Objective Metabolic syndrome ( MS), a disorder involving multiple metabolic abnormalities such obesity,hypertension, diabetes or abnormal glucose tolerance and dyslipidemia, has been observed in many patients receiving coronary artery bypass procedures. In this study we try to examine the perioperative effects of metabolic syndrome on the off-pump coronary artery bypass (OPCABG). Methods A prospective study was conducted in 1060 consecutive OPCABG patients who were admited to Beijing Anzhen Hospital from July 2009 to March 2010. The patients were grouped as MS group and non-MS group according to the diagnostic criteria for Chinese metabolic syndrome. The outcomes such as mortality, atrial fibrillation,stroke, staying in ICU for more than three days, use of IABP, ECMO, dialysis, multiple organ dysfunction score ( MOOS) ,postoperative score for cardiac surgery (PSCS), PaO2/FiO2 , heart rate x central venous pressure/mean artery pressure(pressure-adjusted heart rate, PAHR) ,renal and liver function, platelets, and the dosage of vasoactive agents were analyzed and compared between the two groups by x2 test or t test. Results Three hundred and eighty-nine cases were diagnosed with MS among 1060 cases with OPCABG. In the MS group, 17 cases stayed in ICU for more than 3 days, 2 cases died, 76 had atrial fibrillation, 3 had stroke, 18 cases were treated with intra-aortic balloon counterpulsation (IABP). In the non-MS group, 47 cases stayed in ICU for more than 3 days, 12 cases died, 148 had atrial fibrillation, 3 had stroke, 48 cases were treated withIABP, 3 cases received ECMO and 4 cases received dialysis. No significant difference between MS group and non-MS group was identified in the aspects of mortality, atrial fibrillation, stroke, duration of more than three days in ICU, the use of IABP,ECMO, dialysis after OPACBG based on the x2 test(P＞0.05). However, on the operative days, the MODS and PSCS in MS group were significantly higher than that in non-MS group (P ＜ 0.05). MODS 2. 57 ± 1. 62 in MS group vs. 2. 15 ± 1.65 in non-MS group, PSCS 4.27 ±2.15 in MS group vs. 3.92 ±2.29 in non-MS group. PaO2/FiO2 in MS group was significantly lower than that in non-MS group (249.23 ± 110.99 vs. 283. 33 ± 114. 35), P ＜ 0. 01. PAHR in MS group was significantly higher than that in non-MS group (9.98 ±3.54 vs. 9.23 ±3. 88), P ＜0.05. On the first postoperative days, the MODS in MS group was also significantly higher than that in non-MS group (3.05 ±1.64 vs. 2.82 ± 1.72), P＜0.05. PaO2/FiO2 in MS group was significantly lower than that in non-MS group (277.11 ±122.99 vs.318.47 ±143.84), P＜0.05. Conclusion MS was not a predictor for death, atrial fibrillation, stroke, duration of more than three days in 1CU, the use of IABP, ECMO, dialysis after OPACBG. However, MS had a temporary adverse effect on the respiratory and circulatory systems on the operative day and the first postoperative day after OPCABG.

Purpose:To investigate inhibitory effect of Heplipin on the growth of S37 and B16 implanted into Kunming and C57 mouse respectively. Methods:Heplipin was administrated through gastric inhabatin with the dose of each day such as 3 000 mg/kg (large dose group) 1800 mg/kg(medial dose group) and 1100 mg/kg different (small dose group). Cycolo phosphaincole(CTX, each day 20 mg/kg) and normal saline wasused as postive and negative control respectively. The rates in tumor inhibition, the number of blood vessels, and the rate of necrosis area was tested.Results:The growth suppression of Heplipin to S37 sarcoma and B16 melanoma was 75.1% (large dose, P

Objective Patients in the intensive care unit (ICU) are at high risk for multi-organ failure and death. Few well-established scoring systems have been used in the cardiac surgery. We try to identify a feasible score system for the risk assessment after CABG. Methods 1028 consecutive patients who had received CABG and staying in a single cardiac postoperative intensive care unit of Anzhen hospital were enrolled in the prospective study between October of 2007 and May of 2008 and assessed daily with three score systems, the multiple organ dysfunction score (MODS), the sequential organ failure assessment (SOFA) and our postoperative score for cardiac surgery (PSCS). Four new variances were added to PSCS system, which were Euroscore, IABP, ECMO and dialysis. Euroscore was considered as a preoperative factor which provided the preoperative information of the patient. IABP and ECMO were considered as assistant factors to support circulatory system. The dialysis was also considered as an assistant factor to support renal system. The differences with the respects of sensitivity and specificity among the three systems were compared with Hosmer-Lemeshow goodness-of-fit and receiver operating characteristic (ROC)curve. Results The new variances added to PSCS system were shown to be associated with mortality in a multivariate logistic regression analysis. The EXP(B) value for Euroscore was 3. 803, the EXP(B) value for IABP was 1. 645, the EXP(B) value for ECMO was 3.803, and the EXP(B) value for dialysis was 1.605. In discrimination analysis, ROC values of the operative day score were 0.602 for MODS, 0.571 for SOFA, and 0. 821 for PSCS; ROC values of the maximum score were 0.847 for MODS, 0.830 for SOFA, and 0.929 for PSCS; ROC values of the maximum score during the first 3 days were 0.838 for MODS, 0.814 for SOFA, and 0.919 for PSCS; score changes of ROC value between the third day and the first day were 0.767 for MODS, 0.779 for SOFA, and 0. 780 for PSCS. In calibration analysis, we compared the x2 values, P values and overall corrected percentage of the three different systems. x2 values of the three systems were 6. 763 for MODS, 4. 101 for SOFA, and 1.687 for PSCS; P values of the three systems were 0.454 for MODS, 0. 848 for SOFA, and 0. 975 for PSCS; overall corrected percentages of the three systems were 98.1%, 98%, and 98.3% respectively. Conclusion The sensitivity and specificity of PSCS were superior to MODS and SOFA in predicting death risk after CABG.

Objective To determine the value of CT and MRI in the evaluation of littoral cell angioma(LCA) of spleen.Methods Two experienced radiologists retrospectively analyzed the clinical data,CT and MRI findings of 12 patients with pathology proven LCA of spleen.The patients underwent noncontrast enhanced CT scan,then enhanced CT (n =10) and MRI (n =3) were performed.Results The majority of patients (8/12) showed splenomegaly,with no obvious signs and symptoms of hypersplenism.The majority of patients (10/12) had the uncountable hypodense lesions,a few (2/12) had only a single lesion.None of the lesions contained any calcification or envelopement.On CT,the majority (7/10) of the lesions demonstrated well circumscribed border,with some lesions (3/10) demonstrating a less distinct border.The enhanced scan for low-density nodules demonstrated slow progressive enhancement.On MRI,all the LAC had well circumscribed borders,and demonstrated T1-hypointense and T2-hyperintense signalswith punctual hypointense in the T2 WI,and progressive enhancement on the post contrast images.DWI showed an increased diffusion of the lesions compared to the normal appearing splenic tissue.Conclusion CT and MR imaging of littoral cell angioma of spleen has certain imaging characteristics,those particular findings may potentially aid in the diagnosis.

OBJECTIVETo investigate the status quo and influence factors of self monitoring of blood glucose (SMBG) and self-efficacy of diabetes patients' that participated in community diabetes self management group.

METHODSBeijing, Shanghai, Chongqing, Jiangsu, Guangdong, and Zhejiang were selected as the study sites considering patients management experiences they had. 1 401 adult diabetes patients were recruited from communities via health records system screening, telephone notification, poster advertisement, letters invitation ways. Face to face questionnaire survey was applied to obtain patients' general information, diabetes history, diabetes knowledge awareness, SMBG, and self-efficacy information. Multiple linear regression was used to analyze the relationship between factors and self efficacy.

RESULTSThere were 519 male patients (37.0%) and 882 female patients (63.0%) with an average age of (64.9 ± 8.9) years old. Patients lived in city accounted for 48.0% (672/1 401) and rural patients accounted for 52.0% (729/1 401). Patients who conducted SMBG accounted for 79.9% (1 120/1 401) and 33.3% (446/1 401) patients conducted blood glucose monitoring 1-3 times per month. Rural patients, primary school educated, and new rural cooperative medical system (NCMS) covered patients had a higher proportion of never conducting SMBG which were 21.9% (160/729), 24.2% (160/662), and 26.3% (125/475) , respectively. Scores of self-efficacy was (69.24 ± 16.30) (hundred-mark system) with a relative lower score in monitoring of blood glucose (64.09 ± 20.08) and foot care (63.63 ± 21.40), as well as a highest score in taking medicine and insulin injections (76.10 ± 22.00). Multiple regression analysis on self-efficacy and its related factors show a negative correlation between patients' place of residence and self-efficacy (β' = -0.076) and a positive correlation between education and self-efficacy (β' = 0.114) as well as between diabetes knowledge awareness and self-efficacy (β' = 0.193)(t = -2.46, 3.71, 7.18, P < 0.05).

CONCLUSIONCommunity diabetes patients had a low self-efficacy and it was even lower among low economic and education degree patients. The worst parts were SMBG and foot care. Place of residence, education, and diabetes knowledge awareness are factors that influence patients' self efficacy.

Aged ; Aged, 80 and over ; Blood Glucose ; Blood Glucose Self-Monitoring ; statistics & numerical data ; China ; epidemiology ; Diabetes Mellitus ; therapy ; Female ; Foot ; Humans ; Insulin ; Male ; Medication Adherence ; statistics & numerical data ; Middle Aged ; Regression Analysis ; Self Efficacy ; Surveys and Questionnaires

Sepsis is a critical illness with high morbidity and mortality. Anaerobic glycolysis plays an important role in the pathogenesis of sepsis. Pyruvate dehydrogenase complex (PDHC) serves as a key regulator during sepsis. With PDHC dephosphorylation and deacetylation, PDHC activity is upregulated, allowing pyruvate translocate to mitochondria in aerobic condition, preceding the production of acetyl-CoA to accelerate aerobic oxidation. Activation of PDHC improves the prognosis of sepsis through regulating the balance of lactate, release of inflammatory factors and energy metabolism. A variety of remedies can improve the prognosis of patients with sepsis by up-regulating the activity of PDHC, including dichloroacetate (DCA), vitamin B1, milrinone, tumor necrosis factor binding protein, and ciprofloxacin.This article reviews the role and the regulatory mechanism of PDHC and signal pathway in the sepsis metabolism, in order to innovate treatment for sepsis and multiple organ dysfunction.

Objective:To analyze the mortality level and trend of chronic and non-communicable diseases (NCDs) among elderly residents aged 65 and over in China from 2004 to 2018, and predict the age-standardized mortality rate of NCDs from 2019 to 2023.Methods:Data on resident death was collected from the National Mortality Surveillance data set and used to analyze the unstandardized mortality rates, age-standardized mortality rates, composition ratios and changing trends of NCDs among different genders, urban and rural areas, and geographical regions in China during 2004 to 2018. The age-standardized mortality rates were calculated based on the Year 2010 Population Census of China. The Joinpoint Regression Models were fitted by the weighted least squares method. The average annual percent change (AAPC) and its 95% confidence interval for the entire time period were calculated. Log-linear models were used to predict age-standardized mortality rates.Results:From 2004 to 2018, the age-standardized mortality rates of NCDs decreased from 4 697.05 per 100 000 to 3 555.35 per 100 000, with an average annual decline of 2.0% (95% CI: -2.7%- -1.3%). The age-standardized mortality rates among different genders, urban and rural areas, and regions showed a downward trend. The age-standardized mortality rates of eastern region (AAPC = -2.1%, 95% CI: -2.8%- -1.3%) and central region (AAPC = -2.8%, 95% CI: -3.4%- -2.1%) fell faster than that of western region (AAPC = -0.8%, 95% CI: -1.8%-0.2%). The proportion of deaths caused by NCDs increased from 89.82% to 91.41%, with an average annual increase of 0.1% (95% CI: 0.1%-0.2%). Expected to 2023, the age-standardized mortality rates for male (3 906.23 per 100 000) will be significantly higher than female's (2 708.43 per 100 000); and that in rural areas (3 283.20 per 100 000) will be approximately equal to that in urban areas (3 250.01 per 100 000); the gap of age-standardized mortality rate between the western (3 782.48 per 100 000), eastern (3 037.01 per 100 000), and central region (3 249.24 per 100 000) will be further increased. Conclusion:From 2004 to 2018, age-standardized mortality rates of NCDs of the elderly residents in China showed a downward trend, and the proportion of deaths of NCDs showed an upward trend. Male and the western region elderly residents should be the key population for prevention and control of chronic diseases in the future.

Objective To understand the'backward'provinces and the relatively poor work among the construction of National Demonstration Area,so as to promote communication and future visions among different regions.Methods Methods on Cluster analysis were used to compare the development of National Demonstration Area in different provinces,including the coverage of National Demonstration Area and the scores of non-communicable disease (NCDs) prevention and control work based on a standardized indicating system.Results According to the results from the construction of National Demonstration Area,all the 29 provinces and the Xinjiang Production and Construction Corps (except Tibet and Qinghai) were classified into 6 categories:Shanghai;Beijing,Zhejiang,Chongqing;Tianjin,Shandong,Guangdong and Xinjiang Production and Construction Corps;Hebei,Fujian,Hubei,Jiangsu,Liaoning,Xinjiang,Hunan and Guangxi;Shanxi,Jilin,Henan,Hainan,Sichuan,Anhui and Jiangxi;Inner Mongolia,Shaanxi,Ningxia,Guizhou,Yunnan,Gansu and Heilongjiang.Based on the scores gathered from this study,24 items that representing the achievements from the NCDs prevention and control endeavor were classified into 4 categories:Manpower,special day on NCD,information materials development,policy/strategy support,financial support,mass media,enabled environment,community fitness campaign,health promotion for children and teenage,institutional structure and patient self-management;healthy diet,risk factors on NCDs surveillance,tobacco control and community diagnosis;intervention of high-risk groups,identification of high-risk groups,reporting system on cardiovascular and cerebrovascular events,popularization of basic public health service,workplace intervention programs,construction of demonstration units and mortality surveillance;oral hygiene and tumor registration.Contents including oral hygiene,tumor registration,intervention on high-risk groups,identification of high-risk population,reporting system on cardiovascular and cerebrovascular events,popularization of basic public health service,workplace intervention programs,construction of demonstration units and mortality surveillance were discerned as the relatively weak areas in the construction programs of National Demonstration Area.Conclusions Western regions,especially in some remote provinces had the poorest performance during the construction of National Demonstration Area.Programs regarding chronic disease surveillance,identification and intervention on high-risk groups showed the lowest scores and these outcome-oriented tasks should be further focused on,during the next term of review,in these areas.

Objective To evaluate the effect of a community?based intervention supporting type 2 diabetes mellitus patients in their self?management of the disease. Methods This research was a randomized controlled trial conducted in communities in Fangshan District, Beijing, China. Adult patients with type 2 diabetes from 17 communities in 4 sub?district of Fangshan District were randomly assigned to either the intervention or control group. Participants in the intervention group participated in a three?month group?based diabetes self?management intervention service. Data were collected both in intervention and control group at baseline and after the intervention to evaluate the effect of the intervention. A questionnaire survey was completed by all participants to collect their demographic information, diabetes related health behaviors and skills. A physical examination and lab testing including height, weight, blood pressure, and waist circumference as well as HbA1c, fasting blood glucose, lipid profile were conducted before and after the intervention. Results A total of 500 valid questionnaires were received, including 259 in the intervention group and 241 in the control group. Patients in the intervention group who learned how to conduct the self?monitoring of blood glucose increased from 56.76% (n=147) to 87.26% (n=226) after the intervention, higher than that of control group (63.07%, n=152) (P<0.001). 69.50%(n=180) patients in intervention group had blood glucose monitor at home, which was 60.62% (n=157) prior to the intervention and higher than that of control group (57.68%, n=139) (P=0.004). After the intervention, 3.09% (n=8) patients in intervention group ceased to take medicine by themselves, which was 16.22% (n=42) before the intervention, while the control group was 8.30% (n=20) after the intervention (P=0.009). Patients in the intervention group made significant improvements in implementing self monitoring on blood glucose (SMBG), which was increased from one day per week to 2 days per week, and foot self?examination, which increased from 2 days per week to 7 days per week. The body weight of patients in the intervention group reduced 1.62 kg on average after the intervention, while it increased 0.88 kg in the control group. Similar improvement was found in waist circumstance between the intervention and control group (-0.83 cm vs-0.16 m). There was a significant reduction on body weight and waist circumstance in the intervention group (P<0.05). Conclusion The group activities focusing on people with type 2 diabetes resulted in improvement in their lifestyle and self management behaviors, as well as their body weight and waist circumstance.

Objective:To analyze the changes in self-efficacy and its influencing factors in type 2 diabetic patients after community-based self-management group intervention.Methods:From August to November 2014, a 3-month community-based self-management intervention study of type 2 diabetes patients was implemented in Fangshan District, Beijing. 510 patients were recruited through posters, household inquiries and telephone notification and then were randomly divided into intervention group (260 patients) and control group (250 patients). Finally, 500 patients completed the study, including 259 in the intervention group and 241 in the control group. Self-efficacy score was measured through face-to-face interview at different time points, including pre-intervention, post-intervention, 2 years after the intervention and 5 years after the intervention, respectively. A two-level random coefficient model was fitted to analyze the long-term trend of self-efficacy and its relationship with group intervention.Results:Individual-level educational attainment, disease duration as well as their treatment plans had a positive correlation with self-efficacy of type 2 diabetic patients while gender and age did not affect their self-efficacy. Patients with junior middle school education, senior high school education and university and above education had 4.66 ( P<0.05), 6.40 ( P<0.05) and 11.02 ( P<0.05) points higher than those with primary education, respectively. The self-efficacy of diabetic patients increased by 0.23 ( P<0.05) for each additional course year. The effect of treatment plan on self-efficacy was mainly reflected in the self-efficacy of taking medication or insulin injection as prescribed and blood glucose monitoring. After controlling for the confounding factors, i.e., gender, age, disease duration, educational attainment, and treatment plan, self-efficacy scores at the post-intervention increased in both groups compared to those at the pre-intervention. The intervention group had 7.95 points higher than the control group ( P<0.05). After the intervention, the self-efficacy scores of both groups decreased year by year while the intervention group declined faster, with 5.41 points ( P<0.05) at 2 years after the intervention and 8.94 points ( P<0.05) at 5 years after the intervention. Conclusion:Community-based self-management group intervention could improve the self-efficacy of type 2 diabetic patients while the self-efficacy decreases year by year in the absence of follow-up intervention.