The aim of this study was to validate the accuracy of left ventricular ejection fraction (LVEF) obtained by quantitative gated single photon emission tomography (QGS) perfusion imaging in comparison with gated blood-pool imaging. Resting gated myocardial perfusion imaging was performed in 269 patients with suspected or known coronary artery disease, and followed by equilibrium nuclear cardiac blood-pool imaging in one week. The later was considered as the reference standard. The LVEF from both methods were analyzed. The LVEF were calculated with QGS using Cedars Cardiac Quantification software. We found that LVEF from QGS and blood-pool (Bp)-LVEF were highly correlated (r=0.819, 0.05), whereas when ESV was smaller than 15 mL, QGS-LVEF was significantly higher than Bp-LVEF (mean ± SD: 80.53% ± 7.01%vs 65.06% ± 10.37%, P<0.05). Our findings demonstrate that when ESV values are larger than 15 mL, QGS- LVEF could replace Bp-LVEF. However, when ESV value is smaller than 15 mL, LVEF should be assessed in combination with blood-pool imaging.
BACKGROUND:The present research aimed to explore the risk factors for adverse cardiovascular events in elderly patients with acute myocardial infarction (AMI) combined with NAFLD. MATERIAL AND METHODS:We included 325 AMI patients hospitalized in the Department of Cardiology. AMI patients underwent emergency thrombolysis or percutaneous coronary intervention (PCI). AMI patients were classified into NAFLD group and non-NAFLD group. General clinical data, creatinine and myocardial enzyme, GRACE scores of AMI patients were evaluated and compared between two groups. Incidence of adverse cardiovascular events, including ECG instability, hemodynamic instability and death were evaluated. RESULTS:Compared to patients in the non-NAFLD group, patients in the NAFLD group had remarkably lower proportions of diabetic patients (p=0.001), coronary heart disease (CHD) patients (p=0.027), and CABG/PCI patients (p<0.001), and had significantly higher EF values (p=0.042). Meanwhile, the proportion of adverse cardiovascular events (ECG instability (p<0.001), hemodynamic instability (p=0.033), and deaths (p=0.016)) in patients in the NAFLD group was significantly higher compared to patients in the non-NAFLD group. Multivariate logistic regression analysis showed that GRACE score >140 (OR: 3.005, 95% CI: 1.504–6.032), EF <35% (OR: 2.649, 95% CI: 1.364-4.346), diabetes (OR: 1.308, 95% CI: 1.072–1.589), and NAFLD (OR: 1.112, 95% CI: 1.043–1.324) were independent predictors for elderly AMI patients' adverse cardiovascular events. CONCLUSIONS:The risk for adverse cardiovascular events in elderly acute myocardial infarction patients who also had NAFLD was significantly higher. Therefore, strengthening monitoring and active treatment for elderly AMI patients who also have NAFLD could reduce the incidence of adverse cardiovascular events and improve survival rate prognosis.
China has published the CBHD(China Blue High-Definition)standard shortly after Blu-ray Disk won the international standard competition on the high-definition disks.Depending on China's huge interior market and robust industrial capacity,CBHD hopes to compete with the BD standard in the future HD disks market.CBHD has begun to set up its patent pool,in which China's enterprises will be in charge.After carefully analysing CHDA Announces Plan for CBHD Patent License,this paper points out the issues that should be paid attention,and puts forward improving measures for the CBHD patent pool.It is also believed that the success of the CBHD patent pool is critical in CBHD standard's competition with BD.
Abstract Neuropathic pain affects 7-10% of the global population, and one of its characteristics is sensitization of somatosensory nervous system. Altered expression of ion channels and receptors has been found to be involved in neuronal hyperexcitability after injury to somatosensory nervous system, it is, however, unknown that if ion channels and receptors could gain qualitative changes on the level of structure organization when they are excessively expressed in same one neuron during the development of neuropathic pain. Here we show first that not only the expression of voltage-gated sodium channels Nav1.7 (SCN9A), Nav1.8 (SCN10A) and TRKB (also named NTRK2) increased in DRG neurons of patients with over 3-month severe neuropathic pain induced by brachial plexus avulsion (BPA), but also Nav1.7 and Nav1.8 formed supramolecular active clusters with or without TRKB in DRG neurons of mice with chronic neuropathic pain induced by spared nerve injury or diabetic neuropathy and of BPA pain patients with neuropathic pain. Nav1.7, Nav1.8 and TRKB might function in a coordinated manner in orderly organized supramolecular active clusters to geometrically increase the hyperexcitability of pathological DRG neurons. Our findings suggest that supramolecular active clusters of Nav1.7, Nav1.8 and TRKB might need be targeted for curing neuropathic pain, and that inhibition of both Nav1.7 and Nav1.8 might be required to achieve efficient relief of neuropathic pain.
Neuropathic pain (NP) induced by spinal cord injury (SCI) often causes long-term disturbance for patients, but the mechanisms behind remains unclear. Here, our study showed SCI-induced ectopic expression of Nav1.7 in abundant neurons located in deep and superficial laminae layers of the spinal dorsal horn (SDH) and upregulation of Nav1.7 expression in dorsal root ganglion (DRG) neurons in mice. Pharmacologic studies demonstrated that the efficacy of the blood–brain-barrier (BBB) permeable Nav1.7 inhibitor GNE-0439 for attenuation of NP in SCI mice was significantly better than that of the BBB non-permeable Nav1.7 inhibitor PF-05089771. Moreover, more than 20% of Nav1.7-expressing SDH neurons in SCI mice were activated to express FOS when there were no external stimuli, suggesting that the ectopic expression of Nav1.7 made SDH neurons hypersensitive and Nav1.7-expressing SDH neurons participated in central sensitization and in spontaneous pain and/or walking-evoked mechanical pain. Further investigation showed that NGF, a strong activator of Nav1.7 expression, and its downstream JUN were upregulated after SCI in SDH neurons with similar distribution patterns and in DRG neurons too. In conclusion, our findings showed that the upregulation of Nav1.7 was induced by SCI in both SDH and DRG neurons through increased expression of NGF/JUN, and the inhibition of Nav1.7 in both peripheral and spinal neurons alleviated mechanical pain in SCI mice. These data suggest that BBB permeable Nav1.7 blockers might relieve NP in patients with SCI and that blocking the upregulation of Nav1.7 in the early stage of SCI via selective inhibition of the downstream signaling pathways of NGF or Nav1.7-targeted RNA drugs could be a strategy for therapy of SCI-induced NP.
The aim of this study was to compare the correlation and consistency of left ventricular ejection fraction (LVEF) obtained by ECG-gated myocardial perfusion SPET (GMPS) using the four formulas (R0-R3) in ECToolbox software and by equilibrium radionuclide ventriculography (ERNV), and determine the optimal diagnostic thresholds of the four formulas in a Chinese population. A hundred and three candidate donors (59 male and 44 female), including 38 patients with a history of myocardial infarction and 65 patients with suspected coronary heart disease, underwent both (99m)Tc-MIBI rest GMPS and technetium-99m red blood cells ((99m)Tc-RBC) ERNV within a week. The LVEF values calculated by ECToolbox R0, R1, R2 and R3 were compared with those obtained by ERNV. Using LVEF≥50% obtained by ERNV as the gold standard, the optimal diagnostic thresholds of the four formulas (R0-R3) were assessed by receiver operating characteristic (ROC) curves. Results showed that the mean LVEF value of ERNV was 54.6±17.5%, and the mean LVEF value of the four formulas was 64.1±15.7%, 56.3±15.1%, 69.9±17.9% and 56.3±13.6%, respectively, showing a significantly strong correlation between the results obtained by the two methods (r>0.85, P<0.001). All mean LVEF values obtained by the four formulas were higher than the mean LVEF value obtained by ERNV, and there was very significant difference between R0 and R2 results and the ERNV result (t=12.511 and 18.652, P<0.001). Furthermore, there was significant difference between R1 and R3 results and the ERNV result (t=2.169 and 2.570, P<0.05). Using ERNV LVEF≥50% as the normal diagnostic value, the optimal diagnostic threshold of R0∼R3 was 56.5%, 51.5%, 64.5% and 52.5%, respectively. There was a strong correlation between the LVEF values obtained by the four formulas in ECToolbox software and ERNV, but the numerical values of LVEF differed between the four formulas. In conclusion, A strong correlation was observed among R0, R1, R2 and R3 in the ECToolbox software when compared with ERNV and also between them for the assessment of LVEF. However, there were some differences in the numerical values of LVEF generated by the individual formulas, which must be taken into account in comparing clinical studies.
To discuss the influence of coronary artery lesion of elderly patients with coronary heart disease (CHD) on left ventricular remodeling.Retrospective selection method was used to choose 80 elderly CHD patients who received coronary angiogram examination in Baoding First Central Hospital from January 2014 to February 2018 as the objects of study. According to coronary artery lesion, the patients were classified into single vessel lesion group (single vessel group) and multi-vessel lesion group (multi-vessel group, the number of lesion vessels≧2). Single vessel group included 60 patients, and multi-vessel group includes 20 patients. Intravascular unltrasound was applied to record coronary plaque property of all patients and transthoracic echocardiography was used to record left ventricular remodeling. Later correlation analysis was carried out.The proportion of calcified plaque and mixed plaque was higher than that of single vessel group, and the differences had statistical significance (P<0.05). Left ventricular end diastolic volume (LVEDV) and left ventricular end-systolic volume (LVESV) of multi-vessel group were higher than that of single vessel group, while left ventricular ejection fraction (LVEF) was lower than that of single vessel group. The differences had statistical significance (P<0.05). Linear correlation analysis showed coronary artery lesion was positively correlated with LVEF and calcified plaque (r=0.287, 0.371, P<0.05). Multiple linear regression analysis showed LVEF, calcified plaque and LDL-C were independent risk factors of multi-vessel coronary artery lesion of old CHD patients (P<0.05).The number of coronary artery lesions is significantly correlated with left ventricular remodeling, and can increase the proportion of calcified plaque and mixed plaque, thus leading to left ventricular remodeling abnormity.
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