Objective To analyze the characteristics of pulse pressure index(PPI) and its value in predicting the risk for cerebral and cardiac vascular events in old males with hypertension. Meth-ods The 24-hours ambulatory blood pressure monitoring was performed in a total of 265 elderly men with essential hypertension(EH). The patients were classified into 3 groups based on the lev-el of PPI.PPI≤0.400(103) ,0. 401-0. 500(124) ,and≥0.501(38). Results There was significant difference in PP between day-time and night-time in hypertensive patients. The change of PPI was less than that of PP. With the increase in PPI, SBP(24 h, day-time, night-time), PP(24 h, day-time, night-time), the load of SBP(night-time), systolic blood pressure variation(BPV, 24 h, day-time) were raised significantly (P<0.01); while DBP(24 h, day-time, night-time), nocturnal de-cline in BP and the load of DBP(day-time) declined with the decrease in PPI (P<0.01). High PPI would increase the incidence of cardiac-cerebral vascular events (P < 0.01). Conclusion PPI is a useful parameter in clinical evaluation of arteriosclerosis. It may also have prognostic value for cardiac-cerebral vascular events in elderly men with EH.

Objective To observe the serum adiponectin, leptin level, and adiponectin/leptin ratio (A/L ratio) in elderly male patients with normal BMI and visceral adipose deposit but without metabolic syndrome. Methods A total of 109 elderly males (≥60 years old) were enrolled whose BMI were all less than 25 kg m and without metabolic syndrome. They were divided into non visceral adipose deposit group (n = 67) and visceral adipose deposit group (n = 42 ). Serum levels of adiponectin and leptin were measured by radiological immunological assay (RIA) and the A/L ratio was calculated. Visceral adipose deposit was defined as visceral adipose area more than 100 cm2.Metabolic syndrome diagnosis was according to the definition provided by China Diabetes Society (CDS) in 2004. Results (1)The visceral adipose area [(135.56±31.72)cm2 vs. (68. 65±22.64)cm2 , P＜ 0. 001] and BMI [(22.94 ± 1.35 ) kg/m2 vs. ( 21.38 ± 2.55 ) kg/m2 , P ＜ 0.001] were significantly higher in visceral adipose deposit group than in non visceral adipose deposit group. The A/L ratio was significantly lower in visceral adipose deposit group than in non visceral adipose deposit group ( 2. 17 ± 1.77 vs. 4.54 ± 7.00, P = 0. 034 ) while there was no difference in serum adiponectin or leptin level between those two groups. (2)The A/L ratio was negatively correlated with BMI (r=-0.552, P＜0.001), waist circumstances (r=-0.390, P＜0.001) and abdominal visceral fat area (r=-0.341, P＜0. 001 ). Conclusions The A/L ratio decreases in elderly men with normal BMI and visceral adipose deposit. A/L ratio could be useful in scanning those patients with visceral adipose deposit whose BMI is normal among elderly men.

Objective To examine the effect of father parenting stress and paternal marital satisfaction on father involvement,and to explore the mediating role of maternal perceptions of father involvement in father involvement and maternal marital satisfaction.Methods 300 children's fathers and mothers from 5 kindergartens in Beijing city,Dezhou city,Wuhu city were surveyed with the Chinese version of the PSI/SF,the father involvement questionnaire and the marital satisfaction questionnaire.Results The score of paternal marital satisfaction was (3.98±0.75),(3.84±0.76) for maternal marital satisfaction,(2.26±0.50) for father parenting stress,(2.60±0.49) for father involvement,(2.50±0.50) for maternal perceptions of father involvement.Correlation analysis showed that father parenting stress was negatively correlated with father involvement(r=-0.36,P＜0.01),paternal marital satisfaction was positively correlated with father involvement (r=0.33,P＜0.01),father involvement was positively correlated with maternal marital satisfaction(r=0.36,P ＜0.01),father involvement was positively correlated with maternal perceptions of father involvement (r=0.48,P＜0.01).A structure equation model consisting of father parenting stress,father involvement and marital satisfaction had a better degree of fitting:GFI =0.99,NFI =0.99,CFI =0.99,RMSEA＜0.001.Maternal perceptions of father involvement mediated the effect of father involvement on maternal marital satisfaction (effect value:0.41,P＜0.05).Conclusion Father parenting stress and paternal marital satisfaction could significantly predict father involvement,father involvement could significantly predict maternal marital satisfaction.These studies verified the spillover effect and the crossover effect between spousal subsystem and parental subsystem.

Objective To compare the clinical effects of different surgical management for obsolute glaucoma.Methods 31 eyes of absolute glaucoma were retrospectively analyzed,including 23 case 23 eyes(A group) with cyclocryotherapy,8 case 8 eyes(B group)with cyclocryotherapy combining with paracentesis of anterior chamber,the pain and duration were comparatively observed.Results In the cyclocryotherapy,the pain occurred in 23 eyes,the duration time was 3 to 10 days,the average time was 6.8 days.While 4 eyes occurred pain in the cyclocryotherapy combining with paracentesis of anterior chamber,the duration time was 1 to 3 days,the average time was 2.3 days.There was significant difference(P

Objective To explore the clinical characteristics and gene mutation in a patient clinically diagnosed as dopa-responsive dystonia (DRD) without family history.Methods The clinical characteristics of a patient clinically diagnosed as DRD without family history were collected and molecular and bioinformatic analyses were performed.Results The patient demonstrated as type A tyrosine hydroxylase deficiency and a compound heterozygous mutation of tyrosine hydroxylase (TH) gene was found,including a known nonsense mutation,c.457C＞T and a novel missense mutation,c.734G＞T that was probably pathologically predicted by bioinformatic analysis.Conclusion c.734G＞T may be a novel pathological mutation of TH gene.

Objective:To explore the impact of pain, functional disability, self-efficacy and social support on health-related quality of life (HRQOL) in gout patients.Methods:From November 2019 to January 2020, a total of 218 patients with gout were investigated using the general information questionnaire, Visual Analogue Scale, Health Assessment Questionnaire Disability Index, General Self-Efficacy Scale, Perceived Social Support Scale, and Gout Impact Scale. The structural equation model was established by AMOS 24.0 for parth analysis, and the mechanism of pain dysfuction, self-efficacy and social support affecting the quality of life in gout patients was tested.Results:The total score of Gout Impact Scale, pain, functional disability, self-efficacy and social support respectively was 59.94±18.39, 6.00±2.76, 0.25 0, 0.88, 23.39±6.40 and 62.92±8.24. Pain directly influenced HRQOL ( β=-0.293, P<0.01), and indirectly influenced HRQOL ( β=-0.039, P<0.05). Functional disability directly influenced HRQOL ( β=-0.244, P<0.01). Self-efficacy directly influenced HRQOL ( β=0.182, P<0.01), and indirectly influenced HRQOL ( β=0.202, P<0.01) through pain and functional disability. Social support indirectly influenced HRQOL ( β=0.278, P<0.01) through pain, functional disability and self-efficacy. Conclusions:HRQOL of patients among gout is affected by several factors, mainly affected by pain, functional disability and self-efficacy; and there are interactions among them. Targeted interventions should be strengthened to relieve pain, prevent or slow down the progress of physical disability, enhance self-efficacy and social support to improve HRQOL.

Objective To detect the expression of EIF5A2 in hepatocellular carcinoma(HCC) and to explore its relation with clinicopathological characters and prognosis of HCC patients. Methods The expression of EIF5A2 mRNA and protein in 12 pairs of fresh HCC and corresponding non-tumor tissues adjacent to the cancer was examined by qRT-PCR and Western blot. The expression level of EIF5A2 in 284 pairs of HCC and adjacent non-tumor tissues was detected by IHC staining. Then we analyzed between EIF5A2 expression and clinical pathological parameters and prognosis of HCC patients. Results The relative expression levels of EIF5A2 mRNA and protein in fresh HCC tissues were significantly higher than those in the corresponding adjacent non-tumor tissues (t=5.305, P=0.0003; t=10.120, P < 0.001); EIF5A2 expression in 284 HCC tissues was significantly higher than that in the corresponding adjacent non-tumor tissues (z=-12.186, P < 0.001). The expression of EIF5A2 was significantly correlated with tumor size (χ²=13.079, P < 0.001), tumor multiplicity (χ²=4.589, P=0.032) and differentiation degree (χ²=4.844, P=0.028). The 3- and 5-year overall survival time and disease-free survival time of the patients with high expression of EIF5A2 were significantly shorter than those with low expression of EIF5A2 (P < 0.001). EIF5A2 was an independent prognostic factor affecting the 3- and 5-year overall survival time and disease-free survival time of HCC patients (P < 0.05). Conclusion The up-regulation of EIF5A2 expression may be related with the occurrence and development of hepatocellular carcinoma. The high expression of EIF5A2 is an independent influence factor for poor prognosis and EIF5A2 can be used as a potential molecular marker for predicting the prognosis of HCC patients.

OBJECTIVETo assess the efficacy of sacral neuromodulation (SNM) in patients with intractable constipation.

METHODSA total of 7 patients with intractable constipation were treated with pereutaneous test stimulation of the S3 nerve root and were assessed by sacral never stimulation system in our department from January 2013 to January 2014. Four of these 7 patients received operation for constipation before. The efficacy was assessed by bowel habit diary, clinic constipation scores, subjective questionnaire and clinical signs.

RESULTSThe constipation symptoms were improved significantly in all the 7 patients. The frequency and volume of defecation per week were increased obviously, and the average urine was increased. Six patients underwent permanent implantation of the SNS system. After a median 4 months follow-up, the defecation frequency increased from 0.6 ± 0.5 to 8.0 ± 2.5 per week (P<0.01), and the defecation time decreased from (22.9 ± 11.5) to (3.7 ± 0.8) min (P<0.01). The Cleveland clinic constipation score decreased from 24.6 ± 4.2 to 9.0 ± 0.9 (P<0.01), and the visual analogue scale(VAS) score increased from 8.1 ± 0.9 to 82.5 ± 5.2 (P<0.01).

CONCLUSIONSNM is a clinically efficacious, minimally invasive and safe new technique, which offers an alternative treatment for the patients with intractable constipation resistant to conservative treatment, especially for the patients refractory to traditional operations.

Objective:To investigate the features and advantages of ambulatory blood pressure monitoring (ABPM) applied in children with kidney diseases as well as the correlation between ambulatory blood pressure and clinical indicators.Methods:The clinical data of children with kidney diseases who were hospitalized and received ABPM in Children′s Hospital Affiliated to Capital Institute of Pediatrics from March 2012 to March 2018 were collected.Clinical blood pressure and ABPM indicators were analyzed and compared between different clinical groups.Results:(1) Among 170 cases enrolled, 69 cases (40.6%) were hypertension by measuring clinical blood pressure, 54 cases (31.8%) were ambulatory hypertension, 43 cases (25.3%) of whom had severe ambulatory hypertension, 17 cases (10.0%) had white coat hypertension, 41 cases (24.1%) were defined as masked hypertension, and 139 cases (81.8%) had impaired circadian rhythm of blood pressure.(2) Ninety-five point nine percent (163/170 cases) were detected of abnormal blood pressure by ABPM, and the rate was significantly higher than that detected by clinical blood pressure (40.6%, 69/170 cases) ( χ2=149.176, P<0.001). In the 40 cases who were administrated with antihypertensive drugs, 95.0%(38 cases) were detected to have anomalous blood pressure by ABPM, significantly more than that detected by clinical blood pressure(42.5%, 17/40 cases)( χ2=10.208, P=0.001). (3) Logistic regression analysis indicated that a prolonged clinical course of more than 3 months, obesity and nephrotic-range proteinuria were the risk factors of ambulatory hypertension, and the odd ratios were 5.345, 3.530 and 6.560, respectively.Circadian rhythm disorders of blood pressure were more common in the children with abnormal renal function than in those with normal renal function[89.7%(52/58 cases) vs.75.9%(85/112 cases)], and the difference was statistically significant ( χ2=4.626, P=0.031). Conclusions:Children with kidney diseases have a high incidence of hypertension.ABPM plays a key role in detecting hypertension and recognizing white coat hypertension.Nephrotic-range proteinuria and obesity are risk factors for ambulance hypertension, and abnormal renal function is associated with nocturnal blood pressure disorders.

Objective To evaluate the feasibility and safety of tracheal extubation in operating room for patients with end-stage chronic obstructive pulmonary disease (COPD) after single-lung transplantation. Methods Clinical data of 57 recipients who underwent single-lung transplantation due to end-stage COPD were retrospectively analyzed. According to the evaluation indexes of tracheal extubation in operating room established by our hospital, 17 recipients eligible for tracheal extubation in operating room were assigned into the operating room extubation group (OR extubation group) and 40 recipients receiving tracheal extubation in intensive care unit (ICU) were allocated in the ICU extubation group. The evaluation results of intraoperative tracheal extubation and postoperative recovery were compared between two groups. Results Compared with the ICU extubation group, recipients in the OR extubation group had higher oxygenation index, lower arterial partial pressure of carbon dioxide (PaCO₂), lower blood lactic acid level, less fluctuation range of blood pressure and fewer cases receiving extracorporeal membrane oxygenation (ECMO) during operation (all P < 0.05). Two recipients in the OR extubation group received repeated tracheal intubation at 6 and 8 h after returning to ICU, and tracheal extubation at postoperative 6 and 9 d. In the OR extubation group, time of postoperative mechanical ventilation, length of postoperative ICU and hospital stay of the recipients were shorter than those in the ICU extubation group (all P < 0.05). The incidence of grade 3 primary graft dysfunction (PGD), atrial tachyarrhythmia, continuous renal replacement therapy and 1-year survival rate did not significantly differ between two groups (all P > 0.05). Conclusions The tracheal extubation regimen in the operating room for COPD patients after single-lung transplantation established by our hospital is safe and feasible, which shortens the time of postoperative mechanical ventilation, the length of postoperative ICU and hospital stay, whereas does not increase the incidence of postoperative complications.