Abstract:Objective To explore the differences of traditional Chinese medicine (TCM) syndromes, clinical symptoms and brain-gut peptide level between middle-aged and elderly patients with young patients with postprandial distress syndrome (PDS). Methods A total of 65 PDS patients admitted to our Acupuncture Department from March to October 2018 were enrolled in this study, and divided into the middle-aged and elderly group (>45 years old) and the young group (≤45 years old). The 2 groups of patients were classified according to TCM syndrome differentiation. The severities of dyspepsia, quality of life, anxiety and depression were evaluated by symptom index of dyspepsia (SID), Nepean dyspepsia index (NDI) and hospital anxiety and depression scale (HADS), respectively. The plasma levels of calcitonin gene-related peptide (CGRP), vasoactive intestinal peptide (VIP), ghrelin and substance P (SP) were measured by enzyme-linked immunosorbent assay (ELISA). The data was analyzed using SPSS statistics 20.0. Depending on the types of data, independent sample t test, Mann-Whitney U test, or Chi-square test was used for comparison between 2 groups. Results There was no significant differences in the compositions of liver-stomach disharmony syndrome, spleen-stomach weakness syndrome and spleen-stomach dampness-heat syndrome between the 2 groups (Chi-square=4.787, P=0.091). The score of epigatric burning symptom was significantly higher in the middle-aged and elderly group than the young group [1(0,1) vs 0(0,1), P<0.05], but no such differences were seen in the other symptoms, and scores of NDI and HADS between them (P>0.05). The plasma level of CGRP was significantly higher in the middle-aged and elderly group than the young group [(1.06±0.24) vs(0.93±0.25)ng/ml, P<0.05], but there was no significant differences in the levels of VIP, SP and ghrelin between the 2 groups (P>0.05). Conclusion The middle-aged and elderly PDS patients experience severe epigastric burning symptom, and have significantly increased[JP+2]plasma CGRP level, which may be associated with ageing-related decreased gastrointestinal motility and delayed gastrointestinal emptying.

Abstract:Objective To analyze the related factors of multiple bacterial infections in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A total of 1622 AECOPD patients admitted in our Department of Respiratory Medicine from June 2014 to December 2018 were enrolled and retrospectively analyzed. According to the results of culture of deep sputum specimens, they were divided into non-multiple bacterial infection group and multiple bacterial infection group. The related factors of multiple bacterial infections were analyzed. SPSS statistics 20.0 was used to process the data. Chi-square test was employed for comparison between groups. Multivariate logistic regression was applied to analyze the independent risk factors for multiple bacterial infections in these AECOPD patients. Results The non-multiple bacterial infection group accounted for 89.89% (1458/1622), while the multiple bacterial infection group for 10.11%(164/1622) of the patients. Compared with the non-multiple bacterial infection group, the another group had larger percentage of those over 70 years old, history of smoking ≥10 years, disease course longer than 5 years, complications, frequency of glucocorticoid use ≥5 times/year, glucocorticoid use time within 3 months ≥7d, number of antibacterial drugs used within 3 months ≥3, number of combined antibiotics within 3 months ≥3, and blood glucose ≥11.1mmol/L (all P<0.05). Multivariate logistic regression model analysis showed that the combination of antibiotics within 3 months ≥3(OR=1.874, 95%CI 1.276-2.751; P=0.001), smoking history ≥10 years(OR=1.525, 95%CI 1.037-2.241; P=0.032), complications(OR=1.899,5%CI 1.276-2.827; P=0.002), glucocorticoid use time within 3 months ≥7d(OR=2.053,5%CI1.375-3.064; P<0.001) and age ≥70 years(OR=2.098,5%CI 1.445-3.045; P<0.001) were independent risk factors for multiple bacterial infections in AECOPD. Conclusion Older age, multiple basic diseases, long-term smoking, blind use of antibiotics and long-term use of glucocorticoids may be the main causes of multiple bacterial infections in AECOPD patients.

Abstract:Objective To investigate the effect of epalrestat on serum level of homocysteine (Hcy) and score of Toronto clinical scoring system (TCSS) in patients with diabetic peripheral neuropathy (DPN). Methods A total of 97 patients with type 2 diabetes mellitus admitted in our Department of Endocrinology and Metabolism from April 2016 to April 2017 were enrolled prospectively, and then randomly divided into epalrestat group (n=33), epalrestat combined with mecobalamin group (n=30) and mecobalamin group (n=34). Mecobalamin tablet (0.5mg/time) and epalrestat tablet (50 mg/time) were given to the corresponding patients orally, 3 times per day, for 3 months. The levels of fasting blood glucose (FBG), 2h postprandial blood glucose (2hPBG), glycosylated hemoglobin A1c (HbA1c) and Hcy, and TCSS score were compared before and after treatment in the 3 groups. SPSS statistics 21.0 was used for data analysis. Analysis of variance or Chi-square test was employed for intergroup comparison based on different data types among the 3 groups, and LSD test was applied for comparison between groups. Results The levels of FBG, 2hPBG and HbA1c were decreased in all the 3 groups after treatment, but without significant differences (P>0.05). There was no statistical difference in the Hcy level and TCSS score in the 3 groups before treatment (P>0.05), but the Hcy level [(11.39±1.39) vs (13.40±2.26)μmol/L, (11.27±2.46) vs (13.51±2.32)μmol/L, (10.13±1.84) vs (14.91±6.78)μmol/L] was decreased in all of them after treatment. The score of TCSS [(7.64±1.87) vs (8.30±2.59); (5.83±1.88) vs (9.13±2.91)] was decreased in the epalrestat and epalrestat combined with mecobalamin group after treatment when compared with before treatment. The treatment of epalrestat combined with mecobalamin resulted in the lowest Hcy level [(10.13±1.84) vs (11.39±1.39) or (11.27±2.46)μmol/L] and TCSS score [(5.83±1.88) vs (7.64±1.87) or (8.59±2.22)] when compared with the treatment of epalrestat or mecobalamin (P<0.05). Conclusion Epalrestat combined with mecobalamin shows obvious effect on DPN patients, and it is worthy of promotion in clinical practice.

Abstract:Objective To explore the effect of risk prediction model of vasovagal reflex syndrome after percutaneous coronary intervention (PCI) and optimized treatment procedure on the incidence and treatment time of the syndrome. Methods The patients undergoing coronary artery intervention in our department from January 1,0 to June 30,8 were enrolled in this study. Among them, 3550 patients received surgical treatment during January 1,0 to June 30,6, and were assigned into conventional group, and 161 [including 108 males, at an age of (57.92±10.42)years] suffered from vasovagal reflex and were given routine treatment. The left 1574 patients who were treated surgically during July 1,6 to June 30,8 were assigned into optimized group, and 13 of them [including 9 males, at an age of (53.01±14.78)years] experienced vasovagal reflex and were treated with optimized treatment procedure. The general information, clinical data, incidence of vasovagal reflex, rescue success rate, rescue time and other clinical data of the patients were collected and compared. SPSS statistics 20.0 was used to perform the statistical analysis. Results There were no statistical differences in age, gender, past medical history and other clinical data between the 2 groups. The incidence of vagal reflex syndrome was significantly lower in the optimized group than the conventional group (0.83% vs 4.54%, P<0.05), and that of severe vagal reflex was more significant (0.13% vs 1.18%, P<0.001). The optimized treatment process obviously shortened the rescue time and improved rescue success rate. What′s more, the optimization also attenuated patients′ anxiety, promoted their satisfaction for the quality of medical care during hospitalization, and shortened the average length of hospital stay [(2.82±1.09) vs (4.56±1.25)d, P<0.05]. Conclusion Our risk prediction model for post-PCI vasovagal reflex syndrome and optimized treatment procedure can reduce the postoperative incidence and shorten the treatment time, and are of certain value in clinical practice.

Abstract:Objective To evaluate the immediate and long-term effectiveness of applying cutting balloon angioplasty combined with drug-coating balloon (DCB) in side branch protection of coronary bifurcation lesions. Methods Sixty patients with coronary bifurcation lesions admitted in the Chinese PLA General Hospital from January 2017 to June 2018 were subjected in this study. They were divided into research group (n=28) and control group (n=32) according to use of DCB or ordinary balloon in the side breach after cutting balloon as pretreatment. Basic clinical data, instant effectiveness of operation, perioperative complications, and occurrences of major adverse cardiac events (MACE), target lesion revascularization (TLR) and late lumen loss (LLL) within 9 months after surgery were compared between the 2 groups. SPSS statistics 24.0 was used to perform the statistical analysis. Student′s t test or Chi-square test was employed for comparison between groups in different data types. Results There were no significant differences in lesion types, radiological parameters, postoperative stenosis and minimal lumen diameters (MLD) of main and side branches between 2 groups (P>0.05). No perioperative complications was observed in both groups. The incidence of MACE within 9 months were significantly lower in the research group than in the control group [3.57%(1/28) vs 25.8%(8/31), P=0.044], but no difference was seen in the rate of TLR between them [3.57%(1/28) vs 9.88%(3/31), P>0.05]. Among the patients who underwent radiological examination in 9 months after surgery, there was no difference in the diameter and LLL of main branch between the 2 groups (P>0.05), but statistical differences were seen in MLD [(2.50±0.48) vs (1.96±0.39)mm, P=0.013] and LLL [(0.04±0.07) vs (0.25±0.36)mm,P=0.024] of side branch. Conclusion DCB-combined cutting balloon angioplasty is effective and safe in side branch protection technique of coronary bifurcation lesions.

Abstract:Objective To investigate the prevalence of chronic diseases in the elderly inpatients in Beijing Friendship Hospital and its changes in recent 10 years. Methods Statistical data from the front page of medical records in 60630 elderly inpatients in our hospital from January 2008 to December 2017 were collected and analyzed for the prevalence of chronic diseases. At the same time, the comorbidity of chronic diseases in the elderly inpatients in recent 5 years was analyzed. Results From 2008 to 2012, the top 5 chronic diseases were hypertension (19.60%), coronary atherosclerotic heart disease (15.90%), malignant tumors (13.20%), diabetes mellitus (10.40%) and abnormal lipid metabolism (9.80%). From 2013 to 2017, the top 5 chronic diseases were hypertension (40.00%), malignant tumors (25.92%), diabetes mellitus (19.16%), coronary atherosclerotic heart disease (17.58%) and cataract (15.70%). During 2013 and 2017, there were different statuses of comorbidity among the elderly patients at different ages. The number of comorbidities was (2.71±1.86) in the 60-69-year-old patients,(4.24±1.54) in the 70-79-year-old patients, and(5.93±2.33) in the 80-89-year-old patients. Conclusion The prevalences of malignant tumors, hypertension and cataract are significantly increased in the elderly inpatients in our hospital. The number of chronic diseases is elevated with age. Geriatricians should diagnose and treat the diseases in the elderly in a comprehensive manner.

Abstract:Objective To investigate the effect of HBV infection on wound healing in elderly patients undergoing hip arthroplasty, and to preliminarily analyze the risk factors for poor wound healing in these patients. Methods A total of 180 patients undergoing hip arthroplasty in our Orthopedic Department from January 2014 to June 2018 were retrospectively analysed in this study. According to whether having preoperative HBV infection or not, they were divided into HBV infection group and non-HBV infection group. All patients underwent femoral head replacement or total hip arthroplasty with anterolateral approach. The general conditions, laboratory indicators, intraoperative and incision conditions were compared between the 2 groups, and the risk factors for poor incision healing in patients with HBV infection were analyzed. SPSS statistics 19.0 was used to analyze the data. Independent sample t test or Chi-square test was used for comparison between groups based on data types. Univariate and multivariate logistic regression analysis were used to analyze the influencing factors of incision in HBV patients. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of albumin and intraoperative bleeding volume for poor incision healing in HBV patients. Results The incision healing rate [20.0%(18/90) vs 8.9%(8/90)] was statistically higher and persistent exudation time [(4.3±1.6) vs (2.5±1.4)d]significantly longer in the HBV infection group than in the non-HBV infection group (P<0.05). Multivariate logistic regression analysis[JP+1]showed that low albumin (OR=0.901,5%CI 0.848-0.957; P<0.001) and large volume of intraoperative bleeding (OR=4.572, 95%CI 1.945-10.746; P=0.010) were the main risk factors for poor incision healing in the HBV patients. ROC curve analysis indicated that the areas under curve (AUC) of albumin and intraoperative bleeding volume in predicting poor incision healing in these patients were 0.815 (95%CI 0.789-0.919, P<0.001) and 0.766 (95%CI 0.682-0.851, P<0.001), respectively, and the best cut-off points were 28.2g/L and 440 ml, respectively. Conclusion Compared with the non-HBV patients, the patients with HBV infection tend to have poor incision healing after hip arthroplasty, which is mainly related to low albumin and larger intraoperative bleeding.

Abstract:Objective To investigate the relationship of the severity of coronary heart disease (CHD) with blood glucose and carotid plaque. Methods From December 2015 to November 2018,8 non-diabetic patients with suspected CHD admitted to our hospital were selected and divided into CHD group (n=170) and non-CHD group (n=98) according to the results of coronary angiography. According to the Gensini score, the CHD patients were divided into mild group (n=53), moderate group (n=72) and severe group (n=45). An analysis was made of the relationship between the severity of coronary heart disease and fasting blood glucose (FPG) and carotid plaque. Statistical analysis was performed using SPSS statistics 20.0. Measurement data were expressed as mean±standard deviation ([AKx-D]±s), and t-test or analysis of variance was used for comparison between groups. Numeration data were expressed as number of cases (%). Inter-group comparison was performed using χ² test. Logistic regression analysis was used to identify risk factors for CHD, and Pearson correlation analysis was performed for relationship of the severity of CHD with blood glucose and carotid plaque in patients. Results The FBG level [(6.41±2.46)mmol/L], the number of plaques (1.86±1.12), the carotid sclerosis level score (2.16±1.32), and the Crouse score (1.92±1.63) in the CHD group were significantly higher than those in the non-CHD group [(5.06±1.21)mmol/L, 0.53±0.61,0.38±0.55,0.66±0.57; P<0.05]. The FPG level [(6.82±1.67)mmol/L], number of plaques (2.93±1.24), carotid sclerosis grade (3.57±1.46) and Crouse score (3.87±2.24) in severe CHD group were significantly higher than those in the moderate [(6.15±1.58)mmol/L, 1.64±1.72,1.82±0.64,2.13±0.85] and mild CHD group [(5.67±1.34)mmol/L, 0.67±0.69,0.73±0.51,0.96±0.62], and the moderate CHD group was significantly higher than the mild CHD group (P<0.05). Regression analysis showed that FPG level, carotid atherosclerosis grading score, Crouse score were risk factors for CHD, and that Gensini scores of CHD were positively correlated with FPG level, carotid atherosclerosis score, and Crouse score. Conclusion The FPG level, plaque number, carotid atherosclerosis score and Crouse score in elderly patients with CHD are significantly higher than in those with suspected CHD. FPG level, carotid atherosclerosis score and Crouse score are independent risk factors for CHD, having a positive correlation with CHD Gensini score and playing an important role in the prediction and assessment of CHD.

Abstract:Objective To compare the efficacy and safety between duloxetine and citalopram in the treatment of chronic heart failure (CHF) with depression and anxiety. Methods A total of 65 patients meeting the inclusion criteria were randomly divided into study group (n=29) and control group (n=28). The study group received conventional anti-heart failure treatment plus duloxetine, and the control group received conventional anti-heart failure treatment plus citalopram for 8 weeks. The two groups were evaluated using patient health questionnaire-9 (PHQ-9) and general anxiety disorder-7 (GAD-7). Patients were monitored for cardiac function, ALT, AST, Cr, BP, HR and other safety indicators before and after treatment. SPSS statistics 24.0 was used for statistical analysis. χ² test or Fisher exact probabilities method was employed for comparison of numeration data and t test or repeated measurement variance analysis for measurement data. Results Intra-group comparison found that the scores of PHQ-9 and GAD-7 at each time point were different after treatment (P<0.01) and tended to decrease with time. Comparison between groups found that the changes of PHQ-9 and GAD-7 at each time point were significantly different after treatment (P<0.05), the decrease of PHQ-9 and GAD-7 at each time point in study group was greater than that in control group. After treatment, there was no significant difference in cardiac function between the two groups (P>0.05). There was no significant difference in safety indicators before and after treatment in each group (P>0.05). Conclusion Duloxetine outperformed citalopram in the treatment of depression and anxiety, and their effect on cardiac function was similar. Duloxetine, with good safety, can be used in CHF patients with depression and anxiety.

Abstract:Objective To determine the clinical efficacy of flupentixol/melitracen tablets (deanxit tablets) on chronic obstructive pulmonary disease(COPD) patients accompanied with depression and anxiety symptoms. Methods A total of 128 COPD patients with symptoms of anxiety and/or depression in our department from January 2018 to January 2019 were recruited in this study. They were divided into the deanxit group and control group. The patients of the control group only received conventional COPD treatment, while those of the treatment group were given oral administration of deanxit in every morning besides conventional treatment for COPD. After 4 weeks, Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD), clinical symptoms and modified British medical research council scale (mMRC) were used to survey their mental and physical conditions before and after treatment. Pulmonary function parameters, such as forced expiratory volume in one second (FEV1), forced vital capacity (FVC), FEV1 as a percentage of predicted value (FEV1% pred), and ratio of FEV1 to FVC (FEV1/FVC) were also measured. The results were compared before and after treatment, and between the 2 groups. SPSS statistics 19.0 was used to perform the statistical analysis. Student′s t test or Chi-square test was employed for comparison between the groups in different data types. Results Among 128 patients, 47 patients had anxiety and depression, 57 patients had anxiety alone and 24 patients had depression alone. Compared with the control group, the deanxit group had significantly lower HAMA score [(6.1±1.3) vs (10.7±1.9)], HAMD score [(7.6±1.7) vs (9.7±2.0)], clinical symptoms score [(3.2±1.3) vs (6.0±1.7)] and mMRC score [(1.1±0.7) vs (1.9±0.4)], but obviously higher FEV1/FVC [(78.3±3.9)% vs (67.9±4.4)%] (all P<0.05). Conclusion Deanxit effectively relieves anxiety and depression symptoms and improves the quality of life in the COPD patients.

Abstract:Objective To investigate the effects and mechanism of polydatin on the lipopolysaccharide-induced mitochondrial injury in alveolar epithelial cells. Methods A549 cells were assigned to four groups. Cells in the control group were treated with 0.1% DMSO for 7h only; those in model group received the pretreatment of 0.1% DMSO for 1 h and were incubated with LPS (5mg/L) for 6h; those in the treatment group received the pretreatment of polydatin (50μmol/L) for 1 h and were incubated with LPS (5mg/L) for 6h; and those in the inhibitor group received the pretreatment of polydatin (50μmol/L) and silent information regulator 2 related enzyme 3(SIRT3) inhibitor 3-TYP (50μmol/L) for 1h, and were incubated with LPS (5mg/l) for 6h. The cells were then assessed for viability by CCK-8, ATP level by fluorescein-luciferase kits, status of mitochondrial permeability transition pore (mPTP) by Calcein-AM-CoCl₂ probe, reactive oxygen species (ROS) level by DCFH-DA fluorescent probe, mitochondrial membrane potential (MMP) by fluorescent probe JC-1, and expression of SIRT3 by Western blotting. SPSS statistics 22.0 was used for data analysis. One-way ANOVA, LSD test or Tamhane′s T2 test was used for comparison among groups. Results Compared with control group, SIRT3 expression in model group decreased to (73.3±4.5)%, JC-1 red/green to (54.0±6.5)%, Calcein fluorescence to (2035±217)U, ATP level to (72.2±4.8)% and cell viability of cells to (73.7±3.7)%, but ROS level increased to (218.0%±21.7)%. Compared with model group, SIRT3 expression in treatment group increased to (86.7±7.6)%, JC-1 red/green [JP+1]to (75.8±7.6)%, Calcein fluorescence to (2571±199)U, ATP level to (86.7±6.3)% and cell viability of cells (83.0±3.6)%, but ROS level decreased to (180.0±18.1)%. Compared with treatment group, SIRT3 expression in inhibitor group decreased to (69.0±7.8)%, JC-1 red/green to (62.8±6.2)%, Calcein fluorescence to (2116±254)U, ATP level to (72.8±5.8)% and cell viability of cells (73.3±4.1)%, but the ROS level increased to (212.0±18.2)%. Conclusion Polydatin alleviates LPS-induced mitochondrial injury in alveolar epithelial cells possibly by the activation of SIRT3.

Abstract:Cardiovascular diseases are major complications of type 2 diabetes, accounting for approximately two-thirds of deaths from type 2 diabetes. The research progression of diabetic heart disease in patients with type 2 diabetes is accelerated by a wide array of pathophysiological processes such as abnormal blood glucose, dyslipidemia, insulin resistance, chronic low-grade inflammation, oxidative stress, endothelial dysfunction, vascular calcification and hypercoagulability. Diabetic cardiomyopathy is one of the most common diabetic heart diseases that can lead to cardiac dysfunction and eventually to heart failure, arrhythmia, and even sudden death. This article reviews the pathogenesis of diabetic cardiomyopathy and available and potential treatment options.

Abstract:Myocardial fibrosis (MF) refers to the reduction of normal myocardial cells in myocardium, proliferation of cardiac fibroblasts (CFs) increased proportion of collagen protein type Ⅰ and type Ⅲ, disordered arrangement, and excessive production and deposition of extracellular matrix (ECM). MF, the major pathological manifestation of cardiac remodeling, mainly causes the decrease of myocardial diastolic and systolic force. It is the end-stage manifestation of many cardiac conditions, such as hypertension, coronary heart disease, and arrhythmia. This paper reviews the research progress on the mechanism of MF to provide theoretical basis for finding effective targets and developing corresponding drugs.

Abstract:Globally, hypertension is the biggest risk factor for the occurrences of cardiovascular diseases, and its harm to human health is mainly through target organ damage. The common pothological basis for hypertension, which causes damage to target organs such as heart, brain, and kidney, and their terminal complications, is arterial stiffness, atherosclerosis, stenosis, and occlusion. Pulse wave velocity is one of the important parameters to evaluate arterial stiffness, and it is also one of the indicators for subclinical target organ damage. This review aims to explore the clinical value of pulse wave velocity in hypertensive target organ damage.

Abstract:With the prolongation of the survival time in cancer patients, the incidence of cardiovascular adverse events caused by antineoplastic drugs is increased significantly. Early identification of cardiotoxicity of these drugs is of great significance to improve the quality of life and prognosis. Therefore, this paper reviews the research progress on the manifestations, mechanism, risk assessment, monitoring and prevention of cardiotoxicity of commonly used antineoplastic drugs in clinical practice, with a view to early detection and prevention.

Abstract:Herpes zoster is an acute skin infection caused by the reactivated latent varicella-zoster virus in the dorsal root ganglia of the spinal cord. Recent years have witnessed an increasing incidences of herpes zoster, and neuralgia is one of its main symptoms with post-herpetic neuralgia (PHN) being the most common and difficult complication to control. Until now, no universally accepted definition of PHN has been made, its pathogenesis remains unknown, and its treatment is limited, which exerts serious effects on patients′ quality of life. This article reviews PHN in the respects of its definition, pathogenesis, risk factors and treatment to facilitate its timely prevention and treatment.

Abstract:Constrictive pericarditis, chronic pericardial inflammation caused by a variety of causes, is characterized by pericardial inelasticity, cardiac relaxation, and systemic blood circulation disorder. Some patients have occult onset and lack typical clinical manifestations. Clinicians need detailed echocardiography, CT, MRI, and right cardiac catheterization to identify characteristic imaging features. Surgical pericardiectomy serves as an effective treatment. The misdiagnosis and missed diagnosis rate of this disease is high. This article reviews the status and progress in its diagnosis and treatment.