Differential expression of microRNAs in aortic tissue and plasma in patients with acute aortic dissection

尖锐大动脉的解剖(AAD ) 的帮助 BackgroundBiomarker 的诊断为诊断和治疗是重要的。然而，为在血的 AAD 的 biomarkers 的鉴定是挑战性的任务 .&#x000a0；这研究的目的是寻找新潜在地，在 AAD.MethodsThe miRNAs 表示的 microRNA (miRNAs ) biomarkers 在登上大动脉的织物和血浆介绍被 microarray 分析在二个集合或组检验。织物组与 AAD 和健康男机关施主的四控制由四个病人组成。没有心血管的疾病，血浆组与 AAD 和 20 控制包括了 20 个病人。生物信息学被用来分析 miRNAs.ResultsOur 学习揭示了的表示的差别的潜在的目标在 AAD 病人，大动脉的织物有 30 差别，这表示了 miRNAs 与 13 起来调整并且 17 下面调整，并且血浆 93 差别表示了 miRNAs， 33 是起来调整的， 60 是下面调整的。四 miRNAs 被发现在 AAD 病人在大动脉的织物和血浆起来调整。预言的 miRNA 目标显示四 dysregulated miRNAs 主要指向了与房间房间粘附，细胞外的矩阵新陈代谢，细胞骨架组织，发炎，和与细胞的 cycles.ConclusionsFour miRNAs 有关的多重发信号小径被联系的基因，它在大动脉的织物并且在在 AAD 病人的血浆是起来调整的，在这研究被识别了。这些 miRNAs 可能是为 AAD 的潜在的诊断 biomarkers。更大的样品调查为进一步的确认被需要。

Admission white blood cell count predicts short-term clinical outcomes in patients with uncomplicated Stanford type B acute aortic dissection

sInflammation 被显示了与尖锐大动脉的解剖(AAD ) 相关。现在的学习试图与不复杂的斯坦福类型 B AAD.MethodsFrom 2008 在病人与在里面医院和长期的所有原因死亡在承认上评估白血房间计数(WBCc ) 的协会到 2010，有不复杂的类型 B AAD 的 377 个连续病人的一个总数被注册然后列在后面起来。承认上的临床的数据和 WBCc 是镇定的。主要结束点是在里面医院死亡，长期的所有原因 death.ResultsThe 在里面医院死亡率是 4.2% ，并且长期的所有原因死亡率在 18.9 个月的中部的后续期间是 6.9% 。承认上的 WBCc 被 univariate 考克斯回归分析作为一个连续变量和一个范畴的变量为在里面医院死亡作为一个风险因素识别用一 11.0 敢椠 ? 割掉 ? 潣摬猠敷吗？

Precision cardiovascular medicine in China

1 Introduction In China's Mainland,hospitalization expenses for patients with cardiovascular and cerebrovascular diseases have rapidly increased since 2004 and currently exceed the growth rate of the national gross domestic product.[1]One reason for these high expenses is that the traditional"one-size-for-all"medical model results in low treatment efficacy.Precision and individualized medical models may help reduce the medical burden and provide a sustainable medical model.

Using machine learning to aid treatment decision and risk assessment for severe three-vessel coronary artery disease

BACKGROUND Three-vessel disease(TVD)with a SYNergy between PCI with TAXus and cardiac surgery(SYNTAX)score of≥23 is one of the most severe types of coronary artery disease.We aimed to take advantage of machine learning to help in de-cision-making and prognostic evaluation in such patients.METHODS We analyzed 3786 patients who had TVD with a SYNTAX score of≥23,had no history of previous revascularization,and underwent either coronary artery bypass grafting(CABG)or percutaneous coronary intervention(PCI)after enrollment.The patients were randomly assigned to a training group and testing group.The C4.5 decision tree algorithm was applied in the training group,and all-cause death after a median follow-up of 6.6 years was regarded as the class label.RESULTS The decision tree algorithm selected age and left ventricular end-diastolic diameter(LVEDD)as splitting features and divided the patients into three subgroups:subgroup 1(age of≤67 years and LVEDD of≤53 mm),subgroup 2(age of≤67 years and LVEDD of>53 mm),and subgroup 3(age of>67 years).PCI conferred a patient survival benefit over CABG in sub-group 2.There was no significant difference in the risk of all-cause death between PCI and CABG in subgroup 1 and subgroup 3 in both the training data and testing data.Among the total study population,the multivariable analysis revealed significant dif-ferences in the risk of all-cause death among patients in three subgroups.CONCLUSIONS The combination of age and LVEDD identified by machine learning can contribute to decision-making and risk assessment of death in patients with severe TVD.The present results suggest that PCI is a better choice for young patients with severe TVD characterized by left ventricular dilation.

Evaluation of blood pressure lowering effect by generic and brand-name antihypertensive drugs treatment:a multicenter prospective study in China

Background:Generic drugs are bioequivalent to their brand-name counterparts;however,concerns still exist regarding the effectiveness and safety of generic drugs because of small sample sizes and short follow-up time in most studies.The purpose of this study was to evaluate the long-term antihypertensive efficacy,cost-effectiveness and cardiovascular outcomes of generic drugs compared with brand-name drugs.Methods:In a multicenter,community-based study including 7955 hypertensive patients who were prospectively followed up for an average of 2.5 years,we used the propensity-score-matching method to match the patients using brand-name drugs to those using generic drugs in a ratio of 1:2,2176 patients using brand-name drugs and 4352 patients using generic drugs.Results:There were no significant differences between generic drugs and brand-name drugs in blood pressure(BP)-lowering efficacy,BP control rate,and cardiovascular outcomes including coronary heart disease and stroke.The adjusted mean(95%confidence interval[CI])of systolic BP(SBP)-lowering was-7.9 mmHg(95%CI,-9.9 to-5.9)in the brand-name drug group and-7.1 mmHg(95%CI,-9.1 to-5.1)in the generic drug group after adjusting for age,sex,body mass index,number of antihypertensive drugs and traditionally cardiovascular risk factors.Among patients aged<60 years,brand-name drugs had a higher BP control rate(47%vs.41%;P=0.02)and a greater effect in lowering SBP compared with generic drugs,with the between-group difference of 1.5 mmHg(95%CI,0.2-2.8;P=0.03).BP control rate was higher in male patients using brand-name drugs compared with those using generic drugs(46%vs.40%;P=0.01).Generic drugs treatment yielded an average annual incremental cost-effectiveness ratio of$315.4 per patient per mmHg decrease in SBP compared with brand-name drugs treatment.Conclusions:Our data suggested that generic drugs are suitable and cost-effective in improving hypertension management and facilitating public health benefits,especially in low-and middle-income areas.

Single Nucleotide Polymorphism rs10919543 in FCGR2A/ FCGR3A Region Confers Susceptibility to Takayasu Arteritis in Chinese Population

Background： Takayasu arteritis （TA） is a rare inflammatory arteriopathy of unknown etiology. The aim of this study was to investigate the genetic susceptibility to TA in a Chinese population. Methods： Four single nucleotide polymorphisms （SNPs） those locate in the IL12B region （rs56167332）, the MLX region （rs665268）, the FCGR2A/FCGR3A locus （rsi0919543）, and the HLA-B/M1CA locus （rs12524487）, associated with TA in different population, were genotyped in 123 Chinese TA patients and 147 healthy controls from January 2013 to August 2014. A Chi-square test was used to test for genotype/allele frequencies variants. Results： Among the four SNPs, rs 10919543 was found to be significantly associated with TA in the studied population. The GG genotype of rs 10919543 at the FCGR2A/FCGR3A locus is a high risk factor （odds ratio [OR] = 6.532, 95% confidence interval [C1] = 2.402 - 17.763, P 〈 0.001 ） for TA. Among TA patients, the level of eosinophil granulocytes （Eos） in the peripheral blood was observed to be higher in the GG group of rs 10919543 （n = 23, Eos = 0. I 1 [0.08, 0.17] x 109/L） than the GA ＋ AA group （n = 100, Eos = 0.08 [0.05, 0.13] 10/L, P = 0.028）. No correlation between the genotypes of the other three SNPs and TA patients was observed. Conclusions： Our findings revealed unique genetic pattern in Chinese TA patients that may be partly responsible for the higher risk of TA in this population. FCGR2A/FCGR3A-related immune disorder might contribute to the etiology of TA.

The era of clinical application of gene diagnosis in cardiovascular diseases is coming

Gene diagnosis refers to the use of genetic testing in the diagnosis of inheritable conditions,which has gradually been applied in clinical practice with the completion of the gene sequencing efforts of the Human Genome Project and the advancement of gene detection technology.In the specialty field of cardiology,monogenic cardiovascular diseases are defined as monogenic inherited diseases with cardiovascular damage as the only phenotype,or accompanied by cardiovascular damage.Although the incidence of such diseases is relatively low,in the country of China with its vast population of 1.33 billion,the sheer volume of patients with monogenic cardiovascular diseases is alarming.With early onset,severe symptoms,and poor prognosis,delays in diagnosis and treatment of monogenic cardiovascular diseases often have serious consequences.Gene testing is perfectly suited for early diagnosis of monogenic cardiovascular diseases,especially for“pre-symptomatic”diagnosis.In this article,we generally review the characteristics of common monogenic cardiovascular diseases,summarize the progress of the standardized application of gene testing technology in clinical practice,describe the applicable population and condition of genetic testing for different monogenic cardiovascular diseases,analyze the practicality of genetic diagnosis of these inheritable conditions,and provide guidance on identifying suitable candidates for gene diagnosis.In conclusion,gene diagnosis provides new insights into the way physicians diagnose diseases,and is well-positioned to guide clinical decision making and treatment,especially in cardiology.

Genetics of ischemic and hemorrhagic stroke in Chinese population

Stroke is a major cause of adult death and disability worldwide.Epidemiological and animal studies have provided strong evidence that the pathogenesis of stroke is multi-factorial and induced by a combination of environmental and genetic risk factors,but the identifica-tion of individual causative variants remains little known.Genetic influences are likely to be polygenic with small effect sizes,and stroke itself consists of a number of different subtypes which may each have different genetic profiles.In addition,various ethnic populations may have different stroke risk,such as Asian race.The reasons for high risk of stroke among the Chinese,especially hemorrhagic stroke,remain unknown.Most human studies have taken a candidate gene approach using case-control methodology.To be reliably detected,small relative risks require large sample sizes,probably 1000 patients or more.Genome-wide association(GWA)study is an unbiased and comprehensive approach to identify common risk alleles for complex diseases.Recently,a multistage GWA study has identified three loci on chromosomes 2q,8q and 9p to be associated with intracranial aneurysm in European and Japanese populations.Another GWAfinding is the identification of risk variants for cardioembolic stroke on chromosome 4q25 in European populations.In this review,we mainly focus on the results from case-control association studies on genetic factors that play a role in the risk of ischemic and hemorrhagic stroke in Chinese population.The combined effects of multiple susceptibility genes for stroke risk are also summarized.