AIM: To compare the endotics system (ES), a set of new medical equipment for diagnostic colonoscopy, with video-colonoscopy in the detection of polyps. METHODS: Patients with clinical or familial risk of colonic polyp...AIM: To compare the endotics system (ES), a set of new medical equipment for diagnostic colonoscopy, with video-colonoscopy in the detection of polyps. METHODS: Patients with clinical or familial risk of colonic polyps/carcinomas were eligible for this study. After a standard colonic cleaning, detection of polyps by the ES and by video-colonoscopy was performed in each patient on the same day. In each single patient, the assessment of the presence of polyps was performed by two independent endoscopists, who were randomly assigned to evaluate, in a blind fashion, the presence of polyps either by ES or by standard colonoscopy. The frequency of successful procedures (i.e. reaching to the cecum), the time for endoscopy, and the need for sedation were recorded. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the ES were also calculated. RESULTS: A total of 71 patients (40 men, mean age51.9 ± 12.0 years) were enrolled. The cecum was reached in 81.6% of ES examinations and in 94.3% of colonoscopies (P = 0.03). The average time of endoscopy was 45.1 ± 18.5 and 23.7 ± 7.2 min for the ES and traditional colonoscopy, respectively (P < 0.0001). No patient required sedation during ES examination, compared with 19.7% of patients undergoing colonoscopy (P < 0.0001). The sensitivity and specificity of ES for detecting polyps were 93.3% (95% CI: 68-98) and 100% (95% CI: 76.8-100), respectively. PPV was 100% (95% CI: 76.8-100) and NPV was 97.7% (95% CI: 88-99.9). CONCLUSION: The ES allows the visualization of the entire colonic mucosa in most patients, with good sensitivity/specificity for the detection of lesions and without requiring sedation.展开更多
Objective To evaluate the prevalence,potential risk factors,and correlation between coronary and peripheral microvascular dysfunction in heart failure with nonreduced ejection fraction(nHFrEF)patients.Methods This was...Objective To evaluate the prevalence,potential risk factors,and correlation between coronary and peripheral microvascular dysfunction in heart failure with nonreduced ejection fraction(nHFrEF)patients.Methods This was a prospective registry study.nHFrEF patients admitted to Zhongshan Hospital affiliated with Fudan University from December 2021 to December 2023 were enrolled.According to coronary flow reserve(CFR)or reactive congestion index(RHI),enrolled patients were divided into coronary microvascular endothelial dysfunction(CMD)group(CFR<2.5)and no CMD group(CFR≥2.5)or peripheral microvascular endothelial dysfunction(MED)group(RHI<1.67)and no MED group(RHI≥1.67).Patients'general information,laboratory and auxiliary examination data were collected.Univariate and multivariate logistic regression were used to analyze the influencing factors of CMD and MED in nHFrEF patients,and Spearman correlation analysis was used to evaluate the correlation between MED and CMD.Results A total of 142 nHFrEF patients were enrolled,aged 69.0(59.0,74.0)years,with a male proportion of 66.9%(95/142).The grouping results were as follows:(1)According to CFR,there were 73 cases in the CMD group and 69 cases in the no CMD group;(2)According to RHI,there were 57 cases in the MED group and 85 cases in the no MED group.The prevalence of CMD and MED in this study was 51.4%(73/142)and 40.1%(57/142),respectively.Univariate logistic regression analysis showed that increased heart rate,chronic kidney disease,atrial fibrillation,elevated N-terminal pro-B type natriuretic peptide levels,and increased urinary albumin/creatinine ratio were risk factors for CMD,while increased RHI was a protective factor for CMD;Atrial fibrillation is a risk factor for MED,while increased CFR isa protectivefactor for MED.Incorporating clinically significant variables from univariate analysis into multivariate analysis,the results showed that increased heart rate and elevated RHI remained risk and protective factors for CMD,respectively;increased CFR remains a protective factor for MED.Spearman correlation analysis showed that CFR was negatively correlated with lg urinary albumin/creatinine ratio,lg cardiac troponin T,lg N-terminal pro-B type natriuretic peptide,and heart rate;RHI is positively correlated with CFR.Conclusion The prevalence of CMD and MED in nHFrEF patients is high,and the two have a certain positive correlation.Increased heart rate and RHI are risk and protective factors for CMD,respectively,while increased CFR is a protective factor for MED.MED may be a potential therapeutic target for nHFrEF patients.展开更多
OBJECTIVE To investigate the protective effect against diabetes cardiovascular complications of low molecular weight fucoidan(LMWF)from L.japonica in Qindao, China. METHODS LMWF(50,100 and 200mg·kg-1·d-1)or ...OBJECTIVE To investigate the protective effect against diabetes cardiovascular complications of low molecular weight fucoidan(LMWF)from L.japonica in Qindao, China. METHODS LMWF(50,100 and 200mg·kg-1·d-1)or probucol(100mg·kg-1·d-1)were given orally to Goto-Kakizaki type 2 diabetic rats for 12 weeks.Basal blood pressure,acetylcholine-or flow-mediated relaxation of mesenteric and paw arteries,endothelium-dependent dilation of aorta,eNOS phosphorylation and NO production were measured using laser Doppler flowmetry,force myograph,HE staining,Western blot and an NO assay,respectively.The establishment of diabetic cardiomyopathy(DCM)model and were evaluated by echocardiography and isolated heart perfusion.Ventricle staining with HE or Sirius red was performed to investigate the structural changes in myocardium.Oxidative stress and apoptosis were evaluated by enzyme activities,protein expressions and cell stainings in both myocardial tissues and cultured cardiomyocytes.RESULTS In aorta,LMWF robustly ameliorated the basal hypertension and impairment of endothelium-dependent relaxation in the aorta,as well as mesenteric and paw arteries in diabetic rats.In addition,the reduction in endothelial nitric oxide synthase(eNOS)phosphorylation at Ser1177,eNOS expression and NO production due to diabetes were partially reversed by LMWF treatment.However,probucol,a lipid-modifying drug with antioxidant properties,displayed only mild effects.Moreover,LMWF induced,in a dose-dependent manner,endothelium-dependent vasodilation and eNOS phosphorylation at Ser1177 in normal aorta,and also promoted Ser1177 phosphorylation and NO synthesis in primary cultured vasoendothelial cells.On DCM,LMWF has a beneficial effect by enhancing myocardial contractility and mitigating cardiac fibrosis as well as the production of reactive oxygen species(ROS)and myocyte apoptosis in diabetic hearts.CONCLUSION These data demonstrate for the first time that fucoidan protects vasoendothelial and cardiac function against diabetic injury in type 2diabetes rats via,at least in part,preservation of eNOS function,amelioration of PKCβ-mediated oxidative stress and subsequent cardiomyocyte apoptosis.Fucoidan is therefore a potential candidate drug for protection of endothelium and heart in diabetic cardiovascular complications.展开更多
目的 观察气管插管时不同气囊内压力下气管黏膜的病理改变.方法 选择气管内插管机械通气深昏迷患者60例,按随机原则分为囊内压25、30、35、40 mm Hg(1 mm Hg=0.133 kPa)组(分别记为A1、A2、A3、A4组),观察插管后1、24、48、72 h受压气...目的 观察气管插管时不同气囊内压力下气管黏膜的病理改变.方法 选择气管内插管机械通气深昏迷患者60例,按随机原则分为囊内压25、30、35、40 mm Hg(1 mm Hg=0.133 kPa)组(分别记为A1、A2、A3、A4组),观察插管后1、24、48、72 h受压气管黏膜病理改变.结果 4组患者气管黏膜均有不同程度病理改变,但组内比较差异均无统计学意义.随气囊内压增加,气管黏膜损伤加重;A1组气管黏膜病理改变轻微,均为Ⅰ度;A2组未发现Ⅲ度损伤.损伤1 h时,A3组Ⅱ度损伤例数较A2组明显增多(10例比6例,P【0.05);A4组Ⅱ度及Ⅲ度损伤例数与A3组比较差异有统计学意义(Ⅱ度:7例比10例,Ⅲ度:6例比2例,均P【0.05);而且损伤1 h后,损伤程度不随时间变化而加重.结论 气管插管机械通气气囊内压低于30 mm Hg时气管黏膜病理改变轻微,气管插管时气囊内压低于30 mm Hg较为妥当.展开更多
文摘AIM: To compare the endotics system (ES), a set of new medical equipment for diagnostic colonoscopy, with video-colonoscopy in the detection of polyps. METHODS: Patients with clinical or familial risk of colonic polyps/carcinomas were eligible for this study. After a standard colonic cleaning, detection of polyps by the ES and by video-colonoscopy was performed in each patient on the same day. In each single patient, the assessment of the presence of polyps was performed by two independent endoscopists, who were randomly assigned to evaluate, in a blind fashion, the presence of polyps either by ES or by standard colonoscopy. The frequency of successful procedures (i.e. reaching to the cecum), the time for endoscopy, and the need for sedation were recorded. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the ES were also calculated. RESULTS: A total of 71 patients (40 men, mean age51.9 ± 12.0 years) were enrolled. The cecum was reached in 81.6% of ES examinations and in 94.3% of colonoscopies (P = 0.03). The average time of endoscopy was 45.1 ± 18.5 and 23.7 ± 7.2 min for the ES and traditional colonoscopy, respectively (P < 0.0001). No patient required sedation during ES examination, compared with 19.7% of patients undergoing colonoscopy (P < 0.0001). The sensitivity and specificity of ES for detecting polyps were 93.3% (95% CI: 68-98) and 100% (95% CI: 76.8-100), respectively. PPV was 100% (95% CI: 76.8-100) and NPV was 97.7% (95% CI: 88-99.9). CONCLUSION: The ES allows the visualization of the entire colonic mucosa in most patients, with good sensitivity/specificity for the detection of lesions and without requiring sedation.
文摘Objective To evaluate the prevalence,potential risk factors,and correlation between coronary and peripheral microvascular dysfunction in heart failure with nonreduced ejection fraction(nHFrEF)patients.Methods This was a prospective registry study.nHFrEF patients admitted to Zhongshan Hospital affiliated with Fudan University from December 2021 to December 2023 were enrolled.According to coronary flow reserve(CFR)or reactive congestion index(RHI),enrolled patients were divided into coronary microvascular endothelial dysfunction(CMD)group(CFR<2.5)and no CMD group(CFR≥2.5)or peripheral microvascular endothelial dysfunction(MED)group(RHI<1.67)and no MED group(RHI≥1.67).Patients'general information,laboratory and auxiliary examination data were collected.Univariate and multivariate logistic regression were used to analyze the influencing factors of CMD and MED in nHFrEF patients,and Spearman correlation analysis was used to evaluate the correlation between MED and CMD.Results A total of 142 nHFrEF patients were enrolled,aged 69.0(59.0,74.0)years,with a male proportion of 66.9%(95/142).The grouping results were as follows:(1)According to CFR,there were 73 cases in the CMD group and 69 cases in the no CMD group;(2)According to RHI,there were 57 cases in the MED group and 85 cases in the no MED group.The prevalence of CMD and MED in this study was 51.4%(73/142)and 40.1%(57/142),respectively.Univariate logistic regression analysis showed that increased heart rate,chronic kidney disease,atrial fibrillation,elevated N-terminal pro-B type natriuretic peptide levels,and increased urinary albumin/creatinine ratio were risk factors for CMD,while increased RHI was a protective factor for CMD;Atrial fibrillation is a risk factor for MED,while increased CFR isa protectivefactor for MED.Incorporating clinically significant variables from univariate analysis into multivariate analysis,the results showed that increased heart rate and elevated RHI remained risk and protective factors for CMD,respectively;increased CFR remains a protective factor for MED.Spearman correlation analysis showed that CFR was negatively correlated with lg urinary albumin/creatinine ratio,lg cardiac troponin T,lg N-terminal pro-B type natriuretic peptide,and heart rate;RHI is positively correlated with CFR.Conclusion The prevalence of CMD and MED in nHFrEF patients is high,and the two have a certain positive correlation.Increased heart rate and RHI are risk and protective factors for CMD,respectively,while increased CFR is a protective factor for MED.MED may be a potential therapeutic target for nHFrEF patients.
基金The project supported by National Natural Science Foundation of China(81370339)Promotion Project of Beijing Education Committee(TJSHJ201510025005)
文摘OBJECTIVE To investigate the protective effect against diabetes cardiovascular complications of low molecular weight fucoidan(LMWF)from L.japonica in Qindao, China. METHODS LMWF(50,100 and 200mg·kg-1·d-1)or probucol(100mg·kg-1·d-1)were given orally to Goto-Kakizaki type 2 diabetic rats for 12 weeks.Basal blood pressure,acetylcholine-or flow-mediated relaxation of mesenteric and paw arteries,endothelium-dependent dilation of aorta,eNOS phosphorylation and NO production were measured using laser Doppler flowmetry,force myograph,HE staining,Western blot and an NO assay,respectively.The establishment of diabetic cardiomyopathy(DCM)model and were evaluated by echocardiography and isolated heart perfusion.Ventricle staining with HE or Sirius red was performed to investigate the structural changes in myocardium.Oxidative stress and apoptosis were evaluated by enzyme activities,protein expressions and cell stainings in both myocardial tissues and cultured cardiomyocytes.RESULTS In aorta,LMWF robustly ameliorated the basal hypertension and impairment of endothelium-dependent relaxation in the aorta,as well as mesenteric and paw arteries in diabetic rats.In addition,the reduction in endothelial nitric oxide synthase(eNOS)phosphorylation at Ser1177,eNOS expression and NO production due to diabetes were partially reversed by LMWF treatment.However,probucol,a lipid-modifying drug with antioxidant properties,displayed only mild effects.Moreover,LMWF induced,in a dose-dependent manner,endothelium-dependent vasodilation and eNOS phosphorylation at Ser1177 in normal aorta,and also promoted Ser1177 phosphorylation and NO synthesis in primary cultured vasoendothelial cells.On DCM,LMWF has a beneficial effect by enhancing myocardial contractility and mitigating cardiac fibrosis as well as the production of reactive oxygen species(ROS)and myocyte apoptosis in diabetic hearts.CONCLUSION These data demonstrate for the first time that fucoidan protects vasoendothelial and cardiac function against diabetic injury in type 2diabetes rats via,at least in part,preservation of eNOS function,amelioration of PKCβ-mediated oxidative stress and subsequent cardiomyocyte apoptosis.Fucoidan is therefore a potential candidate drug for protection of endothelium and heart in diabetic cardiovascular complications.
文摘目的 观察气管插管时不同气囊内压力下气管黏膜的病理改变.方法 选择气管内插管机械通气深昏迷患者60例,按随机原则分为囊内压25、30、35、40 mm Hg(1 mm Hg=0.133 kPa)组(分别记为A1、A2、A3、A4组),观察插管后1、24、48、72 h受压气管黏膜病理改变.结果 4组患者气管黏膜均有不同程度病理改变,但组内比较差异均无统计学意义.随气囊内压增加,气管黏膜损伤加重;A1组气管黏膜病理改变轻微,均为Ⅰ度;A2组未发现Ⅲ度损伤.损伤1 h时,A3组Ⅱ度损伤例数较A2组明显增多(10例比6例,P【0.05);A4组Ⅱ度及Ⅲ度损伤例数与A3组比较差异有统计学意义(Ⅱ度:7例比10例,Ⅲ度:6例比2例,均P【0.05);而且损伤1 h后,损伤程度不随时间变化而加重.结论 气管插管机械通气气囊内压低于30 mm Hg时气管黏膜病理改变轻微,气管插管时气囊内压低于30 mm Hg较为妥当.
