[A new prognostic score system of hepatocellular carcinoma following hepatectomy]

Objective: To establish a new scoring system based on the clinicopathological features of hepatocellular carcinoma (HCC) to predict prognosis of patients who received hepatectomy. Methods: A total of 845 HCC patients who underwent hepatectomy from 1999 to 2010 at Cancer Hospital, Chinese Academy of Medical Sciences were retrospectively analyzed. 21 common clinical factors were selected in this analysis. Among these factors, the cut-off values of alpha-fetoprotein (AFP), alkaline phosphatase (ALP) and intraoperative blood loss were evaluated by using a receiver operating characteristic (ROC) curve analysis.The Kaplan-Meier method and Cox regression model were used to evaluate the independent risk factors associated with the prognosis of HCC patients after hepatectomy. HCC postoperatively prognostic scoring system was established according to the minimum weighted method of these independent risk factors, and divided the patients into 3 risk groups, including low-risk, intermediate-risk and high-risk group. The relapse-free survival (RFS) and overall survival (OS) were compared among these groups. Results: The univariate analysis showed that clinical symptoms, preoperative α-fetoprotein (AFP) level, serum alkaline phosphatase (ALP) level, tumor size, tumor number, abdominal lymph node metastasis, macrovascular invasion or tumor thrombus, extrahepatic invasion or serosa perforation, the severity of hepatic cirrhosis, intraoperative blood loss, the liver operative method, pathological tumor thrombus, intraoperative blood transfusion, perioperative blood transfusion were significantly associated with median RFS of these HCC patients (P<0.05). Alternatively, clinical symptoms, preoperative AFP level, serum ALP level, tumor size, tumor number, abdominal lymph node metastasis, macrovascular invasion or tumor thrombus, extrahepatic invasion or serosa perforation, the severity of hepatic cirrhosis, intraoperative blood loss, the liver operative method, pathological lymphocyte invasion, pathological tumor thrombus, intraoperative blood transfusion, perioperative blood transfusion were significantly associated with the median OS of these HCC patients (P<0.05). The multivariate analysis showed that AFP ≥20 ng/ml, clinical symptoms, tumor diameter ≥5 cm, multiple tumors, macrovascular invasion or tumor thrombus, extrahepatic invasion or serosa perforation, moderate and severe liver cirrhosis, non- anatomic resection were the independent risk factors of RFS and OS (P<0.05). The independent risk factor of RFS was intraoperative bleeding loss ≥325 ml (P<0.05); The independent risk factors of OS were abdominal lymph node metastasis and pathological tumors thrombus (P<0.05). The respective weight of 11 independent factors was used to establish the scoring system (scores range from 0 to 26). In the score system, 0 to 5 points were defined as the low-risk group (286 cases), 6 to 12 points were determined as the intermediate-risk group (503 cases), more than 13 points were classified as the high-risk group (56 cases). The median RFS of the low-risk, intermediate-risk and high-risk group were 80, 27 and 6 months, respectively. The differences were statistically significant (P<0.001). The median OS of the three groups were 134, 51 and 15 months, respectively, and the differences were statistically significant (P<0.001). Conclusion: This new score system provides effective prediction of postoperative prognosis for HCC patients.

[Clinical and imaging features of pulmonary veno-occlusive disease and pulmonary capillary hemangioma]

Objective: To improve the diagnosis and treatment of the pulmonary veno-occlusive disease (PVOD) and pulmonary capillary hemangioma (PCH). Methods: The clinical features, radiological findings, laboratory testing and treatment in 8 cases of PVOD/PCH which was diagnosed from 2013 to 2017 were described. Results: PVOD/PCH was rare. The clinical symptoms were easily confused with IPAH, but the decrease of hypoxemia, clubbing, D(L)CO were more obvious, and the imaging features of HRCT were helpful for PVOD/PCH diagnosis. Combined with gene testing, it was helpful to diagnose PVOD/PCH and avoid the risk of surgical biopsy. Conclusion: PVOD and PCH are rare type of pulmonary vascular diseases. According to clinical manifestations, physical examination, pulmonary function test results, HRCT imaging, CPET and gene detection results, PVOD or PCH can be diagnosed.

Brown and black carbon in Beijing aerosol: Implications for the effects of brown coating on light absorption by black carbon

Brown carbon (BrC) is increasingly included in climate models as an emerging category of particulate organic compounds that can absorb solar radiation efficiently at specific wavelengths. Water-soluble organic carbon (WSOC) has been commonly used as a surrogate for BrC; however, it only represents a limited fraction of total organic carbon (OC) mass, which could be as low as about 20% in urban atmosphere. Using methanol as the extraction solvent, up to approximately 90% of the OC in Beijing aerosol was isolated and measured for absorption spectra over the ultraviolet-to-visible wavelength range. Compared to methanol-soluble OC (MSOC), WSOC underestimated BrC absorption by about 50% at 365nm. The mass absorption efficiencies measured for BrC in Beijing aerosol were converted to the imaginary refractive indices of BrC and subsequently used to compute BrC coating-induced enhancement of light absorption (E_abs) by black carbon. E_abs attributed to lensing was reduced in the case of BrC coating relative to that caused by purely-scattering coating. However, this reduction was overwhelmed by the effect of BrC shell absorption, indicating that the overall effect of BrC coating was an increase in E_abs. Methanol extraction significantly reduced charring of OC during thermal-optical analysis, leading to a large increase in the measured elemental carbon (EC) mass and an apparent improvement in the consistency of EC measurements by different thermal-optical methods.

[Subnational analysis of probability of premature mortality caused by four main non-communicable diseases in China during 1990-2015 and " Health China 2030" reduction target]

Objective: To investigate the current status, temporal trend and achieving Health China 2030 reduction target of probability of premature mortality caused by four main non-communicable diseases (NCDs) including cardiovascular and cerebrovascular diseases, tumour, diabetes, and chronic respiratory disease in China both at national and provincial level during 1990 to 2015. Methods: Using the results of Global Burden of Disease study 2015 (GBD 2015), according to the method of calculating premature mortality probability recommended by WHO, the current status and temporal trend by different gender from 1990 to 2015 were calculated, analyzed, and compared. Referring to " Health China 2030" target of reduction 30% of probability of premature mortality caused by major NCDs, we evaluated the difficulty of achieving the reduction target among provinces (not including Taiwan). Results: From 1990 to 2015, the probabilities of premature mortality in cardiovascular and cerebrovascular diseases, tumour, and chronic respiratory disease were all declined consistently for both men and women in China, the total of four main NCDs decreased from 30.69% to 18.54% with higher decreasing in women (from 25.97% to 12.40%) than that in men (from 34.94% to 24.19%). In 2015, the top five provinces in terms of probability of premature mortality caused by four main NCDs were Qinghai (28.81%), Tibet (25.88%), Guizhou (24.67%), Guangxi (23.56%), and Xinjiang (23.21%) in turn, while the top five provinces with the lowest probability were Shanghai (8.40%), Beijing (9.39%), Hong Kong (10.10%), Macao (10.31%), and Zhejiang (11.70%). If achieving the " Health China 2030" target, the probabilities of premature mortality in Qinghai and Tibet with the highest probability should decline to about 20.17%, and 18.12%, respectively in 2030, while 5.88%, and 6.57% in Shanghai and Beijing, respectively. From 1990 to 2015, the probability of premature mortality of four main NCDs declined by 2.00% a year on average, the top five provinces with the fastest decline were Beijing (3.48%), Shanghai (3.24%), Zhejiang (2.81%), Fujian (2.75%), and Guangdong (2.67%), and 11 provinces including these five provinces could achieve the " Health China 2030" target by the usual rate of decline, while other 22 provinces could not achieve the target, they need greater rate of decline in order to achieve the target. Conclusion: From 1990 to 2015, the probabilities of premature mortality of four main NCDs were declined consistently in China both at national and provincial level, compared with women, the men had higher probabilities and declined slower, there were significant different in probabilities of premature mortality and their change speed among provinces. Based on the results from 1990 to 2015, there were about two thirds of the provinces, which the task of achieving the Health China 2030 target will be daunting.

[Clinical analysis of Behçet disease associated with pulmonary vascular disease]

Objective: To investigate the clinical features, therapy and prognosis of Behcet's disease(BD) complicated with pulmonary vascular diseases (PVD). Methods: The clinical manifestation, hemodynamics, pulmonary artery angiographic findings, therapy and prognosis of PVD in BD in Shanghai Pulmonary Hospital from January 2009 to August 2016 were analyzed retrospectively. Results: Seven patients with average of (37±20) years were included. The ratio of male vs. female was 6∶1. Vascular involvement included pulmonary hypertension (PH) (4/7), pulmonary embolism (PE) (3/7) and pulmonary artery aneurysms (PAA) (3/7). All patients received immunosuppressive agents and all PH patients had therapy of PH target drugs. Three out of 4 PE patients underwent anticoagulant therapy. Conclusion: PVD is a rare complication of BD. The common clinical manifestations are PH, PE and PAA. Management of immunosuppressive agents may improve the prognosis and should be recommended.

[Measurement of morphological parameters of internal acousticmeatus using thin-section CT]

Objective: This study aimed to measure the morphological parameters of the internal acoustic meatus(IAM) and its adjacent structures using temporal-bone thin-section CT(computed tomography). Methods: CT images were obtained from 50 Chinese adult patients (25 males and 25 females, 100 sides) which had no visible lesion in the petrous part of the temporal bone and inner ear, the morphological parameters of all inner ear parts were sectionally measured on the specified plane using SPSS 22.0 software for statistical analysis. Results: The integral morphological characteristics of the IAM were observed. These results revealed that anterior-posterior diameter of the internal acoustic poer(IAP)(CD) was (6.93±1.85)mm, the superior-inferior diameter of the IAP(EF) was (4.40±0.86)mm, the length of the IAM(AB) was (9.30±1.60)mm, the superior-inferior diameter of the IAM(the intersection of inner 1/3 section and middle 1/3 section) was (4.13±0.83)mm, the superior-inferior diameter of the IAM(the intersection of middle 1/3 section and outer 1/3 section) was (4.61±1.02)mm, the anterior-posterior diameter of the IAM(the intersection of inner 1/3 section and middle 1/3 section) was (6.62±1.92)mm, the anterior-posterior diameter of the IAM(the intersection of middle 1/3 section and outer 1/3 section) was (6.28±1.65)mm, the depth of transverse crest (superior wall) was (3.10±0.75)mm, the depth of transverse crest (interior wall)the was (1.46±0.59)mm, the distance from transverse crest vertex A to the superior wall of the IAM was (2.05±0.42)mm, the distance from transverse crest vertex A to the interior wall of the IAM was (2.93±0.41)mm, the thickness of the superior bone wall of the IAM (the intersection of inner 1/3 section and middle 1/3 section) was (4.45±1.34)mm, the thickness of the superior bone wall of the IAM (the intersection of middle 1/3 section and outer 1/3 section) was (4.32±1.12)mm, the thickness of the superior bone wall of the IAM (the intersection of outer 1/3 section and transverse crest vertex) was (4.37±1.28)mm, and the appearance ratio of the cells in the whole IAM superior wall was 32%.The whole IAM assumed the shape of short cylinder, inclining about 1 cm outward, with the upper-lower diameter and anterior-posterior diameter about 5 mm. Conclusion: It is necessary for carrying out preoperative the temporal-bone thin-section CT to obtain the morphological parameters of the IAM, determine its basic morphology, and provide references to avoid damaging the other important structures during IAM surgeries.

[Disease burden attributable to household air pollution in 1990 and 2013 in China]

Objective: To assess the disease burden attributable to household air pollution in 1990 and 2013 in China. Methods: Based on data from the Global Burden of Disease Study 2013 in China (GBD 2013), we used population attributable fractions (PAF) to analyze the burden of different diseases attributable to solid-fuel household pollution in 2013 in China(not inclnding HongKang, Macao, Taiwan). We compared PAF, mortality, and disability-adjusted life years (DALY) for diseases attributable to solid-fuel household pollution in 31 provinces in mainland China in 1990 and 2013, and stratified the burden by age group. The estimated world average population during 2000- 2025 was used to calculate age-standardized mortality and DALY rates. Results: In 2013, 14.9% of lower respiratory infections in children <5, 32.5% of chronic obstructive pulmonary disease (COPD), 12.0% of ischemic stroke, 14.2% of hemorrhagic stroke, 10.9% of ischemic heart disease, and 13.7% of lung cancer were attributable to solid-fuel household pollution. In addition, 807 000 deaths were attributable to solid-fuel household pollution, including 296 000 from COPD, 169 000 from hemorrhagic stroke, 152 000 from ischemic heart disease, 88 000 from ischemic stroke, 75 000 from lung cancer, and 28 000 from lower respiratory infections in children <5. The age-standardized mortality rate from solid-fuel household pollution decreased by 59.3% from 158.8/100 000 in 1990 to 64.6/100 000 in 2013. The age-standardized mortality rate from solid-fuel household pollution decreased in all 31 provinces, with the highest decline observed in Shanghai (96.3%), and lowest in Xinjiang (39.9%). In 2013, the age-standardized DALY rate from solid-fuel household pollution was highest in Guizhou (2 233.0/100 000) and lowest in Shanghai (27.0/100 000). The DALY rate was the highest for the >70 age group (7 006.0/100 000). Compared with 1990, the 2013 mortality rate and DALY rate from solid-fuel household pollution decreased in all age groups, with the highest decline observed in the <5 age group (91.9% and 91.8% , respectively). Conclusion: Although the disease burden attributable to household air pollution decreased notably between 1990 and 2013, household pollution caused a high number of deaths and DALY loss in certain western provinces.

[Acute effect of fine particulate matters on daily cardiovascular disease mortality in seven cities of China]

Objective: To explore the effect of fine particulate matters with an aerodynamic diameter less than 2.5 μm (PM(2.5)) on daily cardiovascular disease mortality in seven cities of China. Methods: Daily average concentrations of PM(2.5), cardiovascular disease mortality data and environmental data were collected from January 1, 2013 to December 31, 2015 in seven cities of China, including Shijiazhuang, Haerbin, Shanghai, Wuhan, Guangzhou, Chengdu and Xi' an. We linked generalized additive model with Quasi-Poisson distribution to evaluate the association between daily concentrations of PM(2.5) and cardiovascular disease mortality at single-city level and multi-city level, after adjusting for the long-term and seasonal trend, as well as meteorological factors and the effect of " days of week" . Results: The single-pollutant model indicated that there were marked differences in association strength in these cities, among which the effect in Guangzhou was strongest. At multi-city level, a 10 μg/m(3) increase of PM(2.5) was associated with an increase of 0.315% (95%CI: 0.133%-0.497%) of daily cardiovascular disease mortality. From lag0 to lag2, the effect of PM(2.5) on cardiovascular disease mortality decreased, while it was strongest on lag01. In the two-pollutant model, the estimated effect decreased in all the cities with the adjustments of SO(2) or NO(2). The insignificant combined results suggested that PM(2.5) might have combined effect with other pollutants. Each 10 μg/m(3) increase of PM(2.5) was associated with increases of 0.371% (95%CI: 0.141%-0.600%) and 0.199% (95% CI: 0.077%-0.321%) of cardiovascular disease mortality in males and females, respectively. The effect of PM(2.5) on cardiovascular disease mortality increased with age and decreased with educational level, although the differences between different subgroups were insignificant. The dose-response relationship between PM(2.5) and cardiovascular disease mortality was non-linear and non-threshold, with a steeper curve at lower concentrations. Conclusion: The increases of PM(2.5) concentration can result in the increase of daily cardiovascular mortality.

[Expression of intercellular adhesion molecule-1 and myeloperoxidase in peripheral blood and its significance in elderly patients with OSAHS]

Objective:To investigate the detection and significance of serum intercellular adhesion molecule-1 (ICAM-1) and myeloperoxidase (MPO) in elderly patients with OSAHS in adults.Method:Ninety-three cases of elderly OSAHS patients who confirmed by PSG were observed. According to the range of AHI, they were divided into 3 groups (severe, moderate and mild). 31 cases of healthy person were observed as control group. The serum ICAM-1 and MPO were determined by ELISA method; ICAM-1 and MPO were measured after comprehensive treatment in patients with elderly severe OSAHS, and the correlation between ICAM-1, MPO and PSG were analyzed.Result:①With the severity of snoring increased, the serum levels of ICAM-1 and MPO increased gradually (F=29.937,18.946; P< 0.01); The concentration of ICAM-1 and MPO in each group showed that there was no significant difference between the mild group and the control group (P> 0.05), there were significant differences between the rest each two groups (P< 0.05). ②There was no correlation between serum levels of ICAM-1, MPO, BMI, age in OSAHS patients (P> 0.05). There was a positively relationship between ICAM-1 and MPO . Both of them were negatively correlated with AHI, and positively correlated with LSaO2 (P< 0.01). ③The concentration of ICAM-1, MPO and AHI in 31 elderly patients with severe OSAHS decreased and LSaO₂ increased significantly after 3 months of comprehensive treatment (P< 0.01).Conclusion:The increase of ICAM-1 and MPO concentration in peripheral blood is one of the mechanisms of cardiovascular damage in elderly patients with OSAHS. Determination of peripheral blood ICAM-1, MPO levels in elderly patients with OSAHS to help determine the severity of disease, the evaluation of treatment,which may have a certain reference value for the prediction of cardiovascular disease risk in patients with severe OSAHS.

[Burden of disease attributable to high- sodium diets in China, 2013]

Objective: To examine the burden of disease(BOD)attributable to high-sodium diets in China in 2013. Methods: Data were extracted from the 2013 Global Burden of Disease Study for China to examine the BOD attributable to high-sodium diets in 2013, gender, and disease composition. Measurements for attributable BOD were population attributable fraction(PAF), deaths, standardized mortality and disability-adjusted life years(DALY)(not including Taiwan, China). An average world population age-structure for the period 2000-2025 was adopted to calculate age-standardized rates. Results: In 2013, deaths attributable to high-sodium diets accounted for 12.6% of all deaths and 14.5% of chronic disease deaths. Overall, 7.8% of deaths because of neoplasms, 25.2% of cardiovascular disease deaths, and 22.9% of chronic kidney disease deaths were attributable to high-sodium diets. A total of 1 176 553 deaths were attributable to high-sodium diets and the standardized mortality was 91.5/100 000, which was higher in men than in women(121.7/100 000 and 63.0/100 000, respectively). Overall, 22.759 million DALYs were attributable to high-sodium diets. The DALY standardized rate was 1 588.0/100 000, which was higher in men than in women(2 189.7/100 000 and 993.2/100 000, respectively). When compared by province, PAF in Xinjiang(25.0%), Qinghai(23.7%), Shanxi(23.2%), Tibet(22.1%)and Shandong(20.5%)was higher than other provinces. The standardized mortality in Xinjiang(239.4/100 000), Qinghai(238.9/100 000), Tibet(221.7/100 000), Shanxi(166.2/100 000)and Hebei(149.9/100 000)were higher than other provinces. The DALY standardized rate attributable to high-sodium diets was highest in Xinjiang(4 430.8/100 000), Qinghai(4 422.5/100 000), Tibet(4 021.4/100 000), Shanxi(2 816.6/100 000), and Hebei(2 624.9/100 000). Conclusion: The BOD attributable to high-sodium diets is a serious issue in China, particularly in men and in the northern provinces. Effective measures should be taken in northern provinces to reduce sodium intake.

Production of medically useful nitric monoxide using AC arc discharge

Inhaled nitric monoxide (iNO) is increasingly used as a medical treatment for acute respiratory distress syndrome. A course of the existing nitric monoxide (NO) therapy with gas cylinders could cost up to approximately $15,000 for an average of 30.2 h. Moreover, a gas cylinder containing a mixture of N₂ and NO may potentially leak NO. The objective of this study is to develop an efficient and cost-effective on-site iNO generation system. In the present setup, NO was generated by using dry air or mixed oxygen/nitrogen (O₂/N₂) and an AC power source with an output power level of 5-30 W at atmospheric pressure. The simultaneously produced NO₂ was eliminated with an ammonium sulfite ((NH₄)₂SO₃) solution. The effects of the O₂/N₂ ratio, gas flow rate, discharge gap distance, output energy density and electrode structure on NO_x concentration and the NO/NO₂ ratio are reported. The concentrations of NO and NO₂ reached 62 ppm and 3 ppm, respectively, after absorption and dilution at a gas flow rate of 6 L/min. With the present setup, the AC arc discharge produced NO_x at a stable concentration for at least 6 h using dry air.

[Significance of the seated supine positioning nystagmus for the diagnosis of benign paroxysmal positional vertigo]

Objective:To observe and assess the significance of seated supine positioning nystagmus (SSPN) in the diagnosis of benign paroxysmal positional vertigo(BPPV).Method:Two hundreds patients who were diagnosed BPPV were tested with the seated supine positioning test(SSPT) to observe SSPN,then were tested Supine roll test(SRT) and Dix-Hallpike test(DHT). According to the result of SRT and DHT,patients were divided into different groups. The positive rate and feature of SSPN in different types of BPPV was analyzed.Result:Among the 200 patients,116 cases(58.0%) of them showed SSPN. Among the 116 cases who were divided to the posterior semicircular canal BPPV(PSC-BPPV) group,72 cases of them showed SSPN. Horizontal semicircular canal BPPV(HSC-BPPV) group were 60 cases,44 cases showed SSPN. Anterior semicircular canal BPPV(ASC-BPPV) group were 4 cases and none of them showed SSPN. The direction of SSPN was a combination of torsional nystagmus with the upper pole of the eyes beating toward the affected side combined with vertical nystagmus beating upward (toward the forehead) typically in the PSC-BPPV group. Canalolithiasis of HSC were 41 cases,and 28 cases showed SSPN,and SSPN was contralesional in 22 cases(78.6%) and ipsilesional in 6 cases. Cupulolithiasis of HSC were 19 cases and 16 cases showed SSPN,and SSPN was ipsilesional in 16 cases.Conclusion:Significance of the seated supine positioning nystagmus in different types of BPPV is different.

Association between single nucleotide polymorphisms in AKT1 and the risk of prostate cancer in the Chinese Han population

AKT1, also known as v-akt murine thymoma viral oncogene homolog 1, is involved in the regulation of cell-survival and anti-apoptotic activities, which may affect the pathogenesis of various cancers. However, the association between genetic variants of AKT1 and the risk of developing prostate cancer has not been investigated before. This study investigated the associations between three polymorphisms (rs1130214, rs3730358, and rs2494732) in AKT1 and the risk of development of prostate cancer in the Chinese Han population. Sequenom MassARRAY & iPLEX technology were used to genotype these polymorphisms in 493 Chinese Han patients with prostate cancer and 309 age-matched healthy individuals. Compared to the CC genotype of the rs3730358 polymorphism, the CT genotype of the same polymorphism was strongly associated with a decreased risk of prostate cancer (OR = 0.617, 95%CI = 0.390-0.976, P = 0.037). However, there was no significant difference between the allele frequency of the rs3730358 polymorphism and those of the other two polymorphisms (P > 0.05). Moreover, no significant difference was found in the haplotype analysis (P > 0.05). Our study found that the variant genotype CT of rs3730358 of AKT1 was associated with a decreased risk of prostate cancer, which suggested that this polymorphism could play an important role in the development of the disease.

Finite-temperature scaling of trace distance discord near criticality in spin diamond structure

In this work we explore the quantum correlation quantified by trace distance discord as a measure to analyze the quantum critical behaviors in the Ising-XXZ diamond structure at finite temperatures. It is found that the first-order derivative of the trace distance discord exhibits a maximum around the critical point at finite temperatures. By analyzing the finite-temperature scaling behavior, we show that such a quantum correlation can detect exactly the quantum phase transitions from the entan-gled state in ferrimagnetic phase to an unentangled state in ferrimagnetic phase or to an unentangled state in ferromagnetic phase. The results also indicate that the above two kinds of transitions can be distinguished by the different finite-temperature scaling behaviors. Moreover, we find that the trace distance discord, in contrast to other typical quantum correlations (e.g., concurrence, quantum discord and Hellinger distance), may be more reliable to exactly spotlight the critical points of this model at finite temperatures under certain situations.

[End tidal PCO(2) for evaluation of severity of disease in idiopathic pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension]

Objective: To explore the difference in end tidal PCO(2) (P(ET)CO(2)) between idiopathic pulmonary arterial hypertension (IPAH) and chronic thromboembolic pulmonary hypertension (CTEPH), and to analyze the correlation between P(ET)CO(2) and the indexes of disease severity in IPAH and CTEPH patients. Methods: Data were retrieved from 68 IPAH patients and 52 CTEPH patients who all had received right-heart catheterization, pulmonary function test and cardiopulmonary exercise testing at Shanghai Pulmonary Hospital from October 2011 to October 2014. In addition, other clinical parameters were also collected. Results: The IPAH group had a significantly higher mPAP, PVR [(60±16) mmHg (1 mmHg=0.133 kPa), (13±6) Wood U ] than the CTEPH group [(46±12) mmHg, (9±4) Wood U, t=4.90, 4.83, all P<0.01]. Meanwhile, the IPAH group had a lower percentage of predicted peakVO(2), oxygen pulse [(45±15)%, (60±22)%] compared with the CTEPH group [(53±16)%, (68±21)%, t=-2.42, -1.96, all P<0.05]. The value of P(ET)CO(2) at rest, AT, peak in the IPAH patients [(27±5), (28±7), (25±7) mmHg] were higher than those in the CTEPH patients [(24±4) mmHg, (23±6) mmHg, (21±6) mmHg, t=3.22-4.54, all P<0.01]. There was a significantly difference in P(ET)CO(2) at AT and peak between WHO-FC Ⅰ-Ⅱ and Ⅲ-Ⅳ subgroups in IPAH (t=2.55, 2.60, all P<0.05) and CTEPH (t=2.39, P<0.05), except for P(ET)CO(2) at peak in the CTEPH patients (t=1.71, P>0.05). A moderately inverse correlation was found between P(ET)CO(2) at AT and NT-proBNP in the IPAH group (r=-0.58, P<0.01), meanwhile P(ET)CO(2) at AT in the CTEPH group was weakly correlated with NT-proBNP (r=-0.34, P<0.05). Conclusions: Compared with the CTEPH patients, the IPAH patients had significantly decreased exercise capacity and increased P(ET)CO(2). P(ET)CO(2) could reflect the disease severity in both IPAH and CTEPH patients, being superior in IPAH than in CTEPH. Furthermore, P(ET)CO(2) at AT might be better than P(ET)CO(2) at peak in reflecting the ventilatory efficiency.

[Epidemiological characteristics of dyslipidemia in remote rural areas of Xinjiang, 2009-2010]

Objective: This study aimed to estimate the prevalence of dyslipidemia, hypertriglyceridemia, hypercholesterolemia, high blood low density lipoprotein cholesterol (LDL-C), and low blood high density lipoprotein cholesterol (HDL-C) in remote rural areas of Xinjiang and analyze these indicators' epidemiological characteristics. Methods: A survey of 13 000 individuals (aged ≥18 years) was conducted using a four-stage cluster random sampling method in Jiashi, Xinyuan, Aheqi, and Shawan Counties, Xinjiang, in 2009-2010. After nonpermanent residents were excluded, 12 154 individuals were included in this study. Questionnaire and physical examinations were conducted, including collection of fasting blood to detect TG, TC, LDL-C, and HDL-C. The results were calculated after complex weighting and compared according to the prevalence of different gender and age groups. Results: The overall levels of TG, TC, LDL-C, and HDL-C were 1.34±1.09, 4.45±1.16, 2.36±0.86, and 1.37±0.58 mmol/L, respectively. After complex weighting, the overall prevalence of dyslipidemia was 35.4%; that among men (42.9%) was greater than that among women (29.5%; χ²=234.19, P<0.001), and the prevalence was 35.9%, 34.5%, and 35.1% (χ²=1.52, P=0.467) in participants aged 18-44, 45-59, and ≥60 years, respectively. The overall prevalence of hypertriglyceridemia was 11.4%; that among men (13.5%) was greater than that among women (9.8%; χ²= 40.72, P<0.001), and the prevalence was 9.6%, 13.0%, and 13.2% (χ²=38.71, P<0.001) in participants aged 18-44, 45-59, and ≥60 years, respectively. The prevalence of hypercholesterolemia was 5.7%; that among men(5.0%) was greater than that among women (6.2%; χ²=6.95, P=0.008), and the prevalence was 3.5%, 7.4%, and 8.4% (χ²=105.24, P<0.001) in participants aged 18-4, 45-59, and ≥60 years, respectively. The prevalence of high blood LDL-C was 2.8%, and there was no significant difference between men (3.0%) and women (2.4%; χ²=1.43, P=0.231); the prevalence was 3.5%, 7.4%, and 8.4% (χ²=42.81, P<0.001) in participants aged 18-44, 45-59, and ≥60 years, respectively. The prevalence of low blood HDL-C was 24.0%; that among men (31.6%) was greater than that among women (18.0%; χ²=304.02, P<0.001), and the prevalence was 27.8%, 20.6% and 19.5% (χ²=96.61, P<0.001) in participants aged 18-44, 45-59, and ≥ 60 years, respectively. Conclusions: Low blood HDL-C was the main type of dyslipidemia among the population in remote rural areas of Xinjiang. The prevalence of dyslipidemia among men was greater than that among women, and there was a trend of younger men than women showing dyslipidemia.

Evaluation of efficacy, safety and tolerability of Ambrisentan in Chinese adults with pulmonary arterial hypertension: a prospective open label cohort study

Background

Although several new drugs have been approved in recent years, pulmonary arterial hypertension (PAH) remains a rapidly progressive disease with a poor prognosis. Ambrisentan, a selective endothelin type A antagonist, has been approved for treatment of PAH. This open label study assessed the efficacy and safety of ambrisentan in Chinese subjects with PAH.

Methods

Eligible patients with PAH (World Health Organisation [WHO] functional class [FC] II orIII) were enrolled and received Ambrisentan (5 mg) once daily for a 12-week preliminary evaluation period, and a 12-week dose-adjustment period (dose titration to 10 mgallowed). Endpoints included: change from baseline in 6-Minute Walk Distance (6-MWD), N-Terminal Pro B-Type Natriuretic Peptide (NT-pro-BNP), WHO FC, Borg Dyspnoea Index (BDI), clinical worsening of PAH and incidences of adverse events (AE).

Results

One hundred thirty-three subjects (85 % women, mean age: 36 years) with PAH (WHOFC II or III) were enrolled and received ambrisentan (5 mg) once daily for a 12-week preliminary evaluation period, and a 12-week dose-adjustment period. Mean (SD) duration of drug exposure was 161.7 (27.13) days. Ambrisentan (average daily dose of 6.27 mg) significantly improved exercise capacity (6MWD) from baseline (mean: 377.1 m [m]) at week 12 (+53.6 m, p < 0.001) (primary endpoint). Improvement in exercise capacity was noted as early as week 4, and was sustained up to week 24 (+ 64.4 m, p < 0.001). NT-pro-BNP plasma levels decreased significantly (p < 0.001) at week 12 (−861.4 ng/L) and week 24 (−806 ng/L) from baseline (mean: 1600.7 ng/L). The WHO FC showed improvements for 44 subjects at week 12 and 51 subjects at week 24. BDI scores decreased significantly at week 12 (−0.3, p < 0.001) and week 24 (−0.2, p = 0.003) from baseline (mean: 2.5). Four patients died during the study (sudden cardiac death [n = 2], cerebral haemorrhage [n = 1], cardiac failure [n = 1]). Drug related adverse events occurred in 34.3 % of subjects; peripheral oedema (11.2 %) and flushing (8.2 %) occurred most frequently.

Conclusion

Ambrisentan (5 and 10 mg, orally) significantly improved the exercise capacity in Chinese PAH subjects with a safety profile similar to that observed in global studies.

Trial registration

NCT No. (ClinicalTrials.gov): NCT01808313; Registration date (first time): February 28, 2013.

Electronic supplementary material

The online version of this article (doi:10.1186/s12872-016-0361-9) contains supplementary material, which is available to authorized users.

[The burden of disease attributed to low bone mineral density among population aged ≥40 years old in China, 1990 and 2013]

Objective: To identify cause-specific death and attributed burden of low bone mineral density in China among population aged ≥40 years old , 1990 and 2013. Methods: By using data from Global Burden of Disease(GBD)2013, this study analyzed death caused by low mineral density, and disability-adjusted life years(DALY)among population aged 40 and above in China(not including Taiwan, China). This study also analyzed DALY by composition of injury which due to low bone mineral density. It also analyzed changes in DALY by provinces in China, 1990 and 2013. An average world population age-structure for the period 2000- 2025 was adopted to calculate the age standardized rates. Results: In 2013, there were 38.1 thousands male and 30.7 thousands female who aged 40 and above dead due to low bone mineral density in China. The burden of injury caused by low bone mineral density was more sever in male than female, which accounted for 1.525 million DALY in male and 0.873 million DALY in female. In 1990, low bone mineral density attributed transportation and accidental injury caused 0.794 million and 0.567 million DALY losses, respectively. In 2013, low bone mineral density attributed transportation and accidental injury caused 1.421 million and 0.951 million DALY losses, respectively. Compared to 1990, DALY losses caused by transportation and accidental injury, increased by 79.1% and 67.6%, respectively. In 1990, DALY rate losses due to low bone mineral density attributed transportation and accidental injury were 68.1 per 100 000 and 48.7 per 100 000, respectively. In 2013, DALY rate losses due to low bone mineral density attributed transportation and accidental injury were 102.0 per 100 000 and 68.2 per 100 000, respectively. Compared to 1990, DALY rates which caused by transportation and accidental injury, increased by 49.8% and 40.2%, respectively. According to the ranking of standardized DALY rate in 2013 by provinces, the top 3 provinces, which standardized DALYs attributed to low bone mineral density lost the most, were Zhejiang Province(2.6 per 100 000), Jiangsu Province(2.4 per 100 000), and Fujian Province(2.2 per 100 000). Compared to 1990, the standardized rate of DALY decreased in 27 provinces, while the DALY rate increased in only 6 provinces which included Ningxia Hui Autonomous Region, Qinghai Province, Hebei Province, Guangxi Zhuang Autonomous Region, and Henan Province and Xinjiang Uygur Autonomous Region. Conclusion: This study found that the burden of health losses attributed to it was higher in men than in women. Compared to 1990, DALY rates decreased in most of the provinces, however, the rates of losses of DALY which caused by transportation and accidental injury were still increasing.

[Association between CETP polymorphisms and haplotypes with dyslipidemia in Xinjiang Uygur and Kazak residents]

OBJECTIVE

To explore the relationship between the polymorphisms and haplotypes in the CETP gene and dyslipidemia among Xinjiang Kazak and Uygur residents.

METHODS

A population status survey was performed from 2010 to 2011 in Kashgar Xinjiang Uygur and Kazak residents, stratified cluster sampling method was used to select Uygur, Kazak residents with abnormal blood lipid values (n=367 and 345, respectively) as the dyslipidemia groups, and to select residents with normal lipid values as control group from the same area (n=374 and 390, respectively). SNaPshot technology was applied to detect the DNA of CETP gene rs3764261, rs1800775, rs708272 and rs5882 loci in all selected residents, and linkage disequilibrium analysis and haplotype construction were performed.

RESULTS

(1) In Uygur residents, the dyslipidemia risk of rs708272 CT (OR=0.64, 95%CI 0.46-0.91, P=0.01) and TT genotype (OR=0.60, 95%CI 0.40-0.91, P=0.02) was significantly lower than CC genotype. Dyslipidemia risk of rs3764261 GT (OR=0.55, 95%CI 0.40-0.74, P=0.00) and TT genotype (OR=0.47, 95%CI 0.28-0.78, P<0.01) was significantly lower than GG genetype. Dyslipidemia risk of the rs1800775 CC genotype was higher than AA genotype (OR=1.79, 95%CI 1.17-2.74, P=0.01). There was no statistical significance in CETP gene of the 4 genotype and allele frequency between the dyslipidemia and normal lipid groups in Kazak residents (all P>0.05). (2) In Uighur residents with dyslipidemia, HDL-C level was significantly higher in rs708272 TT genotype carriers than in CC and CT genotypes (all P<0.05) and in rs3764261 TT genotype carriers than in GG genotype carriers (P=0.008), while was significantly lower in rs1800775 CC genotype carriers with AA genotype carriers (P=0.008). (3) Linkage disequilibrium analysis showed that there was strong linkage disequilibrium between rs3764261 and rs708272 (D'=0.869, r(2)=0.869), rs1800775 and rs708272 (D'=0.845, r(2)=0.446) in Uighur residents, and there was strong linkage disequilibrium between rs3764261 and rs708272 (D'=0.963, r(2)=0.963), rs1800775 and rs708272 (D'=0.988, r(2)=0.630) in Kazak residents. (4) Significant differences were observed in frequency distribution of haplotype GACA(OR=0.579, 95%CI 0.388-0.864, P=0.006), GATA (OR=2.183, 95%CI 1.231-3.873, P=0.006), GCCA (OR=0.723, 95%CI 0.549-0.954, P=0.001), TATA (OR=0.723, 95%CI 0.549-0.954, P=0.021) and TATG (OR=0.601, 95%CI 0.429-0.841, P=0.002) in Uighur residents with normal or abnormal lipid profiles, while significant difference was observed in frequency distribution of haplotype GCCG (OR=1.961, 95%CI 1.207-3.188, P=0.005) in Kazak residents with normal or abnormal lipid profiles.

CONCLUSION

CETP genotype rs708272, rs3764261 and rs1800775 polymorphism is closely related to dyslipidemia and haplotype GACA, TATA and TATG will reduce the risk of dyslipidemia, while haplotype GATA, GCCA will increase the risk of dyslipidemia in Uygur residents. The four CETP polymorphisms are not related to the risk of dyslipidemia, but haplotype GCCG is related to increased risk of dyslipidemia in Kazakhs residents.

[Burden of chronic obstructive pulmonary disease attributable to ambient ozone pollution in 1990 and 2013 in China]

OBJECTIVE

To investigate the burden of chronic obstructive pulmonary disease (COPD) in China attributable to ambient ozone pollution in 1990 and 2013.

METHODS

Based on the results of the China Global Burden of Disease Study (GBD) 2013, the population attributable fractions was used to analyze the deaths and disability-adjusted life years (DALY) of COPD attributable to ambient ozone pollution in all provinces (not including Taiwan, China) in 1990 and 2013, and to compare changes of the attributable disease burden in 1990 and 2013.

RESULTS

In 2013, 7.4% (95% uncertainty interval (95% UI): 6.1%-8.6%) of COPD were attributable to ambient ozone pollution, with the highest rate in Hebei province (15.0%, 95%UI: 12.0%-18.7%) and the lowest in Heilongjiang province (2.8%,95%UI: 0.9%-5.3%). In 2013, 67 485 COPD deaths in China were due to ambient ozone pollution, with the highest number in Sichuan province (11 929) and in China lowest in Macao (11). A total of 1.168 million DALYs caused by COPD were due to ambient ozone pollution, with the highest in Sichuan province (0.189 million) and lowest in Macao (257.4). In 2013, the DALY per 100 000 population caused by COPD due to ambient ozone pollution after age standardization was lowest in Heilongjiang province (21.9), Shanghai (26.7), Beijing (38.4), Tianjin (39.3), and Jilin province (39.7) and highest in Sichuan province (206.4), Qinghai province (202.5), Guizhou province (175.3), and Gansu province (171.4). DALYs caused by COPD attributable to ambient ozone pollution increased with age (0.144 million person years for ages 15-49 years, 0.43 million person years for age 50-69 years and 0.594 million person years for age 70 years and above), which were higher in men than in women (0.708 million person years for men and 0.459 million person years for women in 2013). Deaths of COPD attributable to ambient ozone pollution were 49 514 and 67 485 in 1990 and 2013, respectively. DALYs caused by COPD attributable to ozone pollution totaled 0.894 million and 1.168 million person years in 1990 and 2013, respectively. Ambient ozone pollution-related deaths and DALYs increased 36.3% and 30.6%, respectively.

CONCLUSION

Compared with 1990, the disease burden of COPD in 2013 attributed to ambient ozone pollution in China increased substantially. Ambient ozone pollution caused great losses among Chinese residents. More attention should be directed toward western provinces with a particularly high disease burden due to ambient ozone pollution.

Association of APOA1 gene polymorphisms (rs670, rs5069, and rs2070665) with dyslipidemia in the Kazakhs of Xinjiang

The aim of this study was to investigate the potential association between apolipoprotein A1 (APOA1) gene rs670, rs5069, and rs2070665 polymorphisms and dyslipidemia in the Kazakh population of Xinjiang, China. Matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS) was used to identify APOA1 (rs670, rs5069, and rs2070665) genotypes in 736 subjects (341 dyslipidemia patients and 395 control subjects). The frequencies of the CC genotype for rs1421085 were found to be 7.2% (obese group), 4.4% (overweight group), and 5.6% (control group). Polymorphisms of the three loci of the APOA1 gene in Kazakh subjects met Hardy-Weinberg equilibrium. The frequencies of the A allele for rs670 were found to be 14.3% (dyslipidemia group) and 12.7% (control group). The frequencies of the T allele for rs5069 and rs2070665 were: dyslipidmia group (7.2 and 30.1%, respectively) and control group (7.7 and 32.5%, respectively). Frequency distributions of the 3 types of genotypes and alleles of the three loci showed no statistically significant difference (P > 0.05). Significant differences were observed in lipoprotein (α) [Lp(α)] between patients with the rs2070665 CT + TT and CC genotypes (P < 0.05); however, none of the other relevant indicators differed significantly between the two genotypes. No significant association was identified between rs670 or rs5069 and the lipid-related metabolic indices assessed in the study. These findings indicate that the polymorphisms in the APOA1 gene (rs670, rs5069, and rs2070665) are not associated with dyslipidemia in the Kazakh population assessed in this study.

[The study of prevention the gustatory sweating syndrome and facial contour deformity with sternocleidomastoid muscle flaps in the parotidectomy]

Objective:To assess the outcome for prevention the gustatory sweating syndrome and facial contour deformity with sternocleidomastoid muscle flaps in the parotidectomy. Method:It was a prospective study. Eighty-one patients who underwent parotidectomy were randomly divided into 2 groups, sternocleidomastoid muscle flaps group and control group. They were tested with the subjective and objective function testing in 3, 6, 9, 12 months after operation. We assessed the result. Result:All of the result of the sternocleidomastoid muscle flaps group was obviously better than the control group. There was significant difference between the 2 groups (P<0.05). Conclusion:It effectively prevented the gustatory sweating syndrome and facial contour deformity that we used the sternocleidomastoid muscle flaps to fill the cavity in the parotidectomy.

Association between polymorphisms of fat mass and obesity-associated gene and metabolic syndrome in Kazakh adults of Xinjiang, China

The aim of this study was to assess the association between three FTO polymorphisms (rs9939609, rs8057044, and rs1421085) and metabolic syndrome (MS)-related outcomes in the low-income, rural, nomadic minority Khazakh population in far western China. A total of 489 subjects (245 MS patients, 244 controls) were included in the study and DNA samples were genotyped for the three polymorphisms by matrix-assisted laser desorption/ionization time of flight mass spectrometry. The frequencies of the rs1421085 and rs9939609 genotypes and alleles did not differ significantly between MS patients and control, while the frequencies of rs8057044 G alleles and GG genotypes were higher in MS patients (P < 0.05) than in control subjects (G: 61.16 vs 53.53%, GG: 39.07 vs 29.05%) and the frequencies of rs8057044 A genotypes and alleles were lower (P < 0.05) in MS patients compared with controls (AA: 17.36 vs 21.99%, A: 38.84 vs 46.47%). Risk analysis of the rs8057044 polymorphism revealed individuals with GA and GG genotypes to have 1.112 and 1.731 times higher risks of developing MS than those with the AA genotype, respectively, while the G allele was found to be associated with a 1.367 times higher risk of developing MS compared with the A allele. These apparent correlations, however, did not hold true when adjusted for BMI. Weight, WC, HC, and BMI differed significantly between rs8057044 GG and AA+GA genotypes (P < 0.05).

Association of branched-chain amino acids with coronary artery disease: A matched-pair case-control study

BACKGROUND AND AIM

Several recent studies have found an independent relationship between levels of plasma branched-chain amino acids (BCAAs) and risk factors for coronary artery disease (CAD); however, few studies have investigated the associations of BCAAs with CAD and the risk of cardiovascular events. Therefore, the aim of this study was to investigate the relationship between BCAAs and CAD.

METHODS AND RESULTS

We studied 143 patients with CAD diagnosed by coronary angiography at Beijing Hospital (Beijing, China) during 2008-2011. Apparently healthy control individuals (n = 286) and the patients with CAD were matched (2:1 ratio) by age and gender. The healthy control individuals were selected at random from a set of subjects who attended an annual physical examination at the same hospital in 2011. Conditional logistic regression models were used to evaluate the associations between measured variables and CAD. After multivariate adjustment for traditional CAD risk factors, each one-standard-deviation increase in BCAA concentration was associated with an approximately twofold increase in the risk of CAD (odds ratio = 1.63, 95% confidence interval (CI): 1.21-2.20, P = 0.001). As compared with subjects in the lowest quartile of BCAA levels, the odds ratios (95% CIs) for CAD risk in subjects belonging to quartiles 2, 3, and 4 were 1.65 (0.75-3.61), 2.04 (0.92-4.53), and 3.86 (1.71-8.69), respectively (P trend = 0.01).

CONCLUSION

Our results demonstrate that BCAAs are significantly related to CAD development. This relationship is independent of diabetes, hypertension, dyslipidemia, and body mass index.

Lutein alleviates arsenic-induced reproductive toxicity in male mice via Nrf2 signaling

This study aims to investigate the mechanisms involved in the action of lutein (LU) alleviating arsenic-induced reproductive toxicity using mice model. Forty male Kunming mice were received following treatments by gavage: normal saline solution (control), arsenic trioxide (ATO; 5 mg/kg/day), LU (40 mg/kg/day), and ATO + LU (5 mg/kg/day + 40 mg/kg/day). At the end, the mice were killed by cervical dislocation and weighed. Pathological examination was done on the testis. The biomedical parameters including superoxide dismutase (SOD), glutathione (GSH), total antioxidative capability, malondialdehyde (MDA), 8-hydroxydeoxyguanosine (8-OHdG), and reproductive indexes were analyzed. The messenger RNA (mRNA) and protein expression of Nrf2, heme oxygenase 1 (HO-1), glutathione S-transferase (GST), nicotinamide adenine dinucleotide phosphate dehydrogenase, quinone 1 (NQO1) in testis were detected by real-time polymerase chain reaction and Western blot. We found that there was a decrease in sperm count; testis somatic index; the activities of SOD, GSH, total antioxidative capacity ( p < 0.01, respectively) in ATO-treated mice, while there was an increase in the levels of sperm abnormalities, MDA, and 8-OHdG than control ( p < 0.01, respectively). The groups treated with ATO + LU showed recovery of the measured parameters between those of ATO or saline-treated group. The antagonized interaction between ATO and LU was statistically significant ( p < 0.01). Mice treated with ATO + LU also showed greater mRNA expression of Nrf2, HO-1, NQO1, and GST than ATO or saline-treated groups. These findings suggest that LU alleviates reproductive toxicity induced by arsenic in male mice via Nrf2 signaling, which implicates a possible mechanism of LU in preventing the reproductive injury, and elucidates that consuming the rich plant sources of LU will alleviate the reproductive toxicity induced by chemicals.