Clinical Characteristics of Children with Hemophagocytic Syndrome with Different EB Virus DNA Loads / 中国实验血液学杂志

OBJECTIVE@#To analyze the clinical characteristics of hemophagocytic syndrome (HLH) children with different EB virus (EBV) DNA loads, and to explore the relationship between differential indicators and prognosis.@*METHODS@#Clinical data of 73 children with HLH treated in our hospital from January 2015 to April 2022 were collected. According to EBV DNA loads, the children were divided into negative group (≤5×102 copies/ml), low load group (>5×102-<5×105 copies/ml) and high load group (≥5×105copies/ml）. The clinical symptoms and laboratory indexes of the three groups were compared, and the ROC curve was used to determine the best cut-off value of the different indexes. Cox regression model was used to analyze the independent risk factors affecting the prognosis of children, and to analyze the survival of children in each group.@*RESULTS@#The proportion of female children, the swelling rate of liver and spleen lymph nodes and the involvement rate of blood, liver, circulation and central nervous system in the high load group were higher than those in the negative group. The incidence of disseminated intravascular coagulation(DIC) and central nervous system(CNS) involvement in the high load group were higher than those in the low load group. The liver swelling rate and circulatory system involvement rate in the low load group were higher than those in the negative group(P<0.05). PLT counts in the high load group were significantly lower than those in the negative group, and the levels of GGT, TBIL, CK-MB, LDH, TG, SF, and organ involvement were significantly higher than those in the negative group. The levels of CK, LDH, SF and the number of organ involvement in the high load group were significantly higher than those in the low load group. The levels of GGT and TBIL in low load group were significantly higher than those in negative group. In terms of treatment, the proportion of blood purification therapy in the high and low load group was significantly higher than that in the negative group(P<0.01). ROC curve analysis showed that the best cut-off values of PLT, LDH, TG and SF were 49.5, 1139, 3.12 and 1812, respectively. The appellate laboratory indicators were dichotomized according to the cut-off value, and the differential clinical symptoms were included in the Cox regression model. Univariate analysis showed that LDH>1139 U/L, SF>1812 μg/L, dysfunction of central nervous system, number of organ damage, DIC and no blood purification therapy were the risk factors affecting the prognosis of children (P<0.05); Multivariate analysis shows that PLT≤49.5×109/L and dysfunction of central nervous system were risk factors affecting the prognosis of children (P<0.05). Survival analysis showed that there was no significant difference in the survival rate among the three groups.@*CONCLUSION@#The incidence of adverse prognostic factors in children with HLH in the EBV-DNA high load group is higher, and there is no significant difference in the survival rate of the three groups after blood purification therapy. Therefore, early identification and application of blood purification therapy is of great significance for children with HLH in the high load group.

Prevalence of albuminuria and its association with cardiovascular diseases in Chinese residents aged over 35 years / 中华内科杂志

Objective:To investigate the prevalence of albuminuria in Chinese residents aged >35 years and its potential association with cardiovascular disease (CVD).Methods:A total of 34 647 Chinese subjects aged ≥35 years were selected by stratified multi-stage random sampling from 2012 to 2015. Data were collected through questionnaires, physical examinations, and laboratory tests. Albuminuria was categorized into 3 types according to urinary albumin-to- creatinine ratio: normal (<30 mg/g), microalbuminuria (MAU, 30-300 mg/g), and macroalbuminuria (≥300 mg/g). Measurement data were expressed as xˉ±s, and t-tests were used for comparisons between indicators. Qualitative data were expressed as rate or constituent ratio, and the χ2 test or Kruskal-Wallis test was used to examine differences. Logistic regression was used for multivariate analyses. SAS 9.4 software was used for statistical analyses, and P<0.05 was considered statistically significant. Results:The prevalence of abnormal albuminuria was 19.1%; the prevalence was 17.2% for MAU and lower in males (13.8%) than females (20.1%, P<0.01). The risk of CVD was higher among subjects with MAU ( OR=1.23, 95% CI 1.12-1.35) and macroalbuminuria ( OR=1.86, 95% CI 1.50-2.32). When MAU was complicated by hypertension and diabetes mellitus, the CVD risk was 1.76 times higher. Conclusions:The prevalence of MAU is high among Chinese subjects aged 35 years and over. Those with MAU have higher CVD risk, especially those with hypertension and diabetes mellitus.

Silencing of Myh3 Gene by siRNA Inhibits Glycolysis in C2C12 Cells / 中国生物化学与分子生物学报

The Myh3 (myosin heavy chain 3) gene is a marker gene of muscle cell differentiation and regulates the utilization of energy in muscle cells, but whether it affects the glycolysis process of muscle cells in different states is rarely reported. In this paper, the expression patterns of Myh3 and glycolysis-related genes Pkm (M-type pyruvate kinse), Prkag3 (protein kinase adenosine monophosphate-activated γ3-subunit), and Gsk3β (glycogen synthase kinase-3β) were studied by the qRT-PCR (quantitative-Real-Time-PCR) method using C2C12 cells at different stages of myoblast and adipogenic differentiation as models. It was found that in the process of myoblast differentiation of C2C12 cells, the relative expression trends of Myh3 and glycolysis genes Prkag3 and Pkm were basically the same, and the relative expression levels first increased, reached the peak on the second day of differentiation, and then decreased; glycogen synthase the expression trend of the inhibitory gene Gsk3β was relatively stable. In the process of adipogenic differentiation of C2C12 cells, the relative expression trend of Myh3 and glycolysis genes Prkag3 and Pkm remained basically the same, and the relative expression gradually increased, reaching the highest value on the 8th day of differentiation; glycogen synthase inhibitory gene Gsk3β expression remained stable. In the myogenic differentiation state of C2C12 cells, qRT-PCR and Western blotting were used to detect the effects of interfering Myh3 on the mRNA and protein expressions of glycolysis-related genes Pkm, Prkag3, and Gsk3β. The results showed that after interfering with Myh3, the mRNA expressions of glycolysis genes Pkm and Prkag3 were significantly decreased (P 0.05). The protein levels of Myh3 and Pkm were significantly lower than those in the blank group and NC group. Under the adipogenic differentiation state of C2C12 cells, after interfering with Myh3, the mRNA levels of glycogen synthase inhibitor Gsk3β and glycolysis gene Prkag3 were significantly increased (P<0.01), and the mRNA level of glycolysis gene Pkm was decreased; the protein levels of Myh3 and Pkm in the Myh3 interference group were also lower than those in the blank group and NC group. Based on the above studies, there are significant differences in the levels of glycolysis in C2C12 cells in the myogenic and adipogenic states, and the expression patterns of Myh3 and glycolysis genes are similar. Further results showed that Myh3 suppression could inhibit the glycolysis of C2C12 cells in the myogenic state without affecting the glycogen synthesis. Unlike in the myogenic state, interfering expression of Myh3 in the adipogenic state of C2C12 cells inhibited both glycogen synthesis and glycolysis.

Investigation on status of dyslipidemia in Chinese females aged 35 years or above / 中华心血管病杂志

Objective: To investigate the prevalence, awareness, treatment and control status of dyslipidemia among females aged ≥35 years old across China. Methods: Participants were selected by stratified multistage random sampling method in the "Twelfth Five-Year Plan" National Science and Technology Support Project "Survey on the Prevalence of Important Cardiovascular Diseases and Key Technology Research in China" project. This study is a retrospective, cross-sectional study. A total of 17 418 females aged 35 years and over were included in the current study. The basic information such as age, medical history and menopause was collected by questionnaire. The blood lipid parameters were derived from clinical laboratory examinations. The prevalence of dyslipidemia and the rate of awareness, treatment, and control of dyslipidemia were analyzed in females aged 35 years and over. Results: The age of participants was (56.2±13.0) years old, and the prevalence of dyslipidemia was 33.1% (5 765/17 418). The prevalence rates of high total cholesterol, hypertriglyceridemia, low HDL-C and high LDL-C were 9.7% (1 695/17 418), 11.1% (1 925/17 418), 10.9% (1 889/17 418) and 7.3% (1 262/17 418), respectively. The prevalence of dyslipidemia increased with age and the prevalence of dyslipidemia in women who were not married, Han, menarche age>16 years, obesity, central obesity, alcohol consumption, diabetes, hypertension and family history of cardiovascular disease were higher than those without such characteristics (P<0.05). There were 10 432 (59.9%) menopausal females in this cohort and prevalence of dyslipidemia of these participants was 38.8% (4 048/10 432), which was higher than that of non-postmenopausal females (24.6%, 1 717/6 986) (P<0.05). The awareness rates, treatment rates and control rates of dyslipidemia were 33.9% (1 953/5 765), 15.1% (870/5 765) and 2.5% (143/5 765) respectively among females aged 35 years and over in China. Conclusion: The prevalence of dyslipidemia in Chinese females aged 35 years and over is high, and its awareness, treatment, and control rates need to be optimized.

The incidence of hypertension, overweight, and obesity and relationship with cardiovascular events among middle-aged Chinese: 6 years follow-up results / 中华心血管病杂志

Objective: To identify the incidence of hypertension, overweight/obesity in middle-aged population in China, and explore their impact on cardiovascular events. Methods: From 2009 to 2010, 12 areas were sampled in China, and about 1 000 subjects aged 35 - 64 from each area were enrolled to collect the basic information, physical examination and blood tests were also performed. From 2016 to 2017, data from 8 835 subjects, who completed the 6 years follow-up, were analyzed.Blood pressure and body mass index(BMI) at both baseline and the follow-up, as well as incidence of hypertension, overweight and obesity, were calculated. Cox proportional hazard model was used to investigate the impacts of hypertension, overweight and obesity on cardiovascular events after adjusting confounders. Results: At the end of follow-up, both BMI and systolic and diastolic blood pressure increased significantly compared with the baseline levels (all P<0.001). The cumulative incidence of hypertension, overweight and obesity within 6 years was 39.3%(1 146/2 918), 11.5%(406/3 544) and 4.3%(302/7 025), respectively. Compared with subjects with both normal BMI and blood pressure, people with overweight, obesity, hypertension, overweight with hypertension, and obesity with hypertension faced significantly increased risk of cardiovascular disease (HRs (95%CIs) were 2.394(1.130-5.073), 3.341(1.454-7.674), 6.047(2.978-12.279), 5.808(2.924-11.539) and 8.716(4.391-17.302), respectively, all P<0.05), after adjusting for other confounders. Conclusions: The incidence of overweight, obesity, and hypertension is high in middle-aged people in China. Overweight, obesity and hypertension are associated with significantly increased risk of cardiovascular events during the 6 years follow up.

Effects of standardized management of hypertension in the workplace for patients with diabetes / 中华健康管理学杂志

Objective:To evaluate the effects of standardized management of hypertension on blood pressure control of hypertension patients with diabetes mellitus in workplace population.Methods:Taking the type and size of workplace into consideration, 61 work sites were selected in different provinces by using epidemiological field trial method. In each selected province, 2-4 work sites with similar economic and medical conditions were chosen, among which 1-3 were designated as the intervention group and the other one as the control group. In total, 443 patients with hypertension and diabetes mellitus were included, with 347 patients in the intervention group and 96 patients in the control group. After training, doctors conducted standardized management for patients in the intervention group for a period of 24 months, following up with them regularly once a month, and recorded changes in blood pressure, risk factors, target organ damage, and treatment, while the control group had no special intervention, and relevant information was collected only at baseline and 24 months. Blood pressure, blood pressure control rate, and blood glucose changes were compared between the two groups.Results:After receiving standardized management of hypertension, the control rate of hypertension for patients with both hypertension and diabetes mellitus in the intervention group increased from 24.2% to 63.7% ( P<0.05) and the participants’ blood pressure also significantly decreased, by 10.2 (11.9-8.4) mmHg (1 mmHg=0.133 kPa) for systolic blood pressure and 7.7 (8.8-6.6) mmHg for diastolic blood pressure ( P<0.05); moreover, the blood glucose also decreased slightly ( P<0.001). In addition, the control rate of blood pressure increased to 63.7% with the increase of management time. In the control group, the control rate of hypertension increased to 46.9% ( P<0.05) and the systolic and diastolic blood pressure decreased by 5.6 (8.9-2.2) and 4.5 (6.6-2.4) mmHg ( P<0.05). Conclusions:The standardized management of hypertension in the workplace can effectively reduce overall blood pressure levels and improve the control rate of hypertension in the working population.

The incidence of hypertension, overweight, and obesity and relationship with cardiovascular events among middle-aged Chinese: 6 years follow-up results / 中华心血管病杂志

Objective@#To identify the incidence of hypertension, overweight/obesity in middle-aged population in China, and explore their impact on cardiovascular events.@*Methods@#From 2009 to 2010, 12 areas were sampled in China, and about 1 000 subjects aged 35 - 64 from each area were enrolled to collect the basic information, physical examination and blood tests were also performed. From 2016 to 2017, data from 8 835 subjects, who completed the 6 years follow-up, were analyzed.Blood pressure and body mass index(BMI) at both baseline and the follow-up, as well as incidence of hypertension, overweight and obesity, were calculated. Cox proportional hazard model was used to investigate the impacts of hypertension, overweight and obesity on cardiovascular events after adjusting confounders.@*Results@#At the end of follow-up, both BMI and systolic and diastolic blood pressure increased significantly compared with the baseline levels (all P<0.001). The cumulative incidence of hypertension, overweight and obesity within 6 years was 39.3%(1 146/2 918), 11.5%(406/3 544) and 4.3%(302/7 025), respectively. Compared with subjects with both normal BMI and blood pressure, people with overweight, obesity, hypertension, overweight with hypertension, and obesity with hypertension faced significantly increased risk of cardiovascular disease (HRs (95%CIs) were 2.394(1.130-5.073), 3.341(1.454-7.674), 6.047(2.978-12.279), 5.808(2.924-11.539) and 8.716(4.391-17.302), respectively, all P<0.05), after adjusting for other confounders.@*Conclusions@#The incidence of overweight, obesity, and hypertension is high in middle-aged people in China. Overweight, obesity and hypertension are associated with significantly increased risk of cardiovascular events during the 6 years follow up.

Effects of standardized management of hypertension in the workplace for patients with diabetes / 中华健康管理学杂志

Objective@#To evaluate the effects of standardized management of hypertension on blood pressure control of hypertension patients with diabetes mellitus in workplace population.@*Methods@#Taking the type and size of workplace into consideration, 61 work sites were selected in different provinces by using epidemiological field trial method. In each selected province, 2-4 work sites with similar economic and medical conditions were chosen, among which 1-3 were designated as the intervention group and the other one as the control group. In total, 443 patients with hypertension and diabetes mellitus were included, with 347 patients in the intervention group and 96 patients in the control group. After training, doctors conducted standardized management for patients in the intervention group for a period of 24 months, following up with them regularly once a month, and recorded changes in blood pressure, risk factors, target organ damage, and treatment, while the control group had no special intervention, and relevant information was collected only at baseline and 24 months. Blood pressure, blood pressure control rate, and blood glucose changes were compared between the two groups.@*Results@#After receiving standardized management of hypertension, the control rate of hypertension for patients with both hypertension and diabetes mellitus in the intervention group increased from 24.2% to 63.7% (P<0.05) and the participants’ blood pressure also significantly decreased, by 10.2 (11.9-8.4) mmHg (1 mmHg=0.133 kPa) for systolic blood pressure and 7.7 (8.8-6.6) mmHg for diastolic blood pressure (P<0.05); moreover, the blood glucose also decreased slightly (P<0.001). In addition, the control rate of blood pressure increased to 63.7% with the increase of management time. In the control group, the control rate of hypertension increased to 46.9% (P<0.05) and the systolic and diastolic blood pressure decreased by 5.6 (8.9-2.2) and 4.5 (6.6-2.4) mmHg (P<0.05).@*Conclusions@#The standardized management of hypertension in the workplace can effectively reduce overall blood pressure levels and improve the control rate of hypertension in the working population.

Effect of comprehensive intervention on hypertension control program in workplaces in China / 中华流行病学杂志

Objective To evaluate the effect of comprehensive intervention program on hypertension control in workplaces in China.Methods The study design was a non-randomized controlled trial.First,20 sub-centers were selected across China,then hypertension patients in 2-4 workplaces were selected as the intervention group,and hypertension patients in 1 comparable workplace selected,as the control group in each sub-center.The comprehensive intervention strategy which integrating workplace primary prevention of cardiovascular diseases and standardized management of hypertension was adopted in the intervention group for at least 2 years.Patients in the control group continued their usual health care,and only baseline data and 2-year data was collected.Analyses were conducted for hypertension patients in 30 stated-owned enterprises (SOEs),including 20 for the intervention group and 10 for the control group.The primary outcome was the control rate ofhypertension while the intervention effect (IE) was estimated by using the formula:differential value of intervention group [rate (mean)] — differential value of control group [rate (mean)].Results Overall,2 622 patients completed the 2-year follow-up,of which 2 055 were in the intervention group and 567 in the control group,respectively.After 2 years of intervention,the IE on the level of SBP and DBP for intervention group and control group were-7.5 and-3.9 mmHg,respectively (P＜0.05).BMI decreased by 0.4 kg/m2,with the regular exercise rate as 36.4％ and alcohol consumption rate decreased by 14.0％,respectively (P＜0.05).The smoking rate decreased by 6.1％ (P＞0.05).The overall hypertension control rate was 25.0％,and further subgroup analysis showed that our intervention program was particularly effective for those with high education level (27.6％),white-collar employees (41.9％),and those from SOEs whose affiliated hospital had been separated away (41.9％).Conclusion The comprehensive intervention program could greatly improve the hypertension control in the workplaces in China.

Effect of comprehensive intervention on hypertension control program in workplaces in China / 中华流行病学杂志

Objective To evaluate the effect of comprehensive intervention program on hypertension control in workplaces in China.Methods The study design was a non-randomized controlled trial.First,20 sub-centers were selected across China,then hypertension patients in 2-4 workplaces were selected as the intervention group,and hypertension patients in 1 comparable workplace selected,as the control group in each sub-center.The comprehensive intervention strategy which integrating workplace primary prevention of cardiovascular diseases and standardized management of hypertension was adopted in the intervention group for at least 2 years.Patients in the control group continued their usual health care,and only baseline data and 2-year data was collected.Analyses were conducted for hypertension patients in 30 stated-owned enterprises (SOEs),including 20 for the intervention group and 10 for the control group.The primary outcome was the control rate ofhypertension while the intervention effect (IE) was estimated by using the formula:differential value of intervention group [rate (mean)] — differential value of control group [rate (mean)].Results Overall,2 622 patients completed the 2-year follow-up,of which 2 055 were in the intervention group and 567 in the control group,respectively.After 2 years of intervention,the IE on the level of SBP and DBP for intervention group and control group were-7.5 and-3.9 mmHg,respectively (P＜0.05).BMI decreased by 0.4 kg/m2,with the regular exercise rate as 36.4％ and alcohol consumption rate decreased by 14.0％,respectively (P＜0.05).The smoking rate decreased by 6.1％ (P＞0.05).The overall hypertension control rate was 25.0％,and further subgroup analysis showed that our intervention program was particularly effective for those with high education level (27.6％),white-collar employees (41.9％),and those from SOEs whose affiliated hospital had been separated away (41.9％).Conclusion The comprehensive intervention program could greatly improve the hypertension control in the workplaces in China.

Prevalence and associated factors of intra-articular lesions in acute ankle fractures evaluated by arthroscopy and clinical outcomes with minimum 24-month follow-up / 中华医学杂志(英文版)

BACKGROUND@#Acute ankle fractures can lead to high rate of concomitant intra-articular lesions which may compromise clinical results. The purpose of this study was to evaluate the incidence of concomitant intra-articular lesions in acute ankle fractures with arthroscopy. We also sought to analyze the relationship between intra-articular lesions and the fracture type, as well as the severity of the fracture.@*METHODS@#It was a retrospective cohort study. From April 2014 to December 2015, we have chosen arthroscopy-assisted open reduction and internal fixation (AORIF) for the treatment of unstable acute ankle fractures. All concomitant intra-articular lesions were assessed and documented carefully and prospectively, such as ligament injuries, osteochondral lesions, and tibiofibular syndesmosis injuries. All fractures were classified according to the Lauge-Hansen classification system. The American Orthopedic Foot and Ankle Society's (AOFAS) ankle-hindfoot scale was used to assess post-operative function. Statistical comparisons between the intra-articular lesions, the fracture type, and the severity of the presenting fracture were performed using a Chi-squared analysis.@*RESULTS@#Data of 36 patients were analyzed in the study, including 23 supination-type fractures and 13 pronation-type fractures. The incidence of tibiofibular syndesmosis injuries, chondral lesions, and loose bodies were 92%, 72%, and 39%, respectively. Avulsion fractures of the anterior tibiofibular syndesmosis were more commonly found in supination-type fractures than pronation-type fracture (45% vs. 15%, χ = 5.78, P = 0.02), which would cause mechanical blocking in the anterior portion of the ankle. On the contrary, chondral lesions were more commonly found in the more severe fractures than mild fractures (86% vs. 53%, χ = 4.57, P = 0.03). A mean 41.7 months (range, 33.0-51.0 months) of follow-up was achieved. A mean AOFAS's ankle-hindfoot scale was 96.9, and 97.2% of the patients were satisfied with the procedure.@*CONCLUSIONS@#Acute ankle fractures have a high incidence of concomitant intra-articular lesions. Avulsion fractures of the anterior tibiofibular syndesmosis are more commonly found in supination-type fractures. Chondral lesions are related to the severity of the fractures, but not with the classification of the fractures. AORIF can be one reliable solution in dealing with the associated injuries seen with acute ankle fractures.

Improvement in post-partum uterine involution in rats treated with Apios americana / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

OBJECTIVE@#Apios americana, a plant used as a staple ingredient of native American diets, has various properties, including anti-cancer, anti-hyperglycemic, hypotensive, and anti-inflammatory activity. In Japan, Apios is used as a post-natal medication. After parturition, women undergo a period of recovery as they return to pre-pregnancy conditions. However, few health products that aid post-partum recovery are on the market. We explored whether Apios can accelerate the post-partum recovery process, in particular the involution of the uterus.@*METHODS@#Female rats kept in individual cages were mated with two male rats, with the exception of the control group (female rats without mating, on basal diet; n=6). After delivery, rats were divided into five groups based on their diet: basal diet (model; n=6); basal diet+oral intake at 5.4 g/kg of Chanfukang granules (a Chinese patent medicine preparation for post-partum lochia) (positive; n=6); basal diet containing 10% Apios powder (low; n=6); basal diet containing 20% Apios powder (medium; n=6); basal diet containing 40% Apios powder (high; n=6). Five days later, uteri and spleens were weighed. Uterus and spleen indices for each rat were calculated by dividing visceral weight by the total weight. Hormone and cytokine concentrations were measured using enzyme-linked immunosorbent assay (ELISA). Histological analysis of uteri was completed using hematoxylin and eosin (H&E) staining. Expression of matrix metalloproteinases and inhibitors in uteri was measured by western blotting.@*RESULTS@#Our results showed that Apios treatment reduced the post-partum uterus index and regulated the hormone concentrations. Moreover, we found that the process of uterine involution was accelerated, based on morphological changes in the uterus. In addition, our results indicated that Apios alleviated the inflammatory response induced by the involution process. Transforming growth factor β was also found to be regulated by Apios. There were significant downregulation of matrix metalloproteinases and upregulation of their inhibitors by Apios, which suggested that Apios increased the rate of the collagen clearance process.@*CONCLUSIONS@#These results, based on experimental observations at the molecular and protein levels, verified our hypothesis that Apios can improve uterine involution, and demonstrated the potential application of Apios in post-partum care.

Prevalence and associated factors of intra-articular lesions in acute ankle fractures evaluated by arthroscopy and clinical outcomes with minimum 24-month follow-up / 中华医学杂志(英文版)

Background@#Acute ankle fractures can lead to high rate of concomitant intra-articular lesions which may compromise clinical results. The purpose of this study was to evaluate the Prevalence of concomitant intra-articular lesions in acute ankle fractures with arthroscopy. We also sought to analyze the relationship between intra-articular lesions and the fracture type, as well as the severity of the fracture.@*Methods@#It was a retrospective cohort study. From April 2014 to December 2015, we have chosen arthroscopy-assisted open reduction and internal fixation (AORIF) for the treatment of unstable acute ankle fractures. All concomitant intra-articular lesions were assessed and documented carefully and prospectively, such as ligament injuries, osteochondral lesions, and tibiofibular syndesmosis injuries. All fractures were classified according to the Lauge-Hansen classification system. The American Orthopedic Foot and Ankle Society’s (AOFAS) ankle-hindfoot scale was used to assess post-operative function. Statistical comparisons between the intra-articular lesions, the fracture type, and the severity of the presenting fracture were performed using a Chi-squared analysis.@*Results@#Data of 36 patients were analyzed in the study, including 23 supination-type fractures and 13 pronation-type fractures. The incidence of tibiofibular syndesmosis injuries, chondral lesions, and loose bodies were 92%, 72%, and 39%, respectively. Avulsion fractures of the anterior tibiofibular syndesmosis were more commonly found in supination-type fractures than pronation-type fracture (45% vs. 15%, χ2 = 5.78, P = 0.02), which would cause mechanical blocking in the anterior portion of the ankle. On the contrary, chondral lesions were more commonly found in the more severe fractures than mild fractures (86% vs. 53%, χ2 = 4.57, P = 0.03). A mean 41.7 months (range, 33.0–51.0 months) of follow-up was achieved. A mean AOFAS’s ankle-hindfoot scale was 96.9, and 97.2% of the patients were satisfied with the procedure.@*Conclusions@#Acute ankle fractures have a high incidence of concomitant intra-articular lesions. Avulsion fractures of the anterior tibiofibular syndesmosis are more commonly found in supination-type fractures. Chondral lesions are related to the severity of the fractures, but not with the classification of the fractures. AORIF can be one reliable solution in dealing with the associated injuries seen with acute ankle fractures.

Association between high-sensitivity C-reactive protein and both cardiovascular, total mortality events in middle-aged Chinese adults / 中华流行病学杂志

Objective To estimate the association between high-sensitivity C-reactive protein (hs-CRP) and cardiovascular events as well as all-cause mortality events.Methods During 2009-2010,out of the 11 623 individuals,1 000 participants aged 35-64 years,were recruited and divided into 12 age-groups,to have received a study on CVD risk factors.Information on the risk factors of cardiovascular diseases was also collected.Fasting blood sample was gathered for all the participants,with hs-CRP tested.Participants in 7 out of the 12 sites were followed,with 6.21 years (36 075 personyears) as the median follow-up period.Cardiovascular and all-cause mortality events were collected.A total of 6 177 participants had been followed after excluding participants who had baseline infections,or did not take hs-CRP test/physical examination at the baseline.Finally,5 984 participants were included for analysis.Participants were categorized into three groups based on the hs-CRP (mg/L) values:＜ 1,1-3 and ＞3,respectively.Cox proportional hazards regression model was used to analyze the relationships between hs-CRP with cardiovascular events or all-cause mortality events,after adjusting for confounding factors.Results Mean age of the participants was 50.2 years.The incidence rates of cardiovascular disease events were 3.6/1 000 person-years,7.1/1 000 person-years,and 10.4/1 000 person-years among three groups and 3.0/1 000 person-years,5.7/1 000 person-years,9.1/1 000 person-years for all-cause mortality events,respectively.After adjusting for confounding factors,the hazard risks (HR) for cardiovascular events were 1.33 (95％CI:0.95-1.84) in the hs-CRP 1-3 mg/L group and 1.76 (95％CI:1.20-2.60) in the hs-CRP＞3 mg/L group when comparing with the hs-CRP＜ 1 mg/L group (trend test P=0.003).The HRs for all-cause mortality events were 1.76 (95％CI:1.23-2.54) and 2.64 (95％CI:1.74-4.01) (trend test P＜0.001),respectively.Conclusion Hs-CRP appeared an independent predictor for cardiovascular events and all-cause mortality events.

Association between high-sensitivity C-reactive protein and both cardiovascular, total mortality events in middle-aged Chinese adults / 中华流行病学杂志

Objective To estimate the association between high-sensitivity C-reactive protein (hs-CRP) and cardiovascular events as well as all-cause mortality events.Methods During 2009-2010,out of the 11 623 individuals,1 000 participants aged 35-64 years,were recruited and divided into 12 age-groups,to have received a study on CVD risk factors.Information on the risk factors of cardiovascular diseases was also collected.Fasting blood sample was gathered for all the participants,with hs-CRP tested.Participants in 7 out of the 12 sites were followed,with 6.21 years (36 075 personyears) as the median follow-up period.Cardiovascular and all-cause mortality events were collected.A total of 6 177 participants had been followed after excluding participants who had baseline infections,or did not take hs-CRP test/physical examination at the baseline.Finally,5 984 participants were included for analysis.Participants were categorized into three groups based on the hs-CRP (mg/L) values:＜ 1,1-3 and ＞3,respectively.Cox proportional hazards regression model was used to analyze the relationships between hs-CRP with cardiovascular events or all-cause mortality events,after adjusting for confounding factors.Results Mean age of the participants was 50.2 years.The incidence rates of cardiovascular disease events were 3.6/1 000 person-years,7.1/1 000 person-years,and 10.4/1 000 person-years among three groups and 3.0/1 000 person-years,5.7/1 000 person-years,9.1/1 000 person-years for all-cause mortality events,respectively.After adjusting for confounding factors,the hazard risks (HR) for cardiovascular events were 1.33 (95％CI:0.95-1.84) in the hs-CRP 1-3 mg/L group and 1.76 (95％CI:1.20-2.60) in the hs-CRP＞3 mg/L group when comparing with the hs-CRP＜ 1 mg/L group (trend test P=0.003).The HRs for all-cause mortality events were 1.76 (95％CI:1.23-2.54) and 2.64 (95％CI:1.74-4.01) (trend test P＜0.001),respectively.Conclusion Hs-CRP appeared an independent predictor for cardiovascular events and all-cause mortality events.

Prevalence of Ideal Cardiovascular Health Status and Its Association With Socioeconomic Status in Chinese Enterprise Employees / 中国循环杂志

Objectives: To investigate the prevalence of ideal cardiovascular health behaviors and factors, and its association with socioeconomic status (SES) in enterprise employees. Methods: The cluster sampling method was adopted to recruit 27 607 employees aged 18 to 60 years from 45 enterprises across China. The ideal cardiovascular health metrics including behaviors and factors, which were defined according to the AHA criteria, were obtained, and SES was measured by education and occupational class. Multilevel logistic regression models were used to analyze the association between SES and ideal cardiovascular health metrics. Results: Overall, the prevalence of ideal cardiovascular health behavior (smoking, body mass index, salt intake, physical activity) was 51.3%, 67.9%, 14.0%, 31.2%, respectively; prevalence of the ideal cardiovascular factors (fasting blood glucose, total cholesterol, blood pressure) was 72.9%, 81.6%, 27.3%,respectively in this cohort. Among the employees, only 0.6% population met all 7 cardiovascular health metrics. After adjusting the individual and workplace factors, employees with high school (OR=1.18, 95%CI: 1.08-1.29) and college or above education (OR=1.52, 95%CI: 1.37-1.69) were more likely to have ideal cardiovascular health status compared with those with less education; white-collar workers were more likely to have ideal cardiovascular health status compared with blue-collar workers (OR=1.18; 95%CI: 1.08-1.29). Conclusions: The prevalence of ideal cardiovascular health behaviors and factors is low, and is positively associated with SES, suggesting the importance of promoting the cardiovascular health behavior, monitoring/controlling the related cardiovascular factors and reducing the socioeconomic inequalities among Chinese enterprise employees.

The association of fruit and vegetable intake with the changes of serum lipid levels in middle-aged and older Chinese population / 中华预防医学杂志

Objective@#To investigate the association of fruit and vegetable intake with long-term changes of serum lipid levels in middle-aged Chinese and older Chinese population.@*Methods@#The study analyzed the data collected in the 2004 and 2007-2008 cohorts of China Multicenter Collaborative Study of Cardiovascular Epidemiology. Finally, 4 495 participants from 10 groups in various regions of China, who both were followed up in the two cohorts, were included for data analysis. They were aged 41-66 years in 2004. Fruit and vegetable consumption were collected with a simple food frequency questionnaire. The percent changes (Δ%) of serum TC, TG, HDL-C and LDL-C between the two surveys were calculated. Multivariate linear regression models were used to estimate the association of fruit and vegetable intake in 2004 with percentage changes of serum lipid levels during the two surveys.@*Results@#The proportions of individuals who consumed fruits <250, 250-499 and ≥500 g/week were 24.0%, 21.8% and 54.2%, respectively. The proportions of individuals who consumed vegetables <500 and ≥500 g/day were 76.7% and 23.3%, respectively. Compared with fruit intake <250 g/week, the regression coefficients (95% CI) of ΔTC% in 250-499 and ≥500 g/week group were -1.54 (-2.71, -0.37) and -1.77 (-2.79, -0.76). And the regression coefficients (95% CI) of ΔLDL-C% were -2.43 (-4.39, -0.48) and -2.89 (-4.59, -1.19). Compared with vegetable intake <500 g/d, the regression coefficients (95%CI) of ΔTC% and ΔLDL-C% in vegetable intake ≥500 g/d group were -1.01 (-1.95, -0.06) and -1.83 (-3.41, -0.24). However, fruit and vegetable intake had no relationship with ΔTG% and ΔHDL-C%.@*Conclusion@#The consumption of fruit and vegetable was inversely related to long-term changes of TC and LDL-C in middle-aged and older population, but no association was found for changes of TG and HDL-C.

A new method for the treatment of refractory fistula after breast augmentation / 重庆医学

Objective To explore a new surgical method for the treatment of refractory fistula after breast augmentation and to improve patients healing efficiently.Methods This paper had collected two groups,a total of 178 cases of injected breast augmentation,who had shown the polyacrylamide hydrogel(PAAG)mixture shift,and caused abdominal fistula.Among them,89 cases further adopt new design in the treatment of fistula by using breast muscle membrane tissue flap and improve the effect of fistula treatment after the removal of fistula.And the other 89 cases were token the pure clean the cavity away caused by the abnormal material shift into the chest and abdominal wall.Results It was observed that PAAG widely distributed in the chest and abdominal wall and formatted the fistula connected mammary gland,axillary,chest abdominal wall.The area of lesions lacuna shrink by 80％ for the group used tissue flap after 2 weeks,but those not with tissue flap shrink by 45％(P＜0.01).At 4th week,all the patients of flap group achieved tissue healed,while the completely heal ratio of control group was only 73％.Compared two groups of healing rate,the group with tissue flap was obviously better than ones only with surgical method.Conclusion It suggests that main reasons for the liquidity bag and huge cavity are PAAG mixture shift into thoracic and abdominal wall and formed chronic fistula and connected the chest and abdominal wall.Local muscle membrane tissue flap can obviously promote the chest and abdominal wall fistula healing.

Association between body fat percentage, visceral fat index and cardiometabolic risk factor clustering among population aged 35 year old or over, in Tibet Autonomous Region and Xinjiang Uygur Autonomous Region / 中华流行病学杂志

Objective To investigate the association between body fat percentage (BFP),visceral fat index (VFI) and Cardiometabolic Risk Factor Clustering (CRFC),among population aged 35 or older in Tibet and Xinjiang areas.Methods Using the stratified multi-stage random sampling method,7 571 residents aged 35 or above were examined with international standardized examination between 2015 and 2016.Of the eligible 5 643 participants,association of BFP and VFI with CRFC was defined as having two or more of the four risk factors:hypertension,diabetes mellitus,high TG and low HDL-C,at the same time.Logistic regression analysis and receiver operating characteristic (ROC) curve analysis were employed to further explore the relationships.Results The overall prevalence of CRFC among aged 35 and older population in Tibet and Xinjiang areas was 9.78％.BFP and VFI were divided into four groups by quartile.After adjustment for age,gender,race,cigarette smoking,alcohol consumption,education attainments,and altitude of residence,ORs of CRFC seemed to have increased with BFP and VFI.Compared with people having BFP of 5.0％-27.0％,the OR(95％CI) were 1.15(0.86-1.54),1.48(1.05-2.07) and 1.72(1.10-2.68) for the ones who presented 27.1％-31.7％,31.8％-36.6％ and 36.7％-50.0％ of BFP.Compared to people of having 1-6 of VFI,with OR (95％CI) as 1.20(0.81-1.79),1.91(1.30-2.80) and 3.91(2.64-5.77) for the ones having 7-9,10-13 and 14-30 of VFI.Areas under the curve (AUC) of CRFC appeared as 0.55 for BFP and 0.70 for VFI,respectively,with statistically significant difference (P＜0.01).Conclusion Both BFP and VFI levels were closely associated with CRFC while VFI seemed to have a better predictive value than the BFP.

Association between the types of obesity and the 10-year-coronary heart disease risk, in Tibet Autonomous Region and Xinjiang Uygur Autonomous Region / 中华流行病学杂志

Objective To investigate the association between types of obesity and the 10-year-coronary heart disease risk in Tibet and Xinjiang of China.Methods Using the multi-stage random sampling method,7 631 participants aged 35 or older were examined under the International Standardized Examination process but with only 5 802 were eligible for analysis,in the 2015-2016 season.Results The prevalence rates of general obesity,central obesity,visceral obesity and compound obesity were 0.53％,12.62％,10.08％ and 42.35％,respectively.Out of all the compound obesity cases,58.65％ (1 441/2 457) of them appeared as having all types of obesity in our study.Risk related to the 10-year-coronary heart disease was higher in men than in women [(3.05 ± 4.14)％ vs.(1.42-2.37) ％,P＜0.000 1.Compound obesity (30.16％) showed the highest proportion on the risk of 10-year-coronary heart disease than central obesity (28.01％),visceral obesity (18.46％) or the general obesity (19.35％).After adjustment for confounding factors,results from the multivariate analysis showed the risk in compound obesity was higher than central obesity,visceral obesity or general obesity and was associated with the highest risk on the 10-year-coronary heart disease (OR=2.889,95％CI:2.525-3.305).People with anomalous BMI and WC seemed to have had the higher risk (OR=3.168,95％CI:2.730-3.677).Conclusions Obesity was popular in the residents of Tibet and Xinjiang areas of China.Men and people with compound obesity (especially both BMI and WC were abnormal) seemed to carry greater risk on the 10-year-coronary heart disease.