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Objective: To establish a formula for estimating area under the concentration-versus-time curve (AUC) of mycophenolate sodium in Chinese renal allograft recipients with a limited sampling model., Methods: A total of 35 renal allograft recipients were recruited from 2010 to 2013 to receive enteric-coated mycophenolate sodium (EC-MPS), calcineurin (CNI) and prednisone as immunosuppressive triple therapy. The serum concentration of mycophenolic acid (MPA) was assayed by enzyme multiplied immunoassay technique (EMIT) at pre-dose (C0), 0.5 (C0.5), 1.0 (C1), 1.5 (C1.5), 2.0 (C2), 3.0 (C3), 4.0 (C4), 6.0 (C6), 8.0 (C8) and 12.0 (C12) h post-dose respectively. Pharmacokinetic parameters of MPA (C0, C12, Cmax, Tmax, AUC0-12 h) were calculated by software WINNOLIN. Simplified formulae for estimation of MPA-AUC in tacrolimus (Tac) group or cyclosporin A (CsA) group were established by multiple stepwise regression analysis., Results: There were variable MPA AUC0-12 h levels between 14 and 67 mg×h/L (mean: 37 ± 14). The MPA trough level (C0) had no correlations with MPA AUC0-12 h (r(2) = 0.090) . The simplified MPA AUC formula for Tac group was AUC = 5.678+1.718×C4+2.853×C6+1.812×C8+3.413×C12 with four sampling points (C4, C6, C8, C12). Estimated AUC with the formula had correlations with AUC0-12 h (r(2) = 0.890). The mean absolute predict error (APE) was 3.45% (0.41%-24.71%) and the proportion of APE above 15% stood at 11.1% (2/18) . In CsA group, the simplified MPA AUC formula was AUC = 7.072+1.525×C3+1.558×C4+ 1.573×C6+2.285×C8. The correlation was r(2) = 0.952, mean APE was 6.50% (0.02%-12.91%) and proportion of APE above 15% stood at 0. The above formulae were observed to have agreement with AUC0-12 h by Bland-Altman analysis., Conclusion: The simplified MPA AUC formulae with 4-point sampling provide an effective approach for estimating full MPA AUC0-12 h in Chinese renal recipients on EC-MPS plus tacrolimus or cyclosporin A.

Objective: To analyze the epidemiological characteristics of an acute gastroenteritis outbreak in a nursing home caused by norovirus (NoV) and the genotype of the pathogen., Methods: On January 29th 2013, a total of 26 acute gastroenteritis patients infected by norovirus were reported in the nursing home of Jinshan, Shanghai. A questionnaire was used to acquire information of patients involved in the outbreak, 9 stool or anal swab samples were collected from 9 patients without treatment by simple random sampling method, and 4 environmental samples from the surface of doorknobs or toilets were collected. The samples were detected by Real-time PCR for NoV, and positive samples were then amplified by routine RT-PCR. The PCR products were purified, sequenced, and aligned by comparing sequences in GenBank. Phylogenetic trees were constructed by using Clustal X, employing MEGA 5.1 program package., Results: For the 26 patients, 7 were men and 19 were women.8 samples were found NoV positive among the 13 samples when detected by real-time PCR. The sequence alignment showed that the nucleotide sequence homology between Jinshan08 and Jinshan12 strain which obtained sequencing signal was 100%. The phylogenetic analysis revealed that Jinshan08, Jinshan12 and GII.e/NV2634/BCN/Spain/2008 strains in the RdRp region were on the the same branch of evolutionary tree, the confidence level was 99%, and in the N/S region of the Capsid, 2 other strains and Lordsdal strain were in the same branch, the confidence level was 97%., Conclusion: It was confirmed that the acute gastroenteritis outbreak was caused by the new GII.4 NoV recombinant.

Objective: To explore the imaging features of congenital adrenal cortex hyperplasia (CAH)., Methods: A total of 45 patients clinically confirmed as CAH were retrospectively analyzed to investigate the imaging features and strengthening way of the multi-detector-row Computed tomography., Results: The imaging features of all the cases presented as following: 25 with bilateral adrenal hyperplasia, 6 with unilateral adrenal hyperplasia, 6 with adrenal nodular hyperplasia, 2 with adrenal hyperplasia and unilateral solid cystic lesion, 2 with adrenal hyperplasia and double side real cystic lesion, 1 with adrenal hyperplasia and unilateral cystic changes and 3 with normal adrenal. The unilateral or bilateral hyperplasia adrenal could be homogeneously enhanced, while the enhanced performance of other cases was inequitable., Conclusions: The adrenal imaging features of CAH by multi-detector-row CT are variable, with the bilateral adrenal hyperplasia as the main form, which could be restored to normal morphology after hormone replacement therapy.No regression of the tumor size is observed in cases with adrenal mass. CT scanning combined with clinical manifestation and biochemical examination could facilitate the diagnosis of CAH.

Objective: To summarize the clinical features of the third portion of duodenum (PATD) for improving the understanding of PATD., Methods: Sixteen cases with PATD in Peking Union Medical College Hospital(PUMCH) were retrospectively analyzed., Results: The most common symptoms of PATD were upper abdominal pain (12/16) , vomiting (9/16) and distention (7/16).On average, the disease had progressed 5.5 months (including 2.5 months of diagnostic workup) before the diagnosis was established. Patients with pathologically poorly differentiated PATD had shorter course of disease (6.5 vs 16.6 months, P = 0.56) and lower chance of cancer-directed surgery (1/8 vs 6/8, P = 0.04) than those with well differentiated PATD. The diagnostic rate was 11/14 by CT scan while only 2/7 by upper gastrointestinal radiography. Three cases were misdiagnosed as superior mesenteric artery syndrome by barium examination., Conclusions: PATD should be considered in patients presenting upper abdominal symptoms with negative gastro endoscopy and barium examination.Overall, CT scan plays a pivotal role in diagnosing PATD. Making a correct diagnosis timely can improve the outcome of PATD patients, particularly, in those with poorly differentiated pathology.

Objective: To evaluate the efficacy and safety of Kuntai Capsule and Estrogen for Menopausal Syndrome., Methods: Related randomized controlled trials about Kuntai capsule and estrogen in recent 10 years were collected by various kinds of database according to strict inclusion and exclusion criteria. Valid data were extracted to conduct meta-analysis by RevMan5.0., Results: A total of 196 articles were retrieved, but only 6 were finally included. Meta-analysis showed that no significant differences were observed in Kupperman score between Kuntai group and estrogen [WMD = 0.22, 95%CI (-1.14, 1.58), P > 0.05]. While E(2) level was significantly higher in estrogen group than that in Kuntai [WMD = -59.59, 95%CI(-87.35, -31.83), P < 0.01]. The incidence of adverse effects was significantly lower in Kuntai group compared to the estrogen group [RR = 0.61, 95%CI(0.45,0.83), P < 0.01]., Conclusion: Kuntai can improve symptoms of menopausal syndrome effectively as the same as estrogen and tends to have lower incidence of adverse effects.

Objective: To assess the design and the Mainland China subgroup baseline characteristics of the study to evaluate the efficacy and safety of alogliptin versus placebo in subjects with type 2 diabetes (T2DM) as monotherapy, add-on to metformin or add-on to pioglitazone., Methods: This was a multi-center, randomized, double-blind, placebo-controlled, 16-week study comparing alogliptin (ALO, 25 mg, 1/d) versus placebo (PLA) as monotherapy (A), add-on to metformin (B) or add-on to pioglitazone ± metformin (C). The T2DM subjects with glycosylated hemoglobin A1c(HbA1c) between 7% and 10% and aged between 18 years and 75 years were enrolled and randomized to the alogliptin group and the placebo group in 1: 1 ratio with 16 weeks treatment. All patients were followed up every 4 weeks. The safety endpoints consisted of the incidence of hypoglycemia and other adverse events., Results: A total of 491 patients were enrolled in the Mainland China subgroup of the study (181 in group A, 186 in group B and 124 in group C). In each treatment group, the baseline characteristics including age, gender, body mass index, diabetes duration, HbA1c, fasting plasma glucose, body weight, daily dosage of metformin and daily dosage of pioglitazone were all well balanced., Conclusion: The demographic data, medical history, glycemic profile and treatment regimen at baseline in Mainland China subgroup are well balanced. The result of this study will provide the clinical evidence for the use of alogliptin in Chinese T2DM patients.

Objective: To investigate the prevalence and distribution features of overweight, obesity and abdominal obesity among rural adult residents in Hazakh and Uygur population in Xinjiang province, 2010., Methods: Questionnaire-based survey and physical examination were conducted towards the 8611 subjects selected from Hazakh and Uygur residents aged over 18 years old in Yili Xinyuan County and Kashi Jiashi County in Xinjiang province by stratified cluster random sampling method; and thereby the results were analyzed and compared between the two ethnic populations., Results: The prevalence of overweight in Hazakh(male: 29.5% (612/2078) and female: 26.4% (789/2991)) was higher than that in Uygur(male: 25.5% (440/1728) and female: 21.9% (397/1814)). The difference showed statistical significance (male: χ(2) = 7.50, female: χ(2) = 12.27, P < 0.01). The prevalence was higher in males than in females among the same ethic population (Hazakh: χ(2) = 5.79, Uygur: χ(2) = 6.28, P < 0.05). The prevalence of obesity in Hazakh(male:18.2% (379/2078) and female:18.1% (540/2991)) was higher than that in Uygur(male: 9.4% (163/1728) and female: 13.2% (240/1814)). The difference showed statistical significance (male: χ(2) = 59.90, female: χ(2) = 19.32, P < 0.01). The female prevalence was higher than male in Uygur (χ(2) = 12.66, P < 0.01); however, there was no statistically significant difference in the prevalence stratified by gender in Hazakh. The prevalence of abdominal obesity in Hazakh(male: 57.0% (1185/2078) and female: 60.2% (1801/2991)) was higher than that in Uygur(male: 46.9% (811/1728) and female: 59.5% (1080/1814)). The difference showed statistical significance (male: χ(2) = 38.54, P < 0.01; female: χ(2) = 0.216, P > 0.05). And the female prevalence was both higher than male in the two ethic populations (Hazakh: χ(2) = 5.15, P < 0.05; Uygur: χ(2) = 56.50, P < 0.01)., Conclusion: The prevalence abdominal obesity among rural adult residents in Hazakh and Uygur population was much higher than the average level nationwide in China. Hazakh had a higher prevalence of overweight and obesity than Uygur.

Objective: To investigate the prevalence of dyslipidemia among the Uyghur, Kazakh, and Han adults in Xinjiang Region and to analyze the features of distribution., Methods: 3625 Uygur residents, 1773 males and 1852 females, aged (42.89 ± 15.95) years old, 4148 Kazakh residents, 1649 males and 2499 females, aged (44.14 ± 13.27) years old, and 3733 Han residents, 1563 males and 2170 females, aged (49.66 ± 12.24) years old, were selected by stratified cluster random sampling method in year 2010, 11 506 adults in total. Questionnaire and physical examination were conducted, including fasting venous blood samples to test the levels of triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol (HDL-C)., Results: The levels of TG, TC, HDL-C and LDL-C were separately (1.31 ± 1.03), (4.44 ± 1.20), (1.41 ± 0.62), and (2.44 ± 0.81) mmol/L in the Uygur adults; separately (1.24 ± 0.99), (4.55 ± 1.31), (1.41 ± 0.62), and (2.40 ± 0.87) mmol/L in the Kazakh adults; and (1.62 ± 1.34), (4.60 ± 1.10), (1.16 ± 0.68), and (2.23 ± 0.93) mmol/L in the Han adults, respectively. The general prevalence of dyslipidemia in the Uygur, Kazakh, and Han adults were 42.4% (1537/3625), 31.6% (1311/4148), and 30.2% (1127/3733) respectively; while the age-standardized prevalence were separately 42.4%, 31.8%, and 28.2%. The prevalence of dyslipidemia in the Uygur adults was significantly higher than it of the Kazakh and Han adults, with statistical significance (χ(2) = 179.87, P < 0.01). The standardized prevalence of dyslipidemia in the Uygur males was 52.6%, significantly higher than it of the Kazakh and Han males (35.4% and 33.2%), with statistical significance (χ(2) = 159.19, P < 0.01). The prevalence of hypertriglyceridemia among the Han adults was 17.3%, which was significantly higher than it among the Uyghur and Kazakh adults (χ(2) = 172.55, P < 0.01). The prevalence of hypercholesterolemia in Kazakh (6.9%) was higher than it in Uygur (5.2%), with statistical significance (χ(2) = 10.20, P < 0.01). The prevalence of low HDL-C hyperlipidemia in the above 3 ethnic were 33.6%, 20.8% and 11.1%, respectively; while Uygur was the highest (χ(2) = 552.82, P < 0.01), followed by Kazakh, which was higher than Han (χ(2) = 138.01, P < 0.01). There was no significant difference in the prevalence of high LDL-C hyperlipidemia among the adults of the 3 ethnics., Conclusion: The prevalence of dyslipidemia among the Uygur, Kazakh, and Han adults in Xinjiang were all higher than the national average prevalence, the distribution of dyslipidemia varied with ethnicity, age and sex.

Objective: To investigate the safety of thalidomide in the treatment of immune-related bowel diseases for providing clinical reference., Methods: Thirty-five patients with immune-related bowel diseases (31 Crohn's disease, 2 ulcerative colitis and 2 Behcet's disease) treated with thalidomide were enrolled in this study. The incidence, type, severity, duration of thalidomide related adverse drug reaction (ADR) and the dose-effect relationship of neurotoxicity were analyzed., Results: All the patients were treated with a mean dose of thalidomide (109.29 ± 30.37) mg/d for (18.8 ± 12.4) months, and 33 occurred ADR. The three most frequent ADR were numbness [51.4% (18/35) ], somnolence [48.6% (17/35) ] and dermatitis [37.1% (13/35) ]. The median time to development of these three ADR were 6.50, 0.25, and 1.00 months, respectively. Severe ADR leading to withdrawal accounted for 20.0% (7/35), including reasons of peripheral neuritis (3/7), dermatitis (2/7) and myelosuppression (2/7). The incidence of peripheral neuritis was not significantly related to the maximal and initial dose of thalidomide (P > 0.05)., Conclusions: Although the incidence of ADR was relatively high during the treatment of thalidomide, most of them were mild and well tolerated. Thalidomide can be safely used in patients with immune-related bowel diseases under close monitoring.

Objective: To evaluate the relationship between high sensitivity C-reactive protein (hs-CRP) level and the severity of obstructive sleep apnea-hypopnea syndrome (OSAHS) in non-obese patients., Methods: A total of 65 patients with suspected OSAHS were recruited. Those with a history of cardiovascular or cerebrovascular events, arterial hypertension, chronic obstructive pulmonary disease, diabetes mellitus and smoking were excluded. All subjects were examined by polysomnography. Subjects with an apnea-hypopnea index (AHI) ≥ 5 were considered to have OSAHS. They were divided into mild, moderate and severe OSAHS groups and those with an AHI < 5 were accepted into the control group. The serum level of hs-CRP, a biomarker for cardiovascular disease, was measured with peripheral venous blood samples., Results: There were 53 males and 12 females with a mean age 44.3 ± 12.2 years and a body mass index (BMI) <25 kg/m(2). The serum levels of hs-CRP were significantly higher in OSAHS patients than those of the controls (geometric mean [95% confidence interval] 0.416 [0.288-0.600] vs 0.749 [0.559-1.003] mg/L, P < 0.05). Mean levels of hs-CRP did not differ between the group with mild-to-moderate OSAHS and the control group. However, the severe OSAHS group had a higher level of hs-CRP than the control group (P = 0.004). A significant positive relationship existed between hs-CRP and AHI (r = 0.407, P = 0.001) . According to stepwise multivariate analysis, only AHI was a reliable predictor for elevated serum level of hs-CRP among all these related factors (R(2) = 0.166, P = 0.001)., Conclusion: The severity of OSAHS is associated with an elevated serum level of hs-CRP in non-obese patients.

Objective: To investigate the relationship between blood pressure variability (BPV) and left ventricular diastolic function in patients with essential hypertension., Methods: Left ventricular diastolic function of 252 hypertensive patients were assessed by early (E) diastolic transmitral flows to early diastolic mitral annular velocity (Ea) (E/Ea) ratio derived from Doppler echocardiography. Patients were divided into two groups according to normal left ventricular diastolic function group (E/Ea<15, n = 168) and left ventricular diastolic dysfunction group (E/Ea ≥ 15, n = 84). All patients were monitored by ambulatory blood pressure. Standard deviation (SD) and coefficient of variation (CV) of blood pressure were calculated as the BPV. Relationship between BPV and left ventricular diastolic function were analyzed by multivariate logistic regression analysis., Results: All-day average diastolic blood pressure(DBP), the day systolic blood pressure (SBP), night SBP, night DBP, SBPSD, DBPSD and DBPCV in the left ventricular diastolic dysfunction group were significantly higher than in the normal diastolic function group (all P < 0.05). Multivariate logistic regression analysis showed that left ventricular diastolic dysfunction was associated with SBPSD (OR:1.126, 95%CI:1.054-1.203, P < 0.01), SBPCV (OR:1.127, 95%CI:1.036-1.225, P < 0.01) in this patient cohort., Conclusion: High variability of SBP is correlated with left ventricular diastolic dysfunction in hypertensive patients.

Objective: To retrospectively evaluate early and mid-term results of thoracic endovascular repair (TEVAR) of type B aortic dissection by the second generation of stent graft., Methods: From January 2009 to January 2013, 383 acute, 43 sub-acute and 152 chronic patients with type B aortic dissection underwent TEVAR in our aortic center. The mean follow-up period was (27 ± 14) months. All clinical data were analyzed with SPSS 17.0., Results: The 30-day mortality and morbidity were 0.35% and 1.2% respectively. The mid-term mortality and morbidity were 0.35% and 5.5%. Serious complications included retrograde type A dissection (n = 3), new tear at the distal end of stent (n = 26), endoleak (n = 3) and paraplegia (n = 0). The retreatment rate was 5.2% ( 6 patients were transformed to open operation and 24 patients underwent re-intervention)., Conclusions: The early and mid-term results of thoracic endovascular repair (TEVAR) of type B aortic dissection by the second generation of stent graft showed lower mortality, no paraplegia and significant reduced endoleaks in comparison with the first generation stent graft. The new distal tear caused by the stent graft became the major complication. The design of the stent graft still need improvement.

Objective: To evaluate the effectiveness and safety of L-amlodipine besylate for blood pressure control in patients with mild to moderate essential hypertension., Method: A total of 1051 mild to moderate essential hypertensives were recruited from 22 centers and randomized into three groups and were given low-dose L-amlodipine besylate (2.5 mg/d), high-dose L-amlodipine besylate (5.0 mg/d), and amlodipine maleate (5.0 mg/d) on the principle of open-label and parallel control. The study drugs were administered for 8 weeks., Results: After 8 weeks treatments, the response rate of the three groups were 72.4%, 85.6%, and 76.2%, respectively. The rate difference between high-dose L-amlodipine besylate group and the other two groups were statistically significant (P < 0.01), while the rate difference between low-dose L-amlodipine besylate group and amlodipine maleate group was similar (P = 0.28). The event rates of the three groups were similar (4.3%, 4.6%, and 5.1%, respectively, P = 0.84)., Conclusion: High-dose L-amlodipine besylate is superior to the other 2 groups on blood pressure control. The efficacy profiles of amlodipine maleate and low-dose L-amlodipine besylate are equivalent. Safety profiles of these three groups are comparable.

Objective: To explore the effects of intraperitoneal injection of mesenchymal stem cells (MSC) on intestinal barrier in serve acute pancreatitis (SAP) rats., Methods: MSC were harvested and cultured from femurs of one male SD rat. And 30 female SD rats were divided into 3 groups: control group (n = 6), SAP group (n = 12) and MSC transplantation group (n = 12). SAP was induced by intraperitoneal injection of L-arginine (2 g/kg) twice in SAP and MSC groups. In MSC group, the third-generation MSC (5×10(6)) were injected intraperitoneally once daily for 3 days. All rats were sacrificed after 72 h. The histomorphologic alternations of small intestine were measured to evaluate the therapeutic effect of MSC transplantation. Reverse transcription (RT)-PCR were used to identify the expression of TNF-α mRNA and IL-1β mRNA in small intestine and pancreas. Small intestine and pancreatic samples were examined for the engraftment of donor-derived MSC by Y chromosome in situ hybridization analysis., Results: Compared with SAP group, histomorphologic alternations of small intestine significantly lower in MSC group (4.17 ± 0.28 vs 3.00 ± 0.33, P < 0.05). The relative expression quantity of TNF-α mRNA and IL-1β mRNA in pancreas were both significant higher in SAP and MSC groups than those in control group (3.10 ± 0.73 and 1.92 ± 0.37 vs 0.51 ± 0.24, 4.60 ± 0.59 and 2.43 ± 0.39 vs 1.15 ± 0.18, all P < 0.05). Compared with SAP group, the expression quantity of TNF-α mRNA and IL-1β mRNA in pancreas significantly lower in MSC group (both P < 0.05). The relative expression quantity of TNF-α mRNA and IL-1β mRNA in small intestine were both significant higher in SAP and MSC groups than those in control group (2.73 ± 0.91 and 1.55 ± 0.48 vs 0.62 ± 0.20, 5.20 ± 0.94 and 2.10 ± 0.34 vs 0.99 ± 0.10, all P < 0.05). The expressions of TNF-α mRNA and IL-1β mRNA in MSC group were lower than those in SAP group (both P < 0.05). Sry gene was not detected in pancreatic and intestinal tissue of MSC-treated rats., Conclusions: Syngraft MSC exert protective effects on pancreas and small intestine injury. And their beneficial effects are primarily mediated via indirect actions but not by their differentiation into target cells.

Objective: To compare the efficacy, cost and safety of endovascular aortic repair (EVAR) versus open surgery in the treatment of infrarenal abdominal aortic aneurysms., Methods: Retrospective analyses were conducted for the clinical data and follow-up information of 218 cases from January 2002 to December 2011 at our hospital. Open surgery group included 86 patients with an mean age of 65.5 years and a mean aneurysm diameter of 5.4 cm. In EVAR group, there were 132 cases with an average age of 76.8 years and a mean aneurysm diameter of 5.6 cm., Results: Among 86 open cases, there were inverted "Y" type artificial graft (n = 83) and straight artificial graft (n = 3). The surgical success rate was 98.8%, perioperative period mortality rate was 2.3%, a mean volume of blood loss 450 ml and a mean transfusion volume 320 ml. The mean operative duration was 230 min, a mean hospitalization time (30 ± 3) days and a mean hospitalization cost RMB yuan 58 000. In EVAR group, the surgical success rate was 100% and perioperative period mortality rate 0.8%. Separating stent graft (n = 121, 91.7%), straight stent graft (n = 4, 3%) and one-stent-graft (n = 7, 5.3%). The mean operative duration was 150 min, a mean volume of blood loss 140 ml, a mean hospitalization time 15.5 days and a mean hospitalization cost RMB yuan 104 800. The operative duration, volume of blood loss and length of hospital stay of EVAR group were superior to those of open surgery group (P < 0.05). But the cost of group EVAR was significantly higher than that of group open surgery (P < 0.05). In group open surgery, 80 cases (94.1%) received a mean follow-up period of 46 months. And 79 artificial grafts maintained patency (98.8%) and 8 cases died (10%). There were 125 cases in group EVAR (94.7%) with a mean time of 32.5 months; stent graft patency in 120 cases (96%), 10 death; 8 complication cases (5.6%) involved stent migration (n = 2) and iliac artery branch occlusion (n = 6). Long-term effects had no significant difference between two groups (P > 0.05). In terms of the incidence of complications, group EVAR was significantly more than group open surgery (P < 0.05)., Conclusion: In terms of operative duration, volume of blood loss and length of hospital stay, EVAR and open surgery treatment for infrarenal abdominal aortic aneurysms group EVAR is significantly better than group open surgery. As far hospitalization cost, group EVAR is significantly higher than group open surgery. But, in terms of incidence of long-term complications, group EVAR is significantly higher than group open surgery while the latter often requires further interventions.

Objective: To study the clinical characteristics of Hennekam syndrome., Methods: We described a case of long-term iron deficiency anemia, characteristic facial anomalies, growth retardation, and intestinal lymphangiectasia. To our knowledge, this is the first case of Hennekam syndrome reported in China. Meanwhile, relevant literature was also reviewed., Results: A total of 35 cases of Hennekam syndrome were identified, consisting of 18 males and 17 females (age ranging 0 - 40 years old). Lymphangiectasia, lymphedema, facial anomalies (hypertelorism, flat nasal bridge and flat face) and developmental retardation were the major clinical manifestations of the syndrome. CCBE1 mutation may have played an important role in the pathogenesis of the syndrome. Long-term moderate-to-severe iron deficiency anemia was a distinctive feature of our case. Lymphangiography revealed lymphangiectasia of small intestine and lower limb, as well as thoracic outlet obstruction. Complete elimination of anemia and significant increase of serum albumin level were observed several months after the adhesiolysis procedure of the distal end of thoracic duct. However, anemia and severe hypoalbuminemia relapsed after taking greasy food., Conclusions: Hennekam syndrome is a rare autosomal recessive syndrome characterized by defective lymphatic development. Congenital lymphangiectasia should be considered in the patients with unexplained developmental retardation and hypoalbuminemia. Moreover, intestinal lymphangiectasia can be a rare cause of gastrointestinal bleeding.

Objective: To study the value of a combination of vinorelbine and cisplatin (NP) as second-line neoadjuvant chemotherapy regimen for primary breast cancer., Methods: Primary breast cancer patients on neoadjuvant chemotherapy and non-responsive to anthracyclines plus taxanes received the NP regimen. The clinical objective response was evaluated with dynamic contrast-enhanced magnetic resonance imaging (MRI) according to RECIST 1.1 before operation. The pathological response was evaluated by the Miller-Payne grading system. And the toxicities were observed and evaluated according to National Cancer Institute-Common Terminology Criteria Version 3.0 (NCI-CTC v3.0)., Results: A total of 33 breast cancer patients were examined. The outcomes were complete remission (CR, n = 0, 0%), partial remission (PR, n = 16, 48.5%), stable disease (n = 17, 51.5%) and progressive disease (n = 0, 0%). The clinical responsive rate (CR + PR) rate was 48.5%. The pathological response rates were G1 (n = 6, 18.2%), G2 (n = 6, 18.2%), G3 (n = 10, 30.3%), G4 (n = 9, 27.2%) and G5 (n = 2, 6.1%). And the pathological response (G3+G4+G5) was found in 21 cases (63.6%). The most common toxicities included neutropenia and nausea/vomiting. No serious toxicities were observed., Conclusion: As a well-tolerated and effective regimen, NP regimen may be recommended as an option of second-line neoadjuvant chemotherapy regimen for primary breast cancer.

Objective: Study of Once-daily LeVEmir(®) (SOLVE(TM)) was a 24-week international observational study to evaluate the safety and effectiveness of initiating once-daily insulin detemir (Levemir) as add-on therapy in patients with type 2 diabetes mellitus (T2DM) who failed treatment of oral anti-diabetic drugs (OAD)., Methods: The present study was derived from the data of Chinese cohort. A total of 3272 patients with T2DM failing OAD were enrolled in the study. Determir were prescribed to the patients by the decision of the physician. Clinical data were collected at baseline, week 12 and week 24 to evaluate the safety and effectiveness of detemir., Results: The age of the patients was (56.2 ± 10.8) years with a diabetes duration of (7.1 ± 5.2) years. Their BMI was (25.3 ± 3.3) kg/m(2). No patient experienced any major or nocturnal hypoglycaemic event during the study. After 24 weeks of treatment, the glycosylated hemoglobin A1c (HbA1c) decreased from (8.33 ± 1.69)% to (7.16 ± 1.18)% with a mean change of -1.17%, the fasting plasma glucose decreased from (9.52 ± 2.59) mmol/L to (6.84 ± 1.42) mmol/L with a mean change of -2.7 mmol/L, and the 7-point blood glucose profile improved overall. Totally 49.1% of patients achieved HbA1c < 7%. The mean body weight decreased by 0.15 kg., Conclusions: Insulin detemir administered once daily as add-on therapy in patients with T2DM failing OAD regimen significantly reduces the risk of major hypoglycemia, improves glycemic control, increases the percentage of patients achieving treatment target with neutral effect on body weight.

Objective: To characterize the baseline status of Chinese diabetic patients based on data derived from Chinese cohort from SOLVE(TM) study., Methods: Patients with type 2 diabetes initiating basal insulin detemir at the decision of the physician were eligible for the study. Data on demographics, medical history, glycemic profile and treatment regimen at baseline were collected by physicians., Results: A total of 3272 patients [female 42%, male 58%, mean age (56.2 ± 10.8) years] were included in the study. Their BMI was (25.3 ± 3.3) kg/m(2). The duration of diabetes was 4.0 (0.1 - 27.0) years, and the duration of treatment with oral antidiabetic drugs (OADs) was 3.0 (0.0 - 20.2) years. The proportions of subjects with diabetic macro- and micro-vascular complications were 15.8% (515 cases) and 27.1% (866 cases), respectively. The hemoglobin A1c (HbA1c) at baseline was (8.33 ± 1.70)%, and the fasting blood glucose (FPG) was (9.5 ± 2.6) mmol/L., Conclusions: A large proportion of patients with type 2 diabetes remain in poor glycemic control, and the prevalence of diabetic complications is high, which requires optimal therapeutic strategy for the patients with suboptimal glycemic control.

Objective: To re-evaluate and compare the research design and the use of statistical methods in Chinese Journal of Cardiology., Method: Summary the research design and statistical methods in all of the original papers in Chinese Journal of Cardiology all over the year of 2011, and compared the result with the evaluation of 2008., Results: (1) There is no difference in the distribution of the design of researches of between the two volumes. Compared with the early volume, the use of survival regression and non-parameter test are increased, while decreased in the proportion of articles with no statistical analysis. (2) The proportions of articles in the later volume are significant lower than the former, such as 6(4%) with flaws in designs, 5(3%) with flaws in the expressions, 9(5%) with the incomplete of analysis. (3) The rate of correction of variance analysis has been increased, so as the multi-group comparisons and the test of normality. The error rate of usage has been decreased form 17% to 25% without significance in statistics due to the ignorance of the test of homogeneity of variance., Conclusion: Many improvements showed in Chinese Journal of Cardiology such as the regulation of the design and statistics. The homogeneity of variance should be paid more attention in the further application.

Objective: To explore the effects of rehabilitation robot for lower-limb on motor function in hemiplegic patients after stroke., Methods: Forty-eight hemiplegic patients were divided randomly into treatment (n = 24) and control (n = 24) group. The neuro-facilitation technique was applied for both groups. But the treatment group had also rehabilitation robot for lower-limb training of 10 - 20 min/d, 6 d/week for 8 weeks. All patients were assessed with the Fugl-Meyer lower limb (FMA), 10 m maximum walking speed (MWS), function ambulation category (FAC) classification and the modified Barthel index (MBI)at the time of beginning and 8 weeks later., Results: Prior to intervention, no significant differences in any parameter existed between two groups. Eight weeks later, all assessment scores of FMA (25.7 ± 3.5), MWS (52 ± 16), FAC (4.3 ± 1.4) and MBI (82 + 17) were significantly better in the treatment group than those FMA (22.8 ± 3.7), MWS (40 ± 17), FAC (3.4 ± 1.3) and MBI (72 ± 14) in the control group., Conclusion: The application of rehabilitation robot for lower-limb may markedly improve the motor function of lower limb, walking ability and activity of daily living.

Objective: To summarize the clinical features of ulcerative colitis (UC) complicated by toxic megacolon for early diagnosis and proper treatment., Methods: Six cases of toxic megacolon in the patients suffered from UC in Peking Union Medical College Hospital from 1983 to 2010 were analyzed, and related literature was searched and reviewed., Results: The incidence of the toxic megacolon in the patients with UC in our center was 0.7%(6/824), which was lower than those reported in the literature. There were always risk factors triggering the disease. The prognosis of the patients was poor, even after medical care and surgery intervention. Evaluation of the patients and making right timing to perform the surgery would improve the prognosis of the patients in foreign literature., Conclusion: It's crucial to make early diagnosis of the toxic megacolon in the patients suffered from UC. The right choice and timing to perform urgent surgery or selective surgery may improve their prognosis.

Objective: To explore the effects of 7-day quadruple regimen as the first-line therapy strategy for Helicobacter pylori(H. pylori)infection and compare the eradication rate of ilaprazole versus esoprazole-based regimen., Methods: A total of 440 patients with H. pylori infection, who had never received H. pylori eradication treatment, were enrolled from 10 domestic hospitals from October 2010 to July 2011. Diagnosed as chronic gastritis or duodenal ulcer according to their endoscopic examination results, they were randomized into ilaprazole and(or) esoprazole-based bismuth-containing quadruple regimen group with amoxicillin and clarithromycin (n = 110 each). After a 7-day eradication treatment, all patients with duodenal ulcer received PPI (ilaprazole and(or) esoprazole) treatment for 14 days and (13)C urea breath test was performed at least 28 days after the end of therapy. The patients with failed eradication treatment underwent endoscopy examination and biopsy. H. pylori culture and detection of antibiotic-resistant genes were also performed., Results: In gastritis patients, the eradication rate (per-protocol, PP value) were 78.2% (79/101) and 82.0% (82/100) in ilaprazole and esoprazole groups (P = 0.50) while the (intention-to-treat) ITT value of eradication rate were 71.8% (79/110) and 74.5% (82/110) in ilaprazole and esoprazole groups respectively (P = 0.65). And there was no statistical difference (P > 0.05). In duodenal patients, the eradication rate (PP) were 92.1% (93/101) and 91.4% (96/105) in ilaprazole and esoprazole group (P = 0.86) while the ITT value of eradication rate were 84.5% (93/110) and 87.3% (96/110) in ilaprazole and esoprazole groups respectively (P = 0.56). And no significant difference existed between two groups in gastritis and duodenal ulcer patients (P > 0.05). In total, the eradication rate was 80.1% (161/201) (PP) and 73.2% (161/220) (ITT), 91.7% (189/206) (PP) and 85.9% (189/220) (ITT) in chronic gastritis and duodenal ulcer patients respectively. The symptomatic improvements of stomachache, burning, belching and nausea remained almost unchanged. No severe side effect was observed. The point mutations for clarithromycin resistance were detected in all 53 H. pylori strains (100%) isolated from the patients with failed eradication treatment., Conclusions: The eradication rate of PPI based bismuth-containing quadruple regimen as the first-line treatment is satisfactory in chronic gastritis and duodenal ulcer patients. No significant difference exists between the effects of ilaprazole and esoprazole-based groups. And the treatment failure may be attributed mainly to the clarithromycin resistance of H. pylori.

Objective: To explore the potential effects of modified electroconvulsive therapy (MECT) in prefrontal lobe and thalamus in patients with schizophrenia by proton magnetic resonance spectroscopy ((1)H-MRS)., Methods: From November 2010 to June 2011, a total of 31 schizophrenics fulfilling the third edition of the Chinese Classification of Mental Disorders (CCMD-III) were recruited. And prefrontal lobe and thalamus were evaluated by multi-voxel (1)H-MRS before and after 8 sessions of MECT. The subjects were evaluated by the positive and negative syndrome scale (PANSS). And the N-acetylaspartate (NAA), choline-containing compounds (Cho) and creatine compounds (Cr) were measured and the ratios of NAA/Cr and Cho/Cr determined., Results: (1) In left prefrontal lobe and bilateral thalamus, the NAA/Cr ratio at post-treatment demonstrated higher than that at pre-treatment (1.50 ± 0.31 vs 1.35 ± 0.30, t = 2.07, P < 0.05; 1.53 ± 0.31 vs 1.38 ± 0.27, t = 2.03, P < 0.05; 1.51 ± 0.29 vs 1.36 ± 0.26, t = 2.14, P < 0.05). (2) The major influencing factors of the changes of NAA/Cr in left prefrontal lobe were age of onset, decrease rate of PANSS, baseline PANSS total score and duration of illness. And the major influencing factors for left thalamus were age of onset and duration of illness while a major influencing factor for right thalamus was baseline PANSS total score., Conclusion: MECT may modify brain metabolism as measured by (1)H-MRS. The pattern of changes suggests possible neuroprotective effects in schizophrenics. And these effects are correlated with age of onset, duration and severity of illness.

Objective: To investigate the roles of the chemokine receptor CXCR3 and its ligand I-TAC in the pathogenesis of immune thrombocytopenic purpura (ITP)., Methods: A total of 48 ITP patients were enrolled in this study: 30 with newly diagnosed or relapse ITP and 18 in remission after treatment, and 24 healthy volunteers were as controls. IFNγ and I-TAC in plasma were detected by ELISA. The mRNA expression of CXCR3 in the peripheral blood mononuclear cells (PBMNCs) was determined by quantitative RT-PCR., Results: The IFNγ level in the plasma of ITP patients before the treatment was obviously increased than those in the remission group and controls [(71.45 ± 17.62) ng/L vs (36.94 ± 14.86) ng/L and (25.28 ± 12.85) ng/L, all P < 0.05] and those in the remission group was higher than in the controls (P < 0.05). In contrast, there were no statistic differences of the levels of I-TAC among the three groups [(455.56 ± 144.70) ng/L, (488.24 ± 164.70) ng/L and (382.97 ± 167.43) ng/L, P > 0.05]. Both ITP patients before the treatment and remission groups expressed more CXCR3 mRNA [6.76 (3.03, 37.00), 1.76 (0.45, 14.18) vs 0.12 (0.04, 0.28), P < 0.05]. After effective therapy, CXCR3 mRNA expression decreased, while it was still higher than that in the controls., Conclusions: Our data demonstrate that Th1 cytokine (IFNγ) dominance is reflected in ITP. Simultaneously, the CXCR3(+) cell may play a role in cell-mediated immunity through chemotaxis in ITP.

Objective: To evaluate the effect of pitavastatin on blood glucose in patients with hypercholesterolemia, and to investigate the efficacy of pitavastatin in diabetic patients combined with hypercholesterolemia., Method: This study was a 12-week, multi-center, open-label, without parallel-group comparison, phase IV clinical trail., Results: Contrasting to baseline, the prevalences at week 4 and 12 post-treatment of abnormal fasting plasma glucose (FPG) and glycosylated hemoglobin A1c (HbA1c) (FPG: 14.2%vs 14.1% and 11.0%; HbA1c: 14.3% vs 15.1% and 16.1%) in the safety set subjects without diabetes mellitus (DM), as well as in those with DM but not taking glucose-lowering drugs (FPG: 7/7 vs 4/7 and 5/7; HbA1c: 5/5 vs 4/4 and 5/5) had no significant changes (all P values > 0.05). Contrasting to baseline, the levels of TC [(6.51 ± 0.94) mmol/L vs (5.12 ± 0.93) mmol/L and (4.54 ± 1.00) mmol/L], LDL-C [(4.11 ± 0.79) mmol/L vs (3.02 ± 0.81) mmol/L and (2.51 ± 0.70) mmol/L] and TG [2.10 (1.53, 2.54) mmol/L vs 1.62 (1.26, 2.00) mmol/L and 1.35 (1.10, 1.86) mmol/L]at week 4 and 12 post-treatment in the per protocol set 55 subjects with DM were significantly reduced (all P values < 0.05); 33.3% of subjects at high risk and 10.0% of subjects at very high risk had achieved a TC target value; 55.6% of subjects at high risk and 40.0% of subjects at very high risk had achieved a LDL-C target value., Conclusion: Pitavastatin has a safe effect on blood glucose and it could be used to treat diabetic patients combined with hypercholesterolemia in China.

Objective: To evaluate the effect of pitavastatin on high sensitivity C-reactive protein (hsCRP) in patients with hypercholesterolemia, and determine risk factors for the effect., Methods: This study was a 12-week, multicenter, open-label, without parallel-group comparison, phase IV clinical trail., Results: There were 330 subjects in the per protocol set. Contrast to the baseline, the average levels of hsCRP in all of subjects and the group without a history of receiving previous statin medication at week 12 post-treatment decreased respectively 26.4% (1.20 mg/L vs 1.68 mg/L) and 27.5% (1.21 mg/L vs 1.97 mg/L, all P < 0.05). The results of multilevel models indicated that the average levels of hsCRP reduced with the passage of treatment time, the time-varying rate of per-visit was 0.97 mg/L (95% confidence interval 0.96 - 0.98). Controlled individual background covariates, the model predicted that pulse pressure and white blood cell count on the baseline had the significant positive effects on hsCRP (P < 0.01)., Conclusions: Pitavastatin decreases hsCRP in patients with hypercholesterolemia. The main risk factors for the effect are pulse pressure and white blood cell count on the baseline.

Objective: To analyze the prevalence and risk factors of metabolic syndrome (MS) in Xinjiang Uygur adults., Methods: With cluster random sampling, investigations including questionnaire, physical examination and blood testing were performed among 3442 Uygur adults among in Kashgar of Xinjiang on November 2010. Prevalence of MS in groups with different characteristics were calculated and non-conditional logistic regression analysis were used to analyze the risk factors., Results: The prevalence of MS was 21.2% (728/3442), and the age-adjusted prevalence was 18.5%. The prevalence among males and females was 14.5% (245/1694) (age-adjusted prevalence 12.7%) and 27.6% (483/1748) (age-adjusted prevalence 24.4%) respectively (P < 0.05). The prevalence of MS among 18 to 24 years old and 65 years old and above were 4.3% (21/490) and 28.9% (109/377) respectively. The prevalence of MS increased with age (χ(2) = 204.13, P < 0.05). The prevalence of low blood HDL-C, central obesity, hypertension, hypertriglyceridemia and hyperglycemia was 57.5% (1978/3442), 44.5% (1531/3442), 27.5% (948/3442), 20.2% (696/3442) and 8.6% (297/3442) respectively. Compared to age group 18 - 24, the risk of MS occurrence was higher in age group 25 - 34, 35 - 44, 45 - 54, 55 - 64 and 65 years-old above, the according OR (95%CI) values were 2.29 (1.38 - 3.81), 6.91 (4.31 - 11.09), 10.81 (6.72 - 17.40), 12.52 (7.74 - 20.26) and 10.20 (6.20 - 16.78), respectively. Smoking also increased the risk of MS (OR = 2.35, 95%CI: 1.64 - 3.37)., Conclusion: The prevalence of MS in Xinjiang Uygur was in high level; The prevalence of MS is higher in female than in male; The risk factors of MS included female, age and smoking.

Objective: To evaluate the safety and validity of neo-adjuvant chemoradiotherapy followed by surgery for locally advanced esophageal carcinoma., Methods: Patients with IIB, III staged squamous cell carcinoma of thoracic esophagus were randomly allocated to either preoperative chemoradiotherapy followed by surgery (arm A) or surgery alone (arm B). In arm A, chemotherapy and radiotherapy were performed concurrently. Patients received two cycles of vinorelbine and cisplatin. Vinorelbine at 25 mg/m(2) per day was administered as a bolus infusion at d1, d8, d22 and d29. Cisplatin at 75 mg/m(2) was administered by an intravenous infusion at d1 and d22 (or 25 mg/m(2) days 1 - 4 and 22 - 25). A total radiotherapeutic dose of 40 Gy was delivered in 20 daily fractions of 2.0 Gy each (5 d/wk for 4 weeks). Three-incisioned esophagectomy was performed at Weeks 4 - 6 after chemoradiotherapy. Primary outcome was overall survival time. An interim analysis was performed in June 2011., Results: From July 2007 to June 2011, 123 eligible patients were randomly assigned at 7 cooperative cancer centers (54 cases in arm A vs 69 cases in arm B). In arm A, the clinical response rate of chemoradiotherapy was 90.7%. All patients finished the preoperative chemoradiotherapy. Forty-nine cases continued to receive esophagectomy. The pathological complete response rate was 29.6%. The rate of R0 resection in arm A was significant higher than that in arm B(96.0% vs 85.5%, P = 0.015). The most common grade 3/4 toxicity of chemoradiotherapy was leukopenia occurring in 33 cases (61.1%). Vomiting and esophagitis were usually of Grade 1/2. No patient died or abandoned surgery because of chemoradiation toxicity. Between arms A and B, operative duration, blood loss, duration of chest tube drainage and length of postsurgical hospital stay were similar. The incidences of postoperative heart failure (2.0% vs 1.4%, P = 1.000), anastomotic leakage (8.2% vs 11.6%, P = 0.759) and hoarseness (6.1% vs 4.3%, P = 0.691) were not significantly different. The incidence of pulmonary infection in arm A was slightly higher than that in arm B (8.2% vs 1.4%, P = 0.094). No perioperative deaths occurred in either group. There were no significant differences in overall survivals at 1, 2 years between arms A and B (85.6%/75.5% vs 79.1%/66.1%, P = 0.207). The disease-free survivals at 1, 2 years in arm A were slightly higher than in arm B (86.6%/83.2% vs 70.9%/61.8%, P = 0.075)., Conclusion: Neo-adjuvant chemoradiation followed by surgery may achieve a high clinical response rate and pathologic complete tumor regression rate. It significantly increases the R0 resection rate and down stage the esophageal cancer patients. But its ultimate efficacy awaits further follow-up studies.

Objective: To evaluate the safety and efficacy of pitavastatin in patients with hypercholesterolemia in China under conditions of extensive usage., Methods: This was a 12-week, multicenter, open-label, without parallel-group comparison, phase IV clinical trial., Results: There were 427 subjects in the safety set. The adverse events mainly included vomiting, myalgia and the elevations of aspartate transaminase (AST), alanine transaminase (ALT) and creatine kinase (CK), etc. The incidence of drug-related adverse events was 4.22%. There were no significant differences between pre-exposure and post-exposure average levels of renal function indicators and blood routine examination item (all P > 0.05). None of them had a high AST/ALT value, i.e. > 3 times upper limits of normal (ULN), or had a high CK value, i.e. > 10 times ULN. There were 397 subjects in the per protocol set. At week 12 post-treatment, the blood levels of total cholesterol and low density lipoprotein cholesterol (LDL-C) in subjects without previous treatment decreased 24.6% and 31.0% respectively, that of high density lipoprotein cholesterol (HDL-C) in subjects with HDL-C < 1.04 mmol/L increased 60.1% while that of triglyceride (TG) in subjects with TG > 1.70 mmol/L decreased 22.5% (P < 0.05). And 207 (92.3%) subjects were at a low risk, 46 (76.1%) subjects at an intermediate risk, 134 (47.8%) subjects at a high risk and 10 (40.0%) of subjects at a very high risk had achieved a LDL-C target value; the LDL-C goal achievement rate after switching from previous medication to pitavastatin was significant higher than that of pre-switching., Conclusion: Pitavastatin demonstrates positive safety and efficacy. It may be used for the treatment of patients with hypercholesterolemia in China.

Objective: To analyze the clinical characteristics of liver metastases of neuroendocrine tumors (NET) and its treatment outcome, so as to further cognition of NET., Methods: The clinical data of patients with liver metastases of NET diagnosed by Peking Union Medical College Hospital during January 1996 to July 2010 were analyzed retrospectively., Results: The ratio of male to female was 1:1.15 (20:23). The median age at onset of the patients with liver metastases of NET was 47.5 (26 - 70) years. The median duration from onset to diagnosis was 4 (0 - 120) months. The liver metastases were the first manifestation in 69.8% (30/43) cases. The detection rate of primary lesions with routine abdominal imaging (B-type ultrasonography, CT, MRI) was 65.1% (28/43), while increased to 90.7% (39/43) when combined the following one or more special examinations including somatostatin receptor scintigraphy (SRS), PET-CT, endoscopic ultrasound (EUS) (P = 0.004). The definite diagnosis methods mainly depended on surgical specimens (69.8%, 30/43). The ratio of nonfunctional to functional NET with liver metastases was 1.87:1 (28:15). The primary tumors were most commonly located in pancreas [39.3% (11/28) and 73.3% (11/15)], followed by stomach [21.4% (6/28) and 13.3% (2/15)]. Totally 88.4% (38/43) patients received operation, and 9.3% (4/43) patients had reoperation due to missed diagnosis of the primary tumors on earlier operation. Non-surgical treatments included octreotide acetate long-acting release, interventional therapy, chemotherapy and radiotherapy, which were difficult to be evaluated due to less follow-up cases., Conclusions: Liver metastases of NET are common and even the first manifestation symptom. Primary NET with liver metastases is the most commonly nonfunctional and located in digestive system. The detection rates of primary lesions are increased by special examinations including SRS, PET-CT and EUS. Surgical specimens are helpful to the final diagnosis, but it is necessary to improve the preoperative diagnostic rate of primary tumors to avoid repeat surgeries.

Objective: To investigate the status of awareness on tuberculosis (TB) in the public and its impact factors in Zhejiang province., Methods: A multi-stage sampling was applied. Around 6600 subjects were enrolled for questionnaire survey from December 2010 to January 2011 in Zhejiang province. Survey data were input by EpiData 3.0 software, and the the status of awareness on tuberculosis (TB) in the public and impact factors were analyzed by SPSS 13.0 software package., Results: A total of 6546 subjects were investigated, the response rate was 99.18% (6546/6600), 3306 were male and 3240 were female, the age of subjects was (44.90 ± 12.40) year-old. The total key information awareness rate of TB was 45.66% (14 944/32 730). 65.70% (4301/6546) knowing the transmission route, 33.30% (2180/6546) knowing the symptom of TB, 39.21% (2567/6546) knowing where to go when suspected suffering TB, 38.28% (2506, 6546) knowing national free anti-TB drug supply and examination of infectious TB patients, 51.79% (3390/6546) knowing TB is curable in most case. As for the the key information awareness rate, among senior high school or above, primary high school, primary school or below were 57.19% (3257/5695), 52.07% (6 066/11 650), 36.54% (5 621/15 385), respectively; among birthplace in city, rural areas were 54.70 (1745/3190), 44.68% (13 199/29 540), respectively; Amone male, female were 47.11% (7 788/16 530), 44.17% (7 156/16 200); among different occupations, cadre or staff was highest (59.43%, 1 563/2 630), whereas students was lowest (40.33%, 492/1220); among different age groups, subjects aged beyond 50 years was lowest (39.75%, 5 189/13 055). The total key information awareness rate among above different population groups showed statistically difference (all P values < 0.01)., Conclusion: Awareness of knowledge for prevention and therapy of tuberculosis in Zhejiang public was insufficient and imbalanced among subjects with different social demographic characteristics.

Objective: Coronary flow velocity reserve (CFVR) is an important indicator of coronary endothelial functions and microcirculation. Pulse wave velocity (PWV) reflects the degree of aortic sclerosis and it is an independent predictor of cardiovascular events. The present study was designed to evaluate the correlation of large artery stiffness and CFVR., Methods: A total of 101 consecutive subjects were enrolled to measure the brachial-ankle pulse wave velocity (baPWV). According to the presence or absence of higher baPWV (> 1400 cm/s), they were divided into 2 groups. Transthoracic echocardiography was employed to measure coronary flow velocity in coronary left anterior descending (LAD). Then after an intravenous infusion of adenosine triphosphate, the velocity of blood flow was measured when the vessel was in maximal dilation. The ratio of flow velocity of those in maximal dilation to those at rest was CFVR., Results: The subjects with a higher baPWV (> 1400 cm/s) were markedly elder and had higher risks of hypertension and diabetes. Thus age, hypertension and diabetes contributed to arteriosclerosis. More importantly, the subjects with a higher baPWV (> 1400 cm/s) had a much lower level of CFVR (2.66 ± 0.74 vs 2.95 ± 0.76; P < 0.01) than those with a lower baPWV (< 1400 cm/s). Furthermore correlation analysis showed that CFVR and baPWV levels were significantly negatively correlated (r = -0.35, P < 0.01)., Conclusions: A negative correlation exists between artery stiffness and coronary flow velocity reserve. The increased vascular stiffness may impair coronary endothelial function, cause the dysfunction of coronary microcirculation and raise the risks of cardiovascular events.

Objective: To explore the efficacy of Jinghuaweikang capsules plus triple therapy (LACJ) in treatment of Helicobacter pylori (H. pylori) associated gastritis or duodenal ulcer, compare it with bismuth-containing quadruple therapy (LACB) and standard triple therapy (LAC) and analyze the antibiotic sensitivity of gastric mucosal H. pylori strains from the failed patients., Methods: A total of 565 patients with H. pylori infection were recruited from 11 hospitals from January 2010 to June 2011. There were 336 males and 229 females. They underwent gastroendoscopy examination due to upper gastrointestinal symptoms and had never received H. pylori eradication therapies. Duodenal ulcer patients were divided randomly into LACJ therapy group, LACB therapy group and LAC therapy group while gastritis patients LACJ therapy group and LACB therapy group. Group LAC received lansoprazole 30 mg + amoxicillin 1000 mg + clarithromycin 500 mg, twice a day, for 7 d (d1-7). Group LACJ: LAC therapy plus Jinghuaweikang, 3 capsules, twice a day, for 7 d (d1-7) then Jinghuaweikang, 3 capsules, twice a day, for 14 d (d8-21). Group LACB: LAC plus bismuth potassium citrate 220 mg, twice a day, for 7 d (d1-7) and then bismuth potassium citrate 220 mg, twice a day, for 14 d (d8-21). All duodenal ulcer patients received lansoprazole (30 mg, once a day) for 14 days after the first 7-day of treatment (d 8-21). At least 28 days after the end of treatment, all patients underwent (13)C urea breath test. Gastric mucosa was collected under endoscopy from the failed patients. The detection technique of gene chip was employed to detect antibiotics resistant gene from mucosa., Results: The eradication rates of duodenal ulcer patients in groups LACJ, LACB and LAC were as follows: per-protocol (PP), 80.2% (77/96), 89.9% (89/99) and 72.2% (70/97) (P = 0.007), intention-to-treat (ITT), 78.6% (77/98), 88.1% (89/101) and 70.0% (70/100) (P = 0.007). No statistical differences existed between groups LACJ and LACB or LAC (all P > 0.05). But there were statistical differences between groups LACB and LAC (both P = 0.002). The eradication rates of PP and ITT of chronic gastritis patients in groups LACJ and LACB were as follows: 75.8% (97/128), 74.6% (97/130) vs 83.8% (109/130), 80.1% (109/136) (both P > 0.05). The symptomatic improvements of abdominal pain, burning and acid reflux of duodenal ulcer patients in group LACJ were higher than those in groups LACB and LAC. There were statistical differences between groups LACJ and LAC (all P < 0.05). The symptomatic improvements of bloating and belching for chronic gastritis patients in group LACJ were higher than those of group LACB. But no significant difference existed between two groups (all P > 0.05). Sixty samples of gastric mucosa were collected from the failed patients. The detection rates of antibiotic-resistant gene to clarithromycin and amoxicillin were 60.0% (36/36) and 18.3% (11/60) respectively., Conclusions: The efficacy of LACJ for the treatment of H. pylori infection patients is similar to LACB and superior to LAC. And the symptomatic improvement of patients is better than the other two regimens. The main cause of treatment failure is antibiotic resistance of H. pylori strains.

Objective: To explore the clinical manifestations and surgical strategies of scoliosis associated with syringomyelia., Methods: A total of 50 cases diagnosed as scoliosis with syringomyelia between January 2003 and November 2010 were recruited. They were divided into 2 groups: Group A, neurosurgery before scoliosis correction, including suboccipital decompression and syrinx shunting; Group B, one-staged posterior correction and instrumentation without previous neurosurgery. The preoperative, postoperative and last follow-ups of Cobb angle of coronal main curve and thoracic kyphosis were measured. Also the preoperative and postoperative apical vertebra translation, apical vertebra rotation and trunk shift were measured by the same person. The surgical efficacies and complications of correction were compared between 2 groups., Results: All patients underwent posterior pedicle screw instrumentation and had a mean follow-up period of 32.1 months. Among them, 42 patients had clinical symptoms or signs preoperatively and 3 patients improved postoperatively. The mean correction of coronal curve was 65.7% and a mean loss of correction 6.4% during the follow-up. The mean correction of apical vertebra translation and apical vertebra rotation were 63.0% and 60.0% respectively. However, the trunk shift increased 0.4 cm. There were no statistically significant differences for the correction efficacies and complications between 2 groups (P > 0.05)., Conclusion: Scoliosis associated with syringomyelia may be effectively managed if a surgeon manipulates carefully intraoperatively and perioperative spinal monitoring is practiced. Furthermore syrinx will not increase the incidence of postoperative complications without prophylactic neurosurgery.

Objective: To investigate the association of hypertensive target organ damage with abnormal ankle brachial index (ABI) in high-risk hypertensive patients., Methods: During December 2008 to May 2009, a cross-sectional study was conducted to investigated the prevalence of abnormal ABI (ABI < 0.90) in 2674 community-dwelling, hypertensive patients, who aged > 40 years, without coronary heart disease, stroke/transient ischemic attack or known arteriosclerosis, from 18 centers in China. Data were acquired through history, physical examination, laboratory and other diagnostic tests., Results: There were 2615 subjects eligible for the full analysis set. The high-risk hypertensive patients with arterial wall thickening, arterial wall thickening and slightly elevated serum creatinine had a higher prevalence of abnormal ABI than their counterparts respectively (P < 0.05). Compared with the normal group, the abnormal ABI group had a higher serum creatinine level on average (P < 0.01). After adjustment for certain factors including investigation center, demographic factors, cardiovascular disease (CVD) risk and CVD risk factors using an unconditional logistic regression model, arterial wall thickening (OR 2.416, 95%CI 1.395 - 4.183, P = 0.0016) and slightly elevated serum creatinine (OR 3.377, 95%CI 1.267 - 8.997, P = 0.0149) were positively associated with abnormal ABI. However, arterial wall thickening (OR 0.988, 95%CI 0.576 - 1.695, P = 0.9664) and microalbuminuria (OR 1.389, 95%CI 0.685 - 2.817, P = 0.3621) were irrelevant to abnormal ABI., Conclusions: So far as a high-risk hypertensive patient is concerned, there are significant statistical correlations between arterial wall thickening and/or slightly elevated serum creatinine and an abnormal ABI, but no significant statistical correlations between arterial wall thickening or microalbuminuria and an abnormal ABI is observed.

Objective: To explore the surgical approaches, efficacy and safety of percutaneous nephroscopic 2 µm laser incision and drainage in the treatment of peripelvic renal cysts., Methods: The peripelvic renal cysts were punctured percutaneously. A 1.5 - 4.0 cm incision was made at thin avascular area between cyst and pelvis by the 2 µm laser to connect the cyst with the renal collecting system with the help of injecting methylene blue solution into renal pelvis through ureteral catheter. The double-J tube was placed for drainage., Results: The operations were successful in all cases. There were 16 males and 15 females with a mean age of 49 years old. The operative durations ranged from 25 to 120 minutes. And no severe complications occurred. The patients were followed up for an average of 12 months (range: 3 - 36). Among them, cysts disappeared in 18 cases and diminished over 1/3 in 13 cases. There was no recurrence of peripelvic renal cyst., Conclusion: Percutaneous nephroscopic 2 µm laser incision and drainage for peripelvic renal cyst is safe, effective and mini-invasive.

Objective: To explore the relationship and interaction of elevated fasting glucose and hypertension on cardiocerebral vascular disease., Methods: 10 054 males and females were recruited for our cross-sectional study during May 2007 to August 2007. Unconditional logistic regression was used to analysis the relationship between fasting glucose and hypertension on cardiocerebral vascular disease. A product of fasting glucose and hypertension was added to the logistic regression model to evaluate the multiplicative interaction and relative excess risk of interaction (RERI), attributable proportion (AP) of interaction and synergy index (S) was applied to evaluate the additive interaction of the two factors. Bootstrap was used to calculate 95% confidence intervals (CI) of RERI, AP and S., Results: After adjusting age, gender, smoking, drinking, body mass index (BMI) and region, the product of fasting glucose and hypertension was not statistically significant, which means there was no multiplicative interaction between the two. But the additive indexes RERI, AP and S with 95%CI of diabetes and hypertension were 0.64 (0.03, 1.25), 0.27 (0.01, 0.47) and 1.83 (1.02, 5.13) respectively, which means significant additive interaction was shown between the two on cardiovascular disease but not no stroke. And there were no additive interaction between impaired fasting glucose on cardiovascular disease or stroke., Conclusions: Hypertension was independently related to cardiovascular disease and stroke in Beijing citizens, and diabetes were independently related to stroke. There was additive interaction between diabetes and hypertension on cardiovascular disease.

Objective: To examine the relationship between single nucleotide polymorphism (SNP) of adiponectin (APN) locus +45T/G and Han male patients with premature coronary artery heart disease (pCAD)., Methods: A total of 423 male patients of Han ethnic group (< 55 yr old) undergoing coronary arteriography were recruited. Among them, 358 patients were diagnosed as pCAD while another 65 normal control (NC). All subjects were genotyped for adiponectin gene SNP +45 by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay., Results: Statistical differences of TG/GG genotype ratio were observed between two groups. The TG/GG genotype ratio in the pCAD group was 51.1% versus 35.4% in the NC group (χ(2) = 5.45, P = 0.022). After an adjustment of conventional risk factors, such as age, body mass index (BMI) and hypertension, the adiponectin gene SNP +45TG/GG genotype was strongly associated with Han ethnic group male pCAD by binary logistic regression analysis (OR = 1.843, P = 0.035, 95%CI: 1.045 ∼ 3.250). And there were statistical differences between TT genotype and TG/GG genotype among pCAD subjects in the following factors: BMI, total cholesterol (TC), low-density lipoprotein-C (LDL-C) and APN level (P < 0.05). By Pearson correlation analysis, APN was negatively correlated with TC, LDL-C and SNP +45T/G polymorphism., Conclusion: The SNP of adiponectin locus +45T/G is associated with male pCAD. And TG/GG genotype is a possible predisposing gene for Han ethnic group male pCAD.

Objective: To investigate the glycemic control and the related factors of type 1 diabetic patients in Guangdong Province., Methods: Medical records and blood samples of type 1 diabetic patients were collected in 89 tertiary and secondary hospitals from all of the 21 cities in Guangdong Province. The clinical data were analyzed to explore the correlates of glycemic control. HbA1c levels, measured in Guangdong Diabetes Center, were used to assess glycemic control., Results: 851 patients were enrolled from August 6, 2010 to May 25, 2011. There were 408 males and 443 females. The median (interquartile range) age was 29.6 years (20.3 - 41.3 years). The onset age of diabetes was 25.3 years (15.7 - 35.5 years). The disease duration was 3.3 years (1.0 - 7.3 years). The BMI was 19.9 kg/m(2) (17.9 - 21.8 kg/m(2)). HbA1c levels were 8.6% (6.9% - 11.0%) and only 234 (27.50%) patients reached the age-specific target levels. Correlates with poorer glycemic control were 13 - 19 years old (vs 7 - 12 and ≥ 20 years old), lower household income, not on dietary intervention, never accepting diabetic education and shorter diabetic duration., Conclusion: The majority of Guangdong type 1 diabetic patients did not achieve target values for glycemic control, indicating an urgent need for comprehensive management to improve glycemic control.

Objective: To explore the feasibility and efficacy of carotid endarterectomy (CEA) in the treatment of atherosclerotic carotid artery stenosis (ACAS)., Methods: From January 2002 to December 2010, 126 ACAS patients undergoing carotid endarterectomy at our hospital were retrospectively analyzed. There were 92 males and 34 females with an average age of 65.5 years old (range: 48 - 75). Among them, 25 had sequelae of cerebral infarction, 69 symptomatic cerebral ischemia and 32 asymptomatic. Sixty-two patients were monitored intra-operatively with transcranial Doppler (TCD). Among them, 5 patients underwent arterial shunt due to a reduced of blood flow in middle cerebral artery for over 50%. The other 64 patients without TCD monitoring underwent intra-operative arterial shunt. And 22 patients underwent patch angioplasty with autologous or prosthetic vascular patch. Intracranial hyperperfusion was prevented by a compression of common carotid artery or control was successful without perioperative mortality. All patients with cerebral ischemic symptoms and some patients with cerebral infarction sequelae had much post-operative improvement. Deviated tongue protrusion occurred in 10 patients and 8 of them recovered at Week 2 post-operation. And 118 patients were followed up for a mean period of 46.5 months (range: 6 - 96). Two patients with deviated tongue protrusion had slight improvements; 2 patients with severe carotid artery stenosis underwent stent angioplasty; 4 patients with moderate carotid artery stenosis received conservative treatment; among 7 deceased patients, two died of cerebral infarction., Conclusion: CEA is effective in the treatment of carotid artery stenosis with a high success rate. TCD monitoring during CEA is valuable for preventing cerebral ischemia and intracranial hyperperfusion. Arterial shunt and arterial patch angioplasty should be considered according to certain conditions during CEA.

Objective: To observe expression pattern of aquaporin 4 (AQP4) in brain tissue of severely scalded rabbit during early stage of brain edema and its relationship with signal changes in magnetic resonance imaging (MRI), and to explore the feature of water transmembrane transportation in brain edema at early stage after severe scald., Methods: Thirty-five healthy New Zealand white rabbits were divided into control group (C, n = 5) and scald group (S, n = 30) according to the random number table. Rabbits in S group were inflicted with 50% TBSA full-thickness scald with brain edema (confirmed by histopathologic examination). At post scald hour (PSH) 1, 2, 3, 4, 5, and 6, signal change in cerebral MRI, as well as dynamic change in apparent diffusion coefficient (ADC) were examined in rabbits of S group. Specimens were harvested from frontal cortex, parietal cortex, temporal lobe cortex, basal ganglia, and cerebellum in rabbits of S group for determination of protein and gene expressions of AQP4 with immunohistochemical method and RT-PCR. Above-mentioned indexes were also determined in C group. Data were processed with one-way analysis of variance and linear correlation analysis (between protein expression of AQP4 and ADC value)., Results: There was no significant change in image signal of MRI at each time point in S group as compared with that in C group, including T1WI, T2WI, and DWI. Compared with those in C group, ADC in S group at PSH 4, 5, and 6 were significantly decreased (with F values from 0.492 to 2.271, P values all below 0.05). The expression of AQP4 protein in each part of brain tissue in S group was obviously increased at PSH 2, 3, 4, 5, and 6 as compared with those in C group (from 0.164 ± 0.022 to 0.247 ± 0.018), and it peaked at PSH 3 or 4 (from 0.237 ± 0.042 to 0.306 ± 0.026), with F values from 2.420 to 11.439, P values all below 0.05. The expressions of AQP4 protein were similar in brain tissue of all regions, and they were negatively correlated with corresponding ADC values (with r values from -0.489 to -0.337, P < 0.05 or P < 0.01). Compared with that in C group, the expression of AQP4 mRNA in each part of brain tissue in S group was obviously increased at each time point, and it reached the peak at PSH 2 (with F values from 39.992 to 238.584, P values all below 0.05). The expressions of AQP4 mRNA were similar in all brain tissue regions., Conclusions: Brain edema within 6 hours after severe scald was mainly characterized by cytotoxicity, in which AQP4 may play an important role. ADC value may have important reference value for non-invasive and convenient assessment of development of brain edema.

Objective: To explore the characteristics of different subtypes of schizophrenics on prefrontal lobe and thalamus by proton magnetic resonance spectroscopy ((1)H-MRS) and its relationship., Methods: From August 2007 to April 2010 at our center, a total of 159 schizophrenics fulfilling the third edition criteria of Chinese Classification of Mental Disorders (CCMD-III) were recruited. And prefrontal lobe and thalamus were evaluated by multi-voxel (1)H-MRS. There were 88 males and 71 females. There were first-episode (n = 54) and not-first-episode (n = 105), negative subtype (n = 125) and positive subtype (n = 34), medicated (n = 96) and non-medicated (n = 63) by different criteria. The levels of N-acetylaspartate (NAA), choline-containing compounds (Cho) and creatine compounds (Cr) were measured and the ratios of NAA/Cr and Cho/Cr determined. Positive and negative syndrome scale (PANSS) and Wisconsin card sorting test (WCST) were also assessed. Only 45 normal controls received (1)H-MRS., Results: On left prefrontal lobe and left thalamus, the NAA/Cr ratios in different subtypes of patients were lower than those in normal controls (P < 0.05 or 0.01). The NAA/Cr ratios in patients of non-first-episode (1.48 ± 0.34), negative subtype (1.40 ± 0.35) and medicated (1.47 ± 0.36) on right thalamus were also lower than those in normal controls (1.62 ± 0.37, t = 2.25, 3.56, 2.28, P < 0.05 or P < 0.01). Compared with positive subtype schizophrenics, the NAA/Cr ratios in those of negative subtype on right thalamus were lower (1.40 ± 0.35 vs 1.60 ± 0.37, t = 2.92, P < 0.01). On right thalamus of non-medicated schizophrenics, there was a negative correlation between the duration of illness and the ratio of NAA/Cr (r = -0.38, P < 0.05) and a positive correlation between the duration of illness and the ratio of Cho/Cr (r = 0.43, P < 0.01). On right thalamus of negative subtype schizophrenics, the ratios of NAA/Cr were negatively correlated with the total score of PANSS and the score of negative factor respectively (r = -0.36, -0.40, P < 0.05). On left prefrontal lobe of different subtypes, the ratios of NAA/Cr were negatively correlated with the total score of PANSS, the score of negative factor, responses errors and persistent errors (P < 0.01) and positively correlated with completed categories and conceptual level responses (P < 0.05 or P < 0.01)., Conclusion: Abnormalities in neuronal function and/or integrity are present on left prefrontal lobe and left thalamus in schizophrenics. And right thalamus is probably involved in non-first-episode subtype, negative subtype and non-medicated subtype. Different subtypes of schizophrenics may have different characteristics of (1)H-MRS due to the duration of illness and their clinical symptoms.

Objective: To evaluate the relevance of cardiovascular disease (CVD) risk and abnormal ankle brachial index (ABI) in high-risk and very high-risk hypertensive patients and explore the strategies of prevention and treatment for peripheral arterial disease according to the CVD risk., Methods: Between December 2008 and May 2009, the cross-sectional study investigated the prevalence of abnormal ABI (ABI < 0.90) in 2674 community-dwelling, hypertensive patients, aged ≥ 40 years old, without coronary heart disease, stroke/transient ischemic attack or known arteriosclerosis, from 18 centers in China. The relevant data were acquired through history, physical examination, laboratory examinations and other diagnostic tests., Results: The number of subjects available for the full-analysis set was 2615. There was a rising prevalence of abnormal ABI with the advancing age in high-risk hypertensive patients and very high-risk ones (P < 0.001). Compared with the high-risk group, the 60 years (1.3% vs 5.1%) and 70 years (4.1% vs 10.5%) age sub-groups of the very high-risk group had a significantly higher prevalence of abnormal ABI (P < 0.05). After adjusting for such factors as investigational center, target organ damage, CVD risk and demographics, an unconditional Logistic regression model revealed that CVD risk was positively correlated with abnormal ABI (odds ratio 1.874, 95% confidence interval 1.153 - 3.045, P = 0.0112). A very high-risk hypertensive patient was 1.874 times more likely than a high-risk one to have an abnormal ABI., Conclusion: A high-risk hypertensive patient with a higher CVD risk is more prone to have an abnormal ABI. Among the high-risk hypertensive patients in the 60 years and 70 years age sub-groups, such a positive correlation is especially pronounced.

Objective: To explore the relationship between the sputum levels of high mobility group protein B1 (HMGB1) and airway inflammation in bronchial asthma and chronic obstructive pulmonary disease (COPD) patients., Methods: A total of 57 patients with persistent asthma [per Global Initiative for Asthma (GINA) guidelines], 30 patients with stable COPD [stratified by Global Initiative for COPD (GOLD) status] and 20 control subjects were recruited. After completing an asthma control questionnaire, spirometry was performed before sputum induction. The ratio of forced expiratory volume in the first second (FEV(1))/predictive value (FEV(1)%Pre) and neutrophil differential count in induced sputum were recorded. The concentrations of HMGB1 in the supernatant of sputum were measured by ELISA (enzyme-linked immunosorbent assay)., Results: The sputum concentrations of HMGB1 in the asthmatics and COPD patients were significantly higher than those of the control subjects [(291 ± 55) and (511 ± 39) vs (61 ± 5) ng/L, all P < 0.01]. And they were significantly negatively correlated with FEV(1)%Pre in all subjects. The levels of HMGB1 in induced sputum of COPD patients were significantly higher than those of asthmatics and healthy controls (P < 0.01). No significant difference existed in the levels of HMGB1 between patients with eosinophilic and noneosinophilic asthma [(290 ± 55) vs (292 ± 54) ng/L, P > 0.05]. The HMGB1 levels with COPD stage II and stage III were significantly higher than those with stage I [(526 ± 29) and (541 ± 29) vs (471 ± 18) ng/L]. The differences of sputum neutrophil percentage were statistically significant in mild, moderate and severe asthma [(27 ± 2)%, (36 ± 4)%, (49 ± 4)%]. And the sputum levels of HMGB1 were significantly higher in the patients with moderate and severe asthma [(312 ± 14) vs (347 ± 11) ng/L]. And the levels of HMGB1 in asthmatic and COPD patients were positively correlated with neutrophil percentage. According to the multivariate analysis, neutrophil percentage and FEV(1)%Pre were independent predictors of sputum HMGB1, but not smoking, age, gender and eosinophilic percentage., Conclusion: HMGB1 may contribute to airway inflammation through its higher expression in bronchial asthma and COPD patients.

Objective: To evaluate the feasibility and short-term results of transcatheter aortic valve implantation (TAVI) using a new transcatheter valve., Methods: Twenty healthy adult sheep received general anesthesia. Under the guidance of X-ray and transthoracic echocardiography (TTE), the new anti-calcification transcatheter valve was released from delivery system and implanted at the level of native aortic annulus via left common carotid artery. Position and function of the new anti-calcification transcatheter valve were evaluated by angiography and TTE immediately after intervention. Thirty day survival rate of animals was obtained., Results: New transcatheter valves were implanted in all sheep. Fifteen sheep (75%) survived up to 30 days and post-operative examination showed that the transcatheter valve was in optimal position without migration and mitral valve impingement. The native coronary artery was patent in these animals. There was a slight paravalvular leak in 5 sheep. Postoperative echocardiography showed reflux percentage was significantly increased (P < 0.05) compared pre-intervention. Effective orifice area, aortic systolic pressure, diastolic aortic pressure, mean aortic pressure, left ventricular systolic pressure, left ventricular end diastolic pressure and heart rate were similar between post and pre-intervention (all P < 0.05). Five sheep died after TAVI within 30 days, including one fatal ventricular fibrillation occurred immediately after releasing the transcatheter valve and another sheep died of acute myocardial infarction due to left main coronary artery occlusion evidenced by angiography. Two sheep died of severe mitral regurgitation at 8 and 12 hours post-operation and one died of infective endocarditis at 26 days after intervention., Conclusion: Our favorable preliminary results showed that it was feasible to perform TAVI using the new transcatheter valve.

Objective: To evaluate the safety and efficacy of 30 mg pioglitazone hydrochloride combined with sulphonylurea in the treatment of type 2 diabetic patients., Methods: A randomized, double blind, placebo-controlled, parallel group, multicenter study was performed. A total of 236 patients, who had fasting plasma glucose (FPG) 7.5 - 13.0 mmol/L and glycosylated hemoglobin A1c (HbA1c) 7.0% - 12.0%, treated with stable dosage of a sulphonylurea for at least 30 days previously, were randomized to receive placebo or pioglitazone 30 mg once daily for 16 weeks. The sulphonylurea and dosage remained unchanged., Results: The patients who had been treated with pioglitazone 30 mg showed significant decrease than that in the placebo group on the average from baseline in FPG [(1.48 ± 2.08) mmol/L vs (-0.17 ± 1.92) mmol/L, P < 0.05], and in HbA1c [(0.92 ± 0.10)% vs (0.28 ± 0.11)%, P < 0.05]. Since fasting plasma insulin (FIns) levels decreased (0.24 ± 0.04) mU/L and (0.09 ± 0.04) mU/L in the two groups. The homeostatic model assessment insulin resistant (HOMA-IR) decreased 1.42 ± 2.90 and 0.46 ± 3.53 in two groups. The triglyceride level was decreased 0.36 mmol/L and 0.14 mmol/L, and the HDL-C level increased 0.17 mmol/L and 0.05 mmol/L in two groups. There were significant differences in two groups (all P < 0.05)., Conclusions: The 16-week clinical study demonstrated that pioglitazone hydrochloride with a dosage of 30mg daily, could significantly improve the blood glucose control and enhance the insulin sensitivity, lower triglyceride and raise HDL-C level as an additional therapy to a stable-dose sulphonylurea in Chinese type 2 diabetic patients previously poorly controlled by single sulphonylurea therapy, and furthermore had good safety and compliance.

Objective: To investigate the relationship between marital status and prevalence of peripheral arterial disease (PAD) among Beijing residents., Methods: From May to August 2007, 10 054 residents were interviewed to collect demographic and biochemistry information. Generalized linear mixed model was used to determine the relationship between marital status and prevalence of PAD in terms of OR and corresponding 95% confidence intervals., Results: After adjusting the traditional risk factors including age, area, lipid, serum glucose, blood pressure, central obesity, smoking, drinking and physical activities for PAD, relationship between marital status and prevalence of PAD was found both at the female and male groups of those with 45 years or older. Compared with married men, OR and 95% confidence interval of PAD for unmarried men were 1.56 (0.39 - 6.35) and 1.61 (0.77 - 3.35) for those with 45 years younger and older respectively, while compared with married women, OR and 95% confidence interval of PAD for unmarried women were 0.75 (0.22 - 2.57) and 1.78 (1.23 - 2.58) for those with 45 years younger and older respectively. Significant differences (all P < 0.01) were found between married and unmarried women of 45 years or older in terms of age, waist circumstances, systolic blood pressure, fasting glucose, total cholesterol, low-density lipoprotein and smoking., Conclusions: Peripheral arterial disease was related to marital status for women of 45 years or older among Beijing residents. Estrogen level and the distribution of other PAD risk factors might contribute to the observed finding.

Objective: To explore the effects of exogenous transforming growth factor-β3 (TGF-β3) on the activities of its promoter and cAMP-responsive element binding protein-1 (CREB-1) in rat hepatic stellate cell (HSC-T6)., Methods: HSC-T6 was cultured and treated with or without exogenous TGF-β3 (10 µg/L). Then cell extracts, total RNA and nuclear proteins were collected at different time points. The specimens were detected by luciferase reporter assay, Western blotting and real-time RT-PCR (reverse transcription-polymerase chain reaction) respectively., Results: After treatment, the activity of TGF-β3 promoter peaked at 24 h (10.68 ± 0.57 vs 4.83 ± 0.56, 2.2 folds vs control). And the mutational CRE site completely blocked the activity of TGF-β3 promoter (0.73 ± 0.03, P < 0.05). In addition, exogenous TGF-β3 increased the expression of phospho-CREB-1 in a time-dependent manner. It peaked at 1 h (2.0 folds vs control) and declined slowly. And exogenous TGF-β3 had no effect on the mRNA and protein expressions of CREB-1 (P > 0.05)., Conclusion: The activity of TGF-β3 promoter is up-regulated by exogenous TGF-β3. And CRE site in TGF-β3 promoter region is important for the transcription of TGF-β3 gene in HSC-T6. While activating CREB-1, exogenous TGF-β3 has no effect on the expressions of CREB-1 protein and mRNA.