Association of expression of ZNF606 gene from monocytes with the risk of coronary artery disease

AimMessenger RNAs (mRNAs) play an important role in the pathogenesis of coronary artery disease (CAD). We evaluated the association of selected increase in mRNAs from monocytes with the risk of CAD.MethodsChip data (GSE9820) retrieved from Gene Expression Omnibus (GEO) was re-analyzed, and the selected candidate genes, meeting specific conditions, were up-regulated and verified for specific biomarkers of CAD within a prospective cohort study that recruited 194 individuals and subdivided into two groups: group Non-CAD (GN), n = 68 and group CAD (GC), n = 126. The patients in GC were further categorized into three sub-units according to the extent of coronary stenosis shown during coronary angiography, coded as single-vessel stenosis (GC1, n = 53), 2-vessel stenosis (GC2, n = 50), or ≥ 3-vessel stenosis (GC3, n = 23). All candidate mRNAs expressions were analyzed from patients' monocytes with quantitative PCR (q-PCR). Receiver-operating characteristic (ROC) curves and the area under the ROC curves (AUCs) were used to evaluate the mRNAs' feasibility for CAD prediction. AUCs ≥0.8 were accounted as highly specific association with CAD.ResultsGBA2, CSTF3, ZNF606 and MPP5 were selected as mRNAs candidates from chip data reanalysis. GBA2 (P = .002) and ZNF606 (P < .001) expressions were significantly increased in GC. ZNF606 showed significant increase after adjusting the risk factors with logistic regression analysis (OR = 3.804, 95% CI: 1.923, 7.798, P < .001), and its expression level was positively correlated with age (β = 0.04 × 10⁻³, P < .001). The AUCs (and 95% CI) of ZNF606 expression in GC2 and GC3 were ≥0.8.ConclusionThese findings suggest that it is novel and specific for the association of ZNF606 gene expression from monocytes with the risk of CAD, especially in patients with multiple coronary artery stenosis.     

Electrolyte analysis of pleural effusion for discrimination between seawater and freshwater drowning in decomposed bodies

ObjectiveThe diagnosis of drowning is an important issue in forensic investigations. Moreover, discriminating between seawater and freshwater drowning is crucial to identify where the drowning occurred. The present study aimed to investigate electrolyte concentrations in pleural fluid in decomposed bodies in late postmortem intervals and derive cut-off values for the diagnosis of seawater and freshwater drowning.Study designData were collected from 44 seawater drowning cases, 60 freshwater drowning cases, and 30 non-drowning cases with pleural effusion which served as controls. The levels of sodium ion (Na⁺), potassium ion (K⁺), and chloride ion (Cl⁻) of pleural fluid were measured, and two indices were calculated: summation of Na⁺ and K⁺ levels (SUM _Na + K), and summation of Na⁺, K⁺, and Cl⁻ levels (SUM _{Na + K + Cl}). The means of the three ion concentrations and two indices significantly differed between the three groups (p < 0.0001).ResultsThe receiver operating characteristic analysis revealed that the sensitivity and specificity were both 1.000 for SUM _{Na + K + Cl} of 288.3 mEq/L between the seawater and control groups. The Na⁺ value of 109.0 mEq/L also had a high sensitivity of 0.977 and a specificity of 0.933 in the seawater and control groups. The sensitivity and specificity were 0.967 and 1.000, respectively, for SUM _Na + K of 123.2 mEq/L between the freshwater and control groups.ConclusionThe electrolyte concentrations in pleural effusion may be useful for the diagnosis of drowning in decomposed bodies with a longer postmortem interval.     

Clinical profile and impact of family history of premature coronary artery disease on clinical outcomes of patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction: analysis from the HORIZONS-AMI Trial

Background/PurposeFamily history of coronary artery disease (CAD) is a well-established risk factor of future cardiovascular events. The authors sought to examine the relationship between family history of CAD and clinical profile and prognosis of patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).Materials/MethodsBaseline features and clinical outcomes at 30 days and at 3 years from 3601 patients with STEMI enrolled in the HORIZONS-AMI trial were compared in patients with and without family history of premature CAD, which was present in 1059 patients (29.4%).ResultsThese patients were younger (median 56.7 vs. 62.1 years, P < 0.0001) and more often current smokers (52.4% vs. 43.5%, P < 0.0001), had more dyslipidemia (47.7% vs. 41.1%, P = 0.0003), less diabetes mellitus (14.1% vs. 17.5%, P = 0.01) and had shorter symptom onset to balloon times (median 213 vs. 225 min, P = 0.02). Patients with a family history of premature CAD had higher rates of final TIMI 3 flow (93.8% vs. 90.6%, P = 0.002), and myocardial blush grade 2 or 3 (83.2% vs. 78.0% P = 0.0008), and fewer procedural complications. Although the unadjusted 30-day and 3-year mortality rates were lower in patients with a family history of premature CAD (1.8% vs. 3.0%, P = 0.046 and 4.8% vs. 7.7%, P = 0.002, respectively), by multivariable analysis the presence of a family history of premature CAD was not an independent predictor of death at 3 years (HR [95%CI] = 1.00 [0.70, 1.44], P = 0.98).ConclusionsA family history of premature CAD is not an independent predictor of higher mortality.     

Epidemic trend of diabetes in China

Epidemiology is now well recognized as the foundation of public health. The Da Qing study in 1986 was the first milestone study to show that lifestyle intervention can prevent or delay the onset of diabetes. The lead investigator of that study, Professor Xiaoren Pan, is regarded as the forerunner epidemiologist for diabetes in China and even in Asia. In 2006, study participants were followed up to assess the long‐term effects of the interventions after 20 years. As compared with the control group, those in the combined lifestyle intervention group had a 51% lower incidence of diabetes during the active intervention period and a 43% lower incidence over the 20‐year period, adjusted by age. Recently, the National Diabetes Prevalence Survey in China was carried out from 2007 to 2008. The data from that study showed that the prevalence of diabetes in Chinese adults was 9.7%, and the increased rate of diabetes prevalence in China exceeded the International Diabetes Federation estimation. Very recently, we have reported that acarbose is a viable choice for initial therapy in Chinese patients newly diagnosed with type 2 diabetes who have a lower body mass index and exaggerated postprandial glucose excursion compared with Caucasian patients. We are expecting more contributions from epidemiology to the study of diabetes.     

The expanding burden of cardiometabolic risk in China: the China Health and Nutrition Survey

China faces a major increase in cardiovascular disease, yet there is limited population‐based data on risk factors, particularly in children. Fasting blood samples, anthropometry and blood pressure were collected on 9,244 children and adults aged ≥7 years in late 2009 as part of the national China Health and Nutrition Survey. Prevalent overweight, elevated blood pressure, and cardiometabolic risk factors: glucose, HbA1c, triglycerides (TG), total cholesterol (TC), high‐ and low‐density lipoprotein cholesterol (HDL‐C and LDL‐C), and C‐reactive protein (CRP) are presented. We found that 11% of Chinese children and 30% of Chinese adults are overweight. Rates of diabetes, dyslipidaemia, hypertension and inflammation are high and increased with age and were associated with urbanization. Approximately 42% of children have at least one of the following: pre‐diabetes or diabetes, hypertension, high TC, LDL‐C, TG, and CRP and low HDL‐C, as do 70% men and 60% women aged 18–40 years and >90% of men and women ≥60 years. In sum, the HbA1c findings suggest that as many as 27.7 million Chinese children and 334 million Chinese adults may be pre‐diabetic or diabetic. The high prevalence in less urban areas and across all income levels suggests that cardiometabolic risk is pervasive across rural and urban China.     

减重代谢术前患者肥胖相关病耻感的质性研究

目的深入了解减重代谢手术患者术前肥胖相关的病耻感体验,以期为提高患者手术信心和术后自我管理质量提供参考。 方法选择北京市某三级甲等医院9名拟行减重代谢手术的患者为研究对象,采用半结构式访谈法,运用主题分析法对访谈资料进行分析、归纳及提炼主题。 结果减重代谢手术患者的术前病耻感体验归结为4个类属。类属一：病耻感体验,即自卑感、孤独、自责和被歧视的经历;类属二：病耻感来源,一方面来自自身,另一方面来自他人,如亲友和同事、医护人员、公众;类属三：病耻感的应对,包括盲目采取各种方法,减少社会活动、逃避、持有积极减重的态度;类属四：对手术改善肥胖的态度,包括经他人推荐相信减重效果,或对手术了解较少抱着尝试心态。 结论减重代谢手术的患者术前存在病耻感体验,医护人员应为其提供相应的心理支持,指导其采取正确的应对方式;同时应做好社会健康教育,加强公众对肥胖与代谢疾病的认识,正确认识减重代谢手术在治疗肥胖与代谢疾病中的效果。