AIM To investigate the correlation between the expression levels of serum Krüppel-like transcription factor 8(KLF8)and glucose transporter 4(GLUT4)and the severity of coronary heart disease patients with impaired glucose regulation.METHODS A total of 204 patients with coronary heart disease admitted to our hospital from March 2021 to September 2022 were selected as the study subjects,according to whether the patients had impaired glucose regulation,they were divided into non-impaired glucose regulation group(94 cases)and impaired glucose regulation group(110 cases).According to the results of coronary angiography,patients with impaired glucose regulation were grouped into single vessel lesion group(39 cases),double vessel lesions group(42 cases)and triple vessel lesions group(29 cases).According to Gensini score,patients with impaired glucose regulation were divided into mild group(42 cases),moderate group(38 cases)and severe group(30 cases).The serum KLF8 mRNA level of the subjects was measured by real-time fluorescence quantitative PCR(qRT-PCR)and the expression level of GLUT4 in the subjects'serum was detected by enzyme-linked immunosorbent assay(ELISA).Pearson was applied to analyze the correlation between serum KLF8,GLUT4 levels and indicators.RESULTS Compared with the non impaired glucose regulation group,the impaired glucose regulation group significantly increased fasting blood glucose,2-hour postprandial blood glucose,triglycerides,low-density lipoprotein,and total cholesterol;The levels of serum KLF8 and GLUT4 in the impaired glucose regulation group decreased significantly;Compared with patients with impaired glucose regulation in single vessel coronary heart disease,the levels of serum KLF8 and GLUT4 in the two vessel coronary heart disease group and the three vessel coronary heart disease group were significantly lower;Compared with patients with impaired glucose regulation in coronary heart disease with dual vessel lesions,the levels of serum KLF8 and GLUT4 in the triple vessel lesion group were significantly lower;The levels of serum KLF8 and GLUT4 in patients with impaired glucose regulation in coronary heart disease decreased significantly with the severity of the disease;Pearson correlation analysis showed that serum KLF8 and GLUT4 levels in patients with impaired glucose regulation and coronary heart disease were negatively correlated with fasting blood glucose,2-hour postprandial blood glucose,triglycerides,low-density lipoprotein,total cholesterol levels,and Gensini scores.The above statistical differences were all(P<0.01).CONCLUSION The expression levels of serum KLF8 and GLUT in coronary heart disease patients with impaired glucose regulation are obviously decreased,which is negatively correlated with the severity of the disease.
AIM To investigate the influences of Jinkui Shenqi Pill combined with sacubitril-valsartan on TCM syndrome integral(TCMSI),mean ventricular wall stress(MWS)and serum myostatin(MSTN)levels in patients with chronic heart failure(CHF).METHODS A total of 100 CHF patients admitted in our hospital from March 2021 to April 2022 were selected as the research subjects and they were randomly grouped into the control group(50 cases)and the observation group(50 cases).The control group was treated with sacubitril-valsartan and theobservation group was treated with Jinkui Shenqi Pill and sacubitril-valsartan.TCMSI score,MWS and serum MSTN level were compared between the two groups.RESULTS The total effective rate of the observation group was significantly higher than that of the control group(P<0.05);Compared with before treatment,the TCMSI scores of the two groups significantly decreased after treatment,and the observation group was significantly lower than the control group(both P<0.01);After treatment,the stroke volume(SV),left ventricular ejection fraction(LVEF),and 6-minute walking test(6MWT)distance values(LVEF and 6MWT)of the two groups significantly increased,and the observation group was significantly higher than the control group(all P<0.01);Compared with before treatment,the average wall stress(MWS)and left ventricular end systolic diameter(LVESD)were decreased,left ventricular end diastolic diameter(LVEDD)and left ventricular end diastolic volume(LVEDV)were increased,and left ventricular end systolic volume(LVESV)was significantly decreased in both groups after treatment,and the difference between observation group and control group was significant(all P<0.01);Compared with before treatment,after treatment,the standard deviation between sinus beats(SDNN),root mean square(RMSDD)of normal adjacent sinus beat interval difference,percentage of adjacent sinus beat interval difference>50 ms(PNN50),and high-frequency Hertz(HF)were significantly increased in both groups,and the observation group was significantly higher than the control group(all P<0.01);Compared with before treatment,the serum MSTN levels in the two groups significantly decreased after treatment,and the observation group was significantly lower than the control group(both P<0.01).CONCLUSION Jinkui Shenqi Pill combined with sacubitril-valsartan effectively improve the clinical symptoms of CHF patients,reduce their TCMSI scores,MWS and serum MSTN levels and improve cardiac functions and the effect is remarkable.
AIM To explore the application effect of ECG technology in the teaching of monitoring and evaluation of flight physiological parameters by analyzing the heart rate of students in the course of landing route flight on two different simulated flight platforms.METHODS Students Grade 2020 majoring in aviation and aerospace medicine served as research subjects and their heart rates in the pre-flight,takeoff,cruise and landing phases of the takeoff and landing route flight on the CJ-6 Simulation Flight Platform and the Microsoft Simulation Flight Platform were analyzed and the application effect of ECG technology in teaching monitoring and evaluation of flight biology parameters was evaluated.RESULTS The students'heart rate during the takeoff and landing route flight on the CJ-6 Simulation Flight Platform and the Microsoft Simulation Flight Platform was significantly higher than that before flight(P<0.01)and the heart rate on the CJ-6 Simulation Flight Platform was significantly higher than that on the Microsoft Simulation Flight Platform(P<0.05),indicating that the two simulation flight platforms brought certain flight load to the students and the flight load on the CJ-6 Simulation Flight Platform was higher than that on the Microsoft Simulation Flight Platform.Compared with that before flight,some difference was found in the students'heart rate in the takeoff,cruise and landing phases of flight on the two simulated flight platforms,but no significant difference was found in the heart rate in the cruise phase on the Microsoft Simulation Flight Platform.The heart rate in the landing phase was higher than that before flight and in the takeoff and the cruise phases,indicating that the landing phase brought the greatest flight load to the students.The students'heart rate in the take-off and the landing phases on the CJ-6 Simulation Flight Platform was significantly higher than that on the Microsoft Simulation Flight Platform(P<0.05),while no difference was observed in the cruise phase,indicating that the flight load on the CJ-6 Simulation Flight Platform was higher than that on the Microsoft Simulation Flight Platform in the take-off and the landing phases,and the flight difficulty on the two platforms in the cruise phase was equal.CONCLUSION The application effect of ECG technology in the practical teaching course of monitoring and evaluation of flight physiological parameters is good,which can not only improve students'scientific research ability and comprehensive quality,but also cultivate students'aviation medical thinking,which is conducive to the cultivation of military medical talents with practical and innovative ability in the new era under the background of"double first-class"construction.
AIM To evaluate the relationship between hypertension and partial sleep deprivation in young male soldiers.METHODS Young male soldiers under partial sleep deprivation were divided into two groups according to the days they had been partially sleep deprived.Blood pressure,pulse rate,age,height,body weight and other indicators were collected to compare the differences in blood pressure and pulse rate between the two groups,and the logistic regression was used to analyse the risk factors of hypertension.RESULTS Compared with the short-term PSD group,the long-term PSD group has older age(P<0.01),larger body mass(P<0.05),higher smoking index(P<0.05),and longer average PSD days(P<0.01);There was no statistically significant difference in BMI,conscription blood pressure,family history,smoking history,and SAS standard score.There was no statistically significant difference in pulse rate between the long-term and short-term groups.The detection rate of hypertension in the long-term group was higher than that in the short-term group(using Chi square segmentation,8.1%vs.1.4%,P<0.05),and the proportion of Normal height blood pressure was higher than that in the short-term group(using Chi square segmentation,54.7%vs.28.2%,P<0.01).The logistic regression analysis results showed that there is a higher risk of elevated blood pressure when the cumulative number of days of sleep deprivation exceeds 12 months(P<0.01).CONCLUSION Both systolic and diastolic blood pressure increased significantly when partial sleep deprivation lasted for more than 12 months.The proportion of high-normal blood pressure increased significantly when partial sleep deprivation lasted for more than 12 months.Increased blood pressure was associated with cumulative days of partial sleep deprivation.The risk of high blood pressure was significantly increased when partial sleep deprivation lasted.
AIM To investigate the relationship between hemoglobin glycation index(HGI)and in-stent restenosis(ISR)after percutaneous coronary intervention(PCI)in patients with type 2 diabetes mellitus.METHODS A retrospective analysis was performed on 134 patients with T2DM who underwent PCI in the Department of Cardiovascular Medicine,Taizhou People's Hospital from October 2019 to October 2022 and who underwent coronary angiography 8～24 months after surgery due to recurrence of chest pain or by doctor's advice.The patients were divided into two groups according to the examination results of angiography:ISR group(40 cases)and NISR group(94 cases).The differences of basic data,laboratory examinations,medication and interventional therapy between the two groups were analyzed.Multivariate logistic regression was used to analyze the influencing factors of ISR in patients with type 2 diabetes mellitus and receiver operating characteristic curve(ROC)was used to analyze the efficacy of HGI in predicting ISR in patients with type 2 diabetes.RESULTS The age,residual lipoprotein,glycosylated hemoglobin(HbA1c),HGI,Gensini score and total length of stent in ISR group were higher than those in NISR group,and the mean stent diameter was lower than that in NISR group,with statistical significance(P<0.05,P<0.01).Logistic regression analysis showed that HGI was an independent risk factor for ISR in patients with type 2 diabetes mellitus(OR=2.534,95%CI:1.023～6.281,P<0.05).ROC curve showed that the area under the curve of predicting ISR of patients with type 2 diabetes mellitus by HGI was 0.777.When HGI was 0.309,the predictive sensitivity was 72.5%and the specificity was 77.7%.CONCLUSION HGI is independently associated with the risk of ISR in patients with type 2 diabetes mellitus and HGI can be used as a clinical indicator to predict ISR in patients with type 2 diabetes mellitus.
AIM To investigate the correlation between circadian rhythm of blood pressure after percutaneous coronary intervention(PCI)and major adverse cardiovascular events(MACE)in patients with ST segment elevation myocardial infarction(STEMI).METHODS Clinical data of STEMI patients in the Department of Cardiology,Xi'an People's Hospital were collected from June 2019 to December 2020,with a total of 112 cases.According to the nocturnal blood pressure drop rate(NBPDR)on the first day after PCI,the patients were divided into dipper group,non-dipper group,super-dipper group and reverse dipper group,and the patients were followed up for an average of 1.5 years.Univariate Kaplan-Meier regression and multivariate Cox regression models were used to compare the correlation between baseline data and MACE of the four groups.RESULTS Compared with the dipper group,the non-dipper group(P<0.05)and reverse-dipper group(P<0.01)had an increasing risk of MACE.Subgroup analysis showed that female patients in the non-dipper group,patients over 65 years old in the reverse-dipper group and patients younger than 65 years old in the super-dipper group had an increasing risk of MACE(P<0.05),while patients with severe coronary artery disease in the reverse-dipper group had a higher risk of MACE(P<0.05).Additionally,the RCS curve showed that MACE risk was the lowest when NBPDR was equal to 17.05%.CONCLUSION Blood pressure circadian rhythm is closely related to the recurrence of MACE in STEMI patients after PCI.
The sodium-glucose cotransporter 2 inhibitors(SGLT2i)as a new and effective class of therapeutic agents for type 2 diabetes(T2D),have recently emerged indicating an antiarrhythmic effect of the SGLT2 inhibitors in patients with and without diabetes.Several clinical studies have provided robust evidence for a protective and beneficial effect of these agents against atrial fibrillation.The antiarrhythmic mechanisms involved include reverse atrial remodeling,amelioration of mitochondrial function,attenuated sympathetic nervous system activity,regulation of sodium and calcium homeostasis.These new data on antiarrhythmic actions of SGLT2i are herein reviewed,in order to provide a new therapeutic strategy for clinical prevention and treatment of atrial fibrillation.
AIM To investigate macrophage migration inhibitory factor(MIF)mediated effect of oxidized low density lipoprotein(ox-LDL)on vascular endothelial cell function and its mechanism.METHODS Human umbilical vein endothelial cells(HUVECS)were treated with ox-LDL(100 nmol/L)and the expression and function of related proteins were detected by immunoelectrophoresis.Real-time quantitative PCR was used to monitor the expression of inflammatory factors and the effects of drug blockade and gene intervention on the expression of downstream genes were observed.Griess response was used to monitor NO production in endothelial cells under the intervention.Ex vivo,acetylcholine-induced vasodilation was used as an indicator of endothelium-dependent vasodilation to detect endothelial cell function.RESULTS ox-LDL increased the expression of sterol regulatory element binding protein(SREBP2)and MIF,and either drug specific blockage or siRNA inhibition of MIF expression significantly reduced the expression and activation of SREBP2(P<0.05).MIF regulated vascular endothelial cell function through SREBP2(P<0.05).CONSCLUSIONS Oxidative stress such as ox-LDL can increase the expression of SREBP2-mediated inflammasome and inflamma-related adhesion molecules on endothelial cells through MIF,thereby disrupting endothelial cell function,which is one of the important mechanisms for the occurrence and development of atherosclerosis.
There is no effective strategy for preventing or treating myocardial ischemia-reperfusion(MI/R)injury.A recent set of basic and clinical research indicates that implanting a percutaneous ventricular assistance device(pVAD)prior to reperfusion unloads the ventricle and decreases myocardial oxygen consumption.The ventricular unloading induced by pVAD implantation prevents the infarction enlargement and minimizes fibrotic scar formation.The implantation of pVAD before reperfusion is recognized as a promising therapeutic approach for ameliorating MI/R injury.We summarize the application and mechanism of pVAD-induced ventricular unloading in the prevention and treatment of MI/R injury.
Cardiac amyloidosis(CA)is a serious and progressive infiltrative disease that is caused by the deposition of amyloid fibrils between the heart muscle cells and this disease has a poor prognosis.Echocardiography plays an important role in the diagnosis of CA and the evaluation of its prognosis.This article reviews the research progress of echocardiography in the diagnosis of CA.
The combined detection and analysis of inflammatory reaction,biochemical metabolism,cardiopulmonary function and vascular endothelial function related to the pathophysiological mechanism of coronary heart disease is of great value for the early diagnosis and evaluation of coronary heart disease.This article reviews the clinical value,advantages and disadvantages of the combined analysis of related indicators in order to guide clinical selection and application according to the actual situation.
With the development of China's aerospace industry,much attention has been paid to the influence of weightlessness on human physiological functions.Cardiovascular deconditioning to microgravity may have adverse effects on the health and work efficiency of astronauts.Post-space flight orthostatic intolerance or PSOI is one of the common adverse effects after astronaouts're-enters the gravity field from weightlessness.Recent studies suggest that the occurrence of PSOI may be related to multiple factors such as fluid redistribution,hypovolemia,cardiac atrophy,increased venous compliance,low peripheral resistance,abnormal cerebral blood flow regulation,impaired autonomic nerve and baroreflex,and vestibular dysfunction.This article reviews the relevant mechanisms and possible countermeasures.
AIM To explore the application effect of micro-video combined with team-based learning(TBL)in teaching clinical medical students cardiac physical examination.METHODS Experimental control method was used in this study.From February to April 2022,fifty-four five-year-program clinical medicine students of 2019 Grade in Air Force Medical University were selected and randomly divided into experimental group and control group by table of random digits,with 27 students in each group.Micro-video combined with TBL was applied in experimental group and traditional teaching method for cardiac physical examination was used in control group.At the completion of the course,teaching quality and teaching effect were evaluated by scores of practical ability in cardiac physical examination and theoretical examination,and questionnaire survey.RESULTS The scores of both practical ability in cardiac physical examination and the theoretical examination in experimental group were higher than those in control group(P<0.05).The results of the students'self-evaluation survey showed that the students in experimental group were better than their counterparts in control group in their mastery of knowledge,practical performance,interest and initiative in learning,effect of learning and memory,ability of analysis and problem-solving,ability of communication,ability of clinical and scientific research,ability of teamwork and cooperation,and satisfaction with the teaching mode(P<0.05).The evaluation results of the teachers showed that the scores of classroom activity,the ability of clinical critical thinking,the initiative in learning,the ability of communication and understanding,and the problem-solving ability in experimental group were all higher than those in control group(P<0.05).CONCLUSION Micro-video combined with TBL teaching mode effectively improves the teaching efficiency of undergraduate students majoring in clinical medicine,enhances the students'clinical practice ability and makes up for the limitations of traditional teaching methods.
The incidence of cardiovascular disease has increased over the past few decades and it remains a leading cause of sudden death.How to improve early detection and diagnosis of myocardial ischemia to prevent sudden cardiac death is very important.Magnetocardiogram(MCG)system based on quantum technology can detect the magnetic field generated by the excitation of myocardial cells around the heart,record and process this cardiac magnetic field information,analyze its changing characteristics,and provide valuable reference for clinical diagnosis of heart diseases such as myocardial ischemia.The current application of MCG in hospitals,various medical institutions and other research units,due to differences in technical routes,equipment performance and analysis methods,remains a problem of different diagnosis criteria,which has a serious impact on its application.Based on the latest research from home and abroad,and take into consideration of the specific situation in China,domestic experts in this field provide a set of clinical diagnostic requirements for MCG of myocardial ischemia.
AIM To explore the application effect of formative assessment based on case report model in the final examination for interns in cardiovascular medicine.METHODS A total of 84 five-year medical students majoring in clinical medicine and aerospace medicine were divided into two groups.The control group(42 cases)was assessed by traditional method,while the experimental group(42 cases)was assessed by case report mode.RESULTS The examination results in experimental group were significantly better than those in control group(P<0.01).The performance of lecture practice,the in-class learning results of case discussion and after-class review rate in experimental group were higher than those in control group(P<0.05),and no statistical difference was found in in-class learning results of teaching ward-round between the two groups.Compared with the traditional method,the case report could better exercise the ability of analyzing clinical problems,strengthen the ability of differential diagnosis of diseases and deepen the understanding of theoretical knowledge.CONCLUSION The formative assessment based on case report model can improve the assessment results of interns,help to stimulate the learning initiative of interns and better cultivate students'clinical thinking and understanding ability of knowledge.It is an interns assessment that can be popularized.
1临床资料患者女性，21岁，主因“入职体检发现房间隔缺损10 d”于2021年8月22入院。入院查体：T:36.2℃，P:84次/min, R:20次/min, BP:90/60mmHg（1mmHg=0.133k Pa），右心扩大，第二心音固定分裂，胸骨左缘（2～3）肋间可闻及2/6级收缩期杂音。查心脏超声提示房间隔缺损（大血管短轴切面11 mm）（图1A），下腔静脉异位连接（肝后段缺如，经半奇静脉向上走行，汇入部分显示不清）（图1B），
AIM To investigate the effect of heart rate on the long-term prognosis of acute myocarditis.METHODS Clinical data of 138 hospitalized patients with acute myocarditis from January 2017 to July 2022 were retrospectively collected and the patients were divided into MACE and non-MACE groups according to the follow-up results after discharge.Clinical characteristics,laboratory test results,electrocardiogram and echocardiogram of the two groups were compared,logistic regression was applied to analyze the risk factors for the occurrence of MACE in patients with acute myocarditis and ROC curves were applied to evaluate the predictive efficacy of heart rate indicators for the development of MACE.RESULTS The median of follow-up was 34(13,53)months.In the MACE group,age,severe myocarditis,white blood cell count,mean heart rate at discharge and maximum heart rate at discharge were independent risk factors for the development of MACE in patients with acute myocarditis,compared with those in the non-MACE group(P<0.05,P<0.01).ROC curve analysis showed that the area under the ROC curve for mean heart rate at discharge was 0.818(95%CI:0.737～0.899),with a best cut-off value of 78.31,a sensitivity of 76.2%and a specificity of 77.1%.The area under the ROC curve for maximum discharge heart rate was 0.699(95%CI:0.599～0.798),with a best cut-off value of 96.5,a sensitivity of 69.0%and a specificity of 62.5%.CONCLUSION Mean heart rate at discharge and maximum heart rate at discharge are the influential factors for prognosis of patients with acute myocarditis and they can be used as predictors of the development of MACE in the distant future.
AIM To study the protective effect and mechanism of lycorine on hypoxia/reoxygenation(H/R)injury in H9c2 cardiomyocytes.METHODS H9c2 myocardial cells were randomly divided into four groups:control group,H/R group,H/R+low-dose lycorine group and H/R+high-dose lycorine group.CCK-8 was used to analyze the viability of H9c2 myocardial cells.The release of lactate dehydrogenase(LDH),the contents of malondialdehyde(MDA)and reactive oxygen species(ROS),and the activities of superoxide dismutase(SOD)and glutathione peroxidase(GSH Px)were measured with the kit.Apoptosis rate was detected by flow cytometry,Notch1 protein level was detected by Western blotting and the levels of HES-1,HES-5 and Hey-1 mRNA were detected by Real time polymerase chain reaction.RESULTS Compared with those in control group,the activity of H9c2 cardiomyocytes in H/R group decreased(P<0.05),the activity of SOD and GSH-Px decreased(P<0.05),and the apoptosis rate,LDH release,MDA and ROS content,Notch1 protein level,and HES-1,HES-5 and Hey-1 mRNA levels increased(P<0.05).Compared with those in H/R group,the activity of H9c2 cardiomyocytes in both H/R+low-dose lycorine group and H/R+high-dose lycorine group increased(P<0.05),the activity of SOD and GSH-Px increased(P<0.05),the apoptosis rate,LDH release,and MDA and ROS content decreased(P<0.05),and Notch1 protein level,HES-1,HES-5 and Hey-1 mRNA levels increased(P<0.05).CONCLUSION Lycoritine can alleviate the injury effect of H/R induced cardiomyocytes,and whether its mechanism is related to the upregulation of Notch pathway remains to be further studied.
1 临床资料 患儿,女,1岁,肺动脉瓣听诊区收缩期II/6级喷射样杂音,体格检查未见明显异常.心电图示窦性心律.超声二维示:左房前后径 22 mm,左室舒张末期前后径 34 mm,升主动脉内径 12 mm,肺动脉内径 19 mm,左室射血分数 70％.
AIM To study the correlation between renin,aldosterone levels and short-term blood pressure variability in young and middle-aged patients with essential hypertension.METHODS A total of 192 patients with essential hypertension diagnosed in the Gansu Provincial People's Hospital from July 2020 to December 2022 were analyzed retrospectively.Renal function,uric acid,blood lipids,fasting blood glucose,glycosylated hemoglobin(HbA1c),orthostatic plasma renin concentration and aldosterone concentration levels were detected and blood pressure was measured by 24-hour ambulatory blood pressure monitoring.According to the median aldosterone/renin concentration(ARR)(ARR=11.81),96 patients were assigned to high ARR group(>ARR median)and 96 patients were assigned to low ARR group(
