3.Discussion on the relationship between H-type hypertension and left ventricular remodeling
Zhijing REN ; Jing ZHANG ; Hongliang CONG
Tianjin Medical Journal 2016;44(3):356-359
Objective To investigate the effects of homocysteinemia (HHcy) and hypertension on left ventricular re?modeling. Methods A total of 275 patients with coronary heart disease were divided into four groups including H-type hy? pertension group (n=96), non-H-type hypertension group (n=44), HHcy+non-hypertension group (n=53) and control group (n=65) based on their blood pression levels and plasma HHcy levels. The serum levels of glucose (Glu), total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL) and high-density lipoprotein (HDL) were compared between groups. The left ventricular end systolic diameter (LVESD), left ventricular end diastolic diameter (LVEDD), left ventricular posterior wall thickness (LVPWT), ventricular septal thickness (IVST) and left ventricular mass index (LVMI) were observed in four groups. The proportion of patients with left ventricular remodeling was also compared between four groups. The influence fac?tors of left ventricular remodeling were analysed. Results There were no significant differences in biochemical parameters except Hcy level between frour groups. The values of LVMI, left ventricular wall thickness and the proportion of patients with left ventricular remodeling were significantly higher in H-type hypertension group than those of other three groups ( P<0.05). The Hcy level was positively correlated with LVMI and left ventricular wall thickness. Logistic regression analysis showed that HHcy and hypertension were the risk factors of left ventricular remodeling (OR=7.443, 7.754 and 9.948,P<0.05). The risk factors of left ventricular remodeling were higher in patients with both HHcy and hypertension than those in patients with HHcy or hypertension. Conclusion Homocysteine and higher systolic pressure are independent risk factors for left ventricular remodeling and they have a synergistic effect on leading to left ventricular remodeling.
4.Study on Cut-Off Value with D-Dimer Testing for Diagnosis by Exclusion of Venous Thromboembolism in Patients of Different Ages
Jing REN ; Gang LI ; Bowei ZHANG ; Yanxue ZHANG
Tianjin Medical Journal 2014;(1):17-19
Objective To investigate the plasma level of D-dimer in healthy population and hospitalized patients, and to analyze the cut-off value of D-dimer levels in different age groups for the exclusion of venous thromboembolism (VTE) in older patients. Methods A total of 6 717 healthy individuals and 2 976 hospitalized patients were included in the study. The blood level of D-dimer was detected by the Biomerieux VIDAS fluor-euzymelinked immunoassay analyzer assay. Results The blood level of D-dimer was significantly increased with age in healthy people aged over 40 and different age groups of hospitalized patients (P<0.01). The incidence of venous thromboembolism was also increased with age. The cut-off value for the diagnosis of VTE with D-dimer was 504 μg/L in patient group aged ≤40 years, and the sensitivity was 100.0%. The cut-off value was 565μg/L in 41~60-year group, and the sensitivity was 96.2%. The cut-off value was 817μg/L in 61~74-year group, and the sensitivity was 80.8%. The cut-off value was 1 024μg/L in≥75-year group, and the sensitivity was 73.1%. Conclusion The plasma D-dimer level increased with age. The D-dimer cur-off value was higher in older patients than that of other age groups, but the sensitivity in diagnosis was decreased obviously.
5.The improvement of preparation before urodynamic examination in elderly patients
Jing CHANG ; Chuanchuan REN ; Yan ZHANG ; Ruili ZHANG ; Jianguo WEN
Chinese Journal of Geriatrics 2012;31(6):503-505
Objective To explore the effects of improved preparation before urodynamic examination in the elderly patients with voiding disfunction.Methods Totally 424 elderly patients underwent urodynamic examination after improvement of the preparation approach according to pathophysiological characteritics of the elderly patients,and 248 elderly patients before the approach improved in our center were collected as control.The compliance,discontinuation and repetition rate of urodynamic examination were compared between the two groups.Results The compliance of patients who used the improved preparation approach was significantly higher than control (92.5% vs.59.3%,x2=106.428,P<0.001).Whereas the discontinuation and repetition rates of urodynamic examination in the improved group were decreased as compared with control group ( 1.2% vs.6.9%,x2 =14.176,P=0.0002; 8.5% vs.21.4%,x2 =21.487,P<0.001).Conclusions The improved preparation approach according to the pathophysiological characteritics of elderly patients is worthy to popularize in the urodynamic centers.
6.Comparative study of continuous and interval microwave ablation in ex vivo muscular tissues
Bingsong ZHANG ; Jing ZHANG ; Lei FENG ; Jintao REN
Chinese Journal of Ultrasonography 2009;18(7):628-631
Objective To compare the effect of single implanted microwave ablation in continuous and interval irradiating in ex vivo pig muscular tissues, and to provide the experimental data for microwave ablation therapy of uterine fibroid clinically. Methods The pig muscular tissues ablations were performed with 2450 MHz microwave at same output power and action time. The irradiating modes were set as continuous wave and interval wave (emitting per 100 seconds intermitting 10 seconds and 20 seconds). The shape, size, thermal field temperature and the pathologic appearance of the ablation zone were evaluated. Results With the same output power and the same action time,the difference observed in the ablated shape, scope, ahead distance and thermal field temperature had no statistical significance, and the pathologic appearances of the ablated zone were same among the different action modes. Conclusions The difference between continuous and interval microwave ablation effects had no statistical significance in ex vivo pig muscular tissues with single implanted microwave. Both of these two modes may apply for uterine fibroid microwave ablation,and may result in same therapeutic efficacy.
7.Clinical significance of serum interleukin-8 and myocardial enzyme levels in the diagnosis and treatment of children with bronchopneumonia
Jianmei ZHANG ; Xin CHEN ; Jing REN ; Jinli HAO ; Yajing ZHANG
Chinese Journal of Postgraduates of Medicine 2010;33(28):15-17
Objective To investigate the association of serum interleukin-8 (IL-8) and myocardial enzyme levels in children with bronchopneumonia.Methods Serum IL-8 contents were measured by the radioimmunity method and serum myocardial enzyme contents were measured by the Olympus AU640 in 60 children with bronchopneumonia (mild 30 cases and severe 30 cases) as well as in 30 controls.Results Serum IL-8 contents were significantly higher in children with severe bronchopneumonia and mild bronchopneumonia than those in controls [( 2.54 ± 0.65),( 1.28 ± 0.53) μ g/L vs.(0.43 ± 0.08) μ g/L] (P <0.01),and serum myocardial enzyme contents (α-hydroxybutyrate dehydrogenase,MB isoenzyme of creatine kinase,creatine kinase,aspartate aminotransferase) were significantly higher in children with severe bronchopneumonia and mild bronchopneumonia than those in controls (P<0.01).Conclusions IL-8 and myocardial enzyme may play a role in children with bronchopneumonia.Determination of serum IL-8 and myocardial enzyme levels might have important prognostic values in children with bronchopneumonia.
8.The Laboratory Monitoring of Aspirin Therapy in Perioperative Patients with General Surgery
Jing REN ; Jianlong MEN ; Wei LIU ; Bowei ZHANG ; Rui MA
Tianjin Medical Journal 2013;(9):871-874
Objective To investigate the reasonable time limit for stopping the aspirin treatment in preoperative pa-tients with general surgery and the effects on platelet function in postoperative patients with recovering the therapy of aspirin. Methods A total of 121 patients undergoing elective general surgery were divided into stopping aspirin treatment 5 d group (n=59) and stopping aspirin treatment 7 d group (n=62). Fifty healthy volunteers were used as the control group. The arachi-donic acid (AA)-induced platelet aggregation test was used to detect the platelet agglutination rate in all groups. Aspirin was reused 24~48 h after surgery. The level of urinary 11-dehydro-thromboxane B2 (11-DH-TXB2) was assayed by ELISA 7 and 10 d after retreatment. Results The levels of the PAgT (5 min, 8 min and 10 min) were decreased significantly in pa-tients with stopping aspirin treatment 5 d group compared with those of patients with stopping aspirin treatment 7 d group and control group (P<0.05). There was no significant difference in the level of PAgT between patients with stopping aspirin treatment 7 d group and control group. The platelet aggregation showed two different characteristic curves after stopping aspi-rin treatment for 5 d. And the normal curve of platelet aggregation was found after stopping aspirin treatment for 7 d. The lev-els of PAgT and urinary 11-DH-TXB2 were significantly lower in patient recovered the aspirin treatment for 7 d and 10 d than that of control, and which was significantly higher in 7 d group than that of 10 d group (P>0.05). Conclusion The platelet aggregative function returned to normal level in patients with 7-d preoperative stopping aspirin. The laboratory moni-toring of aspirin therapy should be more than 7 d after postoperative reusing aspirin.
9.Investigation of the current state of pension security for rural doctors in several provinces
Liqiang ZHANG ; Daping SONG ; Jing REN ; Donghui ZHAO ; Zaoli WANG
Chinese Journal of Health Policy 2014;(10):64-67
Objectives: To investigate the current state of pension security for rural doctors in 12 provinces those have not introduced related policies. Methods:Two counties were chosen in each province. Data was analyzed in terms of coverage, types and intention of pension security for rural doctors in these areas. Results:The study found that the proportion of rural doctors with pension security was 81. 4% in these areas. 57. 1% of rural doctors with pen-sion security had urban and rural pension insurance. Differences exist among these areas. The safeguard level is too low, and the willingness of rural doctors to attend to pension security is not strong enough. Results:The mechanism of pension security for rural doctors must be improved. These areas should implement classified guidance and syn-chronize various models to solve the problem of pension security for rural doctors.
10.Study on plasma von Willebrand factor in the prediction of risk of ischemic events in patients undergoing off-pump coronary artery bypass graft
Jianlong MEN ; Jing REN ; Bowei ZHANG ; Rui MA ; Zanxin WANG
Chinese Journal of Geriatrics 2014;33(11):1171-1175
Objective To study the variation characteristics of plasma von Willebrand factor antigen (vWF Ag) after the off-pump coronary artery bypass graft (OPCAB) and its predictive value on the assessment of cardiovascular ischemia events in the postoperative patients.Methods A total of 338 patients with non-ST-segment elevation myocardial infarction were selected from 2010 to 2012 in this retrospective cohort study,with 249 males and 89 females and a mean age of (69.2 ± 4.5) years.The level of vWF Ag was assayed by the IL ACL-TOP 700 blood coagulation instrument.Receiver-operator curve (ROC) analysis of vWF Ag levels in the prediction of risk of ischemic events was performed.x2 test and Logistic regression were conducted to analyze the relevance between vWF Ag and clinical pathological factors.Cox regression analysis model were used to evaluate the effect on prognosis.Results There was significant difference in vWF Ag level at different time point between the poor recovery group and the stable disease group (x2 =129.53 and 101.48 respectively,both P<0.01).And the vWF Ag level was higher in the poor recovery group on the 14th,30th,60th,90th day after OPCAB than in the stable disease group at the same time points respectively (all P<0.05).The optimum cut-off point of vWF Ag (the 30th day after OPCAB) for prediction of ischemic events was 251 % within the 31-90th day after OPCAB,the area under ROC curve was 0.839 (95% confidence interval:0.776-0.902).The Logistic regression analysis showed that the vWF Ag level on 30th day after OPCAB was affected by age,left ventricular ejection fraction,left main artery disease,serum creatinine level,vascular number of bypass grafts,history of myocardial infarction and hypertension (all P<0.01).The Cox analysis showed that the cut-off value of vWF Ag (on the 30th day after OPCAB) was the independent prognostic assessment parameter for ischemic events in patients with cardiovascular diseases within one year.Conclusions The variation of serum vWF Ag level can reflect the integrated influence of multiple pathological factors on vascular endothelial function after the OPCAB,it can become the effective predictor for disease progression within 90 days and the long-term prognosis after OPCAB.