1.Association between the Non-Fasting Triglyceride-Glucose Index and Hyperglycemia in pregnancy during the Third Trimester in High Altitudes
Qingqing WANG ; Hongying HOU ; Ma NI ; Yating LIANG ; Xiaoyu CHEN ; WA Zhuoga DA ; Qiang LIU ; Zhenyan HAN
Journal of Sun Yat-sen University(Medical Sciences) 2025;46(5):861-871
ObjectiveTo investigate the relationship between the non-fasting triglyceride and glucose (TyG) index and hyperglycemia in pregnancy during the third trimester in high altitudes. MethodsThis study selected clinical and laboratory data of 774 Tibetan singleton pregnant women who delivered at Chaya People's Hospital of Qamdo city in Xizang autonomous region, from January 2023 to April 2025. The non-fasting TyG index was calculated from non-fasting triglyceride (TG) and random plasma glucose (PG). Based on the tertiles of the non-fasting TyG index values, the individuals were split into three groups (corresponding to non-fasting TyG index of 8.89 and 9.21, respectively). The baseline clinical characteristics, lipid levels and the occurrence of developing hyperglycemia in pregnancy were compared among the three groups. Statistical analyses were performed using ANOVA, Kruskal-Wallis H test, Chi-square test, or Fisher exact test and the relationship between the non-fasting TyG index and hyperglycemia in pregnancy were examined using multivariate logistic regression models and curve fitting. ResultsA total of 774 Tibetan singleton pregnant women were included, with a average age of 27.3 ± 6.1 years, a pre-delivery body mass index (Pre-BMI) of (25.2±2.3)kg/m2 , a proportion of 26.7% (207/774) primigravid women, the mean non-fasting TyG index was 9.1 ± 0.4。Thirty pregnant women were diagnosed with hyperglycemia in pregnancy, with a detection rate of 3.9% (30/774). Statistically significant differences in serum total cholesterol (TC), TG, low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) levels were identified when comparing different non-fasting TyG groups (all P values <0.05). Subsequent trend test analysis indicated that the levels of TC, TG, LDL-C, and PG gradually increased with elevated the non-fasting TyG index ( Ftrend TC=95.61, P<0.001; Ftrend TG=1 051.91, P<0.001; Ftrend LDL-C = 97.20, P < 0.001; Ftrend TG=195.20; P<0.001). After adjustment for maternal age, pre-delivery BMI, altitude, TC, LDL-C, and HDL-C, multivariate Logistic regression models revealed independent positive associations between non-fasting TyG index and hyperglycemia in pregnancy (Model 1: OR=2.72, 95% CI: 1.13-6.53, P=0.026; Model 2: OR=2.56, 95% CI: 1.01-6.50, P=0.048; Model 3: OR=2.72, 95% CI: 1.06-6.97, P=0.037; Model 4: OR=4.02, 95% CI: 1.42-11.40, P=0.009) and the incident of hyperglycemia in pregnancy showed an increasing tendency as increasing with the non-fasting TyG index, however, this association did not statistical significance (P trend >0.05). Curve fitting by restricted cubic splines (RCS) were used to assess linearity between non-fasting TyG and hyperglycemia in pregnancy, and there was a linear dose-response relationship between non-fasting TyG and hyperglycemia in pregnancy (P for non-linear = 0.515). ConclusionNon-fasting TyG index in the third trimester is a risk factor for hyperglycemia in pregnancy among the Tibetan singleton pregnant women at high altitudes and there was a possible linear dose-response relationship between the non-fasting TyG index and hyperglycemia in pregnancy.
2.Therapeutic role of miR-26a on cardiorenal injury in a mice model of angiotensin-II induced chronic kidney disease through inhibition of LIMS1/ILK pathway.
Weijie NI ; Yajie ZHAO ; Jinxin SHEN ; Qing YIN ; Yao WANG ; Zuolin LI ; Taotao TANG ; Yi WEN ; Yilin ZHANG ; Wei JIANG ; Liangyunzi JIANG ; Jinxuan WEI ; Weihua GAN ; Aiqing ZHANG ; Xiaoyu ZHOU ; Bin WANG ; Bi-Cheng LIU
Chinese Medical Journal 2025;138(2):193-204
BACKGROUND:
Chronic kidney disease (CKD) is associated with common pathophysiological processes, such as inflammation and fibrosis, in both the heart and the kidney. However, the underlying molecular mechanisms that drive these processes are not yet fully understood. Therefore, this study focused on the molecular mechanism of heart and kidney injury in CKD.
METHODS:
We generated an microRNA (miR)-26a knockout (KO) mouse model to investigate the role of miR-26a in angiotensin (Ang)-II-induced cardiac and renal injury. We performed Ang-II modeling in wild type (WT) mice and miR-26a KO mice, with six mice in each group. In addition, Ang-II-treated AC16 cells and HK2 cells were used as in vitro models of cardiac and renal injury in the context of CKD. Histological staining, immunohistochemistry, quantitative real-time polymerase chain reaction (PCR), and Western blotting were applied to study the regulation of miR-26a on Ang-II-induced cardiac and renal injury. Immunofluorescence reporter assays were used to detect downstream genes of miR-26a, and immunoprecipitation was employed to identify the interacting protein of LIM and senescent cell antigen-like domain 1 (LIMS1). We also used an adeno-associated virus (AAV) to supplement LIMS1 and explored the specific regulatory mechanism of miR-26a on Ang-II-induced cardiac and renal injury. Dunnett's multiple comparison and t -test were used to analyze the data.
RESULTS:
Compared with the control mice, miR-26a expression was significantly downregulated in both the kidney and the heart after Ang-II infusion. Our study identified LIMS1 as a novel target gene of miR-26a in both heart and kidney tissues. Downregulation of miR-26a activated the LIMS1/integrin-linked kinase (ILK) signaling pathway in the heart and kidney, which represents a common molecular mechanism underlying inflammation and fibrosis in heart and kidney tissues during CKD. Furthermore, knockout of miR-26a worsened inflammation and fibrosis in the heart and kidney by inhibiting the LIMS1/ILK signaling pathway; on the contrary, supplementation with exogenous miR-26a reversed all these changes.
CONCLUSIONS
Our findings suggest that miR-26a could be a promising therapeutic target for the treatment of cardiorenal injury in CKD. This is attributed to its ability to regulate the LIMS1/ILK signaling pathway, which represents a common molecular mechanism in both heart and kidney tissues.
Animals
;
MicroRNAs/metabolism*
;
Angiotensin II/toxicity*
;
Mice
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Renal Insufficiency, Chronic/chemically induced*
;
Mice, Knockout
;
Disease Models, Animal
;
Male
;
Signal Transduction/genetics*
;
LIM Domain Proteins/genetics*
;
Mice, Inbred C57BL
;
Cell Line
;
Humans
3.Chemical constituents from the leaves of Cinnamomum camphora var. linaloolifera and their anti-inflammatory activities.
Mei-Ting WU ; Shi-Yao LIU ; Da-Long HUANG ; Li-Na HE ; Mao GUO ; Lin NI ; Shuang-Quan ZOU
China Journal of Chinese Materia Medica 2021;46(14):3592-3598
Thirteen compounds were isolated and purified from the leaves of Cinnamomum camphora by the macroporous resin,silica gel,and Sephadex LH-20 column chromatographies. Those compounds were further identified by IR,UV,MS,and NMR techniques:( 2 S)-1-( 3″,4″-methylenedioxy phenyl)-3-( 2',6'-dimethoxy-4'-hydroxyphenyl)-propan-2-ol( 1),( 2 R,3 R)-5,7-dimethoxy-3',4'-methylenedioxy flavanol( 2),9-hydroxysesamin( 3),sesamin( 4),piperitol( 5),kobusin( 6),(-)-aptosimon( 7),acuminatolide( 8),1β,11-dihydroxy-5-eudesmene( 9),lasiodiplodin( 10),vanillin( 11),p-hydroxybenzaldehyde( 12),and p-hydroxybenzoic acid ethyl ester( 13). Compound 1 was a novel compound,and compounds 2,6,7,9 and 10 were isolated from Cinnamomum plants for the first time. Compounds 4,7 and 10 were found to possess good inhibitory effect on IL-6 production in LPS-induced BV2 cells at a concentration of 20 μmol·L-1 in the in vitro bioassay,with inhibition rates of 51. 26% ± 4. 13%,67. 82% ± 3. 77% and85. 81%±1. 19%,respectively.
Anti-Inflammatory Agents/pharmacology*
;
Cinnamomum
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Cinnamomum camphora
;
Plant Leaves
4.Efficacy comparison of primary percutaneous coronary intervention by drug-coated balloon angioplasty or drug-eluting stenting in acute myocardial infarction patients with de novo coronary lesions.
Da Peng ZHANG ; Le Feng WANG ; Yu LIU ; Kui Bao LI ; Li XU ; Wei Ming LI ; Zhu Hua NI ; Kun XIA ; Zhi Yong ZHANG ; Xin Chun YANG
Chinese Journal of Cardiology 2020;48(7):600-607
Objective: To compare the safety profile, angiographic and clinical outcomes between drug-coated balloon(DCB) only strategy versus drug eluting stent(DES) implantation in primary percutaneous coronary intervention(PCI) for acute myocardial infarction(AMI) patients. Methods: A total of 380 AMI patients who underwent primary PCI in Beijing Chaoyang Hospital from January 2016 to May 2019 were enrolled. They were allocated into DEB group(n=180) or DES group(n=200). The Primary endpoint was the major adverse cardiac events(MACE) in hospital and within 3 months after discharge, the composite event of cardiac death, non-fatal myocardial infarction(MI), target vessel revascularization(TVR) and in stent thrombosis. The secondary endpoints included: (1)TIMI blood flow grade and myocardial perfusion grade (TMP grade) of infarct-related vessels before and after PCI. (2)The degree of ST segment resolution(STR) between half hour and two hours after PCI, and STR was represented by percentage of summed ST-segment reduction between baseline and post-PCI. Using the most significant lead of ST segment elevation, calculating the rate of decline in the ST segment after treatment; or the most significant lead of the ST segment depression, to calculate the rate of recovery in the ST segment after treatment. STR<50% was defined as incomplete STR. (3)The occurrence of coronary artery dissection during operation. (4)The peak value of myocardial enzymes. (5)The incidence of bleeding in hospital and within 3 months after discharge. The inverse probability weighting method based on propensity score (IPTW) was used to compare the effects of the two treatments on MACE occurrence in the logistic regression model. Results: There was no significant difference in sex, age, risk factors of coronary heart disease, type and site of AMI, interventional therapy data(P>0.05) between the two groups. The ratio of bifurcation lesions in DCB group was significantly higher than that in DES group, and the diameter of the DCB was smaller while the length was longer than that of DES (all P<0.05). One death occurred in each group during hospitalization. Compared with the DES group, the incidence of MI [2.8%(5/180) vs. 0.5% (1/200), P=0.10] and TVR [2.8%(5/180) vs. 0.5%(1/200), P=0.10] in the DCB group during hospitalization showed an increasing trend, and were mostly associated with delayed coronary dissection. The incidence of MACE was similar between the two groups (3.3%(6/180) and 1.0%(2/200), P=0.15) during hospitalization. There was no MACE occurred in the two groups within 3 months after discharge. There was no significant difference between the two groups in TIMI grade, TMP grade, incomplete STR rate and peak value of myocardial enzyme (all P>0.05). The incidence of coronary artery dissection was significantly higher in DCB group than in DES group (8.3%(15/180) and 3.0%(6/200), P=0.02), but most of them were type B or A dissection and did not need special treatment. There was no significant difference in bleeding event between the two groups(P=0.91). Logistic regression analysis showed that there was no difference in the risk of MACE during hospitalization between DES and DCB groups for AMI patients receiving PCI (compared with DCB, OR=0.35, 95%CI 0.08-1.43, P=0.13). Conclusions: The initial safety and efficacy profiles of DCB are similar with those of DES for the AMI patients during PCI. The study highlights that the incidence of coronary dissection (type A or B) is higher post DCB treatment than post DES, but it does not affect blood flow. However, the incidence of in-hospital MI due to delayed coronary dissection trends to be higher post DCB. So we should pay close attention to the risk of delayed coronary dissection after DCB in AMI patients with de novo lesion.
Drug-Eluting Stents
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Humans
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Myocardial Infarction
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Percutaneous Coronary Intervention
;
Stents
;
Treatment Outcome
5.Influence of nifedipine combined metoprolol on blood pressure and heart rate in hypertensive patients with coronary heart disease
Jian-Ling ZHOU ; Da-Gao LI ; Hao NI ; Hai-Wen LIU
Chinese Journal of cardiovascular Rehabilitation Medicine 2018;27(6):692-696
Objective:To study influence of nifedipine combined metoprolol sustained release tablets on blood pressure and heart rate in hypertensive patients with coronary heart disease (CHD).Methods:A total of 120 hypertensive patients with CHD were selected,randomly and equally divided into nifedipine group (n=60,received nifedipine monotherapy) and combined treatment group (n=60,received nifedipine combined metoprolol ),both groups were treated for 12 weeks.Blood pressure,heart rate and indexes of heart rate variability (HRV) were measured and compared between two groups.Results:Compared with before treatment,after treatment,there were significant reductions in 24h mean heart rate (24h HR AV) and mean arterial pressure (MAP),P=0.001 both,and significant rise in standard deviation of normal to normal RR intervals calculated over the 24h period (SDNN),standard devia-tion of normal to normal RR intervals in all 5min segments of the entire recording (SDANN),root-mean square of differences between successive normal to normal intervals (rMSSD) and adjacent normal RR interval difference >50ms stroke accounted for a percentage of 24h total RR interval (PNN50) in two groups,P< 0.05 or < 0.01.Compared with nifedipine group after treatment,there were significant reductions in 24hmHR [ (69.24 ± 10.67) beats/min vs.(64.08 ± 8.94) beats/min] and MAP [ (98.06 ± 5.18) mmHg vs.(92.64 ± 4.43) mmHg,P<0.01 all],and significant rise in SDNN [ (113.89 ± 20.93) ms vs.(124.57 ± 25.34) ms,P<0.05],SDANN [ (108.31 ± 20.26) ms vs.(119.29 ± 19.37) ms,P=0.001],rMSSD [ (29.67 ± 11.92) ms vs.(36.23 ± 12.34) ms,P=0.001] and PNN50 [ (11.25 ± 4.03)% vs.(15.37 ± 4.82)%,P=0.001] in combined treatment group.There was no significant difference in total effective rate between two groups,P= 0.272.Conclusion:Nifedipine combined Metoprolol sustained release tablets possesses significant therapeutic effect on hypertensive patients with CHD.It can effectively control heart rate and blood pressure,and contribute to improving HRV and prognosis,which is worth extending.
6.Analysis of Factors Associated with Death in Maintenance Hemodialysis Patients: A Multicenter Study in China.
Kang-Kang SONG ; De-Long ZHAO ; Yuan-Da WANG ; Yong WANG ; Xue-Feng SUN ; Li-Ning MIAO ; Zhao-Hui NI ; Hong-Li LIN ; Fu-You LIU ; Ying LI ; Ya-Ni HE ; Nian-Song WANG ; Cai-Li WANG ; Ai-Hua ZHANG ; Meng-Hua CHEN ; Xiao-Ping YANG ; Yue-Yi DENG ; Feng-Min SHAO ; Shu-Xia FU ; Jing-Ai FANG ; Guang-Yan CAI ; Xiang-Mei CHEN
Chinese Medical Journal 2017;130(8):885-891
BACKGROUNDPatients on hemodialysis have a high-mortality risk. This study analyzed factors associated with death in patients on maintenance hemodialysis (MHD). While some studies used baseline data of MHD patients, this study used the most recent data obtained from patients just prior to either a primary endpoint or the end of the study period to find the characteristics of patients preceding death.
METHODSParticipants were selected from 16 blood purification centers in China from January 2012 to December 2014. Patients' data were collected retrospectively. Based on survival status, the participants were divided into two groups: survival group and the death group. Logistic regression analysis was performed to determine factors associated with all-cause mortality.
RESULTSIn total, 4104 patients (57.58% male, median age 59 years) were included. Compared with the survival group, the death group had more men and more patients with diabetic nephropathy (DN) and hypertensive nephropathy. The patients preceding death also had lower levels of diastolic blood pressure, hemoglobin, serum albumin, serum calcium, serum phosphate, Kt/V, and higher age. Multivariate analysis revealed that male sex (odd ratio [OR]: 1.437, 95% confidence interval [CI]: 1.094-1.886), age (OR: 1.046, 95% CI: 1.036-1.057), and presence of DN (OR: 1.837, 95% CI: 1.322-2.552) were the risk factors associated with mortality. High serum calcium (OR: 0.585, 95% CI: 0.346-0.989), hemoglobin (OR: 0.974, 95% CI: 0.967-0.981), albumin (OR: 0.939, 95% CI: 0.915-0.963) levels, and dialysis with noncuffed catheter (OR: 0.165, 95% CI: 0.070-0.386) were protective factors based on a multivariate analysis.
CONCLUSIONSHemodialysis patients preceding death had lower hemoglobin, albumin, and serum calcium levels. Multivariate analysis showed that male sex, age, DN, low hemoglobin, low albumin, and low serum calcium were associated with death in hemodialysis patients.
Adult ; Aged ; China ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Renal Dialysis ; adverse effects ; mortality ; Retrospective Studies ; Risk Factors
7.Regulatory effect of liraglutide on the expression of eNOS in the corpus cavernosum of diabetic rats.
Ling YUE ; Jin-ling XU ; Jing DONG ; Guang-da XJANG ; Lin XIANG ; Lin-shuang ZHAO ; Jun-xia ZHANG ; Zhen-yan ZHAI ; Guang-ping ZHU ; Min LIU ; Jing NI ; Yong WANG
National Journal of Andrology 2016;22(3):212-218
UNLABELLEDOCTOBER: To explore the effects of the glucagon-like peptide 1 (GLP-1) liraglutide on the penile erectile function of rats with diabetic erectile dysfunction (DED) by observing the impact of liraglutide on the expression of eNOS in the corpus cavernosum of diabetic rats.
METHODSWe randomly divided 30 six-week-old male SD rats into a normal control (n = 10) and an experimental group (n = 20) , established models of diabetes mellitus (DM) in the experimental rats, and subdivided them into a DM (n = 8) and a GLP-1 group (n = 8) to receive intramuscular injection of normal saline and liraglutide at 5 mg per kg of the body weight per day, respectively. After 12 weeks of intervention, we obtained the levels of FPG, FINS, TG, TC, HDL-C, LDL-C, testosterone, and IL-6 and the indexes of Homa-IR and Homa-β, detected the expressions of Akt/p-Akt and eNOS/p-eNOS in the corpus cavernosum by Western blot, and compared the erectile function between different groups.
RESULTSThe frequency and rate of penile erection were significantly lower in the DM group than in the GLP-1 and normal control groups (P < 0.05) and also lower in the GLP-1 group than in the normal controls (P < 0.05). Immunofluorescence staining showed the expression of eNOS mainly in the cytoplasm of the cavernosal vessels and sinusoidal endothelial cells, markedly lower in the DM and GLP-1 groups than in the normal rats (P < 0.05), but higher in the GLP-1 than in the DM group (P < 0.05). The level of eNOS/p-eNOS in the penile tissue was significantly decreased in the DM and GLP-1 groups in comparison with the normal controls (P < 0.01 or P < 0.05), while that of p-eNOS was markedly increased in the GLP-1 group as compared with the DM group (P < 0.05). No statistically significant differences were observed in the Akt level among the three groups of animals (P > 0.05). The expression of p-Akt was remarkably reduced in the DM and GLP-1 groups in comparison with the control rats (P < 0.01 or P < 0.05), but higher in the GLP-1 than in the DM group (P < 0.05).
CONCLUSIONGLP-1 can protect the function of endothelial cells in the corpus cavernosum and improve the erectile function of DED rats by regulating the Akt/ eNOS signaling pathway, which indicates that GLP-1 could be an important option for the treatment and prevention of DED.
Animals ; Blotting, Western ; Diabetes Mellitus, Experimental ; Erectile Dysfunction ; drug therapy ; enzymology ; Hypoglycemic Agents ; pharmacology ; Liraglutide ; pharmacology ; Male ; Nitric Oxide Synthase Type III ; metabolism ; Penile Erection ; drug effects ; Penis ; drug effects ; enzymology ; physiopathology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Testosterone ; blood
8.Nonsurgical correction of a severe anterior deep overbite accompanied by a gummy smile and posterior scissor bite using a miniscrew-assisted straight-wire technique in an adult high-angle case.
Xue Dong WANG ; Jie Ni ZHANG ; Da Wei LIU ; Fei Fei LEI ; Yan Heng ZHOU
The Korean Journal of Orthodontics 2016;46(4):253-265
In the present report, we describe the successful use of miniscrews to achieve vertical control in combination with the conventional sliding MBT™ straight-wire technique for the treatment of a 26-year-old Chinese woman with a very high mandibular plane angle, deep overbite, retrognathic mandible with backward rotation, prognathic maxilla, and gummy smile. The patient exhibited skeletal Class II malocclusion. Orthodontic miniscrews were placed in the maxillary anterior and posterior segments to provide rigid anchorage and vertical control through intrusion of the incisors and molars. Intrusion and torque control of the maxillary incisors relieved the deep overbite and corrected the gummy smile, while intrusion of the maxillary molars aided in counterclockwise rotation of the mandibular plane, which consequently resulted in an improved facial profile. After 3.5 years of retention, we observed a stable, well-aligned dentition with ideal intercuspation and more harmonious facial contours. Thus, we were able to achieve a satisfactory occlusion, a significantly improved facial profile, and an attractive smile for this patient. The findings from this case suggest that nonsurgical correction using miniscrew anchorage is an effective approach for camouflage treatment of high-angle cases with skeletal Class II malocclusion.
Adult*
;
Asian Continental Ancestry Group
;
Dentition
;
Female
;
Humans
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Incisor
;
Malocclusion
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Mandible
;
Maxilla
;
Molar
;
Overbite*
;
Torque
9.Set up drug lymphocyte stimulation test (3H-TdR) and observe its application in drug-induced liver injury.
Gao-yan CHEN ; Cheng-wei CHEN ; Qing-chun FU ; Xiao-jin WANG ; Liu-da NI ; Xiao-hua JIANG ; Feng ZHOU ; Li-qin SHI ; Rong-tao LAI ; Jun YANG
Chinese Journal of Hepatology 2012;20(3):190-192
OBJECTIVETo set up the drug lymphocyte stimulation test (DLST), as a diagnosis means for DILI which was immunity idiosyncrasy, improve the Diagnosis, level of DILI.
METHODFor the 59 patients who diagnosed as DILI, we separated their PBMC, exploring to the suspicious drug which caused DILI, then use the methods 3H-TdR to test, according to the mixed degree to clear the PBMC count which specific activated by drug.We also set up drug group, negative control and Positive control at the same time. Preliminary experiments was including the best dose of PHA and the best concentration of the drug. We set up 40 healthy group in our experiments as a control, and explore them on the same drug every time. We test the two groups at the same time. We handled the results use t-test.
RESULTSThe methods 3H-TdR could be exactly reflect the PBMC's proliferation degree nearly the same when they were be stimulation by PHA or the sensitive drug. When the DILI patients were explore to the suspicious drug, their stimulation index (SI) Obviously higher than 1.8. Form this test, there were 28 in 59 patients of DILI's group were positive (47.46%), SI was from 1.9 to 43.08, the average was 22.49, the healthy group SI was lower than 1.8, the SI of DILI's group was significantly higher than healthy group (5.78+/-0.75/1.16+/-0.25, P less than 0.05). Our test suggested DLST has Higher specificity (94.92%) and sensitivity (47.46%).
CONCLUSIONDLST was significance for the patients who diagnosed as immunity idiosyncrasy's DILI, it's reflected these patients' Proliferation of PBMC when explored to the suspicious drug for the second time.
Adolescent ; Adult ; Case-Control Studies ; Chemical and Drug Induced Liver Injury ; diagnosis ; Female ; Humans ; Leukocytes, Mononuclear ; Lymphocyte Activation ; Male ; Middle Aged ; Young Adult
10.Clinical analysis of 150 patients with idiopathic pulmonary arterial hypertension
Lin DONG ; Jian-Guo HE ; Guang-Liang SHAN ; Xian-Ling LU ; Wei-Jie ZENG ; Zhi-Hong LIU ; Da-Xin ZHOU ; Hua CAO ; Xin-Hai NI ; Guang-Yi WANG ; Jie-Yan SHEN ; Hong-Yan TIAN ; Yun-Juan SUN ; Qing GU ; Zhi-Hui ZHAO ; Xian-Sheng CHENC ; Chang-Ming XIONG
Chinese Journal of Cardiology 2012;40(8):657-661
Objective To explore the demographic characteristics and clinical features of patients with idiopathic pulmonary arterial hypertension ( IPAH ) in China.Methods Between March 2007 and September 2010,IPAH diagnosis was confirmed by right heart catheterization in 150 adult patients from 31 clinical centers in China.Clinical and hemodynamic data were analyzed and patients were divided into WHO functional class Ⅰ / Ⅱ and WHO functional class Ⅲ/Ⅳ group.Results The mean age of 150 patients were 36 ± 13 years with female patient/male patient ratio of 2∶1,and mean BMI was ( 21.3 ± 3.5 ) kg/m2.Fatigue (n =123,82.0% ) and dyspnea ( n =112,74.7% ) are the most common symptoms.Accentuated pulmonic second sound ( P2 ) was detected in 92.0% ( n =138 ) of patients during physical examination,which was also the most common sign.About 49.0% ( n =73 ) patients were WHO functional class Ⅰ/ Ⅱ patients and 46.0% ( n =68 ) patients were WHO functional class Ⅲ/Ⅳ patients. Six minutes walking distance (6MWD) and Borg dyspnea score was (337 ± 101 ) m and 2.0 (2.0,4.0),respectively.Right ventricular hypertrophy was suggested by ECG in 93.1% ( n =140 ) patients.Right atrial pressure was (10 ±6) mm Hg,mean pulmonary artery pressure was (61 ±16) mm Hg,cardiac index was (2.3 ±0.8)L · min-1 · m-2 and pulmonary vascular resistance(1484 ±699) dyn · s-1 · cm-5 in this cohort.6 MWD (305 m ±89 m vs.377 m ±88 m) was significantly shorter while Borg dyspnea score [3.0 (3.0,5.0) vs.2.0 (2.0,3.0) ] was significantly higher in WHO functional class Ⅲ/Ⅳ patients than in WHO functional class Ⅰ/Ⅱ patients. Similarly hemodynamic parameters were also worse in WHO functional class Ⅲ/Ⅳ patients than in WHO functional class Ⅰ / Ⅱ patients ( all P < 0.05).Conclusion Idiopathic pulmonary arterial hypertension patients in this cohort affect mostly young adults,dominated by female gender and lower body mass index. Fatigue and dyspnea are the most common symptoms and accentuated pulmonic second sound ( P2 ) is the most common sign.IPAH patients are often displaying severe functional and hemodynamic disturbance at first visit to hospitals.Dyspnea and hemodynamic impairment are related to 6MWD and WHO functional class.

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