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High sensitive C-reactive protein, adiponectin, and urine albumin excretion rate in Chinese coronary artery disease patients with different glucose tolerance status

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Chinese Medical Journal 2008年第24期121卷 2509-2516页

作者： GUI Ming-hui HONG Jie LU An-kang CHEN Ying shen wei-feng LI Xiao-ying NING Guang Department of Endocrinology and Metabolism Shanghai Clinical Center for Endocrine and Metabolic Diseases Shanghai Institute of Endocrine and Metabolic Diseases Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai 200025 China Department of Cardiology Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai 200025 China

Background Serum high sensitive C-reactive protein （hs-CRP）, adiponectin levels and urine albumin excretion rate （UAER） are probably associated with inflammation and atherosclerosis. The aim of this study was to determine the three markers in coronary artery disease （CAD） subjects with different glucose tolerance status in a Chinese population and further explore the levels of the three markers in these subjects and the possible association of these markers with CAD risk factors and the severity of CAD as well. Methods A total of 242 subjects with angiographically documented CAD were recruited, and then assigned to three groups： the normal glucose tolerance （NGT）＋ CAD group, including 100 CAD patients with NGT; the impaired glucose tolerance （IGT）＋ CAD group, 40 CAD patients with IGT; the type 2 diabetes mellitus （T2DM）＋ CAD group, 102 CAD patients with T2DM. Serum hs-CRP, adiponectin levels as well as UAER were measured in all subjects. Results Serum hs-CRP levels were increased in the T2DM ＋ CAD group compared with the NGT ＋ CAD group （4.71±2.59） vs （3.60±2.46） mg/L, P=0.037. Serum adiponectin levels were gradually decreased from the NGT ＋ CAD to IGT ＋ CAD to T2DM ＋ CAD groups, （5.99±1.84）, （5.82±1.72） and （4.65±1.71） mg/L, P=0.002 and 0.040 for NGT ＋ CAD and IGT ＋ CAD groups vs T2DM ＋ CAD group, respectively. While the UAER was gradually increased from the NGT ＋ CAD to IGT ＋ CAD to T2DM ＋ CAD groups, （6.42±2.51）, （6.89±2.94） and （15.03±4.22） μg/min （P 〈0.001） for NGT ＋ CAD and IGT ＋ CAD groups vs T2DM ＋ CAD group. Multiple linear stepwise regression analysis showed that waist-hip ratio （WHR） and low density lipoprotein cholesterol （LDL-C） were the significant determinants of serum hs-CRP levels; triglyceride （TG）, high density lipoprotein cholesterol （HDL-C）, age, WHR, T2DM, 2-hour serum insulin （2hINS）, sex, and apolipoprotein B were the significant determinants of serum adiponectin levels; and systolic blood pressure （SBP）, T2DM and hemoglobin A1c （HbA1c） we

关键词： C-reactive protein adiponectin urine albumin excretion rate diabetes mellitus, type 2 coronary artery disease

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Valsartan Decreases Platelet Activity and Arterial Thrombotic Events in Elderly Patients with Hypertension

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Chinese Medical Journal 2015年第2期128卷 153-158页

作者： Fang Wu Hong-Yan Wang Fan Cai Ling-Jie Wang feng-Ru Zhang Xiao-Nan Chen Qian Yang Meng-Hui Jiang Xue-feng Wang wei-feng shen Department of Geriatrics Ruijin Hospital Jiao Tong University School of Medicine Shanghai 200025 China Department of Cardiology Ruijin Hospital Jiao Tong University School of Medicine Shanghai 200025 China Institute of Health Sciences Jiao Tong University School of Medicine and Shanghai Institutes for Biological Sciences Chinese Academy of Sciences Shanghai 200025 China Department of Laboratory Medicine Ruijin Hospital Jiao Tong University School of Medicine Shanghai 200025 China

Background：Angiotensin type 1 receptor （AT1R） antagonists are extensively used for blood pressure control in elderly patients with *** study aimed to investigate the inhibitory effects of AT1R antagonist valsartan on platelet aggregation and the occurrence of cardio-cerebral thrombotic events in elderly patients with ***：Two-hundred and ten patients with hypertension and aged 〉 60 years were randomized to valsartan （n =140） or amlodipine （n =70） on *** primary endpoint was platelet aggregation rate （PAR） induced by arachidonic acid at discharge,and the secondary endpoint was the rate of thrombotic events including brain infarction and myocardial infarction during *** aortic endothelial cells （HAECs） were stimulated by angiotensin Ⅱ （Ang Ⅱ,100 nmol/L） with or without pretreatment of valsartan （100 nmol/L）,and relative expression of cyclooxygenase-2 （COX-2） and thromboxane B2 （TXB2） and both p38 mitogen-activated protein kinase （p38MAPK） and nuclear factor-kB （NF-kB） activities were *** analyses were performed by GraphPad Prism 5.0 software （GraphPad Software,Inc.,California,USA）.Results：PAR was lower after treatment with valsartan （1 1.49 ± 0.69% vs.18.71 ± 2.47%,P 〈 0.001）,associated with more reduced plasmalevels of COX-2 （76.94 ± 7.07 U/L vs.116.4 ± 15.89 U/L,P 〈 0.001） and TXB2 （1667 ± 56.50 pg/ml vs.2207 ± 180.20 pg/ml）（all P 〈 0.001）.Plasma COX-2 and TXB2 levels correlated significantly with PAR in overall patients （r =0.109,P 〈 0.001）.During follow-up （median,18 months）,there was a significantly lower thrombotic event rate in patients treated with valsartan （14.3% vs.32.8%,P =0.002）.Relative expression of COX-2 and secretion of TXB2 with concordant phosphorylation ofp38MAPK and NF-kB were increased in HAECs when stimulated by Ang Ⅱ （100 nmol/L） but were significantly decreased by valsartan pretreatment （100 nmol/L）.Conclusions：AT1R antagonist valsartan decreases platelet activity by attenua

关键词： Angiotensin Type 1 Receptor Antagonist Elderly Hypertension Platelet Activity Thrombosis

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Clinical significance of pain in patients with chronic heart failure

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Chinese Medical Journal 2012年第18期125卷 3223-3227页

作者： GAN Qian ZHANG feng-ru ZHOU Qing-fen DAI Li-ying LIUYe-hong CHAI Xi-chen WU Fang shen wei-feng Department of Cardiology Ruijin Hospital Shanghai Jiao Tong University School ofMedicine ShanghaiChina 200025 Department of Geriatrics Ruijin Hospital Shanghai Jiao Tong University School ofMedicine ShanghaiChina 200025

Background There is a paucity of studies investigating the clinical and biochemical characteristics of pain in chronic heart failure （CHF） patients. This study aimed to determine the clinical and biochemical characteristics and outcomes in Chinese patients with CHF and symptoms of pain. Methods Sociodemographics, serum levels of creatinine, NT-proBNP, high-sensitivity C-reactive protein （hs-CRP）, tumor necrosis factor （TNF）-α, interleukin （IL）-6 and IL-10, and two-dimensional echocardiographic left ventricular ejection fraction （LVEF） were determined in 305 patients with CHF. A questionnaire packet including the Brief Pain Inventory （BPI） and the Minnesota Living with Heart Failure Questionnaire （MLHFQ） was used to assess the degree of pain rated on a 0-10 scale and the quality of life （QOL）. A six-minute walking test was performed during routine clinic visits. Major adverse cardiac events （MACE） were recorded; including all-cause or cardiac mortality and rehospitalization because of myocardial infarction, worsening heart failure or stroke at follow-up. Results Pain occurred in 25.6% of CHF patients, and was more common when the New York Heart Association （NYHA） functional class was worse. More patients with pain were female in gender, and had more co-morbidities, lower LVEF, and shorter distance during the 6-minute walking test. Despite similar serum levels of creatinine, N-terminal prohormone of brain natriuretic peptide （NT-proBNP）, IL-6 and IL-10, the TNF-a levels were higher and MLHFQ scores were greater in CHF patients with pain. At follow-up, CHF patients with moderate to severe pain （≥4 scale） had higher rates of all-cause and cardiac mortality and rehospitalization because of myocardial infarction, worsening heart failure or stroke. Multivariate regression analysis revealed that the presence of pain was an independent risk factor for MACE and reduced QOL in CHF patients.

关键词： chronic heart failure pain quality of life clinical outcome

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Randomized comparison of intracoronary tirofiban versus urokinase as an adjunct to primary percutaneous coronary intervention in patients with acute ST-elevation myocardial infarction： results of the ICTUS-AMI trial

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Chinese Medical Journal 2013年第16期126卷 3079-3086页

作者： ZHU Tian-qi ZHANG Qi DING feng-hua QIU Jian-ping JIN Hui-geng JIANG Li LU Lin ZHANG Rui-yan HU Jian YANG Zhen-kun shen Ying shen wei-feng Department of Cardiology Rui Jin Hospital Shanghai Jiao Tong University School of Medicine Shanghai 200025 China Department of Cardiology Gong Li Hospital Pudong New DistrictShanghai 200135 China Department of Cardiology Putuo District Central Hospital Shanghai200062 China Department of Cardiology Changning District Central HospitalShanghai 200336 China

Background No randomized trial has been performed to compare the efficacy of an intracoronary bolus of tirofiban versus urokinase during primary percutaneous coronary intervention （PCI）.We investigated whether the effects of adjunctive therapy with an intracoronary bolus of urokinase was noninferior to the effects of an intracoronary bolus of tirofiban in patients with ST-elevation myocardial infarction （STEMI） undergoing *** A total of 490 patients with acute STEMI undergoing primary PCI were randomized to an intracoronary bolus of tirofiban （10 μg/kg; n=247） or urokinase （250 kU/20 ml; n=243）.Serum levels of P-selectin,von Willebrand factor （vWF）,CD40 ligand （CD40L）,and serum amyloid A （SAA） in the coronary sinus were measured before and after intracoronary drug *** primary endpoint was the rate of complete （＞70％） ST-segment resolution （STR） at 90 minutes after intervention,and the noninferiority margin was set to 15％.Results In the intention-to-treat analysis,complete STR was achieved in 54.4％ of patients treated with an intracoronary bolus of urokinase and in 60.6％ of those treated with an intracoronary bolus of tirofiban （adjusted difference：-7.0％;95％ confidence interval：-15.7％ to 1.8％）.The corrected TIMI frame count of the infarct-related artery was lower,left ventricular ejection fraction was higher,and the 6-month major adverse cardiac event-free survival tended to be better in the intracoronary tirofiban *** intracoronary bolus of tirofiban resulted in lower levels of P-selectin,vWF,CD40L,and SAA in the coronary sinus compared with an intracoronary bolus of urokinase after primary PCI （P＜0.05）.Conclusions An intracoronary bolus of urokinase as an adjunct to primary PCI for acute STEMI is not equally effective to an intracoronary bolus of tirofiban with respect to improvement in myocardial reperfusion assessed by *** may be caused by less reduction in coronary circulatory platelet activation and inflammation.

关键词： acute myocardial infarction electrocardiography primary percutaneous coronary intervention tirofiban urokinase

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Elevation of tumor necrosis factor-α,interleukin-1β and interleukin-6 levels in aortic intima of Chinese Guizhou minipigs with streptozotocin-induced diabetes

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Chinese Medical Journal 2007年第6期120卷 479-484页

作者： LU Lin ZHANG Qi PU Li-jin XU Xue-wei ZHANG Rui-yan ZHANG Jian-sheng HU Jian YANG Zheng-kun LU An-kang DING feng-hua shen Jie CHEN Qiu-jin LOU sheng FANG Dan-hong shen wei-feng Department of Cardiology Ruijin Hospital Institute of Cardiovascular Disease Medical School of Jiaotong University Shanghai 200025 China

Background Large animal models with toxin-mediated pancreatic damage have been used extensively in researches with respect to diabetes mellitus and cardiovascular diabetic complications. The present study aimed to establish Chinese Guizhou minipig models with streptozotocin （STZ）-induced diabetes and characterize the animal models by analyzing inflammatory cytokine levels in aortic wall, such as tumor necrosis factor （TNF）-α, interleukin-1β （IL-1β） and interleukin-6 （IL-6）. Methods Twenty-two male Chinese Guizhou minipigs （age, 4 to 6 months; weight, 20 kg to 30 kg） were divided into STZ-induced diabetic group （n=-12） and control group （n=-10）. STZ （125 mg/kg） was administrated to induce hyperglycemia and afterwards insulin was used to control fasting blood glucose levels below 10 mmol/L. Oral glucose tolerance test （OGTT） was performed before and one month after STZ administration and serum concentrations of alanine transaminase, asparegine transaminase, albumin, blood urea nitrogen, creatinine, lipids and white blood cell count were measured before and six months later. Animals in both groups were euthanized after six months and pancreas was examined immunohistochemically for islet 13 cells. Aortic intima of diabetic minipigs and controls was analyzed for TNF-α level in tissue conditioned medium by Western blot. TNF-α, IL-β and IL-6 mFINA levels in aortic intima were assayed by reverse transcription and polymerase chain reaction （FIT-PCR）. Results Significant elevation in serum glucose levels was observed one month and six months after STZ induction （P〈0.001） and markedly increased OGTT values were noted, compared with baseline data. The normal pancreas had many irregular sized islets and small clusters of islet β cells, while in pancreas of diabetic minipigs islet β ceils almost disappeared. No statistical difference was notified in serum concentrations of biochemical examinations before and six months after STZ induction. Westem blot demonstrated dramatically in

关键词： diabetes meUitus streptozotocin tumor necrosis factor-α interleukin-1β interleukin-6

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Prevalence, clinical characteristics and outcome in patients with chronic heart failure and diabetes

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Chinese Medical Journal 2010年第6期123卷 646-650页

作者： SHI Chuan WANG Ling-jie HU Dan-feng LI Jin-ping ZHU Tian-qi SHAN Ying ZHAO Jian-rong ZHANG feng-ru shen wei-feng Department of Cardiology Ruiiin HospitalShanghai Jiao Tong University School of MedicineShanghai 200025China Department of Cardiology Huashan HospitalFudan University School of MedicineShanghai 200032China Department of Cardiology Luwan HospitalShanghai 200025China

Background Chronic heart failure（CHF）and diabetes mellitus portend high morbidity and mortality because of an interrelated pathophysiologic *** large cohort study aimed to analyze the prevalence,clinicaI characteristics and long-term outcome of patients with CHF and *** A totaI of 1119 patients with NYHA functionaI class Ⅱ-Ⅳ and left ventricular ejection fraction（LVEF）〈45% between January 1995 and May 2009 were *** variables, biochemical and echocardiographic measurements were retrospectively reviewed,and composite major cardiac events （MCE） including death,headtransplantation, and refractory heart failure requiring multiple hospitalizations were *** The prevalence of CHF with diabetes was progressively increased with time （16.9% in 1995-1999;20.4% in 2000-2004,and 29.1% in 2005-2009）and age（1 8.5% in〈60 years,26.6% in 60-80 years,and 26.6% in〉80 years）.Compared with CHF patients without diabetes,those with diabetes had worse cardiac function,more abnormal biochemical *** higher *** with glucose-lowering agents significantly improved LVEF and decreased *** elevated serum HbA1c level was associated with large left ventricular end-systolic diameter （P〈0.05）,decreased LVEF（P〈0.01）and reduced survival（P〈0.05）.Multivariable Logistic regression analysis revealed that after adjustment for confounding factors,NYHA functional class（OR2.65,95%CI 1.14-6.16,P=0.024）and HbA1c level≥7%（OR2.78, 95%CI 1.00-7.68,P=0.049）were independent risk factors for adverse outcomes in CHF patients with *** Prevalence of CHF with diabetes was increasing during past decades,and patients with CHF and diabetes had worse clinical profiles and *** anti-CHF and diabetes therapies are needed to improve overall outcomes for these patients.

关键词： chronic heart failure diabetes mellitus prognosis medical treatment

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Impact of admission creatinine level on clinical outcomes of patients with acute ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention with drug-eluting stent implantation

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Chinese Medical Journal 2008年第23期121卷 2379-2383页

作者： ZHANG Qi ZHANG Rui-yan shen Jie ZHANG Jian-sheng HU Jian YANG Zheng-kun ZHANG Xian ZHENG Ai-fang shen wei-feng Department of Cardiology Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai 200025 China

Background Prognosis of patients with acute ST-elevation myocardial infarction （STEMI） and renal dysfunction （RD） who received primary percutaneous coronary intervention （PCI） has not been fully investigated in the drug-eluting stent （DES） era. This study aimed to evaluate the impact of admission serum creatinine level on short-term outcomes in patients with acute STEMI undergoing DES-based primary PCI. Methods Primary PCI with DES implantation was attempted in 619 consecutive STEMI patients within 12 hours of symptom onset. Among them, 86 patients had a serum creatinine level ≥115 μmol/L on admission （RD group）, and the remaining 533 patients had normal renal function （non-RD group）. The primary endpoint was 30-day major adverse cardiac events （MACE, including death, non-fatal reinfarction, and target vessel revascularization）, and the secondary endpoint was subacute stent thrombosis. Results Patients in the RD group were older than those in the non-RD group. There are more female patients in the RD group and they had a history of hypertension, myocardial infarction and revascularization. The occurrence rates of Killip class ≥2 （29.1% vs 18.6%, P=0.02） and multi-vessel （62.8% vs 44.5%, P=0.001） and triple vessel disease （32.6% vs 18.2%, P=0.002）, in-hospital mortality （9.3% vs 3.8%, P=0.03）, and MACE rate during hospitalization （17.4% vs 7.7%, P=-0.006） were higher in the RD group than those in the non-RD group. At a 30-day clinical follow-up, the MACE-free survival rate was significantly reduced in the RD group （76.7% vs 89.9%, P=-0.0003）. Angiographic stent thrombosis occurred in 3 （3.5%） and 7 （1.3%） of patients in the RD group and non-RD group, respectively （P=0.15）. Multivariate analysis revealed that the serum creatinine level 〉115 μmol/L on admission was an independent predictor for MACE rate at a 30-day follow-up （Hazard ratio （HR） 3.31,95% CI 1.19-9.18, P 〈0.001）. Conclusion Despite similar prevalence of stent thrombosis at a 30-day clinical follow-u

关键词： acute myocardial infarction percutaneous coronary intervention drug-eluting stent renal dysfunction prognosis

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Impact of angina prior to acute ST-elevation myocardial infarction on short-term outcomes after primary percutaneous coronary intervention： results from the Shanghai Registry of Acute Coronary Syndrome （SRACE）

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Chinese Medical Journal 2012年第6期125卷 977-982页

作者： ZHANG Qi ZHANG Rui-yan ZHU Tian-qi HU Jian YANG Zhen-kun DING feng-hua DU Run ZHU Zheng-bin shen wei-feng Department of Cardiology Rui Jin HospitalShanghai Jiao Tong University School of MedicineShanghai 200025China

Background The clinical significance of ischemic chest pain before acute ST-elevation myocardial infarction （STEMI） remains an interesting issue of investigation particularly in the era of percutaneous coronary intervention （PCI）. This study aimed to assess the impact of angina prior to STEMI on short-term clinical outcomes in patients with acute STEMI undergoing primary PCI. Methods Among a total of 875 consecutive patients with STEMI undergoing primary PCI, 292 had episodes of angina within 24 hours of STEMI （PA group） and the remaining 583 were free of anginal symptoms （non-PA group）. Clinical characteristics, angiographic and procedural features, and in-hospital and 30-day outcomes were compared between the two groups. Results Diabetes was less common （17.5% vs. 23.3%, P=-0.04） and symptom-to-door time was shortened （（191.6_＋96.8） minutes vs. （357.2_＋341.9） minutes, P 〈0.001） in the PA group than in the non-PA group. Patients with angina prior to STEMI had fewer totally or nearly totally occluded infarct-related artery （TIMI flow grade 0-1） at initial angiography （75.0% vs. 90.7%, P 〈0.001）, and achieved more TIMI flow grade 3 after primary PCI （84.2% vs. 78.2%, P=0.04）. These were associated with higher rates of overall procedural success （95.9% vs. 91.8%, P=0.02） and of complete ST-segment resolution at 90 minutes after the procedure （51.7% vs. 40.3%, P=0.001）. During a 30-day clinical follow-up, the left ventricular ejection fraction was significantly improved （（53.0±8.6）% vs. （51.1±9.7）%, P=-0.002） and the primary endpoint of major adverse cardiac events was reduced in the PA group （7.2% vs. 12.7%, P=0.01）. Conclusion Presence of angina prior to acute STEMI is associated with better outcome at a 30-day clinical follow-up in patients undergoing primary PCI.

关键词： acute myocardial infarction preinfarction angina primary angioplasty stent outcomes

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Rational Solutions of First Order Algebraic Ordinary Differential Equations

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Journal of Systems Science & Complexity 2024年第2期37卷 567-580页

作者： feng Shuang shen Liyong School of Physical and Mathematical Sciences Nanjing Tech UniversityNanjing 211816China School of Mathematical Sciences University of Chinese Academy of SciencesBeijing 100049China

Let f(t,y,y')=∑ _(i=0)^(n )a_(i)(t,y)y'^(i)=0 be an irreducible first order ordinary differential equation with polynomial *** in 1998 proved that there exists a constant C such that every rational solution of f(t,y,y')=0 is of degree not greater than *** show that this degree bound C depends not only on the degrees of f in t,y,y' but also on the coefficients of f viewed as the polynomial in t,y,y'.In this paper,the authors show that if f satisfies deg(f,y)0,then the degree bound C only depends on the degrees of f in t,y,y',and furthermore we present an explicit expression for C in terms of the degrees of f in t,y,y'.

关键词： Degree bound first order AODE height rational solution

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Ibutilide decreases defibrillation threshold by the reduction of activation pattern complexity during ventricular fibrillation in canine hearts

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Chinese Medical Journal 2012年第15期125卷 2701-2707页

作者： JIN Qi ZHOU Jian ZHANG Ning LIN Chang-jian PANG Yang GU Gang shen wei-feng WU Li-qun Department of Cardiology Ruijin Hospital Shanghai Jiao TongUniversity School of Medicine Shanghai 200025 China

Background Ibutilide has been commonly used for pharmacologic cardioversion of atrial fibrillation and flutter in clinical settings. The objective of this study was to investigate the effects of ibutilide on the defibrillation threshold （DFT）, restitution properties, dispersion of refractoriness and activation patterns during ventricular fibrillation （VF）. Methods Ibutilide was administrated intravenously in six open-chest beagles. Before and after the drug administration, 20-second episodes of VF were electrically induced and recorded with a 10×10 unipolar electrode plaque sutured on the lateral epicardium of the left ventricle. DFT and VF activation patterns, including type of epicardial activation maps, VF cycle length （VF-CL）, conduction velocity, wavelength （WL） and reentry incidence, were measured. Restitution properties and dispersion of refractoriness were estimated from activation recovery intervals （ARI） during pacing. Results Compared to baseline, ibutilide markedly decreased the DFT by 31% （（491±14） V vs. （337±59） V, P 〈0.01）. The drug significantly reduced the maximal slope of the restitution curve （1.34±0.08 vs. 0.76±0.06, P 〈0.01） and its epicardial dispersion （0.36±0.09 vs. 0.21±0.06, coefficient of variation, P=0.03）. The dispersion of refractoriness was enhanced at the pacing cycle length of 300 ms to 160 ms by ibutilide. The drug significantly increased the VF-CL （（96±19） ms vs. （112±20） ms, P 〈0.01） and the WL （（41±9） mm vs. （52±14） mm, P=0.02） during VF, and reduced the reentry incidence by 25% （0.08±0.02 vs. 0.06±0.02, P 〈0.01）. In the epicardial activation maps, ibutilide significantly reduced the percentage of more complex activation maps during VF. Conclusions Intravenous ibutilide significantly decreased the DFT. It might be due to reduction of activation pattern complexity during VF.

关键词： ventricular fibrillation defibrillation threshold restitution, ibutilide

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