Analysis about the effect of trimetazidine combined with atorvastation calcium on myocardin i level, cardiac and renal function in patients with ischemic cardiomyopathy

Objective:Analyze the effect of trimetazidine combined with atorvastation calcium on Myocardin I level, cardiac and renal function in patients with Ischemic cardiomyopathy. Methods:A total of 82 patients who were admitted in our hospital from January 2013 to May 2016 were selected and divided them randomly into the research group and the control group. All subjects were treated with conventional therapy after admission. On this basis, the control group was given atorvastation calcium, meanwhile the research group was given trimetazidine combined with atorvastation calcium. Then analyzed the cTnI level, evaluated their cardiac and renal function (cardiac function indexes: LVEF, LVESD, LVEDD, renal function indexes: Scr, BUN and mALB) after three months treatment.Results: After treatment, the level of cTnI, LVESD and LVEDD in this two groups were decreased dramatically, the level of cTnI, LVESD and LVEDD in the research group were (0.51±0.24) ng/mL, (38.35±3.94) mm and (51.43±4.56) mm respectively, compared with the control group, these levels were significantly decreased;the level of LVEF was (51.10±4.07)% in research group, increased more obviously than the control group, and the difference was statistical significant. The Scr, BUN and mALB in two groups were decreased after treatment, the research group was significantly reduced, in addition, these levels in research group were (80.14±10.21) μmol/L, (5.89±1.06) mmol/L and (51.35±20.94) mg/24 h respectively, lower than the control group.Conclusion: The therapy of trimetazidine combined with atorvastation calcium in patients with Ischemic cardiomyopathy, was worthy of clinical application, seeing that can ameliorate effectively myocardial injury , the cardiac and renal function.

The Effects of Oxidation States and Spin States of Chromium Interaction with <i>Sargassum Sp</i>.: A Spectroscopic and Density Functional Theoretical Study

The study of various oxidation states of chromium with Sargassum sp. is of particular interest since hexavalent chromium is reduced to trivalent chromium in an aqueous solution. In this study, a systematic density functional theory (DFT) calculations were performed to study the interactions of transition metal chromium ion with different oxidation states and spin states with the Sargassum sp. decorated with carboxylate (acetate) at the wB97XD/6-311++ G(d,p) level of theory. The structures and binding energies of chromium metal-carboxylate complexes at various oxidation states and spin states in gas phase were examined. The coordination strength of Cr(VI) with the acetate ligand was predominantly the strongest compared to the other oxidation states. Vibrational frequency analysis, for the homoleptic monomers of tris [CrIII(AC)3]0 and [CrVI(AC)3]3+ complexes, illustrate good harmony with the experimental and theoretical calculated frequencies. Using the time-dependent DFT (TD-DFT) at the level of CAM-B3LYP/6-311++G(d,p), the vertical excitation energies were obtained. The stabilization energies derived using the second order perturbation theory, Eij(2), of NBO analysis confirmed the greater charge transfer for the observed trends in the metal binding. The calculated binding energies (ΔE) and interactions energies SEij(2) favor the formation of [CrVI(AC)3]3+ complexes. The findings of this study identify efficient electronic factors as major contributors to the metal binding affinities, with promising possibilities for the design of metal-ligand complexes and sensing of the metal ions.

Investigation of Structural and Electronic Properties of [Tris(Benzene-1,2-Dithiolato)M]^3-(M = V, Cr, Mn, Fe and Co) Complexes: A Spectroscopic and Density Functional Theoretical Study

In this study, the first raw transition metals from V to Co complexes with benzene-1,2-dithiolate (L2-) ligand have been studied theoretically to elucidate the geometry, electronic structure and spectroscopic properties of the complexes. Density Functional Theory (DFT) and Time-Dependent Density Functional Theory (TD-DFT) methods have been used. The ground state geometries, binding energies, spectral properties (UV-vis), frontier molecular orbitals (FMOs) analysis, charge analysis and natural bond orbital (NBO) have been investigated. The geometrical parameters are in good agreement with the available experimental data. The metal-ligand binding energies are 1 order of magnitude larger than the physisorption energy of a benzene-1, 2-dthiolate molecule on a metallic surface. The electronic structures of the first raw transition metal series from V to Co have been elucidated by UV-vis spectroscopic using DFT calculations. In accordance with experiment the calculated electronic spectra of these tris complexes show bands at 522, 565, 559, 546 and 863 nm for V3+, Cr3+, Mn3+, Fe3+ and Co3+ respectively which are mainly attributed to ligand to metal charge transfer (LMCT) transitions. The electronic properties analysis shows that the highest occupied molecular orbital (HOMO) is mainly centered on metal coordinated sulfur atoms whereas the lowest unoccupied molecular orbital (LUMO) is mainly located on the metal surface. From calculation of intramolecular interactions and electron delocalization by natural bond orbital (NBO) analysis, the stability of the complexes was estimated. The NBO results showed significant charge transfer from sulfur to central metal ions in the complexes, as well as to the benzene. The calculated charges on metal ions are also reported at various charge schemes. The calculations show encouraging agreement with the available experimental data.

Anisotropic Lattice Strain of Composite Materials of LiMnO2 and H/D-Substituted Chiral Cyanide-Bridged Ni（Ⅱ）-Fe（Ⅲ） Coordination Polymers

Composite materials composed of LiMnO2, a typical electrode material for lithium ion battery, and a chiral cyanide-bridged Ni（Ⅱ）-Fe（Ⅲ） coordination polymer [NiL2][Fe（CN）6]·4H2O （Ni-Fe, H-form） （L = （1R,2R）-（-）-1,2-cyclohexane-diamine） or its deuterium isomer, [NiL2][Fe（CN）6]·4D2O （Ni-Fe, D-form） have been prepared by the various ratios （w/w） of Ni-Fe：LiMnO2 = 10：0 （pure Ni-Fe）, 9：1, 8：2, 7：3, 6：4, 5：5, 4：6, 3：7, 2：8, 1：9 and 0：10 （pure LiMnO2）. Gradual shift of IR （infrared） spectra by changing the ratios and losing difference between H-form and D-form of Ni-Fe due to isotope effects revealed adsorption of Ni-Fe onto LiMnO2 to form composite materials. Formation of composite materials of Ni-Fe and LiMnO2 could be also proved losing ferromagnetic behavior of LiMnO2 on increasing of the ratios of Ni-Fe in each composite. In contrast to smoothly positive thermal expansion of pure LiMnO2 along the crystallographic b axis, variable temperature powder XRD （X-ray diffraction） patterns at 100-300 K of the composite materials exhibited thermally-accessible lattice distortion along the b axis with different ratios. It is also proved deviation of ideal linear correlation of an evaluation function, In K = a/T ＋ b （where, K = （d（T） - d（0））/d（T）, d（T） denotes nλ/（sin 2θ） at T （K））.

Coordination configurations of cupric tartrate in electronic industry wastewater

The coordination structure of cupric tartrate(Cu−TA)complex was investigated by ultraviolet−visible(UV-Vis)and liquid chromatography/mass spectrometer(LC-MS)firstly;furthermore,effective coordination configurations and electronic properties of Cu−TA in aqueous solution were systematically revealed by density functional theory(DFT)calculations.Consistently,Job plots show the possible existence of[Cu(TA)]and[Cu(TA)_(2)]^(2-)at 230 and 255 nm based on UV-Vis results.LC-MS results confirm the existence of the single and high coordination complexes[Cu_(2)(TA)_(2)]^(+),[Cu(TA)_(2)]^(+)and[Cu_(2)(TA)_(3)(H_(2)O)_(2)(OH)_(2)]^(2+).DFT calculation results show that carboxylic oxygen and hydroxyl oxygen of tartaric acid(TA)are preferred sites for Cu(Ⅱ)coordination.[Cu(TA)](1H,3H sites O of TA coordinated with Cu(Ⅱ)),[Cu(TA)_(2)]^(2-)(two 1^(C),2^(H) sites O of TA coordinated with Cu(Ⅱ)),and[Cu(TA)_(3)]^(4-)(three 2H,3H sites O of TA coordinated with Cu(Ⅱ))should be dominant coordination configurations of Cu−TA.The corresponding Gibbs reaction energies are-170.1,-136.2,and-90.2 kJ/mol,respectively.

Theoretical Investigations on Electronic Structures and Absorption Spectra of Unsymmetrical Metal-coordinated Neo-confused Porphyrin in Various Solvents

Though the photo-physical properties of free base porphyrin are attractive, there are still problems for the materials with weak and narrow range absorption of visible light. The unsymmetrical neo-confused porphyrin derivatives were introduced as novel materials for the improvement of photo-chemical and photo-physical properties. The density function theory（DFT）and time dependent density function theory（TDDFT） were applied to calculate the absorption spectrum of unsymmetrical neo-confused porphyrin（N-CP） and metal-coordinated N-CP in various solutions. The Ni and Zn coordinated neo-confused porphyrin dipole moment values are smaller than the values of prototype porphyrin（Pro P） and N–CP. According to the electrophilicity index ω, Ni coordinated N–CP（Ni–N–CP） is susceptible to the polarity of solvents, while the Zn coordinated derivative（Zn–N–CP） is more immune to the solvent environment. Unlike the Gouterman＇s four frontier orbital model of common porphyrin materials, the electron transitions of N–CPs and metalcoordinated N–CPs from H–2 or lower molecular orbitals also contribute to ultraviolet and visible absorption. Most of oscillator strength f values of Zn–N–CP are significantly higher than the values of Ni–N–CP, which reflects the higher absorption intensity of Q and Soret bands. The maximum wavelength at 702.2 nm in vacuum drew our attention to the novel material. The broad absorption range, intense red-shifted Q band and higher stability in solvents suggest that N–CPs, especially Zn–N–CP, can be one class of new candidate dye-sensitized materials.

Effect of Losartan on the Cardiac and Renal Function in Patients With Chronic Heart Failure

Objectives To explore the effect of losartan on cardiac and renal function in patients with chronic heart failure (CHF). Methods Sixty-five patients with CHF were divided into two groups using a randomized, control and single blind method: losartan group (n=30) and convention group (n=35), with a treatment course of 8 weeks for both groups. The concentrations of cystatin C (cys C) in serum, microamount albumin (MA) in urine were measured by immunoturbidimetry. The concentration of aquaporin-2(AQP-2)was determined by enzyme-linked-immunosorbent assay (ELISA) and the heart contractile function was measured by echocardiography before and after treatment respectively. Results Comparing with routine treatment group, left ventricular end-diastolic dimension (LVEDd) decreased significantly, while left ventricular ejection fraction(LVEF)and left ventricular fractional shortening (LVFS) increased significantly in losartan group. The levels of cys C in serum and MA, AQP-2 in urine were significantly lower in losartan group than in routine treatment group. Conclusion Losartan can improve cardiac and renal function in patients with CHF.

Release of Cardiac Biomarkers during a Cycling Race

Objectives: Over the past two decades, a large interest in cardiac marker elevations has developed in endurance sports events. The intense effort is not without risk. We aimed to see if the relatively cardiospecific biomarkers could show the damage on cardiac muscle cells. Methods: Fourteen cyclists were recruited for an international race (177 km). We studied different cardiac biomarkers, renal function markers and blood cytology. The subjects were submitted to three blood test: one before (T0), one just after (T1) and the last one 3 hours after the race (T3). Results: Blood cytology markers, namely erythrocytes, hemoglobin, hematocrit, and average hemoglobin concentration, were found to evolve in a similar way. Renal function markers, such as creatinin, cystatin C and uric acid, showed a post effort increase that might be related to renal blood flow depletion during exercise. Cardiac and muscular markers were all increased at T1. Conclusions: Physiological stress induced by an international cycling race certainly has consequences on cardiac muscle cells. Fortunately, those blood concentration variations are more representative of a transitional state, due to an imbalance created by an intense aerobic effort maintained during several hours, rather than an irreversible injury.

Adsorption of atomic S and C on Mg(0001) surface

First-principle calculations based on density functional theory were used to study the adsorption of atomic sulfur and carbon on the Mg(0001) surface in a wide range of coverages from 1/4 ML(monolayer) to 1 ML. It is found that the adsorption of atomic S and C on the high coordinate hollow site is more energetically favorable than that on other adsorption sites. S atom is favorable to be adsorbed at on-surface site and C atom is favorable to be adsorbed at subsurface site. The results suggest that when the coverage increases, the binding energy for S and C atoms will decrease and the interaction between adsorbed atoms tends to be stronger. It indicates that as coverage increases, S-Mg and C-Mg interaction weakens.

沙库巴曲缬沙坦治疗慢性心力衰竭合并肾功能不全的疗效及对微炎症反应的影响

目的观察沙库巴曲缬沙坦治疗慢性心力衰竭合并肾功能不全的疗效及对微炎症反应的影响。方法选取2019年1月—2021年12月福建医科大学附属第二医院收治的慢性心力衰竭合并肾功能不全患者92例,基于不同用药方案分为联合组和常规组,每组46例。常规组实施常规西药治疗,联合组在常规组基础上采用沙库巴曲缬沙坦治疗。2组均用药3个月后比较治疗效果,治疗前后心肾功能及微炎症改善情况。结果联合组治疗总有效率为95.65%,高于常规组的80.43%(χ^(2)=5.059,P=0.024)。治疗3个月后,2组左室射血分数升高、左室舒张末期内径减小,尿素氮、血清肌酐水平降低,且联合组上述指标改善幅度大于常规组(P均<0.01);2组血清肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)水平降低,且联合组低于常规组(P均<0.01)。结论慢性心力衰竭合并肾功能不全给予沙库巴曲缬沙坦治疗的效果显著,可在改善患者心肾功能的同时,有效降低微炎症反应。

达格列净治疗心力衰竭合并慢性肾脏病的临床观察

目的探讨达格列净对心力衰竭(HF)合并慢性肾脏病(CKD)患者心功能、肾功能、血糖、生活质量的影响及用药安全性。方法选择2021年1月1日至2023年1月1日商丘市第一人民医院收治的156例HF合并CKD患者,根据随机数字表法分为常规治疗组(n=80)和达格列净组(n=76)。常规治疗组患者给予常规治疗,达格列净组患者在常规治疗的基础上给予达格列净片10mg,口服,每日1次。两组患者均治疗6个月。观察两组患者治疗前后的心功能[左室射血分数(LVEF)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)、氨基末端脑利钠肽前体(NT-proBNP)]、肾功能[血肌酐、尿素氮、尿白蛋白排泄率(UAER)、肾小球滤过率(GFR)、肌酐清除率(CCR)]、糖化血红蛋白水平、生活质量,并记录不良反应发生情况。结果治疗后,两组患者的LVESD、LVEDD、NT-proBNP、血肌酐、尿素氮、UAER及达格列净组患者的糖化血红蛋白水平均显著低于同组治疗前,且达格列净组显著低于常规治疗组;LVEF、GFR、CCR、堪萨斯城心肌病问卷评分均显著高于同组治疗前,且达格列净组显著高于常规治疗组(P<0.05)。常规治疗组患者治疗前后的糖化血红蛋白水平比较,差异无统计学意义(P>0.05)。两组患者的头晕、皮疹、肝功能不全、泌尿系统感染、新发透析、低血压的发生率比较,差异均无统计学意义(P>0.05)。结论达格列净能够改善HF合并CKD患者的心功能和肾功能,提高患者的生活质量,降低血糖水平,且未增加不良反应的发生风险。

血清超敏C反应蛋白、胱抑素C与脓毒性休克患者心功能、肾功能损伤的关系

目的检测脓毒性休克患者血清超敏C反应蛋白(hs-CRP)、胱抑素C(Cys C)水平,探讨其与脓毒性休克患者心功能、肾功能损伤的关系。方法选取2020年5月—2023年12月我院收治的脓毒性休克患者50例,纳入休克组。另选取同期健康体检者48名,纳入参照组。比较2组研究对象hs-CRP、Cys C水平,分析脓毒性休克患者血清hs-CRP、Cys C水平与患者左室射血分数(LVEF)、二尖瓣舒张早期血流峰速(E)/二尖瓣环舒张早期速度(E’)、血浆脑钠肽(BNP)、心肌肌钙蛋白Ⅰ(c TnⅠ)、肾小球滤过率(GFR)及急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分的关系。结果2组研究对象年龄、性别分布、身体质量指数(BMI)及基础疾病患病情况等方面的差异均无统计学意义(P>0.05)。休克组患者的血清hs-CRP水平[(181.01±37.39)mg/L]和血清Cys C水平[(2.62±0.25)mg/L]显著高于参照组[(38.78±10.55)mg/L、(0.96±0.15)mg/L],差异均有统计学意义(P<0.05)。休克组患者的血清hs-CRP水平与LVEF、E/E’、BNP、c TnⅠ水平、APACHEⅡ评分有关(P<0.05),与GFR无相关性(P>0.05);休克组患者的血清Cys C水平与GFR水平、APACHEⅡ评分有关(P<0.05),与LVEF、E/E’、BNP及c TnⅠ水平均无相关性(P>0.05)。结论脓毒性休克患者血清hs-CRP、Cys C水平均显著高于健康体验者,推测其可能与心肌细胞受损、炎症因子水平升高、肾血流量降低等因素有关,可作为评估脓毒性休克患者心、肾功能损伤的参考指标。

拉贝洛尔在妊娠高血压综合征血压控制中的应用效果及对患者肾功能和心功能与血清炎症因子水平的影响

目的探究拉贝洛尔在妊娠高血压综合征控制中的应用效果及对患者肾功能、心功能、血清炎症因子水平的影响。方法选取2020年1月至2022年4月丰城市人民医院收治的82例妊娠高血压综合征患者作为研究对象,根据随机数字表法分为A组与B组,每组41例。A组给予硫酸镁治疗,B组给予硫酸镁联合拉贝洛尔治疗,比较两组治疗前后血压水平、肾功能指标、心功能指标、血清炎症因子水平、血液流变学指标及不良妊娠结局发生情况。结果治疗后,B组收缩压(SBP)、舒张压(DBP)水平均低于A组,差异有统计学意义(P<0.05);治疗后,B组血尿素氮(BUN)、血肌酐(SCr)、胱抑素C(CysC)、24 h尿蛋白水平均低于A组,差异有统计学意义(P<0.05);治疗后,B组心肌肌钙蛋白(ⅠcTnⅠ)、B型脑钠肽(BNP)水平均低于A组,差异有统计学意义(P<0.05);治疗后,B组C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平均低于A组,差异有统计学意义(P<0.05);治疗后,B组全血黏度(WBV)与全血还原黏度(WBRV)低、中、高切水平均低于A组,差异有统计学意义(P<0.05);B组不良妊娠结局发生率为9.76%,低于A组的26.83%,差异有统计学意义(P<0.05)。结论拉贝洛尔治疗妊娠期高血压综合征效果显著,可降低患者血压水平,改善其心功能、肾功能、炎症因子水平及血液流变学指标,降低不良妊娠结局发生率。

共享决策理论康复护理在老年心脏手术患者术后恢复中的应用效果

目的:探讨共享决策理论的康复护理在老年心脏手术患者术后恢复中的应用效果。方法:选取2020年4月—2023年4月焦作市第二人民医院收治的94例老年心脏手术患者作为研究对象,按随机数表法分两组,每组各47例。对照组采取常规康复护理,观察组采取共享决策理论的康复护理,持续至术后3个月。对比两组患者心理状态、自护能力、心功能恢复情况、生活质量、并发症发生率及护理满意度。结果:护理后,观察组焦虑自评量表(SAS)、抑郁自评量表(SDS)评分的低于对照组,差异均有统计学意义(t=5.786、7.742,P<0.05);护理后,观察组自我护理能力测定量表(ESCA)评分高于对照组,差异均有统计学意义(t=6.868、9.767、8.107、5.534,P<0.05);护理后,观察组左心射血分数(LVEF)水平高于对照组,左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)水平低于对照组,差异均有统计学意义(t=1.356、5.864、6.641,P<0.05);护理后,观察组生活质量评定问卷(CQQC)中的各维度评分均高于对照组,差异均有统计学意义(t=6.191、7.267、6.765、7.446、9.386、6.408,P<0.05);观察组并发症发生率低于对照组,观察组护理满意度高于对照组,差异均有统计学意义(χ^(2)=5.045、5.371,P<0.05)。结论:共享决策理论的康复护理能减轻老年心脏手术患者负性情绪,提高自护能力,促进心功能恢复,从而改善生活质量,提高护理满意度。

以时机理论为中心的家庭护理模式干预对老年糖尿病肾病患者自护行为及肾功能的影响

目的回顾性分析以时机理论为中心的家庭护理模式干预在老年糖尿病肾病(DN)中的临床应用价值。方法收集漯河市中心医院2021年11月至2023年11月收治的122例老年DN患者,按照护理方法分为时机组(61例)、对照组(61例),对照组接受常规护理,时机组在此基础上接受以时机理论为中心的家庭护理模式干预。比较两组肾功能改善情况、血糖水平、自护行为、生活质量。结果干预后,时机组24 h尿蛋白定量、血肌酐(Scr)指标水平低于对照组(P<0.05);时机组空腹血糖(FBG)、餐后2 h血糖(2 h PG)指标水平均低于对照组(P<0.05);干预后,时机组自我护理能力测量量表(ESCA)评分高于对照组(P<0.05);干预后,时机组生活质量综合评定问卷-74(GQOL-74)评分高于对照组(P<0.05)。结论以时机理论为中心的家庭护理模式干预能改善老年DN患者肾功能、血糖水平,提高自护行为、生活质量。

基于循证理论的预见性护理策略结合声门下间歇冲洗预防2型糖尿病伴心力衰竭患者呼吸机相关性肺炎的效果及对炎性介质水平的影响

目的分析基于循证理论的预见性护理策略结合声门下间歇冲洗在预防2型糖尿病(T2DM)伴心力衰竭(HF)患者呼吸机相关性肺炎(VAP)中的应用效果。方法择取2021年1月至2022年1月收治的100例T2DM伴HF患者为研究对象,随机将其分为对照组和观察组,各50例。对照组采用常规护理干预,观察组在对照组基础上加基于循证理论的预见性护理策略结合声门下间歇冲洗。比较两组的干预效果。结果观察组的VAP发生率、随机血糖水平低于对照组,机械通气时间、气管插管时间及住院时间短于对照组(P<0.05)。干预后,观察组的肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)及C反应蛋白(CRP)水平低于对照组(P<0.05)。干预后,观察组的脑钠肽(BNP)水平及糖化血红蛋白(HbA1c)低于对照组(P<0.05)。结论基于循证理论的预见性护理策略结合声门下间歇冲洗能够有效预防T2DM伴HF患者VAP的发生,降低炎性介质水平,改善血糖及心功能,值得临床推广与应用。

达格列净对慢性肾脏病伴2型糖尿病合并心力衰竭患者心肾功能及预后的影响

目的 观察达格列净对慢性肾脏病伴2型糖尿病合并心力衰竭患者心肾功能及预后的影响。方法 选取2020年3月—2021年3月保定市第一中心医院收治的慢性肾脏病伴2型糖尿病合并心力衰竭患者82例,按照随机数字表法分为观察组及对照组,每组41例。对照组给予常规治疗,观察组在对照组治疗的基础上给予达格列净治疗。2组均治疗12个月。比较2组治疗前后肾功能[血肌酐(SCr)、血尿酸(UA)]、心功能[左室舒张末压(LVEDD)、左室射血分数(LVEF)、6 min步行距离(6MWD)、N端脑钠肽前体(NT-proBNP)]、炎性因子[超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平、生活质量评分(MHFQL),以及预后与不良事件发生情况。结果 治疗12个月后,观察组SCr、UA水平低于治疗前及对照组(P<0.05或P<0.01),对照组治疗前后SCr、UA水平比较差异均无统计学意义(P>0.05);观察组LVEF、LVEDD均较治疗前及对照组改善(P<0.05或P<0.01),对照组治疗前后LVEF、LVEDD比较差异均无统计学意义(P>0.05),2组6MWD均长于治疗前,且观察组长于对照组(P<0.01);观察组NT-proBNP水平低于治疗前及对照组(P<0.05或P<0.01),对照组治疗前后NT-proBNP水平比较差异无统计学意义(P>0.05);2组hs-CRP、IL-6、TNF-α水平均低于治疗前,且观察组低于对照组(P<0.05或P<0.01);2组MHFQL评分均低于治疗前,且观察组低于对照组(P<0.05或P<0.01)。观察组与对照组病死率比较差异无统计学意义(9.76%vs. 12.20%,χ^(2)=0.125,P=0.724);观察组与对照组不良事件总发生率比较差异无统计学意义(24.39%vs. 9.76%,χ^(2)=3.101,P=0.078)。结论 达格列净对慢性肾脏病伴2型糖尿病合并心力衰竭患者心肾功能及预后均有一定的改善作用,值得临床应用。

Renal sympathetic denervation reduces left ventricular hypertrophy and improves cardiac function in patients with resistant hypertension

This study investigated the effect of catheter-based renal sympathetic denervation （RD） on left ventricular hypertrophy （LVH） and systolic and diastolic function in patients with resistant hypertension. LVH and diastolic dysfunction are associated with elevated sympathetic activity and increased morbidity and mortality. The effect of RD on LVH and LV function is unclear

肾功能与左心室结构及功能的相关性研究

目的本研究旨在探讨使用胱抑素C(cystatin C,CysC)估算肾小球滤过率(estimated glomerular filtration rate based on cystatin C,eGFR-CysC)确定的肾功能与心脏磁共振(cardiovascular magnetic resonance,CMR)成像评估的左心室(left ventricular,LV)结构及功能之间的关系。方法从英国生物银行(UK Biobank,UKB)数据库中筛选具有eGFR-CysC和CMR数据的一般人群,使用多元线性回归模型探讨肾功能与心脏表型之间的关联。结果共筛选35847名UKB参与者,eGFR每降低一个标准差(14.21 mL/min/1.73 m^(2)),LV容积变小(舒张末期容积,β=1.359;收缩末期容积,β=0.492),LV搏出量减少(β=0.889),LV质量降低(β=0.639),LV同心度增加(β=-0.002),LV收缩功能受损(β=0.108,P均<0.05)。结论肾功能降低与不良心脏表型之间存在明显关联,独立于心脏代谢疾病等因素。早期积极干预可能有助于预防不良心脏重塑的进展。

槲皮素对心肾综合征大鼠心肾功能的保护作用及机制

目的 基于磷脂酰肌醇3激酶(PI3K)/蛋白激酶B(Akt)/核因子κB(NF-κB)信号通路探讨槲皮素对心肾综合征(CRS)大鼠心肾功能的保护作用及机制。方法 取SD大鼠,采用左冠状动脉前降支结扎结合肾急性缺血再灌注的方法构建CRS模型,将造模成功的大鼠随机分为模型组、槲皮素低剂量组(35 mg/kg)、槲皮素高剂量组(70 mg/kg)、槲皮素高剂量+740Y-P组(70 mg/kg槲皮素+3.5 mg/kg PI3K/Akt/NF-κB信号通路激活剂740Y-P),每组12只;另取12只正常大鼠设为假手术组。每天给药1次,连续14 d。给药结束后,检测大鼠心功能指标[左心室射血分数(LVEF)、舒张末期容积(EDV)、等容舒张时间(IVRT)]与肾功能指标[血尿素氮(BUN)、血肌酐(Scr)、24 h尿蛋白];观察大鼠心肾组织纤维化情况;检测大鼠血清与心肾组织中炎症指标[白细胞介素1β(IL-1β)、肿瘤坏死因子α(TNF-α)]水平及心肾组织中PI3K/Akt/NF-κB信号通路相关蛋白表达。结果 与假手术组比较,模型组大鼠BUN、24 h尿蛋白、Scr水平,心肾组织的胶原容积分数,血清与心肾组织中IL-1β、TNF-α水平,心肾组织中PI3K、Akt、NF-κB p65蛋白磷酸化水平均显著升高(P<0.05),LVEF、IVRT、EDV均显著降低(P<0.05)。与模型组比较,槲皮素低、高剂量组大鼠上述指标均显著改善(P<0.05),且高剂量组的改善效果更好(P<0.05)。740Y-P逆转了高剂量槲皮素对各指标的改善作用(P<0.05)。结论 槲皮素可减轻CRS大鼠心肾纤维化和功能损伤,其作用机制可能与抑制PI3K/Akt/NF-κB信号通路激活有关。