Global and national burden of atherosclerosis from 1990 to 2019: trend analysis based on the Global Burden of Disease Study 2019 / 中华医学杂志(英文版)

BACKGROUND@#Atherosclerosis-related diseases represent significant health issues among adults globally. Despite their widespread impact, comprehensive data concerning the global and national burden and trends of these diseases remain sparse. Our objective is to examine the trends in the burden of atherosclerosis among adults from 1990 to 2019 at both global and national levels.@*METHODS@#We reported the average annual percentage changes (AAPCs) in prevalence, incidence, mortality, and disability-adjusted life years (DALYs) of atherosclerosis-related diseases (ischemic heart disease [IHD], ischemic stroke, and peripheral arterial disease [PAD]) at the global and national levels among individuals based on a trend analysis of the Global Burden of Diseases Study (GBD) 2019. We further analyzed these global trends as a function of age, gender, and the social development index. We also used joinpoint regression analysis to identify the year with the most substantial changes in global trends.@*RESULTS@#Globally, the AAPC of IHD incidence rose from 1990 to 2019 (0.20; 95% confidence interval [CI], 0.12-0.28), with substantial surges in 1995, 2001, 2005, 2010, and 2017. Conversely, AAPC of IHD mortality rates exhibited a different trend until a rise in 2014. The AAPC of incidence rates of ischemic stroke and PAD also escalated during the same period, with respective 0.43 (95% CI, 0.39-0.48) and 0.13 (95% CI, 0.06-0.21). For ischemic stroke, both incidence and mortality soared in 2014, while PAD incidence declined in 1994 and 1998, then sharply climbed in 2016. Nationally, the Northern Mariana Islands experienced the steepest increase in IHD and PAD incidence and mortality between 1990 and 2019. China saw a significant rise in ischemic stroke incidence, whereas the highest mortality rate increase occurred in Timor-Leste. By sociodemographic index (SDI) quintile, low-middle-, middle-, and high-middle-SDI countries all showed upward trends in IHD, ischemic stroke, and PAD incidence. Simultaneously, IHD and ischemic stroke mortality rates, as well as DALYs, dropped in the low-, high-middle-, and high-SDI nations. However, PAD mortality rates and DALYs saw an uptick across all SDI quintiles. Regarding age demographics, a global decrease in the AAPC IHD incidence as noted in individuals above 55 years old, in contrast to an increase in the 20-55 age group during this period. AAPC of mortality rates for IHD, ischemic stroke, and PAD decreased across all ages. The AAPC showed an increase in IHD incidence in both genders. Conversely, IHD's DALYs saw a reduction in both males and females. Ischemic stroke patterns mirrored these trends, whereas all measures for PAD exhibited growth for both sexes.@*CONCLUSIONS@#From 1990 to 2019, there was an overall increasing trend in the global incidence of all three clinical manifestations of atherosclerosis. Between 1990 and 2019, both the mortality rate and DALYs for IHD and ischemic stroke declined across all age groups. Overall, the burden of atherosclerosis-related diseases has not significantly decreased and even shows signs of trending upward. These findings strongly suggest that despite some progress made, efforts to control atherosclerosis diseases globally need to be intensified.

Establishment of HPLC Fingerprints of Paeonia tactilora Decoction Pieces and Its Cluster Analysis and Principal Component Analysis / 中国药房

OBJECTIVE： To establish HPLC fingerprints of Paeonia tactilora decoction pieces， and to conduct its cluster analysis and principal component analysis. METHODS： HPLC method was adopted. The determination was performed on SunFire® C18 column with mobile phase consisted of acetonitril-0.05％ phosphoric acid solution （gradient elution） at the flow rate of 1.0 mL/min. The detection wavelength was set at 230 nm， the column temperature was 30 ℃， the collection time was 70 min，and sample size was 15 μL. Using paeoniflorin as reference， HPLC fingerprints of 26 batches P. tactilora decoction pieces from different habitats and 30 batches by different processed methods were established. The similarity of samples was evaluated by TCM Chromatographic Fingerprint Similarity Evaluation System （2012 edition） to confirm common peak. Cluster analysis and principal component analysis were performed by using SPSS 20.0 software. RESULTS： There were 9 common peaks in HPLC fingerprints of 26 batches of sample from different habitats， the similarity of which was higher than 0.880. Six peaks were identified， including gallic acid， catechin， albiflorin， paeoniflorin， 1，2，3，4，6-pentagalloylglucose and benzoylpaeoniflorin. Cluster analysis showed that 26 batches of samples were clustered into 2 categories when cosine distance was 15. S1-S21 were clustered into one category； S22-S26 were clustered into the other category. By principal component analysis， the accumulative contribution rate of two main components was 81.124％. There were 10 common peaks in HPLC fingerprints of 30 batches of sample by different processed methods， the simi- larity of which was higher than 0.970. Seven peaks were identified， including gallic acid， catechin， aplopaeonoside， albiflorin， paeoniflorin， 1，2，3，4，6-pentagalloylglucose and benzoylpaeoniflorin. Cluster analysis showed that 30 batches of samples were clustered into 2 categories when cosine distance was 25. B1-B10 were clustered into one category； C1-C10 and J1-J10 were clustered into the other category. By principal component analysis， the accumulative contribution rate of four main components was 86.887％. CONCLUSIONS： Established HPLC fingerprint， the results of cluster analysis and principal component analysis can provide reference for quality control of decoction pieces of P. tactilora.

Clinical value of dynamic noninvasive monitoring technique after operation for traumatic brain injury / 中华创伤杂志

Objective To investigate the clinical value of noninvasive monitoring technique in intracranial hemorrhage and secondary brain edema after operation for traumatic brain injury (TBI).Methods A retrospective case-series analysis was done on 196 TBI patients (128 males and 68 females,aged 18-60 years old,median age 36.5 years old) admitted from January 2014 to December 2015 and treated surgically with simultaneous implantation of intracranial pressure (ICP) probe.There were 89 patients with Glasgow coma score (GCS) 6-8 points and 107 with GCS 9-12 points.The values of ICP were recorded.The changes of cerebral electrical impedance (CEI) were monitored in all patients through the BORN-BE noninvasive monitor.Results The disturbance factor of the BORN-BE noninvasive monitor in brain edema in the cerebral stage exhibited a strongly positive correlation with ICP (R =0.954,R2 =0.910,P ＜ 0.05).All the rebleeding occurred within 24 hours after operation in the study.The disturbance factor showed a significant reduction in the bleeding side,which exhibited a strongly negative correlation with the volume of cerebral hemorrhage (R =-0.982,R2 =0.964,P ＜ 0.05).Conclusion After operation for TBI,the ICE changes from dynamic noninvasive monitor can reflect the severity of brain edema digitally,indicating that the postoperative rebleeding and its volume may play an important role in selection of optimal treatment.

Parametric optimization of electroacupuncture against bone-cancer pain in rats and its intervention on mRNA expression of opioid receptor and precursor / 中国针灸

<p><b>OBJECTIVE</b>To observe the intervention of electroacupuncture (EA) with different current frequencies and treatment frequencies on pain thresholt in rats with bone-cancer pain, so as to optimize treatment parameters of EA against bone cancer pain; and by measuring gene expression of opioid receptor and precursor in different tissues to preliminarily explore the possible mechanism of EA against bone cancer pain.</p><p><b>METHODS</b>Ninety healthy female SD rats were randomly divided into a control group, a model group, EA groups (6 subgroups according to different frequencies) and a sham EA group, ten rats in each one. Rats in the control group were injected with 10 µL of amicrobic phosphate buffer solution (PBS) into tibial cavity; rats in the remaining groups were injected with Walker 256 cancer cells to establish model of bone-cancer pain. No treatment was given to rats in the control group and model group; rats in the EA groups were treated with EA at bilateral "Housanli" (ST 36) and "Genduan" with 3 different current frequencies (2 Hz, 100 Hz and 2 Hz/100 Hz), once a day and once every other day, 30 min per treatment (1mA for 15 min, 2 mA for 15 min); rats in the sham EA group were treated with identical acupoints as the EA group, but the acupoints were needled subcutaneously and EA was connected with power off. All the treatment was given for 14 days. Dynamic plantar aesthesiometer was applied to measure the paw withdrawal thresholds (PWTs) of the affected side before the model establishment, 6d, 8d, 10d, 12d, 14d, 16d, 18d, and 20d after model establishment. The mRNA expressions of µ-opioid receptor (MOR), κ-opioid receptor (KOR), δ-opioid receptor (DOR), proopiomelanocortin (POMC) and prodynorphin (PDYN) in dorsal root ganglion (DRG) and lumbar spinal cord dorsal horn (SCDH) of L4-L6 of the affected side were detected by PCR method.</p><p><b>RESULTS</b>There were no differences in PWTs among all groups before model establishment (P>0. 05). Each time point after model establishment, PWTs in model group were obviously lower than those in the control group (all P<0. 01). Compared with the model group, PWTs in each EA subgroup were all increased (all P<0.05), but the differences at different time points were not significant among EA subgroups (P>0.05). The mRNA expressions of MOR, KOR, POMC, and PDYN in L4-L6 DRG in the 2 Hz/100 Hz II group were significantly higher than those in model group (P<0. 05, P<0. 01), while the mRNA expressions of MOR, KOR, DOR, POMC and PDYN in SCDH were not different compared with the model group (P>0. 05).</p><p><b>CONCLUSION</b>EA treatment has obvious analgesic effect on bone-cancer pain, however, its effect is not related with current frequency and treating frequency. EA against bone-cancer pain may be related with increasing the mRNA expression of some peripheral opioid receptors and precursor.</p>

Functional evaluation of spleen T lymphocytes in the rat model of Walker-256 bone cancer pain / 中国比较医学杂志

Objective To observe the functional changes of T lymphocytes in the spleen of rats with bone cancer pain.Methods forty-one healthy female Sprague-Dawley rats were used in this study, and were divided into blank control, PBS and Walker-256 tumor groups.Bone cancer pain model was established by inoculation of Walker 256 cancer cells into the tibial cavity.The paw withdrawal threshold (PWT), paw withdrawal thermal latency (PWL), and spontaneous pain (SP) were all measured before modelling (as base) and at 4, 6, 8, 10, 12, 14, 16, 18, and 20 days after modelling. The function of T lymphocyte proliferation, and the content of T lymphocytes and their subgroups in the spleen were detected by cell counting kit-8 method and flow cytometry, respectively, on day 20 after modelling.Results Before modellng, there were no differences of PWT, PWL, and SP between the PBS and model groups.After modelling, the PWT and SP of model group were significantly decreased on day 4, and were always lower than that of PBS group during the experiment.Statistical analysis revealed that Walker-256 cancer cell inoculation in the tibia induced a significant decrease in PWL on day 8, 10 and 12 after modellng.Compared with the control group, T lymphocyte proliferation, content of T lymphocyte (CD3) and subgroups ( CD4 and CD8) in the PBS group were not significantly decreased.However, T lymphocyte proliferation and the content of CD3 lymphocytes in the model group were significantly lower than those in the blank control group and/or PBS group.Conclusions The bone cancer pain rat model may appear obvious mechanical allodynia and spontaneous pain.Its thermal pain hyperalgesiaonly occurred in the intermediate stage of bone cancer pain. The content of T lymphocytes and its subgroups, and the function of T lymphocyte proliferation are weakened to some extent in the bone cancer pain rat model.

A continuous glycemic observation during early phase of acute myocardial infarction in patients without known diabetes mellitus / 中华内分泌代谢杂志

One hundred and eleven patients with acute myocardial infarction and without known diabetes mellitus who underwent continuous glucose monitoring were divided into normoglycemia(n = 30),transient hyperglycemia(n = 36),and persistent hyperglycemia(n = 45)groups.Compared with other two groups,higher mean blood glucose,standard deviation of blood glucose,largest amplitude of glycemic excursions,mean amplitude of glycemic excursions,and absolute mean of daily differences were observed in the patients with persistent hyperglycemia group(all P<0.01),who were more likely to be female with the history of hypertension and old myocardial infarction(all P<0.05).It was shown that the levels of aspartate aminotransferase,creatine phosphokinase(CK),CK-MB,total cholesterol,triglyceride,low-density lipoprotein cholesterol,HbA1C,and C reactive protein levels were higher in these patients(P<0.01).

Impact of glycometabolic status on cardiac function and recovery in the early phase of acute myocardial infarction / 中国综合临床

Objective To explore the disparity of severity of cardiac dysfunction and recovery among different glycometabolic patients in the early phase of acute myocardial infarction (AMI) . Methods Consecutive 111 AMI patients without known diabetes underwent continuous glucose monitoring. Patients with different glycometabolic status were compared in terms of cadiac dysfunction and recovery at admission and 3month follow up. Results Compared to patients with normglycemia and transient hyperglycemia, patitents with persistent hyperglycemia were more likely to grade Killip Ⅱ or above,which were 13.3% (4/30) ,33. 3% ( 12/36) ,55. 6% (25/45), 20. 0% ( 6/30), 41.7% ( 15/36 ) and 93.3% (42/45) ( Ps ＜ 0. 01 ). In-hospital left ventricular ejection fraction (LVEF), mitral valve protodiastolic E peak velocities (E) and its ratio to late diastolic (E/A) decreased significantly ( LVEF :0. 52 ± 0. 02,0. 48 ± 0. 01 and 0. 37 ± 0. 02; E: [0. 65 ± 0. 41]m/s,[0.55 ± 0.02] m/s and [0.39 ±0. 12]m/s;E/A:1. 15 ±0.08,1.02 ±0.06 and 0.61 ±0.02,respectively) ( Ps ＜ 0. 01 ), whereas LVESV and WMSI increased significantly ( LVESV: [25.83 ± 0. 51] ml,[31.26 ± 1.23] ml, [37, 72 ± 1.01] ml; WMSI: 1.5 ± 0. 3,1.8 ± 0. 2 and 2. 6 ± 0. 4, respectively) ( Ps ＜ 0. 01 )There months after AMI,patitents with persistent hyperglycemia were more likely to grade NYHA Ⅱ or above compared to patients with normglycemia and transient hyperglycemia [67.5% (27/40), 10.0% (3/30) and 11.8% (4/34),respectively] (P ＜0. 01 ). Echocardiographic recovery was observed in each group,but less in persistent hyperglycemia patients. Conclusion Cardiac function of patients with persistent hyperglycemia suffered more severely from AMI and difficult to recover.

Plasma brain natriuretic peptide and atria natriuretic peptide as predictors for diastolic heart failure in patients with type 2 diabetes mellitus / 老年心脏病学杂志（英文版）

Objective To study the change of diastolic cardiac function in diabetic patients and to determine the diagnostic value of plasma brain natriuretic peptide (BNP) and atria natriuretic peptide (ANP) for diastolic heart failure in patients with type 2 diabetes mellitus.Methods Twelve healthy subjects and seventy-one diabetic patients were included in the study.Plasma BNP and ANP were measured with immunoradiometic assay.Results Plasma levels ofBNP andANP increased significantly with increased severity of diastolic heart dysfunction.The ratio of E/A had significant negative correlation with the plasma levels of BNP (r=0.669,P＜0.001) and ANP (r=0.579,P＜0.01).AUC of ANP and BNP in ROC model was 91.9% and 65.3%,respectively.Conclusions The plasma level of BNP might be a valuable predictor for differential diagnosis of diastolic cardiac function in diabetic patients.

Update of the diagnosis and treatment of intravascular large B-cell lymphoma / 医学研究生学报

Intravascular large B-cell lymphoma(IVLBCL) is a rare form of diffuse LBCL characterized by preferential intravascular growth of malignant lymphocytes,aggressive behavior,and an often fatal course.It displays some differences in clinical presentation among diverse geographical areas.The immunophenotype plays a critical role in diagnosis and differential diagnosis.Recent therapeutic approaches,such as the rituximab plus CHOP regimen,could have a positive impact in IVLBCL patients.The use of high-dose chemotherapy supported by autologous stem-cell transplantation may improve current outcomes.

The diagnostic value of plasma NPS in patients of type 2 diabetes mellitus with diastolic heart failure / 医学研究生学报

Objective: To determine the diagnostic value of the concentration of plasma BNP and ANP in patients of type 2 diabetes mellitus with diastolic heart failure(DHF). Methods:12 healthy subjects and 71 diabetic patients were selected into the study. Left ventricular ejection fraction(LVEF) ,mitral annular early diastole (E) and late diastole (A) inflow velocities were measured with Doppler echocardiography .According to the result of ratio of E to A, the DHF patients were subdivided into DHF 1 group:0.8 ≤ E/A

The mechanism of the role of ABC transporters in the multi-drug resistance of SP cells in SPC-A1 cell lines / 医学研究生学报

Objective: Recent researches suggest that tumors are organized in a hierarchy of heterogeneous cell populations and that the capability of maintaining tumor formation/growth specifically resides in a small population of cells called cancer stem cells(CSCs).CSCs are resistant to traditional cancer chemotherapy and radiation therapy because they highly express ATP-binding cassette(ABC) drug transporters and are relatively quiescent,with higher DNA repair and anti-apoptosis abilities.The purpose of this study is to investigate the relationship of ABC transporters with the multi-drug resistance and cancer stem cells of SPC-A1 cell lines.Methods: On the basis of Docetaxel-resistant cell line-SPC-A1/ Docetaxel,we compared the content and biological characteristics of SP cells,the expression of ABC transporters and its effect on the multi-resistance to Docetaxel between SPC-A1 and SPC-A1/ Docetaxel cell lines.Results: SP cells existed in both the SPC-A1 and the SPC-A1/ Docetaxel cell line,with a higher content in the latter.P-gp and BCRP obviously expressed in the SPC-A1/ Docetaxel and SPC-A1/ Docetaxel-SP cells,but only the expression of BCRP was increased in SPC-A1-SP cells.SPC-A1-SP cells also showed obviously higher abilities of proliferation,cloning and tumor formation than SPC-A1/ Docetaxel-SP cells.The multi-drug resistance of SPC-A1/ Docetaxel cells could be reversed with verapamil,but their resistance to Docetaxel could not be reversed completely with the same concentration of the drug.Conclusion: BCRP plays a major role in separating SP cells with tumor stem cell traits and its expression counts for the multi-drug resistance of SPC-A1-SP cells.

Judgment about myocardial function with plasma BNP in patients with noninsulin-dependent diabetes mellitus / 医学研究生学报

Objective:To study the alteration of cardiac function in diabetic patients and evaluate the relationship between cardiac function and BNP. Methods:83 diabetic patients and 12 healthy subjects were selected into the study. Left ventricular ejection fraction(LVEF) and mitral annular early diastole (E) and late diastole (A) inflow velocities were measured with echocardiography. Plasma BNP were measured with Immnoradiometic assay(IRMA)? Results:According to the result of the echocardiography, the diabetics who have no primary cardiac diseases were subdivided into normal cardiac function group( n =24,28.9%),diastolic dysfunction group( n =47,56.7%), systolic dysfunction group( n =6,7.2%), both diastolic and systolic dysfunction group( n =6,7.2%). More than half of diabetic patients have diastolic dysfunction. The plasma level of BNP had significant negative correlation with LVEF( r = -0.614, P

Recent progress in study of the pathogeneses and physiopathologic mechanisms of diabetic cardiomyopathy / 医学研究生学报

Diabetic cardiomyopathy is a type of specific cardiomyopathy which be relevant to metabolic derangement of diabetes mellitus. The exact mechanism is still questionable and has been the focus of much interest and debate in the cardiovascular domain . In this review, we aim to summarize the update advances of its pathogeneses and physiopathologic mechanisms at the histological, molecular and cytologic levels.

Recent progress in the study of the relationship between brain natriuretic peptide and cardiac function / 医学研究生学报

Brain natriuretic peptide(BNP) emerges as another cardiac hormone after atrial natriuretic peptide (ANP). It plays a prominent role in natriuresis, diuresis, vasorelaxation and decreasing blood pressure. The plasma levels of BNP are closely related to the left ventricular function. In this review, the author highlights the latest progress of BNP in the diagnosis, risk stratification, prognosis and therapeutic monitoring of patients with congestive heart failure and other cardiac dysfunction.

The diagnostic value of plasma BNP and ANP in patients with type 2 diabetes mellitus and diastolic heart failure / 中华内分泌代谢杂志

Twelve healthysubjects and 71 diabetic patients, including 47 cases with diastolic heart failure (DHF), were enrolled into the study. Plasma atrial natiuretic peptide (ANP) and brain natriuretic peptide (BNP) were measured with immunoradiometric assay. The result showed that the plasma levels of ANP and BNP were significantly increased in accordance withthe severity of DHF. The ratio of E/A had significantly negative correlation with the plasma levels of BNP(r=-0.669,P