The long-term presence of non-steroidal anti-inflammatory drugs (NSAIDs) in the environmental water samples not only affects the life safety of aquatic organisms and disturbs the ecoenvironment, but also poses a serious threat to human health. In this study, amino-functionalized Fe3O4 nanoparticles (Fe3O4-NH2) were firstly prepared by solvothermal method. Subsequently, polyethyleneimine (PEI) with a branched chain structure was successfully grafted onto Fe3O4 nanoparticles by Schiff base reaction in aqueous solution at room temperature using glutaraldehyde as a cross-linking agent, and a recyclable PEI-grafted magnetic nano-sorbent (Fe3O4@PEI) was synthesized and applied for the detection of NSAIDs in the environmental water samples. The compositional properties of Fe3O4@PEI were investigated by different characterization methods and the parameters affecting the extraction of NSAIDs were optimized. Due to high adsorption of Fe3O4@PEI for NSAIDs, the quantitative analysis of four NSAIDs in the environmental water samples, ketoprofen, naproxen, diclofenac and tolfenamic acid, was performed in combination with high-performance liquid chromatography. A good linear relationship between the chromatographic peak area and concentration was observed in the range of 1−500 µg/mL. The recoveries of the samples at three different spiked levels ranged from 85.6% to 107.8%; the intra-day precision was less than 7.8% (n=6); and the inter-day precision was less than 9.5% (n=3). The method is simple, rapid, accurate and reliable, and can be used for the analysis of NSAIDs in the environmental water samples．

Objective:To confirm the efficacy and safety of cinepazide maleate injection in acute ischemic stroke patients with obvious motor function deficit.Methods:This study is a subgroup analysis of multi-center, randomized, double-blind, placebo-controlled phase Ⅳ clinical trial. A total 812 patients of acute ischemic stroke with obvious limb motor deficit [motor function of limbs score in National Institutes of Health Stroke Scale (NIHSS) ≥4] were enrolled in this subgroup analysis. Patients received either cinepazide maleate injection or placebo. The treatment period was 14 days and follow-up was 90 days. The efficacy endpoints included the proportions of patients with a modified Rankin Scale (mRS) score ≤2, mRS score ≤1 and Barthel Index <95 on day 90. Safety was evaluated by recording all adverse events, monitoring vital signs, laboratory parameters and electrocardiogram.Results:A total of 732 patients were involved in the final efficacy analysis (361 in cinepazide maleate group and 371 in control group). The baseline limb motor function score of NIHSS was 5.23±1.43 in the cinepazide maleate group whereas 5.20±1.36 in the control group. Logistic regression analysis showed that following treatment for 90 days, the proportion of patients with a mRS score ≤2 was significantly higher in the cinepazide maleate group than in the control group [56.0% (202/361) vs 44.2% (164/371), OR=0.60, 95% CI 0.44-0.82, P=0.002]. The proportion of patients with a mRS score ≤1 was higher in the cinepazide maleate group than in the control group [43.3% (139/361) vs 35.2% (118/371), OR=0.69, 95% CI 0.50-0.97, P=0.031]. The proportion of patients with a Barthel Index <95 on day 90 was significantly lower in the cinepazide maleate group than in the control group [45.2% (145/361) vs 55.2% (185/371), OR=0.64, 95% CI 0.46-0.88, P=0.007]. During the treatment and follow-up period, the incidence of the most common adverse events in the cinepazide maleate group was 50.4% (199/395). Constipation and abnormal liver function were more common, but there were no statistically significant differences between the two groups. Conclusion:Cinepazide maleate injection is superior to placebo in improving neurological function and activities of daily living, reducing disability, and promoting functional recovery and safe in patients with acute ischemic stroke with obvious limb motor deficit.

Objective:To investigate the blood pressure change in patients with acute ischemic stroke (AIS) and hypertension treated with cinepazide maleate injection.Methods:This was a subgroup analysis of post-marketing clinical confirmation study of cinepazide maleate injection for acute ischemic stroke: a randomized, double-blinded, multicenter, placebo-parallel controlled trial, which conducted in China from August 2016 to February 2019. Eligible patients fulfilled the inclusive criteria of acute anterior circulation ischemic stroke with National Institutes of Health Stroke Scale (NIHSS) scores of 7-25. The primary endpoints were mean blood pressure of AIS patients treated with cinepazide maleate or control, which were assessed during the treatment period (14 days), and the proportion of the patients with normal blood pressure was analyzed after the treatment period. Furthermore, a subgroup analysis was performed to investigate a possible effect of the history of hypertension on outcomes.Results:This analysis included 809 patients with hypertension. There was no significant difference in patients blood pressure and the proportion of patients with normal blood pressure (60.5% vs. 59.0%, P>0.05) between cinepazide maleate group and control group. Conclusion:Administration of cinepazide maleate injection does not affect the management of clinical blood pressure in patients with AIS.

Objective:To investigate the clinical therapeutic efficacy and safety of domestic imatinib mesylate in treatment of chronic myeloid leukemia (CML).Methods:The clinical data of 87 CML-chronic phase patients treated by domestic imatinib between December 2013 and March 2018 in the Affiliated Hospital of the Southwest Medical University were retrospectively analyzed. The clinical therapeutic efficacy and safety of imatinib was analyzed.Results:The completely hematologic reaction (CHR) rate was 95.4% (83/87), 97.7% (85/87) and 100.0% (87/87), respectively after treatment at 3, 6 and 12 months. The completely cytogenetic reaction (CCyR) rate was 31.0% (27/87), 42.5% (37/87) and 64.4% (56/87), respectively at 3, 6 and 12 months. At 3-month, BCR-ABL/ABL IS value was equal to or less than 10% in 44 patients (50.6%), BCR-ABL/ABL IS value was equal to or less than 0.1% in 4 patients (4.6%). At 6-month, BCR-ABL/ABL IS value was equal to or less than 1% in 39 patients (44.8%), BCR-ABL/ABL IS value was equal to or less than 0.1% in 13 patients (14.9%). The major molecular response rate at 12-month was 35.6% (31/87). The major hematologic adverse reaction was grade Ⅰ-Ⅱ hemacytopenia. The common non-hematology adverse reactions were edema, muscular and joints soreness, nausea and vomiting and diarrhea. Most patients didn't have severe adverse reactions. Conclusions:The clinical efficacy of CML patients treated with domestic imatinib is sure; CML patients are well-tolerated and the adverse reactions are mild. It is worthy of wide application in clinical treatment.

Objective:To assess the efficacy and safety of cinepazide maleate injection in the treatment of patients with acute ischemic stroke.Methods:A multicenter, randomized, double-blind, placebo-controlled phase Ⅳ clinical trial, led by Peking Union Medical College Hospital, was conducted in 65 Hospitals in China. The efficacy of cinepazide maleate injection in patients with acute anterior circulation cerebral infarction with onset time of ≤48 hours, 7≤National Institute of Health stroke scale (NIHSS) score ≤25 was assessed from August 2016 to February 2019, using the proportion of modified Rankin scale (mRS) score≤1 and Barthel index (BI) score≤95 on day 14 as efficacy endpoint. The patients were divided into treatment group who were treated with cinepazide maleate injection and control group who were treated with placebo.Results:A total 937 patients were involved in the final efficacy analysis (466 in treatment group and 471 in control group). The proportion of subjects with mRS score≤1 on day 14 after treatment were higher in the treatment group than that in the control group (102/466(21.89%) vs76/471(16.14%)). Logistic regression analysis showed that patients treated with cinepazide maleate were significantly more likely to have a favorable outcome (mRS score≤1) than patients treated with placebo on day 14 ( OR=0.677, 95% CI 0.484-0.948 , P=0.023), and patients treated with cinepazide maleate were more likely to reach independence in activities of daily living (Barthel Index ≥95) than those treated with placebo on day 14 (125/466(26.82%) vs 91/471(19.32%); OR=0.632, 95% CI0.459-0.869, P=0.005). The rate of adverse events was similar between the treatment and control groups. Conclusion:The 14-day treatment with cinepazide maleate injection could reduce the degree of disability whereas did not increase the risk of adverse events.

Objective To explore the correlation between different body mass indexes and incidence of digestive carcinoma.Methods The retrospective cohort study was conducted.The data of 95 177 participants (75 909 males and 19 268 females) aged (51± 12)years with the range of 18-98 years who participated health examination at the Kailuan General Hospital,Kailuan Linxi Hospital,Kailuan Zhaogezhuang Hospital,Kailuan Tangjiazhuang Hospital,Kailuan Fan' gezhuang Hospital,Kailuan Jinggezhuang Hospital,Kailuan Lyujiatuo Hospital,Kailuan Linnancang Hospital,Kailuan Qianjiaying Hospital,Kailuan Majiagou Hospital and Kailuan Branch Hospital from July 2006 to December 2015 were collected.According to definition of body mass indexes from Chinese guideline for prevention and control of adult overweight and obesity,all the 95 177 participants were allocated into the 3 groups,including 37 660 with BMI＜24 kg/m2 in the normal BMI group,39 793 with with 24 kg/m2 ≤BMI＜ 28 kg/m2 in the overweight group and 17 724 with BMI≥28 kg/m2 in the obesity group.All participants received the same-order health examinations by the fixed team of doctors in 2006,2008,2010,2012 and 2014 at the same place.Epidemiological investigation,anthropometric parameters and biochemical indicators were collected.Observation indicators:(1) comparisons of clinical characteristics among the 3 groups;(2) incidence of digestive carcinoma in the participants;(3) risk factors analysis affecting new-onset digestive carcinoma;(4) comparisons of the fitting degree of BMI on new-onset digestive carcinoma model;(5) stratified analysis of risk factors affecting new-onset digestive carcinoma at different locations.Measurement data with normal distribution were represented as Mean±SD,and comparisons among groups were analyzed using the one-way ANOVA.Measurement data with skewed distribution were described as M (range),and comparisons among groups were analyzed using the Kruskal-Wallis test.Count data were described as case number and percentage,and comparisons among groups were analyzed using the chi-square test.The cumulative incidence was calculated by the Kaplan-Meier method,and comparisons of incidences among groups were done by the Log-rank test.The incidences of digestive carcinomain patients with different BMI were calculated by person-year incidence (incidence density).The hazard ratio (HR) and 95％ confidence interval (CI) of different BMI (continuous variable and classification variable) on new-onset digestive carcinoma were estimated by the COX proportional hazards regression models.Restrictive cubic spline regression was used to calculate the dose-response relation between the continuous variable and the risks of digestive carcinoma.The fitting degree of BMI on new-onset digestive carcinoma model was calculated by the likelihood ratio test and akaike information criterion (AIC).Results (1) Comparisons of clinical characteristics among the 3 groups:age,sex (male),systolic pressure,diastolic pressure,waistline,total cholesterol (TC),triglyceride (TG),fasting plasma glucose (FPG),C reactive protein,cases with smoking,drinking,physical exercise,positive HBsAg,high salt intake,malignant tumor in immediate family were (51± 13)yeas,28 607,(125±20) mmHg (1 mmHg=0.133 kPa),(80± 11) mmHg,(81±9) cm,(4.9± 1.1) mmol/L,1.05 mmol/L(range,0.75-1.49 mmol/L),(5.3±1.6) mmol/L,0.58 mmol/L (range,0.20-1.60 mmol/L),11 962,6 845,5 676,711,.3 640,1 298 in the normal BMI group and (52±12)years,32 928,(133±21) mmHg,(85±11) mmHg,(89±8)cm,(5.0±1.2) mmol/L,1.39 mmol/L (range,0.99-2.08 mmol/L),(5.6± 1.7)mmol/L,0.84 mmol/L (range,0.33-2.07 mmol/L),12 364,7 413,6 322,839,4 401,1 463 in the overweight group and (51 ± 12) years,14 374,(139 ± 21) mmHg,(88 ± 12) mmHg,(96 ± 9) cm,(5.1 ± 1.2) mmol/L,1.67 mmol/L (range,1.18-2.51 mmol/L),(5.7± 1.8) mmol/L,1.22 mmol/L (range,0.53-2.82 mmol/L),5 092,2 818,2 847,355,2 235,704 in the obesity group,showing statistically significant differences among groups (F=90.60,x2 =576.34,F=2 768.38,3 570.80,22 319.30,256.99,x2 =9 108.21,F=507.11,x2 =3 219.47,52.78,64.38,13.36,0.76,130.39,9.74,P＜0.05).(2) Incidence of digestive carcinoma in the participants:all the 95 177 participants were followed up for 845 085 person-year,1 215 were diagnosed as new-onset digestive carcinoma,with a total person-year incidence of 1.44 thousand person / year.Of 1 215 patients,413 had colorectal-anal cancer,306 had liver cancer,234 had gastric cancer,113 had esophageal cancer,91 had the pancreatic cancer,36 had gallbladder carcinoma or cholangiocarcinoma,25 had intestinal cancer.Three patients had intestinal cancer complicated with colorectal-anal cancer.The person-year incidence of digestive carcinoma was 1.46 thousand person / year,1.37 thousand person / year and 1.53 thousand person / year in the normal BMI group,overweight group and obesity group,respectively.The cumulative incidences of digestive carcinoma in the normal BMI,overweight,obesity group were respectively 11.8‰,10.1‰ and 12.1‰,showing a statistically significant difference among 3 groups (x2=6.13,P＜0.05).There was no statistically significant difference between the normal BMI group and obesity group (x2 =1.07,P＞0.05),and statistically significant differences between the overweight group and normal BMI group and obesity group,respectively (x2=3.90,4.10,P ＜ 0.05).(3) Risk factors analysis affecting new-onset digestive carcinoma.Results of COX proportional hazards regression models showed that continuous BMI was not related factor affecting new-onset digestive carcinoma after adjustment of age,gender,systolic pressure,TC,TG,FPG,smoking,drinking,physical exercise,positive HBsAg,high salt intake,malignant tumor in immediate family (HR=0.99,95％CI:0.98-1.01,P＞0.05).After adding BMI as classification variable in the COX model,risk of new-onset digestive carcinoma in the overweight group was reduced compared with normal BMI group (HR =0.88,0.88,95％CI:0.78-1.01,0.77-0.98,P＜0.05) and risk of new-onset digestive carcinoma in the obesity group was not affected (HR=1.03,1.04,95％CI:0.88-1.20,0.89-1.22,P＞0.05).Results of restrictive cubic spline regression showed a "U" shaped relationship between BMI and incidence risk of digestive carcinoma and the lowest incidence of digestive carcinoma in patients with BMI as 25-27 kg/m2.(4) Comparisons of the fitting degree of BMI on new-onset digestive carcinoma model:multivariate model was constructed after adding risk factors of age,gender,systolic pressure,TC,TG,FPG,smoking,drinking,physical exercise,positive HBsAg,high salt intake,malignant tumor in immediate family,and-2Log L and AIC were 27 175.05 and 27 203.05 for the multivariate model.Then BMI variable was added into the multivariate model,and the-2Log L and AIC of the multivariate model+BMI model were 27 169.53 and 27 201.53,respectively,with a statistically significant difference compared with normal BMI group (x2 =5.52,P＜0.05).(5) Stratified analysis of risk factors affecting new-onset digestive carcinoma at different locations.Results of COX proportional hazards regression models showed risks of new-onset digestive carcinoma in the overweight and obesity groups were reduced compared with normal BMI group (HR=0.57,0.42,95％CI:0.38-0.84,0.23-0.79,P＜0.05) in the esophageal cancer model.Risks of new-onset digestive carcinoma in the overweight group were reduced compared with normal BMI group (HR=0.72,95％CI:0.55-0.93,P＜0.05) and risk of new-onset digestive carcinoma in the obesity group was not affected (HR=1.10,95％CI:0.82-1.47,P＞0.05) in the liver cancer model.Conclusions Participants in the overweight group have the lowest incidence of digestive carcinoma,especially in the esophageal cancer and liver cancer model.Incidence of digestive carcinoma is the lowest with BMI as 25-27 kg/m2.

Objective To explore the relationship between alcohol consumption and new-onset cholelithiasis.Methods The retrospective cohort study was conducted.The data of 77 755 participants who participated health examination at the Kailuan General Hospital,Kailuan Linxi Hospital,Kailuan Zhaogezhuang Hospital,Kailuan Tangjiazhuang Hospital,Kailuan Fan'gezhuang Hospital,Kailuan Lyujiatuo Hospital,Kailuan Jinggezhuang Hospital,Kailuan Linnancang Hospital,Kailuan Qianjiaying Hospital,Kailuan Majiagou Hospital and Kailuan Branch Hospital from June 2006 to December 2015 were collected.According to definition of alcohol consumption from literature,all the 77 755 participants were allocated into the 5 groups,including 50 695 with never drinking in the never group,3 154 with alcohol withdrawal time≥ 1 year in the past group,12 410 with light drinking in the light group,1 606 with moderate drinking in the moderate group and 9 890 with heavy drinking in the heavy group.All participants received the same-order health examinations by the fixed team of doctors in 2006,2008,2010,2012 and 2014 at the same place.Epidemiological investigation,anthropometric parameters and biochemical indicators were collected.Observation indicators:(1) comparisons of clinical characteristics among the 5 groups;(2) incidence of cholelithiasis;(3) risk factors analysis affecting new-onset cholelithiasis;(4) comparisons of the fitting degree of alcohol consumption on new-onset cholelithiasis model.Measurement data with normal distribution were represented as (x)±s,and comparisons among groups were analyzed using the one-way ANOVA.The pairwise comparison and homogeneity of variance were done using the least significance difference (LSD) test.Heterogeneity of variance was analyzed by the Dunnett's T3 test.Measurement data with skewed distribution were described as M (Q),and comparisons among groups were analyzed using the rank sum test.Comparisons of count data were analyzed using chi-square test.The cumulative incidence of new-onset cholelithiasis was calculated by the Kaplan-Meier method,and comparisons of incidences among groups were done by the Log-rank test.The hazard ratio (HR) and 95％ confidence interval (CI) of different intakes of alcohol on new-onset cholelithiasis were estimated by the COX proportional hazards regression models.The fitting degree of alcohol consumption on new-onset cholelithiasis model was calculated by the likelihood ratio test and akaike information criterion (AIC).Results (1) Comparisons of clinical characteristics among the 5 groups:male,age,systolic pressure,diastolic pressure,body mass index (BMI),total cholesterol (TC),triglyceride (TG),fasting plasma glucose (FPG) and waistline and cases with diabetes,hypertension,smoking and physical exercise were respectively 33 406,(51±12)years,(130±21) mmHg (1mmHg=0.133 kPa),(83± 12)mmHg,(25±4)kg/m2,(4.93±1.13)mmol/L,1.26 mmol/L (0.90-1.88 mmol/L),(5.5±1.7)mmol/L,(86±10) cm,4 538,21 773,5 873,6 140 in the never group and 3 077,(56±12) years,(134±22)mmHg,(85±12)mmHg,(25± 3) kg/m2,(4.93 ± 1.21) mmol/L,1.29 mmol/L (0.91-1.90 mmol/L),(5.6 ± 1.8) mmol/L,(89 ±9)cm,420,1 652,856,856 in the past group and 11 859,(46±12)years,(127±19)mmHg,(82±11)mmHg,(25±3)kg/m2,(4.89± 1.15) mmol/L,1.30 mmol/L (0.89-2.01 mmol/L),(5.4± 1.4) mmol/L,(87±9)cm,891,4294,2 186,2 186 in the light group and 1 585,(58±11)years,(134±22)mmHg,(84±11)mmHg,(25±3)kg/m2,(5.06±1.21)mmoL/L,1.23 mmoL/L (0.85-1.82 mmol/L),(5.5±1.7) mmol/L,(88±9)cm,159,762,591,591 in the moderate group and 9 868,(52±9) years,(135±21)mmHg,(86±12)mmHg,(25±3)kg/m2,(5.18±1.21)mmoL/L,1.36 mmol/L (0.92-2.19 mmol/L),(5.5±1.5)mmoL/L,(88±9) cm,819,4 900,2 183,2 183 in the heavy group,showing statistically significant differences among groups [x2 =9 989.71,F=869.28,F=254.13,195.97,27.52,112.63,H(x2) =154.09,F=11.92,63.37,x2 =128.17,656.31,23 561.80,656.31,P＜0.05].(2) Incidence of cholelithiasis:all 77 755 participants were observed for (6.8±2.1)years,3 757 were diagnosed as new-onset cholelithiasis,with a cumulative incidence of new-onset cholelithiasis of 4.5％.The cumulative incidences of new-onset cholelithiasis in the never,past,light,moderate and heavy groups were respectively 5.1％,4.9％,3.7％,3.4％ and 3.3％,showing a statistically significant difference among groups (x2=83.14,P＜0.05).The cumulative incidence of new-onset cholelithiasis in the never group was significantly different from that in the past,light,moderate and heavy groups (x2 =18.34,40.58,45.41,48.44,P＜0.05).The cumulative incidence of new-onset cholelithiasis in the past group was significantly different from that in the light,moderate and heavy groups (x2 =18.72,20.47,25.41,P＜0.05).There were statistically significant differences in the cumulative incidence of new-onset cholelithiasis among the light,moderate and heavy groups (x2=8.47,12.41,P＜0.05) and no statistically significant difference between the moderate and heavy groups (x2=0.85,P＞0.05).(3) Risk factors analysis affecting new-onset cholelithiasis:results of COX proportional hazards regression models showed that risks of new-onset cholelithiasis in the light,moderate and heavy groups were reduced compared with never group after adjustment of gender,age,TC,TG,BMI,hypertension,diabetes,smoking and physical exercise (HR=0.88,0.82,0.73,95％CI:0.79-0.98,0.76-0.89,0.64-0.83,P＜0.05).(4) Comparisons of the fitting degree of alcohol consumption on newonset cholelithiasis model:multivariate model was constructed after adding risk factors of gender,age,BMI,TG,TC,hypertension,diabetes mellitus,smoking and physical exercise,and-2Log L and AIC were 76 331.83 and 76 353.83 for the multivariate model.Then drinking variable was added into multivariate model,and the-2Log L and AIC of the multivariate model+drinking model were 76 307.86 and 76 337.86,respectively,with statistically significant differences (x2=23.97,P＜0.05).Conclusion Alcohol consumption is an independent protective factor for new-onset cholelithiasis,and the risk of cholelithiasis is decreased with increasing alcohol intake.

Objective To explore the predictive value of combined application of the different obesity measures on incident gallstone disease (GD) and find the optimal combination.Methods The retrospective cohort study was conducted.The data of 88 947 participants who participated in health examination at the Kailuan General Hospital,Kailuan Linxi Hospital,Kailuan Zhaogezhuang Hospital,Kailuan Tangjiazhuang Hospital,Kailuan Fan'gezhuang Hospital,Kailuan Jinggezhuang Hospital,Kailuan Lyujiatuo Hospital,Kailuan Linnancang Hospital,Kailuan Qianjiaying Hospital,Kailuan Majiagou Hospital and Kailuan Branch Hospital from July 2006 to December 2015 were collected.All participants received the same-order health examinations by the fixed team of doctors in 2006,2008,2010,2012 and 2014 at the same place.Epidemiological investigation,anthropometric parameters and biochemical indicators were collected.Observation indicators:(1) comparisons of general data between 2 genders;(2) incidence of GD;(3) risk factors analysis of the different obesity measures affecting incident GD;(4) comparisons of the fitting degree and predictive value of combined application of the different obesity measures on incident GD model.Measurement data with normal distribution were represented as (x)±s,and comparisons between groups were analyzed using the t test.Measurement data with skewed distribution were described as M (P25,P75),and comparisons between groups were analyzed using the rank sum test.Comparisons of count data were analyzed using the chi-square test.The incidences of GD between 2 genders were calculated by person-year of follow-up.The hazard ratio (HR) and 95％ confidence interval (CI) of the different obesity measures on incident GD were estimated by the COX proportional hazard model.The fitting degree of different combination of obesity measures on incident GD model was calculated by the likelihood ratio test and akaike information criterion (AIC).Results (1) Comparisons of general data between 2 genders:of 88 947 participants,age,body mass index (BMI),waist circumference (WC),systolic pressure,diastolic pressure,total cholesterol (TC),triglyceride (TG),fasting plasma glucose (FPG),cases with diabetes,hypertension,smoking,drinking and physical exercise were respectively (51± 12) years old,(25±3) kg/m2,(88± 10) cm,(132±20) mmHg (1mmHg=0.133 kPa),(84± 12) mmHg,(4.95± 1.16) mmol/L,1.18 mmol/L (0.81 mmol/L,1.74 mmol/L),(5.5±1.6)mmol/L,6 223,31 816,26 993,15 779,11 063 in male participants and (49± 11)yearsold,(25±4)kg/m2,(83±11)cm,(124±21)mmHg,(7911)mmHg,(4.98±1.08)mmol/L,1.30 mmol/L (0.92 mmol/L,2.00 mmol/L),(5.3±1.6)mmol/L,1 409,5 866,248,87,2 450 in female participants,with statistically significant differences [t=587.20,894.27,1 064.97,813.49,986.22,630.97,H(x2)=642.39,t=452.87,x2=35.10,1 205.40,9 619.42,4 901.75,84.82,P＜0.05].(2) Incidence of GD:88 947 participants were followed up for 713 345 person-year,4 291 participants had incident GD,with a total person-year incidence of 6.02 thousand person / year.The total follow-up time,cases with incident GD and person-year incidence were respectively 562 821 person-year,3 268,5.81 thousand person / year in male participants and 150 524 person-year,1 023,6.80 thousand person / year in female participants.(3) Risk factors analysis of the different obesity measures affecting incident GD:the results of COX proportional hazard model:in male participants,adjusted for age,TC,TG,diabetes,hypertension,smoking,drinking and physical exercise,BMI was associated with increased risk of incident GD (HR=1.35,1.63,95％CI:1.24-1.46,1.48-1.80,P＜0.05);WC was associated with increased risk of incident GD (HR=1.27,1.53,95％CI:1.15-1.40,1.39-1.67,P＜0.05);waist-to-height ratio (WHtR) was associated with increased risk of incident GD (HR=1.20,1.44,95％CI:1.09-1.32,1.31-1.58,P＜0.05).In female participants,BMI was associated with increased risk of incident GD (HR=1.35,1.77,95％CI:1.16-1.56,1.49-2.10,P＜0.05);WC was associated with increased risk of incident GD (HR=1.38,1.72,95％CI:1.15-1.66,1.44-2.07,P＜0.05);WHtR was associated with increased risk of incident GD (HR=1.34,1.71,95％CI:1.12-1.61,1.43-2.04,P＜0.05).(4) Comparisons of the fitting degree and predictive value of combined application of the different obesity measures on incident gallstone diseases model:multi-factor model of male participants was constructed after adding risk factors of age,TC,TG,diabetes,hypertension,smoking,drinking and physical exercise,and-2log L and AIC were 71 257 and 71 275.Then BMI,WC,WHtR,BMI+WC,BMI+WHtR,WC+WHtR and BMI+WC+ WHtR were respectively added into the multi-factor model,and-2log L and AIC were respectively 71 156 and 71 178,71 170 and 71 192,71 197 and 71 219,71 134 and 71 160,71 132 and 71 162,71 170 and 71 196,71 132 and 71 162.The minimal mode of AIC was multi-factor model+BMI+WC,with a difference of 123 compared with multi-factor model of-2log L,showing a statistically significant difference (x2 =123.00,P＜ 0.05).The multi-factor model of female participants was constructed after adding risk factors of age,TC,TG,diabetes,hypertension,smoking,drinking and physical exercise,and-2log L and AIC were 19 612 and 19 630.Then BMI,WC,WHtR,BMI+WC,BMI+WHtR,WC+WHtR and BMI+WC+WHtR were respectively added into the multi-factor model,and-2log L and AIC were respectively 19 568 and 19 590,19 575 and 19 597,19 574 and 19 596,19 558 and 19 584,19 557 and 19 583,19 571 and 19 597,19 556 and 19 586.The minimal mode of AIC was multi-factor model+BMI+WHtR,with a difference of 55 compared with multi-factor model of-2log L,showing a statistically significant difference (x2 =55.00,P＜0.05).Conclusions The increased BMI,WC and WHtR are independent risk factors for incident GD,no matter the gender.In males,the combination of BMI and WC can improved the predictive value of the incident GD,while in females,BMI and WHtR are the best combination for predicting incident GD.

Objective To compare the effects of different right ventricular pacing sites on left ventricle systolic function in elderly patients with sick sinus syndrome (SSS).Methods A total of 78 elderly patients with SSS were selected in our hospital from 2014 to 2016,and were divided into the right ventricular apical group (RVA group,40 cases) and right ventricular outflow tract group (RVOT group,38 cases) according to sites of right ventrieular pacing.The QRS duration,accumulative total right ventricular pacing percentage and left ventricle function indicators were compared between the two groups before operation and 3,9 months after operation.Results There was no statistically significant difference in QRS duration and left ventricle function indicators before operation between the two groups (P＞0.05).The QRS durations in the RVA group at 3,9 months after operation were longer than those in the RVOT group,there were statistically significant differences (P＜0.05).No statistically significant difference was found in accumulative total right ventricular pacing percentage at 9 months after operation between the two groups (P＞ 0.05).At 9 months after operation,the left ventricular ejection fraction in the RVOT group was higher than that in the RVA group,and the left ventricular end diastolic diameter was lower than that in the RVA group,there were statistically significant differences (P＜0.05).Conclusion The effects of RVOT pacing on left ventricle systolic function in elderly patients with SSS is superior to the RVA pacing.

Objective To compare the curative effect and safety of non-X-ray fluoroscopic radiofrequency catheter ablation and conventional X-ray fluoroscopic radiofrequency catheter ablation in treating paroxysmal supraventricular tachycardia by Ensite Velocity three-dimensional electroanatomical mapping system.Methods One hundred cases diagnosed as paroxysmal supraventricular tachycardia in this hospital during 2014-2016 were selected and randomly divided into the control group (conventional X-ray exposure) and the experimental group(non-X-ray exposure by three-dimensional electroanatomical mapping system),50 cases in each group.The operation time,X-ray exposure time,complication rate,immediate and follow-up success rate were compared between two groups.Results There was no statistically significant difference in the operation time between the two groups (P＞0.05),but the X-ray exposure time in the experimental group [(0.46±0.14) min] was significantly lower than that of the control group [(13.87 ±4.03) min] and the complication rate (0 ％) was also significantly lower than that of the control group (8.00％);the immediate success rate (98.00 ％) was significantly was significantly decreased compared with the control group[(0.46± 0.14)min vs.(13.87 ±4.03)min],the complication rate was significantly lower than that in the control group(0 ％ vs.8 ％),the immediate success rate was significantly higher than that in the control group(98.00 ％ vs.84.00 ％),the follow up success rate was also significantly higher than that in the control group (94.00 ％ vs.74.00 ％),the differences were statistically significant (P＜0.05).Conclusion Using Ensite Velocity three-dimensional electroanatomical mapping system to conduct radiofrequency catheter ablation has an ideal clinical effect in the treatment of paroxysmal supraventricular tachycardia,which is safe and reliable.