Objective To evaluate the value and security of the use of medical thoracoscopy in the diagnosis of elderly patients with un‐known pleural effusion and to analyze the finally pathological results .Methods STORZ medical thoracoscopy was used to retrospectively study the 68 patients with unknown pleural effusion .Multiple punch biopsy was taken in the questionable diseased regions under direct vi‐sion .The changes of patients′condition in intraoperative and postoperative ,and the causes of pleural effusion were observed .Results Sixty‐three cases were confirmed in 68 cases of patients with unexplained pleural effusion ,the diagnostic rate was 92 .6% .In all cases ,26 cases (38 .2% ) were tuberculosis ,31 cases (45 .6% ) were malignant tumor ,3 cases (4 .4% ) were chronic pus chest and Aspergillus infection in 1 case(1 .5% ) ,a large number of aspergillus hyphae were found in biopsy tissue .Non‐specific inflammatory changed in 7 cases (10 .3% ) ,in which 2 patients were eventually diagnosed with pleural effusion caused by pulmonary schistosomiasis ,and the rest cases were still un‐known .All cases had no serious complications .Conclusion Medical thoracoscopy have a good effect in diagnosing elderly patients with un‐explained pleural effusion ,which could be easily and safely performed .The primary cause of unexplained pleural effusion in elder patients may be malignant tumor ,followed by tuberculosis .

Objective To investigate the effect of electroacupuncture(EA)in improving the reconstruction of synapse after cerebral ischemia.Methods Forty-five Wistar rats were divided into 3 groups:sham-operated group,ischemia group and EA group.The number density(Nv)of synapses and the surface density(Sv)of synaptic joint band were observed 1 hour,1 day,3 days,1 week and 3 weeks after ischemia and EA, respectively.Heat-coagulation-induced occlusion of the middle cerebral artery was performed to establish the model of focal cerebral ischemia.EA group received EA on the acupoints of Baihui and Dazhui.The changes of synaptie structure,Nv and Sv as well as the influence of EA on the above indexes were observed in different time.Results There existed significant decrease of Nv and Sv 1 hour,1 day and 3 days after establishment of models in the isehemia group(P0.05).Conclusion EA can reduce the cerebral ischemic injury by increasing the synaptic amount and area in the cortex of rat model of cerebral isehemia at early stage,promoting the cerebral recovery after ischemia,which will provide substantial morphological basis for the improvement of synaptic reconstruction and recovery from cerebral isehemia by EA at different time after ischemic cerebral injury.

Objective To study the association between serum concentrations of total testosterone levels and coronary heart disease (CHD) in the postmenopausal women. Methods The study was designed as a case-control study.394 postmenopausal female patients were selected from Cardiology Center of the First Affiliated Hospital of Xinjiang Medical University.The case group included 183 women patients with CHD aged (62.7±8.0) years,the control group,211 women with normal coronary aged (60.0 ± 8.8) years. Blood samples were collected to determine total testosterone,fasting glucose and lipid profile. CHD severity was expressed as the numbers of coronary arteries that had a stenosis ≥50％.According to the level of testosteron,all cases were divided into 4 groups by interquartile range method:Q1＜3.5 nmol/L(n=190),3.5 nmol/L≤Q2 ＜10.4 nmol/L(n=64),10.4 nmol/L≤Q3 ＜26.0 nmol/L(n=120) and Q4≥26.0 nmol/L(n=20).The association between the serum total testosterone levels and severity of coronary atherosclerosis was analyzed. Results The average total testosterone was higher in case group than in control group[(10.4 ± 24.3 ) nmol/L vs. ( 6.9 ± 17.4 ) nmol/L,Z =0.79,P =0.555].In Quantitative adjusted models,higher levels of total testosterone had strong correlation with CHD,Q4 incidence of CHD (75.0％,15 cases) was significantly higher than Q1 (46.8％,89 cases),Q2 (40.6％,26 cases)and Q3 (44.2％,53 cases) (x2 =7.69,P=0.048).After adjustment for other risk factors,women in the top quartile of total testosterone levels had a more than 3-fold increase in odds of CHD(OR=3.47,95％CI:1.06-11.32,P＜0.05).In addition,the serum concentrations of total testosterone level were significantly associated with the severity of CHD (F=12.94,P＜0.05). Conclusions Higher levels of total testosterone may be associated with high prevalence and severity of CHD as an independent factor in postmenopausal women.

Objective To study prevalence of metabolic syndrome (MS) , it's components and hyperuricemia (HUA) among Kazakh people in Xinjiang Uighur autonomous region, China. Methods A cross-sectional survey was conducted among Kazakh people aged 35 years and over in seven prefectures of Xinjiang, including Urumqi, Kelamayi (Karamay) , Fukang, Tulufan (Turpan), Hetian (Hotan) , Aletai (Altay) and Yili during October 2007 to March 2010, with a four-stage cluster sampling, the total sample size were 4094. Through the methods of questionnaire survey, physical examination, biochemical examination and so on, to study prevalence of MS in HUA and it's components by blood biochemical examinations. Results A total of 3915 Kazakh adult people, equal number of men and women, were surveyed, with a response rate of 95. 63 percent. Overall prevalence of HUA was 3. 96 percent( 155/3915 ) , 6.02 percent for men and 2. 03 percent for women(114/1894 and 41/2021) , respectively, with statistically significant difference ( P ＜ 0.05 ). Prevalence of MS was 39.47 percent in those with HUA and 22. 53 percent in those without HUA (45/114 and 401/1780), respectively (P ＜ 0.01). Among women, prevalence of MS was 46. 34 percent in those with HUA and 16. 11 percent in those without HUA( 19/41 and 319/1980), respectively (P＜0. 01). Prevalence of high blood pressure, hypertriglyceridemia, lower blood high-density lipoprotein cholesterol (HDL-C) and central obesity were 59.65 percent, 42.11 percent,32.46 percent, 7. 89 percent and 79. 82 percent in those with HUA, respectively, with prevalence of hyperglyceridemia and central obesity significantly higher than in those of non-HUA ( P ＜ 0. 05 ). Among women, prevalence high blood pressure, hypertriglyceridemia, lower blood HDL-C and central obesity were 48.78 percent, 39.02 percent, 41.46 percent, 2.44 percent and 78.05 percent, respectively, in HUA group, with prevalence of hyperglyceridemia, lower blood HDL-cholesterol and central obesity significantly higher than in those of non-HUA ( P ＜ 0. 05 ). Conclusions Prevalence of MS was higher in Kazakh people suffered with HUA than those without HUA, as well as prevalence of components of MS, suggesting that prevention and treatment for HUA is necessary, which can reduce MS and its components in the region.

Four-stage selected random samples were used to analyze the prevalence and distributing feature of hyperuricemia and gout in 13 559 Han,Uighur,and Hazakh adults in Xinjiang. The prevalence of hyperuricemia was 11.00%,3.27%,and 3.94% respectively in Han,Uighur,and Hazakh populations,and 1.32%, 0.65%,and 0.70% for gout,with statistically significant difference among three groups(all P＜0.05). No-conditional logistic regression analysis showed that nationality,body mass index,renal function,and serum lipid were risk factors of hyperuricemia,while female and physical activity were protective factors. Eating seafood and animal visceral organs were independent risk factors of hyperuricemia in Han population. Eating animal visceral organs and drinking alcohol were independent risk factors of hyperuricemia in Hazakh population.

OBJECTIVEThe aim of this study was to identify the appropriate cutoffs for waist-hip-ratio (WHR) for Kazakh adults at high risk of cardiovascular diseases in Xinjiang.

METHODSA Cardiovascular Risk Survey (CRS) study was carried out from October 2007 to March 2010, with 14 618 representative participants selected, including 4 094 Kazakhs. Complete data on 4 004 participants were gathered. The age span of the participants was from 35 to 88 years old with the mean age as 48.60 years. Anthropometric data, blood pressure, serum concentration of serum total cholesterol, triglyceride, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and fasting glucose were documented. Prevalence rate, sensitivity, specificity and distance on the receiver operating characteristic (ROC) curve of each WHR values were calculated.

RESULTS1) The prevalence rates of hypertension, hypertriglyceridemia were high, also with higher WHR seen in both men and women. 2) The prevalence of hypercholesterolemia was high with higher WHR seen in women. 3) The shortest distances in the receiver operating characteristic curves for hypertension, dyslipidemia, diabetes, or ≥ 2 of these risk factors suggested that the WHR cutoffs were 0.92 or 0.91 for men and 0.86 or 0.85 for women.

CONCLUSIONHigher cutoff for WHR was needed in the identification of patients over 35 at high risk of cardiovascular disease among Kazakh population.

Adult ; Aged ; Aged, 80 and over ; China ; epidemiology ; Diabetes Mellitus ; epidemiology ; Dyslipidemias ; epidemiology ; Female ; Humans ; Hypertension ; epidemiology ; Male ; Middle Aged ; Reference Values ; Waist-Hip Ratio

OBJECTIVETo explore the appropriate waist-to-hip ratio (WHR) cutoffs to identify people at high risk of cardiovascular disease of Uygur population aged 35 years and over in Xinjiang.

METHODSThe cardiovascular risk survey (CRS) in Xinjiang was conducted from October 2007 to March 2010, using 4-stagestratified random sampling method and 14 618 representative participated this survey, and the questionnaire survey, anthropometric data, blood pressure, serum total cholesterol, triglyceride, low density lipoprotein (LDL-C), high density lipoprotein (HDL-C) and fasting glucose were measured. A total of 4 657 participants aged 35 years and over with complete anthropometric data were analyzed. The sensitivity, specificity and distance on the receiver operating characteristic (ROC) curve of different WHR levels predicting risk factors of cardiovascular disease were calculated. The analysis method of ROC curve was used to determine the optimum cut-off point of WHR predicting risk factors of cardiovascular disease.

RESULTS(1) There were significantly differences in prevalence of hypertension, diabetes mellitus, hypercholesterolemia, low HDL-C level, and hypertriglyceridemia between WHR < 0.75,0.75 ≤ WHR < 0.80,0.80 ≤ WHR < 0.85,0.85 ≤ WHR < 0.90,0.90 ≤ WHR < 0.95,0.95 ≤ WHR < 1.00, WHR ≥ 1.00 in male participants (P < 0.01 or 0.05), LDL-C level was similar among groups in males (P = 0.139). There were significantly differences in prevalence of hypertension, diabetes mellitus, hypercholesterolemia and hypertriglyceridemia between WHR < 0.75,0.75 ≤ WHR < 0.80,0.80 ≤ WHR < 0.85,0.85 ≤ WHR < 0.90,0.90 ≤ WHR < 0.95,0.95 ≤ WHR < 1.00, WHR ≥ 1.00 in female participants (all P < 0.01), and there were no significantly differences in prevalence of high LDL-C level and low HDL-C level among groups in females (both P > 0.05). (2) ROC analysis for hypertension, dyslipidemia, diabetes and ≥ 2 of these risk factors suggested a WHR cutoff of 0.92 for men and 0.90 for women as the optimal cutoff value for predicting high risk of cardiovascular disease of Uygur population aged 35 years and over in Xinjiang.

CONCLUSIONHigher WHR cutoffs are needed for screening people at high risk of cardiovascular disease among Uygur population aged 35 years and over in Xinjiang.

Adult ; Anthropometry ; Blood Pressure ; Cardiovascular Diseases ; diagnosis ; Diabetes Mellitus ; Dyslipidemias ; Female ; Humans ; Hypercholesterolemia ; Hypertension ; Hypertriglyceridemia ; Male ; Prevalence ; ROC Curve ; Risk Factors ; Triglycerides ; Waist-Hip Ratio

Adipose tissue is a promising target for treating obesity and metabolic diseases. However, pharmacological agents usually fail to effectively engage adipocytes due to their extraordinarily large size and insufficient vascularization, especially in obese subjects. We have previously shown that during cold exposure, connexin43 (Cx43) gap junctions are induced and activated to connect neighboring adipocytes to share limited sympathetic neuronal input amongst multiple cells. We reason the same mechanism may be leveraged to improve the efficacy of various pharmacological agents that target adipose tissue. Using an adipose tissue-specific Cx43 overexpression mouse model, we demonstrate effectiveness in connecting adipocytes to augment metabolic efficacy of the β ₃-adrenergic receptor agonist Mirabegron and FGF21. Additionally, combing those molecules with the Cx43 gap junction channel activator danegaptide shows a similar enhanced efficacy. In light of these findings, we propose a model in which connecting adipocytes via Cx43 gap junction channels primes adipose tissue to pharmacological agents designed to engage it. Thus, Cx43 gap junction activators hold great potential for combination with additional agents targeting adipose tissue.