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Tubal pregnancy is a common cause of maternal mortality in early pregnancy. Transumbilical laparoendoscopic single-site surgery (TU-LESS) has gained popularity due to its safety and aesthetic advantages. However, the lack of affordable disposable entry platforms hinders its widespread adoption. This study aimed to investigate the learning curve of tubal pregnancy removal using single-incision multiport (SIMP) laparoscopy and provide guidance for novice gynecologists. A retrospective analysis was conducted on cases of ectopic pregnancy (EP) diagnosed at Dongguan Songshan Lake Central Hospital from June 2020 to June 2022. The analysis included 50 cases, with 25 undergoing single-port laparoscopy and 25 undergoing conventional laparoscopy (CL). Various indicators, including body mass index (BMI), previous pregnancies, mass size, hemoglobin levels, surgical duration, and complications, were collected. Learning curve analysis using the cumulative sum (CUSUM) technique was performed to assess procedural proficiency. There were no significant differences in patient characteristics or complications between the 2 groups. However, the single-port laparoscopy group exhibited a statistically significant longer average surgical time (41.60â ±â 13.38 minutes) compared to the conventional laparotomy group (32.96â ±â 7.32 minutes). The CUSUM analysis demonstrated a decline in surgical time after the completion of approximately 11 cases, indicating an improvement in SIMP laparoscopy surgical proficiency. SIMP laparoscopy for tubal pregnancy removal achieved similar safety outcomes as CL. Notably, the CUSUM analysis revealed that proficiency in single-port laparoscopy could be achieved after approximately 11 cases, leading to stable surgical times. These findings serve as valuable guidance for novice gynecologists interested in adopting single-incision laparoscopy.
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Laparoscopía , Curva de Aprendizaje , Tempo Operativo , Salpingectomía , Humanos , Femenino , Estudios Retrospectivos , Laparoscopía/métodos , Laparoscopía/educación , Salpingectomía/métodos , Salpingectomía/educación , Adulto , Embarazo , Embarazo Tubario/cirugía , Competencia ClínicaRESUMEN
Background: There are few reports of infantile mitochondrial DNA depletion syndrome (MDDS) caused by variants in RRM2B and the correlation between genotype and phenotype has rarely been analyzed in detail. This study investigated an infantile patient with MDDS, from clinical characteristics to genetic causes. Methods: Routine physical examinations, laboratory assays, which included gas chromatography-mass spectrometry of blood and urine, and MRI scans were performed to obtain an exact diagnosis. Whole-exome sequencing was used to pinpoint the abnormal gene and bioinformatic analyses were performed on the identified variant. Results: The case presented with progressive neurologic deterioration, failure to thrive, respiratory distress and lactic acidosis. Sequencing revealed that the patient had a homozygous novel missense variant, c.155T>C (p.Ile52Thr), in exon 2 of the RRM2B gene. Multiple lines of bioinformatic evidence suggested that this was a likely detrimental variant. In addition, reported RRM2B variants were compiled from the relevant literature to analyze disease etiology. We found a distinctive distribution of genotypes across disease manifestations of different severity. Pathogenic alleles of RRM2B were significantly enriched in MDDS cases. Conclusion: The novel variant is a likely genetic cause of MDDS. It expands our understanding of the pathogenic variant spectrum and the contribution of the RRM2B gene to the disease spectrum of MDDS.
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Background: Combined Oxidative Phosphorylation Deficiency 23 (COXPD23) is a rare mitochondrial disease caused by mutations in the GTPBP3 gene. The rare incidence of the disease and the high clinical heterogeneity pose challenges in making a precise diagnosis. Investigations into the rare COXPD23 patients are of pathophysiological and etiological value. In this study, we investigated the genotype-phenotype relationship in a COXPD23 patient from a Manchu family, with GTPBP3 mutations. Methods: Routine physical examinations, laboratory assays and imaging analyses were performed. The metabolic profiles of amino acids in blood, acylcarnitine in blood and organic acids in urine were used to determine the presence of inherited metabolic diseases. Genetic variations in the family were investigated using whole-exome sequencing and Sanger sequencing. Splicing disruption by a mutation was predicted and verified using a minigene assay. Results: The patient presented with severe lactic acidosis, neurological symptoms, multiple symmetrical lesions in the brain and serious mitochondrial energy metabolism disturbances. The c.689A > C (p.Q230P) and c.809-1_809delinsA compound heterozygous mutations were detected in GTPBP3. The novel c.809-1_809delinsA mutation was located at the splicing site of exon 7 and intron 6 and multiple tools predicted that it would disrupt the normal splicing. The minigene assay proved that the novel mutation resulted in two aberrant transcripts that created premature termination codons. Conclusions: The clinical manifestations, brain imaging change, mitochondrial metabolism disturbances and the detection and validation of the GTPBP3 mutations expand the profile of COXPD23 and the pathogenic mutation spectrum. Our study improves the understanding of the pathophysiology and etiology of COXPD23.
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OBJECTIVE: To simulate hysteroscopic suturing in vitro and analyze the learning curve of gynecologists with different experience levels. METHODS: Three gynecologists were trained on uterine models in a circulating water box. The posterior uterine wall was sutured 10 times under hysteroscopy for 5 consecutive days, and the time of each suture procedure was recorded. RESULTS: Doctors A, B, and C completed 50 posterior uterine sutures. After Dr. C completed 50 sutures on the posterior wall, he added 50 sutures on the anterior wall (Group D). The mean suturing time was 71.54 ± 68.158 s in Group A, 50.10 ± 28.060 s in Group B, 34.04 ± 10.457 s in Group C, and 30.38 ± 8.734 s in Group D. The difference between Groups C and B and between Groups B and A was statistically significant. There was no statistically significant difference between Groups C and D. Simulation curves were created using the number of features as the abscissa and cumulative sum as the coordinate, with peak curves of 19, 27, and 18 cases for Group A, B, and C, respectively. CONCLUSION: Doctors with experience in single-hole laparoscopic surgery or hysteroscopic suture surgery can significantly shorten the hysteroscopic suturing time.
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Levonorgestrel , Entrenamiento Simulado , Masculino , Femenino , Embarazo , Humanos , Curva de Aprendizaje , Histeroscopía , SuturasRESUMEN
RATIONALE: Endometrial vascular dystrophy refers to abnormal vessels that are very tortuous, dilated, and sometimes thrombosed. Endometrial vascular dystrophy is rare under hysteroscopy. PATIENT: All three patients had a history of abnormal uterine bleeding. The duration of vaginal bleeding ranged from 1 month to 2 years. There was no history of unusual diseases, alcohol or drug abuse, or genetic history. DIAGNOSES: Endometrial vascular dystrophy. INTERVENTION: Three patients underwent hysteroscopy and curettage under intravenous general anesthesia. Pathological examination showed secretory endometrium, with one case coexisting with endometrial polyps. OUTCOMES: No recurrence was found during postoperative follow-up at 12 months. LESSONS: Endometrial vascular dystrophy is a rare hysteroscopy phenomenon shown in the secretory endometrium. We believe that it was a capillary loop with different manifestations.
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Enfermedades Uterinas , Neoplasias Uterinas , Embarazo , Femenino , Humanos , Endometrio/patología , Enfermedades Uterinas/diagnóstico , Enfermedades Uterinas/cirugía , Hemorragia Uterina/etiología , Hemorragia Uterina/diagnóstico , Histeroscopía/efectos adversos , Neoplasias Uterinas/patologíaRESUMEN
Context: Cervical cancer is the most common gynecological pernicious tumor with high morbidity and mortality worldwide, especially in developing countries. Arctigenin (ARG), a nature-derived component, has exhibited anti-tumor activity in various tumors. Objective: To explore the effect of ARG on cervical cancer. Materials and methods: The effect and mechanism of ARG on cervical cancer cells were explored by cell counting kit-8 (CCK-8), flow cytometry, transwell and Western blot assays. Additionally, in vivo experiment was conducted in xenografted mice by immunohistochemistry (IHC), terminal deoxynucleotidyl transferase deoxyuridine triphosphate (dUTP) nick end labeling (TUNEL) and Western blot assays. Results: ARG treatment induced both concentration-dependent and time-dependent reductions in the cell viability of SiHa and HeLa cells with a IC50 value of 9.34 µM and 14.45 µM, respectively. ARG increased the apoptosis rate and the protein levels of cleaved-caspase 3 and E-cadherin, but decreased the invaded cell numbers and the protein levels of Vimentin and N-cadherin in vitro. Mechanically, ARG inhibited the expression of focal adhesion kinase (FAK)/paxillin pathway, which was confirmed by the overexpression of FAK in SiHa cells. The inhibitory role of overexpression of FAK in proliferation and invasion, as well as its promoted role in apoptosis were reversed with ARG treatment. Meanwhile, ARG suppressed growth and metastasis, and enhanced apoptosis in vivo. Consistently, ARG administration reduced the relative protein level of p-FAK/FAK and p-paxillin/paxillin in tumor tissues of xenografted mice. Conclusion: ARG inhibited proliferation, invasion and metastasis, but enhanced apoptosis of cervical cancer via the FAK/paxillin axis.
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Objectives: Cervical cancer (CC) is the fourth most prevalent type of cancer in women worldwide and it is considered the leading cause of tumor-related death and malignancy. As part of complexes involved in epigenetic control, the proteins of the chromobox (CBX) family have been found to have a role in the growth of malignancies by preventing differentiation and increasing proliferation. Here, by a thorough investigation, we investigated the expression, prognostic significance, and immune infiltration of CBX in patients with CC. Materials and Methods: Differential expression, clinicopathological parameters, immune cell infiltration, enrichment analysis, genetic alteration, and prognostic value of CBXs in patients with CC were examined using TIMER, Metascape, STRING, GeneMANIA, cBioPortal, UALCAN, The Human Protein Atlas, Gene Expression Profiling Interactive Analysis (GEPIA), and Oncomine. Results: In CC tissues, CBX 2/3/4/5 and CBX 8 expression levels were considerably higher, whereas CBX 6/7 expression levels were lower. In CC, the CBX 5/6/8 promoters have elevated levels of methylation. The expression of CBX 2/6/8 and the pathological stage were connected. A 37% mutation rate of the differentially expressed CBX genes was observed. Also, there was a strong correlation of the CBXs expression with immune cell infiltration, such as T CD4+ cells, macrophages, neutrophils, B cells, T CD8+ cells, and dendritic cells. Conclusion: The investigation discovered that members of the CBXs family may be therapeutic targets for CC patients and may play significant roles in the development of CC tumors.
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Background: Wilson's disease (WD) is an autosomal recessive disease that is caused by mutations in the ATP7B (a copper-transporting P-type ATPase) gene. The disease has a low prevalence and is characterized by a copper metabolism disorder. However, various characteristics of the disease are determined by race and geographic region. We aimed to discover novel ATP7B mutations in pediatric patients with WD from Yunnan province, where there is a high proportion of ethnic minorities. We also performed a comprehensive analysis of ATP7B mutations in the different ethnic groups found in Southwest China. Methods: We recruited 45 patients who had been clinically diagnosed with WD, from 44 unrelated families. Routine clinical examinations and laboratory evaluations were performed and details of age, gender, ethnic group and symptoms at onset were collected. Direct sequencing of the ATP7B gene was performed in 39 of the 45 patients and their families. Results: In this study, participants came from seven different ethnic groups in China: Han, Bai, Dai, Zhuang, Yi, Hui and Jingpo. Three out of ten patients from ethnic minorities presented with elevated transaminases, when compared to the majority of the Han patients. Forty distinct mutations (28 missense, six splicing, three non-sense, two frameshift and one mutation of uncertain significance) were identified in the 39 patients with WD. Four of the mutations were novel and the most frequent mutation was c.2333G > T (p.R778L, allelic frequency: 15.38%). Using the phenotype-genotype correlation analysis, patients from ethnic minorities were shown to be more likely to have homozygous mutations (p = 0.035) than Han patients. The patients who carried the c.2310C > G mutation had lower serum ceruloplasmin levels (p = 0.012). In patients with heterozygous mutations, c.3809A > G was significantly associated with ethnic minorities (p = 0.042). The frequency of a protein-truncating variant (PTV) in Han patients was 34.38% (11/32), while we did not find PTV in patients from ethnic minorities. Conclusion: This study revealed genetic defects in 39 pediatric patients with WD from Yunnan province. Four novel mutations were identified and have enriched the WD database. We characterized the genotypes and phenotypes in different minorities, which will enhance the current knowledge on the population genetics of WD in China.
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Complete androgen insensitivity syndrome (CAIS) is a rare disease that can be easily misdiagnosed. Before puberty, this condition is easily misdiagnosed as an inguinal hernia. This case report describes a 31-year-old phenotypically female patient with CAIS who was misdiagnosed twice previously with an inguinal hernia. Her karyotype analysis showed that she was 46, XY. She underwent a bilateral gonadectomy and long-term hormone replacement therapy. A Leydig cell tumour of the right testis was diagnosed postoperatively. This report also reviews the current understanding of the diagnosis and treatment of CAIS.
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Síndrome de Resistencia Androgénica , Hernia Inguinal , Femenino , Humanos , Masculino , Adulto , Síndrome de Resistencia Androgénica/diagnóstico , Síndrome de Resistencia Androgénica/genética , Síndrome de Resistencia Androgénica/cirugía , Terapia de Reemplazo de Hormonas , Cariotipo , CariotipificaciónRESUMEN
In this article, an unusual case of a 27-year-old woman, who presented with abdominal pain for the previous 2 days, is presented. Ultrasonography revealed a perforated uterus and a straw in the abdominal cavity. A foreign body in the abdominal cavity was diagnosed and removed by laparoscopic surgery, and antibiotics were administered. The patient reported no discomfort during follow-up for 1 month. This report highlights the rare case of a foreign body crossing the uterus into the abdominal cavity. The only possible action was immediate surgery to remove the foreign body from the abdominal cavity.
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Cavidad Abdominal , Cuerpos Extraños , Femenino , Humanos , Adulto , Cavidad Abdominal/diagnóstico por imagen , Cavidad Abdominal/cirugía , Cuerpos Extraños/diagnóstico por imagen , Cuerpos Extraños/cirugíaRESUMEN
Objective: It is suggested that estrogen receptors (ERs) might be associated with the disproportionate vulnerability of women to depressive episodes. Several variants in ER-alpha (ERα) and ER-beta (ERß) have been linked to depression, but the results were not consistent. Hence, we conducted a meta-analysis to evaluate the association between ERα/ERß and depression in a cohort of women. Methods: A comprehensive literature search was performed in public databases. The genetic association between polymorphisms in Erα/ERß and depression risk in a cohort of women was evaluated by odds ratios (ORs) and 95% confidence intervals (CIs). Cochran's Q test and the I2 index were used to evaluate heterogeneity. Results: In total, 10 studies and 4 SNPs (rs2234693, rs9340799, rs4986938, rs1256049) were included in our meta-analysis. rs2234693 genotype was significantly associated with the risk of depression in women by dominant model (CC + CT vs TT, OR = 1.30, 95% CI: 1.09-1.55, p = 0.0031), recessive model (CC vs CT + TT, OR = 1.64, 95% CI: 1.00-2.67, p = 0.0478), additive model (CC vs TT, OR = 1.93, 95% CI: 1.12-3.35, p = 0.0189) and allelic model (C vs T, OR = 1.24, 95% CI: 1.10-1.39, p = 0.0003). For rs9340799, the frequencies of risk genotypes according to the dominant (GG + GA vs AA, OR = 1.47, 95% CI = 1.10-1.98, p = 0.0096, I2 = 0%, p = 0.43) and allelic (G vs A, OR = 1.33, 95% CI: 1.04-1.69, p = 0.0236, I2 = 0%, p = 0.39) models were significantly lower in women with depression than in controls within the Asian subgroup. For rs1256049, risk genotypes were significantly more frequent in depressed subjects than in controls under the dominant model (AA+ GA vs GG, OR = 1.62, 95% CI: 1.19-2.21, p = 0.0024) and the allelic model (A vs G, OR = 1.35, 95% CI: 1.07-1.72, p = 0.012) after sensitivity analysis by omitting one study which induce the heterogeneity. Conclusions: The current meta-analysis is the first and most comprehensive investigation of the association between ERs and depression in women, and the findings support the concept that ERs participate in the etiology of sex heterogeneity in depression.
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Long non-coding RNA tumor protein 53 target gene 1 (TP53TG1) has been unraveled to exert regulatory effects on cancer progression, while the regulatory function of TP53TG1 on cervical cancer (CC) via regulating microRNA (miR)-33a-5p/Forkhead box K2 (FOXK2) axis remains rarely explored. This study aims to unearth the regulatory mechanism of TP53TG1/miR-33a-5p/FOXK2 axis in CC. The CC clinical samples were collected, and CC cells were cultured. TP53TG1, miR-33a-5p and FOXK2 levels were examined in CC tissues and cells. The CC cells were transfected with high- or low-expressed TP53TG1, FOXK2 or miR-33a-5p to determine the changes of CC cell biological activities and the status of phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/AKT/mTOR) pathway. The tumorigenesis in nude mice was conducted. The relationship among TP53TG1, miR-33a-5p and FOXK2 was validated. TP53TG1 and FOXK2 expression levels were increased and miR-33a-5p expression level was reduced in CC cells and tissues. The silenced TP53TG1 or FOXK2, or elevated miR-33a-5p decelerated the CC cell development and restrained the activation of PI3K/AKT/mTOR signaling pathway. The depleted FOXK2 or elevated miR-33a-5p reversed the effects of decreased TP53TG1 on CC cell progression. TP53TG1 sponged miR-33a-5p, which targeted FOXK2. The experiment in vivo validated the outcomes of the experiment in vitro. TP53TG1 accelerates the CC development via regulating miR-33a-5p to target FOXK2 with the involvement of PI3K/AKT/mTOR signaling pathway. This study provides novel theory basis and distinct therapeutic targets for CC treatment.
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Proteínas de Unión al ADN , Factores de Transcripción Forkhead , MicroARNs , ARN Largo no Codificante , Neoplasias del Cuello Uterino , Animales , Línea Celular Tumoral , Proliferación Celular/genética , Proteínas de Unión al ADN/genética , Femenino , Factores de Transcripción Forkhead/genética , Regulación Neoplásica de la Expresión Génica , Humanos , Mamíferos/metabolismo , Ratones , Ratones Desnudos , MicroARNs/genética , MicroARNs/metabolismo , Fosfatidilinositol 3-Quinasas/metabolismo , Proteínas Proto-Oncogénicas c-akt/metabolismo , ARN Largo no Codificante/genética , ARN Largo no Codificante/metabolismo , Serina-Treonina Quinasas TOR/metabolismo , Neoplasias del Cuello Uterino/patologíaRESUMEN
Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age. Several clinical trials have investigated the influence of carnitine on metabolic variables in PCOS, but have yielded conflicting results. This study aimed to summarize the clinical evidence of the effects of carnitine on weight management, glycemic and serum lipids controls in women with PCOS by conducting a meta-analysis of randomized control trials (RCTs). PubMed, Embase, Web of Sciences, Scopus, and the CENTRAL database were searched from inception to March 2021 for eligible articles. Study selection and assessment of quality were conducted independently by two investigators. Effect sizes for each outcome were reported with the weighted mean differences (WMDs) and 95% confidence intervals (CIs). The statistical heterogeneity of the included clinical trials was tested using the I2 statistic. Six studies with 672 PCOS participants were included for meta-analysis. Our results revealed that carnitine supplements significantly decreased total cholesterol, low-density lipoprotein-cholesterol, triglycerides, body weight, body mass index, hip circumference, and waist circumference (All p < .05). In addition, carnitine intervention also improved the levels of high-density lipoprotein cholesterol. However, no significant changes were seen in glucose homeostasis parameters. These results were stable after sensitivity analysis, and no significant publication biases were detected. Based on current evidence, carnitine supplementation in women with PCOS had beneficial effects on weight loss and lipid profiles. Further large-scale, well-designed RCTs are required to confirm these results.
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Síndrome del Ovario Poliquístico , Peso Corporal , Carnitina/uso terapéutico , Suplementos Dietéticos , Femenino , Control Glucémico , Humanos , TriglicéridosRESUMEN
INTRODUCTION: Several studies have been designed to investigate the beneficial effects of probiotic supplementation on metabolic parameters and inflammation status in women with polycystic ovarian syndrome (PCOS), but results have been inconsistent. Herein, we perform a meta-analysis of randomized controlled trials (RCTs) to evaluate the effects of probiotic supplementation on glycemia control, lipidic profiles, weight loss and C-reactive protein (CRP) in women with PCOS. EVIDENCE ACQUISITION: MELINE, EMBASE, and Cochrane Library were searched for RCTs that investigated the effects of probiotic in women with PCOS. Two investigators independently performed the screening, data extraction, and methodological quality assessment. Data were pooled as mean differences (MDs) with 95% confidence intervals (CIs). The statistical heterogeneity was assessed with the I2 test. Sensitivity analyses were performed by the leave-one-out approach. EVIDENCE SYNTHESIS: From the literature search, 26 publications were screened and 6 RCTs involving 406 PCOS participants (aged 25-28.5 years) with follow-up period between 8-12 weeks were included. The pooled results showed that probiotic supplement significantly affected the levels of fasting blood insulin (FBI), quantitative insulin sensitivity check index (QUICKI), triglycerides (TG), and very low density lipoprotein-cholesterol (VLDL-C). However, no significant changes were found in other markers, including fasting plasma glucose, homeostatic model assessment-insulin resistance, total cholesterol, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, body weight, CRP, and dehydroepiandrosterone sulfate levels. The pooled result was robust after the sensitivity analysis. CONCLUSIONS: Our finding provides evidence that daily probiotic consumption has beneficial effects on decreasing FBI, TG, and VLDL-C, and increasing the QUICKI score in PCOS patients.
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Glucemia/análisis , Proteína C-Reactiva/análisis , Colesterol/sangre , Suplementos Dietéticos , Síndrome del Ovario Poliquístico/metabolismo , Síndrome del Ovario Poliquístico/terapia , Probióticos/uso terapéutico , Triglicéridos/sangre , Pérdida de Peso , Femenino , Humanos , Metabolismo de los Lípidos , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
In single photon emission computed tomography (SPECT), due to the attenuation of gamma photons, the analytical reconstruction is complicated, where attenuation should be compensated to obtain quantitative results. We know that the resolution of SPECT is low. The cone-beam SPECT reconstruction can improve the photon density and spatial resolution of the reconstructed image. In practice, to minimize the effect of distance-dependent resolution variation (DDRV), the detector should be set as close as possible to the patient. Therefore it would be more efficacious for the orbit of the detector to be elliptical or another shape. In this paper, based on the Novikov's reconstruction formula and our Ray-driven Technology, we present an analytical cone-beam SPECT reconstruction algorithm for general non-circular orbit. The simulation results demonstrate the accuracy and robustness of our method.
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Algoritmos , Procesamiento de Imagen Asistido por Computador/métodos , Fotones , Tomografía Computarizada de Emisión de Fotón Único/métodos , Procesamiento de Imagen Asistido por Computador/instrumentación , Fantasmas de Imagen , Tomografía Computarizada de Emisión de Fotón Único/instrumentaciónRESUMEN
In this paper, based on Novikov's explicit inversion formula for the attenuated Radon transform, we present a super resolution SPECT reconstruction algorithm with compensation for non-uniform attenuation. Unlike the former methods improving the medical image resolution via super resolution (SR) in the reconstructed image, the proposed method apply the SR algorithm in the low resolution (LR) sinogram, which needs only 1-D shift of the detector, and the PSF is easy to obtain. Simulation results show that our reconstruction algorithm is effective.
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Algoritmos , Procesamiento de Imagen Asistido por Computador/métodos , Tomografía Computarizada de Emisión de Fotón Único/métodos , Simulación por Computador , Fantasmas de Imagen , Tomografía Computarizada de Emisión de Fotón Único/instrumentaciónRESUMEN
OBJECTIVE: Cardiovascular risk factors increase risk for stroke recurrence. Secondary prevention of stroke may be affected not only by established risk factors, but also socioeconomic status. This study evaluates relationships between socioeconomic status and cardiovascular and behavioral factors. DESIGN: Cross-section study. SETTING: Public Health and Education Institute, Peking University. PARTICIPANTS: Outpatients (n = 2354) with a past diagnosis of stroke or transient ischemic attack. INTERVENTION(S): The investigation consisted of a questionnaire regarding patients' socioeconomic and living status, and a clinical examination at the research center. MAIN OUTCOME MEASURE(S): Control rates of risk factors for cardiovascular disease. RESULTS: With regard to hypertension patients, 67.0% were aware of having hypertension, 63.6% were treated and 53.9% had controlled hypertension; for patients with hypercholesterolemia, 46.7% were aware of having hypercholesterolemia, 38.6% were treated and 3.8% had controlled hypercholesterolemia; for patients with diabetes mellitus, 28.0% were aware of having diabetes mellitus, 25.7% were treated and 3.5% had controlled diabetes mellitus. After multivariate analysis, education was the strongest associated factor for controls of hypertension and diabetes mellitus. After adjustment for sex and age, strong and graduated relationships were noted between the level of education and control of risk factors, with the odds ratios increasing at every increment. CONCLUSION: Education exerts the most important effect on the control of established cardiovascular risk factors; Successful intervention to reduce these risk factors will have to be addressed, not just with regard to specific risk factors, but also with the societal conditions that lead to the adoption and maintenance of high-risk behaviors.
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Prevención Secundaria , Clase Social , Accidente Cerebrovascular/prevención & control , Anciano , China , Estudios Transversales , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Persona de Mediana Edad , Conducta de Reducción del Riesgo , Accidente Cerebrovascular/etiología , Encuestas y CuestionariosRESUMEN
OBJECTIVE: To analyze the impact of hypertensive left ventricular hypertrophy (LVH) on cardiovascular events (CVD) in adult Beijing residents. METHODS: CVD risk factor survey was conducted in 7023 Beijing residents aged 25 - 64 by a stratified-random sample design from 1984 to 1993 in three years interval. CVD events were followed up and the association of the hypertensive LVH and risk of CVD and total death was analyzed by multivariable Cox Regression Model. All subjects were followed up to December 2004. RESULTS: There were 211 non hypertensive LVH patients in the cohort and were excluded from the study. (1) There were 2240 hypertensive patients among 6812 subjects on baseline. The total prevalence of LVH was 11.8% (16.1% in male and 7.5% in female). (2) Compared to the group with normal blood pressure and without left ventricular hypertrophy, subjects with hypertensive LVH had significantly higher risk for acute coronary, acute stroke, total CVD and total death rate. The relative risks (RR) were 4.92 (95% CI: 2.3, 10.7), 4.2 (95% CI: 2.6, 7.0), 4.1 (95% CI: 2.6, 6.3) and 3.3 (95% CI: 2.0, 5.3), respectively. (3) Compared to the group with hypertension and without LVH, the group with hypertensive LVH had also significantly higher risk for acute stroke, total CVD and total death rate. The RR were 1.8 (95% CI: 1.1, 2.8), 1.7 (95% CI: 1.2, 2.3) and 1.7 (95% CI: 1.1, 2.7), respectively. (4) The population attribute risks (PAR) of hypertensive LVH to the incidents of acute CHD, acute stroke, total CVD and total death were 13.0%, 11.0%, 10.4% and 7.9%, respectively. CONCLUSIONS: Hypertensive left ventricular hypertrophy was an independent risk factor for long term risk of cardiovascular events and death.