Objective To investigate the distribution characteristics of serum small dense low density lipoprotein-cholesterol (sdLDL-C) levels in healthy normolipidemia and hyperlipidemia and analyze the correlation between sdLDL-C and other serum lipids.Methods Totally 1012 normolipidemic subjects (18 93 years old,503 male,509 females) were grouped according to gender and age (18 -29,30 -69 and ≥70 years old).And 433 hyperlipidemic subjects (23 -90 years) were divided into the following 3 groups based on fasting triglyceride (TG) and low density lipoprotein-cholesterol (LDL-C)levels:hypertriglyceridemia (n =165 ),high-LDL-C ( n =129) and combined hyperlipidemia ( n =139 ).The sdLDL-C and other serum lipids were measured by Olympus AU2700 automatic analyzer.Analysis of Variance and Kruskal-Wallis H test was used for statistical analysis.Results The distribution of the sdLDL-C levels in normolipidemic subjects was near normal distribution.The sdLDL-C levels had differences in gender and age.In the 18 -29 and 30 -69 years old group,the mean values of sdLDL-C were significantly higher in males than in females [ (0.55 -0.21 ) mmol/L vs (0.47 ±0.22) mmol/L,t =2.212,P =0.028 and (0.66±0.28) mmol/L vs (0.62±0.25) mmol/L,t =2.121,P=0.034].In the ≥70 years old group,the difference of sdLDL-C levels in gender was not statistically significant [ male ( 0.54 ± 0.21 )mmol/L vs female (0.54 ± 0.22 ) mmol/L,t =0.022,P =0.982] ; the mean value was ( 0.54 ± 0.22 ) mmol/L The hyperlipidemic subjects had conspicuous higher levels of sdLDL-C compared with normolipidemia [ ( 1.25 ±0.44) mmol/L vs (0.60 ±0.26) mmol/L,t =29.306,P ＜0.001 ].Among all of groups,the combined hyperlipidemia group had the highest sdLDL-C level [ ( 1.52 ± 0.49) mmol/L,F =525.66,P ＜0.001 ] ; the hypertriglyceridemia group had the highest sdLDL-C/LDL -C level (0.47 ±0.12,F =287.93,P ＜0.001 ) and the high-LDL-C group had the highest level of non-sdLDL-C [LDL-C subtract sdLDL-C,(2.71 ± 0.52) mmol/L.F =336.32,P ＜ 0.001 ].The sdLDL-C showed a good positive correlation with TC,TG,LDL-C,ApoB and BMI ( rs =0.66,0.68,0.65,0.79 and 0.27,P ＜ 0.001 ),and negative correlation with HDL-C and ApoA1 ( rt =- 0.42 and - 0.37,P ＜ 0.001 ).Based on partial correlative analysis,sdLDL-C showed a different correlation with TG,LDL-C and TC ( r =0.42,0.28 and 0.15,P ＜ 0.001 ).Conclusions LDL-C and TG are the important factors influencing the sdLDL-C levels.However,TG has greater effect than LDL-C.The sdLDL-C is an appropriate and good index to evaluate the small dense low density lipoprotein (sdLDL) mass and the overall situation of lipid metabolism.In order to make full use of sdLDL in the clinical treatment and health assessment,it is necessary to establish sdLDL-C reference intervals through the survey of distribution of sdLDL-C levels in different geographic areas.

Objective To study the serum small dense low density lipoprotein-cholesterol (sdLDL-C)concentration in patients with clinical and sub-clinical primary hypothyroidism,and to explore the clinical significance of serum sdLDL-C determination in pa-tients with hypothyroidism.Methods 60 patients with clinical hypothyroidism(clinical hypothyroidism group),96 cases with sub-clinical hypothyroidism(sub-clinical hypothyroidism group)and 132 normal subjects (normal group)were enrolled in the study. FT3,FT4,thyroid stimulating hormone (TSH),TG,TC,HDL-C,LDL-C,apolipoprotein AⅠ(ApoAⅠ),apolipoprotein B (ApoB), and sdLDL-C concentrations were measured.Analysis of Variance,Kruskal-Wallis H test and Spearman rank correlation analysis were used for statistical analysis.Results The concentration of sdLDL-C in sub-clinical hypothyroidism group was significantly higher than that in normal group (t=5.78,P <0.01),the concentration of sdLDL-C in clinical hypothyroidism group was signifi-cantly higher than that in sub-clinical hypothyroidism group(t=-2.88,P <0.01)and in normal group (t=6.68,P <0.01).There was statistically significant difference among groups (F =37.66,P <0.01).Correlation analysis showed that sdLDL-C in primary hypothyroidism patients was positively correlated with LgTSH (r =0.203,P =0.011 ),and negatively correlated with FT4 (r =-0.169,P =0.035).Conclusion The high concentration of sdLDL-C is a manifestation of dyslipidemia in primary hypothyroidism patients,and an important risk factor for atherosclerosis in primary hypothyroidism patients.

Objective To investigate the levels of small and dense low-density lipoprotein-cholesterol (sdLDL-C) and the influence of insulin therapy on lipid metabolism in type 2 diabetic patients.Methods The subjects were composed of a normal group (n =400,195 males and 205 females),and a type 2 diabetic patients group (n =193,108 males and 85 females) which was further divided into normal lipid (n =33),hypercholesterolemia (n =21,TC ≥ 5.18 mmol/L),hypertriglyceridemic (n =53,TG ≥ 1.7 mmol/L),combined hyperlipidemia (n =75),and low high-density lipoprotein-cholesterol(n=11,HDL-C＜ 1.04 mmol/L) subgroups.The pre-and post-treatment levels of sdLDL-C and the influence of insulin therapy on lipid metabolism in type 2 diabetic patients (n =122,70 males and 52 females) were compared.Serum concentrations of sdLDL-C (sdLDL-EX SEIKENreagent),triglyceride (TG),total cholesterol (TC),and fasting plasma glucose (FPG) were measured by automatic biochemical analyzer,fasting insulin and C-peptide were determined by chemiluminesence immunoassay,TG/HDL-C,sdLDL-C/ LDL-C,LDL-C/HDL-C,apoB/apoA Ⅰ,and other parameters were calculated.Results Compared with diabetic normal lipid group,the levels of sdLDL-C in hypercholesterolemia,hypertriglyceridemic,and combined hyperlipidemia subgroups were significantly higher(P＜0.05),the levels in combined hyperlipidemia subgroup were the highest.The levels of sdLDL-C in low high density lipoprotein cholesterol group showed no significantly difference (P＞0.05).While compared with normal group,the levels of sdLDL-C,TG,TC,LDL-C,ApoB,sdLDL-C/LDL-C,TC/HDL-C,TG/HDL-C,LDL-C/HDL-C,apoB/apoA Ⅰ,CRP,and HOMA-IR in type 2 diabetic patients were significantly higher(P＜0.05).Compared with pre-treatment group,the levels ofTG,TC,LDL-C,sdLDL-C,sdLDL-C/LDL,TC/HDL-C,TG/HDL-C,LDL-C/HDL-C,and apoB/apoA Ⅰ in post-treatment group were significantly lower(P ＜ 0.05).Conclusions sdLDL-C is the important indicator of lipid metabolism in type 2 diabetes,particularly in evaluating the changes in LDL particles.Insulin therapy is effective both in blood glucose control and improvement of dyslipidemia.Important information of clinical risk of dyslipidoses in type 2 diabetic patients provided by TG/HDL-C,LDL-C/HDL-C,sdLDL-C/LDL-C,and apoB/apoA Ⅰ ratios should be recognized and implemented in future clinical guidelines.

Objective To explore the efficacy of mycophenolate mofetil (MMF), which is a kind of immuno-suppressant drugs, on the treatment of Connective tissue diseases-pulmonary arterial hypertension (CTD-PAH). Methods Medical charts of eleven cases of hospitalized patients who were diagnosed as CTD-PAH and treated by MMF in Beijing Chaoyang Hospital affiliated to the Capital Medical University, from January 2014 to June 2016 were collected and analyzed. Results In the 11 cases of CTD-PAH, the systemic lupus erythematosus (SLE) related pulmonary hypertension (SLE-PAH) were 7, while the systemic sclero-derma associated pulmonary hypertension (SSc-PAH) were 2, and rheumatoid arthritis related pulmonary hy-pertension (RA-PAH) was 1, and the mixed connective tissue disease related pulmonary hypertension (MCTD-PAH) was 1. All patients were women, and the average age was (40 ±14) years, and the average duration of PAH was (34 ±35) months. The combination therapy of corticosteriods and MMF was applied to 7 cases, meanwhile the therapy of corticosteriods, MMF and bosentan was used in 1 case, corticosteriods, MMF and sildenafil was prescribed for 3 cases, and symptoms of the patients alleviated. Except for one case having been followed up for 7 months and one for 6 months, 9 patients completed the 1-year follow-up, and the survival rate was 100%(9/9). Notably, one patient, who had been alleviated for 111 months with therapy of corticosteriods and MMF, adopted the combination therapy of corticosteriods, MMF and bosentan for aggravated chest distress, and became stable eventually. Conclusion MMF may have therapeutic effects on inducing and even maintaining the stabilization of CTD-PAH.

Objective : To investigate the status of occupational stress and analyze its influencing factors among frontline employees working in a chemical fiber manufacturing enterprise, so as to provide insights into the development of occupational stress interventions. Methods : The frontline employees working in a chemical fiber manufacturing enterprise were selected as the study subjects using a cluster sampling method in October 2018. The status of occupational stress was investigated using the Chinese version of the effort-reward imbalance ( ERI ) questionnaire. The influencing factors for occupational stress were identified using a multivariable logistic regression model. Results : A total of 1 780 questionnaires were sent out, and 1 115 valid ones ( 62.64% ) were recovered. Among the 1 115 respondents, there were 427 men ( 38.30% ) and 688 women ( 61.70% ), and 71.22% were at ages of 21 to 39 years. There were 561 respondents with < 1 year of service ( 50.31% ), and the longest length of service was 11 years. In addition, there were 1 069 respondents ( 95.87% ) exposed to high noise, and 346 respondents ( 31.03% ) were diagnosed at a high occupational-stress state and 769 ( 68.97% ) at a low state. Multivariable logistic regression analysis identified 5 years or longer of service ( OR=1.540, 95%CI: 1.057-2.245 ) and exposure to high noise ( OR=1.917, 95%CI: 1.004-3.659 ) as risk factors for occupational stress among frontline employees in the chemical fiber manufacturing enterprise. Conclusions There are 31.03% of frontline employees at a high occupational-stress state in the chemical fiber manufacturing enterprise, and a high occupational-stress state is associated with exposure to high noise and 5 years or longer of service.

Objective:To investigate the changes of inflammatory factors and immune function in bronchial asthma children with Mycoplasma pneumoniae infection.Methods:From March 2019 to March 2020, 78 children with bronchial asthma and Mycoplasma pneumoniae infection in Wenling Maternal and Child Health Hospital were selected as observation group, and 50 bronchial asthma children without Mycoplasma pneumoniae infection during the same period were selected as control group.The levels of inflammatory factors, including tumor necrosis factor-α(TNF-α), interleukin-8(IL-8) and interleukin-13(IL-13), immunoglobulin A(IgA), immunoglobulin G(IgG) and immunoglobulin M(IgM) were measured by enzyme-linked immunosorbent assay, and the changes of T lymphocyte subsets in peripheral blood were measured by flow cytometry.Results:The serum levels of TNF-α[(76.42±16.51)ng/L], IL-8 [(130.92±25.45)ng/L] and IL-13 [(172.35±28.39)ng/L] in the observation group were higher than those in the control group [(58.93±13.24)ng/L, (89.65±17.42)ng/L and (108.47±21.42)ng/L] ( t=6.708, 11.025, 14.665, all P<0.05). The serum levels of IgA [(0.64±0.16)g/L] and IgG [(7.31±1.26)g/L] in the observation group were lower than those in the control group [(1.04±0.19)g/L and (8.64±1.35)g/L], while the serum level of IgM [(1.29±0.24)g/L] was higher than that in the control group [(0.97±0.18)g/L] ( t=12.587, 5.864, 8.714, all P<0.05). The CD 3+ [(62.08±3.87)%], CD 4+ [(38.98±3.31)%] and CD 4+ /CD 8+ (1.29±0.13) in the observation group were lower than those in the control group [(71.38±4.35)%, (45.37±3.18)% and (1.87±0.25)] ( t=12.549, 11.103, 15.512, all P<0.05). Conclusion:Children with bronchial asthma and Mycoplasma pneumoniae infection have obvious inflammatory reaction and low immune function.

Objective To observe the clinical effect of repairing the defect after extended resec-tion of lower lip cancer by modified lip and cheek fan-shaped flap .Methods Six cases of lower lip cancer were treated .The defect of the lower lip was about 1/3-1/2 after 1 cm of enlarged resection outside the margin of the mass .The defect was repaired with modified lip and cheek fan-shaped flaps . The morphology and function were observed 3-36 months after operation .Results All patients healed in one stage ,and the shape and function of lower lip recovered well without complications .Conclusions Lower lip defect about 1/3-1/2 of patients with modified lip and cheek fan-shaped flap is an ideal method of restoration and reconstruction ,with satisfactory results after surgery .

BACKGROUNDPaclitaxel, as a first line anti-neoplastic compound, frequently produces long-term pain after tumors have been treated. Clinical manifestations are varied and non-specific. Pathology of the nervous system during the development of the neuropathic pain is unclear. Thus, early diagnosis and treatment is often unsatisfying for patients. This study aimed to promote considerate understanding of the structural alteration of sensory nerves.

METHODSAll rats were simply randomized into 3 groups: paclitaxel group, vehicle group and saline group. An established rat model of paclitaxel-induced peripheral neuropathy (2 mg/kg) was chosen for our research, behavior tests were operated during the procedure of 56 days. All rats were sampled on days 0, 3, 7, 28 and 56. The hind paw plantar skin, sciatic nerves, dorsal root ganglion and attached fibers, and lumbar spinal cord were processed for light and electron microscopy. The differences among 3 groups were analyzed with one-way analysis of variance (ANOVA).

RESULTSWe affirmed that paclitaxel-induced mechano-allodynia and mechano-hyperalgesia occured after a 3-7-day delay, and this pain peaked at day 28 and persisted to day 56. Paclitaxel and vehicle treatment both evoked thermal-hyperalgesia. Paclitaxel-induced axonal and myelin sheath degeneration was evident. At days 3 and 7, significant increases in atypical mitochondria in both myelinated axons and C-fibers of paclitaxel-treated nerves indicated that injured mitochondria correlated to specific paclitaxel-induced neuropathic pain, and the abnormity sustained till day 56. Microtubule was unaffected in myelinated axons or C-fibers in paclitaxel- or vehicle-treated rats. Significant increase of G ratio was evident with paclitaxel injection at days 7 and 28.

CONCLUSIONOur research suggests a causal role for axonal degeneration, abnormalities in axonal mitochondria, and structural modification of axonal microtubules in paclitaxel-induced neuropathic pain, and the abnormal mitochondria could be connected to the chronic neuropathic pain.

Animals ; Antineoplastic Agents, Phytogenic ; adverse effects ; Axons ; drug effects ; metabolism ; Male ; Microtubules ; drug effects ; metabolism ; Mitochondria ; drug effects ; metabolism ; Neuralgia ; chemically induced ; Paclitaxel ; adverse effects ; Random Allocation ; Rats ; Rats, Sprague-Dawley

Objective    To investigate the effectiveness and safety of totally endoscopic transmitral myectomy (TETM) for hypertrophic obstructive cardiomyopathy (HOCM), comparing with traditional sternotomy modified Morrow procedure (SMMP). Methods    Thirty-eight patients with HOCM who needed surgical intervention were selected from our hospital in 2019, including 14 males and 24 females, with an average age of 56 (44-68) years. According to the operation method, they were divided into a TETM group (n=18) and a SMMP group (n=20). Appropriate patients  were screened by propensity matching scores. Finally, the clinical data of two matched groups were compared and