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Objective To analyze the mortality rate and probability of premature death caused by four major noninfectious chronic diseases (NCDs)in Linyi City from 2013 to 2021, and to provide data support for scientific formulation of chronic disease prevention and control strategy. Methods The mortality data of major chronic diseases in Linyi City from 2013 to 2021 were analyzed. The crude mortality, age-standardized mortality and premature death probability were calculated. The annual percent change (APC) was adopted to analyze the temporal trend of mortality and probability of premature death. Results The average annual crude mortality of four major NCDs was 538.98/100,000, and the age-standardized mortality was 387.3/100,000. The crude mortality rate increased from 517.37/100 000 in 2013 to 563.13/100 000 in 2021 (APC=0.89％, P=0.01). The age-standardized mortality rate decreased from 410.19/100,000 to 364.92/100,000 (APC=-1.8％, P=0.01). The crude mortality and age-standardized mortality of four major NCDs in males were higher than those in females (P<0.05). The average annual probability of premature death caused by four major NCDs was 13.37%. The probability of premature death decreased from 14.49％ in 2013 to 12.32％ in 2021（APC=-2.1％, P=0.00）. From 2013 to 2021, the probability of premature death from malignant tumors, cardiovascular and cerebrovascular diseases, and chronic respiratory diseases in Linyi City dropped from 6.14%, 7.47%, and 1.21% to 5.52%, 6.46%, and 0.5%, respectively (APCs were -1.2%, -2.1%, and -11.3%, respectively, and P values were 0.04, 0.00, and 0.00, respectively). The probability of premature death from diabetes remained stable. The probability of premature death caused by four major NCDs in males was higher than that in females (P<0.05). Conclusion The probability of premature death of the four major NCDs in Linyi has showed a downward trend during 2013-2021. It is suggested to strengthen the prevention and control of diabetes in the next step.
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Objective:To explore whether metabolically healthy obesity(MHO) is a healthy state by observing the incidence of metabolic syndrome(MS) including its components and cardiovascular disease(CVD) in this population.Methods:In 2011, a cohort of 10 140 residents aged 40-79 years old was selected with cluster sampling in the Guiyang urban area. Fasting plasma glucose(FPG), blood lipids, and blood pressure were examined to assess their metabolic status. Height and weight were also measured. Among them, 1 299 metabolically healthy subjects were divided into 3 groups according to body mass index, namely metabolically healthy normal weight(MHNW), metabolically healthy overweight(MHOW), and MHO. Three groups were reassembled in 2014, and finally a total of 966 subjects with baseline and complete follow-up data were included in the analysis. The relationship between MS and its components, and the incidence of CVD were compared among the three groups.Results:(1) After an average follow-up of 3 years, 47.77% of the MHO population transformed into a metabolically unhealthy state. There was no significant difference in the incidence of MS components among the three groups( P>0.05), but there was a significant difference in the incidence of MS( P<0.05); (2) There was no significant difference in the incidence of CVD among the three groups after 3 years of follow-up. Logistic regression was used to analyze the risk factors of CVD in the three groups. Taking the MHNW as the control group, after adjusting for age, gender, FPG, blood lipids, and blood pressure, the risk ratio of the MHOW group was 0.941(0.661-1.202), and MHO group was 0.974(0.702-1.291). Conclusions:After 3 years of follow-up, although the risk of CVD in the MHO population did not increase significantly, the incidences of MS, triglycerides, and FPG abnormality increased compared with the normal people, suggesting that the MHO is not a " stable" healthy state.
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Objective:To establish a prediction model for major adverse cardiovascular and cerebrovascular events (MACCE) in elderly patients with emergency acute coronary syndrome (ACS) within 1 year, and to evaluate its prediction efficiency.Methods:This was a prospective cohort study. Elderly ACS patients who were admitted to the Cardiovascular Care Unit (CCU) or the Emergency Intensive Care Unit (EICU) in Beijing Bo'Ai Hospital through emergency department from January 2019 to December 2021 were successively enrolled. General data of the patients were collected within 24 h after admission, the incidence of malignant arrhythmia, complete revascularization and acute kidney injury (AKI) during hospitalization were recorded. Within 24 h, laboratory indexes such as serum creatinine (Scr), albumin (Alb), hypersensitive C-reactive protein (hs-CRP), creatine kinase isoenzyme MB (CK-MB), D-dimer, cardiac troponin I (cTnI) and N-terminal pro-brain natriuretic peptide (NT-pro-BNP) were measured. In addition, transthoracic echocardiography and the Frailty Screening Questionnaire (FSQ) were performed. Patients were followed up for the occurrence of MACCE within 1 year. The influencing factors of MACCE were screened by univariable and multivariable logistic regression analysis. The cut-off values of continuous variables were determined by receiver operating characteristic (ROC) curve and discretization was carried out with reference to clinical practice. Corresponding scores were set up according to the β regression coefficient of each variable to establish a clinical prediction score scale of MACCE. Finally, ROC curve was used to evaluate its prediction efficiency.Results:The study enrolled 322 elderly ACS patients, and the incidence of MACCE within 1 year was 24.5%. After preliminary screening of independent variables by univariable logistic regression analysis, the influencing factors of MACCE ( P<0.2) were as follows: ① Continuous indicators: age, body mass index (BMI), Alb, hs-CRP, D-dimer, NT-pro-BNP, ejection fraction (EF), Killip grade and FSQ score; ② Discrete indicators: ≥3 comorbidities, incomplete revascularization, and AKI. Multivariable logistic regression analysis after discretization of continuous indicators showed that age ≥84 years old [odds ratio ( OR)=4.351, 95% confidence interval (95% CI): 1.635-11.576, P=0.003], incomplete revascularization ( OR=6.580, 95% CI: 2.397-18.060, P < 0.001), combined with AKI ( OR=2.647, 95% CI: 1.085-6.457, P=0.032), EF ≤50% ( OR=2.742, 95% CI: 1.062-7.084, P=0.037), and FSQ≥3 points ( OR=9.345, 95% CI: 3.156-27.671, P < 0.001) were independent risk factors for MACCE. The total score of the clinical prediction system for MACCE was 8 points, including age ≥84 years old (2 points), incomplete revascularization (2 points), FSQ ≥3 points (2 points), EF ≤50% (1 point), and combined with AKI (1 point). The area under ROC curve (AUC) of the scoring system for predicting MACCE was 0.891, (95% CI: 0.844-0.938, P < 0.001). The optimal cut-off value was >3 points, and the sensitivity and specificity were 0.825 and 0.792, respectively. Conclusions:The prediction score scale of MACCE has a good diagnostic efficacy and has certain guiding value for clinicians to judge the prognosis of elderly ACS patients.
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ObjectiveTo explore the synergetic effect of temperature and PM2.5 on cardiovascular and cerebrovascular diseases. MethodWe collected cardiovascular and cerebrovascular death cases，air pollution and meteorological data during the same period in Pudong New Area from 2013 to 2018.We used generalized additive models （GAMs） with poisson regression including non-stratification model， nonparametric bivariate response model and pollution-stratified parametric model， to assess the interaction between temperature and PM2.5 and on the number of cardiovascular cerebrovascular and cerebrovascular disease deaths. ResultsThe exposure-response relationship between temperature and the number of cardiovascular and cerebrovascular deaths exhibited "U" type and the most comfortable temperature was 18.9 ℃. When the concentrations of PM2.5 increased by 10 μg·m-3， the deaths of total， male， female， ≤75 years and >75 years increased， respectively， by 0.60%（95%CI： 0.30%‒0.91%）， 0.77%（95%CI：0.34%‒1.20%）， 0.46%（95%CI：0.05%‒0.86%）， 0.66%（95%CI：0.03%‒1.30%） and 0.59%（95%CI：0.26%‒0.92%）. With the increase of PM2.5 concentration level， the impact of temperature on cardiovascular and cerebrovascular diseases gradually increased， and the impact was the most significant when the concentration of PM2.5 was more than 150 µg·m-3. There were different sensitive people in different seasons. ConclusionPM2.5 concentration levels of mild pollution and above can exacerbate the negative effects of temperature on cardiovascular and cerebrovascular diseases.
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【Objective】 To investigate the correlation of serum exosomal microRNA-301a (miR-301a) with cardiovascular and cerebrovascular events after peritoneal dialysis in diabetic nephropathy. 【Methods】 A total of 211 patients with diabetic nephropathy treated with peritoneal dialysis from June 2019 to June 2020 in the First Hospital Affiliated of Hebei North University were selected as study subjects. Serum exosomal miR-301a was detected by real-time fluorescence quantitative polymerase chain reaction. The patients were divided into high miR-301a group and low miR-301a group based on the median of miR-301a; the clinical data of the two groups were compared. The correlation of miR-301a with high-sensitivity C-reactive protein (hs-CRP) was analyzed by Spearman. Linear regression was applied to analyze the factors associated with the effect of miR-301a. The patients were followed up for two years. Kaplan-Meier and Log-Rank were conducted to compare the cumulative incidence of cardiovascular and cerebrovascular events between the two groups, and COX regression and restricted cubic spline were used to analyze the level-effect relationship between miR-301a and cardiovascular and cerebrovascular events after peritoneal dialysis. 【Results】 Thirty-seven cases (17.54%) of cardiovascular and cerebrovascular events occurred during follow-up. The hs-CRP level and dialysis duration were lower in low miR-301a group than in high miR-301a group (P<0.05). There was a positive correlation between miR-301a and hs-CRP (rs=0.237, P=0.001). Linear regression analysis showed that hs-CRP was independently associated with miR-301a (P<0.05). The cumulative cardiovascular and cerebrovascular event rate in low miR-301a group was 3.70% (4/108), which was lower than that in high miR-301a group [32.04% (33/103), P<0.001]. COX regression analysis showed that high serum albumin level was an independent protective factor for cardiovascular and cerebrovascular events after peritoneal dialysis in diabetic nephropathy,while high hs-CRP level and miR-301a >1.46 were independent risk factors for cardiovascular and cerebrovascular events after peritoneal dialysis in diabetic nephropathy. Restricted cubic spline fitting COX regression analysis showed a non-linear relationship between miR-301a and cardiovascular and cerebrovascular events after peritoneal dialysis in diabetic nephropathy (P<0.05). 【Conclusion】 hs-CRP is independently associated with miR-301a in diabetic nephropathy peritoneal dialysis patients. High miR-301a level suggests a high risk of cardiovascular and cerebrovascular events after peritoneal dialysis in diabetic nephropathy.
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Objective To explore the impact of temperature and environmental factors on the risk of deaths from cardiovascular and cerebrovascular diseases (CVD) in Wuhan during the course of high temperature. Methods The daily CVD death data and meteorological and atmospheric pollutant concentration data during the high temperature process in Wuhan from 2014 to 2019 were collected. The generalized additive models (GAM) were used to obtain the characteristics of meteorological factors, atmospheric pollutant concentrations, high impact factors and thresholds affecting the relative risk of CVD death. Results The analysis results showed that: (1) When the maximum temperature reached 36.7°C and the lowest temperature reached 25.3°C, the relative risk of CVD death increased significantly; (2) The risk of CVD death during the first high temperature process was the largest, and the average CVD excess mortality rate during the first high temperature process from 2014 to 2019 reached 21.7%; and (3) The average temperature, maximum temperature and PM10 during the course of high temperature were important environmental factors that increased the risk of CVD deaths, and the relative risks were 1.14 (95% confidence interval (95% CI): 1.11-1.17), 1.11 (95% confidence interval (95% CI): 1.08-1.15, and 1.06 (95% confidence interval (95% CI): 1.02-1.09), respectively. Conclusion Temperature and PM10 are important environmental factors that increase the risk of death from CVD during the high temperature process in Wuhan from 2014 to 2019, with the first annual high temperature process having the greatest impact on the risk of CVD death.
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Being the leading cause of death among both urban and rural residents in Hunan Province, China, cardiovascular and cerebrovascular diseases hold a significant position in the region's public health landscape. Their prevalence and impact not only underscore the urgency of effective disease prevention and control but also provide crucial guidance for future initiatives. Consequently, the Hunan Province Cardiovascular and Cerebrovascular Health and Disease Report Summary (2020) hereinafter referred to as the "Annual Report", serves as an extensive and informative document. It meticulously examines the current status of these diseases, highlighting both the existing challenges and opportunities for prevention and control efforts in Hunan Province. The primary objective of this report is to furnish valuable insights and evidence that will empower and enrich future endeavors aimed at combatting cardiovascular and cerebrovascular diseases within the region. In 2017, the year of life expectancy lost due to cardiovascular and cerebrovascular diseases in Hunan Province remained higher than the national average. Additionally, the per capita life expectancy in 2019 (77.1 years) was slightly lower by 0.2 years compared with the national average (77.3 years). Alarmingly, the mortality rates associated with cardiovascular and cerebrovascular diseases were consistently ranking highest, indicating an upward trajectory. Moreover, the prevalence and mortality rates of conditions such as hypertension, coronary heart disease, and stroke, all encompassed within the domain of cardiovascular and cerebrovascular diseases, surpassed the national averages. Consequently, the economic burden attributable to cardiovascular and cerebrovascular diseases is on the rise. And under vertical comparison, in 2019, the life expectancy per capita in Hunan Province increased by 1.26 years compared with 2015. The incidence rate of cardiovascular and cerebrovascular events decreased by 8.34% compared with 2017. A new model of hypertension medical and preventive integration has been established with the efforts of many experts in Hunan Province, and full coverage of standardised outpatient clinics for hypertension at the grassroots level has been realised. The rate of standardised management of patients with hypertension under management in Changsha County, a demonstration area, rose to 65.27%, and the incidence rate of cardiovascular and cerebrovascular events, the incidence rate of stroke, and the mortality rate due to cardiovascular and cerebrovascular events were reduced by 28.08%, 28.62%, and 25.00%, respectively. Hunan Province has made significant strides in the prevention and control of cardiovascular and cerebrovascular diseases in recent years.
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Humans , Cerebrovascular Disorders/epidemiology , Life Expectancy , Incidence , Stroke/epidemiology , China/epidemiology , HypertensionABSTRACT
Gei Herba is a traditional folk herbal medicine with a variety of functions such as replenishing Qi and invigorating spleen， tonifying blood and nourishing Yin， moistening lung and resolving phlegm， activating blood and alleviating edema， moving Qi， and activating blood. The reports about the pharmacological effects of this herbal medicine have been increasing in recent years. By reviewing the ancient and modern literature about Gei Herba， we systematically organized the name， original plants， nature， taste， and functions of this herbal medicine， and summarized the modern pharmacological studies and clinical applications of Gei Herba in cardiovascular and cerebrovascular diseases. Gei Herba was first recorded in the name of "Dijiao" in the Geng Xin Yu Ce（《庚辛玉册》） written in the Ming Dynasty. It is derived from Geum japonicum var. chinense （Rosaceae） and sometimes confused with Adina rubella （Rubiaceae）. This medicine had numerous synonyms in the local materia medica books. Gei Herba is widely distributed and harvested in summer and autumn， with the dried whole grass used as medicine. The historical records of the nature， taste， meridian tropism， main functions， and indications of Gei Herba are not consistent. It is generally believed that Gei Herba is pungent， bitter， sweet， cool， and has tropism to the liver， spleen， and lung meridians. Based on the effects of tonifying Qi， activating blood， and nourishing Yin， modern pharmacological studies have reported that the extracts of Gei Herba and the tannin phenolic acid compounds and triterpenoids isolated from Gei Herba have therapeutic effects on cardiovascular and cerebrovascular diseases such as hypertension， myocardial ischemia， cerebral ischemia， and vascular dementia. This study provides a reference for discovering the clinical advantages of Gei Herba and developing new drugs.
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Objective To analyze the changing trend of disease burden attributable to renal insufficiency in cardiovascular disease (CVD) among the elderly in China from 1990 to 2019, and to forecast the disability-adjusted life years (DALY) in the next 10 years, so as to provide a reference basis for accurate prevention and control of CVD attributable to renal insufficiency in China. Methods Data were obtained from the Global Health Data Exchange (GHDx) database to describe the current status of CVD prevalence attributable to renal insufficiency. The joinpoint model was used to estimate the annual percentage change and average annual percentage change to assess the temporal trend of CVD attributable to renal insufficiency in China. An autoregressive moving average model was created by R4.0.2 software to predict the disease burden of CVD attributable to renal insufficiency in China. Results Compared with 1990, CVD mortality and DALY rates attributed to renal insufficiency increased in the male elderly population and decreased in women. Mortality and DALY rates attributed to ischemic heart disease, ischemic stroke, and peripheral arterial disease attributed to renal insufficiency showed an increasing trend, and mortality and DALY rates for cerebral hemorrhage decreased. There was an overall increasing trend in the attribution of CVD due to renal insufficiency. Conclusion The burden of diseases attributable to renal insufficiency in Chinese elderly with CVD is relatively high, and the impact on each disease is different, which requires the attention of relevant authorities.
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Objective@#To examine the dose-response association between cardiorespiratory fitness ( CRF ) and the risk of cardiovascular and cerebrovascular diseases.@*Methods@#A joint search was performed in Chinese and English electronic databases, including China National Knowledge Infrastructure ( CNKI ) , Wanfang Data, VIP, CBM, PubMed, Embase and Web of Science, to retrieve publications reporting the correlation between CRF and the risk of cardiovascular and cerebrovascular diseases until May, 2021. The pooled risk was estimated using the random effects model, and the dose-response association was evaluated using restricted cubic splines. The source of heterogeneity was assessed by subgroup analysis, and the stability of the results was tested by the trim-and-fill method, while the publication bias was assessed using funnel plots.@*Results@#Totally 37 280 literatures were identified, and 23 eligible studies were finally included in the analysis, which covered 2 605 622 subjects. There were 22 publications identified as high-quality. Meta-analysis revealed that the pooled risk of cardiovascular and cerebrovascular diseases reduced by 42% in the highest CRF group relative to the lowest CRF group ( OR=0.58, 95%CI: 0.52-0.65 ), and a one metabolic equivalent ( MET ) increase in CRF caused a 10% reduction in the pooled risk of cardiovascular and cerebrovascular diseases ( OR=0.90, 95%CI: 0.88-0.92 ). There was a negative linear correlation between CRF and the incidence of cardiovascular and cerebrovascular diseases ( P=0.396 ). Subgroup analysis identified gender, sample size and study regions as possible sources of heterogeneity, and sensitivity analysis showed that the study results were stable.@*Conclusions@#There is a negative linear correlation between CRF and the risk of cardiovascular and cerebrovascular diseases, and an increase in CRF may reduce the risk of cardiovascular and cerebrovascular diseases.
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Objective @#To investigate the mortality of cardiovascular and cerebrovascular diseases and to examine the effects on life expectancy among residents in Yuhang District of Hangzhou City from 2010 to 2020, so as to provide insights into the management of cardiovascular and cerebrovascular diseases.@*Methods@#The mortality surveillance data of cardiovascular and cerebrovascular diseases of registered residents in Yuhang District from 2010 to 2020 were collected from Zhejiang All-cause Death Surveillance System. The crude mortality, standardized mortality, annual percent change ( APC ), Fulfillment index, life expectancy, cause-eliminated life expectancy and years of life lost, and the mortality of cardiovascular and cerebrovascular diseases and the impact on life expectancy were analyzed.@*Results@#A total of 21 761 deaths occurred due to cardiovascular and cerebrovascular diseases in Yuhang District from 2010 to 2020, and the annual average crude and standardized mortality rates of cardiovascular and cerebrovascular diseases were 206.14/105 and 129.62/105, respectively. The annual crude and standardized mortality of cardiovascular and cerebrovascular diseases both appeared a tendency towards a decline from 2010 to 2020, with APC of -3.63% and -5.45%, respectively ( P<0.05 ), and the Fulfillment index showed a tendency towards a reduction in residents at ages of 50 to 79 years ( P<0.05 ). The mean life expectancy and cause-eliminated life expectancy were 82.71 and 88.39 years in Yuhang District from 2010 to 2020, which both appeared a tendency towards a rise, both with APC of 0.50% ( P<0.05 ). The years of life lost were 5.02 to 6.47 years due to cardiovascular and cerebrovascular diseases, and the life loss rates were 6.00% to 7.73%.@*Conclusions@#The mortality of cardiovascular and cerebrovascular diseases appeared a tendency towards a decline decreased and the cause-eliminated life expectancy appeared a tendency towards a rise in Yuhang District from 2010 to 2020. Intensifying the management of cardiovascular and cerebrovascular diseases death may increase the life expectancy.
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Objectives To investigate the effects of low level of ambient NO2 on the death of cardiovascular and cerebrovascular diseases in Enshi city and to identify sensitive population, so as to provide a scientific basis for formulating health policies. Methods The data of air pollutants, meteorological factors and death of cardiovascular and cerebrovascular diseases in Enshi city from 2015 to 2018 were collected. The generalized additive model based on Poisson distribution was used to analyze the effects of low ambient NO2 level on the death risk of cardiovascular and cerebrovascular diseases in Enshi city. A subgroup analysis was performed on age, gender, and season. Results The average concentrations of major gaseous air pollutants in Enshi city from 2015 to 2018 were NO2 (21.40 μg/m3), SO2 (9.68 μg/m3), CO (0.88 mg/m3), and O3 (61.21 μg/m3), respectively, all of which did not exceed the national secondary standard. The results of single pollutant model analysis showed that each 1 μg/m3 increase in NO2 concentration in lag0 day was associated with a 0.33% increase (95% CI: 0.06 - 0.72) (P>0.05) in mortality risk of cardiovascular and cerebrovascular diseases. In the female population, each 1 μg/m3 increase in NO2 concentration in lag01 day was associated with a 0.92% increase (95% CI: 0.26 - 1.56) (P2 concentration in lag0 day was associated with a 0.62% increase (95% CI: 0.12 - 1.12) (P2, CO or O3), the effect of NO2 on the mortality risk of cardiovascular and cerebrovascular diseases in women and the whole population in cold season still existed. Conclusion The low ambient level of NO2 in Enshi city was significantly associated with increased mortality risk of cardiovascular and cerebrovascular diseases in female population as well as in cold seasons in the whole population. Attention should be paid to the health protection of special populations in areas with low ambient pollution level of NO2 in special seasons.
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Ginkgo biloba Extract( GBE50) Dispersible Tablets is a new standardized prescription,which is widely used in the treatment of ischemic cardiovascular and cerebrovascular diseases. However,there are still many problems in its clinical application.Rational and safe use of GBE50 Dispersible Tablets is pivotal to the medication safety and clinical prognosis of patients. This consensus has been jointly formulated by clinical experts of traditional Chinese medicine and western medicine in cardiovascular and cerebrovascular diseases and followed the Manual for the Clinical Experts Consensus of Chinese Patent Medicine published by the China Association of Chinese Medicine. The present study identified clinical problems based on clinical investigation,searched the research papers according to PICO clinical problems,carried out evidence evaluation,classification,and recommendation by GRADE system,and reached the expert consensus with nominal group technique. The consensus combines evidence with expert experience. Sufficient evidence of clinical problems corresponds to " recommendations",while insufficient evidence to " suggestions". Safety issues of GBE50 Dispersible Tablets,such as indications,usage and dosage,and medication for special populations,are defined to improve clinical efficacy,promote rational medication,and reduce drug risks. This consensus needs to be revised based on emerging clinical issues and evidencebased updates in practical applications in the future.
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Humans , Cerebrovascular Disorders/drug therapy , Consensus , Drugs, Chinese Herbal/therapeutic use , Medicine, Chinese Traditional , TabletsABSTRACT
Air pollution has severe detrimental effects on public health.A substantial number of studies have demonstrated that air pollution exposure is a risk factor for the occurrence of cardiovascular and cerebrovascular diseases and a cause of non-communicable diseases.Both long-term and short-term exposure to air pollution are associated with respiratory diseases,stroke,coronary artery disease,and diabetes.Aiming to better understand the association,we reviewed the latest studies about the association of air pollution with cardiovascular and cerebrovascular diseases,especially stroke,coronary heart disease,arrhythmia,hypertension,and heart failure,and summarized the underlying mechanisms of the health damage caused by long-term and short-term exposure to air pollution.
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Humans , Air Pollutants/analysis , Air Pollution/adverse effects , Cardiovascular Diseases/etiology , Cerebrovascular Disorders/etiology , Environmental Exposure/analysis , Particulate Matter/analysis , Stroke/complicationsABSTRACT
Objective To analyze the composition and influencing factors of the hospitalization expenses of patients with cardiovascular and cerebrovascular diseases who has participated in basic medical insurance, and to provide evidence for controlling excessive increase in the hospitalization expenses and reducing the financial burden of patients. Methods The hospitalization information of 14,271 insured patients with cardiovascular and cerebrovascular diseases from January 1, 2019 to December 31, 2019 in Xianning City, Hubei Province was retrospectively collected. The basic information of the patients and the composition of their hospitalization expenses were descriptively analyzed, and the influencing factors of hospitalization expenses of the patients were analyzed by univariate analysis and logistic regression analysis. Results Among the patients included in the study, coronary heart disease, cerebral infarction, cerebral hemorrhage and essential hypertension were the four main types of cardiovascular and cerebrovascular diseases with the largest proportion of hospitalization expenses, accounting for 26.18%, 20.29%, 11.82% and 9.94%, respectively. The largest proportion of hospitalization expenses was treatment expenses and drug expenses, accounting for 44.09% and 32.52%, respectively. Logistic regression analysis showed that age, length of stay, type of insurance, type of cardiovascular and cerebrovascular diseases, whether there were other comorbidities or complications, and whether they visited tertiary medical institutions were the influencing factors of hospitalization expenses for patients with cardiovascular and cerebrovascular diseases. Conclusion It is necessary to strengthen the disease prevention and control for the elderly and patients with cardiovascular and cerebrovascular diseases such as coronary heart disease, cerebral infarction, cerebral hemorrhage and essential hypertension, accelerate the integration of the basic medical insurance system, scientifically and reasonably shorten the length of hospital stay, and strengthen the promotion of the hierarchical medical system.
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Cardiovascular and cerebrovascular diseases are one of the major diseases endangering human health， and its morbidity and mortality are still in the rising stage in our country. Traditional Chinese medicine （TCM） injections play an important role in the prevention and treatment of cardiovascular and cerebrovascular diseases due to their advantages of rapid onset， remarkable curative effect， and convenient use. Among them， Danhong injection （DHI）， a Chinese medicine injection for promoting blood circulation and removing blood stasis， is widely used in the clinical treatment of cardio-cerebrovascular diseases. DHI is composed of Salviae Miltiorrhizae Radix et Rhizoma （Danshen in Chinese） and Carthami Flos （Honghua in Chinese）， and mainly contains phenolic acids， tanshinones and flavonoids. A large number of studies have shown that DHI has a significant effect in the treatment of ischemic cardio-cerebrovascular diseases， is a representative drug of co-therapy of brain and heart of TCM， its pharmacological effects related to many aspects such as anti-inflammatory， anti-oxidation， anti-coagulation. At the same time， Other studies have also explained the protective effects of DHI on cardiovascular and cerebrovascular diseases through the overall regulation and intervention of multiple targets and pathways. However， DHI has a wide range of clinical applications， there are still many unknown pharmacological effects to be further explored. Therefore， this article summarizes the current researches on the chemical components of DHI， the multi-target and multi-path pharmacological mechanisms of DHI in the treatment of cardiovascular and cerebrovascular diseases， and introduces the latest pharmacological research progress， so as to provide theoretical guidance for clinical rational drug use and subsequent in-depth research.
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Ischemic cardiovascular and cerebrovascular diseases threatening human health and survival have high morbidity and mortality. The common cause of them is reduced blood supply caused by vascular stenosis, atherosclerosis, and infarction. However,the pathological processes of ischemic cardiovascular and cerebrovascular diseases are complex, involving oxidative stress, calcium overload, inflammation, apoptosis, autophagy and other mechanisms. Protein drugs such as recombinant tissue plasminogen activator(rt-PA) and urokinase have been proved with excellent therapeutic effects and huge economic and social benefits in the clinical treatment and interventional therapy. Among them, peptide drugs have shown unique advantages and potential prospects owing to their strong biological activity, high target specificity, biochemical diversity, and low toxicity. Chinese medicinal materials, characterized by multi-component and multi-target therapy, have also shown excellent clinical efficacy against ischemic cardiovascular and cerebrovascular diseases. However, the research and development of related peptides in Chinese medicinal materials is at the initial stage. Therefore, this paper reviewed the targets and action mechanisms of a variety of Chinese medicinal material-derived polypeptides with activities against ischemic cardiovascular and cerebrovascular diseases, aiming to provide support for the in-depth research as well as the clinical development and application of these polypeptides.
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Humans , Cerebrovascular Disorders/drug therapy , China , Drugs, Chinese Herbal , Medicine, Chinese Traditional , Peptides , Tissue Plasminogen ActivatorABSTRACT
BACKGROUND: It is generally known that PI3K/Akt/mTOR, MAPK, Jak/Stat, NF-κB and Notch signaling pathways play important roles in cell proliferation and differentiation, gene transcription, and immune inflammation. Hypoxia inducible factor-1α (HIF-1α) plays a crucial role in mediating the hypoxia signaling pathway and acts as a core factor in the hypoxic reaction process. OBJECTIVE: To summarize the relationship between HIF-1α and hypoxia signaling pathways, providing new ideas for the research and treatment of altitude diseases. METHODS: English literatures published during 2000-2019 were retrieved from PubMed and Medline. Chinese literatures published during 2011-2019 were retrieved from CNKI and WanFang databases. Search terms were “hypoxia inducible factor 1α, signal pathway” in English and Chinese, respectively. RESULTS AND CONCLUSION: During the occurrence of hypoxic-related diseases (inflammation, tumor, cardiovascular and cerebrovascular diseases) and altitude disease, the expression levels of HIF-1 and the key factors of these signaling pathways can change to varying degrees. HIF-1 is closely related to these signaling pathway under the hypoxic conditions, regulates molecular expression in these signaling pathways, or are regulated by these signaling pathways to increase or decrease, in response to the changes in the body under hypoxia conditions.
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BACKGROUND: Hypoxia is a common physiological and pathological stress response in various diseases, and exosomes are widely involved in the mechanism of hypoxia injury and its adaptive mechanism. The two are closely related, which is the current research hotspot. OBJECTIVE: To find a new target for the prevention and treatment of high altitude diseases and open up new ideas. METHODS: The PubMed and Medline databases from 2013 to 2020, and the CNKI and Wanfang databases from 2018 to 2019 were searched by computer. The key words were “serum exosomes, hypoxia, tumor, inflammation, cardiovascular and cerebrovascular diseases” in Chinese and English. Finally, 57 articles were included in the review. RESULTS AND CONCLUSION: Hypoxia is a potential environmental death factor by affecting cell cycle, morphology, metabolism, proliferation, differentiation, autophagy, apoptosis and so on. Hypoxia can regulate the release and change the content of exosomes, which is strongly associated with cell specificity, the duration of hypoxia exposure and the severity of hypoxia. In the environment of hypoxia, exosomes can transmit all kinds of biological information and play an important role in biology through specific binding with receptor cells. As a biomarker of disease diagnosis, exosomes have great potential.
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Nucleotide binding oligomerization domain (NOD)-like receptor protein 3, NLRP3) inflammasomes regulate the secretion of caspase-1, interleukin-18 (IL-18), IL-1β, and other cytokines, and participates in aging. In recent years, it has been found that NLRP3 inflammasomes are abnormally activated in aging heart and vessels, and inhibition of NLRP3 inflammasomes can alleviate heart aging and vascular aging. This review summarizes the research of NLRP3 inflammasome in heart and vascular aging, and the related drugs to promote the discovery of the mechanism of NLRP3 inflammasome in heart and vascular aging and the development of related drugs.