[A review of the influence of the 1956 Senior Teacher Training Program on Medical History]

The 1956 Senior Teacher Training Program on Medical History, hosted by the Institute of Traditional Chinese Medicine of the Ministry of Health, was the first teacher training program on the history of medicine in higher education in P. R. China. It was designed in the context of "Learning from the Soviet Union" for teaching reformation, "Integrating Western and Traditional Chinese Medicine" and performing the policy of "Blossom of Hundred Flowers and Contention of Hundred Schools of Thought" (by Mao Zedong for encouraging a variety of thinking conflicts) after the birth of the New China. The teaching management for the program was well organised, with a strong staff, and outcomes. A few of the trainees from this program were engaged in teaching and research of the history of medicine, and made outstanding academic achievements and promoted the teaching and research of the history of medicine in Chinese universities in the second half of the 20^th century. This program also provides a valuable reference for teacher training programs as well as teaching and research of medical history today.

[The predictive value of the CHA2DS2-VASc score for in-hospital outcomes in patients with acute myocardial infarction: China PEACE-retrospective acute myocardial infarction study]

Objectives: This study aimed to evaluate the predictive value of the CHA₂DS₂-VASc score for in-hospital outcomes of patients with acute myocardial infarction (AMI). Methods: Data of 23 728 patients from the China patient-centered Evaluative Assessment of cardiac Events (China PEACE)Retrospective Acute Myocardial Infarction Study were analyzed retrospectively. The patients were categorized into 3 groups according to the CHA₂DS₂-VASc scores: the low score group (score 1-3), the middle score group (score 4-6) and the high score group (score 7-9). The in-hospital outcomes included major adverse cardiovascular events (MACE), death, death or withdrawal from treatment, reinfarction, ischemic stroke,etc. The CHA₂DS₂-VASc score was incorporated into multivariate Cox regression analyses to determine its independent impact on in-hospital outcomes. Receiver operating Characteristic (ROC) curves were constructed, and the area under the curve (AUC) was used to evaluate the predictive value of the CHA₂DS₂-VASc score for in-hospital mortality and death or withdrawal from treatment, respectively. Results: The patients had a median age of 66 (56,75) years, and 30.7% of them were females. Patients with higher CHA₂DS₂-VASc scores had a higher in-hospital mortality and more in-hospital complications (all P<0.001). After adjustment of baseline covariates, the subjects in the high score group were associated with high risks of in-hospital mortality (OR=6.13, 95%CI 4.77-7.87, P<0.001), death or treatment withdrawal (OR=6.43, 95%CI 5.16-8.00, P<0.001) and MACE (OR=4.94, 95%CI 4.06-6.01, P<0.001). The AUCs of the CHA₂DS₂-VASc score were comparable with those of the mini-global registry of acute coronary events(mini-GRACE)score in evaluation of in-hospital mortality (0.699 vs. 0.696, P=0.752) and the death or treatment withdrawal risk (0.708 vs. 0.713, P=0.489). Conclusions: The CHA₂DS₂-VASc score is an independent predictor of in-hospital outcomes for patients with AMI. Its predictive value was comparable with the mini-GRACE score, which could be used as a simple tool for early and rapid outcome evaluation for AMI patients.

[Prevalence and clinical features of familial hypercholesterolemia in Chinese patients with myocardial infarction]

Objective: To analyze the prevalence and clinical features of familial hypercholesterolemia (FH) in Chinese patients with myocardial infarction (MI). Method: This retrospective study recruited a total of 2 119 consecutive patients (age (56.7±10.9) years old) undergoing coronary angiography with first MI from April 2011 to December 2016. Patients were divided into 2 groups: premature MI (male<55 years old, female<60 years old) and non-premature MI. The diagnosis of FH was established according to Dutch Lipid Clinic Network (DLCN) diagnostic criteria and referred as definite/probable FH in our study. The prevalence and clinical features of FH, including lipid level, MI characteristics and stain therapy, were explored. Multivariable logistic regression analysis was used to assess the predictive value of FH for the presence of premature MI. Results: The prevalence of definite/probable FH was 3.68% (78/2 119) in MI patients and 7.28% (68/934) in premature MI patients. Onset of MI occurred 10 years earlier in patients with definite/probable FH than those without FH ((47.9±9.4) years vs. (58.8±10.7) years, P<0.01). Additionally, we found that the risk of premature MI was significantly and independently increased in definite/probable FH patients (OR=5.32, 95%CI 2.77-10.22, P<0.01). None of FH patients reached the target of LDL-C<1.8 mmol/L under statin therapy. Conclusions: The prevalence of FH in Chinese patients with MI is not rare. Clinically, FH is linked with the early onset of MI.

Analysis of the association between plasma PCSK9 and Lp(a) in Han Chinese

PURPOSE

It has been reported that proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors can significantly reduce lipoprotein(a) [Lp(a)], and the mechanism for Lp(a) reduction remains unclear. Recently an interesting clinical research with a small sample showed a positive correlation between plasma PCSK9 and Lp(a) levels in diabetes. Here we aimed to use a relatively large sample to investigate whether such an association exists in Han Chinese.

METHODS

A total of 783 inpatients were consecutively enrolled and composed of 172 patients with type 2 diabetes mellitus (T2DM) and 611 non-T2DM subjects. Plasma PCSK9 level was measured by ELISA, and its association with Lp(a) was assayed by Spearman's correlation and multiple regression. Clinical and biochemical parameters were determined in all subjects studied.

RESULTS

No significant differences in PCSK9 and Lp(a) levels were found between T2DM and non-T2DM patients. PCSK9 level was not related to Lp(a) level either in T2DM or non-T2DM group in bivariate correlation and multiple linear regression analysis. Additionally, no association between the levels of PCSK9 and Lp(a) was found in well, poorly controlled T2DM patients or in T2DM patients with or without coronary artery disease (CAD). Besides, no difference was found among the PCSK9 values across tertiles of Lp(a) level.

CONCLUSION

We found no association of plasma PCSK9 levels with Lp(a) level in Han Chinese with or without T2DM, suggesting that Lp(a) reduction by PCSK9 inhibitors may not be achieved simply through PCSK9 pathway at least in Chinese.

Numerical simulation of the retrieval of aerosol size distribution from multiwavelength laser radar measurements

A numerical investigation was carried out into the feasibility of deriving the aerosol size distribution from aerosol volume extinction and backscattering coefficient measurements by a multiwavelength laser radar. This study employs the regularization method for matrix inversion with the first-order B-spline function as basis functions to approximate the aerosol size distribution. The results of numerical simulations show that (1) the effects of roundoff errors in the numerical calculation are negligible and the approximation errors in the size distribution by the B-spline function are small, (2) the reconstruction errors in the size distribution at its peak are about twice as large as the relative measurement errors when the Lagrange multiplier, which determines the degree of smoothness in the reconstruction, is suitably chosen, and (3) the variation in the complex refractive index due to the humidity change does not produce large errors in the size distribution.