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Objective To evaluate the impact of customized rehabilitation exercise plans based on the results of cardiopulmonary exercise test(CPET)on cardiac function and prognosis in patients with chronic heart failure(CHF).Methods A total of 52 CHF patients admitted to Chengde Central Hospital from February 2020 to September 2021 were selected as the study subjects,and the patients were divided into observation group and control group according to the principle of randomized controlled study,with 26 cases in each group.The control group received rehabilitation treatment excluding exercise.The observation group was given routine rehabilitation treatment and high-intensity rehabilitation exercise plans based on CPET guidance.Above anaerobic threshold Δ50%power was exercise intensity,exercise time was 30 minutes/day,4 days/week,and intervention period was 12 weeks.Before and 12 weeks after intervention,CPET functional indicators,serum brain natriuretic peptide(BNP),left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),and 6-minute walking distance(6MWD)were measured.The Minnesota CHF quality of life questionnaire(LiHFe)was used to evaluate patient's quality of life,readmission rate and cardiogenic mortality within 1 year of follow-up,and univariate and multivariate Logistic regression analysis was used to analyze factors affecting readmission of CHF patients.Results ① Cardiopulmonary function indicators:there was no statistically significant difference in the anaerobic threshold,peak oxygen uptake,and peak oxygen pulse of CPET functional indicators before and after intervention in the control group,after intervention,the CPET functional indicators in the observation group were significantly higher than those before intervention,and the above indexes in the observation group were significantly higher than those of the control group[anaerobic threshold(mL·min-1·kg-1):10.77±1.40 vs.9.59±1.11,anaerobic threshold(%ped):78.95±11.39 vs.70.09±6.48,peak oxygen uptake(mL·min-1·kg-1):15.63±1.36 vs.14.27±1.72,peak oxygen uptake(%ped):72.42±6.91 vs.63.41±7.31,peak oxygen pulse(mL/order):11.38±1.29 vs.9.05±1.64,peak oxygen pulse(%ped):90.23±10.16 vs.80.53±6.73,all P＜0.05].②Serum indicators,cardiac function indicators,exercise ability indicators,and quality of life evaluation:there was no statistically significant difference in serum indicators BNP,cardiac function indicators LVEDD,LVEF,exercise ability indicators 6MWD,and quality of life LiHFe scores between the two groups before intervention.After intervention,BNP and LiHFe scores were significantly reduced compared with before intervention,while LVEF and 6MWD were both increased compared with before intervention,and the changes of the above indexes in the observation group were more significant than those in the control group[BNP(ng/L):313.25±77.91 vs.445.89±110.67,LVEF:0.41±0.08 vs.0.37±0.06,6MWD(m):495.62±91.35 vs.416.04±65.29,LiHFe score:23.27±6.02 vs.29.50±4.61,all P＜0.05].③ Prognostic follow-up:the readmission rate within 1 year in the observation group was significantly lower than that in the control group(23.08%vs.53.85%),and there was no statistically significant difference in the mortality rate of cardiogenic diseases between the two groups.④Logistic univariate analysis showed that hyperlipidemia,New York Heart Association(NYHA)grading,BNP,and rehabilitation exercise were factors that affect the prognosis of CHF patients[odds ratio(OR)and 95%confidence interval(95%CI)were 0.098(0.019-0.494),0.069(0.016-0.294),1.018(1.007-1.029),and 3.889(1.178-12.841),respectively,all P＜0.05].Multivariate analysis showed that after adjusting for other factors,hyperlipidemia,NYHA grading,and BNP were risk factors affecting the prognosis of CHF patients(OR and 95%CI were 0.068(0.007-0.687),0.048(0.005-0.415),1.016(1.002-1.030),respectively,with P＜0.05],the use of rehabilitation exercise therapy was a protective factor affecting the prognosis of CHF patients[OR and 95%CI were 11.179(1.135-10.124),P＜0.05].Receiver operator characteristic curve(ROC curve)analysis showed that hyperlipidemia,NYHA grading,BNP,rehabilitation exercise therapy,and combined testing all had predictive value for the patient's prognosis(all P＜0.05),and the prediction value of joint detection was the highest,with the area under the ROC curve(AUC)=0.984 and P = 0.000.Conclusion Developing a high-intensity individualized cardiac exercise rehabilitation plan under the guidance of CPET can help improve the cardiopulmonary function,cardiac function,and quality of life of CHF patients,which is of great benefit for improving the long-term prognosis of CHF patients and has high safety.
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Objective:To evaluate the effects of GSK484 on ventilator-induced lung injury (VILI) and neutrophil extracelluar traps (NETs) in mice.Methods:Forty-eight SPF healthy male C57BL/6 mice, aged 5-6 weeks, weighing 15-20 g, were divided into 4 groups ( n=12 each) by a random number table method: spontaneous breathing group (group S), spontaneous breathing+ GSK484 intervention group (group SG), VILI group (group V), and VILI + GSK484 intervention group (group VG). The animals kept spontaneous breathing for 4 h after tracheal intubation in S and SG groups. The animals were mechanically ventilated for 4 h (tidal volume 30 ml/kg, respiratory rate 75 breaths/min, inspiratory/expiratory ratio 1∶2, positive end-expiratory pressure 0 mmHg, fraction of inspired oxygen 21%) in V and VG groups. At 3 days before developing the VILI model, GSK484 4 mg/kg was intraperitoneally injected once a day in SG and VG groups, while the equal volume of normal saline was given instead in S and V groups. Blood samples were collected from the abdominal aorta for blood gas analysis at 4 h of spontaneous breathing or mechanical ventilation, and PaO 2 was recorded. The mice were then sacrificed and bronchoalveolar lavage fluid (BALF) was collected and lung tissues were obtained for microscopic examination of the pathological changes (with a light microscope after HE staining) which were scored and for determination of wet to dry weight ratio (W/D ratio), concentrations of interleukin-1beta (IL-1β), IL-6, tumor necrosis factor-alpha (TNF-α) and myeloperoxidase (MPO) in BALF (by enzyme-linked immunosorbent assay), expression of peptidylarginine deiminase 4 (PAD4), neutrophil elastase (NE), high mobility group box 1 (HMGB1) and citrullinated-histone 3 (Cit-H3) in lung tissues (by Western blot). Results:Compared with S and SG groups, the lung injury score and W/D ratio were significantly increased, PaO 2 was decreased, concentrations of IL-1β, IL-6, TNF-α and MPO in BALF were increased, and the expression of PAD4, NE, HMGB1 and Cit-H3 in lung tissues was up-regulated in V and VG groups ( P<0.05). Compared with group V, the lung injury score and W/D ratio were significantly decreased, PaO 2 was increased, the concentrations of IL-1β, IL-6, TNF-α and MPO in BALF were decreased, and the expression of PAD4, NE, HMGB1 and Cit-H3 was down-regulated in group VG ( P<0.05). Conclusions:GSK484 can alleviate VILI in mice, and the mechanism is associated with inhibition of PAD4, reduction of the production of NETs and attenuation of inflammatory responses in lung tissues.
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Objective To investigate the clinical diagnosis value of interferon gamma release assay (IGRA ) for pleural effusion in patients with tuberculous pleurisy .Methods 68 patients with tuberculous pleurisy (tu-berculous group) were included as object of study in Ganzi state people′s hospital ,and selected 70 patients with pneumonic pleurisy(pneumonia group) and 70 patients with malignancy (malignant group) as controls . Enzyme linked immunosorbent assay (ELISA) was used to detect interferon gamma release assay for tubercu-losis infected T cells (TB-IGRA ) in pleural effusion ,and were in progress blood TB-IGRA for tuberculous group .Results The IFN-γ level of patients in tuberculous group[179 .3(158 .1 -276 .2)ng/L] was higher than that those in pneumonia group[86 .7(55 .1 -162 .2)ng/L] and malignant group[92 .7(48 .1 -178 .3) ng/L] ,the difference was statistically significant (P＜0 .05) .The IFN-γ level of TB-IGRA for blood was low-er than that TB-IGRA for pleural effusion ,the difference was statistically significant (P＝0 .012) .The sensi-tivity ,specificity ,positive predictive value ,and negative predictive value of TB-IGRA for pleural effusion high-er than that blood TB-IGRA ,the difference was statistically significant (P＜0 .05) .The AUC of TB-IGRA for pleural effusion was higher than that blood TB-IGRA .Conclusion TB-IGRA for pleural effusion is an impor-tant laboratory index for the diagnosis of tuberculous pleurisy ,and its diagnostic efficiency is higher than that of blood TB-IGRA .
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Objective To investigate the expression of oxidative stress related factors,such as,superoxide dismutase (SOD),heme oxygenase-1 (HO-1),malondialdehyde (MDA) and 8-hydroxy-2'-deoxyguanosine (8-OHdG) in patients with idiopathic membranous nephropathy (IMN) and explore the possible role of oxidative stress in the pathogenesis of IMN.Methods Serum,urine and renal tissue of 40 patients with IMN,20 patients with secondary membranous nephropathy (SMN),and 20 patients with minimal change nephropathy (MCD) were collected from the nephrology department of the First Affiliated Hospital of Zhengzhou University.All of them were diagnosed by renal biopsy from January 2016 to June 2016.Serum,urine and renal tissue of 20 healthy persons were collected as the normal control (NC).The expressions of SOD,HO-1,and 8-OHdG in renal tissues were detected by immunohistochemistry.The levels of SOD,HO-1,MDA and 8-OHdG in serum and urine specimens were detected by ELISA.The relationship between oxidative stress related factors and proteinuria in IMN was investigated as well.Results The expressions of SOD,HO-1 and 8-OHdG were significantly higher than those in MCD group and NC group in renal tissue;the expression of SOD in IMN group was significantly higher than that in MCD group and NC group in serum (all P ＜ 0.01).The expressions of HO-1,MDA and 8-OHdG in the serum and urine of the IMN group were significantly higher than those of the MCD group and the NC group (all P ＜ 0.05).There was a significant positive correlation between the urine expression of 8-OHdG and MDA and proteinuria in the IMN group.Conclusions Oxidative stress-related factors in IMN patients are elevated,which is closely related to clinical manifestations.In that sense,it is confirmed that oxidative stress is involved in the pathogenesis of IMN.
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Objective: To explore the application value on combined examination of blood levels of growth differentiation factor-15 (GDF-15) and NT-pro B-type natriuretic peptide (NT-proBNP) in patients after successful cardiopulmonary resuscitation (CPR) for their recent prognosis. Methods: A total of 102 patients with sudden cardiac arrest and successful CPR in our hospital were enrolled. Blood levels of GDF-15 were examined at immediately, 12 h and 24-48 h after CPR respectively. According to GDF-15 levels, the patients were divided into 3 groups: Group A, the patients with GDF-151200 ng/L at all-time points,n=35; Group C, GDF-15 level consistently increasing at 12 h and 24-48 h after CPR, while it was lower at 24-48 h than 12 h after CPR,n=36. Blood levels of NT-proBNP and left ventricular ejection fraction (LVEF) were also examined. The patients were followed-up for 6 months for post-CPR death. Results: Blood levels of GDF-15 and NT-proBNP were related, NT-proBNP level was changing with GDF-15 varying. GDF-15 and NT-proBNP level was negatively related to LVEF (r=-0.530,P1800 ng/L and NT-proBNP>400 pg/ml had the higher mortality than those had the lower levels of GDF-15 and NT-proBNP,P0.05. Conclusion: Combined examination for blood levels of GDF-15 and NT-proBNP may better predict the recent prognosis in patients who received CPR.
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Objective: To explore the relationship between plasma level of B-type natriuretic peptide (BNP) and short term prognosis in patients of sudden cardiac arrest with successful cardiopulmonary resuscitation (CPR). Methods:A total of 60 relevant patients were divided into 3 groups based on their plasma levels of BNP. Group A, the patients with plasma level of BNP 200 pg/ml , n=22. Group C, the patients with obviously increased BNP at 3 hours after CPR, while at 12-24 hours after CPR, BNP level decreased to lower than 3 hours level,n=22. All patients were followed-up for 6 months to compare the mortality incidence among different groups. Results: There was no patient died in Group A, the mortality incidence in Group B was 11 and in Group C was 3. The 6 months survival rate in Group A was higher than that in Group B (χ2 = 11.337,P=0.001), the survival rates were similar between Group A and Group C (χ2 = 2.330,P=0.127), and the survival rate in Group B was lower than that in Group C (χ2=7.435,P= 0.006). Conclusion: Consistently increased plasma level of BNP may imply heart failure in patients of sudden cardiac arrest with successful CPR, those patients could have poor short term prognosis. It is critical to improve the cardiac function and increase the important organ infusion to make better recent clinical prognosis.
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To compare vertical changes occurring in Class I patients after orthodontic treatment with different extraction patterns in a retrospective study. Records of 47 patients with extraction of maxillary first premolars and mandibular second premolars [4/5, Group A] and 46 patients with extraction of fourth first premolars [4/4, Group B] were obtained in the Orthodontic Department, West China Hospital of Stomatology, Chengdu, Sichuan, China from April 2008 to July 2012. Pretreatment and posttreatment cephalograms were digitized, 8 skeletal and 10 dental cephalometric measurements were selected to evaluate vertical changes. Changes of measurements resulting from orthodontic treatment in each group were compared by paired t-test; changes between 2 groups were compared by Independent t-test. Before treatment, subjects in Group A showed larger angle formed by the intersection of NA and NB lines, overjet, and overbite than those in Group B. After treatment, both groups showed significant vertical changes after orthodontic treatment without remarkable differences between groups. No differences of vertical change were found between the 2 extraction patterns. The hypothesized wedge effects due to mesial movement of posterior teeth might be balanced by the extrusion of posterior teeth as well as the residual growth potentials
Assuntos
Humanos , Cefalometria , Extração Dentária , OrtodontiaRESUMO
Objectiye To reveal epidemiology of malignant tumor in Quanzhou area of Fujian province. Methods Medical record of adults who received health check-up between 2006 and 2010 was collected to estimate the incidence of malignant tumor. Chi-square test was used for data analyses.Results Nearly 12 323 individuals received an annual health check-up during 2006 and 2010,177 of whom were found to have malignant tumors. The identification rate of malignant tumors was 2. 87‰ per year, and the most commonly seen cancer included liver cancer ( 42. 93% ), lung cancer ( 20. 90% ), oesophageal cancer (9. 03% ), cervical cancer ( 8.47% ) and gastric cancer (6. 78% ). Those of 60 to 70 years old showed the highest incidence of cancer. Conclusion Annual health check-up may be helpful to identify early-stage malignant tumors.
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Objective To explore the effect of collagen membrane combined with recombinant human bone morphogenetic protein-2(rhBMP-2) on periodontal tissue regeneration and repair in periodontal defect models of rats.Methods Eighteen male healthy Wistar rats,which were made experimental periodontal bone defects in the inferior incisors,were randomly divided into three groups:control group,collagen membrane group(Co),collagen membrane and rhBMP-2 group(Co/rhBMP-2).Two rats from each group were sacrificed at 4,6,8 weeks after operation.The mandibles were removed,and examined under light microscope.Results In Co/rhBMP-2 group: 4 weeks after operation,a large amount of bone formed in the defects;6 weeks later,new bone filled in the defects;8 weeks later,alveolar bone emerged,newly-formed periodontal ligament and cementum localized at the root edges,no gingival epithelium was observed.In Co group:4 weeks after operation,new bone formed at the edge of the defects;6 weeks later,a larger amount of bone and periost were observed;8 weeks later,a small amount of periodontal ligament and cementum localized at the root edges.In control group: 4 weeks after operation,there was a small amount of newly-formed bone at the edge of the defects;6 weeks later,collagen fibers were found at the edge of defects;8 weeks later,a small amount of periodontal tissue reached its original height and gingival epithelium proliferated obviously.Conclusion Collagen membrane combined with rhBMP-2 which has not only conductive effect but also effect of osteoinduction,can prevent the long-epithelium growing,maintain the growth gap,and promote periodontal tissue to regenerate.
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The transdermal enhancement of ultrasound was discovered 50 years ago.The advantages of low-frequency ultrasound in enhancing the transdermal transport of molecule were discovered in 40 years' study.Because the cavitation is easier to happen in lower frequency ultrasound,the transdermal enhancement of low-frequency ultrasound is higher.The inertial cavitations near the surface of skin play important roles in the transdermal enhancement of low-frequency ultrasound.There are many studies about the effects of the parameters of ultrasound on the transdermal enhancement of low-frequency ultrasound,but there are fewer studies about the effects of other factors.The transdermal enhancement of low-frequency ultrasound has been used for transdermal drug delivery.There are many studies about the transdermal monitoring of glucose and other analytes using low-frequency ultrasound.Many opportunities and challenges lie ahead.
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Objective In order to enhance the use-rate and avoid the harmness of AODAN4 electrosurgical generator,the principle and safe usage are introduces.Methods Two working modes and instructions were illustrated.Results AODAN4 electrosurgical generator is an all-purpose surgical equipment,which is especially suited for oral soft tissue.Conclusion AODAN4 electrosurgical unit is well worth using widely in clinic with many obvious advantages.