OBJECTIVES: To create a mixed valvular heart disease (MVHD)-related age-adjusted comorbidity index (MVACI) model for predicting mortality risk of patients with MVHD. METHODS: A total of 4080 patients with moderate or severe MVHD in the China-VHD study were included. The primary endpoint was 2-year all-cause mortality. A MVACI model prediction model was constructed based on the mortality risk factors identified by univariate and multivariate Cox regression analysis. Restricted cubic splines were used to assess the relationship between MVACI scores and 2-year all-cause mortality. The optimal threshold, determined by the maximum Youden index from receiver operator characteristic (ROC) curve analysis, was used to stratify patients. Kaplan-Meier method was used to calculate 2-year all-cause mortality and compared using the Log-rank test. Univariate and multivariate Cox proportional hazards models were employed to calculate hazard ratios (HR) and 95% confidence intervals (CI), evaluating the association between MVACI scores and mortality. Paired ROC curves were used to compare the discriminative ability of MVACI scores with the European System for Cardiac Operative Risk Evaluation Ⅱ(EuroSCORE Ⅱ) or the age-adjusted Charlson comorbidity index (ACCI) in predicting 2-year clinical outcomes, while calibration curves assessed the calibration of these models. Internal validation was performed using the Bootstrap method. Subgroup analyses were conducted based on etiology, treatment strategies, and disease severity. RESULTS: Multivariate analysis identified the following variables independently associated with 2-year all-cause mortality in patients: pulmonary hypertension, myocardiopathy, heart failure, low body weight (body mass index <18.5 kg/m²), anaemia, hypoalbuminemia, renal insufficiency, cancer, New York Heart Association (NYHA) class and age. The score was independently associated with the risk of all-cause mortality, and exhibited good discrimination (AUC=0.777, 95%CI: 0.755-0.799) and calibration (Brier score 0.062), with significantly better predictive performance than EuroSCORE Ⅱ or ACCI (both adjusted P<0.01). The internal validation showed that the MVACI model's predicted probability of 2-year all-cause mortality was generally consistent with the actual probability. The AUCs for predicting all-cause mortality risk were all above 0.750, and those for predicting adverse events were all above 0.630. The prognostic value of the score remained consistent in patients regardless of their etiology, therapeutic option, and disease severity. CONCLUSIONS The MVACI was constructed in this study based on age and comorbidities, and can be used for mortality risk prediction and risk stratification of MVHD patients. It is a simple algorithmic index and easy to use.
Humans ; Prognosis ; Comorbidity ; Heart Valve Diseases/epidemiology* ; Female ; Male ; Middle Aged ; Aged ; Proportional Hazards Models ; Risk Factors ; China/epidemiology* ; Age Factors ; Risk Assessment ; Adult ; ROC Curve

A total of 100 insomniacs were randomly divided into intervention and contrast groups (n=50 each).The contrast group took only alprazolam while the intervention group received both alprazolam and other comprehensive regimens,including acupuncture,psychotherapy and traditional Chinese medicine.One course of treatment lasted 10 days for both groups and 6 courses were offered.After comprehensive interventions,as compared with contrast group,the scores of Pittsburgh Sleep Quality Index (PSQI) and Athens Insomnia Scale (AIS) decreased obviously in intervention group (P ＜ 0.05).And the curative rate (46％) and the total efficacious rate (96％) of intervention group were higher than those of contrast group (P ＜ 0.05).

[Objective] To observe the antitussive and antiasthmatic actions of Nervilia fordii (Hance) Schitr. (NF). [Methods] NIH mice were randomized into 8 groups: 3 NF water-extract groups and 3 NF ethanol-extract groups in high, moderate and low doses (19.2, 9.6 and 4.8 g?kg-1?d-1 respectively), positive control group (codeine phosphate 50 mg?kg-1?d-1 in the antitussive experiment and theocin 0.1g?kg-1?d-1 in the antiasthmatic experiment) and model group. Mice cough models induced by ultrasonic spray of ammonium hydroxide and guinea pigs asthma models induced by ultrasonic spray of histamine-acetylcholine mixture were adopted to observe the antitussive and antiasthmatic actions of NF. [Results] Water-extract and ethanol-extract of NF in three doses decreased the cough frequency in mice, and ethanol-extract of NF in three doses prolonged the cough latent period (P

AIM　To investigate the relationship between sinomenine distribution and its organic toxicology in rats so as to give some pharmacological data for clinical application of sinomenine. METHODS　Three kinds of administration plans were designed in the experiment, ie sinomenine was ip administered at the dosage of l50 mg*kg-1 per day, repreat-dosed for 6 wk and suspended the drug for 1 wk after 6wk repeat-doses．At the end of the each administration plan，the animals were sacrificed and their blood and their main internal organs were collected for the purpose of measurement of sinomenine concentration in each sample by HPLC. Meanwhile，the histopathological and serological examinations were also done in the experiments. RESULTS　The sinomenine concentration in rats internal organs were in order of liver, heart, lung and brain either in single-dosed treated animals or in repeat-dosed treated animals for 6 wk. However，the concentration of sinomenine could not be detected by HPLC after l wk drug-suspension，the histopathological examination showed that sinomenine at the dosage of l50 mg*kg-l per day for 6wk treatment could slightly damage liver ce11s, dominant1y caused the cell edema，but no any influence on the sero1ogy of liver and kidney. Sinomenine ip could also cause a mild hyperaemia of the rats heart tissues but no any histopathological changes had been observed. In testis tissues no sinomenine had beed detected although the animals were treated by repeat treatment for 6 wk and no any histopathological changes had been found yet. However, Sinomenine could partialy inhibit the sperm vitalities and amount of the dead sperms were a1so augmented. It was similar to in vitro eperiments. These influences of sinomenine on testis could be quickly recovered by drug suspension. CONCLUSION　Sinomenine concentration were in order of liver, heart, kidney, lung and brain either in treatment by single dose or by repeat-dose administration. The histopathological changes were only abserved in liver cells of the animals which indicates that it should be in consideration of the liver functions during treatment course of the drug.

[Objective] To observe the pharmacological action of Ganoderma Lucidum Brewage (GLB) in decreasing blood lipid. [ Methods ] Eighty rats were randimized into 8 groups: blank control (Group A), model ( Group B) high-dose GLB ( Group C), moderate-dose GLB ( Group D), low-dose GLB ( Group E), Ganoderma Lucidum Decoction (Group F), Ganoderma Lucidum Capsule (Group G) and Xuezhi Kang (Group H). So did the mice. Hyperlipidemia mouse models and rat models were induced by yolk and high-fat diet respectively. Effect of GBL in various doses to decrease blood lipid was observed in the two kinds of hyperlipidemia models and was compared with that of Xuezhi Kang, Ganoderma Lucidum Decoction and Ganoderma Lucidum Capsule. [Results] GLB could decrease the serum contents of triglycerides and cholesterol both in model mice and model rats (P

Objective To summarize the clinical characteristics of myotonic dystrophy(DM).Methods The clinical data of 24 DM cases were analyzed retrospectively.Results 83.3%(20/24) of the patients obtained the disease during youth and it progressed slowly.79.2%(19/24) of the patients had positive family history.DM was a multisystem disease characterizing by myotonia,weakness and atrophy involved in multiple muscle groups,especially in distal limbs,neck and face.Extensors were more severe than flexors.Spontaneous myotonic discharges and myogenic damages were shown on electromyogram.Pathological examination of muscle biopsies showed increased number of central nuclei,nuclear chains and predominant atrophic typeⅠfibers in 8 cases,muscle fiber necrosis in 7 cases,fibrous structure disorder in 4 cases,sarcoplasmic masses in 3 cases,and serration of sarolemma in 2 cases.Conclusions The clinical characteristics of DM are weakness,atrophy and myotonia.Electromyogram and muscle biopsy are helpful in diagnosis of this disease.

Objective To observe the difference between Radix AstragaLi(RA) and Radix Fici Hirtae(RFH) in immune regulation and improvement of anaemia.Methods Fatigue resistance,brain hypoxia and normal hypoxia tolerance were observed to measure the anti-stress function.Bloodletting-induced anemia model and cyclophosphamid-induced anemia model were used to observe the effect of blood enrichment.Phagocytic function of macrophage,serum hemolysin level and delayed type hypersensitivity(DTH) reaction were also detected.Results RA and RFH could improve the fatigue resistance,normal hypoxia tolerance and brain hypoxia tolerance,and increase the red blood cell count and hemoglobin content,enhance phagocytic function of macrophage and serum hemolysin level,and increase the DTH reaction.Conclusion Both RA and RFH have an effect on improving anti-stress ability,immune function and blood enrichment,and there are no significant difference between RA and RFH.

Wanglaojichongfu Herb Tea was found to possess the following actions: (1)antibiosis and anti-inflammation, (2) diuresis, (3) inceasing the contraction power of smooth muscle of gastrointestinal canal, (4)promoting the peristalsis of intestinum, (5) contracting the trachea link, (6) decreasing the perfusion amount of lung. The toxic test suggested that the maximal tolerance dose of mice with its extract a day was 220 times as much as clinical administration dose.

AIM: To study the protective effects of Xiaoyan Lidan Tablet(Herba Andrographis,Herba Rabdosiae serrae,Radix Sophorae Flavescentis,etc) on acute hepatic injury in rats. METHODS: Acute hepatic injury was induced by intraperitoneal(ip) injection of carbon tetrachloride and D-galactosamine,respectively.The levels of ALT,AST,ALP,TBA,total bilirubin(T-Bil),total protein (TP) and albumin(ALB) in serum were analyzed.The body weight,liver weight,spleen weight and thymus weight of each rat were measured.The hepatic glycogen content was analyzed individually.Liver tissue pathology was observed. RESULTS: Xiayan Lidan Tablet can decrease ALT,AST,ALP,TBA and T-Bil in serum,reduce necrosis in pathological observation. CONCLUSION: Xiaoyan Lidan Tablet gives the protective effects to acute hepatic injury induced by CCl_4 and D-Gal in rats.

Objective: To study the action of Zhongjiangweiling Capsule (Fructus Amoni, Cortex cinnamoni, Rhizoma Alpiniae officinarum Radix Glycyrrhizae) on the experimental gastric ulcer. Methods: Area of ulcer, gastric juice volume, acidity and pepsin output were measured on experimental gastric ulcer models induced by the ligated pylorus and burned acetic acid and i.p Reserpine in rats. Results: Zhongjingweiling Capule showed to be able to reduce areas of ulcers, gastric juice volume, acidity and pepsin output. Conclusion: Zhongjingweiling Capsule had antiulcer effect in rats.