Experience of valve repair for different types of rheumatic mitral valve disease / 中华胸心血管外科杂志

Objective:To summarize the early results and follow-up of mitral valve repair for rheumatic heart disease(RHD).Methods:From January 2018 to November 2019, 48 patients with rheumatic heart disease undergoing mitral valve repair in Cardiovascular Surgery Department of GaoZhou People' s Hospital were analyzed retrospectively. Surgical methods: according to the condition of mitral valve disease, the prosthetic mitral annulus was used in rheumatic mitral valve repair by the methods of joint incision, valve thinning, calcification stripping, Chordae tendineae release and papillary muscle splitting. All patients with tricuspid regurgitation were fixed with artificial valve ring(type C ring), and with atrial fibrillation were treated with Maze-IV radiofrequency ablation. Data on extracorporeal circulation time, aortic occlusion time, mechanical ventilation time, ICU stay time, and major postoperative complications were collected. Patients were followed up to assess mitral valve, cardiac function, and cardiac rhythm.Results:According to pathological classification, type Ⅰ were 9 cases, 31 cases as type Ⅱ and 8 cases as type Ⅲ. All patients in type I and type II were repaired successfully, and type III has 1 case who was repaired failed and underwent mitral valve replacement due to moderate regurgitation. Cardiopulmonary bypass(CPB) time was(110.62±27.68) min, Cross-clamp time was(76.63±17.63) min, ICU stay was(46.16±11.37) h, mechanical ventilation was(21.60±10.89) h. All survived at 30 days, 1 case of acute renal failure, 1 case of low cardiac output syndrome, 3 cases of pulmonary infection, no complications such as stroke and malignant Arrhythmia. 47 patients were followed up for(9.86±6.78) months. There were no death, malignant Arrhythmia and reoperation during the follow-up, and the cardiac function was improved significantly( P<0.001). Conclusion:The mitral valve repair of RHD can preserve the intact mitral valve structure, maintain the heart function, and have a good survival and quality of life. On the basis of mastering the repair of heart valve, being familiar with the anatomic features of rheumatic mitral valve disease, strictly grasping the indications, fully evaluating before operation, it is feasible to carry out the repair of rheumatic mitral valve, and the early clinical effect is satisfactory, long-term results recommend long-term follow-up.

Prevalence of Opportunistic Pathogens and Diversity of Microbial Communities in the Water System of a Pulmonary Hospital / 生物医学与环境科学（英文）

Objective@#Our objective was to investigate the occurrence of opportunistic pathogens and characterize the bacterial community structures in the water system of a pulmonary hospital.@*Methods@#The water samples were collected from automatic and manual faucets in the consulting room, treatment room, dressing room, respiratory ward, and other non-medical rooms in three buildings of the hospital. Quantitative polymerase chain reaction was used to quantify the load of several waterborne opportunistic pathogens and related microorganisms, including spp., spp., and . Illumina sequencing targeting 16S rRNA genes was performed to profile bacterial communities.@*Results@#The occurrence rates of spp., spp., and were 100%, 100%, and 76%, respectively in all samples. Higher occurrence rates of were observed in the outpatient service building (building 1, 91.7%) and respiration department and wards (building 2, 80%) than in the office building (building 3), where no was found. were more abundant in automatic faucets (average 2.21 × 10 gene copies/L) than in manual faucets (average 1.03 × 10 gene copies/mL) ( < 0.01). , , , , , and were the dominant bacterial phyla. Disinfectant residuals, nitrate, and temperature were found to be the key environmental factors driving microbial community structure shifts in water systems.@*Conclusion@#This study revealed a high level of colonization of water faucets by opportunistic pathogens and provided insight into the characteristics of microbial communities in a hospital water system and approaches to reduce risks of microbial contamination.

Hydroxysafflor yellow A reduces anoxia/reoxygenation-induced injury in rat cardiomyocytes / 基础医学与临床

Objective To observe the protective effect of hydroxysafflor yellow A(HSYA) on anoxia/reoxygenation (A/R) injury of neonatal primary cardiomyocytes, and its relationship with phosphoinositide 3-kinase/protein ki-nase B/glycogen synthase kinase 3β(PI3K/Akt/GSK3β) signaling pathway. Methods Primary cardiomyocytes of neonatal rats were isolated from the rats and incubated for 48 hours. The cells were adhered to each other and then divided into five groups:control group (Con group), anoxia/reoxygenation group (A/R group),HSYA treatment group(A/R+H group),PI3K inhibitor (LY294002)treatment group(A/R+L group)and HSYA+LY294002 treat-ment group (A/R+H+L group),then to collect the supernatant fluid of each group to measure LDH.The flow cy-tometry was used to measure the apoptotic cells. The protein levels of Bcl-2,Bax,Akt,p-Akt (Ser473),GSK3β, p-GSK3β (Ser9) were evalated by Western blot. Results A/R increased LDH release,the apoptosis rate (P<0.001),and the expression of pro-apoptotic protein Bax (P <0.001) with the decrease of anti-apoptotic protein Bcl-2,p-Akt(Ser473), p-GSK3β(Ser9)(P<0.001) as compared with the control group. HSYA treatment de-creased LDH release,the apoptosis rate (P<0.001),and the expression of Bax (P<0.001) and increase the ex-pression of Bcl-2,p-Akt(Ser473),p-GSK3β(Ser9)(P<0.001). Compared with the A/R+H group,the expres-sion of Bax was increased (P<0.001),while the expression of Bcl-2, p-Akt(Ser473), p-GSK3β(Ser9)was de-creased (P<0.001) in the A/R+H+L group. Conclusions HSYA protects rats'cardiomyocytes from anoxia/reoxy-genation injury by regulating PI3K/Akt/GSK3β signaling pathway.

Decreased expression of surfactant protein C in lung tissue of chronic obstructive pulmonary disease rats / 基础医学与临床

Objective To study the role of surfactant protein C ( SP-C) in rat lung of chronic obstructive pulmonary disease (COPD).Methods Forty healthy conventional Sprague-Dawley (SD) rats were randomly divided into four groups , normal control group ( control group ) , smoke exposure group ( smoking group ) , lipopolysaccharide group (LPS group), smoke exposure +Lipopolysaccharide group (COPD group).The arterial partial pressure oxygen (PaO2) and arterial partial pressure of carbon dioxide pathological (PaCO2) were detected.The ultrastructure of lung tissue was observed by transmission electron microscope .Enzyme-linked immuno sorbent assay (ELISA) were performed to determine protein expression of SP-C in lung and bronchoalveolar lavage fluid ( BALF).RT-qPCR were performed to determine mRNA expression of SP-C in lung.Results Compared with control group , smoking group and LPS group, the PaO2 of COPD group was obviously lower , the PaCO2 of COPD group was obviously higher;the ultrastructure and histological analysis of lung tissues showed chronic inflammatory injury ; Compared with control group , the expression of SP-C protein in was reduced , as well as SP-C mRNA expression .Conclusions The expression of SP-C in lung of rats COPD model is down-regulated.SP-C may be involved in COPD .

Clinical application of absorbable net-sliding intertexture with tension band wiring comminuted fracture of inferior patella pole / 中国骨伤

<p><b>OBJECTIVE</b>To explore therapeutic effect of absorbable net-sliding intertexture with tension band wiring in treating comminuted fracture of distal patella pole.</p><p><b>METHODS</b>From January 2012 to December 2016, 80 patients with comminuted fracture of distal patella pole were treated with absorbable net-sliding intertexture with tension band wiring, including 45 males and 35 females aged from 25 to 60 years old with an average of(45.0±2.0) years old. All fractures were freshly closed. VAS scores and motion of knee joint were evaluated at 6 weeks after operation, HSS scores were used to assess clinical effects at 12 months after operation.</p><p><b>RESULTS</b>Operative time was (50.2±10.1) min, blood loss was (20.3±5.2 ) ml. All patients were followed up from 12 to 24 months with an average of (16.0±0.5) months. VAS score was 1.8±0.4, range motion of knee joint was (120.6±1.5)° at 6 weeks after operation. The fracture healing time was (3.0±0.8) months. Postoperative HSS score at 12 months was 95.6±0.6.</p><p><b>CONCLUSIONS</b>Absorbable net-sliding intertexture with tension band wiring in treating comminuted fracture of distal patella pole has advantages of simple operation, stable fixation, which could recover anatomical formation of patella, obtain rapid rehabilitation and favorable prognosis with early exercise. It is an ideal method for treating comminuted fracture of distal patella pole.</p>

Efficacy of one-stage posterior-anterior approach for treatment of severe thoracolumbar fractures / 中华创伤杂志

Objective To observe the outcomes of one-stage posterior short-level pedicle screw fixation combined with anterior fixation of severe thoracolumbar fractures.Methods A retrospective case series study was performed on 21 patients with severe thoracolumbar fractures stabilized by posterior short-level pedicle fixation combined with anterior internal fixation at one stage from January 2012 to December 2014.There were 16 males and 5 females,at age of 17 and 64 years [(38.7 ± 11.4) years].The involved segments included T11 in 2 patients,T12 in 5,Lt in 6 and L2 in 8.For AO fracture classification,type A fractures were seen in 4 patients,type B in 7 and type C in 10.Thoracolumbar injury classification and severity score (TLICS) was (8.12 ± 0.87) points (range,7-10 points).Frankel neurological performance scale was Grade B in 8 patients,Grade C in 11 and Grade D in 2.Operation time,blood loss,nerve function,kyphosis correction and complications were reported.Results Operation time was (234.5 ±57.3)min (range,180-360 min),and blood loss was (387.4 ± 124.4) ml (range,260-950 ml).Time of follow-up was (19.8 ± 3.5)months (range,14-25 months).Nerve function of 18 patients was improved by at least one Frankel scale.Cobb angle was (4.1 ±5.3)° at postoperative 3 days and (4.0 ± 4.9)°at the final follow-up,showing significant differences from that before operation [(-9.3 ± 4.2) °] (P ＜ 0.05).While the difference of Cobb angle did not differ significantly at postoperative 3 days and at final follow-up.No cerebrospinal fluid leakage,vascular injury,incision infection or nerve function deterioration occurred.Conclusion One-stage posterior short-level pediele screw fixation combined with anterior decompression and bone graft fixation is characterized by short operation time,few blood loss,good correction of traumatic kyphosis and good neurological recovery,indicating a good surgical choice for severe thoracolumbar fractures.

Modified anterior approach for treatment of ulnar coronoid process fracture / 中华创伤杂志

Objective To investigate the clinical effect of modified anterior approach to manage fracture of the ulnar coronoid process via the space of brachial artery and vein with median nerve.Methods From June 2012 to January 2013,11 patients with ulnar coronoid fracture were fixed via the modified anterior approach.The operation time,intraoperative blood loss and postoperative complications were recorded.Flexion and rotation range of motion about the injured and normal elbow were observed during postoperative follow-up period.Function of elbow joint was evaluated by mayo elbow performance index (MEPI).Results There was approximate 8 cm in length and 5 cm in width between the brachial vessels and median nerve.Operated angle from radial to ulnar side was fifty degrees and from proximal to distal end was sixty degrees.All the patients were available for follow-up.The fracture healed,that is the elbow flexion restored [(130.7 ±5.0) °] was 96.6％ of the unaffected elbow,elbow extension restored [(7.6 ± 8.1) °] was 84.0％ of the unaffected elbow,pronation restored [(86.9 ± 3.8) °] was 98.2％ of the unaffected side,and supination restored [(85.6 ± 6.0) °] was 96.7％ of the unaffected side.MEPI of the elbow joint was over 75 points.Conclusion Modified anterior approach is relatively safe and simple in operation and results in satisfactory function recovery of the elbow joint,providing a new surgical approach for treatment of coronoid process fracture.

Analysis of 130 forensic expertise cases of simple orbital fracture / 法医学杂志

OBJECTIVE@#To analyze the features of orbital fracture and to discuss its forensic expertise points.@*METHODS@#One hundred and thirty cases of simple orbital fracture from 2010 to 2012 collected from one public security bureau were retrospectively analyzed such as age, gender, tools, position and morphology of the fracture, periorbital and orbital compound injury and the follow-up results after 6 months.@*RESULTS@#In the 130 cases, the wounded were mainly young men and hit by fist. The fracture of simple medial orbital wall accounted for up to 81.5% in all cases. In the periorbital and orbital compound injury, laceration and contusion of eyelid and ethmoidal cellules and maxillary sinus always occurred. After 6 months follow-up, there were 30 cases of comminuted fracture remained enophthalmos compared with the uninjured side.@*CONCLUSION@#It is inappropriate to judge the fracture of simple medial orbital wall as minor injury. We should judge the degree of simple orbital fracture after the injury is stable. Detailed ophthalmology inspection is necessary for forensic expertise of simple orbital fracture.

Venous thromboembolism in 89 patients with lung cancer: Clinical analysis / 肿瘤

Objective: The aim of this study is to investigate the clinical factors in association with venous thromboembolism (VTE) in patients with lung cancer, and to provide evidence for prevention and therapy of VTE. Methods: Clinical information of 2 053 patients with lung cancer definitely diagnosed by cytology or pathology between July 2008 and June 2010 was retrospectively analyzed. VTE wasconfirmed by chest spiral computed tomography (CT), pulmonary arteriography and colorful Dopplerultrasound. The clinical factors including age, gender, pathological type, operation, clinical stage,body mass index, co-morbidity and platelet count as well as D -dimer, interleukin-1 (IL-1) and tumornecrosis factor (TNF) were considered as the potential VTE-related factors. Results: Of 2 053 patients,89 (4.34%) were confirmed with VTE. The incidence rates of VTE in patients with adenocarcinoma andnon-adenocarcinoma were 5.65% (58/1 027) and 3.02% (31/1 026), respectively, and the difference wasstatistically significant (P £?0.003). The incidence rate of VTE in stage I-III A lung cancer patients was significantly lower than that in stage IIIB-IV lung cancer patients [1.48% (10/677) vs 5.74% (79/1 376); P<0.001]. In patients with stage I-IIIA undergoing surgical operation or not, the incidence rates of VTE were 1.55% (10/645) and 0% (0/32), respectively (P=0.044). Significant difference of incidence rate of VTE was also found between the patients with and without co-morbidity [6.73% (56/832) vs 2.70% (33/ 1 221); P<0.001]. The incidence rates of VTE in patients with normal levels of platelet count, D -dimer,IL-1 and TNF were 3.72%, 0.31%, 2.44% and 3.27%, respectively; whereas, the incidence rates in patients with increased levels of these measurements were 6.26%, 19.91%, 10.26% and 7.74%, respectively; the differences between two groups were all significant (P<0.05). Logistic multivariant regression analysisrevealed that the clinical factors of adenocarcinoma, operation, co-morbidy and high levels of D-dimer,IL-1 and TNF in blood were associated with increased risk of VTE (P<0.05). Conclusion: Adenocarcinomais the most common pathological type in lung cancer patients with VTE. The risk factors of VTE include operation, co-morbidity and high levels of D -dimer, IL-1 and TNF in blood. Copyright© 2011 by TUMOR.

Genetic susceptibility of DNA damage induced by vinyl chloride monomer exposure / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To explore the association between DNA damage induced by vinyl chloride monomer (VCM) and polymorphisms of DNA repair genes and xenobiotic metabolism genes of VCM.</p><p><b>METHODS</b>Comet assay was employed to detect DNA damage. Based on the status of DNA damage, the VCM exposure workers were divided into two groups: DNA damage group (75) and control group (75). Case-control design was used to investigate the association between the genetic polymorphisms and DNA damage induced by VCM. Genotypes of XRCC1 (Arg194Trp, Arg280His and Arg399Gln), XPD (Ile199Met, Asp312Asn and Lys751Gln) and CYP2E1 were identified by the PCR-RFLP. PCR assay was used to detect positive and null genotype of GSTT1 and GSTM1.</p><p><b>RESULTS</b>Univariate analysis showed that the CYP2E1 c1c2/c2c2 and XPD751 Lys/Gln and Gln/Gln genotypes were significantly associated with the increased levels of DNA damage, XRCCI 339 Arg/Gln and Gln/Gln genotypes were significantly associated with the decreased levels of DNA damage (P < 0.01, P < 0.05, respectively). Logistic regression analysis showed that there was significant association between the genotypes of XRCC1 194, XRCC1 399, XPD 751, CYP2E1 and DNA damages. A prominent risk decreasing of DNA damage was observed for those individuals possessing XRCC1 399Arg/Gln + Gln/Gln genotypes (OR: 0.35, 95%CI: 0.12 approximately 1.01, respectively); The results also showed that there were significant associations between CYP2E1 c1c2/c2c2 and DNA damage both in high and low VCM-exposed groups (OR: 2.57, 95%CI: 1.01 approximately 6.59 and OR: 2.57, 95%CI: 0.99 approximately 6.87).</p><p><b>CONCLUSION</b>Cumulative exposure dose and genotypes of XRCC1 194, XRCC1 399, XPD 751 and CYP2E1 may modulate the DNA damage induced by VCM exposure.</p>

Differences in goal attainment in clinical management of dyslipidemia in China evaluated by different guidelines / 中华心血管病杂志

<p><b>OBJECTIVE</b>To better understand the similarities and disparities between the newly issued Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults (CG) and exist relevant guidelines by comparing the actual effect on assessment of current clinical management of dyslipidemia in China, in order to promote the use of CG in clinical practice.</p><p><b>METHODS</b>Study participants included 2094 patients from the Second Multi-center Survey of Dyslipidemia Management in China. The goal attainment rate was defined as the proportion of participants who achieved their target low-density lipoprotein cholesterol (LDL-C) levels specified by CG, the Chinese Expert Recommendations on Prevention and Treatment of Dyslipidemia (CR), the updated Adult Treatment Panel III of the National Cholesterol Education Program (ATP III), respectively.</p><p><b>RESULTS</b>(1) The overall goal attainment rates were 62%, 34% and 50% according to CR, ATP III and CG, respectively. (2) With reference to the CG risk stratifications, the risk of nearly 40% of high risk patients and all very high risk patients were underestimated by CR, whereas the risk of more than 40% of patients in any risk groups were overestimated by ATP III. (3) The disparities in risk stratifications accounted for 90% of the difference in overall goal attainment rate (12%) between CR and CG, while the disparities in the risk stratifications and that in LDL-C target levels were responsible for 29% and 71% of the difference (16%) , respectively, between ATP III and CG.</p><p><b>CONCLUSIONS</b>There were significant differences in goal attainment rates assessed by different clinical practice guidelines. CG is more aggressive in risk stratification than CR but simpler and easier to use than ATP III, and hence more appropriate to Chinese patients and should be widely promoted in China.</p>

Efficacy and safety of the single pill combination of valsartan 80 mg plus amlodipine 5 mg in mild to moderate essential hypertensive patients without adequate blood pressure control by monotherapy / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of a once daily valsartan/amlodipine 80/5 mg combination tablet in Chinese mild to moderate hypertensive patients without adequate blood pressure control by monotherapy.</p><p><b>METHODS</b>Two multicenter, randomized, double-blind, double dummy, active-controlled, parallel group trials were conducted. After a washout period (no medication) of 1-4 weeks, patients with Mean Sitting Diastolic Blood Pressure (MSDBP) > or = 95 mm Hg (1 mm Hg = 0.133 kPa) and < 110 mm Hg received a monotherapy of either Amlodipine 5 mg (in study 1) or valsartan 80 mg (in study 2) for 4 weeks. Patients with MSDBP > or = 90 mm Hg and < 110 mm Hg at the end of the monotherapy period were randomized to receive valsartan/amlodipine 80/5 mg treatment, or continue with the monotherapy.</p><p><b>RESULTS</b>In study 1, compared with amlodipine 5 mg, valsartan/amlodipine 80/5 mg once daily further reduced mean sitting systolic blood pressure (MSSBP)/MSDBP 4.4/3 mm Hg (P < 0.0001). In study 2, compared with valsartan 80 mg, valsartan/amlodipine 80/5 mg once daily further reduced MSSBP/MSDBP 6.4/4.2 mm Hg (P < 0.0001). The blood pressure (BP) control rates (BP < 140/90 mm Hg) of combination treatment group were 71.0% and 71.2% respectively, and significantly higher than the monotherapy groups in both trials. Incidence of adverse events was comparable in monotherapy and combination therapy groups.</p><p><b>CONCLUSION</b>Our results showed that valsartan/amlodipine 80/5 mg was superior to amlodipine 5 mg or valsartan 80 mg alone in lowering blood pressure and BP control in patients with mild to moderate hypertension not adequately controlled with amlodipine 5 mg or valsartan 80 mg monotherapy. No new or unexpected safety issues were identified with valsartan/amlodipine combination therapy compared with monotherapy.</p>

Pathogenesis of liver fibrosis in patients with chronic hepatitis B / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To explore the role of sinusoidal endothelial cell in the development of liver fibrosis, and to dissect the relationship among hepatic microcirculation disorders, hepatic sinusoidal capilarization and liver fibrosis.</p><p><b>METHODS</b>Liver biopsy was performed in fifty-six patients with chronic hepatitis B. The liver tissues were observed under light microscope and transmitted electronic microscope.</p><p><b>RESULTS</b>Of 56 cases, 39 cases were mild hepatitis, 10 were moderate hepatitis, and 7 were severe hepatitis. The morphology of hepatic stellate cells (HSCs) was similar to that of fibroblasts in the tissues of the patients with chronic hepatitis B. Collagenous fibers were deposited around the hepatic stellate cells. Electron-dense materials were deposited between sinusoidal endothelial cell and hepatic stellate cell. The size and amount of fenestraes of sinusoidal endothelial cells were reduced in 53 of 56 cases. The consecutive or inconsecutive membrane-like materials were observed along sinusoidal endothelial cells in 20 cases. Collagen fibers were observed in the space of Disse in 15 cases. Even in the patients with normal hepatic functions, red blood cells aggregation and microthrombi could be observed in the liver tissues.</p><p><b>CONCLUSION</b>Sinusoidal endothelial cells are involved in development of liver fibrosis by interacting with hepatic stellate cells. Hepatic microcirculation disorders and sinusoidal capillarization are important changes in the early stage of liver fibrosis.</p>

Hemodynamics of deep vein in lower limb during perioperative period of total hip arthroplasty / 中华创伤杂志

Objective To investigate hemodynamic changes of deep vein in lower limb during the perioperative period of total hip arthroplasty (THA) and early diagnosis of deep vein thrombosis (DVT). Methods Doppler ultrasound, hemorheology detection and plasma D-dimer testing were done on 62 patients treated with THA. Statistical analysis was carried out on the data of patients with or without DVT to study the early diagnosis of DVT. Results The results of Doppler ultrasound showed DVT in 8 patients. Compared with postoperative concentration of plasma D-dimer, the preoperative con-centration of plasma D-dimer was significandy higher in patients with or without DVT (P < 0.05). The levels of hemorheological indices were significantly increased at postoperative day 7 (P < 0.05). Con-clusions Doppler ultrasound combined with plasma D-dimer testing and hemorheology detection are helpful in early diagnosis of DVT.

Cut offs and risk stratification of dyslipidemia in Chinese adults / 中华心血管病杂志

<p><b>OBJECTIVE</b>To establish cut offs and risk stratification of dyslipidemia in Chinese adults.</p><p><b>METHODS</b>Data from 2 widely cited studies: the PRC-US Collaborative Study of Cardiovascular and Cardiopulmonary Epidemiology and the China Multi-Provincial Cardiovascular Cohort Study, with a total of 40 719 Chinese adults, age 35 to 64 at baseline, about half men and half women, followed up for a total of 345 140.5 person years, were used to analyze the relationship between dyslipidemia and ischemic cardiovascular diseases (ICVD, including coronary heart events and ischemic stroke events) using a common data analysis protocol co-developed by the scientists from the 2 studies. The relative risk was estimated with the Cox proportional hazard model adjusting for other conventional cardiovascular risk factors. The 10-year absolute risk of ICVD for a 50 years-old person at different risk factor combinations was used to develop the risk stratification.</p><p><b>RESULTS</b>(1) There was a continuous linear relationship between baseline TC (or LDL-C) and ICVD risk without a threshold; (2) The incidence (absolute risk) of ICVD was similar for LDL-C < 3.37 mmol/L (130 mg/dl) and for TC < 5.18 mmol/L (200 mg/dl); and similar for LDL-C < 4.14 mmol/L (160 mg/dl) and for TC < 6.22 mmol/L (240 mg/dl); (3) The absolute ICVD risk for TC > or = 6.22 mmol/L (240 mg/dl) was slightly less but close to that for grade 1 hypertension; (4) ICVD risk increased as HDL-C decreased; (5) No significant association was found between baseline TG and subsequent ICVD; (6) At any TC level, the absolute ICVD risk for those having only hypertension was higher than that for those having 3 other risk factors.</p><p><b>CONCLUSION</b>The cut offs for diagnosis of dyslipidemia in Chinese adults can refer to those used in relevant international guidelines: TC < 5.18 mmol/L (200 mg/dl) [or LDL-C < 3.37 mmol/L (130 mg/dl)] as normal, TC 5.18 - 6.19 mmol/L (200 - 239 mg/dl) [or LDL-C 3.37 - 4.12 mmol/L (130 - 159 mg/dl)] as borderline high, and TC > or = 6.22 mmol/L (240 mg/dl) [or LDL-C > or = 4.14 mmol/L (160 mg/dl)] as high; HDL-C < 1.04 mmol/L (40 mg/dl) as low, 1.04 - 1.53 mmol/L (40 - 59 mg/dl) as normal and > or = 1.55 mmol/L (60 mg/dl) as optimal. In risk stratification scheme, hypertension plays a role that equals to that of any other 3 risk factors.</p>

The angiographic features of exercise-induced ST-segment elevation in patients without myocardial infarction / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the incidence and angiographic features of exercise-induced ST-segment elevation in patients without prior myocardial infarction.</p><p><b>METHODS</b>Exercise-induced ST-segment elevation occurred in 15 out of 4601 consecutive patients without prior myocardial infarction underwent treadmill exercise testing during a 2-year period. The coronary angiographic features of the 15 patients (13 males, aged between 40 - 75 years) were analyzed.</p><p><b>RESULTS</b>Coronary angiography revealed one hemodynamically relevant stenotic vessel in 6 patients, two hemodynamically relevant stenotic vessels in 6 patients, three hemodynamically relevant stenotic vessels in 3 patients. Left anterior descending (LAD) coronary artery was affected in 12 patients. Left main coronary artery (LMCA) stenosis was evidenced in 1 patient and right coronary artery stenosis in 7 patients. Severe (90% - 100%) occlusions were visualized in 8 out of 13 patients with LAD or LMCA lesions. Elevated ST-segment leads were consistent with the ischemic area where the blood supply of myocardium was affected by diseased vessels.</p><p><b>CONCLUSIONS</b>The incidence of exercise induced ST-segment elevation in patients without prior myocardial infarction is very low and mostly due to severe fixed coronary artery stenosis, especially in LAD. The location of ischemic myocardium can be suggested by ST-segment elevation leads during exercise.</p>

Therapeutic efficacy of valsartan and valsartan/HCTZ in mild to moderate hypertensive patients / 中华心血管病杂志

<p><b>OBJECTIVE</b>To assess the efficacy and safety of valsartan/hydrochlorothiazide (HCTZ) 80/12.5 mg once daily (o.d.) in Chinese patients with mild to moderate essential hypertension who was not adequately controlled by valsartan 80 mg o.d. monotherapy.</p><p><b>METHODS</b>In this multi-center, double-blind, randomized, active controlled, parallel group trial, 1051 out of 1175 Chinese patients with mild to moderate essential hypertension [DBP >or= 95 mm Hg and < 110 mm Hg (1 mm Hg = 0.133 kPa)] completed single-blind run-in period (valsartan 80 mg o.d. therapy for 4 weeks) after 2 week's wash-out period. At the end of the single-blind run-in period, those patients with DBP >or= 95 mm Hg (n = 864) were randomized in 1:1 ratio to Valsartan and Valsartan 80 mg (n = 429)/HCTZ80/12.5 mg (n = 435) treatment o.d. for 8 weeks. Safety and efficacy was assessed every 4 weeks during double blind phase.</p><p><b>RESULTS</b>At the end of study, valsartan/HCTZ 80/12.5 mg combination treatment further reduced systolic (-3.5 mm Hg) and diastolic (-2.2 mm Hg) pressures and increased the rate of patients reaching goal BP level (53.9% vs. 40.9%) compared to valsartan 80 mg o.d. monotherapy. Incidence of side effects was similar between the combination therapy and monotherapy groups (8.9% vs. 5.1%, P > 0.05).</p><p><b>CONCLUSION</b>Efficacy of Valsartan 80 mg/HCTZ 12.5 mg compound was superior to valsartan 80 mg on BP reduction and goal BP control rate in Chinese patients with mild to moderate essential hypertension. The combination of Valsartan 80 mg/hydrochlorothiazide (HCTZ) 12.5 mg provides a suitable treatment for Chinese patients who are not adequately controlled by valsartan 80 mg o.d. monotherapy.</p>

Analysis of 21 cases with intrathoracic angiofollicular lymphoid hyperplasia / 中国癌症杂志

Background and purpose:Angiofollicular lymphoid hyperplasia(Castleman's disease,CD) is a rare kind of abnormal disease with lymphoid hyperplasia. We analyzed the clinical data of 21 patients with pathologically-confirmed CD. Methods:Twenty-one cases,including 10 males and 11 females with a mean age of 38.6 years,with CD were collected from January 1971 to December 2007 in this study. The disease was divided into localized type(n=19) and disseminated type(n=2) . The clinical data,CT images and pathological and surgical results were restrospectively analyzed. Results:All cases were categorized as hyaline vascular type. In 19 cases with localized type of CD,the lesion presented as a solitary soft-tissue mass with a mean diameter of 5.2 cm,located at the left and right hilus of the lung(n=3 and 2 respectively) or in the interior lung(n=3) ,in the thoracic wall(n=2) or in the mediastinum(n=9) . Two cases of disseminated type were characterized by many groups of thoracic lymphadenopathy with a mean diameter of 2.3 cm,without other organ involvement. On plain CT scan,the mean CT value was 42 Hu. After contrast administration,obvious homogeneous enhancement was observed in arterial phase with CT value of 112 Hu. The preoperative misdiagnosis by CT was 90.5%. Conclusion:CD have no specifi c CT characteristic,its verifi cation is mainly based on pathologic examination. Surgical resection for localized type of CD is curative,but for disseminated CD,multidisciplinary therapies are recommended.

Efficacy and safety of olmesartan medoxomil versus losartan potassium in Chinese patients with mild to moderate essential hypertension / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of olmesartan medoxomil compared with losartan potassium in patients with mild to moderate essential hypertension.</p><p><b>METHOD</b>This is a randomized, double-blind, double-dummy, active-controlled, parallel, multi-center study. After a 2-week placebo run-in period, a total of 287 eligible subjects were randomized at 1:1 ratio to receive olmesartan medoxomil 20 mg or losartan potassium 50 mg, once daily for 8 weeks. The blood pressure was assessed after 4 weeks treatment. If the subject's seating diastolic blood pressure (SeDBP) was still >or=90 mm Hg, the dosage was doubled for another 4 weeks; for those subjects whose SeDBP was <90 mm Hg after 4-week treatment, the initial dosage remained unchanged and the treatment continued until completion of the study.</p><p><b>RESULTS</b>(1) The mean trough reduction in SeDBP from baseline in olmesartan group was significantly greater than that in losartan group after 4 weeks (11.72 mm Hg vs 9.23 mm Hg, P=0.004) and 8 weeks treatment (12.94 mm Hg vs 11.01 mm Hg, P=0.035). (2) The number and percentage of responders in olmesartan group (81, 65.3%) were statistically higher than those (68, 52.7%) in losartan group (P=0.028) after 4 weeks treatment and were similar between the two groups after 8 weeks treatment (P>0.05). (3) Individual and overall trough/peak ratios of DBP and SBP in 24-hour ambulatory blood pressure monitoring were higher in olmesartan group than losartan group. The hypotensive effect of olmesartan was more durable than losartan at 24 hour interval. (4) The incidence of study drug-related adverse events (AEs) in olmesartan group (10.5%) was similar as that in losartan group (13.9%, P>0.05). Most of these AEs were mild and transient.</p><p><b>CONCLUSION</b>This study shows that olmesartan medoxomil, at oral dose of 20 mg-40 mg once daily was effective and safe for hypertension treatment and the hypotensive effect was superior to losartan potassium (50 mg-100 mg once daily).</p>

Relationship between single nucleotide polymorphisms of NRAMP1 gene and susceptibility to pulmonary tuberculosis in workers exposed to silica dusts / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To explore the relationship between polymorphisms of natural resistance-associated macrophage protein 1 (NRAMP1) gene and genetic susceptibility of pulmonary tuberculosis (PTB) in workers exposed to silica dusts.</p><p><b>METHODS</b>A 1:2 case control study of 61 male workers with PTB (50 silicosis patients and 11 unsilicosis workers) as the case group and 122 male PTB-free workers (100 silicosis patients and 22 unsilicosis workers) as the control group was conducted with the frequency matched for age of +/- 5 years, the job, the silica exposure, and the condition of cigarette smoking and alcohol drinking. The polymerase chain reaction-restrained fragment length polymorphism technique (PCR-RFLP) was used to detect the single nucleotide polymorphisms (SNPs) of NRAMP1 INT4 and D543N.</p><p><b>RESULTS</b>There was a 2.73 times (95% CI: 1.32 approximately 5.64) increased risk of silicosis for individuals with C allele of NRAMP1 INT4 compared with individuals carrying homozygote (G/G), while SNPs of NRAMP1 D543N was not associated with PTB (P > 0.05).</p><p><b>CONCLUSION</b>The G > C mutation of intron 4 of NRAMP1 gene might be a susceptible factor of silica for the workers exposed to PTB.</p>