Male ; Humans ; Aged ; Sleep Duration ; Aging ; Testosterone ; China ; Sleep

Objective To explore the CT features of pulmonary lymphangiomyomatosis (PLAM).Methods Clinical and high resolution CT (HRCT)data of 14 patients with pathologically proved PLAM were analyzed retrospectively.The clinical and CT features were summarized by combining the literatures.Results All 14 cases were female.They all presented with dyspnea in different degree after the activity. Scattered or widely distributed translucent and cystic lesions with indistinct walls in bilateral lungs were seen on routine CT images. HRCT showed homogeneous clear thin-walled cysts with diameter ranging from several millimeters to 25 mm,wall thickness of 1-2 mm,and surrounded by normal lung tissue.Meanwhile,blood vessels were found around the cysts,and there were no central lobular cores.The cysts were different sizes and irregular distribution.6 patients had extra-pulmonary CT manifestations:1 case with intracranial multiple sclerosis, hepatic and renal angiomyolipomas,and hepatic multiple hemangiomas,3 cases with mediastinal,hepatic and renal angiomyolipomas, and 2 cases with retroperitonea lymphangioleiomyomatosis.Conclusion The CT of PLAM is characterized by the diffuse distribution of thin-walled cystic cavities and the wall thickness is generally uniform.The typical manifestations of HRCT combined with clinical data have great values in the early diagnosis and differential diagnosis.

Objective To investigate the prevalence of nutritional risk,undernutrition and nutritional support among elderly inpatients with coronary heart disease in 11 tertiary A hospitals in China.Methods Records of elderly patients under the age of 90 with coronary heart disease were collected between March 2012 and May 2012 from 11 tertiary A hospitals in China following the direction of diagnosis related group of Beijing government.Results A total of 1 279 consecutive cases were recruited with the average age 74 years old (65-89).The total nutritional risk prevalence was 28.14％ (360/1 279).The prevalence of nutritional risk and nutritional risk score ≥ 5 increased with age.The prevalence of nutritional risk (12.88％ vs.30.08％ vs.42.28％) and nutritional risk scored ≥5 (10.86％ vs.18.61％ vs.27.78％)increased with age.Judging from BMI,most patients were overweight or obese (BMI ≥ 24 kg/m2),accounting for 53.0％ of the total,and prevalence of nutritional risk in this subgroup was 15.12％ (96/635).The prevalence of nutritional risk in patients with normal BMI was 34.24％.The prevalence of undernutrition defined as BMI＜ 18.5 kg/m2 was 4.25％ (51/1 279),among which patients with score ≥ 5 account for 64.7％ (33/51).The prevalence of undernutrition defined as nutritional impairment score =3 was 7.58％ (97/1 279).In patients with nutritional risk,57 were administrated nutrition support (16.6％);in patients without nutritional risk,21 received nutrition support,mostly parenteral nutrition (16 cases,76.2％).In patients with nutritional risk [(79.46± 7.19) years vs.(76.40± 6.16) years],there were statistically significant difference between those who received nutrition support and those who did not in terms of age and the ratio of patients with nutritional risk scored≥5 (35.1％ vs.17.1％) (P =0.001,P=0.002).Conclusions The prevalence of nutritional risk in patients with coronary heart disease was high.The prevalence of undernutrition was low.Prevalence of overweight and obese was high,but there was still nutritional risk in this group of patients.The patients who received nutrition support were older and had high nutritional impairment score,but the indication is not rationale.

Objective To investigate the risk factors of hypertension patients combined with coronary artery disease(CAD)and analyze the correlation. Methods A total of 258 hospitalized hypertension patients from August 2015 to December 2016 were divided into hypertension group(n = 124)and hypertension combined with CAD group(n = 134),according to the results of coronary angiography. The general data,platelet parame-ters,blood lipid level and renal function indexes of all objects were recorded. The differences of all indexes between 2 groups were compared,and the correlation between these indexes and CAD in hypertensive patients was analyzed. Results(1)More smokers and older patients were found in hypertension combined with CAD group;the values of mean platelet volume(MPV),platelet distribution width,creatinine,serum uric acid were higher, but HDL-C level was lower and all the differences were statistically significant(P < 0.05).(2)Multivariable logistic regression analysis demonstrated that age,smoking history,MPV,serum uric acid and low level of HDL-C were independent hazardous factors of CAD in hypertensive patients[OR = 1.062,95% CI:1.032 ~ 1.093;OR =2.048,95% CI:1.078~3.893;OR=2.737,95% CI:1.193~6.278;OR=1.006,95% CI:1.001~1.010;OR=0.280,95% CI:0.115~0.681(all,P<0.05)].(3)Pearson correlation analysis showed that MPV was positively correlated with serum uric acid(r = 0.17,P < 0.05). Conclusions Age,smoking history,MPV,serum uric acid and lower HDL-C value are risk factors of CAD in hypertensive patients and active detection and prevention will benefit reducing the risk for the occurrence of CAD in hypertensive patients.

Abdominal aortic aneurysms(AAAs) is the most common aneurysm,and usually characterized by less symptom.While ruptured AAAs leads to high mortality.Abdominal ultrasonography can effectively detect AAA,decrease the AAAs-related mortality.However,screening AAAs causes some adverse outcomes,including psychological distress and immediate harms in treatment.Meanwhile,the prevalence of AAAs in sex and age is significantly different.Therefore,a reasonable and effective screening strategy is very important.This article search random control trials,systematic reviews,meta-analysis and guidelines in screening AAAs to obtain a reasonable screening strategy.

Objective To investigate the variation and clinical significance of serum levels of inflammatory cyto-kines after percutaneous coronary intervention (PCI)treatment in acute myocardial infarction (AMI)patients. Methods 118 incipient AMI patients with successful underwent PCI (Defined as treatment group,blood samples were collected from pre-operation,12 h after operation,24 h after operation,48 h after operation and 90 d postop-erative follow-up period)and 52 AMI patients with diagnostic coronary angiography (CAG)(Defined as control group,blood samples were collected prior to CAG,12 h after CAG,24 h after CAG,48 h after CAG and 90 d fol-low-up period)were enrolled in this study.Serum levels of IL-6,IL-18,hs-CRP,TNF-αand MMP-9 were detec-ted in all the subjects by enzyme-linked immune sorbent assay(ELISA)and major adverse cardiac events(MACE) occurrence rate was analyzed in 90 days followed-up cases.Results No significant differences in baseline levels of IL-6,IL-18,hs-CRP,TNF-αand MMP-9 were found in the two study groups(P >0.05).No significant differences of levels of IL-6,IL-18,hs-CRP,TNF-αand MMP-9 were found after CAG in control group (P >0.05).The serum levels of IL-6,IL-18,hs-CRP and TNF-αafter PCI were significantly increased (P <0.01 )while no significant differences were found in level of MMP-9 (P >0.05)in PCI group.There were significant differences of levels of IL-6,IL-18,hs-CRP and TNF-αbetween MACE group and without MACE group after PCI.The multivariable lo-gistic analysis showed that IL-6,IL-18,hs-CRP and TNF-αwere risk factors of MACE after 90 days follow-up. Conclusion The concentrations of serum IL-6,IL-18,hs-CRP and TNF-αare significantly increased in AMI pa-tients treated with PCI.PCI operation may induce inflammatory reaction.High serum levels of peripheral inflamma-tory cytokines IL-6,IL-18,hs-CRP and TNF-αhave an important role in major adverse cardiac events(MACE)and short-term prognosis in the first AMI patients treated with successful primary PCI.

Objective To analyze the characteristic of some important clinical indicators, including carotid artery intima-middle thickness ( IMT) , peripheral blood Fib levels, serum IL-18 concentrations and serum MMP-9 con-centrations of acute coronary syndrome ( ACS) patients. On the other hand, to investigate the correlation among those indicators and major adverse cardiac events ( MACE) , and further to evaluate the value of those indicators in early prediction and prognosis judgement of ACS patients with diabetes( DM) in clinic. Methods This study en-rolled 120 ACS patients who had received coronary arteriography( CAG) examination. Among them, 60 cases had DM. Meanwhile, 60 cases who had DM were selected as DM group,60 cases of healthy people who received physi-cal health examination were selected as the control group. Carotid artery IMT was determined by color doppler ultra-sonography. The levels of Fib in peripheral blood were detected by solidification method. Immune turbidimetric method and ELISA were used to measure the concentrations of serum IL-18 and MMP-9 respectively. The CAG re-sults, complications and in-hospital mortality of ACS patients were also collected and analyzed. Results Carotid artery IMT, peripheral blood Fib levels, serum IL-18 concentrations and serum MMP-9 concentrations of ACS pa-tients were significantly increased compared with healthy control(P<0. 01). A comparison of those clinical indica-tors of ACS patients between with DM group and without 2 diabetes group showed a significant increase in ACS pa-tients with DM group. Carotid artery IMT, plasma Fib, serum IL-18, MMP-9 and Gensini score in ACS patients were positively correlated. The incidence of multi-vessel diseases of coronary artery was more frequent in ACS pa-tients with DM versus without DM ( 61. 7%) , while one or two vessel diseases of coronary artery was much more common in ACS patients without DM (61. 7%) . The Gensini score of ACS patients with DM group was much high-er than that of ACS patients without DM group ( P<0. 01 );severe and extremely severe lesions occurred more fre-quently in ACS patients with DM group (73. 3%) ,while mild-to-moderate lesions occurred more frequently in ACS patients without DM group (56. 7%) . Peripheral blood Fib levels, serum IL-18 and MMP-9 concentrations were significantly higher in ACS patients with MACEs compared to ACS patients without MACEs. Peripheral blood Fib levels, serum IL-18 concentrations and serum MMP-9 concentrations of ACS diabetes mellitus extended the down-ward trend with the treatment time after standardized treatment show time-effect relationship. Conclusion Carotid artery IMT, peripheral blood Fib levels, serum IL-18 concentration and serum MMP-9 concentrations have great po-tential to become effective clinical indicators, which could be used to quantitatively predict coronary atherosclero-sis,and further to determine the risk degree and short-term prognosis of ACS patients with DM.

Objective To investigate the antiplatelet aggregation activity of clopidogrel ( small dose) combined with paeonol. Methods Antiplatelet aggregation activity was evaluated by platelet aggregation induced by adenosine diphosphate in vitro, the weight of arteriovenous bypass thrombosis in rats and bleeding time in mice. Results The combination significantly inhibited platelet aggregation, and reduced formation of arteriovenous bypass thrombosis as well as prolonged the bleeding time. Moreover, the activity of combined group was more superior to clopidogrel and paeonol, respectively. Conclusion The antiplatelet aggregation activity of the combination is better than clopi-dogrel, which has bright prospects in clinical applications.

ObjectiveTo investigate the predictive value of heart rate turbulence(HRT) in patients with diabetes mellitus (DM) after acute myocardial infarction (AMI).MethodsNinety-two AMI patients combined with DM (DM group) and 120 AMI patients without DM (non-DM group) were selected.Turbulence onset (TO) and turbulence slope (TS) were two indexes of HRT.HRT was considered positive when TO was ≥0 and TS was ≤2.5 ms/R-R.The differences in clinical data between HRT-positive and HRT-negative patients were compared.And the related risk factors after AMI were analyzed.ResultsAge,left ventricular ejection fraction (LVEF) level,renal insufficiency,LVEF＜40％,standard deviation of sinus cardiac cycle (R-R interval)(SDNN),heart rate variability (HRV) positiveand HRT indexes (TO,TS) between HRT-positive and HRT-negative patients in DM group had significant differences (P ＜ 0.05 ).Age,LVEF level,SDNN and HRT indexes(TO,TS) between HRT-positive and HRT-negative patients in non-DM group had significant differences(P ＜ 0.05).Multivariate Cox regression analysis showed that renal insufficiency (OR=4.8,95％ CI:1.8 - 10.7,P=0.008) and HRT positive (OR=3.7,95％ CI:1.5 - 8.6,P=0.070) in DM group had statistical significance.And HRT positive in non-DM group had statisticalsignificance(OR=23.0,95％ CI:5.2 ～ 86.0,P ＜ 0.01 ).ConclusionsHRT,an index of dynamic electrocardiogram,can predict the risk in patients with DM or without DM after AMI.

Objective To evaluate the dose reduction technology using in CT-guided percutaneous lung biopsy of pulmonary lesions using automated core needle biopsies (ACNB).Methods 412 ACNB cases included 146 consecutive conventional patients (group A,120 kV/100 mA) and 266 consecutive patients (group B,120 kV/20 mA,low-dose scanning,reduce scanning width and scanning frequency).The quality of images was compared by grain homogeneity,fine structure,clearness of tissue interface and artifacts.The total diagnostic accuracy rate,the examination time and radiation dose between group A and group B were compared.Results The fine structure of group B was significantly lower (X~2 ＝7.0508,P ＜ 0.05).The total diagnostic accuracy rate was 95.9% vs 95.1% (X~2 ＝0.1296,P ＜ 0.05).The examination time for biopsy procedure was (16 ±2.2)min vs (15.9 ±2.0)min (t ＝ 1.3579,P ＜ 0.05) ,and the mean effective dose (E) was (1.74 ± 0.7) mSv vs (0.59 ± 0.14) mSv (t ＝ 19.3415 ,P ＜ 0.05) .The E of group B decreased by 66%.Conclusions ACNB is a feasible and accurate method for diagnosing pulmonary lesions,and the E can significantly reduce the dose received in low-dose scanning.