OBJECTIVETo study the long-term effects and mortality of biventricular pacing therapy in patients with congestive heart failure.

METHODSTwenty-five patients, 18 men and 7 women, aged 34-75 [mean aged of (61.42 +/- 10.36)] years, with a cardiac function of New York Heart Association (NYHA) class III (n = 10) or IV (n = 15) received biventricular pacing therapy from Mar. 2001 to Feb. 2005. The etiologies of heart failure were idiopathic dilated cardiomyopathy (16 cases), hypertensive heart disease (3 cases) and ischemic heart disease (6 cases). Left ventricular end-diastolic dimension (LVEDD) was > 60 mm, Left ventricular ejection fraction (LVEF) was < 0.40 and QRS duration was > 130 ms in all the patients. Heart function parameters were repeatedly measured before and 3 months, 6 months, 1 year, 2 years and 3 years after pacemaker implantation. Mortality was also determined. The average follow up period was (20.88 +/- 11.51) months.

RESULTS(1) Mortality: 5 patients died during follow-up (3 non-cardiac and 1 cardiac sudden death and 1 acute myocardial infarction). (2) The mean 6-min walking distance was increased significantly (P < 0.05) at 3 months to 3 years of follow-up. (3) NYHA class: The cardiac function of all patients improved significantly, with a reduction of mean NYHA class of more than one grade at 3 months to 3 years follow-up. (4) LVEDD: LVEDD reduced significantly (P < 0.05) at 3 months to 3 years follow-up. (5) LVEF: LVEF increased significantly (P < 0.05) at 3 months to 2 years follow-up. LVEF also improved at third year's follow-up, but the difference was not significant statistically.

CONCLUSIONSCardiac resynchronization, a pacemaker-based therapy for heart failure, may enhance quality of life and heart function and reverse LV remodeling. The long-term effects of treatment were stable, leading to the reduction of mortality from advanced heart failure.

Adult ; Aged ; Cardiac Pacing, Artificial ; methods ; Death, Sudden, Cardiac ; Female ; Heart Failure ; mortality ; physiopathology ; therapy ; Humans ; Male ; Middle Aged ; Pacemaker, Artificial ; Survival Rate ; Treatment Outcome

OBJECTIVETo investigate the relationship between dyslipidemia and the polymorphism of angiotensin II type 1 receptor (AT(1)R) gene A1166C in hypertensive Kazakans of Xinjiang area.

METHODSPolymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) methods were used to detect the A1166C polymorphism of AT(1)R gene of 296 hypertensive and 198 normotensive Kazakans. Biochemical parameters were measured by autochemical emalyzer.

RESULTS(1) The TC and LDL-C levels are significantly higher in hypertension group than those in normotensive controls [TC: (4.91 +/- 1.19) mmol/L vs. (4.43 +/- 1.20) mmol/L; LDL-C: (3.36 +/- 1.01) mmol/L vs. (2.94 +/- 1.30) mmol/L, P < 0.001). (2) In hypertension group, TC and LDL-C are related to A1166C polymorphism of AT(1)R gene and TC and LDL-C of AC carriers are significantly higher than AA carriers (P < 0.05).

CONCLUSIONThe dyslipidemia is related to A1166C polymorphism of AT(1)R gene in hypertensive Kazakans.

Gene Frequency ; Genotype ; Humans ; Hypertension ; Polymorphism, Genetic ; Receptor, Angiotensin, Type 1 ; genetics

OBJECTIVETo assess the association of polymorphisms of PR domain containing 16 gene (PRDM16) with essential hypertension in ethnic Uygur population from Xinjiang, China.

METHODSFunctional regions of the PRDM16 gene were sequenced in 48 Uygur subjects with essential hypertension selected from 480 hypertensive patients and 819 normotensive controls. Representative variations were genotyped with TaqMan-PCR method. Association of variations of PRDM16 gene with hypertension was analyzed.

RESULTSFor the 4 genotyped representative variations (rs2236518, rs2282198, rs2493292 and rs870171), no significant difference in genotype distribution and allele frequencies has been found between the patient and control groups (P>0.05). By ANOVA analysis, none of the polymorphisms was significantly associated with systolic or diastolic blood pressure (P>0.05). Nor was significant difference in haplotypic frequencies between the two groups detected (P>0.05).

CONCLUSIONWe have found no association between the four polymorphisms (rs2236518, rs2282198, rs2493292 and rs870171) of the PRDM16 gene with essential hypertension in ethnic Uygur population from Xinjiang.

Asian Continental Ancestry Group ; genetics ; Blood Pressure ; genetics ; DNA-Binding Proteins ; genetics ; Essential Hypertension ; Female ; Genetic Predisposition to Disease ; Genotype ; Humans ; Hypertension ; genetics ; Male ; Middle Aged ; Polymorphism, Genetic ; Transcription Factors ; genetics

OBJECTIVETo investigate the relationship between lymphocyte DNA damage and polycyclic aromatic hydrocarbons (PAHs) exposure in coke oven workers.

METHODSTwo hundred and thirty-five coke oven workers and 30 controls were selected in this study. Alkaline single-cell gel electrophoresis was used to evaluate the lymphocyte DNA damage, HPLC was employed to measure 1-hydroxypyrene levels in spot urine samples which were obtained at the end of a workweek (4 days of 8 hours/day) and personal information including occupational exposure, age, sex, smoking and drinking status was collected by the questionnaire.

RESULTSThe lymphocyte DNA damage level expressed as olive moment in coke oven workers was significantly higher than that of controls [2.47 (0.22 approximately 46.68) vs 0.94 (0.42 approximately 4.21), P < 0.01], and correlation between urinary 1-hydroxypyrene concentrations and olive moment was found (Spearman Partial correlation coefficient = 0.22, P < 0.01) in coke oven workers. The 1.9 of olive moment value was used as the limit to determine whether the subject DNA damage was positive. The coke oven workers had significantly higher risk in DNA damage (adjusted OR = 5.38, 95% CI = 2.07 approximately 14.08) than did controls, and dose-response relationships were also found between external exposure (exposure category) or internal doses (urinary 1-hydroxypyrene) and DNA damage.

CONCLUSIONThere are dose-effect and dose-response relationships between PAHs exposure and lymphocyte DNA damage in coke oven workers.

Adult ; Animals ; Coke ; adverse effects ; DNA Damage ; drug effects ; Dose-Response Relationship, Drug ; Female ; Humans ; Lymphocytes ; metabolism ; Male ; Occupational Exposure ; Polycyclic Aromatic Hydrocarbons ; poisoning ; Pyrenes ; analysis ; metabolism ; Surveys and Questionnaires

OBJECTIVETo investigate the association between polymorphisms of metabolic enzyme genes and chromosomal damage risk in peripheral blood lymphocytes among coke oven workers.

METHODSOne hundred and fourty-nine coke oven workers and 24 referents without occupational polycyclic aromatic hydrocarbons (PAH) exposure were recruited in this study. Urinary 1-hydroxypyrene levels were measured as the internal dose of PAH exposure. The 6 per 1 000 of micronucleus value was used as the cut-off value to determine whether the individual's chromosomal damage was positive. The genotypes of CYP1A1, GSTM1, GSTT1, GSTP1, CYP2E1, NQO1, NAT2 and mEH genes were determined by PCR-based methods. Multiple logistic regression was used to calculate the adjusted ORs and the 95% CI for the risk of chromosomal damage and to analyze the gene-gene interaction.

RESULTSIn 173 subjects, after adjusting the occupational exposure, age, sex, smoking and drinking status, the subjects with GSTM1 null genotype have significantly higher risk for chromosomal damage than subjects with GSTM1 positive genotype (adjusted OR = 2.01, 95% CI = 1.03 -3.91). Compared with the wild homozygotes at P187S site of NQO1 gene, the variant homozygotes have significantly higher risk for chromosomal damage (adjusted OR = 3.18, 95% CI = 1.18 - 8.62). The subjects with variant allele at H113Y site of mEH gene have significantly lower risk for chromosomal damage (adjusted OR = 0.40, 95% CI = 0.19 - 0.88). No significant associations were found for other gene polymorphisms and chromosomal damage risk. In addition, the gene-gene interactions were also found among GSTM1, NQO1 gene P187S and mEH gene H113Y polymorphisms for the risk of chromosomal damage risk.

CONCLUSIONSignificant associations between genetic polymorphisms in GSTM1, NQO1 and mEH gene and risk for chromosomal damage were found among occupational PAH-exposed workers, which related to the mechanism of PAH carcinogenesis.

Adult ; DNA Damage ; genetics ; Epoxide Hydrolases ; genetics ; Female ; Genetic Predisposition to Disease ; genetics ; Glutathione Transferase ; genetics ; Humans ; Logistic Models ; Lymphocytes ; metabolism ; Male ; Middle Aged ; Multivariate Analysis ; NAD(P)H Dehydrogenase (Quinone) ; genetics ; Occupational Exposure ; Polycyclic Aromatic Hydrocarbons ; poisoning ; Polymorphism, Genetic ; Pyrenes ; analysis ; Risk Factors

OBJECTIVETo investigate the relationship between the urinary 1-hydroxypyrene level and cytokinesis-block micronucleus and the olive moment of comet assay in peripheral blood lymphocyte in coke oven workers.

METHODSOne hundred and thirty-three workers from a coke plant and 28 referents without occupational PAH exposure were recruited in this study. Urinary level of 1-hydroxypyrene was measured by alkaline hydrolysis combined with high performance liquid chromatography as an internal exposure dose, and the DNA and chromosomal damage of peripheral blood lymphocyte were evaluated with comet assay and cytokinesis-block micronucleus method. Personal information including occupational history, age, sex, smoking and alcohol drinking, was collected by questionnaire.

RESULTSThere existed a good correlationship between the urinary level of 1-hydroxypyrene and frequency of micronuclei per 1 000 binucleated cells or the olive moment of comet assay in the study subjects, after adjusting for sex, age, smoking and alcohol drinking (r > 0.25, P < 0.01). One hundred and sixty-one subjects were divided into three groups by their urine 1-hydroxypyrene level (expressed as 0.30 - 2.44, 2.45 - 7.09 and 7.10 - 33.10 micro mol/mol Cr), and the geometric means of their urinary levels of 1-hydroxypyrene were 1.14, 4.32 and 12.49 micro mol/mol Cr, respectively. After adjusting for age, sex, smoking and alcohol drinking by multiple nonparametric analysis of covariance, the median of olive moment of comet assay in the group of 7.10 - 33.10 micro mol/mol Cr was 3.67, significantly higher than that in the groups of 0.30 - 2.44 and 2.45 - 7.09; and the micronuclei frequencies in the groups of 2.45 - 7.09 and 7.10 - 33.10 micro mol/mol Cr were 8.00 per thousand and 7.50 per thousand, respectively, significantly higher than that in the group of 0.30 - 2.44 micro mol/mol Cr (6.00 per thousand ).

CONCLUSIONSThe comet assay of peripheral blood lymphocyte was more suitable to detect the PAHs-induced early genotoxicity, than the cytokinesis-block micronucleus.

Adult ; Coke ; adverse effects ; Comet Assay ; Female ; Humans ; Male ; Micronuclei, Chromosome-Defective ; drug effects ; Micronucleus Tests ; Occupational Exposure ; adverse effects ; Pyrenes ; metabolism

OBJECTIVETo investigate DNA and chromosome damage in peripheral blood lymphocyte of coke oven workers exposed to polycyclic aromatic hydrocarbons (PAHs).

METHODSOne hundred and thirty-seven coke oven workers and 50 controls without occupational PAHs exposure were investigated. Comet assay and cytokinesis-block micronucleus (CBMN) detection were used to evaluate DNA and chromosomal damage levels in peripheral blood lymphocyte. Urinary 1-hydroxypyrene level was used to assess the personal internal PAHs exposure dose. Personal information including occupational history, age, sex, smoking and drinking status was collected by questionnaire.

RESULTSUrinary 1-hydroxypyrene level in coke oven workers [(5.76 +/- 1.04) micro mol/mol Cr] was significantly higher than that in controls [(0.70 +/- 0.32) micro mol/mol Cr]. The rate of CBMN and comet tail moment of lymphocyte in coke oven workers [8.0 per thousand (0.0 per thousand - 30.0 per thousand ) and 2.09 (0.31 - 75.41), respectively] were higher than those in controls [3.5 per thousand (0.0 per thousand - 13.0 per thousand ) and 1.05 (0.11 - 6.63), P < 0.05]. In controls, the comet moment in smokers was significantly higher than that in non-smokers [1.44 (0.23 - 6.63) vs 0.81 (0.11 - 3.47), P < 0.05]. According to the length of work, 137 coke oven workers were classified into 3 groups i.e. 0.5 yrs , 16.0 yrs and 22.0 yrs group, and the comet moments were 1.34 (0.31 - 37.84), 2.32 (0.49 - 52.97) and 3.20 (0.45 - 75.41) respectively after adjusting the age, sex, smoking, drinking and level of urinary 1-hydroxy-pyrene. There was a rising tendency along with the increase in length of work.

CONCLUSIONUnder present PAHs exposure levels, both comet assay and Cytokinesis-block micronucleus test could detect PAHs-induced genotoxicity in coke oven workers, and comet assay is more suitable to assess the cumulative damage effect on DNA.

Adult ; Coke ; Comet Assay ; DNA Damage ; Female ; Humans ; Lymphocytes ; metabolism ; Male ; Middle Aged ; Occupational Exposure ; analysis ; Polycyclic Aromatic Hydrocarbons ; poisoning ; Pyrenes ; analysis ; Time Factors

OBJECTIVETo analyze etiology of hospitalized hypertensive patients in the department of hypertension from 1999 to 2008.

METHODSThis retrospective study was performed to analyze the etiology of hospitalized hypertensive patients in department of hypertension and to show the distribution change of hypertension from 1999 to 2008.

RESULTS(1) There were 5867 (75.1%) patients with essential hypertension and 1942 (24.9%) patients with secondary hypertension (SH). (2) The prevalence rate of SH increased significantly during the 10 years (χ(2) = 387.621, P < 0.001) and was higher in 2008 than in 1999 (39.3% vs. 9.5%, P < 0.05). The prevalence of obstructive sleep apnea syndrome (OSAS) and primary aldosteronism (PA) in 2008 increased 38.3 and 1.8 times respectively than in 1999 (χ(2) = 304.025, P < 0.001; χ(2) = 42.845, P < 0.001) and other SH remained unchanged. (3) The prevalence of PA complicated with OSAS increased significantly in recent five years (χ(2) = 26.376, P < 0.001). Incidence of OSAS was 23.9% in PA patients and incidence of PA was 6.7% in OSAS patients.

CONCLUSIONSWith the insights gained on hypertension mechanism and the development of new diagnostic technology, percent of diagnosed SH increased remarkably in recent years in hospitalized hypertensive patients in our department of hypertension. OSAS and PA are the leading causes of SH.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Hospitals, Special ; Humans ; Hypertension ; epidemiology ; etiology ; Inpatients ; Male ; Middle Aged ; Prevalence ; Retrospective Studies ; Risk Factors ; Young Adult

OBJECTIVETo analyze the etiology of the patients with hypertension from the People's Hospital of Xinjiang Uigur Autonomous Region, and to investigate the distribution of hypertension in gender and different ages.

METHODSFrom September 1997 to December 2005, the data of 4642 patients with hypertension was retrospective studied.

RESULTS(1) Of all the patients, 85.24% were essential hypertension (EH) and 14.76% were secondary hypertension (SH). Higher prevalence of sleep apnea syndrome (42.92%) and anxiety (15.04%) was found in secondary hypertension. The highest prevalence of primary aldosteronism (12.12%) was found in endocrine hypertension. (2) The male patients with hypertension were more than the female ones, and the incidence of EH, sleep apnea syndrome (SAS) and primary aldosteronism was higher in male patients than female ones, and the following was less than female: anxiety, pheochromocytoma and renovascular hypertension. (3) Among the patients with SH, 21.9% were found in youth, and 9.85% in aged.

CONCLUSIONFor the young, SH should be excluded, especially SAS and anxiety should be screened and differentiated. The highest prevalence of endocrine hypertension is primary aldosteronism in young and middle-aged male. The prevalence of pheochromocytoma in female is higher than that of male.

Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; China ; epidemiology ; Female ; Humans ; Hypertension ; epidemiology ; etiology ; Male ; Middle Aged ; Prevalence ; Retrospective Studies ; Sex Factors ; Young Adult

OBJECTIVETo analyze the etiology of 628 patients with refractory hypertension and to observe the disease distribution with respect to gender and different age groups.

METHODSIn this study, clinical data of 628 refractory hypertensives who hospitalized in our hospital from September 1997 to December 2005 were retrospectively analyzed.

RESULTS(1) There were 80.1% (503/628) patients with essential hypertension, 18.9% (119/628) with secondary hypertension (SH) while diagnosis was not clear in 1.0% (6/628) patients. Renovascular hypertension (33.6%) and obstructive sleep apnea syndrome (23.5%) were the major causes of SH. The highest prevalence rate of endocrine hypertension was primary aldosteronism (13.5%). (2) There were significantly more male patients than female patients with essential hypertension, SH, renal hypertension, obstructive sleep apnea syndrome, primary aldosteronism while the incidence of pheochromocytoma in female was significantly higher than that in male patients (all P < 0.05). The incidence of renovascular hypertension was similar between male and female patients. (3) SH occurred more often in young patients (33.1%) than in aged patients (13.8%, P < 0.05).

CONCLUSIONOur data from this patient cohort showed that SH, especially renovascular hypertension and obstructive sleep apnea syndrome are major causes for refractory hypertension in young patients and primary aldosteronism was the commonest reason of endocrine hypertension in youth and middle-aged patients with refractory hypertension.

Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; China ; epidemiology ; Female ; Humans ; Hyperaldosteronism ; complications ; Hypertension ; epidemiology ; etiology ; Male ; Middle Aged ; Retrospective Studies ; Sex Distribution ; Sleep Apnea, Obstructive ; complications ; Young Adult