ABSTRACT
Objective To assess the impact of glycemic variability on left ventricular function in patients with acute ST-segment elevation myocardial infarction (STEMI) and type 2 diabetes.Methods Three hundred and three patients with type 2 diabetes and first STEMI between May 2014 and December 2016 in Beijing Anzhen Hospital,Capital Medical University were seclected continuously.All participants' continuous glucose monitoring system (CGMS) parameters,echocardiogram and biochemical characteristics were measured at baseline.According to the level of mean amplitude of glycemic excursion (MAGE) which is the gold indicator to present glycemic variability patients were classified into low MAGE group (n=182) and high MAGE group (n =117).Impact of glycemic variability on left ventricular function in patients with acute ST-segment elevation myocardial infarction and type 2 diabetes were analysed.Results (1) Cardiac function evaluation:The level of left ventricular ejection fraction (LVEF) were significantly lower in high MAGE group than in low MAGE group ((43.8± 7.2) vs.(52.3± 8.5) ％,t =4.912,P＜ 0.001).There were significant differences between the two groups in Killip classification (x2 =49.931,P＜ 0.001).(2) Pearson correlation analysis shows that LVEF negatively correlated with the levels of MAGE(r=-0.367,P＜0.001),postprandial glucose excursion (PPGE) (r=-0.274,P=0.003),Hemoglobin A1c(HbA1c) (r=-0.238,P =0.010),serum highsensitive C-reactive protein (hs-CRP) via logarithmic transformation (r =-0.245,P =0.008) and fasting plasma glucose (FPG) (r =-0.229,P =0.021).Killip classification positively correlated with the levels of MAGE (r =0.301,P ＜ 0.001),PPGE (r =0.228,P =0.022),hs-CRP via logarithmic transformation (r =0.234,P =0.019),H bA 1 c (r =0.195,P =0.041) and FPG (r =0.193,P =0.045).(3) Multiple stepwise regression analysis and multivariate Logistic regression analysis indicated that the level of MAGE was independent risk factor of LVEF (t =-2.279,P =0.005,95％ CI(-3.160 -0.219)) and the level of MAGE was an independent risk factor of Killip classification (Waldx2 =5.673,OR=1.665,95％CI(1.095-2.534),P=0.017).Conclusion Glycemic variability is associated with the presence and severity of left ventricular function in patients with STEMI and type 2 diabetes.
ABSTRACT
ObjectiveTo screen the items of Advanced Cancer patient Needs Questionnaire (ACNQ)and develop a short version.MethodsA total of 80 cancer patients of middle and advanced stage were recruited.The items were screened with variation degree method and factor analysis method,combined with clinical meaning of the items.The reliability and validity of newly-development scale were confirmed with new sample of 60 cancer patients.ResnltsThrough statistical methods 12 items were removed from the original scale,forming a short version of Advanced Cancer patient Needs Questionnaire:ACNQ-29.The correlation coefficient of split half reliability was 0.913.The Cronbach′s α coefficient of all items was 0.923.Through principal components and factor analysis,7 principal components were gained including basically the 4 dimensions of physiological,psychological,spiritual and social domain with accumulation contribution of 75.478％.ConclusionsNew scale has good reliability and validity,and more easily for patients to complete.It has feasibility and practicability.
ABSTRACT
Objective To observe the effects of different doses of human recombinant tissue factor pathway inhibitor-1 (TFPI-1) on no-reflow (NR) phenomenon in rabbit.Methods Fifty-two New Zealand white rabbits were subjected to coronary artery occlusion for 120 min and followed by reperfusion for 60 min,and then were randomly (random number) assigned into four groups:control group,large,moderate and low doses TFPI-1 groups ( 1000 ng/kg,100 ng/kg,10 ng/kg bolus and thenl0 ng/kg,1 ng/kg and 0.1 ng/kg per minute infusion for maintenance,each group n =13).The no-reflow area (NA) and ischemic area (IA) was measured by thioflavin S and Evan's blue.The NR severity was expressed by NA/IA.The difference in NR severity was compared between groups.The thrombi and myocardial injury were observed under light microscope.The infarction and NR severity in different groups were compared by using one-way ANOVA followed by LSD procedure.Results There were no significant differences in IA and body weight among four groups (P＞0.05).NR severity in the large,moderate,low doses TFPI-1 groups and control group were (0.210 ±0.061 ),(0.389 +0.110),(0.478 ±0.077) and (0.536 ±0.061 ),respectively.NR severity in the large dose TFPI-1 group was slightest among the four groups (P ＜0.01 ).NR severity in the moderate dose TFPI-1 group was significantly decreased than that in control group ( P ＜ 0.01 ) and in low dose TFPI-1 group (P ＜0.05 ).There was no significant difference in NR severity between the low dose TFPI-1 group and control group ( P ＞ 0.05 ).There was less thrombus formation and lower grade myocardial injury found in the large dose TFPI-1 group. Conclusion Human rTFPI-1 might lessen NR severity in rabbit in dose-dependent,suggesting the option on human rTFPI-1 for treatment of NR phenomenon.
ABSTRACT
Objective To investigate the correlation between serum adiponectin level and severity of coronary artery disease.Methods We measured the serum concentrations of adiponectin in 135 patients whom had received CAG.The severity of coronary artery lesion was evaluated by Gensini score,the number of stenosis vessel and clinical manifestation.Results The serum concentrations of adiponectin in Gensini score 0 group(74.53?30.76 ng/mL)and score 40 group(28.96?11.87 ng/mL)(P40 group were lower than those in score 20-40 group(P