Objective To observe the time characteristics of acute aortic dissection (AAD) in Urumqi and its peripheral areas in Xinjiang Uygur autonomous region, and to explore the effect of meteorological conditions on the onset of AAD.Methods Retrospective analysis of the related data of the adult AAD patients diagnosed by imaging examination, and admitted to the First Affiliated Hospital of Xinjiang Medical University from March 2010 to July 2016 was performed. The onset time, the contemporaneous meteorological data, including daily minimum, average, and the highest temperature, daily average air pressure, daily average relative humidity, daily precipitation, daily average wind speed, daily maximum wind speed, and sunshine duration per day were collected. Analysis of concentrated distribution trend of the AAD onset was done by circular distribution statistics. Meteorological conditions were compared between the AAD day and no AAD day. The changes of air temperature 5 days before onset were observed.Results A total of 379 patients were enrolled, with 307 male and 72 female. The ratio of male to female was 4.19:1, the average age was 52.27±12.18; and the underlying diseases was hypertension (about 58.05%); the incidence sites were Urumqi and Changji city. ① The incidence of AAD in Urumqi and its peripheral areas had clear concentrated trend, and the peak period of AAD corresponded to January 1st to 2nd (homogeneity testr = 0.104,r0.05 = 0.009,P < 0.05). ② The minimum, mean and maximal atmospheric temperatures on the AAD day were lower than no AAD day [℃: 4.10 (-9.55, 14.60) vs. 7.75 (-6.70, 16.20), 14.10 (-1.50, 25.00) vs. 17.50 (0.60, 26.78), 8.50 (-6.22, 19.45) vs. 12.10 (-3.60, 20.90), allP < 0.05], sunshine duration was significantly shorter than no AAD day [hours: 8.50 (4.60, 10.70) vs. 8.90 (5.50, 11.50), P< 0.01], and atmospheric pressure were higher than no AAD day [kPa: 91.24 (90.66, 91.75) vs. 91.12 (90.62, 91.61), 19.11 (18.99, 19.22) vs. 19.09 (18.98, 19.19), bothP < 0.05]; there were no significant differences in the incidence of daytime temperature difference, average relative humidity, precipitation, average wind speed, and maximum wind speed between the two groups. ③ the peak period of AAD occurrence was December (38 cases), which was followed by January (36 cases); and there were 26 cases of each month in May, June, July, and September, which were lower than the rest of months. It was shown by the temperature distribution that the minimum average temperature was in January (-12.46 ℃), followed by December (-9.03 ℃); the maximum average temperature was in July [(24.59±3.21)℃], followed by August [(23.14±3.64)℃]. ④ The patients was sorted according to the quartile of daily mean temperature, into < -5.2 ℃, -5.2-10.7 ℃, 10.7-20.4 ℃, and > 20.4 ℃ groups, and each group had 104, 99, 98, 78 cases of AAD, respectively. The number of AAD in lowest temperature group was 1.33 times of the highest temperature group. In the 45-59 and 60-74 years, the number of AAD in lowest temperature group was higher than that in the highest temperature group (50 vs. 36, 26 vs. 13). In patients with hypertension, the number of AAD in lowest temperature group was higher than that in the highest temperature group (60 vs. 44). ⑤ The maximum air temperature, mean air temperature of the day from 5 days before to the onset day of AAD, and the lowest temperature from 3 days before to the onset day of AAD display slowly decrease trends, but there was no significant difference in daily temperature.Conclusions The incidence of AAD in Urumqi and its peripheral areas was concentrated from January 1st to 2nd of each year. When the temperature was lower than -5.2 ℃, AAD were more likely to attack. The 5 days changes of temperature and daily temperature before the attack were relevant with onset of AAD. It was speculated that the weather conditions such as air temperature may affect patient who has a past history of cardiovascular disease to attack AAD.

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 investigate the value of double contrast-enhanced ultrasonography (DCEUS) in combination with three-dimension (3D) contrast-enhanced ultrasound in diagnosis of benign or malignant gastric ulceration. Methods A total of 47 patients with gastric lesions were enrolled in this study. All have the pathological results, 22 of them were benign ulceration and 25 were malignant. All patients underwent DCEUS and 3D contrast-enhanced ultrasound. On the basis of oral contrast-enhanced ultrasound agents, intravenous contrast-enhanced ultrasound agents were given at the same time. Images and data were recorded. The arrival time (AT), time to peak (TTP), infusion time (IT), baseline intensity (BI), peak intensity (PI) and enhanced intensity (EI) were calculated using the time-intensity curve (TIC). Results All benign ulcerations were imaged as small pits with slight thicken of gastric wall [(8.66±2.87) mm] using DCEUS,while malignant lesions were relatively large irregular-shape, unevenly-bottom pits with significant thicken of gastric wall [(13.98±3.63)~(20.83±3.69) mm]. 3D-DCEUS images were analyzed for gastric mucosal folds, ulceration lesions, as well as local vascularity. All ulceration lesions showed broken of gastric mucosal folds, and malignant lesion showed thickness of gastric wall as“crater”, with rich and irregular vascularity. There were no statistical differences between benign gastric ulcerations and adjacent normal gastric wall (P>0.05). Malignant gastric ulceration were compared with adjacent normal gastric wall tissue, TTP, IT and BI had no statistical differences (P>0.05), while AT, PI, and EI had statistical differences [(9.00±2.02) s vs (10.90±2.75) s, P=0.008], [(35.46±5.77) dB vs (29.73±8.72) dB, P=0.009] and [(30.76±5.76) dB vs (23.45±6.84) dB, P=0.000]. PI and EI in malignant tumors were higher than those in benign ones (P<0.05). Conclusion DCEUS could be a new method in differentiating benign and malignant gastric ulceration, which can get both the anatomy and perfusion information of gastric wall as well as lesions. 3D-DCEUS can improve the quality of the conventional ultrasound image.

Objective To determine whether recombinant adeno-associated virus serotyoe 9 with CaMEK gene transfected on myocardial cells leads to reduce I/R-induced apoptosis.Methods Establish an ischemic/reperfusion(I/R) model of myocardial cells in vitro and the cells were divided into four experimental groups:(1) control group;(2) I/R group;(3) I/R+rAAV9-CBA-CaMEK group;(4) I/R+rAAV9-CBACaMEK+PD98059 group,respectively.The P-ERK1/2 and the Caspase-3,Bax were quqntitated by Western blot.Results These data clearly demonstrate that AAV9-mediated CaMEK gene transfected lead to active ERK1/2 and reduce I/R-induced apoptosis notablely.Conclusion rAAV9-mediated CaMEK gene transfected on myocardial cells can reduce I/R-induced apoptosis.

Objective: To study the predictive value of combination scores of leukocyte and platelet counts (COL-P) for in-hospital mortality in patients with acute ST segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI) treatment. Methods: A total of 660 STEMI patients with emergent PCI in our hospital from 2009-11 to 2013-08 were retrospectively studied. The patients were divided into 3 groups according to COL-P scores: COL-P0 group,n=283, COL-P1 group,n=319 and COL-P3 group,n=58. The relationship between the in-hospital mortality and COL-P scores was analyzed among different groups. Results: There were 88/660 in-hospital death. The patients in death group had the higher white blood cell count and lower platelet count than those in survival group, bothP<0.01. Logistic regression analysis indicated that compared with COL-P0 group, the COL-P scores at COL-P1 level (OR 4.346, 95% CI 2.134-8.850,P<0.001) and COL-P2 level (OR 10.126, 95% CI 4.061-25.250,P<0.001) were the independent risk factors for in-hospital death in STEMI patients after emergent PCI. The in-hospital mortality in COL-P0, COL-P1 and COL-P2 groups were at 4.9%, 15.4% and 43.1% respectively, allP<0.001. Conclusion: COL-P score was useful for predicting the in-hospital mortality in STEMI patients after emergent PCI, while the long term mortality estimation should be further studied.

Objective To study the correlation between renal function and arterial stiffness of Uighur population over 35 years old in Xinjiang area. Methods From October 2007 to March 2010, four-stage stratified random sampling method was applied to collect a total of 4312 Uighur people over 35 years old in Urumqi, Karamay, Fukang, Turpan area, Hotan prefecture, Yili Kazak autonomous prefecture and Altai prefecture. The data of these 4312 general urban and rural Uygur residents were complete. Simplified MDRD formula was used to calculate the estimate glomerular filtration rate (eGFR). Arm-ankle pulse wave velocity (b-aPWV) of both sides was measured and the average value was used in correlation analysis with eCFR, and then the associated risk factors were adjusted. Results The eGFR was negatively correlated with b-aPWV (r=-0.174, P<0.01). Multiple linear regression showed that after adjusting some risk factors such as age, sex, body mass index, systolic blood pressure, diastolic blood pressure, waist circumference, hip circumference, uric acid, fasting blood glucose, total cholesterol, triglycerides, low density lipoprotein, eGFR was still negatively correlated with b-aPWV (P=0.012). Conclusions In Uygur population over 35 years old in Xinjiang, the glomerular filtration rate is negatively correlated with arterial stiffness.

Objective: To compare the 10 years risk for ischemic cardiovascular disease among Han, Uygur, Kazak nationality residents of Xinjiang Uygur Autonomous Region. Methods: From October 2007 to October 2010,14 618 adult (aged ≥35 years) Han (n=5 757),Uygur (n=4 767) and Kazak (n=4 094) residents were selected to join this study through the four-stage stratified cluster sampling method from 7 cities and regions of Xinjiang Uygur Autonomous Region. The 10 years risk for ischemic cardiovascular disease was calculated according to the 10 years ischemic cardiovascular disease risk assessment form modified with Chinese characteristics and compared among the residents of 3 nationalities. Results: (1) There were significant differences in age, body mass index, systolic blood pressure, diastolic blood pressure,fasting blood glucose,triglycerides,total cholesterol,low-density lipoprotein,high-density lipoprotein cholesterol, smoking history, and drinking history among Han, Uygur, Kazak nationality population (all P< 0.001). (2) There were significant differences in 10 years risk for ischemic cardiovascular disease between different gender and age group including 35-39, 40-44, 45-49, 50-54, 55-59, and ≥60 years old between Han, Uygur, Kazak nationality population (all P<0.001). (3) There were significant differences in rates of 10%-20% and>20% of 10 years risk for ischemic cardiovascular disease between different gender in Han, Uygur, Kazak nationality population (P values were 0.013 and <0.001, respectively). There were no significant differences in rates of <5% and 5%-9% of 10 years risk for ischemic cardiovascular disease between different gender in Han,Uygur,Kazak nationality population (all P>0.05).(4) There were significant differences in detection rates of diabetes,hypertension,smoking,hypertriglyceridemia,and obesity in male and female Han,Uygur,Kazak nationality population with 10 years risk for ischemic cardiovascular disease ≥10% (P<0.01 or 0.05). Meanwhile,there was significant difference in detection rates of hypercholesteremia in male Han, Uygur, Kazak nationality adults(P<0.001). There were no significant differences in detection rates of elevated low density lipoprotein cholesterol and reduced high density lipoprotein cholesterol in male and female Han,Uygur,Kazak nationality adults (all P>0.05). Conclusion There are gender and age differences in the 10 years risk for ischemic cardiovascular disease in ≥35 years old Han,Uygur,Kazak nationality adults from Xinjiang Uygur Autonomous Region.

Objective:To systematically evaluate the efficacy and safety of general anesthesia versus conscious sedation in patients with endovascular therapy for acute ischemic stroke.Methods:Databases, including English databases PubMed, Embase and Cochrane, as well as Chinese databases Wan Fang Data and CNKI, were screened for randomized controlled trials (RCT) of general anesthesia versus conscious sedation on the effect of endovascular treatment for acute anterior circulation ischemic stroke. The searching period was from the establishment of databases to July 14, 2022. Two researchers independently screened literatures, extracted data and evaluated the risk of bias. And meta-analysis was performed using RevMan5.3 software.Results:A total of 7 RCTs involving 923 patients were included, with 461 in the general anesthesia group and 462 in the other. As the meta-analysis showing, general anesthesia could significantly improve the good outcomes (modified Rankin Scale score≤2) at 3 months after endovascular treatment in comparison with conscious sedation ( OR=1.34, 95% CI 1.01-1.78, P=0.04), and significantly increased the rate of successful revascularization ( OR=1.87, 95% CI 1.32-2.65, P<0.001). In addition, there were no statistically significant differences between the two groups in mortality ( OR=0.93, 95% CI 0.66-1.29, P=0.65), symptomatic intracranial hemorrhage ( OR=0.88, 95% CI 0.57-1.35, P=0.55) and intervention-related complications ( OR=0.83, 95% CI 0.50-1.36, P=0.46). However, general anesthesia was associated with higher risk for both 20% reduction in mean arterial pressure ( OR=4.76, 95% CI 1.49-15.19, P=0.008) and pneumonia ( OR=2.58, 95% CI 1.51-4.39, P<0.001). Conclusions:Compared with conscious sedation, endovascular treatment under general anesthesia in patients with acute anterior circulation ischemic stroke may contribute to better outcomes and higher successful revascularization. However, this method will lead to the risk of blood pressure variability and the incidence of pneumonia.

OBJECTIVEThe aim of the present study was to assess the association between the polymorphisms of CD36 gene and acute coronary syndrome(ACS).

METHODSGenotypes of CD36 single nucleotide polymorphisms were detected under PCR-RFLP in 522 patients with ACS and 1 215 controls.

RESULTSFor people under Han and Uygur ethnicities, the distribution of genotypes and allele of rs1722505 was significantly different between ACS and the controls(all P < 0.05). For Han population, the frequency of A allele of rs17154181 was significantly lower in ACS group than that in the control group(P = 0.034). Results from logistic regression analysis showed that the AA+AG genotype of rs1722505 was significantly higher in ACS patients than that in controls both between the Hans and the Uygurs(OR = 1.436, 95%CI:1.047-1.970, P = 0.025;OR = 1.589, 95%CI:1.009-2.473, P = 0.046, respectively). For Han people,AA+AG genotype of rs17154181 was significantly lower in ACS patients than that in controls(OR = 0.667, 95% CI:0.494-0.900, P = 0.008).

CONCLUSIONData from the present study suggested that the CD36 gene might serve as a genetic marker of ACS in both Han and Uygur populations.

Acute Coronary Syndrome ; epidemiology ; genetics ; Alleles ; CD36 Antigens ; genetics ; China ; epidemiology ; Ethnic Groups ; genetics ; Gene Frequency ; Genotype ; Humans ; Polymorphism, Single Nucleotide

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