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Yin YH, Sang LX, Chang B. Potential therapeutic targets for nonalcoholic fatty liver disease: Glucagon-like peptide 1. World J Gastroenterol 2023; 29:6235-6238. [PMID: 38186863 PMCID: PMC10768396 DOI: 10.3748/wjg.v29.i48.6235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/08/2023] [Accepted: 12/06/2023] [Indexed: 12/27/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is the most rapidly growing contributor to liver mortality and morbidity. Hepatocellular injury in nonalcoholic steatohepatitis (NASH) is caused by an increase in metabolic substrates (glucose, fructose, and fatty acids), leading fatty acids to participate in pathways that cause cellular injury and a poor response to injury. The pathogenesis of this disease is largely associated with obesity, type 2 diabetes, and increasing age. To date, there are no Food and Drug Administration-approved treatments for NAFLD/NASH or its associated fibrosis. Since one of the pathogenic drivers of NASH is insulin re-sistance, therapies approved for the treatment of type 2 diabetes are being evaluated in patients with NASH. Currently, the glucagon-like peptide-1 receptor agonist (GLP-1RA) semaglutide is a safe, well-studied therapeutic for NAFLD/ NASH patients. Existing research demonstrates that semaglutide can increase the resolution of NASH but not improve fibrosis. However, improving the fibrosis of NAFLD is the only way to improve the long-term prognosis of NAFLD. Given the complex pathophysiology of NASH, combining therapies with complementary mechanisms may be beneficial. Researchers have conducted trials of semaglutide in combination with antifibrotic drugs. However, the results have not fully met expectations, and it cannot be ruled out that the reason is the short trial time. We should continue to pay increasing attention to GLP-1RAs.
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Affiliation(s)
- Yue-Hua Yin
- Department of Gastroenterology, The First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Li-Xuan Sang
- Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang 110022, Liaoning Province, China
| | - Bing Chang
- Department of Gastroenterology, The First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
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Cai SY, Gu X, Liu PJ, Li RS, Jiang JJ, Zhao SP, Yao W, Jiang YN, Yin YH, Yu B, Yuan ZY, Wang JA. [Efficacy and safety of various doses of hybutimibe monotherapy or in combination with atorvastatin for primary hypercholesterolemia: a multicenter, randomized, double-blind, double-dummy, parallel-controlled phase Ⅲ clinical trial]. Zhonghua Xin Xue Guan Bing Za Zhi 2023; 51:180-187. [PMID: 36789598 DOI: 10.3760/cma.j.cn112148-20230105-00009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Objective: To evaluate the efficacy and safety of hybutimibe monotherapy or in combination with atorvastatin in the treatment of primary hypercholesterolemia. Methods: This was a multicenter, randomized, double-blind, double-dummy, parallel-controlled phase Ⅲ clinical trial of patients with untreated primary hypercholesterolemia from 41 centers in China between August 2015 and April 2019. Patients were randomly assigned, at a ratio of 1∶1∶1∶1∶1∶1, to the atorvastatin 10 mg group (group A), hybutimibe 20 mg group (group B), hybutimibe 20 mg plus atorvastatin 10 mg group (group C), hybutimibe 10 mg group (group D), hybutimibe 10 mg plus atorvastatin 10 mg group (group E), and placebo group (group F). After a dietary run-in period for at least 4 weeks, all patients were administered orally once a day according to their groups. The treatment period was 12 weeks after the first dose of the study drug, and efficacy and safety were evaluated at weeks 2, 4, 8, and 12. After the treatment period, patients voluntarily entered the long-term safety evaluation period and continued the assigned treatment (those in group F were randomly assigned to group B or D), with 40 weeks' observation. The primary endpoint was the percent change in low density lipoprotein cholesterol (LDL-C) from baseline at week 12. Secondary endpoints included the percent changes in high density lipoprotein cholesterol (HDL-C), triglyceride (TG), apolipoprotein B (Apo B) at week 12 and changes of the four above-mentioned lipid indicators at weeks 18, 24, 38, and 52. Safety was evaluated during the whole treatment period. Results: Totally, 727 patients were included in the treatment period with a mean age of (55.0±9.3) years old, including 253 males. No statistical differences were observed among the groups in demographics, comorbidities, and baseline blood lipid levels. At week 12, the percent changes in LDL-C were significantly different among groups A to F (all P<0.01). Compared to atorvastatin alone, hybutimibe combined with atorvastatin could further improve LDL-C, TG, and Apo B (all P<0.05). Furthermore, there was no significant difference in percent changes in LDL-C at week 12 between group C and group E (P=0.991 7). During the long-term evaluation period, there were intergroup statistical differences in changes of LDL-C, TG and Apo B at 18, 24, 38, and 52 weeks from baseline among the statins group (group A), hybutimibe group (groups B, D, and F), and combination group (groups C and E) (all P<0.01), with the best effect observed in the combination group. The incidence of adverse events was 64.2% in the statins group, 61.7% in the hybutimibe group, and 71.0% in the combination group during the long-term evaluation period. No treatment-related serious adverse events or adverse events leading to death occurred during the 52-week study period. Conclusions: Hybutimibe combined with atorvastatin showed confirmatory efficacy in patients with untreated primary hypercholesterolemia, which could further enhance the efficacy on the basis of atorvastatin monotherapy, with a good overall safety profile.
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Affiliation(s)
- S Y Cai
- Department of Cardiology, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - X Gu
- Department of Cardiology, Subei People's Hospital of Jiangsu Province, Yangzhou 225001, China
| | - P J Liu
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang 212001, China
| | - R S Li
- Department of Cardiology, Liuzhou People's Hospital, Liuzhou 545026, China
| | - J J Jiang
- Department of Cardiology, Taizhou Hospital of Zhejiang Province, Taizhou 317000, China
| | - S P Zhao
- Department of Cardiology, the Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - W Yao
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Y N Jiang
- Department of Cardiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Y H Yin
- Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - B Yu
- Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Z Y Yuan
- Department of Cardiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - J A Wang
- Department of Cardiology, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
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Kwok CYT, Poon YKP, Chook P, Guo DS, Lin CQ, Yin YH, Celermajer DS, Woo KS. A Potential Strategy for Atherosclerosis Prevention in Modernizing China - Hyperhomocysteinemia, MTHFR C677T Polymorphism and Air Pollution (PM2.5) on Atherogenesis in Chinese Adults. J Nutr Health Aging 2023; 27:134-141. [PMID: 36806868 DOI: 10.1007/s12603-023-1889-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Atherosclerosis is one of the most important global health hazards and air pollution (AP, PM2.5) has been implicated. In addition to traditional risk factors hyperhomocysteinemia (HC) has been recognized in many parts of China related to risk of stroke. METHODS To evaluate the impact of HC (homocysteine >14μmol/l) and PM2.5 air pollution on atherogenesis in modernizing China, we studied 756 asymptomatic Chinese in China from 1998-2007. PM2.5 exposure, HC, folate, and methylenetetrahydrofolate reductase (MTHFR) C/T genotype were evaluated. Brachial flow-mediated dilation (FMD) and carotid intima-media thickness (IMT) were measured by ultrasound. Locations were categorized as zones 1, 2 and 3, with increasing PM2.5 exposure. RESULTS HC was higher (19.4±13.1 and 27.1±25.1μmol/l) in high PM2.5-polluted zones 2 and 3 than in zone 1 (9.7±4.5μmol/l, p<0.0015). The top HC tertile was characterized by lower folate and vitamin B12, but a higher proportion of the MTHFR TT genotype, Metabolic Syndrome (MS) and PM2.5 level (p=0.0018). FMD was significantly lower (7.3±2.3%) and carotid IMT thicker (0.63±0.12mm) in the top HC tertile, compared with low HC tertile (8.4±2.5%, p<0.0001; 0.57±0.1mm, p<0.0001 respectively). Similar differences in FMD and IMT were seen in zones 2 and 3, compared with zone 1 (p<0.0001). On multivariate regression, HC was related to male gender (beta=0.106, p=0.021), MTHFR-TT (beta=0.935, p<0.0001), locations (beta=0.230, p<0.0001) and folate-MTHFR interaction (beta=-0.566, p<0.0001). FMD was related to age (beta= -0.221; p<0.0001), male gender (beta= -0.194, p=0.001) PM2.5 and location (beta=-0.285 to -0.303, p<0.0001). Carotid IMT was related to PM2.5 (beta=0.173, p<0.0001), HC (0.122, p=0.006) but not to MTHFR or location, independent of age, gender, MS, and LDL-C. No significant HC-PM2.5 interaction effect on FMD and IMT was observed. CONCLUSION HC and PM2.5 pollution but not MTHFR genotype were both related to carotid IMT, independent of other traditional risk factors. This has potential implications in dietary and AP strategies for atherosclerosis prevention in China.
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Affiliation(s)
- C Y T Kwok
- Prof KS Woo, Department of Medicine and Therapeutics, Tsang Shiu Tim Building, United College, The Chinese University of Hong Kong, Shatin NT, Hong Kong, Phone: (852) 2647 4966, Fax: (852) 2647 4966, E-mail:
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Pan LL, Gao LL, Yang L, Pan CX, Yin YH, Zhu Y, Zhang J. [Effect of EIT-guided individualized PEEP setting on the incidence of hypoxemia in elderly patients undergoing robot-assisted radical prostatectomy]. Zhonghua Yi Xue Za Zhi 2022; 102:3727-3733. [PMID: 36517421 DOI: 10.3760/cma.j.cn112137-20220415-00818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Objective: To investigate the effect of individualized positive end expiratory pressure (PEEP) setting guided by chest electrical impedance tomography (EIT) on the incidence of hypoxemia in elderly patients undergoing robot-assisted radical prostatectomy in the post anesthesia care unit (PACU). Methods: From September 2020 to October 2021, sixty elderly patients, with the American Association of Anesthesiologists (ASA) of Grade Ⅰ to Ⅲ, who underwent selective robot-assisted radical prostatectomy under general anesthesia in the Cancer Hospital Affiliated to Fudan University were selected. The participants were divided into two groups by the minimum randomized grouping method: EIT-PEEP group (EP group, n=30) and fixed PEEP group (FP group, n=30). After completion of tracheal intubation and establishment of pneumoperitoneum flexion posture, the individualized PEEP setting was guided by EIT in EP group, and the PEEP setting in FP group was 5 cmH2O (1 cmH2O=0.098 kPa) to the end of operation. During the operation, the ventilation mode of pressure regulation volume control was adopted. The driving pressure, dynamic lung compliance (Cdyn), oxygenation index and hemodynamics were recorded at 5 min (T1), 30 min (T2), 60 min (T3) after PEEP setting and at the time of tracheal catheter removal (T4) in both groups. The primary end point was the incidence of hypoxemia in PACU after extubation. Results: The incidence of hypoxemia after extubation was 3.3% (1/30) in EP group and 26.7% (8/30) in FP group (P=0.030). The difference of driving pressure between the two groups at T2 [(13.1±2.4) cmH2O vs (14.9±2.9) cmH2O, P=0.012], T3 [(12.7±2.4) cmH2O vs (15.6±2.8) cmH2O, P<0.001] was statistically significant. In EP group, Cdyn was improved at T2 [(38.4±7.2) ml/cmH2O vs (31.9±5.2) ml/cmH2O, P=0.006] and T3 [(37.5±9.0) ml/cmH2O vs (30.4±5.9) ml/cmH2O, P=0.001]. In EP group, PaO2/FiO2 increased at T1 [(465.7±84.5) mmHg vs (383.5±58.0) mmHg, 1 mmHg=0.133 kPa, P<0.001], T2 [(504.7±105.8) mmHg vs (418.9±73.7) mmHg, P=0.001], T3 [(520.7±92.2) mmHg vs (423.2±90.7) mmHg, P<0.001], T4 [(368.7±42.0) mmHg vs (339.5±54.9) mmHg, P=0.024]. Conclusion: The individualized PEEP setting guided by EIT can reduce the incidence of hypoxemia in elderly patients undergoing robot assisted radical prostatectomy in PACU.
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Affiliation(s)
- L L Pan
- Department of Anesthesiology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - L L Gao
- Department of Anesthesiology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - L Yang
- Department of Anesthesiology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - C X Pan
- Department of Anesthesiology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Y H Yin
- Department of Anesthesiology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Y Zhu
- Department of Anesthesiology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - J Zhang
- Department of Anesthesiology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
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Woo KS, Chook P, Hu YJ, Lao XQ, Lin CQ, Lee P, Kwok C, Wei AN, Guo DS, Yin YH, Lau K, Leung KS, Leung Y, Celermajer DS. The impact of particulate matter air pollution (PM2.5) on atherosclerosis in modernizing China: a report from the CATHAY study. Int J Epidemiol 2021; 50:578-588. [PMID: 33349857 DOI: 10.1093/ije/dyaa235] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2020] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Air pollution has been associated with an increase in cardiovascular diseases incidence. To evaluate whether air pollution can accelerate atherogenic processes, we assessed the effects of air pollution on important surrogate markers of atherosclerosis [brachial flow-mediated dilation (FMD) and carotid intima-media thickness (IMT)]. METHODS A total of 1656 Han Chinese (mean age 46.0 + 11.2 years; male 47%) in Hong Kong, Macau, Pun Yu, Yu County and the 3-Gorges Territories (Yangtze River) were studied between 1996 and 2007 [Chinese Atherosclerosis in the Aged and Young Project (the CATHAY Study)]. Cardiovascular risk profiles were evaluated. Particulate matter with an aerodynamic diameter <2.5 µm (PM2.5) parameters were computed from satellite sensors. Brachial FMD and carotid IMT were measured by ultrasound. RESULTS Health parameters [age, gender, body mass index, waist : hip ratio (WHR) and glucose)] were similar in lowest and highest PM2.5 exposure tertiles, systolic and diastolic blood pressures and triglycerides were higher (P < 0.001) and low-density cholesterol (LDL-C) was lower in the top PM2.5 tertile (P < 0.001). Brachial FMD [7.84 ± 1.77, 95% confidence interval (CI) 7.59-8.10%, vs 8.50 ± 2.52, 95% CI 8.23-8.77%, P < 0.0001) was significantly lower and carotid IMT (0.68 ± 0.13 mm, 95% CI 0.67-0.69 mm vs 0.63 mm ± 0.15 mm 95% CI 0.62-0.64 mm; P < 0.0001) was significantly thicker in the top PM2.5 tertile compared with the lowest tertile. On multiple regression, FMD was inversely related to PM2.5 (beta = 0.134, P = 0.015) independent of gender, age and blood pressure (model R2 = 0.156, F-value = 7.6, P < 0.0001). Carotid IMT was significantly correlated with PM2.5 exposure (beta = 0.381, P < 0.0001) independent of age, location, gender, WHR, blood pressure and LDL-C (model R2 = 0.408, F-value = 51.4, P-value <0.0001). CONCLUSIONS Air pollution is strongly associated with markers of early atherosclerosis, suggesting a potential target for preventive intervention.
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Affiliation(s)
- K S Woo
- Institute of Future Cities, The Chinese University of Hong Kong, Hong Kong SAR.,Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR
| | - P Chook
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR.,Institute of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Y J Hu
- Nineth Peoples' Hospital of Chongqing, China
| | - X Q Lao
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR
| | - C Q Lin
- Department of Civil and Environment and Engineering, Hong Kong University of Science and Technology, Hong Kong SAR
| | - Pwa Lee
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR
| | - Cyt Kwok
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR
| | - A N Wei
- Xuefu Hospital of Chongqing, Second Hospital of Chongqing Medical University, China
| | - D S Guo
- Department of Medicine, Yu County Provincial Hospital, China
| | - Y H Yin
- Second Hospital of Chongqing Medical University, China
| | - Kha Lau
- Department of Civil and Environment and Engineering, Hong Kong University of Science and Technology, Hong Kong SAR
| | - K S Leung
- Institute of Future Cities, The Chinese University of Hong Kong, Hong Kong SAR.,Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Hong Kong SAR
| | - Y Leung
- Institute of Future Cities, The Chinese University of Hong Kong, Hong Kong SAR.,Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Hong Kong SAR
| | - D S Celermajer
- Faculty of Medical and Health Science, The University of Sydney, Sydney, Australia
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Cai YW, Xiong QS, Yin YH, Ling ZY. [Research advances in high-power and short-duration radiofrequency ablation for atrial fibrillation]. Zhonghua Xin Xue Guan Bing Za Zhi 2021; 49:628-631. [PMID: 34126733 DOI: 10.3760/cma.j.cn112148-20210312-00219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Y W Cai
- Department of Cardiology, Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Q S Xiong
- Department of Cardiology, Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Y H Yin
- Department of Cardiology, Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Z Y Ling
- Department of Cardiology, Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
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Xu YJ, Sun X, Jiang H, Yin YH, Weng ML, Sun ZR, Chen WK, Miao CH. Randomized clinical trial of continuous transversus abdominis plane block, epidural or patient-controlled analgesia for patients undergoing laparoscopic colorectal cancer surgery. Br J Surg 2020; 107:e133-e141. [DOI: 10.1002/bjs.11403] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 09/21/2019] [Accepted: 09/25/2019] [Indexed: 11/06/2022]
Abstract
Abstract
Background
The optimal analgesia regimen after laparoscopic colorectal cancer surgery is unclear. The aim of the study was to characterize the beneficial effects of continuous transversus abdominis plane (TAP) blocks initiated before operation on outcomes following laparoscopic colorectal cancer surgery.
Methods
Patients undergoing surgery for colorectal cancer were divided randomly into three groups: combined general–TAP anaesthesia (TAP group), combined general–thoracic epidural anaesthesia (TEA group) and standard general anaesthesia (GA group). The primary endpoint was duration of hospital stay. Secondary endpoints included gastrointestinal motility, pain scores and plasma levels of cytokines.
Results
In total, 180 patients were randomized and 165 completed the trial. The intention-to-treat analysis showed that duration of hospital stay was significantly longer in the TEA group than in the TAP and GA groups (median 4·1 (95 per cent c.i. 3·8 to 4·3) versus 3·1 (3·0 to 3·3) and versus 3·3 (3·2 to 3·6) days respectively; both P < 0·001). Time to first flatus was earlier in the TAP group (P < 0·001). Visual analogue scale (VAS) scores during coughing were lower in the TAP and TEA groups than the GA group (P < 0·001). Raised plasma levels of vascular endothelial growth factor C, interleukin 6, adrenaline and cortisol were attenuated significantly by continuous TAP block.
Conclusion
Continuous TAP analgesia not only improved gastrointestinal motility but also shortened duration of hospital stay. A decreased opioid requirement and attenuating surgical stress response may be potential mechanisms. Registration number: ChiCTR-TRC-1800015535 (http://www.chictr.org.cn).
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Affiliation(s)
- Y J Xu
- Department of Anaesthesiology, Fudan University Shanghai Cancer Centre, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - X Sun
- Department of Anaesthesiology, Fudan University Shanghai Cancer Centre, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - H Jiang
- Department of Anaesthesiology, Fudan University Shanghai Cancer Centre, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Y H Yin
- Department of Anaesthesiology, Fudan University Shanghai Cancer Centre, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - M L Weng
- Department of Anaesthesiology, Fudan University Shanghai Cancer Centre, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Z R Sun
- Department of Anaesthesiology, Fudan University Shanghai Cancer Centre, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - W K Chen
- Department of Anaesthesiology, Fudan University Shanghai Cancer Centre, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - C H Miao
- Department of Anaesthesiology, Fudan University Shanghai Cancer Centre, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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Tian Y, Zhou S, Yin YH, Zheng YX, Wang RP, Liu XQ, Liu ZQ, Liu QF, Liu W, Pang J, Jiang Z, Tian LH, Huang J, Yang L. [Value of two left atrium and pulmonary vein stereoscopic imaging reconstruction methods on guiding radiofrequency ablation for atrial fibrillation]. Zhonghua Xin Xue Guan Bing Za Zhi 2017; 45:930-934. [PMID: 29166718 DOI: 10.3760/cma.j.issn.0253-3758.2017.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To compare the value of two 3D imaging reconstruction methods for left atria and pulmonary vein on guiding the catheter ablation for atrial fibrillation (AF). Methods: From January 2014 to January 2017, a total of 100 drug refractory paroxysmal AF patients were divided into left atria direct angiography group (n=50), and indirect angiography group (n=50). 3D CARTO system was applied for mapping and guiding the ablation procedure. Patients assigned to direct angiography group were treated as follows: intraoperative puncture of atrial septum, inject contrast agent directly into the left atrium, conduct left atrial and pulmonary venous rotation angiography, reconstruct three-dimensional image, integrate the image into real-time X-ray system to facilitate circumferential pulmonary vein isolation. Patients assigned into the indirect angiography group were treated as follows: inject contrast agent through the right ventricle, conduct delayed rotation angiography of the left atria and pulmonary vein to guide circumferential pulmonary vein fixation and ablation. The left atrial and pulmonary venous image acquisition, the operation and X-ray exposure time, the success rate and the incidence of complication of the two groups were compared. The patients were followed up for 3-6 months. Results: General clinical characteristics of the two groups were similar(all P>0.05). Ablation was successful in all 100 patients. The operation time[(112.0±21.4)min vs. (134.0±24.3)min]and X-ray exposure time((10.7±4.7)min vs. (15.8±5.2)min)were significantly lower in direct angiography group than in indirect angiography group (both P<0.01). There was no significant difference between the two groups in the immediate (86%(43/50) vs. 82%(41/50), P=0.59) and short-term (76%(38/50) vs. 72%(36/50), P=0.65) success rate and complication rate (1 aneurysm in the direct angiography group, 1 pericardial tamponade in the indirect angiography group). In-hospital mortality was zero percent. Conclusion: It is safe and effective method to guide the radiofrequency catheter ablation of paroxysmal atrial fibrillation by reconstruction 3D image of left atrium and pulmonary vein. Compared with indirect angiography group, direct angiography group can improve the imaging quality of left atrium and pulmonary vein, decrease the X-ray exposure time of the ablation procedure.
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Affiliation(s)
- Y Tian
- Department of Cardiology , Guizhou Provincial People's Hospital, People's Hospital of Guizhou Medical University, Guiyang 550002, China
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Wang Y, Wu Z, Yin YH, Rao SQ, Liu B, Huang XQ, Liu XX, Li WH, Ye SL, Li SY, Yu XC, Wu DR, Xu J, Wang ZK, Zhang R, Li CQ. Blood service in the Tibetan regions of Garzê and Aba, China: a longitudinal survey. Transfus Med 2017; 27:408-412. [PMID: 28944508 DOI: 10.1111/tme.12468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 08/02/2017] [Accepted: 08/16/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Garzê and Aba form the second largest Tibetan-inhabited area of China. Blood services have never been reported for this region before. OBJECTIVE To assess the current situation and analyse whether a safe and adequate blood supply has been developed in both Garzê and Aba. METHODS We conducted a longitudinal survey covering the period 2011-2016. The subjects of interest were recruited from non-remunerated voluntary donation, blood testing, clinical transfusion practices and infrastructure of local blood service systems. RESULTS The donation rate and blood collection volume were below the average levels of both the Sichuan Province and mainland China. Component therapy was widely used, but inappropriate usage of whole blood existed. A lack of national specific standards for people on the plateaus led to local blood transfusions being conducted without full clinical assessment. Endemic and frequently occurring disease, such as hydatid disease and gastrointestinal disease, were inevitable risks for blood utilisation and safety. The potential influence of religious belief and traditions, like 'male-leaving marriages', of Tibetans on donor recruitment and blood safety requires further research. CONCLUSIONS A relatively safe and complete blood service system has been developed in this region. However, there is still an urgent need for comprehensive and effective support from the government in terms of policies and finance. As an epidemic area of hydatid disease and sexually transmitted disease, this region needs to emphasise public health measures, such as blood safety and inappropriate usage of blood products.
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Affiliation(s)
- Y Wang
- The Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
| | - Z Wu
- Department of Obstetrics and Gynecology, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, Chengdu, China
| | - Y H Yin
- The Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
| | - S Q Rao
- Department of Clinical laboratory, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, Chengdu, China
| | - B Liu
- The Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
| | - X Q Huang
- The Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
| | - X X Liu
- The Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
| | - W H Li
- The Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
| | - S L Ye
- The Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
| | - S Y Li
- Department of Transfusion, People's Hospital of Garzê, Sichuan, China
| | - X C Yu
- Department of Transfusion, People's Hospital of Aba, Sichuan, China
| | - D R Wu
- Blood Center of Aba, Sichuan, China
| | - J Xu
- Blood Center of Garzê, Sichuan, China
| | - Z K Wang
- The Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
| | - R Zhang
- The Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
| | - C Q Li
- The Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
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Tang RB, Wang ZL, Yin YH, Zhang ZH, Li ZQ, Cao J, Cao KJ, Yang YZ, Jiang H, Yang PZ, He B, Liu X, Sun YX, Ma CS. [A multicenter prospective controlled study of catheter ablation for patients with persistent atrial fibrillation using domestic 3D cardiac electrophysiological mapping system]. Zhonghua Xin Xue Guan Bing Za Zhi 2016; 44:401-5. [PMID: 27220574 DOI: 10.3760/cma.j.issn.0253-3758.2016.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To verify the safety and efficacy of the domestic 3D cardiac electrophysiological mapping system for catheter ablation of persistent atrial fibrillation (AF). METHODS From December 2011 to April 2014, 255 patients (184 male) with persistent AF in 13 centers were enrolled in this multicenter prospective controlled study.The patients were allocated to catheter ablation group (experiment group) and antiarrhythmics drugs cardioversion group (control group) with the ratio 2∶1 according to the patients' intention. Left atria were constructed with 3D cardiac electrophysiology mapping system, magnetic sensored saline irrigated radiofrequency ablation catheter (FireMagic™ Cool 3D) and surface reference (Columbus™). Pulmonary vein isolation and left atrial roof line, mitral annulus isthmus line, three tricuspid annulus isthmus line, superior vena cava, the coronary sinus and complex atrial fragmented potentials were targeted if necessary under the guidance of the 3D mapping system. Antiarrhythmics drugs (except amiodarone) were applied to patients for 2 to 3 months after ablation. The patients were followed up for 9 months after 3 months blanking period. The patients in the control group underwent cardioversion with amiodarone and electrical cardioversion if needed. Patients in the control group were also followed up for 9 months. RESULTS Of the 255 patients, 167 cases were in the experiment group and 88 cases were in the control group. In per protocol set (PPS), 155 cases were in the experiment group, 79 cases in the control group. Catheter ablation was successful for all patients in the experiment group under the guidance of the 3D cardiac electrophysiological mapping system. Pumononary veins isolation was achieved in all patients. After 9 months follow-up beyond blanking period, in full analysis set, the success rate was 66.5% (111/167) in the experiment group, which was significantly higher than that in the control group (21.6% (19/88), P<0.001). In PPS, the success rate was also significantly higher in the experiment group than in the control group (67.1% (104/155) vs. 22.8%(18/79), P<0.001). The incidence of adverse events was 19.8% in the experiment group and 13.6% in the control group(P=0.223). The adverse events associated with catheter ablation included 1 case of left subclavian hematoma, 1 case of left subclavian bleeding and 1 case of pericardial effusion, which was alleviated by pericardiocentesis. No pulmonary vein stenosis occurred. CONCLUSION Domestic 3D cardiac electrophysiological mapping system can safely and effectively guide catheter ablation of persistent AF.
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Affiliation(s)
- R B Tang
- Center for Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
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Zhang Y, Ling ZY, Deng SB, Du HA, Yin YH, Yuan J, She Q, Chen YQ. Associations between CD36 gene polymorphisms and susceptibility to coronary artery heart disease. ACTA ACUST UNITED AC 2014; 47:895-903. [PMID: 25118627 PMCID: PMC4181225 DOI: 10.1590/1414-431x20143825] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 05/22/2014] [Indexed: 02/01/2023]
Abstract
Associations between polymorphisms of the CD36 gene and susceptibility to coronary artery heart disease (CHD) are not clear. We assessed allele frequencies and genotype distributions of CD36 gene polymorphisms in 112 CHD patients and 129 control patients using semi-quantitative polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) analysis. Additionally, we detected CD36 mRNA expression by real-time quantitative PCR, and we quantified plasma levels of oxidized low-density lipoprotein (ox-LDL) using an enzyme-linked immunosorbent assay (ELISA). There were no significant differences between the two groups (P>0.05) in allele frequencies of rs1761667 or in genotype distribution and allele frequencies of rs3173798. The genotype distribution of rs1761667 significantly differed between CHD patients and controls (P=0.034), with a significantly higher frequency of the AG genotype in the CHD group compared to the control group (P=0.011). The plasma levels of ox-LDL in patients with the AG genotype were remarkably higher than those with the GG and AA genotypes (P=0.010). In a randomized sample taken from patients in the two groups, the CD36 mRNA expression of the CHD patients was higher than that of the controls. In CHD patients, the CD36 mRNA expression in AG genotype patients was remarkably higher than in those with an AA genotype (P=0.005). After adjusted logistic regression analysis, the AG genotype of rs1761667 was associated with an increased risk of CHD (OR=2.337, 95% CI=1.336-4.087, P=0.003). In conclusion, the rs1761667 polymorphism may be closely associated with developing CHD in the Chongqing Han population of China, and an AG genotype may be a genetic susceptibility factor for CHD.
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Affiliation(s)
- Y Zhang
- Department of Cardiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Z Y Ling
- Department of Cardiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - S B Deng
- Department of Cardiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - H A Du
- Department of Cardiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Y H Yin
- Department of Cardiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - J Yuan
- Department of Cardiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Q She
- Department of Cardiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Y Q Chen
- Department of Cardiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
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Yin YH, Niu L, Cao XL. Study on Electrocatalytic Activity of Platinum for Hydrogen Oxidation in Acidic Solution by Scanning Electrochemical Microscopy. J CHIN CHEM SOC-TAIP 2013. [DOI: 10.1002/jccs.200900158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Abstract
AIM To determine the clinical features of hepatic myelopathy (HM), a rare condition associated with chronic liver disease (CLD), in patients in the city of Harbin, China. METHODS The medical files of 13 patients with HM were selected from 500 randomly chosen files of CLD patients registered in four Harbin hospitals. General information on all cases was summarised and clinical features were compared between HM positive patients (HM group) and HM negative CLD patients (control group). Detailed analysis of the clinical characteristics of HM positive patients was undertaken. RESULTS The patients in the HM group ranged in age from 41-50 years, which did not differ significantly from the control group. However, the sex ratio in the HM group (12 males/1 female) was significantly higher (p<0.05) than in the control group (342 males/145 females).The most frequent underlying aetiology was post type B hepatitis (12 cases). All cases in the HM group had a history of relapsing hepatic encephalopathy (HE) before or after HM onset, and showed electroencephalographic (EEG) abnormalities; however, the results of spinal cord magnetic resonance imaging were negative, and cerebrospinal fluid analysis findings were normal. Except for clinical manifestations of bilateral lower limb spastic paralysis, the two groups did not differ significantly in regard to other symptoms or signs. Hypoproteinaemia (positive predictive value (PPV) 5.69%, negative predictive value (NPV) 99.65%), blood ammonia elevation (PPV 5.29%, NPV, 99.32%) and abnormal EEG (PPV 5.00%, NPV 100.00%) were sensitive and specific for HM diagnosis. CONCLUSION In Harbin, HM is found mainly among middle aged men with CLD caused by viral hepatitis and accompanied by relapsing onset of HE. Bilateral lower limb spastic paralysis with hypoproteinaemia, blood ammonia elevation and/or abnormal EEG are significant diagnostic indicators of HM.
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Affiliation(s)
- Y H Yin
- Department of Neurology, the First Clinical Medical College of Harbin Medical University, Harbin City, Heilongjiang Province, 150001, PR China
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Xie ZX, Niu YH, Ma HX, Yin YH, Liu ZZ, Li ZY. Association of beta-adrenoceptor single nucleotide polymorphisms with resting heart rate. Conf Proc IEEE Eng Med Biol Soc 2007; 2004:2948-51. [PMID: 17270896 DOI: 10.1109/iembs.2004.1403837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
The association of beta-adrenoceptor (B-AR, including three subgroups: Beta1, Beta2 and Beta3) single nucleotide polymorphisms (SNP) with resting heart rate (RHR) were analyzed. RHR of 107 healthy subjects in the supine were detected by computerized system for 8 minutes. Genotyping SNPs of S/G49 and R/G389 of Beta1-AR and W/R64 of Beta3-AR in these subjects were by means of PCR-restriction fragment length polymorphism (PCR-RFLP) technique. Genotyping SNPs of R/G16 and Q/E27 of Beta1-adrenoceptor in these subjects were by means of allele specific primer-PCR (ASP-PCR) technique. It was found that there was no significant difference among RHRs corresponding above SNPs of B-AR, but the SNP of R/G389 of Beta1-AR, in which there was significant difference among RHRs (P<0.05). Either in the female individuals or in the male, those with Beta1-AR G/G389 genotype had the highest RHR. The females with R/R389 genotype had the lowest RHR, however, the males with R/G389 genotype had the lowest RHR. The RHR was not only associated with R/G389 polymorphism of Beta1-adrenoceptor gene significantly, but also was associated with gender in Chinese.
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Affiliation(s)
- Z X Xie
- Dept. of Biomed. Eng., Chongqing Univ., China
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Li JT, Zang HJ, Meng LH, Li LJ, Yin YH, Li TS. Synthesis of ethyl alkylidene alpha cyanoacetates under ultrasound irradiation. Ultrason Sonochem 2001; 8:93-95. [PMID: 11326617 DOI: 10.1016/s1350-4177(00)00067-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Condensation of ketones with ethyl cyanoacetate catalysed by ammonium acetate-acetic acid results in ethyl alkylidene alpha cyanoacetate in 31-89% yield under ultrasound irradiation.
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Affiliation(s)
- J T Li
- Department of Chemistry, Hebei University, No. 1 Hezuo Road, Baoding 071002, People's Republic of China.
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Abstract
Twenty-three hybrid pigs (23 +/- 3 kg body wt) were assigned to three groups to investigate the pharmacokinetics of ampicillin (APC, 10 mg/kg) administered intravenously (i.v.) and intramuscularly (i.m.), and sulfadimidine (SDM, 50 mg/kg) administered intravenously as a bolus injection. In the first series of experiments the animals remained healthy. Subsequently, the pigs were infected with Streptococcus suum by subcutaneous (s.c.) inoculation and the experiments were repeated. The total apparent distribution volume of APC given intravenously was increased from 0.512 +/- 0.026 L/kg in uninfected pigs to 0.68 +/- 0.06 L/kg (P < 0.01) in infected pigs, whereas there were no significant changes in the same parameter for SDM (P > 0.05). The clearance of APC was increased markedly from 0.52 +/- 0.07 L/kg/h in uninfected pigs to 0.62 +/- 0.10 L/kg/h in infected pigs. In contrast, SDM clearance was decreased markedly from 0.023 +/- 0.003 L/kg/h to 0.017 +/- 0.003 L/kg/h (P < 0.05). As a result, the biological half-lives of the drugs were altered to varying degrees in infected pigs. The half-life of SDM was increased from 15.0 +/- 3.0 h in uninfected pigs to 20 +/- 7h in infected pigs (P < 0.05), but differences in APC half-lives between uninfected and infected animals were not observed (P > 0.05). There were no statistically significant differences in pharmacokinetic parameters of APC administered by intramuscular injection between the healthy and the diseased status, although its half-life was shortened from 0.76 +/- 0.22 h in the healthy to 0.57 +/- 0.23 h in the diseased. The results suggest that blood concentrations of APC and SDM are affected differently by the same disease due to its specific effects on their distribution and elimination.
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Affiliation(s)
- Z H Yuan
- Department of Basic Veterinary Sciences, College of Animal Science and Veterinary Medicine, Central China Agricultural University, Wuhan, Hubei
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Yin YH. [The rehabilitative nursing care of patients with facial pigmentation caused by burn]. Zhonghua Hu Li Za Zhi 1996; 31:390-1. [PMID: 9295490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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