BACKGROUND:Previous studies have shown that salidroside has an ameliorative effect on multi-organ fibrosis.However,the protective effect of salidroside on angiotensin ⅱ-induced fibrosis in cardiac fibroblasts is unclear. OBJECTIVE:To investigate the protective effects of salidroside on angiotensin ⅱ-induced oxidative stress and extracellular matrix deposition in cardiac fibroblasts of Sprague-Dawley rats and its mechanism of action. METHODS:Angiotensin Ⅱ was used to induce fibrosis in cardiac fibroblasts,and there were five experimental groups:normal control group,model group(final concentration of angiotensin Ⅱ in culture medium was 1 μmol/L),salidroside low and high dose groups(treatment with salidroside 50,100 μmol/L for 2 hours,followed by co-incubation with angiotensin Ⅱ for 48 hours),SIRT1 inhibitor group(treatment with SIRT1 inhibitor EX527 10 μmol/L for 2 hours,followed by high dose of salidroside for 2 hours and then co-incubation with angiotensin Ⅱ for 48 hours).The cell viability was detected using the cell counting kit-8 method,the cell migration rate was detected by Transwell,the intracellular reactive oxygen species level was detected by DCFH-DA fluorescent probe,and the intracellular malondialdehyde content,superoxide dismutase and catalase activities were detected by relevant kits.The protein and mRNA expression levels of SIRT1,LOXL2,α-SMA,type I collagen and type Ⅲ collagen were detected by western blot and qRT-PCR,respectively. RESULTS AND CONCLUSION:The cells were identified as cardiac fibroblasts by Vimentin fluorescence.Compared with the normal control group,cell viability,cell migration rate,reactive oxygen species level,and malondialdehyde content were significantly increased,superoxide dismutase and catalase activities were significantly decreased,LOXL2,α-SMA,type I collagen,type Ⅲ collagen mRNA and protein expression were significantly increased,and SIRT1 protein expression level was significantly decreased in the model group(all P＜0.01).Compared with the model group,the above indexes showed opposite changes in the salidroside low and high dose groups(all P＜0.05).Moreover,salidroside showed dose-dependent regulation.Compared with salidroside groups,cell migration rate and α-SMA protein expression level were significantly increased in the SIRT1 inhibitor group(both P＜0.001).To conclude,salidroside has a protective effect on angiotensin Ⅱ-induced cardiac fibroblasts and can dose-dependently inhibit oxidative stress and extracellular matrix deposition.

Objective:To investigate the effects of regulation of GATA6 expression by long non-coding RNA(lncRNA)GATA6 antisense RNA 1(GATA6-AS1)on the proliferation,apoptosis,and metastasis of 5-fluorouracil(5-FU)resistant gastric cancer(GC)cells SGC7901/5-FU,and to explore the underlying mechanisms. Methods:Parental SGC7901 cells and SGC7901/5-FU cells were used as controls(treated with blank culture medium).Empty vector pcDNA3.1(control for GATA6-AS1 overexpression),recombinant vector pcDNA3.1-GATA6-AS1(for GATA6-AS1 overexpression),shNC(negative control for GATA6-AS1 silencing)or shGATA6-AS1(for GATA6-AS1 silencing)were transfected into SGC7901/5-FU cells by Lipofectamine 2000 to overexpress or silent GATA-AS1.The mRNA expression of GATA6-AS1 and GATA6 in cells of different treatment groups were examined by real-time fluorescence quantitative PCR.After 5-FU treatment,the proliferation,migration,invasion and apoptosis were analyzed by CCK-8 assay,wound-healing assay,Transwell assay,and flow cytometry(FCM)assay,respectively.The protein expression levels of Bax,Bcl-2,Caspase 3 and GATA6 in different treatment groups were examined by Western blotting.The stability of GATA6 mRNA was evaluated after α-amanitin treatment.The relationship between GATA6-AS1 and GATA6 was studied by RNA pull-down experiment.Furthermore,the SGC7901 cell transplantation tumor model was established using Balb/c nude mice,and the grouping was the same as in vitro experiments with 12 mice in each group.The tumor growth was recored and the tumor inhibition rate was calculated after 5-FU treatment.The histopathological changes of tumor tissue in each group was assessed by HE staining.The protein expression of proliferating cell nuclear antigen(PCNA)in tumor tissues of nude mice in each group was detected by Western blotting. Results:Compared with parental SGC7901 cells(control group),the expression of GATA6-AS1 and GATA6 mRNA was significantly downregulated in SGC7901/5-FU cells(P＜0.05);the proliferation,migration and invasion of SGC7901/5-FU cells was significantly decreased while the apoptosis of SGC7901/5-FU cells was significantly decreased(P＜0.05);the protein expression levels of GATA6,Bax and Caspase 3 were significantly decreased while that of Bcl-2 was significantly increased(P＜0.05).Compared with SGC7901/5-FU-pcDNA group,the above changes showed opposite trends in SGC7901/5-FU cells overexpressing GATA6-AS1.Compared with SGC7901/5-FU-shNC group,the expression of GATA6-AS1 and GATA6 mRNA was significantly downregulated in GATA6-AS1-silencing SGC7901/5-FU cells(P＜0.05);the proliferation,migration and invasion of GATA6-AS1-silencing SGC7901/5-FU cells was significantly decreased while apoptosis of GATA6-AS1-silencing SGC7901/5-FU cells was significantly decreased(P＜0.05);the protein expression levels of GATA6,Bax and Caspase 3 were significantly decreased while that of Bcl-2 was significantly increased(P＜0.05).GATA6-AS1 can increase the stability of GATA6 mRNA and positively regulate the expression of GATA6.In vivo characterization showed that,compared with mice transplanted with parental SGC7901 cells,the tumor volume and PCNA protein expression in tumor tissues were significantly increased in mice transplanted with drug resistant SGC7901/5-FU cells after 5-FU treatment(P＜0.05).Mice in SGC7901/5-FU-GATA6-AS1 group showed significantly reduced tumor volume and PCNA protein expression compared with the SGC7901/5-FU-pcDNA group(P＜0.05),and pathological analysis of the tumor tissues revealed milder development of GC in SGC7901/5-FU-GATA6-AS1 group.Whereas,mice in SGC7901/5-FU-shGATA6-AS1 group showed significantly increased tumor volume and PCNA protein expression compared with the SGC7901/5-FU-shNC group(P＜0.05),and histopathological analysis of the tumor tissues revealed severer development of GC in SGC7901/5-FU-shGATA6-ASl group. Conclusion:Overexpression of GATA6-AS1 can promote the expression of GATA6,inhibit the growth of GC cells,and thus reverse the resistance of SGC7901/5-FU cells to 5-FU.

Sarcopenia, a common complication of cirrhosis, has an incidence rate as high as 40% ~ 70%. Furthermore, adverse events such as shortened survival, lower quality of life, prolonged hospital stay, increased complications, a higher mortality rate, and sometimes altering the liver transplantation prognostic outcome in patients with liver cirrhosis are closely related. In recent years, some progress has been made in the research on the treatment of sarcopenia, but there is no clear treatment plan at present; thus, research and development by researchers and clinicians still need to be strengthened. This article briefly describes the relevant treatment methods for sarcopenia in patients with cirrhosis.

Objective:To analyze the safety and efficacy of left atrial appendage closure(LAAC)with Watchman in patients ≥85 years with atrial fibrillation(AF).Methods:515 elderly patients with atrial fibrillation, including 73 patients aged 85 years or older(85~91), who had undergone Watchman LAAC at Zhoupu Hospital affiliated to Shanghai Health Medical College from August 2016 to December 2020, were retrospectively analyzed.Of those ≥85 years, 44(60.3%)with transesophageal echocardiography records were assigned to the elderly group.Fifty-three patients aged 60 to 65 were selected as the control group.Differences in baseline data, intraoperative conditions, antithrombotic treatment plans and 1-year follow-up prognosis were compared between the two groups.Results:Compared with the control group, there was no difference in AF types, history of ischemic stroke/transient ischaemic attack(all P>0.05), but there were higher incidences of coronary heart disease and renal insufficiency, more severe heart failure, higher CHA 2DS 2-VASC(6.0±1.5 vs.3.6±1.5), HAS-BLED(3.2±1.2 vs.2.3±1.3)scores( t values were 7.682 and 3.871, respectively, P<0.05), and a lower one-stop surgery rate(6 cases or 13.6% vs. 27 cases or 50.9%, χ2=10.517, P<0.05)in the advanced age group.There was no difference in the diameter of the Watchman device, rate of device replacement, compression percentage and residual flow between the two groups during the perioperative period.The incidences of device-related thrombosis were 4.5%(2/44)and 3.8%(2/53)for the advanced age group and the control group, respectively, but the difference was not statistically significant( P>0.05). During the 12-month follow-up, there were no cases of ischemic stroke or intracerebral hemorrhage.Three died of heart failure and 1 died of cancer. Conclusions:LAAC with Watchman is safe and effective for patients over 85 years with AF, but the decision on the procedure should be based on careful assessment of patients' cardiac and renal function and general health.

Objective:To investigate the relationship of delayed cardiac tamponade (CT) after left atrial appendage closure (LAAC) in atrial fibrillation (AF) patients and implanted occluders and adjacent anatomical structures.Methods:This study was a retrospective study. Thirteen AF patients with LAAC complicated with delayed CT and with concurrent emergency pericardiocentesis drainage in Zhoupu Hospital, Shanghai University of Medicine & Health Sciences from August 2016 to June 2021 were selected. The follow-up time was (16±12) months. The clinical data of these patients were retrospectively analyzed, including the relationship between the left atrial appendage and pulmonary artery, vein anatomy by left atrium computed tomography angiography (CTA) before and after LAAC.Results:Thirteen patients with delayed CT were treated by pericardiocentesis and drainage after LAAC and aged (72.1±8.3) years, and 7 patients were male, Six patients received cryoablation simultaneously. The classification types of left atrial appendage included cauliflower and chicken wing types were 8 and 5 respectively. The seal plate diameter of the lobe-and-disc devices was (29.5±2.8)mm; 10 patients had cardiac CTA reviewed. The occluder was attached to pulmonary artery in 8 patients, attached to left superior pulmonary vein only in one patient, and attached to pulmonary artery and left superior pulmonary vein in one patient. The prognosis was good except one patient who died 2 days after LAAC.Conclusions:Delayed CT after LACC is closely related to the location of left atrial appendage adjacent to pulmonary artery and left superior pulmonary vein, and is related to larger occluder and anchor hook.

Objective:To investigate the clinical characteristics and prognosis of coronavirus disease 2019 (COVID-19) patients with Omicron variant combined with atrial fibrillation (AF).Methods:From March 23, 2022 to May 15, 2022, 2 675 aged ≥ 50 years old COVID-19 patients with AF were admitted to Zhoupu Hospital, the designated hospital for COVID-19 in Shanghai. Patients were divided into mild symptoms group, normal group, and serious/critical group according to the symptoms. The clinical data, imaging examination and laboratory results and prognosis of the three group patients were compared.Results:The median age of 2 675 COVID-19 patients was 69.0 (60.0, 81.0) years old, the incidence of AF was 5.05% (135/2 675), the age range of AF patients were from 55 to 101 years old, with a median age of 84.0 (74.0, 89.0), and the number of mild symptoms, normal, serious/critical patients were 68, 30, 37, respectively, including 9 of serious and 28 of critical patients. In the serious/critical patients, aged 55-75 years old accounted for 43.2%, the rate of 2019 novel coronavirus vaccination was 32.4%. The identified new-onset AF was the highest among the three groups, but the rate of persistent AF was the highest in the mild symptoms group (58.8%). The severe/critical group complicated with fever (29.7%), hepatic insufficiency (13.5%), renal insufficiency (46.0%), type 2 diabetes (46.0%), and heart failure were higher in NYHA classification [compared with the mild symptoms and normal group (score): 1.8±1.1 vs. 1.1±0.8, 1.2±0.7, respectively, all P < 0.05]. In term of laboratory examinations, C-reactive protein (CRP), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) levels were significantly higher in serious/critical patients compared to the mild symptoms and normal groups [CRP (mg/L): 27.2 (6.0, 60.8) vs. 7.6 (3.1, 19.3), 12.8 (4.9, 26.3), ALT (U/L): 31.3±15.4 vs. 15.4±9.3, 19.3±11.7, AST (U/L): 78.0±21.7 vs. 34.7±15.6, 38.1±24.4, all P < 0.05]. The hemoglobin (Hb) and albumin (ALB) levels were significantly lower than those in the mild symptoms and normal groups [Hb (g/L): 105.3±22.5 vs. 125.8±25.4, 123.0±20.4, ALB (g/L): 33.7±6.0 vs. 39.0±5.5 and 39.6±13.1, all P < 0.05]. In addition, MB isoenzyme of creatine kinase (CK-MB) was significantly higher in the serious/critical group than that in the mild symptoms group [μg/L: 2.5 (1.5, 3.4) vs. 2.2 (1.2, 2.8), P < 0.05]. In terms of the treatment, the percentage of antiplatelet agents and low-molecular heparin ratio compared among the three groups were statistically significant, with the serious/critical group using the lowest percentage of antiplatelet agents (27.0%) and a higher percentage of low-molecular heparin usage than that in mild symptoms group [81.1% (30/37) vs. 51.5% (35/68), P < 0.05]. In terms of prognosis, the mortality of patients with AF was 18.5% (25/135), all of whom were critical ill, including 32.0% (8/25) with cerebral embolism, pulmonary embolism and cerebral hemorrhage. Among them, 40.0% (10/25) died of multiple organ failure (40.0% combined with gastrointestinal hemorrhage), 20.0% (5/25) died of heart failure, and 12.0% (3/25) died of respiratory failure; while there were no death cases recorded in the mild symptoms, normal group and 9 serious patients. Conclusions:The serious/critical patients infected with COVID-19 Omicron variant with AF, have a worse prognosis and high mortality. Multiple organ failure, heart failure, sudden cardiac death, respiratory failure and embolic disease are the major causes of death.

Pulsed electric field(PEF) provides high-energy instantaneous pulse and release energy to myocardial cell membrane, resulting in irreversible electroporation and causes myocardial cell contents leakage, destruction of intracellular homeostasis, cell death, and slight inflammatory response. PEF as non-thermal energy promotes the design and application of arrhythmia ablation catheter to enter a new stage. There are currently limited clinical studies that have proved the safety and effectieness of Farawave PEF catheter, PVAC GOLD PEF catheter, Lattice-tip Sphere-9 PEF and radiofrequency (RF) catheter used for atrial fibrillation ablation, but still need further discussion. The research of atrial fibrillation ablation with PEF is under study in China. In this paper, the design and application of PEF ablation for tachyarrhythmia are reviewed.
Atrial Fibrillation/surgery* ; Catheter Ablation ; Catheters ; Humans ; Pulmonary Veins/surgery* ; Tachycardia

Objective To study the characteristics of CT images of myocardial bridge(MB)in patients with atherosclerosis.Methods CTA images of MB in 129 patients with atherosclerosis were studied.Another 109 patients without atherosclerosis,in the diagnosis of MB were used as control.The type,age,thickness of MB,length of mural coronary artery and end systolic diameter of mural coronary artery were compared between the two groups.Results In the study group,78 cases (60.5%)were superficial type,51(39.5%) were deep type.While in the control group,70(64%)cases were superficial type and 39(36%)were deep type.There was no significant difference between the two groups.The age,thickness of MB,length of mural coronary artery and end systolic diameter of mural coronary artery in each group were 57.01±10.17 years old,(3.15±1.66)mm,(20.43±7.38)mm,(1.16±0.25)mm and 48.36±9.11 years old,(1.95±1.77)mm,(21.07±6.69)mm,(2.07±0.81)mm.These parameters had significant differences between the two groups except the length of mural coronary artery (P>0.05).Conclusion The MB of the study group is thicker than the control group,and the mural coronary artery diameter of the former is narrower than that of the latter.

Objective To analyze the CTA features of asymptomatic myocardial bridge.Methods The CTA images of 69 cases with asymptomatic solitary myocardial bridge were studied retrospectively, and CTA images of 60 cases with symptoms as the contrast group.The type, age, thickness of myocardial bridge, mural coronary artery length and diameter changes of each cases of two groups were analyzed.Results In the study group, 51 cases of 69 (74%) were superficial style, while 18 cases were deep type (26%).In the contrast group, the superficial and deep style were 13 (22%) and 47 (78%) respectively.The mean age,thickness of myocardial bridge,mural coronary artery length and the diameter of mural coronary artery were (53.01±11.17) years old,(1.25±1.16) mm,(21.33±7.32) mm,(2.86±0.45) mm and (51.36±9.31) years old,(1.45±1.87) mm,(20.07±6.60) mm and (1.37±0.41) mm.The rate of type and diameter of mural coronary artery had significant differences between two groups (P<0.05), while other data had no significant differences (P>0.05).Conclusion The CTA features of asymptomatic myocardial bridge are mostly superficial type.The diameter of mural coronary artery on the end systolic is a factor to judge the rate on the occurrence of clinical symptom.

Objective: To study the characteristics of coronary CT angiography (CTA) in patients with myocardial bridge (MB) with arrhythmia. Methods: Our study included 2 groups: MB+arrhythmia group,n=31, clinical information as medical record, electrocardiogram (ECG), myocardial enzyme, echocardiography and coronary CTA findings were collected; MB group, n=30, the MB patients were without arrhythmia. Results: In MB+arrhythmia group, all patients were with mere MB, coronary artery disease, valve-structural heart diseases and other systemic diseases were excluded. There were 2/31 patients with ventricular fibrillation, 1 with atrial fibrillation, 5 with supraventricular tachycardia and 23 with ventricular tachycardia; 17/31 patients having deep type MB and 14 having superficial type MB. The myocardial systolic end diameter, diastolic end diameter by retrospective ECG gating and the stenosis at cross section of mural coronary MB by CTA were similar between 2 groups,P>0.05. Conclusion: MB+arrhythmia patients had no specific characteristics in coronary CTA; anatomical CTA feature may partly explain the myocardial ischemic symptom while couldn't clarify arrhythmia occurrence in relevant patients.