The surveillance data of new cases of acute myocardial infarction (AMI) from January 1, 2013, to December 31, 2021, in Tengzhou City, Shandong Province, were used to analyze the incidence rate of AMI and its change trend among residents. The age and gender standardized incidence rate was calculated based on the 7th National Population Census 2020. The Cochran-Armitage trend test was used to analyze the trend of onset time and age. From 2013 to 2021, the crude and standardized incidence rate of total AMI in Tengzhou City declined from 130.07/100 000 and 161.12/100 000 to 76.15/100 000 and 72.77/100 000 ( Z=-13.785 and -20.822, both P<0.001). The crude and standardized incidence rates of males were higher than those of females. In 2016, males aged 45-54 years old and females aged 35-64 years old increased by 33.33%, 103.65%, 106.30%, and 95.75% compared to 2015, and the differences were statistically significant ( χ2=6.512, 4.965, 25.115, and 46.004, all P<0.05). The incidence rate of AMI in men aged<35 and 35-44 years old had an upward trend. From 2013 to 2021, the incidence rate of AMI decreased by 55.15% in urban areas and 36.59% in rural areas ( Z=-8.529 and -11.235, both P<0.001).

The surveillance data of new cases of acute myocardial infarction (AMI) from January 1, 2013, to December 31, 2021, in Tengzhou City, Shandong Province, were used to analyze the incidence rate of AMI and its change trend among residents. The age and gender standardized incidence rate was calculated based on the 7th National Population Census 2020. The Cochran-Armitage trend test was used to analyze the trend of onset time and age. From 2013 to 2021, the crude and standardized incidence rate of total AMI in Tengzhou City declined from 130.07/100 000 and 161.12/100 000 to 76.15/100 000 and 72.77/100 000 ( Z=-13.785 and -20.822, both P<0.001). The crude and standardized incidence rates of males were higher than those of females. In 2016, males aged 45-54 years old and females aged 35-64 years old increased by 33.33%, 103.65%, 106.30%, and 95.75% compared to 2015, and the differences were statistically significant ( χ2=6.512, 4.965, 25.115, and 46.004, all P<0.05). The incidence rate of AMI in men aged<35 and 35-44 years old had an upward trend. From 2013 to 2021, the incidence rate of AMI decreased by 55.15% in urban areas and 36.59% in rural areas ( Z=-8.529 and -11.235, both P<0.001).

Objective:To analyze the trends of coronary heart disease mortality in Tengzhou city of Shandong province from 2013 to 2021.Methods:The data of coronary heart disease (ICD-10: I20-I25) from January 2013 to December 2021 were obtained from the Chronic Disease Surveillance Information System-Coronary Heart Disease Management Module of Shandong province; the population data were provided by Tengzhou Public Security Bureau. The 95% confidence interval ( CI) of the rate was calculated using the binomial exact method. The age-standardized mortality rate (ASMR) was calculated based on 2020 National Population Census. The trends of mortality rate were analyzed using the Cochran-Armitage trend test. Results:During 2013 to 2021, there were 20 667 coronary heart disease deaths in Tengzhou city, with an average of 2 296 cases per year. The male-to-female ratio was 1.09∶1, and 80.98% (16 736/20 667) of the death cases were aged 65 years or older. The crude mortality rate and ASMR of coronary heart disease were 131.84/10 5 and 168.22/10 5 in 2013, respectively. The crude mortality rate increased by 13.67% from 2013 to 2021 ( P<0.001) with an average annual increase of 1.59%; while the ASMR decreased by 18.65% from 2013 to 2021 ( P<0.05) with an average annual decease of 2.34%. The crude mortality rate of coronary heart disease in men and women showed an upward trend, with the difference in the increase for women being statistically significant ( P<0.01); while the ASMR both in men and women showed a downward trend ( P<0.001). The crude death rates from 2013 to 2021 in age groups of 65 or older for men and women decreased by 22.40% and 19.73%, respectively (both P<0.001); while the crude death rate for age groups of 44 or younger in men showed an upward trend ( P<0.05). The crude death rate among urban residents decreased by 5.22% from 2013 to 2021 with an annual decrease of 0.67% ( P>0.05); while the crude death rate among rural residents increased by 19.29% with an annual increase of 2.18% ( P<0.001). The overall crude death rate among urban residents was higher than that among rural residents (all P<0.05). Conclusions:From 2013 to 2021, the crude mortality rate of coronary heart disease in Tengzhou city of Shandong province shows an increasing trend while the age-standardized mortality rate shows a decreasing trend. The crude mortality rate of coronary heart disease in people aged 65 and above shows a decreasing trend. In addition, the change trends are different between women and men, and between urban and rural areas.

OBJECTIVE: To explore the clinical and genetic characteristics of a patient with hypertrophic cardiomyopathy as the initial manifestation of Mucopolysaccharidosis type Ⅲ A (MPS Ⅲ A). METHODS: A female patient with MPS Ⅲ A who was admitted to the Affiliated Hospital of Jining Medical University in January 2022 and her family members (seven individuals from three generations) were selected as the study subjects. Clinical data of the proband were collected. Peripheral blood samples of the proband was collected and subjected to whole exome sequencing. Candidate variants were verified by Sanger sequencing. Heparan-N-sulfatase activity was determined for the disease associated with the variant site. RESULTS: The proband was a 49-year-old woman, for whom cardiac MRI has revealed significant thickening (up to 20 mm) of left ventricular wall and delayed gadolinium enhancement at the apical myocardium. Genetic testing revealed that she has harbored compound heterozygous variants in exon 17 of the SGSH gene, namely c.545G>A (p.Arg182His) and c.703G>A (p.Asp235Asn). Based on guidelines from the American College of Medical Genetics and Genomics (ACMG), both variants were predicted to be pathogenic (PM2_Supporting +PM3+PP1Strong+PP3+PP4; PS3+PM1+PM2_Supporting +PM3+PP3+PP4). Sanger sequencing confirmed that her mother was heterozygous for the c.545G>A (p.Arg182His) variant, whilst her father, sisters and her son were heterozygous for the c.703G>A (p.Asp235Asn) variant. Determination of blood leukocyte heparan-N-sulfatase activity suggested that the patient had a low level of 1.6 nmol/(g·h), whilst that of her father, elder and younger sisters and son were all in the normal range. CONCLUSION The compound heterozygous variants of the SGSH gene probably underlay the MPS ⅢA in this patient, for which hypertrophic cardiomyopathy is an associated phenotype.
Female ; Humans ; Cardiomyopathy, Hypertrophic ; Contrast Media ; East Asian People ; Gadolinium ; Mucopolysaccharidosis III ; Mutation ; Pedigree ; Male ; Middle Aged

OBJECTIVETo explore the genetic basis for a Chinese pedigree affected with congenital hypofibrinogenamia.

METHODSPeripheral blood samples were collected from 9 members from the pedigree. Routine coagulation tests including activated partial thromboplastin time (APTT), thrombin time (TT), the prothrombin time (PT) were carried out. The activity of fibrinogen (Fg: C) was measured using Clauss method, and fibrinogen antigen (Fg: Ag) was measured with immunoturbidimetry. All exons and exon-intron boundaries of the fibrinogen Aα, Bβ and γ chain genes were amplified using PCR, which was followed by direct sequencing. Suspected mutation was confirmed by reverse sequencing. The mutant fibrinogen was analyzed with Swiss-PdbViewer.

RESULTSThe proband showed prolonged APTT, PT and TT. Her functional fibrinogen (Fg: C) and antigen fibrinogen (Fg: Ag) levels were reduced to 0.69 g/L and 0.72 g/L, respectively. Her mother and grandmother also had a low levels of fibrinogen, which were 0.99 g/L and 0.83 g/L for Fg: C, 1.02 g/L and 0.87 g/L for Fg: Ag, respectively. The results of other members from the pedigree were all within the normal range. Genetic analysis reveled a heterozygous G>T mutation at nucleotide 7590 in exon 8 of γ gene in the proband, which was predicted to be a novel Ser313Ile mutation. The mutation was also found in her mother and grandmother. Model analysis showed that the Ser313Ile mutation disturbed the hydrogen bonds between Ser313, Asn319 and Asp320. Moreover, the mutation also altered the mutual electrostatic force and affected the folding and instability of the mutant fibrinogen.

CONCLUSIONThe heterozygous Ser313Ile mutation probably underlies the hypofibrinogenemia in this pedigree.

Adult ; Afibrinogenemia ; genetics ; Female ; Fibrinogen ; chemistry ; genetics ; Heterozygote ; Humans ; Male ; Middle Aged ; Mutation ; Pedigree

Objective To investigate the changes of component and morphology in internal carotid vulnerable plaque,for helping to make clinical intervention strategy individually. Methods A total of 47 patients with internal carotid vulnerable plaques and primary hypertension underwent 2 high-resolution and multi-contrast MRI scans, from March 2008 to April 2014 were retrospectively reviewed. At baseline, the plaque was mainly located at the proximal internal carotid artery,and maximum plaque thickness ≥1.5 mm with intraplaque hemorrhage(IPH)and(or)thin or ruptured fibrous cap.Interscan interval was 0.5 years and above. Patients with carotid occlusion or surgery were excluded. Morphological measurements included maximum plaque thickness, maximum plaque area and cross-sectional vessel area (CSVA) on the level of plaque with maximum thickness. The paired-samples t test was performed to compare the difference of plaque morphology between baseline and follow-up carotid MRI.Results The interscan interval was 1.83 (1.59,1.99)years for 47 internal carotid vulnerable plaques.One case(interscan interval 2.16 years)showed IPH within those 11 plaques without IPH at baseline,and one case(interscan interval 1.42 years)had new incident IPH within those 36 plaques with IPH at baseline. Maximum plaque thickness increased significantly from(3.94±1.44)mm to(4.24±1.68)mm(t=2.30,P<0.05)by 5.14%(-3.83,11.34)% per year. Maximum plaque area increased significantly from(49.19±21.15)mm2to(56.03±24.91)mm2(t=3.87,P<0.01)by 6.67%(-2.26,19.60)% per year.CSVA increased significantly from(66.22±27.51)mm2to(73.68±31.47)mm2(t=4.08,P<0.01)by 5.18%(-1.63,12.34)% per year.Conclusion The progression of component,burden and outer remodeling in the internal carotid vulnerable plaque may be faster in hypertension, therefore reasonable intervention strategy and regular follow-up carotid MRI should be performed.

Objective To evaluate the significance of contrast medium (CM) volume and estimated glomerular filtration rate (CM/eGFR) in predicting contrast-induced nephropathy (CIN) after PCI. Methods A total of 307 patients after PCI were enrolled from Nanfang Hospital from May 2014 to October 2015. The patients were divided into the CIN group(n = 29) and the non-CIN group(n = 278) according to whether CIN within 72 hours after PCI. The baseline renal function was assessed by the sCr and CyC, respectively. Results Twenty-nine patients (9.4%, 29/307) developed CIN. There were significant differences in Age, CM、NTpro-BNP、IABP、 Periprocedural Hypotension、Preprocedural sCr/CyC between two groups (P < 0.05, respectively). The result of multivariate logistic regression analysis showed that Age, Cardiac function ≥Ⅲ level, IABP, use CCB, CM/eGFRMDRD, CM/eGFRCyC were independent risk predictors for CIN, respectively. Receiver Operating Characteristic (ROC) curve analysis showed that the area under the curve of CM/eGFRMDRD(AUC = 0.838) was superior to CM/eGFRCyC (AUC = 0.805) without significant difference. The sensitivity and specificity were 79.3%and 76.3%(Cut-off Point = 2.094), respectively. Conclusion Both the CM/eGFRMDRD and CM/eGFRCyC may be good methods to determine maximum CM before PCI and to predict CIN after PCI currently, without significant differences between these two predictors.

Objective To observe the effects of simvastatin combined with aspirin on the heart allograft and detect its mechanism. Methods Heterotopic heart transplantation was performed from Wistar to Sprague-Dawley (SD) rats. All SD rats were randomly assigned to Sham; HT (heart transplantation); HT + simvastatin(HT + S);HT + aspirin (HT + A); HT + aspirin + simvastatin (HT + A + S) group at different time points (day 3, 7, 10, 15, 20, 30 and 40) after transplantation (n=20). eNOS expression was detected by immunohistochemical methods and NO levels was measured by Griess assay. Meanwhile , the analysis of CD4+CD25+Tregs was performed by flow cytometry and histological examination for pathological change of heart and vascular. Results Simvastatin combined with aspirin significantly prolonged the mean survival time of heart allografts in HT + A + S group to (39 ± 5.3) days (n = 19) and in HT group to (8 ± 1.2) days (n = 18) (P < 0.001); simvastatin combined with aspirin delayed pathological changes of the transplanted hearts and protected vascular damage; simvastatin combined with aspirin upregulated eNOS and enhanced NO secretion. The level of CD4+CD25+Tregs in the blood of HT + A + S rats was significantly increased (2.2 ± 0.5)%, (2.9 ± 0.8)%, (4.3 ± 1.0)%, (8.3 ± 1.7)% and (14.3 ± 3.7)% for sham, HT, HT + S, HT + A and HT + A + S group respectively, HT vs. HT + A (P < 0.05) or HT + A + S (P < 0.01). Conclusion Simvastatin combined with aspirin delays the development pathology of myocardial and vascular damage and prolongs the survival time of cardiac allograft. The responsible mechanism is associated with activating CD4+ CD25+ Treg cells induction immune tolerance and enhancing vascular endothelial cell protection.

OBJECTIVETo evaluate the application of small intestine double stoma and succus entericus reinfusion in the patients with severe intra-abdominal infection.

METHODSTen patients with high intestinal perforation from February 2005 to November 2014 were enrolled in the study. All the cases received emergency operation. Small bowel with intestinal perforation was resected, and double stoma was applied in the proximal and distal small intestine. When abdominal infection under control, total enteral nutrition was successfully administered from nasogastric tube. The succus entericus from the proximal intestine was collected and transfused back to the distal intestine. Stool was collected and fecal nitrogen, fat and carbohydrate contents were determined. Related serum protein levels were measured.

RESULTSAs compared to pre-reinfusion, the absorption rate of carbohydrate [(90.9±7.8)% vs. (82.7±15.2)%], fat [(87.6±6.4)% vs. (59.1±10.8)%], and nitrogen [(82.4±9.8)% vs. (67.2±15.4)%] increased after succus entericus reinfusion (P<0.05). The serum protein levels increased significantly as well[fibronectin: (285.6±3.6) vs. (157.0±22.6) mg/L, P<0.01; transferrin: (4.86±0.21) vs. (3.60±0.25) g/L, P<0.05; pre-albumin: (291.3±112.5) vs. (199.1±53.3) mg/L, P<0.05].

CONCLUSIONSmall intestine double stoma and succus entericus reinfusion are effective in improving the absorption of carbohydrate, fat and nitrogen in the patients with severe intra-abdominal infection.

Enteral Nutrition ; Humans ; Intestinal Perforation ; Intestinal Secretions ; Intestine, Small ; Intraabdominal Infections ; Surgical Stomas

Objective To evaluate the application of small intestine double stoma and succus entericus reinfusion in the patients with severe intra-abdominal infection. Methods Ten patients with high intestinal perforation from February 2005 to November 2014 were enrolled in the study. All the cases received emergency operation. Small bowel with intestinal perforation was resected, and double stoma was applied in the proximal and distal small intestine. When abdominal infection under control, total enteral nutrition was successfully administered from nasogastric tube. The succus entericus from the proximal intestine was collected and transfused back to the distal intestine. Stool was collected and fecal nitrogen, fat and carbohydrate contents were determined. Related serum protein levels were measured. Results As compared to pre-reinfusion, the absorption rate of carbohydrate [(90.9±7.8)% vs. (82.7± 15.2)%], fat [(87.6±6.4)% vs. (59.1±10.8)%], and nitrogen [(82.4±9.8)% vs. (67.2±15.4)%] increased after succus entericus reinfusion (P<0.05). The serum protein levels increased significantly as well[fibronectin:(285.6±3.6) vs. (157.0±22.6) mg/L, P<0.01﹔transferrin:(4.86±0.21) vs. (3.60± 0.25) g/L,P<0.05﹔pre-albumin:(291.3±112.5) vs. (199.1±53.3) mg/L, P<0.05]. Conclusion Small intestine double stoma and succus entericus reinfusion are effective in improving the absorption of carbohydrate, fat and nitrogen in the patients with severe intra-abdominal infection.