[Related factors of sarcopenia in hospitalized elderly patients with coronary heart disease].

Objective: To explore the incidence and clinical characteristics of sarcopenia in hospitalized elderly patients with coronary heart disease and search for the related factors. Methods: This study was a single-center observational study. According to the inclusion criteria, elderly patients hospitalized with coronary heart disease from Peking Union Medical College Hospital between December 2017 and December 2018 were enrolled. The patients were divided into sarcopenic group and non-sarcopenic group according to the diagnostic criteria of the Asian Working Group for Sarcopenia. Activities of daily living of the patients were assessed (including ADL and IADL) . Comorbidity of the patients was evaluated by the Charlson comorbidity index (CCI). Long-term medication use of the patients was recorded to assesse whether there was polypharmacy. The nutritional status of the patients was examined by the mini nutritional assessment-short form (MNA-SF). The full tandem stance time of the patients was evaluated. The history of falls over the previous year, urinary incontinence, and living conditions of the patients were also recorded. Multivariate logistic regression was used to analyze the related factors for sarcopenia of elderly patients with coronary heart disease. Results: A total of 364 patients were enrolled in the study. The patients were aged 65-96 (74.6±6.5) years and there were 218 (59.9%) male patients. There were 264 cases of stable coronary heart disease and 100 cases of acute coronary syndrome. The median number of long-term used medication was 7. One hundred and fifty-two (41.8%) patients were complicated with type 2 diabetes, 38 (10.4%) patients were complicated with anxiety/depression, and 98 (26.9%) patients had the history of falls over the previous year. Eighty-two (22.5%) patients were complicated with urinary incontinence, 12 patients (3.3%) were complicated with malnutrition and 33 patients (9.2%) were living alone. There were 81 (22.3%) sarcopenic patients and 283 (77.7%) non-sarcopenic patients among all the hospitalized elderly patients with coronary heart disease. The sarcopenic patients were more older, with lower body mass index(BMI)(both P<0.001), higher CCI and more long-term used medication (both P<0.05), higher proportions of malnutrition, urinary incontinence, history of falls, and living alone (all P<0.05) compared to non-sarcopenic patients. ADL and IADL scores of sarcopenic patients were significantly lower than those of non-sarcopenic patients (both P<0.001). There was also a higher proportion of unable to accomplish full tandem stance among sarcopenic patients compared to non-sarcopenic patients (P<0.001). Moreover, higher hs-CRP level (P=0.047) , lower albumin level (P=0.004) and significantly lower prealbumin level (P<0.001) were observed in sarcopenic patients compared to non-sarcopenic patients. Stepwise multivariate binomial logistic regression analysis revealed that male (OR=5.036, 95%CI 1.782-14.230, P=0.002), low BMI (OR=0.883, 95%CI 0.796-0.980, P=0.019), as well as low prealbumin level (OR=0.990, 95%CI 0.980-1.000, P=0.045) were related factors for sarcopenia among elderly patients with coronary heart disease. Conclusions: Sarcopenia is a geriatric condition commonly seen in hospitalized elderly patients with coronary heart disease. Male, low BMI, and low prealbumin level were the factors related to sarcopenia for older adults with coronary heart disease.

[Effect of comprehensive intervention on hypertension control program in workplaces in China].

Objective: To evaluate the effect of comprehensive intervention program on hypertension control in workplaces in China. Methods: The study design was a non-randomized controlled trial. First, 20 sub-centers were selected across China, then hypertension patients in 2-4 workplaces were selected as the intervention group, and hypertension patients in 1 comparable workplace selected, as the control group in each sub-center. The comprehensive intervention strategy which integrating workplace primary prevention of cardiovascular diseases and standardized management of hypertension was adopted in the intervention group for at least 2 years. Patients in the control group continued their usual health care, and only baseline data and 2-year data was collected. Analyses were conducted for hypertension patients in 30 stated-owned enterprises (SOEs), including 20 for the intervention group and 10 for the control group. The primary outcome was the control rate ofhypertension while the intervention effect (IE) was estimated by using the formula: differential value of intervention group[rate (mean)]-differential value of control group[rate (mean)]. Results: Overall, 2 622 patients completed the 2-year follow-up, of which 2 055 were in the intervention group and 567 in the control group, respectively. After 2 years of intervention, the IE on the level of SBP and DBP for intervention group and control group were-7.5 and-3.9 mmHg, respectively (P<0.05). BMI decreased by 0.4 kg/m(2), with the regular exercise rate as 36.4% and alcohol consumption rate decreased by 14.0%, respectively (P<0.05). The smoking rate decreased by 6.1% (P>0.05). The overall hypertension control rate was 25.0%, and further subgroup analysis showed that our intervention program was particularly effective for those with high education level (27.6%), white-collar employees (41.9%), and those from SOEs whose affiliated hospital had been separated away (41.9%). Conclusion: The comprehensive intervention program could greatly improve the hypertension control in the workplaces in China.

[A Meta-analysis of sublingual immunotherapy in the treatment of seasonal allergic rhinitis].

Objective:To systematically evaluate the efficacy and adverse reactions of sublingual immunotherapy for patients with seasonal allergic rhinitis.Method:Literature databases including PubMed, Embase, Cochrane Library, Medline, CBM, Wanfang, CNKI. The time of literature search was limited from January of 2008 to December of 2017.The literature of randomized controlled trials of sublingual immunotherapy for seasonal allergic rhinitis was screened,the quality of the included literature was evaluated,data was extracted,and meta-analysis was performed using RevMan5.3 software.Result:A total of 10 articles were included. The results of meta-analysis showed that for seasonal allergic rhinitis sublingual immunotherapy compared with the control group can reduce symptom scores （SMD=-0.30, 95%CI［-0.39,-0.21］,P<0.000 01) and medication scores (SMD=-0.18, 95%CI［-0.29，-0.08］, P=0.000 8); sublingual immunotherapy for seasonal allergic rhinitis is not restricted by age in the relief of symptoms, and there is no age restriction on reduce medication requirements; sublingual immunotherapy had a higher incidence of adverse reactions than the control group, but it was mostly localized, such as oral pruritus, ear pruritus, throat irritation.Conclusion:Sublingual immunotherapy can alleviate the symptoms and reduce medication requirements in patients with seasonal allergic rhinitis. The adverse reactions are slightly controllable.

[Nasal irrigation with different concentrations of saline as an adjunctive treatment in allergic rhinitis:A systematic review and Meta-analysis].

Objective:To compare the clinical efficacy of different concentrations of saline irrigation in adjuncative treatment of allergic rhinitis by Meta-analysis. Method:According to the inclusion and exclusion criteria, the studies using random controlled trials were retrieved from the Pubmed, Web of science, The Cochrane Library, Embase et al. The Mata-analysis was performed by using RevMan 5.3 software. Result:In total, 1 457 patients were enrolled in 14 randomized controlled trials, including 739 in the isotonic saline group, 350 in the hypertonic saline group,Times New Roman 368 without saline irragation. The results of Meta-analysis showed that the VAS score of saline irrigation group was lower than no saline irrigation group［95%CI (-1.57, -0.15), P=0.02］, the nasal RQLQ score was lower［95%CI (-3.93, -0.43), P=0.01］, and the effective rate was higher［95%CI(1.15, 1.45), P<0.01］; The score of nasal symptoms and signs in hypertonic saline group was lower than that in normal saline group［95%CI(-1.68, -0.63), P<0.01］, and the effective rate was higher［95%CI(1.19, 1.47), P<0.01］. There were significant differences between the two groups. Conclusion:The efficacy of saline irrigation as an adjunctive treatment in allergic rhinitis is significant. The effect of hypertonic saline irrigation was better than that of isotonic saline.

[The clinical efficacy of vidian neurectomy and conservative treatment on moderate-severe allergic rhinitis: a Meta-analysis].

Objective: To compare the clinical effects of vidian neurectomy with conservative management in the treatment for moderate-severe allergic rhinitis. Method: The studies using case controlled trials which were retrieved from Embase, Pubmed, Web of Science, Cochrane Library etc. The Cochrane risk assessment criteria were used to evaluate the quality of the articles that met the inclusion criteria. Manager 5.3 software was used to data analysis. Result: Six articles were included in meta-analysis. Meta-analysis showed that vidian neurectomy group got lower RQLQ scoresï¼»95%CI (-0.98,-0.63),P<0.001ï¼½, less inCIdence of complicationsï¼»95%CI (0.17, 0.67), P=0.002ï¼½, lower VAS scoreï¼»95%CI (-3.97,-3.65), P<0.001ï¼½and higher clinically effective ratioï¼»95%CI (1.18, 50.52), P=0.03ï¼½than conservative treatment group. Conclusion:In summary, we believe that nasal endoscopic vidian neurectomy in the treatment of moderate-severe allergic rhinitis is superior to conservative treatment.

Differential chemotactic potential of mouse platelet basic protein for thymocyte subsets.

Mouse platelet basic protein (CXCL7/mPBP) was cloned from thymic stromal cells and further identification indicated that it was expressed in thymic monocytes/macrophages (Mo/Mphis). Recombinant mPBP was chemoattractive for target cells of polymorphonuclear leucocytes, peritoneal Mo/Mphis and splenic lymphocytes with distinct potencies. CXCR2 was identified to be a cognate receptor for mPBP. Mouse thymocyte subsets of CD4-CD8- double-negative (DN), CD4+CD8+ double-positive (DP), CD4+CD8- single-positive (CD4SP) and CD4-CD8+ single-positive (CD8SP) expressed cell surface CXCR2 with different positive percentages and expression levels. mPBP was chemoattractive for thymocyte subsets with the potency order DN>DP> CD8SP>CD4SP, consistent with the levels of CXCR2 expressed on the respective cells. Thus, mPBP in thymus is functionally redundant with chemokine CXCL12/ SDF-1. Moreover, our finding that thymic Mo/Mphis can produce mPBP implies that they may have other functions apart from acting as scavengers in thymus.