Objective To analyze the risk factors for the occurrence of coronary slow flow(CSF)and to construct a predictive nomogram for the occurrence of CSF.Methods Totally 103 patients with CSF diagnosed by CAG examination were recorded as the CSF group.A total of 121 patients with normal blood flow in the same period were selected as the con-trol group.The following data of the two groups were collected:age,gender,smoking history,drinking history,body mass index(BMI),blood pressure,past medical history and other basic information,blood potassium,blood sodium,blood phosphorus,blood magnesium,urea nitrogen,creatinine,uric acid,blood glucose,albumin,globulin,creatine ki-nase,creatine kinase isoenzyme,triglycerides,total cholesterol,free fatty acids,low-density lipoprotein(LDL),high-density lipoprotein(HDL),lipoproteins,leukocytes,monocytes,lymphocytes,neutrophils,hemoglobin,red blood cells,red blood cell volume,red blood cell width,hematocrit,platelets,platelet volume,platelet distribution width,D-dimer and other laboratory test information,end-diastolic volume(EDV),end-systolic volume(ESV),stroke volume(SV),ejection fraction(EF),fractional shortening(FS)and other cardiac ultrasound examination results,the percentage of adjacent RR intervals≥50 ms(PNN50),mean standard deviation of normal RR intervals per 5 min(SDNNI),stan-dard deviation of average RR interval(SDNN),root mean square difference of consecutive normal RR intervals(RMS-SD),standard deviation of the mean of all NN intervals within 5 min(SDANN),standard deviation of adjacent NN inter-vals(SDSD),triangular index(TI)and other indexes related to heart rate variability.The indexes with statistical differ-ences in univariate analysis were included in least absolute shrinkage and selection operator(LASSO)regression and multi-variate Logistic regression analysis using the"glmnet"package of R statistical software to screen characteristic variables and analyze the risk factors for CSF.The"rms"package of R statistical software was used to construct a prediction nomo-gram for CSF.The ROC curve of the nomogram was drawn to evaluate the discrimination of the nomogram.The calibration curve was used to evaluate the consistency of the nomogram.The clinical decision curve was used to evaluate the clinical value of the nomogram.Results There were statistically significant differences in the smoking history,hypertension,systolic blood pressure,diastolic blood pressure,BMI,uric acid,blood sugar,triglycerides,total cholesterol,LDL,HDL,lymphocytes,EDV,ESV,EF,FS,PNN50,RMSSD,SDSD,SDNN,SDANN,age,blood sodium,blood magne-sium,neutrophils,red blood cell width,D-dimer,and TI between the CSF group and the control group(all P<0.05).The results of LASSO regression and multivariate Logistic regression analysis showed that smoking,systolic blood pres-sure,triglycerides,lymphocytes,SDNN,and EF were independent risk factors for the occurrence of CSF(all P<0.05).Based on this,a prediction nomogram for the occurrence of CSF was constructed,and the nomogram had good discrimina-tion,consistency,and clinical value.Conclusions Smoking,systolic blood pressure,triglycerides,lymphocytes,SDNN,and EF are independent risk factors for the occurrence of CSF.The prediction nomogram constructed based on the above risk factors has a high predictive value for the occurrence of CSF.
Objective To observe the changes in vitamin D receptor(VDR)gene polymorphisms and serum 25-hy-droxyvitamin D(25(OH)D)levels in patients with Parkinson's disease(PD),and to analyze their correlations with the on-set of PD and their predictive efficiency on the onset of PD in order to clarify the significance of VDR gene polymorphisms and changes in serum 25(OH)D levels.Methods Totally 178 PD patients(PD group)and 185 healthy subjects(control group)during the same period were included.PCR and DNA sequencing methods were used to detect the genotyping of VDR gene FokI(rs2228570)and BsmI(rs1544410)sites,and enzyme-linked immunosorbent assay was used to detect pe-ripheral serum 25(OH)D.The above indicators between the two groups were compared.Multivariate Logistic regression was used to analyze the independent risk factors for the onset of PD;ROC was used to analyze the predictive efficacy of vita-min D receptor gene polymorphisms and serum 25-hydroxyvitamin D levels for the onset of PD.Results The frequencies of T allele and TT genotype of FokI site in the PD group were 48.6%and 25.3%respectively,and 37.7%and 15.1%in the control group,respectively.Comparing the two groups,χ2 were 8.516 and 10.383,respectively,and P were 0.004 and 0.001,respectively.There were no statistically significant differences in the alleles or genotypes of the BsmI locus between the PD group and the control group(all P>0.05).The serum 25(OH)D level in the PD group was(16.06±6.04)ng/mL,and that in the control group was(19.22±6.32)ng/mL(t=-4.873,P=0.000).The serum 25(OH)D levels of patients with TC type and CC type in the PD group were lower than those in the control group(t=-3.093,3.329,respectively;P= 0.002,0.001,respectively).When the serum 25(OH)D levels were consistent,patients with genotypes TT and TC were 2.527 and 1.888 times more likely to develop PD than patients with genotype CC,respectively(all P<0.05).When the genotypes were consistent,patients with deficient serum 25(OH)D level were 1.918 times more likely to develop PD than those with sufficient level(P<0.05).As for genotype TT patients with 25(OH)D deficiency,and genotype TC patients with 25(OH)D deficiency,their risks of developing PD were 4.818 and 3.822 times that of genotype CC patients with sufficient 25(OH)D,respectively(all P<0.05).The AUC under ROC of FokI locus genotype TT in predicting the onset of PD was 0.610,95%CI was 0.532-0.687,the diagnostic cut-off value was 0.502,the sensitivity was 74.5%,and the specificity was 47.4%;The AUC under the ROC of lack of serum 25(OH)D level in predicting the onset of PD was 0.576,the 95%CI was 0.517-0.635,the diagnostic cut-off value was 0.466,the sensitivity was 72.5%,and the specificity was 42.7%,re-spectively;the AUC under ROC of genotype TT combined with serum 25(OH)D deficiency in predicting the onset of PD was 0.693,95%CI was 0.588-0.798,the sensitivity was 64.2%,and the specificity was 74.5%,respectively.Conclu-sions The frequencies of the T allele and TT genotype at the FokI site of the VDR gene are high,and the serum 25(OH)D level is low;the T allele at the FokI site and vitamin D deficiency can promote the occurrence of PD individually or together,and both of them have poor predictive efficiency for the risk of PD onset.
Objective To investigate the clinical value of joint detection of six tumor markers in patients with colorectal cancer. Methods Eighty?six patients with colorectal cancer were included in the study group,86 healthy subjects were selected as the control group at the same period. The difference of tumor markers in different groups,tumor stages and prognosis were compared. Results The levels of carcinoembryonic antigen (CEA),carbohydrate antigen 19?9 (CA19?9),carbohydrate antigen 242 (CA242),carbohydrate antigen 72?4 ( CA72?4) , carbohydrate antigen 125 ( CA125 ) and carbohydrate antigen 50 ( CA50 ) in study group were significantly higher than those in the control group (CEA: (22. 5±6. 2)μg/L vs. (2. 2±1. 0)μg/L;CA19?9:(95. 7±27. 3) U/ml vs. (17. 1±9. 5) U/ml;CA242:(29. 5±8. 3) U/ml vs. (6. 0±2. 7) U/ml;CA72?4:(21. 6 ±5. 1) U/ml vs. (3. 6±1. 2) U/ml;CA125:(95. 4±32. 8) U/ml vs. (18. 9±8. 4) U/ml;CA50:(51. 8±20. 6)μg/L vs. (8. 3±3. 7)μg/L,t=29. 98,25. 22,24. 97,31. 86,20. 95,19. 27,P<0. 05). Among the single index detections,the sensitivity and negative predictive value of CA72?4 were the highest ( 61. 6%, 68. 3%) , the specificity of CA19?9 was the highest( 91. 9%) ,the positive predictive value of CEA was the highest ( 80. 4%) . The sensitivity,positive predictive value and negative predictive value of the joint detection were all higher than those in each single index detection (80. 3%,87. 3%,74. 1%). The levels of CEA,CA19?9,CA242,CA72?4, CA125 and CA50 in patients with stage III and IV were significantly higher than those in patients with stageⅠandⅡ(CEA:(32. 7±7. 1)μg/L vs. (15. 9±4. 4)μg/L;CA19?9:(127. 8±33. 7) U/ml vs. (52. 5±13. 8) U/ml;CA242:(40. 3±12. 7) U/ml vs. (23. 5±8. 6) U/ml;CA72?4:(37. 6±10. 2) U/ml vs. (13. 6±4. 1) U/ml;CA125:(128. 9±38. 4) U/ml vs. (59. 7±12. 8) U/ml;CA50:(88. 3±23. 7)μg/L vs. (41. 8±15. 6)μg/L,t=13. 04,13. 32,7. 11,14. 06,10. 99,10. 64,P<0. 05) . The levels of CEA,CA19?9,CA242,CA72?4,CA125 and CA50 in the recurrent metastasis group were significantly higher than those in the non?recurrent metastasis group ( CEA:( 37. 7 ± 8. 6 ) μg/L vs. ( 3. 8 ± 1. 7 ) μg/L;CA19?9:( 110. 5 ± 29. 4 ) U/ml vs. ( 25. 5 ± 13. 8 ) U/ml;CA242:( 33. 6 ± 10. 3 ) U/ml vs. ( 15. 5 ± 6. 6 ) U/ml;CA72?4:( 33. 1 ± 15. 3 ) U/ml vs. ( 9. 3 ± 3. 0 ) U/ml;CA125:(113. 4±31. 7) U/ml vs. (28. 7±7. 8) U/ml;CA50:(55. 4±14. 6)μg/L vs. (16. 8±9. 6)μg/L,t=29. 04,18. 31,9. 86,11. 47,19. 28,14. 65,P<0. 05) . Conclusion The joint detection of six markers can further improve the sensitivity, positive predictive value and negative predictive value of diagnosis, and can provide a more reliable basis for the auxiliary diagnosis of colorectal cancer.
Objective To observe the expression changes of hsa_circ_0131457 in the pancreatic cancer tissues,and to investigate the effects of hsa_circ_0131457 overexpression on the proliferation,apoptosis,migration,invasion and other biological behaviors of pancreatic cancer cells.Methods Seven cases of pancreatic cancer tissues and 7 cases of matched normal adjacent normal tissues were collected from pancreatic cancer cells PANC-1,SW1990,CFPAC-1,and normal pancreatic duct epithelial cells HPDE6-C7 in the logarithmic growth phase.The expression of hsa_circ_0131457 was detected by real-time fluorescence quantitative PCR.The pancreatic cancer cells with the lowest expression of hsa_circ_0131457 were divided into the overexpression group and control group,which were transfected with hsa_circ_0131457 over-expression plasmid and control plasmid by liposome transfection method,respectively.After transfection,OD values of cells in the two groups were detected by CCK-8 method at 0,24,48,72 and 96 h,apoptosis rate was detected by TUNEL staining method,cell migration distance was recorded by cell scratch test,and the number of transmembrane cells was re-corded by Transwell chamber test.The relative expression levels of apoptosis-related protein cyclin D2(CCND2)and cy-clin dependent kinase 4(CDK4)were detected by Western blotting.Results The relative expression levels of hsa_circ_0131457 in the pancreatic cancer tissues and adjacent normal tissues were 0.011±0.017 and 2.084±2.287,with statisti-cally significant difference(P＜0.05).The relative expression levels of hsa_circ_0131457 in PANC-1,SW1990 and CF-PAC-1 cells were 0.123±0.110,0.159±0.082 and 0.141±0.129,respectively;all of them were lower than that of nor-mal pancreatic ductal epithelial cells(1.174±0.839)(all P＜0.05).Therefore,the pancreatic cancer cells PANC-1 with the lowest expression of hsa_circ_0131457 was used for follow-up study.There were no significant differences in OD values between the two groups at 0 and 24 h(all P＜0.05),and the OD values of the overexpression group were lower than those of the control group at 48,72 and 96 h(all P＜0.05).The apoptosis rate of the overexpression group was higher than that of control group,the cell migration distance was shorter and the number of transmembrane cells was smaller than those of the control group(all P＜0.05).The relative expression levels of CCND2 and CDK4 protein in the overexpression group were higher than those in the control group(all P＜0.05).Conclusions The expression of hsa_circ_0131457 decreases in both pancreatic cancer tissues and cells.Overexpression of hsa_circ_0131457 can inhibit the proliferation,migration and inva-sion of pancreatic cancer cells,and promote apoptosis by up-regulating the expression of CCND2 and CDK4.
目的 观察冠心病患者经皮冠状动脉介入治疗(PCI)前后的心肌灌注情况,并探讨其与近期预后的关系.方法 选取经冠脉造影检查确诊的冠心病患者102例,均行PCI手术.患者分别于术前及术后3个月,应用PHILIPS EPIQ 7C超声诊断仪进行实时心肌超声造影(RTMCE)检查评价心肌灌注情况,记录前壁、下壁、侧壁曲线上升平台期的平均斜率(β)、心肌显峰强度(A)、局部心肌血流量(MBF).记录患者PCI术后6个月心血管不良事件(MACE)发生情况,采用Logistic多因素回归分析术后3个月RTMCE参数对冠心病患者PCI术后6个月发生MACE的影响,绘制其预测冠心病患者PCI术后6个月发生MACE的受试者工作特征(ROC)曲线,比较其预测价值.结果 患者PCI术后3个月前壁、下壁、侧壁的β、A、MBF均较术前升高(P均＜0.05).102例冠心病患者PCI术后6个月发生MACE 15例(14.7%).发生MACE者术后3个月前壁、下壁、侧壁的β、A、MBF均低于未发生MACE者(P均＜0.05).Logistic回归分析结果显示,术后3个月β、A、MBF降低均是冠心病患者PCI术后6个月发生MACE的独立危险因素(P均＜0.05).曲线下面积:侧壁A＞下壁β＞侧壁MBF＞侧壁β＞下壁A＞前壁A＞前壁β＞前壁MBF＞下壁MBF;当侧壁A≤8.75 dB时,其预测冠心病患者PCI术后6个月发生MACE的敏感度为86.67%、特异度为73.56%.结论 冠心病患者PCI术后心肌灌注情况改善,其前壁、下壁、侧壁RTMCE参数β、A、MBF均升高,上述指标降低与患者术后6个月MACE的发生有关,侧壁A对于患者近期预后具有较高的预测价值.
