The Value of Echocardiography Combined with NT-pro BNP Level in Assessment and Prognosis of Diastolic Heart Failure.

BACKGROUND: To investigate the significance of echocardiography combined with N-terminal pro-B-type natriuretic peptide (NT-pro BNP) levels in the evaluation and prognosis of diastolic heart failure (DHF). METHODS: Clinical data were collected from 168 patients with DHF. Serum levels of NT-pro BNP were first measured by ELISA. Meanwhile, the echocardiography was used to examine left ventricular end-diastolic diameter (LVEDD), left ventricular diameter (LVD), and other parameters. Multivariate logistic regression analysis was performed for variables in heart failure assessment grade or poor prognosis. Finally, the predictive ability for New York Heart Association (NYHA) class as well as prognosis was assessed by ROC curves. RESULTS: NT-pro BNP was the overexpression in the serum of patients with DHF. And the degree of elevation was related to NYHA class, while NT-pro BNP levels were significantly higher in the P-MACE group than in the N-MACE group. According to the multivariate logistic regression analysis, the ratio of peak velocity of left atrial early diastolic blood flow to early diastolic peak velocity of mitral annulus (E/Ea) and serum NT-pro BNP level was risk factors for NYHA class and prognosis. However, LVEF, LVEDD, and flow propagation velocity (Vp) can be a benefit condition. In addition, ROC curve showed that echocardiography combined with NT-pro BNP content had higher accuracy in NYHA class and prognostic assessment of DHF than applied separately. CONCLUSIONS: The diagnosis of echocardiography combined with NT-pro BNP levels has the potential to distinguish the NYHA class in heart function of patients with DHF and determine the prognosis of patients.

Study protocol for a randomized controlled trial: Qiliqiangxin in heart failUre: assESsment of reduction in morTality (QUEST).

BACKGROUND: Qiliqiangxin (QLQX) capsule is a Traditional Chinese Medicine (TCM) that has been approved in China for the treatment of chronic heart failure (CHF). Our previous study showed with a background of standard HF treatment, QLQX capsules further reduced the levels of NT-proBNP and the incidence of composite cardiac events (CCEs) in CHF patients. This study aims to further assess the reduction in mortality when using QLQX compared with placebo for heart failure with reduced ejection fraction (HFrEF) patients. METHODS: This study is a randomized, double-blind, placebo-controlled, parallel-group, multi-center, event-driven clinical study of approximately 3080 patients for a targeted 620 events. Patients must have a diagnosis of heart failure for at least 3 months prior to screening. Patients will be randomized 1:1 to receive the placebo or QLQX in addition to their standard medications of CHF. The primary efficacy outcome event is a composite cardiovascular death and re-hospitalization due to the worsening of heart failure. DISCUSSION: The QUEST study is a randomized control study of TCM in chronic heart failure. It will determine the place of QLQX as an new treatment approach and provide additional and innovative information regarding TCM - and the specific used of QLQX in HFrEF. TRIAL REGISTRATION: The trial was registered at http://www.chictr.org.cn. ( Registration No.: ChiCTR1900021929); Date: 2019-03-16.

A Spatial Panel Data Analysis of Economic Growth, Urbanization, and NOx Emissions in China.

Abstract: Is nitrogen oxides emissions spatially correlated in a Chinese context? What is the relationship between nitrogen oxides emission levels and fast-growing economy/urbanization? More importantly, what environmental preservation and economic developing policies should China's central and local governments take to mitigate the overall nitrogen oxides emissions and prevent severe air pollution at the provincial level in specific locations and their neighboring areas? The present study aims to tackle these issues. This is the first research that simultaneously studies the nexus between nitrogen oxides emissions and economic development/urbanization, with the application of a spatial panel data technique. Our empirical findings suggest that spatial dependence of nitrogen oxides emissions distribution exists at the provincial level. Through the investigation of the existence of an environmental Kuznets curve (EKC) embedded within the Stochastic Impacts by Regression on Population, Affluence, and Technology (STIRPAT) framework, we conclude something interesting: an inverse N-shaped EKC describes both the income-nitrogen oxides nexus and the urbanization-nitrogen oxides nexus. Some well-directed policy advice is provided to reduce nitrogen oxides in the future. Moreover, these results contribute to the literature on development and pollution.

Escape of polymer chains from an attractive channel under electrical force.

The escape of polymer chains from an attractive channel under external electrical field is studied using dynamical Monte Carlo method. Though the escaping process is nonequilibrium in nature, results show that the one-dimensional diffusion theoretical model based on the equilibrium assumption can describe the dependence of the average escaping time (τ(0)) on the polymer-channel interaction (ɛ), the electrical field (E), the chain length (n), and the channel length (L), qualitatively. Results indicate that both ɛ and E play very important roles in the escaping dynamics. For small ɛ, the polymer chain moves out of the channel continuously and quickly. While for large ɛ, the polymer chain is difficult to move out of long channels as it is trapped for a long time (τ(trap)) when the end segment is near the critical point x(C). These results are consistent with the theoretical results for the free energy profiles at small ɛ and large ɛ, respectively. The dependence of x(C) and τ(trap) on ɛ and E are discussed, and specific relations are obtained. The configurational properties of polymer chain are also investigated during the escaping process.