Objective  To explore the efficacy of home cardiac rehabilitation exercise in patients with coronary heart disease(CHD) after percutaneous coronary intervention(PCI).Methods  According to the order of admission,92 patients with CHD who were received PCI in the third grade hospital and lived in our community were divided into control group(46 cases) and observation group(46 cases).Patients in control group were received conventional treatment after PCI,and patietns in observation group were received home cardiac rehabilitation exercise on basis of those in control group within 3 months.BMI,heart rate,blood pressure,left ventricular end diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),6 min walking distance and metabolic equivalent (METs) were compared between the two groups.The Seattle angina questionnaire(SAQ) was used to assess quality of life of patietns in the two groups before and after treatment and the results were compared.Results  There were no significant differences of BMI,heart rate,blood pressure,LVEDD,LVEF,6 minutes walking distance,METs and score of every item in SAQ between patient of the two groups before treatment(P＞0.05).BMI,diastolic blood pressure and LVEDD after treatment in patients of observation group were lower than those before treatment,LVEF,6 minutes walking distance,METs and score of every item in SAQ were higher than those before treatment(P＜0.05).LVEDD after treatment in patients of control group was lower than that before treatment,scores of angina stability,treatment satisfaction and disease recognition in SAQ were higher than those before treatment(P＜0.05).Diastolic blood pressure after treatment in patients of observation group was lower than that of control group,LVEF,6 minutes walking distance,METs and score of every item in SAQ were higher than those of control group(P＜0.05).Conclusion  Home cardiac rehabilitation exercise can reduce BMI in patients with CHD after PCI,regulate their blood pressure,improve cardiac function,improve exercise tolerance and quality of life.

Objective  To explore the correlation between fatty liver index(FLI) and insulin resistance(IR) in middle aged and elderly population in China.Methods  A total of 3 592 community population aged over 45 years in Gulou district,Nanjing city were enrolled.The subjects were divided into IR group(1 938 cases) and non-IR group(1 654 cases) according to Homeostatic model assessment of insulin resistance index(HOMA-IR) and divided into FLI＜30 group(2 221 cases),30≤FLI＜60 group(911 cases) and FLI≥60 group(460 cases) based on FLI.General data,biochemical indexes,blood glucose and insulin related indexes of different subgroups were compared.Spearman nonparametric correlation analysis was used to evaluate the correlation between FLI and HOMA-IR,related indicators of islet β cell function.Receiver operating characteristic(ROC) curve was used to analyze the predictive value of FLI for IR.Multivariate logistic regression analysis was conducted to assess the relationship between FLI and IR.Results  The rate of male population,age,blood pressure,blood fat,liver function,plasma glucose and insulin at each time point of OGTT,FLI,homeostatic model assessment of islet β cell function(HOMA-β),ΔI0-30/ΔG0-30 and HOMA-IR of IR group were higher than those of non-IR group,while serum creatinine and Matsuda ISI were lower than those of non-IR group(P＜0.001).The differences of blood pressure,biochemical indexes,plasma glucose and insulin related indexes among different FLI subgroups were statistically significant(P＜0.001).Spearman nonparametric correlation analysis results showed that FLI was positively correlated with HOMA-IR(P＜0.001) and negatively correlated with Matsuda ISI(P<0.001).ROC curve analysis results showed that AUC of IR based on FLI was 0.670(95% CI 0.653-0.688).Multivariate logistic regression analysis results showed that FLI was one of the risk factors for IR and could increase the risk of IR by 1.021 times(P<0.001).Conclusion  FLI is correlated with IR and can be a simple and practical index for evaluating IR in middle-aged and elderly population in China．

Objective  To evaluate the relationship between thyroid stimulating hormone(TSH) level and insulin resistance(IR) in obese non-diabetic patients.Methods  Obese non-diabetic patients who were treated in the clinic of endocrinology department in people’s hospital of Fufeng county from August 2016 to May 2018 were selected as subjects.The clinical data,laboratory results and thyroid morphological and functional evaluation results were collected.The relationship of TSH level and insulin resistance index(HOMA-IR) were computed using multivariate linear regression analysis.Results  TSH level was positively correlated with HOMA-IR(r=0.24,P=0.028),serum insulin(r=0.23,P=0.037)and triglyceride(r=0.30,P=0.006)in the overall cohort,while negatively correlated with serum high density lipoprotein cholesterol(r=-0.25,P=0.002).HOMA-IR was positively correlated with triglyceride(r=0.25,P=0.026),ALT(r=0.37,P=0.001)and amplification of glutamyl transpeptidase(r=0.32,P=0.003).The results of multivariate linear regression analysis showed that TSH(β=0.620,95%CI 0.482-0.758,P=0.015)and BMI(β=0.147,95%CI 0.111-0.184,P=0.034)were significantly correlated with HOMA-IR.Conclusion  TSH is associated with insulin resistance in obese non-diabetic patients,suggesting that the screening of thyroid function is important for obese non-diabetic patients.

Objective  To explore the value of Kawamura classification in evaluating H.pylori infection,gastric mucosal inflammation and atrophy.Methods  The gastric pit crypt openings(COs) in the greater and lesser curvatures of the upper gastric corpus of 71 patients with H.pylori infection were observed under the magnifying endoscopy and divided into “white-edged dark spot” type,“white” type and “dense white pit(DWP)” type according to the COs.Then the pathological biopsy was taken.The patients were received H.pylori eradicaton therapy.After 6 months,65 cases of successfully eradicated patients were performed the gastroscope.The distribution of three types in pre-treatment and post-treatment were compared.The distribution of three types in different degrees of gastric mucosal inflammation activity and atrophy were compared.Results  The distribution of the three types in post-treatment was significantly different with that in pre-treatment(P<0.001).The “white” type was dominated in pre-treatment and the “white-edged dark spot” type was dominated in post-treatment.The degree of inflammation was sequentially increased by “white-edged dark spot” type,“white” type,and “DWP” type,and there were significant differences in the distribution between every two groups(P<0.001).There were no significant differences in the distribution of Kawamura types between different degrees of atrophy(P>0.05).Conclusion The Kawamura classification is useful to determine H.pylori infection and evaluate thegastric mucosal inflammatory activity,but there is no significant advantage in the evaluation of atrophy.

Objective  To explore the effect of serum soluble ST2 in early diagnosis and short-term prognosis evaluation of acute decompensation of chronic heart failure(ADHF).Methods  Sixty patients with ADHF(observation group) and 60 patients with stable chronic heart failure(control group) were concluded.Levels of serum soluble ST2 and plasma amino terminal brain natriuretic peptide(NT-proBNP) were detected and compared between the two groups.Correlations between level of serum soluble ST2 and other indexes in patients with ADHF were evaluated by Pearson correlation analysis.Diagnostic efficacy of serum soluble ST2 and NT-proBNP on ADHF were analyzed by receiver operating characteristic(ROC) curve.Results  Heart rate,blood pressure,acute physiology and chronic health score(APACHE Ⅱ score),soluble ST2,NT-proBNP and serum creatinine were higher in observation group than those in control group,left ventricular ejection fraction(LVEF) was lower than that in control group,and there was significant difference of constituent ratio of New York Heart Association(NYHA) heart function classification between the two groups(P<0.05).Pearson correlation analysis showed that level of serum soluble ST2 in ADHF patients were positively correlated with heart rate,systolic blood pressure,diastolic blood pressure,APACHE Ⅱ score,NYHA heart function classification,NT-proBNP and serum creatinine,and negatively correlated with LVEF(P<0.05).AUC of serum soluble ST2 and NT-proBNP for the diagnosis of ADHF were 0.800 and 0.780 respectively,and the difference was not statistically significant(P=0.894).Level of serum soluble ST2 before treatment was significantly higher than that after treatment in 56 patients who turned to stable chronic heart failure(P<0.001).Conclusion  There is certain value of serum soluble ST2 in early diagnosis of ADHF,and its level is closely related with severity of disease.Serum soluble ST2 is expected to be a biomarker for evaluating short-term prognosis of patients with ADHF.