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Codonolactone is the main biologically active ingredient in Atractylodes lancea. Studies have shown various functions of codonolactone, while its protective effect against neurotoxicity caused by ischemic stroke is unclear. This study investigated the roles of codonolactone in inflammation, oxidative stress and apoptosis after cerebral ischemia-reperfusion (I/R) injury. Rats with codonolactone treatment, I/R treatment and the sham operation group were used in this study. After reperfusion for 24 hours, nerve damage was detected by nerve staining, and the neurological deficits of the rats were analyzed. The contents of superoxide dismutase (SOD), malondialdehyde (MDA), interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in rat brain tissues were also determined. Western blot analysis was performed to determine the expression levels of Akt/Nrf2 pathway-associated proteins. Compared with the I/R group, the cerebral blood flow, infarct volume, brain water content, coronary blood flow and neurological deficits in the codonolactone treatment group, especially with the 80 mg/kg dosage, were significantly reduced. Codonolactone could significantly reduce the expression levels of caspase-3 and Bax, and significantly increase the expression levels of Bcl-2 after I/R. In addition, codonolactone could significantly reduce MDA content and the expression levels of TNF-α and IL-1β in ischemic brain tissues. It also significantly increased SOD activity, the expression levels of heme oxygenase-1 (HO-1) and the phosphorylation of Akt and Nrf2. Codonolactone ameliorated the cerebral I/R injury by improving anti-oxidant, anti-inflammatory activities and reducing apoptosis. Besides, the Akt/Nrf2 pathway was involved in the pharmacological action of the codonolactone.

Background Ventricular arrhythmias (VAs) arising from the origin above pulmonary valve lack comprehensive investigation. This study aimed to disclose the characteristics and radiofrequency catheter ablation (RFCA) outcomes for those VAs. Methods One hundred six VAs arising from the region above pulmonary valve treated with RFCA were included in this study. Results Seventy-five cases were identified in the pulmonary sinus cusps (PSCs, 32 in left sinus cusp (PLC), 15 in right (PRC), 28 in anterior (PAC)) and 31 cases were in the main stem of pulmonary artery (MSPA, 18 above PLC (LMSPA), 3 above PRC (RMSPA), 10 above PAC (AMSPA)). Compared with PSCs VAs, MSPA VAs exhibited a higher R wave amplitude in the inferior leads, a total inferior R amplitude > 5.1 mV predicting MSPA origins. LMSPA, RMSPA and AMSPA VAs resembled PLC, PRC and PAC VAs in electrocardiographic characteristics respectively. No electrophysiological differences were found between PSCs and MSPA VAs. The irrigated-up catheter and R0 Swartz long sheath were more utilized for ablation of PSCs VAs than for MSPA VAs. All these VAs were successfully eliminated by RFCA. Conclusion VAs arising from the origin above pulmonary valve were common. Based on certain electrocardiographic characteristics, they could be roughly located, which contributed to an effective RFCA.

Our previous studies have reported that agonist of α7 nicotinic acetylcholine receptors prevented electrophysiological dysfunction of rats with ischaemic cardiomyopathy (ICM) by eliciting the cholinergic anti‐inflammatory pathway (CAP). Adenosine monophosphate‐activated protein kinase (AMPK) signalling is widely recognized exerting cardioprotective effect in various cardiomyopathy. Here, we aimed to investigate whether the protective effects of the CAP are associated with AMPK signalling in ICM. In vivo, coronary artery of rats was ligated for 4 weeks to induce the ICM and then treated with PNU‐282987 (CAP agonist) and BML‐275 dihydrochloride (AMPK antagonist) for 4 weeks. In vitro, primary macrophages harvested from rats were induced inflammation by Lipopolysaccharide (LPS) treatment and then treated with PNU‐282987 and BML‐275 dihydrochloride. In vivo, exciting CAP by PUN‐282987 elicited an activation of AMPK signalling, alleviated ventricular remodeling, modified the cardiac electrophysiological function, reduced the cardiac expression of collagens and inflammatory cytokines and maintained the integrity of ultrastructure in the ischemic heart. However, the benefits of CAP excitation were blunted by AMPK signaling antagonization. In vitro, excitation of the CAP was observed inhibiting the nuclear transfer of NF‐κB p65 of macrophages and promoting the transformation of Ly‐6Chigh macrophages into Ly‐6Clow macrophages. However, inhibiting AMPK signalling by BML‐275 dihydrochloride reversed the CAP effect on LPS‐treated macrophages. Finally, our findings suggest that eliciting the CAP modulates the inflammatory response in ICM through regulating AMPK signalling.

AimsTo chart the effect of the COVID-19 pandemic on the activity of interventional electrophysiology services in affected regions.MethodsWe reviewed the electrophysiology laboratory records in 3 affected cities: Wenzhou in China, Milan in Italy and London, United Kingdom. We interviewed electrophysiologists in each centre to gather information on the impact of the pandemic on working patterns and on the health of staff members.ResultsThere was a striking decline in interventional electrophysiology activity in each of the centres. The decline occurred within a week of the recognition of widespread community transmission of the virus in each region and shows a striking correlation with the national figures for new diagnoses of COVID-19 in each case. During the period of restriction, work-flow dropped to th allowing the electrophysiology service to resume with a strict testing regime for all patients.ConclusionInterventional electrophysiology is vulnerable to closure in times of great social difficulty including the COVID-19 pandemic. Intense public health intervention can permit suppression of local disease transmission allowing resumption of some normal activity.CONDENSED ABSTRACTCOVID-19 has affected every aspect of life worldwide. In the electrophysiology labs of Wenzhou, Milan and London, activity was suspended as the disease took hold. Only Wenzhou has resumed normal services, facilitated by a monumental nationwide program of public health interventions and supported by stringent testing protocols.WHAT’S NEWWe describe the impact of the COVID-19 pandemic on interventional electrophysiology units in 3 cities: Wenzhou, Milan and London.In all cases, the routine work of the electrophysiology was virtually suspended within a week of the recognition of widespread virus transmission in the area.During the period of restricted activity imposed by the pandemic, centres have dealt with a small number of emergency ablations only, a balanced mix of atrial, ventricular and junctional arrhythmias.In 2 of the 3 centres, electrophysiologists were redeployed to perform other medical duties including in COVID-19 wards.COVID-19 infection occurred in medical and nursaing staff in 2 of the 3 centres.Only in the cases of Wenzhou, China, has a resumption of normal activity been possible; this follows intensive public health intervention and is protected by stringent testing.FUNDINGNoneETHICAL APPROVALNone required from the Research Ethics Committee (REC) London according to the type of study. Institutional ethical approval obtained at the centres of: St. George’s Hospital NHS Foundation Trust, London, UK; Local Health Authority Ethical Approval was obtained in: The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University in Wenzhou, PR China and San Raffaele in Milan, Italy.CONSENTInformed consent was obtained from all participants/interviewees who took part in this study.

Aims To investigate the characteristics of bipolar intracardiac electrograms (bi-EGMs) in target sites of ventricular arrhythmias (VAs) originating from different regions of ventricular outflow tract (VOT). Methods and results Two hundred and seventy patients undergoing first-time ablation for VAs originated from distal great cardiac vein (DGCV), aortic sinus cusps (ASCs), or pulmonary sinus cusps (PSCs) were enrolled in present study. Local intracardiac bipolar recordings on 243 successful sites and 506 attempted but unsuccessful ablation sites were analysed. Specific potentials in bi-EGMs on successful sites were more common compared with unsuccessful sites (76.95%, 187/243 vs. 25.49%, 129/506, P Conclusion Distinctive morphology of bi-EGMs during VAs can be found in different regions of VOT, which probably due to changes in the arrangements of myocardial sleeves. Correct identification and better understanding of the distinctive features of these bi-EGMs with regards to the anatomic location was important, the presence of specific potentials may add help in successful ablation.

Due to increase in customer environmental awareness, governments require enterprises to incorporating carbon footprint in the supply chain performance evaluation. For utilizing expert interviews, this paper designs a new supply chain carbon footprint index system from the perspective of economy, resources and environment. The system highlights the logistics enterprises operational status under the constraint of carbon footprint. However, in order to reduce the influence of subjective factors, this study combined the entropy method and fuzzy comprehensive evaluation to establish the performance assessment model. To verify the validity of the model and practical indexes, this paper selects a logistics enterprise for empirical research. Therefore, recommendations are given based on performance evaluation results lay the foundation for the further development of low-carbon supply chain operations.