Objective To investigate whether admission time was associated with the delay of reperfusion therapy and in-hospital death in patients with ST-elevation myocardial infarction （STEMI）. Methods All patients with STEMI...Objective To investigate whether admission time was associated with the delay of reperfusion therapy and in-hospital death in patients with ST-elevation myocardial infarction （STEMI）. Methods All patients with STEMI who were admitted to the emergency depart- ment and underwent primary percutaneous coronary intervention at Peking University People＇s Hospital between April 2012 and March 2015 were included. We examined differences in clinical characteristics, total ischemic time, and in-hospital death between patients admitted during off-hours and those admitted during regular hours. Multivariate logistic regression was used to estimate the relationship between off-hours admission and clinical outcome. Results The sample comprised 184 and 105 patients with STEMI admitted to hospital during off-hours and regular hours, respectively. Total ischemic and onset-to-door times were significantly shorter in patients admitted during off-hours than among those admitted during regular hours （all P 〈 0.05）. Door-to-balloon （DTB） time, the rate of DTB time 〈 90 min, and in-hospital death were comparable between groups. Multivariate logistic regression showed that age and creatinine level, but not off-hours admission, were associated independently with increased in-hospital death. Conclusions Off-hours admission did not result in delayed reperfusion therapy or increased in-hospital mortality in patients with STEMI. Further efforts should focus on identifying pivotal factors associated with the pre-hospital and in-hospital delay of reperfusion therapy, and implementing quality improvement initiatives for reperfusion programs.展开更多
AIM To investigate the incidence and mortality rates of upper gastrointestinal cancer(UGIC) in Hebei Province, China, and to identify high-risk populations to improve UGIC prevention and control.METHODS Data for UGIC ...AIM To investigate the incidence and mortality rates of upper gastrointestinal cancer(UGIC) in Hebei Province, China, and to identify high-risk populations to improve UGIC prevention and control.METHODS Data for UGIC patients were collected from 21 population-based cancer registries covering 15.25% of the population in Hebei Province. Mortality data were extracted from three national retrospective death surveys(1973-1975, 1990-1992 and 2004-2005). The data were stratified by 5-year age groups, gender and area(high-risk/non-high-risk areas) for analysis. The age-period-cohort and grey system model were used.RESULTS The crude incidence rate of UGIC was 55.47/100000, and the adjusted rate(Segi's population) was 44.90/100000. Males in rural areas had the highest incidence rate(world age-standardized rate = 87.89/100000). The crude mortality rate of UGIC displayed a decreasing trend in Hebei Province from the 1970 s to 2013, and the adjusted rate decreased by 43.81% from the 1970s(58.07/100000) to 2013(32.63/100000). The mortality rate declined more significantly in the high-risk areas(57.26%) than in the non-high-risk areas(55.02%) from the 1970 s to 2013. The median age at diagnosis of UGIC was 65.06 years in 2013. There was a notable delay in the median age at death from the 1970s(66.15 years) to 2013(70.39 years), especially in the high-risk areas. In Cixian, the total trend of the cohort effect declined, and people aged 65-69 years were a population at relatively high risk for UGIC. We predicted that the crude mortality rates of UGIC in Cixian and Shexian would decrease to 98.80 and 133.99 per 100000 in 2018, respectively.CONCLUSION UGIC was the major cause of cancer death in Hebei Province, and males in rural areas were a high-risk population. We should strengthen early detection and treatment of UGIC in this population.展开更多
The noninfarcted myocardium underwent significant electrophysiological remodelling as part of the healed myocardial infarction remodelling. This study aimed at investigating the effects of nervous growth factor （NGF...The noninfarcted myocardium underwent significant electrophysiological remodelling as part of the healed myocardial infarction remodelling. This study aimed at investigating the effects of nervous growth factor （NGF） on delayed afterdepolarizations （DADs） and triggered activity （TA） of the noninfarcted myocardium in the myocardial infarcted rabbit model. Rabbits with the left anterior descending coronary artery occlusion were prepared and recovered for 8 weeks （HMI group, n=9）. Other rabbits with myocardial infarction were infused NGF to the left stellate ganglion （HMI＋NGF group, 400 U/day for 8 weeks, n=8）. Myocytes were isolated from regions of the noninfarcted left ventricular free wall. Action potentials and ion currents were recorded with whole-cell patch clamp. The results showed that more DADs and TA events of HMI＋NGF myocytes than that of HMI and Ctrl group. Iti and ICa-L of NGF＋HMI myocytes were increased significantly compared with HMI and Ctrl cells, which contributed to DADs-related triggered arrhythmia. Comparing with HM1 and Ctrl myocytes, significant prolongations of APD50 and APD90 in HMI＋NGF myocytes were found. The results indicated the electrophysiological change of HMI myocytes with NGF infusion. It suggested that more events of DADs and TA in HMI myocytes with NGF treatment. The underlying mechanism may be involved in the increase of Iti and ICa-L.展开更多
Exergy is the ability of the maximum work done to the objective (relative) outside when the system changes from any state to its dead state. Exergy stems from the gaps of intensive properties between its present state...Exergy is the ability of the maximum work done to the objective (relative) outside when the system changes from any state to its dead state. Exergy stems from the gaps of intensive properties between its present state and its dead state. Generalized differential expression of exergy is advanced without any premise conditions, which is composed of generalized intensive and extensive (additive) properties. Any form of exergy can be deduced out from this generalized expression, only if its characteristic intensive and extensive parameters are known. That the exergy of any closed system is never below zero has been proved.展开更多
文摘Objective To investigate whether admission time was associated with the delay of reperfusion therapy and in-hospital death in patients with ST-elevation myocardial infarction （STEMI）. Methods All patients with STEMI who were admitted to the emergency depart- ment and underwent primary percutaneous coronary intervention at Peking University People＇s Hospital between April 2012 and March 2015 were included. We examined differences in clinical characteristics, total ischemic time, and in-hospital death between patients admitted during off-hours and those admitted during regular hours. Multivariate logistic regression was used to estimate the relationship between off-hours admission and clinical outcome. Results The sample comprised 184 and 105 patients with STEMI admitted to hospital during off-hours and regular hours, respectively. Total ischemic and onset-to-door times were significantly shorter in patients admitted during off-hours than among those admitted during regular hours （all P 〈 0.05）. Door-to-balloon （DTB） time, the rate of DTB time 〈 90 min, and in-hospital death were comparable between groups. Multivariate logistic regression showed that age and creatinine level, but not off-hours admission, were associated independently with increased in-hospital death. Conclusions Off-hours admission did not result in delayed reperfusion therapy or increased in-hospital mortality in patients with STEMI. Further efforts should focus on identifying pivotal factors associated with the pre-hospital and in-hospital delay of reperfusion therapy, and implementing quality improvement initiatives for reperfusion programs.
文摘AIM To investigate the incidence and mortality rates of upper gastrointestinal cancer(UGIC) in Hebei Province, China, and to identify high-risk populations to improve UGIC prevention and control.METHODS Data for UGIC patients were collected from 21 population-based cancer registries covering 15.25% of the population in Hebei Province. Mortality data were extracted from three national retrospective death surveys(1973-1975, 1990-1992 and 2004-2005). The data were stratified by 5-year age groups, gender and area(high-risk/non-high-risk areas) for analysis. The age-period-cohort and grey system model were used.RESULTS The crude incidence rate of UGIC was 55.47/100000, and the adjusted rate(Segi's population) was 44.90/100000. Males in rural areas had the highest incidence rate(world age-standardized rate = 87.89/100000). The crude mortality rate of UGIC displayed a decreasing trend in Hebei Province from the 1970 s to 2013, and the adjusted rate decreased by 43.81% from the 1970s(58.07/100000) to 2013(32.63/100000). The mortality rate declined more significantly in the high-risk areas(57.26%) than in the non-high-risk areas(55.02%) from the 1970 s to 2013. The median age at diagnosis of UGIC was 65.06 years in 2013. There was a notable delay in the median age at death from the 1970s(66.15 years) to 2013(70.39 years), especially in the high-risk areas. In Cixian, the total trend of the cohort effect declined, and people aged 65-69 years were a population at relatively high risk for UGIC. We predicted that the crude mortality rates of UGIC in Cixian and Shexian would decrease to 98.80 and 133.99 per 100000 in 2018, respectively.CONCLUSION UGIC was the major cause of cancer death in Hebei Province, and males in rural areas were a high-risk population. We should strengthen early detection and treatment of UGIC in this population.
基金Supported by the General Program of National Natural Science of China(30770901)
文摘The noninfarcted myocardium underwent significant electrophysiological remodelling as part of the healed myocardial infarction remodelling. This study aimed at investigating the effects of nervous growth factor （NGF） on delayed afterdepolarizations （DADs） and triggered activity （TA） of the noninfarcted myocardium in the myocardial infarcted rabbit model. Rabbits with the left anterior descending coronary artery occlusion were prepared and recovered for 8 weeks （HMI group, n=9）. Other rabbits with myocardial infarction were infused NGF to the left stellate ganglion （HMI＋NGF group, 400 U/day for 8 weeks, n=8）. Myocytes were isolated from regions of the noninfarcted left ventricular free wall. Action potentials and ion currents were recorded with whole-cell patch clamp. The results showed that more DADs and TA events of HMI＋NGF myocytes than that of HMI and Ctrl group. Iti and ICa-L of NGF＋HMI myocytes were increased significantly compared with HMI and Ctrl cells, which contributed to DADs-related triggered arrhythmia. Comparing with HM1 and Ctrl myocytes, significant prolongations of APD50 and APD90 in HMI＋NGF myocytes were found. The results indicated the electrophysiological change of HMI myocytes with NGF infusion. It suggested that more events of DADs and TA in HMI myocytes with NGF treatment. The underlying mechanism may be involved in the increase of Iti and ICa-L.
基金This work was supported by the National Major Basic Research Development Program ( Grant No. G2000026307).
文摘Exergy is the ability of the maximum work done to the objective (relative) outside when the system changes from any state to its dead state. Exergy stems from the gaps of intensive properties between its present state and its dead state. Generalized differential expression of exergy is advanced without any premise conditions, which is composed of generalized intensive and extensive (additive) properties. Any form of exergy can be deduced out from this generalized expression, only if its characteristic intensive and extensive parameters are known. That the exergy of any closed system is never below zero has been proved.
