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Epidemiologic studies are inconsistent regarding the association between plasma copeptin level and heart failure (HF). The aim of this study was to perform a meta-analysis to determine whether high level of copeptin is correlated with incidence of HF and mortality in patients with HF. We searched PUBMED and EMBASE databases for studies conducted from 1966 through May 2016 to identify studies reporting hazard ratio (HR) estimates with 95% confidence intervals (CIs) for the association between plasma copeptin level and HF. A random-effects model was used to combine study-specific risk estimates. A total of 13 studies were included in the meta-analysis, with five studies on the incidence of HF and eight studies on the mortality of patients with HF. For incidence of HF, the summary HR indicated a borderline positive association of high plasma copeptin level with HF risk (HR, 1.60; 95% CI, 0.90-2.85). Furthermore, an increase of 1 standard deviation in log copeptin level was associated with a 17% increase in the risk of incident HF (HR, 1.17; 95% CI, 1.02-1.33). For all-cause mortality of patients with HF, we also found a significant association between elevated plasma copeptin level and increased mortality of HF (HR, 1.76; 95% CI, 1.33-2.33). Our dose-response analysis indicated that an increment in copeptin level of 1 pmol/l was associated with a 3% increase in all-cause mortality (HR, 1.03; 95% CI, 1.01-1.05). In conclusion, our results suggest that elevated plasma copeptin level is associated with an increased risk of HF and all-cause mortality in patients with HF.
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Glicopéptidos/sangre , Insuficiencia Cardíaca/sangre , Insuficiencia Cardíaca/mortalidad , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Adulto JovenRESUMEN
BACKGROUND/AIMS: It is well documented that overexpression of EMMPRIN (extracellular matrix metalloproteinase inducer) and MMPs (matrix metalloproteinases) by monocytes/macrophages plays an important role in atherosclerotic plaque rupture. Green tea polyphenol epigallocatechin-3-gallate (EGCG) has a variety of pharmacological properties and exerts cardiovascular protective effects. Recently, the 67-kD laminin receptor (67LR) has been identified as a cell surface receptor of EGCG. The aim of the present study was to evaluate the effects of EGCG on the expression of EMMPRIN and MMP-9 in PMA-induced macrophages, and the potential mechanisms underlying its effects. METHODS: Human monocytic THP-1 cells were induced to differentiate into macrophages with phorbol 12-myristate 13-acetate (PMA). Protein expression and MMP-9 activity were assayed by Western blot and Gelatin zymography, respectively. Real-time PCR was used to examine EMMPRIN and MMP-9 mRNA expression. RESULTS: We showed that EGCG (10-50µmol/L) significantly inhibited the expression of EMMPRIN and MMP-9 and activation of extracellular signal-regulated kinase 1/2 (ERK1/2), p38 and c-Jun N-terminal kinase (JNK) in PMA-induced macrophages. Downregulation of EMMPRIN by gene silencing hindered PMA-induced MMP-9 secretion and expression, indicating an important role of EMMPRIN in the inhibition of MMP-9 by EGCG. Moreover, 67LR was involved in EGCG-mediated suppression of EMMPRIN and MMP-9 expression. Anti-67LR antibody treatment led to abrogation of the inhibitory action of EGCG on the expression of EMMPRIN and MMP-9 and activation of ERK1/2, p38, and JNK. CONCLUSION: Our results indicate that EGCG restrains EMMPRIN and MMP-9 expression via 67LR in PMA-induced macrophages, which also suggests that EGCG may be a possible therapeutic agent for stabilizing atherosclerotic plaque.
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Basigina/metabolismo , Catequina/análogos & derivados , Macrófagos/metabolismo , Metaloproteinasa 9 de la Matriz/metabolismo , Receptores de Laminina/metabolismo , Acetato de Tetradecanoilforbol/farmacología , Catequina/química , Catequina/farmacología , Muerte Celular/efectos de los fármacos , Diferenciación Celular/efectos de los fármacos , Línea Celular , Humanos , Sistema de Señalización de MAP Quinasas/efectos de los fármacos , Macrófagos/efectos de los fármacos , Macrófagos/enzimología , Inhibidores de Proteínas Quinasas/farmacologíaRESUMEN
OBJECTIVE: To study the causes of false-positive hyoid fractures and forensic identification. METHODS: Twelve cases of false-positive hyoid fractures were collected and analyzed. RESULTS: Improper dissection technique (4 cases) and congenital separation (8 cases) were the main reasons for false-positive hyoid fractures. CONCLUSION: True fractures can be differentiated from false-positive hyoid fractures. False-positive hyoid fracture caused by improper dissection technique can be identified through examination of peripheral muscle, soft tissue hemorrhage, and the characteristics of fracture end.
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Errores Diagnósticos , Fracturas Óseas/diagnóstico , Hueso Hioides/lesiones , Autopsia , Diferenciación Celular , Humanos , MúsculosRESUMEN
OBJECTIVE: To study the correlation between age and general morphology of transverse section of cartilago costalis and its forensic significance. METHODS: Eighty-six corpses' cartilago costalis from the routine postmortem examination were collected and the morphological features of their transverse section were observed. RESULTS: With the increased age, there were regular changes in the color, structure, and material of the general morphology of transverse section of cartilago costalis. But the changes were not affected by gender. CONCLUSION: The good correlation between general morphology of transverse section of cartilago costalis and age can be used to estimate age of the deceased rapidly.
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Cadáver , Cartílago/anatomía & histología , Cartílago/patología , Factores de Edad , Autopsia , HumanosRESUMEN
PURPOSE: Sarcopenia is a geriatric syndrome characterized by progressive loss of muscle mass and function. Meteorin-like (Metrnl) is a secretory protein that has protective effects on skeletal muscle injury. However, the association of Metrnl level with sarcopenia remains unclear. METHODS: A total of 772 community-dwelling older adults (median age = 76 years), comprising 409 males and 363 females, from both urban and rural areas were enrolled. Serum Metrnl was measured by enzyme-linked immunosorbent assay. Appendicular skeletal muscle mass index (ASMI), grip strength, and gait speed were measured for the assessment of sarcopenia. RESULTS: We found that serum Metrnl levels were lower in patients with sarcopenia [median (IQR) = 180.1 (151.3-220.3) pg/mL] than older adults without sarcopenia [211.9 (163.2-270.0) pg/mL, P < 0.001]. Receiver-operating characteristic curve analysis showed that the optimal cut-off value of serum Metrnl level that predicted sarcopenia was 197.2 pg/mL with a sensitivity of 59.2% and a specificity of 63.8% (AUC = 0.63, 95% CI = 0.59-0.67, P < 0.001). Multivariate logistic regression analyses showed that lower serum Metrnl level (< 197.2 pg/mL) was significantly associated with increased risk of sarcopenia (adjusted OR = 2.358, 2.36, 95% CI = 1.528-3.685, P < 0.001). Moreover, serum Metrnl concentration was positively correlated with the components of sarcopenia including ASMI (r = 0.135, P < 0.001), grip strength (r = 0.102, P = 0.005), and gait speed (r = 0.106, P = 0.003). CONCLUSIONS: Taken together, our findings demonstrate that low serum Metrnl level is correlated with increased risk of sarcopenia in the older adults.
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BACKGROUND: The peritumoral environment has been implicated to be important in the process of metastasis and recurrence in hepatocellular carcinoma (HCC). Our aims were to assess the prognostic value of proline-rich tyrosine kinase 2 (Pyk2) in HCC and investigate related molecular mechanism. METHODS: Expression of Pyk2 was tested by immunohistochemistry in tissue microarrays containing 141 paired HCC samples. Correlation between Pyk2 and vascular endothelial growth factor (VEGF) expression in clinical samples was analyzed by Spearman rank correlation. Matrigel invasion, anchorage-independent growth assay and immunoblotting were performed to study the effect of Pyk2 on the invasion and progression of HCC cells and phosphoinositide 3-kinase (PI3K)/AKT pathway activation. RESULTS: Higher Pyk2 density in both tumor and peritumor was associated with lower overall survival (P = 0.044; P = 0.041, respectively), serum AFP levels > 1,000 ng/ml (P = 0.013; P = 0.032, respectively) and postoperative distant metastasis (both P < 0.001). However, only higher peritumoral Pyk2 density was related to lower disease-free survival (P = 0.014) and vascular invasion (P = 0.035). A significant correlation between Pyk2 and VEGF density in tumor or peritumoral liver tissue was observed (r = 0. 3133, P = 0.0002; r = 0.5176, P < 0.0001, respectively). Immunoblotting showed that Pyk2 activated PI3K-AKT pathway to upregulate VEGF expression in HL-7702, SMMC-7721 and HepG2 cells. CONCLUSIONS: High Pyk2, especially peritumoral Pyk2 was associated with poor survival, disease recurrence, and metastasis in HCC. PI3K-AKT pathway was involved in Pyk2-mediated VEGF expression during HCC progression and invasion.
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Carcinoma Hepatocelular/mortalidad , Quinasa 2 de Adhesión Focal/metabolismo , Regulación Neoplásica de la Expresión Génica , Neoplasias Hepáticas/mortalidad , Fosfatidilinositol 3-Quinasa/metabolismo , Proteínas Proto-Oncogénicas c-akt/metabolismo , Apoptosis , Western Blotting , Carcinoma Hepatocelular/enzimología , Carcinoma Hepatocelular/secundario , Adhesión Celular , Movimiento Celular , Proliferación Celular , Femenino , Estudios de Seguimiento , Regulación Neoplásica de la Expresión Génica/fisiología , Humanos , Técnicas para Inmunoenzimas , Hígado/metabolismo , Neoplasias Hepáticas/enzimología , Neoplasias Hepáticas/patología , Metástasis Linfática , Masculino , Persona de Mediana Edad , Invasividad Neoplásica , Estadificación de Neoplasias , Pronóstico , ARN Mensajero/genética , Reacción en Cadena en Tiempo Real de la Polimerasa , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Tasa de Supervivencia , Análisis de Matrices Tisulares , Células Tumorales CultivadasRESUMEN
BACKGROUND: The timely assessment of B-type natriuretic peptide (BNP) marking chronic heart failure risk in patients with coronary heart disease (CHD) helps to reduce patients' mortality. OBJECTIVE: To evaluate the potential of wrist pulse signals for use in the cardiac monitoring of patients with CHD. METHODS: A total of 419 patients with CHD were assigned to Group 1 (BNP < 95 pg/mL, n = 249), 2 (95 < BNP < 221 pg/mL, n = 85), and 3 (BNP > 221 pg/mL, n = 85) according to BNP levels. Wrist pulse signals were measured noninvasively. Both the time-domain method and multiscale entropy (MSE) method were used to extract pulse features. Decision tree (DT) and random forest (RF) algorithms were employed to construct models for classifying three groups, and the models' performance metrics were compared. RESULTS: The pulse features of the three groups differed significantly, suggesting different pathological states of the cardiovascular system in patients with CHD. Moreover, the RF models outperformed the DT models in performance metrics. Furthermore, the optimal RF model was that based on a dataset comprising both time-domain and MSE features, achieving accuracy, average precision, average recall, and average F1-score of 90.900%, 91.048%, 90.900%, and 90.897%, respectively. CONCLUSIONS: The wrist pulse detection technology employed in this study is useful for assessing the cardiac function of patients with CHD.
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Enfermedad Coronaria , Insuficiencia Cardíaca , Humanos , Muñeca , Péptido Natriurético Encefálico , Insuficiencia Cardíaca/diagnóstico , Enfermedad Coronaria/complicaciones , Frecuencia Cardíaca , BiomarcadoresRESUMEN
Visfatin, a pro-inflammatory cytokine predominantly released from leucocytes, is correlated with coronary artery disease (CAD). We have previously reported that the -1535C>T polymorphism (rs1330082), which located on the promoter region of visfatin, was associated with decreased risk of CAD. Here, we investigated the underlying mechanism by which this polymorphism affects the genetic susceptibility to CAD. The difference of the promoter activities between -1535T variant and -1535C allele was tested by luciferase reporter gene assay. The difference of transcription factor binding activities between T and C allele was evaluated by electrophoretic mobility shift assay. In reporter gene assay, we showed that the T variant had a significantly reduced transcriptional activity compared with the C allele. The T-variant significantly attenuated the promoter binding affinity to nuclear transcription factors and this effect became much obvious after treatment with TNF-α. Moreover, competition experiment revealed that the retarded complex formed by T-1535- or C-1535-probe binding to nuclear extracts was nearly completely inhibited by unlabeled activator protein-1 (AP-1) specific probe, indicating that AP-1 might be the target nuclear effector. Taken together, our data provided potential mechanistic link between the visfatin -1535C>T polymorphism and reduced CAD risk.
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Enfermedad de la Arteria Coronaria/genética , Citocinas/genética , Nicotinamida Fosforribosiltransferasa/genética , Polimorfismo de Nucleótido Simple , Sitios de Unión , Enfermedad de la Arteria Coronaria/metabolismo , Citocinas/metabolismo , Ensayo de Cambio de Movilidad Electroforética , Genes Reporteros , Predisposición Genética a la Enfermedad , Células Endoteliales de la Vena Umbilical Humana/metabolismo , Humanos , Interleucina-6/metabolismo , Nicotinamida Fosforribosiltransferasa/metabolismo , Regiones Promotoras Genéticas , ARN Mensajero/metabolismo , Factor de Transcripción AP-1/metabolismo , Transcripción Genética , Transfección , Factor de Necrosis Tumoral alfa/metabolismoRESUMEN
The aim of the present study was to assess the influences of PRKCH gene variants (1425G/A and _15) on the risk of coronary artery disease (CAD) in a Chinese population. Our study population consisted of 470 CAD patients and 434 control subjects. The alleles frequencies of the two variants were significantly higher among CAD patients than control subjects (P = 0.001 for 1425G/A and P = 0.001 for _15, respectively). In the CAD group, the A allele carriers of 1425G/A and _15 polymorphisms had higher low-density lipoprotein cholesterol (LDL-C) levels than homozygote G allele carriers (P = 0.001 and P = 0.021, respectively). In a multiple logistic regression model adjusted for age, sex, body mass index (BMI), etc., a markedly increased risk of developing CAD was found in subjects carrying GA or AA genotype (P = 0.005 and P = 0.018, respectively). In conclusion, we observed that there was a remarkable association of minor alleles (1425G/A and _15) in the PRKCH gene with an elevated risk of CAD and increased levels of LDL-C in this Chinese population.
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Pueblo Asiatico/genética , Enfermedad de la Arteria Coronaria/epidemiología , Enfermedad de la Arteria Coronaria/genética , Predisposición Genética a la Enfermedad/genética , Polimorfismo de Nucleótido Simple/genética , Proteína Quinasa C/genética , Anciano , China/epidemiología , Cartilla de ADN/genética , Femenino , Estudios de Asociación Genética , Genotipo , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa , Factores de Riesgo , Análisis de Secuencia de ADN , Estadísticas no ParamétricasRESUMEN
BACKGROUND: Hyperlipidemia plays a crucial role in the development and progression of coronary artery disease (CAD). Recent studies have identified that microRNAs (miRNAs) are important regulators of lipid metabolism, but little is known about the circulating levels of lipometabolism-related miRNAs and their relationship with the presence of CAD in patients with hyperlipidemia. METHODS: In the present study, we enrolled a total of 255 hyperlipidemia patients with or without CAD and 100 controls with normal blood lipids. The plasma levels of four known lipometabolism-related miRNAs, miR-122, miR-370, miR-33a, and miR-33b were quantified by real-time quantitative PCR. Blood levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol were determined. Furthermore, the severity of CAD was assessed with the Gensini score system based on the degree of luminal narrowing and its geographic importance. RESULTS: Our results revealed for the first time that plasma levels of miR-122 and miR-370 were significantly increased in hyperlipidemia patients compared with controls, and the levels of miR-122 and miR-370 were positively correlated with TC, TG, and LDL-C levels in both hyperlipidemia patients and controls. Multiple logistic regression analysis demonstrated that the increased levels of miR-122 and miR-370 were associated with CAD presence, even after adjustment for other cardiovascular risk factors. Furthermore, miR-122 and miR-370 levels were positively correlated with the severity of CAD quantified by the Gensini score. However, both miR-33a and miR-33b were undetectable in plasma. CONCLUSIONS: Our results suggest that increased plasma levels of miR-122 and miR-370 might be associated with the presence as well as the severity of CAD in hyperlipidemia patients.
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Enfermedad de la Arteria Coronaria/sangre , Hiperlipidemias/sangre , Metabolismo de los Lípidos , MicroARNs/sangre , Anciano , Estudios de Casos y Controles , Colesterol/sangre , LDL-Colesterol/sangre , Enfermedad de la Arteria Coronaria/etiología , Enfermedad de la Arteria Coronaria/patología , Femenino , Humanos , Hiperlipidemias/complicaciones , Modelos Logísticos , Masculino , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Estadísticas no Paramétricas , Triglicéridos/sangreRESUMEN
Background. In Traditional Chinese Medicine (TCM), most of the algorithms are used to solve problems of syndrome diagnosis that only focus on one syndrome, that is, single label learning. However, in clinical practice, patients may simultaneously have more than one syndrome, which has its own symptoms (signs). Methods. We employed a multilabel learning using the relevant feature for each label (REAL) algorithm to construct a syndrome diagnostic model for chronic gastritis (CG) in TCM. REAL combines feature selection methods to select the significant symptoms (signs) of CG. The method was tested on 919 patients using the standard scale. Results. The highest prediction accuracy was achieved when 20 features were selected. The features selected with the information gain were more consistent with the TCM theory. The lowest average accuracy was 54% using multi-label neural networks (BP-MLL), whereas the highest was 82% using REAL for constructing the diagnostic model. For coverage, hamming loss, and ranking loss, the values obtained using the REAL algorithm were the lowest at 0.160, 0.142, and 0.177, respectively. Conclusion. REAL extracts the relevant symptoms (signs) for each syndrome and improves its recognition accuracy. Moreover, the studies will provide a reference for constructing syndrome diagnostic models and guide clinical practice.
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Auscultation signals are nonstationary in nature. Wavelet packet transform (WPT) has currently become a very useful tool in analyzing nonstationary signals. Sample entropy (SampEn) has recently been proposed to act as a measurement for quantifying regularity and complexity of time series data. WPT and SampEn were combined in this paper to analyze auscultation signals in traditional Chinese medicine (TCM). SampEns for WPT coefficients were computed to quantify the signals from qi- and yin-deficient, as well as healthy, subjects. The complexity of the signal can be evaluated with this scheme in different time-frequency resolutions. First, the voice signals were decomposed into approximated and detailed WPT coefficients. Then, SampEn values for approximated and detailed coefficients were calculated. Finally, SampEn values with significant differences in the three kinds of samples were chosen as the feature parameters for the support vector machine to identify the three types of auscultation signals. The recognition accuracy rates were higher than 90%.
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Visfatin, a newly identified proinflammatory adipokine, has been linked to coronary artery disease (CAD). The -1535C>T polymorphism (rs61330082) located in the visfatin gene promoter is reportedly associated with proinflammatory status. However, it is unclear whether this polymorphism correlates with plasma levels of inflammatory markers including visfatin, hs-CRP, IL-6 and TNF-α in CAD patients. The present study was to investigate the potential association of the -1535C>T polymorphism with plasma levels of visfatin, IL-6, C reactive protein (hs-CRP) and TNF-α in patients with CAD. We conducted a hospital based study with 171 CAD patients to examine the association between the -1535C>T polymorphism and plasma levels of visfatin, hs-CRP, IL-6 and TNF-α. Plasma visfatin levels were markedly different between patients with stable angina pectoris (SAP, 11.91 ± 0.70 ng/l) and those with unstable angina pectoris (UAP, 17.49 ± 0.20 ng/l) or acute myocardial infarction (AMI, 16.63 ± 0.22 ng/l; SAP versus UAP or AMI, P < 0.05). Compared with the CC genotype, variant genotypes CT and TT correlated with significantly lower levels of visfatin, hs-CRP, IL-6 and TNF-α in the SAP group (P < 0.05), with lower levels of hs-CRP and IL-6 in the UAP group (P < 0.05), and with lower levels of visfatin in the AMI group (P < 0.05) after adjustment for age, gender, smoking, hypertension, diabetes, dyslipidemia and medication. Our results suggest that the -1535C>T polymorphism is associated with decreased plasma levels of inflammatory markers in CAD patients, reflecting that this polymorphism might provide a useful marker for predicting the development of CAD events.
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Enfermedad de la Arteria Coronaria/genética , Inflamación/genética , Nicotinamida Fosforribosiltransferasa/sangre , Nicotinamida Fosforribosiltransferasa/genética , Regiones Promotoras Genéticas , Adipoquinas/metabolismo , Anciano , Proteína C-Reactiva/genética , Femenino , Genotipo , Humanos , Interleucina-6/genética , Masculino , Persona de Mediana Edad , Polimorfismo Genético , Factores Sexuales , Factor de Necrosis Tumoral alfa/genéticaRESUMEN
The traditional costicartilage analysis inspection is limited to morphological inspection. In recent years, with the development of forensic radiology and molecular genetics, the costicartilage analysis inspection technology has been further enriched and developed. At present, the costicartilage analysis inspection technology have been able to be used in the practice of forensic medicine. This paper reviews the research advances about the costicartilage analysis inspection technology in the identification of human gender, age and so on in order to provide the references for forensic appraisers.
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Determinación de la Edad por el Esqueleto/métodos , Calcificación Fisiológica , Cartílago/fisiología , ADN/análisis , Medicina Legal/métodos , Costillas/fisiología , Análisis para Determinación del Sexo/métodos , Factores de Edad , Cartílago/química , Cartílago/diagnóstico por imagen , ADN/aislamiento & purificación , Dermatoglifia del ADN/métodos , Femenino , Antropología Forense , Humanos , Masculino , Reacción en Cadena de la Polimerasa/métodos , Costillas/diagnóstico por imagen , Caracteres SexualesRESUMEN
OBJECTIVE: To explore potential application of diatom test of lung tissue in investigation of cause of death in victim found in the water. METHODS: Four hundred and seven cases were collected and analyzed for cause of death and the nature of case. Diatom test was performed in tissues and the amount was quantified. Forty-five rabbits died in the water (antemortem, postmortem and different seasons drowning) were randomly divided into 9 groups and the diatom content in lung tissue were tested with the method of nitric acid. RESULTS: In 407 drowning cases, 372 cases showed a positive result of diatom test. In positive cases, the amount of accidents or suicide were 35 and homicide were 21. Thirty-five cases showed negative result of diatom test and majority were homicide in which bodies were thrown into the water after killing. Some drowning cases were in special circumstances. Animal experiments confirmed that a large amount of diatoms in lung tissue were detected in drowning victim and showed the same type in water. The amount of diatom in lung tissue was usually lower in the summer and winter comparing with spring and autumn. CONCLUSION: The diatom test could be considered as an auxiliary evidence in determination of cause of death in body found in the water. The test results were related with manner of death. The nature of case should be synthetically determined based on autopsy, criminal scene and details of the cases, etc.
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Causas de Muerte , Diatomeas/aislamiento & purificación , Ahogamiento/diagnóstico , Patologia Forense/métodos , Pulmón/patología , Animales , Cadáver , Diatomeas/clasificación , Femenino , Agua Dulce , Humanos , Hígado/patología , Masculino , Conejos , Estaciones del Año , Distribución TisularRESUMEN
OBJECTIVE: By using recurrence quantification analysis (RQA) to analyze traditional Chinese medicine pulse signals of patients with coronary heart disease (CHD), this study aims to find nonlinear dynamic parameters of pulses to distinguish patients with CHD from normal subjects. METHODS: First, pulse signals were collected using ZBOX-I pulse digitization gathering analyzer from October 2007 to June 2008. RQA was used to analyze RQA parameters of pulses of 63 patients with CHD and 61 normal subjects. RQA parameters included recurrence rate (RR), determinism (DET), averaged diagonal length (L), entropy of diagonal length (ENTR), length of longest diagonal line (L(max)), laminarity (LAM), trapping time (TT) and length of longest vertical line (V(max)). Then, rank-sum test and BoxPlot were employed to find significant difference and distribution of RQA parameters. Lastly, receiver operating characteristic (ROC) curves were used to assess the diagnostic value of the measurements with significant difference. RESULTS: There were significant differences in RQA parameters of pulse signals between the two groups, including RR, DET, L, ENTR, LAM, TT and V(max), and their areas under the ROC curves were 1.000, 0.898, 0.653, 0.673, 0.885, 0.898, 0.986 and 0.994, respectively. CONCLUSION: Compared with the normal subjects, the pulse signals of the patients with CHD are presented with more certainty, regularity and stability. RQA measurements of RR, TT, Vmax, DET and LAM show good diagnostic value according to their ROC curves.
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Enfermedad Coronaria/diagnóstico , Medicina Tradicional China/métodos , Anciano , Fenómenos Fisiológicos Cardiovasculares , Estudios de Casos y Controles , Humanos , Persona de Mediana Edad , Pulso Arterial , Curva ROCRESUMEN
BACKGROUND: Cardiovascular diseases have been always the most common cause of morbidity and mortality worldwide. Health monitoring of high-risk and suspected patients is essential. Currently, invasive coronary angiography is still the most direct and accurate method of determining the severity of coronary artery lesions, but it may not be the optimal clinical choice for suspected patients who had clinical symptoms of coronary heart disease (CHD) such as chest pain but no coronary artery lesion. Modern medical research indicates that radial pulse waves contain substantial pathophysiologic information about the cardiovascular and circulation systems; therefore, analysis of these waves could be a noninvasive technique for assessing cardiovascular disease. OBJECTIVE: The objective of this study was to analyze the radial pulse wave to construct models for assessing the extent of coronary artery lesions based on pulse features and investigate the latent value of noninvasive detection technology based on pulse wave in the evaluation of cardiovascular disease, so as to promote the development of wearable devices and mobile medicine. METHOD: This study included 529 patients suspected of CHD who had undergone coronary angiography. Patients were sorted into a control group with no lesions, a 1 or 2 lesion group, and a multiple (3 or more) lesion group as determined by coronary angiography. The linear time-domain features and the nonlinear multiscale entropy features of their radial pulse wave signals were compared, and these features were used to construct models for identifying the range of coronary artery lesions using the k-nearest neighbor (KNN), decision tree (DT), and random forest (RF) machine learning algorithms. The average precision of these algorithms was then compared. RESULTS: (1) Compared with the control group, the group with 1 or 2 lesions had increases in their radial pulse wave time-domain features H2/H1, H3/H1, and W2 (P < 0.05), whereas the group with multiple lesions had decreases in MSE1, MSE2, MSE3, MSE4, and MSE5 (P < 0.05). (2) Compared with the 1 or 2 lesion group, the multiple lesion group had increases in T1/T (P < 0.05) and decreases in T and W1 (P < 0.05). (3) The RF model for identifying numbers of coronary artery lesions had a higher average precision than the models built with KNN or DT. Furthermore, average precision of the model was highest (80.98%) if both time-domain features and multiscale entropy features of radial pulse signals were used to construct the model. CONCLUSION: Pulse wave signal can identify the range of coronary artery lesions with acceptable accuracy; this result is promising valuable for assessing the severity of coronary artery lesions. The technique could be used to development of mobile medical treatments or remote home monitoring systems for patients suspected or those at high risk of coronary atherosclerotic heart disease.
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Enfermedad de la Arteria Coronaria/fisiopatología , Vasos Coronarios/fisiopatología , Anciano , Algoritmos , Estudios de Casos y Controles , Angiografía Coronaria/métodos , Femenino , Humanos , Aprendizaje Automático , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: Coronavirus disease 2019 is an epidemic disease throughout the world. The management of vascular access during the epidemic is currently unknown. METHODS: In this multicenter cross-sectional study, we collected vascular access data from hemodialysis patients treated at 44 hospitals in Hubei from 22 January to 10 March 2020. We estimated the management of vascular access during the coronavirus disease 2019 outbreak. RESULTS: Of the 9231 hemodialysis patients included, 5387 patients (58.4%) were men and 2959 patients (32.1%) were older than 65 years. Arteriovenous fistula was the predominant type of vascular access, accounting for 76.5%; 496 patients (5.4%) developed vascular access complications; catheter flow reduction was the most common vascular access complication, and stenosis was the predominant complication among those with arteriovenous access. Overall, 280 vascular access sites were placed in patients newly diagnosed with uremia, of whom 260 (92.8%) underwent catheter insertion; 149 rescue procedures were carried out to treat the vascular access complications, which consisted of 132 catheters, 7 percutaneous transluminal angioplasties, 6 arteriovenous fistula repairs, and 4 arteriovenous fistulas. Occlusion of the arteriovenous access had the highest rescue rate (92.7%), while many other vascular access complications remained untreated; 69 and 142 patients were diagnosed with confirmed and suspected coronavirus disease 2019, respectively. A total of 146 patients died, of whom 29 patients (19.9%) died due to vascular access complications. CONCLUSION: Catheter flow reduction and stenosis of arteriovenous access were the major vascular access complications. Most of the vascular access sites established were catheters, and many of the vascular access complications remained untreated.
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Angioplastia/métodos , COVID-19/epidemiología , Oclusión de Injerto Vascular/terapia , Diálisis Renal/métodos , Insuficiencia Renal/terapia , Adolescente , Adulto , Anciano , Derivación Arteriovenosa Quirúrgica/efectos adversos , China/epidemiología , Comorbilidad , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Insuficiencia Renal/epidemiología , Adulto JovenRESUMEN
BACKGROUND: There is still conflicting evidence that green tea may protect against coronary atherosclerosis therefore the present study investigated the association between green tea consumption and arteriographically determined coronary atherosclerosis in a Chinese population. METHODS AND RESULTS: The study population consisted of 520 consecutive patients (379 men and 141 women) who underwent coronary arteriography for the first time. Patients were divided into 2 groups (Non-coronary artery disease [CAD] and CAD groups) according to the results of coronary arteriography. After adjusting the established and potential confounders, green tea consumption was associated with a reduced risk of CAD in male patients, with an adjusted odds ratio (OR) of 0.62 (95% confidence interval, 0.38-1.01) compared with those who did not drink green tea. Compared to non-tea drinkers, the adjusted ORs were 1.09 (0.61-1.96) in male patients consuming less than 125 g of dried green tea leaves per month, 0.36 (0.19-0.71) for 125-249 g per month and 0.36 (0.17-0.73) for > or =250 g per month, with a statistically significant test for trend (P<0.001). Similar dose-response relationships were also observed for frequency, duration, concentration and starting age of green tea drinking in male patients. In female patients, no inverse association was found between green tea consumption and CAD. CONCLUSIONS: Green tea consumption can protect against the development of coronary atherosclerosis in Chinese male patients.
Asunto(s)
Pueblo Asiatico/estadística & datos numéricos , Camellia sinensis , Enfermedad de la Arteria Coronaria/etnología , Enfermedad de la Arteria Coronaria/prevención & control , Té , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , China/epidemiología , Angiografía Coronaria , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/etiología , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Prevalencia , Medición de Riesgo , Factores de Riesgo , Factores SexualesRESUMEN
Recent studies suggest that the common variant in the GSTM1 and GSTT1 genes modifies the risk of coronary artery disease (CAD), however, it is unclear whether the risk of CAD modulated by variants in the GSTM1 and GSTT1 genes was associated with alterations of indices of oxidative stress and inflammation. Our study is an attempt to provide insight into the role of GST genetic variant and markers of oxidative stress and inflammation in CAD patients. A total of 719 Chinese CAD patients were successfully genotyped. Plasma total antioxidant status (TAOS), glutathione(GSH), C-reactive protein (CRP), fibrinogen (FIB) and white blood cell count (WBC) were determined to evaluate the oxidative stress and inflammatory response. The correlations between GSTM1/GSTT1 genotypes and alterations of indices of oxidative stress and inflammation were analyzed. We found GSTM1-0/GSTT1-0 subjects had higher CRP and FIB and lower TAOS compared to patients with wild-type GSTM1/GSTT1 genes. A stepwise elevations in age, the incidences of hypertension and diabetes mellitus, levels of FIB and the number of WBC were associated with increased number of stenosed vessels. Reductions of plasma TAOS and GSH were associated with increased number of stenosed vessels. Our results suggest that GST polymorphisms maybe modify the effect on markers of oxidative stress and inflammation in Chinese CAD patients.