Normal reference and regional variation of spinal bone mineral density under the quantitative CT in Chinese male population / 中华健康管理学杂志

Objective:To investigate the normal reference values of spinal bone mineral density measured by quantitative computed tomography (QCT) and the differences of bone mineral density (BMD) in different regions of in Chinese adult males.Methods:Men who underwent low-dose CT lung scan for cancer screening in regions of Northeast, North, East, South, Central and Southwest of China from January 2018 to December 2019 were selected. And the lumbar vertebrae BMD values in the male subjects were measured by the QCT system (Mindways Software, Inc.). The mean BMD values and their decline rates were calculated at an age interval of 10 years, and the prevalence of osteoporosis was calculated according to the American College of Radiology spine QCT osteoporosis diagnostic criteria.Results:A total of 50 682 males with a mean age of (50.22±12.79) years (ranged 20 to 98 years) were included in this study. The peak BMD of (173.11±28.56) mg/cm 3 in the healthy Chinese adult male population appeared in the age group of 20 to 29 years and then declined with age. Before the age of 70 years, the BMD was relatively higher in males in South China, and it was lower in Central China and Southwest China, and it was intermediate in Northeast, North and East of China, with statistically significant differences. There was no significant differences in BMD in the males in the two age groups of 70 to 79 years and 80 and older among the regions in China. The overall decline rate of spinal BMD in Chinese males under QCT was about 46.92% over the lifetime, and it declined obviouslyin the 40-49 age group. The overall prevalence of osteoporosis in Chinese male population aged 50 years and above was approximately 11.42%, with the highest prevalence in Southwest China and Central China (14.72% and 13.87%, respectively) and the lowest in North China and South China (8.53% and 7.71%, respectively). Conclusions:A reference of lumbar spine BMD values for healthy males in China based on QCT is established. BMD values were highest in South China and Lowest in Central China.

Baseline characteristics of the Chinese health quantitative CT big data program in 2018—2019 / 中华健康管理学杂志

Objective:To describe the baseline characteristics of the subjects enrolled in the China Quantitative CT (QCT) big data program in 2018—2019.Methods:Based on baseline data from the Chinese health big data project from January 2018 to December 2019 from the eligible enrolled population, measurements of bone mineral density (BMD) and visceral adipose tissue (VAT) were performed using Mindways′ QCT Pro Model 4 system. The baseline data of age, gender, regional distribution, height, weight, abdominal circumference, blood pressure, blood routine and blood biochemical tests were analyzed. And the single factor analysis of variance (ANOVA) was used to check the age related trend of BMD and VAT in both genders.Results:After screening the inclusion exclusion criteria and outliers of the main indicators, 86 113 people were enrolled in the project. The enrollment rate was 92.47%, including 35 431 (41.1%) women and 50 682 (58.9%) men, and the ratio of men to women was 1.43. The mean age was (50.3±12.7) years in all the subjects, and it was (50.2±12.8) years and (50.4±12.5) years in men and women, respectively, and there was no statistical difference between the two genders ( P>0.05). Total of 43 833 people were enrolled in east China, it was the largest group by region (50.90%), it was followed by central China (16 434 people, 19.08%), and the number of people enrolled in Northeast China was the lowest (2 914 people, 3.38%). The rate of completing of health information indicators related to the main outcome of the study were all above 70%, and there were significant differences between men and women (all P<0.05). The mean BMD was (139.33±46.76) mg/cm 3 in women, (135.90±36.48) mg/cm 3 in men, which showed a decreasing trend with age in both gender (both P<0.001); the mean intra-abdominal fat area was (116.39±56.23) cm 2 in women, (191.67±77.07) cm 2 in men, and there was an increasing trend with age in both men and women (both P<0.001). Conclusions:There are gender differences in BMD and VAT measured by QCT with different age tendency, and there are gender differences in health information index. Regional factors should also be taken into account for regional differences in the inclusion of data.

Construction of urban landscape ecological security pattern based on circuit theory: A case study of Hengyang City, Hunan Province, China.

The identification of ecological sources and corridors plays an important role in the construction of ecological security pattern. However, previous studies mainly concentrated on the optimal path selection of species migration and diffusion rather than the random path selection of the species, which makes most conclusions fail to objectively reveal the process of species migration and diffusion. Taking the downtown area of Hengyang City as an example, we selected the ecological sources and ecological corridors with the habitat quality analysis module of InVEST and Circuitscape 4.0 and evaluated the importance and connectivity of relevant ecological elements with the Linkage Mapper, with the aim to construct the ecological security pattern and delimitate the regions prior to ecological restoration. The results showed that there were 85 ecological sources dominated by woodland and grassland, together with a small number of ponds and beaches, which mainly distributed in the southwest of Zhengxiang District, the west of Yanfeng District, the northeast and south central of Zhuhui District, with a total area of 11.8 km2. There were 60 ecological sources with centrality greater than 100, accounting for 70.6% of the total. There were 217 ecological corridors and five potential ecological corridors mainly composed of forest land, among which the proportion of shrubbery and sparse forest land was higher. The corridors with higher importance were mainly distributed in the west of the studied area. After removing the barriers, the regional connectivity had been significantly improved, with the highest extent of 54.9%. The priority areas of ecological restoration were classified into three levels according to the value of cumulative current, namely, the high-grade area, the middle-grade area and the low-grade area. The high-grade area covered 4.3 km2 of barriers, mainly distributed in the southwest of Zhengxiang District, northeast and south central of Zhuhui District. The middle-grade area was dominated by pinch area and ecological source area with centrality less than 100, covering an area of about 12.9 km2, mainly distributed in the central part of Zhengxiang District, northeast and south central of Zhuhui District. The low-level area was mainly distributed in south central of Zhuhui District, with 51.8 km2 of residual ecological sources. By coupling InVEST habitat quality analysis module and circuit theory, the ecological security pattern for biological protection was constructed, which provides scientific reference for biological protection.

Diagnostic value of optical imaging combined with indocyanine green-guided sentinel lymph node biopsy in gastric cancer: a meta-analysis / 中华胃肠外科杂志

Objective@#To systematically evaluate the diagnostic value of optical imaging combined with indocyanine green (ICG)-guided sentinel lymph node (SLN) biopsy in gastric cancer, and to identify potential factors that would influence diagnostic accuracy.@*Methods@#Study was carried out by searching the electronic database of PubMed, Embase, Medline, Web of Science, and the Cochrane Library with keywords as "gastric/stomach" and "cancer/carcinoma/tumor/tumour/adenocarcinoma/neoplasm" and "sentinel lymph node" and "near-infrared/NIR or fluorescent imaging" and "indocyanine green/ICG" . Literature inclusion criteria: (1) gastric cancer clinical stage was cT0-3; (2) clinical stage determined by at least 2 kinds of imaging modalities; (3) optical imaging (near-infrared or fluorescence imaging) combined with ICG-guided SLN biopsy; (4) prospective study to predict lymph node metastasis; (5) intraoperative or postoperative pathology for all lymph nodes removed; (6) patients number in the literature >10 cases. Exclusion criteria: (1) patients with a history of ICG allergy or chemoradiotherapy; (2) previous history of endoscopic mucosal resection or endoscopic submucosal dissection; (3) patients with a variety of gastrointestinal tumor; (4) case reports, conference abstracts, clinical guidelines, editorials, reviews, meta-analysis and correspondence letters; (5) in vitro or animal experiments; (6) insufficient diagnostic efficacy data. The meta-analysis was performed in the Stata12.0 software using the "bivariate mixed-effects model" combined with the "midas" command to pool the data. Information such as true positive value, false positive value, false negative value, and true negative value of each included articles were extracted. The literature quality assessment map was drawn to describe the overall quality of the articles; the heterogeneity analysis was performed with the forest map, with P<0.01 considered as statistical significance; the funnel plot was used to describe publication bias, with P<0.1 considered as statistically significant. Area under curve (AUC) of summary receiver operator characteristic (SROC) was used to describe the diagnostic accuracy and the AUC closer to 1 indicated higher diagnostic accuracy. If there was heterogeneity (I2>50%) among studies, regression analysis and subgroup analysis were performed. P<0.05 was considered as statistically significant.@*Results@#A total of 15 studies (1020 patients) were included. The optical imaging contained near-infrared (NIR) and fluorescent imaging (FI). The diagnostic value of optical imaging combined with ICG-guided SLN biopsy in gastric cancer was as follows: the pooled sensitivity (Sen) was 0.95 (95% CI: 0.82 to 0.99), specificity (Spe) was 1.00 (95% CI: 0.92 to 1.00), positive likelihood ratio (PLR) was 30.39 (95% CI: 9.14 to 101.06), negative likelihood ratio (NLR) was 0.05 (95% CI:0.01 to 0.20), diagnostic odds ratio (DOR) was 225.54 (95% CI: 88.81 to 572.77), AUC was 1.00 (95% CI: 0.99 to 1.00), threshold value was sensitivity=0.95 (95% CI: 0.82 to 0.99) and specificity=1.00 (95% CI: 0.92 to 1.00). Deeks method revealed DOR funnel plot of SLN biopsy was not asymmetrical obviously with significant difference (P=0.01), which indicated remarkable publishing bias. Meta-subgroup analysis showed that compared to FI, NIR imaging had higher sensitivity (0.98 vs. 0.73); compared to 0 minutes, optical imaging performed 20 minutes after ICG injection had higher sensitivity (0.98 vs. 0.70); compared to mean detected number of SLN of 4, mean detected number≥4 had higher sensitivity (0.96 vs. 0.68); compared to HE stain, immunohistochemistry + HE had higher sensitivity (0.99 vs. 0.84); compared to subserous injection of ICG, submucosa injection of ICG had higher sensitivity (0.98 vs. 0.40); compared to injection of 5 g/L ICG, 0.5 g/L and 0.05 g/L had higher sensitivity (0.98 vs. 0.83); compared to cT2-3 tumor, early stage (cT1) tumor had higher sensitivity (0.96 vs. 0.72); compared to ≤ enrolled 26 cases in the study, > 26 cases had higher sensitivity (0.96 vs. 0.65); compared to papers before 2010, papers after 2010 had higher sensitivity (0.97 vs. 0.81); whose differences were all significant. Sensitivity differences between mean tumor diameter of ≤30 cm and >30 cm, open surgery and laparoscopic surgery, lymph node regional dissection and retrieved dissection were not significant (all P>0.05).@*Conclusions@#Optical imaging combined with ICG-guided SLN biopsy is clinically feasible, and especially suitable for early gastric cancer. However, the ICG being used in current studies may be overdosed. Higher sensitivity may be achieved from NIR imaging when compared with FI method.

Related factors of psychological symptoms in males with traumatic urethral stricture / 中国心理卫生杂志

Objective:To explore the related factors of the psychological symptoms in males with traumatic urethral stricture and to test the mediating effect of social support and coping style on traumatic urethral stricture and psychological symptoms.Methods:Totally 43 male patientswith traumatic urethral stenosis and 1 ∶ 1 matched 43 healthy control subjects were selected as the study samples in the Urology Department of a Third Grade Hospital in Beijing.The Symptom Checklist 90 (SCL-90) was used to evaluate the psychological symptoms of the subjects.The Perceived Social Support Scale (PSSS) and Trait Coping Style Questionnaire (TCSQ) were used to assess the social support and coping styles of the subjects.The non-parametric percentile Bootstrap method was used to test the mediating effect of social support and coping style between traumatic urethral stricture and psychological symptoms.Results:The SCL-90 total scores were higher in patients with traumatic urethral stricture than in healthy controls [(2.9 ± 0.6) vs.(2.4 ± 0.7),P ＜ 0.01].The mediating effect of social support and coping style on psychological symptoms was not significant (P ＞ 0.05).Multiple linear regression analysis showed that the SCL-90 total scores were higher in males with traumatic urethral stricture than in normal controls (β =0.55,95％ CI:0.18 -0.92).PSSS family support scores were negatively correlated with SCL-90 scores (β =-0.10,95％ CI:-0.14--0.06).Conclusion:It suggests that male traumatic urethral stricture may cause psychological symptoms which may be associated with family support.

Survival analysis on 3103 HIV/AIDS patients receiving antiretroviral treatment in Dehong prefecture, Yunnan province / 中华流行病学杂志

Objective To determine the survival rate of HIV/AIDS patients after receiving free antiretroviral treatment in Dehong prefecture, Yunnan province. Methods A retrospective cohort analysis was conducted on all the HIV/AIDS patients aged over 16 years who had started antiretroviral treatment during January 2007 throughout December 2009 in Dehong prefecture.Results A total of 3103 HIV/AIDS patients had received antiretroviral treatment during the study period. Among them, the mean age was (36.0 ± 9.9) years and 62.4% were males. 66.2% of them were infected with HIV through heterosexual transmission, and the mean treatment follow-up time was 21.7 months. Most patients well complied with the treatment, i.e., the average times of not taking the medicine were less than 5 per month. The cumulative survival rate of antiretroviral treatment after 1, 2, 3, 4, and 5 years were 0.95, 0.94, 0.93, 0.92, and 0.92, respectively. Data from the Cox proportional hazard regression model analysis indicated that, after adjustment for age, gender, and marital status, the baseline CD4+T cell counts and transmission route could significantly predicate the rates of survival. Those who were with baseline CD4+T cell counts as 200-350/mm3 were less likely to die of AIDS than those with CD4+T cell counts ＜200/mm3 (Hazard Ratio or HR=0.16, 95%CI:0.09-0.28), and HIV-infected through mother-to-child transmission or routes other than heterosexual transmission were less likely to die of AIDS than through injecting drug use (HR=0.35, 95% CI:0.13-1.00). Conclusion Free antiretroviral treatment had significantly improved the survival of HIV/AIDS patients. Earlier initiation of antiretroviral treatment was likely to have achieved better survival effects.

[Vulnerability of eco-economy in northern slope region of Tianshan Mountains].

Based on the theoretical meaning of vulnerability, a vulnerability assessment of eco-econom in fifteen counties in the northern slope region of Tianshan Mountains was conducted. The ecosystem services change to land use was regarded as the impact, and based on the fourteen indices from resource holding, society development, and economy development statistic data, the adaptive ability was evaluated by using the methods of analytic hierarchy process (AHP) and fuzzy synthetic evaluation. On the basis of assessment results of impact and adaptive capacity, the fifteen counties were divided into five classes under the assessment principles, and the district with higher-class number was of more vulnerability. The first class included Usu City and Changji City, the second class included Hutubi County, Miquan County, Fukang City, Jimsar County, Qitai County and Mori Kazak Autonomous County, the third class included Karamay City and Urumqi City, the fourth class included Kuitun City and Shawan County, and the fifth class included Jinghe County, Shihezi City and Manas County. The vulnerability reflected the level of eco-environment change and socioeconomic development, and the vulnerability assessment could be a good way to ensure the sustainable development. Aiming to decrease the vulnerability, various districts belonging to different class of vulnerability should establish relevant tactics according to the vulnerability factors to accelerate the region's sustainable development.

[Ecosystem service value and its aplication in evaluation of eco-economic harmonious development].

Based on the data of land use/cover and by using eco-economic harmony index (EEH) this paper studied the spatiotemporal characteristics of ecosystem service value on the northern slope of Tianshan Mountains, and evaluated the harmony degree of eco-economic development in the region. The results showed that the total ecosystem service value on the northern slope of Tianshan Mountains was increased from 319.93 x 10(8) yuan in 1989 to 321.26 x 10(8) yuan in 2000, with a net increment of 0.42%. The regional eco-economic development was overall at a low harmony level, being higher in eastern part than in middle and western parts, among which, eight counties had a positive value of EEH and their eco-economic development was harmonious, while seven counties had a negative value of EEH and their eco-economic development was inharmonic. The eco-economic development in the region was at the margin of harmony, and thus, more attention should be paid to strengthen the protection of eco-environment and promote the harmonious development of eco-economy to have a sustainable development.

Present status of serum lipid levels in Beijing professional populations and its trend of changes over 15 years--a collaborative study of seven research and clinical laboratories in Beijing.

BACKGROUND: China's economy has been growing rapidly since 1980, which may have affected blood lipid levels. We carried out a study on serum lipid levels and prevalence of lipid abnormalities in Beijing professional populations in 2001-2002 and assessed the changing trends of lipid levels by comparing the results with that of a similar study in 1984-1986. METHODS: The study population included 31,068 government employees, medical and educational workers and scientific research personnel (male/female 6:4). All participants had physical examination and blood chemistry tests. Lipid parameters analyzed included total cholesterol, low- and high-density lipoprotein (LDL and HDL) cholesterol and triglyceride. RESULTS: Total cholesterol, LDL cholesterol and triglyceride concentrations increased significantly as compared with the 1984-1986 study, but the variations of lipid levels with age and sex remained unchanged. Age-adjusted prevalence of dyslipidemia and its distribution in different sexes and age groups were statistically analyzed. Comparing the results with the data of the US in the 1990s, total cholesterol concentration was lower by 16 mg/dl in men and 18 mg/dl in women, whereas LDL cholesterol concentration was lower by 20 mg/dl in men and 15 mg/dl in women. HDL cholesterol was significantly higher than the US in both genders. CONCLUSIONS: The mean levels of total cholesterol (LDL cholesterol ) increased rapidly in the 1980s, stabilized and descended slightly in 1990s. Coronary lipid risk level in Beijing professional populations is significantly lower than in the US.

Apparent protective effect of high density lipoprotein against coronary heart disease in the elderly.

BACKGROUND: This study was designed to evaluate the relationship between high-density lipoprotein cholesterol (HDL-C) level and acute myocardial infarction (AMI) and coronary heart disease (CHD) death and to explore the protective effect of HDL against CHD in the elderly Chinese. METHODS: Started from 1986, 1211 retirees (92% males) were enrolled consecutively and studied prospectively. The average starting age was 70 +/- 9 years, and that at the end of the study was 80 +/- 9 years. During the follow-up study, all the participants received yearly physical examination and blood chemistry survey from 1986 - 2000. The average duration of the follow up study was 11.2 years. The end point of this study was either attacks of AMI or death due to CHD and other causes. CHD risk factors were screened by logistic regression analysis. According to their HDL-C levels, cases were divided into low (< 1.03 mmol/L), medium (or normal, 1.03 - 1.56 mmol/L) and high (> 1.56 mmol/L) level groups, the differences in incidence of AMI and CHD death in each group were analyzed. RESULTS: The cumulative attacks of acute coronary syndrome (mostly AMI) were 214 cases, including 89 cases of coronary death and 308 death caused by other diseases during the follow up study. AMI occurrence and CHD death in normal HDL-C group were lower than those in the low HDL-C group by 40% and 53%; and those in the high HDL-C group were lower than in the normal group by 56% and 50%, respectively. Statistical analysis on normal lipid cases (411 cases, total cholesterol < 5.17 mmol/L, triglyceride < 1.69 mmol/L) revealed that the cases at low HDL-C level had similar rates of AMI events and CHD mortality as those of the entire group (including hyperlipidemia); however, AMI attacks and CHD deaths decreased significantly at the normal and high HDL-C levels. The results demonstrated that the protective effect of HDL against coronary artery disease is more prominent in people with low lipid level. CONCLUSION: Low HDL is an important independent risk factor for AMI attacks and CHD death in the elderly; high HDL has significant protective effect against coronary artery disease.

A long-term follow-up study of serum lipid levels and coronary heart disease in the elderly.

BACKGROUND: It is still controversial whether or not the correlation between lipid abnormality and coronary heart disease (CHD) becomes weaker in the elderly, and whether patients above 80 years old still benefit from lipid management for the secondary prevention of CHD. The purpose of this study is to assess the correlation between hyperlipidemia and the risk of CHD events in the elderly, and to determine if it is appropriate to use lipid-lowering drugs in those aged above 80, as prescribed by the recommended guidelines for lipid management. METHODS: One thousand two hundred and eleven retirees, mainly males (92%), aged 70 +/- 9 years, were enrolled in this study. Lifestyle habits and medical history were recorded via questionnaires. During the period 1986 - 2000, all subjects participated in an annual physical examination with a blood chemistry survey. The mean follow-up period was 11.2 years. Subjects with incidental illnesses, especially cardiovascular diseases, were diagnosed or treated promptly. Serum lipid parameters, including total cholesterol (TC), low and high-density lipoprotein cholesterol (LDL-C and HDL-C) and triglyceride (TG) levels were analyzed according to standardization of lipid and lipoprotein measurements. The association between lipid levels and the prevalence of acute myocardial infarction (AMI) or coronary death was analyzed statistically. RESULTS: Lipid abnormalities occurred in 2/3 of the 1211 subjects. The most common lipid disorder was high TC and high LDL-C, which was much more prevalent than high TG. Among the subjects, 51.6% had TC levels above 5.2 mmol/L. Mean TC and LDL-C reached peak levels in the 65 - 74 age group without significant decrease until ages over 90. The cumulative total number of deaths due to various causes was 397 in the 15-year follow-up period, with the mortality rate in the high lipid group slightly lower than that in the normal lipid group (30.6% vs 35.3%), although the difference was not significant (P = 0.1931). However, there were more cases of coronary death in the high lipid group than in the normal lipid group (7.9% vs 4.6%, P = 0.0045). When examining AMI survivors, more AMI cases were found in the high lipid group than in the low lipid group (20.9% vs 11.4%, P < 0.0001). The cumulative number of coronary deaths was 89 (with 88 cases above age 70), and the total number of CHD cases was 214 (17.7% of the whole group). Logistic regression analysis reveals that age, hypertension, LDL-C, and HDL-C are important risk factors for CHD. Lifestyle changes were common, but only 45% of the hyperlipidemic cases received drug treatment. Statins were commonly used only in recent years. CONCLUSION: The above results show that high TC and LDL-C levels are correlated with a high CHD risk even in people over 80. For elderly patients with clinical CHD and an aggregation of CHD risk factors, cholesterol-lowering therapy might be considered if the general health of the patient makes this permissible.

Apparent protective effect of high density lipoprotein against coronary heart disease in the elderly / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>This study was designed to evaluate the relationship between high-density lipoprotein cholesterol (HDL-C) level and acute myocardial infarction (AMI) and coronary heart disease (CHD) death and to explore the protective effect of HDL against CHD in the elderly Chinese.</p><p><b>METHODS</b>Started from 1986, 1211 retirees (92% males) were enrolled consecutively and studied prospectively. The average starting age was 70 +/- 9 years, and that at the end of the study was 80 +/- 9 years. During the follow-up study, all the participants received yearly physical examination and blood chemistry survey from 1986 - 2000. The average duration of the follow up study was 11.2 years. The end point of this study was either attacks of AMI or death due to CHD and other causes. CHD risk factors were screened by logistic regression analysis. According to their HDL-C levels, cases were divided into low (< 1.03 mmol/L), medium (or normal, 1.03 - 1.56 mmol/L) and high (> 1.56 mmol/L) level groups, the differences in incidence of AMI and CHD death in each group were analyzed.</p><p><b>RESULTS</b>The cumulative attacks of acute coronary syndrome (mostly AMI) were 214 cases, including 89 cases of coronary death and 308 death caused by other diseases during the follow up study. AMI occurrence and CHD death in normal HDL-C group were lower than those in the low HDL-C group by 40% and 53%; and those in the high HDL-C group were lower than in the normal group by 56% and 50%, respectively. Statistical analysis on normal lipid cases (411 cases, total cholesterol < 5.17 mmol/L, triglyceride < 1.69 mmol/L) revealed that the cases at low HDL-C level had similar rates of AMI events and CHD mortality as those of the entire group (including hyperlipidemia); however, AMI attacks and CHD deaths decreased significantly at the normal and high HDL-C levels. The results demonstrated that the protective effect of HDL against coronary artery disease is more prominent in people with low lipid level.</p><p><b>CONCLUSION</b>Low HDL is an important independent risk factor for AMI attacks and CHD death in the elderly; high HDL has significant protective effect against coronary artery disease.</p>

A long-term follow-up study of serum lipid levels and coronary heart disease in the elderly / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>It is still controversial whether or not the correlation between lipid abnormality and coronary heart disease (CHD) becomes weaker in the elderly, and whether patients above 80 years old still benefit from lipid management for the secondary prevention of CHD. The purpose of this study is to assess the correlation between hyperlipidemia and the risk of CHD events in the elderly, and to determine if it is appropriate to use lipid-lowering drugs in those aged above 80, as prescribed by the recommended guidelines for lipid management.</p><p><b>METHODS</b>One thousand two hundred and eleven retirees, mainly males (92%), aged 70 +/- 9 years, were enrolled in this study. Lifestyle habits and medical history were recorded via questionnaires. During the period 1986 - 2000, all subjects participated in an annual physical examination with a blood chemistry survey. The mean follow-up period was 11.2 years. Subjects with incidental illnesses, especially cardiovascular diseases, were diagnosed or treated promptly. Serum lipid parameters, including total cholesterol (TC), low and high-density lipoprotein cholesterol (LDL-C and HDL-C) and triglyceride (TG) levels were analyzed according to standardization of lipid and lipoprotein measurements. The association between lipid levels and the prevalence of acute myocardial infarction (AMI) or coronary death was analyzed statistically.</p><p><b>RESULTS</b>Lipid abnormalities occurred in 2/3 of the 1211 subjects. The most common lipid disorder was high TC and high LDL-C, which was much more prevalent than high TG. Among the subjects, 51.6% had TC levels above 5.2 mmol/L. Mean TC and LDL-C reached peak levels in the 65 - 74 age group without significant decrease until ages over 90. The cumulative total number of deaths due to various causes was 397 in the 15-year follow-up period, with the mortality rate in the high lipid group slightly lower than that in the normal lipid group (30.6% vs 35.3%), although the difference was not significant (P = 0.1931). However, there were more cases of coronary death in the high lipid group than in the normal lipid group (7.9% vs 4.6%, P = 0.0045). When examining AMI survivors, more AMI cases were found in the high lipid group than in the low lipid group (20.9% vs 11.4%, P < 0.0001). The cumulative number of coronary deaths was 89 (with 88 cases above age 70), and the total number of CHD cases was 214 (17.7% of the whole group). Logistic regression analysis reveals that age, hypertension, LDL-C, and HDL-C are important risk factors for CHD. Lifestyle changes were common, but only 45% of the hyperlipidemic cases received drug treatment. Statins were commonly used only in recent years.</p><p><b>CONCLUSION</b>The above results show that high TC and LDL-C levels are correlated with a high CHD risk even in people over 80. For elderly patients with clinical CHD and an aggregation of CHD risk factors, cholesterol-lowering therapy might be considered if the general health of the patient makes this permissible.</p>

[Apparent protective effect of high density lipoprotein against coronary heart disease in the elderly].

OBJECTIVE: To evaluate the relationship between the level of high-density lipoprotein cholesterol (HDL-C) and acute myocardial infarction (AMI) events and coronary heart disease (CHD) death, and to explore the protective effect of high level HDL against CHD in the elderly Chinese. METHOD: A prospective study was done upon 1211 retired cadres, 92% of which were males, enrolled in succession since 1986, aged 70 +/- 9 on average when being enrolled and aged 80 +/- 9 on average by the end of the study. During a follow up study with an average duration of 11.2 years, till the year 2000 or a specific subject died of CHD or other disease, all the participants received yearly physical examination and blood chemistry survey. CHD risk factors were screened by logistic regression analysis. According to their HDL-C levels, the subjects were divided into 3 groups: low HDL-C (< 1.03 mmol/L), medium HDL-C (1.03 - 1.56 mmol/L), and high HDL-C (> 1.56 mmol/L) groups. The differences in AMI event and CHD death in each group were analyzed. RESULTS: 411 of the subjects were with normal blood lipid (normal blood lipid group, total cholesterol < 5.17 mmol/L, triglyceride < 1.69 mmol/L), 338 subjects were basically healthy (basically healthy group), and 214 subjects developed CHD during the follow-up (CHD group). 23.2% of the subjects could be included in the low HDL-C group, 68.7% in the medium HDL-C group, and 68.5% in the high HDL-C group. The low HDL-C rate was 16.9% in the basically healthy group and 35.0% in the CHD group (P = 0.000165). The high HDL-C rate was 12.4% in the basically healthy group and 3.3% in the CHD group (P = 0.000645). During the follow up study, 214 cumulative attacks of acute coronary syndrome (mostly AMI) were recorded with 89 deaths. 308 cases died of other diseases. The AMI event rate and CHD death rate in the normal HDL-C group were lower than those in the low HDL-C group by 40% and 53% respectively. The AMI event rate and CHD death rate in the high HDL-C group were lower than those in the normal HDL-C group by 56% and 50% respectively. In the normal lipid group, AMI event rate and CHD mortality in the individuals with low HDL-C level were lower than those in the individuals with medium HDL-C level by 79% and 77% respectively (both P < 0.0001). The number of individuals with high HDL-C level was low, however, no CHD death occurred among these subjects. CONCLUSION: Low HDL is an important independent risk factor of AMI attacks and CHD death in the elderly. High HDL protects effectively against coronary artery disease. High TC level weakens the protective effect of HDL-C.

The comparative study of adrenal medulla hyperplasia in rats on MRI and pathological examination / 中华放射学杂志

Objective To determine the value of Magnetic resonance imaging(MRI)technique on diagnosis of adrenal medulla hyperplasia model rats confirmed by pathology study.Methods Sixty male SD rats were divided into 6 groups randomly,10 rats in each group.As experiment group,A,B,C groups were subcutaneously injected with reserpine(0.4 mg?kg~(-1)?d~(-1))from the beginning to 40,60,80 days respectively.As compare,the control groups(a,b,c group)were only injected with sodium chloride simultaneously.MRI technique and pathology study were performed for all the subjects on 40,60,and 80 days respectively.Results The percent of medulla were higher in B and C groups than that in b and c groups respectively[(34.3?5.8)% vs.(25.7?8.9)%,t=2.462,P