Predictive value of bilirubin and serum γ-glutamyltranspeptidase levels in type-2 diabetes mellitus patients with acute coronary syndrome

BACKGROUND Cardiovascular disease is a major complication of diabetes mellitus(DM).Type-2 DM(T2DM)is associated with an increased risk of cardiovascular events and mortality,while serum biomarkers may facilitate the prediction of these outcomes.Early differential diagnosis of T2DM complicated with acute coronary syndrome(ACS)plays an important role in controlling disease progression and improving safety.AIM To investigate the correlation of serum bilirubin andγ-glutamyltranspeptidase(γ-GGT)with major adverse cardiovascular events(MACEs)in T2DM patients with ACS.METHODS The clinical data of inpatients from January 2022 to December 2022 were analyzed retrospectively.According to different conditions,they were divided into the T2DM complicated with ACS group(T2DM+ACS,n=96),simple T2DM group(T2DM,n=85),and simple ACS group(ACS,n=90).The clinical data and laboratory indices were compared among the three groups,and the correlations of serum total bilirubin(TBIL)levels and serumγ-GGT levels with other indices were discussed.T2DM+ACS patients received a 90-day follow-up after discharge and were divided into event(n=15)and nonevent(n=81)groups according to the occurrence of MACEs;Univariate and multivariate analyses were further used to screen the independent influencing factors of MACEs in patients.RESULTS The T2DM+ACS group showed higherγ-GGT,total cholesterol,low-density lipoprotein cholesterol(LDL-C)and glycosylated hemoglobin(HbA1c)and lower TBIL and high-density lipoprotein cholesterol levels than the T2DM and ACS groups(P<0.05).Based on univariate analysis,the event and nonevent groups were significantly different in age(t=3.3612,P=0.0011),TBIL level(t=3.0742,P=0.0028),γ-GGT level(t=2.6887,P=0.0085),LDL-C level(t=2.0816,P=0.0401),HbA1c level(t=2.7862,P=0.0065)and left ventricular ejection fraction(LEVF)levels(t=3.2047,P=0.0018).Multivariate logistic regression analysis further identified that TBIL level and LEVF level were protective factor for MACEs,and age andγ-GGT level were risk factors(P<0.05).CONCLUSION Serum TBIL levels are decreased andγ-GGT levels are increased in T2DM+ACS patients,and the two indices are significantly negatively correlated.TBIL andγ-GGT are independent influencing factors for MACEs in such patients.

The research on floe ice force acting on the"Xue Long"icebreaker based on synthetic ice test and virtual mass numerical method

When the ice-going ships advance in the polar region,the navigation in the floe ice region is often encountered,the hull will suffer the high-frequency contact force produced by the floe ice,which will affect the navigation performance of the ship.Therefore,it is necessary to predict the water and ice force acting on the hull accurately.In this paper,the numerical simulation and experimental verification will be conducted for the polar scientific research ship-"Xue Long".Based on the computational fluid dynamics(CFD)and DEM theory,a virtual mass method is proposed to realize the predicting of the water and ice force and the simulation of the interaction phenomenon between the ice and hull,the numerical method is built to calculate the force acting on the hull.At the same time,the synthetic ice is used to carry out the experimental research on the advancing straight with different speeds and the oblique navigation with different drift angles.The optimal virtual mass coefficient is determined through the comparison and analysis of the numerical simulation and test results under typical condition.According to the optimal virtual mass coefficient,the numerical simulation is carried out with different speeds and drift angles,which is compared with the experiment more deeply.It is found that the virtual mass method based on the combination of CFD and DEM can simulate the overturning and the sliding along the hull of the floe ice vividly,the relative error of the total resistance between model test and numerical method in advancing straight is almost within 10%,while the relative error of the total longitudinal force in oblique navigation is almost within 15%.