Objective To observe traditional Chinese medicine (TCM) Huoxue Tongmai capsules (HXTMC) for the regulation of small molecule metabolites in plasma of patients with coronary heart disease and TCM blood stasis syndrome. Methods A prospective study was conducted in which 136 patients with coronary heart disease and blood stasis syndrome treated in Dagang district in Tianjin from January 2009 to December 2013 were selected and randomly divided into two groups:control group (68 cases) and HXTMC group (68 cases). The control group received the conventional oral therapy with nitrates, β receptor blockers, calcium antagonists, enteric coated aspirin, etc, and the HXTMC group received the conventional therapy and additionally oral administration of HXTMC, 4 capsules each time (each capsule 0.25 g), trice a day, 30 days constituting a therapeutic course, 3 courses in total. According to the standard of curative effect evaluation of angina pectoris in coronary heart disease, the clinic total curative effects of angina pectoris and electrocardiogram (ECG) were evaluated. The concentrations of copeptin, tumor necrosis factor-α(TNF-α) and interleukin-10 (IL-10) in the plasma were tested by enzyme-linked immunosorbent assay (ELISA), and the TNF-α/IL-10 ratio was calculated. Results The total clinical effective rates of patients and the ECG in HXTMC group were significantly higher than those of the control group [clinic total effective rates:89.71%(61/68) vs. 80.88%(55/68), ECG total effective rates:57.35%(39/68) vs. 48.53%(33/68), both P<0.05]. Concentration of copeptin and TNF-α/IL-10 ratio in the plasma after treatment of the both groups were significantly lower than those before treatment, and the changes were more obvious in HXTMC group [copeptin (ng/L): 0.22±0.04 vs. 0.31±0.05, TNF-α/IL-10 ratio:0.49±0.11 vs. 0.65±0.09, both P<0.05]. Conclusion Addition of HXTMC to conventional therapy for treatment of patients with coronary heart disease accompanied by blood stasis syndrome can lower the plasma level of copeptin and TNF-α/IL-10 ratio, thus it may improve the clinical curative effects of the patients.

Objective To investigate the early diagnostic and prognostic value of plasma D-dimer level in acute aortic dissection.Method Data of totally 500 acute chest pain patients were studied,in which 250 cases were in group of acute aortic dissection (group AAD) confirmed by aortic computerized tomographic angiography (CTA) or cardiac ultrasonography,and the rest 250 cases were in non AAD group (group control).The D-dimer test was performed in all patients within 72 hours after onset of chest pain,and comparison of plasma D-dimer concentration was carried out between two groups.The D-dimer diagnostic value in AAD was analyzed by plotting the receiver operating characteristic (ROC) curve.According to AAD patients with aortic CTA findings,the whole aortic artery was divided into four segments by the major vascular branches,and the false lumen area was measured by degree score,the relationship between the score and D-dimer level were analyzed.To study the prognostic value of D-dimer in AAD,the comparison of D-dimer level was carried out between survival group and death group,and the AAD patients were further stratified by the surgery and Stanford type.Results The plasma D-dimer concentrations in AAD group were significantly higher than those in controls (P ＜0.01).The sensitivity,specificity,positive predictive value and negative predictive value of D-dimer (＞ 1.14 mg/L) in the diagnosis of AAD were 81.2％,79.39％,74.63％ and 72.4％ respectively,and the area under the ROC curve was 0.083.The elevated level of D-dimer was positively correlated with the extent of AAD false lumen (Spearman-Rho =0.418,P ＜ 0.01).D-dimer levels in the death group were higher than those in the survival group.Conclusions D-dimer may be a valuable biomarker in early diagnosis of AAD.The elevated level of D-dimer was useful to evaluate the extent of the dissection and prognosis of AAD.

Objective: To explore the imaging manifestations of multi-slice spiral CT angiography (CTA) and relationship with in-hospital death in patients with aortic dissection (AD). Methods: The clinical data of 429 patients with AD who underwent CTA in Zhongshan Hospital of Fudan University between January 2009 and January 2016 were retrospectively analyzed. AD patients were divided into 2 groups, including operation group who underwent surgery or interventional therapy (370 cases) and non-operation group who underwent medical conservative treatment(59 cases). The multi-slice spiral CTA imaging features of AD were analyzed, and multivariate logistic regression analysis was used to investigate the relationship between imaging manifestations and in-hospital death in AD patients. Results: There were 12 cases (3.24%) of in-hospital death in operation group, and 28 cases (47.46%) of in-hospital death in non-operation group(P<0.001). AD involved different vascular branches. Multi-slice spiral CTA can clearly show the dissection of true and false lumen, and intimal tear was detected in 363 (84.62%) cases, outer wall calcification was revealed in 63 (14.69%) cases, and thrombus formation was present in 227 (52.91%) cases. The multivariate logistic regression analysis showed that the number of branch vessels involved (OR=1.374, 95%CI 1.081-1.745, P=0.009) and tearing false lumen range(OR=2.059, 95%CI 1.252-3.385, P=0.004) were independent risk factors of in-hospital death in AD patients, and the number of branch vessels involved (OR=1.600, 95%CI 1.062-2.411, P=0.025) was independent risk factor of in-hospital death in the operation group, while the tearing false lumen range (OR=2.315, 95%CI 1.019-5.262, P=0.045) was independent risk factor of in-hospital death of non-operation group. Conclusions Multi-slice spiral CTA can clearly show the entire AD, true and false lumen, intimal tear, wall calcification and thrombosis of AD patients. The number of branch vessels involved and tearing false lumen range are the independent risk factors of in-hospital death in AD patients.

Objective To understand the background level of total radioactivity in drinking water around Tianwan Nuclear Power Plant. Methods According to the original plan of the National Health and Family Planning Commission of China, the monitoring of gross α and gross β radioactivity levels in drinking water during dry and rain periods around Tianwan Nuclear Power Plant, and water samples were collected including source water, factory water, peripheral water and reservoir water. Results A gross of 200 water samples were monitored at 35 sampling sites from 2016 to 2018.The gross α and gross β radioactivity levels in the dry period were (0.038 ± 0.033) Bq/L and (0.11 ± 0.03) Bq/L. The gross α and gross β radioactivity levels in the wet period were (0.038 ± 0.024) Bq/L and (0.11 ± 0.03) Bq/L. There were statistically significant differences in gross α and gross β radioactivity levels between the source water and the other water during the dry season (P < 0.05). There were statistically significant differences in gross α and gross β radioactivity levels in different years (P < 0.05). There were statistically significant differences in gross α and gross β radioactivity levels at different distances from the nuclear power plant (P < 0.05). Conclusion The gross α level and gross β level of radioactivity in drinking water around Tianwan Nuclear Power Plant are in line with the standard of drinking water, regular, fixed and continuous monitoring should be carried out, and radionuclide monitoring and radiological investigation should be carried out on this basis.In view of the density of personnel in the vicinity of nuclear power plants in China, nuclear emergency preparedness training should also be strengthened.

AIM:To assess the evolving burden of cataracts in China from 1990 to 2019.METHODS: Data on disease burden related to cataracts in China were retrieved from the Global Burden of Disease(GBD)2019 study based on large public databases. Utilizing data from the GBD 2019 study, we extracted information on cataract-related disease burden in China from extensive public databases. Analysis of prevalence and disability-adjusted life years(DALYs)associated with cataracts in China was conducted based on GBD 2019 findings. The variable characteristics of age-standardized prevalence rates(ASPR)and age-standardized DALYs rates(ASDR)in China and its neighboring countries were also explored.RESULTS: Between 1990 and 2019, the number of prevalent cases of blindness and vision loss caused by cataracts in China increased by 223.54%, and the corresponding DALYs raised by 142.14%. Over the past 30 years, females exhibited higher age-standardized prevalence and DALYs rates compared to males. Meanwhile, individuals aged 65 to 84 years were found to be more susceptible to cataracts than other age groups. Compared with neighboring countries, China ranked from the 9th position in 1990(867.09, 95%UI: 761.36 to 975.42, per 100 000 population)to the 11th in 2019(991.56, 95%UI: 861.52 to 1131.04, per 100 000 population)in ASPR, while from the 9th in 1990(65.85, 95%UI: 46.39 to 89.41, per 100 000 population)to the 10th position in 2019(59.16, 95%UI: 41.70 to 80.15, per 100 000 population)in ASDR. However, on a global scale, China maintained relatively low ASDR and ASPR for cataracts in 2019.CONCLUSION: The study highlights a substantial rise in the prevalence and DALYs associated with blindness and vision loss due to cataracts from 1990 to 2019 in China, and underscores the urgent need for increased early screening of cataracts, particularly among the elderly and females.