Observational Study of Chinese Medicine Syndrome Distribution in Patients with Acute Myocardial Infarction and Its Impact on Prognosis / 中国结合医学杂志

OBJECTIVE@#To investigate the distribution of Chinese medicine (CM) syndrome in patients with acute myocardial infarction (AMI) on admission and its impact on prognosis.@*METHODS@#A total of 525 AMI patients were prospectively recruited and classifified into 4 groups based on their clinical characteristics: excess-heat, excess-cold, deficiency-heat and deficiency-cold syndromes. Major adverse cardiovascular events (MACEs) were followed up.@*RESULTS@#The excess syndrome was more common than deficiency syndrome (72.95% vs. 27.05%; P<0.05). Totally 495 (94.29%) of 525 AMI patients were followed up (median 277 days). There were 59 (11.92%) MACEs. After adjusted with confounding factors in Cox regression models, the hazard ratio (95% confifidence interval) of excess-heat, excess-cold, defificiency-heat and defificiency-cold syndrome groups were 1, 1.25 (0.63, 2.49; P<0.05), 2.37 (1.14, 4.94; P<0.05), 3.76 (1.71, 8.28; P<0.05), respectively.@*CONCLUSIONS@#Excess syndrome was more common in AMI patients and had better prognosis, while defificiency-cold syndrome had the poorest prognosis. CM syndrome was of value in predicting long-term outcomes in AMI patients.

Reference value of plasma N-terminal-pro-B-type natriuretic peptide in middle-aged and elderly Chinese / 中华心血管病杂志

<p><b>OBJECTIVE</b>To establish the normal ranges for plasma N-terminal-pro-B-type natriuretic peptide (NT-proBNP) of middle-aged and elderly ( ≥ 40 years) healthy subjects in China.</p><p><b>METHODS</b>A total of 5133 subjects (2170 men and 2963 women) from the cohort of Shanghai Heart Health Study (SHHS) were included in this study. Plasma NT-proBNP was measured by electrochemiluminescence immunoassay. The reference values (2.5th- 97.5th quartiles) were determined using both empiric and quantile regression methods.</p><p><b>RESULTS</b>Plasma NT-proBNP values were higher in women than in men at all respective age groups (all P < 0.01) , and natural log-transformed NT-proBNP values increased in proportion with age for both genders and there was a lineal correlation between natural log-transformed NT-proBNP values and age (all P < 0.01) . Quantile regression derived normal reference values for NT-proBNP in male were 4.5-86.8 ng/L in the 40-44 years old group, 5.4-108.5 ng/L in the 45-49 years old group, 6.6-135.5 ng/L in the 50-54 years old group, 7.9-169.4 ng/L in the 55-59 years old group, 9.6-211.7 ng/L in the 60-64 years old group, 11.7-264.6 ng/L in the 65-69 years old group, 14.2-330.7 ng/L in the 70-74 years old group, and 18.1-429.2 ng/L in the ≥ 75 years old group. The reference values in female for NT-pro-BNP in respective age group were 8.5-141.8 ng/L, 10.4-166.6 ng/L, 12.8-195.7 ng/L, 15.7-229.9 ng/L, 19.3-270.1 ng/L, 23.7-317.3 ng/L, 29.1-372.8 ng/L, and 35.7-451.9 ng/L.</p><p><b>CONCLUSION</b>This study preliminarily establishes the normal ranges of plasma NT-proBNP in middle-aged and elderly ( ≥ 40 years) Chinese.</p>

Epidemiological survey on pre-hypertension and hypertension prevalence among adolescents aged 11 to 17 years in Shanghai / 中华心血管病杂志

<p><b>OBJECTIVE</b>To assess the prevalence of pre-hypertension and hypertension as well as the association with overweight/obesity in Shanghai adolescents.</p><p><b>METHODS</b>School children aged 11 - 17 years in four schools in Shanghai were included in this survey. All students were visited in May 2010 at school by trained nurses or physicians who administered a questionnaire and carried out anthropometric measurements. Anthropometric measurements included height, weight, heart rate and blood pressure. Repeat measurements were performed in school children with elevated blood pressure within one month. The pre-hypertension and hypertension was defined on the basis of the 2004 National High Blood Pressure Education Program Working Group definitions. The overweight and obesity was defined using cutoff points recommended by Working Group of Obesity, China (WGOC).</p><p><b>RESULTS</b>There were 4175 school children aged 11 - 17 years [mean (15.0 ± 1.9) years, 52.3% (n = 2183) girls and 47.7% (n = 1992) boys]. There were 72.5% (n = 3025) participants with normal blood pressure [ girls (n = 1666) 76.3% and boys (n = 1361) 68.3%], 18.0% (n = 750)participants with pre-hypertension [14.2% (n = 310) for girls and 22.1% (n = 440) for boys], 8.3% (n = 346) participants with stage 1 hypertension [8.2% (n = 179) for girls and 8.3% (n = 165) for boys] and 1.3% (n = 54) participants with stage 2 hypertension [1.3% (n = 28) for girls and 1.3% (n = 26) for boys]. The prevalence of overweight and obesity was 6.7% (n = 147) and 3.0% (n = 66) for girls and 13.7% (n = 273) and 6.3% (n = 125) for boys. After adjusting for gender, age, parental history of hypertension and physical activities, multivariable logistic regression analysis showed that the overweight [adjusted odds ratio and 95% confidence interval: 1.42 (1.16 - 1.75)] and obesity [adjusted odds ratio and 95% confidence interval: 2.35 (1.78 - 3.11)] were independent predictors of elevated blood pressure in this cohort.</p><p><b>CONCLUSIONS</b>The prevalence of elevated blood pressure is common in adolescents in Shanghai. Overweight and obesity are closely associated with the elevated blood pressure in this cohort.</p>

Association between the urinary microalbumin/creatinine ratio and cardiovascular risk factors among elderly community subjects / 中华心血管病杂志

<p><b>OBJECTIVE</b>To determine the value of the urinary microalbumin/creatinine ratio (UACR) and the relationship between UACR and traditional cardiovascular risk factors among elderly community subjects.</p><p><b>METHODS</b>A representative population in Shanghai rural district aged more than 65 years who participated in the heart health survey of the key projects in the national science and technology pillar program in the eleventh five-year plan period of China were sampled via a clustered complex sampling method. A midstream collection from the first morning void collected was used to measure the urinary microalbumin, the urinary creatinine and the UACR. Baseline information including traditional cardiovascular risk factors were obtained by standard questionaire to analyze the distribution status of UACR in the population with or without the risk factors.</p><p><b>RESULTS</b>(1) There were 1718 subjects (721 males) of (73.3 ± 5.5) years included in this study. (2) The prevalence of with at least one cardiovascular risk factor was 78.00% in this cohort, the top there risk factors were dyslipidemia (61.06%), hypertension (44.59%) and diabetes (13.80%). (3) The median (the lower quartile-the upper quartile) of the UACR of the population without cardiovascular diseases and risk factors was 13.81 (6.03 - 26.51) µg/mg. The level of UACR was significantly higher in females than that in males [17.12 (7.28 - 33.28) µg/mg vs. 5.49 (2.92 - 9.76) µg/mg, P < 0.01]. (4) The level of UACR in population with hypertension, diabetes or dyslipidemia was 16.27 (6.65 - 42.00) µg/mg, 26.27 (10.92 - 76.65) µg/mg and 16.39 (6.98 - 41.03) µg/mg respectively, all exceeding that of the healthy group (P < 0.05 or P < 0.01). (5) The levels of UACR increased in proportion to the increase of cardiovascular risk factor numbers, the UACR of the population with 0, 1, 2, 3 and 4 cardiovascular risk factors were 13.81 (6.03 - 26.51) µg/mg, 15.76 (6.79 - 36.44) µg/mg, 13.82 (5.68 - 34.43) µg/mg, 16.47 (6.07 - 50.56) µg/mg and 18.63 (11.26 - 83.09) µg/mg, respectively. The population with 4 cluster of cardiovascular risk factors posed the higher level of UACR than that of population with 0 cardiovascular risk factors (P < 0.05).</p><p><b>CONCLUSIONS</b>The three most common risk factors of cardiovascular diseases among the elderly community subjects aged more than 65 years are dyslipidemia, hypertension and diabetes, all of which are related to the elevation of UACR.</p>

Analysis of the correlation between non-invasive hemodynamic monitor and cardiac echocardiography on the evaluation of cardiac function / 中国医疗器械杂志

<p><b>OBJECTIVE</b>To explore the possibility of clinical evaluation of cardiac function by CHM T3002 non-invasive hemodynamic monitor.</p><p><b>METHODS</b>A total of 26 patients admitted to Zhongshan Hospital in Shanghai were enrolled, including 11 cardiac insufficiency patients and 15 control. Each subject was tested by non-invasive cardiac hemodynamic monitor immediately after echocardiography. Linear regression analysis and Bland-Altman consistency analysis were used in the analysis of relevance and consistency between two different methods.</p><p><b>RESULTS</b>Linear correlation was shown on LVEF, SV, SVI, CO, CI, EDV, LVET and PEP/LVET, but not on PEP, between the two methods. Moreover, the consistency of the two methods was highly confirmed on LVEF and LVET, less on SV, SVI, CO, CI and EDV, while awfully weak on PEP and PEP/LVET.</p><p><b>CONCLUSION</b>CHM T3002 non-invasive hemodynamic monitor may be useful in assessing patients' cardiac function, however, it can not replace cardiac echocardiography.</p>

Impact of pathogen burden on in-stent restenosis in patients after coronary stent implantation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Although some certain infectious pathogens could be detected in the patients with coronary artery disease, the roles of these infectious factors in the development of coronary artery diseases remain largely unknown. Since the number of infectious pathogens has been argued to be relative to the coronary artery diseases, we therefore examined whether there is a link between the number of infections and the incidence of in-stent restenosis after stent implantation.</p><p><b>METHODS</b>One hundred and eighty-one patients were enrolled in this study. Infectious pathogens including serum anti-Chlymydia pneumoniae, cytomegalovirus, Helico pylori, human herpes simplex virus-1, human herpes simplex virus-2 antibodies and hepatitis B virus antigen were measured in all patients before coronary stent implantation. Coronary angiography was performed before, immediately after and 6 months after stent implantation.</p><p><b>RESULTS</b>Restenosis rate 6 months post stent implantation was similar in patients with low pathogen burden (< 3 pathogens, 33.3%) to those with high pathogen burden (> or = 3 pathogens, 29.1%).</p><p><b>CONCLUSIONS</b>Previous infections with Chlymydia pneumoniae, cytomegalovirus, Helico pylori, human herpes simplex virus-1, human herpes simplex virus-2 and hepatitis B virus do not contribute to the incidence of restenosis after stent implantation.</p>