Objective To investigate the correlation of short-term systolic blood pressure variability (SBPV) with esti?mated glomeruar filtration rate (eGFR) in the elderly. Methods In physical examination for the third time of kailuan group, the method of cluster sampling was used to collect randomly retired employees, age≥60 in kailuan group. The 24-hour am?bulatory blood pressure monitoring was given to these objects. Finally, 1 405 participants with integral data were recruited in?to the survey. SBPV indices were standard deviation of systolic blood pressure (SD), variability independent of the mean (VIM), maximum-minimum difference (MMD), and average real variability (ARV). Multivariate stepwise linear regression models were used to analyze the influence of short-term SBPV on eGFR. Results (1) Among 1 405 participants (67.16 ± 5.82) years, 933 individuals (66.4%) were male and 472 (33.6%) were female. (2) Study population were divided into four groups based on the 24-hour mean SBP, daytime mean SBP, night time mean SBP (group 1:mean SBP<120 mmHg, group 2:120≤mean SBP<140 mmHg, group 3:140≤mean SBP<160 mmHg, group 4:mean SBP≥160 mmHg), respectively. Values of SD, MMD and ARV, but not VIM were increased with increased mean SBP. (3) The participants were grouped according to the median SBPV with between-group comparison of the eGFR. The average eGFR levels were lower in the high 24-hour SB?PV group (SD, VIM, MMD and ARV), day-time SBPV group (SD, VIM, MMD and ARV) and night-time SBPV group (SD, MMD and ARV) than those in the low SBPV groups (P<0.05). (4) Multivariate stepwise linear regression showed that eGFR increased with 3 indices of 24-hour SBPV (SD, MMD and ARV) and 2 indices of day-time SBPV (MMD and ARV) but not for night-time SBPV (β=-0.07,-0.11,-0.07,-0.12 and-0.07, respectively). Conclusion There is a certain degree of asso?ciation between short-term SBPV indices and eGFR.

Objective To investigate the effect of atorvastatin on atherosclerosis formation of common carotid artery and its possible mechanism. Methods A total of 36 male apolipoprotein E gene knockout (ApoE-/-) mice were randomly divided into 3 groups: a control group, a model group, and an atorvastatin group. The mice of the control group were fed with normal diet and received a sham operation, while the mice in the model group and the atorvastatin group were given high fat diet and received a right common carotid artery cannulation. At 5 weeks after procedure, the mice in the model group and the atorvastatin group were intragastric administration of normal saline and atorvastatin (10 mg/kg daily), respectively. At 8 weeks after procedure, the blood from femoral arteries was obtained for biochemical detection, then right common carotid arteries were taken out for histopathological study. Real-time quantitative polymerase chain reaction (PCR) was used to detect the expression levels of NF-κB mRNA in the plaques. Western blotting was used to detect phosphorylated NF-κB p65. Results The lipid levels in the model group and the atorvastatin group were significant higher than those in the control group (al P<0. 05). The lipid level in the atorvastatin group was lower than that in the model group, but there was no significant difference (P> 0. 05 ). The histopathological study showed that the obvious plaque formation and the necrotic core and neovessels in plaques were observed in the model group; obviously thickened intima and more intact endothelial cel s in the vessel wal were observed in the atorvastatin group. The plaque burden in the model group and the atorvastatin group was significantly higher than that in the control group (al P<0. 001), while the plaque burden in the atorvastatin group was significantly less than that in the model group (P<0. 001). Real-time fluorescence quantitative PCR detection showed that the expression levels of NF-κB mRNA in the model group and the atorvastatin group were significantly higher than that in the control group (al P<0. 001), and the expression level of NF-κB mRNA in the atorvastatin group was significant lower than that in the model group (P= 0. 022). Western blotting showed that the expression level of the phosphorylated NF-κB p65 was significantly higher than that of the control group (P<0. 001), and the expression level of the phosphorylated NF-κB p65 was significantly lower than that in the model group (P<0. 001). Conclusions Atorvastatin may reduce atherosclerosis in the common carotid artery in ApoE-/-) mice by down-regulating NF-κB.

Objective To study the effect of combination of Hydrochlorothiaside (HCTZ) with Captopril or spironolactone on serum high-sensitivity C-reactive protein (hsCRP) in hypertension patients. Methods A multi-centre, random and parallel control study was applied in this study. Slight and moderate hypertension patiens were se-lected. The patients were treated with placebo for two weeks and HCTZ 12.5 mga day for 6 weeks,wbo were then randomly divided into HCTZ group(12.5 mg once a day), spironolactone group(HCTZ 12.5 mg once a day + Spi-ronolactone 20 rag once a day) and captopril group(HCTZ 12.5 mg once a day + Captopril 25 rag twice a day) . By the end of one-year follow up, HCTZ group was randomly added to Spironolactone group and Captopril group because combination therapy was superior to single medication,which was recognized. During the treatment, the patients were followed up once a month ,for monitoring blood pressure, and serum hsCRP level was measured every year. Follow-up last for 4 years. By the end of 4 years, the patients were divided into treatment group and control group in order to compare the changes of serum hsCRP levels. Results At the end of 4 years, the blood pressure and serum hsCRP level were significantly decreased as compared with baseline, and were statistically different from that of control group (P <0.05 or 0.01). Multi-factor analysis showed that pre-treatment systolic blood pressue and serum hsCRP level, post-treatment decrease value of systolic blood pressue and age were the major influencing factors for the de-crease of serum hsCRP level(P < 0.05 for each). Conclusion The long-term combinaion of HCTZ with Spironolactone or Captopril not only effectivley decreases blood pressure but also decreases serum hsCRP level. The decrease value of systolic blood pressure is the major factor for influencing serum hsCRP level.

Objective To investigate the metabolite changes in the preschool children with autism spectrum disorder (ASD) using MR spectroscopy (MRS) and explore the associations between image findings and clinical variables, which may provide a noninvasive brain biochemical method for the early diagnosis and prevention of autism. Methods Twenty one cases of preschool ASD children (3-6 years old) and age-and sex-matched 20 preschool healthy controls underwent single voxel short (SVS) short TE (TE=30 ms) MRS. The absolute metabolite concentrations in the anterior cingulate cortex (ACC) , anterior middle anterior cingulate cortex (aMCC) and posterior cingulate (PCC) were quantitatively analyzed using LCModel software. Two independent sample t tests were used for analysis. The relationships between metabolite concentrations and diagnostic and statistical manual of mental disorders (DSM-IV) , childhood autism rating scale (CARS) and autism behavior checklist (ABC) were analyzed by Pearson correlation analysis. Results Compared to control subjects, ASD patients had significantly lower N-acetylaspartate (NAA) values (4.35 ± 0.80, 6.34±0.82, 8.04±0.97 mmol/L respectively) in ACC, aMCC and PCC (t=2.640, P=0.012;t=2.182, P=0.035;t=3.343, P=0.002) , had significantly lower choline (Cho) 1.32±0.22 mmol/L (t=2.905, P=0.006) and glutamine and glutamate complex (Glx) 10.02 ± 0.88 mmol/L (t=2.090, P=0.043) in PCC. Cho, total creatine (tCr) , myo-Inositol (MI) and Glx levels did not differ between groups in other aforementioned regions (P>0.05). Negative correlations between the NAA ualues in the PCC and CARS (r=-0.504, P=0.020) were detected, and no significant correlation among DSM-IV, CARS, ABC and other metabolite values (P>0.05). Condnsions The biochemical changes in the preschool children with ASD in cingulate reflect the neuronal loss, structural or functional damage and cell membrane enzyme metabolic dysfunctions, may reveal the pathological basis of ASD. These results may provide noninvasive and quantitative methods for the diagnosis and prognosis evaluation of ASD child.

OBJECTIVE:To promote the rational application of antibiotics on pediatric outpatients.METHODS:Considering the fact of our hospital,taking the acute respiratory tract infection(ARI)as an example,and using retrospective document for analysis from the aspects of the dominant idea in medication,varieties of antibiotics,the ways of administration,the course of treatment and etc.RESULTS:Subjective mistakes gave rise to the abuse of antibiotics;the variety of pediatric drugs was limited by the adverse effects of antibiotics and the diversify of drug resistance;the situation of drug abuse by intravenous drop was serious; the main cause for course shortage was due to the particularity of ambulatory treatment,uncertainty of etiology and drug resistance.CONCLUSIONS:The rational application of antibiotics on pediatric outpatients can be improved by enhancing the publicity of rational drug use,writing drug administration guidance for pediatric antibiotics applicable to the local area,developing more specifications and dosage forms.

Objective:To explore whether hyperuricemia was an independent risk factor for all-cause mortality in patients with atrial fibrillation.Methods:Patients with atrial fibrillation who were confirmed by 12-lead electrocardiogram in 11 hospitals of Kailuan Group from 2006 to 2007 were selected as the research objects.All patients were followed up by prospective cohort study, and all-cause deaths were observed.The last follow-up time was December 31, 2013.Kaplan-Meier curve and Cox proportional hazards model were used to analyze and compare the risk of all-cause mortality in patients with atrial fibrillation in the hyperuricemia group compared with the normal uric acid group.Results:A total of 388 community-based patients with atrial fibrillation were included in the final statistical analysis, with 136 all-cause deaths occurred during an average follow-up period of 6.93 years.The incidence of all-cause mortality was 9.24% per year(36/390)in the hyperuricemia group, whereas 5.16% per year(100/1 937) in the normal uric acid group.In the univariate Cox proportional risk model analysis, the risk ratio (95% CI) of all-cause death in patients with atrial fibrillation in the hyperuricemia group (95% CI) was 1.84(1.26-2.69) times that in the normal uric acid group ( P<0.01). After adjusting for potential confounding variables, the adjusted risk ratio (95% CI) of all-cause death in patients with atrial fibrillation in hyperuricemia group was still 1.94(1.32-2.85) times of that in normal uric acid group ( P<0.01). After adjustment for potential confounding variables, for each 0.01 g/L increase in uric acid (1 g/L=5 950 μmol/L), the risk of all-cause death in patients with atrial fibrillation increased by 1.15 (1.05-1.26) times ( P<0.01). Conclusion:Hyperuricemia was an independent risk factor for all-cause death in patients with atrial fibrillation in community.

Objective: To invest the status of symptom clusters in patients with cancer receiving FOLFOX6 chemotherapy during the course of chemotherapy. Methods: Total 100 patients with cancer receiving FOLFOX6 chemotherapy were investigated using MD. Anderson Symptom Inventory-Chinese (MDASI-C). Results: The top severity of symptoms were lack of appetite and nausea during chemotherapy; weary was the highest score during the intermission of chemotherapy. Exploratory factor analysis showed four main symptom clusters: gastrointestinal symptom clusters, physical symptom clusters, mental symptom clusters and subjective feeling clusters. There were no significant difference in the scores of subjective feeling clusters between chemotherapy and the first day after discharge (P>0.05), other symptom clusters also declined slowly; the symptom clusters began to ease significantly from the three day after discharge (P<0.05). Conclusion Patients with cancer suffer from multiple symptoms during FOLFOX6 chemotherapy and during the intermission of chemotherapy. The results are good for establishing early predictions of symptom clusters in intermission of chemotherapy.

Objective:To construct of occupational protection ability system for nursing staff, in order to improve the ability of occupational protection of nursing staff.Method:based on knowledge attitude/belief practice theory, the occupational protection ability system for nursing staff were established by literature review, Delphi method, expert group discussion and semi-structured interviews.Results:The rates of questionnaires return were 19/20 and 15/16 in the first and second round expert consultation. The authority coefficient of expert were 0.892 and 0.921. The coordination coefficient of experts′ opinion were 0.377 and 0.456. The training system included 3 first-level indexes, 11 second-level indexes and 109 third-level indexes.Conclusion:The results of ability system are reliable, which can provide reference for training the nursing staff′s occupational protection ability.

Objective To explore the relationship between‘ideal’cardiovascular behaviors and factors and the incidence of hypertension. Methods A prospective cohort study including 52 133 workers who had participated in the 2006-2007 Kailuan health examination without history of cerebral infraction,myocardial infarction or hypertension but with complete data,was carried out. All workers were followed on their occurrence of hypertension. According to the AHA definition of‘ideal’ cardiovascular health behaviors and factors,the cumulative incidence rates of hypertension in different groups were calculated under the life table method,and compared by Log-rank test,Cox proportional hazards regression was used to calculate the hazard rations and 95% confidence intervals for baseline behaviors and factors. Results The cumulative incidence rates of hypertension according 0-1,2,3,4, 5-7 ideal cardiovascular health behaviors and factors were 65.72%,59.14%,54.59%,50.24% and 34.22%,respectively in the 0-1,2,3,4,5-7 groups. Data from the Cox proportional hazards model showed that after adjusting for age,education level and family history of hypertension,the ones who had 2,3,4,5-7 ideal cardiovascular behaviors/factors were 0.75,0.69,0.63,0.36 times more than those who had 0-1 ideal behaviors. Conclusion The incidence of hypertension and risk reduced along with the increase of ideal cardiovascular health behaviors and factors.

Objective To observe the prevalence of metabolic syndrome(MS) among people with diabetes.Methods 9 275 diabetic patients (FPG was ≥7.0 mmol/L or FPG＜7.0 mmol/L but diagnosed as diabetes or having history of diabetes,or were under hypoglycemic agents treatment) of 101 510 employees of Kailuan group who took physical check-up between 2006 and 2007,were recruited to take part in this study.Using the latest defined diagnostic criteria on MS from the 2010 hypertension guidelines,prevalence of MS among the population was analyzed,according to age and gender.Multiple logistic regression analysis was used to test the relevant factors of MS.Results There were 6 105 cases with MS among the population with the prevalence as 65.8％ (female:70.0％,male:64.9％).Stratified by age and gender,the prevalence rates of MS among young-age group,middle-age group and elderly group were 59.7％,66.0％ and 68.8％,respectively.The prevalence in males among the three groups was 61.4％,64.9％ and 67.0％,respectively.The prevalence rates in females among the three groups were 50.3％,70.7％ and 78.8％,respectively Stratified by age and gender,the prevalence of waist abnormal in female was the highest (100.0％) in the youth group that with MS.However,the prevalence of dyslipidemia appeared the highest (86.3％) in males.In the elderly group with MS,the prevalence of abnormal blood pressure was the highest in both males and females,up to 96.0％.Results from multi-factor logistic regression analysis showed that cigarette smoking would increase the risk of developing MS in the youth group (OR=1.89,95％CI:1.09-3.28) and the risk of developing MS of man was lower than women in the middle-aged group (OR=0.77,95％ CI:0.67-0.89; OR=0.48,95％ CI:0.35-0.66).Conclusion In the diabetic population,MS prevalence in female appeared to be higher than in males.The prevalence of MS tended to increase with age.Cigarette smoking could increase the risk of MS in the youth group.