Current status of blood lipids in people with hypertension and diabetes in Henan province / 中华心血管病杂志

Objective@#To investigate the blood lipid levels and prevalence of dyslipidemia in people with hypertension and diabetes in Henan province.@*Methods@#From April 2016 to April 2017, multi-stage cluster sampling was adopted to investigate 71 285 local residents aged between 35 and 75 from 6 districts and counties in Henan province including Zhongmu county of Zhengzhou city, Huojia county of Xinxiang city, Hualong district of Puyang city, Qi county of Hebi city, Xigong district of Luoyang city, and Wugang city of Pingdingshan city. Blood samples were collected. According to the diagnostic criteria of hypertension and diabetes, the study population was divided into control group (n=29 427), hypertension group (n=21 965), diabetes group (n=8 009) and hypertension-diabetes group (n=11 884). Comparisons on blood lipid levels and dyslipidemia between 4 groups were performed.@*Results@#The total cholesterol (TC) level of all subjects was 4.37 (3.78, 5.05) mmol/L. The triglyceride (TG) level was 1.27 (0.97, 1.80) mmol/L, the low-density lipoprotein cholesterol (LDL-C) level was 2.34 (1.88, 2.88) mmol/L and the high-density lipoprotein cholesterol (HDL-C) level was 1.31 (1.08, 1.59) mmol/L. Except for the TC level in women aged 65-75 years and LDL-C levels in women aged 55-64 and 65-75 years, there were significant differences in TC, TG, LDL-C and HDL-C levels between subjects of control group, hypertension group, diabetes group, and hypertension-diabetes group in different age ranges (including 35-44, 45-54, 55-64,and 65-75 years) and genders(all P<0.01).Except for the LDL-C and HDL-C in men aged 35-44 years and LDL-C in women aged 65-75 years, there were significant differences in the dyslipidemia rates of TC, TG, LDL-C and HDL-C between subjects of control group, hypertension group, diabetes group and hypertension-diabetes group in different age ranges and genders(P<0.01 or <0.05). After adjusting for age, gender, smoking, drinking, snoring, region, and body mass index, multivariate logistic regression analysis showed that hypertension (OR=1.221, 95%CI 1.113-1.339, P<0.01), diabetes (OR=1.636, 95%CI 1.461-1.833, P<0.01) and hypertension-diabetes (OR=1.832, 95%CI 1.658-2.023, P<0.01) were independent risk factors for TC abnormality. Hypertension (OR=1.566, 95%CI 1.478-1.659, P<0.01), diabetes (OR=2.182, 95%CI 2.031-2.342, P<0.01) and hypertension-diabetes (OR=2.655, 95%CI 2.492-2.829, P<0.01) were also independent risk factors for TG abnormality. Diabetes (OR=1.510, 95%CI 1.309-1.742, P<0.01) and hypertension-diabetes (OR=1.461, 95%CI 1.285-1.661, P<0.01) were independent risk factors for LDL-C abnormality. Diabetes (OR=1.261, 95%CI 1.180-1.346, P<0.01) and hypertension-diabetes (OR=1.195, 95%CI 1.126-1.268, P<0.01) were independent risk factors for HDL-C abnormality.@*Conclusion@#The prevalence of dyslipidemia in patients with hypertension and diabetes is high in Henan province, so adequate blood lipid education and control should be applied to people with risk factors as soon as possible.

Application value of TRANCE technology in lower limb arterial occlusive disease / 医疗卫生装备

Objective To explore the application value of triggered angiography non-contrast enhanced (TRANCE) technology in diagnosing lower limb arterial occlusive disease.Methods Totally 22 lower limb arterial occlusive disease patients were randomly selected,and then underwent TRANCE and DSA examinations.The arteries from the abdomen to the lower limb were divided into abdominal aorta,common iliac artery,external iliac artery,internal iliac artery,superficial femoral artery,deep femoral artery,popliteal artery,anterior tibial artery,posterior tibial artery and peroneal artery.Totally 337 sections displayed clearly were chosen to go through examinations by TRANCE and DSA.Results Of the 337 sections there were 312 ones with the same stenoses found by TRANCE and DSA,TRANCE found 16 sections with worse stenoses and 9 milder ones than by DSA.There were 153 sections with the same moderate stenoses (≥50％) displayed by TRANCE and DSA;Of the 153 sections,there were 15 ones with worse stenoses and 6 ones with milder stenoses found by TRANCE than by DSA.Kappa value of the two methods was 0.905.Conclusion TRANCE technology is a non-invasive,safe and nonradiative diagnosing method for the lower limb arterial occlusive disease.

Survey on the early reperfusion therapy status in patients with ST-segment elevation myocardial infarction hospitalized in tertiary and secondary hospitals in Henan province / 中华心血管病杂志

<p><b>OBJECTIVE</b>To observe the early reperfusion therapy status for patients with ST elevation acute myocardial infarction (STEMI) hospitalized in tertiary and secondary hospitals in Henan province.</p><p><b>METHODS</b>Baseline data, early reperfusion treatment and in-hospital mortality of STEMI patients hospitalized in 17 hospitals in Henan province (8 tertiary hospitals, 9 secondary hospitals) from June 2011 to June 2012 were obtained using a uniformed questionnaire.</p><p><b>RESULTS</b>One thousand six hundred and eighty six patients were enrolled, of which 886 patients were hospitalized in tertiary hospitals and 880 patients were early hospitalized in secondary hospitals. Six hundred and fifty four patients (38.8%, 654/1 686) underwent early reperfusion therapy (543 with thrombolysis and 111 with primary percutaneous coronary intervention (PCI)). There was no difference in the proportion of early reperfusion therapy between tertiary and secondary hospitals (40.1% (355/886) vs. 37.4% (299/800), P = 0.257). The median time from symptom onset to first medical contact, door-to-needle and door-to-balloon was 132 min, 18 min and 60 min, respectively. The median time from symptom onset to first medical contact (150 min vs. 120 min, P = 0.001), door-to-needle (30 min vs. 18 min, P = 0.003) and symptom onset-to-thrombolysis (3.5 h vs. 2.7 h, P = 0.001) were significantly longer in tertiary hospitals than in secondary hospitals. No difference was found in median time of door-to-balloon, symptom onset-to-primary PCI or symptom onset-to-elected PCI between tertiary and secondary hospitals (all P > 0.05). The proportion of door-to-needle ≤ 30 min was lower in tertiary hospitals than in secondary hospitals (46.4% (84/181) vs. 62.2% (153/246), P = 0.001). However, there was no difference in the proportion of door-to-balloon ≤ 90 min between tertiary and secondary hospitals (58.8% (60/102) vs. 57.1% (4/7), P = 1.000). In-hospital mortality was also similar between tertiary and secondary hospitals (5.8% (51/886) vs. 5.5% (44/800), P = 0.820).</p><p><b>CONCLUSIONS</b>Early reperfusion rate is low, and thrombolysis is the main early reperfusion therapy in both tertiary and secondary hospitals in Henan province. Tertiary hospitals did not take advantage of their primary PCI capability. There is great room for improvement in early reperfusion therapy in tertiary and secondary hospitals.</p>

Influence of Fluvastatin on Inflammation Factors and Therapeutic Effect in Patients with Early Diabetic Nephropathy / 中国药师

Objective:To investigate the effects of fluvastatin on high-sensitivity c-reactive protein( hs-CRP) , tumor necrosis fac-tor-α(TNF-α), urine albumer excretion rate (UAER)and serum creatinine (Cr) in the patients with early diabetic nephropathy. Methods:Totally 69 patients with early diabetic nephropathy were randomly divided into the observation group with 34 cases and the control group with 35 cases. The observation group was treated by low-protein diet plus fluvastatin, and the control group was treated by low-protein diet only. The course of treatment was 8 weeks. Totally 65 nondiabetic persons were selected as the normal group, and the levels of TNF-α, hs-CRP, UAER, ALT and Cr were detected before and after the treatment. Results:The levels of TNF-α, hs-CRP and UAER in the observation group and the control group were significantly higher than those in the normal group(P0. 05). Compared with that before the treatment, the level of UAER was de-creased significantly in the control group after the treatment (P0. 05). In the observation group, the levels of TNF-α, hs-CRP and UAER were all decreased sig-nificantly after the treatment (P<0. 05). Conclusion:UAER, hs-CRP and TNF-α are closely connected with diabetic nephropathy. Fluvastatin can decrease the levels of TNF-α, hs-CRP and UAER. Low-protein diet plus fluvastatin is effective and safe in the treat-ment of early diabetic nephropathy, and the efficacy is superior to that of low-protein diet only.

The correlation study between rs3093059 of C-reactive protein and ischemic stroke / 中国医师进修杂志

ObjectiveTo investigate the correlation between rs3093059 in single nucleotide polymorphism (SNP) of C-reactive protein (CRP) and ischemic stroke (IS).MethodsOne hundred and twenty-eight patients with IS were selected as observation group and 112 individuals without atherosclerotic vascular disease were recruited as control group.Genotype of rs3093059 in SNP of CRP in two groups determined by polymerase chain reaction-restrictive fragment length polymorphism(PCR-RFLP) were compared.The risk factors of IS were analyzed by multi-factor non-conditional Logistic regression model.ResultsThe distribution of genotype and allele frequency of rs3093059 in two groups conformed to Hardy-Weinberg balance test (P ＞ 0.05).It showed that all the cases belonged to the same population.Observation group comparing with control group,genotypes (GG 90 cases vs.94 cases,GC 18 cases vs.3cases,CC 20 cases vs.15 cases),allele frequency (G allele 198 cases vs.191 cases,C allele 58 cases vs.33cases) and dominant model distribution(CC + GC 108 cases vs.97 cases,CC 20 cases vs.15 cases) of rs3093059 had no significant difference (P＞ 0.05).But negative model distribution (CC + GC 38 cases vs.18 cases,GG 90 cases vs.94 cases) of rs3093059 had statistical significance (P ＜ 0.05).According to multi-factor non-conditional Logistic regression model analysis,the male sex,history of hypertension,diabetes and smoking,and negative model of rs3093059 were independent risk factors of IS (P ＜ 0.05).Conclusion The negative model of rs3093059 is an independent risk factor of IS.