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Objective:To explore the validity of the effective arterial elastance (Ea) before and after fluid challenge in evaluating the fluid challenge in septic shock patients.Methods:A retrospective study was conducted in the medical intensive care unit (MICU) of Peking Union Medical College Hospital from October 2016 to October 2020. 116 septic shock patients were enrolled. All patients received fluid challenge by 500 mL Gelatin or normal saline under invasive hemodynamic monitoring. Heart rate (HR), mean arterial pressure (MAP), cardiac output (CO) and other hemodynamic variables were collected at 10 minutes before and immediately after fluid challenge. An increase in CO greater than 10% after fluid challenge was defined as the positive preload responsiveness, as well as the definition of positive pressure responsiveness was an increase in MAP greater than 10%. Receiver operating characteristic curves (ROC curves) were established to evaluate the predictive abilities of baseline Ea and other arterial load indices in detecting the preload responders and pressure responders. The correlation of the baseline Ea with CO changes after fluid challenge as well as MAP changes were tested by Pearson correlation analysis. Patients with positive preload responsiveness were divided into two groups according to the pressure responsiveness. The changes in Ea and other arterial load indices were analyzed.Results:A total of 116 patients were finally analyzed. Sixty-three patients were preload responders and 53 patients were preload non-responders. There was no significant difference in demographics and baseline physical variables between the two groups. Ea in preload responders was higher than that in preload non-responders (mmHg/mL: 2.51±1.08 vs. 1.87±0.68, P < 0.01). ROC curve analysis showed that the baseline Ea could predict the preload responsiveness at an area under ROC curve (AUC) = 0.71 [95% confidence interval (95% CI) was 0.62-0.81, P < 0.001]. The cut-off value was 1.97 mmHg/mL with a sensitivity of 71.4% and a specificity of 60.4%. The baseline Ea did not present the predictive ability to detect the pressure responders and pressure non-responders (AUC = 0.52, 95% CI was 0.41-0.63, P = 0.73). Pearson correlation analysis showed that the changes in CO after fluid challenge was moderately correlated to the baseline Ea ( r = 0.47, P < 0.001), meanwhile a weak positive correlation between the changes in MAP and baseline Ea was found ( r = 0.20, P = 0.03). In preload responders, 27 (42.9%) of 63 patients were pressure responders and 36 (57.1%) patients were pressure non-responders. No statistical difference was found in the baseline Ea or other arterial load indices between the two groups. Fluid challenge decreased Ea both in pressure non-responders and pressure responders (mmHg/mL: 2.13±0.94 vs. 2.51±1.08, P < 0.01; 2.47±1.18 vs. 2.69±1.30, P < 0.05). Moreover, the changes in CO and changes in MAP were strongly correlated with the changes in Ea ( r values were -0.50 and 0.58, respectively, both P < 0.001). Conclusions:The Ea > 1.97 mmHg/mL before fluid challenge could predict fluid responsiveness in septic shock patients. The baseline Ea was not able to predict the subsequent changes in arterial pressure through fluid challenge. A significant decrease in Ea inducing by fluid administration explained why patients increased their CO without improving blood pressure.
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Objective To explore the short-term hemodynamic change of fluid challenge (FC) with crystalloid or colloid and define fluid responsiveness at the optimal time in patients with septic shock. Methods A prospective observational study was conducted. Septic shock patients monitored with pulmonary catheters admitted to medical intensive care unit (ICU) of the Peking Union Medical College Hospital from July 2016 to December 2018 were enrolled. All included patients received FC and were divided into two groups according to the type of fluid used, i.e. crystalloid group (normal saline for 500 mL) and colloid group (4% succinyl gelatin for 500 mL). The choice of fluid type was decided by the attending physician. Hemodynamic variables were measured at baseline, and 0 (immediately), 10, 30, 45, 60, 90, 120 minutes after FC, included cardiac index (CI), heart rate (HR), mean artery pressure (MAP), central venous pressure (CVP) and pulmonary arterial wedge pressure (PAWP). Fluid responsiveness was defined as CI increased by more than 10% after FC. The data were analyzed by repeated measurements of variance between the two groups as well as responders and nonresponders. Results Forty patients were included, 20 cases each in colloid group and crystalloid group; of whom 26 were fluid responders with 12 of colloid group and 14 of crystalloid group. Of the 14 nonresponders, 8 were of colloid group and 6 of crystalloid group. ① Compared with before FC, CI (mL·s-1·m-2) was significantly increased in crystalloid and colloid groups after FC (71.7±16.7 vs. 65.0±16.7, 68.3±25.0 vs. 63.3±23.3, both P < 0.05). In the colloid group, volume expansion increased the CI to maximum (76.7±18.3) at 30 minutes after FC, at 120 minutes after FC, a significantly higher CI (70.0±16.7) was also observed (P < 0.05), an increased in CI≥10% was observed at 60 minutes after FC. In the crystalloid group, CI was increased to maximum at 10 minutes (73.3±28.3) and decreased to baseline at 60 minutes, an increased in CI≥10% was also observed at 10 minutes after FC. In addition, there was no significant difference in CI changes between colloidal group and crystalloid group at different time points after FC. ② CI did not change over time in nonresponders groups, whereas in responders CI increased parallelly to that in both crystalloid and colloid groups over time. However, an increased in CI≥10% was observed through the 120 minutes after FC in responders of colloid group compared with that of at 30 minutes after FC in crystalloid group. There was significant difference in CI changes between colloidal group and crystalloid group at 30, 45, 60, 90 minutes after FC (mL·s-1·m-2: 18.3±3.3 vs. 8.3±1.7, 18.3±3.3 vs. 5.0±1.7, 13.3±1.7 vs. 3.3±1.7, 11.7±3.3 vs. 3.3±1.7, all P <0.05). ③ The maximal values of CVP and PAWP were observed at the end of FC. In colloid group, both the two variables were notably higher than that before FC over 120 minutes compared with that of only at 10 minutes in crystalloid group. The MAP in colloid increased to maximum immediately at the end of FC and decreased to baseline at 45 minutes, however, the MAP in crystalloid group and HR of both groups showed no differences over 120 minutes. Conclusions Hemodynamic changes were significantly different between crystalloid and colloid after FC in patients with septic shock. Therefore, the timing of fluid responsiveness assessment should be different individually. The assessment time of colloid group may be prolonged to 30 minutes after FC while that of crystal group can be at 10 minute after FC.
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Klinefelter syndrome(KS) is the most common sex chromosome disorder in males,which is caused by the presence of the extra X chromosome that maybe inherited from mother or father. Approximately 80% karyotype of the cases is 47,XXY. KS is characterized by small firm testes, hypergonadotropic hypogonadism, infertility,gynaecomastia, increased height. However, cognitive disabilities and psychiatric disorders are rarely diagnosed in KS because they lack screening in related aspects. At the present, the pathogenesis of cognitive disabilities and increased risk of psychiatric diseases in KS have not been delineated. In this article,we report two cases of KS,and review their clinical manifestations,diagnosis,and treatments.
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Kallmann syndrome ( KS) is a rare disease and characteristic of an absence of puberty, infertility, and a defective sensation of smell (anosmia or hyposmia). Here, we analyze the features of a case of KS diagnosed clinically. In addition, the etiology, genetic features, clinical manifestations, diagnosis, and treatment of KS were reviewed.
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Objective To systematically evaluate the therapeutic effect of pulse high volume hemofiltration (PHVHF) for treatment of patients with sepsis. Methods Databases such as PubMed in American National Medical Library, Holland medical abstract Embase, the Cochrane Library, China National Knowledge Internet (CNKI), China Biological Medical Literature Database (CBM), VIP, WanFang databases, etc. were searched by computer to retrieve randomized controlled trials (RCTs) on PHVHF for treatment of patients with sepsis, and the retrieval time ranged from the creation of database to March 25, 2017. Both groups of patients received conventional treatments, including antibiotics, fluid resuscitation, vasoactive agents as well as other organ function support treatments to maintain the basic vital signs stable. Patients in PHVHF group received PHVHF besides conventional treatment, while the patients in control group received conventional treatment or any other continuous renal replacement therapy (CRRT) mode with PHVHF excluded. The literatures accepted should at least include one of the following changes of outcome indicators, such as overall mortality, the levels of inflammatory mediators eliminated, acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score, service life of filter, amount of replacement fluids used. Two researchers independently screened literatures, extracted data, and assessed the methodological quality of included studies. Meta-analysis was conducted by using RevMan 5.3 software and the publication bias was evaluated by visually inspecting funnel plots. Results A total of 11 RCTs involving 410 patients met eligibility criteria, of which 204 patients in the PHVHF group and 206 patients in the control group. In the control group 5 RCTs used other CRRT modes, and 6 RCTs applied the conventional therapy. Meta-analyses showed that interleukin-6 [IL-6, standard mean difference (SMD) = -0.80, 95% confidence interval (95%CI) = -1.56 to -0.06, P = 0.04], tumor necrosis factor-α (TNF-α, SMD = -0.78, 95%CI = -1.33 to -0.23, P = 0.006), APACHE Ⅱ scores [mean difference (MD) = -3.80, 95%CI = -5.08 to -2.52, P < 0.000 01] were obviously lower than those in control group, but no significant statistical significance in mortality was seen between the two groups [relative risk (RR) = 0.72, 95%CI = 0.49 - 1.07, P = 0.10]. Further subgroup analyses suggested that compared with conventional treatment group, in PHVHF group mortality (RR = 0.40, 95%CI = 0.16 - 0.95, P = 0.04), IL-6 (SMD =-1.87, 95%CI = -3.58 to -0.16, P = 0.03), TNF-α (SMD = -1.32, 95%CI = -2.24 to -0.40, P = 0.005), and APACHE Ⅱscore (MD = -4.29, 95%CI = -6.02 to -2.56, P < 0.000 01) were significantly decreased; however, only a significantly decreased APACHE Ⅱ score (MD = -2.95, 95%CI = -4.56 to -1.35, P = 0.000 3) was observed in PHVHF group compared to that in subgroup of other CRRT modes. Conclusions Compared with using conventional therapy alone, using PHVHF combined with conventional therapy for treatment of patients with sepsis can more effectively improve their prognosis, and PHVHF can be the efficacious alternatives of other CRRT modes especially the HVHF. However, due to the limited quantity and quality of the included studies, further high-quality, multicenter, large-scale RCTs are needed to verify the above conclusion.
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Objective To evaluate the accuracy of central venous-to-arterial carbon dioxide partial pressure difference (Pcv-aCO2) before and after rapid rehydration test (fluid challenge) in predicting the fluid responsiveness in patients with septic shock. Methods A prospective observation was conducted. Forty septic shock patients admitted to medical intensive care unit (ICU) of Peking Union Medical College Hospital from October 2015 to June 2017 were enrolled. All of the patients received fluid challenge in the presence of invasive hemodynamic monitoring. Heart rate (HR), blood pressure, cardiac index (CI), Pcv-aCO2 and other physiological variables were recorded at 10 minutes before and immediately after fluid challenge. Fluid responsiveness was defined as an increase in CI greater than 10% after fluid challenge, whereas fluid non-responsiveness was defined as no increase or increase in CI less than 10%. The correlation between Pcv-aCO2 and CI was explored by Pearson correlation analysis. Receiver operating characteristic (ROC) curves were established to evaluate the discriminatory abilities of baseline and the changes after fluid challenge in Pcv-aCO2 and other physiological variables to define the fluid responsiveness. The patients were separated into two groups according to the initial value of Pcv-aCO2. The cut-off value of 6 mmHg (1 mmHg = 0.133 kPa) was chosen according to previous studies. The discriminatory abilities of baseline and the change in Pcv-aCO2(ΔPcv-aCO2) were assessed in each group. Results A total of 40 patients were finally included in this study. Twenty-two patients responded to the fluid challenge (responders). Eighteen patients were fluid non-responders. There was no significant difference in baseline physiological variable between the two groups. Fluid challenge could increase CI and blood pressure significantly, decrease HR notably and had no effect on Pcv-aCO2 in fluid responders. In non-responders, blood pressure was increased significantly and CI, HR, Pcv-aCO2 showed no change after fluid challenge. Pcv-aCO2 was comparable in responders and non-responders. In 40 patients, CI and Pcv-aCO2 was inversely correlated before fluid challenge (r = -0.391, P = 0.012) and the correlation between them weakened after fluid challenge (r = -0.301, P = 0.059). There was no significant correlation between the changes in CI and Pcv-aCO2 after fluid challenge (r = -0.164, P = 0.312). The baseline Pcv-aCO2 and ΔPcv-aCO2 could not discriminate between responders and non-responders, with the area under ROC curve (AUC) of 0.50 [95% confidence interval (95%CI) =0.32-0.69] and 0.51 (95%CI = 0.33-0.70), respectively. HR and blood pressure before fluid challenge and their changes after fluid challenge showed very poor discriminative performances. Before fluid challenge, 16 patients had a Pcv-aCO2 > 6 mmHg. Their mean CI was significantly lower and Pcv-aCO2 was significantly higher than that in 24 patients whose Pcv-aCO2 ≤6 mmHg [n = 24; CI (mL·s-1·m-2): 48.3±11.7 vs. 65.0±18.3, P < 0.01; Pcv-aCO2 (mmHg): 8.4±1.9 vs. 2.9±2.8, P < 0.01]. Pcv-aCO2was decreased significantly after fluid challenge in patients with an initial Pcv-aCO2 > 6 mmHg and their ΔPcv-aCO2 was notably different as compared with the patients whose baseline Pcv-aCO2≤6 mmHg (mmHg: -3.8±3.4 vs. 0.9±2.9, P < 0.01). 68.8% (11/16) patients responded to the fluid challenge in patients with an initial Pcv-aCO2 > 6 mmHg. The AUC of the baseline Pcv-aCO2 and ΔPcv-aCO2 to define fluid responsiveness was 0.85 (95%CI = 0.66-1.00) and 0.84 (95%CI = 0.63-1.00), respectively, and the positive predictive value was 1 when the cut-off value was 8.0 mmHg and -4.2 mmHg, respectively. 45.8% (11/24) patients responded to the fluid challenge in patients whose baseline Pcv-aCO2≤6 mmHg. There was no predictive value of baseline Pcv-aCO2 and ΔPcv-aCO2 on fluid responsiveness. Conclusion Pcv-aCO2 and its change cannot serve as a surrogate of the change in cardiac output to define the response to fluid challenge in septic shock patients whose baseline Pcv-aCO2≤6 mmHg, while the predictive values of baseline Pcv-aCO2and the change in Pcv-aCO2 are presented in patients with the initial value of Pcv-aCO2 > 6 mmHg. Clinical Trial Registration Clinical Trials, NCT01941472.
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Objective To study the distribution of glycosylated hemoglobin A1c (HbA1c) levels in Xiamen,and to investigate the relationship among HbA1c level and gender and age.Methods This was a cross-sectional study.10 487 cases of physical examination individuals in Zhongshan hospital from January 2013 to April 2014 were recruited.HbA1c was measured by ARKRAY HA-8180 automatic glycosylated hemoglobin analyzer (Japan).All data were collected for analyzing the HbA1c levels in different sex and age groups,exploring the rule between HbA1c and age,and comparing the different diagnostic criteria of diabetes mellitus(DM).Differences between the two groups were compared using the Independent Samples T Test.The measurement data of multiple group were compared with single factor analysis of variance (One way ANOVA),and the comparison between two groups was performed with LSD T test.Correlation between different variables was analyzed by Pearson correlation and linear regression.Results Focused on all the 10 487 cases and 9 436 cases with HbA1c ＜ 6.5％ physical examination population,the levels of HbA1c were positively correlated with age,the linear regression equations were HbA1c (％) =0.021 2 × age (years) + 4.811 9 (r =0.348 9,P=0.000) and HbA1c(％) =0.010 9 × age (years) + 5.0944 (r=0.4257,P =0.000)respectively; HbA1c levels in male physical examination population were significantly higher than those in females (P ＜ 0.001),moreover,in different gender groups,HbA1c level had gradually risen with increasing age.Patients at risk for diabetes (prediabetes,39.60％) diagnosed by the criteria of 2010 American Diabetes Association (ADA) were 2.55 times more than those diagnosed by the criteria of international expert committee (15.55％).Conclusions The HbA1c level is related to age and gender in Xiamen city.It is necessary to establish different reference intervals and DM diagnostic cut-off point.The criteria of 2010 ADA can identify more high-risk DM individuals,with is especially suitable for the physical examination screening.
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17α-hydroxylase/17,20-lyase deficiency (17OHD) is a rare cause of congenital adrenal hyperplasia.The patient predominantly presents with low-renin hypertension,hypokalemia,lack of secondary sexual development,and in women with primary amenorrhea,in male with pseudohermaphroditism.We herewith analyse the clinical features of a case of 17OHD diagnosed by gene sequencing.And the etiology,clinical manifestations,genetic features,diagnosis and treatment for 17OHD were reviewed.
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Fulminant type 1 diabetes (FT1 D) has been identified as a new subtype of idiopathic diabetes.FT1D is characterized by abrupt and complete destruction of pancreatic β cells,with diabetic ketosis or diabetic ketoacidosis occurring within a week after the onset of hyperglycemic symptoms.At the time of initial presentation,plasma glucose level is increased,with near normal HbA1C.Serum pancreatic enzyme is elevated in the majority of patients with FT1D.Flu-like symptoms or gastrointestinal symptoms precede disease onset in most of patients.However,the pathogenesis of this disease remains unclear.Factors such as viral infection,autoimmune,and pregnancy based on the background of genes may account for FT1D.We herewith report two cases of FT1 D,and review its clinical features,diagnosis,and treatment.
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Objective To investigate the morbidity rate of hyperuricemia and its association with hypertriglyceridemia and hypertension in elderly people in Fujian Quanzhou.Methods A crosssectional population survey for hyperuricemia was performed in Fujian Quanzhou.Questionnaire and physical examination were conducted in 1358 subjects.The levels of serum UA and lipid-profile as well as blood pressure were measured.Results In the same aged group,the level of blood uric acid was significantly higher in male (371.7±83.6) μmol/L than in female (294.8±66.5) μmol/L (t=15.8,P＜0.01).Blood uric acid concentration was gradually increased with aging in the group at age 40-70 years,but was gradually decreased with aging in female group aged over 70 years (F=12.1,P＜0.01).The total morbidity rate of hyperuricemia was 18.6％.The incidence of hypertriglyceridemia or hypertension in female with hyperuricemia was higher than those with normouricemia (22.1％ vs.10.5％,59.1％ vs.26.2％,x2=16.3,65.0,all P＜0.01).The incidence of hypertension in male with hyperuricemia was higher than those with normouricemia (54.6％ vs.42.8％,x2=4.0,P＜0.05).Conclusions The morbidity rate of hyperuricemia in elderly people is higher in south China coast than other region of China.The incidence of hypertriglyceridemia and hypertension in people with hyperuricemia is significantly higher than those with normouricemia.
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Type B insulin resistance (TBIR) is a rare disease caused by the presence of insulin receptor autoantibodies (IRA).African middle-aged women are predisposed to it.Most patients have an underlying autoimmune disease,most commonly systemic lupus erythematosus (SLE).The patients predominantly present with abnormalities of glucose homeostasis ranging from extreme insulin resistance and symptomatic hyperglycemia to lifethreatening hypoglycemia,usually accompanied with manifestation of insulin resistance such as acanthosis nigricans,hyperandrogenism,and polycystic ovary.The diagnosis can be established by the elevation of IRA.We herewith report a ease of TBIR complicated with SLE,and the clinical features,diagnosis and treatment of TBIR are reviewed.
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Mild cognitive impairment (MCI) is an important risk factor for Alzheimer's disease.It is of great value to investigate the etiology and pathogenesis of MCI.Studies have shown that diabetes may cause damage to both the structure and function of brain tissue,resulting in MCI.We published one article in Diabetes Care titled Serum level of endogenous secretory receptor for advanced glycation end products and other factors in type 2 diabetes patients with mild cognitive impairment to elaborate the relationship between diabetes and MCI.
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The effect of AMP-activated protein kinase (AMPK) on KiSS-1 mRNA levels was detected by realtime PCR in the hypothalamic GT1-7 neurons. The promoter activity of KiSS-1 gene was detected by DualLuciferase Reporter Assay System.The effects of AMPK on the protein expression and subcellular distribution of SP1 were determined by Western blot.The results showed that AMPK reduced the mRNA expression and promoter activity of KiSS-1 gene while SP1 increased the promoter activity of KiSS-1 gene. Besides,AMPK alse decreased the translocation of SP1.These results suggest that AMPK may inhibit the expression of KiSS-1 gene by decreasing the translocation of SP1 from cytoplasm to nucleus in the hypothalamus GT1-7 neurons.
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Two patients with typical Gitelman syndrome were diagnosed by gene and their clinical data and endocrine and metabolic status were evaluated.The etiology,clinical manifestation,laboratory findings,genetic diagnosis,and treatment for Gitelman syndrome were reviewed.
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Objective To study clinical feature and therapeutic choice of pituitary adenomas. Methods The clinical data of 239 cases of pituitary adenomas were analyzed. Results Total 93 male and 146 female cases were recruited. The average age was (43.8 ± 14.9 ) years old (3.9-77 years). Prolactinomas were the most common pituitary adenomas (26.8%) , 179 patients (74.9%) underwent surgery, of which 108 (60.3%) with transsphenoidal approach and 71 (39.7%) transcranial approach. The other 60 cases were treated nonsurgically. Conclusions Pituitary adenomas may present hormonal abnormalities or neurological symptoms.Some adenomas were accidently detected by MRI. Prolactinomas were the most common pituitary adenomas.
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Montreal cognitive assessment(MoCA, Beijing Version) was chosen as cognition assessment implement. 63 patients suffering from type 2 diabetes mellitus with mild cognitive impairment (MCI) were chosen to form a research group, and 27 patients with type 2 diabetes mellitus and normal cognitive function served as a control group. It was found that atherosclerosis played an important role in the pathogenesis of MCI in type 2diabetes, therefore, early prevention and management of atherosclerosis may help to improve the cognitive function.
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Objective To study the assessment implement and its related factors in type 2 diabetic patients with mild cognitive impairment(MCI).Methods Montreal Cognitive Assessment(MoCA)(Beijing Version)was chosen as cognition assessment implement.58 type 2 diabetic patients with MCI were enrolled as the research group and 30 type 2 diabetic patients with normal cognitive function as control.HbA_(1C),blood lipid,urine microalbumin,liver and renal functions were measured in all subjects.Results Compared with control group,the blood levels of HbA_(1C)[(10.48±2.38 vs 9.28±2.19)%,P<0.05],total cholesterol[(4.87±1.18 vs 4.18±1.04)mmol/L,P<0.01],and low-density lipeprotein-cholesterol[LDL-C,(2.97±0.87 vs 2.37±0.61)mmol/L,P<0.01]increased,and high-density lipoprotein-cholesterol decreased[(1.084±0.34 vs 1.25±0.33)mmoL/L,P<0.05]in MCI group.There were significant differences in the duration of diabetes mellitus,diabetic retinopathy,body mass index,and abdominal circumference between MCI group and control group(all P<0.05).There were no significant differences in blood triglycerides,alanine aminotransferase(ALT),aspartate aminotransferase(AST),creatinine,and urine microalbumin between the two groups.MoCA scores were negatively correlated with HbA_(1C)(r=-0.396,P=0.002)and LDL-C(r=-0.275,P=0.036)in MCI group.Multiple regression analysis showed that HbA_(1C) was a significantly independent determinant for the MoCA scores.Conclusion The risk factors such as longer duration of diabetes mellitus.more diabetea mellitus complications,obesity,dyslipidemia,and inefficient control of blood glucoge all contribute to the development and aggravation of cognitive impairment.Therefore,good control of blood glucose and lipids,and reduction of complication and body weight may help to improve the cognitive function.
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Objective To observe the effect of diliazem on cerebral oxygen metabolism during the period of blood pressure lowering in hypertensive urgencies.Methods 30 patients of hypertensive urgencies were randomized into two groups with 15 cases each.Group Ⅰ was administered with nitroglycerin.Group Ⅱ was administered with diliazem.Nitroglycerin was injected from 2.5?g/(kg?min).Group Ⅱ were received intravenous injection of diltiazem 5~10 mg,and then were continuously infusion by 5~15?g/kg/min with mictosyringe.Blood gas analysis was carried out by taking blood samples from right internal jugular vein bulb and radial artery,and D(a-jv)O2 and CEO2 were calculated before,during and after induced blood pressure lowering 0.5,1,2,3 hours.Results Compared with those in group Ⅰ,SjvO2 increased significantly in group Ⅱ(P0.05).Conclusion Diltiazem can decrease cerebral metabolism,improve oxygenation and play a role in cerebral protection in hypertensive urgencies.
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Objective To investigate the association of the polymorphism of endothelial nitric oxide synthase (eNOS) gene 27bp variable number of tandem repeats (VNTR) with essential hypertension (EH) and type 2 diabetes mellitus (DM) in Chinese population. Methods (1) Genotypes were determined by polymerase chain reaction (PCR)-agarose gel electrophoresis. (2) Fasting serum nitric oxide metabolites (NOx) were measured by nitrate reductase. (3) During oral glucose tolerance test (OGTT) serum immunoreactive insulin (IRI) and C peptide (CP) were measured by radioimmunoassay. Results (1) The frequenciesofaalleleinEHandtype2DMgroupwere significantly higher than that in control group (0.109 vs 0.051; 0.129vs 0.051, P