Association of N-cadherin (CDH2) polymorphisms with schizophrenia susceptibility and clinical symptoms in Han Chinese population / 中华行为医学与脑科学杂志

Objective:A case-control association analysis was performed to investigate if the single nucleotide polymorphisms (SNPs) of N-cadherin(CDH2) gene is implicated in schizophrenia in a Han Chinese population.Methods:A total of 528 patients with paranoid schizophrenia and 528 healthy controls were recruited from northern Henan province to analyze 25 SNPs located in CDH2 gene.The clinical symptoms of 267 first-episode schizophrenia patients were evaluated with positive and negative syndrome scale (PANSS), and the correlation between CDH2 gene and clinical symptoms was analyzed by SNPStats software online.Results:Allele frequencies of rs9951577 and rs1231268 were significantly correlated with schizophrenia( P<0.05), genotype frequency of rs1639387 was significantly correlated with schizophrenia( P=0.044). After gender classification, SNPs rs1789470 and rs28365328 were found to be significantly correlated with schizophrenia in female patients ( P=0.044, 0.019). In addition, the study found that CDH2 was correlated with the clinical characteristics of schizophrenia( P<0.05), and the negative factor score of patients between GG type rs1231268 and the other two genotypes (AG+ AA) ((21.12±8.41) vs (18.87±7.52)) was statistically significant ( P<0.05). Conclusion:CDH2 gene may be one of the susceptibility genes to SZ, and has definite correlation with clinical negative symptoms.

Phenomenological study of the effects of traumatic birth events on compassion fatigue among midwives / 中国实用护理杂志

Objective:To provide theoretical reference for the construction of effective prevention and control strategies. The study deeply investigates the impact of traumatic birth events on compassion fatigue and inner feelings of midwives.Methods:Fifteen midwives from five tertiary hospitals in Guangzhou were interviewed in depth by semi-structured interview method from April to June 2021. Colaizzi analysis and Nvivo12 plus software were used to analyze and integrate the data and extract themes.Results:Three main themes were extracted, including the characteristics of traumatic birth events (high incidence, sudden and dangerous, preventable and controllable); exacerbating compassion fatigue (reducing compassion satisfaction levels; exacerbating burnout; and aggravating traumatic stress responses); and exploring effective coping strategies (time required for adjustment, seeking stress release).Conclusions:As a strong stressor, traumatic birth events aggravate the symptoms of compassion fatigue in midwives. Managers should pay attention to the occupational exposure of traumatic childbirth events, actively guide midwives to make psychological adjustments. In addition, managers can increase social support and strengthen the ideological and political education of midwives, so that they have good stress tolerance and excellent professional psychological quality.

Risk of venous thromboembolism in Chinese pregnant women: Hong Kong venous thromboembolism study

BACKGROUND: Previous Caucasian studies have described venous thromboembolism in pregnancy; however, little is known about its incidence during pregnancy and early postpartum period in the Chinese population. We investigated the risk of venous thromboembolism in a “real-world” cohort of pregnant Chinese women with no prior history of venous thromboembolism. METHODS: In this observational study, 15,325 pregnancies were identified in 14,162 Chinese women at Queen Mary Hospital, Hong Kong between January 2004 and September 2016. Demographic data, obstetric information, and laboratory and imaging data were retrieved and reviewed. RESULTS: The mean age at pregnancy was 32.4±5.3 years, and the median age was 33 years (interquartile range, 29–36 yr). Pre-existing or newly diagnosed diabetes mellitus was present in 627 women (4.1%); 359 (0.7%) women had pre-existing or newly detected hypertension. There was a small number of women with pre-existing heart disease and/or rheumatic conditions. Most deliveries (86.0%) were normal vaginal; the remaining were Cesarean section 2,146 (14.0%). The incidence of venous thromboembolism was 0.4 per 1,000 pregnancies, of which 83.3% were deep vein thrombosis and 16.7% were pulmonary embolism. In contrast to previous studies, 66.7% of venous thrombosis occurred in the first trimester. CONCLUSION: Chinese women had a substantially lower risk of venous thromboembolism during pregnancy and the postpartum period compared to that of Caucasians. The occurrence of pregnancy-related venous thromboembolism was largely confined to the early pregnancy period, probably related to the adoption of thromboprophylaxis, a lower rate of Cesarean section, and early mobilization.

Clinical Application of BI-RADS（5th Ed）Mammography Lexicon in the Category of Suspicious Calcification / 中山大学学报(医学科学版)

@#Objective】 To explore the clinical application of the fifth edition of BI- RADS for the category of suspicious calcification. 【Methods】 Mammograms of patients with suspicious calcification from May 2012 to May 2017 were reviewed retrospectively. The morphology（amorphous，coarse heterogeneous，fine pleomorphic，fine linear or fine linear branching）and distribution（diffuse，regional，grouped，linear，segmental）of suspected calcification according to the fifth edition of the BI- RADS were analyzed. Taking pathology as the gold standard，the positive predictive value（PPV）of morphology，distribution and combination of morphology and distribution was calculated and compared with the PPV range of the fifth edition of BI- RADS. 【Results】 A total of 170 patients were included in the study，116 were benign，54 were malignant，and PPV was 31.8%（54/170）. In terms of morphology，amorphous，coarse heterogeneous， fine pleomorphic calcification were category 4B（10%

Safety and effectiveness of percutaneous coronary intervention using main branch stenting in combination with side branch drug-coated balloons on coronary bifurcation lesions / 中华老年医学杂志

Objective To evaluate the safety and effectiveness of drug-eluting stents (DES)implanted in the main branch(MB)of the coronary artery combined with drug-coated balloon(DCB)inflation in the side branch(SB)in patients with coronary bifurcation lesions.Methods A total of 68 patients with true coronary bifurcation lesions(Medina 1,1,1;1,0,1;0,1,1) admitted into our hospital from June 2017 to June 2018 were enrolled in this single center observation study.Patients were treated with DES MB implantation and DCB SB inflation,and were followed up and assessed with quantitative coronary angiography(CAG)at 6 months after PCI.The primary endpoints were late lumen loss(LLL)of MB and SB at 6 months after PCI.Results DES was implanted in MB in 68 patients.DCB was used in SB in 67 patients,and DES was implanted in SB in 1 patient due to TIMI 1 flow in SB after predilation.The rate of residual stenosis was (8.9 ± 5.6) ％ in MB and (19.7 ± 6.2)％ in SB immediately after PCI.Of 68 patients,type A dissection occurred in 7 cases and type B dissection in 5 cases in MB immediately after PCI.Overall 64 patients were followed up and assessed with quantitative CAG at 6 months after PCI.The LLL of MB was (0.25±0.31)mm and the LLL of SB was-(0.12±0.38)mm.All patients' SB dissection disappeared,and 1 patient died due to cerebral hemorrhage at 2 months after PCI.The 30-day main adverse cardiac events(MACE)was 0,and 6-month MACE was 5.97％,in which 2 cases had angina pectoris at about 3 months after PCI,with CAG showing in-stent restenosis(ISR)in the left anterior descending coronary artery(LAD)and good SB.DCB was used to treat ISR.LAD was good when assessed with CAG at 6 months during follow-up.Myocardial infarction occurred in 2 cases at about 4 months after PCI,but not in the target-vessel.Conclusions DES MB implantation combined with DCB SB inflation is safe and effective in treating coronary bifurcations lesions.

Clinical characteristics and long-term prognosis of spontaneous coronary artery dissection: a single-center Chinese experience

Background and Objective: Spontaneous coronary artery dissection [SCD] remains a rare and important cause of coronary artery disease [CAD]. The purpose of this study was to describe the clinical and angiographic features in SCD and to evaluate the treatment and long-term prognosis of this condition in China

Methods: This retrospective cohort study included 118 Chinese patients with SCD confirmed by coronary angiography. Clinical and angiographic features, treatment modalities and outcomes of SCD were estimated

Results: The overall prevalence of SCD was 0.15%. Age was 57 +/- 10 years; 86% patients were men; 75% presented with acute coronary syndrome [ACS]; 72% had concomitant atherosclerotic CAD. SCD often affected right coronary artery [RCA] and caused a short dissection [< 20mm]. A conservative therapy was used in 28% of patients and revascularization in 72% [percutaneous coronary intervention [PCI] 57%; coronary artery bypass grafting [CABG] 15%]. Only one patient died during hospitalization due to multiple organ failure after CABG. During a median follow-up of 43 months [range, 1 - 158 months], 32 patients had a new-onset ACS, 9 received revascularization [7 PCI and 2 CABG], and 8 died. The Kaplan-Meier estimated 12-year rates of freedom from cardiac death and ACS were both higher in revascularization versus conservative therapy [78% versus 57%; P = 0.023; 48% versus 25%, P = 0.014]. No significant difference was found in freedom from revascularization between the two therapies

Conclusions: In China, SCD was usually associated with atherosclerosis and predominantly affected male population. SCD often affected RCA and caused a short dissection. In-hospital mortality rate was low regardless of therapeutic strategy. However, a significantly better long-term prognosis was observed in the revascularization compared with conservative therapy

Effect of levosimendan on cardiomyocyte apoptosis after coronary microembolization in swine / 中华老年心脑血管病杂志

Objective To study the effect of levosimendan on cardiomyocyte apoptosis after coronary microembolization (CME) in swine,Methods Fifteen healthy swines were randomly divided into sham operation group,CME group and levosimendan treatment group (5 in each group).Their cardiac function was assessed by echocardiography,their cardiomyocyte apoptosis was assyed with TUNEL staining,and Caspase-3 expression was detected by Western blot at 12 h after operation.Results The LVEF was lower,the left ventricular minor axis was shorter and the cardiac output volume was smaller while the LVEDD was longer in CME group than sham operation group (P＜0.05).The cardiac function was significantly better in CME group than in sham operation group (P＜0.05).The cardiomyocyte apoptosis rate and Caspase-3 expression level were significantly higher in CME group than in sham operation group (P＜0.05).The cardiomyocyte apoptosis rate was significantly higher while the Caspase-3 expression level was significantly lower in levosimendan treatment group than in CME group (6.820％±-1.974 ％ vs 10.558％±2.425％,P＜0.05).Conclusion Pretreatment with levosimendan can effecively reduce the cardiomyocyte apoptosis and improve the cardiac function after CME by inhibiting the Caspase-3 expression in cardiomyocytes.

Comparison of 5-year outcomes of zotarolimus-eluting stents and everolimus-eluting stents / 中国介入心脏病学杂志

Objective To compare 5-year clinical outcomes of the safety and efficacy of zotarolimus-eluting stent(ZES)and everolimus-eluting stent(EES).Methods A total of 480 patients receiving either ZES(n=244)or EES(n=236)placement from January 2011 to December 2012 in Wuhan Asia Heart Hospital were included in this study.The primary end point of the study was 5-year all-cause mortality including acute myocardial infarction,and target vessel revascularization after the index EES/ZES placement.The secondary end points included subsequent in-stent restenosis and in-stent occlusion at 5 years.Results There were no significant differences in all-cause mortality and acute myocardial infarction outcomes between the ZES and the EES groups(P＞0.05).Compared with patients receiving EES,patients receiving ZES had a significantly higher rate of 5-year target vessel revascularization(10.2％vs.5.1％,P=0.040),in-stent restenosis(11.5％vs.5.9％,P=0.036),and in-stent occlusion(6.1％vs.2.1％,P=0.038).Conclusions At 5 years,patients receiving EES generally had better or comparable long-term outcomes compared with patients receiving ZES.

Eff ect of early intervention on 12-month follow-up clinical prognosis in patients with high-risk non-ST-segment elevation acute coronary syndrome / 中国介入心脏病学杂志

Objective To compare 12-month follow-up clinical outcome of an early to a delayed intervention in the management of high-risk non-ST elevation acute coronary syndrome (NSTE-ACS) patients. Methods 758 consecutive high-risk NSTE-ACS patients treated with percutaneous coronary artery intervention(PCI)were enrolled between Jauary 2015 and December 2015 in Wuhan Asia Heart Hospital. They were divided into 2 groups according to diff erent intervention time, the early PCI group(within 24 h after diagnosis,n=185)and the delayed group (more than 24 h after diagnosis, n=573).The baseline clinical data, angiographic features, data related to PCI, the 12-month follow-up major adverse cardiac events (MACE) were analyzed retrospectively. MACE were defi ned as all-cause death and recurrent nonfatal myocardial infarction. Results Primary endpoint status after 12-month follow-up were collected in 711 of 758 initially enrolled patients. Incidence of MACE was 14.5% in the early and 11.2% in the delayed PCI group(χ2=1.289,P=0.256). No signifi cant diff erences were found in the occurrence of the individual components of all-cause death and nonfatal myocardial infarction. Mean hospital stay were(7.6±3.1)d in the early and (10.7±3.8)d in the delayed PCI group(t=2.489,P=0.014). Mean medical expenses in RMB were(48.5±13.5) thousand yuan in the early and(52.8±16.4)thousand yuan in the delayed PCI group(t=2.132,P=0.038). Conclusions After 12-month follow-up,no diff erence in incidence of MACE was seen between early and delayed invasive strategy,but with shorter hospital stay and reduced medical expenses.

Role of Soluble ST2 Levels and Beta-Blockers Dosage on Cardiovascular Events of Patients with Unselected ST-Segment Elevation Myocardial Infarction / 中华医学杂志(英文版)

<p><b>Background</b>Serum soluble ST2 (sST2) levels are elevated early after acute myocardial infarction and are related to adverse left ventricular (LV) remodeling and cardiovascular outcomes in ST-segment elevation myocardial infarction (STEMI). Beta-blockers (BB) have been shown to improve LV remodeling and survival. However, the relationship between sST2, final therapeutic BB dose, and cardiovascular outcomes in STEMI patients remains unknown.</p><p><b>Methods</b>A total of 186 STEMI patients were enrolled at the Wuhan Asia Heart Hospital between January 2015 and June 2015. All patients received standard treatment and were followed up for 1 year. Serum sST2 was measured at baseline. Patients were divided into four groups according to their baseline sST2 values (high >56 ng/ml vs. low ≤56 ng/ml) and final therapeutic BB dose (high ≥47.5 mg/d vs. low <47.5 mg/d). Cox regression analyses were performed to determine whether sST2 and BB were independent risk factors for cardiovascular events in STEMI.</p><p><b>Results</b>Baseline sST2 levels were positively correlated with heart rate (r = 0.327, P = 0.002), Killip class (r = 0.408, P = 0.000), lg N-terminal prohormone B-type natriuretic peptide (r = 0.467, P = 0.000), lg troponin I (r = 0.331, P = 0.000), and lg C-reactive protein (r = 0.307, P = 0.000) and negatively correlated to systolic blood pressure (r = -0.243, P = 0.009) and LV ejection fraction (r = -0.402, P = 0.000). Patients with higher baseline sST2 concentrations who were not titrated to high-dose BB therapy (P < 0.0001) had worse outcomes. Baseline high sST2 (hazard ratio [HR]: 2.653; 95% confidence interval [CI]: 1.201-8.929; P = 0.041) and final low BB dosage (HR: 1.904; 95% CI, 1.084-3.053; P = 0.035) were independent predictors of cardiovascular events in STEMI.</p><p><b>Conclusions</b>High baseline sST2 levels and final low BB dosage predicted cardiovascular events in STEMI. Hence, sST2 may be a useful biomarker in cardiac pathophysiology.</p>

Pneumothorax related to subclavian vein puncture: analysis of the causes in 47 patients / 介入放射学杂志

Objective To investigate the risk factors that may induce pneumothorax resulted from subclavian vein puncture during interventional therapy for arrhythmia.Methods The clinical data of 4 351 patients with heart disease,who were admitted to Wuhan Asia Heart Disease Hospital,China,during the period from January 2010 to January 2014 to receive subclavian vein puncture for the performance of radiofrequency catheter ablation or pacemaker implantation,were retrospectively analyzed.The gender,age,presence of chronic obstructive pulmonary disease (COPD) and the shape of clavicle of patients who developed pneumothorax were analyzed,and their relationships with the occurrence of pneumothorax were evaluated.Results Of the 4 351 patients,47 patients developed pneumothorax(1.08％),their age was 12-72 years old with a mean of (47.1±18.4) years old.Among the 47 patients,37 patients were females (78.7％).The angle between clavicle and sternum ＜60°(oblique clavicle) was seen in 27 patients,coexisting COPD was seen in 2 patients.The occurrence of pneumothorax was strikingly higher in females than that in males (OR=2.7,95％ CI=1.4-5.2).In patients with oblique clavicle the risk of pneumothorax was obviously increased (OR=3.5,95％ CI=1.6-7.9) and in patients with COPD the probability of pneumothorax was remarkably increased (OR=2.3,95％CI=1.2-4.7).No special treatment was employed in 5 pneumothorax patients,and the pneumothorax was absorbed by itself.In 19 patients,the pneumothorax was relieved through thoracic puncture and suction.Closed drainage of thoracic cavity was employed in 23 patients.All patients were discharged from hospital with complete rehabilitation.Conclusion Clinically,pneumothorax has been an important clinical problem in interventional therapy.In female patients and in patients who have oblique clavicle or coexisting COPD,pneumothorax is more likely to occur when they receive subclavian vein puncture.

Efficacy and Safety of the WATCHMAN Left Atrial Appendage System for Stroke Prevention in Chinese Patients with Nonvalvular Atrial Fibrillation: A Single-center, Prospective, Observational Study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>In patients with nonvalvular atrial fibrillation (NVAF), embolic stroke is thought to be associated with left atrial appendage (LAA) thrombi. The WATCHMAN LAA Occlusion Device has been shown to be noninferior to conventional oral anticoagulation with warfarin for stroke prevention in patients with NVAF. This study aimed to evaluate the procedural feasibility, safety and 12-month outcomes of the WATCHMAN LAA Occlusion Device in NVAF patients with high risk for stroke in China.</p><p><b>METHODS</b>The clinical data of 106 NVAF patients, who were consecutively underwent LAA closure with the WATCHMAN Device between April 2014 and May 2015, were collected. Patients were followed up at 1, 3, 6, and 12 months after discharge. A transesophageal echocardiograph was performed at 45 days after implantation and repeated in case of an unexpected event during the follow-up period.</p><p><b>RESULTS</b>This study included 106 NVAF patients with a mean age of 64.2 ± 8.6 years (ranging from 50 to 88 years), and the mean CHA2DS2-VASc score of all patients was 3.6 ± 1.6 (ranging from 2 to 9). Among those 106 NVAF patients, 100 (94.3%) patients were implanted with the device successfully. The procedural success rate was 94.3% (100/106), and the occlusion rate was 100.0% (100/100). There were one tamponade, one ischemic stroke, and eight minor pericardial effusions during hospitalization. During 12-month follow-up period, two patients developed a thrombus layer on the device that resolved with additional anticoagulation: one with visible device-thrombus experienced transient ischemic stroke, and one had a hemorrhagic stroke. There were no deaths in this study. The overall survival rate was 100.0%, and nonmajor adverse event rate was 95.0% (95/100). In this study, the expected annual rate of ischemic stroke risk in these patients according to the CHA2DS2-VASc score was 4.0%, while the observed ischemic stroke rate was 2.0% per year.</p><p><b>CONCLUSIONS</b>LAA closure with the WATCHMAN Device was feasible, efficient, and safe for NVAF to prevent the accidence of stroke in Chinese patients. During the 12-month follow-up period, the observed ischemic stroke rate (2.0% per year) in our study was lower than the predicted annual stroke risk (4.0%) using the CHA2DS2-VASc score.</p>

Correlation Study Between Serum Soluble ST2 Level and the Early Clinical Prognosis in Patients With Acute ST-elevation Myocardial Infarction / 中国循环杂志

Objective: To preliminarily investigate the relationship between the baseline level of serum soluble ST2 (sST2) and 30-day MACE occurrence rate in patients with ST-elevation myocardial infarction (STEMI). Methods: A total of 121 patients with confirmed diagnosis of STEMI in our hospital from 2015-05-01 to 2015-07-30 were consecutively enrolled. According to baseline sST2 level, the patients were divided into 2 groups:Low sST2 group, the patients with sST2≤56.68 ng/ml, n=61 and High sST2 group, the patients with sST2>56.68 ng/ml, n=60. Clinical condition and 30-day MACE (defined as death and new onset of congestive heart failure) occurrence rate were compared between 2 groups. Results: ① The systolic blood pressure (SBP), Killip class≥II grade, blood levels of cTNI, NT-proBNP, hs-CRP and LVEF were different between 2 groups, all P56.68 ng/ml was the risk factor for 30-day MACE occurrence (HR=1.152, 95%CI 1.078-1.231, P=0.000). Conclusion: Increased baseline level of sST2 implied the higher incidence of death and new onset of congestive heart failure in STEMI patients.

Detection of HepG2 Cells in Artificial Samples by Multifunctional Microfluidic Chip / 分析化学

A multi-functional microfluidic chip with multi-orifice flow fractionation ( MOFF) and magnetic capture technique was developed to specifically separate and capture the HepG2 cells in artificial samples. The chip contained a glass substrate and a polydimethylsiloxane ( PDMS) microchannel cover plate. The PDMS cover plate consisted of 3 injection channels of 10-mm-long, a MOFF separation zone and a hexagonal cavity cell enrichment-detection zone. Among which, the MOFF separation zone had a total length of 20 mm and was consisted of 80 semi-rhombic shrinkage / expansion units with a length of 0. 18 mm, a depth of 50 μm, a shrinkage area width of 0. 06 mm, and an expansion area of 0. 20 mm. The angle between each group of shrinkage / expansion units was 103. 0°. In this experiment, HepG2-blood cell suspension was used as the sample. Based on the principle that the magnetic bead surface-modified c-Met antibody could specifically bind to HepG2 cells, an immunomagnetic bead ( Anti-MNCs) suspension at a concentration of 50 μg / mL was prepared by surface carboxylated beads, EDC (1 mg / mL), NHS (1 mg / mL) and c-Met antibody. Under the optimized flow rate (50 μL/ min), a few HepG2 in suspension samples were efficiently captured at the detection zone of chip via a magnetic field; the carbon quantum dots were prepared by microwave heating with citric acid and thiourea to label HepG2 cells which achieved in-situ fluorescence visualization of captured HepG2. Cells captured in the chip detection area were counted by microscope. The capture rate of HepG2 cells was 88. 5% ±6. 7% (106 blood cells and 10 HepG2 cells per 500 μL). The results demonstrated that the developed multifunctional microfluidic chip may serve as a promising tool for separation and capture of tumour cells.

Cost-effectiveness and cost-utility of neonatal congenital hypothyroidism screening in Foshan City / 重庆医学

Objective To obtain the economic data in the aspects of cost-effectiveness and cost-utility of neonatal congenital hypothyroidism(CH) screening in Foshan City and to make assessment on the effect of screening works.Methods The economic related data were collected by the screening center,literatures,official resources and questionnaire investigation.The statistical tool and Tree Age Pro health decision analysis software were used to conduct the assessment on the cost-effectiveness and cost-utility of screening works.Results The screening program invested 17.95 million Yuan in total during 2000-2007,and the gain benefits was 117.69 million Yuan,net benefit was 9 975.52 ten thousand Yuan.The cost-benefit ratio was 1.00∶6.56.Each investing 3 216 Yuan could avoid a disability-adjusted life year.Conclusion The CH screening item has good economic applicability and is worth investing more funding for further promotion and popularization.

Impact of admission serum total cholesterol level on in-hospital mortality in patients with acute aortic dissection

Objective: To find out the association between serum total cholesterol [TC] on admission and in-hospital mortality in patients with acute aortic dissection [AAD]

Methods: From January 2007 to January 2014, we enrolled 1492 consecutive AAD patients with serum TC measured immediately on admission. Baseline characteristics and in-hospital mortality were compared between the patients with serum TC above and below the median [4.00 mmol/L]. Propensity score matching [PSM] was used to account for known confounders in the study. Cox proportional hazard model was performed to calculate the hazard ratio [HR] and 95% confidence interval [Cl] for admission serum TC levels

Results: With the use of PSM, 521 matched pairs of patients with AAD were yielded in this analysis due to their similar propensity scores. Patients with admission serum TC < 4.00 mmol/L, as compared with those with admission serum TC > 4.00 mmol/L, had higher in-hospital mortality [11.7% vs. 5.8%; HR, 2.06; 95% Cl, 1.33-3.19, P = 0.001]. Stratified analysis according to Stanford classification showed that the inverse association between admission serum TC and in-hospital mortality was observed in patients with Type-A AAD [24.0% vs. 11.3%; HR, 2.18; 95% Cl, 1.33- 3.57, P = 0.002] but not in those with Type-B AAD [3.8% vs. 2.2%; HR, 1.71; 95% Cl, 0.67-4.34, P= 0.261]

Conclusions: Lower serum TC level on admission was strongly associated with higher in-hospital mortality in patients with Type-A AAD

High-density lipoprotein cholesterol and in-hospital mortality in patients with acute aortic dissection / 华中科技大学学报（医学）（英德文版）

The association between high-density lipoprotein cholesterol (HDL-C) and mortality in patients with acute aortic dissection (AAD) is unclear. From January 2007 to January 2014, a total of 928 consecutive AAD patients who were admitted within 48 h after the onset of symptoms were enrolled in the study. Patients were divided into two groups according to whether serum HDL-C level was below the normal lower limit or not. The Cox proportional hazard regression model was used to identify the predictive value of HDL-C for in-hospital mortality in patients with AAD. As compared with normal HDL-C group (n=585), low HDL-C group (n=343) had lower levels of systolic blood pressure and hemoglobin and higher levels of leukocyte, alanine aminotransferase, blood glucose, blood urea nitrogen, creatinine and urea acid. Low HDL-C group had significantly higher in-hospital mortality than normal HDL-C group (21.6% vs. 12.6%, log-rank=10.869, P=0.001). After adjustment for baseline variables including demographics and biologic data, the increased risk of in-hospital mortality in low HDL-C group was substantially attenuated and showed no significant difference (adjusted hazard ratio, 1.23; 95% confidence interval, 0.86-1.77; P=0.259). Low HDL-C is strongly but not independently associated with in-hospital mortality in patients with AAD.

High residual platelet reactivity in patients with acute coronary syndrome and diabetes mellitus receiving dual antiplatelet therapy with clopidogrel or ticagrelor and its influence on prognosis / 中国介入心脏病学杂志

Objective To observe high residual platelet reactivity in patients with acute coronary syndrome and diabetes mellitus receiving dual antiplatelet therapy with clopidogrel or ticagrelor and its influence on prognosis. Methods A total of 175 patients with acute coronary syndrome and diabetes mellitus in Wuhan Asia Heart Hospital were included in this retrospective study, and all patients were divided into two groups : ticagrelor group ( n = 22 ) and clopidogrel group ( n = 153 ) . The platelet aggregation function was tested by light transmission platelet aggregation (LTA). The high residual platelet reactivity was defined as maximum platelet aggregation rate ﹥46. 0%. The differences of high residual platelet reactivity and the effect of high residual platelet reactivity on cardiovascular events were compared between the two groups. Results The number of patients with high residual platelet reactivity in the clopidogrel group were 99 patients (64. 7%), and 8 patients(36. 4%) in the ticagrelor group (P=0. 011) . For stent thrombosis developed in three months, 3 patients were from the high residual platelet reaction group ( n=107 ) , none from the normal residual platelet reaction group ( n =68 ) ( P =0. 016 ) . For bleeding events at 3 months, there were 2 patients (1. 9%, 2/107) from the high residual platelet reaction group and 2 patients (2. 9%, 2/68) were from the normal residual platelet reaction group (P=0. 631). Conclusions Ticagrelor significantly decreases high residual platelet reactivity than clopidogrel. High residual platelet reactivity increases stent thrombosis risk for ACS and type 2 diabetes mellitus.

Soluble ST2 level in coronary artery disease：relation to adverse outcome / 中国介入心脏病学杂志

Objective We assessed phe predicpive value of solable ST2 ( sST2 ) on clinical oupcomes in papienps wiph spable angina, unspable angina,non-ST elevapion mtocardial infarcpion (NSTEMI) and ST elevapion mtocardial infarcpion ( STEMI). Methods We included 212 papienps of whom 62 had spable angina, 48 had unspable angina,50 had NSTEMI, and 52 had STEMI. Papienps were followed for a mean period of 22 monphs. The conprol group consisped of 50 individuals wiphoup significanp spenosis on coronart angiographt. Serum level of sST2 was measured bt ELIS As. Results sST2 levels were significanplt increased in papienps wiph STEMI as compared po papienps wiph NSTEMI, unspable angina and spableangina as well as wiph conprols. In papienps wiph STEMI, phe sST2 level reached ips peak ralue (594. 27 ± 74. 36) ng/ L ap 12 hours afper AMI and decresed po (392. 75 ± 82. 89)ng/ L 24 hours afper AMI. Papienps wiph STEMI had phe highesp sST2 levels among phe 4 groups boph ap peak and prough and was posipivelt correlaped po TnI levels (P = 0. 576, P < 0. 001). During follow-up, 18 papienps (8. 5% ) died and 66 papienps (15. 1% ) presenped evenps of combined endpoinp (all cause deaph, MI and rehospipalisapion for cardiac causes). The sST2 level of phe 18 deceased papienps was higher phan phe opher 194 papienps [(516. 36 ± 49. 38)ng/ L vs. (237. 64 ± 37. 69)ng/ L, P < 0. 001). sST2 onlt showed predicpive valve of morpalipt in STEMI papienps amont differenp ptpes of CAD. Conclusions The levels of sST2 mat reflecp differenp ptpes of CAD. sST2 was associaped wiph morpalipt in papienps wiph STEMI bup nop in papienps wiph NSTEMI or spable angina.

Diagnostic Value of CT Coronary Angiography on Pulmonary Embolism in Suspicious PE Patients / 中国循环杂志

Objective: To study clinical characteristics and anatomical distributions of pulmonary embolism (PE) in suspicious PE patients and to explore if CT coronary angiography (CTCA) may simultaneously exclude PE. Methods: A total of 403 consecutive patients with suspicious PE admitted to cardiology department of our hospital from 2013-01 to 2014-10 were retrospectively studied. According to embolus distribution by CT pulmonary angiography (CTPA) and CTCA, the patients were divided into 2 groups: PE group,n=261 and Non-PE group,n=142. The clinical symptoms and imaging characteristics were analyzed and compared between 2 groups. Results: The overall prevalence of PE was 64.8% (261/403), suspicious PE patients were all with chest distress, palpitation, chest pain and syncope. Compared with Non-PE group, the patients in PE group were with more female gender and palpitation, while less chest pain,P0.05. In PE group, the sign of emboli were found in 245/261 patients (93.9%) at CTCA scanning area, the rest 16 patients (6.1%) had the small area of PE, and the emboli were only located at both upper pulmonary arteries. Conclusion: In patients with dififculty of breath, palpitation, chest pain and syncope, coronary artery disease (CAD) and PE should be simultaneously considered for accurate diagnosis. CTCA may meanwhile ifnd PE during CAD diagnosis.