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Objective: To investigate the quality of life and associated factors in patients with coronary heart disease (CHD) in China. Methods: A cross-sectional study of 25 provinces and cities in China was performed from June to September 2020. A questionnaire was used to collect the socio-demographic and clinical information of patients with CHD, while the European Five-dimensional Quality of Life Scale (EQ-5D) was used to assess the quality of life. Multiple linear regression model was performed to analyze the associated factors. Results: The median age of the 1 075 responders was 60 (52, 67) years, and 797 (74.1%) were men. The EQ-5D and EQ-VAS indices were 0.7 (0.5, 0.8) and 60.0 (40.0, 80.0). Among the five dimensions in the quality of life scale, the frequency of anxiety/depression was the highest (59.8%), while problems in self-care was the lowest (35.8%). In the multiple linear regression model, female, increasing age, obesity, comorbidity(ies), anxiety/depression, social media channels, and receiving the CABG therapy were associated with the lower EQ-5D index (all P<0.05). In addition, increasing age, obesity, comorbidity (ies), depression, anxiety and depression, social media channels, and receiving the CABG therapy were associated with lower EQ-VAS index (all P<0.05). Conclusion: Over half of the patients with CHD in China have a low quality of life, which is related to gender, age, obesity, treatment pathway, the presence or absence of comorbidity (ies), and psychological state. In addition to managing the adverse effects of traditional socio-demographic factors on the quality of life, clinical practices should pay attention to the psychological state of patients. Moreover, establishing a WeChat group for doctor-patient communication could improve the quality of life of CHD patients.
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Masculino , Humanos , Feminino , Qualidade de Vida/psicologia , Autorrelato , Estudos Transversais , Doença das Coronárias , Inquéritos e Questionários , ObesidadeRESUMO
Although herbal medicines(HMs)are widely used in the prevention and treatment of obesity and obesity-associated disorders,the key constituents exhibiting anti-obesity activity and their molecular mechanisms are poorly understood.Recently,we assessed the inhibitory potentials of several HMs against human pancreatic lipase(hPL,a key therapeutic target for human obesity),among which the root-extract of Rhodiola crenulata(ERC)showed the most potent anti-hPL activity.In this study,we adopted an integrated strategy,involving bioactivity-guided fractionation techniques,chemical profiling,and biochemical assays,to identify the key anti-hPL constituents in ERC.Nine ERC fractions(retention time=12.5-35 min),obtained using reverse-phase liquid chromatography,showed strong anti-hPL activity,while the major constituents in these bioactive fractions were subsequently identified using liquid chromatography-quadrupole time-of-flight mass spectrometry(LC-Q-TOF-MS/MS).Among the identified ERC constituents,1,2,3,4,6-penta-O-galloyl-β-D-glucopyranose(PGG)and catechin gallate(CG)showed the most potent anti-hPL activity,with pIC50 values of 7.59±0.03 and 7.68±0.23,respectively.Further investigations revealed that PGG and CG potently inhibited hPL in a non-competitive manner,with inhibition constant(Ki)values of 0.012 and 0.082 μM,respectively.Collectively,our integrative analyses enabled us to efficiently identify and characterize the key anti-obesity constituents in ERC,as well as to elucidate their anti-hPL mechanisms.These findings provide convincing evidence in support of the anti-obesity and lipid-lowering properties of ERC.
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Objective:Effects of pole-specific acupuncture combined with Bobath on upper limb function, daily life ability and nerve function after traumatic brain injury were observed.Methods:A total of 142 patients with cerebral hemiplegia after traumatic brain injury from January 2019 to December 2020, were divided into the Bobath group (47 cases), the pole-specific acupuncture group (47 cases) and combination group (48 cases) by the random number method. Bobath group received Bobath rehabilitation, the pole-specific acupuncture group received pole-specific acupuncture rehabilitation, and combination group was given pole-specific acupuncture rehabilitation and Bobath treatment. The overall rehabilitation efficiency, limb function Fugl-Meyer scale score, Barthel index of daily life ability, nerve function, and other indicators were observed and compared.Results:After treatment, the overall recovery efficiency (86.96%) in combination group was significantly higher than that of the Bobath group (65.96%) and acupuncture group (64.44%)( χ2=5.84, P=0.016). After treatment, the limb function Fugl-Meyer scale (including upper limb and lower limb function scores)( F=19.38, 24.83, all Ps<0.01), daily life ability Barthel index (including cognitive ability situation score, language ability score, self-care ability score, social adaptability score and total score) of combination group were significantly higher than those in the Bobath group and acupuncture group ( F=14.91, 15.87, 18.71, 18.88, 32.62, all Ps<0.001), while the NIHSS score of combination group was significantly lower than that of the Bobath group and acupuncture group ( F=31.71, P<0.01). After treatment, the NE[(58.29±9.82)μg/L vs. (86.29±12.35)μg/L, (88.34±12.87)μg/L, F=33.39], DA[(204.29±20.26)μg/L vs. (278.72±27.56)μg/L, (281.14±27.82)μg/L, F=55.50], 5-HT[(231.27±20.12)μg/L vs. (294.74±29.34)μg/L, (298.19±28.73)μg/L, F=13.86], E[(21.85±3.19)μg/L vs. (28.37±4.07)μg/L, (28.26±4.14)μg/L, F=9.34] of combination group were significantly lower than those in the Bobath group and acupuncture group ( P<0.01). Conclusion:Magnetic pole-specific acupuncture combined with Bobath can improve the function of limbs, daily quality of life and nerve function of the patients with traumatic craniocerebral injury with cerebral palsy.
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Objective To investigate the effect of aerobic exercise combined with Levocarnitine in treating stable angina pectoris ( SAP ) and its effect on vascular endothelial function and serum levels of superoxide dismutase ( SOD ), total antioxidant capacity ( TAC ), glutathione peroxidase ( GSH-px ), malondialdehyde (MDA),and lipid peroxide( LPO) . Methods One hundred and fifty patients with SAP were selected in Affiliated Hospital of Yan′an University from september 2017 to september 2018 and randomly divided into control group and observation group( 75 cases in each group) . Both groups received routine intervention according to the guidelines. The control group was given with intravenous drip of left carnitine(3 g／time and once a day). On basis of the control group,the observation group was treated with regular aerobic exercise therapy. After 8 weeks＇ treatment for two groups,attack frequency degree of angina pectoris,score of life quality of Seattle angina scale(SAQ),and clinical effect were compared between the two groups. And the vascular endothelial function ( plasma endothelin ( ET ) 1, nitric oxide ( NO )), flow mediated vasodilation(FMD) of brachial artery and antioxidant effect(serum levels of SOD,TAC,GSH-px, MDA and LPO) were detected. Results After 8 weeks＇treatment,frequency of angina pectoris and episode of duration of angina pectoris in the observation group were less(( 4. 19± 0. 56) vs. ( 6. 22 ± 0. 89) time, (4. 31±0. 50) vs. (5. 25±0. 71) min),while life quality indexes SAQ score was higher,than those in the control group,and the difference was statistically significant (( 18. 44 ± 2. 30) vs. ( 12. 49 ± 1. 82) score, (56. 31±6. 62) vs. (48. 05± 5. 88) score,(14. 46 ± 1. 99) vs. ( 9. 22 ± 1. 10) score,( 21. 41 ± 2. 95)) vs. (18. 09±2. 26) score,(16. 14±2. 17) vs. (12. 05±1. 82) score,(all P＜0. 01)). The total clinical effective rate of the observation group ( 92%( 69 ／ 75)) was higher than that of the control group ( 80%( 60 ／75)),the difference was statistically significant (χ2＝4. 485,P＝0. 034). After 8 weeks′ treatment,level of ET-1,FMD of brachial artery,MDA,and LPO were lower than those in the control group(( 65. 38± 7. 91) ng／L vs. (77. 12±8. 56) ng／L,( 9. 44± 1. 34)% vs. ( 12. 55± 1. 81)%,(2. 81± 0. 43) μmol／L vs. ( 3. 90 ±0. 50) μmol／L,(3. 14±0. 44) μmol／L vs. (4. 40± 0. 63) μmol／L),while NO,SOD,TAC,GSH-px were higher than control group(( 67. 51 ± 7. 79) μmol／L vs. ( 52. 17± 6. 08) μmol／L,( 85. 25± 9. 67) U／L vs. (76. 01±8. 33) U／L,(12. 79±1. 80) kU／L vs. (9. 64±11. 05) kU／L,(117. 65±15. 03) U／L vs. (111. 76 ±14. 19) U／L),and the difference was statistically significant (all P＜0. 01). Conclusion Aerobic exercise combined with Levocarnitine in treating SAP can reduce the attack of angina pectoris, improve the life treatment of patients,and improve the clinical effect,which may be related to the improvement of endothelial function and antioxidant effect.
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Background:@#Depression and anxiety have been correlated with elevated risks for quality-of-life (QOL), adverse outcomes, and medical expenditure in patients with acute coronary syndrome (ACS). However, the relevant data are lacking for Chinese ACS populations, especially regarding different effects of major depression, anxiety, and comorbidity. The objective of this study was to evaluate the dynamic changes of depression and/or anxiety over 12 months and examine the effects of depression, anxiety, and comorbidity on QOL, adverse outcomes, and medical expenditure in Chinese patients with ACS.@*Methods:@#For this prospective longitudinal study, a total of 647 patients with ACS were recruited from North China between January 2013 and June 2015. Among them, 531 patients (82.1%) completed 12-month follow-ups. Logistic regression model was utilized for analyzing the association of baseline major depression, anxiety, and comorbidity with 12-month all-cause mortality, cardiovascular events, QOL, and health expenditure.@*Results:@#During a follow-up period of 12 months, 7.3% experienced non-fatal myocardial infarction (MI) and 35.8% cardiac rehospitalization. Baseline comorbidity, rather than major depression/anxiety, strongly predicted poor 12-month QOL as measured by short-form health survey-12 (odds ratio [OR]: 1.77, 95% confidence interval [CI]: 1.22–2.52, P = 0.003). Regarding 12-month non-fatal MI and cardiac re-hospitalization, baseline anxiety (OR: 2.83, 95% CI: 1.33–5.89, P < 0.01; OR: 4.47, 95% CI: 1.50–13.00, P < 0.01), major depression (OR: 2.58, 95% CI: 1.02–6.15, P < 0.05; OR: 5.22, 95% CI: 1.42–17.57, P < 0.03), and comorbidity (OR: 6.33, 95% CI: 2.96–13.79, P < 0.0001, OR: 14.08, 95% CI: 4.99–41.66, P < 0.0001) were all independent predictors, and comorbidity had the highest predictive value. Number of re-hospitalization stay, admission frequency within 12 months and medical expenditure within 2 months were the highest in patients with ACS with comorbidity.@*Conclusions:@#Major depression and anxiety may predict 12-month non-fatal MI and cardiac re-hospitalization. However, comorbidity has the highest predictive value with greater medical expenditure and worse QOL in Chinese patients with ACS. And depression with comorbid anxiety may be a new target of mood status in patients with ACS.
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@#AIM: To observe the visual acuity changes within 24h after femtosecond laser small incision lenticule extraction(SMILE)and femtosecond laser <i>in situ </i>keratomileusis(FS-LASIK)for myopia.<p>METHODS: A retrospective analysis was made of 80 myopic patients(160 eyes)who underwent corneal refractive surgery in our hospital from August 2017 to March 2018. They were divided into two groups according to different surgical methods, 40 cases(80 eyes)in SMILE group and 40 cases(80 eyes)in FS-LASIK group. The visual acuity, intraocular pressure, corneal endothelial cells, intraoperative and postoperative complications were observed within 24h.<p>RESULTS: The operation was successfully completed in both groups. The uncorrected visual acuity(UCVA)of SMILE group and FS-LASIK group improved gradually at 2, 4, 6, 8, 12 and 24h after operation. At 2, 4, 6, 8, 12, 24h after operation, the UCVA of FS-LASIK group was better than that of SMILE group, and the difference was statistically significant(<i>P</i><0.05). The UCVA of SMILE group was the best 12 and 24h after operation, and that of FS-LASIK group was the best 6 and 24h after operation. The results of intragroup comparison before and after operation showed that the intraocular pressure(IOP)of the two groups was lower than that before operation, the density of corneal endothelial cells, the coefficient of variation were significantly decreased, the area of corneal endothelial cells and the proportion of hexagonal cells were significantly increased; the difference was statistically significant(<i>P</i><0.01). The results of comparison between groups after operation showed that there was no significant difference in intraocular pressure and corneal endothelial cell related indexes between the two groups(<i>P</i>>0.05). No serious complications occurred during and after operation in both groups.<p>CONCLUSION: Within 24h after SMILE and FS-LASIK, the visual acuity changed greatly, and good visual acuity was obtained.
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BACKGROUND@#Depression and anxiety have been correlated with elevated risks for quality-of-life (QOL), adverse outcomes, and medical expenditure in patients with acute coronary syndrome (ACS). However, the relevant data are lacking for Chinese ACS populations, especially regarding different effects of major depression, anxiety, and comorbidity. The objective of this study was to evaluate the dynamic changes of depression and/or anxiety over 12 months and examine the effects of depression, anxiety, and comorbidity on QOL, adverse outcomes, and medical expenditure in Chinese patients with ACS.@*METHODS@#For this prospective longitudinal study, a total of 647 patients with ACS were recruited from North China between January 2013 and June 2015. Among them, 531 patients (82.1%) completed 12-month follow-ups. Logistic regression model was utilized for analyzing the association of baseline major depression, anxiety, and comorbidity with 12-month all-cause mortality, cardiovascular events, QOL, and health expenditure.@*RESULTS@#During a follow-up period of 12 months, 7.3% experienced non-fatal myocardial infarction (MI) and 35.8% cardiac re-hospitalization. Baseline comorbidity, rather than major depression/anxiety, strongly predicted poor 12-month QOL as measured by short-form health survey-12 (odds ratio [OR]: 1.77, 95% confidence interval [CI]: 1.22-2.52, P = 0.003). Regarding 12-month non-fatal MI and cardiac re-hospitalization, baseline anxiety (OR: 2.83, 95% CI: 1.33-5.89, P < 0.01; OR: 4.47, 95% CI: 1.50-13.00, P < 0.01), major depression (OR: 2.58, 95% CI: 1.02-6.15, P < 0.05; OR: 5.22, 95% CI: 1.42-17.57, P < 0.03), and comorbidity (OR: 6.33, 95% CI: 2.96-13.79, P < 0.0001, OR: 14.08, 95% CI: 4.99-41.66, P < 0.0001) were all independent predictors, and comorbidity had the highest predictive value. Number of re-hospitalization stay, admission frequency within 12 months and medical expenditure within 2 months were the highest in patients with ACS with comorbidity.@*CONCLUSIONS@#Major depression and anxiety may predict 12-month non-fatal MI and cardiac re-hospitalization. However, comorbidity has the highest predictive value with greater medical expenditure and worse QOL in Chinese patients with ACS. And depression with comorbid anxiety may be a new target of mood status in patients with ACS.
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Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Síndrome Coronariana Aguda , Economia , Ansiedade , Depressão , Modelos Logísticos , Estudos Longitudinais , Infarto do Miocárdio , Economia , Estudos Prospectivos , Qualidade de VidaRESUMO
@#AIM: To explore the clinical effect of small incision lenticule extraction(SMILE)and femtosecond laser <i>in situ</i> keratomileusis(FS-LASIK)in correcting high myopia and the effect on cornea and tear film stability. <p>METHODS: Totally 120 patients with high myopia treated in the hospital from August 2016 to February 2017 were selected as the research subjects. According to the surgical methods, the patients were divided into SMILE group and FS-LASIK group, 67 cases 134 eyes in SMILE group and, and 53 cases 106 eyes in FS-LASIK group. Group SMILE was treated with SMILE, and group FS-LASIK was treated by FS-LASIK. The influence of normal vision and stability of cornea and tear film. <p>RESULTS: There was no significant difference in uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA)and diopter between two groups after 1mo and 3mo(<i>P</i>>0.05). There was no significant difference in BUT and SⅠt between the two groups of patients before and 1mo after operation(<i>P</i>>0.05). After 3mo between the two groups, BUT and SⅠt in the two groups were statistically different, and the SMILE group was significantly better than the FS-LASIK group(<i>P</i><0.001). There was no significant difference between the two groups of corneal thinning point and posterior vertex height at preoperative and postoperative 1 and 3mo(<i>P</i>>0.05). <p>CONCLUSION: SMILE and FS-LASIK are equally safe and effective and have good predictability and stability. The postoperative tear film stability is superior to FS-LASIK, and there is no significant difference in the biomechanical stability of the two kinds of methods.
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<p><b>Background</b>Previous studies have shown that hypertension is an important factor contributing to the occurrence and progression of diabetic kidney damage. However, the relationship between the patterns of blood pressure (BP) trajectory and kidney damage in the diabetic population remains unclear. This prospective study investigated the effect of long-term systolic BP (SBP) trajectory on kidney damage in the diabetic population based on an 8-year follow-up community-based cohort.</p><p><b>Methods</b>This study included 4556 diabetic participants among 101,510 participants. BP, estimated glomerular filtration rate (eGFR), and urinary protein were measured every 2 years from 2006 to 2014. SBP trajectory was identified by the censored normal modeling. Five discrete SBP trajectories were identified according to SBP range and the changing pattern over time. Kidney damage was evaluated through eGFR and urinary protein value. A multivariate logistic regression model was used to analyze the influence of different SBP trajectory groups on kidney damage.</p><p><b>Results</b>We identified five discrete SBP trajectories: low-stable group (n = 864), moderate-stable group (n = 1980), moderate increasing group (n = 609), elevated decreasing group, (n = 679), and elevated stable group (n = 424). The detection rate of kidney damage in the low-stable group (SBP: 118-124 mmHg) was the lowest among the five groups. The detection rate of each kidney damage index was higher in the elevated stable group (SBP: 159-172 mmHg) compared with the low-stable group. For details, the gap was 4.14 (11.6% vs. 2.8%) in eGFR <60 ml·min·1.73 m and 3.66 (17.2% vs. 4.7%), 3.38 (25.0% vs. 7.4%), and 1.8 (10.6% vs. 5.9%) times in positive urinary protein, eGFR <60 ml·min·1.73 m and/or positive urinary protein, and eGFR decline ≥30%, respectively (P < 0.01).</p><p><b>Conclusion</b>An elevated stable SBP trajectory is an independent risk factor for kidney damage in the diabetic population.</p>
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Feminino , Humanos , Masculino , Povo Asiático , Pressão Sanguínea , Fisiologia , Taxa de Filtração Glomerular , Fisiologia , Hipertensão , Modelos Logísticos , Estudos Prospectivos , Fatores de RiscoRESUMO
Objective To compare the reliability of intravascular ultrasound (IVUS) and quantitative coronary analysis (QCA) used in coronary intermediate lesion.Methods 90 patients diagnosed as coronary intermediate lesion by coronary angiography were divided into QCA group (n =43) and IVUS group (n =47) according to a random number table method.The QCA group received conventional coronary angiography,while the IVUS group were given intravascular ultrasound.Minimum lumen area,diameter stenosis rate,reference vessel diameter and minimum lumen diameter of the two groups and the correlation between the two methods were compared and analyzed.The treatment plan was made according to the results,and appropriate drug intervention was administered after the treatment.The cardiovascular events in 3,6,9 and 12 months of the two group were also compared.Results The diameter stenosis rate of the QCA group and lumen area stenosis rate in IVUS group showed no correlation (P =0.351),and the minimum lumen area of IVUS group was (4.6 ± 0.68) mm2.The IVUS group were analyzed by both IVUS and QCA methods.The reference vessel diameter of the two groups was positively correlated[(3.16 ±0.22)mm vs.(3.29 ±0.18)mm,r =0.627.,P =0.031],and the minimal lumen diameter of the two groups was also positively associated[(2.01 ± 0.16)mm vs.(2.03 ±0.19)mm,r =0.782,P =0.019].After 1-year follow-up,the incidence rate of cardiovascular event of the QCA group was significantly higher than that of the IVUS group (x2 =4.126,P =0.033).Kaplan-Meier analysis showed that the incidence rate of cardiovascular events in the IVUS group was significantly reduced(Log-rank x2 =4.979,P =0.026).Conclusion The application of IVUS is more comprehensive in qualitative and quantitative analysis of the characteristics of the lesion,and can provide more accurate reference for reasonable treatment plan.
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Objective To study the apoptosis mechanism of HeLa cells induced by berberine (BR). Methods HeLa cells were treated by different concentrations of BR with different times. CCK-8 assay was used to detect the HeLa cells proliferation activity. Detecting the expression of STAT3 in control HeLa cells and BR treated HeLa cells. HeLa cell cycles were detected by flow cytometry(FCM). The relative expression of STAT3, CYCLIN B1, CDC2 and C-MYC was examined by real-time PCR. The relative expressions of STAT3, CYCLIN B1, CDC2 and C-MYC proteins were examined by Western blot analysis. Results BR can effectively inhibit the proliferation of HeLa cells in vitro, which exhibits a dose-dependent and time-dependent manner. The FCM showed that the the proportion of BR-treated cells in G2/M phase was higher than control group. Real-time PCR results showed that rel-ative expression of STAT3,CYCLIN B1,CDC2 and C-MYC genes in HeLa cells treated with BR was lower than the control group.Western blot results showed that relative expression of STAT3,CYCLIN B1,CDC 2 and C-MYC pro-teins in HeLa cells treated with BR was lower than the control group. Conclusions BR can induce apoptosis of cer-vical cancer by targeting STAT3.
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Objective To study the apoptosis mechanism of HeLa cells induced by berberine (BR). Methods HeLa cells were treated by different concentrations of BR with different times. CCK-8 assay was used to detect the HeLa cells proliferation activity. Detecting the expression of STAT3 in control HeLa cells and BR treated HeLa cells. HeLa cell cycles were detected by flow cytometry(FCM). The relative expression of STAT3, CYCLIN B1, CDC2 and C-MYC was examined by real-time PCR. The relative expressions of STAT3, CYCLIN B1, CDC2 and C-MYC proteins were examined by Western blot analysis. Results BR can effectively inhibit the proliferation of HeLa cells in vitro, which exhibits a dose-dependent and time-dependent manner. The FCM showed that the the proportion of BR-treated cells in G2/M phase was higher than control group. Real-time PCR results showed that rel-ative expression of STAT3,CYCLIN B1,CDC2 and C-MYC genes in HeLa cells treated with BR was lower than the control group.Western blot results showed that relative expression of STAT3,CYCLIN B1,CDC 2 and C-MYC pro-teins in HeLa cells treated with BR was lower than the control group. Conclusions BR can induce apoptosis of cer-vical cancer by targeting STAT3.
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<p><b>OBJECTIVE</b>To observe the risk factors and prevalence of cardiovascular disease, and predict the 10-year risk of ischemic cardiovascular disease (ICVD) of a rural residents in Xianghe of Hebei province.</p><p><b>METHODS</b>Two thousand five hundred and thirty two adults ( ≥ 35 years old) were surveyed at internal medicine outpatient department of Xianghe asthma hospital in Hebei province by face-to-face interview, physical examination and biochemical test. Subjects aged 35 to 59 were also evaluated using the National 10-year Risk Assessment for ICVD.</p><p><b>RESULTS</b>The prevalence of stroke and coronary heart disease was 2.2% (56/2532) and 6.9% (176/2532) respectively, the age- and sex-standardized prevalence was 1.3% and 5.9% respectively. The prevalence of hypertension, diabetes, dyslipidemia, overweight, obese and central obesity was 59.9% (1516/2532), 26.9% (682/2532), 68.5% (1735/2532), 40.9% (1038/2532), 14.8% (374/2532) and 49.5% (1254/2532) respectively, the age- and sex-standardized prevalence was 43.8%, 19.9%, 56.5%, 35.1%, 15.6%, 41.9%, respectively. Ten-year ICVD risk was higher than 10% in 14.1% (188/1336) residents aged between 35 to 59 years.</p><p><b>CONCLUSIONS</b>Risk factors and prevalence of cardiovascular disease as well as 10-year risk of ICVD are high in this rural population in Xianghe of Hebei province. Intensive prevention and therapy strategies are urgently needed to attenuate the ICVD risk factors and treat ICVD in rural area of China.</p>
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Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Cardiovasculares , Epidemiologia , China , Epidemiologia , Prevalência , Fatores de Risco , População RuralRESUMO
<p><b>OBJECTIVE</b>To evaluate the effects and clinical prognosis of out-patient department-based smoking cessation services for coronary heart disease (CHD) patients.</p><p><b>METHODS</b>A total of 140 smoking patients diagnosed with coronary heart disease in our cardiovascular department were randomly divided into the intensive smoking cessation clinic follow-up group (intervention group, patients were informed on the importance and methods to quit smoking at the first visit and reminded for that at months interval for 6 months, n = 70) and the conventional treatment group (control group, n = 70). After 6 months, the smoking status, cardiovascular event rates, drug usage, out-patient medical costs and quality of life were compared between the two groups.</p><p><b>RESULTS</b>Age, gender, concomitant diseases, drug usage were similar between the two groups at baseline (all P > 0.05). After 6 months, smoking quit rate [34.2% (24/70) vs. 5.7% (4/70), P < 0.01], drug use rates: lipid-lowering drugs [95.3% (67/70) vs. 80.4% (56/70)], β blockers [82.4% (57/70) vs. 41.3% (28/70)], and ACEI/ARB [61.4% (43/70) vs. 34.4% (24/70)] were significantly higher in the intervention group than in the control group, while total cardiovascular event rates [21.4% (15/70) vs. 47.1% (33/70), P < 0.01] and out-patient medical costs (3789.3 RMB vs. 4984.2 RMB, P < 0.01) were significantly lower in the intervention group than in the control group. The quality of life scores derived from MYO health survey questionnaire was significantly higher in the intervention group than in the control group (P < 0.01). The top three reasons responsible for continuous smoking for all patients failed to quit smoking were: (1) others smoked more than me and still alive and healthy [90.3% (56/62)]; (2) smoking helped me to keep relaxed and reduce trouble in daily work and life [70.9% (44/62)]; (3) smoking was essential while chatting and drinking with friends [66.1% (41/62)]. The overall satisfactory rate to this smoking cessation program was 42.8% and the satisfactory rate was up to 50.0% by patients.</p><p><b>CONCLUSIONS</b>Intensive outpatient smoking cessation follow-up program can significantly improve the smoking cessation rates, the guideline drug use rate and the quality of life while reduce medical costs for coronary heart disease patients.</p>
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Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença das Coronárias , Pacientes Ambulatoriais , Abandono do Hábito de Fumar , MétodosRESUMO
<p><b>OBJECTIVE</b>To investigate the basic characteristics of passive smoking population, and the impact of passive smoking on heart rate variability, heart rate and blood pressure.</p><p><b>METHODS</b>Eighty-six passive smokers [mean age: (52.4 ± 7.6) years] were recruited from patients and their relatives who visited cardiovascular outpatient department and excluded structural heart disease between June 2010 and June 2012, 80 normal subjects who were not exposed to smoking served as controls. Questionnaire survey, 24 hours ambulatory electrocardiogram examination and blood pressure measurement were performed in all recruited subjects.</p><p><b>RESULTS</b>(1) Non-marriage rate [18.60% (16/86) vs. 3.75% (3/80), P < 0.01] was significantly higher while education level were significantly lower in passive smoking group than in control group. Passive smokers were more likely service industry workers [29.07% (25/86) vs. 15.00% (12/80), P < 0.05] and had longer daily working time [(7.56 ± 1.24) h vs. (6.02 ± 0.96) h, P < 0.01], and were less likely to be professional technology industry employers [20.93% (18/86) vs. 36.25% (29/80), P < 0.05] and managers [13.95% (12/86) vs. 38.75% (31/80), P < 0.01] compared to controls. The main place of passive smoking was workplace (67.44%, 58/86), entertainment venues (63.95%,55/86), restaurants (48.84%, 42/86). (2) Standard of the normal sinus RR intervals (SDNN), the normal consecutive sinus RR interval difference between the root-mean-square (rMSSD) and adjacent the difference between the RR interval>50 ms the number of share the percentage (PNN50) were significantly lower in passive smoking group than in the control group (all P < 0.05). Every 5 min average of the standard deviation of sinus RR cycle (SDNN index) and 24 h every 5 min sinus RR interval mean standard deviation (SDANN) were similar between the 2 groups (all P > 0.05). Ultra-low-frequency power (VLF), low frequency power (LF), high frequency power (HF) and LF/HF were significantly lower in passive smoking group than in the control group (all P < 0.01). (3) Heart rate and diastolic blood pressure were significantly higher in passive smoking group than in control group (all P < 0.05) while systolic blood pressure was similar between the 2 groups (P > 0.05).</p><p><b>CONCLUSIONS</b>Marriage status, education level, profession and daily working time are independent determinants for passive smoking. Passive smoking mainly occurred in the workplace, entertainment venues and restaurants. Passive smoking is linked with reduced heart rate variability, increased 24 h average heart rate and diastolic blood pressure.</p>
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Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pressão Sanguínea , Fisiologia , Estudos de Casos e Controles , Frequência Cardíaca , Fisiologia , Poluição por Fumaça de TabacoRESUMO
<p><b>OBJECTIVE</b>To investigate the safety and efficacy of rotational atherectomy followed by drug-eluting stent implantation for treating patients with heavily calcified coronary lesions.</p><p><b>METHODS</b>From March 1, 2010 to September 1, 2012, 65 cases with 78 heavily calcified coronary lesions which were treated with rotational atherectomy followed by drug-eluting stent implantation in Peking University People's Hospital were included, and 36 cases also underwent intravascular ultrasound to guide the rotational atherectomy procedure and drug-eluting stent implantation.All patients were followed up in hospital and post discharge. Procedure parameters, complications and major adverse cardiovascular events (cardiac death, non-fatal myocardial infarction, percutaneous coronary intervention related myocardial infarction, target vessel revascularization, recurrent angina, intra-stent restenosis and stent thrombosis) were analyzed.</p><p><b>RESULTS</b>Direct rotational atherectomy was performed in 64.6%(42/65) patients, rescued rotational atherectomy in 35.4%(23/65) patients, drug-eluting stents implantation was applied to all cases after rotational atherectomy. The immediate procedural success rate was 100% (78/78). The average burr/artery ratio was 0.50 ± 0.04, the average number of burr used per case was 1.15 ± 0.36. The average burr/artery ratio was 0.52 ± 0.03 and the average number of burr used per cases was 1.19 ± 0.40 in 36 cases guided with intravascular ultrasound. Five cases (7.7%) developed complications and were treated accordingly during procedure with satisfactory results. The incidence of major adverse cardiovascular events was 13.8% (9/65) during (17.6 ± 8.5) months follow-up.</p><p><b>CONCLUSION</b>Rotational atherectomy followed by drug-eluting stent implantation is a safe and efficient technique for treating heavily calcified coronary lesions.</p>
Assuntos
Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aterectomia Coronária , Métodos , Doença da Artéria Coronariana , Cirurgia Geral , Stents Farmacológicos , Seguimentos , Estudos Retrospectivos , Resultado do TratamentoRESUMO
<p><b>OBJECTIVE</b>The types and risk factors of arrhythmia were analyzed on acute coronary syndrome (ACS) patients under the age of 44 years who were hospitalized in Henan province between September 2009 to June 2012.</p><p><b>METHODS</b>Medical records of eligible patients were obtained from the information system of the First Affiliated Hospital of Zhengzhou University teleconsultation information center. Middle aged and elderly ACS patients who were hospitalized at the same period served as controls. Data on arrhythmia types, blood pressure, thyroid disease, respiratory sleep apnea syndrome, smoking history, history of alcohol consumption, eating habits, family history of early-onset arrhythmia, laboratory tests were analyzed.</p><p><b>RESULTS</b>(1) Arrhythmia was detected in 110 out of young ACS patients (55%), which was significantly lower than that in the elderly ACS patients (71.05%, P < 0.01). (2) The top three arrhythmias in young ACS patients were: sinus tachycardia (30.50%), the premature ventricular contractions (19.00%), atrial flutter/atrial fibrillation (16.50%). Incidence of sinus tachycardia, atrial flutter/atrial fibrillation were significantly higher while incidence of ventricular tachycardia, ventricular fibrillation, paroxysmal supraventricular tachycardia were significantly lower in young ACS patients than in middle-aged ACS patients (all P < 0.05). The incidence of sinus tachycardia was higher while incidence of ventricular premature accelerated ventricular spontaneous cardiac rhythm, ventricular tachycardia, ventricular fibrillation, non-paroxysmal supraventricular tachycardia, atrial flutter/atrial fibrillation, paroxysmal supraventricular tachycardia, sinus bradycardia, nodal escape, atrioventricular block were significantly lower in young ACS patients than in elderly ACS patients (all P < 0.05). (3) Body mass index, incidence of smoking, coronary three-vessel disease, drinking, eating salty foods, thyroid dysfunction, sleep apnea were significantly higher in youth ACS patients with arrhythmia than in young ACS patients without arrhythmia (all P < 0. 05). (4) Logistic regression analysis found that number of diseased coronary vessels (OR = 24.293), smoking (OR = 1.112) and alcohol consumption (OR = 1.039) were independent risk factor for developing arrhythmia in young ACS patients from Henan province.</p><p><b>CONCLUSIONS</b>The main types of arrhythmia are sinus tachycardia, premature ventricular contractions, atrial flutter/atrial fibrillation and the major risk factors related to the arrhythmia are number of diseased coronary vessels, smoking and alcohol consumption in young ACS patients from Henan province.</p>
Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Síndrome Coronariana Aguda , Epidemiologia , Arritmias Cardíacas , Epidemiologia , China , Epidemiologia , Fatores de RiscoRESUMO
<p><b>OBJECTIVE</b>To investigate the low-density lipoprotein cholesterol (LDL-C) levels in outpatients with coronary heart disease (CHD) visiting cardiology outpatient clinics of 8 hospitals in Beijing.</p><p><b>METHODS</b>A total of 903 outpatients with CHD were enrolled from 4 three-tier hospitals and 4 two-tier hospitals in Beijing. All patients were asked to finish the questionnaire including demographic data, CHD history, the knowledge on cholesterol, and the use of statins. Blood lipid was examined and the LDL-C control rate and related factors were then analyzed.</p><p><b>RESULTS</b>Questionnaire was obtained from 876 patients [619 male: 70.7%, mean age: (64.9 ± 10.7) years old] and blood lipid data were available in 709 patients. The general LDL-C control rate was 36.9% (262/709) and was 13.5% (27/173) in very high risk CHD patients, and lower in patients treated in two-tier hospitals than patients treated in three-tier hospitals[31.3% (121/386) vs. 43.7% (141/323), P < 0.01], in female patients than in male patients [27.1% (60/261) vs. 41.3% (201/496), P < 0.01] and in diabetic patients than in non-diabetic patients [13.5% (27/200) vs. 44.7% (197/441), P < 0.01]. The LDL-C control rate was lower in patients less than 60 years old and patients over 80 years old than that in 60-70 years old patients and 70 - 80 years old patients (P < 0.05). LDL-C control rate was not affected by the history of hypertension, percutaneous coronary intervention or coronary artery bypass grafting, smoking, lipid examination frequency, knowledge on goal level of LDL-C, diet control and regularly physical exercising (all P > 0.05). There were 18.2% (129/709) patients not taking statins or not aware if they were taking statin or not. The main reason for not taking statin [47.9% (23/48)] was statin was no prescribed by doctors, followed by withdrawal by patients due to various reasons [27.1% (13/48)].</p><p><b>CONCLUSIONS</b>LDL-C control rate was low in patients with CHD visiting cardiology outpatient clinics in Beijing. The CHD patients and cardiologists should be encouraged to achieve better LDL-C control by following lipid lowering guidelines and it is also important to improve the drug compliance among CHD patients.</p>
Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , LDL-Colesterol , Sangue , Doença das Coronárias , SangueRESUMO
<p><b>OBJECTIVE</b>To explore the relationship and interaction of elevated fasting glucose and hypertension on cardiocerebral vascular disease.</p><p><b>METHODS</b>10 054 males and females were recruited for our cross-sectional study during May 2007 to August 2007. Unconditional logistic regression was used to analysis the relationship between fasting glucose and hypertension on cardiocerebral vascular disease. A product of fasting glucose and hypertension was added to the logistic regression model to evaluate the multiplicative interaction and relative excess risk of interaction (RERI), attributable proportion (AP) of interaction and synergy index (S) was applied to evaluate the additive interaction of the two factors. Bootstrap was used to calculate 95% confidence intervals (CI) of RERI, AP and S.</p><p><b>RESULTS</b>After adjusting age, gender, smoking, drinking, body mass index (BMI) and region, the product of fasting glucose and hypertension was not statistically significant, which means there was no multiplicative interaction between the two. But the additive indexes RERI, AP and S with 95%CI of diabetes and hypertension were 0.64 (0.03, 1.25), 0.27 (0.01, 0.47) and 1.83 (1.02, 5.13) respectively, which means significant additive interaction was shown between the two on cardiovascular disease but not no stroke. And there were no additive interaction between impaired fasting glucose on cardiovascular disease or stroke.</p><p><b>CONCLUSIONS</b>Hypertension was independently related to cardiovascular disease and stroke in Beijing citizens, and diabetes were independently related to stroke. There was additive interaction between diabetes and hypertension on cardiovascular disease.</p>
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Glicemia , Metabolismo , Pressão Sanguínea , Doenças Cardiovasculares , Epidemiologia , Transtornos Cerebrovasculares , Epidemiologia , China , Epidemiologia , Estudos Transversais , Hipertensão , Sangue , Fatores de RiscoRESUMO
<p><b>OBJECTIVE</b>To report the status and trend of cardio-cerebral-vascular disease (CCVD) mortality in China between 2004 and 2008.</p><p><b>METHODS</b>The mortality data from population-based survey of National Disease Surveillance System in 2004 and 2008 were analyzed. This surveillance system is consisted of 161 disease surveillance points (DSPs) located in 31 provinces of China including 64 urban and 97 rural DSPs. The total population of surveillance is over 73 millions and accounted for around 6% of the whole population of China. CCVD included ischemic heart diseases (ICD-10: I05-I09, I11, I20-I27, I30-I52) and cerebral-vascular disease (ICD-10: I60-I69). The status and trend of cardiovascular disease (CVD), cerebral-vascular disease (CD), ischemic heart disease (IHD) and acute myocardial infarction (AMI) mortalities from 2004 to 2008 were analyzed by age, gender, and urban/rural regions.</p><p><b>RESULTS</b>The mortality of CCVD was higher in 2008 (229/100 000) than in 2004 (223.5/100 000), which was decreased in urban region (-11.7/100 000) while increased in rural region (+16.0/100 000). The mortality of CD decreased from 134.8/100 000 (2004) to 128.3/100 000 (2008). Mortality of IHD and AMI increased from 66.1/100 000 and 40.4/100 000 (2004) to 71/100 000 and 45.7/100 000 (2008), which remained stable in urban region (+0.98/100 000 and -1.96/100 000) while significantly increased in rural region (+6.7/100 000 and +9.2/100 000). The mortality rates for CVD, CD and AMI were higher in rural population than that in urban population. The age-standardized mortality rates of CVD, CD and IHD were lower in 2008 than in 2004. The mortality rates of CD and IHD decreased in 40-, 60-, and over 80 age groups (except for IHD) in 2008 than in 2004. However, IHD mortality was significantly higher in age of 80 and over group from 2004 to 2008. There were a net 5.5/100 000 increase, 6.4/100 000 decrease and 4.9/100 000 increase for CCVD, CD and IHD between 2004 and 2008. The mortality rate rise in CCVD was mainly due to the increased mortality of IHD and CD in rural population. The CCVD mortality increased with age and was significantly higher in male than in female population.</p><p><b>CONCLUSIONS</b>Despite decreased mortality in CD, CCVD mortality increased from 2004 to 2008, mainly due to the increased mortality of IHD and AMI in rural population. Enhanced CCVD primary and secondary prevention, particular for stressing on primary prevention, is necessary in China, especially in rural areas. Meanwhile, they will give the greatest contributions for a raise of the healthy life expectancy in China.</p>