Objective To study the prevalence of dilated cardiomyopathy and the quasi-latent Keshan disease in villages of non-endemic areas of six Keshan disease endemic provinces in China,and to provide reference values for proposing a elimination standard of keshan disease.Methods County,township and village was selected as the study area by using multi-stage sampling in non-Keshan disease areas of Sichuan,Shanxi,Henan,Shandong and in Keshan disease areas of Chongqing and Yunnan.In each county two townships were selected and in each township one village was chosen.The residents of the villages sampled were surveyed by questionnaire,physical examination,electrocardiogram (ECG) and cardiac echocardiography.Suspected dilated cardiomyopathy patients had chest X-ray.Dilated cardiomyopathy patients were diagnosed according to the criteria proposed by 2006 World Health Organization/International Society and Federation of Cardiology (WHO/ISFC).Results The number of investigated villages was 126 and 54 139 people were surveyed by questionnaire and clinical examination.Ten patients with dilated cardiomyopathy were found,the prevalence was 18.47/100 000(10/54 139),and its 95％ confidence interval was 18.11/100 000-18.84/100 000.A total of 197 patients with quasi-latent Keshan disease were found,the prevalence was 363.88/100 000 (197/54 139),and its 95％ confidence interval was 362.27/100 000-365.49/ 100 000.The prevalence of male quasi-latent Keshan disease was 353.34/100 000(83/23 490) and of female was 372.07/100 000(114/30 639).The number of subjects with normal and abnormal ECG was 45 222 and 8917,respectively,and the rate of abnormal ECG was 16.47％.The highest rate of abnormal ECG was 38.28％ (1585/4141) in Chongqing.The lowest rate of abnormal ECG was 8.10％ (1175/14 507) in Yunnan.The highest detection rate of T wave and ST segment changes was 4.67％ (2528/54 139).In abnormal ECG indices,the detection rate of Henan,Shandong and Chongqing was higher,and all of them were higher than 10.0％.Conclusions We suggest that the reference baselines of dilated cardiomyopathy and quasi-latent Keshan disease in Keshan disease areas of the six provinces in the south of China be 18.47/100 000 and 363.88/100 000,respectively.

OBJECTIVETo investigate the correlation between lifestyle factors, parental obesity and adiposity in children, in order to provide theoretical evidence for public health policy establishment.

METHODSA cross-sectional observation study was conducted among approximately 20 thousand children aged 2 - 18 years old in urban and rural regions of Beijing, by using stratified randomization clustering sampling methods. Familial environmental risk factors of children adiposity and parental obesity were assessed with standardized questionnaire. Anthropometric measurements, including height and weight, were conducted. SPSS 13.0 software was applied to analyze the data, including general description, chi(2) trend test and non-condition logistic analyse.

RESULTSWith IOTF obesity references, the prevalence of obesity in 21,198 children aged 2 - 18 years old was 5.6%. The behavioral characters (for example, smoking and drinking) and children obesity showed significant familial aggregation. In groups including "both parents not smoke", "only one parent smoke" and "both parents smoke", the smoking rates of offsprings were 1.50%, 2.93% and 6.01%, respectively (chi(trend)(2) = 107.009, P < 0.01). A similar pattern was found for offsprings' alcohol consumption rates (5.85%, 9.12% and 13.96%; chi(trend)(2) = 107.009, P < 0.01). Based on parents' BMI status, in groups including "both parents had normal weight", "father was obese", "mother was obese" and "both parents were obese", the prevalence of obesity in children were 3.29%, 11.48%, 9.12% and 27.01%, respectively (chi(trend)(2) = 293.404, P < 0.01). After controlling for sex and ages, factors such as physical exercises, sleeping times per day, fat intakes, watching TV, drinking alcohol were impact factors of children obesity. After controlling of confounding factors, such as children gender, age, birth weight, puberty, smoking history, drinking history, fat intakes, soft drink, physical exercises, education experiences of parents, smoking history, drinking history, family income and so on, maternal obesity had a greater influence on daughters than on sons (OR = 5.93, 95% CI: 3.57 - 9.84), and paternal obesity showed similar influence on sons (OR = 4.29, 95% CI: 3.21 - 5.72). Comparing to parents with normal weight, obese parents had more powerful impact on daughters (OR = 28.51, 95% CI: 15.13 - 53.72) than on sons (OR = 7.21, 95% CI: 4.07 - 12.75), regarding to 2 - 5 years group and 10 - 12 years group versus other age group (OR = 18.67, 95% CI: 1.49 - 234.46; OR = 22.25, 95% CI: 10.62 - 46.59).

CONCLUSIONParental obesity is an independent risk factor of adiposity in children; gender and age affect this association. The lifestyle patterns of parents should have great impact on children. When prevention or intervention with children obesity, familial environmental factors should be emphasized.

Adolescent ; Alcohol Drinking ; Child ; Child, Preschool ; China ; epidemiology ; Cross-Sectional Studies ; Family Characteristics ; Female ; Humans ; Life Style ; Male ; Obesity ; epidemiology ; prevention & control ; Parents ; Prevalence ; Risk Factors ; Sampling Studies ; Smoking ; Surveys and Questionnaires

Child ; Electrocardiography ; Humans ; Male ; Ventricular Fibrillation ; physiopathology

Objective To evaluate the changes in epithelial thickness profile and its relationship with diopter following small incision lenticule extraction (SMILE) for moderate and high myopia.Methods Together 46 myopia or myopic astigmatism (92 eyes) who underwent SMILE were included under the informed consent from January 2016 to March 2017 and were decided into 2 groups according to the diopter:moderate myopia group (58 eyes)and high myopia group (34 eyes).Epithelial thickness profile was measured using spectral-domain optical coherence tomography at different corneal zones (0-2 mm,＞ 2-5 mm and ＞ 5-6 mm cornea) preoperatively before surgery and 1 month and 6 months after surgery for observing the changes in epithelial thickness and its correction with diopter.Results The mean epithelial thickness in the central zone was (55.68 ± 3.61) μm before surgery,and,6 months after surgery,it was thickened by (3.85-±3.99),(3.46 ±3.29) and (2.85 ±3.18) μm in the 0-2 mm,＞2-5 mum and ＞5-6 mm cornea respectively,and the difference was statistically significant among the three zones (P ＜ 0.01).After surgery for 6 months,the epithelial thickness in the high myopia group was thickened more obviously compared with the moderate myopia group (t =1.440,P =-0.047).And no correlation was found between changes in the epithelial thickness at 0-2 mm cornea and diopter after surgery(moderate myopia group:r =0.219,P=0.633;high myopia group:r =0.197,P =0.585).Conclusion Significant epithelial thickening was observed after SMILE,presenting the thickened epithelium.The higher the diopter was,the more thickened the epithelium was.The epithelial changes does not appear to affect the diopter after SMILE.

Objective To analyze the surveillance results and grasp the situation of Keshan disease in Wudalianchi city Heilongjiang province.Methods In 2009,Kaifa village was selected as the surveillance point in Wudalianchi city,total resident population were monitored by routine clinical examination and 12-lead electrocardiogram(ECG) tracing.Suspected cases with Keshan disease were taken chest X-ray,and Keshan disease was diagnosed based on Keshan Disease Diagnostic Criteria (WS/T 210-2011).Results A total of 795 people were investigated,including 397 males and 398 females.Eighteen people were found to be the patients with Keshan disease,of which 13 cases were latent Keshan patients,5 cases were chronic Keshan patients.The overall detection rate was 2.27％,aged 24 to 83 years old.There was no acute type and subacute type of Keshan disease in the surveillance point.Twenty nine cases of abnormal ECG were detected,the detection rate was 3.65％ (29/795),of which the 18 patients with Keshan disease were all had abnormal ECGs,mainly taken the form of ST-T changes and completely right bundle branch blocked.Six cases of male patients with Keshan disease were detected,the detection rate was 1.52％ (6/397); 12 cases of female patients with Keshan disease were detected,the detection rate was 3.01％ (12/398).Conclusions There is still potential and chronic Keshan disease cases in Wudalianchi city.We must keep on the monitoring on Keshan disease,master the dynamical changes of the disease conditions,and carry out the targeted prevention and control of Keshan disease.

OBJECTIVETo construct an off-line hybrid bioartificial liver supporting system with human liver cell line, and study it's effect on the plasma from patients with liver failure.

METHODSWe established the bioreactor using Psu-2s (Fresenius) cultured with Hep G2 cell transfected with human augmenter of liver regeneration (hALR) gene, then constructed a hybrid bioartificial liver supporting system, at last using the bioartificial liver support system to purify the plasma treated 2 hours with serum bilirubin absorbent, separated from acute on chronic liver failure patients infected by hepatitis B virus.

RESULTSBioreactor was successful constructed. The cell viability in perigastrum of bioreactor is 85.2% and cell propagated rapidly. Before and after treating with bilirubin absorbent, serum total bilirubin was (176.19 +/- 54.14) micromol/L and (50.1 +/- 16.85) micromol/L respectively (P = 0.0002). While there were no significance difference in the level of albumin, urea and glucose. At the begin and end of treatment with bioartificial liver, serum total bilirubin was (50.10 +/- 16.85) micromol/L and (30.27 +/- 15.02) micromol/L respectively (P = 0.000), the urea and albumin increased, urea has significantly difference, but the change of albumin hasn't.

CONCLUSIONThe off-line hybrid bioartificial liver supporting system with human liver cell line were builded successfully and have synthesis and metabolism functions for acute on chronic liver failure patients.

Adult ; Artifacts ; Bilirubin ; metabolism ; Bioreactors ; standards ; Chimera ; End Stage Liver Disease ; physiopathology ; Hepatocytes ; metabolism ; physiology ; Humans ; Liver ; physiology ; Liver Failure ; Liver, Artificial ; utilization ; Male ; Middle Aged

OBJECTIVETo investigate the effect of fresh meniscal allografts combined with osteochondral allografts transplantation for treatment of osteoarthritis.

METHODSThirty-six rabbits were used in the experiment and were randomly divided into 3 groups: in group A, the fresh medial meniscal allografts combined with osteochondral allografts from medial tibial plateau were implanted into medial articular meniscal and medial tibial plateau osteochondral defects; in group B,the fresh medial meniscal allografts were implanted into medial meniscal allografts defects; in group C, the freezing medial meniscal allografts were implanted into medial meniscal allografts defects. General observation, histology examination and glycosaminoglycan (GAG) examination in cartilage of medial tibial plateau were performed at the 4th, 8th and 12th week after operation.

RESULTSThere were no significant differences in cellular counting and amount of GAG between group A and group B, but the cellular amount of group A was significantly more than that of group C at the 12th week.

CONCLUSIONFresh meniscal allografts combined with osteochondral allografts transplantation can repair meniscal and osteochondral defects.

Animals ; Cartilage ; transplantation ; Female ; Male ; Menisci, Tibial ; transplantation ; Rabbits ; Transplantation, Homologous

Objective:To analyze the situation and influence factors of catastrophic health expenditure in national forest areas of Heilongjiang in 2015,and propose some measures to reduce the incidence of catastrophic health expenditure.Methods:The calculating method for international catastrophic health expenditure was used to estimate the catastrophic health expenditure rate,average gap and relative gap calculation method were estimated based on logistic regression analysis method.Results:In the standard definition of 15％,25％,30％ and 40％,the catastrophic health expenditure rates of Heilongjiang national forest areas in 2015 were 27.29％,14.79％,11.80％ and 8.27％;the average gap were 5.29％,3.25％,2.59％ and 1.61％;the relative gap were 19.38％,21.97％,21.95％and 19.47％.Family economic income and household cultural degree were the protective factors for catastrophic health expenditure.Low-insurance family,family with the elderly above 65 years old and family member hospitalization were risk factors for catastrophic health expenditure.Conclusion:The government should pay more attention to the poor,increase the family income in multi-channel;focus on prevention and timely medical treatment so as to reduce the risk of serious illness;increase investment in education,improve the education level of residents;pay attention to the elderly population and improve the medical security system.

Objective: To explore the diagnosis value of late gadolinium enhancement(LGE) detected by magnetic resonance imaging(MRI) in acute myocardial infarction(AMI) patients. Methods: The clinical and MRI data of 52 AMI patients hospitalized from January 2016 to July 2017 in our hospital were retrospectively analyzed. All patients received medication and revascularization therapies after admission and cardiac magnetic resonance examination was performed within 1 week after admission. According to whether there was LGE, AMI patients were divided into LGE(+) group(33 cases) and LGE(-) group(19 cases). According to the existence of microvascular obstruction(MVO) and/or intramyocardial hemorrhage(IMH),LGE(+) patients were divided into MVO/IMH(+) group(18 cases) and MVO/IMH(-) group(15 cases). Results: (1)There were no statistical significance between the LGE(+)group and LGE(-)group in the age, gender,smoking history, hypertension, diabetes mellitus, dyslipidemia, ventricular arrhythmia, culprit vessel, left ventricular end-diastolic volume(LVEDV), and left ventricular end-systolic volume(LVESV) (all P>0.05). The left ventricular ejection fraction was significantly lower in LGE(+) group than in LGE(-) group( (38.7±17.6) % vs. (51.2±7.9)%, P=0.001). (2)The infarct size was positively correlated with LVEDV and LVESV(r=0.436,P=0.011;r=0.479,P=0.005,respectively), and negatively correlated with left ventricular ejection fraction (r=-0.641, P<0.001) in LGE(+) group. (3) The infarct size, LVEDV, and LVESV were significantly higher in MVO/IMH(+) group thanin MVO/IMH(-) group ((26.5±7.3)%vs. (16.2±8.3)%, P=0.001; (145.7±40.9)ml vs. (112.2±23.8)ml,P=0.009; (90.0±30.8)ml vs. (61.4±19.0)ml,P=0.004, respectively), and the left ventricular ejection fraction was significantly lower in MVO/IMH(+) group than in MVO/IMH(-) group ((29.8±15.0)% vs. (49.3±14.5)%, P=0.001). Conclusions LGE detected bycardiac magnetic resonance can provide useful information on the myocardial necrosis extent of AMI patients. Presence of MVO/IMH in LGE(+) patients is linked with larger infarct size and worse cardiac dysfunction in AMI patients.

Objective To characterize the multimorbidity patterns of chronic diseases in middle-aged and elderly people in China，and explore the correlation and intensity among chronic diseases by using association rules. Methods A total of 17 796 people over 45 years old from 9 provinces and cities in China were sampled and surveyed. The data were analyzed by Apriori algorithm in R3.4.3 software to investigate the multimorbidity of chronic diseases. Results Among total 17 796 respondents, the number of patients with at least one chronic disease was 12 245 (68.81%), and the number of patients with two or more chronic diseases was 7 321 (41.15%). Among the selected association rules, according to the ranking of support degree, the most common three chronic disease multimorbidities were dyslipidemia and heart disease, diabetes mellitus and dyslipidemia, asthma and chronic lung disease. The rule support was 6.77%, 5.27%, 4.28%, and the rule confidence was 34.38%, 43.14%, and 70.81%, respectively. Multiple results of association rules pointed to heart disease. After screening, the greatest association rules were found in the age group over 75 years old. Conclusions Heart disease exists in a variety of chronic disease multimorbidity patterns. Screening and prevention measures should be strengthened. Dyslipidemia is strongly associated with diabetes and hypertension, and male patients are more vulnerable to suffer from dyslipidemia. Chronic diseases intend to be more common and complicated along with age increase.