Objective To explore the association between HbA1c and acute myocardial infarction(AMI) in youth. Methods Seventy-two AMI patients (≤44y) diagnosed during the period from January in 2009 to August in 2012 were enrolled and 79 young age-matched adults without coronary artery disease at the same period were enrolled to be control group. The relationship between HbA1c, fasting blood-glucose(FBG) and AMI was explored. Results (1)Compared with the control group,the plasma FBG and HbA1C value were significantly higher(P<0.05) in AMI group. (2)Logistic regression analysis showed that HbA1c is the independent risk factor for AMI in youth. (3)In AMI group, the HbA1c level in single vessel disease had remarkable difference with that in double vessel disease and triple vessel disease(P<0.05). Conclusions Increasing HbA1c level is the independent risk factor for AMI in youth,and positively correlated with the degree of coronary artery lesions. Primary intervention of glycometabolism abnormality possibly becomes the new opinion for prevention and cure of AMI.

Defibrillators ; Humans ; Myocardial Infarction

Extracorporeal Membrane Oxygenation ; Humans ; Percutaneous Coronary Intervention ; adverse effects ; Shock, Cardiogenic

Objective To summarize clinical application, method and result of extra-corporeal membrane oxygenation ( ECMO) used during beating heart coronary artery bypass grafting ( CABG) in high risk patients. Methods Twenty one patients [ mean age ( 75. 7 ± 3. 6 ) years old ] who received beating-heart CABG surgery assisted with ECMO were included in the study. We observed the condition when ECMO weaned off, the duration on mechanical rentilato time of ICU stay and the occurance of related complications. Results Among the 21 patients, ECMO was weaned off uneventfully after surgery in 8 patients. Immediate weaning was failed in another 8 patients and required gradual weaning in 2. 0-4. 5 hrs. Five patients could not wean off the ECMO in operation room needing continuous ECMO support in CCU. ECMO was weaned off in CCU gradually with IABP support [mean IABP support time: (115. 0 ± 25. 9) hrs]. Among the 5 patients admitted into CCU, 1 patient had oozing from insertion site at femoral artery/rein region and was stopped with compressive bandage. Lower limb ischemia happened in another 1 patient and was recovered after set up of by-pass circulation. All 21 patients recovered well and smoothly. Mean in-hospital stay was (17. 4 ± 2. 8) d. Conclusions ECMO is a safe and effective circulatory support during beating heart coronary artery bypass surgery for high-risk patients with severe coronary artery disease in reducing the mortality and complications.

Objective To explore the influence of smoking on clopidogrel resistance in patients with coro-nary artery disease. Methods A total of 216 patients with coronary artery disease who accept selective percutane-ous coronary intervention in our hospital from May 2015 to December 2015 were selected as study subjects;their average age was 63 years old ,146 were male and 70 were female. All the patients were divided into clopidogrel resistance group (CR group) and normal clopidogrel response group (NCR group) according to the results of platelet aggregation test. History of smoking ,alcohol drinking and diabetes mellitus ,baseline medication uses , level of platelet counts,platelet distribution width,mean platelet volume,HbA1c,and results of echocardiogram and coronary angiography were compared between the two groups. Results The rate of smoking was significantly higher in CR group than in NCR group (P < 0.05). The changed value of PDW before and after treatment with clopidogrel was smaller in CR group than in NCR group ,the difference was statistically significant (P < 0.05). Conclusions Smoking may be a protective factor for clopidogrel resistance. The changed value of PDW before and after treatment with clopidogrel can reflect the level of clopidogrel resistance.

Objective To investigate the effects of circumferential pulmonary vein isolation (CPVI) on atrial effective refractory period (ERP) in patients with paroxysmal atrial fibrillation.Methods 30 patients who underwent radiofrequency catheter ablation for paroxysmal AF were enrolled in this study.Using FAM mode,the RA and LA anatomical models were achieved in the CARTO 3 system.SVC,MRA,RAA,LA-A,LA-R,LA-P,LAA,LSPV,LIPV,RSPV,RIPV,CSp,CSd,were respectively located in the RA or LA anatomical model.Before and after CPVI,ERPs were measured in different locations of the atrium using programmed stimulation.The ERPs of the RA (SVC,MRA,RAA,CSp),LA (LA-A,LA-R,LA-P,LAA,CSd),PVs (LSPV,RSPV,LIPV,RIPV) were compared.Bilateral CPVIs were completed in all patients,and PV-LA bidirectional conduction block was achieved.The changes of electrophysiological characteristics of atrium before and after CPVI were observed.Results (1) ERP at different locations in the atrium before CPVI:Comparisons of ERPs at different locations of atrium:RAA had the minimal ERPs[(197.4 ± 28.6) ms (P ＜ 0.01);followed by PVs measuring,respectively,LSPV (213.0 ± 47.5) ms,LIPV (208.9 ± 45.9) ms,RSPV (209.3 ± 43.6) ms,RIPV (213.5 ± 48.1) ms and LAA (218.1 ± 27.7) ms.Comparisons of ERPs in RA,LA,and PVs showed:PVs had the lowest ERPs (211.2 ± 35.2) ms versus RA ERP (227.0 ± 23.7) ms versus LA ERP (241.0 ± 21.5) ms (P ＜ 0.05).(2) Comparisons of ERPs before and after CPVI:Comparisons of ERPs at different locations of atrium showed:RAA [(197.4 ± 28.6) ms vs.(208.6 ± 32.2) ms,P=0.003],CSp [(234.7 ± 29.1) ms vs.(246.9 ± 29.7) ms,P=0.007],LA-R [(242.9 ± 28.9) ms vs.(258.3 ± 26.9) ms,P=0.003],LA-P [(252.2 ± 28.5) ms vs.(261.1 ± 30.2) ms,P=0.039]and CSd [(238.6 ± 28.3) ms vs.(250.3 ± 23.6) ms,P =0.009].ERPs were found statistically prolonged at all different locations after CPVI.Comparisons of ERPs at RAand LA after CPVI showed:RA [(227.0 ± 23.7) ms vs.(235.9 ± 21.7)ms,P=0.002]and LA [(241.0 ± 21.5) ms vs.(249.7 ± 19.9) ms,P =0.001],which were statistically increased after CPVI.(3) A total of 90 episodes of atrial arrhythmias were induced before CPVI which were found at RAA (n =17),LAA (n =12),and PVs (n =36).After CPVI,8 episodes of atrial arrhythmias were induced which were found at,RAA (n =4),LAA (n =3),and SVC (n =1).Conclusions (1) Compared with other parts of atrium,ERPs at PVs,LAA and RAA are significantly shorter in patients with paroxysmal AF.At PVs,LAA and RAA,atrial arrhythmias are easily to be induce by programmed stimulation.(2) In patients with paroxysmal Af:PVs has the shortest ERPsfollowed by RAs whereas LA ERPs is the longest.There is a large ERP gradient change between PVs and LA.(3) The ERPs at RAs,LAs,As,and LA-PV are prolonged after CPVI.(4) Atrial arrhythmia is less likely to be induced after CPVI.

Objective:To investigate the influence of infarct vessel diameter, blood flow before operation, blood flow status after operation, coronary artery disease, number of coronary artery lesions and other risk factors on the levels of inflammatory factors IL-1, IL-6, IL-10 in the coronary blood of patients with acute coronary syndrome (ACS), and to determine the relationship between inflammatory factors and ACS and its impact on clinical status.Methods:The peripheral blood and coronary blood of 54 patients with ACS underwent emergency interventional treatment were collected before the operation. The level of IL-1, IL-6, and IL-10 in the blood sample was detected by an automatic biochemical analyzer.Results:Postoperative adverse cardiac events were positively correlated with the patient's age, D-to-B time, and the number of coronary artery lesions (all P<0.05). The levels of IL-1, IL-6 and IL-10 in coronary blood of ACS patients were higher than those in peripheral blood (all P<0.05). The number of coronary artery disease branches (≥3), the onset time of myocardial infarction (>4 h), diabetes mellitus, ischemic post-treatment, preoperative blood flow level ( 2.5 mm, coronary artery disease number ≥ 3, severe right coronary artery disease, preoperative blood flow 22 frames, and cardiovascular events, the IL-10 levels are higher (all P<0.05). Conclusions:The levels of inflammatory factors IL-1, IL-6, and IL-10 in coronary blood of ACS patients are higher than those in peripheral blood, suggesting that acute coronary artery originates from local coronary inflammatory reaction, and the increase of inflammatory factors in peripheral blood belongs to "Erosion" effect. The level of inflammatory factors is significantly related to the diameter of the diseased blood vessel, preoperative blood flow, the number of coronary artery disease, the location of myocardial infarction, diabetes and smoking history.

Sorghum (Sorghum bicolor L.) was one of the most important crops in the world next to wheat, rice, maize, soybean and barley. Using the callus derived from immature inflorescence as the recipients, we efficiently transformed sorghum varieties 115, ICS21B and 5-27 with the insecticidal Bacillus thuringiensis (Bt) cry1Ab gene carried in the T-DNA of binary vectors which contained hygromycin resistance gene and gus gene via Agrobacterium tumefaciens. After gradient selection with hygromycin, a total of 21 independent transgenic plant lines, 52 transgenic plants were regenerated, and the average stably transformation efficiency was 1.9%. The integration and transcription of cry1Ab gene in transgenic sorghum was confirmed by PCR analysis, Southern blotting and RT-PCR analysis. The Bt proteins were expressed in most transgenic plants with different level from plant to plant by Western blotting and ELISA assay. According to insect bioassay in laboratory, the transgenic plants with a relatively high level of Bt gene expression displayed insect-resistance to pink rice borer (Sesamina inferens).
Agrobacterium tumefaciens ; genetics ; metabolism ; Bacterial Proteins ; genetics ; metabolism ; Endotoxins ; genetics ; metabolism ; Hemolysin Proteins ; genetics ; metabolism ; Pest Control, Biological ; Plants, Genetically Modified ; genetics ; Sorghum ; genetics ; Transformation, Genetic

Objective To compare the perioperative characteristics and long term outcomes between extracorporeal membrane oxygenation (ECMO)-conventional cardiopulmonary switch (experimental group,26 cases) and off-pump high-risk coronary artery bypass grafting (OPCABG group,24cases).Methods Perioperative characteristics and survival rate were retrospectively analyzed between experimental group and OPCABG group.Long term survival rates without major cardiovascular adverse events (MACE) were comparatively analyzed via Kaplan-Meier curves.Results The average Euroscore value were 11.7 ± 2.4 and 10.9 ± 2.0,respectively(P =0.208).The experimental group had a higher complete revascularization rate (96.2％ vs.66.7％,P =0.009),a shorter length of postoperative ECMO support [(33.1±23.6)h vs.(80.8±18.5)h],an intensive care unit stay[(4.8±1.1)d vs.(10.2±9.0)d]and a hospital stay [(17.7±6.3)d vs.(28.2±17.5)d] (all P＜0.05) as compared with OPCABG group.Preoperative New York Heart Association (NYHA) grading of cardiac function (r =0.511,P =0.008) and intraoperative ultrafiltration volume (r =-0.442,P =0.024) were significantly correlated with postoperative ECMO continuation in the experimental group.The follow-up period was (45.4 ± 15.2) months.The experimental group had a higher survival rate without MACE than had the OPCABG group (Log-rank test:x2=4.828,P=0.028).Conclusions The ECMO-conventional cardiopulmonary switch mode might facilitate a higher complete revascularization,a lower incidence of postoperative morbidities and improve the longterm survival rate without MACE for patients with high risks.

Objective:This paper is to evaluate the curative effect of Self-made Jishen prescription combined with conventional western medicine in the treatment of type 2 diabetic kidney disease (DKD) with both deficiency of both qi and yin and blood stasis.Methods:A total of 80 patients from February 2019 to July 2020 with the syndrome of deficiency of both Qi and Yin with blood stasis in the DKD Ⅲ stage of Ruzhou Jiren Diabetes Hospital were selected. Those patients who met the diagnostic criteria were randomly divided into 2 groups, the control group and the treatment group, according to registration orders, with 40 in each group. The control group was treated with conventional western medicine therapy, and the treatment group was treated with modified self-made Jishen prescription on the basis of the control group. The treatment of both groups lasted for 3 months. Traditional Chinese Medicine (TCM) symptoms were scored before and after the treatment; hexokinase method was used to detect FPG, sarcosine oxidase method was used to detect SCr and eGFR were calculated, latex enhanced turbidimetric inhibition immuno assay method was used to detect hypersensitive C-reactive protein (hs-CRP), the sandwich ELISA was used to detect transforming growth factor-β1 (TGF-β1), and HbA1c was detected by high performance liquid chromatography; 24 h urine was collected, and 24 hUTP was detected by pyrogallol red-molybdenum method; and the clinical efficacy was evaluated.Results:The total effective rate was 87.5% (35/40) in the treatment group and 67.5% (27/40) in the control group. The difference between the two groups was statistically significant ( Z=-2.72, P=0.006). After treatment, hs-CRP [(2.52±1.02) mg/L vs. (3.21±1.22) mg/L, t=2.74], TGF-β1 [(32.2±6.52) mg/L vs. (38.3±6.8) mg/L, t=-4.97], 24 hUTP [(120.91±38.84) mg vs. (144.84 ±49.69) mg, t=-5.94] in the treatment group were significantly lower than those in the control group ( P<0.05); eGFR [(66.23±4.91)ml?min -1?1.73m -2vs. (59.69 ±4.51) ml?min -1?1.73m -2, t=6.61] in the treatment group was significantly higher than that of the control group ( P<0.05). The TCM Symptom Score after treatment in the treatment group was significantly lower than that of the control group ( P<0.01). Conclusion:For the patients with T2DM kidney disease of Phase Ⅲ with Deficiency of both Qi and Yin and Blood Stasis, the treatment of self-made Jishen prescription combined with conventional western medicine can inhibit the inflammatory reaction and renal interstitial fibrosis, improve the glomerular filtration rate, and reduce the excretion of urine protein.