Objectives:This study aims to investigate the association between cumulative fasting blood glucose(FBG)and presence of coronary artery calcification(CAC). Methods:A total of 1 113 participants were recruited from the Beijing Community-based Cohort of Atherosclerosis.Anthropometric measurements and laboratory examinations including FBG were performed in 1998,2008-2009 and 2013-2014 respectively,and coronary CT scan was performed in 2013-2014.Participants were classified into 4 groups according to the level of cumulative FBG(10-year weighted cumulative value of at least 2 FBGs):<50.0 mmol/L group(n=495),50.0-55.9 mmol/L group(n=345),56.0-69.9 mmol/L group(n=176),and≥70.0 mmol/L group(n=97).CAC score>0 was defined as presence of CAC.Multivariable logistic regression model was applied to analyze the impact of cumulative FBG exposure on the risk of CAC,and subgroup analyses were conducted according to factors such as sex and age. Results:The mean age of enrolled participants was(59.7±6.4)years,523(47.0%)were male and 478(42.9%)had CAC.The proportion of subjects with CAC increased with the increment of cumulative FBG.Compared with the<50.0 mmol/L group,the multivariable-adjusted OR(95%CI)for CAC in the 50.0-55.9 mmol/L group,56.0-69.9 mmol/L group,and≥70.0 mmol/L group were 1.43(1.04-1.98),1.92(1.24-2.99)and 2.79(1.35-5.77),respectively(Ptrend<0.05).The risk for CAC increased by 34%per 10 mmol/L increase in cumulative FBG,with OR(95%CI)of 1.34(1.12-1.59).There was no statistically significant difference in the risk of CAC presence for each 10 mmol/L increase in cumulative FBG level between the subgroups(all P≥0.05). Conclusions:Elevated cumulative FBG is a risk factor for the prevalence of CAC,indicating the importance of maintaining healthy FBG in preventing the occurrence of CAC.

Objective To evaluate the clinical efficacy of modified Bascom cleft lift procedure in the treatment of chronic sinus.Methods Modified Bascom cleft lift procedure was performed in 53 patients admitted from Oct 2012 to Jul 2016.49 cases were male and 4 were female.The average age was (25.4± 2.3) years.Results All patients were satisfied with the operation.There were 49 cases of primary healing and 4 cases of incision complications.The average follow-up was (12.1 ±4.3) months,no recurrence was observed.Conclusion The modified Bascom cleft lift technique is effective and reliable,with less complications and a lower recurrence rate.

Objective To evaluate video-assisted anal fistula treatment (VAAFT) for Parks type Ⅱ anal fistula.Methods 40 Parks type Ⅱ anal fistula patients underwent VAAFT procedure from June 2015 to June 2017.Results were compared with 40 cases treated by incision and thread drawing.Results There was no significant difference between the two groups for curative effect,postoperative urinary retention,wound edema,bleeding and recurrence rate after 6 months of operation (90％ vs.95％,x2 =0.722,P =0.697;5％ vs.8％,x2 =0.213,P=1.0;2％ vs.8％,x2 =1.053,P=0.615;0 vs.5％,x2 =2.051,P =0.494;10％ vs.5％,x2 =0.721,P =0.675).Pain on first day and one week after operation in the VAAFT was less [(1.9±0.6) vs.(3.7±1.0),t =9.438,P=0.001;(0.9±0.7) vs.(1.9±0.8),t=6.269,P=0.001],hospital stay was shorter [8.4 ±1.3) d vs.(9.2 ±2.2) d,t =2.030,P=0.047],wound healing was faster [(27 ±8) dm.(38 ±6) d,t =7.328,P =0.001].The Jorge-Wexner incontinence score [(0.5±0.7) vs.(1.2±1.3),t =2.951,P=0.005] and the fecal incontinence severity index [(1.1±1.6) vs.(5.1 ±3.2),t =7.097,P=0.001] were lower in patients receiving VAAFT procedure.Conclusion Video-assisted anal fistula treatment is a safe and effective surgical method with the advantages of less trauma,and pain,quicker recovery and no damage to the anal sphincter.

Objective: To explore the relationship between overnight urinary sodium to potassium ratio and the risk of cardiovascular disease (CVD). Methods: A subsample of 10 percent of the participants (35-59 years old) from the People's Republic of China-United States Collaborative Study of Cardiovascular and Cardiopulmonary Epidemiology (prospective survey) were used. Three consecutive overnight urine samples were collected in the autumn of 1983-1984 and the spring in 1985-1986, respectively. Urinary sodium and potassium were detected and calculated for 8 hours excretion. The occurrences of cardiovascular events were recorded in 2 years interval from 1987-1988 until December 31, 2005. Participants were divided into first ratio group, second ratio group, and third ratio group based on the tertiles of sodium to potassium ratio. Cox proportional hazard regression model was used to determine the relationship between sodium to potassium ratio and risk of CVD. In addition, participants were divided into 2 subgroups by the median of overnight urinary sodium and potassium, and then combined each other for 4 subgroups including low sodium-low potassium group, low sodium-high potassium group, high sodium-low potassium group, and high sodium-high potassium group, to explore the relationship between different sodium-potassium combinations and the risk of CVD. Results: A total of 954 participants were included in the final analysis, of whom 459 (48.1%) were males. There were 318 cases in the first, second and third ratio group, respectively. There were 347 cases in low sodium-low potassium group and high sodium-high potassium group, and 130 cases in low sodium-high potassium group and high sodium-low potassium group. After a median follow-up of 18.6 (18.3, 19.3) years, cardiovascular events occurred in 81 participants, including 64 stroke and 20 coronary heart disease events. Multivariate analysis showed that comparing with the first ratio group, the hazard ratios (HR) in the second and the third ratio groups were 2.04 (95%CI 1.06-3.95, P=0.034) and 2.07 (95%CI 1.07-4.03, P=0.032), respectively. The CVD risk in low sodium-low potassium group was 24% higher than the low sodium-high potassium group (reference), but this result did not reach statistical significant level (P=0.685). The risks in high sodium-high potassium group (HR=3.32, 95%CI 1.26-8.76,P=0.015) and high sodium-low potassium (HR=3.04, 95%CI 1.05-8.83, P=0.041) group were both significantly increased. Conclusions Overnight urinary sodium to potassium ratio is positively correlated with the risk of cardiovascular events. High urinary sodium plays a more important role for the increased risk of cardiovascular events than low potassium.

Objective: To investigate the association of fruit and vegetable intake with long-term changes of serum lipid levels in middle-aged Chinese and older Chinese population. Methods: The study analyzed the data collected in the 2004 and 2007-2008 cohorts of China Multicenter Collaborative Study of Cardiovascular Epidemiology. Finally, 4 495 participants from 10 groups in various regions of China, who both were followed up in the two cohorts, were included for data analysis. They were aged 41-66 years in 2004. Fruit and vegetable consumption were collected with a simple food frequency questionnaire. The percent changes (Δ%) of serum TC, TG, HDL-C and LDL-C between the two surveys were calculated. Multivariate linear regression models were used to estimate the association of fruit and vegetable intake in 2004 with percentage changes of serum lipid levels during the two surveys. Results: The proportions of individuals who consumed fruits <250, 250-499 and ≥500 g/week were 24.0%, 21.8% and 54.2%, respectively. The proportions of individuals who consumed vegetables <500 and ≥500 g/day were 76.7% and 23.3%, respectively. Compared with fruit intake <250 g/week, the regression coefficients (95% CI) of ΔTC% in 250-499 and ≥500 g/week group were -1.54 (-2.71, -0.37) and -1.77 (-2.79, -0.76). And the regression coefficients (95% CI) of ΔLDL-C% were -2.43 (-4.39, -0.48) and -2.89 (-4.59, -1.19). Compared with vegetable intake <500 g/d, the regression coefficients (95%CI) of ΔTC% and ΔLDL-C% in vegetable intake ≥500 g/d group were -1.01 (-1.95, -0.06) and -1.83 (-3.41, -0.24). However, fruit and vegetable intake had no relationship with ΔTG% and ΔHDL-C%. Conclusion The consumption of fruit and vegetable was inversely related to long-term changes of TC and LDL-C in middle-aged and older population, but no association was found for changes of TG and HDL-C.

Objective: To evaluate the applications and problems of statistical methods for articles published in《Chinese Circulation Journal》. Methods: We reviewed the statistical methods for original articles published in《Chinese Circulation Journal》in 2010, 2011 and 2015; general status with problems was analyzed and the situations were compared among different years. Results: A total of 404 articles were enrolled, statistical hypothesis testing was performed in 366 of them, 32 had descriptive statistics only and 6 articles were meta-analysis. The most frequently used statistical methods were student'st-test (57.4%), followed by chi-squared analysis (56.7%), analysis of variance (35.2%) and regression analysis (23.0%). The main statistical problems in Methods included in described method un-matched to really used method and insufifcient or wrong description. The proportion of insufifcient or wrong description in 2010 and 2011 was 36.6% (71/194), while in 2015 was 26.2% (55/210),P=0.02. The major wrong application of statistical approach was ignoring design with improper method and using unsatisifed precondition for speciifc analysis. The proportion of improper statistical method application in 2010 and 2011 was 19.1% (33/173), in 2015 was 19.7% (38/193),P=0.88. Conclusion: The quality of statistics was improved in 2015 than 2010 and 2011 for articles published in《Chinese Circulation Journal》; while there were still problems at certain degree, enhanced statistical review should be conducted in medical journals.

Methods: A cross-sectional study was conducted based on the data cohort of China multicenter collaborative study of cardiovascular epidemiology in 2007-2008. A total of 7227 participants were enrolled including 3304 male and 3923 female at the mean age of (55.6±7.1) years. Tea drinking information was collected by questionnaire; participants were stratified by gender and grouped by regular tea drinking. Relationship between tea drinking and blood lipids, lipoprotein levels were assessed by covariance analysis. Results: There were 3012/7227 (41.7%) participants (male: 58.9% and female: 27.2%) regularly drunk tea. With adjusted age, urban and rural, education level, cigarette smoking, alcohol drinking, body mass index (BMI), daily red meat intake, physical work intensity, exercise intensity, histories of hypertension, diabetes and hypercholesterolemia, in male gender, compared with non-regular tea drinker, regular tea drinker had decreased blood level of low density lipoprotein cholesterol (LDL-C), the difference was -0.12 mmol/L, P=0.0001 and increased triglyceride (TG), the difference was 0.11 mmol/L, P=0.0001; in female gender, regular tea drinker showed increased high density lipoprotein cholesterol (HDL-C), the difference was 0.06 mmol/L, P<0.0001. Conclusion: In our research, regular tea drinking was negatively related to blood LDL-C level and positively related to TG in male gender, while it was positively related to HDL-C in female gender; the above correlations were independent from possible influencing factors. The impact of long term regular tea drinking on blood lipids and lipoprotein levels should be further prospectively investigated in community based middle and aged population.

Objective To explore the relationship between weight status in early adulthood and body weight change at middle age in adults and type 2 diabetes mellitus (T2DM).Methods The data of 14 population samples from China Multicenter Collaborative Study of Cardiovascular Epidemiology conducted in 1998 were used.Approximately 1 000 men and women in each sample were surveyed for cardiovascular disease risk factors,including body weight at age 25 years.The body mass index (BMI) at the age 25 years was calculated.The association between body weight in early adulthood and body weight change at middle age and T2DM was examined by using logistic regression model.Results The incidence of T2DM in low weight group (BMI＜ 18.5 kg/m2),normal weight group (BMI:18.5-23.9 kg/m2),overweight group (BMI:24.0-27.9 kg/m2) and obese group (BMI:≥28.0 kg/m2) at 25 years old were 2.4％(30/1 263),2.8％(266/9 562),4.0％(70/1 739) and 6.4％ (7/110),respectively (P value for trend＜0.01).The incidence of T2DM for adults with weight change ＜-7.5 kg,-7.5--2.6 kg,-2.5-2.5 kg,2.6-7.5 kg,7.6-12.5 kg and ＞ 12.5 kg at middle age were 2.5％ (18/712),1.3％(21/1 629),2.1％(48/2 330),2.3％(59/2 585),3.7％(94/2 518),and 4.6％(133/ 2 900) respectively.(P value for trend ＜0.01),Multivariate logistic regression analysis showed that overweight and obesity at age 25 years and subsequent weight gain were positively correlated with T2DM after adjusted other risk factors (all P values for trend ＜0.01).Conclusion Overweight and obesity in early adulthood and weight gain at middle age were both independently associated with the increased risk of T2DM in middle-aged men and women.

Objective: To investigate the relationship between exercise and serum lipid level in middle-aged population. Methods: Based on “multicenter collaborative study of cardiovascular epidemiology” research, a total of 3482 subjects at the age of (35-59) years from urban and rural areas of Beijing and Guangzhou were enrolled in this study. According to daily energy expenditure of exercise (EEexer), the participants were divided into 3 groups: No exercise group, (daily) EEexer below median group and (daily) EEexer above median group. The type and duration of exercise were collected by the questionnaire, daily EEexer was calculated and the relationship between exercise and serum lipid level was estimated by covariance analysis. Results: There were 47.1% (807/1712) male and 41.1% (727/1770) female participants having exercise. With controlled age, area, education level, smoking, drinking, BMI and energy expenditure of physical activity outside of exercise (EEPA), serum levels of TC, LDL-C, non-HDL-C and TG were decreased in women by elevated EEexer groups accordingly, and among them, there were significant differences in LDL-C and non-HDL-C levels between groups, P<0.05; compared with No exercise group, in female daily EEexer above median group, LDL-C and non-HDL-C levels decreased about 0.14 mmol/L,P=0.0063 and 0.14 mmol/L, P=0.0155 respectively; while in men, TC, LDL-C, non-HDL-C and TG levels showed a decreasing trends by elevated EEexer groups but with no statistical significance. No association was found for HDL-C in men and women. Conclusion: Serum levels of LDL-C and non-HDL-C were lower in female daily EEexer above median group than No excise group, the effects were independent from working and other physical activities.

Objective To explore the relationship between early adulthood weight status and body weight changes from early adulthood to middle age and high-density lipoprotein cholesterol (HDL-C) level.Methods Data were obtained from China Multicenter Collaborative Study of Cardiovascular Epidemiology Study,which was conducted in 1998,15 participants population samples aged from 35-59 years old from 12 provinces were selected by random cluster sampling.Approximately 1 000 men and women in each sample population were surveyed for cardiovascular disease risk factors,body weight at age 25 from all participants were also obtained.Body mass index (BMI) at the age of 25 years was calculated with the weight at 25 years and the height measured during the survey,participants were divided into underweight (BMI ＜ 18.5 kg/m2,n =1 331),normal-weight (18.5 kg/m2 ≤BMI ＜24 kg/m2,n =10 400),overweight (24 kg/m2 ≤BMI ＜ 28 kg/m2,n =2 019) and obesity (BMI≥28 kg/m2,n =133) groups.Weight change was defined as the difference between the body weight at the age of 25 and at the survey and was grouped into ＜-7.5 kg (n =903),-7.5--2.6kg (n=1 883),-2.5-2.5 kg (n=2573),2.6-7.5 kg (n=2786),7.6-12.5 kg (n =2 674) and ＞ 12.5 kg (n =3 064).The association of body weight status in early adulthood and body weight change from early adulthood to middle age with HDL-C level was examined by logistic regression model.Results The prevalence of low HDL-C in underweight,normal weight,overweight and obesity groups at age of 25 years were 10.7％ (143/1 331),15.5％ (1 612/10 400),16.3％ (330/2 019) and 24.8％ (33/133),respectively (P for trend ＜ 0.01).The prevalence of low HDL-C for adult weight change were 8.8％ (79/903),8.0％ (151/1 883),10.5％ (269/2 573),13.4％ (373/2 786),19.1％ (511/2 674),and 24.0％ (735/3 064) (P for trend ＜0.01)for weight change of ＜-7.5 kg,-7.5--2.6 kg,-2.5-2.5 kg,2.6-7.5 kg,7.6-12.5 kg and ＞ 12.5 kg,respectively.Multivariate logistic regression showed that overweight and obesity at age of 25 years and subsequent weight gain till middle age were positively correlated with low HDL-C after adjusted other risk factors(all P for trend ＜ 0.01).Conclusion Overweight and obesity in early adulthood and significant adult weight gain from early adulthood to middle age were both independently associated with marked increases in the risk of low HDL-C in middle-aged Chinese men and women.Thus,body weight control at early adulthood could be a key strategy to reduce the incidence of low HDL-C at middle-aged population.