OBJECTIVETo investigate the expressions of vascular endothelial growth factors (VEGF)-A, -C and -D and their prognostic significance and relation to angio- and lymphangiogenesis in gastric cancer.

METHODSThe expression of VEGF-A, -C and -D in 123 primary gastric cancers was detected by immunohistochemical staining. The lymphatic vessel density (LVD) and microvessel density (MVD) were assessed after immunohistochemical double-staining with D2-40 and CD34, respectively. The correlation between the expression of those VEGF factors and clinicopathological parameters were analyzed by univariate method. The overall survival was evaluated by Kaplan-Meier method and log-rank test. Multivariate analysis was carried out using Cox proportion hazard model.

RESULTSThe positive expression rate of VEGF-A, -C and -D in primary gastric cancer samples were 64.2%, 65.9% and 41.5%, respectively. High expression of VEGF-A, or -C or -D, or any two of them was correlated with high LVD (P < 0.05). High expression of both VEGF-A and -C was associated with high MVD, lymph node metastasis, LVI and MVI (P < 0.05). Both VEGF-C and -D high expression was correlated with LVI and lymph node metastasis (P < 0.05). The patients with high expression of these factors had a statistically shorter overall survival (P < 0.05). The patients with both VEGF-A and -C expression had the shortest survival (56 months). Multivariate analysis showed that VEGF-A high expression, MVD, lymph node metastasis and depth of tumor invasion were independent survival predictors (P = 0.033, 0.002, 0.019 and P < 0.001, respectively).

CONCLUSIONHigh expression of both VEGF-A and -C imply high potential of lymphangiogenesis, metastasis and poorer survival in gastric cancer patients. High expression of VEGF-C and -D may induce lymphangiogenesis and promote lymph node metastasis, but only VEGF-A is an independent predictor of survival.

Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Lymphangiogenesis ; Lymphatic Metastasis ; Lymphatic Vessels ; pathology ; Male ; Microvessels ; pathology ; Middle Aged ; Neovascularization, Pathologic ; Proportional Hazards Models ; Stomach Neoplasms ; metabolism ; pathology ; Survival Rate ; Vascular Endothelial Growth Factor A ; metabolism ; Vascular Endothelial Growth Factor C ; metabolism ; Vascular Endothelial Growth Factor D ; metabolism

Objective To explore the relationship between serum homocysteine and metabolic syndrome (MS).Methods A cohort with 1680 people involved in a community-based population in Beijing was investigated.Metabolic syndrome was defined by NCEP-ATP Ⅲ criteria.Multivariate logistic regression analysis was used to estimate the odds ratios (OR) of MS.Multiple linear regression analysis was performed to analyze the association between Hcy and characteristic variables.Results Homocysteine was higher in MS population compared to those without MS ( 17.99 μmol/L vs.17.18 μmol/L,P=0.007) after adjusted for age and sex.Levels of homocysteine increased with the presence of MS components (from 0 to 4 or 5) (16.71,16.94,17.62,18.20,17.82 μmol/L respectively,P=0.044 for linear trend).Among the components,groups with larger waist circumference,higher blood pressure and triglycerides showed significantly higher Hcy level than their counterparts.Results from multiple logistic regression analysis revealed that the highest Hcy quartile (Hcy Ⅳ ) was significantly associated with MS.Compared with the lowest Hcy quartile (Hcy Ⅰ ),the adjusted odds ratio of having MS in HcyⅣ was 1.379(1.005-1.892) after adjusting for age,sex,levels on creatinine/estimated glomerular filtration rate (eGFR)/low-density lipoprotein cholesterol (LDL-C) and uric acid,smoking,alcohol intake and exercise.In the partial correlation analyses,Hcy was positively associated with body mass index (BMI),waist circumsternece,blood pressure,LDL-C,triglycerides (TG),uric acid,serum creatinine,eGFR,but inversely associated with high-density lipoprotein cholesterol (HDL-C) and independently with age and sex.In multiple linear regression analysis,age,male sex,BMI,LDL-C,creatinine and uric acid were found to be independently associated with Hcy level.Conclusion There was an association noticed between the MS using NCEP-ATP Ⅲ criteria and the highest quartile level of Hcy in this study.Factors as age and being male,the levels of BMI,LDL-C,creatinine and uric acid were independently associated with the Hcy level.

OBJECTIVETo analyze the association between single nucleotide polymorphisms (SNPs) of peroxisome proliferator-activated receptor(PPAR) and arterial stiffness in adult Chinese population (> 50 years).

METHODSCardiovascular risk factors from participants of Beijing epidemiological investigation were analyzed. Carotid-femoral pulse wave velocity (cfPWV) was measured by Complior system. The subjects were divided into normal arterial stiffness group (cfPWV < 12 m/s, n = 844) and increased arterial stiffness group (cfPWV > 12 m/s, n = 530). Three valid SNPs including rs1053049, rs1800234 and rs8192678 in the PPAR and PPARγC1a gene were genotyped by TaqMan allelic discrimination assays.

RESULTSThe age [(67.9 ± 8.8) years vs. (58.0 ± 9.7) years], prevalence of hypertension [71.1% (377/530) vs. 30.5% (257/844)] and diabetes mellitus [21.7% (115/530) vs. 11.0% (93/844)] were all significantly higher in increased arterial stiffness group than in normal group (all P < 0.05). The frequencies of CC, CT and TT type of rs8192678 [CC: 32.2% (272/844) vs. 30.8% (163/530), CT: 48.7% (411/844) vs. 52.1% (276/530), TT: 19.1% (161/844) vs. 17.2% (91/530)], rs1053049 [CC: 55.7% (470/844) vs. 51.3% (272/530), CT: 36.7% (310/844) vs. 39.1% (207/530), TT: 7.6% (64/844) vs. 9.6% (51/530)] and rs1800234 [CC: 88.4% (746/844) vs. 90.4% (479/530), CT + TT: 11.6% (98/844) vs. 9.6% (51/530)] were similar between the two groups. There was also no association between haplotypes and the increased arterial stiffness in this cohort.

CONCLUSIONSIn this community-based population, we found that aging, hypertension and diabetes mellitus were associated but SNPs of PPAR and PPARγC1a were not associated with arterial stiffness.

Aged ; Asian Continental Ancestry Group ; genetics ; Cardiovascular Diseases ; genetics ; Female ; Humans ; Male ; Middle Aged ; Peroxisome Proliferator-Activated Receptors ; genetics ; Polymorphism, Single Nucleotide ; Risk Factors ; Vascular Stiffness

OBJECTIVETo explore the relationship between serum N-terminal pro-brain natriuretic peptide (NT-proBNP) and metabolic syndrome (MS).

METHODSA total of 1323 Beijing residents (559 male) were investigated. MS was defined by the modified 2004 Chinese Diabetes Society criteria and 439 cases were diagnosed as MS according to this criteria. Multivariate logistic regression analysis was used to estimate the odds ratios (OR) of MS. Multiple linear regression analysis was performed to analyze the association between NT-proBNP and characteristic variables.

RESULTSNT-proBNP was significantly lower in MS group compared to non-MS group [32.51 (29.17, 36.14) ng/L vs.38.55 (35.73, 41.50) ng/L, P = 0.012] after adjusted for age and gender. NT-proBNP level decreased with the presence of MS components (from 0 to 4 or 5) (45.92, 37.24, 35.40, 31.55 and 33.65 ng/L respectively, P = 0.043 for linear trend). Among the components, groups with larger waist circumference, higher fasting glucose and triglycerides were associated with lower NT-proBNP level. After adjustment for potential confounders, compared with the lowest NT-proBNP quartile, the adjusted odds ratio of the second, third and fourth quartile for having MS were 0.782 (95%CI: 0.544 - 1.122, P > 0.05), 0.709 (95%CI: 0.489 - 1.028, P > 0.05), 0.604 (95%CI: 0.405 - 0.900, P < 0.05), respectively. Multiple linear regression analysis showed that female gender (β = 0.248, P < 0.001), age (β = 0.167, P < 0.001), systolic blood pressure (β = 0.154, P < 0.001) were positively related to NT-proBNP level while waist circumference (β = -0.082, P = 0.004), diastolic blood pressure (β = -0.085, P = 0.015), triglycerides (β = -0.101, P < 0.001), total cholesterol (β = -0.078, P = 0.004), eGFR (β = -0.150, P < 0.001) were negatively correlated to NT-proBNP level.

CONCLUSIONIn this cohort, higher serum NT-proBNP concentration is associated with lower incidence of metabolic syndrome.

Aged ; Aged, 80 and over ; Cross-Sectional Studies ; Female ; Humans ; Male ; Metabolic Syndrome ; blood ; Natriuretic Peptide, Brain ; blood ; Peptide Fragments ; blood

OBJECTIVETo investigate the effects of bradykinin (BK) on the proliferation, apoptosis and differentiation of human keratinocyte (HKC) and the underlying mechanisms.

METHODSHKCs were cultured together with 1 x 10(-4) - 1 x 10(-9) mol/L of BK. With methyl thiotetrazole (MTT) and trypan blue staining it was shown that the BK in dose of 1 x 10(-4) mol/L possessed most powerful inhibitory effect, and the survival rate of HKC was 69.3%. Therefore, BK was employed in the dose of 1 x 10(-4) mol/L in the following studies. When the growth of HKCs reached the logarithmic phase, BK in the concentration of 1 x 10(-4) mol/L was added, and it was categorized as the test group (E). HKCs without BK served as the control group (C). The cell cycle and apoptosis were detected by flow cytometry after being cultured for 24 and 48 hours. The change in intracellular calcium [Ca(2+)](i) was determined by means of laser scanning confocal microscopy with calcium fluorescence probe Fluo-3/AM technique. The expression of HKC differentiation labeling protein keratin10 (K10) and involucrin were detected with Strept Avidin-Biotin Complex (SABC) immunocytochemical assay.

RESULTSThe cell ratio in G0/G1 phase in E group increased by 34.57% while in S phase decreased by 58.91% in reference to that in C group. The G1/S phase switching of HKCs was obviously inhibited by BK, and apoptosis was stimulated (apoptotic rate of 15.34% in E group vs 5.60% in C group, P < 0.05). The [Ca(2+)](i) increased transiently in HKCs by 163.0% in E group after 3 minutes of BK activation and decreased thereafter in reference to that in C group. The K10 expression in HKC was down-regulated in E group with positive cell rate of 2.20%, which was lower than that of C group (6.89%, P < 0.05).

CONCLUSIONThe cell cycle process of HKC could be inhibited by high concentration of BK with increased apoptosis and an increase in [Ca(2+)](i), which might be the mechanism of inhibition of growth of HKC in vitro. Furthermore, the epithelial regeneration and HKC differentiation can also be inhibited by BK.

Apoptosis ; drug effects ; Bradykinin ; pharmacology ; Cell Cycle ; Cell Differentiation ; drug effects ; Cell Proliferation ; drug effects ; Cells, Cultured ; Humans ; Keratinocytes ; cytology ; metabolism ; Keratins ; metabolism

OBJECTIVETo study blood pressure levels, the prevalence of hypertension and factors associated with the development of hypertension in Hasakh children in the Yili region of Xinjiang Province.

METHODSA total of 2438 Hasakh school children from the Yili region of Xinjiang Province were sampled by stratified random cluster sampling method between May and June 2009. Height, weight, waist circumference, hip circumference, skinfold thickness and blood pressure were measured. Body mass index (BMI) was calculated.

RESULTSMean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 94±13 mm Hg and 60±9 mm Hg respectively in the 2438 children, and both averages were lower than in the Han children. Hypertension was noted in 138 children (5.66%). The prevalence of hypertension in girls (6.97%, 84/1206) was higher than in boys (4.38%, 54/1232) (P<0.05). The prevalence of hypertension and blood pressone were positively correlated with BMI, waist circumference, hip circumference, skinfold thickness circumference, gender and age.

CONCLUSIONSAverage blood pressure levels in Hasakh children in the Yili region of Xinjiang Province are lower than in domestic age-matched Han children. The prevalence of hypertension in girls is higher than in boys. Obesity is highly correlated with the development of hypertension.

Adolescent ; Blood Pressure ; Body Mass Index ; Child ; China ; epidemiology ; ethnology ; Female ; Humans ; Hypertension ; epidemiology ; etiology ; Male ; Obesity ; physiopathology ; Prevalence ; Risk Factors ; Skinfold Thickness ; Waist Circumference

China ; epidemiology ; Dysentery, Bacillary ; epidemiology ; microbiology ; Humans ; Shiga Toxin ; Shigella ; classification

OBJECTIVETo evaluate the incidence of super-response and the potential predictors related to super-response after cardiac resynchronization therapy (CRT) in patients with congestive heart failure.

METHODS190 patients [145 men and 45 women;age: (60.48 ± 11.91) years] underwent CRT between March 2001 and March 2012 were enrolled in this multi-center trial, of which, 54 patients with ischemic cardiomyopathy and 136 patients with non-ischemic cardiomyopathy. These patients were followed up from 6 months to 11 years (mean 58 months) post CRT.

RESULTSTen patients died within 6 months post CRT, the others were followed up for more than 6 months. At 6-month follow-up, 51 patients were identified as CRT super-responders (28.33%), 75 patients were CRT responders (41.67%) and 29 patients were CRT non-responders (16.11%), and 25 patients were CRT negative responders (13.89%). Super-response occurred more frequently in non-ischemic cardiomyopathy patients, while non-response most commonly occurred in ischemic cardiomyopathy patients (P < 0.05); patients in the negative response group had higher serum creatinine level than other groups (P < 0.05) , and patients in the non-response group and negative response group had higher pulmonary artery pressure than patients in the super-response group (P < 0.05); the average QRS duration was ≥ 160 ms before CRT, and the mean decrease was around 30 ms after CRT in the super-response group while the average QRS duration was 139 ms before CRT, and the mean reduction was around 8 ms after CRT in the negative response group (P < 0.05). LV lead position in the super-response group was usually in the middle and base of the heart, while in the negative response group it was more commonly located in the apex of the heart (P < 0.01) .

CONCLUSIONSLV lead located at the middle and pre-CRT ORS duration ≥ 160 ms are associated with super-response post CRT procedure in this patient cohort.

Adult ; Aged ; Aged, 80 and over ; Cardiac Resynchronization Therapy ; Female ; Follow-Up Studies ; Heart Failure ; therapy ; Humans ; Male ; Middle Aged ; Treatment Outcome

BACKGROUNDSurgical treatment options for patients with cirrhosis and portal hypertension are complicated. In this study, we evaluated the effectiveness of a new treatment strategy, splenic auto-transplantation and oesophageal transection anastomosis. We report results from clinical observations, splenic immune function and portal dynamics in 274 patients.

METHODSFrom 1979 to 2005, 274 cirrhosis patients with portal hypertension underwent the new treatment strategy, and were followed up to compare results with those patients who underwent traditional surgical treatment. From 1999 to 2002, a randomized controlled trial (RCT) was performed on 40 patients to compare their post-operative immune function. From 1994 to 2006, another RCT enrolled 28 patients to compare portal dynamics using three-dimensional dynamic contrast-enhanced magnetic resonance angiography (3D DEC MRA) investigation post operation.

RESULTSAmong 274 patients (mean age 41.8 years), the emergency operative mortality (4.4%), selective operative mortality (2.2%), complication rate (17.9%), prevalence of hepatic encephalopathy (< 1%), rate of portal hypertension gastritis (PHG) bleeding (9.1%), and morbidity of hepatic carcinoma (8%) were similar to those patients undergoing traditional operation; the spleen immunology function (Tuftsin, IgM) decreased in both groups 2 months post operation, but this decrease did not reach statistical significance. Through 3D DCE MRA, the cross sectional area and the velocity and volume of blood flow of the main portal vein decreased significantly after operation in both groups. The velocity and volume of blood flow in the auto-transplantation group was significantly lower than that in the control group.

CONCLUSIONSSplenic auto-transplantation and esophageal transection anastomosis is a safe, effective, and reasonable treatment strategy for patients with portal hypertension with varicial bleeding. It not only can correct hypersplenism, but may also achieve complete hemostasis. Spleens auto-transplanted into the retroperitoneal space can preserve immune function and establish broad collateral circulation.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anastomosis, Surgical ; Child ; Esophagus ; surgery ; Female ; Humans ; Hypertension, Portal ; immunology ; surgery ; Imaging, Three-Dimensional ; Immunoglobulin M ; blood ; Male ; Middle Aged ; Prospective Studies ; Spleen ; transplantation ; Transplantation, Autologous

OBJECTIVETo evaluate the long-term effects and analyze causes of non-response to cardiac resynchronization therapy (CRT) in heart failure (HF) patients with permanent atrial fibrillation (AF).

METHODSThirty-three patients with HF and AF [29 men, mean age (61 ± 10) years, NYHA class III or IV, left ventricular ejection fraction (LVEF) ≤ 35%, QRS ≥ 120 ms in 31 cases] underwent bi-ventricular pacing (n = 26) or bi-ventricular pacing and atrioventricular node ablation (AVN-ablation, n = 7) were included in this study. Non-response was defined: the increase of left ventricular ejection fraction (LVEF) was less than 15%. Patients were followed-up for 4 years.

RESULTSSix patients died during follow up. Non-responder to CRT was observed in 6 out of 27 survived patients (22.22%). Six out of 7 patients underwent AVN-ablation were in responder group and 1 in non-responder group. Comparing with responder group, the baseline LVEF was significantly higher (37% vs. 32%, P = 0.003), and the history of HF was significantly longer (6.3 years vs. 4.1 years, P = 0.039), pulmonary artery pressure was significantly higher (53 vs. 32 mm Hg, P = 0.027), bi-ventricular pacing percentage (BIVP%) was significantly lower (75.86% vs. 91.73%, P = 0.007) in non-responder group.

CONCLUSIONSHigher LVEF, longer HF history, higher pulmonary artery pressure and lower BIVP% are factors linked with non-responses to CRT in this patient cohort. CRT plus AVN-ablation is associated with high response rate to CRT in this patient cohort.

Adult ; Aged ; Aged, 80 and over ; Atrial Fibrillation ; complications ; therapy ; Cardiac Resynchronization Therapy ; Female ; Heart Failure ; complications ; therapy ; Humans ; Logistic Models ; Male ; Middle Aged ; Treatment Outcome