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BACKGROUND@#Although intensively studied in patients with cardiovascular diseases (CVDs), the prognostic value of diastolic blood pressure (DBP) has little been elucidated in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). This study aimed to reveal the prognostic value of DBP in AECOPD patients.@*METHODS@#Inpatients with AECOPD were prospectively enrolled from 10 medical centers in China between September 2017 and July 2021. DBP was measured on admission. The primary outcome was all-cause in-hospital mortality; invasive mechanical ventilation and intensive care unit (ICU) admission were secondary outcomes. Least absolute shrinkage and selection operator (LASSO) and multivariable Cox regressions were used to identify independent prognostic factors and calculate the hazard ratio (HR) and 95% confidence interval (CI) for adverse outcomes.@*RESULTS@#Among 13,633 included patients with AECOPD, 197 (1.45%) died during their hospital stay. Multivariable Cox regression analysis showed that low DBP on admission (<70 mmHg) was associated with increased risk of in-hospital mortality (HR = 2.16, 95% CI: 1.53-3.05, Z = 4.37, P <0.01), invasive mechanical ventilation (HR = 1.65, 95% CI: 1.32-2.05, Z = 19.67, P <0.01), and ICU admission (HR = 1.45, 95% CI: 1.24-1.69, Z = 22.08, P <0.01) in the overall cohort. Similar findings were observed in subgroups with or without CVDs, except for invasive mechanical ventilation in the subgroup with CVDs. When DBP was further categorized in 5-mmHg increments from <50 mmHg to ≥100 mmHg, and 75 to <80 mmHg was taken as reference, HRs for in-hospital mortality increased almost linearly with decreased DBP in the overall cohort and subgroups of patients with CVDs; higher DBP was not associated with the risk of in-hospital mortality.@*CONCLUSION@#Low on-admission DBP, particularly <70 mmHg, was associated with an increased risk of adverse outcomes among inpatients with AECOPD, with or without CVDs, which may serve as a convenient predictor of poor prognosis in these patients.@*CLINICAL TRIAL REGISTRATION@#Chinese Clinical Trail Registry, No. ChiCTR2100044625.
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Humans , Blood Pressure , Pulmonary Disease, Chronic Obstructive/therapy , Cohort Studies , Respiration, Artificial , Inpatients , Hospital MortalityABSTRACT
BACKGROUND: Inert biomaterials such as metal usually hold poor biocompatibility and weak bonding force, which is against the effect of dental or bone implants. Therefore, how to improve their biocompatibility has become the research hotspot.OBJECTIVE: To prepare collagen-coated titanium alloy (Ti6Al4V), and to assess its biocompatibility.METHODS: Ti6Al4V served as the matrix, the 3-amino propyl triethoxy silane (KH550) as the crosslinking agent, and the three-dimensional printed titanium alloy coated by collagen type Ⅰ and Ⅱ was prepared,respectively. The coated materials were co-cultured with mouse preosteoblasts MC-3T3-E1 to evaluate its biocompatibility. The effect of different kinds of collagen on the cell differentiation was compared by differential recognition of surface proteins.RESULTS AND CONCLUSION: When the N content on the titanium alloy surface (Φ10 cm) was 8.41%, the cladding quantity of collagen type Ⅰ and Ⅱ was 0.81 and 0.77 mg, respectively. Compared with the bare titanium alloy, the cell adhered well and distributed extensively on the coated titanium alloy,which showed strong viability and fast proliferation.The cells cultured on collagen type Ⅰ coated materials expressed the proteins associated with matrix synthesis, and those on collagen type Ⅱ coated materials expressed the proteins associated with mineralization. These results clarify that the collagen coating can improve the biocompatibility of titanium alloy, and different types of collagens act on different functional proteins.
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Objective To study the two-phase flow dynamics distribution and red blood cell distribution under the fluid-solid coupling interaction in left coronary artery at the typical time point within one cardiac cycle,and to investigate the formation and development mechanisms of left coronary artery atherosclerotic plaque Methods The blood was regarded as a two-phase fluid.Based on fluid-solid interaction between blood and vascular wall,the computational fluid dynamics method was used to make the transient numerical simulation of two-phase flow in the left coronary artery under fluid-solid interaction;the distribution of blood flow in the left coronary artery at the typical time point within one cardiac cycle was studied,the relationship between hemodynamic parameters and the formation of atherosclerotic plaque was analyzed.Results A lowspeed eddy zone existed in an area between the distal segment of circumferential branch and the proximal outside of blunt-edge branch of the left coronary artery,where both internal wall shear stress and red blood cell volume fraction were very small and the blood flow pattern was very complicated.Conclusion At the lowspeed eddy zone that carries small wall shear stress,the lipid concentration polarization and macromolecular material deposition are easy to be produced.The area that has less red blood cells is liable to develop hypoxia,resulting in increased vascular wall permeability and intimal injury,which will activate the immune system,causing lipid accumulation in vascular wall and intimal hyperplasia and,thus,to induce the formation of atherosclerotic plaque.(J Intervent Radiol,2017,26:253-257)
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This study was designed to use iTRAQ technology coupled with 2D LC-MS/MS to study the comparative proteomics of different processing technology for pilose antler. 1015 proteins were identified with 2D LC combined with MOLDI TOF/TOF mass spectrometry. Comparative analysis with Protein Pilot (Version 4.5) revealed that 87 proteins were changed (P ≤ 0.05, the ratio of > 1.50 or < 0.60 as the threshold selection of difference proteins), of which 24 were up regulated and 33 were down regulated in the traditional frying process (TFP) compared with the fresh pilose antler (P ≤ 0.05). 7 significant different proteins (P ≤ 0.001), most of these significantly changed proteins were found to be involved in calcium ion binding and ATP binding associated with human healthy. Freeze drying with protective agent (FDP) (Trehalose) can improve the content of significantly different proteins (P ≤ 0.001) including Collagen alpha-1 (XII) chain (COL12A1) and Collagen alpha-1 (II) chain (COL2A1). The significant function involves in platelets activating, maintenance of spermatogonium, and disorder expression in tumor cells. The functional annotation by Hierarchical clustering and GO (gene ontology) showed that the main molecule functions of the proteins significantly changed in these processes were involved in binding (52.7%), catalytic (25.3%), structural molecule and transporter (6.6%).
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Objective To observe the in vitro effect of leptin, alone or in combination with tumor necrosis factor-alpha (TNF-α) on inducible nitric oxide (NO) and on inducible matrix metallo-proteinase-1 3 (MMP-13) in rabbit articular chondrocytes. Methods The chondrocytes from the articular cartilage of 2-month-old rabbits were cultivated and identified, and the second filial generation chondrocytes were cocultured on plates with different concentrations of leptin alone or in combination with TNF-α for 48 h or 96 h after 12 h starvation. The concentration of NO and MMP-13 was measured in the chondrocytes culture supernatant fluid. The results were statistically analyzed. Results There was no significant difference in the concentrations of NO between the different concentrations of leptin alone groups and the blank control group (P ＞ 0. 05). In combination with the same concentration of TNF-α (10 ng/mL), leptin could dose-dependently increase the concentration of NO in the chondrocytes culture supernatant fluid in vitro. There was significant value in average concentration of MMP-13 on the main effect of both time and dose (P ＜0. 05) . No MMP-13 was detected in the blank control group. Conclusion Leptin can induce MMP-13 and have synergistic induction effect on NO with TNF-α in rabbit articular chondrocytes in vitro.
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Objective To explore change of diaphragm electromyograms in patients with obstructive sleep apnea-hypoventilation syndrome (OSAHS) before and after nocturnal sleep, as well as effective nasal continuous positive airway pressure (n-CPAP) ventilation treatment for more than two months. Methods Diaphragm electromyogram was recorded with chest surface electrodes in 22 patients with moderate and severe OSAHS and 24 normal people, and phrenic nerve conduction time (PNCT) and diaphragm compound muscle action potential (CMAP) provoked by unilateral magnetic stimulation (UMS) were measured for them before and after sleep. Measurements were repeated for five patients with severe OSAHS after effective OSAHS patients before and after nocturnal sleep than that in normal people bilaterally, (8.4±0. 6)ms and (8.4±0. 9)ms vs (7. 3±0. 8)ms and (7. 3±0. 8) ms for the left side; and (8.4±1.3) ms and (8. 9 ± 0. 8) ms vs (7.2 ± 0. 8) ms and (7.2 ± 0. 8 ) ms for the right side ( P < 0. 01 ), respectively ; and amplitude of CMAP was significantly lower in OSAHS patients, (0. 60±0. 20)mV and (0. 64±0. 29)mV vs (0. 98 ± 0. 28)mV and (0. 97±0. 27)mV for the left side; and (0. 53±0. 23)mV and (0. 56±0. 26)mV vs (0. 93 ±0. 29) mV and ( 0. 94 ± 0. 29 ) mV for the right side, respectively ( P < 0. 01 ) ; but no significant significantly shortened bilaterally in five patients with severe OSAHS after effective n-CPAP ventilation treatment for more than two months, (8.6±0. 7)ms vs (7.4±0. 5)ms for the lfet side and (7. 8±0. 6)ms vs (6.4 ± 0. 6) ms for the fight side ( P < 0. 05 ), respectively. Conclusions Both phrenic nerve conduction and diaphragm muscle function are weakened in patients with OSAHA, which may be related to hypoxia and/ or disturbance of sleep structure at night.
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Objective To evaluate the feasibility of measuring phrenic nerve conduction time(PNCT)and elicited compound muscle action potential(CMAP)of diaphragm with surface electrodes.Methods PNCT and amplitude of diaphragm CMAP elicited by unilateral magnetic stimulation(UMS)of the phrenic nerve were measured with surface electrodes and the results were compared with those measured with oesophageal electrodes.Results (1)PNCT measured with oesophageal electrode was similar to those measured with surface electrode;the amplitude of CMAP measured with oesophageal electrode was higher than those with surface electrode.(2)There was a significant relationship between the amplitudes of right CMAP measured with oesophageal electrode and those with surface electrodes,whereas there was no such relationship for the left side.(3)The PNCT and the amplitude of CMAP were not related to age,height,weight and perimeter of abdomen no matter measured with oesophageal or surface electrodes.Conclusion Surface electrodes is a useful and noninvasive method to evaluate the function of phrenic nerve and diaphragm.