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21.
The current standard biomarker for myocardial infarction (MI) is high‐sensitive troponin. Although powerful in clinical setting, search for new markers is warranted as early diagnosis of MI is associated with improved outcomes. Extracellular vesicles (EVs) attracted considerable interest as new blood biomarkers. A training cohort used for diagnostic modelling included 30 patients with STEMI, 38 with stable angina (SA) and 30 matched‐controls. Extracellular vesicle concentration was assessed by nanoparticle tracking analysis. Extracellular vesicle surface‐epitopes were measured by flow cytometry. Diagnostic models were developed using machine learning algorithms and validated on an independent cohort of 80 patients. Serum EV concentration from STEMI patients was increased as compared to controls and SA. EV levels of CD62P, CD42a, CD41b, CD31 and CD40 increased in STEMI, and to a lesser extent in SA patients. An aggregate marker including EV concentration and CD62P/CD42a levels achieved non‐inferiority to troponin, discriminating STEMI from controls (AUC = 0.969). A random forest model based on EV biomarkers discriminated the two groups with 100% accuracy. EV markers and RF model confirmed high diagnostic performance at validation. In conclusion, patients with acute MI or SA exhibit characteristic EV biomarker profiles. EV biomarkers hold great potential as early markers for the management of patients with MI.  相似文献   
22.
Numerous studies have demonstrated that thioredoxin-interacting protein (TXNIP) expression of peripheral blood leucocytes is increased in coronary artery disease (CAD). However, the molecular mechanism of this phenomenon remained unclear. DNA methylation plays important roles in the regulation of gene expression. Therefore, we speculated there might be a close association between the expression of TXNIP and methylation. In this study, we found that compared with controls, DNA methylation at cg19693031 was decreased in CAD, while mRNA expressions of TXNIP and inflammatory factors, NLRP3, IL-1β, IL-18, were increased. Methylation at cg19693031 was negatively associated with TXNIP expression in the cohort, THP-1 and macrophages/foam cells. Furthermore, Transwell assay and co-cultured adhesion assay were performed to investigate functions of TXNIP on the migration of THP-1 or the adhesion of THP-1 on the surface of endothelial cells, respectively. Notably, overexpressed TXNIP promoted the migration and adhesion of THP-1 cells and expressions of NLRP3, IL-18 and IL-1β. Oppositely, knock-down TXNIP inhibited the migration and adhesion of THP-1 and expressions of NLRP3, IL-18. In conclusion, increased TXNIP expression, related to cg19693031 demethylation orientates monocytes towards an inflammatory status through the NLRP3 inflammasome pathway involved in the development of CAD.  相似文献   
23.
目的:探究Interlock可解脱弹簧圈在脾动脉瘤的腔内治疗中的应用价值。方法:回顾性分析2016年2月至2019年2月于本中心使用Interlock可解脱弹簧圈治疗的36例脾动脉瘤患者的临床资料,包括10例男性,26例女性,31例真性动脉瘤,5例假性脾动脉瘤,术前均行超声或CTA明确诊断。术中栓塞后,立即血管造影以明确技术成功率。围手术期及术后2周、3个月和6个月监测血常规、胰淀粉酶和主动脉CTA,观察并发症的发生情况。结果:6例患者弹簧圈栓塞动脉瘤远近端及瘤腔,其余仅栓塞脾动脉瘤瘤腔。术中DSA血管造影提示即刻脾动脉瘤栓塞闭塞率为97%以上,术中共使用128枚Interlock弹簧圈,其中104枚为钻石型,24枚为普通2D型。弹簧圈平均直径为6.3±4.2(2-12)mm,平均长度为16±13.5(3-32)mm,瘤体平均尺寸为40.6±12.5(15-70) mm。围手术期无并发症发生。平均随访10.0±3.2(6-15)个月,1月后2例出现脾梗死,7例发生轻微腹痛及低热等症状,所有病例均未见瘤腔再通和瘤体增大。结论:Interlock可解脱弹簧圈可以安全有效地治疗脾动脉瘤,但其远期疗效需长期随访观察。  相似文献   
24.
目的:探讨乌司他丁对非停跳冠脉搭桥术患者的心肺保护作用。方法:选取2017年12月-2019年4月我院收治的非停跳冠脉搭桥术患者76例,根据使用的药物不同分为两组,对照组应用常规方法,研究组应用乌司他丁,在麻醉之后切皮之前为T1,旁路血管开放时时间点为T2,手术结束为T3,手术之后的8 h为T4。比较两组治疗前后的心肺功能指标、动脉血气分析及血浆炎症因子、氧合指数术后恢复。结果:和T1进行对比时,两组T3、T4中的气道阻力(Air way Resistance,Raw)、呼吸指数(Respiratory Index,RI)、肺泡-动脉血氧分压差P(A-a)DO2均有所升高,在T2、T4中(PVR)有所升高,在T2、T3、T4中肺顺应性(Compliance of Lung,CL)有所降低。和对照组进行对比时,研究组在T3、T4中肺循环阻力(pulmonary vascular resistance, PVR)、RI、P(A-a)DO2有所降低,在T2、T3、T4中通气死腔百分比(VD/VT)有所降低(P0.05),在T2中CL有所升高(P0.05);治疗前,两组BNP、TNF-α、IL-6、IL-8无统计学意义(P0.05),治疗后BNP、肿瘤坏死因子(tumor necrosis factor-α,TNF-α)、白细胞介素-6 (Interleukin-6,IL-6)、白细胞介素-8 (Interleukin-8,IL-8)在T1、T2、T3、T4中低于对照组(P0.05),肌钙蛋白(cardiac troponin,cTnI)在T1中和对照组没有明显差异(P0.05),T2、T3、T4中研究组明显低于对照组(P0.05),研究组氧合指数高于对照组(P0.05);研究组T1、T2、T3、T4时平均动脉压(mean artery pressure,MBP)均高于对照组(P0.05),T1、T2、T3、T4时心率均低于对照组(P0.05);研究组ICU停留时间、ICU带气管插管时间、ICU机械通气时间、肺部并发症均低于对照组(P0.05)。结论:乌司他丁用于非停跳冠脉搭桥术的效果较好,可以保护患者的心肺功能。  相似文献   
25.
摘要 目的:探讨血清同型半胱氨酸(homocysteine, Hcy)、叶酸、维生素B12水平与冠状动脉病变严重程度的相关性。方法:选取经冠脉造影检查确诊的稳定期冠心病患者220例为研究组,并以同期健康查体志愿者100例为对照组。检测和比较两组血清Hcy、叶酸、维生素B12和N -末端脑钠肽前体(N-terminal brain natriuretic peptide precursor,NT-proBNP)水平。研究组根据冠脉造影情况进行SYNTAX评分评价,通过心脏超声检查检测左室射血分数(left ventricular ejection fraction,LVEF),确定冠脉病变严重程度。比较研究组SYNTAX低分组(1~22分)、中分组(23~32分)和高分组(≥33分)患者上述各指标水平,并分析研究组血清Hcy、叶酸、维生素B12水平与其血清NT-proBNP 水平、SYNTAX评分和LVEF的关系。结果:与对照组比较,研究组血清Hcy和NT-proBNP水平升高而血清叶酸、维生素B12水平降低(P<0.05)。研究组SYNTAX评分和LVEF分别为(28.76±6.58)分和(47.33±8.66)%,SYNTAX中分和高分患者血清Hcy和NT-proBNP水平高于SYNTAX低分患者而血清叶酸、维生素B12水平和LVEF则低于SYNTAX低分患者,SYNTAX高分患者血清Hcy和NT-proBNP水平高于SYNTAX中分患者而血清叶酸、维生素B12水平和LVEF则低于SYNTAX中分患者(P<0.05)。Pearson线性相关分析结果显示研究组血清Hcy水平与其血清NT-proBNP 水平、SYNTAX评分均呈正相关(r=0.881,0.793,P<0.05),与其LVEF则呈负相关(r=-0.876,P<0.05);而其血清叶酸、维生素B12水平与其血清NT-proBNP 水平、SYNTAX评分均呈负相关(叶酸:r=-0.786,-0.825;维生素B12:r=-0.884,-0.818,P<0.05),与其LVEF则呈正相关(r=0.893,0.859,P<0.05)。结论:血清Hcy是冠心病的重要危险因素,其水平随着冠状动脉病变程度加重而升高;血清叶酸、维生素B12是冠心病的保护因素,其水平随着冠状动脉病变程度加重而降低。  相似文献   
26.
PurposeCardiovascular disease (CVD) is a leading cause of death globally. Electrocardiogram (ECG), which records the electrical activity of the heart, has been used for the diagnosis of CVD. The automated and robust detection of CVD from ECG signals plays a significant role for early and accurate clinical diagnosis. The purpose of this study is to provide automated detection of coronary artery disease (CAD) from ECG signals using capsule networks (CapsNet).MethodsDeep learning-based approaches have become increasingly popular in computer aided diagnosis systems. Capsule networks are one of the new promising approaches in the field of deep learning. In this study, we used 1D version of CapsNet for the automated detection of coronary artery disease (CAD) on two second (95,300) and five second-long (38,120) ECG segments. These segments are obtained from 40 normal and 7 CAD subjects. In the experimental studies, 5-fold cross validation technique is employed to evaluate performance of the model.ResultsThe proposed model, which is named as 1D-CADCapsNet, yielded a promising 5-fold diagnosis accuracy of 99.44% and 98.62% for two- and five-second ECG signal groups, respectively. We have obtained the highest performance results using 2 s ECG segment than the state-of-art studies reported in the literature.Conclusions1D-CADCapsNet model automatically learns the pertinent representations from raw ECG data without using any hand-crafted technique and can be used as a fast and accurate diagnostic tool to help cardiologists.  相似文献   
27.
28.
目的分析肺炎支原体感染对川崎病的影响及其机制,以期指导临床诊疗。方法回顾性分析2013年8月至2018年8月我科住院的496例川崎病患儿临床资料,其中合并肺炎支原体感染组193例,未合并肺炎支原体感染组303例。应用倾向评分匹配法1∶1校正2组的年龄、性别、是否为不完全型川崎病、是否使用糖皮质激素、丙种球蛋白使用时间、丙种球蛋白使用方法和阿司匹林初始剂量,比较2组患儿的总发热天数、冠状动脉直径、冠状动脉扩张发生率、冠状动脉瘤发生率和丙种球蛋白无反应发生率。结果川崎病合并肺炎支原体感染组男性患儿多,更易发生颈部淋巴结肿大,年龄、中性粒细胞百分比、血沉和低密度脂蛋白高于川崎病未合并肺炎支原体感染组,血钾、血钙、高密度脂蛋白和白蛋白低于川崎病未合并肺炎支原体感染组,差异有统计学意义(均P<0.05)。应用倾向评分匹配法1∶1配对后发现,川崎病合并肺炎支原体感染组患儿总发热时间更长[8(6~10)d vs 7(6~9)d,Z=-2.089,P<0.05),冠状动脉直径值更大[(2.81±0.81)mm vs(2.63±0.45)mm,t=2.532,P<0.05],冠状动脉瘤发生率更高(5.5% vs 1.1%,χ2=5.516,P<0.05)。结论肺炎支原体感染可能引起川崎病患儿脂质代谢及电解质的紊乱,其炎症反应更强,持续时间更长,对冠状动脉损伤更大。  相似文献   
29.
目的探讨老年冠心病患者血尿酸(SUA)水平与肠道菌群的关系,为该类患者的治疗提供参考。方法选择2018年5月至2019年5月我院收治的83例冠心病患者为研究组,选择同期我院83例健康体检者的作为对照组。比较两组对象SUA水平及粪便标本中肠道菌群分布情况(乳杆菌、双歧杆菌、幽门螺杆菌、大肠埃希菌、链球菌);比较不同菌群紊乱程度冠心病患者SUA水平;比较不同SUA水平冠心病患者肠道菌群分布情况。采用Pearson相关分析冠心病患者SUA水平与肠道菌群相关性。结果研究组患者肠道乳杆菌、双歧杆菌数量明显低于对照组(均P<0.05),而肠道幽门螺杆菌、大肠埃希菌、链球菌数量明显高于对照组(均P<0.05)。研究组患者SUA水平明显高于对照组(P<0.05),不同菌群紊乱程度冠心病患者SUA水平有差异有统计学意义(均P<0.05)。不同SUA水平冠心病患者肠道乳杆菌、双歧杆菌、幽门螺杆菌、大肠埃希菌、链球菌数量差异有统计学意义(均P<0.05)。冠心病患者SUA水平与肠道乳杆菌、双歧杆菌数量呈负相关(r=-0.872、-0.912,均P<0.001),与肠道幽门螺杆菌、大肠埃希菌、链球菌数量呈正相关(r=0.915、0.896、0.889,均P<0.001)。结论冠心病患者存在肠道细菌紊乱及高尿酸现象。冠心病患者SUA水平与肠道菌群显著相关,检测冠心病患者SUA水平对监测肠道菌群状态及治疗方案制定具有重要意义。  相似文献   
30.
Aim: To find out risk factors for postoperative cognitive dysfunction (POCD) after coronary artery bypass grafting (CABG), and to provide basis for clinical prevention of POCD. A total of 88 patients who underwent CABG were surveyed with Telephone Questionnaire (TICS-M) for their cognitive impairment after 3, 7, 21, 90, 180 days post-surgery. The occurrence of POCD was diagnosed by Neuropsychological Battery which included Vocabular Learning Test (VLT), Wisconsin Card Sorting Test (WCST), Trail Making Test (TMT) and Symbol Digit Modalities Test (SDMT). The preoperative, intraoperative and postoperative risk factors were assessed by the χ2 or t test. Multivariate analysis was used to study the correlation between the risk factors and the occurrence of POCD. Age, aortic plaque, carotid artery stenosis, cerebrovascular disease, anesthesia time, the rate of decline in intraoperative hemoglobin concentration (ΔHb) and systemic inflammatory response syndrome (SIRS) score on postoperative day 2 had statistically significant (P<0.05) influence on the occurrence of POCD. Aortic plaque, carotid artery stenosis, anesthesia time and SIRS score (odds ratio (OR) value > 1, P<0.05) are the risk factors for POCD. The incidence of day-21 and -180 POCD was approximately 26.1 and 22.7%, respectively.  相似文献   
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