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Glycosylated haemoglobin index (HGI) has been shown to correlate with the prognosis of metabolic diseases, but the relationship with mortality remains unclear. This study included 18,285 US adults who participated in the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2018. During the median follow-up period of 115 months, a total of 2572 all-cause deaths and 671 cardiovascular disease (CVD) deaths occurred. The restricted cubic spline revealed a U-shaped correlation between HGI and all-cause and CVD mortality. After adjusting for all covariates, the optimal inflection point values in all-cause and CVD deaths were 0.17 and 0.02, respectively. In the left side of the inflection point, the risk of all-cause mortality and CVD mortality decreased by approximately 24% (HR 0.76, 95% CI 0.69, 0.84) and 25% (HR 0.75, 95% CI 0.60, 0.96) with the increase in HGI. Conversely, in the right of the inflection point, an increase of 1 unit in the HGI was linked with a 17% (HR 1.17, 95% CI 1.07, 1.27) and 31% (HR 1.31, 95% CI 1.15, 1.49) increase in all-cause and CVD mortality. Our study showed that HGI is an important tool for predicting the risk of all-cause mortality and CVD death in US adults and there is a U-shaped relationship between HGI and mortality.
Sujet(s)
Maladies cardiovasculaires , Hémoglobine glyquée , Enquêtes nutritionnelles , Humains , Maladies cardiovasculaires/mortalité , Mâle , Femelle , Adulte d'âge moyen , Adulte , Hémoglobine glyquée/analyse , Hémoglobine glyquée/métabolisme , Cause de décès , Sujet âgé , Pronostic , Facteurs de risque , États-Unis/épidémiologieRÉSUMÉ
BACKGROUND: Cor triatriatum sinister (CTS) is an uncommon congenital cardiac anomaly. Atrial fibrillation (AF) is commonly the initial symptom in patients with CTS, occurring in approximately 32% of the cases. The complexity of performing AF catheter ablation, particularly in cases with persistent AF, increases in patients with CTS due to its unique structural challenges. CASE PRESENTATION: We report the treatment course of a 60-year-old male patient diagnosed with CTS, who underwent catheter ablation of drug-refractory, persistent AF. The complex anatomical structure of the condition made catheter ablation of AF challenging. To navigate these challenges, we performed comprehensive assessments using transthoracic echocardiography and transesophageal echocardiography, along with cardiac computed tomography angiography, prior to treatment initiation. The intricate anatomy of CTS was further clarified during the procedure via intracardiac echocardiography (ICE). Additionally, the complexity of catheter manipulation was further reduced with the aid of the VIZIGO sheath and the vein of Marshall ethanol infusion to achieve effective mitral isthmus blockage, thereby circumventing the impact of the CTS membrane. CONCLUSIONS: This case underscores the complexity and potential of advanced ablation techniques in managing cardiac arrhythmias associated with unusual cardiac anatomies. During the procedure, ICE facilitated detailed modeling of the left atrium, including the membranous structure and its openings, thus providing a clearer understanding of CTS. It is noteworthy that the membrane within the CTS may serve as a potential substrate for arrhythmias, which warrants further validation through larger sample studies.
Sujet(s)
Fibrillation auriculaire , Ablation par cathéter , Coeur triatrial , Humains , Coeur triatrial/chirurgie , Coeur triatrial/complications , Coeur triatrial/imagerie diagnostique , Mâle , Fibrillation auriculaire/chirurgie , Adulte d'âge moyen , Ablation par cathéter/méthodes , Échocardiographie transoesophagienne/méthodes , ÉchocardiographieRÉSUMÉ
BACKGROUND: Diabetic cardiomyopathy (DCM), which is a complication of diabetes, poses a great threat to public health. Recent studies have confirmed the role of NLRP3 (NOD-like receptor protein 3) activation in DCM development through the inflammatory response. Teneligliptin is an oral hypoglycemic dipeptidyl peptidase-IV inhibitor used to treat diabetes. Teneligliptin has recently been reported to have anti-inflammatory and protective effects on myocardial cells. AIM: To examine the therapeutic effects of teneligliptin on DCM in diabetic mice. METHODS: Streptozotocin was administered to induce diabetes in mice, followed by treatment with 30 mg/kg teneligliptin. RESULTS: Marked increases in cardiomyocyte area and cardiac hypertrophy indicator heart weight/tibia length reductions in fractional shortening, ejection fraction, and heart rate; increases in creatine kinase-MB (CK-MB), aspartate transaminase (AST), and lactate dehydrogenase (LDH) levels; and upregulated NADPH oxidase 4 were observed in diabetic mice, all of which were significantly reversed by teneligliptin. Moreover, NLRP3 inflammasome activation and increased release of interleukin-1ß in diabetic mice were inhibited by teneligliptin. Primary mouse cardiomyocytes were treated with high glucose (30 mmol/L) with or without teneligliptin (2.5 or 5 µM) for 24 h. NLRP3 inflammasome activation. Increases in CK-MB, AST, and LDH levels in glucose-stimulated cardiomyocytes were markedly inhibited by teneligliptin, and AMP (p-adenosine 5'-monophosphate)-p-AMPK (activated protein kinase) levels were increased. Furthermore, the beneficial effects of teneligliptin on hyperglycaemia-induced cardiomyocytes were abolished by the AMPK signaling inhibitor compound C. CONCLUSION: Overall, teneligliptin mitigated DCM by mitigating activation of the NLRP3 inflammasome.
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BACKGROUND: Paroxysmal supraventricular tachycardia (PSVT) is characterized by episodes of rapid tachycardia with sudden onset and sudden termination. PSVT treatment has evolved considerably over the past 30 years. Currently, radiofrequency catheter ablation is the first-line treatment. HYPOTHESIS: We conducted a randomized controlled trial to compare safety and effectiveness of PSVT ablation between the Jinjiang and Johnson (J&J) catheters in 57 patients in our hospital. METHODS AND RESULTS: Patients were randomly assigned to ablation procedures using either the Jinjiang system or the J&J Carto system. Follow-up was performed 3 days, 1, and 6 months after the procedure. Success rate, ablation time, frequency of ablation, and rates of complications and recurrence did not significantly differ between the groups. One Jinjiang group patient (3.6%) experienced arrhythmia recurrence during the 6-month follow-up. CONCLUSIONS: The Jinjiang catheter for radiofrequency ablation of PSVT is as safe and effective as the J&J catheter.
Sujet(s)
Ablation par cathéter , Tachycardie paroxystique , Tachycardie supraventriculaire , Tachycardie ventriculaire , Humains , Tachycardie paroxystique/chirurgie , Ablation par cathéter/méthodes , Tachycardie ventriculaire/chirurgieRÉSUMÉ
How effectively our leaders are trained and prepared for the future is the ultimate success as it helps in achieving sustainable development goals. Simultaneously, education also holds a central position to acknowledge social, environmental, and ethical issues. Besides, healthcare sector is the major subject of discussion when there is a discussion of sustainable development, the reason being its direct linkage with SDG 3 which purely preaches healthcare and well-being. The healthcare sector itself aspires to protect health; however, it is also the highest emitter of pollution that creates vicious cycle. This establishes a greater interest to determine the factors that break the cycle through the sustainable healthcare organizations which is subjected to reduce emissions and protect environment, nature, and society. The study specifically focusing on sustainable development goal 3 intends to examine the collective role of green leadership, green education, and green finance from the perspective of private sector employees. We explore whether these factors are helpful to achieve SDG3 agenda in the presence of mediator, public health expenditure. With the help of PLS-methodology, the study concludes that green leadership and green education are strong indicators of SDG3. Besides, green finance also facilitates economies to find innovative ways through which health and well-being of individuals can be taken care of. The positive and significant mediation effect of public health expenditure indicates that there is a need to dedicate the efforts toward public health expenditures.
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Dépenses de santé , Développement durable , Humains , Leadership , Prestations des soins de santé , Secteur des soins de santé , Chine , Développement économiqueRÉSUMÉ
OBJECTIVE: To demonstrate the value of Internet of things (IoT)-based diagnosis-treatment model in improving medical service quality during the novel coronavirus pneumonia (COVID-19) outbreak. METHODS: In this retrospective analysis, 483 patients with chronic diseases treated between January 2020 and March 2021 were selected and grouped as follows based on different intervention methods: a research group (the Res group) with 229 patients that were given IoT-based diagnosis and treatment, and a control group (the Con group) with 254 patients that were treated with routine diagnosis and treatment. The qualified rate of medical records, the missing rate of medical records, and the incidence of doctor-patient disputes were compared between the two groups. In addition, investigations were made regarding patients' daily living ability, psychological state, health behavior, self-care ability, quality of life, as well as treatment satisfaction. RESULTS: There was no difference in the qualified rate of medical records between the Res group and the Con group (P>0.05), but the missing rate of medical records and the incidence of doctor-patient disputes were lower in the Res group (both P<0.05). An obviously improved living ability was observed in both groups after the treatment (both P<0.05), with no statistical significance between groups (P>0.05). Besides, the Res group presented lower scores of SAS and SDS but higher scores of SRAHP, ES-CA and SF-36 than the Con group after treatment (all P<0.05). Finally, according to the satisfaction survey, more patients in the Res group were very satisfied but fewer cases were dissatisfied with the medical service they received as compared with the Con group (both P<0.05). CONCLUSIONS: The IoT-based diagnosis-treatment model can effectively improve the quality of medical services and patients' self-care ability, which is extremely important and promising for addressing the current medical limitations during the COVID-19 epidemic.
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Cardiovascular risk factors have attracted increasing attention in recent years with the acceleration of population aging, amongst which cardiac hypertrophy is the initiating link to heart failure. Pirfenidone is a promising agent for the treatment of idiopathic pulmonary fibrosis and has recently proven to exert inhibitory effects on the inflammatory response. This study proposes to explore the potential pharmacological action of Pirfenidone in treating cardiac hypertrophy in a rodent model. Four groups of mice were used in the present study: the control, ISO (5 mg/kg/day) for 7 days, Pirfenidone (200 mg/kg/day) for 14 days, and Spironolactone (SPI) (200 mg/kg/day) for 14 days groups. Increased heart weight index, left ventricle (LV) weight index, LV wall thickness, declined LV volume, and elevated serum levels of CK-MB, AST, and LDH were observed in ISO-challenged mice, all of which were dramatically reversed by the administration of Pirfenidone or SPI. Furthermore, an elevated cross-sectional area of cardiomyocytes in the wheat germ agglutinin (WGA) staining of heart cross-sections, upregulated atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), ß Myosin Heavy Chain (ß-MHC), and excessively released tumor necrosis factor-α (TNF-α) and interleukin 6 (IL-6) in cardiac tissues were observed in the ISO group but greatly alleviated by Pirfenidone or SPI. Lastly, the promoted expression levels of p-JAK-2/JAK-2 and p-STAT3/STAT-3 in the cardiac tissues of ISO-challenged mice were significantly repressed by Pirfenidone or SPI. Collectively, our data reveals a therapeutic property of Pirfenidone on ISO-induced cardiac hypertrophy in mice.
Sujet(s)
Facteur de transcription STAT-3 , TYK2 Kinase , Animaux , Cardiomégalie/traitement médicamenteux , Cardiomégalie/métabolisme , Cardiomégalie/anatomopathologie , Isoprénaline/métabolisme , Isoprénaline/pharmacologie , Isoprénaline/usage thérapeutique , Souris , Myocytes cardiaques/métabolisme , Pyridones , Facteur de transcription STAT-3/métabolisme , Transduction du signal , TYK2 Kinase/métabolisme , TYK2 Kinase/pharmacologie , TYK2 Kinase/usage thérapeutique , Tyrosine/métabolismeRÉSUMÉ
OBJECTIVE: To compare the hospitalization expenses among three single diseases in The First Affiliated Hospital of Hebei North University (a tertiary Class A general hospital), and analyze the factors affecting hospitalization costs, so as to provide some basis for controlling the unreasonable increase of hospitalization expenses as well as to render references for medical management. METHODS: By retrospective investigation, we selected the basic information of inpatient medical records and detailed billing of patients hospitalized in our hospital from Jan. 1, 2016 to Dec. 31, 2018. The collected data were sorted based on the International Classification of Diseases (ICD-10). Finally, 1,199 cases of frequently-occurring diseases and common illnesses such as rectal cancer (RC), nodular goiter (NG) and chronic renal failure (hemodialysis, HD) (CRF) were selected to conduct descriptive statistics on influencing factors and cost structure. The influencing factors of hospitalization expenses were identified by one-way analysis of variance (ANOVA) and multiple linear regression analysis. RESULTS: The hospitalization cost of inpatients with RC or CRF (HD) mainly spent on drugs, diagnosis and materials. As to NG, the cost of surgery, diagnosis and materials were the main components of hospitalization costs. Occupation and length of stay (LOS) were identified as the main influencing factors of hospitalization expenses for RC patients. While age and LOS were the main influencing factors of hospitalization cost for NG patients, and LOS alone for patients with CRF (HD). A across-sectional study was conducted on the CRF (HD) patients over 60 years old. CONCLUSIONS: In order to reasonably control inpatient medical expenses, comprehensive intervention should be carried out in clinical work, from rational drug use and selection of consumables, to shorten the hospitalization days to an appropriate level and reduce the waste of medical resources.
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With the development of society and the continuous progress of science and technology, it has become the mainstream measure to promote the development of the social economy through science and technology. Therefore, to improve the current situation of tourism consumption, improve the consumer sentiment of tourists, and promote the development of the tourism economy, the convolutional neural network (CNN) technology model is used to analyze the tourist's consumer psychology and behavior. Based on this, the user's consumption situation is analyzed, thus providing support for the intelligent improvement of tourism consumption. First, the basic characteristics of tourism consumption mood and behavior are introduced, and the methods to improve the tourism consumption mood and behavior are briefly introduced. Then, the CNN algorithm is employed to identify consumers' travel consumption behaviors and emotions. To improve the recognition effect, the algorithm is combined with skeleton node behavior recognition and video image behavior recognition. Finally, the performance of the designed algorithm is tested. The accuracy of the human behavior recognition (HBR) algorithm is more than 0.88. Compared with the detection effect of the HBR algorithm, the combined algorithm adopted in this work can reduce the image processing time and improve the detection efficiency. The multithread method can effectively reduce the complexity of the model and improve the recognition accuracy. The test results on different data sets show that the proposed algorithm can better adapt to the changes in identification samples and obtain more accurate recognition results compared with similar algorithms. In summary, this study not only provides technical support for the rational analysis of consumer sentiment and consumer behavior but also contributes to the comprehensive development of the tourism market.
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Apprentissage profond , Tourisme , Humains , , Algorithmes , Comportement du consommateurRÉSUMÉ
OBJECTIVE: To study the expression of RUNX3 in colorectal adenocarcinoma tissues and its correlation with microvessel density (MVD), and investigate the clinical pathological prognostic significance of RUNX3 and MVD in patients with colorectal cancer. METHODS: The expression value of RUNX3 and MVD in 70 specimens' colorectal adenocarcinoma tissues were detected by immunohistochemistry staining technique. The correlation between their expression and the clinicopathologic features was also investigated. RESULTS: The expression value of RUNX3 and the positive rates of RUNX3 in colorectal adenocarcinoma tissues were 3.25 ± 1.14 and 25.71% (18/70). The expression value of MVD in colorectal adenocarcinoma tissues was 13.14 ± 3.23. Expression of RUNX3 and MVD value were correlated with CEA, serosal invasion, liver metastasis, lymph node metastasis, and TNM stage (P < 0.01). The expression value of RUNX3 had negative correlations with that of MVD. CONCLUSIONS: The high expression of RUNX3 could inhibit tumor microvascular generation in order to have negative control response on invasion and distant metastasis.
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OBJECTIVE: To study the expression of caveolin-1 in colorectal adenocarcinoma tissues and its correlation with microlymphatic vessel density (LMVD), and to investigate the clinical pathological prognostic significance of caveolin-1 and LMVD in patients with colorectal cancer. METHODS: The expression of caveolin-1 and LMVD in 45 specimens of normal colorectal tissues, and 90 specimens of colorectal adenocarcinoma tissues were detected by immunohistochemistry technique. The correlation between their expression and the clinicopathologic features was analyzed. Multivariable Cox regression was used to analyze the association between the laboratory indices and overall survival time. RESULTS: The positive rates of caveolin-1 in colorectal adenocarcinoma tissues were significantly higher than those in normal colorectal tissues (P < 0.01). LMVD in colorectal adenocarcinoma tissues were significantly higher than those in normal colorectal tissues (P < 0.01). Mean LMVD in group with caveolin-1 positive was significantly higher than in that with caveolin-1 negative. The median survival time was 26.7 months. Cox regression analysis showed that the caveolin-1 expression, invation depth, lymph node metastasis, TNM stage, liver metastasis and LMVD were independent risk factors of overall survival time of patients with colorectal carcinoma. CONCLUSIONS: Caveolin-1 may contribute to the lymphangiogenesis in the tumor. During the occurrence and development of colorectal adenocarcinoma, there is a close relationship between the expression of caveolin-1 and lymphatic microvessel of tumor. Caveolin-1 expression and microlymphatic vessel density are significant prognostic value of colorectal carcinoma.