Impacts of smoking status on the clinical outcomes of coronary non-target lesions in patients with coronary heart disease: a single-center angiographic study / 中华医学杂志(英文版)

BACKGROUND@#Coronary atherosclerotic plaque could go through rapid progression and induce adverse cardiac events. This study aimed to evaluate the impacts of smoking status on clinical outcomes of coronary non-target lesions.@*METHODS@#Consecutive patients with coronary heart disease who underwent two serial coronary angiographies were included. All coronary non-target lesions were recorded at first coronary angiography and analyzed using quantitative coronary angiography at both procedures. Patients were grouped into non-smokers, quitters, and smokers according to their smoking status. Clinical outcomes including rapid lesion progression, lesion re-vascularization, and myocardial infarction were recorded at second coronary angiography. Multivariable Cox regression analysis was used to investigate the association between smoking status and clinical outcomes.@*RESULTS@#A total of 1255 patients and 1670 lesions were included. Smokers were younger and more likely to be male compared with non-smokers. Increase in percent diameter stenosis was significantly lower (2.7 [0.6, 7.1] % vs. 3.5 [0.9, 8.9]%) and 3.4 [1.1, 7.7]%, P = 0.020) in quitters than those in smokers and non-smokers. Quitters tended to have a decreased incidence of rapid lesions progression (15.8% [76/482] vs. 21.6% [74/342] and 20.6% [89/431], P = 0.062), lesion re-vascularization (13.1% [63/482] vs. 15.5% [53/432] and 15.5% [67/431], P = 0.448), lesion-related myocardial infarction (0.8% [4/482] vs. 2.6% [9/342] and 1.4% [6/431], P = 0.110) and all-cause myocardial infarction (1.9% [9/482] vs. 4.1% [14/342] and 2.3% [10/431], P = 0.128) compared with smokers and non-smokers. In multivariable analysis, smoking status was not an independent predictor for rapid lesion progression, lesion re-vascularization, and lesion-related myocardial infarction except that a higher risk of all-cause myocardial infarction was observed in smokers than non-smokers (hazards ratio: 3.00, 95% confidence interval: 1.04-8.62, P = 0.042).@*CONCLUSION@#Smoking cessation mitigates the increase in percent diameter stenosis of coronary non-target lesions, meanwhile, smokers are associated with increased risk for all-cause myocardial infarction compared with non-smokers.

Predictive Value of IABP-SHOCKⅡRisk Score for 30-day Mortality in Chinese Patients With Cardiogenic Shock After Acute Myocardial Infarction / 中国循环杂志

Objectives:To investigate the predictive value of IABP-SHOCKⅡ risk score for 30-day mortality in Chinese patients with cardiogenic shock after acute myocardial infarction. Methods:A total of 212 hospitalized Chinese patients with cardiogenic shock after acute myocardial infarction were enrolled from June 2014 to July 2017. The IABP-SHOCKⅡrisk score was calculated at admission. The endpoint of this study was all-cause 30-day death. The predictive value of IABP-SHOCKⅡ risk score for these patients was assessed by calculating the area under receiver operating characteristic (ROC) curve. Results:According to the IABP-SHOCKⅡrisk score at admission, the patients were divided into 3 groups:score 0-2 group, n=106; score 3-4 group, n=56 and score 5-9 group, n=50. Patients were older, incidence of cerebral stroke, lactic acid, glucose at admission and creatinine levels were higher. while incidence of TIMI grade 3 was lower in score 3-4 group and score 5-9 group than in score 0-2 group (all P＜0.05). Percent of male patients was lower in score 5-9 group than in score 0-2 group (P＜0.05). Incidence of cerebral stroke, lactic acid, and creatinine levels were higher. while incidence of TIMI grade 3 was lower in score 5-9 group than in score 3-4 group (all P＜0.05). Sixty-eight patients died during the 30 days follow-up, mortality was 6.6%, 37.5% and 80% in the score 0-2 group, score 3-4 group, and score 5-9 group, respectively (P＜0.05). The ROC curve analysis showed that AUC was 0.853, and 95%CI was 0.796-0.911. Conclusions:IABP-SHOCKⅡ risk score is suitable for risk stratification and assessment of 30-day mortality in Chinese patients with cardiogenic shock after acute myocardial infarction and may facilitate the clinical decision making to improve the outcome of these patients.

Correlation Study Between Serum Level of Cardiac M2-muscarinic Receptor Autoantibody and Hypertrophic Cardiomyopathy / 中国循环杂志

Objectives: To study serum level of M2-muscarinic receptor autoantibody (M2-AAb) in hypertrophic cardiomyopathy (HCM) patients with its relationship to relevant clinical parameters. Methods: Our research included in 2 groups: HCM group, 133 patients and they were divided into 3 subgroups:Obstructive hypertrophic cardiomyopathy (HOCM) subgroup, 72, Latent obstructive hypertrophic cardiomyopathy (LHOCM) subgroup, 22 and Non-obstructive hypertrophic cardiomyopathy (NOCM) subgroup, 39; since there was no obstruction of left ventricular outflow tract (LVOT) in LHOCM and NOCM patients at resting, LHOCM and NOCM patients were combined as LHOCM+NOCM subgroup, 61 in comparison with HOCM subgroup. And Control group, 40 subjects had no organic heart disease and autoimmune diseases which were confirmed by 12 lead ECG, transthoracic echocardiography and routine hematological tests, they were not using β-blockers, glucocorticoids and immune-suppressants. Serum levels of M2-AAb were examined by ELISA, the relationship between M2-AAb and relevant clinical parameters were studied. Results: Compared with Control group, HCM group had increased serum level of M2-AAb [22.91 (17.21, 29.64) ng/ml] vs (17.14±5.66) ng/ml, P<0.01; M2-AAb was similar among HOCM, LHOCM and NOCM subgroups; M2-AAb in female patients were higher than male, P=0.001. Further investigation presented that the patients with family history of sudden death had the higher M2-AAb, P<0.05; patients with atrial fibrillation (AF) or left atrial diameter (LAD)≥50 mm or moderate to severe mitral regurgitation (MR) had the higher M2-AAb than those without such problems, all P<0.05. In HCM group, log M2-AAb was positively related to resting LVOT gradient (r=0.178, P=0.040); in HOCM subgroup, log M2-AAb was marginal positively related to resting LVOT gradient (r=0.224, P=0.058). Conclusions: Serum M2-AAb was elevated in HCM patients; gender, family history of sudden death may affect M2-AAb level; patients combining AF or LAD≥50 mm or moderate-severe MR had the higher M2-AAb and it was related to resting LVOT gradient.

Incidence of coronary artery disease and outcome of patients with left ventricular noncompaction / 中华心血管病杂志

<p><b>OBJECTIVE</b>To analyze the incidence of coronary artery disease (CAD) and outcome of patients with left ventricular noncompaction (LVNC).</p><p><b>METHODS</b>Fifty-one patients with LVNC evaluated by echocardiography and/or cardiac magnetic resonance (CMR) from January 2006 to August 2010 were retrospectively reviewed. Coronary angiography or MDCT was performed for detecting coronary artery disease. Predictors of the cardiac events were analyzed by Cox regression analysis.</p><p><b>RESULTS</b>There were 31 LVNC patients without CAD and 20 LVNC patients with CAD including single vessel coronary disease in 9 cases, double vessel coronary disease in 3 cases, three vessel coronary disease in 5 cases and left main coronary disease in 3 cases. Coronary artery bypass graft and percutaneous coronary intervention (PCI) were performed in 4 patients. Compared to LVNC patients without CAD, mean age (P = 0.008), incidence of hypertension (65.0% vs. 19.4%, P = 0.001), diabetes mellitus (40.0% vs. 12.9%, P = 0.026) and hyperlipidemia (55.0% vs. 25.8%, P = 0.035) were significantly higher while NT-proBNP level was significantly lower (P = 0.049) in LVNC patients with CAD. Incidence of major cardiac events was similar in LVNC patients with or without CAD. LogNT-proBNP is the independent prognostic factor for adverse cardiac events in patients with LVNC (HR 3.993, 95%CI 1.140 - 13.988, P = 0.030).</p><p><b>CONCLUSIONS</b>Coronary artery disease is common in patients with LVNC and associated with traditional risk factors for CAD. Poor prognosis is associated with increased NT-proBNP but not with CAD in this patient cohort.</p>

Protective effect of allicin on human periodontal ligament cells with nicotine-induced oxidative damage / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To explore the protective effect of allicin on nicotine-induced oxidative damage to human periodontal ligament cells (HPDLCs).</p><p><b>METHODS</b>(1) Establish nicotine-induced oxidative damage model on HPDLCs. Use water-soluble tetrazolium (WST) colorimetric method to find out the nicotine concentration (X) that could inhibit HPDLCs' growth for the following experiments. (2) HPDLCs of the fifth passage were divided into 5 groups: The control group, the nicotine group and the nicotine+allicin groups(the concentration of allicin was 15, 30, and 60 microg x mL(-1) respectively). Different kinds of culture media were added. Similarly, use WST colorimetric method to choose the allicin concentration (Y) that could significantly improve the survival rate of HPDLCs. (3) HPDLCs were divided into 3 groups: The control group, the nicotine group, the nicotine+allicin group and different media were added. The glutathion (GSH) concentrations in HPDLCs were determined in 1, 4, 8, 12 and 24h respectively.</p><p><b>RESULTS</b>0.8 mg x mL(-1) nicotine could inhibit the HPDLCs survival rate significantly (77% of the control, P < 0.05). But 60 microg x mL(-1) allicin could prevent the inhibition effects evidently, improving the survival rate to 112% of that of the nicotine group (P < 0.05) and reaching the survival rate level of control group (P > 0.05). The GSH concentrations of nicotine+allicin group were higher than that of the nicotine group always (P < 0.05) and by 82% at 8 h after culture, but had no difference with that of the control group (P > 0.05).</p><p><b>CONCLUSION</b>60 microg x mL(-1) allicin can protect the HPDLCs against oxidative damage induced by nicotine.</p>

Clinical and echocardiographic characteristics of mitral chordal rupture from 292 hospitalized patients / 中华心血管病杂志

<p><b>OBJECTIVE</b>To analyze the clinical, echocardiographic features and therapy efficacy of patients with ruptured mitral chordae tendineae.</p><p><b>METHODS</b>Clinical data, echocardiographic and pathological results from 292 hospitalized patients with ruptured mitral chordae tendineae were retrospectively analyzed.</p><p><b>RESULTS</b>There were 99 cases (33.9%) with rupture of anterior leaflet and 180 cases (61.6%) with rupture of posterior leaflet, 13 cases (4.5%) with both anterior and posterior leaflet ruptures. Partial rupture of mitral chordae tendineae was found in 266 cases (91.1%) and total rupture in 26 cases (8.9%). Two hundred and fourteen cases (73.3%) were primary chordal rupture and 78 (26.7%) were secondary chordal rupture (P < 0.05). Primary chordal rupture was mostly due to mucus degeneration of the mitral valve, mostly presented as posterior leaflet rupture in aged male patients. Secondary chordal rupture was mostly caused by infective endocarditis, coronary heart disease, congenital heart disease and rheumatic heart diseases. Patients with secondary chordal rupture cases were significantly younger than patients with primary chordal rupture and there were significantly more anterior leaflet rupture than posterior leaflet rupture. One hundred and thirty patients received mitral valve reconstruction operation and another 110 underwent mitral valve replacement therapy and discharged complication free. The remaining 52 cases received medication therapy and discharged with improved symptoms (12 with mild chordal rupture without operation indication, 17 cases contraindicated to operative therapy, 7 cases transferred to other hospitals and 16 patients refused operation therapy).</p><p><b>CONCLUSIONS</b>The incidence of posterior leaflet rupture is higher than that of anterior leaflet rupture. Rupture of both anterior and posterior leaflet is rare and there are more primary chordal ruptures than secondary chordal ruptures based on our patient cohort. Mitral valve reconstruction operation and mitral valve replacement therapy are effective operative therapy options for the treatment of mitral chordal ruptures in indicated patients.</p>

Correlation between dry eye and refractive regression after laser in situ keratomileusis / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate the correlation between chronic dry eye and refractive regression after laser in situ keratomileusis (LASIK)for myopia.METHODS:Two hundred and twenty-five eyes of 225 patients were enrolled in this study.Examinations including Schirmer test,tear break-up time(BUT),corneal sensation,and ocular surface staining were performed before and 6 months after LASIK.Dry eye symptoms were assessed using the McMonnies Dry Eye Symptom Survey.Data were analyzed on history and treatment response.RESULTS:Refractive regression after LASIK was related to chronic dry eye.It occurred in 8(25.0%)of 32 patients with chronic dry eye and in 18(9.3%)of 193 patients without dry eye(P＜0.01).CONCLUSION:The risk of refractive regression was increased in patients with chronic dry eye.