Communication skills of providers at primary healthcare facilities in rural China

INTRODUCTION

Effective provider-patient communication has been confirmed to improve diagnosis, treatment planning, health outcomes, patient satisfaction, and treatment compliance. Few studies have measured the effectiveness of communication between patients and rural providers in China. To fill this gap in the literature, the present study describes the communication skills of providers at primary healthcare facilities in rural China and investigates the provider- and facility-level factors underlying these communication skills.

METHODS

The standardised patients successfully completed 504 interactions across two tiers of China's rural health system and engaged with providers at village clinics and township health centres. We assessed providers' communication skills based on recorded interactions between the providers and the standardised patients using the SEGUE Framework, which contains the following five dimensions: 'Set the stage', 'Elicit information', 'Give information', 'Understand the patient's perspective', and 'End the encounter'.

RESULTS

The providers' overall average score was 50.6% on the SEGUE communication tasks. They did well in 'Set the stage' (54.4%) and 'Elicit information' (56.2%) but performed poorly in 'End the encounter' (24.5%) and 'Understand the patient's perspective' (44.0%). Female and younger providers scored 0.75 (P<0.05) and 0.04 (P<0.01) points higher than their male and older counterparts on total SEGUE score, respectively.

CONCLUSION

Providers in rural China had relatively poor communication skills overall, especially in terms of their demonstration of care for patients and inviting them to participate in the interaction. Gender and age were significantly associated with providers' level of communication skills in rural China.

AB0028 IMBALANCES OF TH17/TREG IN CARDIOVASCULAR EVENTS OF PATIENTS WITH ANKYLOSING SPONDYLITIS

Background:

Ankylosing spondylitis (AS) is a common inflammatory joint disease affecting articulations of axial skeleton and asymmetrical peripheral arthrosis. It has been highlighted that patients with AS exhibit an increased risk of cardiovascular diseases (CVD) compared to the general population [1]. However, little is known about the relationship between cardiovascular burden in AS patients and Th17/Treg imbalance.

Objectives:

We aimed to investigated the relationship between cardiovascular events in AS patients and the status of T cell subsets. Furthermore, we want to identify other clinical and/or laboratory features which are associated with the cardiovascular risk in AS patients.

Methods:

The study included 32 AS patients with cardiovascular diseases and 32 age-matched AS patients as controls. All the AS patients were hospitalised at the Second Hospital of Shanxi Medical University and met the diagnostic criteria for AS revised in New York in 1984. We collected demographics, laboratory features [erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), DD (D-dimer), PLT (platelet count)], and absolute counts of lymphocyte and CD4+ T cell subset. The absolute numbers of lymphocytes and CD4+ T cells in peripheral blood were measured by Flow Cytometer.

Results:

1. There was statistically significant decrease in Th17 levels (P=0.012) in the AS with CVD group compared to the AS group, while the Treg cells number (P=0.426) and the ratio of Th17/Treg (P=0.202) have no statistically significant differences; 2. DD was significantly increased in AS patients with CVD; 3. The use of NSAIDs between the two groups is significantly different(P=0.013). 86.7% of the AS group have received NSAIDs, while only 58.1% of the AS patients with CVD have received the NSAIDs.

Conclusion:

The findings suggested that the cardiovascular events of AS patients correlated with imbalanced T cell subsets and the decreased Th17 cells may be a laboratory feature of AS patients with CVD. Patients with high DD level might have a higher risk of CVD. Monitoring of Th17 cells and DD could be beneficial in cardiovascular burden of patients with AS. However, current studies indicate that Th17 cells mediate the inflammatory response and play a crucial role in the development of CVD [2]. One explanation is that the AS patients with CVD in our study had a long disease duration and immunomodulatory therapy might have an impact on the status of T cell subsets. Meanwhile, the different disease activities of AS patients can be additional factors.

References:

[1]Haroon N, Paterson J M, Li P, et al. Patients with Ankylosing Spondylitis Have Increased Cardiovascular and Cerebrovascular Mortality[J]. Annals of Internal Medicine, 2015, 163(6):409. doi:10.7326/M14-2470

[2]van Bruggen, N. and W. Ouyang, Th17 Cells at the Crossroads of Autoimmunity, Inflammation, and Atherosclerosis. Immunity, 2014. 40(1): p. 10-12. doi:https://doi.org/10.1016/j.immuni.2013.12.00

Table 1.

Absolute lymphocyte and CD4+ T cell subset counts (cells/μL) in the AS with CVD group and AS group

Cell count (cells/μL)AS with CVDASP-valueTotal T1447.97±11.491442.49±11.490.970Total B217.06(144.55- 324.97)291.27(171.13-321.16)0.262NK268.09(171.51-396.99)277.71(167.08- 462.45)0.858Th1137.23(69.8-185.45)127.04(76.9-197.26)0.693Th28.42(5.56-10.47)8.03(5.50-9.95)0.848Th175.77(4.00-8.61)8.89(5.91-13.88)0.012*Treg29.64(17.07-47.19)34.51(23.26-47.19)0.426Th1/Th214.99(10.50-24.21)17.36(12.71-25.98)0.430Th17/Treg0.23(0.12-0.39)0.31(0.18-0.52)0.202

*P<0.05 **p <0.01. Data with a normal distribution and homogeneity of variance are presented as mean±standard deviation. Data without a normal distribution are presented as the median (interquartile range)

Figure 1.

Differences in Treg, Th17 cell counts and Th17/Treg between AS with CVD group and AS group. There was statistically significant decrease in Th17 levels(P=0.012) in the AS with CVD group. * P < 0.05 **P < 0.01. Data were compared using the Wilcoxon’s rank sum test.

Disclosure of Interests:

None declared

THU0325 REDUCED OF TREG CELLS ASSOCIATED WITH THE DISEASE ACTIVITY OF ANCA-ASSOCIATED VASCULITIS

Background:

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a group of autoimmune disease that can cause systemic organ damage, characterized with the presence of abnormal antibodies (ANCAs) in the circulation and the small- and medium-vessel vasculitis[1].However,the etiology of AAV remained unclear. Several observations have showed that the breakdown of immune tolerance caused by many complex interactions was involved in the pathogenesis of AAV[2].It has been confirmed that the disorder of the CD4+T cell,especially the imbalance of Th17 and Treg cells can destroy the immune tolerance and cause many autoimmune disease[3]. But the relationship between the Th17/Treg and AAV is unknown.

Objectives:

We investigated the absolute numbers of CD4+T subsets cells in peripheral blood of patients with AAV and healthy adults,and then compared them in different disease activity of AAV to explore the role of CD4+T subsets cells in the pathogenesis and development of AAV.

Methods:

49 patients with AAV,hospitalized at the Second Hospital of Shanxi Medical University from the May 2016 to the November 2019 were enrolled, and 31 age and gender-matched healthy adults were anticipated as controls.According to BVAS, the patients were divided into disease-activity group (BVAS≥15, n=27) and non-disease-activity group (BVAS<15, n=22). The absolute numbers of CD4+T subsets cells including Th17 and Tregs in peripheral blood of these individuals were detected by flow cytometry.We analyzed whether there was difference of CD4+T subsets between the patients and healthy controls,and between disease-activity group and non-disease-activity group.

Results:

There was significant decreased level of Treg cells in the patients with AAV compared with healthy controls,especially in the disease-activity group. The absolute numbers of Treg cells was decreased in the patients with AAV compared with healthy controls (P<0.001) leading to a higher Th17/Treg ratio in the patients (P<0.01).Similarly,the absolute number of Treg cells was decreased in the disease- activity group (P<0.01) compared with the non-disease-activity group, and the absolute number of Treg cells was significant negative correlation with the disease activity indexes such as BVAS (r=-0.342,P=0.016), erythrocyte sedimentation rate(ESR) (r=-0.315,P=0.027) and C-reactive protein(CRP) (r=-0.305,P=0.033). But there was no statistically significant in the absolute number of Th17 cells between the patients and healthy controls, and between disease-activity group and non-disease-activity group.

Conclusion:

The results we investigated here suggested that the decreased number of Treg cells failed to control autoimmune inflammatory response and maintain immune tolerance, and the disease activity of AAV was associated with the reduced number of Treg cells.

Figure 1.

(A-C) Characteristics of the absolute number of Th17 cells and Treg cells in peripheral blood of healthy controls (n=31) and the patients with AAV (n=49). There was significant decreased level of Treg cells in the patients with AAV compared with healthy controls leading to a higher Th17/Treg ratio in the patients with AAV. (D-F) The absolute number of Treg cells was decreased in the disease- activity group (n=27) compared with the non-disease-activity group (n=21). The absolute number of Th17 cells and Treg cells was detected by flow cytometry. Statistical analyses were performed by the Mann-Whitney U test. *p<0.05,**p<0.01, ***p<0.001.

References:

[1]Cosmi, L., Th17 and Treg lymphocytes as cellular biomarkers of disease activity in Granulomatosis with Polyangiitis. Eur J Immunol, 2017.47(4): p. 633-636.

[2]Pagnoux, C.,Updates in ANCA-associated vasculitis.Eur J Rheumatol, 2016.3: p. 122-133.

[3]Diller, M.L., et al., Balancing Inflammation: The Link between Th17 and Regulatory T Cells. Mediators Inflamm, 2016.2016: p. 6309219.

Disclosure of Interests:

None declared

Risk of Gastrointestinal Adverse Events in Cancer Patients Treated With Immune Checkpoint Inhibitor Plus Chemotherapy: A Systematic Review and Meta-Analysis

Background: The combination of immune checkpoint inhibitors (ICIs) and chemotherapy can improve clinical outcomes in the treatment of various tumors, but may also be associated with more adverse events (AEs). We performed a systematic review and meta-analysis to characterize the risk of gastrointestinal AEs in cancer patients treated with ICI plus chemotherapy.

Methods: This review was based on comprehensive search through PubMed, EMBASE, and the Cochrane Library for randomized controlled trials (RCTs) that reported gastrointestinal AEs following the use of ICI plus chemotherapy. Literature screening, data extraction, and quality evaluation were performed by two individual reviewers. Revman (version 5.3) was used for meta-analysis. Risk ratios (RR) with 95% confidence interval (CI) were calculated. Meta-analysis was conducted according to different types of ICIs [programmed death 1 (PD-1), programmed death ligand 1 (PD-L1), and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) inhibitors].

Results: After a full-text review, 10 trials involving 5,142 patients were included in the study. Compared with chemotherapy alone, PD-1 inhibitor plus chemotherapy significantly increased the risk of diarrhea (RR = 1.38, 95% CI, 1.13–1.68, P = 0.001; I² = 0%) and colitis (RR = 2.90, 95% CI, 1.02–8.21, P = 0.050; I² = 0%), PD-L1 inhibitor plus chemotherapy significantly increased the risk of nausea (RR = 1.17, 95% CI, 1.02-1.35, P = 0.020; I² = 0%), while CTLA-4 inhibitor plus chemotherapy significantly increased the risk of decreased appetite (RR = 1.49, 95% CI, 1.17–1.90, P = 0.001; I² = 0%), diarrhea (RR = 2.23, 95% CI, 1.90–2.63, P < 0.00001; I² = 0%), and colitis (RR = 28.39, 95% CI, 5.59–144.24, P < 0.001; I² = 0%).

Conclusions: This meta-analysis demonstrated that ICI plus chemotherapy is associated with a higher risk of gastrointestinal AEs. However, combining different ICIs may lead to diverse gastrointestinal toxicities. Clinicians should be aware of these AEs in the application of ICI plus chemotherapy.

[Effect of comprehensive AIDS intervention among men aged 50 or over who had non-marital sexual behavior]

Objective: To evaluate the effectiveness of AIDS intervention programs on men aged 50 or over and having had non-marital sexual behavior. Methods: A community-based intervention/experimental and based on individual level study was adopted. Stratified sampling method was used. 12 townships/streets in Fuyang district of Hangzhou were identified as intervention or control group (six research sites each). All of the subjects in the township (street) were included. The inclusion criteria of study objects would include men aged 50 or older who reported having unmarried sex in the last year. Estimated sample size was 290, with each 145 in the intervention group and the control group. All the intervention group participants were provided with a total of 4 intervention-related items (knowledge and education on AIDS prevention, information radiation and behavioral change, broadcast expert lectures), every 3 months, for 12 month, the main evaluation indicators would include: incidence of non-marital sex and commercial sex in the last year, condom use when having non-marital sex in the last episode. Results: A total of 312 subjects were recruited. 300 of them completed the baseline study while 284 of them completed the follow-up survey. Among the subjects who had undergone the baseline study, the average age was (65.58±7.89), 71.33% were married or cohabiting with someone, 52.00% having had primary school education. After the implementation of intervention programs, the incidence of non-marital sex dropped to 59.42% (82/138) and the incidence of commercial sex dropped from 79.73% (118/148) to 55.07% (76/138). Condom use rate in the last non-marital sexual contact increased from 19.59% (29/148) to 51.22% (42/82). In the control group, the incidence of non-marital sex in the year before dropped to 74.66% (109/146) and the incidence of commercial sex dropped from 91.45% (139/152) to 72.60% (106/146). Rates of condom use during the last non-marital sexual contact dropped from 32.89% (50/152) to 31.19% (34/109). Statistically, there were significant differences appeared between the two groups on the incidence of non-marital sex in the past year (χ(2)=7.48, P=0.008), the incidence of commercial sex in the last year (χ(2)=9.47, P=0.003) and the rate of condom use in the last sex experience (χ(2)=7.83, P=0.007). Conclusions: Results from this intervention study showed that: in the intervention group, both the incidence rates of non-marital or commercial sex had reduced, together with the increase of condom use in non-marital sex in the last sexual experience. Intervention strategies that involving knowledge and education on AIDS prevention, information radiation and behavioral change, broadcasting lectures by experts etc. were all proved effective.

The reduced lncRNA NKILA inhibited proliferation and promoted apoptosis of chondrocytes via miR-145/SP1/NF-κB signaling in human osteoarthritis

OBJECTIVE

Growing evidence has shown that long non-coding RNAs (lncRNAs) play some roles in the progression of osteoarthritis. In this study, we investigated the functions and mechanisms of lncRNA NKILA (NKILA) of chondrocytes in human osteoarthritis (OA).

PATIENTS AND METHODS

RT-PCR was used to detect the expressions of NKILA and miR-145 in OA tissues. After transfection of NKILA overexpression lentivirus (LV-NKILA) and NKILA downregulation lentivirus (LV-shNKILA) into primary chondrocytes, MTT assay was carried out to measure the cell proliferation of chondrocytes. The expressions of SP1, Bcl-2, Bax, cleaved caspase-3 and NF-κB signaling factors were detected by Western blot. Moreover, luciferase assay was performed to explore the binding site of NKILA and miR-145, miR-145 and SP1. Finally, JSH, a NF-κB signaling inhibitor, was added into chondrocytes transfected with LV-shNKILA or miR-145 mimic to detect that NKILA functions via miR-145/SP1/NF-κB signaling pathway.

RESULTS

We found that NKILA and SP1 were significantly reduced, miR-145 was increased in cartilage tissues of OA patients. After LV-NKILA transfection, the proliferation ability of chondrocytes was improved and cell apoptosis was inhibited; however, the proliferation ability of chondrocytes was repressed, and cell apoptosis was increased in LV-sh NKILA group. MiR-145 was predicted to be a potential target of NKILA and luciferase gene reporter assay confirmed that NKILA could directly bind with miR-145. Furthermore, SP1 was predicted to be a target gene of miR-145 and luciferase gene reporter assay proved that miR-145 could directly bind with SP1. Finally, we added JSH, a NF-κB signaling inhibitor, into chondrocytes with LV-shNKILA or miR-145 mimic. Results showed that the repressed SP1 was reversed after the addition of JSH in both LV-shNKILA and miR-145 mimic group. Further, the repressed proliferation capacities and promoted cell apoptosis were also reversed after the addition of JSH.

CONCLUSIONS

According to the results, this study uncovers NKILA is reduced in human osteoarthritic cartilage tissues. Furthermore, we firstly uncover that the reduced NKILA could function as a ceRNA to improve miR-145, which inhibited SP1 expression and regulated NF-κB signaling pathway, thereby promoting tissue inflammation, and inhibiting proliferation and promoting apoptosis of chondrocytes. Thus, it may be used as a promising prognostic marker and a potential target for osteoarthritis.

[Study of tumor necrosis factor receptor superfamily 1B gene polymorphism in relation to the outcomes of HCV infection]

Objective: To investigate the tumor necrosis factor receptor superfamily 1B gene (TNFRSF1B) polymorphism in relation to the outcomes of hepatitis C virus (HCV) infection. Methods: One thousand six hundred and forty-five cases without HCV infection, 545 cases with HCV clearance, and 783 cases with chronic HCV infection were enrolled. TaqMan probe method was used to investigate genotype rs1061622 (T > G) and rs1061624 (G > A). Two single nucleotide polymorphisms (SNPs) sites were genotyped and haplotypes were constructed to evaluate their relation with the outcome of HCV infection. Results: Logistic regression analysis showed that there was no relation to the two SNPs with HCV infection susceptibility and chronicity (P > 0.05). Haplotype analysis showed that carrier TA had an increased susceptibility to HCV infection [adjusted odds ratio (OR) = 1.15, 95% confidence interval (CI): 1.01 to 1.30, P = 0.038)]. Carrier TA and GG haplotypes were conducive to chronic HCV infection (adjusted OR = 1.28, 95% CI: 1.08 to 1.53, P = 0.006; OR = 1.31, 95% CI: 1.03 to 1.66, P = 0.026). Conclusion: The combinational effects of rs1061622 and rs1061624 in TNFRSF1B gene may increase the risk of HCV chronicity and infection.

[Association between TNFRSF11A and TNFRSF11B gene polymorphisms and the outcome of hepatitis C virus infection]

Objective: To explore the relationship between the tumor necrosis factor receptor superfamily members 11A (TNFRSF11A) and 11B (TNFRSF11B) gene polymorphisms and the outcome of hepatitis C virus (HCV) infection. Methods: In this case-control study, 749 cases of persistent HCV infection, 494 cases of spontaneous clearance and 1 486 control subjects were included from 2008 to 2016. TaqMan-MGB probe method was used to detect the genotype of TNFRSF11A rs1805034 and TNFRSF11B rs2073617. The genotypes distribution of the two single nucleotide polymorphisms (SNP) were analyzed in different populations. Results: Co-dominant model showed that individuals carrying the rs2073617 CC genotype were prone to have chronic HCV infection, compared with individuals carrying the rs2073617 TT genotype (OR=1.517, 95%CI: 1.055-2.181, P=0.024). Recessive model results showed that individuals carrying rs2073617 CC genotype were more likely to develop chronic HCV infection compared with individuals carrying rs2073617 TT or TC genotype (OR=1.435, 95%CI: 1.033-1.996, P=0.032). Additive model showed that the risk for chronic HCV infection increased with the increase of the number of rs2073617 C alleles (OR=1.204, 95%CI: 1.013-1.431, P=0.035). Conclusion: The genetic polymorphism of TNFRSF11B rs2073617 might be related with the chronicity of HCV infection.

[Understanding the China Blue Paper on Obesity Prevention and Control and policy implications and recommendations for obesity prevention and control in China]

With the rapid economic development and dramatic changes in lifestyle, the prevalence of overweight and obesity in China has been increasing significantly and become a serious public health threat. This article introduced the main contents of "China Blue Paper on Obesity Prevention and Control", aiming to facilitate understanding and applications of the "China Blue Paper on Obesity Prevention and Control" by policymakers, researchers and practitioners in related fields. Built upon these, recommendations were made for obesity screening, diagnosis, treatment and management, prevention and control policies and strategies, and future research priorities in China.

Road network intersection density and childhood obesity risk in the US: a national longitudinal study

OBJECTIVES

Road intersection density is an important indicator of walkability. The objectives of this study were to examine the trends in intersection density in the US from 2007 to 2011 and assess the associations between intersection density and childhood obesity risk at the state level.

STUDY DESIGN

Longitudinal analyses were conducted to assess the spatial-temporal changes of population-weighted intersection density in relation to the risk of childhood obesity in the US.

METHODS

Road network data from the Topologically Integrated Geographic Encoding and Referencing (TIGER) (2007-2011), the prevalence of overweight and obesity data from the National Survey of Children's Health (NSCH) (2007-2011), and the American Community Survey (ACS) (2011) were used. Geographic information system (GIS) visualization and spatial and regression analyses were conducted. Mixed-effect models were fit to assess the longitudinal relationship between intersection density and childhood obesity.

RESULTS

Between 2007 and 2011, population-weighted intersection density remained relatively stable in most states. Low-intersection-density states were clustered in the Southeastern region in both 2007 and 2011. The high-intersection-density states were clustered in the Middle Atlantic Division. California and Nevada also were identified as high-intersection-density clusters in 2011. States with lower road intersection density corresponded with states with higher childhood obesity prevalence. Our mixed-effect model estimates suggested that increased intersection density was associated with decreased obesity prevalence.

CONCLUSIONS

This study provided empirical evidence for longitudinal associations between neighborhood intersection density and childhood obesity prevalence based on national data and offered a new perspective of the role that road network plays in childhood obesity prevention.

1171Myocardial perfusion mapping in cardiac amyloidosis - exploring the spectrum from infiltration to ischaemia

Background

Cardiac involvement is the main driver of outcome in systemic amyloidosis, but the relationship between amyloid deposits and outcomes is not well understood. The simple explanation of physical, mechanical replacement of the interstitium by amyloid seems insufficient. Preliminary studies support the hypothesis that myocardial ischaemia could contribute to cell damage.

Purpose

(1) To assess myocardial ischaemia in cardiac amyloidosis. (2) To compare patients with cardiac amyloidosis to patients assessed on invasive coronary angiography (ICA) to have normal coronary physiology (NCP), microvascular dysfunction (MVD) and triple vessel coronary disease (3VD). (3) To assess correlation of perfusion mapping to markers of disease severity and prognosis.

Methods

86 patients and 20 healthy volunteers (HV) underwent CMR at 1.5T (Siemens) with standard cine, PSIR-LGE, T1, T2, Extracellular Volume (ECV) mapping and adenosine stress with myocardial blood flow (MBF) mapping. Thirty-eight patients also underwent ICA with 3 vessel assessment of Index of Microcirculatory Resistance and Fractional Flow Reserve: 7 had cardiac amyloidosis, 8 had NCP, 15 had MVD and 8 had 3VD.

Results

Cardiac amyloidosis patients had severe reduction in stress MBF and myocardial perfusion reserve (MPR) (1.22ml/g/min±0.70 and 1.62±0.63) compared to HV (3.21ml/g/min±0.64, p<0.001 and 4.17±0.78, p<0.001), NCP (2.66±0.56, p<0.001 and 2.51±0.43, p=0.036) and MVD (2.10±0.31, p<0.001 and 2.29±0.87, p=0.014) with the degree of reduction being similar only to patients with 3VD (1.44±0.54, p=1.000 and 1.64±0.68, p=1.000) (Figure 1). Rest MBF was also lower in amyloidosis than HV. Cardiac amyloidosis stress MBF and MPR inversely correlated with amyloid burden (ECV, r=−0.715, p<0.001, transmurality of LGE, p<0.01), systolic dysfunction (EF, r=0.405, p<0.01), and blood biomarkers (NT-proBNP (r=−0.678, p<0.001) and Troponin T (r=−0.628, p<0.001)). There was a correlation between stress MBF and native T1 (r=−0.588, p<0.001) but not T2 (p=0.591). Stress MBF and MPR were early disease markers, being elevated in patients with early cardiac amyloid infiltration (raised ECV, no LGE, P<0.01 vs HV).

Conclusion

Myocardial ischaemia is common in cardiac amyloidosis – with stress MBF and MPR similar to that of patients with 3VD. The reduction correlates with the degree of amyloid infiltration and markers of adverse prognosis, highlighting the potential role of myocardial ischaemia as a key mechanism in the pathophysiology of cardiac amyloidosis.

The Ultrafast Assembly of a Dipeptide Supramolecular Organogel and its Phase Transition from Gel to Crystal

A gel-to-crystal phase transition of a dipeptide supramolecular assembly mediates active water transportation in oils. The addition of water into ultrafast-assembling dipeptide organogels can induce a lamellar-to-hexagonal structural transformation of dipeptide molecular arrangement. Consequently, a phase transition from gel to crystal occurs and in turn water is transported in the dipeptide crystal via well-defined channels. On a macroscopic scale, water transport in the bulk system exhibits an anisotropic characteristic, which can be tuned by the presence of ions in the Hofmeister series. These favorable features enable the automatic separation of dispersed nanoparticles from dissolved electrolytes in aqueous solution. These findings demonstrate the potential of this assembled system for active filtration without external pressure.

[Association between plasma microRNA-29a and left ventricular hypertrophy in patients with hypertension]

Objective: Previous studies have shown that plasma microRNA-29a (miRNA-29a) is associated with myocardial fibrosis and the degree of cardiac hypertrophy in patients with hypertrophic cardiomyopathy. However, the relationship between plasma miRNA-29a and hypertensive left ventricular hypertrophy (LVH) has not yet been reported. So the purpose of this study is to investigate the relationship between the plasma miRNA-29a and hypertensive LVH. Method: Enrolled 168 hypertensive patients and classified the patients into 2 groups: those with LVH (LVH group, n=41) and those without LVH (NLVH group, n=127). All patients underwent echocardiography examination. Left ventricular mass index (LVMI) was calculated by interventricular septal thickness (IVSd), left ventricular posterior wall thickness(LVPWTd), left ventricular end diastolic dimension (LVEDD) and left ventricular mass index (LVMI) were obtained. Plasma levels of miRNA-29a were assessed by quantitative real-time polymerase chain reaction (qRT-PCR). The relationship between plasma miRNA-29a levels and LVH was analyzed. Results: Plasma miRNA-29a was significantly higher in LVH group than in NLVH group (0.52±0.10 vs. 0.37±0.07, t=9.788, P<0.01) . Pearson correlation analysis evidenced a positive correlation between plasma miRNA-29a levels and IVSd(R=0.459, P<0.01), LVPWTd (R=0.398, P<0.01), and LVMI (R=0.745, P<0.01). After adjustment for gender, age, systolic blood pressure, diastolic blood pressure, body mass index, hypertension duration, antihypertensive drugs, multiple regression analysis showed that there were still positive correlations between plasma miRNA-29a level and IVSd (β=0.535, P<0.01), LVPWTd (β=0.085, P<0.01), and LVMI (β=0.806, P<0.01). Conclusion: Plasma miRNA-29a level is positively associated with LVH in hypertensive patients, and future studies are warranted to explore if miRNA-29a could be used as a potential biomarker for LVH assessment in hypertensive patients.