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Objective:To investigate the effect of intravenous anesthesia on the detection rate of lesions in diagnostic gastroscopy.Methods:A total of 9 071 subjects who underwent diagnostic gastroscopy at the Digestive Endoscopy Center of Yangzhou University Affiliated Hospital from March 2021 to February 2022 were selected. Data were collected from the gastroscopy quality control system, including age, gender, examination physician, Helicobacter pylori infection, examination method, withdrawal time, number of images left, number of biopsies, biopsy site, gastroscopy diagnosis, pathological diagnosis, etc. They were divided into anesthesia group and general group based on the examination method, and propensity score matching (PSM) was performed on the two groups of subjects. Excluding confounding factors, the detection of lesion location and lesion type in two groups of subjects was analyzed; Simultaneously, univariate and multivariate logistic regression analysis was used to analyze the influencing factors of the detection rate of precancerous lesions and malignant tumors in the upper gastrointestinal tract.Results:After PSM, 1 655 subjects were included in both groups. In terms of lesion location, the detection rate of gastric body lesions in the anesthesia group was higher than that in the general group ( P<0.05), and the detection rate of esophageal lesions in the anesthesia group was lower than that in the general group ( P<0.05); In terms of lesion types, the detection rate of precancerous lesions such as gastric polyps, mucosal protrusions, mucosal atrophy, and intestinal metaplasia in the anesthesia group was higher than that in the general group (all P<0.05). The results of logistic regression analysis showed that intravenous anesthesia was an independent influencing factor for the detection rate of precancerous lesions and malignant tumors in diagnostic gastroscopy ( OR=1.338, 95% CI: 1.070-1.674, P<0.05). Conclusions:Intravenous anesthesia is an independent influencing factor for the detection rate of precancerous lesions and malignant tumors in diagnostic gastroscopy, and can improve the detection rate of upper gastrointestinal lesions.
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Objective:To investigate the relationship between double mutations of myosin heavy chain gene (MYH6) p.Gly743Arg and p.Glu1389Lys and the cardiac phenotype.Methods:Patients carrying double mutations in the MYH6 gene p.Gly743Arg and p.Glu1389Lys were screened from 52 unrelated left ventricular hypertrophy (LVH) who were admitted to the Second Hospital of Chongqing Medical University from 2015 to 2020, and the genetic testing of peripheral blood of patients by second-generation whole-exome sequencing assay technology and genomic DNA of their family members Sanger sequencing was performed to validate the genomic DNA of the family members. The cardiac phenotype was evaluated by electrocardiogram, coronary computed tomography angiography (CTA), echocardiography, and cardiac magnetic resonance imaging (MRI) as adjuncts.Results:All whole-exome gene were detected in 52 unrelated patients with LVH, of which 1 patient (1.9%) had double mutations in MYH6 gene p.Gly743Arg and p.Glu1389Lys (proband). Two members of the maternal line of this patient carried p.Glu1389Lys mutation, but there was no obvious clinical phenotype. Two members of the paternal line carried p.Gly743Arg mutation and had obvious clinical phenotype of bradycardia, but there was no LVH. The male proband, aged 21 years old, presented with LVH and sinus bradycardia but no coronary artery stenosis on CTA before treatment, MRI showed that the left ventricular end diastolic diameter was 58 mm. After treatment with angiotensin receptor-enkephalinase inhibitor (ARNI), electrocardiogram showed that the heart rate increased significantly (from 43 bpm to 72 bpm). Echocardiography showed that the left ventricular end diastolic diameter decreased significantly (from 60 mm to 49 mm).Conclusions:The p.Glu1389Lys mutation of the MYH6 gene may not manifest the phenotype of heart disease. MYH6 gene p.Gly743Arg mutation may be manifested asymptomatic sinus bradycardia, but there is no LVH phenotype. The cardiac disease phenotype caused by the double mutations of p.Gly743Arg and p.Glu1389Lys in the MYH6 gene is more obvious. Asymptomatic LVH and sinus bradycardia can appear in adolescence, but the LVH phenotype can be reversed in a short period of time after ARNI treatment.
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Objective:To investigate the lowering effect on lipid and safety of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor in patients with extremely high risk atherosclerotic cardiovascular disease (ASCVD).Methods:The outpatients and in-patients with extremely high risk ASCVD admitted to the Second Affiliated Hospital of Chongqing Medical University from April to October in 2019 were enrolled. The enrolled patients were divided into two groups by random number table method. The patients in the atorvastatin group were given only 20 mg atorvastatin orally every night for 4 weeks. In the combined group, oral atorvastatin was administered with subcutaneous injection of 140 mg evolocumab, a PCSK9 inhibitor, once every 2 weeks, and the course of treatment was 4 weeks. Serum lipid profile was measured before and 4 weeks after treatment, including triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and lipoprotein-a (Lp-a). Adverse events were recorded.Results:During the study period, a total of 40 patients were enrolled, with 20 patients in the atorvastatin group and 20 in the combined group. There was no significant difference in blood lipid profile before treatment between the two groups. After 4 weeks of treatment, the levels of TC and LDL-C in the two groups and Lp-a level in the combined group were significantly lower than those before treatment, while the levels of TG and HDL-C in the two groups were not statistically significant. Further analysis showed that the differences in TC, LDL-C and Lp-a between before and after treatment in the combined group were significantly higher than those in the atorvastatin group [TC difference (mmol/L): 2.78±1.98 vs. 0.54±0.83, LDL-C difference (mmol/L): 1.91±1.38 vs. 0.39±0.72, Lp-a difference (mg/L): 115.87±138.93 vs. -84.19±251.85, all P < 0.05]. Only 1 patient in the combined group developed allergic reaction, mainly manifested as skin rash, who alleviated after anti-allergic treatment. No other adverse reactions such as abnormal liver function and increased myozyme occurred in the two groups. Conclusion:PCSK9 inhibitor could rapidly and effectively reduced the levels of TC, LDL-C and Lp-a in extremely high risk ASCVD patients, while had little effect on the levels of TG and HDL-C. It is safe to some extent.
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OBJECTIVE@#To explore the compliance of extramural hospital treatment and the long-term survival status in patients with acute myocardial infarction (AMI) in Chongqing. @*METHODS@#A total of 636 patients with AMI, from grade 3 and first-class hospitals in Chongqing during Jan 2005 and Jan 2009, were enrolled for this study. The patients were followed-up for 5 years to investigate the extramural hospital treatment and influential factors. @*RESULTS@#A total of 574 patients finished a five-year follow-up, and 180 cases died from cardiac death. The mortality was 31.4%. The poor compliance was a major feature in the pass away patients. @*CONCLUSION@#The low treatment compliance is the independent risky factor for 5-year prognosis.
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Humans , Acute Disease , Hospitals , Myocardial Infarction , Mortality , Therapeutics , Patient Compliance , Prognosis , Risk Factors , Survival AnalysisABSTRACT
Objective To observe the incidence of fragmented QRS complex (fQRS)and ST Segment depression fQRS (STD fQRS)during the first 48 hours after non-ST elevation myocardial infarction(NSTE MI)and discuss the value of predicting mortality in patients with NSTE MI .Methods Based on the ECGs ,the patients with NSTE MI were divided into two groups :fQRS and non fQRS group .And then fQRS group was divided into two sub-groups :STD fQRS and non-STD fQRS group .Their mortality was studied during long-term follow-up .Results (1)731 patients with NSTE ACS [the NSTE MI group(n=609) and the UA group(n=122)] were studied .The incidence of fQRS in the NSTE MI group was higher than that of the UA group .(2)All cause mortality in the fQRS group were higher than that in the non-fQRS group ,and all-cause mortality in the STD fQRS group were higher than that in the non-STD fQRS group ,all the above results were not only in the early stages of NSTE MI ,but also in the long term fol-low-up .(3) Multivariate Cox regression analysis revealed that STD fQRS was an independent significant predictor for all cause mortality ,but not of the fQRS .Conclusion The STD fQRS may be an independent predictor of mortality in patients with NSTE MI .
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One hundred and forty six elderly patients with constipation undergoing colonoscopy during March 2012 and August 2013 were randomly assigned to trial and control groups.Seventy patients in trial group received Macrogol electrolytes powder combined with Chinese herb medicine Simo decoction for bowel preparation and 76 patients in control group received macrogol electrolytes powder only.The first defecation,times of defecation and tolerance of patients were compared between two groups.The quality of bowel preparation was evaluated by endoscopists with Boston Bowel Preparation Scale (BBPS).The first defecation time was shorter in trial group than that in control group (55.7 ± 27.9 vs.72.9 ± 34.8,P ＜ 0.05).However,no statistical significance was found in the times of defecation and tolerance of patients between two groups.The mean BBPS score in trial groups was higher than that in control group (7.87 ± 1.08 vs.6.97 ± 0.96,P ＜ 0.05).Chinese herb medicine Simo decoction combined with conventional method shows satisfactory result for bowel preparation in elderly patients with constipation undergoing colonoscopy.
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Induced pluripotent stem(iPS)-cell technology is a great breakthrough in stem cell research field in recent years, it is not only injecting new vitality for the research of reprogramming of somatic cell, but also bringing a new dawn to the study of mechanism of disease and development of regenerative medicine. As key issues of iPS-cell technology, the study of iPS cell induction system has progressed in the composition of transcription factor, gene delivery, as well as induction efficiency. In this article, research advance of iPS cell induction system in recent years is reviewed and the prospect is discussed as well.
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Objective:To compare the efficacy and safety between cryoablation(Cryo)and radiofrequency (RF)ablation in patients with atrioventricular nodal reentrant tachycardia(AVNRT). Methods: A total of 83 patients with AVNRT underwent electrophysiological treatment in our hospital from October 2006 to March 2009 were studied. Patients were divided into two groups according to their own choices. Cryo group (n=41) and RF group (n=42). The clinical characteristics,success rate,procedural time and ablative time were compared between two groups. Results:The procedural time and ablative time in Cryo group was significantly longer than those in RF group (119.14±40.16 min vs.85.86±28.24 min,P=0.001; 1118.91±620.62 s vs.370.97±279.23 s,P<0.001). The acute success rate was achieved in 40/41(97.6%)patients in Cryo group,and 42/42(100.0%) in RF group. Transient AV-block was encountered in 6 (15%) patients in the Cryo group and 5 (11.9%) in RF group (P=0.681). There was no complete atrial-ventricular(AV)conduction block at the end of procedures. There was no recurrence of AVNRT in either Cryo group nor in RF group during 11.6±5.5 months of follow up period.Conclusion:Cryoablation was as effective and safe as RF ablation for AVNRT. Cryo-energy was one kind of alternative ablation energy for AVNRT.
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<p><b>OBJECTIVE</b>To explore the relationship between body mass index, waist circumference and blood pressure among residents in Chongqing area.</p><p><b>METHODS</b>A total of 5246 residents aged 15 and over in Chongqing area were enrolled in this study by use of stratified sampling and cluster sampling methods. Data on blood pressure (SBP, DBP), pulse, height, body weight, waist and hip circumferences as well as questionnaire survey were analyzed.</p><p><b>RESULTS</b>The level of SBP and DBP and hypertension prevalence rate were significantly positively correlated with BMI (all P < 0.01). SBP, DBP levels and hypertension prevalence rate were significantly higher in people with abdomen obesity than people with normal waist circumference (all P < 0.01). BMI, waist circumference in hypertensive residents were significantly higher than non-hypertensive residents (all P < 0.01).</p><p><b>CONCLUSION</b>Blood pressure level and hypertension prevalence rate were closely related with BMI and waist circumference among residents in Chongqing area.</p>
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Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Blood Pressure , Body Mass Index , China , Epidemiology , Heart Rate , Hypertension , Epidemiology , Prevalence , Risk Factors , Rural Population , Urban Population , Waist Circumference , Waist-Hip RatioABSTRACT
<p><b>OBJECTIVE</b>This study was designed to compare clinical efficacy of segmental pulmonary vein ablation (SPVI), amiodarone or amiodarone plus losartan on sinus rhythm maintenance in patients with lone paroxysmal atrial fibrillation (PAF).</p><p><b>METHODS</b>Patients with lone PAF were treated with amiodarone alone (A, n = 52), segmental pulmonary vein isolation (SPVI, n = 51), or amiodarone plus losartan (AL, n = 51). The primary endpoint of this study was the incidence of symptomatic atrial tachyarrhythmia (> 30 s) documented by 12 lead ECG or Holter during 12 months follow-up period.</p><p><b>RESULTS</b>During follow-up, AF was documented in 24 patients (46.2%) in A group, 11 patients (21.6%) in SPVI group and 12 (23.5%) in AL group (P < 0.05 vs. A group). The Kaplan-Meier survival analysis demonstrated a significant equally reduction in AF recurrence in SPVI and AL groups (P = 0.009, log-rank test and P = 0.018, log-rank test, respectively) compared with A group. The hazard ratio for AF recurrence in patients treated with SPVI and amiodarone plus losartan was 0.41 (95% CI 0.200 to 0.848, P = 0.016) and 0.46 (95% CI 0.225 to 0.953, P = 0.036), respectively. Incidences of major adverse cardiac events were similar among the groups (9.6% in A, 3.9% in SPVI and 7.8% in AL group, P > 0.05).</p><p><b>CONCLUSION</b>The results of this study suggest that the segmental pulmonary vein isolation and amiodarone plus losartan are superior to amiodarone alone for preventing AF recurrence in patients with lone PAF.</p>
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Aged , Humans , Middle Aged , Amiodarone , Therapeutic Uses , Anti-Arrhythmia Agents , Therapeutic Uses , Atrial Fibrillation , Therapeutics , Catheter Ablation , Methods , Combined Modality Therapy , Follow-Up Studies , Losartan , Therapeutic Uses , Prospective Studies , Treatment OutcomeABSTRACT
Background Coronary slow flow(CSF)phenomenon is characterized by delayed opacification of coronary vessels in normal coronary angiogram.Although clinical and pathological features have been previously described,its pathogenesis remains unclear.Objective To explore the risk factors related to coronary slow flow.Methods Thirty three patients with documented coronary slow flow which were defined according to TIMI frame count method(TFC)and 33 patients with normal coronary flow were enrolled.Clinical data and biochemical parameters were determined.Results Baseline data analysis showed that CSF group had higher baseline level of platelets count [(149.2?41.5)?109 vs(128.1?38.7)?109,P=0.037] and serum uric acid [(328.1?85.2)vs(282.8?82.4)?mol/L,P=0.032],while other variables were similar between the two groups.After adjustment for BMI,total cholesterol,urea,logistic regression showed that blood platelets count(?2=8.350,?=0.026,P=0.004),2-hour postprandial blood glucose(?2=4.920,?=0.289,P=0.026)and serum uric acid level(?2=5.305,?=0.009,P=0.021)were independent predictors for CSF.Conclusion These data suggest that elevated blood platelets count,2-hour postprandial blood glucose and serum uric acid level may predisposed to coronary slow flow.
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Objective To explore the effect of xanthine oxidase inhibitors allopurinol on collagen remodeling of non-infarcted myocardium after myocardial infarction in rats.Methods Myocardial infarction models were produced by ligation of anterior descending coronary artery.The survivals were randomly divided into 3 groups:sham operation group, MI group and allopurinol group(50 mg/kg).On the 7th, 14th, 21st and 28th day respectively, the collagen content were examined. The type Ⅰ and type Ⅲ collagen volume fraction(CVF) and Ⅰ/Ⅲ ratio in non-infarcted zones(NIZ) were examined with PSR staining, mRNA expressions were detected with RT-PCR, the activities of xanthine oxidase(XO) and O—?2,?OH-scavenging in NIZ were examined by colorimetry.In addition, the expression of XO protein by Western blotting analysis and pathological change in LV were detected on the 28th day.ResultsCompared with sham group,the mRNA expressions, CVF of typeⅠand type Ⅲ collagen in NIZ were increased in MI group.The typeⅠ/Ⅲ ratio in NIZ was increased after decreased.The collagen content and activity of XO were boosted but the activities of O—?2,?OH-scavenging were decreased(P
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Objective To investigate the effects of pravastatin on the expressions of hyperpolarization-activated cyclic nucleotide-gated channel subunits,HCN2 and HCN4 of right ventricular after myocardial infarction (MI) in rats. Methods Sprague-Dawley rats MI model was induced by ligating the left anterior descending coronary artery,and then 20 MI rats were randomly and equally divided into 24-hour group,1-week group,4-week group and pravastatin group (20 mg?kg-1?d-1 for 4 weeks by gavage). Another 5 rats served as sham-operation group. Real-time PCR and Western blotting were used to measure the mRNA and protein expressions of HCN2 and HCN4 in the heart tissues of each group. Results The mRNA and protein expressions of HCN2,and mRNA expression of HCN4 were up-regulated in 4-week group and pravastatin group compared with sham-operation group. The expression of HCN2 in pravastatin group were markedly attenuated compared with 4-week group. The protein expression of HCN4 was not detected in all groups. Conclusion The expression of HCN2 and HCN4 were up-regulated in myocardial infarction rats. Pravastatin may reverse the up-regulated expressions of HCN2 at mRNA and protein levels.
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Objective To explore the effect of xanthine oxidase inhibitor allopurinol on cardiomyocyte apoptosis in rats after myocardial infarction(MI).Methods MI model was established by the ligation of anterior descending coronary artery.The survivors were randomly divided into 3 groups: sham operation group(n=5),MI group(n=16) and allopurinol group(n=15,receiving allopurinol 50 mg?kg-1? d-1).After 28 days,the infarct size was measured.In non-infarcted zone(NIZ),cardiomyocyte apoptosis was detected by TUNEL;the expression of Fas was detected by immunohistochemistry;the expressions of xanthine oxidase(XO) and caspase 3 were detected by Western blot.In addition,the activities of XO and ?O-2,?OH-scavenging in NIZ were detected by colorimetry.Results Compared with sham operation group,the apoptosis index and expressions of Fas,XO,caspase 3 in NIZ were significantly increased in MI group.The activity of XO was increased but the activities of ?O-2 and ?OH-scavenging were decreased(P0.05).Conclusion Allopurinol could inhibit the cardiomyocyte apoptosis in NIZ in rats.The protective mechanism of allopurinol involves the reduction of reactive oxygen species and depression of the expressions of Fas and caspase 3.
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Objective To investigate the modulation of electrophysiological properties of hyperpolarization-activated cyclic nucleotide-gated channels(HCN) HCN1 and HCN2 by transfecting MinK-related peptide 1(MiRP1) in Chinese hamster ovarian(CHO) cells.Methods CHO cells were co-transfected with plasmid DNA encoding either of the cardiac HCN isoforms(HCN1,HCN2) with MiRP1 to observe the effect of MiRP1 on HCN whole-cell currents.Whole-cell patch clamp technique was used to record the 2 channel currents of the transfected cells.Results MiRP1 significantly increased whole-cell current density of HCN2 [(37.8?4.8) pA/pF(n=11) vs control(25.9?1.7) pA/pF(n=10);at-140 mV,P0.05].Moreover,MiRP1 accelerated the activation kinetic of HCN1 [tau(180.9?8.6) ms vs control(306.1?45.6) ms;at-80 mV,P
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PURPOSE: To know whether the cardiac function of the patients with heart disease is impaired or improved after long-term taking ?-AR antagonists. METHODS: After giving the rats ?-AR selective antagonist, atenolol, for 12wk, the method of radioligand binding assay and the experiment of isolated left-atrium contractive function were carried out to observe the quantity and distribution of ?-AR, its subtypes, ?-AR, and the change of left - atrium contractive function. RESULTS: After long-term administration of atenolol, there were no any obvious changes in ?-AR, the density of the total ?-AR, ?1-AR, and the proportion of ?2-AR in tota1 amount of ?-AR, but the con centrat ion - response cu rves shi fted l e ftwa rd s si gn ifi cant ly as compared with control group- The PA2 value of isoprotenol(ISO) - induced positive inotropic effect after antagonized by ?1-AR selective antagonist CGP20712A in atenolol group was increased significantly as compared with control group. But the PKB value after antagonized by ICI 118511 showed no obvious difference between two groups. HPLC detection showed that the level of plasma atenolol was 3. 5pmol/L in atenolol group and the leveIs of plasma norepinephrine had no significant difference between two groups. But the level of plasma adrenaline in atenolol group was obviously lower than that in control group. CONCLUSIO- N: The long-term administration of ?l-AR antagonist will cause significant increase of the sensitivity of heart ?-AR, especially ?1-AR to excitant ISO. But the number of ?-AR and its subtypes did not change significantly. Besides, after the long-term administration of ?1-AR antagonist atenolol, the level of plasma adrenaline in rats was much lower than that in control group.
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Objective:To study the ischemic myocardial angiogenesis induced by electrical stimulation below contraction threshold.Methods:24 infarcted rats were given electrical stimulation below contraction threshold for 5 days with 10Hz,15Hz,25Hz,50Hz stimulus frequencies.12 other infarcted rats were electrically stimulated with effective stimulus frequency which induced myoardial angiogenesis and treated with VEGF neutralizing antiboby,L-NAME for 5 days.Capillary density(CD),activity of NOS,expression of VEGF mRNA and protein,were detected.Results:CD,activity of NOS,expression of VEGFmRNA and protein in ischemic myocardium were significantly augmented in the 25Hz group compared with the other groups.CD and activity of NOS in ischemic myocardium significantly decreased in 25Hz+VEGF neutralizing antibody group compared with that of the 25Hz group.CD in ischemic myocardium significantly decreased in the 25Hz+L-NAME group compared with that of the 25Hz group,but expression of VEGF mRNA and protein were in the absence of changes the 2 groups.Conclusion:Myocardial angiogenesis induced by electrical stimulation below contraction threshold at 25Hz frequeney is dependent on the expression of VEGF.Nitric oxide can mediate mitogenic effect of VEGF on capillary endothelial cells.