Objective To analyze the differences of hospitalization mortality of coronary stenting in patients with coronary heart disease between the elderly (≥65 years old ) and non elderly. Methods Totally 3252 patients who underwent coronary stenting in Guangdong Provincial People’s Hospital were studied retrospectively. They were divided into elderly group (≥65 years old, n=1344) and non elderly group (

Objective To investigate the correlation between matrix metalloproteinase-3 (MMP-3)serum level and polymorphism(5A/6A) and the stability of carotid plaque in Chinese Han population.Methods Two hundred and eighty acute cerebral infarction patients from the department of neurology of Taizhou Hospital were divided into carotid vulnerable plaque group and carotid stable plaque group according to the results of carotid B-mode uhrasonngraphy.Serum MMP-3 level waa measured by means of enzyme-linked immunosorbent assay (ELISA).At the same time, genotype was determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) for the common 5A/6A functional promoter polymorphism of the MMP-3 gene.The serum MMP-3 level and genotype frequencies of the MMP-3 gene between the two groups were analyzed.Results The genotype frequencies of the MMP-3 gene 5A/6A polymorphism of the two groups were in Hardy-Weinberg equilibrium The genotype distribution of the MMP-3 promoter 5A/6A polymorphism between the carotid vulnerable plaque group and the carotid stable plaque group was significantly different(χ2 =6.13, P =0.01, OR = 1.90, 95% CI 1.14-3.15).The frequencies of 5A allele were 20.6% and 12.8% in the carotid vulnerable plaque group and the carotid stable plaque group respectively (χ2=6.09, P=0.01, OR =1.76, 95%CI 1.12-2.77).Serum level of MMP-3 in the carotid vulnerable plaque group was higher than that in the carotid stable plaque group (t = 3.39, P =0.00).Conclusion The present findings suggest that serum level of MMP-3 and genetic polymorphism of 5A/6A in MMP-3 promoter are related with carotid vulnerable plaque in Chinese Han population and 5A allele may be a susceptible predictor of carotid vulnerable plaque.

Adenine ; analogs & derivatives ; Hepatitis B, Chronic ; Humans ; Organophosphonates ; Tenofovir ; Treatment Failure

Objective To explore the effects of different doses of topiramate (TPM) on the expression of nerve cell adhesion molecule (NCAM) and growth-associated protein 43 (GAP- 43) mRNA in hippocampus of rats with epilepsy. MethodsForty-eight rats were randomly divided into normal control group, kainic acid (KA) group, 10 mg/kg TPM group, 40 mg/kg TPM group, 100 mg/kg TPM group and 400 mg/kg TPM group (n=8). The models of rats with epilepsy treated by different doses of TPM were established. The behavior of rats was observed, and the expression of NCAM and GAP- 43 mRNA in hippocampus of rats was determined by Real-time PCR. Results The expression of NCAM and GAP- 43 mRNA in KA group was significantly higher than that in normal control group (P<0.01), while there was no significant difference between 10 and 40 mg/kg TPM groups and KA group, that in 100 and 400 mg/kg TPM groups was significantly lower than that in KA group (P<0.01), and that in 400 mg/kg TPM group was significantly lower than that in 100 mg/kg TPM group (P<0.01). Conclusion KA can up-regulate the expression of NCAM and GAP- 43 mRNA in hippocampus of rats with epilepsy. Higher dose of TPM can inhibit the expression of NCAM and GAP- 43 mRNA, and the inhibitory effect is related with the dose of TPM.

Objective: To understand the mortality and probability of premature death due to malignant tumors, cardio-cerebrovascular diseases, diabetes and chronic respiratory diseases in Taizhou City, Zhejiang Province, so as to provide the basis for the improvement of chronic diseases prevention and control strategies. Methods: The death data of the four chronic diseases among local residents in Taizhou City from 2019 to 2022 were collected through Taizhou Chronic Disease Information Management System, and the crude mortality, standardized mortality (standardized by the data of the seventh national population census in 2020) and probability of premature death were calculated. The trends in mortality and probability of premature death were analyzed using annual percent change (APC). The attainment of probability of premature death due to the four chronic diseases were evaluated using the target values and predicted values in 2025 and 2030. Results: There were 119 899 deaths from the four chronic diseases in Taizhou City from 2019 to 2022, with the crude mortality of 494.48/105 and the standardized mortality of 410.68/105, which was no significant changing trend (APC=4.680% and -2.795%, both P>0.05). The probability of premature death decreased from 10.39% to 8.69% (APC=-6.027%, P<0.05). The crude mortality and standardized mortality in males were higher than those in females (562.13/105 vs. 424.08/105; 461.67/105 vs. 353.81/105; both P<0.05). The crude mortality and standardized mortality in rural areas were higher than those in urban areas (499.65/105 vs. 480.52/105; 429.20/105 vs. 365.68/105; both P<0.05). The probability of premature death in women and rural residents showed downward trends (APC=-8.210% and -7.558%, both P<0.05) from 2019 to 2022. The standardized mortality and probability of premature death due to malignant tumors showed downward trends (APC=-6.090% and -8.019%, both P<0.05). The crude mortality of diabetes showed an upward trend (APC=18.654%, P<0.05). The predicted values for probability of premature death due to due to the four chronic diseases in 2025 and 2030 were 7.27% and 5.40%, respectively, and were lower than the target values of 10.02% and 8.77%. Conclusions From 2019 to 2022, there was no significant trends in the mortality of four chronic diseases in Taizhou City, with rural men being the key population for prevention and control. The probability of premature death showed a downward trend, and it was expected to achieve the target in 2025 and 2030.

Objective To analyze the correlation between cerebral atrophy and white matter lesions (WML) in magnetic resonance imaging (MRI) by quantitative and qualitative methods. Methods Two hundred and seventy-two patients with WML admitted to the Department of Neurology of Taizhou Central Hospital from January 2015 to December 2017 were enrolled, by adopting MCMxxxVI 9.0 TM image processing tool and Analyze 9.0TM image editing tool, the volume within the skull, whole brain tissue, cerebrospinal fluid, subarachnoid volume on the surface of the brain, gray matter, normal brain white matter and diseased white matter were quantitatively determined in the MRI, Fazekas visual score was used to qualitatively evaluate the WML of MRI, and the correlation between brain atrophy and WML was analyzed. Results General linear model analysis showed that the WML volume had a negative correlation with total brain atrophy or decreased whole brain volume (β = -0.432, P = 0.004), especially with deep brain atrophy, namely WML volume had a significant positive correlation with the increase of ventricular volume (β = 0.098, P = 0.031), and it had no correlation with superficial brain atrophy or the increase of subarachnoid volume on the surface of the brain (β = 0.088, P = 0.547). Fazekas rating scale used for the correlation analysis of WML and brain atrophy also showed similar results. After adjusting for the gender and skull content volume, it was shown that the WML volume was well fitted with brain volume model, and so was the WML with the following volumes: cerebral white matter volume without any pathological changes, the whole brain tissue volume, gray matter volume models (brain volume R2 = 0.25, cerebral white matter volume with no pathological changes R2 = 0.35, whole brain tissue volume R2 = 0.77, gray matter volume R2 = 0.25, all P < 0.05). Conclusion MRI analysis showed WML was associated with brain atrophy, primarily with deep brain atrophy.

OBJECTIVETo investigate the association of matrix metalloproteinase-3 (MMP-3) serum level and the promoter 5A/6A polymorphism of the MMP-3 gene with atherosclerotic cerebral infarction (ACI) in a Chinese Han population.

METHODSTwo hundred and fifteen patients with acute ACI from the Department of Neurology of Taizhou Hospital and 226 healthy controls were included in the study. Serum MMP-3 level was measured by enzyme-linked immunosorbent assay (ELISA). Genotype was determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) for the common 5A/6A functional promoter polymorphism of the MMP-3 gene.

RESULTSThe genotype distribution of the MMP-3 promoter 5A/6A polymorphism between the ACI patients group and the control group was significantly different (chi (2)= 9.389, P= 0.002). The frequencies of the 5A allele were 14.2% and 7.7% in the ACI patients group and the control group respectively (chi (2)= 9.430, P= 0.002). Serum level of MMP-3 in the ACI patients group was significantly higher than that in the control group (t= 24.867, P= 0.000). Among the ACI patients group, serum MMP-3 levels also had significant difference between the 5A/6A+ 5A/5A and the 6A/6A genotype (t= 2.057, P= 0.041).

CONCLUSIONThe present findings suggest that serum level of MMP-3 obviously increased within 48 hours of ischemic stroke and the genetic polymorphism of 5A/6A in the MMP-3 promoter is associated with ACI and MMP-3 expression in the Chinese Han population.

Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; genetics ; Case-Control Studies ; Cerebral Infarction ; blood ; complications ; genetics ; Ethnic Groups ; genetics ; Female ; Gene Frequency ; Genotype ; Humans ; Intracranial Arteriosclerosis ; blood ; complications ; genetics ; Male ; Matrix Metalloproteinase 3 ; blood ; genetics ; Middle Aged ; Polymorphism, Genetic ; Promoter Regions, Genetic ; genetics

Objective:To explore the risk factors of hepatocellular carcinoma (HCC) in patients with hepatitis B cirrhosis receiving nucleoside/nucleotide analogues (NAs) antiviral therapy.Methods:The clinical data of 253 patients receiving NAs antiviral therapy in Zhejiang Provincial People’s Hospital from November 2014 to October 2019 were retrospectively analyzed. During treatment, HCC occurred in 116 patients. Multivariate logistic regression was used to analyze the risk factors of progression to HCC in patients with hepatitis B cirrhosis.Results:Multivariate logistic regression analysis showed that age( OR=1.094, 95% CI 1.034-1.158, P<0.01), smoking history( OR=5.056, 95% CI 1.453-17.594, P<0.05), family history of hepatocellular carcinoma( OR=6.763, 95% CI 1.253-36.499, P<0.05), Lamivudin (LAM) resistance( OR=6.097, 95% CI 1.370-27.134, P<0.05), fasting blood glucose(FBG)level( OR=7.219, 95% CI 3.716-14.024, P<0.01) were independent risk factors for the progression of hepatitis B cirrhosis to HCC; while HBV DNA negative conversion( OR=0.028, 95% CI 0.006-0.137, P<0.01) was a protective factor. Conclusions:For hepatitis B cirrhosis patients receiving antiviral therapy, drug resistance, HBV DNA, FBG levels should be closely monitored, intervention measures such as quitting smoking should be taken and NAs with high drug resistance gene barrier should be selected to prevent the occurrence of HCC.

Objective:To evaluate the prognostic value of sepsis-induced coagulopathy (SIC) in patients with sepsis.Methods:From January 2019 to December 2021, patients with sepsis admitted to the Intensive Care Unit of our hospital were retrospectively classified into the SIC group and non-SIC group according to SIC diagnostic criteria. The baseline clinical data, severity score, total length of hospital stay, length of ICU stay and 28-day survival were compared between the two groups. Kaplan-Meier was used to compare the 28-day survival of patients with sepsis between the two groups. Cox proportional hazard regression model was employed to analyze the risk factors of prognosis in patients with sepsis.Results:Totally 274 patients with sepsis were included in the analysis, including 139 patients in the SIC group and 135 patients in the non-SIC group. The two groups were compared in the perspectives of the Platelet count (PLT), prothrombin time (PT) , procalcitonin (PCT), D dimer, hematocrit, red blood cell distribution width, hemoglobin, acute kidney injury (AKI), the use of continuous renal replacement treatment (CRRT), the use of vasoactive drugs, sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation (APACHEⅡ) score were compared between the two groups and the difference were statistically different (all P<0.05). Kaplan-Meier analysis showed that the 28-day mortality rate in the SIC group was significantly higher than that in the non-SIC group (32.4% vs. 14.1%, P<0.05). COX proportional hazard model showed that SIC score ( HR= 2.17, 95% CI: 1.15-3.91, P<0.05), APACHEⅡ score ( HR= 1.13, 95% CI: 1.09-1.17, P<0.05) and the use of vasoactive drugs ( HR=3.66, 95% CI: 1.53-8.75, P<0.05) were independent influencing factors for 28-day death in patients with sepsis. Conclusions:Patients with sepsis and SIC have more severe disease and increased mortality risk. SIC score exhibits good clinical value in predicting the prognosis of patients with sepsis.

Objective To compare the effect of postural changes on the mechanical ventilation in patients with acute respiratory distress syndrome ( ARDS ) .Methods A total of 40 ARDS patients with mechanical ventilation from January 2010 to December 2012 and without contraindications for mechanical ventilation in the prone position were selected , who were divided into the prone position ventilation group and the supine position ventilation group by random number table method , with 20 patients in each group .The changes of vital signs and arterial blood gas before and after mechanical ventilation were compared between the two groups, including the mean airway pressure , plateau pressure and airway resistance three days after treatment . Also, the mechanical ventilation time and the time taken to stay emergency room were compared between the two groups.Results Compared with before treatment , the T, P, MAP and PaCO2 after treatment all decreased in the two groups, with statistically significant differences (P<0.01);the PETCO2, pH, PaO2, PaO2/FiO2 after treatment all increased in the two groups , with statistically significant differences (P<0.01).There were no statistically significant differences between the two groups in T , P, PETCO2 , MAP, pH, PaO2 , PaCO2 ( P>0.05).The PaO2/FiO2 in the prone position ventilation group was (282 ±22) three days after treatment , which was higher than that of (245 ±21) in the supine position ventilation group three days after treatment , and the difference was statistically significant (t=6.18, P<0.01).The mean airway pressure, plateau pressure and airway resistance three days after treatment was (6.8 ±0.5) cmH2O, (17.1 ±2.0) cmH2O and (14.9 ± 1.2)cmH2O/(L· s) in the prone position ventilation group, respectively, which was (8.5 ±0.9) cmH2O, (20.6 ±2.3)cmH2O and (21.1 ±0.8)cmH2O/(L· s) in the supine position ventilation group , respectively, and the differences were statistically significant (t =7.38, 5.13, 18.83, respectively;P <0.01).The mechanical ventilation time and the time taken to stay emergency room in the prone position ventilation group were shorter than those in the supine position ventilation , and the differences were statistically significant ( t=9.007, 6.379, respectively;P <0.01).Conclusions Prone position ventilation can be more effective in improving oxygenation index and redressing hypoxemia , and has relatively little impact on the patients ’ airway, which is an ideal position of mechanical ventilation .