Diabetic cardiomyopathy (DCM) is a serious complication of diabetes mellitus (DM). One of the hallmarks of the DCM is enhanced oxidative stress in myocardium. The aim of this study was to research the underlying mechanisms involved in the effects of dapagliflozin (Dap) on myocardial oxidative stress both in streptozotocin-induced DCM rats and rat embryonic cardiac myoblasts H9C2 cells exposed to high glucose (33.0 mM). In in vivo studies, diabetic rats were given Dap (1 mg/ kg/ day) by gavage for eight weeks. Dap treatment obviously ameliorated cardiac dysfunction, and improved myocardial fibrosis, apoptosis and oxidase stress. In in vitro studies, Dap also attenuated the enhanced levels of reactive oxygen species and cell death in H9C2 cells incubated with high glucose. Mechanically, Dap administration remarkably reduced the expression of membrane-bound nicotinamide adenine dinucleotide phosphate (NADPH) oxidase subunits gp91phox and p22phox, suppressed the p67phox subunit translocation to membrane, and decreased the compensatory elevated copper, zinc superoxide dismutase (Cu/Zn-SOD) protein expression and total SOD activity both in vivo and in vitro. Collectively, our results indicated that Dap protects cardiac myocytes from damage caused by hyperglycemia through suppressing NADPH oxidase-mediated oxidative stress.
Background To explore the value of the right hemi-diaphragmatic excursion (DE) and its variation in predicting extubation outcome in mechanically ventilated patients with COPD. Methods All included patients with COPD received mechanical ventilation (MV) and were ready to wean from MV. After patients passed the 30 min spontaneous breathing trail (SBT), extubation was considered to be feasible, and the right DE measured by ultrasound at 0 min, 5 min, and 30 min of SBT were named as DE 0 , DE 5 , and DE 30 , respectively. Results Twenty-five patients succeeded extubation; 12 patients failed. The area under receiver operator characteristic curve (AUC ROC) of DE 30 and ΔDE 30−5 (the variation between 30 and 5 min) were 0.762 and 0.835; a cutoff value of DE 30 > 1.72 cm and ΔDE 30−5 > 0.16 cm were associated with a successful extubation with a sensitivity of 76% and 84%, a specificity of 75% and 83.3%, respectively. The predictive probability equation of the DE 30 plus ΔDE 30−5 was P = 1/[1 + e −(−5.625+ 17.689×ΔDE 30−5 +1.802×DE 30) ], a cutoff value of P > 0.626 was associated with a successful extubation with the AUC ROC of 0.867, a sensitivity of 92%, and a specificity of 83.3%. Conclusion The combination of DE 30 and ΔDE 30−5 could improve the predictive value and could be used as the predictor of extubation outcome in mechanically ventilated patients with COPD.
Purpose: The purpose of our study was to explore the relationship between EAT thickness and left atrial phasic function in patient with non-valvular atrial fibrillation (NVAF). Methods: 100 NVAF patients were enrolled, including 50 patients with paroxysmal AF and 50 patients with persistent AF. Another 50 patients without AF in sinus rhythm were selected as the control group. EAT thickness in front of the right ventricular free wall was measured using transthoracic echocardiography(TTE) at end-systole, while left atrial phasic function parameters were measured by Real-time three-dimensional echocardiography(RT-3DE) and two-dimensional speckle tacking imaging(2D-STI), including left atrial total emptying fraction(LATEF), left atrial active emptying fraction(LAAEF), left atrial passive emptying fraction(LAPEF), left atrial reservoir strain(LASr), left atrial contraction strain(LASct) and left atrial conduit strain(LAScd). Subsequently, we compared EAT thickness and left atrial phasic function parameters in each group, and analyzed the relationship between EAT thickness and left atrial phasic function parameters. Results: Compared with control group, patients with paroxysmal AF and persistent AF groups had sequentially greater EAT thickness and left atrial diameter (LAD), but sequentially lower left atrial phasic function parameters (LATEF, LAAEF, LAPEF, LASr, LASct, LAScd) (all p<0. 001). By Pearson and Spearman Correlation Coefficient, EAT thickness was significantly positively correlated with LAD and negatively correlated with left atrial phasic function parameters (all p<0. 001). Conclusions: EAT thickness in front of the ventricular free wall measured by TTE was significantly correlated with left atrial phasic function in patients with NVAF, which could effectively reflect the trend of left atrial function changes, thus providing some reference for clinical practice and early intervention of left atrial remodeling.
Purpose: The purpose of our study was to explore the relationship between EAT thickness and left atrial phasic function in patient with non-valvular atrial fibrillation (NVAF). Methods: 100 NVAF patients were enrolled, including 50 patients with paroxysmal AF and 50 patients with persistent AF. Another 50 patients without AF in sinus rhythm were selected as the control group. EAT thickness in front of the right ventricular free wall was measured using transthoracic echocardiography(TTE) at end-systole, while left atrial phasic function parameters were measured by Real-time three-dimensional echocardiography(RT-3DE) and two-dimensional speckle tacking imaging(2D-STI), including left atrial total emptying fraction(LATEF), left atrial active emptying fraction(LAAEF), left atrial passive emptying fraction(LAPEF), left atrial reservoir strain(LASr), left atrial contraction strain(LASct) and left atrial conduit strain(LAScd). Subsequently, we compared EAT thickness and left atrial phasic function parameters in each group, and analyzed the relationship between EAT thickness and left atrial phasic function parameters. Results: Compared with control group, patients with paroxysmal AF and persistent AF groups had sequentially greater EAT thickness and left atrial diameter (LAD), but sequentially lower left atrial phasic function parameters (LATEF, LAAEF, LAPEF, LASr, LASct, LAScd) (all p<0. 001). By Pearson and Spearman Correlation Coefficient, EAT thickness was significantly positively correlated with LAD and negatively correlated with left atrial phasic function parameters (all p<0. 001). Conclusions: EAT thickness in front of the ventricular free wall measured by TTE was significantly correlated with left atrial phasic function in patients with NVAF, which could effectively reflect the trend of left atrial function changes, thus providing some reference for clinical practice and early intervention of left atrial remodeling.
A pelvic accessory spleen is uncommon and most patients with this condition are asymptomatic. Ureteral calculus is a common disease and can cause acute abdominal pain. We report a 51‐year‐old male patient who presented at our hospital with acute right lower abdominal pain and gross hematuria. A large mass on the right side of the pelvis was detected on an ultrasound examination, as well as a calculus in the lower segment of the right ureter. Computed tomography angiography showed the presence of a long vascular pedicle with an artery originating from the splenic artery and a vein that joined with the splenic vein. Laparoscopy was carried out and it showed a solid mass covered with omentum on the right lower abdomen. The mass was then removed surgically. Histopathological examination of the resected specimens confirmed splenic tissue. We speculate that the accessory spleen and ureteral calculus caused right lower abdominal pain in our case. However, the ureteral calculus might have played a much more important role in causing acute right lower abdominal pain than the accessory spleen.
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