简介：摘要甲状腺相关性眼病（TAO）是成年人最常见的眼眶疾病的一种，一般认为它属自身免疫性疾病或器官免疫性疾病，MicroRNA（miRNA）是具有调控功能的一类非编码小分子RNA，主要作用是参与基因转录后的表达调控，与眼部细胞的生长、发育、分化、凋亡及代谢功能的维持关系密切。近年来的研究显示，miRNA可能参与GO的发病。本文对近年来miRNA与GO的相关研究进行综述。

简介：Thecasepresentedhereoffersusanopportunitytodiscussanincreasinglycommonlyconfrontedclinicalchallenge.Twoissuesareraised:howbesttomanagethepatient’svalvularheartdisease,includingboththeindicationsforsurgicalinterventionandtheprostheticoptions,andhowbesttomanagehisaorticdilatation.Letustakethemoneatatime.Thepatienthassevereaorticregurgitationbutanormalejectionfraction.Althoughwedonothavehisventriculardimensions,hehasaclassIindicationforinterventiongivenhissymptoms.

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简介：AreviewarticlebyHaoetal.(JAmCollCardiol2017;69(24):2952–66)hashadhugerepercussionsamongthosefamiliarwithtraditionalChinesemedicine(TCM)intheinternationalacademiccommunity.ItevaluatedtheefficacyandsafetyofTCMforcardiovasculardiseaseandthepharmacologicaleffectofactiveTCMingredientsonthecardiovascularsystemandpotentialmechanisms.Wehaveseveralcomments:Firstly,wegiveabriefsummaryaddressingnonpharmacotherapyinTCM,includingacupuncture,moxibustion,Qigong,andTaiChi.Secondly,wehaveaddedtraditionalantiarrhythmicdrug–relatedrandomizedcontrolledtrialstomakethecoveragemorecomprehensive.Lastly,wesupporttheconceptthatresearchinto,developmentof,andapplicationofactiveingredientsispartofmodernTCM.

简介：Cardiovasculardiseaseistheleadingcauseofpregnancy-relateddeathsintheUnitedStates[1].Anestimated4%ofallpregnanciesintheUnitedStatesareaffectedbymaternalcardiovasculardisease,with80%ofthesecasesattributedtocongenitalheartdisease(CHD)[2–4].SecondarytoimproveddiagnosisandmanagementofCHD,morewomenwithCHDarereachingreproductiveage,andmanyofthesewomendesirepregnancy.WhilemanypregnantwomenwithCHDwillhaveanuncomplicatedpregnancyanddelivery,somewithmorecomplexcardiaclesionsorcomorbiditieswillhaveanincreasedriskofmaternalandneonatalmorbidityanddeath.Individualizedpreconception,antepartum,intrapartum.

简介：Dataontheprevalenceofdepressioninadultcongenitalheartdisease(ACHD)patientsdifferwidely.Weaimtosummarizethebestavailableinformationontheprevalenceofdepression,itsprognosticimpact,andpsychiatricinterventionsfordepressedACHDpatients.WereviewedreferencesinrelevantpublicationsuptoOctober17,2017.Forhomogeneityofdata,studiesinwhichdepressionwasindependentlyassessedinpatientsaged18yearsorolderorwithamean/medianageolderthan18yearswereincluded.Retrospectiveandpostoperativeevaluationstudieswereexcluded.Twentypublicationsmetthesecriteria.StudysamplesincludedACHDpatientsfollowedupatACHD-specializedhospitalsin13countries.Theprevalenceofdepressiondifferedwidely,rangingfrom6to69%.Depressionhasbeenshowntobeanindependentpredictorofadverseclinicaloutcomes.Itisalsofrequentlyassociatedwithotherprognosticvariables(i.e.,poorfunctionalclass,unfavorableperceivedhealthstatus,andlowqualityoflife).Currently,norandomizedclinicaltrialsonpsychiatricinterventionsinACHDareavailable.Insummary,depressionishighlyprevalentinACHDpatients,yetitisoftenunrecognizedanduntreated.Theadverseprognosticimpactofdepressioncallsforspecializedpsychiatricinterventions,forwhichmoreresearchisneededintheACHDpatientpopulation.

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简介：Withimprovementsintheirsurgicalandmedicalmanagement,thenumberofpatientswithcongenitalheartdisease(CHD)reachingadulthoodhasincreasedoverthelastdecade.AsthepopulationofadultCHDpatientscontinuestorise,anincreasingnumberofthesepatientswillrequireevaluationforhearttransplantation.ItisimportanttorecognizeadvancedheartfailureandotherassociatedcomplicationsearlyinthiscohortofcomplexpatientsforearlyreferraltoanadultCHDspecialist.Asthesepatientspresentwithuniquechallengesbecauseoftheirmultiplecomorbiditiesandcomplexanatomy,thereneedstobeacarefulselectionprocessfortransplantationtooptimizetheutilizationofdonororgans.

简介：Congenitalheartdisease(CHD)-associatedpulmonaryarterialhypertension(PAH)includesaheterogeneouspatientpopulationthatcanbecharacterizedbytheunderlyingcardiacmalformation.CHD-associatedPAHhasanestimatedprevalenceof5–10%inadultpatients,withanincreasingnumberofpatientssurvivingtoadulthoodbecauseofadvancesinthesurgicalmanagementandthedevelopmentofpulmonaryarterialhypertension(PAH)-targetedpharmacotherapy.Althoughlimiteddataexist,targetedPAHpharmacotherapyhasproventobebeneficialinpatientswithCHD-associatedPAH,withobservedimprovementinfunctionalclass,increaseinexercisecapacity,andimprovementinqualityoflifeandcardiopulmonaryhemodynamics.Additionally,therehasbeenincreasinginterestinthe“treat-to-close”strategy.PAH-targetedpharmacotherapymaybeusedtooptimizecardiopulmonaryhemodynamicssoastoimprovepatients’operabilityinrepairingthecardiacdefect.Althoughtherehavebeensignificantadvancesinthemanagementofthisdiseasestateinthepast2decades,mortalityremainshigh,andongoingclinicaltrialsareneededtobetterunderstandthetreat-to-closestrategy.

简介：摘要目的研究在Graves甲亢患者中采取甲亢灵胶囊与减量法碘-131联合治疗的临床效果。方法本次分析目标是2015年7月至2017年7月期间纳入且研究的50例Graves甲亢患者，以随机数字表法进行分组，将常规一次性口服治疗应用在参照组，将甲亢灵胶囊与减量法碘-131联合治疗应用在实验组，比较两组Graves甲亢患者不同治疗的效果。结果数据显示，实验组Graves甲亢患者临床有效率计算值高于参照组指标，P＜0.05，具有统计学检验分析意义。虽然不良反应计算值低于参照组指标，但P＞0.05，无统计学差异。结论将甲亢灵胶囊与减量法碘-131联合治疗应用在Graves甲亢患者中具有显著的效果。

简介：维生素D作为维持机体钙磷代谢平衡的重要激素,对机体骨与矿物质盐代谢起着重要的调节作用.近年来研究发现Graves病患者体内维生素D水平偏低,这可能预示着Graves病患者机体内将出现一系列骨代谢紊乱的发生,测量Graves病患者体内维生素D水平,有助于Graves病相关骨质疏松的治疗和预防.此外,还有研究者发现维生素D缺乏可能参与Graves病的发生发展,而补充维生素D可能有助于Graves病的预防和治疗.本文将对维生素D与Graves病相关性及其可能存在的机制的研究新进展进行综述.

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简介：目的:研究平目汤含药血清对前脂肪细胞及成熟脂肪细胞的作用,探讨其治疗Graves眼病的机制。方法:采用组织块法将人Graves眼病眼眶前脂肪细胞原代培养并传代,选用间接免疫荧光技术鉴定;用平目汤药液灌胃SD大鼠制备平目汤含药血清,并配成低(5%)、中(10%)、高(20%)三个剂量组;油红O染色观察前脂肪细胞的诱导分化作用;MTT法检测平目汤对前脂肪细胞增殖的影响;流式细胞术检测平目汤对成熟脂肪细胞凋亡率的影响。结果:(1)通过组织块法成功培养出梭形细胞,间接免疫荧光检测为前脂肪细胞。(2)成功诱导前脂肪细胞分化,油红O染色证实为成熟脂肪细胞。(3)平目汤各组均可显著抑制前脂肪细胞的分化,与空白对照组及地塞米松组比较差异明显。(4)平目汤各组均可下调前脂肪细胞增殖活性,以平目汤中剂量组、干预96h效果最佳,组间比较差异有统计学意义(P<0.05)。(5)平目汤各组成熟脂肪细胞凋亡率明显高于空白对照组(P<0.05),以平目汤中剂量组效果最佳。结论:平目汤含药血清可抑制人Graves眼病眼眶前脂肪细胞增殖、促进眼眶成熟脂肪细胞凋亡、减少眼眶脂肪细胞的数量,从而减少眼眶脂肪容积、改善Graves突眼症状。

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简介：摘要目的探讨血清甲状腺自身抗体、碘摄入量与Graves病发生、转归相关性。方法对比分析研究组Graves病患者、对照组健康人群；高尿碘Graves病患者、非高尿碘Graves病患者Graves病患者；Graves病转归良好者、Graves病转归不良者TSAb检测值。结果研究组TSAb活性显著高于对照组（P<0.05）；高尿碘Graves病患者TSAb活性显著高于非高尿碘Graves病患者（P＜0.05）；转归良好Graves病者TSAb活性显著低于转归不良Graves病者（P＜0.05）。结论临床医生应准确掌握Graves病发生、转归与碘摄入量、血清甲状腺自身抗体相关性，接诊病例后综合判断其实际病情并给予各项对症治疗，从而使患者获得更优疗效、预后。

简介：Atrialarrhythmias,includingatrialfibrillation,inthesettingofcongenitalheartdisease(CHD)areepidemiologicallyandmechanisticallydifferentfromthoseencounteredinthegeneralpopulation.ThesearrhythmiasoccuratyoungeragesinpatientswithCHD,andarefrequentlydegenerativeandprogressive.Theepidemiology,incidence,andprevalenceofthespectrumofatrialarrhythmias,includingatrialfibrillation,varyaccordingtothespecificCHDtype,priortreatment,andresidualandongoingstructuralandfunctionalsequelae.Thecombinedimpactofincisionalscars,abnormalhemodynamics,atrialchamberdilatation,andincreasesinatrialwallthicknessanddistributionoffibrosisresultsinahighlydynamicandcontinuouslychangingatrialsubstratethatishighlypredisposedtoarrhythmias.Giventhemultiplesubstrates,individualizedtherapeuticplanscanincludepharmacologictherapy,catheter-basedablation,andsurgicaltherapiesperformedconcomitantlywithprimarysurgicalinterventionforhemodynamicallysignificantsequelaeofCHD.AdvancedimagingwithCTorMRIcanprovidevaluableinformationfordecisionmakingandproceduralplanning.ApplicationofnoveltherapeutictechnologiesandpharmacologicagentsnecessitatesspecialconsiderationswhenappliedtotheCHDpopulationandrequiresgreaterstudyinspecificsubsetsofCHDpatients.

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