Objective To evaluate the clinical outcomes of patients complicated with major bleeding after primary coronary intervention (PCI) for acute ST-segment elevation myocardial infarction (STEMI). Methods During the period of January 2004-January 2008, primary PC1 was performed in 412 consecutive patients with acute STEMI at Shanghai Ruijin Hospital. The clinical data were retrospectively analyzed. Major adverse cardiac events (MACE), including death, reoccurrence of myocardial infarction and target vessel revascularization, in patients with major bleeding were compared with that in patients without major bleeding. Results Compared to patients without bleeding, the patients with bleeding were older (70.0 ± 8.9 years vs 64.9 ± 12.7 years, P = 0.04), mainly the females (51.9% vs 23.1%, P = 0.001) and treated more often with glycoprotein (GP) Ⅱb/Ⅲa receptor inhibitor (88.9% vs 69.4%, P = 0.03) or intra-aortic balloon pump (7.4% vs 1.3%, P = 0.02). In-hospital and one-year MACE rate in the patients with bleeding was 18.5% and 37.0% respectively, which were significantly higher than that in the patients without bleeding (5.7% and 14.3%, with P = 0.008 and P = 0.002, respectively). Multivariate analysis indicated that patient aged over 70 years, feminine gender and use of GP Ⅱb/Ⅲa receptor inhibitor were independent predictors for the occurrence of major bleeding. The occurrence of major bleeding after primary PCI was significantly correlated with MACE occurred within one year after the procedure (OR 2.79, 95% CI: 2.21-5.90, P < 0.001). Conclusion In patients with acute STEMI, the occurrence of major bleeding after primary PCI is closely linked to the increased MACE rate within one year after the treatment. Feminine gender, aged patient and use of GP Ⅱb/Ⅲa receptor inhibitor are independent predictors to increase the danger of major bleeding.

Aged, 80 and over ; Aortic Aneurysm, Abdominal ; surgery ; Arteriosclerosis Obliterans ; surgery ; Blood Vessel Prosthesis Implantation ; methods ; Humans ; Male

Objective To evaluate the influnce of atrial fibrillation(AF)/atrial flutter on the mortality and prognosis of patients with AMI. Methods A total of 297 consecutive patients were studied from Jan.2001 to Dec. 2005 and were categorized into 2 groups according to the presence or absence of AF/atrial flutter. The 30 d and 6 mo mortalities, Killip Grades, cardiogenic shock, arrhythmia and left ventricular ejectory functional (LVEF) 6 months after AMI with Doppler US between the 2 groups were compared. Results The incidence of AF/atrial fluttler was 12.5% with older age, higher Killip Gorade, higher CPK peak, higher rates of previous myocardial infarction and multivascular involvement than those without AF/atrial flutter. The short and medium-term mortalities in AF/atrial flutter group were both significantly higher than those of non-AF/atrial flutter group(P

OBJECTIVE:To provide methodological reference for converting non-utility scale measurement results into health utility values. METHODS:Referring to domestic and foreign literatures,mapping methods and relevant models in health utility measurement were summarized. The effect of each model on probability mapping was introduced by taking the Medical outcomes study 12-item short form health survey measurement results converting into the EuroQol group's 5-domain utility values as exam-ple.RESULTS:The mapping methods can be adopted to obtain the health utility values by establishing the mapping relationship be-tween non-utility scale and utility scale. The common models included ordinary least square(OLS)model,censored least absolute deviations(CLAD)model,Tobit model,multinomial Logistic regression(MNL)model,Bayesian networks(BN)model,etc. OLS model was relatively simple with a good predictive validity,but it would be limited by the ceiling effect;Tobit model was not limit-ed by the ceiling or floor effect,when the error term satisfied the variance homogeneity and normality,prediction result of Tobit model was better than OLS model;CLAD model can be used for the situation of Tobit model unsuitable for non-variance homoge-neity of the error term;MNL model firstly determined a health state by regression analysis and then determined its utility value;the prediction validity of BN model was good and it didn't involved many assumptions and restrictions condition in econometrics, but the construction of BN model was greatly influenced by domain experts. Main methods for the calculation of health utility value with MNL or BN model were Monte Carlo simulation method,expected-utility method,most-likely probability methed,etc. We can carry out the model performance evaluation by using the R2,the adjusted R2,the mean error,the mean squared error and the mean absolute error,and then select the optimal model to calculate health utility values. CONCLUSIONS:Due to the advantages and disadvantages of each mapping model,it is necessary to select different mapping models based on the actual conditions.

Objective To evaluate the effect of sevoflurane on activities of Na+-K+-ATPase and Ca2+-ATPase in the hippocampus of diabetic rats.Methods SPF healthy male Wistar rats,aged 8 weeks,weighing 180-200 g,were fed a high-fat diet for 3 consecutive weeks and streptozotocin was intraperitoneal-ly injected to induce type 2 diabetes mellitus.Forty-four rats with diabetes mellitus were divided into 2 groups (n=22 each) using a random number table:diabetic group (D group) and sevoflurane group (S group).Another 22 healthy Wistar rats,aged 8 weeks,weighing 180-200 g,served as control group (C group).Oxygen was inhaled for 2 h in C and D groups,and 2.4％ sevoflurane was inhaled for 2 h in S group.Eight rats were sacrificed at 30 min after treatment,brains were removed and hippocampi were isolated for measurement of Na+-K+-ATPase and Ca2+-ATPase activities in hippocampal tissues by spectrophotometry.Ten rats were randomly selected at 1 day after treatment,and Morris water maze test was performed to assess the cognitive function.Four rats were randomly sacrificed,brains were removed and hippocampi were isolated for examination of the mitochondrial ultrastructure with a transmission electron microscope.Results Compared with group C,the escape latency was significantly prolonged,the number of crossing the original platform was reduced,the percentage of time of staying at the original platform quadrant was decreased,the activities of Na+-K+-ATPase and Ca2+-ATPase in hippocampi were decreased (P＜ 0.05),and mitochondrial swelling and decreased mitochondrial cristae were observed under the electron microscope in group D.Compared with group D,the escape latency was significantly prolonged,the number of crossing the original platform was reduced,the percentage of time of staying at the original platform quadrant was decreased,the activities of Na+-K+-ATPase and Ca2+-ATPase in hippocampi were decreased (P＜ 0.05),and mitochondrial swelling and vacuolization were found under the electron microscope in group S.Conclusion The mechanism by which sevoflurane aggravates cognitive dysfunction is related to deceasing activities of Na+-K+-ATPase and Ca2+-ATPase in the hippocampus of diabetic rats.

Objective:To explore the value of color Doppler ultrasound scanner in screening peripheral artery atherosclerosis(AS)of undergraduates on campus.Methods:From June 2020 to June 2022,a total of 300 college student volunteers were selected from Sichuan University of Arts and Sciences and Dazhou Vocational and Technical College,and they were divided into peripheral AS group(59 cases)and healthy control group(241 cases)according to the occurrence of peripheral AS.The general data and blood flow parameters of the two groups were compared,and the risk factors of peripheral AS of undergraduates on campus were further analyzed.Results:The differences of the gender,hyperglycemia rate,hypertension rate,smoking history rate,triglycerides(TG),total cholesterol(TC)and high-density lipoprotein cholesterol(HDL-C)between the AS group and the healthy control group were not statistically significant(P>0.05).The differences of age,obesity rate,hyperlipidemia rate and low-density lipoprotein cholesterol(LDL-C)between AS group and healthy control group were statistically significant(t=6.666,x2=4.256,5.292,t=4.515,P<0.05),respectively.The maximum blood flow velocity(Vmax)and minimum blood flow velocity(Vmin)of the AS group were lower than those of the healthy control group,with statistically significant differences(t=-3.753,-3.905,P<0.05).The resistance index(RI)of the AS group was higher than that of the healthy control group,with statistically significant differences(t=3.126,P<0.05).The dependent variable of the AS group was assigned a value of 1,and the healthy control group was assigned a value of 0.The factors with P<0.05 in univariate analysis were used as independent variables.The multiple factor binary logistic analysis showed that age and high LDL-C were risk factors for peripheral AS(OR=1.664,1.192,P<0.05),while high Vmax and high Vmin were protective factors for peripheral AS(OR=-0.102,-0.170,P<0.05),respectively.Conclusion:The higher the LDL-C level,the lower the Vmax and Vmin,are the higher risks of undergraduates who occur peripheral AS.The LDL-C and ultrasonic blood flow parameters(Vmax and Vmin)can be used to assist the diagnosis about whether occurs peripheral AS.

OBJECTIVETo explore the prevalence and the different risk factors for asthma in children between urban and rural areas in Fuzhou, Fujian province.

METHODThe epidemiological survey of asthma in 0-14 years old children was conducted from October 2009 to October 2010 between Fuzhou urban and rural areas in Fujian province. The investigation subjects were selected in urban and rural areas by phased stratified random cluster sampling. The 2010 third national epidemiological survey questionnaire of children with asthma was used for screening for possible patients. Diagnosis of asthma was confirmed by physical examination. The children with asthma were designated as the positive cases, while non asthmatic children who were age, gender, ethnic, and living environment matched with asthmatic patients were designated as negative control. Comparison of the prevalence of asthma in children between Fuzhou urban and rural areas was performed. The influencing factors of asthma were analyzed and screened by the regression equation model of two element Logistic regression.

RESULTTotally 12 235 questionnaires of children with asthma and allergic disease screening were issued and 11 738 questionnaire were sent back (6 221 were male and 5 517 were female). The return rate was 95.9% in urban Fuzhou; 648 children were diagnosed as asthma. The prevalence of asthma in male was 6.48% and female children was 4.44% (comparison of the prevalence of gender χ(2) = 23.267, P < 0.001) in urban areas . A total of 6 000 questionnaires of children with asthma and allergic disease screening were sent out and 5 860 were responded (male children 3 228, female children 2 632). The recovery rate was 97.7% in rural Fuzhou; 135 children with asthma was diagnosed. The prevalence of asthma in male was 2.73%and female children and was 1.79%. Adding protein supplement before 6 months (OR = 1.908, 95%CI:1.233-2.959), the use of antibiotics in the treatment of asthma (OR = 14.541, 95%CI:8.920-23.705), furniture materials (non wood) (OR = 2.432, 95%CI:1.563-3.785) were the main risk factors of children with asthma in urban. Adding protein supplement before 6 months(OR = 3.021, 95%CI:1.357-6.711), the use of antibiotics in the treatment of asthma(OR = 14.784, 95%CI:3.842-56.885), the use of coal as fuel (OR = 63.339, 95% CI: 7.993-501.943), domesticated livestock (OR = 13.659, 95% CI:1.342-139.068), the family smoking before and after birth (OR = 6.226, 95%CI:2.674-14.495) and chemical fiber pillow (OR = 3.638, 95%CI:1.241-10.666) were the main risk factors of children with asthma in rural areas.

CONCLUSIONThe prevalence of children with asthma in urban areas was higher than that in rural areas. The prevalence of asthma in male children was higher than in female children. Adding protein food supplement before 6 months, the use of antibiotics and non solid wood furniture material were the main risk factors in children with asthma in urban areas. Adding protein supplement before 6 months, the use of antibiotics, domesticated livestock, the use of coal as fuel and the family smoking before and after birth were the main risk factor of asthma in children in rural areas.

Adolescent ; Anti-Bacterial Agents ; administration & dosage ; adverse effects ; Asthma ; epidemiology ; etiology ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Logistic Models ; Male ; Prevalence ; Risk Factors ; Rural Population ; statistics & numerical data ; Sampling Studies ; Smoking ; adverse effects ; Surveys and Questionnaires ; Urban Population ; statistics & numerical data

Objective To establish a method for measurement of ²³⁹Pu in fecal samples based on inductively coupled plasma-mass spectrometry (ICP-MS), and to provide a novel method for assessing the internal exposure of workers. Methods Fecal samples were collected from workers and labeled. The samples were pretreated with carbonization ashing and microwave digestion devices, purified on TEVA resin, and measured using ICP-MS. Results The detection limit of ²³⁹Pu in fecal samples based on ICP-MS was 1.91 × 10⁻⁴ Bq. Conclusion In the routine monitoring of class S substances characterized by a 5 μm aerodynamic diameter during 12 months, the committed effective dose corresponding to the detection limit is 0.17 mSv. This value meets the requirements of relevant national standards and ICP-MS can be used as a novel means for accurate evaluation of internal exposure for workers.

Objective:To investigate the clinical profile of primary bilateral macronodular adrenal hyperplasia(PBMAH) and sex difference.Methods:One hundred and forty cases of PBMAH were recruited in our center from 2014, and all patients were evaluated for hormone secretion, adrenal imaging, and metabolic parameters.Results:Overt Cushing′s syndrome accounted for 76.4% of PBMAH cohort and 47.9% were female. The overt group had higher serum cortisol and 24 h urinary free cortisol levels, lower adrenocorticotropic hormone, higher serum cortisol after low-dose dexamethasone suppression tests, larger total adrenal size, and a higher percentage of obesity, hypertension, diabetes mellitus, and hypokalemia than the subclinical group(all P<0.05). When compared with the male group, the female group had smaller adrenal size( P<0.001), lower HbA 1C( P=0.003), higher total cholesterol( P=0.005), and lower density lipoprotein-cholesterol levels( P=0.035). Further, 24 h urinary free cortisol in the male group was found to be positively correlated with diastolic blood pressure, fasting glucose, 2 h postprandial glucose after oral glucose tolerance test(OGTT), and HbA 1C after adjusted for age, body mass index, and onset duration, and was negatively correlated with body mass index and potassium levels. While 24 h urinary free cortisol in the female group was positively correlated only with diastolic blood pressure, fasting glucose, and 2 h postprandial glucose after OGTT(all P<0.05). During follow-up, 80.0% of patients achieved remission after unilateral adrenalectomy, with a recurrence rate of 17.9%. Conclusion:PBMAH related metabolic disorder is more pronounced in overt Cushing′s syndrome and males. Unilateral adrenalectomy as an effective treatment can benefit the majority of patients.