BACKGROUND: Patients with atrial fibrillation (AF) and prior stroke history have a high risk of cardiovascular events despite anticoagulation therapy. It is unclear whether catheter ablation (CA) has further benefits in these patients. METHODS: AF patients with a previous history of stroke or systemic embolism (SE) from the prospective Chinese Atrial Fibrillation Registry study between August 2011 and December 2020 were included in the analysis. Patients were matched in a 1:1 ratio to CA or medical treatment (MT) based on propensity score. The primary outcome was a composite of all-cause death or ischemic stroke (IS)/SE. RESULTS: During a total of 4.1 ± 2.3 years of follow-up, the primary outcome occurred in 111 patients in the CA group (3.3 per 100 person-years) and in 229 patients in the MT group (5.7 per 100 person-years). The CA group had a lower risk of the primary outcome compared to the MT group [hazard ratio (HR) = 0.59, 95% CI: 0.47-0.74, P < 0.001]. There was a significant decreasing risk of all-cause mortality (HR = 0.43, 95% CI: 0.31-0.61, P < 0.001), IS/SE (HR = 0.73, 95% CI: 0.54-0.97, P = 0.033), cardiovascular mortality (HR = 0.32, 95% CI: 0.19-0.54, P < 0.001) and AF recurrence (HR = 0.33, 95% CI: 0.30-0.37, P < 0.001) in the CA group compared to that in the MT group. Sensitivity analysis generated consistent results when adjusting for time-dependent usage of anticoagulants. CONCLUSIONS In AF patients with a prior stroke history, CA was associated with a lower combined risk of all-cause death or IS/SE. Further clinical trials are warranted to confirm the benefits of CA in these patients.

OBJECTIVE: To investigate the effect of Notch signaling pathways on differentiation of mouse embryonic stem cells(ESC) into haematopoietic stem cells or haematopoietic progenitors cells(HSC/HPC). METHODS: Mouse embryonic stem cells were proliferated in vitro to form embryoid bodies; the differentiation of embryoid bodies should be induced in vitro, the experiments were divided into BE, control, VEGF, DAPT and VEGF-DAPT groups; HSC/HPC ohenotype: CD117D34Sca1 was detected by flow cytometry; the related gene expression was detected by RT-PCR. RESULTS: The number of VEGF-induced HSC/HPC in VEGF group was significantey higher than that in the control and EB group (P<0.05), suggesting that VEGF promotes ESC differentiation to HSC/HPC; the number of DAPT-induced HSC/HPC in DAPT group was significanty higher than that in the Control and EB groups(P<0.05), suggesting that DAPT promotes ESC differentiation to HSC/HPC; the number of VEGF+DAPT-induced HSC/HPC in VEGF-DAPT group was significantly higher than that in VEGF and DAPT groups(P<0.05), suggesting that DAPT and VEGF play a synergistic role to promote differentiation of ESC into HSC/HPC. CONCLUSION Notch signal pathway inhibits differentiation of ESC into HSC / HPC by VEGF.
Animals ; Cell Differentiation ; Hematopoietic Stem Cells ; Mice ; Mouse Embryonic Stem Cells ; Receptors, Notch ; Signal Transduction ; Vascular Endothelial Growth Factor A

Objective To evaluate the safety and efficacy of the CARTO3-based total three-dimensional(T3D,total three-dimensional)zero X-ray mapping technique in radiofrequency catheter ablation of elderly patients with atrial fibrillation. Methods A total of 60 patients diagnosed with paroxysmal atrial fibrillation underwent radiofrequency catheter ablation at the Beijing Anzhen Hospital Arrhythmia Center from December 2015 to April 2017 were included. All patients were randomly divided into the study group(30 cases) and the control group(30 cases). T3D technique was utilized in the study group, and patients in the control group received conventional AF ablation. The procedure parameters success rate of circumferential pulmonary vein isolation(CPVI), rates of atrial fibrillation recurrence complication were compared between the two groups. Results All the 60 patients with paroxysmal atrial fibrillation had successful atrial fibrillation ablation and finished follow-up. Compared with the control group, the time of atrium three-dimensional reconstruction in the study group was longer [study group vs control group:(57.7±11.0)min vs.(10.4±3.5)min,P<0.001)];X-ray exposure time was significantly shorter in the study group[study group vs control group:0 min vs.(15.73±3.91)min,(P<0.001)]. The diff erence in circumferential pulmonary vein ablation time between the two groups was not of statistical significance[study group vs. control group:(49.9 ± 11.3)min vs.(51.1 ± 12.6)min,P=0.699].CPVI was successful in all patients in both groups. There was no signifi cant diff erence in the early and late recurrence rate and the incidence of complications between the two groups(P>0.05). Conclusions The application of T3D technique in radiofrequency ablation for elderly patients with paroxysmal atrial fi brillation is safe and eff ective, which can reduce the time of X-ray exposure and has important clinical value.

The UHPLC-LTQ-Orbitrap high resolution mass spectrometer was used to explore the chemical compositions in safflower. The rapid separation of the compositions was conducted by the UHPLC, following by high resolution full scan and MS2 scan, under the positive and negative ion mode. The chemical formula of compositions were deduced by full scan data in less than 5, then the potential structures were confirmed by the MS2 data. Forty-nine compounds were detected, of which 26 was identified, and 5 compounds was validated by the standard substances.
Carthamus tinctorius ; chemistry ; Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Molecular Structure ; Tandem Mass Spectrometry ; methods

OBJECTIVETo explore the effect of acupuncture-drug compound anesthesia on immune function in patients with extracorporeal circulation undergoing cardiac surgery.

METHODSThirty cases undergoing cardiac surgery which included atrial septal defect neoplasty, ventricular septal defect neoplasty, mitral valve replacement and pulmonary valve coarctotomy were randomly divided into group A and group B, 15 cases in each group. Group A was given general anesthesia plus acupuncture at Neiguan (PC 6), Lieque (LU 7) and Yunmen (LU 2), and group B was given simple general anesthesia. Tumor necrosis factor-alpha (TNF-alpha), interleukin-2 (IL-2) and interleukin-10 (IL-10) levels before and after surgery were compared.

RESULTSThe level of TNF-alpha was increased and the levels of IL-2 and IL-10 in the serum were decreased in both groups after extracorporeal circulation for 2 h and 24 h, and the ranges of all changes were more less in group A (all P < 0.05).

CONCLUSIONCompared with simple general anesthesia, acupuncture-drug compound anesthesia can improve immune suppression partially in the perioperative periods under the same conditions of controlling anesthesia degree.

Acupuncture Analgesia ; Adult ; Anesthesia, General ; Cardiac Surgical Procedures ; Female ; Heart Diseases ; blood ; immunology ; surgery ; Humans ; Inflammation Mediators ; blood ; Interleukin-10 ; blood ; Interleukin-2 ; blood ; Male ; Middle Aged ; Perioperative Care ; Tumor Necrosis Factor-alpha ; blood ; Young Adult

Objective To study the influence of mesenchymal stem cells(MSCs) implantation on ventricular remodeling and heart function after myocardial infarcion. Methods Bone marrow was aspirated from Gui-zhou Xiang swines.After being isolated,cultured and co-cultured with 5-azacytidine,either autologous MSCs(experiment group) or a comparable volume of physiologic saline(control group) were injected into the infarcted myocardium.Three and six weeks later,echocardiographic measurement was performed to assess the myocardial structure and heart function,and single photon emission computed tomography(SPECT) was employed for myocardial imaging.Implanted stem cells were detected by the anti-Brdv antibody DAB with HE staining. Results Left ventricular ejection fraction(EF),fractional shortening and wall thickening were higher in experiment group than control group.The thickness of the ventricular wall and septum was found increased while the left ventricular chamber size was smaller in experiment group.It was indicated by SPECT that three and six weeks after implantation,there was obvious image defect in control group while in experiment group there were some imaging areas in the infarcted area.Brdv-labelled cells were observed in the central part of and around the infarcted area.Conclusion Implantation of MSCs into the infarcted myocardium is believed to attenuate the remodeling process,inhibit the extent of wall thinning and dilatation of the ventricular chamber.MSCs implantation may also improve the contractile ability of the myocardium and heart function.

The objective of the study was to research the distribution features of HLA-DRB1 alleles in Shandong Hans' population and explore the possibility of finding the cord blood donor of HLA-DR matched to perform the stem cell transplantation for more patients from larger region of China and even other areas in the world. The subjects of the study were drawn from 3 438 Shandong Hans donors in Shandong Umbilical Cord Blood Bank and were tested by PCR-SSP technique for HLA-DR low resolution typing. The result indicated that the most prevalent five alleles of HLA-DRB1 locus were DRB1 * 15 (0.1817), * 07 (0.1369), * 09 (0.1221), * 04 (0.1084) and * 12 (0.1038). The DR18 has the lowest gene frequency 0.0003, while DRB1 * 10, * 16 and * 01 showed lower gene frequencies (GF), which GF were 0.0151, 0.0262, and 0.0322 respectively. As compared the HLA-DRB1 GF of Shandong Hans with those of other Han Chinese and other ethnic populations, there were unique distributed features of DRB1 alleles among various races populations, and those among the studied population groups from various regions with the same race origin. The difference from various regions in the same race was less than that among different races. In conclusion, a patient of Han Chinese is easier to search a DR-matched cord blood donor in Shandong Umbilical Cord Blood Bank, especially from northern Hans. No DRB1 allele is unique to single racial group and majority of DRB1 low-resolution phenotypes are common to all studied groups. It is reasonable for some patients from other races including Caucasian and Japanese to receive a transplant of cord blood stem cell matched with HLA-DR in Shandong Umbilical Cord Blood Bank.
Asian Continental Ancestry Group ; genetics ; Blood Donors ; European Continental Ancestry Group ; genetics ; Fetal Blood ; immunology ; Gene Frequency ; HLA-DR Antigens ; genetics ; HLA-DRB1 Chains ; Humans

To explore a method of predicting acute graft versus host disease (aGVHD) after unrelated cord blood transplantation (UCBT), the HLA-A, -B, -DRB1 molecular three-dimensional structures in 25 patients with blood disorder who underwent UCBT and their donors were modeled by using molecular modeling technique. First, full amino acid sequences of each HLA antigen from HLA data banks were loaded down, and then amino acid sequence of extracellular antigen binding region was chosen. Third step, SPDBV software of SWISS-MODEL server was used to modeling the three-dimensional structures of each different allele of HLA-A, -B and -DRB1 between patients and donors and the parameter "root mean square deviation" (RMSD) was used to indicate the structure differences. Last, RMSD of each different HLA allele of each donor-patient pair were added together to get total RMSD. The 25 patients were divided into 3 groups: the first group did not develop aGVHD; the second group developed aGVHD graded I-II and the third group developed aGVHD graded III-IV. The results showed that in the 25 patients divided into three groups, 8 patients in the first group did not develop aGVHD (32%); 13 patients in the second group developed grade I-II of aGVHD (52%) and 4 patients in the third group developed aGVHD III-IV (16%). The total RMSDs of each group were 0.24 +/- 0.15, 0.25 +/- 0.14 and 0.47 +/- 0.22 respectively. The total RMSD of the third group was significantly higher than that of the other two groups. In conclusion, utilization of modeling HLA molecular three-dimension can predict the severe aGVHD after UCBT quickly, simply and accurately. It provides scientific basis in choosing a optimal cord blood donor to avoid severe aGVHD for physicians and the cord blood banks. And it is instructive too to direct the application of immunosuppressive agents after transplantation in clinic.
Acute Disease ; Adolescent ; Adult ; Child ; Child, Preschool ; Cord Blood Stem Cell Transplantation ; adverse effects ; Graft vs Host Disease ; etiology ; HLA Antigens ; chemistry ; HLA-A Antigens ; chemistry ; HLA-B Antigens ; chemistry ; HLA-DR Antigens ; chemistry ; HLA-DRB1 Chains ; Histocompatibility Testing ; Humans ; Models, Molecular