Table of Content

20 April 2021, Volume 36 Issue 4

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Meta analysis of correlation between coronary artery calcification score and coronary artery disease and all-cause mortality

Bi Yue, Li Yongjun, Wang Mengmeng

2021, 36(4):  293-302.  doi:10.3969/j.issn.1004-583X.2021.04.001

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Objective To systematically review the correlations among coronary artery calcification score(CACS), coronary artery disease and all-cause mortality. Methods The databases of Pubmed, The Cochrane Library, EMbase, CKNI and WanFang Data were electronically searched to collect cohort studies on the correlations between CACS, CAD and all-cause mortality from the inception of databases to June 2020. Meta analysis was performed with Stata 14.0 software when two data clerks independently screened literatures, they extracted data and assessed risk of bias of included studies. Results A total of 11 cohort studies were included, including 59 143 cases. The Meta results showed that CACS≤100 group [HR=2.46,95%CI(1.77,3.41),P=0.000,I²=55.5%],100<CACS≤400 group[HR=3.62,95%CI(2.24,5.83),P=0.000,I²=42.2%] and CACS>400 group [HR=5.09,95%CI(2.02,12.84),P=0.001,I²=70.7%] are more likely to occur CAD and all-cause deaths compared to CACS<10 group. Conclusion There is a higher risk of coronary artery disease and all-cause mortality for patients with CAC.

Association between rs1799971 polymorphism in mu opioid receptor 1 gene and susceptibility to alcohol dependence: a meta-analysis

Wang Lingli, Zhao Zhiqiang, Jin Xinrong

2021, 36(4):  303-310.  doi:10.3969/j.issn.1004-583X.2021.04.002

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Objective To investigate the association between rs1799971 polymorphism in mu opioid receptor 1 (OPRM1) gene and susceptibility of alcohol dependence. Methods Through five online databases including PubMed, Web of Science, EMBASE, CNKI, and Wanfang electronic database, the studies related to the research objective were accessed, and the search deadline was on July 10, 2020. And the selected literature is based on the established inclusion criteria and exclusion criteria, and the included studies subjects is assess the quality using the Newcastle-Ottawa Scale (NOS). The data was merged by RevMan5.3 software, the allele model (A vs. G), homozygous model (AA vs. GG), heterozygous model (AG vs. GG), dominance model (AA+AG vs. GG) and recessive model (AA vs. AG+GG) P value, odds ratio (ORs) and 95% confidence interval (95% CIs) was calculated. Results A total of 22 studies with 24 independent researches were included in the meta-analysis. All eligible studies received five or more NOS scores and were in favorable quality for the included methodology. The results suggested that rs1799971 polymorphism was associated with alcohol dependence (P=0.03). Subgroup analysis indicated the association only existed in the asian population. Especially AG-genotype carriers had an increased risk of alcohol dependence. Conclusion Rs1799971 polymorphism in OPRM1 gene is significantly associated with the risk of alcohol dependence in Asians, especially AG-genotype carriers have an elevated alcohol dependence risk.

Clinical efficacy of lidocaine combined with rosuvastatin in treating acute coronary syndrome concurrent with acute arrhythmia among patients intolerant of amiodarone

Cui Guoyan, Zheng Wen, Zhang Liwei

2021, 36(4):  311-314.  doi:10.3969/j.issn.1004-583X.2021.04.003

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Objective To investigate the effects of lidocaine combined with rosuvastatin in treating acute coronary syndrome(ACS) concurrent with acute arrhythmia among patients intolerant of amiodarone. Methods A total of 110 patients with ACS who were intolerant of amiodarone were recruited from our hospital, and they were divided into two groups, the control group (n=55) were given thrombolytic therapy, the observation group (n=55) were given idocaine combined with rosuvastatin. The both groups were treated with thrombolysis and low molecular weight heparin, and the changes in clinical efficacy, cardiac function, inflammatory factors and oxidative stress indicators were compared between two groups. Results The total response rate in the observation group was significantly higher than that in the control group (96.36% vs 85.45%,P<0.05). After treatment, the indexes of heart rate variability (HRV) in the observation group were higher than those in control group (P<0.05); HRV indexes in the observation group were higher than those in the control group (P<0.05); the serum tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein(hs-CRP) and malondialdehyde(MDA) in the observation group were lower than those in the control group, and superoxide dismutase (SOD) in the observation group was higher than that in the control group (P<0.05). Conclusion Lidocaine combined with rosuvastatin in treating ACS concurrent with acute arrhythmia among patients intolerant of amiodarone can reduce inflammatory response and oxidative stress, regulate HRV, and further improve the efficacy of antiarrhythmias.

Relationship between expression of serum vascular endothelial growth factor, procalcitonin, high-sensitivity C-reactive protein and severity of cerebral edema in patients with acute cerebral infarction

Chen Guangpeng, Miao Guoyin, Yang Yanqin

2021, 36(4):  315-318.  doi:10.3969/j.issn.1004-583X.2021.04.004

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Objective To explore the relationship between the expression of serum vascular endothelial growth factor(VEGF), procalcitonin(PCT), high-sensitivity C-reactive protein(hs-CRP) and the severity of cerebral edema in patients with acute cerebral infarction(ACI). Methods A total of 102 ACI patients diagnosed in our hospital were selected, the patients were divided into a mild group (n=34), moderate group(n=42) severe group(n=26) according to the National Institutes of Health Stroke Scale(NIHSS). The disturbance coefficient values of cerebral electrical impedance(CEI) of the affected cerebral hemisphere was detected, aiming to compare the disturbance coefficient values of serum VEGF, PCT, hs-CRP and CEI in each group, and analyze the correlation among these values. Results Repeated measurements showed that the disturbance coefficient values of serum VEGF, PCT, hs-CRP, and affected side CEI were statistically significant in terms of time point, between groups, interaction of time point and between groups (P<0.05); the disturbance coefficient values of affected side CEI was positively correlated with the level of serum VEGF, PCT, and hs-CRP (P<0.05). Conclusion The more severe the condition of ACI patients, the higher the level of serum VEGF, PCT, hs-CRP, and the higher the CEI disturbance coefficient values on the affected side CIE. Serum VEGF, PCT, hs-CRP are closely related to the degree of cerebral edema, and may be involved in the occurrence and development of cerebral edema in ACI , it can play an early auxiliary role on evaluating the condition and the severity of cerebral edema.

Rural-urban difference of risk factors in middle-aged high-risk groups with stroke in Chifeng City

Li Wenping, Li Wenli, Zhang Chao, Fu Jia

2021, 36(4):  319-322.  doi:10.3969/j.issn.1004-583X.2021.04.005

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Objective To investigate the rural-urban difference of risk factors in middle-aged high-risk groups with stroke in Chifeng City. Methods The method of cluster sampling was used for the urban and rural resident population aged 40 to 65 years old in Chifeng City, and those residents had face-to-face interviews and physical examinations to collect the basic information. The screening results were statistically analyzed. Results 1 832 middle-aged high-risk residents aged 40 to 65 were included in the study, including 950 urban residents (51.9%) and 882 rural residents (48.1%).There was no significant difference in age and gender between urban and rural residents (P>0.05). The exposure rates, such as family history of stroke, hypertension, diabetes, overweight or obesity, and dyslipidemia in urban residents were higher than those in rural residents(P<0.05), while the exposure rates of lack of exercise and smoking history were lower (P<0.05). Conclusion There are differences in the exposure of risk factors between rural-urban middle-aged high-risk groups with stroke in Chifeng City. It is necessary to carry out the targeted stroke prevention and treatment strategies, the focus of city is on the control of diseases such as hypertension, diabetes, dyslipidemia, and obesity, while the focus of village is on the intervention of unhealthy lifestyles such as smoking and insufficient exercise.

Changes and clinical significance of serum suPAR, sTREM-1, TNF-α,IL-6 in patients with community-acquired pneumonia

Zheng Xiao, Zheng Yonghua, Hu Xiaoyan, Chen Zhanjun, Ji Huaxia, Qian Bao

2021, 36(4):  323-327.  doi:10.3969/j.issn.1004-583X.2021.04.006

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Objective To investigate the changes and clinical significance of serum urokinase type plasminogen activator receptor(suPAR), soluble myeloid cells trigger receptor 1 (sTREM-1), tumor necrosis factor-ɑ(TNF-ɑ), interleukin-6(IL-6) in patients with community-acquired pneumonia(CAP). Methods A total of 100 CAP patients in our hospital from Apr 2018 to Sep 2020 were selected, 50 cases of CAP were in severe group and 50 cases of CAP were non-severe group, while 50 healthy people who had physical examination in our hospital during the same period were selected as control group. The serum levels of suPAR, sTREM-1, TNF-α and IL-6 in each group were detected by enzyme-linked immunosorbent assay, the severity of CAP patients were evaluated by Pneumonia Severity Score(PSI), Acute Physiology and Chronic Health Assessment Ⅱ(APACHE Ⅱ) scoring system. Results suPAR, sTREM-1, TNF-α, IL-6 were higher in severe group than those in non-severe group, and the above indexes in non-severe group were higher than those in control group(P<0.05). PSI, APACHEⅡ scores in severe group were higher than those in non-severe group(all P<0.01). Correlation analysis showed that suPAR, sTREM-1, TNF-α, IL-6 levels were positively correlated with PSI score and APACHE Ⅱ score (r=0.867, 0.858, 0.723, 0.853, 0.846, 0.711, 0.821; all P<0.01). By prognosis outcome, the severe group was subdivided into death group (18 cases) and survival group (32 cases), and the levels of suPAR, sTREM-1 and IL-6 in death group were higher than those in survival group (all P<0.01). Logistic regression analysis showed that suPAR, sTREM-1, IL-6 levels were dependent risks for severe CAP (P<0.05). ROC curve analysis showed that AUCs of suPAR, sTREM-1, and IL-6 for the detection of severe CAP were 0.876, 0.831, 0.780, 0.852, respectively (P<0.01). Conclusion suPAR,sTREM-1, IL-6 in CAP patients are significantly increased, and they were positively correlated with the severity and prognosis of the disease, and could be used as reference indicators for the examination of severe CAP.

High-flux hemodialysis in the frailty of elderly patients with end-stage renal disease

Zhang Jinjin, Jin Ruixia, Sun Wei

2021, 36(4):  328-331.  doi:10.3969/j.issn.1004-583X.2021.04.007

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Objective To analyze the effects of high-flux hemodialysis(HFHD) and low-flux hemodialysis(LFHD) on the frailty of elderly patients with end-stage renal disease(ESRD). Methods The study involved 86 patients with ESRD over 60 years who were treated from Nov 2018 to May 2019. The debilitating condition of the patients were assessed before dialysis, the patients were divided into LFHD group and HFHD group according to odd and even ways, 43 cases in each group; and the general information and auxiliary examination results between the two groups before and after treatment were collected to compare the difference in the incidence of frailty and influencing factors. Results The incidence of frailty(P<0.05), blood phosphorus(P), parathyroid hormone(PTH), β₂-microglobulin(β₂-MG), vitamin B₁₂(VitB₁₂), triglyceride(TG), creatinine(SCr),urea (Urea) and albumin(ALB) in HFHD group were significantly decreased than those in LFHD group(P<0.05), while hemoglobin(Hb), high-density lipoprotein(HDL-C) and hematocrit(HCT) in HFHD group significantly increased than those in LFHD group (P<0.05). Logistic regression analysis showed that age, P, PTH, β₂-MG, Hb, ALB were the common influencing factors of frailty in both groups(P<0.05). Conclusion HFHD can improve the frailty of elderly ESRD patients.

Comparative study on volume load and nutritional status in hemodialysis patients with diabetic kidney disease and non-diabetic kidney disease

Liu Meng, Hu Guicai, Yang Zongna, Guo Weiwei, Chen Wanxin

2021, 36(4):  332-335.  doi:10.3969/j.issn.1004-583X.2021.04.008

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Objective To study the volume load and nutritional status in hemodialysis patients with diabetic kidney disease (DKD). Methods A total of 92 patients with long-term and regular hemodialysis were selected from Blood Purification Center of The Affiliated Hospital of Chengde Medical College. According to the etiology of kidney disease, those patients were divided into DKD hemodialysis group and non-DKD hemodialysis group. The body composition monitor(BCM) was used to analyze human body composition and the biochemical indexes scale was used to evaluate the nutritional status and volume load of the two groups. Results Compared with the non-DKD hemodialysis group, the mean arterial pressure (MAP), overhydration (OH), and extracellular water (ECW) in the DKD hemodialysis group were higher(P<0.05). However, the indexes of albumin, lean tissue index (LTI), and muscle tissue content (LTM) in the DKD hemodialysis group were lower than those in the non-DKD hemodialysis group(P<0.05). Conclusion Compared with non-DKD hemodialysis patients, DKD hemodialysis patients have a higher risk of volume overload and malnutrition.

Therapeutic effect of chocolate balloon dilatation angioplasty on diabetic infrapopliteal artery occlusion

Wang Wenqi, Ma Hongfang, Du Yaping, Ding Haixia, Bai Lei, Wang Fujun

2021, 36(4):  336-339.  doi:10.3969/j.issn.1004-583X.2021.04.009

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Objective To investigate the efficacy and safety of chocolate balloon dilatation angioplasty on diabetic patients with infrapopliteal artery occlusion. Methods Fifty-six diabetic patients with infrapopliteal artery occlusion from September 2020 to February 2021 were selected and randomly divided into two groups with 28 patients in each group. The control group was treated with ordinary balloon for interventional treatment of percutaneous infrapopliteal artery intraluminal angioplasty, while the observation group was treated with chocolate balloon. The operative success rate, intraoperative flow limiting dissection formation were observed between the two groups; the ankle-brachial index(ABI), transcutaneous oxygen pressure(tcpO₂), and symptom improvement were compared between the two groups before and after surgery. Results The success rate of technology in the observation group and the control group were both 100%, and the success rate of operation were 96.43% and 89.29%, respectively; 6 infrapopliteal arteries formed flow restriction dissections after balloon dilation in the observation group (6/39) , and 15 infrapopliteal arteries formed in the control group (15/40).The rate of intraoperative flow limiting dissection formation in the observation group was lower than that in the control group(P<0.05). ABI and tcpO₂ in the observation group were significantly better than that in the control group(P<0.05). Symptoms were significantly improved after surgery in the both groups. Conclusion The application of chocolate balloon dilatation in the treatment of infrapopliteal artery occlusion is satisfactory, can effectively reduce the occurrence of flow limiting dissection, the short-term effect is more superior.

Study on correlation between serum bilirubin level and carotid plaque in type 2 diabetes mellitus

Jin Hui, Liu Shangquan

2021, 36(4):  340-343.  doi:10.3969/j.issn.1004-583X.2021.04.010

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Objective To explore the correlation between serum bilirubin level and carotid plaque formation in type 2 diabetes mellitus. Methods Nine hundred and fifty two hospitalized patients with type 2 diabetes were selected, and the patients were divided into 426 patients with carotid plaque (plaque group) and 526 patients without carotid plaque (non-plaque group) according to the results of carotid artery color ultrasonography. The essential information and data including the serum bilirubin level, blood glucose, blood lipids, glycated hemoglobin, etc. were recorded, and related factors affecting the formation of carotid plaque were studied. Results Compared to the patients in non-plaque group, the patients in the plaque group were featured with more males, older age, longer course of disease, longer combined history of smoking and hypertension, lower total bilirubin(TBIL) and indirect bilirubin(IBIL) levels, higher serum creatinine(Scr) and greater total cholesterol(TCHO) and low-density lipoprotein cholesterol(LDL-C) levels(P<0.05). The gender, age, course of disease, smoking history were considered to be independent risk factors of carotid plaque, and indirect bilirubin was considered to be a protective factor for carotid plaque. Conclusion The level of serum indirect bilirubin is independently correlated with the risk of carotid plaque when the serum total bilirubin level is within the physiological range.

Content of PTX3 in the serum of patients with systemic sclerosis and corresponding significance in vasculopathy

Li Hongyan, Wang Xiaoping, Yang Lin, He Jingjing, Liu Aijing

2021, 36(4):  344-347.  doi:10.3969/j.issn.1004-583X.2021.04.011

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Objective To explore the significance of level of pentraxin 3 (PTX3) in the serum for evaluating the disease activities of patients with systemic sclerosis (SSc) and vasculopathy. Methods Thirty seven patients with SSc receiving initial therapy were selected and divided into the case group, and 31 healthy subjects were selected and divided into the control group, the case group was further divided into the disease active group and inactive group, duodenal ulcer (DU) group and non-DU group, pulmonary hypertension (PAH) group and non-PAH group, aiming to analyze the correlation between the levels of serum PTX3 , fibroblast growth factor 2(FGF2) and modified Rodnan skin scores (mRss), nailfold microcirculation test total score (NCTS) in groups. Results The level of serum PTX3 in SSc group were significantly higher than that in the control group(P<0.05),and the level off PTX3 in disease active group was higher than that in the inactive group and the control group. The levels of PTX3 and PTX3/FGF2 in DU and PAH groups were higher than those in the negative control group(P<0.05).The level of PTX3 was positively associated with NCTS, total cholesterol (CHOL) and low density lipoprotein cholesterin(LDL-G)(P<0.05). Elevated level of PTX3/FGF2 was risk factor of patients with SSc accompanying with PAH(P<0.05). Conclusion Serum PTX3 level in patients with SSc delivers certain clinical significance in determine disease activity .PTX3/FGF2 may be risk factor for patients with SSc accompanying with PAH.

MRI features of multi-segmental brucella spondylitis and spinal tuberculosis

Wu Yanhui, Dong Chunjiao, Zhao Guofang, Guo Lijie, Zhao Hui, Xing Weihong

2021, 36(4):  348-352.  doi:10.3969/j.issn.1004-583X.2021.04.012

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Objective To explore the different imaging characteristics of multi-segment brucella spondylitis (BS) and spinal tuberculosis (ST) in magnetic resonance imaging (MRI), so as to improve the level of early diagnosis and differential diagnosis. Methods Retrospective analysis was performed in 33 patients with multi-segment BS and 30 patients with multi-segment ST, who were diagnosed clinically or pathologically. Lesion location, vertebral body shape, surrounding tissues,and accompanying signs were studied according the different manifestations on MRI. Results The proportion of vertebral morphology, intervertebral disc involvement, kyphosis, sequestrum and calcification, paravertebral abscess were significantly different between the patients with multi-segmental BS and the patients with multi-segmental ST (P<0.05). Conclusion MRI findings of multi-segment BS and ST are different, MRI is helpful in differential diagnosis.

Relations between serum 25-(OH)D level and short stature in children

Shao Na, Wang Shuo, Li Yao, Luo Xuemei, Tan Chuanmei

2021, 36(4):  353-356.  doi:10.3969/j.issn.1004-583X.2021.04.013

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Objective The purpose of this study is to investigate the relations between serum 25-(OH)D level and short stature in children. Methods One hundred and seventy two patients who visited the pediatric endocrine clinic of the hospital and were diagnosed to have short stature (94 males, 78 females, 8.50±3.18 years old) were retrospectively collected, 78 cases were included in the growth hormone deficiency (GHD) group, 94 cases were included in the idiopathic short stature (ISS) group according to the causes. A total of 175 healthy children (84 males and 91 females, 7.65±1.19 years old) undergoing physical examination in the hospital during the same period were selected to be controlled. The relations between serum 25-(OH) D level and short stature of children were analyzed. Results (1)The differences in the age, height and body mass of children in GHD group, ISS group and control group were statistically significant (P<0.05), the serum 25-(OH)D level in GHD group was significantly lower than that in ISS group and control group(P<0.01).The difference in serum 25-(OH)D level between different genders in ISS group (P<0.05) was a statistically significant, and serum 25-(OH)D level in male children was higher than that in female children(P=0.011).(2)The proportion of vitamin D deficiency in GHD group (30.76%, 24/78) was higher than that in ISS group (6.38%,6/94)(χ²=17.604, P<0.01). Conclusion The decreased serum 25-(OH)D level is more obvious in children with short stature, especially in children with GHD among them.

Correlation between serum uric acid and catecholamines in college students

Li Yaru, Zhao Haiying, Ji Xiaoyi, Wang Menglin, Wang Hao, Li Ling, Jiang Ling, Wang Xinyu

2021, 36(4):  357-360.  doi:10.3969/j.issn.1004-583X.2021.04.014

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Objective To study the correlation between serum uric acid(SUA) level and catecholamines, blood pressure in college students. Methods A total of 285 from 5 185 college students who participated in the blood pressure survey were selected by using R language stratified random sampling method. According to SUA level, college students were divided into non-hyperuricemia group (177 cases) and hyperuricemia group (108 cases). The plasma catecholamine, biochemical and other indicators were tested and compared between two groups. The correlation was analyzed between SUA and plasma epinephrine(E), norepinephrine(NE), dopamine(DA), systolic blood pressure(SBP), diastolic blood pressures(DBP), heart rate(HR), body mass index(BMI), fasting blood glucose(FBG), serum creatinine(SCr), total cholesterol(TC), triglycerides(TG), high-density lipoprotein cholesterol(HDL-C), and low-density lipoprotein cholesterol(LDL-C). Results In female college students, the plasma E in hyperuricemia group was higher than that in non-hyperuricemia group (P<0.05). In the college students, SBP, DBP, BMI, SCr, SUA, TC, TG, LDL-C in hyperuricemia group were higher than those in non-hyperuricemia group, but HDL-C was lower than that in non-hyperuricemia group (all P<0.05). SUA was positively correlated with plasma E in female college students (P<0.05). The SUA level of all participants was positively correlated with SBP, DBP, BMI, SCr, TG, and LDL-C (all P<0.05), but negatively correlated with HDL-C (P<0.05). Conclusion In the college students, hyperuricemia is closely related with hypertension, obesity, dyslipidemia, and elevated SCr, the higher plasma E level and the greater hyperuricemia risk. The correlation is the strongest between the plasma E and SUA in female college students.

Primary Sjögren’s syndrome with pulmonary embolism:a case report and literature review

Cui Lu, Li Jing, Liu Yuhong

2021, 36(4):  361-364.  doi:10.3969/j.issn.1004-583X.2021.04.015

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This study analyzed the data of a patient with primary Sjögren's syndrome (pSS)complicated with pulmonary embolism admitted to the Yanan University Affiliated Hospital, and reviewed the relevant literature.If SS Patients, who were also related to the respiratory system or active inflammation, are encountered in clinical, they should be vigilant and memorize the differential diagnosis of SS pulmonary manifestations. CT angiography(CTA) should be performed as soon as possible for patients with multiple risk factors or high risk of pulmonary embolism. Thrombosis might be caused by pulmonary infection or inflammatory activity of primary disease.