Throughout the last decade, the use of energy drinks has been increasingly looked upon with caution as potentially dangerous due to their perceived strong concentration of caffeine aside from other substances such as ...Throughout the last decade, the use of energy drinks has been increasingly looked upon with caution as potentially dangerous due to their perceived strong concentration of caffeine aside from other substances such as taurine, guarana, and L-carnitine that are largely unknown to the general public. In addition, a large number of energy drink intoxications have been reported all over the world including cases of seizures and arrhythmias. In this paper, we focus on the effect of energy drinks on the cardiovascular system and whether the current ongoing call for the products' sales and regulation of their contents should continue.展开更多
Chromatographic behavior of co-eluted compounds from un-extracted drug-free plasma samples was studied by LC-MS and LC-MS/MS with positive APCI.Under soft gradient,total ion chromatogram（TIC） consisted of two major ...Chromatographic behavior of co-eluted compounds from un-extracted drug-free plasma samples was studied by LC-MS and LC-MS/MS with positive APCI.Under soft gradient,total ion chromatogram（TIC） consisted of two major peaks separated by a constant lower intensity region.Early peak（0.15-0.4 min） belongs to polar plasma compounds and consisted of smaller mass ions（m/z〈 250）;late peak（3.6-4.6 min） belongs to thermally unstable phospholipids and consisted of fragments with mlz〈300.Late peak is more sensitive to variations in chromatographic and MS parameters.Screening of most targeted cardiovascular drugs at levels lower than 50 ng/mL has been possible by LC-MS for drugs with retention factors larger than three.Matrix effects and recovery,at 20 and 200 ng/mL,were evaluated for spiked plasma samples with 15 cardiovascular drugs,by MRM-LC-MS/MS.Average recoveries were above 90%and matrix effects expressed as percent matrix factor（%MF） were above 100%,indicating enhancement character for APCI.Large uncertainties were significant for drugs with smaller masses（m/z〈 250） and retention factors lower than two.展开更多
BACKGROUND Chronic heart failure(CHF)is a complex syndrome characterized by a progressive reduction of the left ventricular(LV)contractility,low exercise tolerance,and increased mortality and morbidity.Diastolic dysfu...BACKGROUND Chronic heart failure(CHF)is a complex syndrome characterized by a progressive reduction of the left ventricular(LV)contractility,low exercise tolerance,and increased mortality and morbidity.Diastolic dysfunction(DD)of the LV,is a keystone in the pathophysiology of CHF and plays a major role in the progression of most cardiac diseases.Also,it is well estimated that exercise training induces several beneficial effects on patients with CHF.AIM To evaluate the impact of a cardiac rehabilitation program on the DD and LV ejection fraction(EF)in patients with CHF.METHODS Thirty-two stable patients with CHF(age:56±10 years,EF:32%±8%,88%men)participated in an exercise rehabilitation program.They were randomly assigned to aerobic exercise(AER)or combined aerobic and strength training(COM),based on age and peak oxygen uptake,as stratified randomization criteria.Before and after the program,they underwent a symptom-limited maximal cardiopulmonary exercise testing(CPET)and serial echocardiography evaluation to evaluate peak oxygen uptake(VO2peak),peak workload(Wpeak),DD grade,right ventricular systolic pressure(RVSP),and EF.RESULTS The whole cohort improved VO2peak,and Wpeak,as well as DD grade(P<0.05).Overall,9 patients(28.1%)improved DD grade,while 23(71.9%)remained at the same DD grade;this was a significant difference,considering DD grade at baseline(P<0.05).In addition,the whole cohort improved RVSP and EF(P<0.05).Not any between-group differences were observed in the variables assessed(P>0.05).CONCLUSION Exercise rehabilitation improves indices of diastolic and systolic dysfunction.Exercise protocol was not observed to affect outcomes.These results need to be further investigated in larger samples.展开更多
目的探究达格列净联合常规治疗对2型糖尿病伴心力衰竭患者的心血管保护作用及对血清炎症因子和可溶性生长刺激表达基因2(sST2)水平的影响。方法前瞻性选取2020年9月至2022年8月江苏省昆山市第一人民医院收治的86例2型糖尿病伴心力衰竭...目的探究达格列净联合常规治疗对2型糖尿病伴心力衰竭患者的心血管保护作用及对血清炎症因子和可溶性生长刺激表达基因2(sST2)水平的影响。方法前瞻性选取2020年9月至2022年8月江苏省昆山市第一人民医院收治的86例2型糖尿病伴心力衰竭患者为研究对象,按随机数字表法分为对照组和观察组,各43例。对照组予以常规治疗降糖及抗心力衰竭治疗,观察组在对照组基础上增加达格列净治疗。比较两组治疗前、治疗6个月后的血糖[糖化血红蛋白(HbA1c)、空腹血糖、餐后2 h血糖(2 h PG)]、血脂[总胆固醇、甘油三酯、低密度脂蛋白胆固醇(LDL-C)]、心功能[左心室射血分数(LVEF)、血浆N端脑钠肽前体(NT-proBNP)、6 min步行试验(6MWT)]、血清指标[白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、sST2]水平及心血管事件及不良反应发生率。结果治疗6个月后,观察组的HbA1c、空腹血糖、2 h PG、总胆固醇、甘油三酯、LDL-C水平分别为(6.65±0.73)%、(6.25±1.54)mmol/L、(7.88±1.35)mmol/L、(3.87±0.85)mmol/L、(1.52±0.46)mmol/L、(2.41±0.63)mmol/L,均明显低于对照组[(7.07±0.85)%、(7.16±1.49)mmol/L、(8.82±1.48)mmol/L、(4.24±0.82)mmol/L、(1.73±0.51)mmol/L、(2.69±0.61)mmol/L],差异均有统计学意义(P<0.05)。治疗6个月后,观察组的LVEF、6MWT水平分别为(52.28±3.43)%、(424.87±72.58)m,均明显高于对照组[(50.79±3.25)%、(367.52±74.43)m],血浆NT-proBNP水平为(1778.65±224.37)pg/mL,低于对照组[(2943.41±256.22)pg/mL],差异均有统计学意义(P<0.05)。治疗6个月后,观察组的血清IL-1β、TNF-α、sST2水平分别为(6.60±1.14)pg/mL、(22.15±4.30)ng/L、(0.42±0.13)g/L,均明显低于对照组[(7.19±1.39)pg/mL、(29.68±5.24)ng/L、(0.50±0.16)g/L],差异均有统计学意义(P<0.05)。观察组心血管事件总发生率为9.30%,低于对照组(25.58%),差异有统计学意义(P<0.05)。两组均无严重不良反应发生。结论在使用常规降糖、抗心力衰竭治疗2型糖尿病伴心力衰竭患者基础上增加达格列净可有效降低其血糖、血脂及血清IL-1β、TNF-α、sST2水平,减少心血管事件的发生,具有一定心血管保护作用。展开更多
目的应用序贯法探讨丙泊酚或不同剂量瑞马唑仑对舒芬太尼抑制老年患者气管插管反应的半数有效剂量(50%effective dose,ED_(50))的影响。方法选择2022年10至12月在气管插管全身麻醉下接受择期手术的老年患者,美国麻醉医师协会(American S...目的应用序贯法探讨丙泊酚或不同剂量瑞马唑仑对舒芬太尼抑制老年患者气管插管反应的半数有效剂量(50%effective dose,ED_(50))的影响。方法选择2022年10至12月在气管插管全身麻醉下接受择期手术的老年患者,美国麻醉医师协会(American Society of Anesthesiologists,ASA)分级Ⅰ、Ⅱ级,年龄65~80岁,将患者采用随机数字表法分为4组:丙泊酚组(P组,诱导时给予丙泊酚2mg/kg)和瑞马唑仑组(R1、R2、R3组,诱导时分别静脉注射瑞马唑仑0.2、0.3、0.4mg/kg)。麻醉诱导时给予Dixon序贯法设定剂量的舒芬太尼后,静脉注射丙泊酚或相应剂量瑞马唑仑及顺式阿曲库铵0.15mg/kg,待4个成串刺激(train of four,TOF)计数为0时行气管插管。若气管插管反应阳性,则下一例患者舒芬太尼剂量提高1个浓度梯度,否则降低1个浓度梯度,各相邻浓度之间的比为1∶1.1,直至出现7个转折点终止研究。采用Probit回归分析计算舒芬太尼抑制老年患者气管插管反应ED_(50)和95%有效剂量(95%effective dose,ED_(95))以及相应的95%置信区间(confidenceinterval,CI)。记录所有患者低血压、心动过缓、注射痛等不良反应的发生情况。结果本研究共纳入老年患者113例,P、R1、R2、R3组分别24、28、30、31例。丙泊酚2mg/kg或0.2、0.3、0.4mg/kg瑞马唑仑时舒芬太尼抑制老年患者气管插管反应的ED_(50)和ED_(95)及相应95%CI分别为:P组ED_(50)为0.236μg/kg(95%CI:0.218~0.256),ED_(95)为0.266μg/kg(95%CI:0.250~0.398);R1组ED_(50)为0.284μg/kg(95%CI:0.265~0.309),ED_(95)为0.329μg/kg(95%CI:0.306~0.478);R2组ED_(50)为0.239μg/kg(95%CI:0.221~0.260),ED_(95)为0.282μg/kg(95%CI:0.261~0.415);R3组ED_(50)为0.198μg/kg(95%CI:0.182~0.211),ED_(95)为0.231μg/kg(95%CI:0.216~0.303)。与P组相比,R1、R2、R3组低血压、心动过缓、注射痛发生率较低(P<0.05)。R2组舒芬太尼ED_(50)与P组相类似,但低血压、注射痛发生率与P组相比较低。结论随着瑞马唑仑剂量的增加,舒芬太尼抑制老年患者气管插管反应的ED_(50)逐渐降低;在ED_(50)相近的情况下,瑞马唑仑相较于丙泊酚诱导的低血压、心动过缓、注射痛发生率更低,因而在老年患者气管插管全身麻醉中,使用瑞马唑仑诱导更具有优势。展开更多
Objective:To investigate the effects of low dose tibolone short-term therapy on clinic, endocrine and markers of cardiovascular disease in healthy postmenopausal women.Methods: A prospective study involved a total of ...Objective:To investigate the effects of low dose tibolone short-term therapy on clinic, endocrine and markers of cardiovascular disease in healthy postmenopausal women.Methods: A prospective study involved a total of 42 eligible postmenopausal women. 22 cases as group A and 20 cases as group B. Complete baseline work-up including Kupperman score,body mass index (BMI), gonadotropin (FSH, LH), estrogen (E2), testosterone (T), sex hormone binding globulin (SHBG), plasminogen activator inhibitor type 1 (PAI-1), tissue plasminogen activator (tPA), high-sensitivity C-response protein (hs-CRP), nitrogen oxide (NO)and fasting lipid, glucose(FPG), insulin(FINS) were performed in all subjects. Postmenopausal women in group A were treated with 1.25 mg tibolone daily. Women in group B were treated with 0. 625 mg tibolone daily. Women both in group A and group B were given calcium 600 mg with vitamin D 125IU per day. At the end of the 12-weeks therapy, subjects were re-evaluated and above parameters were measured.Results:No significant differences between group A and group B were found at baseline.Twenty-eight cases (fourteen cases in each group) completed the study. Kupperman score decreased from (22.1±8.0) and (25.4±7.5) to (7.7±4.5) and (5.2±4.5) and plasminogen activator inhibitor type 1 decreased from (95.8±32.4)μg/L and (102.9±42.6)μg/L to (72.2±39.6)μg/L and (79.9±30. 1) μg/L significantly in group A and group B respectively after treatment. In group A, Blood pressure decreased significantly from (120 ± 10)/(83 ± 6) mmHg to (110±14)/(77± 9) mmHg (P＜0.05), testosterone increased significantly from (0. 6 ±0. 4)nmol/L to (1.3 ± 1.1) nmol/L (P＜0. 05), free testosterone increased from (0. 001 ±0. 002)nmol/L to (0. 003±0. 003) nmol/L significantly (P＜0.01), SHBG decreased from (7.6±4. 9)nmol/L to (4. 3±2.9) nmol/L significantly (P＜0.05), total cholesterol decreased from (5.4±0. 8) mmol/L to (5.0±0.8) mmol/L significantly (P＜0.01), ApoA decreased from (1.8±0.3)mg/dl to (1.7±0. 3) mg/dl significantly (P＜0.05), fasting glucose decreased from (5. 6±0.8)mmol/L to (3.9±1.1) mmol/L significantly (P＜0.01) and no significant differences in BMI,FSH, LH, E2, tPA, hs-CRP, NO, TG, HDL-C, LDL-C, apoB were found after treatment. In group B, there were no significant differences in other parameters found after treatment except Kupperman score and PAI-1.Conclusions: 1.25 mg/d tibolone short-term therapy was associated with improved fibrinolytic factors and decreased Kupperman score, blood pressure, total cholesterol and fasting blood glucose level. 0. 625 mg/d tibolone therapy resulted in decrease Kupperman score and improvement of fibrinolytic factors. These changes relieve climacteric symptoms and may have some benefits on preventing the development of cardiovascular disease. An increased testosterone and free testosterone levels in 1.25 mg dose of tibolone therapy may increase energy level, general wellbeing and sexual desire in postmenopausal women. Low dose tibolone replacement therapy is a convenient effective HRT for postmenopausal展开更多
AIM: To evaluate the long-term risk of gastroduodenal ulcer and cardiovascular events induced by celecoxib in a population-based, randomized, double-blind, placebo-controlled study.METHODS: From 2004 to 2006, a total ...AIM: To evaluate the long-term risk of gastroduodenal ulcer and cardiovascular events induced by celecoxib in a population-based, randomized, double-blind, placebo-controlled study.METHODS: From 2004 to 2006, a total of 1024 Chinese patients (aged 35 to 64 years) with severe chronic atrophic gastritis, intestinal metaplasia or dysplasia were randomly assigned to receive 200 mg of celecoxib twice daily or placebo in Linqu County (Shandong Province, China), a high-risk area of gastric cancer. All gastroduodenal ulcer and cardiovascular events occurred were recorded and the patients were followed up for 1.5 years after treatment. At the end of the trial, a systematic interview survey about other adverse events was conducted. RESULTS: Gastroduodenal ulcer was detected in 19 of 463 (3.72%) patients who received celecoxib and 17 of 473 (3.31%) patients who received placebo, respectively (odds ratio = 1.13, 95% CI = 0.58-2.19). Cardiovascular (CV) events occurred in 4 patients who received celecoxib and in 5 patients who received placebo, respectively. Compared with those who received placebo, patients who received celecoxib had no signif icant increase in occurrence of CV events (hazard ratio = 0.84, 95% CI = 0.23-3.15). Among the adverse events acquired by interview survey, only the frequency of bloating was signif icantly higher in patients treated with celecoxib than in those treated with placebo. CONCLUSION: Treatment of gastric cancer with celecoxib is not associated with increased risk of gastroduodenal ulcer and cardiovascular events.展开更多
Objective To discuss the cardiac toxicities of a heat waves and ozone exposure on cardiovascular diseases（CVDs） and explore a possible mechanism. Methods The incidence of ozone exposure combined with heat wave was s...Objective To discuss the cardiac toxicities of a heat waves and ozone exposure on cardiovascular diseases（CVDs） and explore a possible mechanism. Methods The incidence of ozone exposure combined with heat wave was simulated in the Shanghai Meteorological and Environmental Animal Exposure System（Shanghai-METAS）. A total of 64 Apo E-/-mice, matched by weight, were randomly divided into 8 groups and exposed to heat wave conditions or ozone. The levels of creatine kinase（CK）, D-lactate dehydrogenase（D-LDH）, intercellular adhesion molecule 1（sICAM-1）, tumor necrosis factor alpha（TNF-α）, nitric oxide（NO）, endothelin-1（ET-1）, D-dimer（D2 D）, plasminogen activator inhibitor-1（PAI-1） and blood lipid in plasma and heat shock protein-60（HSP60）, hypoxia inducible factor 1 alpha（HIF-1α）, interleukin-6（IL-6）, C-reactive protein（CRP）, superoxide dismutase（SOD）, and malondialdehyde（MDA） in hearts were measured after exposure. Results The levels of all indicators, except for SOD, increased with the ozone-only exposure. However, cardiac damage was most significant when the heat wave conditions were combined with severe ozone exposure. Moreover, the levels of CK, D-LDH, NO, PAI-1, sICAM-1, and TNF-α in plasma increased significantly（P 〈 0.05）, and the contents of HSP60, HIF-1α, CRP, and MDA in hearts increased considerably（P 〈 0.05）, but the activity of SOD decreased significantly. In addition, the levels of four blood lipid items remarkably increased（except the level of HDL-C which decreased significantly） with ozone exposure. Conclusion A short-term exposure to a heat wave and ozone causes severe toxic effects on the heart. Cardiac damage was most significant under combined heat wave and severe ozone exposure simulations.展开更多
We present a novel methodology and strategy to predict pressures and flow rates in the global cardiovascular network in different postures varying from supine to upright. A closed-loop, multiscale mathematical model o...We present a novel methodology and strategy to predict pressures and flow rates in the global cardiovascular network in different postures varying from supine to upright. A closed-loop, multiscale mathematical model of the entire cardiovascular system (CVS) is developed through an integration of one-dimensional (1D) modeling of the large systemic arteries and veins, and zero-dimensional (0D) lumped-parameter modeling of the heart, the cardiac-pulmonary circulation, the cardiac and venous valves, as well as the microcirculation. A versatile junction model is proposed and incorporated into the 1D model to cope with splitting and/or merging flows across a multibranched junction, which is validated to be capable of estimating both subcritical and supercritical flows while ensuring the mass conservation and total pressure continuity. To model gravitational effects on global hemodynamics during postural change, a robust venous valve model is further established for the 1D venous flows and distributed throughout the entire venous network with consideration of its anatomically realistic numbers and locations. The present integrated model is proven to enable reasonable prediction of pressure and flow rate waveforms associated with cardiopulmonary circulation, systemic circulation in arteries and veins, as well as microcirculation within normal physiological ranges, particularly in mean venous pressures, which well match the in vivo measurements. Applications of the cardiovascular model at different postures demonstrate that gravity exerts remarkable influence on arterial and venous pressures, venous returns and cardiac outputs whereas venous pressures below the heart level show a specific correlation between central venous and hydrostatic pressures in right atrium and veins.展开更多
文摘Throughout the last decade, the use of energy drinks has been increasingly looked upon with caution as potentially dangerous due to their perceived strong concentration of caffeine aside from other substances such as taurine, guarana, and L-carnitine that are largely unknown to the general public. In addition, a large number of energy drink intoxications have been reported all over the world including cases of seizures and arrhythmias. In this paper, we focus on the effect of energy drinks on the cardiovascular system and whether the current ongoing call for the products' sales and regulation of their contents should continue.
基金supported by Dean of Scientific Research at Jordan University of Science and Technology(JUST)(No.159/ 2012)
文摘Chromatographic behavior of co-eluted compounds from un-extracted drug-free plasma samples was studied by LC-MS and LC-MS/MS with positive APCI.Under soft gradient,total ion chromatogram（TIC） consisted of two major peaks separated by a constant lower intensity region.Early peak（0.15-0.4 min） belongs to polar plasma compounds and consisted of smaller mass ions（m/z〈 250）;late peak（3.6-4.6 min） belongs to thermally unstable phospholipids and consisted of fragments with mlz〈300.Late peak is more sensitive to variations in chromatographic and MS parameters.Screening of most targeted cardiovascular drugs at levels lower than 50 ng/mL has been possible by LC-MS for drugs with retention factors larger than three.Matrix effects and recovery,at 20 and 200 ng/mL,were evaluated for spiked plasma samples with 15 cardiovascular drugs,by MRM-LC-MS/MS.Average recoveries were above 90%and matrix effects expressed as percent matrix factor（%MF） were above 100%,indicating enhancement character for APCI.Large uncertainties were significant for drugs with smaller masses（m/z〈 250） and retention factors lower than two.
文摘BACKGROUND Chronic heart failure(CHF)is a complex syndrome characterized by a progressive reduction of the left ventricular(LV)contractility,low exercise tolerance,and increased mortality and morbidity.Diastolic dysfunction(DD)of the LV,is a keystone in the pathophysiology of CHF and plays a major role in the progression of most cardiac diseases.Also,it is well estimated that exercise training induces several beneficial effects on patients with CHF.AIM To evaluate the impact of a cardiac rehabilitation program on the DD and LV ejection fraction(EF)in patients with CHF.METHODS Thirty-two stable patients with CHF(age:56±10 years,EF:32%±8%,88%men)participated in an exercise rehabilitation program.They were randomly assigned to aerobic exercise(AER)or combined aerobic and strength training(COM),based on age and peak oxygen uptake,as stratified randomization criteria.Before and after the program,they underwent a symptom-limited maximal cardiopulmonary exercise testing(CPET)and serial echocardiography evaluation to evaluate peak oxygen uptake(VO2peak),peak workload(Wpeak),DD grade,right ventricular systolic pressure(RVSP),and EF.RESULTS The whole cohort improved VO2peak,and Wpeak,as well as DD grade(P<0.05).Overall,9 patients(28.1%)improved DD grade,while 23(71.9%)remained at the same DD grade;this was a significant difference,considering DD grade at baseline(P<0.05).In addition,the whole cohort improved RVSP and EF(P<0.05).Not any between-group differences were observed in the variables assessed(P>0.05).CONCLUSION Exercise rehabilitation improves indices of diastolic and systolic dysfunction.Exercise protocol was not observed to affect outcomes.These results need to be further investigated in larger samples.
文摘目的探究达格列净联合常规治疗对2型糖尿病伴心力衰竭患者的心血管保护作用及对血清炎症因子和可溶性生长刺激表达基因2(sST2)水平的影响。方法前瞻性选取2020年9月至2022年8月江苏省昆山市第一人民医院收治的86例2型糖尿病伴心力衰竭患者为研究对象,按随机数字表法分为对照组和观察组,各43例。对照组予以常规治疗降糖及抗心力衰竭治疗,观察组在对照组基础上增加达格列净治疗。比较两组治疗前、治疗6个月后的血糖[糖化血红蛋白(HbA1c)、空腹血糖、餐后2 h血糖(2 h PG)]、血脂[总胆固醇、甘油三酯、低密度脂蛋白胆固醇(LDL-C)]、心功能[左心室射血分数(LVEF)、血浆N端脑钠肽前体(NT-proBNP)、6 min步行试验(6MWT)]、血清指标[白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、sST2]水平及心血管事件及不良反应发生率。结果治疗6个月后,观察组的HbA1c、空腹血糖、2 h PG、总胆固醇、甘油三酯、LDL-C水平分别为(6.65±0.73)%、(6.25±1.54)mmol/L、(7.88±1.35)mmol/L、(3.87±0.85)mmol/L、(1.52±0.46)mmol/L、(2.41±0.63)mmol/L,均明显低于对照组[(7.07±0.85)%、(7.16±1.49)mmol/L、(8.82±1.48)mmol/L、(4.24±0.82)mmol/L、(1.73±0.51)mmol/L、(2.69±0.61)mmol/L],差异均有统计学意义(P<0.05)。治疗6个月后,观察组的LVEF、6MWT水平分别为(52.28±3.43)%、(424.87±72.58)m,均明显高于对照组[(50.79±3.25)%、(367.52±74.43)m],血浆NT-proBNP水平为(1778.65±224.37)pg/mL,低于对照组[(2943.41±256.22)pg/mL],差异均有统计学意义(P<0.05)。治疗6个月后,观察组的血清IL-1β、TNF-α、sST2水平分别为(6.60±1.14)pg/mL、(22.15±4.30)ng/L、(0.42±0.13)g/L,均明显低于对照组[(7.19±1.39)pg/mL、(29.68±5.24)ng/L、(0.50±0.16)g/L],差异均有统计学意义(P<0.05)。观察组心血管事件总发生率为9.30%,低于对照组(25.58%),差异有统计学意义(P<0.05)。两组均无严重不良反应发生。结论在使用常规降糖、抗心力衰竭治疗2型糖尿病伴心力衰竭患者基础上增加达格列净可有效降低其血糖、血脂及血清IL-1β、TNF-α、sST2水平,减少心血管事件的发生,具有一定心血管保护作用。
文摘目的应用序贯法探讨丙泊酚或不同剂量瑞马唑仑对舒芬太尼抑制老年患者气管插管反应的半数有效剂量(50%effective dose,ED_(50))的影响。方法选择2022年10至12月在气管插管全身麻醉下接受择期手术的老年患者,美国麻醉医师协会(American Society of Anesthesiologists,ASA)分级Ⅰ、Ⅱ级,年龄65~80岁,将患者采用随机数字表法分为4组:丙泊酚组(P组,诱导时给予丙泊酚2mg/kg)和瑞马唑仑组(R1、R2、R3组,诱导时分别静脉注射瑞马唑仑0.2、0.3、0.4mg/kg)。麻醉诱导时给予Dixon序贯法设定剂量的舒芬太尼后,静脉注射丙泊酚或相应剂量瑞马唑仑及顺式阿曲库铵0.15mg/kg,待4个成串刺激(train of four,TOF)计数为0时行气管插管。若气管插管反应阳性,则下一例患者舒芬太尼剂量提高1个浓度梯度,否则降低1个浓度梯度,各相邻浓度之间的比为1∶1.1,直至出现7个转折点终止研究。采用Probit回归分析计算舒芬太尼抑制老年患者气管插管反应ED_(50)和95%有效剂量(95%effective dose,ED_(95))以及相应的95%置信区间(confidenceinterval,CI)。记录所有患者低血压、心动过缓、注射痛等不良反应的发生情况。结果本研究共纳入老年患者113例,P、R1、R2、R3组分别24、28、30、31例。丙泊酚2mg/kg或0.2、0.3、0.4mg/kg瑞马唑仑时舒芬太尼抑制老年患者气管插管反应的ED_(50)和ED_(95)及相应95%CI分别为:P组ED_(50)为0.236μg/kg(95%CI:0.218~0.256),ED_(95)为0.266μg/kg(95%CI:0.250~0.398);R1组ED_(50)为0.284μg/kg(95%CI:0.265~0.309),ED_(95)为0.329μg/kg(95%CI:0.306~0.478);R2组ED_(50)为0.239μg/kg(95%CI:0.221~0.260),ED_(95)为0.282μg/kg(95%CI:0.261~0.415);R3组ED_(50)为0.198μg/kg(95%CI:0.182~0.211),ED_(95)为0.231μg/kg(95%CI:0.216~0.303)。与P组相比,R1、R2、R3组低血压、心动过缓、注射痛发生率较低(P<0.05)。R2组舒芬太尼ED_(50)与P组相类似,但低血压、注射痛发生率与P组相比较低。结论随着瑞马唑仑剂量的增加,舒芬太尼抑制老年患者气管插管反应的ED_(50)逐渐降低;在ED_(50)相近的情况下,瑞马唑仑相较于丙泊酚诱导的低血压、心动过缓、注射痛发生率更低,因而在老年患者气管插管全身麻醉中,使用瑞马唑仑诱导更具有优势。
文摘Objective:To investigate the effects of low dose tibolone short-term therapy on clinic, endocrine and markers of cardiovascular disease in healthy postmenopausal women.Methods: A prospective study involved a total of 42 eligible postmenopausal women. 22 cases as group A and 20 cases as group B. Complete baseline work-up including Kupperman score,body mass index (BMI), gonadotropin (FSH, LH), estrogen (E2), testosterone (T), sex hormone binding globulin (SHBG), plasminogen activator inhibitor type 1 (PAI-1), tissue plasminogen activator (tPA), high-sensitivity C-response protein (hs-CRP), nitrogen oxide (NO)and fasting lipid, glucose(FPG), insulin(FINS) were performed in all subjects. Postmenopausal women in group A were treated with 1.25 mg tibolone daily. Women in group B were treated with 0. 625 mg tibolone daily. Women both in group A and group B were given calcium 600 mg with vitamin D 125IU per day. At the end of the 12-weeks therapy, subjects were re-evaluated and above parameters were measured.Results:No significant differences between group A and group B were found at baseline.Twenty-eight cases (fourteen cases in each group) completed the study. Kupperman score decreased from (22.1±8.0) and (25.4±7.5) to (7.7±4.5) and (5.2±4.5) and plasminogen activator inhibitor type 1 decreased from (95.8±32.4)μg/L and (102.9±42.6)μg/L to (72.2±39.6)μg/L and (79.9±30. 1) μg/L significantly in group A and group B respectively after treatment. In group A, Blood pressure decreased significantly from (120 ± 10)/(83 ± 6) mmHg to (110±14)/(77± 9) mmHg (P＜0.05), testosterone increased significantly from (0. 6 ±0. 4)nmol/L to (1.3 ± 1.1) nmol/L (P＜0. 05), free testosterone increased from (0. 001 ±0. 002)nmol/L to (0. 003±0. 003) nmol/L significantly (P＜0.01), SHBG decreased from (7.6±4. 9)nmol/L to (4. 3±2.9) nmol/L significantly (P＜0.05), total cholesterol decreased from (5.4±0. 8) mmol/L to (5.0±0.8) mmol/L significantly (P＜0.01), ApoA decreased from (1.8±0.3)mg/dl to (1.7±0. 3) mg/dl significantly (P＜0.05), fasting glucose decreased from (5. 6±0.8)mmol/L to (3.9±1.1) mmol/L significantly (P＜0.01) and no significant differences in BMI,FSH, LH, E2, tPA, hs-CRP, NO, TG, HDL-C, LDL-C, apoB were found after treatment. In group B, there were no significant differences in other parameters found after treatment except Kupperman score and PAI-1.Conclusions: 1.25 mg/d tibolone short-term therapy was associated with improved fibrinolytic factors and decreased Kupperman score, blood pressure, total cholesterol and fasting blood glucose level. 0. 625 mg/d tibolone therapy resulted in decrease Kupperman score and improvement of fibrinolytic factors. These changes relieve climacteric symptoms and may have some benefits on preventing the development of cardiovascular disease. An increased testosterone and free testosterone levels in 1.25 mg dose of tibolone therapy may increase energy level, general wellbeing and sexual desire in postmenopausal women. Low dose tibolone replacement therapy is a convenient effective HRT for postmenopausal
基金(in part) Grants from National High Technology R&D Program (No. 2002BA711A06) National "211" Project in Peking University 529 and 533, Beijing Municipal Commission of Science and Technology (No. H209-20030130)+1 种基金 National Natural Science Foundation of China (No. 30471957)Research Grant Council Earmarked Grant (HKU 7256/01M) of the Hong Kong Special Administration Region, and Research Grant from Peking University School of Oncology, Beijing Cancer Hospital & Institute, China
文摘AIM: To evaluate the long-term risk of gastroduodenal ulcer and cardiovascular events induced by celecoxib in a population-based, randomized, double-blind, placebo-controlled study.METHODS: From 2004 to 2006, a total of 1024 Chinese patients (aged 35 to 64 years) with severe chronic atrophic gastritis, intestinal metaplasia or dysplasia were randomly assigned to receive 200 mg of celecoxib twice daily or placebo in Linqu County (Shandong Province, China), a high-risk area of gastric cancer. All gastroduodenal ulcer and cardiovascular events occurred were recorded and the patients were followed up for 1.5 years after treatment. At the end of the trial, a systematic interview survey about other adverse events was conducted. RESULTS: Gastroduodenal ulcer was detected in 19 of 463 (3.72%) patients who received celecoxib and 17 of 473 (3.31%) patients who received placebo, respectively (odds ratio = 1.13, 95% CI = 0.58-2.19). Cardiovascular (CV) events occurred in 4 patients who received celecoxib and in 5 patients who received placebo, respectively. Compared with those who received placebo, patients who received celecoxib had no signif icant increase in occurrence of CV events (hazard ratio = 0.84, 95% CI = 0.23-3.15). Among the adverse events acquired by interview survey, only the frequency of bloating was signif icantly higher in patients treated with celecoxib than in those treated with placebo. CONCLUSION: Treatment of gastric cancer with celecoxib is not associated with increased risk of gastroduodenal ulcer and cardiovascular events.
基金supported by the National Natural Science Foundation of China [Grant No.41375121]the Key Research Plan of Hebei Province,China [Grant No.18273705D]
文摘Objective To discuss the cardiac toxicities of a heat waves and ozone exposure on cardiovascular diseases（CVDs） and explore a possible mechanism. Methods The incidence of ozone exposure combined with heat wave was simulated in the Shanghai Meteorological and Environmental Animal Exposure System（Shanghai-METAS）. A total of 64 Apo E-/-mice, matched by weight, were randomly divided into 8 groups and exposed to heat wave conditions or ozone. The levels of creatine kinase（CK）, D-lactate dehydrogenase（D-LDH）, intercellular adhesion molecule 1（sICAM-1）, tumor necrosis factor alpha（TNF-α）, nitric oxide（NO）, endothelin-1（ET-1）, D-dimer（D2 D）, plasminogen activator inhibitor-1（PAI-1） and blood lipid in plasma and heat shock protein-60（HSP60）, hypoxia inducible factor 1 alpha（HIF-1α）, interleukin-6（IL-6）, C-reactive protein（CRP）, superoxide dismutase（SOD）, and malondialdehyde（MDA） in hearts were measured after exposure. Results The levels of all indicators, except for SOD, increased with the ozone-only exposure. However, cardiac damage was most significant when the heat wave conditions were combined with severe ozone exposure. Moreover, the levels of CK, D-LDH, NO, PAI-1, sICAM-1, and TNF-α in plasma increased significantly（P 〈 0.05）, and the contents of HSP60, HIF-1α, CRP, and MDA in hearts increased considerably（P 〈 0.05）, but the activity of SOD decreased significantly. In addition, the levels of four blood lipid items remarkably increased（except the level of HDL-C which decreased significantly） with ozone exposure. Conclusion A short-term exposure to a heat wave and ozone causes severe toxic effects on the heart. Cardiac damage was most significant under combined heat wave and severe ozone exposure simulations.
基金supported by a Grant-in-Aid for Scientific Research (Grant 17300141)Japan Society for the Promotion of Science and Research and Development of the Next Generation Integrated Simulation of Living Matter, JST,a part of the Development and Use of the Next Generation Supercomputer Project of the Ministry of Education, Culture, Sports, Science and Technology (MEXT), Japanthe RIKEN Junior Research Associate Program
文摘We present a novel methodology and strategy to predict pressures and flow rates in the global cardiovascular network in different postures varying from supine to upright. A closed-loop, multiscale mathematical model of the entire cardiovascular system (CVS) is developed through an integration of one-dimensional (1D) modeling of the large systemic arteries and veins, and zero-dimensional (0D) lumped-parameter modeling of the heart, the cardiac-pulmonary circulation, the cardiac and venous valves, as well as the microcirculation. A versatile junction model is proposed and incorporated into the 1D model to cope with splitting and/or merging flows across a multibranched junction, which is validated to be capable of estimating both subcritical and supercritical flows while ensuring the mass conservation and total pressure continuity. To model gravitational effects on global hemodynamics during postural change, a robust venous valve model is further established for the 1D venous flows and distributed throughout the entire venous network with consideration of its anatomically realistic numbers and locations. The present integrated model is proven to enable reasonable prediction of pressure and flow rate waveforms associated with cardiopulmonary circulation, systemic circulation in arteries and veins, as well as microcirculation within normal physiological ranges, particularly in mean venous pressures, which well match the in vivo measurements. Applications of the cardiovascular model at different postures demonstrate that gravity exerts remarkable influence on arterial and venous pressures, venous returns and cardiac outputs whereas venous pressures below the heart level show a specific correlation between central venous and hydrostatic pressures in right atrium and veins.
