OBJECTIVETo verify the optimal cut-off points for overweight and obesity in Chinese adults based on the relationship of baseline body mass index (BMI) to all-cause mortality, and incidence of cardiovascular diseases from pooled data of Chinese cohorts.

METHODSThe prospective study data of existing cohort studies in China were collected, and the age-adjusted all-cause mortality stratified by BMI were estimated. The similar analysis was repeated after excluding deaths within the first three years of follow-up and after excluding smokers. The incidence of age-adjusted coronary heart disease (CHD) and stroke stratified by BMI were also analyzed. Multiple Cox regression coefficients of BMI for the incidence of CHD and stroke after controlling other risk factors were pooled utilizing the methods of weighting by inverse of variance to reveal whether BMI had independent effect and its strength on the incidence of CHD and stroke.

RESULTSThe data of 4 cohorts including 76,227 persons, with 745,346 person-years of follow-up were collected and analyzed. The age-adjusted all-cause mortality stratified by BMI showed a U-shaped curve, even after excluding deaths within the first three years of follow-up and excluding smokers. Age-adjusted all-cause mortality increased when BMI was lower than 18.5 and higher than 28. The incidence of CHD and stroke, especially ishemic stroke increased with increasing BMI, this was consistent with parallel increasing of risk factors. Cox regression analysis showed that BMI was an independent risk factor for both CHD and stroke. Each amount of 2 kg/m2 increase in baseline BMI might cause 15.4%, 6.1% and 18.8% increase in relative risk of CHD, total stroke and ischemic stroke. Reduction of BMI to under 24 might prevent the incidence of CHD by 11% and that of stroke by 15% for men, and 22% of both diseases for women.

CONCLUSIONBMI < or = 18.5, 24-27.9 and > or = 28 (kg/m2) is the appropriate cut-off points for underweight, overweight and obesity in Chinese adults.

Adult ; Aged ; Body Mass Index ; Cardiovascular Diseases ; epidemiology ; etiology ; mortality ; Cause of Death ; China ; epidemiology ; Cohort Studies ; Female ; Humans ; Male ; Middle Aged ; Obesity ; complications ; Prospective Studies ; Reference Values ; Smoking ; adverse effects ; Stroke ; epidemiology ; etiology ; mortality

Acute Disease ; Case-Control Studies ; Child, Preschool ; Echocardiography, Doppler ; Female ; Heart ; physiopathology ; Humans ; Infant ; Male ; Mucocutaneous Lymph Node Syndrome ; diagnostic imaging ; physiopathology

Aim To investigate the role of autophagy and its mechanism in Raji cell death induced by arse-nic trioxide. Methods Transmission electron micros-copy ( SEM) and MDC fluorescence staining were used to observe autophagy. MTT colorimetry was employed to assay the cellular proliferating activity. Cell apopto-sis and cell cycle analysis were performed using FITC-Annexin-V/PI double staining and flow cytometry ( FCM) . The expressions of LC3 and the conversion of LC3-I to LC3-II were measured by western bloting. The expression of bcl-2 mRNA and p53 mRNA were detected by reverse transcription-polymerase chain re-action ( RT-PCR ) . Results Arsenic trioxide could obviously inhibit the proliferation of Raji cells, arrest the cells at G2/M phase and induce apoptosis. Mean-while, arsenic trioxide markedly inhibited the expres-sion of bcl-2 mRNA and enhanced the expression of p53 mRNA in Raji cells. Arsenic trioxide also induced autophagy synchronously which paralleled with the in-duction of apoptosis in Raji cells, and 3-MA, an auto-phagy inhibitor, was able to reverse the arsenic triox-ide-activated autophagic activity, up-regulate bcl-2, down-regulated p53 expression and suppress the lethal effect of arsenic trioxide on Raji cells to reduce their sensitivity to arsenic trioxide. In contrast, the Rapamy-cin, an autophagy inducer, possessed the completely opposite effects on Raji cells compared with 3-MA. Conclusions The apoptosis and autophagic cell death are coexistent in arsenic trioxide-triggered death of Raji lymphoma cells, and Bcl-2 and p53 may play a key regulating role in this process.

Objective To explore relationship between resistin'adipenectin and insulin resistance(IR) in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods Based on polysomnography (PSG) and disease history ,68 patients were divided into three groups: mild ( L, n = 24 ), moderate ( M, n = 13 ), severe ( S, n = 31 ) OSAHS, and normal control ( n = 20 ). Fasting serum glucose, insulin, lipoids, resistin and adipanectin were measured. HOMA-IR was calculated, the correlation between HOMA-IR and resistin, adiponectin, lipoids, body mass index, waist-to-hip ratio, apnea-hypopnea index ( AHI), the lowest saturation of blood oxygen ( LSaO2) and the per-centage of total sleep time spent with an oxygen saturation less than 90% (T90) were analysed. Results The levels of serum resistins in each OSAHS group were (8.04 ±2. 14), ( 10.85±4.89 ), ( 13.34±3.52 )mg/L, and were sig-nificantly higher than those in control group ( 9.49 ± 2.40) mg/L ( P < 0.05 ), S were significantly higher than L (P<0.05) ;The levels of serum adiponectin of OSAHS groups were(6. 21 ± 1.74), (4. 19±1.80), (2.26± 1.17 ) mg/L, and were significantly lower than those in control group(9.49±2.40) mg/L (P < 0.05 ), and the inter-group differences were statistically significant (P <0. 05). HOMA-IR of M and S were(4.07±0.97), (5.61± 2.26) significantly higher than those of L and control group( 1.57 ±0. 58 ), (2.47 ±1.52 ) ( P < 0.05 ), and inter-group differences between M and S were statistical significant( P < 0.05 ). Spearman correlation analysis showed that HOMA-IR was significantly positive correlated with resistin, total cholesterol, triglyceride, body mass index,waist-hip rafio,AHI,T90( r =0. 794,0.438,0. 430,0. 351,0. 456,0.775,0.624 ,P <0.01 ) ,negative with adiponectin, LSaO2 (r=-0.563, -0.623 ,P <0.01 ). Partial correlation analysis showed that after the effect of adiponeetin and resis-tin were controlled,HOMA-IR was significant positive correlation with T90 and AHI(r =0.231,0.358 ,P <0.05 ). Multiple stepwise regression analysis showed that, to HOMA-IR, resistin and AHI were the most significant impact factors (R2 =0.613,F=69.810,P<0.01). Conclusions HOMA-IR is significantly positively correlated with the severity of OSAHS,independent of the blood lipids, body mass index, waist-hip ratio, resistin, adiponectin and other factors;the effects of blood lipids,body mass index,waist-hip ratio and other factors on HOMA-IR probably depend on resistin and adiponectin;AHI and plasma resistin level may determine the level of insulin resistance in patients with OSAHS.

Adult ; Antigens, CD34 ; metabolism ; Diagnosis, Differential ; Female ; Frontal Bone ; Hemangioma ; metabolism ; pathology ; surgery ; Hemangioma, Cavernous ; pathology ; Humans ; Platelet Endothelial Cell Adhesion Molecule-1 ; metabolism ; Sarcoma, Kaposi ; metabolism ; pathology ; Skull Neoplasms ; metabolism ; pathology ; surgery

Dust ; analysis ; Humans ; Magnoliopsida ; Pneumoconiosis ; epidemiology ; Prevalence

Adrenal Hyperplasia, Congenital ; complications ; metabolism ; Body Height ; Growth Disorders ; etiology ; Humans ; Risk Factors ; Steroid 21-Hydroxylase ; metabolism

OBJECTIVEFor prevention of obesity in Chinese population, it is necessary to define the optimal range of healthy weight and the appropriate cut-off points of BMI and waist circumference for Chinese adults. The Working Group on Obesity in China under the support of International Life Sciences Institute Focal point in China organized a meta-analysis on the relation between BMI, waist circumference and risk factors of related chronic diseases (e.g., high diabetes, diabetes mellitus, and lipoprotein disorders).

METHODS13 population studies in all met the criteria for enrollment, with data of 239,972 adults (20-70 year) surveyed in the 1990s. Data on waist circumference was available for 111,411 persons and data on serum lipids and glucose were available for more than 80,000. The study populations located in 21 provinces, municipalities and autonomous regions in mainland China as well as in Taiwan. Each enrolled study provided data according to a common protocol and uniform format. The Center for data management in Department of Epidemiology, Fu Wai Hospital was responsible for statistical analysis.

RESULTS AND CONCLUSIONThe prevalence of hypertension, diabetes, dyslipidemia and clustering of risk factors all increased with increasing levels of BMI or waist circumference. BMI at 24 with best sensitivity and specificity for identification of the risk factors, was recommended as the cut-off point for overweight, BMI at 28 which may identify the risk factors with specificity around 90% was recommended as the cut-off point for obesity. Waist circumference beyond 85 cm for men and beyond 80 cm for women were recommended as the cut-off points for central obesity. Analysis of population attributable risk percent illustrated that reducing BMI to normal range (< 24) could prevent 45%-50% clustering of risk factors. Treatment of obese persons (BMI > or = 28) with drugs could prevent 15%-17% clustering of risk factors. The waist circumference controlled under 85 cm for men and under 80 cm for women, could prevent 47%-58% clustering of risk factors. According to these, a classification of overweight and obesity for Chinese adults is recommended.

Adult ; Aged ; Body Mass Index ; Body Weight ; China ; Diabetes Mellitus ; epidemiology ; ethnology ; Female ; Health Surveys ; Humans ; Hypertension ; epidemiology ; ethnology ; Male ; Middle Aged ; Obesity ; classification ; complications ; ethnology ; Reference Values ; Risk Factors ; Sex Factors ; Thorax ; anatomy & histology

Objective To explore the expression of transforming growth factor ?1(TGF-?1)in the mucosa of guinea pigs with otitis media with effusion(OME)and the role of TGF-?1 in the development of OME.Methods 70 guinea pigs were randomly devided into 7 groups,each with 10 animals.OME was produced by injecting deactivated streptococcus pneumoniae into the typmpanic cavity of guinea pigs.The expression of TGF-?1 was examined by means of immunohistochemistry 6 h,1 d,3 d,7 d,14 d and 30 d after injection.Results TGF-?1 expression could be detected in the middle ear mucosa at 7 d after injection and reached maximum at 30 d.Conclusion TGF-?1 is expressed in the middle ear mucosa of the guinea pigs with OME induced by deactivated streptococcus pneumoniae,and this indicates that TGF-?1 may play a role in the chronic protraction of OME.

OBJECTIVE: To investigate the correlationship between the assessment of subjective and objective in patients with chronic(CRS) rhinosinusitis before and after FESS. METHOD: Seventy patients with CRS were objectively assessment of VAS and subjectively assessment including the Lund-Kennedy endoscopic scale and Lund-Mackay scale. All patients were followed up 1 year and repeated both the objective and subjective assessment. The correlationship among the different assessments were investigated and the scales of before and after FESS were compared. RESULT: There were positive correlation between the scale of VAS and Lund-Mackay(r = 0.866, P < 0.01), positive correlation between the scale of Lund-Kennedy and Lund-Mackay(r = 0.803, P < 0.01), and positive correlation between the scale of VAS and Lund-Kennedy (r = 0.912, P < 0.01) before the FESS. There were positive correlation between scale of VAS and Lund-Kennedy after 6 and 12 months of FESS with the r-value of 0.798 and 0.882 respectively. The scales of VAS including nasal obstruction, nasal discharge and head pain have positive correlation with the total scale of Lund-Kennedy with r-value of 0.691, 0.760 and 0.751 respectively. And the scales of VAS including hyposmia and general malaise have positive correlation with the total scale of Lund-Kennedy with r-value of 0.327, and 0.438 respectively. The scale of Lund-Mackay before has positive correlation with both the scale of Lund-Kennedy and VAS. CONCLUSION In patients with CRS, there were correlations among the scales of CT assessment, nasal endoscopic evaluation and VAS before FESS, and there were also correlations between the scales of CT assessment and nasal endoscopic evaluation after 6 and 12 months of FESS. It indicated that to evaluate the patients with CRS properly, the comprehensive assessment including subjective and CT and endoscopic scale should been applied in clinic.
Adolescent ; Adult ; Chronic Disease ; Endoscopy ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Nose ; surgery ; Sinusitis ; surgery ; Treatment Outcome ; Young Adult