Clinical Experience of Treating Metabolic Associated Fatty Liver Disease with Huangqi （Radix Astragali） in Lingnan （岭南） Area / 中医杂志

Based on the unique syndrome characteristics of metabolic associated fatty liver disease （MAFLD） in Lingnan （岭南） area， this paper discussed the clinical experience of Huangqi （Radix Astragali） in the treatment of MAFLD in Lingnan area. It is summarized that spleen deficiency and yang weakness， and internal accumulation of damp-turbidity are the source of the disease， and at the early stage， Huangqi， commonly 15~30 g， could be used to fortify the spleen and warm the earth， thereby making the deficiency fire latent， as well as raise the clear and warm the exterior so as to inhibit damp-turbidity； medication needs to be progressively supplemented， and can be used together with Taizishen （Radix Pseudostellariae）， Baizhu （Rhizoma Atractylodis Macrocephalae）， Fuling （Poria）， and Fangfeng （Radix Saposhnikoviae） to back up the earth and inhibit dampness. Qi stagnation and blood constraint， yin dampness and heat accumulation are the pathogenesis of disease progression. Huangqi should be taken to invigorate the spleen and flourish the liver， unblock yang， and move stagnation. The dosage is often maintained at 30~60 g， to circulate the qi and unblock yang qi in the middle jiao （焦）， usually combined with Chaihu （Radix Bupleuri）， Baishao （Radix Paeoniae Alba） and Yujin （Radix Curcumae） integrating warm and cool medicinals. Stubborn turbid and fat condensing in the liver is a severe stage of the disease and may be concurrent with various pathogens such as dampness， phlegm， and heat， for which 60~90 g Huangqi should be used to invigorate blood and disperse fat， reinforce healthy qi and expel pathogens， often with medicinals that can disperse fat and direct the turbid downward such as Shanzha （Fructus Crataegi）， Juemingzi （Semen Cassiae）， Lulutong （Fructus Liquidambaris） and Zexie （Rhizoma Alismatis）. When prescribing， it is suggested to combine with other medicinals according to the season， thereby adjusting the ascending and descending of the property of Huangqi， thereby conforming to the nature of the four seasons.

Drinking behavior among government employees in Changsha and its influencing factors / 中南大学学报(医学版)

OBJECTIVES@#To analyze the prevalence and influencing factors for drinking behavior and heavy drinking among government employees in Changsha and provide a basis for carrying out interventions for drinking behaviors and formulating public health promotion plans for government employees.@*METHODS@#Government employees were recruited consecutively from the Health Management Center of a general hospital in Changsha between December 2017 and December 2018. Information on sociodemograpic characteristics, drinking behaviors, life events, and psychosocial characteristics was collected using a standard set of questionnaire. Drinking behavior was defined as drinking once or more per week for the past 12 months. The differences in drinking rates and excessive drinking rates among groups with different characteristics were compared. Multivariate analysis was performed to analyze the associated factors of drinking behaviors and heavy drinking for government employees.@*RESULTS@#A total of 6 190 people completed this investigation. The overall drinking rate of government employees in Changsha was 21.9%, and the rate of drinking was higher in males than that in females (44.7% vs 4.0%, @*CONCLUSIONS@#The drinking and heavy drinking rates of government employees are high in Changsha. Marital status, physical exercise, and frequency of social intercourse are the common influencing factors of male drinking behavior and female drinking behavior. The life events stimulation is the influencing factor of heavy drinking.

Type 1 neurofibromatosis in a three-year-old girl with B-lineage acute lymphocytic leukemia:A case report / 中南大学学报(医学版)

Neurofibromatosis 1 (NF1) is an autosomal dominant genetic disease first manifesting in childhood, which affects multiple organs, childhood development and neurocognitive status. These patients have a high predisposition to develop both benign and malignant tumors. On September 30, 2018, a rare case of NF1 with B-lineage acute lymphocytic leukemia (ALL) was treated in the Department of Pediatrics, Third Xiangya Hospital, Central South University. The child presented with café au lait macules (CALM) since the date of birth. And the diagnosis of B-lineage ALL was made by bone marrow cytomorphologic examination and immunological phenotype detection. ETV6/RUNX1 fusion gene was positive. Also, a de novo mutation of c. 2773delT (p. Leu925Ter) was found in the exon of NF1 gene by gene sequencing, which was a nonsense mutation and led to the premature termination of peptide synthesis. Molecular genetic testing is recommended to confirm NF1, particularly in children with only pigmentary features of the diagnostic criteria. NF1-affected individuals should be referred to a specialist of NF1 clinical network for long-term follow-up and surveillance.

Analysis of the related factors of complications after laparoscopic D2 radical operation in the treatment of advanced gastric cancer / 中国基层医药

Objective@#To analyze the related factors of postoperative complications after laparoscopic assisted D2 radical resection for advanced gastric cancer.@*Methods@#From August 2015 to July 2017, 80 patients with advanced gastric cancer admitted to the First Hospital of Jiaxing were selected.All the patients were treated with laparoscopic-assisted D2 radical resection, and the risk factors related to postoperative complications were analyzed by logistic regression analysis model.@*Results@#There were 33 cases (41.25%) with postoperative system complications, 19 cases (23.75%) with complications of level Ⅱ and above; 15 cases (18.75%) with postoperative local complications, among them 12 cases (15.00%) appeared level Ⅱ and above local complications.The number of concomitant diseases and age were related risk factors for systemic complications in patients with advanced gastric cancer after laparoscopic D2 radical resection (OR=1.982, 95%CI: 2.183-34.405, OR=6.587, 95%CI: 1.738-23.495, all P<0.05). The preoperative neoadjuvant chemotherapy, reconstruction method and age were the risk factors for local complications in patients with advanced gastric cancer after laparoscopic D2 radical resection (OR=8.273, 95%CI: 4.982-35.394, OR=12.304, 95%CI: 2.384-88.921, OR=6.365, 95%CI: 2.183-21.384, all P<0.05).@*Conclusion@#Treatment of advanced gastric cancer patients with laparoscopic D2 radical mastectomy, attention should be paid to control the patients' age, preoperative neoadjuvant chemotherapy, reconstruction mode, associated disease and other related risk factors.In order to ensure the safety of patients and to avoid postoperative complications.

Analysis of the related factors of complications after laparoscopic D2 radical operation in the treatment of advanced gastric cancer / 中国基层医药

Objective To analyze the related factors of postoperative complications after laparoscopic assisted D2 radical resection for advanced gastric cancer.Methods From August 2015 to July 2017,80 patients with advanced gastric cancer admitted to the First Hospital of Jiaxing were selected.All the patients were treated with laparoscopic-assisted D2 radical resection,and the risk factors related to postoperative complications were analyzed by logistic regression analysis model.Results There were 33 cases (41.25％) with postoperative system complications,19 cases (23.75％) with complications of level Ⅱ and above;15 cases (18.75％) with postoperative local complications,among them 12 cases (15.00％) appeared level Ⅱ and above local complications.The number of concomitant diseases and age were related risk factors for systemic complications in patients with advanced gastric cancer after laparoscopic D2 radical resection (OR =1.982,95 ％ CI:2.183-34.405,OR =6.587,95 ％ CI:1.738-23.495,all P ＜ 0.05).The preoperative neoadjuvant chemotherapy,reconstruction method and age were the risk factors for local complications in patients with advanced gastric cancer after laparoscopic D2 radical resection (OR =8.273,95 ％ CI:4.982-35.394,OR =12.304,95 ％ CI:2.384-88.921,OR =6.365,95 ％ CI:2.183-21.384,all P ＜ 0.05).Conclusion Treatment of advanced gastric cancer patients with laparoscopic D2 radical mastectomy,attention should be paid to control the patients'age,preoperative neoadjuvant chemotherapy,reconstruction mode,associated disease and other related risk factors.In order to ensure the safety of patients and to avoid postoperative complications.

Correlation between cerebrovascular hemodynamic index accumulative score and subclinical arteriosclerosis indicators / 中南大学学报(医学版)

Objective:To explore the correlation between cerebrovascular hemodynamic index (CVHI) accumulative score and subclinical arteriosclerosis indicators.Methods:A total of 27 184 cases were collected from the Health Management Center,the Third Xiangya Hospital,Central South University.Linear regression analysis was carried out to confirm the correlations between CVHI accumulative score and the modified Framingham stroke profile (FSP),as well as between CVHI accumulative score and cerebrovascular diseases (ICVD) scale.The correlation between CVHI accumulative score and brachial-ankle pulse wave velocity (baPWV),carotid plaque orcarotid intima-media thickness (CIMT) was analyzed by multifactor logistic regression model in 11 580 cases.Moreover,the correlation between CVHI accumulative score and microalbuminuria or serum cystatin C was performed by multifactor logistic regression model in 9 860 cases.Results:In this study,the people whose CVHI accumulative score was less than 75 accounted for 12.98％.The CVHI accumulative score was negatively related with the modified FSP score (r=-0.484,P＜0.01) or ICVD score (r=-0.455,P＜0.01).The multifactor logistic regression model found that the baPWV,carotid plaque,microalbuminuria and serum cystatin C were independent predictors for CVHI accumulative score.Conclusion:The CVHI accumulative score is correlated with the modified FSP score,ICVD score and indexes of subclinical arteriosclerosis (baPWV,carotid plaque,microalbuminuria and serum cystatin C).The CVHI accumulative score could be used as a tool for zero-level and primary prevention of cerebral stroke.

Shear wave elastography combined with conventional ultrasonography in the diagnosis of gastroesophageal varices in patients with hepatitis B-related hepatocellular carcinoma / 中华超声影像学杂志

Objective To evaluate the value of shear wave elastography(SWE) in the diagnosis of gastroesophageal varices in patients with hepatitis B-related hepatocellular carcinoma(HCC). Methods From October 2016 to May 2017,a total of 325 patients with hepatitis B-related HCC received conventional ultrasonography and SWE examinations in Shanghai Eastern Hepatobiliary Surgery Hospital were selected. The basic clinical data,conventional ultrasonography,SWE examination parameters and gastroscopy results of 192 patients were successfully collected. The training group ( 120 cases) and the validation group (72 cases) were divided from these patients according to the time order of entering the study.The gastroscopy results were used as the gold standard and the training group were analyzed using univariate and multivariate analysis.A new GOV diagnostic model was established and the diagnosis value of which were validated and evaluated in the validation group. Results Among 9 parameters studied,the maximum flow velocity of the portal vein,the thickness of the spleen and the stiffness of the spleen were independent factors affecting GOV in patients with hepatitis B-related HCC with odds ratio of 0.755(95% CI 0.617-0.924),1.375(95%CI 1.171-1.614) and 1.093(95% CI 1.043 -1.145),respectively(all P < 0.01).T he area under ROC curve of GOV diagnostic model that containd these 3 parameters diagnosing GOV in validation group was 0.914 (95% CI,0.832~0.995).The -1.49 was the best cut-off value with sensitivity,specificity,positive predictive value,negative predivtive value and coincidence rate of 79.0%,92.5%,91.3%,81.5% and 85.8%,respectively. Conclusions The GOV diagnostic model established by combining SWE and conventional ultrasonography is of certain value in diagnosis of GOV in patients with hepatitis B-related HCC yet needs further validation.

Application of quality evaluation indicators of health checkup based on a three-dimensional quality structure mode / 中华健康管理学杂志

Based on the theory of three-dimensional quality structure pattern, this review introduced the application of three-dimensional quality structure pattern in a quality evaluation system of health examination and examined its relationship with the quality evaluation index system based on literature analysis. The existing problems in current research and application were noted, and some suggestions for further research were put forward.

Status of liver fibrosis evaluated by aspartate aminotransferase to platelet ratio in patients with non-alcoholic fatty liver disease / 中华全科医师杂志

Objective To evaluate the prevalence and risk factors of progressive liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD).Methods A total of 2 054 subjects who underwent health check up and were diagnosed as NAFLD in 9 institutions were included in the study.Blood routine and biochemical findings were collected to calculate aspartate aminotransferase-to-platelet ratio index (APRI).Subjects were divided into three groups according to diagnostic threshold of liver fibrosis:APRI ＜0.43 group,APRI 0.43-0.53 group and APRI ≥ 0.54 group.The correlation between APRI and biochemical variables was analyzed,and the risk factors of progressive fibrosis were also analyzed.Results Among 2 054 subjects (male/female 1 598/456) there were 61 cases with APRI ≥ 0.98 (2.97％,progressive fibrosis),318 with APRI ≥0.54 (15.48％),1 475 with APRI ＜ 0.43 (71.81％),261 with APRI 0.43-0.53 (12.71％).Logistic stepwise regression analysis showed that TG (P =0.002,OR =1.095,95％CI:1.033-1.161),2 hPG(P =0.000,OR =1.103,95％ CI:1.058-1.151,BUN(P =0.034,OR =1.215,95 ％ CI:1.014-1.454) were risk factors,and H DL-C (P =0.034,OR =0.353,95 ％ CI:O.135-0.924) was a protective factor for the progression of fibrosis.Conclusion The progressive fibrosis in patients with NAFLD is closely associated to blood glucose and lipid metabolism disorder.

Progress in the pathogenesis of obesity-induced hypertension / 中国医师杂志

Obesity is one of the major risk factors of primary hypertension,with the dramatic increase in obesity.Obesity-induced hypertension also gradually increases.Due to promoting the occurrence and development of high blood pressure,obesity has caused wide public concern.In recent years,the pathogenesis of obesity-induced hypertension has become the study hotspot.However,fat and blood pressure relationship is complicated.This review article emphatically reviewed the activation of the sympathetic nervous system,the renin-angiotensin-aldosterone system (RAAS) activation,insulin and insulin resistance,leptin and leptin resistance,the gastrointestinal tract anomalies in the pathogenesis of obesity hypertension of the latest research progress.

Quantitative analysis of CEUS in staging of small hepatocellular carcinoma / 中国介入影像与治疗学

Objective To investigate the value of CEUS quantitative analysis in diagnosis of different pathological stages of small hepatocellular carcinoma (HCC).Methods Data of 112 patients with HCC confirmed by surgical or biopsy were analyzed retrospectively.All the diameter of single tumor or the sum of the largest two lesions in multiple tumors were within 3 cm.Three groups were classified based on the Edmonson stage:High differentiation group (n=50,stage Ⅰ or Ⅱ),median differentiation group (n=30,stage Ⅲ),low differentiation group (n=32,stage Ⅳ).Qontraxt ultrasound imaging analysis software was utilized to measure CEUS parameters,including the maximum intensity of tumor (TMAX),nontumor's intensity (NT),maximum intensity of nontumor (NTMAX),appear time,time to peak,washout time,and the ratio of TMAX/NT and TMAX/NTMAX were calculated.The differences among the three groups was compared by statistics test.Results The values of TMAX,TMAX/NTMAX and washout time were statistically different among the three groups (all P＜0.05).The maximum values of TMAX,TMAX/NTMAX and the shortest washout time were found in the low differentiation group.And the minimum values of TMAX,TMAX/NTMAX and the longest washout time were found in the high differentiation group.There were no statistical differences of NT,NTMAX,TMAX/NT,appear time and time to peak among the three groups (all P＞0.05).Conclusion The quantitative parameters of CEUS is helpful in distinguishing different Edmonson stage of small HCC.

Association between the changes in ideal cardiovascular health status and the decline of glomerular filtration rates in medical examination people / 中南大学学报(医学版)

Objective:To explore the association between the changes in ideal cardiovascular health (CVH) indices and the renal function.Methods:The retrospective cohort study consisted of 837 Chinese individuals from Department of Health Management in the Third Xiangya Hospital.The general information,anthropometry and blood biochemistry were obtained for all subjects from 2008 to 2014,respectively.The 6-year changes of 7 ideal CVH metrics defined by American Heart Association and the estimated glomerular filtration rate (eGFR) were calculated.Linear regression analysis was used to study the association between the changes in the ideal CVH metrics and eGFR.Covariance analysis was used to compare the levels of changes in eGFR stratified by variations of the ideal CVH metrics.Results:After 6 years' follow-up,we did not find significant difference in ideal cardiovascular health indexes between 2014 and 2008 [(3.3±1.4) items vs.(3.2±1.3) items,respectively] (P＜0.05).However,the eGFR in 2014 was significantly lower than that in 2008 [(99.8±22.7) mL/(min.1.73 m2)vs (104.3±24.9) mL/(min.1.73 m2),respectively] (P＜0.01).After adjusting for age,sex,history of hypertension and diabetes,and history of drug usage (antihypertensive,cholesterol-lowering and blood glucose-lowering medication),the changes in ideal CVH metrics were positively associated with the changes in eGFR (β=0.701,P＜0.01).With the improved change in ideal CVH metrics from ≤-2 points,-1 point,0 point,1 point to ≥ 2 points,the magnitude of decline in eGFR was gradually decreased,with significant difference (F=21.71,P＜0.01).Conclusion:The changes in ideal CVH metrics are an independent risk factor for changes of eGFR.Positive changes in ideal CVH metrics exert a favorable effect on renal function evolution.

Changes of cerebrovascular hemodynamic accumulative scores in health checkup population and their influencing factors / 中华健康管理学杂志

Objective To investigate the changes of cerebrovascular hemodynamic accumulative score in health checkup population and their influencing factors.Methods A total of 1 840 people aged 23-88 years were checked by CVHI and accumulative scores were calculated.The general information,blood biochemistry,highly sensitive C-reaction protein (hs-CRP),homocysteine (Hcy),carotid intima-media thickness (CIMT) and brachial-ankle pulse wave velocity (baPWV) were also collected during the corresponding period.Results The proportion of abnormal CVHI accumulative score (＜75 points) was increasing with age.Compared with the normal CVHI accumulative score (≥75 points) group,the proportion of hypertensive disease,diabetes and stroke family history was significantly higher in the abnormal group (P＜ 0.05).In addition,the levels of age,body mass index (BMI),waist circumference (WC),systolic blood pressure (SBP),diastolic blood pressure (DBP),triglyceride (TG),low density lipoprotein cholesterol (LDL-C),fasting plasma glucose (FPG),hs-CRP,Hcy,CIMT and baPWV were also significantly increased in the abnormal group (P＜0.05).Correlation analysis showed a negative correlation between CVHI accumulative score and age,history of hypertension,diabetes,BMI,WC,SBP,DBP,LDL-C,TG,FPG,hs-CRP,Hcy,baPWV (P＜ 0.05),but a positive correlation with HDL-C (P＜0.05).Multiple factor analysis determined that age [OR(95％C1):1.017(1.002-1.033)],history of hypertension [OR(95％CI):1.510(1.096-2.081)],BMI [OR(95％CI):1.235(1.135-1.344)],SBP [OR(95％CI):1.044(1.030-1.059)],LDL-C [OR(95％CI):1.673(1.444-1.937)],TG [OR(95％CI):1.116(1.035-1.204)],hs-CRP [OR(95％CI):1.037(1.003-1.073)],Hcy [OR(95％CI):1.099(1.062-1.136)],baPWV [OR(95％CI):1.001(1.000-1.002)] were being selected into the regression model (P＜0.05),and they were independent influencing factors of decreased CVHI accumulative scores.Conelusion The decreased CVHI accumulative score has a significant relationship with exposure levels of risk factors in stroke.Therefore,we conclude that the detection of CVHI is a convenient and feasible method to screen high risk individuals for stroke in middle and old aged population undergoing medical examination.

Influence of HMGB1/MAPK/m-TOR signaling pathway on cell autophagy and chemotherapy resistance in K562 cells / 中南大学学报(医学版)

To observe the effect of high-mobility group box 1 (HMGB1) on autophagy and chemotherapy resistance in human leukemiacell line (K562) cells, and to explore the underlying mechanisms.
 Methods: The K562 cells were cultured in vitro and divided into 6 groups: a chemotherapeutic group, a chemotherapeutic control group, a HMGB1 preconditioning group, a HMGB1 preconditioning control group, a HMGB1 siRNA group and a siRNA control group. The chemotherapeutic group was further divided into a vincristine (VCR) group, an etoposide (VP-16) group, a cytosine arabinoside (Ara-C) group, a adriamycin (ADM) group and a arsenic trioxide (As2O3) group. The cell activity was evaluated by cell counting kit-8. The protein levels of HMGB1, microtubule-associate protein1light chain3 (LC3), AMP-activated protein kinase (AMPK) and mammalian target of rapamycin (m-TOR) were determined by Western blotting. The level of serum HMGB1 was evaluated by enzyme-linked immunosorbent assay (ELISA). The autophagy was examined by monodansylcadaverine staining and observed under transmission electron microscopy.
 Results: Compared with the control group, the cell activity was significantly decreased and the level of serum HMGB1 was significantly increased in the chemotherapeutic (VCR, VP-16, Ara-C, ADM and As2O3) groups (all P<0.05). Compared with the control group, the cell activity and the level of serum HMGB1 were significantly increased in the HMGB1 preconditioning group (both P<0.05). Compared with the siRNA control group, the cell activity and the level of serum HMGB1 were significantly decreased in the HMGB1 siRNA group (both P<0.05). Compared with the control group, the expression of LC3-II and the formation of autophagic bodies were increased in the HMGB1 preconditioning group (both P<0.05), the p-AMPK expression was increased and p-mTOR expression was decreased (both P<0.05).
 Conclusion: HMGB1 can increase the autophagy and promote chemotherapy resistance through the pathway of AMPK/m-TOR in K562 cells.

Obesity indices for prediction of chronic kidney disease: a cross-sectional study in 26 655 Chinese adults / 中南大学学报(医学版)

OBJECTIVE@#To investigate the associations between chronic kidney disease (CKD) and body mass index (BMI), waist circumference(WC), waist-to-height ratio (WheiR) in Chinese adults.
@*METHODS@#A total of 26 655 participants, who voluntarily attended annual health examination at the Health Management Center in the Third Xiangya Hospital of Central South University from June 2013 to February 2014, were enrolled for this study. Logistic regression and receiver operating characteristic (ROC) curve analysis were performed.
@*RESULTS@#The prevalence rate of CKD was 9.6% and 3.1% in male and female subjects, respectively. Multivariate logistic regression analysis showed that BMI, WC and WheiR were independent risk factors for CKD in diabetic male and hypertensive male subjects (P<0.01). However, no association between these obesity indices and CKD was found in women after multivariate adjustment. In diabetic male subjects, when BMI≥28.7 kg/m(2), WC=90.7 cm and WheiR=0.56, the sensitivity and specificity prediction for CKD was 24.8%, 58.5%, 45.5% and 83.3%, 54.4%, 69.6%, respectively. In hypertensive male subjects, when the optimum cut-off points for BMI, WC and WheiR were ≥
27.0 kg/m(2), 91.2 cm and 0.54, the sensibility prediction for CKD were 41.0%, 47.0% and 50.1%, respectively, while the specificity prediction were 68.0%, 63.0% and 61.4%, respectively. The area under the ROC curve of BMI, WC, WheiR for CKD prediction were 0.56, 0.57, 0.59 in diabetic male subjects and 0.54, 0.56, 0.57 in hypertensive male subjects, respectively.
@*CONCLUSION@#BMI, WC and WheiR are associated with the increased risk for CKD in diabetic or hypertensive male subjects. However, the value for these obesity indices is limited in screening CKD.

Epidemiological analysis for prehypertension and its risk factors in community of Changsha / 中南大学学报(医学版)

OBJECTIVE@#To explore the epidemiological features of prehypertension in community of Changsha and its relevant risk factors.
@*METHODS@#A total of 15 000 participants from 5 communities in Changsha were surveyed by randomly stratified cluster sampling. The questionnaire interviews and physical examination were conducted for these people, and their serum biochemical indexes were also collected and analyzed.
@*RESULTS@#The prevalence of prehypertension was 34.6%. The prevalence for males was higher than that in females (44.7% vs 21.7%, P<0.01). The prevalence for males was declined in older age, but for females was increased. Central obesity, age, overweight, male, drinking, smoking, high-level total cholesterol, high-level triglyceride, high-level density-lipoprotein cholesterol, low-level density-lipoprotein cholesterol, high-level fasting blood glucose, high-level creatinine, high-level uric acid were the risk factors for prehypertension, while high level of education was a protective factor.
@*CONCLUSION@#The prevalence for prehypertension is 34.6% in community of Changsha, and the prevalence for males is higher than that for females. It is important to strengthen the health publicity and education in community for earlier prevention.

Research on the application value of stepped screening on hypertension with self-report health measurement questionnaire / 中华健康管理学杂志

Objective To explore the application value of stepped screening on hypertension with self-report health measurement questionnaire by comparing the accuracy of the different levels of screening. Methods A total of 6 715 subjects with hypertension (average age of 53.47 ± 11.07 years) were selected from those who completed the physical examination in the department of health management in the Third Xiangya Hospital of Central South University for questionnaire survey, routine inspection and special inspection for hypertension. And the patients were divided into four groups based on their hypertension risk levels: the questionnaire survey group, routine inspection group, questionnaire + routine inspection group and questionnaire+routine inspection+special inspection group. The results were compared respectively to calculate the sensitivity, specificity, positive predictive value and coincidence rate of single inspection and joint inspection. Results Nearly 90.00%of the subjects had hypertension associated with the risk factors, while 20.83% of the subjects had hypertension associated with other clinical diseases (the highest percentage was seen in hypertension with diabetes as 14.88%). According to the guidelines of stratification, 3.41% of the patients were at low risk, 23.78% at moderate risk, 47.85% at high risk, and 24.96% at extremely high risk. Sensitivity and specificity of routine inspection were 95.56%and 45.51%in judgment of moderate risk, which became 100.00%and 45.51%after addition of questionnaire survey;as a result, thesensitivity increased. Sensitivity and specificity of routine inspection were 15.03%and 96.28%in judgment of high risk, which became 30.03% and 99.14% after addition of questionnaire survey; as a result, the sensitivity doubled. Sensitivity and specificity of routine inspection were 15.03%and 100.00%in judgment of extremely high risk, and the sensitivity increased to 94.45%after addition of questionnaire survey, while the specificity remained unchanged. Conclusion Addition of questionnaire on the basis of routine physical examination could greatly increase the detection rate of hypertension patients at different risk levels, and increase the sensitivity as well as specificity for detection of moderate risk, high risk and extremely high risk. Therefore, health information and data acquired from the questionnaire and data obtained from the medical inspection equipment are equally important and suggest health management (physical examination) institutions to take questionnaire as a necessary and primary screening in physical examination and chronic disease screening.

Problems in application of carotid ultrasonography in health checkup population / 中华健康管理学杂志

Carotid ultrasound examination is a very mature examination method, it is widely used in clinical diagnosis and health checkup. Carotid ultrasound examination plays an important role in the prediction of the occurrence of cardiovascular disease. However, there are still certain problems in the application of the examination in the domestic health checkup population, which mainly include that the method and the standard are not unified, and the reporting form is not standardized. Carotid ultrasound examination must be standardized as soon as possible.

Association of metabolic syndrome with serum cystatin C in people undergoing health examination / 中南大学学报(医学版)

OBJECTIVE@#To investigate the relationship between metabolic syndrome (MetS) and cystatin C in people undergoing healthy examination.
@*METHODS@#A total of 6 783 subjects were analyzed. They were divided into MetS group (n=1 578), metabolic disturbance (MetD) group (n=3 617) and healthy control (HC) group (n=1 588). The general information, anthropometry, blood sample and urine sample were collected for all the subjects. Multiple logistic regression analysis was used to identify risk factors for MetS and analysis of covariance was used to investigate the correlation between the number of metabolic disturbance components and cystatin C.
@*RESULTS@#Compared with the HC group, the level of cystatin C significantly increased in MetS and MetD group; compared with MetD group, the level of cystatin C significantly increased in MetS group (P<0.05). After correction by age, sex, smoking, alcohol intake, menopause, waist circumference, body mass index, blood pressure, plasma cholesterol, fasting plasma glucose, estimated glomerular filtration rate, serum uric acid, microalbuminria, high sensitive C-reaction protein and homocysteine, the cystatin C was closely related with MetS (OR=1.951, 95% CI 1.265-3.009, P<0.05). Similarly, the OR value of risk with MetS was increased with the quartile of cystatin C level (P<0.05). In addition, with the increase in metabolic disturbance components, the level of cystatin C was also increased significantly (P<0.01).
@*CONCLUSION@#Serum cystatin C in our study was significantly associated with MetS. Moreover, the level of cystatin C may be correlated with severity of MetD.

Clinical Observation of Mirabilite Combined with Cisplatin Intraperitoneal in the Treatment of Elderly Colorectal Malignant Ascites / 中国药房

OBJECTIVE:To observe the clinical efficacy and ADR of Mirabilite combined with intrapetitoneal in the treatment of elderly colorectal malignant ascites. METHODS:77 cases of patients with elderly colorectal malignant ascites were randomly di-vided into treatment group (n=40) and control group (n=37). The control group received the treatment of intraperitoneal alone, while the treatment group was based on the control group additionally received Mirabilite combined with intrapetitoneal. The clini-cal efficacy,quality of life (QOL),and ADR in 2 groups were compared and statistically analyzed. RESULTS:Compared with control group,the effective rate in treatment group was 77.5% and the disease control rate was 87.5%,with significant difference (P<0.05);the QOL score in treatment group was better than control group,with significant difference(P<0.05);the incidence of local ADR in Mirabilite for external use was low. CONCLUSIONS:Mirabilite combined with intraperitoneal has better efficacy in the elderly colorectal malignant ascites and better QOL.