High prevalence of aspirin resistance in elderly patients with cardiovascular disease and metabolic syndrome

BackgroundMetabolic 症候群被知道是一个 prothrombotic 状态。我们拿了这研究检验阿司匹林抵抗可以与新陈代谢的症候群被联系的一个假设，并且与心血管的疾病(CVD ) 在病人估计阿司匹林抵抗的另外的潜在的决定因素有 CVD 的 469 个老病人全部的 .MethodsA 被招募。有新陈代谢的症候群的 172 个病人并且没有新陈代谢的症候群(控制组) ， 297 收到了每日的阿司匹林治疗(&#x02265；75 mg ) 超过一个月。血小板聚集被轻传播 aggregometry (LTA ) 测量。阿司匹林抵抗被定义为 &#x02265；20% arachidonic 酸(AA )- 并且 &#x02265；70% 腺苷 diphosphate (自动数据处理) 根据 LTA 导致了聚集。阿司匹林半应答者被定义为遇见一个(然而并非) 这些 criteria.ResultsBy LTA， 469 中的 38 个(8.1%) 病人们是阿司匹林抵抗。阿司匹林抵抗的流行与控制组相比在新陈代谢的症候群组是更高的[11.6 % 对 6.6% ，机会比率(或)= 2.039；95% 信心间隔(CI ) ：1.047-3.973 ] 。在 multivariate 逻辑回归分析，新陈代谢的症候群(或 = 4.951， 95% CI：1.440-17.019， P = 0.011 ) 是为有 CVD 和新陈代谢的症候群的病人的重要数字是的阿司匹林 resistance.ConclusionsA 的一个重要风险因素对阿司匹林治疗抵抗。这可能进一步在这些病人增加心血管的病态和死亡的风险。

Effect of Simulated Microgravity and its Associated Mechanism on Pulmonary Circulation in Rats

Objective To study the effect of Simulated Microgravity and its Associated Mechanism on Pulmonary Circulation in Rats. Methods Rat tail-suspension model was used to simulate the physiological effects of microgravity and changes in pulmonary blood vessel morphology, pulmonary arterial and venous blood pressure, pulmonary vascular resistance, pulmonary vasomotoricity, as well as the regulation of pulmonary circulation by cytokines produced and released by the lung of rats were measured. Results The walls of pulmonary blood vessels of rats were thickened, and the pulmonary artery was reconstructed with increased pulmonary vascular resistance. The pulmonary blood vessels of rats became more prone to dilation as contractions increased. Rat epithelial Adrenomedulin gene transcription and protein expression were upregulated. The level of basic fibroblast growth Factor of rat was also elevated. Conclusion Findings from the present study on rats revealed that the microgravity can affect pulmonary blood vessel structure, pulmonary arterial pressure, and pulmonary blood vessel self-regulation and cytokine production.

Effects of spaceflight and simulated microgravity on microbial growth and secondary metabolism

Spaceflight and ground-based microgravity analog experiments have suggested that microgravity can affect microbial growth and metabolism. Although the effects of microgravity and its analogs on microorganisms have been studied for more than 50 years, plausible conflicting and diverse results have frequently been reported in different experiments, especially regarding microbial growth and secondary metabolism. Until now, only the responses of a few typical microbes to microgravity have been investigated; systematic studies of the genetic and phenotypic responses of these microorganisms to microgravity in space are still insufficient due to technological and logistical hurdles. The use of different test strains and secondary metabolites in these studies appears to have caused diverse and conflicting results. Moreover, subtle changes in the extracellular microenvironments around microbial cells play a key role in the diverse responses of microbial growth and secondary metabolisms. Therefore, "indirect" effects represent a reasonable pathway to explain the occurrence of these phenomena in microorganisms. This review summarizes current knowledge on the changes in microbial growth and secondary metabolism in response to spaceflight and its analogs and discusses the diverse and conflicting results. In addition, recommendations are given for future studies on the effects of microgravity in space on microbial growth and secondary metabolism.

Novel therapy for idiopathic pulmonary arterial hypertension： Can hepatocyte growth factor be beneficial？

1 Introduction Idiopathic pulmonary arterial hypertension (IPAH) is a progressive, nearly fatal condition that until recently has had very few treatment options.Median survival time for untreated IPAH was 2.8 years without effective drug intervention.IPAH is characterized by deregulated proliferation of pulmonary arterial endothelial and intimal smooth muscle cells resulting in progressive pulmonary vascular remodeling and an increase in pulmonary arterial pressure.

A survey on the epidemiology of trauma and China trauma care training in subtropical regions of Hainan Province

Objective: To investigate the epidemiology of trauma patients in subtropical areas of Hainan Province and the improvement of the level of trauma treatment in China trauma care training (CTCT). Methods: From 01-01-2015 to 01-01-2016, the epidemiological data of 2476 patients with trauma were collected. From 01-01-2016 to 01-01-2017, 105 professional doctors and nurses in emergency surgery took part in CTCT, and their knowledge were compared before and after training. Results: There were 1656 male and 820 female trauma patients with 1614 cases in the middle and young age and 478 cases were the elderly. In terms of occupational distribution, 736 peasants, 574 workers and 458 retirees were involved. In May, the number of patients was the highest 332. October to January was the high-incidence season of trauma. In 24 hours a day: 11:00-13:00, 18:00-19:00, 23:00-03:00 were the high incidence periods. Referred to trauma sites, 904 cases of trauma happened on roads, 540 cases in family and 370 cases in restaurants or entertainment facilities. Through CTCT, the scores of the theoretical examination, the assessment of the trauma treatment skills and the field test scores of the emergency surgery practitioners were better than before (P<0.05).The misdiagnosis rate of severe trauma patients decreased from 26.21% to 15.36% (P<0.05). The mortality rate of severe trauma patients decreased from 18.67% to 13.94% (P<0.05). Conclusions:Trauma epidemiology in Hainan is closely related to its special geographical environment, which provides a reference for the prevention and treatment of trauma in Hainan, and some information for the government to formulate corresponding laws and regulations, as well as emergency plans and other relevant strategies. CTCT training improves the level of theoretical knowledge and first aid skills of medical personnel involved in trauma treatment. Health departments and medical education departments may consider extending CTCT training and continuing education programs to Hainan and other parts of China.

Prognosis and weaning of elderly multiple organ dysfunction syndrome patients with invasive mechanical ventilation

Background Elderly multiple organ dysfunction syndrome （MODS） patients receiving invasive mechanical ventilation have poor prognosis in intensive care units （ICUs）.We studied the usefulness of four commonly used severity scores and extrapulmonary factors that affected weaning to predict outcome of such patients.Methods Clinical data of 197 patients on admission to ICUs （from January 2009 to June 2012） were used retrospectively.The Acute Physiology and Chronic Health Evaluation （APACHE） Ⅱ,APACHE Ⅲ,Sample Acute Physiological Score （SAPS） Ⅱ and MODS scores were calculated.All the patients were grouped into survivors and nonsurvivors according to the prognosis.Patients,who weaned from ventilator （n=154）,were subdivided into a successful weaning group and a failed weaning group.The receiver operating characteristic （ROC） curves and Logistic regression was used for prognostic and weaning assessment.Results Based on the outcomes,the areas under the ROC of APACHE Ⅱ,APACHE Ⅲ,SAPS Ⅱ,and MODS were 0.837,0.833,0.824,and 0.837,respectively.The Logistic regression analysis revealed that the odds ratio （OR） of underlying lung diseases,serum albumin and creatinine,and the number of organ failures was 2.374,0.920,1.003,and 1.547.APACHE Ⅱ scores on admission performed excellent （ROC：0.921） on the weaning assessments.Conclusions APACHE Ⅱ and MODS systems were marginally better for evaluating the prognosis of elderly MODS patients who received invasive mechanical ventilation.Underlying lung diseases,serum albumin,serum creatinine and the number of organ failures were independent prognostic factors.Using the APACHE Ⅱ scores on admission before weaning may increase the likelihood of successful weaning.（ClinicalTrial.gov identifier NCT01802983）.