Medicine
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We sought to investigate the prognostic significance of prodromal angina (PA) in unselected patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) and its additive predictive value to the GRACE score. We prospectively enrolled 3015 consecutive STEMI patients undergoing PPCI. Patients were divided in 2 groups according to the presence or absence of PA. ⋯ In patients with STEMI undergoing PPCI the presence of PA is independently associated with a lower risk of 2-year cardiac mortality. However, the incorporation of this variable to the GRACE score slightly worsened the classification of risk. Accordingly, it seems unlikely that the evaluation of PA may be useful in clinical practice.
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Randomized Controlled Trial
Characteristics of repaglinide and its mechanism of action on insulin secretion in patients with newly diagnosed type-2 diabetes mellitus.
This study aims to compare the effect of repaglinide and metformin among Chinese patients with newly diagnosed diabetes, and explore the possible mechanisms by which repaglinide alters insulin secretion. Sixty subjects with glycated hemoglobin (HbA1c) < 10.0% were randomly selected to receive repaglinide or metformin monotherapy for 15 weeks. Blood glucose levels, glycemic variability, β-cell function, and first-phase insulin secretion were compared between these 2 groups at baseline and at 15 weeks. ⋯ The insulin levels of the cell medium in the repaglinide group remained significantly higher at all timepoints. This study manifests that repaglinide has a noninferiority effect on the glycemic parameters of Chinese patients with newly diagnosed diabetes, when compared with metformin. The PCNT-F-actin pathway plays an important role in the repaglinide regulation process of on-demand insulin secretion.
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To explore the therapy of ankle joint dislocation treating dislocated trimalleolar fractures accompanied with the complex posterior malleolus fracture without separation of the tibiofibular syndesmosis and improve surgical results. Patients who had dislocated trimalleolar fractures accompanied with the complex posterior malleolus fracture without separation of the tibiofibular syndesmosis were retrospectively analyzed and 30 patients were enrolled the study. They were all treated by ankle joint dislocation and the surgical results were evaluated by the Baird-Jackson ankle scoring system. ⋯ According to the Baird-Jackson ankle scoring system, the excellent and good result was 28 cases, fair was 2 cases which the excellent and good rate was 93.3% without talar necrosis in any cases. Ankle joint dislocation can achieve the satisfactory results in treating dislocated trimalleolar fractures accompanied with the complex posterior malleolus fracture without separation of the tibiofibular syndesmosis. Ankle joint dislocation can make joint cartilage restore accurately with excellent results.
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Vitamin D maintains calcium balance and has immunomodulatory effects. Only few studies have revealed the relationship between vitamin D and its associated factors in Mycobacterium avium complex (MAC) infection. This study aimed to investigate the effects of MAC infection on serum vitamin D, human cationic antimicrobial protein 18, its C-terminal 37 amino acid fragment (hCAP18/LL-37) levels, and bone mineral density (BMD). ⋯ Based on a multivariate analysis, patients with MAC lung disease had significantly lower body mass index [odds ratio (OR), 19.1; 95% confidence interval (CI), 2.0-419.0; P < .01] and vertebral BMD (OR, 12.4; 95% CI, 1.7-160.6; P = .012) than control participants. Serum hCAP18/LL-37 level and BMD were significantly decreased in patients with MAC lung disease without relation to serum vitamin D level. The vitamin D-independent pathway might affect the waning of antimicrobial peptides and decrease in BMD.
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Bronchial foreign body aspiration is a critical condition that jeopardizes the respiratory function of children. Prompt diagnosis and removal of the foreign body can reduce occurrence of foreign body complications and mortality. Aspiration of spherical plastic beads is rare, and the bead is difficult to retrieve. ⋯ Foreign body aspiration in children constitutes a medical emergency in severe cases. Flexible bronchoscopy and balloon-tipped catheter retrieval can be used as an effective noninvasive treatment for aspiration of plastic beads.