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We aimed to investigate the relationship of dietary zinc intake with new-onset hypertension among Chinese adults. A total of 12,177 participants who were free of hypertension at baseline from the China Health and Nutrition Survey were included. Dietary intake was assessed by three consecutive 24-h dietary recalls combined with a household food inventory. Participants with systolic blood pressure ≽ 140 mmHg or diastolic blood pressure ≽ 90 mmHg or diagnosed by a physician or under antihypertensive treatment during the follow-up were defined as having new-onset hypertension. During a median follow-up duration of 6.1 years, 4269 participants developed new-onset hypertension. Overall, the association between dietary zinc intake and new-onset hypertension followed a J-shape (P for non-linearity < 0.001). The risk of new-onset hypertension significantly decreased with the increment of dietary zinc intake (per mg/day: hazard ratio (HR) 0.93; 95% confidence interval (CI) 0.88-0.98) in participants with zinc intake < 10.9 mg/day, and increased with the increment of zinc intake (per mg/day: HR 1.14; 95% CI 1.11-1.16) in participants with zinc intake ≽ 10.9 mg/day. In conclusion, there was a J-shaped association between dietary zinc intake and new-onset hypertension in general Chinese adults, with an inflection point at about 10.9 mg/day.
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Adult , Humans , Cohort Studies , Zinc , Diet , Hypertension/epidemiology , Eating , China/epidemiologyABSTRACT
Our previous investigation suggested that faster seventh cervical nerve (C7) regeneration occurs in patients with cerebral injury undergoing contralateral C7 transfer. This finding needed further verification, and the mechanism remained largely unknown. Here, Tinel's test revealed faster C7 regeneration in patients with cerebral injury, which was further confirmed in mice by electrophysiological recordings and histological analysis. Furthermore, we identified an altered systemic inflammatory response that led to the transformation of macrophage polarization as a mechanism underlying the increased nerve regeneration in patients with cerebral injury. In mice, we showed that, as a contributing factor, serum amyloid protein A1 (SAA1) promoted C7 regeneration and interfered with macrophage polarization in vivo. Our results indicate that altered inflammation promotes the regenerative capacity of the C7 nerve by altering macrophage behavior. SAA1 may be a therapeutic target to improve the recovery of injured peripheral nerves.
Subject(s)
Animals , Humans , Mice , Brachial Plexus , Brachial Plexus Neuropathies/surgery , Nerve Transfer , Peripheral Nerves , Spinal NervesABSTRACT
Our previous investigation suggested that faster seventh cervical nerve (C7) regeneration occurs in patients with cerebral injury undergoing contralateral C7 transfer. This finding needed further verification, and the mechanism remained largely unknown. Here, Tinel’s test revealed faster C7 regeneration in patients with cerebral injury, which was further confirmed in mice by electrophysiological recordings and histological analysis. Furthermore, we identified an altered systemic inflammatory response that led to the transformation of macrophage polarization as a mechanism underlying the increased nerve regeneration in patients with cerebral injury. In mice, we showed that, as a contributing factor, serum amyloid protein A1 (SAA1) promoted C7 regeneration and interfered with macrophage polarization in vivo. Our results indicate that altered inflammation promotes the regenerative capacity of the C7 nerve by altering macrophage behavior. SAA1 may be a therapeutic target to improve the recovery of injured peripheral nerves.
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Objective To study the correlation between homocysteine levels and MTHFR C677T gene polymorphism of cerebral infarction.Methods Four hundred and fifty patients with cerebral infarction in our hospital were selected as the study group from February 2012 to August 2015,including 181 diabetes patients and 269 non-diabetic patients.Also 285 cases of physical examination healthy people in the outpatient department were selected as the control group.The MTHFR C677T polymorphism and the correlation between genotype and Hcy levels were analyzed by pyrosequencing.Results The difference of distributions of MTHFR genotype between the study group and the control group was statistically significant (P ＜ 0.05).The frequency of the T gene in the study group was significantly higher than the control group,the difference was statistically significant (x2 =13.67,P =0.00).The Hcy concentrations of the study group was significantly higher than the control group,and the difference was statistically significant (t =12.71,P =0.00).The Hcy levels of different MTHFR genotype in the cerebral infarction patients were statistically significant (F =17.68,P =0.00).Hcy levels in non-diabetic patients with cerebral infarction was significantly higher than in diabetic patients with cerebral infarction,and the difference was statistically significant (t =2.97,P =0.00).Hcy concentrations of TT genotype of non-diabetic group was significantly higher than the TT genotype of the diabetic group,CC type Hcy concentration significantly lower than the diabetic group,and the differences were statistically significant (t =5.67,2.18;P =0.00,0.03).In cerebral infarction patients both with non-diabetic and diabetic,the Hcy levels of MTHFR gene TT genotype were significantly higher than those of CC and CT genotype,and the differences were statistically significant (P ＜ 0.05),and the differences of Hcy levels between the genotype of CT and CC was not statistically significant (P ＞ 0.05).Conclusion The T allele frequency of MTHFR C677T in the cerebral infarction patients is much higher than healthy people.MTHFR TT genotype is related to serum Hcy levels.Maybe it is a risk factor for cerebral infarction.
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Objective To observe the effect of power-assisted functional electrical stimulation (PAFES)therapy on ankle joint function recovery in stroke patients.Methods Ninety hemiplegic stroke patients were randomly and evenly divided into a control group,a PAFES group,and a neuromuscular electrical stimulation (NMES)group.All groups received conventional rehabilitation training.PAFES group adopted PAFES treatment on affected lower extremities and NMES group was given the NMES therapy on the tibialis anterior of the affected lower limbs,in addition to conventional rehabilitation training.The active range of motion (AROM) of ankle dorsiflexion,FuglMeyer motor assessment (FMA),Barthel index (BI) and Ankle flexion and extension movement (AFEM) in 10 seconds were evaluated before the trial and after 4 weeks treatment.Results After treatment,there were significant differences in the AROM of ankle dorsiflexion,FMA,BI and AFEM (P ＜ 0.05) compared with before treatment within each group.The improvement of AROM of ankle dorsiflexion in PAFES group (8.19 ± 3.39) ° and the values in NMES group (8.96 ± 3.68) ° were to a significantly greater extend than control group (3.88 ± 4.10) ° (P ＜0.05) ; the improvement of FMA and BI in PAFES group was also superior to those in NMES group and control group (P ＜ 0.05).Conclusion The intelligent PAFES therapy could help improve AROM of ankle dorsiflexion,the motor function of the affected lower extremity and the ability of the activities of daily living in stroke patients.
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Objective To investigate the incidence and influencing factors of aldosterone breakthrough during therapy with angiotensin Ⅱ receptor blockers (ARB) alone,or combined with angiotensin-converting enzyme inhibitors (ACEI) in Chinese patients with non-diabetic nephropathy.Methods A total of 144 patients with non-diabetic nephropathy were treated with ARB or combination therapy of ACEI and ARB for a mean follow-up period of 12 months.Aldosterone breakthrough was determined according to the change of plasma aldosterone concentration before and after treatment during 6-month and 12-month ACEI/ARB treatment.Results In 6 months,aldosterone breakthrough occurred in 21 patients,corresponding to 14.58％,while in 12 months,occurred in 39 patients,corresponding to 27.08％.Although the overall urinary protein excretion (UPE) decreased after treatment in both groups (P＜0.05),non-breakthrough group had a more remarkable reduction in UPE (P＜0.05).Univariate Logistic regression demonstrated that risk factors of aldosterone breakthrough included pre-treatment values of UPE (OR=3.643,P=0.073) and eGFR (OR=0.980,P=0.025).Multivariate Logistic model revealed pre-treatment values of eGFR was positively associated with aldosterone breakthrough (OR=0.980,P=0.025).Conclusions The incidence of the aldosterone breakthrough increases with duration of treatment.The patients with aldosterone breathrough have higher level of UPE,and enhanced decline in eGFR.Pretreatment value of eGFR is independent risk factor of aldosterone breakthrough.
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Objective To explore the relationship of serum anti-MICA antibody and development of chronic rejection (CR) after renal transplantation. Methods The enrolled 105 patients included 43 cases of CR, and 62 cases of functioning renal allograft as controls. Data including PRA level before transplantation, HLA mismatch, cold ischemic time, SCr at discharge, immunosuppressive regimen,and months after transplantation were analyzed. Blood samples were collected immediately after grouping for anti-MICA antibodies, SCr determination. Acute rejection episodes and renal allograft function which was evaluated by △SCr/M [(SCr at present - SCr at discharge) /months after transplantation) were compared between anti-MICA-antibody positive patients and anti-MICA-antibody negative patients. Results There was no significant difference in gender, age, HLA mismatch, cold ischemic time, immunosuppressive regimen, SCr at discharge, months after transplantation between CR and control groups (P＞0.05). Serum creatinine level and number of antiMICA-antibody positive patients in CR group were significantly increased as compared with those in control group (P＜0.01 ). Acute rejection episodes during the first 3 months after transplantation in anti-MICA-antibody positive patients were significantly more than those in anti-MICA-antibody negative patients (P＜0.05),and the △SCr/M in the former was higher than that in the latter (8.3 +3.6 vs 2.4 ± 2.6, P＜0.05). Conclusion Humoral immunoreaction mediated by MICA partly participates the development of CR after renal transplantation. MICA antibody is a risk factor affecting long-term allograft function.
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Objective To observe the efficacy and adverse effects of MRC UKALL Ⅻ/ECOG E2993 regimen in inducing remission of Chinese adults with acute iymphoblastic leukemia(ALL). Methods 11 cases of previously untreated ALL patients were treated with MRC UKALL Ⅻ/ECOG E2993 regimen, then observe the efficacy and adverse effects. Results All of the 11 patients achieved complete rcmission(CR), the CR rate was 100 %. Among the 11 patients,8 patients achieved CR after the first course of chemotherapy. In the 8 patients which could be followed up, 5 patients achieved durative CR, among that the longest survival time was 30 months, and 3 patients had relapses. This regimen has a severe myelosuppression. There was an effect on liver function, mostly in the increase of glutamic-pyruvic transaminase and glutamic-oxaloacetic transaminase.After the symptomatic treatment, liver function could return to normal. No treatment-related deaths occurred. Conclusion MRC UKALL Ⅻ/ECOG E2993 regimen can be used as inducing remission therapy for Chinese adults with acute lymphoblastic leukemia.
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Objective To evaluate the role of the combination of angiotensin receptor blocker (ARB)and angiotensin corwerting enzyme inhibitor(ACEI)in functional protection and long-term survival of renal allograft. Methods Thirty-two renal transplant recipients without diabetes mellitus,whose albuminuria concentration in 24-hours collection was more than 0.5 g/d or serum Cr concentration was higher than 177 mmol/L,were randomly divided into experimental group(n=23,male 9 and female 14 cases,mean age 40 years)and control group(n=9,male 5 and female 4 cases,mean age 35 years).Combination of ARB(Valsartan,80rag Qd)and ACEI(Benazapril,20 mg Bid)theraPy was given to each patient every day for 3 years in experimental group.The recipients in control group never received this administration.The serum Cr concentration,albuminuria in 24-hours collection and survival of renal allograft were compared between the 2 groups after 3 years. Results There was significant difference(P＜0.05) of serum Cr concentration between experimental group and control group(252.2±117.9 mmol/L VS 375.3±203.0 mmol/L),especially for chronic allograft nephropathy (CAN)patieats(282.4±147.3 mmol/L vs 528.7±107.8 mmol/L,P＜0.01).There was no difference (P＞0.05)in terms of the values of alburninuria(1.0±0.6 g/d vs 1.3±0.7 g/d)and survival of renal allograft(76 months VS 71 months)after 3 years between 2 groups.Comclusion The administration of ARB+ACEI could protect function of renal allograft with different pathological changes especially for CAN.
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Objective Recurrence of local segmental glomerulosclerosis (FSGS) in 2 patients with renal allograft was reported.Methods A male child aged 15 years and a male adult aged 25 years with primary FSGS, who were subjected to cadaveric kidney transplantation, had a recurrent nephritic syndrome showing massive proteinuria, hyperlipidemia and hypertension respectively in 2 weeks and 18 months postoperatively, that was suspected a recurrent FSGS. The child immediately was treated with Benazepril hydrochloride, 30?mg /day plus high dosage of Prednisolone ( 1?mg /kg every day) for 6 weeks, but proteinuria did not to be ameliorated. The adult was treated with high dosage of Prednisolone ( 1?mg /kg every) and Tripterygium wifordii for 12 weeks, but the syndrome was not improved. Results Two patients had recurrent FSGS according to renal biopsy revealing characterized by similar features: diffuse effacement of foot processes on electron microscope, segmental or focal sclerosis under light microscope and IgM, IgG, C3 deposits. The therapy of plasmapheresis as well as high dosage of Benazepril hydrochloride was added to institute respectively for continuous 3 sessions with removal of 1.5 volume plasma ( 1 200?ml of plasma) in the child and successive 6 sessions with removal of same volume ( 3 000?ml of plasma). The child's proteinuria had a significant reduction from 8.29?g /day to 4.52?g /day after a week post pheresis, that kept 4.52 ～ 5.56 ?g/day with stable creatitine (180～200??mol/L) following 18 months. The adult's proteinaria obvious decreased from 4.68?g /day to 1.50?g /day after plasma exchange a week and keeping decline to 1.06?g /day with normal renal function following 12 months. Conclusion FSGS may immediately be recurrence in pediatric renal transplants. The mechanism of recurrent FSGS may be associated with excessive glomerular filtration, circulating factor altering glomerular permeability, injection of anti thymocyte and lymphocyte immunoglobulin, and hyperlipidemia. Plasmapheresis in combined with ACE inhibitor can reduce proteinuria significantly rather than a single ACE inhibitor.
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Objective To explore the effects of percutaneous renal biopsy(PRB) on the etiological diagnosis and therapeutic regimen of patients with acute renal failure(ARF),so as to further improve the diagnostic and therapeutic levels of ARF.Methods From Nov.1992 to Dec.2007,176 patients were admitted in the Renal Division of Nanfang Hospital.All the patients matched the diagnostic criteria and were clinically diagnosed as ARF:within 48h the serum creatinine(SCr) ascended(≥26.5?mol/L) and increased by more than 50%,and the urine volume of less than 0.5ml/kg?h persisted in 6 hours.All the patients were undergone PRB and the clinical data were analyzed retrospectively.Results The final etiological diagnosis rate elevated from 64.2%(113/176) before PRB to 96.6%(170/176) after PRB.The coincidence of etiological diagnosis before and after PRB was 95.6%(108/113).Of 176 cases,170 were finally diagnosed as ARF,and the 6 remainders who were clinically misdiagnosed as ARF were finally diagnosed as chronic renal insufficiency(CRI).The therapeutic regimen for 83 patients was supplemented and for another 10 patients was modified after PRB,the total adjusted rate was up to 52.8%(93/176).After PRB,8 patients were finally diagnosed as IgA nephropathy,of them one case was specifically diagnosed as IgA protractedly leading to CRI,6 cases were ARF complicated with IgA,and one case was crescent formation induced by IgA nephropathy that leading to ARF.Conclusion PRB is a very useful technique for the etiological diagnosis of ARF on determining the therapeutic regimen and defining the prognosis.