International journal of clinical and experimental medicine最新文献

To compare the feasibility, efficiency and safety of coronary angiography (CAG) and interventional procedures between the radial and femoral catheterization approaches in Chinese population using systematic review and meta-analysis, we conducted a search of the studies comparing radial and femoral catheterization approaches in patients underwent either CAG or percutaneous coronary intervention (PCI) in Chinese population. Fixed-effect relative risk (RR) for the primary end points and the second end points were compared between the two approaches. A total of 27 studies (n=8,749 patients) were finally included in the analysis. The success rate of radial approach was slightly lower than that of femoral approach in patients receiving CAG (P=0.004), but similar in patients receiving a further PCI treatment (P=0.11). The risk of major adverse cardiovascular events (MACEs) was similar between two approaches (P=0.27). Radial catheterization had a significantly lower rate of puncture site complications (P<0.00001), but a lower rate of puncture success rate (P=0.02). In patients with acute myocardial infarction (AMI), there was no difference in neither the risk of MACEs nor PCI success rate between two approaches (P=0.23 and 0.45, respectively), but a board line decrease of puncture success rate was observed in radial catheterization group (P=0.04). There were no significant differences in the volumes of contrast media, X-ray exposure time and operation time between the two approaches (all P>0.05). Thus, we concluded that radial approach is a safe method for CAG or PCI compared to traditional femoral approach in Chinese population due to their similar success rate of the procedure and risk of MACEs, and a decreased risk of puncture site complications.

Background: Colorectal carcinoma (CRC) and non-alcoholic fatty liver disease (NAFLD) share common risk factors. Insulin resistance (IR) has an important role in both diseases. It has been speculated that the prevalence of colorectal neoplasms might be increased in patients with NAFLD. However, It is unclear whether NAFLD is an actual risk factor or any association is incidental coexistance due to the role of IR in both disease. We aimed to assess the risk for CRC in patients with NAFLD in relation to IR.

Method: This study was designed prospectively and cross-sectionally. We determined NAFLD by ultrasonography and measured IR by the homeostatic model of assessment-insulin resistance model.

Results: The prevalences of CRC and adenoma were shown to be significantly higher in patients with IR (respectively; P: 0.005, P: 0.008). But prevalence of CRC was found to be significantly lower in subjects with NAFLD (P: 0.001). On multivariate logistic regression analysis, the risks of colorectal adenoma and carcinoma were significantly associated with the presence of IR (respectively; OR: 2.338, 95% CI: 1.080-4.993, P: 0.003 and : 5.023, 95% CI: 1.789-9.789, P: 0.001). The risk for CRC was significantly associated with the absence of NAFLD (OR: 7.380, 95% CI: 3.069-7.961, P: 0.010). The absence of NAFLD in the presence of IR was associated with significantly high risk for CRC (OR: 5.218, 95% CI: 1.538-7.448, P: 0.017).

Conclusion: The risk of CRC can increased in subjects with IR but without NAFLD. The absence of NAFLD in the presence of IR may predict the CRC.

The aim of this study was to explore the influence of combination therapy in different administration time on antihypertensive efficacy and blood pressure variability in patients with essential hypertension. A total of 86 patients with stage II to III essential hypertension were randomly divided into 4 groups: taking indapamide and losartan potassium together in the morning or in the evening 2 to 4 hours before sleep, indapamide in the morning and losartan potassium in the evening, losartan potassium in the morning and indapamide in the evening. Ambulatory blood pressure monitoring was performed before and 12 weeks after the medication. The result showed that statistically significant reductions from baseline of systolic blood pressure/diastolic blood pressure occurred in all treatment groups. There was no significant difference of the reductions or SI among the four groups, neither the rate of decline of BP in the night or the circadian rhythm. In group B, the numbers of rapid rise in BP in the morning hours were significantly less after the medication, while not in the other groups. It is concluded that independent of the administration time, both once-daily treatment and component-based dual therapy had significant antihypertensive effect, but the night taken-together combination resulted in reductions of BP, SI and morning blood pressure peak that may have advantages over the other combinations, without the increased incidence of hypotension at night. Medicines should be taken 2 to 4 hours before sleep.

Objective: To investigate the differential gene expression of cytokines and compare their impacts on the immune functions among the acute myocardial infarction patients (AMI), the stable angina patients (SA) and the controls.

Methods: 20 patients with AMI, 20 patients with SA and 20 healthy volunteers were recruited into the study. Whole human genome microarray analysis was used to detect the gene expression differences in interferons, interleukins, chemokines, tumor necrosis factors and associated receptors in peripheral blood mononuclear cells (PBMCs) among three groups.

Results: Compared with SA patients and the controls respectively, in AMI patients, IFNα2, IFNαR1, IFNαR2, IFNγR1, IFNγR2, L1β, IL16, IL18, Cxcl1, Cxcl2, Cxcl6, CxcR2, CxcR4, LIGHT, TNFR1, LT-βR, CD137, TRAILR, and TWEAKR mRNA expressions were significantly up-regulated (P<0.05), while Ccl5, Ccl24, Ccl28, CcR5, TWEAK, CD40, CD27, and BAFFR mRNA expressions were significantly down-regulated (P<0.05). But, there was no significant difference in cytokine expression between the SA patients and the controls.

Conclusion: In AMI patients, mRNA expression levels of cytokines were imbalanced, indicating the dysfunction of the immune system. Together with no significant change of cytokines was observed between the SA and controls, showing the different cytokine related immune activity in the AMI and SA patients.

Allogenetic transfusion has long been considered to be a relatively safe and extremely effective blood transfusion treatment. However, acute hypervolemic hemodilution (AHH) combined with the remifentanil-induced controlled hypotension (CH) have rarely been examined. Herein, 40 intracranial aneurysm surgery patients were randomly divided into nitroglycerin group (A group, n=20) and remifentanil group (B group, n=20). During intracranial aneurysm surgery, MAP, HR, Hb, and Hct were recorded. SjvO2, PjvO2, SaO2, PaO2 were measured, and CaO2, Da-jvO2, CjvO2, CERO2, VADL were calculated. In addition, The venous blood samples were collected for determining PT, TT, APTT, FBG, VIII, VWF and electrolytes. The results show that HR in nitroglycerin group dramatically accelerated and HR in remifentanil group slowed at 30 minutes after hypotension and 5 minutes after aneurysm occlusion (P<0.01) after hypotension. Compared with A group, the SjvO2 and CjvO2 of B group increased significantly and the Da-jvO2 and CERO2 decreased significantly at T3, T4. In addition, There were no significant differences between after AHH and before AHH in two groups (P>0.05) on TT, PT, APTT, FIB, VIII, VWF, Na(+), Cl(-), K(+), Ca(2+). These results suggest that AHH combined with remifentanil-based CH significantly lowered cerebral metabolic rate of oxygen and had effects on blood coagulation without clinical hemorrhagic signs increased and had important clinical significance for blood conservation.

Objectives: An animal model using beagle dog has been established to investigate the postmortem redistribution of lidocaine.

Materials and methods: 18 dogs were euthanized and injected lidocaine (13 mg/kg) via epidural immediately. An autopsy was performed at 0, 12, 24, 48, 72, 96 hours after drug administration. All animals were stored in supine position at room temperature. For the other groups, lidocaine was given via epidural 6, 12, 24 hours after dogs were euthanized. Followed treatments were as above described. All samples were treated for detection of the concentration of lidocaine.

Results: It was found that lidocaine could diffuse via blood vessel rapidly post administration. And the concentration of lidocaine in the blood from ventriculus sinister increased obviously in a time-dependent manner. Meanwhile, the postmortem tissue distribution of lidocaine was significantly different. However, the process of postmortem redistribution of lidocaine was obviously delayed in dogs which were given drugs after death.

Conclusions: Together results revealed the process of postmortem redistribution of lidocaine via epidural injection, and provided the method to distinguish the lidocaine-induced death and drug administration after death.

Background: Existing literature has shown that patients with coronary artery disease (CAD) can benefit greatly from the strength training; therefore, the strength training should play a more important role in cardiac rehabilitation. However, the medical community may still have conservation to apply the strength training owing to no comprehensive study so far to compare the effectiveness of the strength training to the other trainings, such as aerobic training.

Objective: To evaluate the effect of strength training on motor function in patients with CAD.

Methods: Published articles from the earliest date available to July 2015 were identified using electronic searches. Two reviewers selected independently relevant randomized controlled trials (RCTs) investigating exercise program with strength training versus control interventions (exercise without strength training, including aerobic training and no exercise group) for the treatment of CAD patients. We examined effects of exercise with strength training versus control interventions on peak oxygen uptake (VO2peak), duration of exercise test and muscle strength. Two reviewers extracted data independently.

Results: Twenty seven trials that represented 1151 participants passed the selection criteria and were evaluated for the effects of strength training in CAD patients. For improving VO2peak [SMD (95%CI) = 0.58 (0.11, 1.06)] and muscle strength [upper limb, SMD (95% CI) =0.44 (0.34, 0.55); lower limb, SMD (95% CI) =0.33 (0.16, 0.50)], exercise program with strength training were significantly more effective than one without it. But there is no significantly difference on duration of exercise test [SMD (95%CI) = 0.17 (-0.04, 0.39)] in strength training group than in control group.

Conclusions: We conclude strength training is effective in improving muscle strength and VO2peak, in CAD patients, when compared to patients with control group. Furthermore, our evaluations suggest that strength training does not compromise clinical trial completion or safety.

Objective: To study the role of age plays in the relationship between smoking status and obesity in both Chinese men and women.

Methods: From Chinese Physical and Psychological Database, participants were divided into non-smokers, current smokers, and former smokers. Body mass index (BMI), waist circumference (WC), fat percentage, fat mass, and fat free mass were measured. The mean, standard deviation and frequency of these indicators were calculated for each age bracket. One-way ANOVA and post-hoc test analyses were used to detect the difference among these three groups.

Results: In men, from 19 to 24 years old, BMI, WC and fat free mass of current smokers were higher than that of non-smokers (P<0.01). However, fat mass and fat percentage of current smokers were lower than that of non-smokers but higher than that of former smokers (P<0.01). From 25 to 34 years old, BMI and fat mass of former smokers were higher than non-smokers and current smokers (P<0.01). In addition, WC and fat free mass of non-smokers were lower than that of current smokers and former smokers (P<0.01). From 45 to older, BMI, WC, fat mass, fat free mass and fat percentage of former smokers were higher than that of current smokers (P<0.01). From 55 to older, BMI, WC, fat mass, fat free mass and fat percentage of current smokers were lower than that of non-smokers (P<0.01). In women, smoking status might not be significantly related to obesity (P>0.05).

Conclusion: For young men, smoking might have an effect on increasing fat free mass, BMI and WC, and decreasing fat mass and fat percentage. For middle and older men, smoking might have an effect on decreasing fat free mass, fat mass, BMI, WC, and fat percentage. Obesity risk should be paid more attention in smoking cessation programs for those former smokers.

Context: As many studies proved that sodium iodide symporter (NIS) plays a key role in radioactive iodide (RAI) therapy of thyroid cancer, however, a growing number of studies suggests that part of differentiated thyroid carcinomas (DTC) with overexpression of NIS are insensitive to RAI well.

Objective: The aim of this meta-analysis is to assess the expression of NIS in differentiated thyroid cancer, compared with normal thyroid tissue.

Data sources: PUBMED, Sinomed, CNKI, Wanfang and VIP were searched for relevant case-control studies up to now.

Study selection: Studies that concerning the qualitative expression NIS in DTC were included.

Data extraction: Working independently, authors used a standard form to extract data. For quality assessment, Newcastle-Ottawa Scale (NOS) were applied.

Data synthesis: Totally nine eligible studies included, involving 765 cases and 473 controls. The results revealed that the expression of NIS had a statistically increased in DTC, compared with controls (OddsRadio OR: 1.47, 95% CI: 1.12 to 1.94, Z=2.78, P=0.005). Since the existence of the significant heterogeneity, subgroup analysis and sensitivity analysis were performed and found that the heterogeneity came from the different criteria evaluate positive NIS expression (Liu 2008, Mu 2010) and the small simple size of the control group (Lin. J D2001). The heterogeneity disappeared or dropped to below 50% after remove these studies.

Conclusion: Our study shows that the expression of NIS is significantly increased in DTC, which could help explain the reason for individual with a poor response to RAI therapy. In other word, the reduced iodide uptake in thyroid cancer may not caused by the decreased expression of NIS, function of NIS protein or its post-transcriptional translocation might be the point.