Development and validation of nurses′ perception scale of patients' suicide risk / 中国实用护理杂志

Objective:To develop the nursing staff's perception scale of patients′ suicide risk and test its reliability and validity, so as to provide basis for managers to formulate training strategies for nurses' suicide gatekeepers.Methods:This was a cross-sectional study. Based on cognitive-experiential self-theory, and on the basis of literature review and semi-structured interviews at home and abroad, a scale item pool was formed, and an initial scale was formed through expert inquiry and pre-investigation. In September, 2022, a cross-sectional survey was conducted among 459 nurses from three tertiary general hospitals and oncology hospitals by convenience sampling method in Jinan and Dezhou, Shandong Province. SPSS25.0 and AMOS23.0 software were used to analyze the items and test the reliability and validity of the scale.Results:The formal scale included three dimensions, namely, cognitive judgment, emotional evaluation, and concern, with 15 items in total. Exploratory factor analysis extracted three common factors, and the cumulative variance contribution rate was 67.845%. The results of confirmatory factor analysis showed that each test quantity of the fitness of the formal scale model is within the acceptable range and loads of 15 items in the corresponding factors were all >0.45; the content validity index S-CVI of the scale was 0.972, Cronbach′s α coefficient of the total scale was 0.907, and the half reliability was 0.814. Conclusion:The scale of nurses′ perception of patients′ suicide risk has good reliability and validity, and it can be used to evaluate nurses′ perceptions of patients′ suicide risk.

User persona application in the field of cancer basing on online health community: a scoping review / 中国实用护理杂志

Objective:To summarize the research on the application of online health community-based user personain the field of cancer at home and abroad, so as to provide reference for the related research and application in this field in the future.Methods:Computer search of CNKI, China biomedical literature database, VIP, Wanfang, Web of Science, Embase, MEDLINE, PubMed, CINAHL, Cochrane Library, a total of 10 Chinese and English databases, focused on the relevant research on building user personas based on online health communities in the field of cancer, and the search time limit was from the establishment of the database to April 20, 2022. Literature was screened, data extracted and summarized.Results:Totally 11 literatures were included. The construction process of user persona based on online health community included data collection, tag extraction and persona presentation. The functional diversity and implementation feasibility were showed in the application content in the field of cancer. It can quickly identify the differences in health information needs of cancer patients, provide personalized decision support and nursing services, strengthen health information education, and improve patients′ self-management ability.Conclusions:The integration of user persona and cancer field based on online health community was in the initial exploration stage, and the feasibility and effectiveness of promoting patients′ health behavior were confirmed by existing studies. In the future, it is still necessary to be promoted in the empirical research on its application in clinical practice, so as to lay a foundation for providing targeted patient health management programs in the future.

Compliance and withdraw reason of sublingual immunotherapy in 245 patients with allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the compliance of patients with allergic rhinitis（AR） receiving sublingual immunotherapy and its influencing factors. Methods:The clinical data of 291 AR patients who received sublingual immunotherapy for dust mites at the First Hospital of Peking University from January 2016 to January 2018 were retrospectively analyzed, and their outpatient or telephone follow-up was conducted. For patients whose treatment time was less than 2 years, the time and reason for the loss were recorded, and the factors affecting their compliance were discussed from the aspects of gender, age, and education. Results:Among the 291 patients, 245 cases（84.2%） were successfully followed up, and 193 cases（78.8%） fell off midway（treatment time<2 years）. The overall compliance rate was 21.22%（52/245）. The compliance rate of children is higher than that of adults（χ²=21.306, P<0.05）, and gender and education level have no significant effect on the compliance rate. The time period for the largest number of shedding was 6-<12 months after treatment（68 cases, 27.8%）. The main cause of shedding was symptom relief, which was considered cured（16.7%）. Secondly, within 3 months after treatment, a total of 61 patients（24.9%） fell off, of which 34 cases（13.9%） fell off because of troublesome medication, often missed medication, and simply stopped taking the drug. Statistics on the overall reasons for shedding in 193 patients, the top three shedding reasons were: cured after symptom relief（59 cases, 30.6%）, troublesome medication, discontinuation after missed dose（44 cases, 22.8%）, slow onset or ineffectiveness（26 cases, 13.5%）. Conclusion:The overall compliance of sublingual immunotherapy in patients with allergic rhinitis is poor, and the compliance of children is better than that of adults. Clinicians should focus on the reasons for patients to fall off at various times, strengthen patient education, enhance patient confidence in treatment, and improve the compliance of patients.

The Effect of Ena/VASP Family on the Expression of GPIb-IX Complex in Human Megakaryoblastic Leukemia Dami Cells / 中国实验血液学杂志

OBJECTIVE@#To explore the effects of Ena/VASP gene family on the expression of glycoprotein (GP) Ib-IX complex in human megakaryoblastic leukemia Dami cells.@*METHODS@#SiRNAs targeting Ena/VASP gene family were designed and synthesized to interfere Enah, EVL and VASP gene expression. When the siRNAs were transfected into Dami cells by using LipofectamineTM 2000 for 48 h, the expression of GPIb-IX complex was detected by quantitative real-time PCR, Western blot and flow cytometry.@*RESULTS@#We successfully established siVASP , siEVL and si Enah Dami cell lines. And it was found that the expression of GPIb-IX complex had no evident reduction in siEVL or siVASP Dami cells at both mRNA and protein level, while the total protein and membrane protein of GPIb-IX complex were obviously reduced when Enah was knocked down.@*CONCLUSION@#Enah could affect the expression of GPIb-IX complex in human megakaryoblastic leukemia Dami cells, but the underlying mechanism still needs to be further explored.

Main Factors Influencing the Platelet Spreading / 中国实验血液学杂志

OBJECTIVE@#To explore the main factors of platelet spreading and provide the foundation for related research.@*METHODS@#Platelets (2×107/ml) were draw from C57BL/6J mouse and kept at 22 ℃ for 1-2 hours. Platelets (2×107/ml) were were allowed to adhere and spread on the fibrinogen-coated slides, after staining F-actin in platelets, the platelets were observed with the confocal microscopy. The effects of different concentrations of fibrinogen (10 μg/ml, 30 μg/ml, 100 μg/ml) and kinds of agonists ［thrombin(0.01,0.05,0.1 U/ml), ADP（5,10,20 μmol/L）, U46619（0.125,0.25,0.5 μmol/L）］ on platelets were analyzed. The platelet spreading was successful if the spreading rate was higher after treated with agonists.@*RESULTS@#Compared to the group which coated with 10 μg/ml and 100 μg/ml fibrinogen, the platelet density is optimal when coated with 30 μg/ml fibrinogen. In addition, under the stimulation of thrombin, ADP and U46619, the spreading rate of platelets showed a certain concentration-dependent increasing.@*CONCLUSION@#The platelet spreading is easily influenced by various factors, the platelet spreading can be induced successfully at 0.1 U/ml thrombin, 20 μmol/L ADP and 0.5 μmol/L U46619 on the slide coated with 30 μg/ml fibrinogen.

The Role of Zyxin in Regulating Platelet Cytoskeleton Distribution / 中国实验血液学杂志

OBJECTIVE@#To investigate the regulatory effect of zyxin on the distribution of platelet cytoskeleton.@*METHODS@#Platelets were isolated from zyxin-knockout (Zyx@*RESULTS@#After zyxin gene was knockout, the expressions of cytoskeleton proteins β-actin, α-actinin, filamin A, and myosin Ⅱ A in resting and Jas-induced platelets were significantly increased. In the platelet spreading on fibrinogen surface, F-actin was increased in Zyx@*CONCLUSION@#Zyxin significantly regulates the distribution of platelet cytoskeleton, which plays an important role in maintaining platelet cytoskeleton homeostasis.

Discovery of a small-molecule activator of beclin-1 that induces autophagy-associated cell death and apoptosis in triple negative breast cancer / 药学学报

Autophagy is a lysosomal degradation pathway, and plays a crucial role in cellular homeostasis, development, immunity, tumor suppression, metabolism, prevention of neurodegeneration, and lifespan extension. Thus, pharmacological stimulation of autophagy may be an effective approach for preventing or treating certain human diseases and/or aging. Here, combined with allosteric site identification methods, high-throughput virtual screening, and in vitro activity evaluation, we found that compound 10 can activate autophagy and has good anti-MDA-MB-231 cell proliferation activity (the half maximal inhibitory concentration IC50 = 8.25 ± 1.53 μmol·L-1). Subsequently, molecular docking, molecular dynamics simulation, and immunoblotting assay demonstrate that compound 10 can target and activate beclin-1. In vitro studies have shown that compound 10 can induce autophagy-associated cell death in MDA-MB-231 cells. In addition, it was found that compound 10 can induce apoptosis in MDA-MB-231 cells. Taken together, we identified the candidate compound 10 as an effective and selective targeting beclin-1 to activate autophagy as a lead compound, which provide a reference for further development and optimization of small molecule drugs targeting beclin-1 to activate autophagy for clinical treatment.

Effect of amitriptyline on lipid deposition and biochemical metabolism in a cell model of nonalcoholic fatty liver disease / 临床肝胆病杂志

ObjectiveTo investigate the effect of amitriptyline on lipid deposition and biochemical metabolism in a cell model of nonalcoholic fatty liver disease (NAFLD) by regulating the acid sphingomyelinase (ASM)/ceramide (CE) pathway. MethodsHepG2 and L02 cells were cultured in vitro to establish a cell model of NAFLD. MTT colorimetry was used to measure cell proliferation rate, and oil red O staining was used to observe the change of lipid droplets in cells. In the experiment, the cells were divided into normal control group, model group, Ami group, TNFα group, and Ami+TNFα group. An automatic biochemical analyzer was used to measure the levels of triglyceride (TG) and total cholesterol (TC) in cells and the levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in supernatant; ELISA was used to measure the levels of CE and ASM in cells; Western blot was used to measure the protein expression ASM in cells, and RT-PCR was used to measure the mRNA expression of ASM in cells. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the Turkey test was used for further comparison between two groups. ResultsCompared with the normal control group, the NAFLD model group had significant increases in the protein and mRNA expression of ASM and the levels of CE, TG, TC, ALT, and AST (all P＜0.05). Compared with the model group, the Ami group had significant reductions in the protein and mRNA expression of ASM and the levels of CE, TG, TC, ALT, and AST (all P＜0.05), and the TNFα group had significant increases in the protein and mRNA expression of ASM and the levels of CE, TG, ALT, and AST (all P＜0.05). Compared with the TNFα group, the Ami+TNFα group had significant reductions in the protein and mRNA expression of ASM and the levels of CE, TG, TC, ALT, and AST (all P＜0.05). ConclusionThe ASM/CE pathway promotes lipid accumulation and may lead to hepatocyte steatosis, and amitriptyline can alleviate lipid deposition in NAFLD hepatocytes by inhibiting the ASM/CE pathway.

A preliminary study on the mixed teaching of human parasitology based on MOOC resources and the experimental teaching digital platform / 中国血吸虫病防治杂志

The mixed teaching model combines the advantages of traditional teaching and network teaching in the “Internet +” era, which has become one of the important trends in the higher education teaching development. In order to follow this development trend, the human parasitology teaching team makes a reasonable use of modern information techniques, actively promotes the construction and application of online resources, and conducts mixed online and offline teaching based on MOOC resources and the experimental teaching digital platform. This mixed teaching model has shown a positive impact on both teaching and learning among teachers and students; however, students’ personalized independent and deep learning remains unsatisfactory. It is suggested that the online course resources construction, teaching design and digital literacy remain to be increased, so as to create a high-level, innovative and challenging online-offline mixed “golden course”

Nucleolar protein 6 promotes cell proliferation and acts as a potential novel prognostic marker for hepatocellular carcinoma / 中华医学杂志(英文版)

BACKGROUND@#Nucleolar protein 6 (NOL6) is a nucleolar RNA-associated protein that is highly conserved between species. It has been proved to be associated with the prognosis of liver cancer. However, the underlying mechanism has not been fully established. This study aimed to assess the relationship between NOL6 and liver cancer prognosis.@*METHODS@#We constructed an NOL6-short hairpin RNA (shRNA)-expressing lentivirus. Through viral transfection, cell growth assay and fluorescence-activated cell sorting, we evaluated the effect of shRNA-mediated NOL6 knockdown on the proliferation, colony formation, and apoptosis of hepatocellular carcinoma (HCC) cells. The relationship between NOL6 expression and HCC patient survival has been established through bioinformatics analysis. We also explored the downstream molecular regulatory network of NOL6 in HCC by performing an Ingenuity Pathway Analysis in the database.@*RESULTS@#Increased NOL6 expression was detected in HCC cells compared to normal controls; HCC patients with high NOL6 expression had poorer prognoses than those with low expression. NOL6 knockdown inhibited HCC cell proliferation, apoptosis, and colony formation. Also, MAPK8, CEBPA, and FOSL1 were selected as potential downstream genes of NOL6.@*CONCLUSIONS@#NOL6 up-regulates HCC cell proliferation and affects downstream expression of related genes. Moreover, NOL6 is considered to be associated with poor prognosis in HCC patients.

Preparation and in vitro evaluation of fused deposition modeling 3D printed verapa-mil hydrochloride gastric floating formulations / 北京大学学报(医学版)

OBJECTIVE@#To explore the feasibility of preparing gastric floating formulations by fused de-position modeling (FDM) 3D printing technology, to evaluate the in vitro properties of the prepared FDM 3D printed gastric floating formulations, and to compare the influence of different external shapes of the formulation with their in vitro properties.@*METHODS@#Verapamil hydrochloride and polyvinyl alcohol (PVA) were used as the model drug and the excipient, respectively. The capsule-shaped and hemisphere-shaped gastric floating formulations were then prepared by FDM 3D printing. The infill percentages were 15%, the layer heights were 0.2 mm, and the roof or floor thicknesses were 0.8 mm for both the 3D printed formulations, while the number of shells was 3 and 4 for capsule-shaped and hemisphere-shaped formulation, respectively. Scanning electron microscopy (SEM) was used to observe the morpho-logy of the surface and cross section of the formulations. Gravimetric method was adopted to measure the weights of the formulations. Texture analyzer was employed to evaluate the hardness of the formulations. High performance liquid chromatography method was used to determine the drug contents of the formulations. The in vitro floating and drug release behavior of the formulations were also characterized.@*RESULTS@#SEM showed that the appearance of the FDM 3D printed gastric floating formulations were both intact and free from defects with the filling structure which was consistent with the design. The weight variations of the two formulations were relatively low, indicating a high reproducibility of the 3D printing fabrication. Above 800.0 N of hardness was obtained in two mutually perpendicular directions for the two formulations. The drug contents of the two formulations approached to 100%, showing no drug loss during the 3D printing process. The two formulations floated in vitro without any lag time, and the in vitro floating time of the capsule-shaped and hemisphere-shaped formulation were (3.97±0.41) h and (4.48±0.21) h, respectively. The in vitro release of the two formulations was significantly slower than that of the commercially available immediate-release tablets.@*CONCLUSION@#The capsule-shaped and hemisphere-shaped verapamil hydrochloride gastric floating formulations were prepared by FDM 3D printing technology successfully. Only the floating time was found to be influenced by the external shape of the 3D printed formulations in this study.

Effect of Protein Kinase A Activation on Aggregation Function of Platelets / 中国实验血液学杂志

OBJECTIVE@#To investigate the effect of protein kinase A (PKA) activation on aggregation funetion of platelets in vitro.@*METHODS@#The peripheral blood of healthy adults were collected, and the washed platelets were gained from collected peripheral blood. The washed platelets were treated with PKA activator Forskolin, then the platelet aggregation was induced by using Ristocetin, Thrombin, Collagen and ADP respectively, the platelet aggregation level was detected by the platelet aggregator.@*RESULTS@#Compared with the controls, 5 μmol/L forskolin significantly inhibited ADP and collagen-induced platelet aggregation (P＜0.001), and showed mild inhibiting effect on Thrombin-induced platelet aggregation (P＜0.05). 2.5-10 μmol/L forskolin significantly inhibited ADP and Collagen -induced platelet aggregation (P＜0.001); but not showed significantly inhibitory effects on Ristocetin-induced platelet aggregation (P＞0.05).@*CONCLUSION@#PKA activation inhibits agonists-induced platelet aggregation.

Observation of early active exercises on mechanical ventilation weaning patients with myasthenia gravis / 中国实用护理杂志

Objective:To compare the difference of weaning time, comfort and satisfaction during the time, and arterial blood gas analysis in early active exercises of mechanical ventilation patients with myasthenia gravis (MG).Methods:Fifty-six mechanical ventilation patients with MG hospitalized in the Department of Neurology, Tangdu Hospital, Air Force Military Medical University were enrolled from January 2014 to January 2018. All the patients were divided into observation group ( n=30) and control group ( n=30) according to the random number table. Observation group performed active exercise, that encourage patients get out of bed as early as possible. Control group implement passive exercise. Then, analyzed the difference of weaning time, comfort and satisfaction during the time, and arterial blood gas results between this two groups. Results:The weaning time of observation group was (6.2±2.3) days, while (9.8±3.9) days of control group, the difference was significantly ( t value was 5.559, P<0.01). The comfort of observation group were (81.20±4.93) points, while (64.54±2.62) points of control group, the difference was significantly ( t value was15.798, P<0.01). In the observation group, 3 cases were satisfied with the nursing service, 27 cases were satisfied, and the patient satisfaction score was (93.67 ± 2.20) points; in the control group, 2 cases were generally satisfied, 15 cases were relatively satisfied, 9 cases were satisfied, and the patient satisfaction score was (85.81 ± 5.49) points, the difference between the two groups was statistically significant ( χ2 value was 23.312 2, t value was - 7.205 7, P < 0.01).There were no difference of arterial blood gas results between the two groups ( P>0.05) .Conclusion:Early active exercises can shorten the weaning time of mechanical ventilation patients with MG, improve patients comfort and satisfaction with nursing services during the weaning time, and have no effect on patients' respiratory function and acid-base balance.

Evaluation of readiness of evidence-based practice for the prevention and management of deep vein thrombosis after spinal orthopedic surgery / 中国实用护理杂志

Objective:To understand the preparation of evidence-based nursing practice for postoperative venous thrombosis in the department of spine and orthopedics in our hospital, and to identify the obstacle factors in the process of evidence-based nursing practice so as to promote the successful transformation and application of evidence.Methods:A questionnaire survey was conducted among 164 nurses in Department of Orthopedics of Wuhan Union Hospital in Hubei Province by using self-made general data questionnaire and Clinic Readiness of Evidence-Based Nursing Assessment (CREBNA).Results:The total score of CREBNA was (135.99 ±14.52) points, accounting for 87.10% of the full score. The average score of each subscale item was from high to low: organization environment subscale (4.44±0.67) points, evidence subscale (4.41±0.60) points and promotion factor subscale (4.31±0.69) points. Multiple stepwise regression analysis showed that different levels of understanding of evidence-based nursing practice was the main influencing factor of spine orthopedic nurses′ evidence-based practice readiness ( P<0.05). Conclusion:In this study, there were good level of readiness for evidence-based nursing practice and the current environment is conducive to the development of evidence-based practice programs. Before the application of evidence, managers should clarify the obstacles to change and formulate individual intervention measures to promote the clinical application of evidence.

Evaluation of readiness of evidence-based practice for the prevention and management of deep vein thrombosis after spinal orthopedic surgery / 中国实用护理杂志

Objective@#To understand the preparation of evidence-based nursing practice for postoperative venous thrombosis in the department of spine and orthopedics in our hospital, and to identify the obstacle factors in the process of evidence-based nursing practice so as to promote the successful transformation and application of evidence.@*Methods@#A questionnaire survey was conducted among 164 nurses in Department of Orthopedics of Wuhan Union Hospital in Hubei Province by using self-made general data questionnaire and Clinic Readiness of Evidence-Based Nursing Assessment (CREBNA).@*Results@#The total score of CREBNA was (135.99 ±14.52) points, accounting for 87.10% of the full score. The average score of each subscale item was from high to low: organization environment subscale (4.44±0.67) points, evidence subscale (4.41±0.60) points and promotion factor subscale (4.31±0.69) points. Multiple stepwise regression analysis showed that different levels of understanding of evidence-based nursing practice was the main influencing factor of spine orthopedic nurses′ evidence-based practice readiness (P<0.05).@*Conclusion@#In this study, there were good level of readiness for evidence-based nursing practice and the current environment is conducive to the development of evidence-based practice programs. Before the application of evidence, managers should clarify the obstacles to change and formulate individual intervention measures to promote the clinical application of evidence.

Diagnostic accuracy of RPR, FIB-4, APRI and AAR in liver fibrosis patients with chronic hepatitis B / 中国实用内科杂志

OBJECTIVE: We intended to evaluate the diagnostic efficiency of red cell distribution width to platelet ratio(RPR),and compare it with other three markers of fibrosis-4(FIB-4), aspartate aminotransferase-to-platelet-ratio-index(APRI) and aspartateaminotransferase-to-alanine aminotransferase ratio(AAR) for judging liver fibrosis and fibrosis severity in patients with chronic hepatitis B(CHB). METHODS: who had not received antiviral treatment met the requirements of this cross-sectional study. Hematology,biochemistry, virology testing and liver biopsy were performed. Receiver-operating characteristic curves were constructed and the area under the ROC curve was calculated. RESULTS: The cut-off value for distinguishing F0-1, F2-3 and F4 was 0.079, 0.141 and 0.279,respectively(P<0.001) for RPR; 1.194, 3.703 and 4.383(P<0.001) for FIB-4; 0.384, 0.660 and 1.441, respectively(P<0.001) for APRI; and 0.915, 0.850 and 0.960(P=0.706) for AAR. The sensitivity was 76.09% for RPR, 78.26% for FIB-4, 97.83% for AAR and80.43% for APRI; specificity was 81.48% for RPR, 75.93% for FIB-4, 14.81% for AAR and 80.43% for APRI; the AUROC was 0.787 for RPR, 0.778 for FIB-4, 0.540 for AAR and 0.759 for APRI. The common cut-off value was 0.11, 1.94, 0.60 and 0.59 for RPR, FIB-4, AAR and APRI respectively. CONCLUSION: RPR, FIB-4 and APRI have good efficiency in appraising significant and severe fibrosis in patients with CHB, however RPR is superior to FIB-4 and FIB-4 is superior to APRI, therefore, RPR is a better index in evaluating liver cirrhosis.

Predictive study on school absences due to illness with seasonal exponential smoothing method / 中华疾病控制杂志

Objective To establish a suitable exponential smoothing prediction model for school absentees due to illness, to discuss its application value for predicting school absences due to illness, and to provide a basis for early warning of absence due to illness. Methods Numbers of schools absences by year and month due to illness in 30 primary schools from November 2015 to June 2017 were collected from symptom monitoring system of border county, southern Yunnan and Simple seasonal model, Winters addition model and Winters multiplication model were used to build simulation. The data of July 2017 to December 2017 were used for model validation. The three models were overall compared and evaluated through indicator analysis, statistical analysis and residual diagram analysis. The best model was selected to predict school absences due to illness from January 2018 to March 2018. Results Simple seasonal model, Winters addition model and Winters multiplication model were used to fit the variation trend of number of school absences due to illness in time series. The root mean square error (RMSE) of three models were 445.11, 420.99 and 258.75; R2adj were 0.72, 0.72 and 0.77; R2 were 0.92, 0.93 and 0.98; P values of Ljung-Box Q were 0.54, 0.43 and 0.21. As for prediction method linear trend, Alpha were 0.999, 1.000 and 0.298. The average relative error between predicted value and actual value was 9.62%, 21.90% and 7.52%. Conclusion Winters multiplication model has practical value to predict school absence due to illness and provide scientific basis for early identification of abnormal signals.

Exploration and practice of teaching reform and course construction of human parasitology / 中华医学教育探索杂志

In order to adapt to the needs of innovative medical personnel training,Zunyi Medical University conducted teaching reform and curriculum construction for human parasitology.Key teachers were trained by strengthening the construction of the teaching staff.Through the preparation of lessons,lectures,supervision and other measures,the teaching quality has been improved.Teaching reform was carried out by the introduction of humanities knowledge,scientific research training,and formative evaluation.Through the development of quality curriculum resources,standardized teaching archives,improved scientific research,and quality service for the society,the curriculum construction of human parasitology has been greatly improved.

Correlation between vascular endothelia injury factors and occupational hand-arm vibration disease / 中国职业医学

OBJECTIVE: To analyze the correlation between vascular endothelia injury factors and occupational hand-arm vibration disease( HAVD). METHODS: A judge sampling method was used to select 23 male patients with HAVD as the HAVD group,61 male workers who exposed to hand-arm vibration without HAVD as the vibration exposure group,64 male workers without hand-arm vibration exposure as the control group. The plasma levels of myosin light chain 2( MLC2),endothelin-1( ET-1) and vinculin( VCL) were detected by enzyme-linked immunosorbent assay. Logistic regression analysis was used to analyze the related indicators of HAVD for building the new multivariable model index Y. The indicators of HAVD were screened and judged by receiver operating characteristic( ROC) curves. RESULTS: There was significant difference in plasma levels of MLC2 among the three groups( P < 0. 05). The levels from high to low was as follows: HAVD group > vibration exposure group > control group. The plasma level of ET-1 in HAVD group was lower than that in the control group( P < 0. 05),but there was no significant difference between vibration exposure group and HAVD group( P > 0. 05). There was no significant difference among the three groups in the plasma level of VCL( P > 0. 05).The logistic regression analysis results showed that after adjusting confounding factors such as age,length of service,smoking,alcohol drinking and subjective symptoms,the higher MLC2 plasma level,the higher risk of HAVD( P < 0. 01),and the lower ET-1 plasma level,the higher risk of HAVD( P < 0. 05). According to ROC curve analysis,the area under the ROC curve( A_Z) value of the plasma levels of MLC2 and ET-1 were 0. 820 and 0. 524,respectively( P < 0. 01). The predictive probability index Y built with MLC2 and ET-1 by logistic regression model was used to judge the A_Z value of HAVD to be 0. 799( P < 0. 01). The A_Z values from high to low was as follows: MLC2 > Y> ET-1( P < 0. 01).CONCLUSION: The plasma levels of MLC2 and ET-1 are correlated with HAVD. The efficacy of MLC2 as a biomarker for screening HAVD is better than that of ET-1. No association was found between VCL and HAVD.

Comparison of Apical and Asymmetric Septal Phenotype in Patients With Hypertrophic Cardiomyopathy: Clinical Features and Prognosis / 中国循环杂志

Objectives: To compare the clinical features and long-term outcomes of patients with apical hypertrophic cardiomyopathy (ApHCM) and patients with asymmetric septal hypertrophic cardiomyopathy (ASHCM). Methods: Data from 600 patients (300 with ApHCM and 300 with ASHCM) identified in a consecutive single-center cohort between 1996 and 2014 were retrospectively analyzed. The two groups were 1:1 matched by age of diagnosis, gender and the presence of outflow tract obstruction. Clinical features, cardiovascular mortalities, incidence of sudden cardiac death and cardiovascular morbidity (including unexplained syncope, atrial fibrillation, nonsustained ventricular tachycardia, progressive heart failure, embolic stroke or transient ischemic attack and myocardial infarction) were compared between the two groups. Results: Forty-two patients (14.0%) had a maximum LV wall thickness of ≥30 mm in the ASHCM group compared to only 11 patients (3.7%) in the ApHCM group (P<0.01). 156 patients in ApHCM group (52.0%)and 168 patients in ASHCM group(56.0%)underwent cardiovascular NMR examination, the incidence of late gadolinium enhancement was significantly lower in ApHCM group than in ASHCM group(26.9% vs 76.2%,P<0.01). The mean follow-up durations for ApHCM and ASHCM were (7.5 ± 4.0) years and (6.6 ± 5.4) years, respectively. The incidence of cardiovascular death (1.0% vs 5.7%), sudden cardiac death (0.33% vs 3.3%) and major adverse cardiovascular event (18.3% vs 40.3%) were significantly lower in the ApHCM group than in the ASHCM group (all P<0.01). Unexplained syncope, nonsustained ventricular tachycardia, and progressive heart failure were less common in ApHCM group than in ASHCM group (all P<0.05). Multivariate COX regression analysis showed that late gadolinium enhancement positivity (HR=4.62, 95% CI: 2.28- 68.0, P=0.02) and unexplained syncope (HR=8.56, 95% CI: 2.1-16.6, P<0.01) were independent predictors of cardiovascular mortality. Unexplained syncope was independent predictor for sudden cardiac death (HR=4.40, 95% CI: 1.5-15.2, P=0.02). Conclusions: After eliminating the interference of age at diagnosis, gender and outflow tract obstruction, patients with ApHCM represent a more benign prognosis with a lower incidence of cardiovascular mortality and morbidity than patients with ASHCM.