Objective To observe the protection of aprotinin, ulinastatin and aminomethylbenzoic acid, aminomethylbenzoie acid on blood fibrinolytie system during cardiopulmonary bypass(CPB). Methods Thirty-six patients with rheumatic heart disease who were treated by valve replacement were randomly divided into three groups: aprotinin group (group A, 12 cases): aprotinin 2000 kU was added into the priming solution; ulinastatin and aminomethylbenzoic acid group (group UP, 12 cases): ulinastatin 12 000 U/kg and aminomethylbenzoic acid 10 mg/kg was added into the priming solution; aminomethylbenzoie acid group (group P, 12 cases): aminomethylbenzoic acid 10 mg/kg was added into the priming solution. Results There was no significant difference in CPB time and blood transfusion among three groups; the postoperative 24 h chest tube drainage in group UP was (443.3 ± 150.8) ml, in group P was (430.0 ± 178.3) ml and in group A was (290.0 ± 98.0) ml, there were significant differences between group UP, group P and group A (P < 0.05). There was 1 case of severe allergic reaction in group A. Conclusion Aprotinin, ulinastatin and aminomethylbenzoic acid, aminomethylbenzoic acid are effective in stabilizing blood fibrinolytic system and preserving platelet function during CPB, leading to less postoperative blood loss.

OBJECTIVETo investigate the association of serum pigment epithelium-derived factor (PEDF) level and polymorphisms in PEDF gene promoter region -358G→A with non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus (T2DM) of Han Nationality in Fujian Province.

METHODSA total of 282 T2DM patients with NAFLD (DM1 group) and 170 age- and gender-matched T2DM patients without NAFLD (DM2 group) were examined for PEDF gene SNP-358G→A polymorphisms using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Serum pigment epithelium-derived factor(PEDF) level, fasting plasma glucose (FPG), fasting insulin (FINS) and glycosylated hemoglobin (HbA1c) were also measured.

RESULTSThe patients in DM1 group showed a significantly higher mean level of serum PEDF than those in DM2 group (P<0.05). Logistic regression analysis revealed that PEDF level was an independent risk factor for NAFLD in T2DM. The frequencies of PEDF gene -358G→A genotypes (GG, GA, and AA) and alleles (G/A) differed significanly between DM1 and DM2 groups (P<0.05). In terms of PEDF gene SNP -358G→A alleles, the GA genotype carriers had a 2.032 times higher risk of developing NAFLD compared with the GG genotype carriers, and the risk increased to 2.068 times in the carriers of the A allele (GA and AA genotypes; P<0.05).

CONCLUSIONSerum PEDF level is an independent risk factor of NAFLD in T2DM. Elevated serum PEDF level is a protective factor against insulin resistance. In T2DM patients, PEDF gene promoter region -358G→A polymorphism is associated with NAFLD, and the A allele contributes to an increased risk of NAFLD.

Alleles ; Case-Control Studies ; Diabetes Mellitus, Type 2 ; genetics ; Ethnic Groups ; Eye Proteins ; genetics ; Genotype ; Humans ; Insulin Resistance ; Nerve Growth Factors ; genetics ; Non-alcoholic Fatty Liver Disease ; genetics ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Promoter Regions, Genetic ; Risk Factors ; Serpins ; genetics

Objective:To explore the effects of genotypes of one-carbon metabolism (OCM)-related enzyme single nucleotide polymorphisms (SNPs) sites and anti-epileptic drugs on OCM metabolite levels in epileptic patients, and to screen valproic acid (VPA) teratogenic susceptibility genes.Methods:Three hundred and seventy-two epileptic patients, admitted to our hospital from January 2019 to December 2020, were enrolled in the study; patients taking VPA, levetiracetam (LEV), lamotrigine (LTG) or oxcarbazepine (OXC) for more than 6 months without attack during regular medication were classified as VPA group ( n=95), LEV group ( n=61), LTG group ( n=57) and OXC group ( n=70); firstly diagnosed epileptic patients who had never taken antiepileptic drugs or had not taken antiepileptic drugs in the previous 6 months were assigned into blank control group ( n=89). Plasma folic acid (FA), vitamin B12 (VitB 12) and homocysteine (Hcy) levels were determined by automatic chemiluminescence immunoassay, and genotypes of OCM-related enzyme SNPs sites were detected by Sequenom iPLEX. Results:(1) As compared with LEV group and blank control group, VPA group had significantly decreased FA level and significantly increased Hcy level ( P<0.05). (2) Patients with DNA methyltransferase (DNMT) 3a rs12987326(-178G>A) GA type had significantly higher Hcy level than those with GG type ( P<0.05); patients with DNMT1 rs2288350(82G>C) GC type had significantly higher Hcy level than those with GG type ( P<0.05); patients with DNMT1 rs75616428 (55850G>C) GC type had significantly lower VitB 12 level than those with GG type ( P<0.05). Patients with DNMT1 rs1863771(128G>A) GA+AA type had significantly higher FA level than those with GG type, patients with folate receptor 2 rs2298444(59T>C) CT+CC type had significantly higher Hcy level than those with TT type, patients with 5,10-methylenetetrahydrofolate reductase rs1801131(1298A>C) AC+CC type had significantly higher Hcy level than those with AA type, and patients with DNMT3a rs6722613(2327C>T) CT+TT type had significantly lower VitB 12 level than those with CC type ( P<0.05). Conclusions:Decreased FA and increased Hcy levels can be noted in epileptic patients who used VPA; some gene variations in SNPs of OCM also affect the OCM metabolite levels in epileptic patients. Epileptic patients during pregnancy should avoid using VPA or detecting SNPs genotypes before medication to reduce the incidence of fetal malformation.

Objective:We evaluated frailty in elderly hospitalized patients with atrial fibrillation and analyzed the relevance, consistency, and diagnostic power of different frailty tools.Methods:From September 2018 to April 2019, a total of 197 elderly patients with atrial fibrillation aged ≥ 65 years in Beijing Hospital, Chinese PLA General Hospital, and Beijing Tsinghua Changgung Hospital were prospectively enrolled.Five frailty tools, including the clinical frailty scale(CFS), FRAIL scale(FRAIL), Fried frailty phenotype(Fried), Edmonton frail scale(EFS), and comprehensive geriatric assessment-frailty index(CGA-FI), were used for frailty assessment.Results:A total of 197 hospitalized elderly patients with atrial fibrillation were enrolled, with an average age of(77.5±7.1)years old(57.4% male). The prevalence of frailty, according to the five frailty tools, were 25.4%(FRAIL), 27.9%(EFS), 34.5%(Fried), 40.6%(CFS), and 42.6%(CGA-FI), respectively.CFS had a good correlation(correlation coefficient 0.80)and and consistency(Kappa value 0.71, 95% CI 0.61~0.81)with CGA-FI.The combined frailty index was used as the gold standard for frailty diagnosis.The results showed that CFS and CGA-FI had high diagnostic sensitivity(95.9 % and 98.0 %, respectively)and specificity(77.7 % and 75.7 %, respectively). Conclusions:Frailty is common in elderly hospitalized patients with atrial fibrillation, showing multidimensional features, and physical weakness is not prominet.CFS and CGA-FI are recommended for the assessment of frailty in patients with atrial fibrillation, which had good correlation and consistency.