Abstract:Aim To explore the diagnostic value of peripheral blood monocyte to high density lipoprotein cholesterol ratio (MHR) in lower extremity arterial stenosis. Methods 311 consecutive cases treated in the Eighth Affiliated Hospital of Sun Yat-sen University from August 2018 to August 2020 were selected. According to the degree of lower extremity arterial stenosis, the patients were divided into four groups:(1)control group (n＝65):lower extremity artery was normal; (2)mild lesion group (n＝77):30%≤lower extremity arterial stenosis＜50%; (3)moderate lesion group (n＝60):50%≤lower extremity arterial stenosis ≤ 75%; (4)severe lesion group (n＝109):lower extremity arterial stenosis＞75% or occlusion. MHR was calculated. The clinical data and laboratory results of the four groups were collected and compared. The influencing factors of lower extremity arterial stenosis and the diagnostic value of MHR in lower extremity arterial stenosis were analyzed. Results The differences in age, MHR, high-sensitivity C-reactive protein, hemoglobin, high-density lipoprotein cholesterol, serum creatinine (SCr), blood uric acid, blood homocysteine, history of hypertension, and history of diabetes were statistically significant among the four groups (P＜0.05). Multivariate Logistic regression analysis showed that advanced age, high MHR, high SCr and history of diabetes were risk factors for patients with lower extremity arterial stenosis (P＜0.05). Based on the predicted probability obtained from the multivariate Logistic regression model, the ROC curve was drawn, and the area under the curve was 0.953; When the predicted probability is 0.86, the sensitivity and specificity for the diagnosis of lower extremity arterial stenosis were 85.8% and 92.3%.Conclusions High MHR is a risk factor for lower extremity arterial stenosis. The multivariate Logistic regression model established in this article has a high diagnostic value for lower extremity arterial stenosis.

Abstract:Aim Through the analysis of serum metabolites in coronary heart disease (CHD) patients with different degrees of coronary artery lesion, to find new biomarkers for predicting and diagnosing CHD. Methods 92 CHD patients who met the experimental requirements from July 2017 to December 2018 in Tianjin Third Central Hospital were selected for serum analysis, including 57 males and 35 females. Among them, 24 patients had coronary artery stenosis ＜50%, 19 patients had at least one coronary artery stenosis ≥50% and ≤70%, 23 patients had at least one coronary artery stenosis ＞70%, 26 patients had acute coronary occlusion. Liquid chromatography-mass spectrometry was used to detect the chromatographic peak and mass spectrum peak of metabolites in samples, in order to determine the metabolites.The clinical diagnostic efficacy of characteristic metabolites was evaluated by ROC curve. Results 47 different metabolites were identified in metabolic disorders, and 10 characteristic metabolites were finally identified. With the increase of the degree of coronary artery stenosis, the metabolic pathway changed, including the decrease of glycerol phospholipid and fatty acid metabolism, and the increase of glycosphingolipid and purine metabolism. ROC curve analysis showed that the area under the curve of characteristic metabolites was all greater than 0.75. Conclusion Metabolic disorders are present in CHD patients with different degrees of coronary artery lesion, and the characteristic metabolites have diagnostic value.

Abstract:Aim To evaluate whether the value of 64-detector spiral computed tomography coronary angiography （64-DSCTCA） is identical between female and male in diagnosis of patients with coronary artery stenosis. Methods 75 female and 75 male patients with coronary artery disease （CAD） or suspected CAD were chosen, who had been examined with not only 64-DSCTCA but also coronary angiography （CAG）. The result of CAG was regarded as the gold standard. The sensitivities, specificities, positive prediction values and negative prediction values of 64-DSCTCA were respectively calculated in diagnosis of female and male patients with CAD （coronary artery stenosis≥50%）, coronary artery moderate stenosis （stenosis 50%～75%）, severe stenosis and occlusion （stenosis 76%～100%）. The aforementioned results were analyzed by statistical method, and contrasted between female and male. Results For the sensitivity, specificity, and negative prediction value of 64-DSCTCA in diagnosis of CAD, the differences were not statistically significant （P>0.05）, but positive prediction value was lower in female than that in male （P<0.05）. For the sensitivity, specificity, positive prediction value, and negative prediction value of 64-DSCTCA in diagnosis of coronary artery moderate stenosis, the differences were not statistically significant between female and male （P>0.05）. For the sensitivity, specificity, and negative prediction value of 64-DSCTCA in diagnosis of coronary artery severe stenosis and occlusion, the differences were not statistically significant （P>0.05）, but positive prediction value was lower in female than that in male （P<0.05）. Conclusions Diagnostic value of 64-DSCTCA is different in female and male. Positive prediction value of 64-DSCTCA is lower in female than that in male for diagnosis of CAD, coronary artery severe stenosis and occlusion.

Abstract:Aim To study the diagnostic value of brachial-ankle pulse wave velocity （baPWV） and ankle-brachial index （ABI） for early atherosclerosis （As） in patients with hypertension.Methods 2400 cases of patients with hypertension were collected from January 2010 to December 2014 in our hospital. These patients were divided into two groups: non-As hypertension group （1200 cases） and As hypertension group （1200 cases）. 1248 cases of healthy examination persons in the same period were regarded as the control group. baPWV, ABI and intima-media thickness （IMT） were detected and compared in the three groups.Results Compared with the control group, the levels of baPWV, SBP, DBP, TG and LDLC were significantly increased in the non-As hypertension group and the As hypertension group （P<0.05） Compared with the non-As hypertension group, the levels of baPWV, TG and LDLC were significantly increased in the As hypertension group （P<0.05）. Compared with the control group, the levels of ABI and HDLC were obviously decreased and the IMT thickening rate was significantly increased in the As hypertension group （P<0.05）, but the changes of ABI and IMT thickening rate were not obvious in the non-As hypertension group （P>0.05）. There was no obvious correlation between baPWV and ABI in the control group and the non-As hypertension group, but there was obviously negative correlation between baPWV and ABI in the As hypertension group （r＝-0.718，P<0.05）.Conclusions The baPWV and ABI can more accurately reflect vascular structure and function changes, and be obviously correlated with the As degree. They are helpful to the early diagnosis of As lesion for patients with hypertension.

Abstract:Aim To evaluate the diagnostic value of serum lipids, lipoprotein (a) and their combination in coronary heart disease (CHD). Methods 546 patients with suspected CHD were enrolled into this study and divided into CHD group (n=354) and non-CHD group (n=192) according to the result of coronary arterography. Their clinical data were analysed by case-control method, and serum lipids were detected by standard method. Results Compared with non-CHD group, the levels of serum total cholesterol, low density lipoprotein cholesterol, lipoprotein (a) and the ratio of total cholesterol to high density lipoprotein cholesterol in CHD group were significantly raised, whereas the level of high density lipoprotein cholesterol were significantly lowered. There was no significant difference in serum triglyceride level and triglyceride/high density lipoprotein cholesterol ratio between two groups. The abnormal rate of total cholesterol, low density lipoprotein cholesterol, total cholesterol/high density lipoprotein cholesterol ratio and lipoprotein (a) in CHD group significantly increased, while the abnormal rate of other lipids didnt show significant difference. The predicative value and likelihood ratio of lipoprotein (a) for CHD was not superior to that of other lipids, but when combined with low density lipoprotein cholesterol, these value would further be elevated. In logistic regression model, lipoprotein (a) wasnt more related to CHD risk than other lipids. Conclusion The diagnostic value of lipoprotein (a) isnt better than other lipids. When combined with low density lipoprotein cholesterol, it may be regarded as a better predicative marker for CHD.