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Objective To explore the effect of Internet+cardiac rehabilitation on hypertension patients with coronary heart disease. Methods 80 patients with hypertension and coronary heart disease admitted to our hospital from January 2022 to April 2023 were randomly divided into the combined group (n = 40) and the conventional group (n = 40). Both groups were given routine cardiac rehabilitation interventions. The combined group combined adoptionof the Internet for continuous interventionson the basis of routine cardiac rehabilitation interventions. Compare the oxygen uptake, blood pressure, compliance, and self-management scores between two groups before intervention and three months after discharge. Results The AT Mets, AT VO2, peak VO2, and expected value compliance ratio in the combined group were all higher than those in the conventional group (P < 0.05) ; The systolic and diastolic blood pressure in the combination group were lower than those in the control group, and the proportion of complete compliance was significantly higher than that in the control group (P < 0.05); The self-management scores of the joint group were higher than those of the conventional group (P < 0.05). Conclusion The continuous interventions of Internet plus cardiac rehabilitation can control the blood pressure of patients with hypertension and coronary heart disease, and patients' compliance behavior is significantly improved, andthus improving patients' self-management ability, which can be used for reference and promotion in clinical practice. [ABSTRACT FROM AUTHOR]

Objective To explore the relationship between blood uric acid levels and non-alcoholic fatty liver disease in patients with type H hypertension. Methods The clinical data of 284 patients with type H hypertension admitted to the Cardiovascular Department, Xianyang Hospital, Yan'an University in 2022 were collected and retrospectively reviewed. The patients were divided into NAFLD group (n = 88) and normal group (n = 196) according to whether they had NAFLD. The general information and laboratory indicators were compared between the two groups. Multivariate logistic regression analysis was conducted to explore the influencing factors of NAFLD in H-type hypertension patients. The draw ROC curves were plotted to observe the role of SUA in predicting NAFLD and select the optimal cutoff value based on the maximum Youden index. Results The NAFLD group demonstrated higher levels in body mass index, systolic blood pressure, diastolic blood pressure, total cholesterol, triglycerides, low-density lipoprotein cholesterol, SUA, γ-Glutamyl transpeptidase and alanine aminotransferase compared to the normal group, but significantly lower levels at age and high-density lipoprotein cholesterol(P < 0.05). The multivariate logistic regression analysis showed that elevated levels of BMI(OR = 1.173, 95%CI: 1.066 ~ 1.291), SUA(OR = 1.005, 95%CI: 1.001 ~ 1.010), and TG(OR = 1.929, 95%CI: 1.042 ~ 3.574)were risk factors for NAFLD in patients with type H hypertension (P < 0.05). The ROC curves showed that the area under the curve (AUC) of SUA, TG, BMI, and their combination were 0.709, 0.707, 0.750, and 0.796, respectively. Conclusion type H hypertensive NAFLD patients have high levels of BMI, SUA, TG compared to non-NAFLD patients. Elevated SUA is a risk factor for type H hypertensive NAFLD patients, with SUA > 337 μmol/L as a significant value for predicting NAFLD. [ABSTRACT FROM AUTHOR]

Objective The aim of this study was to explore the influencing factors of orthostatic intolerance in adolescent idiopathic scoliosis patients after surgery for the first time out of bed movement. Methods A retrospective analysis was conducted on the clinical data of 226 adolescent idiopathic scoliosis patients admitted to Nanjing Drum Tower Hospital from June 2021 to June 2023. Based on whether upright intolerance occurred during the first postoperative ambulation, patients with upright intolerance were included in the upright intolerance group, and patients without upright intolerance were included in the non upright intolerance group. Collect general data of two groups of patients, as well as their blood pressure at different positions during their first postoperative out of bed activity. Conduct univariate and multivariate logistic regression analysis on the influencing factors of upright intolerance during their first postoperative out of bed activity in adolescent idiopathic scoliosis patients. Results Out of 226 patients who underwent their first postoperative ambulation, 102 experienced orthostatic intolerance, accounting for 45.13% (102/226) of the cases. The systolic and diastolic blood pressure in both sitting and standing positions were lower in the orthostatic intolerance group than in the non orthostatic intolerance group (P < 0.05). Through univariate analysis, it can be seen that the postoperative bed rest time, sitting pain score, standing pain score, postoperative hospitalization time, and proportion of posture adaptation training in the orthostatic intolerance group were significantly different from those in the non orthostatic intolerance group (P < 0.05). Through multiple logistic regression analysis, it can be seen that long postoperative bed rest time, degree of sitting pain, degree of standing pain, and lack of posture adaptation training are risk factors for upright intolerance (P < 0.05). Conclusion Long postoperative bed rest time, sitting pain, standing pain, and lack of posture adaptation training are the main risk factors affecting upright intolerance of adolescent idiopathic scoliosis patients after surgery for the first time out of bed activity. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the safety and efficacy of non-intubated general anesthesia with remimazolam combined with remifentanil in AngioJet mechanical thrombectomy for lower extremity deep vein thrombosis. METHODS: Totally 120 patients who underwent AngioJet mechanical thrombectomy for lower extremity deep vein thrombosis in Linyi People’s Hospital from Oct. 2021 to Oct. 2023 were extracted to be divided into the non-intubated general anesthesia group (n =60) and awake sedation group (n =60) through the random number table method. The non-intubated general anesthesia group received remimazolam combined with remifentanil for non intubated general anesthesia, while the awake sedation group was given awake sedation anesthesia. Vital signs of two groups of patients, including systolic blood pressure (SBP), diastolic blood pressure (DBP), cardiac output (CO), systemic vascular resistance (SVR), stroke volume and heart rate were compared at at the time of admission (T1), target vessel puncture (T2), drug spraying (T3), 15 minutes after drug spraying (T4 ), thrombus aspiration (T5), and 5 minutes after surgery (T6), 1 hour after surgery (T7), 4 hours after surgery (T8), and 12 hours after surgery (T9). The use of antihypertensive drugs during and after surgery, occurrence of hematuria and adverse events, target vessel puncture time, patients’ satisfaction score, and clinicians’ satisfaction score were recorded and compared between two groups. RESULTS: (1) From T1 to T9, there were statistically significant differences within the SBP and DBP groups between the non-intubated general anesthesia group and awake sedation group (P<0. 001). Both groups showed an increase in SBP and DBP at T3 and returned to normal at T9. The non-intubated general anesthesia group showed a significant decrease in SBP and DBP from T2 to T5 compared with the awake sedation group, with statistically significant difference (P<0. 001). (2) From T1 to T6, there were statistically significant differences with SVR and CO groups between the non-intubated general anesthesia group and awake sedation group (P<0. 001). SVR increased in both groups from T3 to T6, while CO decreased in both groups from T2 to T5. At various time points from T2 to T6, SVR of the non-intubated general anesthesia group was significantly lower than that of the awake sedation group, with statistically significant difference (P<0. 05). At various time points from T3 to T6, CO in the non-intubated general anesthesia group were significantly higher than those in the awake sedation group, with statistically significant difference (P<0. 05). (3) The clinicians’ satisfaction score and patients’ satisfaction score in the non-intubation general anesthesia group were significantly higher than those in the wake sedation group, with statistically significant differences ( P < 0. 001). (4) The use rate of antihypertensive drugs during surgery, the incidence of body movements, the incidence of severe hypertension and hypertensive subacute disease during surgery in the non-intubated general anesthesia group were significantly lower than those in the wake sedation group, with statistically significant differences (P < 0. 001). CONCLUSIONS: Remazolam combined with remifentanil for non-intubation general anesthesia has good safety and efficacy in AngioJet mechanical thrombectomy for lower extremity deep vein thrombosis [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the mechanism of Shenmai injection (SMI) on improving ventricular remodeling in rats with chronic heart failure (CHF). METHODS: According to random number table method, 40 rats were divided into sham surgery group (0. 9% sodium chloride injection, intramuscular injection), model group (0. 9% sodium chloride injection, intramuscular injection), positive control group ( valsartan 10 mg/ kg, intramuscular injection) and SMI group (Shenmai injection 0. 38 mL/ kg, intramuscular injection), with 10 rats in each group. Except for sham surgery group, another groups were established CHF model by ligation of left anterior descending coronary artery. After establishment of the model, the related drugs were administered once a day for 28 d. Echocardiography was applied to observe the changes of left ventricular and evaluate situation of cardiac function based on hemodynamics. Enzyme-linked immunosorbent assay ( ELISA) were performed to measure serum levels of N-terminal pro-brain natriuretic peptide ( NT-proBNP ), transforming growth factor-β1 (TGF-β1), matrix metalloproteinases 9 (MMP-9) and connective tissue growth factor (CTGF). Morphological changes of myocardium were observed by hematoxylin-eosin (HE) staining and MASSON staining. Expression levels of TGF-β1, Smad2, Smad3 and Smad7 were detected through quantification reverse transcription polymerase chain reaction. RESULTS: Compared with the sham group, the left ventricular ejection fraction (LVEF), left ventricular short-axis shortening rate (LVFS), left ventricular posterior wall thickness (LVPWs), aortic flow peak velocity (AV Peak Velocity), left ventricular pressure (LVP), left ventricular systolic pressure (LVSP), +dp/ dtmax and -dp/ dtmin in the model group decreased significantly; and left ventricular volume (LV vols), left ventricular end-systolic diameter (LVIDs), left ventricular end diastolic pressure (LVEDP) increased significantly; the serum levels of NT-proBNP, TGF-β1, MMP-9 and CTGF decreased significantly; the mRNA expression of TGF-β1, Smad2, and Smad3 increased significantly, the mRNA expression of Smad7 decreased significantly, with statistically significant differences ( P < 0. 01). The morphological analysis showed that there was little cardiomyocyte remained in myocardium with structural disorder and serious degree of fibrosis. Compared with the model group, SMI can significantly increase the levels of LVEF, LVFS and LVPWs in the heart of rats with CHF, reduce LV vols and LVIDs, improve hemodynamics, and reduce the levels of NT-proBNP, TGF-β1, MMP-9 and CTGF, down-regulate the mRNA expression of TGF-β1, Smad2 and Smad3 and up-regulate the mRNA expression of Smad7, with statistically significant differences (P <0. 01). SMI can inhibit myocardial cell necrosis and alleviate myocardial fibrosis. CONCLUSIONS: SMI could inhibit ventricular remodeling and achieve anti-CHF effects by participating into enhancing cardiac function, improving hemodynamics, alleviating myocardial injury, reducing the degree of fibrosis and regulating TGF-β/Smads signaling pathway. [ABSTRACT FROM AUTHOR]

AIM: To examine how the variation of the β1-adrenergic receptor gene affects the occurrence of ventricular arrhythmias and the prognosis over a 6-month period in individuals suffering from acute ST-segment elevation myocardial infarction (STEMI). METHODS: A study was conducted retrospectively, where patients diagnosed STEMI and treated at Yunfu City People's Hospital between January 2021 and February 2023 were included based on predefined criteria. The patients were then divided into three groups according to their genotypes of the β1-adrenergic receptor Arg389Gly gene polymorphism: CC group (Arg389Arg), CG group (Arg389Gly), and GG group (Gly389Gly). Discrepancies in initial clinical data upon admission [such as Killip classification, heart rate, systolic and diastolic blood pressure, left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVDD), and serum tumor necrosis factor alpha (TNF-α), N-terminal pro-B-type natriuretic peptide (NT-proBNP), creatine kinase MB (CK-MB) and high-sensitivity C-reactive protein (hs-CRP) ], and outcomes gathered during a 6-month follow-up via telephone after discharge (heart rate, NT-proBNP, CK-MB, LVEF, LVDD, and occurrences of major adverse cardiac events) were compared across the three groups. RESULTS: The study enrolled a total of 178 STEMI patients with ventricular arrhythmias, comprising 87 cases in CC group (48. 9%), 73 cases in CG group (41. 0%), and 18 cases in GG group (10. 1%). There were no notable variances in demographic characteristics such as age, sex, weight, BMI, smoking history, alcohol consumption history, comorbidities, blood pressure, heart rate, Killip classification (III amd IV), TNF-α, NT-proBNP, CK-MB, hs-CRP, LVEF and LVDD across the three groups (P>0. 05). Following a 6-month monitoring period, the cardiac function parameters in CG and GG groups exhibited significant improvement compared to those in CC group (P<0. 05), with noteworthy lower levels of NT-proBNP and CK-MB in GG group in contrast to CG group (P<0. 05). Notably, there were significant discrepancies in the incidence of major adverse cardiac events during the follow-up period among the study groups, with 17 cases in CC group (19. 5%), 5 cases in CG group (6. 9%), and 1 case in GG group (5. 6%) (χ²=6. 887, P<0. 05). CONCLUSION: There is no correlation between the severity of STEMI accompanied by ventricular arrhythmias and the β1-adrenergic receptor Arg389Gly gene polymorphism. However, this gene variant is connected with enhancements in cardiac function and short-term prognosis post-treatment. [ABSTRACT FROM AUTHOR]

Objective To identify the key factors associated with diabetic retinopathy (DR) complications in elderly patients, providing a reference for clinical research. Methods This study utilized data from the “Diabetes Complications Early Warning Dataset” publicly available from the National Population Health Science Data Center. A Python program was developed for data preprocessing, resulting in a dataset of 1 337 elderly patients. Descriptive statistics were performed, and Elastic Net regression, EMVS logistic regression, and Lasso regression models were constructed for comparison. The optimal model, EMVS logistic regression, was selected for key factor extraction, with results validated through bootstrap sampling. Results The EMVS logistic regression model outperformed others in model comparison, achieving an AUC value of 0.801, surpassing the AUC values of 0.764 for Elastic Net regression and 0.759 for Lasso regression. The EMVS logistic regression model ultimately identified 10 key factors; among them, systolic blood pressure, diastolic blood pressure, BMI, kidney disease, glycated hemoglobin, and serum creatinine were identified as risk factors for diabetic retinopathy, while hematocrit, total protein, alanine aminotransferase, and prothrombin time were protective factors. The Brier scores were 0.101 and 0.12, respectively, and the calibration curve indicated good consistency of the model. Conclusion The introduction of EMVS logistic regression in the study of diabetic retinopathy complications yielded effective key factor selection. Based on the identified key factors for diabetic retinopathy in elderly patients, healthcare professionals can more effectively guide elderly patients in taking preventive measures, thereby slowing disease progression and significantly improving their quality of life and health status. [ABSTRACT FROM AUTHOR]

Objective To investigate the association between chronic kidney disease (CKD) and body mass index (BMI). Methods Participants who underwent health check-ups from 2017 to 2020 were included in the study, and data on demographic characteristics, physical examinations, and biochemical tests were collected. The latent class growth model (LCGM) was used to identify the trajectories of BMI changes. Cox proportional hazards regression was employed to evaluate the impact of baseline variables and BMI trajectories on the occurrence of CKD. The coefficient product method was utilized to analyze the mediating effects of fasting blood glucose (FBG), systolic blood pressure (SBP), diastolic blood pressure (DBP), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG) in the BMI-CKD relationship. Two-sample Mendelian randomization was conducted to analyze the causal relationship between BMI and CKD, along with sensitivity analyses. Results Among 15 243 participants, four categories of BMI change trajectories were identified: low normal group (22.04%), high normal group (38.16%), persistently overweight group (30.48%), and persistently obese group (9.32%). Multivariate Cox regression revealed that persistent overweight significantly increased the risk of CKD, with a hazard ratio (HR) of 1.28 (95%CI: 1.07-1.54). Mediation analysis indicated that logFBG mediated 46.51% (95%CI: 24.87%-93.66%) of the BMI-CKD association, while SBP and DBP mediated 18.33% (95%CI: 8.48%-39.79%) and 12.73% (95%CI: 1.29%-50.52%), respectively. Mendelian randomization provided evidence supporting a causal relationship between BMI and CKD. Conclusion The impact of BMI on CKD can be mediated by FBG and blood pressure, and a causal relationship is found between the two, highlighting the significance of this finding for the prevention and management of CKD. [ABSTRACT FROM AUTHOR]

Objective: To observe the effects of sevoflurane combine with remifentanil on awakening quality, stress response and cellular immune function in children with indirect inguinal hernia undergoing laparoscopic operation. Methods: 102 children with indirect inguinal hernia received in our hospital from November 2023 to January 2024 were divided into control group (51 cases, anesthesia regimen was remifentanil) and observation group (51 cases, anesthesia regimen was Propofol combined with remifentanil) by random number table method. The hemodynamic indexes [heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP)], Awakening situation [time of awakening, extubation and respiratory recovery], stress response indexes (blood glucose and plasma cortisol) and cellular immune function (CD4", CD8", CD4/CD8") were compared in two groups, the incidence of adverse reactions was statistically compared in two groups. Results: HR, SBP and DBP at 10 min after skin incision and extubation in observation group were higher than those in control group (P<0.05). The time of awakening, extubation and respiratory recovery in observation group were shorter than those in control group (P<0.05). The blood glucose and cortisol in observation group were lower than those in control group at the time of skin incision and extubation (P<0.05). 12 h after operation, CD4 and CD4/CD8+ in observation group were higher than those in control group, and CD8 was lower than that in control group (P<0.05). The total incidence of adverse reactions: control group was 9.80%; observation group was 11.76%, there was no difference in two groups (P>0.05). Conclusion: Remifentanil and sevoflurane are selected as anesthetic drugs for children with indirect inguinal hernia undergoing laparoscopic operation, which can maintain hemodynamic stability, improve awakening quality, reduce stress response and relieve immunosuppression. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Modern Laboratory Medicine is the property of Journal of Modern Laboratory Medicine Editorial Department and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To explore the application effect of different administration methods of cisatracurium combined with propofol in laparoscopic surgery and its impact on muscle relaxation and recovery. Methods: 120 patients who underwent laparoscopic surgery in our hospital from January 2021 to November 2023 were selected. They were randomly divided into an intermittent medication group and a one-time medication group, with 60 patients in each group. All patients were treated with 2 mg/kg propofol, 0. 4μg/kg sufentanil, and 0. 5μg/kg after entering the operating room. The intermittent administration group received intravenous injection of cisatracurium once every 2 hours, with a dose of 0. 1 mg/kg. The one-time administration group received a single intravenous injection of 0. 1 mg/kg cisatracurium to induce muscle relaxation, and the muscle relaxation effect was determined based on the T1 seizure inhibition value, with T1=12%. When T1＞12%, intravenous injection of 0. 03 mg/kg cisatracurium was administered. Compare the dosage, effective time of muscle relaxation, maintenance time of muscle relaxation, maximum inhibition of T1, onset time of muscle relaxation, baseline value upon entry (T1), immediate start of surgery (T2), 20 minutes after surgery (T3), and immediate end of surgery (T4) in two groups of patients, as well as the changes in vital signs, recovery of postoperative muscle relaxation, and incidence of adverse reactions. Results: There was no significant difference in the maintenance time, T1maximum inhibition program, and onset time of muscle relaxation between the two groups of patients (P＞0. 05). The dosage of cisatracurium in the one-time treatment group was lower than that in the intermittent treatment group, and the effective time of muscle relaxation was higher than that in the intermittent treatment group (P＜0. 05); There were no significant changes in heart rate (HR), systolic blood pressure (SBP), blood oxygen saturation (SPO2), and diastolic blood pressure (DBP) levels at T1, T2, T3, and T4 in the two groups of patients, and there was no significant difference between the one-time administration group and the intermittent administration group (P＞0. 05); The TOFr 0. 90, TOFr 0. 80, TOFr 0. 75, TOFr 0. 25, and extubation time of patients in the one-time administration group were significantly lower than those in the intermittent administration group (P＜0. 05); The incidence of ad verse reactions such as bradycardia, rash, bronchospasm, and hypotension in the one-time administration group was significantly lower than that in the intermittent administration group (P＜0. 05). Conclusion: Intermittent administration and one-time administration of cisatracurium in laparoscopic surgery have no significant impact on the patient’s intraoperative vital signs, muscle relaxation maintenance time, and muscle relaxation effect. However, one-time administration and T1 seizure inhibition value can reduce the dosage of cisatracurium administration, promote postoperative muscle relaxation recovery, and have high safety. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate the effects of rosiglitazone on insulin resistance, resting and exercise blood pressure in patients with type 2 diabetes mellitus (T2DM) complicated with coronary artery heart disease (CHD). METHODS: Totally 258 patients with T2DM complicated with CHD admitted into the First Affiliated Hospital of Xi’ an Jiaotong University from Nov. 2021 to Oct. 2022 were extracted to be randomly divided into the rosiglitazone group and control group via the random number table method, with 129 cases in each group. All patients were given routine treatments such as antiplatelet aggregation, blood sugar control, and blood lipid regulation. The rosiglitazone group was additionally treated with oral Rosiglitazone tablets at a dose of 4 mg / time, once a day. All patients were treated continuously for 12 months. The anthropometric indicators, biochemical indicators, resting and exercise blood pressure, and the incidence rate of exercise-induced hypertension were compared between the rosiglitazone group and control group before and after treatment. RESULTS: After treatment, the body weight (t = 3. 339, P< 0. 001), body mass index (t = 3. 093, P = 0. 002) and subcutaneous adipose tissue (t = 5. 086, P<0. 001) of the rosiglitazone group increased significantly compared with the control group; after treatment, the adiponectin (t = 15. 135, P< 0. 001) in the rosiglitazone group increased significantly compared with the control group, while the glycosylated hemoglobin (t = 4. 305, P<0. 001), fasting blood glucose (t = 5. 190, P< 0. 001), and homeostatic model assessment of insulin resistance indicator (t = 6. 815, P<0. 001) decreased significantly compared with the control group; after treatment, the systolic and diastolic blood pressure of the rosiglitazone group decreased significantly compared with the control group at rest, 3 minutes during exercise, peak exercise, 1 minute after exercise, 3 minutes after exercise, and 5 minutes after exercise (P<0. 05), with statistically significant differences. After treatment, the incidence of exercise-induced hypertension in the rosiglitazone group was significantly lower than that in the control group, with statistically significant differences [11. 6% (15 / 129) vs. 29. 5% (38 / 129), χ² = 12. 562, P < 0. 001] . CONCLUSIONS: Rosiglitazone can significantly improve insulin resistance, resting and exercise blood pressure in T2DM patients with CHD, reduce the incidence of exercise-induced hypertension, and improve the exercise ability of patients. [ABSTRACT FROM AUTHOR]

Aim To investigate the levels of a disintegrin and metalloprotease 10 (ADAM-10) and soluble urokinase plasminogen activator receptor (suPAR) in the serum of hypertension patients with atherosclerosis and their relationship with the severity of disease. Methods From February 2021 to February 2023, 125 hypertension patients with atherosclerosis who visited our hospital were collected as the study group, and 76 healthy people were collected as control group. The patients in the study group were grouped into mild group (n = 40), moderate group (n = 42) and severe group (n = 43) according to the degree of atherosclerosis, after 60 days of treatment, the patients were grouped into a good prognosis group (n = 74) and a poor prognosis group (n = 51) based on their prognosis. Enzyme linked immunosorbent assay (ELISA) was applied to measure serum ADAM-10 and suPAR levels; Clinical data of patients with different prognosis were compared; Pearson method was applied to analyze the relationship between serum ADAM-10, suPAR levels and carotid intima-media thickness (IMT) in patients with hypertension and atherosclerosis; Multivariate Logistic regression was applied to analyze the influencing factors of poor prognosis in patients with hypertension and atherosclerosis; Receiver operating characteristic (ROC) curve was applied to evaluate the predictive value of ADAM-10 and suPAR alone and jointly for poor prognosis of hypertension with atherosclerosis. Results The levels of serum ADAM-10 and suPAR were significantly higher in the study group than those in control group (P<0. 05); The serum ADAM-10 and suPAR levels in moderate group and severe group were obviously higher than those in mild group (P<0. 05), while the serum ADAM-10 and suPAR levels were obviously higher in severe group than those in moderate group (P<0. 05); The serum ADAM-10 and suPAR levels, left and right IMT, systolic blood pressure, and diastolic blood pressure of patients with poor prognosis were significantly higher than those of patients with good prognosis (P<0. 05); Pearson correlation analysis showed that serum ADAM10 and suPAR levels in patients with hypertension and atherosclerosis were positively correlated with systolic blood pressure, diastolic blood pressure and IMT (P<0. 001); Logistic regression analysis showed that the increased levels of systolic blood pressure, diastolic blood pressure, ADAM-10, suPAR and IMT were risk factors for poor prognosis of hypertension patients with atherosclerosis (P<0. 05); ROC curve analysis showed that the area under the curve (AUC) of serum ADAM-10 and suPAR levels alone and jointly predicting poor prognosis of hypertension with atherosclerosis was 0. 819, 0. 830 and 0. 900, respectively, the combination of the two was superior to their individual predictions (Zcombination-ADAM-10 = 2. 766, P= 0. 006; Zcombination-suPAR = 2. 602, P = 0. 009). Conclusion The levels of serum ADAM-10 and suPAR in patients with hypertension and atherosclerosis are significantly increased, and are positively correlated with the severity of atherosclerosis. Both of them have a high predictive value for evaluating the prognosis of patients with hypertension and atherosclerosis. [ABSTRACT FROM AUTHOR]

Objective To investigate the correlation between exposure of uric acid accumulation and the risks of acute pancreatitis (AP) in the population in Kailuan Group. Methods A prospective study was performed based on the subjects receiving annual physical examination during 2006 to 2010 in Kailuan Group. All of them had no AP history but had complete data on UA. The starting point of follow-up was when the subjects completed the health examination in 2010, and the end point was new AP events, deaths or the end of follow-up (2021-12-31) . Exposure of uric acid accumulation (cumUA) was calculated according to the average values of uric acid measured in each two consecutive physical examinations and the interval between these two consecutive physical examinations. The cumulative incidences of AP indifferent subgroups (determined by the quartile of cumUA) were described using Kaplan-Meier product limit-method and compared by log-rank test. Multivariate Cox proportional hazards regression model was used to analyze the impacts of different cumUA subgroups on new occurrence of AP events. Results A total of 55, 799 subjects were included in this study. The subjects were divided into four groups according to the quartile of cumUA. Sex ratio, average age, BMI, systolic blood pressure (SBP), diastolic blood pressure (DBP), FPG, TC, TG, LDL-C, HDL-C, smoking, alcohol consumption, education ≥ 9 years, physical exercise, history of hypertension, and history of cholelithiasis differed significantly among the groups (P < 0.05), there was no difference in diabetes history among the 4 groups (P = 0.30) . 153 patients developed AP during an average follow-up of (10.52 ± 1.75) years, the incidence rates were 1.65, 2.76, 2.13 and 3.96 per 10 000 person-year in the Q1, Q2, Q3and Q4, respectively (P < 0.01) . After adjusting sex, age, TC, TG, eGFR, smoking, alcohol consumption, education, physical activity, and history of hypertension, diabetes, or cholelithiasis, Multivariate analysis showed a significantly increased risk in Q4 (HR = 1.77, 95%CI: 1.07 - 2.92) as comparing with Q1. After excluding deaths during the follow-up period, Multivariate Cox regression analysis was performed again in Q4 HR = 1.75 (95%CI: 1.04 - 2.95) . Conclusions With the increase of cumUA exposure, both morbidity and risk of AP occurrence have the tendency of rising. [ABSTRACT FROM AUTHOR]

Acute myocardial infarction has the characteristics of rapid progression, dangerous condition, unstable hemodynamics, and is prone to thrombosis, resulting in a high clinical mortality rate. Intra-aortic balloon counterpulsation (IABP) has the function of increasing intra-aortic diastolic pressure, reducing left ventricular afterload, and enhancing coronary artery blood supply. It is a common auxiliary and transitional treatment method for coronary intervention, which can significantly improve the safety and clinical efficacy of coronary intervention. Therefore, it is widely used in high-risk and complex coronary heart disease, mainly acute myocardial infarction. This article reviews the research progress on the application effect and thrombosis management of IABP in acute myocardial infarction in recent years. [ABSTRACT FROM AUTHOR]

Objective To evaluate the effectiveness and safety of Yiyang Pill in preventing and treating cardiovascular adverse reactions in patients with traditional Chinese medicine (TCM) syndrome with qi and yin deficiency and thyroid stimulating hormone (TSH) inhibition after differentiated thyroid cancer (DTC) resection. Methods A randomized, double-blind, placebo-controlled clinical trial was conducted, and 120 patients with TSH inhibition after DTC surgery were enrolled and randomized into two groups in a 1: 1 ratio using SAS 9.4 software generated random tables. The control group received a placebo and TSH suppression therapy, whereas the treatment group received the Yiyang Pill and TSH suppression therapy. The treatment period was 3 months. The incidence of cardiovascular adverse reactions, blood pressure, blood lipids, thyroid function, the dosage of levothyroxine, the efficacy of TCM syndrome, and safety indicators were compared between the two groups. Multivariate Logistic regression was used to analyze the influencing factors of cardiovascular adverse reactions. Results The incidence of cardiovascular adverse reactions in the treatment group was lower than that in the control group (P <0.05), and the efficacy of TCM syndrome treatment was significantly higher than in the control group (P<0.05). The free tetraiodothyronine level in the treatment group was higher than that before treatment (P<0.05), and the systolic and diastolic blood pressure in the control group increased compared to those before treatment (P<0.05). No severe adverse events were observed in either group.Compared with the control group, the cardiovascular incidence in the treatment group was lower, and the cardiovascular incidence in the < 100 µg/d group was lower than that in the group with = 100 µg/d before treatment. Conclusion The Yiyang Pill can reduce the incidence of cardiovascular adverse reactions in patients after DTC surgery, effectively improve TCM syndromes, and be safe to use.Yiyang Pill treatment is a protective factor for cardiovascular adverse reactions, and the dosage of levothyroxine = 100 µg/d was a risk factor. [ABSTRACT FROM AUTHOR]

Objective To establish the animal model of comorbidity of knee osteoarthritis (KOA) and hypertension with pattern of liver and kidney deficiency and evaluate its characteristics of comorbidity and pattern. Methods Wistar-Kyoto (WKY) rats and spontaneously hypertensive rats (SHR) were assigned to the WKY control group (control group), hypertension combined with KOA sham-operation group (sham-operation group), hypertension combined with KOA group (model group), hypertension combined with KOA and liver-kidney deficiency pattern group (LKD group). The animal model of KOA combined with hypertension was prepared by anterior cruciate ligament transection (ACLT) in spontaneously hypertensive rats. ACLT combined with intramuscular injection of hydrocortisone was performed to prepare an animal model of KOA with liver-kidney deficiency (LKD) pattern type, combined with hypertension. Then, the related indexes of LKD syndrome were detected in turn, including the contents of thyroid stimulating hormone (TSH), testosterone (T), corticosterone (CORT), adrenocorticotropic hormone (ACTH) in serum, and enzyme activities of alanine transaminase (ALT), aspartate transaminase (AST), and alkaline phosphatase (ALP) in serum, the mass ratio of liver, kidney, spleen, thymus to the brain, body weight, anal temperature, activity situation, and emotion. Systolic blood pressure, diastolic blood pressure, and other blood pressure-related indices were also detected. The levels of serum tumor necrosis factor-α (TNF-α) and interleukin-1TNF-β (IL-1TNF-β), plantar mechanical pain sensitivity threshold, weight difference score of both hind limbs, hind limb joint swelling, and quadruped gait parameters were also measured. Furthermore, hematoxylin-eosin, safranine-fast green, and Masson staining were performed to observe pathological changes, cartilage degeneration, and bone destruction of the knee joint, and the microstructure parameters of the tibia were detected by Micro-CT imaging. Results Compared to the model group, the contents of serum TSH, ACTH, T, CORT and the mass ratio of the kidney, spleen, and thymus to the brain in the LKD group decreased (P < 0.05). Compared to the control group, the systolic blood pressure and diastolic blood pressure of the other three groups increased significantly (P < 0.05). Compared to the sham-operation group, serum TNF-α and IL-1TNF-β levels increased, plantar mechanical pain threshold decreased, weight difference score of both hind limbs and joint swelling of the affected limb increased (P < 0.05), and gait parameters (e.g., gait length and standing time of the affected limbs) became abnormal in the model and LKD groups. Simultaneously, the cartilage surface defect of the rat knee joint was severe, the arrangement of the surface chondrocytes was altered, the cartilage layer became thinner, the muscle fibers increased, and the cartilage ossification was severe. Furthermore, the relative volume, thickness, and number of trabeculae of the knee joint decreased significantly (P < 0.05). Conclusion The rat model established in this study is consistent with the clinical characteristics of integrated traditional Chinese and Western medicine in patients with comorbidities of hypertension and KOA with liver and kidney deficiency pattern. This rat model can characterize the typical symptoms of liver and kidney deficiency pattern. It has typical pathological changes in knee cartilage and subchondral bone tissues and can maintain a stable range of high systolic and diastolic blood pressure. It also explore the scientific connotation of simultaneous treatment of different diseases in traditional Chinese medicine, revealing the therapeutic mechanism and developing new drugs. [ABSTRACT FROM AUTHOR]

Objective To investigate the effects of intraoperative electroacupuncture analgesia on the stress response to tracheal intubation in patients undergoing general anesthesia for thyroid surgery. Methods A total of 60 patients scheduled for elective combined general anesthesia and thyroid surgery at the Affiliated TCM Hospital of Guangzhou Medical University from June 2022 to June 2023 were randomly assigned to either the control group (Ctr group) or the electroacupuncture group (EA group). Both groups underwent tracheal intubation under general anesthesia. In the EA group, electroacupuncture was applied at bilateral Neiguan (PC6), Quchi (LI11), and Lieque (LU7) acupoints for 15 minutes before tracheal intubation and before extubation, in addition to routine general anesthesia and analgesia. Hemodynamic parameters including systolic blood pressure (SBP), mean arterial pressure (MAP), diastolic blood pressure (DBP), and heart rate (HR) were observed at different time points in both groups (before intubation: T0; 1, 5, 10, 15, and 30 minutes after intubation: T1, T5, T10, T15, T30; 1 minute before extubation: EXBT1; 1 and 5 minutes after extubation: EXAT1, EXAT5). The total amount of opioid analgesics used intraoperatively and any adverse reactions were recorded. Results Significant statistical differences were observed between the EA group and Ctr group in SBP at T1-T15, EXAT1, and EXAT5; MAP at T5-T15 and EXAT1; DBP at T15 and EXAT1; HR at T1, T5, EXAT1, and EXAT5 (P < 0.05). During T1-T15, the SBP, MAP, DBP, and HR in the EA group showed a decreasing trend and were lower compared to the Ctr group. The SBP, MAP, and DBP fluctuations were smaller in the EA group compared to the Ctr group, while the HR fluctuations were larger in the EA group after intubation but smaller after extubation. There was no significant difference in the total amount of opioid analgesics used intraoperatively between the two groups (P > 0.05). The incidence of adverse reactions such as nausea and vomiting differed significantly (P < 0.05), while the incidence of rash and hypertension did not differ significantly between the two groups (P > 0.05). Conclusion Intraoperative electroacupuncture analgesia can effectively attenuate the vascular stress response induced by tracheal intubation and extubation in patients undergoing thyroid surgery and reduce the occurrence of opioid-related adverse reactions. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To explore the relationship between the expressions of P21, P27 and proliferating cell nuclear antigen (PCNA) in glomerular mesangial tissue and poor renal prognosis in patients with immunoglobulin A (IgA) nephropathy. Methods: A total of 145 patients with IgA nephropathy treated in Xiaogan Central Hospital from April 2017 to August 2019 were selected as the research object. The expressions of P21, P27 and PCNA in glomerular mesangial tissue were detected by immunohistochemistry. All patients were followed up for 24 months, and the prognosis were counted. The expressions of P21, P27 and PCNA in glomerular mesangial tissue of patients with different prognosis were compared and the influencing factors of poor prognosis in patients with IgA nephropathy were analyzed by Logistic regression analysis. Results: The expression rates of P21, P27 and PCNA positive cells in glomerular mesangial tissue of patients with IgA nephropathy were (38.69±6.83)%, (55.94±8.08)%, (33.47±5.72)%, respectively. The incidence rete of poor prognosis in patients with IgA nephropathy was 17.24%, and the expression rates of P21 and PCNA positive cells in glomerular mesangial tissue of patients with poor prognosis were higher than those in good prognosis group (P<0.05), while the expression rate of P27 positive cells was lower than that in good prognosis group (P<0.05). Logistic multiple regression analysis showed that elevated diastolic blood pressure, increased 24 h proteinuria, mesangial cell proliferation, segmental glomerulosclerosis, renal tubular atrophy/interstitial fibrosis, crescentic body, increased expression rates of P21 and PCNA positive cells and decreased expression rate of P27 positive cells were all risk factors affecting the poor prognosis of patients with IgA nephropathy (P<0.05). Conclusion: There are positive expressions of P21, P27 and PCNA in glomerular mesangial tissue of IgA nephropathy. The expression rates of P21 and PCNA positive cells in glomerular mesangial tissue of of patients with poor prognosis of IgA nephropathy are higher than those with good prognosis, while the expression rate of P27 protein positive cells is lower than those with good prognosis, which are risk factors for poor prognosis of patients with IgA nephropathy. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Continuous blood pressure monitoring is helpful to the diagnosis and treatment of cardiovascular diseases. At present, machine learning and deep learning are used to predict blood pressure by manually extracting feature parameters. This method cannot reconstruct complete blood pressure signals. Therefore, a continuous non-invasive arterial blood pressure measurement method based on the fused U-net model is proposed. Firstly, the original photoplethysmogram (PPG) signal is used as the input to reduce the error of manually extracting feature parameters. Secondly, the U-net network is used to reconstruct the arterial blood pressure signal. In order to further improve the accuracy of the predicted blood pressure waveform, the reconstructed blood pressure signal is used as the input of the MultiResUnet network. The MultiRes module is used to learn different features from the data. The Res Path module alleviates the semantic differences between the encoder and the decoder, making the model learning easier. The arterial blood pressure (ABP) waveform predicted by the fused U-net network in the subject evaluation of MIMIC-III dataset is highly correlated with the actual waveform. The calculated mean absolute errors of systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean pressure (MAP) are 2.20 ± 4.30 mmHg, 1.82 ± 3.146 mmHg and 2.25 ± 2.86 mmHg. The method satisfies the requirements of the Association for the Advancement of Medical Instrumentation (AAMI) standard and reaches Grade A in the British High Pressure Society (BHS) standard. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To study the relationship between carotid artery elastic ultrasound parameters and left ventricular diastolic function in patients with prehypertension. 161 patients who were diagnosed and treated in the First Affiliated Hospital of Hebei North University from December 2019 to December 2020 due to abnormal blood pressure were selected, and they were divided into prehypertension group (82 cases) and hypertension group (79 cases) according to blood pressure level. Another 80 healthy volunteers who underwent physical examination in our hospital during the same period were selected as the control group. Clinical data of three groups were collected, and biochemical indexes and blood pressure were detected. The carotid artery elastic ultrasound parameters [carotid intima-media thickness (IMT), compliance coefficient (CC), dilation coefficient (DC), vascular elasticity index (α, β) and pulse wave conduction velocity (PWV)] were measured by the software of quality intima-media thickness (QIMT) and quantitative arterial stiffness (QAS) of ultrasonic radiofrequency signal in ultrasonic diagnostic instrument. Left ventricular function indexes [(left ventricular ejection fraction (LVEF), left ventricular mass index (LVMI), peak early diastolic blood flow velocity (E)/peak late diastolic blood flow velocity (A), isovolumic relaxation time (IVRT), and diastolic deceleration time (DT)] were examined by echocardiography. Pearson correlation method was used to analyze the correlation between carotid artery elastic ultrasound parameters and ventricular indexes. Results: The systolic blood pressure and diastolic blood pressure levels were statistically significant in the three groups (P＜0.05). The IMT, α, β and PWV in the prehypertensive group and the hypertension group were higher than those in the control group, and the DC and CC were lower than those in the control group (P＜0.05). The IMT, α, β and PWV in the prehypertensive group were lower than those in the hypertension group, and the DC and CC were higher than those in the hypertension group (P＜0.05). E/A in the prehypertension and hypertension groups were lower than that in the control group, IVRT and DT were higher than those in the control group (P＜0.05), and E/A in the prehypertension group was higher than that in the hypertension group, IVRT and DT were lower than that in the hypertension group (P＜0.05). According to Pearson correlation analysis, IMT, α, β, PWV were negatively correlated with E/A, and positively correlated with IVRT and DT (P＜0.05). DC and CC were positively correlated with E/A, and negatively correlated with IVRT and DT (P＜0.05). Conclusion: In patients with prehypertension, carotid vascular elasticity is decreased, accompanied by impaired left ventricular diastolic function. Ultrasound parameters of carotid vascular elasticity are closely related to left ventricular diastolic function. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationship between serum Sestrin2 level and cardiovascular diseases (CVDs) in patients with type 2 diabetes mellitus (T2DM) and its predictive value. 198 patients with T2DM who were admitted to the General Hospital of the Eastern Theater Command of Chinese PLA from September 2017 to July 2020 were selected, and they were divided into non-CVDs group (n=106) and CVDs group (n=92) according to the incidence of CVDs during 2-year follow-up. Serum Sestrin2 level, general data and laboratory indicators in the two groups were compared. Multivariate Logistic regression was used to analyze the influencing factors of T2DM complicated with CVDs. The predictive efficacy of serum Sestrin2 level on T2DM complicated with CVDs was analyzed by receiver operating characteristic (ROC) curve. Results: Compared with the non-CVDs group, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), uric acid (UA), insulin 2h after meals (2hINS), 2 h postprandial C-peptide (2hCP), triglyceride (TG), total cholesterol (TC), low density lipoprotein-C (LDL-C), homeostasis model assessment for insulin resistance index (HOMA-IR), Sestrin2 in the CVDs group were significantly increased (P＜0.05). There were no statistically significant differences in diabetes course, waist circumference, age, gender, smoking history, blood urea nitrogen (BUN), drinking history, serum creatinine (SCr), blood glucose 2 h after meal (2hPG), high density lipoprotein-C (HDL-C), fasting blood glucose, fasting insulin and family history of cardiovascular disease in the two groups (P＞0.05). Multivariate Logistic regression model showed that increased BMI, UA, 2hINS, 2hCP and Sestrin2 levels were risk factors for T2DM complicated with CVDs (P＜0.05). ROC curve showed that serum Sestrin2 was highly effective in predicting the patients with T2DM complicated with CVDs, with the area under curve (AUC) (95%CI) of 0.729 (0.472 ~ 0.984), and a critical point of 10.35ng/mL. Conclusion: Serum Sestin2 is highly expressed in patients with T2DM complicated with CVDs, which is related to the increased risk of T2DM complicated with CVDs.It has a high value in assisting clinical prediction of the risk of T2DM complicated with CVDs. [ABSTRACT FROM AUTHOR]

Objective: To analyze the risk factors of moderate to severe obstructive sleep apnea ypopnea syndrome (OSAHS) and construct a risk prediction model for it. Methods: 97 patients with OSAHS who received polysomnography (PSG) in our hospital from January 2017 to January 2021 were selected, and they were divided into moderate severe group with 46 cases and mild group with 51 cases according to the PSG results. The clinical data of all patients were collected, the risk factors of moderate and severe OSAHS were analyzed by univariate and multivariate Logistic regression analysis, and the risk prediction model was constructed. The application value of the risk prediction model of moderate and severe OSAHS was analyzed by the receiver operating characteristic (ROC) curve. Results: The univariate analysis showed that the proportion of male, systolic blood pressure, diastolic blood pressure, neck circumference, diabetes, hypertension, hyperlipidemia, Mallampati grade Ⅲ-Ⅳ, body mass index (BMI), Epworth Sleepiness scale (ESS) score, C-reactive protein and serum uric acid in the moderate and severe group were higher than those in the mild group (all P＜0.05) . Multivariate Logistic regression analysis showed that male, diabetes, hypertension, the modified Mallampati grade Ⅲ～Ⅳ, increased BMI, elevated C-reactive protein, and elevated serum uric acid were independent risk factors for moderate to severe OSAHS (all P＜0.05) . Moderate and severe OSAHS risk prediction model equation y=-12.558+0.950×gender+0.030×BMI+1.808×diabetes+0.046×hypertension+1.787×modified Malampati grade+1.925×C-reactive protein+0.570 ×serum uric acid. ROC curve analysis showed that the area under curve (AUC), sensitivity and specificity of the model for predicting moderate and severe OSAHS were 0.914 (95% CI:0.839～0.961), 80.43% and 90.20%, respectively. Conclusion: Male, increased BMI, diabetes, hypertension, modified Mallampati grade Ⅲ-Ⅳ, elevated C-reactive protein, and elevated serum uric acid are risk factors for moderate to severe OSAHS, the prediction model based on the above factors has good predictive value for moderate to severe OSAHS. [ABSTRACT FROM AUTHOR]

Objective To summarize the clinical characteristic of stroke in the plateau area with altitude of 4000 m above, and to screen the risk factors of hemorrhagic stroke. Methods The clinical data of 103 stroke patients (including 71 hemorrhagic stroke and 32 ischemic stroke) admitted to Ngari Prefecture People's Hospital of Tibet Autonomous Region from January 2017 to December 2018 were retrospectively analyzed, and the clinical characteristic of hemorrhagic stroke and ischemic stroke were compared. Univariate and multivariate Logistic regression analyses were used to screen the risk factors of hemorrhagic stroke. Results The age of hemorrhagic stroke patients was lower than that of ischemic stroke patients [(57.48 ± 10.81) years vs. (64.03 ± 10.96) years; t = 2.836, P = 0.006], and the systolic blood pressure at admission [(171.92 ± 28.95) mm Hg vs. (141.81 ± 23.24) mm Hg; t = 5.174, P = 0.000], diastolic blood pressure [(107.58 ± 18.76) mm Hg vs. (93.44 ± 14.94) mm Hg; t = 3.757, P = 0.000], hemoglobin [(189.54 ± 28.12) g/L vs. (165.35 ± 25.42) g/L; t = 4.111, P = 0.000] and total cholesterol [(4.60 ± 0.88) mmol/L vs. (4.04 ± 0.82) mmol/L; t = 3.118, P = 0.002] were higher than those of ischemic stroke patients. Logistic regression analysis showed that systolic blood pressure on admission (OR = 1.048, 95%CI: 1.024-1.073; P = 0.000) and hemoglobin (OR = 1.043, 95%CI: 1.015-1.072; P = 0.002) elevation were risk factors of hemorrhagic stroke. Conclusions Hemorrhagic stroke is the main type of stroke in the plateau area with altitude of 4000 m above. Patients with high systolic blood pressure on admission and hemoglobin are more likely to have hemorrhagic stroke. [ABSTRACT FROM AUTHOR]

Objective: To analyze the influencing factors of cardiac autonomic neuropathy(CAN)in hospitalized patients with type 2 diabetes mellitus(T2DM), and to investigate its effect on nocturnal asymptomatic hypoglycemia(AH)and nocturnal ventricular arrhythmia(VA), Methods: 174 patients with T2DM who were admitted to Affiliated Hospital of Zhaoqing Medical College from January 2020 to July 2022 were selected, and they were divided into CAN group and non-CAN group according to whether they were complicated with CAN, Multivariate Logistic regression was used to analyze the influencing factors of CAN in hospitalized patients with T2DM, The incidence of nocturnal AH was monitored by dynamic blood glucose monitoring system, and the incidence of nocturnal VA was monitored by dynamic electrocardiogram, Results: The incidence rate of CAN in 174 patients with T2DM was 37.93%(66/174).Univariate analysis showed that the age in the CAN group was older than that in the non-CAN group, and the course of disease was longer than that in the non-CAN group, and systolic blood pressure, diastolic blood pressure, glycosylated hemoglobin(HbA1c), homeostasis model assessment-insulin resistance(HOMA-IR), blood uric acid and the proportion of microvascular complications were higher than those in the non-CAN group(P＜0.05), Multivariate Logistic regression analysis showed that increased age, prolonged course of disease, elevated HOMA-IR, elevated blood uric acid and microvascular complications were independent risk factors for CAN in hospitalized patients with T2DM(P＜0.05), Compared with the non-CAN group, the incidence rate of nocturnal AH and VA in the CAN group were increased(P＜0.05), Conclusions: Age, course of disease, HOMA-IR, blood uric acid and microvascular complications are influencing factors for CAN in hospitalized patients with T2DM, and CAN increases the incidence rate of nocturnal AH and nocturnal VA in hospitalized patients with T2DM, early screening of CAN may help reduce the risk of nocturnal AH and nocturnal VA in hospitalized patients with T2DM, [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of lidocaine throat surface anesthesia on stress response, hemodynamics and recovery quality in patients undergoing laparoscopic cholecystectomy (LC). Methods: Using random number table method, 80 patients undergoing LC who were admitted to Changsha First Hospital from April 2019 to June 2021 were divided into control group (40 cases, receiving general anesthesia) and observation group(40 cases, receiving lidocaine throat surface anesthesia on the basis of control group). Hemodynamic indexes, stress response indexes, occurrence of cough and agitation, pain condition and quality of life were compared in the two groups. Results: The systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) in the observation group from the tracheal intubation immediately (T1) to the end of the operation (T4) were lower than those in the control group in the same period (P<0.05). The cortisol (Cor) and adrenocorticotropic hormone (ACTH) in the observation group at immediately after operation were lower than those in the control group(P<0.05). The incidence of cough, incidence of agitation and total incidence in the observation group were significantly lower than those in the control group(P<0.05). Visual analog scale (VAS) score in the observation group at 6 h after operation, 12 h after operation and 24 h after operation were lower than those in the control group in the same period (P<0.05). The scores of vitality, physical pain, social function, physiological function, overall health, mental health, physiological function and emotional function in the observation group at 1 month after operation were higher than those in the control group (P<0.05). Conclusion: Lidocaine throat surface anesthesia for patients undergoing LC can play a protective role in the airway, reduce the stress response of patients, maintain the dynamic balance of patients' blood flow, and improve recovery quality. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of magnesium sulfate combined with labetalol on coagulation function, oxidative stress and vascular endothelial function in patients with severe preeclampsia. Methods: 94 patients with severe preeclampsia who came to Chaohu Hospital affiliated to Anhui Medical University from January 2020 to September 2022 were selected. The patients were randomly divided into control group (magnesium sulfate treatment, 47 cases) and study group (magnesium sulfate combined with labetalol treatment, 47 cases) by random number table method. Before and after treatment, the changes of systolic blood pressure (SBP), diastolic blood pressure (DBP), 24 h urine protein volume (24hUP), coagulation function, oxidative stress and vascular endothelial function indexes were observed in two groups, and the drug safety in the two groups was observed. Results: After treatment, SBP, DBP and 24hUP in the study group were lower than those in the control group (P<0.05). After treatment, endothelin-1 (ET-1) in the study group was lower than that in the control group, while nitric oxide (NO) was higher than that in the control group (P<0.05). After treatment, malondialdehyde (MDA) in the study group was lower than that in the control group, and superoxide dismutase(SOD) in the study group was higher than that in the control group (P<0.05). After treatment, the fibrinogen (Fg) and D-dimer (D-D) in the study group were lower than those in the control group, and the prothrombin time (PT) and thrombin time (APTT) in the study group were higher than those in the control group (P<0.05). There was no significant difference in the incidence of adverse reactions in the two groups (P>0.05). Conclusion: Labelolol combined with magnesium sulfate in the treatment of patients with severe preeclampsia can reduce 24hUP, effectively reduce blood pressure, improve coagulation function and vascular endothelial function, and alleviate oxidative stress damage. [ABSTRACT FROM AUTHOR]

Objective: To explore the effect and safety of Daglilipin combined with Liraglutide on blood glucose control and insulin function in patients with obese type 2 diabetes mellitus (T2DM). Methods: A total of 106 obese T2DM patients were divided into two groups according to treatment methods: combination group was treated with dagliagliazine combined with liraglutide (55 cases), and control group was treated with liraglutide (51 cases). The therapeutic effect and the occurrence of adverse reactions were recorded and compared between the two groups. Lipid metabolism indexes (adiponectin (APN), total cholesterol (TC), triglyceride (TG) and insulin function indexes (homeostasis islet β) were detected before and after treatment in the two groups Changes in cell secretion function index (HOMA-β), insulin evaluation index (HOMA-IR), blood pressure [systolic blood pressure (SBP), diastolic blood pressure (DBP)] and body mass index (BMI). Results: The total effective rate of combined group was higher than that of control group (P<0.05), and the total incidence of adverse reactions was higher than that of control group (P<0.05). After treatment, the levels of TC, TG, HOMA-IR and SBP, DBP in peripheral blood of the observation group were lower than those of the control group (P<0.05), while the concentration of APN, HOMA-IR and BMI were higher than those of the control group (P<0.05). Conclusion: Dagliagliazine combined with Liraglutide can effectively control the levels of blood glucose, blood lipid and blood pressure in obese T2DM patients, protect the function of the islet, but may also lead to more adverse reactions. [ABSTRACT FROM AUTHOR]

Objective To investigate the relationship between the changes of arterial stiffness parameters and neurological functional improvement in patients with acute cerebral infarction. Methods According to clinical prognosis, 107 patients with acute cerebral infarction were divided into the discharge group (n = 90) and in-hospital mortality group (n = 17) . Patients in the discharge group were further divided into functional improvement group (n = 51) and non-functional improvement group (n = 39) . On the 1st and 7th d after admission, 24-h non-invasive blood pressure was monitored and arterial stiffness parameters including arterial stiffness index (ASI) and pulse wave velocity (PWV) were measured. The severity of cerebral infarction was determined by National Institutes of Health Stroke Scale (NIHSS) . The recovery of neurological function was evaluated by modified Rankin scale (mRS) . The independent predictors of in-hospital mortality and neurological functional improvement were identified by Logistic regression analysis. Results NIHSS score, ASI and PWV upon admission of patients in the in-hospital mortality group were significantly higher than those in the discharge group (all P < 0.05) . Logistic regression analysis found that NIHSS score upon admission and ASI were the independent predictors of in-hospital mortality. In the neurological functional improvement group, the PWV measured on the 7th d was significantly lower than that measured on the 1st d (P < 0.05) . There were significant differences in PWV measured on the 1st and 7th d between patients with and without neurological functional improvement (both P < 0.05) . Decline in PWV and central diastolic blood pressure (CDBP) were the independent predictors of neurological functional improvement (both P < 0.05) . Conclusions Increased ASI is associated with higher in-hospital mortality in patients with acute cerebral infarction. Additionally, PWV decline is correlated with neurological functional improvement in patients with acute cerebral infarction during hospitalization. [ABSTRACT FROM AUTHOR]

Objective We aimed to analyze and predict the risk of white matter lesions (WMLs) in hypertensive patients with different traditional Chinese medicine (TCM) syndromes, and to explore the relationship and influencing factors between them. Methods From September 2019 to December 2021, 309 patients were enrolled from the cardiovascular departments of the Affiliated Hospital of Gansu University of Traditional Chinese Medicine according to the inclusion and exclusion criteria, and they were divided into four syndromes: phlegm and blood stasis syndrome, kidney qi deficiency syndrome, liver fire hyperactivity syndrome, and yin deficiency and yang hyperactivity syndrome. Diastolic blood pressure (DBP), homocysteine acid (Hcy), uric acid (UA), and serum cystatin C (Cys C) were measured. The ARWMC and Fazekas scales were used to assess the site, score, and the degree of WMLs (mild, moderate, or severe) in hypertensive patients with different syndromes, and the correlation between risk factors and different syndromes was summarized. Results There were significant differences in DBP, Hcy, UA, and Cys C among different TCM syndrome types (P<0. 05). WMLs were assessed by the Fazekas and ARWMC scales, and there was no significant difference in the distribution of WMLs sites among different syndrome types. There was no significant difference in the Fazekas scores of WMLs, but there was a significant difference in the ARWMC ratings among different syndrome types (P<0. 05). The WMLs Fazekas and ARWMC risk classification analysis of different TCM syndrome types were significantly different (P<0. 05). According to the Fazekas scale assessment, there were differences in WMLs among all of the syndrome types (P<0. 05). Spearman rank correlation analysis showed that the WMLs degree was positively correlated with age, Hcy, Cys C, and UA in the phlegm and blood stasis syndrome group (rs =0. 22, 0. 23, 0. 18, 0. 24, P<0. 05). The WMLs degree was negatively correlated with HUA and HHcy (rs =-0. 19, -0. 21, P<0. 05). The degree of WMLs was positively correlated with UA (rs =0. 48, P<0. 05), and negatively correlated with HUA (rs = -0. 47, P<0. 05). The degree of WMLs in yin deficiency and yang hyperactivity syndrome group was positively correlated with age, HUA, and Cys C (rs = 0. 37, 0. 27, 0. 27, P <0. 05), and negatively correlated with UA (rs = -0. 32, P < 0. 05). The degree of WMLs in the kidney qi deficiency syndrome group was positively correlated with Hcy (rs = 0. 33, P <0. 05), but negatively correlated with HHcy and DBP (rs = -0. 32, -0. 30, P < 0. 05). The phlegm and blood stasis syndrome had more risk factors with a statistically significant difference (P < 0. 05) compared with the liver fire hyperactivity syndrome, yin deficiency and yang hyperactivity syndrome, and kidney qi deficiency syndrome. According to the ARWMC rating, there were differences in WMLs among all syndrome types (P<0. 05). Spearman rank correlation analysis showed that the WMLs degree was positively correlated with UA (rs =0. 57, P<0. 05) and negatively correlated with HUA (rs =-0. 58, P<0. 05) in patients with hypertension and the ARWMC rating. The degree of WMLs was positively correlated with UA (rs = 0. 34, P <0. 05), and negatively correlated with HUA (rs =-0. 44, P<0. 05). The degree of WMLs in the kidney qi deficiency syndrome group was positively correlated with Cys C (rs =0. 26, P<0. 05), and negatively correlated with diabetes mellitus and HUA (rs =-0. 30, -0. 28, P<0. 05). There were more risk factors with statistically significant differences (P<0. 05) in the kidney qi deficiency syndrome compared with phlegm and blood stasis syndrome, liver fire hyperactivity syndrome, and yin deficiency and yang hyperactivity syndrome. Conclusion The phlegm and blood stasis syndrome and kidney qi deficiency syndrome may be TCM syndrome types with higher incidences of WMLs in hypertensive patients. [ABSTRACT FROM AUTHOR]

Objective: To analyze the influencing factors of maintenance hemodialysis (MHD) patients complicated with restless leg syndrome (RLS), and to explore the improvement effect of aerobic exercise on MHD patients complicated with RLS. Methods: 120 patients who received MHD treatment in Beijing Chaoyang Hospital Affiliated to Capital Medical University from May 2019 to January 2022 were selected as subjects. According to the presence or absence of RLS, 120 MHD patients were divided into combined with RLS group (n=28) and non-combined with RLS group (n=92). Clinical data of patients were collected, and the influencing factors of MHD patients complicated with RLS were analyzed by multivariate Logistic regression, and the improvement effect of aerobic exercise on MHD patients complicated with RLS was discussed. Results: MHD complicated with RLS were associated with gender, dialysis age, hypertension, drinking history, systolic blood pressure, diastolic blood pressure, blood phosphorus, vitamin B12 (VitB12), ferritin (SF), homocysteine (Hcy), blood magnesium, β2 microglobulin (β2-MG) (P<0.05). The results of multivariate Logistic regression analysis showed that longer dialysis age, higher β2-MG, higher VitB12, higher Hcy, drinking history, lower SF, higher blood magnesium, gender with female and higher blood phosphorus were the risk factors for MHD complicated with RLS(P<0.05). 12 weeks after intervention, Pittsburgh Sleep Quality Index (PSQI), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS) scores of MHD patients complicated with RLS decreased compared with those before intervention (P<0.05). Conclusion: The longer dialysis age, higher ẞ2-MG, higher VitB12, higher Hcy, drinking history, lower SF, higher blood magnesium, gender with female, higher blood phosphorus all increase the risk of MHD complicated with RLS. Aerobic exercise in MHD patients complicated with RLS can help to improve the patients' sleep, depression and anxiety, and the effect is better. [ABSTRACT FROM AUTHOR]

Objective: To understand the dietary intake of high-risk population with hypertension in Haikou, and to analyze the relationship between dietary intake and blood pressure, especially the relationship between sodium intake and blood pressure, so as to provide a scientific basis for salt reduction. Methods: A multi-stage cluster sampling was used from July to December 2021 to collect 3-4 community service centers from each of the four districts in Haikou. A total of 15 community service centers were collected, and 295 permanent residents aged 55-74 were recruited from 15 community service centers, with 20 eligible subjects from each community. The subjects underwent general physical examination and laboratory tests, and a dietary survey was conducted using the self-developed Android phone APP "Nutrition Assistant" (registration number: 2021SR1547832). SPSS 21.0 was used for t test, χ² test and multiple regression analysis. Results: In Haikou, 69.4% of the subjects had energy intake above energy requirement, and 44.8% had fat intake above the acceptable range of macronutrients. There were only differences in energy, carbohydrate, vitamin B 6 and sodium intake (t=-2.174, -1.990, 2.333, -5.442, P=0.031, 0.048, 0.021, <0.001, respectively). There were significant differences in BMI, family history of chronic diseases, systolic blood pressure and diastolic blood pressure (F value or χ² value=4.260, 19.045, 139.916, 36.864, P value=0.015, <0.001, <0.001, <0.001, respectively). Multiple regression analysis analysis showed that 24h sodium excretion was significantly correlated with systolic and diastolic blood pressure (t = 12.964, P<0.001), and for every 1 mmol increase in sodium excretion, systolic and diastolic blood pressure increased by 0.135 mmhg and 0.068 mmhg, respectively. Conclusion: The dietary intake of the middle-aged and elderly people at high risk of hypertension in the Haikou community was unbalanced, and the intake of sodium salt was strongly correlated with blood pressure, so it is necessary to continue to promote salt reduction as one of the key ways to prevent and control hypertension. [ABSTRACT FROM AUTHOR]

Objective: To study the relationship between serum growth differentiation factor 15 (GDF-15), fibroblast growth factor21 (FGF21) and liver fibrosis and metabolic syndrome (MS) in patients with nonalcoholic fatty liver disease (NAFLD). Methods: 102patients with NAFLD who were admitted to our hospital from January 2019 to February 2021 were enrolled as the study group. Another100 physical examination volunteers in the same period were selected as the control group. Serum GDF-15, FGF21 and liver fibrosis indicators levels were compared in the two groups, and Pearson correlation analysis was used to determine the relationship between serum GDF-15, FGF21 and liver fibrosis indicators levels. In addition, patients in the study group were divided into MS group and non-MS group according to whether they had concurrent MS. Serum GDF-15 and FGF21 levels and baseline data in the MS group and non-MS group were compared. Multivariate Logistic regression analysis was used to determine the influencing factors of NAFLD complicated with MS. Results: The serum GDF-15 and FGF21 levels in the study group were higher than those in the control group (all P＜0.05).The serum hyaluronic acid (HA), laminin (LN), type Ⅲ precollagen (PCⅢ) and type Ⅳ collagen (ⅣC) levels in the study group were higher than those in the control group (all P＜0.05). Pearson correlation analysis showed that serum GDF-15 and FGF21 levels were positively correlated with serum HA, LN, PCⅢ and ⅣC levels (all P＜0.05). Univariate analysis showed that serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), GDF-15 and FGF21, as well as body mass index, fasting blood glucose (FPG), 2-hour postprandial blood glucose (2hPG), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglyceride (TG) were correlated with MS (all P＜0.05). Multivariate Logistic regression analysis showed that the increase of serum AST and ALT was the protective factor for NAFLD complicated with MS, while the increase of body mass index, GDF-15, FGF21, FPG, 2hPG, SBP, DBP and TG was the risk factor for NAFLD complicated with MS (all P＜0.05). Conclusions: Serum GDF-15 and FGF21 are closely related to liver fibrosis and MS in patients with NAFLD, and which can be used as auxiliary biological indicators to predict liver fibrosis and MS in patients with NAFLD. [ABSTRACT FROM AUTHOR]

Objective: To analyze the characteristics of coronary artery disease, the difference of the clinical efficacy of primary percutaneous coronary intervention (PPCI) treatment and the risk factors of in-hospital death in female patients with acute ST-segment elevation myocardial infarction (STEMI) of different ages. Methods: 408 female patients with STEMI who received PPCI treatment in our hospital from January 2018 to March 2022 were selected, and they were divided into group A (age less than or equal to 65 years, n=161) and group B (age greater than 65 years, n=247) according to the different onset ages. The characteristics of PPCI coronary artery lesions at different onset ages, the differences in clinical efficacy after treatment, and the incidence of in-hospital adverse events were compared. Univariate and multivariate Logistic regression analysis were used to analyze the risk factors of in-hospital mortality in female patients with STEMI. Results: There were significant differences in the number of lesions vessels and calcified lesions between group A and group B (P<0.05). There were no significant differences in the location of lesions vessels, preoperative TIMI blood flow grade, and bifurcation lesions between group A and group B (P>0.05). There was no significant difference in the proportion of intra-aortic pump between the two groups (P>0.05). The time from symptom onset to vessel opening (S-to-D) and portal-balloon dilatation (D-to-B) in the group B were longer than those in the group A (P<0.05). There was no significant difference in the proportion of intraoperative death, stent thrombosis and BARC3-5 bleeding between the two groups (P>0.05). The incidence of postoperative death in the group B was lower than that in the group A (P<0.05). Patients were divided into survival group (n=369) and death group (n=39) according to different prognostic outcomes. Univariate analysis showed that female patients with STEMI of in-hospital death were related to age, diabetes, body mass index (BMI), Killip cardiac function grade, preoperative TIMI blood flow grade, postoperative TIMI blood flow grade, hospitalization days, S-to-D time, D-to-B time, systolic blood pressure (SBP), diastolic blood pressure (DBP), white blood cell count (WBC), neutrophil, platelet volume distribution width (PDW), left ventricular ejection fraction (LVEF) and creatine kinase isoenzyme (CK-MB) (P<0.05). Multivariate Logistic regression analysis showed that older age, lower LVEF, higher CK-MB, postoperative TIMI blood flow grade 0~I, and longer S-to-D time were risk factors for female patients with STEMI of in-hospital death (P<0.05). Conclusion: There are certain differences in the characteristics of coronary artery lesions and the therapeutic efficacy of PPCI in female patients with STEMI of different ages. In addition, older age, lower LVEF, higher CK-MB, postoperative TIMI grade 0~I, and longer S-to-D time are risk factors for female patients with STEMI of in-hospital death [ABSTRACT FROM AUTHOR]

Objective: To discuss the protective effectof follistatin-like 1 (FSTL1) on doxorubicin (DOX) -induced acute myocardial injury of the mice, and to clarify its related mechanism. Methods: A total of 80 C57BL/6J mice were used to establish the acute myocardial injury models by intraperitoneal injection of DOX for one time. The mice were divided into 5 groups (n=8) according to the different doses (0, 5, 10, 15, and 20 mg·kg-1 ) of DOX, and didvided into 5 groups (n=8) according to the different intervention time (0, 0. 5, 1. 0, 2. 0, and 3. 0 d). The other 32 mice were randonly divided into normal saline group, FSTL1 group, DOX group, and DOX-FSTL1 group. The echocardiographic and hemodynamic indexes of the mice in various groups were detected; enzyme-linked immunosorbent assay (ELISA) method was used to detect the levels of tumor necrosis factor- α (TNF- α), N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiae troponin-T (cTn-T) in serum of the mice in various groups; the activities of superoxide dismutase (SOD), the levels of malondialdehyde (MDA), 4-hydroxynonenal (4-HNE) and 15-F2t isoprostane in myocardium tissue of the mice in various groups were detected by oxidative stress kit; the expression levels of FSTL1 mRNA in myocardium tissue of the mice in various groups were detected by real-time fluorescence quantitative PCR (RT-qPCR) method; the expression levels of nuclear factor E2 related factor 2 (Nrf2) and FSTL1 proteins in myocardium tissue of the mice in various groups were detected by Western blotting method. Results: Compared with normal saline group, the left ventricular ejection fraction (LVEF), left ventricular fraction shortening ( LVFS), left ventricular systolic pressure (LVSP), maximum rise rate of left ventricular pressure (+dP/dtmax), and maximum drop rate of left ventricular pressure (－dp / dtmax) of the mice in DOX group and DOX+FSTL1 group were significantly decreased (P<0. 05), and the heart rate (HR), left ventricular end-diastolic volume (LVEDV), and left ventricular diastolic pressure were increased (P<0. 05); compared with DOX group, the LVEF, +dP/dtmax, and －dp /dtmax of the mice in DOX+FSTL1 group were significantly increased (P<0. 05), and the LVEDV was significantly decreased (P<0. 05). Compared with normal saline group, the serum levels of TNF-α, NT-proBNP and cTn-T in serum of the mice in DOX group and DOX+FSTL1 group were significantly increased (P<0. 05); compared with DOX group, the serum levels of NT-proBNP and cTn-T in serum of the mice in DOX+ FSTL1 group were significantly decreased (P<0. 05). Compared with normal saline group, the activity of SOD in myocardium tissue of the mice in DOX group was significantly decreased (P<0. 05), and the levels of MDA, 4-HNE, and 15-F2t-isoprostane were significantly increased (P<0. 05), the level of 15-F2t isoprostane in serum of the mice in DOX+FSTL1 group was increased (P<0. 05); compared with DOX group, the SOD activity in myocardium tissue of the mice in DOX+FSTL1 group was increased (P< 0. 05), and the levels of MDA, 4-HNE, and 15-F2t-isoprostane were decreased (P<0. 05). Compared with 0 mg·kg-1 DOX group, the levels of FSTL1 mRNA in myocardium tissue of the mice in the other groups were significantly decreased with the increasing of the doxorubicin dose (P<0. 05). Compared with DOX 0 d group, the levels of FSTL1 mRNA in myocardium tissue of the mice in the other groups were significantly decreased with the prolongation of the doxorubicin intervention time (P<0. 05). Compared with normal saline group, the expresison levels of FSTL1 and Nrf2 proteins in myocardium tissue of the mice in DOX group was decreased (P<0. 05); compared with DOX group, the expression levels of FSTL1 and Nrf2 proteins in myocardium tissue of the mice in DOX+FSTL1 group were increased (P<0. 05). Conclusion: FSTL1 can alleviate the DOX-induced acute myocardial injury and improve the cardiac function by regulating the oxidative stress, and its mechanism may be reated to up-regulating the Nrf2 expression. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Modern Laboratory Medicine is the property of Journal of Modern Laboratory Medicine Editorial Department and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Modern Laboratory Medicine is the property of Journal of Modern Laboratory Medicine Editorial Department and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim To investigate the relationship between blood lipid levels and rapid eye movement (REM) and non-REM related obstructive sleep apnea hypopnea syndrome (OSAHS) by retrospective analysis of the related data of hypertension patients with OSAHS. Methods Retrospective analysis was made on 478 patients who were hospitalized in the Hypertension Department of Anzhen Hospital from January 1, 2017 to December 31, 2020 and did not take lipid-lowering drugs in the first half of the year. Collecting general data (gender, age, height and weight) of patients at admission, detecting total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDLC) and high density lipoprotein cholesterol (HDLC), and recording oxygen reduction index, minimum oxygen saturation, average oxygen saturation, sleep apnea hypopnea index (AHI), 24 h systolic blood pressure (24h SBP) and 24 h diastolic blood pressure (24h DBP). According to whether hypertension patients had OSAHS or not, they were divided into two groups: without OSAHS group and with OSAHS group. The clinical data of the two groups were compared, and the related influencing factors of OSAHS were analyzed by multivariate linear regression equation, spearman equation was used to analyze the correlation between blood lipid level and various indexes of OSAHS. In addition, according to different types of OSAHS, the correlation between AHI and blood lipid indicators in REM OSAHS and non-REM OSAHS patients was analyzed. Results Multivariate linear regression analysis showed that body mass index (BMI) and TG were the relevant influencing factors of OSAHS (P<0. 05). Spearman equation analysis showed that TC was positively correlated with BMI and arousal index (P<0. 05), HDLC was negatively correlated with BMI, hypoxemia index, longest apnea time, arousal index and AHI, and positively correlated with the lowest oxygen saturation (all P<0. 05); TG was positively correlated with BMI, hypoxemia index, arousal index and AHI, and negatively correlated with the lowest and average oxygen saturation (P<0. 05); AHInon-REM was positively correlated with TC, TG and negatively correlated with HDLC in patients with OSAHS of different types (P<0. 05); AHIREM was positively correlated with TC and TG levels (P<0. 05), but not with HDLC (P> 0. 05). Conclusions In patients with hypertension, BMI and TG levels are independent risk factors of OSAHS, and TG can be an independent risk factor positively correlated with the severity of OSAHS; non-REM OSAHS may affect HDLC synthesis by regulating the level of body hormones and thus change the blood lipid. [ABSTRACT FROM AUTHOR]

BACKGROUND: Obesity is an important risk factor for elevated blood pressure, impaired glucose tolerance and dyslipidemia, in which imbalance in skeletal muscle renin-angiotensin system homeostasis may play a key role. Aerobic exercise is an important non-drug treatment for obesity, but the effects of aerobic exercises with different volumes are not been clarified. OBJECTIVE: To compare the effects of different load volumes of aerobic exercises on inflammatory responses and insulin signaling pathways of the skeletal muscle in obese rats and to explore the possible mechanism of the renin-angiotensin system. METHODS: Thirty Wistar-Kyoto rats were fed with high-fat diet. After 20 weeks, they were randomly divided into obese sedentary group, obese low-volume exercise group or obese high-volume exercise group. In the meantime, another 10 rats fed with standard chow were selected as the normal control group. Animals in the obese low- and high-volume exercise groups were subjected to aerobic exercise, 150 and 300 minutes per week, respectively; those in the normal control group and obese sedentary group were caged quietly. After 12 weeks, body mass, body composition, blood pressure, glucose and lipid metabolism, inflammatory factor levels, and the expression of insulin signaling, inflammatory pathway and renin-angiotensin system axis protein molecules in the skeletal muscle were detected. RESULTS AND CONCLUSION: Body mass and body composition: compared with the obese sedentary group, body mass decreased significantly in the obese low- and high-volume exercise groups (P < 0.05). Compared with the obese low-volume exercise group, retroperitoneal and epididymal fat mass decreased significantly in the obese high-volume exercise group (P < 0.05). Blood pressure: compared with the obese sedentary group, systolic and diastolic blood pressure decreased significantly in the obese low- and high-volume exercise groups (P < 0.05). Glucose and lipid metabolism and inflammatory factors: compared with the obese sedentary group, contents of the above biochemical indexes decreased significantly in the obese low- and high-volume exercise groups (P < 0.05). Skeletal muscle insulin signal pathway: compared with the obese sedentary group, the protein expressions of phosphorylated protein kinase B and glucose transporter 4 increased significantly in the obese low- and high-volume exercise groups (P < 0.05), while the protein expression of protein tyrosine phosphatase 1B decreased significantly in the obese high-volume exercise group (P < 0.05). Skeletal muscle inflammation pathway: compared with the obese sedentary group, the protein expression of phosphorylated inhibitor α of nuclear factor κB decreased significantly in the obese low- and high-volume exercise groups (P < 0.05), and the protein expression of interleukin-6 decreased significantly in the obese high-volume exercise group (P < 0.05); compared with the obese low-volume exercise group, the protein expression of phosphorylated inhibitor α of nuclear factor κB decreased significantly in the obese high-volume exercise group (P < 0.05). Renin-angiotensin system axis of the skeletal muscle: compared with the obese sedentary group, the expression of angiotensin II type 1 receptor and Mas receptor proteins, as well as the ratio of angiotensin-converting enzyme/angiotensin-converting enzyme 2 and angiotensin II type 1 receptor/ Mas receptor decreased significantly in the obese high-volume exercise group (P < 0.05). To conclude, aerobic exercise with different load volumes can improve body composition, glucose and lipid metabolism and blood pressure, ameliorate skeletal muscle insulin signaling pathway, and relieve inflammatory response in obese rats. However, the effect of high load volume protocol (300 minutes per week) is better than that of low load volume (150 minutes per week) and the mechanism may be related to the transition of skeletal muscle renin-angiotensin system balance from angiotensin-converting enzyme/angiotensin II type 1 receptor axis to angiotensin-converting enzyme 2/Mas receptor axis induced by high-volume aerobic exercises. [ABSTRACT FROM AUTHOR]

Objective To investigate the improvement effect of effective-compound compatibility of Bufei Yishen prescrtion（ECC-BYP Ⅲ) on pulmonary hypertension （PH) of the rats induced by smoke and bacteria, and to preliminarily elucidate its mechanism. Methods SPF SD rats were randomly divided into control group （n=9) and modeling group（n=140).The rats in control groujp were given conventional feeding，and the rats in modeling group were given cigarette-smoke and Klebsiellabacillus （Kp) to make the PH model. Then the rats in model group were divided into model group（n=10), low（n=9), medium（n=10), and high（n=10) doses （3.24, 6.48 and 12.96 mg·kg－1·d－1) of ECC-BYP Ⅲgroups, according to the equivalent pulmonary function of the rats among various groups.The rats in ECC-BYP Ⅲ groups were administered with different doses of ECC-BYP Ⅲ, respectively, and the rats in control and model groups were administered with same volume of solvent for 4 weeks. On the 29th day，the mean pulmonary artery pressure （mPAP), pulmonary artery systolic pressure （PASP)，pulmonary artery diastolic pressure （PADP), and right ventricular hypertrophy index （RVHI) of the rats in various groups were measured.The lung tissues of the rats in various groups were taken out. Hematoxylin-eosin（HE)staining was used to detect the periarteriolar inflammation in lung tissue；victoria blue staining was used to detect the percentages of non-muscular, partial muscular, and muscular pulmonary arterioles in pulmonary arterioles of the rats, the percentages of wall thickness of pulmonary muscular arterioles in vessel diameter（WT%)，and luminal area in pulmonary muscular arterioles （LA%). Enzyme-linked immunosorbent assay （ELISA) method was used to detect the levels of interleukin 6 （IL-6), tumor necrosis factor （TNF-α), endothelin-1 （ET-1), and protracyclin （PGI2) in lung tissue of the rats in various groups. Results Compared with control group，the mPAP, PASP, PADP of the rats in model group were increased（P<0.05 or P<0.01), RVHI was increased（P<0.01)，and there were obvious inflammatory cell infiltration around the pulmonary arterioles； the levels of TNF-α and IL-6 in lung tissue were increased（P<0.01)，the percentage of muscular arteriole and WT% of pulmonary were increased and non-muscular arteriole and LA% were decreased（P<0.05 or P<0.01), and the level of ET-1 and ET-1/PGI2 ratio in lung tissue was increased（P<0.01). Compared with model group, the mPAP and PADP of the rats in high dose of ECC-BYP Ⅲ group were decreased（P<0.05)，the inflammatory cell infiltration of the rats in medium and high doses of ECC-BYP Ⅲ groups was improved，and the levels of TNF-α, IL-6, WT%，percentage of muscular arteriole were decreased（P<0.01)，and LA% was increased （P<0.01)；compared with model group，the ET-1 levels in lung tissue of the rats in medium and high dose of ECC-BYP Ⅲ groups were decreased（P<0.05 or P<0.01)，and the ET-1/PGI2 ratio of the rats in high of ECC-BYP Ⅲ group was decreased（P<0.05).Compared with low dose of ECC-BYP Ⅲ group, the WT % and ET-1 in lung tissue were decreased（P<0.05 or P<0.01) and LA % was increased（P<0.01)，the levels of TNF-α in lung tissue of the rats in medium dose of ECC-BYP Ⅲ group was decreased and the level of IL-6 and ET-1/PGI2 ratio in lung tissue of the rats in high dose of ECC-BYP Ⅲ group were decreased（P<0.05 ). Conclusion ECC-BYP Ⅲ can reduce PH and wall thickness of the pulmonary arterioles, improve the lumen stenosis and pulmonary arteriolation，improve the pulmonary vascular remodeling，and its mechanism may be related to reducing the inflammation response of the pulmonary perivascular and improve unbalance of peripheral vasoconstriction vasular factor level/diastolic vascular factor level. [ABSTRACT FROM AUTHOR]

Objective To observe the difference of hypotensive effect of sarcubitril/valsartan between hypertensive patients with increased left atrial diameter (LAD) and with normal LAD. Methods A total of 80 patients who were diagnosed as essential hypertension in Nanjing First Hospital from June 2021 to January 2022 were selected, and they all did not take antihypertensive drugs in the past two weeks. According to the size of LAD, they were divided into first group (LAD≥40 mm, n=50) and second group (LAD＜40 mm, n=30) . After enrollment, all patients were given a daily dose of 100 mg of sarcubitril/valsartan. If the blood pressure reached the standard after 1 week［systolic blood pressure (SBP) ＜140 mmHg and diastolic blood pressure (DBP) ＜90 mmHg］, continue to use 100 mg of sarcubitril/valsartan. If not, increase the dose to 200 mg of sarcubitril/valsartan per day. If the blood pressure reaches the standard after 2 weeks, continue to use 200 mg dose. If the blood pressure does not reach the standard, add it to 400 mg dose per day or add other kinds of antihypertensive drugs according to the patient's individualized situation. The changes of blood pressure level and the rate of reaching the standard of blood pressure in the two groups for 4 weeks (28th day) were observed and compared. Results Compared with second group, the decrease of SBP ［7th day: (11.06±1.36) mmHg vs (7.53±1.31) mmHg, P＜0.01; 14th day: (19.70±2.62) mmHg vs (13.80±1.92) mmHg, P＜0.01］ and the decrease of DBP ［7th day: (5.76±2.63) mmHg vs (4.47±1.31) mmHg, P=0.014; 14th day: (10.02±3.17) mmHg vs (8.23±2.84) mmHg, P=0.013］ were significant higher in the first group. After four weeks, there was no significant difference in SBP, DBP levels and the distribution of proportion of combined use of antihypertensive drugs between the two groups (P＞0.05) . Conclusion Compared with hypertensive patients with normal LAD, sarcubitril/valsartan has a better effect on blood pressure reduction in patients with increased LAD is more superior, and the blood pressure reduction range is very obvious in the first two weeks after use.

OBJECTIVE: To systematically review the efficacy of Songling Xuemaikang capsules in the treatment of hypertension and hyperlipidemia by methodological quality assessment tools including AMSTAR 2 scale and grading system of evidence evaluation ( GRADE). METHODS: Systematic reviews of studies with Songling Xuemaikang capsules were enrolled by retrieving databases including CNKI, CBM, Wanfang Data, VIP, the Cochrane Library, PubMed, Web of Science and Springer from base-building to Jul. 27th, 2022. The research results of systematic review were collated and summarized, the quality of each outcome index was evaluated by using the GRADE system, and the quality of enrolled literature was evaluated by using the AMSTAR 2 scale. RESULTS: Finally 9 systematic reviews were enrolled, 8 of which were on the treatment of hypertension with Songling Xuemaikang capsules and 1 on hyperlipidemia with Songling Xuemaikang capsules. The research results of systematic review indicated that compared with pharmaceutical chemicals alone, the efficacy of Songling Xuemaikang capsules combined with pharmaceutical chemicals was better, mainly in terms of indicators such as the total effective rate, systolic blood pressure, diastolic blood pressure, total cholesterol, triacylglycerol, low density lipoprotein cholesterol and low density lipoprotein cholesterol. The results of the GRADE evaluation showed that 9 were moderate evidence, 23 were low evidence and 2 were very low evidence. The results of AMSTAR 2 scale evaluation showed that the methodological quality of all 9 studies was extremely low. CONCLUSIONS: Songling Xuemaikang capsules have a certain efficacy in the treatment of hypertension and hyperlipidemia, but the original literature is of low quality. It is recommended that high-quality clinical randomized controlled trials be conducted to evaluate the safety, efficacy and economical efficiency of Songling Xuemaikang capsules with reference to the evaluation methods of evidence-based medical guidelines, so as to provide higher-quality evidence for clinical purposes. [ABSTRACT FROM AUTHOR]

Objective: To influencing factors on prognosis of patients with exertional heat stroke (EHS), and to analyze the predictive value of serum tumor necrosis factor-α (TNF-α), high mobility group protein 1 (HMGB1) and CC-like chemokine 5 (CCL5) at admission on the risk of death of patients with EHS. Methods: 50 patients with EHS who were admitted to our hospital from May 2018 to April 2022 were selected, and serum TNF-α, HMGB1 and CCL5 levels at admission were detected by enzyme-linked immunosorbent assay.With recovery or death as the observation end point, patients were divided into survival group (32 cases) and death group (18 cases), and multivariate Logistic regression was used to analyze the influencing factors of patients’ prognosis. The predictive value of serum TNF-α,HMGB1 and CCL5 on the risk of death was analyzed by receiver operating characteristic (ROC) curve. Results: The TNF-α, HMGB1and CCL5 levels in the death group were higher than those in the survival group (P＜0.05) . Body temperature, heart rate, Acute physiology and chronic health scoring system II (APACHE II) score, blood sodium, blood potassium, blood calcium, myoglobin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), urea nitrogen, creatinine and total bilirubin levels in death group were higher than those in survival group. Systolic blood pressure, diastolic blood pressure and finger pulse oxygen were lower than those in survival group (P＜0.05) . Multivariate Logistic regression analysis showed that higher levels of TNF-α, HMGB1 and CCL5 at admission were risk factors for death of patients with EHS (P＜0.05) . ROC curve analysis showed that the area under the curve (0.95CI) of combined detection of serum TNF-α, HMGB1 and CCL5 at admission to predict the risk of death was 0.869 (0.739～0.975), indicated a good prediction efficiency. Conclusion: High levels of serum TNF-α, HMGB1 and CCL5 at admission are adverse factors for the prognosis of patients with EHS, and combined detection of these three indicators has certain predictive value for the risk of death of patients. [ABSTRACT FROM AUTHOR]

Objective:To observe the effects of etomidate target controlled infusion combined with dexmedetomidine anesthesia on cellular immune function,inflammatory factors and stress response in patients undergoing radical gastrectomy for gastric cancer.Methods:100 patients with gastric cancer who were selected for radical gastrectomy in our hospital from April 2021 to June 2022 were selected,and they were divided into control group (n=50） and observation group（n=50） according to the form of envelope lottery.Patients in control group were anesthetically treated with etomidate injection target controlled infusion.The observation group was combined with dexmedetomidine hydrochloride injection intravenous infusion on the basis of the control group.The occurrence of adverse reactions in patients,hemodynamic indexes[heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) ],stress response indexes[cortisol (Cor), epinephrine (E), adrenocorticotropic hormone (ACTH) ],inflammatory factors[tumor necrosis factor-α (TNF-α), interleukin-6（IL-6), high sensitivity C-reactive protein（hs-CRP) ],cellular immune function indexes of the two groups were observed.Results SBP,HR and DBP in the observation group were lower than those in the control group at the time of medication and at the time of extubation (P＜0.05). There was no difference in the incidence of adverse reactions between the two groups (P＞0.05). 1 d after operation,E IL-6,Cor,TNF-α,ACTH,hs-CRP and CD8+in the observation group were lower than those in the control group (P＜0.05). The CD4+CD3+and CD4+/CD8+in the observation group at 1 d after operation were higher than those in the control group (P＜0.05). Conclusion For patients undergoing radical gastrectomy for gastric cancer with etomidate target controlled infusion combined with dexmedetomidine anesthesia,the hemodynamics and stress response can be effectively controlled,and the influence of inflammatory factors and immune function can be greatly reduced,which is conducive to the smooth operation. [ABSTRACT FROM AUTHOR]

Objective: To analyze the effect of intra aortic balloon counterpulsation（IABP) on patients with acute myocardial infarction（AMI) complicated with ardiogenic shock（CS) undergoing percutaneous coronary intervention（PCI) and the risk factors of postoperative in-hospital death. Methods: 105 patients with AMI complicated with CS who were treated in our hospital from June 2020 to May 2022 were selected. The patients treated with PCI directly were set as the control group（n=59 cases), and the patients treated with PCI assisted by IABP were set as the study group（n=46 cases). The postoperative cardiac indexes [left ventricular ejection fraction（LVEF), left ventricular end diastolic diameter（LVEDD) and left ventricular end systolic diameter（LVESD）], myocardial zymogram indexes [cardiac troponin T and troponin I, creatine kinase isoenzyme（CK-MB）] and postoperative major cardiovascular adverse events were compared between the two groups. The patients were divided into survival group（n=74) and death group（n=31）according to whether they survived at discharge. The clinical data of the two groups were compared, and the risk factors of in-hospital death were analyzed by multivariate logistic regression model. Results: The LVEF of the two groups after operation was increased, LVEDD and LVESD were decreased, and LVEF of the study group was higher than that of the control group, and LVEDD and LVESD were lower than those of the control group（P＜0.05). The myocardial zymogram indexes of the two groups after operation were significantly decreased compared with those before operation, and the levels of troponin I, troponin T and CK-MB of the study group were lower than those of the control group（P＜0.05). There were 5 cases of recurrent myocardial infarction and 7 cases of acute thrombosis of the control group after operation, 2 cases and 3 cases of the study group respectively（P＞0.05). There were 23 deaths of the control group, and 8 deaths of the study group. The number of deaths of the study group was lower than that of the control group（P＜0.05). The age, Killip grade ≥ grade III, hyperlipidemia, LVEF ＜ 40%, proportion of TIMI blood flow grade ≤ grade II, leukocyte count and serum creatinine level of the death group were higher than those of the survival group, and systolic blood pressure, diastolic blood pressure, hemoglobin, troponin I,troponin T, CK-MB, LVEF and IABP assisted were lower than those in the survival group（P＜0.05). Multivariate logistic regression analysis showed that age ≥ 65 years, Killip grade ≥ grade III, LVEF ＜ 40% and TIMI blood flow grade ≤ grade II were the risk factors for in-hospital death of patients（P＜0.05). Conclusion: IABP assisted supported PCI can effectively improve cardiac function in patients with AMI complicated with CS. Age ≥ 65 years, Killip grade ≥ grade III, LVEF ＜40%, TIMI blood flow grade ≤ grade II are the risk factors for in-hospital death. [ABSTRACT FROM AUTHOR]