Analysis of therapeutic effects of rural patients with hypertension by combination administration of low dosage of hydrochlorothiazide and nitrendipine / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the therapeutic effects of combination administration of hydrochlorothiazide and nitrendipine at low dosage in the treatment of rural hypertension patients.</p><p><b>METHODS</b>By the method of cluster random sampling, 5292 primary hypertension patients from Fuxin, Liaoning Province were divided into health education group (control group) and drug intervention group in June 2006. The drug intervention group were treated with hydrochlorothiazide, nitrendipine and captopril by stepwise approach and we observe the antihypertensive effect of drug and the effect on the onset of stroke.</p><p><b>RESULTS</b>The average follow-up time was 15 months. At last, 308 patients were lost to follow-up (the lost follow-up rate was 5.8 percent). The 4984 in cohort, including 2530 of intervention group and 2454 of control group, had examination of all indicators. Through health education and drug intervention, the average blood pressure in drug intervention group decreased by 16.1/9.4 mm Hg (1 mm Hg = 0.133 kPa) while the average blood pressure in control group decreased by 6.7/3.5 mm Hg. The control rate of blood pressure in drug intervention group was higher than control group (33.1% vs. 15.1%, P < 0.001). Through drug intervention, the morbidity risk of nonfatal stroke in drug intervention group decreased by 57.3% compared to control group, the total morbidity risk of stroke decreased by 59.4%. The results had significant statistical difference. And, the morbidity of severe hypopotassaemia (K(+) < 3.0 mmol/L) and diabetes mellitus had no significant statistical difference between two groups.</p><p><b>CONCLUSIONS</b>The low-cost antihypertensive program based on thiazide had good antihypertensive effect, high safety and good cost-effect ratio. The program could be used in rural areas of China.</p>

Serrated lesions of colon and their malignant potential / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the serrated lesions of colon and to compare the malignant potential between traditional serrated adenomas (TSA) and conventional adenomas (CAD).</p><p><b>METHODS</b>A total of 5347 cases of colorectal polyps encountered in five regional hospitals during a five-year period were retrospectively reviewed. The serrated lesions were classified on the basis of histologic examination. One hundred and eighty-seven cases of CAD (including 160 cases of tubular adenoma and 27 cases of villous adenoma) and 36 cases of invasive adenocarcinoma were randomly selected as the controls. The degree of dysplasia and expressions of Ki-67, p53 and beta-catenin in TSA and CAD were compared.</p><p><b>RESULTS</b>Amongst the 5347 colorectal polyps studied, 258 cases (4.8%) of serrated lesions were found, which included 112 cases (43.4%, 112/258) of hyperplastic polyp, 78 cases (30.2%, 78/258) of TSA and 26 cases (10.1%, 26/258) of sessile serrated adenoma. Sixty-two cases of TSA were identified from 3 hospitals, in which moderate dysplasia was found in 13 cases. High-grade intraepithelial neoplasia and ICA were found in 6 cases (9.6%). Compared with the 187 cases of CAD, moderate dysplasia were found in 27 cases and high-grade intraepithelial neoplasia and invasive adenocarcinoma were found in 25 cases (13.3%, χ(2) = 19.373, P = 0.000). There was statistically significant difference between TSA and CAD in the degree of dysphasia. The expression of Ki-67, p53 and beta-catenin in TSA and CAD showed no significant difference (P > 0.05).</p><p><b>CONCLUSIONS</b>The incidence of serrated lesions is lower in northern Chinese population than that in Caucasians. TSA has obvious malignant potential; but the rate associated with high-grade intraepithelial neoplasia and invasive adenocarcinoma is lower than that in CAD.</p>

Microsurgerical anatomy of transcallosal-transchoroidal approach to the third ventricle / 中华神经医学杂志

Objective To supply microanatomic data for the application of the transcallosal-transchoroidal approach, and discuss its clinical value of this application. Methods Twelve adult cadaveric wet brains were carefully dissected under microscope with a magnification ranging for 4-10 times, and the anatomic features of the paracele, the choroids plexus, the choroidal fissure and the diatela were successively explored. Three adult cadaveric fresh heads were studied,simulating the procedures of the transcallosal-transchoroidal approach. Observation was performed on related anatomic structures, and measurement of relative parameter was taken, too. Results In the body of the lateral ventricle, the choroid plexus is located in the medial part of the floor. The choroidal fissure is a C-shaped natural cleft between the thalamus and the fomix, being white translucent membranes, and it could be identified by following the choroid plexus in the lateral ventricle. After carefully opening the taenia fornicis, the contents of the velum interpositum are exposed. The cavity of the third vertricle is reached through opening the roof of the third vertricle between the 2 internal cerebral veins. The distances between the coronal suture at the medial border of the brain and the callosal sulcus were (39.12±3.94) mm; the distances between the coronal suture at the medial border of the brain and the interventricular foramen were (61.53±4.02) mm; the distances between the posterior border of the interventricular foremen and the coalesced area of the fornix and the callosum were (28.65±2.23) mm; the AC-PC distances were (25.94±2.16) mm; the distances between the interventricular foremen and the corpus albicans were (19.62±1.79) mm. Conclusion As compared with other approaches to the third ventricle, the transcallosal-transchoroidal approach, which follows a natural route, is of advantages in few injury and wide exposure, we suggest, therefore, that the transcallosal-transchoroidal approach be extensively adopted in clinical neurosurgery.

Correlation between body mass index, waist circumference and blood pressure in rural residents from west part of Liaoning Province / 中华心血管病杂志

<p><b>OBJECTIVE</b>This study observed the association between body mass index (BMI), waist circumference (WC) and blood pressure level in rural residents from west Liaoning province.</p><p><b>METHODS</b>This epidemiological study using stratified cluster random sampling was conducted from 2004 to 2006 in Fuxin County, Liaoning Province, 43,692 rural residents (21,680 males) aged 35-74 years old [(49. 8 +/-10.2) years] were surveyed. Database was established with the help of Epidata 3.1 software.</p><p><b>RESULTS</b>In total 43,692 persons were surveyed, including 21,680 male (49.6%) and 22,012 female (50.4%). The average BMI and WC was (23.31 +/- 3.08) kg/m2 and (80.87 +/- 9.0) cm, respectively. No matter male or female, SBP started from 20 kg/m2, increased with the increase of BMI; DBP increased gradually with the increase of BMI; the prevalence of hypertension were significant differences among different BMI groups (P < 0.001). Multiple logistic regression show that in male, using the group with BMI, <18 kg/m2 as control, 28-30 kg/m2 group OR and 95% CI was 6.285 (4.612-8.566); in female, when BMI >22 kg/ m2 OR increased with the increasing of BMI. In male and female, both SBP and DBP, also the prevalence rate of hypertension increased gradually with the increase of WC (P < 0.001). No matter in male or female, when BMI <24 kg/m2, and WC male <85 cm, female WC <80 cm, the average blood pressure levels and prevalence of hypertension are the lowest; after adjusting for age and other risk factors, the prevalence rate of overweight and obesity for male with hypertension OR are 1.704 (1.592-1.825) and 3.710 (3.148 -4.371) , respectively, for female is 1.527 (1.428-1.632) and 3.014 (2.668-3.405), respectively. When the WC is higher than the standard, male and female hypertension risk OR and 95% CI are 1.231 (1.153-1.314) and 1.353 (1.269-1.442), respectively.</p><p><b>CONCLUSION</b>Both BMI and WC are risk factors of hypertension.</p>

Anatomic and clinical study on transcallosal-interforniceal approach to third ventricle / 中华神经医学杂志

Objective To explore the microanatomic features of the transcallosal-interforniceal approach, and discuss the value of its clinical application. Methods Fifteen adult cadaveric head specimens were dissected by microsurgical anatomic skills to simulate the procedures of the transcallosal-interforniceal approach. Observation and measurement were performed on related anatomic structures. In clinical, 21 patients with the third ventricle tumors underwent tumor resection via the transcallosal-interforniceal approach. Results Using two points on the cortical surface as references that were located 5 and 7 cm anterior to the central sulcus respectively, mean values of related measurements on P5-foramen of Monro (FM) and P7-FM were obtained as follows: (1) the depth of the interhemispheric fissure was 38.46 and 37.62 ram; (2) the height of the corpus callosum was 7.18 and 7.78 nun; (3) the height of the septum pellucidum was 7.53 and 9.88 mm; (4) the thickness of the fornix was 4.72 and 5.16 mm. Under the operative microscope, the tumors were totally removed in 11 cases,subtotally in 8 cases, and partially in 2 cases. Conclusions The corridor of the transcallosal-interforniceal approach should be limited between the lines of P5-FM and P7-FM. The quantitative information obtained in this study permits the preservation of important anatomic structures in operation, such as the motor strip, genu of the corpus callosum, fornical commissure and anterior commissure. This approach is deserved to be applied generally for providing a quite large operative field,making total tumor removal easier, and decreasing the incidence of postoperative complications.