Clinical features of 17 cases of rhabdomyolysis / 中华心血管病杂志

<p><b>OBJECTIVE</b>We retrospectively analyzed the causes, diagnosis, clinical characteristics, treatment and prognosis of 17 patients with rhabdomyolysis.</p><p><b>METHODS</b>Rhabdomyolysis cases diagnosed from January 2005 to March 2014 in our department were included.</p><p><b>RESULTS</b>A total of 17 rhabdomyolysis patients (male 13, mean age (60.4 ± 15.7) years) were analyzed.Four cases had coronary heart disease combined with hypertension, hyperlipaemia, atrial fibrillation, 10 cases had dilated cardiomyopathy combined with coronary heart disease, hyperlipaemia, atrial fibrillation, 8 cases had atrial fibrillation combined with hypertension, coronary heart disease, hyperlipaemia, 1 patient had pulmonary embolism combined with hyperlipaemia, 1 patient had aortic dissection combined with hypertension, 10 hypertension patients were combined with coronary heart disease, hyperlipaemia, atrial fibrillation, aortic dissection and 1 patient with ventricular tachycardia was combined with depression.Various degrees of liver and kidney dysfunction, reduced hemoglobin and myoglobinuria were found in all patients.Fever was found in 7 cases, relevant neurological signs in 5 cases. Digestive tract discomfort and muscle weakness or muscle pain symptoms were seen in all patients during hospitalization. All cases underwent renal replacement therapy and respirator was used in 14 patients to support breathing. Post therapy, 10 cases improved but 7 cases died. All 17 patients had history of statin use.</p><p><b>CONCLUSION</b>Statin may be the major cause of rhabdomyolysis in these patients, and the mortality of rhabdomyolysis is high despite various therapy stratigies.</p>

Association between body mass index and cardiovascular events in male elderly hypertensive patients / 中华心血管病杂志

<p><b>OBJECTIVE</b>To observe the long-term relationship between body mass index (BMI) and cardiovascular events in male elderly hypertensive patients.</p><p><b>METHODS</b>A total of 839 male elderly (>65 years old) hypertensive patients were included in this prospective study. Baseline data were obtained on January 2004 and participants were followed up yearly till January 2014. Patients were divided into 3 groups according to their BMI: normal weight group (18.5 kg/m² ≤ BMI<24.0 kg/²), overweight group (24.0 kg/m² ≤ BMI<28.0 kg/m²), obese group (BMI ≥ 28.0 kg/m²). All-cause death and cardiovascular events were compared.</p><p><b>RESULTS</b>The average age of all 839 hypertension men was (75.4 ± 4.8) years at baseline. Baseline systolic blood pressure was (133.7 ± 14.6) mmHg (1 mmHg=0.133 kPa), diastolic blood pressure was (74.3 ± 9.3)mmHg. Baseline systolic and diastolic blood pressure was similar among the three groups. All 839 patients completed follow-up. There were 178 all-cause deaths, 54 cardiovascular deaths, 51 new/recurrent myocardial infarctions and 105 new/recurrent strokes during follow up. Incidence of all-cause mortality in overweight group (16.74%,72/430) was significantly lower than in normal weight group (27.01% (74/274), P<0.05). Kaplan-Meier curves showed the all-cause mortality and cardiovascular mortality were higher in normal weight group than in the other two groups. According to the Cox proportional hazards regression model, the risk of all-cause mortality (RR=0.867, 95% CI: 0.792-0.949) and cardiovascular death (RR=0.179, 95% CI : 0.05-0.645) in patients with a BMI ≥ 24.0 kg/m² were lower than in the group with BMI<24.0 kg/m².</p><p><b>CONCLUSION</b>Obesity paradox phenomenon is observed in elderly male hypertensive patients in that higher BMI is associated with lower mortality risks in elderly male hypertensive patients during the 10 years follow-up.</p>

Genome-wide Analysis of DNA Methylation in Coronary Heart Disease Patients with MeDIP-Seq / 中国药房

OBJECTIVE:To explore the genome-wide methylation differences between coronary heart disease (CHD) patients and healthy volunteers,and to investigate the relationsip of DNA methylation with CHD from epigenetics. METHODS:In case-control study,subjects were divided into CHD group(50 cases)and health control group(50 cases). DNA of 2 groups were sequenced with methylated DNA immunoprecipitation sequencing technology. The genome-wide methylation differences were analyzed and compared between 2 groups. RESULTS:The number of methylation peak in CHD group was higher than health group,with statistical signfi-cance(P<0.05). The methylation peak mainly distributed in 5'UTR,Intron functional elements. The number of reads in AQP1,SHB and other gene promoters in CHD group were lower than health group,and its methylation level decreased. The number of reads in GRK5 and serveal gene promoters on chrX in CHD group were higher than helath group,and its methylation level increased,with sta-tistical significance(P<0.01). CONCLUSIONS:The genome-wide methylation level of CHD patients are higher than those of healthy volunteers. The occurence of CHD is possibly associated with the change of methylation level of related gene promoters.

Clinical characteristics of 42 patients with cardiac amyloidosis / 中华内科杂志

Objective To characterize the clinical features of patients with cardiac amyloidosis (CA).Methods Totally 42 patients with CA admitted to Guangdong General Hospital since 2008 were included and retrospectively analyzed in the present study.CA was confirmed by abdomen and endocardium biopsy examination.Clinical manifestations,electrocardiogram and echocardiography were collected for the evaluation.Results Several clinic features are common in CA.In the present study,37 cases (88.1％) presented with chest tightness,dyspnea,20 cases(47.6％) with chest pain,27 cases(64.3％) with right heart failure,27 cases (64.3％) with fatigue,and 30 cases (71.4％) with renal insufficiency and proteinuria.Electrocardiogram (ECG) showed that 32 of the patients (76.2％) were with low voltage in limb leads,29 cases (69％) of them were with poor R wave progression in precordial leads,17 cases (40.5％) with ST-T change,28 cases(66.7％) with pseudo-necrotic Q wave and 36 cases (85.7％) with various kinds of arrhythmia.Echocardiography indicated that all of the subjects (100％) were with different degrees of left ventricular posterior wall or ventricular septal thickness,and left atrial hypertrophy with different degree of myocardial grain appearance or ground-glass opacity.Thirty-six cases (85.7％) were with pericardial effusion,and 27 cases (64.3％) were with abnormal left ventricular eject function.Conclusion For those who were with unexplained clinical cardiac insufficiency,renal insufficiency,myocardial hypertrophy,but normal of ventricular size in echocardiography and low voltage on ECG limb leads,a tissue biopsy from abdomen,labial glands or endocardium should be considered in the diagnosis of CA.

The surgical treatment effect on upper airway in treating refractory hypertension accompanied with OSAHS / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the clinical treatment effect of refractory hypertension accompanied with OSAHS by surgery on upper airway.@*METHOD@#Thirty-two patients were enrolled in our research. PSG and blood pressure were examined on preoperation and 6th month, 1 year, 2 year of postoperation.@*RESULT@#The AHI and the time of SaO2 < 90% were lower significantly, and LSaO2 was improved (P < 0.01). The blood pressures of 32 patients were decreased.@*CONCLUSION@#The operation on upper airway could improve the hypertension of patient with OSAHS effectively.

Clinical application of renal scintigraphy in elder renal arterial stenosis / 中国介入心脏病学杂志

Objective To evaluate the forecasting value of renal scintigraphy (ECT) on the diagnosis of renovascular hypertension (RVH). Methods Twenty-four cases of coronary heart disease and hypertension were selected. All of them were suspected of RVH. They underwent ECT and renal arterial angiography (RAA). Results The 24 cases were diagnosed as RVH. The diagnostic sensitivity of renal scintigraphy in RVH was 83.3% (P