Dyslipidemia and cardiovascular disease risk factors in patients with type 1 diabetes:A single-center experience

BACKGROUND Type 1 diabetes(T1D)contributes to altered lipid profiles and increases the risk of cardiovascular disease(CVD).Youth with T1D may have additional CVD risk factors within the first decade of diagnosis.AIM To examine risk factors for dyslipidemia in young subjects with T1D.METHODS Longitudinal and cross-sectional retrospective study of 170 young subjects with T1D(86 males;baseline mean age 12.2±5.6 years and hemoglobin A1c 8.4%±1.4%)were followed in a single tertiary diabetes center for a median duration of 15 years.Predictors for outcomes of lipid profiles at last visit(total cholesterol[TC],triglycerides[TGs],low-density lipoprotein-cholesterol[LDL-c],and highdensity lipoprotein-cholesterol[HDL-c])were analyzed by stepwise linear regression models.RESULTS At baseline,79.5%of the patients had at least one additional CVD risk factor(borderline dyslipidemia/dyslipidemia[37.5%],pre-hypertension/hypertension[27.6%],and overweight/obesity[16.5%])and 41.6%had multiple(≥2)CVD risk factors.A positive family history of at least one CVD risk factor in a first-degree relative was reported in 54.1%of the cohort.Predictors of elevated TC:family history of CVD(β[SE]=23.1[8.3],P=0.006);of elevated LDL-c:baseline diastolic blood pressure(DBP)(β[SE]=11.4[4.7],P=0.003)and family history of CVD(β[SE]=20.7[6.8],P=0.017);of elevated TGs:baseline DBP(β[SE]=23.8[9.1],P=0.010)and family history of CVD(β[SE]=31.0[13.1],P=0.020);and of low HDL-c levels:baseline DBP(β[SE]=4.8[2.1],P=0.022]).CONCLUSION Our findings suggest that elevated lipid profiles are associated with DBP and a positive family history of CVD.It is of utmost importance to prevent and control modifiable risk factors such as these,as early as childhood,given that inadequate glycemic control and elevation in blood pressure intensify the risk of dyslipidemia.

Aging is a risk factor of nonalcoholic fatty liver disease in premenopausal women

AIM: To clarify the relationship between age, menopause, and nonalcoholic fatty liver disease (NAFLD) in women. METHODS: We conducted a follow-up study on non-alcoholic fatty liver disease by using abdominal ultrasonography, and investigated the relationship of age and menopause with the development of NAFLD in women. We followed 1829 women and 2572 men (response rate, 86%) selected in 2001 to represent the non-institutionalized adult population of Gifu, Japan. Data collected included self-reported medical history, lifestyle factors, and menopausal status. The postmenopausal state was defined as beginning 1 year after the cessation of menses. We diagnosed NAFLD with the aid of abdominal ultrasonography by using diagnostic criteria describedRESULTS: The prevalence of NAFLD in women increases with age, but does not alter with age in men. Furthermore, the prevalence of NAFLD in premenopausal women (6%) was lower than that in men (24%) and in postmenopausal women (15%). The associations of the postmenopausal state and hormone replacement therapy with NAFLD were statistically significant in a univariate logistic regression model. At the follow-up examination, 67 women (5%) were newly diagnosed with NAFLD. The incidence of NAFLD was 3.5% (28/802) in premenopausal women, 7.5% (4/53) in menopausal women, 6.1% (24/392) in postmenopausal women, and 5.3% (11/206) in women receiving hormone replacement therapy. The weight gain in premenopausal women was equal to that in postmenopausal women. Metabolic syndrome and weight gain were independent risk factors for NAFLD in pre-and postmenopausal women, but age was an independent risk factor in premenopausal women only. CONCLUSION: Aging is a risk factor for NAFLD in premenopausal women, independent of weight gain or influence of metabolic syndrome.

Inflammatory bowel disease:Epidemiology,pathology and risk factors for hypercoagulability

Hypercoagulability observed in patients with inflammatory bowel diseases (IBD) may lead to thromboembolic events (TE), which affect the venous and arterial systems alike and are an important factor in patients’ morbidity and mortality. The risk of TE in IBD patients has been demonstrated to be approximately three-fold higher as compared to the general population. The pathogenesis of thrombosis in IBD patients is multifactorial and not fully explained. The most commonly listed factors include genetic and immune abnormalities, disequilibrium between procoagulant and anticoagulant factors, although recently, the role of endothelial damage as an IBD-triggering factor is underlined. Several studies report that the levels of some coagulation enzymes, including fibrinogen, factors V, VII, VIII, active factor XI, tissue factor, prothrombin fragment 1 + 2 and the thrombin-antithrombin complex, are altered in IBD patients. It has been demonstrated that there is a significant decrease of tissue plasminogen activator level, a marked increase of plasminogen activator inhibitor type 1 and thrombin-activable fibrinolysis inhibitor, a significantly lower level of antithrombin III and tissue factor pathway inhibitor. IBD patients have been also observed to produce an increased amount of various anticoagulant antibodies. Hyperhomocysteinemia, which is a potential risk factor for TE was also observed in some IBD patients. Further studies are necessary to assess the role of coagulation abnormalities in IBD etiology and to determine indications for thromboprophylactic treatment in patients at high risk of developing TE.

Prevalence of Major Cardiovascular Risk Factors and Cardiovascular Disease in Women in China: Surveillance Efforts

In this study, we aimed to assess the relationship of socioeconomic status and acculturation with cardiovascular disease （CVD） risk profiles and CVD and examine the CVD risk factors associated with CVD. We used data from the 2010 China Chronic Disease and Risk Factor Surveillance surveys, which consisted of a nationally representative sample of women. The following prevalence was found： myocardial infarction （MI）：

Epidemiological studies of migration and environmental risk factors in the inflammatory bowel diseases

Inflammatory bowel diseases(IBD)are idiopathic chronic diseases of the gastrointestinal tract well known to be associated with both genetic and environmental risk factors.Permissive genotypes may manifest into clinical phenotypes under certain environmental influences and these may be best studied from migratory studies.Exploring differences between first and second generation migrants may further highlight the contribution of environmental factors towards the development of IBD.There are few opportunities that have been offered so far.We aim to review the available migration studies on IBD,evaluate the known environmental factors associated with IBD,and explore modern migration patterns to identify new opportunities and candidate migrant groups in IBD migration research.

Predictors of disease recurrence after radical resection and adjuvant chemotherapy in patients with stage IIb-IIIa squamous cell lung cancer:A retrospective analysis

BACKGROUND Lung cancer(LC)is a global medical,social and economic problem and is one of the most common cancers and the leading cause of mortality from malignant neoplasms.LC is characterized by an aggressive course,and in the presence of disease recurrence risk factors,patients,even at an early stage,may be indicated for adjuvant therapy to improve survival.However,combined treatment does not always guarantee a favorable prognosis.In this regard,establishing predictors of LC recurrence is highly important both for determining the optimal treatment plan for the patients and for evaluating its effectiveness.AIM To establish predictors of disease recurrence after radical resection and adjuvant chemotherapy in patients with stage IIb-IIIa lung squamous cell carcinoma(LSCC).METHODS A retrospective case-control cohort study included 69 patients with LSCC who underwent radical surgery at the Orenburg Regional Clinical Oncology Center from 2009 to 2018.Postoperatively,all patients received adjuvant chemotherapy.Histological samples of the resected lung were stained with Mayer's hematoxylin and eosin and examined under a light microscope.Univariate and multivariate analyses were used to identify predictors associated with the risk of disease recurrence.Receiver operating characteristic curves were constructed to discriminate between patients with a high risk of disease recurrence and those with a low risk of disease recurrence.Survival was analyzed using the Kaplan-Meier method.The log-rank test was used to compare survival curves between patient subgroups.Differences were considered to be significant at P<0.05.RESULTS The following predictors of a high risk of disease recurrence in patients with stage IIb-IIa LSCC were established:a low degree of tumor differentiation[odds ratio(OR)=7.94,95%CI=1.08-135.81,P=0.049];metastases in regional lymph nodes(OR=5.67,95%CI=1.09-36.54,P=0.048);the presence of loose,fine-fiber connective tissue in the tumor stroma(OR=21.70,95%CI=4.27-110.38,P=0.0002);and fragmentation of the tumor solid component(OR=2.53,95%CI=1.01-12.23,P=0.049).The area under the curve of the predictive model was 0.846(95%CI=0.73-0.96,P<0.0001).The sensitivity,accuracy and specificity of the method were 91.8%,86.9%and 75.0%,respectively.In the group of patients with a low risk of LSCC recurrence,the 1-,2-and 5-year disease-free survival(DFS)rates were 84.2%,84.2%and 75.8%,respectively,while in the group with a high risk of LSCC recurrence the DFS rates were 71.7%,40.1%and 8.2%,respectively(P<0.00001).Accordingly,in the first group of patients,the 1-,2-and 5-year overall survival(OS)rates were 94.7%,82.5%and 82.5%,respectively,while in the second group of patients,the OS rates were 89.8%,80.1%and 10.3%,respectively(P<0.00001).CONCLUSION The developed method allows us to identify a group of patients at high risk of disease recurrence and to adjust to ongoing treatment.

The Importance of Setting Treatment Goals for Cardiovascular Diseases

Background: Guidelines are issued by most major organizations that focus on a specific disease entity. Guidelines should be a significant help to the practicing physician who may not be up-to-date with the recent medical literature. Unfortunately, when conflicting guidelines for a specific disease are published, confusion results. Purpose: This article provides a suggested guideline outcome measure that would benefit the physician and patient. Methods: A review of 19 different guidelines for cardiovascular disease treatment is one example of the lack of specific outcomes that currently exist. The basic problem with most guidelines is that they do not state the expected end result (i.e., the benefit to the patient) if that guideline is followed. When guidelines use cardiovascular disease risk factors to dictate therapy, the end benefit is never stated so that the patient can make an appropriate choice of which (if any) guideline to follow. Results: A good example is guidelines published by the American Heart Association for reducing cardiovascular disease. These guidelines are risk factor based and only indicate that cardiovascular disease would be reduced if followed. No specific percentage in the reduction of the incidence of disease is given. In contrast, when elimination of the disease is the stated goal of the guideline, the end result is clear. To date, this goal has been stated by only one organization devoted to eliminating cardiovascular disease. Conclusion: Guidelines need to be written to provide the physician and the patient with a specific end point that is expected when the guideline is followed. Patient acceptance and compliance will be much improved if the patient knows the risk/benefit of following the guideline’s recommendations.

Risk factors for the occurrence and development of Binswanger disease: A controlled observation

BACKGROUND： Some scholars think that hypertension is the major risk factor to cause Binswanger disease （BD）, however, BD is also found in some persons with normal blood pressure, so we presume that some other factors, such as diabetes mellitus, hyperlipemia, coronary heart disease and transient ischemic attacks and so on, might participant in the onset of BD. OBJECTIVE： To comparatively observe the difference in accompanying diseases, transcranial doppler （TCD） performance, blood glucose and blood lipid level between BD patients and healthy subjects who received health examination, and between BD patients with different disease condition. DESIGN ： Case-control analysis SETTING ： Department of Emergency, Qingdao Municipal Hospita PARTICIPANTS： Totally 126 patients with BD, 65 male and 61 female, aged from 67 to 85 years old, who hospitalized in the Medical School Hospital of Qingdao University and Qingdao Municipal People＇s Hospital, were chosen, serving as BD patients group. All the patients met the clinical diagnostic criteria of BD introduced by Bennett et al. Another 126 persons, 65 male and 61 female, aged ranging from 67 to 80 years, who received health examination in the same hospital, were homeochronously chosen, serving as control group. Informed consents were obtained from all the subjects. METHODS ： After being admitted, all the subjects including BD patients and persons who homeochrenously received health examination in the same hospital were given examinations of blood pressure, blood lipid, blood glucose, electrocardiogram （ECG） and TCD. Fifty-seven patients with BD were in the stable period and 69 in the progressive period （Stable period： no local or subcortical function disorder found, and no changes in the range of white matter lesion showed by CT and/or MRI in recent 3 months; Progressive period： with local or subcortical function disorder and increase in the range of white matter lesion showed by CT and/or MRI in recent 3 months）. According to intimal thickening of carotid artery and vertebral artery preformed by TCD, BD was graded as mild intimal thickening （〈 1.1 mm）, moderate intimal thickening （1.1 to 1.2 mm） and severe intimal thickening （〉 1.2 mm）. MAIN OUTCOME MEASURES ： Comparison of the ratio of BD patients with accompanied diabetes mellitus, hypedipemia, coronary heart disease and transient ischemic attacks, TCD performance, blood glucose and blood lipid level between BD patients group and control group, and among BD patients with vadous disease conditions. RESULTS： Totally 126 BD patients and 126 subjects who received health examination all participated in the result analysis. Intergroup comparison： ①The ratio of BD patients with accompanied hypertension, diabetes mellitus, hypedipemia, transient ischemic attacks and coronary heart disease was 91.3%, 46.8%, 42.9%, 81.7% and 46.0% respectively in the BD patients group, and that was 36.5%, 17.5%, 15.9%, 34.1% and 34.1%, respectively in the control group. Significant difference existed between two groups （x^2=86.201, 24.907,25.660,58.620,9.900, P 〈 0.01 ）.②Compared with control group, anterior, middle cerebral and vertebrobasilar arteriosclerosis and insufficient cerebral blood supply existed significantly in BD patients with different disease condition （x^2=40.34,7.585,15.429, P 〈 0.01 ）.③Compared with control group, the level of blood glucose, total cholesterol and triglyceride of BD patients increased significantly （t=6.939,3.891,3.711 ,P 〈 0.01 ）. Comparison among BD patients with different disease condition： ① Compared with stable period, transient ischemic attacks and coronary heart disease were found much in the BD patients at progressive period, with significant difference （x^2=7.196,13.517,P 〈 0.01 ）.② Mild arteriosclerosis at stable period was found in 17 cases, and significant difference existed compared with progressive period （x^2=6.523,P 〈 0.05）.③ There was no significant difference in the blood glucose and blood lipid level （t=-1.755 6,0.583 1,0.824 6, P 〉 0.05）. CONCLUSION： Hypertension, cerebral arteriosclerosis, diabetes mellitus, hypedipemia, coronary heart disease and transient ischemic attacks have important effects on the onset of BD; Transient ischemic attacks and coronary heart disease can worsen the symptoms of BD patients.

Effect of Different Styles of Coronary Heart Disease and Its Risk Factors on Cardiac Remodeling and Dysfunction

Objectives To evaluate the effect of different styles of coronary heart disease （CHD）, different regions of acute myocardial infarction （AMI）, its risk factors and branches of coronary stenosis on left ventricular remodeling and dysfunction by applying echocardiography. Methods 251 patients with CHD and 96 patients without CHD （NoCHD） were verified by selective coronary angiography. CHD patients were divided into stable angina pectoris （SAP） 26, unstable angina pectoris（UAP） 53, acute myocardial infarction （AMI） 140 and old myocardial infarction （OMI） 30 based on clinical situation, cTnT, cardiac enzyme and ECG. AMI patients were further divided into subgroups including acute anterior myocardial infarct （Aa,n = 53）, acute inferior myocardial infarction （Ai, n=54） and Aa＋Ai （n=33） based on ECG. Cardiac parameters： end-diastolic interventricular septum thickness（IVSd）, end-diastolic left ventricular internal diameter （LVd）, left ventricular mass （LM）, end-diastolic left ventricular volume （EDV）, end-systolic left ventricular volume （ESV） and left ventricular ejection fraction（LVEF） were measured by ACUSON 128XP/10 echocardiography. Multiples linear regression analyses were performed to test statistical associations between LVEF and the involved branches of coronary stenosis, blood pressure, lipids, glucose and etc after onset of myocardial infarction. Results EDV and ESV were increased and LVEF decreased on patients with AMI,OMI and UAP （P〈0.05-0.0001）. LM was mainly increased in patients with OMI （P〈0.01） and LVd was mainly enlarged in patients with AMI. EF was significantly decreased and EDV, ESV, LM and LVd were remarkably increased in AMI patients with Aa and Aa＋Ai. With the multiple linear regression analyses by SPSS software, we found that LVEF was negatively correlated to the involved branches of coronary stenosis as well as to systolic blood pressure after onset of myocardial infarction while there was no significant correlation between LVEF and other factors. LVEF was significantly decreased, and LVd and LM increased in AMI patients with antecedent hypertension, compared to patients without hypertension （P〈0.001）. Conclusions Effects of different styles of CHD and different regions of AMI on left ventricular remodeling and cardiac function are different. Myocardial infarction, especially Aa and Aa＋Ai, is one of the most important causes of left ventricular remodeling and cardiac dysfunction. Multiple vessel stenosis and systolic blood pressure at the onset of myocardial infarction reduce LVEF in AMI patients. Antecedent hypertension may accelerate the effect of AMI on cardiac remodeling and dysfunction. Therefore primary and secondary preventions of CHD are critical for protecting heart from remodeling and dysfunction.

Risk factors of hospital-acquired pneumonia in patients with neurosurgical diseases:a Meta analysis

Objective To evaluate risk factors of hospital - acquired pneumonia in patients with neurosurgical diseases. Methods Totally 17 literatures from 2001 - 2009 were selected according to the criteria and assessed by Meta - analysis. The pools OR values of influencing factors

Relationship of Body Mass Index, Waist Circumference and Cardiovascular Risk Factors in Chinese Adult

Objective To compare the relative risk of waist circumference （WC） and/or BMI on cardiovascular risk factors. Methods A cross-sectional data of 41 087 adults （19 567 male and 21 520 female） from the 2002 China National Nutrition and Health Survey were examined. According to the obesity definition of WGOC （BMI, 24 kg/m^2 and 28 kg/m^2; WC, male 85 cm and 95 cm for male, 80 cm and 90 cm for female）, the study population were divided into 9 groups. The prevalence and odds ratio （ORs） of cardiovascular disease （CVD） risk factors （hypertension, high fasting plasma glucose and dyslipidemia） were compared among these 9 groups. Stepwise linear regression analyses were used to compare the likelihood of BMI and/or WC on CVD risk factors. Results Both the indexes levels and the odds ratios of CVD risk factors were significantly increased （decreased for HDL-C levels） along with the increase of WC and/or BMI, even when the effect of age, sex, income, education, sedentary activity and dietary factors were adjusted. The variances （R2） in CVD risk factors explained by WC only and BMI only were quite similar, but a little bit larger when WC and BMI were combined. The standard fl was higher of BMI when predicting systolic BP and was higher of WC when predicting TG, TC and HDL. Conclusions BMI and WC had independent effects on CVD risk factors and combination of BMI and WC would be more predictive. Findings from the present study provided substantive evidence for the WGOC recommendation of a combined use of BMI and WC classifications.

Waist Circumference Reference Values for Screening Cardiovascular Risk Factors in Chinese Children and Adolescents

Objectives To explore the optimal threshold values of waist circumference （WC） for detecting cardiovascular （CV） risk factors among Chinese children and adolescents. Methods Association of WC with CV risk factors was studied among 65 898 children aged 7-18 years whose data were pooled from nine previous studies in China. CV risk factors in this study included hypertension （blood pressure above 95 percentile levels）, dyslipidemia （with one or more of the following three indexes： TG ≥ 1.7 mmol/L, TC ≥ 5.18 mmol/L, and HDL-C ≤ 1.04 mmol/L） and elevated glucose level （fasting plasma glucose ≥5.6 mmol/L）. Receive-operating characteristic analysis （ROC） and logistic regression were employed to derive optimal age- and sex-specific waist circumference references for predicting CV risk factors. Results A slight increasing trend of CV risk factors was observed starting from the 75th percentile of waist circumference in the study population, while a remarkable increasing trend occurred from the 90th percentile. The optimal waist circumference thresholds for predicting high blood pressures were at the 75th percentile for both boys and girls, which was at the 90th percentiles for detecting at least two of the above three CV risk factors. In comparison with children with waist circumference below the 75th percentile, the odds ratio of two CV risk factors doubled among children with waist circumference between the 75th and the 90th percentile, and increased by 6 times among children with waist circumference above the 90th percentile. The trend of high blood pressure increasing with waist circumference remained significant after having been stratified by BMI category. Conclusion The 75th and the 90th percentiles of WC are the optimal cut-off points for predicting an increased and a substantially increased risk of CV factors in Chinese children and adolescents, respectively.

Apolipoprotein AI gene polymorphisms and risk for coronary artery disease in Chinese Xinjiang Uygur and Han population

Objective To analyze the relationship between polymorphism at the Apolipoprotein AI (Apo AI) gene and the risk for coronary artery disease. Methods A total of 107 patients (mean age 56 ±11 years) diagnosed as having stable angina pectoris (SAP) (23 cases), unstable angina pectoris (UAP) (23 cases) or myocardial infarction (MI) (61 cases) were prospectively evaluated. DNA was obtained from the 107 patients and 50 controls. In order to determine the Apo AI genotypes at two polymorphic sites (G/A at -75 bp, and C/T at+83 bp), DNA was PCR amplified and digested with MspI. Results The frequency of carriers of the rare allele at the - 75 bp site (M1-) was 0.49 in cases and 0.30 in controls (P<0. 05). The frequencies of the M1-allele among patients with SAP, UAP, MI and controls were 0. 37 (vs. controls, P > 0. 05), 0.54 (vs. controls, P < 0.05), 0.52 (vs. controls, P<0. 05) and 0. 30, respectively. The frequencies for carriers of the rare allele at the + 83bp polymorphism (M2) were observed among patients with SAP (0. 09, vs. controls, P > 0.05), UAP (0.11, vs. controls, P>0.05) or MI (0. 12, vs. controls, P>0. 05) and controls (0. 12). There was an slightly increase in the frequency of the Ml - allele in patients with SAP to UAP or MI (0. 37 vs. 0. 54 vs. 0. 52; all P>0. 05) and Ml polymorphism as a risk factor for CAD ( OR = 3. 74, P < 0. 05). In the + 83bp polymorphism there was no difference in the allelelic frequencies in cases and controls (0. 11 vs. 0. 12; P > 0. 05). There was no significantdifference in the frequency of the M2 - allele in patients with SAP to UAP or MI (0.09 vs. 0. 11 vs. 0. 12; all P>0. 05) and M2 polymorphism not as a factor for CAD (OR=0.80, P>0. 05).Plasma lipoprotein values in patients with the allele M1-and M2 - had no different levels than those homozygous for the M1+and M2+(P>0.05). Conclusion Ml polymorphism (M1 - ) may be as a risk factor for CAD and M2 polymorphism (M2 - ) not as a factor for CAD in Chinese Xinjiang Uygur and Han population.

How far cardio metabolic and psychological factors affect salt sensitivity in normotensive adult population?

AIM To evaluate the prevalence of salt sensitivity and the impact of cardiometabolic and psychological characteristics on salt sensitivity in normotensive population. METHODS Of all participants,anthropometric measurements and fasting venous blood samples were collected,and study questionnaires were completed. Salt Sensitivity was defined based on the difference in mean arterial pressure with infusion of 2 L of normal saline followed by a low sodium diet and administration of three dosesof oral furosemide the day after. RESULTS Of 131 participants,56(42.7%) were diagnosed with salt sensitivity. Crude and age and sex adjusted regression analysis showed that low-density lipoprotein cholesterol and depression were positively associated with salt sensitivity(OR = 1.02,95%CI: 1.01-1.04 and OR = 1.15,95%CI: 1.00-1.34,respectively). CONCLUSION The high prevalence of salt sensitivity and its significant relation with prevalent risk factors necessitates considering its reduction actions at the population level and the need for further research.

Incidence of gastroesophageal reflux disease in Uygur and Han Chinese adults in Urumqi

AIM:To investigate the incidence of gastroesophageal reflux disease(GERD) and its related risk factors in Uygur and Han Chinese adult in Urumqi,China.METHODS:A population-based cross-sectional survey was undertaken in a total of 972 Uygur(684 male and 288 female) aged from 24 to 61 and 1023 Han Chinese(752 male and 271 female) aged from 23 to 63 years.All participants were recruited from the residents who visited hospital for health examination from November 2011 to May 2012.Each participant signed an informed consent and completed a GERD questionnaire(GerdQ) and a lifestyle-food frequency questionnaire survey.Participants whose Gerd Q score was ≥ 8 and met one of the following requirements would be enrolled into this research:(1) being diagnosed with erosive esophagitis(EE) or Barrett's esophagus(BE) by endoscopy;(2) negative manifestation under endoscopy(non-erosive reflux disease,NERD) with abnormal acid reflux revealed by 24-h esophageal pH monitoring;and(3) suffering from typical heartburn and regurgitation with positive result of proton pump inhibitor test.RESULTS:According to Gerd Q scoring criteria,340 cases of Uygur and 286 cases of Han Chinese were defined as GERD.GERD incidence in Uygur was significantly higher than in Han Chinese(35% vs 28%,χ2 = 11.09,P < 0.005),Gerd Q score in Uygur was higher than in Han Chinese(7.85 ± 3.1 vs 7.15 ± 2.9,P < 0.005),and Gerd Q total score in Uygur male was higher than in female(8.15 ± 2.8 vs 6.85 ± 2.5,P < 0.005).According to normalized methods,304(31%) cases of Uygur were diagnosed with GERD,including 89 cases of EE,185 cases of NERD and 30 cases of BE;256(25%) cases of Han Chinese were diagnosed with GERD,including 90 cases of EE,140 cases of NERD and 26 cases of BE.GERD incidence in Uygur was significantly higher than in Han Chinese(31% vs 25%,χ2 = 9.34,P < 0.005) while the incidences were higher in males of both groups than in females(26% vs 5% in Uygur,χ2 = 35.95,P < 0.005,and 19.8% vs 5.2% in Han,χ2 = 5.48,P < 0.025).GERD incidence in Uygur male was higher than in Han Chinese male(26% vs 19.8%,χ2 = 16.51,P < 0.005),and incidence of NERD in Uygur was higher than in Han Chinese(χ2 = 10.06,P < 0.005).Occupation(r = 0.623),gender(r = 0.839),smoking(r = 0.322),strong tea(r = 0.658),alcohol drinking(r = 0.696),meat-based diet(mainly meat)(r = 0.676) and body mass index(BMI)(r = 0.567) were linearly correlated with GERD in Uygur(r = 0.833,P = 0.000);while gender(r = 0.957),age(r = 0.016),occupation(r = 0.482),strong tea(r = 1.124),alcohol drinking(r = 0.558),meat diet(r = 0.591) and BMI(r = 0.246) were linearly correlated with GERD in Han Chinese(r = 0.786,P = 0.01).There was no significant difference between Gerd Q scoring and three normalized methods for the diagnosis of GERD.CONCLUSION:GERD is highly prevalent in adult in Urumqi,especially in Uygur.Male,civil servant,smoking,strong tea,alcohol drinking,meat diet and BMI are risk factors correlated to GERD.

Hypertension and Alzheimer’s disease

Alzheimer’s disease （AD） accounts for 60% to 80% of dementia cases and is the most common cause of dementia. In the past decade, studies have shown a close association between blood pressure and AD. It is found that elevated blood pressure at midlife would in-crease the risk of dementia, including AD. However, there is nodefnitive conclusion about the relationship between elderly blood pressure and cognitive function. Abnormal pulse pressure may also increase the risk of dementia. The impact of antihypertensive drugs is inconclusive, and the mechanism of their protection of cognitive function is not clear.

The Study on the Correlation Between Plasma Adiponectin Level and Coronary Heart Disease

Objectives To investigate the relationship between plasma adiponectin level and coronary heart disease （CHD）, and some established cardiovascular risk factors and to probe its probable pathogenesis which adiponectin results in CHD. Methods The levels of plasma adiponectin, fasting plasma insulin （FINS）, C-reactive protein （CRP） and P-selectin were measured by ELISA, plasma ET-1 was measured by radioimmunoassay （RIA） in 75 male patients with CHD and 30 healthy male people. Body mass index （BMI）, waist / hip ratio （WHR） and insulin resistance index （Homa-IR） were calculated respectively. Results （1）The plasma adiponectin levels in CHD group were lower compared with control group[（5.18±2.57）mg / L vs（8.94±2.59）mg / L, P〈 0.001 ], there was no significant difference of plasma adiponectin levels in CHD sub-groups （P 〉 0.05）.（2） Based on multinominal stepwise logistic regression analysis, adiponectin was one of significant and independent risk factors for CHD. （3） Multivariate liner stepwise regression analysis showed that adiponectin had significant correlation with BMI and TG, BMI and TG were independent factors influencing on plasma adiponectin levels. （4） Pearson correlation analysis indicated plasma adiponectin levels were inversely related to FINS levels , Homa-IR, CRP, P-selectin and ET-1. Conclusions （ 1 ）Plasma adiponectin levels are lower in CHD patients compared the control subjects, there are no significant difference of plasma adiponectin levels in patients with SAP, UAP and AMI. （2） Plasma adiponectin levels are relative with CHD. Hypoadiponectinemia is an independent risk factor for CHD. （3）Established cardiovascular risk factors such as BMI and TG have an obvious influence on adiponectin. （4）The probable pathogenesis by which adiponectin involves in CHD is suggested that adiponectin relates to insulin resistance, inflammatory reaction and dysfunction of vessel endothelium.

Incidence,prevalence,and causes of spinal injuries in China,1990-2019:Findings from the Global Burden of Disease Study 2019

Background:Spinal injuries are an urgent public health priority;nevertheless,no China-wide studies of these injuries exist.This study measured the incidence,prevalence,causes,regional distribution,and annual trends of spinal injuries in China from 1990 to 2019.Methods:We used data from the Global Burden of Diseases,Injuries,and Risk Factors Study 2019 to estimate the incidence and prevalence of spinal injuries in China.The data of 33 provincial-level administrative regions(excluding Taiwan,China)provided by the National Center for Chronic and Noncommunicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention(CDC)were use to systematically analyze the provincial etiology,geographical distribution,and annual trends of spinal injuries.The Bayesian meta-regression tool DisMod-MR 2.1 was used to ensure the consistency among incidence,prevalence,and mortality rates in each case.Results:From 1990 to 2019,the number of living patients with spinal injuries in China increased by 138.32%,from 2.14 million to 5.10 million,while the corresponding age-standardized prevalence increased from 0.20%(95%uncertainty interval[UI]:0.18-0.21%)to 0.27%(95%UI:0.26-0.29%).The incidence of spinal injuries in China increased by 89.91%(95%UI:72.39-107.66%),and the prevalence increased by 98.20%(95%UI:89.56-106.82%),both the most significant increases among the G20 countries;71.00%of the increase could be explained by age-specific prevalence.In 2019,the incidence was 16.47(95%UI:12.08-22.00,per 100,000 population),and the prevalence was 358.30(95%UI:333.96-386.62,per 100,000 population).Based on the data of 33 provincial-level administrative regions provided by CDC,age-standardized incidence and prevalence were both highest in developed provinces in Eastern China.The primary causes were falls and road injuries;however,the prevalence and specific causes differed across provinces.Conclusions:In China,the overall disease burden of spinal injuries increased significantly during the past three decades but varied considerably according to geographical location.The primary causes were falls and road injuries;however,the prevalence and specific causes differed across provinces.

Risk factors,biomarkers and patho-mechanisms of chronic kidney disease

Supported by the National Natural Science Foundation of China,the research team led by Prof.Hou Fanfan(侯凡凡)and Liu Youhua at the State Key Laboratory of Organ Failure Research,Southern Medical University,has made remarkable progress in identifying the risk factors and biomarkers and elucidating the patho-mechanisms of chronic kidney disease(CKD).Four papers describing these findings were

Profile of men＇s health in Malaysia： problems and ：hallenges

Men＇s health concerns have evolved from the traditional andrology and male sexual health to a more holistic approach that encompasses male psychological, social and physical health. The poor state of health in men compared to their female counterparts is well documented. A review of the epidemiological data from Malaysia noted a similar trend in which men die at higher rates in under 1 and above 15 years old groups and most disease categories compared to women. In Malaysia, the main causes of death in men are non-communicable diseases and injuries. Risk factors, such as risk-taking behaviour, smoking and hypertension, are prevalent and amenable to early interventions. Erectile dysfunction, premature ejaculation and prostate disorders are also prevalent. However, many of these morbidities go unreported and are not diagnosed early; therefore, opportunities for early intervention are missed. This reflects poor health knowledge and inadequate health-care utilisation among Malaysian men. Their health-seeking behaviour has been shown to be strongly influenced by family members and friends. However, more research is needed to identify men＇s unmet health-care needs and to develop optimal strategies for addressing them. Because the Malaysian population is aging and there is an increase in sedentary lifestyles, optimizing men＇s health will remain a challenge unless effective measures are implemented. The existing male-unfriendly health-care system and the negative influence of masculinity on men＇s health behaviour must be addressed. A national men＇s health policy based on a male-friendly approach to health-care delivery is urgently needed to provide a framework for addressing these challenges.