ABSTRACT
Objective:To investigate the prevalence and prognosis of non-alcoholic fatty liver disease (NAFLD) complicated with coronary vulnerable plaque (VP).Method:Consecutive patients were included who had undergone coronary artery CT angiography (CCTA) from January 1, 2011 to January 30, 2015 at the First People′s Hospital of Neijiang. NAFLD was diagnosed according to the liver imaging findings (liver/spleen CT ratio≤1.0) and clinical data. Baseline data, diagnosis, vulnerable plaque were recorded and followed up. The end points included all-cause death rate, cardiac death rate, non-fatal myocardial infarction rate, and elective coronary revascularization rate.Result:A total of 1 069 patients were eventually recruited in this study, including 316 (29.6%) cases diagnosed as NAFLD. In patients with NAFLD, 130 (41.1%) cases had vulnerable plaque, which was significantly higher than 217 of 753 non-NAFLD patients (28.8%) ( P<0.01). The percentages of spotty calcification, low attenuation plaque, positive remodeling and napkin ring sign in NAFLD cohort were 36.5%, 14.2%, 17.6% and 6.8% respectively, while those corresponding in non-NAFLD cohort were 18.4%, 6.3%, 5.8% and 3.2% respectively. The proportion of each vulnerable feature in NAFLD cohort was significantly higher than that in the non-NAFLD cohort, with P values of 0.016, 0.028, 0.019 and 0.042, respectively. The cardiac mortality rate in NAFLD group was significantly higher than and that of non-NAFLD group (7.0% vs. 3.6%, P=0.044). Multivariate Cox analysis suggested that NAFLD was not an independent risk factor for cardiac death. NAFLD subgroup ( n=316) was divided into VP positive group (NAFLD+VP+, n=130) and VP negative group (NAFLD+VP-, n=186). The mean follow-up time was 4.6±1.3 years. All-cause mortality rate, cardiac death rate, elective coronary artery reconstruction rate, non-fatal myocardial infarction rate in NAFLD+VP+group were 20.8%, 12.3%, 25.4%, 13.8% respectively, which were significantly higher than those corresponding rates in NAFLD+VP-group (5.9%, 3.2%, 8.6%, 6.5%) ( P<0.01, 0.002,<0.01, and 0.032 respectively). Conclusion:The incidences of cardiac mortality, elective coronary revascularization, and non-fatal myocardial infarction are significantly higher in patients with NAFLD than those without. NAFLD combined with vulnerable plaque of coronary arteries predicts worse prognosis.
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Objective:To investigate the therapeutic effect of continuous blood purification (CBP) on acute pancreatitis (AP) and its influence on prognosis.Methods:200 patients with AP in our hospital from January 2010 to December 2016 were selected as the subjects,and they were divided into conventional treatment group and CBP treatment group according to the random number table method,600 cases in each group.The conventional treatment group was received conventional drug therapy,and the CBP treatment group was treated with CBP on the basis of commonly used drugs.The disappeared time of clinical symptoms after treatment and the changes of inflammatory factors and the changes of intestinal function before and 72 h after treatment were compared between the two groups,the mortality rate was compared between the two groups at 7 d after treatment.Results:Abdominal pain disappeared time,abdominal distension disappeared time and abdominal tenderness disappeared time in CBP treatment group after treatment were lower than the conventional treatment group (P＜0.05).There was no significant difference in the levels of endotoxin,C reactive protein (CRP),amylase (AMS),two amine oxidase and malondialdehyde before treatment in the two groups (P＞0.05).At 72 h after treatment,endotoxin,CRP,AMS,two amine oxidase and malondialdehyde levels were lower than those before treatment,and the CBP treatment group was lower than the conventional treatment group (P＜0.05).The mortality rate of CBP treatment group was lower than that of conventional treatment group at 7 d after treatment,the difference was statistically significant (P＜0.05).Conclusion:CBP can effectively improve the clinical therapeutic effect of AP,and improve the clinical prognosis of patients.
ABSTRACT
Objective To investigate the expression of pro-apoptotic factor (Smac) and Survivin in gastric ulcer tissue.Methods Selected the 80 cases of gastric ulcer patients as the research object in the first people′s hospital of neijiang,in which no precancerous lesions of 40 cases of gastric ulcer (N group),40 cases of precancerous lesions of gastric ulcer(Y group),two groups of patients were Smac mRNA and Survivin mRNA were detected by using PCR method,immunohistochemical SP method of Smac and Survivin in specimens of table detect.Gastric ulcer patients were treated by triple therapy,and the apoptosis index was detected by TUNEL.Results Smac in N group(++) and (+++) in the expression accounted for 82.5％ was higher than that in Y group accounted for 47.5％,Survivin in group N (++) and (+++) in the expression accounted for 15.0％ was significantly lower than Y group accounted for 35.0％;And Smac mRNA in the N group relative expression the amount was significantly higher than that of Y group,while the expression of Survivin mRNA in the N group were significantly lower than Y group;N group the apoptosis index of the triple therapy after treatment than before treatment significantly decreased,the difference was statistically significant(P<0.05).Conclusion The clinical application of Smac and Survivin can be used as an auxiliary diagnostic index for the diagnosis of precancerous lesions in patients with gastric ulcer.Patients with gastric ulcer without precancerous lesion treated by triple therapy which can effectively control the apoptosis index of patients,improve the survival rate of patients.