Calcium channel blockers improve prognosis of patients with coronavirus disease 2019 and hypertension / 中华医学杂志(英文版)

BACKGROUND@#Hypertension is considered an important risk factor for the coronavirus disease 2019 (COVID-19). The commonly anti-hypertensive drugs are the renin-angiotensin-aldosterone system (RAAS) inhibitors, calcium channel blockers (CCBs), and beta-blockers. The association between commonly used anti-hypertensive medications and the clinical outcome of COVID-19 patients with hypertension has not been well studied.@*METHODS@#We conducted a retrospective cohort study that included all patients admitted with COVID-19 to Huo Shen Shan Hospital and Guanggu District of the Maternal and Child Health Hospital of Hubei Province, Wuhan, China. Clinical and laboratory characteristics were extracted from electronic medical records. Hypertension and anti-hypertensive treatment were confirmed by medical history and clinical records. The primary clinical endpoint was all-cause mortality. Secondary endpoints included the rates of patients in common wards transferred to the intensive care unit and hospital stay duration. Logistic regression was used to explore the risk factors associated with mortality and prognosis. Propensity score matching was used to balance the confounders between different anti-hypertensive treatments. Kaplan-Meier curves were used to compare the cumulative recovery rate. Log-rank tests were performed to test for differences in Kaplan-Meier curves between different groups.@*RESULTS@#Among 4569 hospitalized patients with COVID-19, 31.7% (1449/4569) had a history of hypertension. There were significant differences in mortality rates between hypertensive patients with CCBs (7/359) and those without (21/359) (1.95% vs. 5.85%, risk ratio [RR]: 0.32, 95% confidence interval [CI]: 0.13-0.76, χ2 = 7.61, P = 0.0058). After matching for confounders, the mortality rates were similar between the RAAS inhibitor (4/236) and non-RAAS inhibitor (9/236) cohorts (1.69% vs. 3.81%, RR: 0.43, 95% CI: 0.13-1.43, χ2 = 1.98, P = 0.1596). Hypertensive patients with beta-blockers (13/340) showed no statistical difference in mortality compared with those without (11/340) (3.82% vs. 3.24%, RR: 1.19, 95% CI: 0.53-2.69, χ2 = 0.17, P = 0.6777).@*CONCLUSIONS@#In our study, we did not find any positive or negative effects of RAAS inhibitors or beta-blockers in COVID-19 patients with hypertension, while CCBs could improve prognosis.

Effect Research Antiventricular Remodeling of Qili Qiangxin Capsules in Treating Dilated Cardiomyopathy / 中国实验方剂学杂志

Objective:To discuss the effect of Qili Qiangxin capsules on cardiac function, myocardial fibrosis and ventricular remodeling of patients with dilated cardiomyopathy (DCM) and Yang Qi deficiency and blood stasis syndrome. Method:One hundred and seven patients were randomly divided into control group (53 cases) and observation group (54 cases) by random number table. Patients in control group got metoprolol succinate sustained-release tablet, 47.5 mg/time, 1 time/day, sacubitril valsartan sodium tablets, 50 mg/time, 1 time/day, hydrochlorothiazide tablets, 20 mg/time, 1 time/day, and spironolactone tablets, 20 mg/time, 1 time/day. In addition to the therapy of control group, patients in observation group were also given Qili Qiangxin capsules, 4 granules/time, 3 times/days. A course of treatment was 6 months. Before and after treatment, levels of left ventricular end-diastolic diameter (LVEDd), left ventricular ejection fraction (LVEF), left ventricular end systolic diameter (LVESD), interventricular septal thickness (IVST), left ventricular posterior wall thickness (LVPWT), left ventricular myocardial mass (LVM) and left ventricular myocardial mass index (LVMI) were recorded by echocardiography. The classification of cardiac function was recorded by New York College of Cardiology (NYHA). Lee's heart failure and Yang Qi deficiency and blood stasis syndrome were scored. And levels of N-terminal B-type natriuretic peptide (NT-proBNP), soluble ST2 (sST2), galectin-3 (galectin-3), angiotensin-Ⅱ(Ang-Ⅱ), matrix metalloproteinase-2 (MMP-2), MMP-9, matrix metalloproteinase inhibitor-1 (TIMP-1), type I procollagen carboxy-terminal peptide (PIP) and type I collagen carboxy-terminal cross-linking peptide (CITP) were detected. Result:After treatment, levels of LVEDd, LVESD, IVST, LVPWT, LVM and LVMI were lower than those in control group (PPZ=2.031, PPPConclusion:In addition to the routine western medicine, Qili Qiangxin capsules can relieve clinical symptoms, degree of heart failure of DCM patients and ventricular remodeling, ameliorate heart function, regulate levels of sST2, galectin-3, MMPs and Ang-Ⅱ, inhibit myocardial fibrosis, and delay heart failure.

Relationship between computational fluid dynamics simulation and acoustic rhinometry and rhinomanometry in nasal cavity / 上海第二医科大学学报

Objective To reconstruct a computational fluid dynamics (CFD) model of human nasal cavity, and make comparison analysis with acoustic rhinometry and rhinomanometry. Methods One healthy volunteer was performed CT scanning of nasal cavity, three dimensional CFD model was established by Simplant 10.0 and Gambit 2.3.16, and Fluent 6.3.2 was employed to simulate the airflow of nasal cavity. Acoustic rhinometer was used to assess the area of nasal cavity, rhinomanometry was adopted to measure the airflow and intranasal pressure drop during inspiration, and the results were compared with those obtained from CFD model. Results Cross section area of nasal cavity obtained from CFD model matches well with that measured by acoustic rhinometer within 30 mm distance from nostril, while the latter was larger than the former beyond 50 mm distance from nostril. The trend of intranasal pressure drop at different airflows measured by CFD model was the same as that measured by rhinomanometry, while the transnasal pressure obtained by CFD model was lower than that recorded by rhinomanometry. Conclusion CFD model can accurately simulate the shape of nasal cavity and measure the parameters of intranasal airflow, which helps to understand the airflow characteristics of nasal cavity.