Evaluation and Comparison of Academic Impact and Disruptive Innovation Level of Medical Journals: Bibliometric Analysis and Disruptive Evaluation.

BACKGROUND: As an important platform for researchers to present their academic findings, medical journals have a close relationship between their evaluation orientation and the value orientation of their published research results. However, the differences between the academic impact and level of disruptive innovation of medical journals have not been examined by any study yet. OBJECTIVE: This study aims to compare the relationships and differences between the academic impact, disruptive innovation levels, and peer review results of medical journals and published research papers. We also analyzed the similarities and differences in the impact evaluations, disruptive innovations, and peer reviews for different types of medical research papers and the underlying reasons. METHODS: The general and internal medicine Science Citation Index Expanded (SCIE) journals in 2018 were chosen as the study object to explore the differences in the academic impact and level of disruptive innovation of medical journals based on the OpenCitations Index of PubMed open PMID-to-PMID citations (POCI) and H1Connect databases, respectively, and we compared them with the results of peer review. RESULTS: First, the correlation coefficients of the Journal Disruption Index (JDI) with the Journal Cumulative Citation for 5 years (JCC5), Journal Impact Factor (JIF), and Journal Citation Indicator (JCI) were 0.677, 0.585, and 0.621, respectively. The correlation coefficient of the absolute disruption index (Dz) with the Cumulative Citation for 5 years (CC5) was 0.635. However, the average difference in the disruptive innovation and academic influence rankings of journals reached 20 places (about 17.5%). The average difference in the disruptive innovation and influence rankings of research papers reached about 2700 places (about 17.7%). The differences reflect the essential difference between the two evaluation systems. Second, the top 7 journals selected based on JDI, JCC5, JIF, and JCI were the same, and all of them were H-journals. Although 8 (8/15, 53%), 96 (96/150, 64%), and 880 (880/1500, 58.67%) of the top 0.1%, top 1%, and top 10% papers selected based on Dz and CC5, respectively, were the same. Third, research papers with the "changes clinical practice" tag showed only moderate innovation (4.96) and impact (241.67) levels but had high levels of peer-reviewed recognition (6.00) and attention (2.83). CONCLUSIONS: The results of the study show that research evaluation based on innovative indicators is detached from the traditional impact evaluation system. The 3 evaluation systems (impact evaluation, disruptive innovation evaluation, and peer review) only have high consistency for authoritative journals and top papers. Neither a single impact indicator nor an innovative indicator can directly reflect the impact of medical research for clinical practice. How to establish an integrated, comprehensive, scientific, and reasonable journal evaluation system to improve the existing evaluation system of medical journals still needs further research.

Engineering marine phospholipid nanoliposomes via glycerol-infused proliposomes: Mechanisms, strategies, and versatile applications in scalable food-grade nanoliposome production.

This study presents a novel approach using polyol-based proliposome to produce marine phospholipids nanoliposomes. Proliposomes were formulated by blending glycerol with phospholipids across varying mass ratios (2:1 to 1:10) at room temperature. Analysis employing polarized light microscopy, FTIR, and DSC revealed that glycerol disrupted the stacked acyl groups within phospholipids, lowering the phase transition temperature (Tm). Krill oil phospholipids (KOP) proliposomes exhibited superior performance in nanoliposomes formation, with a mean diameter of 125.60 ± 3.97 nm, attributed to the decreased Tm (-7.64 and 7.00 °C) compared to soybean phospholipids, along with a correspondingly higher absolute zeta potential (-39.77 ± 1.18 mV). The resulting KOP proliposomes demonstrated liposomes formation stability over six months and under various environmental stresses (dilution, thermal, ionic strength, pH), coupled with in vitro absorption exceeding 90 %. This investigation elucidates the mechanism behind glycerol-formulated proliposomes and proposes innovative strategies for scalable, solvent-free nanoliposome production with implications for functional foods and pharmaceutical applications.

Fabrication of Magnetic Al-Based Fe3O4@MIL-53 Metal Organic Framework for Capture of Multi-Pollutants Residue in Milk Followed by HPLC-UV.

The efficient capture of multi-pollutant residues in food is vital for food safety monitoring. In this study, in-situ-fabricated magnetic MIL-53(Al) metal organic frameworks (MOFs), with good magnetic responsiveness, were synthesized and applied for the magnetic solid-phase extraction (MSPE) of chloramphenicol, bisphenol A, estradiol, and diethylstilbestrol. Terephthalic acid (H2BDC) organic ligands were pre-coupled on the surface of amino-Fe3O4 composites (H2BDC@Fe3O4). Fe3O4@MIL-53(Al) MOF was fabricated by in-situ hydrothermal polymerization of H2BDC, Al (NO3)3, and H2BDC@Fe3O4. This approach highly increased the stability of the material. The magnetic Fe3O4@MIL-53(Al) MOF-based MSPE was combined with high-performance liquid chromatography-photo diode array detection, to establish a novel sensitive method for analyzing multi-pollutant residues in milk. This method showed good linear correlations, in the range of 0.05-5.00 µg/mL, with good reproducibility. The limit of detection was 0.004-0.108 µg/mL. The presented method was verified using a milk sample, spiked with four pollutants, which enabled high-throughput detection and the accuracies of 88.17-107.58% confirmed its applicability, in real sample analysis.

Effect of Molar Substitution on the Properties of γ-Hydroxypropyl Starch.

A new type of hydroxyalkyl starch, γ-hydroxypropyl starch (γ-HPS), was prepared by etherification of alkali-activated starch with 3-chloropropanol. The reaction efficiency, morphological change, thermodynamic and apparent viscosity properties, and other physicochemical characteristics were described. The molar substitution (MS) of modified whole starch was determined to be 0.008, 0.017, 0.053, 0.106, and 0.178, with a ratio of 5%, 15%, 25%, 35%, and 45% 3-chloropropanol to starch (v/w), respectively. Compared to native starch, the granular size and shape and the X-ray diffraction pattern of γ-HPS are not very different. For low-substituted γ-HPS, the implications may be less evident. Thermal stability measurements by means of thermogravimetric analyses and differential scanning calorimetry (TGA-DSC) proved that thermal stability was reduced and water retaining capacity was increased after hydroxypropylation. Furthermore, the findings also showed that the solubility, light transmittance, and retrogradation of γ-HPS pastes could be improved by etherification. The greater the MS of the γ-HPS, the more its freeze-thaw stability and acid resistivity increased. In this study, we provide relevant information for the application of γ-HPS in food and non-food industries.

Quantitative analysis of degree of substitution/molar substitution of etherified polysaccharide derivatives.

Due to the unique properties such as nontoxicity, biodegradability, availability from renewable resources, and cost-effectiveness, polysaccharides play a very important part in the science and technology field. The various chemically modified derivatives of these offer a wide range of high value-added in both food and non-food industries. Among the chemical modification, etherified polysaccharide is one of the most widespread derivatives by introducing an ether group which is commonly stable in both acidic and alkaline conditions. Hydroxyalkylation, alkylation, carboxymethylation, cationization, and cyanoethylation are some of the modifications commonly employed to prepare polysaccharides ethers derivatives. There also has been a growing tendency for creating new types of modification by combining the different means of chemical techniques. The correct determination of degree of substitution (DS)/molar substitution (MS) is crucially important. The objective of this article is to summarize developments in synthetic etherified polysaccharides, involving analytical methods for determination of MS/DS, measurement processes, and the associated mechanisms.

Analysis of Molar Substitution of Hydroxybutyl Group by Zeisel Reaction in Starch Ethers.

A new etherified starch, δ-hydroxybutyl starch (δ-HBS), was prepared by utilising 4-chlorobutan-1-ol as the etherifying reagent. The method of Zeisel gas chromatography for the determination of the molar substitution was described. This technique offers a simple and rapid method for quantitative analysis with reproducible results. Meanwhile, the mechanism of the Zeisel reaction was also investigated.

Optimized trimetallic benzotriazole-5-carboxylate MOFs with coordinately unsaturated active sites as an efficient electrocatalyst for the oxygen evolution reaction.

Exploring efficient and stable oxygen evolution reaction (OER) catalysts with earth-abundant elements has been an urgent task in water splitting. Metal-organic frameworks (MOFs), possessing abundant active metal sites and tunable porous crystalline structures, are promising as OER catalysts. In this paper, a MOF based on benzotriazole-5-carboxylate (Co3-btca) that contains unsaturated coordinated metal centers and a 1D channel was selected to act as an OER catalyst. To optimize the OER performance, isostructural bimetallic and trimetallic frameworks were obtained by doping with Fe and/or Ni ions. The optimized Co2.36Fe0.19Ni0.45-btca possesses the lowest overpotential of 292 mV at 10 mA cm-2 and a small Tafel slope of 72.6 mV dec-1. The enhanced catalytic performance could be attributed to the synergistic effect between the unsaturated coordinated Co, Fe and Ni sites, which are beneficial for the nucleophilic attack of OH- forming adsorption intermediates.

Tryptophan/copper-catalyzed aromatization reaction of chiral cyclohexanones to phenols.

By merging organocatalysis with copper catalysis, a highly efficient stereospecific approach for the synthesis of chiral phenols from cyclohexanones has been developed for the first time. The aromatization reaction proceeds through the in situ formation of enone intermediates and further subsequent bromination/dehydrobromination reactions. And a series of functionalized phenol derivatives are obtained in good yields (up to 89%) and good to excellent enantioselectivities (up to 99% ee).

The Immunogenicity of CRISP1 Plasmid-Based Contraceptive Vaccine can be Improved When Using Chitosan Nanoparticles as the Carrier.

PROBLEM: To evaluate the effectiveness and security of a contraceptive vaccine using plasmid DNA encoding mouse CRISP1 as antigen and chitosan nanoparticles as the carrier. METHOD OF STUDY: Chitosan-pcDNA3.1-mCRISP1 Nanoparticles (CS-DNA NPs) were prepared and characterized in terms of morphology, zeta potential, polydispersity index, and binding capacity of pDNA. The cytotoxicity and gene transfer capability of CS-DNA NPs were assessed in COS-7 cells compared to Lipofectamine 2000(™) . Four groups of mice received three injections of 0.9% normal saline, pcDNA3.1 vector, pcDNA3.1-CRISP1, or CS-DNA NPs, respectively. ELISA was used to examine the immune responses. Fertility and mean litter size were analyzed by natural mating. RESULTS: CS-DNA NPs have a spherical or elliptical shape with a mean diameter of 189.3 nm, positive zeta potential, and good DNA condensation. It also showed high DNAse resistance and good transfection efficiency without cell toxicity. The titers of anti-mCRISP1 antibodies from CS-DNA NP-immunized mice were significantly higher than that of pcDNA3.1-CRISP1 group. Male and female CS-DNA NP-immunized animals were recognized with a statistically significant reduction in their fertility compared with pcDNA3.1-CRISP1-immunized mice. CONCLUSION: This study demonstrated that using chitosan-DNA nanoparticles as the carrier can improve the immunogenicity of mCRISP1 DNA contraceptive vaccine with good security.

Journal Impact Factor: Do the Numerator and Denominator Need Correction?

To correct the incongruence of document types between the numerator and denominator in the traditional impact factor (IF), we make a corresponding adjustment to its formula and present five corrective IFs: IFTotal/Total, IFTotal/AREL, IFAR/AR, IFAREL/AR, and IFAREL/AREL. Based on a survey of researchers in the fields of ophthalmology and mathematics, we obtained the real impact ranking of sample journals in the minds of peer experts. The correlations between various IFs and questionnaire score were analyzed to verify their journal evaluation effects. The results show that it is scientific and reasonable to use five corrective IFs for journal evaluation for both ophthalmology and mathematics. For ophthalmology, the journal evaluation effects of the five corrective IFs are superior than those of traditional IF: the corrective effect of IFAR/AR is the best, IFAREL/AR is better than IFTotal/Total, followed by IFTotal/AREL, and IFAREL/AREL. For mathematics, the journal evaluation effect of traditional IF is superior than those of the five corrective IFs: the corrective effect of IFTotal/Total is best, IFAREL/AR is better than IFTotal/AREL and IFAREL/AREL, and the corrective effect of IFAR/AR is the worst. In conclusion, not all disciplinary journal IF need correction. The results in the current paper show that to correct the IF of ophthalmologic journals may be valuable, but it seems to be meaningless for mathematic journals.

Absorption Characteristics and Environmental Significance of Dissolved Organic Matter in Lake Dongping.

As an important water source in Shandong Province, Lake Dongping is one of the most important inland lakes to South-to-North Water Diversion East Route Project. We tried to provide the basis for real-time monitoring of water quality mutation by using CDOM absorption characteristics. The average values of CDOM absorption coefficients [a(280)，a(350)，a(440)] were (12.90±1.17)，(3.11±0.40) and (0.65±0.09) m-1. a(440) had linear relationships with total nitrogen (p<0.01), total phosphorus (p<0.001), dissolved organic carbon (p<0.001), chemical oxygen demand (p<0.001), Chlorophyll a (p<0.001), which can be used to estimate the water quality parameters. The results showed that CDOM absorption coefficient reflects the nutritional status of Lake Dongping, which is close to eutrophication level. There was an obvious decrease of CDOM absorption coefficients from river mouth of Dawen River to lake center and then to the outlets of lake. This illustrated that terrestrial input is the main source of nutrients and pollutants in Lake Dongping.

An Analysis of Peer-Reviewed Scores and Impact Factors with Different Citation Time Windows: A Case Study of 28 Ophthalmologic Journals.

BACKGROUND: An important attribute of the traditional impact factor was the controversial 2-year citation window. So far, several scholars have proposed using different citation time windows for evaluating journals. However, there is no confirmation whether a longer citation time window would be better. How did the journal evaluation effects of 3IF, 4IF, and 6IF comparing with 2IF and 5IF? In order to understand these questions, we made a comparative study of impact factors with different citation time windows with the peer-reviewed scores of ophthalmologic journals indexed by Science Citation Index Expanded (SCIE) database. METHODS: The peer-reviewed scores of 28 ophthalmologic journals were obtained through a self-designed survey questionnaire. Impact factors with different citation time windows (including 2IF, 3IF, 4IF, 5IF, and 6IF) of 28 ophthalmologic journals were computed and compared in accordance with each impact factor's definition and formula, using the citation analysis function of the Web of Science (WoS) database. An analysis of the correlation between impact factors with different citation time windows and peer-reviewed scores was carried out. RESULTS: Although impact factor values with different citation time windows were different, there was a high level of correlation between them when it came to evaluating journals. In the current study, for ophthalmologic journals' impact factors with different time windows in 2013, 3IF and 4IF seemed the ideal ranges for comparison, when assessed in relation to peer-reviewed scores. In addition, the 3-year and 4-year windows were quite consistent with the cited peak age of documents published by ophthalmologic journals. RESEARCH LIMITATIONS: Our study is based on ophthalmology journals and we only analyze the impact factors with different citation time window in 2013, so it has yet to be ascertained whether other disciplines (especially those with a later cited peak) or other years would follow the same or similar patterns. ORIGINALITY/ VALUE: We designed the survey questionnaire ourselves, specifically to assess the real influence of journals. We used peer-reviewed scores to judge the journal evaluation effect of impact factors with different citation time windows. The main purpose of this study was to help researchers better understand the role of impact factors with different citation time windows in journal evaluation.

Osteopontin facilitates invasion in human trophoblastic cells via promoting matrix metalloproteinase-9 in vitro.

Successful implantation of embryo and placentation depend on proper trophoblast proliferation and differentiated into specialized invasive trophoblast. However, little is known about the regulatory factors and mechanisms in trophoblast proliferation and differentiation. Osteopontin (OPN) is a member of the small integrin-binding ligand N-linked glycoprotein family and participates in cell adhesion and invasion. It has been identified that OPN is highly expressed in invasive trophoblasts in human placenta. In this study, we demonstrated that OPN is constitutively expressed in highly invasive phenotype of human choriocarcinoma cell lines of JAR and JEG-3 cells, and OPN could promote trophoblast proliferation and invasion, partly through promoting MMP-9 secretion. Inhibition of OPN will compromise the abilities of proliferation and invasion in JAR and JEG-3 cell lines. Our data showed that the expression of OPN in trophoblast may participate in placentation, OPN expression defects may be involved in gestational trophoblastic diseases.

Osteopontin is expressed in the mouse uterus during early pregnancy and promotes mouse blastocyst attachment and invasion in vitro.

Embryo implantation into the maternal uterus is a decisive step for successful mammalian pregnancy. Osteopontin (OPN) is a member of the small integrin-binding ligand N-linked glycoprotein family and participates in cell adhesion and invasion. In this study, we showed that Opn mRNA levels are up-regulated in the mouse uterus on day 4 and at the implantation sites on days 5 and 8 of pregnancy. Immunohistochemistry localized the OPN protein to the glandular epithelium on day 4 and to the decidual zone on day 8 of pregnancy. OPN mRNA and proteins are induced by in vivo and in vitro decidualization. OPN expression in the endometrial stromal cells is regulated by progesterone, a key regulator during decidualization. As a secreted protein, the protein level of OPN in the uterine cavity is enriched on day 4, and in vitro embryo culturing has indicated that OPN can facilitate blastocyst hatching and adhesion. Knockdown of OPN attenuates the adhesion and invasion of blastocysts in mouse endometrial stromal cells by suppressing the expression and enzymatic activity of matrix metalloproteinase-9 in the trophoblast. Our data indicated that OPN expression in the mouse uterus during early pregnancy is essential for blastocyst hatching and adhesion and that the knockdown of OPN in mouse endometrial stroma cells could lead to a restrained in vitro trophoblast invasion.

[Efficacy of tianmaixiaoke tablets in the treatment of newly diagnosed type 2 diabetes mellitus in China].

OBJECTIVE: To explore the efficacy and influencing factors of chromium picolinate (tianmaixiaoke tablet) in the treatment of newly diagnosed type 2 diabetes mellitus in China. METHODS: A total of 84 outpatients with newly diagnosed type 2 diabetes mellitus visiting 4 hospitals in Beijing were randomly divided into two equal groups: study group receiving tianmaixiaoke tablet 240 mg bid for 24 weeks (n = 42) and control group sitagliptin 100 mg qd for 24 weeks (n = 42). The levels of fasting plasma glucose (FPG), plasma glucose 2 h after meal (PG2 h) and glycated hemoglobin (HbA1c) were detected before and 24 weeks after treatment. The serum levels of chromium and insulin were detected. RESULTS: Study was completed in 76 patients. The serum level of chromium was significantly lower in the diabetes group than in the normal group at baseline ((56 ± 28) µg/L vs (112 ± 21) µg/L, P = 0.00). At 24 weeks after treatment, the levels of HbA1c, FPG and PG2 h decreased while the serum level of chromium increased significantly in both groups. There were 11 patients with changed HbA1c from baseline (ΔHbA1c) ≥ 1% in the study group. At 24 weeks after treatment, HbA1c decreased by 1.61% (from 8.38% ± 0.72% to 6.77% ± 0.62%) and serum level of chromium increased by 35.14 µg/L in the ΔHbA1c ≥ 1% group with a low baseline serum level of chromium ((36.2 ± 18.0) µg/L). Both study group and control group were divided into three subgroups according to baseline serum level of chromium. ΔHbA1c reduced with the increase in baseline serum level of chromium in study group, while in control group, ΔHbA1c was unrelated with baseline serum level of chromium. At 24 weeks after treatment, insulin resistance index (HOMA-IR) reduced, ß cell function index (HOMA-ß) and insulinogenic index (IGI) increased in both groups. Multiple linear regression showed that the variables significantly associated with ΔHbA1c were baseline HbA1c and the baseline serum level of chromium. CONCLUSIONS: Chromium is commonly deficient in the newly diagnosed type 2 diabetics in China. HbA1c decreases and serum chromium increases significantly after chromium supplementation in the patients with a low baseline serum level of chromium.

Human adenovirus type 41 possesses different amount of short and long fibers in the virion.

To determine the ratio of short fiber (sfiber) to long fiber (lfiber) in human adenovirus type 41 (HAdV-41) virions, sfiber and lfiber were expressed in E. coli, quantified, and used as loading standards in Western blot. Densitometric analyses of the standard and target bands indicated that the ratio of sfiber to lfiber in virions was 5.7±0.7. Sfiber-deleted HAdV-41, HAdV-41-DSF-GFP, was constructed, and Western blot analysis showed that the amount of lfiber in HAdV-41-DSF-GFP was about 7.3±1.9 times of that in HAdV-41 virions, confirming a ratio of approximate 6 for sfiber to lfiber in HAdV-41. In HAdV-41-infected cells, mRNAs of the sfiber and lfiber were comparable in quantity, while the expression at protein level was significantly different. Our results suggested an unequal number of short and long fibers, which might result from their differential protein expression during HAdV-41 packaging. The method used here could be extended to quantify other trace proteins.

[Expression of dendritic cell marker CD21 is a positive prognostic factor in diffuse large B-cell lymphoma].

OBJECTIVE: To analyze CD21 expression in diffuse large B cell lymphoma (DLBCL) and to explore its relationship with the clinicopathological characteristics and prognosis. METHODS: The clinical data from 80 DLBCL patients who were treated in First Hospital of Jilin University from June 2005 to September 2011 were retrospectively analyzed. The cases were subjected to immunohistochemical staining (SP method) for Ki-67, CD20, CD79a, CD3, CD43, CD5, cyclin D1, bcl-2, CD10, bcl-6, GCET-1, FOXP-1 and MUM-1 protein expression in the tumor tissue. Immunohistochemistry was also used to detect CD21 expression in the tumor tissue. SPSS 18.0 was used to analyze the relationship between CD21 expression and various clinical factors, and the relationship between various clinical factors including CD21 and overall survival. RESULTS: In the patients aged under 60 years, the incidence of CD21(+) lymphoma (64.0%, 16/25) was significantly higher than that of CD21(-) lymphoma (38.2%, 21/55). There were more CD21(+) lymphoma patients who were at clinical stages I-II (52.0%, 13/25) than patients with CD21(-)lymphomas (23.6%, 13/55). There were also more CD21(+) lymphoma patients (68.0%, 17/25) having less than two extranodal sites involvement than CD21(-)lymphoma patients (41.8%, 23/55). In addition, there were more CD21(+) lymphoma patients with IPI 0-2 (68.0%, 17/25) than CD21(-)lymphoma patients (41.8%, 23/55). There were more CD21(+) lymphoma patients with GCB subtype (60.0%, 15/25) than CD21(-)lymphoma patients (23.6%, 13/55). Death related to DLBCL was less in CD21(+) lymphoma patients (32.0%, 8/25) than CD21(-) lymphoma patients (56.4%, 31/55). Univariate analysis showed that these clinical pathological characteristics affected the overall survival of DLBCL patients, including age, ECOG score, LDH, extranodal involvement, IPI index, CD21 expression, treatment option and efficacy (P < 0.05) . Cox multivariate analysis showed that ECOG score, LDH, extranodal involvement, CD21 expression were closely related to prognosis, and the difference was statistically significant (P < 0.05). Among the 80 patients, the overall survival (OS) of CD21(+) lymphoma patients was significantly higher than that of CD21(-) lymphoma patients. CONCLUSIONS: The expression of CD21 is associated with young age at onset, early clinical stage, small number of involvement and low IPI index. The OS and median overall survival of CD21(+) lymphoma patients are significantly higher than those of CD21(-) patients. CD21 expression, ECOG score, LDH, extranodal involvement are independent prognostic factors in DLBCL, and in particular, the expression of CD21 is more significant in the prognosis of DLBCL patients.

[Antihypertensive effect of metformin in essential hypertensive patients with hyperinsulinemia.].

OBJECTIVE: To investigate the possibility and utility of metformin alone or in combination with fosinopril to reduce blood pressure in patients with essential hypertension. METHODS: A total of 140 cases of non-diabetic essential hypertension with hyperinsulinemia were recruited and randomly assigned to two groups: a group of 68 treated with metformin 500 mg tid and a group of 72 treated with fosinopril 10 mg qd. The duration of the treatment was 8 weeks. Combination therapy with the two drugs was used after 4 weeks of treatment if needed. If the target goals of systolic blood pressure (SBP) < 140 mm Hg (1 mm Hg = 0.133 kPa) and/or diastolic blood pressure (DBP) < 90 mm Hg were not attained 4 weeks, combination therapy with two drugs was used in either group in the next 4 weeks. The changes of blood pressure and insulin sensitivity of the two groups were observed before and after treatment. RESULTS: (1) After 4 weeks of treatment, SBP in metformin group and fosinopril group decreased by (13.0 +/- 1.2) mm Hg and (15.4 +/- 1.4) mm Hg, and DBP decreased by (9.0 +/- 1.0) mm Hg and (10.4 +/- 1.1) mm Hg respectively. After 8 weeks of treatment, SBP in metformin group and fosinopril group decreased by (17.8 +/- 1.5) mm Hg and (20.9 +/- 1.5) mm Hg, and DBP decreased by (13.2 +/- 0.9) mm Hg and (15.3 +/- 1.1) mm Hg respectively. There was no significant difference in the decline of blood pressure between the two groups (P > 0.05). The rates of combination therapy were both 54% in the two groups. (2) Fasting insulin as well as 30 min and 120 min insulin levels after oral glucose tolerance test and insulin area under the curve in the metformin group were significantly reduced after 4 and 8 weeks of treatment as compared with those of baseline (P < 0.05 and P < 0.01). In the fosinopril group, however, they decreased only after 8 weeks treatment (P < 0.05). The insulin action index in the metformin group was higher than that in the fosinopril group after 4 weeks of treatment (P < 0.05), but there was no significant difference between the two groups after 8 weeks of treatment (P > 0.05). CONCLUSION: Metformin and fosinopril have similar antihypertensive effect and a good synergy in essential hypertension with hyperinsulinemia.

[Study on the distribution and risk factors of hypertension among children: a cohort study].

OBJECTIVE: To explore the association between hypertension and the tendency of change among children,so as to lay a foundation for the prevention and control of hypertension. METHODS: Based on findings from the prevalence survey that carried out in September 1999 in Daqing of Heilongjiang province. New admission children were selected as subjects to conduct a five-year cohort study. All the subjects were interviewed with questionnaires and their blood specimens were collected for biochemical analysis. All data were analyzed using SPSS 10.0 software. Results The prevalence of hypertension among 447 children was found 2.01% at the baseline study but increased to 5.37% in the fifth year. During a five year period, the systolic pressure level among children increased from (100.65 +/- 11.62)mmHg (1 mm Hg = 0.133 kPa) to (106.67 +/- 9.29) mm Hg,while the diastolic pressure level was from (66.27 +/- 11.31) mm Hg to (70.28 +/- 7.98) mm Hg and showed significant difference between boys and girls. There were association between hypertension and family history, body mass index (BMI), triglyceride, insulin, insulin resistance index while insulin sensitivity index and family history, BMI and insulin sensitivity index appeared to be the important factors. Children under this study were divided to 'with family history or without' and then every group was divided to 'with over weight-obesity or normal'. Obesity and insulin sensitivity seemed the key risk factors on hypertension. Descent of insulin sensitivity was an independent risk factor. CONCLUSION: The level of blood tension among children in Daqing city was higher than that from the national data. The present study confirmed that over-weight,obesity, heredity and insulin resistance were the risk factors of hypertension while insulin resistance was related to hypertension. The interaction of these risk factors was independent or correlated to each other.