OBJECTIVETo probe into the relationship between hypertension and hemodynamic score of cerebral vascular accumulative function by though studying the history of hypertension and level of blood pressure.

METHODSThe database of blood pressure and cerebral vascular hemodynamic indexes (CVHI) were from baseline data and measurement in a cohort. 18,512 participants who met the included criteria were enlisted in the study. The function scores were estimated using uniform methods according to CVHI. Participants were grouped by age, years of having hypertension and level of blood pressure. Differences of the function score between different groups were compared.

RESULTSThe function score in hypertension group was significantly lower than that of normal tension group, which decreased by 13.3 points. Within 5 years of hypertension history, the function score decreased as course of hypertension prolonged. The same trend was found between the score and level of both systolic and diastolic blood pressure. When systolic blood pressure elevated to 140 mmHg or diastolic blood pressure elevated to 95 mmHg, the function score was below 75 points.

CONCLUSIONThere were significant relationship between decrease of the function scores and medical history, course of hypertension as well as level of blood pressure.

Adult ; Age of Onset ; Aged ; Blood Pressure ; physiology ; Cerebrovascular Circulation ; physiology ; China ; epidemiology ; Cohort Studies ; Female ; Hemodynamics ; physiology ; Humans ; Hypertension ; epidemiology ; physiopathology ; Male ; Middle Aged

OBJECTIVETo present data from a baseline investigation on stroke-related cohort population in rural area of Shanghai.

METHODSA cross-sectional study was carried out in a cluster sampling population aged 40 years and over. General information and data on common risk factors in the population were gathered and cerebral vascular hemodynamic indexes were checked. Hemodynamic score was estimated according to single indexes by unified methods. 5335 persons who had met the inclusion criteria were enlisted in the study. Exposure level of risk factors, prevalence of stroke, and hemodynamic indexes were analyzed and distributional characteristics were described.

RESULTSExposure rate of hypertension, heart disease, diabetes, family history of hypertension, overweight or obesity in males were 31.74%, 6.09%, 1.16%, 3.22%, 17.64%, 29.68% and were 32.76%, 9.22%, 1.55%, 3.84%, 19.22%, 29.44% in female respectively. Standard prevalence of stroke was 1167.3/100000, which in male was significantly higher than that in female (P < 0.05). The change of cerebral vascular hemodynamic indexes was significantly associated with age. Hemodynamic score in 21.3% of the subjects was below 75 points.

CONCLUSIONSAmong population of 40 years old and over in rural areas, hypertension was the principal risk factor regarding the rate of stroke. Prevalence of stroke in males was significantly higher than that in females. Abnormal rate of hemodynamic score was about 20% in this population.

Adult ; Age Factors ; Aged ; Aged, 80 and over ; Brain ; blood supply ; China ; epidemiology ; Cohort Studies ; Cross-Sectional Studies ; Female ; Hemodynamics ; Humans ; Hypertension ; complications ; epidemiology ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Rural Health ; Sampling Studies ; Sex Factors ; Stroke ; epidemiology ; physiopathology

OBJECTIVETo study the role of cerebrovascular hemodynamic indexes (CVHI) changing in stroke and to provide reference for stroke prevention and risk factor study.

METHODSFrom 2003 to 2004, participants aged 40 years and above in two communities in Fengxian district were recruited by cluster sampling. Risk factors of stroke and CVHI were investigated and checked during baseline investigation. A total of 10 565 individuals completed the survey and met the inclusion criterion. After baseline investigation, the cohort was followed up for stroke occurrence. Relative risk (RR) of CVHI and common risk factors were estimated by cohort study design.

RESULTSAge of the cohort was (56.2 ± 11.4) years. 4444 (42.1%) were males and 6121 (57.9%) were females. Total follow-up duration was 67 885.7 person-years. A total of 195 stroke cases occurred and incidence density of stroke was 287.2 per 100 000 person-years. Stroke incidence in exposure groups of hypertension, heart disease and alcohol drinking was 3.47% (108/3118), 2.96% (21/710) and 2.50% (47/1882), respectively. The incidence in corresponding non-exposure group was 1.17% (87/7448), 1.77% (174/9855) and 1.70% (148/8683) respectively. There was significant difference between 2 groups (χ(2) value was 62.72, 4.56 and 4.94, respectively, P < 0.05). Stroke incidence in CVHI score < 25, 25 - 49, 50 - 74 and ≥ 75 groups was 9.12% (59/647), 5.68% (44/775), 2.52% (39/1545) and 0.72% (53/7403)(χ(2)trend = 273.57, P < 0.05), respectively. Incidence of stroke in 40 - 49, 50 - 59, 60 - 69, ≥ 70 years age group was 0.22% (8/3565), 1.28% (43/3357), 2.71% (50/1848) and 5.88% (94/1600) (χ(2)trend = 181.48, P < 0.05), respectively. Multiple Cox regression analysis indicated that RR (95%CI) value of hypertension and cigarette smoking was 1.40(1.02 - 1.92) and 1.59(1.19 - 2.12), respectively when comparing with non-exposure group. RR (95%CI) value in CVHI score < 25, 25 - 49 and 50 - 74 points group were 6.15 (4.08 - 9.26), 4.55 (2.98 - 6.96) and 2.68 (1.75 - 4.09), respectively when comparing with the score ≥ 75 points group. RR (95%CI) value in age 50 - 59, 60 - 69 and ≥ 70 years group was 4.61 (2.16 - 9.82), 7.81 (3.67 - 16.60) and 13.49(6.44 - 28.24), respectively when comparing with below 40 years group.

CONCLUSIONCVHI score is the strong independent predictive factor and hypertension, cigarette smoking and age are the independent risk factors of stroke.

Aged ; Brain ; physiopathology ; Cohort Studies ; Female ; Hemodynamics ; Humans ; Male ; Middle Aged ; Risk Factors ; Stroke ; epidemiology ; etiology ; physiopathology

OBJECTIVETo compare the efficacy of preemptive epidural analgesia combined with postoperative epidural analgesia, postoperative epidural analgesia alone and intravenous analgesia for postoperative pain relief and their effects on plasma interleukin-6 (IL-6) concentration following radical surgery for gastric carcinoma.

METHODSSixty-six patients with gastric carcinoma scheduled for gastrectomy were randomly divided into 3 groups, namely group P (n=22), group E (n=22) and group V (n=22), to receive preemptive epidural analgesia combined with postoperative epidural analgesia, exclusive postoperative epidural analgesia, and exclusive postoperative intravenous analgesia, respectively. Hemodynamic data were recorded for all the patients during the operation, and visual analogue scale (VAS) was used to assess the pain intensity at 4, 8, 16, 24, 48 and 72 h after surgery. Plasma IL-6 concentration was determined before surgery and at 24, 48, 72 h after surgery.

RESULTSNo significant changes occurred in the hemodynamics during the preoperative periods. VAS and IL-6 were lower in group P than in group E and V, and group E had lower measurement than group V (P<0.05).

CONCLUSIONPreemptive epidural analgesia combined with postoperative epidural analgesia provides more satisfactory pain relief and more effectively prevents IL-6 increment than exclusive epidural analgesia or intravenous analgesia after gastrectomy for gastric carcinoma.

Adult ; Amides ; administration & dosage ; Analgesia, Epidural ; methods ; Analgesics ; administration & dosage ; Female ; Fentanyl ; administration & dosage ; Gastrectomy ; methods ; Humans ; Infusions, Intravenous ; Interleukin-6 ; blood ; Male ; Middle Aged ; Morphine ; administration & dosage ; Pain, Postoperative ; drug therapy ; Stomach Neoplasms ; blood ; surgery ; Treatment Outcome

Objective From May 2010 to May 2013 and from June 2013 to June 2016, we compared the clinical analysis of patients with necrotizing enterocolitis (NEC) in the Department of Pediatrics, studied incidence rate of NEC and the relationship between stages of NEC and prognosis, and compared the prognosis between the two three-year periods to provide the experience of diagnosis and treatment for clinical practice in the future. Methods The clinical data of patients diagnosed with NEC were retrospectively analyzed according to the diagnostic criteria of modified Bell staging classification using SPSS statistical software package. Early diagnosis rate and prognosis were compared between the two three-year periods. P＜0.05 showed that statistical significance was found. Results From May 2010 to May 2013, 40 cases of NEC were diagnosed in our hospital, among which 8 was in the first stage (20%),24 in the second stage (60%),and 8 in the third stage (20%) . The number of premature infants was 32, accounting for 80% , among which 25 cases were infants with very low birth weight accounting for 62.5% and 8 cases were full-term infants, accounting for 20% (P＜0.05) . In the study, 32 cases (80%) received traditional treatment, which was effective in stage Ⅰ. During the second stage, two abandoned the treatment was confirmed death in the follow-up, two underwent surgery successfully due to the progression of the disease and four (25%) died in the hospital. Statistic significance of treatment of internal medicine was found when comparing stage Ⅰ with stage Ⅱ (P＜0.05) . Ten children underwent surgery, among which one gave up treatment after the surgery because of financial problems and was found dead in the follow-up and four (60%) died in the hospital. The comparison of surgical treatment in patients in stage Ⅱ and Ⅲ showed no statistical significance (P＞0.05) . Fatality rates were statistically significant (P＜0.05) . From June 2013 to June 2016, 41 children were diagnosed with NEC in our hospital, including 24 cases in stage Ⅰ (59%), 14 in stage Ⅱ (34%), and 3 in stage Ⅲ (7%) . The number of premature infants was 33, accounting for 80%, among which 26 cases were infants with very low birth weight accounting for 62.5% and 8 cases were full-term infants, accounting for 20% (P＜0.05) . In the study, 35 cases (85.3%) received traditional treatment, which was effective in stage Ⅰ. During the second stage, one underwent surgery successfully due to the progression of the disease. Statistic significance of treatment of internal medicine was found when comparing stage Ⅰ with stage Ⅱ (P＜0.05) . Four children underwent surgery, among which one gave up treatment after the surgery because of financial problems and was found dead in the follow-up and the surgery was successful in other three. The comparison of surgical treatment in patients in stage Ⅱ and Ⅲ showed statistical significance (P＜0.05) . Fatality rates were statistically significant comparing the two three-year periods (P＜0.05) . The comparison of the rates of early diagnosis in the two three-year periods showed statistically significance (P＜0.001) . Conclusion Early diagnosis of NEC is the key to reduce mortality. Intestinal fatty acid binding protein (I-FABP) is a serological marker for early diagnosis of NEC. As an important factor, the reduction of the incidence of premature birth will result in the drop in the incidence of NEC.

OBJECTIVETo explore the exposed level of stroke risk factors in Fengxian county of Shanghai and the relationships between risk factors and stroke.

METHODSCommunity based populations including 10,565 individuals aged 40 years old and over were cluster sampled from Fengxian county in 2003 or 2004. Status of exposure on common risk factors such as hypertension, cardiovascular disease, diabetes, family history of stroke, cigarette smoking, alcohol intake were gathered while cerebral vascular hemodynamic index (CVHI) was examined, with CVHI score below 75 points as abnormal. During 2003 to 2006, 78 stroke cases occurred. The relationships between risk factors and stroke were analyzed by univariate and Cox proportional hazards regression models.

RESULTSRates of exposure regarding hypertension, cardiovascular disease, diabetes, family history of stroke, obesity (BMI > or = 28 kg/m2), smoking, drinking and CVHI score abnormal were 21.14%, 6.72%, 1.88%, 5.63%, 4.17%, 34.96%, 17.81% and 29.43%, respectively. Data from Univariate analysis indicated that relative risk (95% CI) of above-mentioned risk factors were 2.76 (1.76-4.32), 2.19 (1.16-4.14), 1.52 (0.38-6.19), 1.58 (0.69-3.62), 1.24 (0.45-3.38), 1.75 (1.12-2.73), 2.10 (1.30-3.39) and 12.72 (7.02-23.06), respectively. Results from Cox proportional hazards regression models analysis showed that cigarette smoking, CVHI score abnormal were screened into equation.

CONCLUSIONAmong all the risk factors, rate of hypertension was the highest while hypertension, cardiovascular disease, cigarette smoking, alcohol intake and abnomal CVHI score had remarkable etiological correlations to stroke. Abnormal CVHI score, cigarette smoking seemed to be the independent forecasting factors related to stroke.

Adult ; Aged ; Alcohol Drinking ; adverse effects ; Cardiovascular Diseases ; complications ; China ; epidemiology ; Diabetes Complications ; Female ; Hemodynamics ; Humans ; Hypertension ; complications ; Male ; Middle Aged ; Obesity ; complications ; Proportional Hazards Models ; Risk Factors ; Smoking ; adverse effects ; Stroke ; epidemiology ; etiology

OBJECTIVETo establish a predicting model for stroke according to cerebral vascular hemodynamic indexes and major risk factors of stroke.

METHODSParticipants selected from a stroke cohort with 25,355 population in China. The first step was to carry out principal component analysis using CVHI. Logistic regression with principal component and main risk factors of stroke were then served as independent variables and stroke come on as dependent variables. The predictive model was established according to coefficient of regression and probability of each participant was also estimated. Finally, ROC curve was protracted and predictive efficacy was measured.

RESULTSThe accumulative contribution rates of four principal components were 58.1%, 79.4%, 88.4% and 94.6% respectively. Seven variables were being selected into the equation with the first to fourth principal component as history of hypertension, age and sex. Area under ROC curve was 0.855 and optimal cut-off point was probability over 0.05. Sensitivity, specificity and accuracy of stroke prediction were 80.7%, 78.5% and 78.5% respectively.

CONCLUSIONThe model established by principal component and regression could effectively predict the incidence of stroke coming on.

Brain ; blood supply ; Hemodynamics ; physiology ; Humans ; Logistic Models ; Models, Biological ; Principal Component Analysis ; Risk Factors ; Stroke ; etiology

Objective To describe the distribution of over weight and obesity to discover the level of exposure on risk factors of stroke among people aged 40 and over, in a community-based population.Methods From 2003 to 2004, people aged t≥40 years in a community of Fengxian district in Shanghai were selected by cluster sampling. Out of 11 791 individuals who were selected, 10 565 met the inclusion criteria and responded to the investigation. By face to face interview, a cross-sectional survey was carried out, using a questionnaire for risk factors of stroke. Height, weight and blood pressures were measured and cerebrovascular hemodynamic parameters (CVHP) were checked. Age and gender distribution of over weight and obesity in the population were described. Using 60 year as cut-off point, participants were grouped into three: normal, over weight and obesity by body mass index. Level of stroke risk factor exposure between groups was compared and logistic regression model was used for multiple analyses. Results Proportions of over weight and obesity were 28.5 percent and 4.1 percent in male and 26.3 percent and 4.2 percent in female (P=0.045 ). Systolic and diastolic blood pressure in over weight group were (132.5±19.4)ram Hg and (83.9±10.5)mm Hg(1 mm Hg= 0.133 kPa),which were higher than that in normal weight group and lower than that in obese group (P<0.05). Exposure rate of heart disease,family history of stroke in < 60 year old group and diabetes in ≥60 year group increased along with the increase of weight. Exposure rate of hypertension, abnormality of CVHP score in both age groups were also increased with the increase of weight. Data from multiple logistic regression indicated that hypertension,family history of stroke and heart disease, CVHP score below 75 points, sex and age were independent factors of over weight and obese. Conclusion The prevalence of over weight or obesity in a community-based population among aged 40 years or over was around 30 percent. The overall exposure rate of stroke risk factors were increasing along with the increase of weight, especially for those in the middle age.

OBJECTIVETo study the value of combined measurement of intestinal fatty acid-binding protein (I-FABP) and fecal calprotectin (FC) in the diagnosis of necrotizing enterocolitis (NEC) in full-term neonates.

METHODSA total of 36 full-term neonates with NEC (case group) and 39 neonates without digestive system diseases (control group) were enrolled as study subjects. ELISA was used to measure the serum I-FABP level and fecal FC level, and the clinical value of I-FABP combined with FC in the diagnosis of NEC was evaluated.

RESULTSThe case group had significantly higher I-FABP and FC levels than the control group (P<0.05). In the case group, serum I-FABP level was positively correlated with fecal FC level (r=0.71, P<0.05). In the diagnosis of NEC, I-FABP alone, FC alone, and I-FABP/FC combination had sensitivities of 83.3%, 81.5%, and 79.5%, specificities of 72.5%, 75.8%, and 86.3%, and areas under the ROC curve (AUCs) of 0.82, 0.81, and 0.88. The combined measurement showed significantly higher specificity and AUC than single measurement (P<0.05).

CONCLUSIONSChildren with NEC have significant increases in I-FABP and FC levels, and there is a correlation between them. Combined measurement of I-FABP and FC can increase the specificity of the diagnosis of NEC.

Enterocolitis, Necrotizing ; diagnosis ; Fatty Acid-Binding Proteins ; blood ; Feces ; chemistry ; Female ; Humans ; Infant, Newborn ; Leukocyte L1 Antigen Complex ; analysis ; Male

Adolescent ; Adult ; Aged ; Aged, 80 and over ; China ; epidemiology ; Community-Acquired Infections ; epidemiology ; microbiology ; Female ; Humans ; Male ; Middle Aged ; Pneumonia, Mycoplasma ; epidemiology ; Young Adult