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Objective:To study the relationship between serum osteopontin and osteopontin and type 2 diabetes mellitus (T2DM) complicated with coronary heart disease, and to evaluate the correlation between the levels of serum osteopontin and osteopontin with the severity of coronary artery lesions in T2DM patients.Methods:A total of 100 T2DM patients who were suspected to have stable coronary heart disease and underwent coronary angiography from November 2019 to December 2020 were selected from the Affiliated Hospital of Chengde Medical College, according to coronary angiography results, 60 patients with confirmed coronary heart disease were classified as the case group and 40 patients with non-coronary heart disease were classified as the control group for retrospective analysis. The clinical data and biochemical indicators of all patients were recorded, and Gensini score was calculated. The concentration of osteopontin and osteopontin in serum was quantitatively determined by double-antibody enzyme linked immunosorbent assay method. Independent sample t-test was used to compare the mean of normal distribution measurement data between the two groups. The non normal distribution data are represented by M ( Q1, Q3), and Mann Whitney U test is used for comparison between groups. Composition comparison between count data groups χ 2 inspection. Spearman correlation analysis was used to analyze the correlation between serum osteopontin and osteopontin and Gensini score in patients with T2DM. Results:Univariate analysis showed that serum osteopontin and osteopontin were (13.076(8.433, 23.552) μg/L) and (0.437(0.300, 0.630) μg/L) significantly higher in the case group than in the control group (6.367(4.605, 9.048) μg/L) and (0.299(0.196, 0.399) μg/L) respectively, with statistically significant differences ( Z=5.12, 3.28, all P<0.001). Multi-factor logistic regression analysis showed that osteoprotegerin ( OR=2.887, 95% CI:1.850-8.515, P=0.024) and osteopontin ( OR=13.109, 95%CI: 2.557-67.204, P=0.002) were associated with T2DM combined with coronary heart disease, and the risk of T2DM combined with coronary heart disease increased with higher levels of osteoprotegerin and osteopontin. Spearman correlation analysis showed that serum osteopontin and osteoprotegerin were positively correlated with Gensini score in T2DM patients ( r=0.591, 0.467; all P<0.05). Conclusion:Serum osteopontin and osteoprotegerin are associated with T2DM combined with coronary heart disease, and high serum osteopontin and osteoprotegerin are risk factors for T2DM combined with coronary heart disease; serum osteopontin and osteoprotegerin are positively correlated with the degree of coronary artery disease in T2DM patients.
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Objective:To explore the correlation between systemic inflammatory response index (SIRI) and clinical outcome of patients with massive cerebral infarction (MCI) after craniotomy and decompression.Methods:The clinical data of 50 MCI patients who were treated in the Affiliated Hospital of Qingdao University from January 2016 to December 2020 and underwent craniotomy and decompression were retrospectively analyzed. The measurement data of normal distribution were expressed as xˉ± s, and the measurement data of non normal distribution were expressed as M( Q1, Q3). T-test or rank sum test was used for comparison between the two groups. Multivariate Logistic regression was used to analyze the relationship between SIRI and prognosis of MCI patients and establish a prediction model. The predictive value and optimal cutoff value of SIRI were analyzed by receiver operating characteristic curve (ROC). Results:Among the 50 MCI patients who underwent craniotomy and decompression, 12 (24%, 12/50) had a good prognosis; In the poor prognosis group, 38 cases (76%, 12/50), of which 9 cases (18%, 9/50) died during hospitalization. The age of patients in the good prognosis group and the poor prognosis group ((54±11) years and (63±9) years; t=2.72, P=0.015), body mass index (BMI): ((23.91±2.64) kg/m 2 and (26.72±3.28) kg/m 2, t=3.01, P=0.006)), neutrophil count (7.08 (5.12, 7.38))×10 9/L and 10.59 (8.91,14.64)×10 9/L, Z=5.72, P<0.001), white blood cell count ((9.09±2.80)×10 9/L and (13.20±3.49) ×10 9/L; t=4.16, P<0.001), SIRI (2.49(1.78, 4.75) and 8.34(5.17, 13.61); Z=3.84, P<0.001), Glasgow Coma Score (12(9,14) and 8(6,10); Z=3.36, P=0.002) and lymphocyte count (1.58(0.91, 1.91)×10 9/L and 0.77(0.59,1.02) ×10 9/L; Z=3.30, P=0.001).The difference between the two groups was statistically significant. The prognosis of patients with dominant hemisphere infarction was worse than that of patients with non-dominant hemisphere infarction (22 cases (91.67%, 22/24) vs. 16 cases (61.54%, 16/26); χ 2=6.21, P=0.013). The ICU stay in the good prognosis group was significantly shorter than that in the poor prognosis group (2 (1, 5) days vs. 8 (3, 19) days; Z=2.78, P=0.005). Multivariate Logistic regression analysis showed that SIRI and GCS were correlated with clinical prognosis: SIRI ( OR: 2.378; 95% CI: 1.131-5.003; P=0.022); GCS at admission ( OR: 0.548; 95% CI: 0.307-0.980; P=0.043). The ROC curve analysis of SIRI prediction of poor prognosis: Area under the curve (AUC): 0.871, (95% CI: 0.765-0.976, P<0.001), sensitivity was 78.9%, specificity was 88.3%, and the optimal cut-off value was 4.96. The sensitivity, specificity and AUC of GCS for predicting poor prognosis after MCI craniotomy decompression were 89.5%, 58.3% and 0.791 (95% CI: 0.638~0.943, P=0.003), and the best truncation value was 11.5. Conclusion:SIRI was an effective predictor of clinical outcome for MCI patients underwent Craniotomy for decompression, and SIRI value greater than 4.96 indicates adverse clinical outcome.
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<p><b>OBJECTIVE</b>To set up the multiple risk factors model of patients with anatomical left ventricular aneurysm (LVA) post acute ST-elevation myocardial infarction (STEMI) and quantitatively assess the pathopoiesis of all the factors.</p><p><b>METHODS</b>A total of 518 consecutive inpatients with acute STEMI hospitalized from June 2010 to December 2013 in our hospital were enrolled in this study, patients were divided into two groups: LVA group (n = 106, 20.5%) and non-LVA group (n = 412, 79.5%). All demographic and clinical data were collected by cardiologists. Finally, all of the risk factors for anatomical LVA in the acute STEMI patients were quantitatively analyzed by a binary logistic regression model.</p><p><b>RESULTS</b>The multiple risk factors logistic regression model was set up for the anatomical LVA in patients with acute STEMI. Anterior wall myocardial infarction, occlusion of the left anterior descending branch, two or three vessels stenosis, high systolic blood pressure, sinus tachycardia and white blood cell count over 10 000 per microliter were all independent risk factors of the LVA in acute STEMI, with the odds ratio (OR) 18.21, 21.56, 4.22, 7.16, 1.98 and 1.57, respectively (all P < 0.05) . However, first medical contact less than 12 hours (OR = 0.60), collateral circulation of the coronary arteries(OR = 0.53), primary percutanous coronary intervention(OR = 0.23) and venous thrombolysis(OR = 0.12) were all protecting factors of the LVA in acute STEMI patients (all P < 0.05).</p><p><b>CONCLUSION</b>Anterior wall STEMI, occlusion of the left anterior descending branch, two or three vessels stenosis, high systolic blood pressure, sinus tachycardia and white blood cell count over 10 000 per microlitre are independent risk factors of the LVA in acute STEMI patients. However, first medical contact less than twelve hours, collateral circulation of the coronary arteries, together with the primary percutanous coronary intervention and venous thrombolysis are protective factors of the LVA in patients with acute STEMI. It is important for cardiologists to assess the risks of LVA and make emergent and suitable efforts to reduce the risk of developing LVA in STEMI patients.</p>
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Humanos , Doença Aguda , Infarto Miocárdico de Parede Anterior , Circulação Colateral , Aneurisma Cardíaco , Epidemiologia , Modelos Logísticos , Infarto do Miocárdio , Fatores de RiscoRESUMO
BACKGROUND:Buprenorphine transdermal patches have the characteristics of stable blood concentration, long duration of analgesia, respiratory depression and less side effects, which have been widely used in the treatment of moderate to severe chronic pain. OBJECTIVE:To observe the clinical outcome of preoperative analgesia by buprenorphine transdermal patches for pain management after posterior lumbar surgery. METHODS: Eighty patients scheduled for posterior lumbar decompression and interbody fusion under general anesthesia were enroled, 45 males and 35 females, aged 42-71 years, who were randomly divided into two groups, 40 cases in each group: experimental group and control group. In the experimental group, buprenorphine transdermal patches were given 2 days prior to the internal fixation, and intravenous injection of parecoxib was given for postoperative pain management. In the control group, placebo patches were given prior to the internal fixation, and self-control vein analgesia pump and intravenous injection of parecoxib were given for postoperative pain management. Visual analog scale scores were recorded at 6, 12, 24, 48 hours after surgery as wel as doses of tramadol hydrochloride and pethidine hydrochloride used postoperatively and side effects. The patient's satisfaction, drainage and blood count, erythrocyte sedimentation rate, C-reactive protein level at 48 hours postoperatively were detected and recorded in the two groups. RESULTS AND CONCLUSION:There was no significant difference between these two groups in visual analog scale scores, dosage of tramadol hydrochloride and pethidine hydrochloride used postoperatively, postoperative drainage amount, leukocyte count, erythrocyte sedimentation rate and C-reactive protein level (P > 0.05). Postoperative incidence of nausea, vomiting and delirium was lower in the experimental group than the control group (P < 0.05), but the patient's satisfaction in the experimental group was better than that in the control group (P< 0.05). These findings indicate that buprenorphine transdermal patches have better preemptive analgesia for posterior lumbar surgery, with less adverse effects and better patient's satisfaction.
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Learners' autonomous learning serves as the target of the second and foreign language teaching.It is also a key factor showing whether the reform of the college English teaching in our country will succeed or fail.The particular English language teaching environment in China is far from being ideal in comparison with the second or even foreign language teaching environment in the Western Countries.The paper makes an analysis on certain factors relating autonomous learning in the English language teaching environment in China and a discussion on how to develop and promote the Chinese English language learners' autonomous learning.
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Special efforts were made to probe ways of improving the English teaching of the three-year vocational students in our university and enhance their ability to use English. By analyzing the cause of the students＇ failure in last year＇s national standard examination and working out ways to choose appropriate teaching materials and to improve teaching methods, the students＇ overal linguistic level and communication abilities were greatly enhanced. We came to the conclusion that lessons must be taught from our own experience as well as from that of other schools, close attention must be paid to the latest development in English teaching for three-year vocational students in our country and prompt actions must be taken. Only by doing so can we stay in line with the reform of English teaching across the nation.