Associations between 24-hour urinary sodium excretion and all-cause mortality in adults living in north China / 中华心血管病杂志

Objective: To investigate the associations between 24-hour urinary sodium excretion (24hUNaE) and all-cause mortality in adult Northern Chinese population. Methods: Data from this study were derived from the prospective urban and rural epidemiology (PURE) study in north China. Baseline information of all participants were obtained by face to face interview through trained research staffs based on questionnaires, and morning fasting urine samples of participants were collected to estimate 24hUNaE and 24-hour potassium excretion (24hUKE). Multivariable frailty Cox regression models were used to explore the association between 24hUNaE (<3.00, 3.00-3.99, 4.00-4.99, 5.00-5.99 and ≥6 g/d) and all-cause death. Results: A total of 27 310 participants were included in this study. The mean 24hUNaE was (5.84±1.73) g/d. After a median follow-up of 8.8 years, 1 024 participants died (3.7%), including 390 cardiovascular related deaths and 591 non-cardiovascular related deaths. The cause of death of the remaining patients could not be determined. Using 24hUNaE level of 4.00-4.99 g/d as the reference group, after fully adjustment, 24hUNaE ≥6.00 g/d was associated with an increased risk of all-cause death (HR=1.24, 95%CI: 1.02-1.49) and cardiovascular related death (HR=1.39, 95%CI: 1.02-1.88). 24hUNaE<3.00 g/d was associated with increased risk of all-cause mortality (HR=1.38, 95%CI: 0.96-1.99). There was no significant association between 24hUNaE and non-cardiovascular related death. Furthermore, using the combination of 24hUNaE 4.00-4.99 g/d and 24hUKE≥2.11 g/d as the reference group, the highest risk occurred in participants with the combination of low sodium (<3.00 g/d) and low potassium (<2.11 g/d). Conclusion: 24hUNaE equal or higher than 6 g/d or lower than 3 g/d is associated with increased risk of all-cause mortality and cardiovascular related death in Northern Chinese population. Besides, moderate sodium intake in combination with increased potassium intake might reduce the risk of all-cause death.

Efficacy of monotherapy with 15 antihypertensive agents in treating essential hypertension assessed by 24-hour ambulatory blood pressure monitoring / 中国医学科学院学报

<p><b>OBJECTIVE</b>To evaluate the efficacy of the monotherapy of 15 agents in treating essential hypertension.</p><p><b>METHODS</b>After 2-week wash-out, a total of 370 patients with seated diastolic blood pressure 95-114 mmHg and seated systolic blood pressure < 180 mmHg were randomized to different therapeutic groups. 24-hour ambulatory blood pressure monitoring was performed before medication and at the end of 8 weeks.</p><p><b>RESULT</b>All the agents significantly reduced the 24 hour mean blood pressures after treatment except doxazosin, terazosin, and torasemide.</p><p><b>CONCLUSION</b>The result suggested that the angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, beta-blockers and long-acting calcium antagonists were effective in treating essential hypertension, while the low-dose doxazosin, terazosin and torasemide can be used for combination therapy but not for monotherapy.</p>

Comparison of clinic and ambulatory blood pressure in response to antihypertensive drugs in Chinese patients / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To compare the difference between 24-h ambulatory blood pressure (ABP) and trough clinic blood pressure (CBP) after 8 weeks of therapy.</p><p><b>METHODS</b>The study used meta-regression analysis to summarize three randomized, double-blind, active controlled trials in order to compare the difference between the magnitude of the reduction in 24-h average ABP and CBP Patients. Chinese patients with seated diastolic blood pressure (SDBP) 95-115 mmHg and ambulatory diastolic blood pressure (ADBP) > or =85 mmHg.</p><p><b>RESULTS</b>The average age of 126 patients was 47.7 +/- 8.3 years, ranging from 25 to 67 (95 males and 31 females). All regimens reduced 24-h ABP and CBP after 8 weeks of treatment. In the 126 patients the baseline 24-h SBP and DBP values (142.7/94.4 mmHg) were markedly lower than those for clinic values (152.6/102.6 mmHg; P<0.0001). Similarly, the 24-h SBP and DBP values (132.7/87.7 mmHg) in week 8 were markedly lower than the clinic values (138.9/92.7 mmHg; P<0.0001). The differences between the treatment-induced reductions in 24-h ABP and CBP were statistically significant (the difference was 3.7/3.3 mmHg for SBP/DBP, P=0.0069/P<0.0001).</p><p><b>CONCLUSION</b>All regimens significantly reduced seated CBP and ABP. The effect of antihypertensive treatment was greater on CBP than that on ABP, suggesting that assessment on effectiveness of an antihypertensive treatment using CBP readings only has to be carefully interpreted, and a more systematic application of ABP monitoring should be adopted.</p>

Adaptive designs for clinical trial / 中华流行病学杂志

<p><b>OBJECTIVE</b>In order to provide readers with general concepts and methodology on adaptive designs for clinical trial.</p><p><b>METHODS</b>Definition of adaptive designs for clinical trial and basic idea of adaptive adjustment were introduced through an example.</p><p><b>RESULTS</b>The relationship between adaptive designs and group sequential design was summarized. Ways to embody two basic statistical rules of clinical trial under adaptive adjustments setting were also introduced.</p><p><b>CONCLUSION</b>Adaptive designs provided clinical trial with a great flexibility, which could greatly improve the efficiency of clinical trial.</p>

Serum Uric Acid and Prehypertension / 中华高血压杂志

Background Previous experimental and clinical studies have proved that elevated serum uric acid increased risk for developing hypertension.Whereas,there are a paucity of information on the relationship between serum uric acid and prehypertension.Objective The purpose of this research is to evaluate the association between the serum uric acid and prehypertension.Method A cohort of seven thousand eight hundred thirty-nine subjects without hypertension and other cardiovascular diseases were recruited from a cross sectional study in urban and rural place in 9 provinces during 2005-2006.Based on serum uric acid(324 ?mol/L for overall population,366 ?mol/L for male,285 ?mol/L for female),people were categorized into quartiles.The odds ratio for prehypertension was calculat ed with the lowest quartile as the reference.Results The prevalence of prehypertension increased with increasing uric acid in total population(P324 ?mol/L)to lowest quartile 1(

Relationship between sample size and variation of means for personal noise exposure in weaving workers / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the relationship between sample size and variance of means for personal noise exposure in weaving workers as to contributing evidence for establishing personal noise exposure measurement guideline.</p><p><b>METHODS</b>A personal noise exposure measurement database from a group of weaving workers was used in the randomized re-sampling data analysis. The sampling cases were one number selecting from one to fifteen at each randomized re-sampling procedure. The randomized re-sampling was one thousand times from original personal noise exposure measurement database to get one thousands of re-sampling database. One thousands of L(Aeq.8 h) mean were calculated by re-sampling databases. The variation of randomized re-sampling means was analyzed for different re-sampling numbers.</p><p><b>RESULTS</b>The change for narrow trend of maximum, minimum, 95 percent number, 5 percent number of L(Aeq.8 h) mean was faster when randomized re-sampling number was smaller in variation vs randomized re-sampling number curve analysis. After that, the change for narrow trend of L(Aeq.8 h) mean was smooth for increasing the randomized re-sampling numbers. The 95% - 5% of L(Aeq.8 h) mean was about half for randomized re-sampling four cases (3.30 dB) vs one case (7.40 dB), and about one third for seven cases (2.44 dB), and about one fourth for eleven cases (1.85 dB).</p><p><b>CONCLUSION</b>The sample size in personal noise exposure measurement guideline could be selected from four to eleven.</p>

Relationship between impulse noise and continuous noise inducing hearing loss by dosimeter measurement in working populations / 中华预防医学杂志

<p><b>OBJECTIVE</b>To compare the dose-response relationship differences between impulse noise exposure workers and continuous noise exposure workers in prevalence of noise inducing hearing loss using dosimeter measurement.</p><p><b>METHODS</b>Thirty-two mechanical workers in a workshop were selected as impulse noise group and 163 textile workers in a textile factory as continuous noise group. SH-126 dosimeter was used to measure A weighted equal sound level of eight hours (L(Aeq.8 h)) during full working duration with equal energy rule for the selected workers. The cumulative noise exposure (CNE) was calculated by L(Aeq.8 h) and noise working years with equal energy rule for each worker. Hearing thresholds were measured by audiometer by routine method and adjusted by age and gender with GBZ49 - 2002. Hearing loss was diagnosed by GBZ49 - 2002 for each worker.</p><p><b>RESULTS</b>CNE of impulse noise group [(103.2 +/- 4.2) dB (A) .year] was found lower than the continuous noise group [(110.6 +/- 6.0) dB (A) .year] by significance, P < 0.05. The hearing loss prevalence of impulse noise group (68.8%) was similar as continuous noise group (65%) without significance, P > 0.05. Strata analysis showed the hearing loss prevalence in 100 - 104 dB (A) .year and 105 - 109 dB (A) .year of impulse noise group was double than that of continuous noise group (76.9%, 90.9% vs 30.4%, 50.0%), P < 0.05. The chi-square test showed a relationship between CNE and hearing loss prevalence that was in high significance (P < 0.01) in both impulse noise group and continuous noise group. Logistic regression model showed the dose-response relationship curve of impulse noise group was left shift and sharp slope.</p><p><b>CONCLUSION</b>The damage of impulse noise on hearing loss was much more than that of continuous noise according to equal energy rule of dosimeter data.</p>