Objective:To explore the effect of continuous non-invasive blood pressure monitoring on intraoperative hemodynamics and postoperative myocardial injury in craniotomy.Methods:120 cases of elective craniotomy were divid...Objective:To explore the effect of continuous non-invasive blood pressure monitoring on intraoperative hemodynamics and postoperative myocardial injury in craniotomy.Methods:120 cases of elective craniotomy were divided into the self-control group(continuous non-invasive blood pressure monitoring and intermittent cuff non-invasive blood pressure monitoring,CNAP group)and propensity score matching group(only intermittent cuff non-invasive blood pressure measurement in previous craniotomy,PSM group);Goal-directed hemodynamic management in CNAP group included heart rate(HR),blood pressure(BP),stroke volume(SV),stroke variability(SVV),and systemic vascular resistance index(SVRI).The main index is to compare the troponin level within 72 hours after operation between the CNAP group and the PSM group;The secondary indicators are the comparison of the hemodynamic conditions between the CNAP group and the PSM at 10 specific time points.Results:The incidence of postoperative myocardial injury in the CNAP group was significantly lower than that in the PSM group(12%vs.30%,P=0.01);in the CNAP group hypotensive episodes(6 vs.3,P=0.01),positive balance of fluid therapy(700 vs.500 mL,P<0.001),more use of vasoactive drugs(29 vs.18,P=0.04),more stable hemodynamics medical status(P=0.03)were recorded.Conclusion:The hemodynamic management strategy based on continuous non-invasive blood pressure monitoring can reduce the incidence of myocardial injury after elective craniotomy and maintain a more stable hemodynamic state.展开更多
Failure of an automated blood pressure cuff to deflate when a patient is under general anesthesia can lead to catastrophic consequences if unnoticed for more than three hours [1]. We present this as a hearsay case in ...Failure of an automated blood pressure cuff to deflate when a patient is under general anesthesia can lead to catastrophic consequences if unnoticed for more than three hours [1]. We present this as a hearsay case in which an automated blood pressure cuff of the Spacelabs Ultraview Clinical Workstation monitor (model No. 90385) applied pressure for about five hours resulting in limb thrombosis. In order to analyze this catastrophe, simulation scenarios were tested to elucidate the possible errors and malfunctions that may have led to this injury. We present the analysis of the advantages and validity of the hearsay case report. We also include our proposed criteria that should be required when a hearsay case is considered for publication.展开更多
Background: First responders (firefighters, paramedics, and police) working in an urban setting can be exposed to a high-stress environment caused by strenuous physical exertion, potentially dangerous work conditions,...Background: First responders (firefighters, paramedics, and police) working in an urban setting can be exposed to a high-stress environment caused by strenuous physical exertion, potentially dangerous work conditions, sleep deprivation due to shift work, poor dietary habits, psychological stress and noise levels that are excessive. This may induce chronic increases in blood pressure. The purpose of this study was to determine the presence of hypertension in people working in occupations generally accepted as high stress in comparison to those working in an environment where less of these obvious high stressors were present. Methods: Resting blood pressure was measured by TrUBP in 1067 on-duty first responders (fire, paramedic, and police), and in participants generally associated with a lower-stress work environment (transit workers, city and bank employees, factory workers and legislature employees). Results: The average age, systolic and diastolic blood pressures were significantly lower in those employees working in a high-stress environment than those in a low-stress job. This difference was observed in both male and female sexes. Conclusions: Our data do not support an association of high resting blood pressure values in those employed in activities typically associated with a high-stress urban working environment.展开更多
Background: Tooth loss results in impaired mastication, which in turn, makes it difficult to chew hard food, consequently leading to deteriorate dietary habits and to develop hypertension. The purpose of this study wa...Background: Tooth loss results in impaired mastication, which in turn, makes it difficult to chew hard food, consequently leading to deteriorate dietary habits and to develop hypertension. The purpose of this study was to examine the effect of tooth loss on blood pressure among Congolese population. Methods: A cross-sectional study was conducted from October 2019 until December 2023 among Congolese population aged at least 30 years reporting to the living in DR Congo. All participants were enrolled from Dental Clinic located in the DR Congo. To be eligible to participate in the study, were the willing to participate and having signed informed consent;had a missing tooth;had carried out blood pressure measurement (hypertension/normotensive). The exclusion criteria were determined: being less than 30 years old, being pregnant for women considering the risk of existing gestational hypertension, obesity, excessive alcohol consumption, smoking, and diabetes. Hypertension was defined as the mean of three measurements of systolic blood pressure (SBP) (140 mmHg or higher), diastolic blood pressure (DBP) (90 mm or higher) or physician diagnosed hypertension confirmed from medical records. We determined the number of tooth loss from oral examination. A multivariable logistic regression model was used to investigate the effect of tooth loss on blood pressure. Results: In all, 25,396 participants were enrolled among Congolese population for this study. After oral examination, 13,421 were excluded for no tooth loss and 11,975 participants were selected. The average number of tooth loss among study population was 11.06. Among the participants with hypertension had lost an average of 11 teeth, significantly higher than those without hypertension (6.09) (p = 0.001). After adjusting for covariates (socio-demographic characteristics), tooth loss (>10) was significantly associated with hypertension, with OR = 1.32 (95% CI 1.073 - 2.38). Conclusion: Tooth loss maybe associated with severe hypertension among Congolese population adults. Prevention of tooth loss is very important to the overall health of this population.展开更多
Background Hypertension is associated with an increased risk of calcific aortic valve stenosis(CAVS).However,the directionality of causation between blood pressure traits and aortic stenosis is unclear,as is the benef...Background Hypertension is associated with an increased risk of calcific aortic valve stenosis(CAVS).However,the directionality of causation between blood pressure traits and aortic stenosis is unclear,as is the benefit of antihypertensive drugs for CAVS.Methods Using genome-wide association studies(GWAS)summary statistics,we performed bidirectional two-sample univariable mendelian randomization(UVMR)to assess the causal associations of systolic blood pressure(SBP),diastolic blood pressure(DBP),and pulse pressure(PP)with CAVS.Multivariable mendelian randomization(MVMR)was conducted to evaluate the direct effect of hypertension on CAVS,adjusting for confounders.Drug target mendelian randomization(MR)and summary-level MR(SMR)were used to estimate the effects of 12 classes of antihypertensive drugs and their target genes on CAVS risk.Inverse variance weighting was the primary MR method,with sensitivity analyses to validate results.Results UVMR showed SBP,DBP,and PP have causal effects on CAVS,with no significant reverse causality.MVMR confirmed the causality between hypertension and CAVS after adjusting for confounders.Drug-target MR analyses indicated that calcium channel blockers(CCBs),loop diuretics,and thiazide diuretics via SBP lowering exerted protective effects on CAVS risk.SMR analysis showed that the CCBs target gene CACNA2D2 and ARBs target gene AGTR1 were positively associated with CAVS risk,while diuretics target genes SLC12A5 and SLC12A1 were negatively associated with aortic stenosis risk.Conclusions Hypertension has a causal relationship with CAVS.Managing SBP in hypertensive patients with CCBs may prevent CAVS.ARBs might exert protective effects on CAVS independent of blood pressure reduction.The relationship between diuretics and CAVS is complex,with opposite effects through different mechanisms.展开更多
Background Both medication and non-medication therapies are effective approaches to control blood pressure (BP) in hypertension patients.However,the association of joint changes in antihypertensive medication use and ...Background Both medication and non-medication therapies are effective approaches to control blood pressure (BP) in hypertension patients.However,the association of joint changes in antihypertensive medication use and healthy lifestyle index (HLI)with BP control among hypertension patients is seldom reported,which needs to provide more evidence by prospective intervention studies.We examined the association of antihypertensive medication use and HLI with BP control among employees with hypertension in China based on a workplace-based multicomponent intervention program.Methods Between January 2013 and December 2014,a cluster randomized clinical trial of a workplace-based multicomponent intervention program was conducted in 60 workplaces across 20 urban areas in China.Workplaces were randomly divided into intervention (n=40) and control (n=20) groups.Basic information on employees at each workplace was collected by trained professionals,including sociodemographic characteristics,medical history,family history,lifestyle behaviors,medication status and physical measurements.After baseline,the intervention group received a 2-year intervention to achieve BP control,which included:(1) a workplace wellness program for all employees;(2) a guidelines-oriented hypertension management protocol.HLI including nonsmoking,nondrinking,adequate physical activity,weight within reference range and balanced diet,were coded on a 5-point scale (range:0-5,with higher score indicating a healthier lifestyle).Antihypertensive medication use was defined as taking drug within the last 2 weeks.Changes in HLI,antihypertensive medication use and BP control from baseline to 24 months were measured after the intervention.Results Overall,4655 employees were included (age:46.3±7.6 years,men:3547 (82.3%)).After 24 months of the intervention,there was a significant improvement in lifestyle[smoking (OR=0.65,95%CI:0.43-0.99;P=0.045),drinking (OR=0.52,95%CI:0.40-0.68;P<0.001),regular exercise (OR=3.10,95%CI:2.53-3.78;P<0.001),excessive intake of fatty food (OR=0.17,95%CI:0.06-0.52;P=0.002),restrictive use of salt (OR=0.26,95%CI:0.12-0.56;P=0.001)].Compare to employees with a deteriorating lifestyle after the intervention,those with an improved lifestyle had a higher BP control.In the intervention group,compared with employees not using antihypertensive medication,those who consistent used (OR=2.34;95%CI:1.16-4.72;P=0.017) or changed from not using to using antihypertensive medication (OR=2.24;95%CI:1.08-4.62;P=0.030) had higher BP control.Compared with those having lower HLI,participants with a same (OR=1.38;95%CI:0.99-1.93;P=0.056) or high (OR=1.79;95%CI:1.27~2.53;P<0.001) HLI had higher BP control.Those who used antihypertensive medication and had a high HLI had the highest BP control (OR=1.88;95%CI:1.32-2.67,P<0.001).Subgroup analysis also showed the consistent effect as the above.Conclusion These findings suggest that adherence to antihypertensive medication treatment and healthy lifestyle were associated with a significant improvement in BP control among employees with hypertension.展开更多
[Objectives]To investigate differences in BMI and renal function across constitution types and influencing factors of blood pressure.[Methods]92 college student volunteers aged 18-25 from January 2023 to December 2024...[Objectives]To investigate differences in BMI and renal function across constitution types and influencing factors of blood pressure.[Methods]92 college student volunteers aged 18-25 from January 2023 to December 2024 were selected.BMI,blood pressure,and renal function markers—blood urea nitrogen(BUN),creatinine(Cr),uric acid(UA),were compared across constitution types.Multiple stepwise regression analysis was applied to identify the influencing factors of blood pressure.[Results]Among 92 healthy participants aged 18-25,Shar-predominant constitution accounted for 50%,Khii-predominant for 25%,and Badgan-predominant for 20.65%.Significant differences existed in mean systolic and diastolic blood pressure across constitution types(systolic:F=4.56,P=0.001;diastolic:F=3.78,P=0.005).Shar-predominant group showed significantly higher systolic blood pressure than other types(P<0.05),while Khii-predominant group had higher diastolic pressure.Shar-predominant constitution demonstrated significantly greater height,weight,and BMI compared to other types(P<0.05).Males exhibited significantly higher height,weight,and BMI than females(P<0.05).Shar-predominant group showed significantly elevated urea,uric acid,and creatinine levels compared to other constitution types(P<0.05).Males had significantly higher mean urea,uric acid,and creatinine levels than females(P<0.05).Correlation analysis revealed stronger associations between BMI,renal function,and blood pressure in Shar-predominant group(r>0.50,P<0.05).Multiple regression analysis identified BMI as the primary influencing factor for blood pressure,followed by urea and uric acid.In Shar-predominant group,BMI exerted the strongest effect on blood pressure(β=0.60-0.65,P<0.001).[Conclusions]This study provides important evidence for health management in populations with different constitution types.展开更多
Objective:To evaluate the effect of labetalol combined with aspirin on improving blood pressure in patients with hypertensive disorders of pregnancy(HDP).Methods:Eighty-two patients with HDP who visited the hospital f...Objective:To evaluate the effect of labetalol combined with aspirin on improving blood pressure in patients with hypertensive disorders of pregnancy(HDP).Methods:Eighty-two patients with HDP who visited the hospital from August 2022 to August 2024 were selected as samples and randomly divided into two groups.Group A was treated with labetalol and aspirin,while Group B was treated with labetalol only.The efficacy,blood pressure,vascular endothelial function,coagulation indexes,and pregnancy outcomes were compared between the two groups.Results:The efficacy of Group A was higher than that of Group B(P<0.05).The systolic blood pressure(SBP),diastolic blood pressure(DBP),and endothelin-1(ET-1)in Group A were lower than those in Group B(P<0.05).The prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT),and fibrinogen(FIB)in Group A were all better than those in Group B(P<0.05).The rate of adverse pregnancy outcomes in Group A was lower than that in Group B(P<0.05).Conclusion:The combination of labetalol and aspirin for the treatment of HDP can stabilize blood pressure,optimize vascular endothelial function,improve coagulation indexes and pregnancy outcomes,which is highly effective and feasible.展开更多
G-protein coupled receptor kinase 4(GRK4)gene plays a core role in renal dopamine D1 receptor function for handing renal sodium excretion,the rs1801058 T variant has~50%frequency in the general East Asian population b...G-protein coupled receptor kinase 4(GRK4)gene plays a core role in renal dopamine D1 receptor function for handing renal sodium excretion,the rs1801058 T variant has~50%frequency in the general East Asian population but lacks functional evidence for salt-sensitivity.In this prospective study,we identified rs1801058 genotypes by sequencing in hypertensives patients and analyzed the variant's effects on blood pressure response to acute salt loading in 150 newly diagnosed hypertension patients.Our data indicated that there were no statistically significant difference in blood pressure changes between the overall rs1801058 genotype groups.Carriers of the C allele showed a significant rise in heart rate change according to acute saline loading.Among patients age≤40year,T allele carriers showed higher changes in systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP),and heart rate(HR)than C allele carriers when diuretic shrinkage.GRK4 single rs1801058 polymorphism cannot directly explain salt sensitivity in the Chinese hypertension patients.展开更多
Objective:To analyze the characteristics of ambulatory blood pressure in elderly patients with hypertension and find out the risk factors of abnormal circadian rhythm.Methods:According to the circadian rhythm of patie...Objective:To analyze the characteristics of ambulatory blood pressure in elderly patients with hypertension and find out the risk factors of abnormal circadian rhythm.Methods:According to the circadian rhythm of patients'blood pressure,they were divided into Group A,Group B and Group C,and all the data of hypertension patients in this study were collected,including age,gender,BMI,smoking,drinking,basic diseases(diabetes,cerebrovascular disease,hyperlipidemia,etc.),fasting blood glucose,ambulatory blood pressure(24-hour mean systolic pressure,24-hour mean diastolic pressure,daytime mean systolic pressure and daytime mean diastolic pressure).Results:There were significant differences in mean systolic blood pressure and mean diastolic blood pressure at night among Group A,Group B and Group C(P<0.05).Age,hyperlipidemia and fasting blood glucose were risk factors for circadian rhythm abnormality(P<0.05),and 24-hour urinary sodium was a protective factor for circadian rhythm abnormality(P<0.05).Conclusion:Age,hyperlipidemia and fasting blood glucose are risk factors for circadian rhythm abnormality(P<0.05),and 24-hour urinary sodium is a protective factor for circadian rhythm abnormality(P<0.05).展开更多
Objective:To analyze the characteristics of ambulatory blood pressure in elderly patients with hypertension and find out the risk factors of abnormal circadian rhythm.Methods:According to the circadian rhythm of patie...Objective:To analyze the characteristics of ambulatory blood pressure in elderly patients with hypertension and find out the risk factors of abnormal circadian rhythm.Methods:According to the circadian rhythm of patients’blood pressure,they were divided into group A,group B,and group C,and all the data of hypertension patients in this study were collected,including age,gender,BMI,smoking,drinking,basic diseases(diabetes,cerebrovascular disease,hyperlipidemia,etc.),fasting blood glucose,ambulatory blood pressure(24-hour mean systolic pressure,24-hour mean diastolic pressure,daytime mean systolic pressure and daytime mean diastolic pressure).Results:There were significant differences in mean systolic blood pressure and mean diastolic blood pressure at night among group A,group B and group C(P<0.05).Age,hyperlipidemia and fasting blood glucose were risk factors for circadian rhythm abnormality(P<0.05),and 24-hour urinary sodium was a protective factor for circadian rhythm abnormality(P<0.05).Conclusion:Age,hyperlipidemia and fasting blood glucose are risk factors for circadian rhythm abnormality(P<0.05),and 24-hour urinary sodium is a protective factor for circadian rhythm abnormality(P<0.05).展开更多
Objective:To explore the application of“tertiary hospitals-secondary hospitals and nursing care institutions-community-family”four-dimensional linkage care model in peritoneal dialysis patients.Methods:99 cases of p...Objective:To explore the application of“tertiary hospitals-secondary hospitals and nursing care institutions-community-family”four-dimensional linkage care model in peritoneal dialysis patients.Methods:99 cases of peritoneal dialysis patients were divided into 47 cases in the control group and 52 cases in the intervention group.In the control group,the routine discharge follow-up model was adopted;in the intervention group,the hospital-led medical unit was adopted as the basis of the“tertiary hospitals-secondary hospitals and nursing care institutions-community-family”quadruple linkage care model,and the patients’systolic blood pressure was compared with those in the control group before and after discharge.The systolic blood pressure,diastolic blood pressure,N-terminal brain natriuretic peptide,and sodium were compared between the two groups.Results:The systolic blood pressure,diastolic blood pressure,N-terminal brain natriuretic peptide,and blood sodium of patients in the intervention group were significantly better than those of the control group(all P<0.001).Conclusion:Based on the“tertiary hospital-secondary hospital and nursing home-community-family”quadratic care model,the blood pressure control rate of elderly peritoneal dialysis patients can be increased to meet the standard,reduce the symptoms of the disease,and improve the satisfaction.展开更多
Objective:This study aimed to determine the effect of a culture-specificbehavior modificationprogram on glycated hemoglobin(HbA1c)and blood pressure among adults with diabetes and hypertension.Methods:This study was a...Objective:This study aimed to determine the effect of a culture-specificbehavior modificationprogram on glycated hemoglobin(HbA1c)and blood pressure among adults with diabetes and hypertension.Methods:This study was a single-blind randomized controlled trial design.From January to May 2024,a total of 60 patients with uncontrolled type 2 diabetes and hypertension from the primary care unit of a hospital in northeastern(Isan)Thailand were recruited.The intervention group received the usual care supplemented by a culture-specificbehavior modificationprogramm implemented through interactive classes and online web application consisting of information,motivation,and behavioral skills(diet,exercise,and medication use),the control group received the usual care.HbA1c and blood pressure measurements were collected at both baseline and at 12 weeks.Results:A total of 51 patients completed the study,the intervention group(n=26)and control group(n=25),respectively.After 12 weeks,23.1%of patients in the intervention group could maintain their HbA1c<7.0%;those with poorly controlled HbA1c decreased from 7.7%at baseline to 3.8%at 12 weeks.After 12 weeks,69.2%of intervention group participants could maintain systolic blood pressure<130 mmHg and 53.8%could keep diastolic blood pressure<80 mmHg.Analysis revealed that HbA1c,systolic and diastolic blood pressure levels in the intervention group were lower than the control group after the intervention(P<0.05).There was a statistically significantdifference a linear combination of HbA1c and blood pressure(systolic and diastolic BP levels)between time and group(P<0.05).Conclusion:These results suggest that healthcare providers can incorporate elements of this program to manage blood glucose and blood pressure effectively.Future studies should consider a longitudinal design with a larger sample size and include outcomes of lipid levels to confirmlong-term motivation.展开更多
Long-term exposure to fine particulate matters(PM_(2.5))has been associated with respiratory and cardiovascular diseases and the burden are potentially higher in China experiencing heavy air pollution.In this study,we...Long-term exposure to fine particulate matters(PM_(2.5))has been associated with respiratory and cardiovascular diseases and the burden are potentially higher in China experiencing heavy air pollution.In this study,we established the exposure-response association between long-term exposures to PM_(2.5)and lung function and blood pressure in Chinesemiddle-aged and older adults using linearmixed-effects and generalized additive mixedmodels based on 3 waves longitudinal health outcomes data by enrolling 19,988 participants from 121 cities across themainland of China.We also assessed the effect of Clean Air Policy(CAP)based on a quasi-experimental difference-in-differences(DID)design.A 10μg/m^(3)increase in PM_(2.5)concentration was associated with a 7.18(95%confidence interval[CI]:-8.35,-6.02)L/min decrease in PEF(peak expiratory flow)and a 0.72(95%[CI]:0.53,0.90)and a 0.30(95%[CI]:0.18,0.42)mmHg increase in systolic and diastolic blood pressure,respectively.The associations were more pronounced in males and rural areas for PEF,but similar across subgroups for blood pressure.DID results suggested that the effect of CAP on health outcomes were sensitive tomagnitudes of reduction in PM_(2.5).A 5μg/m^(3)reduction in PM_(2.5)or more generally led to 18.70(95%[CI]:0.79,36.61)higher PEF and-2.05(95%[CI]:-3.87,-0.23)lower diastolic blood pressure,respectively,compared to no reduction or increase in exposure.However,the effects were significant only in rural areas.Our analysis support CAP aiming to benefit public health and provides insights to inform future control policy for efficiently decreasing air pollution exposure burden.展开更多
Objective:To observe the therapeutic effect of Moist Burn Ointment combined with rotating moxibustion on patients with pressure ulcers and deficiency of both Qi and blood.Methods:40 patients with pressure ulcers and d...Objective:To observe the therapeutic effect of Moist Burn Ointment combined with rotating moxibustion on patients with pressure ulcers and deficiency of both Qi and blood.Methods:40 patients with pressure ulcers and deficiency of both Qi and blood were randomly divided into two groups from July 2024 to November 2025.Group A received Moist Burn Ointment combined with rotating moxibustion,while Group B received Moist Burn Ointment only.Results:Group A showed better efficacy,wound healing time,dressing change frequency,satisfaction,PUSH score,and adverse reaction indicators compared to Group B(P<0.05).Conclusion:The combination of Moist Burn Ointment and rotating moxibustion in the treatment of patients with pressure ulcers and deficiency of both Qi and blood can shorten wound healing time,reduce dressing change frequency,and alleviate the degree of pressure ulcers,which is safe and efficient.展开更多
BACKGROUND Metabolic dysfunction-associated steatotic liver disease(MASLD),hepatic fibrosis,and cirrhosis are major risk factors for hepatocellular carcinoma(HCC),yet current blood-based diagnostic assays lack suffici...BACKGROUND Metabolic dysfunction-associated steatotic liver disease(MASLD),hepatic fibrosis,and cirrhosis are major risk factors for hepatocellular carcinoma(HCC),yet current blood-based diagnostic assays lack sufficient accuracy for routine clinical use.Identifying a non-invasive molecular signature that accurately detects liver disease could improve early diagnosis and monitoring.We hypothesized that the Liver FibraChek Dx■serum assay could discriminate MASLD and HCC from healthy controls using a multiplex biomarker-based algorithm.AIM To evaluate the diagnostic performance of the Liver FibraChek Dx■assay for detecting MASLD and HCC.METHODS This was a prospective,single-center study conducted in a United States tertiary care setting.Serum samples were collected from 45 participants(14 MASLD,19 HCC,12 healthy controls)with liver histology confirmed by biopsy.The Liver FibraChek Dx■algorithm integrates weighted values of aspartate aminotransferase,alanine aminotransferase,taurocholic acid,L-tyrosine,platelet count,and patient age to generate a risk score.Wilcoxon rank sum tests were used to assess associations with histologic diagnosis,and receiver operating characteristic(ROC)curves quantified diagnostic performance.RESULTS Liver FibraChek Dx■risk scores were significantly elevated in MASLD and HCC compared to controls(median:6.92±3.86 vs 3.61±1.67,P<0.001).The area under the ROC curve was 0.890(95%CI:0.776-1.000)for distinguishing diseased from healthy individuals.Sensitivity was 93.9%,specificity 75.0%,positive predictive value 91.1%,negative predictive value 81.8%,and overall accuracy 88.9%.CONCLUSION The Liver FibraChek Dx■assay accurately detects liver disease and shows promise as a non-invasive tool for diagnosing and monitoring MASLD and HCC.展开更多
Dear Editor,The primary objective of the letter is to emphasize the importance of personalized management of arterial blood pressure(ABP)in the context of off-pump coronary artery bypass grafting(CABG)surgery.Coronary...Dear Editor,The primary objective of the letter is to emphasize the importance of personalized management of arterial blood pressure(ABP)in the context of off-pump coronary artery bypass grafting(CABG)surgery.Coronary artery disease,a leading global cause of mortality,necessitates a substantial number of cardiac surgeries,with approximately 400,000 CABG operations conducted annually in the United States.Postoperative heart failure(HF)is a common occurrence after CABG surgery,with readmission rates within 30 d due to HF ranging from 12% to 16%.展开更多
Objective:This study aims to evaluate the clinical efficacy of non-invasive positive pressure ventilation(NIPPV)in patients with severe bronchial asthma combined with respiratory failure.Methods:90 patients with sever...Objective:This study aims to evaluate the clinical efficacy of non-invasive positive pressure ventilation(NIPPV)in patients with severe bronchial asthma combined with respiratory failure.Methods:90 patients with severe bronchial asthma combined with respiratory failure between September 2022 and December 2023 were selected for the study and randomly divided into the experimental group(NIPPV-assisted treatment)and the control group.The differences between the two groups were compared in terms of total effective rate of treatment,days of clinical symptom disappearance,days of hospitalization,lung function indexes,incidence of adverse reactions,and quality of life.Results:Patients in the experimental group had a significantly higher total effective rate of treatment(97.78%)than the control group(75.56%).In terms of pulmonary function indexes,patients in the experimental group showed significant improvement after treatment,especially the increase in forced expiratory volume and forced vital capacity,while these improvements were not as obvious in the control group.In addition,the incidence of adverse reactions was significantly lower in the experimental group than in the control group,suggesting that the application of NIPPV is relatively safe.Quality of life assessment also showed that patients in the experimental group had significantly better quality of life than the control group after treatment.Conclusion:This study demonstrated the effectiveness of NIPPV as an adjunctive treatment for severe bronchial asthma combined with respiratory failure.NIPPV can improve lung function,reduce the incidence of adverse effects,increase the overall effectiveness of the treatment,and contribute to the improvement of patients'quality of life.Therefore,NIPPV should be regarded as an effective and safe treatment in clinical management,especially in patients with severe bronchial asthma combined with respiratory failure,where its application has potential clinical significance.展开更多
Objective: To discuss the effect of lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation on the blood gas results and systemic state of patients with COPD complicated by severe p...Objective: To discuss the effect of lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation on the blood gas results and systemic state of patients with COPD complicated by severe pneumonia. Methods: A total of 68 patients with COPD complicated by severe pneumonia who were treated in the hospital between November 2015 and April 2017 were collected, retrospectively analyzed and then divided into the group A (n=35) who received noninvasive positive pressure ventilation and the group B (n=33) who received lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation. The differences in arterial blood gas and serum index levels were compared between the two groups before and after treatment. Results: Before treatment, there was no statistically significant difference in arterial blood gas index levels as well as serum contents of inflammatory mediators, stress hormones and myocardial enzyme spectrum indexes between the two groups. After treatment, arterial blood gas indexes PH and PaO2 levels of group B were higher than those of group A;serum inflammatory mediators HMGB1, PCT and hs-CRP contents were lower than those of group A;serum stress hormones Cor, AngⅠ and AngⅡcontents were lower than those of group A;serum myocardial enzyme spectrum indexesα-HBDH and cTn-Ⅰ contents were lower than those of group A. Conclusion: Lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation can effectively optimize the arterial blood gas levels, reduce systemic inflammatory stress state and protect the myocardial function of patients with COPD complicated by severe pneumonia.展开更多
OBJECTIVE: To investigate blood pressure rhythm(BPR)in Yin deficiency syndrome of hypertension(YDSH)patients and develop a random forest model for predicting YDSH.METHODS: Our study was consistent with technical proce...OBJECTIVE: To investigate blood pressure rhythm(BPR)in Yin deficiency syndrome of hypertension(YDSH)patients and develop a random forest model for predicting YDSH.METHODS: Our study was consistent with technical processes and specification for developing guidelines of Evidence-based Chinese medicine clinical practice(T/CACM 1032-2017). We enrolled 234 patients who had been diagnosed with primary hypertension without antihypertensive medications prior to the enrollment. All participants were divided into Yin deficiency group(YX, n = 74) and non-Yin deficiency group(NYX, n = 160).Participants were professionally grouped by three experienced chief Traditional Chinese Medicine(TCM)physicians according to four examinations(i.e.,inspection, listening and smelling, inquiry and palpation).We collected data on 24 h ambulatory blood pressure monitoring(ABPM) and YDSH rating scale. We divided 24 h of a day into 12 two-hour periods [Chen-Shi(7:00-9:00), Si-Shi(9:00-11:00), Wu-Shi(11:00-13:00), Wei-Shi(13:00-15:00), Shen-Shi(15:00-17:00), You-Shi(17:00-19:00), Xu-Shi(19:00-21:00), Hai-Shi(21:00-23:00), ZiShi(23:00-1:00), Chou-Shi(1:00-3:00), Yin-Shi(3:00-5:00), Mao-Shi(5:00-7:00)] according to the theory of “midnight-midday ebb flow”. We used random forest to build the diagnostic model of YDSH, with whether it was Yin deficiency syndrome as the outcome. RESULTS: Compared with NYX group, YX group had more female participants with older age, lower waist circumference, body mass index(BMI), diastolic blood pressure(DBP), and smoking and drinking rate(all P < 0.05). The YDSH rating scores of YX group [28.5(21.0-36.0)] were significantly higher than NYX group [13.0(8.0-22.0)](P < 0.001), and the typical symptoms of YX group included vexing heat in the chest, palms and soles, dizziness, dry eyes, string-like and fine pulse, soreness and weakness of lumbus and knees, palpitations, reddened cheeks, and tinnitus(all P < 0.05). The ratio of non-dipper hypertension in YX group was higher than in NYX group(56.9% vs 44.4%, P = 0.004). Compared with NYX group, 24 h DBP standard deviation(SD), nighttime DBP SD, Si-Shi DBP, Si-Shi mean arterial pressure(MAP), Hi-Shi systolic blood pressure(SBP), Hi-Shi DBP, Hi-Shi MAP, Zi-Shi SBP, Zi-Shi DBP, Zi-Shi MAP, ChouShi SBP SD, Chou-Shi DBP SD, Chou-Shi SBP coefficient of variation(CV) were lower in YX group(all P < 0.05). Binary Logistic Regression analysis showed that the diagnosis of YDSH was positively correlated with age, heart rate, YDSH rating scores, and four TCM symptoms including vexing heat in the chest, palms and soles, string-like and fine pulse, soreness and weakness of lumbus and knees, and reddened cheeks(all P < 0.05), but was negatively correlated with smoking(P﹥0.05). In addition, the diagnosis of YDSH was positively correlated with daytime SBP SD, nighttime SBP SD, nighttime SBP CV, and Hi-Shi SBP CV, but was negatively correlated with 24 h SBP CV, daytime DBP SD, nighttime DBP SD, and Hi-Shi DBP(all P < 0.05). Hi-Shi SBP CV had independent and positive correlation with the diagnosis of YDSH after adjusting the variables of age, gender, course of hypertension, BMI, waist circumference, SBP, DBP, heart rate, smoking and drinking(P = 0.029). Diagnostic model of YDSH was established and verified based on the random forest. The results showed that the calculation accuracy, specificity and sensitivity were 77.3%, 77.8% and 76.9%, respectively. CONCLUSION: The BPR was significantly attenuated in YDSH patients, including lower 24 h DBP SD and nighttime DBP SD, and Hi-Shi SBP CV is independently correlated with the diagnosis of YDSH. The prediction accuracy of diagnosis model of YDSH based on the random forest was good, which could be valuable for clinicians to differentiate YDSH and non-Yin deficiency patients for more effective hypertensive treatment of TCM.展开更多
文摘Objective:To explore the effect of continuous non-invasive blood pressure monitoring on intraoperative hemodynamics and postoperative myocardial injury in craniotomy.Methods:120 cases of elective craniotomy were divided into the self-control group(continuous non-invasive blood pressure monitoring and intermittent cuff non-invasive blood pressure monitoring,CNAP group)and propensity score matching group(only intermittent cuff non-invasive blood pressure measurement in previous craniotomy,PSM group);Goal-directed hemodynamic management in CNAP group included heart rate(HR),blood pressure(BP),stroke volume(SV),stroke variability(SVV),and systemic vascular resistance index(SVRI).The main index is to compare the troponin level within 72 hours after operation between the CNAP group and the PSM group;The secondary indicators are the comparison of the hemodynamic conditions between the CNAP group and the PSM at 10 specific time points.Results:The incidence of postoperative myocardial injury in the CNAP group was significantly lower than that in the PSM group(12%vs.30%,P=0.01);in the CNAP group hypotensive episodes(6 vs.3,P=0.01),positive balance of fluid therapy(700 vs.500 mL,P<0.001),more use of vasoactive drugs(29 vs.18,P=0.04),more stable hemodynamics medical status(P=0.03)were recorded.Conclusion:The hemodynamic management strategy based on continuous non-invasive blood pressure monitoring can reduce the incidence of myocardial injury after elective craniotomy and maintain a more stable hemodynamic state.
文摘Failure of an automated blood pressure cuff to deflate when a patient is under general anesthesia can lead to catastrophic consequences if unnoticed for more than three hours [1]. We present this as a hearsay case in which an automated blood pressure cuff of the Spacelabs Ultraview Clinical Workstation monitor (model No. 90385) applied pressure for about five hours resulting in limb thrombosis. In order to analyze this catastrophe, simulation scenarios were tested to elucidate the possible errors and malfunctions that may have led to this injury. We present the analysis of the advantages and validity of the hearsay case report. We also include our proposed criteria that should be required when a hearsay case is considered for publication.
文摘Background: First responders (firefighters, paramedics, and police) working in an urban setting can be exposed to a high-stress environment caused by strenuous physical exertion, potentially dangerous work conditions, sleep deprivation due to shift work, poor dietary habits, psychological stress and noise levels that are excessive. This may induce chronic increases in blood pressure. The purpose of this study was to determine the presence of hypertension in people working in occupations generally accepted as high stress in comparison to those working in an environment where less of these obvious high stressors were present. Methods: Resting blood pressure was measured by TrUBP in 1067 on-duty first responders (fire, paramedic, and police), and in participants generally associated with a lower-stress work environment (transit workers, city and bank employees, factory workers and legislature employees). Results: The average age, systolic and diastolic blood pressures were significantly lower in those employees working in a high-stress environment than those in a low-stress job. This difference was observed in both male and female sexes. Conclusions: Our data do not support an association of high resting blood pressure values in those employed in activities typically associated with a high-stress urban working environment.
文摘Background: Tooth loss results in impaired mastication, which in turn, makes it difficult to chew hard food, consequently leading to deteriorate dietary habits and to develop hypertension. The purpose of this study was to examine the effect of tooth loss on blood pressure among Congolese population. Methods: A cross-sectional study was conducted from October 2019 until December 2023 among Congolese population aged at least 30 years reporting to the living in DR Congo. All participants were enrolled from Dental Clinic located in the DR Congo. To be eligible to participate in the study, were the willing to participate and having signed informed consent;had a missing tooth;had carried out blood pressure measurement (hypertension/normotensive). The exclusion criteria were determined: being less than 30 years old, being pregnant for women considering the risk of existing gestational hypertension, obesity, excessive alcohol consumption, smoking, and diabetes. Hypertension was defined as the mean of three measurements of systolic blood pressure (SBP) (140 mmHg or higher), diastolic blood pressure (DBP) (90 mm or higher) or physician diagnosed hypertension confirmed from medical records. We determined the number of tooth loss from oral examination. A multivariable logistic regression model was used to investigate the effect of tooth loss on blood pressure. Results: In all, 25,396 participants were enrolled among Congolese population for this study. After oral examination, 13,421 were excluded for no tooth loss and 11,975 participants were selected. The average number of tooth loss among study population was 11.06. Among the participants with hypertension had lost an average of 11 teeth, significantly higher than those without hypertension (6.09) (p = 0.001). After adjusting for covariates (socio-demographic characteristics), tooth loss (>10) was significantly associated with hypertension, with OR = 1.32 (95% CI 1.073 - 2.38). Conclusion: Tooth loss maybe associated with severe hypertension among Congolese population adults. Prevention of tooth loss is very important to the overall health of this population.
基金supported by the National Natural Science Foundation of China(82170375,U23A20395)1.3.5 project for disciplines of excellence from West China Hospital of Sichuan University(ZYGD23021,23HXF-H009)Sichuan Science and Technology Program 2023NSFSC1645。
文摘Background Hypertension is associated with an increased risk of calcific aortic valve stenosis(CAVS).However,the directionality of causation between blood pressure traits and aortic stenosis is unclear,as is the benefit of antihypertensive drugs for CAVS.Methods Using genome-wide association studies(GWAS)summary statistics,we performed bidirectional two-sample univariable mendelian randomization(UVMR)to assess the causal associations of systolic blood pressure(SBP),diastolic blood pressure(DBP),and pulse pressure(PP)with CAVS.Multivariable mendelian randomization(MVMR)was conducted to evaluate the direct effect of hypertension on CAVS,adjusting for confounders.Drug target mendelian randomization(MR)and summary-level MR(SMR)were used to estimate the effects of 12 classes of antihypertensive drugs and their target genes on CAVS risk.Inverse variance weighting was the primary MR method,with sensitivity analyses to validate results.Results UVMR showed SBP,DBP,and PP have causal effects on CAVS,with no significant reverse causality.MVMR confirmed the causality between hypertension and CAVS after adjusting for confounders.Drug-target MR analyses indicated that calcium channel blockers(CCBs),loop diuretics,and thiazide diuretics via SBP lowering exerted protective effects on CAVS risk.SMR analysis showed that the CCBs target gene CACNA2D2 and ARBs target gene AGTR1 were positively associated with CAVS risk,while diuretics target genes SLC12A5 and SLC12A1 were negatively associated with aortic stenosis risk.Conclusions Hypertension has a causal relationship with CAVS.Managing SBP in hypertensive patients with CCBs may prevent CAVS.ARBs might exert protective effects on CAVS independent of blood pressure reduction.The relationship between diuretics and CAVS is complex,with opposite effects through different mechanisms.
基金supported by grant 2011BAI11B01 from the Projects in the Chinese National Science and Technology Pillar Program during the 12th Five-year Plan Periodby grant 2017-I2M-1-004 from the Chinese Academy of Medical Science Innovation Fund for Medical Sciencesby the Major science and technology special plan project of Yunnan Province (202302AA310045)。
文摘Background Both medication and non-medication therapies are effective approaches to control blood pressure (BP) in hypertension patients.However,the association of joint changes in antihypertensive medication use and healthy lifestyle index (HLI)with BP control among hypertension patients is seldom reported,which needs to provide more evidence by prospective intervention studies.We examined the association of antihypertensive medication use and HLI with BP control among employees with hypertension in China based on a workplace-based multicomponent intervention program.Methods Between January 2013 and December 2014,a cluster randomized clinical trial of a workplace-based multicomponent intervention program was conducted in 60 workplaces across 20 urban areas in China.Workplaces were randomly divided into intervention (n=40) and control (n=20) groups.Basic information on employees at each workplace was collected by trained professionals,including sociodemographic characteristics,medical history,family history,lifestyle behaviors,medication status and physical measurements.After baseline,the intervention group received a 2-year intervention to achieve BP control,which included:(1) a workplace wellness program for all employees;(2) a guidelines-oriented hypertension management protocol.HLI including nonsmoking,nondrinking,adequate physical activity,weight within reference range and balanced diet,were coded on a 5-point scale (range:0-5,with higher score indicating a healthier lifestyle).Antihypertensive medication use was defined as taking drug within the last 2 weeks.Changes in HLI,antihypertensive medication use and BP control from baseline to 24 months were measured after the intervention.Results Overall,4655 employees were included (age:46.3±7.6 years,men:3547 (82.3%)).After 24 months of the intervention,there was a significant improvement in lifestyle[smoking (OR=0.65,95%CI:0.43-0.99;P=0.045),drinking (OR=0.52,95%CI:0.40-0.68;P<0.001),regular exercise (OR=3.10,95%CI:2.53-3.78;P<0.001),excessive intake of fatty food (OR=0.17,95%CI:0.06-0.52;P=0.002),restrictive use of salt (OR=0.26,95%CI:0.12-0.56;P=0.001)].Compare to employees with a deteriorating lifestyle after the intervention,those with an improved lifestyle had a higher BP control.In the intervention group,compared with employees not using antihypertensive medication,those who consistent used (OR=2.34;95%CI:1.16-4.72;P=0.017) or changed from not using to using antihypertensive medication (OR=2.24;95%CI:1.08-4.62;P=0.030) had higher BP control.Compared with those having lower HLI,participants with a same (OR=1.38;95%CI:0.99-1.93;P=0.056) or high (OR=1.79;95%CI:1.27~2.53;P<0.001) HLI had higher BP control.Those who used antihypertensive medication and had a high HLI had the highest BP control (OR=1.88;95%CI:1.32-2.67,P<0.001).Subgroup analysis also showed the consistent effect as the above.Conclusion These findings suggest that adherence to antihypertensive medication treatment and healthy lifestyle were associated with a significant improvement in BP control among employees with hypertension.
基金Supported by Project of Science and Technology Department of Inner Mongolia Autonomous Region(2021GG0117).
文摘[Objectives]To investigate differences in BMI and renal function across constitution types and influencing factors of blood pressure.[Methods]92 college student volunteers aged 18-25 from January 2023 to December 2024 were selected.BMI,blood pressure,and renal function markers—blood urea nitrogen(BUN),creatinine(Cr),uric acid(UA),were compared across constitution types.Multiple stepwise regression analysis was applied to identify the influencing factors of blood pressure.[Results]Among 92 healthy participants aged 18-25,Shar-predominant constitution accounted for 50%,Khii-predominant for 25%,and Badgan-predominant for 20.65%.Significant differences existed in mean systolic and diastolic blood pressure across constitution types(systolic:F=4.56,P=0.001;diastolic:F=3.78,P=0.005).Shar-predominant group showed significantly higher systolic blood pressure than other types(P<0.05),while Khii-predominant group had higher diastolic pressure.Shar-predominant constitution demonstrated significantly greater height,weight,and BMI compared to other types(P<0.05).Males exhibited significantly higher height,weight,and BMI than females(P<0.05).Shar-predominant group showed significantly elevated urea,uric acid,and creatinine levels compared to other constitution types(P<0.05).Males had significantly higher mean urea,uric acid,and creatinine levels than females(P<0.05).Correlation analysis revealed stronger associations between BMI,renal function,and blood pressure in Shar-predominant group(r>0.50,P<0.05).Multiple regression analysis identified BMI as the primary influencing factor for blood pressure,followed by urea and uric acid.In Shar-predominant group,BMI exerted the strongest effect on blood pressure(β=0.60-0.65,P<0.001).[Conclusions]This study provides important evidence for health management in populations with different constitution types.
文摘Objective:To evaluate the effect of labetalol combined with aspirin on improving blood pressure in patients with hypertensive disorders of pregnancy(HDP).Methods:Eighty-two patients with HDP who visited the hospital from August 2022 to August 2024 were selected as samples and randomly divided into two groups.Group A was treated with labetalol and aspirin,while Group B was treated with labetalol only.The efficacy,blood pressure,vascular endothelial function,coagulation indexes,and pregnancy outcomes were compared between the two groups.Results:The efficacy of Group A was higher than that of Group B(P<0.05).The systolic blood pressure(SBP),diastolic blood pressure(DBP),and endothelin-1(ET-1)in Group A were lower than those in Group B(P<0.05).The prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT),and fibrinogen(FIB)in Group A were all better than those in Group B(P<0.05).The rate of adverse pregnancy outcomes in Group A was lower than that in Group B(P<0.05).Conclusion:The combination of labetalol and aspirin for the treatment of HDP can stabilize blood pressure,optimize vascular endothelial function,improve coagulation indexes and pregnancy outcomes,which is highly effective and feasible.
文摘G-protein coupled receptor kinase 4(GRK4)gene plays a core role in renal dopamine D1 receptor function for handing renal sodium excretion,the rs1801058 T variant has~50%frequency in the general East Asian population but lacks functional evidence for salt-sensitivity.In this prospective study,we identified rs1801058 genotypes by sequencing in hypertensives patients and analyzed the variant's effects on blood pressure response to acute salt loading in 150 newly diagnosed hypertension patients.Our data indicated that there were no statistically significant difference in blood pressure changes between the overall rs1801058 genotype groups.Carriers of the C allele showed a significant rise in heart rate change according to acute saline loading.Among patients age≤40year,T allele carriers showed higher changes in systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP),and heart rate(HR)than C allele carriers when diuretic shrinkage.GRK4 single rs1801058 polymorphism cannot directly explain salt sensitivity in the Chinese hypertension patients.
文摘Objective:To analyze the characteristics of ambulatory blood pressure in elderly patients with hypertension and find out the risk factors of abnormal circadian rhythm.Methods:According to the circadian rhythm of patients'blood pressure,they were divided into Group A,Group B and Group C,and all the data of hypertension patients in this study were collected,including age,gender,BMI,smoking,drinking,basic diseases(diabetes,cerebrovascular disease,hyperlipidemia,etc.),fasting blood glucose,ambulatory blood pressure(24-hour mean systolic pressure,24-hour mean diastolic pressure,daytime mean systolic pressure and daytime mean diastolic pressure).Results:There were significant differences in mean systolic blood pressure and mean diastolic blood pressure at night among Group A,Group B and Group C(P<0.05).Age,hyperlipidemia and fasting blood glucose were risk factors for circadian rhythm abnormality(P<0.05),and 24-hour urinary sodium was a protective factor for circadian rhythm abnormality(P<0.05).Conclusion:Age,hyperlipidemia and fasting blood glucose are risk factors for circadian rhythm abnormality(P<0.05),and 24-hour urinary sodium is a protective factor for circadian rhythm abnormality(P<0.05).
文摘Objective:To analyze the characteristics of ambulatory blood pressure in elderly patients with hypertension and find out the risk factors of abnormal circadian rhythm.Methods:According to the circadian rhythm of patients’blood pressure,they were divided into group A,group B,and group C,and all the data of hypertension patients in this study were collected,including age,gender,BMI,smoking,drinking,basic diseases(diabetes,cerebrovascular disease,hyperlipidemia,etc.),fasting blood glucose,ambulatory blood pressure(24-hour mean systolic pressure,24-hour mean diastolic pressure,daytime mean systolic pressure and daytime mean diastolic pressure).Results:There were significant differences in mean systolic blood pressure and mean diastolic blood pressure at night among group A,group B and group C(P<0.05).Age,hyperlipidemia and fasting blood glucose were risk factors for circadian rhythm abnormality(P<0.05),and 24-hour urinary sodium was a protective factor for circadian rhythm abnormality(P<0.05).Conclusion:Age,hyperlipidemia and fasting blood glucose are risk factors for circadian rhythm abnormality(P<0.05),and 24-hour urinary sodium is a protective factor for circadian rhythm abnormality(P<0.05).
文摘Objective:To explore the application of“tertiary hospitals-secondary hospitals and nursing care institutions-community-family”four-dimensional linkage care model in peritoneal dialysis patients.Methods:99 cases of peritoneal dialysis patients were divided into 47 cases in the control group and 52 cases in the intervention group.In the control group,the routine discharge follow-up model was adopted;in the intervention group,the hospital-led medical unit was adopted as the basis of the“tertiary hospitals-secondary hospitals and nursing care institutions-community-family”quadruple linkage care model,and the patients’systolic blood pressure was compared with those in the control group before and after discharge.The systolic blood pressure,diastolic blood pressure,N-terminal brain natriuretic peptide,and sodium were compared between the two groups.Results:The systolic blood pressure,diastolic blood pressure,N-terminal brain natriuretic peptide,and blood sodium of patients in the intervention group were significantly better than those of the control group(all P<0.001).Conclusion:Based on the“tertiary hospital-secondary hospital and nursing home-community-family”quadratic care model,the blood pressure control rate of elderly peritoneal dialysis patients can be increased to meet the standard,reduce the symptoms of the disease,and improve the satisfaction.
基金supported by the 90th Anniversary of Chulalong-korn University Scholarship(Ratchadaphiseksomphot Endowment Fund)。
文摘Objective:This study aimed to determine the effect of a culture-specificbehavior modificationprogram on glycated hemoglobin(HbA1c)and blood pressure among adults with diabetes and hypertension.Methods:This study was a single-blind randomized controlled trial design.From January to May 2024,a total of 60 patients with uncontrolled type 2 diabetes and hypertension from the primary care unit of a hospital in northeastern(Isan)Thailand were recruited.The intervention group received the usual care supplemented by a culture-specificbehavior modificationprogramm implemented through interactive classes and online web application consisting of information,motivation,and behavioral skills(diet,exercise,and medication use),the control group received the usual care.HbA1c and blood pressure measurements were collected at both baseline and at 12 weeks.Results:A total of 51 patients completed the study,the intervention group(n=26)and control group(n=25),respectively.After 12 weeks,23.1%of patients in the intervention group could maintain their HbA1c<7.0%;those with poorly controlled HbA1c decreased from 7.7%at baseline to 3.8%at 12 weeks.After 12 weeks,69.2%of intervention group participants could maintain systolic blood pressure<130 mmHg and 53.8%could keep diastolic blood pressure<80 mmHg.Analysis revealed that HbA1c,systolic and diastolic blood pressure levels in the intervention group were lower than the control group after the intervention(P<0.05).There was a statistically significantdifference a linear combination of HbA1c and blood pressure(systolic and diastolic BP levels)between time and group(P<0.05).Conclusion:These results suggest that healthcare providers can incorporate elements of this program to manage blood glucose and blood pressure effectively.Future studies should consider a longitudinal design with a larger sample size and include outcomes of lipid levels to confirmlong-term motivation.
基金supported by the National Institute of Environmental Health Sciences(NIEHS)of United States(No.R00ES027511)the National Natural Science Foundation of China(No.42201303).
文摘Long-term exposure to fine particulate matters(PM_(2.5))has been associated with respiratory and cardiovascular diseases and the burden are potentially higher in China experiencing heavy air pollution.In this study,we established the exposure-response association between long-term exposures to PM_(2.5)and lung function and blood pressure in Chinesemiddle-aged and older adults using linearmixed-effects and generalized additive mixedmodels based on 3 waves longitudinal health outcomes data by enrolling 19,988 participants from 121 cities across themainland of China.We also assessed the effect of Clean Air Policy(CAP)based on a quasi-experimental difference-in-differences(DID)design.A 10μg/m^(3)increase in PM_(2.5)concentration was associated with a 7.18(95%confidence interval[CI]:-8.35,-6.02)L/min decrease in PEF(peak expiratory flow)and a 0.72(95%[CI]:0.53,0.90)and a 0.30(95%[CI]:0.18,0.42)mmHg increase in systolic and diastolic blood pressure,respectively.The associations were more pronounced in males and rural areas for PEF,but similar across subgroups for blood pressure.DID results suggested that the effect of CAP on health outcomes were sensitive tomagnitudes of reduction in PM_(2.5).A 5μg/m^(3)reduction in PM_(2.5)or more generally led to 18.70(95%[CI]:0.79,36.61)higher PEF and-2.05(95%[CI]:-3.87,-0.23)lower diastolic blood pressure,respectively,compared to no reduction or increase in exposure.However,the effects were significant only in rural areas.Our analysis support CAP aiming to benefit public health and provides insights to inform future control policy for efficiently decreasing air pollution exposure burden.
文摘Objective:To observe the therapeutic effect of Moist Burn Ointment combined with rotating moxibustion on patients with pressure ulcers and deficiency of both Qi and blood.Methods:40 patients with pressure ulcers and deficiency of both Qi and blood were randomly divided into two groups from July 2024 to November 2025.Group A received Moist Burn Ointment combined with rotating moxibustion,while Group B received Moist Burn Ointment only.Results:Group A showed better efficacy,wound healing time,dressing change frequency,satisfaction,PUSH score,and adverse reaction indicators compared to Group B(P<0.05).Conclusion:The combination of Moist Burn Ointment and rotating moxibustion in the treatment of patients with pressure ulcers and deficiency of both Qi and blood can shorten wound healing time,reduce dressing change frequency,and alleviate the degree of pressure ulcers,which is safe and efficient.
文摘BACKGROUND Metabolic dysfunction-associated steatotic liver disease(MASLD),hepatic fibrosis,and cirrhosis are major risk factors for hepatocellular carcinoma(HCC),yet current blood-based diagnostic assays lack sufficient accuracy for routine clinical use.Identifying a non-invasive molecular signature that accurately detects liver disease could improve early diagnosis and monitoring.We hypothesized that the Liver FibraChek Dx■serum assay could discriminate MASLD and HCC from healthy controls using a multiplex biomarker-based algorithm.AIM To evaluate the diagnostic performance of the Liver FibraChek Dx■assay for detecting MASLD and HCC.METHODS This was a prospective,single-center study conducted in a United States tertiary care setting.Serum samples were collected from 45 participants(14 MASLD,19 HCC,12 healthy controls)with liver histology confirmed by biopsy.The Liver FibraChek Dx■algorithm integrates weighted values of aspartate aminotransferase,alanine aminotransferase,taurocholic acid,L-tyrosine,platelet count,and patient age to generate a risk score.Wilcoxon rank sum tests were used to assess associations with histologic diagnosis,and receiver operating characteristic(ROC)curves quantified diagnostic performance.RESULTS Liver FibraChek Dx■risk scores were significantly elevated in MASLD and HCC compared to controls(median:6.92±3.86 vs 3.61±1.67,P<0.001).The area under the ROC curve was 0.890(95%CI:0.776-1.000)for distinguishing diseased from healthy individuals.Sensitivity was 93.9%,specificity 75.0%,positive predictive value 91.1%,negative predictive value 81.8%,and overall accuracy 88.9%.CONCLUSION The Liver FibraChek Dx■assay accurately detects liver disease and shows promise as a non-invasive tool for diagnosing and monitoring MASLD and HCC.
基金supported by the National Key Technologies Research and Development Program(2021YFF1200602)the National Science Fund for Excellent Overseas Scholars(0401260011)+1 种基金the National Defense Science and Technology Innovation Fund of Chinese Academy of Sciences(c02022088)Tianjin Science and Technology Program(20JCZDJC00810).
文摘Dear Editor,The primary objective of the letter is to emphasize the importance of personalized management of arterial blood pressure(ABP)in the context of off-pump coronary artery bypass grafting(CABG)surgery.Coronary artery disease,a leading global cause of mortality,necessitates a substantial number of cardiac surgeries,with approximately 400,000 CABG operations conducted annually in the United States.Postoperative heart failure(HF)is a common occurrence after CABG surgery,with readmission rates within 30 d due to HF ranging from 12% to 16%.
文摘Objective:This study aims to evaluate the clinical efficacy of non-invasive positive pressure ventilation(NIPPV)in patients with severe bronchial asthma combined with respiratory failure.Methods:90 patients with severe bronchial asthma combined with respiratory failure between September 2022 and December 2023 were selected for the study and randomly divided into the experimental group(NIPPV-assisted treatment)and the control group.The differences between the two groups were compared in terms of total effective rate of treatment,days of clinical symptom disappearance,days of hospitalization,lung function indexes,incidence of adverse reactions,and quality of life.Results:Patients in the experimental group had a significantly higher total effective rate of treatment(97.78%)than the control group(75.56%).In terms of pulmonary function indexes,patients in the experimental group showed significant improvement after treatment,especially the increase in forced expiratory volume and forced vital capacity,while these improvements were not as obvious in the control group.In addition,the incidence of adverse reactions was significantly lower in the experimental group than in the control group,suggesting that the application of NIPPV is relatively safe.Quality of life assessment also showed that patients in the experimental group had significantly better quality of life than the control group after treatment.Conclusion:This study demonstrated the effectiveness of NIPPV as an adjunctive treatment for severe bronchial asthma combined with respiratory failure.NIPPV can improve lung function,reduce the incidence of adverse effects,increase the overall effectiveness of the treatment,and contribute to the improvement of patients'quality of life.Therefore,NIPPV should be regarded as an effective and safe treatment in clinical management,especially in patients with severe bronchial asthma combined with respiratory failure,where its application has potential clinical significance.
文摘Objective: To discuss the effect of lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation on the blood gas results and systemic state of patients with COPD complicated by severe pneumonia. Methods: A total of 68 patients with COPD complicated by severe pneumonia who were treated in the hospital between November 2015 and April 2017 were collected, retrospectively analyzed and then divided into the group A (n=35) who received noninvasive positive pressure ventilation and the group B (n=33) who received lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation. The differences in arterial blood gas and serum index levels were compared between the two groups before and after treatment. Results: Before treatment, there was no statistically significant difference in arterial blood gas index levels as well as serum contents of inflammatory mediators, stress hormones and myocardial enzyme spectrum indexes between the two groups. After treatment, arterial blood gas indexes PH and PaO2 levels of group B were higher than those of group A;serum inflammatory mediators HMGB1, PCT and hs-CRP contents were lower than those of group A;serum stress hormones Cor, AngⅠ and AngⅡcontents were lower than those of group A;serum myocardial enzyme spectrum indexesα-HBDH and cTn-Ⅰ contents were lower than those of group A. Conclusion: Lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation can effectively optimize the arterial blood gas levels, reduce systemic inflammatory stress state and protect the myocardial function of patients with COPD complicated by severe pneumonia.
基金National Key R&D Program of China Project:Study on Syndrome Differentiation Standard of Yin deficiency Syndrome in Hypertension (No. 2018YFC1704403)National Key R&D Program of China Project:Systematic Study on the Standard of Syndrome Differentiation of Yin Deficiency Syndrome (No. 2018YFC1704400)+1 种基金the Natural Science Foundation of Jiangsu Province:Exploring the Cardioprotective Effect and Mechanism of Qinggan Zishen Formula on Obesity and Hypertension Based on Nrf2 Regulation of Cardiac Homeostasis (No. BK20221422)the Natural Science Foundation of Jiangsu Province:Mechanism Study on the Promotion of Cardiac Energy Metabolism Balance and Inhibition of DOX Induced Heart Failure through Nr1d1/Nfil3 Mediated Circadian Pathway by Yiqi Wenyang Formula (No. BK20220739)。
文摘OBJECTIVE: To investigate blood pressure rhythm(BPR)in Yin deficiency syndrome of hypertension(YDSH)patients and develop a random forest model for predicting YDSH.METHODS: Our study was consistent with technical processes and specification for developing guidelines of Evidence-based Chinese medicine clinical practice(T/CACM 1032-2017). We enrolled 234 patients who had been diagnosed with primary hypertension without antihypertensive medications prior to the enrollment. All participants were divided into Yin deficiency group(YX, n = 74) and non-Yin deficiency group(NYX, n = 160).Participants were professionally grouped by three experienced chief Traditional Chinese Medicine(TCM)physicians according to four examinations(i.e.,inspection, listening and smelling, inquiry and palpation).We collected data on 24 h ambulatory blood pressure monitoring(ABPM) and YDSH rating scale. We divided 24 h of a day into 12 two-hour periods [Chen-Shi(7:00-9:00), Si-Shi(9:00-11:00), Wu-Shi(11:00-13:00), Wei-Shi(13:00-15:00), Shen-Shi(15:00-17:00), You-Shi(17:00-19:00), Xu-Shi(19:00-21:00), Hai-Shi(21:00-23:00), ZiShi(23:00-1:00), Chou-Shi(1:00-3:00), Yin-Shi(3:00-5:00), Mao-Shi(5:00-7:00)] according to the theory of “midnight-midday ebb flow”. We used random forest to build the diagnostic model of YDSH, with whether it was Yin deficiency syndrome as the outcome. RESULTS: Compared with NYX group, YX group had more female participants with older age, lower waist circumference, body mass index(BMI), diastolic blood pressure(DBP), and smoking and drinking rate(all P < 0.05). The YDSH rating scores of YX group [28.5(21.0-36.0)] were significantly higher than NYX group [13.0(8.0-22.0)](P < 0.001), and the typical symptoms of YX group included vexing heat in the chest, palms and soles, dizziness, dry eyes, string-like and fine pulse, soreness and weakness of lumbus and knees, palpitations, reddened cheeks, and tinnitus(all P < 0.05). The ratio of non-dipper hypertension in YX group was higher than in NYX group(56.9% vs 44.4%, P = 0.004). Compared with NYX group, 24 h DBP standard deviation(SD), nighttime DBP SD, Si-Shi DBP, Si-Shi mean arterial pressure(MAP), Hi-Shi systolic blood pressure(SBP), Hi-Shi DBP, Hi-Shi MAP, Zi-Shi SBP, Zi-Shi DBP, Zi-Shi MAP, ChouShi SBP SD, Chou-Shi DBP SD, Chou-Shi SBP coefficient of variation(CV) were lower in YX group(all P < 0.05). Binary Logistic Regression analysis showed that the diagnosis of YDSH was positively correlated with age, heart rate, YDSH rating scores, and four TCM symptoms including vexing heat in the chest, palms and soles, string-like and fine pulse, soreness and weakness of lumbus and knees, and reddened cheeks(all P < 0.05), but was negatively correlated with smoking(P﹥0.05). In addition, the diagnosis of YDSH was positively correlated with daytime SBP SD, nighttime SBP SD, nighttime SBP CV, and Hi-Shi SBP CV, but was negatively correlated with 24 h SBP CV, daytime DBP SD, nighttime DBP SD, and Hi-Shi DBP(all P < 0.05). Hi-Shi SBP CV had independent and positive correlation with the diagnosis of YDSH after adjusting the variables of age, gender, course of hypertension, BMI, waist circumference, SBP, DBP, heart rate, smoking and drinking(P = 0.029). Diagnostic model of YDSH was established and verified based on the random forest. The results showed that the calculation accuracy, specificity and sensitivity were 77.3%, 77.8% and 76.9%, respectively. CONCLUSION: The BPR was significantly attenuated in YDSH patients, including lower 24 h DBP SD and nighttime DBP SD, and Hi-Shi SBP CV is independently correlated with the diagnosis of YDSH. The prediction accuracy of diagnosis model of YDSH based on the random forest was good, which could be valuable for clinicians to differentiate YDSH and non-Yin deficiency patients for more effective hypertensive treatment of TCM.
