No abstract

Objective. To evaluate the application value of serum lipoprotein-associated phospholipase A2 (Lp-PLA2) and homocysteine (Hcy) combined with color Doppler detection in elderly patients with acute coronary syndrome (ACS) and the influence on their endothelial function. Methods. From February 2019 to October 2020, 100 elderly patients with suspected ACS treated in our hospital were recruited and assigned (1 : 1) to a control group or an experimental group. The control group received color Doppler detection, and the experimental group received the combined detection of serum Lp-PLA2 and Hcy and color Doppler. Positive results were determined by the combined detection of the levels of LP-PLA2 and Hcy and color Doppler. The two groups were compared in terms of specificity, susceptibility, positive detection rate, negative detection rate, test accuracy, the area under the receiver operating characteristic (ROC) curve (AUC), the expression levels of interleukin-2 (IL-2), interleukin-12 (IL-12), interleukin-13 (IL-13), and the vascular endothelial function. The patients with ACS were divided into three subgroups according to the Gensini score three-quartile interval, and their Lp-PLA2 levels were calculated for analysis. Results. The test specificity, susceptibility, positive detection rate, negative detection rate, test accuracy, and AUC in the experimental group were much better than the those in the control group (all P < 0.05 ), and there were no significant differences in the expression levels of IL-2, IL-12, IL-13, and vascular endothelial function between the two groups ( P > 0.05 ). The three subgroups showed similar levels of fasting blood glucose, total cholesterol, triglyceride, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, apolipoprotein A-I, glutamic-pyruvic transaminase, lutamic-oxaloacetic transaminase, homocysteine, and amino-terminal pro-brain natriuretic peptide (all P > 0.05 ). The severe condition group had the highest Lp-PLA2 level, followed by the moderate group, and then the mild group ( P < 0.05 ). Moreover, the levels of LP-PLA2, aspartate transaminase (AST), and N-terminal pro hormone B-type natriuretic peptide (NT-proBNP) were all influencing factors for the coronary Gensini score (all P < 0.05 ). Conclusion. The combined detection of serum Lp-PLA2, Hcy, and color Doppler significantly improves the diagnostic accuracy, specificity, and susceptibility in the elderly with ACS, with little impact on their vascular endothelial function.

Objective. To explore the effect of individual nursing combined with dietary management on blood glucose levels and quality of life in elderly patients with acute coronary syndrome with diabetes. Method. This study included 68 elderly patients who underwent acute coronary syndrome at Department of Emergency in our hospital from January 2018 to January 2020. And they were assigned to a control group (n = 34) treated with individual nursing and a research group (n = 34) treated with individual nursing and dietary management according to the random number table. A comparison of the changes in blood glucose levels, anxiety and depression, quality of life, and nursing satisfaction was made between groups before and after nursing. Result. Before nursing, the differences in blood glucose levels, SAS scores, and SDS scores between groups were not considered statistically significant ( P > 0.05 ). After nursing, the blood glucose levels, SAS, and SDS levels of patients in both groups significantly decreased, and the research group presented a higher decrease when compared with the control group ( P < 0.05 ). The short form health survey (SF-36) showed that the research group had higher scores in physical function (PF), general health (GH), vitality (VT), mental health (MH), social function (SF), role-physical (RP), bodily pain (BP), and role-emotional (RE) compared with the control group ( P < 0.05 ). The satisfaction survey presented that the research group had a significantly higher total score than the control group [(91.40 ± 5.23) vs. (86.61 ± 7.14), P < 0.05 ]. Conclusion. The combination of individual nursing and dietary management not only effectively reduces glycosylated hemoglobin levels and anxiety and depression but also wins better nursing satisfaction in the treatment of acute coronary syndrome in elderly patients. Moreover, their quality of life has been significantly improved after discharge.

Background: Ischemia-reperfusion (IR) injury is one of major causes of acute kidney injury (AKI). Chemerin chemokine-like receptor 1 (CMKLR1) has been reported to involved in the progression of IR injury. Here, we investigated the protective role of CMKLR1 antagonist, α-NETA, in IR mouse model, and dissected the underlying regulatory mechanism. Methods: IR injury mouse model was established to evaluate the protective effects of α-NETA on IR injury. Kidney injury associated parameters and functions were examined to evaluate the renal function of Sham, IR, and IR+ α-NETA mice. Renal morphological changes and apoptosis were determined by PAS and TUNEL staining in IR and α-NETA treated mice. ELISA, RT-qPCR, and western blot were performed to examine the inflammatory responses and expression of CMKLR1. Results: α-NETA administration attenuated IR-induced renal tubular injury and epithelial cell apoptosis in IR injury mice. Kidney injury related cystatin C, kidney injury molecule-1, neutrophil gelatinase-associated lipocalin, and renal morphology were significantly improved. Mechanistically, α-NETA suppressed the inflammatory responses through inhibiting the expression of CMKLR1, and then protected the IR-induced renal damage and restored the renal function. Conclusion: CMKLR1 plays important role in renal ischemia-reperfusion injury, targeting CMKLR1 by using the small molecule inhibitor α-NETA is a potential treatment strategy for AKI.