The aim of this study was to investigate whether clinic, cumulative, and 24h ambulatory systolic blood pressure (SBP) was associated with chronic kidney damage, defind as estimated glomerular filtration rate (eGFR) <60 ml/(min·1.73 m2) and/or microalbuminuria ≥30 mg/L, and, if so, which measurement of SBP is more associated with chronic kidney damage in Chinese elderly. A total of 1207 participants older than 60 years old were included in the final analysis. Clinical blood pressure, cumulative blood pressure exposure was calculated and ambulatory 24h blood pressure was assessed. Multiple logistic regression analysis showed that the clinic (p < .001), cumulative (p = .033), 24h average (p < .001), daytime (p = .001) and nighttime SBP (p = .001) were respectively associated with lower eGFR, and cumulative (p = .008), 24 average (p < .001), daytime (p < .001), and nighttime SBP (p < .001) were the risk factors of microalbuminuria. The degree of correlation were strongest between 24h average SBP and chronic kidney damage (odds ratio, 1.78; 95% confidence interval, 1.46-2.15; p < .001), clinic SBP and eGFR (odds ratio, 1.57; 95% confidence interval, 1.13-2.17; p = .007), nighttime SBP and microalbuminuria (odds ratio, 1.45; 95% confidence interval, 1.05-2.00; p = .024). The likelihood ratio test demonstrated that the introduction of 24h average SBP will improve the goodness of fit of the clinic SBP model(p < .05), while the introduction of cumulative SBP exposure has no such effect(p > .05). Cumulative SBP exposure seems inferior to other measurement in indentifying chronic kidney damage, including decreased GFR and microalbuminuria.

Background: Connective tissue growth factor (CTGF) and transforming growth factor β1 (TGF-β1) are emerging biomarkers for tissue fibrosis. The aim of this study was to investigate the association between circulating CTGF, TGF-β1 levels and cardiac diastolic dysfunction in patients with diastolic heart failure (DHF). Methods: Admitted subjects were screened for heart failure and those with left ventricular (LV) ejection fraction <45% were excluded. Diastolic dysfunction was defined as functional abnormalities that exist during LV relaxation and filling by echocardiographic criteria. Totally 114 patients with DHF and 72 controls were enrolled. Plasma levels of CTGF, TGF-β1, and B-type natriuretic peptide (BNP) were determined. Results: The plasma CTGF and TGF-β1 levels increased significantly in patients with DHF. Circulating CTGF and TGF-β1 levels were correlated with echocardiographic parameter E/e’ and diastolic dysfunction grading in DHF patients. In multivariate logistic analysis, CTGF was significantly associated with diastolic dysfunction (odds ratio: 1.027, p < 0.001). Plasma CTGF (AUC: 0.770 ± 0.036, p < 0.001) and CTGF/BNP (AUC: 0.839 ± 0.036, p < 0.001) showed good predictive power to the diagnosis of DHF. Conclusions: This finding suggested CTGF could be involved in the pathophysiology of diastolic heart failure and CTGF/BNP might have auxiliary diagnostic value on diastolic heart failure.

Background: The introduction of endovascular surgery has led to frequent stent use, although in-stent restenosis (ISR) remains a challenging issue. Drug-coated balloon (DCB) and conventional balloon angioplasty (BA) are common endovascular procedures for addressing ISR in the femoropopliteal artery. However, there is controversy regarding which procedure provides the greatest benefit to patients. Methods: The PubMed, EMBASE, and Cochrane Central Register of Controlled Trials databases were searched for prospective controlled trials that compared DCB and BA for patients with ISR in the femoropopliteal artery. The study has been approved by Ethics Committee of Wuhan Central Hospital. Results: The meta-analysis included 6 prospective trials with 541 patients. We found that DCB use was associated with significant reductions in binary restenosis at 6 months (relative risk [RR]: 0.45, 95% confidence interval [CI]: 0.33–0.63; P < .00001), binary restenosis at 1 year (RR: 0.44, 95% CI: 0.34–0.57; P < .00001), target lesion revascularization (TLR) at 6 months (RR: 0.36, 95% CI: 0.20–0.65; P = .0006), and TLR at 1 year (RR: 0.38, 95% CI: 0.27–0.54; P < .00001). The DCB group also had significantly better clinical improvement (RR: 1.39, 95% CI: 1.13–1.71; P = .002), although we did not detect inter-group differences in terms of death, target vessel thrombosis, or ipsilateral amputation. The brand of DCB may a cause of heterogeneity. Conclusion: Relative to BA, DCB use increases the durability of treatment for ISR in the femoropopliteal artery, based on significant reductions in binary restenosis and TLR at 6–12 months after the procedure. Furthermore, DCB use was associated with better clinical improvement. However, additional randomized controlled trials are needed to validate these findings.

Background: Allergic bronchopulmonary mycosis (ABPM) is a complex pulmonary disorder caused by a hyperimmune response to the endobronchial growth of certain fungi. This study aims to aid physicians in better understanding the need for earlier recognition of ABPM.Methods: Patients with a confirmed diagnosis of ABPM after evaluation were analyzed retrospectively.Clinical features, previous diagnoses and potential diagnostic errors, laboratory findings were reviewed and compiled.Results: Fifty-seven patients were diagnosed with ABPM in which 22 were misdiagnosed. Eosinophilia was observed in 11 patients and an elevated total serum Ig E level greater than 1,000 kU/L was detected in 25 of the 57 patients. All of the patients were tested for specific Ig E in which positive to different fungi. The two most common abnormalities found on chest high-resolution computed tomography (HRCT) exams were central bronchiectasis and mucus plugs. A mild to moderate obstructive pattern of lung function was observed in 32 cases. By bronchofiberscopic observation, bronchial lumen was seen to have significant inflammation in 12 patients. After 3 weeks of treatment, a decreased serum total Ig E value was observed.Conclusions: This study highlights the importance of increasing awareness and understanding of non-Aspergillus-ABPM among physicians and draws attention to the need for establishing more elaborate diagnostic criteria for non-Aspergillus-ABPM, which is a rare kind of disease.

Objective. Elderly patients with hip surgery are prone to postoperative cognitive dysfunction (POCD), leading to health management difficulties. This study is aimed at investigating the effect of ultrasound radiomics-guided iliac fascia block on POCD. Methods. A total of 67 cases of patients who had undergone hip joint surgery were divided into a training set ( n = 47 ) and a validation set (radiomics-guided group, n = 20 ). The patients were intervened with ultrasound radiomics-guided iliac fascia block, and the maximum relevance minimum redundancy sifts out the image omics features obtained from 2D ultrasound images of patients. Another 20 patients undergone general anesthesia served as control. The incidence of POCD, the total amount of fentanyl, the visual analogue score (VAS) at different time points, and the levels of CRP and NSE in plasma were compared between the two groups. Results. The AUC on the training and validation sets were higher than 0.940. The incidence of POCD in the radiomics-guided and general anesthesia group was 5% and 30%, respectively ( P = 0.037 ). Compared with the general anesthesia group, the dosage of fentanyl in the radiomics-guided was lower, the VAS score at 6 h, 1 d, and 2 d after operation was smaller, and the levels of CRP and NSE were lower (all P < 0.05 ). Conclusions. For elderly patients with hip surgery, the ultrasound radiomics-guided iliac fascia block can reduce the incidence of POCD and improve the effect of nerve block.