Objective: To investigate the inlfuence of different blood pressure (BP) circadian rhythm on cardiac function in hypertensive patients.
Methods: A total of 180 hypertensive patients with well controlled day-time blood pressure were divided into 3 groups. Dipper group, n=30, Non-dipper group, n=99 and Reverse dipper group, n=51. The relationship between cardiac function, relevant clinical index and blood pressure circadian rhythm were analyzed.
Results: The mean systolic and diastolic BP, BP classiifcation and the antihypertensive medication were similar among 3 groups.①The ratio of peak mitral E wave to peak mitral annulus E' wave (E/E') increased accordingly from Dipper group, Non-dipper group and Reverse-dipper group as (8.1 ± 2.4), (8.6 ± 2.5) and (9.6 ± 3.2), P<0.05. ②Left atrial volume index (LAVi) in Reverse-dipper and Non-dipper groups were higher than that in Dipper group as (43.8 ± 11.8) ml/m2, (40.7 ± 9.8) ml/m2 and (36.6 ± 8.5) ml/m2, P<0.05 or P<0.01. ③E/E' was positively related to nocturnal systolic BP and age, negatively related to nocturnal BP decline rate (nocturnal BPR); E/E' was independently related to age and BPR. LAVi was positively related to nocturnal systolic BP, pulse pressure, age and hypertension course, negatively related to the mean diastolic BP, day-time diastolic BP and BPR; LAVi was independently related to BPR, pulse pressure and hypertension course. Left ventricular ejection fraction had no statistic differences among 3 groups.
Conclusion: Abnormal blood pressure circadian rhythm was associated with the cardiac injury in hypertensive patients. The cardiac injury increased accordingly from Non-dipper group to Reverse-dipper group and the main damage was in diastolic function.

Objective:To investigate the effect of multiple medications on the risk of small intestinal bacterial overgrowth(SIBO)in the elderly.Methods:Clinical data of 85 inpatients in the Department of Geriatrics, the First Hospital of Lanzhou University undergone HMBT from August 2017 to April 2021 were retrospectively analyzed.According to the HMBT results, they were divided into a SIBO(+ )group and a SIBO(-)group.Polypharmacy was defined as ≥ 5 types of medications.We analyzed the difference in the rate of polypharmacy between the two groups.Results:A total of 85 hospitalized elderly patients were included in the study.Of these patients, 38(44.71%)tested positive for SIBO.Polypharmacy occurred in 41 patients(48.24%). There were significant differences in types of drugs and polypharmacy between the SIBO(+ )group and the SIBO(-)group( t=3.01 and χ2=14.33, P<0.05 for both). Moreover, polypharmacy was a risk factor for SIBO( P=0.017, OR=10.85, 95% CI: 1.52-77.29). Among 14 commonly used drugs, gastrointestinal motility drugs were closely related to SIBO.There was a positive correlation between polypharmacy and the change in hydrogen levels at 90 min( P=0.040, r=0.22, 95% CI: 0.01-0.42). Conclusions:Polypharmacy is correlated with SIBO in the elderly, is a risk factor for SIBO and is helpful in clinical practice to assess the risk of SIBO and decide further examinations, contributing to early diagnosis and early treatment.

Objective To investigate the value of early trophic feeding on maintenance of the integrity of intestinal mucosa barrier in severe traumatic patients.Methods The seriously traumatic patients were eligible for enrollment to this study from January 1st,2014 to March 31st,2015 in the intensive care unit of Xiangcheng People's Hospital.All patients were randomly divided into early enteral nutrition (EEN)group and the control group.Within 12 to 24 hours after ICU admission,all patients were fed on enteral nutrition.In the EEN group,the nutrient was reached to 25％ of target nutrient amount [104.6 kJ/ (kg · d)],and in the control group,the nutrition was reached to 60％ of the target nutrient amount.Comparisons of feeding intolerance,incidence of newly developed lung infection,the total length of hospital stay,ICU medical costs,and the markers of mucosa barrier function including lactulose/mannitol ratios (L/M),serum lactic acid level,and diamine oxidase (the first day,the third day and the seventh day) between two groups were carried out.Results Of them,56 patients were treated with early enteral nutrition.Early enteral feeding intolerance and ICU associated infection complications were significantly lower in EEN group than those in control group (P =0.012,P =0.046).There were no significant differences in ICU associated infection complications,the length of ICU stay,the length of hospital stay,ICU medical costs,L/M ratios,D-lactic acid level and diamine oxidase concentration between the two groups (P=0.135,P=0.126,P =0.223,P =0.235).Conclusions Under the seriously traumatic stress,the significantly increased intestinal mucosal permeability will be occurred early.In patients with early trophic feeding,the intestinal mucous membrane barrier function can be improved,thus decreasing ICU associated infection complications and incidence of feeding intolerance.