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Objective:To investigate the effect of outpatient cardiac rehabilitation on the quality of life and lifestyle changes in patients with coronary heart disease.Methods:A total of 135 patients with coronary heart disease who received exercise rehabilitation in the Cardiac Rehabilitation Center of Second Hospital of Shanxi Medical University were enrolled in the study. Among them, 63 cases seldom attended (≤12 sessions, low-attending group), 37 cases less frequently attended (13-24 sessions, medium-attending group) and 35 cases attended frequently (≥25 sessions, high-attending group). The clinical data, cardiac rehabilitation, Seattle Angina Scale (SAQ) score and SF-36 quality of life score before and after rehabilitation, and lifestyle changes such as out-of-hospital exercise were documented and compared among the three groups.Results:Compared with baseline, the 5-dimensional scores of SAQ and the 9-dimensional scores of SF-36 (except for role-emotional and health change) were not significantly improved after cardiac rehabilitation in low-attending group ( P>0.05), while the angina stability, angina frequency, treatment satisfaction of SAQ, and bodily pain, health change of SF-36 in medium-attending group were improved ( P<0.05), and both SAQ and SF-36 in high-attending group were increased ( P<0.05). After cardiac rehabilitation, the SAQ and SF-36 scores of patients in high-attending group were significantly higher than those of patients in low-attending group ( P<0.05). The lifestyle was changed in 77.14%(27/35)patients of high-attending group, which was higher and that of low-attending group(38.10%, 24/63) (χ 2=13.74, P<0.001). Conclusion:The outpatient exercise rehabilitation can improve the quality of life and change lifestyle of patients with coronary heart disease; and the effect of rehabilitation is associated with the attending frequency.
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BACKGROUND: Inducing factors are currently used as a main method for the differentiation of bone marrow mesenchymal stem cells (BMSCs) into chondrocytes. OBJECTIVE: To investigate the collaborative stimulation of transforming growth factor beta1 (TGF-β1) and insulin-like growth factor 1 (IGF-1) to induce the directed differentiation of BMSCs to chondrocytes, and to explore the best inductive effect. METHODS: Rat BMSCs were isolated, cultured and purified using adherent culture. Then, different inducing factors were added in the induction medium: TGF-β1+IGF-1 group, TGF-β1 group, IGF-1 group, and control group without growth factors. Immunofluorescence was carried out at 21 days of induction. The expression of collagen type Ⅱ was evaluated by immuncytochemical staining at 7, 14 and 21 days of induction. RESULTS AND CONCLUSION: (1) Immunofluorescence detection of the TGF-β1+IGF-1 and TGF-β1 groups showed highly expressed collagen type Ⅱ (brown red-stained cytoplasm), while negatively expressed collagen type Ⅱ in the other two groups. (2) Findings from the immuncytochemical staining showed that the expression of collagen type Ⅱ was stronger in the TGF-β1+IGF-1 group than the TGF-β1 group (P < 0.01), and the expression was gradually enhanced with time. Meanwhile, there was also no expression of collagen type Ⅱ in the IGF-1 and control groups. To conclude, the combination of TGF-β1 and IGF-1 can achieve the better inductive effect on the chondrogenic differentiation of BMSCs in vitro.
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<p><b>BACKGROUND</b>High rate of in-stent restenosis (ISR) remained an unsolved clinical problem in clinical practice, especially among patients with diabetes mellitus (DM). Diabetic patients often had hypertriglyceridemia with elevated levels of very low-density lipoprotein cholesterol (VLDL-C). Increasing evidence suggested that VLDL-C was known as a significant risk factor for atherosclerosis and had been recommended as a treatment target by current dyslipidemia guidelines. However, the role of VLDL-C in the occurrence and development of ISR in coronary artery disease (CAD) patients with DM had not been studied. The aim of this study was to evaluate the association between the elevated levels of VLDL-C and the risk of ISR in CAD patients with DM.</p><p><b>METHODS</b>A total of 1390 diabetic patients, who underwent coronary drug-eluting stent (DES) implantation at Beijing Anzhen Hospital and followed up by angiography within 6-24 months, were consecutively enrolled. Patients' demographic and clinical characteristics, including age, gender, CAD risk factors, family history, life style, medical history, and coronary angiographic information, were collected carefully at baseline percutaneous coronary intervention and follow-up angiography. Multivariate Cox's proportional hazards regression modeling using the step-wise method (entry, 0.05; removal, 0.05) was used to determine the independent risk associated with ISR in diabetic patients.</p><p><b>RESULTS</b>Finally, 1206 of patients were included in this study. ISR occurred in 132/1206 diabetic patients (10.9%) by follow-up angiography. Patients with ISR had elevated median serum VLDL-C levels compared with those without ISR (0.65 mmol/L vs. 0.52 mmol/L, P = 0.030). The multivariate regression analysis showed that VLDL-C was significantly associated with the risk of ISR in diabetic CAD patients (hazard ratio [HR] = 1.15, 95% confidence interval [CI]: 1.03-1.29, P = 0.017). The HR for the risk of ISR associated with VLDL-C level ≥0.52 mmol/L was 3.01 (95% CI: 1.24-7.34, P = 0.015).</p><p><b>CONCLUSION</b>The elevated level of serum VLDL-C was a significant and independent risk factor for ISR in diabetic CAD patients after coronary DES implantation.</p>