Knowledge graph analysis of pyroptosis research in traditional Chinese medicine based on VOSviewer and CiteSpace / 中国中药杂志

To explore the research hotspots and frontier directions of pyroptosis in the field of traditional Chinese medicine(TCM), the authors searched CNKI and Web of Science for literature related to pyroptosis in TCM, screened literature according to the search strategy and inclusion criteria, and analyzed the publication trend of the included literature. VOSviewer was used to draw author cooperation and keyword co-occurrence network diagrams, and CiteSpace was employed for keyword clustering, emergence, and timeline view. Finally, 507 Chinese literature and 464 English literature were included, and it was found that the number of Chinese and English literature was increasing rapidly year by year. The co-occurrence of the authors showed that in terms of Chinese literature, there was a representative research team composed of DU Guan-hua, WANG Shou-bao and FANG Lian-hua, and for English literature, the representative research team was composed of XIAO Xiao-he, BAI Zhao-fang and XU Guang. The network visualization of Chinese and English keywords revealed that inflammation, apoptosis, oxidative stress, autophagy, organ damage, fibrosis, atherosclerosis, and ischemia-reperfusion injury were the primary research diseases and pathological processes in TCM; berberine, resveratrol, puerarin, na-ringenin, astragaloside Ⅳ, and baicalin were the representative active ingredients; NLRP3/caspase-1/GSDMD, TLR4/NF-κB/NLRP3, and p38/MAPK signaling pathways were the main research pathways. Keyword clustering, emergence, and timeline analysis indicated that the pyroptosis research in TCM focused on the mechanism of TCM monomers and compounds intervening in diseases and pathological processes. Pyroptosis is a research hotspot in the area of TCM, and the current discussion mainly focuses on the mechanism of the therapeutic effect of TCM.

Metabonomics: A Useful Tool to Reveal Underlying Relationships between Altered Chinese Medicine Syndromes and Ultrafiltration in Treatment of Heart Failure / 中国结合医学杂志

OBJECTIVE@#To reveal the underlying relationships between Chinese medicine (CM) syndromes and ultrafiltration (UF) in the treatment of heart failure based on a metabonomic approach.@*METHODS@#Seventeen acute decompensated heart failure (ADHF) patients were enrolled, and their CM syndromes before and after UF were collected. In addition, their venous plasma collected before and after UF was used for liquid chromatographmass spectrometer-based metabonomic analysis. Both reversed phase liquid chromatography and hydrophilic interaction liquid chromatography were used to analyze the plasma samples. Partial least-squares to latent structure-discriminant analyses were used for data analysis.@*RESULTS@#An obvious difference was observed pre- and post-treatment. A total of 17 potential biomarkers associating with alterd syndromes with UF including hypoxanthine, 1-methylhistidine, phytosphingosine, O-decanoyl-R-carnitine, etc. were screened out, showing a significant change after UF. The major adjusted metabolic pathways were purine metabolism, histidine metabolism, leucine and isoleucine metabolism, arginine and proline metabolism, carnitine shuttle, sphingolipid metabolism and phospholipid metabolism.@*CONCLUSIONS@#Metabonomic approach is a useful tool to identify potential biomarkers of altered syndromes link to UF and could provide a theoretical basis for further research on the therapeutic mechanism of UF combined with CM.

Hypoxia and inflammation are risk factors for acute myocardial injury in patients with coronavirus disease 2019 / 北京大学学报(医学版)

OBJECTIVE@#To investigate the risk factors for acute myocardial injury in coronavirus disease 2019 (COVID-19) patients.@*METHODS@#This is a retrospective analysis of a COVID-19 cohort, in which 149 confirmed COVID-19 patients enrolled were divided into the group of myocardial injury (19 cases) and the group of non-myocardial injury (130 cases). Myocardial injury was defined according to Fourth universal definition of myocardial infarction released by European Society of Cardiology (ESC) in 2018, that cardiac troponin (cTn) was above 99th percentile of the reference level. Clinical information and results of laboratory tests of the eligible patients were collected. Factors associated with myocardial injury in COVID-19 patients were evaluated.@*RESULTS@#Compared with the group of non-injury, the patients in the group of injury were older and had a larger proportion of severe or critical cases (P < 0.05), higher respiratory rate and lower percutaneous oxygen saturation (SpO2) without oxygen therapy on admission (P < 0.05). All inflammatory indexes except for tumor necrosis factor α (TNF-α) showed significant elevation in the patients of the group of injury (P < 0.05). Analyzed by Spearman correlation test, we showed that the levels of circulatory cTnI were in positive correlation with the levels of high-sensitivity C-reactive protein (hs-CRP), ferritin, receptor of interleukin-2 (IL-2R), interleukin-6 (IL-6) and interleukin-8 (IL-8) (ρ > 0, P < 0.05). Lower SpO2 without oxygen therapy on admission (OR: 0.860, 95%CI: 0.779-0.949, P=0.003) and higher plasma IL-6 levels (OR: 1.068, 95%CI: 1.019-1.120, P=0.006) were independent risk factors for acute myocardial injury in the patients with COVID-19 by multivariate Logistic regression analyses.@*CONCLUSION@#Hypoxic state and inflammation may play a key role in the pathogenesis of acute myocardial injury in COVID-19 patients.

Feasibility study of SYNTAX Ⅱ score in guiding the strategy of two-staged hybrid coronary artery revascularization / 中国介入心脏病学杂志

Objective To evaluate the feasibility of selecting the hybrid operation strategy according to the preoperative SYNTAX Ⅱ score by analyzing the characteristics of the SYNTAX score and the changes of the SYNTAX Ⅱ score in the different stages of the hybrid coronary artery bypass surgery. Methods Patients admitted in our hospital from Jan 1, 2016 to December 31, 2017 who received staged hybrid coronary revascularization (first stage CABG, followed by second stage PCI) were reviewed. The total SYNTAX Ⅱ scores before and after minimally invasive direct coronary artery bypass grafting (MIDCAB) were compared. Results A total of 50 patients were analyzed and scored by coronary angiography with lumen stenosis exceeding 50％. The SYNTAX Ⅰ score before MIDCAB was 36.00 points (13.00, 70.50) and the ratio of SYNTAX Ⅰ score>33 points was 58％ (29/50). After MIDCAB operation, the residual SYNTAX Ⅰ score was 11.50 points (7.00, 18.50), which decreased by 25.50 points (19.00, 33.75). According to the SYNTAX Ⅱ score before MIDCAB, a proportion of 10％ (5/50) patients who received PCI procedure showed a lower 4-year mortality than the CABG operation. The forecasted proportion SYNTAX Ⅱ score after MIDCAB increased to 38％ (19/50) while the actual proportion after MIDCAB was 42％ (21/50). The consistency between the forecasted value and the actual value was 90％ (45/50, P=0.125, McNemar test). Conclusions Using SYNTAX Ⅱ score to predict PCI or CABG treatment after MIDCAB is feasiable. The changes in SYNTAX Ⅱ score before and after MIDCAB was mainly resulted from the improvement in creatinine level after operation.

Efficacy and safety of "2-staged" Hybrid Coronary Revascularization Using Bilateral Internal Thoracic Artery Y Graft for Patients With Multivessel Coronary Artery Disease / 中国循环杂志

Objectives: To explore the feasibility and safety of "2-staged" hybrid coronary revascularization using bilateral internal thoracic artery (BITA) for the treatment of multivessel coronary artery disease. Methods: Data of 65 patients who underwent "2-staged" hybrid technique (HCR) using BITA (BITA-HCR group) in our heart center because of multivessel coronary artery lesions during 2014.05-2017.05 were retrospectively analyzed. Results were compared with 96 patients who underwent "2-staged" HCR with single ITA (SITA-HCR group) by the same surgeon over the same time period. Results: There was no significant difference of preoperative characteristics between two groups. Operation time was significantly longer [(204.6±28.7) min vs (147.9±31.6) min, P<0.05], number of distal anastomoses was significantly higher [(2.2±0.5) vs (1.0±0.0), P<0.05], number of stents was significantly lower [(1.90±0.67) vs (2.40±0.49), P<0.05] in BITA-HCR group than in SITA-HCR group. Bleeding volume [(520.1±120.3) ml vs (532.2±350.3)ml, P>0.05], mechanical ventilation time [(7.7±3.2) h vs (6.9±2.3) h, P>0.05] and blood transfusion required [5(7.7%)vs 8(8.3%), P>0.05] were similar between the two groups. Conclusions: The "2-staged" hybrid procedure using BITA is safe and feasible for the revascularization of multiple coronary artery lesions.

Effect of transcatheter embolization by autologous fat particles in the treatment of coronary artery perforation during percutaneous coronary intervention / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Coronary artery perforation (CAP) is a rare but severe complication of percutaneous coronary intervention (PCI). The aim of our study was to evaluate the effect and safety of transcatheter embolization by autologous fat particles in the treatment of CAP.</p><p><b>METHODS</b>Once the CAP was confirmed, a little autologous subcutaneous fatty tissue was obtained from the groin of the patient and then was made into 1 mm × 1 mm fat particles. The perforated vessel was embolized by fat particles via a micro-catheter. There were eight patients undergoing transcatheter embolization by autologous fat particles in the treatment of CAP during PCI in Peking University Third Hospital from February 2009 to June 2014, and the clinical data of these patients were collected and analyzed retrospectively.</p><p><b>RESULTS</b>The lesion morphology of the patients was classified based on the American College of Cardiology/American Heart Association Task Force classification, there were one patient with Class B2 lesion and seven patients with Class C lesions (there were five patients with chronic total occlusion lesions). According to the Ellis classification of CAP, there were six patients with Class II perforations and two patients with Class III perforations. The causes of perforation included that seven patients induced by guide wire and one patient by balloon predilation. Three patients had pericardial effusion. All of the eight patients with CAP underwent transcatheter embolization by autologous fat particles. Coronary angiography confirmed that all of them were embolized successfully. There was no severe complication after the procedure. The coronary angiography of one patient at 1 week and another patient at 2 years after the embolization showed that the embolized arteries had recanalized. The median follow-up time was 20.3 months (8.8-50.2 months), the event-free survival rate was 100%.</p><p><b>CONCLUSIONS</b>Transcatheter embolization by autologous fat particles was an effective, safe, cheap, and easy way to treat the perforation of small vessels during PCI.</p>

Usefulness of lumen area parameters determined by intravascular ultrasound to predict functional significance of intermediate coronary artery stenosis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Coronary artery disease is the leading cause of death in China. Percutaneous coronary intervention is a recent milestone technology for treatment coronary artery disease. However, clinical decision making for patients with intermediate coronary stenosis is still controversial. We designed this study to assess the optimal intravascular ultrasound (IVUS) criteria for predicting functional significance of intermediate coronary lesions.</p><p><b>METHODS</b>We enrolled 141 patients with 165 intermediate coronary lesions located in vessels with a diameter ≥ 2.50 mm. IVUS of intermediate coronary lesions were performed before intervention. Pressure-derived fractional flow reserve (FFR) was measured at maximal hyperemia induced by adenosine infusion. An FFR < 0.80 was considered as abnormal functional significance.</p><p><b>RESULTS</b>For the overall 165 lesions, the mean FFR value was 0.84 ± 0.09. The diameter of the stenosis by visual estimation on angiogram was (59.63 ± 11.29)%. Minimum lumen diameter (MLD), minimum lumen area (MLA) and plaque burden (PB) were (2.00 ± 0.36) mm, (3.88 ± 1.34) mm(2), (67.28 ± 9.89)% respectively by IVUS measurements. An FFR < 0.80 was seen in 43 lesions (30.5%). There was a moderate correlation between IVUS parameters and FFR, including MLD (r = 0.372, P < 0.001), MLA (r = 0.442, P < 0.001) and PB (r = -0.172, P < 0.05). MLA was a predictor for FFR as a continuous variable independent of possible confounding variables (P < 0.05), and MLA and PB, were predictors for FFR < 0.80 as binary variables (P < 0.05). The best cutoff value of MLA to predict FFR < 0.80 was < 3.15 mm(2), with a 73.6% diagnostic accuracy; sensitivity 71.4%, specificity 67.0%, AUC = 0.709, and P < 0.001. The cutoff value of the PB to predict FFR < 0.80 was 65.45%; sensitivity 82.6%, specificity 41.2%, AUC = 0.644, and P < 0.01. If both MLA and PB were taken into account, the negative predictive value and the positive predictive value were 88.7% and 64.8% respectively.</p><p><b>CONCLUSIONS</b>Anatomic measurements of intermediate coronary lesions obtained by IVUS showed a moderate correlation to FFR values. IVUS-derived MLA ≥ 3.15 mm(2) may be useful to exclude FFR < 0.80, but poor specificity limits its applicability for physiological assessment of lesions < 3.15 mm(2). MLA was one of many factors affecting coronary flow hemodynamics. Both MLA and PB should be taken into account when determining functional ischemia.</p>

Association between serum resistin level and cardiovascular events in postmenopausal women with acute coronary syndrome undergoing percutaneous coronary intervention / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>As an adipocytokine, resistin has been proposed as a link between inflammation, metabolic disorder and atherosclerosis. The aim of the study is to evaluate whether serum resistin is associated with acute coronary syndrome (ACS) and major adverse cardiovascular events (MACEs) among postmenopausal women with ACS undergoing percutaneous coronary intervention (PCI).</p><p><b>METHODS</b>A total of 106 consecutive postmenopausal women who underwent coronary angiography for evaluation of suspected myocardial ischemia were enrolled. Pre-procedure serum resistin, inflammatory and metabolic biomarkers were measured. All participants were followed for seven years for MACEs, including cardiovascular death, recurrent nonfatal myocardial infarction, and re-PCI.</p><p><b>RESULTS</b>Patients with ACS (n = 69) had significantly higher resistin levels than those without coronary artery disease (CAD) (n = 37) (4.61 (1.79 - 10.80) ng/ml vs. 2.36 (0.85 - 4.15) ng/ml, P = 0.002). Correlation analysis revealed positive correlations between resistin levels and inflammatory and metabolic factors (P < 0.05). A follow-up of a mean of 83.4 months showed that patients with ACS suffered more MACEs than those without (13.0% vs. 2.7%, P = 0.05). Adjusted for cardiovascular risks, inflammatory and metabolic factors, multiple Logistic regression analysis indicated that an elevated resistin level was an independent predictor of ACS onset (OR = 1.139, 95%CI 1.024 - 1.268, P = 0.017) and of MACEs after PCI (OR = 1.099, 95%CI 1.015 - 1.189, P = 0.019). To clarify the association between resistin levels and MACEs, ACS patients were divided into two subgroups on the basis of resistin levels. Compared with the low resistin subgroup (≤ 4.35 ng/ml, n = 32), patients in the high resistin subgroup (> 4.35 ng/ml, n = 37) were more prone to suffer MACEs (21.6% vs. 3.1%, P = 0.015). Kaplan-Meier analysis showed a significantly lower event-free survival rate in ACS patients with high resistin levels than in the low resistin subgroup (78.4% vs. 96.9%, Log rank 5.594, P = 0.018).</p><p><b>CONCLUSION</b>An elevated serum resistin level is associated with ACS and cardiovascular events and acts as a predictor in progression of ACS in postmenopausal women.</p>

Current status of morning blood pressure control and medication of hypertensive patients in Beijing / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the current status of morning blood pressure and medication of hypertensive patients in Beijing.</p><p><b>METHODS</b>This study included 2187 hypertensive patients who visited the ambulance of our cardiology department in the morning (7:00-10:00) from March 2012 to April 2012. Patients were divided into three groups: no antihypertensive agent group, single antihypertensive drug therapy group (include CCB, ARB, ACEI, β-blocker) and combined drug therapy group at least one month. Blood pressure control rate was compared among the groups.</p><p><b>RESULTS</b>Target blood pressure was not reached in 1193 patients (54.6%), most patients took CCB and the target blood pressure was not reached in 61.7% (295/478) patients taking CCB. There was no significant difference on target blood pressure uncontrolled rate among the four single drug subgroups (CCB, ARB, ACEI, β-blocker). The blood pressure uncontrolled rate was 46.3% (63/136) for amlodipine, 70.5% (55/78) for nifedipine and 73.8% (31/42) for felodipine. There OR of uncontrolled blood pressure rate was 0.36 (amlodipine vs. nifedipine, 95%CI:0.20-0.65) and 0.31% (amlodipine vs. felodipine, 95%CI:0.14-0.66).</p><p><b>CONCLUSION</b>The morning blood pressure uncontrolled rate is high in hypertensive patients visiting Beijing tertiary hospitals. Amlodipine is possible superior to nifedipine and felodipine on morning blood pressure control in this patient cohort.</p>

Predictive value of postprocedural leukocyte count on myocardial perfusion, left ventricular function and clinical outcomes in ST-elevated myocardial infarction after percutaneous coronary intervention / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Baseline white blood cell (WBC) count was correlated with ischemic events occurrence in patients with ST-elevated myocardial infarction (STEMI). However, circulating WBC count is altered after percutaneous coronary intervention (PCI). The aim of this study was to assess the relationship between postprocedural WBC count and clinical outcomes in STEMI patients who underwent PCI.</p><p><b>METHODS</b>A total of 242 consecutive acute STEMI patients who underwent successful primary PCI were enrolled and followed up for two years. WBC counts were measured within 12 hours after PCI. ST-segment resolution (ST-R) and myocardial blush grades (MBG) were evaluated immediately after PCI. Left ventricular ejection fraction (LVEF) was obtained at baseline and 12 - 18 months after PCI.</p><p><b>RESULTS</b>Postprocedural WBC count was an independent inverse predictor of ST-R (OR 0.80, P < 0.0001) and MBG 3 (OR 0.82, P < 0.0001). It was negatively correlated with LVEF (baseline r = -0.22, P = 0.001; 12 - 18 months r = -0.29, P < 0.0001). The best cutoff value of WBC for predicting death was determined to be 13.0 × 10(9)/L. The patients with a postprocedural WBC count above 13.0 × 10(9)/L showed a significantly lower cumulative survival rate (30 days, 82.4% vs. 99.0%, P < 0.0001 and 2 years 75.0% vs. 96.4%, P < 0.0001). Multivariate Cox regression analysis showed that a postprocedural WBC count was a strong independent predictor of 30-day mortality (HR 8.48, P = 0.019) and 2-year mortality (HR 4.93, P = 0.009).</p><p><b>CONCLUSIONS</b>Increased postprocedural WBC count is correlated with myocardial malperfusion and left ventricular dysfunction, and is an independent predictor of poor clinical outcomes in STEMI patients who underwent PCI.</p>

Association between fractional flow reserve and quantitative coronary angiography parameters in intermediate coronary artery stenosis / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the relationship between quantitative coronary angiography (QCA) parameters and fractional flow reserve (FFR) for identifying ideal angiographic parameters predictive of myocardial ischemia.</p><p><b>METHODS</b>The study included 121 lesions with QCA and FFR data from 106 patients [mean age: (63 ± 10) years]. The lesions were grouped into FFR > 0.75 group and FFR ≤ 0.75 group. Assessed parameters by QCA included percentage diameter stenosis, minimum luminal diameter (MLD), percentage area stenosis, minimum luminal area (MLA), reference vessel diameter (RVD) and lesion length (LL). Correlation analysis was used to identify the relationship between QCA parameters and FFR value, and receiver operating characteristic (ROC) curve was used to determine parameters predictive of FFR ≤ 0.75.</p><p><b>RESULTS</b>LL was significantly higher [(14.8 ± 7.9) mm vs. (10.7 ± 5.4) mm, P = 0.024] while MLD [(1.47 ± 0.31) mm vs. (1.82 ± 0.51) mm, P = 0.028], RVD [(2.30 ± 0.50) mm vs. (2.81 ± 0.64) mm, P = 0.036], and MLA [(2.30 ± 1.50) mm(2) vs. (3.60 ± 2.30) mm(2), P = 0.038] were significantly lower in FFR ≤ 0.75 group than in FFR > 0.75 group. LL (r = -0.209, P = 0.040) was negatively correlated with FFR, and MLD (r = 0.414, P = 0.040), RVD (r = 0.303, P = 0.000) and MLA (r = 0.315, P = 0.002) were positively correlated with FFR. ROC analysis showed that MLD ≥ 1.6 mm was the best cut-off value to predict FFR > 0.75 with sensitivity 63%, specificity 82%, and positive predictive value 96%.</p><p><b>CONCLUSIONS</b>QCA derived anatomic parameters of intermediate coronary lesions correlate to FFR value in some extent. MLD ≥ 1.6 mm is the best cut-off value to predict FFR > 0.75 in patients with intermediate coronary lesions.</p>

A rare case of arterial thrombosis due to heparin-induced thrombocytopenia / 中华医学杂志(英文版)

A 78-year-old man presented with an eight-hour history of chest distress. Electrocardiograph and serum cardiac enzymes were suggestive of acute inferior myocardial infarction with right ventricular infarction. The patient, who underwent emergency percutaneous coronary intervention, suffered from thrombocytopenia presenting with cerebral infarction and myocadial reinfarction during haparin exposure. The laboratory test for heparin-induced thrombocytopenia (HIT) specific antibodies (heparin-platelet factor, PF4) was positive. The case was diagnosed as arteries thrombosis due to heparin-induced thrombocytopenia; the patient died after cessation of heparin.

Impact of primary hypertension on hematuria of the patients with benign prostatic hyperplasia / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Both benign prostatic hyperplasia (BPH) and primary hypertension are common in the elderly men. The purpose of this study was to investigate the possible effect of primary hypertension on the hematuria in patients with BPH.</p><p><b>METHODS</b>All patients who underwent transurethral resection of prostate or opening operation had confirmed diagnoses of BPH histologically. comparative analysis of packet was used to analyze the incidence of hematuria in 423 BPH patients with or without hypertension. Immunostaining of CD34 and vascular endothelial growth factor (VEGF) was carried out in tissues of 50 cases of simple BPH and 50 cases of BPH accompanied with hypertension.</p><p><b>RESULTS</b>The incidence of hematuria in the BPH with hypertension was significantly higher than that in the simple BPH (P < 0.01). Furthermore, the incidence of hematuria in patients who had hypertension for more than 10 years was clearly higher than that in the patients who had hypertension for less than 10 years (P < 0.01). Both microvessel density (MVD) based on CD34 immunostaining and VEGF expression were significantly higher in the BPH tissues of patients with hypertension than that in the simple BPH (P < 0.01, P < 0.05).</p><p><b>CONCLUSIONS</b>Long-term hypertension may significantly increase the incidence of hematuria in patients with both BPH and hypertension. Increased MVD level and VEGF expression may account for the higher incidence of hematuria in these patients.</p>

Extent and relative changes of equities in using the prenatal care services among premature delivery women with different educational levels / 中华流行病学杂志

Objective To understand the extent and relative changes of equities in using the prenatal care services among premature delivery women from 4 counties/cities in Jiangsu and Zhejiang provinces, from 1995 to 2000. Methods The study population consisted of 97 537women who delivered singleton live birth of 28 to 41 gestational weeks in 4 counties/cities of Jiangsu and Zhejiang provinces, from 1995 to 2000. The proportions of women with early prenatal visit, of those with at least five prenatal visits and the hospital delivery rates between premature and term delivery groups were calculated. Inequalities in the above indictors by comparing rate difference ( RD), rate ratio ( RR ) and concentration index ( CI ) among women with different educational levels,were examined. Chi-square and One-way ANOVA were used to compare the differences. Results The proportions of having received early prenatal among those women with premature delivery in different education levels were 82.89%, 91.06%, 93.96%, 93.11% respectively, which were less than that of those with full term delivery (86.36%, 93.95%, 95.65%, 96.41%, P=0.008). The proportions of having received early prenatal among the women with high educational levels were higher (RD=-10.05, RR=0.90, CI=0.0104) than those with low educational attainment (RD=-10.22, RR=0.89, CI=0.0131); The proportions of having received at least five prenatal visits among those women with premature delivery in different education levels were 86.54%, 93.17%, 92.99%, 96.49%,respectively, which were less than those with full term delivery (94.60%, 96.65%, 96.15%, 96.66%,P=0.005). The proportions of having had at least five prenatal visits among the women with high educational attainment were higher (RD=-2.06, RR=0.98, CI=0.0006) than those with lower educational attainment (RD=-9.95, RR=0.90, CI=0.0077); The proportions of hospital delivery among the women with full term delivery in different education levels were significantly higher (99.45%, 99.75%, 99.83%, 99.77% ) than those with premature deliveries (98.42%, 99.54%, 99.61%,100.00%, P=0.005). The proportions of hospital delivery among women with high educational attainment was higher (RD =-0.32, CI= 0.0003 ) than those with lower educational attainment ( RD =-1.58, CI=0.0013). Conclusion Education related inequities in prenatal care utilization had not been improved among the Chinese women under our study. Inequities were seen in those women with full-term delivery the preterm delivery ones.

Increased postprocedural neutrophil count is an independent predictive factor of poor prognosis in acute ST elevation myocardial infarction patients treated with percutaneous coronary intervention / 中华心血管病杂志

<p><b>OBJECTIVE</b>The aim of the study was to evaluate the prognostic value of the postprocedural neutrophil count in patients with first acute ST elevation myocardial infarction (STEMI) treated with successful primary percutaneous coronary intervention (PCI).</p><p><b>METHODS</b>A total of 226 consecutive STEMI patients underwent successful primary PCI were enrolled. Electrocardiograms were recorded before PCI and 2 hours after PCI. Neutrophil counts were measured within 12 hours after PCI. All patients were followed up for 2 years. Logistic regression analysis was used to evaluate predictive values of postprocedural neutrophil for ST-segment resolution (STR) after PCI and for death, non-fatal myocardial infarction and heart failure at 30 days and 2 years post PCI. Time-to-event analyses were performed using the Kaplan-Meier survival curves in patients with various ranges of postprocedural neutrophil counts.</p><p><b>RESULTS</b>Postprocedural neutrophil count ranged from 2.83x10(9)/L to 18.74x10(9)/L, first quartile, median and fourth quartile were 5.66x10(9)/L, 7.38x10(9)/L and 9.34x10(9)/L respectively. Multivariable logistic analysis showed that when postprocedural neutrophil count increased 1x10(9)/L, the risk of non-STR increased 2.28 fold (OR: 2.28, P=0.009), the risk of death (OR: 1.63, P=0.010) and heart failure (OR: 1.16, P=0.035) at 30 days increased 1.63 and 1.16 folds respectively, and the risk of death (OR: 1.29, P=0.003) and heart failure (OR: 1.20, P=0.007) at 2 years increased 1.29 and 1.20 folds respectively, but the risk of non-fatal myocardial infarction was not affected by postprocedural neutrophil count. Furthermore, the patients with postprocedural neutrophil count>or=9.34x10(9)/L had significant lower 30-day (89.1% vs. 99.1% vs. 98.2%, P=0.010) and 2-year (82.4% vs. 96.1% vs. 96.3%, P=0.003) survival rates compared with the patients with postprocedural neutrophil count from 5.66x10(9)/L to 9.33x10(9)/L and the patients with postprocedural neutrophil count<5.66x10(9)/L (all P<0.05).</p><p><b>CONCLUSION</b>Postprocedural neutrophil count is an independent predictor of short- and long-term death and heart failure in first acute STEMI patients treated with successful primary PCI.</p>

Birth weight distribution among premature infants and related social factors / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the distribution of birth weight among premature infants and the associated social factors.</p><p><b>METHODS</b>The study population consisted of 97 537 women who delivered singleton live birth of 20 to 41 gestational weeks in 4 counties/cities, Jiangsu and Zhejiang provinces, China from 1995 to 2000. Chi-square test was employed to test the difference of proportions between respective groups. One- way ANOVA was used to test the differences regarding the mean of gestational weeks at the first prenatal visit and the mean of prenatal visits between the two groups. Multivariate logistic regression was conducted to examine the factors associated with premature birth.</p><p><b>RESULTS</b>Women aged 35 years had higher (8.8%) premature incidence than those aged less than 24 years (5.6%), 25 - 29 years (4.6%), or 30 - 34 years (4.5%, P < 0.001). Women with height less than 149 cm had higher (6.8%) premature incidence than those with height taller than 150 cm (5.0%). Women whose BMI were at least 28 and 24 - 28 had higher (5.5%, 5.5%) premature incidences than those whose BMI were 18.5 - 24.0 (5.0%), < 18.5 (4.6%, P < 0.001). The incidence of premature birth was 6.0% among women without previous pregnancy, higher than that among those women with 4 times of pregnancies (5.7%), 2 times of pregnancies (4.3%), and 3 times of pregnancies (4.0%). Parous women with at least two deliveries had higher (9.3%) premature incidence than the primiparous women (5.2%) and whose women with only one delivery (4.5%, P < 0.001). Women who received early prenatal care had lower 4.7% premature incidence than those who did not receive the service (6.1%). The mean times of prenatal visits among women with premature births was 8.53, less than that of those with full term delivery (10.97). Women with less than four times of prenatal visit had higher (18.9%) premature incidence than those with at least five prenatal visits (4.9%). Multivariate logistic regression showed that premature delivery risk was associated with age, height, BMI, gravidity, parity, early prenatal care, the mean of gestational weeks at first prenatal visit and the mean number of prenatal visits etc.</p><p><b>CONCLUSION</b>Premature delivery risk was associated with factors as age, height, BMI, gravidity, parity, early prenatal care, the mean of gestational weeks at first prenatal visit, the mean number of prenatal visits etc.</p>

Post-term pregnancy and associated social factors among pregnant women in Jiaxing city, China, 1993 to 2000 / 中华流行病学杂志

Objective To understand the status of post-term pregnancy and associated social factors among pregnant women in Jiaxing city, from 1993 to 2000. Methods The study population consisted of 16 033 women who had delivered singleton live births in Jiaxing city, Zhejiang province, from 1993 to 2000. Chi-square test was employed to test the difference of proportions between respective groups. Multivariate logistic regression was conducted to examine the factors associated with post-term pregnancy. Results The incidence rates of post-term pregnancy were 8.7%, 10.6%, 9.4%, 7.4%, 4.3%, 2.6%, 3.3% and 4.0% from 1993 to 2000, respectively. Women who received premarital health care serviees had lower (5.6%) post-term incidence than those who did not (7.8%). Women who received county or above level health care services had lower (4.3%) post-term incidence than women who receive township level service (8.5%). Women who had primary school education had higher (11.5%) post-term incidence than women who received junior higher school education (6.8%), senior high school education (3.8%), or college education (2.9%), (P< 0.001). Farmers had higher (9.5%) post-term incidence than workers in the rural areas (8.9%), in urban areas (4.3%) or women with other professions (4.2%). Women whose husbands were rural workers had higher (9.8%) post-term incidence than farmers (9.4%), urban workers (5.0%)or with other professions (3.6%, P<0.001). Data from multivariate logistic regression showed that the risk of post-term pregnancy was associated with the length and the level of using health care services together with schooling and occupation. Conclusion The incidence of post-term pregnancy was decreasing in Jiaxing city during the period from 1993 to 2000 and the risk was associated with the length and level of health care service as well as the level of education and occupation of those women.

Immune response induced by human cytomegalovirus DNA vaccine / 病毒学报

Human cytomegalovirus is an important pathogen which widely infects human. In this study, an eukaryotic expression vector containing human cytomegalovirus gB680 and pp65m genes was injected into BALB/c mice to explore the immune response. Firstly, the recombinant plasmid pVAX1/gB680+pp65m and plasmid pVAX1 were transfected into COS-7 cells respectively and the transiently expressed product was detected by RT-PCR and Western blot. The maxiprepared plasmid pVAX1/gB680 + pp65m and pVAX1 by alkaline lysis with SDS and purified by Sepharose 4FF column chromatography were then used to immunize BALB/c mice and the humoral and cellular immune responses were determined. Recombinant plasmid pVAX1/gB680+pp65m could be expressed in COS-7 cells, and could induce antibodies and cellular immune responses in BALB/c mice.

Effect of hypertension on cell proliferation and apoptosis in benign prostatic hyperplasia / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the effect of hypertension on cell proliferation and apoptosis in benign prostatic hyperplasia (BPH).</p><p><b>METHODS</b>The techniques of immunohistochemistry and terminal deoxynucleotidyl transferase-mediated dUTP biotin nick end labeling(TUNEL) were used to detect the proliferative index (PI) and apoptotic index (AI) in both epithelium and stroma of simple BPH (40 cases) and BPH with hypertension (40 cases), respectively.</p><p><b>RESULTS</b>In both the groups of simple BPH and BPH with hypertension, the value of PI was significantly higher than that of AI in epithelium and stroma (P < 0.05), and PI was closely related to the prostate volume (P < 0.05). As compared with the simple BPH group, PI was significantly increased in epithelium and stroma in the group of BPH with hypertension( P < 0.05), in which the disease history of hypertension was positively associated with PI in epithelium and stroma (p < 0.05).</p><p><b>CONCLUSION</b>Hypertension, particularly persistent hypertension state, may enhance cell proliferation in both epithelium and stroma of BPH, and consequently lead to the enlargement of the prostate.</p>

Association study between benign prostatic hyperplasia and primary hypertension / 中华外科杂志

<p><b>OBJECTIVE</b>To assess whether primary hypertension affects the occurrence and progression of benign prostatic hyperplasia (BPH).</p><p><b>METHODS</b>A total of 423 cases of BPH, undergoing transurethral resection of prostate (TURP) or open surgery due to severe low urinary tract symptoms, were reviewed and analyzed. All cases were verified to be BPH postoperatively following histopathological examination.</p><p><b>RESULTS</b>Of 423 patients, 295 cases (69.7%) were simple BPH (group BPH-NT); 128 cases (30.3%) were BPH with hypertension (group BPH-HT). The mean age and the incidence of haematuria were significantly higher in group BPH-HT than those in group BPH-NT (P < 0.05). The time of BPH occurrence and surgical treatment in group BPH-HT with mean diastolic blood pressure >/= 90 mmHg was significantly earlier than those with diastolic blood pressure < 90 mmHg (P < 0.05; P < 0.01). As compared with group BPH-NT, the time of BPH occurrence was significantly earlier in group BPH-HT with more than 10 years hypertension; the rate of urinary retention and haematuria was significantly higher and prostatic volume was significantly greater in group BPH-HT with more than 20 years hypertension; (all P < 0.05). Additionally, prostatic volume was positively correlated with the years of hypertension in group BPH-HT (Rsq = 0.056, P = 0.009).</p><p><b>CONCLUSIONS</b>The present results demonstrate that BPH may be frequently accompanied by the disease of hypertension. A long-term hypertension, particularly the condition of high diastolic blood pressure may improve the occurrence and clinical progression of BPH.</p>