Self perceived burden and its influencing factors in patients with chronic heart failure / 现代临床护理

Objective To explore the self perceived burden and its related factors in patients with chronic heart failure,and provide evidence for clinical nursing intervention.Method Using activity of daily living scale,general self-efficacy and selfperception burden interview scale to investigate the 298 cases of patients with chronic heart failure from our hospital.Results The self-perceived burden score was (24.84±6.74),and it was at the mild to moderate level,there were 77.52％ patients with mild to severe self-feeling burden.The self-efficacy score was (23.71 ±6.66),below the national norm (P＜0.01).The self-perceived burden was negatively correlated with self-efficacy (r=-0.365,P＜0.001).Factors including ages,gender,primary caregivers and self-efficacy were related with self-perceived burden in patients with chronic heart failure (all P＜0.05).Conclusions The self-perceived burden score of CHF patient is mild to moderate level,where age,gender,primary caregiver and self-efficiency are factors.Clinical staff should develop targeted interventions to reduce the burden on the level of self-feelings such patients,improving the quality of life of patients.

A heart failure staging model based on machine learning classification algorithms / 中国组织工程研究

BACKGROUND:Early detection and accurate staging diagnosis of heart failure are the basis of good clinical therapy efficacy. Due to lack of simple and effective staging model for the diagnosis of heart failure, it is difficult to diagnose heart failure in clinics, leading to poor control of heart failure. OBJECTIVE:To establish the disease staging model based on Adaboost and SVM for heart failure, and improve the accuracy of diagnosis and staging of heart failure. METHODS:A total of 194 cases were roled into this study, including heart failure patients and healthy physical examination persons. According to the stage standards formulated by American Colege of Cardiology and American Heart Association, specific clinical feature parameters closely related to heart failure were colected and selected. Based on clinical diagnosis results and using Adaboost model and SVM model, we trained the models for heart failure diagnosis and staging, thus obtaining diagnosis model. RESULTS AND CONCLUSION: The parameters included stroke volume, cardiac output, left ventricular ejection fraction, left atrial diameter, left ventricular internal diameter at end-systole, N-terminal pro-brain natriuretic peptide and heart rate variability. As for the Adaboost model, its sensitivity and specificity was 100% and 94.4%, respectively. At the same time the SVM model had good sensitivity and specificity, 86.5% and 89.4% respectively. Adaboost classification model can be accurate in the diagnosis of heart failure symptoms, the accuracy reached 89.36%. On the basis of the diagnosis of heart failure, the SVM classification model is effective in staging the severity of heart failure, staging accuracy for staging B and C was 86.49% and 81.48%, respectively. The findings indicate that, combining Adaboost and SVM machine learning models could provide an accurate diagnosis and staging model for heart failure.

Differential gene expression profiling for identification of protective transcription factors in different subtypes of nasopharyngeal carcinoma / 南方医科大学学报

<p><b>OBJECTIVE</b>To analyze the dysregulated genes among the differentially expressed genes in 41 nasopharyngeal biopsy samples and identify their protective transcriptional factors.</p><p><b>METHODS</b>The differentially expressed gene profiles were obtained by analyzing both types I and II nasopharyngeal carcinoma (NPC_I and NPC_II, respectively) using EXCEL and Bioinformatics tools. The transcriptional factors were further studied only when (1) the difference in the binding sites of the differentially expressed genes between NPC_I and NPC_II groups was statistically significant, (2) the expressions of the transcription factors were correlated with the gene expressions in the samples, and (3) the transcription factors affected at least 40% of the expression of the related genes.</p><p><b>RESULTS</b>In NPC_I samples, 80 transcription factors were found to be up-regulated, in which RUNX3, GATA3, NR3C1, NRF1, RXRA, SMAD7, TBP, and ZBTB6 were positive factors and HLF and MTF1 were negative factors, involved in the regulation of the genes in T cell receptor signaling pathway. No eligible transcription factors were found in association with down-regulated genes in NPC_I compared to NPC_II gene expression profiles.</p><p><b>CONCLUSIONS</b>The over-expressed genes in NPC_I are mainly related to immune responses, and we found 8 positive factors and 2 negative factors that regulate the genes in T cell receptor signaling pathway. The 10 transcription factors may serve as potential therapeutic targets for NPC_I. We failed to identify any transcription factors associated with down-regulated genes in NPC_I relative to NPC_II possibly as a result of multiple factors that affect the differential gene expressions in NPC_II including the transcription factors, DNA phosphorylation and modification, chromosome variation and environmental factors.</p>

Monocyte chemoattractant protein-1-2518 G/A polymorphism, plasma levels, and premature stable coronary artery disease.

BACKGROUND: We examined the -2518G/A polymorphism of the MCP-1 gene, its plasma levels, and premature stable CAD in a Chinese population. METHODS: The study comprised 132 patients with premature stable CAD (cases) and 153 controls. Genotypes were determined by ligase detection reaction-polymerase chain reaction sequencing and grouping. Plasma MCP-1 level was detected with enzyme-linked immunosorbent assay. RESULTS: No differences were found between genotype distribution and allele frequencies of MCP-1 gene -2518 G/A polymorphism (AA:18.1%; AG:51.5%; GG:30.3% in cases; AA:16.3%; AG:52.9%; GG:30.7% in controls; P = 0.918). The G allele prevalence was 0.561 in cases and 0.572 in controls (P = 0.786). No significant difference was found in plasma MCP-1 level between cases and controls [(47.50 +/- 26.65) vs. (41.05 +/- 15.71) pg/ml, P = 0.272)] or among the 3 genotypes [AA, (43.49 +/- 10.50) pg/ml; AG, (46.09 +/- 25.08) pg/ml; GG, (40.03 +/- 18.13) pg/ml; P = 0.381]. Logistic regression analysis confirmed the lack of association between MCP-1-2518 G/A single nucleotide polymorphism and premature stable CAD after adjustment for confounding parameters. CONCLUSIONS: The MCP-1-2518 G/A single nucleotide polymorphism does not affect plasma levels of MCP-1 or susceptibility to premature stable CAD in a Chinese population.

Myeloperoxidase gene-463G > A polymorphism and premature coronary artery disease.

We investigated the association between myeloperoxidase gene -463G > A polymorphism and premature coronary artery disease (CAD) in two Chinese population samples: 229 patients and 230 controls. Genotypes were determined by ligase detection reaction-polymerase chain reaction sequencing and the grouping technique. We found lower frequencies of both the A/A genotype and the A allele in patients (p < 0.05). Multivariate logistic regression showed that the risk of premature CAD in subjects carrying the AA genotype was reduced by 83% in relation to individuals carrying the G/G genotype (OR = 0.172, 95% CI: 0.057-0.526, p = 0.002). Our results indicate that -463G > A polymorphism of the myeloperoxidase gene is associated with premature CAD in Chinese individuals, suggesting that the AA genotype is a protective factor against premature CAD.

Myeloperoxidase gene-463G > a polymorphism and premature coronary artery disease

We investigated the association between myeloperoxidase gene -463G > A polymorphism and premature coronary artery disease (CAD) in two Chinese population samples: 229 patients and 230 controls. Genotypes were determined by ligase detection reaction-polymerase chain reaction sequencing and the grouping technique. We found lower frequencies of both the A/A genotype and the A allele in patients (p < 0.05). Multivariate logistic regression showed that the risk of premature CAD in subjects carrying the AA genotype was reduced by 83 percent in relation to individuals carrying the G/G genotype (OR = 0.172, 95 percent CI: 0.057-0.526, p = 0.002). Our results indicate that -463G > A polymorphism of the myeloperoxidase gene is associated with premature CAD in Chinese individuals, suggesting that the AA genotype is a protective factor against premature CAD.

Clustering of cardiovascular risk factors in patients of premature stable coronary heart disease complicated with nonalcoholic fatty liver / 中华全科医师杂志

Objective To study the characteristics of clustering of cardiovascular risk factors in patients less than 50 years-old of premature stable coronary heart disease(PSCHD)complicated with nonalcoholic fatty liver(NAFL).Methods One hundred and six patients with documented PSCHD were recruited into this study and their clinical data,including biochemical parameters,high-sensitivity C-reactive protein(hsCRP),white blood cell(WBC)count,ete.,were analyzed based on whether they had NAFL by B-type ultrasound scanning and their homeostasis model assessment ratio(Homa-IR)by the criteria for metabolic syndrome formulated by the International Diabetes Federation.Results Thirty-two (30.1percent)of 106 patients of PSCHD complicated with NAFL,and 74(69.9 percent)without NAFL. As compared to patients without NAFL,patients with NAFL had higher fasting blood glucose(FBS),serum level of insulin(INS),total cholesterol(TC),triglyceride(TG),serum activity of alanine aminotransferase(ALT),hsCRP,WBC count,body mass index(BMI),Homa-IR,and higher proportion of those with abnormal blood glucose,hypertension.metabolic syndrome(MS)and carotid atherosclerosis (CA)(P＜0.05),respectively.Bi-variate correlation analysis revealed that hsCRP positively correlated to BMI,TG,ALT and Homa IR(r=0.420,P=0.000;r=0.200,P=0.040;r=0.218,P=0.048:and r=0.546,P=0.000,respectively)and inversely correlated with serum level of high-density lipoprotein cholesterol(HDL-C)(r=-0.220,P=0.023).WBC count positively correlated with FBS(r=0.211,P=0.030).BMI,hsCRP,ALT,and proportions of hypertension,diabetes,MS,NAFL and CA in patients with Homa-IR above median were significantly higher than those in patients with that below median ( P＜0.05,respectively).Conclusions More risk faetors for chronic inflammatory reaction,cardiovascular disease and insulin resistance were clustered more obviously in patients of PSCHD complicated with NAFL.

Factors associated with dyslipidemia awareness among residents in Beijing:results from CCEIP / 中国实用内科杂志

Objective To investigate the factors associated with awareness of dyslipidemia among residents in Beijing.Methods Cross-sectional data of 3 373 patients with dyslipidemia from CCEIP were analyzed.The patients were seleted from 10 054 residents from Daxing,Chaoyang,Haidian,and Xicheng Districts of Beijing during June-August,2007.The socioeconomic status and awareness of dyslipidemia were surveyed by questionnaires.The risk factors for cardiovascular diseases(CVDs),such as hypertension,obesity and diabetes,were assessed by physical examination and fasting blood analysis.Results (1)Awareness of dyslipidemia was improved with the increase of patients' age (P