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1.
Article in Chinese | WPRIM | ID: wpr-928710

ABSTRACT

OBJECTIVE@#To observe the expression level of serum homocysteine (Hcy) and methylenetetrahydrofolate reductase (MTHFR) gene polymorphism in patients with hematological diseases complicated with coronary heart disease, and analyze the relationship between serum Hcy level, MTHFR gene polymorphism and coronary heart disease.@*METHODS@#The medical records of 80 patients with coronary heart disease who completed treatment of hematological diseases during the period from March 2018 to March 2020 were selected as observation group. In addition, the medical records of 92 patients with hematological diseases who completed treatment in our hospital during the same period were selected as control group. Venous blood samples of the two groups were collected to detect serum Hcy level and MTHFR gene polymorphism. The serum Hcy levels of the two groups with different MTHFR genotypes were compared, and the effects of the above indicators on hematological diseases complicated with coronary heart disease were analyzed.@*RESULTS@#The detection rates of MTHFR gene TT and TC in the observation group were higher than those in the control group, while the distribution frequency of MTHFR genotype CC was lower (P<0.05). The serum Hcy levels of the patients with MTHFR genotype TT and TC in the observation group was higher than the control group (P<0.05). Binary logistic regression analysis showed that MTHFR gene TC/CC genotype serum Hcy overexpression may be influencing factor which induced coronary heart disease in patients with hematological diseases (OR=2.107/OR=1.634, P<0.05). ROC curves showed that the AUC of serum Hcy level of MTHFR gene TC/CC genotype and hematological disease complicated with coronary heart disease were both > 0.8. When MTHFR gene TC reaching the optimal threshold of 22.165 μmol/L, the sensitivity was 0.950 and the specificity was 0.837, While MTHFR gene CC reached the optimal threshold of 19.630 μmol/L, the sensitivity was 0.938 and the specificity was 0.826, the best predictive value could be obtained.@*CONCLUSION@#The changes of serum Hcy and MTHFR gene polymorphisms may be involved in the pathological process in patients with hematological diseases complicated with coronary heart disease. In the future, early detection of serum Hcy levels and MTHFR gene polymorphisms in patients with hematological diseases can be used to predict the risk of coronary heart disease.


Subject(s)
Coronary Disease/genetics , Genotype , Hematologic Diseases/complications , Homocysteine , Humans , Methylenetetrahydrofolate Reductase (NADPH2)/genetics , Polymorphism, Genetic
2.
Chinese Medical Journal ; (24): 2081-2090, 2021.
Article in English | WPRIM | ID: wpr-887596

ABSTRACT

BACKGROUND@#High-frequency irreversible electroporation (H-FIRE) is a novel, next-generation nanoknife technology with the advantage of relieving irreversible electroporation (IRE)-induced muscle contractions. However, the difference between IRE and H-FIRE with distinct ablation parameters was not clearly defined. This study aimed to compare the efficacy of the two treatments in vivo.@*METHODS@#Ten Bama miniature swine were divided into two group: five in the 1-day group and five in the 7-day group. The efficacy of IRE and H-FIRE ablation was compared by volume transfer constant (Krans), rate constant (Kep) and extravascular extracellular volume fraction (Ve) value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), size of the ablation zone, and histologic analysis. Each animal underwent the IRE and H-FIRE. Temperatures of the electrodes were measured during ablation. DCE-MRI images were obtained 1, 4, and 7 days after ablation in the 7-day group. All animals in the two groups were euthanized 1 day or 7 days after ablation, and subsequently, IRE and H-FIRE treated liver tissues were collected for histological examination. Student's t test or Mann-Whitney U test was applied for comparing any two groups. One-way analysis of variance (ANOVA) test and Welch's ANOVA test followed by Holm-Sidak's multiple comparisons test, one-way ANOVA with repeated measures followed by Bonferroni test, or Kruskal-Wallis H test followed by Dunn's multiple comparison test was used for multiple group comparisons and post hoc analyses. Pearson correlation coefficient test was conducted to analyze the relationship between two variables.@*RESULTS@#Higher Ve was seen in IRE zone than in H-FIRE zone (0.14 ± 0.02 vs. 0.08 ± 0.05, t = 2.408, P = 0.043) on day 4, but no significant difference was seen in Ktrans or Kep between IRE and H-FIRE zones at all time points (all P > 0.05). For IRE zone, the greatest Ktrans was seen on day 7, which was significantly higher than that on day 1 (P = 0.033). The ablation zone size of H-FIRE was significantly larger than IRE 1 day (4.74 ± 0.88 cm2vs. 3.20 ± 0.77 cm2, t = 3.241, P = 0.009) and 4 days (2.22 ± 0.83 cm2vs. 1.30 ± 0.50 cm2, t = 2.343, P = 0.041) after treatment. Apoptotic index (0.05 ± 0.02 vs. 0.73 ± 0.06 vs. 0.68 ± 0.07, F = 241.300, P  0.05). Electrode temperature variations were not significantly different between the two zones (18.00 ± 3.77°C vs. 16.20 ± 7.45°C, t = 0.682, P = 0.504). The Ktrans value (r = 0.940, P = 0.017) and the Kep value (r = 0.895, P = 0.040) of the H-FIRE zone were positively correlated with the number of hepatocytes in the ablation zone.@*CONCLUSIONS@#H-FIRE showed a comparable ablation effect to IRE. DCE-MRI has the potential to monitor the changes of H-FIRE ablation zone.


Subject(s)
Animals , Contrast Media , Electroporation , Follow-Up Studies , Liver/surgery , Magnetic Resonance Imaging , Swine
3.
Article in English | WPRIM | ID: wpr-773981

ABSTRACT

OBJECTIVE@#To evaluate the effectiveness of integrative medicine (IM) on patients with coronary artery disease (CAD) and investigate the prognostic factors of CAD in a real-world setting.@*METHODS@#A total of 1,087 hospitalized patients with CAD from four hospitals in Beijing, China were consecutively selected between August 2011 and February 2012. The patients were assigned to two groups based on the treatment: Chinese medicine (CM) plus conventional treatment, i.e., IM therapy (IM group); or conventional treatment alone (CT group). The endpoint was major adverse cardiac events [MACE; including cardiac death, myocardial infarction (MI), and revascularization].@*RESULTS@#A total of 1,040 patients finished the 2-year follow-up. Of them, 49.4% (514/1,040) received IM therapy. During the 2-year follow-up, the total incidence of MACE was 11.3%. Most of the events involved revascularization (9.3%). Cardiac death/MI occurred in 3.0% of cases. For revascularization, logistic stepwise regression analysis revealed that age ⩾ 65 years [odds ratio (OR), 2.224], MI (OR, 2.561), diabetes mellitus (OR, 1.650), multi-vessel lesions (OR, 2.554), baseline high sensitivity C-reactive protein level ⩾ 3 mg/L (OR, 1.678), and moderate or severe anxiety/depression (OR, 1.849) were negative predictors (P<0.05); while anti-platelet agents (OR, 0.422), β-blockers (OR, 0.626), statins (OR, 0.318), and IM therapy (OR, 0.583) were protective predictors (P<0.05). For cardiac death/MI, age ⩾ 65 years (OR, 6.389) and heart failure (OR, 7.969) were negative predictors (P<0.05), while statin use (OR, 0.323) was a protective predictor (P<0.05) and IM therapy showed a beneficial tendency (OR, 0.587), although the difference was not statistically significant (P=0.218).@*CONCLUSION@#In a real-world setting, for patients with CAD, IM therapy was associated with a decreased incidence of revascularization and showed a potential benefit in reducing the incidence of cardiac death or MI.


Subject(s)
Aged , Coronary Artery Disease , Drug Therapy , Female , Humans , Integrative Medicine , Logistic Models , Male , Medicine, Chinese Traditional , Middle Aged , Prognosis
4.
Chinese Journal of Pathology ; (12): 92-97, 2019.
Article in Chinese | WPRIM | ID: wpr-810444

ABSTRACT

Objective@#To investigate the expression of immunomarkers CK7, CK20, CK17, CDX2, MUC1 and MUC2 in primary adenocarcinoma of the ampulla of Vater, to explore the role of these markers in the histopathologic subclassification of ampullary carcinoma; and to provide biologic basis for precision treatment of patients with different types of ampullary carcinoma.@*Methods@#Forty-two cases of primary ampullary carcinoma were collected at Peking University People′s Hospital, from 2012 to 2018 year. There were 22 males and 20 females. Aged range 42 to 88 years old, with mean aged (62±11) years. Among the patients, 6 was high differentiation, 19 median differentiation, and 17 low differentiation. Immunohistochemical studies on the expression of CK7, CK20, CK17, CDX2, MUC1 and MUC2 were performed in 42 cases of primary ampullary carcinoma. The relationship between different ampullary carcinoma subtypes and clinicopathologic survival data was analyzed using SPSS 16.0 statistical software.@*Results@#Three histopathologic subtypes were observed. Among 42 cases, 8(19.0%)were classified as intestinal subtype, which showed a positive expression rate of 8/8 for both CK20 and CDX2, and 5/8 for MUC2. Both CK7 and CK17 were weakly expressed in one case (1/8). No expression was observed for MUC1 in this subtype. Twenty-two (52.4%,22/42) cases were classified as pancreaticobiliary subtype, which showed a positive expression rate of 100.0%(22/22) for both CK7 and MUC1, and 90.9% (20/22) for CK17. No expression was observed for CK20, CDX2 and MUC2.The remaining 12 (28.6%) cases were classified as mixed subtype, which showed variable expression patterns. The expression frequencies of these 6 immunomarkers in different subtypes of ampullary carcinoma did not correlate with various clinicopathologic factors such as patient gender and age, tumor size, histologic differentiation, pancreatic and bile duct invasion, or the depth of duodenal invasion. However, stage Ⅲ+Ⅳ diseases were more commonly seen in pancreaticobiliary type (63.6%,14/22) than intestinal type (2/8) and mixed type (3/9; χ2=6.508, P=0.039). Follow-up data showed a trend of better survival rate for patients with intestinal subtype than those with mixed and pancreaticobiliary subtypes.@*Conclusions@#Ampullary carcinoma can be subclassified into three different subtypes using a panel of six immunomarkers, especially for the identification of subtypes of poorly differentiated carcinoma. CK7, CK17 and MUC1 are major markers of pancreaticobiliary subtype, whereas CK20, CDX2 and MUC2 are useful markers for intestinal subtype. The mixed subtype variably expresses these markers. The prognosis of patients with intestinal subtype appears better than that of pancreaticobiliary and mixed subtypes. Accurate subtyping of ampullary carcinoma is clinically important to patient management and prognosis assessment.

5.
Journal of Practical Radiology ; (12): 1747-1750, 2019.
Article in Chinese | WPRIM | ID: wpr-789936

ABSTRACT

Objective To summarize the chest CT features of IgG4-related lung disease(IgG4-RLD).Methods The clinical data and chest CT findings of 10 patients with IgG4-RLD diagnosed by the pathological findings of lungs or bronchus were analyzed retrospectively,including masses,nodules,ground glass opacities,pulmonary interlobular septal thickening,bronchovascular bundle thickening,mediastinal lymph nodes enlargement and pleural involvement.Results There were two types of chest CT findings in 10 patients:(1 )Isolated mass/nodule type in 5 patients,presenting as a single lung mass (n=3)and a single lung nodule (n=2),and the lesions were in irregular shape, with shallow lobulated edges and burrs,with no mediastinal lymph nodes enlargement.(2)Interstitial thickening in 5 patients,presenting with thickening of pulmonary lobular septum(n=5)and thickening of bronchovascular bundle(n=4),multiple patchyground glass opacities(n=3), consolidation(n=3),mild mediastinum lymph nodes enlargement(n=3),a little bilateral pleural effusion(n=2)and nodular thickening of pleura(n=2).Serum IgG4 level was increased in 4 cases.Conclusion Chest CT findings of IgG4-RLD can be classified into two types:solitary mass/nodule type and interstitial type.Combing the chest CT manifestation with clinical characteristics will improve the diagnostic accuracy of IgG4-RLD.

6.
Chinese Journal of School Health ; (12): 1315-1317, 2019.
Article in Chinese | WPRIM | ID: wpr-816598

ABSTRACT

Objective@#To analyze the relationship between daily behavior and self-perceived academic performance among students in Jiangxi, and to provide a scientific basis for developing health behavior among adolescents and children.@*Methods@#By using stratified cluster sampling, 12 primary and secondary schools from six counties of Jiangxi Province were selected, and a total of 2 284 students were investigated with questions including breakfast consumption, number of days participating in sports activities (≥45 min) and the average screen time during the past 7 days. Regression analysis was carried out by using ordered multi-classification logistic.@*Results@#Of the 2 284 students surveyed, 1 374(60.16%) perceived their academic performance as very good or good, 613 (26.84%) and 297(13.00%) perceived as moderate or poor. Primary school, having breakfast every day, not playing on mobile or computer during weekday was positively associated with higher self-perceived academic performance (OR=0.50, 0.57 and 0.64, respectively, P<0.05), no sports activities ≥45 min during the past 7 d was associated with poor(OR=1.57, P<0.01). Among the 2 284 students, 67.43% students ate breakfast every day in the past 7 d, 75.39% students did not play mobile phones or computers at school, 40.89% students did not participate in sports activities (≥45 min).@*Conclusion@#Breakfast skipping and insufficient physical exercise shows adverse effects, and no/limited screen time during weekdays shows positive effects on academic performance. Intervention of visky behaviors should to carried out from different perspectives to promote the develpment of the health habits among students.

7.
Article in Chinese | WPRIM | ID: wpr-755636

ABSTRACT

Objective To investigate the effect of genetic factors on the occurrence of chronic post-thoracotomy pain syndrome ( PTPS) from the perspective of genetic polymorphisms. Methods Two hun-dred patients of both sexes, of American Society of Anesthesiologists physical statusⅠ or Ⅱ, aged 18-80 yr, scheduled for elective video-assisted thoracoscopic radical lung cancer surgery, were enrolled in this study. Blood samples were taken before operation for genotype analysis of 20 SNP loci, such as rs4073 and rs3774932, after DNA extraction. Postoperative multimodal analgesia was applied to maintain the visual an-alogue scale score <3. All the patients were followed up for 2-4 months after operation to record the occur-rence of PTPS. The patients were divided into 2 groups according to whether PTPS occurred: non-PTPS group (group N) and PTPS group (group P). Results The incidence of PTPS was 38. 7% after surgery, and there were 114 patients in group N and 72 cases in group P . There was significant difference in A/T al-lele and genotype frequency at interleukin-8 rs4073 site and NF-κB1 rs3774932 site between the two groups (P<0. 05). Conclusion Interleukin-8 and NF-kappa B1 genetic polymorphisms are associated with the occurrence of PTPS.

8.
Article in Chinese | WPRIM | ID: wpr-777968

ABSTRACT

Objective To study the influences of mental disorders on female systemic lupus erythematosus(SLE)and analyze the factors. Methods We used symptom check list -90 (SCL-90) as a basis for judging mental disorders disease activity. Disease activity, social support and depreciation - discrimination were used as possible influencing factors. Social support and discomfort – discrimination were possible influencing factors. Multivariate unconditional logistic regression model was used to analyze the influencing factors of mental disorders. Results The total score of SCL-90 of patients with female SLE was significantly higher than that of norm models [(136.39±48.66) vs (129.96±38.76)] (P<0.05), in 289 SLE patients, the number of patients with mental disorders was 128 (44.3%). High monthly income(OR=0.770, 95% CI:0.604-0.981, P=0.034) was a protective factor for mental disorders. High disease activity (OR=1.792, 95% CI:1.023-3.138, P=0.042)and high discomfort–discrimination (OR=1.100, 95% CI:1.035-1.169, P=0.002)were risk factors for mental disorders. Conclusions Female SLE patients have a higher risk of mental disorders than the general population. And eliminating self-depreciation, reducing social discrimination, active employment, increasing monthly income, standardizing treatment and reducing disease activity may effectively alleviate mental disorders in SLE patients.

9.
Chinese Medical Journal ; (24): 454-460, 2018.
Article in English | WPRIM | ID: wpr-342017

ABSTRACT

<p><b>Background</b>MicroRNAs (miRNAs) have been reported to play vital roles in liver regeneration. Previous studies mainly focused on the functions of intracellular miRNAs, while the functions of circulating exosomal miRNAs in liver regeneration remain largely unknown. The aim of this study was to identify the key exosomal miRNA that played vital roles in liver regeneration.</p><p><b>Methods</b>The Sprague-Dawley male rats were assigned to 70% partially hepatectomized group (n = 6) and sham surgery group (n = 6). The peripheral blood of both groups was collected 24 h after surgery. The exosomal miRNAs were extracted, and microarray was used to find out the key miRNA implicated in liver regeneration. Adenovirus was used to overexpress the key miRNA in rats, and proliferating cell nuclear antigen (PCNA) staining was applied to study the effect of key miRNA overexpression on liver regeneration. Western blotting was used to validate the predicted target of the key miRNA.</p><p><b>Results</b>Exosomal miR-10a was upregulated more than nine times in hepatectomized rats. The level of miR-10a was increased in the early phase of liver regeneration, reached the top at 72 h postsurgery, and decreased to perioperative level 168 h after surgery. Moreover, enforced expression of miR-10a by adenovirus facilitated the process of liver regeneration as evidenced by immunohistochemical staining of PCNA. Erythropoietin-producing hepatocellular receptor A4 (EphA4) has been predicted to be a target of miR-10a. The protein level of EphA4 was decreased in the early phase of liver regeneration, reached the bottom at 72 h postsurgery, and rose to perioperative level 168 h after surgery, which was negatively correlated with miR-10a, confirming that EphA4 served as a downstream target of miR-10a. Moreover, inhibition of EphA4 by rhynchophylline could promote the proliferation of hepatocytes by regulating the cell cycle.</p><p><b>Conclusion</b>Exosomal miR-10a might accelerate liver regeneration through downregulation of EphA4.</p>

10.
Chinese Medical Journal ; (24): 600-607, 2018.
Article in English | WPRIM | ID: wpr-341991

ABSTRACT

<p><b>Background</b>Currently, drug-eluting balloon (DEB) appears to be an attractive alternative option for the treatment of in-stent restenosis (ISR). Nevertheless, the clinical outcomes of DEB have seldom been compared to those of new-generation drug-eluting stent (DES). Thus, this meta-analysis aimed to evaluate the safety and efficacy of DEB compared to those of new-generation DES in the treatment of ISR.</p><p><b>Methods</b>A comprehensive search of electronic databases including PubMed, EMBASE, and Cochrane Library up to November 2, 2017 was performed to identify pertinent articles comparing DEB to new-generation DES for the treatment of ISR. In addition, conference proceedings for the scientific sessions of the American College of Cardiology, American Heart Association, European Society of Cardiology, Transcatheter Cardiovascular Therapeutics, and EuroPCR were also searched. The primary endpoint was target lesion revascularization (TLR) at the longest follow-up. Dichotomous variables were presented as risk ratios (RR s) with 95% confidence intervals (CI s), while the overall RR s were estimated using the Mantel-Haenszel random-effects model.</p><p><b>Results</b>Five randomized controlled trials (RCTs) and eight observational studies involving 2743 patients were included in the present meta-analysis. Overall, DEB was comparable to new-generation DES in terms of TLR (RR = 1.24, 95% CI: 0.89-1.72, P = 0.21), cardiac death (RR = 1.55, 95% CI: 0.89-2.71, P = 0.12), major adverse cardiovascular event (RR = 1.21, 95% CI: 0.98-1.48, P = 0.07), myocardial infarction (RR = 1.12, 95% CI: 0.72-1.76, P = 0.62), and stent thrombosis (RR = 0.95, 95% CI: 0.38-2.42, P = 0.92). However, DEB was associated with higher risk of all-cause mortality than new-generation DES (RR = 1.65, 95% CI: 1.09-2.50, P = 0.02). This was especially true in the real-world observational studies (RR = 1.79, 95% CI: 1.12-2.88, P = 0.02). In RCTs, however, no significant difference was found between the two treatment strategies in the risk of all-cause mortality.</p><p><b>Conclusions</b>The current meta-analysis showed that DEB and new-generation DES had comparable safety and efficacy for the treatment of ISR in RCTs. However, treatment with DEB was associated with higher risk of all-cause mortality in the real-world nonrandomized studies.</p>

11.
Article in Chinese | WPRIM | ID: wpr-691270

ABSTRACT

As the perioperative chemotherapy and conversion therapy has been widely implemented on the standard treatment of gastric cancer patients, it is of great importance to evaluate the efficacy of these patients accurately by effective methods. Being an important grading standard for histomorphological evaluation of excision specimens after neoadjuvant chemotherapy, pathological tumor regression grade (TRG) system is mainly used to assess the degree of fibrosis of tumor tissue and the proportion of residual tumor cells. TRG evaluation may provide important information referring to clinical decision making and prognostic judgment, and may imply on different efficacy and survival rates. Currently, four TRG standards can be used to evaluate the efficacy of neoadjuvant chemotherapy or translational therapy for primary gastric cancer, including Becker, Mandard, Ninomiya and Ryan, among which Ryan's 0-3 classification system is the most widely used. The main factors influencing the outcome of postoperative pathological TRG evaluation of gastric cancer include tumor localization, macroscopic observation and dissection of specimens, microscopic evaluation, as well as TRG evaluation criteria that are too complicated and difficult to operate. Although some studies have found that tumor regression of gastric cancer may be associated with some molecular markers, it may bring greater benefits to the choice of treatment decisions and prognosis judgment if further studies can confirm that specific biomarkers can help estimate the efficacy of neoadjuvant chemotherapy and translational therapy for gastric cancer after endoscopic biopsy.

12.
Article in Chinese | WPRIM | ID: wpr-700554

ABSTRACT

At present,there are still many problems in critical care medicine education and teaching,such as imperfect theoretical system,inconsistent teaching materials,uneven teaching staff,lack of practice opportunities and places.The development of intensive care medical teaching should be combined with "organ-system-centered" teaching reform,strengthen the construction of the theoretical system,drive the development of teaching staff,build high-quality practice bases,promote the curriculum to be more specialized,optimized and standardized,so as to promote the development of the subject.

13.
Tianjin Medical Journal ; (12): 60-64, 2018.
Article in Chinese | WPRIM | ID: wpr-697973

ABSTRACT

Objective To study the findings and clinical application of the diffusion tensor imaging (DTI) of the trigeminal nerve root in patients with trigeminal neuralgia (TN). Methods Forty-nine patients with unilateral TN caused by vascular compression and surgically confirmed were collected in this study. The subjects were divided into group A (contact, n=22), group B (displacement, n=11) and group C (atrophy, n=16), according to the relationship between blood vessels and nerves. Conventional MRI and horizontal DTI were performed to measure cross-sectional area (CSA), mean diffusivity (MD) value, fractional anisotropy (FA) value, axial diffusivity (AD) value and radial diffusivity (RD) value in nerve roots of affected side and unaffected side. The trigeminal indexes of both affected and unaffected trigeminal nerves and data of the affected trigeminal indexes of TN patients were compared between the groups. Results The CSA and FA values were significantly lower, MD and RD values of trigeminal nerves were significantly higher in affected side than those of unaffected side ( P<0.05). But there was no significant difference in AD value between affected side and unaffected side of TN patients ( P>0.05). Values of CSA and FA were significantly higher in group A than those of group C. The value of RD was significantly lower in group A than that of group C. FA value was significantly higher in group B than that of group C (P<0.05). Conclusion The magnetic resonance DTI sequence can reflect changes in trigeminal nerve microstructure, suggesting that trigeminal demyelination is caused by vascular compression, and altered diffusion indexes of trigeminal nerve are reliable basis for the pathogenesis and the severity evaluation of TN.

14.
Article in Chinese | WPRIM | ID: wpr-695758

ABSTRACT

Objective To investigate the epidemiological status and the anticoagulation treatment of atrial fibrillation (AF) patients,and to provide evidence for improving anticoagulation therapeutic effect in AF patients.Methods We performed a cross-sectional epidemiological investigation of 1 000 patients and out-patients with AF in Huashan Hospital.The clinical data including clinical feature,coexistent diseases,auxiliary examination,and treatment regimen of these patients were collected.The clinical features and anticoagulation status of AF patients were analyzed based on the stroke history,stroke risk evaluation and CHA2DS2-VASc score stratification.Results The mean age of these AF patients was (72.1 ± 11.1) years old.The most common coexistent diseases were hypertension (65%),coronary heart disease (32%) and diabetes (27%).About 6% of the AF patients were diagosed with non-valvularatrial fibrillation (NVAF),and 22% had stroke history.Patients were divided into two groups according to their stroke history.Compared with the non-stroke group,the stroke group was found to be older,with longer course of AF and poorer hypertension control.The overall anticoagulation rate was 32 % and antiplatelet rate was 46 %.The anticoagulation rate of stroke group was 44%,higher than the non-stroke group (P<0.001) but 78% of these patients began anticoagulation therapy after the occurrence of stroke.When CHA2 DS2-VASc scores of NVAF patients were 2 to 5,the anticoagulation proportion increased gradually.When the scores were 2 to 6,the antiplatelet ratio increased gradually.But when the scores were 7-8 points,both anticoagulation and antiplatelet rates were in decline.Conclusions The anticoagulation rate in AF patients was still low at present,while relatively higher in patients with stroke.Anticoagulation could prevent stroke,AF patients still could benefit from anticoagulation after stroke,but anticoagulation before stroke could get more benefits.

15.
Article in Chinese | WPRIM | ID: wpr-695075

ABSTRACT

Purpose To study the clinicopathological characteristics of blastic Plasmacytoid dendritic cell neoplasms, and improve the acknowledgement and diagnostic level. Methods The clinicopathological features, immunohistochemistry and EBV test results of 10 cases with BPDCN were analyzed retrospectively, with review of literature. Results Skin lesions were the first symptom in 10 patients, tumor cells expression of CD43, CD56, CD4 was positive in 8 cases, CD123 were positive in 5 cases, the T and B cell specific markers is not expression. EB virus encoded small RNA(EBER ) in situ hybridization is negative;no clonal rearrangement of B cell receptor(BCR) or T cell receptor(TCR) gene. Conclusion BPDCN is a rare malignant tumor of the skin, easy to involve the skin. It is necessary to combine clinical with pathological for definite diagnosis.

16.
Chinese Journal of Cardiology ; (12): 857-861, 2017.
Article in Chinese | WPRIM | ID: wpr-809385

ABSTRACT

Objective@#To observe the value of evaluating the coronary collateral circulation of chronic total occlusion (CTO) by transluminal attenuation gradient (TAG) and Rentrop grading, and analyze the influencing factors for coronary collateral circulation.@*Methods@#A total of 179 CTO patients admitted to Beijing Anzhen hospital during June 2013 to August 2016 were included in this study.All patients received coronary computed tomographic angiography (CCTA) examination before coronary angiography.Finally, 75 patients (79 vessels) were enrolled.Patients were divided into two groups on the basis of Rentrop classification.The Rentrop 3 was defined as a well-developed coronary collateral circulation group, including 50 CTO vessels, Rentrop 2 or below was defined as poorly-developed collateral circulation group, including 29 vessels.TAG values in patients with various Rentrop grades were analyzed.Univariate and multivariate analysis were used to determine the predictors of collateral circulation.@*Results@#TAG increased consistently in proportion to the angiographic extent of collateral flow (TAG was (-33.6±24.4), (-16.5±15.7) and (-12.8±15.8) HU/10 mm in patients with Rentrop grade 0 or 1, 2 and 3, respectively, P=0.007). Number of good collateral circulation vessels predicted by TAG≥15.6 HU/10 mm was 45(57.0%, 45/79), and 50 (63.3%, 50/79) by Rentrop grade (P=0.383). Prevalence of diabetes was significantly lower (20.8%(10/48) vs. 48.1%(13/27), P=0.01), while history of previous myocardial infarction (MI) was significantly higher (35.4%(17/48) vs. 11.1%(3/27), P=0.02) in patients with good collateral circulation than in patients with poor collateral circulation.The TAG of the good collateral circulation group was significantly higher than in poorly collateral circulation group ((-12.8±15.8) HU/10 mm vs. (-21.2±19.6) HU/10mm, P=0.041). Multiple logistic regression analysis revealed that history of MI (OR=0.196, 95%CI 0.041-0.936, P=0.041) and diabetes(OR=6.604, 95%CI 1.726-25.274, P=0.006) were independent predictors of coronary collateral circulation.@*Conclusions@#TAG could be used to evaluate status of coronary collateral circulation.Presence of MI history and absence of diabetes history are the two independent predictors of well-developed coronary collateral circulation in CTO patients.

17.
Chinese Journal of Cardiology ; (12): 19-25, 2017.
Article in Chinese | WPRIM | ID: wpr-807991

ABSTRACT

Objective@#To compare the long-term clinical outcomes of consecutive patients treated with coronary artery bypass grafting (CABG) or percutaneous coronary intervention(PCI) with drug-eluting stents (DES) for bifurcation lesions in unprotected left main coronary artery (ULMCA).@*Methods@#A total of 663 consecutively patients with unprotected left main bifurcation disease (defined as stenosis≥50%) who received either drug-eluting stents (DES) implantation (n=316) or underwent CABG (n=347) between January 2003 and July 2009 in Beijing Anzhen Hospital were enrolled retrospectively in this study.The endpoints of the study were death, repeat revascularization, myocardial infarction (MI), stroke, the composite of cardiac death, MI or stroke and MACCE (major adverse cardiac and cerebrovascular events, the composite of cardiac death, MI, stroke or repeat revascularization). To reduce the bias between two compared groups , our study applid propensity score matching by logistic regression.Cumulative survival rate was calculated by Kaplan-Meier method.Multiple regression analyses, hazard ratio(HR) and 95%CI were tested by Cox proportional hazard models with the CABG group as the reference category.@*Results@#The median follow-up was 7.2 years (interquartile range 5.1 to 8.3 years) in the overall patients.Unadjusted analysis showed that MACCE rate (PCI 44.5% vs. CABG 45.7%, P=0.036), the rate of repeat revascularization (PCI 33.7% vs. CABG 19.5%, P<0.001), the composite rate of serious outcomes (cardiac death, MI or stroke) (PCI 20.4% vs. CABG 34.3%, P=0.032), stroke rate (PCI 3.7% vs. CABG 23.5%, P<0.001) were significantly different for patients undergoing PCI or CABG. Death rate (PCI 13.0% vs. CABG 18.9%, P=0.12) and MI rate (PCI 11.3% vs. CABG 6.1%, P=0.108) were similar between PCI and CABG group.After adjusting covariates with multivariate Cox hazard regression model, there was no significant difference in rates of death (P=0.286), MI(P=0.165) and the composite rate of serious outcomes (cardiac death, MI or stroke) (P=0.305) between the two groups. Patients in PCI group suffered significant higher rates of MACCE(P=0.011), mainly driven by the significant higher rates of repeat revascularization(HR=2.46, 95%CI 1.662-3.642, P<0.001). However, stroke rate was still significantly higher in CABG group than in PCI group(P=0.001)after multivariate adjusting. After propensity score matching (PSM), there was no more significant difference for all covariates in the matched cohorts (202 pairs). Further PSM analysis showed that overall findings were consistent with multivariate Cox hazard regression model except for MI (PCI 12.7% vs. CABG 3.8%, P=0.039).@*Conclusions@#During a follow-up up to 8.3 years, the survival rate is similar between the PCI and the CABG group in patients with unprotected left main bifurcation disease.The rate of repeat revascularization is significantly higher whereas stroke rate is significantly lower in the PCI group compared to CABG group.After propensity score matching, PCI group not only had a significant higher rate of repeat revascularization, but also had significantly higher risk of MI in the matched cohorts; while they did not seem to translate into any disparity of mortality in ULMCA bifurcation disease patients.Accordingly, PCI for ULMCA disease can be used as a reasonable treatment option alternative to CABG.

18.
Article in Chinese | WPRIM | ID: wpr-509627

ABSTRACT

Objective To study curative efficacy of dezocine in treatment of receiving laparoscopic appendectomy and its effects on white blood cell count and c reactive protein.Methods 90 patients of laparoscopic appendectomy who received therapy from January 2015 to October 2016 in our hospital were selected as research objects,according to random number table,those patients were divided into the observation group and the control group,45 cases in each group.The control group was treated with sufentanil, while the observation group was treated with dezocine.Then operation index, T0 (preoperative),T1(extubation),T2(after extubation) mean arterial pressure(MAP),heart rate(HR), respiration rate(RR),isual analogue scale/score ( VAS) , ramsay score ( RSS) , white blood cell count and c reactive protein of two groups after treatment were compared .Results After treatment, MAP,HR in the observation group were significantly lower than control group [(78.30 ±6.20)mmHg vs.(86.08 ±6.09)mmHg,(76.45 ±5.90)mmHg vs.(80.48 ±5.80)mmHg,(90.82 ±9.50)time/min vs.(96.73 ±9.83)time /min,(87.21 ±8.15)time /min vs.(93.59 ±9.90)time /min](P<0.05); VAS, RSS score were significantly lower than the control group[(2.60 ±0.70)score vs.(5.29 ±0.83)score,(3.53 ±0.92)score vs.(6.38 ± 1.21)score](P<0.05); White blood cell count, c reactive protein were significantly lower than the control group[(7.92 ±2.01) ×109/L vs.(14.98 ±2.11) ×109/L,(7.90 ±2.30)mg/L vs(12.46 ±3.10)mg/L](P<0.05).Conclusion Dezocine is well for receiving laparoscopic appendectomy, obvious analgesic effect, can significantly reduce the white blood cell count and c reactive protein.

19.
Article in Chinese | WPRIM | ID: wpr-297201

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the effect of annexin A2 (AnxA2) on epithelial growth factor receptor (EGFR)/nuclear factor-κB (NF-κB) signal transduction and mucin expression in human airway epithelial H292 cells treated with Mycoplasma pneumoniae (MP).</p><p><b>METHODS</b>H292 cells were divided into control group, MP group, NC-siRNA+MP group, and AnxA2 siRNA+MP group. The cells in the MP group were incubated with 5 μg/mL MP antigen for 2 hours. The cells in the NC-siRNA+MP and AnxA2 siRNA+MP groups were transfected with NC-siRNA and AnxA2 siRNA for 24 hours, followed by MP antigen stimulation for 2 hours. The MTT method was used to measure cell viability; quantitative real-time PCR was used to measure the mRNA expression of AnxA2; Western blot was used to measure the protein expression of AnxA2, phosphorylated EGFR (p-EGFR), and phosphorylated p65 NF-κB (p-p65 NF-κB); ELISA was used to measure the secretion of mucin 5AC (MUC5AC) and mucin 5B (MUC5B).</p><p><b>RESULTS</b>The MP and NC-siRNA+MP groups had lower cell viability than the control group (P<0.05). The AnxA2 siRNA+MP group had higher cell viability than the MP and NC-siRNA+MP groups and lower cell viability than the control group (P<0.05). The MP and NC-siRNA+MP groups had significantly higher mRNA and protein expression of AnxA2 than the AnxA2 siRNA+MP group (P<0.05). Compared with the control group, the MP and NC-siRNA+MP groups had significant increases in the protein expression of p-EGFR, p-p65 NF-κB, MUC5AC, and MUC5B (P<0.05); the AnxA2 siRNA+MP group had lower protein expression than the MP and NC-siRNA+MP groups, but higher protein expression than the control group (P<0.05).</p><p><b>CONCLUSIONS</b>AnxA2 is involved in the airway lesion induced by MP antigen via mediating EGFR/NF-κB signaling activation and mucin expression in human airway epithelial cells.</p>


Subject(s)
Annexin A2 , Physiology , Bronchi , Physiology , Cells, Cultured , Epithelial Cells , Microbiology , Humans , Mucins , Mycoplasma pneumoniae , Virulence , NF-kappa B , Physiology , ErbB Receptors , Physiology , Signal Transduction , Physiology
20.
Article in Chinese | WPRIM | ID: wpr-611390

ABSTRACT

Objective To analyze the characteristics of preoperative CTO lesions by coronary CT angiography (CCTA) and to compare the lesion characteristics and clinical data of patients with subsequent vs failed PCI.Methods A total of 113 patients were randomly selected and 116 vessels were analyzed by CCTA before PCI.The patients were further investigated as PCI success group vs PCI failure group according to their PCI result.Multivariate logistic regression analysis was used to determine the factors that affected the success of CTO intervention.The ROC curve was used to determine and evaluate the CT-CTO score and J-CTO score for diagnostic efficacy.Results The success rate of PCI was 55.2%.64 lesions were successfully opened,with the success rate of 72.4%.The prevalence of smoking in patients in the PCI failure group was significantly higher than that in PCI success group (65.4% vs.42.2%,P < 0.05).There were no significant differences between the two groups in age,gender,history of hypertension,diabetes mellitus,and myocardial infarction(P > 0.05).Statistical differences were observed between the PCI success group and the PCI failure group in the presence of occlusion segment head-end bifurcation,occlusion severe incision,severe calcification (calcification ≥ 180°),occlusion segment length ≥ 20 mm,occlusion of calcification lesions,occlusion segment distal shape of the unambiguous of fiber cap shape of the distal occlusion segment under CCTA(P < 0.05).In the PCI failure group,approximately 17.3% of the patients had previous attempt to open the CTO lesions,which were higher than the PCI success group (9.4%).However,The difference was not statistically significant (P > 0.05).Multivariate logistic regression analysis showed that the unambiguous distal fibrous cap of the occlusion segment and the occlusion of the proximal branch and the occlusion length ≥20 mm were the main factors affecting the failure of CTO intervention.In terms of prediction,the predictive value 30 CT-CTO score yielded a higher area under the ROC curve than that of the J-CTO score (0.8776 vs 0.7387,P ≤ 0.05).Conclusion CT angiography can predict the success rate of intervention for CTO lesions.Compared with J-CTO score,CT-CTO score has a higher predictive value.Unambiguous fiber cap shape,occlusion segment head end bifurcation,occlusion segment length ≥20 mm were the independent risk factors that affecting the success of CTO operation.

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