Nchọpụta Mweghachi Akwara Akwara pelvic

Atherosclerosis bụ isi ihe na-akpata ọrịa obi, bụ nke na-anọgide na-eduga n'ụwa nile na-anwụ anwụ. E gosipụtara insulin-like growth factor I (IGF1) iji belata ihe omume obi. /-) oke nri a elu-abụba diet.Our gara aga in vitro results na-atụ aro na macrophages ekere òkè dị ukwuu na mediating mmetụta nke IGF1 na atherosclerotic plaques, ma kpọmkwem usoro na-anọgide na-edoghị anya.We hypothesized na nnọọ na-amụba IGF1 etoju na macrophages ga- gbochie atherosclerosis.
Mgbe ozuzu novel macrophage-kpọmkwem IGF1-overexpressing transgenic ụmụ oke n'ime Apoe-/- ndabere (MF-IGF1 ụmụ oke), anyị enyocha atherosclerotic plaque ibu arọ, kwụsie ike, na monocyte recruitment.We accelerated mmepe nke atherosclerosis site na ịzụ ụmụ anụmanụ a elu- nri abụba maka ọnwa atọ. Anyị tụlekwara ọkwa cholesterol na nguzobe cell foam na vivo na in vitro.
Macrophage IGF1 overexpression downregulated plaque ibu site 30%, belata plaque macrophages site 47%, na kwalite atụmatụ na stabilize plaque phenotype. Monocyte mbanye e belatara 70% na MF-IGF1 ụmụ oke na jikọtara ya na 27% mbelata na-ekesa ọkwa nke CXC. chemokine ligand 12 (CXCL12) .CXCL12 protein ọkwa na-ebelata na plaques na peritoneal macrophages na ụmụ oke MF-IGF1. In vitro, IGF1 kpamkpam gbochiri oxidized obere njupụta lipoprotein (oxLDL) -dabere na CXCL12 mRNA transcription (98%) <0.01), na ọgwụgwọ IGF1 belatara protein CXCL12 (mbelata 56%, P <0.001).
CXCL12 na-ebelata nkwupụta nke ATP-binding cassette transporter A1 (ABCA1), onye na-ebufe cholesterol bụ isi nke na-eme ka efflux cholesterol si na macrophages. Anyị chọtara mmụba okpukpu abụọ na ABCA1 protein na peritoneal macrophages dịpụrụ adịpụ na ụmụ oke MF-IGF1. Anyị tụrụ mgbanwe mgbanwe. na cholesterol efflux site n'ịkwado peritoneal macrophages na oxLDL wee chọpụta mmụba 42% na efflux na ụmụ oke MF-IGF1. Anyị hụkwara mmụba 27% na cholesterol efflux na sel THP-1 nke IGF1 (100 ng / mL) na-eji apolipoprotein AI. dị ka onye na-anabata cholesterol.
Nsonaazụ anyị na-egosi na macrophage IGF1 na-ebelata atherosclerosis ma belata CXCL12, chemokine ọhụrụ na-etinye aka na atherosclerosis progression.IGF1 nwere ike belata CXCL12 site n'ibelata ọrụ monocyte na ịba ụba ABCA1, si otú ahụ na-eme ka atheroprotective mmetụta ya, si otú ahụ na-amụba cholesterol efflux ikike.
Mgbanwe na mkpụrụ ndụ TTR (rs76992529; Val122Ile) ka a na-ahụ naanị n'ime ndị agbụrụ Africa (ugboro ọnụọgụ: 3-4%) na-ebute mpịachi nke tetrameric transthyretin complex, nke dị na transthyretin amyloidosis nke ketara eketa.Degeneration (hATTR) na-akwakọba dị ka extracellular amyloid fibrils. Ịtụle mmetụta nke amyloidogenic TTR variant a na obi nkụda mmụọ (HF) ihe ize ndụ na ihe niile na-akpata ọnwụ na a nnukwu, geographically iche iche otu ìgwè nke ndị Africa America nwere ike inye nghọta banyere mkpa ụlọ ọgwụ nke a variant. .Anyị tụlere ndị na-eso ndị ojii na Geographic na Racially different Causes of Stroke (REGARDS) ọmụmụ iji nyochaa njikọ nke TTR Val122Ile mutation na HF na ihe niile na-akpata ọnwụ.
Anyị na-enyocha ndị na-eso ndị America ojii na-ahụ maka onwe ha na nyocha REGARDS na-enweghị HF na ntọala. A na-eji Poisson regression mee atụmatụ na ọ ga-eme ka obi ghara ịda mbà na ọnwụ na-akpata ọnwụ niile. Anyị na-eji ụdị mgbanwe Cox regression multivariate na-eme ka ọnụ ọgụgụ mmadụ, ụlọ ọgwụ na mmekọrịta mmadụ na ibe ya. ihe, na mkpụrụ ndụ ihe nketa nke Africa iji chọpụta ihe ize ndụ nke HF na ihe niile kpatara ọnwụ na ndị mmadụ nwere ụdị mkpụrụ ndụ ihe nketa TTR Val122Ile ma e jiri ya tụnyere ndị na-enweghị ụdị.
N'ime 7,514 ndị sonyere ojii (afọ etiti: 64 afọ; 61% nwanyị), ọnụọgụ ọnụọgụ nke TTR Val122Ile bụ 3.1% (ndị na-ebu 232; 7,282 ndị na-abụghị ndị na-ebu).Mmetụta nke HF (kwa 1000 mmadụ-afọ) bụ 15.9 (95% CI: 11.5-21.9) n'etiti ndị na-ebu dị iche iche na 7.2 (95% CI: 6.6-7.9) n'etiti ndị na-abụghị ndị dị iche iche.Val122Ile variant carriers nwere nnukwu ihe ize ndụ nke ịmepụta HF ma e jiri ya tụnyere ndị na-abụghị ndị na-ebu (HR: 2.46 [95% CI). : 1.72-3.53]; P <0.0001) .Mmetụta nke ihe niile na-akpata ọnwụ (kwa afọ 1000 mmadụ) bụ 41.5 (95% CI: 34.6-49.7) n'etiti ndị na-ebu dị iche iche na 33.9 (95% CI: 52.7-3) n'etiti variant na-abụghị ndị na-ebu.Val122Ile variant ebu nwere ihe ize ndụ dị elu nke ihe niile kpatara ọnwụ ma e jiri ya tụnyere ndị na-abụghị ndị na-ebu (HR: 1.44 [95% CI: 1.18-1.76]; P=0.0004) .TTR variant carrier status and gender emeghị. na-emekọrịta ihe na HF na ihe niile kpatara ọnwụ.
N'ime nnukwu ìgwè nke ndị ojii America, anyị na-egosi na amyloid Val122Ile mutation na TTR gene na-ejikọta ya na ihe ize ndụ 2.5 dị elu nke HF na ihe dịka 40% ihe ize ndụ dị elu nke ọnwụ niile. Site na mmalite nke ọtụtụ hATTR. Usoro ọgwụgwọ, ọnụnọ nke mmụgharị TTR Val122 nke a na-ahụkarị na ndị sitere na Africa nwere ike were ya dị ka ihe a na-eme n'ụlọ ọgwụ ma mee ngwa ngwa nweta ọgwụgwọ.
Ịrụ ọrụ nke guanylate cyclase / natriuretic peptide receptor A (GC-A / NPRA) site na obi hormones atrial na ụbụrụ natriuretic peptides (ANP na BNP) na-emepụta cGMP.cGMP onye ozi nke abụọ na-eme ka akara ngosi ala na mmetụta ndu nke ANP / NPRA maka diuretic. , diuretic, vasodilatory, nzaghachi antimitotic na mmetụta antihypertrophic obi obi. Okwu nke Npr1 gene (encoding GC-A / NPRA) na-achịkwa ọtụtụ ihe mkpali dị n'èzí na nke dị n'ime, ma usoro hormonal na epigenetic nke na-edozi ụkpụrụ Npr1 amaghị ama. N'ime ọmụmụ ihe a bụ iji nyochaa ọrụ vitamin D (vitD) n'ịhazi ntụgharị mkpụrụ ndụ Npr1 na okwu site n'ịchịkwa ihe epigenetic.
Ọmụmụ ihe ọmụmụ bioinformatic anyị nke murine Npr1 na-akwalite gosipụtara ọnụnọ nke ihe nzaghachi vitD anọ (VDRE) na mpaghara -583 ruo -495 nke saịtị mmalite ederede, yana usoro nkwenye zuru oke nke VDRE yiri. , A na-ebugharị ihe ndị a na-arụ n'oge na-adịghị anya na sel thoracic aortic smooth muscle (RTASMCs) na mouse mesangial cell (MMCs) ma tụọ maka ihe abụọ luciferase assay kits.Ọrụ ederede.
Nyocha Luciferase gosiri na ọgwụgwọ na vitamin D3 (1α,25-dihydroxy; VD3) mụbara ọrụ nkwalite Npr1 karịa 6-fold na usoro dabere na dose. Western blot na densitometric analysis gosiri na NPRA protein protein na MMC mụbara nke ukwuu na VD3 na-abawanye. ntinye uche, 3.5-fold na RTASMCs na 4.7-fold na RTASMCs, na a na-ahụ mmetụta kachasị na 100 nM.VD3 na-eme ka protein dị elu nke onye na-anabata vitD (VDR) na-adabere na dose. N'ihu VD3, histone. A na-egbochi ọrụ deacetylase (HDAC) 50% dị ka a tụrụ ya site na ọrụ HDAC / mgbochi ELISA kit. Ọzọkwa, ọgwụgwọ na VD3 belatara klas I HDAC enzymes, HDAC1 na HDAC3 protein, na histones na-adabere na dose, H3 na lysine residues 9 na. 14 (H3-K9/14 ac) na lysine H4 na acid residue 12 (H4-K14ac).
Nsonaazụ na-egosi na VD3 epigenetically na-achịkwa okwu mkpụrụ ndụ Npr1 site n'ịchịkwa mgbanwe mgbanwe nke histone. Nchọpụta nke ebumnuche epigenetic nke vitamin D na-egosi dị ka ndị na-achịkwa Npr1 gene transcription na protein okwu ga-enwe mmetụta dị mkpa maka ọbara mgbali elu na usoro obi obi.
gosiri na nchikota na superconductivity kwalitere intracellular conduction na ụzọ abụọ nke cardiomyocytes dịpụrụ adịpụ, na-eme ka njikọta na ọrụ ventricular aka ekpe.
Emere nnwale ahụ site na iji ọgụgụ isi mmadụ dị n'ime sel site na iji echiche quantum nke ntinye na njiri ike;a tụrụ omume eletrik intracellular gafee oghere nkwụsị (GI) nke enalapril (E.) na angiotensin II (Ang II) kpatara.E.Na-agbanye na 1 ug / ml (25 ug / ml) n'elu nkeji 4. A na-enweta ala dị larịị na valvụ na 106% na-asọba na akpa ahụ.Ang II. A na-agbanye ya na 1 ug / min, GI belatara (55%) na e nweghị ala dị larịị.
Anyị na-eche na a na-eru ala dị larịị ka e belatara njikọ, ma ọ bụghị na Ang II. Na steeti na-arụ ọrụ nke ọma, E. coli dị irè karị n'ịkwalite njikọ nke myocytes na-ada ada, na-eme ka ọrụ ventricular aka ekpe dịkwuo mma.
Ọrịa Coronavirus (COVID-19) sitere na ọrịa asymptomatic ruo n'ọrịa siri ike nwere ọtụtụ akụkụ ahụ. Nnyocha e mere n'oge na-adịbeghị anya egosila njikọ dị n'etiti ọkwa lipid serum dị ala, ya bụ lipoprotein dị elu (HDL), lipoprotein dị ala (LDL), na mkpokọta. cholesterol (TC), na oke ọrịa COVID-19. Agbanyeghị, nsonaazụ ya enweghị agbanwe agbanwe, amabeghị oke njikọ ahụ ugbu a.
Anyị mere nyocha usoro na meta-analysis nke 1) ọdịiche dị na ọkwa HDL, LDL, TC, na triglyceride (TG) n'etiti ndị ọrịa COVID-19 na njikwa ahụike 2) nwere na enweghị ọrịa siri ike na COVID-19 Patient 3) COVID- Onye ọrịa 19 nwụrụ wee dị ndụ. Anyị etinyela akụkọ sitere na PubMed na Embase dị ka nke Septemba 1, 2021. Anyị nyochara ihe dị iche iche pụtara (pMD) na ọkwa lipid (mg/dL) nke otu ndị dị n'elu site na iji nyocha meta-analysis. wee nyochaa nhụsianya mbipụta site na iji nkata ọwara.
N'ime akụkọ 441 eweghachiri, edemede 29 (26 na-atụgharị azụ azụ na ndị otu 3 na-atụ anya ya) zutere njirisi nsonye, ​​yana ngụkọta nke ndị sonyere 256,721. Ndị ọrịa nwere COVID-19 nwere ọkwa HDL dị ala (pMD = -6.95) na TC (pMD = -14.9) (Table 1 na Figure 1).LDL na ọkwa TG adịghị iche n'etiti ndị ọrịa nwere na ndị na-enweghị COVID-19. Ndị ọrịa COVID-19 siri ike nwere ọkwa HDL dị ala (pMD = -4.4), LDL (pMD = -4.4). ) na TC (pMD = -10.4) ma e jiri ya tụnyere ndị ọrịa COVID-19 na-adịghị ahụkebe. Ndị ọrịa nwụrụ nwere obere HDL (pMD = -2.5), LDL (pMD = -10.6) na TC (pMD = -14.9). Ọkwa TG adịghị iche na COVID-19 njọ ma ọ bụ ọnwụ. Ọ nweghị nke nyocha ndị a dị n'elu gosiri enweghị mmasị n'akwụkwọ akụkọ.
Nnyocha anyị gosiri na ndị ọrịa nwere COVID-19 nwere ọkwa lipid ọbara dị ala ma e jiri ya tụnyere njikwa ahụike. N'ime ndị ọrịa COVID-19, ọkwa HDL dị ala, LDL na TC jikọtara oke na ọnwụ. Anyị kwenyere na ọkwa lipoprotein dị ala bụ nke abụọ na sistemu. mbufụt na imeju adịghị arụ ọrụ. Enwere ike ịchọpụta ọkwa lipid ọbara dị ka ihe nwere ike ibute ọrịa na ndị ọrịa COVID-19.
Atrial na ụbụrụ natriuretic peptides (ANP na BNP) na-ekesa homonụ nke sitere na obi nke na-arụ ọrụ dị mkpa n'ịhazi ọbara mgbali elu na mmiri homeostasis na imezigharị obi obi site na vasodilatory na diuretic mmetụta.Ma ANP na BNP na-eme site na-ejikọta transmembrane guanylate cyclase / natriuretic. peptide receptor-A (GC-A/NPR-A) .Mmeghasị usoro nke Npr1 gene (encoding GC-A/NPRA) na-ebute oke ibu, ọbara mgbali elu, na nkụchi obi. .Ebumnuche nke ọmụmụ a bụ ịchọpụta ma Npr1 na-arụ ọrụ dị oke mkpa n'ịhazi glucose homeostasis na ụmụ oke Npr1 mebiri emebi.
Okenye nwoke na nwanyi (izu 16-18) Npr1 knockout haplotype (Npr1 +/-, 1-opi), ụdị anụ ọhịa (Npr1 +/+, 2-opi) na mkpụrụ ndụ ihe nketa (Npr1 + +/++, 4 -copy) Oke. a na-ebu ọnụ maka awa 16 ma nwee ohere ịnweta mmiri n'efu. A na-eme nchịkwa ọnụ na intraperitoneal nke glucose (2 g / kg arọ ahụ) na ụmụ oke iji chọpụta ule nnabata glucose ọnụ (OGTT) na intraperitoneal glucose tolerance test (IPGTT) . A na-ekpebi ọkwa site n'ọbara ọdụ na 0, 15, 30, 60, 90, na 120 nkeji na-eji AlphaTRAK Blood Glucose Monitoring System (Zoetis Inc, Kalamazoo, MI) .Systolic ọbara mgbali (SBP) kpebisiri ike site na kọmputa na-adịghị emerụ ahụ. usoro ọdụ ọdụ (Visitech 2000).
Nsonaazụ gosiri na ọkwa glucose ọbara n'ime ụmụ oke 2-mbipụta (OGTT: 101 ± 4 mg/dL) mụbara na nkeji iri na ise mgbe nchịkwa glucose (2 g / kg arọ ahụ) gachara ma gbadata na nso basal na nkeji 120 n'ime ụmụ nwoke. .na ụmụ nwanyị 98 ± 3 mg / dL, IPGT: ụmụ nwoke 100 ± 3 mg / dL, ụmụ nwanyị 97 ± 4 mg / dL), ebe n'ime ụmụ oke 1-mbipụta, ọkwa glucose ọbara nọgidere na-ebuli elu ọbụna mgbe nkeji 120 gasịrị (OGTT: ụmụ nwoke 244 ± 6 mg/dL, nwanyi 220 ± 4 mg/dL, IPGT: nwoke 250 ± 5 mg/dL, nwanyi 225 ± 6 mg/dL) ma e jiri ya tụnyere ụmụ oke 2-depụta.4-nṅomi ụmụ oke nwekwara belata ọkwa glucose ọbara nke ukwuu. Nkeji 120 (OGTT: 78 ± 3 mg / dL maka ụmụ nwoke, 73 ± 2 mg / dL maka ụmụ nwanyị, IPGT: 76 ± 4 mg / dL maka ụmụ nwoke na 70 ± 3 mg / dL maka ụmụ nwanyị).dL) ma e jiri ya tụnyere ụmụ oke 2. SBP dị elu nke ukwuu na ụmụ oke 1 (134 ± 3 mmHg na ụmụ nwoke na 125 ± 3 mmHg na ụmụ nwanyị) karịa na ụmụ oke 2-depụta (101 ± 2 mmHg na ụmụ nwoke na 92 ​​± 2 mmHg n'ime ụmụ nwanyị).N'otu aka ahụ, ụmụ oke 4-copy nwekwara SBP dị ala karịa ụmụ oke 2 (85 ± 3 mmHg na ụmụ nwoke na 78 ± 2 mmHg n'ime ụmụ nwanyị). Ọkwa glucose ọbara kachasị dị ntakịrị na OGTT ma e jiri ya tụnyere ya. na IPGTT.
Nchọpụta dị ugbu a na-egosi na Npr1 gbochiri ịrị elu nke ọkwa glucose ọbara na-esochi ịma aka glucose yana anabataghị nnabata glucose dị n'ụdị oke ọhịa na mkpụrụ ndụ ihe nketa, na-atụ aro na Npr1 na-arụ ọrụ dị mkpa n'ịhazi ọkwa glucose na mfu nke Npr1 Action na-emetụta nke ọma. ọrụ akụrụ na obi na ụmụ oke mutant. Ọrụ a kwadoro site na onyinye NIH (HL062147).
Central Arkansas Veterans Health Health System John L. McClellan Memorial Veterans Hospital, Little Rock, Arkansas
Ndị ọrịa na-arịa ọrịa akụrụ na-adịghị ala ala (CKD) na ndị na-abụghị ST-segment elevation myocardial infarction (NSTEMI) na-anọchite anya ihe ịma aka ụlọ ọgwụ dị ịrịba ama. Nkwekọrịta dị n'etiti ọmụmụ ihe na-eme nchọpụta na-ejighị n'aka. ọgwụgwọ n'otu aka ahụ (2) Ọ̀tụ̀tụ̀ ọrụ gbasara akụrụ na-emetụta nsonaazụ ya?(3) Ọ̀tụ̀tụ̀ ndị na-anwụ anwụ ọ̀ bụ otu ihe ahụ na ọgwụgwọ ọgwụ naanị n'ọmụmụ ihe n'usoro n'usoro na nleba anya?
A họpụtara ọmụmụ ihe dabere na njirisi ndị a: (1) akụkọ gbasara ma ọ bụ nlele anya nke ndị ọrịa nwere NSTEMI na CKD (2) ọnụọgụ ndị ọrịa na ọnwụ dị maka ọgwụgwọ mkpasu iwe na nchekwa na ọkwa ọ bụla nke ọrụ gbasara akụrụ, gụnyere atụmatụ nzacha glomerular filtration (eGFR). ) 30–60 na <30.Emechara meta-analysis with subgroup ntụnyere site n'ịgbakọ erughị eru maka ọnwụ sitere na mmegide megide ọgwụgwọ mgbanwe.
(1) Ọmụmụ ihe ise na-enweghị usoro na ọmụmụ nyocha anọ zutere njirisi nhọrọ, yana ngụkọta nke ndị ọrịa 362,486 na-anata ọgwụgwọ mmegide ma ọ bụ mgbanwe n'etiti 1994 na 2020
(2) N'ime ọmụmụ ihe a na-atụghị anya ya, ọnụọgụ ọnwụ maka ọnwụ n'ihi ọgwụgwọ na-emerụ ahụ na ndị ọrịa nwere eGFR 30-60 bụ 0.739, oge ntụkwasị obi (CI) bụ 0.382-1.431, p = 0.370. N'ihe nyocha nke eGFR 30-60, oke ohere maka ọgwụgwọ mkparị maka ọnwụ bụ 0.144, CI 0.012-0.892, p=0.037.
(3) N'ime nchọpụta a na-atụghị anya ya, ọnụọgụ ọnwụ maka ọnwụ n'ihi ọgwụgwọ na-emerụ ahụ na ndị ọrịa nwere eGFR <30 bụ 0.790, CI 0.135-4.63, p=0.794. N'ọmụmụ ihe nyocha, ndị ọrịa nwere eGFR <30 nwere oke nha nke 0.384 maka ọnwụ, CI 0.281–0.552, p<.05.
(4) Ihe ize ndụ nke ọnwụ na ndị ọrịa nwere eGFR 30-60 na-agwọ ya na ọgwụgwọ nchekwa naanị bụ 0.128 (CI-0.001-0.227) na otu ọmụmụ ihe na-enweghị usoro na 0.44 (CI 0.227-0.6525) n'ime otu nnyocha nyocha, p< 0.01.N'ime nchọpụta a na-atụghị anya ya, ihe ize ndụ nke ọnwụ bụ 0.345 (CI-0.103-0.794) na ndị ọrịa nwere eGFR <30 na-enweta ọgwụgwọ nchekwa naanị na 0.463 (CI 0.00-0.926) na nchọpụta nyocha, p=0.579.
(1) N'agbanyeghị mmetụta dị mma nke ọgwụgwọ mmekpa ahụ na ma ọmụmụ ihe na-enweghị usoro na ntinye aka, oke ọgbaghara maka ọnwụ n'ọmụmụ ihe nleba anya dị ịrịba ama.
(2) Nnyocha nleba anya egosila na ọgwụgwọ ịwakpo ahụ nwere oke ohere dị ala maka ọnwụ na ndị ọrịa nwere eGFR 30-60 na eGFR <30.
(3) Ndị ọrịa nọ n'ìgwè nleba anya nwere nnukwu ihe ize ndụ nke ịnwụ site na ọgwụgwọ na-echekwa naanị.
(4) Achọkwu nyocha iji mepụta ihe atụ maka ịhọrọ ndị ọrịa ga-erite uru kachasị na ọgwụgwọ mmegide ma ọ bụ mgbanwe.
(5) Ihe mgbochi nke ọmụmụ a gụnyere ọdịiche dị na ọnụ ọgụgụ ndị ọrịa nọ n'ìgwè ọmụmụ, enweghị data hemodynamic na angiographic dị ka eGFR, na enwere ike na ụfọdụ ọmụmụ gụnyere ndị ọrịa nwere angina pectoris na-adịghị akwụ ụgwọ na-abụghị NSTEMI.
N'agbanyeghị ọganihu nkà na ụzụ na nkà mmụta obi, cardiogenic shock dị ka mgbagwoju anya nke nnukwu myocardial infarction na-anọgide na-abụ ihe ịma aka ahụike. na nnukwu ọrịa obi na-arịa ọrịa obi (ACS) .Ebumnobi anyị bụ iji chọpụta otú cardiogenic ujo nke abụọ na ACS na-achọ n'ibu nkwado ọbara na-ejikwa na ụlọ ọrụ anyị na iji tụnyere ụlọ ọgwụ n'etiti ndị lanarịrị na ndị na-adịghị ndụ.
Nnyocha nyocha azụ azụ nke ndị ọrịa dị afọ 18-89 chọrọ nkwado usoro mgbasa ozi nwa oge na ntọala ACS na Mahadum Texas Lubbock Medical Center site na August 2018 ruo Ọgọst 2019. Atụnyere mwepu nke na-anwụ anwụ na onye na-adịghị ndụ. A na-eji nchikota ule maka mgbanwe dị iche iche na nke na-aga n'ihu.
Ngụkọta nke ndị ọrịa 39 gụnyere, 90% bụ nwoke, afọ nke afọ bụ 62 afọ, 62% nwere ọrịa shuga, na ihe nrịbama ahụ pụtara 29.01± 5.84 kg/m2.Intra-aortic balloon pump bụ ihe a na-ejikarị arụ ọrụ. ngwaọrụ nkwado, nke na-esote Impella (92% vs 8%). Ọnụ ọgụgụ ndị nwụrụ anwụ n'ozuzu bụ 18% . Ọnụ ọgụgụ obi dị elu na lactate na ntinye n'oge eji nkwado ígwè ọrụ jikọtara ya na ọnwụ (105 bpm vs 83.91 bpm, p=0.02) (6.85) mmol / l vs 2.55 mmol / lp, 0.003. Percutaneous coronary intervention (PCI) Ọnụnọ nke nkwado igwe tupu oge ma ọ bụ akwara akwara ọbara (CABG) na 44% nke ndị ọrịa jikọtara ya na nlanarị (53% vs 0% p=0.01) .
Ọnụ ọgụgụ obi dị elu na ọkwa lactate n'oge ntinye nke nkwado n'ibu na-ejikọta ya na ọnwụ na ndị ọrịa nwere ọrịa cardiogenic ujo nke abụọ na nnukwu ọrịa obi. Mmalite nke nkwado n'ibu tupu PCI ejikọta ya na survival. Ọ dị mkpa ka ọmụmụ ihe dị ukwuu na nke siri ike dị mkpa iji kọwaa mkpakọrịta ndị a.
Ijikwa hidradenitis suppurativa (HS) nwere ike bụrụ ihe ịma aka. N'ọtụtụ ọnọdụ, mgbaàmà ndị ọrịa na-akawanye mma mgbe ntinye aka mbụ nke mgbanwe mgbanwe. .Anyị na-akọwa onye ọrịa nke na-ajụ ịwa ahụ nke mere ọgwụgwọ radieshon n'elu.
A 44-afọ nwoke ọkọnọ na diffous ndim nke buttocks, gluteal cleft, perineum, na bilateral apata HS.The ndidi bụ refractory ka ịwa ahụ debridement na ọgwụgwọ na ọgwụ nje na corticosteroids.He nwetara gbawara n'ezie electron doo radieshon ọgwụgwọ na a ngụkọta dose nke 30 Gy na 10 kewara doses ma nọgide na-enwe a ele mmadụ anya n'ihu nzaghachi maka 2 izu mgbe mmalite nke ọgwụgwọ. Objective anụ ahụ nnyocha n'ime 1 ọnwa nke ọgwụgwọ gosiri a 25% mbelata na ngụkọta ebe nke mbufụt na akara flattening nke ewelitere. ebe. N'oge ahụ, ndị ọrịa na-akọ na mbelata nke onwe onye na mgbu na drainage. A na-ewere nzaghachi na-adịgide adịgide na 6 na 12 ọnwa mgbe ọgwụgwọ gasịrị.
Usoro ọgwụgwọ radieshon nwere uru anecdotal maka ọrịa dị iche iche na-adịghị mma ma mụọ ya na obere doses (mgbe ụfọdụ otu doses) na njikwa nke HS. Anyị họọrọ iji usoro nkewa nke anyị kwenyere na ọ bụ nke kachasị nchebe na ikekwe ogologo oge n'usoro nke ibelata mmetụta.
Ebe ọgwụgwọ onye ọrịa na-egosi hidradenitis suppurativa na buttocks, gluteal cleft, perineum na bilateral thighs tupu ọgwụgwọ.
Elu eletrọnịke ọkụ radieshon ọgwụgwọ dị irè n'ịgwọ ọrịa na-adịghị mma na-ekwe nkwa maka refractory HS.Studies nke mkpokọta dose na fractionation regimens dị mkpa iji bulie na-eduzi n'ọdịnihu ojiji.
N'ozuzu US bi, 1 n'ime 5,000 ndị mmadụ nwere mitochondrial myopathy. Clinical ngosipụta nwere ike roughly kewara ụzọ atọ: adịghị ala ala na-aga n'ihu mpụga ophthalmoplegia, skeletal-CNS syndrome ma ọ bụ mfe myopathy. Obi abnormalities na-eme na 30-32% nke ikpe, tumadi dị ka. hypertrophic cardiomyopathy, dilated cardiomyopathy, ma ọ bụ conduction abnormalities.Anyị na-egosi ikpe nke bilateral ala nsọtụ adịghị ike, mgbu, na ọzịza na muscle biopsy nchoputa nke mitochondrial myopathy.Nkọwa nke ikpe: A na-ezigara nwa akwụkwọ nwoke dị afọ 21 nke gụsịrị akwụkwọ n'ụlọ ọgwụ anyị. mgbe izu 3 nke adịghị ike ụkwụ, ihe mgbu, na ọzịza mgbe ọ bịarutere United States site na India. Nnyocha gosipụtara tachycardia, 2+ isi nke pitting edema na ikpere abụọ, 4/5 MRC-grade adịghị ike, nro dị nro na nso nso na nke dị anya muscle ìgwè. nke elu na nke dị n'akụkụ elu, ọ dịghị mmetụta miri emi na-atụgharị azụ azụ, nkwụsị ụkwụ, na ptosis bilateral na mgbochi mmegharị nke extraocular.Nchọpụta ụlọ nyocha mbụ gosipụtara creatinine kinase mụbara site na 691 IU / L, ụbụrụ natriuretic peptide mụbara site na 3437 pg / ml, troponin mụbara site na 47.1. ng/L, myoglobin mụbara site na 195 ng/mL, na lactate mụbara site na 7.7 mmol /L, serum bicarbonate belatara site na 12 mmol/L.Lumbar puncture results na ndị a na-enyo enyo na ọrịa Guillain-Barre enweghị ntụkwasị obi n'ihi traumatic taps.Electrocardiogram gosiri axis aka ekpe. Deviation with left anterior bundle block.Chest X-ray na CT angiography of chest/abdomen/pelvis gosiri mmụba obi na ibu ibu.Eche bed ya ECHO gosiri obere aka ekpe systemic hypokinesia, 40-44% ala ejection ntakiri, na nwayọọ pulmonary ọbara mgbali. A nabatara onye ọrịa na ngalaba nlekọta ahụike ahụike n'ihi mbelata nke nrụgide mkpali kacha elu. Ophthalmology kwadoro ophthalmoplegia, ewezuga akwara cranial palsy, myasthenia gravis, na retinitis pigmentosa.Gq1b antibody negative.Mgbochi autoimmune na ọrịa na-efe efe abụghị ihe na-enye aka. nke akwara femoris rectus nke onye ọrịa gosiri gbasasịrị acha anụnụ anụnụ na cytochrome-c oxidase-adịghị mma eriri nwere ụba perimuscular na endomysial connective anụ ahụ na-arụ ọrụ na nke na-adịghị ala ala mitochondrial myopathy. Metoprolol na methylprednisolone.
Ekwesịrị ịtụle myopathy na nchoputa dị iche iche nke ndị ọrịa na-enyo enyo na ọrịa Guillain-Barre. Anyị na-akọ akụkọ na-adọrọ mmasị nke myopathy na ngosipụta nke obi obi a ma ama. Myopathy na-egosipụta dị ka myocarditis kwesịrị ịkpalite enyo nke ọrịa mitochondrial. Ahụmahụ anyị na-emesi mkpa ọ dị iji otu ndị otu interdisciplinary. ụzọ iji chọpụta ọrịa pathologies na-adịghị ahụkebe na ntinye aka n'ọtụtụ dịgasị iche iche.
Ebumnuche nke ọmụmụ a bụ ịchọpụta ohere nke ịchọpụta Gaisbock na ndị ọrịa nwere polycythemia na-adịghị ala ala na ọbara mgbali elu.
A nabatara otu nwoke Caucasian dị afọ 40 n'ụlọ ọgwụ na-enwe ọzịza ụkwụ na-aga n'ihu na ụbara oxygen ka ọ gachara izu abụọ n'ụlọ ọgwụ ya na oyi oyi COVID-19. Mgbe ọ tụlechara akụkọ ahụike onye ọrịa ahụ, a chọpụtara na ọ nwere ọbara mgbali elu na-agwọghị ya yana polycythemia na-agbasa. afọ iri na ọtụtụ nleta. Akụkọ ahụike na-adịbeghị anya gụnyere nchọpụta nke thrombosis miri emi (DVT) n'otu ụkwụ ahụ ọnwa abụọ na ọkara gara aga, na ọgwụgwọ na Xarelto.
Onye ọrịa ahụ kọrọ akụkọ ihe mere eme nke afọ 12 nke obere testosterone. Otú ọ dị, ọ dịghị eji ihe mgbakwunye testosterone ọ bụla maka ọnwa itoolu gara aga. Ọ kọrọ ike ọgwụgwụ ụbọchị , edemede ugboro ugboro n'abalị, na snoring ugboro ugboro. Onye ọrịa a enwebeghị ọmụmụ ụra ma ọ bụ jiri CPAP. Onye ọrịa ahụ na-aṅụ sịga ọkara otu mkpọ ụtaba kwa ụbọchị maka afọ 13 n'usoro, otu mkpọ kwa ụbọchị, maka afọ 10 n'usoro, ma kwụsị ise siga afọ 12 gara aga. O jiri oge ndụ ya niile rụọ ọrụ siri ike na ụlọ ọrụ mmepụta ihe.