4 cases of simple blunt trauma to the heart,with laceration of cardiac valve in 2 cases,perforation of valve in 1 and rupture of chordae tendineae in 1,were reported.The immediate symptoms were chest pain and sensation of oppression,palpitation,dizziness or syncope.The most threatening episode,however,was acute heart failure,which occurred 3-6 months after the injury.3 cases in this series required emergent operation due to acute heart failure.2 patients made an uneventful recovery following valve replacement,and 1 patient died of ventricular fibrillation during operation.Autopsy confirmed the diagnosis of Marfan's syndrome.A brief discussion on blunt trauma of the heart was made with analysis of the mechanism involved,and the literature was reviewed.Preliminary experience in diagnosis and management of this series of patients was presented.

Adult ; Balloon Occlusion ; instrumentation ; Ductus Arteriosus, Patent ; complications ; therapy ; Equipment Design ; Female ; Humans ; Hypertension, Pulmonary ; complications

Background: Clinical dexamethasone (DEX) treatment or stress in bovines results in extensive physiological changes with prominent hyperglycemia and neutrophils dysfunction. Objectives: To elucidate the effects of DEX treatment in vivo on cellular energy status and the underlying mechanism in circulating neutrophils. Methods: We selected eight-month-old male bovines and injected DEX for 3 consecutive days (1 time/d). The levels of glucose, total protein (TP), total cholesterol (TC), and the proinflammatory cytokines interleukin (IL)-1β, IL-6 and tumor necrosis factor (TNF)-α in blood were examined, and we then detected glycogen and adenosine triphosphate (ATP) content, phosphofructosekinase-1 (PFK1) and glucose-6-phosphate dehydrogenase (G6PDH) activity, glucose transporter (GLUT)1, GLUT4, sodium/glucose cotransporter (SGLT)1 and citrate synthase (CS) protein expression and autophagy levels in circulating neutrophils. Results: DEX injection markedly increased blood glucose, TP and TC levels, the Ca 2+ /P 5+ ratio and the neutrophil/lymphocyte ratio and significantly decreased blood IL-1β, IL-6 and TNF-α levels. Particularly in neutrophils, DEX injection inhibited p65-NFκB activation and elevated glycogen and ATP contents and SGLT1, GLUT1 and GR expression while inhibiting PFK1 activity, enhancing G6PDH activity and CS expression and lowering cell autophagy levels. Conclusions DEX induced neutrophils glucose uptake by enhancing SGLT1 and GLUT1 expression and the transformation of energy metabolism from glycolysis to pentose phosphate pathway (PPP)-tricarboxylic acid (TCA) cycle. This finding gives us a new perspective on deeper understanding of clinical anti-inflammatory effects of DEX on bovine.