Objective To investigate the characteristics of blood pressure and coronary artery impairment in patients with essential hypertension (EH) combining coronary heart disease (CHD). Methods A total of 358 patients with EH combining CHD and other 144 patients with CHD were measured with ambulatory blood pressure monitoring (ABPM), and the parameters of ambulatory blood pressure were analyzed. All the patients underwent coronary angiography. The severity of coronary artery stenosis was evaluated in accordance with the number of impaired arteries. Results Compared to the patients with simplex CHD, those with EH combining CHD had much heavier artery stenosis and more diffuse lesions, with significant differences (χ2=6.03, P=0.019). The 24h systolic blood pressure (SBP), day SBP, night SBP, 24h pulse pressure (PP), day PP and night PP were higher in the patients with EH combining CHD compared to those of the patients with simplex CHD (The t values were 2.580, 2.045, 2.675, 2.037, 2.601, and 1.995, respectively, while the P values were 0.015, 0.037, 0.009, 0.041, 0.017, and 0.047, respectively). Conclusion Compared to the patients with simplex CHD, the patients with EH combining CHD suffer from much severe coronary artery impairment, so a good controlling of blood pressure is advisable to improve the coronary artery impairment for the patients with EH combining CHD.
Objective To observe the effect of NLRP3 inflammasome inhibitor MCC950 intervention on airway Muc5ac level in asthmatic mice, and to explore the role and mechanism of NLRP3 inflammasome in asthmatic airway mucus hypersecretion. Methods A total of 50 SPF grade BALB/c female mice aged 6 - 8 weeks were randomly divided into normal control group (NS group), asthma model group (AS group), dexamethasone group (Dex group), MCC950 high-dose intervention group (MH group) and MCC950 low-dose intervention group (ML group), with 10 mice in each group. Furthermore, the bronchoalveolar lavage fluid (BALF) of mice in each group was counted by total cell count, associated with white blood cell different count. In addition, the concentrations of interleukin (IL)-18 and IL-1β in BALF were tested by enzyme-linked immunosorbent assay; The lung tissues were prepared into paraffin-embedded sections, which were then subject to hematoxylin-eosin (HE) staining, Alcian blue-periodic acid Schiff base staining and Masson staining to observe the pathological changes of lung tissues. Immunohistochemistry was used to detect the protein expression levels of Muc5ac, NLRP3 and caspase-1 in lung tissues. Real-time quantitative polymerase chain reaction was performed to detect the relative mRNA expressions of Muc5ac, NLRP3 and Caspase-1 in lung tissues. Results Compared with NS group, AS group showed significant increase in total cell count of BALF, the percentage of eosinophils, the infiltration score of inflammatory cells around the airway, the positive relative staining area of airway mucus and the deposition area of airway collagen fibers in mice (P<0.05), upregulated protein expression levels of Muc5ac, NLRP3 and Caspase-1 in lung tissues (P<0.05), elevated relative mRNA expressions of Muc5ac, NLRP3 and Caspase-1 in lung tissues (P<0.05), and raised concentrations of IL-18 and IL-1β in BALF (P<0.05). While compared with AS group, the above indicators were reduced in MH group and ML group (P<0.05). Moreover, in relative to Dex group, these indicators were increased in MH group ML group (P<0.05). In addition, no statistically significant difference was observed in the aforementioned indications between MH group and ML group.Conclusions MCC950 intervention can inhibit airway inflammation and airway mucus secretion in asthmatic mice. Its mechanism is speculated to be related to the suppression of NLRP3, Caspase-1, IL-18 and IL-1β expressions, downregulation of Muc5ac expression, and inhibition in airway mucus hypersecretion.
Objective To comprehensively observe, recognize, learn and understand the clinical features of tuberculous meningitis (TBM). Methods We retrospectively analyzed the general data, clinical manifestations, clinical examinations and treatment prognosis of 152 patients with TBM who were hospitalized in the Second Affiliated Hospital of Zunyi Medical College between January 2016 and February 2017. Results The mean age of the 152 patients with TBM was (43.9±20.4) years old, the ratio of male to female was 1.45:1, and the average length of hospital stay was (20.0±18.9) days. The clinical manifestations were mainly headache [95.4% (145/152)], nausea and vomiting [42.8% (65/152)], and fever [61.8% (94/152)]. The main co-morbidities were secondary pulmonary tuberculosis [52.0% (79/152)], hematogenous disseminated tuberculosis [37.5% (57/152)], and tuberculous pleurisy [30.9% (47/152)]. The positive rate of γ-interferon release test was 90.8% (129/142), and the brain pressure of lumbar puncture was elevated. The typical biochemical changes of cerebrospinal fluid were " low glucose, low chlorine, and high protein”. The positive rate of tuberculosis smear was extremely low, and the positive rate of GeneXpert MTB/RIF in cerebrospinal fluid was 21.9% (7/32). The TBM patiens were prone to combine with hypoproteinemia, the proportion reached 29.6% (45/152), and the proportion of hyponatremia reached 45.3% (69/152). Treated with early diagnosis and treatment, 92.1% (140/152) improved and discharged. Conclusions TBM patients are mainly young and middle-aged with various clinical manifestations and less respiratory symptoms; and are easy to be combined with pulmonary tuberculosis and other extrapulmonary tuberculosis. γ-interferon release test and cerebrospinal fluid GeneXpert MTB/RIF can be used for the auxiliary diagnosis of tuberculosis. Early detection, early diagnosis and treatment, rational and regular chemotherapy, strengthening symptomatic supportive treatment, and improving the precise diagnosis and treatment of TBM, can improve its clinical prognosis.