Joint association of depression symptoms and 10-year risk of ischemic cardiovascular disease with the cardiovascular disease in middle-aged and elderly people in China / 北京大学学报(医学版)

OBJECTIVE@#To explore joint association of depression symptoms and 10-year risk of ischemic cardiovascular disease (CVD) in middle-aged and elderly people in China.@*METHODS@#Based on China Health and Retirement Longitudinal Study(CHARLS)database using 2011 baseline data and the follow-up cohort data of 2013, 2015 and 2018, describe the distribution characteristics of baseline depressive symptoms and 10-year risk of ischemic cardiovascular disease in 2011. Cox survival analysis model was used to analyze the individual, independent and joint association of depression symptoms and 10-year risk of ischemic cardiovascular disease with cardiovascular disease.@*RESULTS@#A total of 9 412 subjects were enrolled. The detection rate of depressive symptoms at baseline was 44.7%, and the 10-year middle and high risk of ischemic cardiovascular disease was 13.62%. During an average follow-up of 6.19 (6.19±1.66) years, 1 401 cases of cardiovascular disease were diagnosed in 58 258 person-years, revealing an overall incidence density of 24.048/1 000 person-years. After adjusting the factors, in terms of individual impact, the participants with depressive symptoms had a higher risk of developing CVD (HR=1.263, 95%CI: 1.133-1.408), while medium to high risk of ischemic cardiovascular disease had a higher risk of developing CVD (HR=1.892, 95%CI: 1.662-2.154). Among independent influences, participants with depressive symptoms had a higher risk of developing CVD (HR=1.269, 95% CI: 1.138-1.415), while medium to high risk of 10-year risk of ischemic cardiovascular disease had a higher risk of developing CVD (HR=1.898, 95%CI: 1.668-2.160). Joint impact result showed the incidence of cardiovascular disease in the low risk of 10-year risk of ischemic cardiovascular disease with depressive symptoms group, middle and high risk of 10-year risk of ischemic cardiovascular disease without depressive symptoms group, and 10-year middle and high risk of ischemic cardiovascular disease with depressive symptoms group were 1.390, 2.149, and 2.339 times higher than that of low risk of 10-year risk of ischemic cardiovascular disease without depressive symptoms (P < 0.001).@*CONCLUSION@#The superimposed depression symptoms of the middle and high-risk population at the 10-year risk of ischemic cardiovascular disease will aggravate the risk of cardiovascular disease in middle-aged and elderly people. In combination with the actual lifestyle intervention and physical index health management, attention should be paid to mental health intervention.

Effects of gestational weight on the association between serum high sensitivity C reaction protein and gestational diabetes mellitus among twin gestations: A cohort study / 北京大学学报(医学版)

OBJECTIVE@#To investigate the association between serum high sensitivity C-reaction protein (hsCRP) in early pregnancy and gestational diabetes mellitus (GDM) among twin pregnant women, and to explore the effects of the pre-pregnant body mass index (BMI) and gestational weight gain (GWG) status on such association.@*METHODS@#Twin pregnant women with pre-pregnant BMI greater than or equal to 18.5 kg/m2 were recruited at Department of Obstetrics and Gynecology of Peking University Third Hospital from March 2017 to December 2020. Serum samples collected in early pregnancy were analyzed for hsCRP using particle-enhanced immunoturbidimetric method. In the following visits, the information about GWG and GDM were prospectively collected in every trimester. The association effect between hsCRP tertiles and GDM were estimated using Logistic regression, and further converted into risk ratio (RR). Cochran-Mantel-Haenszel test and mediation analysis were used to explore the effects of BMI and GWG status on the association.@*RESULTS@#Among the included 570 twin pregnant women, 31.6% deve-loped GDM, 26.1% were pre-pregnant overweight or obesity, and 49.5% with GWG out of referenced range. After adjustment for confounding factors, risk of developing GDM in twin gestations with the middle tertile and highest tertile of serum hsCRP in early pregnancy were 1.42 fold (95%CI: 1.02-1.89) and 1.54 fold (95%CI: 1.12-2.02), respectively, compared with the lowest tertile of serum hsCRP, and there existed significantly linear trend (P=0.022). Findings from mediation analysis illustrated that pre-pregnant BMI had partial mediating effect on the association, and BMI accounted for 23.84% (P < 0.001) of the increasing GDM risks with elevated hsCRP. Joint analysis with hsCRP and GWG found that those who were with GWG out of referenced range accompanied with the higher hsCRP tertiles (>1.21 mg/L) had significantly 2.31 fold increased risk according to those who were with GWG in the referenced range accompanied with the lowest hsCRP tertile (≤1.21 mg/L, P < 0.01).@*CONCLUSION@#Elevated hsCRP in early pregnancy significantly increased GDM risk among twin pregnant women. The hsCRP-GDM association was dependent on GWG status, and pre-pregnant BMI had partial mediating effect on such association. It is suggested that twin pregnant women should consider systemic inflammation and gestational weight at the same time to reduce GDM risk.

Associations of distribution of time spent in physical activity and sedentary behavior with obesity / 北京大学学报(医学版)

OBJECTIVE@#To explore associations of distribution of time spent in physical activity (PA) and sedentary behavior (SB) with obesity with taking account that time is finite during the day of adult residents in Wuhai City.@*METHODS@#A cross-sectional study was undertaken in Wuhai City, and we carried out a sampling of local residents aged 18-79 by using multiple stratified cluster sampling method. Data about social demographic characteristics, time spent in PA and SB, diet intake, controlling situation of chronic disease and other covariates were obtained by qualified investigators for face-to-face questionnaire survey. Data about height, weight, and waist circumstance, were obtained by doctors in a secondary hospital or above for body measurements. The statistical method used in our study was known as compositional data analysis, which had been used to process compositional data in many fields. Liner regression analysis with compositional data was used to synthetically analyze the associations of distribution of time spent in PA and SB with obesity,and to investigate the effect of re-allocating time from one behavior to another one whilst the remaining one was kept stable.@*RESULTS@#The investigation revealed the special advantage of compositional data analysis in processing time-use data. The result of liner regression analysis with the compositional data showed that after controlling the potential confounding factors, the associations of distribution of time spent in PA and SB was significantly associated with body mass index (BMI, P<0.001) and the negative natural logarithm of waist to height ratio (-lnWHtR, P<0.001). Among them, in professional population, the proportion of time spent in moderate-to-vigorous physical activity (MVPA) was negatively correlated with -lnWHtR (β=-0.008, P=0.022), while the proportion of time spent in SB was positively correlated with BMI and -lnWHtR (β=0.117, P=0.003; β=0.007, P=0.005). However, in nonprofessional population, the proportion of time spent in MVPA was only negatively correlated with BMI (β=-0.079, P=0.041). Nevertheless, the proportion of time spent in low-intensity physical activity (LIPA) was not significantly associated with BMI and -lnWHtR in both professional and nonprofessional population. In addition, the effects of MVPA replacing another behavior and of MVPA being displaced by another behavior were not symmetrical, and 10 minutes of MVPA replacing LIPA or SB had a greater influence on intervention and prevention of obesity than 10 minutes MVPA being replaced by LIPA or SB.@*CONCLUSION@#The research has resulted in a solution of the associations of the distribution of time spent in PA, SB with health risk. Our results suggest that public health messages should target the health effects of the distribution of time of PA and SB synergistically in developing PA guidelines and health management practice, rather than simply increasing or decreasing the absolute time of PA or SB, so that we can provide scientific suggestions to make people get a profounder healthy effect.

Relationship between sugary drinks and diabetes of adults in Wuhai city / 北京大学学报(医学版)

OBJECTIVE@#To explore the relationship between sugary drinks and diabetes of adults in Wuhai city.@*METHODS@#A multiple stage stratified cluster sampling was conducted on 8 131 residents who were between 35 and 79 years by cross-sectional study in Wuhai city. Questionnaires, physical measurements and laboratory tests were used to collect information on demographic information, dietary behavior, health status, blood glucose indicators. Besides, other covariate information was also collected by these ways. The analysis was carried out by chi-square test, trend chi-square test and multifactor Logistic regression.@*RESULTS@#The detection rates of impaired fasting glucose and diabetes of people who were 35 years old and above in Wuhai city were 6.0% and 18.4%, respectively, and they both increased with age (P<0.01, P< 0.01). The detection rates of impaired fasting glucose and diabetes of the men were both far higher than the women (P< 0.01, P< 0.01). For the men, the detection rate of diabetes increased with age (Ptrend<0.01), but for the women, and the detection rate of impaired fasting glucose and diabetes both increased with age (Ptrend<0.01, Ptrend<0.01). The consumption rate of sugary drinks of the people who were 35 years old and above in Wuhai city was 30.2%. And after all the subjects were classified into three groups, A (0- mL/d), B (16- mL/d), and C (237- mL/d) according to the daily different drinking quantities, statistical results found that group A accounted for 75.4%, group B for 21.5%, and group C for 3.1%. In group A, for comparison, the impaired fasting glucose OR values of group B and group C were 1.4 and 2.2, respectively. And diabetes OR values of group B and group C were 1.2 and 2.1 respectively compared with group A, and the trend of OR values increased both had statistical significance (Ptrend <0.01, Ptrend < 0.01). Also, after adjusting for other covariates in multifactor Logistic regression, the OR values of impaired fasting glucose in group B and group C were 1.6 and 3.8 respectively, and the OR values of diabetes were 1.9 and 4.9 respectively, compared with group A, and besides, the trend of OR values increased both still had statistical significance (Ptrend <0.01, Ptrend < 0.01).@*CONCLUSION@#Increased consumption of sugary drinks will increase the risk of impaired fasting glucose and diabetes. Residents in Wuhai city should control their consumption of sugary drinks.

Genetic evidence for recombination and mutation in the emergence of human enterovirus 71 / 病毒学报

We wished to understand the genetic recombination and phylogenetic characteristics of human en- terovirus A71 (EV-A71) and to explore its potential virulence-related sites. Full-length genomes of three EV-A71 strains isolated from patients in Chenzhou City (China) were sequenced and analyzed. Possible re- combination events and crossover sites were analyzed with Recombination Detection Program v4. 1. 6 by comparison with the complete genome sequences of 231 strains of EV-A71. Similarly, plot and bootscanning analyses were undertaken with SimPlot v3. 5. 1. Phylogenetic trees based on the sequences of VP1 regions were constructed with MEGA v5. 2 using the Kimura two-parameter model and neighbor-joining method. Results suggested that recombination events were detected among the three EV-A71 isolates from Chenzhou City. The common main parent sequence was from JF799986 isolated from samples in Guang- zhou City (China) in 2009, and the minor parent sequence was TW/70516/08. Intertypic recombination e- vents were found in the C4b strain (strain SHZH98 isolated in 1998) and C4a strain (Fuyang strain isola- ted in 2008) with the prototype strains of CVA4 and CVA14 in the 3D region. The chi-square test was used to screen-out potential virulence-related sites with nucleotide substitutions of different types of hand, foot, and mouth disease (HFMD) cases using SPSS v19.0. Results suggested that there were no significant nucleotide substitutions between death cases and severe-HFMD cases. Eighteen significant nucleotide substitutions were found between death/severe-HFMD cases and mild-HFMD cases, and all these 18 substitutions were distributed only in P2 and P3 regions. Intertypic recombination among the predominant circulating EV-A71 strains in the Chinese mainland and other EV-A strains probably dates before 1998, and intratypic recombination might have occurred frequently in the HFMD outbreak from 2008 to 2012. Substitutions in the non-capsid region may be correlated with the changes in virulence of EV-A71. These data suggest that researchers should pay more attention to the relationships between substitutions in the noncapsid region and the virulence of the virus.

Establishment of human colorectal tissue model in HIV-1 mucosal infection / 中华预防医学杂志

<p><b>OBJECTIVE</b>To establish human colorectal tissue model in HIV-1 mucosal infection and by using pseudotyped virus to simulate the biological process of HIV-1 mucosal infection from HIV-1 entering into mucosa to local infection establishment.</p><p><b>METHODS</b>Tumor adjacent normal colorectal tissues were obtained with informed consent. After excised the muscularis externa, the mucosa and submucosa were dissected into the same blocks and cultured in 12-well cell culture plates. The cultured tissue structure and morphology were observed from day 0 to day 13 by staining with the hematoxylin eosin (HE), and the tissue activity was detected by 3(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The established tissues explants were infected by a single cycle replicated pseudotyped virus and propagated for 6 - 7 days, then subjected to the detection of p24 production within supernatant to verify the applicability of the model for the studying of HIV-1 mucosal infection. The applicability of the established explants for safety and reactivity evaluation of mucosa topical drugs was conducted by the using of first generation antiseptic Nonoxynol-9 (N-9) as an example.</p><p><b>RESULTS</b>HE staining showed the structure of colorectal tissue was remained well until 5(th) day and still evident until 13(th) day. The tissue activity of cultured mucosa was above 80% at day 4, and still remained over 50% at day 7 as detected by MTT assay. After infected by pseudo virus, the increased level of p24 was detected from supernatant collected on 1(st), 4(th), 8(th) day, which indicated a local infection was created. In addition, the dose changing of N-9 was reflected sensitively by the activity of this model.</p><p><b>CONCLUSION</b>Ex vivo human colorectal tissue model mimic HIV-1 mucosal infection was established that can be used to replicate the bioprocess of human HIV-1 mucosal infection.</p>

Isolation of a wild-type virulent phage of Helicobacter pylori and its simulated treatments of gastrointestinal Hp in vitro / 南方医科大学学报

<p><b>OBJECTIVE</b>To isolate the wild-type virulent phage of Helicobacter pylori (Hp) and simulate the treatments in vitro to investigate the methods for oral Hp-assisted penetration of the phage through the gastric barrier and offspring phage release for infection and treatment of gastrointestinal Hp.</p><p><b>METHODS</b>The Hp strain was cultured with the candle cylinder method and the virulent phage was isolated by single plate or double plate experiment. A simulated gastric juice was applied and the bactericidal effect of the phage was tested with double flats experiment.</p><p><b>RESULTS</b>After a 1.5-h treatment in simulated gastric juice, the orally derived Hp-borne phage was still capable of forming plaques while the control phage was not.</p><p><b>CONCLUSION</b>The oral Hp can help the phage resist the gastric juice and then infect the gastrointestinal Hp.</p>

Analysis on evaluation of medical device adverse events monitoring and some factors influencing MDAE's reporting by medical personnels / 中国医疗器械杂志

<p><b>OBJECTIVE</b>To investigate the knowledge level related to medical device adverse events (MDAEs) among medical personnels, some factors influencing the reporting behavior and supervision and administrative strategies.</p><p><b>METHODS</b>Stratified sampling, cluster sampling and random sampling were adopted together and a questionnaire survey was conducted among 1897 subjects from 33 hospitals.</p><p><b>RESULTS</b>Medical personnels knew a very little about MDAEs and medical devices' post-market monitoring, but their attitudes towards its benefits were positive. Their intentions to report MDAEs were relatively strong, but there were still some barriers about it.</p><p><b>CONCLUSION</b>A monitoring system and a professional training model about MDAEs reporting should be established and improved in hospitals.</p>

Association between AvaII exon 13 polymorphism at the LDL receptor gene different and serum lipid levels in normotensives and essential hypertensives in Shanghai / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate the AvaII polymorphism of low density lipoprotein receptor gene in both health and essential hypertension populations, and to evaluate the association of AvaII polymorphism with level of blood lipid.</p><p><b>METHODS</b>Using polymerase chain reaction (PCR), AvaII polymorphism was studied in 109 health individuals and 319 patients with essential hypertension.</p><p><b>RESULTS</b>There were three kinds of genotype: (+/+), (+/-), (-/-). The frequencies of the three genotypes were shown as follows: (+/+) 0.9%, (+/-) 27.5%, (-/-) 71.6% in health population and (+/+) 1.2%, (+/-) 33.9%, (-/-) 64.9% in essential hypertension population, respectively. The frequencies of the two alleles were shown as follows: (+) 14.7%, (-) 85.3% in health population, (+) 18.2%, (-) 81.8% in essential hypertension population and (+) 17.3%, (-) 82.7% in the community, respectively. In male essential hypertension cases, the genotypes were associated with serum TC and LDL-C level in the following order: (-/-) < (+/-) (P < 0.05). In women and healthy population, there was a similar trend but not statistically significant (P > 0.05).</p><p><b>CONCLUSIONS</b>A significant association was found between the common variation of LDL-R gene and serum TC and LDL-C levels. (+) Allele was associated with elevated level of serum TC and LDL-C, but (-) allele was associated with a low level of serum TC and LDL-C. The frequencies of (-) allele in both group were related to serum low level TC while LDL-C was much higher than that reported in the western countries. These data indicated that genetic factors which resistant to hypercholesterolemia in Chinese people were different from those findings in West while might be one of the reasons to explain why that serum TC level in Chinese was lower than people in the western countries.</p>