Predictive value of NT-proBNP level and IVC-CI on volume load and prognosis in patients with acute heart failure / 医学研究生学报

ObjectiveThe assessment of volume load status in patients with acute heart failure is of great significance for preventing volume overload. The aim of this study was to explore the predictive value of NT-proBNP level and IVC-CI on volume load and prognosis in patients with acute heart failure. MethodsFrom January 2017 to April 2019, the clinical characteristics of 98 patients with acute heart failure diagnosed and treated in the Peking University People's Hospital were retrospectively reviewed in this study. All of them were treated with routine anti-heart failure treatment. According to the level of relative volume balance, they were divided into volume overload group (65 cases) and non-volume overload group (33 cases). All the patients were followed up for 30 days after discharge. The patients with death and cardiogenic rehospitalization were included in the event group (30 cases), and the rest were in the non-event group (68 cases). NT-proBNP and IVC-CI in different volume load groups and different prognosis groups were compared. The volume index levels (serum albumin, hemoglobin, hematocrit, PCWP, CVP) of patients in different volume load groups were compared. The effects of NT-proBNP and IVC-CI on volume load and prognosis of patients were analyzed.ResultsThe levels of NT-proBNP [（1306.39±313.98）pg/mL], PCWP [（19.63±1.95）mmHg] and CVP [（14.65±1.03）cmHg] in the volume overload group were higher than those in the non-volume overload group, while the IVC-CI [（38.26±8.14）%], albumin [（16.23±2.12）g/L], hemoglobin and hematocrit [（36.26±2.78）%] in the volume overload group were lower than those in the non-volume overload group (P0.05). On discharge, the AUC of NT-proBNP, IVC-CI in predicting patients with acute heart failure was respectively 0.806 and 0.847. Although the prediction accuracy was relatively high, the AUC of combined prediction was 0.982, which was significantly higher than that of NT-proBNP and IVC-CI (Z=3.589, 3.274, both P<0.05).Conclusion There is a correlation between NT-proBNP, IVC-CI and volume indexes. The combined detection of NT-proBNP and IVC-CI can help to assess the volume load status of patients with acute heart failure and improve the predictive value of short-term prognosis of patients.

Observation on therapeutic effect of " acupuncture" on premature ovarian insufficiency of kidney deficiency / 中国针灸

OBJECTIVE@#To observe the clinical efficacy of " acupuncture" and oral estradiol and dydrogesterone tablets (femoston) on premature ovarian insufficiency of kidney deficiency.@*METHODS@#A total of 50 patients with premature ovarian insufficiency of kidney deficiency were randomized into an observation group and a control group, 25 cases in each one.In the observation group, " acupuncture" was applied at Baihui (GV 20), Zhongwan (CV 12), Guanyuan (CV 4), Qihai (CV 6), Zhongji (CV 3), Yaoyangguan (GV 3), Yaoshu (GV 2), Mingmen (GV 4), etc. once every 2 days, 1 month as a course. In the control group, femoston was prescribed for oral administration, one tablet per time, once a day, 1 month as a course. Both of the two groups were given consecutive treatment for 3 courses. Before and after treatment, the clinical symptoms, menstrual improvement as well as the changes of estradiol (E), luteotrophic hormone (LH) and follicle-stimulating hormone (FSH) in serum were observed in the two groups.@*RESULTS@#After treatment, the clinical symptoms and menstrual conditions were improved (<0.01), the levels of FSH and LH were significantly reduced (<0.01), and the levels of E were significantly increased in the two groups (<0.01). There were no significant difference in menstrual improvement rate and menstrual improvement time between the observation group and the control group (<0.05), the recurrence rate of menopause and clinical symptom score improvement in the observation group were superior to the control group (<0.05). In the observation group, the level of E in serum was lower and the levels of FSH and LH in serum were significantly lower than those in the control group (<0.05, <0.01). In the observation group, the rate of adverse reaction was 4.0% (1/25), which was lower than 36.0% (9/25) in the control group (<0.05).@*CONCLUSION@#" acupuncture" has better therapeutic effect for premature ovarian insufficiency of kidney deficiency. It is superior to femoston in improving clinical symptoms and recurrence rate of menopause as well as reducing the levels of FSH and LH.

Effect of 5-hydroxtryptamine on megakaryocytopoiesis--review / 中国实验血液学杂志

5-hydroxtryptamine (5-HT, serotonin) has been recognized not only as a neurotransmitter and vasoactive agent, but also as a growth factor. 5-HT mainly binds to 5-HT(2) receptors or 5-HT(1) receptors on cell surface to stimulate cell proliferation through Ras or MAPK pathway in many cell types. It has been reported that 5-HT stimulates megakaryocytopoiesis via 5-HT receptors. The possible mechanism of 5-HT on the proliferation and differentiation of megakaryocytes (MK) has been discussed in this review article. In early stage of megakaryocytopoiesis, 5-HT may bind to 5-HT(2B) receptor on megakaryocytes, and promotes their proliferation and differentiation. In the late stage, 5-HT may involve in the platelet release procedure by inducing nitric oxide (NO) synthesis via 5-HT(2A) receptors. 5-HT can also antagonize the apoptotic effect induced by thrombospondin-1 (TSP-1) which is a platelet alpha granule protein and has synergic effect with platelet-derived growth factor (PDGF) to enhance megakaryocytes proliferation. Therefore, 5-HT is likely to be an important substance in the feedback regulation of thrombopoiesis. In this review the 5-HT and its receptors, 5-HT as cell growth factor, pathway of 5-HT stimulating cell proliferation and influance of 5-HT on MK-progenitor cells were summarized.

Clinical feature of acquired pure amegakaryocytic thrombocytopenic purpura / 中国基层医药

Objective To explore the clinical feature of acquired pure amegakdryocytic thrombocytopenic purpura(AATP).Methods 18 patients were analyzed retrospectively.And 112 patients with ITP in the same term were to be control group.Each group's megakaryocytic (MK),platelet (PLT) count,mean platelet volume (MPV) and platelet associated immunoglobulin G(PAIgG) were rested.Results The MK total number of AATP group was obvious decreased or even absent,while the ITP group was increased[(0.8?1.5) vs (195.0?47.3),P0.05).About the PAIgG posi- tive rate,AATP group was 55.6 % while ITP group was 83% (P