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To analyze the detection capacity of radioactive substances in food in China， and improve the radioactive contamination monitoring system. By studying the distribution of certified institutions and testing items and the results of proficiency assessment， the current situation and deficiencies of the detection capacities were analyzed， and corresponding countermeasures were put forward. The capacity of radioactive material detection in China can better support the operation of the monitoring system， however， the effectiveness and sustainability of testing capacity， the layout of capacity network and the construction of food radioactive pollution monitoring system need to be further improved and strengthened， so as to meet the needs of normal circumstances and rapid response in case of nuclear or radiological emergencies in China.

ObjectiveTo determine the effect of blended teaching method in epidemiology teaching for students in clinical medicine.MethodsA total of 143 students in clinical medicine at Tongji University School of Medicine in the fall semester of 2021‒2022 were enrolled in the study. A self-assessment questionnaire was used to assess the satisfaction and recognition on the blended teaching method in epidemiology.ResultsIn terms of teaching effect， 84.6% of the students obtained excellent and good grades in the final evaluation， while 7.0% of the students did not pass the final exam. Approximately 21.0% of the students had difficulties in understanding the concept of bias and its control. The 90.2% were satisfied with the design of the blended teaching method， 84.2% were satisfied with the online video courses， and 60.9% completed more than 75.0% of the online learning resources before class. Additionally， 80.5% of the students responded that they could master the knowledge of epidemiology， and 81.2% considered that the blended teaching method may facilitate personalized learning and they could learn more knowledge of epidemiology.ConclusionBlended teaching method attains remarkable achievements in epidemiology teaching. However， curriculum design， teaching effect， and acceptance may be further strengthened.

ObjectiveTo determine the risk factors associated with hypoglycemia in community patients with type 2 diabetes mellitus（T2DM）.MethodsA case-control study was performed among 914 patients with T2DM and no medical history of hypoglycemia were selected in the Diabetes Unit of Tongji University School of Medicine Affiliated Anting Community Health Center in 2018. A total of 196 patients with T2DM who had ≥1 hypoglycemia event in the past 12 months were presented as the case group， and 718 patients who did not have any hypoglycemia event during the same period were included as the control group. Medical history， medication， life style， and related factors were collected. Multivariate logistic regression analysis was used to determine the risk factors associated with hypoglycemia.ResultsHistory of coronary heart disease ［adjusted odds ratio（aOR）=2.077， 95% CI： 1.293-3.337］， renal disease （aOR=4.775， 95% CI： 1.537-14.830）， and previous insulin use （aOR =1.765， 95%CI： 1.147-2.716） significantly increased the risk of hypoglycemia， while angiotensin converting enzyme inhibitors（ACEI）（aOR =0.127， 95%CI： 0.044-0.366） and β-receptor blockers （aOR =0.271， 95%CI： 0.119-0.616） decreased the risk of hypoglycemia among diabetic patients.ConclusionIncidence of hypoglycemia in community patients with diabetes is high. History of coronary heart disease and kidney disease， and previous insulin use may increase the risk of hypoglycemia， which warrants further attention by community general practitioners.

In order to address the limitation and isolation of a single accident model for accident reporting research, this study integrates the advantages of the STAMP (System Theoretical Accident Modeling and Process) model and the HFACS (Human Factors Analysis and Classification System) model, and analyzed and studied 249 collapse accident case reports from 2012 to 2021. It identified 27 collapse accident risk factors, and developed a collapse accident network. This study used core-edge analysis and centrality analysis to identify key risk factors such as failure to strictly implement the safety production responsibility system, inadequate review of relevant qualifications, inadequate on-site management, and dereliction of duty in on-site supervision. Finally, the correlation direction index was used to excavate the cause-result characteristics of each risk factor. [ABSTRACT FROM AUTHOR]

Objective The random forest and Logistic regression method were used to analyze the prognostic factors of cardiogenic death in patients with chronic heart failure complicated by atrial fibrillation. Methods Using the method of the cohort study, we selected patients with chronic heart failure complicated by atrial fibrillation in six traditional Chinese medicine (TCM) hospitals in Shandong Province (Affiliated Hospital of Shandong University of TCM, Weifang Hospital of TCM, Rizhao Hospital of TCM, Zibo Hospital of TCM, Qingdao Hospital of TCM, and Jinan Hospital of TCM) as the research object. We collected a total of 72 original data samples during hospitalization, including baseline data, complications, TCM pattern factors, cardiac color Doppler ultrasound, laboratory examination, and Chinese and Western medicinal treatment. After discharge, we followed up with the patients every six months to obtain the incidence of cardiac death. According to the occurrence of cardiac death, the included cases were divided into the endpoint group and the non-endpoint group. The statistically significant variables between the groups were selected by single factor analysis and successively included in the random forest model. The variable set with the smallest estimation error rate outside the bag was taken as the pre-treatment factor of cardiac death, and the importance of prognostic factors was ranked according to the reduction in the average Gini index. Multivariate logistic regression was further used to analyze the nature of prognostic factors. Results A total of 723 cases were included in the study, including 99 cases of cardiogenic death; 25 of 72 variables were screened out by single-factor analysis. Results of the stepwise random forest model showed that when the number of included variables was 11, estimation error rate outside the bag of the model was the smallest. Finally, the top 11 variables of the mean Gini index reduction were selected as the prognostic factors of cardiac death. Cardiac function grading, aortic valve stenosis, anticoagulant drugs, Yiqi TCM injection, heart rate, bilirubin, diastolic pressure, yang deficiency pattern, peripheral vascular disease, hypolipidemia drugs, and NT-ProBNP were ranked from high to low. Multivariate Logistic regression analysis showed that factors such as increased cardiac function grading (OR = 2.204) combined with aortic stenosis (OR = 12.852), increased heart rate (OR = 1.008), increased bilirubin (OR = 1.025), as well as increased diastolic blood pressure (OR = 1.029) combined with peripheral vascular disease (OR = 8.751) and an increase of NT-ProBNP (OR = 1.922), were risk factors for cardiac death in Western medicine. Taking anticoagulants (OR = 0.437) and hypolipidemics (OR = 0.366) were both protective factors for cardiac death in Western medicine. The yang deficiency pattern (OR = 1.127) was a TCM risk factor for cardiogenic death in patients, while the use of Yiqi TCM injections (OR = 0.261) was a TCM protective factor of cardiogenic death in patients. Conclusion Cardiac function grading, aortic valve stenosis, anticoagulants, Yiqi TCM injection, heart rate, bilirubin, diastolic pressure, yang deficiency pattern, peripheral vascular disease, hypolipidemics, and NT-ProBNP are prognostic factors of cardiogenic death in patients with chronic heart failure complicated by atrial fibrillation. The data analysis method combined with random forest and Logistic regression can realize complementary advantages and is suitable for high-dimensional and complex prognostic factor analysis of Chinese and Western medicine, which has clinical promotion value. [ABSTRACT FROM AUTHOR]

The article discusses a study that analyzes the partial mtDNA D-loop sequences and phylogeny of sympatric goat populations in lower valley of Yellow River, China.

Tumor microenvironment (TME) is a dynamic network distributed around tumor cells. Cancer-associated fibroblasts (CAFs), as an important component of the TME, are not only closely related to normal fibroblasts, but also can secrete a variety of substances to participate in the regulation of the TME. Exosomes, one of the substances from CAFs, can promote the formation and development of lung cancer, including promoting the formation of TME, increasing pulmonary tumor cell invasion and metastasis, mediating pulmonary tumor immunosuppression and participating in radiotherapy and chemotherapy resistance. This article reviews the current research status and progress of cancer associated fibroblasts-derived exosomes in lung cancer.
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The cell cycle-related transcription factor E2F1 is a member of the cell cycle-related transcription factor E2F family, mainly involved in various cell processes including cell cycle progression, DNA repair, DNA replication, cell differentiation, proliferation, and apoptosis. E2F1 is highly expressed in a variety of tumor tissues and cells, and it plays a role as a cancer-promoting gene. The up-regulation of E2F1 expression is closely related to the occurrence, development, metastasis and prognosis of tumors. Therefore, E2F1 is expected to become a new target for cancer treatment. This article reviews the latest research progress of E2F1 in current common tumors.
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The good effect of enhanced recovery after surgery is reflected in reducing the incidence of perioperative complications and shortening the hospital stays. However, the concern for the management of perioperative patients and the quality of life of patients after surgery is not high enough. Evaluating clinical efficacy from the perspective of patient-reported data has received increasing attention. Combining the current domestic and foreign research results on the outcome of patient reports, this article systematically discusses the concept connotation, research significance, and clinical application of thoracic surgery for the outcome of patient reports with proposing a clinical outcome research model that draws on foreign patient reports to develop Chinese characteristics. Combine the related research of discipline characteristics, and summarize and analyze the existing literature reports.
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Recently, with the proliferation of high-resolution computed tomography (CT), the frequency of small pulmonary nodules appears higher and more precise than previously estimated, especially in CT screening in patients with high risk factors for lung cancer. Video-assisted thoracoscopic surgery (VATS) provides a new minimally invasive treatment for the diagnosis and treatment of small pulmonary nodules. The VATS results in less pain, shorter hospital stay, and reduced surgical complications, making it more widely available. How to accurately locate and mark lesions is important for video-assisted thoracoscopic surgery. This article reviews the various techniques used to locate pulmonary nodules in surgery in recent years and summarizes the advantages and disadvantages of them.
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Fibroblast growth factor receptors (FGFRs) are in the superfamily of receptor tyrosine kinases’ (RTKs). Fibroblast growth factors (FGFs) bind to FGFRs with high-affinity, involving in many biological processes, such as the regulation of organ development, angiogenesis, cell proliferation, migration and anti-apoptosis. The activating mutations and amplification of the FGFR gene, resulting in FGFR protein amplification, are closely associated with the development and progression of many malignancies in human. In recent years, various small molecule FGFR inhibitors with different chemical backbones are designed, synthesized, and mainly applied to the clinical anti-cancer research. This article is devoted to review of selective second generation of small molecule FGFR inhibitors that are currently used in clinical trials, and the interaction with the FGFR protein, in order to provide strategies to the design of small molecule FGFR inhibitors.

Objective: To explore the present state of occupational hazards and health status of workers in the automobile maintenance industry., Methods: The monitoring results of occupational hazards in 25 automobile maintenance companies, occupational health examination results of 751 male workers in 63 automobile maintenance companies, and physical examination results of 205 male students in one Research Institute were statistically analyzed in 2012., Results: The concentrations of benzene, toluene, xylene, ethyl acetate, and butyl acetate in the workplace were 0.3∼21.7, 0.4∼40.3, 0.4∼84.8, 1.9∼34.3, and 0.7∼516.7 mg/m(3), respectively; benzene concentration exceeded the upper limit in two workplaces, and butyl acetate concentration exceeded the upper limit in one workplace. The intensity of noise was 70.3∼ 91.3 dB (A) and exceeded the upper limit in one workplace. The prevalence of blood system involvement in spray painters was 15.6%, significant higher than that of the control group (P < 0.05). High-frequency hearing loss was detected in 53.9%of all metalers. Logistic regression analysis indicated that blood system involvement was not correlated with age and working years in spray painters; high-frequency hearing loss in metalers was positively correlated with age, but not correlated with working years., Conclusion: The status of occupational hazards in the automobile maintenance industry should not be neglected, and the management of noxious positions and personal protection should be strengthened in enterprises.

Objective: To compare the epidemiological characteristics and differences in brachial-ankle pulse wave velocity (baPWV) among middle-aged residents between Shanghai and Inner Mongolia autonomous region(Inner Mongolia), and to observe the prevalence of arterial stiffness in the two populations., Methods: A total of 922 volunteers aged between 45 and 59 from Shanghai and Inner Mongolia were selected by stratified cluster random sample method. BaPWV was measured and related data were collected., Results: A total of 903 cases were enrolled in this study, including 441 from Shanghai and 462 from Inner Mongolia. The baPWV value of middle-aged residents in Inner Mongolia was higher than that in Shanghai [(1 548 ± 281) cm/s and (1 476 ± 254) cm/s, P < 0.001]. The abnormal rate of baPWV (baPWV ≥ 1 400 cm/s) in Inner Mongolia was also higher than that in Shanghai [67.5% (312) and 57.4% (253) , P < 0.001]. The baPWV value of middle-aged men in Inner Mongolia was (1 568 ± 299) cm/s, while it was (1 508 ± 260) cm/s in Shanghai, no statistical difference was found (P > 0.05). The baPWV value of middle-aged women in Inner Mongolia was (1 534 ± 268) cm/s, which was higher than that of Shanghai [(1 468 ± 252) cm/s, P < 0.01]. The abnormal rate of baPWV of middle-aged men in Inner Mongolia and Shanghai was 67.0% (126/188) and 60.8% (59/97), respectively (P > 0.05). The abnormal rate of baPWV of middle-aged women in Inner Mongolia and Shanghai was 67.9% (186/274) and 56.4% (194/344), respectively., Conclusions: The difference of baPWV value and abnormal rate of baPWV of middle-aged residents between Inner Mongolia and Shanghai exists. Middle-aged people in Inner Mongolia should be more alert to the incidence of arteriosclerosis and cardio-cerebrovascular diseases.

Objective: To investigate the congenital heart disease (CHD) prevalence of students in Liangshan prefecture in Sichuan province, and to explore the risk factors of CHD., Methods: Stratified cluster sampling was conducted in collecting demographic data. Heart auscultation was used to screening the CHD, and colour Doppler flow imaging was used to diagnose the CHD., Results: A total of 10,021 student were collected in this study. About 19.74% of total cases had cardiac murmur. Sixty-eight students were diagnosed as CHD through colour Doppler flow imaging, accounting for 0.68%. In addition, the top three ranks of CHD were atrial septal defect, patent ductus arteriosus, interventricular septal defect. Our study also found that per capita income of CHD families was lower than non-CHD families, meanwhile, the CHD prevalence of Yi nationality was higher than other nationalities. There was no statistical significance in age, gender, height, weight, body mass index, head circumference, waist circumference between different types of CHD., Conclusions: The CHD prevalence of students in Liangshan prefecture has been in a high level in China; therefore we need pay more attention on screening for the CHD.

Objective: To investigate epidemiological characteristics and differences in ankle-brachial index (ABI) among the natural population in Shanghai and Inner Mongolia, and to observe the prevalence of lower extremity peripheral arterial disease (PAD)., Methods: A total of 2604 volunteers from Shanghai and Inner Mongolia were selected by stratified cluster random sample. ABI was measured and related data were collected., Results: The ABI value in Shanghai was 1.074 ± 0.095, while it was 1.062 ± 0.075 in Inner Mongolia (P < 0.001). The prevalence of lower extremity PAD in Shanghai was 4.2%, while it was 1.9% in Inner Mongolia (P < 0.01). For males, the ABI value in Shanghai was 1.078 ± 0.105, and it was 1.075 ± 0.080 in Inner Mongolia (P > 0.05). For females, the ABI value in Shanghai was 1.073 ± 0.089, while it was 1.052 ± 0.070 in Inner Mongolia (P < 0.001). For males, the prevalence of lower extremity PAD of the in Shanghai was 4.7%, while it was 2.0% in Inner Mongolia (P < 0.05). For females, the prevalence of lower extremity PAD of in Shanghai was 4.0%, while it was 1.8% in Inner Mongolia (P < 0.05). The ABI values in age group of < 50 years in Shanghai and Inner Mongolia were 1.037 ± 0.082 and 1.055 ± 0.068, respectively (P < 0.05). The prevalences of lower extremity PAD in age group of < 50 years in Shanghai and Inner Mongolia were 7.6% and 1.2%, respectively (P < 0.001). There were no significant differences in ABI value and the prevalence of lower extremity PAD between Shanghai and Inner Mongolia in both age group of 50 - 69 years and ≥ 70 years (all P values > 0.05)., Conclusions: The ABI value in Shanghai is higher than that in Inner Mongolia and the prevalence of lower extremity PAD in both males and females in Shanghai is significantly higher than that in Inner Mongolia. But they are lower than the level of western countries. In different age groups, the difference of the prevalence of lower extremity PAD between Shanghai and Inner Mongolia is only displayed in the age group of < 50 years, which may be related to the limited sample size. The natural population in Shanghai exposed artery atherosclerotic disease risk factors may increase and we need to pay more attention to the lower extremity PAD.

Objective: To investigate the current status of treatment goals for blood pressure, serum lipids and blood glucose in the elderly patients (> 65 years old) with coronary heart disease (CHD) in China and to identify their associated factors., Methods: In this cross-sectional survey, the CHD subjects aged > 65 years old were recruited from 66 hospitals in Beijing, Shanghai, Tianjin, Guangdong, Zhejiang and Xinjiang from June 2006 to January 2007., Results: A total of 2420 participants, including 1441 males and 979 females. Their mean age was (73 ± 6) years. The targeted blood pressure was systolic blood pressure < 130 mm Hg (1 mm Hg = 0.133 kPa) and diastolic blood pressure < 80 mm Hg. And the success rate was 24.8% (559/2420). The blood pressure achievement rate among the females was 21.8% (213/979). And it was lower than 26.8%(386/1441) among the males (P < 0.01). The serum lipids goal of achievement was LDL-C (low density lipoprotein-cholesterol) < 2.6 mmol/L for the high-risk patients and LDL-C < 2.07 mmol/L especially for the super-high-risk patients. The success rate for achieving the target LDL-C level was 36.5%(884 cases). The LDL-C achievement rate among the females was 28.7% (281 cases). And it was obviously lower than 41.8%(603 cases) among the males (P < 0.01). The success rate for achieving the target LDL-C level increased with aging (P < 0.05). The blood glucose goal of achievement was FPG (fasting plasma glucose) > 4.4 mmol/L and FPG < 6.1 mmol/L. The success rate for achieving the target blood glucose level was 61.0% (1476/2420). Binary logistic regression analysis indicated that the independent risk factors of achieving the blood pressure target for the elderly CHD patients were female, history of hypertension, diuretics and nifedipine. The odds ratio (OR) of these risk factors were 1.245 [95% confidence interval (CI): 1.016 - 1.527], 2.889 (95%CI: 2.319 - 3.599), 0.689 (95%CI: 0.538 - 0.883), 0.405 (95%CI: 0.170 - 0.964) respectively. The independent risk factors of achieving the serum lipids target for the elderly CHD patients were female, the duration of hypertension of 10 - 20 years, the duration of hypertension of 20 - 30 years, diabetic history or dyslipidemia and therapeutic lifestyle change (TLC). The OR of these risk factors were 1.750 (95%CI: 1.252 - 2.445), 3.988 (95%CI: 1.951 - 8.152), 2.158 (95%CI: 1.075 - 4.333), 3.026 (95%CI: 1.986 - 4.610), 2.166 (95%CI: 1.549 - 3.030) and 0.493 (95%CI: 0.302 - 0.805) respectively. The independent risk factors of achieving the blood glucose target for the elderly CHD patients were diabetic history, TLC, diuretics, calcium channel blocker (CCB) and hypoglycemic drugs. The OR of these risk factors were 3.191 (95%CI: 2.259 - 4.507), 0.690 (95%CI: 0.528 - 0.902), 1.507 (95%CI: 1.150 - 1.975), 0.718 (95%CI: 0.579 - 0.890) and 0.477 (95%CI: 0.235 - 0.969) respectively., Conclusion: In the present survey, the achievement rates of blood pressure, serum lipids and blood glucose are low in the elderly CHD patients, especially in females. There has been a huge gap between the treatment guidelines and clinical practices in China. We should carry out different strategies according to different conditions to enhance the health and life quality for the elderly CHD patients.

Objective: To explore the effect of MnCl(2) on the mitochondrial function of human lung cells, and to study the changes of protein expression level of nuclear respiratory factor-1 (NRF-1) in mitochondrial dysfunction induced by MnCl(2)., Methods: The effects of MnCl(2) on cell survival rate were assessed by the reductions of tetrazolium dye (MTT) in cultured cell lines 16HBE and A549 cells. All tested16HBE and A549 cells were incubated with different concentrations of MnCl(2). The permeability transition pore (PTP) of mitochondria, mitochondrial membrane potential and the inhibition rate of mitochondrial enzymes as indicators of mitochondrial damage were measured by fluorescent spectrometry and MTT assay, respectively. Apoptosis was determined by flow cytometry. Protein levels of NRF-1 and mtTFA were measured by Western blot assay., Results: MnCl(2) decreased the survival rate of the two cell lines. The IC(50) of 16HBE and A549 cells were 1.91 mmol/L and 1.98 mmol/L, respectively. MnCl(2) caused a concentration-dependent decrease of mitochondrial enzymes and the inhibition rate of mitochondrial enzymes of the two cell lines induced by 1.00 mmol/L MnCl(2) were (52.8 ± 5.4)% and (50.6 ± 2.2)%, respectively. The PTP opening increased in MnCl(2)-treated cells in a dose- and time-dependent manner. Compared with the control group, mitochondrial membrane potential in the two cell lines was decreased by MnCl(2), by (7.9 ± 3.0)%, (26.2 ± 2.2)% and (27.8 ± 4.1)% in the 16HBE cells, and (4.7 ± 1.0)%, (14.9 ± 2.4)% and (27.5 ± 1.2)% in the A549 cells. Increased apoptosis rates of the two cell lines were induced by 1.00 mmol/L MnCl(2), (12.3 ± 1.9)% and (6.0 ± 0.4)%, respectively. The results of Western blot assay revealed that the protein levels of NRF-1 and mtTFA were decreased in manganese-treated cells in a dose-dependent manner, with a significant difference compared with that of the control cells (P < 0.05)., Conclusion: MnCl(2) induces mitochondrial dysfunction in 16HBE and A549 cells, and decreases the expression level of nuclear respiratory factor-1 (NRF-1), indicating that NRF-1 may play an important role in mitochondrial dysfunction.

Objective: To investigate the effect of Shenfu injection on ischemia-reperfusion injury of rat kidney and its mechanism., Methods: Fifty-five male SD rats were randomly divided into 5 groups: sham operation group (Sham group), Ischemia-reperfusion group (IR group), Shenfu injection (5 mL/kg) treated group (SF5 + IR group), Shenfu Injection (10 mL/kg) treated group (SF10+IR group) and Shenfu Injection (15 mL/kg) treated group (SF15+IR group). The rats were anesthetized with valebarbitone. Bilateral kidneys were exposed through midline incision. Right kidney was removed and left renal pedicels were occluded for 50 min with a traumatic mini-clamp then unclamped for 24 h. Animals in (SF5+IR group), (SF10+IR group) and (SF15+IR group) received Shenfu Injection of 5 mL/kg, 10 mL/kg and 15 mL/kg respectively through intraperitoneal injection every day for 7 days. At 24 hours after reperfusion, blood and renal tissue were taken for examination., Results: Ischemia-reperfusion injury rat model was established successfully. The level of serum BUN, CREA and MDA were lower in (SF5+IR) group and (SF10+IR)group and (SF15+IR) group than in IR group (P < 0.05). The level of SOD in (SF5+IR) group and (SF10+IR) group and (SF15+IR) group increased significantly than in IR group (P < 0.05). Furthermore, all of the changes were observed in a dose-dependent manner, (SF15 + IR) group demonstrated the best effect by compared with others (P < 0.05)., Conclusion: Shenfu injection can protect rats against acute renal ischemia-reperfusion injury by increasing SOD activity and decreasing MDA content.

Objective: To evaluate the therapeutic effects of combination administration of hydrochlorothiazide and nitrendipine at low dosage in the treatment of rural hypertension patients., Methods: By the method of cluster random sampling, 5292 primary hypertension patients from Fuxin, Liaoning Province were divided into health education group (control group) and drug intervention group in June 2006. The drug intervention group were treated with hydrochlorothiazide, nitrendipine and captopril by stepwise approach and we observe the antihypertensive effect of drug and the effect on the onset of stroke., Results: The average follow-up time was 15 months. At last, 308 patients were lost to follow-up (the lost follow-up rate was 5.8 percent). The 4984 in cohort, including 2530 of intervention group and 2454 of control group, had examination of all indicators. Through health education and drug intervention, the average blood pressure in drug intervention group decreased by 16.1/9.4 mm Hg (1 mm Hg = 0.133 kPa) while the average blood pressure in control group decreased by 6.7/3.5 mm Hg. The control rate of blood pressure in drug intervention group was higher than control group (33.1% vs. 15.1%, P < 0.001). Through drug intervention, the morbidity risk of nonfatal stroke in drug intervention group decreased by 57.3% compared to control group, the total morbidity risk of stroke decreased by 59.4%. The results had significant statistical difference. And, the morbidity of severe hypopotassaemia (K(+) < 3.0 mmol/L) and diabetes mellitus had no significant statistical difference between two groups., Conclusions: The low-cost antihypertensive program based on thiazide had good antihypertensive effect, high safety and good cost-effect ratio. The program could be used in rural areas of China.

Objective: To investigate the prevalence of peripheral arterial disease (PAD) and correlative risk factors among natural population in China., Methods: Ankle brachial index (ABI) was measured by trained doctors and related data were collected in residents from Beijing, Shanghai, Changsha, Guangdong, Neimenggu, and Xinjiang selected through cluster multistage and random sampling method. PAD was defined as an ABI < or = 0.9 in either leg., Results: The prevalence of PAD among 21 152 eligible participants was 3.08%, the standardized prevalence was 3.04%. The prevalence in males and females was 2.52% and 3.66% and the standardized prevalence was 1.84% and 4.31% respectively, the prevalence rate was significantly lower in males than that in females (P < 0.01). The prevalence in both males and females increased significantly in proportion to aging (P < 0.01). The prevalence in Han Chinese was significantly higher than that in non-Han Chinese (P < 0.01). Logistic regression analysis showed that older age, female gender, Han Chinese, waist circumference, smoking, lipid disorder, diabetes mellitus, coronary artery disease and a history of ischemic stroke were associated with the increased prevalence of PAD. Incidence of known PAD was 1.38% in this cohort., Conclusions: Older age, female gender, Han Chinese, waist circumference, smoking, lipid disorder, diabetes mellitus, coronary artery disease and a history of ischemic stroke were associated with the increased prevalence of PAD in natural Chinese population.

Objective: To conduct a meta-analysis of the effect of levosimendan on B-type natriuretic peptide (BNP) levels and evaluate the therapeutic effect of levosimendan on advanced heart failure., Methods: A meta-analysis was performed on the selected data to analyze the effect of levosimendan on BNP levels., Results: Levosimendan decreased BNP by a mean of 337.66 [95%CI (-296.30, -379.02)] pg/ml 24 h after the administration, and by 259.92 [95%CI (-195.76, -324.08)] pg/ml at 48 h, and by 123.09 [95%CI(-53.32,-195.86)] pg/ml at 1 week. Levosimendan resulted in improvements of the cardiac function by about 29%, 22%, and 10% at 24 h, 48 h and 1 week after the administration., Conclusion: Levosimendan produces favorable effects on the cardiac functions and BNP levels.

Objective: To investigate the value of cardiac troponin I (cTnI) levels in assessing myocardial protection by remifentanil precondition against myocardial injury induced by off-pump coronary artery bypass (OPCAB)., Methods: Twenty-four patients undergoing OPCAB were randomized into control and remifentanil preconditioning group (n=12). All the patients received pretreatment with oral diazepam (10 mg), intramuscular morphine (10 mg) and hyosine (0.3 mg). General anesthesia was induced with midazolam (0.08 mg/kg), etomidate (0.1-0.3 mg/kg), fentanyl (5-10 microg/kg), and rocuronium (1 mg/kg), and maintained with isoflurane inhalation and propofol infusion. Intermittent fentanyl and pipecuronium were given intravenously. In remifentanil preconditioning group, remifentanil (5 microg/kg in 50 ml normal saline) was infused in 10 min after anesthesia induction, and only NS was administered in the control group. Blood samples were obtained before and at 0, 2, 6, 24, and 48 h after the operation to determine serum cTnI levels., Results: In both of the two groups, the cTnI levels increased significantly at the postoperative time points (0, 2, 6, 24, and 48 h) as compared with those before the operation (P<0.05). The cTnI levels of remifentanil preconditioning group were markedly decreased after the operation in comparison with those of the control group (P<0.05)., Conclusion: Remifentanil preconditioning decreases the cTnI levels and reduces myocardial injury induced by OPCAB.

A recombinant strain Escherichia coli DH5alpha(pMD19-glnA) including Bacillus subtilis glnA gene was constructed. Capillary electrophoresis and nuclear magnetic resonance were used to determine qualitatively the product of transformation by recombinant strain, and the relative level of mRNA expression of glnA was also determined by fluorescence quantitative RT-PCR. Subsequently, SDS-PAGE (polyacrylamide gel electrophoresis) was used to analysis the relative level of protein. Surprisingly, there was no increase of glutamine production in this recombinant strain, but an obvious increase in the GABA (gamma-aminobutyric acid ) production. It was showed in the experiment that protein expression of the glutamine synthetase did not increase, although glnA gene can be transcribed normally in this recombined strain. The phenomenon of exogenous glnA gene interfering metabolism of Escherichia coli was worthy of further study.

Objective: To investigate the association between glucose metabolism status and brachial-ankle pulse wave velocity (baPWV) in Chinese patients with coronary artery disease (CAD)., Methods: baPWV values were measured in 198 CAD patients. Plasma glucose, serum lipids, hsCRP and other baseline data were obtained in all the patients. According to the glucose level, the participants were divided into 3 groups: normal glucose tolerance (NGT) group, impaired glucose regulation (IGR) group and diabetes mellitus (DM) group., Results: baPWV values in the DM group (1807 +/- 381) cm/s were significantly higher than those in the NGT group [(1615 +/- 248) cm/s, P = 0.000] and IGR group [(1674 +/- 277) cm/s, P = 0.035]. Multiple stepwise linear regression analyses indicated that higher baPWV values were associated with aging and hsCRP levels in 198 patients. In DM group, higher baPWV values were independently associated with aging and HbA1c levels., Conclusions: In patients with coronary artery disease, baPWV values increase with different glucose metabolism status from NGT to IGR then DM. baPWV values in the patients with DM were significantly higher than those in the other two groups. Glycemic control may ameliorate arterial stiffness.

Objective: To elucidate the molecular evolutional characteristics of HIV-1 nucleoside reverse transcriptase inhibitor (NRTI) drug resistance-associated mutations in patients with AIDS receiving highly active antiretroviral therapy., Methods: We selected 4 AIDS patients receiving highly active antiretroviral therapy (HAART) with good adherence under a HIV-1 drug resistance cohort from a rural region in central China. Those people carried susceptible virus at the beginning of treatment and gradually came to produce virus resistant to NRTIs during the process of antiretroviral therapy (ART). Reverse transcriptase (RT) genes from each patient's peripheral blood samples (from 3 to 33 months after withdrawal) were cloned and sequenced in succession., Results: We sequenced a total number of 855 clones and obtained the HIV-1 NRTI drug resistance-associated mutations patterns of the 4 patients. Typical resistance mutations of thymidine analogue mutations (TAMs) pattern 1, such as L210W, T215Y and M41L, were generated in patient 'A'. TAMs pattern 2, including D67N, K70R and K219Q mutations, was discovered in patient 'B'. Interestingly, in patient 'C', some clones comprising not only TAMs pattern 1 mutations (T215Y) but also TAMs pattern 2 mutations (K70R, D67N)., Conclusion: The four patients show different pathways on HIV-1 NRTI drug resistance-associated mutations, including TAMs pattern 1, TAMs pattern 2 and the fusion pattern of TAMs-1 & TAMs-2. We also noticed that the tendency of gradual accumulation was obvious and those mutations detected earlier tended to be the predominant strains.

PCR-RFLP was used to analyze the polymorphisms of exon 2 of GOLA-DQB1 gene in Laiwu black goats, Lubo goats, and Boer goats. The effects of genotypes of exon 2 of GOLA-DQB1 gene on immune traits were estimated. Seven genotypes (AA, BB, CC, AB, AC, BC, and DD) were detected by analyzing restriction maps. Polymorphic sites were detected at base position 24, 151 of exon 2 of GOLA-DQB1 gene. The results showed that the effects of breed were major effect. W-SCR in Laiwu black goats with genotype BC was significantly higher than that with genotype AC and CC (P<0.05), W-LCR in Laiwu black goats with genotype BC was significantly lower than that with genotype CC (P<0.05); W-LCC in Laiwu black goats with genotype BC was lower than that with genotype AC, CC (P>0.05). W-LCC in Boer goats with genotype BC was lower than that with genotype AA, AB, and BB (P>0.05); W-LCC in Lubo goats with genotype BC and AC was significantly lower than that with genotype AA (P<0.05). It was concluded from the results that GOLA-DQB1 was the gene affecting the immune traits. These results may be applied to marker assisted selection in disease resistance breeding of goats.

Objective: To evaluate the value of measuring ankle brachial index (ABI) for diagnosing peripheral arterial disease(PAD) compared with conventional digital subtraction angiography (DSA) as the reference standard., Methods: A total of 383 consecutive inpatients (245 male, mean age 64.1 +/- 11.7 years) underwent both conventional DSA and ABI measurements., Results: The rate of statin intervention was 90.9%, ACEI 69.2%, antiplatelet 96.6% and beta-blockers 67.9%. The intravascular stenosis was classified into six degrees: normal, < 30%, 30% - 49%, 50% - 69%, 70% - 89% and > or = 90%. Compared to the traditional gold standard (DSA) in diagnosis PDA, the ABI value decreased in proportion to the severity of PAD (the ABI value was 1.08 +/- 0.11, 1.05 +/- 0.16, 0.99 +/- 0.17, 0.66 +/- 0.24, 0.55 +/- 0.28 and 0.54 +/- 0.00 respectively in the six ranks). There was a significant correlation between DSA and ABI in diagnosis PAD., Conclusion: ABI measurement is an accurate and reliable non-invasive alternative to conventional DSA in the assessment of lower extremity arteries in patients with peripheral arterial disease.

Objective: To investigate the relationship between brachial-ankle pulse wave velocity (baPWV) and different stage of cardiac dysfunction., Methods: 253 consecutive patients with coronary atherosclerotic heart disease were enrolled from August 2006 to February 2007. Patients were grouped according to the functional classification of New York Heart Association (NYHA). The baPWV was measured non-invasively with a VP1000 automated PWV/ABI analyzer (PWV/ABI, Colin CO. Ltd., Komaki, Japan). At the same time, BNP, EF, LAEDV and LVESV were measured in all the patients., Results: Brachial-ankle PWV was significantly correlated with cardiac function classification of NYHA (r = 0. 444, P < 0.001), BNP( r = 0.394, < 0.001) and left ventricular end diastolic volume (r = - 0.130, P < 0.05). The under area of receiver operating charachateistic (ROC) curve was 73.9%. The ROC curve demonstrated that when the value of brachial-ankle PWV was equal to or larger than 1717 cm/s (> 1717 cm/s), the sensitivity of diagnosing mild cardiac dysfunction was 72.9% and specifity 61.8%. When its value was equal to or larger than 1900 cm/s (> or = 1900 cm/s), the sensitivity and specificity were 61.5% and 81.9% respectively., Conclusion: Brachial-ankle PWV is significantly correlated to the NYHA classification of heart failure and it may be a prospective index to diagnose early stage of cardiac dysfunction.

Objective: To evaluate the risk factors for peripheral arterial disease (PAD) and the relationship of low ankle brachial index (ABI) to all-cause and cardiovascular disease (CVD) mortality in Chinese male patients with hypertension., Methods: The data of 1606 male participants with hypertension from the eight hospitals in Beijing and Shanghai were analyzed. ABI was ascertained at baseline by measuring the systolic pressures on bilateral brachial and tibial arteries. ABI < or = 0.9 was used as the diagnostic criteria for PAD identification. The follow-up survey was conducted from November 2005 to January 2006., Results: Of 1606 male participants with hypertension at baseline, 406 (25.3% ) were in low-ABI group and 1200 (74.7%) were in normal-ABI group. Older age, TC, history of diabetes, history of smoking and 2-grade hypertension were associated with low ABI in male patients with hypertension. During the (12.87 +/- 2.94) months follow-up, there were 153 deaths. Of which, 62 were attributable to CVD. Low ABI was associated with adjusted all-cause and CVD mortality risk of 1.728 (1.223-2.441) and 2.388 (1.409-4.046) respectively in Cox regression models. Rate of survival for the low-ABI group was significantly worse than for the normal-ABI group. The risk of all-cause and CVD mortality was increased with the decline of ABI., Conclusion: Low ABI is independently associated with the high risks of all-cause and CVD mortality in Chinese male patients with hypertension. The utility of ABI as a tool for predicting mortality in the patients with hypertension should be popularized.

Objective: Ankle brachial index (ABI) is thought to be an efficient means of objectively assessing the potency of lower extremity arterial system. This study is aimed to evaluate the relationship between ABI and cardiovascular disease CVD mortality in Chinese male patients with metabolic syndrome (MS)., Methods: 1224 Chinese male patients with MS were selected from Beijing and Shanghai and the baseline examinations were carried out. All the participants were divided into 2 main groups: ABI < or = 0.9 (n = 268) and ABI 0.9 - 1.4 (n = 956). and they were followed up for (13.2 +/- 2.7) months., Results: As to baseline characteristics, age, systolic blood pressure (SBP), hypertensive disease and diabetes mellitus morbidity and smoking history had significant difference between the 2 groups (P < 0.05 or P < 0.01). All-cause mortality and CVD mortality decreased gradually while the ABI increased from 0.4 to 1.4. With Cox regression analysis, relative ratio (RR) value of all-cause mortality and CVD mortality also showed the decreasing trend with the rising of ABI., Conclusion: In Chinese male patients with MS, ABI is one of the most important parameters in indicating possible prognosis and foreseeing all-cause and CVD mortality. Male subjects with relatively old age, higher systolic blood pressure, hypertensive disease and diabetes mellitus morbidity, smoking history may be associated with lower ABI (< or = 0.9) and relatively higher all-cause and CVD mortality. Our results suggest the urgent need for frequent measurement of the ABI in clinical practice before diagnosing peripheral artery disease and making therapeutic decision, especially in some high-risk population such as male patients with MS.

Objective: To investigate the prevalence of diabetes mellitus (DM) and glucose abnormalities in patients with ischemic chronic heart failure (CHF)., Methods: A total of 1004 hospitalized eligible patients from 52 hospitals in 7 Chinese cities were included in this study., Results: In this survey, 420 out of 1004 patients had DM history (41.8%), 175 patients were newly diagnosed as DM (17.4%), 208 patients (20.7%) had impaired glucose tolerance (IGT). NYHA grade increases in proportion to severity of abnormal glucose metabolism [(r(s)) = 0.17, P = 0.001]. After adjustment of age and other factors, logistic regression analyses showed risk of suffering severe CHF symptoms (NYHA III/IV) increases with the severity of abnormal glucose metabolism: OR, 1.2, 95% CI: 0.7 - 1.7 in patients with IGT; 1.4, 95% CI: 0.9 - 2.1 in the newly diagnosed DM patients and 1.7, 95% CI: 1.2 - 2.4 in the DM history group, respectively., Conclusions: High prevalence of abnormal glucose metabolism was observed in patients with chronic ischemic hear failure and the severity of abnormal glucose metabolism was closely related to NYHA symptom grade.

Objective: To investigate the association between high-sensitivity C-reactive protein and peripheral arterial disease., Methods: The study population comprised 643 subjects aged at least 40 years in whom both CRP and ankle-brachial index were measured. The survey included information on demographic characteristics, clinical examinations and ankle-brachial index (ABI). Ankle-brachial index (ABI) < 0.9 was diagnostic of PAD., Results: 64 subjects (10%) were diagnosed as PAD. The prevalence of current smoking, hypertension, diabetes, low HDL cholesterol and history of cardiovascular disease in the participants with PAD were higher than without (P < 0.05). The prevalence of hypertension, diabetes, and history of cardiovascular disease was higher in subjects with high CRP (P < 0.05). In logistic regression analyses, the moderate CRP group and high CRP group had a two-fold higher OR compared with the low CRP group. The P-trend across CRP groups was statistically significant (P = 0.036). High log-transformed hs-CRP level was significantly related to PAD after adjustment for the cardiovascular risk factors mentioned above (P = 0.007)., Conclusion: hs-CRP is related to PAD and high level hs-CRP is an independent risk factor for PAD in Chinese adults aged 40 years and more.

Objective: To study the relationship between ankle-brachial index (ABI) and all cause mortality and cardiovascular disease mortality in men with several atherosclerotic risk factors., Methods: 1941 male patients with no less than two atherosclerotic risk factors, aged 67 (36 approximately 96), from 20 hospitals in Shanghai and Beijing, underwent examination of ABI and were followed up for 13.6 +/- 1.3 months to record the all cause mortality and cardiovascular disease (CVD) mortality., Results: The baseline examination showed that 467 patients were with the ABI 0.9 (7.7% and 1.8%, both P < 0.01). After adjusting other risk factors, the patients with 0.41 < ABI

Objective: To investigate the association between pulse pressure (PP), pulse pressure index (PPI), and stroke in rural areas., Methods: 29970 people>or=35 years old in rural areas of Fuxin City, Liaoning Province, were selected by cluster multistage sampling. Blood pressure was measured. History of stroke was taken. SPSS11.5 statistical software was used for data analysis., Results: (1) The prevalence of stroke was 2.48%. (2) The PP level of the stroke group was 65 mm Hg+/-19 mm Hg in men and 70 mm Hg+/-21 mm Hg in women; while the PP level of the non-stroke group was 52 mm Hg+/-14 mm Hg in men and 53 mm Hg+/-17 mm Hg in women. The PPI level of the stroke group was 0.40+/-0.08 in men and 0.42+/-0.08 in women; while the PPI of the non-stroke was 0.38+/-0.07 in men and 0.39+/-0.07 in women. The PP and PPI levels of the stroke group were significantly higher than those of the non-stroke group (both P<0.01). (2) The prevalence of stroke increased along with the increase of PP and PPI in both genders (both P<0.01). (3) Receiver operating characteristic (ROC) curve analysis showed that the areas of PP and PPI under ROC curve was 0.720 (95% CI, 0.694-0.746) and 0.581 (95% CI, 0.553-0.610) in men when the optional cutoff was selected; and were 0.755 (95% CI, 0.727-0.784) and 0.681 (95% CI, 0.583-0.650) in women. The sensitivity in prediction of stroke of PP was higher than that of PPI; and the specificity in prediction of stroke of PP was lightly lower than that of PPI in men and was higher than that of PP in women. The area of PP under ROC curve was significantly larger than that of PPI (P<0.01)., Conclusions: As risk factors of stroke, PP and PPI are associated with the prevalence of stroke. PP is superior to PPI in predicting the prevalence of stroke.

Objective: To investigate the prevalence of peripheral arterial disease (PAD) complicated in metabolic syndrome (MS) and its risk factors., Methods: The clinical data of 2115 in-patients and out-patients with MS, 1132 males and 983 females, aged 67.6 +/- 5.1 (32 approximately 91), diagnosed and treated in several hospitals in Beijing and Shanghai, were collected. The patients underwent measurement of the systolic pressures of the brachial artery and ankle artery so as to calculate the ankle-brachial index (ABI). An ABI less than 0.9 was considered to be indicative of significant PAD. The data underwent statistical analysis., Results: 476 patients (22.5%) were found to have PAD, among which 246 were male aged 71.3 +/- 9.4 (51.68%) and 230 were female (48.32%) aged 71.2 +/- 8.2. The risk of PAD among then MS patients became higher along with the increase of age (OR = 1.069, 95% CI = 1.054 - 1.083), gender (OR = 1.498, 95% CI = 1.091 - 2.058), smoking status (OR = 1.763, 95% CI = 1.294 - 2.402), history of coronary heart disease, history of diabetes mellitus, and history of stroke were independently associated with low ABI (ABI < 0.9) (all P < 0.05). Higher blood urea nitrogen, creatine (CRE), and uric acid values of the female MS patients complicated by PAD was 7 mmol/L +/- 4 mmol/L, 101 mmol/L +/- 77 mmol/L, and 343 mmol/L +/- 115 mmol/L respectively, all significantly higher than those of the female MS patients not complicated by PAD (6 mmol/L +/- 4 mmol/L, 84 mmol/L +/- 70 mmol/L, and 308 mmol/L +/- 100 mmol/L respectively, P < 0.0001, P = 0.002, and P < 0.001). However, the BUN value of the male patients with MS complicated by PAD was 7.2 mmol/L +/- 4.9 mmol/L, significantly higher than that of the male MS patients nor complicated b PAD (6.5 mmol/L +/- 4.3 mmol/L, P = 0.036), however, he values of CRE and UA of the male MS patients complicated and not complicated by PAD were not significantly different (both P > 0.05), only the value of BUN of the of the male MS patients complicated by PAD was 7.2 +/- 4.9 at high risk of PAD in female patients, NOT in male patients except BUN value (P < 0.05)., Conclusion: Patients with MS have high risk of complication by PAD, especially when they become older. Female patients with MS are more likely to have a trend towards kidney dysfunction.

Objective: To investigate the prevalence of metabolic syndrome (MS) in the patients with coronary heart disease (CHD) in China., Methods: The clinical data, including anthropometric data, case record form (CRF), clinical examination, etc. of all CHD patients hospitalized from 1 Jun 2005 to 31 Sep 2005 in the department of cardiology of 52 hospitals in 7 northern, middle, and southern cities in China. A total of 3513 CHD patients, 2341 males and 1172 females, aged 23 approximately 99, were recruited., Results: The prevalence of MS was 30.4% among the 3513 CHD patients, 27.4% among the males and 36.4% among the females. The prevalence of MS among the CHD patients in the northern cities was 36.5%, significantly higher than those in the middle and southern cites (25.% and 25.1% respectively, chi(2) = 50.252, P < 0.001), with a trend to gradually decrease from north to south. The prevalence of MS among the CHD patients receiving acute admission was 28.8%, not significantly different from that receiving scheduled admission (31.2%, P = 0.139). There was a clear age-related increase in the prevalence of MS (chi(2) = 23.625, P < 0.001). The prevalence of MS of the males aged < 60 was higher than that of the females aged < 60; and the prevalence of MS of the females aged > 60 was higher than that of the females aged > 60., Conclusion: The prevalence of MS in CHD patients is rather high in China. It is important to screen for MS in patients with high risk for new vascular incidents.

Objective: To evaluate the relationship between uric acid (UA) and peripheral arterial disease (PAD) in Chinese patients with coronary heart disease (CHD)., Methods: UA levels and PAD were evaluated in 3251 Chinese hospitalized patients with CHD (age > or = 50 years). PAD was diagnosed when the ankle-brachial index was < 0.9 but patients with an ankle-brachial index of > 1.4 were excluded because of false negative rate. Potential confounding variables with P < 0.10 were adjusted for multivariate analysis., Results: In univariate analysis, UA levels were higher in patients with PAD than in those without PAD (349.80 micromol/L +/- 128.45 micromol/L vs. 323.00 micromol/L +/- 110.72 micromol/L, P < 0.001). Rate of hyperuricemia in patients with PAD and without PAD were 31.62% and 22.48% (P < 0.001) respectively. Prevalence rates of PAD for quintiles of UA level were 23.2%, 27.4%, 36.1%, 43.2% and 72.7%, respectively (P-trend < 0.05). With UA level as a continuous variable, the multivariate-adjusted odds ratio for PAD was 1.002 (95% confidence interval: 1.001 - 1.002) (P < 0.001). The optimal cut-off point for UA as determined by the receiver operating characteristic curve, was 227.2 micromol/L. The sensitivity and specificity at this cut-off point were 84.6% and 20.3%, respectively. The area under curve was 0.521 (95% confidence interval: 0.504 - 0.547) and the multivariate-adjusted odds ratio for PAD for UA above this level was 1.292 (95% confidence interval: 1.047 - 1.596) (P < 0.01). The results, however, after exclusion those cases who used diuretics, were similar., Conclusion: Elevated uric acid level seemed a significant and independent risk factor for PAD in Chinese hospitalized patients with CHD (age > or = 50 years).

Objective: To investigate the relationship between smoking and peripheral arterial disease (PAD) by investigate the smoking status and measuring the (ABI)., Methods: A questionnaire survey was conducted among 3379 male patients hospitalized in the departments of cardiovascular internal medicine, nephrology, and endocrinology, aged 40-98, 2253 smokers and 1126 non-smokers, to understand their life styles, anamnesis, and smoking history. All patients underwent measurement of systolic blood pressures of the upper arm and ankle so as to calculate the ankle-brachial index (ABI). Measurement. An ABI less than or equal to 0.9 was considered to be indicative of significant PAD., Results: The ABI levels in the smoker group were significantly lower than those in the non-smoker group (P < 0.05). The prevalence of PAD was 24.94% in the smoker group, and 20.60% in the non-smoker group. The age-adjusted OR of the smokers was 1.480 (95% CI: 1.237-1.770), with a significant dosage-effect relationship between smoking and PAD., Conclusion: Smoking is a significant risk factor of PAD. The prevalence of PAD was increased with the dosage of smoking.