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(...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.展开更多
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...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.展开更多
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 help...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.展开更多
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...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.展开更多
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 th...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.展开更多
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 c...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.展开更多
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 secondar...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.展开更多
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...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.展开更多
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...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.展开更多
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...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。展开更多
基金National Natural Science Foundation of China(81603385)China Postdoctoral Science Foundation(2018M643843)+1 种基金Natural Science Foundation of Shaanxi Province(2017JM8056)Key Research and Development Foundation of Shaanxi province(2018SF-241)
文摘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.
文摘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.
文摘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.
文摘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.
文摘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.
文摘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.
文摘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.
文摘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.
文摘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.
文摘目的: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。