Objective To provide rationales for preventing and treating dyslipidemia by understanding the current status of lipids and related metabolic factors.Methods A total of 2 590 permanent residents aged ≥ 18 years were selected by random cluster sampling from three urbanized communities of Sijiqing Street.And the rate of abnormal lipid metabolism was calculated for different ages and genders.Spearman's correlation analyses were conducted for the levels of total cholesterol (TC),total triglyceride (TG),low density lipoprotein-cholesterol (LDL-C),high density lipoprotein-cholesterol (HDL-C),body mass index (BMI),waist circumference (WC),systolic blood pressure (SBP),diastolic blood pressure (DBP),fasting plasma glucose (FPG),glycated hemoglobin (HbA 1 c) and uric acid (UA) levels.Both x2 test and logisic regression were employed to examine the correlations between dyslipidemia and overweight/obesity,hypertension,hyperglycemia and hyperuricemia.Results ① The total rate of abnormal lipid metabolism was 60.0％ (1 554/2 590) with a standardized rate of 57.2％.High TC rate was 42.9％ (1 111/2 590) with a standardized rate of 40.5％.And the edge incremental rate was 31.7％ (822/ 2 590),the standardized rate 30.5％,the incremental rate 11.2％ (289/2 590) and the standardized rate 10.0％.High TG rate was 33.0％ (855/2 590) with a standardized rate of 30.7％.And the edge incremental rate was 15.3％ (397/2 590),the standardized rate 14.3％,the incremental rate 17.7％ (458/2 590) and the standardized rate 16.4％.High LDL-C rate was 30.4％ (787/2 590) with a standardized rate of 28.4％.And the edge incremental rate was 22.9％ (594/2 590),the standardized rate 21.7％,the incremental rate 7.5％ (193/2 590) and the standardized rate 6.7％.Low HDL-C rate was 12.6％ (327/2 590) with a standardized rate of 12.8％.The rates of high TC,high TG,high LDL-C,low HDL-C and abnormal lipid metabolism among gender showed no statistically significant difference (P ＞ 0.05);② For both males & females,high TC rate,high TG rate,high LDL-C rate and total rate of abnormal lipid metabolism increased with age (P ＜ 0.01) while low HDL-C rate did not change with age (P ＞ 0.05);③Spearman's correlation analysis showed that the levels of TC,TG and LDL-C were positively correlated with BMI,WC,SBP,DBP,FBG,HbA1C and UA (all P ＜0.01) while the level of HDL-C had negative correlations with BMI,WC,SBP,DBP,FBG,HbA1 c,and UA (all P ＜ 0.05);④The total rate of abnormal lipid metabolism and various types of abnormal lipid metabolism increased with a rising level of BMI in the upward trend (trend test P ＜ 0.01),various types of abnormal lipid metabolism rate between different groups (elevated & non-elevated) of blood pressure,glucose and uric acid also were statistically significant (all P ＜ 0.05);⑤ Non-conditional logistic regression analysis showed that,after adjusting for age and gender,overweight or obesity and hypertension were risk factors of high TC and high LDL-C;overweight or obesity,hyperuricemia was a risk factor for low HDL-C;overweight or obesity,hypertension,hyperglycemia and hyperuricemia were risk factors for high TG and total abnormal blood lipid.Conclusions Urbanized community groups have a high rate of dyslipidemia.And abnormal lipid metabolism is affected by overweight or obesity,hypertension,hyperglycemia and hyperuricemia.The target population should be regularly monitored and comprehensively controlled.

Objective To investigate the changes of serum soluble receptor for advanced glycation end products(sRAGE)in patients with hypertensive disorder in pregnancy,and analyze the relationship between serum sRAGE and hypertensive disorder in pregnancy.Methods Seventy-five patients with hypertensive disorder in pregnancy including 33 gestational hypertension cases and 42 eclampsism cases,55 normal control were selected.Morphologic changes of placenta were analyzed by means of HE staining.ELISA method was used to determine the level of serum sRAGE.Results Placentomes of cytotrophoblastic cells,nodule of syneytiotrophoblast,thickening of basement membrane,fibrinoid necrosis,villus interstitial edema,reduction in vascularity of villus were much more frequently seen in hypertensive disorder in pregnancy.There were also fabric hyperplasy of hehcine artery,narrow lumina,fibrinoid neerosi and inflammatory cell infiltrating in the uterine decidua in hypertensive disorder in pregnancy.The level of serum sRAGE was significantly decreased in patients with hypertensive disorder in pregnancy[(287.6±36.5)ng/L]when compared with normal controls[(312.8±53.7)ng/L](P<0.01).In hypertensive disorder in pregnancy,the level of serum sRAGE in patients accompanied with eclampsism[(281.9±19.7)ng/L]was lower than that in patients accompanied with gestational hypertension[(293.6±20.3)ng/L](P<0.05).Conclusions HE staining of the placenta showed vascular endothelial damage is the pathogenic basis of hypertensive disorder in pregnancy.The level of serum sRAGE is significantly decreased in patients with hypertensive disorder in pregnancy,it may be contributed to the pathogenesis and development of hypertensive disorder in pregnancy.The level of serum sRAGE may be helpful in predicting hypertensive disorder in pregnancy.

AIM: To explore the protective effect of phytosterol ester (PSE) on aortic aging in rats.ME-THODS: The female SD rats (12 months old, n=42) were randomly divided into control group, model group and PSE group.During the experiment, the rats in control group, model group and PSE group were treated with basic feed, high-fat diet (HFD) and HFD with 2% PSE (W/W) for 6 months, respectively.The morphological changes of the aorta were observed by HE staining and Masson staining, and the absolute area of smooth muscle cells and collagen fiber in the vascular wall were measured by image analysis.The levels of advanced glycosylation end products (AGEs), malondialdehyde (MDA), superoxide dismutase (SOD) and catalase (CAT) in the plasma were detected.The expression of silent information regulator 1 (SIRT1) and peroxisome proliferator-activated receptor γ (PPARγ) at mRNA and protein levels in the vascular tissue was determined by real time PCR and Western blot, respectively.RESULTS: PSE significantly lowered plasma TC and LDL-C, and increased plasma HDL-C level (P<0.05), but had no effect on plasma TG level.PSE significantly attenuated the thickening of intima and media of aging aortic, and decreased the migration of vascular smooth muscle cells (VSMC) and the amount of VSMC and collagen fiber in the aorta (P<0.05).PSE significantly reduced the contents of AGEs and MDA (P<0.05), but had no effect on the activity of SOD and CAT in the plasma.PSE also down-regulated the expression of PPARγ and up-regulated the expression of SIRT1 (P<0.05).CONCLUSION: PSE is able to attenuate the senescence process in the aorta by reducing the production of reactive oxygen species in plasma, and activating SIRT1, or inhibiting the expression of PPARγ in vascular tissues.

Objective To investigate the correlation between serum biochemical parameters and Parkinson's disease (PD) risk in the elderly.Methods The 277 inpatients with PD as PD group in Jiangsu Province Hospital from January 2009 to December 2013 were selected,at the same time,the 277 age and gender-matched healthy persons were enrolled as control group.The levels of total cholesterol (TG),total bilirubin (TB),uric acid (UA),low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were detected and compared between the two groups.Results The levels of TG,UA,TB,HDL-C and LDL-C were significantly lower in PD group than in control group [(4.35±1.13) mmol/L vs.(4.95±0.98) mmol/L,t=6.63;(278.00± 101.89)μmol/L vs.(380.90 ± 108.28) μmol/L,t =12.44;(13.02 ± 7.56) μmol/L vs.(17.39 ± 7.30)μmol/L,t=7.09;(1.26±0.37) mmol/L vs.(1.34±0.28) mmol/L,t=3.38;(2.59±0.79) mmol/L vs.(3.17±0.91) mmol/L,t=7.42,all P＜0.05].Logistic multiple regression analysis showed that the decreased levels of TB,UA and LDL-C were independently associated with prevalence risk of PD (OR=0.940,0.991 and 0.219,all P＜0.001).The combined score of TB,UA and LDL-C was constructed by using the linear weighted method.ROC curve was drawn to select the higher diagnostic validity index among TB,UA,LDL-C and combined score.The area under the ROC curve for TB,UA,LDL-C and combined score was 0.713,0.765,0.682 and 0.809 (all P＜0.001),and the value of combined score was the highest.Conclusions The decreased levels of TB,UA and LDL-C are independently associated with PD.They possess certain clinical value in evaluating the prevalence risk of PD.

Objective To understand the trends of the prevalence of hyperuricemia of urbanized community residents Sijiqing Streets in Jianggan district in Hangzhou in the past 4 years,and analyze the correlation between hyperuricemia and metabolic factors,which provide scientific endence for prevention and treatment of hyperuricemia in communities.Methods 1 670 cases equal to or greater than 20 years old were randomly selected to analyze the trends of the prevalence of hyperuricemia in the past 4 consecutive years,which from urbanized community physical examination in 2010 to 2013 (male 749 cases,female 921 cases).Comparative analysis of age,BMI,waist circumference,systolic blood pressure,diastolic blood pressure,fasting blood glucose,glycosylated hemoglobin (HbA1C),TG,TC,LDL-C,and HDL-C levels between hyperuricemia group(male 264 cases,female 181 cases) and non hyperuricemia group (male 485 cases,female 740 cases) on 2013,and analyze the related metabolic factors to hyperuricemia by using non conditional logistic regression analysis.Results ①From 2010 to 2013,male hyperuricemia prevalence rates were 27.9％ (209/749,standardized rates were 27.4％)、29.1％ (218/749,standardized rates were 27.9％),33.2％ (249/749,standardized rates were 31.8％) and 35.2％ (264/749,standardized rates were 32.9％).The prevalence rates of female were 12.6％ (116/921,standardized rates were 11.7％),13.5％ (124/921,standardized rates were 11.9％),18.0％ (166/921,standardized rates were 15.7％) and 19.7(181/921,standardized rates were 17.2％),showed a increased tends year by year (the x2 of tends of male and female were 11.907 and 22.759,respectively,all P ＜ 0.01).In age stratified,the prevalence of hyperuricemia in middle and elder age group were increased significantly (the x2 of middle and elder aged man were 4.387、8.545,The x2 of middle and elder aged woman were 12.043、12.274,all P ＜ 0.05).The annual rate of male was higher than female (the x2 were 61.764、62.060、51.241、51.393,respectively,all P ＜ 0.01).② The male and female hyperuricemia group of age,BMI,waist circumference,systolic blood pressure,diastolic blood pressure,TG,TC,LDL-C levels were higher than those in non hyperuricemia group (the t of male were-2.052,-8.624,-8.772,-3.932,-4.380,-5.006,-3.564,-3.834,respectively; The t of female were-6.021,-8.839,-7.586,-4.702,-4.431,-6.334,-5.317,-5.119,respectively,all P ＜ 0.01),HDL-C levels were lower than those of non hyperuricemia group(the t of male and female were 6.097 and 3.170,respectively,all P ＜ 0.01),fasting blood glucose,HbA1c levels of non hyperuricemia group in female were also higher than the non hyperuricemia group (t =-2.750,-3.711,all P ＜ 0.01),however,Nor was statistical significance in male between the two groups (t =0.432,1.315,all P ＞ 0.05).③The non conditional Logistic regression analysis showed that,independent risk factor for male hyperuricemia were overweight (OR:2.151,95％ CI:1.439-3.215) or obese (OR:2.882,95％ CI:1.541-5.389),hypertension (OR:1.564,95％ CI:1.100 -2.224),dyslipidemia (OR:1.678,95 ％ CI:1.165-2.417) and abdominal obesity (OR:1.708,95 ％ CI:1.146-2.547),independent risk factors for hyperuricemia in women were overweight (OR:2.067,95％ CI:1.290-3.313) or obese (OR:2.843,95％ CI:1.523-5.309),hypertension (OR:1.530,95％ CI:1.042-2.248),dyslipidemia (OR:1.784,95 ％ CI:1.191-2.672) and hyperglycemia (OR:1.768,95％ CI:1.221-2.561).Conclusions The community people have a higher prevalence of hyperuricemia,which showed a increased trend,especially in the middle and old age year by year; overweight or obesity,abdominal obesity,hypertension and dyslipidaemia influence male prevalence rate of hyperurieemia,overweight or obesity,hypertension,hyperglycemia and dyslipidemia influence female prevalence rate of hyperuricemia,we should strengthen the comprehensive prevention and treatment of hyperuricemia in this community.

OBJECTIVETo investigate the clinical features and individualized treatment strategies for infants with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA).

METHODData of 25 less than 1-year-old infants with ALCAPA who presented at Guangdong Cardiovascular Institute between 2006 and 2013 were retrospectively reviewed. The patients' cardiac function was evaluated with echocardiography during follow-up.

RESULTMost patients presented with symptoms of heart failure, such as tachypnea, diaphoresis, poor feeding, failure to thrive etc. Electrocardiogram showed abnormal q wave in 23 patients and ST-T segment change in 16 patients.Echocardiography showed dilated left ventricle in 25 patients, endocardial hyperplasia in 5 patients, dilated right coronary artery and extensive collateralization between the right and left coronary artery systems in 11 patients. The left ventricular ejection fraction (LVEF) was (45.5±13.9)% (25%-77%). The left ventricular fractional shortening (LVFS) was (22.0±7.3)% (12%-38%). Twenty one patients underwent cardiovascular CT scan. Left coronary artery originated from left posterior sinus in 9 patients, from right posterior sinus in 1 patient, from lower main pulmonary artery in 5 patients, from the bifurcation of main pulmonary artery in 1 patient.Five patients showed ambiguous left coronary artery origination.Sixteen patients were misdiagnosed in other primary or secondary hospitals in 17 patients who were transferred to our tertiary hospital, only 1 case who underwent angiography was diagnosed correctly. Two patients were misdiagnosed in 8 patients first-presented in our hospital. Their diagnoses were corrected after reexamining with echocardiography and cardiovascular CT scan. The preoperative therapies included using inotropic agents, diuretics and vasodilators according to cardiac function. Two patients underwent left coronary artery orifice ligation. Twenty three patients underwent reimplantation of left coronary artery to reconstruct dual coronary system. Patients of NYHA IV with moderate mitral regurgitation (MR) and NYHA III with severe MR underwent mitral annuloplasty. If LVEF was less than 30% after weaning from cardiopulmonary bypass, blood pressure could not be maintained with medication, or lactates increased progressively, extracorporeal membrane oxygenation (ECMO) was demanded. Two patients showed low cardiac output syndrome immediately after surgical procedures, died from refractory ventricular fibrillation even with ECMO.In survived 23 patients during the early stage after surgeries, duration of ventilation was 7-500 hours, 11 of them were supported with ventilator for less than 60 hours. The mean length of hospital stay was (23.4±13.9) d (8-65 d). The follow-up duration ranged from 1-91 months (median 28.5 months). One case was lost to follow up. The patient died from infection 3 months after discharge. The cardiac functions of the remaining 22 patients were improved. The size of left ventricle of 14 patients recovered to normal. LVEF increased to the normal level in 20 cases. No patient underwent redo procedure.

CONCLUSIONThe accurate diagnosis can be made based on history, electrocardiogram, echocardiography and other imaging diagnostic tools.Individualized treatment strategy is helpful for seriously sick infants. Aggressive ECMO support can increase surviving rate for patients with postoperative low cardiac output syndrome.

Bland White Garland Syndrome ; Cardiac Output, Low ; Cardiopulmonary Bypass ; Coronary Vessel Anomalies ; surgery ; Echocardiography ; Electrocardiography ; Extracorporeal Membrane Oxygenation ; Humans ; Infant ; Mitral Valve Insufficiency ; Perioperative Care ; methods ; Pulmonary Artery ; abnormalities ; Retrospective Studies ; Ventricular Function, Left

Objective: To evaluate the intervention effects of response to heatwave in communities of four cities, China. Methods: Baseline survey on heatwave and climate change related knowledge, attitude and practice (KAP) was conducted in the pilot communities in Harbin, Nanjing, Shenzhen and Chongqing, using face-to-face questionnaire interview in November, 2011 to November, 2013. Finally, 1 604 residents were interviewed. Intervention measures were implemented in summers of 2013 and 2014, including delivering early warning information of heatwave health risk and launching health education and promotion. The second survey was conducted in same communities using the same questionnaire and sampling method as baseline survey in November, 2014, and 1 640 residents were interviewed. The Chi-square test was used to compare the demographic characteristics and KAP of community residents between before and after intervention, and the factors that affected the intervention effect were selected by logistic multiple stepwise regression model. Results: The age of the residents interviewed before and after intervention was (46.4 ± 15.5) years and (45.0 ± 15.9) years, respectively. Overall, the residents' awareness rates of heatwave before and after intervention were 70.5% (1 131/1 604) and 82.9% (1 359/1 640) (χ²=69.40, P<0.001). The rate of residents who had wished to receive early warning information increased 6.3% (χ²=41.11, P<0.001), which reached 94.6% (1 551/1 604) after intervention from 88.3% (1 416/1 604) in baseline survey. Both heatwave health risk early warning and health education had big impacts to residents. There were 92.7% (1 105 residents) among the 1 192 residents who had received the early warning information arrange work and rest time according to the early warning information and 93.0% (1 231 residents) among the 1 323 residents who knew about health education activities being conducted in community thought that the community health education activities had made active role in protecting health from heatwaves. After a series of intervention, male had a effect on attitude about hot wave than female in Nanjing and Chongqing, OR (95%CI) were 1.48(1.02-2.16) and 1.45 (1.18-2.05) , respectively; compared with subjects below primary school education, people with college degree or above had higer KAP in all cities (ORs range from 1.18 to 2.05), P<0.05; regular physical exercise (ORs range from 1.39 to 2.70) also had profound impacts on KAP in all cities (P<0.05). Conclusion s Early warning and health education were effective measures to enhance residents' response capacity to climate change.

Atherosclerosis (AS) is a chronic and progressive arterial disease. It is an important cause of the occurrence and development of cardiovascular and cerebrovascular diseases. With the development of Traditional Chinese Medicine (TCM), TCM has many advantages in the therapy of AS, with less adverse reactions. Studies have shown that TCM can resist AS, and the mechanism mainly belongs to regulating lipid metabolism, anti-lipid peroxidation, anti-inflammation, anticoagulation, and protecting the structure and function of vascular endothelial cells. The mechanism of TCM for AS is warranted to be studied systematically, and the chemical components need to be further clarified.

AIM:To evaluate the clinical efficacy and safety of pneumoperitoneum-free single-hole endoscopy combined with ropivacaine local infiltra-tion anesthesia in pregnancy with ovarian tumor.METHODS:Twenty-eight pregnant women with ovarian tumor were randomly divided into two groups:observation group(n=16)and control group(n=12).The first time out of bed,ventilation time,postoperative hospital stay,non-invasive blood pressure,heart rate(HR),respiratory fre-quency(RR)and blood oxygen saturation(SpO2)were compared between the two groups.Pain score,Ramsay sedation score,SAS anxiety score,postoperative complications,patient satisfaction and recovery quality scale QoR15 were evaluated at 6,24 and 48 hours after operation.RESULTS:There was no significant difference in postopera-tive hospital stay,Ramsay score,RR,SpO2 and the incidence of complications between the two groups(P>0.05),but the time of getting out of bed and ventilation time were shortened,the scores of non-invasive blood pressure,HR,pain and anxiety in the observation group were lower than those in the control group,and the scores of patient satisfac-tion and QoR15 in the observation group were bet-ter than those in the control group(P<0.05).CON-CLUSION:The application of pneumoperitoneum-free single-hole endoscope combined with ropiva-caine local infiltration anesthesia in pregnancy with ovarian tumor can reach satisfactory clinical re-sults,including reducing postoperative pain and anxiety,which is worth popularizing.

Objective:To investigate functional outcomes and condition-specific quality-of-life (CSQoL) after intersphincteric resection (ISR) in patients with low rectal cancer using traditional and exploratory questionnaires.Methods:A prospective observational study was conducted in the Characteristic Medical Center of the People′s Liberation Army Rocket Force. Patients with low rectal cancer who underwent ISR with ileostomy reversal from May 2020 to April 2023 were enrolled. An electronic self-assessment survey was sent to enrolled patients at 3 to 6, 12, and 24 to 36 months after reversal, and differences in functional and CSQoL results between the 3 groups were analyzed with generalized estimation equations. Functional outcomes were determined by the Wexner incontinence score (WIS) and the low anterior resection syndrome (LARS) score. In line with the five frequency responses ranging from never (score 0) to always (score 4) defined by the WIS, an exploratory survey was used to measure the severity of 16 LARS-specific variables confirmed by the latest international Delphi consensus. Furthermore, CSQoL was evaluated using the fecal incontinence quality-of-life scale (FIQL) and the visual analog scale (VAS).Results:A total of 90 patients were enrolled in the study. There were 64 males and 26 females, aged (58.6±10.4) years (range: 28 to 79 years). The median distance from the distal tumor margin to the anal verge( M(IQR)) was 3.0 (1.5) cm (range: 1.0 to 5.0 cm). There were 55 patients who completed the questionnaires at 3 to 6 months, 59 patients at 12 months, and 40 patients at 24 to 36 months of follow-up, respectively. The summary score of FIQL and VAS improved significantly after reversal (2.33±0.69 vs. 2.40±0.66 vs. 2.79±0.76, χ2=11.703, P=0.003; 5.31±1.65 vs. 5.61±1.90 vs. 6.58±1.92, χ2=12.781, P=0.002), but the differences in the WIS and LARS score did not reach statistical significance (both P>0.05). The survey responses for the LARS-specific variables indicated that “emptying difficulties” and “dissatisfaction with the bowels” were the most frequent symptom and consequence after ISR, respectively. The exploratory severity score for LARS improved significantly among the 3 time periods(34 (14) vs. 31 (13) vs. 23 (17), χ2=13.952, P=0.001). Furthermore, the FIQL summary score was strongly correlated with the LARS severity score ( r s=-0.72, P<0.01). Conclusions:Although a high prevalence of LARS may persist for years, patients reported an improvement in CSQoL and functional outcomes after ISR. The highest priorities recommended by the international consensus might provide better assessments the severity of LARS.