Validation of the iHealth Track upper-arm blood pressure monitor KN-550BT in general population according to the AAMI/ESH/ISO Universal Standard (ISO 81060-2:2018+AMD1:2020).

OBJECTIVE: To validate the iHealth Track KN-550BT oscillometric upper-arm blood pressure monitor in general population according to the AAMI/ESH/ISO Universal Standard (ISO 81060-2:2018+AMD1:2020). METHODS: Participants were recruited and the same left-arm sequential method was used for blood pressure measurement according to the ISO 81060-2:2018+AMD1:2020. The validation results were assessed following the protocol and the Bland-Altman scatterplot was used to show the difference between the test device and reference results. RESULTS: A total of 89 qualified participants were included in the final analysis. For the validation Criterion 1, the mean ± SD of the differences between the test device and reference readings was -1.22 ±â€…5.76 mmHg and -0.08 ±â€…4.40 mmHg for systolic and diastolic blood pressure, respectively. For Criterion 2, the mean ± SD of the differences between the test device and reference readings per participant was -1.22 ±â€…5.06 mmHg and -0.08 ±â€…3.84 mmHg for systolic and diastolic blood pressure, respectively. CONCLUSION: The iHealth Track KN-550BT upper-arm blood pressure monitor passed all the requirements of the AAMI/ESH/ISO Universal Standard (ISO 81060-2:2018+AMD1:2020) and can be recommended for clinical use and self-measurement in general population.

Structure-guided peptide engineering of a positive allosteric modulator targeting the outer pore of TRPV1 for long-lasting analgesia.

Transient receptor potential vanilloid 1 (TRPV1) ion channel is a classic analgesic target, but antagonists of TRPV1 failed in clinical trials due to their side effects like hyperthermia. Here we rationally engineer a peptide s-RhTx as a positive allosteric modulator (PAM) of TRPV1. Patch-clamp recordings demonstrate s-RhTx selectively potentiated TRPV1 activation. s-RhTx also slows down capsaicin-induced desensitization of TRPV1 in the presence of calcium to cause more calcium influx in TRPV1-expressing cells. In addition, our thermodynamic mutant cycle analysis shows that E652 in TRPV1 outer pore specifically interacts with R12 and K22 in s-RhTx. Furthermore, we demonstrate in vivo that s-RhTx exhibits long-lasting analgesic effects in noxious heat hyperalgesia and CFA-induced chronic inflammatory pain by promoting the reversible degeneration of intra-epidermal nerve fiber (IENF) expressing TRPV1 channels in mice, while their body temperature remains unaffected. Our results suggest s-RhTx is an analgesic agent as a PAM of TRPV1.

Essential oil from the roots of Paeonia lactiflora pall. has protective effect against corticosterone-induced depression in mice via modulation of PI3K/Akt signaling pathway.

For thousands of years, the roots of Paeonia lactiflora Pall (PLP) has been considered by traditional Chinese medicine as a drug that can improve mental or emotional disorders, including depression, anxiety and affective disorders. Unfortunately, the research on the mechanism of action and active ingredients of this beneficial drug is not comprehensive. This study focused on the activity of essential oil from PLP (EOP), systematically studied the antidepressant effect of EOP for the first time, and discussed the potential mechanism of its antidepressant effect. In this study, we used a mouse model of corticosterone (CORT)-induced depression, and found that EOP had a significant antidepressant effect on the symptoms of CORT-induced depression in mice, and significantly down-regulated the levels of CRH, ACTH and cortisol in the brain tissues of mice. In addition, we found that EOP treatment alleviated CORT-induced hippocampal neuron injury in mice In vitro experiments. It was also found that EOP could inhibit CORT-induced apoptosis and improve the proliferation ability and cell viability of PC12 cells. Further, with the help of network analysis, it was revealed that PI3K-Akt might be one of the main signaling pathways of EOP against CORT-induced hippocampal neuron apoptosis. In this study, we also found that EOP up-regulated the phosphorylation of PI3K and Akt in CORT-induced mouse hippocampal neurons and PC12 cells, and promoted the nuclear transcription of Nrf2 in CORT-induced PC12 cells. In conclusion, with the integrated approach, we demonstrated that EOP exerted anti-apoptotic effects on hippocampal neurons through PI3K/Akt/Nrf2 signaling pathway.

Alleviation of oxidative stress in pancreatic tissue of hyperglycemic mice by Lactiplantibacillus plantarum SCS4.

This study aimed to investigate the effect of Lactiplantibacillus plantarum SCS4 in alleviating oxidative stress in the pancreatic tissue of hyperglycemic mice. A total of 90 six-week-old specific pathogen-free male Kunming mice were randomly divided into six groups [normal group (NG), blank control group (MG), phosphate-buffered saline (PBS) control group (CG), SCS4 first control group (DT1), SCS4 second control group (DT2), and SCS4 third control group (DT3)]. Except the NG group, in the other five groups, streptozotocin (STZ) was intraperitoneally injected for five consecutive days to establish a hyperglycemia model; the concentration of STZ was 50 mg/kg (bw). After successful modeling, DT1, DT2, and DT3 mice were administered 0.2 ml of L. plantarum SCS4 bacterial solution (1010 colony forming unit/ml), the cellular content of L. plantarum SCS4, and the inactivated cellular content of L. plantarum SCS4, respectively. Furthermore, 0.2 ml of PBS was given to mice in the CG group for control. The levels of insulin (INS), reactive oxygen species (ROS), malondialdehyde (MDA), and antioxidant enzymes such as superoxide dismutase (SOD), glutathione peroxidase (GPx), and catalase (CAT) were measured by enzyme-linked immunosorbent assay, and the morphology of the pancreas was observed. The results showed that after 10 weeks of gavage treatment, the level of INS in the DT3 group significantly increased to 6.36 mIU/L compared with that in the MG group (p < .05). Meanwhile, the levels of ROS and MDA of DT3 returned to normal levels of 291.07 IU/ml and 4.29 mnol/L, respectively. The activities of various antioxidant enzymes increased. The levels of SOD, CAT, and GPx in DT3 were the closest to the levels in NG. In addition, the pathological sections showed that the degree of pancreatic tissue lesions was relatively more severe in the MG group than in the NG group. The degree of pancreatic tissue lesions was relatively less severe in the DT2 group than in the MG group, and no significant lesion was seen in the DT3 group. Our results indicated that the inactivated bacterial content of L. planetarium SCS4 was more effective in improving oxidative stress in the pancreas of hyperglycemic mice. PRACTICAL APPLICATIONS: L. plantarum SCS4 was separated from fermented sausage in Sichuan. This study indicated that inactivated bacterial content of L. planetarium SCS4 was more effective in improving oxidative stress in the pancreas of hyperglycemic mice. The results suggested that lactic acid bacteria from traditional foods with ability of improving oxidative damage, which can be applied in food nutrition and related fields to make people with good dietary habits and prevent the occurrence of chronic diseases such as type II diabetes effectively.

Health benefits of spices in individuals with chemotherapeutic drug-induced cardiotoxicity.

Cardio-oncology is an emerging field that mainly focuses on a series of cardiovascular diseases caused by chemotherapy and radiotherapy. In the history and culture of human nutrition, spices have been emphasized for their wide range of economic and medical applications in addition to being used as a food-flavoring agent and food preservative. Currently, an increasing number of studies have focused on the health benefits of spices in preventing cardiovascular diseases, particularly their antioxidant effects against cardiovascular damage. This review summarizes the cardioprotective effects of black pepper, cardamom, clove, garlic, ginger, onion, and other spices against chemotherapeutic drug-induced cardiotoxicity and the potential mechanisms. Here, we recommend dietary adjustments with spices for patients with cancer to prevent or mitigate the cardiotoxicity induced by chemotherapeutic agents.

Antiepileptic Effects of Cicadae Periostracum on Mice and Its Antiapoptotic Effects in H2O2-Stimulated PC12 Cells via Regulation of PI3K/Akt/Nrf2 Signaling Pathways.

Cicadae Periostracum (CPM), a commonly used animal traditional Chinese medicine (TCM), possesses antifebrile, spasmolytic, antiasthmatic, and antiphlogistic effects. In our present paper, we aimed to systemically investigate the antiepileptic effects of CPM in epileptic mice and explore the related molecular mechanism. Pentylenetetrazole- (PTZ) and strychnine-induced convulsion mice were established, and the results showed CPM could prolong the latency of convulsion and death and improve the neuronal damage in the hippocampus of PTZ-induced mice. Furthermore, the H2O2-treated PC12 cells were prepared to explore the possible mechanisms for the antiepileptic effects of CPM. CCK-8 results showed that CPM significantly improved the cell viability of H2O2-treated PC12 cells. Results of the acridine orange- (AO-) ethidium bromide (EB) staining, cell mitochondrial membrane potential (MOMP) analysis, and flow cytometry analysis showed that CPM significantly suppressed the H2O2-induced apoptosis in PC12 cells. In addition, CPM also downregulated the proapoptosis proteins, including Bax, cleaved- (C-) caspase-3, and C-caspase-9, and upregulated Bcl-2. Furthermore, CPM reduced the reactive oxygen species (ROS) levels via increasing antioxidative enzyme activities, including superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-Px). Importantly, CPM could increase the phosphorylation of phosphoinositide 3-kinase (PI3K) and protein kinase B (Akt) in H2O2-induced PC12 cells and can promote the nuclear transfer of the nuclear factor E2-related factor 2 (Nrf2) and increase the expression of heme oxygenase-1 (HO-1) in the cytoplasm. In conclusion, our present study suggested CPM possessed antiepileptic effects through antiapoptosis of neuron cells via regulation of the PI3K/Akt/Nrf2 signaling pathway.

Exploring the antioxidant effect of Lactobacillus plantarum SCS2 on mice with type 2 diabetes.

This study aimed to evaluate the antioxidant effect of Lactobacillus plantarum SCS2 (L. plantarum SCS2). After 1 week of acclimation, 120 male KM mice were divided into normal group (NG), model group (MG), solvent control group (KG), and different test groups (TG1, TG2, TG3) (n = 20/group) randomly. In the second week, except NG mice, other mice were given 0.2 ml 50 mg/kg (body weight) streptozocin (STZ) through intraperitoneal injection for 5 days. After successful modeling, NG and MG mice were fed normally, KG mice was given 0.5 ml 0.1 mol/L phosphate buffer saline (PBS) per day, TG1, TG2, and TG3 mice were given 0.5 ml suspension, intracellular content and heat-killed intracellular content of L. plantarum SCS2 per day for 9 weeks. Body weight and blood glucose were observed and recorded during intragastric administration. Glucose tolerance levels were measured at the twelfth week, then mice were sacrificed and the serum was collected to measure insulin (INS), glycosylated hemoglobin (HbA1c), malondialdehyde (MDA), reactive oxygen species (ROS) and antioxidant enzymes. The results showed that the reduction of weight loss in TG1 and TG2 mice was observed, which was consistent with the blood glucose. At the same time, the INS level of TG1, TG2, and TG3 mice were increased and the HbA1c levels were decreased. Otherwise, the MDA and ROS content in the serum of TG1, TG2, and TG3 mice were decreased and the level of antioxidant enzymes was increased. Interestingly, the activity and content of antioxidant enzymes in TG2 group was the highest in the three test groups. PRACTICAL APPLICATIONS: The results of this study showed that L. plantarum SCS2 could effectively reduce blood glucose, relieve weight loss, improve INS deficiency, and also improve oxidative stress by increasing the activity of antioxidant enzymes. The findings suggest that L. plantarum SCS2 could improve diabetes-related symptoms by alleviating oxidative stress. In the future, people could promote the application of lactic acid bacteria (LAB) which is found in traditional foods with the ability of improving oxidative damage in food nutrition and related fields, so as to guide residents to form good dietary habits, and effectively prevent type 2 diabetes. Meanwhile, it also can enhance the edible value of traditional foods.

Hydroxy-α-sanshool Possesses Protective Potentials on H2O2-Stimulated PC12 Cells by Suppression of Oxidative Stress-Induced Apoptosis through Regulation of PI3K/Akt Signal Pathway.

Zanthoxylum bungeanum pericarp is a commonly used herbal medicine in China with effects of anti-inflammatory and analgesic, improving learning and memory ability, while hydroxy-α-sanshool (HAS) is the most important active ingredient of Z. bungeanum pericarps. The purpose of this study was to investigate the neuroprotective effect of HAS and its related possible mechanisms using a H2O2-stimulated PC12 cell model. CCK-8 assay results showed that HAS had a significant protective effect on H2O2-stimulated PC12 cells without obvious cytotoxicity on normal PC12 cells. Flow cytometry and fluorescence microscope (DAPI staining and DCFH-DA staining) indicated that HAS could reduce the H2O2-induced apoptosis in PC12 cells via reduction of intracellular ROS and increase of mitochondrial membrane potential (MMP). Subsequently, results of malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-Px) determination suggested that HAS could increase the enzyme activities of SOD, CAT, and GSH-Px whereas it could decrease the MDA contents in H2O2-stimulated PC12 cells. Furthermore, the western blotting assays showed that HAS could upregulate the expressions of p-PI3k, Akt, p-Akt, and Bcl-2, while it could downregulate the expressions of cleaved caspase-3 and Bax in H2O2-stimulated PC12 cells. Collectively, it could be concluded according to our results that HAS possesses protective potentials on H2O2-stimulated PC12 cells through suppression of oxidative stress-induced apoptosis via regulation of PI3K/Akt signal pathway.

Pre-Registration Assessment of Bone-Filling Products.

The use of bone-filling material to repair bone defects and fix implanted bone grafts is a developing area in medicine. Investigators can evaluate bone-filling materials through use of several indices to make comparisons and to determine suitability for application in humans1 . However, it is quite difficult to transform their discovery into practical use, because the viability of the studied material might require examination of all aspects of properties. In addition, for a material to become a product, a complete procedure involving a declaration, registration, and approval is necessary. This article introduces the technical indices that the investigators and reporters should provide in their declaration and registration data to meet the relevant standards in China. The indices include physical and chemical properties, biocompatibility, biosecurity, pre-clinical animal model tests, sterilization and disinfection, product duration, and packaging. Full consideration of all possible indices is crucial to realize the transformation from a designed product to a commercial medical device, which requires effective interaction between clinicians and engineers.

Upregulation of PITX2 Promotes Letrozole Resistance Via Transcriptional Activation of IFITM1 Signaling in Breast Cancer Cells.

PURPOSE: Although the interferon α (IFNα) signaling and the paired-like homeodomain transcription factor 2 (PITX2) have both been implicated in the progression of breast cancer (BCa), it remains obscure whether these two pathways act in a coordinated manner. We therefore aimed to elucidate the expression and function of PITX2 during the pathogenesis of endocrine resistance in BCa. MATERIALS AND METHODS: PITX2 expression was assessed in BCa tissues using quantitative reverse transcription polymerase chain reaction (RT-qPCR) and immunohistochemistry and in experimentally induced letrozole-resistant BCa cells using RT-qPCR and immunoblotting. Effects of PITX2 deregulation on BCa progression was determined by assessing MTT, apoptosis and xenograft model. Finally, using multiple assays, the transcriptional regulation of interferon-inducible transmembrane protein 1 (IFITM1) by PITX2 was studied at both molecular and functional levels. RESULTS: PITX2 expression was induced in letrozole-resistant BCa tissues and cells, and PITX2 induction by IFNα signaling powerfully protected BCa cells against letrozole insult and potentiated letrozole-resistance. Mechanistically, PITX2 enhanced IFNα-induced AKT activation by transactivating the transcription of IFITM1, thus rendering BCa cells unresponsive to letrozoleelicited cell death. Additionally, ablation of IFITM1 expression using siRNA substantially abolished IFNα-elicited AKT phosphorylation, even in the presence of PITX2 overexpression, thus sensitizing BCa cells to letrozole treatment. CONCLUSION: These results demonstrate that constitutive upregulation of PITX2/IFITM1 cascade is an intrinsic adaptive mechanism during the pathogenesis of letrozole-resistance, and modulation of PITX2/IFITM1 level using different genetic and pharmacological means would thus have a novel therapeutic potential against letrozole resistance in BCa.

Somatic mutation profiling of liver and biliary cancer by targeted next generation sequencing.

Liver and biliary cancers are highly lethal cancer types lacking effective treatments. The somatic mutations, particularly those with low mutant allele frequencies, in Chinese patients with liver and biliary cancer have not been profiled, and the frequency of patients benefiting from targeted therapy has not been studied. The present study evaluated the tumor tissues of 45 Chinese patients with hepatocellular carcinoma (HCC) and 12 Chinese patients with biliary tract cancer (BTC) by targeted next generation sequencing, with an average coverage of 639×, to identify alterations in 372 cancer-related genes. A total of 263 variants were identified in 139 genes, with 85.6% of these variants not previously reported in the Catalogue Of Somatic Mutations In Cancer database, and the mutation profile was different from the current datasets, including The Cancer Genome Atlas dataset and the National Cancer Center Japan (NCC_JP) dataset. Patients with hepatitis B virus (HBV) infection harbored more mutations than those without HBV infection, and the mutations in HBV carriers occurred preferentially in genes involved in vascular endothelial growth factor signaling pathways. Mutations in fibroblast growth factor and RAS signaling pathways were enriched in patients with cirrhosis, and alterations in interleukin and transforming growth factor signaling pathways were more frequently identified in individuals with abnormal bilirubin expression. Of all the patients, 7% exhibited variants in the target of sorafenib, and 42% harbored variants in the targets of drugs that have been approved to treat other types of cancer. These findings indicate diverse HCC/BTC variants patterns in different populations, and that the mutation load and patterns are correlated with clinical features. Further clinical studies are now warranted to evaluate the efficacies of other targeted drugs besides sorafenib in the treatment of patients with liver and biliary cancer.

Serum Dickkopf-1 acts as a new biomarker in human breast cancer.

BACKGROUND: The serum levels of Dickkopf-1 (DKK1), a secreted Wnt family protein, are different in patients suffering various types of cancers. In the present study, we aim to explore the diagnostic value of DKK1 as a new biomarker in breast cancer. METHODS: Serum was collected from 38 patients with breast cancer and 23 healthy controls. Serological levels of DKK1 were examined by enzyme-linked immunosorbent assay (ELISA). Significance and diagnostic performance including receiver operator characteristic (ROC) and areas under the curve were determined by SPSS software. RESULTS: Serum level of DKK1 was significantly increased in breast cancer patients compared to the healthy controls (P˂0.05). The expression levels of CA15-3 were also evaluated in patients suffering from breast cancer in comparison with healthy controls (P˂0.05). AUC for DKK1 and CA15-3 were 0.81 and 0.64 respectively. Sensitivity and specificity of DKK1 were more than CA15-3 in earlier stage of breast cancer. DKK1 expression in HER-2, estrogen receptor (ER) and progesterone receptor (PR) positive patients was decreased compared with HER-2, ER and PR negative patients. CONCLUSIONS: We found that the expression level of DKK1 in serum was increased in breast cancer patients, suggesting that serum expression level of DKK1 could be a useful biomarker in breast cancer.

Chemometric Classification of Different Tree Peony Species Native to China Based on the Assessment of Major Fatty Acids of Seed Oil and Phenotypic Characteristics of the Seeds.

In the present study, we quantitatively measured five major fatty acids (FA) in seed oil using gas chromatography/mass spectrometry (GC/MS) and examined four phenotypic characteristics of the seeds from 19 populations from nine wild tree peony species native to China. The results showed that the unsaturated FAs contents were dominant, of which α-linolenic acid (ALA), linoleic acid, and oleic acid (OA) contents ranged from 14.84 to 42.54 g/100 g, 7.33 to 19.66 g/100 g, and 15.07 - 35.31 g/100 g crude oil, respectively. The phenotypic seed characteristics, such as thousand seed weight (244.01 - 1772.91 g), seed volume (91.31 - 1000.79 mm3 ), weight rate of kernel and coat (1.29 - 3.62) and oil extraction ratio (20.32 - 34.69%), dramatically varied. Based on the contents of the five FAs, the nine species were classified into two groups. The species belonging to subsection Vaginatae were arranged in cluster I and were characterized by high ALA content. Cluster II, consistent with subsection Delavayanae, had a high OA content. From horizontal and vertical perspectives, the natural distribution areas of these two groups were different, reflecting differences in the FA contents and phenotypic seed characteristics. In conclusion, the FAs composition could be used as a chemotaxonomic marker for tree peony species.

miR-1271 inhibits ERα expression and confers letrozole resistance in breast cancer.

Attenuation of estrogen receptor α (ERα) expression via unknown mechanism(s) is a hallmark of endocrine-resistant breast cancer (BCa) progression. Here, we report that miR-1271 was significantly down-regulated in letrozole-resistant BCa tissues and in letrozole-resistant BCa cells. miR-1271 directly targeted the chromatin of DNA damage-inducible transcript 3 (DDIT3) gene. miR-1271 expression level was inversely correlated to DDIT3 mRNA level in BCa biopsies. Form a mechanistic standpoint, reintroduction of exogenous miR-1271 could effectively restore ERα level via inhibiting DDIT3 expression, thereby potentiating letrozole sensitivity in BCa cells. Moreover, DDIT3 deregulation promoted letrozole-resistance by acting as a potent corepressor of ESR1 transcription. Taken together, we have identified that disruption of the miR-1271/DDIT3/ERα cascade plays a causative role in the pathogenesis of letrozole resistance in BCa.

Performance measures for management of chronic heart failure patients with acute coronary syndrome in China: results from the Bridging the Gap on Coronary Heart Disease Secondary Prevention in China (BRIG) Project.

BACKGROUND: Chronic heart failure (CHF) is a severe clinical syndrome associated with high morbidity and mortality, and with high health care expenditures. No nationwide data are currently available regarding the quality of clinical management of CHF patients in China. The aim of this study was to assess the quality of care of CHF inpatients in China. METHODS: The American College of Cardiology/American Heart Association Clinical Performance Measures for Adults with Chronic Heart Failure (Inpatient Measurement Set) with slight modifications was used to measure the performance status in 612 CHF patients with acute coronary syndrome (ACS) from 65 hospitals across all regions of China. RESULTS: The implementation rates of guideline recommended strategies for CHF management were low. Only 57.5% of the CHF patients received complete discharge instructions, 53.6% of the patients received evaluation of left ventricular systolic function, 62.8% received an angiotensin-converting enzyme inhibitor/angiotensin receptor blocker at discharge, and 52.7% received a ß-blocker at discharge, 56.3% of the smokers received smoking cessation counseling. The rate of warfarin utilization was only 9.7% in CHF patients with atrial fibrillation. Most patients (81.4%) did not receive all the first four treatments. There were marked differences in the quality of CHF management among patients with different characteristics. CONCLUSIONS: Performance measures provide a standardized method of assessing quality of care, and can thus highlight problems in disease management in clinical practice. The quality of care for CHF patients with ACS in China needs to be improved.

[Clustering of cardiovascular risk factors and hypertension control status among hypertensive patients in the outpatient setting].

OBJECTIVE: To investigate the status of the clustering of cardiovascular risk factors and hypertension control among hypertensive patients in the outpatient setting in China. METHODS: This multi-center cross-sectional study was carried out from June to December 2009. Study patients were consecutively recruited from 46 hypertension outpatient clinics in 22 provinces, autonomous regions, and municipalities of China according to identical inclusion criteria. More than 100 consecutive patients should be recruited in each outpatient clinic, and 5206 hypertensive outpatients were included. The patients were examined by questionnaires, physical examinations, and biochemical analyses. Risk factors were defined according to the 2010 Chinese guidelines for the management of hypertension. RESULTS: In this patient cohort, dyslipidemia was found in 61.5% (3203/5206), obesity in 56.0% (2917/5206), and impaired glucose regulation in 27.8% (1449/5206) patients. The prevalence of smoking was 34.9% (910/2605) in male hypertensive patients, 88.9% (4630/5206) hypertensive patients had at least one of the above-mentioned four risk factors and 17.4% (906/5206) had three or more risk factors. Only 4.1% (211/5206) hypertensive outpatients were classified as low cardiovascular risk patients, 72.5% (3774/5206) hypertensive outpatients were classified as high or very high cardiovascular risk patients. The general blood pressure control rate was 44.3% (2304/5206), which was higher in the age group of ≥ 65 years than in those of 35-44 years [51.3% (818/1596) vs. 29.6% (160/541), P < 0.01], higher in low-risk patients than in high-risk patients [65.4% (138/211)vs. 41.9% (1581/3774), P < 0.01] and higher in patients under regular therapy ( ≥ 9 months per year) than in those of irregular therapy (< 6 months per year) [50.7% (1744/3442)vs. 30.0% (391/1305), P < 0.01]. CONCLUSION: Clustering of cardiovascular risk factors, especially dyslipidemia and obesity, is common, and cardiovascular risk is high while blood pressure control rate is low among hypertensive outpatients in China.

[Association between both triglyceride level, newly identified carotid plaque and middle-aged and elderly population, Beijing].

OBJECTIVE: To evaluate the association between triglyceride (TG) level and newly identified 5-year carotid plaque and to explore the prediction value of TG level on the newly-identified carotid plaque with risk factors of traditional atherosclerosis. METHODS: A cohort study was adopted. The baseline survey including CVD risk factors and B-mode ultrasound of carotid artery was performed in 2002, and the second follow-up examination was performed in 2007. We evaluated 1949 participants with lipid measurements and B-mode ultrasound of carotid arteries in the two surveys (with mean age as 57.9±8.1 years and 39.2% were men). The baseline TG levels were divided into four groups: group 1 (TG<1.13 mmol/L), group 2 (TG=1.13-1.69 mmol/L), group 3 (TG=1.70-2.25 mmol/L) and group 4 (TG≥2.26 mmol/L). Newly identified carotid plaque was regarded as the indicator of progression of carotid atherosclerosis. New relationship between fasting TG levels and newly identified carotid plaque was analysed. RESULTS: Compared to newly identified carotid plaque which including different TG level groups, the incidence of newly artery plaque had significantly increased along with the increase of baseline triglyceride level (30.8%, 38.8%, 41.9% and 44.2% respectively, with χ2=21.22, P<0.01). Compared to individuals (TG<1.13 mmol/L), TG seemed a risk factor of plaque progression (P<0.01). After adjusted for age, sex, dyslipidemia and other risk factors, high TG group (TG≥2.26 mmol/L) appeared a significant independent predictor of newly identified carotid plaque (OR=1.37, 95%CI: 1.00-1.86). When further stratifying the traditional atherosclerosis risk factors, we found that high TG group with smoking or hypertension was an independent factor of atherosclerosis progression. CONCLUSION: With the increase of triglyceride levels, the rate of newly identified carotid plaque also increased. After adjusting age, sex, dyslipidemia and other risk factors, serum fasting TG≥2.26 mmol/L appeared to be an independent predictor of newly developed carotid plaque.

[Association between high sensitivity C-reactive protein levels in serum and the 5-year-accumulative-risk of diabetes].

OBJECTIVE: To analyze the association between hs-CRP (high-sensitivity C-reactive protein) levels in serum and the 5-year-accumulative-risk of diabetes in a general population. METHODS: Participants were from the cohort of Peking University residential community in the Chinese Multi-provincial Cohort Study (CMCS). Two surveys on cardiovascular risk factors and the measurements of serum hs-CRP levels were conducted in 2002 and 2007, respectively. Individuals with incomplete information and those having infectious diseases at baseline were excluded. A total of 1045 participants aged 45 to 74 years and free of diabetes at baseline were included in this analysis. RESULTS: The age-standardized 5-year accumulative incidence rate of diabetes was 8.8% (male: 9.8%, female: 8.2%) and increased significantly with the level of hs-CRP in both women and men (P<0.01). After adjustment for age, hypertension, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol, triglycerides, fasting glucose, smoking status and central obesity, people with hs-CRP≥3 mg/L had a 3.30 times higher risk of developing diabetes in men and 2.58 times for women when compared to those with hs-CRP<1 mg/L. The areas under the receiver operating characteristic curves of baseline hs-CRP level in predicting the incidence of diabetes were 0.619 (95%CI: 0.536-0.701) in men and 0.667 (95%CI: 0.585-0.749) in women. CONCLUSION: Serum hs-CRP levels could predict the incidence of diabetes, indicating that inflammation might have great importance in the onset of diabetes.

[Relationship between serum non-high-density lipoprotein cholesterol and incidence of cardiovascular disease].

OBJECTIVE: To evaluate the relationship between serum non-HDL-C and incidence of various cardiovascular disease (CVD) in Chinese population aged 35-64 years. METHODS: This prospective study was performed from 1992 to 2004 in 11 provinces of China and the association between baseline non-HDL-C level with the risk of various CVD events was analyzed in 29 937 subjects aged 35-64 years using Cox multivariate proportional hazards regression. CVD events in this study including acute coronary events (ACE), ischemic stroke, hemorrhagic stroke and ischemic cardiovascular disease (ICVD). RESULTS: (1) Adjusted for age, gender, smoking status, diabetes, body mass index and blood pressure, the relative risk of ACE, ischemic stroke and ICVD in groups of non-HDL-C 3.37 - 4.13 mmol/L (130 - 159 mg/dl), 4.14 - 4.91 mmol/L (160 - 189 mg/dl) and ≥ 4.92 mmol/L (190 mg/dl) was 1.24 (0.91 - 1.70), 1.78 (1.25 - 2.53), 2.23 (1.48 - 3.35); 1.34 (1.07 - 1.68), 1.38 (1.04 - 1.83), 1.38 (0.97 - 1.94) and 1.37 (1.12 - 1.63), 1.52 (1.22 - 1.90), 1.70 (1.30 - 2.22), respectively. The risk of hemorrhagic stroke was declined obviously in group > 4.92 mmol/L (190 mg/dl). (2) The correlation between VLDL-C and ACE was the strongest in four CVD events when VLDL-C and LDL-C were joint analyzed, ICVD events ranked the second. The risk for ischemic stroke also borderline increased with increasing VLDL-C and LDL-C (P > 0.05). CONCLUSION: Increased non-HDL-C is associated with increased risk of suffering ACE, ischemic stroke and ICVD and VLDL-C plays a critical role in the development of ICVD events, especially ACS, in middle aged Chinese population.

[Distribution characteristics and risk factors of carotid atherosclerosis in middle-aged and elderly Chinese].

OBJECTIVE: To describe the distribution characteristics of carotid atherosclerosis and to analyze its association with cardiovascular risk factors in middle-aged and elderly Chinese. METHODS: In 2007, the second cross-sectional examination for cardiovascular risk factors and B-mode ultrasound imaging on carotid arteries were performed in a Chinese population consisting of 2681 subjects aged 43-81 years old from two cohorts participants of the People's Republic of China/United States of America collaborative study (USA-PRC study) and the Chinese multi-provincial cohort study (CMCS). The association of cardiovascular risk factors with intima-media thickening (ITM) and plaque of carotid arteries was analyzed. RESULTS: (1) The mean intima-media thickening (Mean-IMT) of carotid artery was 0.68 mm, the maximal intima-media thickening (Max-IMT) was 1.07 mm. (2) The prevalence rate of carotid plaque was 60.3% in all subjects. As for the different sites of carotid arteries, the plaque prevalence rate at carotid bulb was 61.2% for male and 51.6% for female (chi2 = 23.44, P < 0.01), and at the internal carotid artery was 24.7% for male and 12.2% for female (chi2 = 69.57, P < 0.01), at the common carotid artery was 20.9% for male and 13.8% for female (chi2 = 23.18, P < 0.01). (3) After adjusting for age and other cardiovascular risk factors, the Mean-IMT and Max-IMT increased with elevated levels of systolic blood pressure, plasma glucose and low density lipoproteins cholesterol (LDL-C) (all P < 0.05). Hypertension, diabetes, smoking and high LDL-C (P < 0.05) were independent predict factors for the risk of carotid plaque. CONCLUSION: The carotid atherosclerosis was common in middle and older age Chinese and was positively associated with classical cardiovascular disease risk factors.