PURPOSE: Coronary flow reserve (CFR) in the non-infarcted myocardium is often impaired following acute myocardial infarction (AMI). However, the clinical significance of CFR in the non-infarcted myocardium is not fully understood. The objective of the present study was to assess whether a relationship exists between CFR and left ventricular remodeling following AMI. MATERIALS AND METHODS: We enrolled 18 consecutive patients undergoing coronary intervention. Heart function was analyzed using real-time myocardial contrast echocardiography at one week and six months after coronary angioplasty. Ten subjects were enrolled as the control group and were examined using the same method at the same time to assess CFR. Cardiac troponin I (cTnI) levels were routinely analyzed to estimate peak concentration. RESULTS: CFR was 1.55+/-0.11 in the infarcted zone and 2.05+/-0.31 in the remote zone (p<0.01) at one week following AMI. According to CFR values in the remote zone, all patients were divided into two groups: Group I (CFR <2.05) and Group II (CFR >2.05). The levels of cTnI were higher in Group I compared to Group II on admission (36.40 vs. 21.38, p<0.05). Furthermore, left ventricular end diastolic volume was higher in Group I compared to Group II at six months following coronary angioplasty. CONCLUSION: Microvascular dysfunction is commonly observed in the remote myocardium. The CFR value accurately predicts adverse ventricular remodeling following AMI.
Aged ; Coronary Angiography ; Coronary Circulation/physiology ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction/*physiopathology/radiography ; Myocardium/*pathology ; Ventricular Remodeling/*physiology

PURPOSE: Coronary flow reserve (CFR) in the non-infarcted myocardium is often impaired following acute myocardial infarction (AMI). However, the clinical significance of CFR in the non-infarcted myocardium is not fully understood. The objective of the present study was to assess whether a relationship exists between CFR and left ventricular remodeling following AMI. MATERIALS AND METHODS: We enrolled 18 consecutive patients undergoing coronary intervention. Heart function was analyzed using real-time myocardial contrast echocardiography at one week and six months after coronary angioplasty. Ten subjects were enrolled as the control group and were examined using the same method at the same time to assess CFR. Cardiac troponin I (cTnI) levels were routinely analyzed to estimate peak concentration. RESULTS: CFR was 1.55+/-0.11 in the infarcted zone and 2.05+/-0.31 in the remote zone (p<0.01) at one week following AMI. According to CFR values in the remote zone, all patients were divided into two groups: Group I (CFR <2.05) and Group II (CFR >2.05). The levels of cTnI were higher in Group I compared to Group II on admission (36.40 vs. 21.38, p<0.05). Furthermore, left ventricular end diastolic volume was higher in Group I compared to Group II at six months following coronary angioplasty. CONCLUSION: Microvascular dysfunction is commonly observed in the remote myocardium. The CFR value accurately predicts adverse ventricular remodeling following AMI.
Aged ; Coronary Angiography ; Coronary Circulation/physiology ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction/*physiopathology/radiography ; Myocardium/*pathology ; Ventricular Remodeling/*physiology

Objective:To analyze the predictive value of serological measures within 24 hours of admission in acute pancreatitis patients against patients with severe acute pancreatitis(SAP), because the severity of acute pancreatitis was characterized by a timely assessment and prediction by emergency department physicians upon visit.Methods:A total of 119 acute pancreatitis patients admitted in Emergency Department in Beijing Jishuitan Hospital, Capital Medical University from January 2022 to December 2022 were retrospectively collected. According to the revised Atlanta classification, patients were characterized by mild acute pancreatitis group (77 cases), moderately severe acute pancreatitis group (27 cases), and SAP group (15 cases). Basic characteristics, early disease severity scores and early serological indexes of the three groups were compared, independent risk factors of serological indexes affecting the occurrence of SAP were analyzed, and receiver operator characteristic curve was drawn, evaluate the predictive value of related serological indexes for SAP.Results:There were no significant differences in the basic characteristics of the three groups including of gender, age, BMI, type of pancreatitis and complications ( P>0.05), but there were significant differences in early BISPA, Ranson, APACHEⅡ and Panc3 scores among the three groups ( P<0.05).Albumin-bilirubin score ( OR=3.653, 95% CI 1.665-8.012, P=0.001), blood urea nitrogen ( OR=1.117, 95% CI 1.039-1.202, P=0.003) were independent risk factors for SAP. The areas under ROC curve predicted by albumin-bilirubin score, blood urea nitrogen and albumin-bilirubin score combined with blood urea nitrogen were 0.762, 0.776 and 0.857, respectively, which showed no statistical difference compared with earlier Ranson, BISAP and APACHE Ⅱ scoring systems, respectively ( P>0.05). Conclusions:Early albumin-bilirubin score and blood urea nitrogen indexes of acute pancreatitis patients have good predictive value for SAP. Albumin-bilirubin score combined with blood urea nitrogen can improve the predictive value of SAP, and the predictive effect is as good as early Ranson, BISAP and APACHEⅡ scoring systems.

Objective To analyze the outcome indexes selected in the randomized controlled trials(RCTs)on traditional Chinese medicine(TCM)for skin rash caused by EGFR-TKI.Methods Seven databases were researched and the literature was screened according to the inclusion and exclusion criteria,then summarize and categorize outcome indexes to calculate frequency of outcomes and analyze.Results 46 out of 2241 papers were included.The outcome indexes of 40 RCTs were mainly divided into seven categories,that is physical symptoms/signs(37.97%),quality of life(17.65%),safety indicators(13.37%),traditional Chinese medicine symptoms/syndromes(16.58%),long-term prognosis(1.60%),blood biochemical index(9.09%)and others(3.74%).Problems as follow:First,there is a high risk of clinical trial bias in the treatment of EGFR-TKI-associated rash with TCM.Besides,the measurement time points was largely different with the severity of rash not considered.What's more,oversimplify the reports of compound outcome indicators and safety evaluation,lack of treatment time window and full process observation.Last,grading criteria for rash were inconsistent and the function of quality of life assessment tool was relatively simple.Conclusion At present,the use of outcome indicators has not been standardized in the RCTs for skin rash related EGFR-TKI by TCM,and relevant construction work should be carried out in the future to build a core index set with the characteristics of TCM treatment.

Lung cancer is the malignant tumor with the highest incidence and mortality among the Chinese.Tumor node metastasis(TNM)staging established by the American Joint Committee on Cancer(AJCC)and International Union Against Cancer(UICC)is a commonly used criterion,but it still has limitations in judging the prognosis of non-small cell lung cancer(NSCLC)patients.With the advantages of real-time and convenient sampling,the immune score based on peripheral blood biomarkers have the ability to predict prognosis and efficacy of NSCLC patients,which have been developed and validated in clinical studies.However,clinical impleruentation of peripheral immune scores is still not widely in NSCLC patients.Therefore,this study introduces and evaluates the 6 peripheral immune scores and reviews the reseach progress of them in the treatment of NSCLC.

Objective:To systematically evaluate the factors that promote and hinder exercise in patients with chronic kidney disease, and to provide reference for exercise intervention.Methods:The Cochrane Library,Web of Science, PubMed, Embase, CNKI, Wanfang, VIP and China Biomedical Literature Database were searched for qualitative researches on the promoting and hindering factors of exercise in patients with chronic kidney disease.The retrieval period was from the establishment of the database to January 2022. Qualitative Research Authenticity Evaluation Tool (version 2016) from JBI Evidence-Based Health Care Center was used to evaluate the quality of the literatures, and Meta-integration was used to analyze the results.Results:A total of 10 articles were included and 60 results were extracted, which were grouped into 8 new categories and integrated into 2 results:the promoting factors included personal exercise motivation,exercise self-efficacy stimulation,physical and psychological benefits and good social support;the hindering factors included disease and treatment factors,low exercise self-efficacy,fear of exercise risk and weak social support.Conclusions:Exercise of patients with chronic kidney disease is affected by many factors, so we should deeply understand the actual situation of patients,pay attention to the core factors affecting exercise, and improve the health of patients.