ABSTRACT
Objective To investigate the predictive effects of small dense low density lipoprotein cholesterol (sdLDL-C) level and sdLDL-C/high density lipoprotein cholesterol (HDL-C) ratio on the occurrence in patients with acute coronary syndrome (ACS). Methods Two hundred and sixty-eight patients with acute chest pain and diagnosed as ACS according to the clinical symptoms, changes in electrocardiogram and myocardial enzymes, and coronary angiography from November 2017 to April 2018 were enrolled. One hundred and thirty-four cases of unstable angina (UA) and 134 cases of acute myocardial infarction (AMI) were included. Meanwhile, 66 patients with non-ACS were selected as the control group. They baseline data were matched with those of ACS in the same period. Results The sdLDL-C levels and sdLDL-C/HDL-C of ACS patients were significantly increased [0.88(0.70, 1.09) mmol/L vs. 0.61(0.41, 0.84) mmol/L, 0.98(0.72, 1.30) vs. 0.58(0.40, 0.86)]. The sdLDL-C levels and sdLDL-C/HDL-C of AMI group were higher than those of UA group [0.94(0.82, 1.21) mmol/L vs. 0.78 (0.61, 0.98) mmol/L, 1.10(0.79, 1.40) vs. 0.86 (0.62, 1.19)], while those of UA group were also higher than those of the control group [0.78(0.61, 0.98) mmol/L vs. 0.61(0.41, 0.84) mmol/L, 0.86(0.62, 1.19) vs. 0.58(0.40, 0.86)]. There were significant differences (P＜0.01). Logistic regression analysis showed that sdLDL-C level was an independent risk factor for ACS prediction. Compared with those of the control group, the OR values of ACS group, UA group and AMI group were respectively 26.85, 15.19 and 74.40. Correlation analysis showed that sdLDL-C was significantly positively correlated with TC and LDL-C levels (r＝0.697, 0.684, P＜0.01), while it controlled TC and LDL-C levels, and sdLDL-C levels were still significantly positively correlated with ACS (r＝0.185, P＝0.001). ROC analysis revealed that sdLDL-C≥0.613 mmol/L had a sensitivity of 86.6% and specificity of 51.5%, and a sdLDL-C/HDL-C≥0.938 mmol/L had a sensitivity of 53.7% and specificity of 87.9%. ROC curve was used to analyze AMI in ACS group, and the best threshold sdLDL-C＝0.732 mmol/L divided the cases into low-risk groups and high-risk groups. Logistic regression analysis showed that, compared with the low-risk groups, the relative risk estimates of the AMI in the high-risk group was 4.84, after other indicators were adjusted. Conclusions sdLDL-C levels and sdLDL-C/HDL-C are closely related to the occurrence of ACS. As independent risk factors, they are risk assessment predictors for ACS.
ABSTRACT
Vitamin D is an important organic substance in the body to maintain the balance of calcium and phosphorus, and it is also closely related to the occurrence and development of coronary atherosclerotic heart disease (referred to as coronary heart disease). Vitamin D deficiency can lead to the occurrence of coronary heart disease by activating the inflammatory response, weakening the protective effect of the vascular endothelium, activating the renin-angiotensin-aldosterone system, impairing insulin function, triggering abnormal glucose and lipid metabolism, and increasing body weight. The effect of vitamin D supplementation on coronary heart disease still requires large-scale clinical trials to confirm.
ABSTRACT
The existing contents and standards for the standardized residents training are incomplete. Clinical management guidelines and expert consensus should be included in the standardized residents training, since they are very important for clinical decisions. Some guidelines and expert consensus have been included in the standardized residents training in our cardiovascular department,and with the problem-based teaching method, the quality of standardized residents training was improved in the cardiovascular department of ShengJing hospital.
ABSTRACT
Objective To discuss the clinical value of new- utility anal vacuum tube in preventing anastomotic fistula after colorectal cancer anterior resection. Methods Ninety-six patients having underwent the colorectal cancer anterior resection were divided into new-utility anal vacuum tube group and normal anal vacuum tube group by random digits table method with 48 cases each. The complication, anus exhaust time and postoperative drainage volume were compared between 2 groups. Results The incidences of tube defluxion, proctalgia, anus skin damage, bed sheet pollution and anastomotic fistula in new-utility anal vacuum tube group were significantly lower than those in normal anal vacuum tube group: 6.25% (3/48) vs. 31.25% (15/48), 10.42% (5/48) vs. 41.67% (20/48), 0 vs. 25.00%(12/48), 6.25%(3/48) vs. 60.42%(29/48), 2.08%(1/48) vs. 12.50%(6/48), the anus exhaust time was significantly shorter than that in normal anal vacuum tube group:(44.1 ± 8.9) h vs. (48.9 ± 9.6) h, the postoperative drainage volumes form the first day to fifth day were significantly more than those in normal anal vacuum tube group: (31.2 ± 15.1) ml vs. (15.6 ± 8.2) ml, (25.3 ± 13.2) ml vs. (15.8 ± 6.5) ml, (15.6 ± 9.1) ml vs. (10.3 ± 4.5) ml, (104.3 ± 38.2) ml vs. (90.6 ± 12.3) ml and (93.7 ± 32.5) ml vs. (80.7 ± 18.9) ml, and there were statistical differences (P<0.01 or <0.05). The patients in new-utility anal vacuum tube group had different symptoms, but patients could tolerate. Conclusions The new-utility anal vacuum tube can reduce the incidence of anastomotic fistula, and be safe and reliable, which is worthy of wide application.
ABSTRACT
Objective To discover,diagnose and treat colorectal cancer in the early period and further improve the survival rate,reduce morbidity and mortality of the colorectal cancer by early screening for colorectal cancer in Jinjiang.Methods According to “The Guide of Cancer Screening and Early Diagnosis and Treatment in China by the Experts Group of Ministry of Health”,the case history was collected while the stool occult blood and FOBT were detected to discover high risk crowd who then inspected by electron enterscope.Results The screening was practiced in Xibin,Zimao and Neikeng town respectively.The crowd of 40-74 years old was 10 116 and 2631 of them accepted screening(acclimation rate,26％).Two hundred and fifty-seven high-risk people were discovered(9.8％ of 2631)and 86 of them(acclimation rate,33％,86/257)were inspected by electron enterscope.Twenty-two cases were detected with colorectal affection(detection rate,8.6％,22/257),20 cases were diagnosed as colorectal adenoma and 2 cases were diagnosed as adenocarcinoma by pathological section.All of them accepted therapy.Conclusion Carrying out early screening for colorectal cancer is important.It can reduce morbidity and mortality of the colorectal cancer and then improve the cure rate and prolong survival in patients with colorectal cancer.
ABSTRACT
Objective To improve the early diagnosis and prognosis factor of pancreatic carcinoma by summarizing and analyzing the clinical data. Methods The clinical data of 90 patients with pancreatic carcinoma of our hospital from 1989 to 2005 were analyzed retrospectively. Results The symptoms of pancreatic carcinoma were very complicated,the most common manifestations were bellyache,jaundice and weight loss. Main physical signs in these patients included abdominal tenderness,abdominal mass,hepatomegalia,gallbladder enlargement. Jaundice was the outstanding manifestation of pancreatic head cancer. Among all patients,16 cases accepted sugical resection(17.8%),and the 1-year,3-year,5-year survival rate were 22. 2%,11.1% and 2. 2% respectively. Our data showed that the most important prognostic factors which influenced life span were the surgical procedures,tumor size and location,histological differentiation,TNM stage. Conclusions Clinical manifestations of pancreatic carcinoma are related to TNM stage,tumor size and location,histology type,complication disease. Clinical symptoms only provide clue for diagnosis of pancreatic carcinoma. Laboratory and imaging examination will provide objective evidence for further diagnosis and prognosis in pancreatic carcinoma.
ABSTRACT
BACKGROUND:Mental material has shadow intervention effects on multi-slice helical CT (MDCT).Mental wall thickness and lumens inner diameter in stent structure can significantly affect longitudinal axis imaging quality of MDCT target vessel stent.However.there are few studies involved in this aspect.OBJECTIVE:To analyze the effect of various coronary stent materials and structures on patency images of target vessel by MDCT evaluation,and to provide clinical evidences for improving stent technique.DESIGN,TIME AND SETTING:The comparison observation was conducted at the Shenzhou Hospital,Shenyang Medical College.and Shengjing Hospital,China Medical University from January 2006 to December 2008.PARTICIPANTS:A total of 139 patients with coronary heart disease who were treated with stent implantation were divided into material and construct groups (227 stents were implanted).There were 92 stainless steel stents,135 nick-eltitanium alloy stents,85 thin mental wall stents (<140μm).142 thick mental wall stents (≥140μm).71 small diameter stents (<3 mm),and 156 big diameter stents (≥3mm).METHODS:During following up,patients were checked using 64-slice helical CT and routine coronary arteriongraphy to compare patency images of target vessels in the two groups.MAIN OUTCOME MEASURES:MDCT was scored by four-mark standard to evaluate sensitivity,specificity,accuracy,positive and negative predictive values of MDCT.RESULTS:A total of 227 stents were implanted into 139 patients.CT images of stainless steel stent group were poorer than nickel-titanium alloy group,and the indicators including image score,sensitivity,specificity,positive and negative predictive values of the stainless steel stent group were significantly less than nickel-titanium alloy group (P<0.05).CT images of thick-wall stent were poorer than thin-wall stent,while the indicators including image score,sensitivity,specificity,positive and negative predictive values of the thick-wall stent were significantly less than thin-wall stent (P<0.05).CT images of small-diameter stent were poorer than large-diameter stent,while the indicators including image score,sensitivity,specificity,positive and negative predictive values of the small-diameter stent were significantly less than large-diameter stent (P<0.05).CONCLUSION:Materials,wall thickness and diameter of coronary stent may influence images of target vessels via MDCT evaluation.
ABSTRACT
Objective To determine the relationship between angiotensin converting enzyme gene polymorphism and ? myosin heavy chain gene and dilated cardiomyopathy (DCM) among people of Han nationality in Liaoning province. Methods The insertion/deletion (I/D) polymorphism of ACE gene was detected by the polymerase chain reaction (PCR) in 43 patients with DCM and 53 normal controls. The exons 13,14 of cardiac ?-MHC gene from 43 patients and 53 controls were amplified restrictively by using PCR. The amplified products of PCR were digested by restrictive en-donuclease DdeⅠ and NlaⅢ to identify the mutations at No. 8848 and 9124 nucleotide of ?-MHC gene. Results The frequency of ACE DD genotype and the frequency of the allele D was remarkably higher in individuals with DCM than those in normal control people ( P