1.Analysis of prognostic risk factors in elderly patients with acute coronary syndrome
Chinese Journal of Geriatrics 2011;30(6):460-463
Objective To explore short-term prognosis of patients with acute coronary syndrome (ACS) and prognostic risk factors, and to provide information for prognostic risk assessment. Methods A total of 156 patients with acute coronary syndrome were enrolled. The correlations of baseline characteristics with 30-day improvement, death, angina pectoris and heart failure were analyzed using unordered multivariate logistic regression. Results Logistic regression analysis showed that the independent risk factors for 30-day death included age (OR=1.20, 95%CI: 1.07-1.34), diabetes (OR=19.41, 95%CI: 3.02-124.70), leukocytosis (OR=11.36, 95%CI: 1.87-69.11) and increased platelet (OR=7.72, 95%CI: 1.29-46.15). The independent risk factors for 30-day angina pectoris included leukocytosis (OR=2.35, 95%CI: 0.89-6.17) and dyslipidemia (OR=6.25, 95%CI: 2.11-18.48). The independent risk factors for the occurrence of heart failure during 30-day post-ACS included age (OR=1.10, 95%CI: 1.03-1.17), male (OR=4.18, 95%CI: 0.81-21.51), leukocytosis (OR=2.97, 95%CI: 1.09-8.14) and dyslipidemia (OR=7.69, 95%CI: 2.39-24.76). Conclusions Age, diabetes, leukocytosis and increased platelet are independent risk factors associated with 30-day death; Leukocytosis and dyslipidemia are independent risk factors associated with 30-day angina pectoris; Age, male, leukocytosis and dyslipidemia are the independent risk factors associated with 30-day heart failure.
2.Comparative study of diagnostic value of computed tomographic virtual endoscopy versus electronic colonoscopy for colon cancer in elderly patients
Junwen XU ; Chaofeng HOU ; Zuqi ZHAO ; Juan LI
Chinese Journal of Geriatrics 2016;35(9):964-967
Objective To study the diagnostic value of computed tomographic virtual endoscopy versus electronic colonoscopy for colon cancer in elderly patients.Methods The 69 cases of elderly patients with colon cancer received CTVE and electronic colonoscopy before surgery to compare achievement rates,sensitivities,and endoscopy coincidence rate with pathologic classification between the two methods.Results For a definite diagnosis of colon cancer in elderly patients,achievement ratio was 98.6% (68/69) in CTVE and 62.3% (43/69) in electronic colonoscopy(x2 =14.72,P< 0.05);sensitivity was 95.6% (65/68) in CTVE and 97.7% (42/43) in electronic eolonoscopy(x2=0.003,P > 0.05);endoscopy coincidence rate with pathologic classification was 95.4% (62/65) in C-TVE and 95.2%(40/42) in electronic colonoscopy.Conclusions CT virtual endoscopy may be one of examination methods in elderly patients with colon cancer.
3.Effect of Bruton's tyrosine kinase in hyperoxia-induced acute lung injury
Hui MENG ; Dawei CAO ; Chaofeng LIU ; Mingxia HOU ; Fang HE ; Xinri ZHANG
Chinese Journal of Emergency Medicine 2017;26(2):181-185
Objective To investigate both in mechanism of hyperoxia-induced acute lung injury (HALI) by vivo experiment,to observe the Bruton' s tyrosine kinase (Btk) and nuclear factor kappa B (NF-κB) signals expression level.Methods Total of 72 healthy male Kunming mice were randomly (random number) divided into four groups:air control group,hyperoxia exposure 3 days group (H3d group),hyperoxia exposure 3 days + inhibitor group (H3d + Ⅰ group) and inhibitor groups.Then the pathological changes of lung tissues were observed under light microscope;The total protein content (TP) of bronchoalveolar lavage fluid (BALF) and wet/dry weight ratio (W/D) of lung were detected;The protein expression of Btk,p-Btk,pNF-κB p65 were mersured by Western blot;tlhe mRNA level of IL-6 was determined by real-time polymerase chain reaction (qRT-PCR);the level of monocyte chemoattractant protein-1 (MCP-1) in serum was detected by enzyme-linked immunosorbent assay (ELISA).Statistcal significance was determined by 1-way ANOVA.Results There were no significant difference in the data between the control group and the inhibitor group (P > 0.05).The pathological injury in light microscope,content of total protein in BALF,W/D ratio of lung tissues in H3d group were significantly higher than H3d + Ⅰ group (Respectively P =O.002,P =0.000).Western blot analysis showed that expression of Btk,p-Btk,pNF-κB p65 in H3d group were significantly higher than those in H3d + Ⅰ group (Respectively P =0.002,P =0.013,P =0.000).RT-qPCR results showed that the expression of IL-6 mRNA in H3d group were significantly higher than control group (P =0.004),inhibitor group (P =0.000) and H3d + Ⅰ group (P =0.021).In addition,The serum MCP-1 levels in H3d group were higher markely than the control group (P =0.002),inhibitor group (P =0.000) and H3d + Ⅰ group (P =0.009).The correlation analysis showed that pNF-κB p65 were positively correlated wiht Btk and p-Btk (r =0.902 and 0.954,P < 0.01).Conclusions Btk may trigger the release of IL-6 and MCP-1 by mediating the signaling pathway of NF-κB in vivo study,which was most important in the occurrence of HALI.Therefore,inhibiting the Btk activity would alleviate the severity of lung injury effectively.
4.Clinical characteristics and risk factors of atrial fibrillation in elderly patients
Chaofeng HOU ; Junwen XU ; Fenglin SONG
Chinese Journal of Geriatrics 2020;39(8):870-873
Objective:To investigate the clinical characteristics and risk factors of paroxysmal atrial fibrillation(AF)and persistent atrial fibrillation in elderly patients, in order to provide a theoretical basis for clinical diagnosis and treatment and risk assessment of adverse prognosis.Methods:A total of 201 non-valvular AF patients aged 60-90 years admitted to Heji Hospital from Jan.2017 to Aug.2019 were enrolled in this retrospective study.Of the 201 patients, 102 cases met the diagnostic criteria for paroxysmal AF and 99 cases met the diagnostic criteria for persistent AF.During the same period, 100 healthy elderly people from the physical examination center were included.Clinical data, laboratory test results and echocardiography data were collected.Differences in clinical parameter values between the two groups were analyzed by Hotelling's Trace multivariate analysis.Risk factors for AF were analyzed by comparison of correlation factors, single factor analysis and unconditional logistic regression multivariate analysis.Results:The paroxysmal AF group had a mean age of (70.2±6.5) years old, with 73 males(73.7.6%)and 26 females(26.3%), while the persistent AF group’s mean age was (65.3±5.23), with 61 males(59.8%)and 41 females(40.2%). There were a significant difference in age between the paroxysmal AF group and the persistent AF group( t=5.99, χ2=4.39, P<0.05). Hotelling's Trace multivariate analysis indicated differences in clinical parameter values between the two groups( F=6.26, P<0.01). Levels of serum uric acid, homocysteine(Hcy), high sensitivity C-reactive protein(hs-CRP)and D-dimer, and anterior and posterior diameter of the left atrium were higher in the persistent AF group than in the paroxysmal AF group( P<0.05), while levels of total cholesterol, platelet count and left ventricular ejection fraction(LVEF)were higher in the paroxysmal AF group than in the persistent AF group( P<0.05). History of hypertension( OR=8.92, 95% CI: 4.18-19.05)and smoking history( OR=4.47, 95% CI: 1.87-10.71)were risk factors for persistent AF, while history of hypertension( OR=9.11, 95% CI: 4.21-19.69), smoking history( OR=3.56, 95% CI: 1.44-8.81)and drinking history( OR=9.32, 95% CI: 2.49-34.96)were risk factors for paroxysmal AF. Conclusions:The incidences of AF can be significantly reduced by controlling hypertension within an ideal range and quitting smoking and drinking.High concentrations of serum Hcy, D-dimer, hs-CRP and uric acid and increased anterior and posterior diameter of the left atrium may contribute to the persistence of AF.
5.Prenatal cytogenetic and molecular genetic analysis of a fetus with confined placenta mosaicism for trisomy 16.
Zhihui JIAO ; Chaofeng ZHU ; Yaqin HOU ; Li WANG ; Xiangdong KONG
Chinese Journal of Medical Genetics 2021;38(8):771-774
OBJECTIVE:
To review the clinical data of a fetus with false positive result of non-invasive prenatal testing (NIPT) due to confined placental mosaicism (CPM).
METHODS:
Amniotic fluid sample was taken from a pregnant women with high risk for chromosome 16 aneuploidy for karyotyping analysis, single nucleotide polymorphism array (SNP array) and interphase fluorescence in situ hybridization (FISH). Genetic testing was also conducted on the fetal and maternal surface of the placenta, root of umbilical cord and fetal skin tissue after induced abortion.
RESULTS:
Cytogenetic analysis of the amniotic fluid sample yielded a normal karyotype. SNP array revealed mosaicism (20%) of trisomy 16 in the fetus. FISH confirmed the presence of mosaicism (25%) for trisomy 16. After induced labor, all sampled sites of placenta were confirmed to contain trisomy 16 by SNP array, while the analysis of fetal skin tissue yielded a negative result.
CONCLUSION
CPM is an important factor for false positive NIPT result. Prenatal identification of CPM and strengthened pregnancy management are important to reduce adverse pregnancy outcomes.
Amniocentesis
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Chromosomes, Human, Pair 16/genetics*
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Cytogenetic Analysis
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Female
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Fetus
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Humans
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In Situ Hybridization, Fluorescence
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Molecular Biology
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Mosaicism
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Placenta
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Pregnancy
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Prenatal Diagnosis
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Trisomy/genetics*