1.Value of left ventricular Tei index for diagnosis of congestive heart failure in elderly patients
Jidong YANG ; Zhaocai ZHANG ; Zhaodun ZHANG
Chinese Journal of Geriatrics 2000;0(06):-
Objective To evaluate the value of left ventricular Tei index for diagnosis of congestive heart failure(CHF)in elderly patients. Methods One hundred and thirty-eight elderly patients suggestive of CHF and 30 healthy middle-aged individuals were enrolled, Tei index, left ventricular ejection fraction (LVEF) and early to late diastolic mitral flow velocity ratio (E/A) were echocardiographically detected. Tei index in elderly patients with and without CHF, and healthy middle-aged individuals was determined, and then the diagnostic value of the above 3 parameters for CHF in elderly patients were evaluated. Results Tei index was singnificantly increased in patients with CHF compared with patients without CHF (0.77?0.14 vs 0.45?0.10,P
2.Incidence of upper gastrointestinal bleeding and relevant factors associated with dual antiplatelet therapy in patients with coronary heart disease
Jun YANG ; Feng LING ; Zhaocai ZHANG ; Yiyang DAI ; Caiya ZHANG
Chinese Journal of Emergency Medicine 2011;20(11):1183-1186
Objective To investigate the incidence and relevant factors of upper gastrointestinal bleeding(UGB)in patients with coronary heart disease(CHD)undergoing dual antiplatelet therapy(DAT)with aspirin plus clopidogrel.Methods A total of 391 CHD patients treated with aspirin plus clopidogrel (DAT group)and 502 control CHD patients receiving single antiplatelet therapy(SAT)with aspirin or clopidogrel(SAT group)were enrolled.The incidence and relevant factors associated with UGB were retrospectively analyzed in both groups of patients.Data were analyzed with Chi-square test and logistic regression by using SAS software version 9.0.Results The incidence of UGB in DAT group was significantly higher compared with SAT group(7.1% vs.3.4%,P < 0.01).The factors,including DAT,age over 65 years,medication duration over 3 months and previous digestive diseases increased the risk of UGB in CHD patients(P < 0.05),while the use of PPIs(proton-pump inhibitors)or gastric mucosal protectives lowered the risk of UGB(OR:0.415,95% CI 0.226 ~ 0.762,P =0.0035).Conclusions DAT can significantly increase the risk of UGB.UGB can be increased in elderly CHD patients and those with long-term medication and previous digestive diseases.Utility of PPIs or gastric mucosal protectives can effectively lower the incidence of UGB.
3.Effects of high volume hemofiltration(HVHF) on cytokines in elderly patients with septic shock and MODS
Guolong CAI ; Jin YAN ; Yihua YU ; Zhaocai ZHANG ; Jiangou CHEN
Chinese Journal of Emergency Medicine 2006;0(01):-
Objective To study the effects of HVHF on cytokines in elderly patients with septic shock and MODS. Methods 22 elderly patients with septic shock and MODS were included in this prospective and interventional study. Before HVHF and 1,3,6,9,12,18 and 24 hour after HVHF, blood sample and ultrafiltration fluid were collected for cytokines analysis(radioimmunoassay). Results All patients finished HVHF. No severe side effects were observed,and the APACHEⅡ and MODS scores were decreased during HVHF(P
4.Effects of plasma brain natriuretic peptide on prognosis of elderly patients with severe sepsis
Yihua YU ; Jing YAN ; Guolong CAI ; Shijin GONG ; Haiwen DAI ; Zhaocai ZHANG ; Jin CHEN
Chinese Journal of Emergency Medicine 2008;17(11):1187-1190
Objective To evaluate the predictive value of brain natriuretic peptide (BNP) on mortality in elderly patient with severe sepsis or septic shock. Method Eighty-three elderly patients meeting with criteria of severe sepsis or septic shock by the American College of Chest Physicians and the Society of Critical Care Medicine (ACCP/SCCM) in 2001, admitted in Intensive Care Unit (ICU) of Zhejiang Hospital during May 2004 to June 2007, were enrolled, and patients with chronic renal failure were excluded. The patients were divided into survivor and non - survivor group according to whether they survived within 28 days staying in ICU, the difference of plasma BNP level,serum C-creative protein (CRP) concentration, APACHE II and SOFA scores on admission day and BNP level on the third day between the two groups were compared; thereafter, the relationship between muhiple variables including age, admission day, BNP, CRP, APACHE 11 and SOFA scores, the 3rd day BNP level and 28-day mortality were analyzed by Logistic regression, and meanwhile the independent predictors for ICU moaality among which were determined. Results BNP levels on both admission day and the 3rd day were significantly higher in nomurvivor group than those in survivor group[ ( 1056.38±676.34) pg/ml vs. (611.59±610.02) pg/ml,p =0.002 and (1448.48+891.11) pg/ml vs. (522.41±575.20) pg/ml, P<0.001, respectively]. By Logistic regression analysis, BNP level on the 3rd day and SOFA score on admission day were independent predictors of ICU mortality, The receiver operating characteristic (ROC) curves indicated that values of areas under the curve of the admission day and the 3rd day BNP levels for 28-days mortality were 0.735 (95% CI,0. 621~0. 848, P <0.001) andO.836 (95% CI, 0.746~0,926,P<0.001), respectively. Conclusions Plasma BNP inereaseds in majority of eldedy patients with severe sepsis or septic shock, which may serve as irdex for prognosis in elderly severe septic paients.
5.Correlation Between Endotheliocyte Function,Inflammation-Related Factors and TCM Syndromes in Sepsis Patients
Minchun YANG ; Zhaocai ZHANG ; Guolong CAI ; Caibao HU ; Hui YAO ; Yaping XU ; Jing YAN
Journal of Traditional Chinese Medicine 1993;0(03):-
Objective To study dynamically the correlation between endotheliocyte functions,inflammation-related factors and TCM syndromes in sepsis patients.Methods According to the TCM syndrome differentiation,68 septic patients were divided into Qi-fen group (23 cases),Ying-fen group (28 cases),and Xue-fen group (17 cases).The control group (26 cases) was built up for contrast.Serum von willebrand factor (vWf),nitric oxide (NO),tumor necrosis factor-? (TNF-?),interleukin 6 (IL-6),interleukin 2(IL-2),interleukin 4 (IL-4),and white blood cell (WBC) count of all groups were measured.Results TNF-?,IL-6,and WBC in all the sepsis groups were significantly higher than those in the control group (P
6.Cardiac collagen metabolism in murine viral heart diseases
Zhaocai ZHANG ; Yingzhen YANG ; Ruizhen CHEN ; Leilei CHENG ; Junbo GE ; Haozhu CHEN
Chinese Journal of Pathophysiology 2000;0(08):-
AIM: To investigate the dynamic alteration of cardiac collagen metabolism in mice with acute,chronic myocarditis and dilated cardiomyopathy(DCM).METHODS: BALB/c mice infected with coxsackievirus B_3 were used to establish animal models of acute,chronic myocarditis and dilated cardiomyopathy,while uninfected animals were also prepared and served as controls.After verification of models by histopathological methods and echocardiography,serum concentration of aminoterminal propeptide of type Ⅲ procollagen(PIIINP),aminoterminal propeptide of type Ⅰ procollagen(PINP) and carboxyterminal propeptide of type I procollagen(PICP) in each group of mice were detected by enzyme linked immunosorbent assay(ELISA).The expression of matrix metalloproteinase 1(MMP1) and its tissue inhibitor(TIMP-1) were determined by Western blotting analysis.The MMP-1 activity was also detected.RESULTS: Marked myocardial fibrosis was observed in all groups of CVB_3-infected mice.Reparative fibrosis,promotion of synthesis and degradation of cardiac collagens were presented in heart tissue of acute myocarditis mice. Both reparative and reactive fibrosis,enhanced synthesis and lightened degradation of collagen were present in chronic myocarditis,while reactive fibrosis and excess collagen synthesis were confirmed in DCM.Expression and activity of(MMP-1) was progressively decreased.TIMP-1 showed unchanged.The ratio of MMP-1/TIMP-1 was progressively descended.CONCLUSION: Collagen metabolism was special in different phase of viral heart diseases,which may play different roles in the progression and prognosis of these kinds of disease.
7.Assessment of fluid treatment in elderly patients with severe sepsis guided by monitoring the variation of stroke volume
Yihua YU ; Jing YAN ; Haiwen DAI ; Shijin GONG ; Guolong CAI ; Zhaocai ZHANG ; Jin CHEN
Medical Journal of Chinese People's Liberation Army 1983;0(05):-
0.05).Conclusions Fluid therapy guided by functional hemodynamic index SVV in elderly patients with severe sepsis under MV is safe and more effective than that guided by CVP.SVV is valuable in prodicting the response to fluid treatment in elderly patients with severe sepsis.
8.Role of antibody chin in analysis of inflammatory cytokine expression in severe sepsis
Jing YAN ; Zhaocai ZHANG ; Guolong CAI ; Yihua YU ; Caibao HU ; Liang WU ;
Chinese Journal of Emergency Medicine 2006;0(09):-
Objective To investigate the expression of inflammatory cytokines in patients with severe sepsis by using an antibody chip.Methods Twelve patients with severe sepsis and other 10 patients whose age and gender were matehed were enrolled in this study.Proteins from patients were labeled with biotin.The biotin-labeled proteins reaeted with antibody chips,on which there were antibodies of 40 major inflammatory cytokines.The target proteins were conjugated with streptomycin antibody labeled by horseradish peroxidase(HRP),and signals were imaged by laser scanner.Results In comparison with control group,the serum levels of inflammatory eytokines ineluding pro-and anti-inflammatory cytokines,ehemokines and certain eytokines receptors were notably increased,while expression of anti-inflammatory interleukin(IL)-2,-4,-13,-15 was remarkably decreased in sepsis group.Conclusions Excess inflammatory response and imbalance of pro-and anti-inflammatory eytokines were presented in the eourse of severe sepsis.
9.Effect of early goal-directed therapy on myocardial protection in severe sepsis/septic shock patients
Song QIAO ; Guolong CAI ; Jing YAN ; Yihua YU ; Zhaocai ZHANG ; Molei YAN ; Caibao HU
Medical Journal of Chinese People's Liberation Army 1983;0(02):-
0.05) between two groups.After EGDT,the level of cTnI in EGDT group was obviously dowered on the 7th day (0.16?0.22?g/L) and 14th day (0.09?0.13?g/L) compared with those in control group (0.39?0.43,0.29?0.29?g/L,P
10.Prognostic value of stroke volume variation in septic patients
Haiwen DAI ; Zhaocai ZHANG ; Jin CHEN ; Shijin GONG ; Guolong CAI ; Yihua YU ; Chengwu TAN ; Molei YAN ; Liang WU ; Jing YAN
Chinese Journal of Emergency Medicine 2010;19(3):285-288
Objective To investigate the prognostic value of stroke volume variation (SVV) in patients with severe sepsis after early goal-directed therapy (EGDT). Method Thirty-eight mechanically ventilated patients with severe sepsis underwent EGTD were divided into high SVV (≥10%) group and low SW (< 10%) group according to the data obtained from pulse contour continuous cardiac output (PiCCO) analysis device. The differ-enees in the rate of 28-day survival, length of ICU stay, duration of meehanical ventilation and eomplieation of in-fection between two groups of patients were compared. The rate of 28-day survival of patients was analyzed by using Kaplain-Meier survival analysis, and the relationship between SVV and mortality within 28 days was analyzed by using logistic regression model. Results In comparison with low SVV group, the rate of 28-day survival of high SVV group was signifieantly increased (87.5 % vs. 57.1%, P = 0.032), the length of ICU stay was significantly shortened (27.1±9.2) vs. (41.6±10.0) (P = 0. 004) and duration of mechanical ventilation was significantly more brief (20.4±7.3) vs. (28.5±8.3) (P = 0.038). The rate of cumulative survival of patients in high SVV group was higher than that in low SVV group. In addition, logistie analysis showed SW < 10% increased the risk of 28-day mortality (OR = 3.97; 95% CI 1.63 - 9.21, P = 0. 014). Conclusions The SVV can be served as a prognostic indicator in patients with severe sepsis after EGDT.