BACKGROUND：Carotid intima media thickness （CIMT） and stiffness are taken as useful surrogate markers of atherosclerosis. In China, the number of elderly patients undergoing hemodialysis has increased year by year, ...BACKGROUND：Carotid intima media thickness （CIMT） and stiffness are taken as useful surrogate markers of atherosclerosis. In China, the number of elderly patients undergoing hemodialysis has increased year by year, with the increase of dialysis-related cardiovascular events. This study was undertaken to examine carotid stiffness in elderly hemodialysis patients by the ultrasound techniques in order to find out the possible risk factors. From January 2006 to February 2010, a total of 87 patients （41 males and 46 females） treated with routine hemodialysis at the 97th Hospital of People＇s Liberation Army were enrolled in this study. The distensibility coefficient （DC） of the carotid artery was detected by Doppler ultrasonic diagnosis apparatus （Philips HBI5000, frequency 12 MHz） for evaluation of arterial stiffness. Serum albumin, total cholesterol （TC）, high density lipoprotein （HDL）, low density lipoprotein （LDL）, triglyceride （TG）, glucose, creatinine, calcium, phosphorus, and intact parathyroid hormone （iPTH） were examined with standard methods. The liner correlation and multiple stepwise regression analysis were used to find correlations between them. RESULTS： In this study, the systolic blood pressure was 153.33±25.98 mmHg, DBP 84.22± 10.39 mmHg, TC 4.39±1.05 mmol/L, TG 1.36±0.72 mmol/L, LDL 2.47±0.77 mmol/L, Cr 889.82± 207.38 μmol/L, Glu 5.36±1.87 mmol/L, Ca 12.00±2.19±0.21 mmol/L, and DC 13.39±5.32×10-3/kPa. DC was associated with age （r =-0.459, P〈0.001）, SBP （r =-0.527, P〈0.001）, and serum calcium （r =-0.273, P=0.011）. The multiple stepwise regression analysis showed that SBP, age, increased serum calcium level, and diabetes were independent risk factors for decreasing DC. CONCLUSION： Systolic blood pressure, age, increased serum calcium level and diabetes in elderly hemodialysis patients are independent risk factors for increased carotid arterial stiffness.展开更多
Objective: Management of Graves' orbitopathy (GO) continues to be a challenge to clinical endocrinologists. In the last few years, surveys on GO management have succeeded in elucidating trends in Europe and Latin ...Objective: Management of Graves' orbitopathy (GO) continues to be a challenge to clinical endocrinologists. In the last few years, surveys on GO management have succeeded in elucidating trends in Europe and Latin America. To determine how endocrinologists in China assess and treat patients with GO and gain insight into how to make the management of this disease more uniform and standardized. Methods: Based on the questionnaire used in the European survey on GO, a questionnaire in China was drafted and circulated to the members of Chinese Society of Endocrinology (CSE) during the annual meeting. Results: A total of 124 valid responses were analysed. Almost all respondents (94.4%) claimed that a multidisciplinary approach for GO management was valuable. Over 80% of the participants advocated the assessment of exophthalmometry, vision, visual fields by perimetry, eye movements, and fundoscopy. Glucocorticoids were preferred as the first-line therapy by 92.7% of respondents, among them, 59.7% choose the intravenous route. The treatment strategy for GO with intravenous glucocorticoids therapy still remains debatable. Anti-thyroid drugs (ATDs) were the most common choice (72.6%) for first-line therapy of coexisting hyperthyroidism. Treatment options for GO were very similar among Chinese, Latin-American and Eu-ropean respondents, whereas radioactive iodine and surgical treatment were more often indicated for co-existing hyperthyroidism in China. Conclusion: The appropriate treatment for patients with GO is controversial even among thyroid specialists. Further training of thyroid specialists, easier access of patients to multidisciplinary centres and establishment of practice guidelines are required for the management of this condition in China. Copyright ? 2015, Chinese Medical Association Production. Production and hosting by Elsevier B.V. on behalf of KeAi Communications Co., Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).展开更多
文摘BACKGROUND：Carotid intima media thickness （CIMT） and stiffness are taken as useful surrogate markers of atherosclerosis. In China, the number of elderly patients undergoing hemodialysis has increased year by year, with the increase of dialysis-related cardiovascular events. This study was undertaken to examine carotid stiffness in elderly hemodialysis patients by the ultrasound techniques in order to find out the possible risk factors. From January 2006 to February 2010, a total of 87 patients （41 males and 46 females） treated with routine hemodialysis at the 97th Hospital of People＇s Liberation Army were enrolled in this study. The distensibility coefficient （DC） of the carotid artery was detected by Doppler ultrasonic diagnosis apparatus （Philips HBI5000, frequency 12 MHz） for evaluation of arterial stiffness. Serum albumin, total cholesterol （TC）, high density lipoprotein （HDL）, low density lipoprotein （LDL）, triglyceride （TG）, glucose, creatinine, calcium, phosphorus, and intact parathyroid hormone （iPTH） were examined with standard methods. The liner correlation and multiple stepwise regression analysis were used to find correlations between them. RESULTS： In this study, the systolic blood pressure was 153.33±25.98 mmHg, DBP 84.22± 10.39 mmHg, TC 4.39±1.05 mmol/L, TG 1.36±0.72 mmol/L, LDL 2.47±0.77 mmol/L, Cr 889.82± 207.38 μmol/L, Glu 5.36±1.87 mmol/L, Ca 12.00±2.19±0.21 mmol/L, and DC 13.39±5.32×10-3/kPa. DC was associated with age （r =-0.459, P〈0.001）, SBP （r =-0.527, P〈0.001）, and serum calcium （r =-0.273, P=0.011）. The multiple stepwise regression analysis showed that SBP, age, increased serum calcium level, and diabetes were independent risk factors for decreasing DC. CONCLUSION： Systolic blood pressure, age, increased serum calcium level and diabetes in elderly hemodialysis patients are independent risk factors for increased carotid arterial stiffness.
文摘Objective: Management of Graves' orbitopathy (GO) continues to be a challenge to clinical endocrinologists. In the last few years, surveys on GO management have succeeded in elucidating trends in Europe and Latin America. To determine how endocrinologists in China assess and treat patients with GO and gain insight into how to make the management of this disease more uniform and standardized. Methods: Based on the questionnaire used in the European survey on GO, a questionnaire in China was drafted and circulated to the members of Chinese Society of Endocrinology (CSE) during the annual meeting. Results: A total of 124 valid responses were analysed. Almost all respondents (94.4%) claimed that a multidisciplinary approach for GO management was valuable. Over 80% of the participants advocated the assessment of exophthalmometry, vision, visual fields by perimetry, eye movements, and fundoscopy. Glucocorticoids were preferred as the first-line therapy by 92.7% of respondents, among them, 59.7% choose the intravenous route. The treatment strategy for GO with intravenous glucocorticoids therapy still remains debatable. Anti-thyroid drugs (ATDs) were the most common choice (72.6%) for first-line therapy of coexisting hyperthyroidism. Treatment options for GO were very similar among Chinese, Latin-American and Eu-ropean respondents, whereas radioactive iodine and surgical treatment were more often indicated for co-existing hyperthyroidism in China. Conclusion: The appropriate treatment for patients with GO is controversial even among thyroid specialists. Further training of thyroid specialists, easier access of patients to multidisciplinary centres and establishment of practice guidelines are required for the management of this condition in China. Copyright ? 2015, Chinese Medical Association Production. Production and hosting by Elsevier B.V. on behalf of KeAi Communications Co., Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
