Objective To evaluate the efficacy of n-3 PUFAs (fish oil) for prevention of cardiovascular events. Methods Randomized controlled trials (RCTs) were searched from the following electronic databases: PubMed, EMbase, The Cochrane Library (Issue 1, 2009), CBM, and CNKI. Quality assessment and data extraction were conducted by two reviewers independently. Disagreement was resolved through discussion. All data were analyzed by using Review Manager 4.2 software. Results Five studies involving 37 689 participants met the inclusion criteria. Meta-analysis results showed that: 1) Compared with placebo, the incidence rates of the cardiovascular death (RR=0.91, 95% CI 0.84 to 0.98), cardiovascular events (RR=0.95, 95%CI 0.91 to 0.98), angina (RR=0.79, 95%CI 0.64 to 0.96), and myocardial infarction (RR=0.79, 95%CI 0.65 to 0.96) could be reduced by n-3 PUFAs (fish oil). 2) There were no significant differences in death from any cause, the hospitalization rates of cardiovascular disease, sudden death, and heart failure (RR=0.95, 95%CI 0.90 to 1.00; RR=0.97, 95%CI 0.93 to 1.02; RR=0.90, 95%CI 0.79 to 1.01; RR=0.98, 95%CI 0.91 to 1.06). 3) Compared with placebo, the incidence rates of the arrhythmia and stroke could be increased, but there were no significant differences (RR=1.14, 95%CI: 0.80 to 1.62; RR=1.12, 95%CI 0.97 to 1.30). Conclusion Compared with placebo, n-3 PUFAs (fish oil) has good effects on reducing the incidence rates of total cardiovascular events, cardiovascular death, myocardial infarction, and angina pectoris, and it has the same efficacy in death from all cause, sudden death, heart failure, and the hospitalization rates of cardiovascular disease. There are no significant differences in the increased rates of arrhythmia and stroke.
Objective To investigate the clinical characteristics of prepapillary and preretinal vascular loops. Methods The clinical manifestation, results of the fundus fluorescein angiography, and the prognosis of 20 cases(24 eyes) with prepapillary and preretinal vascual loops were analyzed retrospectively. Results 66.7% of prepapillary and preretinal vascular loops were involved in one eye, and 95.8% of vascular loops were located within one optic disc diameter. There were different configuration types of the vascular loops. Among 20 cases(24 eyes) of the vascular loops, 70.8%(17 eyes) were arterial, 12.5%(3 eyes) were venous, and 16.7%(4 eyes) were both arterial and venous. 62.5% of eyes with prepapillary and preretinal vascular loops were associated with other congenital and developmental anomalies of retinal vascular vessels. Conclusion Most PRVL are arterial and superior to the optic disc. The serious distortion of the vascular loops may result in disturbance of blood flow in artery and retinal hemorrhage, which cause visual loss. (Chin J Ocul Fundus Dis, 1999, 15: 9-11)
Cardiovascular disease is the leading cause of death worldwide, accounting for 48.0% of all deaths in Europe and 34.3% in the United States. Studies have shown that arterial stiffness takes precedence over vascular structural changes and is therefore considered to be an independent predictor of many cardiovascular diseases. At the same time, the characteristics of Korotkoff signal is related to vascular compliance. The purpose of this study is to explore the feasibility of detecting vascular stiffness based on the characteristics of Korotkoff signal. First, the Korotkoff signals of normal and stiff vessels were collected and preprocessed. Then the scattering features of Korotkoff signal were extracted by wavelet scattering network. Next, the long short-term memory (LSTM) network was established as a classification model to classify the normal and stiff vessels according to the scattering features. Finally, the performance of the classification model was evaluated by some parameters, such as accuracy, sensitivity, and specificity. In this study, 97 cases of Korotkoff signal were collected, including 47 cases from normal vessels and 50 cases from stiff vessels, which were divided into training set and test set according to the ratio of 8 : 2. The accuracy, sensitivity and specificity of the final classification model was 86.4%, 92.3% and 77.8%, respectively. At present, non-invasive screening method for vascular stiffness is very limited. The results of this study show that the characteristics of Korotkoff signal are affected by vascular compliance, and it is feasible to use the characteristics of Korotkoff signal to detect vascular stiffness. This study might be providing a new idea for non-invasive detection of vascular stiffness.
In June 2022, the American Lipid Society released "NLA scientific statement on statin intolerance: a new definition and key considerations for ASCVD risk reduction in the statin intolerant patient", which provides the latest definition, modifiable factors, and treatment strategies of statin intolerance. According to the guidelines, for statin intolerance, the statin medication regimen should be adjusted first (reducing the dose, switching to another statin, reducing the frequency of medication), and if the patient is still intolerant, non-statin drugs should be considered to reduce the risk of ASCVD in the patient. The interpretation of this guideline will help clinicians and researchers identify, manage and intervene in the statin intolerance syndrome.
ObjectiveTo analyze and compare the clinical and pathological characteristics of patients with porto-sinusoidal vascular disease (PSVD) and liver cirrhosis (LC), so as to provide a reference for reducing misdiagnosis and missed diagnosis. MethodsThe patients who underwent liver biopsy in the Department of Infectious Diseases in the First Hospital of Lanzhou University from January 2008 to December 2022 were retrospectively collected. The clinical, biochemical, imaging, and liver biopsy pathological data of the patients with PSVD and LC were compared. ResultsA total of 45 patients with PSVD and 48 patients with LC were included. The males to females ratio in the patients with PSVD and LC was 25∶20 and 21∶27, respectively, and the average age of the patients with PSVD was younger than that of the patients with LC (P<0.001). The patients with PSVD had overall better liver function, although the proportion of the patients with the Child-Pugh class B in the two groups was all higher, the proportion of patients with the Child-Pugh class B and the end stage liver disease model score ≥10 points in the patients with PSVD was lower (nearly three times) than those in the patients with LC (P<0.05). The initial diagnosis rate of the patients with PSVD was lower than that of the patients with the LC (6.7% vs. 95.8%, χ2=74.0786, P<0.001). The imaging findings of the patients with PSVD as compared with LC showed that the proportion of the portal hypertension was higher (33.3% vs. 39.6%) in both, but the flow velocity of the portal vein was faster (P=0.039), and the extrahepatic bile duct diameter was smaller (P=0.001). The main specific manifestations of liver biopsy histopathology in the patients with PSVD were the portal occlusion [19 (42.2%)], nodular regenerative hyperplasia [1 (2.2%)], and incomplete septal cirrhosis or fibrosis [14 (31.1%)], as well as the non-specific manifestation was the fine bile duct reaction [8 (17.8%)]. And the proportion of the patients with the liver tissue inflammatory activity grading (G) and liver fibrosis staging (S) ＞G2S2 in the patients with PSVD was lower as compared with the patients with LC [12 (26.7%) vs. 48 (100%), χ2=54.560, P<0.001]. ConclusionThe diagnosis of PSVD and LC should “seek common ground while reserving differences”, and it is necessary that a routine examination in combination with imaging manifestation and liver pathology, and should focus on a liver vascular abnormality so as to reduce a rate of misdiagnosis.
Objective To detect the clinical characters and the classification of the congenital retinal vascular anomalies. Methods Nine cases (12 eyes) of congenital retinal vascular anomalies were examined by ocular examination and fundus fluorescein angiography (FFA), in which 3 cases (4 eyes) were examined by indocyanine green angiography (ICGA) simultaneously. Results The congenital retinal vascular anomalies were located at the posterior pole in 8 cases (10 eyes), and extended to peripheral retina in 1 case (2 eyes). Congenital retinal vascular anomalies were classified as follows: congenital retinal macrovessel (1 case, 1 eye); congenital retinal arteriolar tortuosity (2 cases, 3 eyes); inherited retinal venous beading (1 case, 2 eyes); and congenital prepapillary vascular loops (5 cases, 6 eyes). Four cases (5 eyes) were associated with spontaneous hemor rhage induced by physical exertion (Valsalva maneuver). Conclusion Most of the congenital retinal anomalies are located at the posterior pole, involving arteries and veins, and can be associated with spontaneous hemorrhage induced by Valsalva maneuver. (Chin J Ocul Fundus Dis，2003，19：269-332)
ObjectiveTo systematically evaluate the efficacy and safety of Polypill on cardiovascular risk factors. MethodSuch databases as Embase, Cochrane Library, PubMed, Web of Science, China National Knowledge Infrastracture, WanFang, and China Biology Medicine Disc were searched from their establishment to May 2015 for randomized controlled trials on the efficacy and safety of Polypillon on cardiovascular risk factors. Meta-analyses were performed by using the RevMan 5.2 software. ResultsSix studies were included which all came from overseas including 1 155 patients treated with Polypill and 1 149 treated with placebo or single or combined medicaiton. The meta-analysis showed that:when compared with the controls, Polypills could significantly reduce systolic blood pressure[WMD=-9.39 mm Hg (1 mm Hg=0.133 kPa), 95%CI (-14.44, -4.33) mm Hg, P=0.0003], diastolic blood pressure[WMD=-5.32 mm Hg, 95%CI (-8.10, -2.55) mm Hg, P=0.0002], total cholesterol[WMD=-1.11 mmol/L, 95%CI (-1.48, -0.74) mmol/L, P<0.00001], and low density lipoprotein[WMD=-0.91 mmol/L, 95%CI (-1.25, -0.57) mmol/L, P<0.00001]. However, those who took Polypill were easier to discontinue medication [OR=1.49, 95%CI (1.19, 1.87), P=0.0005]. In the respect of adverse effects, there was no significant difference between the two groups[OR=1.47, 95%CI (0.67, 3.25), P=0.34]. ConclusionsThe efficacy of Polypill on cardiovascular risk factors is obvious. Polypills can significantly reduce blood pressure and lipids. Tolerability is lower in those taking Polypills, but the difference is minor. There is no significant difference in the respect of adverse effects.
ObjectivesTo explore the safety and efficacy of beta-blockers (BBs) in patients with chronic obstructive pulmonary disease (COPD) and its effect on prognosis. MethodsThe data of 366 patients with acute exacerbation of COPD in this department were analyzed retrospectively. The use rate and related events of BBs were evaluated, including comorbidity, indications, contraindications and related clinical indicators. ResultsOf the 366 patients, 156 (42.6%) had at least one indication of the use of BBs, but only 53 (34.0%) of these patients used BBs, and 61 patients (39.1%) had no contraindications but did not use BBs. At admission, 72 patients (19.7%) were treated with BBs, 177 (45.6%) with antiplatelet drugs, 145 (39.6%) with statins, and angiotensin converting enzyme inhibitor/angiotensin II receptor blocker was used in 168 (45.9%) patients. Twenty-five patients (6.8%) had ischemic heart disease during hospitalization. Fifty-seven patients (15.6%) had cardiovascular and cerebrovascular events during admission. The patients with cardiovascular and cerebrovascular events had longer hospitalization (P<0.01) and higher in-hospital mortality (P=0.02). ConclusionsPatients with COPD have a clear indication of BBs use, but the clinical use rate is still very low. Further research is needed to explore the prescription disorders of BBs in patients with COPD.