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Background The benefit/risk ratio of stenting in acute ST-segment elevation myocardial infarction (STEMI) patients with single vessel intermediate stenosis culprit lesions merits further study, therefore the subject of the present study. Methods and results It was a prospective, multicenter, randomized controlled trial. Between April 2012 and July 2015, 399 acute STEMI patients with single vessel disease and intermediate (40%–70%) stenosis of the culprit lesion before or after aspiration thrombectomy and/or intracoronary tirofiban (15 µg/kg) were enrolled and were randomly assigned (1: 1) to stenting group (n = 201) and non-stenting group (n = 198). In stenting group, patients received pharmacologic therapy plus standard percutaneous coronary intervention (PCI) with stent implantation. In non-stenting group, patients received pharmacologic therapy and PCI (thrombectomy), but without dilatation or stenting. Primary endpoint was 12-month rate of major adverse cardiac and cerebrovascular events (MACCE), a composite of cardiac death, non-fatal myocardial infarction (MI), repeat revascularization and stroke. Secondary endpoints were 12-month rates of all cause death, ischemia driven admission and bleeding complication. Median follow-up time was 12.4 ± 3.1 months. At 12 months, MACCE occurred in 8.0% of the patients in stenting group, as compared with 15.2% in the non-stenting group (adjusted HR: 0.42, 95% CI: 0.19–0.89, P = 0.02). The stenting group had lower non-fatal MI rate than non-stenting group, (1.5% vs. 5.5%, P = 0.03). The two groups shared similar cardiac death, repeat revascularization, stroke, all cause death, ischemia driven readmission and bleeding rates at 12 months. Conclusions Stent implantation had better efficacy and safety in reducing MACCE risks among acute STEMI patients with single vessel intermediate stenosis culprit lesions.

Maternal diet has long been recognized as a significant factor affecting offspring development and health, but the target genes affected by a maternal high-lipid diet are currently unknown. In this study, the gene expression profile of neonatal mouse liver was analyzed using gene chips to identify genes with significant up- or downregulated expression levels due to maternal high-fat diet during gestation. Real-time PCR and Western blotting were used to measure key genes selected using microarray. Serum lipid, glucose, and insulin levels in adult offspring from dams fed with chow or a high-lipid diet were measured using commercial kits. Results indicate that the expression of genes involved in cholesterol and fatty acid synthesis were significantly inhibited, while the expression of genes involved in glycolysis were significantly decreased by maternal high-lipid diet during gestation. SREBP1 might be the key gene regulating genes involved in fatty acid, glucose, and cholesterol metabolism in response to a maternal high-fat diet.

Background Acute kidney injury (AKI) is common after surgery for acute aortic dissection (AAD) and increases in-hospital and long-term mortality. However, few data exist on the clinical and prognostic relevance of early preoperative AKI in patients with type A AAD. We aimed to determine the incidence and predictors of preoperative AKI and the impact of AKI on in-hospital outcomes in patients with type A AAD. Methods From May 2009 to June 2014, we retrospectively enrolled 178 patients admitted to our hospital within 48 h from symptom onset and receiving open surgery for type A AAD. The patients were divided into no AKI and AKI groups and staged with AKI severity according to the KDIGO criteria before surgery. Results AKI occurred in 41 patients (23.0%). The incidence of in-hospital complications was significantly higher in patients with preoperative AKI compared to no AKI (41.5% vs. 9.5%, P < 0.001), including renal infarction (7.3% vs. 0, P = 0.012), and it increased with AKI severity (Ptrend < 0.001). Patients with AKI had higher in-hospital mortality compared with patients without AKI, although no significant difference was found (14.6% vs. 5.1%, P = 0.079). Multivariate analysis indicated that male gender, diastolic blood pressure on admission and bilateral renal artery involvement were independent predictors of preoperative AKI in patients with type A AAD. Conclusions Early AKI before surgery was common in patients with type A AAD, and was associated with increased in-hospital complications. Male gender, diastolic blood pressure on admission and bilateral renal artery involvement were major predictors for preoperative AKI.

Objective: Angiogenic therapy is emerging as a potential strategy for the treatment of ischemic heart disease but is limited by a relatively short half-life of growth factors. Fibrin glue (FG) provides a reservoir for controlled- release of growth factors. The aim of this study was to evaluate the effects of basic fibroblast growth factor (bFGF) incorporating FG on angiogenesis and cardiac performance in a canine infarct model. Methods: Acute myocardial infarction was induced by ligation of the left anterior descending coronary artery (LAD). Group I (n=6) underwent ligation of LAD alone. In Group II, transmural channels were created in the infarct area (n=6). In Group III, non-transmural channels were created to locate FG cylinders containing bFGF (n=6). Eight weeks after operation, myocardial perfusion was assessed by single photon emission computed tomography, cardiac function by echocardiography, and vascular development by immunohistochemical staining. Results: Total vascular density and the number of large vessels (internal diameter ≥50 μm) were dramatically higher in Group III than in Groups I and II at eight weeks. Only the controlled-release group exhibited an improvement in regional myocardial perfusion associated with lower defect score. Animals in Group III presented improved cardiac regional systolic and diastolic functions as well as global systolic function in comparison with the other two groups. Conclusions: Enhanced and sustained angiogenic response can be achieved by controlled-release bFGF incorporating FG within transmyocardial laser channels, thus enabling improvement in myocardial perfusion and cardiac function.

This study is to examine the contribution of socioeconomic status (SES) to the risk of nonfatal pedestrian injury among children. The sample was obtained from two urban cities of China using multi-staged randomized sampling. Information was collected by respondents' reporting using self-administrative way in the classroom under the guidance of interviewers. A logistic regression analysis was applied to examine the associations between SES and nonfatal children pedestrian injury. The results showed that boys and children aged 10 had significantly increased odds of suffering nonfatal pedestrian injury. Migrant children were at higher risk of being injured. Students whose mothers' educational levels were either less than secondary school or postgraduate were more likely to sustain injury. Children who were from wealthier families or poorer families easily suffered from injury compared to children from middle families. Children living with grandparents, or siblings, or a single father, or a single mother were all at increased risk of injury. The possible causes or pathways of these SESs' impacts on pedestrian injury were explored in discussion. This study suggests that SESs are important determinants of nonfatal pedestrian injury among children in China.

Objective To examine relationships between weight status and different forms of bullying victimization among adolescents aged 11-18 years. Methods The relationships between weight status and bullying victimization (physical, verbal, and relational) were examined utilizing data from the Guangdong Provincial Youth Health Behavior Survey. Data on height, weight, and victimization behaviors were collected by self-reporting from 12 439 subjects. (χ 2 test and logistic regression were used to analyze relationships between weight and bullying victimization. Results The incidence of victimization for adolescents aged 11-18 years was 8.6%, with higher rates for boys (12.4%) than for girls (4.7%). For children with normal, overweight and obese body mass index (BMI), the incidence rates of victimization were 8.2%, 17.3%, and 11.5%, respectively. Compared to normal weight, overweight was a risk factor for bullying victimization (OR=1.60, 95% CI:1.18-2.17), and it also increased children's risk of being teased in a hurtful way (OR=2.13, 95% CI: 1.41-3.24) and being made fun of due to physical appearance (OR=3.58, 95% CI: 2.27-5.67). Obesity only increased the risk for children of being made fun of due to physical appearance (OR=2.45, 95% CI: 1.44-4.15). Conclusions The victimization for children at school is common in Guangdong province, China. Overweight and obese children are more likely to be victims of bullying behaviors, especially verbal victimization.

The available literature has not been able to demonstrate the exact association between preoperative statin therapy and the reduction in the rates of major adverse cardiac and cerebrovascular events (MACCE). The aim of this study is to explore these unanswered questions.A review of patients having CABG surgery between June 2003 and September 2005 (n=2013) was performed at Beijing Anzhen Hospital of the Capital University of Medical Science The preoperative demographic, morbidity and co-morbidity variability and the preoperative medications were compared between two groups: group I, on statins, n=904; group II, not on statins, n=1109. A Cox proportional hazard analysis was performed to determine the independent risk-reducing association with outcome variability after CABG surgery.Our study demonstrated that pre-hospital statins therapy did not reduce the risk of all-cause mortality or overall MACCE during hospital stay (1.7% versus 2.4%, respectively, P0.05; 4.4% versus 4.5%; P0.05, respectively). Compared with patients not receiving statin therapy, the hazard ratio for all-cause mortality during hospital stay was 0.696 (95% CI, 0.394-1.231, P = 0.213). The significant predictors of mortality during follow-up are age, triple-vessel CAD and blood creatinine (Cr) level.Pre-hospital statin therapy did not reduce the risk of mortality or the rates of MACCE during in hospital stay after CABG surgery.

Background: Coronary artery ectasia (CAE) is well-recognized, angiographic finding of abnormal coronary dilatation. The role of inflammation in atherosclerosis is increasingly well known. However, the association between inflammation and CAE has been controversial. Method: Fifty-five patients with CAE and non-obstructive coronary artery disease (CAD), 38 with obstructive CAD, and 33 angiographically normal coronary controls were enrolled in the study. The peripheral blood was taken, and white blood cell count (WBCC) as well as other leukocyte subtypes including neutrophils, lymphocytes, and monocyte cell count (MCC) were measured. The plasma levels of C-reactive protein (CRP) and interleukin-6 (IL-6) were determined by ELISA. Results: The higher number of WBCC, neutrophil and MCC were found in patients with CAE compared with obstructive CAD patients as well as normal controls (p < 0.01, respectively). Moreover, levels of plasma CRP and IL-6 were also significantly higher in patients with CAE than that in patients with obstructive CAD, and subjects without coronary artery disease (p < 0.001, respectively). Univariate analysis showed that the sex, current smoking, numbers of WBCC, neutrophil, MCC, levels of CRP and IL-6 were related with CAE, while MCC was independently linked with a diagnosis of CAE. CRP was the independent variable most strongly associated with CAE by multivariate analysis. Conclusions: Taken together, this study confirmed and expanded previous limited findings that a more significant chronic inflammation might be linked with the pathogenesis of CAE that was associated with not only inflammatory markers but also inflammatory cells in patients with CAE.

Background Social changes and economic development are associated with obesity epidemic. This study is to investigate the trends of socio-economic disparity in obesity from 2002 to 2010 in a Chinese population experiencing the world’s fastest economic development. Methods Four standardized surveys were conducted in a population of 85 million residents in Guangdong, China between 2002 and 2010. Multistage random cluster sampling was used to recruit representative samples. Information on socio-economic status (SES), proxied by education, occupation and residential area, was collected by face-to-face interviews. The weight, height and waist circumference of the participants were also measured. Results Women with low education had an increased BMI of 0.85 kg/m2, while women with high education had a decreased BMI of 0.16 kg/m2 (p = 0.032 for interaction test). Similar trends were observed by using occupation and residential area as the SES indicators. Analysis in men yielded similar patterns. Waist circumference increased from 73.7 to 78.4 cm, and the increasing trends of statistical significance (p

Background Mesenchymal stem cells (MSCs) have been recently demonstrated as a promising stem cell type to rescue damaged myocardium after acute infarction. One of the most important mechanisms underlying their therapeutic effects is the secretion of paracrine factors. However, the expression profile of paracrine factors of MSCs in infarcted hearts, especially at single cell level, is poorly defined. Methods and Results We aimed to depict the transcriptional profile of paracrine factors secreted by MSCs in vivo, with particular interest in the comparison between normal and infarcted hearts. Bone marrow mesenchymal stem cells were isolated and injected into mice hearts immediately after infarction surgery. Bioluminescence imaging (BLI) indicated a proportion of cells still alive even up to 10 days post surgery. Paralleled with survived cells, cardiac function was significantly improved after MSC injection compared to that in PBS-injected mice, indicated by MRI and histology. Despite increased number of vessels in MSC-injected hearts, endothelial cells and cardiomyocytes transdifferentiation were not observed in infarcted hearts 5 days after infarction. Furthermore, laser capture microdissection (LCM) followed by high through-put real time PCR was employed in our study, uncovering that the injected MSCs, compared to local cardiomyocytes, displayed elevated levels of secreted factors. To further investigate the regulation of those factors, we performed single cell analysis to dissect the gene expression profile of MSCs at single cell level in infarcted and normal hearts, respectively. Consistent with the in vivo observation, a similar regulation pattern of those factors was detected in cultured MSCs under hypoxia. Conclusions Our study, for the first time, elucidated gene expression profiles, as well as regulation of paracrine factors, of MSCs at single cell level in vivo, indicating that paracrine factors from MSCs account for the improvement of cardiac function after infarction.

Background and Objective MicroRNAs (miRNAs) have been shown to be associated with various physiological and pathological conditions, including inflammation and cardiovascular disease, but little is known about their relationship with the presence of coronary artery disease (CAD) and disease severity. Methods A total of 195 consecutive subjects who underwent coronary angiography for chest pain evaluation were enrolled in this study. In CAD patients severity of coronary lesions was assessed by the number of diseased vessels and the Synergy between PCI with Taxus and Cardiac surgery score (SYNTAX score). Plasma levels of miRNA-145 were quantified by real-time quantitative polymerase chain reaction test, and logarithmic transformation of miRNA-145 levels (Ln_miRNA-145) was used for analyses due to its skewed distribution. Results Of the 195 total subjects 167 patients were diagnosed as having CAD. Ln_miRNA-145 was significantly lower in CAD patients compared with the non-CAD group (-6.11±0.92 vs. -5.06±1.25; p

The purpose of this study is to compare the effectiveness and safety of cervical disc arthroplasty with anterior cervical discectomy and fusion for treatment of symptomatic cervical disc disease. Anterior cervical discectomy and fusion (ACDF) is the conventional surgical treatment for symptomatic cervical disc disease. Recently, cervical disc arthroplasty (CDA) has been developed to address some of the shortcomings associated with ACDF by preserving function of the motion segment. Controversy still surrounds regarding whether CDA is better. We systematically searched six electronic databases (Medline, Embase, Clinical, Ovid, BIOSIS and Cochrane registry of controlled clinical trials) to identify randomized controlled trials (RCTs) published up to April 2014 in which CDA was compared with ACDF for the treatment of symptomatic cervical disc disease. Effective data were extracted after the assessment of methodological quality of the trials. Then, we performed the meta-analysis. Eighteen relevant RCTs with a total of 4061 patients were included. The results of the meta-analysis indicated that CDA was superior to ACDF regarding better neurological success (P

Ganoderma (G.) is a famous medicinal fungus found in the regions of China, Japan, Korea, and Eastern Russia, and the polysaccharide from G. atrum (PSG) – one of the most important species of Ganodermataceae – has been shown to possess excellent bioactivity. Ultrasonic treatment has been widely used to improve the yield recovery, physicochemical properties and bioactivity of polysaccharides. In order to improve the yield recovery and modify the molecular structure of PSG, the authors employed the ultrasonic technique and assessed its effects on structure, physicochemical properties and antioxidant activity of PSG.

Background Metabolic syndrome (MetSyn) increases the incidence of cardiovascular disease. Information on changes in prevalence of MetSyn in developing countries is limited. This study aims to compare MetSyn prevalence and its associated vascular risk over the period between 2002 and 2010 in a population which has had the world’s fastest economic development over the past three decades. Methods Two health surveys were conducted by using the multistage cluster random sampling method in a Chinese population of 85 million in southern China. The participants received a full medical check-up, including measurement of blood pressure (BP), obesity indices, fasting lipids and glucose levels. Data describing socio-economic status and lifestyle factors were also collected through interview. Metabolic syndrome was defined in accordance with the International Diabetes Federation criteria. Results A total of 3,561 participants from Survey 2010 were included in the data analysis. Women had a significantly higher prevalence of MetSyn than men. Comparison between the two surveys shows that age-standardized prevalence of MetSyn increased fourfold (from 5.4% in 2002 to 21.3% in 2010) in those ≧ 20 years. Among the MetSyn components, prevalence of hyperglycaemia has increased most (from 9.1% to 53.1%). The age-standardized prevalence of central obesity, hypertension, hypertriglyceridaemia and low HDL-cholesterol increased from 13.5% to 25.4%, from 23.6% to 40.8%, from 12.1% to 17.4% and from 32.1% to 71.1%, respectively. Differences between rural and urban residents in the prevalence in MetSyn and its components narrowed in 2010. Conclusions Cardiovascular risk escalated dramatically in this population between 2002 and 2010. The escalation may relate to the rapid economic development, which led to accelerating changes in nutrition, lifestyle, and socio-economic status. Our findings suggest that health transition in rapidly developing second- and third-world countries may be much faster than what has been observed in Western countries., published_or_final_version

Obesity epidemic is related to industrialization and urbanization that have lead to changes in nutrition, lifestyle and socio-economic status. However, information on the trajectory of the obesity epidemic in populations experiencing rapid economic development is limited. We therefore investigate trends in obesity from 2002 to 2010 in a southern Chinese population experiencing world's fastest economic development.Between 2002 and 2010 four standardized surveys were conducted in a population of 85 million residents in Guangdong, China. Multistage cluster sampling was adopted to recruit representative samples. Weight, height and waist circumference of the participants were measured in a standardized way. The analysis included residents aged between 18 and 69 years. The number of participants included in the present analysis for Surveys conducted in 2002, 2004, 2007 and 2010 were 13058, 7646, 6441 and 8575, respectively.From year 2002 to 2010, the age-standardized Body mass index (BMI) insignificantly changed from 21.7 kg m(-2) to 22.3 kg m(-2), and the prevalence of overweight and overall obesity from 15.8 to 16.6% (both P0.05). The age-standardized waist circumference increased from 73.7 to 78.4 cm, and prevalence of abdominal obesity increased from 12.9 to 23.7% (both P0.001). In urban areas, BMI and overall obesity changed little during the 8-year period (BMI increased from 22.6 to 22.7 kg m(-2) and overall obesity changed from 23.7 to 21.4%), whereas there were slight increases of the same in rural areas (BMI increased from 20.8 to 22.1 kg m(-2)and overall obesity increased from 8.2 to 13.3%). Waist circumference and abdominal obesity increased significantly in both areas, but the increase was more pronounced in rural areas (in urban area, waist circumference increased from 75.1 to 78.5 cm and abdominal obesity from 16.8 to 26.5%; in rural area, waist circumference from 72.2 to 78.3 and abdominal obesity from 8.8 to 22.0%).BMI and overall obesity in this population, which has experienced the world's fastest economic development over the past three decades, has been leveling-off, while waist circumference and abdominal obesity, independent predictors of cardiovascular risk, have continued to rise. Our findings suggest that obesity epidemic transition in rapidly developing populations may be much faster than what has been observed in Western countries.

To compare the rates of mortality, myocardial infarction (MI), repeat revascularization and stent thrombosis after percutaneous coronary intervention (PCI) with implantation of stents for diabetics versus nondiabetics with multivessel disease to evaluate the impact of diabetes on long-term clinical outcomes.We consecutively recruited a total of 1985 patients with multivessel disease at our institution from July 2003 to December 2005. And they were divided into two groups of diabetes (n = 587) or non-diabetes (n = 1398). The primary endpoint was all-cause mortality at 24 months.After adjusting with Logistic regression, the risk of mortality in the diabetics was significantly higher than that in the nondiabetics (4.4% vs 2.0%, hazard ratio [HR] 1.83, 95% confidence interval [CI] 1.02 to 3.67, P = 0.021). Similar outcome was also found in the adjusted risk of cardiac mortality (2.7% vs 1.1%, HR = 2.04, 95%CI 1.12 to 3.89, P = 0.032) at 24 months, although the adjusted risk of nonfatal MI and repeat revascularization was similar. However, diabetes significantly increased the risk of stent thrombosis. The major adverse cardiac event (MACE) rate was also lower in the nondiabetics (15.8% vs 11.9%, HR = 1.52, 95%CI 1.12 to 1.89, P = 0.043).In patients with multivessel disease, diabetes is correlated with increase risks of mortality, stent thrombosis and MACE at long-term follow-up compared with non-diabetes.

To investigate the number of drinking occasions per day and average amount consumed per drinking occasion of primary and middle school students in four cities of China, and understand the relationship among drinking occasion, average amount consumed per drinking occasion and total drinking water.A total of 5914 primary and middle school students from Beijing, Shanghai, Guangzhou and Chengdu were selected using multiple-stage random sampling method, and 5868 students completed the study from September to October in 2011. The detailed information of amounts and types of daily drinking water was recorded by subjects using a 24 hours measurement for seven consecutive days. Analysis of the relationship among drinking occasion, average amount consumed per drinking occasion and total drinking water was carried out.The daily total drinking water of subjects was (1089 ± 540) ml; the daily number of drinking occasions was (4.7 ± 1.8) times, with 79.1% (4639/5868) of subjects reporting 6 or less drinking occasions. The amount consumed per drinking occasion was (239 ± 96) ml, plain water (231 ± 112) ml, and beverages (237 ± 112) ml. The number of drinking occasions of subjects was positively correlated with total drinking water (r = 0.614, P0.05), and negatively correlated with the average amount consumed per drinking occasion (r = -0.211, P0.05). Total drinking water and the average amount consumed per drinking occasion was positively correlated (r = 0.598, P0.05).The number of drinking occasion of primary and middle school students more than 6 times was fewer in four cities of China, but the average amount of beverages consumed per drinking occasion was relatively more. With the increasing of drinking occasion, the average amount consumed per drinking occasion decreased, but total drinking water increased.

Background: We evaluated the relationship between pregnancy-associated plasma protein-A (PAPP-A) and coronary plaque instability as assessed by intravascular ultrasound (IVUS). Methods: We performed greyscale IVUS analysis in culprit lesions of 93 patients with unstable angina (UA) and 72 with stable angina (SA). A sandwich enzyme-linked immunosorbent assay technique was used to assay circulating PAPP-A. Results: Patients with UA had higher PAPP-A levels than those with SA 10.8 mIU/l [interquartile range (IQR) 8.3-14.4] vs. 5.4 (IQR 2.9-9.8) mIU/l, p < 0.001]. Lesions in patients with higher PAPP-A levels were associated with larger plaque burden than lesions in patients with lower PAPP-A levels. IVUS attenuated plaque, positive remodeling and plaque rupture. Thrombus and angiographic Ambrose type-II eccentric lesions or multiple irregularities were more common in patients with higher PAPP-A levels than in those with lower PAPP-A levels. They were also more common in patients with UA and higher PAPP-A levels than in patients with (1) SA and higher PAPP-A levels, (2) UA and lower PAPP-A levels or (3) SA and lower PAPP-A levels. Conclusions: Higher PAPP-A levels were associated with coronary plaque instability in vivo and unstable symptoms in patients with coronary artery disease.

The optimal revascularization strategy in patients with heart failure with preserved ejection fraction (HFPEF) remains unclear. The aim of the present study was to compare the effects of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in patients with HFPEF.From July 2003 through September 2005, a total of 920 patients with coronary artery disease (CAD) and HFPEF (ejection fraction ≥ 50%) underwent PCI (n = 350) or CABG (n = 570). We compared the groups with respect to the primary outcome of mortality, and the secondary outcomes of main adverse cardiac and cerebral vascular events (MACCE), including death, myocardial infarction, stroke and repeat revascularization, at a median follow-up of 543 days.In-hospital mortality was significantly lower in the PCI group than in the CABG group (0.3% vs. 2.5%, adjusted P = 0.016). During follow-up, there was no significant difference in the two groups with regard to mortality rates (2.3% vs. 3.5%, adjusted P = 0.423). Patients receiving PCI had higher MACCE rates as compared with patients receiving CABG (13.4% vs. 4.0%, adjusted P0.001), mainly due to higher rate of repeat revascularization (adjusted P0.001). Independent predictors of mortality were age, New York Heart Association (NYHA) class and chronic total occlusion.Among patients with CAD and HFPEF, PCI was shown to be as good as CABG with respect to the mortality rate, although there was a higher rate of repeat revascularization in patients undergoing PCI.

To explore the prevalence of weight misperception and related influencing factors among adult residents in Guangdong province so as to provide information for prevention and control on weight misperception.A multi-stage stratified random sampling method was used to select the sample. Forty-two streets/villages were selected from 21 counties/districts through randomly sampling. Four communities were then chosen from every selected town or district, followed by 40 families chosen from every village or community. Questionnaire was used to collect data on weight perception and its related risk factors. SPSS 16.0 was used for data analysis.There were 6625 respondents participating in the study. Out of them, 50.2% participants misperceived their weight status, among which 35.9% of them underestimated while 14.3% overestimated their weights. Females aged 15 - 24 were more likely to overestimate weights than males in the same age group (38.6% vs. 18.5%), while males were more likely to underestimate weights than females (25.8% vs. 8.5%). The prevalence of underestimation on weights increased with the increase of age in both males and females but the prevalence of overestimation on weights decreased. Data from multivariate results from logistic analysis showed that rural residents, males, being elderly, residents with low education level, manual occupations (agriculture, forestry, animal husbandry and fishery), low family income and with anxiety were the major risk factors on underestimation of weight. However, factors as being urban residents, females, adolescents, minority and never having received weight measurement etc. were the major risk factors of overestimated on weight.Misperceptions of weight status in Guangdong province exhibited a high prevalence with complicated influencing factors, calling for more psychological research to be carried out to prevent and reduce the misperceptions on weight status.

To compare the short- and long-term outcomes of percutaneous coronary intervention versus coronary artery bypass grafting in patients with severe left ventricular dilatation (LVD).From July 2003 to September 2005, we enrolled 251 patients with severe LVD to undergo coronary revascularization with either PCI (n = 101) or CABG (n = 150) and analyzed the effects of different revascularization strategies on the in-hospital and follow-up major adverse cardiovascular and cerebrovascular events (MACCE).Compared with those in the CABG group, the patients in the PCI group had lower incidence of in-hospital MACCE events [3.0% (3/101) vs 10.7% (16/150), P = 0.024], due mainly to a lower in-hospital mortality (2.0%vs 8.7%, P = 0.028). Ninety-nine (98.0%) patients in the PCI group and 136 (90.7%) patients in the CABG group were followed up for (516 ± 182) days and (515 ± 231) days, respectively. Although no difference existed in the follow-up incidence of MACCE between two groups, the PCI patients had a trend of a higher incidence of MACCE events [18.2% (18/99) vs 9.6% (13/136), P = 0.054], due mainly to a higher rate of repeat revascularization [14 (14.1%) vs (0.7%), P0.01]. Two patients groups had the comparable follow-up rates of mortality [4 (4.0%) vs 12 (8.8%), P = 0.151], myocardial infarction [2 (2.0%) vs 1 (0.7%), P = 0.781] and stroke [2 (2.0%) vs 0 (0.0%), P = 0.176].For the patients with severe LVD. PCI is both safe and feasible. And it has a lower rate of in-hospital mortality, and a comparable incidence of follow-up MACCE events. However, the rate of follow-up repeat revascularization is higher.

BackgroundThe American Diabetes Association and World Health Organization have recently adopted the HbA1c measurement as one method of diagnostic criteria for diabetes. The change in diagnostic criteria has important implications for diabetes treatment and prevention. We therefore investigate diabetes using HbA1c and glucose criteria together, and assess the prevalent trend in a developing southern Chinese population with 85 million residents.MethodsA stratified multistage random sampling method was applied and a representative sample of 3590 residents 18 years of age or above was obtained in 2010. Each participant received a full medical check-up, including measurement of fasting plasma glucose, 2-hour post-load plasma glucose, and HbA1c. Information on history of diagnosis and treatment of diabetes was collected. The prevalence of diabetes obtained from the present survey was compared with the data from the survey in 2002.ResultsThe prevalence of diabetes based on both glucose and HbA1c measurements was 21.7% (95% CI: 17.4%-26.1%) in 2010, which suggests that more than 1 in 5 adult residents were suffering from diabetes in this developing population. Only 12.9% (95% CI: 8.3%-17.6%) of diabetic residents were aware of their condition. The prevalence of pre-diabetes was 66.3% (95% CI: 62.7%-69.8%). The prevalence of diabetes and pre-diabetes which met all the three diagnostic thresholds (fast plasma glucose, 2 hour post-load plasma glucose, and HbA1c) was 3.1% and 5.2%, respectively. Diabetes and pre-diabetes as determined by HbA1c measurement had higher vascular risk than those determined by glucose levels. The prevalence of diabetes increased from 2.9% (95% CI: 2.0%-3.7%) in 2002 to 13.8% (95% CI: 10.2%-17.3%) in 2010 based on the same glucose criteria.ConclusionsOur results show that the diabetes epidemic is accelerating in China. The awareness of diabetes is extremely low. The glucose test and HbA1c measurement should be used together to increase detection of diabetes and pre-diabetes.

Background The metabolic syndrome has been shown to increase the incidence of cardiovascular disease. Little information exists on the prevalence of the metabolic syndrome for southern Chinese. We therefore investigate the prevalence of the metabolic syndrome in a southern Chinese population with 85 million residents. Methods The Guangdong Nutrition and Health Survey 2002 is a cross-sectional survey designed to assess the health and nutritional status of 85 million residents in Guangdong province located in southern China. Stratified multistage random sampling method was applied in this survey and a provincial representative sample of 6,468 residents aged 20 years or above was obtained in the present study. The participants received a full medical check-up including measurement of blood pressure, obesity indices, fasting lipids and glucose levels. Data describing socioeconomic and lifestyle factors was also collected through interview. Metabolic syndrome was defined in accordance with the International Diabetes Federation criteria. Results The prevalence of metabolic syndrome was 7.30%, translating into a total of 4.0 million residents aged 20 years or above having the condition in this southern Chinese population. The urban population had higher prevalence of the syndrome than the rural population (10.57% vs 4.30%). Females had a higher prevalence of metabolic syndrome than males (8.99% vs 5.27%). More than 60% of the adults had at least one component of the metabolic syndrome. Conclusions Our results indicate that a large proportion of southern Chinese adults have the metabolic syndrome and associated risk factors. The metabolic syndrome has become an important public health problem in China. These findings emphasize the urgent need to develop population level strategies for the prevention, detection, and treatment of cardiovascular risk in China.

To explore the relationship between distorted weight perception and suicide ideation among normal weight adolescents in Guangdong province.This study used the data of Guangdong Provincial Youth Health Risk Behavior Survey in 2004 and 2007. To identify the association between distorted weight perception and suicide ideation, a logistic regression analysis was performed. The effects of age, economic status, mother's education, mental health, and depression were also adjusted.A total of 12 729 people participated in this study, 6096 males and 6633 females. The prevalence of suicide ideation among normal weight adolescents was 13.58% (1729/12 729) in the past 12 months, with higher prevalence in girls (16.15%, 1071/6633) than that in boys (10.79%, 658/6096) (χ(2) = 77.71, P = 0.00). It was common that the adolescents misperceived their weight. Only 44.93% (5719/12 729) of normal weight students correctly perceived their body weight while 43.52% (5540/12 729) of them overestimated their weight and 11.43% (1455/12 729) underestimated their weight. The distorted weight perception in girls (65.58%, 4350/6633) was higher than that in boys (43.39%, 2645/6096) (χ(2) = 993.91, P = 0.00). Distorted weight perception was significantly associated with suicide ideation after controlling for factors age, economic status, mother's education, mental health, and depression. The students who overestimate their body weight were more likely to have suicide ideation than that who correctly perceived their weight (OR = 1.43, 95%CI: 1.27 - 1.61).The prevalence of distorted weight perception was high and it significantly associated with suicide ideation.

To investigate the water intake sources of adults in the four cities of China in summer.A total of 64 adults aged 18 - 60 yrs from the four cities (Beijing, Shanghai, Chengdu and Guangzhou) were selected using convenient sampling method. The information on amounts and types of daily drinking water was recorded by subjects for three consecutive days using a quantitative measurement. The food samples were collected by using duplicate portion method and the water content of food samples were determined.The median of daily total water intake of 63 subjects was 3045 ml, while daily total drinking water was 1600 ml, the median ratio of which accounting for 55.8% of total water intake. Water from food was 1157 ml, the median ratio of which accounting for 41.4% of total water intake. The median of daily total water intake (3566 ml) and the ratio of water from food (55.3%) of subjects in Chengdu was significantly higher than subjects in Guangzhou (2929 ml, 45.4%), Shanghai (2748 ml, 33.1%) and Beijing (2743 ml, 31.3%) (daily total water intake: χ² = 10.42, P = 0.015;the proportion of water: χ² = 28.48, P0.01). Daily total water intake in men (3302 ml) was significantly higher than that in women (2900 ml) (Z = 2.35, P = 0.019).Daily total water intake of subjects in summer was more than the current Chinese recommended total water intake (2200 ml), with the main part of drinking water and water from food.

This study is to explore the effects of quercetin (QUE) on the 3 week-old mice ovarian development and relative hormone levels. The 3 week-old mice were exposed to QUE (45, 25, and 5 mg x kg(-1) x hd(-1)) by gavage for 50 days. The estrous cycle during 50 days and the changes of hormone level such as FSH, LH, etc were monitored. Moreover, the ovaries were removed after sacrifice. The organ index was measured, and the ratios of different stages of follicles were analyzed by HE staining. Furthermore, the proportion of PCNA positive cells during all stages was detected by immunohistochemistry. The results showed that QUE could increase body weight of mice and reduce the anogenital distance (AGD) to some extent, and was able to disrupt mice's estrous cycle, but it could not extend or reduce the cycle regularity. It increased ovarian organ index with a dose-dependent manner. The proportion of the primordial follicle and secondary follicles rose obviously, and that of mature follicles', atretic follicles' and corpus luteums' reduced, while primordial follicle had no change. Immunohistochemistry analysis showed that QUE could effectively increase the percentage of proliferating cells in all kinds of follicles. Serum hormone assay showed that there were significant changes of FSH and LH levels. In summary, QUE showed an estrogen-like effect on mice's ovarian development. The weight of ovary, the proportion of all kinds of follicles, the development of ovarian cells and the level of plasma hormone in mice were altered obviously by oral administration of QUE.

To evaluate short-term and long-term prognosis of revascularization in patients with acute coronary syndrome.A total of 6005 patients who received coronary revascularization in our institution between July 2003 and September 2005 were enrolled. The patients were followed up in clinic or by telephone after discharge between September 2006 and November 2006. The clinical and prognosis data of all-cause mortality, neo-myocardial infarction, nonfatal stroke, and re-revascularization of ST-segment elevation myocardial infarction (STEMI), non ST-segment elevation myocardial infarction (NSTEMI) and major adverse cardiovascular and cerebrovascular events (MACCE) were analyzed.Among 4865 acute coronary syndrome patients, 955 cases were STEMI; 263 cases were NSTEMI; and 3647 cases were unstable angina (UA) pectoris. There were no significant difference for in-hospital mortality and late mortality (18 month survival 96%, 98% and 98%) between patients with STEMI, NSTEMI and UA. Patients with UA had lower MACCE rate (18 month non-MACCE survival of STEMI, NSTEMI and UA group were 86%, 86%, and 89% respectively).Despite different clinical characteristics, patients with STEMI, NSTEMI and UA undergoing revascularization had similar short-term and long-term mortality. Patients with UA had lower MACCE rate.

The coronary slow flow phenomenon (CSFP) is an important, angiographic entity characterized by delayed progression of the injected contrast medium through the coronary tree. It is a frequent finding, typically observed in patients presenting with acute coronary syndromes. Although it is well known to interventional cardiologists for approximately four decades, the pathogenic mechanisms remain unclear. The clinical implications are significant, with over 80% of patients experiencing recurrent chest pain, resulting in considerable impairment in quality of life. This article will address in detail the characteristics, possible mechanisms, and clinical implications of this entity to provide further insight into its clinical significance and management strategies.

To compare the magnitude of inequities in health-related behaviors among males in Guangdong province, and to investigate the extent of the disparities.Data sets available from the Guangdong Chronic Diseases and Risk Factors Survey 2007 are used. Concentration index (C) and concentration curve are employed to measure the differential of males' health-related behaviors across urban and rural areas in Guangdong. Odds ratios of 6 health-related behaviors among different areas are derived from 4 logistic models, after adjusting for age, married state, educational status, occupation and income.Results from Cs reveal that the inequality gradients disadvantageous to men in rural areas are:smoking (C = -0.075, P = 0.000), alcohol intake (C = -0.023, P = 0.002), blood pressure (C = 0.106, P = 0.000), blood sugar (C = 0.114, P = 0.000) and weight (C = 0.107, P = 0.000), while lack of physical activity (C = 0.044, P = 0.000)concentrates in the more affluent areas. The magnitudes of these inequalities appear to be higher on health-seeking behaviors than on health-risk behaviors. After adjusting for age and marital status, there is still strong evidence showing the rural-urban differences in the health related behaviors among males in Guangdong province. When educational status, occupation and income are added to the logistic model as control factors, the results have led to a loss of statistical significance on such rural-urban inequalities, indicating that socioeconomic factors play an important role on these health-related behaviors which leads to the inequalities among males in Guangdong province.To reduce the gaps in health-related behaviors seen in the rural and urban areas, effective policies should be developed to change the social determinants of rural-urban differences in health and to strengthen the implementation of health-related programs on those vulnerable groups.

The prevalence of cardiovascular risk factors is growing. People with metabolic syndrome (MS) plus five cardiovascular risk factors are at a higher risk of developing coronary artery disease (CAD). The effect of metabolic syndrome on outcomes in patients with preexisting CAD has not been well studied. The present study was conducted to assess the prevalence, characteristics and long-term prognosis of CAD with metabolic syndrome and to determine which factor is the most influential prognostic factor of CAD.The DESIRE (drug-eluting stent impact on revascularization) registry represented a database of 2368 CAD patients between July 2003 and September 2004. The median long-term follow-up was 3.5 years (293 -1855 days). Metabolic syndrome was based on the modified version of Adult Treatment Panel (ATP) III Definition of Metabolic Syndrome in 2005 using body mass index (BMI) instead of waist circumference. We tested the utility of MS and its components to predict the incidence of major adverse cardiac and cerebral events (MACCE) in a large cohort of patients undergoing revascularization.The presence of MACCE was predicted only by MS (OR = 1.319, 95% CI 1.020 - 1.706, P = 0.035) but not other cardiovascular risk factors, such as advance age, male, smoking, high LDL cholesterol and CAD family history. MS was present in 45.6% (high fasting glucose 44.5%; high triglyceride 45.0%; low HDL 50.8%; high blood pressure 61.4%; high BMI 60.7%).Among the traditional cardiovascular risk factors, only metabolic syndrome has a primary predictive ability for MACCE in CAD patients.

C-reactive protein (CRP) is a lowly expressed marker for inflammatory response. This study aimed to evaluate the prognostic value of baseline CRP levels in patients undergoing coronary revascularization in the context of modern medical treatment.This was a retrospective study in a single center. Four hundred and fourteen patients were enrolled, who underwent coronary revascularization and received adequate medication for secondary prevention of coronary heart disease. The study compared the follow-up clinical outcomes between high level CRP group (CRP5 mg/L) and low level one. The median follow-up time was 551 days.Compared with low CRP group, the relative risk (RR) of the major adverse cardiovascular and cerebral events (MACCE) in high CRP group was 5.131 (95%CI: 1.864-14.123, P = 0.002). There were no significant differences in death, myocardial infarction and stroke during the follow-up between two groups, but a higher risk of re-revascularization was found in high CRP group (RR 6.008, 95%CI: 1.667-21.665, P = 0.006). Cox regression analysis showed that only CRP level could contribute to MACCE during the follow-up. MACCE-free rate was much lower in high CRP group (Kaplan-Meier log-rank P0.001).In the context of modern medical treatment, the baseline level of CRP is an independent predictor for long-term prognosis in patients with coronary revascularization.

To determine the impact of BMI on clinical outcome in patients with heart failure underwent coronary revascularization.The DESIRE-plus (Drug-Eluting Stent Impact on Revascularization-plus) was a single-center registry of coronary revascularization in our institution between July 1, 2004 and September 30, 2005. We analyzed heart failure patients with the complete data of body mass index (BMI) data from the DESIRE-plus trial and grouped them by BMI (normal BMI group, BMI24; overweight group, BMI 24-27.9; obesity group, BMIor = 28). Total mortality, cardiac mortality and MACCE including death, neo-myocardial infarction, stroke, re-revascularization were recorded. We evaluated risk estimates for three bodyweight groups.1010 patients were included in the study (295 in normal BMI group; 495 in overweight group and 220 obesity group). Median follow-up was 542 days. Overweight and obese patients were younger (59.3 +/- 10.14 years, 58.6 +/- 10.30 years vs 62.6 +/- 9.93 years, P0.01) and had a significantly higher incidence of hypertension (61.2, 66.8% vs 52.5%, P = 0.017), stable angina pectoris (21.2%, 23.7% vs 17.0%, P = 0.05) and higher triglyceride [(1.90 +/- 1.05) mmol/L, (2.10 +/- 1.12) mmol/L vs (1.48 +/- 0.92) mmol/L, P0.01)], fasting blood glucose level [(6.07 +/- 2.09) mmol/L, (5.96 +/- 1.53) mmol/L vs (5.67 +/- 1.92) mmol/L, P = 0.021), blood creatinine (84.9 +/- 21.7) micromol/L, (90.2 +/- 30.9) micromol/L vs (82.2 +/- 25.8) micromol/L, P = 0.002] compared with normal BMI patients. Multivariate Cox regression model showed obese patients had an decreased hazard risk (HR) for total mortality (0.285, 95%CI 0.104 - 0.777) and MACCE (0.596, 95%CI 0.401 - 0.885) compared with those for patients with normal BMI, overweight patients had no increased risk for total mortality (HR 0.769, 95%CI 0.442 - 1.338) and MACCE (0.998, 95%CI 0.754 - 1.322), there was hardly any significantly difference in cardiac mortality between three groups (P = 0.223).There were more risk factors in heart failure patients with coronary heart disease complicated with obesity or overweight, but the prognosis after revascularization of them is at least no worse than the normal weight coronary heart disease patients.

To understand the prevalence of suicide attempts and its related risk factors in Guangdong province to provide scientific basis information for suicide intervention.Multi-stage stratified random sampling method was used to select the sample. 42 streets or towns were selected from 21 counties or districts through randomly sampling. 4 communities were then chosen from every selected town or district, followed by 40 families chosen from every village or community. Questionnaire was used to collect data on suicide attempts and its related risk factors. SPSS 16.0 was used for data analysis.6625 peoples were participated in the study. The 12-month incidence of suicidal attempts was 0.8%. It was higher for females (1.1%) than that for males (0.5%), and the 25 - 35 years (1.6%) age group was among the highest. There was no significant difference between the prevalence rates in urban or rural residents.from multivariate analysis showed that factors as: being female (OR = 2.1), experienced negative events of life (OR = 15.5), in poor sleeping condition (OR = 1.6), feeling lonely (OR = 1.5) and anxiety (OR = 1.8) were high risk for suicide attempts.Suicide attempts in Guangdong province exhibited a high prevalence with complicated influencing factors. Comprehensive countermeasures are needed to prevent and reduce suicidal behaviors.

Herba Moslae is a well-known edible and medicinal plant in China, and the essential oil, which is assumed to contain the active components, was isolated by steam distillation method. The aim of this study was to investigate the antimicrobial activity and the antioxidant activity of the essential oil from Herba Moslae.The essential oil from Herba Moslae exhibited antimicrobial activity against all of the tested bacteria and fungi. The minimum inhibitory concentration (MIC) values for bacteria ranged from 118 to 472 microg mL(-1), and the minimum bactericidal concentration (MBC) values were from 236 to 944 microg mL(-1). The oil showed pronounced antibacterial and antifungal activity against Staphylococcus aureus and Aspergillus oryzae, but weak inhibition to Escherichia coli. The antioxidant activity of the essential oil from Herba Moslae was evaluated by using DPPH radical scavenging assay, beta-carotene/linoleic acid bleaching assay and metal chelating activity assay. In addition, the amount of total phenolic content in the oil (386 +/- 1 microg kg(-1)) was determined.This study suggests that the essential oil from Herba Moslae could be potentially used as a new potential source of natural antimicrobial, antioxidants and antiputrefactive in food industry.

Cyclocarya paliurus (Batal.) Iljinskaja is a well-known edible and medicinal plant in China and is commonly called the 'sweet tea tree'. It has been reported to have a broad range of therapeutic and nutritional values in lowering blood sugar, blood lipids and blood pressure. However, much of the annual C. paliurus production is wasted. Recent reports have suggested that polysaccharides are the main active ingredients responsible for the observed bioactivities of C. paliurus. In this study, response surface methodology was used to determine the optimal conditions for microwave-assisted extraction (MAE) of polysaccharides from C. paliurus.The optimal conditions for MAE of polysaccharides were a duration of microwave radiation of 20.8 min, a temperature of 100.9 degrees C and a water/material ratio of 22.1:1. Under these conditions the yield of polysaccharides was up to 5.04 +/- 0.09%. Compared with conventional heat reflux extraction and ultrasound-assisted extraction, MAE of polysaccharides from C. paliurus (Batal.) Iljinskaja saved a lot of time and gave the highest yield.The present study suggests that MAE is a good alternative method for the extraction of polysaccharides from C. paliurus (Batal.) Iljinskaja.

A water-soluble polysaccharide from the seeds of Plantago asiatica L. (P. asiatica L. polysaccharide, PLP) was extracted with hot water and purified by gel filtration chromatography. The chemical characteristics of PLP were determined by high-performance gel permeation chromatography (HPGPC) and Fourier transform infrared (FTIR) spectroscopy. In addition, the antioxidant activities of PLP in vitro were evaluated using various test systems, including scavenging of 1,1-diphenyl-2-picryl-hydrazyl (DPPH) radicals, scavenging of superoxide radicals generated by 1,2,3-phentriol autoxidation, scavenging of hydroxyl radicals and inhibition of lipid peroxidation.The molecular weight of PLP was determined by HPGPC to be about 1894 kDa. PLP contained 29.2 g kg(-1) protein and 145.8 g kg(-1) uronic acid. The FTIR spectrum of PLP also revealed typical characteristics of a polysaccharide containing protein and uronic acid. Moreover, the results showed that PLP possessed antioxidant activities, but lower than those of ascorbic acid.PLP is an acid protein-bound polysaccharide of high molecular weight, but its structure needs further study. The present results suggest that PLP could potentially be used as a natural antioxidant.

To evaluate the outcome of health education program on drowning prevention among primary and secondary school children in rural areas.A township was selected and all the students from grade 3 to 5, grade 7 to 8, and grade 10 to 11 were selected to take part in the program. Twelve intervention measures on natural water safety and drowning prevention were carried out for one year. Information was collected using the same questionnaire before and after the intervention program.One year after the intervention was carried out, children's knowledge on drowning prevention improved significantly (13.21, 95%CI: 12.51 - 13.90), and a positive effect was also noticed among boys (12.77, 95%CI: 11.77 - 13.77), girls (13.80, 95%CI: 12.82 - 14.78), and among primary school children(15.51, 95%CI: 14.30 - 16.72), senior high school children (10.78, 95%CI: 9.50 - 12.05) and junior high school children (12.77, 95%CI: 11.84 - 13.71). Overall rates on risk behaviors dropped from 41.4% to 32.2% (by 22.2%) including 15.6% for boys, 35.2% for girls and 13.8%, 29.3%, 26.3% for primary school children, senior high school children, junior high school children, respectively. The incidence rates for non-fatal drowning decreased by 58.9% (from 5.6% to 2.3%). The person-times for treatment on sight, in emergency settings, in outpatient clinic or in the hospitals had a reduction from 399, 78, 36 to 175, 32, 14, respectively.Health education program could improve children's perception on water safety, and reduce their risk behaviors as well as on the incidence of non-fatal drowning in the rural areas.

To assess whether chronic renal insufficiency and anemia are significant independent and combined predictors of poor long-term outcomes after percutaneous coronary intervention (PCI).We examined the clinical and outcome data of 3770 PCI patients based on the pre-PCI values of glomerular filtration rate (GFR) and hemoglobin (Hb). Depending on their baseline GFR and Hb, the patients were classified into six groups: normal renal function with anemia or not; mild renal impairment with combined anemia or not; severe renal insufficiency with anemia or not. The clinical features and prognosis of patients were compared.Significant differences were found between the groups regarding female gender, age, body mass index, prior history of hypertension, diabetes mellitus, prior stroke, acute coronary syndrome, systolic blood pressure, left ventricular ejection fraction, total serum cholesterol, LDL-C and angiographic features (P0. 01). When evaluated as continuous variables, GFR and Hb were independent predictors of long-term mortality after adjusting for effects of each other (GFR: HR 0.979, 95% CI 0.960-0.999, P = 0.035; Hemoglobin: HR 0.952, 95% CI 0.921-0.984, P = 0.004). Mild renal insufficiency with anemia (HR 4.123, 95% CI 1.637-10.386, P = 0.003), severe renal insufficiency without anemia (HR 5.287, 95% CI 1.627-17.183, P = 0. 006) and severe renal insufficiency with anemia (HR 7.134, 95% CI 2.180-23.342, P = 0.001) having a statistically significant decrease in survival in patients undergoing PCI .Renal insufficiency and anemia are significant independent and combined predictors of long-term mortality in patients undergoing PCI.

In the present study, the contents of eighteen inorganic elements such as Ca, K, Mg, Cu, Cr, Zn and Sr in oleum camelliae during different stages of refining process were determined using ICP-AES technique. The recoveries obtained by the standard addition method ranged between 82.7% and 112.5%, and RSDs were lower than 6.66%. The detection limits of the method for the eighteen elements were in the range of 0.4-10 microg x L(-1). The experimental results proved that oleum camelliae is rich in inorganic elements. The results also showed that depending on the intensity of refining, the contents of elements will decrease accordingly. After the degumming process, the contents of elements P, Ca and Mg in oleum camelliae declined remarkably. Besides, the contents of some trace elements such as Fe, Cu, Mn and Ni that cause oxidation to occur decreased significantly after refining. In addition, Pb was not detected after the degumming and deacidification process while Co and Cd were not detected both in the crude oil and the refined oil. In conclusion, through refining many excessive metal elements in oleum camelliae were removed effectively and the levels of these elements were able to meet the national standards set by the government. Meanwhile, the experimental results indicated that the ICP-AES technique, which can be used to determine the inorganic elements in oleum camelliae, is easy to operate, rapid, accurate, and highly sensitive, and can also determine many elements simultaneously.

Background Studies comparing coronary artery bypass grafting (CABG) with drug-eluting stent (DES) for the treatment of diabetic patients with multivessel disease are relatively scarce although controversies exist concerning the relative efficacy of CABG versus DES. Hypothesis The aim of this study was to evaluate the effect of drug-eluting stent (DES) implantation in diabetic patients with multivessel disease compared with CABG. Methods We included 645 consecutive diabetic patients who underwent either CABG (n = 282) or DES implantation (n = 363) in our institution from July 2003 to December 2005. Results At 12 mo after index revascularization procedure, the total mortality rate was similar in the CABG and DES group (3.2% versus 3.0%, hazard ratio [HR] of CABG versus percutaneous coronary intervention [PCI] 0.58, 95% confidence interval [CI]: 0.14 to 2.45, p = 0.460), but the rate of major adverse cardiac cerebrovascular events was lower in the CABG group (7.8% versus 17.9%, HR: 0.15, 95% CI: 0.06 to 0.37, p < 0.001) mainly due to less repeat revascularization with CABG (1.4% versus 11.6%, HR: 0.02, 95% CI: 0.01 to 0.13, p < 0.001). Age, 3-vessel disease, and serum creatinine ≥1.5 mg/dl were positive independent predictors of 12 mo death. Conclusions At 12 mo, CABG was associated with less adverse events primarily due to less repeat revascularization compared with DES although there was no significant difference in mortality and myocardial infarction (MI) rates between the 2 groups; high repeat revascularization rate related to DES resulted from high restenosis rate in diabetic patients and lower rate of complete revascularization offered by PCI. Copyright © 2009 Wiley Periodicals, Inc.

This study determined the profile of renal insufficiency in patients without chronic kidney disease (CKD) undergoing coronary revascularization and elucidated the effect of renal insufficiency of different degrees on clinical outcomes after revascularization and examined whether the reasonable choice of the mode of revascularization could favourably influence prognosis.Patients undergoing coronary revascularization were grouped by estimated creatinine clearance (CrCl) (Group I, CrClor = 90 ml/min; Group II, 60or = CrCl90 ml/min; Group III, 30or = CrCl60 ml/min; Group IV, CrCl30 ml/min). We evaluated the relationship between the CrCl and the clinical outcomes of all of the patients.The mean Scr level of 2896 patients was (80.0 +/- 35.4) micromol/L. There were 1035 patients (35.7%) in Group I, 1337 patients (46.2%) in Group II, 524 patients (18.1%) in Group III and no patient in Group IV. During hospitalization, significant difference was found among Group I-III on mortality (1.0%, 2.5% and 2.9%, P = 0.009) and major adverse cardiac cerebra events (MACCE) (1.4%, 3.5% and 4.6%, P = 0.001). Compared with the normal renal function group, there were significantly higher rate of mortality (2.5% vs. 1.0%, P = 0.007), new-onset myocardial infarction (1.0% vs. 0.2%, P = 0.018) and MACCE (3.5% vs. 1.4%, P = 0.002) in mild renal insufficiency (Grou II). During follow-up, there were significant difference among Group I-III on mortality (2.0%, 3.0% and 5.7%, P = 0.002), stroke (1.0%, 1.8% and 3.1%, P = 0.023) and MACCE (9.9%, 10.3% and 16.6%, P = 0.001). The independent risk factors for all-cause death in patients after revascularization were the mode of revascularization (OR 8.332, 95%CI 2.386 - 22.869, P = 0.001), age (OR 1.184, 95%CI 1.020 - 1.246, P = 0.001), and the level of CrCl (OR 0.503, 95%CI 0.186 - 0.988, P = 0.045). In patients with normal renal function and mild renal insufficiency, the all-cause mortality after PCI was significantly lower that than after CABG (both P0.01).Renal insufficiency is common in patients without CKD undergoing coronary revascularization, even mild renal insufficiency is correlated with adverse clinical outcomes after revascularization. In patients with normal renal function or mild renal insufficiency, the mode of revascularization might lead to a prognostic difference.

To understand the incidence and characteristics of nonfatal drowning among primary and middle school students in rural area and to provide basic information for intervention.A rural town was selected and all students from 3th-8th grades, 10th grade and 11th grade were studied. All data were collected, using a self-administrated questionnaires which was guided by investigator.The overall incidence rate of nonfatal drowning was 5.65% (549/9732) and were 7.69%, 5.80%, 2.39% for primary, secondary and high school students, respectively. Male students had a higher rate (7.14%) than that of females (4.03%). The incidence rates of non-treated, treated in emergency and under hospitalization were 4.52%, 0.77% and 0.35%. The major reasons of drowning were swimming (46.88%), falling into waters (15.67%), diving (13.79%) and rescuing others (6.24%). The proportion of drowning occurred in the afternoon, evening, at noon or in the morning were 59.94%, 15.64%, 14.77% and 9.65% respectively. The common sites of drowning were river/lake (42.48%), swimming pool (19.56%), reservoir (11.39%) and pond (4.38%). 66.76% of the drowning cases were witnessed by other person, and 17.86% were conscious when being removed from waters.The incidence of nonfatal drowning among students in rural areas was high, and the natural body of waters was the most common site causing drowning while swimming was the major reason of drowning. Intervention targeting on primary and middle school students in rural should be carried out to reduce the incidence.