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Objective:To investigate the effects of applying Stent Boost Subtract (SBS) technique during percutaneous coronary intervention in patients with complex coronary lesions.Methods:200 patients with coronary artery disease (CAD) who hospitalized in the department of cardiology in Guangzhou First People′s Hospital from June 2018 to June 2020 were enrolled. The coronary lesions of all patients were corresponding to B2 or C type suggested by American Heart Association (AHA)/American College of Cardiology (ACC) according to coronary angiography and treated with percutaneous coronary intervention (PCI). Patients were randomly divided into SBS group ( n=82, SBS technique was applied during PCI) and IVUS group [ n=118, intravascular ultrasound (IVUS) was applied during PCI]. After stent implantation, quantitative coronary angiography (QCA) automatic analysis system was used to measure the related parameters of stent diameter (including the minimum, maximum and mean value of stent diameter) and calculate the stent eccentricity index. During PCI, stent eccentricity index, post-stent expansion, poorly positioned stent with open lesions, failure of overlapping stent with long lesions, mean cumulative dose (CD), product of total dose area (DAP), X-ray time, operation time and operation cost of each PCI were recorded in the two groups. Patients were followed up for 18 months after PCI, and the occurrence of adverse cardiovascular events (MACE) was recorded during the follow-up period, and the cumulative survival rate without MACE was compared between the two groups. Results:There were no statistically significant differences between the two groups in stent eccentricity index, proportion of guided stent expansion, proportion of poorly positioned stent with open lesions, proportion of stent failure to overlap, with statistically significant difference[(0.12±0.04) vs (0.10±0.03); 80.49% vs 85.49%; 2.44% vs 2.54%; 1.22% vs 2.54%, all P>0.05]. There were no significant differences in CD, X-ray time and DAP in SBS group compared with IVUS group [(1 394.18±42.29)Gy/cm 2 vs (1 391.82±45.06)Gy/cm 2; (18.79±3.01)min vs (18.95±3.12)min, (100.24±5.70)Gy/cm 2 vs (99.47±5.93)Gy/cm 2; all P>0.05]. The operation time in SBS group was shorter than that in IVUS group [(70.91±6.51)min vs (73.89±8.95)min, P<0.05], and the operation cost was less than that in IVUS group [(2.98±0.86)ten thousand yuan vs (3.85±0.81)ten thousand yuan, P<0.05]. After 18 months of follow-up after PCI, Kaplan-Meier survival analysis showed that there was no significant difference in MACE event-free survival between SBS group and IVUS group (91.46% vs 94.07%, Log Rank=0.480, P=0.489). Conclusions:SBS is a kind of convenient and effective technique in guiding PCI in patients with complex coronary lesions without increasing operation time and radiation dose, which can achieve the same effect as IVUS guidance.
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Objective:To investigate the relationship between sleep quality and slow-flow in patients with acute coronary syndrome during percutaneous coronary intervention(PCI) and its impact on clinical prognosis.Methods:200 patients with ACS hospitalized in the cardiology department of Guangzhou First People's Hospital from January 2017 to October 2018 were selected. The Pittsburgh Sleep Quality Index (PSQI) was measured before elective PCI, and the sleep breathing of patients was monitored by micro motion sensitive mattress sleep monitoring system (MSMSMS). The patients were divided into normal sleep group (68 cases, PSQI≤7 points) and sleep disorder group (132 cases, PSQI>7 points). The levels of plasma endothelin-1 (ET-1) and nitric oxide (NO) were measured. The " slow-flow" that took place during PCI were also recorded. Major cardiac adverse events (MACE) of patients took placed during 12 months follow-up periods were recorded and compared between two groups.Results:Compared with normal sleep group, patients in sleep disorder group had higher ratio of sleep apnea-hypopnea syndrome (SAHS), hypoxemia and lower deep sleep (25.00% vs 10.29%, 25.76% vs 11.76%, 66.67% vs 48.53%, all P<0.05); lower level of NO and higher level of ET-1 [(28.65±3.26)μmol/L vs (30.24±4.08)μmol/L; (21.17±3.08)pg/ml vs (18.90±2.95)pg/ml, P<0.05]; more slow-flow events took place during PCI in sleep disorder group than normal sleep group (16.67 vs 5.88%, P<0.05); After 12 months of follow-up, Kaplan-Meier survival analysis showed patients of the two groups had significantly different cumulative non-events survival rates (19.70% vs 7.35%, Log rank=5.06, P=0.025). Conclusions:Sleep disorder increase the slow-flow phenomenon during PCI in patients with ACS and affect the clinical prognosis.
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Objective:To investivate the relationship of serum estradiol and oxidative stress with microcirculation resistance in women with syndrome X.Methods:A total of 120 patients with syndrome X who were hospitalized in the Department of Cardiology in Guangzhou First People's Hospital from January 2015 to January 2019 were enrolled. All patients underwent coronary angiography and pressure wire examination and were divided into two groups according to the index of microcirculation resistance (IMR). Forty healthy people in the medical examination center were used as controls in the same period. The level of serum estradiol, interleukin-1 (IL-1), tumor necrosis factor-α (TNF-α), superoxide dismutase (SOD) were measured among three groups.Results:The rate of diabetes mellitus in high IMR group was higher than that in control group and low IMR group ( P<0.05). There was no significant difference between low IMR group and control group ( P>0.05). The levels of serum estradiol and SOD were significantly lower in high IMR group than those in low IMR group and control group. The levels of IL-1 and TNF-α were significantly higher in high IMR group than those in low IMR group and control group ( P<0.05). These indexes have the same relationship between low-IMR group and control group ( P<0.05). The level of serum estradiol was negatively correlated with the levels of IL-1 and TNF-α in high and low IMR groups and positively correlated with the level of SOD in these groups. Multivariate logistic regression analysis showed that diabetes, low serum estradiol level, low SOD level, high IL-1 level, high TNF-α level were the independent risk factors for microcirculation resistance in women with syndrome X ( P<0.05). Conclusions:The decreased serum estradiol is an important factor for coronary microcirculation disorders in women with syndrome X. The decrease of serum estradiol level leads to the loss of the corresponding antagonistic effect in oxidative stress state, which may be one of the important mechanisms of the formation and progress of coronary microcirculation disorder.
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Objective Investigation of the significance for applying the percentage of neutrophils, neutrophil to lymphocyte ratio combined with contrast enhanced ultrasonography in the diagnose of coronary artery disease through examining the percentage of neutrophils, neutrophil to lymphocyte ratio on peripheral blood. Methods 130 patients with acute coronary syndrome (ACS group) , 90 patients with stable angina (SAP group) and 50 nonCAD patients (control group were observed. The neutrophils counts of all the patients were detected and Neut％, NLR were calculated; all the patients were asked to examine enhanced carotid contrast echocardiography. The plaque enhancement (DE) , and luminal enhancement ratio (Ratio) were recorded. The differences in neut％, NLR and CEUS were compared among the three groups. The Pearson correlation analysis was used to analyze the correlation between Ratio and Neut％, NLR. Multivariate logistic regression analysis was used to evaluate the predictive value of Neut％, NLR and CEUS for ACS. Results (1) The value of Neut％, NLR of the peripheral blood, DE, and Ratio in both ACS group and SAP group were higher than those in control group, and the value of ACS group was higher than that in SAP group (P < 0.05 or P < 0.01); (2) The analysis of Linear correlation showed that the ratio of CEUS in ACS patients was positively correlated with Neut％ (r = 0.422, P = 0.001) and NLR (r = 0.407, P = 0.001). (3) The ROC results showed that circulating Neut％, NLR and DE, Ratio play a significant role in the diagnose of unstable plague in CAD patients; (4) Multivariate logistic regression analysis showed that Neut％, NLR, DE, Ratio were independent indicators of the ACS patients (P< 0.05 or P < 0.01).Conclusions Contrast enhanced carotid examination combined with leukocyte analysis on peripheral blood were useful to detect plaque instability and inflammatory response in CAD patients, and it also provide lots of objective evidence for predicting and intervening unstable plaque in CAD patients.
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Objective To investigate the value of baseline levels of aldosterone(ALD)in predicting the cardiovascular events and in-stent restenosis12 months after coronary stent implantation. Methods 268 patients with coronary heart disease admitted to the department of cardiology from January 2014 to July 2016 were selected (96 cases of stable angina pectoris and 172 cases of acute coronary syndrome).The ALD level in the preprocedural serum was detected before coronary stent implantation. According to the level of ALD,the patients were divided into two groups:ALD<130 pg/mL(n=127)and ALD≥130 pg/mL(n=141).The cardiovascular events(angina pectoris,myocardial infarction,death)and in-stent restenosis were observed and recorded 12 months after the procedures. Logistic regression analysis was done to analyze the independent risk factors of ISR. Results The baseline levels of ALD in the patients with acute coronary syndrome were significantly higher than those with stable angina pectoris[(160 ± 58)pg/mL vs.(118 ± 46)pg/mL,P < 0.05]. The cardiovascular events and those in in-stent restenosis in the patients with high baseline levels of ALD were significantly higher than those with normal baseline levels of ALD 12 months too(24.1% vs 3.1%;P<0.05;16% vs 7.4%;P<0.05).Logistic regression analysis showed that serum ALD levels were the strongest predictors of ISR,with the odds ratio of 2.56 per 10 pg/mL. Conclusions Preprocedural ALD level is a predictor for 12 months outcome of in-stent restenosis for the patents undergoing coronary stent implantation. It indicates that the complications and clinical restenosis in 12 months are markedly influenced by the activation of the rennin angiotensin aldostenone system.
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Objective To investigate the predicting value of Notch1 levels expressed in peripheral blood mononuclear cell (PBMC) for coronary artery calcification.Methods 300 consecutive patients with coronary artery disease (CAD) who hospitalizing in the department of cardiology in Guangzhou first people's hospital from January 2016 to June 2017 were enrolled.All Patients received 320-slice multi-detector row computed tomography scanning and coronary artery calcium sore(CCS)were measured.Patients were divided into three groups:control group (CCS =0),Low CCS group (CCS ＜97.6) and high CCS group (CCS ≥97.6) according to the mean value of CCS (CCS =97.6).Notch1 expressed in PBMC,serum interlekin-6 (IL-6) and high sensitivity C reactive protein (hs-CRP)of patients were examined and compared among three groups.Results The levels of Notch1 in PBMC and serum IL-6,hs-CRP of patients in high CCS group were significant higher than the other two groups [Notch1:7.02 ± 0.86 vs 6.32 ± 0.78 vs 5.49 ± 0.71;IL-6:(133.66 ± 10.18) μg/L vs (127.49 ± 10.79) μg/L vs (111.62 ± 9.87) μg/L;hs-CRP:(3.98 ± 1.02) mg/L vs (3.11 ±0.95)mg/L vs (2.56 ±0.76)mg/L] (P ＜0.05).The Spearman correlation analysis showed that the levels of Notch1 in PBMC were positive correlated with the levels of serum IL-6 and hs-CRP in enrolled patients with coronary calcification (P ＜ 0.05).Multivariate logistic regression analysis showed that the levels of Notch1 in PBMC and serum IL-6 were two strong independent risk factors for severity of coronary calcification in patients with CAD (P ＜ 0.05).Conclusions Notch1 expression in PBMC of patients with CAD was valuable to predicate the severity of coronary calcification.That the Notch1 signal path regulating the inflammation conditions in patients may be one of the most important mechanisms in the formation and progress of coronary calcification.
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Objective To investigate the effect of renal sympathetic denervation (RSD) on the activity of renalase in dogs with chronic heart failure (CHF).Methods After induced by abdominal aorta constriction,dogs were divided into three groups according to whether they underwent double renal artery ablation:2 dogs in control group,2 dogs in sham-operated group (no renal artery ablation),and 5 dogs in RSD group (renal artery ablation).Plasma noradrenaline (NE),B-type natriuretic peptide (BNP),and renalase were determined in 5 dogs with RSD (RSD group),2 control dogs (control group),and 2 shamoperated dogs (sham-operated group).Results NE,BNP and heart rate were significantly higher and renalase was lower in CHF group than those in control group (all P ＜ 0.05).Compared to the control dogs with CHF,the levels of renalase were significantly increased in 6 weeks after RSD [(1 948.78 ±49.19) ng/ml vs (1 847.35 ±20.72)ng/ml,P =0.029],and NE [(166.30 ±7.68)pg/ml vs (181.29 ±8.57)pg/ml],and BNP [(75.10 ± 5.58)lμg/ml vs (89.79 ± 2.04) μg/ml] were decreased in 8 weeks after RSD (all P ＜ 0.05).An decreased trend of the levels of renalase was observed in 8 weeks than in 6 weeks in CHF dogs after RSD,without significant difference (P ＞ 0.05).Conclusions The activity of renalase in dogs with CHF can be affected by RSD.
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Objective To investigate the relationship between circulating microRNA-21 (miR-21 ) and unstable plague in patients with coronary artery disease (CAD).Methods A total of 100 consecutive patients with CAD admitted in the department of cardiology in Guangzhou first people’s hospital from January 2012 to December 2014 were enrolled.All patients were checked with coronary angiograph and intravascular ultrasound (IVUS)and were divided into two groups according to the presence of unstable plague detected by IVUS:stable plague group (n =45)and unstable plague group (n =55).Another 50 healthy people asking for routine physical examination during the same periods were enrolled as control group.Plasma miRNA-21 of patients were measured by the methods of quantitative realtime fluorescent Polymerase Chain Reaction (qRT-PCR).Results The levels of plasma miRNA-21 in patients of unstable plague group were significant higher than that in patients of stable plague group and control group (0.87 ±0.10)vs.(0.78 ±0.11)vs.(0.67 ±0.08),P <0.05.The receiver operation curve (ROC)showed that plasma miRNA-21 had great significance in assessing the CAD patients with unstable plague evidenced by the areas under the ROC curve to be 0.869 (95%CI:0.797 -0.940,P <0.05).Multivariate logistic regression analysis showed that plasma miRNA-21 was one strong independent predicative factor for unstable plague in patients with CAD (P <0.05 ).Conclusions The increasing levels of plasma miRNA-21 had the capabilitiy to predicate the unstable coronary plague in CAD patients.That miRNA-21 may be one valuable biomarker for predicating unstable plague in patients with CAD.
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Objective To investigate the effect of stress-induced hyperglycemia (SHG) on myocardial perfusion and clinical prognosis in elderly patients with acute myocardial infarction (AMI) who underwent primary percutaneous coronary intervention (PCI).Methods 348 elderly patients with first-time occurrence of acute ST-elevation myocardial infarction (STEMI) who underwent primary PCI within 12 hours from June 2008 to June 2010 were enrolled and followed up.All patients were divided into three groups according to serum glucose (SG) on admission:normal group (SG＜ 7.0 mmol/L,n=112);SG elevation group (7.0 mmol/L≤SG≤11.1 mmol/L,n=128) and (steady high blood glucose) SHG group (SG＞11.1 mmol/L,n=108).Myocardial perfusion indexes,including ST segment resolution (STR),TIMI myocardial perfusion grade (TMPG),peak value of creatine kinase CK-MB,left ventricular ejection (LVEF),and major adverse cardiac events (MACE) of patients in three groups,were measured and compared after emergency PCI.Results The blood glucose levels were increased,ST-elevation 2 h after PCI were well declined,the percentages of patients with TMPG 2-3 were decreased and peak values of CK-MB were increased in the three groups (all P＜0.01).After 12 months of follow-up,Kaplan-Meier survival analysis showed that patients of three groups had significantly different cumulative non-events survival rates [89.3％ (100/112) vs.85.9％ (110/128),76.3％ (83/108),P＜0.05].Multivariate Cox regression analysis showed that steady high blood glucose were the independent predictor for the occurrence of MACE in patients undergoing PCI after adjusting for age and gender,and the risk of MACE was increased by 5.811 folds in SHG group as compared with normal group (P＜0.01).Conclusions Stress induced hyperglycemia in elderly patients with STEMI can decrease myocardial perfusion level after primary PCI,which will lead to high incidence of MACE.
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Objective To investigate the relationship between renal sympathetic nerve activity and the severity of heart failure in dogs with chronic heart failure ( CHF) .Methods CHF were induced by ab-dominal aorta constriction.Plasma renin activity ( PRA) , adrenaline ( E) , and noradrenaline ( NE) were determined in 9 dogs with CHF (CHF group) and 3 sham-operated dogs (control group).Results E, NE, PRA, and B-type natriuretic peptide ( BNP) were significantly higher in CHF group than those in con-trol group (all P <0.01).Compared to 10-week post-operation, PRA [(2.08 ±0.08)ng/(ml? h) vs (2.26 ±0.16)ng/(ml? h)], NE [(184.01 ±11.76)pg/ml vs (202.99 ±16.54)pg/ml] and BNP [(85.87 ±11.41)μg/ml vs (100.41 ±9.24)μg/ml] were significantly increased in the 12-week post-op-eration (all P <0.01).PRA [10 weeks post-operation:(2.13 ±0.08)ng/(ml? h) vs (2.02 ±0.05)ng/(ml? h);12 weeks post-operation:(2.38 ±0.09)ng/(ml? h) vs (2.11 ±0.07)ng/(ml? h)] and NE [10 weeks post-operation: (191.75 ±8.40) pg/ml vs (174.33 ±7.08) pg/ml;12 weeks post-operation:(215.69 ±6.26)pg/ml vs (186.36 ±7.98)pg/ml] were higher in high BNP group than those in low BNP group both in 10 and 12 weeks post-operation ( P =0.013, P =0.013, P =0.002, respectively).Con-clusions PRA was increased in dogs with CHF and associated with the severity of CHF.
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Objective To investigate the effect and mechanism of ischemic postconditioning (IPC) on myocardial perfusion levels of acute ST-segment elevation myocardial infarction (STEMI) patients having underwent primary percutaneous coronary intervention (PCI), and the safety of IPC. Methods One hundred and sixty patients with STEMI were enrolled, and they accepted the primary PCI therapy within the onset of 12 h. The patients were divided into 2 groups according the treatment method:control group (routine PCI group, 82 cases) and IPC group (78 cases). The ST-segment resolution, TIMI myocardial perfusion grade (TMPG), before and after PCI levels of nitrogen monoxidum (NO), endothelin (ET)-1, tissue-type plasminogen activator (t-PA), plasminogen activator inhibitor (PAI)-1, rate of intraoperative complication were observed. The patients were followed up for 6 months, the rate of major adverse cardiac event (MACE) was recorded. Results The rates of ST-segment resolution and TMPG well in IPC group were significantly higher than those in control group:84.62%(66/78) vs. 67.07%(55/82) and 80.77%(63/78) vs. 64.63%(53/82), and the rate of ischemia-reperfusion injury in IPC group was significantly lower than that in control group: 7.69%(6/78) vs. 24.39%(20/82), and there were statistical differences ( P0.05). The rate of MACE in IPC group was significantly lower than that in control group:3.85% (3/78) vs. 14.63% (12/82), and there was statistical difference (P<0.05). Conclusions Applying IPC in patients with STEMI having underwent primary PCI is safe and can improve myocardial perfusion levels. The improvement of vessel endothelial function and fibrinolysis activity attained from IPC may be the major mechanism.
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Objective To investigate the effects of high dose atovastatin administration on platelet activity and ventricular remodeling of patients with ST-Segment elevation myocardial infarction (STEMI) underwent primary percutaneous coronary intervention (PCI).Methods A total of 260 STEMI patients who hospitalized in our Department of Cardiology from June 2012 to December 2013 was enrolled and randomly divided into two groups:controlled group (n =140) and high dose atorvastatin group (n =120).Indicators of platelet activities including mean platelet volume (MPV),platelet large cell ratio (P-LCR),blood CD62p,and glucose protein Ⅱ b/Ⅲa (PAC-1) were measured before and 48 hours after PCI.TIMI myocardial perfusion grade (TMPG) after PCI was recorded and patients accepted ultrasound cardiogram (UCG) examinations 5 ～7 days after PCI and 6 months after discharge.After PCI,Patients were followed up for 6 months,statin-associated liver impairment,myopath and major adverse cardiac events (MACE) happened during follow-up periods were recorded.Results MPV,P-LCR,CD62p,and PAC-1 in patients of high dose atorvastatin group were less than controlled group and TMPG were better than controlled group [(12.96±1.73)fl vs (14.18 ± 1.86)fl,P ＜0.05;(29.12 ±5.83)％ vs (30.66 ±6.12)％,P ＜ 0.05;(45.36±5.24)％ vs (48.44±4.75)％,P ＜0.01;(74.61 ±5.57)％ vs (78.55±5.78)％,P ＜0.01].Six months after PCI,UCG examination showed that Left ventricular end-diastolic volume (LV-EDV),left ventricular end-systolic volume (LVESV) and left ventricular mass index (LVMI) in high dose group were less than controlled group while the left ventricular ejection fraction (LVEF) was higher than controlled group [(110.46 ±8.86)ml vs (112.61 ±8.5)ml,P ＜0.01;(60.16 ±6.13)ml vs (63.52 ± 5.54)ml,P ＜0.01;(1O1.69±4.35)g/m2 vs (103.96 ±4.17)g/m2,P ＜0.05;(50.08 ±3.78)％ vs (48.47 ± 4.12) ％,P ＜ 0.05].After 6 months of follow-up,the incidence rate of statin-associated liver impairment and myopathe had no significant difference between two groups and Kaplan-Meier survival analysis showed patients of two groups had significantly different cumulative non-events survival rates (91.7％ vs 82.4％,Log rank =4.409,P =O.036).Conclusions Loading dose atorvastatin before PCI combined high maintenance dose after PCI can inhibit platelet activation and improve myocardial perfusion levels of patients with STEMI underwent primary PCI.It also can reduce Left ventricular remodeling and improve patient's prognosis without increasing side effects.
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Objective To assess the roles of renalase and renal sympathetic nerve activity in patients with chronic heart failure (CHF). Methods Plasma renin activity (PRA), angiotensinⅠ (AngⅠ), angiotensin Ⅱ(AngⅡ),adrenaline (E), noradrenaline (NE) and renalase were determined in 60 patients with CHF (CHF group) and in 42 healthy cases (control group). Data were compared between patients with mild and serious CHF. Results PRA, E, NE and AngⅠincreased and renalase decreased in CHF group than those in control group. Compared with mild CHF, renalase and left ventricular ejection fraction decreased (P < 0.01, 0.034), while N-terminal pro-B-type natriuretic peptide (NT-proBNP) and PRA significantly increased (P<0.01). Linear correlation analysis showed that renalase was inversely correlated with Log NT-proBNP (r = -0.400, P = 0.002) and Log NE (r=-0.314, P = 0.014). Logistic regression analysis showed that NT-proBNP (OR = 6.963, 95%CI = 1.223 to 39.638), PRA (OR = 3.736, 95%CI = 1.031 to 13.540) and renalase (OR = 0.253, 95%CI = 0.069 to 0.927) were associated with increased NYHA classes. Conclusions PRA would increase while renalase would decrease in patients with CHF. PRA and renalase were correlated to the severity of CHF.
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Objective To investigate the relationship between cytochrome P450 (CYP) 2C19 genetic polymorphism and clopidogrel resistance (CR) in patients with acute coronary syndrome(ACS),and to assess the effects of genetic polymorphism at CYP2C19 (681G ＞ A) on the prognosis of ACS patients.Methods A total of 462 patients with ACS were enrolled and received loading dose clopidogrel(600 mg).The blood samples of patients were collected before and 24 hours after taking loading dose clopidogrel,then 5 μmol/L ADP-induced platelet aggregation ratio(PAR) was examined.Difference of two PAR ≤ 10％ was defined as CR.Genomic DNA of patients were extracted from whole blood samples according to standard protocols and the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was used to genotype the single nucleotide polymorphism of the CYP2C19 681G ＞ A.According to whether the gene CYP2C19 681A was carried,patients were divided into two groups:wild type group and non-wild type group.After PCI treatment,patients were followed up for 6 months and major cardiac adverse events (MACE) happened during follow-up periods were recorded.Results Totally 127 enrolled cases were finally defined as CR(27.5％),the frequency of CYP2C19 681A in patients with CR was higher than that in patients without CR(46.9％ vs 28.1％,P ＜ 0.01).The ratio of CR in wild type group were lower than non-wide type group(17.4％ vs 36.1％,P ＜ 0.01).Binary logistic regression analysis indicated that gene CYP2C19 681A was a strong independent predictor for CR in patients with ACS(OR 3.642,P ＜ 0.05).After 6 months of follow-up,Kaplan-Meier survival analysis showed patients of wild type group and non-wild type group had significantly different cumulative non-events survival rates (94.8％ vs 89.6％,Log rank =4.296,P =0.038).Conclusions The genetic polymorphism of CYP2C19 was associated with CR in patients with ACS.The mutation of CYP2C19 gene increased the risk of MACE in ACS patients undergoing PCI treatments and affected the patients' prognosis.
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Objective To perform calibration verification for the blood glucose test in Hitachi and Olympus automatic biochemistry analyzers and present a method of calibration verification and evaluate the results.Methods The glucose test results were divided into two groups:Hitachi and Olympus groups according to the different analytical instruments.The calibration verification was performed following the current College of American Pathologists strategies.The slope and intercept of the calibration line were tested by one-sample t test and the percentage differences were calculated.The percentage differences were compared with allowable errors.If the slope and intercept had no statistically significant difference from 1 and 0 respectively and the percentage differences were within the limits of allowable errors,the calibration line was evaluated as verified 1 ; if the slope and intercept had no statistically significant difference from 1 and 0 respectively and at least one of the percentage differences exceeded the limits of allowable errors,the calibration line was evaluated as different 1 ; if the slope or intercept had statistically significant difference from 1 and 0 respectively and the percentage differences were within the limits of allowable errors,the calibration line was evaluated as verified 2; if the slope or intercept had statistically significant difference from 1 and 0 respectively and at least one of the percentage differences exceeded the limits of allowable errors,the calibration line was evaluated as different 2.Results In Hitachi group,verified 1,different 1,verified 2 and different 2 were 5.4％ ( 4/74 ),0.0％ ( 0/74 ),68.9％ ( 51/74 ) and 25.7％ ( 19/74 ),respectively.In Olympus group,verified 1,different 1,verified 2 and different 2 were 16.4％ (12/73),0.0％ (0/73),58.9％ (43/73) and 24.7％ ( 18/73 ),respectively.Conclusions The current College of American Pathologist strategies could be performed as a reasonable and feasible method for calibration verification.Most of participating laboratories ( 74.8％,110/147 passed the assessment of calibration verification.
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Objective To study the effects of ischemia postconditioning(IPC) in reducing ischemia-reperfusion injury(IRI) in acute limp ischemia(ALI) and investigate the mechanism.Methods 45 New Zealand rabbits were treated with the method that combined high lipid diets and femoral intima injury by balloon inflation to build up limp atherosclerotic stenosis model,then they were randomly divided into three groups( each group 15 rabbits):control group;IR group and IPC group.Serum creatine phosphate kinase(CK),malondialehyde(MDA),superoxide dismutase (SOD) in three groups were measured before occlusion and 2 hours after sustaining reperfusion.The histological changes of limp skeletal muscle of experimental rabbits were analyzed and TUNEL method was used to access apoptosis of skeletal muscle cells.Results The levels of CK,M DA in IPC group were lower than IR group [ (7.49 ± 0.84)vs (8.19 ± 1.06),P＜0.05],[ (3.67 ±0.36) vs (4.06 ±0.55),P ＜0.05] while SOD level was higher than IR group [ (420.40 ± 30.94 ) vs ( 384.73 ± 44.12),P ＜ 0.05 ] ; The injury of skeletal muscles in I PC group was lighter than IR group and the apoptosis index of skeletal muscle cells was significantly decreased compared with that in IR group[(12.27+2.11)％ vs (16.62 ± 1.44)％,P＜0.01].Conclusion Applying IPC in acute limp ischemia could alleviate IRI and protect skeletal muscles.The mechanism was associated with oxidation resistance enhancing and the effects in reducing apoptosis of skeletal muscles induced by IRI.
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Objective To investigate the association of insulin resistance (IR),blood pressure variability (BPV) and the severity of acute coronary syndrome (ACS),and assess the effect of percutaneous coronary intervention (PCI) on recent prognosis.Methods A total of 260 patients diagnosed as ACS and hospitalized in our department of cardiology from December 2009 to December 2010 were enrolled in the study.There were 93 cases of unstable angina pectoris ( UAP),84 of non ST segment elevation myocardial infarction and 83 of unstable angina pectoris.The subjects were divided into two groups according to 24 hour systolic blood pressure coefficient of variability (24 h SBP-CV) levels:high-CV group (24 h SBP-CV ＞11.5,n =130) and low-CV group(24 h SBP-CV ＜ 11.5,n =130).The differences in HOMA-IR and the severity of coronary artery diseases between the two groups were compared.The association of major adverse cardiac events within 6 months after PCI treatment,and IR as well as BPV was analyzed.Results Compared with the low-CV group,ACS patients in the high-CV group had obviously higher HOMA-IR levels (5.7 ± 1.2 vs 4.0 ± 1.4,P ＜0.01 ),more multivessel diseases (49.2％ vs 33.3％,P ＜0.05) and B2/C type coronary diseases (48.5％ vs 27.7％,P ＜0.01 ),and higher coronary Gensini scores (59.7 ± 17.5vs 43.8 ± 18.6,P ＜ 0.01 ).Multi-factors logistic regression analysis indicated that both 24 h BPV-CV and IR were independent predictors for MACE incidence within 6 months after undergone PCI ( P ＜ 0.05 or P ＜0.01 ).Conclusions IR and BPV were obviously associated with the severity of coronary artery diseases in ACS patients.IR and 24 h BPV-CV were valuable in predicting recent prognosis of ACS patients.
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ObjectiveTo evaluate creatinine proficiency testing data by robust Z-score analysis.MethodsThe data were collected from three proficiency surveys of routine biochemical test in 2009,to which 1 179,1 169 and 1 168 laboratories participated respectively.Creatinine data were divided into Jaffe group and enzymatic group based on the analytical method used.The results tested by both methods were compared using Mann-Whitney test.The outliers were deleted using the TUKEY fence established by quartile values.The normality of raw data and trimmed data was tested using one-sample Kolmogorov-Smirnov test.The performance of the laboratories was assessed using robust Z-score,whose values were considered satisfactory when ｜ Z-score｜ ≤2,questionable when 2 ＜ ｜ Z-score ｜ ＜ 3 and unsatisfactory when ｜ Z-score ｜ ≥3.Results86.7％ results tested using Jaffe and enzymatic methods were not comparable.The raw data in all research groups were not normally distributed.After deletion of outliers,73.3％ trimmed data in most research groups were normally distributed.For the three proficiency tests in 2009,in Jaffe group,the satisfactory rates were 89.8％( 495/551 ),87.2％( 468/537 ) and 89.5％( 476/532 ) respectively,unsatisfactory rates were 3.3％ ( 18/551 ),6.5％ (35/537) and 4.5％ (24/532) respectively; while in enzymatic group,the satisfactory rates were 88.8％ (558/628),89.3％ (564/632) and 88.1％ (560/636) respectively,unsatisfactory rates were 5.6％( 35/628 ),5.2％ (33/632) and 6.6％(42/636) respectively.Conclusion It is reasonable to choose robust Z-score as a proficiency testing assessment index,because it avoids the influence of the outliers on evaluation results.
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ObjectiveTo describe upper and lower limits and their sources of reference intervals in routine chemistry assays and to make a comparison between routine and dry chemistry in these aspects.MethodsThe data of reference intervals were collected,which come from the third run of 2010 External Quality Assessment (EQA) programs in routine and dry chemistry performed by National Center for Clinical Laboratories(NCCL).All data from maternal and child care service center,children's hospital and corporations were excluded.Then all the abnormal values and errors (for instance,the lower limit was higher than the upper one or the upper limit was as the same as the lower one,etc.) were eliminated,either.Data statistics was performed by SPSS 13.0 referring to upper and lower limits of reference intervals and sources of 24 routine chemistry assays ( including serum potassium and serum sodium,etc).Comparison was made between routine and dry chemistry in these aspects in 23 assays.Data from adult men were reported when gender difference was present.ResultsThe three main sources of reference intervals were National Guide to Clinical LaboratoryProcedures, instructions of reagent manufacturesanddetermined by their own laboratory.In comparison of reference intervals between routine and dry chemistry,6 assays had statistical significant difference in both upper limits and lower ones while,4 assays in one-sided limits and 13 assays were not statistically significant in both limits.Conclusions The reference intervals of routine chemistry have big differences among institutions and the sources of them are various.Only a few assays have statistical significant difference in routine and dry chemistry among medical institutions,it might be discussed in further study whether the statistical results have clinical values.In order to achieve the result agreement among clinical assays,all the laboratories must share the common reference intervals on the basis of standardization.
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Objective To investigate relationship of microalbuminuria (MAU) and insulin resistance (IR) to severity of coronary lesions in patients with acute coronary syndrome (ACS), and its predictive value for short-term prognosis in then.Methods In total, 162 ACS patients admitted to the department of cardiology, Guangzhou First People's Hospital, Guangzhou, Guangdong province during January 2008 to June 2009 were selected and divided into three groups according to their urine albumin excretion rate (UAER): 54 cases in normal group with UAER less than 20 μg/min, 62 cases in microalbuminuria group with UAER of (20-200)μg/min, and 46 cases in mass-albuminuria group with UAER more than 200 μg/min.Difference in IR (by homeostasis model assessment, HOMA ) and severity of coronary lesions among the three groups was assessed.Effects of baseline MAU and IR on main adverse cardiac events within the recent six months were observed in ACS patients after percutaneous coronary intervention (PCI).Results IR increased and coronary lesions aggravated as UAER increasing in all the three groups of ACS patients (P＜0.05 or P＜0.01).MAU associated with IR, with a coefficient of correlation of 0.366 (P＜0.01).Results of multivariate logistic regression analysis showed that both MAU and IR were strong independent predictors for main adverse cardiac events in ACS patients within six months after PCI.Conclusions MAU and IR associate with severity of coronary lesions in ACS patients, suggesting certain predictive value for main adverse cardiac events in short-term after PCI.