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Objective @#To clarify the distribution of traditional Chinese medicine (TCM) pattern and its associated risk factors after percutaneous coronary intervention (PCI), and evaluate the reporting quality of existing studies to guide future research standardization.@*Methods@#English databases including PubMed, Cochrane Library, and Web of Science, as well as Chinese databases including China National Knowledge Infrastructure (CNKI), China Scientific Journal Database (VIP), and Wanfang Database were searched to retrieve papers about PCI. The time span for the paper retrieval was set from the foundation of the databases to October 1, 2023. Statistical analyses were performed using Stata 12 and Python (V 3.9). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement was used to assess the reporting quality of included studies.@*Result@#Overall, 1 356 articles were selected, and 40 cross-sectional studies were included with 10 270 participants. The most common TCM patterns before, one to two weeks after, and six months to one year after PCI was Qi stagnation and blood stasis (n = 261, 36.45%), intertwined phlegm and blood stasis (n = 109, 27.18%), and Qi deficiency and blood stasis (n = 645, 37.03%), respectively. Smoking [odds ratio (OR) = 1.15, 95% confidence interval (CI) (0.83 – 1.47), I 2 = 24.7%, P = 0.257], pattern of congealing cold and Qi stagnation [OR = 4.62, 95% CI (1.37 – 7.86), I 2 = 61.6%, P = 0.074], and low-density lipoprotein (LDL) [OR = 1.38, 95% CI (0.92 – 1.85), I 2 = 12.2%, P = 0.286] were risk factors for restenosis. Hypertension [OR = 7.26, 95% CI (3.54 – 14.88), I 2 = 91.6%, P = 0.001], and overweight [i.e., body mass index (BMI) > 23] [OR = 1.20, 95% CI (1.07 – 1.35), I 2 = 85.3%, P = 0.009] were significant risk factors of concomitant anxiety.@*Conclusion@#This systematic review andet a-analysis revealed that patients with different TCM pattern types have distinct characteristics and risk factors after PCI. More high-qualitystudies are warranted to provide supportive evidence for future research and clinical practice.
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Objective·To explore the correlation between body compositions and cardiovascular fitness(CRF)in patients with coronary heart disease(CHD).Methods·The CHD patients(CHD group)who underwent elective percutaneous coronary intervention treatment at Renji Hospital,Shanghai Jiao Tong University School of Medicine from October 2022 to June 2023 as well as healthy people(control group)were selected.All the participants completed cardiopulmonary exercise testing(CPET)to determine CRF and bioelectrical impedance analysis(BIA)to determine body compositions on the same day.Results·A total of 191 patients with coronary heart disease and 188 healthy individuals were included.There was no statistically significant difference in baseline characteristics between the two groups.Compared with the control group,the CRF indicators of the CHD group were significantly reduced(all P<0.05).In terms of body composition indicators,the trunk muscle mass(TMM)of the CHD group was significantly lower than that of the control group(P<0.01),and the trunk fat mass(TFM)was significantly higher than that of the control group(P<0.01).Correlation analysis showed that TMM(R=0.538),lower limbs muscle mass(LMM)(R=0.754),and lower limbs fat mass(LFM)(R=0.593)were positively correlated with peak oxygen uptake per kilogram of bodyweight(VO2peak/kg)in the CHD group(all P<0.01),while TFM(R=-0.563)was negatively correlated with VO2peak/kg(P<0.01).There was no statistically significant correlation between other body composition indicators and VO2peak/kg.According to VO2peak/kg,the CHD patients were divided into low CRF group,medium CRF group,and high CRF group.The results showed that there were statistically significant differences in LMM,TMM,LFM,and TFM among the three groups of patients(all P<0.05).Multiple linear regression analysis suggested that age,gender,TMM,TFM,LMM,and LFM were related factors of VO2peak/kg in the patients with CHD.The VO2peak/kg of CHD patients increased with the increase of TMM,LMM,and LFM and the decrease of age and TFM;the female patients had lower VO2peak/kg compared to the males.Conclusion·The CRF of CHD patients is significantly lower than that of the healthy population,with higher TFM and lower TMM;in the CHD patients,CRF is negatively correlated with TFM and positively correlated with TMM,LMM,and LFM.
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Objective To establish an individual Nomgram model for predicting the risk of coronary heart disease complicated with pulmonary hypertension. Methods From January 2017 to December 2021 , 352 patients with coronary heart disease (CHD) complicated with pulmonary hypertension in our hospital were selected, and 352 patients with coronary heart disease but without pulmonary hypertension were selected as the control group. The clinical baseline data of the two groups were analyzed first, and then logistics multivariate analysis was performed. To explore the risk factors of coronary heart disease complicated with pulmonary hypertension, the Nomgram model was established to predict the risk, and the predictive value of the model was tested by receiver characteristic curve (ROC). Results Logistics multivariate analysis showed that alcoholism, smoking, stroke history, hypertension course, CHD course, PASP, HCT, PaCO2, D-dimer, NIHSS score and low PaO2 were all independent risk factors for CHD complicated with pulmonary hypertension. Nomgram model prediction results for patients with coronary heart disease showed that Alcohol abuse, smoking, stroke history, duration of hypertension (5.66 years), duration of coronary heart disease (2.12 years), NIHSS (12.33 points), PASP (75.22mmHg), HCT (33.22%), PaCO2 (56.11mmHg), D-dimer (255.12μg/L), PaO2 (56.22mmHg) is a risk factor for coronary heart disease complicated with pulmonary hypertension. ROC curve showed that the area under the prediction curve of Nomgram model for coronary heart disease complicated with pulmonary hypertension was 0.675. Conclusion Nomgram model can predict pulmonary hypertension in patients with coronary heart disease to a certain extent.
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Diabetic retinopathy(DR) and coronary heart disease(CHD) are both major chronic vascular complications that seriously jeopardize the health of the population and often occur together in clinical practice, it is of great clinical value to actively explore the association between the two in the process of disease development and methods of prevention and treatment of modern medicine and traditional Chinese medicine(TCM). According to TCM, the heart and eyes physiologically communicate with each other by taking Qi, blood and veins as bridges, blood stasis obstructing collaterals is the common TCM etiology of DR and CHD, whose mechanism involves inflammation, oxidative stress and endothelial dysfunction. Promoting blood circulation and removing blood stasis plays an important role in the same treatment for different diseases and prevention and treatment of comorbidities, possibly by inhibiting the expression of interleukin-1β(IL-1β), endothelin-1(ET-1) and hypoxia inducible factor-1α/vascular endothelial growth factor(HIF-1α/VEGF), regulating phosphatidylinositol 3-kinases/protein kinase B/mammalian target of rapamycin(PI3K/Akt/mTOR) pathway, initiating adenosine monophosphate(AMP)-activated protein kinase/silent information regulator 1(AMPK/SIRT1) and nuclear transcription factor erythroid 2-related factor 2/heme oxygenase-1(Nrf2/HO-1) signaling pathways, inhibiting Hippo/Yes-associated protein(Hippo/YAP) signaling pathway, inhibiting mitochondrial permeability transition pore and anti-platelet agglutination for treating DR and CHD, which provides a multi-component, multi-pathway and multi-target selection strategies and ideas for the prevention and treatment of DR and CHD by TCM from a biological perspective. Based on this, subsequent studies should focus on constructing clinically relevant comorbidity models, conducting multicenter prospective studies, and fully utilizing artificial intelligence technology to gain a deeper understanding of the relationship between the two diseases, so as to elucidate the mechanism of promoting blood circulation and removing blood stasis in preventing and treating panvascular diseases.
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Background: Coronary Heart Disease (CHD) is one of the largest contributors to mortality and morbidity worldwide. Globally, CHD accounts for 17.5 million deaths in 2012, with over 75% of deaths occurring in developing countries. By 2015, 16% of all female and male deaths were caused by CHD. Dyslipidemia is the most common risk factor of CHD for the excessive level of lipids in blood. Most dyslipidemias are hyperlipidemias in developing countries; that is, an accumulation in blood lipids. CHD was 18 times more likely to grow according to hypertension with dyslipidemia category than with non-dyslipidemias. The aim of this study was to assess the effect of dyslipidemia associated with hypertension for coronary heart disease and identify risk factors for CHD among cardiac patients. Material & Methods: This was a case control study and was conducted in the Department of Medicine, LABAID Specialized Hospital, Dhaka, Bangladesh during the period from May,2022 to March,2023. We included 170 cardiac patients in our study. The patients were divided into two groups – Case group (Patients diagnosed with CHD) & Control group. Results: In total 170 patients from both the groups completed the study. In our study we found most of our patients were male (58%) compared to female (42%). We found the mean age was 46.1±11.3 & 47.1±9.3 years in case & control group respectively. Family history of hypertension was significantly higher in case group (52%). Among all patients, BMI was higher in case group. Cholesterol, systolic & diastolic bp was found significantly higher in case group than control group. HDL was found lower & LDL was found higher in case group. Among 85 cases, majority (68%) had dyslipidemia associated with hypertension. We found dyslipidemia was 55% & 36% in case & control group respectively. Hypertension was also found significantly higher in case group. Age ? 60 years, family history of CHD, smoking, diabetes & obesity were also individual risk factors of CHD among cardiac patients. In dyslipidemia with hypertension group 68 patients were diagnosed with CHD which is higher than non-hypertension group. Conclusion: In our study, we found that dyslipidemia, hypertension, age ? 60 years, family history of CHD, smoking, diabetes & obesity are individual risk factors of CHD development. Relationship of dyslipidemia with coronary heart disease in hypertension is significant. We also found dyslipidemia with hypertension is an established risk factor of prime importance that increased the risks of CHD among cardiac patients
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Vitamin D deficiency is one of the prominent nutritional deficiencies in India that needs special attention. The effects of hypovitaminosis D on skeletal and cardiovascular functions are well known. However, its effect on metabolic disorders like type 2 diabetes mellitus (T2DM) is still left unexplored. In the present study, our primary aim is to find out the potential effect of hypovitaminosis D in T2DM patients. The study was conducted on 250 T2DM patients mainly from Madhya Pradesh, India. Among them, 125 had hypovitaminosis D (case group) and were compared against the control group of 125 patients with normal serum vitamin D. We were mainly investigating the major T2DM-related complications including chronic kidney disease (CKD), coronary heart disease (CHD and recurrent infections. Major organ functions including liver, kidney, and cardiac functions were affected by hypovitaminosis D in T2DM patients when compared to control counterparts. We also noticed an association between hypovitaminosis D and the exacerbation of T2DM comorbidities. Our findings show the importance of maintaining normal serum vitamin D levels in T2DM patients to avoid further complications.
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A variety of enzymes are involved in human development, such as chromatin domain helicase DNA-binding protein 7(CHD7), which is an ATP-dependent chromatin remodeling enzyme.The CHD7 could regulate many important transcription factors and may be involved in the process of growth development.Mutations in CHD7 can cause many developmental disorders, such as abnormal heart defects and delayed growth/development.At the same time, CHD7 affects neuronal differentiation and forebrain development, and has multiple target genes during brain development.Children with congenital heart disease are more likely to have the abnormal brain function and exocardiac malformations.Therefore, more attention has been paid to the children with congenital heart disease and brain dysplasia in clinical practice.This paper summarizes the biological function and mechanism of CHD7, as well as the effects of CHD7 on congenital heart disease with brain dysplasia inchildren, which could provide implications for the future study in this area.
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Objective To collect information from the traditional Chinese medicine(TCM)four diagnostic information of patients with coronary heart disease(CHD)and to observe the characteristics of their Chinese medicine syndrome factor at different ages,to provide an objective basis for the Chinese medicine treatment of patients with CHD at different ages.Methods The TCM Four Diagnostic Information Collection Scale for CHD developed by the group was used to collect the four diagnostic information of patients with coronary heart disease,and the syndrome elements were extracted according to the syndrome differentiation standard to observe the distribution of syndrome elements at different ages.Results CHD is located in the heart and accompanied by liver,kidney,stomach,lung and other organs.Qi deficiency is the most common syndrome factor,followed by phlegm turbidity,yin deficiency,blood stasis and qi stagnation.Among the syndrome elements of disease location,the heart and liver were the most common in the young group,and the heart and kidney were more common in the middle-aged group and the elderly group.Among the syndrome elements of disease nature,qi deficiency was more common in the young group,phlegm turbidity and qi stagnation were more common in the empirical group,and qi deficiency and phlegm turbidity were the most frequent.In the middle-aged group,qi deficiency was more common in deficiency syndrome,phlegm turbidity and blood stasis were more common in excess syndrome,and the frequency of qi deficiency and phlegm turbidity and blood stasis was the highest.In the elderly group,qi deficiency and yin deficiency were more common in deficiency syndrome,phlegm turbidity and blood stasis were more common in excess syndrome,and qi and yin deficiency combined with phlegm turbidity and blood stasis had the highest frequency.Conclusion The combination of syndrome elements in patients with CHD in different age groups has its own characteristics.The young,middle and elderly groups are all visible in the mixture of deficiency and excess,while the young group is the most common with qi deficiency and phlegm turbidity,the middle-aged group is the most common with qi deficiency and phlegm turbidity and blood stasis,and the elderly group is the most common with qi and yin deficiency and phlegm turbidity and blood stasis.With the increase of age,the complexity of the combination of syndrome elements is higher.
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Introduction@#Ignorance about appropriate Infant and Young Child Feeding (IYCF) Practices among parents of children with Congenital Heart Defects (CHD) can exacerbate malnutrition in these children leading to significant morbidity and mortality. Use of novel methods for Intensive Nutrition Counselling such as Whatsapp social media group can lead to considerable improvement in nutritional status of the child. @*Objectives@#To assess the efficacy of Whatsapp group for Intensive Nutritional Counselling to parents of children with CHD. @*Methods@#This is a two-year prospective interventional study, one-group before-after study design. Here, intervention is in the form of specialised focussed nutrition counselling for parents of children with CHD through Whatsapp social media group. @*Results@#Majority of the patients 16 (30.0%) were in the age group of 7-12 months, predominant diagnosis (25 patients i.e. 48.9%) was Ventricular Septal Defect (VSD). Sixty-eight percent patient-families belonged to lower socio-economic class. Before intervention, 71.1% of children (37 of 52) were found to be underweight, 35.5% children were stunted and 65.6% children were wasted. Post intervention there was significant improvement in all the 3 anthropometric indicators. This intervention particularly helped improve IYCF habits for the age group of 7-12 months. Post intervention all parents included the 8 food groups in their children’s diet thus providing them wholesome nutrition whereas earlier only 2-3 food groups were given to children on a daily basis. @*Conclusion@#This is the first study to explore use of Whatsapp group to educate parents of children with CHD about specific nutrition counselling, resulting in improvement in child anthropometric indices.
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Objective@#To explore the differential expression profiles of DNA methylation sites/regions and potential molecular mechanisms in the peripheral blood of coronary heart disease (CHD)-induced unstable angina pectoris patients with or without Qi deficiency and blood stasis syndrome, and to provide scientific evidence for the conbination of disease and syndrome.@*Methods@#According to the pre-determined inclusion and exclusion criteria, the study subjects were enrolled and divided into two groups namely CHD-induced unstable angina group (G group) and healthy control group (J group) to conduct “disease” analysis, while G group was further divided into Qi deficiency and blood stasis syndrome group (case group) and non-Qi deficiency blood stasis syndrome group (control group) to perform “syndrome” analysis. The general data and clinical information of the study subjects were collected. The peripheral venous blood was extracted on an empty stomach, and the Illumina Infinium MethylationEPIC BeadChip (850K methylation chip) was used to detect the differential expressionprofiles of DNA methylation in each group, ChAMP software (V 2.14.0) was used for the differential methylation data analysis, with a threshold of the adjusted P value (adj.P.val) < 0.01. Gene Ontology (GO) and Kyoto Encyclopedia of Genomes (KEGG) were employed for the functional and pathway enrichment analyses of related mapped genes.@*Results@#A total of 263 differentially methylated CpG positions (DMPs) were screened out between G and J groups, including 191 hypermethylated positions such as cg05845204 and cg08906898, and 72 hypomethylated positions such as cg26919182 and cg13149459. These positions were mainly mapped to 148 genes encompassing RNA binding motif protein 39 (RBM39), acetyl-CoA acyltransferase 2 (ACAA2), protein phosphatase 1 regulatory subunit 12B (PPP1R12B), and the dual-specificity tyrosine phosphorylation-regulated kinase 2 (DYRK2). GO functional enrichment analysis revealed that the genes of the DMPs were primarily enriched in protein localization to chromosomes, regulation of cell morphogenesis, negative regulation of calcium-mediated signals, etc. KEGG pathway analysis suggested that the genes were mainly enriched in fatty acid metabolism and endocytosis pathways. In addition, a total of 23 differential methylation regions (DMRs) were identified, with overlapping genes such as transmembrane protein 232 (TMEM232), ribosomal protein large P1 (RPLP1), peroxisomal biogenesis factor 10 (PEX10), and forkhead box N3 (FOXN3) recognized. It was found that GO functions were mainly enriched in the negative regulation of Ras protein signal transduction, small GTPase-mediated signal transduction, negative regulation, etc. A total of 1 703 differential methylation sites were screened out between case and control groups, including 444 increased methylation positions such as cg05573767 and 1 259 decreased methylationpositions such as cg19938535, and cg03893872. These positions were mapped to 1 108 genes such as ribosomal protein S6 kinase A2 (RPS6KA2), leucine rich repeat containing 16A (LRRC16A), and hedgehog acyltransferase (HHAT). According to the GO functional enrichment analysis, the genes relating to the DMPs were mainly enriched in biological functions such as transmembrane receptor protein serine/threonine kinase signaling pathway and axonogenesis. The KEGG pathway enrichment analysis suggested the involvement of Rap1 signaling pathway, adenosine 5’-monophosphate-activated protein kinase (AMPK) signaling pathway, etc. A total of 21 DMRs were identified, including 22 overlapping genes such as mucin 4 (MUC4), three prime repair exonuclease 1 (TREX1), and LIM homeobox 6 (LHX6). GO analysis demonstrated that the genes primarily participated in molecular functions such as positive regulation of transmembrane transport, regulation of fatty acid metabolism, and copper ion binding.@*Conclusion@#This study reveals the methylation patterns of DMPs and DMRs in patients with Qi deficiency and blood stasis syndrome caused by CHD-induced unstable angina pectoris. Potential epigenetic regulation of fatty acid metabolism, Rap1 signaling, and other molecular functions are involved in the development of CHD between the "disease" and "syndrome".
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Chromodomain-helicase-DNA-binding protein 1 (CHD1) deletion is among the most common mutations in prostate cancer (PCa), but its role remains unclear. In this study, RNA sequencing was conducted in PCa cells after clustered regularly interspaced palindromic repeat (CRISPR)/CRISPR-associated protein 9 (Cas9)-based CHD1 knockout. Gene set enrichment analysis (GSEA) indicated upregulation of hypoxia-related pathways. A subsequent study confirmed that CHD1 deletion significantly upregulated hypoxia-inducible factor 1α (HIF1α) expression. Mechanistic investigation revealed that CHD1 deletion upregulated HIF1α by transcriptionally downregulating prolyl hydroxylase domain protein 2 (PHD2), a prolyl hydroxylase catalyzing the hydroxylation of HIF1α and thus promoting its degradation by the E3 ligase von Hippel-Lindau tumor suppressor (VHL). Functional analysis showed that CHD1 deletion promoted angiogenesis and glycolysis, possibly through HIF1α target genes. Taken together, these findings indicate that CHD1 deletion enhances HIF1α expression through PHD2 downregulation and therefore promotes angiogenesis and metabolic reprogramming in PCa.
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Male , Humans , Von Hippel-Lindau Tumor Suppressor Protein/metabolism , DNA-Binding Proteins/metabolism , Prolyl Hydroxylases/metabolism , Hypoxia , Prostatic Neoplasms/pathology , Glycolysis , Hypoxia-Inducible Factor 1, alpha Subunit/metabolism , Cell Line, Tumor , DNA Helicases/metabolismABSTRACT
Objective To analyze the risk factors of coronary heart disease (CHD) in patients with type 2 diabetes mellitus (T2M) in Suining area, and build a risk prediction model to provide theoretical basis for the prevention and treatment of CHD in PATIENTS with T2M. Methods A total of 476 T2M patients treated in our hospital from January 2021 to December 2021 were selected and divided into experimental group (n=79) and control group (n=397) according to whether they had coronary heart disease. The angiographic characteristics of coronary artery lesions in patients with T2M combined with coronary heart disease were observed. Age, sex, body mass index (BMI), smoking, alcohol consumption , T2M course, FBG, FINS, HOMA, TC, LDL-C, SBP, DBP and UA levels of all patients were analyzed. Univariate analysis and Logistic regression were used to analyze the influencing factors of coronary heart disease and establish a risk prediction model. ROC curve was used to predict the efficiency of the model. Results A total of 79 cases (16.60%) of patients with T2M complicated with coronary heart disease, including 64 cases (81.01%) of patients with T2M complicated with coronary artery disease. Mild stenosis in 5 cases (6.33%), moderate stenosis in 20 cases (25.32%) and severe stenosis in 54 cases (68.35%); The mean age, smoking proportion, BMI, T2M course and the levels of FBG, FINS, HOMA-IR, TC, LDL-C, SBP, DBP and UA in experimental group were significantly higher than those in control group (P-(-0.513+0.919×(old age)+1.129×(increased SBP)+ 1.724×(increased FBG)+ 1.529×(increased LDL-C)]. ROC curve was used to analyze the predictive performance of the regression model. The results showed that the AUC of the risk prediction model for coronary heart disease in T2M patients was 0.728, 95% CI (0.651-0.829). Conclusions T2M patients in Suining have a high risk of coronary heart disease. For elderly patients with elevated SBP, LDL-C and FBG, the risk of coronary heart disease can be assessed by predictive model and targeted intervention measures can reduce the risk of coronary heart disease in T2M patients.
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Coronary heart disease (CHD) with atherosclerosis is a common chronic disease worldwide, and anxiety and depression are potential and crucial risk factors for adverse prognosis in CHD. Chaihu Longgu Mulitang (CLMT), first mentioned in the Shang Han Lun (《伤寒论》), is a classic prescription for treating Shaoyang diseases combined with disturbance of the mind and spirit, with the effects of harmonizing Shaoyang and calming the mind. Current research on mechanisms has shown that CLMT can play a role in CHD complicated with anxiety and depression through multiple pathways, including regulating related signaling pathways, inhibiting the expression of inflammatory factors, improving oxidative stress damage, modulating neurotransmitter levels, suppressing the hypothalamic-pituitary-adrenal axis, promoting mobilization of mesenchymal stem cells from the bone marrow, and inhibiting platelet activation. Clinical studies have demonstrated that CLMT significantly improves symptoms such as angina and insomnia caused by CHD complicated with anxiety and depression, effectively reduces negative emotions, improves traditional Chinese medicine (TCM) syndrome scores, and decreases levels of inflammatory factors. Furthermore, it has fewer adverse reactions and higher safety than conventional western medicine treatments. This article provides a review of the mechanisms and clinical studies of CLMT in the treatment of CHD complicated with anxiety and depression based on a comprehensive analysis of literature from the China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP, PubMed, and other databases in the past 15 years, in order to provide references for further research on the use of CLMT in the management of CHD complicated with anxiety and depression.
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During the tumorigenic process, cancer cells may become overly dependent on the activity of backup cellular pathways for their survival, representing vulnerabilities that could be exploited as therapeutic targets. Certain molecular vulnerabilities manifest as a synthetic lethality relationship, and the identification and characterization of new synthetic lethal interactions may pave the way for the development of new therapeutic approaches for human cancer. Our goal was to investigate a possible synthetic lethal interaction between a member of the Chromodomain Helicase DNA binding proteins family (CHD4) and a member of the histone methyltransferases family (SETDB1) in the molecular context of a cell line (Hs578T) representing the triple negative breast cancer (TNBC), a subtype of breast cancer lacking validated molecular targets for treatment. Therefore, we employed the CRISPR-Cas9 gene editing tool to individually or simultaneously introduce indels in the genomic loci corresponding to the catalytic domains of SETDB1 and CHD4 in the Hs578T cell line. Our main findings included: a) introduction of indels in exon 22 of SETDB1 sensitized Hs578T to the action of the genotoxic chemotherapy doxorubicin; b) by sequentially introducing indels in exon 22 of SETDB1 and exon 23 of CHD4 and tracking the percentage of the remaining wild-type sequences in the mixed cell populations generated, we obtained evidence of the existence of a synthetic lethality interaction between these genes. Considering the lack of molecular targets in TNBC, our findings provided valuable insights for development of new therapeutic approaches not only for TNBC but also for other cancer types.
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About 10% of children with congenital heart disease (CHD) have pulmonary arterial hypertension (PAH). In this study,we explored the diagnostic values of neutrophil-to-lymphocyte ratio (NLR) and Tei index for CHD-PAH in children. Inorder to complete the study, two hundred CHD children treated in our hospital from January 2015 to January 2017 wereenrolled and divided into postoperative-PAH group (n=29) and no postoperative-PAH group (n=171) according to follow-upresults. The peripheral blood was drawn after surgery, neutrophils and lymphocytes were measured by routine blood test,and NLR was calculated. Ventricular Tei index was determined by pulse Doppler, and the other basic data were compared.Factors affecting postoperative PAH were explored by multivariate analysis. The correlations of NLR and Tei index withN-terminal pro-B-type natriuretic peptide (NT-proBNP) and cardiac output/pulmonary blood flow (CO/Qp), were analyzed.The structural equation model of PAH was constructed. According to receiver operating characteristic (ROC) curves, the optimalcutoff values of NLR and Tei index for evaluating postoperative PAH were investigated. It has been found that NLR and Tei indexare closely related to CHD-PAH in children, which indirectly reflect the severity and have high diagnostic values.
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Tong (dredging) method in traditional Chinese medicine (TCM) emphasizes soothing the stagnated Qi, blood, and body fluid in zang-fu organs, meridians, and collaterals to remove pathogens, reinforce vital Qi, and balance Yin and Yang of the human body. Tong method can be adopted to disperse sweat pore, attack pathogenic Qi, harmonize Yin and Yang, as well as tonify deficiency, and resolve stagnation. It has been proved effective in treating coronary heart disease (CHD), which falls into the category of "chest impediment and heart pain" in TCM, with the key pathogenesis lying in blood vessel obstruction. Therefore, dredging blood vessels is the primary therapeutic principle for CHD. Specifically, there are four aspects. The first is dispersing and dredging the sweat pore of the heart. If the sweat pore is occluded by pathogenic cold, which makes Yang-qi undissipated, Cinnamomi Ramulus, Piperis Longi Fructus, Alpiniae Officinarum Rhizoma, and Asari Radix et Rhizoma can be prescribed for warming and dredging heart Yang. If the Yang-qi of the heart and chest stagnated in the body, which hinders Qi and blood to nourish the myocardium, resulting in chest pain, Poria and Alismatis Rhizoma can be prescribed. For CHD due to atherosclerosis and inflammation, heat-clearing, toxin-removing, and inflammation-resisting Chinese medicinal herbs such as Coptidis Rhizoma and Rhei Radix et Rhizoma are recommended. The second is attacking and dredging the collaterals of the heart. Salviae Miltiorrhizae Radix et Rhizoma, Chuanxiong Rhizoma, Notoginseng Radix et Rhizoma, etc. can be prescribed for blood stasis, Trichosanthis Fructus, Allii Macrostemonis Bulbus, Pinelliae Rhizoma, etc. for phlegm, and Aquilariae Lignum Resinatum, Euodiae Fructus, etc. for pathogenic cold. Since the chronic disease can affect collaterals, Moschus and Santali Albi Lignum can be added to promote blood circulation and remove the obstruction of collaterals of the heart. The third is harmonizing and dredging the mind. Cinnamomi Ramulus, Coptidis Rhizoma, Cinnamomi Cortex, etc. are selected for restoring the coordination between the heart and the kidney. According to the specific syndrome, the methods of nourishing the mind and calming the nerves through tranquilizing the mind, calming down the mind, and inducing resuscitation can be selected using such Chinese medicines as Ziziphi Spinosae Semen, Polygalae Radix, and Draconis Ossa. The fourth is tonifying and dredging the Qi and blood of the heart. The deficiency syndrome of CHD is divided into Qi deficiency and kidney deficiency. Invigorating Qi and strengthening the heart are the first essentials for the treatment of CHD. In Qi invigoration, Qi and blood must be strengthened simultaneously to strengthen the heart and clear the pulse. Hence, Bazhentang modified by Salviae Miltiorrhizae Radix et Rhizoma and Carthami Flos can be chosen. In kidney Qi tonifying, kidney and heart must be strengthened simultaneously, and the methods of tonifying kidney and activating blood can be used. Ginseng Radix et Rhizoma and Astragali Radix are considered as the first choice for tonifying heart Qi, and Epimedii Folium and Morindae Officinalis Radix for tonifying kidney Qi, which are added with Salviae Miltiorrhizae Radix et Rhizoma and Rehmanniae Radix Praeparata to obtain the kidney-tonifying and blood-activating prescription. It is suitable for treating CHD due to kidney deficiency and blood stasis. Simultaneous treatment of heart and kidney is more suitable for middle-aged and elderly patients and chronically ill patients. Tong method can be used in various clinical diseases as well as CHD.
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The present study explored the correlation of coronary heart disease(CHD) with blood stasis syndrome in postmenopausal women with artery elasticity and endothelial function indexes and evaluated the diagnostic efficacy of the prediction model via logistic regression and receiver operating characteristic(ROC) curve model. A retrospective comparison was made between 366 postmenopausal CHD patients from August 1, 2020, to September 30, 2021, in the Department of Cardiology of Integrated Traditional Chinese and Western Medicine of China-Japan Friendship Hospital, who were divided into the blood stasis syndrome group(n=196) and the non-blood stasis syndrome group(n=170). General clinical characteristics of the two groups were compared. Multivariate logistic regression analysis was used to probe the correlation of CHD with blood stasis syndrome in postmenopausal women with brachial-ankle pulse wave velocity(baPWV), ankle-brachial index(ABI), and flow-mediated dilatation(FMD), and the ROC curve was drawn to evaluate the diagnostic efficiency of the prediction model. Multivariate logistic regression analysis showed that the correlation coefficients of CHD with blood stasis syndrome in postmenopausal women with baPWV, ABI, and FMD were 1.123, 0.109, and 0.719, respectively(P=0.004, P=0.005, P<0.001),and the regression equation for predicting probability P was P=1/[1+e~(-(3.131+0.116×baPWV-2.217×ABI-0.330×FMD))]. ROC curve analysis suggested that in the context of baPWV≥19.19 m·s~(-1) or ABI≤1.22 or FMD≤9.7%, it was of great significance to predict the diagnosis of CHD with blood stasis syndrome in postmenopausal women. The AUC of baPWV, ABI, FMD, and prediction probability P was 0.763, 0.607, 0.705, and 0.836, respectively. The AUC of prediction probability P was higher than that of each index alone(P<0.001), and the sensitivity and specificity were 0.888 and 0.647, respectively. The results demonstrate that baPWV, ABI, and FMD are independently correlated with CHD with blood stasis syndrome in postmenopausal women, and show certain independent predictive abilities(P<0.05). The combined evaluation of the three possesses the best diagnostic efficiency.
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Female , Humans , Ankle Brachial Index , Brachial Artery , Coronary Disease/diagnosis , Elasticity , Logistic Models , Postmenopause , Pulse Wave Analysis , ROC Curve , Retrospective StudiesABSTRACT
@#Introduction: Indonesia has a serious burden of cardiovascular disease, especially coronary heart disease (CHD). The prevalence of CHD has not in fact increased; however, there has been a significant increase in the prevalence of CHD risk factors. Several of these occurring together could cause metabolic syndrome, whose prevalence is relatively high in Indonesia, and consequently increase the risk of CHD. This study aims to obtain the risk of CHD in patients with metabolic syndrome in Indonesia. Methods: This is a retrospective cohort study with a median followed up of 6.8 years, secondary data from the Indonesian Family Life Survey (IFLS) waves 4 and 5 (2007-2014), and a study population of 6,571 respondents aged 40-69 years. The Joint Interim Statement criteria were used to define metabolic syndrome, with the omission of one component. Results: The prevalence of metabolic syndrome was 20%; the highest component was low HDL at 69.1%, followed by hypertension at 59.7%, and central obesity at 39.7%. The incidence of CHD was 2.72%, with an incidence rate 34per 100,000 person-years. Multivariate analysis found that the relative risk (RR) hazard ratio (HR) was 2.16 (95% CI 1.564-2.985). Conclusion: Subjects with metabolic syndrome had a two times higher risk of developing CHD, as adjusted by sex, age, smoking status, and physical activity.
ABSTRACT
Background@#Congenital heart disease is the most common causes of major congenital malformations. Congenital heart disease (CHD) represents, globally, 28% of all congenital anomalies, with a prevalence of about 8 to 10 per 1000 people live births, and they mostly require corrective surgery.@*Objective@#To describe outcomes of congenital heart surgery in children under 15 years in Vientiane, Lao PDR.@*Methods@#We undertook retrospective analyses of children with CHD who underwent cardiac surgery by the ASD teams at the Laos-Luxembourg Heart Center, Mahosot Hospital, Vientiane Capital, by reviewing the medical charts of patients discharged during 1st January 2014 to 31st December 2018.@*Results@#Of a total of 415 patients with CHD, 185 underwent cardiac surgery that were the simple lesion 62.1%; moderate lesion 36.0%, complex lesion 1.6%, respectively. The patients who met the inclusion criteria in this study were 158 with a median age of 51 months and those with preschool age of 52.0%. Corrective surgery was the commonest conducted at 98.1%. The major procedure was VSD closure at 34.8%. The post-operative complication found in 30.0%. Overall in hospital mortality rate was 8.8% (by RICHS-1 method). @*Conclusion@#Congenital heart disease surgery in children under 15 years old at Laos-Luxembourg Heart Center, Mahosot Hospital was significantly associated with post-operative complications and high mortality. Therefore, trainings on CHD surgery and Post-CHD surgery care must be urgently organized to the Lao cardiac surgeons and nurses to reduce complications and deaths.
ABSTRACT
This research was to evaluate the economics of Shexiang Tongxin Dropping Pills combined with conventional therapy for patients with coronary heart disease(CHD) in Chinese medical environment. From the perspective of medical insurance, a Markov model was established in this study based on the results of Meta-analysis comparing the effectiveness and safety of Shexiang Tongxin Dripping Pills combined with conventional treatment and conventional treatment alone. The experimental group was treated with She-xiang Tongxin Dropping Pills combined with conventional Western medicine treatment, while the control group was treated with conventional Western medicine treatment alone. The cost-utility analysis and sensitivity analysis were performed for the two regimens using Treeage pro. After 30 cycles of model simulation, according to the results of Markov model, the total cost and health output were CNY 237 795.73 and 16.36 QALYs(the quality adjusted life years, QALYs), respectively for Shexiang Tongxin Dropping Pills combined with conventional Western medicine treatment, CNY 247 396.55 and 16.36 QALYs respectively for the conventional Western medicine treatment alone. Compared with the conventional treatment alone, the Shexiang Tongxin Dropping Pills combined with conventional treatment had lower long-term cost and higher health output, with advantages of cost-utility and pharmacoeconomic advantages. The sensitivity analysis results showed that the conclusion was relatively stable. Based on the above results, it is considered that compared with the conventional Western medicine alone, Shexiang Tongxin Dropping Pill combined with conventional Western medicine is a treatment regimen with pharmacoeconomic advantages for the treatment of CHD.