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Objective:To explore the efficacy of pedicled bladder muscle flap in the repair of urinary tract obstruction.Methods:The data of 26 patients with urinary tract obstruction admitted to Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine from March 2016 to June 2021 were retrospectively reviewed. There were 14 males and 12 females, with the age ranged from 2 to 75 years old. Refractory bladder neck obstruction after prostatic hyperplasia surgery in 12 cases, with the age of (70.0±3.5) years old.They all experienced at least 2 times of transurethral stenosis incisionor resection. Transpubic cystostomy tube was placed in 9 patients. Posttraumatic pelvic fractures lead to bladder neck atresia and urethral injury in 6 girls, with the age of (10.5±2.1) years old. The bladder neck atresia and urethral obliteration length was 1-2 cm determined by urethrography. Eight cases suffered ureteral strictures after gynecological myomectomy or ureteroscopy holmium laser lithotripsy(4 cases of each type), including two males and six females, with the age of (55.0±3.2) years old. The length of ureteral stricture or defect was 5-6 cm determined by intravenous urography(IVU) or CT urography(CTU). The patients with bladder neck obstruction underwent the following surgery: The "Y" incision of the bladder and stenosis of the prostate urethra was performed and the pedicled bladder muscle flap was inserted into the normal urethral mucosa to complete the Y-V plasty. In the 6 girl patients, pedicled bladder muscle flap(2-4 cm) augmented reconstruction were performed. All above 18 patients, whose urethral catheter was indwelled for 3-4 weeks, urinary flow rate and urethroscopy examination were performed to evaluate the effect of surgery 4 weeks and 3 months after the operation. As the 8 cases with ureteral strictures, the pedicled bladder muscle flap (7-8 cm) ureteroplasty was performed and the ureteral stent was retained for 4 weeks. Ultrasonography and IVU/CTU were performed 4 weeks and 3 months postoperatively. The patency of the ureteral lumen and whether it is accompanied by hydronephrosis, lower back pain, and urinary tract infection were assessed.Results:All patients underwent pedicled bladder muscle flap reconstructive surgery successfully and no serious complications occurred postoperatively. The patients were followed up for (8.2± 2.2) months. As urethral catheters were removed, 10 patients with refractory neck obstruction could return to normal urination with the urinary flow Q max (17.2±2.8)ml/s, while 2 patient had dysuria and were treated with regular urethral dilatation. The catheter was removed 4 weeks after the reconstructive surgery in 6 girls with bladder neck atresia and urethral injury after posttraumatic pelvic fracture. Five could successfully urinate with the urinary flow Q max of (16.7±1.1)ml/s, and one girl had urinary incontinence, waiting for further operation.The ureteral stent was removed after ureteroplasty in 8 patients. CTU and IVU examination showed no ureters with obstruction.No one had low back pain, discomfort, or urinary tract infection. Conclusions:The reconstruction using the pedicled bladder muscle flap was a convenient, minimally invasive and effective technique for the management of adjacent lower ureters, bladder neck, and proximal urethra.
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The treatment of vesicovaginal fistula after radiotherapy is difficult. Surgical repair is challenging and the success rate is low. The gracilis flap is widely used in the repair surgery of the perineal region, while it is rarely reported for the repair of vesicovaginal fistula domestically. This article reports a case of vesicovaginal fistula after radiotherapy treated with gracilis flap tamponade. The patient was admitted to the hospital because of continuous vaginal leakage of urine for more than 3 years. Digital vaginal examination and urethroscopy showed that a fistula with a diameter of about 3 cm located at the bladder triangle leading to the vagina. The patient had history of cervical cancer surgery and 23 times of postoperative adjuvant radiotherapy. She underwent vesicovaginal fistula repair with gracilis muscle flap. The urethral catheter was removed 3 weeks after the operation. The patient could urinate normally without vaginal leakage. After 10 months of follow-up, there was no vaginal leakage of urine and patient remains continent.
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Objective:To explore the correlation between blood glucose levels and the three factors of sarcopenia (muscle mass, strength and function) in older Chinese community dwellers.Methods:This is a retrospective study conducted by collecting the data of patients in Jiangsu Huaqiao Road Community Health Service Center from 2018 to 2019. Two hundred and fifty people aged 60 years or elder were selected. Among them, 101 were men and 149 were women. According to the American Diabetes Association diagnostic criteria for diabetes mellitus in 2018, they were divided into normal glucose tolerance (NGT) group, pre-diabetes group and diabetes group. The patients were assessed for sarcopenia as well.Results:Compared with those in the NGT group, muscle mass and upper limb muscle strength did not change in the diabetic group, but lower limb muscle strength and body function [walking speed, balance, short physical performance battery (SPPB)] decreased significantly in the diabetic group. Pearson correlation analyses showed that fasting plasma glucose(FPG) was negatively correlated with walking speed ( r=-0.248, P=0.001), three-pose balance ( r=-0.166, P=0.013) and SSPB ( r=-0.213, P=0.001). Glycosylated hemoglobin A1c(HbA1c) was positively correlated with sitting and standing time ( r=0.205, P=0.002), and negatively correlated with three-pose balance ( r=-0.186, P=0.006) and SSPB ( r=-0.154, P=0.024). Multiple regression analyses showed that FPG was negatively associated with walking speed (β=-0.125, P=0.005) and SPPB (β=-0.034, P=0.012), and that HbA1c was positively associated with sitting and standing time (β= 0.218, P =0.006) and negatively associated with three-pose balance (β=-0.143, P=0.012), and SPPB (β=-0.117, P =0.036). Conclusions:There is no significant correlation between blood glucose levels and muscle mass in the elderly; however, FPG is closely correlated with gait speed, and HbA1c is closely correlated with muscle strength of lower limbs and balance ability in the elderly.
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Objective:To explore the differences of the diagnostic performance between the most recent 2018 version of liver imaging reporting and data system (LI-RADS v2018) and 2017 version (LI-RADS v2017) based on gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced MRI to diagnose hepatocellular carcinoma (HCC) in high-risk patients.Methods:The clinical data and imaging findings of 237 patients in high-risk of HCC who underwent Gd-EOB-DTPA enhanced MRI and obtained postoperative or biopsy pathological results within one month from June 2016 to December 2019 in Tianjin Third Central Hospital were collected retrospectively. A total of 282 observations were obtained as study objects. Two independent radiologists blindly reviewed the preoperative MRI of all patients. The observations were categorized according to LI-RADS v2018 and v2017 respectively. The inter-observer agreement of the categorization between the two radiologists was tested by kappa analysis. With the LR-5 and LR-4+5 as the diagnosis of HCC, the sensitivity, specificity, accuracy, and Youden index of the LI-RADS v2017 and LI-RADS v2018 were evaluated with postoperative histopathological results as references. The McNemar test was used to compare the diagnostic performance between the two versions.Results:The two physicians had good consistency in the categorization of observations, with kappa values between 0.536 and 0.793. Using LR-5 as the criterion for HCC diagnosis, the Youden index (0.687) of LI-RADS v2018 was higher than that of v2017 (0.612). The sensitivity [80.6% (166/206)] and accuracy [82.6% (233/282)] were both higher than those of LI-RADS v2017 [70.4% (145/206) and 75.9%(214/282)] (χ2=19.048, 14.087, both P<0.001). The specificity was slightly lower [88.2%(67/76) and 90.8%(69/76), respectively], but there was no statistical difference (χ2=0.500, P=0.500). With LR-4+5 as the diagnosis of HCC, the diagnostic performance of the two versions was the same. The sensitivity [91.3% (188/206)] and accuracy [87.6% (247/282)] were higher, and the specificity [77.6% (59/76)] were lower than the LR-5 standard of LI-RADS v2018 (χ2=20.045, P<0.001; χ2=5.633, P=0.018; χ2=16.056, P<0.001), and the Youden index (0.689) was also higher than the LR-5 standard of LI-RADS v2018. Conclusions:Based on Gd-EOB-DTPA enhanced MRI, the LI-RADS v2018 has higher sensitivity and accuracy in diagnosing HCC than v2017. Correct use can provide more objective diagnostic evidence for the clinic.
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OBJECTIVE@#To analyze the reentry situation of HBsAg single reagent reactive blood donors in Anhui province, and to verify the rationality and effectiveness of reentry strategy of blood donors in Anhui province.@*METHODS@#Shielded blood donors who were HBsAg single reagent reactive might voluntarily apply for returning to the team of blood donors after the shield of 6 months. Blood bankstaff that shielded those donors should draw blood and conduct screening tests. Samples from donors who were HBsAg negative should be delivered to Anhui Blood Center to conduct the reentry detections. Shielded blood donors were allowed to return to the team if the results of HBsAg test, neutralization test, HBcAb test and nucleic acid test were negative.@*RESULTS@#109 person-portions of samples for returning to team from September 2013 to December 2016 were delivered to Anhui Blood Center. After reentry tests, 60 of them were negative, 8 cases were positive, while 41 cases were undetermined, and the qualified rate was 55.05%.25 negative donors were from Hefei, 20 of them donated blood again and were negative.@*CONCLUSION@#The shielding and reentry strategy of blood donors with HBsAg single reagent reactive in Anhui province is rational and effective. However, there are still some deficiencies in trace of donors and information transmission, which needs to be further improved.
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Humans , Blood Donors , DNA, Viral , Hepatitis B , Hepatitis B Surface Antigens , Hepatitis B virusABSTRACT
Objective:To investigate the clinical efficacy of lingual mucosa graft coupled penis flap urethroplasty for crippled hypospadias.Methods:Between January 2016 and August 2019, 16 patients with crippled hypospadias in Shanghai Sixth People's Hospital were included in this study. Their mean age was 35.2 years (range from 25 to 44 years). All patients presented voiding difficulty and failed after 2 or more times of urethroplasty. Their mean times was 4.6(range from 2 to 7 times). Uroflowmetry examination showed their mean Q max was 6.7 ml/s (range from 3.8 to 9.6ml/s). Chordee was found in six patients. Urethrocele was found in 2 patients. Urethrocutaneous fistula was found in 2 patients. All patients received lingual mucosa graft coupled penis flap urethroplasty. By removing the ischemic and fibrotic urethra, urethral plate was reconstructed with lingual mucosa graft and the penis flap was transplanted to cover the reconstructed urethra plate to form a new urethral lumen, which was used to repair the defective urethra. The catheters were removed three weeks after the surgery. Uroflowmetry examination, cystourethrography and cystoscope were performed after the catheters out. Results:All patients underwent smooth surgery with an average duration of 128.4 minutes (range from 105 to 150 minutes). After mean follow-up of 18.6 months (range from 3 to 30 months), successful outcome was achieved in 14 patients and uroflowmetry examination at the seventh week after surgery showed their mean Q max was 22.4 ml/s (range from 15.6 to 29.8 ml/s). 2 cases had urethrocutaneous fistula which were cured after repair of penile urethral fistula. 2 patients still had a certain level of chordee while they were satisfied with the appearance of their penis, so there was no further treatment. Conclusions:Single stage lingual mucosa graft coupled penis flap urethroplasty has short operation period, relatively high success rate and relatively few complications. Single stage lingual mucosa graft coupled penile flap urethroplasty is an available option for crippled hypospadias with several times of failed urethroplasty.
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Sarcopenia is a geriatric syndrome characterized by the decline in muscle mass and function associated with aging.Many studies have revealed that secondary sarcopenia associated with chronic obstructive pulmonary disease(COPD)can further reduce lung function and the ability of conducting daily living activities for the patients.Moreover, inflammation, increased energy expenditure, decreased physical endurance induced by COPD may accelerate the deterioration of sarcopenia.The aim of this review is to tentatively explore possible mechanisms linking the two diseases and promote early intervention for sarcopenia.
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OBJECTIVE Despite the status of cisplatin (DDP) as a classical chemotherapeutic agent in the treatment of cancer, the development of multidrug resistance often leads to a failure of DDP therapy.Traditional Chinese medicine(TCM)as adjuvant chemotherapy of cancer drugs in China has been widely used in cancer treatment.ZuoJin WAN (ZJW),a TCM formula,was proved reversing drug resistance in gastric cancer,but its exact mechanism was still unclear. METHODS CCK-8 assay was used to detect the cell viability. The levels of proteins and mRNA were evaluated using Western blot and q-PCR. Mitochondrial membrane potential was measured by fl ow cytometry. Depolymerisa-tion of F-actin and translocation of G-actin(gamma-actin)from the cytoplasm to the mitochondria was detected using an immuno fl uorescence assay. RESULTS phosphorylated coflin-1 (p-coflin-1) was overexpressed in the DDP-resistant human gastric cancer cell lines SGC7901/DDP and BGC823/DDP, relative to the respective parent cell lines(SGC7901 and BGC823),and DDP induced the dephosphory-lation of p-coflin-1 in both parent lines but not in the DDP-resistant lines. However, ZJW could induce the dephosphorylation of pcoflin-1 and promote coflin-1 translocation from the cytoplasm into the mito-chondria in both SGC7901/DDP and BGC823/DDP cells. This mitochondrial translocation of coflin-1 was found to induce the conversion of flamentous actin to globular-actin, activate mitochondrial dam-age and calcium overloading, and induce the mitochondrial apoptosis pathway. These effects of ZJW on DDP-resistant human gastric cancer cell lines could be reversed via transfection with coflin-1-specifc siRNA,or treatment with a PP1 and PP2A inhibitor.CONCLUSION ZJW can be used as an inhibitor of chemoresistance in gastric cancer, which may partly be due to dephosphorylation of p-coflin-1 via the activation of PP1 and PP2A.
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Objective To investigate the impact of tube current and tube voltage on CT attenuation,the correlation between CT attenuation and iodine concentration,as well as the percentage of reducing dosage for contrast agent while reducing the tube voltage.Methods A total of 100 saline solutions with decreasing dilution of contrast medium,in which concentration was between 0.5 to 50.0 mg/ml with the interval of 0.5 mg/ml,was produced.Each of the 25 syringes with a 4 ml sample was fixed on a cylindrical CT calibrated water phantom with an equal distance used the tape.CT scans were performed with a total of 15 scanning methods of the combination of the different tube voltages (70,80,100,140 kV) and tube current (100,200,280 mA).All of the CT attenuations were measured and recorded.The differences of CT attenuations under different scanning tube currents and tube voltages were compared with one-way ANOVA.The Pearson correlation analysis was used to analyze the relationship between CT attenuation and iodine concentration,and linear correlation equations were calculated and shown by regression analysis.According to the equations,the changes of contrast medium dosage were calculated with the changes of tube voltage.Results There was no significant difference in CT attenuations on different tube currents when the tube voltage was fixed (all P＞0.05),while when the tube current was fixed,the difference of CT attenuations on different tube voltages was statistically significant (all P＜0.05).Under different scanning conditions,the CT attenuations was linearly related to the iodine concentration (r2 was 0.953 to 0.997,all P＜0.01).While the tube voltage was reduced from 140 kV to 120 kV,100 kV,80 kV,70 kV,respectively,the iodine concentration of the samples were reduced by 15.4％,33.7％,53.4％,64.7％ respectively.While the voltage was reduced from 120 kV to 100 kV,80 kV,70 kV,respectively,the iodine concentration were rednced by 21.6％,44.9％,58.2％,respectively.While the voltage was reduced from 100 kV to 80 kV and 70 kV,the iodine concentration was reduced by 29.7％ and 46.7％,respectively.While the voltage was reduced from 80 kV to 70 kV,the iodine concentration was reduced by 24.1％.Conclusion CT attenuation can keep constant in low tube voltage setting by reducing the dosage of contrast agent,which can achieve a low radiation dose and low contrast agent dosage.
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The risk factors of diastolic heart failure include among others: hypertension,diabetes,myocardial ischemia and aging.The underlying mechanisms for this cardiac complication are incompletely understood.With the increase of aging of the population,the prevalence and mortality of diastolic heart failure is rising gradually.It seriously affects the life quality and life span of people.In order to more truly reveal the underlying mechanisms of diastolic heart failure and to develope novel therapeutic strategies,the experimental animal models are extremely important.The present review focuses on providing an overview of the characteristics of these models for the growing number of investigators who seek to understand the pathology of diastolic heart failure.
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Objective To investigate the feasibility of reducing bolus?tracking monitor frequency in coronary CT angiography (CTA). Methods This prospective study including 120 patients with suspected coronary artery disease (CAD). According to the examination registration order, the patients were divided into groups A, B and C (n=40 for each group). All patients underwent coronary CTA with bolus?tracking technology, and were monitored at 10 s after the injection of contrast. The monitoring frequency of bolus?tracking for Group A was every 1.14 s, that for Group B was every 1.47 s , and for Group C was every 2.00 s, while the trigger threshold was set as 100 HU. To evaluate the image quality, the objective evaluation included signal noise ratio (SNR) and contrast noise ratio (CNR) of aorta (AO), CNR of left main coronary artery (LM) and right coronary artery (RCA), and the subjective score was recorded for each coronary artery segment. The monitoring times when CT density of the region of interest (ROI) reached the threshold, the CT value and the effective dose (ED) in the 3 groups were recorded. Objective image quality, monitoring parameters and radiation dose were compared using analysis of variance method, subjective image quality was compared withχ2 tests. Results There was no significant difference in AO (SNR and CNR), LM (CNR) and RCA (CNR) among the 3 groups, respectively (P>0.05). Subjective image quality scores of groups A, B, C were (1.879±0.042), (1.876±0.042), (1.881±0.042 ), with no significant difference (χ2=0.003,P>0.05). The monitoring times of to reach the threshold in groups A, B, C were (4.78±2.37), (3.76±1.39), (2.77±0.99), and ED were (0.058±0.031),(0.031±0.011), (0.021±0.007) mSv, with the significant difference (F=9.009, 31.998, respectively, P<0.01). Peak CT values during monitoring among three groups were (133 ± 24), (142 ± 39), (137±26) HU, respectively, with no significant difference (F=0.575,P=0.565). Conclusions It is feasible to reduce monitoring times when performing coronary CTA in dual?source CT scanner. The bolus?tracking monitor frequency in every 2 seconds can not only obtain satisfactory image quality, but also significantly reduce radiation dose.
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<p><b>OBJECTIVE</b>To investigate the plasma level of amino-terminal pro-brain natriuretic peptide (NT-proBNP) and related influencing factors in a community-based healthy population in Beijing area.</p><p><b>METHODS</b>We measured plasma NT-proBNP level by fluoroimmunoassay between March 2012 and July 2012 from 1 034 healthy subjects (including 486 men and 548 women). Empiric method was used to determine the reference value and influencing factors were analyzed.</p><p><b>RESULTS</b>Age and gender are important factors affecting the level of NT-proBNP in healthy subjects. NT-proBNP plasma level is significantly higher in women than in men within each age strata below 75 years old, i.e. < 45, 45-54, 55-64 and 65-74 years old (P = 0.005, 0.001, 0.001, 0.011 respectively), but NT-proBNP plasma level is similar between male and female older than 75 years (P = 0.504). NT-proBNP level also increases with age irrespective of gender. Body mass index (BMI) is another independent influencing factor of NT-proBNP (P < 0.001), while estimated glomerular filtration rate is not influencing factor. The reference range of NT-proBNP is < 133 ng/L for men and < 289 ng/L for women aged < 55 years old, < 185 ng/L for men and < 333 ng/L for women aged between 55 and 64 years old, and < 465 ng/L for men and < 378 ng/L for women aged ≥ 75 years old.</p><p><b>CONCLUSION</b>The major influencing factors of NT-proBNP level in the healthy population are age, gender and BMI. It essential to establish normal reference range of NT-proBNP according to these factors for Chinese population.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Asian People , Health Status , Natriuretic Peptide, Brain , Peptide Fragments , Reference ValuesABSTRACT
<p><b>OBJECTIVE</b>To investigate the frequency and predictors of recovery and relapse of left ventricular systolic dysfunction (LVSD) in hospitalized patients with dilated cardiomyopathy (DCM).</p><p><b>METHODS</b>Patients with DCM hospitalized in Fuwai Hospital from October 2008 to December 2013 with repeat echocardiography results after discharge were reviewed and followed to December 2014 or until all-cause death or cardiac transplantation. Rate of recovery of LVSD, defined as an absolute increase in left ventricular ejection fraction (LVEF) of >10% to a level of >50% on follow-up, and those with relapse of LVSD, defined as a decrease in LVEF to a level of <45% after initial recovery was obtained and related factors affecting LVSD recovery and relapse were analyzed.</p><p><b>RESULTS</b>After a mean follow-up of (28 ± 17) months, recovery of LVSD was evidenced in 114 of 382 patients (29.8%), LVEF increased from (31.6 ± 6.0) % to (55.8 ± 3.7) % (P<0.01) and left ventricular end-diastolic diameter (LVEDD) decreased from (65.1 ± 6.7) mm to (53.5 ± 4.9) mm (P<0.01) in these patients. Multiple logistic regression analysis showed that symptom duration of heart failure (OR=0.986, P<0.01), systolic blood pressure (SBP) (OR=1.026, P<0.01), LVEDD (OR=0.938, P<0.01) and LVEF (OR=1.038, P<0.05) at admission were independent predictors of LVSD recovery. During the subsequent follow-up of (24 ±1 3) months after initial recovery, 17 of 88 patients (19.3%) suffered a relapse of LVSD, LVEF decreased from (54.3 ± 2.6) % to (36.6 ± 5.1) % (P<0.01), LVEDD increased from (57.5 ± 4 .2) mm to (62.8 ± 6.8) mm (P<0.01) in these patients. Multiple logistic regression analysis showed that less decrease in LVEDD at initial recovery of LVSD was independent predictor of LVSD relapse.</p><p><b>CONCLUSIONS</b>About 30% hospitalized patients with DCM experienced LVSD recovery in this patient cohort. Symptom duration of heart failure, SBP, LVEDD and LVEF on admission were predictors of LVSD recovery. Moreover, LVSD relapse was observed in around 20% patients after initial LVSD recovery and less decrease in LVEDD at initial recovery serves as an independent risk factor for LVSD relapse.</p>
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Humans , Blood Pressure , Cardiomyopathy, Dilated , Heart Failure , Hospitalization , Recurrence , Risk Factors , Ventricular Dysfunction, Left , Ventricular Function, LeftABSTRACT
<p><b>OBJECTIVE</b>To explore the predict value of plasma soluble ST2 (sST2) on one-year mortality for hospitalized patients with chronic heart failure (HF).</p><p><b>METHODS</b>A total of 1 244 consecutive hospitalized patients admitted to Heart Failure Center Fuwai Hospital between March 2009 and July 2012 and with HF as their primary diagnosis were included. Plasma sST2 was measured in all patients and patients were followed up for 1 year, and the primary endpoint was defined as all-cause death.</p><p><b>RESULTS</b>There were 193 deaths during follow up. sST2 concentrations at admission were positively correlated with NT-proBNP, NYHA functional class and heart rate, and negatively correlated with left ventricular ejection fraction, blood sodium, total cholesterol and glomerular filtration rate at admission. sST2 concentrations were significantly higher in non-survivors compared with survivors (P < 0.001). Multivariable Cox regression analyses showed that sST2 independently predicted 1-year mortality (per 1 log unit, hazard ratio 1.87, 95% confidence interval: 1.56 to 2.25, P < 0.001). In receiver operating characteristic analyses, the area under the curve for ST2 was 0.776 which was similar to that of N-terminal pro-B-type natriuretic peptide (NT-proBNP) (AUC = 0.775). The prognostic value was improved when combining these two biomarkers together (AUC = 0.813).</p><p><b>CONCLUSIONS</b>sST2 concentration at admission is correlated with clinical and biochemical indexes and associated with 1-year mortality for hospitalized patients with HF.</p>
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Humans , Biomarkers , Cause of Death , Chronic Disease , Heart Failure , Natriuretic Peptide, Brain , Peptide Fragments , Prognosis , ROC Curve , Ventricular Function, LeftABSTRACT
<p><b>OBJECTIVE</b>To explore the cognitive function status and potential influence factors on cognitive function in hospitalized patients with chronic heart failure.</p><p><b>METHODS</b>Using a cross-sectional research design, CHF patients (n = 267, mean age (63.8 ± 9.4) years) were recruited from two care units-Heart Failure Care Unit and Intensive Care Unit of our hospital. Cognitive function status was evaluated by the Montreal Cognitive Assessment (MoCA) screen test.</p><p><b>RESULTS</b>Based on the MoCA score, 37.8% (101/267) patients suffered from cognitive impairment (score<26), especially on the three specific cognitive functions-memory, langue and executive capability. Multifactorial analysis showed that after controlling for other factors, there was a downward trend on cognitive function with aging (OR = 1.09, 95%CI:1.05-1.14) while higher left ventricular ejection fraction (LVEF) was related to better cognitive function (OR = 0.97, 95%CI:0.95-0.99); patients who took medicine regularly also had better cognitive function (OR = 3.71, 95%CI:1.40-10.91); cognitive function was better in patients with high level of social support compared those with low social support (OR = 0.92, 95%CI:0.88-0.96).</p><p><b>CONCLUSIONS</b>Incidence of cognitive impairment is high in hospitalized patients with chronic heart failure. Age, LVEF, whether taking medication regularly and social support are factors related to cognitive function in CHF patients.</p>
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Aged , Humans , Middle Aged , Chronic Disease , Cognition , Cognition Disorders , Epidemiology , Cross-Sectional Studies , Heart Failure , Incidence , Ventricular Function, LeftABSTRACT
<p><b>OBJECTIVE</b>To observe the frequency and predictors of recovery of normal left ventricular ejection fraction (LVEF) and end-diastolic diameter (LVEDD) in patients with dilated cardiomyopathy (DCM).</p><p><b>METHODS</b>A consecutive cohort of 296 patients with DCM were reviewed and followed up for at least 12 months or to death or cardiac transplantation, to identify those with recovery of normal LVEF, defined as LVEF ≥ 50%, or recovery of normal LVEDD, defined as LVEDD ≤ 55/50 mm for male/female, or both by follow up echocardiography.Variables regarded as potentially relevant to left ventricular function and dimension recovery were evaluated to identify predictors using multivariable logistic regression analysis.</p><p><b>RESULTS</b>After a median follow-up of 28 months, normal LVEF was evidenced in 81 patients (27.4%), normal LVEDD was found in 63 patients (21.3%) and both parameters were recovered in 52 patients (17.6%), LVEF was increased from (31.7 ± 6.3)% to ( 57.5 ± 5.2)% (P < 0.01) and LVEDD decreased from (62.7 ± 4.3) mm to (50.2 ± 3.7) mm (P < 0.01) in these 52 patients. Multivariable logistic regression analysis showed that shorter symptom duration, higher systolic blood pressure at admission, smaller LVEDD and lower LVEF by echocardiography at baseline were independent predictors of subsequent recovery of normal LVEF and LVEDD.</p><p><b>CONCLUSION</b>Current therapy for heart failure could lead to recovery of normal LVEF and LVEDD in part of DCM patients, especially for DCM patients with short symptom duration, higher systolic blood pressure at admission, less enlarged LVEDD and less reduced LVEF at baseline echocardiography.</p>
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Female , Humans , Male , Cardiomyopathy, Dilated , Echocardiography , Heart Failure , Stroke Volume , Ventricular Function, LeftABSTRACT
In part of the patients with blood disease or malignant tumors, especially those with leukemia and multiple myeloma, the disease state and unsuitable treatment often resulted in the inconsistence between positive and negative ABO blood group, displaying attenuation of the antigen or antibody of ABO blood group. This study was purposed to analyze the course of inconsistence between positive and negative ABO blood group and to perform the correct typing of erythrocytes and genes. The serology, absorption and elution test were used to examine the 12 tumor patient of the inconsistence between positive and negative typing. The 6th, 7th exon and 5-7th introns were amplified by PCR for questionable samples, and the gene sequencing of exon was performed. The results showed that 9 specimens were determined as 6 of A group, 2 of O group, 1 of B group, 3 cases were identified as O46, B108, and A102 group, respectively, by the serology, absorption and elution typing. The genotype of 2 cases among them was not identified because of the erroneous PCR amplified result or the contradicted sequencing results, failing to determine the ABO genotype. It is concluded that the serological method for blood grouping, genotyping, absorption and elution method can be used for the blood samples unable to typing because of the inconsistence between positive and negative typing of ABO group, therefore, guaranteeing the safety and effectiveness.