Epidemiology of overweight and obesity among high school seniors in Beijing / 中国学校卫生

Objective@#To analyze the prevalence and changing trend of overweight and obesity among high school seniors in Beijing from 2009 to 2018, and to provide scientific basis for health and education departments to work out effective measures to prevent and control overweight and obesity among adolescents.@*Methods@#The physical examination data of 700 588 high school seniors in Beijing from 2009 to 2018 were selected to describe the distribution characteristics of the detection rate of overweight and obesity, and to analyze whether there are differences in the prevalence of overweight and obesity among different genders and regions.@*Results@#From 2009 to 2018, the prevalence rate of total overweight and obesity of high school seniors in Beijing showed an increasing trend by year ( χ 2=3.58, P <0.01). After 2016, the rising trend was more stable, and it declined for the first time in 2018. The prevalence of overweight ( χ 2=6 681.34, P <0.01) and obesity ( χ 2=15 663.08, P <0.01) were higher in male than in female. The prevalence of overweight and obesity in urban students was higher than that in suburban students (29.55%,27.95%; χ 2=211.43, P < 0.01 ), the prevalence of obesity in urban students was higher than that in suburban students from 2009 to 2013, and the prevalence of obesity in suburban students was higher than that in urban students from 2014 to 2018. The districts and counties with the highest detection rates of overweight and obesity are Shijingshan District (overweight: 19.06%, obesity: 13.99%), and the districts and counties with the lowest detection rates of overweight and obesity are Yanqing District (overweight: 13.48%, obesity: 7.18%).@*Conclusion@#From 2009 to 2018, the prevalence of overweight and obesity among high school seniors in Beijing has been increasing by year, and tends to be stable after 2016. Significant upward trend in obesity prevalence in suburban areas of Beijing has been observed.

Evaluation value of atherogenic index of plasma for long-term prognosis of coronary artery disease / 中国医师杂志

Objective:To determine the predictive value of atherogenic index of plasma (AIP) on the long-term prognosis of patients with coronary artery disease (CAD).Methods:A total of 2 500 patients with coronary heart disease who underwent coronary angiography in Affiliated Hospital of Jining Medical University from May 2013 to November 2015 were retrospectively analyzed. According to the AIP value, the subjects were divided into low AIP group (AIP<0.06) and high AIP group (AIP≥0.06). The incidence of major adverse cardiovascular events (MACE) was compared between the two groups. Kaplan-meier method was used to evaluate the MACE-free survival rate, and multivariate Cox survival analysis was used to evaluate the independent predictors of MACE.Results:A total of 2 427 patients were followed up, with a follow-up rate of 97.08% and a median follow-up time of 4.29 years. There were 1 123 cases in the low AIP group and 1 304 cases in the high AIP group, among which 624 patients (25.7%) had MACE. The total incidence of MACE in the high AIP group was higher than that in the low AIP group ( HR=1.43, 95% CI: 1.22-1.68, P<0.01). Kaplan-meier curves showed that the MACE-free survival rate was significantly lower in the high AIP group ( P<0.01). After adjusting for multiple confounding factors, AIP was still associated with the prognosis of CHD patients. Increased AIP (≥0.06) was an independent predictor of MACE in CHD patients within 4 years ( HR=1.34, 95% CI: 1.14-1.58, P<0.01). Conclusions:AIP (≥0.06) was an independent predictor of MACE occurrence in patients with CAD within 4 years. AIP has a certain value in the long-term prognosis of patients with CAD.

Research advances in autoimmune hepatitis-related hepatocellular carcinoma / 临床肝胆病杂志

Autoimmune hepatitis (AIH)-related hepatocellular carcinoma (HCC) is defined as HCC that develops on the basis of long-term AIH and has a relatively low incidence rate of 0-6%. The risk factors for HCC in AIH patients include old age, male sex, diabetes, alcohol use, AIH recurrence and persistent alanine aminotransferase abnormalities, failure in immunosuppressive therapy and related treatments, and long-term liver cirrhosis. Liver cirrhosis is an important stage for the development of HCC in AIH, and the incidence rate of HCC increases significantly after AIH progresses to liver cirrhosis. At present, there are few reports on the mechanism of HCC in AIH, which may be associated with the changes in specific molecular biological characteristics (including chromosomes, telomeres, and genes) induced by liver cirrhosis, the cell death-inflammation-cancer pathway, and intestinal microecological disorders. It is of great importance to identify the AIH population at a high risk of HCC in a timely manner and enhance intervention, follow-up, and monitoring.

Screening of lipid parameters in coronary artery disease based on LASSO regression / 中国综合临床

Objective:Using lasso regression analysis to screen out the blood lipid indexes closely related to coronary heart diseaseMethods:The clinical data of 3 062 patients with coronary heart disease who were hospitalized in the Department of Cardiology, Affiliated Hospital of Jining Medical College from May 2013 to November 2015 were retrospectively analyzed.They were divided into control group ( n=2 427) and coronary angiography group ( n=635). R language was used for statistical analysis.Multiple logistic regression models were established for indicators of blood lipid related to CAD, and their multicollinearity severity was assessed.LASSO regression was used to screen out the representative lipid parameters in the CAD prediction model. Results:A total of 3 062 patients were enrolled, including 2 427 patients in coronary heart disease group and 635 patients in control group.The inclusion of lipid parameters into multiple logistic regression model leads to serious multicollinearity.Stepwise regression can only partially reduce multicollinearity severity, while LASSO regression model significantly reduces multicollinearity severity.Low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and non-high density lipoprotein cholesterol (non-HDL-C) were found to be the representative lipid indexes for predicting coronary heart disease by LASSO regression analysis.Conclusion:LASSO regression has advantages in processing multicollinearity data.LASSO regression showed that LDL-C, HDL-C and non-HDL-C were representative lipid indicators for predicting coronary heart disease..

Expression and significance of insulin-like growth factor binding protein-related protein 1 in pancreatic neoplasms and its relationship with tumor microenvironment / 中华消化杂志

Objective To observe the expression of insulin-like growth factor binding protein-related protein 1 (IGFBPrP1) in human pancreatic tumor tissues and investigate its significance and relationship with clinic pathological characteristics and tumor microenvironment of the pancreatic neoplasms.Methods A total of 236 patients with surgically resected pancreatic tissue from January 2007 to December 2017 were selected from the First Hospital of Shanxi Medical University.Totally 236 patients were divided into paracancer control group (normal pancreatic tissue adjacent to the tumor,n =111),benign group (benign or low-grade malignant tumor such as solid pseudopapillary tumor,n =37),and malignant group (malignant tumors such as pancreatic ductal adenocarcinoma,n =88).The histomorphology and collagen deposition were observed using hematoxylin-eosin (H-E) staining and Sirius red staining in the three groups.The expressions of IGFBPrP1,transforming growth factor β1 (TGFβ1),α-smooth muscle actin (α-SMA)and collagen type Ⅰ of pancreatic tissues in the three groups were detected by immunohistochemical staining.The relationship between IGFBPrP1 and TGFβ1,α-SMA or collagen type Ⅰ,and the relathionship between IGFBPrP1 and clinicopathological features of the pancreatic neoplasms were analyzed.T test and one-way analysis of variance were used for statistical analysis,and Spearman rank correlation test was used for correlation analysis.Results In benign group and malignant group,there were obvious cell atypia,and the cell atypia of malignant group was more significant than benign group.The contents of collagen fibers in benign group and malignant group were significantly higher than that in paracancer control group.IGFBPrP1,TGFβ1,α-SMA and collagen type Ⅰ were highly expressed in the endochylema of the tumor cells and (or) the myofibroblast.The expression level of IGFBPrP1 in highly differentiated ductal adenocarcinoma was significantly higher than that in moderately and poorly differentiated ductal adenocarcinoma ((9.46 ± 2.10) × 104 vs.(6.48 ± 1.38) × 104 and (6.07 ± 1.29) × 104);t =7.430 and 6.767,both P ＜ 0.05).The expression of IGFBPrP1 in human pancreatic neoplasms was positively correlated with TGFβ1,α-SMA and collagen type Ⅰ (r=0.530,0.619,0.625;all P ＜0.05).Conclusions IGFBPrP1 is highly expressed in pancreatic tumor tissue and its expression level may correlate with the histological grade of pancreatic neoplasms.The expression of IGFBPrP1 in human pancreatic tumor tissues may be accompanied by the activation of pancreatic stellate cells and the generation of cancer-related fibroblasts,and IGFBPrP1 may involve in the formation of tumor by changing the tumor microenvironment.

Effect of high body mass index on perioperative complications under thoracoscope radical resection of lung cancer and its clinical efficacy / 肿瘤研究与临床

Objective To investigate the effect of high body mass index (BMI) on perioperative complications under thoracoscope radical resection of lung cancer and its clinical efficacy.Methods A total of 235 patients who received pulmonary radical resection under thoracoscope between January 2012 and December 2017 in Department of Thoracic Surgery of the First Hospital of Lanzhou University were retrospectively analyzed.The patients were divided into normal BMI group (BMI≥ 18.5 kg/m2 and BMI ＜24.0 kg/m2,n =147) and high BMI group (BMI≥24.0 kg/m2,n =88) according to BMI in China.The incidence of postoperative complications and clinical efficacy were compared by using x2 test and t test.Logistic regression was used to identify that if high BMI was the independent risk factor of postoperative pulmonary infection in patients with lung cancer.Results The incidence of the complications in high BMI group was higher than that in normal BMI group,including pulmonary infection [17.0％ (15/88) vs.6.1％(9/147),x2 =7.162,P ＜ 0.05],pulmonary atelectasis [11.4％ (10/88) vs.3.4％ (5/147),x2 =5.840,P ＜ 0.05],respiratory failure [5.7％ (5/88) vs.0.1％ (1/147),x2 =5.535,P ＜ 0.05] and poor wound healing [10.2％ (9/88)vs.3.4％ (5/147),x2 =4.578,P ＜ 0.05].Postoperative recovery time [(7.1±1.4) d vs.(6.7±0.8) d,t =2.706,P ＜ 0.05],chest drainage tube removal time [(3.8±1.6) d vs.(3.4±0.7) d,t =3.089,P ＜ 0.05] in high BMI group were longer than those in normal BMI group.Multiple-factor analysis showed that the independent risk factors were diabetes,high blood pressure,high BMI,long operation time,old age,smoking history (all P ＜0.05).Conclusions The incidence of pulmonary infection,pulmonary atelectasis and poor wound healing for the patients with high BMI is increased.Besides,postoperative recovery time and chest drainage tube removal time are prolonged.High BMI is an independent risk factor of pulmonary infection.

Expression of NUF2 in breast cancer and its clinical significance / 南方医科大学学报

OBJECTIVE@#To investigate the expression of the cell division- associated gene NUF2 in breast cancer and its clinical significance.@*METHODS@#The expression of NUF2 in breast cancer tissues was analyzed using Oncomine database. The relationship between the expression of NUF2 and the prognosis of breast cancer was analyzed using the Kaplan-Meier Plotter database. Gene set enrichment analysis (GSEA) and GEO database were used to investigate the effect of NUF2 on gene enrichment. The String database was utilized to analyze the proteins associated with NUF2. The TIMER database was analyzed to assess the correlations of NUF2 with BUB1, MAD2L1 and MYC. The expressions of NUF2 mRNA in 8 pairs of breast cancer tissues and adjacent tissues were verified by q-PCR.@*RESULTS@#Compared with that in normal breast tissue, NUF2 was significantly overexpressed in breast cancer ( < 0.001). The overall survival time (HR = 1.52, = 0.015) and the recurrence-free survival time (HR = 1.85, = 3.2e-14) of the patients with high NUF2 expression were significantly shorter than those of patients with low NUF2 expression. In patients with high NUF2 expression, the enriched genes were involved mainly in cell cycle, P53, G2/M, DNA repair, MYC, and PI3K-AKT-MTOR signaling pathways, which were associated with tumor proliferation, invasion, metastasis and stemness. Combination of the results of String database, gene enrichment and TIMER database analyses suggested that NUF2 interacted directly with BUB1, MAD2L1, and MYC, which could promote the progression of breast cancer. The results of q-PCR showed that NUF2 expression was up-regulated in 6 cancer tissues and down-regulated in 2 cancer tissues.@*CONCLUSIONS@#NUF2 gene is overexpressed in breast cancer, and its expression level is important in predicting the prognosis of breast cancer.

Value of contrast-enhanced endoscopic ultrasonography in the differential diagnosis of mass-type chronic pancreatitis and pancreatic cancer: A Meta-analysis / 临床肝胆病杂志

ObjectiveTo systematically evaluate the value of contrast-enhanced endoscopic ultrasonography (CE-EUS) in the differential diagnosis of mass-type chronic pancreatitis and pancreatic cancer. MethodsCNKI, Wanfang Data, CBM, PubMed, Embase, and the Cochrane Library were searched for Chinese and English articles on the value of CE-EUC in the differential diagnosis of mass-type chronic pancreatitis and pancreatic cancer published up to December 31, 2018. Secondary screening, scoring, and data extraction were performed, and then Meta-Disc1.4 and stata12.0 software were used for meta-analysis. ResultsA total of 20 articles with 1888 patients were included in this study. The meta-analysis showed that in the differential diagnosis of mass-type chronic pancreatitis and pancreatic cancer, CE-EUS had a pooled sensitivity of 86% (95% confidence interval ［CI］: 83%-89%), a specificity of 93% (95%CI: 92%-95%), a positive likelihood ratio of 12.01 (95%CI: 9.72-14.85), a negative likelihood ratio of 0.16 (95%CI: 0.10-0.26), a diagnostic odds ratio of 76.12 (95%CI: 54.50-106.31), and an area under the summary receiver operating characteristic curve of 0.965 5. No sources of heterogeneity were found in the threshold effect test, the meta-regression analysis, and the sensitivity analysis. After the four articles causing heterogeneity were excluded, the heterogeneity of all included articles was reduced to an acceptable range, and there were no significant changes in the results of the meta-analysis. ConclusionCE-EUS has a good value in the differential diagnosis of mass-type chronic pancreatitis and pancreatic cancer, and its application in clinical practice can improve the diagnostic rate of pancreatic cancer.

Improved synthesis of analgesic pentazocine / 中国药科大学学报

@#A new synthetic process of pentazocine has been developed. Starting from 3, 4-dimethylpyridin and benzyl chloride, via quaternarization, Grignard reaction addition/reduction/salt, cyclization, hydrogenation, alkylation and recrystallization, pentazocine were obtained in a total yield of 8. 4%(with a molar mass of 3, 4-dimethylpyridin), with purity greater than 99. 97%. The improved synthetic route is suitable for industrial production.

Anti-inflammatory Effect of the Luteolin-4, 4' -dipyridy Co-crystal on Macrophage RAW264.7 in Mice / 中国药房

OBJECTIVE: To study anti-inflammatory effect and mechanism of the luteolin · 4, 4' -dipyridy co-crystal.METHODS: Using macrophage RAW264. 7 of normal mice as control, the inflammation model was established with lipopolysaccharide (LPS) -induced RAW264. 7 cells. MTT assay was used to detect cells activity 2 h after treatment of different concentrations of luteolin (10, 20, 40, 80 μmol/L), 4, 4' -dipyridy (10,20, 40,80 μmol/L) and luteolin·4, 4' -dipyridy co-crystal (10, 20, 40, 80 μmol/L). The mRNA expression of iNOS and COX-2 in RAW264. 7 cells at 40 μmol/L were determined by qRT-PCR. The protein expression of TNF-α and IL-6 in RAW264. 7 cells at 40 μmol/L were determined by ELISA. The protein expression of NF-κB p65 in RAW264. 7 cells at 40 μmol/L were determined by Western bolt. RESULTS: Compared with normal cells, the activity of RAW264. 7 cells was decreased significantly after induced by LPS (P<0. 01); mRNA expression of iNOS and COX-2, protein expression of TNF-α, IL-6 and NF-κB p65 were increased significantly (P<0. 01). Both luteolin and luteolin · 4, 4' -dipyridy co-crystal could enhance the activity of RAW264. 7 cells after induced by LPS (P<0. 05 or P<0. 01) in concentration-dependent manner. 4, 4' -dipyridy had no significant effect on the activity of RAW264. 7 cells after induced by LPS. After luteolin and luteolin· 4, 4' -dipyridy co-crystal at 40 μmol/L, mRNA expression of iNOS and COX-2, protein expression of TNF-α, IL-6 and NF-κB p65 in RAW264. 7 cells after induced by LPS were decreased significantly (P<0. 05 or P<0. 01); the luteolin · 4, 4' -dipyridy co-crystal was better than luteolin (P<0. 05 or P<0. 01). CONCLUSIONS: The luteolin·4, 4' -dipyridy co-crystal can inhibit the generation of inflammatory factors by down-regulating NF-κB signal, and its anti-i nflammatory effect is better than luteolin.

Effect of probiotics in treatment of nonalcoholic fatty liver disease: A Meta-analysis / 临床肝胆病杂志

ObjectiveTo systematically analyze the value of probiotics in the treatment of nonalcoholic fatty liver disease (NAFLD). MethodsPubMed, The Cochrane Library, Embase, Medline, CNKI, VIP, and Wanfang Data were searched for randomized controlled trials (RCTs) on probiotics in the treatment on NAFLD published before December 2017. Secondary screening was performed for retrieval results, the risk of bias of the studies included was evaluated, and related data were extracted. RevMan 5.3 was used for the meta-analysis. ResultsA total of 11 RCTs with 599 NAFLD patients were included. The results showed that probiotics significantly improved the levels of alanine aminotransferase (mean difference ［MD］=-15.23, 95% confidence interval ［CI］: -19.63 to -10.82, P＜0.000 01), aspartate aminotransferase (MD=-17.08, 95%CI: -24.23 to -9.92, P＜0.000 01), gamma-glutamyl transpeptidase (MD=-20.49, 95%CI: -26.23 to -14.74, P＜0.000 01), triglyceride (MD=-0.12, 95%CI: -0.24 to -0.01, P=0.04), total cholesterol (MD=-0.33, 95%CI: -0.56 to -0.11, P=0.003), high-density lipoprotein (MD=-0.07, 95%CI: -0.14 to -0.01, P=0.03), tumor necrosis factor-α (MD=-0.38, 95%CI: -0.52 to -0.24, P＜0.000 01), and homeostasis model assessment of insulin resistance (MD=-0.39, 95%CI: -0.53 to -0.24, P＜0.000 01). However, probiotics had no significant effect on body mass index (MD=-0.73, 95%CI: -1.91 to 0.46, P=0.23) and low-density lipoprotein (MD=-0.30, 95%CI: -0.60 to 0.01, P=006). ConclusionProbiotics can significantly reduce the levels of liver aminotransferases, blood lipids, inflammatory factors, and insulin resistance in patients with NAFLD and thus exerts a certain therapeutic effect on NAFLD.

Role of immunoproteasome subunit β2i in DOCA/salt-induced vascular inflammation in mice / 中国病理生理杂志

AIM:To investigate the role of immunoproteasome subunit β2i in deoxycorticosterone acetate (DOCA)/salt-induced vascular inflammation in mice.METHODS:Wild-type and β2i knockout male mice were used.The right kidney was removed and DOCA pellet was subcutaneously implanted in the mice.The mice were then received 1% NaCl as drinking water for 3 weeks.The total RNA and protein were isolated from thoracic aorta 3 weeks later.The aortic tissues were fixed in formalin, embedded in paraffin and sectioned.Western blot, real-time PCR and immunohistochemistry were performed to detect the expression of β2i, macrophage marker Mac-2, NF-κB, and proinflammatory cytokines IL-1β, IL-6 and TNF-α in thoracic aorta.RESULTS:Compared with sham group, DOCA/salt treatment significantly increased the expression of β2i at mRNA and protein levels, increased the infiltration of macrophages and expression of Mac-2, and upregulated the expression of NF-κB and proinflammatory cytokines including IL-1β, IL-6 and TNF-α in wild-type group, whereas theses effects were markedly attenuated in β2i knockout mice.CONCLUSION:Immuneproteasome subunit β2i is involved in DOCA/salt-induced vascular inflammation through activation of NF-κB signaling in the mice.

Expression and clinical significance of HSPA9 in hepatocellular carcinoma / 重庆医学

Objective To investigate the expression of HSPA9 in hepatocellular carcinoma(HCC) and its relationship with clinicopathological features and prognosis.Methods Forty-nine cases HCC treated by operative resection and follow up data in our hospital from January 2006 to January 2010 were retrospectively analyzed.Immunohistochemistry was performed to determine the expression of HSPA9 in HCC and paratumor tissues.The relationship between HSPA9 expression and clinicopathological features and prognosis was statistically analyzed.Results The HSPA9 protein expression in tumor tissue was higher that that in the paratumor tissue(t=6.601,P＜0.01),moreover the over expression of HSPA9 was significantly correlated with lymph node metastasis (P =0.005),TNM-stage(P =0.015),tumor differentiation (P =0.033),microvascular invasion (P =0.009) and recurrence (P =0.047).In the survival analysis results,the patients with over expression of HSPA9 had a much lower total survival rate(P=0.002)and much higher postoperative cumulative recurrence rate(P =0.003).There were significant differences in TNM-stage,microvascular invasion,lymph node metastasis,tumor differentiation and HSPA9 staining for overall survival and cumulative recurrence rate based on a univariate analysis(P＜0.05).Conclusion HSPA9 has over expression in HCC.The over expression of HS-PA9 is closely related to invasion and metastasis pathological features and can serve as an independent prognostic risk factor for predicting the prognosis of HCC.

Clinical efficacy of circular wound edge protector in preventing surgical site infection following open abdominal surgery / 中国感染控制杂志

Objective To explore the efficacy of circular wound edge protector(CWEP)in preventing surgical site infection (SSI)following open abdominal surgery,analyze the related risk factors for postoperative SSI,and provide scientific basis for preventing SSI following open abdominal surgery.Methods 162 patients who underwent open abdominal surgery in a hospital from March 2014 to December 2015 were randomly divided into intervention group (used CWEP during surgery)and control group (used sterile gauze pad to protect incision).Length of hospital stay,cost of dressing change,and SSI between two groups were compared,risk factors for postoperative SSI were analyzed.Results Incidence of SSI in intervention group was lower than control group (14.81%[12/81]vs 34.57%[28/81],P <0.05);grade-A incision healing rate of intervention group was higher than control group(86.42% vs 66.67%,P <0.05).The cost of dressing change in intervention group was lower than control group([305.5 ± 176.7]yuan vs [431.6 ± 381.4 ]yuan,P = 0.008 ). Multivariate logistic regression analysis indicated that hypoproteinemia(OR,2.88[95%CI ,1.21-6.87]),body mass index ≥24(OR,3.11[95%CI ,1.12-8.66]),and blood loss≥400 mL(OR,3.98[95%CI ,1.36- 11.64])were independent risk factors for postoperative SSI,while CWEP use was the protective factor(OR,0.24[95%CI ,0.09-0.59]).Conclusion CWEP can effectively reduce the incidence of SSI following open abdominal surgery.

Clinical study of combination of trimetazidine/coenzyme as a adjunctive treatment in the elderly patients with chronic heart failure / 中国综合临床

Objective To observe the efficacy and safety of trimetazidine/coenzyme Q10 combination in the treatment of the elderly patients with chronic heart failure(CHF).Methods Sixty-two male patients aged over 80 years with CHF were randomly divided into intervention group and control group.Patients in control group received optimal conventional CHF therapy according to the guideline for CHF,while patients in intervention group received trimetazidine of 20 mg,3 times per day,coenzyme Q10 20 mg,3 times per day,additionally for 6 weeks.Left ventricular ejection fraction (LVEF),left ventricular end diastolic diameter (LVEDD),plasma brain natriuretic peptide (BNP),6 min walking distance (6MWT) and NYHA cardiac function classification of two groups before and after treatment were observed.Results Before treatmen,the NYHA function class of patients in intervention and control groups were 2.8±0.7,2.7±0.7 respectively,after treatment were 2.1± 0.6,2.4 ± 0.7 respectively,the differences were significant before and after treatment (t=6.808,2.249;P＜0.01,P＜0.05).Before treatment,BNP of intervention and control groups were (540±351)ng/L,(483 ± 351) ng/L respectively,after treatment were (219± 172) ng/L,(316 ± 202) ng/L respectively,the differences were significant before and after treatment (Z =-4.927,-4.042;P ＜ 0.01).Moreover,after treatment,NYHA function class and plasma BNP in intervention group were significantly better than those in control group (t =-2.109,P ＜ 0.05;Z =-2.219,P ＜ 0.05).Before treatment,LVEF,LVEDD and 6MWT of intervention group were (44.3 ± 3.1) ％,(54.0 ± 4.7) mm and (217.0 ± 60.9) m respectively,after treatment were (46.8±3.9) ％,(53.2±4.3) mm and (267.0±91.1) m respectively,the differences were significant before and after treatment(t=-8.313,2.254,-4.561;P＜0.01 or P＜0.05).Moreover,after treatment,LVEF and 6MWT in intervention group were significantly better than those in control group ((44.9± 3.5)％,(213.2 ±78.1) m;t =2.000,2.186;P ＜ 0.05).No significant adverse events were detected in the intervention group.Conclusion Combination of trimetazidine and coenzyme Q10 on the basis of the conventional treatment in the elderly with CHF,can further improve cardiac dysfunction and have a good safety.

Comparison of Sirolimus and Everolimus Drug-eluting Stents for Treating the Patients With Non ST-elevation Acute Coronary Syndrome / 中国循环杂志

Objective: To compare the efifcacy and safety of sirolimus-eluting stent (SES) and everolimus-eluting stent (EES) for treating the patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS). Methods: A total of 400 NSTE-ACS patients treated in Jining Medical College Hospital from 2013-09 to 2014-09 were studied. According to different stents, the patients were divided into 2 groups: SES group,n=220 and EES group,n=180. A prospective follow-up study was conducted for 1.5 years to compare the incidence rate of major adverse cardiovascular events (MACE). The patients were further stratiifed by GRACE scores as Low risk group (score140). MACE free survival was studied by Kaplan-Meier curve and analyzed by Long-rank test, predictive value of GRACE for 1.5 year MACE incidence rate was examined. Results: There were 355/400 (89%) patients completed (16.7 ± 5.7) months of follow-up study including 205 in SES group and 150 in EES group. MACE occurrence rates were similar between SES group and EES group (16.10% vs 18.0%), P>0.05. By GRACE score stratiifcation, MACE rates in High risk SES group were higher than High risk EES group (48.00%vs 16.00%),P0.05. ROC curve indicated that the predictive value of GRACE score for 1.5 year MACE incidence was for AUC=0.762, 95% CI (1.026-1.050),P<0.001. Conclusion: Implanting of EES would be more beneifcial for NSTE-ACS patients with high GRACE risk; GRACE score has the better predictive value for their long-term prognosis.

The Predictive Value for Long-term Prognosis of GRACE Score and SYNTAX Score in Patients With Non-ST Elevation Acute Coronary Syndrome / 中国循环杂志

Objective: To clarify the predictive value for long-term prognosis of GRACE score and SYNTAX score in patients with non-ST elevation acute coronary syndrome (NSTE-ACS). Methods: A total of 784 NSTE-ACS patients treated in our hospital from 2009-01 to 2014-01 were retrospectively studied. According to the treatment, the patients were divided into 3 groups: Medication group,n=410, Stent group,n=325 and CABG group,n=49. Based on 2 scoring systems, the patients were divided into another 3 groups: Low risk group, Medium risk group and High-risk group. The relationship between GRACE score and SYNTAX score was studied by Pearson correlation analysis, survival analysis was conducted by Kaplan-Meier method, univariate and multivariate analysis were performed by Cox proportional hazard model, and the area under curve (AUC) of ROC analysis was used to compare two methods. Results: All 784 patients completed the follow-up study at the median of 47.7 months. Pearson correlation analysis showed that there was a weak positive correlation between GRACE score and SYNTAX score (r=0.40,P0.05. Cox proportional hazard model and ROC analysis indicated that GRACE and SYNTAX scores had the important predictive value for lone term prognosis of NSTE-ACS. ROC analysis of GRACE score, SYNTAX score, the combination of GRACE and SYNTAX scores showed that 3 of them all had good predictive value for MACE occurrence, three of 95% CI had signiifcant overlapping without statistic differences. Conclusion: GRACE score and SYNTAX score are related, both of them have important while similar predictive value for long term prognosis in NSTE-ACS patients, the combination of 2 scores cannot increase the predictive value. GRACE score is appropriate for the risk stratiifcation in NSTE-ACS patients.

Effect of early tracheal intubation on hypoxemia and level of blood lactate, C-reactive protein in patients with severe intracerebral hemorrhage / 临床神经病学杂志

Objective To explore the effect of early tracheal intubation on hypoxemia and level of blood lactate, C-reactive protein(CRP) in patients with severe intracerebral hemorrhage .Methods Fifty-four patients with severe intracerebral hemorrhage were divided into routine tracheal intubation (routine intubation group,n=25) and early tracheal intubation group(early intubation group,n=29) radomly.In routine tracheal intubation group, tracheal intubation was performed only when respiratory failure occurred .In early intubation group , tracheal intubation was performed as long as hypoxemia which can not be fixed by inspiring oxygen , tongue retropulsion or vomit occurred . Levels of artery blood gas analysis , lactate and CRP were tested before and after 2 h ( lactate ) or 24 h ( CRP ) of tracheal intubation .Heart rate and respiratory frequency were also monitored .Results PaO2 , PaCO2 , SaO2 and heart rate were markedly improved after intubation in both groups , levels of lactate and CRP were evidently reduced after intubation in both groups(all P<0.05).After intubation, the PaO2 of early intubation group was significantly higner and the CRP of early intubation group was significantly lower than that of routine intubation group ( all P<0.05);Before intubation, the PaO2 and SaO2 of early intubation group were significantly higher and levels of lactate and CRP were significantly lower than those of routine intubation group ( P<0.05 ) .Conclusion Early tracheal intubation can improve hypoxemia and reduce the level of lactate and CRP in patients with severe intracerebral hemorrhage .

Changes of ox-LDL and TNF-αcontent in patients with different degrees coronary heart disease / 心血管康复医学杂志

Objective:To explore changes of oxidized loW density lipoprotein (ox-LDL)and tumor necrosis factor (TNF)-αcontent in patients With different degrees coronary heart disease (CHD)and their correlation.Methods:A total of 100 CHD patients diagnosed by coronary angiography (CAG)Were selected and divided into stable angina pectoris (SAP)group (n=23),unstable angina pectoris (UAP)group (n=48)and acute myocardial infarction (AMI)group (n=29);single vessel group (n=31),double vessel group (n=33)and multi-vessel disease group (n=36);mild stenosis group (n=27), moderate stenosis group (n=31)and severe stenosis group (n=42).A total of 30 middle-aged and aged people Without CHD and severe organic diseases,Were enrolled as healthy control group.Content of total cholesterol (TC),triglyceride(TG),high density lipoprotein cholesterol (HDL-C),loW density lipoprotein cholesterol (LDL-C),ox-LDL and TNF-α Were measured among above groups.Results:Compared With healthy control group,there Were significant increase in blood lipid levels (except HDL-C),TNF-αlevel,and significant decrease in HDL-C level in CHD group,P <0.05 all; compared With SAP group,thereWere significant increase in levels of ox-LDL and TNF-αin UAP group and AMI group (P <0.05 all),and those of AMI groupWere significantly higher than those of UAP group (P <0.05 both);comparedWith single vessel disease group,there Were significant increase in levels of ox-LDL [(432.19±80.75)μg/L vs.(560.47± 84.21)μg/L,(619.31±88.49)μg/L]and TNF-α[(9.01±2.75)ng/L vs.(10.06±2.78)ng/L,(11.14±2.74)ng/L] in double-vessel and multi-vessel disease group (P <0.05 all),and those of multi-vessel disease group Were significantly higher than those of double-vessel disease group (P <0.05 both);comparedWith mild stenosis group,thereWere significant increase in levels of ox-LDL [(459.43±53.36)μg/L vs.(531.33±68.12)μg/L,(610.62±93.43)μg/L]and TNF-α[(8.98±2.66)ng/L vs.(9.94±2.87)ng/L,(11.12±3.21)ng/L]in moderate stenosis group and severe stenosis group (P <0.05 all),and those of severe stenosis groupWere significantly higher than those of moderate stenosis group (P <0.05 both);Spearman correlation analysis indicated that ox-LDL levelWas positively correlatedWith TNF-αlevel (r =0.83,P <0.01).Conclusion:Levels of ox-LDL and TNF-αare closely correlatedWith lesion severity in CHD patients.

Effects of Deanxit on depression and clinical outcomes in elderly patients with acute coronary syndrome / 中华行为医学与脑科学杂志

Objective To investigate deanxit clinical efficacy of depression in elderly patients with acute coronary syndrome(ACS).Methods 88 elderly patients with ACS and depression were randomly divided into Deanxit (2 tablets daily ; Deanxit,n =43) or placebo (control,n =45) treatment in addition to standard therapy.SDA score,SDS score,MACE and cardiac autonomic nerve function were performed at 12 weeks follow-up.Results In deanxit group,SDA score and SDS score were significantly reduced (34.28 ± 6.35 vs 52.68 ± 5.74,41.19 ±4.63 vs 54.68 ± 4.32,P ＜ 0.05),MACE were also decreased (4.6％ vs 28.9 ％,P ＜ 0.05).SDNN were significantly higher than control (109.03 ± 23.08 vs 98.29 ± 27.44,P ＜ 0.05),but LF was reduced (152.89 ± 92.75vs 249.21 ± 64.17,P＜ 0.05).Conclusion Deanxit can improve the depression and clinical symptoms in elderly patients with ACS and depression.By improving the cardiac autonomic nerve function,deanxit possible reduce the onset of severe arrhythmia and improve the short-term prognosis.