1.Tei index for right ventricular function monitoring in pregnant women complicated with cardiac disease and pulmonary hypertension
Zhiling ZHANG ; Jianhua LIN ; Ruqi TAO
Chinese Journal of Obstetrics and Gynecology 2009;44(5):341-344
Objective To investigate clinical value of Tei index used for monitoring right ventricular (RV) function in pregnant women complicating cardiac disease accompanying pulmonary hypertension(PH) and the influence on left ventricular(LV) function due to overload pressure of RV. Methods Fifty-eight pregnant women complicating cardiac disease (including 32 cases with congenital heart disease,14 cases with rheumatic heart disease and 8 cases with arrhythmia)were enrolled in this study, among 26 cases coexisted with pulmonary hypertension. According to the pressure of PH, those patients were divided into three groups:11 cases in mild group[30-49 mm Hg (1 mm Hg=0.133 kPa)],9 cases in moderate group (50-79 mm Hg)and 6 cases in severe group (≥80 mm Hg). In the mean time, 15 healthy pregnant women were matched as control. Tei index were measured for LV and RV respectively. Results (1) The isovolumetric relaxation time [IRT,(93±52) ms] and isovolumetric contraction time [ICT,(66±41) ms] of RV in PH group were significantly higher than normal controls [(39±19) ms in IRT and (38±20) ms in ICT] and the other patients without PH group[(59±12) ms in IRT and (43±19)ms in ICT, P<0.01, P<0.05;P<0.05,P<0.05]; however, ejection time (ET) was(239±46) ms significantly shortened in PH group (P<0.05,P<0.01) when compared with (250±41) ms in patients without PH and (299±38) ms in normal controls. Tei index in PH group were 0.72±0.49, which were significantly higher than 0.38±0.12 in normal controls and 0.43±0.16 in patients without PH (P<0.01,P<0.05). (2) The IRT[(99±27)ms] and ICT[(71±40) ms] of LV in PH group were significantly higher than in normal controls [(88±20) ms,(50±24)ms] (P<0.01,P<0.01). ET of LV in PH group [(202±26)ms] were significantly shortened that (290±21)ms in normal controls and (220±36)ms in patients without PH (P<0.01,P<0.05). Tei index of LV in PH group were significantly higher than 0.43±0.15 in normal controls and 0.58±0.21 in patients without PH (P<0.01,P<0.05). (3) Positive correlation between Tei index of RV and pressure of pumonaroy artery were observed (r=0.84, P<0.01). (4) Tei index of RV in severe PH were significantly higher than mild PH (0.75±0.43 vs. 0.68±0.35, P<0.01) and moderate PH (0.75±0.43 vs. 0.71±0.14, P<0.05). Conclusions (1)The Tei index is a novel efficient Doppler index in assessing RV function of pregnant women complicating cardiac disease accompanying PH. And the fluctuation of Tei index might reflect seriousness of the disease. (2) The overload pressure of RV pressure due to PH has significant influence on LV function.
2.Ventrieular remodeling and matrix metalloproteinase-1 and its tissue inhibitor of metalloproteinase-1 in serum in third trimester of pregnant women with cardiac disease
Zhiling ZHANG ; Jianhua LIN ; Ruqi TAO
Chinese Journal of Obstetrics and Gynecology 2009;44(10):731-735
Objective To analyse the relationship between the left ventricular(LV)structure,function and changes of concentration of serum matrix metalloproteinase-1(MMP-1),tissue inhibitor of matrix metalloproteinase-1(TIMP-1),and evaluate the value of the change of serum MMP-1 and serum TIMP-1 in ventrieular remodeling of pregnant women complicating cardiac disease.Methods Fifty-eight cases of pregnant women with cardiac disease divided into three groups[group A had 17 cases who had clinical manifestations and no left ventricular hypertrophy(LVH)],group B had 15 cases who had clinical manifestations and LVH but no palmonaly hypertension(PH),group C had 26 cases who had clinical manifestations,LVH and PH which divided into three groups again:11 cases of slight group[PH from 30-49 mm Hg(1 mm Hg=0.133 kPa)],9 cases of moderate group(PH from 50-79 mm Hg)and 6 cases of severe group(PH≥80 mm Hg).Fifteen healthy pregnant women acted as control group.The left ventricular structure and function[(left ventrieular nlasS index(LVMI),left ventricular end-diastolic diameter(INEDd),Ejection fraction(EF),E peak(E),A peak(A)and E/A],pulmonary pressure and plasma MMP-1,TIMP-1 values were determined in the third trimester of pregnancy.Results(1)LVMI (148±7)g/m~2 and LVEDd(58.9±3.5)mm in group C increased significantly(totally P<0.01),EF (51.0±4.4)% decreased significantly(P<0.01),E(50±10)cm/s decreased significantly(P<0.01),A(81±13)cm/s increased(P<0.05)and E/A(0.6±0.3)decreased significantly(P<0.01)compared with normal subjects,group A and group B.(2)LVMI(150±7)g/m~2,LVEDd(69.7±3.4)mm in severe pulmonary hypertension group increased significantly(P<0.01),EF(45.6±2.6)% decreased significantly(P<0.01),E(44±9)cm/s decreased(P<0.05),A(86±8)cm/s increased(P<0.05)and E/A(0.52±0.17)decreased significantly(P<0.01)compared with slight and moderate pulmonary hypertension group.(3)Plasma MMP-1(41±10)μg/L and TIMP-1(393±37)μg/L values in group C increased significantly compared with normal subjects,group A and group B(P<0.01).(4)Plasma MMP-1(42±7)μg/L and TIMP-1(411±31)μg/L values of severe pulmonary hypertension group increased significantly compared with slight pulmonary hypertension group(P<0.05,P<0.01).(5)The correlation analysis indicated that:There was positive correlation between the serum concentration of MMP-1 and TIMP-1(r=0.587.P<0.01).The serum concentration of MMP-1 was positively correlated with LVMI and LVEDd significantly(r=0.782,P<0.001;r=0.648,P<0.01)and was negatively correlated with EF significantly(r:-0.587,P<0.01).(6)Plasma MMP-1 values>50μg/L and plasma TIMP-1 values >450μg/L in 3 cardiac disease failure cases.Conclusions (1)The ventricular remodeling can be found in the third trimester of pregnancy of women complicating cardiac disease,and the more serious the left ventricular hypertrophy and PH,the more obvious the ventricular remodeling.(2)The changes in the plasma MMP-1/TIMP-1 values and MMP-1/TIMP-1 balance may play an important role in the left ventrieular structural.functional,and clinical manifestations of pregnant women complicating cardiac disease.(3)An increased MMP-1 and TIMP-1 level maybe can predict the presence of cardiac disease failure.
3. Study on the proliferation and the expression of S100A8 and S100A9 in Helicobacter pylor -infected human gastric epithelial cells GES-1
Ruqi CHANG ; Lijuan HUO ; Linglin TIAN ; Peng ZHANG
Chinese Journal of Digestion 2018;38(6):377-381
Objective:
To investigate the effects of
4.Drug resistance and risk factors of multidrug-resistant organism in chronic osteomyelitis: a multi-center retrospective study
Le ZHANG ; Ruqi ZHANG ; Weiwei WU ; Zemin LIU ; Qi YANG ; Kun HE ; Xiaoping CUI ; Yonghong ZHANG
Chinese Journal of Orthopaedic Trauma 2023;25(12):1056-1063
Objective:To investigate the spectrum, drug resistance and risk factors of multidrug resistant organism (MDRO) in chronic osteomyelitis.Methods:A retrospective study was conducted by cluster sampling to analyze the 414 patients with chronic osteomyelitis who had been admitted to Department of Orthopaedics, The Second Hospital Affiliated to Shanxi Medical University, Department of Orthopaedics, The People's Hospital of Shanxi Province, Department of Traumatology, Yuncheng City Hospital, and Department of Orthopaedics, Linfen City Hospital from January 2016 to December 2021. The patients were assigned into 2 groups according to whether MDRO had been detected or not. In the MDRO infection group of 150 cases, there were 118 males and 32 females with an age of (48.8±16.2) years; in the non-MDRO infection group of 264 cases, there were 194 males and 70 females with an age of (46.0±17.8) years. The characteristics of bacterial spectrum and drug resistance in MDRO infection were described and analyzed. The 2 groups were compared in terms of clinical data like gender, age, course of disease, body mass index, history of antibiotic use before admission, combined internal diseases, combined trauma, and length of hospital stay. The items with P<0.05 were included in a multivariate logistic regression model to explore the risk factors for MDRO infection. Results:Pathogenic bacteria (331 strains) were detected in 286 of the 414 patients with chronic osteomyelitis, and infection with 168 strains of MDRO was detected in 150 of the 286 patients, yielding a detection rate of 50.8% (168/331). Of the 168 strains of MDR, 129 (76.8%, 129/168) were Gram-positive and 39 (23.2%, 39/168) Gram-negative. Staphylococcus aureus was the most frequently detected species of Gram-positive bacteria (58.1%, 75/129) and the most frequently detected pathogen (44.6%, 75/168) in this study. The resistance of Gram-positive bacteria to peptides and oxazolidinones was low (less than 10%). Multivariate logistic regression analysis showed that age ≥45 years ( OR=6.991, 95% CI: 3.525 to 13.865, P<0.001), essential hypertension ( OR=4.191, 95% CI: 2.070 to 8.485, P<0.001), trauma ( OR=4.232, 95% CI: 2.409 to 7.435, P<0.001) and length of hospital stay ( OR=1.015, 95% CI: 1.001 to 1.029, P=0.030) were the risk factors for MDRO infection in patients with chronic osteomyelitis. Conclusions:The detection rate of MDRO is at a medium to high level. Gram positive bacteria are the main pathogens and resistant to most antibiotics. Antibiotic therapy guided by bacterial culture is of great significance for patients with chronic osteomyelitis. Age≥45 years, essential hypertension, trauma, and long hospital stay are risk factors for MDRO infection in patients with chronic osteomyelitis.