Clinical characteristics and prognosis of young (<35 years) patients with acute ST-segment elevation myocardial infarction / 中华心血管病杂志

Objective: To analyze the risk factors and clinical characteristics as well as long-term prognosis of young patients (aged 18-35 years) with acute ST-segment elevation myocardial infarction (STEMI). Methods: In this retrospective study, from January 2007 to December 2017, STEMI patients who were hospitalized in Beijing Anzhen Hospital, Capital Medical University and younger than 45 years old were collected. Patients were divided to the 18-35 years old group and 36-44 years old group. The basic information of patients, clinical laboratory results, surgical information and discharge diagnosis of enrolled patients were extracted from the electronic medical record system. Subgroup analysis on STEMI patients aged 18 to 35 years was performed to compare the clinical features and outcome of patients with normal coronary angiography or stenotic coronary angiography. Results: 496 patients (20.3%) were between 18 and 35 years old, 480 cases (96.8%) were men, and 371 cases (74.8%) were smokers. The proportion of hypertension and diabetes was lower, but percent of obese (122 cases (43.3%)), level of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), uric acid and homocysteine ​​(Hcy) were significantly higher in patients aged 18 to 35 years compared with STEMI patients aged 36 to 44 years (all P<0.05). In the 18-35 years old group, there were 53 patients (10.7%) with normal coronary angiography and 443 patients (89.3%) with stenosis. The age, proportion of hypertension and diabetes, TC, LDL-C, and triglyceride (TG) levels were lower in the normal coronary angiography group than those in the coronary artery stenosis group (all P<0.05). The main coronary artery lesions were single vessel lesions (263 cases (59.4%)), and the main culprit vessels were left anterior descending artery lesions (238 cases (53.7%)). The follow-up time was 7.0 (4.0, 10.0) years, cardiovascular events were reported in 62 patients (18.9%), of which 14 patients (3.2%) died. The survival rate of patients without cardiovascular events in normal coronary angiography group was higher than that in stenosis group (P=0.029). Multivariate Cox regression analysis showed that diabetes (HR=2.713, 95%CI 1.479-4.976, P=0.001) and dyslipidemia (HR=2.819, 95%CI 1.564-5.079, P=0.001) were independent risk factors for recurrence of cardiovascular events in adult STEMI patients aged 18 to 35 years. Conclusions: STEMI patients aged 18 to 35 years were featured by male sex, obese and smokers. The proportion of hypertension and diabetes was low, while the levels of LDL-C, uric acid and Hcy were high in these patients. Coronary artery stenosis was common, and the stenosis was more likely to occur in the left anterior descending branch. Patients with normal coronary angiography had a better prognosis than those with stenosis. Diabetes and hyperlipidemia increased the risk of recurrent cardiovascular events.

Difference on prevalence and trends of conventional risk factors for ASCVD between young Chinese and American adults with first acute myocardial infarction / 中华心血管病杂志

Objective: This study aimed to compare the prevalence and trends of conventional risk factors for atherosclerotic cardiovascular disease(ASCVD) between young Chinese and American adults with first acute myocardial infarction. Methods: This was a retrospective cohort analysis. Hospitalized yang adults (aged from 18 to 44 years old) with first acute myocardial infarction(AMI) from January 2007 through December 2017 were identified from Beijing Anzhen hospital medical record system. Prevalence and trends of hypertension, diabetes mellitus, obesity, smoking, and dyslipidemia were analyzed and compared with young American adults, whose data were reported by Yandrapalli et al, and the hospitalizations for a first AMI in young adults aged 18 to 44 years were identified from national inpatient sample from January 2005 through September 2015. Results: Chinese cohort included 2 866 young adults with a first AMI (male, n=2 739, female, n=127), the mean age was (39±5) years. Presentation of AMI was more frequently ST-segment elevation myocardial infarction (77.3%, 2 214/2 866). American cohort included 280 875 subjects (male, n=203 700, female, n=77 175), the mean age was 39±5 years. Presentation of AMI was more frequently non-ST-segment elevation myocardial infarction (53.6%, 150 549/280 875). In China, dyslipidemia 2 254 (78.6%), smoking 2 084(72.7%), and hypertension 1 170 (40.8%) were most prevalent, and 96.0% (2 752/2 866) of patients had at least 1 risk factor; in the United States, smoking 159 537(56.8%), dyslipidemia 145 212 (51.7%), and hypertension 139 876 (49.8%) were most prevalent, and 90.3% (253 630/280 875) of patients had at least 1 risk factor. Women had a prevalence of diabetes was higher in women, and prevalence of dyslipidemia and smoking was higher in men in China (all P<0.05);prevalence of obesity, diabetes and hypertension was higher in Women, and prevalence of dyslipidemia and smoking was higher in man in the United States (all P<0.001). Prevalence of dyslipidemia and smoking was higher Chinese men (79.3% vs. 54.6%, 75.5% vs. 58.1%,all P<0.001), and prevalence of obesity, diabetes and hypertension was lower (13.1% vs. 18.6%, 14.9% vs. 19.9%, 40.6% vs. 49.3%, all P<0.001)in Chinses cohort than those in the United States cohort. Prevalence of smoking and obesity was lower (12.6% vs. 53.4%, 10.2% vs. 26.9%, all P<0.001) and prevalence of dyslipidemia was higher (63.8% vs. 44.1% P<0.001) in Chinese women than those in the United States women. Patients presenting with non-ST-segment elevation myocardial infarction had a higher prevalence of obesity, diabetes and hypertension than patients presenting with ST-segment elevation myocardial infarction in China (20.1% vs.10.9%, 17.6% vs. 14.5%, 47.4% vs. 38.9%, all P<0.05). The prevalence of the three risk factors also was higher in patients presenting with non-ST-segment elevation myocardial infarction in the US (24.0% vs.17.0%, 25.0% vs. 20.0%, 54.6% vs. 44.2%, all P<0.001), prevalence of smoking and dyslipidemia was lower in these patients (53.5% vs. 60.5%,51.4% vs. 52.1%, all P<0.001). The prevalence of hypertension and obesity increased and the rate of smoking reduced in China from 2007 through 2017 (all trend P<0.001). The prevalence of all these five conventional risk factors increased temporally in the United States from 2005 to 2015 (all trend P<0.001). The prevalence of hypertension increased by 15.6% in China and 14.5% in the United States, respectively, accounting the largest increase. Conclusions: Smoking, dyslipidemia, and hypertension are most prevalent in China and United State. Significant sex and AMI subtype difference are observed for individual risk factors. The prevalence of hypertension and obesity increased significantly over time in China and all these five conventional risk factors increased significantly in the United States.

Research advances in M. Tuberculosis polyketide synthase 13 inhibitors / 药学学报

Polyketide synthase 13 (Pks13) performs a critical role in the final assembly step of mycolic acid synthesis in Mycobacterium tuberculosis. The inhibition of Pks13 can influence the biosynthesis of mycolic acid, which leads to Mycobacterium tuberculosis cell death. Researchers have discovered Pks13 inhibitors with five chemical scaffolds as antituberculosis agents. Herein, we summarize recent advances in the study of Pks13 inhibitors including the process of discovery, the mechanism of action and structure-activity relationships.

Recent advances in study of drugs against Gram-negative pathogens / 药学学报

The long-term use of antibiotics in clinical practice leads to bacterial variation and resistance. In addition, the excessive or improper use of antibiotics in medical and agricultural fields increases the occurrence of bacterial resistance. In 2017, the World Health Organization has for the first time released a list of 12 bacteria or bacterial families that pose the greatest threat to human health and for which new antibiotics are desperately needed, and three quarters of them are Gram-negative bacteria. Gram-negative bacteria has multi-layered cell wall that prevents many antibiotics from accessing their targets. Therefore, it is very difficult to develop drugs against Gram-negative bacteria, no new class of antibiotic has been approved for Gram-negative pathogens in over fifty years. Here, we summarized recent advances in the study of new antibacterial agents with different mechanisms of action against Gram-negative pathogens.

Genetic and environmental effects on the bone development of the hand and wrist in Chinese young twins / 生物医学与环境科学（英文）

We assessed genetic and environmental effects on bone development of the hand and wrist, and on key anthropometric measures in Chinese young twins. In total, 139 monozygotic and 95 dizygotic twin pairs aged from 5 to 18 years were recruited. The twin correlations of total hand and wrist scores for monozygotic (MZ) and dizygotic (DZ) twins were 0.71 and 0.36, respectively. Bivariate model analysis showed moderate genetic correlations only for total skeletal maturity vs. weight and total skeletal maturity vs. waist circumference (r, 0.51 and 0.46, respectively). Our findings demonstrated that genetic factors played important roles in bone development of the hand and wrist in Chinese young twins, and that these genetic effects might be distinct from those influencing anthropometric measures.

Association Between Serum Uric Acid and Prevalence of Type 2 Diabetes Diagnosed using HbA1c Criteria Among Chinese Adults in Qingdao, China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To determine whether elevated serum uric acid (UA) levels are associated with type 2 diabetes diagnosed using HbA1c levels among Chinese adults.</p><p><b>METHODS</b>We conducted two population-based cross-sectional studies in Qingdao in China in 2006 and 2009. A total of 6894 (39.4% men) subjects aged 35-74 years were included in the data analysis. Newly diagnosed diabetes was defined as HbA1c level of ⋝6.5%, and prediabetes was classified as HbA1c level between 5.7% and 6.4% according to the International Diabetes Federation criteria. Multivariate logistic regression was employed to assess the association between UA and prevalence of type 2 diabetes defined using Glycated hemoglobin A1c (HbA1c) levels.</p><p><b>RESULTS</b>Subjects with prediabetes had higher UA levels than those with normal glucose tolerance, newly diagnosed diabetes, and known diabetes, with corresponding values of 325.1 (82.5) µmol/L, 310.9 (84.2) µmol/L, 291.3 (81.7) µmol/L, 305.2 (83.6) µmol/L, respectively (P<0.001 for all comparisons). Binary logistic regression analysis showed that UA was a possible predictor for the prevalence of type 2 diabetes diagnosed using HbA1c levels, and the second quartile of UA levels had a higher odds ratio (OR: 4.088; 95% CI: 2.900-5.765) for HbA1c than the other quartiles after adjusting for age, body mass index, sex, marital status, education, income, alcohol consumption, smoking, and cardiometabolic parameters.</p><p><b>CONCLUSION</b>Serum UA is significantly associated with type 2 diabetes diagnosed using HbA1c levels, independent of other cardiometabolic parameters.</p>

Design and synthesis of novel benzimidazole derivatives as anti-tuberculosis agents / 药学学报

In recent studies some urea derivatives have been identified as potent anti-tuberculosis agents by targeting mycobacterial membrane protein large 3 (MmpL3). However, this compound series as exemplified by AU1235 exhibited poor in vitro pharmacokinetic profile. With AU1235 as the lead, we have identified a novel benzimidazole series as potential anti-tuberculosis agents by using scaffold hopping approach. Among these synthesized compounds, 2-aminobenzimidazole derivative 8b showed the potent anti-tuberculosis activity with the MIC value of 0.03 microg x mL(-1). This compound also showed improved metabolic stability compared to AU1235. Our investigation indicated that benzimidazole derivatives are the promising lead for further optimization as anti-tuberculosis agents.

Prognosis analysis of 247 cases of gastrointestinal stromal tumor / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features and prognostic factors of gastrointestinal stromal tumor (GIST).</p><p><b>METHODS</b>Clinicopathologic data of 247 patients with GIST from January 2003 to November 2012 in the Affiliated Hospital of Qingdao University Medical College, and the prognostic factors were evaluated retrospectively by univariate and multivariate analysis with Log-rank test and Cox proportional hazard model.</p><p><b>RESULTS</b>Patients were followed up with a median time of 26 months (1 to 113 months). Twenty-six patients developed recurrence or metastasis, and 18 died of GIST. The 1-, 3-, 5-year survival rates were 94%, 91% and 83% respectively. Univariate analysis showed that age, tumor location, tumor size, mitotic count and tumor rupture were predictive factors of survival after resection of primary GIST (all P<0.01). For patients at intermediate and high risk to relapse, imatinib group had a higher 5-year overall survival rate than non-imatinib group (85.7% vs. 81.0%, P<0.05). Multivariate analysis revealed that tumor size (RR=2.248, 95%CI:1.081-4.677, P=0.030), mitotic count (RR=2.220, 95%CI:1.032-4.776, P=0.041) and tumor rupture (RR=5.183, 95%CI:1.677-16.017, P=0.004) were independent prognostic factors.</p><p><b>CONCLUSIONS</b>Tumor size, mitotic count and tumor rupture affect the prognosis after resection of primary GIST independently. Imatinib adjuvant therapy can improve overall survival of patients at intermediate and high risk to relapse after surgery.</p>

Meta-analysis of extralevator abdominoperineal excision and conventional abdominoperineal excision for low rectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the perforation, circumferential resection margin (CRM) and postoperative perineal wound complications after extralevator abdominoperineal excision (ELAPE) and conventional abdominoperineal excision (APE) for low rectal cancer by using systematic review method.</p><p><b>METHODS</b>The Cochrane Library, PubMed, EMbase, CNKI and VIP database were searched for literatures in which ELAPE and APE were compared for the treatment of low rectal cancer. Meta-analysis was performed to deal with data extracted by Cochrane Systematic Reviews methods.</p><p><b>RESULTS</b>Six studies met the inclusion criteria including one randomized control study and five non-randomized control studies with a total of 656 cases including 346 cases of ELAPE and 310 cases of APE. Meta-analysis showed a lower positive CRM rate (RR=0.48, 95%CI:0.36-0.65) and a lower local recurrence rate (RR=0.43, 95%CI:0.19-0.99) in ELAPE compared with APE. There were no significant differences in operative perforation rate (RR=0.45, 95%CI:0.15-1.37) and post-operative perineal wound complications rate (RR=1.20, 95%CI:0.57-2.50) between the two surgical procedures.</p><p><b>CONCLUSION</b>ELAPE is associated with lower rates of positive CRM and local recurrence compared with APE.</p>

Synthesis and anti-tubercular activity of novel alkyl substituted riminophenazine derivatives / 药学学报

A series of novel riminophenazine derivatives bearing an alkyl substituent attached to N-5 and imino nitrogen at C-3 position of the phenazine ring were obtained through rational drug design, aiming to maintain high anti-tubercular activity, lower toxicity and reduce lipophilicity. All target compounds were prepared by utilizing simple and flexible synthetic route and evaluated against Mycobacterium tuberculosis H37Rv and screened for mammalian cytotoxicity. The results demonstrated that compounds with a cyclopropyl substituent at N-5 position were more active than the reference compound clofazimine. In particular, 2-(4-chloroanilino)-5-cyclopropyl-3-(4-methoxycyclohexyl) imino-3, 5-dihydrophenazine (25) was found to be the most potent compound with low cytotoxicity and lipophilicity. This compound could serve as a valuable lead molecule for further optimization.

Heritability of serum uric acid in adult twins / 中华流行病学杂志

Objective To assess the heritability of serum uric acid in adult,using the classic twin design.Methods Adult Twins were recruited from the Qingdao Twin Registry.Uric acid,height,weight were measured.Zygosity in all the same-sex twin pairs was determined by 16 polymorphic markers.Heritability was assessed by structural equation models,with age,gender and body mass index(BMI) included as covariates.Results In total,687 twin pairs were available for data analyses,including 420 pairs of monozygotic and 267 pairs of dizygotic twins.After logarithm transformed,uric acid in males ( 17.47±1.91 ) was significantly higher than in females ( 15.22±1.70,P＜0.0001 ).After adjustment on age,sex and BMI,intraclass correlations for uric acid were 0.70 for monozygotic twins and 0.40 for dizygotic twins.The sex-limitation AE model,combining additive genetic and unique environmental factors,could produce the best fit for the data.Heritability estimate for uric acid was 70.5% (95% CI:65.9-74.6),with the proportion of unique environmental effects as 29.5%(95%CI:25.4-34.2).Conclusion Additive genetic effects appeared to be the major contributor to the variation of uric acid in this twins sample being studied.

Change of the Level of Serum Leptin in Children with Primary Nephritic Syndrome Treated with Glucocorticosteroid / 实用儿科临床杂志

Objective To study the change of the level of serum leptin in children with primary nephritic syndrome(PNS)treated with glucocorticosteroid.Methods Totally 30 PNS patients and 26 healthy children in whom were a matchable age,sex and body mass index(BMI)with the PNS patients were recruited in this study.The PNS patients were treated with prednisone in middle-term or long-term coure of treatment.Serum leptin and BMI of PNS patients were abserved before treatment,after 2,6 months treatment and in the end.The se-rum total cholesteroc(TC)and triglyeride(TG)were abserved in PNS patients after 2,6 months treatment and in the end.Results The se-rum leptin level was(2.75?2.29)?g/L in the PNS patient before treatment and control group was(2.65?2.22)?g/L.There was not significantly different between the PNS patient and control group.The level of serum leptin after 2 months treatment was(9.29?7.19)?g/L and BMI was(18.12?1.90)kg/m2.They were higher than that in control group,6 months treatment and in the end(Pa