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Heart failure (HF) is a complex clinical syndrome, which is caused by cardiac structural abnormalities and dysfunction. It can lead to ventricular filling and impaired ejection capacity with high incidence and mortality . The constant activation of the rennin-angiotensin-aldosterone system (RAAS) plays an important role in the development of heart failure. Angiotensin angiotensin converting enzyme inhibitor (ACEI), angiotensin angiotensin receptor antagonist (ARB) and aldoste?rone receptor antagonist (MRA) had been confirmed to be with good therapeutic effects therefore played important roles in heart failure treatment strategy shown by large scale clinical trials. The first PARADIM-HF data published by European So?ciety of Cardiology in annual meeting on August 30, 2014 showed that LCZ696 can reduce cardiovascular mortality risk of HF patient by 20%when combining with beta blockers and MRA . It also reduced the number of hospitalizations of patients with chronic heart failure (CHF) by 21%. LCZ696, using its unique dual phase mode verified that the regulation of neuroen?docrine is the modern concept for the treatment of heart failure. LCZ696 lead to innovation and shed new light in traditional drug treatment for heart failure.
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Objective To investigate the clinical prognostic value of neutrophils to lymphocyte ratio(NLR)in patients with ST-segment elevation myocardial infarction(STIMI)who underwent percutaneous coronary intervention(PCI). Meth?ods A total of 326 patients with acute ST segment elevation myocardial infarction were enrolled. According to the neutro?phils to lymphocyte ratio, patients were divided into group T1(≤3.46), group T2(3.47-6.75)and group T3(>6.75). Basic clinical data,laboratory indexes,coronary angiography results, TIMI grading and left ventricular ejection fraction(LVEF) were collected in all groups. Incidence of adverse events in hospital such as acute heart failure, thrombosis, ventricular tachy?cardia and ventricular fibrillation, atrial fibrillation, atrioventricular block and cardiogenic shock, were recorded. Major ad?verse cardiac events(MACE), death of all causes, non-fatal MI, ischemic stroke and readmission due to heart failure at the 6-month follow-up were also noted. Results The incidence of heart failure, atrial fibrillation, ventricular tachycardia/ven?tricular fibrillation and cardiogenic shock was higher in group T3 than those in the other two groups(P < 0.05).The inci?dence of multivessel coronary artery disease was significantly higher in group T3 than that in group T1 (54.1% vs 37.0%, P<0.05). The percentage of TIMI grade 3 in post-operative infracted artery was significantly lower than that in group T1 (83.5%vs 94.4%). Left ventricular ejection fraction was significantly lower in group T3 than that of group T1 during hospital?ization (0.48 ± 0.10 vs 0.52 ± 0.10). There was no significant difference in the incidences of death, non-fatal MI, ischemic stroke at 6 month follow up. But the rate of readmission due to heart failure was significantly higher in group T3 than that in the group T1(P<0.05). Conclusion Neutrophils to lymphocyte ratio may be a useful marker to predict the prognosis of pa?tients with heart failure due to acute myocardial infarction.
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Objective To understand the efficacy of meibomian gland compression by themselves and outpatient meibomian gland dredge treatment with dry eye young patients of meibomian gland dysfunction.Methods Selected 48 young patients with dry eye of meibomian gland dysfunction,patients were divided into two groups according to the wishes,28 patients were given method guidance of meibomian gland compression by themselves (compression group),every 10 minutes,three times a day,4 weeks after the referral.Other 20 cases meibomian gland dredge by a doctor at the eye clinic performed under anesthesia (dredge group),2 weeks,4 weeks after the referral and then dredge,3 times.All patients were given to health education,all patients before treatment and after treatment for 4 weeks underwent Schirmer Ⅰ test (S Ⅰ t),tear film breakup time (BUT),corneal fluorescein staining (CFL) examination and compared.Results The level of BUT,S Ⅰ t,CFL before treatment in two groups had no significant difference (P ＞ 0.05).After treatment for 4 weeks,eye symptom had improved in two groups.The level of BUT,CFL before and after treatment for 4 weeks in two groups had significant difference (P ＜ 0.05).But the level of S Ⅰ t,BUT,CFL after treatment for 4 weeks between two groups had no significant difference (P ＞ 0.05).Conclusion Dry eye young patients of meibomian gland dysfunction if they can correctly perform meibomian gland compression by themselves can also be reached effectively alleviate dry eye and ocular discomfort symptom improvement purposes.
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Objective To analyze the family and clinical characteristics of talking about killing self (TAKS) among children and adolescents and its relationship with social competency.Methods One thousand nine hundred and seventy-five 7-17-year-old students from 12 schools (each four for primary,middle and high schools) of Wuhan area,were approached through multistage random cluster sampling,and administered with a self-designed general information questionnaire and the Chinese version of Children' s Depression Inventory.In addition,subjects' parents completed Achenbach' s Child Behavior Checklist (CBCL).TAKS was judged based on item 91 (talk about killing self) of CBCL.Multiple Logistic Regression was used to identify factors associated with TAKS.Results The half-year prevalence rate (95％ CI) of parent-reported TAKS was 4.1％ (3.2％,5.0％).TAKS was significantly associated with bad marital status of parents (OR=2.29),unemployment of fathers (OR=2.07),frequently jangling between father and mother (OR=2.23),parents ever having fought with each other intensely (OR=2.00),being frequently bullied by classmates (OR=2.11),internal behavior problem (OR=2.28),external behavior problem (OR=2.50) and depressive symptoms (OR=4.83).TAKS subjects had significantly lower social compctency score than non-TAKS subjects((18.8±7.6) vs.(20.9±6.9),P=0.007).Conclusion The prevalence of TAKS is higher among children and adolescents with several disadvantaged family factors,behavior problems and depression.Children and adolescents with TAKS also have worse social competency.More close clinical attention should be paid to such phenomenon.
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The recent investigations have demonstrated that epigenetic such as DNA methylation and histone modification was closely associated with cell growth and malignant tumors, and epigenetic modification was responsible for an important cause of oncogenesis. However, for the recent years some observations have been also shown that the development of tumorigenesis was attributed to transformation expression in microRNA. The latest investigations have revealed that epigenetic was involved in modulation of microRNA expression, on the contrary some kinds of microRNAs could also control epigenetic, moreover, the reciprocal modulation between microRNA and epigenetic could regulate gene expression and induce tumorigenesis. At the same time the data likewise displayed that epigenetic adjusted microRNA expression principally in a way of DNA methylation or histone modification, nevertheless microRNA regulated epigenetic by way of methyltransferases expression, DNA methylation maintenance and histone modification. With regard to the reciprocal modulation between microRNA and epigenetic, a comprehensive and systemic review of reciprocal relationship in modulation of cell growth and oncogenesis was gived.
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AIM: To evaluate the effect of captopril on action potential duration and outward delayed rectification potassium current (Ik). METHODS: Action potentials were recorded using a conventional glass microelectrode filled with 3 mol/L KCl solution. Membrane patch clamp whole cell recording technique was used to investigate the Ik current maximum in the holding potential - 50 mV, lasting time 100 ms, command potential + 40 mV. RESULTS: The action potential duration of 30%, 50% repolarization (APD30, APD50) and ERP were significantly prolonged, but APD90 wasn' t prolonged significantly when captopril group compared with ischemic group. The amplitude of Ik increased significantly in ischemic group, but significantly decreased in captopril group and in captopril + ischemic group. The shapes of current - voltage relationship were unchanged among groups, but significantly upward in ischemic group and downward in captopril and captopril + ischemic group. CONCLUSION:Captopril exerts electrophysiologic action due to decreasing delay outward rectification potassium current and prolonging action potential duration of APD30, APD50 and ERP.