Background: Both technical and nontechnical skills are important factors in cardiac emergency incident. The effects of structured framework on these skills have not been thoroughly studied. We hypothesized that struct...Background: Both technical and nontechnical skills are important factors in cardiac emergency incident. The effects of structured framework on these skills have not been thoroughly studied. We hypothesized that structured framework can improve the clinical performance and reduce errors to improve patients’ safety. Methodology: A total of 24 teams composed of cardiac residents, attending surgeons and ICU nurses performed simulated emergency incident tasks in cardiopulmonary resuscitation (CPR) and tracheal intubation (TI) scenarios. Framework education was introduced to the assigned groups in two separate semesters. All the scenarios were recorded by video for further evaluation by cardiologist and emergency medicine specialist. Clinical performance, time consumption in simulated scenarios, correlation between framework training and nontechnical skills performance were assessed. Results: The average percentages of CPR completed in the Group 1 (G1) with framework education and the Group 2 (G2) were 85% (SEM: 6.20%) and 53% (SEM: 5.77%) respectively (P < 0.001). And the average percentages of TI completed in G2 with framework education was 87% (SEM: 3.96%), higher than G1 (50%, SEM: 5.64%) (P < 0.001). As for time consumption, the mean time to complete CPR in groups with framework education was shorter than in groups without framework education (P o complete TI in groups with framework education was shorter than in groups without framework education (P < 0.005). Further, there was a significant correlation between framework training and communication in simulated scenarios. Conclusion: The framework provides the whole procedure of the task to every participant. Structured framework education can improve nontechnical skills as well as technical skills of doctors and nurses. Further, researches should be conducted to evaluate the clinical performance and correlation between technical skills and nontechnical skills in cardiothoracic training.展开更多
Common bile duct(CBD)stones are a frequent problem in Chinese populations,and their incidence is particularly high in certain areas(Wang et al.,2013).In recent years,laparoscopic common bile duct exploration(LCBDE)and...Common bile duct(CBD)stones are a frequent problem in Chinese populations,and their incidence is particularly high in certain areas(Wang et al.,2013).In recent years,laparoscopic common bile duct exploration(LCBDE)and endoscopic retrograde cholangiopancreatography(ERCP)have been the main surgical procedures for CBD stones,although each has different advantages and disadvantages in the treatment of choledocholithiasis(Loor et al.,2017;Zhou et al.,2017).展开更多
AIM:To compare the efficacy and safety of paclitaxel combined with fluorouracil plus cisplatin(PCF),and oxaliplatin combined with fluorouracil plus leucovorin(FOLFOX-4) regimens for advanced gastric cancer(AGC).METHOD...AIM:To compare the efficacy and safety of paclitaxel combined with fluorouracil plus cisplatin(PCF),and oxaliplatin combined with fluorouracil plus leucovorin(FOLFOX-4) regimens for advanced gastric cancer(AGC).METHODS:Ninety-four patients with AGC were randomly assigned to receive paclitaxel(50 mg/m2 iv) on days 1,8 and 15,cisplatin(20 mg/m2 iv) and ? uorouracil(750 mg/m2 iv) on days 1-5,or oxaliplatin(85 mg/m2 iv) and leucovorin(200 mg/m2 iv) on day 1,followed by bolus fluorouracil(400 mg/m2 iv) and fluorouracil(600 mg/m2 iv) on days 1 and 2.The primary end point was the 1-year survival time.RESULTS:The overall response rate(ORR) of the pa-tients was 48.0% and 45.5% to PCF and FOLFOX-4,respectively.The disease control rate(DCR) of PCF and FOLFOX-4 was 82.0% and 81.8%,respectively.The median survival times(MSTs) of the patients were 10.8 and 9.9 mo,respectively,after treatment with PCF and FOLFOX-4.The 1-year survival rate of the patients was 36.0% and 34.1%,respectively,after treatment with PCF and FOLFOX-4.No significant difference was observed in ORR,DCR,MST or 1-year survival rate between the two groups.The most common adverse events were anemia,nausea and vomiting,and grade 3/4 alopecia in PCF treatment group,and anemia,grade 1/2 neurotoxic effect and grade 3/4 neutropenia in FOLFOX-4 treatment group.CONCLUSION:Patients with AGC have a similar response rate to PCF and FOLFOX-4 regimens with a similar survival rate.The PCF and FOLFOX-4 regimens are efficacious and tolerable as a promising therapy for AGC.展开更多
Objective To evaluate the associations between the serum anion gap （AG） with the severity and prognosis of coronary artery disease （CAD）. Methods We measured serum electrolytes in 18,115 CAD patients indicated by ...Objective To evaluate the associations between the serum anion gap （AG） with the severity and prognosis of coronary artery disease （CAD）. Methods We measured serum electrolytes in 18,115 CAD patients indicated by coronary angiography. The serum AG was calculated according to the equation： AG = Na^＋ [（mmol/L） ＋ K^＋ （mmol/L）] - [Cl^- （mmol/L） ＋ HCO3^- （mmol/L）]. Results A total of 4510 （24.9%） participants had their AG levels greater than 16 mmol/L. The serum AG was independently associated with measures of CAD severity, including more severe clinical types of CAD （P 〈 0.001） and worse cardiac function （P = 0.004）. Patients in the 4th quartile of serum AG （≥ 15.92 mmol/L） had a 5.171-fold increased risk of 30 days all-cause death （P 〈 0.001）. This association was robust, even after adjustment for age, sex, evaluated glomerular filtration rate [hazard ratio （HR）： 4.861, 95% confidence interval （CI）： 2.150–10.993, P 〈 0.001], clinical diagnosis, severity of coronary artery stenosis, cardiac function grades, and other confounders （HR： 3.318, 95% CI： 1.76–2.27, P = 0.009）. Conclusion In this large population-based study, our findings reveal a high percentage of increased serum AG in CAD. Higher AG is associated with more severe clinical types of CAD and worse cardiac function. Furthermore, the increased serum AG is an independent, significant, and strong predictor of all-cause mortality. These findings support a role for the serum AG in the risk-stratification of CAD.展开更多
Background Previous studies have demonstrated that micro RNA-204(mi R-204) is involved in atherosclerosis and vascular calcification. However, the value of mi R-204 as the predictive biomarker for cardiovascular disea...Background Previous studies have demonstrated that micro RNA-204(mi R-204) is involved in atherosclerosis and vascular calcification. However, the value of mi R-204 as the predictive biomarker for cardiovascular disease(CVD) remains unclear. We aimed to evaluate the association between the circulating mi R-204 level and ten-year CVD risk based on the Framingham risk score(FRS). Methods In this retrospective study, we enrolled 194 consecutive patients with type 2 diabetes mellitus(T2DM) without CVD in Beijing Anzhen Hospital between January 2015 and September 2016. We used the FRS to evaluate the risk of CVD for each patient. Circulating mi R-204 levels were measured by quantitative real-time polymerase chain reaction. Results Circulating mi R-204 levels were significantly lower in the group of patients(0.49 ± 0.13) at high risk of CVD(FRS > 20%) than in the low(FRS < 10%) and intermediate(FRS: 10%–20%) risk groups(0.87 ± 0.19 and 0.75 ± 0.25, respectively;P < 0.001). FRS was negatively correlated with mi R-204 levels(r =-0.421, P < 0.001). According to multivariate logistic analyses, reduced mi R-204 level was independently associated with an increased risk of CVD after adjusting for conventional risk factors(OR = 0.876, 95% CI: 0.807–0.950, P = 0.001). Receiver-operating characteristic curve analysis showed that the circulating mi R-204 level can predict the high risk of CVD with higher specificity than the traditional risk factor of high systolic blood pressure or the protective factor of high-density lipoprotein cholesterol. Conclusions Our study demonstrated that patients with lower circulating mi R-204 levels were at high risk for CVD. After adjustment for potential confounders, mi R-204 was independently associated with CVD in patients with T2DM.展开更多
目的探讨槲皮素对应激致小鼠抑郁症的作用及相关机制。方法将90只小鼠按随机数字表法分为对照组、模型组、高剂量槲皮素组、中剂量槲皮素组、低剂量槲皮素组,每组18只。除对照组外,其他4组均采用慢性不可预知性温和应激制备抑郁模型,连...目的探讨槲皮素对应激致小鼠抑郁症的作用及相关机制。方法将90只小鼠按随机数字表法分为对照组、模型组、高剂量槲皮素组、中剂量槲皮素组、低剂量槲皮素组,每组18只。除对照组外,其他4组均采用慢性不可预知性温和应激制备抑郁模型,连续给予应激4周。从应激第3周开始,高、中、低剂量槲皮素组分别给予5、10、20 mg/(kg·d)的槲皮素(溶于2 ml 0.9%氯化钠溶液中)灌胃干预,模型组及对照组仅给予2 ml 0.9%氯化钠溶液灌胃。应激处理4周,每周记录并比较各组小鼠体质量变化、抑郁行为以及海马组织IL-1β、TNF-α、5-羟色胺(5-HT)及脑源性神经营养因子(BDNF)水平。结果造模第3、4周,各组小鼠体质量为对照组>高剂量槲皮素组>中剂量槲皮素组>低剂量槲皮素组>模型组(均P<0.05)。造模结束后,各组小鼠旷场活动路程比较,差异无统计学意义(P>0.05);各组小鼠游泳不动时间、悬尾不动时间均为对照组>高剂量槲皮素组>中剂量槲皮素组>低剂量槲皮素组>模型组(均P<0.05);海马组织IL-1β、TNF-α表达为对照组<高剂量槲皮素组<中剂量槲皮素组<低剂量槲皮素组<模型组(均P<0.05),5-HT、BDNF表达为对照组>高剂量槲皮素组>中剂量槲皮素组>低剂量槲皮素组>模型组(均P<0.05)。结论槲皮素具有抗抑郁作用,其作用机制可能与海马组织IL-1β、TNF-α表达降低,5-HT、BDNF表达升高有关。展开更多
Located at the head of the Indo-Burma biodiversity hotspot,the Kunming Institute of Zoology(KIZ),Chinese Academy of Sciences(CAS),serves as China’s main center for research into the diverse animal and ecological reso...Located at the head of the Indo-Burma biodiversity hotspot,the Kunming Institute of Zoology(KIZ),Chinese Academy of Sciences(CAS),serves as China’s main center for research into the diverse animal and ecological resources of southwestern China,Eastern Himalayas,and Southeast Asia.展开更多
Background Transradial coronary procedure （TRP） traumatizes the radial artery （RA）, especially resulting in changes to arterial wall morphology. This study explored the significance of the early onset of traumatic...Background Transradial coronary procedure （TRP） traumatizes the radial artery （RA）, especially resulting in changes to arterial wall morphology. This study explored the significance of the early onset of traumatic effects to wall layers of the RA following the first TRP （FTRP） and repeat TRP （RTRP） using very-high-frequency ultrabiomicroscopy （VHFUBM）. Methods A total of 1431 patients that re- ceived TRP were divided into the FTRP group that comprised 781 patients and the RTRP group that comprised 650 patients depending on the number of procedures. Two-dimensional RA images were acquired by 30-55 MHz ultrasound one day before and one day after the pro- cedure. Results After TRP, the incidence of intimal tears, medial dissections and external elastic lamina fracture were greater in the RTRP （P 〈 0.001）. The RTRP group showed significantly thicker intimal thickness （IT）, media thickness （MT）, adventitia thickness and all complex layer thicknesses as compared with the FTRP group （P 〈 0.001）. Conclusions Multivariate linear regression analysis discovered that repeated TRP and other observations were independent predictors of increased IT in post-operative RA. VHFUBM provides an approach to study structural and histopathological injury in the wall layers of RA which showed increased trauma to the RA following RTRP.展开更多
BACKGROUND Triglyceride(TG)and its related metabolic indices,all recognized as surrogates of insulin resistance,have been demonstrated to be relevant to clinical prognosis.However,the relative value of these TG-relate...BACKGROUND Triglyceride(TG)and its related metabolic indices,all recognized as surrogates of insulin resistance,have been demonstrated to be relevant to clinical prognosis.However,the relative value of these TG-related indices for predicting cardiovascular events among patients with acute coronary syndrome(ACS)has not been examined.METHODS The TG,the triglyceride-glucose(TyG)index,the atherogenic index of plasma,TG to high-density lipoprotein cholesterol ratio,and the lipoprotein combine index were assessed in 1694 ACS patients undergoing percutaneous coronary intervention.The primary endpoint was major adverse cardiovascular event(MACE),which was the composite of all-cause mortality,stroke,myocardial infarction,or unplanned repeat revascularization.RESULTS During a median follow-up of 31 months,345 patients(20.4%)had MACE.The risk of the MACE was increased with higher TG and the four TG-derived metabolic indices[TG-adjusted hazard ratio(HR)=1.002,95%CI:1.001-1.003;TyG index-adjusted HR=1.736,95%CI:1.398-2.156;atherogenic index of plasma-adjusted HR=2.513,95%CI:1.562-4.043;TG to high-density lipoprotein cholesterol ratio-adjusted HR=1.148,95%CI:1.048-1.258;and lipoprotein combine index-adjusted HR=1.009,95%CI:1.004-1.014;P<0.001 for all indices].TG and all the four indices significantly improved the predictive ability for MACE in addition to the baseline model.Among them,TyG index showed the best ability for predicting MACE compared with the other three indices from all the three measurements(P<0.05 for all comparison).CONCLUSIONS TG and TG-derived metabolic indices were all strongly associated with MACE among ACS patients undergoing percutaneous coronary intervention.Among all the indices,TyG index showed the best ability to predict the risk of MACE.展开更多
We derived a theoretical solution of the shock stand-off distance for a non-equilibrium flow over spheres based on Wen and Hornung＇s solution and Olivier＇s solution. Compared with previous approaches, the main advan...We derived a theoretical solution of the shock stand-off distance for a non-equilibrium flow over spheres based on Wen and Hornung＇s solution and Olivier＇s solution. Compared with previous approaches, the main advantage of the present approach is allowing an analytic solution without involving any semi-empirical parameter for the whole non-equilibrium flow regimes. The effects of some important physical quantities therefore can be fully revealed via the analytic solution. By combining the current solution with Ideal Dissociating Gas（IDG） model, we investigate the effects of free stream kinetic energy and free stream dissociation level（which can be very different between different facilities） on the shock stand-off distance.展开更多
Objective To evaluate the effects and mechanisms of glucose-insulin-potassium(GIK)on post-procedural myocardial injury(PMI)after percutaneous coronary intervention(PCI).Methods A total of 200 non-diabetic patients wit...Objective To evaluate the effects and mechanisms of glucose-insulin-potassium(GIK)on post-procedural myocardial injury(PMI)after percutaneous coronary intervention(PCI).Methods A total of 200 non-diabetic patients with documented coronary heart disease(CHD)were divided into the Group GIK and Group G,with 100 patients in each group.Patients in Group G were given intravenous infusion of glucose solution 2 hours before PCI.As compared,patients in Group GIK were given GIK.Results Both post-procedural creatine phosphokinase isoenzyme MB(CK-MB;62.1±47.8 vs.48.8±52.6 U/L,P=0.007)and cTnI(0.68±0.83 vs.0.19±0.24 ng/mL,P<0.001)in Group GIK were significantly higher than those in Group G.In Group G,9.0%and 4.0%of patients had post-procedural increases in CK-MB 1-3 times and>3 times,which were significantly lower than those in Group GIK(14.0%and 7.0%,respectively;all P values<0.01);13.0%and 7.0%of patients had post-procedural increases in cTnI 1-3 times and>3 times,which were also significantly lower than those in Group GIK(21.0%and 13.0%,respectively;all P<0.001).Pre-procedural(10.2±4.5 vs.5.1±6.3,P<0.001)and post-procedural rapid blood glucose(RBG)levels(8.9±3.9 vs.5.3±5.6,P<0.001)in Group G were higher than those in Group GIK.In adjusted logistic models,usage of GIK(compared with glucose solution)remained significantly and independently associated with higher risk of post-procedural increases in both CK-MB and cTnI levels>3 times.Furthermore,pre-procedural RBG levels<5.0mmol/L were significantly associated with higher risk of post-procedural increases in both CK-MB and cTnI levels.Conclusions In non-diabetic patients with CHD,the administration of GIK may increase the risk of PMI due to hypoglycemia induced by GIK.展开更多
Cardiovascular diseases(CVD)are the leading cause of death in the world and one of the most common diseases in the elderly,with high prevalence and poor prognosis,which seriously affect the health of the elder patient...Cardiovascular diseases(CVD)are the leading cause of death in the world and one of the most common diseases in the elderly,with high prevalence and poor prognosis,which seriously affect the health of the elder patients.One report showed that global deaths from CVD increased from 12.4 million in 1990 to 19.8 million in 2022,reflecting the global population growth and aging,as well as the impact of metabolic,environmental,and behavioral risks.[1]With the progress of aging population,the burden of CVD in the elderly in China has increased year by year,and factors including multiple complications,organ function decline,and high complication rate have made the interventional treatment of CVD in the elderly one of the difficulties and focuses in the field of cardiology in China.展开更多
文摘Background: Both technical and nontechnical skills are important factors in cardiac emergency incident. The effects of structured framework on these skills have not been thoroughly studied. We hypothesized that structured framework can improve the clinical performance and reduce errors to improve patients’ safety. Methodology: A total of 24 teams composed of cardiac residents, attending surgeons and ICU nurses performed simulated emergency incident tasks in cardiopulmonary resuscitation (CPR) and tracheal intubation (TI) scenarios. Framework education was introduced to the assigned groups in two separate semesters. All the scenarios were recorded by video for further evaluation by cardiologist and emergency medicine specialist. Clinical performance, time consumption in simulated scenarios, correlation between framework training and nontechnical skills performance were assessed. Results: The average percentages of CPR completed in the Group 1 (G1) with framework education and the Group 2 (G2) were 85% (SEM: 6.20%) and 53% (SEM: 5.77%) respectively (P < 0.001). And the average percentages of TI completed in G2 with framework education was 87% (SEM: 3.96%), higher than G1 (50%, SEM: 5.64%) (P < 0.001). As for time consumption, the mean time to complete CPR in groups with framework education was shorter than in groups without framework education (P o complete TI in groups with framework education was shorter than in groups without framework education (P < 0.005). Further, there was a significant correlation between framework training and communication in simulated scenarios. Conclusion: The framework provides the whole procedure of the task to every participant. Structured framework education can improve nontechnical skills as well as technical skills of doctors and nurses. Further, researches should be conducted to evaluate the clinical performance and correlation between technical skills and nontechnical skills in cardiothoracic training.
基金Project supported by the Foundation Project for Medical Science and Technology of Zhejiang Province(Nos.2019ZH022 and 2018KY478)the Zhejiang Province Public Welfare Technology Application Research Project(No.LGF19H180021),China
文摘Common bile duct(CBD)stones are a frequent problem in Chinese populations,and their incidence is particularly high in certain areas(Wang et al.,2013).In recent years,laparoscopic common bile duct exploration(LCBDE)and endoscopic retrograde cholangiopancreatography(ERCP)have been the main surgical procedures for CBD stones,although each has different advantages and disadvantages in the treatment of choledocholithiasis(Loor et al.,2017;Zhou et al.,2017).
基金Supported by The National Natural Science Foundation of China, No. 30872176, 30950022 and 30972703Jiangsu Province of China, No. K200403Department of Public Health and Department of Science and Technology (BS2005616)
文摘AIM:To compare the efficacy and safety of paclitaxel combined with fluorouracil plus cisplatin(PCF),and oxaliplatin combined with fluorouracil plus leucovorin(FOLFOX-4) regimens for advanced gastric cancer(AGC).METHODS:Ninety-four patients with AGC were randomly assigned to receive paclitaxel(50 mg/m2 iv) on days 1,8 and 15,cisplatin(20 mg/m2 iv) and ? uorouracil(750 mg/m2 iv) on days 1-5,or oxaliplatin(85 mg/m2 iv) and leucovorin(200 mg/m2 iv) on day 1,followed by bolus fluorouracil(400 mg/m2 iv) and fluorouracil(600 mg/m2 iv) on days 1 and 2.The primary end point was the 1-year survival time.RESULTS:The overall response rate(ORR) of the pa-tients was 48.0% and 45.5% to PCF and FOLFOX-4,respectively.The disease control rate(DCR) of PCF and FOLFOX-4 was 82.0% and 81.8%,respectively.The median survival times(MSTs) of the patients were 10.8 and 9.9 mo,respectively,after treatment with PCF and FOLFOX-4.The 1-year survival rate of the patients was 36.0% and 34.1%,respectively,after treatment with PCF and FOLFOX-4.No significant difference was observed in ORR,DCR,MST or 1-year survival rate between the two groups.The most common adverse events were anemia,nausea and vomiting,and grade 3/4 alopecia in PCF treatment group,and anemia,grade 1/2 neurotoxic effect and grade 3/4 neutropenia in FOLFOX-4 treatment group.CONCLUSION:Patients with AGC have a similar response rate to PCF and FOLFOX-4 regimens with a similar survival rate.The PCF and FOLFOX-4 regimens are efficacious and tolerable as a promising therapy for AGC.
基金Acknowledgement This work was supported by the Beijing Nova Program （No. Z121107002512053）, the Beijing Health System High Level Health Technology Talent Cultivation Plan （No. 2013-3-013）, the Beijing Outstanding Talent Training Program （No. 2014000021223ZK32）, and the National Natural Science Foundation of China （No. 81100143） to S.W.Y., and the Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support （No. ZYLX201303） to Y.J.Z.
文摘Objective To evaluate the associations between the serum anion gap （AG） with the severity and prognosis of coronary artery disease （CAD）. Methods We measured serum electrolytes in 18,115 CAD patients indicated by coronary angiography. The serum AG was calculated according to the equation： AG = Na^＋ [（mmol/L） ＋ K^＋ （mmol/L）] - [Cl^- （mmol/L） ＋ HCO3^- （mmol/L）]. Results A total of 4510 （24.9%） participants had their AG levels greater than 16 mmol/L. The serum AG was independently associated with measures of CAD severity, including more severe clinical types of CAD （P 〈 0.001） and worse cardiac function （P = 0.004）. Patients in the 4th quartile of serum AG （≥ 15.92 mmol/L） had a 5.171-fold increased risk of 30 days all-cause death （P 〈 0.001）. This association was robust, even after adjustment for age, sex, evaluated glomerular filtration rate [hazard ratio （HR）： 4.861, 95% confidence interval （CI）： 2.150–10.993, P 〈 0.001], clinical diagnosis, severity of coronary artery stenosis, cardiac function grades, and other confounders （HR： 3.318, 95% CI： 1.76–2.27, P = 0.009）. Conclusion In this large population-based study, our findings reveal a high percentage of increased serum AG in CAD. Higher AG is associated with more severe clinical types of CAD and worse cardiac function. Furthermore, the increased serum AG is an independent, significant, and strong predictor of all-cause mortality. These findings support a role for the serum AG in the risk-stratification of CAD.
基金the National Natural Scientific Foundation of China (No. 81573744 & No. 81973841)。
文摘Background Previous studies have demonstrated that micro RNA-204(mi R-204) is involved in atherosclerosis and vascular calcification. However, the value of mi R-204 as the predictive biomarker for cardiovascular disease(CVD) remains unclear. We aimed to evaluate the association between the circulating mi R-204 level and ten-year CVD risk based on the Framingham risk score(FRS). Methods In this retrospective study, we enrolled 194 consecutive patients with type 2 diabetes mellitus(T2DM) without CVD in Beijing Anzhen Hospital between January 2015 and September 2016. We used the FRS to evaluate the risk of CVD for each patient. Circulating mi R-204 levels were measured by quantitative real-time polymerase chain reaction. Results Circulating mi R-204 levels were significantly lower in the group of patients(0.49 ± 0.13) at high risk of CVD(FRS > 20%) than in the low(FRS < 10%) and intermediate(FRS: 10%–20%) risk groups(0.87 ± 0.19 and 0.75 ± 0.25, respectively;P < 0.001). FRS was negatively correlated with mi R-204 levels(r =-0.421, P < 0.001). According to multivariate logistic analyses, reduced mi R-204 level was independently associated with an increased risk of CVD after adjusting for conventional risk factors(OR = 0.876, 95% CI: 0.807–0.950, P = 0.001). Receiver-operating characteristic curve analysis showed that the circulating mi R-204 level can predict the high risk of CVD with higher specificity than the traditional risk factor of high systolic blood pressure or the protective factor of high-density lipoprotein cholesterol. Conclusions Our study demonstrated that patients with lower circulating mi R-204 levels were at high risk for CVD. After adjustment for potential confounders, mi R-204 was independently associated with CVD in patients with T2DM.
文摘目的探讨槲皮素对应激致小鼠抑郁症的作用及相关机制。方法将90只小鼠按随机数字表法分为对照组、模型组、高剂量槲皮素组、中剂量槲皮素组、低剂量槲皮素组,每组18只。除对照组外,其他4组均采用慢性不可预知性温和应激制备抑郁模型,连续给予应激4周。从应激第3周开始,高、中、低剂量槲皮素组分别给予5、10、20 mg/(kg·d)的槲皮素(溶于2 ml 0.9%氯化钠溶液中)灌胃干预,模型组及对照组仅给予2 ml 0.9%氯化钠溶液灌胃。应激处理4周,每周记录并比较各组小鼠体质量变化、抑郁行为以及海马组织IL-1β、TNF-α、5-羟色胺(5-HT)及脑源性神经营养因子(BDNF)水平。结果造模第3、4周,各组小鼠体质量为对照组>高剂量槲皮素组>中剂量槲皮素组>低剂量槲皮素组>模型组(均P<0.05)。造模结束后,各组小鼠旷场活动路程比较,差异无统计学意义(P>0.05);各组小鼠游泳不动时间、悬尾不动时间均为对照组>高剂量槲皮素组>中剂量槲皮素组>低剂量槲皮素组>模型组(均P<0.05);海马组织IL-1β、TNF-α表达为对照组<高剂量槲皮素组<中剂量槲皮素组<低剂量槲皮素组<模型组(均P<0.05),5-HT、BDNF表达为对照组>高剂量槲皮素组>中剂量槲皮素组>低剂量槲皮素组>模型组(均P<0.05)。结论槲皮素具有抗抑郁作用,其作用机制可能与海马组织IL-1β、TNF-α表达降低,5-HT、BDNF表达升高有关。
文摘Located at the head of the Indo-Burma biodiversity hotspot,the Kunming Institute of Zoology(KIZ),Chinese Academy of Sciences(CAS),serves as China’s main center for research into the diverse animal and ecological resources of southwestern China,Eastern Himalayas,and Southeast Asia.
文摘Background Transradial coronary procedure （TRP） traumatizes the radial artery （RA）, especially resulting in changes to arterial wall morphology. This study explored the significance of the early onset of traumatic effects to wall layers of the RA following the first TRP （FTRP） and repeat TRP （RTRP） using very-high-frequency ultrabiomicroscopy （VHFUBM）. Methods A total of 1431 patients that re- ceived TRP were divided into the FTRP group that comprised 781 patients and the RTRP group that comprised 650 patients depending on the number of procedures. Two-dimensional RA images were acquired by 30-55 MHz ultrasound one day before and one day after the pro- cedure. Results After TRP, the incidence of intimal tears, medial dissections and external elastic lamina fracture were greater in the RTRP （P 〈 0.001）. The RTRP group showed significantly thicker intimal thickness （IT）, media thickness （MT）, adventitia thickness and all complex layer thicknesses as compared with the FTRP group （P 〈 0.001）. Conclusions Multivariate linear regression analysis discovered that repeated TRP and other observations were independent predictors of increased IT in post-operative RA. VHFUBM provides an approach to study structural and histopathological injury in the wall layers of RA which showed increased trauma to the RA following RTRP.
基金supported by the National Key Research and Development Program of China (2017YFC 0908800)the Beijing Municipal Administration of Hospitals’ Mission Plan (SML20180601)+2 种基金the China Postdoctoral Science Foundation (2021M692253)the Beijing Postdoctoral Research Foundation (2021-ZZ023)the Beijing Municipal Health Commission (Jing 19-15)
文摘BACKGROUND Triglyceride(TG)and its related metabolic indices,all recognized as surrogates of insulin resistance,have been demonstrated to be relevant to clinical prognosis.However,the relative value of these TG-related indices for predicting cardiovascular events among patients with acute coronary syndrome(ACS)has not been examined.METHODS The TG,the triglyceride-glucose(TyG)index,the atherogenic index of plasma,TG to high-density lipoprotein cholesterol ratio,and the lipoprotein combine index were assessed in 1694 ACS patients undergoing percutaneous coronary intervention.The primary endpoint was major adverse cardiovascular event(MACE),which was the composite of all-cause mortality,stroke,myocardial infarction,or unplanned repeat revascularization.RESULTS During a median follow-up of 31 months,345 patients(20.4%)had MACE.The risk of the MACE was increased with higher TG and the four TG-derived metabolic indices[TG-adjusted hazard ratio(HR)=1.002,95%CI:1.001-1.003;TyG index-adjusted HR=1.736,95%CI:1.398-2.156;atherogenic index of plasma-adjusted HR=2.513,95%CI:1.562-4.043;TG to high-density lipoprotein cholesterol ratio-adjusted HR=1.148,95%CI:1.048-1.258;and lipoprotein combine index-adjusted HR=1.009,95%CI:1.004-1.014;P<0.001 for all indices].TG and all the four indices significantly improved the predictive ability for MACE in addition to the baseline model.Among them,TyG index showed the best ability for predicting MACE compared with the other three indices from all the three measurements(P<0.05 for all comparison).CONCLUSIONS TG and TG-derived metabolic indices were all strongly associated with MACE among ACS patients undergoing percutaneous coronary intervention.Among all the indices,TyG index showed the best ability to predict the risk of MACE.
基金co-supported by the Research Grants Council of Hong Kong,China(No.C5010-14E)the National Natural Science Foundation of China(No.11372265)
文摘We derived a theoretical solution of the shock stand-off distance for a non-equilibrium flow over spheres based on Wen and Hornung＇s solution and Olivier＇s solution. Compared with previous approaches, the main advantage of the present approach is allowing an analytic solution without involving any semi-empirical parameter for the whole non-equilibrium flow regimes. The effects of some important physical quantities therefore can be fully revealed via the analytic solution. By combining the current solution with Ideal Dissociating Gas（IDG） model, we investigate the effects of free stream kinetic energy and free stream dissociation level（which can be very different between different facilities） on the shock stand-off distance.
基金The report was supported by grants from the Beijing Nova Program(No.Z121107002512053)the Beijing Health System High Level Health Technology Talent Cultivation Plan(No.2013-3-013)+3 种基金Beijing Outstanding Talent Training Program(No.2014000021223ZK32)the National Natural Science Foundation of China(No.81100143)the Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support(No.ZYLX 201303)and the National Key Clinical Speciality Construction Project.
文摘Objective To evaluate the effects and mechanisms of glucose-insulin-potassium(GIK)on post-procedural myocardial injury(PMI)after percutaneous coronary intervention(PCI).Methods A total of 200 non-diabetic patients with documented coronary heart disease(CHD)were divided into the Group GIK and Group G,with 100 patients in each group.Patients in Group G were given intravenous infusion of glucose solution 2 hours before PCI.As compared,patients in Group GIK were given GIK.Results Both post-procedural creatine phosphokinase isoenzyme MB(CK-MB;62.1±47.8 vs.48.8±52.6 U/L,P=0.007)and cTnI(0.68±0.83 vs.0.19±0.24 ng/mL,P<0.001)in Group GIK were significantly higher than those in Group G.In Group G,9.0%and 4.0%of patients had post-procedural increases in CK-MB 1-3 times and>3 times,which were significantly lower than those in Group GIK(14.0%and 7.0%,respectively;all P values<0.01);13.0%and 7.0%of patients had post-procedural increases in cTnI 1-3 times and>3 times,which were also significantly lower than those in Group GIK(21.0%and 13.0%,respectively;all P<0.001).Pre-procedural(10.2±4.5 vs.5.1±6.3,P<0.001)and post-procedural rapid blood glucose(RBG)levels(8.9±3.9 vs.5.3±5.6,P<0.001)in Group G were higher than those in Group GIK.In adjusted logistic models,usage of GIK(compared with glucose solution)remained significantly and independently associated with higher risk of post-procedural increases in both CK-MB and cTnI levels>3 times.Furthermore,pre-procedural RBG levels<5.0mmol/L were significantly associated with higher risk of post-procedural increases in both CK-MB and cTnI levels.Conclusions In non-diabetic patients with CHD,the administration of GIK may increase the risk of PMI due to hypoglycemia induced by GIK.
文摘Cardiovascular diseases(CVD)are the leading cause of death in the world and one of the most common diseases in the elderly,with high prevalence and poor prognosis,which seriously affect the health of the elder patients.One report showed that global deaths from CVD increased from 12.4 million in 1990 to 19.8 million in 2022,reflecting the global population growth and aging,as well as the impact of metabolic,environmental,and behavioral risks.[1]With the progress of aging population,the burden of CVD in the elderly in China has increased year by year,and factors including multiple complications,organ function decline,and high complication rate have made the interventional treatment of CVD in the elderly one of the difficulties and focuses in the field of cardiology in China.
