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Objective:To study the influence of intensive magnet fields on radiation dose measurement, and to demonstrate the feasibility of measuring magnet field correction factor by a combination of medical linac with variable magnet fields in view of needing for accurate measurement of the doses from reference beam arising in MR image-guided radiotherapy.Methods:A photon radiation field and a variable field with 6 MV nominal high voltage were produced by using conventional medical electron linear accelerator equipped with a pair of electromagnets with magnetic field strength up to 1.5 T. Both PTW30013 and PTW31010 ionization chambers were used to test the responses of ionization chambers under different magnetic field strengths at four orientations in which the angles between ionization chamber axis and magnetic field direction were 0°, 180°, 90° and 270°, respectively. The magnetic factors, kB, M was calculated and compared with the reported values in literature. Results:The response of ionization chamber was proportional to the magnetic field strength before it reached to a peak around 1 T, and then fell down as the magnetic field continued to rise. When the magnetic field was 0.35 T, the magnetic factors of PTW31010 were 0.988 2±0.000 3 and 0.997 4±0.000 4 corresponding to 90° and 0° directions, the discrepancy between 0° scenario and literature was 0.05% ± 0.04%. When the magnetic field reached 1.5 T, the magnetic factor of PTW30013 was 0.958 9±0.000 5 at the situation of 90°, which was 0.60% ± 0.05% different from the literature value.Conclusions:Conventional 6 MV medical accelerator equipped with electromagnet can be used to measure the magnetic field factor of reference dosimetry for MRIgRT.
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Objective: To observe the clinical effect of Qiliqiangxin capsule combined with recombinant human brain natriuretic peptide in acute left heart failure patients 7 days after onset as well as the effects of plasma MDA and ET-1. Methods: In total, 240 hospitalized patients with acute left heart failure from October 2017 to May 2021 were selected from the Department of Emergency and Critical Care Center of Beijing Anzhen Hospital, Capital Medical University and the Department of Cardiology of the Jilin Provincial People's Hospital. They were randomly divided into routine treatment group and combined treatment group, with 120 cases in each group. The routine treatment group was treated with vasodilation, diuresis, cardiotonic and recombinant human brain natriuretic peptide. The combined treatment group was treated with Qiliqiangxin capsules based on the routine treatment group. One week later, the changes in clinical efficacy, ejection fraction, left ventricular commoid diameter, and plasma BNP, MDA, and ET-1 were compared between the two groups before and after treatment. SPSS 11.5 statistical software was used. The measurement data was expressed in x¯±s, the independent sample t-test was used for comparison between groups, and the paired t-test was used for comparison before and after treatment within groups. Counting data was expressed as case (%), and the rank sum test was used for inter-group comparison. Result: In terms of clinical efficacy, the total effective rate of the combined treatment group was significantly higher than that of the conventional treatment group, and the difference was statistically significant (P<0.05). Compared with the routine treatment group, the left ventricular ejection fraction in the combined treatment group was significantly increased (P<0.05). The levels of plasma BNP, MDA and ET-1 were significantly decreased (P<0.05). Conclusion: Qiliqiangxin capsule combined with rhBNP treatment can effectively improve the clinical symptoms of acute heart failure, as well as reduce the lipid peroxidation product MDA content and endothetin ET-1 level in blood. The clinical application value of the Qiliqiangxin capsule needs to be further confirmed by further trials.
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Humans , Heart Failure/physiopathology , Natriuretic Peptide, Brain/therapeutic use , Stroke Volume/physiology , Ventricular Function, Left/physiology , Cardiotonic Agents/therapeutic use , Drugs, Chinese Herbal/therapeutic use , Recombinant Proteins/therapeutic use , Cardiovascular Agents/therapeutic use , Drug Therapy, CombinationABSTRACT
Objective:To examine the effect of anemia on the prognosis of elderly patients with acute coronary syndrome.Methods:We searched PubMed, Scopus, OVID, the Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure, China Biology Medicine Disc, the WanFang and Weipu databases for studies on the association between anemia and the prognosis of acute coronary syndrome in elderly patients.The date range included the period from the establishment of the database to December 10, 2022.Two reviewers independently completed the literature screening and data extraction according to the inclusion and exclusion criteria for the literature.Stata 16.0 software was used to analyze the data.Results:Of 1 399 references retrieved from the initial search, 13 met the inclusion criteria, including a total of 9540 patients with a mean age of 70.3 years.2872 of these patients had concurrent anemia and 6 668 patients had no anemia.In elderly patients with acute coronary syndrome, those with anemia showed significantly increased risk of death, compared with those with no anemia( RR=2.28, 95% CI: 1.74-3.00). Anemia also increased the incidence of ischemia( RR=1.36, 95% CI: 1.13-1.64)and bleeding events( RR=2.18, 95% CI: 1.59-3.01)( P<0.05 for all). Conclusions:Anemia significantly increases the risk of death and is associated with poor prognosis in elderly patients with acute coronary syndrome.
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In order to clarify the influence of acute hypobaric hypoxia on the bile acids of the rat small intestine, we used ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) to identify bile acids in the contents of the small intestine from untreated and acute hypobaric hypoxia-treated rats. Thirty-nine bile acids were detected; PCA and OPLS-DA analysis revealed marked differences in the composition of bile acids between the untreated and the acute hypobaric hypoxia groups. Bile acids were screened with VIP > 1, |log2FC| ≥ 1, P < 0.05, and a total of 7 bile acids with significant differences in content between the two groups were obtained, including 5 conjugated bile acids, 2 unconjugated bile acids; in addition, the content of conjugated bile acids has risen in the treated group. This study demonstrated the influence of high-altitude hypoxic environment on bile acid composition and metabolism in rats. All the animal experiments in this study were approved by the 940th Hospital Ethics Committee (approval No: 2020KYLL012).
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Global plastics production has been increasing year by year. Due to the large quantity of plastics and the difficulty of their degradation, plastics are continuously accumulated in the environment. Therefore, plastic waste has become one of the most serious threats to the global environment. Microplastics can be absorbed into organisms through the mouth, respiratory tract and skin, causing organ(intestine, liver) toxicity, reproductive and developmental toxicity, and neurotoxicity. Moreover, microplastics can also take up other pollutants distributed in the surrounding environment, such as heavy metals and organic pollutants, jointly exerting combined toxic effects. The extracts of microplastics, including microplastics unstable polymers and additives, also have toxic effects. The molecular mechanisms involved in the toxic effects induced by microplastics include oxidative stress, inflammation, disturbance of intestinal flora, disturbance of gene expression, and others.
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OBJECTIVE: To explore the exercise capacity of patients with occupational pneumoconiosis with varying degrees of pulmonary dysfunction. METHODS: A total of 488 hospitalized occupational pneumoconiosis patients were selected as study subjects using the judgment sampling method and examined for pulmonary function test and cardiopulmonary exercise test(CPET). Among them, 272 patients with normal lung function were assigned as the control group, and 216 patients with abnormal lung function as the case group. The case group was divided into mild, moderate and severe pulmonary dysfunction subgroups according to the forced expiratory volume in one second/predicted value ratio(FEV_1%pred).RESULTS: The FEV_1%pred, maximal voluntary ventilation(MVV), maximum exercise tidal volume(VT_(max)), breathing reserve(BR), maximal Watt(W_(max)), maximum oxygen uptake(VO_(2max)) and anaerobic threshold(AT) in patients of the case group were lower than that in the control group(all P<0.05). The FEV_1%pred, MVV, VT_(max), W_(max), and VO_(2max) in patients in the 3 subgroups of abnormal lung function were decreased(all P<0.05) compared with the control group. The VO_(2max) and AT decreased in the case group with the increase of the degree of pulmonary dysfunction(P<0.05). The FEV1%pred, MVV, maximal exercise minute ventilation and VT_(max) of the study subjects were positively correlated with VO_(2max) and AT(all P<0.01), but the BR had no correlation with VO_(2max) and AT(all P>0.05). CONCLUSION: The more serious the abnormal degree of pulmonary function in the patients with occupational pneumoconiosis, the more obvious the decline of their exercise ability, showing a dose-effect relationship.
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Objective:To study the effects of conservative treatment versus percutaneous interventional treatment(PCI)on symptoms and prognosis of chronic coronary syndrome patients aged over 75 years with fractional flow reserve(FFR)in the grey zone(0.75≤FFR≤0.80).Methods:A total of 96 coronary heart disease(CHD)patients aged over 75 years undergone FFR examination in our hospital from January 2011 to December 2017 were retrospectively selected.All patients showed stenosis of 50%-90% in at least one main coronary artery and had FFR values within the range of 0.75-0.80(0.75≤FFR≤0.80). According to the treatment, patients were divided into the optimized medication group(OMT group, n=35)and the PCI group(n=61). The degree of angina alleviation assessed by the Seattle Angina Questionnaire(SAQ)and the incidence of major adverse cardiovascular endpoints(death, myocardial infarction, stroke, and repeated revascularization)were recorded during the one-year follow-up after treatment.Results:There was no significant difference in baseline data including age, gender and comorbidities between the OMT and PCI groups( P>0.05). The incidence of previous myocardial infarction, and the basal level of low-density lipoprotein cholesterol(LDL-C)were higher in the PCI group than in the OMT group( P<0.05). One-year follow-up showed that there was no significant difference between the OMT and PCI groups in the score of SAQ(77.6 ± 19.5 vs. 83.1 ± 22.8, P>0.05)and the incidence of composite MACEs(11.4% or 4 / 35 vs. 9.8% or 6/61, P>0.05). However, the incidence of repeated target vessel revascularization was lower in the PCI group than in the OMT group(1.6% or 1 case vs. 5.8% or 2 cases, P<0.05). Conclusions:In elderly CHD patients aged over 75 years with FFR values between 0.75-0.8 in the grey zone, optimal medication treatment has similar effects as the PCI on symptom alleviation, and no significant increase in composite MACEs is found at one-year follow-up.
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Plasma protein products are also called blood products. At present, more than 30 kinds of blood prod-ucts have been issued worldwide. Because of their particular source of raw materials as well as the safety, reliability and irreplaceability in the treatment of some diseases, many blood products are in short supply in the market. Rare diseases are usually caused by genetic deficiency, autoimmunity, allergy and so on, which imposes a huge burden on patients and their families. Orphan drugs generally include the products of diagnostic reagents, vaccines, medicines and medical devices used for the prevention, diagnosis and treatment of rare diseases and rare conditions. Since the adoption of the Orphan Drug Act(ODA)in the United States in 1983, many countries or regions have passed the relevant laws aiming to encourage enterprises to develop orphan drugs by means of the research funding, tax relief, priority approval and market monopoly. The pass of ODA has greatly promoted the development of related blood product enterprises. This paper sum-marizes the plasma protein products approved by the pharmaceutical regulatory departments of the United States, the Eu-ropean Union, Japan and Australia as orphans, including four categories and 18 varieties, accounting for 56% of all plas-ma protein products in the world. At present, China has not yet enacted legislation to define rare diseases and orphan drugs, which has restricted to a certain extent the development of domestic blood product enterprises. The policy divi-dends from ODA will help the development of domestic blood product enterprises and narrow the gap between the domes-tic enterprises and the international blood product giants.
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<p><b>Background</b>Despite its limitations, unfractionated heparin (UFH) has been the standard anticoagulant used during percutaneous coronary intervention (PCI). This study compared the safety of low-dose UFH with sequential enoxaparin with that of UFH in patients with diabetes mellitus (DM) and complex coronary artery disease receiving elective PCI.</p><p><b>Methods</b>In this retrospective study, 514 consecutive patients with atherosclerotic cardiovascular diseases and type 2 DM were admitted to the hospital and received selective PCI, from January 2013 to December 2015. All patients with PCI received low-dose UFH with enoxaparin (intraductal 50 U/kg UFH and 0.75 mg/kg enoxaparin, n = 254; UFH-Enox group) or UFH only (intraductal 100 U/kg UFH, n = 260; UFH group). The study endpoints were major adverse cardiac events (MACEs), namely death, myocardial infarction (MI), stroke, target-vessel immediate revascularization (TVR), and thrombolysis in MI (TIMI) major bleeding, within 30 days and 1 year after PCI. Any catheter thrombosis during the procedure was recorded.</p><p><b>Results</b>Only one patient had an intraductal thrombus in the UFH group. At the 30-day follow-up, no MACE occurred in any group; seven and five cases of recurrent angina and/or rehospitalization were reported in the UFH-Enox and UFH groups, respectively; there was no significant difference between the two groups (χ = 0.11, P = 0.77). There was no TIMI major bleeding in the groups. With respect to the 1-year endpoint, two cases of recurrent MI and two of TVRs were reported in the UFH-Enox group, whereas in the UFH group, one case of recurrent MI and three of TVRs were reported; no significant difference existed between the two groups (χ = 0, P = 0.99). There were 30 and 25 recurrent angina and/or rehospitalizations in the UFH-Enox and UFH groups, respectively; there was no significant difference between the two groups (χ = 0.37, P = 0.57).</p><p><b>Conclusion</b>In elective PCI, low-dose UFH with sequential enoxaparin has similar effects and safety to the UFH-only method.</p>
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Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Anticoagulants , Therapeutic Uses , Coronary Artery Disease , Drug Therapy , General Surgery , Diabetes Mellitus , Drug Therapy , General Surgery , Enoxaparin , Therapeutic Uses , Heparin , Therapeutic Uses , Percutaneous Coronary Intervention , Methods , Retrospective StudiesABSTRACT
Objective To observe the clinical efficacy of arthroscopy and fibula osteotomy in the treatment of medial knee osteoarthritis.Methods Thirty-six patients with medial knee osteoarthritis treated in our hospital from September 2014 to September 2016 were divided into two groups according to the acceptable surgical protocol.The control group was treated by fibula osteotomy,and the observation group received arthroscopy combined with fibula osteotomy.The clinical signs and symptoms,VAS and ISOA scores were evaluated and compared between the two groups.Results The control group of 18 cases,clinical recovery in 0 cases,markedly effective in 7 cases,effective in 8 cases,3 cases with no effect,the effective rate was 38.9％;observation group of 18 cases,3 cases clinically cured,effective in 10 cases,effective in 5 cases,the effective rate was 72.2％.The effective rate of observation group was better than that of the control group,the difference was signicant (P ＜ 0.05).VAS and ISOA in both groups were significantly improved after operation,the difference was signicant (P ＜ 0.05);VAS improvement in observation group was better than that in control group,the difference was signicant(P ＜ 0.05),ISOA score in observation group was significantly better than that in control group,the difference was signicant(P ＜0.01).The clinical signs and symptoms(pain and numbness,walking,living and working abilities,tenderness,straight leg raising test,knee and Achilles reflex,total score) in two groups were improved respectively compared with those before treatment,and the differences were statistically significant(P ＜ 0.05).The pain and numbness,walking,tenderness,straight leg raising test and total score in the observation group were significantly different from those in the control group(P ＜ 0.05).Conclusion The arthroscopy and fibula osteotomy is safe and feasible to treat patients of medial knee osteoarthritis with less traumatic,more effective and better functional recovery.
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[Objective]To investigate the efficacy and safety of ALA-PDT following CO2laser preconditioning for recal-citrant plantar warts.[Methods]Patients with recalcitrant plantar warts were enrolled in this study,and received ALA-PDT treatment following CO2laser preconditioning. Cure rate and side effects were observed.[Results]Twenty patients were en-rolled and 85%(17/20)showed complete clearance of plantar warts after one to three times of ALA-PDT. PDT treatment time was once in two patients(10%),twice in five patients(25%)while three times in 10 patients(50%).No infection or scar tissue was observed.Five(25%)patients were infected with one type of HPV,while 15(75%)patients with two or mul-tiple types of HPV. No difference was observed in complete clearance rate between patients with single or multiple HPV gen-otypes infection.[Conclusions]Superpulse carbon dioxide laser pretreatment enhanced the efficacy of ALA-PDT treatment on recalcitrant plantar warts.Further study is needed to determine the association of HPV genotype with outcome of recalci-trant plantar warts.
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Objective To investigate the relationship between fragmented QRS (fQRS) complexes and the severity of coronary artery lesions in elder patients with complex coronary artery lesions.Methods Two-hundred and one elder patients with complex coronary lesions undergone coronary angiography in Beijing Anzhen Hospital from January 2013 to July 2016 were enrolled.Based on the coronary lesions,patients were divided into the complex coronary lesions group and the simple coronary lesions group.The clinical features and coronary scores were compared between groups.Logistic regression analysis was used to evaluate the risk factors of complex coronary lesions.Results Compared with simple coronary lesions group,the complex coronary lesions group was associated with higher rate of fQRS (31.3％ vs.17.2％,x2 =9.68,P＜0.01),more number of fQRS leads [(1.0±1.5) vs.(0.5±0.8),t=-4.04,P＜0.01],longer duration of QRS [(87.2±10.7) ms vs.(84.1±8.9) ms,t=-3.09,P＜0.01].Moreover,patients with fQRS had a lower level of high density lipoprotein cholesterol (HDL-C) [M(Q25,Q75),0.9 (0.8,1.1) mmol/L vs.1.0 (0.9,1.2) mmol/L,t=-2.84,P＜0.01] and a higher Gensini score [40 (8-76) vs.22 (16-2),t=8.63,P＜0.01] compared with those without fQRS.Furthermore,Logistic regression analysis showed that HDL C (OR=0.346,95％CI:0.163 0.674,P＜0.05),fQRS (OR=2.215,95％ CI:1.381-3.725,P＜0.05) and the number of fQRS leads (OR=4.613,95％ CI:2.412-9.578,P＜0.05) were independent risk factors for patients with high Gensini score,and there was a positive correlation between fQRS and Gensini scores (=0.624,P＜0.01).Conclusions fQRS might be a noninvasive indicator of severity of coronary artery lesions for elder patients with complex coronary lesions.
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Objectives To evaluate the efficacy and safety of administering Ivabradine in the elder patients with chronic heart failure(HF).Methods Totally 52 outpatients with chronic stable HF in Fuwai Hospital and Anzhen Hospital from August 2015 to February 2016,with heart rates (HR)of ＞70 bpmafter optimized medical therapy were selected and administrated Ivabradine for 3 months(Ivabradine group).50 patients who received optimized medical therapy except Ivabradine for economic or other reasons were recruited as control group during the same period.Initial dose of Ivabradine was 2.5 mg two times a day,up to a maximum of 7.5 mg two times a day,adjusting the dose according to HR.Resting HR of the patients was maintained around 60 beats/min and not lower than 55 beats/min.HR,N-terminal pro-brain natriuretic peptide (NT-proBNP),6-minute walk distance,Minnesota heart failure quality of life(MLHFQ),left ventricular ejection fraction(LVEF) and adverse effects were recorded.Results At baseline,no significant differences were found in HR,NT-proBNP,the scores of MLHFQ,6-minute walk distance (all P＞ 0.05) between Ivabradine group and control group.After 3 months of treatment,compared with control group,Ivabradine group showed significantly decreased levels of HR,the scores of MLHFQ and NT-proBNP(allP＜0.01),and significantly increased 6-minute walk distance and LVEF(all P＜0.01).Compared with baseline data,Ivabradine treatment showed the decreased levels of HR [(69.5 ± 10.2)bpm vs.(80.2 ± 7.8)bpm,P＜0.05],the scores of MLHFQ [(14.9±4.3)scores vs.(23.5±6.2)scores(P＜0.05)]and NT-proBNP [1 682 ng/L (212-3 628) vs.2 450 (254-5 344) ng/L,P ＜ 0.05] significantly,and showed the significantly increased levels of 6-minute walk distance [(386.4 ± 101.8)m vs.(282.9 ± 86.3)m,P＜ 0.05]and LVEF [(40.0±6.0)％vs.(31.0±7.0)％ (P＜0.05)].Few adverse effects were recorded.Conclusions In elderly outpatients with stable HF,Ivabradine treatment is effective and safe.
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Objective To discuss the clinical efficacy of hot-tonifying needling in treating stomachache due to deficient cold in spleen-stomach.Method Forty patients with stomachache due to deficient cold in spleen-stomach were divided into a treatment group and a control group by using random number table method according to registration order, 20 cases in each group. The control group was intervened by twisting tonifying method, while the treatment group was intervened by hot tonifying needling method. The Visual Analogue Scale (VAS) was observed before and after the treatment, and the clinical efficacies were compared.Result The VAS scores were significantly changed after the treatment in both groups (P<0.05); there was a significant difference in comparing the VAS score between the two groups after the treatment (P<0.05); the difference in the change of VAS score between the two groups was statistically significant (P<0.05). The total effective rate was 95.0％ in the treatment group, versus 60.0％ in the control group, and the difference was statistically significant (P<0.05), and there were significant differences in comparing the clinical efficacy and relapse rate between the two groups (P<0.05).Conclusion Hot-tonifying needling is effective in treating stomachache due to deficient cold in spleen-stomach, with less adverse effects and lower relapse rate.
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Objective To discuss the clinical efficacy of hot-tonifying needling in treating stomachache due to deficient cold in spleen-stomach.Method Forty patients with stomachache due to deficient cold in spleen-stomach were divided into a treatment group and a control group by using random number table method according to registration order, 20 cases in each group. The control group was intervened by twisting tonifying method, while the treatment group was intervened by hot tonifying needling method. The Visual Analogue Scale (VAS) was observed before and after the treatment, and the clinical efficacies were compared.Result The VAS scores were significantly changed after the treatment in both groups (P<0.05); there was a significant difference in comparing the VAS score between the two groups after the treatment (P<0.05); the difference in the change of VAS score between the two groups was statistically significant (P<0.05). The total effective rate was 95.0％ in the treatment group, versus 60.0％ in the control group, and the difference was statistically significant (P<0.05), and there were significant differences in comparing the clinical efficacy and relapse rate between the two groups (P<0.05).Conclusion Hot-tonifying needling is effective in treating stomachache due to deficient cold in spleen-stomach, with less adverse effects and lower relapse rate.
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? AIM: To explore the curative effect of dacryocystorhinostomy under endoscopy with mitomycin for the treatment of chronic dacryocystitis.?METHODS: Totally 73 cases ( 78 eyes ) with chronic dacryocystitis were treated with dacryocystorhinostomy under endoscopy with mitomycin and followed up for 6-12mo.?RESULTS: In the 73 patients, 66 cases with 70 eyes (90%) were cured, 2 cases with 3 eyes (4%) improved, 5 cases with 5 eyes ( 6%) not changed. In the recurrent 5 eyes, 2 eyes were treated under endoscopy to remove granulation, enlarge the opening, then anesthetic tube was placed after cotton sheet with 0. 4g/L mitomycin was put on the incision for 5min. The rest 3 eyes were treated in superior hospital with laser, and all were successful. There was no severe complication observed.?CONCLUSION:Dacryocystorhinostomy under endoscopy with mitomycin for chronic dacryocystitis is effective.
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Objective To compare the effect of atorvastatin and rosuvastatin on myocardial injure and inflammatory factors in patients with unstable angina pectoris(UAP)undergoing percutaneous coronary intervention(PCI).Methods Ninety six UAP pa-tients undergoing PCI were enrolled in the study and divided into two groups,patients were given atorvastatin(20 mg/d)or rosuv-astatin(20 mg/d)besides conventional treatment for 1 week before PCI.Datas were collected before medication,PCI and Twenty-four hours after PCI,including CK-MB,cTnI,hs-CRP,TNF-α,IL-6 and IL-10.Results Twenty-four hours after surgery,the PCI, CK-MB,cTnI,hs-CRP,TNF-α,IL-6 of rosuvastatin group were lower than those of atorvastatin group(P <0.05),but IL-10 of ro-suvastatin group was higher than that of atorvastatin group(P <0.05).Conclusion Rosuvastatin (20 mg/d)is better than atorvas-tatin (20 mg/d)in the efficacy of UAP patients undergoing PCI,which can reduce the level of myocardial injure and inflammatory factors effectively.
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Objective The present study was designed to investigate the efficiency of simvastatin therapy for experimental pul‐monary hypertension (PH) in rat ,and the effects on the number and function of circulating endothelial progenitor cells (EPC) . Methods Twenty four Sprague Dawley rats were divided into 3 groups randomly :model group ,treatment group and control group , 8 rats in each group .Rats were treated with a single subcutaneous injection of monocrotaline to induce PH (PBS used as control) . The rats in the experimental group were administrated with simvastatin 3 days following subcutaneous injection of monocrotaline .In the 21st day ,the number of circulating EPC ,the right ventricle systolic pressure of rat ,pulmonary vascular structural changes and the quantity of cultured EPC were measured .At the same time ,EPC in each group were cultured in vitro ,then the ability of prolif‐eration and function were analyzed and compared .Results The number of circulating EPC in model group was decreased signifi‐cantly compared to both control and model groups (P< 0 .01) .Compared with model group ,simvastatin treatment markedly de‐creased the RVSP and the ratio of media thickness to eternal diameter (P<0 .01) ,but the ratio of vessel area to total arterial area (VA/TAA) was definitively increased(P<0 .01) .After 7 days of culture in vitro ,both the output of EPC and the ability of prolif‐eration ,conglutination and migration of EPC in treatment group were up -regulated compared with those in model group (P<0 .01) .Conclusion This study confirmed that simvastatin effectively treat experimental PH through improving quantity and func‐tion of circulating EPC .
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<p><b>BACKGROUND</b>A number of studies have demonstrated the rates of overall and aneurysm-related mortality and morbidity in Western populations. The cardiovascular risk factors influencing postoperative outcome have been also reported. Until recently, little has been known about the prognosis in this patient cohort in the Chinese population. We evaluated the independent predictors of mortality and morbidity in abdominal aortic aneurysm (AAA) patients undergoing elective surgical treatment and emphasized whether the coronary artery revascularization could have any effect on the overall mortality and morbidity in patients following the current guideline recommendation.</p><p><b>METHODS</b>A total of 386 patients (174 women) undergoing surgery in Beijing Anzhen Hospital from January 2008 to June 2010 were enrolled (mean age (70.6±10.5) years). Kaplan-Meier curves were constructed to compare the mortality and morbidity of AAA patients with coronary artery revascularization and those without. A Cox proportional hazards model was constructed to identify clinical factors associated with two-year outcomes. The primary outcomes were death from any cause, the pre-specified morbidity was re-hospitalization for pulmonary conditions, congestive heart failure, angina, ischemic/hemorrhagic stroke.</p><p><b>RESULTS</b>During the two-year follow-up, 34 patients died and 65 experienced re-hospitalization with pulmonary conditions, congestive heart failure, angina, or ischemic/hemorrhagic stroke. Kaplan-Meier survival analysis showed that the AAA patients with cardiac revascularization had no higher incidence of overall mortality and major morbidity than those without (log-rank test P = 0.35 and P = 0.40, respectively). Cox proportional hazards regression analysis showed that level of lowdensity lipoprotein (HR, 4.06; 95% CI: 1.19-18.7, P = 0.027) and AAA size (HR, 2.18; 95% CI: 1.28-11.65, P = 0.036) were independently associated with the incidence of overall mortality. Long-term use of angiotensin converting enzyme inhibitors, statins, AAA size and systolic blood pressure were independent predictors of the secondary pre-specified outcomes.</p><p><b>CONCLUSIONS</b>Coronary artery revascularization following the guideline recommendations did not increase the mortality and morbidity of Chinese with AAA who were undergoing repair. Absence of angiotensin converting enzyme inhibitors and statins, AAA size, and systolic blood pressure were powerful predictors of the clinical events.</p>
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Aortic Aneurysm, Abdominal , General Surgery , Coronary Artery Bypass , Coronary Artery Disease , General SurgeryABSTRACT
ObjectiveTo investigate clinical risk factors and coronary angiographic features in young men with acute myocardial infarction (AMI).MethodsWe retrospectively studied 200 young men with AMI and compared with 104 non-CHD men,89 old men with AMI.All patients were admitted to hospital from January 2009 to December 2010 and undergone coronary angiography,and the clinic and coronary angiographic features were assessed.The relation between body mass index (BMI),smoking history,familial history of early coronary artery disease,essential hypertension,type 2 diabetes mellitus,hyperlipidemia,serum uric acid ( UA),lipids,hemoglobin (Hb),fasting blood glucose (FBG) with coronary artery disease and its severity was observed.The severity of CAD was diagnosed by the number of diseased vessel.Results In young men with AMI group,the factors such as smoking history,obesity,essential hypertension,type 2 diabetes mellitus,familial history of early coronary artery disease were remarkably different ( P ＜ 0.05 ) ; body mass index,fasting blood glucose,total cholesterol,triglyceride,low density lipoprotein cholesterol were higher than the control group ( P ＜ 0.05 ),hemoglobin was lower than the control group ( P ＜ 0.05 ).Applying Logistic regression analysis,obesity ( OR =11.020),type 2 diabetes mellitus ( OR =5.805 ),essential hypertension ( OR =4.428 ),familial history of early coronary artery disease ( OR =2.883 ),smoking history ( OR =2.153 ) and lower concentration hemoglobin ( OR =1.034) are independent risk factors (P ＜ 0.05) for young men with AMI. According to coronary angiography in young men with AMI,there were 14 cases with zero-vessel disease,109 cases with singlevessel disease (54.50％,69 cases involved with left anterior descending artery) and 42 cases with twovessel disease,35 cases with three-vessel disease.The ratio of single vessel disease involved left anterior desending artery in young men was higher than that of old men with AMI ( P ＜ 0.05 ).Conclusions Obesity,type 2 diabetes mellitus,essential hypertension,familial history of early coronary artery disease,smoking history and lower concentration of hemoglobin are risk factors of young men with AMI ; Single vessel coronary disease is seen more frequently in young men with AMI.