OBJECTIVETo explore the influence of acute glucose and fat loading on endothelium dependent flow-mediated vasodilation (FMD) in patients with essential hypertension (EH).

METHODSPatients with EH were randomly divided into three groups: oral glucose loading alone (n = 26), oral standardized fat loading alone (n = 38), combined glucose and fat loading (n = 34). FMD of the brachial artery was assessed by high resolution ultrasound technique respectively.

RESULTS(1) Compared to control group, postprandial abnormal serum triglyceride metabolism was evidenced and FMD was significantly reduced and the lowest FMD occurred at 4 hours and returned to the baseline level at 8 hours post fat loading alone in EH patients. (2) GS-AUC and 1 hour glucose were significantly higher in EH patients than in controls (all P < 0.05), FMD was also significant decreased (-31.4%) at 1 hour and returned to baseline level at 2 hours post oral glucose loading. (3) After combined glucose and fat loading, FMD at 1 hour (5.45 ± 1.93 vs. 9.46 ± 3.33, P < 0.05) was significantly lower than that in glucose loading alone and FMD at 4 hours (7.98 ± 1.64 vs. 9.66 ± 2.26, P < 0.05), was also lower than that in fat loading alone in EH patients. (4) FMD was negatively correlated with SBP, GS-AUC, DBP, TG-AUC (γ = -0.46, -0.44, -0.41, -0.38, respectively, all P < 0.05).

CONCLUSIONCombined glucose and fat loading additively reduced FMD in hypertensive patients.

Adult ; Aged ; Brachial Artery ; physiopathology ; Dietary Fats ; administration & dosage ; Endothelium, Vascular ; physiopathology ; Female ; Glucose ; administration & dosage ; Humans ; Hypertension ; physiopathology ; Male ; Middle Aged ; Triglycerides ; blood ; Vasodilation

OBJECTIVETo observe the association between preprocedural high sensitivity C-reactive protein (hs-CRP) level and incidence of contrast induced acute kidney injury (CI-AKI) in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) and the impact of atorvastatin pretreatment on CI-AKI.

METHODSAccording to the level of preprocedural hs-CRP, 270 ACS patients were divided into three groups: high hs-CRP group (hs-CRP ≥ 3 mg/L, n = 176), moderate hs-CRP group (hs-CRP 1-3 mg/L, n = 60) and normal hs-CRP group (hs-CRP < 1 mg/L, n = 34). According to the dosage of preprocedural atorvastatin, the high hs-CRP group was further divided into 10 mg group (n = 49), 20 mg group (n = 66) and 40 mg group (n = 61). Serum creatinine (Scr), blood urea nitrogen (BUN), cystatin C (Cys C), hs-CRP were measured at before and 24 hours, 48 hours after PCI. CCr and GFR were calculated according to Scr and Cys C. Risk factors for CI-AKI were determined by multivariate logistic regression analysis.

RESULTS(1) Cys C was significantly increased and GFR after PCI significantly reduced in high and moderate hs-CRP groups compared with normal hs-CRP group (P < 0.05). (2) Incidence of CI-AKI was 43.18%, 38.33%, 20.59% in high, moderate and normal hs-CRP groups, respectively (P < 0.05). (3) In high hs-CRP group, postprocedural GFR was significantly higher while postprocedural Cys C and hs-CRP were significantly lower in 40 mg statin subgroup than 10 mg and 20 mg statin subgroups (P < 0.05), similar trends were documented when comparing 20 mg statin subgroup with 10 mg statin subgroup (P < 0.05). (4) Multivariate logistic regression analysis showed that pretreatment with high dose atorvastatin was a protective factor for post CI-AKI (20 mg atorvastatin: OR = 0.15, 95%CI 0.06 - 0.33, P = 0.001; 40 mg atorvastatin: OR = 0.10, 95%CI 0.04 - 0.23, P = 0.001), while high levels of preprocedural hs-CRP (OR = 2.06, 95%CI 1.01 - 4.23, P = 0.048), diabetes mellitus (OR = 10.71, 95%CI 5.29 - 21.70, P = 0.001), advanced age (OR = 2.64, 95%CI 1.05 - 6.63, P = 0.038) and renal failure (OR = 5.14, 95%CI 1.13 - 23.39, P = 0.034) were independent risk factors of CI-AKI.

CONCLUSIONHigh hs-CRP level is linked with the development of CI-AKI in ACS patients undergoing PCI and pretreatment with 40 mg atorvastatin is associated with lower incidence CI-AKI, possibly by reducing the postprocedural inflammation responses.

Acute Coronary Syndrome ; drug therapy ; metabolism ; Acute Kidney Injury ; etiology ; Aged ; Angioplasty, Balloon, Coronary ; Atorvastatin Calcium ; C-Reactive Protein ; metabolism ; Contrast Media ; adverse effects ; Female ; Heptanoic Acids ; administration & dosage ; therapeutic use ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Prospective Studies ; Pyrroles ; administration & dosage ; therapeutic use

Enterotoxigenic Escherichia coli（ETEC）infection can induce watery diarrhea，leading to dehydration，electrolyte disturbance，and even death in severe cases. Recombinant B subunit/inactivated whole-cell cholera（rBS/WC）vaccine is effective in preventing ETEC infectious diarrhea. On the basis of the latest evidence on etiology and epidemiology of ETEC，as well as the effectiveness，safety，and health economics of rBS/WC vaccine，National Clinical Research Center for Child Health（The Children’s Hospital，Zhejiang University School of Medicine）and Zhejiang Provincial Center for Disease Control and Prevention invited experts to develop expert consensus on rBS/WC vaccine in prevention of ETEC infectious diarrhea. It aims to provide the clinicians and vaccination professionals with guidelines on using rBS/WC vaccine to reduce the incidence of ETEC infectious diarrhea.