OBJECTIVETo analyze the associations of blood pressure (BP) level with carotid intima-media thickness (CIMT) and plaque in a middle-aged and elderly hypertensive population.

METHODSBy block randomized sampling, an epidemiological investigation was conducted among hypertensives aged 45 - 75 years in the northern rural area of Jiangsu Province. Blood pressure was measured, and carotid CIMT and plaque were determined using a coloured ultrasonograph. The relationship between blood pressure level and CIMT or plaque was analyzed using a multivariable linear regression or logistic regression model.

RESULTSA total of 524 subjects (male 242) were enrolled. CIMT and plaque prevalence were (0.7 ± 0.1) mm and 46.3% in males and (0.7 ± 0.1) mm and 34.0% in females. After adjustment for relevant variables, CIMT increased 0.001 12 mm with 1 mmHg systolic BP increase in males (P < 0.001) but this trend was not significant in females. The risk of plaque number > 1 was significantly higher in those with grade III hypertension compared to grade I hypertensives (OR: 2.136, 95%CI: 1.138 - 4.012, P = 0.018).

CONCLUSIONIn this middle-aged and elderly hypertensive population, carotid CIMT is positively in relation to systolic BP, especially for male patients. Higher BP is associated with higher risk of plaque occurrence. Hypertension is thus an independent risk factor for the formation of atherosclerosis.

Aged ; Blood Pressure ; physiology ; Carotid Intima-Media Thickness ; Female ; Humans ; Hypertension ; epidemiology ; physiopathology ; Male ; Middle Aged ; Plaque, Atherosclerotic ; epidemiology ; physiopathology

Objectives To assess the performance of first trimester ultrasound screening for fetal structural and chromosomal anomalies based on a detailed anomaly and nuchal translucency (NT) scan at 11-13+6 weeks' gestation.Methods A prospective cohort study was conducted at Nanjing Drum Tower Hospital.Fetuses with a crown-rump length (CRL) between 45 mm and 84 mm scanned during December 2015 to March 2016 were enrolled in this study.After a detailed first-trimester anomaly scan followed the protocol of systematic standardized scan plans,fetuses with congenital abnormalities were screened out.Second trimester ultrasound screening and postnatal examination were performed for further examination of fetal anomalies.Cytogenetic analysis was performed on the fetuses with informed consent.Results (1) A total of 1 154 fetuses were enrolled in this study and among them,36 (3.1％) cases of fetal abnormalities were diagnosed through prenatal examination (35 cases) and postnatal examination (one case).(2) Twenty-one (58.3％) out of the 36 cases with structural and chromosomal anomalies were screened out by using the first-trimester scan,including eight cases of congenital cardiac defect (two cases of atrioventricular septal defect,one case of tricuspid atresia,one case of tetralogy of tetralogy,one case of right ventricle aneurysms and one cases of hypoplastic left heart syndrome combined with cystic hygroma with one case combined with polydactyly),four cases of central nervous system anomaly (three cases of exencephaly and one case of anencephaly combined with double outlet right ventricle),two cases of cleft palate/lip with one case combined with double outlet right ventricle,two cases of exomphalos,one case of amniotic band syndrome,one case of spinal bifida combined with megacystis,one case of umbilical cyst,one case of polydactyly and one case of cystic hygroma.One case of twin pregnancy chose selective fetocide to the fetus with exencephaly and 16 cases terminated pregnancy.The other four cases were confirmed by second trimester ultrasound screening and postnatal examination.Fourteen (38.9％,14/36) new cases of structural and chromosomal anomalies were detected by the second-trimester scan,six of which terminated the pregnancies and the rest were confirmed at term.One (2.8％,1/36) case of polydactyly was detected postnatally.(3) Chromosomal microarray analysis was performed on 28 cases,seven of which were identified as having chromosomal abnormalities including five cases detected in the first trimester and two cases detected in the second trimester.(4) Out of the 20 fetuses with abnormal NT in early trimester,which accounted for 1.7％ of all enrolled fetuses,nine were indentified with major structural or chromosomal abnormalies,a quarter of all abnormal fetus.Conclusions Detailed anomaly scan and NT scan in the first-trimester can increase the detection rate of fetal structural and chromosomal anomalies as compared with the traditional NT scan and provide earlier detection of severe fetal abnormalities as compared with second trimester anomaly scan.

Objective To investigate the diagnostic value of double balloon endoscopy (DBE) in the elderly. Methods Clinical manifestations and endoscopic findings of 42 elderly patients (aged 60-80 years) and 73 young and middle-aged patients (aged 12-59 years) with small bowel lesions were obtained and compared. Factors influencing the diagnostic outcome of DBE in patients with small bowel bleeding were identified,and the optimal check time after the latest bleeding was determined.Results The procedures of 85.7％ (36/42) in the elderly and 79.5％(58/73) in young and middle aged were completed (P＞0.05).There was no significant difference in the procedure time between the two age groups.No severe complications were observed in the elderly group.The overall positive rate by double balloon enteroscopy examination were 71.4 ％ (30/42) and 63.0 ％ (46/73),respectively in the two groups (P＞ 0.05). Ulcer and tumor lesions were the most common findings,and diverticula and angiodysplasia were the second common findings. Longer duration of bleeding and higher number of bleeding episodes were found in the elderly with positive DBE findings than those with negative findings. Positive diagnostic rate was significantly higher when DBE was performed within 7 days than that after 7 days (90％ vs. 40％). Conclusions DBE is a safe,reliable diagnostic modality,especially in the elderly patients with small bowel bleeding in which ulcer and tumor lesions are the most common identifications.DBE is of greater benefit in patients with more bleeding episodes over a long period,and should be performed within 7 days after the last bleeding.

Objective To investigate the risk factors of nosocomial infections in patients with head and neck cancer during radiotherapy .Methods Clinical data of 189 patients with head and neck cancer receiving radiotherapy in Huzhou Central Hospital during August 2011 and December 2014 were retrospectively studied .Chi-square test and multivariate Logistic regression analysis were performed to explore the risk factors of nosocomial infections in patients during radiotherapy .Results Among 189 patients with head and neck cancer receiving radiotherapy , nosocomial infection was observed in 64 (33.86%) patients.Univariate analysis showed that radiation-induced oral mucositis (χ2 =11.47, P<0.01), underlying disease (χ2 =6.59, P<0.05), stage of tumor Ⅲ-Ⅳ (χ2 =4.36, P<0.05), whole-neck radiation (χ2 =7.64, P <0.05), dose of radiation ≥50 Gy(χ2 =8.92, P <0.05), combined chemotherapy (χ2 =6.53, P<0.01), invasive operation (χ2 =4.21, P<0.05), PS score=1 (χ2 =3.58, P<0.05) and low body mass index (χ2 =9.56, P <0.05) were risk factors of nosocomial infections . Multivariate Logistic regression analysis indicated that radiation-induced oral mucositis ( OR=3.46, χ2 =8.72, P<0.01),underlying disease (OR=1.91, χ2 =4.66, P<0.05), stage of tumor Ⅲ-Ⅳ (OR=2.01,χ2 =5.22, P<0.05), whole-neck radiation (OR=1.78,χ2 =4.89, P<0.05), dose of radiation ≥50 Gy (OR=1.69,χ2 =3.25, P<0.05), combined chemotherapy (OR=1.84, χ2 =6.91, P<0.05) and low body mass index (OR=1.53, χ2 =2.59, P<0.05) were independent risk factors of nosocomial infection.Conclusions Nosocomial infections are popular in patients with head and neck cancer during radiotherapy.Radiation-induced oral mucositis, underlying disease, stage of tumor, radiation field, dose of radiation, combined chemotherapy and body mass index are associated with the occurrence of nosocomial infections in these patients .

In order to develop a rapid detection kit for novel avian influenza virus (AIV) subtype H7N9, two sets of specific primers and probes were designed based on the nucleotide sequences of hemagglutinin antigen (HA) and neuraminidase antigen (NA) of novel H7N9 virus (2013) available in GenBank to establish the method of TaqMan probe-based multiplex real-time RT-PCR for rapid detection of AIV subtype H7N9. The primer and probe of HA were for all H7 subtype AIVs, while the primer and probe of NA were only for novel N9 subtype AIVs. The results showed that this method had high sensitivity and specificity. This method was applicable to the testing of positive standard sample with a minimum concentration of 10 copies/microL; it not only distinguished H7 subtype from H1, H3, H5, H6, and H9 subtypes, but also distinguished novel N9 subtype from traditional N9 subtype. A total of 2700 samples from Zhuhai, China were tested by this method, and the results were as expected. For the advantages of sensitivity and specificity, the method holds promise for wide application.
Animals ; Birds ; virology ; Influenza A Virus, H7N9 Subtype ; genetics ; isolation & purification ; physiology ; Influenza in Birds ; prevention & control ; virology ; Real-Time Polymerase Chain Reaction ; methods ; Species Specificity ; Taq Polymerase ; metabolism ; Time Factors

In order to study the proliferation inhibition effect of H5N1 subtype avian influenza virus (AIV) with small interfere RNA (siRNA), a total of 4 siRNAs were designed in accordance with the NP and PA genes of H5N1 subtype AIV, the siRNAs were then transfected to chicken embryo fibroblast(CEF), CEF was infected with H5N1 subtype AIV after 6 hrs. Virus titer of cell supernatant was tested at 16-56hrs post infection, and pathological changes of the cells was observed; mRNA levels of NP, PA, HA and p13-actin gene were tested at 36hrs post infection. The results showed that these 4 siRNAs could inhibit the prolif-eration of H5N1 subtype AIV in CEF in varying degrees, and one siRNA targeting PA was best per-formed. The experimental results also showed that the inhibition effect was decreased with the time prolonged. This research provides a basis for further studying RNAi on AIV prevention and control.
Actins ; genetics ; Animals ; Chick Embryo ; DNA Primers ; genetics ; Fibroblasts ; virology ; Hemagglutination ; Hemagglutinin Glycoproteins, Influenza Virus ; genetics ; Hemagglutinins ; genetics ; Humans ; Influenza A Virus, H5N1 Subtype ; genetics ; growth & development ; physiology ; RNA Interference ; RNA Replicase ; genetics ; RNA, Small Interfering ; chemical synthesis ; genetics ; RNA-Binding Proteins ; genetics ; Real-Time Polymerase Chain Reaction ; Specific Pathogen-Free Organisms ; Transfection ; Viral Core Proteins ; genetics ; Viral Proteins ; genetics ; Virus Replication

Carcinoma, Hepatocellular ; metabolism ; pathology ; Core Binding Factor Alpha 3 Subunit ; metabolism ; Female ; Hepatocytes ; metabolism ; Humans ; Liver ; metabolism ; pathology ; Liver Neoplasms ; metabolism ; pathology ; Male ; RNA, Messenger ; genetics

OBJECTIVETo study the humoral immunity reconstitution and its relationship with infection in patients with multiple myeloma (MM) after undergoing autologous hematopoietic stem cell transplantation (auto-HSCT).

METHODSForty-two MM patients undergoing auto-HSCT were included in this study. Peripheral blood were obtained for immunoglobulin detection, including IgG, IgA and IgM before transplantation and 1, 3, 6, 12, 18 and 24 months after transplantation. The time, type, pathogen of infection between 1 and 24 month after transplantation were analyzed.

RESULTSThe level of IgA at 6 month [(0.75±0.59) g/L] after auto-HSCT was lower than that of pre-auto-HSCT [(1.04±0.70) g/L], and reached the level of pre-auto-HSCT at 9 months [(0.99±0.52) g/L] after auto-HSCT. The level of IgM reached the level of pre-auto-HSCT [(0.45±0.26) g/L] at 3 months after auto-ASCT [(0.50±0.26) g/L]. The level of IgG reached the level of pre-auto-HSCT [(9.80±2.98) g/L] at 1 month after auto-HSCT [(11.09±2.69) g/L], and higher than that of pre-auto-HSCT at 9 months after auto-HSCT [(12.07±3.57) g/L]. The level of IgG with IgG-type MM was higher than that of patients with light-chain type and IgD-type MM at 6, 9 and 12 months after auto-HSCT. The IgA level of patients who obtained complete remission (CR) is much higher than that of patients who obtained nCR in IgG-type patients. The incidence of infection in 6 month after auto-HSCT was higher than that of (6-12) month and >12 month after auto-HSCT. The incidence of infection was strongly negative correlated with IgA (r =-0.943, P=0.005) and IgG (r=-0.943, P=0.005) level. The frequency of viral infection was also negatively correlated with IgA and IgG.

CONCLUSIONThe reconstitution time of IgG, IgA and IgM was different in MM patients after auto-HSCT. IgG recovered first, then IgM, and IgM the last. The incidence of infection was negatively correlated with IgA and IgG. With the recovery of IgG and IgA, the incidence of infection was decreased accordingly.

Adult ; Aged ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; Immunity, Humoral ; Male ; Middle Aged ; Multiple Myeloma ; immunology ; therapy ; Transplantation, Autologous ; Virus Diseases ; immunology

BACKGROUNDSuccessful periodontal regeneration depends on the migration, proliferation and differentiation of periodontal ligament cells in periodontal defects. The total protein content and the ultrastructure demonstrate the metabolizability and activity of periodontal ligament cells. This study was conducted to observe the effects of Shuanghuangbu, a mixture of medicinal herbs, on the total protein content and the ultrastructure of human periodontal ligament cells.

METHODSPeriodontal ligament cells were grown to confluence and then cultured in Dulbecco's modified eagle medium (DMEM) supplemented with Shuanghuangbu over the concentration range of 0 to 1000 microg/ml. The total protein content in cultured cells was determined by using Coommasie brilliant blue technique. Periodontal ligament cells were incubated in 0 and 100 microg/ml Shuanghuangbu decoction for 5 days, then observed through transmission electron microscope.

RESULTSThe total protein content of human periodontal ligament cells increased in each experiment group added 10 - 1000 microg/ml Shuanghuangbu respectively, and the effect of 100 microg/ml was excellent. Under the transmission electron microscope, there were more rough endoplasmic reticulums and mitochodrias in the experiment group than those in the control group.

CONCLUSIONShuanghuangbu stimulates the protein synthesis of human periodontal ligament cells and improves human periodontal ligament cells' metabolizability and activity.

Cells, Cultured ; Dose-Response Relationship, Drug ; Drugs, Chinese Herbal ; pharmacology ; Humans ; Immunohistochemistry ; Microscopy, Electron, Transmission ; Periodontal Ligament ; chemistry ; drug effects ; ultrastructure ; Proteins ; analysis

OBJECTIVETo compare the incidence of emotional disorder in patients with acute or stable coronary heart disease.

METHODSA total of 298 patients with suspected coronary heart disease (CHD) were designed into three groups based on of coronary angiography results: acute coronary syndrome (ACS, n = 128), stable angina pectoris (SAP, n = 108) and non-CHD (n = 62). All patients were evaluated by Zung Self-rating Depression Scale (SDS), Zung Self-rating Anxiety Scale(SAS) and Hamilton Depression Rating Scale (HRSD) for depression and anxiety before coronary angiography (CAG), 3 days after CAG, and 1 day before discharge.

RESULTSIncidences of depression and anxiety were significantly higher the ACS group (65.6%and 78.9% before CAG; 60.9% and 70.3% 3 days post CAG; 45.3%and 64.8% before discharge) compared patients with SAP (18.5% and 26.9% before CAG; 17.6% and 28.7% 3 days post CAG; 15.7% and 26.9% before discharge, all P < 0.05 vs. ACS) and non-CHD patients (32.3% and 25.8% before CAG; 27.4% and 24.2% 3 days post CAG; 29.0% and 30.6% before discharge, all P < 0.05 vs. ACS) while the depression and anxiety incidences were similar between patients with SAP and non-CHD in this cohort (P > 0.05).

CONCLUSIONEmotional disorder is common in patients with suspected heart diseases, especially in patients with ACS. Psychological distress of patients with suspected heart disease should be evaluated and treated.

Acute Coronary Syndrome ; psychology ; Adult ; Aged ; Anxiety Disorders ; etiology ; Coronary Disease ; psychology ; Depressive Disorder ; etiology ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Psychiatric Status Rating Scales ; Risk Factors