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Objective This study aimed to determine the association of hyperlipidemia with clinical endpoints among hospitalized patients with COVID-19, especially those with pre-existing cardiovascular diseases (CVDs) and diabetes. Methods This multicenter retrospective cohort study included all patients who were hospitalized due to COVID-19 from 21 hospitals in Hubei province, China between December 31, 2019 and April 21, 2020. Patients who were aged < 18 or ≥ 85 years old, in pregnancy, with acute lethal organ injury (e.g., acute myocardial infarction, severe acute pancreatitis, acute stroke), hypothyroidism, malignant diseases, severe malnutrition, and those with normal lipid profile under lipid-lowering medicines (e.g., statin, niacin, fenofibrate, gemfibrozil, and ezetimibe) were excluded. Propensity score matching (PSM) analysis at 1:1 ratio was performed to minimize baseline differences between patient groups of hyperlipidemia and non-hyperlipidemia. PSM analyses with the same strategies were further conducted for the parameters of hyperlipidemia in patients with increased triglyceride (TG), increased low-density lipoprotein cholesterol (LDL-C), and decreased high-density lipoprotein cholesterol (HDL-C). Mixed-effect Cox model analysis was performed to investigate the associations of the 28-days all-cause deaths of COVID-19 patients with hyperlipidemia and the abnormalities of lipid parameters. The results were verified in male, female patients, and in patients with pre-existing CVDs and type 2 diabetes. Results Of 10 945 inpatients confirmed as COVID-19, there were 9822 inpatients included in the study, comprising 3513 (35.8%) cases without hyperlipidemia and 6309 (64.2%) cases with hyperlipidemia. Based on a mixed-effect Cox model after PSM at 1:1 ratio, hyperlipidemia was not associated with increased or decreased 28-day all-cause death [adjusted hazard ratio (
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , COVID-19/therapy , Cardiovascular Diseases/complications , Case-Control Studies , Cause of Death , China/epidemiology , Diabetes Mellitus, Type 2/complications , Hospitalization , Hyperlipidemias/complications , Propensity Score , Proportional Hazards Models , Retrospective Studies , Risk FactorsABSTRACT
Objective::Based on LC-MS and molecular docking strategy, to study the pharmacodynamic material basis of Jinqi Jiangtang tablets in the treatment of type 2 diabetes mellitus(T2DM). Method::UPLC-Q-TOF-MS was used to identify the chemical constituents of Jinqi Jiangtang tablets. On this basis, the disease targets were screened based on the online disease target database and protein-protein interaction(PPI). The molecular docking technology was used to verify the relationship between the chemical constituents and disease targets in Jinqi Jiangtang tablets, so as to find out the potential pharmacodynamic basis of Jinqi Jiangtang tablets in the treatment of T2DM. Result::Based on UPLC-Q-TOF-MS, 51 chemical constituents were identified in Jinqi Jiangtang tablets, including 31 astragalus, 16 coptis and 4 honeysuckle. The key targets of catalase from micrococcus lysodeiktic(CAT) receptor, peroxisome proliferative actived receptor(PPARG) receptor and insulin(INS) receptor were identified by CTD database, topological analysis and related literature. Based on LC-MS and molecular docking technology, we found that magnoflorine, coptisine, epiberberine, astragaloside Ⅳ, caffeic acid, palmatine, berberine, jateorhizine, berberubine, berberastine, groenlandne, lycoranine B, demethyleneberberine, isomucrontolula-7-O-glucoside and calycosin-7-O-glucoside were used to treat type 2 diabetes potential pharmacodynamic material basis of urinary diseases. Conclusion::Protein interaction and network topology analysis are helpful for the rapid localization of core targets. In addition, molecular docking technology can realize large-scale virtual screening of potential candidate compounds. The integration of LC-MS and molecular docking technology can facilitate and quickly find the potential pharmacodynamic substance basis in traditional Chinese medicine prescriptions, and provide a reference for subsequent drug activity screening experiments.
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The liver plays a central role in hemostasis as the site of synthesis of most procoagulant and anticoagulant factors, and the clearance of many hemostatic and fibrinolytic components. On one hand, the decreased synthetic capacity of the liver due to end-stage liver diseases（ESLD） results in decreased hepatocyte-derived hemostatic proteins in plasma. On the other hand, intrahepatic and systemic inflammation in liver diseases results in chronic endothelial cell activation with additional consumption of platelets and hemostatic proteins. This two-way change makes the clotting state of end-stage liver disease extremely complicated and unpredictable. The common laboratory tests, such as prothrombin time (PT) and activated partial thromboplastin time (aPTT), cannot precisely reflect the change of hemostasis in vivo in ESLD. Thus, in-depth understanding this disorder with more comprehensive tests, can more effectively promote the progress of diagnosis and treatment of coagulopathy in ESLD. This article reviews the characteristics of changes in coagulation function, related detection methods, treatment and prevention in ESLD.
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Objective To investigate the evaluation of the doctor-patient trust by family members based on the general interpersonal trust scale, and explore the influencing factors of the evaluation of doctor-patient trust by patient family members, and to provide references for improving the doctor-patient trust and the doctor-patient relationship. Methods A survey of 3010 patient family members in 10 hospitals from 5 provinces in China was conducted using a self-made questionnaire and a general interpersonal trust scale. Results Only 47.2% of the family members agreed that the doctor-patient trust degree was good, and the interpersonal trust score was (70.52±7.07) points. The age, monthly income level, life satisfaction of family members are the important factors affecting the evaluation of doctor-patient trust (P < 0.05). Conclusion The patient family members have low recognition of doctor-patient trust, and some targeted measures should be taken to improve the interpersonal trust level and life satisfaction of the family members, so as to further enhance the doctor-patient trust.
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<p><b>OBJECTIVE</b>To review our experience in surgical management of proximal anterior cerebral artery (A1) aneurysms in 23 patients.</p><p><b>METHODS</b>Between January, 2004 and December, 2014, 23 patients (1.6%) with A1 aneurysms diagnosed by CTA or DSA were treated surgically. The "3H" therapy was adopted for postoperative prevention of cerebrovascular spasm. All the patients were followed up and examined with cerebrovascular CTA at 6, 12, 48 and 60 months after the operation with their Glasgow Outcome Scale score recorded.</p><p><b>RESULTS</b>The patients consisted of 15 men and 8 women with an age range of 16 to 72 years (mean 51.3 years). The average diameter of the aneurysms was 5.8 mm, ranging from 3.2 to 9.7 mm. Twenty-two saccular aneurysms were found in these patients; 21 patients presented with SAH and two had vascular malformation. All the A1 aneurysms were managed through the pterional approach, and the mean postoperative Glasgow Outcome Scale score was 4.8.</p><p><b>CONCLUSION</b>Thorough analysis of the angiographic data is essential for the diagnosis and treatment of A1 aneurysms. Preservation of the perforators and prevention of aneurysm rupture are critical during the surgery. Full exposure of the Sylvian fissure and temporary occlusion of the parent artery ensures safe and effective dissection of A1 aneurysms.</p>
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Objective: To compare the advantages and disadvantages of the intraluminal suture, electrocautarization of middle cerebral artery combined with unilateral ligation of common carotid artery and electrocautarization of middle cerebral artery combined with bilateral ligation of common carotid artery for establishment of focal cerebral ischemia models in rats. Methods: The focal cerebral ischemia rat models were induced by 3 means. Twenty rats were randomly allocated into intraluminal suture group (n = 6), electrocautarization with unilateral ligation group (n = 7), and electrocautarization with bilateral ligation group (n = 7) according to the different methods for establishment of the rat model. A laser Doppler flow metry was used to detect the relative values of the cerebral blood flow before and after cerebral infarction. The neurological deficit scores of models were measured after 24 h, and the brain slices were stained with 2,3,5-triphenyl tetrazolium chloride. The volume of cerebral infarction was calculated. Results: Circled digit oneThe neurological deficit scores in the intraluminal suture group (9.6 ± 0.6) and the electrocautarization with bilateral ligation group (9.8 ± 0.6) were higher than those in the electrocautarization with unilateral ligation group (5.7 ± 0.7). The differences were statistically significant (P < 0.01). Circled digit twoThe volume of cerebral infarction in the intraluminal suture group (131.5 ± 15.8) mm3 and the electrocautarization with bilateral ligation group (141.7 ± 19.8) mm3 were larger than that in the electrocautarization with unilateral ligation group (39.9 ± 11.4) mm3. The differences were statistically significant (P < 0.01). Circled digit threeThe relative value of cerebral blood flow (CBF) in the electrocautarization with bilateral ligation group was lower than that in the electrocautarization with unilateral ligation group. The difference was statistically significant (P < 0.05). After reperfusion, the relative value of CBF in the intraluminal suture group was higher than that in the electrocautarization with bilateral ligation group. The difference was statistically significant (P < 0.05). Conclusion: The three methods had their advantages and disadvantages in inducing focal cerebral ischemia model in rats. A different model should be used according to the purposes of research.