Reference values of brachial-ankle pulse wave velocity for Northern Chinese

Background Brachial-ankle pulse wave velocity （baPWV） is a reliable method for measuring arterial elasticity, but the absence of reference value for baPWV has limited its wide use. We conducted an epidemical study in north China to investigate the reference value of baPWV for Chinese people and its influential factors. Methods A total of 974 identified healthy subjects were recruited in this study. The values of baPWV were evaluated noninvasively with an automatic device. Results For healthy population, the mean value of baPWV was higher for male （P 〈0.001）. Multiple regression analysis demonstrated that both age and systolic blood pressure were positively associated with baPWV for male and female （P 〈0.001）. BaPWV value was higher in male than in female in younger group （〈50 years） but not in older group （P〈-0.001）. The upper limits of baPWV were 1394/1264 cm/s, 1435/1361 cm/s, 1552/1433 cm/s, 1597/1609 cm/s and 1798/1915 cm/s for healthy male/female at 10 years interval （age range 20-70 years）. Conclusions Aging is the most important reason of arterial stiffness, but the effect of age on baPWV augmentation is greater for healthy female than their male counterpart. The reference values of baPWV by sex and age are very useful for clinical and preventive medicine.     

喉上提速度减慢是卒中后误吸的独立危险因素

目的 吞咽启动延迟是卒中后吞咽困难患者常见的异常之一,也是误吸的最多见原因之一。本研究的目的是明确喉上提速度与吞咽延迟哪一种异常更容易造成误吸。方法 对63例连续会诊于吞咽困难康复小组的卒中患者进行电视透视检查,测量喉上提幅度、喉上提速度、咽吞咽潜伏期及喉关闭时间,并记录是否误吸。根据是否误吸分成误吸组（n=34）及非误吸组（n=29）,观察喉上提幅度、喉上提速度、喉关闭时间、咽吞咽潜伏期与误吸的关系。结果 误吸与非误吸两组之间,喉关闭时间（P＝0.035）与喉上提速度（P =0.002）之间存在统计学差异。Logistic回归分析发现喉上提速度减慢是导致误吸的独立危险因素（OR 0.994,95%CI0.989～1.000,P =0.046）。结论 在喉上提幅度、喉上提速度、喉关闭时间、咽吞咽潜伏期4个参数中,喉上提速度减慢导致误吸独立的危险因素。     

应用不同品牌机械瓣行主动脉瓣置换术患者的血流动力学变化

目的 探讨应用不同品牌19 mm机械瓣行单纯主动脉瓣置换术后早期血流动力学变化情况。 方法回顾性分析2007年1月至2012年1月北京安贞医院116例单纯主动脉瓣狭窄患者行主动脉瓣置换术后血流动力学变化,其中男61例、女55例,年龄（52±13） 岁。根据使用的瓣膜品牌将患者分为3组： SJ.Regent瓣膜组,38例（33%）,男20例、女18例,平均年龄（52±15） 岁; Carbomedics瓣膜组,40例（34%）,男21例、女19例,平均年龄（51±17） 岁。On-X瓣膜组,38例（33%）,男20例、女18例,平均年龄（55±16） 岁。比较患者术前和术后左心室收缩期末内径、左心室舒张期末内径、射血分数（EF）值、室间隔厚度、左心室壁厚度、主动脉瓣瓣上流速、跨瓣压差以及术后有效瓣口面积指数（EOAI）。 结果 三组患者术前及术后的左心室收缩期末内径、左心室舒张期末内径、EF值、室间隔厚度、左心室壁厚度差异均无统计学意义 （P＞0.05）。主动脉瓣瓣上流速和跨瓣压差术前、术后有差异有统计学意义。SJ.Regent瓣膜组和Carbomedics瓣膜组患者较On-X瓣膜组患者的术后主动脉瓣瓣上流速 ［（244.30±33.67） cm/s vs. （249.69±79.13） cm/s vs. （294.83±52.05） cm/s］和跨瓣压差［（27.77±3.33） mm Hg vs. （33.58±18.90） mm Hg vs. （38.56±13.21） mm Hg］明显偏小,其差异有统计学意义。 结论 运用19 mm机械瓣进行主动脉瓣置换术,SJ.Regent和Carbomedics瓣膜较On-X瓣膜有更好的血流动力学效果。     

多模态影像学研究帕金森病伴左旋多巴诱导异动症进展

帕金森病（PD）是常见神经退行性疾病；左旋多巴诱导异动症（LID）是PD患者长期服用左旋多巴药物所致常见致残性运动并发症。MR结构成像、功能MRI及PET显像可观察LID患者脑结构、功能及代谢改变，为阐述脑相关发病机制提供多模态影像学依据，有助于临床早期诊断。本文就多模态影像学研究PD伴LID进展进行综述。     

5 year oncological outcomes of the HIGHLOW randomized clinical trial

IntroductionThe oncological outcomes of low ligation (LL) compared to high ligation (HL) of the inferior mesenteric artery (IMA) during low-anterior rectal resection (LAR) with total mesorectal excision are still debated. The aim of this study is to report the 5 year oncologic outcomes of patients undergoing laparoscopic LAR with either HL vs. LL of the IMAMaterials and methodsBetween June 2014 and December 2016, patients who underwent elective laparoscopic LAR + TME in 6 Italian non-academic hospitals were randomized to HL or LL of IMA after meeting the inclusion criteria (HighLow trial; ClinicalTrials.gov Identifier NCT02153801). We analyzed the rate of local recurrence, distant metastasis, overall survival, disease-specific survival, and disease-free survival at 5 years of patients previously enrolled.ResultsFive-year follow up data were available for 196 patients. Recurrence happened in 42 (21.4%) of patients. There was no statistically significant difference in the distant recurrence rate (15.8% HL vs. 18.9% LL; P = 0.970) and pelvic recurrence rate (4,9% HL vs 3,2% LL; P = 0.843). No statistically significant difference was found in 5-year OS (p = 0.545), DSS (p = 0.732) or DFS (p = 0.985) between HL and LL. Low vs medium and upper rectum site of tumor, conversion rate, Clavien-Dindo post-operative grade ≥3 complications and tumor stage were found statistically significantly associated to poor oncological outcomes in univariate analysis; in multivariate analysis, however, only conversion rate and stage 3 cancer were found to be independent risk factors for poor DFS at 5 years.ConclusionWe confirmed the results found in the previous 3-year survival analysis, the level of inferior mesenteric artery ligation does not affect OS, DSS and DFS at 5-year follow-up.