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Objective:To investigate the effects of different lipid-lowering regimens on blood lipids, endothelial function and safety in patients with unstable angina.Methods:Patients who admitted to Henan Provincial People's Hospital for unstable angina from September 2018 to May 2019 were randomly (random number) divided into the conventional treatment group, intensive statin group and intensive lipid-lowering group. Follow-up was performed at 1, 3, and 6 months after treatment according to the predetermined lipid-lowering regimen. Assessments included lipid profile, liver function, muscle enzymes, hypersensitive C-reactive protein (hs-CRP), endothelial function (reactive hyperemia index, RHI), ischemic events, myalgia, and discontinuation. The differences of the follow-up indicators among the three groups were analyzed.Results:A total of 375 patients were enrolled and randomly divided into three groups, 125 patients in each group. There were no significant differences in demographic data and medication among the three groups. At the 1st month, the low density lipoprotein cholesterin (LDL-C) compliance rate of the intensive statin group was significantly higher than those in the conventional treatment group ( χ2=3.939, P=0.047) and the intensive lipid-lowering group ( χ2=4.63, P=0.031). At the 3rd month, the reductions of LDL-C in the intensive statin group and the intensive lipid-lowering group were significantly better than that in the conventional treatment group( P<0.01). At the 6th month, the reduction rate of LDL-C in the intensive lipid-lowering group was higher than that in the intensive statin group ( q=4.332, P<0.01). At the 1st month, the improvement of hs-CRP and RHI in the intensive statin group was significantly better than that in the conventional treatment group( q=4.133, P<0.05). From the 3rd month of treatment, the incidence of cardiovascular events in the intensive statin group and the intensive lipid-lowering group showed a tendency to decrease compared with the conventional treatment group, but no statistically significant difference was found. At the 6th months of treatment, the withdrawal rates were significantly higher in the intensive statin group and the intensive lipid-lowering group than that in the conventional treatment group (χ 2=4.488, P=0.03 and χ2=5.039, P=0.02). There were no significant differences in the ratio of liver enzyme and muscle enzyme elevation and the incidence of myalgia among the three groups (all P>0.05). Conclusions:Intensive statin therapy can make LDL-C reach the standard in patients with unstable angina pectoris as soon as possible, significantly improve inflammation indicators and endothelial function, and has good safety.
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Objective:To explore the relationship between plasma homocysteine level and renal dysfunction in elderly patients with coronary heart disease(CHD).Methods:Eight hundreds and fifty-eight elderly patients with CHD were enrolled at cardiology department of our hospital from January 2015 to July 2017.The patients were divided into the renal insufficiency(RI, defined as an estimated glomerular filtration rate(eGFR)<60 ml/min)group and the non-kidney disease(NKD)group.Using the random number table, the RI group was randomly sub-grouped into the intervention group and the placebo group.The intervention group was treated with folic acid(10 mg/d), vitamin B6(10 mg/d)and vitamin B12(1 mg/d), while the placebo group was given oral placebo.Serum homocysteine(Hcy), creatinine(Cr), blood urea nitrogen(BUN), total cholesterol(TC), triglyceride(TG)and hemoglobin(Hb)were measured by enzyme-linked immunosorbent assay.Pearson correlation was used to analyze the correlations of Hcy with Cr, BUN and eGFR between the RI and NKD groups.Plasma Hcy, Cr, BUN and Hb levels before, and 6, 12 months after treatment were determined and compared between the two subgroups.Staging of renal function was analyzed and clinical effect was evaluated 12 months after treatment in the two subgroups.Results:Serum levels of Hcy, Cr and BUN were higher( t=3.174, 4.857 and 2.644, all P=0.000)and the level of eGFR was lower( t=-2.867, P=0.000)in the RI group than in the NKD group.Plasma Hcy level was positively correlated with plasma levels of Cr and BUN( r=0.308 and 1.214, all P=0.000)and negatively correlated with the eGFR level( r=-0.148, P=0.003). There was no significant difference in plasma Hcy, Hb, Cr and BUN levels between the intervention and placebo group before treatment( P>0.05). At each monitoring time point, serum levels of Hcy, Cr and BUN were decreased continuously in the intervention group( F=314.527, 234.861 and 176.332, P=0.012, 0.000 and 0.006), while plasma Hcy level had no significant change and plasma levels of Cr and BUN were increased continuously in the placebo group( F=196.427, 223.753 and 314.552, P=0.216, 0.000 and 0.002). After 12 months of treatment, plasma levels of Hcy, Cr and BUN were lower in the intervention group than in the placebo group( t=1.284, 0.779 and 2.541, P=0.016, 0.000 and 0.005). There was no significant difference in plasma Hb level between the two subgroups before and after treatment( F=113.764, P=0.182). There was no significant difference in the renal function staging between the two subgroups before treatment( χ2=4.263, P=0.119), while it was improved in the intervention group versus in the placebo group at the end of follow-up( χ2=73.599, P=0.000). Conclusions:The high level of plasma Hcy can be regarded as an independent risk factor for renal insufficiency, and has a correlation with the renal disease progression and prognosis in elderly patients with CHD.
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Objective:To evaluate the effectiveness and feasibility of health management based on cloud platform for population with high-risk of coronary heart disease (CHD).Methods:In this study, self-control method was used to study the high-risk group of CHD in two community outpatient clinics in Jinshui District, Zhengzhou through cloud platform. One year later, the clinical indicators, the degree of mastering CHD prevention knowledge andthe medicine compliance of the group were evaluated. Finally, the feasibility and acceptance of cloud platform management were evaluated through questionnaire survey.Results:A total of 272 people were enrolled intothe group. After one year of cloud platform management, the blood lipid, uric acid, homocysteine and fasting blood glucose in the group weresignificantly improved (all P<0.05), but the glycosylated hemoglobin was not significantly reduced [(6.4±1.2)% vs.(6.3±1.1)%, P>0.05]. The degree of mastering CHD prevention knowledgewas significantly improved, and the medicine compliance was not significantly improved [(5.0±1.6) vs. (5.0±1.5), P>0.05]. Questionnaire survey showed that 228 (83.8%) of the patients had a high acceptance of cloud platform management, and 208 (76.5%) of the group wanted to continue to use cloud platform for health management. Conclusions:Health management based on cloud platform can improve the clinical index control of the high-risk population of CHD, and help the high-risk population to master the relevant knowledge of CHD prevention. Some functions of cloud platform need to be further improved.
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OBJECTIVE： To explore the ways to improve the efficiency and quality of ethical review in multi-center clinical trial. METHODS： After issuing the policy of Opinions on Deepening the Reform of Approval System and Encouraging the Innovation of Pharmaceutical Medical Devices and Measures for the Administration of Drug Registration （Revised Version）， combined with the practice of our center， the methods to improve the efficiency and quality of ethical review， the possible problems of complete filling system and the way to improve the efficiency and quality of ethical review in multi-center clinical trial were analyzed in our center. RESULTS & CONCLUSIONS： Our center adopted a variety of review methods （conference review， rapid review， filing system， etc.）， implemented hierarchical management and differential review process for research projects， and formulated defined rules of filling system operation and other ways to improve the efficiency and quality of review， doubled the review efficiency， increased the number of follow-up review and field visit. In the process of exploration， the ethics committee of our center believes that the complete implementation of the filing system will lead to problems such as the difficulty to evaluate the quality of the ethical review of the leader unit， different research qualifications and conditions of each center， etc. In order to improve the efficiency and quality of the ethical review of multi-center clinical research， the measures are can be adopted， such as improving the quality of the ethical review of the center， strengthening the communication and mutual recognition of the ethics committees of each center， and establishing the preliminary review system of the secretary of the ethics committee， so as to realize the balance of efficiency and quality.
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Objective To evaluate the clinical efficacy of modified Bascom cleft lift procedure in the treatment of chronic sinus.Methods Modified Bascom cleft lift procedure was performed in 53 patients admitted from Oct 2012 to Jul 2016.49 cases were male and 4 were female.The average age was (25.4± 2.3) years.Results All patients were satisfied with the operation.There were 49 cases of primary healing and 4 cases of incision complications.The average follow-up was (12.1 ±4.3) months,no recurrence was observed.Conclusion The modified Bascom cleft lift technique is effective and reliable,with less complications and a lower recurrence rate.
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Objective To explore the effect of troponin Ⅰ (anti-cTnⅠ) autoantibodies on the quality of life and prognosis in patients with ischemic cardiomyopathy.Methods Patients hospitalized in Henan Provincial People's Hospital for ischemic cardiomyopathy from June 2016 to June 2017 were enrolled.At the same time,physical examiners were selected as the control group.Anti-cTnⅠ autoantibodies were detected in the serum from the patients and control group,which were expressed as the OD value.After six months,all patients were followed up,including death,times of readmission,instrument treatment (CRT-P or CRT-D) or heart transplantation,and quality of life questionnaire (SF-36).The effect of anti-cTnⅠ autoantibodies on the prognosis and quality of life were analyzed.Results In 127 patients with ischemic cardiomyopathy,the OD value of anti-cTnI autoantibodies were significantly higher than that in the control group[(0.55 ± 0.24) vs (0.46 ± 0.07),P＜0.05].With a positive standard of more than 0.67,26 patients with ischemic cardiomyopathy were tested positive for anti-cTnⅠ autoantibodies,with a positive rate of 20.5％.After 6 months of outpatient or telephone follow-up,9 patients were lost to follow-up,and 118 patients were followed up,including 24 patients with positive anti-cTnⅠ autoantibodies.Compared with patients with negative anti-cTnⅠ autoantibodies,the times of readmission in patients with positive anti-cTnⅠ autoantibodies increased significantly[(1.42 ± 0.79)vs (0.30 ± 0.55),P＜0.01] and the physiological function was decreased significantly[(56 ± 19.4) vs (67 ± 20.8),P=0.032].The physiological function,vitality and social function of patients with reduced ejection fraction in the anti-cTnⅠ autoantibodies positive group were significantly worse than those in the anti-cTnI autoantibodies negative group,but there was no significant difference in quality of life between the anti-cTnⅠ autoantibodies positive and negative groups in the patients with preserved and median ejection fraction.Conclusions Patients with ischemic cardiomyopathy of seropositivity for anti-cTnⅠ autoantibodies have worse prognosis and quality of life,especially in those with reduced ejection fraction.
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Objective:To explore the biological effects of amino acid transporter gene SLC7A5 (solute carrier family 7,member 5) on tumor cells and the regulatory mechanism at transcriptional level.Methods:The expression of SLC7A5 was examined in human normal tissues and corresponding tumor tissues by Gene Expression Omnibus (GEO) database.The recombinant plasmid of SLC7A5 gene was constructed,and the effect of the SLC7A5 gene on tumor cell proliferation was investigated by methylthiazolyldiphenyl-tetrazolium bromide (MTT) and flow cytometry.SLC7A5 gene promoter and transcription factor binding sites were predicted through bioinformatics analysis,and the gene promoter recombinant plasmid was constructed.Then the dual luciferase reporter gene assay and reverse transcription polymerase chain reaction (RT-PCR) were used to explore the regulation of transforming growth factor-β1 (TGF-β1) signal on SLC7A5 gene expression.Results:The GEO database analysis showed that the distribution of SLC7A5 was tissue specific,and its expression level was significantly higher in the tumor tissues than that in the corresponding normal tissues.The results of MTT and flow cytometry showed that SLC7A5 could promote cell proliferation.Results from the promoter analysis,reporter gene assay and RT-PCR confirmed that TGF-β1 could up-regulate the activity of SLC7A5 promoter and promote the expression of the SLC7A5 gene.Conclusion:SLC7A5 gene plays a role in promoting tumor development,which is regulated by the TGF-β1 signaling pathway.
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Objective To investigate the difference and the correlation of the vowel's phonation threshold pressure and nasalance in normal subjects .Methods The Aeroview (GLOTTAL Enterprises)with the materials /pa/,/pi/,/pu/ was used to obtain phonation threshold pressure values and The NasalviewTM (Tiger Electronics Inc .,Seattle ,Shanghai) with the materials /a/,/i/,/u/was used to obtain nasalance values .A total of 30 subjects (15 males ,15 females ,and aged 19~30) years old received the tests .The results of the vowel's phonation threshold pressure and nasalance gender score difference were compared .Results The PTP gender scores of /a/,/i/,/u/in maleswere4.53±0.70cm,5.21±0.80cm,5.87±1.45cm,andinfemaleswere4.09±0.30cm,4.47±0.30cm, and 4 .77 ± 0 .32 cm ,respectively .There were significant differences between males and females in PTP values (P 0 .05) .The na‐salance gender score differences showed that females were greater than males .There were significant differences in different vowels(P<0 .05) .This study found a weak correlation between PTP and nasalance .Conclusion The relationship between oral pressure and nasal flow cannot be accurately measured by measuring PTP ,and /pa/is a relatively suit‐able material for testing oral pressure .
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Objective To evaluate the effect of preoperative aescuven forte tablets in the prevention of procedure for prolapse and hemorrhoids(PPH) complications.Methods One hundred and seventy-nine patients underwent PPH in the Erlonglu Hospital of Beijing from June 2013 to June 2014 were divided into postoperative aescuven forte tablets group (n =90) and preoperative aescuven forte tablets group (n =89).The postoperative pain,bleeding,retention of urine,anal swelling,length of stay in hospital and recurrence were compared between the two groups.Results The incidence of postoperative pain,bleeding,retention of urine,anal swelling were lower than in the preoperative aescuven forte tablets group (pain after operations rate:7.9％ (7/89) vs.20.0％ (18/90),x2 =5.484,P＜ 0.05;Wound bleeding:0 vs.6.7 ％ (6/90),P =0.026;retention of urine:9.0％ (8/89) vs.20.0％(18/90),x2 =4.370,P＜0.05;anal swelling:1.1％(1/89) vs.8.9％(8/90),P=0.035),and length of stay in hospital was shorter(11.9±3.9) d vs.(13.3 ±5.0) d,t=3.134,P＜0.05).There was no recurrence both of two groups follow up for more than 2 months.Conclusion Preoperative oral aescuven forte tablets of 2 h can reduce PPH complications and worthy of popularization and application.
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Objective Discussing the role of Yunnan baiyao in the newborn umbilical cord.Methods 120 cases newborns were selected and randomly divided into the control group of 60cases and the observation group of 60 cases according to birth order.The two kinds of newborns were both used single valve care,and were disinfected with 75%alcohol twice a day,Newborns of the observation group were dipped in Yunnan baiyao cream which was taken 75%alcohol to apply the root of umbilical and around after each nursing time.Observed the umbilical cord healing of two groups of newborns and take notes.Results In the observation group newborns,umbilical cord on the drying time [(3.1 ±1.1)d]and off time[(6.6 ±1.8)d]were better than the control group[(3.1 ±1.1)d,(8.0 ±3.2)d](t =7.8,2.95,all P <0.05);6 cases occurred redness and swelling around the belly button,2 cases occurred hemor-rhage,17 cases occurred secretions.which were better than that in control group(18 cases,6 cases,35 cases).The statistical analysis showed significant difference in the data of the two groups.Conclusion Yunnan baiyao can promote healing of umbilical cord,it should be popularize in clinical use.
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ObjectiveTo evaluate the efficacy and safety of spironolactone in treatment NYHA (New York Heart Association) class Ⅰ - Ⅱ heart failure patients. MethodsEighty eight patients with NYHA classⅠ- Ⅱheart failure were randomized to sprionolactone or placebo groups.Patients were assessed by echocardiography and 6-minute walking test (6MWT) ,plasma aldosterone and NT-proBNP were measured before and 6 months after treatment; serum potassium and creatinine were monitored through the study. ResultsThe E/A and E/E' in spironolactone group were significantly lower than those of control group (1.2±0.7 vs. 1.7±0.6, P=0.007;15.2±2.3vs. 17.7±3.0, P=0.000). No differences were observed in left ventricular end-diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF)between two groups after treatment. Left ventricular mass index (LVMI) in spironolactone group decreased after theatment [(117 ±27) g/m2 vs.(112 ± 19) g/m2,P = 0.044]. Plasma aldosterone level in spironolactone group after treatment was significantly lower than that of control group [ ( 157 ± 16) ng/L vs.( 165 ± 16) ng/L, P =0. 021 ]. Although there were no differences in plasma NT-proBNP level between two groups after treatment, it decreased significantly comparing with that of before treatment ( P = 0. 000). No differences were observed in serum potassium and creatinine between two groups after treatment. However serum potassium and creatinine in spironolactone group increased significantly after treatment [ ( 83 ± 18 )pmol/Lvs. (87 ± 22) μmol/L, P =0.047; (4.4 ±0.4) mmoL/L vs. (4.5 ±0.6) mmol/L, P =0. 012]. ConclusionSpironolactone can alleviate cardiac remolding and diastolic function in NYHA classⅠ - Ⅱ heart failure patients.
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Objective To study the relation between the level of serum carbohydrate antigen-125 (CA125) and heart function as well as the myocardial remodeling in patients with congestive heart failure(CHF). Methods 79 patients with CHF were divided into three groups based on the standard of New York Heart Association Classification. 25 healthy persons were served as control group. Level of CA125 was measured by MEIA. NT-proBNP was detected by Roche Cardiac Reading instrument. TNF-? was measured by radioimmunoassay. Left ventricular mass index (LVMI),left atrial volume index (LAVI) and left ventricular ejection fraction (LVEF) were detected by echocardiography. The levels of CA125,NT-proBNP,TNF-?,LVMI,LAVI and LVEF in different groups were compared.The relationship between CA125 and NT- proBNP,TNF-?,LVMI,LAVI and LVEF was evaluate.Results Levels of CA125,NT-proBNP,TNF-?,LVMI and LAVI in patients with CHF were much higher than those without CHF. The LVEF was much lower in NYHA Ⅲ and NYHA Ⅳ group than that in without CHF and NYHAⅠgroup. Conclusion CA125 was positively associated with the NT-proBNP,TNF-? and LVMI.
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AIM: To set the model of rat bone marrow me se nchymal stem cells (BMMSCs) that differentiate into cardiomyocytes and observe t he connection structure between cells. METHODS: BMMSCs were isolated by adhering to culture plates and cultured in vitro to expand. Induction of BMMSCs to differentiate into cardi omyo cytes was conducted by treating the cells with 5-aza. Immunocytochemical stainin g was used to identify sarcomeric actin and intercalated disc-like structure wh en the cells were cultured for additional 1 week, 2 or 3 weeks, respectively. RESULTS: Sarcomeric actin positive cells were observed in 1 week , 2 or 3 weeks after 5-aza treatment. Some cells stained positive for connexin4 3 at 1 week and 2 weeks after 5-aza treatment, with brown pellet located disper sively around nucleus. 3 weeks after 5-aza treatment, connexin43 positive cells s howed brown pellet arranging in thready structure around nucleus, such structure could be seen between very few cells which was similar to intercalated disc-lik e structure in normal heart tissue. CONCLUSION: During the process of BMMSCs differentiating into ca rdiomyocytes, intercalated disc-like structure is gradually formed with increas e in culture time and cell density.