Objective To investigate the relationship of plasma brain natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels with the severity of heart dysfunction in elderly patients with heart failure. Methods BNP levels were measured by immunofluorescence in 106 hospitalized patients with heart failure, while NT-proBNP levels were measured by electrochemiluminescence immunoassay in 48 patients. The severity of heart dysfunction was determined by NYHA classification. The left ventricular ejection fraction (LVEF) measured by Color Doppler Ultrasound was used to show the left ventricular systolic function. Results In patients with BNP≤400 ng/L versus BNP>400 ng/L, the rates of LVEF≤45% were 16.4% versus 46.8% (χ~2= 13. 93, P=0. 001), the rates of E/A<1 were 62.3% versus 40. 4% (χ~2 =22. 19,P = 0.024) and the rates of Cr>107 μmol/L were 13.1% versus 38.3% (χ~2 = 11. 31, P = 0. 002) . In patients with NT-proBNP≤400 ng/L versus NT-proBNP>400 ng/L, the rates of LVEF≤45% were 25. 0% versus 58. 3% (χ~2 = 10. 00,P = 0. 019) and the rates of Cr>107 μmol/L were 20. 8% versus 50.0% (χ~2=8. 50,P = 0. 035). Conclusions BNP or NT-proBNP levels increase significantly along the deterioration of the heart failure severity, and it may be important to use BNP or NT-proBNP to predict left ventricular function.

Objective To summarize the experiences of treatment of calculus obstructive pyonephrosis with transureteroscopic holium laser lithotripsy. Methods There were 13 patients with flank pain and fever, all patients received antibacterial therapy and nutritional support before operation ,the patients of calculus obstructive pyonephrosis were treated using transureteroscopic holium laser lithotripsy. Results The ureteral calculus were cleared off in 10 cases, and in three cases, the stone moved to pelvis during operation that they needed additional procedure of ESWL, no severe complications were observed. Conclusion Transureteroscopic holium laser lithotripsy is safe,minimal in-vasive and effective method for treatment of calculus obstructive pyonephrosis and the therapeutic scheme can be the first choice.

Objective To investigate the prevalence,awareness,control status and associated risk factors of hypertension in a rural population in Xianghe county in North China.Methods A total of 830 adults (aged≥35) from Xianghe county were examined during July to August,2011.Blood pressure was obtained using a standardized sphygmomanometer after a 5-minute sitting rest.Information on gender,age,education level,marital status,smoking,drinking,income,family history of hypertension and use of antihypertensive medications was obtained.Results A total of 42.4％ of all subjects had hypertension.Among those with hypertension,the awareness rate was 54.8％ and 50.0％ of the patients were taking antihypertension medication with the control rate of 11.9％ [BP ＜ 140/90 mm Hg (1 mm Hg =0.133 kPa)].Lower age and education level,lower body mass index,negative family history of hypertension were associated with poor awareness of hypertension and worse compliance with the treatment.Older age,positive family history and alcohol consumption were associated with poor blood pressure control.Conclusions Hypertension is highly prevalent in Xianghe rural area.The awareness,treatment and control rate are all low.There is an urgent need for comprehensive strategies to improve prevention,screening,and treatment of hypertension in rural China.

Objective To observe the relationship between brachial-ankle pulse wave velocity(baPWV)and cardiovascular risk factors as well as clinical cardiovascular events in high cardiovascular risk patients.MethodsRelevant clinical data,including baPWV,height,weight,waist circumference,blood pressure,heart rate,history and blood biochemistry test were collected in 111 consecutive patients with high cardiovascular risk.High cardiovascular risk patients are defined as those who developed cardiovascular events (coronary heart disease,ischemic stroke and transient ischemic attack) before or those who have two or more cardiovascular risk factors(more than 50 years old,smoking,obesity,hypertension,diabetes mellitus and hyperlipidemia).The number of risk factors and cardiovascular events between patients with high baPWV (≥1700 cm/s) and low baPWV (<1700 cm/s) were compared.ResultsCompared with low baPWV group,the cardiovascular events and the number of cardiovascular risk factors were higher in high baPWV group(35.3% versus 60.5%,P<0.01 and (3.9±1.2)versus (4.4±0.9),P<0.05,respectively).The factors influencing baPWV were age (P<0.001)and systolic blood pressure (P<0.01).ConclusionIn patients with high cardiovascular risk,the cardiovascular events and the number of risk factors were more frequent in patients with higher baPWV.Age and systolic blood pressure are independent risk factors of baPWV.

Objective To investigate the potential effects of vegetables and fruits (F&V) consumption on the prevention of hypertension in Chinese population of North China.Methods A cohort of 10 635 cases were established in Kailuan community in Tangshan city and Jingmei community in Beijing city in July 2012.After a mean follow-up time of 47.2 month,the potential effects of different amounts of vegetables,fruits and F&V consumption on the new incidence of hypertension were studied and compared with univariant by multivariant Cox regression method.Results A total of 10 104 completed the follow-up survey and 576 cases of new hypertension were recorded.The incidence of hypertension in participants with ≤2,>2.0-<4.1-<5.0,≥5.0 serving F&V per day was 6.2%,6.0%,5.1% and 4.6%,respectively.With comparison to those participants consuming the lowest amount of vegetables,fruits and F&V,the hazard ratio for reducing the risk of hypertension and the 95% confidence intervals were 0.62 (0.46-0.83),0.87(0.78-0.97) and 0.69(0.54-0.80) for separate vegetables and fruits and total F&V(P<0.05).Conclusion Increasing the consumption of vegetables and fruits can significantly bring down the incidence of hypertension in North China populations.

Objective: To analyze the clinical symptoms of spinal tuberculosis in children and the effect of surgical treatment. Methods: From October 2012 to October 2017, 60 cases of spinal tuberculosis admitted to Shanxi Dayi Hospital were selected, including 31 male children and 29 female children.The age of the children was (7.92±2.93)years old; 4 children with cervical vertebra lesions, 3 children with cervical thoracic junction lesions, 23 children with thoracic vertebra lesions, 28 children with lumbar vertebra lesions, and 2 children with lumbar sacral vertebra lesions.There were 27 children with neurological damage.Among them, 2 children with Frankel classification of A, 4 children with B, 7 children with C, and 14 children with D. All children were treated by surgery, and standing full spine X-rays were taken before and after operation.The sagittal deviation distance and sagittal Cobb angle of the children's trunk were measured, and spinal fusion and fixation of all children were recorded. Results: In 52 cases (86.67%), the main symptoms were pain or radiation pain, 45 cases (75.00%) showed local palpable mass, and 7 cases (11.67%) had palpable paraspinal or abdominal mass.There were 37 cases (61.67%) with kyphosis and different degrees of spinal bulge, 11 cases (18.33%) showed abnormal sensation and limb numbness.There were 11 cases (18.33%) with walking difficulty.All 60 cases of spinal tuberculosis had abnormal X-ray manifestations.There were abnormal physiological curvature or kyphosis in the diseased area of children, the intervertebral space of children became narrow, and the edge of vertebral body was blurred, there were widening, flattening or wedge-like changes.The operative time was (184.29±23.28)min, and the intraoperative bleeding was (475.39±30.28)mL.The fusion fixation segment was (10.27±1.92) and the sagittal plane was (10.27±1.92). Cobb angle was 106.7°, postoperative correction was 31.3°, the correction rate was 76.21%, the mean preoperative correction of thoracic kyphosis was 76.7°, postoperative correction was 15.7 °, the average correction was 55.9°, the mean sagittal deviation distance of trunk was -15.42 mm, postoperative correction was 0.63 mm, and the average correction was 20.68 mm. Conclusion Pain is the first symptom of spinal tuberculosis in children, most of them will be complicated with severe kyphosis.Surgical treatment of children with spinal tuberculosis can get better clinical results, and it is worthy of popularizing in clinic.The choice of surgical approach and fusion range is the key to the treatment process.

Objective The aim of this study was to investigate the differences on origin distribution and radiofrequency ablation characteristics between premature ventricular contractions (PVC) from left and right ventricular.Methods A total of 354 frequent PVC patients were enrolled.Two hundred and eighty patients were PVCs with right ventricular origin (group RV) and 74 patients with left ventricular origin (group LV).The age,gender,ablation power,temperature and duration,time of target potential before QRS onset,fluoroscopic time,procedure time and success rate were compared between the two groups.Results Majority PVCs (79.10％) were of right ventricular origin,in which the most common site was at right ventricular outflow tract (RVOT) (55.93％);whereas,only 20.90％ were of left ventricular.There were significantly differences between group RV and group LV in age [(44.7 ± 13.6) yrs vs (49.6 ±15.9) yrs,P =0.017],gender [male:35.4％ (99) vs 55.4％ (41),P =0.002],time of target potential before QRS onset [(37.9 ± 16.2) msvs (31.3 ± 11.7) ms,P=0.008],procedure time [(85.1 ± 36.9) minvs (100.8 ± 45.5) min,P=0.017],fluoroscopic time [(12.3 ± 9.2) min vs (15.9± 10.8) min,P =0.028] and success rate (96.4％ vs 89.2％,P =0.012).Conclusions Radiofrequency ablation of PVCs was a safe and effective method.Subjects with RV PVCs are younger and more females than subjects with LV PVCs.The radiofrequency ablation for RV PVCs was easier,and the success rate was higher than that for LV PVCs.

Objective To investigate the optimal workflow and protocol for integrated PET/MR by comparison with PET/CT.Methods A total of 228 patients were enrolled in this study for PET/CT and PET/MR evaluation on the same day.Six PET/MR protocols with different MR sequences but the same PET acquisition protocol were investigated and the optimal protocol was identified based on image quality,acquisition time and diagnostic performance.Results PET/MR workflow was similar to PET/CT,however,some special issues needed to be considered for PET/MR.Among the 6 protocols,protocol No.6 outperformed others for body and head regions.Types of artifacts were found more often in PET/MR than in PET/CT.Conclusions By optimizing the protocol,PET/MR could achieve almost the same diagnostic performance as PET/CT.However,the issues of long acquisition time and artifacts on PET/MR need to be further improved.

The atherosclerotic plaque vulnerability may be related to inflammation,immunity,metabolism and blood clotting.One of the key factors affecting plaque stability is inflammatory reaction.This study was to investigate the relationship between vulnerability of coronary artery plaque evaluated with coronary angiography (CAG),intravascular ultrasound (IVUS) and the levels of plasma inflammatory markers.Methods Fifty-eight consecutive patients with acute coronary syndrome who had coronary lesion of a single vessel were divided into 3 groups based on angiographic morphology of the lesions:type Ⅰ lesion group (n =16),type Ⅱ lesion group (n =25) and type Ⅲ lesion group (n =17).The control group consisted of 17 patients with stable angina.Plasma levels of high sensitivity C reaction protein (hs-CRP),matrix metalloproteinase (MMP,including MMP-2 and MMP-9),CD40 ligand (CD40L) and pregnancy associated plasma protein-A (PAPP-A) were measured by ELISA.A subgroup of 28 patients (including 18 ACS patients and 10 stable angina control patients) who underwent IVUS study,were analyzed.Results The plasma levels of MMP-2,MMP-9 and PAPP-A in type Ⅱ lesion group were significantly higher than those in other groups (all P＜0.05).In type Ⅱ lesion group,linear correlation analyses showed significant positive correlation between levels of hs-CRP and MMP-2 (r=0.508);MMP-2 and MMP-9,CD40L,PAPP-A (r=0.647,0.704 and 0.751,respectively);MMP-9 and CD40L,PAPP-A (r=0.491 and 0.639,respectively);CD40L and PAPP-A (r=0.896).IVUS subgroup analysis showed that the area of plaques and plaque burden in culprit lesion,the incidence of high-risk plaques,remodeling index (RI) and positive remodeling percentage in ACS patients were significantly greater than those in control subgroup (P=0.000,0.037,0.028,0.015 and 0.040,respectively).Compared with control subgroup,the plasma levels of hs-CRP,MMP-2,MMP-9 and PAPP-A were markedly elevated (P=0.033,0.000,0.000 and 0.027,respectively).Conclusions CAG and IVUS combined with study on plasma levels of inflammation mediators are helpful in judging the vulnerability of coronary artery plaques.(J Geriatr Cardiol 2008;5:207-211)

objective To evaluate the vulnerability of coronary artery plaque with coronary angiography(CAG),intravascular ultrasound(IVUS)and the levels of plasma inflammatory markers.Methods 58 consecutive patients with lesion of a single blood vessel demonstrated successfully by CAG were randomly divided into 3 groups based on the angiographic morphology of the the lesions:type Ⅰ lesion group(n=16),type Ⅱ lesion group(n=25),type Ⅲ lesion group(n=17).Meantime,a control group of stable angina(n=17)was established.A subgroup of 28 patients(including 18 acute coonary sysdrome (ACS)patients and 10 stable angina control patients)who underwent IVUS study were analyzed.Then the plasma levels of high sensitivity CRP(hs-CRP),matrix metalloproteinase(MMP,including MMP-2 and MMP-9),CD40 ligand(CD40 L)and pregnancy associated plasma protein-A(PAPP-A)were measured with ELISA.Analyses were performed by statistical package SPSS 11.0.Results The plasma levels of MMP-2,MMP-9 and PAPP-A in typeⅡ lesion group were significantly higher than the other groups(P＜0.05,0.05,0.001,respectively).In type Ⅱ lesion group,linear correlation analysis manifested significantly positive correlation between levels of hs-CRP and MMP-2(r=0.508);MMP-2 and MMP-9,CD40 L,PAPP-A(r=0.647,0.704,0.751,respectively);MMP-9 and CD40L,PAPP-A(r=0.491,0.639,respectively);CD40L and PAPP-A(r=0.896).IVUS subgroup analysis showed that the area of plaques and plaques burden in culprit lesion,the incidence of high-risk plaques,remodeling index(RI)and positive remodeling percentage in ACS patients were significantly greater than those in the control group(P=0.000,0.037,0.028,0.015,0.040,respectively).Compared with the control group,the plasma levels of hs-CRP,MMP-2,MMP-9 and PAPP-A were markedly elevated(P=0.033,0.000,0.000,0.027,respectively).Conclusions CAG and IVUS combined with the study on plasma levels of inflammation mediators were helpful in judging the vulnerability of coronary artery plaques.