Objective To assess the estimated 10-year risk of stroke among hypertensive outpatients known with diabetes from cardiovascular clinics of 36 tertiary hospitals in China and to analyze the characteristics of the risk factors and the 10-year risk of stroke between the southern and the northern patients.Methods A multi-center prevalence survey was conducted from October 2011 to June 2012.Hypertensive outpatients known with diabetes were enrolled from cardiovascular clinics of 36 tertiary hospitals in China.A total of 15 914 outpatients were included in the final analysis.The 10-year probability of stroke was evaluated by the Framingham stroke risk profile.According to the 10-year probability of stroke,patients were divided into low risk (≤ 5％),medium risk (6％ ～9％) and high risk (≥10％).Results (1) Of all the hypertensive outpatients known with diabetes,the mean age was (64.6 ± 10.1) years and the mean systolic pressure was (138.7 ± 19.3) mmHg(1 mmHg =0.133 kPa).Among them,7.4％ with atrial fibrillation,11.2％ with left ventricular hypertrophy,57.2％ with cardiovascular diseases,17.1％ smokers and 37.0％ using mono-hypoglycemic agent.The southern patients who were older with more smokers had higher proportions of men and left ventricular hypertrophy,lower Levels of systolic blood pressure,and lower proportions of other cardiovascular diseases than those of the northern patients (all P ＜ 0.05).(2) The mean 10-year probability of stroke was (20.9 ± 16.2) ％.The southern patients had a higher mean 10-year probability of stroke than that of the northern patients [(22.4 ± 17.1)％ vs (19.7 ± 15.2)％] (P ＜ 0.01).After adjusted by age and sex,the southern patients still had a higher mean 10-year probability of stroke (P ＜0.05).(3) All the patients had 7.7％ with low risk,17.4％ with medium risk,and 74.9％ with high risk.The southern patients had lower proportions of low and medium risk than those of the northern patients (6.7％ vs 8.4％,15.5％ vs 18.9％),but had a higher proportion of high risk than that of the northern patients (77.7％ vs 72.7％,all P ＜ 0.01).Conclusions Among the hypertensive outpatients known with diabetes from the cardiovascular clinics of our study,most of them were at the 10-year high risk of stroke.The southern patients had a higher mean 10-year probability of stroke than that of the northern patients.

AlM: To study clinical reference value of retinal microvascular changes in patients with cerebral microbleeds ( CMBs) and discuss its clinical significance.
METHODS:From January 2012 to December 2013, 125 hospitalized patients were collected, including 81 cases were male, 44 cases were female, mean age 76. 3 ± 11. 2 years old. For all patients, functions of liver and kidney, blood - lipoids, blood sugar and blood biochemical examination were tested, and fundus photography and cerebral MR was done. According to the fundus camera eyes, retinal arteriolar equivalent ( RAE) , retinal venular equivalent ( RVE) , retinal vein diameter ratio ( AVR) and arteriovenous crossing sign ( AVN ) were identified, CMBs were classified with cerebral MRl. All the data were processed by SPSS statistical software.
RESULTS: The central retinal arteriolar equivalent (CRAE), central retinal venular equivalent (CRVE) and AVR values in the eyes were found no statistical difference (P<0. 05). Of CMBs classification, the grade 0 in 75 cases, 1 in 27 cases, 2 in 9 cases and 3 in 14 cases were included. The RVE, AVR and AVN and the different grades of CMBs had statistically significant correlation ( P<0. 01). The higher CMBs classification, the more obvious retinal microvascular changes were found. ln respectively to eliminate risk factors such as age, sex, blood glucose and blood pressure, AVR and AVN were still influencing factors for CMBs classification.
COCLUSlON: The results show that retinal microvascular changes, especially small retinal vein arteriovenous cross width, and arteriovenous crossing phenomenon, in which CMBs will happen more likely. After sex, age, hypertension and hyperglycemia in patients with traditional cardiovascular risk factors being ruled out, the retinal microvascular changes are still relatively factors of CMB's occurrence.

This study is to explore whether the protective effect of resveratrol on ischemia-reperfusion injury is correlated with the structural and functional association between M3 receptor (M3 subtype of muscarinic acetylcholine receptor) and Cx43 (connexin 43 gap junction proteins). Immunoprecipitation, immunoblotting and immunofluorescence were applied to investigate whether resveratrol has an effect on structural and functional association between M3 and Cx43. The effect of resveratrol on electrocardiogram Lead II ex vivo in rats, SOD (superoxide dismutase) activity and MDA (malondialdehyde) content was also observed in order to evaluate the protective effect of resveratrol on ischemia-reperfusion injury. Resveratrol could restore the structural and functional association between M3 receptor and Cx43 gap junction proteins that was partially destroyed under ischemia-reperfusion injury. The phosphorylation and spatial distribution disturbances in Cx43 expression caused by ischemia-reperfusion injury were also restored. Also, the QRS duration, SOD activity and MDA content were restored. Resveratrol could restore the structural and functional association between M3 receptor and Cx43 gap junction proteins.
Animals ; Connexin 43 ; metabolism ; Electrocardiography ; Heart ; drug effects ; physiopathology ; In Vitro Techniques ; Male ; Malondialdehyde ; metabolism ; Myocardial Reperfusion Injury ; metabolism ; physiopathology ; Myocardium ; metabolism ; Phosphorylation ; drug effects ; Protective Agents ; pharmacology ; Random Allocation ; Rats ; Rats, Wistar ; Receptor, Muscarinic M3 ; metabolism ; Stilbenes ; pharmacology ; Superoxide Dismutase ; metabolism

OBJECTIVETo investigate the effect of reconstruction of lower eyelid ectropion with expanded flap.

METHODSFourty patients with lower eyelid ectropion were reconstructed using tissue expander. The volume of the smallest expander was 30 ml, and that of the biggest one was 150 ml. The expand time was from 2-months to 3-months, then advancement or transposition flaps were created and employed in the defected lesion where the scar was removed just in one operation.

RESULTSAll patients have been followed up for 2-year with satisfactory results and no recurrences was appearance.

CONCLUSIONSApplication of expander reasonable may get satisfactory result in reconstruction of lower eyelid ectropion. The incision in donor site is hidden and the symptom seldom recurs.

Adolescent ; Adult ; Blepharoplasty ; methods ; Child ; Ectropion ; surgery ; Humans ; Male ; Surgical Flaps ; Tissue Expansion Devices ; Young Adult

OBJECTIVETo establish a method for determining glyphosate in the air of workplaces by ion chromatography.

METHODSUltra-fine glass fiber filter paper was used to collect glyphosate from the workplace air. After being ultrasonically eluted with deionized water, samples were determined by ion chromatography using a conductivity detector.

RESULTSWithin the range of 0.05-1.00 mg/L, a linear relationship was found with a limit of detection of 0.003 mg/m(3). The minimum detectable concentration was 0.000 41 mg/m(3) (calculated by sampling 75 L of air). For three different concentrations of glyphosate, the intra-batch relative standard deviations (RSDs) were 1.8%, 1.6%, and 0.8%, respectively, and the inter-batch RSDs were 1.9%, 2.1%, and 2.2%, respectively. The recovery rate ranged from 94.8% to 97.4%. The elution efficiency ranged from 94.5% to 96.7%. The sampling efficiency was 100%. Samples could be stored at room temperature for at least 7 days.

CONCLUSIONThis presented method meets the requirements of Guide for establishing occupational health standards-Part 4: Determination methods of air chemicals in workplace and is feasible for determination of glyphosate in the air of workplaces.

Air Pollutants, Occupational ; analysis ; Chromatography, Gas ; Glycine ; analogs & derivatives ; analysis ; Workplace

AIM:To elucidate the association between chronic kidney injury and interleukin-33 (IL-33;an alarmin)/suppression of tumorigencity 2 (ST2) in patients with systemic lupus erythematosus (SLE).METHODS:Serum levels of IL-33 and soluble ST2 (sST2) were assessed by ELISA in 50 SLE patients and 30 healthy controls (HC).RESULTS:The levels of IL-33 and sST2,and IL-33/sST2 ratio were significantly higher in SLE patients than those in the HC.The IL-33 and sST2 levels were positively associated with SLE disease activity index (SLEDAI),erythrocyte sedimentation rate (ESR),proteinuria and triglyceride,but negatively associated with complement C3.IL-33/sST2 ratio was positively associated with SLEDAI and estimated glomerular filtration rate (eGFR).Independent explanatory variables associated with high IL-33/sST2 included chronic kidney disease (CKD) staging and albumin (R2 =0.442),especially CKD staging.CONCLUSION:Elevated serum sST2 and IL-33 levels in SLE patients are correlated with disease activity and risk factors of kidney injury.IL-33/sST2 ratio may serve as a potential biomarker for chronic kidney injury in SLE patients.

Objective To analyze the relation among aortic root dimension(ARD) measured by echocardiography, cardiovascular disease risk factors and cardiovascular disease in adult Beijing community population.Methods Echocardiography was performed in 1041 individuals in a suburban community of Beijing from 2004 to 2005. ARD and other echocardiographic parameters including left atria dimension, left ventricular mass, septal and posterior wall thickness and dimension were analyzed. Histories of cardiovascular disease as well as risk factors were obtained. Spearman correlation was used to determine the relation between ARD and other cardiovascular risk factors. Multifactorial logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of ARD and cardiovascular disease.ResultsAscending aortic dimension (AAD) and mean root dimension(MRD) were positively associated with age, weight, BMI, systolic and diastolic blood pressure, left atria dimension, left ventricular mass, left ventricular septal and posterior wall thickness, and left ventricular dimension. With the lowest quintile of AAD and MRD as the reference, ORs for the highest quintile of AAD for specific cardiovascular diseases in female were as follows: stroke (OR=2.20,95%CI:1.03-4.72,P=0.04),chronic heart failure (OR=2.62, 95%CI:1.49-4.61,P=0.001),total cardiovascular disease (OR=2.52, 95%CI:1.51-4.21,P<0.001).ORs of MRD were as follows: chronic heart failure (OR=2.19, 95%CI:1.26-3.80,P=0.01), total cardiovascular disease (OR=2.20, 95%CI:1.32-3.68,P=0.002). After adjustment for age, BMI, smoking status, TC,hypertension, diabetes mellitus, the ORs were not statistically significant (P>0.05).Conclusion ARD was positively associated with several CHD risk factors, but was not independent risk factor for cardiovascular disease. ARD may act as an intermediate risk factor for cardiovascular disease. Combined ARD and traditional cardiovascular disease risk factors might enhance the predict power for cardiovascular disease.

Objective To observe the relationship between serum uric acid and brachial ankle pulse wave velocity (ba-PWV) in Beijing community individuals.Methods This epidemiological survey was performed in residents of two communities from Shijingshan District in Beijing from 2007 to 2008.Cardiovascular risk factors and ba-PWV were measured. Two thousand five hundred and forty three individuals with both ba-PWV and serum uric acid measurements were included.Ba-PWV ≥ 1400 cm/s was defined as abnormal.The individuals were divided into four groups (Q1,Q2,Q3 and Q4 group) according to the gender-specific quartiles of serum uric acid. Univariate logistic regression was used to evaluate the relation between various cardiovascular risk factors and ba-PWV abnormality.Multivariate logistic regression was used to evaluate the relation between serum uric acid and ba-PWV abnormality after adjusting for other cardiovascular risk factors.Results Body mass index,triglyeride and prevalence of hypertension increased with increasing levels of serum uric acid (all P ＜0.01 ).Univariate logistic regression analysis showed that age,gender,smoking,hypertension,systolic blood pressure,diastolic blood pressure,diabetes,body mass index,total cholesterol,triglyeride and estimated glomerular filtration rate were related with ba-PWV abnormality( all P ＜0.01 ).Compared with Q1 group,ba-PWV abnormality OR value of Q4 group was 1.73 (95％ CI:1.34- 2.22,P ＜0.01 ).Multivariate logistic regression revealed that ba-PWV abnomality OR value of Q4 group was 1.66 (95％ CI:1.16 -2.37,P＜0.01 ) after adjusting for age,gender,smoking,hypertension,systolic blood pressure,diastolic blood pressure,diabetes,body mass index,total cholesterol,triglyeride and estimated glomerular filtration rate when compared with Q1 group and OR values were 1.55 (95％ CI:0.88 -2.74,P＞0.05) and 1.65 (95％ CI:1.04-2.64,P＜0.05) in male and female respectively.Conclusion Increased serum uric acid was independently associated with ba-PWV abnormality in Beijing community residents.

Objective To assess the association between left ventricular (LV) twist and untwist with the severity of diastolic dysfunction of high cardiovascular risk population in the community.Methods This cross-sectional survey was performed in high cardiovascular risk people with normal left ventricular (LV) ejection fraction in an urban community of Beijing (n =620 ). Normal LV diastolic function was defined in 305 subjects,mild diastolic dysfunction in 266 subjects and moderate/severe diastolic dysfunction in 49 subjects.Peak LV twist,peak twist velocity,peak untwist velocity and untwist rate were measured in apical and basal short-axis images using speckle tracking echocardiography.Results Peak LV twist was similar among subjects with normal diastolic function, mild diastolic dysfunction and moderate/severe diastolic dysfunction.Peak twist velocity [ ( 129.3 ±45.3 ) °/s vs.( 118.0 ±36.2) °/s ] and untwist velocity [ ( -132.9 ±50.4) °/s vs.( -121.2 ±41.4)°/s were significantly higher in mild diastolic dysfunction group than in normal diastolic function group ( all P ＜ 0.01 ) and similar between normal diastolic function and moderate/severe diastolic dysfunction group (P ＞ 0.05 ). Untwist rate of moderate/severe diastolic dysfunction decreased significantly than that of normal diastolic function [ (41.9 ± 32.9)°/s vs.(57.7 ± 36.2) °/s,P ＜ 0.01 ] and mild diastolic dysfunction group [ (41.9 ± 32.9 ) °/s vs.( 60.9 ± 39.9 ) °/s,P ＜ 0.01 ].Conclusions Twist and untwist parameters are increased/preserved in population with normal systolic function and mild diastolic dysfunction and “normalized” or reduced in those with advanced diastolic dysfunction.The maintaining (if not increasing) of LV twist in early diastolic dysfunction might serve as a compensatory mechanism in case of reduced myocardial relaxation in these subjects.

Objective To analyze the stress changes of thoracic vertebra(T)11-sacrum(S)titanium rods in patients with ankylosing spondylitis after vertebral column decancellation(VCD)osteotomy,and provide reference for the selection and improvement of titanium rods before surgery.Methods The original data of the continuous scanning tomographic images of patients with ankylosing spondylitis after VCD osteotomy were imported into Mimics 21.0 in DICOM format,and T11-S vertebrae,screws and titanium rods were respectively reconstructed.They were imported into 3-Matic to establish a preliminary geometric modeling,and then processed with noise removal,paving,smoothing,etc.The improved model was imported into Hypermesh 10 software for grid division,and the material was imported into ANSYS 19.2 to display the finite element model after attribute assignment,Set the boundary and load conditions,and measure the stress value at the connection between the screw and the titanium rod.Results Under neutral position,forward bending,lateral bending,and axial rotation conditions,the titanium rod had the highest stress at the upper vertebrae(T11)and the lowest stress at the top vertebrae(L3);Under the backward extension condition,the titanium rod has the highest stress at the lower end vertebra(L5).Conclusion In the upper and lower vertebrae,it is possible to consider increasing the diameter of the titanium rod,enhancing its hardness,or changing it to a double rod.