ABSTRACT
Abstract Background: The intracoronary high-thrombus burden during the primary percutaneous coronary intervention in patients with ST-elevation myocardial infarction (STEMI) can lead to poor outcomes. Monocytes have been described to play an important role in thrombotic disorders. Objectives: This study aimed to investigate the relationship between admission monocyte count and angiographic intracoronary thrombus burden in patients receiving primary percutaneous coronary intervention (PPCI). Methods: A total of 273 patients with acute STEMI who underwent PPCI were enrolled. The patients were divided into two groups according to the thrombolysis in myocardial infarction (TIMI) thrombus grade: low-thrombus burden group with a grade of 0-2 and high-thrombus burden group with a grade of 3-4. The monocyte count and other laboratory parameters were measured on admission before PPCI. P-value < 0.05 was considered significant. Results: There were 95 patients (34.8%) in the high-thrombus burden group, and 178 patients (65.2%) in the low-thrombus burden group. Patients with high-thrombus burden had significantly higher admission monocyte count (0.61 ± 0.29×109/L vs. 0.53 ± 0.24×109/L, p = 0.021). In multivariate analysis, monocyte count was the independent predictor of angiographic high-thrombus burden (odds ratio 3.107, 95% confidence interval [CI] 1.199-7.052, p = 0.020). For the prediction of angiographic high-thrombus burden, admission monocyte count at a cut-off value of 0.48×109/L yielded 0.59 ROC-AUC (71.9% sensitivity, 46.9% specificity). Conclusions: Monocyte count on admission was an independent clinical predictor of high-thrombus burden in patients with STEMI undergoing PPCI. Our findings suggest that admission monocyte count may be available for early risk stratification of high-thrombus burden in acute STEMI patients and might allow the optimization of antithrombotic therapy to improve the outcomes of PPCI.
Resumo Fundamento: A carga trombótica intracoronária durante a intervenção coronária percutânea primária em pacientes com Infarto com Supradesnivelamento do Segmento ST (STEMI) pode levar a resultados negativos.Os monócitos foram descritos para desempenhar um papel importante nos distúrbios trombóticos. Objetivos: Este estudo investigou a relação entre a contagem de monócitos no momento da internação e a carga trombótica angiográfica intracoronária em pacientes submetidos à intervenção coronária percutânea primária (ICPP). Métodos: Um total de 273 pacientes com STEMI agudo submetidos à ICPP participaram. Os pacientes se dividiram em dois grupos de acordo com o grau trombótico na trombólise do infarto do miocárdio (TIMI): grupo baixa carga trombótica, com graus de 0-2, e grupo alta carga trombótica, com graus de 3-4. A contagem de monócitos e outros parâmetros laboratoriais foram medidos na internação antes da ICPP. Consideramos o valor de p < 0,05 significativo. Resultados: Havia 95 pacientes (34,8%) no grupo alta carga trombótica, e 178 pacientes (65,2%) no grupo baixa carga trombótica. Pacientes com alta carga trombótica apresentaram contagem de monócitos no momento da internação mais alta (0,61 ± 0,29×109/L vs. 0,53 ± 0,24×109/L, p = 0,021). Na análise multivariada, a contagem de monócitos foi o indicador independente da alta carga trombótica angiográfica (odds ratio 3,107, intervalo de confiança de 95% [IC] 1,199-7,052, p = 0,020). Para a previsão da alta carga trombótica angiográfica, a contagem de monócitos na internação tinha ponto de corte de 0,48×109/L, chegou a 0.59 ROC-AUC (71,9% sensibilidade, 46,9% especificidade). Conclusões: a contagem de monócitos na internação foi um indicador clínico independente da alta carga trombótica em pacientes com STEMI submetidos à ICPP. Nossos achados sugerem que a contagem de monócitos na internação pode estar disponível para a estratificação de risco precoce da alta carga trombótica em pacientes com STEMI agudo, e podem levar à otimização da terapia antitrombótica para melhorar os resultados da ICPP.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Coronary Thrombosis/blood , Coronary Thrombosis/diagnostic imaging , Monocytes , Percutaneous Coronary Intervention/methods , ST Elevation Myocardial Infarction/surgery , ST Elevation Myocardial Infarction/blood , Patient Admission , Reference Values , Stroke Volume/physiology , Time Factors , Echocardiography , Logistic Models , Multivariate Analysis , Retrospective Studies , Risk Factors , Coronary Angiography/methods , Statistics, Nonparametric , Risk Assessment , Leukocyte CountABSTRACT
Objective@#To investigate the histone acetylation level and histone deacetylase (HDAC) activity of peripheral blood CD4+ T lymphocytes in patients with oral lichen planus (OLP). @*Methods @#Twenty-three OLP patients were selected from August 2016 to January 2017 from the Stomatological Hospital, Southern Medical University. The diagnosis was confirmed by pathology, and the lesions were divided into a nonerosive OLP group (11 cases) and an erosive OLP group (12 cases). Ten healthy sex- and age-matched volunteers served as controls. Immunomagnetic beads were used to separate CD4+ T lymphocytes, and histones and nucleoproteins were extracted. The global histone H3/H4 acetylation levels and HDAC activity of CD4+ T lymphocytes from all subjects were detected by ELISA. The differences between the OLP and control groups were statistically analyzed. @*Results@#Global histone H3 hypoacetylation was observed in the OLP group compared with the control group (u = -2.410, P = 0.012). However, there was no significant difference in the serum CD4+ T lymphocyte histone H4 acetylation level between the OLP and control group (u = -1.412, P = 0.158). HDAC activity was significantly higher in the OLP group than in the healthy control group (F = 5.749, P = 0.023), and much higher HDAC activity was observed in the erosive group than in the nonerosive (P = 0.014) and healthy control groups (P = 0.001). The degree of histone H3 acetylation correlated negatively with increased HDAC activity in the OLP group (rs = -0.771, P < 0.001). There was no correlation between the level of histone H3 acetylation and HDAC activity in the healthy control group (rs = 0.382,P = 0.276). The histone H4 acetylation level in the OLP group showed no correlation with HDAC activity (rs = 0.149, P = 0.498), and the histone H4 acetylation level in the control group also showed no correlation with HDAC activity (rs = 0.527, P = 0.117).@*Conclusion @#Abnormal histone acetylation of CD4+ T lymphocytes in the peripheral blood of patients with OLP was identified and could be related to HDAC activity, suggesting that the epigenetic modification of histone acetylation may play a role in the pathogenesis of OLP.
ABSTRACT
Objective@#To explore the application effect of secondary personalized chairside education on changing the knowledge and behavior of patients with oral periodontal disease.@*Methods@#A total of 124 patients experiencing initial periodontal disease were selected. Sixty-two patients were observed in the observation group, and 62 patients were observed in the control group. After the doctor checked and determined the periodontal condition of the patients, the nurse conducted a targeted, personalized secondary one-on-one chairside mission for the observation group; in the control group, the nurses provided routine one-to-one health education to the patients before treatment. Statistical analysis was conducted to assess periodontal knowledge mastery, self-care behaviors, rate of return for periodontal treatment and patient satisfaction after 3 months. The plaque index and scale index were statistically analyzed before and 3 months after treatment. @*Results @#No statistical difference was found in the general data between the two groups of patients (P > 0.05); however, the degree of mastery of periodontal knowledge in the observation group was higher than that in the control group. The degrees of mastery of the clinical manifestations, hazards and treatment methods were 96.7%, 93.5%, and 91.9% in the observation group and 72.5%, 48.3%, and 69.3% in the control group, respectively; the difference was statistically significant (P < 0.05). The patients in the observation group were more likely than those in the control group to brush more than 2 times daily, use dental floss and use an interdental brush; 100%, 96.7%, and 77.4% of patients in the observation group and 80.6%, 56.4%, and 40.3% of patients in the control group participated in these oral health care behaviors, respectively. The difference was statistically significant (P < 0.05). The rate of recovery and patient satisfaction were higher in the observation group than in control group at 3 months; the rate of recovery and patient satisfaction were 80.6% and 96%, in the observation group and 41.9% and 88.7% in the control group, respectively. The difference was statistically significant (P < 0.05). After 3 months, the plaque index in the observation group was lower than that in the control group (1.71 ± 1.12, 2.35 ± 0.78), and the difference was statistically significant (P < 0.05).@*Conclusion@#Secondary personalized chairside education can significantly improve the patient’s cognition of the disease, allow the formation of accurate oral health awareness, and change the patient’s bad oral hygiene habits and medical behavior. Thus, this method is an effective oral health education method and can change the knowledge and beliefs of patients with oral periodontitis.