1.Relationship between gastric schistosomiasis and gastric cancer
Zhiheng FANG ; Guihe WANG ; Fei XIA
Chinese Journal of Postgraduates of Medicine 2012;35(8):24-25
ObjectiveTo investigate the relationship between gastrc schistosomiasis and gastrc cancer.MethodsThe data of 11 cases of gastrc schistosomiasis were retrospective analyzed.Results 54.5% (6/11) of gastrc schistosomiasis cases complicated with gastrc cancer,and 83.3% (5/6) was well-differentiated and moderately differentiated.Seen around the parasite eggs were obvious intestinal metaplasia,glandhyperplasia,abnormalepitheliallesionsandother seriousatypicalhyperplasia.ConclusionsGastric schistosomiasis significantly increases the risk of gastrc cancer.Gnstrc schistosomiasis does not have specific symptoms,and it is clinically sumilar to chronic gastrtis.Therefore,patients with chronic gastrtis-likesymptoms in the schistosomiasis endemic areas should be subjected to an intensive test for gastrc schistosomiasis in the biopsy specimens collected from pyloric antrum and gastric lesser curvature.Patients infected by gastric schistosomiasis are strongly suggested to go regularly for gastric cancer check with gastroscopy.
2.Association between the changes in ideal cardiovascular health status and the decline of glomerular filtration rates in medical examination people
Yaqin WANG ; Pingting YANG ; Xia CAO ; Liuxin WU ; Zhiheng CHEN
Journal of Central South University(Medical Sciences) 2017;42(6):681-686
Objective:To explore the association between the changes in ideal cardiovascular health (CVH) indices and the renal function.Methods:The retrospective cohort study consisted of 837 Chinese individuals from Department of Health Management in the Third Xiangya Hospital.The general information,anthropometry and blood biochemistry were obtained for all subjects from 2008 to 2014,respectively.The 6-year changes of 7 ideal CVH metrics defined by American Heart Association and the estimated glomerular filtration rate (eGFR) were calculated.Linear regression analysis was used to study the association between the changes in the ideal CVH metrics and eGFR.Covariance analysis was used to compare the levels of changes in eGFR stratified by variations of the ideal CVH metrics.Results:After 6 years' follow-up,we did not find significant difference in ideal cardiovascular health indexes between 2014 and 2008 [(3.3±1.4) items vs.(3.2±1.3) items,respectively] (P<0.05).However,the eGFR in 2014 was significantly lower than that in 2008 [(99.8±22.7) mL/(min.1.73 m2)vs (104.3±24.9) mL/(min.1.73 m2),respectively] (P<0.01).After adjusting for age,sex,history of hypertension and diabetes,and history of drug usage (antihypertensive,cholesterol-lowering and blood glucose-lowering medication),the changes in ideal CVH metrics were positively associated with the changes in eGFR (β=0.701,P<0.01).With the improved change in ideal CVH metrics from ≤-2 points,-1 point,0 point,1 point to ≥ 2 points,the magnitude of decline in eGFR was gradually decreased,with significant difference (F=21.71,P<0.01).Conclusion:The changes in ideal CVH metrics are an independent risk factor for changes of eGFR.Positive changes in ideal CVH metrics exert a favorable effect on renal function evolution.
3.Effects of graded management of health on hypertension
Yaqin WANG ; Zhiheng CHEN ; Pingting YANG ; Xia CAO
Chinese Journal of Health Management 2013;(2):86-90
Objective To evaluate the effect of graded management of health in hypertensive populations.Methods Hypertensive adults who were detected in health checkup between January 2008 and June 2011 and with no severe liver or kidney disease,chronic consumptive disease and cancer were enrolled in this investigation.Those with low or modest hypertensive risk received grade 2health management,and those with high or extreme high risk got grade 3health management.At the end of the intervention,50% participants were randomly selected in each year(1441 in 2008,1508 in 2009,1533 in 2010,and 1601 in 2011) to compare lifestyle modification,blood pressure,blood glucose and blood lipid profiles by using multiDunnett's t test and x2 analyses.Results In both grade 2 and 3 health management groups,compared with baseline,high-salt diet,current cigarette smoking,alcohol consumption and insufficient physical activity were significantly improved after intervention (x2 values were 154.27 and 81.16,52.43 and 9.37,61.40 and 12.13,46.54 and 12.05,respectively; all P < 0.05).Blood glucose in grade 2 health management group and waistline in grade 3 health management group showed no significant change.Body weight,blood glucose,blood lipid profiles and serum creatinine of grade 2 health management group were significantly declined after intervention.In both groups,systolic and diastolic blood pressure were significantly decreased(F values were 13.12 and 56.86,56.86 and 239.89,respectively; all P <0.05),and those with normal blood pressure were increased from 28.8% and 23.4% to 37.9% and 28.2% in grade 2 and 3 health management groups(F values were 12.78 and 22.93,respectively ; all P < 0.05).Conclusion These data suggest the beneficial effects of graded management of health on blood pressure control and reduced risks of cardiovascular disease.
4.Prenatal nicotine exposure induces cardiac fibrosis in adult male offspring
Weijia DONG ; Xining LI ; Zhiheng XIA ; Yujuan ZHANG
Chinese Journal of Pharmacology and Toxicology 2017;31(6):621-625
OBJECTIVE To investigate the effect of prenatal nicotine exposure on cardiac ejection function and myocardial fibrosis of the offspring of rats.METHODS Pregnant rats were sc given nicotine 6.0 mg· kg-1,once daily for 17 d.The body mass and heart mass of the offspring were detected at the 21th day of gestation,and 15 and 90 d after birth.Heart rate of 90 d offspring was recorded by ECG,and cardiac functions were detected by Doppler ultrasonography,including cardiac output (CO),stroke volume (SV),ejection fraction (EF),left ventricular long axis shortening fraction (FS),interventricular septum diastolic diameter (IVSd) and left ventricular posterior wall diastolic diameter (LVPWd).The myocardial ultrastructure was detected under an electron microscope.Masson staining was used to detect the myocardial collagen fiber deposition.The level of collagen protein type Ⅰ in heart tissue was detected by radioimmunoassay.RESULTS Compared with control group,prenatal nicotine exposure resulted in a decrease of heart mass and body mass in groups of 21 d fetal rats and 15 d offspring(P<0.05,P<0.01),but had no effect on the 90 d offspring.Compared with the normal control group,the heart rate of 90 d offspring increased [366+10 vs (418+10) min-1] (P<0.05),CO,FS and EF decreased (P<0.01),and IVSd and LVPWd increased (P<0.05,P<0.01).Electron microscopy revealed that in the heart of nicotine 90 d offspring,myocardial fiber arrangement was loosened and confused,while extracellular matrix increased.Masson staining showed collagen deposited in the myocardium.The level of collagen type Ⅰ in heart tissue increased [0.59±0.09 vs (0.40±0.05) tμg·g-1 tissue] (P<0.01).CONCLUSION Prenatal nicotine exposure induces the increased level of cardiac collagen type Ⅰ,myocardial fibrosis and decrease of cardiac ejection function in adult offspring,which may lead to increased susceptibility to cardiovascular diseases.
5.Research on the application value of stepped screening on hypertension with self-report health measurement questionnaire
Pingting YANG ; Xin HUANG ; Yaqin WANG ; Xia CAO ; Liuxin WU ; Zhiheng CHEN
Chinese Journal of Health Management 2016;10(5):349-354
Objective To explore the application value of stepped screening on hypertension with self-report health measurement questionnaire by comparing the accuracy of the different levels of screening. Methods A total of 6 715 subjects with hypertension (average age of 53.47 ± 11.07 years) were selected from those who completed the physical examination in the department of health management in the Third Xiangya Hospital of Central South University for questionnaire survey, routine inspection and special inspection for hypertension. And the patients were divided into four groups based on their hypertension risk levels: the questionnaire survey group, routine inspection group, questionnaire + routine inspection group and questionnaire+routine inspection+special inspection group. The results were compared respectively to calculate the sensitivity, specificity, positive predictive value and coincidence rate of single inspection and joint inspection. Results Nearly 90.00%of the subjects had hypertension associated with the risk factors, while 20.83% of the subjects had hypertension associated with other clinical diseases (the highest percentage was seen in hypertension with diabetes as 14.88%). According to the guidelines of stratification, 3.41% of the patients were at low risk, 23.78% at moderate risk, 47.85% at high risk, and 24.96% at extremely high risk. Sensitivity and specificity of routine inspection were 95.56%and 45.51%in judgment of moderate risk, which became 100.00%and 45.51%after addition of questionnaire survey;as a result, thesensitivity increased. Sensitivity and specificity of routine inspection were 15.03%and 96.28%in judgment of high risk, which became 30.03% and 99.14% after addition of questionnaire survey; as a result, the sensitivity doubled. Sensitivity and specificity of routine inspection were 15.03%and 100.00%in judgment of extremely high risk, and the sensitivity increased to 94.45%after addition of questionnaire survey, while the specificity remained unchanged. Conclusion Addition of questionnaire on the basis of routine physical examination could greatly increase the detection rate of hypertension patients at different risk levels, and increase the sensitivity as well as specificity for detection of moderate risk, high risk and extremely high risk. Therefore, health information and data acquired from the questionnaire and data obtained from the medical inspection equipment are equally important and suggest health management (physical examination) institutions to take questionnaire as a necessary and primary screening in physical examination and chronic disease screening.
6.Serum thymidine kinase 1 measurement in health check-up
Zhiheng CHEN ; Yaqin WANG ; Xiaoling ZHU ; Hui ZHOU ; Yingxin LIU ; Pinting YANG ; Xia CAO
Chinese Journal of Health Management 2011;05(6):349-352
Objective To evaluate the utility of serum thymidine kinase 1(STK1)in health screening.Methods A total of 8896 adults who participated in health check-up during November 2009 and November 2010 were tested for STK1 by using sensitive chemiluminescence's dot blot assay.Results The level of STK1 of group A(STK1 > 2 pmol/L)was much higher than that of the group B(STK1 < 2 pmol/L)[(5.47 ±4.23)vs(0.62 ±0.48)pmol/L;t =11.90,P =0.00].The STK1 level was not correlated with gender.However,the mean age of individuals in the group A was higher than that in the group B[(48.2 ± 12.0)vs(41.8 ± 12.3)years; t =5.37,P =0.00].The positive detection rate of STK1 was 1.2%(108/ 8896).In the group A,there were 1.9% pre-or post-treatment malignancy,27.8% pre-malignant tumor or benign disease,36.0% nontumorous proliferation disease,14.8% hepatitis B virus/HP infection,10.2%fatty liver,and 9.3% other diseases.No pre-treatment malignancy and pre-malignancy were found in the group B.Conclusion STK1 measurement could reflect the situation of cell proliferation and predict the risk of any type of malignancy.
7.Status of liver fibrosis evaluated by aspartate aminotransferase to platelet ratio in patients with non-alcoholic fatty liver disease
Annan LIU ; Xiaolan ZHAO ; Zhiheng CHEN ; Qun ZHANG ; Hai'ou HONG ; Yu WANG ; Shouqing HUANG ; Qibin WANG ; Yanni XIA ; Ling ZHU
Chinese Journal of General Practitioners 2017;16(3):219-223
Objective To evaluate the prevalence and risk factors of progressive liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD).Methods A total of 2 054 subjects who underwent health check up and were diagnosed as NAFLD in 9 institutions were included in the study.Blood routine and biochemical findings were collected to calculate aspartate aminotransferase-to-platelet ratio index (APRI).Subjects were divided into three groups according to diagnostic threshold of liver fibrosis:APRI <0.43 group,APRI 0.43-0.53 group and APRI ≥ 0.54 group.The correlation between APRI and biochemical variables was analyzed,and the risk factors of progressive fibrosis were also analyzed.Results Among 2 054 subjects (male/female 1 598/456) there were 61 cases with APRI ≥ 0.98 (2.97%,progressive fibrosis),318 with APRI ≥0.54 (15.48%),1 475 with APRI < 0.43 (71.81%),261 with APRI 0.43-0.53 (12.71%).Logistic stepwise regression analysis showed that TG (P =0.002,OR =1.095,95%CI:1.033-1.161),2 hPG(P =0.000,OR =1.103,95% CI:1.058-1.151,BUN(P =0.034,OR =1.215,95 % CI:1.014-1.454) were risk factors,and H DL-C (P =0.034,OR =0.353,95 % CI:O.135-0.924) was a protective factor for the progression of fibrosis.Conclusion The progressive fibrosis in patients with NAFLD is closely associated to blood glucose and lipid metabolism disorder.
8.Diabetic cardiomyopathy in medical examination patients with impaired glucose tolerance and Type 2 diabetes.
Yaqin WANG ; Pingting YANG ; Xia CAO ; Meilin LIU ; Zhiheng CHEN
Journal of Central South University(Medical Sciences) 2014;39(6):564-569
OBJECTIVE:
To investigate the change of diabetic cardiomyopathy in patients with impaired glucose tolerance (IGT) and Type 2 diabetes (T2DM) and its influencing factors.
METHODS:
Patients with IGT and T2DM were divided into an IGT group (n=314), a T2DM group (n=368) and an NC group (400 normal subjects). The left ventricular ejection fractions (LVEF) and the interventricular septal depth (IVSd) were measured by Doppler echocardiography. The general information and blood biochemistry were also collected during the corresponding time period.
RESULTS:
Compared with the NC group, waist circumference (WC), bodymass index (BMI), premature family history of cardiovascular disease, the serum levels of fasting plasma glucose (FPG), HbA1c, TC, TG, hyperlipidemia, BUN and Cr significantly increased (P<0.01) in the IGT and T2DM groups. Compared with the NC group and the IGT group, the LVEF significantly decreased (P<0.01) and the IVSd significantly increased (P<0.01) in the T2DM group. The LVEF and IVSd did not have obvious difference between the NC group and the IGT group. Pearson correlation analysis showed a negative correlation between LVEF and HbA1c, TC and duration of disease (P<0.01); but a positive correlation between IVSd and WC, BMI, HbA1c and duration of disease, and a negative correlation between IVSd and HDL (P<0.05). In the multiple linear stepwise regression, HbA1c and duration of disease showed a significant association with both LVEF and IVSd (P<0.05).
CONCLUSION
T2DM has a close association with cardiomyopathy. HbA1c and duration of disease are the independent predictors for LVEF and IVSd.
Blood Glucose
;
Body Mass Index
;
Case-Control Studies
;
Diabetes Mellitus, Type 2
;
physiopathology
;
Diabetic Cardiomyopathies
;
physiopathology
;
Echocardiography, Doppler
;
Glucose Intolerance
;
Glycated Hemoglobin A
;
Humans
;
Ventricular Function, Left
;
Waist Circumference
9.Carotid intima-media thickness and estimated glomerular filtration rate in hypertensive patients.
Pingting YANG ; Hong YUAN ; Chunyan WENG ; Yaqin WANG ; Xia CAO ; Zhiheng CHEN
Journal of Central South University(Medical Sciences) 2014;39(5):465-470
OBJECTIVE:
To determine the association between carotid atherosclerosis and renal function in hypertensive patients.
METHODS:
A total of 2 809 hypertensive patients aged (56.59±10.79) years were enrolled. Carotid intima-media thickness (cIMT) was derived via B-mode ultrasonography and chronic kidney disease (CKD) was evaluated by the estimated glomerular filtration rate (eGFR) with Cockcroft- Gault method. The patients were divided into 3 groups: a normal group, a thick group, and a plaque group according to the results of carotid ultrasonography.
RESULTS:
The eGFR of the normal group was (111.09±25.61) mL/(min.1.73m(2)), that of the thick group and the plaque group was (94.45±27.14) mL/(min.1.73m(2)) and (85.98±26.92) mL/ (min.1.73m(2)). Binary logistic analysis showed that age (OR=3.590), smoking status (OR=1.543), systolic blood pressure (OR=1.018), diastolic blood pressure (OR=0.977), fasting plasma glucose (OR=1.132), triglyceride (OR=0.873) and eGFR (OR=0.986) were significantly correlated with cIMT. Subgroup analyses on different genders showed that eGFR was a significant independent risk factor in men (OR=0.991) but not in women.
CONCLUSION
The thicker the cIMT, the lower the eGFR in hypertensive patients. With the development of cIMT, eGFR gradually decreases and contributes to the occurrence and development of early-stage atherosclerosis in hypertensive patients.
Aged
;
Atherosclerosis
;
Blood Pressure
;
Carotid Arteries
;
diagnostic imaging
;
pathology
;
Carotid Artery Diseases
;
Carotid Intima-Media Thickness
;
Female
;
Glomerular Filtration Rate
;
Humans
;
Hypertension
;
physiopathology
;
Male
;
Middle Aged
;
Renal Insufficiency, Chronic
;
Risk Factors
;
Smoking
10.Application of serum thymidine kinase 1 of 26 055 cases in health screening for early detection of premalignant/early malignant tumors.
Xia CAO ; Yaqin WANG ; Pingting YANG ; Hui ZHOU ; Chang LIU ; Zhiheng CHEN
Journal of Central South University(Medical Sciences) 2014;39(10):1029-1034
OBJECTIVE:
To determine the application of serum thymidine kinase 1 (STK1) in general health screening for early detection of premalignant/early malignant tumors.
METHODS:
A cross sectional study was carried out in 26 055 health screenings from 8 centers of Changsha in 2011. The concentration of STK1 was determined by a sensitive chemiluminescent dot blot ECL assay.
RESULTS:
In the elevated STK1 group 60.35% showed diseases with a higher risk of premalignant/ early cancerous progression. The positive rate of elevated STK1 (>2.0 pmol/L) was 2.61%. There was a significantly higher rate with moderate/severe type of hyperplasia of breasts and prostate with elevated STK1 than people with normal STK1 values.
CONCLUSION
STK1 may be a reliable marker for risk assessment of premalignant/early malignant tumors.
Biomarkers, Tumor
;
blood
;
Breast
;
pathology
;
Cross-Sectional Studies
;
Early Detection of Cancer
;
Female
;
Humans
;
Hyperplasia
;
Male
;
Neoplasms
;
diagnosis
;
Precancerous Conditions
;
diagnosis
;
Prostate
;
pathology
;
Thymidine Kinase
;
blood