Deep Neural Network Based Cardio Vascular Disease Prediction Using Binarized Butterfly Optimization

In this digital era,Cardio Vascular Disease(CVD)has become the lead-ing cause of death which has led to the mortality of 17.9 million lives each year.Earlier Diagnosis of the people who are at higher risk of CVDs helps them to receive proper treatment and helps prevent deaths.It becomes inevitable to pro-pose a solution to predict the CVD with high accuracy.A system for predicting Cardio Vascular Disease using Deep Neural Network with Binarized Butterfly Optimization Algorithm(DNN–BBoA)is proposed.The BBoA is incorporated to select the best features.The optimal features are fed to the deep neural network classifier and it improves prediction accuracy and reduces the time complexity.The usage of a deep neural network further helps to improve the prediction accu-racy with minimal complexity.The proposed system is tested with two datasets namely the Heart disease dataset from UCI repository and CVD dataset from Kag-gle Repository.The proposed work is compared with different machine learning classifiers such as Support Vector Machine,Random Forest,and Decision Tree Classifier.The accuracy of the proposed DNN–BBoA is 99.35%for the heart dis-ease data set from UCI repository yielding an accuracy of 80.98%for Kaggle repository for cardiovascular disease dataset.

Multi-target mechanism of triphala in cardio-cerebral vascular diseases based on network pharmacology

OBJECTIVE Numerous references made clear that triphala is revered as a multiuse therapeutic and perhaps even panacea historically.Nevertheless,the protective mechanism of triphala on cardio-cerebral vascular diseases(CCVDs)remains not comprehensive understanding.Hence,a network pharmacology-based method was suggested in this study to address this problem.METHODS This study was based on network pharmacology and bioinformatics analysis.Information on compounds in herbal medicines of triphala formula was acquired from public databases.Oral bioavailability as well as drug-likeness were screened by using absorption,distribution,metabolism,and excretion(ADME)criteria.Then,components of triphala,candidate targets of each component and known therapeutic targets of CCVDs were collected.Compound-target gene and compounds-CCVDs target networks were created through network pharmacology data sources.In addition,key targets and pathway enrichment were analyzed by STRING database and DAVID database.Moreover,we verified three of the key targets(PTGS2,MMP9 and IL-6)predicted by using Western blotting analysis.RESULTS Network analysis determined 132 compounds in three herbal medicines that were subjected to ADME screening,and 23 compounds as well as 65 genes formed the principal pathways linked to CCVDs.And 10 compounds,which actually linked to more than three genes,are determined as crucial chemicals.Core genes in this network were IL-6,TNF,VEGFA,PTGS2,CXCL8,TP53,CCL2,IL-10,MMP9 and SERPINE1.And pathways in cancer,TNF signaling path⁃way,neuroactive ligand-receptor interaction,etc.related to CCVDs were identified.In vitro experiments,the results indi⁃cated that compared with the control group(no treatment),PTGS2,MMP9 and IL-6 were up-regulated by treatment of 10μg·L^-1 TNF-α,while pretreatment with 20-80 mg·L^-1 triphala could significantly inhibit the expression of PTGS2,MMP9 and IL-6.With increasing Triphala concentration,the expression of PTGS2,MMP9 and IL-6 decreased.CON⁃CLUSION Complex components and pharmacological mechanism of triphala,and obtained some potential therapeutic targets of CCVDs,which could provide theoretical basis for the research and development of new drugs for treating CCVDs.

Cardio-Oncology: The Need of the Hour Subspeciality

There have been considerable advancements in cancer therapy in recent years. However, adverse effects often defeat the benefits, especially on the cardiovascular system. The effects of chemotherapeutic agents on the cardiovascular system can be directly on the heart by altering the coagulability state or by altering the hemodynamic system. Some drugs like Sunitinib and Bevacizumab show Heart Failure which is chemotherapy-induced. Other agents are notorious for showing QT prolongation like Vandetanib. Similarly, other agents with demonstrated cardiotoxicity would be molecular-targeted drugs (Trastuzumab and Pertuzumab) and cytostatic agents (Anthracycline antibiotics, Cyclophosphamide and 5-FU). These effects may present early or late, during or after the treatment. Most of the research has focused on the management and monitoring of patients for cancer who are under treatment, for example new biomarkers in the field of proteomics have been discovered for the diagnosis, treatment, and monitoring of patients. While the upgrades have been successful in reducing mortalities, with the advent of better treatment outcomes, the several adverse effects on the cardiac system cannot be dismissed. For instance, damage to the cardiomyocytes is most frequently associated with the treatment. The damage can further expedite LV failure, valvular dysfunction, conduction abnormalities, etc. Hence, a better management plan for patients with cancer would be one that not only caters to primary cancer treatment but also incorporates ventricular systolic function evaluation using echocardiography, electrocardiography, and cardiac biomarkers for the well-being of patients. Our article focuses on introducing an ideal cardio-oncology team along with the components required for setting up the team. This needs a multidisciplinary approach to reduce patients’ cardiovascular morbidity, during and after the interventions. With the growing population of patients undergoing cancer therapy, the risk of developing cardiovascular problems has further escalated. Hence, development of a cardio-oncology multidisciplinary team would be of utmost importance to not only improve patient care but also to improve quality of life.

Adipose tissue-derived stem cells as a therapeutic tool for cardiovascular disease

Adipose tissue-deried stem cells( ADSCs) are adult stem cells that can be easily harvested from subcutaneous adipose tissue. Many studies have demonstrated that ADSCs differentiate into vascular endothelial cells(VECs), vascular smooth muscle cells(VSMCs), and cardiomyocytes in vitro and in vivo. However, ADSCs may fuse with tissue-resident cells and obtain the corresponding characteristics of those cells. If fusion occurs, ADSCs may express markers of VECs, VSMCs, and cardiomyocytes without direct differentiation into these cell types. ADSCs also produce a variety of paracrine factors such as vascular endothelial growth factor, hepatocyte growth factor, and insulin-like growth factor-1 that have proangiogenic and/or antiapoptotic activities. Thus, ADSCs have the potential to regenerate the cardiovascular system via direct differentiation into VECs, VSMCs, and cardiomyocytes, fusion with tissueresident cells, and the production of paracrine factors. Numerous animal studies have demonstrated the efficacy of ADSC implantation in the treatment of acute myocardial infarction(AMI), ischemic cardiomyopathy(ICM), dilated cardiomyopathy, hindlimb ischemia, and stroke. Clinical studies regarding the use of autologous ADSCs for treating patients with AMI and ICM have recently been initiated. ADSC implantation has been reported as safe and effective so far. Therefore, ADSCs appear to be useful for the treatment of cardiovascular disease. However, the tumorigenic potential of ADSCs requires careful evaluation before their safe clinical application.

The Relationships between Respiratory Disease, Cardio-cerebral Vascular Disease and Temperature Change

Respiratory disease and cardio-cerebral vascular disease frequently occur in Anyang City. In this paper, by comparing incidence num- bers of respiratory disease and cardio-cerebral vascular disease in Anyang People＇s Hospital during 2010 -2012 with seasonal change of local tem- perature,it is found that they have obvious relationship, which has very important significance for preventing respiratory disease and cardio-cerebral vascular disease in the future.

Human photosynthesis, the ultimate answer to the long term mystery of Kleiber’s law or E = M^3/4: Implication in the context of gerontology and neurodegenerative diseases

Kleiber’s Law or E = M3/4 is a mathematical expression known since 1932 that outlines the relationship between mass (biomass) and the use of energy. It is compelling because it supports a long standing observation that larger animals appear to use energy more efficiently than smaller ones. For example, an elephant’s weight is 200,000 times of a mouse, but uses only about 10,000 fold energy;thus a cat, having a mass of about 100 times of a mouse, only spends roughly 33 fold energy. In other words, the bigger you are, the less energy per gram of tissue you actually need to stay alive. Many facts pertaining to animal size call for a rational explanation. This paper takes into account that the fascinating relationship between mass and energy use for any living thing is governed strictly by a mathematical universal formula across all living species, operating in the tiniest of bacteria to the biggest of whales and sequoia tress. For the first time, we report a capacity for the mammal eukaryotic cell to split, break or dissociate water molecules through melanin. Even though E = M3/4 was discovered eight decades ago, no proper satisfactory explanation exists. Nevertheless, our multiyear detailed study on the “Human Photosynthesis” or first found in the human retina and later in all eukaryotic cells, may finally unravel this mystery, namely, the bigger you are the more surface area you have to absorb electromagnetic radiation and the more potential exists to use that electromagnetic radiation spectra to perform work. We propose a future application of this theory in the context of human diseases, especially age-related disorders, such as retinopathy, cerebrovascular and Alzheimer disease and these implications may not only foster a better understanding of the pathobiology of these devastating diseases but also develop much more effective therapies in the foreseeable future.

High-Intensity Interval Training v/s Steady-State Cardio in Rehabilitation of Neurological Patients

Neuropathy is nerve damage that can cause chronic neuropathic pain, which is challenging to cure and has a significant financial burden. Exercise therapies, including High-Intensity Interval Training (HIIT) and steady-state cardio, are being explored as potential treatments for neuropathic pain. This systematic review compares the effectiveness of HIIT and steady-state cardio for improving function in neurological patients. This article provides an overview of the systematic review conducted on the effects of exercise on neuropathic patients, with a focus on high-intensity interval training (HIIT) and steady-state cardio. The authors conducted a comprehensive search of various databases, identified relevant studies based on predetermined inclusion criteria, and used the EPPI automation application to process the data. The final selection of studies was based on validity and relevance, with redundant articles removed. The article reviews four studies that compare high-intensity interval training (HIIT) to moderate-intensity continuous training (MICT) on various health outcomes. The studies found that HIIT can improve aerobic fitness, cerebral blood flow, and brain function in stroke patients;lower diastolic blood pressure more than MICT and improve insulin sensitivity and skeletal muscle mitochondrial content in obese individuals, potentially helping with the prevention and management of type 2 diabetes. In people with multiple sclerosis, acute exercise can decrease the plasma neurofilament light chain while increasing the flow of the kynurenine pathway. The available clinical and preclinical data suggest that further study on high-intensity interval training (HIIT) and its potential to alleviate neuropathic pain is justified. Randomized controlled trials are needed to investigate the type, intensity, frequency, and duration of exercise, which could lead to consensus and specific HIIT-based advice for patients with neuropathies.

肿瘤与心血管疾病:评估和管理

根据全球癌症数据显示,2020年全球新发癌症病例中高达23.7%的患者来自于中国,中国癌症死亡病例占全球癌症死亡病例的30.2%[1]。随着人口老龄化的进程及生活方式的改变,我国癌症的新发及死亡负担将会进一步加重。而随着肿瘤诊疗水平的进步,肿瘤患者的死因构成比发生了一定变化,心血管疾病逐渐成为仅次于肿瘤本身的死因,甚至在部分肿瘤类型中已经成为首要死因。肿瘤患者逐渐增加的心血管疾病负担与二者共同的危险因素有关,如高血压、高血脂、糖尿病等均在其中发挥重要作用[1-3];此外,抗肿瘤治疗相关心血管毒性仍然是肿瘤心脏病学领域临床及研究关注的重点及热点[4]。

2020年太原市居民四类主要慢病早死概率分析

目的分析2020年太原市居民四类主要慢病早死概率,为慢病防治、实现“健康中国2030”重大慢性病早死概率下降目标提供支持。方法利用人口死亡信息登记管理系统2020年太原市户籍居民死亡资料,分析慢病死亡率(标化死亡率)和早死概率。结果2020年太原市居民四类主要慢病标化死亡率347.35/10万,占全部死亡的92.19%;心脑血管疾病、恶性肿瘤、糖尿病、慢性呼吸系统疾病引起的死亡标化死亡率为321.02/10万,占总死亡的85.31%。四类慢病早死概率为11.02%,与山西省2015年早死概率相比较降幅达42%,并且男性早死概率高于女性。结论太原市2020年慢性非传染性疾病死亡率水平较高,并且太原市居民报告的慢性病死亡以心脑血管疾病、恶性肿瘤、慢性呼吸系统疾病、糖尿病为主。虽2020年太原市居民重大慢病早死概率下降幅度较大,但应进一步针对不同人群尤其男性人群制定有效的危险因素干预。

非奈利酮对2型糖尿病患者心肾保护作用的研究进展

盐皮质激素受体拮抗剂是心力衰竭患者的指南推荐治疗药物。然而,高钾血症和激素副作用的相关风险限制了其在2型糖尿病合并中晚期慢性肾脏病及心血管疾病高风险患者中的广泛使用。非奈利酮是一种新型非甾体类盐皮质激素受体拮抗剂,用于与2型糖尿病相关的心血管疾病和慢性肾脏病患者,达到心肾保护的作用。本文对非奈利酮在治疗2型糖尿病中心肾保护的作用机制、药理特性、安全性等进行综述,旨在为2型糖尿病合并心力衰竭及肾脏损伤患者的临床治疗提供帮助。

心脑血管病患者CT增强检查中非离子型碘对比剂相关急性不良反应预测模型的构建

目的探究心脑血管病患者CT增强检查中非离子型碘对比剂相关急性不良反应(ICM-AARs)预测模型构建的价值。方法选取2023年1月~2023年5月期间于四川大学华西医院进行CT增强检查的心脑血管病患者2031例,统计ICM注射后1h内AARs的发生情况,从2031例患者中选取符合纳入标准的未发生AARs的患者174例,纳入未发生ICM-AARs组,发生AARs的患者58例纳入ICM-AARs组,收集并比较两组患者临床资料,采用Logistic回归分析明确导致心脑血管病患者CT增强检查中发生AARs的危险因素。应用独立危险因素构建列线图预测模型,并采用受试者工作特征曲线(ROC)、Bootstrap法验及Calibration曲线对模型进行评价。结果2031例心脑血管病患者进行CT增强检查中发生ICM-AARs 58例,ICM-AARs发生率为2.86%;ICM-AARs组有过敏史、检查前未水化、未外预热、注射速率≥3.5mL/s、静脉注射及使用碘普罗胺的人数占比均高于未发生ICM-AARs组(P<0.05);Logistic回归分析结果显示,有过敏史、检查前未水化、未外预热、注射速率≥3.5mL/s、静脉注射及使用碘普罗胺是影响CT增强检查发生ICM-AARs的独立危险因素(P<0.05);ROC曲线显示,预测模型曲线下面积(AUC)为0.765(95%CI:0.706~818),灵敏度89.66%、特异度81.03%、约登指数0.706;Bootstrap法验证结果显示,C-index值为0.779(95%CI:0.713~0.861);Calibration曲线结果显示,Hosmer-Lemeshowχ^(2)=0.708,P=0.295。结论有过敏史、检查前未水化、未外预热、注射速率≥3.5mL/s、静脉注射及碘普罗胺均为心脑血管病患者CT增强检查中发生ICMAARs的独立危险因素,上述因素构建的列线图预测模型对ICM-AARs具有较高的预测效能。

同型半胱氨酸及尿酸水平与社区人群中国动脉粥样硬化性心血管疾病风险预测关系的研究

目的:基于中国动脉粥样硬化性心血管疾病风险预测[prediction for atherosclerotic cardio-vascular disease(ASCVD)risk in China,China-PAR]模型,探讨血同型半胱氨酸(homocysteine,HCY)及UA水平与社区人群心血管病10年风险的关系。方法:以2023年3月至5月,在我中心体检的1699例50~85岁参检者作为对象,收集年龄、性别等基本临床特征,检测HCY、UA等生化指标,采用China-PAR模型进行心血管10年风险评分。按照血HCY及UA是否升高,分为四组:HCY及UA正常组,单纯高HCY组,单纯高UA组,HCY及UA升高组,比较四组间China-PAR评分的差异。结果:HCY及UA正常组,单纯高HCY组,单纯高UA组,HCY及UA升高组的心血管10年风险值中位数分别为:7.6%,11.1%,9.5%,12.9%;各组心血管10年风险高危分布情况分别为:484例(37.8%),78例(54.9%),97例(45.8%),39例(60.0%)。HCY及UA升高组心血管10年风险值中位数、高危占比显著高于前三组(P<0.01)。单因素二元Logistic回归分析显示:BMI、TG、肌酐、FBG、HbAlc、HCY、UA与心血管10年风险高危相关(P<0.01),相关系数分别为:0.158、0.258、0.009、0.715、0.986、0.059、0.003;多因素二元Logistic回归显示:BMI,FBG、HbAlc、HCY对心血管10年风险高危有显著的正向影响关系(P<0.01),相关系数分别为:0.108、0.468、0.433、0.044,UA对心血管10年风险高危无相关(P>0.05)。结论:血HCY及UA水平与社区人群China-PAR心血管10年风险高危正相关,且血HCY的相关性强于血UA。

血清尿酸水平与维持性血液透析患者死亡风险的相关性

目的探讨血清尿酸(serum uric acid,SUA)水平对维持性血液透析(maintenance hemodialysis,MHD)患者全因死亡率和心脑血管疾病死亡率的影响。方法回顾性收集2015年1月1日至2016年12月31日在复旦大学附属中山医院行维持性血液透析患者的临床资料,根据SUA水平三分位值将患者分为低SUA组(SUA≤399μmol/L)、中SUA组(SUA 400~460μmol/L)、高SUA组(SUA≥461μmol/L),比较3组患者临床资料和实验室检查结果。采用Kaplan-Meier法绘制生存曲线,log-rank检验比较3组患者生存率。采用多元Cox回归模型分析MHD患者SUA水平与全因死亡率、心脑血管疾病死亡率的关系。结果共入选436例MHD患者,低SUA组149例、中SUA组144例、高SUA组143例。中位随访时间59.7(38.4,60.9)个月,随访期间130例患者死亡,其中90例(69.2%)死于心脑血管疾病。Kaplan-Meier生存分析显示,低SUA组患者总生存率和心脑血管疾病生存率低于中SUA组和高SUA组。Cox回归分析显示,校正年龄、性别、合并症等因素后,SUA水平每升高10μmol/L,患者全因死亡风险下降2.6%(HR=0.974,95%CI 0.952~0.996,P=0.022),心脑血管疾病死亡风险下降3.7%(HR=0.963,95%CI 0.937~0.991,P=0.008);低SUA组患者的全因死亡(HR=1.841,95%CI 1.138~2.979,P=0.013)和心脑血管疾病死亡(HR=2.353,95%CI1.288~4.300,P=0.005)风险高于高SUA组。结论低SUA水平与MHD患者全因死亡和心脑血管疾病死亡独立相关。

阿司匹林治疗高龄心脑血管病的临床疗效分析

目的分析阿司匹林治疗高龄心脑血管病的效果。方法随机选取2022年2月—2023年5月闽侯县人民医院收治的80例高龄心脑血管疾病患者作为研究对象,以随机抽签法分为对照组和观察组,各40例,分别采取常规治疗与联合阿司匹林治疗,对比两组凝血功能、血小板聚集情况和不良反应发生情况。结果治疗后,观察组纤维蛋白原(Fibrinogen,FIB)为(3.04±0.38)g/L,低于对照组的(3.78±0.41)g/L,差异有统计学意义(t=8.372,P<0.05);两组其余凝血功能指标治疗前后比较,差异无统计学意义(P均>0.05)。观察组血小板聚集情况优于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率对比,差异无统计学意义(P>0.05)。结论阿司匹林用于治疗高龄心脑血管疾病,可以改善部分凝血功能,并降低血小板聚集率,不良反应较少。

Before the Jury Is out on Cinacalcet’s Cardiovascular Effects in Hemodialysis Patients: Is Troponin a Missing Link?

Raised levels of the cardiac biomarker, Troponin I, are frequently encountered in hemodialysis patients and appear to be prognostic indicators for cardiovascular risk. Though evidence suggests that control of secondary hyperparathyroidism may reduce cardiac endpoints, the effect of the calcimimetic agent, cinacalcet, remains controversial. This retrospective study aimed at evaluating troponin levels in hemodialysis patients with severe secondary hyper parathyroidism (SHPT) who are on cinacalcet vs controls on conventional treatment. In addition, clinical outcomes including all-cause, cardiovascular morbidity and mortality were compared among both groups. A decline in Troponin I levels was observed in the cinacalcet group, this however was not translated clinically into improved survival. In fact, all-cause and cardiac mortality was similar in the two groups. Conversely, comparison of the incidence of cardiovascular events revealed lower rates in the cinacalcet group including cardiac, cerebral and peripheral vascular complications. Given some of our study limitations, further long-term, placebo-controlled trials are necessary to definitively establish the effect of cinacalet on cardiac biomarkers and ultimately its impact on clinical outcomes.

A cardioembolic stroke

A 76-year-old woman with unspecified congenital heart disease was admitted on April 25th for TIA. She had a possible history of atrial fibrillation. A slight fever was noted on admission. Her ECG was abnormal, as well as her transthoracic echocardiography (TTE). Troponin I was slightly increased. On May 11th, a stroke occurred, in relation with an occlusion of the basilar artery. The patient was transferred to our institution for an emergency desobstruction. A dramatic improvement allowed her to be discharged to a rehabilitation center on May 18th. However, she was re-hospitalized on June 5th, due to sepsis and neurological worsening. MRI showed new ischemic brain lesions. Several episodes of paroxysmal atrial fibrillation were documented, as well as pulmonary hypertension. Effective heparin therapy was initiated and transesophageal echocardiography (TEE) was requested this time. It revealed a congenital valvular heart disease (a subaortic membrane), complicated by infective endocarditis. Despite a monitoring of aPTT, a fatal hemorrhagic shock occurred. We report this unfortunately remarkable case to address the following important points: 1) In the setting of a neurological event, abnormal ECG and/or abnormal TTE and/or Troponin I elevation may indicate a cardioembolic mechanism and therefore seek a cardiac source of embolism. 2) When TTE fails to identify a cardiac source of embolism, TEE should be performed, especially when a preexisting heart disease is suspected or known. 3) The multiplicity in space (infarcts in both the anterior and posterior circulation, or bilateral) and/or the multiplicity in time (infarcts of different age) may indicate a cardioembolic stroke. 4) Congenital subaortic membrane predisposes to infective endocarditis. 5) When anticoagulant therapy is initiated on strong arguments in a septic patient (much discussed in infective endocarditis), aPTT monitoring alone may not be enough. An anti-Xa monitoring may be more appropriate.

化痰逐瘀法治疗心脑血管疾病的研究进展

化痰逐瘀法以中医理论为指导原则,主要治疗痰瘀阻滞型心脑血管疾病,为中医特色治法之一。近年来,随着心脑血管疾病发病率逐年增加,人们对其治疗机制进行深入研究发现,化痰逐瘀法对单纯西医治疗效果不明显的心绞痛、高血压、中风、痴呆、癫痫等心脑血管疾病有独特的治疗优势和显著的治疗作用,可以提高治愈率并有效改善患者生活质量。未来深入研究探索化痰逐瘀法对心脑血管疾病的作用机制,能够有效提高临床疗效、减轻医药负担。

多中心无心脑血管疾病危险因素成年受检者颈动脉内-中膜厚度的相关因素分析

目的分析无心脑血管危险因素的成年受检者颈动脉内-中膜厚度(IMT)百分位数值及其影响因素。方法连续性纳入2019年12月至2021年12月国内53家医院参加的“脑卒中高危人群筛查脑颈动脉超声规范化评估”数据库中2738名无心脑血管疾病危险因素的成年受检者颈总动脉(CCA)内径、颈动脉球部(CB)内径、颈内动脉(ICA)内径及CCA远段IMT测值。按性别与年龄对IMT进行分层描述[百分位数值以第5、10、25、50、75、90及95百分位数(P_(5)、P_(10)、P_(25)、P_(50)、P_(75)、P_(90)、P_(95))表示],并依据IMT的中位数值将所有研究对象分为IMT<0.6 mm组和IMT≥0.6 mm组,比较两组受检者的年龄、性别、体质量指数(BMI)、侧别及CCA、CB、ICA内径,采用多因素Logistic回归分析方法分析IMT增加的影响因素。结果(1)女性平均IMT为(0.56±0.02)mm,男性平均IMT为(0.59±0.03)mm。女性和男性IMT百分位数值均随年龄的增长而增加(均P<0.01);对19~69岁颈总动脉远段IMT增长值的横断面计算结果显示,男性与女性IMT每年分别增加0.003、0.005 mm。(2)IMT与CCA内径(r=0.130,P<0.01)、ICA内径(r=0.067,P<0.01)、CB内径(r=0.143,P<0.01)、年龄(r=0.302,P<0.01)、BMI(r=0.142,P<0.01)均呈正相关性,男性IMT大于女性IMT(t=8.784,P<0.01),左侧与右侧IMT测值差异无统计学意义[左侧比右侧:(0.57±0.02)mm比(0.57±0.02)mm,t=-0.301,P=0.763]。(3)Logistic回归分析结果表明,CB内径(OR=1.193,95%CI:1.109~1.283)、年龄(OR=1.049,95%CI:1.042~1.055)、女性(OR=0.688,95%CI:0.602~0.787)为IMT增加的独立影响因素。结论年龄、性别、CB内径均为无心脑血管疾病危险因素成年受检者正常范围内IMT增加的影响因素。

基于电子病历的心脑血管疾病精准防控方案设计

目的/意义基于大数据建立心脑血管电子病历分析平台,通过影像学数据分析技术和临床文档分析技术,向患者提供精准诊断、治疗方案、科学给药、预后预测、智慧健康教育处方等精准服务。方法/过程利用Protégé开发构建心脑血管疾病医学本体、知识规则、知识图谱。基于所构建知识图谱形成心脑血管疾病临床诊断、治疗、病理分析、预后判断等知识库,进而设计心脑血管电子病历分析平台。结果/结论心脑血管电子病历分析平台能够为不同人群提供个性化诊疗方案,向患者提供多种精准诊疗服务。

内蒙古包头地区40岁及以上人群抗血小板聚集类药物使用现状及影响因素的真实世界研究

目的明确真实世界内蒙古包头地区40岁及以上人群抗血小板聚集类药物的使用情况,以及不同人群服药率的影响因素。方法采用以居委会、村委会为单位的多级、整群、随机抽样方法,在2021年6月—2022年9月抽取包头地区40岁及以上常住居民。采用调查问卷形式收集研究对象的一般资料、既往病史及抗血小板聚集类药物使用情况。按照是否有心脑血管疾病(cardio cerebrovascular diseases,CVD)以及是否存在CVD危险因素将研究对象分为3组:CVD组(既往患CVD人群)、CVD危险因素组(无CVD病史,有以下1个或多个CVD危险因素:高血压、糖尿病、高血脂、吸烟史、饮酒史、肥胖)、健康对照组(无CVD病史,无CVD危险因素)。比较3组间一般资料的差异。根据是否服用抗血小板聚集类药物,将CVD组和CVD危险因素组的研究对象分别分为服药组和未服药组,采用单因素和多因素分析调查两组中影响服药的相关因素。结果①研究共纳入2100例有效调查对象,其中CVD组298例(14.2%)、CVD危险因素组1040例(49.5%)、健康对照组762例(36.3%)。3组人群中抗血小板聚集类药物应用率分别为51.68%(154例)、33.46%(348例)和6.69%(51例),组间差异有统计学意义(P<0.001)。②多因素分析显示,CVD组中较高学历(以小学及以下学历为基线,高中OR 2.429,95%CI 1.277~4.619,P=0.007、本科及以上学历OR 8.500,95%CI 1.015~12.165,P=0.048)以及合并糖尿病(OR 2.820,95%CI 1.377~5.777,P=0.005)的患者更倾向于应用抗血小板聚集类药物;CVD危险因素组中抗血小板聚集类药物应用率受个人经济收入(以<1.0万/年为基线,>5.0万/年OR 18.547,95%CI 8.948~38.444,P<0.001)、学历(以小学及以下学历为基线,本科及以上学历OR5.512,95%CI1.736~17.495,P=0.004)、吸烟史(OR0.712,95%CI0.541~0.936,P=0.015)、BMI(与低BMI患者相比,BMI正常OR5.640,95%CI1.172~27.144,P=0.031);肥胖(OR8.440,95%CI1.684~42.293,P=0.009)、患高血压(OR246.029,95%CI112.44~538.337,P<0.001)、患糖尿病(OR117.689,95%CI51.041~271.367,P<0.001)等因素的独立影响。③CVD组和CVD危险因素组的服药原因中医师处方占比最高,分别为83.12%和79.60%;健康对照组服药原因从高到低依次为自觉应该服用(47.06%)、亲友介绍(29.41%)、广告媒体宣传(13.73%)和医师处方(9.80%)。结论内蒙古包头地区40岁及以上人群中使用抗血小板聚集类药物进行CVD一级、二级预防的情况不理想,不同人群服药影响因素各不相同,且存在健康人群不规范和错误用药情况。