Combination of High-Density Lipoprotein Cholesterol and Lipoprotein(a) as a Predictor of Collateral Circulation in Patients With Severe Unilateral Internal Carotid Artery Stenosis or Occlusion

Background@#and Purpose Collateral circulation is considered an important factor affecting the risk of stroke, but the factors that affect collateral circulation remain unclear. This study was performed to identify the factors associated with collateral circulation, especially blood lipids. @*Methods@#The study involved patients who had undergone digital subtraction angiography and were confirmed as having severe unilateral stenosis or occlusion of the internal carotid artery (ICA). We classified the collateral circulation status of each patient as good (Grade 3 or 4) or poor (Grade 0, 1, or 2) according to the grading system of the American Society of Interventional and Therapeutic Neuroradiology/American Society of Interventional Radiology. We collected data on patients’ characteristics and identified the factors that affect collateral circulation. @*Results@#This study included 212 patients. The multivariate logistic regression analysis showed that the high-density lipoprotein cholesterol (HDL-C) concentration and a complete anterior half of the circle of Willis were independent protective factors for good collateral circulation, whereas elevated lipoprotein(a) [Lp(a)] and serum creatinine concentrations were independent risk factors for good collateral circulation. The area under the receiver operating characteristics curve (AUC) was 0.68 (95% confidence interval [CI], 0.61–0.76) for HDL-C and 0.69 (95% CI, 0.62–0.76) for Lp(a). A binary logistic regression model analysis of the joint factor of HDL-C and Lp(a) yielded an AUC of 0.77 (95% CI, 0.71–0.84). @*Conclusions@#In patients with severe unilateral ICA stenosis or occlusion, the combination of HDL-C and Lp(a) is a useful predictor of collateral circulation.

Clinical characteristics of insulin resistance and its relationship with metabolic complications in obese children and adolescents / 中华实用儿科临床杂志

Objective:To study the clinical characteristics of growth development and metabolic disorders in obese children and adolescents with insulin resistance (IR).Methods:Normal weight or obese children and adolescents who hospitalized at the Department of Children′s Health Care of Children′s Hospital Affiliated to Nanjing Medical University from September 2015 to April 2018 were recruited.Children′s height, body weight and waist circumference were measured, and waist-to-height ratio (WHtR) and body mass index (BMI) were calculated.Puberty process was determined by Tanner stage.Blood glucose, blood lipid and insulin were measured in fasting state, and homeostasis model assessment of insulin resistance (HOMA-IR) was calculated based on fasting blood glucose and insulin levels.IR was considered when HOMA-IR was over 2.69.Non-alcoholic fatty liver (NAFLD) was diagnosed by abdominal ultrasound.Results:(1) A total of 691 subjects were included, including 183 cases with the age of (9.73±2.38) years in the normal weight group/normal group, and 508 cases with the age of (10.24±2.05) years old in the obese group.The rate of IR was higher in obese group than that in normal group (55.71% vs. 10.38%), and the difference was statistically significant ( P<0.001). (2)HOMA-IR was positively correlated with age ( r=0.256, P<0.001), BMI ( r=0.426, P<0.001), waist circumference ( r=0.454, P<0.001), and WHtR ( r=0.321, P<0.001). After the adjustment for age, sex, and puberty stage, HOMA-IR was also positively correlated with BMI ( r=0.418, P<0.001), waist circumference ( r=0.419, P<0.001) and WHtR ( r=0.375, P<0.001). (3) During puberty, HOMA-IR in both of obese group and normal group was increased, and HOMA-IR in obese group was more particularly serious compared to normal group[TannerⅠ: 2.60(1.49, 3.94) vs.1.28(0.80, 1.90); Tanner Ⅱ: 3.07(1.75, 5.17) vs.1.80(1.16, 2.96); Tanner Ⅲ: 4.33(2.80, 6.57) vs.2.47(1.41, 3.68); Tanner Ⅳ-Ⅴ: 3.49(1.04, 5.78) vs.1.91(0.54, 2.60)], and the differences were all statistically significant(all P<0.05). (4)Compared with the obese objects without IR, obese children and adolescents with IR had higher systolic blood pressure[112(104, 124) mmHg vs.109(98, 121) mmHg, 1 mmHg=0.133 kPa], triglyceride level [1.27(0.95, 1.81) mmol/L vs.1.09(0.79, 1.61) mmol/L], fas-ting blood glucose level [4.80(4.46, 5.01) mmol/L vs.4.48(4.16, 4.76) mmol/L] and fasting insulin level [21.27(16.21, 28.56) mmol/L vs.7.62(4.43, 10.83) mmol/L], and the differences were all statistically significant(all P<0.05). IR was a risk factor for NAFLD in obese children( OR=1.536, 95% CI: 1.049-2.247, P<0.05). Conclusions:Serious and abdominal obesity in children and adolescents is a major risk factor for the development of IR.HOMA-IR of obese children and adolescents is particularly serious during puberty.The obese children with IR are more likely to have metabolic disorders in blood glucose, serum lipid and blood pressure, and have the risk of NAFLD development.

The effects of painful procedures during neonatal period on rats' hippocampal gene expression profiles in later life / 中国新生儿科杂志

Objective To study the effects of painful procedures during neonatal period on rats' hippocampal gene expression in later life.Method A total of 28 newborn male rats were randomly assigned into two equal groups.From day1 (P1) to day7(P7) after birth,rats in the pain group received four times of needle acupuncture at the foot everyday,simulating the infants' experience in the NICU.Rats in control group were touched at the same side of the foot with a cotton swab.Transcriptome sequencing of the hippocampus of the two groups were examined on day 8 (P8) and day 21 (P21).The gene expression profiles were established and the differentially expressed genes were screened for functional analysis.Quantitative Real-time polymerase chain reaction (qRT-PCR) was used to confirm these differentially expressed genes (GABRB1,GRIN2A,IL1 RAPL1) related to pain-stimulated response or brain cognition,and one of the key genes was further verified using Western blotting.Result The sequencing results showed that there were only 6 differentially expressed genes in hippocampal tissues of rats on P8 in the two groups.Howerer,the number increased to 53 on P21 and 85.0％ of these genes were down-regulated (45/53).Gene Ontology (GO) function enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis showed that the differentially expressed genes were mainly expressed on the cell membrane,voltage-gated ion channels,synapses,neurotransmitter receptors,immune responses,etc.The qRT-PCR and Western-blot results of key genes were consistent with the transcriptome sequencing.Conclusion Pain stimuli at an early stage after birth may trigger differentially expression of voltage-gated ion channel proteins,neurotransmitter receptors,and some key genes such as GABRB1 on hippocampal synaptic cell membranes in rats.These phenomenon may provide initial explanation for the molecular mechanism of early pain stimuli on neonatal brain development.

Ma Yinglong Musk Hemorrhoids Ointment combined with psychological intervention in the treatment of perianal eczema and its effect on quality of life / 中国生化药物杂志

Objective To investigate the effect of Musk Hemorrhoids Ointment Combined with psychological intervention in patients with perianal eczema and the effect on the quality of life of patients. Methods 70 patients with perianal eczema were randomly divided into control group (n=35) and observation group (n=35). The control group using triamicinolone acetonide acetate and miconazole nitrate neomycin sulfate cream with the treatment, the observation group with musk hemorrhoids ointment combined with psychological intervention treatment by SF-36 life quality scale of two groups before and after treatment to assess the quality of life, compared 2 groups of clinical curative effect and influence on the quality of life of patients. Results The observation group after treatment itching, exudation and lesion area and the symptoms and signs improved time shorter than the control group (P<0.05); quality of life score of SF-36 in observation group after treatment were higher than those in control group (P<0.05); the observation group after 2 weeks of treatment, the clinical efficiency and control group had significant difference (P<0.05). Conclusion Patients with perianal eczema with musk hemorrhoids ointment combined with psychological intervention treatment effect is ideal, it is worthy of popularization and application.

Hyperuricemia is an independent risk factor for renal pathological damage and poor prognosis in lupus nephritis patients / 中南大学学报(医学版)

To explore the correlation between hyperuricemia and renal damage in patients with lupus nephritis (LN).
 Methods: The data for clinical features, laboratory and renal pathological examination were collected from 177 renal biopsy-proven LN patients with or without hyperuricemia and were retrospectively analyzed to determine the correlation between serum uric acid and renal damage.
 Results: LN patients with hyperuricemia group had higher rate of hypertension and higher level of blood urea nitrogen and serum creatinine while lower estimated glomerular filtration rate (eGFR) and lower positive rate of anti-U1RNP antibody (P<0.05). In the LN patients with hyperuricemia group, renal pathological scores, including acitive index, chronic index and tubulointerstitial lesions, were higher than those in the LN patients without hyperuricemia group (P<0.05). The level of serum uric acid was positively correlated with serum creatinine, renal pathological classification and renal pathological scores while negatively correlated with eGFR (P<0.05).
 Conclusion: LN patients with hyperuricemia are associated with more serious renal damage. Hyperuricemia is an important predictor for poor prognosis in patients with LN.

Impact of early repetitive painful procedures on pain response in full-term infants / 中华实用儿科临床杂志

Objective To explore the impact of early repetitive painful procedures on subsequent pain behaviors and physiological indicators in full-term infants.Methods Sixty-two full-term neonates were enrolled (male 36 cases,female 26 cases) from the medical center of neonatal care at Nanjing Children's Hospital Affiliated to Nanjing Medical University from March to May in 2009.The data of all painful procedures were performed on those neonates and their responses to them were collected by using digital video recording were collected.The Neonatal Facial Coding System C(NFCS) and Neonatal Infant Pain Scale(NIPS) were used prospectively to evaluate the pain response to painful procedures.Results The average experience of pain caused by operation on newborn at the hospital was 56.5 times (12-249 times),and the daily average was 5.9 times (4-26 times).After they were exposed to more than 10 repetitive pain procedures,the full-term neonates showed the declining pain response assessed by NFCS and NIPS during the subsequent painful procedures (NFCS:P10=0.012,P20=0.015,P30=0.041;NIPS:P10=0.006,P20=0.015,P30=0.049),and the temporarily enhanced pain response was observed in the preparation phase of the subsequent painful procedures (NFCS:P2＜0.001,P3＜0.001,P4=0.004,P5=0.009;NIPS:P2＜0.001,P3＜0.001,P4=0.045,P5 =0.031).Bnt there was no difference in preparation phase.There was no alternation in latency and crying time after repetitiing painful procedures,but the proportion of crying neonates in the preparation phase of the painful procedures was increased(P=0.032).Conclusions After exposed to repetitive pain,full-term neonates expressed hypoalgesia during subsequent painful procedures,but the temporary irritation was enhanced during the following phases exposed to stress.

Effects of overfeeding in breastfeeding period on blood pressure and vascular endothelial dilation function of rats / 中华临床营养杂志

Objective To study the effects of postnatal overfeeding and high-fat diet on blood pressure of rats,and to explore the pathophysiological mechanism underlying hypertension induced by continuous early postnatal overfeeding.Methods Male Sprague-Dawley rats were randomly divided into normal feeding group (10/litter) and overfeeding group (3/litter) on postnatal day 3 with a random number table.After weaning at postnatal week 3,the rats were randomly given standard chow or high-fat (HF) diet until week 16.Hence four groups were analyzed,namely normal feeding group,breastfed overfeeding group,post-weaning overfeeding group,and continuous overfeeding group.Body weight was continuously monitored in each week.Visceral fat pad (retroperitoneal and perigenital),systolic pressure,and heart rate were observed at week 3 and week 16.Thoracic aorta was sampled for measurement of vascular endothelial dilation function.Histological morphology was observed with HE staining,nitric oxide content of thoracic aorta was detected with nitrate reductase method.The mRNA expression of endothelial nitric oxide synthase (eNOS) in thoracic aorta was determined by real-time polymerase chain reaction.The protein expressions of eNOS and phosphorylated eNOS were determined by Western blot.Results At week 3,breastfed overfeeding rats displayed significantly larger body weight [(77.80 ± 0.57) g vs.(62.80 ±0.85) g,t =14.576,P ＜ 0.01] and visceral fat [retroperitoneal:(8.19 ± 0.49) mg/g vs.(4.92 ± 0.31) mg/g,t =5.629,P＜0.01;perigenital:(3.50 ±0.29) mg/g vs.(2.08 ±0.13) mg/g,t =4.552,P ＜0.01] compared with normal feedindg rats,and the protein expression of phosphorylated eNOS in aortic tissues was significantly reduced to week 16 (F =15.215,P ＜0.01);high-fat diet feeding after weaning further increased the body weight and fat mass in breastfed overfeeding rats.At week 16,continuous overfeeding rats showed hypertension [(149 ± 1.94) mmHg (1 mmHg =0.133 kPa),F =22.834,P ＜0.01],impaired vascular endothelial dilation function (F =7.648,P ＜ 0.05),and reduced protein expression of phosphorylated eNOS (F =15.215,P ＜ 0.01),while the post-weaning overfeeding group only had elevated blood pressure.Conclusions Overfeeding in breastfeeding period and high-fat diet after weaning leads to hypertension.The continuous decrease in phosphorylated eNOS in vascular tissues may be an important molecular process participating in the occurrence of vascular endothelial dysfunction in adults induced by postnatal overfeeding.

Effects of repetitive noxious stimuli during neonatal period on pain sensitivity during adulthood in rats / 中华麻醉学杂志

Objective To evaluate the effects of repetitive noxious stimuli during the neonatal period on the pain sensitivity during adulthood in rats.Methods Twenty pathogen-free male neonatal SpragueDawley rats,weighing 6.2-6.8 g,were randomly divided into 2 groups (n=10 each) using a random number table:control group (group C) and repetitive noxious stimuli group (group RNS).In RNS group,neonatal rats sequentially received needle pricks into the dorsal surface of 4 paws at 6 h intervals with a 28 G needle per day during the first postnatal week.In group C,the animals received non-painful tactile stimuli with cotton tip rub.At the age of 10 weeks,complete Freund' s adjuvant was injected into the plantar surface of the right hind paw to induce inflammatory pain.Before injection,and at 24 h and 7 days after injection (T0-2),the mechanical and thermal thresholds were measured,and alcohol preference test was performed for assessment of the behavior at T2.Results The mechanical threshold of the right paws was significantly lower at T1.2 than that of the left paws in the two groups.Compared to group C,the mechanical threshold of the left and right paws at T0-2 and thermal threshold of the right paws at T1 were significantly decreased,and alcohol intake was increased in group RNS.Conclusion Repetitive noxious stimuli during the neonatal period can lead to increase in the pain sensitivity during adulthood in rats.

Association between elevated visfatin and carotid atherosclerosis in patients with chronic kidney disease / 中南大学学报(医学版)

OBJECTIVE@#To determine the levels of visfatin in patients with chronic kidney disease (CKD) and to explore the relationship between visfatin levels and caroid atherosclerosis in CKD patients.@*METHODS@#A total of 180 CKD patients (102 non-dialyzed patients and 78 dialysis patients) and 42 healthy subjects enrolled in this study. The serum levels of visfatin, IL-6, and high sensitive C-reactive protein (hsCRP) were measured by ELISA. Common carotid arteries intima-media thickness (CCA-IMT), cross-sectional calculated intima-media thickness (c IMT) area and atherosclerotic plaque were detected by non-invasive high-resolution B-mode ultrasonography.@*RESULTS@#The serum levels of visfatin, IL-6 and hsCRP were significantly increased in CKD patients compared with age matched healthy subjects (P<0.01). The serum levels of visfatin, IL-6 and hsCRP in the dialyzed patients were significantly higher than those in non-dialyzed patients (P<0.05). Visfatin levels increased with the progression of renal dysfunction and inversely related to creatinine clearance (Ccr) in non-dialyzed patients (r=-0.415, P<0.05). Patients with carotid artery plaques showed significantly higher levels of visfatin[(34.22±7.96) ng/mL)] compared with those without plaques [(28.24±6.18) ng/mL, P<0.05]. The serum levels of visfatin were closely correlated with IL-6 (r=0.548, P<0.001), hsCRP (r=0.430, P<0.001), CCA-IMT (r=0.462, P<0.05), and c IMT area (r=0.411, P<0.05). After adjusting for GFR, age, gender, and other risk factors associated with atherosclerosis, multiple stepwise regression analysis showed that serum visfatin is a independent risk factor for CCA-IMT (β=0.433, P<0.01) and c IMT area (β=0.412, P<0.01).@*CONCLUSION@#The serum level of visfatin increase with the progression of CKD and should be considered to be a new risk factor for atherosclerosis in CKD.

Relation of Isolated Systolic High-Normal Blood Pressure and Coronary Heart Disease in Middle-Aged and Elderly Persons / 天津医药

Objective To investigate the relationship between isolated systolic high-normal blood pressure and cor-onary heart disease (CHD) in the middle-aged and elderly population. Methods A total of 236 patients over 50 years old and undergone coronary angiography were enrolled and divided into isolated systolic high-normal blood pressure (ISHNBP) group (n=135) and non-ISHNBP (NISHNBP) group (n=101) according to their systolic and diastolic blood pressure levels. All clinical data and angiographic data were collected. Results There was no significant difference in systolic blood pres-sure between NISHNBP group and ISHNBP group (P>0.05). There were significantly lower levels of diastolic blood pres-sure and higher pulse pressure in ISHNBP group (P＜0.01). Results of multivariate logistic analysis showed that isolated sys-tolic high-normal blood pressure was the independent risk factor for CHD (OR=2.67,95%CI:1.50-4.75, P＜0.01). And the distribution of diseased coronary vessel numbers was more extensive in the ISHNBP group (P＜0.01). Conclusion The iso-lated systolic blood pressure in the middle-aged and elderly population with high risk of coronary heart disease should be paid attention to, and make appropriate interventions, which may help reduce the incidence of cardiovascular disease.

Correlation of diastolic blood pressure and isolated systolic hypertension with coronary heart disease in the elderly / 中华老年医学杂志

Objective To investigate the correlation of diastolic blood pressure (DBP) ＜70mm Hg and isolated systolic hypertension (ISH) with coronary atherosclerosis (CAS) and coronary heart disease (CHD) in elderly patients and to analyze the independent risk factors for low DBP.Methods A total of 246 elderly patients with untreated ISH who underwent coronary angiography were divided into the low DBP group (n=102) and the non-low DBP group (n=144) according to DBP level.All clinical and angiographic data were collected and the retrospective analysis was performed to assess the risk of CAS and CHD in patients with low DBP and to analyze the risk factors for low DBP.Results There were no significant differences in systolic pressure level between the low DBP group and the non low DBP group [(156.2±15.6) mmHgvs.(154.4±14.2) mmHg,t=0.93,P＞0.05],while pulse pressure level was significantly higher in the low DBP group than in the non-lowDBPgroup [(91.3±±17.7) mmHgvs.(72.9±15.1) mm Hg,t=8.54,P＜0.01].Stepwise logistic analysis showed that age,diabetes and smoking were independent risk factors for low DBP.After adjustment for age,gender and other common risk factors,low DBP was independently associated with CAS and CHD (OR =1.72 and 1.44,95％ CI:1.082.72 and 1.04-1.99,respectively,both P＜ 0.05).Conclusions Low DBP is independently associated with CAS and CHD in elderly patients with untreated ISH.Age,diabetes and smoking are the independent risk factors for low DBP.

The effects of neonatal pain on health in the short-term and long-term / 国际儿科学杂志

It has become increasingly appreciated that newborn perceive and respond to pain.For immature preterm and illness term neonates,exposing to repeated and prolonged procedure pain can not only have short-term effects,such as behavioral and physiological variation or stress hormone and pain sensitization alternation,but also can cause long-term impacts including nervous system and pain system plasticity,chronic-pain-syndrome formation,endocrine modulating interference and behavioral,cognitive or emotional disorders.Here we provide a review about the effects of neonatal pain on health of short-term and long-term,and the mechanism of pain is also involved.

VENTILATORY VOLUMES AND RESPIRATORY FLOW RATE IN HEALTHY PILOTS / 解放军医学杂志

Ventilatory volumes and respiratory flow rate during quiet and rapid respiration were measured in 480 healthy pilots of our Air Force. The mean values were: VE, 9.58?1.74 1/min; MVV, 154.69?19.48 l/min; PIFR, 23.56?4.60 l/min; and FPIFR, 182.388?29.95 l/min.Regression analysis showed that they correlated well with each other as well as with body surface area (BSA), age, sitting height etc. The regression. formulae are Y = 2.97398 + 3.74173X2 for VE, Y = 103.921-0.839956X1 + 44.4811X2 for MVV, Y = 20.2761+0.735782X4 for PIFR, and Y = 99.9757-0.69924X1+ 59.7506X2 for FPIFR, where X1 stands for age, X2 for BSA, and X4 for vital capacity.The above results should provide a valuable physiological basis for designing aircraft oxygen equipment,for laying down the standard of on-board oxygen supply, and for pulmonary functional tests in pilots.