Objective To explore the connection between immune-related plasma proteins and Parkinson's disease.Methods By analyzing genome-wide association study data of 4907 immune-related plasma proteins,we assessed their direct impact on the risk of Parkinson's disease.Single-nucleus RNA sequencing data were also utilized for protein expression analysis.Results Four im-mune-related proteins,cerebral dopamine neurotrophic factor(CDNF),cathepsin B(CTSB),im-munoglobulin G Fc receptor 2a(FCGR2A),and hemoglobin beta subunit(HBB),were identified to be associated with the risk of Parkinson's disease.Among them,increased expression levels of CDNF,CTSB and HBB were found to decrease the risk(OR=0.871,95％CI:0.779-0.973,P=0.015;OR=0.835,95％CI:0.758-0.920,P=0.001;OR=0.735,95％CI:0.631-0.857,P=0.001),whereas increased level of FCGR2A was associated with a higher risk of PD(OR=1.137,95％CI:1.058-1.223,P=0.001).Singl e-cell sequencing analyzes protein expression and its dis-tribution among different cell types in the brain.CDNF and CTSB exhibit high expression levels in multiple brain cell types,FCGR2A is predominantly expressed in brain microglia and HBB shows minimal expression in the brain.Conclusion There are potential links between the four proteins CDNF,CTSB,FCGR2A and HBB and the risk of Parkinson's disease.Our results emphasize that the genetic risk variants of Parkinson's disease influence the disease's occurrence by modulating the expression of these immune-related proteins.Additionally,single-cell expression data reveal the expression patterns of these target proteins in the brain.
Objective To explore the efficacy of digoxin injection in the treatment of acute heart failure(HF)combined with rapid atrial fibrillation(AF).Methods A total of 956 acute HF pa-tients admitted in our CCU between January 2021 and December 2022 were selected,and 89 pa-tients complicated with rapid AF were screened from them according to the relevant diagnosis and medication regimen.Among them,47 cases were in the digoxin injection group and 42 cases were in the cedilanid group.Ventricular rate,left ventricular ejection fraction(LVEF),end-diastolic volume(LVEDV)and end-systolic volume(LVESV),serum creatinine,24-h urine volume(UV),and sST2,IL-6,and NT-proBNP levels were compared between the two groups.The incidence of MACE within 3 months after discharge was observed during the follow-up.Logistic regression analysis was used to analyze the influencing factors for MACE occurrence,and ROC curve analy-sis was employed to analyze the value of sST2,IL-6 and NT-proBNP alone and combined together in predicting MACE occurrence.Results The effective rate in 3 d after treatment was significant-ly higher in the digoxin injection group than the cedilanid group(P＜0.05).The heart rate was obviously lower in the former group than the latter group at 2 and 6 h after treatment(P＜0.05).The levels of sST2,IL-6 and NT-proBNP were decreased in both groups after treatment,with the levels in the digoxin injection group statistically lower than those in the cedilanid group(P＜0.05,P＜0.01).sST2,IL-6 and NT-proBNP were independent predictors for MACE occurrence in acute HF patients complicated with rapid AF(OR=1.031,95％CI:1.009-1.069;OR=1.045,95％CI:1.000-1.092;OR=1.000,95％CI:1.000-1.001).ROC curve analysis showed the AUC value of the combined 3 indicators in predicting MACE was 0.908(95％CI:0.828-0.959).Conclu-sion In the treatment of acute HF combined with rapid AF,digoxin injection can effectively im-prove the symptoms of chest tightness and palpitations,with advantages of rapid action and better control of heart rate when compared with cedilanid,and it will exert better therapeutic effects in consideration of the changes in sST2,IL-6,and NT-proBNP levels.The 3 indicators are independ-ent predictors of MACE in the patients,and their combination shows a greater predictive value in assessing the incidence of MACE for their prognosis.
Objective To investigate the relationship between uric acid(UA)and cardiac function as well as long-term prognosis in elderly patients with chronic heart failure(CHF)and concomi-tant atrial fibrillation(AF).Methods A retrospective cohort study was conducted on 324 consec-utively recruited elderly CHF patients with concomitant AF who were hospitalized in our depart-ment from August 2018 to August 2020.According to their UA level,they were divided into a high UA group(150 cases)and a normal UA group(174 cases).The clinical data,results of labo-ratory tests and echocardiogram indicators were collected.All patients were followed up for 3 years after discharge.The endpoint was major adverse cardiovascular events.Results Univariate analysis of variance showed that the UA level was significantly higher in the patients with NYHA Class IV than those with Classes Ⅱ and Ⅲ(445.39±184.54 µmol/L vs 378.86±122.64 µmol/L and 403.50±142.15 μmol/L,P＜0.05).Multivariate Cox analysis indicated that age(95％CI:1.012-1.075,P=0.007),UA level(95％CI:1.000-1.004,P=0.048)and use of statins(95％CI:0.215-0.721,P=0.003)were significantly associated with the risk of cardiac death.Conclu-sion UA is associated with the long-term prognosis of elderly CHF patients with concomitant AF,and has certain predictive value for long-term cardiac death.
Objective To investigate the levels of soluble tyrosine kinase-1(sFlt-1)and chemokine C-C ligand 3(CCL3)in serum of patients with coronary heart disease(CHD)and their correlation with the severity of the disease.Methods A total of 230 elderly CHD patients admitted to the De-partment of Cardiovascular Medicine of Xinxiang Central Hospital from November 2020 to No-vember 2022 were collected as the study subjects(CHD group),and according to their Gensini score,they were divided into mild(n=89),moderate(n=95),and severe(n=46)CHD sub-groups.Another 230 healthy individuals who taking physical examination during the same period served as the control group.ELISA was applied to measure serum levels of sFlt-1 and CCL3.ROC curve was plotted to analyze the diagnostic values of serum sFlt-1 and CCL3 levels for CHD.Pear-son correlation analysis was employed to analyze the relationship between serum sFlt-1 and CCL3 levels and the CHD severity.Results The serum levels of sFlt-1 and CCL3 were obviously higher in the CHD group than the control group(121.71±29.80 ng/L vs 98.70±17.57 ng/L,18.22± 5.41 ng/L vs 13.68±3.89 ng/L,P＜0.01).ROC curve analysis showed that the AUC value of the two indicators combined together was significantly greater than that of them alone in diagnosis of CHD(0.886 vs 0.791,0.775,P＜0.01).The serum levels of sFlt-1 and CCL3 were increased along with the severity of the disease and Gensini score when the levels and the score were compared among the mild,moderate and severe subgroups(P＜0.05).Pearson correlation analysis indicated that the serum levels of sFlt-1 and CCL3 were positively correlated with the Gensini score(r=0.420,r=0.479,P＜0.01).Conclusion The levels of serum sFlt-1 and CCL3 are obviously ele-vated in CHD patients,and closely associated with the severity of coronary lesions.
Objective To investigate the effect of afferent blockade of visceral adipose tissue(VAT)on cardiac function and cardiac neural remodeling in rats after myocardial infarction(MI).Methods After 30 healthy SPF-grade male SD rats were subjected,12 of them were randomly divided into control group(n=6)and activation group(n=6).In the activation group,low-dose capsaicin(1 mmol/L)was used to activate VAT afferent nerves,while in the control group,an equal amount of normal saline was injected,and real-time blood pressure and heart rate were monitored for 30 min.The other 18 rats were randomly assigned into sham group(n=6),MI group(n=6),and high-dose capsaicin blockade group(n=6).The MI model was established by ligating the left anterior descending coronary artery.After MI modeling,the high-dose capsaicin blockade group was give 33 mmol/L capsaicin to block VAT afferent nerve,and the sham opera-tion group and MI group were injected with the same amount of normal saline.After 2 weeks,car-diac function was measured by echocardiography,infarct size was measured by TTC staining,heart rate variability was analyzed,and myocardial tyrosine hydroxylase(TH)was measured.The levels of myocardial superoxide dismutase(SOD)and malondialdehyde(MDA)were measured by biochemical methods.Results More significant changes in blood pressure and heart rate were observed in the activation group than the control group(P＜0.01).The MI group had obviously larger infarct size,higher LVEDD and LVESD,and increased myocardial TH density and MDA level,but lower LVEF and myocardial SOD activity than the sham group(P＜0.05).However,the infarct size,LVEDD(9.15±0.37 mm vs 10.1±0.85 mm),LVESD(6.33±0.40 mm vs 7.87±0.86 mm)were obviously decreased,while LVEF[(67.04±3.34)％vs(47.10±3.89)％]and myocar-dial FS[(33.26±2.50)％vs(20.81±2.14)％]activity were greatly increased in the high dose capsaicin group than the MI group(P＜0.05).Conclusion Activation of VAT afferent nerve can increase blood pressure and heart rate;while its blockade can reduce the infarct size,protect cardiac function and inhibit cardiac nerve remodeling in MI rats,possibly by reducing oxidative stress.
Objective To explore the influencing factors for long-term poor prognosis of patients with acute ischemic stroke with large vessel occlusion(LVO-AIS)in the course of intravascular treatment.Methods A total of 123 LVO-AIS patients undergoing vascular recanalization in Department of Neurology of Tianmen First People's Hospital from January 2021 to December 2022 were consecutively recruited,and according to their modified Rankin Scale(mRS)score at 90 d after surgery,they were divided into good prognosis group(mRS≤2,n=58)and poor prognosis group(mRS＞2,n=65).Their general clinical data were compared between the two groups.Multi-variate logistic regression analysis was applied to identify the risk factors of poor prognosis in LVO-AIS patients.Results The good ratio of collateral circulation in good prognosis group was higher than that in poor prognosis group(94.83％vs 47.69％,P＜0.01).Multivariate logistic regression analysis showed that age(OR=1.092,95％CI:0.989-1.205,P=0.046),diabetes(OR=0.122,95％CI:0.026-0.561,P=0.007),symptomatic intracranial hemorrhage(OR=0.038,95％C I:0.002-0.656,P=0.024),and poor collateral circulation(OR=0.037,95％CI:0.007-0.196,P=0.000)were independent risk factors for poor prognosis in LVO-AIS patients after intravascular treatment.Conclusion For the LVO-AIS patients,those with advanced age,di-abetes,symptomatic intracranial hemorrhage and poor collateral circulation are prone to poor prognosis after intravascular treatment.
Objective To explore the correlation between the characteristics of left atrial(LA)strain and exercise endurance in patients with chronic heart failure(CHF).Methods A total of 212 CHF patients admitted to our hospital from November 2021 to January 2023 were prospec-tively subjected in this study.According to their maximal oxygen uptake(VO2max),they were di-vided into high endurance group[≥16 ml/(kg·min),125 cases]and low endurance group[＜16 ml/(kg·min),125 cases].The general data and results of laboratory test were analyzed and com-pared between the two groups.Logistic regression analysis was used to analyze the related factors affecting the exercise endurance.Results Significant differences were observed between the two groups in level of NT-proBNP,ratio of early diastolic peak velocity of mitral valve(E)to early di-astolic peak velocity of mitral annulus(e'),E,LVEDVI,LVESVI,LVSVI,LVEF,LVGLS,LA maximum volume index(LAVImax),LA minimum volume index(LAVImin),LA reservoir strain(LASr),LA conduit strain duct strain(LAScd),and LA contractile strain(LASct)(P＜0.05).Multivariate logistic regression analysis showed that LASr(OR=0.987,95％CI:1.003-1.029),LAScd(OR=1.177,95％CI:0.688-0.955),LASct(OR=1.341,95％CI:0.507-0.884).NT-proBNP(OR=1.002,95％CI:0.995-1.000),E/e'(OR=1.086,95％CI:1.000-1.183),LVEDVI(OR=1.127,95％CI:0.805-0.936)and LVEF(OR=0.909,95％CI:0.824-1.000)were related factors influencing exercise endurance in CHF patients(P＜0.05).Restricted cube chart revealed that there was a significant nonlinear relationship between LASr,LAScd and LASct and exercise endurance in the patients(x2=9.830,16.820,9.080,P＜0.05).Conclusion The char-acteristic indicators of LA strain are related to exercise endurance of CHF patients.
Objective To investigate the relationship between cerebral atrophy and total burden of cerebral small vessel disease in patients with recent small subcortical infarct(RSSI).Methods A total of 194 elderly RSSI patients admitted to Department of Neurology of Changzhou Second People's Hospital Affiliated to Nanjing Medical University from September 2021 to November 2022 were recruited in this study.All patients completed cranial MRI examination and were divid-ed into a non-mild group 1(97 cases)and a moderate to severe group 1(97 cases)based on the to-tal burden of cerebral small vessel diseases(CSVD)imaging.Visual assessment scale was used to assess the severity of brain atrophy in the whole brain and various regions of the brain.According to the global cortical atrophy scale(GCA)score,all patients were divided into a non-mild group 2(88 cases)and a moderate to severe group 2(106 cases).Brain atrophy in various regions,medial temporal lobe atrophy(MTA)score,frontal temporal lobe atrophy(FTA)score,and posterior cortical atrophy(PA)score were evaluated.Their general clinical and imaging data were collected,multivariate logistic regression analysis was employed to analyze the relationship between GCA score and total burden of CSVD imaging in RSSI patients,and Spearman correlation analysis was further adopted to explore the correlation of GCA score and different parts of brain atrophy with total burden of CSVD imaging.Results When compared with the non-mild group 1,the moderate to severe group 1 had significantly larger proportions of having GCA score of 2-3 points,PA score of 2-3 points,MTA score of 2-4 points and FTA score of 2-4 points(P＜0.01).The ra-tio of having 2-4 points in total imaging burden score of CSVD was obviously higher in the mod-erate to severe group 2 than the non-mild group 2(P＜0.01).Multivariate logistic regression anal-ysis showed that age and total burden of CSVD imaging were independent risk factors for brain atrophy in RSSI patients(OR=1.184,95％CI:1.099-1.276,P=0.000;OR=3.537,95％CI:1.664-7.518,P=0.001).Spearman correlation analysis revealed that the total burden score of CSVD imaging was positively correlated with GCA,MTA,FTA and PA scores in RSSI patients(r=0.518,r=0.382,r=0.471,r=0.388,P=0.000).Conclusion The total burden of CSVD is an independent risk factor for GCA in elderly RSSI patients.The more serious the total burden of CSVD is,the higher the grade of GCA is.The total burden of CSVD is related to the whole brain and brain atrophy in other different regions of the brain.
Objective To evaluate the value of perfusion imaging mismatch and low perfusion ratio(HIR)based on CT perfusion imaging in predicting acute intracranial large vessel occlusion(LVO)associated with intracranial atherosclerotic stenosis(ICAS).Methods A total of 82 pa-tients with acute intracranial LVO who underwent emergency thrombectomy in our hospital from February 2019 to December 2020 were enrolled in this study.According to the etiology,they were divided into ICAS-related LVO group(ICAS-LVO,65 cases)and cardiogenic embolism group(17 cases).ROC curve was plotted to analyze the predictive value of CT perfusion imaging parame-ters.Results Compared with the cardiogenic embolism group,the ICAS-LVO group had signifi-cantly larger male ratio,higher BMI and TG level,more severe progression of disease,longer time from onset to surgery,larger proportion of ischemic penumbra and higher mismatch ratio,and ob-viously less ratio of atrial fibrillation,lower BNP and HDL levels,smaller infarct volume,and lower HIR(P＜0.05,P＜0.01).ROC curve analysis showed that HIR and mismatch ratio had good predictive value for the etiology of ICAS-LVO.The optimal cut-off value of HIR was 0.26,with an AUC value of 0.74,a specificity of 0.88,and a sensitivity of 0.54.The optimal cutoff for the mismatch ratio was 3.84,with an AUC value of 0.84,a specificity of 0.75,and a sensitivity of 0.90.Generalized linear model revealed that HIR and cerebral blood volume index had no signifi-cant difference in prognostic performance(P=0.175).Conclusion HIR and mismatch ratio are helpful to identify the pathogenesis earlier and formulate surgical strategies more accurately,thereby reducing iatrogenic injury to a greater extent,increasing the effective reperfusion rate,re-ducing the disability and mortality,and improving the prognosis of clinical outcomes.
Objective To survey the nutritional status of elderly hospitalized patients with hyper-tension and frailty,and explore the correlation between nutrition and frailty.Methods A total of 801 elderly hypertensive patients admitted to our hospital from October 2022 to December 2023 were cosecutively enrolled,and according to Fried frailty phenotype criteria,they were divided into frailty group(score:≥3,276 cases),pre-frailty group(score:1-3,362 cases)and non-frailty group(score:0,163 cases).At the same time,MNA was used to evaluate the nutritional risk of the patients,and the scores of ADL and the score of ACCI were recorded.Logistic regression mod-el was used to analyze the influencing factors of frailty in elderly hypertensive patients,Spearman correlation analysis was employed to analyze the relationship between frailty and nutrition-related indicators,and ROC curve was plotted to analyze the predictive performance of these nutritional indicators in the occurrence of frailty.Results There were statistically differences among the three groups in terms of age,mean SBP,complication of other chronic diseases,polypharmacy,mean handgrip strength,calf circumference,MNA score and classification,ADL and ACCI scores,and levels of hemoglobin,HDL-C,LDL-C,TC,albumin,25-hydroxyvitamin D[25(OH)D],bone alkaline phosphatase,VitB12 and Hcy(P＜0.05,P＜0.01).Multivariate logistic regression analysis revealed that polypharmacy(OR=2.361,95％CI:1.332-4.183),MNA score ≥24(OR=0.298,95％CI:0.110-0.808),ADL score(OR=1.094,95％CI:1.028-1.166),albumin(OR=0.963,95％CI:0.934-0.994),and 25(OH)D(OR=0.989,95％CI:0.980-0.998)were independent risk factors for frailty in elderly hypertensive patients(P＜0.05,P＜0.01).Frailty was positively cor-related with age,polypharmacy,other chronic diseases,and ACCI score(P＜0.01),and negatively with MNA score,MNA classification,hemoglobin,albumin,25(OH)D,HDL-C,LDL-C,Hcy,average grip strength,and calf circumference(P＜0.01).ROC curve analysis showed that the AUC values of 25(OH)D,albumin,and MNA score were 0.607,0.588,and 0.700,separately.Con-clusion Elderly patients with hypertension and frailty have poor nutritional status,and identify-ing early frailty relies on nutritional risk assessment.Frail patients have a high risk of malnutri-tion and are influenced by various factors.Among them,albumin,MNA score,and 25(OH)D can effectively predict the occurrence of frailty in elderly hospitalized hypertensive patients,with MNA score having stronger predictive performance.
Objective To investigate the correlation between aCAS and the location and volume of cerebral WMH in the elderly people.Methods A total of 188 elderly WMH patients admitted to our hospital from September 2022 to September 2023 were enrolled and divided into no or mild(stenosis≤49％,137 cases),moderate(50％-69％,25 cases),and severe aCAS groups(≥70％,26 cases)according to the degree of carotid stenosis.All of the patients underwent cranial MRI scanning to assess total,periventricular,deep,and juxtacortical WMH volumes.Univariate and multivariate generalized linear model analyses were used.Results The moderate and severe aCAS groups had significantly older age,larger proportions of coronary heart disease and smoking,and higher total,peri ventricular,and juxtacortical WMH volumes than the no or mild aCAS group,and the deep WMH in the severe aCAS group was higher than that in the no or mild aCAS group(P＜0.05).Multivariate generalized linear model analysis showed that both moderate and severe aCAS were independent risk factors for total WMH volume(OR=325.629,95％CI:24.255-4371.608;OR=51.088,95％CI:4.135-631.128),periventricular WMH volume(OR=27.655,95％CI:5.168-147.976;OR=8.988,95％CI:1.754-46.051),deep WMH volume(OR=3.641,95％CI:1.511-8.774;OR=2.589,95％CI:1.105-6.064)and juxtacortical WMH volume(OR=3.005,95％CI:1.831-4.933;OR=2.199,95％CI:1.36-3.566)(P＜0.05,P＜0.01).Conclusion aCAS is an independent risk factor for WMH in the elderly population,and stenosis＞50％has a greater correlation with WMH volume.
Objective To investigate the cardioprotective effect of dapagliflozin on elderly type 2 di-abetes mellitus(T2DM)patients with concomitant hypertension with different body mass index(BMI).Methods A total of 338 elderly T2DM patients with concomitant hypertension admitted to our department from January 2021 to January 2023 were recruited and divided into two groups based on their medication regimen:the dapagliflozin group(170 patients)and the control group(168 patients).According to their BMI,the patients of the dapagliflozin group were further as-signed into the normal body mass subgroup(34 cases),overweight subgroup(83 cases),and obese subgroup(53 cases).General clinical data were collected before and in 6 months after treat-ment,including body weight,BMI,FPG,glycosylated hemoglobin(HbA1c),left atrium diameter(LAD),inter-ventricular septum thickness(IVST),left ventricular posterior wall thickness(LVPWT),maximum mitral flow velocity during early diastolic period divided by peak mitral ring velocity during early diastolic period(E/e'),and left ventricular mass index(LVMI)and as-sessed adverse drug reactions as well as the incidence of adverse events during follow-up.Results Compared with before treatment,the levels of FPG,HbA1c,IVST,LVPWT and LVMI were sig-nificantly decreased in both groups after 6 months of treatment(P＜0.05).The dapagliflozin group obtained significantly decreased body mass,BMI,LAD,IVST,LVPWT,E/e'and LVMI levels than the control group(P＜0.01).Kaplan-Meier survival analysis revealed a statistically significant difference in cumulative survival rate of adverse events between the two groups(Plog rank=0.038).Multivariate Cox analysis demonstrated that both dapagliflozin(HR=0.218,95％CI:0.076-0.626,P=0.005)and ACEI/ARB/ARNI(HR=0.364,95％CI:0.143-0.927,P=0.034)were protective factors,while,female(HR=3.881,95％CI:1.241-12.135,P=0.020),duration of hypertension(HR=1.054,95％CI:1.000-1.110,P=0.049),body mass(HR=1.055,95％CI:1.005-1.108,P=0.030),age(HR=1.103,95％CI:1.022-1.190,P=0.012),and LVMI(HR=1.029,95％CI:1.001-1.058,P=0.039)were risk factors for major adverse events among all participants included.Compared with the normal body mass subgroup,the over-weight group had more obvious improvements in △IVST,△LVPWT,△E/e'and △LVMI,and the obese group had significant improvements in △LAD,△IVST,△LVPWT,△E/e'and △LVMI(P＜0.05).The obese subgroup obtained more obvious improvements in △LAD,△IVST,△LVPWT,△E/e'and △LVMI than the overweight subgroup(P＜0.05).Conclusion Dapagliflozin demon-strates a cardioprotective effect at different degrees in elderly T2DM patients with hypertension,irrespective of their BMI.It significantly regulates blood glucose,promotes weight reduction,en-hances ventricular remodeling,and exhibits favorable safety.
Objective To analyze the relationship of lipoprotein(a)[Lp(a)]with poor prognosis in chronic heart failure(CHF)patients aged over 80 years,and explore the influencing factors for poor prognosis in these patients.Methods A total of 135 over-80-year-old patients with acute de-compensated CHF admitted in Tianjin University Chest Hospital from June 2018 to August 2021 were enrolled in this study.With Lp(a)300 mg/L as the cut-off value,they were divided into higher Lp(a)group(73 cases)and lower Lp(a)group(62 cases).Their baseline clinical data and outcomes after 12 months of follow-up were collected.The primary endpoint was composite end-point including re-hospitalization due to CHF and/or all-cause mortality.Kaplan-Meier survival curve were plotted to compare the survival rates between the two groups.Logistic regression anal-ysis was employed to analyze the risk factors of poor prognosis in these patients.Results The higher Lp(a)group had larger proportion of chronic kidney disease and higher levels of homocys-teine,total cholesterol and low-density lipoprotein-cholesterol than the lower Lp(a)group(P＜0.05).Kaplan-Meier survival analysis showed that the lower group obtained significantly longer 1-year survival time without primary endpoint events than the higher group[9.8 months(95％CI:8.884-10.665)vs 8.2 months(95％CI:7.057-9.272),P＜0.05].Multivariate logistic regression analysis revealed that Lp(a)≥300 mg/L(OR=2.841,95％CI:1.133-7.092,P=0.026),female(OR=2.809,95％CI:1.111-7.092,P=0.029)and use of diuretic(OR=4.631,95％CI:1.103-19.443,P=0.036)were independent risk factors for primary endpoint events within 1 year.Con-clusion Lp(a)≥300 mg/L is an independent risk factor for re-hospitalization due to CHF and/or all-cause mortality in elderly CHF patients within 1 year after discharge.
Objective To investigate the correlation of ceramides(Cer),triglyceride-glucose(TyG)index,residual cholesterol(RC)and intracranial atherosclerotic stenosis(ICAS)in elderly with ischemic stroke(IS).Methods A total of 209 elderly IS patients admitted in the Affiliated Hospi-tal of Xuzhou Medical University from January to December 2022 were recruited,and according to intracranial artery stenosis,they were divided into stenosis group(n=122)and non-stenosis group(n=87).TyG index and RC levels were calculated after testing different types of Cer.Spearman correlation analysis and logistic regression analysis were used.Results Compared with the non-stenosis group,the stenosis group had significantly larger proportions of higher levels of LP(a),HbA1c,TyG index,RC and Cer16∶0,Cer18∶0,Cer24∶1,Cer16∶0/Cer24∶0,Cer24∶1/24∶0 and Cer18∶0/24∶0,and lower Cer24∶ 0 level(P＜0.05,P＜0.01).The levels of Cer16∶0,Cer18∶0,Cer24∶1,Cer16∶0/24∶0,Cer18∶0/24∶0,Cer24∶1/24∶0,LP(a),HbA1c,TyG index and RC were positively correlated with(r=0.290,0.343,0.383,0.436,0.434,0.481,0.166,0.248,0.140,0.204,P＜0.05,P＜0.01),and Cer24∶0 was negatively with ICAS(r=-0.247,P＜0.01).Cer18∶0,Cer24∶1,Cer16∶0/Cer24∶0,Cer18∶0/Cer24∶0 and RC were important influencing factors for ICAS(P＜0.05,P＜0.01).Conclusion The levels of Cer,TyG index and RC are higher in elderly IS patients,and these indicators might be the risk factors for ICAS.
Objective To analyze the antihypertensive compliance rate,drug use and complication distribution among very old hypertensive inpatients under the antihypertensive standard of 150/90 mm Hg in our country(1 mm Hg=0.133 kPa).Methods A total of 409 hospitalized patients aged ≥80 years and diagnosed with hypertension in all departments of Air Force Medical Center of PLA were enrolled,and according to their clinical outcomes,they were divided into intensive antihypertensive group(106 cases,SBP＜130 mm Hg),standard antihypertensive group(155 ca-ses,SBP 130-149 mm Hg)and non-standard blood pressure group(148 cases,SBP ≥150 mm Hg).The status of blood pressure control was analyze in each group.Results When 150/90 mm Hg was used as the blood pressure standard,25.9％were in the intensive blood pressure group,37.9％were in the standard blood pressure group,36.2％were in the non-standard blood pressure group.The proportion of patients aged＞90 years was significantly lower in the non-standard blood pressure group than the intensive antihypertensive group and the standard anti-hypertensive group(4.1％vs 7.5％and 12.3％,P＜0.05).The ratio of single-drug therapy was significantly higher in the standard antihypertensive group than the intensive antihypertensive group(46.5％vs 32.1％,P＜0.05),and that of dual combination therapy was obviously higher in the intensive antihypertensive group than the standard antihypertensive group(35.8％vs 22.6％,P＜0.05).The proportions of heart damage and cerebrovascular damage were significantly higher(43.4％vs 21.9％,26.4％vs 14.8％),and the proportion of complicated retinopathy was notably lower(11.3％vs 23.9％)in the intensive antihypertensive group than the standard antihypertens-ive group(P＜0.05).Conclusion For very old hypertensive patients in our country,it is more sci-entific and practical to use 150/90 mm Hg as the starting standard for blood pressure reduction.Intensified blood pressure reduction increases cardiovascular and cerebrovascular damages in them instead.
Objective To investigate the clinical features and related risk factors of chronic heart failure(CHF)patients with ischemic stroke.Methods A total of 153 elderly CHF patients with-out atrial fibrillation(AF)/atrial flutter(AFL)admitted in our hospital from January 2021 to January 2023 were enrolled,and according to diagnosis,they were divided into CHF group(84 cases)and ischemic stroke group(69 cases,CHF+ischemic stroke).General information,medical history and auxiliary examination indicators were collected.All of them were followed up for 6 months.SPSS statistical software was used to analyze the data of the 2 groups of patients,and the risk factors related to ischemic stroke were identified.Results Significant differences were observed in terms of age,hypertension,diabetes,partial thromboplastin time,left atrial diameter,left ventricular ejection fraction,right ventricular diameter,left ventri-cular end-systolic diameter,left ventricular end-diastolic diameter,CHF classification,thrombosis risk(CHA2DS2-VASc)score,HAS-BLED score,and usage of antiplatelet agents between the two groups(P＜0.05,P＜0.01).Multivariate logistic regression analysis showed that CHA2DS2-VASc score(OR=2.471,95％CI:1.356-4.502,P=0.003)and HAS-BLED score(OR=6.626,95％CI:2.049-21.432,P=0.002)were independent risk factors for ischemic stroke.ROC curve analysis indicated that the AUC value of CHA2DS2-VASc score and HAS-BLED score in predicting ischemic stroke in elderly CHF patients without AF/AFL was 0.936(95％CI:0.898-0.975,P＜0.01)and 0.922(95％CI:0.880-0.964,P＜0.01),respectively.Conclusion High CHA2DS2-VASc score and high HAS-BLED score are independent risk factors for ischemic stroke in elderly CHF patients with-out AF/AFL.
Objective To investigate the effect of 3-n-butylphthalide(NBP)on etoposide-induced senescence in human umbilical vein endothelial cells(HUVECs).Methods HUVECs were divid-ed into blank control group,etoposide group(500 nmol/L etoposide+dimethyl sulfoxide),etopo-side+low-,medium-and high-dose NBP groups(500 nmol/L etoposide+5,10 and 20 μmol/L NBP,respectively).Senescence-related β galactosidase(SA-β-gal)staining was used to observe the change in senescent cell proportion.Real-time quantitative PCR was employed to detect the mRNA levels of senescence-associated secretory phenotype(SASP),such as IL-8,IL-1β,and CXC chemokine ligand 1(CXCL1).Western blotting was applied to measure the expression level of ag-ing-related protein,P21.Immunofluorescence staining was utilized to detect the proportion of pro-liferation-related protein Ki67 positive cells.Results Significantly higher P21 expression(1.00± 0.00 vs 0.59±0.09),larger ratio of SA-β-gal positive cells(29.58±4.51)％vs(11.27±1.18)％,increased mRNA levels of IL-8(2.49±0.11 vs 1.00±0.03),IL-1β(6.32±0.15 vs 1.00±0.03)and CXCL1(2.40±0.24 vs 1.00±0.04),but reduced proportion of Ki67 positive cells(5.95±1.55)％vs(27.38±7.00)％were observed in the etoposide group than the blank control group(P＜0.05).Low-dose NBP treatment decreased the ratio of SA-β-gal positive cells,P21 protein level,and mRNA level of IL-1β,and increased the proportion of Ki67 positive cells when compared with the etoposide group(P＜0.05).Conclusion NBP has an antagonistic effect on etoposide-induced se-nescence of vascular endothelial cells.
Objective To investigate the clinical value of serum soluble Axl receptor tyrosine ki-nase(sAxlTK)in evaluating short-term prognosis in patients with acute decompensated heart failure(ADHF).Methods A total of 238 elderly ADHF patients admitted to Bozhou People's Hospital from January 1,2018 to October 1,2021 were recruited and divided into poor prognosis group(45 patients)and good prognosis group(193 patients)according to the occurrence of com-plex events within 90 d of follow-up.Based on the optimal cut-off value of serum sAxlTK level,they were also assigned into high level group(80 cases)and low level group(158 cases).Serum levels of sAxlTK,troponin Ⅰ(cTnⅠ)and N-terminal B-type natriuretic peptide precursor(NT-proBNP)were detected.Results Serum sAxlTK level was significantly higher in the poor prognosis group than the good prognosis group[43.89(33.95,51.44)μg/L vs 23.89(18.73,33.92)μg/L,P＜0.01].Multivariate logistic regression analysis showed that serum cTnⅠ and sAxlTK levels were independent risk factors for short-term poor prognosis in ADHF patients(OR=1.922,95％CI:1.035-3.568,P=0.039;OR=1.021,95％CI:1.008-1.034,P=0.001).ROC curve analysis indicated that the AUC value of combined serum sAxlTK,cTnⅠ and NT-proBNP levels to predict short-term poor prognosis was 0.836(95％CI:0.778-0.895).The incidence of complex events within 90 d was significantly higher in the high level group than the low level group(45.0％vs 5.7％,P＜0.05).Kaplan-Meier curve analysis revealed that the cumulative inci-dence of complex events was also higher in the high level group than the low level group(X2=66.991,Plog rank＜0.01).The high level group had significantly lower overall survival rate and worse survival prognosis than the low level group(X2=16.899,Plog rank＜0.01).Conclusion High serum sAxlTK level in elderly ADHF patients at admission is associated with a higher risk of 90-day short-term poor prognosis.Serum sAxlTK has the potential to become a useful tool for early prediction of short-term poor prognosis,and its combination with cTnⅠ and NT-proBNP can fur-ther improve the accuracy of prognosis prediction.
Objective To explore the role of microRNA-145-5p(miR-145-5p)in the regulation of inflammatory response and oxidative stress process in cellular model of atherosclerosis.Methods Human monocytic leukemia THP-1 cells-derived foam cells were constructed in vitro.Then,the relative expression of miR-145-5p in the model and control groups of cells were detected by qRT-PCR.TargetScan database was used to predict the targeting relationship between miR-145-5p and Toll-like receptor 4(TLR4).The 293T cells were divided into wild-type+mimic group,wild-type+mimic negative control(NC)group,and mutant+mimic group,mutant+mimic NC group,and dual luciferase assay was employed to verify the targeting relationship of miR-145-5p and TLR4.Foam cells were cultured in vitro and divided into miR-145-5p mimic group,mimic NC group,miR-145-5p inhibitor group,and inhibitor NC group according to the corresponding treat-ments.The expression of TLR4 at mRNA and protein levels was detected by qRT-PCR and Wes-tern blotting.The contents of TNF-α,IL-1β and IL-6 were detected by ELISA.Biochemical reagent kits were applied for generation of reactive oxygen species(ROS),content of MDA and activity of SOD.Results The expression of miR-145-5p was significantly reduced in the model group than the control group(0.29±0.01 vs 1.00±0.08,t=11.180,P＜0.01).Dual luciferase assay showed that luciferase activity was significantly lower in the miR-145-5p mimic group than the mimic NC group(t=8.612,P＜0.01).Compared with the mimic NC group,the mimic group had obviously lower mRNA and protein levels of TLR4 and contents of TNF-α,IL-1β,lL-6,ROS and MDA,and higher miR-145-5p expression level and SOD activity(P＜0.05,P＜0.01).The treatment of inhibi-tor resulted in increased TLR4 mRNA and protein levels and TNF-α,IL-1β,IL-6,ROS and MDA contents,and decreased miR-145-5p expression and SOD activity when compared with the above levels in the inhibitor NC group(P＜0.05,P＜0.01).Conclusion MiR-145-5p inhibits inflamma-tion and oxidative stress in cellular model of atherosclerosis by targeting TLR4.
Objective To investigate the correlation between the total CSVD burden and fundus vasculopathy,and evaluate significance of fundus vasculopathy for cognitive impairment in CSVD patients.Methods A total of 290 inpatients who taking physical examination in our department from May 2021 to August 2022 were consecutively recruited,and according to their score of CSVD,they were divided into group 0(129 cases),group 1(51 case),group 2(42 cases),group 3(44 cases),and group 4(24 cases).All the subjects underwent brain magnetic resonance imaging,fundus fluorescein angiography,and cognitive function assessment.The total CSVD burden and fundus vasculopathy were evaluated.The general clinical data,results of laboratory tests,fundus vascularization,and cognitive function were compared among the groups with different CSVD burden scores.Spearman correlation analysis and linear correlation analysis were used to explore the correlation between total CSVD burden score and fundus vascular disease.Results Significant differences were observed in terms of age,years of education,cerebral infarction/TIA,total cho-lesterol,LDL-C,creatinine,MoC A and MMSE scores,positive results of connectivity test,digit-symbol conversion test,Stroop colour-word interference test and verbal fluency test,values of CRAE,CRVE,AVR,Scheie grade,DWMH and PVWMH,enlarged perivascular space in the basal ganglia(BG-EPVS),lacunar infarct and cerebral microbleeds(CMB)in different CSVD total bur-den groups(P＜0.05,P＜0.01).Spearman correlation analysis showed that total CSVD burden was negatively correlated with CRAE and AVR(r=-0.655,P=0.000;r=-0.679,P=0.000),and positively with CRVE and Scheie grade(r=0.560,P=0.000;r=0.685,P=0.000).Multivari-ate linear analysis showed that the total CSVD burden after adjusting for relevant risk factors was significantly correlated with CRAE,CRVE,AVR and Scheie grades(P＜0.01).Conclusion Fun-dus vasculopathy is strongly associated with increased total CSVD burden,and it can be regarded as a valid predictor of CSVD-related cognitive impairment.
