目的应用沿血管周围间隙的扩散张量图像分析技术(DTI-ALPS)检测新诊断2型糖尿病(T2DM)患者脑胶质淋巴系统功能,探讨其与胰岛素抵抗指数(HOMA-IR)的相关性。方法选取徐州医科大学附属医院2023年4~6月临床确诊的新诊断的T2DM患者30例作为...目的应用沿血管周围间隙的扩散张量图像分析技术(DTI-ALPS)检测新诊断2型糖尿病(T2DM)患者脑胶质淋巴系统功能,探讨其与胰岛素抵抗指数(HOMA-IR)的相关性。方法选取徐州医科大学附属医院2023年4~6月临床确诊的新诊断的T2DM患者30例作为新诊断T2DM组,同时选取本院体检的与新诊断T2DM组年龄、性别相匹配的健康人30例为对照组。收集受试者临床检验指标(糖化血红蛋白、空腹血糖、空腹胰岛素水平),选取稳态模型作为评估胰岛素抵抗的指数,计算得出胰岛素抵抗HOMA-IR指数。采用3.0T核磁共振对60例受试者进行扫描,利用DTI计算ALPS指数,比较两组间的差异。采用Pearson相关性分析新诊断T2DM组HOMA-IR与ALPS指数之间的相关性。结果新诊断T2DM组空腹血糖、空腹胰岛素、糖化血红蛋白、HOMA-IR高于正常对照组(P<0.05)。新诊断T2DM组ALPS指数下降(1.50±0.22 vs 1.31±0.18,P<0.001),与HOMA-IR呈负相关(r=-0.622,P<0.001)。结论DTI-ALPS技术可用于评估新诊断T2DM患者的胶质淋巴系统功能,其功能的下降与胰岛素抵抗密切相关。展开更多
Objective To clarify the association between rs1050450 polymorphism in Glutathione peroxidase-1 （GPx-1） and the risk of cardi-ovascular diseases （CVD） by performing a meta-analysis of published studies. There is g...Objective To clarify the association between rs1050450 polymorphism in Glutathione peroxidase-1 （GPx-1） and the risk of cardi-ovascular diseases （CVD） by performing a meta-analysis of published studies. There is growing evidence from different study types for an association of the GPx-1 polymorphism and cardiovascular outcomes, but observational studies have so far shown inconsistent results. Me-thods Relevant publications were searched through PubMed, Embase database databases and the Cochrane Library. We used odds ratios （ORs） with 95%confidence intervals （CIs） to assess the strength of association under the best genetic model. Both Q statistic and the I2 were used to check heterogeneity. Meta-regression analysis was performed to explore heterogeneity source. Sensitivity analysis, cumulative me-ta-analysis analysis and publication bias were used to test the reliability of the results. Results Data were available from two cohort studies and 8 case-control studies involving 1,430 cases and 3,767 controls. The pooled ORs for overall CVD risk was 1.36 with 95%CI：1.08-1.70 under a co-dominant model, and that for East Asian subgroup was 1.84 （95%CI：1.39-2.43）. Substantial heterogeneity for ORs were de-tected among all the included studies, mainly caused by ethnic differences between East Asian and non-East Asian populations. Although Egger＇s regression test suggested no statistical significant publication bias, Begg＇s funnel plot exhibited obvious asymmetry. The statistical significance disappeared after adjusting for potential publication bias in the overall studies. However, no substantial publication bias was found in the East Asian subgroup. Conclusions GPx-1 gene Pro198Leu and Pro197Leu polymorphisms considerably increased the risk of CVD in the East Asian population. Large-scale investigations are needed to confirm the results in different ethnicities.展开更多
Background Atrial fibrillation （AF） is associated with inflammation and endothelial dysfunction. However, the association between inflammation （as indexed by high-sensitivity C-reactive protein, hs-CRP） and endoth...Background Atrial fibrillation （AF） is associated with inflammation and endothelial dysfunction. However, the association between inflammation （as indexed by high-sensitivity C-reactive protein, hs-CRP） and endothelial function [as indexed by big endothelin-1 （ET-1）] in AF patients remains unclear. Methods We enrolled 128 patients with lone AF, among which 83 had paroxysmal AF, and 45 had persistent AF. Eighty-two age- and gender-matched controls of paroxysmal supraventricular tachycardia without AF history were evaluated. Plasma hs-CRP, big ET-1 levels and other clinical characteristics were compared among the groups. Results Patients with persistent AF had higher hs-CRP concentrations than those with paroxysmal AF （P 〈 0.05）, both groups had higher hs-CRP level than controls （P 〈 0.05）. Patients with persistent AF had higher big ET-1 level than those with paroxysmal AF, although the difference did not reach the statistical significance （P 〉 0.05）, and both groups had higher big ET-1 levels than controls （P 〈 0.05）. Multiple regression analyses revealed hs-CRP as an inde- pendent determinant of AF （P 〈 0.001）. Further adjusted for big ET-1, both big ET-1 and hs-CRP were independent predictors for AF （P 〈 0.001）, but the odds ratio for hs-CRP in predicting AF attenuated from 8.043 to 3.241. There was a positive relation between hs-CRP level and big ET-1 level in paroxysmal AF patients （r = 0.563, P 〈 0.05）, however, the relationship in persistent AF patients was poor （r = 0.094, P 〈 0.05）. Conclusions Both plasma hs-CRP and big ET-1 levels are elevated in lone AF patients, and are associated with AF. In paroxysmal lone AF patients, there were significant positive correlations between plasma hs-CRP level and big ET- 1 level.展开更多
Objective The optimal strategy during primary percutaneous coronary intervention （PCI） in patients with acute myocardial infarction and multivessel disease is still controversial. Therefore, the aim of our study is ...Objective The optimal strategy during primary percutaneous coronary intervention （PCI） in patients with acute myocardial infarction and multivessel disease is still controversial. Therefore, the aim of our study is to evaluate the short- and long-term effect of complete revas- cularization （CR） versus infarct-related artery revascularization （IR） following primary PCI. Methods We identified randomized controlled studies （RCTs） by systematic search of PubMed, EMBASE, Web of Science, ClinicalTrials.gov Website, Cochrane Library and Google scholar Database. Primary outcome was major adverse cardiac events （MACE）. Result Nine RCTs （2198 patients） with mean follow-up of 21.1 months were retrieved. Overall, CR was associated with significantly lower risk of MACE compared with IR therapy when followed by long-term duration （≥ 12 months） （RR： 0.56; 95% Ch 0.47-0.68; I^2 = 58.5%）. Additionally, CR was associated with equivalent rates of all-cause mortality （RR： 0.76; 95% CI： 0.53-1.08; I^2= 0.0%） and myocardial infarction （RR： 0.81; 95% CI： 0.57-1.16; I^2= 26.4%） compared with control. Meanwhile, risk of stroke was similar between groups （RR： 0.73; 95% CI： 0.24-2.19; I^2= 0.0%）. However, rates of cardiac death and target vessel revascularization were significantly decreased in the CR group （RR： 0.41; 95% CI： 0.23-0.72; I^2 = 0.0% and RR： 0.46; 95% CI： 0.37-0.57; I^2= 47.4%）. Conclusion Complete revascularization appears to have long-term clinical benefit with regard to adverse cardiac events following primary PCI. However, more studies are needed to confirm these findings.展开更多
文摘目的应用沿血管周围间隙的扩散张量图像分析技术(DTI-ALPS)检测新诊断2型糖尿病(T2DM)患者脑胶质淋巴系统功能,探讨其与胰岛素抵抗指数(HOMA-IR)的相关性。方法选取徐州医科大学附属医院2023年4~6月临床确诊的新诊断的T2DM患者30例作为新诊断T2DM组,同时选取本院体检的与新诊断T2DM组年龄、性别相匹配的健康人30例为对照组。收集受试者临床检验指标(糖化血红蛋白、空腹血糖、空腹胰岛素水平),选取稳态模型作为评估胰岛素抵抗的指数,计算得出胰岛素抵抗HOMA-IR指数。采用3.0T核磁共振对60例受试者进行扫描,利用DTI计算ALPS指数,比较两组间的差异。采用Pearson相关性分析新诊断T2DM组HOMA-IR与ALPS指数之间的相关性。结果新诊断T2DM组空腹血糖、空腹胰岛素、糖化血红蛋白、HOMA-IR高于正常对照组(P<0.05)。新诊断T2DM组ALPS指数下降(1.50±0.22 vs 1.31±0.18,P<0.001),与HOMA-IR呈负相关(r=-0.622,P<0.001)。结论DTI-ALPS技术可用于评估新诊断T2DM患者的胶质淋巴系统功能,其功能的下降与胰岛素抵抗密切相关。
文摘Objective To clarify the association between rs1050450 polymorphism in Glutathione peroxidase-1 （GPx-1） and the risk of cardi-ovascular diseases （CVD） by performing a meta-analysis of published studies. There is growing evidence from different study types for an association of the GPx-1 polymorphism and cardiovascular outcomes, but observational studies have so far shown inconsistent results. Me-thods Relevant publications were searched through PubMed, Embase database databases and the Cochrane Library. We used odds ratios （ORs） with 95%confidence intervals （CIs） to assess the strength of association under the best genetic model. Both Q statistic and the I2 were used to check heterogeneity. Meta-regression analysis was performed to explore heterogeneity source. Sensitivity analysis, cumulative me-ta-analysis analysis and publication bias were used to test the reliability of the results. Results Data were available from two cohort studies and 8 case-control studies involving 1,430 cases and 3,767 controls. The pooled ORs for overall CVD risk was 1.36 with 95%CI：1.08-1.70 under a co-dominant model, and that for East Asian subgroup was 1.84 （95%CI：1.39-2.43）. Substantial heterogeneity for ORs were de-tected among all the included studies, mainly caused by ethnic differences between East Asian and non-East Asian populations. Although Egger＇s regression test suggested no statistical significant publication bias, Begg＇s funnel plot exhibited obvious asymmetry. The statistical significance disappeared after adjusting for potential publication bias in the overall studies. However, no substantial publication bias was found in the East Asian subgroup. Conclusions GPx-1 gene Pro198Leu and Pro197Leu polymorphisms considerably increased the risk of CVD in the East Asian population. Large-scale investigations are needed to confirm the results in different ethnicities.
文摘Background Atrial fibrillation （AF） is associated with inflammation and endothelial dysfunction. However, the association between inflammation （as indexed by high-sensitivity C-reactive protein, hs-CRP） and endothelial function [as indexed by big endothelin-1 （ET-1）] in AF patients remains unclear. Methods We enrolled 128 patients with lone AF, among which 83 had paroxysmal AF, and 45 had persistent AF. Eighty-two age- and gender-matched controls of paroxysmal supraventricular tachycardia without AF history were evaluated. Plasma hs-CRP, big ET-1 levels and other clinical characteristics were compared among the groups. Results Patients with persistent AF had higher hs-CRP concentrations than those with paroxysmal AF （P 〈 0.05）, both groups had higher hs-CRP level than controls （P 〈 0.05）. Patients with persistent AF had higher big ET-1 level than those with paroxysmal AF, although the difference did not reach the statistical significance （P 〉 0.05）, and both groups had higher big ET-1 levels than controls （P 〈 0.05）. Multiple regression analyses revealed hs-CRP as an inde- pendent determinant of AF （P 〈 0.001）. Further adjusted for big ET-1, both big ET-1 and hs-CRP were independent predictors for AF （P 〈 0.001）, but the odds ratio for hs-CRP in predicting AF attenuated from 8.043 to 3.241. There was a positive relation between hs-CRP level and big ET-1 level in paroxysmal AF patients （r = 0.563, P 〈 0.05）, however, the relationship in persistent AF patients was poor （r = 0.094, P 〈 0.05）. Conclusions Both plasma hs-CRP and big ET-1 levels are elevated in lone AF patients, and are associated with AF. In paroxysmal lone AF patients, there were significant positive correlations between plasma hs-CRP level and big ET- 1 level.
基金Acknowledgement This work is supported by grants from National Natural Science foundation of China （81570323） and Beijing Lab for Cardiovascular Precision Medicine, Beijing, China （PXM2017_014226_000037）.
文摘Objective The optimal strategy during primary percutaneous coronary intervention （PCI） in patients with acute myocardial infarction and multivessel disease is still controversial. Therefore, the aim of our study is to evaluate the short- and long-term effect of complete revas- cularization （CR） versus infarct-related artery revascularization （IR） following primary PCI. Methods We identified randomized controlled studies （RCTs） by systematic search of PubMed, EMBASE, Web of Science, ClinicalTrials.gov Website, Cochrane Library and Google scholar Database. Primary outcome was major adverse cardiac events （MACE）. Result Nine RCTs （2198 patients） with mean follow-up of 21.1 months were retrieved. Overall, CR was associated with significantly lower risk of MACE compared with IR therapy when followed by long-term duration （≥ 12 months） （RR： 0.56; 95% Ch 0.47-0.68; I^2 = 58.5%）. Additionally, CR was associated with equivalent rates of all-cause mortality （RR： 0.76; 95% CI： 0.53-1.08; I^2= 0.0%） and myocardial infarction （RR： 0.81; 95% CI： 0.57-1.16; I^2= 26.4%） compared with control. Meanwhile, risk of stroke was similar between groups （RR： 0.73; 95% CI： 0.24-2.19; I^2= 0.0%）. However, rates of cardiac death and target vessel revascularization were significantly decreased in the CR group （RR： 0.41; 95% CI： 0.23-0.72; I^2 = 0.0% and RR： 0.46; 95% CI： 0.37-0.57; I^2= 47.4%）. Conclusion Complete revascularization appears to have long-term clinical benefit with regard to adverse cardiac events following primary PCI. However, more studies are needed to confirm these findings.
