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Objective:To analyze clinical characteristics of patients of Tibetan nationality with vitiligo in the Tibet autonomous region.Methods:Clinical data were collected from 527 patients of Tibetan nationality with vitiligo, who visited Department of Dermatology, People′s Hospital of Tibet Autonomous Region from January 2018 to December 2019, including age, gender, seasons at onset, involved body sites, classification and stages of vitiligo, concomitant diseases and laboratory test results.Results:Among the 527 patients of Tibetan nationality with vitiligo, the ratio of male to female was 0.97∶1, and vitiligo usually occurred at 10 - 30 years of age. As for clinical staging, 335 (63.6%) patients were diagnosed with progressive vitiligo, and 192 (36.4%) with stable vitiligo; as for clinical classification, there were 97 (18.4%) patients with segmental vitiligo, 293 (55.6%) with vitiligo vulgaris, 79 (15%) with mixed vitiligo and 58 (11%) with unclassified vitiligo; vitiligo lesions were mainly located on the face and neck (253 cases, 48%) , followed by the trunk (148 cases, 28%) , upper limbs (64 cases, 12%) , lower limbs (46 cases, 9%) , and perineal and perianal mucosa (16 cases, 3%) ; vitiligo usually occurred in summer (198 cases, 37.6%) and spring (154 cases, 29.2%) , followed by autumn (98 cases, 18.6%) and winter (77 cases, 14.6%) ; 140 (26.6%) patients suffered from other diseases such as thyroid diseases (85 cases, 16.1%) , and 74 (14.0%) suffered from subclinical thyroid diseases; one or more serological abnormalities were observed in 22 patients, including 18 with progressive vitiligo. Compared with the patients with stable vitiligo, those with progressive vitiligo showed significantly increased thyroid stimulating hormone (TSH) levels ( P = 0.004) . Spearman rank correlation analysis showed that altitude was weakly correlated with the stage of vitiligo ( rs = -0.18, P < 0.001) , the stage of vitiligo was weakly negatively correlated with the TSH level ( rs = -0.12, P = 0.005) and complement C3 level ( rs = -0.09, P = 0.041) , and the classification of vitiligo was weakly correlated with the TSH level ( rs = -0.11, P = 0.011) . Conclusion:In this study, the patients of Tibetan nationality with vitiligo were mostly aged at 10 - 30 years, vitiligo lesions were mainly located on the face and neck, and usually occurred in spring and summer, and the prevalence of comorbid thyroid dysfunction was relatively high.
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Objective To study changes in serum homocysteine(Hcy) and its correlation with serum levels of folic acid and high sensitivity C-reactive protein(hs-CRP)in Tibetan patients with mildto-moderate Alzheimer's disease at various high altitude areas,so as to direct the clinical diagnosis and treatment of AD in plateau hypoxia environment Method 108 cases were divided into four groups:23 AD Tibetan patients at middle altitude(AD/middle altitude group)and 23 healthy Tibetan subjects (healthy/middle altitude group) in Qinghai-Tibet Plateau Xining region,altitude at 2,260 m,31 AD Tibetan patients (AD/high altitude group)and 31 healthy Tibetan elderly subjects (healthy/high altitude group)in Yushu region at altitude of 3,800 m.Among the total study subjects,half are males,aged from 60 to 85 years.The levels of serum Hcy,Vitamin B12 and folic acid(FA)were measured by the Fluorescence Polarization Immunoassay(FPIA).Serum hs-CRP,triglyceride(TG)and low density lipoprotein cholesterol(LDL-C)were measured by automatic biochemistry analyzer.Correlation of Hcy with FA and hs-CRP was analyzed.Result Both high altitude and middle altitude group showed the levels of Hcy and hs-CRP were significantly higher in AD Tibetan patients than in healthy control at the same altitude(allP＜0.05).The levels of Hcy,LDL-C and hs-CRP of subjects were higherat high altitude than at middle altitude(P＜0.05).In contrast,folic acid levels in AD and control groups were lower at the high altitude than at middle altitude(P＜0.05).The levels of vitamin B12 and TG were not significantly different among all four groups.Multiple logistic regression analysis showed that altitude,folacin and hs-CRP were the risk factors for Hcy in patients with AD at plateau(OR =0.351,2.794,3.021,P=0.045,0.037,0.016).Conclusion Along with increased altitude,serum level of Hcy is significantly increased in AD Tibetan patients living in high altitude area.High altitude,high hs-CRP and lower folacin may be the risk factors for hyper-homocysteine in AD Tibetan patients with high altitude,and their combined effects are involved in the occurrence and development of AD.
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Objective To explore the relationship between the fibroblast growth factor 2 (FGFR2) gene polymorphism (rs 2981582 ,rs 1219648 ,rs 2420946) and the breast cancer risk in Tibetan population ,Qinghai province .Methods This is a case con‐trol study .Peripheral blood samples from 210 breast cancer patients and 230 healthy women in Qinghai area were collected .DNA samples were extracted from peripheral blood cells .FGFR2 gene polymorphism (rs 2981582 ,rs 1219648 ,rs 2420946) were typed by Taqman‐MGB probe based on PCR and DNA sequencing ,then analyzed its correlation with breast cancer in Tibetan population , Qinghai province .Results The genotype frequencies of rs 2981582 CC ,CT and TT were 40 .48% ,39 .05% and 20 .47% among the breast cancer patients while 36 .09% ,48 .69% and 15 .22% among the controls .The genotype frequencies of rs 1219648 GG ,AG and AA were 24 .76% ,26 .19 % and 49 .05% among the patients while 23 .91% ,47 .39% and 28 .70% among the controls .The genotype frequencies of rs 2420946 CC ,CT and TT were 29 .05% ,45 .24% and 25 .71% among the patients while 30 .87% , 51 .74% and 17 .39% among the controls .The genotype frequencies of all genetic loci had no significant difference between rs 2981582 and rs 2420946 (P>0 .05) .But the genotype frequencies of rs 1219648 AA have statistical sense (P< 0 .05) ,compared with GG ,the incidence of breast cancer was remarkably increased with AA [OR=1 .65 ,95% CI= (1 .01 ,2 .69)] .Conclusion This study shows that FGFR2 rs1219648 AA is related to breast cancer risk among Tibetan population .
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Objective To investigate the curative effect of Candesartan on chronic systolic heart failure in Tibetan pla?teau. Methods A total of 526 patients with chronic systolic heart failure were divided into two groups randomly (Treatment group N=252;Control group N=274). Regular medicines, such as cardiac, diuretic and vasodilator drugs , are given to pa?tients in both groups according to their primary underlined diseases. Additionally, enalapril is added in control group, while candesartan is added in treatment group. Improvement of cardiac function, LVEF, LVEDD and blood pressure were compared between these two groups after 8 weeks. Results There was no significant difference in effective rate (i.e., 45.2%in treat?ment group and 44.9% in control group, respectively), efficiency rate (i.e. 54.8% in treatment group and 55.1% in control group, respectively) and inefficiency rate (i.e. 2.0%in treatment group and 2.2%in control group, respectively) between treat?ment and control groups . After treatment, LVEF in the two groups are all improved, while LVEDD and blood pressure both de?creased with statistical significance. However, the difference between the two groups is not significant. Conclusion No sta?tistical difference was found in curative effect on chronic systolic heart failure in Tibetan Plateau between two groups.
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Objective To explore the trends and influencing factors of woman′s menarche age in Shigatse area of Tibet .Methods Totally 2 492 cases of female outpatients been surveyed from July to December 2010 ,of which 1 492 cases of Tibetan and 941 ca‐ses of Han ,and the relationship between their menarche age and nationality ,altitude and residence were analyzed .Results The‐woman′s menarche age of Tibetan was significantly higher than that of Han women(15 .090 ± 1 .898 vs .13 .920 ± 1 .538 ,P<0 .05);the woman′s menarche age were significantly different among the different altitude groups (P<0 .01) ,the age of menarche increa‐ses gradually along with the altitude increasing ,and Pearson correlation value was 0 .323 .Menarche age of Tibetan women living in the town was significantly less than that of rural women (14 .760 ± 1 .784 vs .15 .580 ± 1 .873 ,P< 0 .05) .Conclusion Menarche age of Tibetan were later than Han women ,and were gradually delay with the elevation increase .
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Objective To study the iodine nutritional status of population living in Tibetan pastoral areas,in order to provide a scientific basis for prevention and control of iodine deficiency disorders.Methods Drinking water samples were collected to test iodine content in agricultural town(Kajiaman) and pastoral area(Zuogaiduoma town) of Hezuo in Gannan Tibetan autonomous prefecture.Thirty of child-bearing age,pregnant and breastfeeding women were selected,respectively,and 90 male adults aged 20-50 from these families(1 from each family) and 90 children aged 8-10 (30 people in each age group) from local schools were randomly sampled at the same time,and urinary iodine (UI) was measured randomly.Edible salt and main food samples were collected to test iodine content from the 10 families of the three types of women,respectively,and they were asked to recall its family intake of food species in the past 24 h excluding spices.The water iodine was determined using arseniccerium redox method (GB/T 5750.1-2006) ; UI with ammonium persulfate digestion-arsenic cerium catalytic spectrophotometric method (WS/T 107-2006) ; salt iodine used direct determination method(GB/T 13025.7-1999); and food iodine with alkali the gray arsenic cerium contact colorimetry.All these work were done in May,2011.Results The average of water iodine was (1.63 ± 0.14)μg/L in agricultural areas and (2.08 ±1.90)μg/Lin pastoral areas of the 10 water samples tested,respectively.The median urinary iodine(MUI) among women of pregnant,lactating and child-bearing age,male adults and children was 141.99,126.65,253.33,258.07,191.0μg/L,respectively,in agricultural areas and 137.26,97.36,126.16,159.48,285.07 μg/L,respectively,in pastoral areas.The difference of MUI in lactating,male adults and children between pastoral and agricultural areas was statistically significant.The proportion of UI ＜ 50 μg/L was less than 20％,and ＜ 100 μg/L was less than 50％ among all population except lactating woman and pregnant women in pastoral areas.The iodized salt coverage rate was 100％(30/30) in agricultural areas and 90％(27/30) in pastoral areas,and the salt iodine was (32.1 ± 7.8)mg/kg in agricultural areas and (32.3 ± 6.0)mg/kg in pastoral areas,respectively.The food structure in agricultural areas was mainly potato,naked oat fruit,cabbage and so on,the average dietary iodine content was 285.7 μg/kg,and in pastoral areas was mainly chow mein,wheat flour,ghee,yogurt,barley and so on,the average dietary iodine content was 51.1 μg/kg.Conclusions There is no iodine deficiency in general in the population in Tibetan areas with low water iodine.However,iodine nutrition of pregnant women can not be guaranteed.It is recommended that classified guidance measures be taken to ensure the sustainable elimination of iodine deficiency disorders in the Tibetan minority areas.
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ObjectiveTo evaluate the effects of atorvastatin 10 mg or simvastatin 20 mg on serum lipids and high sensitive C-reactive protein (hs-CRP) in Tibetan type 2 diabetic patients with dyslipidemias.MethodsSeventy Tibetan type 2 diabetic patients with dyslipidemias were divided into two groups by random number table: atorvastatin 10 mg group(35 cases,treated with atorvastatin 10 mg/d) and simvastatin 20 mg group (35 cases, treated with simvastatin 20 mg/d). Before and 4 weeks after treatment, total cholesterol(TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglyceride (TG), apolipoprotein B (ApoB), white blood cell (WBC) count, fasting blood glucose (FBG) and hs-CRP were measured and adverse reactions were observed. ResultsAfter treatment for 4 weeks, the levels of TC, LDL-C and ApoB were significantly decreased in two groups (P＜ 0.01 ), and the level of TG was significantly decreased in atorvastatin 10 mg group [( 1.39 + 0.63 ) mmol/L vs.( 1.95 ±1.62) mmol/L,P＜0.05], but was not significantly decreased in simvastatin 20 mg group [(1.72 ±0.32)mmol/L vs. ( 1.93 ± 0.83 ) mmol/L,P ＞ 0.05]. The level of hs-CRP was significantly decreased in two groups (P ＜ 0.05), and the decreased range in atorvastatin 10 mg group was higher than that in simvastatin 20 mg group (40.51％ vs. 35.34％ ,P ＜ 0.05). Stepwise regression analysis showed that the decreased hs-CRP was independent of reduced serum lipids and had relationship with the kinds of statins (B =-0.384,P=0.022).ConclusionsThe effects of simvastatin on serum TC, LDL-C are the same as atorvastatin. Both have significant anti-inflammatory effects, while the degree of hs-CRP reducing by atorvastatin 10 mg is higher than that by simvastatin 20 mg in Tibetan type 2 diabetes.
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Objective: To explore relation among abnormal pulse pressure (PP) and cardiovascular risk factors, cardiac function in Tibetan adults through survey on distributive characteristics of PP in Tibetan adults from Songpan county, Sichuan province in China. Methods: An cross-section study was carried out in Songpan county, Sichuan province of China. Questionnaire investigation and Physical examination were performed by multi-phase, stratified, unequal proportional and random cluster sampling to investigate 1015 Tibetan adults aged 18~74 years. Results: In Songpan county the average PP is （45.59±14.22）mmHg ; the incidence rate of abnormal PP was 14.09％（143/1015）. Multifactor linear regression and Logistic regression analysis showed that abnormal PP was positively related with age (OR=1.05, P<0.05) and negatively related with level of high density lipoprotein (OR=-2.69, P<0.05). Compare with normal PP group, systemic vascular resistance [SVR, (1112.61±346.74) kPa/L vs. (1308.27±354.87) kPa/L, t=-4.87] significantly increased, levels of cardiac index [CI, (3.55±1.00) L/min•m2 vs. (3.22±0.54) L/min•m2, t=3.08] and stroke index [SI, (45.68±12.76) ml/m2 vs. (39.45±9.52) ml/m2, t=4.37] significantly decreased in abnormal PP group (P<0.05 all). Conclusion: Abnormal PP is common in Chinese Tibetan adults aged 18~74 years, which associated with cardiovascular risk factors and change of cardiac function. Health management for Tibetan adults with abnormal PP is strongly advocated.