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Objective: To illustrate the developmental process and the morphological characteristics of myodural bridge (MDB) in human and SD rats, provide the developmental morphological basis for further MDB functional studies. Methods: In this study, histological section and immunohistochemical staining, scanning electron microscope(SEM) and transmission electron microscopy(TEM) were used to study the MDB of of human fetus and SD rat embryos(E), choroid plexus and arachnoid granules of SD rat embryos(E). Results: The MDB appeared at E15w, completed about at E19-25w in humans, appeared at E18d and completed at about 7d after birth in rats. The tissue differentiation of rat embryos and human fetuses is similar. Cells differentiated from mesenchymal cells to fibroblasts and fibroblasts, followed by the maturing of type I collagen fibers. TEM shows that mesenchymal cells differentiate into fibroblasts at E14d, and collagen fibers appear in the extracellular matrix at E17d of rats. SEM shows that secreted vesicles appeared on the epithelial surface of choroid plexus after E16d of rats, and arachnoid granules appeared in the transverse sinus 3d after birth in rats. Damaging the suboccipital region on P0 newborn rat, the height of microvilli, secretory granule and on the surface of the choroid plexus epithelium cell were more than the control group at postoperative 3, 5, 7 weeks. Conclusion: Morphological development of MDB of human and rats is similar, but shows obvious spatial and temporal differences. The development of MDB, choroid plexus, the arachnoid granules have time intersected. It is speculated that the development of these structures is interrelated. [ABSTRACT FROM AUTHOR]

Few studies have been conducted specifically on the dense connective tissue located in the posterior medial part of the cervical epidural space. This study was undertaken to examine the presence of this connection between the cervical dura mater and the posterior wall of spinal canal at the level of C1–C2. 30 head-neck specimens of Chinese adults were used. Gross dissection was performed on the suboccipital regions of the 20 specimens. Having been treated with the P45 plastination method, 10 specimens were sliced (9 sagittal and 1 horizontal sections). As a result, a dense fibrous band was identified in the nuchal ligament of 29 specimens (except for one horizontal section case). This fascial structure arose from the tissue of the posterior border of the nuchal ligament and then projected anteriorly and superiorly to enter the atlantoaxial interspace. It was termed as to be named ligament (TBNL). In all 30 specimens the existence of a fibrous connection was found between the posterior aspect of the cervical dura mater and the posterior wall of the spinal canal at the level of the atlas to the axis. This fibrous connection was identified as vertebrodural ligament (VDL). The VDL was mainly subdivided into three parts, and five variations of VDL were identified. These two structures, TBNL and VDL, firmly link the posterior aspect of cervical dura mater to the rear of the atlas-axis and the nuchal region. According to these findings, the authors speculated that the movements of the head and neck are likely to affect the shape of the cervical dural sleeve via the TBNL and VDL. It is hypothesized that the muscles directly associated with the cervical dural sleeve, in the suboccipital region, may work as a pump providing an important force required to move the CSF in the spinal canal. [ABSTRACT FROM AUTHOR]

Objective We aimed to investigate the morphological changes and potential correlation between chronic headaches and the rectus capitis posterior minor muscle (RCPmi). Methods Comparison of RCPmi between patients with chronic headaches and healthy adult volunteers were collected using magnetic resonance imaging (MRI) and Mimics software. Results Among the 235 MRI images analyzed, the data between the two groups were considered statistically significant. The number of males was larger than that of females ( p < 0.001) and the headache group showed greater hypertrophy than the control group in both males ( p < 0.001) and females ( p = 0.001). Conclusions Chronic headaches were correlated with the RCPmi. Patients with chronic headaches suffered from more obvious hypertrophy than that of the control group. Additionally, it was supposed that RCPmi hypertrophy may be one pathogenesis of the chronic headaches. [ABSTRACT FROM AUTHOR]

The myodural bridge complex (MDBC) is described as a functional anatomic structure that involves the dense connective tissue fibers, muscles, and ligaments in the suboccipital region. It has recently been proposed that the MDBC can influence cerebrospinal fluid (CSF) circulation. In the present study, bleomycin (BLM), a type of antibiotic that is poisonous to cells, was injected into the posterior atlanto-occipital interspace (PAOiS) of rats to induce fibrous hyperplasia of structures in PAOiS. Sagittal sections of tissues obtained from the posterior-occipital region of the rats were stained utilizing the Masson Trichrome staining method. Semiquantitative analysis evidenced that the collagen volume fraction of collagen fibers of the MDBC, as well as the sum of the area of the spinal dura mater and the posterior atlanto-occipital membrane in the BLM group were significantly increased (p < .05) compared to that of the other groups. This finding illustrates that the MDBC fibers as well as other tissues in the PAOiS of rats in the BLM group developed fibrotic changes which reduced compliance of the spinal dura mater. Indeed, the sectional area of the rectus capitis dorsal minor muscle in the BLM group was measured to be increased. These changes may further restrict CSF flow. The present research provides support for the recent hypothesis proposed by Labuda et al. concerning the pathophysiology observed in symptomatic adult Chiari malformation Type I patients, that there exists a relationship between the altered compliance of the anatomic structures within the craniocervical region and the resultant compensatory hyperplasia of the MDBC., (© 2022 The Authors. The Anatomical Record published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)

The myodural bridge (MDB) is a dense connective tissue structure that connects the subocciptal musculature to the spinal dura mater. The purpose of this study was to clarify morphological evolution characteristics and compositional changes in the fibrous structures of MDB during its growth and development in the atlanto-occipital interspace. For this, histological sections from Sprague-Dawley (SD) rats (age, E17 to adulthood) were stained with Masson's Trichrome and Picrosirius Red. The results demonstrated that at age E18, the posterior arch of the atlas was completely closed and MDB fibers had already begun to form. In rat embryos (E18-E21), only few fibers and muscles were present in the suboccipital region, and these were lightly stained. In postnatal rats, an obvious increase in the amount of fibers and muscle tissues was noted. At age P1, MDB fibers originated from the rectus capitis posterior minor muscle and merged into the atlanto-occipital membrane, which was closely attached to the spinal dura mater. As rats matured, MDB fibers gradually became denser and more organized. This study also showed that in postnatal rats, MDB was mainly composed of type I collagen fibers. By observing the development of MDB in SD rats, the function of MDB can be further understood. This study provides a morphological basis for future functional studies involving the MDB., (© 2020 American Association for Anatomy.)

Objective We aimed to investigate the morphological changes and potential correlation between chronic headaches and the rectus capitis posterior minor muscle (RCPmi). Methods Comparison of RCPmi between patients with chronic headaches and healthy adult volunteers were collected using magnetic resonance imaging (MRI) and Mimics software. Results Among the 235 MRI images analyzed, the data between the two groups were considered statistically significant. The number of males was larger than that of females ( p < 0.001) and the headache group showed greater hypertrophy than the control group in both males ( p < 0.001) and females ( p = 0.001). Conclusions Chronic headaches were correlated with the RCPmi. Patients with chronic headaches suffered from more obvious hypertrophy than that of the control group. Additionally, it was supposed that RCPmi hypertrophy may be one pathogenesis of the chronic headaches.

Objective: To investigate the effect of temperature on hospital admission among patients with chronic systolic heart failure (CSHF)., Methods: Data regarding in-hospital patients with CSHF were gathered from 12 hospitals in Hubei province, between 2000 and 2010. Patients with a history of congenital heart disease and the history of cancer from this series, were excluded. Chi-square (χ(2)) tests and t tests were used for descriptive analysis. Univariate and multivariate logistic regression methods were performed to determinate the risk of hospital admission of every month to compare with the previous one. We used 2-tailed 95% confidence interval (CI), and tests with P < 0.01 to consider the significant levels, statistically. We also used the SPSS 13.0 for Windows, release 15, 2006 (SPSS Inc, Chicago, Ill) for data analyses., Results: (1) 48 964 patients were enrolled in the present study. The numbers of admission increased 18.71%, 13.84%, -21.90%, -34.62%, -21.97%, -3.81%, -2.04%, 10.13%, -17.13%, -0.85%, 21.54% and 42.70% from January to December when compared to the average number of admission. (2) The odds ratios (ORs) (95% CI, P values) of hospital admission in January, February and December were 1.09 (0.96 - 1.23, 0.54), 0.98 (0.84 - 1.10, 0.46) and 0.96 (0.84 - 1.08, 0.59), respectively in females which did not show any significant differences when compared to the number in August. However the ratios were 0.61 (0.54 - 0.69, < 0.01), 0.80 (0.68 - 0.92, < 0.01) and 0.73 (0.64 - 0.83, < 0.01), respectively, in males that showed significant differences when, compared to the figures in August. (3) The OR of admission increased more when temperature got lower for patients with coronary artery disease, hypertension heart disease or rheumatic heart disease, but not with dilated cardiomyopathy. (4) The OR of admission showed a different impact on patients with different occupation, along with the change of temperature. Low or high temperature did not seem to have different effects on the OR of admission in patients who were free-lanced or unemployed., Conclusion: Temperature seemed to have significant effects on the risk of admission, which related to gender, etiology or occupation.

Background: The effects of anxiety and depression on the recurrence of persistent atrial fibrillation (AF) after circumferential pulmonary vein ablation (CPVA) are not clear. Whether CPVA can alleviate the anxiety and depression symptoms of persistent AF patients is unknown., Methods: One hundred and sixty-four patients with persistent AF, of which 43 treated with CPVA (CPVA group) and 103 treated with anti-arrhythmics drugs (medicine group), were enrolled. The Zung Self-Rating Anxiety Scale (SAS), and Zung Self-Rating Depression Scale (SDS) were assessed before and 12 months after treatment in all patients., Results: The scores of SAS (40.33 ± 7.90 vs. 49.76 ± 9.52, P < 0.01) and SDS (42.33 ± 8.73 vs. 48.17 ± 8.77, P < 0.01) decreased 12 months after CPVA. Over 12 months follow-up, AF relapsed in 17 patients in CPVA group. Compared with the data in the recurrent group (17 patients), the scores of SAS and SDS were significantly lower in the non-recurrent group (26 patients) at baseline. The results of multivariate Logistic regression analysis showed normal scores of SAS and SDS were the independent risk factors of AF recurrence after CPVA., Conclusions: Anxiety and depression increase the recurrence risk of persistent AF after CPVA. CPVA can ameliorate the anxiety and depression symptoms in patients with persistent AF.

Objective: To explore the effects of renal sympathetic denervation on inducibility of atrial fibrillation (AF) during rapid atrial pacing., Methods: Thirteen dogs were selected and divided into control group (n=7) and renal artery ablation group (RAA) (n=6). In the control group, the animals were subjected to atrial pacing at 800 beats/min for 7 hours. And atrial effective refractory period (AERP) and induced AF were measured hourly during non-pacing. In the RAA group, after each renal artery ablation, the procedures of pacing and electrophysiological measurement were nearly the same as those in the control group. Blood was collected before and after pacing to measure the levels of rennin, angiotensin AngII (AngII) and aldosterone., Results: There was a persistent decrease in AERP in both groups. However, after a 7-hour pacing, induced number of times and duration of AF were higher in the control group than those in the RAA group. The plasma concentrations of rennin and aldosterone increased significantly after 7-hour rapid pacing in the control group (rennin: (120±31) to (185±104) pg/ml, P<0.01, aldosterone: (288±43) to (370±110) pg/ml, P=0.01). No significant difference existed in the levels of AngII at pre- and post-pacing in the control group ((160±48) to (189±164) pg/ml, P=0.23). The levels of rennin and aldosterone showed a decreasing trend in the RAA group. But there was no statistical significance., Conclusions: Episodes of AF during short-time rapid atrial pacing may be decreased by renal sympathetic denervation. This effect is probably related with the decreased activity of RAAS.

Objective: To determinate the prognostic value of red cell distribution width (RDW) and the relationships between RDW and clinical characteristics in patients with chronic heart failure (CHF)., Methods: A total of 16 681 in-hospital patients with chronic systolic HF and LVEF < 50% from 12 hospitals in Hubei province, China were enrolled. All patients were followed up with telephone call. Patients were divided into RDW ≤ 13.2% (n = 3981), 13.3% - 14.1% (n = 3996), 14.2% - 14.8% (n = 4319) and ≥ 14.9% (n = 4385) groups. Multivariate Cox regression analysis was performed to determine whether RDW is an independent risk factor of all-cause mortality in overall patients, patients with various etiologies. Multivariate Cox proportional hazard analysis was performed to determine the risk of all-cause mortality among various RDW groups., Results: (1) Compared with RDW ≤ 13.2% group, adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of all-cause mortality for RDW 13.3% - 14.1%, 14.2% - 14.8% and ≥ 14.9% were 0.892 (95%CI 0.818 - 0.973, P = 0.01), 0.859 (95%CI 0.793 - 0.931, P < 0.01) and 1.034 (95%CI 0.961 - 1.111, P = 0.373) respectively. (2) Compared with MCV normal group, the adjusted HRs of MCV elevation and MCV decline groups were 1.351 (95%CI 1.063 - 1.718, P < 0.01) and 1.316 (95%CI 1.034 - 1.675, P < 0.01), respectively. (3) Compared to patients with rheumatic heart diseases, the adjusted HR for all-cause mortality in patients with coronary heart disease, dilated cardiomyopathy and hypertensive heart disease with RDW > 16% were 1.437 (95%CI 1.141 - 1.810, P < 0.01), 1.651 (95%CI 1.276 - 2.138, P < 0.01) and 1.276 (95%CI 1.004 - 1.621, P < 0.01), respectively. (4) The RDW is independently correlated with BMI (r = -0.345, P < 0.01), diastolic blood pressure (r = -0.321, P < 0.01), albumin (r = -0.411, P < 0.01), blood urine nitrogen (r = 0.476, P < 0.01), right ventricular end-diastolic diameter (r = 0.383, P < 0.01), LVEF (r = -0.463, P < 0.01) and heart rate (r = 0.379, P < 0.01)., Conclusions: There is a J shape relationship between all-cause mortality and RDW. The elevation or decline of MCV with increased RDW is linked with increased all-cause mortality in CHF patients.

Objective: To investigate the prevalence and related factors of medicinal therapy in patients with chronic systolic heart failure (CSHF)., Methods: Data on in-hospital patients with CSHF were studied from 12 hospitals in Hubei province, in 2000 and 2010. Differences on gender and age were calculated and Multivariate Cox regression analysis was performed to determinate the independent risk factors of all-cause mortality., Results: (1) 16 681 patients were enrolled in this study. Among which, 6453 died during the 5.82 ± 1.63 years of follow-up. The annual medical expenditure was larger in the survival group than in the dead ones (3.19 ± 0.65 vs. 3.32 ± 0.57, P < 0.01). (2) The prevalence of Angiotensin II receptor blocker increased along with age which accounted as 7.73%, 7.35%, 12.26%, 14.29%, 17.19%, 19.87% and 20.49%, respectively, in the < 30, 30 - 39, 40 - 49, 50 - 59, 60 - 69, 70 - 79 and ≥ 80-year groups. The distribution of digitalis, diuretics, β-receptor blocker, Angiotensin-converting enzyme inhibitors showed inversed U shape. (3) The annual medical expenditure increased as patients got older, with age groups < 30, 30 - 39, 40 - 49, 50 - 59, 60 - 69 and 70 - 79 years old as 2.96 ± 0.70, 3.09 ± 0.62, 3.15 ± 0.58, 3.30 ± 0.59 and 3.25 ± 0.58, respectively (P < 0.01). It reduced to the same level as in the 50 - 59 year-old group. The distribution of annual medical expenditure showed similar pattern in males. However, the trends were only found in patients at 50 - 59, 60 - 69, 70 - 79 and ≥ 80 years-old groups in female., Conclusion: More attention should be paid to medicinal therapy in patients with CSHF. Medicinal therapy shifted with age and gender, of which females had more adverse trend than in males.

Objective: To determinate the prognostic value of etiology in patients with chronic systolic heart failure (CSHF)., Methods: Data of in-hospital patients with CSHF were investigated between 2000 and 2010 from 12 hospitals in Hubei province. All patients were followed up through telephone calls. Univariate and multivariate Cox proportional hazards analyses were then used to explore the differences in the all-cause mortality, heart failure (HF) mortality and sudden cardiac death (SCD) among patients caused by different etiologies. Kaplan-Meier curve were then constructed and Univariate and multivariate Cox regression analyses were used to select demographic and clinical variables in predicting the all-cause mortality, HF mortality and SCD in CSHF patients. Multivariate logistic models and ROC curve were developed with or without the confirmed etiology to assess the incremental additive information related to different etiologies., Results: (1) Over the median 3 (2 - 4) years follow-up program, 6453 (38.69%) patients died, including 5505 (33.00%) due to HF prognosis and 717 (4.30%) died of SCD. All-cause mortality rates accounted for 34.50%, 54.30%, 41.48% and 15.76%, with HF mortality rates as 30.11%, 44.95%, 36.25% and 13.10%. SCDs accounted 8.46%, 8.45%, 9.84% and 1.05% in patients with CHD, DCM, HHD and RHD, respectively. (2) Compared with RHD patients, the adjusted HRs for all-cause mortality were 1.554 (1.240 to 1.947; P < 0.001), 1.405 (1.119 to 1.764; P = 0.003) and 1.315 (1.147 to 1.467; P = 0.005) while the adjusted HRs and 95%CIs for HF mortality were 1.458 (1.213 - 1.751; P < 0.001), 1.763 (1.448 - 2.147; P < 0.001) and 1.281 (1.067 - 1.537; P = 0.008), in patients with CHD, DCM and HHD, respectively. There were no significant differences in CHD (HR 3.345; 95%CI, 1.291 to 8.666; P = 0.013) or HHD (HR 2.062; 95%CI, 0.794 to 5.352; P = 0.137), while only DCM (HR 4.764; 95%CI, 1.799 to 12.618; P = 0.002) remained significant in SCD despite of the multivariate adjustment. (3) Etiology increased the sensitivity and specificity of predicting models for all-cause mortality (AUC 0.839, 95%CI, 0.832 to 0.845 vs. 0.776, 95%CI, 0.768 to 0.784) and HF mortality (AUC 0.814, 95%CI, 0.806 to 0.822 vs. 0.796, 95%CI, 0.788 to 0.804) but not with SCD (AUC 0.777, 95%CI, 0.749 to 0.809 vs. 0.747, 95%CI, 0.727 to 0.766)., Conclusion: CSHF due to CHD, DCM and HHD carried a worse prognosis than that of RHD. Different etiologies provided significant incremental prognostic information beyond readily available clinical variables for all-cause mortality and HF mortality.

Objective: To evaluate systemically the prevalence and prognostic values of liver function abnormalities in patients with chronic systolic heart failure (HF) have not been systematically evaluated., Methods: A total of 16 681 hospitalized patients with a diagnosis of chronic systolic HF and left ventricular ejection fraction (LVEF) < 50% were recruited from 12 hospitals in Hubei Province. All patients were followed up by telephone contacts. And they were divided into the death and survival groups according to the follow-up results., Results: Over a median follow-up period of 3 years, 6453 (38.69%) patients died. The prevalence of liver function abnormality was 71.94% (12 001/16 681). The elevations of direct bilirubin, γ-glutamyl-transferase and alanine aminotransferase were the most common findings accounting for 33.37% (4863/14 574), 32.51% (4337/13 341) and 30.12% (5024/16 681) respectively. The abnormality of alkaline phosphatase was rare and its increase and decrease accounted for 3.82% (474/12 397) and 4.51% (559/12 397) respectively. The prevalence of low albumin and total bilirubin elevation was 23.24% (3408/14 664) and 19.37% (3231/16 681). And high direct bilirubin (HR 1.264, 95%CI 1.103 - 1.423; P = 0.02), high total bilirubin (HR 1.126, 95%CI 1.019 - 1.234; P = 0.02) and low albumin (HR 0.889, 95%CI 0.794 - 0.889; P < 0.01) were determined as the independent risk factors of total mortality. There were the correlations of LVEF with direct bilirubin (r = -0.235, P < 0.01), total bilirubin (r = -0.209, P < 0.01), albumin (r = 0.107, P < 0.01) and right ventricular end-diastolic diameter (RVDD) with direct bilirubin (r = 0.149, P < 0.01), total bilirubin (r = 0.154, P < 0.01) and albumin (r = -0.086, P < 0.01)., Conclusion: The prevalence of liver function abnormalities is high in patients with chronic systolic HF. Low albumin, high direct bilirubin and high total bilirubin increase their total mortalities. Low LVEF and high RVDD are positively correlated with a high prevalence of liver function abnormalities.

Objective: To evaluate the current status of chronic heart failure (CHF) in Hubei province and analyze the epidemiology of CHF including the general condition, etiology and pharmacological therapy., Methods: Data of in-hospital patients with CHF were investigated between 2000 and 2010 from 12 hospitals in Hubei Province., Inclusion Criteria: over 18 years of age, organic heart disease and with the symptom of HF including dyspnea and fatigue. Patients with a history of myocardial infarction in the prior 12 months, congenital heart disease, pericardial disease and the history of cancer were excluded., Results: (1) A total of 12 450 patients were enrolled (7166 male, 57.56%). The average age was (62.0 ± 14.5) years. Patients in the scale of age ≥ 80, 70 - 79, 60 - 69, 50 - 59, 40 - 49 and < 40 was 9.53% (1187/12 450), 30.80% (3835/12 450), 23.45% (2920/12 450), 18.81% (2342/12 450), 10.73% (1336/12 450) and 6.67% (830/12 450), respectively (P < 0.01). The NYHA class I, II, III and IV was 0.60%, 23.20%, 50.31% and 26.50%, respectively. (2) The age of patients was significant reduced from 2000 - 2003, 2004 - 2006 to 2007 - 2010 [(66.4 ± 14.1) years, (64.9 ± 14.4) years and (64.2 ± 14.8) years, P < 0.01]. (3) The major causes of CHF were hypertension (31.54%), coronary heart disease (28.24%), dilated cardiomyopathy (26.57%) and rheumatic valvular heart disease (17.49%). The most frequent etiology for CHF was rheumatic valvular heart disease in patients aged less than 40 years old, dilated cardiomyopathy in patients aged 40 - 49 and 50 - 59 years and hypertension in patients aged 60-69, 70-79 and ≥ 80 years. (4) Drug use was as follows: Digitalis (47.49%), diuretics (68.75%), ACEI (50.66%), β-blocker (44.06%) and aldosterone antagonist (53.08%). Use of digitalis (Wald χ(2) = 903.41, P < 0.01;r = 0.271, P < 0.01), diuretics (Wald χ(2) = 818.05, P < 0.01; r = 0.249, P < 0.01), aldosterone antagonists (Wald χ(2) = 76.92, P < 0.01; r = 0.091, P < 0.01) increased while the β-blocker (Wald χ(2) = 160.65, P < 0.01; r = -0.117, P < 0.01) declined in proportion to NYHA class increase., Conclusions: The age of in-hospital patients with CHF declined in the previous 10 years. The primary etiology was hypertension for aged CHF in-hospital patients with CHF. There was big gap between guideline recommended standard therapy and current drug use for in-hospital patients with CHF in Hubei province.

Objective: To explore the predictive value of QT interval dynamicity for sudden death in patients with idiopathic dilated cardiomyopathy (DCM)., Methods: Fifty-five patients with DCM (DCM group) and 27 healthy subjects (Control group, Con) were enrolled. Investigations included history collection, clinical examination, echocardiography, electrocardiogram and 24 h ambulatory electrocardiogram. Following indexes were determined: left ventricle end diastolic dimension (LVEDD), left ventricle ejection fraction (LVEF), QT dispersion (QTd), SDNN, the slope of QT/RR plots of the linear regression, ventricular premature beats (VPB) and non-sustained ventricular tachycardia (NSVT). Primary end point for patients with DCM was all cause death., Results: LVEDD, QTd, VPB/24 h, NSVT/24 h, QTe/RR slope and QTp/RR slope were significantly higher while LVEF and SDNN were significantly lower in DCM group than in Con group (all P < 0.05). LVEDD, LVEF, QTd, SDNN, QTe/RR slope and QTp/RR slope were significantly different among DCM sudden death group, DCM non sudden death group and Con group (P < 0.05). LVEF, SDNN, QTe/RR slope and QTp/RR slope were significantly different between DCM sudden death and non sudden death group (P < 0.05). LVEF, QTd, VPB/24 h, QTe/RR slope and QTp/RR slope were significantly different between DCM with NSVT and DCM without NSVT group (P < 0.05). The sudden death rate of DCM patients with QTe/RR slope ≥ 0.210 was significantly higher than DCM patients with QTe/RR slope < 0.210 (54.5% vs. 21.1%, P < 0.05). Sudden death rate of QTp/RR slope ≥ 0.190 was also higher than those < 0.190 (52.2% vs. 21.9%, P < 0.05). The sudden death rate of DCM patients with both LVEF ≤ 35% and NSVT+ was 62.5%. Combining QTe/RR ≥ 0.210 with NSVT+ or LVEF ≤ 35%, the sudden death rates were 62.5% or 66.7%. Combining QTp/RR ≥ 0.190 with NSVT+ or LVEF ≤ 35%, the sudden death rates were 66.7% or 61.5%. Combining QTe/RR ≥ 0.210 or QTp/RR ≥ 0.190 with NVST+ and LVEF ≤ 35%, the sudden death rates were 77.8% or 70.0%., Conclusions: High QT/RR slope is a risk factor for sudden death of DCM patients. QT/RR slope is a useful predictor for sudden death in DCM patients either independently or combined with NSVT or LVEF.

Objective: To study the lipids reducing property of curcumin on Hyperlipidemia mice after fermented by Monascus purureus., Methods: The stain Monascus purureus was used for microbial transformation, and both substrate control and strain control were set. The mice were reared with high lipid and cholesterol feed for 15d to establish the Hyperlipidemia models. The models were treated with fermented curcumin in 500 mg/kg, 200 mg/kg, 100 mg/kg, substrate control and strain control in 500 mg/kg. Positive and Normal group were treated with natural saline. The general situation was observed and the changes of TG, TC, HDL-C levels in serum and liver were tested after 10 d., Results: Fermented curcumin could significantly reduce the serum TC, TG of Hyperlipidemia mice all in high, middle and low doses. Serum TC was reduced by 38.7%, 34.5%, 32.7% and TG was reduced by 38.3%, 28.6%, 30.1%, respectively while substrate control and strain control had no effect. Fermented curcumin also could reduce the TC, TG in liver but no effect of curcumin substrate at the same dose., Conclusion: The property of lipids reducing of curcumin is significantly enhanced after fermentation.