Effects of Outdoor Temperature on Blood Pressure in a Prospective Cohort of Northwest China.

OBJECTIVE: The relationship between outdoor temperature and blood pressure (BP) has been inconclusive. We analyzed data from a prospective cohort study in northwestern China to investigate the effect of outdoor temperature on BP and effect modification by season. METHODS: A total of 32,710 individuals who participated in both the baseline survey and the first follow-up in 2011-2015 were included in the study. A linear mixed-effect model and generalized additive mixed model (GAMM) were applied to estimate the association between outdoor temperature and BP after adjusting for confounding variables. RESULTS: The mean differences in systolic blood pressure (SBP) and diastolic blood pressure (DBP) between summer and winter were 3.5 mmHg and 2.75 mmHg, respectively. After adjusting for individual characteristics, meteorological factors and air pollutants, a significant increase in SBP and DBP was observed for lag 06 day and lag 04 day, a 0.28 mmHg (95% CI: 0.27-0.30) per 1 °C decrease in average temperature for SBP and a 0.16 mmHg (95% CI: 0.15-0.17) per 1 °C decrease in average temperature for DBP, respectively. The effects of the average temperature on both SBP and DBP were stronger in summer than in other seasons. The effects of the average temperature on BP were also greater if individuals were older, male, overweight or obese, a smoker or drinker, or had cardiovascular diseases (CVDs), hypertension, and diabetes. CONCLUSIONS: This study demonstrated a significant negative association between outdoor temperature and BP in a high-altitude environment of northwest China. Moreover, BP showed a significant seasonal variation. The association between BP and temperature differed by season and individuals' demographic characteristics (age, gender, BMI), unhealthy behaviors (smoking and alcohol consumption), and chronic disease status (CVDs, hypertension, and diabetes).

The relationship between serum uric acid and metabolic syndrome in premenopausal and postmenopausal women in the Jinchang Cohort.

The aim of the study was to explore the association between serum uric acid (SUA) and metabolic syndrome (MetS) in premenopausal and postmenopausal women in the Jinchang Cohort. We studied 3808 female Jinchuan Nonferrous Metals Corporation workers aged 40-60 years. Cohort data from epidemiological surveys and medical exams were used. MetS was defined using the 2009 Joint Interim Society criteria. The relationship between SUA and MetS was evaluated using multiple logistic regression after adjusting for potential confounders. MetS and hyperuricemia were more prevalent in postmenopausal women than premenopausal ones (35.3% versus 15.2% and 9.2% versus 4.2%, respectively). Premenopausal and postmenopausal women with hyperuricemia had 2.81 (95% CI: 1.72-4.61) and 2.10 (95% CI: 1.44-3.08), respectively, times the odds of having MetS than their counterparts without hyperuricemia. Even within normal SUA quartiles, only premenopausal women in the highest and second-highest quartile had 3.57 (95% CI: 2.24-5.68) and 2.78 (95% CI: 1.71-4.50), respectively, times the odds of having MetS than those in the lowest quartile. Even in the normal range, the odds ratios for MetS increased gradually according to SUA levels in all women (Ptrend < 0.001). In conclusion, there was a significant correlation between SUA levels and MetS, and the association was stronger in premenopausal women than postmenopausal ones.

[Clinical Effect of Bushen Quyu Recipe Combined with Acupuncture in Treatment of Clomiphene- resistant Polycystic Ovary Syndrome Infertility Patients after Cold Needle Puncture Drainage Operation].

Objective To observe the clinical effects of Bushen Quyu Recipe (BQR) combined with acupuncture in treatment of clomiphene-resistant polycystic ovary syndrome (PCOS) infertility pa- tients after cold needle puncture drainage operation. Methods Totally 170 clomiphene-resistant PCOS in- fertility patients were recruited from March 2011 to October 2013, who were assigned to the control group and the observation group according to random blocking method, 85 cases in each group. Patients in the control group received cold needle puncture drainage operation alone, while those in the observation group additionally took BQR and received acupuncture after cold needle puncture drainage operation. Clinical efficacy was observed in the two groups before and after treatment. The spontaneous ovulation rate and the pregnancy rate were followed-up. The levels of serum sex hormones and hermodynamic indicators of ovarian blood flow were detected in the two groups before and after treatment. Results Successful pregnancy occurred in 63 cases of the observation group, significantly better than that of the con- trol group (52 cases; x² =7. 63, P <0. 05). The spontaneous ovulation rate was 75. 29% at month 3 of follow-ups and 88. 24% at month 6 of follow-ups in the observation group, significantly higher than those of the control group [56. 47% , 67. 06%; x² =6. 70, X² =10. 98, P <0. 05). In the observation group the total pregnancy rate was 74. 12% , higher than that of the control group [61. 18% ; X² =4. 46, P <0. 05). Compared with before treatment in the same group, levels of luteinizing hormone (LH) , testesterone (T) , estradiol (E2) significantly decreased in the two groups after treatment; levels of follicular stimulating hormone (FSH) , peak systolic velocity (PSV) , end diastolic volume (EDV) obviously increased in the two groups after treatment (P <0. 05). The decrement of T, LH, E2 levels and the increment of FSH, PSV, EDV levels were obviously higher in the observation group than in the control group (P <0. 05). Conclusion BQR combined with acupuncture in treatment of clomiphene-resistant PCOS infertility pa- tients after cold needle puncture drainage operation could effectively promote the recovery of menstruation, elevate the success rate of pregnancy, and was helpful to improving levels of sex hormones and ovarian blood perfusion.

The association between diurnal temperature range and emergency room admissions for cardiovascular, respiratory, digestive and genitourinary disease among the elderly: a time series study.

OBJECTIVES: To evaluate the short-term effect of diurnal temperature range (DTR) on emergency room (ER) admissions among elderly adults in Beijing. METHODS: After controlling the long-time and seasonal trend, weather, air pollution and other confounding factors, a semi-parametric generalized additive model (GAM) was used to analyze the exposure-effect relationship between DTR and daily ER admissions among elderly adults with different lag structures from 2009 to 2011 in Beijing. We examined the effects of DTR for stratified groups by age and gender, and conducted the modifying effect of season on DTR to test the possible interaction. RESULTS: Significant associations were found between DTR and four major causes of daily ER admissions among elderly adults in Beijing. A 1 °C increase in the 8-day moving average of DTR (lag 07) corresponded to an increase of 2.08% (95% CI: 0.88%-3.29%) in respiratory ER admissions and 2.14% (95% CI: 0.71%-3.59%) in digestive ER admissions. A 1 °C increase in the 3-day and 6-day moving average of DTR (lag 02 and lag 05) corresponded to a 0.76% (95% CI: 0.07%-1.46%) increase in cardiovascular ER admissions, and 1.81% (95% CI: 0.21%-3.45%) increase in genitourinary ER admissions, respectively. The people aged 75 years and older were associated more strongly with DTR than the 65-74 age group. The modifying effect of season on DTR was observed and it was various in four causes. CONCLUSIONS: This study strengthens the evidence that DTR is an independent risk factor for ER admissions among elderly persons. Some prevention programs that target the elderly and other high risk subgroups for impending large temperature changes may reduce the impact of DTR on people's health.

[Comparison of surgery for staging using laparoscopy and laparotomy in patients with endometrial cancer].

OBJECTIVE: To compare the surgical outcomes for staging by laparoscopy and laparotomy in patients with endometrial cancer, evaluate the feasibility of laparoscopic surgical treatment of endometrial cancer, compare the difference between clinical and surgical staging of endometrial cancer and elucidate the advantages and feasibility of its surgical staging. METHODS: Fifty-six patients diagnosed pre-operatively as stage I endometrial cancer were reviewed for surgery for staging. They were assigned into laparoscopic group (n = 34) and laparotomic (open) group (n = 22). The operative parameters including operating time, intra-operative blood loss, the number of lymph nodes removed, gastrointestinal recovery time, urinary catheterization time, complications and post-operative hospital stay were compared. RESULTS: The pre-operative clinical characteristics before operation between two groups were similar. No significant differences were found in age and body mass index between two groups. As compared with the open group, the laparoscopic group had a longer operation time (213 min ± 49 min vs 162 min ± 30 min, P < 0.05), less hemoglobin change (12 g/L ± 8 g/L vs 19 g/L ± 8 g/L, P < 0.05), shorter hospital stay (6.3 d ± 1.7 d vs 9.5 d ± 1.8 d, P < 0.01) and shorter gastrointestinal recovery time (1.8 d ± 0.6 d vs 2.7 d ± 1.2 d, P < 0.01). While there was no significant difference between two groups in the number of lymph nodes removed, urinary catheterization time, costs and complications. The total coincidence was 57.14% between clinical and surgical staging. CONCLUSION: Laparoscopic staging surgery is both feasible and safe in the treatment of endometrial cancer. And the surgical staging truly reflects the extent of cancer invasion and it is thus necessary for early-stage endometrial cancer.

[Perioperative intervention to prevent lower extremity deep venous thrombosis after gynecologic surgery].

OBJECTIVE: To investigate the preventative effect of perioperative intervention to lower extremity deep venous thrombosis (DVT) after gynecologic surgery. METHODS: The 1062 patients,who received gynecologic surgery during 2007 June to 2008 June, were divided into intervention and nonintervention groups randomizely. According to the risk factors of DVT, the patients in intervention group were divided into 4 subgroups: low, mid, high and extremely high risk. Each group had its own preventive measures. If patients had spontaneous pain, tenderness and swelling, positivity of Neuhof or Homan syndrome, and extension of one low extremity superficial vein, the low extremity color Doppler ultrasound would be carried out immediately. The ultrasound would also be routinely carried out in the high and extremely high risk groups in intervention group after 2 and 7 days after surgery. A prospective study was carried out investigating incidence of DVT and coagulation function perioperation. The vein blood samples were taken at in a week before surgery and 48 hours post-operation. RESULTS: The incidence of DVT of intervention group was 1.10% (6/546), and in nonintervention group, the incidence was 3.29% (17/516). There was significant difference between two groups (P < 0.05). The incidence of DVT in extremely high risk subgroup was 21.05% (4/19), which was significantly higher than that of low(0), mid(0)and high risk groups [2.13% (2/94), P < 0.05]. D-dimer, antithrombin-III (AT-III) post-operation were all higher than that pre-operation in the two groups, but there was no significant difference (P > 0.05). The indexes of coagulation system,such as blood platelet count, prothrombin time (PT), active partial thromboplastin time (APTT), fibrinogen (Fbg), thrombin time (TT), tissue-plasminogen activator (t-PA), plasminogen activator inhibitor (PAI), were not significantly changed perioperation (P > 0.05 in all pre-or post-operation indexes). CONCLUSIONS: Perioperative intervention measurement according to different risk of DVT could cut down the incidence of DVT. DVT preventive intervention is suggested to high and extremely high risk people.

[Assessment of different homeostatic methods used in laparoscopic intramural myomectomy].

OBJECTIVE: To explore the safe and effective method of hemostasis in laparoscopic hysteromyomectomy (LM). METHODS: Two hundred and eighty women with symptomatic uterine intramural fibroids undergoing LM were assigned to 4 groups, Group A undergoing fibroid pedicle ligation, Group B injected with 12 IU diluted vasopressin around the myoma, Group C injected with 20 IU oxytocin combined with pedicle ligation, and Group D injected with vasopressin combined with pedicle ligation. The operation time, amount of blood loss, operative complications, bowel deflation, post-operative hemoglobin dropping, and length of hospital stay were compared. RESULTS: The amounts of blood loss of Groups A and C were (171 +/- 146) ml and (184 +/- 140) ml, both significantly higher than those of Groups B and D [(115 +/- 70) ml and (106 +/- 73) ml, both P < 0.01]. The length of hospital stay of Group D was (2.9 +/- 0.5) d, significantly shorter than those of Groups A, B, and C [(3.1 +/- 0.7) d, (3.6 +/- 0.8) d, and (3.3 +/- 0.7) d, all P < 0.05]. The bowel deflation time of Group D was (20 +/- 6) h, significantly shorter than those of the Groups A, B, and C [(26 +/-) h, (25 +/- 7) h, and (25 +/- 8) h respectively, all P < 0.05]. The post-operative hemoglobin dropping of group D was (1.1 +/- 0.9) g/L, significantly less than those of Groups A, B, and C [(1.5 +/- 1.0), (1.4 +/- 0.8), and (1.2 +/- 0.7) g/L respectively, all P < 0.05]. CONCLUSIONS: Vasopressin (12 IU) injection around the myoma is a simple, effective, and safe homeostatic procedure during LM. Pedicle ligation can reduce advanced post-operative bleeding post-operation.

[Clinical study on different operation procedure for hysterectomy].

OBJECTIVE: To investigate the effects and outcomes of four procedures for hysterectomy. METHOD: Retrospectively, we analyzed the clinical characteristics of 756 cases who respectively received hysterectomy by total abdominohysterectomy (TAH, 260 cases), modified abdominohysterectomy (MAH, 180 cases), transvaginal hysterectomy (TVH, 106 cases), or laparoscopic assisted vaginal hysterectomy (LAVH) (210 cases) and compared their effects and outcomes. RESULTS: The average operation time of TAH (98 +/- 23) minutes, MAH (67 +/- 18) minutes, TVH (63 +/- 19) minutes and LAVH (99 +/- 35) minutes. The average operation time of LAVH and TAH groups was significantly longer than that of TVH and MAH groups (P < 0.05). The volume of hemorrhage during operation in TAH group (180 +/- 49) ml was much more than that of other three groups significantly [MAH (102 +/- 43) ml, TVH (93 +/- 31) ml, LAVH (111 +/- 39) ml]. The average time of antibiotic administration and bowel function recovery in TAH group [(5.2 +/- 2.6) days, (36 +/- 9) hours] was significantly longer than that of TVH [(3.2 +/- 1.6) days, (21 +/- 4) hours], LAVH [(3.5 +/- 1.9) days, (23 +/- 6) hours] and MAH [(3.3 +/- 1.7) days, (23 +/- 7) hours] (P < 0.05). The incidence of fever in TAH group was significantly higher than that of other three groups also. The average hospital stay after operation in TVH [(3.3 +/- 1.2) days] and LAVH [(3.6 +/- 1.1) days] groups was significantly shorter than that of MAH [(5.6 +/- 1.9) days] or TAH [(5.4 +/- 2.3) days] groups (P < 0.05). CONCLUSIONS: Different procedures for total hysterectomy have their own advantages and disadvantages. Microinvasive surgery by laparoscopy for hysterectomy will be mainstream in the future.

[Effects of pentylenetetrazol at subconvulsant and convulsant dose on NMDA receptor subunits in rats].

OBJECTIVE: To investigate the expression of N-methyl-D-asparate (NMDA) receptor subunit proteins after administration of different doses of pentylenetetrazol (PTZ). METHODS: After ip injection of a subconvulsant (35 mg/kg) and convulsant (50 mg/kg) dose of PTZ, the rats were decapitated at different time points. The levels of cortical NR1 NR2A and NR2B subunit proteins were detected by immunoblotting. RESULT: 35 mg/kg PTZ and 50 mg/kg PTZ elicited different behavioral changes (P<0.001). The NR2A subunit in the cortex significantly increased 1 h after PTZ injection (P<0.05). For the 50 mg/kg group, both the NR2A and NR2B subunits proteins increased at 1 h in the cortex and then decreased; the protein levels returned to normal after 48 h. However, NR1 subunit had no changes. CONCLUSION: The NR2 subunit is involved in PTZ-induced seizure.