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BACKGROUND@#Stroke is the leading cause of death in China, and predicting the stroke burden could provide essential information guiding the setting of medium- and long-term health policies and priorities. The study aimed to project trends associated with stroke burden in China through 2050, not only in terms of incidence and mortality but also for prevalence and disability-adjusted life years (DALYs).@*METHODS@#Data on stroke rates in incidence, prevalence, deaths, and DALYs in China between 1990 and 2019 were obtained from a recent Global Burden of Disease study. Demographic-specific trends in rates over time were estimated using three models: the loglinear model, the Lee-Carter model, and a functional time series model. The mean absolute percentage error and the root mean squared error were used for model selection. Projections up to 2050 were estimated using the best fitting model. United Nations population data were used to project the absolute numbers through 2050.@*RESULTS@#From 2019 to 2050, the crude rates for all measures of the stroke burden are projected to increase continuously among both men and women. We project that compared with those in 2019, the incidence, prevalence, deaths, and DALYs because of stroke in China in 2050 will increase by 55.58%, 119.16%, 72.15%, and 20.04%, respectively; the corresponding increases in number were 2.19, 34.27, 1.58, and 9.21 million. The age-standardized rate is projected to substantially decline for incidence (8.94%), death (40.37%), and DALYs (43.47%), but the age-standardized prevalence rate is predicted to increase by 10.82%. By 2050, the burden of stroke among the population aged ≥65 years will increase significantly: by 104.70% for incidence, by 218.48% for prevalence, by 100.00% for death, and by 58.93% for DALYs.@*CONCLUSIONS@#With the aging population in China increasing over the next three decades, the burden of stroke will be markedly increased. Continuous efforts are needed to improve stroke health care and secondary prevention, especially for older adults.
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Male , Humans , Female , Aged , Cost of Illness , Quality-Adjusted Life Years , Stroke/epidemiology , Incidence , Prevalence , China/epidemiologyABSTRACT
The rapidly growing emergence of drug resistant bacteria has become one of the most important public health concerns.However, the development of new drugs is of more difficulties.Extended infusion or prolonged infusion of antibiotics is a significant way of antimicrobial stewardship programs, which has been proven beneficial to better pharmacokinetic/pharmacodynamic targets attainment and improved clinical outcomes.This review discussed the rationality of prolonging the infusion time of commonly used antibiotics in PICU.
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Antimicrobial de-escalation is defined as the discontinuation of one or more components of combination empirical therapy, and/or the change from a broad-spectrum to a narrower spectrum antimicrobial.Antimicrobial de-escalation is one of the mostly used antibiotic management strategies in intensive care units.This review discussed current situations and possible obstacles for its implementations.
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Ovarian cancer is a malignant tumor of female reproductive system with high morbidity and mortality. Currently， ovarian cancer patients are mainly treated by primary debulking surgery combined with taxotere/cyclophosphamide （TC） chemotherapy， with the five-year survival rate of 36%-46%. Chinese medicinal materials play a positive role in preventing the occurrence and development of ovarian cancer via multiple targets. The flavonoid monomers in representative Chinese herbal medicines， such as Epimedii Folium， Scutellariae Radix， Curcumae Longae Rhizoma， Ginkgo Folium， Bupleuri Radix， and Longicerae Japonicae Flos， have been proved to have significant anti-tumor activity and been widely used in the treatment of malignant tumors. We reviewed the relevant literature and summarized that flavonoid monomers can regulate multiple signaling pathways to inhibit cell proliferation， block tumor cell cycle， induce apoptosis and autophagy， reduce the ability of cell invasion and migration， inhibit tumor angiogenesis， and reverse platinum resistance， thereby inhibiting the occurrence and development of ovarian cancer. Such pathways include phosphatidylinositol 3- kinase （PI3K）/protein kinase B （Akt）/mammalian target of rapamycin （mTOR） signaling pathway， Janus kinase （JAK）/signal transducer and activator of transcription 3 （STAT3） signaling pathway， mitogen-activated protein kinase （MAPK） signaling pathway， secreted glycoprotein （Wnt）/β-catenin signaling pathway， Notch signaling pathway， and nuclear factor kappaB （NF-κB） signaling pathway. By reviewing the regulatory effect of flavonoid monomers on the signaling pathways of ovarian cancer， we aim to provide a theoretical basis for the research on the roles of flavonoid monomers in inhibiting the occurrence and development of ovarian cancer.
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Ovarian cancer is a malignant tumor of female reproductive system with high morbidity and mortality. Currently， ovarian cancer patients are mainly treated by primary debulking surgery combined with taxotere/cyclophosphamide （TC） chemotherapy， with the five-year survival rate of 36%-46%. Chinese medicinal materials play a positive role in preventing the occurrence and development of ovarian cancer via multiple targets. The flavonoid monomers in representative Chinese herbal medicines， such as Epimedii Folium， Scutellariae Radix， Curcumae Longae Rhizoma， Ginkgo Folium， Bupleuri Radix， and Longicerae Japonicae Flos， have been proved to have significant anti-tumor activity and been widely used in the treatment of malignant tumors. We reviewed the relevant literature and summarized that flavonoid monomers can regulate multiple signaling pathways to inhibit cell proliferation， block tumor cell cycle， induce apoptosis and autophagy， reduce the ability of cell invasion and migration， inhibit tumor angiogenesis， and reverse platinum resistance， thereby inhibiting the occurrence and development of ovarian cancer. Such pathways include phosphatidylinositol 3- kinase （PI3K）/protein kinase B （Akt）/mammalian target of rapamycin （mTOR） signaling pathway， Janus kinase （JAK）/signal transducer and activator of transcription 3 （STAT3） signaling pathway， mitogen-activated protein kinase （MAPK） signaling pathway， secreted glycoprotein （Wnt）/β-catenin signaling pathway， Notch signaling pathway， and nuclear factor kappaB （NF-κB） signaling pathway. By reviewing the regulatory effect of flavonoid monomers on the signaling pathways of ovarian cancer， we aim to provide a theoretical basis for the research on the roles of flavonoid monomers in inhibiting the occurrence and development of ovarian cancer.
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Transcranial magneto-acoustic electrical stimulation (TMAES) is a novel method of brain nerve regulation and research, which uses induction current generated by the coupling of ultrasound and magnetic field to regulate neural electrical activity in different brain regions. As the second special envoy of nerve signal, calcium plays a key role in nerve signal transmission. In order to investigate the effect of TMAES on prefrontal cortex electrical activity, 15 mice were divided into control group, ultrasound stimulation (TUS) group and TMAES group. The TMAES group received 2.6 W/cm 2 and 0.3 T of magnetic induction intensity, the TUS group received only ultrasound stimulation, and the control group received no ultrasound and magnetic field for one week. The calcium ion concentration in the prefrontal cortex of mice was recorded in real time by optical fiber photometric detection technology. The new object recognition experiment was conducted to compare the behavioral differences and the time-frequency distribution of calcium signal in each group. The results showed that the mean value of calcium transient signal in the TMAES group was (4.84 ± 0.11)% within 10 s after the stimulation, which was higher than that in the TUS group (4.40 ± 0.10)% and the control group (4.22 ± 0.08)%, and the waveform of calcium transient signal was slower, suggesting that calcium metabolism was faster. The main energy band of the TMAES group was 0-20 Hz, that of the TUS group was 0-12 Hz and that of the control group was 0-8 Hz. The cognitive index was 0.71 in the TMAES group, 0.63 in the TUS group, and 0.58 in the control group, indicating that both ultrasonic and magneto-acoustic stimulation could improve the cognitive ability of mice, but the effect of the TMAES group was better than that of the TUS group. These results suggest that TMAES can change the calcium homeostasis of prefrontal cortex nerve clusters, regulate the discharge activity of prefrontal nerve clusters, and promote cognitive function. The results of this study provide data support and reference for further exploration of the deep neural mechanism of TMAES.
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Animals , Mice , Acoustics , Brain , Calcium , Electric Stimulation , Prefrontal Cortex , Transcranial Direct Current Stimulation , Transcranial Magnetic StimulationABSTRACT
Objective To evaluate the compliancy of HIV pre-exposure prophylaxis (PREP) in men who have sex with men (MSM) in Chengdu,Sichuan province,and explore the influencing factors.Methods From 1 July 2013 to 30 September 2015,a random,open,multi-center and parallel control intervention study was conducted in 328 MSM enrolled by non-probability sampling in Chengdu.The MSM were divided into 3 groups randomly,i.e.daily group,intermittent group (before and after exposure) and control group.Clinical follow-up and questionnaire survey were carried out every 3 months.Their PrEP compliances were evaluated respectively and multivariate logistic regression analysis was conducted to identify the related factors.Results A total of 141 MSM were surveyed,in whom 59(41.8％) had good PrEP compliancy.The PrEP compliancy rate was 69.0％ in daily group,higher than that in intermittent group (14.3％),the difference had significance (x2=45.29,P＜0.001).Multivariate logistic analysis indicated that type of PrEP was the influencing factors of PrEP compliancy.Compared with daily group,the intermittent group had worse PrEP compliancy (OR=0.07,95％CI:0.03-0.16).Conclusion The PrEP compliance of the MSM in this study was poor,the compliancy would be influenced by the type of PREP.
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Objective To evaluate the compliancy of HIV pre-exposure prophylaxis (PREP) in men who have sex with men (MSM) in Chengdu,Sichuan province,and explore the influencing factors.Methods From 1 July 2013 to 30 September 2015,a random,open,multi-center and parallel control intervention study was conducted in 328 MSM enrolled by non-probability sampling in Chengdu.The MSM were divided into 3 groups randomly,i.e.daily group,intermittent group (before and after exposure) and control group.Clinical follow-up and questionnaire survey were carried out every 3 months.Their PrEP compliances were evaluated respectively and multivariate logistic regression analysis was conducted to identify the related factors.Results A total of 141 MSM were surveyed,in whom 59(41.8％) had good PrEP compliancy.The PrEP compliancy rate was 69.0％ in daily group,higher than that in intermittent group (14.3％),the difference had significance (x2=45.29,P＜0.001).Multivariate logistic analysis indicated that type of PrEP was the influencing factors of PrEP compliancy.Compared with daily group,the intermittent group had worse PrEP compliancy (OR=0.07,95％CI:0.03-0.16).Conclusion The PrEP compliance of the MSM in this study was poor,the compliancy would be influenced by the type of PREP.
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OBJECTIVE:To systematically review the efficacy and safety of exenatide in the weight loss of obesity and over-weight,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from Cochrane Library,PubMed,Med-line,EMBase,CJFD,VIP and Wanfang Database,randomized controlled trails (RCT) about exenatide versus placebo or other medicines in the treatment of obesity or overweight were collected. Meta-analysis was performed by using Rev Man 5.3.0 software after data extract and quality evaluation. RESULTS:A total of 25 RCTs were enrolled,involving 5 307 patients. Results of Meta-anal-ysis showed body mass in exenatide groups was significantly lower than placebo group[SMD=-2.06,95%CI(-2.97,-1.15),P<0.001],insulin group [SMD=-3.51,95%CI(-4.52,-2.51),P<0.001],glyburide group [SMD=-3.70,95%CI(-4.28,-3.12),P<0.001],rosiglitazone group [SMD=-1.25,95%CI(-1.71,-0.80),P<0.001] and sitagliptin group[SMD=-0.71,95%CI(-0.93,-0.48),P<0.001],and there was no significant difference with metformin group and tasilutai group. Incidence of ad-verse reactions in exenatide group was significantly higher than insulin group[RR=1.22,95%CI(1.06,1.41),P=0.006] and lower than tasilutai group [RR=0.95,95%CI(0.91,0.99),P=0.02],and there was no significant difference with placebo group and met-formin group. CONCLUSIONS:Exenatide can effectively reduce the body mass of obesity and overweight,however,digestive sys-tem shows more adverse reactions. Due to the limit of methodological quality,more high-quality,large-scale and long-term fol-low-up RCTs are needed for further verification for the conclusion.
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Objective Assembly whole mitochondrial genome sequence of Rongshui miniature pig ( RMP ) breed and analysis the structure of mitochondrion based on the next-generation sequecing method.Comparison of phylogenetic relationship and genetic diversity among different pig breeds.Methods We collected peripheral venous blood sample from RMP and constructed two paired-end sequencing libraries.A whole-genome shotgun sequencing strategy and Illumina Genome Analyser sequencing technology were used in our study.Results The mitochondrial genome of RMP consists of 13 protein coding genes, 2 ribosomal RNA genes, 22 transfer RNA genes and the length of pig is 16888 bp.The GC content of this pig mitochondrial genome is about 44 %.Based on phlogenetic analysis, population genetic analysis, our findings confirmed that the ancestral cluster in East Asia mainly occurred among Diannan 7#pig, Hainan wild boar, Lanyu and RMP.Conclusion RMP, a typical miniature pig breed in China, is an earlier ancestor than Lanyu pig breed.