Background:Acute myocardial infarction (AMI) is one of the leading causes of death and physical disability worldwide. However, the development of community- based cardiac rehabilitation (CR) in AMI patients is hysteretic. Here, we aimed to evaluate the safety and efficacy of CR applied in the community in AMI patients who underwent percutaneous coronary intervention (PCI).Methods:A total of 130 ST-segment elevated myocardial infarction (STEMI) patients after PCI were randomly divided into 2 groups in the community, rehabilitation group (n = 65) and control group (n = 65). Cardiac function, a 6-minute walk distance, exercise time and steps, cardiovascular risk factors were monitored respectively and compared before and after the intervention of 2 groups. The software of EpiData 3.1 was used to input research data and SPSS16.0 was used for statistical analysis.Results:After a planned rehabilitation intervention, the rehabilitation group showed better results than the control group. The rehabilitation group had a significant improvement in recurrence angina and readmission (P < .01). Left ventricular ejection fraction (LVEF) of rehabilitation group showed improvement in phase II (t = 4.963, P < .01) and phase III (t = 11.802, P < .01), and the New York Heart Association (NYHA) classification was recovered within class II. There was a significant difference compared with before (Z = 7.238, P < .01). Six minutes walking distance, aerobic exercise time, and steps all achieved rehabilitation requirements in rehabilitation group in phase II and III, there existed distinct variation between 2 phases. Rehabilitation group had a better result in cardiovascular risk factors than control group (P < .05).Conclusion:Community-based CR after PCI through simple but safe exercise methods can improve the AMI patient's living quality, which includes increasing cardiac ejection fraction, exercise tolerance, and physical status. It must be emphasized that the good result should be established by the foundation of close cooperation between cardiologists and general practitioners, also the importance of cooperation of patients and their families should not be ignored. The rehabilitation program we used is feasible, safe, and effective.
Abstract:An imaging-based automated large-scale particle image velocimetry (LSPIV) system for flash flood monitoring is developed and deployed in a mountainous stream in the Longchi Catchment, Chengdu, China. This system is built from a low-cost Raspberry Pi board-level computer with a camera module, which can acquire continuous images/videos automatically at programmed intervals. The minimum quadratic difference algorithm tracks surface patterns as flow tracers to estimate the distribution of surface velocities. Meanwhile, a stereo imaging-based 'virtual pole' method has been developed to reconstruct the threedimensional topography with a stereo digital camera, and a cross-sectional bathymetry has been generated without manual surveying. The varying water stage and water surface gradient, which are critical parameters that affect image rectification and surface velocity measurements, can also be directly resolved by applying the two imaging modules together. Discharge can then be estimated with the velocity-area method through selected cross sections. A flash flood that occurred between 24 July 2014 and 25 July 2014 is selected for analysis. The water surface level reconstructed from image processing was validated with marked water levels, and a good agreement was found with a root mean square error of 3.7 cm. The discharge recorded during the flood recession process ranged from approximately 3.5 to 27 m 3 /s. The rating curve obtained can be well described by a power function, and the linear regression suggested a Manning's n roughness coefficient of 0.18 of one specific cross section. Some limitations of the presented large-scale particle image velocimetry system are also put forward, and possible solutions are provided for future improvements. With these proposed upgrades, the system can provide valuable datasets of flash floods in steep mountainous streams, which are critically needed for improving our understanding and modelling of many hydrological processes associated with flood generation, propagation and erosion, as well as for real-time forecasting.
Emerging evidence suggests that dipeptidyl peptidase-4 (DPP-4) inhibitors, including sitagliptin, exert favourable effects on the vascular endothelium. DPP-4 inhibitors suppress the degradation of glucagon-like peptide-1 (GLP-1), which has been reported to enhance nitric oxide (NO) production. However, the effects of DPP-4 inhibitors on endothelin-1 (ET-1) expression in the aorta, as well as the underlying mechanisms responsible for these effects, have yet to be investigated in animal models of diabetes mellitus (DM). In the present study, the rats were randomly divided into the following four groups: i) control; ii) DM; iii) DM + low-dose sitagliptin (10 mg/kg); and iv) DM + high-dose sitagliptin (30 mg/kg). Apart from the control group, all the rats received a high-fat diet for 8 weeks prior to the induction of diabetes with an intraperitoneal injection of streptozotocin. The treatments were then administered for 12 weeks. The serum levels of ET-1, NO, GLP-1 and insulin were measured as well as endothelial function. The expression of ET-1, AMP-activated protein kinase (AMPK) and nuclear factor (NF)-κB/IκBα were determined. After 12 weeks of treatment, the diabetic rats receiving sitagliptin showed significantly elevated serum levels of GLP-1 and NO, and reduced levels of ET-1. Moreover, sitagliptin significantly attenuated endothelial dysfunction as well as the remodeling of the aortic wall. Notably, sitagliptin inhibited ET-1 expression at the transcriptional and translational level in the aorta, which may have been mediated by the suppression of the NF-κB/IκBα system induced by AMPK activation. The majority of the above-mentioned effects were dose dependent. Taken together, the findings of the present study indicate that sitagliptin inhibits ET-1 expression in the aortic endothelium by suppressing the NF-κB/IκBα system through the activation of the AMPK pathway in diabetic rats. These findings further demonstrate some of the vasoprotective properties of DPP-4 inhibitors in vivo.
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