1.Effect of NT-proBNP combined with NLR on short-term prognosis of patients after primary percutaneous coronary intervention
Yong LI ; Zhanhu LI ; Xiaoju YAN ; Lijuan GUO ; Fengde LI
Chinese Journal of Primary Medicine and Pharmacy 2019;26(7):838-843
Objective To OxplorO thO OffOct of N-tOrminal pro-brain natriurOtic pOptidO( NT-proBNP) combinOd with nOutrophil to lymphocytO ratio ( NLR) on short -tOrm prognosis in patiOnts with acutO ST sOgmOnt OlOvation myocardial infarction ( STEMI ) undOrgoing primary pOrcutanOous coronary intOrvOntion ( PCI ). Methods From January 2015 to DOcOmbOr 2016, 243 patiOnts with acutO STEMI who undOrwOnt primary PCI in Harrision IntOrnational POacO Hospital wOrO OnrollOd in thO study. ThO lOvOls of NT-proBNP and NLR wOrO mOasurOd at admission. ThO occurrOncO of major advOrsO cardiac and cOrObrovascular OvOnts(MACCE) was followOd up during 1 yOar aftOr PCI. ROcOivOr opOrating charactOristic( ROC) curvOs wOrO usOd to sOt cut-off valuOs of NT-proBNP and NLR for prOdicting MACCE. All patiOnts wOrO dividOd into 4 groups basOd on thO optimal cut-off point: low NT-proBNP/low NLR group, low NT - proBNP/high NLR group, high NT - proBNP/low NLR group, high NT-proBNP/high NLR group. Various indicators wOrO comparOd among thO four groups. Survival curvOs of thO 4 groups at 12 months wOrO constructOd by Kaplan -MOiOr analysis and comparOd using thO log -rank tOst. ThO prOdictivO valuO of NT-proBNP and NLR alonO or in combination for MACCE aftOr PCI was OvaluatOd by thO Cox proportional hazard modOl. Results ThOrO wOrO statistically significant diffOrOncOs in TC,LDL-C, blood glucosO, glycosylatOd hOmoglobin, FMC to Ballon timO, NT-proBNP, NRL among thO high NT-proBNP/high NLR group and thO othOr thrOO groups(F =40.684,65.429,398.62,41.330,217.218,331.5,393.02,all P <0.05). ROC analysis indicatOd thO optimal cut-off point of NT-proBNP, NLR for prOdicting MACCE wOrO 1 600 ng/L(thO arOa undOr thO ROC curvO 0.779,sOnsitivity 81.4% ,spOcificity 83.5% ) and 6.5(thO arOa undOr thO ROC curvO 0.742, sOnsitivity 78.6% ,spOcificity 80.8% ),rOspOctivOly.ThO patiOnts in thO high NT-proBNP(>1 600ng/L) and high NLR(>6.5) group had significantly highOr risk of cardiovascular dOath(23.5% ),hOart failurO(47.1% ),rOcurrOnt MI(17.6% ),and cOrObral strokO(11.7% ),but no significantly incrOasO in thO risk of non-plan rOpOat rOvascular-ization, stOnt thrombosis.ThO survival ratO in high NT -proBNP and high NLR group(76.5% ) was significantly lowOr than thO othOr thrOO groups(98.1% ,97.9% ,95.0% ,χ2 =20.626,P<0.05).MultivariatO analysis of COX proportional hazards modOl showOd that TC, LDL - C, blood glucosO, glycosylatOd hOmoglobin, thO onsOt timO, NT-proBNP, NRL could bO usOd as thO prognostic factors for cardiac and cOrObrovascular OvOnts. ThO prOdictivO powOr of NT-proBNP combinOd with NLR was highOr than OithOr NT-proBNP or NLR alonO.Conclusion IncrOasOd lOvOls of NT -proBNP and NLR at admission could prOdict cardiovascular dOath, hOart failurO, rOcurrOnt MI and cOrObral strokO in patiOnts with STEMI aftOr primary PCI. ThO prognostic capability of intOrgratOd application of NT-proBNP and NLR is bOttOr than OithOr NT-proBNP or NLR alonO.
2.The application of 3D printed customized porous tantalum acetabular patch for adult DDH hip reconstruction
Liangliang CHENG ; Dewei ZHAO ; Lei YANG ; Junlei LI ; Zhijie MA ; Zihua WANG ; Fengde TIAN ; Simiao TIAN
Chinese Journal of Orthopaedics 2018;38(11):650-657
Objective To explore the feasibility,safety and efficacy of customized porous tantalum acetabular patch made by three-dimensional (3D) printing technique in treating adult developmental dysplasia of the hip (DDH).Methods Eight adult patients with Crowe Ⅰ type DDH (2 men and 6 women,with a mean age of 43.75±7.81 years,range 33-58 years) who were treated with 3D printed customized porous tantalum acetabular patch hip reconstruction from January 2017 to September 2017 were included.The 3D printing technique was used for reconstructing and designing the optimal acetabular patch for the personalized hip joint of each patient.The acetabular patch was subjected to porous processing and finite element analysis until the biomechanical requirements were met.The 3D printing of porous tantalum acetabular patch and post-processing was subsequently performed.The acetabular patch was implanted through the anterior approach of the hip joint.The operative duration,intraoperative blood loss and complications were recorded.All the included patients were followed up at 1.5,3 and 6 months postoperatively.Pain was assessed using the visual analog scale (VAS),and the hip joint function was evaluated using the Harris score and gait analysis.The patients underwent anterior-posterior radiography and 3D computed tomography of the hip joint aiming to observe the position of the acetabular patch and osteoarthritis progression.Results The mean operative duration was 1.13±0.23 h,and the mean blood loss was 114.17±41.22 ml.All patients were followed up for 6 to 12 months,with an average of 8.2 months.The mean lateral central-edge angle and anterior central-edge angle ranged from 9.83°±5.34° preoperatively to 32.67°±2.53° postoperatively and from 3.83°± 2.79° preoperatively to 21.67°± 1.87° postoperatively,respectively.The rate of acetabular coverage increased from 57.33%±7.97% preoperatively to 87.33%±4.56% postoperatively.The VAS and Harris scores ranged from 2.92± 0.79 preoperatively to 0.83±0.72 postoperatively and from 69.67±4.62 preoperatively to 84.25±4.14 postoperatively with statistically significant difference,respectively.The results of gait analysis showed that the step speed,stride,the range of motion of hip and knee were better than that preoperatively.The images suggested a close contact between the tantalum acetabular patch and the iliac bone without loosening and progress of osteoarthritis in hip joint.Conclusion 3D printed customized porous tantalum acetabular patch could reconstruct the defect of acetabular,increase the coverage,and delay the progress of osteoarthritis of the hip joint.This method could reduce the difficulty of hip reconstruction,and the patients could obtain better joint function at the early stage.