1.Prognosis of new-onset left bundle branch block after transcatheter aortic valve replacement in patients with aortic stenosis: A systematic review and meta-analysis
Jialu WANG ; Shidong LIU ; Xiangxiang HAN ; Xiang LEI ; Tao FANG ; Shuai DONG ; Bing SONG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2022;29(05):624-633
Objective To systematically review the clinical outcome of patients with new-onset left bundle branch block (LBBB) following transcatheter aortic valve replacement (TAVR). Methods Electronic search was performed in PubMed, EMbase, Cochrane Library, Web of Science, CNKI, Wanfang and CBM databases to identify studies about the new-onset LBBB after TAVR from inception to March 19, 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using Stata 15.0 software. Results A total of 17 cohort studies were included, covering 9 205 patients, including 2 202 patients with new-onset LBBB and 7 003 without new-onset LBBB after TAVR. The results of meta-analysis showed that patients with new-onset LBBB after TAVR at 30-day (RR=1.65, 95%CI 1.30 to 2.10, P<0.001) and 1-year (RR=1.30, 95%CI 1.16 to 1.45, P<0.001) all-cause mortality was higher than no new-onset LBBB group. One-year cardiovascular mortality was higher in the new-onset LBBB group (RR=1.47, 95%CI 1.21 to 1.79, P<0.001). In the occurrence of 30-day (RR=1.51, 95%CI 1.10 to 2.08, P=0.011) and 1-year (RR=1.34, 95%CI 1.14 to 1.58, P=0.001) rehospitalization rate, 30-day (RR=3.05, 95% CI 1.49 to 6.22, P=0.002) and 1-year (RR=2.15, 95%CI 1.52 to 3.03, P<0.001) pacemaker implantation, the incidence of patients with new-onset LBBB was higher than that of the no new-onset LBBB group. Conclusion Compared with the patients without LBBB after TAVR, the clinical prognosis of patients with new-onset LBBB after TAVR is poor. In the future, the management and follow-up of the patients with LBBB after TAVR should be further strengthened to improve the prognosis of patients.
2.Clinical efficacy of transcatheter aortic valve replacement in elderly patients with aortic stenosis: A systematic review and meta-analysis
Xiang LEI ; Shidong LIU ; Tao FANG ; Xiangxiang HAN ; Jialu WANG ; Bing SONG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2020;27(12):1446-1453
Objective To compare the complications of transcatheter aortic valve replacement (TAVR) between aortic valve stenosis (AS) patients ≥90 years and patients <90 years, and to explore the efficacy and safety of TAVR in AS patients ≥90 years. Methods Databases including PubMed, The Cochrane Library, EMbase, Medline, CNKI, Wanfang Data and China Biology Medicine disc (CBMdisc) were searched by computer from inception to May 2019. Two reviewers independently screened the literature, extracted the data and evaluated the quality of the included studies. RevMan 5.3 and Stata 15.0 were used for meta-analysis. Results A total of 12 cohort studies were included, including 60 186 patients (11 350 patients ≥90 years and 48 836 patients <90 years). Meta-analysis showed that compared with the patients <90 years, those ≥90 years had higher all-cause mortality in the hospital (OR=1.51, 95%CI 1.37 to 1.66, P<0.000 01), on postoperative 30 d (OR=1.68, 95%CI 1.50 to 1.89, P<0.000 01) and at postoperative 1 year (OR=1.36, 95%CI 1.25 to 1.48, P<0.000 01), and had higher incidence of stroke (OR=1.31, 95%CI 1.18 to 1.46, P<0.000 01), bleeding events (OR=1.14, 95%CI 1.07 to 1.20, P<0.000 01) and vascular complications (OR=1.31, 95%CI 1.18 to 1.46, P<0.000 01). Conclusion All-cause mortality and the incidence of some complications after TAVR in AS patients ≥90 years are higher than those in patients <90 years, but this difference is clinically acceptable. Therefore, TAVR treatment is safe and effective for elderly patients.
3.Effect of matrix metalloproteinase-26 on human glioma angiogenesis
Yuhui ZHANG ; Wei LI ; Xiangxiang LI ; Bo FANG ; Xiaona CHANG ; Chenchen TANG ; Lihong ZHANG ; Yilei LI
Chinese Journal of Clinical and Experimental Pathology 2017;33(6):623-628
To investigate the effect of MMP-26 on human glioma angiogenesis and the possible mechanism.Methods The MMP-26 plasmid and empty plasmid pcDNA3.1 were stably transfected into U251 cells to establish a nude mice xenograft model,and then an in vitro human tumor tissue-based three-dimensional angiagenic model.Tissue disks were visually assessed over time to determine the percentage of wells that developed an angiogenic response(I%) and the density and length of neovessel growth were graded at intervals using a semiquantitative visual growth-rating scheme (angiogenic index,AI,0-16scale) in groups of MMP-26 transfected U251 cells (U251-MMP-26),pcDNA3.1 vector-transfected U251 cells (U251-pcDNA3.1) and non-transfected U251 cells (U251).RT-PCR and immunohistochemistry were used to detect the expression of mRNA and protein of MMP-26 and VEGF in groups of U251-MMP-26,U251-pcDNA3.1 and U251.Immunohistochemical localization of CD31 was determined in the endothelial tubes invading the fibrin-thrombin clot matrix.Results Immunohistochemical endothelial cell markers CD31 was positive in the vascular tubes invading the fibrin-thrombin clot matrix,confirming their endothelial origin.The angiogenesis results showed that difference of length of micro capillaries,density of branches,and the area occupied between U251-MMP-26 groups and control groups were significant.The percentage of tumor implants that developed invasion (I%) and the angiogenic index AI in U251-MMP-26 group on day 14 were higher than those of U251-pcDNA3.1 group and U251 group (P < 0.05).The trends of I% and AI in 14 days were significant compared with those in control groups.The expression of mRNA and protein of MMP-26and VEGF in U251-MMP-26 group was significantly higher in U251-MMP-26 group than those in U251-pcDNA3.1 group and U251 group(P <0.01).Conclusion The effect of MMP-26 on promoting glioma angiogenesis may be related to the increased expression of VEGF,which can be used as targets for anti-tumor therapy.
4.Studies on HPLC Fingerprint Difference ofRadix Platycodonis from Different Origins Based on Platycodins
Jinxiang ZENG ; Xiangxiang FANG ; Jixiao ZHU ; Bo WU ; Guoyue ZHONG ; Fuqing LIU ; Hongze LI ; Fengyu HAN
World Science and Technology-Modernization of Traditional Chinese Medicine 2015;(5):1000-1006
The HPLC fingerprint differences ofRadix Platycodonis from different origins were studied to provide references for their quality control and production. The total platycodins were purified by DB101 macroporous resin. HPLC-ELSD fingerprints of the total platycodins for 39 batches ofRadix Platycodonis samples from 9 provinces were performed on an Agilent HC-C8 column (4.6 mm x 250 mm, 5μm) with gradient elution. The mobile phase was acetonitrile-0.5% acetic acid. The injection volume was 6μL. The flow rate was 0.5 mL·min-1. The temperature of drift tube was set at 90℃. And the gas flow (N2) was set at 1.2 mL·min-1. The results showed that there were large differences in the quality ofRadix Platycodonis from different origins with the common fingerprints of 6 batches of samples fromChifeng in Inner Mongolia as references. The quality ofRadix Platycodonis was closely related to the seeds, the ecological environment, the way of drying and storing and so on. It was concluded that it was important to strengthen the provenance base construction, standardization of the seeds, reasonable formulation of the regionalization, and standardization of the production processing for the cultivation and production ofRadix Platycodonis.
5.Effects of family and peer support upon the stages of health-related behavior in adolescent.
Mingzhu FANG ; Liangwen XU ; Xianhong HUANG ; Fang GU ; Xuping QU ; Ming XU ; Xiangxiang LUO
Chinese Journal of Preventive Medicine 2015;49(9):810-816
OBJECTIVETo investigate the stages of health-related behaviors, family and peer support situation about adolescent in Wuhan, and to provide evidence for health intervention and health promotion.
METHODSBased on the principle of multi-stage stratified cluster sampling, extracted two junior middle school and two high school in two cities in Wuhan from March 2012 to May. A total of 1 200 students, which were part of the first and second grade class in middle school and high school, toke as the investigation object. The study surveyed following content, including the demographic situation, adolescent health-related behavior (physical activity, sedentary behavior, high-fat diet behavior, fruit and vegetable intaking behavior), stages of adolescent health related behavior (precontemplation, contemplation, preparation, action, maintenance) and adolescent support got from family and peer. The questionnaire was distributed in 1 200 copies, the valid questionnaires were 1 052 and the effective rate was 87.67%. Using χ² test to compare the different stages of change in health related behavior, t test was used to compare different groups of social support and using analysis of variance and post test to analyze social support of the four types behavior.
RESULTSIn 1 052 students, there was 555 (52.8%) middle school students, 497 (47.2%) high school students, and 553 (52.6%) boys, 499 (47.4%) girls. In physical exercise and sedentary behavior, numbers of precontemplation was respectively accounting for 42.2% (444/1 200) and 28.4% (299/1 200). In high-fat diet behavior, the stages of preparation and maintain was occupied 46.7% (492/1 200). In fruit and vegetable intake behavior, there was 32.9% (346/1200) students in contemplation. Numbers in action stage was both less in the above four behavior, accounting for 6.2% (65/1 200), 8.9% (94/1 200), 14.0% (147/1 200) and 6.3% (66/1 200) separately. Adolescent peer support score respectively (2.9 ± 0.7), (2.8 ± 0.8) and (2.9 ± 0.9), which was higher than the family support scores ((2.7 ± 1.1), (2.5 ± 1.2) and (2.9 ± 1.2)) (t values were -8.72, -11.22 and -2.59, respectively. All P values were < 0.001) in physical exercise, sedentary behavior and high fat diet, but in the intake of fruits and vegetables behavior, family support score was higher than peer support (score was respectively (3.3 ± 0.9) and (3.5 ± 1.2); t < 9.97, P < 0.001). ANOVA and post hoc comparison showed that the score of family and peer support in the after-action stage was significantly higher than that the before-action stage in physical exercise, high-fat diet and fruit and vegetable intake behavior, while the differences in sedentary behavior was not significant.
CONCLUSIONYouth health-related behaviors remained in its infancy, there was a certain impact on its stages which showed that the higher social support the more advanced stages of behavior.
Adolescent ; Adolescent Behavior ; Diet, High-Fat ; Exercise ; Family ; Feeding Behavior ; Female ; Fruit ; Health Behavior ; Humans ; Male ; Peer Group ; Schools ; Social Support ; Students ; Surveys and Questionnaires ; Vegetables
6.Effects of family and peer support upon the stages of health-related behavior in adolescent
Mingzhu FANG ; Liangwen XU ; Xianhong HUANG ; Fang GU ; Xuping QU ; Ming XU ; Xiangxiang LUO
Chinese Journal of Preventive Medicine 2015;(9):810-816
Objective To investigate the stages of health-related behaviors , family and peer support situation about adolescent in Wuhan, and to provide evidence for health intervention and health promotion. Methods Based on the principle of multi-stage stratified cluster sampling, extracted two junior middle school and two high school in two cities in Wuhan from March 2012 to May. A total of 1 200 students, which were part of the first and second grade class in middle school and high school, toke as the investigation object. The study surveyed following content, including the demographic situation, adolescent health-related behavior (physical activity, sedentary behavior, high-fat diet behavior, fruit and vegetable intaking behavior), stages of adolescent health related behavior (precontemplation, contemplation, preparation, action, maintenance) and adolescent support got from family and peer. The questionnaire was distributed in 1 200 copies, the valid questionnaires were 1 052 and the effective rate was 87.67%. Usingχ2
test to compare the different stages of change in health related behavior, t test was used to compare different groups of social support and using analysis of variance and post test to analyze social support of the four types behavior. Results In 1 052 students, there was 555 (52.8%) middle school students, 497 (47.2%) high school students, and 553 (52.6%) boys, 499 (47.4%) girls. In physical exercise and sedentary behavior, numbers of precontemplation was respectively accounting for 42.2%(444/1 200) and 28.4%(299/1 200). In high-fat diet behavior, the stages of preparation and maintain was occupied 46.7%(492/1 200). In fruit and vegetable intake behavior, there was 32.9%(346/1200) students in contemplation. Numbers in action stage was both less in the above four behavior, accounting for 6.2% (65/1 200), 8.9% (94/1 200), 14.0%(147/1 200) and 6.3%(66/1 200) separately. Adolescent peer support score respectively (2.9±0.7),(2.8±0.8) and (2.9±0.9), which was higher than the family support scores ((2.7±1.1),(2.5±1.2) and (2.9±1.2)) (t values were-8.72,-11.22 and-2.59,respectively.All P values were <0.001) in physical exercise,sedentary behavior and high fat diet ,but in the intake of fruits and vegetables behavior,family support score was higher than peer support (score was respectively (3.3 ± 0.9) and (3.5 ± 1.2);t=9.97,P<0.001).ANOVA and post hoc comparison showed that the score of family and peer support in the after-action stage was significantly higher than that the before-action stage in physical exercise, high-fat diet and fruit and vegetable intake behavior, while the differences in sedentary behavior was not significant. Conclusion Youth health-related behaviors remained in its infancy, there was a certain impact on its stages which showed that the higher social support the more advanced stages of behavior.
7.Effects of family and peer support upon the stages of health-related behavior in adolescent
Mingzhu FANG ; Liangwen XU ; Xianhong HUANG ; Fang GU ; Xuping QU ; Ming XU ; Xiangxiang LUO
Chinese Journal of Preventive Medicine 2015;(9):810-816
Objective To investigate the stages of health-related behaviors , family and peer support situation about adolescent in Wuhan, and to provide evidence for health intervention and health promotion. Methods Based on the principle of multi-stage stratified cluster sampling, extracted two junior middle school and two high school in two cities in Wuhan from March 2012 to May. A total of 1 200 students, which were part of the first and second grade class in middle school and high school, toke as the investigation object. The study surveyed following content, including the demographic situation, adolescent health-related behavior (physical activity, sedentary behavior, high-fat diet behavior, fruit and vegetable intaking behavior), stages of adolescent health related behavior (precontemplation, contemplation, preparation, action, maintenance) and adolescent support got from family and peer. The questionnaire was distributed in 1 200 copies, the valid questionnaires were 1 052 and the effective rate was 87.67%. Usingχ2
test to compare the different stages of change in health related behavior, t test was used to compare different groups of social support and using analysis of variance and post test to analyze social support of the four types behavior. Results In 1 052 students, there was 555 (52.8%) middle school students, 497 (47.2%) high school students, and 553 (52.6%) boys, 499 (47.4%) girls. In physical exercise and sedentary behavior, numbers of precontemplation was respectively accounting for 42.2%(444/1 200) and 28.4%(299/1 200). In high-fat diet behavior, the stages of preparation and maintain was occupied 46.7%(492/1 200). In fruit and vegetable intake behavior, there was 32.9%(346/1200) students in contemplation. Numbers in action stage was both less in the above four behavior, accounting for 6.2% (65/1 200), 8.9% (94/1 200), 14.0%(147/1 200) and 6.3%(66/1 200) separately. Adolescent peer support score respectively (2.9±0.7),(2.8±0.8) and (2.9±0.9), which was higher than the family support scores ((2.7±1.1),(2.5±1.2) and (2.9±1.2)) (t values were-8.72,-11.22 and-2.59,respectively.All P values were <0.001) in physical exercise,sedentary behavior and high fat diet ,but in the intake of fruits and vegetables behavior,family support score was higher than peer support (score was respectively (3.3 ± 0.9) and (3.5 ± 1.2);t=9.97,P<0.001).ANOVA and post hoc comparison showed that the score of family and peer support in the after-action stage was significantly higher than that the before-action stage in physical exercise, high-fat diet and fruit and vegetable intake behavior, while the differences in sedentary behavior was not significant. Conclusion Youth health-related behaviors remained in its infancy, there was a certain impact on its stages which showed that the higher social support the more advanced stages of behavior.
8.Investigation on the sleep quality of naval afloat and ashore personnel
Zhirong FANG ; Yanpeng LI ; Zhengqing ZHAO ; Jinxin LU ; Xiangxiang ZHAO ; Jianhua ZHUANG ; Zhongxin ZHAO
Chinese journal of nautical medicine and hyperbaric medicine 2015;22(5):356-358
Objective To investigate the sleep quality and daytime sleepiness between naval afloat and ashore personnel.Methods Sleep quality and daytime sleepiness of 50 naval afloat personnel and 50 naval ashore personnel were evaluated by using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS).Results The incidence of sleeping disorder among the afloat or shipboard naval personnel accounted for 57.14%, which showed statistical significance as compared with 29.17% of the ashore personnel (P < 0.05).Statistical significance could be seen in sleep quality, sleep latency, sleep time, sleep efficiency, sleep disorder as well as daytime dysfunction, when comparisons were made between the 2 groups (P<0.05).The incidence of daytime sleepiness in the naval afloat personnel was 61.22%, which was of statistical significance, as compared with 27.08% of the ashore personnel (P < 0.05).Conclusions The sleep quality of the afloat naval personnel was poorer than that of the ashore personnel, while daytime sleepiness was severer.
9.Investigation on the sleep quality of naval afloat and ashore personnel
Zhirong FANG ; Yanpeng LI ; Zhengqing ZHAO ; Jinxin LU ; Xiangxiang ZHAO ; Jianhua ZHUANG ; Zhongxin ZHAO
Chinese journal of nautical medicine and hyperbaric medicine 2015;22(5):356-358
Objective To investigate the sleep quality and daytime sleepiness between naval afloat and ashore personnel.Methods Sleep quality and daytime sleepiness of 50 naval afloat personnel and 50 naval ashore personnel were evaluated by using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS).Results The incidence of sleeping disorder among the afloat or shipboard naval personnel accounted for 57.14%, which showed statistical significance as compared with 29.17% of the ashore personnel (P < 0.05).Statistical significance could be seen in sleep quality, sleep latency, sleep time, sleep efficiency, sleep disorder as well as daytime dysfunction, when comparisons were made between the 2 groups (P<0.05).The incidence of daytime sleepiness in the naval afloat personnel was 61.22%, which was of statistical significance, as compared with 27.08% of the ashore personnel (P < 0.05).Conclusions The sleep quality of the afloat naval personnel was poorer than that of the ashore personnel, while daytime sleepiness was severer.
10.Prognosis of hip fractures in elderly patients:Effects of albumin, lymphocyte and hemoglobin
Zhenheng WANG ; Yongchao FANG ; Xiangxiang KAN ; Ting GUO ; Jianning ZHAO
Chinese Journal of Tissue Engineering Research 2013;(52):9095-9100
BACKGROUND:Studies have shown that malnutrition was associated with death of elder people after fracture of hip, but there were no above-mentioned reports in China.
OBJECTIVE: To retrospectively analyze the relationship of blood albumin, total lymphocyte count and hemoglobin levels to prognosis when elder patients with fracture of hip were on admission.
METHODS:130 elderly patients with hip fractures aged ≥ 70 years were included underwent either total hip arthroplasty or bipolar arthroplasty. Admission serum albumin, total lymphocytecount and hemoglobin levels were recorded. The patients were fol owed up for 1 year or til the death. Survival data were available in 92 patients. Rates of survival were calculated by the Kaplan-Meier method and the Log-Rank test. Cox proportional hazard regression model received prognostic multivariate analysis.
RESULTS AND CONCLUSION:Of the 92 patients, albumin<35 g/L in 20 cases (22%), total lymphocyte count<1.5×106/L in 67 cases (73%), and hemoglobin<120 g/L in 56 cases (61%). Kaplan-Meier method showed that the survival rate of patients with normal albumin (≥ 35 g/L) was significantly higher than those with reduced albumin (<35 g/L) (P<0.01). No significant difference was detected in the survival rate of patients with normal total lymphocyte count (≥ 1.5×106/L) and reduced total lymphocyte count (<1.5×106/L) (P>0.05). The survival rate of patients with normal hemoglobin (≥ 120 g/L) was significantly higher than those with decreased hemoglobin (<120 g/L) (P <0.05). Cox multivariate analysis displayed that albumin decrease is an independent prognostic factor for death of patients with hip fracture. Results indicated that the prognosis of elder patients with hip fracture was strongly associated with their nutritional conditions. Albumin and hemoglobin levels at admission can be considered as important indexes for judging patient’s prognosis.

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