27 results on '"Liang MA"'
Search Results
2. Epigenetic connection between gut microbiota-derived short-chain fatty acids and chromatin histone modification in kidney diseases
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Lingzhi Li, Shenyu Zhao, Ting Xiang, Han Feng, Liang Ma, Ping Fu, and Yuanyuan Ji
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Medicine - Published
- 2022
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3. Casein kinase 2 interacting protein 1 positively regulates caudal-related homeobox 1 in intestinal-type gastric cancer
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Liang Ma, Ying Cao, Jian-Jun Hu, Ming-Liang Chu, and Xin Chen and Li-Min Chen
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Medicine - Abstract
Abstract. Background. Gastric cancer (GC) is one of the most common malignancies, and intestinal-type GC is the main histopathologic type of GC in China. We previously reported that casein kinase 2 interacting protein 1 (CKIP-1) acts as a candidate tumor suppressor in intestinal-type GC. CKIP-1 participates in the regulation of multiple signaling pathways, including the Wnt/β-catenin pathway, of which caudal-related homeobox 1 (CDX1) may be a downstream target gene. The purpose of this study was to investigate the relationship between CKIP-1 and CDX1 in intestinal-type GC. Methods. Sixty-seven gastroscopy biopsy specimens and surgically resected gastric specimens were divided into four groups: gastric mucosa group, intestinal metaplasia (IM) group, dysplasia group, and intestinal-type GC group. The expression levels of CKIP-1 and CDX1 were detected in these groups and GC cell lines, and the correlations between these expression levels were analyzed. SGC7901 and BGC823 cells were divided into CKIP-1 shRNA groups and CKIP-1 over-expression groups, and CDX1 expression was detected. β-Catenin expression was detected in intestinal-type GC tissue samples and CKIP-1 shRNA and CKIP-1 over-expression SGC7901 cells, and its correlation with CKIP-1 expression in intestinal-type GC tissue was analyzed. The Wnt/β-catenin pathway inhibitor DKK-1 and activator LiCl were incubated with SGC7901 cells, BGC823 cells, and CKIP-1 shRNA and CKIP-1 over-expression SGC7901 and BGC823 cells, following which CDX1 and Ki-67 expression were detected. Results. The expression levels of CKIP-1 and CDX1 were lower in patients with intestinal-type GC than in patients with IM and dysplasia (both P
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- 2020
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4. Progresses in pharmaceutical and surgical management of premature ejaculation
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Qin-Bo Hu, Dong Zhang, Liang Ma, Derry Mingyao Ng, Maria Haleem, Qi Ma, and Li-Min Chen
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Medicine - Abstract
Abstract. Objective:. Premature ejaculation (PE) is regarded as one of the most common male sexual dysfunctions. This review introduced several pharmaceutical and surgical methods for the management of PE. The definition, etiology, behavioral, and psychological therapy of PE were also discussed. Data sources:. “Premature,” “ejaculation,” or “sexual dysfuction” were used as the medical subject headings (MeSH) to obtain relevant articles before June 2019 on Pubmed, Google Scholar and CNKI. Most articles used were written in English and several Chinese articles were also cited. Study selection:. Full-text articles of retrospective/prospective/randomized controlled trials were analyzed. Animal experiments and letters were excluded. Results:. There are four PE sub-types: lifelong PE, acquired PE, natural variable PE, and subjective PE. Behavioral therapy, psychotherapy, medication, topical anesthetics, and surgery are currently used for the treatment of PE. However, all the above treatments have limitations. Therefore, novel ways should be investigated to more efficiently control PE. Conclusions:. The pharmaceutical therapy that is currently being used in clinical practice for the management of PE is still the main choice globally due to its good efficacy. Surgery may be a choice for patients who are resistant to medication. However, it should be performed cautiously.
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- 2019
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5. Analysis of biopsy-proven nephrotic syndrome in Tibetan patients
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Rongshuang Huang, Jing Liu, Min Shi, Shenju Gou, Liang Ma, Ping Fu, and Yuanyuan Ji
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Medicine - Published
- 2022
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6. Roles of short-chain fatty acids in kidney diseases
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Ling-Zhi Li, Si-Bei Tao, Liang Ma, Ping Fu, and Yuan-Yuan Ji
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Medicine - Abstract
Abstract. Objective:. In kidney diseases, uncontrolled blood pressure, inflammation, oxidative stress, imbalanced immunity response, and metabolic dysfunction were associated with the progressive deterioration of renal function. Short-chain fatty acids (SCFAs), as a group of metabolites fermented by gut microbiota exerted regulatory effects on kidney diseases through their activation of trans-membrane G protein-coupled receptors and their inhibition of histone acetylation. In this review article, we updated recent research advances that provided an opportunity to explore our understanding in physiology and function of SCFAs in kidney disease. Data sources:. We performed a comprehensive search in both PubMed and Embase using “short-chain fatty acids” and “kidney” with no restrictions on publication date. Study selection:. After reading through the title and abstract for early screening, the full text of relevant studies was identified and reviewed to summarize the roles of SCFAs in kidney diseases. Results:. Though controversial, growing evidence suggested SCFAs appeared to have a complex but yet poorly understood communications with cellular and molecular processes that affected kidney function and responses to injury. From recent studies, SCFAs influenced multiple aspects of renal physiology including inflammation and immunity, fibrosis, blood pressure, and energy metabolism. Conclusions:. The roles of intestinal SCFAs in kidney diseases were exciting regions in recent years; however, clinical trials and animal experiments in kidney diseases were still lacked. Thus, more research would be needed to obtain better understanding of SCFAs’ potential effects in kidney diseases.
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- 2019
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7. Big Data Research in Chronic Kidney Disease
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Xiao-Xi Zeng, Jing Liu, Liang Ma, and Ping Fu
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Chronic Kidney Disease ,Computational Biology ,Databse ,Machine Learning ,Medicine - Published
- 2018
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8. Pharmacological Inhibition of Macrophage Toll-like Receptor 4/Nuclear Factor-kappa B Alleviates Rhabdomyolysis-induced Acute Kidney Injury
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Rong-Shuang Huang, Jiao-Jiao Zhou, Yu-Ying Feng, Min Shi, Fan Guo, Shen-Ju Gou, Stephen Salerno, Liang Ma, and Ping Fu
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Acute Kidney Injury ,Macrophages ,Rhabdomyolysis ,Toll-Like Receptor 4 ,NF-kappa B ,Medicine - Abstract
Background: Acute kidney injury (AKI) is the most common and life-threatening systemic complication of rhabdomyolysis. Inflammation plays an important role in the development of rhabdomyolysis-induced AKI. This study aimed to investigate the kidney model of AKI caused by rhabdomyolysis to verify the role of macrophage Toll-like receptor 4/nuclear factor-kappa B (TLR4/NF-κB) signaling pathway. Methods: C57BL/6 mice were injected with a 50% glycerin solution at bilateral back limbs to induce rhabdomyolysis, and CLI-095 or pyrrolidine dithiocarbamate (PDTC) was intraperitoneally injected at 0.5 h before molding. Serum creatinine levels, creatine kinase, the expression of tumor necrosis factor (TNF)-α, interleukin (IL)-1β and IL-6, and hematoxylin and eosin stainings of kidney tissues were tested. The infiltration of macrophage, mRNA levels, and protein expression of TLR4 and NF-κB were investigated by immunofluorescence double-staining techniques, reverse transcriptase-quantitative polymerase chain reaction, and Western blotting, respectively. In vitro, macrophage RAW264.7 was stimulated by ferrous myoglobin; the cytokines, TLR4 and NF-κB expressions were also detected. Results: In an in vivo study, using CLI-095 or PDTC to block TLR4/NF-κB, functional and histologic results showed that the inhibition of TLR4 or NF-κB alleviated glycerol-induced renal damages (P < 0.01). CLI-095 or PDTC administration suppressed proinflammatory cytokine (TNF-α, IL-6, and IL-1β) production and macrophage infiltration into the kidney (P < 0.01). Moreover, in an in vitro study, CLI-095 or PDTC suppressed myoglobin-induced expression of TLR4, NF-κB, and proinflammatory cytokine levels in macrophage RAW264.7 cells (P < 0.01). Conclusion: The pharmacological inhibition of TLR4/NF-κB exhibited protective effects on rhabdomyolysis-induced AKI by the regulation of proinflammatory cytokine production and macrophage infiltration.
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- 2017
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9. Effects of Cyclosporine A on the Development of Metanephros in the Pregnant BALB/c Mice
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Yu-Jie Liao, Rong-Shuang Huang, Wei-Jing Lai, Fang Liu, Liang Ma, Yuan-Sheng Xie, Stephen Salerno, Yi Li, and Ping Fu
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Apoptosis ,Cyclosporine A ,Metanephros ,Nephron ,Ureteric Bud ,Medicine - Abstract
Background: Cyclosporine A (CsA) is a commonly used clinical immunosuppressant. However, CsA exposure in rabbits during the gestation period was shown to cause a postnatal decrease in the number of nephrons, with the effects remaining unknown. In this study, we aimed to explore the effects of CsA on metanephros development in the pregnant BALB/c mice. Methods: Pregnant mice were randomly divided into two groups, and CsA (10 mg·kg−1·d−1) was subcutaneously injected from gestation day 10.5 to day 16.5 in the CsA group, whereas a comparable volume of normal saline was given to the control group. All of the mice were sacrificed on gestation day 17.5 and serum CsA concentration was measured. The fetuses were removed and weighed, and their kidneys were prepared for histological assessment and polymerase chain reaction assay. In an in vitro experiment, embryo kidneys of fetal mice on gestation day 12.5 were used, and CsA (10 μmol/L) was added in the culture of the CsA group. The growth pattern of the ureteric bud and nephrons was assessed by lectin staining. Results: No significant differences in the weight of embryo (4.54 ± 1.22 vs. 3.26 ± 1.09 mg) were observed between the CsA and control groups, the thickness of the cortical (510.0 ± 30.3 vs. 350.0 ± 29.7 μm, P < 0.05) and nephrogenic zone (272.5 ± 17.2 vs. 173.3 ± 24.0 μm, P < 0.05), and the number of glomeruli (36.5 ± 0.7 vs. 27.5 ± 2.1, P < 0.05) were reduced in the CsA group when compared to the control group. The cell proliferation of Ki-67 positive index between control and CsA group (307.0 ± 20.0 vs. 219.0 ± 25.0, P < 0.05) in the nephrogenic zone was decreased with the increase of apoptotic cells (17.0 ± 2.0 vs. 159.0 ± 33.0, P < 0.05). The mRNA expression of WT-1, Pax2, and Pax8 was downregulated by CsA treatment. As for the in vitro CsA group, the branch number of the ureteric bud was decreased in the CsA-treated group with the nephrons missing in contrast to control after the incubation for 24 h and 72 h (all P < 0.0001). Conclusion: Treatment of CsA suppressed metanephros development in the pregnant mice; however, the potential action of mechanism needs to be further investigated.
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- 2017
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10. Analysis of biopsy-proven nephrotic syndrome in Tibetan patients
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Rongshuang Huang, Jing Liu, Min Shi, Shenju Gou, Liang Ma, Ping Fu, and Yuanyuan Ji
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medicine.medical_specialty ,Nephrotic Syndrome ,medicine.diagnostic_test ,business.industry ,Biopsy ,General Medicine ,Tibet ,medicine.disease ,Gastroenterology ,Internal medicine ,Correspondence ,medicine ,Medicine ,Humans ,business ,Nephrotic syndrome - Published
- 2021
11. Effects of Cyclosporine A on the Development of Metanephros in the Pregnant BALB/c Mice
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Stephen Salerno, Yuan-Sheng Xie, Fang Liu, Wei-Jing Lai, Liang Ma, Rongshuang Huang, Ping Fu, Yi Li, and Yu-Jie Liao
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0301 basic medicine ,Ureteric Bud ,Apoptosis ,Cyclosporine A ,Metanephros ,Nephron ,medicine.medical_treatment ,030232 urology & nephrology ,lcsh:Medicine ,Kidney ,BALB/c ,Andrology ,Mice ,PAX8 Transcription Factor ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,medicine ,Animals ,WT1 Proteins ,Saline ,Cell Proliferation ,Mice, Inbred BALB C ,Fetus ,biology ,business.industry ,PAX2 Transcription Factor ,lcsh:R ,Embryo ,Nephrons ,General Medicine ,biology.organism_classification ,Repressor Proteins ,030104 developmental biology ,medicine.anatomical_structure ,Ureteric bud ,Mesonephros ,Cyclosporine ,Gestation ,Original Article ,Female ,business ,Immunosuppressive Agents - Abstract
Background: Cyclosporine A (CsA) is a commonly used clinical immunosuppressant. However, CsA exposure in rabbits during the gestation period was shown to cause a postnatal decrease in the number of nephrons, with the effects remaining unknown. In this study, we aimed to explore the effects of CsA on metanephros development in the pregnant BALB/c mice. Methods: Pregnant mice were randomly divided into two groups, and CsA (10 mg·kg−1·d−1) was subcutaneously injected from gestation day 10.5 to day 16.5 in the CsA group, whereas a comparable volume of normal saline was given to the control group. All of the mice were sacrificed on gestation day 17.5 and serum CsA concentration was measured. The fetuses were removed and weighed, and their kidneys were prepared for histological assessment and polymerase chain reaction assay. In an in vitro experiment, embryo kidneys of fetal mice on gestation day 12.5 were used, and CsA (10 μmol/L) was added in the culture of the CsA group. The growth pattern of the ureteric bud and nephrons was assessed by lectin staining. Results: No significant differences in the weight of embryo (4.54 ± 1.22 vs. 3.26 ± 1.09 mg) were observed between the CsA and control groups, the thickness of the cortical (510.0 ± 30.3 vs. 350.0 ± 29.7 μm, P < 0.05) and nephrogenic zone (272.5 ± 17.2 vs. 173.3 ± 24.0 μm, P < 0.05), and the number of glomeruli (36.5 ± 0.7 vs. 27.5 ± 2.1, P < 0.05) were reduced in the CsA group when compared to the control group. The cell proliferation of Ki-67 positive index between control and CsA group (307.0 ± 20.0 vs. 219.0 ± 25.0, P < 0.05) in the nephrogenic zone was decreased with the increase of apoptotic cells (17.0 ± 2.0 vs. 159.0 ± 33.0, P < 0.05). The mRNA expression of WT-1, Pax2, and Pax8 was downregulated by CsA treatment. As for the in vitro CsA group, the branch number of the ureteric bud was decreased in the CsA-treated group with the nephrons missing in contrast to control after the incubation for 24 h and 72 h (all P < 0.0001). Conclusion: Treatment of CsA suppressed metanephros development in the pregnant mice; however, the potential action of mechanism needs to be further investigated. Key words: Apoptosis; Cyclosporine A; Metanephros; Nephron; Ureteric Bud
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- 2017
12. Comparison of Efficacy and Safety between First and Second Generation Drug-eluting Stents in Patients with Stable Coronary Artery Disease
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Jinqing Yuan, Yuan Wen, Yuejin Yang, Bo Xu, Yuan-Liang Ma, Shubin Qiao, Ru Liu, Yi Yao, Fei Xiong, Runlin Gao, and Zhan Gao
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Drug ,medicine.medical_specialty ,Percutaneous ,medicine.medical_treatment ,media_common.quotation_subject ,lcsh:Medicine ,030204 cardiovascular system & hematology ,Single Center ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Medicine ,In patient ,030212 general & internal medicine ,media_common ,business.industry ,lcsh:R ,Percutaneous coronary intervention ,Retrospective cohort study ,General Medicine ,medicine.disease ,First generation ,Surgery ,Cardiology ,Drug-eluting Stents ,Percutaneous Coronary Intervention ,Stable Coronary Artery Disease ,business - Abstract
Background: Lots of trials demonstrate that second-generation drug-eluting stents (G2-DES), with their improved properties, offer significantly superior efficacy and safety profiles compared to first generation DES (G1-DES) for patients with coronary artery disease (CAD) receiving percutaneous coronary intervention (PCI). This study aimed to verify the advantage of G2-DES over G1-DES in Chinese patients with stable CAD (SCAD). Methods: For this retrospective observational analysis, 2709 SCAD patients with either G1-DES (n = 863) or G2-DES (n = 1846) were enrolled consecutively throughout 2013. Propensity score matching (PSM) was applied to control differing baseline factors. Two-year outcomes, including major adverse coronary events as well as individual events, including target vessel-related myocardial infarction, target lesion revascularization (TLR), target vessel revascularization, and cardiogenic death were evaluated. Results: The incidence of revascularization between G1- and G2-DES showed a trend of significant difference with a threshold P - value (8.6% vs. 6.7%, χ2 = 2.995, P = 0.084). G2-DES significantly improved TLR-free survival compared to G1-DES (96.6% vs. 97.9%, P = 0.049) and revascularization-free survival curve showed a trend of improvement of G2-DES (92.0% vs. 93.8%, P = 0.082). These differences diminished after PSM. Multivariate Cox proportional hazard regression analysis showed a trend for G1-associated increase in revascularization (hazard ratio: 1.28, 95% confidence interval: 0.95–1.72, P = 0.099) while no significance was found after PSM. Other endpoints showed no significant differences after multivariate adjustment regardless of PSM. Conclusions: G1-DES showed the same safety as G2-DES in this large Chinese cohort of real-world patients. However, G2-DES improved TLR-free survival of SCAD patients 2 years after PCI. The advantage was influenced by baseline clinical factors. G1-DES was associated with a trend of increase in revascularization risk and was not an independent predictor of worse medium-term prognosis compared with G2-DES.
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- 2017
13. Long-term Outcomes of Primary Percutaneous Coronary Intervention with Second-generation Drug-eluting Stents in ST-elevation Myocardial Infarction Patients Caused by Very Late Stent Thrombosis
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Bo Xu, Chuang-Shi Wang, Yuan-Liang Ma, Chen He, Xiao-Fang Tang, Lin Jiang, Yi Yao, Jia-Hui Zhang, Runlin Gao, and Jinqing Yuan
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Adult ,Male ,ST-elevation Myocardial Infarction ,medicine.medical_specialty ,Time Factors ,Paclitaxel ,medicine.medical_treatment ,Myocardial Infarction ,lcsh:Medicine ,Kaplan-Meier Estimate ,030204 cardiovascular system & hematology ,03 medical and health sciences ,Primary Percutaneous Coronary Intervention ,Percutaneous Coronary Intervention ,0302 clinical medicine ,Second-generation Drug-eluting Stents ,Risk Factors ,Interquartile range ,Internal medicine ,Angioplasty ,medicine ,Humans ,Stent Thrombosis ,cardiovascular diseases ,030212 general & internal medicine ,Myocardial infarction ,Angioplasty, Balloon, Coronary ,Aged ,Retrospective Studies ,Sirolimus ,business.industry ,lcsh:R ,Percutaneous coronary intervention ,Drug-Eluting Stents ,Thrombosis ,Retrospective cohort study ,General Medicine ,Thrombolysis ,Middle Aged ,medicine.disease ,Treatment Outcome ,surgical procedures, operative ,Conventional PCI ,Cardiology ,Original Article ,Female ,business - Abstract
Background: The ST-segment elevation myocardial infarction (STEMI) patients due to stent thrombosis (ST) remain a therapeutic challenge for a clinician. Till date, very few researches have been conducted regarding the safety and effectiveness of primary percutaneous coronary intervention (PCI) with second-generation drug-eluting stents (DES) for STEMI caused by very late ST (VLST). This retrospective study evaluated the safety, efficacy, and outcomes of primary PCI with second-generation DES for STEMI due to VLST compared with primary PCI for STEMI due to de novo lesion. Methods: Between January 2007 and December 2013, STEMI patients with primary PCI in Fuwai Hospital had only second-generation DES implanted for de novo lesion (558 patients) and VLST (50 patients) were included in this retrospective study. The primary end points included cardiac death and reinfarction. The secondary end points included cardiac death, reinfarction, and target lesion revascularization. Continuous variables were expressed as mean (standard deviation) or median (interquartile range) and compared by Student’s t-test or Mann-Whitney U-test as appropriate. Categorical variables were expressed as counts and percentages, and comparison of these variables was performed with Chi-square or Fisher’s exact test. A two-tailed value of P < 0.05 was considered statistically significant for all comparisons. Statistical analyses were performed by SAS software (version 9.4, SAS Institute Inc., Cary, USA) for Windows. Results: In-hospital primary end point and the secondary end point were no significant differences between two groups (P = 1.000 and P = 1.000, respectively). No significant differences between two groups were observed according to the long-term primary end point and the secondary end point. Kaplan-Meier survival curves showed no significant difference between the two groups in the primary end point and the secondary end point at 2 years (P = 0.340 and P = 0.243, respectively). According to Cox analysis, female, intra-aortic balloon pump support, and postprocedural thrombolysis in myocardial infarction flow 3 were found to be independent predictors for long-term follow-up. Conclusion: Primary PCI with second-generation DES is a reasonable choice for STEMI patients caused by VLST. Key words: Primary Percutaneous Coronary Intervention; Second-generation Drug-eluting Stents; ST-elevation Myocardial Infarction; Stent Thrombosis
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- 2017
14. Determinants of Calcium Infusion Rate During Continuous Veno-venous Hemofiltration with Regional Citrate Anticoagulation in Critically Ill Patients with Acute Kidney Injury
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Yue Zheng, Wen-Xiong Li, Wen-Liang Ma, Yue Han, Li-Feng Huang, De-Lin Liu, and Qi Ding
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Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,030232 urology & nephrology ,lcsh:Medicine ,chemistry.chemical_element ,Calcium ,Citric Acid ,Anticoagulation ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Interquartile range ,Hemofiltration ,medicine ,Humans ,Prospective Studies ,Aged ,Trisodium citrate ,Calcium metabolism ,business.industry ,lcsh:R ,Acute kidney injury ,Anticoagulants ,030208 emergency & critical care medicine ,General Medicine ,Blood flow ,Acute Kidney Injury ,Middle Aged ,medicine.disease ,Surgery ,Citrate ,chemistry ,Anesthesia ,Female ,Original Article ,Citric acid ,business - Abstract
Background: It is unclear that how to decide the calcium infusion rate during continuous veno-venous hemofiltration (CVVH) with regional citrate anticoagulation (RCA). This study aimed to assess the determinants of calcium infusion rate during CVVH with RCA in critically ill patients with acute kidney injury (AKI). Methods: A total of 18 patients with AKI requiring CVVH were prospectively analyzed. Postdilution CVVH was performed with a fixed blood flow rate of 150 ml/min and a replacement fluid flow rate of 2000 ml/h for each new circuit. The infusion of 4% trisodium citrate was started at a rate of 29.9 mmol/h prefilter and adjusted according to postfilter ionized calcium. The infusion of 10% calcium gluconate was initiated at a rate of 5.5 mmol/h and adjusted according to systemic ionized calcium. The infusion rate of trisodium citrate and calcium gluconate as well as ultrafiltrate flow rate were recorded at 1, 2, 4, 6, 12, and 24 h after starting CVVH, respectively. The calcium loss rate by CVVH was also calculated. Results: Fifty-seven sessions of CVVH were performed in 18 AKI patients. The citrate infusion rate, calcium loss rate by CVVH, and calcium infusion rate were 31.30 (interquartile range: 2.70), 4.60 ± 0.48, and 5.50 ± 0.35 mmol/h, respectively. The calcium infusion rate was significantly higher than that of calcium loss rate by CVVH (P < 0.01). The correlation coefficient between the calcium and citrate infusion rates, and calcium infusion and calcium loss rates by CVVH was −0.031 (P > 0.05) and 0.932 (P < 0.01), respectively. In addition, calcium infusion rate (mmol/h) = 1.77 + 0.8 × (calcium loss rate by CVVH, mmol/h). Conclusions: The calcium infusion rate correlates significantly with the calcium loss rate by CVVH but not with the citrate infusion rate in a fixed blood flow rate during CVVH with RCA.
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- 2016
15. Comparison of Efficacy and Safety between First- and Second-Generation Drug-Eluting Stents in Patients with Acute Coronary Syndrome
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Ying Song, Runlin Gao, Yuan-Liang Ma, Xiao-Fang Tang, Ru Liu, Na Xu, Yi Yao, Jingjing Xu, Yuejin Yang, Lin Jiang, Ping Jiang, Shubin Qiao, Bo Xu, Jue Chen, Xueyan Zhao, Jinqing Yuan, Huan-Huan Wang, and Zhan Gao
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Acute Coronary Syndrome ,First-Generation Drug-Eluting Stent ,Percutaneous Coronary Intervention ,Second-Generation Drug-Eluting Stent ,Stent Thrombosis ,Male ,medicine.medical_specialty ,Acute coronary syndrome ,medicine.medical_treatment ,Myocardial Infarction ,lcsh:Medicine ,Kaplan-Meier Estimate ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Medicine ,Humans ,030212 general & internal medicine ,Myocardial infarction ,Prospective Studies ,Aged ,business.industry ,Coronary Thrombosis ,lcsh:R ,Hazard ratio ,Stent ,Percutaneous coronary intervention ,Drug-Eluting Stents ,General Medicine ,Middle Aged ,medicine.disease ,Thrombosis ,Exact test ,Cardiology ,Female ,Original Article ,business ,Mace - Abstract
Background: It remains undetermined whether second-generation drug-eluting stents (G2-DESs) outperform first-generation DESs (G1-DESs) in patients with acute coronary syndrome (ACS). We aimed to compare the efficacy and safety of G1-DES and G2-DES in ACS patients in a high-volume cardiovascular center. Methods: In 2013, 10,724 consecutive patients underwent percutaneous coronary intervention in our institution. We included 4037 patients with ACS who underwent exclusively G1-DES or G2-DES implantation (n = 364 and n = 3673, respectively). We used propensity score matching to minimize the imbalance between the G1-DES and G2-DES groups and followed patients for 2 years. The efficacy endpoints were major adverse cardiac events (MACEs) and its components including target vessel-related myocardial infarction (TV-MI), target vessel revascularization/target lesion revascularization (TVR/TLR), and cardiac death. The safety endpoint was stent thrombosis. Continuous variables were compared by Mann-Whitney U-test, and categorical variables were compared using Pearson’s Chi-square or Fisher’s exact test. Kaplan-Meier curves were constructed to compare the event-free survival rates, and multivariate Cox proportional hazards regression analysis was used to assess whether stent type was an independent risk factor for the efficacy and safety endpoints. Results: At the 2-year follow-up, the results for MACE and it components, as well as stent thrombosis, were similar for G1-DES and G2-DES (MACE, 5.2% vs. 4.3%, χ2 = 0.514, P= 0.474; TV-MI, 0.8% vs. 0.4%, P= 0.407; TVR, 4.9% vs. 3.7%, χ2 = 0.939, P= 0.333; TLR, 3.8% vs. 2.5%, χ2 = 1.610, P= 0.205; cardiac death, 0.3% vs. 0.5%, P= 0.670; and stent thrombosis, 0.5% vs. 0.4%, P> 0.999). Kaplan-Meier analysis indicated similar event-free survival rates between G1-DES and G2-DES after propensity score matching (all: log-rank P> 0.05). Multivariate analysis demonstrated that stent type was not an independent risk factor for the efficacy and safety endpoints (MACE, hazard ratio [HR] = 0.805, 95% confidence interval [CI]: 0.455-1.424, P= 0.456; TV-MI, HR = 0.500, 95% CI: 0.101- 2.475, P= 0.395; TVR, HR = 0.732, 95% CI: 0.403-1.330, P= 0.306; TLR, HR = 0.629, 95% CI: 0.313-1.264, P= 0.193; cardiac death, HR = 1.991, 95% CI: 0.223-17.814, P= 0.538; and stent thrombosis, HR = 0.746, 95% CI: 0.125-4.467, P= 0.749). Conclusion: G1-DES and G2-DES have similar efficacy and safety profiles in ACS patients at the 2-year follow-up. Key words: Acute Coronary Syndrome; First-Generation Drug-Eluting Stent; Percutaneous Coronary Intervention; Second-Generation Drug-Eluting Stent; Stent Thrombosis
- Published
- 2018
16. Head to Head Comparison of Two Point-of-care Platelet Function Tests Used for Assessment of On-clopidogrel Platelet Reactivity in Chinese Acute Myocardial Infarction Patients Undergoing Percutaneous Coronary Intervention
- Author
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Miao Wang, Chen He, Ying Song, Yuan-Liang Ma, Jia-Hui Zhang, Xiao-Fang Tang, Runlin Gao, Ru Liu, Yi Yao, Lei Song, Jinqing Yuan, Jingjing Xu, and Xian-Min Meng
- Subjects
Blood Platelets ,Male ,medicine.medical_specialty ,China ,Ticlopidine ,Platelet Aggregation ,VerifyNow ,medicine.medical_treatment ,Point-of-Care Systems ,Myocardial Infarction ,lcsh:Medicine ,030204 cardiovascular system & hematology ,Clopidogrel ,Thromboelastography ,03 medical and health sciences ,0302 clinical medicine ,Percutaneous Coronary Intervention ,Internal medicine ,medicine ,Humans ,Myocardial infarction ,Aged ,Aspirin ,medicine.diagnostic_test ,business.industry ,lcsh:R ,Percutaneous coronary intervention ,General Medicine ,Middle Aged ,medicine.disease ,Receptors, Purinergic P2Y12 ,Surgery ,Thrombelastography ,Adenosine Diphosphate ,Conventional PCI ,Cardiology ,Platelet aggregation inhibitor ,Female ,Original Article ,business ,030217 neurology & neurosurgery ,Platelet Aggregation Inhibitors ,medicine.drug - Abstract
Background: Platelet function tests are widely used in clinical practice to guide personalized antiplatelet therapy. In China, the thromboelastography (TEG) test has been well accepted in clinics, whereas VerifyNow, mainly used for scientific research, has not been used in routine clinical practice. The aim of the current study was to compare these two point-of-care platelet function tests and to analyze the consistency between the two tests for evaluating on-clopidogrel platelet reactivity in Chinese acute myocardial infarction patients undergoing percutaneous coronary intervention (PCI). Methods: A total of 184 patients admitted to Fuwai Hospital between August 2014 and May 2015 were enrolled in the study. On-clopidogrel platelet reactivity was assessed 3 days after PCI by TEG and VerifyNow using adenosine diphosphate as an agonist. Based on the previous reports, an inhibition of platelet aggregation (IPA) 230 for VerifyNow was defined as high on-clopidogrel platelet reactivity (HPR). An IPA >70% or a PRU 205 for HPR and PRU
- Published
- 2016
17. Delayed diagnosis for tricuspid regurgitation after blunt chest trauma
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Haige, Zhao, Robert A, McCready, Jingya, Fan, Peng, Hu, Yiming, Ni, Dominige, Calcaterra, and Liang, Ma
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Adult ,Male ,Delayed Diagnosis ,Thoracic Injuries ,Humans ,Female ,Middle Aged ,Wounds, Nonpenetrating ,Tricuspid Valve Insufficiency - Published
- 2014
18. Chronic intermittent hypoxia aggravates cardiomyocyte apoptosis in rat ovariectomized model
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Ying-Hui, Gao, Lin, Chen, Yan-Liang, Ma, and Quan-Ying, He
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Rats, Sprague-Dawley ,Disease Models, Animal ,Oxidative Stress ,Sleep Apnea, Obstructive ,Ovariectomy ,Body Weight ,Animals ,Apoptosis ,Female ,Myocytes, Cardiac ,Organ Size ,Hypoxia ,Rats - Abstract
The prevalence of obstructive sleep apnea (OSA) increases after menopause in women, but remains under diagnosed because of social or lifestyle factors. It is important to evaluate the hazards of OSA on cardiovascular disease in menopausal women. We tested the hypothesis that chronic intermittent hypoxia (CIH) may aggravate cardiomyocyte apoptosis in ovariectomized (OVX) Sprague Dawley (SD) rats; the changes of anti-oxidation ability in cardiac muscles may be one of the reasons for cardiomyocyte apoptosis.Forty-eight 60-day old female SD rats were randomly divided into a CIH group, OVX group, OVX+CIH (OC) group, and handled control (HC) group, and the rats were exposed either to CIH (nadir O2 6%) or handled normoxic controls. The changes of body weight and whole heart weight were measured. Super oxide dismutase (SOD) and malonaldehyde (MDA) were used to evaluate the level of oxidative stress. TdT-mediated dUTP nick end labeling (TUNEL) was used to measure apoptosis in each rat. Western blotting was used to measure apoptosis associated proteins in cardiac muscle samples from each rat.When compared with the HC and CIH groups, the levels of oxidative stress in the OC and OVX groups were significantly higher. The levels of SOD in the HC, CIH, OC, and OVX groups were (47.99 ± 4.89), (53.60 ± 4.47), (20.99 ± 2.72), and (30.64 ± 3.79) mmol/mg protein; significantly increased in the CIH group (P0.05) and significantly decreased in the OC (P0.01) and OVX (P0.05) groups. The levels of MDA in the HC, CIH, OVX, and OC groups were (1.63 ± 0.20), (1.93 ± 0.77), (3.30 ± 0.39), and (1.95 ± 0.20) mmol/mg protein; it significantly increased in the CIH (P0.05), OC (P0.01), and OVX (P0.05) groups compared with the HC group. Bax protein expression was significantly increased and bcl-2 protein expression was significantly reduced after CIH compared with HC rats (P0.05). The protein expression of bax and bcl-2 in the OC group was not significantly different from the CIH group, but the ratio of bax/bcl-2 was significantly increased in the OC group (P0.05); this was associated with severe cardiomycyte apoptosis in the OC group. TUNEL confirmed this observation.This study found that CIH may induce oxidative stress in OVX rats but not in CIH rats, and cause more severe cardiomyocyte apoptosis in OVX rats compared with CIH rats. This means that OVX rats exposed to CIH suffered more severe cardiac injury compared with CIH rats due to reduced antioxidation. These findings may partly explain the reason why OSA has a worse cardiovascular impact on menopausal women, and emphasize the importance of detection and early treatment of OSA in menopausal patients.
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- 2012
19. RNA interference targeting mu-opioid receptors reverses the inhibition of fentanyl on glucose-evoked insulin release of rat islets
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Tao-Lai, Qian, Lei, Zhang, Xin-Hua, Wang, Sheng, Liu, Liang, Ma, and Ying, Lu
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Male ,Cell Survival ,Receptors, Opioid, mu ,Rats ,Analgesics, Opioid ,Fentanyl ,Rats, Sprague-Dawley ,Islets of Langerhans ,Glucose ,Insulin Secretion ,Animals ,Insulin ,RNA Interference ,RNA, Messenger ,Cells, Cultured - Abstract
Mu opioid receptor plays an important role in many physiological functions. Fentanyl is a widely used opioid receptor agonist for analgesia. This study was conducted to test the role of mu-opioid receptor on insulin release by determining whether fentanyl affected insulin release from freshly isolated rat pancreatic islets and if small interfering RNAs (siRNA) targeting mu-opioid receptor in the islets could knock down mu-opioid receptor expression.Islets were isolated from ripe SD rats' pancreas by common bile duct intraductal collagenase V digestion and purified by discontinuous Ficoll density gradient centrifugation. The siRNA knock-down of mu-opioid receptor mRNA and protein in islet cells was analyzed by semi-quantitative real time-PCR and Western blotting. After siRNA-transfection for 48 hours, the islets were co-cultured with fentanyl as follows: 0 ng/ml, 3 ng/ml and 30 ng/ml for 48 hours. Then glucose-evoked insulin release was performed. As a control, the insulin release was also analyzed in islets without siRNA-trasfection after being co-cultured with fentanyl for 48 hours.After 48 hours of transfections, specific siRNA targeting of mu-opioid receptors produced significant reduction of mu-opioid receptor mRNA and protein (P0.01). Fentanyl significantly inhibited glucose-evoked insulin release in islets in a concentration dependent manner (P0.01). But after siRNA-transfection for 48 hours, the inhibition on glucose-evoked insulin release was reversed (P0.01).RNA interference specifically reduces mu-opioid receptor mRNA and protein expression, leading to reversal of the fentanyl-induced inhibition on glucose-evoked insulin release of rat islets. The activation of opioid receptor induced by fentanyl functions to inhibit insulin release. The use of RNAi presents a promising tool for future research in diabetic mechanisms and a novel therapy for diabetes.
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- 2011
20. Assessment of culprit lesions by intravascular ultrasound in patients with acute myocardial infarction
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Jian, Liu, Chuan-Fen, Liu, Ming-Yu, Lu, Yu-Liang, Ma, Long, Wang, Hong, Chen, and Wei-Min, Wang
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Adult ,Aged, 80 and over ,Male ,Electrocardiography ,Acute Disease ,Myocardial Infarction ,Humans ,Angioplasty, Balloon, Coronary ,Middle Aged ,Coronary Angiography ,Ultrasonography, Interventional ,Aged - Abstract
Intravascular ultrasound has become the standard invasive method for diagnosing coronary artery disease. The aim of the present study was to evaluate the ability of intravascular ultrasound for assessment of culprit lesion morphology during primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI).We performed 18 intravascular ultrasound assessments preintervention during the primary PCI for AMI. intravascular ultrasound analysis included qualitative and quantitative measurements of reference and lesion external elastic membrane (EEM), lumen, and plaque plus media (PM) area. Positive remodeling was defined as lesion/mean reference EEM1.0. Culprit lesions were identified by a combination of electrocardiogram (ECG) and coronary angiography.There was an average of 1.44 infarct-related artery (IRA) plaques per patient. The incidences of thrombus and plaque ruptures were 28% (5) and 33% (6), respectively. Hypoechoic plaque was observed in 72% (13) of AMI patients. Calcified lesions could be found in 33% (6) of culprit lesions. Sixty percent of the culprit lesion sites presented with positive remodeling.Intravascular ultrasound is a safe and feasible imaging modality in patients with AMI and can help identify plaque rupture, intracoronary thrombus or calcification. The culprit lesion site in AMI cases often presents with positive remodeling.
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- 2009
21. Comparison of Efficacy and Safety between First- and Second-Generation Drug-Eluting Stents in Patients with Acute Coronary Syndrome
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Yuan-Liang Ma, Xiao-Fang Tang, Yi Yao, Na Xu, Ying Song, Ping Jiang, Jing-Jing Xu, Huan-Huan Wang, Lin Jiang, Ru Liu, Xue-Yan Zhao, Jue Chen, Zhan Gao, Shu-Bin Qiao, Yue-Jin Yang, Run-Lin Gao, Bo Xu, and Jin-Qing Yuan
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Acute Coronary Syndrome ,First-Generation Drug-Eluting Stent ,Percutaneous Coronary Intervention ,Second-Generation Drug-Eluting Stent ,Stent Thrombosis ,Medicine - Abstract
Background: It remains undetermined whether second-generation drug-eluting stents (G2-DESs) outperform first-generation DESs (G1-DESs) in patients with acute coronary syndrome (ACS). We aimed to compare the efficacy and safety of G1-DES and G2-DES in ACS patients in a high-volume cardiovascular center. Methods: In 2013, 10,724 consecutive patients underwent percutaneous coronary intervention in our institution. We included 4037 patients with ACS who underwent exclusively G1-DES or G2-DES implantation (n = 364 and n = 3673, respectively). We used propensity score matching to minimize the imbalance between the G1-DES and G2-DES groups and followed patients for 2 years. The efficacy endpoints were major adverse cardiac events (MACEs) and its components including target vessel-related myocardial infarction (TV-MI), target vessel revascularization/target lesion revascularization (TVR/TLR), and cardiac death. The safety endpoint was stent thrombosis. Continuous variables were compared by Mann-Whitney U-test, and categorical variables were compared using Pearson's Chi-square or Fisher's exact test. Kaplan-Meier curves were constructed to compare the event-free survival rates, and multivariate Cox proportional hazards regression analysis was used to assess whether stent type was an independent risk factor for the efficacy and safety endpoints. Results: At the 2-year follow-up, the results for MACE and it components, as well as stent thrombosis, were similar for G1-DES and G2-DES (MACE, 5.2% vs. 4.3%, χ2 = 0.514, P = 0.474; TV-MI, 0.8% vs. 0.4%, P = 0.407; TVR, 4.9% vs. 3.7%, χ2 = 0.939, P = 0.333; TLR, 3.8% vs. 2.5%, χ2 = 1.610, P = 0.205; cardiac death, 0.3% vs. 0.5%, P = 0.670; and stent thrombosis, 0.5% vs. 0.4%, P > 0.999). Kaplan-Meier analysis indicated similar event-free survival rates between G1-DES and G2-DES after propensity score matching (all: log-rank P > 0.05). Multivariate analysis demonstrated that stent type was not an independent risk factor for the efficacy and safety endpoints (MACE, hazard ratio [HR] = 0.805, 95% confidence interval [CI]: 0.455–1.424, P = 0.456; TV-MI, HR = 0.500, 95% CI: 0.101–2.475, P = 0.395; TVR, HR = 0.732, 95% CI: 0.403–1.330, P = 0.306; TLR, HR = 0.629, 95% CI: 0.313–1.264, P = 0.193; cardiac death, HR = 1.991, 95% CI: 0.223–17.814, P = 0.538; and stent thrombosis, HR = 0.746, 95% CI: 0.125–4.467, P = 0.749). Conclusion: G1-DES and G2-DES have similar efficacy and safety profiles in ACS patients at the 2-year follow-up.
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- 2018
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22. Long-term Outcomes of Primary Percutaneous Coronary Intervention with Second-generation Drug-eluting Stents in ST-elevation Myocardial Infarction Patients Caused by Very Late Stent Thrombosis
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Chen He, Yuan-Liang Ma, Chuang-Shi Wang, Lin Jiang, Jia-Hui Zhang, Yi Yao, Xiao-Fang Tang, Bo Xu, Run-Lin Gao, and Jin-Qing Yuan
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Primary Percutaneous Coronary Intervention ,Second-generation Drug-eluting Stents ,ST-elevation Myocardial Infarction ,Stent Thrombosis ,Medicine - Abstract
Background: The ST-segment elevation myocardial infarction (STEMI) patients due to stent thrombosis (ST) remain a therapeutic challenge for a clinician. Till date, very few researches have been conducted regarding the safety and effectiveness of primary percutaneous coronary intervention (PCI) with second-generation drug-eluting stents (DES) for STEMI caused by very late ST (VLST). This retrospective study evaluated the safety, efficacy, and outcomes of primary PCI with second-generation DES for STEMI due to VLST compared with primary PCI for STEMI due to de novo lesion. Methods: Between January 2007 and December 2013, STEMI patients with primary PCI in Fuwai Hospital had only second-generation DES implanted for de novo lesion (558 patients) and VLST (50 patients) were included in this retrospective study. The primary end points included cardiac death and reinfarction. The secondary end points included cardiac death, reinfarction, and target lesion revascularization. Continuous variables were expressed as mean (standard deviation) or median (interquartile range) and compared by Student's t- test or Mann-Whitney U-test as appropriate. Categorical variables were expressed as counts and percentages, and comparison of these variables was performed with Chi-square or Fisher's exact test. A two-tailed value of P < 0.05 was considered statistically significant for all comparisons. Statistical analyses were performed by SAS software (version 9.4, SAS Institute Inc., Cary, USA) for Windows. Results: In-hospital primary end point and the secondary end point were no significant differences between two groups (P = 1.000 and P = 1.000, respectively). No significant differences between two groups were observed according to the long-term primary end point and the secondary end point. Kaplan-Meier survival curves showed no significant difference between the two groups in the primary end point and the secondary end point at 2 years (P = 0.340 and P = 0.243, respectively). According to Cox analysis, female, intra-aortic balloon pump support, and postprocedural thrombolysis in myocardial infarction flow 3 were found to be independent predictors for long-term follow-up. Conclusion: Primary PCI with second-generation DES is a reasonable choice for STEMI patients caused by VLST.
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- 2017
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23. Comparison of Efficacy and Safety between First and Second Generation Drug-eluting Stents in Patients with Stable Coronary Artery Disease: A Single-center Retrospective Study
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Ru Liu, Fei Xiong, Yuan Wen, Yuan-Liang Ma, Yi Yao, Zhan Gao, Bo Xu, Yue-Jin Yang, Shu-Bin Qiao, Run-Lin Gao, and Jin-Qing Yuan
- Subjects
Drug-eluting Stents ,Percutaneous Coronary Intervention ,Stable Coronary Artery Disease ,Medicine - Abstract
Background: Lots of trials demonstrate that second-generation drug-eluting stents (G2-DES), with their improved properties, offer significantly superior efficacy and safety profiles compared to first generation DES (G1-DES) for patients with coronary artery disease (CAD) receiving percutaneous coronary intervention (PCI). This study aimed to verify the advantage of G2-DES over G1-DES in Chinese patients with stable CAD (SCAD). Methods: For this retrospective observational analysis, 2709 SCAD patients with either G1-DES (n = 863) or G2-DES (n = 1846) were enrolled consecutively throughout 2013. Propensity score matching (PSM) was applied to control differing baseline factors. Two-year outcomes, including major adverse coronary events as well as individual events, including target vessel-related myocardial infarction, target lesion revascularization (TLR), target vessel revascularization, and cardiogenic death were evaluated. Results: The incidence of revascularization between G1- and G2-DES showed a trend of significant difference with a threshold P - value (8.6% vs. 6.7%, χ2 = 2.995, P = 0.084). G2-DES significantly improved TLR-free survival compared to G1-DES (96.6% vs. 97.9%, P = 0.049) and revascularization-free survival curve showed a trend of improvement of G2-DES (92.0% vs. 93.8%, P = 0.082). These differences diminished after PSM. Multivariate Cox proportional hazard regression analysis showed a trend for G1-associated increase in revascularization (hazard ratio: 1.28, 95% confidence interval: 0.95–1.72, P = 0.099) while no significance was found after PSM. Other endpoints showed no significant differences after multivariate adjustment regardless of PSM. Conclusions: G1-DES showed the same safety as G2-DES in this large Chinese cohort of real-world patients. However, G2-DES improved TLR-free survival of SCAD patients 2 years after PCI. The advantage was influenced by baseline clinical factors. G1-DES was associated with a trend of increase in revascularization risk and was not an independent predictor of worse medium-term prognosis compared with G2-DES.
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- 2017
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24. Head to Head Comparison of Two Point-of-care Platelet Function Tests Used for Assessment of On-clopidogrel Platelet Reactivity in Chinese Acute Myocardial Infarction Patients Undergoing Percutaneous Coronary Intervention
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Yi Yao, Jia-Hui Zhang, Xiao-Fang Tang, Chen He, Yuan-Liang Ma, Jing-Jing Xu, Ying Song, Ru Liu, Xian-Min Meng, Lei Song, Miao Wang, Run-Lin Gao, and Jin-Qing Yuan
- Subjects
Blood Platelets ,Clopidogrel ,Thromboelastography ,VerifyNow ,Medicine - Abstract
Background: Platelet function tests are widely used in clinical practice to guide personalized antiplatelet therapy. In China, the thromboelastography (TEG) test has been well accepted in clinics, whereas VerifyNow, mainly used for scientific research, has not been used in routine clinical practice. The aim of the current study was to compare these two point-of-care platelet function tests and to analyze the consistency between the two tests for evaluating on-clopidogrel platelet reactivity in Chinese acute myocardial infarction patients undergoing percutaneous coronary intervention (PCI). Methods: A total of 184 patients admitted to Fuwai Hospital between August 2014 and May 2015 were enrolled in the study. On-clopidogrel platelet reactivity was assessed 3 days after PCI by TEG and VerifyNow using adenosine diphosphate as an agonist. Based on the previous reports, an inhibition of platelet aggregation (IPA) 230 for VerifyNow was defined as high on-clopidogrel platelet reactivity (HPR). An IPA >70% or a PRU 205 for HPR and PRU
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- 2016
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25. Determinants of Calcium Infusion Rate During Continuous Veno-venous Hemofiltration with Regional Citrate Anticoagulation in Critically Ill Patients with Acute Kidney Injury
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De-Lin Liu, Li-Feng Huang, Wen-Liang Ma, Qi Ding, Yue Han, Yue Zheng, and Wen-Xiong Li
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Anticoagulation ,Calcium ,Citrate ,Hemofiltration ,Medicine - Abstract
Background: It is unclear that how to decide the calcium infusion rate during continuous veno-venous hemofiltration (CVVH) with regional citrate anticoagulation (RCA). This study aimed to assess the determinants of calcium infusion rate during CVVH with RCA in critically ill patients with acute kidney injury (AKI). Methods: A total of 18 patients with AKI requiring CVVH were prospectively analyzed. Postdilution CVVH was performed with a fixed blood flow rate of 150 ml/min and a replacement fluid flow rate of 2000 ml/h for each new circuit. The infusion of 4% trisodium citrate was started at a rate of 29.9 mmol/h prefilter and adjusted according to postfilter ionized calcium. The infusion of 10% calcium gluconate was initiated at a rate of 5.5 mmol/h and adjusted according to systemic ionized calcium. The infusion rate of trisodium citrate and calcium gluconate as well as ultrafiltrate flow rate were recorded at 1, 2, 4, 6, 12, and 24 h after starting CVVH, respectively. The calcium loss rate by CVVH was also calculated. Results: Fifty-seven sessions of CVVH were performed in 18 AKI patients. The citrate infusion rate, calcium loss rate by CVVH, and calcium infusion rate were 31.30 (interquartile range: 2.70), 4.60 ± 0.48, and 5.50 ± 0.35 mmol/h, respectively. The calcium infusion rate was significantly higher than that of calcium loss rate by CVVH (P < 0.01). The correlation coefficient between the calcium and citrate infusion rates, and calcium infusion and calcium loss rates by CVVH was −0.031 (P > 0.05) and 0.932 (P < 0.01), respectively. In addition, calcium infusion rate (mmol/h) = 1.77 + 0.8 × (calcium loss rate by CVVH, mmol/h). Conclusions: The calcium infusion rate correlates significantly with the calcium loss rate by CVVH but not with the citrate infusion rate in a fixed blood flow rate during CVVH with RCA.
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- 2016
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26. Application of Minimum Effective Cuff Inflating Volume for Laryngeal Mask Airway and its Impact on Postoperative Pharyngeal Complications
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Bing-Bing Li, Jie Yan, Hong-Gang Zhou, Jing Hao, Ai-Jia Liu, and Zheng-Liang Ma
- Subjects
Airways ,Laryngeal Mask ,Postoperative Complications ,Medicine - Abstract
Background: High intracuff pressure can cause severe pharyngeal complications including sore throat or hoarseness after laryngeal mask airway (LMA) removal postoperatively. Though the application of minimum effective cuff inflating volume is suggested to maintain airway sealing and adequacy of ventilation for patients receiving general anesthesia with LMA at lower level of the intracuff pressure, it is currently not a standard care in most of the anesthetic departments. In this study, the minimum effective cuff inflating volume was determined for classic LMA Well Lead™ (Well Lead Medical Co., Ltd., China) and its impact on postoperative pharyngeal complications was also explored. Methods: Patients with American Society of Anesthesiologists physical status (I–III) undergoing the short-duration urological surgery were recruited in this trial. First, the minimum effective cuff inflating volume was determined for size 4 or 5 LMA Well Lead in the study 1. Immediately following placement and confirmation of ideal LMA position, the cuff was inflated with 5, 7, 10 ml of air and up to 30 ml at 5 ml increment. The intracuff pressure, oropharyngeal leak pressure (OLP), and inspiratory peak airway pressure under positive pressure ventilation at the corresponding cuff volume as indicated above were recorded. Second, the enrolled patients were randomly allocated into minimum effective cuff inflating volume group (MC) and routine care (RC) group in the study 2. The minimum effective cuff inflating volume was applied and maintained in MC group, whereas the cuff volume was inflated with half of the maximum cuff inflating volume recommended by manufacturer in RC group throughout the surgical procedure and stay in postanesthesia care unit prior to LMA removal. The incidence of pharyngeal complications at 0, 2, 24, and 48 h after removal of LMA and other intra-operative adverse events were also documented. Results: The intracuff pressure varied with the cuff inflating volume in a positive linear correlation manner (Y = 11.68X − 42.1, r2 = 0.9191) under the range of 5–30 ml for size 4 LMA. In similar with size 4 LMA, the data were also showed the linear relationship between the intracuff pressure and the cuff inflating volume (Y = 7.39X − 10.9, r2 = 0.8855) for size 5 LMA. The minimal effective cuff inflating volume for size 4 or 5 LMA was 7–9 ml in combination of considering OLP needed to maintain airway sealing during intermittently positive pressure ventilation. The intracuff pressure in MC group was lower compared with RC group (63.0 ± 3.7 vs. 126.4 ± 24.0 cmH2O for size 4 LMA; 55.6 ± 2.4 vs. 138.5± 26.8 cmH2O for size 5 LMA; P < 0.0001). The incidence of pharyngeal adverse events was lower in MC group versus the RC group at 2, 24 h after LMA removal. Conclusions: The relationship between the cuff inflating volume and the intracuff pressure for size 4 or 5 LMA Well LeadTM is in a linear correlation manner at the range of 5–30 ml. The minimal cuff inflating volume is adequate for satisfactory airway sealing and consequently associated with lower incidence of postoperative pharyngeal complications for LMA Well Lead.™
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- 2015
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27. Analysis of 1-year Consecutive Application with Focused Transthoracic Echocardiography in Noncardiac Surgery
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Bing-Bing Li, Xin-Long Cui, Yuan Zhang, Juan Zhang, and Zheng-Liang Ma
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Echocardiography ,Hypotension ,Intraoperative Complication ,Noncardiac ,Surgery ,Transthoracic ,Medicine - Published
- 2017
- Full Text
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