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Liu Y.-H.,Shanghai JiaoTong University | Su J.-Y.,Center Hospital of Minhang District | Wang L.-J.,Shanghai JiaoTong University | Li J.-P.,Shanghai JiaoTong University | And 6 more authors.
Chinese Medical Journal | Year: 2012

Background Potentially lethal ventricular arrhythmias (PLVAs) occur frequently in survivors after acute myocardial infarction and are increasingly recognized in other forms of structural heart diseases. This study investigated the prevalence and prognostic significance of PLVAs in patients with chronic heart failure (CHF). Methods Data concerning demographics, etiology of heart failure, NYHA functional class, biochemical variables, electrocardiographic and echocardiographic findings, and medical treatments were collected by reviewing hospital medical records from 1080 patients with NYHA II-IV and a left ventricular (LV) ejection fraction ≤45%. PLVAs were defined as multi-focal ventricular ectopy (>30 beats/h on Holter monitoring), bursts of ventricular premature beats, and nonsustained ventricular tachycardia. All-cause mortality, sudden death, and rehospitalization due to worsening heart failure, or cardiac transplantation during 5-year follow-up after discharge were recorded. Results The occurrence rate of PLVAs in CHF was 30.2%, and increased with age; 23.4% in patients <45 years old, 27.8% in those between 45-65 years old, and 33.5% in patients >65 years old (P = 0.033). Patients with PLVAs had larger LV size and lower ejection fraction (both P <0.01) and higher all-cause mortality (P = 0.014) during 5-year follow-up than those without PLVAs. Age (OR 1.041, 95% CI 1.004-1.079, P = 0.03) and LV end-diastolic dimension (OR 1.068, 95% CI 1.013-1.126, P = 0.015) independently predicted the occurrence of PLVAs. And PLVA was an independent factor for all-cause mortality (RR 1.702, 95% CI 1.017-2.848, P = 0.031) and sudden death (RR 1.937, 95% CI 1.068-3.516, P = 0.030) in patients with CHF. Conclusion PLVAs are common and exert a negative impact on long-term clinical outcome in patients with CHF.

Ye R.,Jiangsu University | Yang W.,Tongji University | Yuan Y.,University of Sichuan | Deng X.,Center Hospital of Minhang District
PLoS ONE | Year: 2014

Obstructive sleep apnea (OSA) is a highly heterogeneous sleep disorder, and increasing evidence suggests that genetic factors play a role in the etiology of OSA. Airway muscle dysfunction might promote pharyngeal collapsibility, mutations or single nucleotide polymorphisms (SNPs) in the delta-sarcoglycan (SCGD) gene associated with muscle dysfunction. To evaluate if SCGD gene SNPs are associated with OSA, 101 individuals without OSA and 97 OSA patients were recruited randomly. The genotype distributions of SNPs (rs157350, rs7715464, rs32076, rs13170573 and rs1835919) in case and control populations were evaluated. The GG, GC and CC genotypes of rs13170573 in control and OSA groups were 51.5% and 37.1%, 36.6% and 35.1%, and 11.9% and 27.8%, respectively. Significantly fewer OSA patients possessed the GG genotype and significantly more possessed the CC genotype compared with controls. Further multivariate logistic regression analysis showed that the CC genotype was an independent risk factor for OSA, with an odds ratio (OR) of 2.17 (95% confidence interval [CI]: 1.19-6.01). Other factors, such as age ≥50 years, male gender, body mass index (BMI) ≥25 kg/m2, low-density lipoprotein cholesterol (LDL-C) level ≥3.33 mg/dL, smoking and hypertension, were also independent risk factors for OSA in our multivariate logistic regression model. © 2014 Ye et al.

Li X.-L.,Center Hospital of Minhang District | Zhao X.-O.,309th Hospital of Chinese PLA
Journal of Clinical Rehabilitative Tissue Engineering Research | Year: 2010

BACKGROUND: Early rehabilitation following total knee replacement has arisen more attention. The aim of continuous passive joint motion is to recover knee function, prevent anchylosis, accelerate blood and synovia circulation, therefore, enhance tissue repair. OBJECTIVE: To evaluate the efficacy of continuous passive joint motion following total knee replacement. METHODS: Totally 48 patients, who underwent artificial total knee arthroplasty at the Department of Orthopedics, Center Hospital of Minhang District, Shanghai Ruikang Hospital Group and Department of Rehabilitation Medicine, 309th Hospital of Chinese PLA between December 2007 and October 2009 were selected. The patients were randomly divided into the experimental and control groups, with 24 cases in each group. The isometric contraction of qudraceps muscles, combined with physical agent assistant, was performed prior to total knee replacement. Patients in the experimental group was received continuous passive joint motion training at day 2 after operation, with 5°-10°increasing per day. Patients in the control group were treated with conventional methods. The knee functional score, and visual analog scale (VAS) was performed to evaluate knee functions and pains, in addition, perimeter between two legs, and range of motion were measured. RESULTS AND CONCLUSION: The knee functional score, VAS, perimeter between two legs, and range of motion were similar prior to and after total knee replacement (P < 0.05). Compared to the control group, the knee functional score of the experimental group was dramatically increased at days 3 and weeks 2 after operation (P > 0.01), the VAS and perimeter between two legs were significantly declined (P > 0.01), the range of motion was obvious improved after replacement, with greater excellent rate (P > 0.01). There was no deep venous thrombosis or infections. The results demonstrated that early rehabilitation following knee replacement is conductive to easing pain, eliminating swelling, and enhancing knee stability.

Hu W.,Center Hospital of Minhang District | Jin X.,Center Hospital of Minhang District | Gu J.,Center Hospital of Minhang District | Zhang P.,Center Hospital of Minhang District | And 6 more authors.
Journal of the American Society of Hypertension | Year: 2015

Although hypertension (HTN), obstructive sleep apnea (OSA), and obesity frequently co-occur, the precise role of obesity in this interrelationship is not completely understood. A total of 727 OSA patients were assigned to body mass index (BMI) <25 (27.6%; n = 201), 25≤BMI 29.99 (53.4%; n = 388), and BMI ≥30 (19%; n = 138). HTN risk factors in each group were evaluated. A total of 244 (33.6%) patients exhibited co-morbid HTN, of whom 20.5% (50/244), 52.9% (129/244), and 26.6% (65/244) were distributed between the BMI BMI <29.99, and BMI ≥30 groups, respectively. Multiple logistic regression indicated that age, male gender, triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and apnea-hypopnea index (AHI) scores were HTN risk factors for the BMI<25 group. In the 25≤BMI 29.99 group, risk factors were age, BMI, diabetes, and AHI. Finally, in the BMI ≥30 group, risk factors were age, diabetes, TG, LDL-C and AHI. These results demonstrate that different risk factor panels were associated with HTN in OSA patients with different BMIs.

Du G.,Center Hospital of Minhang District | Li X.,Center Hospital of Minhang District
Chinese Journal of Rehabilitation Medicine | Year: 2013

Objective: To observe the clinical effects of cobamamide combined with rehabilitation therapy in acute lumbar disc herniation for limb numbness and pain. Method: A total of 130 cases of lumbar intervertebral disc herniation were randomly divided into observation group and control group, 65 cases in each. The control group received lumbar traction and medium frequency electrotherapy, the observation group was treated by lumbar traction, medium frequency electrotherapy and cobamamide intramuscular injection treatment. After 2 courses of treatment, the effects on patients limb pain and numbness were evaluated. Result: VAS scores in observation group were lower than that in control group, the difference was significant (P < 0.05). Before treatment, 86 patients had symptoms of limbs numbness; after treatment the effects of relieving numbness in observation group and control group were 88.64% and 59.52% respectively, there was significant difference (P < 0.05). The effective rate in observation group was 96.92%, in control group 76.92%, the difference was significant (P < 0.05). No one appeared adverse drug reaction of cobamamide during the treatment. Conclusion: Cobamamide combined with rehabilitation therapy is effective for relieving numbness and pain in lumbar intervertebral disc herniation patients.

Yu Q.,Center Hospital of Minhang District | Yin G.,Center Hospital of Minhang District | Zhang P.,Center Hospital of Minhang District | Song Z.,Center Hospital of Minhang District | And 3 more authors.
PLoS ONE | Year: 2014

Obstructive sleep apnea (OSA) is highly associated with hypertension. However, the correlation between hypertension and OSA at different levels of severity and the influence of gender on that correlation are unclear. A total of 996 patients (776 males and 190 females) with OSA were recruited. The influence of gender on the correlation between hypertension and OSA at different stratifications of severity, based on the apnea-hypopnea index (AHI), was fully evaluated together with the major health risk factors obesity, age, and diabetes. Females with OSA were significantly older on average than males with OSA. Moreover, females had milder degrees of OSA on average than the extent of severity seen in males. The proportion of females with diabetes or hypertension was higher than that of males. The proportion of males with hypertension and obesity increased significantly with OSA, and age also increased with OSA. The percentage of females with hypertension at different degrees of OSA severity was stable at about 26% in the mild, moderate, and severe OSA groups. Among females, age was increased significantly in the moderate relative to the mild OSA group. Moreover, the proportion of obese subjects was increased significantly in the severe compared with the moderate OSA group. The proportions of males and females with diabetes were not significantly different among all OSA severity groups. An ordinal multivariate logistic regression analysis confirmed that hypertension, age, and obesity were associated with OSA severity in males, whereas only age and obesity were associated with OSA severity in females. Although the proportion of subjects with hypertension was higher in females with OSA than in males with OSA, the proportion of subjects with hypertension increased as the severity of OSA increased in males but not in females. © 2014 Yu et al.

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