Objective To investigate the relationship between the quality of life and different frequency of sudden death in Yunnan unexplained sudden death disease area.Methods According to the stratified cluster sampling method,728 individuals were selected as the respondents in Heqing County,Eryuan County of Dali Bai Autonomous Prefecture,and in Dayao County of Chuxiong Yi Autonomous Prefecture.According to the random sampling,649 individuals were selected as the control in Yongping County,Dali Bai Autonomous Prefecture.Data of the quality of life (WHOQOL-BREF version) were collected through household surveys.Analysis method including ANOVA,Chi-squared test and multilinear regression were used.Results Compared with the control population,the household income of population in the diseased area was not significantly different statistically (x2 =7.052,P ＞ 0.05).But the differences in education level and chronic disease situation were statistically significant (x2 =35.727,9.810,all P ＜ 0.05).According to the frequency of the sudden death,from one to four,the total scores of the quality of life,the scores of the physiology domain,the scores of the psychological domain,the scores of the environmental domain and the scores of the social relations domain (1 time:54.30,13.74,14.43,11.21,14.91;2 times:54.75,13.86,14.65,11.12,15.10;3 times:52.40,13.21,13.76,11.00,14.41;4 times:49.21,12.15,12.54,9.87,14.64)were all lower than those of the control group (56.03,14.11,14.78,11.88 and 15.26),the differences between two groups were statistically significant (x2 =41.88,25.75,41.07,35.07,8.08,all P ＜ 0.05);the total scores and each domain score of the quality of life were negatively correlated with the frequency of sudden death (the multi-variables regression coefficient were as follows:-1.195,-0.341,-0.356,-0.314,and-0.185,all P ＜ 0.05).Conclusions The quality of life of those who have lived in Yunnan unexplained sudden death area is associated with the outbreak frequency of sudden death.Following increasing of the outbreak frequency of Yunnan unexplained sudden death,the quality of life of the population living in Yunnan unexplained sudden death area has decreased.

Objective To explore the correlations between the social support and the quality of life to them who live in Yunnan sudden unexplained death ward,and provide a scientific basis for taking effective measures to improve the people' s quality of life in the ward.Methods Using the cross-sectional household survey to collect the information of the inhabitants on social support and quality of life by the Social Support Scale,and the WHOQOL-brief Scale.Results The total score of social support,scores of subjective support,objective support in Yunnan sudden death ward ((40.85±8.34),(9.58±3.58),(23.86±4.87)) were lower than those of the control group in the same dimension ((41.82±7.12),(10.47±3.26),(24.51±4.68)) (all P＜0.05).But the score of social support utility in Yunnan sudden death ward (7.41±2.67)was no significant difference between the two groups (6.84±2.56,P＞0.05).After using multiple linear regression to control other confounding factors,such as house-hold income per capita,scores of social support,subjective support,objective support and social support utility were positively correlated with the score of quality of life in Yunnan sudden death ward (the correlation coefficient between the scores of social support and the dimensions related to the quality of life were 0.30,0.11,0.29,0.28,0.36;the correlation coefficient between the scores of objective support and the dimensions related to the quality of life were 0.15,0.05,0.13,0.14,0.19;the correlation coefficient between the scores of subjective social support and the dimensions related to the quality of life were 0.18,0.06,0.21,0.23; the correlation coefficient between the scores of social support utility and the dimensions related to the quality of life were 0.11,0.05,0.10,0.09,0.11 (all P＜0.05).Conclusions The people who live in Yunnan sudden death ward get less social support and social support utility is low,which cause the worse quality of their life.To make this situation better,more social support is necessary to enhance the utilization.

Objective To evaluate the role of large conductance calcium-activated potassium (BKCa) channels in vascular hyporesponsiveness in rats with obstructive jaundice.Methods Eighteen male Sprague-Dawley rats,weighing 180-200 g,were randomly divided into 3 groups (n =6 each) using a random number table:control group (group C),sham operation group (group S),and bile duct ligation group (group BDL).Obstructive jaundice was produced by common bile duct ligation.At 7 days after surgery,blood samples were collected for determination of the levels of serum total bilirubin (TBL),direct bilirubin (DBL),indirect bilirubin (IBL),alanine aminotransferase (ALT),and aspartate aminotransferase (AST).Thoracic aortic rings were prepared,and the endothelium was removed.The aortic rings were sequentially perfused with different concentrations of norepinephrine (NE) and sodium nitroprusside (SNP),and the maximum amplitude of contraction and dilatation of aortic rings was recorded.The aortic rings were then perfused with BKCa channel blocker Chtx with the final concentration of 10 7 mol/L,followed by perfusion with different concentrations of NE and SNP again,and the maximum amplitude of contraction and dilatation of aortic rings was recorded under each concentration.The percentage of maximum contraction and dilatation (maximum amplitude after Chtx administration÷maximum amplitude before Chtx administration× 100％) was calculated.Results Compared with C and S groups,the levels of TBL,DBL,IBL,ALT and AST in serum were significantly increased,the maximum amplitude of NE-induced contraction of aortic rings was decreased,and the percentage of the maximum NE-induced dilatation of aortic rings was increased,the maximum amplitude of SNP-induced contraction of aortic rings was increased,and the percentage of the maximum SNP-induced dilatation of aortic rings was decreased in group BDL.Conclusion Excessivc opening of BKCa channels may be involved in the mechanism of vascular hyporesponsiveness in rats with obstructive jaundice.

Objective: To explore the progression rate of cortid maximal plaque area and the risk of new ischemic cardiovascular disease (ICVD) in a rural cohort in Beijing.
Methods: The PRC-USA collaborative study had been regularly conducted in Shijingshan area in Beijing. The carotid ultrasound examination, ICVD risk factor and acute cardiovascular events follow-up were conducted in those participants. A total of 1479 subjects who received at least 2 carotid ultrasound examinations and had no cardiovascular disease before the second ultrasound were studied. They were divided into 5 groups:①Control group, the participants had no plaque detected by 2 ultrasounds; ② New plaque group, new plaque was found at the second ultrasound examination; ③ Plaque regression group; ④ Plaque stabilized group and ⑤ Plaque progression group. The hazard ratio (HR) between the progression rate of corotid maximal plaque area and new ICVD events was estimated by Cox proportional hazard regression analysis .
Results: Compared with Control group, the HR for new ICVD events were higher in groups②,③,④and⑤at 3.5, 5.7, 6.2 and 7.3 respectively, all P<0.05. The increasing trend of HRs remained signiifcant with the adjusted age and gender, P<0.001.
Conclusion: The progression rate of maximal corot id plaque area rate could predict the risk of new ICVD events in clinical practice.

OBJECTIVETo observe the changes of hospitalization rates and in-hospital mortality for coronary heart disease (CHD) in Beijing from 2007-2012.

METHODSPatients hospitalized for CHD in Beijing from 1 January 2007 to 31 December 2012 were identified from"The Cardiovascular Disease Surveillance System in Beijing". In total, 421 929 patients aged ≥25 years of permanent Beijing residents were admitted for CHD in Beijing during the 6 years. After excluding duplicate records and validation for the completeness and accuracy of the records, the hospitalization rates for CHD and in-hospital CHD mortality were analyzed. Trends in hospitalization rates and the in-hospital mortality for CHD were analyzed with Poisson regression models.

RESULTSThe age-standardized average hospitalization rate of CHD was 515.3 per 100 000 population in patients aged ≥25 years in Beijing. During the six years, an increasing trend was observed in the hospitalization rates for CHD after adjusting the age and gender (P<0.001). The age-standardized hospitalization rates of CHD increased by 43.0% in the past six years. The greatest increases of hospitalization rates were noted in both men and women between 45 to 54 years. The age-standardized in-hospital mortality decreased from 3.3% to 2.2% over the time (P<0.001), with a in-hospital mortality reduction for acute myocardial infarction from 11.3% to 8.5%.

CONCLUSIONSAn increasing trend in hospitalization rate was observed during 2007-2012 for Beijing residents aged ≥25 years, indicating an urgent need in CHD prevention in Beijing. The in-hospital mortality reduction during this period might reflect the improvement in the in-hospital treatment modalities of CHD.

Anterior Wall Myocardial Infarction ; Coronary Artery Disease ; Coronary Disease ; Hospital Mortality ; Hospitalization ; Hospitals ; Humans

OBJECTIVETo evaluate the association between very low density lipoprotein cholesterol (VLDL-C) and cholesterol absorption and synthesis markers in patients with moderate and high risk of coronary heart disease.

METHODSA total 363 statin-naïve patients with moderate and high risk of coronary heart disease were consecutively recruited from two hospitals in Shanxi and Henan provinces between October 2008 and June 2009. A standard questionnaire and physical examination were performed at baseline. Atorvastatin (20 mg/day) was administered to patients for 4 weeks. Venous blood samples after an overnight fast were collected before and after treatment for measuring VLDL-C and cholesterol absorption and synthesis markers. In qualitative analyses, the baseline level of cholesterol absorption and synthesis markers and their reduction after atorvastatin treatment were categorized into 3 tertile groups.

RESULTS(1) Of 363 patients, 283 patients with mean age of (55.43±9.01)years old with complete data were finally analyzed. The median level of baseline VLDL-C was 1.06 (0.65, 1.86) mmol/L. The median level of baseline cholesterol absorption marker (Campesterol) and cholesterol synthesis marker (Lathosterol) was 6.01 (3.78, 9.45) mg/L and 13.46 (8.30, 21.07) mg/L, respectively. (2) Partial correlation analysis and multiple regression showed the baseline level of VLDL-C was positively correlated with Campesterol (r=0.153, P<0.05) but not with Lathosterol(r=0.182, P=0.173). Furthermore, baseline VLDL-C level significantly increased with tertile of the baseline level of Campesterol in the qualitative analyses(P for trend=0.035). (3) Mean reduction in VLDL-C levels was 38.0% after 4 weeks atorvastatin treatment. VLDL-C reduction was positively correlated with Campesterol reduction (r=0.331, P<0.001). VLDL-C reduction significantly increased with the tertile of Campesterol reduction (P for trend=0.032). But this trend was not observed between VLDL-C level and Lathosterol (P for trend=0.798).

CONCLUSIONThe level of VLDL-C was closely related to cholesterol absorption marker, and further studies are needed to validate if inhibitor of cholesterol absorption (for example by Ezetimibe) could bring about more effective VLDL-C lowering effect in this patient cohort.

Atorvastatin Calcium ; Biomarkers ; Cholesterol ; analogs & derivatives ; Cholesterol, LDL ; Cholesterol, VLDL ; Coronary Artery Disease ; Ezetimibe ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Phytosterols ; Risk Factors

BACKGROUND:For dislocation of acromioclavicular joint induced by coracoclavicular ligament fracture,single EndoButton Plate reconstruction and double EndoButton Plates reconstruction are common repair methods.Further study on the stress distribution and fracture risk of the two repair methods is of great significance. OBJECTIVE:To study the biomechanical properties of the coracoclavicular ligament,and compare the fixation effect,stress distribution and failure mode of single and double EndoButton Plates reconstruction. METHODS:(1)Finite element simulation analysis:Mimics,Wrap and SolidWorks were used to establish normal coracoclavicular ligament,single EndoButton Plate reconstruction and double EndoButton Plates reconstruction.Ansys software was used to analyze the stress and deformation of the scapula and clavicle of each model under vertical load.(2)Sample experiment:Fifteen intact scapular-clavicle specimens were randomly grouped into five groups,with three specimens in each group.In group A,the acromioclavicular ligament was severed and the coracoclavicular ligament remained intact.In group B,acromioclavicular ligaments and trapeoid ligaments were severed,leaving intact conical ligaments.In group C,acromioclavicular ligaments and conical ligaments were cut off,and the intact traprex ligaments were retained.In group D,acromioclavicular and coracoclavicular ligaments were severed,and coracoclavicular ligaments were repaired by single EndoButton Plate reconstruction.In group E,acromioclavicular and coracoclavicular ligaments were severed,and the coracoclavicular ligaments were repaired by double EndoButton Plates reconstruction.The mechanical experiment was carried out by a mechanical testing machine to analyze the biomechanical status,stress distribution and failure patterns of the scapular-clavicle and clavicle. RESULTS AND CONCLUSION:(1)Finite element simulation analysis:The average stress of coracoclavicular ligament attached specimens was the lowest,and the risk of coracoclavicular fracture was less than that of single and double EndoButton Plates reconstruction.The mean stress of the coracoid process was similar in single and double EndoButton Plates reconstruction,and the fracture risk was similar.(2)Sample experiment:In groups A,B,C,D and E,the stiffness of specimens was(26.4±3.5),(19.8±2.8),(21.3±3.2),(57.7±4.1),and(46.2±2.8)N/mm,respectively;the ultimate loads were(545.5±53.7),(360.1±42.1),(250.9±44.4),(643.5±39.1),and(511.9±31.7)N,respectively;global stiffness in groups D and E was higher than that in group A(P=0.000 06,0.000 3);ultimate load in group D was higher than that in group A(P<0.05);the ultimate load was not significantly different between the group E and group A(P>0.05).Ligament fracture was observed in groups A,B and C and coracoid process fracture was found in groups D and E.(3)These results suggest that from the biomechanical analysis,Single EndoButton Plate reconstruction and double EndoButton Plates reconstruction are effective treatment techniques for coracoclavicular ligament fracture in acromioclavicular joint dislocation,but increase the risk of fracture.The double EndoButton Plates reconstruction dispersed the stress of the steel plate and reduced the contact force between the steel plate and bone,but slightly reduced the ultimate bearing capacity.Single and double EndoButton Plates reconstruction should be selected according to the actual clinical situation.

OBJECTIVETo describe the changes of serum total cholesterol (TC) and the prevalence of hypercholesterolemia from 1992 to 2007 in the general population from Chinese multi-provincial cohort study (CMCS).

METHODSCMCS database were established on participants aged 35-64 years from 11 provinces during the baseline examination on cardiovascular risk factors in 1992. Participants were followed up and invited to re-examine risk factors in 2007. Five thousand seven hundred and forty participants with complete data from these two examinations were included in this study for investigating the changes of serum TC level.

RESULTS(1) From 1992 to 2007, the mean level of TC increased from 4.65 mmol/L to 4.96 mmol/L for men, and from 4.40 mmol/L to 5.35 mmol/L for women. The prevalence of hypercholesterolemia increased from 5.1% (141/2 791) to 8.5% (237/2 791) in men, and from 4.9% (143/2 949) to 20.0% (590/2 949) in women. (2) Stratified by sex and age, the maximum increase in TC of 0.95 mmol/L was observed in women aged 35-44 years. Stratified by district, the maximum increase in TC of 0.88 mmol/L was observed in participants who had low baseline TC level living at rural area. Furthermore, baseline TC level was categorized into quintiles, the increases in TC level were highest in the lowest quintile both in men and women (0.93 mmol/L and 1.45 mmol/L, respectively). (3) Thirty-six point five percent (302/827) participants with hypercholesterolemia in 2007 developed from those with baseline TC 5.18-6.21 mmol/L, and 49.6% (410/827) developed from those with baseline TC < 5.18 mmol/L.

CONCLUSIONSFrom 1992 to 2007, the mean level of TC increased in both men and women. The greatest increases in TC were observed in the participants with the lowest quintile of baseline TC and those living in the rural area.

Adult ; China ; epidemiology ; Cholesterol ; blood ; Cohort Studies ; Female ; Humans ; Hypercholesterolemia ; epidemiology ; Male ; Middle Aged ; Prevalence

OBJECTIVETo observe the association between the leukocyte count and blood pressure value and hypertension risk in a Chinese community-based population.

METHODSA total of 4 188 participants who took part in the baseline examination in 1992 and the follow-up survey in 2007 from the Chinese Multi-Provincial Cohort Study were included in this study. The relationship of leukocyte and blood pressure value and hypertension risk were evaluated by cross-sectional analyses.The prospective association between baseline leukocyte count and blood pressure changes and risk of hypertension were analyzed in 2 954 normotensive individuals at baseline examination.The associations between leukocyte count and blood pressure was evaluated with Spearman's rank correlation analyses and linear regression models,and the associations between leukocyte count and risk of hypertension was evaluated with logistic regression models.

RESULTS(1) The cross-sectional study results showed that the correlation coefficient of leukocyte count and systolic blood pressure and diastolic blood pressure was 0.208 and 0.154 (both P < 0.001), respectively.Multiple linear regression analyses showed that every 1×10(9)/L increment in leukocyte count was associated with 1.41 mmHg (1 mmHg = 0.133 kPa) systolic blood pressure increase (95% CI: 1.20-1.63 mmHg, P < 0.001) and 0.63 mmHg diastolic blood pressure increase (95% CI: 0.51-0.76 mmHg, P < 0.001). Multivariable logistic regression analyses showed that every 1×10(9)/L increment in leukocyte count was associated with a 15% increased risk of hypertension (OR: 1.15, 95% CI: 1.12-1.19, P < 0.001). (2) During 15 years of follow-up, 47.2% (1 394/2 954) normotensive individuals progressed to hypertension. Spearman's rank correlation analyses showed that, the correlation coefficient of leukocyte count and systolic blood pressure change and diastolic blood pressure change was 0.062 (P = 0.003) and 0.102 (P < 0.001), respectively.Multiple linear regression analyses showed that every 1×10(9)/L increment in baseline leukocyte count was associated with 1.03 mmHg systolic blood pressure increase (95% CI: 0.74-1.32 mmHg, P < 0.001) and 0.64 mmHg diastolic blood pressure increase (95% CI: 0.48-0.80 mmHg, P < 0.001). Multivariable logistic regression analyses showed that every 1×10(9)/L increment in leukocyte count was associated with a 9% increased risk of incident hypertension (OR: 1.09, 95% CI: 1.06-1.13, P < 0.001).

CONCLUSIONElevated leukocyte count is associated with increased blood pressure value and hypertension among Chinese community-based population, suggesting that inflammation may participate in the pathogenesis of hypertension.

Blood Pressure ; Cohort Studies ; Cross-Sectional Studies ; Diastole ; Humans ; Hypertension ; epidemiology ; Leukocyte Count ; Logistic Models ; Prospective Studies ; Regression Analysis ; Systole