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Objective·To analyze and explore the influencing factors that lead to cognitive deterioration in individuals with elevated fasting blood glucose(FBG)and the metabolic clues associated with changes in the risk of cognitive deterioration.Methods·Data from the Alzheimer's Disease Neuroimaging Initiative(ADNI)database were downloaded,and the samples with FBG and follow-up data were selected from the database.Clinical information,including age,gender,body mass index,education years,apolipoprotein E4(APOE4)genotype and race,and corresponding metabolic indicator data,including amino acids,fatty acids,proteins and others were obtained.Based on the FBG levels and diagnosis of cognitive impairment stages in Alzheimer's disease,the subjects were categorized into four groups:normal FBG without/with cognitive deterioration,and elevated FBG without/with cognitive deterioration.The univariate analysis method,the Cox proportional hazards model,orthogonal projections to latent structures discriminant analysis(OPLSDA),and Spearman correlation analysis were employed for data analysis.Results·A total of 1 317 subjects were included,among which 1 153 had normal FBG level(>3.9 mmol/L and<6.1 mmol/L)and 164 had elevated FBG level(≥6.1 mmol/L).In the normal FBG group,275 subjects showed cognitive deterioration,while in the elevated FBG group,53 subjects showed cognitive deterioration.Univariate analysis revealed significant differences in gender and race between the normal FBG and elevated FBG group,and significant differences in age,gender,and APOE4 genotype between the groups with and without cognitive deterioration(all P<0.05).Cox regression analysis indicated that primary influencing factors for cognitive deterioration were APOE4 positivity,elevated FBG,and increasing age in order(HR=2.22,HR=1.38,HR=1.02;all P<0.05).In the analysis of baseline metabolic indicators in the groups without and with cognitive deterioration,as well as metabolic indicators before and after cognitive deterioration at different FBG levels,the results of the analysis of variance revealed that in the cognitively deteriorated population,the ratio of phospholipids carried by high-density lipoproteins(HDL)to total lipids was significantly higher;low-density lipoprotein(LDL)particle concentration and the lipids carried by LDL were significantly higher after cognitive deterioration.Correlation analysis showed that valine and leucine were significantly correlated not only with FBG level but also with phosphorylated tau(pTau)level in the plasma in the cognitively deteriorated population.Cholesterol and the ratio of phospholipids to total lipids carried by HDL were significantly correlated with pTau levels in cerebrospinal fluid(CSF).Conclusion·Compared to the individuals with normal FBG level,those with high FBG level have a significantly higher risk of cognitive deterioration.Additionally,different metabolic indicators show significant differences between the groups without and with cognitive deterioration,as well as metabolic indicators before and after cognitive deterioration at different FBG levels.Overall,LDL and its lipid content,and HDL-carried phospholipids show an increasing trend during cognitive deterioration,and the branched-chain amino acids valine and leucine are significantly correlated with pTau levels in CSF and plasma,suggesting that these metabolic markers may play an important role in cognitive deterioration.
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Objective:To retrospectively analyze the clinical and serological characteristics in rehabilitated patients with common novel coronavirus pneumonia(COVID-19).Methods:A total of 165 patients with common COVID-19 were enrolled in this retrospective study, in which clinical data was collected from February 23 to March 15, 2020 in Leishenshan Hospital(Wuhan, China). The patients with COVID-19 were divided into elderly group and non-elderly group according to their age, and the differences in the clinical and serological metabolic characteristics between these two groups were analyzed.Results:49.7% patients were over 60 years old. The most common clinical symptoms were fever, cough, and fatigue, followed by muscle soreness. Expectoration and digestive tract symptoms were rare. Dyspnea occurred more frequently in the elderly group than in non-elderly group(47.56% vs 25.30%, P<0.01). Hypertension was the most common concomitant disease(accounting for 29.1%)followed by diabetes. Hypertension was more common in the elderly group than in non-elderly group(41.46% vs 16.86%, P<0.01), but without significant difference in diabetes between the two groups. The counts of leukocytes and lymphocytes in all patients were in the normal range, and no difference was observed between the groups. The comparison of serological indicators showed that serum creatinine in the elderly group was higher than that in the non-elderly group( P<0.01)while serum albumin, glomerular filtration rate, and serum calcium were lower in the elderly group. After serum albumin correction, the levels of albumin corrected calcium in all patients were in the normal range, without significant difference between these two groups. There was no significant difference between the two groups when the length of hospital stay was taken as the index of outcome [(34.01±10.24) vs(30.97±10.51)d, P>0.05]. Conclusion:Fever, cough, and fatigue are the most common clinical symptoms in patients with ordinary COVID-19. The elderly are more likely to develop dyspnea. The blood routine and metabolic characteristics in patients with common COVID-19 are normal, but serum albumin level is more likely to decrease in elderly patients with COVID-19.
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Objective To investigate the expression of circular RNA (circRNA) in peripheral blood of gravidas with gestational diabetes mellitus (GDM) using gene chip technology, and to provide evidence for studying pathogenesis of GDM. Methods A prospective cohort-based nested case-control study was used to select 1 018 pregnant women who were examined and delivered in Guangzhou Women and Children's Medical Center from September 2014 to April 2016. The information of prenatal examination was recorded and the outcome of delivery was followed up. Six pregnant women diagnosed as GDM were selected as the GDM group. Six normal pregnant women who were collected blood samples by 1 ∶ 1 were selected as the control group. The difference of gestational week was less than 7 days, the number of previous pregnancies was less than 2 times, and the difference of previous delivery times as same as the control group. The expression of circRNA in maternal peripheral blood was analyzed by chromosome microarray technique, and the function and the regulation network forecast were analyzed by GO (http://www.geneontology.org/), KEGG PATHWAY (http://www.genome.jp/kegg/pathway.html) and CircNet(http://circnet.mbc.nctu.edu.tw/). t-test was used for data analysis. ResuLts Compared to the normal pregnant women, 2 678 circRNAs were identified to be differentially expressed >2.0 times in GDM women, among which 1 532 were up-regulated and 1 146 were down-regulated. Functional analysis showed that the up-regulated circRNA was enriched in the biological processes of insulin response, gene silencing regulation, glucagon response and cell senescence. Signal pathway analysis showed that circRNA involved in insulin pathway. Taking has_circ_0042852 and has_circ_0004001 as center, the possible GDM-related regulatory networks were predicted. ConcLusions The peripheral blood of GDM women is rich in circRNAs, which might involve in many biological processes, insulin signaling pathway and possibly induding GDM-related regulatory networks.
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The changes of carotid intima media thickness (cIMT) in type 2 diabetic patients with vitamin D insufficiency and subclinical macrovascular disease after 12 months' intervention therapy with calcitriol were observed.86 patients with vitamin D insufficiency [25 (OH) D＜30 ng/ml] and subclinical macrovascular disease were randomized to group A (n =44,treated with 0.5 μg/day calcitriol) or group B (n =42,blank control) for 12 months.40 patients in each group completed the follow up.After 12 months of therapy with calcitriol (0.5 μg.qd.po.),levels of high sensitive-Creactive protein,sCD36,and cIMT were significantly decreased,while 25 (OH) D and ankle brachial index were significantly increased (P＜0.05) in group A,suggesting that calcitriol could improve cIMT in patients with vitamin D insufficiency and subclinical macrovascular disease.
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Objective:To explore therapeutic effect of rehabilitation intervention on patients with diabetes mellitus (DM)complicated tuberculosis (TB).Methods:A total of 108 DM + TB patients treated in our hospital from Jan 2008 to Aug 2013 were enrolled.According to random number method,they were randomly and equally divided into rehabilitation intervention group and routine treatment group.The intervention course was eight weeks,and then rehabilitation effect was compared between two groups.Results:Compared with before treatment,after treatment, there were significant reductions in fasting blood glucose (FBG)and 2h postprandial blood glucose (2hPBG)in both groups,P <0.01 all;compared with routine treatment group,after treatment,there were significant reductions in levels of FBG [(6.77±1.82)mmol/L vs.(5.54±1.46)mmol/L]and 2hPBG [(7.94±1.83)mmol/L vs.(6.87 ±1.42)mmol/L],P <0.01 both,and significant rise in percentages of significant reduced or disappeared pleural effusion (51.85% vs.83.33%)and significant reduced or closed TB focus (44.44% vs.72.22%)in rehabilitation intervention group,P <0.01 both.Conclusion:Rehabilitation intervention can make patients get better control of blood glucose,promote absorption of pleural effusion and pulmonary tuberculosis focus.
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Objective To evaluate the levels of high-sensitivity-CRP(hs-CRP),interleukin-10(IL-10) in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS).Methods Fifty cases with obstructive sleep apnea-hypopnea syndrome from Jul.2012 to Dec.2013 in the People's Hospital of Pudong New Area were selected as our subjects,of which,22 patients were with mild-moderate OSAHS and 28 patients were with severe OSA.Twenty-seven health people were served as control group.The levels of hs-CRP,IL-10 were measured.Information of sleep study and other clinical characteristics were collected.Results There were no significant differences in terms of age,hip circumference and waist-to-hipratio (WHR) among three groups (P ＞0.05).Body mass index (BMI),neck circumference,waist circumference,Apnea-Hypopnea Index (AHI),the lowest arterial oxygen saturation(SaO2％) and hs-CRP in mild,severe OSA and control group were (28.01 ±3.41),(28.55±2.87) and (5.51±3.28) kg/m2,(41.18±4.37),(41.46±3.32) and (38.76±2.66) cm,(101.86±8.05),(102.32±7.97) and (94.56±10.25) cm,(44.55±16.26),(10.54±7.08) and (2.02 ±1.51) time/h,(85.05±6.40)％,(72.85±15.07)％,(88.59±3.43)％,(8.35±2.71),(9.19±2.85),(7.06 ± 1.30) mg/L,and the differences were significant(P＜0.05).In patients with OSA,SaO2％ was related to BMI (r =-0.274,P =0.027) and AHI (r =-0.651,P ＜ 0.001).Level of hs-CRP was associated with AHI (r =0.336,P =0.006) and BMI (r =0.247,P =0.047),and weakly associated with IL-10 concentrations.Conclusion Levels of hs-CRP is an important inflammation marker of OSAHS severity.However,levels of IL-10 shows an increasing in mild-moderate OSA patients,then decreasing in patients with severe OSA.
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Objective To approach the effect of hyperglycemia on admission on the prognosis in female pa-tients with acute myocardial infarction (AMI) during hospital stay. Methods 171 female AMI patients without a history of diabetes mellitus from January 1998 to December 2007 were divided into 3 groups according to the blood glucose level on admission. Group Ⅰ included 69 cases with blood glucose <6. 1 mmol/L,group Ⅱ included 49 cases with blood glucose between 6.1 and 7.8 mmol/L,and group Ⅲ included 53 cases with blood glucose >7.8 mmoL/ L. The basic clinical profile, infarct sites, the incidence rates of the main complications and the mortality of the pa-rhythmia among group Ⅲ ,group Ⅰ and group Ⅱ were significantly different ( the incidence rate of cardiac failure was 30.43% (21/69) ,32.65% (16/49) and 58.49% (31/53), the incidence rate of cardiogenic shock was 5.80% (4/69) ,8.16% (4/49) and 24.53% (13/53) ; the incidence rate of severe arrhythmia was 24.64% (17/69) ,30. 61% (15/49) and 54.72% ( 29/53), respeetivley in group Ⅰ, group Ⅱ and group Ⅲ, P < 0.05 for each). The in-hospital mortality in group Ⅲ (28.30% (15/53) ) was remarkably higher than group Ⅰ ( 13.04% (6/69)) ,with significant difference ( P < 0.05 ). Conclusions Elevated blood glucose level on admission is associated with s markedly increased risk of cardiac failure,severe arrhythmia,cardiogenic shock and mortality during hospital stay in female patients suffering from AMI.
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Objective To evaluate therapeutic roles of parenteral and enteral nutrition in patients with dysphagia complicating stroke. Method Seventy-two patients with dysphagia after stroke were randomly divided into group A (parenteral and enteral nutrition in sequence) and group B (parenteral nutrition) who were respectively given nutritional support 48 hours after the illness,measured hospital nutrition parameters,and observed the incidence rate of complications including tympanites,diarrhea and stress-induced ulcer,aspiration pneumonia.Death rate were compared between two groups at the end of the third week after admitted in hospital. Results Nutrition parameters in group A were higher than that in group B.There was significant difference (P0.05). Conclusion Parenteral and enteral nutrition in sequence for patients with dysphagia after stroke are safe and effective.
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Objective:To assess the therapeutic effects and adverse reactions of MS Contin in the treatment of acute myocardial infarction (AMI). Methods: 42 AMI patients were divided into experiment group and control group. Experiment group were given oral administration of MS Contin for 1 week besides the routine treatment of AMI for patients in the control group. Results: Between the two groups, the differences in the product of heart rate and blood pressure ( HR?BP) , the frequency of angina pecto-ris attack, the recovery time of the ST segment and the incidence of acute arrhythmia were significant. The most common side effects observed were: vomiting, constipation, hallucination, and the most severe toxic side effect was respiratory inhibition. Conclusion : In the treatment of AMI, MS Contin could relieve the pain effectively, reduce the incidence of angina pectoris attack and severe arrhythmia, decrease myocardial oxygen consumption, have tolerable side effects in the majority of patients. It is preferable to use MS Contin as a concurrent treatment of AMI.
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OBJECTIVE: To investigate the therapeutic mechanism of tetromethylpyrazine and aminoguanidine on diabetic nephropathy. METHODS: Diabetic rats were induced by streptozotocin. They were divided into 5 groups: normal control group (group C), untreated diabetic group (group DM), tetromethylpyrazine treated group (group TMP), aminoguanidine treated group (group AG) and tetromethylpyrazine and aminoguanidine treated group (group TMP+AG). The expression of vascular endothelial growth factor (VEGF) in renal cortex of the rats in each group was observed by immunohistochemical staining after 12 weeks. RESULTS: The expression of VEGF in renal cortex of the rats in group TMP+AG and group C was alike. The expression of VEGF in renal cortex of group TMP and group AG decreased significantly as compared with that of group C, but was still above normal level. CONCLUSION: The therapeutic mechanism of tetromethylpyrazine and aminoguanidine on diabetic nephropathy may be inhibiting the over-expression of VEGF in kidney of diabetic rats.
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In terms of technology,modern development of a hospital is increasingly reliant on the update of medical equipment,the fixed assets of which have now taken up 50%～70%of the total,increasing from 20～30% formerly.It is not unusual that a hospital promotes the overall level of technology in one aspect through introducing an advanced equipment.So the revenue brought by the adoption of medical equipment has increased inevitably,and will keep the trend with more momentum.Therefore,it is becoming more and more important to do the maintenance of the equipment well.This article presents the requirements,goal and procedure of enterprise-pattern management of medical equipment in a hospital and makes exploration in the field of hospital modern management concerning medical equipment.
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Purpose: The clinical effects of scalp acupuncture in treating infantile cerebral palsy were observed. Methods: Forty-five patients were treated by scalp acupuncture, functional exercise, intravenous drip,and parents' instructive training. Results: Basic recovery occurred in 4 cases, marked effectiveness in 21 cases and effectiveness in 15 cases. The total effective rate was 88.9%. The shorter duration and the longer course were,the better curative effects got. Conclusion: A combined treatment of scalp acupuncture, physiotherapy and intravenous drip can markedly improve clinical symptoms, signs, and intelligence in children with cerebral palsy.
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Objective: To investigate the dynamic changes in the content of endothelin(ET) in the plasma of coronary heart disease(CHD) patients and the relationship between myocardial function and ET.Methods: The plasma ET levels of 62 CHD patients were measured by immunoradiometric assay(IRMA) at 12 h,24 h,48 h,96 h and 7 d after the attack of CHD.The left ventricular ejection fraction(LVEF) was detected by echocardiography and the cardiac function was assessed according to the NYHA classification criteria.Results: The plasma ET level was significantly higher in the CHD patients than in the healthy controls(P
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Objective:Atrioventricular nodal reentrant tachycardia(AVNRT) is a common type of arrhythmia,for which radiofrequency ablation(RFCA) is the first therapeutic option.This study is to investigate the causes of 16 cases of temporary atrioventricular block(AVB) during RFCA and 2 cases of permanent AVB after RFCA in common and refractory AVNRT.Methods: We performed RFCA for 77 AVNRT patients by gradually increasing the ablation time,energy and frequency.Generally we chose the lower zone as the first position of ablation and,if invalid,moved the catheter gradually up to the middle or upper zone.Then we analyzed the correlation of AVB with A/V and H-wave in different positions.Results: The AVB risk was increased with the upward movement of the ablation zone and increase of A/V or H-wave(P 0.05). Conclusion: The method of gradually increasing the ablation time,energy and frequency can prevent temporary from permanent AVB.In the common AVNRT group,the middle and lower zone ablation,the multiple-peak A wave,small A wave and big V wave(A/V ≤ 0.45?0.37) with no H wave or H≤0.003?0.01 mV could significantly decrease the risk of RFCA related AVB,but the risk of AVB remains among the refractory AVNRT patients with CSO abnormality or expansion,even if with ablation in the lower zone.
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The placement of stent in coronary artery reduces the restenosis rate of percutaneous transluminal coronary angioplasty(PTCA),but the restenosis has perplexed us so far. May be a novel drug coated stent will bring us a new hope in the coming years.
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Cardiac complications(cerebral-cardiac syndrome) very often induced by acute traumatic brain injury include abnomal ECG, decreased myocardial contractile function, increased myocardial enzymes and pathological changes etc. In order to better understand the cerebral-cardiac syndrome related to the traumatic brain injury, the major clinical features, mechanism and clinical significance are reviewed.
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Through G protein coupling and intracellular signal transmission, opioid peptides and its receptors in myocardial tissues participate in IPC have the function of early and delayed protection. The molecular mechanism of ”trigger-regulatory medium-effector” is of great significance in the study of the pathogenesis of IPC, as well as exploring the new idea for CHD prevention and cure.
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100 U/L were higher than those in group of CK-MB≤100 U/L(P
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Objective:To investigate the couse of 24 cases AVB during RFCA and 5 cases after RFCA in total 94 AVNRT patients. Methods:94 AVNRT patients received RFCA in which time, the energy and power were gradually discussed. The correlation among AVB and both different anatomical positions (upper, middle and lower zone) and A/V, H-value in intraventricular ablation mapping were studied respectively. Results: With the elevation of ablation zone, the AVB risk was also increased. The intraventricular ablation mapping showed that:①Increase of A/V and H-value means higher AVB risk;② Simultaneous increase of A/V and H-value would lead to the most dangerous result. Conclusion:It is of great importance to perform RFCA under such situation:middle and lower zone as ablation positions multiple-peak A wave, A/V(0.1-0.25) and no H or slightest H(≤0.02?0.03)mV are present in intraventricular ablation mapping, which could significantly lower the risk of RFCA-related AVB.
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Objective:Comparing differences between transesophageal and the intracardia electrophysiologic study,to assure the clinical value of transesophageal pacing on diagnosis of various types of supraventricular tachycardia and different accessory pathway. Methods: Comparing the results of transesophageal atrial pacing(TEAP) and electrophysiological study(EPS) in 142 patients during radiofrequency ablation.Results:Atrioventricular reentrant tachycardia(AVRT)with anterograde,P_(V1)-P_E was more than 25ms,R-P_E was more than 75 ms,with the exception of right septal accessory pathway(RSAP) P_(V1)-P_E was more than 25ms,R-P_E more than 75 ms,with the exception of right septal accessory pathway(RSAP) P_(V1)-P_E was 0,R-P_E more than 75 ms,in patient with atrial reentrant tachycardia(ART)P_(V1)P_E more than 25 ms,R-P_E more than 150 ms and R-P_E more than PE-R.Atrioventricular junctional reentrant tachycardia(AVNRT)P_(V1)-P_E less than 25 ms.R-P_E less than 70 ms.Conclusion:Transesophagus P_(V1)-P_E and R-P_E hold great clinical value on diagnosis of various types of supraventricular tachycardia and different accessory pathway.