目的 心房颤动与体内的炎性反应状态密切相关.新型冠状病毒SARS-CoV-2引起的新型冠状病毒肺炎(COVID-19)患者可快速进展为重症肺炎、急性呼吸窘迫综合征(ARDS)或多器官功能衰竭(MOF),甚至死亡,炎性因子风暴是病情恶化的主要机制之一.病原体入侵人体,激活机体的免疫系统,释放促炎因子,当机体免疫系统失去负反馈调节时,导致炎性因子大量释放,最终引起炎性因子风暴.SARS-CoV-2病毒与ACE2结合,使AngⅡ水平升高,加重炎性反应,这些均促进了心房电重构或结构重构,增加心房颤动的易感性.

心房颤动(房颤)是临床常见的心律失常,可导致动脉栓塞和心力衰竭等并发症,具有较高的致残率和致死率.衰老、肥胖、糖尿病、高血压等是房颤发生的独立危险因素.微小RNA(miRNA)在心房发育、重构中发挥关键作用,且稳定性佳、易获取,有望成为房颤防治的重要靶点.该文介绍miRNA在房颤发病中的作用和在房颤防治中的应用.

报道1例T2DM合并盆腔脓肿及脑脓肿患者,因“闭经伴下腹胀2年,发现盆腔包块10余天”入院.既往体健,未发现糖尿病.查体发现下腹部轻压痛,阴道黄色脓性分泌物.75 g OGTT确诊T2DM.盆腔脓肿、脑脓肿均经病灶切除术后病理证实.胰岛素、手术综合抗生素治疗有效.糖尿病与感染两者相互作用,同时治疗效果更佳.

In recent years,the unusual CD4+CD28T cells were found in the atheromatous plaque and peripheral blood in patients with acute coronary syndrome.The cells that expand largely and survive for a long time mainly secrete Thl cytokines.In addition,the CD4+CD28-T cells also have cytotoxicity.Accumulation of CD4+CD28-T cells causes plaque instability and involve in the development of acute coronary syndrome.The study on CD4+CD28-T cells could provide novel means to prevent and cure acute coronary syndrome.

CD4 + CD28-T cells are found in acute coronary syndrome and some autoimmune diseases.The characteristics of these cells include their cytotoxic potential,resistance to apoptosis and tissue-infiltrating capacity.The aberrant expression of genes in the CD4 + CD28-T cells might due to abnormal DNA methylation.These genes are closely related with the development of diseases.Further study on CD4 + CD28-T cell features and DNA methylation in diseaseswill,elucidate the pathogenesis of diseases and provide new clues for the treatment.

Objective To analyse the manifestations of angiography and the curative effect of emergency transcatheter arterial embolisation(ETAE)in patients with massive hemoptysis due to bronchial artery to pulmonary vein fistula.Methods 11cases of massive hemoptysis due to bronchial artery to pulmonary vein fistula underwent emergency arteriography.After bleeding arteries were located,the patients were given embolotherapy with gelfoam strips and polyvinyl alcohol(PVA) particles.The arteriography manifestations and therapeutic outcome from all 11patients were retrospectively analysed.Results 26bronchial arteries were located and embolized successfully in 11patients.Hemoptysis of all patients was stopped in 3days after embolotherapy.During 16-month follow-up,there were no rebleedings and severe complications.Conclusion ETAE is a safe and effective treatment for the massive hemoptysis due to bronchial artery to pulmonary vein fistula.The premise of successful treatment is to locate the bleeding arteries accurately,and the key of successful treatment is to thoroughly and completely embolize the bleeding arterials.

Endometriosis(EMs),as a common disease among fertile women,its pathogenesis is not quite clear.Recent years,more and more researchers have got to hold the concept that disorder in the immune system play an important role in the development of EMs.TLR4 is one of the important innate immune receptors.It could identify endogenous and exogenous ligands,and activate NF-KB and TNF –α through a signal-transduction-mechanisms,then promote and regulate the innate immunity and induce acquired immune responses.This article made a review of progress in the research of TLR4 in the pathogenesis of EMs for better further study.