Association between pulse pressure and new-onset diabetes in hypertensive patients / 中华心血管病杂志

Objective: To determine the association between pulse pressure and the risk of new-onset diabetes in hypertensive patients. Methods: In this prospective cohort study, hypertensive patients from the Kailuan Study, who were diagnosed in 2006-2007 check-up, were screened for enrollment. Participants who finished the biennial follow-up until December 31, 2017 were finally included in this analysis. The primary outcome was incident diabetes development. The pulse pressure variables were divided into quartiles (Q1-Q4), and the Kaplan-Meier curve was used to examine and estimate the cumulative incidence of new-onset diabetes among quartiles. Cox proportional hazards regression model was performed to explore the association between pulse pressure and the risk of new-onset diabetes in hypertensive patients. Results: During an average follow-up of 8.17 years, 6 617 new-onset diabetes were identified out of the 32 917 hypertensive patients with no history or evidence of diabetes in 2006-2007 check-up. Participants were classified into quartiles according to pulse pressure levels as follows: Q1 group(<41 mmHg (1mmHg=0.133kPa))(n=7 995); Q2 group(41-<51 mmHg) (n=8 196); Q3 group (51-<61 mmHg) (n= 8 270); Q4 group (≥61 mmHg) (n=8 456). The cumulative incidences of new-onset diabetes across the quartiles were 16.94%, 19.61%, 21.07%, and 22.33%, respectively, with the incidence density was 20.27, 23.20, 24.92, and 26.10 per 1 000 person-years, respectively. The cumulative incidence of new-onset diabetes increased in proportion with increasing pulse pressure levels (P<0.01 by the Log-rank test). After multivariate adjustment, compared with the first quartile, the hazard ratios for new-onset diabetes in the third and fourth quartiles were 1.13 (95%CI 1.04-1.22, P<0.01) and 1.14 (95%CI 1.05-1.24, P<0.01), respectively. The risk of new-onset diabetes increased 5%(HR=1.05, 95%CI 1.02-1.08, P<0.01) with the fractional pulse pressure increased per 1 SD (0.13). Findings from the three sensitivity analyses were consistent with the main results in this cohort. Conclusions: Pulse pressure at baseline is positively associated with the incidence of new-onset diabetes among hypertensive individuals, and pulse pressure is an independent risk factor for the development of diabetes in hypertensive patients.

Effect of cyclophosphamide on fungal infection in SLE mice detected by fluorescent quantitative PCR

Objective: To observe the effect of the cyclophosphamide (CTX) on systemic lupus erythematosus mice by fluorescent quantitative polymerase chain reaction. Methods: (BALB/c × C57BL/J6) F1 hybrid mice were used as recipients of donor lymphocytes which were injected intravenously. Mice were randomly divided into control group and treatment group, serum autoantibody and urinary protein were measured, renal pathological changes and the situation of fungal infection were observed. Results: The reduced urinary protein, ameliorated renal lesions were found in the CTX-treated mice. Candida albicans and Aspergillus flavus were detected respectively in respiratory tract and gastrointestinal tract. Conclusions: CTX can alleviate lupus nephritis and the fluorescent quantitative PCR is a rapid and sensitive method for the detection of fungal infection.

Effect of cyclophosphamide on fungal infection in SLE mice detected by fluorescent quantitative PCR

OBJECTIVE@#To observe the effect of the cyclophosphamide (CTX) on systemic lupus erythematosus mice by fluorescent quantitative polymerase chain reaction.@*METHODS@#(BALB/c × C57BL/J6) F1 hybrid mice were used as recipients of donor lymphocytes which were injected intravenously. Mice were randomly divided into control group and treatment group, serum autoantibody and urinary protein were measured, renal pathological changes and the situation of fungal infection were observed.@*RESULTS@#The reduced urinary protein, ameliorated renal lesions were found in the CTX-treated mice. Candida albicans and Aspergillus flavus were detected respectively in respiratory tract and gastrointestinal tract.@*CONCLUSIONS@#CTX can alleviate lupus nephritis and the fluorescent quantitative PCR is a rapid and sensitive method for the detection of fungal infection.

[Progress in home uroflowmetry in evaluation of lower urinary tract symptoms in patients].

Uroflowmetry is the most widely used non-invasive urodynamic tool for most patients with suspected lower urinary tract dysfunction. Home uroflowmetry can produce multiple representative flow readings in adequate privacy condition when patients feel a normal desire. Because of its advantages of decreasing variability, describing circadian rhythms and combating problems inherent to clinic-based measurements, it can improve diagnostic accuracy and predictive value. Further studies are required to confirm quantitative data of patient's preferences and to measure cost-benefit of home uroflowmetry.

[Abnormal expression and significance of MIR-184 in human renal carcinoma].

OBJECTIVE: To explore the role of microRNA-184(MIR-184) in the development of renal cell carcinoma(RCC). METHODS: The expressions of MIR-184 in 51 patients with RCC Investigated, normal adjacent tissues (ADTs) matched by fluorescence quantitative PCR technology (RT-qPCR) and the correlations analyzed between MIR-184 expression and the age, gender and clinical stage of RCC patients. RESULTS: The average expression of MIR-184 in RCC was -14.664 6 ± 5.362 4, while that in ADTs was -10.408 7 ± 3.482 7(P<0.01). Bounded with the MIR-184 expression in RCC, patients were divided into lower-expression group and higher-expression group. Meanwhile, the RCC patients were divided into three groups according to the age, gender and clinical stage of the patients. Chi-square statistical analysis showed that the expression level of MIR-184 was not significantly correlated with the patient's age, gender and clinical stage (respectively: P>0.03, P>0.99, P>0.03). CONCLUSION: MIR-184 in RCC was significantly lower than that in ADTs, which may have potential significance in the occurrence and development of RCC.

[Age-specific reference ranges for prostate specific antigen in 16 222 Chinese men].

OBJECTIVE: To investigate the PSA level of 16 222 asymptematic men in Shenzhen who came from different areas of China, in order to find out the PSA levels of Chinese men. METHODS: Serum samples of 16 222 men who came to Peking University Shenzhen Hospital for health examination were collected, all of whom had no symptoms. Their serum PSA levels were measured with MEIA with ILMA instrument. RESULTS: The mean PSA level of the 16 222 men in our research was 0.986 µg/L, and the standard deviation was 1.190. The 95% percentile was 2.375 µg/L. Of all the cases ,the 95% percentile of 15 498 was lower than 2.5 µg/L, about 95.472%;that of 699 was between 2.5-10.0 µg/L, about 4.306%;And if took 4.0 µg/L as reference value,that of 15 948 cases was below 4.0 µg/L, about 98.244%;that of 249 was between 4.0-10.0 µg/L, about 1.534%;That of only 36 cases was greater than 10.0 µg/L, about 0.222%;The 95% percentiles of the different age groups were: 10-19 years 0-1.067 µg/L;20-29 years 0-1.818 µg/L;30-39 years 0-1.914 µg/L;40-49 years 0-2.001 µg/L;50-59 years 0-2.900 µg/L;60-69 years 0-5.862 µg/L;70-79 years 0-8.536 µg/L;elder than 80 years 0-12.869 µg/L;There were statistic differences between thedifferent age groups. CONCLUSION: Our data demonstrate that the mean value of PSA levels of Chinese men is 0.986 µg/L at present stage, and the 95% percentile is 2.375 g/L. Our PSA levels of each age group are different from Oesterling's reference values which are commonly accepted in the world. The PSA level of Chinese men who are under 60 years is lower than that of Euramericans, while the PSA level of Chinese men who are above 60 years is higher than that of Euramericans. This shows that for the men who are under 60 the reference value should be 2.5 µg/L, while for the men who are above 60, we could still use 4 µg/L as reference value.

[Comparison of new portable home electronic uroflowmeter with Laborie uroflowmeter].

OBJECTIVE: To design a new portable home electronic uroflowmeter and compare it with traditional methods. METHODS: The system consists of collectors, urine conducting apparatus, intelligent cell phone, wireless network communication technology, computer analysis and drawing, and data storage technology, etc., and can automatically collect voiding information from patients with lower urinary tract symptoms(LUTS) Through Bluetooth, the voiding information was sent to the patient's intelligent cell phone from the collector, then stored directly by intelligent cell phone and wirelessly transmitted to the workstation in hospital. The system was primarily tested with regard to accuracy of measurement of the voided volume. Multiple doses with known volume were introduced in the system and Laborie uroflowmeter. Furthermore, 38 outpatients who had LUTS were tested simultaneously with the system and Laborie uroflowmeter. The statistical method for assessing agreement between the two methods of clinical measurement was Bland-Altman analysis. Among the subjects, there were 22 male patients and 16 female patients, ranging from 21 to 37 years old, with an average age of 25.5 years, of whom, 19 were tested once and 19 patients twice, equaling to 57 tests. RESULTS: The system could accurately collect and analyze voiding time, uroflowmetry, voided volume, and automatically provide uroflowmetry parameters. The measurement error of 100, 200, 300, 500 and 800 mL is less than 5%. 12.28%, 5.26% and 3.51% of the Qmax, Qave and voided volume points were beyond the 95% limits of agreement. The maximum absolute values of the Qmax, Qave and voided volume difference were 0.38 mL/s, 0.70 mL/s and 2.90 mL, respectively.They agreed with the recommendation of Standardization International Continence Society. CONCLUSION: The new portable home electronic uroflowmeter has good agreement with Laborie uroflowmeter,and is a new LUTS monitoring system integrated with correct, reliable, real-time, convenient and easy-managing advantages. It is as noninvasive and reliable as traditional methods, and its portable feature facilitates application out of hospitals. It can also record voiding diaries.

[Ketamine-associated urinary tract damage].

Ketamine is widely used as an anesthetic during surgical procedures in both animals and humans. As its unique effects of inducing the dissociative hallucinatory,vivid dreams, out-of-body experiences, and delirium, it has diverted from legitimate uses to the illicit drug market, and abusing ketamine has become a serious social problem. The abusers may use ketamine alone or mixe it with other drugs to get an intense pleasure. There are case reports from all over the world in recent years that abusing ketamine may induce severe lower urinary tract symptoms (LUTS), and a variety of anatomical and functional lesions can be found in the urinary tract if further examinations are administrated. There is no universally recognized treatment protocols for this syndrome. Ketamine cessation or even reduction is the most effective treatment to prevent deterioration of the urinary tract, and intravesical instillation of hyaluranic acid (cystitstat) and oral pentosan polysulphate (elmiron) may take effect. The pathogenesis of ketamine-associated urinary tract destruction is unclear, and further study is needed.

[Development of remote wireless mobile voiding diary and a report of its objective voiding in 20 young people].

OBJECTIVE: To find out the data of the micturitions in healthy young people with the remote & mobile voiding diary monitoring system. METHODS: Twenty healthy young people were studied and ten of them were female. The ages ranged from 22 to 35 years (the mean age: 27.4 years). The females were 22-33 years old (the mean age: 26.4 years ) and the males 24-35 years old (the mean age: 28.4 years). With the remote & mobile voiding diary monitoring system, their voiding information was collected. Through bluetooth, the voiding information was sent to the patient's intelligent cell phone from the collector, then stored directly by intelligent cell phone and wirelessly transmitted to the workstation in the hospital. All of them completed the voiding diaries for 7 days and the data were analyzed. RESULTS: The average micturition of the young healthy people was 5.6 times (3.4-7.4) per 24 hours,in which 5.3 (3.4-7.3) times were in the daytime and 0.3 (0-1.3)times in the night. The functional voiding volume was 318 mL (66-642 mL). The mean voiding volume in 24 hours was 1 724 mL (1152-2 415 mL), in which 1 289 mL (786-2 039 mL) was in the daytime and 435 mL (292-805 mL) in the night. The mean drinking volume was 1 022 mL (453-1 721 mL) in the daytime and 7 mL (0-43 mL) in the night. The nocturia index (Ni) was 1.03, the nocturnal polyuria index (NPi) 26%, and the nocturnal bladder capacity index (NBCi) 0.27. CONCLUSION: The remote & mobile voiding diary monitoring system can help us get the objective voiding information from young health people for the first time. It is reliable, maneuverable and can be widely used in clinical diagnosis.

[Advances in clinical study of nocturia].

Nocturia is one of the most common reasons for interrupted sleep in general adult population. The condition affects both men and women, with an incidence that increases dramatically with age. Nocturia has a negative impact on quality of life, affecting both morbidity and mortality. International Continence Society (ICS) issued a report of terminology standardization in 2002, in which nocturia is defined as waking during the night at least once to urinate. Nocturia is a common complaint in elderly population. Although most cases of nocturia are assumed to be caused by urologic problems, the interacting effects of aging and sleep on renal and urinary function, in fact, cause nocturia in the elderly. Effective diagnosis of the condition is dependent on a clear understanding of its underlying etiology. Multiple factors may cause nocturia, such as behavioral or environmental factors and pathologic conditions. In general, the causes of nocturia fall into three categories: diurnal polyuria, nocturnal polyuria, and low bladder capacity. Careful evaluation of medications and underlying medical conditions is essential for the proper management of nocturia. A voiding diary is necessary to diagnose the syndrome of nocturnal polyuria, which is a common cause of nocturia. Addressing any underlying conditions that contribute to nocturia is the first step in treating the condition. Lifestyle and behavioral changes may provide benefit in some individuals, but for many cases, pharmacotherapy is the best option. Antimuscarinic agents are first-line therapies for overactive bladder and are often used in the management of nocturia. Current treatment options also include desmopressin, a synthetic analog of arginine vasopressin, which can increase urinary osmolality and decrease total urinary volume. The desmopressin therefore increases the length of time until the first nocturnal void and decreases the number of nocturnal voids, the NUV voided, and the percentage of urine voided at night.

Behavioral characteristics of men who have sex with men with sadomasochism associated with bleeding / 中华流行病学杂志

Objective To investigate the behavioral characteristics of men who have sex with men(MSM)with sadomasochism associated bleeding and to analyze the relationship with HIV/AIDS high risk behavior.Methods Using modified snowball sampling methods(target sampling methods)to carry out a cross-sectional study on persons with behavior of sadomasochism that associated with bleeding in MSM,using a valid questionnaire.Another control group without the related behavior was set up.SPSS 13.0 was used.Results People practicing sadomasochism associated with bleeding had higher percentage in the following indicators:number of accumulated same gender sexual partners (median=20),anal intercourse(median=10),oral intercourse(median=10),hand intercourse (median=15)with same gender sexual partners,number of same gender sexual partners in the previous six months(median=4),numbers of anal intercourse(median=3),hand intercourse(median=3),were more than in the control group.People with sadomasochism associated bleeding had higher rates in the following behaviors:condom was ever broken or slipped in the previous six months (22.6%),suffering from disease of sexual transmitted infections(28.0%),involving in group-sex intercourse(34.8%),having sex with same sex strangers at the place for MSM in the previous six months(62.2%),ever having initiative or passive behavior of oral-anal sex(64.0%),fist-sex(18.9%),finger-sex(66.7%),bleeding during sexual intercourse(58.3%),first coition object was pupil (33.8%),having strong suicide attempts(33.3%)and suicide attempt(23.6%)etc.were more than in the control group.Conclusion MSM who had the behavior of sadomasochism which associated with bleeding had the higher percentage of HIV/AIDS high risk behaviors than the persons without those behaviors.The latter group called for special concern on interventions.