Objective To evaluate the changes of CD4+ CD25+ regulatory cells (Treg) in peripheral blood and the serum levels of transforming growth factor beta-1 (TGF-β1)in elderly patients with hepatocellular carcinoma. Methods The ratios of Treg in the peripheral blood of patients aged over 80 years from 22 hepatocellular carcinoma,26 metastatic liver cancer,20 healthy controls,were determined by flow cytometry.Meanwhile,the serum levels of TGF-β1 were detected by ELISA.Results The ratio of Treg to total CD; T cells in the peripheral blood [(9.71±3.23)％ vs.(5.81±1.18)％,P＜0.01]and the serum levels of TGF-β1 [(78.10±29.41)ng/L vs.(7.78± 3.54) ng/L,P＜0.01]of elderly patients with hepatocellular carcinoma were significantly higher than those in the healthy controls.Meanwhile,the ratio of Treg to total CD[ T cells in the peripheral blood [(9.71±3.23)％ vs.(7.36±2.07) ％,P＜0.05]and the serum levels of TGF-β1[(78.10± 29.41 )ng/L vs.(19.33± 10.90) ng/L,P＜ 0.01 ]in the patients with hepatocellular carcinoma was increased as compared with those in metastatic liver cancer (P＜0.05 or P＜0.01).The correlation indicated that the ratio of Treg to total CD4+ T cells in the peripheral blood were positively related with TGF-β1 levels and tumor clinical stage(r=0.698 and 0.782,P＜ 0.01 ),but negatively with Karnofsky performance status score(KPS) (r=-0.643,P＜0.01). Conclusions The ratio of Treg to total CD4+ T cells in the peripheral blood from elderly hepatocellular carcinoma is increased and correlated with TGF-βl level,tumor clinical stage and KPS.It might helpful to determine the prognosis of elderly hepatocellular carcinoma by detecting the ratio of Treg to total CD4+ T cells in the peripheral blood.

Objective The aim of this study was to evaluate the benefits of i.v. iron therapy in iron-defi-cient patients with left ventricular ejection fraction preserved heart failure (HFpEF). Methods 61 HFpEF pa-tients with iron deficiency were randomized to treatment with or without i.v. iron,as ferric carboxymaltose(FCM, n = 31)or placebo(saline,n = 29)for 24 weeks of a double-blind,placebo-controlled trial. The primary end-point was the change in 6-min-walk-test(6MWT)distance from baseline to Week 24. Secondary end-points includ-ed changes in New York Heart Association(NYHA)class,health-related quality of life(QoL),with NT-proBNP under observation. Results Compared with the control group at week 16 and 24,the iron treatment group has much more improve in 6MWT and the health-related quality of life(HRQoL)(P<0.05). The changes in NT-proB-NP level and NYHA heart function classification only show significance at week 24(P<0.05)but not at week 16 (P>0.05). Conclusion In this study,Treatment with intravenous ferric carboxymaltose can improve symptoms, functional capacity,and quality of life.

The study intended to evaluate the effect of high-dese atorvastafin on serum high sensitive C-reactive protein (hs-CRP) and renal function in patients with acute myocardial infarction undergoing elective pereutancous coronary intervention ( PCI ). One hundred and sixty seven patients were randomly divided into two groups: in test group (n =84) patients received oral atorvastatin 80 mg/d and in control group (n = 83) patients received atorvastatin 20 mg/d, the medication in both groups was lasted for 7 days before PCL Compared to levels at 24 h before PCI, serum hs-CRP and creatinine levels at 48 h after PCI were increased in both groups ( both P < 0. 05), and glomerular filtration rate was decreased ( P < 0. 05 ). Compared to control group, serum hs-CRP and creatinine levels 24 h before PCI and 48 h after PCI in test group were significantly lower, and glomerular filtration rate was significantly higher (P <0. 05, respectively). The incidence of contrast-induced nephropathy was lower in test group than that in control group[7% (6/84) vs.18% (15/83), P <0.05]. The results indicate that high-dose atorvastatin might be effective in protecting patients with acute myocardial infarction undergoing elective PCI from contrast-induced nephropathy via inflammatory response inhibition.

Objective:To compare serum level of β thromboglobulin in patients with coronary heart disease (CHD) complicated different complications.Methods:According to their complications,a total of 398 patients with unsta- ble angina pectoris (UAP)were divided into pure UAP group (UAP control group,n=82),hypertension group (n=89),diabetes mellitus (DM)group (n=133)and brain infarction group (n=94).Serum level of β thromboglobu- lin were measured and compared among four groups 6h after onset and before discharge.Incidence of myocardial in- farction within six months were followed up in four groups.Results:On 6h after onset,the serum level of β throm- boglobulin of brain infarction group,DM group,hypertension group,UAP control group was (61.13±3.32)ng/ml,(59.77±3.15)ng/ml,(52.12±3.27)ng/m, (48.55±3.14)ng/ml respectively,in which the level of brain infarction group was the highest,the difference between any two groups were significant (P<0.01 all);Compared with 6h after onset,there were significant reductions in serum levels of β thromboglobulin of four groups before dis- charge P<0.01 all,their ordering and difference significant degree were no change.The incidence of myocardial infarction (MI)in brain infarction group,DM group,hypertension group,UAP control group was 11.7%,6.0%, 3.4%,2.4% respectively,the MI incidence of brain infarction group was significant more than that of UAP con- trol group,the differences among other groups was no significant,P>0.05.Conclusion:β-thromboglobulin level during UAP onset is significant higher than that of remission period,and it rises most significantly in brain infarction group,and in this group the percentage of myocardial infarction occurred within six months is highest

OBJECTIVETo investigate the quantity, quality and effect of health management service project for patients with hypertension and diabetes in basic public health service project of Sichuan province.

METHODS44 health clinics or community health service center, 22 counties and 11 cities was extracted by method of multistage stratified sampling on March, 2014. In each institution we sampled 10 resident health record of hyperpietic and 10 of diabetic. Number of managed patients was recorded to calculate the rate of health management. Telephone survey was used to judge the accuracy and standardability of services the patients received according to the national basic public health service specifications. We compared the satisfaction rate and blood pressure/blood sugar control rate of patients which had accurate record to which had not, and which got normative services to which didn't.

RESULTS33.8% (69 680/206 154) of the hyperpietics and 24.0% (25 562/106 508) of the diabetics were managed. 81.16% (702/865) of the records were with accurate information. 74.36% (522/702) of the patients received normative services. Blood pressure was well controlled in 86.92% (299/344) of the hyperpietics, and FPG was well controlled in 85.46% (288/337) of the diabetics. The satisfaction rate was 94.58% (698/738). The satisfaction rate of patients which had accurate record was 98.69% (677/686), but of which had not was just 40.38% (21/52) (χ² = 320.52, P < 0.001). The satisfaction rate of patients which got normative services was 99.22% (508/512), and of which did not get was 97.13% (169/174) (χ² = 2.92, P = 0.087).

CONCLUSIONThe quality of managed chronic patients was well, and got obvious effect. Measures need to implement for increasing the management rate, accuracy and standardability of health management services for hyperpietic and diabetic.

Objective: To explore the association between DNA methylation and body mass index (BMI) using Mendelian randomization analysis. Methods: A total of 469 participants were selected from the Chinese National Twin Registry in 2013, who were living in Shandong, Jiangsu, Zhejiang, and Sichuan provinces, and at least 18 years of age. A questionnaire survey and physical examination were conducted to collect demographic, clinical, and behavioral information. Peripheral blood cells were collected to detect genotype and methylation status. Association analyses between DNA methylation and BMI and between CpGs and cis-SNP were conducted. With rs748212 as the instrumental variable, the association between cg15053022 and BMI was explored using the Mendelian randomization method. Results: A total of 469 participants were selected. The mean age of participants was (44.8±13.2) years and the BMI was (25.0±3.8) kg/m². Nine BMI-related DNA methylation sites were found and DNA methylation site cg15053022 in the ATP4A gene was negatively associated with cis-SNP rs748212 (β=-0.020); the mean methylation level of AA, AC, and CC were 0.212±0.025, 0.242±0.024, and 0.264±0.028, respectively. rs748212 was associated with BMI (β=0.04, P=0.007) and closely related to cg15053022 (F=237.66, P=0.143). Mendelian randomization analysis showed lower methylation levels at cg15053022 were associated with higher BMI (β=-1.97, P<0.001). Conclusion This study supported the impact of cg15053022 methylation in the ATP4A gene on BMI using Mendelian randomization analysis and provided the basis for using Mendelian randomization analysis in methylation studies.

Objective To investigate the quantity, quality and effect of health management service project for patients with hypertension and diabetes in basic public health service project of Sichuan province. Methods 44 health clinics or community health service center, 22 counties and 11 cities was extracted by method of multistage stratified sampling on March,2014. In each institution we sampled 10 resident health record of hyperpietic and 10 of diabetic. Number of managed patients was recorded to calculate the rate of health management. Telephone survey was used to judge the accuracy and standardability of services the patients received according to the national basic public health service specifications. We compared the satisfaction rate and blood pressure/blood sugar control rate of patients which had accurate record to which had not, and which got normative services to which didn't. Results 33.8%(69 680/206 154) of the hyperpietics and 24.0% (25 562/106 508) of the diabetics were managed. 81.16%(702/865) of the records were with accurate information. 74.36%(522/702) of the patients received normative services. Blood pressure was well controlled in 86.92%(299/344) of the hyperpietics, and FPG was well controlled in 85.46%(288/337) of the diabetics. The satisfaction rate was 94.58% (698/738). The satisfaction rate of patients which had accurate record was 98.69%(677/686), but of which had not was just 40.38% (21/52) (χ2=320.52,P<0.001). The satisfaction rate of patients which got normative services was 99.22% (508/512), and of which did not get was 97.13% (169/174) (χ2=2.92,P=0.087). Conclusion The quality of managed chronic patients was well, and got obvious effect. Measures need to implement for increasing the management rate, accuracy and standardability of health management services for hyperpietic and diabetic.

Objective To investigate the quantity, quality and effect of health management service project for patients with hypertension and diabetes in basic public health service project of Sichuan province. Methods 44 health clinics or community health service center, 22 counties and 11 cities was extracted by method of multistage stratified sampling on March,2014. In each institution we sampled 10 resident health record of hyperpietic and 10 of diabetic. Number of managed patients was recorded to calculate the rate of health management. Telephone survey was used to judge the accuracy and standardability of services the patients received according to the national basic public health service specifications. We compared the satisfaction rate and blood pressure/blood sugar control rate of patients which had accurate record to which had not, and which got normative services to which didn't. Results 33.8%(69 680/206 154) of the hyperpietics and 24.0% (25 562/106 508) of the diabetics were managed. 81.16%(702/865) of the records were with accurate information. 74.36%(522/702) of the patients received normative services. Blood pressure was well controlled in 86.92%(299/344) of the hyperpietics, and FPG was well controlled in 85.46%(288/337) of the diabetics. The satisfaction rate was 94.58% (698/738). The satisfaction rate of patients which had accurate record was 98.69%(677/686), but of which had not was just 40.38% (21/52) (χ2=320.52,P<0.001). The satisfaction rate of patients which got normative services was 99.22% (508/512), and of which did not get was 97.13% (169/174) (χ2=2.92,P=0.087). Conclusion The quality of managed chronic patients was well, and got obvious effect. Measures need to implement for increasing the management rate, accuracy and standardability of health management services for hyperpietic and diabetic.

Objective:To quantitate the association between birth weight and phenotypes of physical indicators in adulthood, i.e. BMI and waist circumference (WC) and to what degree genetic or environmental factors affect birth weight-obesity association.Methods:A total of 6 623 gender matched twin pairs aged 25 to 79 years were recruited through the Chinese National Twin Registry. The twins reported their own birth weight, current height and weight, and WC using a self-administered questionnaire. BMI was calculated according to the self-reports of body height and weight. Within twin-pair design was used to quantitate the association between birth weight and phenotypes related to obesity while bivariate structural equation models were used to decompose the phenotype correlation.Results:After adjusted for multiple factors, twin-pair analyses within monozygotic (MZ) showed that, on average, a 1.0 kg increase in birth weight corresponded to an increase of 0.33 kg/m 2 in BMI and 0.95 cm in WC in adulthood ( P<0.001). Bivariate structural equation models showed significant positive unique environmental correlation between birth weight and the two obesity-related phenotypes. Conclusion:The study supported the role of twin-specific supply line factors on relationship between birth weight and physical indicators in adulthood.

Objective:To analyze the heritability of coronary heart disease (CHD) among the Chinese twin adults.Methods:A total of 20 477 same-sex twin pairs aged 25 years and older from the Chinese National Twin Registry were interviewed. Structure equation model was used to estimate the heritability of CHD.Results:After adjusting for age and gender, the overall heritability of CHD was 0.75(0.68-0.81). Stratified analyses showed that genetic factors play a more important role in CHD incidence in ≥40 years or female twins. While the development of CHD was mainly influenced by environmental factors in 25-39 years or male twins.Conclusion:CHD is influenced by both genetic and environmental factors and the heritability is high.