ABSTRACT
Objective:To analyze the changes of serum lipidomics in patients with sepsis and healthy controls, search for the differences of lipid metabolites, and reveal the changes of lipidomics in the process of sepsis.Methods:A prospective observational study was conducted. From September 2019 to April 2020, morning blood samples of upper extremity superficial veins were collected from 30 patients with definite sepsis diagnosed in intensive care unit (ICU) of Shanxi Bethune Hospital and 30 age-matched healthy subjects during the same period. Serum lipid metabolites were analyzed by ultra-high performance liquid chromatography-mass spectrometry/mass spectrometry (UPLC-MS/MS), and the quality control samples were analyzed by base peak spectroscopy (BPC) and verified experimental repetition. Student t-test and fold change (FC) were used for screening significant differences in lipid metabolites and determining their expression changes. Principal component analysis (PCA) and orthogonal projectionto latent structure discriminant analysis (OPLS-DA) were used to determine the entire allocation of experimental groups apiece, access the quality of being near to the true value of model, and screen the differential lipid metabolites with variable importance of projection (VIP). Finally, Metabo Analyst platform database was used to analyze lipid molecular metabolic pathways. Results:BPC results showed that the experimental repeatability was good and the experimental data was reliable. The main parameter model interpretation rate of PCA model R 2X = 0.511, indicating that the model was reliable. The main parameter model interpretation rate of OPLS-DA model R 2Y = 0.954, Q 2 = 0.913, indicating that the model was stable and reliable. With FC > 2.0 or FC < 0.5, P < 0.05, a total of 72 differential lipid metabolites were obtained based on VIP > 1. Based on Metabo Analyst 5.0, 24 distinguishable lipid metabolites were identified including 8 phosphatidylethanolamine (PE), 7 lysophosphatidylcholine (LPC), 6 phosphatidylcholine (PC), 2 lysophosphatidylethanolamine (LPE) and 1 phosphatidylserine (PS). Compared with healthy volunteers, the lipid molecules expression proved down-regulated in most sepsis patients, including PC, LPC, LPE, and some PE, while some PE and PS were up-regulated, which was mainly related to the PE (18∶0p/20∶4), PC (16∶0/16∶0) and LPC (18∶1) metabolic pathways in glycerophospholipids. Conclusions:There are significant differences in lipid metabolites between the sera of sepsis patients and healthy volunteers. PE (18∶0p/20∶4), PC (16∶0/16∶0) and LPC (18∶1) may be new targets for sepsis prediction and intervention.
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Objective To evaluate the safety of cardiac rehabilitation(CR)for the elderly patients with chronic heart failure(CHF). Methods All 72 patients with CHF over the age of 60 were enrolled and randomly divided into two groups: the experimental groups(n=35)and control groups(n=37). Patients in both groups were treated strictly according to the treatment guideline. On the basis of drug treatment,patients in experimental group were given a comprehensive CR program. The occurrence of all-cause death,due to deterioration of heart failure readmission and serious adverse events were compared after 12 months. ResultsCompared with the control group,the incidence of all-cause and the cases for the deterioration of heart failure readmission decreased in the experimental group after 12 months(P 0.05). Conclusion For the elderly CHF patients,cardiac rehabilitation can effectively reduce all-cause death and deterioration of heart failure readmission in patients,but the serious adverse events had no obvious change. It is safe and effective for the elderly patients with chronic heart failure.
ABSTRACT
Objective In order to discuss the contribution and significance of lowering increased serum uric acid levels in cardio-vascular disease prevention and control .Methods All 100 hyperuricemia in senile patients with hypertension and diabetes mellitus were received the standard drug treatments for bloodpressure ,blood sugar management .According to the patients′will divided them into uric acid intervention group(study group) and control group .The study group were given low purine diet and benzbromarone tablet (50 mg/day ,course of 1 year) ,then compare the changes between the 2 group and within each group after 3months ,6months and 1 years in the metabolism indexes before and after intervention (serum uric acid ,glycosylated hemoglobin ,fasting blood glu-cose ,2-hours postprandial glucose ,and the changes of dynamic blood pressure ) ,and follow-up the occurrence of cases in primary end point events (all-cause death ,total cardiovascular death) .Results (1)In study group ,3months ,6months and 1 years after in-tervention ,the serum uric acid lever was significantly lower than that before intervention and the control group ,P<0 .01 .(2)The study group patients′dynamic blood pressure was significantly lower than that before intervention and the control group after 6 ,12 months ,meanwhile the study group patients′success rate of dynamic blood pressure level is higher than themselves before the in-tervention after 6 ,12 months ,P<0 .05 .(3)The 2 groups of patients′glycosylated hemoglobin ,fasting plasma glucose ,2-hours post-prandial glucose ,control rate of blood glucose at each testing point before and after the intervention had no difference .(4)The oc-currence of cases between the 2 groups for all-cause death and total cardiovascular death had no difference .Conclusion (1)Reduc-ing the mortality and disability rate of hyperuricemia in elderly patients with hypertension and diabetes mellitus ,the most critical measures is still a reasonable standard blood pressure and blood sugar management .Based on this therapy ,effectively reducing the increased serum level of uric acid can improve the control rate of blood pressure .