Causal associations between blood pressure and the risk of myocardial infarction: A bidirectional Mendelian randomization study.

Introduction: Many observational studies imply elevated blood pressure (BP) as a leading risk factor for incident myocardial infarction (MI), but whether this relationship is causal remains unknown. In this study, we used bidirectional Mendelian randomization (MR) to investigate the potential causal association of BP levels with the risk of MI. Methods: Genetic variants associated with BP and MI traits were retrieved from the International Consortium of Blood Pressure (N = 7,57,601) and UKB (N = 3,61,194), obtaining 1,26,40,541 variants. We used two-sample MR (TSMR) analyses to examine the potential bidirectional causal association of systolic BP (SBP), diastolic BP (DBP) and pulse pressure (PP) with MI. Results: The forward MR analysis identified a potentially causal association between MI and BP except PP[odds ratio (OR) SBP: 1.0008, P = 1.911 × 10-22; ORDBP: 1.0014, P = 1.788 × 10-28;odds ratio (OR)pp: 1.0092, P = 0.179]. However, the reverse analysis suggested no causal relation (betaSBP: 5.469, P = 0.763; betaDBP: 3.624, P = 0.588; betaPP: -0.074, P = 0.912). These findings were robust in sensitivity analyses such as the MR-Egger method, the maximum likelihood method and the MR pleiotropy residual sum and outlier test (MR-PRESSO). No horizontal pleiotropy (p = 0.869 for SBP, p = 0.109 for DBP and p = 0.978 for PP in the forward results and p = 0.168 for SBP, P = 0.892 for DBP and p = 0.989 for PP in the reverse results) was observed. Conclusions: Elevated SBP or DBP levels increase the risk of MI, but there is no causal relationship between MI and changes in BP including PP. Independent of other risk factors, optimal BP control might represent an important therapeutic target for MI prevention in the general population.

[Expression of estrogen receptor alpha in the testis of infertile men with spermatogenic arrest].

OBJECTIVE: To explore the association of spermatogenic arrest with the expression of estrogen receptor alpha (ERalpha) in human testes. METHODS: We examined the testicular biopsy specimens of 120 infertile men by HE staining, detected the expression of ERalpha in the specimens of those with spermatogenic arrest by the two-step immunohistochemical method, and compared the results with those of 10 healthy men. RESULTS: Of the 120 specimens from the infertile men, 31 (25.8%) met the diagnostic criteria of spermatogenic arrest. In the testis tissue of normal men, ERalpha expressed in Sertoli, myoid and Leydig cells, but not in spermatogenic cells, while in the testis tissues of those with spermatogenic arrest, ERalpha expressed lowly in Sertoli, myoid and Leydig cells, with statistically significant differences in immunostaining intensity between the two groups (P < 0.05). CONCLUSION: Androgen receptor (AR) and ERalpha may play a coordinating role in facilitating spermatogenesis. Spermatogenic arrest may be related to a complex series of disorders in cell signal transduction involving AR, ERalpha and HSP90.

[Mentality and behavior of children with congenital heart diseases].

OBJECTIVE: The present study was designed to investigate the influence of Congenital Heart Disease (CHD) on the mentality and behavior in children, and to compare post operative mentality and behavior in children receiving interventional therapy and congenital heart surgery. METHOD: Mentality and behavior of 232 children suffering from CHD were examined with Achenbach Child Behavior Checklist (CBCL) edited by XU Tao-yuan in 1992 and 100 sex, age, education and achievement-matched children with pneumonia were enrolled as controls. RESULTS: The mentality and behavior abnormal rates of the boys and girls suffering from CHD were significantly higher than those of controls (P < 0.01, P < 0.05). The behavior abnormities of the boys presented as depression, social flinch, physical complains, assault and violate rules. Whereas the girls presented as depression, social flinch, physical complains and violate rules. The total cursory mark of postoperative check result of the interventional and surgical children, both in girls and in boys, were significantly lower than those of the preoperative children (P < 0.05). The total and assault cursory mark of postoperative check result of children treated with interventional therapy were significantly lower than those of children treated with the surgical operations (P < 0.05). The abnormal rates of mentality and behavior positively correlated with the disease course. CONCLUSIONS: CHD is associated with increased abnormal mentality and behavior of the children. Early treatment, especially the interventional therapy can significantly improve the mentality and behavior of the children with CHD.

[Mentality and behavior of children suffering from viral myocarditis].

OBJECTIVE: The present study was designed to investigate the influence of viral myocarditis on mental behavior of the children. METHODS: Mentality and behavior of the 178 children suffering from viral myocarditis were examined with Achenbach Child Behavior Checklist (CBCL) edited by Gong Yao-xian in 1986 and 104 sex, age, education and achievement-matched children with pneumonia or upper respiratory infection were enrolled as controls. RESULTS: The mentality and behavior of the children with viral myocarditis were distinctly abnormal. The abnormal rates of boys and girls suffering from acute and deferment viral myocarditis were evidently higher than those of control children (P < 0.01). The behavioral abnormalities of boys were hypochondria, social difficulties, unwell of body and attack. Whereas, the girls presented hypochondria, unwell of body, social flinch and disobeyed discipline, which was significantly different from the control children. The total and hypochondria cursory mark of the second check result of deferment boys were evidently higher than those of the first check (P < 0.05). The total cursory mark of the second check result of deferment girls was higher than that of the first check (P < 0.05) and evidently higher than that of the acute second check result (P < 0.01). The abnormal rates of mentality and behavior correlated positively with the age of children and they were associated with the severity of the illness. CONCLUSION: Viral myocarditis evidently affected the mentality and behavior of children, which should be paid great attention to.