Objective To evaluate the changes of CD4+ CD25+ regulatory cells (Treg) in peripheral blood and the serum levels of transforming growth factor beta-1 (TGF-β1)in elderly patients with hepatocellular carcinoma. Methods The ratios of Treg in the peripheral blood of patients aged over 80 years from 22 hepatocellular carcinoma,26 metastatic liver cancer,20 healthy controls,were determined by flow cytometry.Meanwhile,the serum levels of TGF-β1 were detected by ELISA.Results The ratio of Treg to total CD; T cells in the peripheral blood [(9.71±3.23)％ vs.(5.81±1.18)％,P＜0.01]and the serum levels of TGF-β1 [(78.10±29.41)ng/L vs.(7.78± 3.54) ng/L,P＜0.01]of elderly patients with hepatocellular carcinoma were significantly higher than those in the healthy controls.Meanwhile,the ratio of Treg to total CD[ T cells in the peripheral blood [(9.71±3.23)％ vs.(7.36±2.07) ％,P＜0.05]and the serum levels of TGF-β1[(78.10± 29.41 )ng/L vs.(19.33± 10.90) ng/L,P＜ 0.01 ]in the patients with hepatocellular carcinoma was increased as compared with those in metastatic liver cancer (P＜0.05 or P＜0.01).The correlation indicated that the ratio of Treg to total CD4+ T cells in the peripheral blood were positively related with TGF-β1 levels and tumor clinical stage(r=0.698 and 0.782,P＜ 0.01 ),but negatively with Karnofsky performance status score(KPS) (r=-0.643,P＜0.01). Conclusions The ratio of Treg to total CD4+ T cells in the peripheral blood from elderly hepatocellular carcinoma is increased and correlated with TGF-βl level,tumor clinical stage and KPS.It might helpful to determine the prognosis of elderly hepatocellular carcinoma by detecting the ratio of Treg to total CD4+ T cells in the peripheral blood.

Objective The aim of this study was to evaluate the benefits of i.v. iron therapy in iron-defi-cient patients with left ventricular ejection fraction preserved heart failure (HFpEF). Methods 61 HFpEF pa-tients with iron deficiency were randomized to treatment with or without i.v. iron,as ferric carboxymaltose(FCM, n = 31)or placebo(saline,n = 29)for 24 weeks of a double-blind,placebo-controlled trial. The primary end-point was the change in 6-min-walk-test(6MWT)distance from baseline to Week 24. Secondary end-points includ-ed changes in New York Heart Association(NYHA)class,health-related quality of life(QoL),with NT-proBNP under observation. Results Compared with the control group at week 16 and 24,the iron treatment group has much more improve in 6MWT and the health-related quality of life(HRQoL)(P<0.05). The changes in NT-proB-NP level and NYHA heart function classification only show significance at week 24(P<0.05)but not at week 16 (P>0.05). Conclusion In this study,Treatment with intravenous ferric carboxymaltose can improve symptoms, functional capacity,and quality of life.

The study intended to evaluate the effect of high-dese atorvastafin on serum high sensitive C-reactive protein (hs-CRP) and renal function in patients with acute myocardial infarction undergoing elective pereutancous coronary intervention ( PCI ). One hundred and sixty seven patients were randomly divided into two groups: in test group (n =84) patients received oral atorvastatin 80 mg/d and in control group (n = 83) patients received atorvastatin 20 mg/d, the medication in both groups was lasted for 7 days before PCL Compared to levels at 24 h before PCI, serum hs-CRP and creatinine levels at 48 h after PCI were increased in both groups ( both P < 0. 05), and glomerular filtration rate was decreased ( P < 0. 05 ). Compared to control group, serum hs-CRP and creatinine levels 24 h before PCI and 48 h after PCI in test group were significantly lower, and glomerular filtration rate was significantly higher (P <0. 05, respectively). The incidence of contrast-induced nephropathy was lower in test group than that in control group[7% (6/84) vs.18% (15/83), P <0.05]. The results indicate that high-dose atorvastatin might be effective in protecting patients with acute myocardial infarction undergoing elective PCI from contrast-induced nephropathy via inflammatory response inhibition.

Objective:To compare serum level of β thromboglobulin in patients with coronary heart disease (CHD) complicated different complications.Methods:According to their complications,a total of 398 patients with unsta- ble angina pectoris (UAP)were divided into pure UAP group (UAP control group,n=82),hypertension group (n=89),diabetes mellitus (DM)group (n=133)and brain infarction group (n=94).Serum level of β thromboglobu- lin were measured and compared among four groups 6h after onset and before discharge.Incidence of myocardial in- farction within six months were followed up in four groups.Results:On 6h after onset,the serum level of β throm- boglobulin of brain infarction group,DM group,hypertension group,UAP control group was (61.13±3.32)ng/ml,(59.77±3.15)ng/ml,(52.12±3.27)ng/m, (48.55±3.14)ng/ml respectively,in which the level of brain infarction group was the highest,the difference between any two groups were significant (P<0.01 all);Compared with 6h after onset,there were significant reductions in serum levels of β thromboglobulin of four groups before dis- charge P<0.01 all,their ordering and difference significant degree were no change.The incidence of myocardial infarction (MI)in brain infarction group,DM group,hypertension group,UAP control group was 11.7%,6.0%, 3.4%,2.4% respectively,the MI incidence of brain infarction group was significant more than that of UAP con- trol group,the differences among other groups was no significant,P>0.05.Conclusion:β-thromboglobulin level during UAP onset is significant higher than that of remission period,and it rises most significantly in brain infarction group,and in this group the percentage of myocardial infarction occurred within six months is highest

OBJECTIVETo investigate the quantity, quality and effect of health management service project for patients with hypertension and diabetes in basic public health service project of Sichuan province.

METHODS44 health clinics or community health service center, 22 counties and 11 cities was extracted by method of multistage stratified sampling on March, 2014. In each institution we sampled 10 resident health record of hyperpietic and 10 of diabetic. Number of managed patients was recorded to calculate the rate of health management. Telephone survey was used to judge the accuracy and standardability of services the patients received according to the national basic public health service specifications. We compared the satisfaction rate and blood pressure/blood sugar control rate of patients which had accurate record to which had not, and which got normative services to which didn't.

RESULTS33.8% (69 680/206 154) of the hyperpietics and 24.0% (25 562/106 508) of the diabetics were managed. 81.16% (702/865) of the records were with accurate information. 74.36% (522/702) of the patients received normative services. Blood pressure was well controlled in 86.92% (299/344) of the hyperpietics, and FPG was well controlled in 85.46% (288/337) of the diabetics. The satisfaction rate was 94.58% (698/738). The satisfaction rate of patients which had accurate record was 98.69% (677/686), but of which had not was just 40.38% (21/52) (χ² = 320.52, P < 0.001). The satisfaction rate of patients which got normative services was 99.22% (508/512), and of which did not get was 97.13% (169/174) (χ² = 2.92, P = 0.087).

CONCLUSIONThe quality of managed chronic patients was well, and got obvious effect. Measures need to implement for increasing the management rate, accuracy and standardability of health management services for hyperpietic and diabetic.

Blood Glucose ; China ; Community Health Services ; Cross-Sectional Studies ; Diabetes Mellitus ; Disease Management ; Humans ; Hypertension ; United States

Objective: To explore the association between DNA methylation and body mass index (BMI) using Mendelian randomization analysis. Methods: A total of 469 participants were selected from the Chinese National Twin Registry in 2013, who were living in Shandong, Jiangsu, Zhejiang, and Sichuan provinces, and at least 18 years of age. A questionnaire survey and physical examination were conducted to collect demographic, clinical, and behavioral information. Peripheral blood cells were collected to detect genotype and methylation status. Association analyses between DNA methylation and BMI and between CpGs and cis-SNP were conducted. With rs748212 as the instrumental variable, the association between cg15053022 and BMI was explored using the Mendelian randomization method. Results: A total of 469 participants were selected. The mean age of participants was (44.8±13.2) years and the BMI was (25.0±3.8) kg/m². Nine BMI-related DNA methylation sites were found and DNA methylation site cg15053022 in the ATP4A gene was negatively associated with cis-SNP rs748212 (β=-0.020); the mean methylation level of AA, AC, and CC were 0.212±0.025, 0.242±0.024, and 0.264±0.028, respectively. rs748212 was associated with BMI (β=0.04, P=0.007) and closely related to cg15053022 (F=237.66, P=0.143). Mendelian randomization analysis showed lower methylation levels at cg15053022 were associated with higher BMI (β=-1.97, P<0.001). Conclusion This study supported the impact of cg15053022 methylation in the ATP4A gene on BMI using Mendelian randomization analysis and provided the basis for using Mendelian randomization analysis in methylation studies.

BACKGROUNDNumerous studies have demonstrated that the peroxisome proliferator-activated receptor-γ (PPARγ) plays an important role in regulating endothelial progenitor cells (EPC) function. Telmisartan, as a partial agonist of PPARγ, may have an effect on the regulation of EPC functions. The purpose of this study was to investigate the effects of telmisartan on EPC proliferation and differentiation.

METHODSPeripheral blood derived mononuclear cells containing EPC were isolated from healthy volunteers and then cultured on fibronectin-coated dishes in the presence or absence of telmisartan. The proliferative activity of EPC was determined by colony forming units (CFU) and MTT assay. The migratory activity of EPC was assessed by transwell assay. The expression of endothelial cells (EC) markers, including vascular endothelial cadherin (VE-cadherin), von Willebrand factor (vWF) and endothelial nitric oxide synthase (eNOS), were measured by Western blotting analysis.

RESULTSMorphological analysis revealed that telmisartan significantly increased the proliferation of EPC and the number of endothelial cell colony forming units. Telmisartan could enhance the expression of the makers of mature EC, including VE-cadherin, vWF, and eNOS, which indicated telmisartan could stimulate EPC to differentiate into mature EC. Telmisartan increased the phosphorylation of Akt in EPC. The inhibition of Akt activation significantly attenuated the effect of telmisartan on EPC functions, suggesting that Akt is involved in the stimulatory effect of telmisartan on EPC differentiation.

CONCLUSIONSThe results of this study demonstrate that telmisartan promotes EPC functions via activation of Akt.

Benzimidazoles ; pharmacology ; Benzoates ; pharmacology ; Cell Differentiation ; drug effects ; genetics ; Cell Proliferation ; drug effects ; Cells, Cultured ; Endothelial Cells ; cytology ; Humans ; Proto-Oncogene Proteins c-akt ; genetics ; metabolism ; Stem Cells ; cytology ; drug effects

OBJECTIVETo explore the heritability of body mass index (BMI) in twins across different regions and genders in China.

METHODSA total of 11 122 adult twin pairs from the Chinese National Twin Registry were interviewed. A structural equation model was used to estimate the heritability of BMI.

RESULTSThis study included 6 226 monozygotic twin pairs and 4 896 dizygotic twin pairs, with the age range as 25-85 (39.0 ± 10.8) years. Under stratified analysis by region, results showed that the highest and lowest rates on heritability of BMI in men were seen in Tianjin and Zhejiang, as 67.8% (95% CI: 50.1%-85.8%) and 42.1% (95% CI: 27.2%-60.9%), while in women were seen in Sichuan and Heilongjiang as 56.2% (95% CI: 47.5%-70.0%) and 11.2% (95% CI: 0.0%-31.7%), respectively. Results from the stratified analysis showed that, by gender, the heritability of BMI in men was higher than that in women from the same region. The biggest differences of heritability of BMI between men and women were seen in Heilongjiang as 55.3% (95% CI: 35.5%-80.0%) and 11.2% (95% CI: 0-31.7%), while the smallest differences were seen in Sichuan as 61.5% (95% CI: 40.7%-86.4%) and 56.2% (95% CI: 47.5%-70.0%), respectively.

CONCLUSIONThe heritability of BMI across different regions and genders showed certain differences in the Chinese twins.

Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; genetics ; Body Mass Index ; China ; Cities ; Female ; Humans ; Male ; Middle Aged ; Registries ; Twins, Dizygotic ; genetics ; statistics & numerical data ; Twins, Monozygotic ; genetics ; statistics & numerical data

OBJECTIVETo understand the change trend of birth weight of twins in China from 1995 to 2012.

METHODSA total of 10 827 twins born between 1995 and 2012 registered in national twin registry system in 8 provinces in China were included in this study. A retrospective study was conducted to analyze the change trend of twin's birth weight.

RESULTSMean birth weight of twins decreased by 0.01 kg every five years after adjusting sex, ovum type and place of birth (P = 0.041). The birth weight decreased both in superior twin and in inferior twin over time. After 2007, the birth weight of superior twin decreased by 0.008 kg each year, while the birth weight of inferior twin decreased by 0.014 kg each year. Mean relative difference in birth weight and birth weight discordant rate decreased before 2002, then increased from the lowest point 8.16% and 16.20% to highest point 9.99% and 22.40% respectively.

CONCLUSIONThe birth weight of twins in China decreased between 1995 and 2012, while the birth weight discordant rate increased, suggesting that close attention should be paid to the discordance of twin body weight to reduce the risk of adverse health outcome.

Birth Rate ; Birth Weight ; China ; epidemiology ; Humans ; Infant, Newborn ; Registries ; Retrospective Studies ; Twins

OBJECTIVETo analyze the associations between birth weight and overweight/obesity among children.

METHODSA total of 8 267 twin pairs younger than 18 years old from the Chinese National Twin Registry were included in the study. Associations between birth weight, childhood BMI and overweight/obesity were explored by this co-twin control study.

RESULTSAfter adjusting for sex and zygosity, when birth weight had an increase of 0.5 kg per fold, the OR values for overweight and obesity were 1.87(95%CI: 1.40-2.48) for 2-6 year olds, 1.69 (95%CI: 1.16-2.46) for 6-12 year olds and 1.28 (95%CI: 0.80-2.07) for 12-18 year olds.

RESULTSfrom the stratified analysis in the 2-6 year-olds, statistically significant differences were seen. When birth weight increased 0.5 kg per fold, the risk of overweight and obesity increased by 0.87 times among the dizygotic twins, more than that of the monozygotic twins (OR=1.86, 95%CI:1.24-2.81). The risk for male twins was 1.12 times higher than that of female twins (OR=1.65, 95%CI:1.11-2.44).

CONCLUSIONSBirth weight seemed associated with overweight and obesity for kids at early childhood or at age for schools. However, guidance on the implementation of public health interventions is still needed on these children.

Adolescent ; Birth Weight ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Male ; Obesity ; ethnology ; Overweight ; ethnology ; Registries ; Risk ; Twins, Dizygotic ; Twins, Monozygotic