Objective To investigate the prevalence of cardiovascular and cerebrovascular diseases in the army old male hypertensive patients in Beijing. Methods From October 2011 to April 2014, old male patients in the geriatric department of the General Hospital of Chi-nese People's Liberation Army were enrolled and categorized into 3 groups: normotensive, well-controlled hypertensive and poorly-con-trolled hypertensive groups. The prevalence of cardiovascular and cerebrovascular diseases was recorded and binary logistic regression was used to analyze the differences among the groups. Results 719 old male patients were enrolled, 228 in normotensive group, 389 in well-con-trolled hypertensive group and 102 in poorly-controlled hypertensive group. Compared to normotensive group, there was more incidence of angina (OR=2.547, P<0.001), myocardial infarction (OR=2.493, P=0.003), cerebral thrombosis (OR=3.438, P=0.003) and peripheral artery atherosclerotic disease (OR=1.766, P=0.026) in the well-controlled hypertensive group, and it was more of angina (OR=4.123, P<0.001), la-cunar infarction (OR=2.810, P=0.020), cerebral thrombosis (OR=3.484, P=0.001) and peripheral artery atherosclerotic disease (OR=3.773, P<0.001) in the poorly-controlled hypertensive group. There was not significant difference of prevalence of cerebral hemorrhage (0.9%, 1%and 1%, respectively). Conclusion In the army old male hypertensive patients in Beijing, control rate of blood pressure was higher than com-mon population, but the prevalence of ischemic diseases was still higher than in the normotensive patients. Anti-hypertension and control of other risk factors could reduce the mobidity of cerebral haemorrahge.

Objective To evaluate if the assay of platelet-associated immunoglobulin G (PAIgG) can improve the sensitivity of monoclonal antibody immobilization of platelet antigens assay (MAIPA) in immune thrombocytopenic purpura (ITP).Methods Anti-GP Ⅱb/Ⅲa and anti-GP Ⅰb/Ⅸ autoantibodies were detected by a modified MAIPA;PAIgG was detected by competitive ELISA.MAIPA and PAIgG were done simultaneously in 190 patients with thrombocytopenia,in which 132 were diagnosed as ITP according to the diagnostic criteria Kappa test was used to analyze the concordance between MAIPA and PAIgG.Results The sensitivities of PAIgG alone or in parallel with MAIPA to ITP were 32.6% and 37.2% higher than MAIPA alone respectively,while their specifieities were 51.7% and 56.9% lower respectively.The sensitivity,specificity,positive predictive value,negative predictive value of PAIgG in series with MAIPA were all not superior to MAIPA alone.The kappa values between MAIPA and PAIgG in ITP and non-immune thrombocytopenia were 0.129 and 0.012 respectively,which meant the concordance between them was poor.Conclusion The detection of PAIgG should not be used as screening before MAIPA in distinguishing immune from non-immune thrombocytopenia.

OBJECTIVETo explore risk factors of patients with Tourette syndrome (TS) to develop the comorbidity attention-deficit hyperactivity disorder (ADHD) (TS + ADHD), so as to provide evidence for its prevention and intervention.

METHODSA total of 150 patients with TS were divided into two groups (TS group; TS + ADHD group) according to DSM-IV with 75 patients in each group. All the enrolled patients were investigated using self-designed questionnaire and Family Environment Scale-Chinese Edition (FES-CV). Forty-six factors were used as variables and were quantified. Data were analyzed by SPSS10.0 and the odds ratios of different factors to TS + ADHD were calculated by using univariate and multivariate analysis.

RESULTS(1) Families of children with TS + ADHD had lower score in cohesion, expression, intellectual-cultural orientation, active-recreational orientation, moral religious emphasis and organization, but had higher conflict score in FES-CV than the control group. (2) Single-factor analysis indicated that 8 factors were associated with TS + ADHD including ADHD family history positive (OR = 24.318), low family education (OR = 18.617), longer delay of treatment (OR = 10.796), maternal smoking (OR = 9.094), family conflict (OR = 5.781), hypoxia at birth (OR = 2.562), lower culture level of parents (OR = 1.941) and poor expressiveness (OR = 0.967). (3) Five factors including ADHD family history positive (OR = 13.805), family conflict (OR = 8.459), low family education (OR = 5.477), lower culture level of parents (OR = 2.164) and maternal smoking (OR = 2.075) were selected for the multivariate regression analysis.

CONCLUSIONThe key risk factors of co-occurrence of TS with ADHD were positive ADHD family history, family conflict, low family education, lower culture level of parents and maternal smoking.

Adolescent ; Attention Deficit Disorder with Hyperactivity ; epidemiology ; Case-Control Studies ; Child ; Child, Preschool ; Comorbidity ; Female ; Humans ; Male ; Risk Factors ; Tourette Syndrome ; epidemiology

OBJECTIVETo investigate the clinical results of external fixation and AO titanium elastic intramedullary nailing for treatment of tibia-fibula comminuted closed fractures.

METHODSFrom June 2010 to June 2012,58 patients with tibia-fibula comminuted closed fractures were treated with external fixation and AO titanium elastic intramedullary nailing, including 31 males and 27 females with an average age of 38.5 years old ranging from 21 to 57 years old. According to the system of AO Classification, the fractures were classified as type B1 in 9 cases,type B2 in 7 cases, type B3 in 10 cases, type Cl in 14 cases, type C2 in 12 cases,and type C3 in 6 cases. According to the system of Winquist-Hanson,the fractures' comminuted were classified as grade 1 in 23 cases, grade 2 in 17 cases, grade 3 in 12 cases, and grade 4 in 6 cases. According to the system of Johner-Wruhs, clinical results were compared between different type and grade groups by the time of last followed-up.

RESULTSAll 58 patients were followed up with an average time of 6.8 months (ranged from 18 to 36 weeks). All fractures had clinical healing with an average time of 28 weeks (ranged from 24 to 32 weeks). The total rate of good to excellent results was 91.4%. The rate of good to excellent in the group of grade 1 was higher than that of other grades. The complication rates and fracture healing time would increase respectively with higher Winquist-Hanson's grade. The complication rates in the group of type C3 was higher than that of other types, but the rate of good to excellent was lower than that of other types. The complication rates in the group of type B1 was lower than that of other types,but the rate of good to excellent was higher than that of other types.

CONCLUSIONMinimal invasiveusing AO titanium elastic intramedullary nailing combined with external fixation for treatment of tibia-fibula fractures especially for the multiple-segment,long spiral mild-to-moderate comminuted with hidden fracture can get satisfactory reduction and reliable fixation,it conformes to the principle of BO completely, protects the fracture end blood supply,reduces the external fixation time, has less skin soft tissue complications, postoperative function recovered satisfactorily.

Adult ; Bone Nails ; Bone Plates ; External Fixators ; Female ; Fibula ; injuries ; surgery ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Fractures, Closed ; surgery ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Tibia ; injuries ; surgery ; Young Adult

Objective To detect the expression and activity of AMP-activated protein kinase α subunit (AMPKα) and peroxisome proliferator-activated receptor-α (PPARα) in liver of high-fat fed rats treated with metformin, and to investigate the mechanisms underlying metformin decreasing the total cholesterol (TC) and triglyceride (TG) contents of the liver. Methods Total 30 male Wistar rats were randomly divided into control group (group C), high-fat diet fed group (group HF) and high-fat diet feeding plus metformin treatment group (group Met,metformin was administered orally at the last month of high-fat diet feeding). After feeding for 5 months, TC and TG in liver and sera were determined, respectively. The mRNA and protein levels and activity of AMPKα and PPARα in the liver were determined by real-time PCR and Western blotting. The activity of PPARα transcriptor binding to DNA was detected by ELISA. Results Five months of high-fat diet feeding induced a significant decrease in AMPKα and phosphorylated-AMPKα protein expression as well as AMPKα2 and PPARα mRNA levels in the liver of rats (all P＜0.05), while it did not alter PPARα protein expresssion and the PPARα activity binding to DNA as well as AMPKα1 mRNA levels. The TC and TG contents in the liver (P＜0.05) and serum (P＜0.05) were sharply increased in group HF than those in group C. Treatment with metformin for 1 month led to a marked increase of AMPKα2 mRNA level, AMPKα and phosphorylated-AMPKα protein expression as well as the PPARα activity in group Met compared with group HF(all P＜0.05), while the PPARα protein expression and the PPARα mRNA level did not show significant change. Consistent with these findings, the TC and TG contents in rat liver as well as sera were strikingly decreased (all P＜0.05). Conclusion The activations of AMPKα and PPARα induced by metformin may contribute to the decrease of TC and TG content in liver and sera of the high-fat fed rats.

Objective To compare the efficacy of a modified percutaneous transhepatic variceal embolization (PTVE) with 2-Octyl-Cyanoacrylate (2-OCA) and endoscopic variceal obturation (EVO) in preventing gastric variceal bleeding.Methods Seventy-seven patients with history of gastric variceal bleeding who underwent either EVO or PTVE were retrospectively reviewed.The rebleeding rate,survival rate and complications were compared between the two groups.Results EVO was performed in 45 patients; PTVE was performed in 32 patients.During the follow-up (19.78 ± 7.70 months in EVO group,vs.21.53 ± 8.56 months in PTVE group),rebleeding occurred in 17 patients (37.78％) of EVO group,and in 4 patients (12.5％) of PTVE group (P =0.028).The cumulative rebleeding free rate for EVO was 75％,59％,and 49％ in 1,2,and 3 years,respectively; 93％,84％,84％ for PTVE (P =0.011).There is no significant different in survival rate and the incidence of complications was similar in two groups.Conclusion Compared with EVO,PTVE with 2-OCA demonstrates advantage as an effective and safe method for gastric varices.

Objectives To investigate the overall prevalence of cardiovascular disease (CVD) in subjects hospitalized for chronic obstructive pulmonary disease (COPD),and explore the prevalence of the major CVD complications and trends in patients with COPD over a 10-year period.Methods Medical records in the PLA General Hospital,Beijing Union Medical College Hospital,and Beijing Hospital from 2000/01/01 to 2010/03/03 were retrospectively reviewed.A total of 4960 patients with COPD were reviewed in the study (3570 males,mean age,72.2 ± 10.5 years; 1390 females,mean age,72.0 ± 10.4 years).Results The prevalence of CVD in COPD patients was 51.7％.The three most prevalent CVDs were ischemic heart disease (28.9％),heart failure (19.6％),and arrhythmia (12.6％).During the 10-year study period,the prevalence of various CVDs in COPD patients showed a gradual increasing trend with increasing age.There was higher morbidity due to ischemic heart disease (P ＜ 0.01) in male COPD patients than in the female counterparts.However,heart failure (P ＜ 0.01)and hypertension (P ＜ 0.01) occurred less frequently in male COPD patients than in female COPD patients.Furthermore,the prevalence of ischemic heart disease decreased year by year.In addition to heart failure,various types of CVD complications in COPD patients tended to occur in younger subjects.The prevalence of all major types of CVD in women tended to increase year by year.Conclusions The prevalence of CVD in patients hospitalized for COPD in Beijing was high.Age,sex and CVD trends,as well as life style changes,should be considered when prevention and control strategies are formulated.

Objective To investigate the effects of partial body weight supported treadmill training (BW- STT) on post-stroke depression (PSD) and on patients' quality of life.Methods Sixty patients with PSD were re- cruited and divided into a training group (n=30,male 17,female 13) and a control group (n=30,male 16,fe- male 14).All patients were treated with routine internal medication and rehabilitation.The patients of the training group also received BWSTT in addition to their routine treatment.All patients' neurological impairment was evaluated using the Modified Edinburgh-Scandinavian Stroke Scale (MESSS).The Hamilton depression scale (HAMD) was used for evaluating the degree of depression.The Fugl-Meyer scale and the Barthel index were used to assess ambula- tion and balance,and facility in the activities of daily living.All patients were assessed before and after the treat- ment.Results After four weeks of treatment,depression in the training group had improved significantly more than in the control group.Conclusion BWSTT intervention is very important for patients with PSD:it can reduce the degree of depression and improve the quality of life.

Objective To investigate the risk factors of delayed gastric emptying (DGE) after pancreaticoduodenectomy,in order to provide a theoretical basis for prevention and treatment of this complication.Methods The term DGE was searched in Pubmed,Medline,EMBASE,Cochrane Library,CNKI,Wanfang,and published literatures were collected to determine the risk factors of DGE after pancreaticoduodenectomy.The Review Manager 5.3 software was used in the analysis.Results A total of 52 articles were included.The results of Meta-analysis showed that age and preoperative bilirubin levels did not significantly influence the incidence of DGE.Preoperative cholangitis (OR =3.39,95％ CI 1.97 ～ 5.82),hypoalbuminemia (OR =2.53,95％ CI 1.59 ～4.02),and intraoperative blood loss of more than 1 L (OR =1.98,95％ CI 1.18 ～ 3.33) significantly increased the incidence of DGE.Pyloric resection (RR =2.06,95％ CI 1.05 ～4.05),antecolic reconstruction (RR =0.74,95％ CI 0.56 ～ 0.99) and Braun enteroenterostomy (OR =0.36,95％ CI 0.17 ～0.77) significantly decreased the risk of DGE.When compared with Roux-enY enteroenterostomy,Billroth Ⅱ enteroenterostomy reduced the incidence of clinically relevant DGE (RR =0.30,95 ％ CI 0.11 ～ 0.79).Postoperative pancreatic fistula (OR =3.84,95 ％ CI 2.71 ～ 5.44) and intraabdominal infection/abscess (OR =3.95,95％ CI 2.87 ～ 5.43) were significantly associated with a high incidence of DGE.Conclusions Hypoalbuminemia,cholangitis,large blood loss,and postoperative abdominal complications were the risk factors of DGE.Pyloric resection,antecolic reconstruction,Billroth Ⅱ enteroenterostomy,and Braun enteroenterostomy significantly reduced the incidence of DGE.Subgroup analysis showed that differences on DGE definition in studies might be an important cause for the heterogeneity in the results of the different studies.

OBJECTIVE:To compare genetic diversity of Spatolobi caulis from different areas of Guangxi by random amplified polymorphic DNA(RAPD)and inter-simple sequence repeat(ISSR). METHODS:Through using POPGENE 32 software,Ntsys software and SPSS 17.0 software,RAPD and ISSR methods were used to study genetic diversity of 9 samples of S. caulis from dif-ferent areas of Guangxi. RESULTS:After amplification of screened 3 RAPD primers and 4 ISSR primers,and there were 198 and 315 locus,and 37 and 80 polymorphism locus. Rates of polymorphism locus were 18.7% and 25.4%;the number of effective al-leles were 1.416 8 and 1.584 0;genetic diversity index were 0.269 4 and 0.351 3;Shannon diversity index were 0.431 6 and 0.529 9. All the values of ISSR marker were higher than RAPD marker. The average genetic similarity coefficient of ISSR and RAPD were 0.757 64 and 0.683 80,indicating ISSR was more sensitive for the detection of genetic diversity. The clustering result of them was close to each other. The correlation coefficient of them were 0.847,indicating very significant positive correlation at the level of 0.001. CONCLUSIONS:ISSR could reflect more information of genetic diversity than RAPD,and is more suitable for research of genetic diversity of S. caulis from different areas of Guangxi.