简介：Cardiovasculardisease(CVD)isthenumberonecauseofmortalityworld-wideandplacesahighmedicalandsocioeconomicburdenondevelopingcountries.OurunderstandingofCVDanditsevolutionoverthelast100yearshasalteredconsiderably.ReasonsfortheincreasedrateofCVDinthedevelopingworldincluderapidurbanizationandthedemographicshiftknownasthemodernepidemiologictransition.ThecaseforinterventionisbasedonbothmajorhumanandeconomicimpactsofCVD.Ithasbeenestimatedthatcost-effectiveinterventionsindevelopingcountrieswithahighburdenofCVDcouldresultinaprojected24millionlivessaved.ThisreductioninCVDmortalitycouldreduceeconomiccostsby$8billion.Approachestointerventioninclude:1)cardiovascularhealthpromotionandCVDpreventionand2)actionplansadvocatedbytheWorldHealthOrganization.

简介：Cardiovasculardisease(CVD)istheleadingcauseofdeathworldwide.ThisarticlefocusesoncurrentguidelinesfortheprimarypreventionofCVDandaddressesmanagementofkeyriskfactors.Dietarymodification,weightloss,exercise,andtobaccousecessationarespecificareaswherefocusedeffortscansuccessfullyreduceCVDriskonbothanindividualandasocietallevel.Specificareasrequiringmanagementincludedyslipidemia,hypertension,physicalactivity,diabetes,aspirinuse,andalcoholintake.Thesepreventiveeffortshavemajorpublichealthimplications.Astheglobalpopulationcontinuestogrow,healthcareexpenditureswillalsorise,withthepotentialtoeventuallyoverwhelmthehealthcaresystem.ThereforeitisimperativetoapplyourcollectiveeffortsonCVDpreventiontoimprovethecardiovascularhealthofindividuals,communities,andnations.

简介：Airwaydiseasesarethemostcommonlydescribedlungmanifestationsofinflammatoryboweldisease(IBD).However,thesimilaritiesindiseasepathogenesisandthesharingofimportantenvironmentalriskfactorsandgeneticsusceptibilitysuggestthatthereisacomplexinterplaybetweenIBDandairwaydiseases.RecentevidenceofIBDoccurrenceamongpatientswithairwaydiseasesandthehigherthanestimatedprevalenceofsubclinicalairwayinjuriesamongIBDpatientssupportthehypothesisofatwo-wayassociation.Futureresearcheffortsshouldbedirectedtowardfurtherexplorationofthisassociation,asairwaydiseasesarehighlyprevalentconditionswithasubstantialpublichealthimpact.

简介：Parkinsonsdisease(PD)isacommon,progressiveneurodegenerativediseasecharacterisedbydegenerationofnigrostriataldopaminergicneurons,aggregationofα-synucleinandmotorsymptoms.Currentdopamine-replacementstrategiesprovidesymptomaticrelief,howevertheireffectivenesswearoffovertimeandtheirprolongeduseleadstodisablingside-effectsinPDpatients.ThereisthereforeacriticalneedtodevelopnewdrugsanddrugtargetstoprotectdopaminergicneuronsandtheiraxonsfromdegenerationinPD.Overrecentyears,therehasbeenrobustevidencegeneratedshowingthatepigeneticdysregulationoccursinPDpatients,andthatepigeneticmodulationisapromisingtherapeuticapproachforPD.Thisarticlefirstdiscussesthepresentevidenceimplicatingglobal,anddopaminergicneuron-specific,alterationsinthemethylomeinPD,andthetherapeuticpotentialofpharmacologicallytargetingthemethylome.Itthenfocusesonanothermechanismofepigeneticregulation,histoneacetylation,anddescribeshowthehistoneacetyltransferase(HAT)andhistonedeacetylase(HDAC)enzymesthatmediatethisprocessareattractivetherapeutictargetsforPD.Itdiscussestheuseofactivatorsand/orinhibitorsofHDACsandHATsinmodelsofPD,andhowtheseapproachesfortheselectivemodulationofhistoneacetylationelicitneuroprotectiveeffects.Finally,itoutlinesthepotentialofemployingsmallmoleculeepigeneticmodulatorsasneuroprotectivetherapiesforPD,andthefutureresearchthatwillberequiredtodetermineandrealisethistherapeuticpotential.

简介：Thedeveloppercutaneoustreatmentsformitralregurgitation(MR)havebeenbasedonestablishedsurgicalprocedures.Mostarebasedinsomewayonmitralannuloplasty.IndirectangioplastyutilizingcoronarysinusandleafletrepairwiththeMitraClipdevicehavethemostdevelopmentandclinicalapplication.Morerecently,afterthesuccessoftranscatheteraorticvalvereplacement,transcathetermitralvalvereplacementhasemerged.Acriticalunansweredquestioniswhattherelativerolesofvalverepairandvalvereplacementwillbe.ThelargestexperienceinpracticeiswithMitraClipleafletrepair.Theevidencebaseforthedevelopmentofthesenoveltherapiesincludessomedatainsurgicalcandidates,andregistrystudiesthathavebeendonepredominantlyinhighriskpopulations.

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简介：T1mappingusingcardiovascularmagneticresonance(CMR)introducesnoveltechniquesformyocardialtissuecharacterizationtodetectandquantifydiseaseprocessesoccurringatthemicroscopiclevel.EventhoughT1mappinghaslimitedspatialresolution,cellularandmolecularchangesoccurringwithineachvoxelcanaffecttheaggregateT1signalrenderingthemquantifiable.TheestimatedT1-basedparametersquantifiedona“map”demonstratethespatiallocalizationofthesechangeswherebyeachpixelexpressesthequantitativevalueofthatparameter.Thisquantificationpermitsdetectionofdiffusediseaseevenifitisnotdirectlyvisible.Ratherthanrelyingonnonspecificfunctionalmeasures,T1mappingfocusesonintrinsicchangesofmyocardialcompositionthatadvancesunderstandingaboutspecificdiseasepathways.Thesechangesinmyocardialtissuecompositioninformdiagnosisandprognosis.T1mappingencompassestwokeyparameters:native(i.e.,precontrast)T1andextracellularvolumefraction(ECV)derivedfromadditionalpostcontrastT1andbloodT1measurements.Theseadvancesintroducenewtoolstodetectfocalanddiffusemyocardialderangementsoccurringincardiacdiseasethatcanbeotherwisedifficulttodetect.T1andECVmappingfosterprecisionmedicineandpersonalizedcare,promisingtoimprovepatientoutcomesthroughtargetedtherapy.CapitalizingontheopportunitiesintroducedbyT1mappingandECVrequiresfurtherinvestigation.

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简介：BackgroundPulseoximetryscreening(POS)hasbeenproposedasaneffective,noninvasive,inexpensivetoolallowingearlierdiagnosisofcriticalcongenitalheartdisease(CCHD).However,mostneonatesaredischargedfromthehospitalwithoutthisevaluationinChina.ThisstudyaimedatassessingthefeasibilityofPOSfornewbornsindetectingCCHDinthedepartmentofobstetricsandneonatalintensivecareunit(NICU).MethodsPOSwasperformedin355neonatesborninthedepartmentofobstetricsoradmittedtotheNICUbetweenJanuary2015andJune2015.Theseneonatesweredividedintonormalgroup,mildcongenitalheartdiseasegroup(MCHD)andCCHDgroup,accordingtotheresultofechocardiographyorcomputerizedtomography(CT).Thegestationalage,birthweightandarterialoxygensaturation(SpO_2)werecomparedamongthethreegroups.TheSpO_2valueanddiagnosistimeoftheCCHDcaseswereclassifiedandanalyzed.ResultsTheprematurebirthandlowbirthweightwerethehighriskfactorsofmildcongenitalheartdisease.Therewasnodifference(P>0.05)inSpO_2betweentheMCHDgroupandthenormalgroup.SignificantdifferenceintheSpO_2appearedbetweentheCCHDgroupandthenormalgroup(P<0.05).CombinationofPOSandclinicalexaminationcanreducethemissingdiagnosisrateinscreeningforCCHD.ConclusionsPOSincursverylowcostandriskofharmandisnotrequiredforspecialtraining,therefore,aneffectivewaytoidentifyCCHDinneonates.

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简介：Therecognitionthatpsychosocialriskfactorscontributetothepathogenesisofcardiovasculardiseasehasledtothedevelopmentofanewfieldofbehavioralcardiology.Theinitialimpetusforthisfieldwasstudiesperformedinthe1980sand1990sthatprovidedepidemiologicalevidenceandapathophysiologicalbasisforastronglinkbetweenanumberofpsychosocialriskfactorsandcardiovasculardisease,includingdepression,anxiety,hostility,jobstress,andpoorsocialsupport.Inrecentyears,additionalpsychosocialriskfactorshavebeenidentified,includingpessimism;otherformsofchronicstress,suchaschildhoodabuseandtrauma,andthepsychologicalstressthatmaybeassociatedwithchronicmedicalillness;lackoflifepurpose;andthesyndromeof“vitalexhaustion,”whichconsistsofatriadofexhaustion,demoralization,andirritability.Newresearchinthelastdecadehasalsoestablishedthatpositivepsychosocialfactors,suchasoptimism,positiveemotions,avibrantsociallife,andastrongsenseoflifepurpose,canhaveanimportanthealth-bufferingeffectthroughtheirfavorableinfluenceonhealthbehaviorsandpromotionofpositivephysiologicalfunctioning.Patientscanbescreenedforpsychosocialriskfactorsinclinicalpracticethrougheithertheuseofopen-endedquestions,whichcanbeintegratedintoaphysician’sstandardreviewofsystems,ortheuseofshortquestionnaires.Physicianscanassistinthetreatmentofpsychosocialriskfactorsinvariousways,suchasscreeningpatientsforpsychologicaldistressandmakingappropriatereferralswhenindicated,providingpatientswithpracticallifestylesuggestions,andemployingofficepersonneltoteachpatientsbehavioralorpsychosocialinterventionsthatcanpromoteasenseofwell-beingand/orreducestress.

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简介：Genisteiniseffectiveagainstamyloid-βtoxicity,buttheunderlyingmechanismsareunclear.Wehypothesizedthatgenisteinmayprotectneuronsbyinhibitingthemitochondrialapoptoticpathway,andtherebyplayaroleinthepreventionofAlzheimer'sdisease.AratmodelofAlzheimer'sdiseasewasestablishedbyintraperitonealinjectionofD-galactoseandintracerebralinjectionofamyloid-βpeptide(25–35).Inthegenisteintreatmentgroups,a7-daypretreatmentwithgenistein(10,30,90mg/kg)wasgivenpriortoestablishingAlzheimer'sdiseasemodel,for49consecutivedays.Terminaldeoxyribonucleotidyltransferase-mediateddUTPnickendlabelingassaydemonstratedareductioninapoptosisinthehippocampusofratstreatedwithgenistein.Westernblotanalysisshowedthatexpressionlevelsofcapase-3,Baxandcytochromecweredecreasedcomparedwiththemodelgroup.Furthermore,immunohistochemicalstainingrevealedreductionsincytochromecandBaximmunoreactivityintheserats.MorriswatermazerevealedasubstantialshorteningofescapelatencybygenisteininAlzheimer'sdiseaserats.Thesefindingssuggestthatgenisteindecreasesneuronallossinthehippocampus,andimproveslearningandmemoryability.Theneuroprotectiveeffectsofgenisteinareassociatedwiththeinhibitionofthemitochondrialapoptoticpathway,asshownbyitsabilitytoreducelevelsofcaspase-3,Baxandcytochromec.

简介：Background:Manydisease-specificfactorssuchasmuscularweakness,increasedmusclestiffness,varyingposturalstrategies,andchangesinposturalreflexeshavebeenshowntoleadtoposturalinstabilityandfallriskinpeoplewithParkinson'sdisease(PD).Recently,analyticaltechniques,inspiredbythedynamicalsystemsperspectiveonmovementcontrolandcoordination,havebeenusedtoexaminethemechanismsunderlyingthedynamicsofposturaldeclinesandtheemergenceofposturalinstabilitiesinpeoplewithPD.Methods:Awavelet-basedtechniquewasusedtoidentifylimitcycleoscillations(LCOs)intheanterior–posterior(AP)posturalswayofpeoplewithmildPD(n=10)comparedtoage-matchedcontrols(n=10).Participantsstoodonafoamandonarigidsurfacewhilecompletingadualtask(speaking).Results:Therewasnosignificantdifferenceintherootmeansquareofcenterofpressurebetweengroups.Threeoutof10participantswithPDdemonstratedLCOsonthefoamsurface,whilenoneinthecontrolgroupdemonstratedLCOs.AninvertedpendulummodelofbipedalstancewasusedtodemonstratethatLCOsoccurduetodisease-specificchangesassociatedwithPD:time-delayandneuromuscularfeedbackgain.Conclusion:Overall,theLCOanalysisandmathematicalmodelappeartocapturethesubtleposturalinstabilitiesassociatedwithmildPD.Inaddition,thesefindingsprovideinsightsintothemechanismsthatleadtotheemergenceofunstablepostureinpatientswithPD.

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简介：AIM:Toinvestigatetheproteinexpressionofphosphataseandtensinhomolog(PTEN)inhumanliverbiopsiesofpatientswithalcoholicandnon-alcoholicliverdisease.METHODS:PTENproteinexpressionwasassessedbyimmunohistochemistryinformalin-fixed,paraffinembeddedliversectionsofpatientswithnon-alcoholicfattyliverdisease(NAFLD)(n=44)oralcoholicliverdisease(ALD)(n=25).Liverresectionsobtainedfrom3healthysubjectscandidateforpartialliverdonationservedascontrols.Histologicalevaluationswereperformedbytwoexperiencedpathologists,anddiagnosesestablishedbasedoninternationalcriteria.TheintensityofthePTENstaininginnucleiwascomparedbetweensteatoticandnon-steatoticareasofeachliverfragmentanalyzed.Foreachliverspecimen,theantibody-stainedsectionswereexaminedandscoredblindlybythreeindependentobservers,whowereunawareofthepatients’clinicalhistory.RESULTS:Inhealthyindividuals,PTENimmunostainingwasintenseinboththecytoplasmandnucleiofallhepatocytes.However,PTENwasstronglydownregulatedinboththenucleusandthecytoplasmofhepatocytesfromsteatoticareasinpatientswithNAFLD,independentlyofthediseasestage.Incontrast,nochangesinPTENproteinexpressionwereobservedinpatientswithALD,regardlessofthepresenceofsteatosisorthestageofthedisease.ThedegreeofPTENdownregulationinhepatocytesofpatientswithNAFLDcorrelatedwiththepercentageofsteatosis(r=0.3061,P=0.0459)andtheBMI(r=0.4268,P=0.0043).Hovewer,inpatientswithALD,PTENexpressionwasnotcorrelatedwiththepercentageofsteatosiswithorwithoutobesityasaconfoundingfactor(P=0.5574).Finally,PTENexpressionlevelinsteatoticareasofALDpatientswassignificantlydifferentfromthatseeninsteatoticareasofNAFLDpatients(P<0.0001).CONCLUSION:PTENproteinexpressionisdownregulatedearlyinNAFLD,butnotinALD.PTENimmunohistochemicaldetectioncouldhelpinthedifferentialdiagnosisofN

简介：EighteenisolatesofRhizoctoniasolanicollectedfrominfectedriceplantsinfourdifferentlocationsofBangladeshwerestudiedbyusingmorphologicalcharactersandmolecularmarkers.AnastomosisstudywithareferenceisolateconfirmedthatalltheisolatesbelongedtoR.solani.Significantvariationwasobservedinsclerotialsize,shapeanddistribution.Un-weightedpairgroupmethodwitharithmeticmeandendrogramconstructedbasedontheGower’sgeneralsimilaritycoefficientshowedthattheseisolatesweregroupedintofourclustersatthe0.68similaritycoefficentaccordingtomorphologicalcharacters.ClusterIwasamajorclusterconsistingof13isolates,whileclustersⅡtoⅣconsistedof1or2isolates.Analysesbyvariablenumberoftandemrepeatandamplifiedfragmentlengthpolymorphismmarkersshowedthattheisolatesweregroupedintofiveandthreeclustersatasimilaritycoefficientof0.64and0.69,respectively.Althoughmostofthevariabilitywasfoundbetweenisolatesfromdifferentregionsasexpected,significantvariationwasobservedwithintheisolatescollectedfromsimilaragro-ecologicalregions.OurresultssuggestthepresenceofdifferentracesofR.solaniwithinthesamelocalgeographicregions.

简介：In2014theAmericanCollegeofCardiology/AmericanHeartAssociationissuedfournewguidelinesforcardiovasculardiseasepreventionthatfocusedoncardiovascularriskassessment,lifestylemanagement,obesitymanagement,andbloodcholesterolmanagement.Thedevelopmentofanatheroscleroticcardiovasculardiseaseriskcalculatorformedthebasisoftheriskassessmentguideline,andthelifestylemanagementguidelinefocusedonrecommendinganevidence-baseddietarypattern.Thebloodcholesterolmanagementguidelinespecificallyidentifiedfourgroupsofpatientsshowntobenefitfrommoderate-intensityorhigh-intensitystatintherapyfrompreviousclinicaltrialsandabandonedtheuseofspecificlow-densitylipoprotein(LDL)cholesterol(LDL-C)goallevelsonthebasisofthelackofclinicaltrialevidence.Therecommendationsfortreatmentwithmoderate-intensityorhigh-intensitystatintherapyarebasedonrigorousevidencefromrandomizedclinicaltrials.Guidancehassincebeenprovidedfortheuseofnonstatintherapies,includingcholesterolabsorptioninhibitorandproproteinconvertasesubtilisin/kexintype9monoclonalantibodytherapywhenadequatereductionofLDL-Clevelsisnotachievedwithmaximallytoleratedstatintherapy.TherecentdevelopmentandapplicationofthesetherapieshaveresultedinremarkablereductionsinLDL-Clevelsthatarewelltolerated,andpreliminaryoutcomedataarepromisinginshowingsubstantialatheroscleroticcardiovasculardiseaseeventreductionsbeyondstatintherapy.