Objective: To evaluate the effect of standard management for hypertension in community population of Suzhou city. Methods: We conducted a prospective study of standard management for hypertension in community population of Suzhou city. The project included 3 groups: Standard group, the patients received standardized management,n=81 711, Control group, the patients received general management, n=38 944, and No-management group,n=1 644 249. The incidence rate of stroke and coronary artery disease (CAD) were compared among different groups according to 2010 chronic disease report of Suzhou city. Results: Compared with initial condition, the final average blood pressure drop in Standard group was (13.78/7.06) mmHg, which was better than that in Control group, X2=1852.91,P<0.01. The incidence rate of stroke in Standard group, Control group and No-management group were 1.72%, 2.41% and 3.59%, the incidence rate of CAD were 0.43%, 0.66% and 1.29% respectively. Conclusion: Standard management for hypertension was better than general management for preventing and controlling the incidence of stroke and CAD in community population.

Objective　To investigate the correlation and diagnostic value of miR-96 and serum IGF-1 in patients with post-stroke cognitive dysfunction (PSCI).Methods　178 patients with ischemic stroke in recovery stage were recruited and divided into PSCI group (n=61) and non-PSCI group (n=117),expression levels of miR-96 and serum IGF-1 were compared.Patients were further divided into high miR-96 group and low miR-96 group according to the median levels,MOCA scores was compared.Auxiliary diagnostic value of miR-96,serum IGF-1 levels in PSCI were analyzed.Results　Expression level of miR-96 of PSCI group was higher,serum IGF-1 was lower than that of non-PSCI group (P<0.05).Pearson test showed that expression level of miR-96 of PSCI patients was negatively correlated with the level of serum IGF-1 (P<0.05).MOCA score in high miR-96 group and low IGF-1 group were lower than those in low miR-96 group and high IGF-1 group (P<0.05).ROC curve showed mir-96 had good diagnostic value for PSCI.Conclusion　High expression of miR-96 in PSCI patients can downregulate the level of IGF-1,and early determination of the level of miR-96 has auxiliary diagnostic value for PSCI.

Objective To observe the survival and reproduction of Oncomelania hupensis snails and their susceptibility to schistosome in schistosomiasis non-endemic area of the Yangtze River estuary in Southern Jiangsu.Methods The soil and water from the Yangtze River estuary of Southern Jiangsu were used for the experiment.The snails reproduced in the same year were collected from the upper reaches of the Yangtze River and raised in the laboratory.The snail survival and reproduction rates and schistosome infection of the snails were observed.The soil collected from schistosomiasis endemic area was used in the control group.Results There was no significant difference between the experimental and control groups for the snail survival rates both in 6 and 12 months (X~2= 0.727 8,P > 0.05 and X~2 = 0.416 1,P > 0.05).Each female snail reproduced 67.69 eggs in average (95 % CI:24.026 0-110.097 4).The average hatchability rate of snail eggs was 83.60%,and there was no significant difference between the 2 groups (X~2= 9.131 8,P > 0.05).The schistosome infection rate of the second generation snails was 1.40% (5/356) 60 days after the infection in the laboratory.Conclusions The snails collected from the upper reaches of the Yangtze River marshland can survival and reproduce in the soil and water from schistosomiasis non-endemic area of the Yangtze River estuary of Southern Jiangsu,and the second generation of the snails can be infected with schistosome in the laboratory.

ObjectiveTo explore the clinical application of ultrasound guided percutaneous right internal jugular vein catheterization in hemodialysis,and to analyze the methods,precautions and prevention of complications of puncture.MethodsTotally 297 patients of chronic renal insufficiency with uremia underwent ultrasound guided percutaneous right internal jugular vein catheterization according to technical points of increasing the success rate of puncture.ResultsThe total successful rate of puncture was 100％.The first puncture succeeded in 244 patients (244/297,82.15 ％),the second in 30 (30/297,10.10％) and the third in 23 (23/297,7.74％) patients.The complication rate was 15.15％ (45/297).Poor adherence of catheter led to cited blood difficultly and inadequate flow in 31 patients.ConclusionUltrasound guidance can greatly improve the success rate of puncture in percutaneous right internal jugular vein catheterization,while reduce the incidence of complications.

Objective: To observe the protective effect of salidroside pretreatment on rabbit heart after limb ischemia/reperfusion (I/R). Methods: A total of 24 New Zealand rabbits were randomly and equally divided into sham operation group, I/R + placebo group （I/R group）and salidroside pretreatment group（salidroside group）. Before establishment of rabbit models of limb I/R, salidroside group received salidroside injection via ear marginal vein, and I/R group received saline injection, once a day for three days. After model establishment, echocardiography was used to evaluate rabbit cardiac function of each group 4h after reperfusion, including left ventricular end-systolic dimension (LVESd), left ventricular end-diastolic dimension (LVEDd), left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (FS). Blood sample was taken to measure serum cardiac troponin I (cTnI) and tumor necrosis factor (TNF)-α. Some ventricular tissue homogenates were taken to measure levels of superoxide dismutase (SOD) and malonyl diadehyde (MDA). Then heart sample was taken to receive pathological examination. Results: Compared with I/R group 4h after reperfusion, there were significant decrease in LVESd [(0.69±0.07) mm vs. (0.62±0.05) mm] and significant increase in LVEF [(64.6±3.4) % vs. (72.1±3.6) %], FS [(34.2±3.2) % vs. (41.7±3.4) %] (P<0.05 all), but these indexes of salidroside group were all no significant different than those of sham operation group (P>0.05). Compared with I/R group, there were significant decrease in cTnI [(5.24±0.34) μg/ml vs. (1.06±0.12) μg/ml], MDA [(8.92±2.18) μmol/L vs. (6.79±1.43) μmol/L] and TNF-α [(37.43±10.02) pg/ L vs. (19.73±6.31) pg/ L], and significant increase in SOD level [(16.61±3.75) U/ml vs. (22.26±4.73) U/ml] in salidroside group (P<0.05 all). Pathological results indicated that injury degree in salidroside group was significantly attenuated than that of I/R group. Conclusion: Salidroside pretreatment could protect cardiac function and relieve rabbit cardiac injury after limb ischemia/reperfusion.

ObjectiveTo explore the predictive effect of serum TC/HDL-C ratio on ischemic and hemorrhagic stroke incidence in middle aged Chinese population.MethodsA prospective study was conducted based on the PRC-USA Collaborative Study on Cardiovascular and Cardiopulmonary Epidemiology. A total of 10 121 individuals (4921 men and 5200 women), aged 35—59 years were selected from 4 cohorts, in Beijing and Guangzhou, urban and rural. The average following up time was 15.9 years. During the follow-up period, 277 ischemic and 125 hemorrhagic stroke cases were diagnosed.ResultsThe age adjusted incidence rate of ischemic stroke was 144.1,169.4,166.7,226.9 and 282.2 in the group of TC/HDL-C ratio

Objective To explore the relationship between sleep status and the risk of diabetes in adults.Methods The baseline data of 53 260 subjects who were aged 30-79 years and had been enrolled into China Kadoorie Biobank (CKB) study from Suzhou,Jiangsu province were analyzed.Multiple logistic regression models were used to investigate the association between sleep status and diabetes after adjusting for potential confounders.Results Among 53 260 subjects,5.3％ had diabetes.The proportions of difficultly falling asleep,early morning arousal and snoring frequently was 7.2％,10.0％ and 29.5％,respectively.There were 22.6％ of subjects reporting sleep duration ≤6 hours.After controlling for possible confounders,the subjects with difficulty falling sleep (OR=1.63 for male,95％ CI:1.30-2.05;OR=1.48 for female,95％ CI:1.27-1.73),early morning arousal (OR=1.37 for male,95％CI:1.12-1.68;OR=1.31 for female,95％CI:1.14-1.51) or snoring frequently (OR=1.16 for male,95％CI:1.00-1.34;OR=1.39 for female,95％CI:1.23-1.57) had a higher risk of diabetes.Using hypnotics regularly was associated with the risk of diabetes in females (OR=1.42,95％CI:1.06-1.92).Compared with 8 hours sleep duration daily,shorter sleep duration (≤ 6 hours) was associated with risk of diabetes in both males (OR=1.37,95％CI:1.17-1.60) and females (OR=1.24,95％ CI:1.08-1.41).No statistical significant association was found between longer sleep duration (≥9 hours) and the risk of diabetes.Conclusion Sleep problems,including difficulty falling asleep,early morning arousal,snoring frequently and shorter sleep duration,were associated with the risk of diabetes,but no statistical significant association was observed between longer sleep duration and the risk of diabetes.

BACKGROUND:Osteochondral defect of the joint is a difficult problem faced by orthopedic surgeons,and traditional repair methods are difficult to obtain satisfactory curative effects.Hydroxyapatite-polyvinyl alcohol-based composite hydrogel material is a direction of current research. OBJECTIVE:To prepare hydroxyapatite-polyvinyl alcohol/collagen-chitosan-gelatin composite hydrogel material and characterize its physical characteristics,to verify its histocompatibility and cell adhesion and proliferation ability after implantation in vivo,and explore its repair effect on rabbit osteochondral defects. METHODS:The cylindrical porous poly(lactic acid)scaffold was prepared by 3D printing technology(the pore sizes were 1.2,1.4,1.6 and 1.8 mm,respectively).The poly(lactic acid)scaffold was injected with polyvinyl alcohol and hydroxyapatite mixed emulsion.After freezing thawing and dichloromethane dissolution,hydroxyapatite-polyvinyl alcohol hydrogel was prepared.Then,the collagen-chitosan-gelatin mixture was injected into the hydroxyapatite-polyvinyl alcohol hydrogel and crosslinked with genipin.Finally,the hydroxyapatite-polyvinyl alcohol/collagen-chitosan-gelatin composite hydrogel was prepared by alcohol cleaning and freeze-drying.The physical characteristics of the four groups of hydrogels were characterized,and the hydrogels with the best performance were screened for follow-up experiments.Hydroxyapatite-polyvinyl alcohol hydrogel and collagen-chitosan-gelatin composite hydrogel were implanted subcutaneously in SD rats.Hematoxylin-eosin staining and Masson staining were used to observe the adhesion growth of cells on the material surface.Osteochondral defect(diameter:5 mm,depth:6 mm)models were made in the femoral trochlea of bilateral knee joints of 15 rabbits.The composite hydrogel was implanted on the left side(experimental group),while no material was implanted on the right side(control group).Micro-CT and histology were used to evaluate the repair effect of osteochondral defects. RESULTS AND CONCLUSION:(1)Based on the results of porosity,water content,mechanical testing and scanning electron microscopy,it was concluded that the hydroxyapatite-polyvinyl alcohol/collagen-chitosan-gelatin composite hydrogel with a pore size of 1.2 mm was more consistent with the general characteristics of natural cartilage,which was used for subsequent experiments.(2)Hematoxylin-eosin staining and Masson staining exhibited that with the extension of subcutaneous implantation time of the materials,the adhesion of cells around the two materials increased significantly,and the proliferation of cells after the implantation of collagen-chitosan-gelatin was better,a large number of cells could be seen growing into the formed network structure,and the network structure was gradually degraded.(3)In the rabbit osteochondral defect experiment,8 weeks after surgery,Micro-CT examination demonstrated that the material implanted in the experimental group had good integration with the surrounding bone-cartilage,with some bone growth on the surface and inside,while the cartilage and subcartilage in the control group still had obvious defects,without effective repair.Hematoxylin-eosin staining and toluidine blue staining displayed that the composite hydrogel in the experimental group integrated with the surrounding articular cartilage 4-8 weeks after implantation.With the extension of time,new cartilage gradually formed on the surface of the material.At 12 weeks,most of the defect was covered by new cartilage,and good bone growth was also observed in the subcartilage.In the control group,the deep bone defects were mostly repaired and the superficial cartilage and subchondral bone defects were also repaired to a certain extent,but they were mainly replaced by fibrous tissue and part of fibrocartilage 12 weeks after surgery.(4)In conclusion,hydroxyapatite-polyvinyl alcohol/collagen-chitosan-gelatin composite hydrogel material can mimic the structure and function of natural cartilage,and can effectively repair osteochondral defects in animal experiments.

Objective:To report the application of our self-made Kirschner wire connecting rod combined with a conventional intramedullary nail extractor in difficult extraction of intramedullary devices.Methods:From January 2012 to August 2017, 10 patients with a hard-to-remove intramedullary device were treated at Department of Orthopaedics, The Fifth Hospital Affiliated to Xinjiang Medical University. They were 7 males and 3 females with a mean age of (40.0±9.0) years. In cases where no relevant extractor was available for the intramedullary device or it was impossible to connect the extractor connecting rod to the tail of the intramedullary device, the Kirschner wire was bent and pulled through the screw hole or the hole newly drilled at the tail of the intramedullary device to be tied or fixed with a conventional extractor connecting rod to form an effective connection. Next, our self-made Kirschner wire connecting rod was used to pull out the intramedullary device. In this cohort, 7 intramedullary nails in the tibia, 1 femoral intramedullary nail, 1 humeral intramedullary nail, and 1 tibial elastic nail were removed. The difficult extraction was due to "cold welding" of the tail cap of the intramedullary nail in 3 cases, mismatch between the screw rod of the extractor and the tail screw hole of the intramedullary nail in 4 cases, and unavailability of relevant removal tools in 3 cases. The time for intramedullary device removal, blood loss and postoperative adverse reactions were recorded.Results:Of this cohort, 9 patients underwent simple removal of the intramedullary device and 1 patient replacement of the intramedullary device. The total time for removal of an intramedullary device was (2.3±0.8) h, ranging from 1.0 to 3.2 h. The amount of blood loss was (159.0±61.0) mL, ranging from 80 to 250 mL. The follow-up was (14.5±2.2) months, ranging from 11 to 18 months. There was no infection or fracture associated with implant removal.Conclusion:Application of our self-made Kirschner wire connecting rod in combination with a conventional intramedullary nail extractor is an easy operation to successfully extract hard-to-remove intramedullary implants, requiring no more special instruments.

OBJECTIVETo evaluate the roles of folic acid and beta-carotene in the chemoprevention of gastric and other gastrointestinal (GI) cancers.

METHODSIn a randomized, double-blind, placebo-controlled trial, a total of 216 patients with atrophic gastritis were randomly assigned to one of the four groups: (1) folate (FA, 20 mg per day plus vitamin B(12) 1 mg, intramuscularly, per month for one year, then 20 mg two times a week plus 1 mg per three months for the next year); (2) natural beta-carotene (N-betaC, 30 mg per day for first year, then 30 mg two times a week for the next); (3) synthetic beta-carotene (S-betaC, administered as in N-betaC); and (4) placebo. Follow-ups continued from 1994 to 2001.

RESULTSA total of 7 new cases of gastrointestinal cancers were diagnosed with 3 stomach, 1 colon and 1 esophageal cancers occurring in the placebo group; 1 stomach cancer in both of the N-betaC and S-betaC groups, and no cancer occurring in FA group. In terms of GI cancers, there was a significant reduction in the FA group, compared with the placebo group (P = 0.04). A similar trend was observed in both N-betaC and S-betaC groups (P = 0.07 - 0.08). Taken together, the three intervention groups displayed a highly significant decrease in occurrence (P = 0.004, vs placebo), and a lower risk for GI cancers (OR = 0.12; 95% confidence interval, 0.03 - 0.51). For development of gastric cancer, any one of the three active-treated groups did not reach statistically significant reduction. The FA group showed obvious improvement of the gastric mucosal lesions with more patients displaying lesions reversed or stable atrophy and inflammation (P = 0.04), reversed intestinal metaplasia (P = 0.06) at the end of follow-up, and reversed displasia (P = 0.017) at 12 months. Two cases of false jaundice were found in beta-carotene groups with no influence on administration, and no side-effects were reported in FA group.

CONCLUSIONSThis trial revealed the interventional effect of folic acid on the development of GI cancers, a similar effect of beta-carotene was also detected. Also, folic acid may be of use to treat atrophic gastritis by preventing or reversing the precancerous lesions.

Adult ; Aged ; Anticarcinogenic Agents ; therapeutic use ; Double-Blind Method ; Female ; Folic Acid ; adverse effects ; therapeutic use ; Gastric Mucosa ; pathology ; Gastrointestinal Neoplasms ; prevention & control ; Humans ; Male ; Middle Aged ; Patient Compliance ; Stomach Neoplasms ; prevention & control ; beta Carotene ; therapeutic use