The relationship between thrombin activatable fibrinolysis inhibitor and coronary heart disease / 预防医学

Objective@#To analyze the relationship between thrombin activatable fibrinolysis inhibitor ( TAFI ) and coronary heart disease ( CHD ), and to provide evidence for the prevention of CHD. @*Methods@#The patients with CHD in Fushun Central Hospital in Liaoning Province were selected as the case group, the patients without CHD in the same hospital and period were selected as the control group. The demographic information and clinical examination results ( serum TAFI, lipid, glucose, etc. ) were collected to analyze the association between TAFI and CHD by logistic regression models.The multivariate logistic regression analysis was used to explore the relationship between TAFI and CHD.@*Results@#There were 222 cases, including 100 cases of stable angina, 44 cases of unstable angina and 78 cases of acute myocardial infarction, and 222 controls. The median ages of cases and controls were 62 and 57 years old. The results of multivariate logistic regression analysis showed that serum TAFI>22.88 μg/mL ( P75 of controls ) was associated with the risk of CHD ( OR=1.619, 95%CI: 1.011-2.593 ), unstable angina ( OR=2.917, 95%CI: 1.433-5.939 ) and acute myocardial infarction ( OR=2.626, 95%CI: 1.007-6.847 ). @*Conclusion@#The high level of TAFI is related to CHD, unstable angina and acute myocardial infarction.

Current Trends for ST-segment Elevation Myocardial Infarction during the Past 5 Years in Rural Areas of China's Liaoning Province: A Multicenter Study.

BACKGROUND: Since 2010, two versions of National Guidelines aimed at promoting the management of ST-segment elevation myocardial infarction (STEMI) have been formulated by the Chinese Society of Cardiology. However, little is known about the changes in clinical characteristics, management, and in-hospital outcomes in rural areas. METHODS: In the present multicenter, cross-sectional study, participants were enrolled from rural hospitals located in Liaoning province in Northeast China, during two different periods (from June 2009 to June 2010 and from January 2015 to December 2015). Data collection was conducted using a standardized questionnaire. In total, 607 and 637 STEMI patients were recruited in the 2010 and 2015 cohorts, respectively. RESULTS: STEMI patients in rural hospitals were older in the second group (63 years vs. 65 years, P = 0.039). We found increases in the prevalence of hypertension, prior percutaneous coronary intervention (PCI), and prior stroke. Over the past 5 years, the cost during hospitalization almost doubled. The proportion of STEMI patients who underwent emergency reperfusion had significantly increased from 42.34% to 54.47% (P < 0.0001). Concurrently, the proportion of primary PCI increased from 3.62% to 10.52% (P < 0.0001). The past 5 years have also seen marked increases in the use of guideline-recommended drugs and clinical examinations. However, in-hospital mortality and major adverse cardiac events did not significantly change over time (13.01% vs. 10.20%, P = 0.121; 13.34% vs. 13.66%, P = 0.872). CONCLUSIONS: Despite the great progress that has been made in guideline-recommended therapies, in-hospital outcomes among rural STEMI patients have not significantly improved. Therefore, there is still substantial room for improvement in the quality of care.

Association between apolipoprotein E polymorphisms and premature coronary artery disease: a meta-analysis.

BACKGROUND: Although several studies have explored the genetic polymorphisms of apolipoprotein E (APOE) and their impact on premature coronary artery disease (PCAD), there is still some controversy regarding the significance of their association. Our aim is to estimate the association between APOE polymorphisms and PCAD via meta-analysis. METHODS: All relevant case-control studies and cohort studies published in Chinese or English prior to March 2016 were searched for in electronic databases. Detailed information concerning each piece of literature was independently extracted by two researchers. We used STATA11.0 to process all data and to determine the pooled odds ratio (OR). Altogether, four genetic models were applied to calculate OR and 95% confidence interval (CI): (1) ε2 allele vs. ε3 allele; (2) ε2 carriers vs. ε3/3; (3) ε4 allele vs. ε3 allele; (4) ε4 carriers vs. ε3/3. RESULTS: Eighteen studies concerning APOE polymorphisms and their impact on PCAD were included in the final analysis. The pooled analysis displayed that the ε2 allele and ε2 carriers increased the risk of PCAD significantly among Asians (OR 1.54; 95% CI, 1.09-2.17; OR 1.65; 1.10-2.47), while they showed protective effects on PCAD in Caucasians (OR 0.77; 95% CI, 0.62-0.95; OR 0.69; 0.54-0.89). Subjects with the ε4 allele and ε4 carriers showed significant associations with PCAD (OR 1.62; 95% CI, 1.27-2.06; OR 1.65; 1.27-2.15). CONCLUSIONS: Our investigation supported the fact that the ε2 allele in APOE may appear as a risk factor for PCAD in Asians while a protective factor in Caucasians and that the ε4 allele acted as a genetic risk factor for PCAD.

A comparison of mandible preservation method and mandibulotomy approach in oral and oropharyngeal cancer: A meta-analysis.

OBJECTIVE: This study aims to compare the prognoses outcomes of mandibular preservation method (MPM) and the mandibulotomy approach (MLA) in oral and oropharyngeal cancer (OOPC) patients. METHOD: We searched PubMed, Web of Science, EMBASE, Chinese BioMedical Literature Database (CBM), Cochrane Library, and clinicaltrials.gov up to September 2016 to identify the studies that compared the prognoses of the MPM versus the MLA in OOPC patients. Two authors individually extracted the data and performed quality assessment. The surgical margins, overall survival rate, total and local recurrence rates, fistula formation, and other functional outcomes were evaluated. RESULT: Six studies with 309 patients were included in our analysis. No significant difference was found regarding the surgical margins, overall survival rate, total and local recurrence rates, and speech and tongue movement between the MPM and MLA groups. However, the MPM group showed a significantly lower fistula formation rate than the MLA group after the operation. CONCLUSION: These findings suggest that the MPM may provide a similar clinical outcome to the MLA, but that the MPM has a lower complication rate in the treatment of OOPC patients.

Intake of low sodium salt substitute for 3years attenuates the increase in blood pressure in a rural population of North China - A randomized controlled trial.

BACKGROUND: Lowering salt intake is one of the successful and cost-effective methods to reduce blood pressure (BP). In this randomized controlled study, we investigated the effects of a 3-year substitution of table salt with a low-sodium salt substitute in a rural population of North China. METHODS: Subjects from 200 families residing in five villages in Liaoning, North China were registered in this study and randomly divided into two groups: normal salt (100% sodium chloride) and low salt substitute (65% NaCl, 25% KCl, 10% MgSO4). We compared the effects of the low-sodium salt substitute and normal salt on differences in BP from baseline to various follow-up time points during this 3-year study period. We also examined several factors that may affect the long-term changes in BP. Hypertension was defined per World Health Organization guidelines as BP≥140/90mmHg. RESULTS: The low sodium substitute significantly reduced the increase in both systolic and diastolic BP compared with the regular salt (P=0.000). Also, the population aged 40-70years showed most beneficial response to the salt substitute compared with those aged <40 or >70years. The low salt substitute had similar beneficial effects in both males and females. In addition, the salt type consumed and body mass index significantly affected the change in BP. CONCLUSION: Use of the salt substitute significantly reduces the increase in BP over a long term, and thus, the salt substitute can be used as a replacement for regular salt in the daily diet to prevent/diminish the incidence of hypertension.

Diagnostic Value of Soluble Suppression of Tumorigenicity-2 for Heart Failure.

BACKGROUND: Many studies have explored the diagnostic performance of soluble suppression of tumorigenicity-2 (sST2) for heart failure (HF), but the results are inconsistent. Here, we performed a meta-analysis to assess the role of sST2 in the diagnosis of HF. METHODS: We searched PubMed, Web of Science, Cochrane Library, China National Knowledge Infrastructure, and Wanfang Database from inception to April 2015. Studies that investigated the diagnostic role of sST2 for HF were reviewed. The numbers of true-positive, false-positive, false-negative, and true-negative results were extracted to calculate pooled diagnostic odds ratio (DOR) with 95% confidence interval (CI) and the summary receiver operating characteristic curve and area under the curve (AUC). The Spearman correlation coefficient was used to check the threshold effect. The Cochran Q statistic (P < 0.05) and the inconsistency index (I2 > 50%) were used to assess the nonthreshold effect. Meta-regression was conducted to explore the source of heterogeneity; subgroup analysis showed the results in different subgroups. Finally, the Deeks' test was performed to assess the publication bias. RESULTS: Nine articles including 10 studies were included in the meta-analysis. The pooled sensitivity was 0.84 (95% CI: 0.81-0.86), and pooled specificity was 0.74 (95% CI: 0.72-0.76). The summary DOR was 8.49 (95% CI: 4.54-15.86), and AUC was 0.81 (standard error: 0.03). The Spearman correlation coefficient identified the nonsignificant threshold effect (coefficient = 0.49, P = 0.148), but the nonthreshold effect heterogeneity was significant (Cochran Q = 58.52, P < 0.0001; I2 = 84.6%). Meta-regression found that characteristics of controls might be the suggestive source of nonthreshold effect heterogeneity (P = 0.095). Subgroup analysis found that DOR was 5.65 and 7.86, respectively for the controls of hospital patients and healthy populations. Deeks' test demonstrated that there was no publication bias (P = 0.616). CONCLUSION: The meta-analysis illustrated that sST2 might play a role in diagnosing HF.

Quantity of Cerebral Microbleeds, Antiplatelet Therapy, and Intracerebral Hemorrhage Outcomes: A Systematic Review and Meta-analysis.

BACKGROUND AND PURPOSE: Cerebral microbleeds (CMBs) increase future intracerebral hemorrhage (ICH) risk after ischemic stroke (IS) or transient ischemic attack (TIA). However, whether CMB-related ICH risk depends on CMB quantity, CMB location, or antithrombotic agents is unclear. We performed a systematic review and meta-analysis to investigate CMB-related ICH risk, stratifying patients according to the quantity of CMB, the location of CMB, and the type of antithrombotic therapy used. METHODS: Literature databases were searched for prospective cohorts reporting ICH outcomes in patients with IS or TIA with baseline CMB evaluation. We calculated pooled relative ratios (RRs) for ICH among patients with and without CMBs. Pooled RRs of CMB-related ICH were further calculated in subgroups stratified by CMB quantity, CMB location, and antithrombotic therapy. RESULTS: Among the 10 included studies, the pooled RR of future ICH was 7.73 (95% confidence interval [CI], 4.07-14.70; P < .001) in CMB versus non-CMB patients. Subgroup analysis revealed that compared with non-CMB patients, multiple-CMB patients were at an increased risk for future ICH (RR = 8.02; 95% CI, 3.21-20.01; P < .001), whereas single-CMB patients did not incur this risk (RR = 2.33; 95% CI, .63-8.63; P = .205). A strong association was found between CMB presence and subsequent ICH in antiplatelet users (RR = 16.56; 95% CI, 3.68-74.42; P < .001). Studies on CMB-related ICH according to CMB locations and in anticoagulant users are lacking for subgroup analysis. CONCLUSION: Our study revealed that patients with IS or TIA with multiple CMBs may incur a higher risk of future ICH, and the presence of CMBs in patients with IS or TIA using antiplatelet agents may significantly increase the subsequent ICH risk.

Prediction of all-cause mortality with copeptin in cardio-cerebrovascular patients: A meta-analysis of prospective studies.

BACKGROUND: Measurement of the biomarker copeptin may help identify disease severity and risk of mortality for a various diseases. This study sought to determine the relationship between copeptin and all-cause mortality of patients with cardio-cerebrovascular disease. METHODS: Database of Medline and Web of Science were searched for studies with data involving the baseline copeptin levels and subsequent all-cause mortality outcomes. The pooled HRs of all-cause mortality were calculated and presented with 95%CIs. Subgroup analysis and sensitivity analysis were conducted to explore the possible sources of heterogeneity. RESULTS: Data from 14,395 participants were derived from 28 prospective studies. Higher copeptin significantly increased the risk of all-cause mortality (per unit copeptin: HR=1.020, 95%CI=1.004-1.036; log unit copeptin: HR=2.884, 95%CI=1.844-4.512; categorical copeptin: HR=3.371, 95%CI=2.077-5.472). Subgroup analysis indicated that the risk of all-cause death was higher in cerebrovascular patients (per unit copeptin: HR=2.537, 95%CI=0.956-6.731; log unit copeptin: HR=3.419, 95%CI=2.391-4.888) than cardiovascular patients (per unit copeptin: HR=1.011, 95%CI=1.002-1.020; log unit copeptin: HR=2.009, 95%CI=1.119-3.608). CONCLUSION: Copeptin is associated with all-cause mortality of patients with cardiovascular and cerebrovascular disease. Our study suggests that copeptin seems to be a promising novel biomarker for prediction of mortality in cardio-cerebrovascular patients, especially for cerebrovascular patients.

Gene polymorphism of XRCC1 Arg399Gln and cervical carcinoma susceptibility in Asians: a meta-analysis based on 1,759 cases and 2,497 controls.

Many epidemiological studies in Asian populations have investigated associations between the Arg399Gln gene polymorphism of X-ray repair cross complementing gene 1 (XRCC1) and risk of cervical carcinoma, but no conclusions have been available because of controversial results. Therefore a meta-analysis was conducted for clarification. Relevant studies were identified by searching the Pubmed, Embase, the Web of Science, Cochrane Collaboration's database, Chinese National Knowledge Infrastructure (CNKI), Wanfang database and China Biological Medicinse (CBM) until September, 2012. A total of eight studies were included in the present meta- analysis, which described 1,759 cervical carcinoma cases and 2,497 controls. Odds ratios (ORs) and corresponding 95% confidence intervals (95%CIs) as effect size were calculated by fixed-effect or random-effect models. The overall results indicated that the XRCC1-399G/A polymorphism was marginally associated with cervical carcinoma in Asians: OR (95%CI): 1.16 (1.07, 1.26) in the G/A vs G/G inheritance model, 1.24 (0.87, 1.76)in A/A vs G/G inheritance model, 1.13 (1.01, 1.27) in the dominant inheritance model and 1.18 (0.94, 1.47) in the recessive inheritance model. Subgroup analyses on sample size showed no significant correlation in the small- sample size group but the large-sample size group was consistent with the outcomes of overall meta-analysis. In the subgroup analysis by regions, we only found significant association under the G/A vs G/G inheritance model in the Chinese population. For the non-Chinese populations, no correlation was detected in any genetic inheritance model. In the Asian populations, XRCC1-399G/A gene polymorphism was implied to be associated with cervical carcinoma.

[Meta-analysis on the relationship between 25-hydroxyvitamin D level and hypertension].

OBJECTIVE: To explore the association between 25-hydroxyvitamin D level and hypertension so as to provide rationales for developing preventive strategies and understanding the etiology of hypertension. METHODS: The articles on the association of 25-hydroxyvitamin D level and hypertension were retrieved by searching international and national databases from 2000 to 2011. The relationship between 25-hydroxyvitamin D level and hypertension was assessed by Meta-analysis with Stata11.0 software. RESULTS: The results of Meta analysis showed that the pooled OR values of hypertension with 25-hydroxyvitamin D level deficiency and sufficiency was 1.37 (95%CI 1.23 - 1.53). Subgroup analysis revealed in 25-hydroxyvitamin D level, can be drawn between 25-hydroxyvitamin D level and the incidence of hypertension was statistically significant. The pooled OR values of hypertension with 25-hydroxyvitamin D level in 35 nmol/L and 35 - 68 nmol/L were 2.02 (95%CI 1.49 - 2.74) and 1.23 (95%CI 1.02 - 1.49) (P < 0.05). CONCLUSIONS: The 25-hydroxyvitamin D level is associated with hypertension. With regards to the question of whether or not the 25-hydroxyvitamin D level deficiency serves as one of the potential risk factor for hypertension, prospective studies of larger sample sizes are warranted.

Prospective multi-center study of female patients with ST-elevation myocardial infarction in Liaoning province, China.

BACKGROUND: In cardiology, it is controversial whether gender influences prognosis after acute myocardial infarction (MI). We examined the 30-day and 1-year prognosis for female patients with ST-elevation myocardial infarction (STEMI) in Liaoning province, and we analyzed factors that influenced these outcomes. METHODS: This was a prospective, multicenter, observational study in which patient data were collected by questionnaire at the time of diagnosis and at approximately 30 days and 1 year later by telephone inquiries. Patients were diagnosed with STEMI between June 1, 2009 and June 1, 2010 at any of the 20 hospitals that gave treatment representative of current STEMI treatment in Liaoning Province. Unified follow-up questionnaire was used to visit the STEMI patients. RESULTS: We analyzed data from a total of 1429 consecutive patients with STEMI in Liaoning province. Female patients were older (70.0 vs. 60.3, P < 0.001) and were less likely to receive emergency reperfusion therapy than male ones (39.2% vs. 58.0%, P < 0.001). Female gender was associated with higher unadjusted 30-day mortality rates (HR = 2.118, 95%CI: 1.572 - 2.854, P < 0.001) and higher unadjusted 1-year mortality rates (HR = 2.174, 95%CI: 1.659 - 2.848, P < 0.001). Multivariate Cox regression analysis showed that female gender was not an independent predictor of 30-day mortality rates (HR = 1.273, 95%CI: 0.929 - 1.745, P = 0.133) nor of 1-year mortality rates (HR = 1.112, 95%CI: 0.831 - 1.487, P = 0.475). CONCLUSIONS: Women with STEMI appear to be at increased risk of 30-day and 1-year mortality compared with male STEMI patients, but this difference may be explained by older age and less frequent receipt of reperfusion therapy among the women.

[The process of application and implementation on methodologies for comparative effectiveness studies].

Comparative effectiveness research is able to compare the clinical effects of diagnosis and treatment measures effectively, thus providing evidence for making medical decision. In addition that the large-scale clinical randomized controlled trials, cluster randomized trials, quasi-trial, and mathematical models have started to be used in the designing processes of comparative effectiveness research, observational studies on the foundation of electronic medical records have also been paid enough attention. For each research topic, every procedure on the following areas as: generation of a specific piece of evidence, as well as synthesis, communication, translation and application of related data need to have corresponding statistical methods to perform statistical analysis and quality control.

[Relationship between methylenetetrahydrofolate reductase gene C677T polymorphism and susceptibility of ischemic stroke: a meta-analysis].

OBJECTIVE: To evaluate the relationship between the methylenetetrahydrofolate reductase (MTHFR) gene polymorphism and the susceptibility of ischemic stroke among different ethnic populations. METHODS: The databases of MEDLINE, EMBASE, Cochrane Library and others were searched. And a total of 17 studies published in English between 2000 and October 2010 on the association of MTHFR gene C677T polymorphism with ischemic stroke were selected. A comprehensive quantitative analysis was performed by meta-analysis. RESULTS: The results showed that the pooled OR values of ischemic stroke with TT and CC genotype were 1.30 (95%CI: 1.11 to 1.52) and 0.88 (95%CI: 0.79 to 0.98) respectively. And when sub-grouped by ethnic populations, the Caucasians were more likely than other populations to suffer ischemic stroke. There was a low probability of publication bias. CONCLUSION: The presence of MTHFR TT gene is associated with an elevated risk of developing ischemic stroke, especially in Caucasians.

[Meta analysis on the relationship between subclinical hypothyroidism and the levels of systolic blood pressure].

OBJECTIVE: To investigate the association between subclinical hypothyroidism and levels of systolic blood pressure (SBP), so as to provide evidence for the development of prevention strategy and understanding the etiology of hypertension. METHODS: The articles on the association of subclinical hypothyroidism and systolic blood pressure levels were retrieved by searching international and national databases from 1999 to 2010. The relationship between subclinical hypothyroidism and systolic blood pressure levels was assessed by meta analysis with Stata 11 software. The weighted mean difference (WMD) and 95% confidence interval (CI) were calculated, and the publication bias was assessed by Begg's test and Egger's test. RESULTS: (1) There was significant difference in SBP levels between patients with subclinical hypothyroidism and normal subjects (WMD=2.04 mm Hg, 95%CI: 0.64 to 3.45, P<0.05). (2) Subgroup analysis indicated that there was significant difference seen in thyroid stimulating hormone (TSH) mean difference values <7 mU/L group (WMD=2.33 mm Hg, 95%CI: 0.60 to 4.06, P<0.05) but not in the group that TSH mean difference values were >7 mU/L. There was significant difference seen in the Asian group (WMD=2.62 mm Hg, 95%CI: 1.69 to 3.55, P<0.05) in the community group (WMD=2.77 mm Hg, 95%CI: 1.61 to 3.93, P<0.05) but not in the European group and or in the hospital group. There was significant difference in the cross-sectional group (WMD=2.77 mm Hg, 95%CI: 1.61 to 3.93, P<0.05), but not in the case-control group. (3) Results from both Begg's test and Egger's test did not show significant difference, indicating that there was no publication bias existed. CONCLUSION: Subclinical hypothyroidism was associated with the elevated systolic blood pressure. In terms of the role of subclinical hypothyroidism that might serve as one of the potential risk factor for the elevated systolic blood pressure. Well designed and large sample-sized prospective studies were necessary to confirm the association between subclinical hypothyroidism and systolic blood pressure. Random controlled trials were also needed to study whether the treatment could lower the risk. Active treatment for subclinical hypothyroidism might be useful for prevention and treatment of hypertension.

[Meta-analysis on the association between subclinical hypothyroidism and the left ventricular functions under Doppler echocardiography].

OBJECTIVE: To explore the association between subclinical hypothyroidism and the left ventricular functions under conventional 2D Doppler echocardiography and to provide evidence for the protection of heart function. METHODS: Literatures regarding the association of subclinical hypothyroidism and the left ventricular functions were retrieved in large databases from home and abroad for the last 12 years. The left ventricular systolic function was assessed by left ventricular ejection fraction and the shortening of left ventricular fraction. The left ventricular diastolic function was assessed by left ventricular early diastolic filling flow velocity, late diastolic filling flow velocity, their ratios (E/A), and the left ventricular isovolumic relaxation time. The relationship between subclinical hypothyroidism and the left ventricular functions were assessed by Meta-analysis with Stata 11 software. The weighted mean difference (WMD) and 95% confidence interval (CI) were calculated, and the publication bias was assessed by Begg's test. RESULTS: 13 eligible papers were included. (1) Statistics on the combined data showed that in the evaluation of left ventricular diastolic function indicators. There were significant differences in left ventricular late diastolic filling flow velocity (WMD = 4.51, 95%CI: 2.41 to 6.61) and E/A (WMD = -0.22, 95%CI: -0.30 to -0.13), as well as the left ventricular isovolumic relaxation time (WMD = 6.13, 95%CI: 2.79 to 9.48) between patients with subclinical hypothyroidism and normal controls but, no significant difference was found in left ventricular early diastolic filling flow velocity. Looking at the left ventricular systolic function indicators. There were no significant differences in the left ventricular ejection fraction and left ventricular fractional shortening between patients with subclinical hypothyroidism and normal controls. (2) Data from the subgroup analysis showed that the differences of left ventricular late diastolic filling flow velocity, E/A and left ventricular isovolumic relaxation time were significantly different between patients with subclinical hypothyroidism and normal controls in the mean heart rate ≥ 72 bpm group. The difference of left ventricular isovolumic relaxation time was significantly different in the mean heart rate < 72 bpm group, and the difference of left ventricular late diastolic filling flow velocity was significant in the mean age < 60-year-old group. CONCLUSION: Subclinical hypothyroidism was associated with the left ventricular diastolic dysfunction, but not associated with the left ventricular systolic dysfunction. The results suggested that subclinical hypothyroidism might change the heart function which could be evaluated by Doppler echocardiography.

Association of Ala589Ser polymorphism of WNK4 gene with essential hypertension in a high-risk Chinese population.

Recent studies on the association between particular single nucleotide polymorphisms of serine-threonine kinase with no lysine (K) 4 gene (WNK4) and essential hypertension have yielded controversial results. Here, frequencies of Ala589Ser polymorphism within exon 8 of the WNK4 gene were assessed among 259 unrelated ethnic Chinese patients with essential hypertension and 235 strictly matched normotensive controls. All subjects were derived from a relatively isolated population identified in the Kerqin desert region in Zhangwu county of Liaoning, northeastern China, which features a dry climate and the people having a high dietary salt intake, in addition to a significantly higher prevalence (approximately 35%) of essential hypertension. Genotypes were verified with polymerase chain reaction-restriction fragment length polymorphism and confirmed by direct sequencing. Expression pattern and regulatory mechanisms of the WNK4 gene were also explored using Northern blotting and in vitro hormone stimulation assays. Strong associations between the Ala589Ser polymorphism and both raised systolic and diastolic blood pressures were identified. In addition to the kidneys, WNK4 gene expression was also found in many other organs. Several cis-acting elements had been discovered in the promoter region of the gene. As revealed by preliminary experiment, various hormones can down-regulate the expression of WNK4, among which glucocorticoid hormone seems to act in a dose-dependent manner. The WNK4 gene probably plays an important role in the pathogenesis of essential hypertension. As a missense mutation, the Ala589Ser polymorphism may bring changes to the enzyme's function(s), resulting in increased susceptibility to the disease.

[Multivariate analysis on the relationship between polymorphisms on chromosome 17 and essential hypertension].

OBJECTIVE: To explore the relationship of polymorphisms of D17S1878, D17S932 sites and essential hypertension. METHODS: Sixty-seven pedigrees were collected at the region with high prevalence of hypertension. The polymorphisms of D17S1878 and D17S932 sites were genotyped using Genetic Analyzer and GeneScan Software. Case-control study in sibs with different phenotype was carried out and logistic analysis was used for multivariate analysis. RESULTS: There were significant differences on the distributions of age, male, drinking, average systolic pressure, average diastolic pressure, the characteristics of rash,body mass index (BMI), total cholesterol amount,triglyceride, low density lipoprotein (LDL) between the hypertensive-affected sibs and the normotensive sibs (P< 0.05). There was significant difference between the affected hypertensive and normotensive sibs in the D17S1878 site (P < 0.05), while there was no significant difference in D17S932 (P > 0.05). After non-conditional logistic analysis, data showed that both sites were not included in the model, while age (OR = 1.044, 95% CI: 1.019-1.069), drinking (OR = 2.644, 95% CI: 1.778-3.932), the characteristics of rash (OR = 3.078, 95% CI: 1.721- 5.504), triglyceride (OR = 1.305, 95% CI: 1.016-1.676), LDL-C (OR = 1.787, 95% CI: 1.296-2.646), as risk factors, were included in the model. CONCLUSION: The polymorphisms of D17S1878 and D17S932 possibly were not associated with essential hypertension.

[Multi-factorial analysis on the flap thickness influenced by laser operation in situ keratomileusis].

OBJECTIVE: To investigate the various factors that influencing the flap thickness after laser operation in situ keratomileusis (LASIK). METHODS: 369 LASIK eyes (192 cases; among them, 15 patients for surgery monocular) with M2 130 microkeratome heads, grouped by left or right eye were analyzed by Chi-square test and logistic regression analysis based on age, sex, occupation, family history of myopia and ophthalmologic examination results before and after LASIK. The result of analysis of one-way variance which P < 0.05 as the variance to described with logistic regression analysis. RESULTS: Results from logistic regression analysis showed that the flap thickness after LASIK of right eye group was related to two factors: the preoperative refractive power (P = 0.017, OR = 0.832,95% CI: 0.715-0.968), and the corneal thickness (P = 0.000, OR = 1.023, 95% CI: 1.011-1.036) while left eye group was related to three factors: the preoperative astigmatism power (P = 0.044, OR = 2.094, 95% CI: 1.021-4.294), negative pressure suction time (P = 0.019, OR = 1.418, 95% CI: 1.059-1.898) and the corneal thickness (P = 0.000, OR = 1.049, 95% CI: 1.025-1.073). CONCLUSION: Corneal thickness, the preoperative astigmatism power and the negative pressure suction time tended to make the flap thicker while the preoperative refractive power tended to make the flap thinner. Results showed that the flap thickness performed at the first time was more obvious than at the second time.

[Polymorphisms of D17S1878 and D17S932 on the Chromosome 17 and risk of essential hypertension.].

OBJECTIVES: To identify the possible relationship between polymorphisms of D17S1878 and D17S932 on the Chromosome 17 and risk of essential hypertension (EH). METHODS: The polymorphisms of D17S1878 and D17S932 were genotyped using Genetic Analyzer in 325 subjects from 67 Chinese families with EH in Liaoning province. The polymorphisms of D17S1878 and D17S932 sites were genotyped using Genetic Analyzer and GeneScan Software; PHASE2.1 Software was used in hyplotype analysis and affected sib pair analysis was used in linkage analysis. RESULTS: 61 hyplotypes were found in the study population with 272 hypertensive and 53 normotensive subjects and the frequency of haplotype H1 [(CA)(18)/(CA)(11)] in the hypertensive (15.4%) was significantly higher than that in the normotensive (6.3%, P < 0.05). Affected sib pair analysis could be applied in 180 subjects, the t values of the D17S1878 and D17S932 were 1.88 and 3.95, respectively (both P < 0.05) suggesting that the transitivity and consistency of the D17S1878 and D17S932 in sib pairs from the pedigrees were higher than expected (25%). CONCLUSION: The polymorphisms of D17S1878 and D17S932 were possibly linked with predisposing genes of essential hypertension.