OBJECTIVEThe analyze the correlation of heart and kidney biomarkers to different heart and kidney diseases and explore the pathogenesis and classification of cardiorenal syndrome.

METHODSThis study involved 841 consecutive patients (600 males and 241 females) admitted between January, 2008 and May, 2008, who underwent NT-ProBNP and creatinine tests during hospitalization. The patients were classified according to the clinical diagnosis at the admission and to the status of the heart and kidney biomarkers.

RESULTSThe heart and kidney biomarkers were significantly different between genders. NT-proBNP showed slight elevations in patients with atrial fibrillation, mild non-heart disease, hypertension and angina, but significant elevation in patients with severe non-heart disease. In patients with renal artery stenosis, the heart and kidney biomarkers were moderately increased, which was also seen in patients with diabetes mellitus, myocardial infarction and coronary artery bypass grafting. In dilated cardiomyopathy and rheumatic heart disease, NT-proBNP showed marked increase with only slight increase of creatinine. Patients with chronic kidney disease had the highest NT-proBNP and creatinine levels and the lowest eGFR. The heart and kidneys index increased with the severity of the disease. From Ronco type I to type IV, NT-proBNP rose gradually, but the difference was not statistically significant (P>0.05), and the type I and IV patients had the highest creatinine level; type III involved mainly acute coronary syndrome, heart failure and renal stenosis. According to a modified classification, cardiarenal syndrome was characterized mainly by a marked increase of NT-proBNP, while renalcardiac syndrome by creatinine increases (P<0.05). Acute coronary syndrome, heart failure and renal artery stenosis represented a special entity of cardiorenal syndrome.

CONCLUSIONSHeart and kidney biomarkers and clinical diagnosis are closely related. The heart and kidneys index more accurately reflects the severity of the cardiorenal syndrome. The heart and kidney biomarkers can be used in Ronco classification. The simplified classification is convenient to use and facilitates the clinical decisions of the treatment.

Aged ; Aged, 80 and over ; Biomarkers ; blood ; Female ; Heart Diseases ; blood ; complications ; diagnosis ; Humans ; Kidney Diseases ; blood ; complications ; diagnosis ; Male ; Middle Aged ; Natriuretic Peptide, Brain ; blood ; Syndrome

OBJECTIVETo assess the value of contrast-enhanced ultrasonography (CEUS) and fluorodeoxyglucose positron emission tomography-computed tomography (¹⁸F-FDG PET/CT) in evaluating the stability of carotid atherosclerosis.

METHODSSeventeen patients with 21 carotid artery plaques received examinations with CEUS. According to the nature of the plaques, the patients were divided into soft and mixed plaque group and hard and calcified plaque group. The maximal enhancement intensity of the plaques (I(MAX)) and maximal plaque density (D(MAX)) were measured to quantify the neovasculature. The patients also underwent concurrent ¹⁸F-FDG PET/CT, and ¹⁸F-FDG uptake was quantified by the mean standard uptake values (SUV(mean)), an index reflecting the inflammatory activity in the plaque. The findings in CEUS and PET/CT were comparatively analyzed for these cases.

RESULTSThe D(MAX) of the plaque in soft and mixed plaque group was significantly greater than that in hard and calcified plaque group (4.26±3.65 vs 1.41±1.47, P<0.05); the I(MAX) was also greater in the former group, but this difference was not statistically significant (26.83±19.61 vs 24.73±29.85, P=0.869). The soft and mixed plaques tended to have higher SUVmean than the hard and calcified plaques (1.70±0.45 vs 1.47±0.12, P=0.099). The values of I(MAX) and D(MAX) were not found to correlate to SUV(mean) in these patients.

CONCLUSIONCEUS can sensitively show the status of neovascularization within the carotid atherosclerosis plaques, and PET/CT reflects the inflammatory activity in the plaques. The combination of these two imaging modalities allows the evaluation of plaque stability in terms of neoangiogenesis and inflammatory activity.

Aged ; Aged, 80 and over ; Carotid Stenosis ; diagnostic imaging ; Female ; Fluorodeoxyglucose F18 ; Humans ; Male ; Middle Aged ; Positron-Emission Tomography ; Tomography, X-Ray Computed

Objective To investigate the dynamics and development trends of drinking water type of endemic fluorosis after water improvement in Xinbaerhuyouqi of Hulunbeir city, Inner Mongolia and to provide a scientific evidence for the development of countermeasures. Methods We mainly selected Adunchulusumu and Kerlunsumu in Xinbaerhuyouqi of Hulunbeir city as the two monitoring points after water improvement in 2000 -2009. Of these, 1 sample of centralized water supply source water and 3 samples of tap water and 5 samples of noncentralized water supply source water according to water well locations of east, west, south, north and center were collected and the levels of water fluoride were tested; the prevalence of dental fluorosis of school children aged 8 to 12 were examined; from 2002 onwards, the urine samples of 30 children aged 8 to 12(five age groups, six urine samples for each age group) were collected, and all urine samples were collected in the case of less than 30, and urine fluoride was tested. Dental fluorosis was diagnosed using Dean method; water fluoride was tested using fluoride ion selective electrode(WS/T 106-1999); urinary fluoride was tested by determination of fluoride in urine using ion-selective electrode(WS/T 89-1996). Results In 2000 - 2009, the mean levels of fluorine in drinking water in Adunchulusumu and Kerlunsumu were 1.79 - 4.35 mg/L and 1.38 - 3.18 mg/L, respectively; the detection rate of dental fluorosis of children aged 8 to 12 were 45.24％(19/42) - 89.78％(123/137) and 40.00％ (28/70) - 74.47％ (70/94), respectively; the median urinary fluoride of them were 2.30 - 4.15 mg/L and 2.73 - 4.55 mg/L, respectively. ConclusionsThe detection rate of children's dental fluorosis remains high in Xinbaerhuyouqi during the past 10 years after changing water. The endemic fluorosis remains a serious disease. Effective prevention and control measures must be taken to control the occurrence of fluorosis in the future.

Objective To evaluate the effect of different time-window of anticoagulant therapy on secondary thrombocytosis after splenectomy. Methods Total of 200 patients with splenectomy were divided into control group (n=100) and experiment group (n=100).When throm-bocyte was over 500 ×109/L, the control group was given low molecular dextran 500 mL, low molecular heparin calcium 5000 IU, aspirin 50 mg and dipyridamole 25 mg.At postoperation 24 h, the experiment group was given low molecular dextran 500 mL, low molecular heparin calcium 5000 IU, aspirin 50 mg and dipyridamole tablets 25 mg.When platelet dropped to 400 ×109/L, drug stopped to be given.The change and difference of blood platelet level were compared between the two groups. Results The blood platelet level in two groups reached peak value at 15 days after splenectomy.In experiment group, the blood platelet level increased slowly and steadily, not exceeding 500 ×109/L.In control group, the blood platelet level increased rapidly and sharply, the peak value reached ( 945.5 ±154.4 ) ×109/L.The blood platelet level of experiment group decreased steadily from the peak value, and at 21 d after splenectomy returned to normal levels.The blood platelet level of control group returned to normal levels at 25 d after splenectomy.At postoperation 3-27 d, the blood platelet level of experiment group were significantly lower than that in control group, the difference showed statis-tically significant (P<0.05).At postoperation 29 d, the blood platelet level of two groups was no statistically signifi-cant difference(P>0.05).At 3 months of splenectomy, the blood platelet level of two groups were within the normal range.Conclusion The early anticoagulant therapy ( postoperation 24 h) can effectively prevent secondary thrombocy-tosis after splenectomy, superior to conventional anticoagulant therapy.

OBJECTIVETo evaluate neointimal proliferation following placement of a new drug-eluting stent (BUMA) by optical coherence tomography (OCT).

METHODSTwenty-two patients with coronary artery disease were randomized into BUMA group (n=15) and Endeavor group (n=7) and underwent OCT imaging after 9 months of stent implantation.

RESULTSThe neointima hyperplasia (NIH) thickness in BUMA group were significantly smaller than that in endeavor group (0.220-/+0.140 mm vs 0.269-/+0.207 mm, P<0.001), and the uncovered Struts were significantly lower in BUMA group than in Endeavor group (5.65% vs 6.56%, P<0.0001). The luminal late loss in BUMA group was also significantly lower (34.87-/+11.50 vs 40.82-/+18.53, P=0.025).

CONCLUSIONBUMA stent is safe and effective for treatment of coronary artery disease.

Angioplasty, Balloon, Coronary ; adverse effects ; Cell Proliferation ; Coronary Artery Disease ; pathology ; therapy ; Coronary Vessels ; pathology ; Drug-Eluting Stents ; adverse effects ; Humans ; Prospective Studies ; Tomography, Optical Coherence ; Tunica Intima ; pathology

Objective To study the impacts of the Three Gorges dam and change of water level on the survival of the local rodents, and to provide scientific basis to control the outbreak of rodent-borne diseases.Methods Four villages located around the Three Gorges dam were selected in the study. The mouse populations by using Elton night trapping method was monitored. Metallic spring traps were set for two consecutive nights. The mouse density and identified the mouse species was calculated. The mouse species indoor and outdoor, as well as the mouse density indoor and outdoor were compared. The impacts of water level in the dam and cleaning work on local mouse density were also analyzed. Results A total of 678 mice were caught in this study, 517 were caught indoor and 161 outdoor. Indoor dominant species was flavipectus; accounting for 36.49%(189/517), while outdoor was apodemus, reaching 56.88% (91/161). For mouse species, there was a significant difference between indoor and outdoor(x2 = 678.00, P ＜ 0.01 ). The average mouse density was 8.44%(678/8036) in trap nights. Indoor mouse density reached 14.44%(517/3581 ), which was significantly higher than that of outdoor(3.61%, 161/4455 ).For mouse density, there was a significant difference between indoor and outdoor(x2 = 301.04, P ＜ 0.01 ). When the water level was up to 156 m, mouse density reached 10%(513/5132), which was higher than that of before (5.68%, 165/2904). There was a significant difference in mouse density before and after reserving water (x2 = 44.68, P ＜ 0.01 ). With the change of water level, upstream mouse density formed a high platform from May 2007 to May 2008, followed by 12.25%(80/653), 13.16%(90/684), 12.95%(90/695), and decreased to 8.38%(28/334) after cleaning of the dam. Conclusions The Three Gorges dam and change of water level actually alter the survival environment of the local mouse, and affect local mouse density and mouse species. These may lead to local outbreak or epidemic of rodent-borne diseases.

OBJECTIVETo estimate the association of driver sleepiness with the risk of car crashes.

METHODSA population-based case-control study was conducted in Shenyang, a northeastern city in China, between November 2001 and July 2002. The case group comprised 406 car drivers involved in crashes, and 438 car drivers recruited at randomly selected sites, and on the day of week, and the time of day when they were driving on highways in the study region during the study period were used as control groups. Face-to-face interviews with drivers were conducted according to a well-structured questionnaire covering the circumstances of their current trip and their background information. Stanford sleepiness scale and Epworth sleepiness scale were used to quantify acute sleepiness and chronic sleepiness respectively.

RESULTSThere was a strong association between chronic sleepiness and the risk of car crash. Significantly increased risk of crash was associated with drivers who identified themselves as sleepy (Epworth sleepiness score > or = 10 vs < 10; adjusted odds ratio 2.07, 95% confidence interval 1.30 to 3.29), but no increased risk was associated with measures of acute sleepiness.

CONCLUSIONSChronic sleepiness in car drivers significantly increases the risk of car crash. Reductions in road traffic injuries may be achieved if fewer people drive when they are sleepy.

Accidents, Traffic ; Adult ; Aged ; Automobile Driving ; Case-Control Studies ; China ; Fatigue ; Female ; Humans ; Male ; Middle Aged ; Odds Ratio ; Risk Factors ; Sleep ; Urban Population

BACKGROUNDIn general, percutaneous coronary intervention (PCI) relieves vessel stenosis by implantation of a stent, however, the relationship between plaque characteristics and response after stenting is not clear.

METHODSWe enrolled 68 patients (68 vessels) with diagnosed unstable angina pectoris that prospectively underwent PCI and an optical coherence tomography (OCT) examination was done before and after stenting. Coronary plaques were classified as fibrous, lipid-rich and calcified plaque according to OCT examination, and fibrous cap thickness, lumen eccentricity, stent expansion, stent malapposition, tissue prolapse, thrombosis, dissection and stent symmetry were noted.

RESULTSThe frequency of prolapse was higher in lipid-rich plaques than fibrous plaques (85% vs. 40%, P < 0.001). Dissection most often occurred in fibrous plaque compared with lipid-rich and calcified plaques (60% vs. 32% vs. 29%, P < 0.001). The frequency of stent strut malapposition in calcified plaques was higher than firous and lipid-rich plaques (71% vs. 40% vs. 5%, P < 0.001). In-stent micro-thrombosis was detected only in lipid-rich plaques, with a frequency of 37% (15/41). The risk factors of micro-thrombosis after PCI were cap thickness (OR 0.903, 95%CI 0.829 - 0.985), lumen eccentricity (OR 1.147, 95%CI 1.012 - 1.30), and stent length (OR 1.495, 95%CI 1.032 - 2.166).

CONCLUSIONPlaque response after PCI is associated with its characteristics, and of those, micro-thrombosis after stenting in lipid-rich plaques was the most significant finding and can be predicted.

Adult ; Aged ; Aged, 80 and over ; Angioplasty, Balloon, Coronary ; methods ; Coronary Artery Disease ; therapy ; Drug-Eluting Stents ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Tomography, Optical Coherence ; methods

Objective To understand the development situation and existing problems of personnel allocation of assistive device institu-tions during the"Twelfth Five-Year"period in Shanghai,China.Methods A questionnaire was designed and a census was conducted to ob-tain the personnel allocation data from district and street level assistive institutions in 2010 and 2014 about age,education background,ma-jor and years of working, etc. Results During the comparison between 2010 and 2014, there was significant difference only on years of working from district level(P<0.01),and there were significant differences on age,education background,major and years of working from street level (χ2≥43.603, P<0.001). The personnel structures in urban districts and suburban districts were significantly different between 2010 and 2014(χ2≥16.166,P<0.001).Conclusion During the"Twelfth Five-Year"period,the construction of talents for assistive device in-stitutions got remarkable achievement in Shanghai,but it is still necessary to strengthen professional training and reduce the difference of structure.

Objective The active ingredient was used as index to optimize the extraction and enrichment process of anti-in-flammatory and analgesic active-fraction(ARF)of Dianbaizhu. Methods Methyl salicylate triglycoside-B was chosen as index com-ponent to extract and enrich methyl salicylate glycosides. Extraction and elution solvents were optimized. The HPLC fingerprint was ob-tained with Thermo Hypersil Gold C18(250 mm×4.6 mm,5μm)column and a gradient elution with the mobile phase consisting of ace-tonitrile(A)-0.2％acetic acid(B)at a flow rate of 1.0 ml/min. And the detection wavelength was set at 294 nm. Results The opti-mized extraction solvent of Dianbaizhu was the 30％ethanol and the optimized elution solvent of ARF enriched by AB-8 macroporous resins was the 35％ethanol. The methodological study on similarity and RSD in ARF HPLC fingerprint of three batches of samples cor-responded to related regulations. Conclusion The extraction and enrichment process of ARF is stable and repeatable.