Association Between Lipid Profiles and Left Ventricular Hypertrophy: New Evidence from a Retrospective Study

ObjectiveTo explore the association between lipid profiles and left ventricular hypertrophy in a Chinese general population.MethodsWe conducted a retrospective observational study to investigate the relationship between lipid markers [including triglycerides, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein (HDL) cholesterol, non-HDL-cholesterol, apolipoprotein A-I, apolipoprotein B, lipoprotein[a], and composite lipid profiles] and left ventricular hypertrophy. A total of 309,400 participants of two populations (one from Beijing and another from nationwide) who underwent physical examinations at different health management centers between 2009 and 2018 in China were included in the cross-sectional study. 7,475 participants who had multiple physical examinations and initially did not have left ventricular hypertrophy constituted a longitudinal cohort to analyze the association between lipid markers and the new-onset of left ventricular hypertrophy. Left ventricular hypertrophy was measured by echocardiography and defined as an end-diastolic thickness of the interventricular septum or left ventricle posterior wall > 11 mm. The Logistic regression model was used in the cross-sectional study. Cox model and Cox model with restricted cubic splines were used in the longitudinal cohort.ResultsIn the cross-sectional study, for participants in the highest tertile of each lipid marker compared to the respective lowest, triglycerides [odds ratio (OR): 1.250, 95%CI: 1.060 to 1.474], HDL-cholesterol (OR: 0.780, 95%CI: 0.662 to 0.918), and lipoprotein(a) (OR: 1.311, 95%CI: 1.115 to 1.541) had an association with left ventricular hypertrophy. In the longitudinal cohort, for participants in the highest tertile of each lipid marker at the baseline compared to the respective lowest, triglycerides [hazard ratio (HR): 3.277, 95%CI: 1.720 to 6.244], HDL-cholesterol (HR: 0.516, 95%CI: 0.283 to 0.940), non-HDL-cholesterol (HR: 2.309, 95%CI: 1.296 to 4.112), apolipoprotein B (HR: 2.244, 95%CI: 1.251 to 4.032) showed an association with new-onset left ventricular hypertrophy. In the Cox model with forward stepwise selection, triglycerides were the only lipid markers entered into the final model.ConclusionLipids levels, especially triglycerides, are associated with left ventricular hypertrophy. Controlling triglycerides level potentiate to be a strategy in harnessing cardiac remodeling but deserve to be further investigated.     

健康体检人群脉搏波传导速度特征及其与心血管疾病危险因素关系的分析

目的　分析健康体检人群脉搏波传导速度特征,及其与心血管疾病危险因素的相关性。方法　选择四川省人民医院13841名健康体检人员,询问疾病史,测量身高、体重、BMI、血压等,检测FPG、血脂、UA等生化指标,应用动脉硬化仪检测踝臂脉搏波传导速度(baPWV)。结果　健康体检男女性人群baPWV值均随年龄增长而逐渐升高,<60岁男性baPWV值明显高于女性。多元线性回归分析显示年龄、SBP、BMI、FPG、UA和TG水平均为baPWV的影响因素,其中年龄、SBP对baPWV的影响最大,标准化回归系数>0．42。结论　健康体检人群的baPWV值随性别、年龄呈不同的分布特征。应加强对老年人群,尤其是老年女性的baPWV监测,早期预防高危人群心血管事件的发生。     

血脂水平对血压正常高值人群脉搏波传导速度的影响

目的 探讨血脂和脂蛋白比值对血压正常高值人群脉搏波传导速度的影响.方法 选择11 611名血压正常的健康体检者,分为正常血压值组(血压＜ 120/80 mmHg)和血压正常高值组(血压为120 ～ 139/80 ～ 89 mmHg).应用全自动动脉硬化仪测定人选者肱踝脉搏波传导速度(baPWV),同时测量身高、体重、FPG、TC、TG、HDL-C、LDL-C等指标,并计算HDL-C和TC/HDL-C比值、LDL-C/HDL-C比值.分析血脂和脂蛋白比值异常情况对不同血压组脉搏波传导速度的影响.结果 血压正常高值组的baPWV异常率均高于血压正常组.血压正常组中除HDL-C外,TC、TG、LDL-C、TC/HDL-C、LDL-C/HDL-C的升高均使baPWV的异常率显著增加(P＜0.001).血压正常高值组中,TC和LDL-C的升高使baPWV的异常率显著增加(P＜0.001).多元logistic回归分析显示,除年龄、BMI、FPG外,TC/HDL-C异常是血压正常组动脉僵硬度增高的独立危险因子(OR=1.732),TG异常是血压正常高值组的独立危险因素(OR=1.301).结论 在正常血压不同水平下,血脂和脂蛋白比值的异常是动脉僵硬度增高的独立危险因素.     

Development of the Individualised Developmental Care Knowledge and Attitude Scale

BackgroundThere is a need for a valid and reliable scale to determine the individualised developmental care levels of nurses who provide care for preterm newborns.AimsTo develop the Individualised Developmental Care Knowledge and Attitude Scale for nurses who provide care to preterm newborns and to evaluate its validity and reliability.MethodsThis methodological study was performed with 260 nurses who provide care for preterm newborns in neonatal intensive care units. The content validity of the research was evaluated under the guidance of professionals working in the pediatric field. Collected data were analysed using values, percentage, mean, standard deviation, correlation analysis, Cronbach's alpha reliability coefficient and factor analysis methods.ResultsThe total Content Validity Index for all items was found to be 0.930. The result of Bartlett's test of sphericity (x² = 4691.061, p = 0.000) was significant, and the KMO (Kaiser-Meyer-Olkin) measure of sampling adequacy was 0.906. The fit indices for confirmatory factor analysis were x²/SD = 4.35, GFI = 0.97, AGFI = 0.97, CFI = 0.97, RMSEA = 0.057 and SRMR = 0.062. All of the related fit indices were in the accepted range. The Individualised Developmental Care Knowledge and Attitude Scale was developed at the end of the study, and 34 items and four dimensions were identified. The Cronbach's alpha of the full scale was 0.937.ConclusionsFrom the results, it can be concluded that the Individualised Developmental Care Knowledge and Attitude Scale is both a reliable and valid measurement tool for determining individualised developmental levels.     

体重指数对血压、血糖、血脂及尿酸的影响

目的探讨体重指数（BMI）对血压、血糖、血脂及尿酸的影响。方法对2011年医院体检中心3404名健康体检人群的BMI、血压、血糖、血脂、尿酸等结果进行统计分析。结果超重检出率为33．84％,肥胖检出率为15．54％;随BMI的升高,高密度脂蛋白胆固醇水平减低,收缩压、舒张压、空腹血糖、总胆固醇、三酰甘油、尿酸、低密度脂蛋白胆固醇水平逐渐升高,高血压、高血糖、高血脂、高尿酸检出率亦增高。结论健康体检人群超重、肥胖率较高,超重、肥胖与高血压、高血糖、高血脂、高尿酸关系密切,需早期采取有效措施控制超重和肥胖倾向。     

一个回族家系亨廷顿舞蹈病的临床特征与基因突变分析

目的 分析1个回族家系亨廷顿舞蹈病的临床表现与基因突变特点.方法 应用降落聚合酶链反应( touchdown PCR)、分子克隆及基因测序等技术对1个临床诊断为亨廷顿舞蹈病的回族家系成员进行IT15基因检测.结果 先证者首发症状为双下肢疼痛,逐渐发展为舞蹈样不自主运动、情绪异常、记忆力、智力减弱等,其染色体4p16.3的IT15基因异常片段CAG重复次数为46次;其子为症状前患者CAG重复次数为44次.结论 该家系存在母系传递过程中IT15基因上CAG重复次数减少的现象,并发现1例CAA插入.     

汉族人群乙醛脱氢酶2基因多态性与原发性高血压动脉硬化的相关性

目的：探讨乙醛脱氢酶2（ALDH2）基因多态性与原发性高血压（essentia1 hypertension,EH）患者动脉硬化的关系。方法按臂踝脉搏传导速度（brachial ankle pulse wave velocity ,baPWV）将四川省内的300例汉族EH患者分为动脉硬化组（214例）和非动脉硬化组（86例）,采用DNA微阵列芯片法检测比较两组ALDH2基因的多态性分布,并进行多因素的Lo－gistic回归分析。结果两组基因型分布均符合Hardy－Weinberg 平衡。与非动脉硬化组相比,动脉硬化组ALDH2基因AA／AG基因型和A等位基因频率明显增加,差异有统计学意义（分别为61．2％vs 38．4％和34．6％vs 20．9％,P＜0．05）。 Logistic回归分析显示,在调整了年龄、性别、体重指数、吸烟、饮酒、收缩压、舒张压、血脂等传统危险因素后,ALDH2基因多态性与EH患者动脉硬化相关（ OR ＝0．399,95％CI：0．327～1．245,P ＝0．038）。结论四川省内汉族人群ALDH2基因多态性与EH患者动脉硬化相关。     

PHILOS锁定钢板与髓内钉治疗297例肱骨近端骨折患者的疗效对比研究

目的 对比PHILOS锁定钢板和髓内钉内固定手术治疗肱骨近端骨折的临床疗效.方法 回顾性分析2015年1月至2019年1月期间因肱骨近端骨折于本院骨科行手术治疗的患者297例,根据手术方法分为PHILOS组(n=150)和髓内钉组(n=147),收集患者手术时长,住院总时长,平均切口长度,术中输血率,术后6h、12h、...     

杭州某医院体检中心顾客满意度调查及对策研究

目的 了解医院体检中心顾客的满意度情况,找出工作中的存在问题,为提高服务满意度和医疗服务质量提供参考.方法 采用自制的调查表,随机抽样调查201例医院体检中心顾客,对其体检中心多个维度的满意度进行调查并对其选择医院的原因做出分析.结果 顾客对中心各项满意度评分均在3.5-4.0分之间,总体满意度达到4.07,其中,医务...