Abstract Background and purpose: the Dietary Approaches to Stop Hypertension (DASH) diet has multifunctional health benefits. We evaluated the effects of low-sodium salt applied to Chinese modified DASH diet on arterial stiffness in older patients with hypertension and type 2 diabetes. Methods: sixty-one older adults with hypertension and type 2 diabetes were randomly allocated to low sodium salt group (n = 31) or normal sodium salt group (n = 30). They were given the Chinese modified DASH diet plus low-sodium salt (52 % sodium chloride) or same diet plus regular salt (99 % sodium chloride) for eight weeks, respectively. Brachial and ankle pulse wave conduction velocity, ankle brachial index and atherosclerosis-related indices were measured at baseline and week 8. In addition, 24-hour urine and blood samples were measured at baseline, the 4th week and the end of the intervention. Results: as compared with the baseline, the low sodium salt group significantly decreased in ankle brachial index (-0.09 ± 0.11, p < 0.001) and brachial and ankle pulse wave conduction velocity (-133.07 ± 265.99 cm/s, p = 0.010) at week 8 while the normal sodium salt group only decreased significantly in ankle brachial index (-0.06 ± 0.12, p = 0.010) at week 8. Conclusion: the low-sodium salt applied to Chinese modified DASH diet may improve arterial stiffness in patients with hypertension and type 2 diabetes. Further research with an extended follow-up is needed.

Resumen Antecedentes y propósito: la dieta DASH (del inglés Dietary Approaches to Stop Hypertension) tiene beneficios multifuncionales para la salud. Evaluamos los efectos de una sal baja en sodio aplicada a la versión modificada china de la dieta DASH sobre la rigidez arterial en pacientes mayores con hipertensión y diabetes tipo 2. Métodos: sesenta y un adultos mayores con hipertensión arterial y diabetes tipo 2 fueron asignados al azar al grupo de sal baja en sodio (n = 31) o al grupo de sal con contenido normal de sodio (n = 30). Se les administró la versión china modificada de la dieta DASH más sal baja en sodio (52 % de cloruro de sodio) o la misma dieta más sal con la cantidad normal de sodio (99 % cloruro de sodio) durante ocho semanas, respectivamente. Se midieron la velocidad de onda de pulso brazo-tobillo, el índice brazo-tobillo y los índices relacionados con la aterosclerosis al inicio del estudio y a la semana 8. Se recogieron muestras de orina y sangre de 24 horas al inicio, a la cuarta semana y al final de la intervención. Resultados: en comparación con el estado inicial, el grupo de sal baja en sodio disminuyó significativamente el índice brazo-tobillo (-0,09 ± 0,11, p < 0,001) y la velocidad de onda de pulso brazo-tobillo (-133,07 ± 265,99 cm/s, p = 0,010) en la semana 8, mientras que el grupo de sal con contenido normal de sodio solo disminuyó significativamente en el índice brazo-tobillo (-0,06 ± 0,12, p = 0,010) en la semana 8. Conclusión: la sal baja en sodio aplicada a la versión china modificada de la dieta DASH puede mejorar la rigidez arterial en pacientes con hipertensión y diabetes tipo 2. Se necesitan más investigaciones con un seguimiento prolongado.

Abstract Aim: to investigate the effects of low sodium formula salt combined with the Chinese Modified Dietary Approaches to Stop Hypertension (DASH) diet on cerebrovascular function in patients with hypertension and type 2 diabetes. Methods: an eight-week single-arm trial was conducted in 66 patients with hypertension and type 2 diabetes to investigate effects of low sodium formula salt (potassium chloride 56 %, sodium chloride 23 %, 5 g/day) combined with Chinese Modified DASH diet on cerebrovascular function (measured by transcranial Doppler sonography), indicators of chronic diseases (blood pressure, blood glucose and blood lipids) and urinary excretion. The above indicators were performed before and after intervention. Results: fifty-nine subjects completed the study. Peak systolic velocity, mean flow velocity, end-diastolic velocity, pulsatility index and resistance index of internal cerebral artery and vertebral artery decreased significantly (p < 0.05); pulsatility index and resistance index of anterior cerebral artery and middle cerebral artery decreased significantly (p < 0.05); and end-diastolic velocity and pulsatility index of basilar artery decreased significantly (p < 0.05). Systolic blood pressure, diastolic blood pressure, fasting blood glucose and postprandial blood glucose decreased significantly (p < 0.001; p < 0.001; p < 0.001; p < 0.001). Blood pressure and blood glucose control rates increased significantly (p < 0.001). Conclusions: based on the study, 23 % low-sodium formula combined with CM-DASH diet pattern can improve cerebrovascular function in community patients with hypertension complicated with diabetes and has a good short-term benefit of blood pressure and glucose control.

Resumen Objetivo: investigar los efectos de una sal baja en sodio combinada con la versión china de la dieta DASH (del inglés Dietary Approaches to Stop Hypertension) modificada en la función cerebrovascular en pacientes con hipertensión y diabetes tipo 2. Métodos: en 66 pacientes con hipertensión y diabetes tipo 2 se llevó a cabo un ensayo de ocho semanas para investigar los efectos de la sal baja en sodio (cloruro de potasio 56 %, cloruro de sodio 23 %, 5 g/día) combinada con la dieta DASH en su versión china modificada en la función cerebrovascular (medido por sonografía Doppler transcraneal), los indicadores de enfermedades crónicas (presión arterial, glucosa sanguínea y lípidos sanguíneos) y la excreción urinaria. Los indicadores anteriores se midieron antes y después de la intervención. Resultados: cincuenta y nueve sujetos completaron el estudio. La velocidad sistólica máxima, la velocidad media del flujo, la velocidad diastólica final, el índice de pulsatilidad y el índice de resistencia de la arteria cerebral anterior y la arteria vertebral disminuyeron significativamente (p < 0,05); el índice de pulsatilidad y el índice de resistencia de la arteria cerebral anterior y la arteria media disminuyeron significativamente (p < 0,05); y la velocidad diastólica final y el índice de pulsatilidad de la arteria basilar disminuyeron significativamente (p < 0,05). La presión arterial sistémica, la presión arterial diastólica, la glucosa arterial en ayuno y la glucemia posprandial disminuyeron significativamente (p < 0,001, p < 0,001, p < 0,001, p < 0,001). La presión arterial y las tasas de control de glucosa en sangre aumentaron significativamente (p < 0,001). Conclusiones: la fórmula de sal con un 23 % de sodio combinada con la dieta DASH en su versión china modificada puede mejorar la función cerebrovascular en pacientes comunitarios con hipertensión complicada por la diabetes y es beneficiosa a corto plazo para la presión arterial y el control de la glucosa.

Abstract Introduction: hypertension and diabetes are chronic disorders associated with an increased risk of cardiovascular disease. Objectives: to evaluate the effect of 52 % low-sodium salt applied to the Chinese-modified DASH (CM-DASH) diet on risk of atherosclerotic cardiovascular disease (ASCVD) in patients with hypertension and type-2 diabetes. Methods: the low-sodium salt group (LSSG) took 5 g/day of 52 % low-sodium salt plus CM-DASH diet for 8 weeks, while the normal-sodium salt group (NSSG) took the same dose of normal-sodium salt plus CM-DASH diet for 8 weeks. Blood tests, 24-hour urine tests, anthropometric measurements, and 10-year risk of ASCVD prediction were assessed. Results: compared with baseline, both LSSG and NSSG showed a significant reduction in 10-year risk of ASCVD, but we did not find any statistically significant differences in 10-year risk of ASCVD between LSSG and NSSG. Conclusions: our study shows that salt limits and DASH diets reduce the risk of cardiovascular disease whereas low-sodium salt containing 52 % sodium chloride did not significantly lower the risk of cardiovascular disease when compared to regular salt. Due to the limitations of the research, additional studies will be necessary to confirm our findings.

Resumen Introducción: la hipertensión y la diabetes son trastornos crónicos asociados a un mayor riesgo de enfermedad cardiovascular. Objetivos: evaluar el efecto de la sal baja en sodio (52 %) aplicada a la dieta DASH modificada en China (CM-DASH) sobre los riesgos de enfermedad cardiovascular aterosclerótica (ECA) en pacientes con hipertensión arterial y diabetes de tipo 2. Métodos: el grupo de sal baja en sodio (LSSG) tomó 5 g/día de sal baja en sodio al 52 % más dieta CM-DASH durante 8 semanas, mientras que el grupo de sal normal en sodio (NSSG) tomó la misma dosis de sal normal en sodio más dieta CM-DASH durante 8 semanas. Se evaluaron los análisis de sangre, los análisis de orina de 24 horas, las mediciones antropométricas y los riesgos de predicción de ECVA a 10 años. Resultados: en comparación con el valor basal, tanto el LSSG como el NSSG mostraron una reducción significativa de los riesgos a 10 años de ECVA, mientras que no se encontraron diferencias estadísticamente significativas en los riesgos a 10 años de ECVA entre el LSSG y el NSSG. Conclusiones: nuestro estudio muestra que los límites de sal y las dietas DASH reducen el riesgo de enfermedad cardiovascular mientras que la sal baja en sodio con un 52 % de cloruro sódico no redujo significativamente el riesgo de enfermedad cardiovascular en comparación con la sal normal. Debido a las limitaciones de la investigación, serán necesarios estudios adicionales para confirmar nuestros hallazgos

Resumen Objetivos: evaluar el efecto de la reducción de sodio basada en una dieta DASH modificada sobre la presión arterial en pacientes hipertensos con diabetes de tipo 2. Material y métodos: sesenta y un pacientes hipertensos con diabetes de tipo 2 fueron seleccionados de la comunidad y asignados aleatoriamente a un grupo de sal común y un grupo de sal baja en sodio, que recibieron una intervención dietética de 8 semanas en la que las semanas 1-2 fueron la fase de orientación dietética, las semanas 3-4 fueron la fase de alimentación centralizada, y las semanas 5-8 fueron la fase de atención médica domiciliaria. Los participantes fueron seguidos en el hospital una vez por semana para recopilar información sobre la presión arterial, la sal y el uso de drogas en pacientes ambulatorios. Los exámenes físicos se realizaron a las 4 semanas y al final de la intervención, así como al inicio del estudio. Resultados: después de la intervención, la presión arterial tanto del grupo bajo en sodio (PAS: -14,32 mmHg, p < 0,001; PAD: -6,32 mmHg, p < 0,001) como del grupo de sal común (PAS: -10,98 mmHg, p < 0,001; PAD: -5,24 mmHg, p = 0,001) disminuyó significativamente con una disminución más pronunciada en el grupo bajo en sodio pero sin diferencias estadísticamente significativas entre los dos grupos (PAS: -0,28 mmHg, p = 0,929; PAD: -3,32 mmHg, p = 0,093). Al final de la intervención, la ingesta de sodio disminuyó significativamente, pero la ingesta de potasio aumentó en el grupo bajo en sodio (p < 0,05); sin embargo, el grupo de la sal común no tuvo cambios significativos. Conclusión: la reducción de la ingesta de sodio basada en la dieta DASH modificada tuvo un buen efecto sobre la presión arterial sistólica y diastólica en pacientes hipertensos con diabetes de tipo 2. La reducción de sodio basada en la dieta DASH modificada es segura y eficaz, por lo que puede utilizarse como guía para una vida saludable en pacientes hipertensos.

Abstract Objectives: to evaluate the effect of sodium reduction based on a modified DASH diet on blood pressure in hypertensive patients with type 2 diabetes. Material and methods: sixty-one hypertensive patients with type 2 diabetes were selected from the community and randomly allocated to a common salt group and low sodium salt group receiving the 8-week dietary intervention, in which weeks 1-2 was the dietary guidance phase, weeks 3-4 was the centralized feeding phase, and weeks 5-8 was the home medical care phase. Participants were followed up in the hospital once a week to collect information on outpatient blood pressure, salt, and drug use. Physical examinations were conducted at 4 weeks and the end of the intervention, as well as at baseline. Results: after the intervention, the blood pressure of both the low sodium group (SBP: -14.32 mmHg, p < 0.001; DBP: -6.32mmHg, p < 0.001) and the common salt group (SBP: -10.98 mmHg, p < 0.001; DBP: -5.24 mmHg, p = 0.001) decreased significantly with a more pronounced decrease in the low sodium group but no statistically significant differences between the two groups (SBP: -0.28 mmHg, p = 0.929; DBP: -3.32 mmHg, p = 0.093). At the end of the intervention, sodium intake was significantly decreased, but potassium intake was increased in the low sodium group (p < 0.05); however, the common salt group had no significant change. Conclusion: reducing sodium intake based on the modified DASH diet had a good effect on systolic and diastolic blood pressure in hypertensive patients with type 2 diabetes. Sodium reduction based on the modified DASH diet is safe and effective, and can be used as a guide for healthy living in hypertensive patients.

ABSTRACT Purpose: To evaluate the role of contrast-enhanced ultrasound (CEUS) in differentiating bland thrombus from tumor thrombus of the inferior vena cava (IVC) in patients with renal cell carcinoma (RCC). Materials and Methods: We retrospectively investigated 30 consecutive patients who underwent robot-assisted radical nephrectomy with IVC thrombectomy and had pathologically confirmed RCC. All patients underwent US and CEUS examination. Two off-line readers observed and recorded thrombus imaging information and enhancement patterns. Sensitivity, specificity, accuracy, positive predictive value and negative predictive value for bland thrombus were assessed. Results: Of the 30 patients, no adverse events occurred during administration of the contrast agent. Early enhancement of the mass within the IVC lumen on CEUS was an indicator of tumor thrombus. Bland thrombus showed no intraluminal flow on CEUS. There were eight (26.7%) patients with bland thrombus, including three level II, two level III, and three level IV. There were three cases with cephalic bland thrombus and five cases with caudal bland thrombus. Three caudal bland thrombi extended to the iliac vein and underwent surgical IVC interruption. Based on no intraluminal flow, for bland thrombus, CEUS had 87.5% sensitivity, 100% specificity, 96.7% accuracy, 100% positive predictive value and 95.6% negative predictive value. Conclusion: Our study demonstrates the potential of CEUS in the differentiation of bland and tumor thrombus of the IVC in patients with RCC. Since CEUS is an effective, inexpensive, and non-invasive method, it could be a reliable tool in the evaluation of IVC thrombus in patients with RCC.

This study aimed to evaluate the feasibility and repeatability of the flash-replenishment method in contrast-enhanced ultrasound (CEUS) perfusion imaging and assess quantitatively microvascular perfusion in the liver. Twenty healthy New Zealand rabbits were submitted to CEUS perfusion imaging with continuous intravenous infusion. Using flash-replenishment kinetics, the dynamic process of depletion and refilling of microbubble contrast agent was recorded. The hepatic microvascular perfusion parameters were calculated, including region of interest, peak intensity (PI), area under the curve (AUC), and hepatic artery to vein transit time (HA-HVTT). A consistency test was performed for multiple measurements by the same operator and blind measurements by two different operators. The hepatic perfusion imaging of 3×108 bubbles/min had minimal error and the best imaging effect and repeatability. The variability of the perfusion parameter measured at 3 cm depth under the liver capsule was at a minimum with coefficient of variation of 3.9%. The interclass correlation coefficient (ICC) of measurements taken by the same operator was 0.985, (95% confidence interval, CI=0.927-0.998). Measurements taken by two operators had good consistency and reliability, with the ICC of 0.948 (95%CI=0.853-0.982). The PI and AUC of liver parenchyma after reperfusion were lower than before blocking; and HA-HVTT was significantly longer than before blocking (P<0.05). The flash-replenishment method in CEUS perfusion imaging showed good stability and repeatability, which provide a valuable experimental basis for the quantitative assessment of hepatic microvascular perfusion in clinical practice.

ABSTRACT The VLDLR gene plays important roles in the growth and adiposity in humans and mice. The purpose of this study was to investigate the relationship between VLDLR gene genetic polymorphisms and growth and abdominal fat traits of the Gaoyou domestic duck. A total of 267 Gaoyou ducks were employed for testing. A 18bp deletion was identified in VLDLR signal peptide coding region. The results of c2 test suggested that the genotype frequencies of VLDLR signal peptide coding region were not in Hardy-Weinberg equilibrium. Least squares analysis showed that body weight (BW) of -18bp/-18bp genotype ducks was significantly higher than those of other genotypes from six (BW6) (p<0.05) to ten weeks of age (BW10) (p<0.01). The association analysis was performed taken body weight as covariant for abdominal percentage (AFP). Results showed that there was not interaction between genotype (p>0.05) and body weight for AFP and different genotypes had a significant effect on AFP (p<0.05). The results of Bonferroni t-test revealed that the abdominal fat percentage (AFP) of -18bp/-18bp genotype was significantly lower than those of +18bp/-18bp (p<0.05). Preliminary studies have shown that VLDLR may be a candidate gene for the selection for growth and abdominal fat, and the results of the present study indicate that VLDLR strongly influences carcass abdominal fat content of Gaoyou ducks.