Effects of PCSK9 inhibitors on blood lipids and inflammatory factors in patients with coronary heart disease / 中国临床药理学与治疗学

AIM: To observe the effect of PCSK9 inhibitors on blood lipid levels and common inflammatory factors in patients with coronary heart disease. METHODS: The clinical data of 201 patients with coronary heart disease who were admitted to the Department of Cardiology of Shanghai East Hospital from April 2020 to June 2021 were retrospectively analyzed. The patients were divided into PCSK9 inhibitor treatment group (101 cases: statin + PCSK9 inhibitor) and control group (100 cases: statin treatment only) according to their medication status. Blood lipids, blood routine, CRP and FIB were re-examined after 1 month of treatment. The changes of blood lipids and inflammatory factors before and after treatment were compared. RESULTS: Before treatment, there was no significant difference in blood lipids, blood routine, CRP and FIB between the two groups (P> 0.05). The levels of sdLDL and Lp(a) were significantly decreased (P< 0.05); the levels of WBC, CRP, N and FIB were significantly decreased (P< 0.05). Compared with the control group, the levels of TC, HDL, LDL-C, CRP and FIB in the PCSK9 inhibitor group were significantly changed (P< 0.05), and the results were statistically significant. CONCLUSION: PCSK9 inhibitors can not only reduce LDL-C levels, but also reduce Lp(a) levels. PCSK9 inhibitors can reduce CRP and FIB levels, suggesting that it can partially improve inflammation in peripheral blood in patients with coronary heart disease.

Research progress and application prospects of circRNA in cardiovascular diseases / 中国临床药理学与治疗学

CircRNA is a single-stranded, covalently closed non-coding RNA, whose mechanism mainly involves sponge adsorption of micro RNA (miRNA), regulation of protein transcription and post-transcriptional levels, interaction with RNA-binding proteins and few coding proteins of circRNA. Meanwhile, because of its abundant expression, highly conserved and dynamic changes, circRNAs have promising applications such as becoming biomarkers of diseases, developing circRNA vaccines and gene editing therapies for circRNAs. Cardiovascular diseases are the leading cause of death from diseases worldwide, and existing therapeutic approaches can delay the development of heart diseases, but are still limited by the unknown pathogenesis and therapeutic targets. Many studies have reported the mechanistic link between circRNAs and cardiac diseases, therefore, this review is to explain the progress of circRNA research in cardiovascular diseases and to illustrate the three clinical applications in which circRNAs are currently involved.

An intelligent new method for batch weighing of blood components / 中国输血杂志

【Objective】 To establish a method for batch weighing blood components intelligently and accurately. 【Methods】 Virus inactivated plasma was used as weighing samples. The traditional electric scale and cryoprecipitation preparation instrument were used to weigh plasma with five specifications. The consistency of the weighing results by the two methods was statistically analyzed. Two groups of virus inactivated plasma with basically the same number of bags were randomly selected, and weighted by the same group of staff using these two equipment, the time for weighing and the time from weighing to registering were calculated statistically. 【Results】 227 bags of plasma were weighed in batches by the two methods, and statistical analysis showed no significant difference in standardized blood volume. There was no significant difference in plasma weighing time (71/68)by the same staff, weighing basically the same number of bags. However, the time difference from weighing to registering was statistically significant, as the new method was 2.65 s shorter than the traditional one (P<0.05). 【Conclusion】 The new method is accurate for batch weighing, and can realize the informatization and intellectualization of blood weighting. The time consumed from weighing to registration was improved by the new method, but not in time for weighing.

STAF score predict paroxysmal atrial fibrillation in patients with recurrent acute ischemic stroke / 国际脑血管病杂志

Objective:To investigate the predictive value of STAF (score for the targeting of atrial fibrillation) score for paroxysmal atrial fibrillation (PAF) in patients with recurrent acute ischemic stroke.Methods:Consecutive patients with recurrent acute ischemic stroke hospitalized in the Department of Neurology, Huizhou Municipal Central Hospital from January 2014 to January 2020 were enrolled retrospectively. All patients were divided into a sinus rhythm (SR) group and a PAF group. PAF was defined as no PAF during the last stroke hospitalization or after discharge, and PAF was found by routine ECG, ambulatory ECG or long-term ECG monitoring after this recurrent acute ischemic stroke. Multivariate logistic regression analysis was used to evaluate the independent related factors of PAF in patients with recurrent acute ischemic stroke. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of STAF for PAF in patients with recurrent acute ischemic stroke. Results:A total of 234 patients with recurrent acute ischemic stroke were enrolled, including 174 males (74.4%), aged 67.15±10.63 years, and 199 (85.0%) in the SR group and 35 (15.0%) in the PAF group. Univariate analysis showed that the proportion of patients in age >62 years old (94.3% vs. 63.8%; χ2=12.777, P<0.001) and left atrial enlargement (54.3% vs. 11.1%; χ2=40.379, P<0.001) of the PAF group was significantly higher than those of the SR group. Multivariate logistic regression analysis showed that age (odd ratio [ OR] 1.071, 95% confidence interval [ CI] 1.028-1.114; P=0.001) or age >62 years ( OR 17.512, 95% CI 2.881-106.453; P=0.002), left atrial enlargement ( OR 17.511, 95% CI 6.298-48.687; P<0.001), absence of vascular etiology ( OR 8.562, 95% CI 2.534-28.923; P=0.001), STAF score ( OR 2.715, 95% CI 1.969-3.744; P<0.001) and STAF score ≥5 ( OR 12.714, 95% CI 5.636-28.681; P<0.001) were independently associated with PAF. ROC curve analysis showed that the area under the curve of STAF for predicting PAF in patients with recurrent acute ischemic stroke was 0.848 (95% CI 0.779-0.917), and the sensitivity and specificity of STAF ≥5 for predicting PAF were 58.1% and 89.4%, respectively; the area under the curve for predicting PAF in patients with recurrent ischemic stroke of undetermined cause was 0.809 (95% CI 0.663-0.956), and the sensitivity and specificity of STAF ≥5 for predicting PAF were 53.8% and 91.3%, respectively. Conclusions:PAF is likely to exist in patients with recurrent acute ischemic stroke and aged >62 years, left atrial enlargement and absence of vascular etiology. STAF has medium predictive value for PAF in patients with recurrent acute ischemic stroke, but the sensitivity is not high.

Evaluation of volume response value in patients with septic shock by mechanical ventilation combined with ultrasound / 中华急诊医学杂志

Objective:To evaluate the value of mechanical ventilation combined with ultrasound in evaluating the volume reactivity of patients with septic shock.Methods:A prospective study was performed, and 59 patients with septic shock who were admitted to the Emergency Intensive Care Unit of the First Affiliated Hospital of Xinjiang Medical University from October 2016 to February 2018 were included according to the established inclusion and exclusion criteria. First, end-expiratory block test (EEO) and end-inhalation block test (EIO) were performed, followed by volume expansion test (VE) (intravenous infusion of 250 mL saline for 10 min), with cardiac index (CI) change value after VE (ΔCI)≥15% for volume-responsive group (37 cases), ΔCI<15% for volume-free group (22 cases), Vigileo-FloTrac system was used to continuously monitor EEO, EIO, and VE before and after changes in hemodynamic parameters, such as central venous pressure (CVP), mean arterial pressure (MAP), stroke volume variation (SVV), CI, and improved inferior vena cava diameter (IVCD) and respiratory variability index (RVI). The values of predicted capacity reactivity such as changes in CVP, MAP, SVV, CI, and RVI before and after EIO were evaluated, and the relationship between EEO, EIO, and capacity reactivity was analyzed by ROC curve.Results:There was no significant difference between MAP and CI in the response group and non-response group after EEO, EIO and VE intervention ( P>0.05). EEO-ΔSVV, EEO-ΔRVI, EEO-ΔCVP, EIO-ΔSVV and EIO-ΔRVI were compared between the reaction group and the non-reaction group, and the difference was statistically significant ( P<0.05); In the correlation analysis, EEO-ΔRVI and EIO-ΔRVI were correlated with VE-ΔRVI ( r=0.695, P<0.01; r=-0.489, P<0.01); EEO-ΔCVP and VE-ΔCVP were correlated ( r=0.566, P<0.01); EEO-ΔSVV, EIO-ΔSVV are related to VE-ΔSVV ( r=0.842, P<0.01; r= -0.727, P<0.01), and the ROC curve showed ( AUCEEO-ΔSVV=0.890, 95% CI: 0.792-0.988), showed AUCEEO-ΔSVV> AUCEEO-ΔRVI> AUCEIO-ΔSVV> AUCEIO-ΔRVI> AUCEEO-ΔCVP. Conclusions:EEO and EIO combined with ultrasound have certain clinical value in the evaluation of volume responsiveness in patients with septic shock, and the evaluation value of SVV and RVI is superior to CVP, MAP, and CI.

The clinical study on the relationship between silent cerebral ischemia and cognitive impairment in inpa-tiens older than sixty with nonvalvula atrial fibrillation / 中国神经精神疾病杂志

Objectives The aim of this study was to study the relationship between silent cerebral ischemia (SCI) and mild cognitive impairment(MCI)in inpatients with nonvalvula atrial fibrillation (NAF) and those with sinus rhythm (SR) older than sixty. Methods Ninety-eight inpatients were enrolled from November 2014 to November 2015 in Hui?zhou Municipal Central Hospital: 45 patients with NAF and 53 with SR. All general clinical data was collected. The Montreal Cognitive Assessment (MoCA) and brain MRI were used to assess the cognitive performance of patients within 1 weeks of admission. Results The MoCA scores were lower in patients with NAF than in those with SR[16(10,20) vs. 20 (15,23),P=0.006]. At least one foci of SCI was present in patients 80%with NAF and 52.8%with SR (NAF vs. SR, P=0.018).The rates of SCIs in the cortex/subcortex were higher in the NAF group than in the SR group (25.2%vs. 12.4%, P=0.017). Multivariate analysis showed that MoCA score were related to the degree of education in NAF patients and were related to age and education level in SR patients. Conclusions NAF is an independent risk factor for cognitive impair?ment in NAF patient and associated with the SCI present. Educational level is a factor affecting the cognitive function with elderly patients.

Clinical study of the predictive value of the IL-9 cytokines in the patients with acute respiratory distress syndrome / 中华急诊医学杂志

Objective To investigate the predictive value of IL-9 cytokines in the patients with acute respiratory distress syndrome (ARDS).Methods According to Berlin definition of ARDS published in 2012,data of 28 patients with ARDS and another 22 healthy subjects as control were collected for prospective study from June,2013 to July,2014.Of them,there were 23 patients with severe pneumonia,1 patient with acute mercury poisoning,2 patients with severe acute pancreatitis,2 patients with acute paraquat poisoning.The survivors of ARDS patients were followed up.The ARDS patients were divided into moderate group (n =18) and severe group (n =10) as per the severity of the disease diagnosed at the first day after admission.And the ARDS patients were also divided into non-survival group (n =15) and survival group (n =13) according to the ARDS patients survived for 28 days.Three mLs of peripheral venous blood were collected in the early morning from fasted ARDS patients on the first and the third day after diagnosis of ARDS confirmed,and those of healthy subjects were collected on the first day after admission.The IL-9 cytokine level of peripheral venous blood detected by using enzyme linked immunosorbent assay (ELISA).The comparisons of levels of IL-9 cytokine were carried out between ARDS group and control group on the first day after diagnosis of ARDS established,between moderate group and severe group on the first day and the third day,and between survival group and non-survival group.The receiver operating characteristic (ROC) curve was used to evaluate the performance of IL-9 as a prognostic indicator in the early stage of ARDS.Data were analyzed by using SPSS 19.0 software.Results On the first day after diagnosis of ARDS,there were no statistically significant differences in age,APACHE Ⅱ score,procalcitonin (PCT),C-reactive protein (CRP),white blood cell count,lactate,and albumin between survival group and non-survival group (P ＞ 0.05).PH value in non-survival group was significantly lower than that in survival group (P＜0.05).IL-9 cytokine level of peripheral venous serum in ARDS group was significantly higher than that in healthy control group (P ＜ 0.05).There were no statistically significant differences in IL-9 level of peripheral venous serum both between moderate group and severe group and between survival group and non-survival group (P ＞ 0.05).On the third day,IL-9 level in severe group was significantly higher than that in moderate group (P ＜ 0.05),and that in survival group was significantly lower than that in non-survival group (P ＜ 0.05).The ROC of IL-9 at the first day for predicting mortality had all area under curve (AUC) to be 0.579 (95％ CI 0.361-0.798,P ＞ 0.05).The ROC of IL-9 on the third day for predicting mortality had AUC of 0.769 (95％ CI 0.592-0.947,P ＜ 0.05).When the cut-off value of IL-9 for the death followed up for 28 day' s was 2.88 pg/mL,the sensitivity was 86.7％,and the specificity was 61.5％.Conclusions IL-9 levels of in patients with ARDS were significantly higher,and IL-9 level can be helpful for the assessment of ARDS severity in the early stage,and for prognosis as well.

Clinic research on Saccharomyces boulardii in preventing and treating antibiotics associated diarrhea in infant pneumonia / 药学实践杂志

Objective To investigate the therapeutic effect of Saccharomyces boulardii on antibiotics associated diarrhea (AAD)in infant pneumonia.Methods 302 hospitalized infant patients (1 month-3 years) with pneumonia but without gastroenteric disease were selected , and antibiotics were administrated intravenously at least 5 continuous days for each patient .Patients were all giv-en antibiotics and randomly divided into three groups:control group with no Saccharomyces boulardii administration ( group A, 60 ca-ses);Saccharomyces boulardii were applied as addition on the occurrence of diarrhea (group B, 92 cases), and Saccharomyces boular-dii and antibiotics were co-administrated (group C, 150 cases).Incidences of AAD in all groups were carefully examined and differ-ences of therapeutic effect between groups were compared and analyzed .Results The incidence of AAD in Group C was significantly lower than that in other groups .In term of diarrhea severity, no significant difference was observed in all groups (P>0.05).Howev-er, duration of diarrhea showed significant different between groups (P<0.001):group A with the longest duration and group C with the shortest .The results indicated that the total efficiency of anti-diarrhea in group C was significantly higher than that in control group (P<0.05).However, group B presented no significant difference compared with neither control group nor group C in term of therapeu -tic effect on diarrhea .Conclusion Administration of Saccharomyces boulardii Sachets could shorten the duration of diarrhea on the oc-currence of AAD in infant pneumonia .According to our results , Saccharomyces boulardii was effective in both preventing the develop-ment of AAD and shortening duration of diarrhea , and therefore improved therapeutic effect on ADD .

General paralysis of insane: two case reports / 临床神经病学杂志

Objective To explore the clinical manifestation,laboratory tests,imaging and treatment of general paralysis of insane(GPI).Methods The clinical data of 2 patients with GPI analyzed retrospectively.Results 2 sufferers were both male,and mainly presented with memory decline and mental disorder.One case presented with visceral crisis.Both rapid plasma reagin test and treponema gelatin agglutination test in serum and CSF were positive.Brain MRI scanning showed ventriculomegaly.After antisyphilitic treatments,2 patients obviously improved.Conclusion GPI are often seen in middle-aged males and its misdiagnosis rate is high.The diagnosis of GPI should be considered in young patients with dementia without clear reason.Early diagnosis and active treatments are important for the prognosis of this disease.