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Objective To investigate the correlation of vitamin D with essential hypertension and its target organ damages in the elderly.Methods In the retrospective study,365 elderly participants aged ≥ 60 years hospitalized in our department during January 2013 to February 2014 were involved,including 247 patients with confirmed essential hypertension(HT)and 118 patients without HT.Serum 25-hydroxy vitamin D[25(OH)D]levels were measured and compared between HT and non-HT group,and binary regression analysis was used to discuss potential influencing factors of HT.The damage index of vitamin D target organ was compared between vitamin D deficiency group(n=198)and vitamin D non deficiency group(n=49).Results The median serum 25(OH)D level of participants is 35.3 nmol/L,77.5%(283 cases)were in the insufficient vitamin D status.The level of 25(OH)D was significantly lower in HT group than in non-HT group(34.0 vs.38.7 nmol/L,P0.05)in albumin/creatinine ratio,serum creatinine,estimated glomerular filtration rate,ankle-brachial index,pulse wave velocity,intima media thickness of carotid artery,Sokolow-Lyon index,cornell index and left ventricular mass index.The serum 25(OH)D level was significantly lower in CHD plus HT group than non-CHD(P<0.05).The 25(OH)D level was negatively correlated with coronary heart disease(B=-0.021,P=0.019).The serum 25(OH)D level was significantly lower in groups with double-and triple-vessel coronary artery disease than in non-CHD group(P<0.01).Conclusions Vitamin D insufficiency is common in the elderly.The serum 25(OH)D level is significantly lower in old patients with HT especially with stage 3 HT than in non-HT ones.The 25(OH)D level is lower in HT patients with comorbid CHD,and more obvious in HT patients with multi-vessel coronary artery disease.An insufficient vitamin D status is not correlated with hypertensive target organ damages including kidney,peripheral vascular and left ventricular cardiac structure.
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Objective:To assess the consequences of switching aspirin dosage from 100 mg/d to 40 mg/d on cardiovascular benefit,bleeding risk and platelet aggregation in very elderly patients. Methods:Arachidonic acid induced platelet aggregation(AA-Ag)was measured in 537 patients aged 80 or older treated with aspirin (100 mg/d).In the study,100 patients with low on-treatment platelet ag-gregation and at high risk of bleeding and low risk of cardiovascular events,were switched to aspirin (40 mg/d)and their platelet aggregation was measured again 7 days later.Their bleeding and upper gastroin-testinal symptoms were also recorded in following 3 months.Results:The study observed a heterogeneous distributed aspirin 100 mg/d AA-Ag (range:0.42% to 28.78%)in the 537 very elderly patients.Aspi-rin 100 mg/d AA-Ag before the switch in aspirin 40 mg/d group was 5.00% ±2.32% and the rate of the patients with low on-treatment platelet aggregation was 71.00%.The rates of melena or occult blood positive,other minimal bleeding,upper gastrointestinal symptoms and a history of gastrointestinal bleeding in 40 mg/d group were higher than those in 100 mg/d group.On a regimen of aspirin 40 mg/d,AA-Ag increased to 11.21% ±4.95%(range:2.12% to 28.84%)with 95.00%of the patients with AA-Ag<20%and the rate of the patients with low on-treatment platelet aggregation was 15.00%.Multiple vari-able analysis revealed that aspirin 40 mg/d AA-Ag was significantly influenced by aspirin 100 mg/d AA-Ag,BMI and platelet counts.The rate of gastrointestinal bleeding decreased from 12.00% to 5.00%, and upper gastrointestinal symptoms decreased from 59.00% to 21.00% after the switch in 40 mg/d group.Conclusion:Switching aspirin dosage from 100 mg/d to 40 mg/d reduces the bleeding events and improves upper gastrointestinal symptoms,thus inhibiting platelet aggregation effectively in very elderly patients.
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Objective To explore the relationship of adult attachment,life orientation style and job burnout among nurses.Methods Relationship Questionnaire (RQ) and Experience of close relationships (ECR) inventory were used to measure 566 nurses' adult attachment.Life orientation test (LOT-R) and Maslach's Burnout Inventory-General Scale (MBI-GS) were administrated to measure subjects'optimism,pessimism,and job burnout.Results ①Distribution of adult attachment style in nurses were 36％ for secure,29.3％ for dismissing,18.4％for preoccupied and 6.7％ for fearful.②Attachment avoidance were positive correlated with pessimism (r =0.139) and negative correlated with optimism (r =-0.212) significantly; and there was significant positive correlation between attachment avoidance and ineffectiveness (r=0.122) also.Attachment anxiety was positively related to pessimism (r=0.151),and three indexes of job burnout (r=0.238,0.281,0.143 respectively).Meanwhile,there were significant negative correlations among optimism and job burnout indexes (r =-0.12,-0.193,-0.230).③There were significant differences among four attachment groups on optimism and pessimism.For job burnout,the four groups had significant differences only on depersonalization,instead of ineffectiveness and emotion exhaustion.④ Regression analysis suggested that attachment anxious was a valid positive predictor of job burnout,while optimism was a negative predictor.Conclusion Both adult attachment and life orientation style are contributed to job burnout among nurses.
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Objective To estimate the patterns and frequency of anomalous coronary origin with angiography in the Chinese elderly population and evaluate the correlation between anomalous coronary origin and development of coronary atherosclerotic stenosis. Methods A retrospective analysis was performed on the basis of angiographic data among elderly patients who underwent coronary arteriography in Beijing University First Hospital. Those with anomalous origin of coronary arteries were selected for further assessment and significant stenosis in coronary arteries was recorded.Results Among 2031 patients, 46 patients were found to have anomalous origin of coronary artery,with an incidence rate of 2.3%. Right coronary artery was the most common anomalous vessel, being involved in 26 patients (56.5%). The anomalous origin was more frequent in right coronary artery than in left coronary artery (41.3%). The most common anomaly was right coronary artery arising from left coronary sinus in 13 patients (28.3%). Significant atherosclerotic lesions in the anomalous arteries were seen in 37 patients (80.4%). Conclusions In Chinese elderly population, the anomalous origin of coronary artery is more frequent in right coronary artery, the most common anomaly resides in right coronary artery arising from left coronary sinus. The anomalous coronary artery increases risk for development of coronary atherosclerotic stenosis.
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Objective To investigate the relationship between peripheral atheroselerosis and coronary heart disease(CHD) in the elderly.MethodsCarotid and femoral intima-media thickness (IMT),total plaque area and carotid total plaque score were measured in 152 elderly inpatients by vascular ultrasound one week before coronary angiography,meanwhile carotid atherosclerosis was classified.The severity of CHD was estimated by the number of vessel lesions and Gensini score. ResultsCarotid and femoral IMT,plaque morbidity,total plaque area and total plaque score were much higher in the patients with CHD than in those without(all P<0.05).Carotid total plaque area,total plaque score,femoral total plaque area and femoral IMT were much higher in the patients with two-vessel lesions[(1.57±0.37)mm~2,(4.595±3.39),(0.51±0.21)mm~2 and (1.07±0.15)mm] or three-vessel lesions [(1.885±0.15) mm~2,(6.67±5.90),(0.59±0.23) mm~2 and (1.15±0.14) mm] than in those with single-vessel lesion [(0.58±0.11 )mm~2,(3.82±2.11),(0.24±0.26) mm~2 and (0.97±0.11)mm,all P<0.05)].There was positive correlation between the classification of carotid atherosclerosis(r= 0.282,P< 0.01),total plaque score (r= 0.307,P < 0.01),total plaque area ( r=0.494,P<0.01) and the number of vessel lesions.There was also positive correlation between carotid total plaque area and Gensini score(r=0.472,P<0.01),between femoral IMT(r=0.415,P<0.01),total plaque area and the number of vessel lesions(r=0.692,P<0.01),and between femoral IMT(r=0.404,P<0.01),total plaque area ( r=0.648,P<0.01 ) and Gensini score.Using multiple stepwise regression analysis,the following parameters were found to be independent predictors of coronary artery Gensini score: carotid total plaque area (OR=2.2; 95% CI:0.79 ～2.46),femoral total plaque area(OR= 1.6;95% CI:O.28～1.35) and femoral IMT (OR=1.6;95% CI:1.20～15.10).Conclusions The assessment of peripheral atherosclerosis by ultrasonography is significantly associated with the prevalence and severity of CHD.
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Aim To observe the effect of methotrexate (MTX) on proliferation, migration and apoptosis of cultured vascular smooth muscle cells (VSMC). Methods Rabbit thoracaortic VSMC were cultured in vitro.VSMC proliferation was evaluated by cell counting and cell cycle analysis. Monolayer cell scrape was used to observe VSMC migration. Apoptosis was observed with flow cytometry, DNA gel electrophoresis and TUNEL stain. Results MTX (25～100 nmol?L -1) inhibited VSMC proliferation in a dose-dependent manner.25 nmol?L -1 and 50 nmol?L -1 MTX increased the percentage of the S phase cells and decreased the percentage of the G 2/M phase cells (P
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Objective To evaluate the influence of percutaneous coronary intervention (PCI) on NT-proBNP and Hs-CRP level of the elderly with coronary heart disease. Methods Twenty-four patients who underwent PCI, and thirty patients who underwent coronary angiography (CAG) were enrolled in this study. Plasma NT-proBNP and Hs-CRP concentrations before and at 0, 1 h, 24 h and 72 h after PCI were assayed in all patients. Results There were no significant difference in plasma NT-proBNP level at baseline level between the PCI and CAG group, and also no significant change in the CAG group after the procedure. Plasma NT-proBNP level was increased significantly from 231.31?233.52 pg/mL to the peak concentration of 663.75?614.93 pg/mL at 24 h after PCI. Statistical differences were observed between the baseline levels and at 24 h as well as 72 h after the operation in the PCI group. Plasma NT-proBNP concentrations also showed significant differences between the PCI and CAG group at each time point after the procedures. Remarkable elevation in plasma Hs-CRP level was observed at 72 h after procedure in all patients. Conclusion Elevation of plasma NT-proBNP concontrations might be induced by transient myocardial ischemia in PCI. NT-proBNP may be a marker of myocardial ischemia and may be useful to detect untypical ischemia in the elderly. Plasma Hs-CRP increased at 72 h after PCI and CAG, which may be related to inflammation reaction induced by vessel puncture.
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Objective:To analyze the relationship between plasma level of cortistatin(CST) and coronary heart disease(CHD) and the factors that influence the level of CST.Methods: Plasma levels of CST were measured using ELISA method.The clinical data and the levels of CST of 40 healthy subjects and 39 CHD patients before and 1 d after percutaneous coronary intervention(PCI) were compared.And the factors that influenced the CST level were analyzed.Results: The CST levels of CHD group before or 1 d after PCI were significantly higher than those of the control group(1.97?1.12 and 2.01?0.77 vs 1.21?0.27,P0.05);There was no correlation between CST levels and fasting blood glucose(FBG),high sensitivity C-reactive protein(hsCRP),left ventricular ejection fraction(LVEF),severity of lesions of coronary arteries or history of hypertension;The levels of triglyceride(TG) and total cholesterol(TCHOL) negatively correlated with CST levels(?=-2.594,P
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Objective To evaluate the function of p27 gene on the neointimal formation after balloon injury in rabbit carotid artery. Methods The cultured vascular smooth muscle cells (VSMCs) were infected with Adp27. Using MTT assay we measured the proliferation of VSMCs. Balloon injured rabbit carotid arteries were also infected with Adp27, and then we evaluated the ratio of intima to media. Results MTT assay of rabbit VSMCs proliferation demonstrated an obvious inhibition in Adp27 treated group. And p27 overexpression had an effect on the cell cycle. It could induce cell cycle arrest in G1 phase and reduce the cells in S phase. Overexpression of p27 could also reduce the neointimal hyperplasia by 27.43%. Conclusion The p27 gene can reduce the neointimal formation after balloon injury in rabbit carotid artery effectively.