Objective The aim of this study was to assess the distribution histogram of arm circumference (AC) in adult hypertensives in Beijing area, and to establish which size of cuffs is most appropriate in clinical practice. Methods We conducted a cross-sectional survey in a cohort of 424 (male 61.6%) consecutive hypertensives patients. Arm circumference was measured at the mid-point of the right upper arm. Subjects were stratified in three groups: group 1 with AC between 22-26 cm (small size), group 2 AC between 27-34 cm(medium size), and group 3 AC great than 34 cm (large size). Using AC of 32 cm as cutoff point, patients were subdivided as group A (AC

BACKGROUND: Both pulse pressure (PP) and aortic stiffness are the predictors of coronary artery disease (CAD). The relationship between aortic PP and atherosclerosis may be bi-directional. Some investigations have tested the relationship between coronary arteriongraphy-diagnosed coronary heart disease and aorta pulse pressure (APP).OBJECTIVE: To observe the relationship between coronary atherosclerosis and APP in patients with primary hypertension.DESIGN: Case control observation.SETTING: Department of Cardiology, Xuanwu Hospital, Capital University of Medical SciencesPARTICIPANTS: A total of 300 patients with primary hypertension who received the treatment in the Department of Cardiology, Xuanwu Hospital, Capital University of Medical Science between July 2002 and January 2005. The patients were all untreated hypertensive patients who were referred for a first diagnostic coronary angiography. All of them met the diagnostic criteria of international hypertensive association. Secondary hypertension, myocardial disease, valvular disease of the heart (VDH), heart failure, liver and renal insufficiency and so on were excluded. The patients, 170 male and 130 female, were aged (61±11 )years. Informed consents were obtained from all the patients.METHODS: A total of 300 untreated hypertensive patients were recruited for a first diagnostic coronary angiography. According to whether having coronary artery disease (CAD), the patients were divided into CAD group (143 in total, 92 male, 64%) and non-CAD group (157 in total, 82 male, 52%). Informed consents were obtained from all the patients.The following data were collected: invasive intra-aortic systolic blood pressure (ASBP) and intra-aortic diastolic blood pressure (ADBP), extent of coronary artery disease, and basic clinical materials of the patients. All the observed index were expressed as Mean±SD. Independent sample t test was used in the comparison between two groups, and P ＜ 0.05was set as significant difference.MAIN OUTCOME MEASURES: ASBP, ADBP and BP, ratio of stroke volume (SV), which reflects aortic stiffness, to aortic pulse pressure (APP); The number of branch and stegnotic extent of coronary artery disease (Cases with stegnotic extent ＜ 50% were included in non-CAD group; Basic clinical indexes and routine biochemical indexes of patients after admission (including fasting blood glucose, serum creatinine, blood lipid and so on).RESULTS: The enrolled 300 patients with hypertension all participated in the result analysis. In the whole population, ASBP and PP were significantly higher in CAD group than non-CAD group [(150.3±26.5) vs. (145.6±23.3) mm Hg, P ＜ 0.05;(77.1±22.7) vs. (70.4±19.3) mm Hg, P ＜ 0.05)]. The ratio of APP to SV in CAD group was markedly higher than that in non-CAD group(1.20±0.44) vs. (0.96±0.33), P ＜ 0.05]. Fasting blood glucose of patients in the CAD group was significantly higher than that in the non-CAD group [(1.38±0.27) vs. (1.08±0.28) mmol/L, P ＜ 0.01]. Serum creatinine of patients in the CAD group was significantly higher than that of non-CAD group [(11.98±2.15) vs. (11.19±1.58) μ mol/L, P ＜0.01]. High-density lipoprotein cholesterol of patients in the CAD group was significantly lower than that in the non-CAD group [(0.54±0.13) vs. (0.62±0.18) mmol/L, P＜ 0.01].CONCLUSION: Atherosclerosis may further aggravate the aortic stiffness and then cause the increase of APP in patients with primary hypertension.

Objective To analyze the clinical characteristics and risk factors of patients with confirmed venous thromboembolism (VTE) in order to improve recognition of VTE, and reduce the rate of missed diagnosis and wrong diagnosis. Methods A retrospectively review was performed for 205 patients diagnosed with VTE confirmed by CT pulmonary angiography (CTPA), radionuclide pulmonary ventilation/perfusion (V/Q) imaging, lower extremity deep vein ultrasound or venography in the First Affiliated Hospital of Bengbu Medical College from January 2009 to December 2018. The clinical manifestations, laboratory examination results, imaging results, treatment and prognosis of patients diagnosed with VTE were analyzed. The clinical possibility was assessed by pulmonary thromboembolism (PTE) simplified Wells score and deep venous thrombosis (DVT) Wells score. 130 non-VTE patients admitted in the same period were enrolled as controls, and the risk factors of VTE were screened by multivariate Logistic regression analysis. Results Among 205 VTE patients, 14 cases had incomplete data, 2 cases were complicated with other diseases deteriorated, 2 cases were excluded because of economic reasons, 10 cases abandoned treatment because of serious illness, and finally 177 cases were included in the analysis. The main clinical symptoms of VTE patients were chest tightness (36.16%), followed by chest pain (29.94%), dyspnea (29.38%) and hemoptysis (24.29%). Swelling or tenderness of unilateral/bilateral lower extremities (38.98%) and lung moist rale (20.90%) were the most common signs. ST-T changes were the main changes in electrocardiogram (ECG, 49.15%), followed by SⅠQⅢTⅢ or QⅢTⅢ changes (35.03%). Only 5.65% of the patients had plasma D-dimer less than 0.5 mg/L. 31.07% (55/177) patients had normal arterial blood gas results. Of the 177 VTE patients, 175 were diagnosed as PTE by CTPA, with bilateral/multi-lobar pulmonary artery embolism and its branches being the main type [44.57% (78/175)]. Two cases were diagnosed as PTE by V/Q imaging. Among them, 112 cases were received lower extremity deep venous ultrasound or lower extremity deep venography, 51 cases were diagnosed as lower extremity DVT, with thrombosis of popliteal and above vein as common [68.63% (35/51)]. The clinical possibility assessment showed that 67.23% (119/177) patients might have PTE (PTE simplified Wells score greater than or equal to 2), 38.98% (69/177) patients might have lower extremity DVT (DVT Wells score greater than or equal to 2). Multivariate Logistic regression analysis showed that operation less than 4 weeks [odds ratio (OR) = 5.503, 95% confidence interval (95%CI) = 1.577-19.206, P = 0.007], trauma or fracture less than 3 months (OR = 6.771, 95%CI = 1.510-30.370, P = 0.012), VTE history (OR = 0.072, 95%CI =0.009-0.549, P = 0.011) were independent risk factors for VTE occurrence. Thrombolytic therapy was administered in 13 cases while anticoagulant therapy alone was prescribed in 164 cases. 176 patients recovered, while 1 case died. Conclusions VTE clinical manifestations are not specific. Patients with risk factors should be vigilant, be strengthen with diagnostic awareness, paid attention to the evaluation of clinical possibilities. Timely thrombolytic or anticoagulant treatment after diagnosis, can improve the survival rate.