Associations of Serum Irisin Level With Brachial Ankle Pulse Wave Velocity and Ankle Brachial Index in Hospitalized Patients / 中国循环杂志

Objectives:To investigate the association between serum Irisin and brachial ankle pulse wave velocity (Ba-PWV) and ankle brachial index (ABI) in hospitalized adult patients. Methods: A total of 147 patients hospitalized in Fuwai Hospital were enrolled in this study. Patients with acute cerebral haemorrhage and cerebral infarction, acute myocardial infarction, hepatic and renal dysfunction as well as malignant tumor and hematopoietic disorders were excluded. Ba-PWV, brachial systolic pressure and ankle systolic pressure were measured by Complior device. Then ABI was calculated. Serum Irisin level was determined with ELISA kit. The recruited subjects were allocated to 2 groups based on Ba-PWV: high Ba-PWV group (Ba-PWV≥1 400 cm/s, n=93) and low Ba-PWV group (Ba-PWV<1 400 cm/s, n=54). According to ABI, the participants were also divided into 2 groups: low ABI group (ABI<0.9, n=31) and high ABI group (ABI≥0.9, n=116). Results: Patients in high Ba-PWV group were older, (P=0.035), had higher prevalence of hypertension (P=0.006), higher ESR (P=0.02), higher fast glucose (P=0.002) and lower serum Irisin level (P=0.007). Multiple stepwise regression analysis showed that serum Irisin was independently related to Ba-PWV (β=-0.559,P=0.003,OR=0.572 (0.394-0.831) . Patients in low ABI group were older (P=0.005), had higher LDL-C (P=0.004), higher total cholesterol (P=0.002), higher fast glucose (P=0.007), higher apolipoprotein B (P=0.030), less smoker (P=0.045), and lower serum Irisin level (P=0.014). Multiple stepwise regression analysis showed that serum Irisin was independently related to low ABI (β=-0.734, P=0.035, OR=0.480 (0.243-0.949). Conclusions The serum Irisin level is related with arterial stiffness and peripheral arterial atherosclerosis in this patient cohort.

Relationship Between Soluble ST2, Galectin-3 and Clinical Prognosis of Ventricular Septal Myectomy in Patients With Obstructive Hypertrophic Cardiomyopathy / 中国循环杂志

Objective: To explore the relationship between plasma levels of soluble ST2 (sST2), galectin-3 (Gal-3) and clinical prognosis of ventricular septal myectomy in patients with obstructive hypertrophic cardiomyopathy (HOCM). Methods: A total of 200 consecutive HOCM patients received modified Morrow surgery in our hospital from 2011-03 to 2016-02 were studied. According to plasma levels of sST2, patients were divided into 3 groups: Low sST2 group (sST2<9.05 ng/ml), Middle sST2 group (sST2 9.05-16.74 ng/ml) and High sST2 group (sST2>16.74 ng/ml); based on plasma levels of Gal-3, patients were divided into another 3 groups: Low Gal-3 group (Gal-3<6.19 ng/ml), Middle group (Gal-3 6.19-8.22 ng/ml) and High Gal-3 group (Gal-3>8.22 ng/ml); in addition, Control group, n=42 volunteers without heart disease. Plasma levels of sST2 and Gal-3 were measured by ELISA, compared between Control group and HOCM group (n=42 patients with matched gender and age to Control group). The predictive value of sST2 and Gal-3 on major endpoint events including all cause death or cardiovascular hospitalization were assessed by Cox regression analysis.Results: Compared with Control group, plasma levels of sST2 and Gal-3 were increased in HOCM patients, P<0.01. The patients were followed-up for the average of 26 months, Kaplan-meier survival analysis showed that the incidences of composite endpoint event were similar at different levels of sST2 and Gal-3 (log-rank P=0.06 and P=0.68). Cox regression analysis indicated that either sST2 or Gal-3 could not independently predict the endpoint events, both P>0.05, while age was an independent risk factor for composite endpoint event occurrence (HR=1.06, 95% CI 1.02-1.11, P<0.01). Conclusion: Plasma levels of sST2 and Gal-3 were not related to clinical prognosis of ventricular septal myectomy in HOCM patients even they had increased sST2 and Gal-3; while advanced age was the independent predictor for endpoint event occurrence.

Clinical effects comparison of different kinds of repair operation in treatment of patients with PCSD / 中国内镜杂志

Objective To investigate the effects of repair operation by hysteroscopy combined with laparoscopy and transvaginal on menstruation time, intrauterine pregnancy rate and recurrence rate of patients with PCSD. Methods 100 patients with PCSD were chosen from January 2014 to January 2016 and divided into A group (50 patients) with repair operation by hysteroscopy and laparoscopy and B group (50 patients) with repair operation by transvaginal; the operation time, the intraoperative blood loss, the vaginal bleeding time after operation, the anal exsufflation for first time, the hospital stay, the menstruation recovery effect, the width and depth of uterine diverticulum before and after treatment, intrauterine pregnancy rate and recurrence rate with follow-up of both groups were compared. Results The operation time of B group were significantly better than A group (P < 0.05). The intraoperative blood loss, vaginal bleeding time after operation and hospital staying time of A group were significantly better than that in B group (P < 0.05). There was no significant difference in the anal exsufflation for first time between the two groups (P > 0.05). There was no significant difference in the menstruation recovery effect between the two groups (P > 0.05). The width and depth of uterine diverticulum after treatment of both groups were significantly better than that before treatment (P < 0.05). There was no significant difference in the width and depth of uterine diverticulum after treatment between the two groups (P > 0.05). There was no significant difference in the intrauterine pregnancy rate and recurrence rate between the two groups (P > 0.05). Conclusion Repair operation by hysteroscopy combined with laparoscopy and transvaginal in the treatment of patients with PCSD possess the same clinical effects; repair operation by hysteroscopy and laparoscopy can efficiently reduce the trauma degree in operation and shorten the vaginal bleeding time after operation and hospital staying time, and repair operation by transvaginal possess the advantage including more simply operation and lower operation difficulty.

Establishment of a rat model of mycoplasma pneumonia and the treatment / 南方医科大学学报

<p><b>OBJECTIVE</b>To establish a rat model of mycoplasma pneumonia (MP) for investigating the pathogenesis of MP and its therapy with drugs.</p><p><b>METHODS</b>Thirty Wistar rats were randomly divided into 6 groups (n=5), including a control group, a MP model group, a erythromycin lactobionate group and 3 erythromycin microspheres groups (high, middle, and low dose groups). With the exception of those in the control group, all the rats received intranasal MP administration followed by corresponding treatments administered via tail vein injection. At different time points after inoculation of the pathogen, the lungs of the rats were taken for histopathological scoring.</p><p><b>RESULTS</b>In the MP model group, the lung pathology was characterized by patchy interstitial pneumonitis with predominantly lymphocyte infiltration and mucosal edema. The bronchiolar walls became thickened and the lumens narrowed. In erythromycin lactobionate and erythromycin microspheres treatment (high and middle dose) groups, clear cell boundaries were observed in the lungs where no obvious pathological changes were found. RT-PCR amplification showed positive results of MP RNA in the model group, erythromycin lactobionate group and erythromycin microsphere groups.</p><p><b>CONCLUSION</b>The approach described is practicable to establish rat models of MP. Erythromycin microspheres can effectively relieve the lung inflammations and has therapeutic effect on MP.</p>

Predictive value of admission amino-terminal pro-B-type natriuretic peptide on in-hospital mortality in patients with decompensated heart failure / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the predictive value of admission plasma amino-terminal pro-B-type natriuretic peptide (NT-proBNP) on in-hospital mortality in patients with decompensated heart failure.</p><p><b>METHODS</b>Plasma NT-proBNP levels were measured in patients with decompensated heart failure within 24 hours after admission with ELISA method. The NT-proBNP levels were compared between survivals and dying patients in hospital. ROC analyses were performed to evaluate the predictive value of admission plasma NT-proBNP on in-hospital mortality and to identify the optimal NT-proBNP cut-point for predicting in-hospital mortality. A binary logistic regress analyses was used to evaluate if NT-proBNP was an independent predictor for in-hospital mortality.</p><p><b>RESULTS</b>A total of 804 patients with decompensated heart failure were enrolled in his study (293 valvular heart diseases, 219 ischemic cardiomyopathy, 141 dilated cardiomyopathy, 14 hypertrophic cardiomyopathy, 21 restrictive cardiomyopathy, 39 hypertensive heart disease, 41 chronic pulmonary heart disease and 36 adult congenital heart disease) and 96 patients were in class II, 450 in class III and 258 in cases IV according to NYHA Classification. During hospitalization, 64 deaths were recorded and the on admission plasma NT-proBNP levels of patients died during hospitalization were significantly higher than those of survivals [4321.1 (3063.8, 6606.5) pmol/L vs. 1921.6 (873.9, 3739.2) pmol/L, P<0.01]. Area under receiver operating characteristic curve (AUC) of NT-proBNP to predict in-hospital death was 0.772 (95% CI: 0.718 - 0.825, P<0.01), the optimal plasma NT-proBNP cut-point for predicting in-hospital mortality was 3500 pmol/L, with a sensitivity of 70.3%, a specificity of 72.0%, an accuracy of 71.9%, a positive predictive value of 17. 8% and a negative predictive value of 96.6%. Patients whose NT-proBNP levels were equal or more than 3500 pmol/L had a much higher in-hospital mortality (17.8%) compared with those with NT-proBNP levels of less than 3500 pmol/L (3.4%), P<0.01. Binary logistic regress analyses demonstrated that admission plasma NT-proBNP, pneumonia, heart rate and NYHA class were independent predictors for in-hospital mortality in patients with decompensated heart failure (P<0.05 or 0.01) and admission plasma NT-proBNP was the strongest predictor for in-hospital mortality.</p><p><b>CONCLUSIONS</b>Admission plasma NT-proBNP level was an independent predictor for in-hospital mortality in patients with decompensated heart failure. The optimal NT-proBNP cut-point for predicting in-hospital mortality was 3500 pmol/L in this patient cohort.</p>

Surgical outcome and clinical follow-up in patients with symptomatic myocardial bridging / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Myocardial bridging with systolic compression of the left anterior descending coronary artery (LAD) may be associated with myocardial ischaemia. The clinical outcome in patients with surgical treatment for symptomatic myocardial bridging remains undetermined. This study assessed the middle- and long-term results of surgical treatment for symptomatic myocardial bridging.</p><p><b>METHODS</b>From 1997 to 2006, 37,463 patients received selective coronary angiography in the Fuwai Cardiovascular Hospital, Beijing, China. Of these, 484 patients had angiographic diagnosis of myocardial bridging. Of the 484 patients, 35 underwent surgery for treatment of myocardial bridging with significant systolic arterial compression. Among the surgical treatment patients, 24 presented with other cardiac disorders, and the remaining 11 symptomatic patients with isolated myocardial bridging were included in the follow-up study.</p><p><b>RESULTS</b>The angiographic prevalence of myocardial bridging was 1.3% in this study. The coronary angiographies of the 11 patients revealed myocardial bridging in the middle segment of LAD causing systolic compression > or = 75% (ranging from 75% to 90%). The mean age of patients was 48.4 years. Surgical myotomy was performed in 3 patients and coronary artery bypass grafting (CABG) in 8 patients. Eight patients were operated on with an off-pump approach and 3 with a cardiopulmonary bypass technique after median sternotomy. Conversion to on-pump CABG surgery was necessary in 1 patient because of perforation of the right ventricle. The left internal mammary artery was used in all patients with CABG. The acute clinical success rate was 100% with respect to the absence of myocardial infarction, death or other major in-hospital complications. All of the patients were followed up clinically. The median follow-up was 35.3 months (range: 6 to 120 months). Nine patients were free from symptoms and one of them continued taking beta blockers. The remaining 2 patients with myotomy had atypical chest pain. One received coronary angiography again and no stenosis was found two years after operation; while exercise testing was performed in the other patient and revealed no evidence of myocardial ischaemia. None of the patients sustained a myocardial infarction or other major adverse cardiac events (death or vessel revascularization) during follow-up.</p><p><b>CONCLUSIONS</b>Myocardial bridging is a relatively common angiographic finding. Surgical myotomy or CABG should be limited to patients who are refractory to oral medication. Surgical relief of myocardial ischaemia due to systolic compression of intramyocardial coronary arteries can be accomplished with low operative risk and excellent middle- and long-term results.</p>

Germline Mutations of BRCA1 Gene in Korean Breast and/or Ovarian Cancer Families / 대한암학회지

PURPOSE: To understand the involvement of BRCA1 gene in Korean breast and/or ovarian cancer families. MATERIALS AND METHODS: Germline mutations of BRCA1 gene were analyzed in 13 families which included 3 hereditary site-specific breast cancer families, 6 suspected breast cancer families, and 3 suspected breast-ovarian cancer family, and one Li-Fraumeni family by screening BRCA1 gene using single strand conformation polymorphism (SSCP) analysis on polymerase chain reaction (PCR) amplified genomic DNA and confirmed the results by sequencing. RESULTS: Including one family with previously reported nonsense mutation of BRCA1 gene, we detected two mutations in unrelated families. One newly identified mutation was frame shift mutation resulting from TG deletion in codon 1701, which results in a truncated BRCA1 protein, at codon 1714. CONCLUSION: The proportion of families who inherit the mutated BRCA1 gene seems to be small among Korean breast and/or ovarian cancer families.