Objective To explore the clinical characteristics of patients with pre-hypertension accompanied by increased hemoglobin(Hb) level and effect of high-salt diet on their long-term prognosis.Methods A total of 421 patients with pre-hypertension were divided into group A(Hb≤138g/L,217 cases) and group B(Hb>138g/L,204 cases) according to baseline median Hb level dichotomies.Clinical data and prognosis of the two groups were compared.At the same time,patients in group B were divided into high salt group(117 cases) and normal salt group(87 cases) according to the salt intake.Clinical data and prognosis of the two groups were compared.Cox regression analysis was used to assess risk factors for developing hypertension and MACCE during follow-up in group B patients.Results Proportions of patients with single coronary artery lesion,Gensini score and number of diseased coronary arterys in group A were lower than those in group B,while proportion of patients with no coronary artery lesion was higher than those in group B(P＜0.05).During follow-up,proportions of patients with hypertension and MACCE in group B were higher than those in group A(P＜0.05).Kaplan-Meier curve analysis showed that incidences of hypertension and MACCE in patients of goup B were higher than those of group A(P＜0.05).Cox regression analysis showed that both high salt diet and diabetes history were independent risk factors for hypertension and MACCE during follow-up in group B(P＜0.05).Proportions of patients with MACCE in high salt group was higher than those in normal salt group(P＜0.05).Kaplan-Meier curve analysis showed that incidence of hypertension and MACCE in high salt group were higher than those in normal salt group(P＜0.05).Conclusion Coronary lesions in patients with pre-hypertension accompanied by increased Hb level is serious Incidence rates of hypertension and MACCE during follow-up are high,and high salt diet can furtherly lead to the occurrence of hypertension and MACCE.

Objective To evaluate the value of Fukuda stepping test for involvement lateralization semicircular canal of benign paroxysmal positional vertigo(BPPV) patients.Methods A total of 200 cases of BPPV patients admitted in the dizziness clinic of our hospital were observed.The general information was collected,and each patient took both the Fukuda stepping test and positioning test.The correlation between the results of Fukuda stepping test and the affected semicircular canal were compared.Results A total of 140 patients(70.0%) were positive of Fukuda stepping test，while 60 patients(30.0%) were negative in 200 BPPV patients.Among the 140 BPPV patients with positive Fukuda stepping test,there were 82 patients(58.6%) in which the direction of Fukuda stepping test was consistent with the side of affected semicircular canal while 58 patients(41.4%) were not.There were 131 patients (65.5%) of posterior semicircular canal involved,44 patients(22%) of geotropic horizontal semicircular canal involved,24 patients(12%) of apogeotropic horizontal semicircular canal involved and 1 patients(0.5%) of superior semicircular canal involved in 200 BPPV patients.There was no statistically significant difference between coincidence ratios of the posterior semicircular canal,geotropic horizontal semicircular canal and apogeotropic horizontal semicircular canal involved direction which were related to the deviation direction of Fukuda stepping test(P=0.630).There was no statistically significant difference in the constituent ratios of consistent or not and nagative in the direction of Fukuda stepping test and the involved direction between patients whose age≤50 years old and >50 years old（P=0.998）.There was statistically significant difference in the constituent ratios of consistent or not and nagative between patients whose onset≤1 day and >1 day（P=0.024）.Conclusion For the BPPV patients of the early stage(onset≤1 day),the deviation direction of the Fukuda stepping test has a good coincidence ratio with the affected semicircular canal side.Fukuda stepping test has some value for involvement lateralization of BPPV.

Objective To explore the correlation between brachial artery blood flow velocity measured by color Doppler flow imaging (CDFI) and maturation of autologous arteriovenous fistula (AVF).Methods Clinical data of 141 patients who underwent end to side cephalic radial anastomosis was collected from December 2015 to August 2018 in our hospital.A comparative study of CDFI results before and after AVF was performed.Results Among 141 patients,116 AVF cases achieved maturation successfully（mature group）and 25 cases did not achieve maturation（immature group）.The prevalence of diabetes mellitus and the proportion of diabetic nephropathy as primary diseases in immature group were higher than those in mature group(P＜0.05).The diameter of cephalic vein in mature group was higher than that in immature group before operation.At 8 weeks after operation,the diameter of fistula anastomosis,diameter of brachial artery,max blood flow velocity of brachial artery and flow velocity change of brachial artery in mature group ware all higher than those in immature group(P＜0.05).Conclusion The diameter of brachial artery,max blood flow velocity of brachial artery and flow velocity change of brachial artery are measured early after operation can forecast the maturity of internal fistula and find the immature internal fistula early.

Objective To investigate the situation of vitamin D level in Chaoyang district of Beijing in recent two years,and explore the influencing factors of vitamin D deficiency and the correlation with blood lipid.Methods A cross sectional study was conducted to include 3905 subjects who underwent physical examination at Beijing first integrated traditional Chinese and western medicine hospital.Venous blood was taken to test 25-hydroxy-vitamin D[25(OH)D] and blood biochemical indexes.Multiple linear regression analysis was used to evaluate the correlation between 25(OH)D and blood lipid.Results The average serum 25(OH)D level of all subjects was(16.22±6.95) ng/ml,deficiency serious was found in 636 cases (16.29 %),deficiency was found in 2372 cases(60.74%),insufficiency was found in 713 cases(18.26%),plenty was found in 184 cases(4.71%).Subjects with different 25(OH)D levels had statistically significant differences in gender,age,weight,BMI,waist circumference,waist to hip ratio,systolic blood pressure,diastolic blood pressure,fasting plasma glucose(FPG),uric acid(UA),creatinine(Cr),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C) and low-density lipoprotein cholesterol(LDL-C)(P<0.05).There were statistically significant differences in 25(OH)D levels among subjects of different gender(P=0.010),different BMI and gender(P=0.030) and physical examination in different season(P<0.001).Age distribution of subjects with different 25(OH)D levels was statistically significant(P＜0.001).The results of multiple linear regression analysis showed that 25(OH)D level was negatively correlated with TC(r=-0.35,P=0.016),TG(r=-0.28,P=0.046),LDL-C(r=-0.33,P=0.022),waist circumference(r=-0.30,P=0.035),waist to hip ratio(r=-0.30,P=0.032),and positively correlated with HDL-C(r=0.27,P=0.049).Conclusion Vitamin D deficiency in Chaoyang district of Beijing is common and should be paid attention.Vitamin D deficiency is associated with age,gender,seasonal variation，waist circumference,waist to hip ratio,BMI and blood lipid.

Objective〓〖WT5”BZ〗To explore the correlation between serum phosphorus and thyroid function in Graves’disease patients.〖WT5”HZ〗Methods〓〖WT5”BZ〗A total of 348 newonset or recurrent Graves’ disease patients without medication were enrolled in our study,and their clinical data including electrolyte,liver and kidney function,thyroid function,thyrotropin receptor antibody（TRAb） and iodine uptake rate were collected.According to the normal high cutoff value for serum phosphorus（1.45mmol/L）,the patients were divided into hyperphosphatemic group and normophosphatemic group.Nonparametric test was used to analyze the different parameters between the two groups,and logistic regression analysis was used to analyze the related factors that might affect serum phosphorus level.〖WT5”HZ〗Results〓〖WT5”BZ〗The incidence of hyperphosphatemia was 41.38%（144/348）.Patients in hyperphosphatemic group showed that age and BMI were lower than those in normophosphatemic group(P<0.05),while triiodothyronine（T3），free triiodothyronine（FT3）TRAb,3h radioactive iodine uptake（3h RAIU）,24h radioactive iodine uptake（24h RAIU） and calcium(Ca) were higher than those in normophosphatemic group(P<0.05).BMI（r=-0.158）,T3（r=-0.146）,FT3(r=0.188),3h RAIU(r=0.159) and 24h RAIU(r=0.186) are correlated with serum phosphorus〖JP3〗(P<0.05).Logistic regression analysis indicated that age（OR=0.982,95%CI 0.966～0.998,P=0.032）,〖JP〗gender（OR=0.555,95%CI 0.346～0.891,P=0.015) and FT3（OR=0.555,95%CI 0.346～0.891,P=0.015) were the relative factors for hyperphosphatemia..〖WT5”HZ〗Conclusion〓〖WT5”BZ〗There is abnormal phosphorus metabolism in Graves’disease patients.Patients of younger age,female and elevated FT3 are more likely to suffer hyperphosphatemia.

To evaluate the value of drug combined with plasma exchange (PE) in the treatment of refractory rheumatoid arthritis (RA).〖WT5”HZ〗Methods〓〖WT5”BZ〗A total of 80 cases of refractory RA patients were randomly divided into PE treatment group and control group with 40 cases in each group.Disease activity score 28（DAS28）,VAS,rheumatoid factor (RF),erythrocyte sedimentation rate (ESR) ,Creactive protein(CRP),anticyclic citrullinated peptide(CCP) antibodies,lymphocytes and efficacy were compared before treatment and at 7d,28d,and 56d after treatment.〖WT5”HZ〗Results〓〖WT5”BZ〗Compared with the control group,DAS28,VAS，ESR in the PE treatment group were significantly decreased at 7d,28d and 56d after treatment,and RF,antiCCP antibody,CRP were significantly decreased at 7d,28d after treatment (P<0.05).〖JP2〗American college of rheumatology (ACR) 20,ACR50 and ACR70 were significantly〖JP〗 improved (P<0.05).The ratios of CD3+T cells in the PE group was significantly higher at 7d and 28d than those before 〖JP2〗treatment (P<0.05), the ratios of CD8+T lymphocytes were significantly lower than those before treatment(P<0.05), and the ratio of CD4+T cells was significantly higher than those before treatment and at the same period in the control group(P<0.05).The ratio of CD4+/CD8+ T lymphocytes〖JP〗 in the PE treatment group was significantly higher than those before and at 7d,  28d after the treatment(P<0.05),while the difference in the control group before and after treatment was not statistically significant(P>0.05).The adverse reaction of PE treatment was mild,and the condition was improved after symptomatic treatment.〖WT5”HZ〗Conclusion〓〖WT5”BZ〗Drug combined with PE therapy can quickly relieve the clinical symptoms of refractory RA patients with mild adverse reaction,and has an obvious therapeutic effect on refractory RA.

Objective To investigate the association between Hb/RDW and RPR to disease activity in rheumatoid arthritis（RA） patients.Methods A total of 102 RA patients(RA group) and 103 healthy subjects（control group） were enrolled.The hemoglobin to red cell distribution width ratio(Hb/RDW) and red blood cell distribution width-to-platelet ratio (RPR) were calculated and compared between two groups.Correlation of Hb/RDW and RPR with disease activity and difference of Hb/RDW and RPR before and after treatment in RA patients were analyzed.According to the Hb/RDW and RPR in RA patients,The receiver operating characteristic（ROC） curve were drawn to evaluate the diagnostic function of Hb/RDW and RPR in RA.Results The levels of Hb/RDW in RA group was decreased than those in control group while the RPR was increased（P＜0.05）.With the increase of DAS28, the Hb/RDW and RPR of RA patients decreased（P＜0.05）.Hb/RDW was negative correlated with ESR,CRP and DAS28 in RA patients(r=-0.381,r=-0.214,r=-0.319,all P＜0.05),whereas RPR was negative correlated with ESR,CRP and DAS28 (r=-0.295,r=-0.282,r=-0.278，all P＜0.05).Furthermore,compare with DAS28 before treatment in RA patients,DAS28 score obviously decreased after treatment,whereas Hb/RDW and RPR obviously increased（P＜0.05）.In addition,the area under the ROC curve of Hb/RDW and RPR for diagnosis of RA was 0.863（P＜0.001）and 0.567（P=0.098）.Conclusion The Hb/RDW has good sensitivity and specificity for the diagnosis of RA.Hb/RDW and RPR may be helpful to assess the disease activity and to evaluate the treatment of RA patients.

Objective To explore the effect of inhibiting intracellular SIRT6 gene expression in H9C2 cardiomyocytes by RNA interference technology on cell injure induced by anoxia/reoxygenation(A/R) and its mechanism.Methods H9C2 cardiomyocytes were randomly divided into control(Con) group,A/R group,negative control(NC) group and SIRT6-shRNA plasmid treated group(shRNA group).Survival rate,apoptotic rate,Caspase-3 activity,expression levels of SIRT6,nuclear factor(NF)-κBp65,I-κBα and interleukin(IL)-6 and tumor necrosis factor(TNF)-α in culture medium of H9C2 cardiomyocytes in four groups were assessed and compared.Results Compared with Con group,survival rate of H9C2 cardiomyocytes and the expression level of I-κBα protein in cytoplasm decreased significantly in A/R group,apoptotic rate of H9C2 cardiomyocytes,expression levels of SIRT6 mRNA and protein,NF-κBp65 protein in nucleus,IL-6,TNF-α in culture medium and Caspase-3 activity increased significantly in A/R group（P<0.05）.Compared with A/R group,survival rate of H9C2 cardiomyocytes,expression levels of SIRT6 mRNA and protein and I-κBα protein in cytoplasm decreased significantly in shRNA group,while apoptotic rate of H9C2 cardiomyocytes,expression levels of NF-κBp65 protein in nucleus,IL-6,TNF-α in culture medium and Caspase-3 activity increased significantly in shRNA group（P<0.05）.Conclusion Inhibition of intracellular SIRT6 gene expression in H9C2 cardiomyocytes can promote the secretion of inflammatory cytokines,activate NF-κB signaling pathway,induce cell apoptosis and aggravate cardiomyocytes injury induced by A/R.