Objective : To evaluate the risk of cardiovascular disease in hypertensive patients managed by communities in Tongxiang in the next 10 years,and to provide evidence for the development of cardiovascular disease prevention strategies. Methods: The information about hypertensive patients managed by communities was collected from Tongxiang resident health records management system. The risk of ischemic cardiovascular disease（ICVD）in the next 10 years was assessed by the Assessment Scale of 10-Year ICVD Risk in Chinese. Results: A total of 27 173 hypertensive patients managed by communities with complete data were recruited,including 11 868 males,accounting for 43.68%,and 15 305 females,accounting for 56.32%. The median（inter-quartile range）of the total scores of 10-year ICVD risk in hypertensive patients was 8.00（3.00）,with 9.00（2.00）in males and 8.00（2.00）in females. The total scores of 10-year ICVD risk in males was significantly higher than those in females（P<0.05）. A total of 8 764 patients had high 10-year ICVD risk,accounting for 32.25%. The proportion of high10-year ICVD risk in females with hypertension was higher than that in males（P<0.05）. The weights of ICVD risk factors in males were 54.58% in age,17.42% in systolic blood pressure,14.27% in smoking,7.77% in body mass index,4.51% in total cholesterol and 1.45% in diabetes;the ones in females were 63.57% in age,14.63% in systolic blood pressure,9.81% in body mass index,6.00% in total cholesterol,5.88% in diabetes and 0.11% in smoking. Conclusion The ICVD risk of hypertensive patients managed by communities in Tongxiang is higher in the next 10 years. Male patients should focus on the control of blood pressure and smoking,while female patients should focus on the control of blood pressure and body weight.

Objective To investigate the incidence rate,timing and risk factors of metachronous pulmonary metastasis after curative resection in patients with rectal cancer.Methods A total of 198 patients with rectal cancer undergoing curative resection in gastroenterology surgery department of Beijing Hospital from 2007 to 2012 were enrolled in this retrospective study.The metachronous metastasis and recurrence were observed.Clinicopathologic factors which might be associated with postoperative pulmonary metastasis were analyzed by the univariate and multivariate analysis.Results The 5-year disease-free survival was 76.8％ in a total of 198 patients cohort.The most frequent metastatic sites were the lung(incidence of 11.6 ％)followed by liver(7.6 ％).Median interval from rectal surgery to diagnosis of pulmonary metastasis was much longer than that of hepatic metastasis(19 vs.11 months,P =0.002).Tumor location,current tumor-node-metastasis (TNM)stage,and a positive circumferential resection margin(CRM)were identified as the independent risk factors for pulmonary metastasis.The most common metachronous metastasis site for rectal cancer after curative surgery was the lung in elderly patients.Conclusions The lung is the most common metachronous metastatic site after curative surgery of rectal cancer in elderly patients.For patients with unfavorable risk profiles,a more intensive surveillance program is needed for the early detection of metachronous metastasis and recurrence.

Objective:To explore the association between snoring and prevalent hypertension among adults in Zhejiang with a cross-sectional study.Methods:After excluding participants with self-reported, physician-diagnosed heart diseases, stroke and cancer at baseline study, 56 728 participants aged 30-79 in the China Kadoorie Biobank study from Tongxiang, Zhejiang were included for the final analysis. Three multivariable logistic regression models were used to estimate the ORs for the associations of snoring with prevalent hypertension. Results:The proportion of participants who snored frequently, snored sometimes, and never snored were 24.55%, 23.94%, and 51.51%, respectively. The corresponding figures of males were 32.40%, 26.55%, and 41.05%, respectively. The corresponding figures of females were 19.00%, 22.08%, and 58.92%, respectively ( P<0.001). After adjusted socio-demographic factors, behavioral lifestyle, BMI, waist circumference, and sleep duration etc., in comparison with participants who never snored, the odds ratios (95% CI) of hypertension for those who snored frequently and snored sometimes were 1.17 (1.12-1.23) and 1.12 (1.07-1.18), respectively. The effects of snoring on hypertension were statistically significantly different between women and men, participants who were central obese and those who were not, and between premenopausal and post-menopausal women. Conclusion:Snoring was associated positively with hypertension among adults. The effect of snoring on prevalent hypertension were obvious, especially among people, being female, being central obese, and being premenopausal.

Objective To explore the clinical values of Sensory Organization Test (SOT) of dynamic posturography in the diagnosis of peripheral vertigo.Methods A total of 112 patients with peripheral vertigo were retrospectively analyzed.All the patients firstly underwent the inspection of SOT followed by caloric test.The results were conducted a comparative analysis.Assessments of SOT evaluated the patient's effective use of visual,vestibular,and somatosensory information for balance control during a variety of changing task conditions.The unilateral weakness was selected as assessment parameter of caloric test.Fourty-two healthy subjects were selected as control group underwent the dynamic posturography.Results Among the 42 cases of control group,results of SOT in dynamic posturography were normal.The SOT composite scores owned a significant difference between control and peripheral vertigo subjects.Among the 112 cases with peripheral vertigo,results of SOT in dynamic posturography were abnormal in 37 cases,with a sensitivity of 33.0％;caloric test was abnormal in 72 cases,with a sensitivity of 64.3％.There existed a significant difference between dynamic posturography and caloric test.Conclusion SOT is a key test in dynamic posturography that reflects the balance reconstruction after peripheral injury,and provides information about the integration and proportion of the visual,proprioceptive,and vestibular components of balance.

Objective:To evaluate the effect of comprehensive intervention combined with clinical preventive services and lifestyle adjustment on high-risk populations of cardiovascular disease.Methods:In 2015, 4 towns (streets) in Tongxiang City, of Zhejiang Province including Heshan Town, Longxiang Street, Wutong Street, and Fengming Street, were selected by using the typical sampling. The towns (streets) were allocated to the intervention group (Heshan Town and Longxiang Street) and the control group (Wutong Street and Fengming Street) by using the cluster random sampling. In each town (street), hypertension patients aged 50 to 74 years old who were taking community medicine management and with a 10-year cardiovascular disease risk ≥10% were recruited as subjects. There were 1 823 subjects in the intervention group and 1 883 in the control group. The intervention group was given a 1-year comprehensive intervention combining clinical preventive services and lifestyle adjustment, while the control group received routine chronic disease management. After the intervention, the final questionnaire investigation was conducted and health physical examination data were obtained. The death, acute coronary heart disease events and stroke incidence were the primary outcomes, and cardiovascular disease-related knowledge and behavior, clinical preventive services utilization, physical changes, blood fat index and 10-year cardiovascular disease risk were the secondary outcomes. The difference-in-difference model was used to evaluate the effects of interventions.Results:The age of subjects in the intervention and control group was (68.76±3.75) and (67.90±4.56) years old, respectively. After 1-year intervention, the incidence of mortality, acute coronary events and stroke in intervention group was 1.65% (30 cases), 0.27% (5 cases) and 2.69% (49 cases), respectively, which showed no statistical difference compared to the control group [1.33% (25 cases), 0.32% (6 cases) and 2.07% (39 cases)]. After adjusting for the age, gender, education, marital status, self-assessed family income level and situation of taking antihypertensive drugs, the difference-in-difference model showed that the body mass index and diastolic blood pressure in the intervention group decreased by 0.33 kg/m 2 and 1.49 mmHg (1 mmHg=0.133 kPa). Compared with the control group, daily vegetable consumption proportion, the awareness rates of aspirin, stains, salt intake, and oil intake increased by 4.76%, 26.22%, 29.56%, 10.80%, and 15.17%, respectively ( P<0.05). Conclusion:After the 1-year comprehensive intervention, there was no significant change in primary outcomes among high-risk populations of cardiovascular disease. In secondary outcomes, body mass index and diastolic blood pressure declined and cardiovascular disease-related knowledge awareness increased.

Objective:To explore the prospective associations between physical activity and incident ischemic stroke in adults.Methods:Data of China Kadoorie Biobank study in Tongxiang of Zhejiang were used. After excluding participants with cancers, strokes, heart diseases and diabetes at baseline study, a total of 53 916 participants aged 30-79 years were included in the final analysis. The participants were divided into 5 groups according to the quintiles of their physical activity level. Cox proportional hazard regression models was used to calculate the hazard ratios ( HR) for the analysis on the association between baseline physical activity level and risk for ischemic stroke. Results:The total physical activity level in the participants was (30.63±15.25) metabolic equivalent (MET)-h/d, and it was higher in men [(31.04±15.48) MET-h/d] than that in women [(30.33±15.07) MET-h/d] ( P<0.001). In 595 526 person-years of the follow-up (average 11.4 years), a total of 1 138 men and 1 082 women were newly diagnosed with ischemic stroke. Compared to participants with the lowest physical activity level (<16.17 MET-h/d), after adjusting for socio-demographic factors, lifestyle, BMI, waist circumference, and SBP, the HRs for the risk for ischemic stroke in those with moderate low physical activity level (16.17-24.94 MET-h/d), moderate physical activity level (24.95-35.63 MET-h/d), moderate high physical activity level (35.64-43.86 MET-h/d) and the highest physical activity level (≥43.87 MET-h/d) were 0.93 (95% CI: 0.83-1.04), 0.87 (95% CI: 0.76-0.98), 0.82 (95% CI: 0.71-0.95) and 0.76 (95% CI: 0.64-0.89), respectively. Conclusion:Improving physical activity level has an effect on reducing the risk for ischemic stroke.

Objective:To evaluate the effect of comprehensive intervention combined with clinical preventive services and lifestyle adjustment on high-risk populations of cardiovascular disease.Methods:In 2015, 4 towns (streets) in Tongxiang City, of Zhejiang Province including Heshan Town, Longxiang Street, Wutong Street, and Fengming Street, were selected by using the typical sampling. The towns (streets) were allocated to the intervention group (Heshan Town and Longxiang Street) and the control group (Wutong Street and Fengming Street) by using the cluster random sampling. In each town (street), hypertension patients aged 50 to 74 years old who were taking community medicine management and with a 10-year cardiovascular disease risk ≥10% were recruited as subjects. There were 1 823 subjects in the intervention group and 1 883 in the control group. The intervention group was given a 1-year comprehensive intervention combining clinical preventive services and lifestyle adjustment, while the control group received routine chronic disease management. After the intervention, the final questionnaire investigation was conducted and health physical examination data were obtained. The death, acute coronary heart disease events and stroke incidence were the primary outcomes, and cardiovascular disease-related knowledge and behavior, clinical preventive services utilization, physical changes, blood fat index and 10-year cardiovascular disease risk were the secondary outcomes. The difference-in-difference model was used to evaluate the effects of interventions.Results:The age of subjects in the intervention and control group was (68.76±3.75) and (67.90±4.56) years old, respectively. After 1-year intervention, the incidence of mortality, acute coronary events and stroke in intervention group was 1.65% (30 cases), 0.27% (5 cases) and 2.69% (49 cases), respectively, which showed no statistical difference compared to the control group [1.33% (25 cases), 0.32% (6 cases) and 2.07% (39 cases)]. After adjusting for the age, gender, education, marital status, self-assessed family income level and situation of taking antihypertensive drugs, the difference-in-difference model showed that the body mass index and diastolic blood pressure in the intervention group decreased by 0.33 kg/m 2 and 1.49 mmHg (1 mmHg=0.133 kPa). Compared with the control group, daily vegetable consumption proportion, the awareness rates of aspirin, stains, salt intake, and oil intake increased by 4.76%, 26.22%, 29.56%, 10.80%, and 15.17%, respectively ( P<0.05). Conclusion:After the 1-year comprehensive intervention, there was no significant change in primary outcomes among high-risk populations of cardiovascular disease. In secondary outcomes, body mass index and diastolic blood pressure declined and cardiovascular disease-related knowledge awareness increased.

Objective:We tested more frequency (0.01-3.0 Hz) of the sinusoidal harmonic acceleration test(SHAT) by the NKI rotation chair, aimed to analyze the results of the normal youth.Methods:Fifty normal young people were tested with sinusoidal harmonic acceleration by NKI rotation chair. Including 24 men and 26 women, aged from 20 to 40 years old, with median age of 27 years, with no vestibular dysfunction participated in the present study. All the volunteers accepted the sinusoidal harmonic acceleration test by the NKI rotation chair, the frequency included 0.01 Hz, 0.02 Hz, 0.03 Hz, 0.05 Hz, 0.1 Hz, 0.2 Hz, 0.3 Hz, 0.6 Hz, 1.0 Hz, 1.5 Hz, 2.0 Hz, 3.0 Hz. Taken the gain, phase, and asymmetry as the parameters, the trait of each frequency was analysed.Results:From 0.01 Hz to 1.5 Hz, the gain increased close to 1 gradually, and with fluctuates slightly at the 2.0 Hz and 3.0 Hz frequencies. The phase decreased as frequencies increased close to 0 at 0.3 Hz. The frequency above 0.6 Hz presented negative. Asymmetric values were distributed on both positive and negative sides at each frequency and were different from each other, both values were less than 20%.Conclusion:Broadband SHAT can accurately assess the horizontal semicircular canal function at different frequencies in a wider frequency range, and objectively, reflect the physiological function of the horizontal semicircular canal, and expand the clinical value of traditional SHAT.

OBJECTIVETo discuss the characteristics of subjective visual gravity (subjective visual vertical/horizontal, SVV/SVH) and assess its clinical application for peripheral unilateral vestibular compensation.

METHODS69 cases of acute peripheral unilateral vestibular dysfunction patients (case group) accepted SVV/SVH, spontaneous nystagmus (SN), caloric test (CT) and other vestibular function tests. 49 healthy people (control group) accepted SVV/SVH only. SVV/SVH, SN and unilateral weakness (UW) were selected as for the observation indicators. The correlations between SVV/SVH, SN, UW and courses were investigated respectively, as well as the characteristic of SVV/SVH, SN in period of vestibular compensation.

RESULTSAmong case group SVV, SVH positive in 42 patients(60.9%) and 44 patients(63.8%), the absolute values of the skew angle were in the range between 2.1°-20.0°, 2.1°-22.2°. Skew angles of SVV/SVH in control were in the range between -1.5°-2.0° and -2.0°-1.6°, and had no statistical significance with case group(t=5.336 and 5.864, P<0.05). SN-positive 28 cases (40.6%), the range of intensities at 2.4°-17.1°; UW-positive 50 cases (72.5%). In case group, positive correlation between SVV and SVH(r=0.948, P=0.00), negatively correlated between SVV/SVH and SN respectively(r values were -0.720, -0.733, P values were 0.00), no correlation between the skew angle of SVV/SVH, strength of SN and UW value(r values were 0.191, 0.189, and 0.179, P>0.05), there was no correlation between the absolute value of SVV, SVH, SN, UW with the duration (rs values were -0.075, -0.065, -0.212, and 0.126, P>0.05).

CONCLUSIONSubjective visual gravity can be used not only to assess the range of unilateral peripheral vestibular dysfunction, but also help assess the static compensatory of otolithic, guidance and assessment of vestibular rehabilitation.

Caloric Tests ; Gravitation ; Humans ; Otolithic Membrane ; Pilot Projects ; Vestibular Diseases ; physiopathology ; Vestibular Function Tests ; Vestibule, Labyrinth ; physiopathology ; Visual Perception

Objective: To evaluate the data of unilateral centrifugation subjective visual vertical (UC-SVV) in healthy young people.To study the function of utricle. Methods: Between Decem ber 2017 and May 2018, thirty-two healthy young volunteers were tested by static subjective visual vertical(SVV) and low velocity UC-SVV with Neuro Kinetics Inc I-portal 6.0 Video nystagmus recording system and NOTC rotating chair system.The static SVV preset angle were -15.00°, 15.00°, -20.00°, 20.00°, -12.00° and 12.00° respectively.UC-SVV test parameters: rotating chair′s peak speed was 60°/s.The shift time from the middle to the lateral position was 30 s and the displacement was 3.85 cm.The chair rotated at 60 s at left, right and middle positions.Subjects underwent SVV during this period.SPSS 17.0 software was used to analyze the data. Results: The mean and standard deviation of static SVV deviation in 32 volunteers was 0.21°±0.17°, 95%CI (-0.14°, 0.55°). The mean and standard deviation of UC-SVV in the left, middle and right positions of the clockwise was 0.24°±0.25°, -0.10°±0.27°, -0.63°±0.26°, 95%CI(-0.26°, 0.74°), (-0.65°, 0.44°), (-1.16°, -0.10°). The mean and standard deviation of UC-SVV in the left, middle and right positions of the counter clockwise was 0.03°±0.27°, -0.11°±0.26°, -0.23°±0.26°, 95%CI(-0.52°, 0.59°), (-0.65°, 0.42°), (-0.76°, 0.30°). There was significant difference in the deviation between the left and the right side of counter clockwise rotation of UC-SVV(t=2.432, P<0.05), however, there was no significant difference in the angle of deviation between the left and right sides and the median position(t value was 0.951, -1.400, both P>0.05). There was no significant difference among each position in clockwise rotation of UC-SVV(F=0.253, P>0.05). Conclusion UC-SVV test with peak speed of 60°/s can cause vertical line deviation in the left and right lateral position, but the angle is small and the value of clinical application is limited.