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Objectives:The risk factors affecting the blood perfusion of side branch(SB)in coronary bifurcation lesions were explored by the three-dimensional quantitative coronary angiography(3D-QCA)and the Murray's law based quantitative flow ratio(μQFR),and a risk prediction model affecting SB perfusion disorders was established to provide reference for the percutaneous coronary intervention(PCI)strategies of bifurcation lesions. Methods:From October 2022 to April 2023,393 bifurcation lesions were evaluated by coronary angiography in Hunan Provincial People's Hospital.The general clinical evaluation index of the patient,the anatomical index of coronary bifurcation lesion,and the μQFR representing branch perfusion in bifurcation lesion were collected.All samples were randomly divided into training set and test set at the 8:2 ratio.Univariate logistic regression was used to determine filter variables,and the influencing factors of branch perfusion in bifurcated lesions were evaluated by multivariate logistic regression analysis.A risk prediction model was established,and the accuracy of the model was further verified in the test set. Results:The maximum area stenosis rate,maximum lumen diameter stenosis rate of the bifurcation nucleus,ostia diameter stenosis rate,as well as the branch maximum diameter stenosis rate,and length of the bifurcation lesion are independent predictors of SB perfusion disorders(SB μQFR<0.8),P<0.05.A SB perfusion disorder risk prediction model was established based on the above five independent risk factors.The area under the ROC curve of the model was 0.926(95%CI:0.896-0.958),the sensitivity was 0.864(95%CI:0.818-0.910),and the specificity was 0.850(95%CI:0.780-0.920).This model was applied to the test set,the results showed that the area under the ROC curve of this model was 0.897(95%CI:0.817-0.976),the sensitivity was 0.870(95%CI:0.756-0.936),and the specificity was 0.923(95%CI:0.759-0.986). Conclusions:The blood perfusion of branches in coronary bifurcation lesions is mainly related to multiple anatomical factors of the main branch and SB.Among them,the maximum area stenosis rate,maximum lumen diameter stenosis rate of the bifurcation nucleus,ostia diameter stenosis rate,branch maximum diameter stenosis rate and length of the bifurcation lesion are independent predictors of perfusion disorders in the SB.Future studies are needed to validate the clinical value of the established risk prediction model of the SB perfusion disorders in daily clinical practice.
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Objective:To explore the effect of LILRB2 on the proliferation and apoptosis of colorectal cancer SW480 cells, and to further explore its mechanism.Methods:Colorectal cancer SW480 cells were cultured in vitro and divided into blank control group, negative control group and experimental group. The expression of LILRB2 was detected by flow cytometry. The expression of LILRB2 was detected by qPCR, and the empty vector plasmid and the LILRB2 plasmid were transfected into SW480 cells respectively; cell proliferation was detected by CCK-8 method; cell apoptosis was detected by flow cytometry. Western blot was used to detect changes in the expression of related proteins.Results:The expression level of LILRB2 in SW480 was 0.84 ± 0.09, twice higher than that in FHC cells (0.38 ± 0.05) , and the difference was statistically significant ( P<0.05) . After virus infection, the expression of LILRB2 (0.48 ± 0.07) in SW480 cells of the experimental group decreased significantly. CCK-8 experiment results showed that after 12 hours of treatment, the proliferation of SW480 cells in the LILRB2 low expression experimental group was inhibited, and the percentage of apoptosis in SW480 cells in the LILRB2 low expression experimental group increased to 49.3%±1.2%, which was statistically significant ( P<0.05) compared with the percentage of apoptosis in the blank control group and the negative control group (7.48%±0.85%, 7.35%±0.93%) . The ROS level of SW480 cells in the experimental group with low LILRB2 expression was significantly higher than that in the blank control group and negative control group ( P<0.05) . After adding ROS scavenger NAC, the apoptosis of LILRB2 in the experimental group increased. Conclusion:The low expression of LILRB2 inhibits the proliferation of SW480 cells and induces apoptosis, which may play a role by regulating the level of ROS, providing a theoretical basis for the study of LILRB2 in colorectal cancer.
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Objective@#To explore the association between dust exposure and the incidence of hypertension in male coal miners.@*Methods@#Using the method of retrospective cohort study,a hypertension cohort of colliery in Henan Province was established in January 2006. From 2006 to 2017,all the male coal miners in a colliery who were exposed to dust were selected into the exposure group including tunneling, mining,auxiliary and combining workers, and workers from administrative logistics departments who were not exposed to dust were selected into the control group. The eligible participants should satisfy following conditions: working more than one year, with clear and complete record of occupation change, and with complete archives and reliable diagnosis of occupational health surveillance. The exclusion criteria of participants were with hypertension at the baseline of study or with heart,liver,kidney diseases and malignant tumors. A total of 12 647 participants were enrolled in this study (11 663 in the exposure group and 984 in the control group). The follow-up period was from January 2006 to December 2017,with a total follow-up of 89 259.75 person-years. Questionnaires and physical measurements were used to collect general demographic characteristics, occupational exposure history and occupational health surveillance data of all participants. The Cox proportional hazards regression model was used to estimate the association between the dust exposure and the incidence of hypertension.@*Results@#During the follow-up period, 2 549 new-onset hypertension patients were identified with an incidence density of hypertension about 2 855.71 per 100 000 person-years. The incidence density of hypertension was 2 967.58 per 100 000 person-years in the exposure group, and 1 643.85 per 100 000 person-years in the control group. The results of multivariate Cox proportional hazards regression model showed that after the adjustment of marriage, age, smoking, alcohol drinking and body mass index,the risk of hypertension was higher in the exposure group compared with the control group (HR=1.692, 95%CI: 1.410-2.032). Further analysis showed that compared with workers from administrative logistics departments,the risk of hypertension in tunneling,mining and auxiliary working was 1.629(1.345-1.973),1.677(1.374-2.046) and 1.782(1.475-2.151),respectively.@*Conclusion@#Dust exposure may increase the risk of hypertension in male coal miners.
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Objective@#To investigate the prevalence and influencing factors of lower respiratory tract disease.@*Methods@#The health physical examination data of 4000 coal dust exposed workers who had physical examination in the Institute of Occupational Disease Prevention and Treatment in 2016 were collected and analyzed with SPSS 20.0 software.@*Results@#Out of the 4000 coal workers, the Prevalence rate of pulmonary tuberculosis, chronic bronchitis, CWP were 1.00% (40/4000) , 0.63% (25/4000) , 0.43% (17/4000) . 17 coal workers suffered from coal workers. The prevalence of workers both exposed to silicon and coal dust was 1.15% (2/174) , which was higher than that of other the job type. The prevalence of CWP among age groups, length of service and occupational category were found significant difference (P<0.05) , raising with the increase of duration of dust exposure and age increasing (χ2trend=17.171, 5.344, P<0.05) . The prevalence of emphysema and chronic bronchitis between different working years and different ages are all statistically significant (P<0.05) , increasing with duration of dust exposure (χ2trend=9.906, 10.118, P<0.05) .@*Conclusion@#The prevalence rate of CWP is not high, and closely related with duration of dust exposure and dust species. The prevalence of lower respiratory tract disease is higher in the tunneling and mining workers and raising with the duration of dust exposure.
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Objective To analyze the prevention value of endoscopic retrograde appendicitis treatment (ERAT) for postoperative infection of patients with appendicitis. Methods A total of 71 patients with acute appendicitis were selected and divided into two groups, 35 patients in the observation group were treated with ERAT, and 36 patients of the control group underwent laparoscopic appendectomy.The operation indicators, postoperative adverse events, pain scores, and levels of serum inflammatory factors were compared between the two groups. Results The observation group got a longer operation time, less bleeding, shorter in-bed and hospital stay, and lower hospital cost ( all P<0. 05). The main postoperative adverse event was recurrence in the observation group and infection in the control group, and the total adverse event rate was no significantly different between the two groups ( P>0. 05). Twelve hours after treatment, the pain score of the observation group was lower than that of the control group ( P<0. 05). The post-operational serum levers of hypersensitivity C reactive protein, interleukin 1β, interleukin 6, and tumor necrosis factor α decreased in both groups, while the serum levers of interleukin 4 and interleukin 10 increased, especially in the observation group ( all P<0. 05). Conclusion ERAT is more conducive to balance serum inflammatory factors and stabilize immune function compared with laparoscopic appendectomy, which can effectively prevent postoperative infection.
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Bloodstream infection is one of the leading causes of death worldwide. Rapid determination of the primary pathogen is crucial for diagnosis and antibiotic therapy of bacteremia. The application of Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) was a major breakthrough in microbiology. This technology is simple, rapid, economical and accurate, which has been introduced into the microbiology laboratory formicroorganism identificationwidely. Recently, MALDI-TOF MS was combined with extraction methods for direct pathogens identificationfrom positive blood cultures. The methods of pathogensextraction from positive blood cultures are crucial for the accuracy of identification. And developing a standard extraction protocolhas become a hot spot of research in recent years. (Chin J Lab Med, 2018, 41: 563-566)
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Objective@#To assess the clinical characteristics and identify the risk factors in the acute myocardial infarction (AMI) patients complicating with ventricular septal rupture (VSR).@*Methods@#A retrospective study was performed on 96 AMI patients complicating with VSR, who were hospitalized in the Second Xiangya Hospital of Central South University, Hunan Provincial Peoples′ Hospital, the First Affiliated Hospital of University of South China, the Second Affiliated hospital of University of south China, Xiangtan Central Hospital from December 2007 to May 2017. There were 46 females and the age was (66.2±10.7) years (from 43 to 90 years). Patients were divided into in-hospital survival group (n=64) and in-hospital death group (n=32). The 96 patients were also divided into the early death group (survived ≤2 weeks after admission, n=50) and non-early death group (survived>2 weeks after admission, n=46). Multivariate logistic regression was used to analyze the independent risk factors of the early death.@*Results@#Location of VSR was available in 71 patients, VSR was located at the apical or anterior septum near the apical region in 64.0% (32/50) patients with the anterior AMI, VSR was located at the posterior wall and basal inferior segment in 57.1% (12/21) patients with non-anterior AMI. Compared to the in-hospital survival group, patients in the in-hospital death group were older ((69.6±11.3) years vs. (64.6±10.1) years, P=0.031), incidence of non-ventricular aneurysm (71.9% (23/32) vs. 37.5% (24/64), P=0.001) and anterior AMI (84.4%(27/32) vs. 62.5%(40/64), P=0.028) was significantly higher in the in-hospital death group than in the in-hospital survival group. The comparison between the early death group and non-early death group showed that older age, female, no history of angina or myocardial infarction, Killip grade>Ⅲ, and non-ventricular aneurysm were related to increased risk of the early mortality in this patient cohort. Logistic regression analysis revealed that female (OR=5.109,95%CI 1.19-22.00, P=0.012), no history of angina or myocardial infarction (OR=23.34, 95%CI 3.44-158.37, P=0.001), Killip grade>Ⅲ(OR=5.35, 95%CI 1.26-22.66, P=0.019) and non-ventricular aneurysm (OR=6.30,95%CI 1.67-23.73, P=0.005) were independent risk factors for early death in this patient cohort.@*Conclusion@#The risk factors of in-hospital death include older age, non-ventricular aneurysm and anterior AMI. Female, no history of angina or myocardial infarction, Killip grade>Ⅲ and non-ventricular aneurysm are independent risk factors for the early death of AMI patients complicating VSR.
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Programmed cell death plays an important role in cardio protection, and Notch1 was an important factor related to programmed cell death. The role of Notch1 on ischemia myocardium remains unclear.H9C2 myocardial cells were cultured with routine medium, transfected with Notch1 over expression plasmid, Notch1-siRNA-overexpression plasmid and vehicle plasmid for further hypoxic experiment. Condition of hypoxic experiment was 1% oxygen centration and culturing for 12hours, then the cell proliferation activity and apoptosis rate was assessed by MTS kit and flow cytometry, respectively. The expressions of Caspase-3, Caspase-9 and Bcl-2 were determined by RT-qPCR and Western Blot, respectively. Compared with normoxia treatment, hypoxia could decrease H9C2 cell proliferation activity as well as Bcl-2 mRNA expression, and increase cell apoptosis rate as well as Caspase-3 and Caspase-9 mRNA expression. Notch1 activation could increase proliferation activity as well as Bcl-2 mRNA expression, while decrease apoptosis rate as well as Caspase-3 and Caspase-9 mRNA expression. Compared with Notch1 activation H9C2 cells, the opposite effect on programmed cell death was observed in cells with Notch1-siRNA-overexpression plasmid. Targeted activation of Notch1 gene to reduce hypoxia-induced programmed cell death in myocardial cells via up-regulating the expression of Caspase-3 and Caspase-9 and inhibiting the expression of Bcl-2
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Objective: To explore the risk factors for Type 1 cardio-renal syndrome (CRS1) atfer ST-segment elevation myocardial infarction (STEMI). Methods: A total of 378 patients with STEMI were divided into two groups: a CRS1 group (n=98) and a non-CRS1 group (n=280). Clinical characteristics in the 2 groups were compared, and independent risk factors for CRS1 after STEMI were analyzed, and the effect of emergency Results: In the 378 STEMI patients, CRS1 was found in 98 patients (25.9%). Between the 2 groups, there was significant difference in 12 parameters, including age, history of diabetes, admission mean arterial pressure, admission systolic blood pressure, admission heart rate, Killip classification, left ventricular ejection fraction, baseline serum creatinine, baseline evaluated glomerular ifltration rate (eGFR), emergency PCI, β-blockers and angiotensin converting enzyme inhibitor/angiotensin, receptor antagonist (ACEI/ARB) application (allP0.05). Conclusion: CRS1 is a common complication of STEMI, which is associated with many factors. Immediate revascularization can reduce the incidence of CRS1 in patients with ST-segment elevation myocardial infarction.
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Objecitve To investigate the changes of chronotropic response before and after percutaneous coronary intervention ( PCI)in patients with coronary disease .Methods A total of 339 patients with coronary disease was included in this study .All sub-jects underwent treadmill exercise test and coronary angiogram , and some patients underwent PCI if necessary .The parameters of chro-notropic response were recorded and analyzed , including ratio of the highest to predicted heart rates ( rHR) ,chronotropic response in-dex ( CRI) , and heart rate reserve ( HRR) .After coronary angiogram , the score of gensin was recorded and analyzed .Results There was significant difference in the parameter of CRI between unstable angina pectoris and silent myocardial ischemia groups ( P 40 ( t =2.567, 2.223, 2.062, all P <0.05).Conclusions Parameters (rHR, CRI, and HRR) had important clinical values in evaluating the changes of chronotropic response before and after PCI in patients with coronary disease with a negative correlation with the score of Gensin.
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China has entered the aging society , in urban communities and rural grassroots their are still many older people lack of health insurance , elderly patients with chronic diseases become the most difficult people to see a doctor, this needs to train more general practitioners to solve these problems .From a macroscopical view , general practitioners can bring substantial economic benefits and broad social benefits .From a microscopic view , they also can make effective use of family medical resources , bring convenient for old people going to a doctor and carry out an important role of health education .Improving the General Practitioner -Elderlyservice mode , the govern-ment needs to further improve the elderly medical service system and security system , vigorously promote grass -roots community health service institutions of medical conditions , develop specialized general medical personnel ac-cording to the needs of the elderly , implement contractual service relationships between general practitioners and the elderly.
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OBJECTIVE@#To estimate the therapeutic effect and safety of intra-aortic balloon pumps (IABP) in patients with serious cardiovascular diseases.@*METHODS@#We retrospectively analyzed the clinical data of 68 patients with serious cardiovascular diseases, who were enrolled in Hunan Provincial People's Hospital between 2009 and 2011. All patients received IABP support. The systolic blood pressure, diastolic blood pressure,heart rate, N-terminal precursor of brain natriuretic peptide (NT-proBNP), and renal function of all patients were determined before and after the IABP. Cardiac events and mortality were observed after IABP support.@*RESULTS@#The disease in 51 patients improved after IABP support. The systolic blood pressure, diastolic blood pressure,heart rate, and NT-proBNP were significantly lower than those before the IABP. Thirty-seven patients with acute myocardial infarction successfully completed percutaneous coronary intervention surgery after the IABP support. Five patients had IABP-related complications, but no serious complication occurred.@*CONCLUSION@#IABP is an effective and safe procedure for critical cardiovascular patients. IABP should be applied early for the patients with appropriate indications.
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Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cardiomiopatías , Cirugía General , Terapéutica , Enfermedad Crítica , Contrapulsador Intraaórtico , Métodos , Infarto del Miocardio , Cirugía General , Terapéutica , Estudios RetrospectivosRESUMEN
Objective To observe the changes of the heart rate turbulence(HRT)in patients with isolated systolic hypertension(ISH).Methods 85 patients with ISH,80 patients with common hypertension and 58 control subjects were investigated.Turbulence onset(TO)and turbulence slope(TS)were recorded of 24 hours dynamic electrocardiogram.Results The difference of HRT in the three groups was significant(P<0.01).The values of TO and TS was significantly higher in common hypertension group and ISH group than in control group(P<0.05);TS was significantly lower in ISH group than in common hypertension group(P<0.05),but the difference of TO between ISH group with common hypertension group was not obvious.Conclusion The HRT in patients with primary hypertension is significantly lower,which is more significant in patients with ISH than in patients with common hypertension.It suggests that the cardiac autonomic nerves dysfunction perhaps has an important influence on development of hypertension and its prognosis.