OBJECTIVE To establish a prediction model of coronary heart disease(CHD)in elderly patients with diabetes mellitus(DM)based on machine learning(ML)algorithms.METHODS Based on the Medical Big Data Research Centre of Ch...OBJECTIVE To establish a prediction model of coronary heart disease(CHD)in elderly patients with diabetes mellitus(DM)based on machine learning(ML)algorithms.METHODS Based on the Medical Big Data Research Centre of Chinese PLA General Hospital in Beijing,China,we identified a cohort of elderly inpatients(≥60 years),including 10,533 patients with DM complicated with CHD and 12,634 patients with DM without CHD,from January 2008 to December 2017.We collected demographic characteristics and clinical data.After selecting the important features,we established five ML models,including extreme gradient boosting(XGBoost),random forest(RF),decision tree(DT),adaptive boosting(Adaboost)and logistic regression(LR).We compared the receiver operating characteristic curves,area under the curve(AUC)and other relevant parameters of different models and determined the optimal classification model.The model was then applied to 7447 elderly patients with DM admitted from January 2018 to December 2019 to further validate the performance of the model.RESULTS Fifteen features were selected and included in the ML model.The classification precision in the test set of the XGBoost,RF,DT,Adaboost and LR models was 0.778,0.789,0.753,0.750 and 0.689,respectively;and the AUCs of the subjects were 0.851,0.845,0.823,0.833 and 0.731,respectively.Applying the XGBoost model with optimal performance to a newly recruited dataset for validation,the diagnostic sensitivity,specificity,precision,and AUC were 0.792,0.808,0.748 and 0.880,respectively.CONCLUSIONS The XGBoost model established in the present study had certain predictive value for elderly patients with DM complicated with CHD.展开更多
OBJECTIVE To investigate the effects of sodium-glucose cotransporter 2 inhibitors(SGLT2i)on cardiovascular outcomes in elderly Chinese patients with comorbid coronary heart disease(CHD)and type 2 diabetes mellitus(T2D...OBJECTIVE To investigate the effects of sodium-glucose cotransporter 2 inhibitors(SGLT2i)on cardiovascular outcomes in elderly Chinese patients with comorbid coronary heart disease(CHD)and type 2 diabetes mellitus(T2DM).METHODS A retrospective cohort study was conducted on 501 elderly inpatients(≥60 years)with comorbid CHD/T2DM in Department of Cardiovascular Medicine and Endocrinology,Chinese PLA General Hospital from January 2018 to December 2019.These patients were divided into two groups according to the administration of SGLT2i.All the demographic characteristics and clinical data were collected.Cardiovascular outcomes,including all-cause mortality,major adverse cardiovascular events(MACE),and hospitalization for heart failure(HHF),were followed up.RESULTS In the cohort,there were 167 patients in the SGLT2i group and 334 patients in the control group.In the efficacy analyses,the incidence of MACE was lower in the SGLT2i group than in the control group:3.6%vs.9.3%(P=0.022).A lower risk of MACE was observed in the SGLT2i group[hazard ratio(HR)=0.40,95%CI:0.17-0.95].There was no significant difference in the incidence of all-cause mortality or HHF between the two groups.No significant difference of HR was observed for all-cause mortality(HR=0.41,95%CI:0.12-1.41)or HHF(HR=0.58,95%CI:0.12-2.81).CONCLUSIONS SGLT2i treatment exhibited benefits for elderly patients with comorbid CHD/T2DM with a lower risk for MACE.展开更多
Background The induced pluripotent stem cell （iPSC） has shown great potential in cellular therapy of myocardial infarction （MI）, while its application is hampered by the low efficiency of cardiomyocyte differentia...Background The induced pluripotent stem cell （iPSC） has shown great potential in cellular therapy of myocardial infarction （MI）, while its application is hampered by the low efficiency of cardiomyocyte differentiation. The present study was designed to investigate the effects of cardiotrophin-1 （CT-1） on cardiomyocyte differentiation from mouse induced pluripotent stem cells （miPSCs） and the underlying mechanisms involved. Methods The optimal treatment condition for cardiomyocyte differentiation from miPSCs was established with ideal concentration （10 ng/mL） and duration （from day 3 to day 14） of CT-1 administration. Up-regulated expression of cardiac specific genes that accounted for embryonic cardiogenesis was observed by quantitative RT-PCR. Elevated amount of a-myosin heavy chain （ct-MHC） and cardiac troponin I （cTn I） positive cells were detected by immunofluorescence staining and flow cytometry analysis in CT- 1 group. Results Transmission electron microscopic analysis revealed that cells treated with CT- 1 showed better organized sacromeric structure and more mitochondria, which are morphological characteristic of matured cardiomyocytes. Western blot demonstrated that CT-1 promotes cardiomyocyte differentiation from miPSCs partly via JAK2/STAT3/Pim-1 pathway as compared with control group. Conclusions These findings suggested that CT-1 could enhance the cardiomyocyte differentiation as well as the maturation of mouse induced pluripotent stem cell derived cardiomyocytes by regulating JAK2/STAT3/Pim-1 signaling pathway.展开更多
基金supported by the Key Project of Chinese Military Health Care Projects(No.18BJZ32)the Projects of International Cooperation and Exchanges NSFC(No.81820108019)+2 种基金the Technical Fund for the Foundation Strengthening Program of China(2021-JCJG-JJ-1079)the Chinese Military Innovation Project(CX19028)the Project of National Clinical Research Center for Geriatric Disease(NCRCG-PLAGH-2019024).
文摘OBJECTIVE To establish a prediction model of coronary heart disease(CHD)in elderly patients with diabetes mellitus(DM)based on machine learning(ML)algorithms.METHODS Based on the Medical Big Data Research Centre of Chinese PLA General Hospital in Beijing,China,we identified a cohort of elderly inpatients(≥60 years),including 10,533 patients with DM complicated with CHD and 12,634 patients with DM without CHD,from January 2008 to December 2017.We collected demographic characteristics and clinical data.After selecting the important features,we established five ML models,including extreme gradient boosting(XGBoost),random forest(RF),decision tree(DT),adaptive boosting(Adaboost)and logistic regression(LR).We compared the receiver operating characteristic curves,area under the curve(AUC)and other relevant parameters of different models and determined the optimal classification model.The model was then applied to 7447 elderly patients with DM admitted from January 2018 to December 2019 to further validate the performance of the model.RESULTS Fifteen features were selected and included in the ML model.The classification precision in the test set of the XGBoost,RF,DT,Adaboost and LR models was 0.778,0.789,0.753,0.750 and 0.689,respectively;and the AUCs of the subjects were 0.851,0.845,0.823,0.833 and 0.731,respectively.Applying the XGBoost model with optimal performance to a newly recruited dataset for validation,the diagnostic sensitivity,specificity,precision,and AUC were 0.792,0.808,0.748 and 0.880,respectively.CONCLUSIONS The XGBoost model established in the present study had certain predictive value for elderly patients with DM complicated with CHD.
基金This study was supported by the National Nature Science Foundation of China(No.81870249&No.81900409&No.91939303)the National Key R&D Program of China(2016YFA0100903)+2 种基金the Key Project of Chinese Military Health Care Projects(18BJZ32)the Science Foundation of the Chinese PLA General Hospital(2018XXFC-9)the Medical Big Data Project of Chinese PLA General Hospital(2018MBD-026).
文摘OBJECTIVE To investigate the effects of sodium-glucose cotransporter 2 inhibitors(SGLT2i)on cardiovascular outcomes in elderly Chinese patients with comorbid coronary heart disease(CHD)and type 2 diabetes mellitus(T2DM).METHODS A retrospective cohort study was conducted on 501 elderly inpatients(≥60 years)with comorbid CHD/T2DM in Department of Cardiovascular Medicine and Endocrinology,Chinese PLA General Hospital from January 2018 to December 2019.These patients were divided into two groups according to the administration of SGLT2i.All the demographic characteristics and clinical data were collected.Cardiovascular outcomes,including all-cause mortality,major adverse cardiovascular events(MACE),and hospitalization for heart failure(HHF),were followed up.RESULTS In the cohort,there were 167 patients in the SGLT2i group and 334 patients in the control group.In the efficacy analyses,the incidence of MACE was lower in the SGLT2i group than in the control group:3.6%vs.9.3%(P=0.022).A lower risk of MACE was observed in the SGLT2i group[hazard ratio(HR)=0.40,95%CI:0.17-0.95].There was no significant difference in the incidence of all-cause mortality or HHF between the two groups.No significant difference of HR was observed for all-cause mortality(HR=0.41,95%CI:0.12-1.41)or HHF(HR=0.58,95%CI:0.12-2.81).CONCLUSIONS SGLT2i treatment exhibited benefits for elderly patients with comorbid CHD/T2DM with a lower risk for MACE.
基金This work was supported by the National Funds for Distinguished Young Scientists of China （No. 81325009） and National Nature Science Foundation of China （No. 81270168, No. 81227901）, （Feng Cao BWS12J037）, Innovation Team granted by Ministry of Education PRC （IRT1053）, National Basic Research Program of China （2012CB518101）. Shaanxi Province Program （2013K12-02-03, 2014KCT-20）. The authors declare no conflict of interest.
文摘Background The induced pluripotent stem cell （iPSC） has shown great potential in cellular therapy of myocardial infarction （MI）, while its application is hampered by the low efficiency of cardiomyocyte differentiation. The present study was designed to investigate the effects of cardiotrophin-1 （CT-1） on cardiomyocyte differentiation from mouse induced pluripotent stem cells （miPSCs） and the underlying mechanisms involved. Methods The optimal treatment condition for cardiomyocyte differentiation from miPSCs was established with ideal concentration （10 ng/mL） and duration （from day 3 to day 14） of CT-1 administration. Up-regulated expression of cardiac specific genes that accounted for embryonic cardiogenesis was observed by quantitative RT-PCR. Elevated amount of a-myosin heavy chain （ct-MHC） and cardiac troponin I （cTn I） positive cells were detected by immunofluorescence staining and flow cytometry analysis in CT- 1 group. Results Transmission electron microscopic analysis revealed that cells treated with CT- 1 showed better organized sacromeric structure and more mitochondria, which are morphological characteristic of matured cardiomyocytes. Western blot demonstrated that CT-1 promotes cardiomyocyte differentiation from miPSCs partly via JAK2/STAT3/Pim-1 pathway as compared with control group. Conclusions These findings suggested that CT-1 could enhance the cardiomyocyte differentiation as well as the maturation of mouse induced pluripotent stem cell derived cardiomyocytes by regulating JAK2/STAT3/Pim-1 signaling pathway.
