目的 评估CHADS2、CHA2DS2-VASc和自行改良的CHA2DS2-VASc-LA2评分对经食管超声(TEE)检出左心房或左心耳血栓(LAT)的预测价值.方法 纳入2007年6月至2012年6月在我科拟行射频消融术且术前TEE检查、心脏多层CT扫描等相关临床资料完整的非瓣膜性心房颤动(NVAF)患者,共203例,其中TEE提示LAT者39例(血栓组),未检出LAT者164例(对照组).对患者的一般情况、既往病史、入院时检查、CHADS2评分和CHA2DS2-VASc评分进行单因素分析和多因素logistic回归分析,根据logistic回归分析结果,将独立预测因素左心房容积指数(LAVI)≥32 mL/m2记为2分,加入CHA2DS2-VASc评分中组合成新的评分方案CHA2DS2-VASc-LA2.绘制受试者工作特征曲线(ROC),比较CHADS2、CHA2DS2-VASc和CHA2DS2-VASc-LA2评分方案对NVAF患者LAT形成的预测价值.结果 对CHADS2、CHA2DS2-VASc及CHA2DS2-VASc-LA2三种评分进行ROC曲线检测,发现CHADS2诊断价值偏低(AUC=0.661,P=0.002),CHA2DS2-VASc和CHA2DS2-VASc-LA2诊断价值中等(AUC=0.731,P＜0.001; AUC=0.771,P＜0.001).使用CHA2DS2-VASc-LA2评分后血栓组CHADS2评分为0分的3例低危患者分值均有上升,血栓组中无CHA2DS2-VASc-LA2评分为0分者.结论 CHA2DS2-VASc-LA2评分较CHADS2、CHA2DS2-VASc评分系统能更好地预测NVAF低危人群的LAT形成,CHA2DS2-VASc-LA2评分为0分者可避免常规的TEE检查.

Background informationAngiotensin‐(1–7) [ANG‐(1–7)] mediates vasodilation, antiproliferation, anti‐apoptosis and antifibrosis, therefore, it opposes the effects of angiotensin II (ANG II). However, the detailed signal transduction mechanism following the Mas receptor activated by ANG‐(1–7) is still poorly understood. Src homology2‐containing inositol phosphatase 1 (SHP‐1), a redoxsensitive protein tyrosine phosphatase, negatively influences downstream signalling molecules, such as mitogen‐activated protein kinases (MAPKs), through dephosphorylation, thereby inhibiting proliferative and profibrotic signalling induced by ANG II. Therefore, we hypothesised that SHP‐1 may mediate the antiproliferative signalling of ANG‐(1–7) through the regulation of the dynamic balance of MAPKs and SHP‐1 in isolated cardiac fibroblasts. Primary culture of neonatal Sprague–Dawley rats cardiac fibroblasts was treated separately with different interventions to investigate this issue.ResultsOur data revealed that ANG II increased the phosphorylation of extracellular signal‐related kinase (p‐ERK1/2) and the ratio of (p‐ERK1/2)/(ERK1/2), but ANG‐(1–7) decreased them. The effects of ANG‐(1–7) on the phosphorylation p‐ERK1/2 were blocked by the Mas receptor antagonist A‐779. Unlike ANG II, which decreased the activity of SHP‐1, ANG‐(1–7) increased its activity. Overexpression of SHP‐1 attenuated the ANG II‐stimulated phosphorylation of c‐Src, its downstream molecules ERK1/2, α‐smooth muscle actin and transforming growth factor‐β1 (TGF‐β1). These effects were also inhibited by the specific inhibitor of SHP‐1, sodium stibogluconate. ANG‐(1–7) had no significant effects on the gene expression of TGF‐β1, collagen I or collagen III, but was found to antagonise the stimulatory effects of ANG II on them.ConclusionsANG‐(1–7), through Mas receptor, activates SHP‐1 in cardiac fibroblasts, which can negatively modulate ANG II‐induced phosphorylation of c‐Src and MAPKs, and inhibits profibrotic factors TGF‐β1 and collagen production. ANG‐(1–7) can thereby serve as a protective role by counteracting the effects of ANG II.

Objective To investigate the potential association between serum lipids and atrial fibrillation(AF).Methods Five hundred and ninety-eight patients with AF including 295 patients with paroxysmal AF(PAF) and 303 patients with non-paroxysmal AF(NPAF) were enrolled,and 596 non-AF patients with hypertension and diabetes were served as control.Primary clinical and laboratory data including white blood cell count(WBC),neutrophilic granulocyte ratio,liver function,blood lipids,blood glucose,renal function,thyroid function,electrocardiograph(ECG) / Holter-ECG and echocardiograph were collected in all patients.

AIM: To explore the role of placental growth factor(PLGF) in the process of angiotensin Ⅱ(Ang Ⅱ)-induced activation of cardiac fibroblasts(CFs).METHODS: Primary culture and identification of CFs from neonatal Sprague-Dawley rats were performed.The method of fluorescence immunocytochemistry was employed to observe the expression of alpha-smooth muscle actin(α-SMA).Real-time PCR and Western blotting were used to determine mRNA and protein levels.The cell proliferation was observed by WST-1 assay.RESULTS: Compared with control group,the PLGF expression at mRNA and protein levels in Ang II-treated CFs was significantly increased,whereas the mRNA expression of PLGF was decreased in the CFs treated with telmisartan and Ang Ⅱ.Treatment with PLGF induced the proliferation of CFs and increased the protein expression of α-SMA.Treatment with PLGF for 60 min significantly increased the protein levels of p-ERK1/2 in the CFs.Compared with Ang Ⅱ group,the proliferation of CFs was depressed and the protein expression of α-SMA was attenuated in Ang II+anti-PLGF group.The mRNA expression levels of type Ⅰ and type Ⅲ collagens were also down-regulated.CONCLUSION: PLGF might be involved in the process of Ang Ⅱ-induced proliferation of CFs and fibrosis.

The phenotypes and locality factors of the tung tree varieties Guitung No.2 and local traditional cultivated tung trees were investigated.The results showed that "Dami","Xiaomi" and "Wuzhua" were the main cultivated tung tree varieties,and mainly distributed the area below 500m in elevation.Five plants aged above 22 years of the local cultivated tung tree variety "Jinsiyoutong" were selected,which were the preferred variety for developing tung tree resources.Compaired with the variety of "Jinsiyoutong",the variety of Guitong No.2 was suited for close planting and planted in high population in order to obtain high output.

OBJECTIVE: To investigate root canal curvature in maxillary anterior teeth. METHODS: About 400 human maxillary anterior teeth were examined by indirect digital radiography both from labiolingual and mesiodistal directions. The root canal curvature was analyzed. RESULTS: The major sort of maxillary anterior teeth was type I. The proportion of maxillary center incisors, maxillary lateral incisors, maxillary canines curved in mesiodistal were 11.17%, 16.19% and 21.43%, in labio-lingual were 39.59%, 40.00% and 29.59%, both in labiolingual and mesiodistal directions were 4.60%, 35.24% and 24.49%. About 50% of maxillary anterior teeth were moderate curve, the degree of root canal curvature of maxillary canines was larger than that of maxillary incisors, and radius of curvature and length of the curved part of root canal of maxillary canines were smaller than that of maxillary incisors. CONCLUSION: Root canal curvature in maxillary anterior is complex, especially in maxillary canine. In order to improve quality of root canal therapy, we need to understand types of root canal, degree of root canal curvature and radius of curvature completely.