Le-Xin Wang

B-type natriuretic peptide in patients with clinical hyperthyroidism

Aims: To investigate the level and clinical significance of plasma B-type natriuretic peptide (BNP) in patients with hyperthyroidism. Methods: Plasma BNP was measured in 32 healthy subjects and 67 patients with clinical hyperthyroidism. Left ventricular anatomy and function was assessed with echocardiography. Results: The average BNP in hyperthyroid patients was higher than that in healthy subjects (186±140 vs 34±17 ng/l, p =0.001). The increase in BNP was mainly found in hyperthyroid patients who had clinical and echocardiographic evidence of left ventricular dysfunction (250±190 ng/l). The BNP level in patients with hyperthyroidism, but with normal left ventricular function, was similar to that of the controls (37±17 vs 34±17, ng/l, p > 0.05). Multi-regression analysis showed that left atrial diameter and left ventricular ejection fraction were independently associated with the plasma levels of BNP. Conclusions: there is a significant elevation in plasma BNP in patients with hyperthyroidism; the increase is largely due to hyperthyroidism-induced left ventricular dysfunction. Measurements of plasma BNP may help to detect heart failure in patients with clinical hyperthyroidism.

Bedside tests of B-type natriuretic peptide in the diagnosis of left ventricular diastolic dysfunction in hypertensive patients

To investigate the value of B‐type natriuretic peptide (BNP) in diagnosing left ventricular diastolic dysfunction in patients with hypertension.

Gensenoside Rg3 inhibits hypoxia-induced VEGF expression in human cancer cells.

Aims: The ginsenoside Rg3 (Rg3) inhibits xenograft growth and angiogenesis in tumors mainly via down-regulates VEGF expression. This study was designed to investigate the mechanisms by which Rg3 down-regulates VEGF expression. Methods: MTT assay was performed to investigate the effect of Rg3 on the growth of human esophageal carcinoma cell line Eca-109 and 786-0 cells under normoxic and hypoxic conditions. ELISA was used to detect VEGF protein secreted by the cells under normoxic and hypoxic conditions. Real-time quantitative reverse transcriptase polymerase chain reaction and Western blotting were used to detect gene expression and protein synthesis. Results: Rg3 inhibited Eca-109 and 786-0 cell proliferation and induced a significant reduction in VEGF mRNA under hypoxia conditions. Rg3 treatment inhibited hypoxia-induced expression HIF-1Α, COX-2 and NF-ĸB under normoxic and hypoxic conditions. Treatment with Rg3 reduced the hypoxia-induced phosphorylation of STAT3 in a dose-dependent manner in the both cell lines. Rg3 treatment also inhibited the phosphorylation of ERK1/2 and JNK induced by hypoxia. Conclusions: Rg3 targets hypoxia-induced multiple signaling pathways to down-regulate VEGF expression in cancer cells. These actions may contribute to the overall efficacy of Rg3 against tumor angiogenesis and growth.

Totally thoracoscopic repair of atrial septal defect without robotic assistance: A single-center experience

OBJECTIVE The recent advent of robotically assisted surgery has enabled totally endoscopic repair of atrial septal defects and patent foramen ovale. This study investigates the feasibility and safety of totally endoscopic repair of an atrial septal defect through small incisions on the chest without robotic assistance. METHODS Forty patients (23 female patients; average age, 15.4 ± 8.7 years; age range, 6-47 years) with secundum-type ASDs were selected for this study. Cardiopulmonary bypass was achieved peripherally. Through 3-port incisions in the right chest, pericardiotomy, bicaval occlusion, atriotomy, and ASD repair were performed by a surgeon through a thoracoscopy. RESULTS The cardiopulmonary bypass and aortic crossclamp times were 56.2 ± 21.1 and 38.3 ± 8.6 minutes, respectively. The length of stay in the intensive care unit was 23.0 ± 4.1 hours. There were no mortalities and no major complications in this cohort. Patients were discharged from the hospital 4 to 6 days after the operation. Transesophageal echocardiographic analysis immediately after the operation and at 30 days showed complete closure of the defect without residual shunt. CONCLUSIONS Totally endoscopic atrial septal defect repair can be achieved without a robotically assisted surgical system. This technique is safe and effective and can be used as a therapeutic option for ASD.

The protective effect of 17β-estradiol against hydrogen peroxide-induced apoptosis on mesenchymal stem cell.

This study was designed to investigate the function of 17β-estradiol (17β-E2) against oxidative stress on the cell death of mice bone marrow mesenchymal stem cells (BMSCs) induced by hydrogen peroxide (H₂O₂). BMSCs were treated with 17β-E2 for 24h and then treated with 100μM H₂O₂ for 1h. Cell viability, apoptosis, caspase-9 mRNA, JNKs (Jun N-terminal kinases) and c-Jun protein expression in BMSCs were evaluated. Cell apoptosis of BMSCs were increased in a dose-dependent manner after treated with H₂O₂ compared to control group. But pretreatment with 17β-E2 can inhibit apoptosis of BMSCs, preserve the mitochondrial transmembrane potential, decrease caspase-9 mRNA, JNK1/2 and c-Jun protein expression. In conclusion, 17β-E₂ exerts antiapoptotic effects in BMSCs which related to the mitochondria death pathway and JNKs pathway. The study revealed that 17β-E₂ can reduce the donor stem cells damage.

Clinical Features and Management Outcomes of Severe Hand, Foot and Mouth Disease

Objective: This study was designed to describe the clinical features and management outcomes of severe hand, foot and mouth disease (HFMD). Subjects and Methods: Data on 147 severe HFMD patients during an outbreak in 2009 were analyzed. Results: Most patients were under 3 years of age; 102 (69.4%) were boys. All had skin rashes and fever of ≥38°C. All (n = 147, 100%) showed signs of central nervous system involvement, such as lethargy (n = 124, 84.4%), myoclonic jerks (n = 76, 51.7%), or drowsiness (n = 34, 23.1%). Respiratory symptoms were mainly tachypnea (n = 112, 76.2%) or bradypnea (n = 21, 14.3%). Common cardiovascular symptoms included tachycardia (n = 134, 91.2%) and hypertension (n = 23, 15.5%). Chest X-ray showed increased markings in 76 (51.7%) or consolidation in 44 (29.9%). Hyperglycemia and elevated blood lactic acid levels were found in 127 (86.4%) and 130 (88.4%), respectively. Positive enterovirus EV71-PCR was found in 113 (76.9%). All patients were treated with mechanical ventilation for 61.2 ± 12.8 h (range, 40–96 h), as well as mannitol, dexamethasone, gamma globulin and ribavirin. Dopamine, dobutamine or amrinone was administered in 58.5, 51.0 and 21.8%, respectively. Three patients (2%) died during hospitalization. All others had a full recovery and were discharged after 14.2 ± 1.6 days (range, 12–17 days). Conclusion: Central nervous and cardiorespiratory systems were involved in the patients with severe HFMD. Fasting blood glucose and lactic acid levels increased in the majority of patients. Mechanical ventilation and supportive pharmacotherapy were associated with a good clinical outcome in these patients.

Increased Nanog Expression Promotes Tumor Development and Cisplatin Resistance in Human Esophageal Cancer Cells

Background/Aims: Nanog plays a key role in stem cell self-renewal and pluripotency differentiation in embryonic stem cells ( ESCs). Recently, some studies reported that abnormal expression of Nanog could be detected in several tumors, indicating that Nanog might be related to tumor development. However, studies on the correlation between Nanog expression and esophageal cancer are sparse. Methods: In this study, we established two esophageal cancer cell lines 9706-Nanog and 9706-shNanog which stably expressed Nanog and Nanog-short-hairpin RNA (shRNA) genes. Results: We found that Nanog expression could promote the proliferation and invasiveness of the cancer cells, and inhibit the apoptosis. We also treated 9706-Nanog, EC9706 and 9706-shNanog cell lines with cisplatin and evaluated the drug sensitivity of the three cell lines. We found that the sensitivity of cisplatin was decreased with increased expression of Nanog. The expression of MDR-1 was also increased in 9706Nanog cells. Conclusions: Nanog may play an important role in human esophageal cancer development, and could be used as a therapeutic target in esophageal cancer treatment.

Single Dose Administration of L-Carnitine Improves Antioxidant Activities in Healthy Subjects

L-carnitine has been used as a supplement to treat cardiovascular or liver disease. However, there has been little information about the effect of L-carnitine on anti-oxidation capability in healthy human subjects. This study was designed to investigate the correlation between plasma L-carnitine concentration and antioxidant activity. Liquid L-carnitine (2.0 g) was administered orally as a single dose in 12 healthy subjects. Plasma concentration of L-carnitine was detected by HPLC. The baseline concentration of L-carnitine was 39.14 ± 5.65 µmol/L. After single oral administration, the maximum plasma concentration (C(max)) and area under the curve (AUC(0-∞)) were 84.7 ± 25.2 µmol/L and 2,676.4 ± 708.3 µmol/L·h, respectively. The half-life and the time required to reach the C(max) was 60.3 ± 15.0 min and 3.4 ± 0.46 h, respectively. There was a gradual increase in plasma concentrations of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), catalase and total antioxidative capacity (T-AOC) in the first 3.5 h following L-carnitine administration. The plasma concentrations of SOD, GSH-Px, catalase and T-AOC returned to baseline levels within 24 h. A positive correlation was found between L-carnitine concentration and the antioxidant index of SOD (r = 0.992, P < 0.01), GSH-Px (r = 0.932, P < 0.01), catalase (r = 0.972, P < 0.01) or T-AOC (r = 0.934, P < 0.01). In conclusion, L-carnitine increases activities of antioxidant enzymes and the total antioxidant capacity in healthy subjects. It may be useful as a supplementary therapy for chronic illnesses involving excessive oxidative stress.

Value of B-type natriuretic peptide in diagnosing left ventricular dysfunction in dialysis-dependent patients

Background: B‐type natriuretic peptide (BNP) is elevated in patients with end‐stage renal failure. The reported accuracy of BNP in diagnosing left ventricular dysfunction in these patients has been inconsistent.

Surgical left cardiac sympathetic denervation for long QT syndrome: effects on QT interval and heart rate.

The primary aim of the present study was to investigate the short-term effects of surgical left cardiac sympathetic denervation (LCSD) on the QT interval and heart rate in patients with congenital long QT syndrome (LQTS). Left cardiac sympathetic denervation was performed in five LQTS patients who had a history of syncope. The patients’ 12-lead and 24-h Holter monitoring ECG was recorded 24 h before and 24 h after LCSD. Treadmill exercise tests were also performed before and 6 days after surgery to assess changes in heart rate and the QT interval after surgery. Left cardiac sympathetic denervation was successful in all patients. The mean value of the corrected QT interval (QTc) in the five patients decreased from 0.59 ± 0.05 to 0.48 ± 0.04 s (P = 0.006) immediately after the procedure and remained short (0.47 ± 0.04, P < 0.05) after a 21-month follow-up. The mean value of QTc on the 24-h Holter monitoring ECG also decreased in all patients (0.67 ± 0.07 vs 0.60 ± 0.05 s, P < 0.01). The mean, maximum, and minimum heart rate on the 24-h ECG remained unchanged (P > 0.05). The maximum heart rate during the exercise tests decreased from 162 ± 4 beats/min before surgery to 129 ± 10 beats/min (P < 0.01). The exercise-induced increase in QTc remained unchanged after the surgery (P > 0.05). Although four of the five patients were syncope-free until 21 months postoperatively, the remaining patient had a recurrence of syncope, requiring an increased dose of β blocker. These findings indicate that LCSD shortens QTc and diminishes the exercise-induced increase in heart rate whereas the resting heart rate and exercise-induced increase in QTc remain unchanged. These results may have implications for the effectiveness and limitations of LCSD.