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Objective:To investigate the relationship between central venous-arterial blood carbon dioxide partial pressure difference (Pcv-aCO 2) and left ventricular ejection fraction(LVEF) in acute myocardial infarction. Methods:Clinical data of patients with acute myocardial infarction admitted to the Intensive Care Unit of Fujian Provincial Hospital from November 2019 to October 2021 were retrospectively analyzed. LVEF was measured by bedside echocardiogram. The patients were divided into the normal LVEF group (LVEF ≥ 52%) and decreased LVEF group (LVEF < 52%) according to LVEF. The differences in general information and hemodynamic parameters between the two groups were compared. The normality of the above data was tested by the Jarque-Bera test. Correlation analysis of hemodynamic indices with LVEF was performed. Binary logistic regression was used to analyze the risk factors associated with the decrease in LVEF. The feasibility of diagnosing LVEF decline with Pcv-aCO 2 was assessed using receiver operating characteristic (ROC) curve. Results:Seventy-two patients with acute myocardial infarction were included for analysis, including 25 patients in the normal LVEF group and 47 patients in the decreased LVEF group. Pcv-aCO 2 was significantly higher in the decreased LVEF group than that in the normal LVEF group [(7.13±1.19) mmHg vs. (5.41±1.23) mmHg, P<0.01]. There was a negative correlation between LVEF and Pcv-aCO 2 ( rs= -0.740, P<0.01). The area under the ROC curve for Pcv-aCO 2 was 0.849 (95% CI: 0.758-0.939, P<0.01). The binary logistic regression analysis showed that Pcv-aCO 2 was an independent risk factor for decreased LVEF ( OR=2.251, 95% CI: 1.326-3.820). Conclusions:To a certain extent, the increase of Pcv-aCO 2 can predict the decrease of LVEF in acute myocardial infarction.
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Objective: To investigate influence of isometric exercise (IE) training on number of endothelial progenitor cells (EPCs) and level of vascular endothelial growth factor (VEGF) of circulating blood in patients with coronary chronic total occlusion (CTO). Methods: A total of 20 CTO patients were divided into training group (n=10) and control group (n=10). Both groups received routine medication for three months, training group also received three-month IE training (maximal handgrip was used to induce maximum IE of upper limb muscles, leading to temporary physiological ischemia of skeletal muscle),while control group remained sedentary without exercise training. Flow cytometry was used to measure number of blood EPCs, and enzyme linked immunosorbent assay (ELISA) was used to measure serum concentration of VEGF. Results: Before treatment, the differences of levels of blood EPCs and VEGF between two groups were no significant（P>0.05）. Compared with before treatment, there were significant increase in blood number of EPCs [(0.028±0.009)% vs. (0.044±0.016)%] and VEGF concentration [(65.3±15.1) pg/ml vs. (98.5±17.4)pg/ml] after three-month treatment in training group (P=0.015, P0.05. The blood numbers of EPCs were positively correlated with VEGF concentration in training group and control group (r=0.727, r=0.785, P<0.05 both). Conclusions: Isometric exercise training can increase blood number of EPCs and VEGF concentration in coronary CTO patients, which may contribute to collateral angiogenesis in remote ischemic myocardium.
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Objective To probe into the effect of systematic nursing model on treatment compliance and clinical efficacy of elderly patients with diabetes. Methods 100 elderly patients with diabetes in our hospital were selected from January 2008 to December 2010.The patients were divided into the study group and the control group randomly,50 cases in each group.The patients in the control group were treated with conventional care model,while the patients in the study group were treated with systematic nursing model.The compliance,clinical treatment effect,and improvement of clinical indicators were compared and ana lyzed in two groups respectively. Results Compared with the control group,treatment compliance indexes such as self-monitoring,diet control,medication compliance,exercise therapy in the study group were significantly improved,the difference was statistically significant.Compared with the control group,the clinical efficacy of patients in the study group was significantly improved.Compared with the control group,the FBG,PBG and HbAlc were improved significantly,the difference was statistically significant. Conclusions Systematic nursing model plays a positive role in promoting treatment compliance and clinical effects of elderly patients with diabetes mellitus.The interventions need to be further enriched and perfected.
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Objective To analyze reasons of open operation after percutaneous vertebroplasty.Methods From January 2008 to January 2012,516 patients (587 vertebrae) underwent percutaneous vertebroplasty in our hospital.Among them,13 patients occurred serious complications after operation:9 cases of spinal cord injury and 4 cases of nerve root injury.There were 5 males and 9 females,aged from 53 to 72 years (average,64.5 years).There were 10 cases of osteoporotic fracture,2 cases of vertebral metastases and 1 case of vertebral hemangioma.The lesion segments were as follows:T7 in 1 case,T8 in 1 case,T9 in 2 cases,T10 in 1 case,T11 in 1 case,T12 in 2 cases,L1 in 3 cases,L3 in 1 case and L4 in 1 case.According to the American Spinal Injury Association (ASIA) classification,9 patients with spinal cord injury were rated as follows:grade A in 2 cases,grade B in 1 case and grade C in 6 cases.Four patients with nerve root injury had skin hypesthesia,and the muscle strengths of them were grade Ⅱ.All patients underwent posterior open operation 4-12 h after definite diagnosis.Results Thirteen patients were followed up for 3 to 47 months (average,14.1 months).The reasons of open operation were as follows:bone cement leakage in 6 cases (46.2％,6/13),puncture failure in 3 cases (23.1％,3/13) and indication select error in 4 cases (30.8％,4/13).All 6 cases of bone cement leakage were non vascular leakage,including 2 cases of leakage into the spinal canal and 4 cases of leakage into the nerve root canal.At final follow up,the muscle strength was improved to grade V in 3 patients with nerve root injury and grade Ⅳ in remaining 1 patient.And skin sensation was also improved.The ASIA grade of 7 patients with spinal cord injury was improved:grade D in 4 cases and grade E in 3 cases.For remaining 2 patients,there was no change in ASIA grade.Conclusion The reasons of open operation after percutaneous vertebroplasty include bone cement leakage,puncture failure,and indication select error.And bone cement leakage is the most common.
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ObjectiveTo investigate the influence of nateglinide treatment of newly diagnosed patients with type 2 diabetes on the state of inflammatory response. MethodsThe clinical data of 74 newly diagnosed patients with type 2 diabetes were retrospectively reviewed,and treated with nateglinide,before and after treatment,the fasting blood glucose (FBG), postprandial blood glucose 0.5h ( 0.5 hPG), 1 h postprandial blood glucose ( 1 hPG) ,2h postprandial blood glucose(2hPG) ,fasting insulin(FINS) ,0.5h postprandial insulin(0. 5hINS) ,postprandial 1h insulin( 1 bINS),2h postprandial insulin(2hINS),interleulin-2(IL-2) and C-reactive protein(CRP) levels were observed. ResultsAfter treatment,the FBG,0. 5hPG, 1hPG,2hPG, FINS,0. 5hINS, 1hINS,2hINS, IL-2 and CRP of patients were ( 8.0 ± 1.5) mmol/L,(12.0±1.8)mmol/L,(10.2 ± 1.3) mmol/L,(10.5 ±1.2) mmol/L,(168.2 ±11.5) pmol/L,(213.5±23.5) pmol/L,(197.0 ±21.5) pmol/L,(189.5 ±12.0) pmol/L,(14.0 ±1.5) μg/L, (13.5 ±1.5) mg/L,compared with( 10. 5 ± 1.0) mmol/L, ( 14. 5 ± 1.5) mmol/L, ( 12. 5 ± 1.4) mmol/L, ( 11.6 ±2.0) mmol/L,(180.7 ±12.0) pmol/L,(229.8 ±26.0) pmol/L,(218.5 ±23.0) pmol/L, (197.0± 14.5) pmol/L,(12.5 ±2.0) μg/L, (22.8 ±2.0) mg/L before treatment decreased significantly(t =11. 9293,9. 1785,10. 3561,4. 1115,6. 4696,4.0009,5. 8744,3. 4279,5. 2307,32.0006, all P ＜0. 05). There was no serious adverse events in treatment process. ConclusionNateglinide treatment of newly diagnosed patients with type 2 diabetes could significantly improve the patient's inflammatory response state,and there was no serious adverse events in treatment process.
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Objective To study the efficacy of low dose of combined angiotensin Ⅱ type 1 receptor blockade(ARB)valsartan with angiotensin-converting enzyme inhibitor(ACEI)ramipril on the expression of the gene of angiotensin Ⅱ type 1 receptor(AT1R)and type 2 receptor(AT2R)in cardiovascular vessels and brain in SHR.Methods SHRs 7-8 weeks old were received valsartan 30 mg/(kg?d),or ramipril 1 mg/(kg?d),or valsartan 15 mg/(kg?d)combined with ramipril 0.5 mg/(kg?d)by gavage for three months.SBP,LV/BW ratio,plasma angiotensin Ⅱ,plasma and myocardial NO levels were determined.The severity of myocardial interstitial fibrosis was assessed by image analysis.ACE mRNA,AT1R mRNA and AT2R mRNA expression were detected in the LV myocardium,aorta and brain by the RT-PCR.Results Combined low dose of valsartan and ramipril was shown to reduce more significantly the expression of AT1R mRNA and ACE mRNA in myocardium,aorta and brain than valsartan or ramipril monotherapy(AT1R mRNA:P
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@# ObjectiveTo analyse the state of traumatic conditions, associated injury and complications of patients with acute spinal cord injury (SCI) and provide the therapeutic principles of early treatment.Methods1352 cases with acute SCI were studied retrospectively.ResultsAmong patients, 875 cases had complete SCI and 477 cases had incomplete SCI. Complications included pulmonary infection, urinary system infection, bedsore and so on. The associated injuries included craniocerebral injury, fractures of limbs and pelvic, hemopneumothorax and so on. Conservative treatments involved high doses of methylprednisolone pulse therapy (MPPT), hyperbaric oxygen treatment (HOT), the use of dehydrating and neurotrophy agents, etc. The operation of decompress and internal fixation was applied in cases with spinal instability, vertebral dislocation and spinal compression. The associated injury was treated by specialist.ConclusionThe key point of raising remedy level includes thinking highly of field first aid, prompt and perfect early treatment, dealing with associated injury, preventing secondary SCI and complications and early rehabilitation directions.