OBJECTIVEMeasures of ventilation-CO₂output relationship have been shown to be more prognostic than peak O₂uptake in assessing life expectancy in patients with chronic heart failure (CHF). Because both the ratios (VE/Vco₂) and slopes (VE-vs-Vco₂) of ventilation-co₂ output of differing durations can be used, we aim to ascertain which measurements best predicted CHF life expectancy.

METHODSTwo hundred and seventy-one CHF patients with NYHA class II-IV underwent incremental cardiopulmonary exercise testing (CPET) and were followed-up for a median duration of 479 days. Four different linear regression VE-vs- Vco₂ slopes were calculated from warm-up exercise onset to: 180 s, anaerobic threshold (AT), ventilatory compensation point (VCP); and peak exercise. Five VE/Vco₂ ratios were calculated for the following durations: rest (120 s), warm-up (30 s), AT (60 s), lowest value (90 s), and peak exercise (30 s). Death or heart transplant were considered end-points. Multiple statistical analyses were performed.

RESULTSCHF patients had high lowest VE/Vco₂ (41.0 ± 9.2, 141 ± 30%pred), high VE/Vco₂ at AT (42.5 ± 10.4, 145 ± 35%pred), and high VE-vs-Vco₂ slope to VCP (37.6 ± 12.1, 126 ± 41%pred). The best predictor of death was a higher lowest VE/Vco₂ (≥ 42, ≥ 141%pred), whereas the VE-vs-Vco₂slope to VCP was less variable than other slopes. For death prognosis in 6 months, %pred values were superior: for longer times, absolute values were superior.

CONCLUSIONThe increased lowest VE/Vco₂ ratio easily identifiable and simply measured during exercise, is the best measurement to assess the ventilation-co₂output relationship in prognosticating death in CHF patients.

Carbon Dioxide ; metabolism ; Chronic Disease ; Disease Progression ; Exercise Test ; Heart Failure ; diagnosis ; mortality ; physiopathology ; Humans ; Life Expectancy ; Respiratory Function Tests

To automatically infer the patterns of vessel structure such as the distal ends, segments, bifurvessel structures, and crossing of two vessels in X-ray angiographic images, a novel method is presented based on Gabor filter and circle detector. The method can cope with varying vessel curvature and intensity feature occur along the longitudinal vessel direction. The present study can facilitate 2-D quantitative description of vessel tree and 3-D vessel reconstruction, and provide an elementary clue for the diagnostics. The proposed method has been successively applied to both synthetic images for validation purposes and the actual angiographic images, which yielded encouraging results.
Algorithms ; Angiography ; methods ; Artifacts ; Blood Vessels ; anatomy & histology ; pathology ; Humans ; Image Enhancement ; methods ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Pattern Recognition, Automated ; methods

OBJECTIVETo investigate the expression characteristics of the gene of coiled-coil domain-containing protein 70 (Ccdc70) in the mouse testis and its potential role in spermatogenesis.

METHODSUsing expression profile microarray, we screened the mouse testis-specific gene Ccdc70, studied its expression characteristics in the mouse testis by RT-PCR, real-time PCR, Western blot and immunohistochemistry, followed by bioinformatic analysis of the Ccdc70 protein.

RESULTSThe Ccdc70 gene was expressed highly in the testis but lowly in the epididymis of the mice. The Ccdc70 protein was expressed mainly in the spermatocytes and round spermatids of the testis and in the epithelial cells of the epididymis. Bioinformatic analysis showed a structural domain in the Ccdc70 protein, which was highly conserved in mammalian evolution.

CONCLUSIONThe Ccdc70 gene is highly expressed in the mouse testis and mainly in the spermatocytes, round spermatids, and epididymal epithelial cells, which indicates that it is involved in the regulation of spermatogenesis and epididymal sperm maturation.

Animals ; Computational Biology ; Gene Expression Regulation, Developmental ; Male ; Mice ; Proteins ; genetics ; Spermatogenesis ; genetics ; Testis ; metabolism

0.05);2)After 12,24,36 months' treatment,BP was decreased significantly in each group (P0.05).Conclusion Both combined spirono- lactone/HCTZ and captopril/HCTZ significantly reduced BP and LVMI or LVMI and the maguitude of reduction was further enhanced after prolonged treatment.

Objective To investigate the seroprevalence of tick-borne diseases in humans and domestic animals from rural areas of Zhejiang province. Methods Anji county, Jindong district and Tiantai county were selected for samples collection according to their geographic locations and historical prevalence of tick-borne diseases. Blood samples of humans and domestic animals were collected in the three sites. An indirect immuno-fluorescent antibody test was used to determine the presence of IgG antibodies of Rickettsiae heilongjiangii, Orientia tsutsugamushi, R. typhi, Anaplasma phagocytos, Ehrlichia chaffeensis, Bartonella, R. hainan and Coxiella burnetii in these samples.Results Six hundred and eighty-three blood samples including 579 from humans and 104 from domestic animals(53 from cattles and 51 from sheep)were collected from the three sites. Antibody positive rates of Orientia tsutsugamushi, R. typhi, Ehrlichia chaffeensis and Coxiella burnetii were significantly different between these sites. IgG from all the 8 pathogens were detected in samples from humans. It was found that the sero-prevalence rates of R. typhi, Bartonella and C. burnetii(20.7%,10.9%, 5.5%)of adults were higher than those of other Rickettsiae under investigation. The seroprevalence of R. typhi increased along with age. IgG from the 7 pathogens were detected in samples from domestic animals except for Anaplasma phagocytos. The sero-prevalence rates of R. typhi, Bartonella and R. hainan(69.2%, 51.0%, 22.1%)of adults were higher than those of other Rickettsiae investigated. Conclusion Tick-borne diseases did spread widely in humans and domestic animals from different rural areas of Zhejiang province. The sero-prevalence rates of R. typhi,B. henselae, R. hainan and C. burnetii were higher than that from other pathogens.

OBJECTIVESTo evaluate the feasibility and effectiveness of stent placement in treating hepatic artery stenosis after orthotopic liver transplantation (OLT).

METHODSFrom November 2003 to September 2005, 14 patients who had hepatic artery stenosis after OLT underwent stent placement in their narrowed hepatic arteries. This included early interventional treatment in 10 patients and delayed interventional treatment in 4 patients. The technical results, clinical outcomes, and the hepatic artery patencies were reviewed.

RESULTSTechnical and immediate success was 100%. After a mean follow-up of 146 days (range, 9-345 days), all patients' hepatic arteries were patent, except that hepatic arterious restenosis occurred in 2 patients at 26 and 45 days after the stent placement. Of the 10 patients who received early treatment, 8 survived with normal results of liver function test and 2 patients died of septic multiple-organ failure at 9 and 30 days after the stent procedure. One patient received a retransplantation because of refractory biliary infection. Of the 4 patients who received a delayed interventional treatment, 1 patient survived for 345 days but with abnormal liver functional test results, the other 3 patients died of septic multiple-organ failure resulting from liver abscesses biliary infection.

CONCLUSIONHepatic artery stenosis after OLT can successfully be treated with stent placement and an early interventional treatment is the key for a good clinical outcome.

Adult ; Constriction, Pathologic ; therapy ; Female ; Graft Occlusion, Vascular ; etiology ; therapy ; Hepatic Artery ; surgery ; Humans ; Liver Transplantation ; Male ; Middle Aged ; Stents ; Vascular Diseases ; etiology ; therapy

Objectives: To compare the short-term and mid-term outcomes of elderly patients (>60 years old) with valvular heart disease (VHD) underwent bioprosthetic or mechanical valve replacement. Methods: Between January 2007 and December 2010, 559 elderly patients underwent valve replacement in Fuwai Hospital, clinical data of these patients were analyzed retrospectively (319 cases with bioprostheses vs 240 cases with mechanical prostheses). After matching, data from 192 cases in each group were compared. Results: The mortality within 30 postoperative days were similar (2.1% in both groups). All-cause death during follow up was also similar between the two groups (13.6% vs 13.7%, P=0.98). There was no statistically significant difference on the hospital readmission rate between the two groups (25.5% vs 35.9%, P=0.17). No significant difference was found on thromboembolic and hemorrhagic events free survival between the two groups (144 cases vs 138 cases, P=0.78). Conclusions: Short-term and mid-term survival and readmission rate are similar for the elderly VHD patients receiving bioprosthetic or mechanical valve replacement.

OBJECTIVETo explore the impact of patient compliance on the long-term outcomes in hypertensive patients receiving hydrochlorothiazide (HCTZ) based combination therapy with spironolactone or captopril.

METHODSA total of 853 patients with mild to moderate hypertension were recruited and randomly divided into HCTZ group (HCTZ 12.5 mg q.d), spironolactone group (HCTZ 12.5 mg q.d and spironolactone 20 mg q.d), and captopril group (HCTZ 12.5 mg q.d and captopril 25 mg bid) after 2-week placebo washout period and 6-week loading period for HCTZ. Since the efficacy of combination therapy was proven to be better than monotherapy 1 year after therapy beginning, patients in HCTZ group were randomly assigned to spironolactone group or captopril group. The patients were followed up for 4 years. Patients were divided to compliance (n = 424) or non-compliance group (n = 429) according test drug taking questionnaire. During the follow-up time, the blood pressure and the outcomes were recorded monthly, and blood biochemical parameters were determined once a year.

RESULTSAt the end of follow up, incidence of cardio-cerebral vascular events was significantly lower in compliance group (2 fatal, 8 non-fatal) than that in noncompliance group (7 fatal, 21 non-fatal, P < 0.05). Systolic blood pressure [-(19.4 +/- 20.6) mm Hg, 1 mm Hg = 0.133 kPa] and diastolic blood pressure [-(10.7 +/- 13.5) mm Hg] were significantly reduced compared values at baseline and noncompliance group (all P < 0.001) while the reduction did not reach statistically significance in noncompliance group [-(7.3 +/- 18.2) mm Hg and -(3.5 +/- 10.2) mm Hg, all P > 0.05 vs. baseline]. The serum BUN, Cr and UA levels in the compliance group were significantly higher and the serum K(+), CHO, LDL-C level were significantly lower than baseline values. The serum BUN, UA levels in the compliance group were significantly higher while the serum K(+), cholesterol levels were significantly lower than those in the noncompliance group (all P < 0.05).

CONCLUSIONSThis study indicates that patient compliance could affect the long-term outcome and antihypertensive efficacy in hypertensive patients receiving HCTZ based combination therapy with spironolactone or captopril.

Aged ; Antihypertensive Agents ; therapeutic use ; Captopril ; therapeutic use ; Drug Therapy, Combination ; Female ; Follow-Up Studies ; Humans ; Hydrochlorothiazide ; therapeutic use ; Hypertension ; drug therapy ; Male ; Middle Aged ; Patient Compliance ; Spironolactone ; therapeutic use ; Treatment Outcome

Objective: Several COVID-19 patients have overlapping comorbidities. The independent role of each component contributing to the risk of COVID-19 is unknown, and how some non-cardiometabolic comorbidities affect the risk of COVID-19 remains unclear. Methods: A retrospective follow-up design was adopted. A total of 1,160 laboratory-confirmed patients were enrolled from nine provinces in China. Data on comorbidities were obtained from the patients' medical records. Multivariable logistic regression models were used to estimate the odds ratio ( Results: Overall, 158 (13.6%) patients were diagnosed with severe illness and 32 (2.7%) had unfavorable outcomes. Hypertension (2.87, 1.30-6.32), type 2 diabetes (T2DM) (3.57, 2.32-5.49), cardiovascular disease (CVD) (3.78, 1.81-7.89), fatty liver disease (7.53, 1.96-28.96), hyperlipidemia (2.15, 1.26-3.67), other lung diseases (6.00, 3.01-11.96), and electrolyte imbalance (10.40, 3.00-26.10) were independently linked to increased odds of being severely ill. T2DM (6.07, 2.89-12.75), CVD (8.47, 6.03-11.89), and electrolyte imbalance (19.44, 11.47-32.96) were also strong predictors of unfavorable outcomes. Women with comorbidities were more likely to have severe disease on admission (5.46, 3.25-9.19), while men with comorbidities were more likely to have unfavorable treatment outcomes (6.58, 1.46-29.64) within two weeks. Conclusion Besides hypertension, diabetes, and CVD, fatty liver disease, hyperlipidemia, other lung diseases, and electrolyte imbalance were independent risk factors for COVID-19 severity and poor treatment outcome. Women with comorbidities were more likely to have severe disease, while men with comorbidities were more likely to have unfavorable treatment outcomes.
Adult ; Aged ; COVID-19/virology* ; China/epidemiology* ; Comorbidity ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Severity of Illness Index ; Treatment Outcome