Background: The origin distribution in right ventricular outflow tract (RVOT) ventricular arrhythmias (VAs), as well as the initial ablation effectiveness of reversed U-curve method and antegrade method, remains unclear. Objectives: To investigate the origin distribution of RVOT-type VAs and compare the initial ablation effectiveness of the two methods. Method: Consecutive patients who had idiopathic RVOT-type VAs were prospectively enrolled. After activation mapping, patients were randomly assigned to supravalvular strategy using the reversed U-curve or subvalvular strategy using the antegrade method. The primary outcome was initial ablation (IA) success, defined as the successful ablation within the first three attempts. Results: Sixty-one patients were enrolled from November 2018 to June 2020. Activation mapping revealed that 34/61 (55.7%) of the earliest ventricular activating (EVA) sites were above the pulmonary valves (PVs). The IA success rate was 25/33 (75.8%) in the patients assigned to supravalvular strategy as compared with 16/28 (57.1%) in those assigned to subvalvular strategy (p = 0.172). Multivariate analysis revealed a substantial and qualitative interaction between the EVA sites and IA strategies (pinteraction < 0.001). Either strategy had a remarkably higher IA success rate in treating its ipsilateral EVA sites than contralateral ones (p < 0.0083). Conclusion: Of the idiopathic RVOT-type VA origins, half were located above the PV. The supravalvular and subvalvular strategies did not differ in IA success rates. However, they were complementary to reveal the EVA sites and facilitate ipsilateral ablation, which produces a significantly higher IA success rate. Clinical Trial Registration: Chinese Clinical Trial Registry number, https://www.chictr.org.cn/showproj.aspx?proj=45623, ChiCTR2000029331.
This study examined the effects of preventive atorvastatin (Ator) treatment on vasodilatation of small pulmonary arteries (SPAs) in monocrotaline (MCT)-induced pulmonary hypertensive rats. SD rats were randomly assigned to: normal control (Ctr), pulmonary arterial hypertension (PAH), PAH treated with 5 mg/kg/d Ator (LAtor), or 10 mg/kg/d Ator (HAtor). PAH was induced by MCT injection (40 mg/kg, i.p.). Mean pulmonary artery pressure (mPAP), right ventricular hypertrophy index (RVHI%), endothelium-dependent relaxations (EDdRs), and endothelium-independent relaxations (EDiRs) were determined. Four weeks after MCT injection, mPAP was higher in PAH group compared to that in Ctr group, and this effect was suppressed by Ator treatment (PAH: 32.19 ± 0.91 mm Hg vs. LAtor: 19.13 ± 1.01 mm Hg, HAtor: 17.55 ± 0.20 mm Hg, p < 0.05). Similar trend of changes in RVHI% was found in the same way. EDdRs of SPA rings in PAH group were markedly decreased 2 and 4 weeks after MCT injection, while in Ator treated groups, the impairment can only be detected 4 weeks after MCT injection. There were no differences in EDiRs among all groups 1 week after MCT injection. However, 2 weeks and 4 weeks after MCT injection, EDiRs were significantly impaired, while in HAtor and LAtor groups, EDiR was only impaired 4 weeks but not 2 weeks after MCT injection. Preventive treatment with atorvastatin for 2 weeks ameliorated endothelium-dependent and endothelium-independent vasodilative dysfunction in small pulmonary artery rings of MCT-induced PAH rats. It suggests that MCT-induced damage of endothelial function was progressing, and Ator was only beneficial in the early stage of MCT-induced PAH.
Colorectal cancer (CRC) development involves a series of molecular events that drive the progression from normal colorectal epithelium to adenoma and eventually to invasive carcinoma. While the involvement of extrachromosomal circular DNAs (ecDNAs) in cancer genome remodeling has been established, their specific roles in CRC formation remain unclear. Using Circle-Sequencing and whole transcriptomic sequencing, we comprehensively profile circular DNAs and transcriptomes in healthy individuals, colorectal adenoma, and CRC patients. Our delineate analyses characterize the key circular DNAs involved in oncogene expression through the normal-adenoma–carcinoma continuum and highlight that immune response-related pathways and cell cycle pathways, are the dominat events in CRC progression. Notably, chr8 ecDNA 64950741–114379093 exhibits robust up-regulation during CRC progression. Further validation in a new cohort of 50 CRC patients confirms the higher expression of chr8 ecDNA 64950741–114379093 and its strong correlation with poor prognosis. Thus, these findings provide unprecedented insights into the landscape of circular DNAs in CRC and highlights the potential of chr8 ecDNA 64950741–114379093 as a promising biomarker and therapeutic target for CRC management.
Objective: To explore the curative effect of psychological consultation combined with growth hormone(GH) for treatment of anxious emotion of short teenagers. Methods: Physical examination table and self-rating anxiety scale(SAS) were used to screened out 16 teenagers with short stature and 35 teenagers with comparatively short stature from 1 000 middle school students,then they were divided into psychotherapy group,GH plus psychotherapy group,and control group.Psychological consultation was conducted once a week,secretory recombinant human GH was applied by subcutaneous injection at 30 munites before sleeping according the dose of 0.15~0.20 IU·kg-1·d-1,once a day.SAS was carried out before and after treatment. Results: The mean values of SAS in GH plus psychotherapy group and psychotherapy group after treatment were significantly lower than those before treatment.The mean value of SAS in GH plus psychotherapy group was significantly lower than that in psychotherapy group,while the mean value of SAS in control group after treatment was significantly higher than those in the other two groups,there was statistically significant difference. Conclusion: The teenagers with short stature lead to anxious emotion easily,the curative effect of GH combined with psychotherapy is superior to the curative effect of simple psychotherapy for relieving anxious emotion of the teenagers with short stature.
Objectives Radiofrequency catheter ablation is the first-line treatment for idiopathic premature ventricular complexes (PVCs) and ventricular tachycardias (VTs). However, the outcomes were less compared among the categories. The study aims to assess the effectiveness and safety of catheter ablation for idiopathic PVC/VTs in a single high-volume centre, using the right ventricular outflow tract (RVOT) as a reference. Design Retrospective cohort study. Setting Patient data were collected from a tertiary hospital in Guizhou, China. Participants Between September 2013 and September 2022, 1028 patients (male: 41.3%; age: 46.5±15.6 years) who underwent the first catheter ablation for idiopathic monomorphic PVC/VTs were enrolled. Outcome measures Acute success, procedure-related complications, and long-term recurrence were assessed. Antiarrhythmic drugs (AADs) were not administrated after procedures unless recurrence was identified. Results The overall acute success rate was 90.3%, with 368 patients (35.8%) experiencing left ventricular PVC/VTs. No cases of third-degree atrioventricular block or death were reported. Complications were more common in patients with left ventricular PVC/VTs than those with right-sided ones (4.6% vs 0.1%, p<0.001). A total of 926 patients (90.1%) were followed up for an average of 9.7±3.7 months, and only the PVC/VTs category was found to be associated with long-term success rates. The RVOT, endocardial left ventricular outflow tract (endoLVOT), tricuspid annulus (TA) free wall, posterior septum and fascicular VT had long-term success rates exceeding 85%. Other types of PVC/VTs showed significantly higher risks of recurrence. Conclusions Besides RVOT and fascicular VT, single-procedure catheter ablation without AADs is highly effective for endoLVOT, TA-free wall and posterior septum. Patients with left ventricular PVC/VTs have higher complication risks compared with right ones.
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