Atrial functional mitral regurgitation (AFMR) is mitral regurgitation in patients with atrial fibrillation (AF), whose left atrium (LA) is enlarged, the left ventricle is not enlarged or only slightly enlarged, the left ventricular ejection fraction is preserved, and the mitral valve itself has no apparent lesion. At present, the etiology, pathophysiology and mechanism of this disease have not been completely clear yet. Existing studies have found that the causes of AFMR mainly include AF, enlargement of LA and mitral annulus, destruction of mitral annular shape, inability of mitral valve remodeling to compensate for mitral annular expansion, and hamstringing of the posterior mitral leaflet by atriogenic tethering. AFMR is demonstrated to be associated with an increased risk of mortality and readmission due to heart failure. Therefore, it serves as a primary therapeutic target for patients with heart failure and AF. However, the optimal treatment of AFMR still remains controversial. Therefore, this article will mainly expound the current definition, etiology, pathophysiological mechanism, treatment, and prognosis of AFMR.

Neuroscientists have emphasized visceral influences on consciousness and attention, but the potential neurophysiological pathways remain under exploration. Here, we found two neurophysiological pathways of heart-brain interaction based on the relationship between oxygen-transport by red blood cells (RBCs) and consciousness/attention. To this end, we collected a dataset based on the routine physical examination, the breaking continuous flash suppression (b-CFS) paradigm, and an attention network test (ANT) in 140 immigrants under the hypoxic Tibetan environment. We combined electroencephalography and multilevel mediation analysis to investigate the relationship between RBC properties and consciousness/attention. The results showed that RBC function, via two independent neurophysiological pathways, not only triggered interoceptive re-representations in the insula and awareness connected to orienting attention but also induced an immune response corresponding to consciousness and executive control. Importantly, consciousness played a fundamental role in executive function which might be associated with the level of perceived stress. These results indicated the important role of oxygen-transport in heart-brain interactions, in which the related stress response affected consciousness and executive control. The findings provide new insights into the neurophysiological schema of heart-brain interactions.
Awareness ; Brain ; Consciousness ; Humans ; Oxygen ; Visual Perception

Aim To investigate the role of naringenin in nuclear factor erythroid 2-related factor 2 (Nrf2)/ phase II detoxifying enzyme activities and evaluate its effects on vascular inflammation. Methods Western blot, immunofluorescence and reverse transcription- qPCR were used to detect the protein expression. The activities of phase II detoxifying enzymes were measured by commercial kits. Immunoprecipitation technology was used to detect the interaction between Nrf2 and kelch-like ECH-associated protein 1 ( Keap-1). Results Naringenin promoted the dislocation of Nr£2 from Keap-1 and increased Nrf2 nuclear accumulation in RAW264. 7 macrophages. Naringenin up-regulated expressions of phase II detoxifying enzymes such as NAD(P)H quinone oxidoreductase ( NQO-1), gluta thione S-transferase (GST) and glutamate-cysteine lig- ase (GCL). It also reduced the levels of cytokines in macrophages. Moreover, the Nrf2 inhibitor ML385 reduced phase II detoxifying enzyme expressions and increased cytokine levels. In addition, we found naringenin increased the expressions and activities of liver phase II detoxifying enzymes ( NQO-1, GST and GCL) and reduced aortic inflammation in atherosclerotic model mice. The effects were dependent on Nr£2 activity. Conclusions Naringenin activates Nrf2 and promotes phase II detoxifying enzyme activities, which leads to the inhibition of vascular inflammation.

Many studies have shown that high-altitude exposure could significantly influence human cognition, and the approaches which could enhance the human cognition in high-altitude hypoxia environment attract great attention. In the present study, we recruited a total of 60 subjects who had been migrated to Tibet University as adults for more than one year. These participants were randomly divided into the experimental group and the control group. The participants in the experimental group were instructed to complete a hyperbaric oxygen treatment, and those in the control group just completed a wait condition. By using the attention network test (ANT), the changes of the attention function before and after a single session of hyperbaric oxygen treatment were explored. The results showed that single hyperbaric oxygen treatment significantly improved the orienting function of attention, with an obvious post-intervention effect, but not the alerting and conflict function of attention. We also found a strong association between alerting function and conflict function after the end of intervention, suggesting the change of the overall performance of attention function. The present findings might suggest that the improvement of attention function by a single session of hyperbaric oxygen intervention is derived from the increase of general cognitive resources, rather than the transfer of cognitive resources within the attention system.
Adult ; Humans ; Hyperbaric Oxygenation ; Orientation ; Oxygen ; Reaction Time ; Tibet ; Transients and Migrants

Background:The Food and Drug Administration recently announced that the use of morcellation may cause fibroids or pelvic dissemination and metastasis of uterine sarcoma;therefore,the use of morcellation is limited in the USA.A large sample study is necessary to assess the proportion of uterine malignant tumors found in patients with laparoscopic myomectomy.Methods:A national multicenter study was performed in China.From 2002 to 2014,33,723 cases were retrospectively selected.We calculated the prevalence and recorded the clinical characteristics of the patients with malignancy after morcellation application.A total of 62 cases were finally pathologically confirmed as malignant postoperatively.Additionally,the medical records of the 62 patients were analyzed in details.Results:The proportion of postoperative malignancy after morcellation application was 0.18％ (62/33,723) for patients who underwent laparoscopic myomectomy.Nearly 62.9％ (39/62) of patients had demonstrated blood flow signals in the uterine fibroids before surgery.And,23 (37.1％) patients showed rapid growth at the final preoperative ultrasound.With respect to the pathological types,38 (61.3％) patients had detectable endometrial stromal sarcoma,13 (21.0％) had detectable uterine leiomyosarcoma,only 3 (3.2％) had detectable carcinosarcoma,and 5 (8.1％) patients with leiomyoma had an undetermined malignant potential.Conclusions:The proportion of malignancy is low after using morcellation in patients who undergo laparoscopic myomectomy.Patients with fast-growing uterine fibroids and abnormal ultrasonic tumor blood flow should be considered for malignant potential,and morcellation should be avoided.

OBJECTIVETo analyze the cytogenetic characteristics of different age subgroups in patients with acute myeloid leukemia (AML), and to explore the relationship between age and cytogenetics.

METHODSBetween January 2004 and December 2011, Bone marrow (BM) samples from 640 patients with de novo AML were analyzed retrospectively. The analyses were performed according to standard culturing and banding techniques, and clonal abnormalities were defined and described according to the International System for Human Cytogenetic Nomenclature (ISCN 2009). The cytogenetic subtypes were performed as normal, balanced, and unbalanced karyotypes. In the last group, the age distribution of complex and monosome karyotypes were further analyzed. The patients were divided into 8 age groups: 0 - 9, 10 - 19, 20 - 29, 30 - 39, 40 - 49, 50 - 59, 60 - 69, and ≥ 70 year old groups.

RESULTSThe distribution of normal, balanced, and unbalanced karyotypes showed age specific characteristics. The incidence of normal karyotype increased from 6.67% (0 ∼ 9 year old) to 58.33% (≥ 70) (χ(2) = 20.68, P = 0.001) and balanced karyotype decreased from 73.33% (0 ∼ 9) to 11.11% (≥ 70) (χ(2) = 48.22, P < 0.01). The frequency of unbalanced karyotypes increased from 20.0% (0 ∼ 9) to 30.56% (≥ 70) (χ(2) = 18.963, P = 0.008). The frequency of complex karyotype was 6.67% in 0 - 9 year old group, followed by 0% in 10 - 19 and 20 - 29 year old group, and from 1.72% to 11.11% from 30 - 39 to ≥ 70 year old group (χ(2) = 8.341, P = 0.08). Monosome karyotype was only detected in patients in 30 year old or older groups. Although an increased tendency was observed with ages, there was no significant difference (χ(2) = 4.778, P = 0.311).

CONCLUSIONThe different age profiles of the cytogenetic subtypes may indicate the different mechanisms of the pathogenesis of AML, which may also offer beneficial information for etiological research of AML.

Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Karyotype ; Karyotyping ; Leukemia, Myeloid, Acute ; genetics ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

OBJECTIVETo explore the relationship between gene polymorphism of GABAA receptors and childhood autism by detecting rs140682, rs2081648 and rs140679 site of single nucleotide polymorphism (SNP) in GABAA receptors gene.

METHODSA total of 94 children with autism and 124 normal children were enrolled in a hospital from November 2010 to May 2011. Childhood autism rating scale (CARS) and autism behavior checklist (ABC) were used to evaluate or investigate the case group. After collecting venous blood and extracting the genome DNA, the allele and genotype of SNP rs140682, rs2081648 and rs140679 site in GABAA receptors gene were detected by PCR-RFLP. The allele and genotype of case group and control group were analyzed by χ(2) test, while the score of scales was analyzed by Spearman rank correlation analysis.

RESULTSThe age of the case group was 5.12 ± 0.32, and it was 5.25 ± 0.27 in the control group (P < 0.05). In case group, the frequency of genotype CC, CT and TT of rs140682 site was 44, 41 and 9, while it was 48, 65, and 11 in control group (P > 0.05), respectively. The frequency of genotype AA, AG and GG of rs2081648 site was 8, 58 and 28 in case group, while it was 12, 49 and 63 in control group (P < 0.05), respectively. In case group, the frequency of genotype CC, CT and TT of rs140679 site was 15, 36 and 43, while it was 18, 59 and 47 in control group (P > 0.05), respectively. It was revealed by Spearman rank correlation analysis that of rs2081648 site, there was a positive correlation between genotype AG and sensation factor (S), social intercourse factor (R), and language factor (L) of autism behavior checklist (ABC) (r values were 0.149, 0.165 and 0.155, all P values < 0.05). A negative correlation between genotype GG and S, R, L and self-help factor (V) was proved (r values were -0.140, -0.173, -0.158 and -0.135, all P values < 0.05). There was a positive correlation between allele A and R and L factors (r values were 0.153 and 0.137, all P values < 0.05), while a negative correlation between allele G and R and L factors (r values were -0.153 and -0.137, all P values < 0.05). In case group, 42 children were diagnosed with mild-to-moderate autism, while 52 children were severe autism. There was no statistically significant correlation between allele or genotype of SNP rs140682 and rs140679 site and the degree of autism (P > 0.05). There was a positive correlation between allele A and genotype AG and the degree of autism (r values were 0.147 and 0.616, all P values < 0.05), while a negative correlation between allele G and genotype GG and the degree of autism (r values were -0.159 and -0.616, all P values < 0.05).

CONCLUSIONThe SNP rs2081648 site which located in GABAA receptors gene may be related to autism. No evidence for significant association between rs140682 and rs140679 site and autism was found.

Alleles ; Autistic Disorder ; genetics ; Child ; Child, Preschool ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Humans ; Male ; Polymorphism, Single Nucleotide ; Receptors, GABA-A ; genetics

Objective To observe the changes of Na(v)1.6 expression in rats after acute cerebral ischemia and the effect of Riluzole (the sodium channel blocker) on these changes, and discuss the relationship between level of Na(v)l.6 and cerebral ischemia. Methods One hundred and five healthy SD rats were randomly divided into sham-operated group (n=15), ischemia control group (IC, n=45) and Riluzole therapy group (RT, n=45). Rat models of focal acute cerebral ischemia in the later 2 groups were established by permanent occlusion of right middle cerebral artery. Riluzole at a dosage of 8 mg/kg was given once daily to the rats of the RT group 30 min after ischemia. Tissues from the striatum were collected at different time points (6 h, and 1, 2, 3 and 7 d after ischemia); the expressions of Na(v)1.6 in the striatum were detected by immunofluorescence staining and real-time quantitative PCR at each time point; and the infarct volume was observed by triphenyltetrazolium chloride staining at each time point.Results The rats in the IC group and RT group showed neurologic impairment, especially 2 d after ischemia; rats of the IC group presented significantly higher scores of neurological function scale than those of the RT group at the same time point (P＜0.05). Immunofluorescence staining showed that the expression of Na (v)1.6 was up-regulated, and reached its peak level 1 d after ischemia but then, was down-regulated both in the IC group and RT group. Real-time quantitative PCR showed that the expression of Na(v)1.6 in the IC group was up-regulated 1 d after ischemia, and then down-regulated 2, 3 and 7 d after ischemia, however, that in the RT group was down-regulated 6 h after ischemia; the mRNA expression of Na (v)1.6 in the RT group was obviously down-regulated as compared with that in the IC group at the same time point (P＜0.05). The infarction volume became the largest 3 daRer ischemia both in the IC group and RT group; the infarction volume in RT group was smaller than that in IC group at the same time point (P＜0.05). Conclusion The expression of Na(v)1.6 is down-regulated after cerebral ischemic injury to mitigate acute cerebral ischemic injury, indicating that Na (v)1.6 might involve in the development of cerebral ischemic injury.

Clinical laboratory biological safety is one of whole society safety. This paper introduced briefly the current situation of clinical medical laboratory biosafty in the hospital. and set forth common biological hazards specifically for whose characteristics. Combining the biosafety administration measures from abroad, the issue of laboratory biological safety administration was considered, and put forward some suggestions according to related law and regulation of national laboratory safety administration in order to strengthen clinical laboratory biosafety administration.

OBJECTIVEIn mid-July 2005, five patients presented with septic shock to a hospital in Ziyang city in Sichuan, China, to identify the etiology of the unknown reason disease, an epidemiological, clinical, and laboratory study were conducted.

METHODSAn enhanced surveillance program were established in Sichuan, the following activities were introduced: active case finding in Sichuan of (a) laboratory diagnosed Streptococcus suis infection and (b) clinically diagnosed probable cases with exposure history; supplemented by (c) monitoring reports on meningococcal meningitis. Streptococcus suis serotype 2 infection was confirmed by culture and biochemical reactions, followed by sequencing for specific genes for serotype and virulence factors.

RESULTSFrom June 10 to August 21, 2005, 68 laboratory confirmed cases of human Streptococcus suis infections were reported. All were villagers who gave a history of direct exposure to deceased or sick pigs in their backyards where slaughtering was performed. Twenty six (38%) presented with toxic shock syndrome of which 15 (58%) died. Other presentations were septicaemia or meningitis. All isolates were tested positive for genes for tuf, species-specific 16S rRNA, cps2J, mrp, ef and sly. There were 136 clinically diagnosed probable cases with similar exposure history but incomplete laboratory investigations.

CONCLUSIONAn outbreak of human Streptococcus suis serotype 2 infections occurred in villagers after direct exposure to deceased or sick pigs in Sichuan. Prohibition of slaughtering in backyards brought the outbreak to a halt. A virulent strain of the bacteria is speculated to be in circulation, and is responsible for the unusual presentation of toxic shock syndrome with high case fatality.

Animals ; Bacteremia ; epidemiology ; microbiology ; China ; epidemiology ; Disease Outbreaks ; Humans ; Meningitis, Bacterial ; epidemiology ; microbiology ; Shock, Septic ; epidemiology ; microbiology ; Streptococcal Infections ; epidemiology ; microbiology ; veterinary ; Streptococcus suis ; isolation & purification ; Swine ; Swine Diseases ; microbiology