1800 MHz射频电磁场对中国仓鼠肺成纤维细胞DNA损伤的影响

目的研究全球移动通讯系统(GSM)1800 MHz射频电磁场对中国仓鼠肺成纤维细胞(CHL)DNA损伤的影响.方法采用DNA双链断裂的早期标志性事件H2AX的磷酸化作为检测指标,将细胞间断(5 min开,10 min关)暴露于比吸收率为0或3.0 W/kg的1800 MHz射频电磁场1或24 h后,用4%多聚甲醛固定后进行γH2AX免疫荧光分析,即用鼠源抗γH2AX单克隆抗体为一抗和异硫酸酯荧光素标记的山羊来源抗鼠抗体为二抗,显示细胞核内γH2AX的形成情况.以4,6-二咪基-4-联苯基吲哚标记细胞核,采用Image Pro-Plus图像软件分析数据,以20 mg/L的DNA损伤剂二乙酰氨基芴(AAF)作用2 h作为阳性对照.各处理条件至少检测50个细胞的γH2AX 焦点数,焦点超过5个的细胞定义为γH2AX焦点阳性细胞,将该焦点阳性细胞率作为评价细胞DNA损伤程度的指标.结果γH2AX焦点阳性细胞率在1800 MHz射频暴露24 h后为(37.9±8.6)%,在阳性对照组为(50.9±9.4)%,与假辐照组的(28.0±8.4)%比较,明显增高;而射频暴露1 h后的γH2AX焦点阳性细胞率为(31.8±8.7)%,增加不明显.结论 1800 MHz 比吸收率为3.0 W/kg的射频电磁场辐照24 h对CHL细胞DNA有损伤作用.     

Establishment and characterization of cloned CD4− CD8−αβ-T cell receptor (TCR)-bearing autoreactive T cells from autoimmune NZB×NZW F1 mice

Murine models such as NZB/W F₁, NZB.H-2^bm12 and MRL.lpr/lpr mice have provided greater insight into the pathogenic mechanisms of lupus. To understand further the roles of T cells and cytokines in the pathogenesis of murine lupus, 11 cloned anti-DNA antibodies augmenting autoreactive T cell lines were derived from NZB/W F₁ mice. All these autoreactive cells responded to syngeneic splenic cells and helped syngeneic B cells to produce anti-DNA antibodies, especially the IgG antibody. Ten out of 11 autoreactive T cell lines expressed neither CD4 nor CD8 cell surface markers on their surface. In addition, the cytokine production pattern of these autoreactive T cell lines was predominantly of type 0 (Th0) or type 2 T helper cells (Th2). To further investigate the role of accessory molecules in the activation of these autoreactive T cell lines, expression of IL-2R and heat-stable antigen (HSA) on these autoreactive T cells was analysed. Results suggest that the HSA played a critical role in the activation and function of these double-negative cloned autoreactive T cells.     

In vitro and in vivo functional analysis of CD5+ and CD5− B cells of autoimmune NZB × NZW F1 mice

T cell-mediated immune responses are likely to be important in the pathogenesis of systemic vasculitis. However, identifying the T cells involved has proved difficult, and there are conflicting reports regarding T cell proliferation in response to different autoantigens. Perinuclear (P) and cytoplasmic (C) anti-neutrophil cytoplasmic antibodies (ANCA) are closely associated with systemic vasculitis, and are generally specific for MPO or PR3, respectively. We studied the proliferative responses to MPO and PR3 of peripheral blood mononuclear cells from patients with P-ANCA or C-ANCA specific for these antigens by ELISA. These responses were compared with those of normal controls, and of disease controls with P- or C-ANCA not specific for MPO or PR3. The patient group as a whole showed significant T cell proliferation in response to the autoantigens compared with controls (P =0·005). Cells from nine of 13 P-ANCA-positive, anti-MPO-positive patients proliferated in response to MPO, compared with five of 16 controls (P =0·04). Cells from five of eight C-ANCA-positive, anti-PR3-positive patients proliferated in response to PR3, compared with two of 11 controls (P =0·05). These experiments demonstrate that patients with P-ANCA or C-ANCA possess T cells which respond to MPO or PR3, respectively. As in other autoimmune diseases, responses to both antigens were also seen in a proportion of healthy controls. Further analysis of these responses will be important in understanding the pathogenesis of systemic vasculitis and in designing specific immunotherapy.     

Temperature Monitoring in Radiofrequency Catheter Ablation of Atrial Flutter Using the Linear Ablation Technique

Temperature Monitoring of Ablation. Introduction: Information about temperature and impedance monitoring during radiofrequency catheter linear ablation of atrial flutter bas not been reported. We proposed that a radiofrequency catheter ablation system using a closed-loop temperature control model could decrease the incidence of coagulum formation and shorten the radiation exposure and procedure times compared with those found in a power control model.
Methods and Results: Forty patients (8 women and 32 men; mean age 64 ± 7 years) with atrial flutter were referred for radiofrequency ablation. The patients were randomized into two groups: group I patients underwent radiofrequency catheter linear ablation of atrial flutter using a power control of energy output model; and group II patients underwent the closed-loop temperature control model with a target electrode temperature of 70°C. As compared with group II, group I patients bad a higher incidence of coagulum formation (12% vs 2%, P < 0.05), temperature shutdown (11% vs 0%, P < 0.01), and impedance shutdown (16% vs 3%, P < 0.01), more radiofrequency applications (7 ± 3 vs 4 ± 2, P < 0.01), and longer procedure time (100 ± 25 vs 75 ± 23 minutes, P < 0.05) and radiation exposure time (31 ± 10 vs 20 ± 7 minutes, P < 0.05) required for successful ablation. Larger deviations of temperature (9.0°± 2.4°C vs 5.0°± 1.2°C, P < 0.0001) and impedance (9.2 ± 2.6 ω vs 5.3 ± 1.6 ω, P < 0.0001) were also found in group I patients compared with those in group II.
Conclusions : This study demonstrated that a closed-loop temperature control model could facilitate the effects of radiofrequency catheter ablation of the atrial flutter circuit by decreasing coagulum formation, temperature and impedance shutdown, and procedure and radiation exposure times.     

Long-Term Outcome of Radiofrequency Catheter Ablation for Topical Atrial Flutter: Risk Prediction of Recurrent Arrhythmias

RF Catheter Ablation for Atrial Flutter. Introduction: Little is known about the predictors of recurrent atrial flutter or fibrillation after successful radiofrequency ablation of typical atrial flutter. In addition, there is only limited evidence suggesting that elimination of atrial flutter would modify the natural history of atrial fibrillation in patients who experienced both of these arrhythmias. The aims of the present study were to investigate the long-term results of radiofrequency catheter ablation and to examine the predictors for late occurrence of atrial fibrillation in a large population with typical atrial flutter. Methods and Results: The study population consisted of 144 patients (mean age 56 ± 18 years) with successful ablation of clinically documented typical atrial flutter. In the first 50 patients, successful ablation was defined as termination and noninducibility of atrial flutter; for the subsequent 94 patients, successful ablation was defined as achievement of bidirectional isthmus conduction block and no induction of atrial flutter. The clinical and echocardiographic variables were analyzed in relation to the late occurrence of atrial flutter or fibrillation. Over the follow-up period of 17 ± 13 months, 14 (9.7%) patients had recurrence of typical atrial flutter. In the first 50 patients, 8 (16%) had recurrence of atrial flutter, compared with only 6 (6%) of the following 94 patients. Patients with incomplete isthmus block had a significantly higher incidence of recurrent atrial flutter than those with complete isthmus block (6/16 vs 0/78, P < 0.0001) in the following 94 patients. There was no predictor for recurrence of atrial flutter after successful ablation as determined by univariate and multivariate analysis. Although successful ablation of atrial flutter eliminated atrial fibrillation in 45% of patients with a prior history of atrial fibrillation, 31 (21.5%) of 144 patients undergoing this procedure developed atrial fibrillation during the follow-up period. Univariate analysis revealed that three clinical variables were related to the occurrence of atrial fibrillation: (1) the presence of structural heart disease; (2) a history of atrial fibrillation before ablation; and (3) inducible sustained atrial fibrillation after ablation. By multivariate analysis, only a history of atrial fibrillation and inducible sustained atrial fibrillation could predict the late development of atrial fibrillation after atrial flutter ablation. Conclusion: Radiofrequency catheter ablation of typical atrial flutter is highly effective and associated with a low recurrence rate of atrial flutter, but atrial fibrillation continues to be a long-term risk for patients undergoing this procedure. The presence of structural heart disease and prior spontaneous or inducible sustained atrial fibrillation increases the risk of developing atrial fibrillation.     

Acute treatment of recent-onset atrial fibrillation and flutter with a tailored dosing regimen of intravenous amiodarone: A randomized, digoxin-controlled study

A 24 h intravenous dosing regimen of amiodarone was designedto reach a peak plasma concentration at 1 h and to maintainthe concentration above a certain level during the infusionperiod A randomized, open-label, digoxin-controlled study wasundertaken to observe the efficacy and safety of the dosingregimen of amiodarone in treating recent-onset, persistent,atrial fibrillation and flutter with ventricular rates above130 beats. min^–1. Fifty patients with a mean age of 70± 7 (SD) years were enrolled and randomly assigned toreceive either amiodarone intravenously (n=26) or digoxin (n=24).Amiodarone HCl was infused over 24 h according to the followingregimen: 5 mg. min^–1, 3 mg. min^–1, 1 mg. min^–1and 0.5 mg. min^–1 for 1, 3, 6 and 14 h, respectively,for a 70-kg subject. Digoxin (0.013 mg. kg^–1) was infusedin three divided doses, each dose 2 h apart and infused over30 min. The mean heart rates in the amiodarone group decreased significantlyfrom 157 ± 20 beats. min^–1 to 122 ± 25 beats.min^–1 after 1 h (P<005 vs baseline), and then decreasedfurther to stabilize at 96 ± 25 beats. min^–1 after6 h (P<0.05). The digoxin group had fewer dramatic alterationsin heart rates, compared to the amiodarone group, in the first8h (P<0.05, respectively). Maximum reduction was reachedonly after 8 h. The amiodarone infusion was prematurely abortedin two patients due to severe bradycardia and death after conversionin one patient and aggravation of heart failure in the other.Overall, 24 of 26 patients (92%) in the amiodarone group and17 of 24 (71%) in the digoxin group were restored to sinus rhythmwithin 24 h. The accumulated rates of conversion over 24 h weresignificantly different between the two groups (P=0.0048). Digoxin,while not as effective as amiodarone in the treatment of recent-onsetatrial fibrillation and flutter, appears to be safer. Therefore,we suggest the use of digoxin as the first line drug for thetype of patients that formed the basis of the current studyand reserve amiodarone for refractory cases or those in whomdigoxin is not suitable.     

Radiofrequency Ablation of Idiopathic Left Ventricular Tachycardia with Changing EGG Morphology

Idiopathic left ventricular tachycardia is a distinct clinical entity with a typical ECG of right bundle branch block and left axis deviation. We presented a 39-year-old man with idiopathic left ventricular tachycardia, which demonstrated change in the configuration of QRS complex during successive radiofrequency catheter ablation. We proposed that this idiopathic left ventricular tachycardia may have alternative pathways within the reentrant circuit leading to different exits.