body surface area (BSA) and age. There were 54 patients with dilated ascending aorta (Group 1) and 58 patients with nondilated ascending aorta (group 2). The plasma levels of MMP‐2 and MMP‐9 were determined by ELISA. Results: The mean ascending aorta diameter was 4.49 ± 0.49 mm in group 1 and 3.51 ± 0.46 mm in group 2 (P < 0.001). There were no significant difference in gender, BSA, presence of hypertension, diabetes mellitus, hyperlipidemia, and smoking between the 2 groups. Nevertheless, no significant difference was observed in the levels of MMP‐2 and MMP‐9 between the 2 groups. The ascending aorta diameter correlated significantly with age (r = 0.438 P < 0.001). No significant correlation was observed between plasma MMP‐2 and MMP‐9 concentration and ascending aorta diameter, respectively (r = ?0.005 P = 0.58, r = ?0.106 P = 0.07). Multivariate analysis showed that age was independent predictor of aortic dilatation (P ≤ 0.001). Conclusion: Age was an independent predictor of aortic dilatation in patients with BAV, whereas MMP‐2 and 9 levels were not relevant by aortic dilatation.     

Filtration efficiency of surgical sterilization fabric for respiratory protection during COVID-19 pandemic

BackgroundDue to COVID-19 and high demand for respirators, some healthcare professionals have been using the Halyard H600 fabric as an alternative to N95 respirators without testing the filtration efficiency of the fabric with established scientific methods. The purpose of this study was to assess the efficiency of the Halyard H600 as a respirator filtering material as compared to the NIOSH-certified N95 and P100 filters, and determine if H600 is a good alternative for respiratory protection for healthcare professionals during the COVID-19 pandemic.MethodsThree filter types (Halyard H600, N95, and P100) were challenged with salt particles inside an exposure chamber at a flow rate of 43 LPM and relative humidity of 40 ± 2%. N95 and P100 respirator filters were tested initially to establish the validity of the chamber, followed by the Halyard H600 fabric. Particle penetration was measured using an aerosol spectrometer. The filtration efficiency was calculated for different particle sizes by measuring the particle number concentration upstream and downstream of the filter. The pressure drop across the filter materials was measured using a manometer.ResultsThe efficiency of the P100 for particles ≥250 nm was 100%. The N95 efficiency was 97 ± 1% at 275 nm, 99 ± 0% at 324 nm, and 100% for larger particles. The Halyard H600 fabric had a variable efficiency with an average of 62 ± 28% at 275 nm, 89 ± 8% at 324 nm, and 100% efficiency for particles >450 nm. The pressure drop values for P100 and N95 were 32 and 8 mmH₂O, respectively. The Halyard H600 fabric resistance increased dramatically from 30 mmH₂O at the start of the exposure to 65 mmH₂O after 16-minutes of exposure.ConclusionThe high variability in filter efficiency for particles ≤324 nm and the increased fabric breathing resistance demonstrate that the Halyard H600 has an inferior performance and is not a good substitute for N95 and P100. Thus, the use of the Halyard H600 fabric for respiratory protection is not recommended.