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Objective:To explore the differences in intravascular ultrasound results in elderly coronary heart disease(CHD)patients with different uric acid levels.Methods:A total of 145 elderly patients diagnosed with CHD in our hospital from December 2017 to May 2020 were included as study subjects.Uric acid levels were measured and intravascular ultrasound examination was conducted in all patients.They were divided into different groups based on uric acid levels: Group A(uric acid≤199 μmol/L), Group B(uric acid 200~399 μmol/L)and Group C(uric acid≥400 μmol/L). Data from intravascular ultrasound-derived indexes were analyzed and compared between the three groups.Results:There was no significant difference in the degree of left main stenosis between Group A and Group B, but it was less severe in both groups than in Group C( F=5.625, P=0.039). Plaque fibrous cap thickness showed no significant difference between Group B and Group C, but it was smaller than in Group A( F=7.825, P=0.020). Group C had the largest plaque area and maximum thickness among the three groups, followed by Group B[(11.12±1.73)mm 2 and(1.76±0.24)mm]and Group A[(8.29±3.14)mm 2 and(1.38±0.09)mm]( F=6.384 and 6.827, P=0.028 and 0.015). Conclusions:Elevated uric acid levels in elderly CHD patients can increase the area and thickness of plaques, and reduce plaque fibrous cap thickness, leading to an increased risk of formation of unstable plaques, which can be life-threatening for these patients.Thus, monitoring and managing uric acid levels should be stressed in elderly CHD patients.
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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.
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Objective To analyze the biochemical characteristics and clinical characteristics of heart failure patients with intermediate ejection fraction.Methods From June 2012 to June 2017,nine hundred and thirty patients with heart failure who were hospitalized and treated in Beijing Anzhen Hospital were selected.According to left ventricular ejection fraction (LVEF),the patients were divided into heart failure with reduced left ventricular ejection fraction group (LVEF＜40％),heart failure with midrange left ventricular ejection fraction group (LVEF 40％-49％) and heart failure with preserved left ventricular ejection fraction group (LVEF ≥ 50％).The number of cases of acute heart failure and chronic stable heart failure was recorded.The general patient information (gender,age,body mass index (BMI),systolic blood pressure (SBP),diastolic blood pressure (DBP),heart rate (HR),NYHA classification) laboratory test results (Brain Brain natriuretic peptide (BNP)) and echocardiography (left ventricular end-diastolic diameter (LVEDD),left atrium diameter (LAD),septal thickness (interventricular septum thickness,IVSD),left ventricle posterior wall thickness (LVPWT) were collected.Results The proportion of patients with acute heart failure in the midrange left ventricular ejection fraction heart failure was similar to the heart failure with reduced left ventricular ejection fraction (38.0％ (35/92) vs.45.4％ (210/463),P＞0.05),but significantly higher than the heart failure with preserved left ventricular ejection fraction (38.0％ (35/92) vs.10.4％(210/463),P=0.000).The proportion of NYHA class IV patients in the heart failure with midrange left ventricular ejection fraction was lower than the heart failure with reduced left ventricular ejection fraction(10.9％(10/92) vs.24.6％(114/463),P=0.000),and higher than the heart failure with preserved left ventricular ejection fraction (10.9 (10/92) ％ vs.2.9％ (11/375),P =0.000).Left atrial diameter,left ventricular end diastolic diameter in the heart failure with reduced left ventricular ejection fraction were maximum ((47 ± 8) mm,(67.3 ± 9.0) mm),the heart failure with midrange left ventricular ejection fraction were medium ((44 ± 7) mm,(60.0 ± 7.5) mm),the heart failure with preserved left ventricular ejection fraction were minimum((42±7) mm,(41.7±6.1)mm),and the difference between the three groups was statistically significant (F =44.200,F =648.426,P ＜ 0.05).Conclusion Some biochemical and echocardiographic features of heart failure with midrange left ventricular ejection fraction patients are located between heart failure with reduced left ventricular ejection fraction and heart failure with preserved left ventricular ejection fraction.The LVEDD is significantly increased in heart failure with midrange left ventricular ejection fraction and heart failure with reduced left ventricular ejection fraction group.The ventricular remodeling in heart failure with midrange left ventricular ejection fraction is similar to that of heart failure with reduced left ventricular ejection fraction.
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OBJECTIVE:To investigate the effects of dexmedetomidine pretreatment on hepatic ischemia-reperfusion injury in patients with hepatocellular carcinoma radical surgery (HCRS).METHODS:A total of 40 patients underwent elective HCRS were randomly divided into control group (20 cases) and observation group (20 cases).Before operation,observation group was given Dexmedetomidine hydrochloride injection with loading dose of 0.7 μg/kg within 10 min,maintained at 0.4 μg/(kg.h) until the end of surgery.Control group was given constant volume of 0.9％ Sodium chloride injection as observation group and same anesthetic scheme.The levels ofALT,AST,IL-1,IL-6,CRP and TNF-α,the occurrence of ADR were observed in 2 groups before surgery,4 h,24 h,72 h after surgery.RESULTS:Before surgery,there was no statistical significance in the levels ofAST,ALT,IL-1,IL-6,CRP and TNF-α between 2 groups at different time points (P＞0.05).After surgery,the levels of AST and ALT in 2 groups were significantly higher than before surgery,and the observation group was significantly lower than the control group,with statisti-cal significance (P＜0.05).The levels of AST and ALT in 2 groups were decreasing gradually as time.4,24,72 h after surgery,the levels of IL-1 and IL-6 in 2 groups,TNF-α levels 4,24 h after surgery and CRP levels 24,72 h after surgery were significantly higher than before surgery,and the observation group was significantly lower than the control group;the levels of TNF-α in 2 groups 72 h after surgery were significantly lower than before surgery,with statistical significance (P＜0.05).The levels of IL-1,IL-6 and TNF-α were decreasing gradually as time.There was no statistical significance in the incidence of ADR between 2 groups (P＞0.05).CONCLUSIONS:Dexmedeptomidine pretreatment can relieve hepatic ischemia-reperfusion injury in HCRS patients,reduce the level of inflammatory cells without increasing the occurrence of ADR.
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Objective: To investigate the impact of anemia on prognosis for acute coronary syndrome (ACS) patients after percutaneous coronary intervention (PCI). Methods: A total of 220 ACS patients with successful PCI were studied. According to WHO standard, anemia was deifned by HB<130 g/L in male, HB<120 g/L in female, the patients were divided into 2 groups: Anemia group,n=56 and Non-anemia group, n=164, clinical condition was followed-up for 1 year to record the incidence of major adverse cardiac events ( MACE); based on MACE incidence, the patients were divided into another 2 groups: MACE group,n=61, Non-MACE group,n=159, clinical condition with relevant risk factors were analyzed and compared between 2 groups. Results: The patients’ mean age was at (62.39 ± 10.17) years, the ratio of anemia was 26.8% (56/220). Compared with Non-anemia group, the patients in Anemia group had more female gender and 3-vessel disease, higher Gensini score and MACE incidence; while decreased eGFR, lower levels of TC, TG and lower ratios of hypertension and smoking, allP<0.05. Compared with Non-MACE group, the patients in MACE group had the elder age, higher occurrence rates of anemia, diabetes, left ventricular dysfunction (LVEF<50%) and decreased eGFR, allP<0.05-0.001. Logistic analysis indicated that anemia (OR=2.507, 95% CI 1.012-6.208,P=0.047) was the independent risk factors for MACE occurrence in ACS patients at 1 year after PCI. Conclusion: ACS patients combining anemia had the higher incidence of MACE, anemia was the independent risk factor for poor prognosis in ACS patients after PCI.
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We aimed to investigate the role of polymorphisms in IL-16 genes on the susceptibility of Coronary Artery Disease [CAD]. A total of 260 CAD cases and 281 health controls were collected between January 2008 and November 2011. Genotyping of IL-16 rs8034928, rs3848180, rs1131445, rs4778889 and rs11556218 was conducted by polymerase chain reaction [PCR] and matrix-assisted laser desorption/ionization time-of-flight [MALDI-TOF] mass spectrometry technologies. The frequencies of rs8034928 C allele and rs3848180 G allele in the CAD cases in CAD group were significantly higher than in controls. Compared with rs8034928 T/T genotype, a significant higher risk of CAD was found in C/C genotype [OR=1.87, 95%CI=1.17-3.03], and variant of rs8034928 showed a significant increased risk of CAD in dominant [OR=1.48, 95%CI=1.04-2.10] and recessive model [OR=1.70, 95%CI=1.10-2.67]. The rs3848180 G/G was found to be associated with risk of CAD [OR=1.79, 95%CI=1.16-2.75], and G allele carries had a significant risk of CAD [OR=1.47, 95%CI=1.02-2.13]. Our study indicated that rs8034928 and rs11556218 polymorphisms are associated with CAD risk in a Chinese population, and IL-16 gene polymorphisms may be used as a predictor to the susceptibility of CAD
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Humans , Female , Male , Interleukin-16/genetics , Polymorphism, Genetic , Risk FactorsABSTRACT
<p><b>BACKGROUND</b>The role of chronic hyperglycaemia as a coronary artery disease (CAD) risk factor is well-known, and the glycemic variability is still a matter of debate. The aim of this study was to investigate the association of admission glycemic excursion and hemoglobin A(1c) (HbA(1c)) with the presence and severity of CAD in patients with undiagnosed diabetes mellitus (DM).</p><p><b>METHODS</b>We studied 286 newly diagnosed DM patients without prior revascularization undergoing coronary angiography for suspected ischaemic chest pain. Patients were grouped into those with CAD and without CAD according to angiographic results. The severity of CAD was assessed using the Gensini score. Glycemic variability, indicated as the mean amplitude of glycemic excursions (MAGE), was determined by a continuous glucose monitoring system. Serum levels of HbA(1c) and high-sensitive C-reactive protein (hs-CRP) as well as plasma concentrations of fasting glucose, lipids and creatinine were measured in all patients. Predictors of CAD were determined using multivariate Logistic regression model and receiver-operating characteristic (ROC) curves.</p><p><b>RESULTS</b>The newly diagnosed DM patients with CAD were older, and more were male and current cigarette smokers compared with the patients without CAD. The CAD group had significantly higher levels of MAGE and HbA(1c). Individuals with high levels of HbA(1c) (≥ 7%) or MAGE (≥ 3.4 mmol/L) had also significantly higher CAD prevalence. Logistic regression analysis revealed that high MAGE level and high HbA(1c) level were independent predictors for CAD. The area under the receiver-operating characteristic curve for MAGE (0.606, P = 0.005) was superior to that for HbA(1c) (0.582, P = 0.028). Gensini score closely correlated with age, MAGE, HbA(1c), hs-CRP, creatinine and total cholesterol. Multivariate analysis indicated that age (P < 0.001), MAGE (P < 0.001), HbA(1c) (P = 0.022) and hs-CRP (P = 0.005) were independent determinants for Gensini score.</p><p><b>CONCLUSIONS</b>Both admission glycemic excursion and chronic hyperglycaemia are associated with the severity of CAD in newly diagnosed DM patients. MAGE displays a significant value in predicting CAD in patients with undiagnosed diabetes even more than HbA(1c).</p>
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Aged , Female , Humans , Male , Middle Aged , Blood Glucose , Metabolism , Coronary Angiography , Coronary Artery Disease , Blood , Diagnostic Imaging , Metabolism , Diabetes Mellitus , Blood , Diagnostic Imaging , Metabolism , Glycated Hemoglobin , Metabolism , Logistic Models , Risk FactorsABSTRACT
<p><b>BACKGROUND</b>Atherosclerotic plaque rupture is the primary mechanism of thrombosis which plays a key role in the onset of acute coronary syndromes. Detection of these plaques prone to rupture (vulnerable plaque) could be clinically significant for prevention of cardiac events. It has been shown that high metabolism cells have a high uptake of fluorine-18 fluorodeoxyglucose ((18)F-FDG). The objective of this study was to investigate the correlation of FDG uptake and the immuno-histochemistry parameters of plaques, and the effect of atorvastatin on vulnerable atherosclerotic plaque in a rabbit model.</p><p><b>METHODS</b>Ten male New Zealand White rabbits were divided into three groups as follows: (1) normal control group (n = 2, C group): the animals were fed a standard diet at 120 g/d and were given water ad labium; (2) atherosclerosis group (n = 4, As group): animals were fed with high fat diet for 5 months after aortic endothelia damage; (3) treatment group (atherosclerosis + atorvastatin, n = 4, Statin group): animals were fed with high fat diet for 5 months and then changed into normal chow plus atorvastatin (2.5 mg·d(-1)·kg(-1)) treatment for another 4 months. Then these four rabbits were imaged with fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) and sacrificed for pathohistologic studies. FDG uptake by the aorta was expressed as target-to-background ratio (TBR). Maximal standardized uptake value (SUV) was measured over the thoracic and abdominal aortas. The aortic smooth muscle cell (SMC) number, CD-14 antibody positive cell (macrophage) number and the ratio of the thickness of fibrous cap to the thickness of lipid core (cap-to-core ratio) in atherosclerotic plaques were analyzed.</p><p><b>RESULTS</b>As group showed significantly higher uptake of FDG than C group (SUVs: 0.746 ± 0.172 vs. 0.286 ± 0.073, P < 0.001). After 4 months of atorvastatin treatment and the modification of diet, SUVs decreased significantly (Statin group: 0.550 ± 0.134, compared to As group, P < 0.001). However, no marked difference was found in TBR, the number of macrophages, the number of SMC and the cap-to-core ratio in the aortic segments between Statin group and As group. The correlation of aortic FDG uptake with SMC assessed by histopathology was negatively significant (r = -0.57, P < 0.001). When aortic FDG uptake was expressed as TBR, it correlated significantly (r = 0.69, P < 0.001) with the macrophage number, and also correlated significantly (r = -0.78, P < 0.001) with the cap-to-core ratio.</p><p><b>CONCLUSION</b>(18)F-FDG PET/CT might serve as a useful non-invasive imaging technique for detection of atherosclerotic plaque and potentially permit monitoring of relative changes in inflammation within the atherosclerotic lesion.</p>
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Animals , Male , Rabbits , Aorta , Diagnostic Imaging , Pathology , Atherosclerosis , Diagnostic Imaging , Fluorodeoxyglucose F18 , Plaque, Atherosclerotic , Diagnostic Imaging , Positron-Emission Tomography , MethodsABSTRACT
<p><b>OBJECTIVE</b>To evaluate the clinical feasibility and effect of the computer-assisted auto-frame navigation system for distal locking of tibial intramedullary nails.</p><p><b>METHODS</b>The hardware components of the system included a PC computer with a monitor, auto mechanical stereotactical localization cubic frame, foot holder and localization operative apparatus. Special navigation software can be used for registration of X-ray fluoroscopic images and real-time controlling navigation of tools. Twenty-one cases of close tibial and fibular fractures were treated with closed intramedullary nailing, 6 of which involved in middle third, 12 in middle and lower third, 3 in lower third. C-arm alignment and registration time, fluoroscopic time and drilling time involved in the locking procedure were recorded. The size of unreamed or reamed tibial nails ranged from 8/300-11/330.</p><p><b>RESULTS</b>All distal holes except 1 were locked successfully. In 9 of 41 locked holes (21.95%), the drill bit touched the canal of locking hole without damage of the nail and clinical consequences. The fluoroscopy time per pair of screws was 2.23+/-0.31 s.</p><p><b>CONCLUSIONS</b>The computer-assisted auto-frame navigation system for distal locking is well designed, easy to operate and do not need additional instruments during the procedure. The developed system enables the physician to precisely navigate surgical instruments throughout the anatomy using just a few computer-calibrated radiographic images. The total time of X-ray exposure per procedure can be significantly reduced.</p>
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Adult , Female , Humans , Male , Middle Aged , Bone Nails , Equipment Design , Feasibility Studies , Fluoroscopy , Fracture Fixation, Intramedullary , Surgery, Computer-Assisted , Tibial Fractures , General Surgery , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To measure and evaluate the personal noise exposure of cold rolling mill workers by using noise dosimeter.</p><p><b>METHODS</b>According to job category and work type, all workers were divided into 11 groups. 3 to 5 day shift (8:00 to 16:00) workers from each group were selected as subjects for personal noise exposure measurement. SH-126 dosimeters were worn by each subject and collect noise data by a phone fix at collar. All subjects were asked to take notes about their working activities when they were wearing SH-126 dosimeters. Each worker's L(A)(eq) of 8 hours, geometric mean and range of each group were computed.</p><p><b>RESULTS</b>There were many noise sources in the workshop. Recorded data showed that noise exposure of cold rolling mill was unstable. The varieties of personal noise levels were quite large. Among 53 workers, the highest noise exposure level was 100.0 dB (A), the lowest was 81.2 dB (A); the highest work type was of the foreside welders [94.20 dB (A)], and the lowest was of the straight-cutters [89.02 dB (A)]; quality checkers had the biggest rang [16.3 dB (A)], and primary rolling workers had the lest [2.3 dB (A)].</p><p><b>CONCLUSION</b>Noise exposure of all the 11 groups were more than 85 dB (A). Noise protection of these workers should be improved. It suggested that measuring personal noise exposure individually with dosimeters might obtain the noise exposure level more integrally in the complicated environment.</p>
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Humans , Environmental Monitoring , Methods , Noise, Occupational , Occupational ExposureABSTRACT
A cross sectional study of 769 patients was performed to evaluate the association of blood uric acid with coronary heart disease (CHD) in different metabolic disorders. It showed that uric acid was not independently associated with CHD. However, when the other abnormal metabolic factors were absent, uric acid might be related to CHD.
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Objective To investigate the effect of bezafibrate on serum pro-inflammatory cytokine levels and blood pressure change in patients with hypertriglyceridemia and hypertension after antihypertensive therapy with extended release nifedipine. Methods Fifty-eight patients with both hypertriglyceridemia and hypertension, which was treated with extended release nifedipine, were randomized into 2 groups: bezafibrate group (n=30) and placebo group (n=28). Changes in levels of blood lipids, high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor?(TNF-?) and interleukin-6 (IL-6) were observed following the treatment. A correlation between these changes and blood pressure was analyzed in both groups. Results The levels of triglyceride, total and low density lipoprotein cholesterol were significantly reduced (P