Objective To explore that whether the normoxic low altitude measurement of arterial blood pressure would predict subsequent susceptibility to acute mountain sickness ( AMS) during rapid ascent to high altitude .Methods Arterial blood pressure ( using a wrist sphygmomanometer ) was determined in two hundred and four healthy lowlanders first exposed to 3700 m-altitude (Lhasa) from plain (500 m) by air, and the Lake Louise self-report questionnaire(LLS) was used to assess AMS.We compared the low altitude blood pressure related indicators of two groups ( AMS and non-AMS ) and analyzed the relationship of diagnostic score and blood pressure related indicators .Results ①The incidence of AMS in the selected subjects was 53.92% by LLS.AMS scores increased markedly at high-altitude (P<0.05 versus low altitude).②Diastolic blood pressure (DBP) and mean arterial BP (MABP) in the AMS group were higher than those in the non-AMS group(P<0.05).The low altitude DBP levels for diagnosis of AMS at high-altitude (3700 m) had an area under curve(AUC) =0.598, P<0.05, with sensitivity of 56.3%, specificity of 63.2%, and cut-off point of 72.5 mmHg. Conclusion ①After acute exposure to high altitude , the incidence of AMS increases significantly .②A higher baseline DBP may be considered a potential risk factor for AMS , and is positively associated with LLS .DBP may serve as a predic-tive parameter for diagnosis of AMS .However , the clinical application of DBP as a predictive criterion is limited because of its poor specificity or sensitivity .The use of DBP as a predictive criterion should be combined with other indicators for the better predictive value of AMS .

Objective To investigate the change in ventricular repolarization at different altitudes and time courses among healthy young males .Methods A total of 143 healthy young men living on the plains were randomly selected as subjects.Their change in relative parameters of ventricular repolarization was measured by the same person at 500 m above sea level,24 hours their ascent to the plateau at an altitude of 3700 m was,after one week′s acclimatization on the 4400 m plateau and after 50 days acclimatization on the 4400 m plateau.Results Compared with 500 m,at 3700 m above sea level in 24 hours and after one week′s acclimatization on the 4400 m plateau,the heart rate(HR),systolic blood pressure(SBP), diastolic blood pressure(DBP), heart rate-corrected-QT (QTc)interval and heart rate-corrected T-peak to T-end (TpTec) on V3 lead were significantly increased(P<0.05).while oxygen saturation, QT interval,T-peak toT-end(TpTe)interval on V3 lead were significantly decreased ( P<0.05) .Compared with 500 m, oxygen saturation significantly decreased ( P<0.05),while SBP,DBP,QT interval,QTc interval,TpTe interval,TpTec interval did not change significantly (P>0.05) after 50 days acclimatization on the 4400 m plateau.Conclusion The ventricular repolarization duration of these young healthy men was significantly increased when they rapidly ascentded to high altitude .With prolonging residence at high alti-tude,the ventricular repolarization duration gradually returned to the level on the plains ,suggesting that the the ventricular repolarization duration will be restored to its level on the sea level by the adaptation and adjustment mechanism of the body .

Objective To observe the protein expression of Notch 1 in the cultured calcified human heart valve interstitial cells (hVICs) in vitro and related mechanisms.Methods hVICs were divided into two groups:control hVICs were cultured in conventional media for 14 days and calcified hVICs were cultured with calcification inducers:[3-glycerophosphate (500 μl),ascorbic acid (200 μl),dexamethasone (100 μl) for 7 days.The calcified hVICs were further divided into calcified hVICs group and inhibited calcified hVICs by adding specific Notch1 inhibitor DAPT (50 μmol/L(4 μl/hole))groups and cultured for another 7 days.Inflammatory response of all groups were induced by lipopolysaccharide (LPS) for 8 to 12 hours.Western blot was used to detect the protein expression of Notch1,phosphorylation nuclear transcription factor κB (p-NF-κB),bone morphogenetic protein-2/4(BMP-2/4).ELISA was applied to detect the content of BMP-2 secretion of the groups.Von Kossa staining was used to observe of cellular calcification.Results (1)Von Kossa staining is positive in the induced calcification group,the expression of Notch1,p-NF-κB,BMP-2 and BMP-4 is significantly higher in the induced calcification group than in the control group (all P ＜ 0.05).The expression of BMP-2 is significantly higher in the induced calcification group than in control group ((88.23 ± 3.28) pg/ml vs.(25.41 ± 3.68) pg/ml,P =0.02).(2) After treatment with DAPT,the calcification and the expression of Notch1,p-NF-κB,BMP-2 and BMP-4 were significantly decreased compared to calcification group (all P ＜ 0.05).The expression of BMP-2 is (26.74 ± 4.62) pg/ml in the calcification inhibition group and (80.41 ± 2.96) pg/ml in calcified control group (P =0.02).Conclusions Upregulated Notch 1 expression promotes BMP-2/4 secretion in LPS stimulated hVICs,and contributes to osteogenic changes in hVICs.Inhibiting Notch1 can decrease the BMP-2/4 secretion and calcification in hVICs,which may serve as a novel therapeutic option for treating calcific valve disease.

Objective: To evaluate the prevalence and risk factors of aortic valve calcification among the elderly (≥65 years old) resident of Wuxi city, Jiangsu province. Methods: The household registration population aged ≥65 years old in Wuxi city was selected as the research subject by stratified sampling method from August 2017 to December 2018. Echocardiography was performed to assess the aortic valve calcification, and the participants were divided into calcification group and non-calcification group. Multivariate logistic regression analysis was used to explore the related risk factors of aortic valve calcification. Results: The age of the respondents was (73.6±7.1) years old, of which 48.8% (461 cases) were males.The prevalence rate of aortic valve calcification was 22.0% (208/944) in the elderly (≥ 65 years old) residents in Wuxi city. The prevalence rate in 65-69 years old, 70-74 years old, 75-79 years old, 80-84 years old and ≥85 years old was 16.7% (58/347),16.7% (41/245),16.2% (26/161),23.3% (24/103), and 67.0% (59/88),respectively. There were significant differences in age, weight, abdominal circumference, hip circumference, high-salt diets, exercise, hypertension, hyperlipidemia, diabetes, coronary heart disease, cerebrovascular disease, and carotid atherosclerosis between the non-calcified group (736 cases) and the calcified group (208 cases) (P<0.01 or 0.05).Multivariate logistic regression analysis showed that age (OR=1.077, 95%CI 1.053-1.101, P<0.001), diabetes mellitus (OR=1.697, 95%CI 1.174-2.453, P=0.005), and coronary heart disease (OR=1.964, 95%CI 1.378-2.799, P<0.001) were the risk factors of aortic valve calcification. Conclusions The prevalence of aortic valve calcification in the elderly (≥65 years old) residents in Wuxi city of Jiangsu province increases with aging. Age, diabetes mellitus and coronary heart disease are the risk factors of aortic valve calcification in this population cohort.

Objective:To investigate the correlation between serum growth differentiation factor 11 (GDF11) level and coronary artery lesions in patients with ST-segment elevation myocardial infarction (STEMI), and the predictive efficacy of nomogram risk prediction model based on GDF11 combined with traditional risk factors on the occurrence of STEMI.Methods:This study was a retrospective cross-sectional study. Patients hospitalized in the Department of Cardiology of the 904th Hospital of Joint Logistic Support Force of People′s Liberation Army of China from 2016 to 2018 were selected and divided into control group and STEMI group. The demographic data, blood lipid level, laboratory indicators of blood and GDF11 level were collected. Logistic regression analysis screened out independent correlated factors for the occurrence of STEMI. Spearman correlation analysis clarified the correlation of each indicator with the SYNTAX or Gensini scores. A nomogram risk prediction model for the risk of STEMI occurrence and the receiver operating characteristic curve was used to compare the prediction efficiency of each model.Results:A total of 367 patients were enrolled, divided into control group ( n=172) and STEMI group ( n=195), age (66.5±11.8), male 222 (60.49%). The serum GDF11 level of STEMI group was significantly lower than that of the control group (36.20 (16.60, 70.75) μg/L vs. 85.00 (53.93, 117.10) μg/L, P<0.001). The results of multivariate logistic regression analysis showed serum GDF11( OR=0.98, 95% CI: 0.97-0.99) and traditional independent risk factors such as smoking, diabetes, C-reactive protein, homocysteine, lipoprotein (a) and apolipoprotein A1/B were independent correlate factors for the occurrence of STEMI ( P<0.05). Spearman correlation analysis showed that serum GDF11 was negatively correlated with SYNTAX score and Gensini score ( P<0.05). The nomogram model constructed by serum GDF11 combined with traditional independent risk factors (AUC=0.85, 95% CI: 0.81-0.89) had better predictive value for the occurrence of STEMI than the traditional nomogram model constructed by independent risk factors(AUC=0.80, 95% CI:0.75-0.84) or serum GDF11 (AUC=0.76, 95% CI: 0.72-0.81), all P<0.01. Conclusions:Serum GDF11 is an independent correlate factor in the occurrence of STEMI and is negatively correlated with the severity of coronary artery lesions in patients with STEMI. The nomogram model constructed based on GDF11 combined with traditional risk factors can be a good predictor for the occurrence of STEMI.