[Association of triglyceride glucose index and risk of incident hypertension: a prospective cohort study]

Objective: To explore the relationship between the triglyceride glucose (TyG) index and the risk of developing hypertension among rural Chinese adults. Methods: A prospective cohort study was conducted from 2007 to 2008, involving 20 194 adults selected through random cluster sampling from a rural community in Luoyang City, Henan Province. Follow-ups were carried out in 2013-2014 and 2018-2020. After excluding participants with hypertension at baseline, those with missing TyG index data, individuals who passed away during follow-up, and those with incomplete hypertension status at the second visit, 9 802 participants were included in the analysis. Baseline and follow-up assessments included questionnaire interviews, physical measurements (including blood pressure), and blood sample collection for fasting lipid and glucose levels. Participants were divided into four groups according to TyG index quartiles, and a modified Poisson regression model was utilized to assess the association between TyG index quartiles and hypertension risk. Results: The study cohort comprised 9 802 participants with a median age of 48 (39, 57) years, including 3 803 males (38.80%). Participants were distributed across TyG index quartiles as follows: TyG<8.2 group (2 224 individuals), TyG 8.2-8.5 group (2 653 individuals), TyG 8.6-8.9 (2 441 individuals), and TyG≥9.0 (2 484 individuals). Over a follow-up period of (11.1±1.3) years, 3 378 subjects developed hypertension, resulting in a cumulative incidence of 34.46% (3 378/9 802). The risk of hypertension increased with higher TyG index quartiles (Ptrend<0.05). Compared to the TyG<8.2, the TyG 8.2-8.5 (RR=1.11, 95%CI 1.01-1.22, P=0.023), TyG 8.6-8.9 (RR=1.16, 95%CI 1.06-1.27, P=0.023), and TyG≥9.0 (RR=1.20, 95%CI 1.10-1.31, P=0.023) exhibited increased hypertension risk after adjusting for age, gender, educational level, and other potential confounders. Subgroup analyses based on gender and age at baseline yielded results consistent with the main analysis. Conclusions: The TyG index is positively correlated with the risk of developing hypertension in the rural adult population.

[Estimating the basic reproduction number of COVID-19 in Wuhan, China]

Objective: The number of confirmed and suspected cases of the COVID-19 in Hubei province is still increasing. However, the estimations of the basic reproduction number of COVID-19 varied greatly across studies. The objectives of this study are 1) to estimate the basic reproduction number (R(0)) of COVID-19 reflecting the infectiousness of the virus and 2) to assess the effectiveness of a range of controlling intervention. Methods: The reported number of daily confirmed cases from January 17 to February 8, 2020 in Hubei province were collected and used for model fit. Four methods, the exponential growth (EG), maximum likelihood estimation (ML), sequential Bayesian method (SB) and time dependent reproduction numbers (TD), were applied to estimate the R(0). Results: Among the four methods, the EG method fitted the data best. The estimated R(0) was 3.49 (95%CI: 3.42-3.58) by using EG method. The R(0) was estimated to be 2.95 (95%CI: 2.86-3.03) after taking control measures. Conclusions: In the early stage of the epidemic, it is appropriate to estimate R(0) using the EG method. Meanwhile, timely and effective control measures were warranted to further reduce the spread of COVID-19.

Articular capsule repair in initial artificial hip replacement via anterolateral approach to the hip joint

This study was carried out to explore articular capsule repair in first artificial hip replacement (AHR) via anterolateral approach and its influence on postoperative dislocation. A total of 292 patients who received AHR via anterolateral approach and had the articular capsule repaired in People’s Hospital of Zhengzhou (Henan, China) from February 2008 to February 2014 were selected and divided into total hip replacement (THR) group (group A1) and artificial femoral head replacement (AFHR) group (group A2). Five hundred and five cases in the control group treated using the same approach but receiving no articular capsule repair were divided into THR group (group B1) and AFHR group (group B2). Condition of postoperative dislocation was compared between the two groups. All cases were followed up for 6 months to 5 years (average: 3.75 years); it was noted that the difference in average age, gender, disease constitution and follow-up time in the two groups was not significant (P>0.05). Moreover, groups A1 and B1 were found with 1 case of early hip joint dislocation (0.73%) and 13 cases of hip joint dislocation (5.24%) respectively post-operatively, and the comparison between the two groups was statistically significant (P less than 0.05). One case of hip joint dislocation (0.65%) was found in group A2 and 5 cases (1.95%) in group B2 in early post operation and the difference between two groups had no statistical significance (P>0.05). Neither the repair group nor the control group developed late-onset dislocation after the operation. Thus, we can state that articular capsule repair is feasible during the first AHR via anterolateral approach, which decreases the occurrence of early hip joint dislocation after operation and proves that repairing articular capsule during AFHR via anterolateral approach is unnecessary.

Preliminary observation on human saliva alpha-fetoprotein in patients with hepatocellular carcinoma

The saliva samples from 13 patients with hepatocellular carcinoma and a control group of 21 random healthy adults were measured for alpha-fetoprotein (AFP), using a highly sensitive sandwich enzyme immunoassay specific for human AFP. In patients with hepatocellular carcinoma, significantly higher levels of saliva AFP were observed (mean +/- Sx: 3 552.6 +/- 2 829.9 ng/L) when compared with the value of the normal controls (mean +/- Sx18.1 +/- 3.8 ng/L, P < 0.001). There was significant correlation between saliva and serum AFP in both normal controls (rs = 0.526, n = 21, P < 0.005) and patients with hepatocellular carcinoma (rs = 0.931, n = 13, P < 0.001). In patients with hepatocellular carcinoma, those with positive serum AFP had positive saliva AFP, while those whose serum AFP was negative showed saliva AFP negative as well. It is likely that saliva AFP is derived from plasma by passive seepage. It is promising that the saliva AFP surveillance may be helpful in detection of AFP positive hepatocellular carcinoma, because of its noninvasiveness, acceptableness by almost every person, simplicity in technique, and the strong correlation between saliva and serum AFP.

[Clinical significance of serum secretory immunoglobulin A in cholelithiasis and biliary tract obstruction]

The sera of 93 patients with biliary tract diseases and other diseases were analyzed for secretory immunoglobulin A (sIg A) by sandwich enzyme immunoassay and the results were compared with that in a control group of 117 adults. Serum SIg A levels in patients with bile duct stones or non-cholelithic extrahepatic biliary tract obstruction were markedly higher than that in the control group (P less than 0.001). After drainage of biliary tract, the obstruction was relieved and serum SIg A levels decreased significantly (P less than 0.001). A strong correlation was observed between serum SIg A concentrations and severity of biliary obstruction, rs = 0.743, P less than 0.001. It was also showed that, for the diagnosis of bile duct stone, serum SIgA was more sensitive than serum bilirubin (P less than 0.05) and AKP (P less than 0.025).

[Secretory immunoglobulin A levels of the bile in cholelithiasis]

Secretory immunoglobulin A (SIgA) in the bile was measured in 71 patients with cholelithiasis and in a control group of 10 patients without hepatobiliary disease, by using enzyme immunoassay specific to SIgA. Bile SIgA levels of patients with pigment stone, positive culture of bile for bacteria in a all of them, were significantly lower than that in control group (P less than 0.005); constituent ratios of SIgA in total immunoglobulins were markedly lower than that in the control (P less than 0.001); relative coefficient of excretion of SIgA was also significantly lower than that in the control (P less than 0.001). In patients with infectious cholecystolithiasis, bile SIgA concentrations were lower than that without infection (P less than 0.01), and that in the control (P less than 0.01). These results suggest that there is certain relation between biliary tract infection and low concentrations of bile SIgA.