ABSTRACT
Background@#and Purpose As a leading cause of disability and death in China, stroke as well as its epidemiologic features have gained increasing attention. Prior studies, however, have overgeneralized the north-to-south gradient in China. Whether the differences exist across urban and rural areas remains unexplored. This study therefore aims to investigate the north-to-south gradient in stroke incidence across urban and rural China. @*Methods@#The present prospective cohort study analyzed data from the China Health and Nutrition Survey 1997 to 2015. By including 16,917 individuals from diverse social contexts, we calculated the age-standardized incidence of stroke across regions and the age-adjusted risk ratio (aRR). Cox proportional hazards models with time-varying covariates were employed to analyze variations in incident stroke. @*Results@#During the follow-up, age-standardized incidence of stroke ranged from 4.17 per 1,000 person-years (95% confidence interval [CI], 3.38 to 4.96) in the north region to 1.95 (95% CI, 1.60 to 2.30) in the south region (aRR, 2.04; 95% CI, 1.58 to 2.64; P<0.001). The north-to-south gradient of stroke incidence was observed only in rural areas, but not in urban areas. Hierarchical modelling analyses further indicated that the regional differences could be mostly explained by the disparities in the prevalence of hypertension. @*Conclusions@#The present study extends the current evidence on the north-to-south gradient by demonstrating that the difference varied across urban and rural China. Our findings highlight the importance of hypertension management as the measure for alleviating regional differences in stroke incidence.
ABSTRACT
OBJECTIVE@#To compare the changes in muscle enzyme between children with myocarditis and Duchene/Becker muscular dystrophy (DMD/BMD), and to seek the explanations for variation. @*METHODS@#The retrospective analysis for 83 myocarditis children (myocarditis group) and 69 DMD/BMD children (DMD/BMD group), who were collected from Department of Pediatric of Shengjing Hospital affiliated to China Medical University since January 2008 to May 2015, was carried out. At the same time, 24 healthy children from the Department of Pediatric Development served as a control group. The examination indexes included creatine kinase (CK), creatine kinase-isoenzyme MB (CK-MB), creatine kinase isoenzyme MB mass (CK-MB mass), cardiac troponin I (cTnI) and high-sensitive-cTnT (hs-cTnT). @*RESULTS@#1) In the myocarditis group, the CK increased from 100 to 1 000 U/L, reached a peak after 5 days, which lasted for a week and then dropped to the normal; the CK-MB reached a peak after 5 to 7 days and dropped to the normal a month later; the CK-MB mass reached a peak on the first day and dropped to the normal after 3 weeks; the cTn reached to a peak after 5 days and dropped to the normal after about 17 days; hs-cTnT reached to a peak on the first day and dropped to the normal after about 19 days. 2) In the DMD/BMD group, the CK increased significantly and 27 cases had a CK value of more than 10 000 U/L. After the treatment for 1 to 2 weeks, their enzyme rose again after a slight drop. In terms of cTnI, 6 cases showed a moderate increase, 5 of them couldn't drop to the normal level until more than 3 weeks later; the hs-cTnT increased in the 45 cases, which lasted for more than 3 weeks in the 31 cases of them and showed a tendency of persisting increase. @*CONCLUSION@#The cTnI and hs-cTnT rise significantly and possess wider observation window than CK and CK-MB mass in myocarditis children, with more sensitive and specific changes. The myocardial damage can occur before myasthenia and keep this trend for a long time in the DMD/BMD children. The trend of cTnI change in myocarditis children is similar to hs-cTnT, while hs-cTnT in DMD/BMD children is more sensitive than cTnI.
Subject(s)
Child , Female , Humans , Male , Biomarkers , China , Creatine Kinase , Blood , Metabolism , Creatine Kinase, MB Form , Blood , Metabolism , Muscle Weakness , Muscular Dystrophy, Duchenne , Therapeutics , Myocarditis , Therapeutics , Retrospective Studies , Time Factors , Troponin I , Blood , Metabolism , Troponin T , Blood , MetabolismABSTRACT
Objective To find time pint of the irreversible kidney injuru by observing renal pathological appearance and podocytes phenotype after complete ureteral obstruction.Methods The animal model of complete unilateral uretersal obstruction was consructed in 2-weekold and 2-month-old rats respectively.HE staining was employed to evaluate the degree of pathological changes,and immunofluorescence double staining to observe the transitional progression of podocyte.Results Grossly,there appeared pyelectasis at 2 h after obstruction and thinner renal cortex after 3 days of obstruction.Histologically,proximal tube display dilated and hydropic degeneration of tubular epithelial cells was observed after 12-day obstruction.The tubular epithelium showed distorted swelling after 3-day obstruction.Immunofluorescence double staining showed that podocytes decreased and the double-labeled macrophages was increased during 1 d to 2 d after unilateral ureteral obstruction operation.Conclusion Compared with control groups,the unilateral ureteral obstruction groups shows podocyte-to-macrophage transition at 1 d after the operation, while the pelvis shows obviously dilated.From the 1st day to the 7th day after unilateral ureteral obstruction,it shows increasing tendency of the podocytes transition.