Prevalence of high blood pressure and high normal blood pressure among 7- to 17-year-old children and adolescents in developed regions, China from 2014 to 2017: using new national blood pressure reference for Chinese children and adolescents.

As the first blood pressure (BP) reference considering influence of height in China, national blood pressure reference for Chinese han children and adolescents aged 7 to 17 years (CCBP) was issued in 2017. The current study aimed to observe the short-term trends in BP and prevalence of high blood pressure (HBP) and high normal blood pressure (HNBP) using this CCBP reference in Suzhou, China. Data of children and adolescents aged 7 to 17 years were collected from 2014 to 2017. Total population of 2014 to 2017 were 617,383, 684,453, 695,302, and 774,605, respectively, and proportions of males were 54.1%, 54.0%, 53.9%, and 53.8%, respectively. P-trend tests were conducted to examine the trends of BP among different age, region, body mass index, and socioeconomic status groups for each gender. Multivariate logistic regression analyses found secular decreases in prevalence of HBP and HNBP, after adjustment for potential confounders. Compared with that in 2014, the odds ratios (95% confidence intervals) for total study population were 0.936 (0.928, 0.944) in 2015, 0.879 (0.872, 0.887) in 2016, and 0.934 (0.926, 0.941) in 2017. In conclusion, prevalence of HBP and HNBP decreased among children and adolescents in developed regions of China from 2014 to 2017, and a slight rise were found in 2017.

The short-term effects of outdoor temperature on blood pressure among children and adolescents: finding from a large sample cross-sectional study in Suzhou, China.

Although several studies have demonstrated a short-term association between outdoor temperature and blood pressure (BP) among various adult groups, evidence among children and adolescents is lacking. One hundred ninety-four thousand one hundred four participants from 2016 Health Promotion Program for Children and Adolescents (HPPCA) were analyzed through generalized linear mixed-effects models to estimate the short-term effects of two outdoor temperature variables (average and minimum temperature) on participants' BP. Decreasing outdoor temperature was associated with significant increases in systolic BP (SBP), diastolic BP (DBP), and prevalence of hypertension during lag 0 through lag 6. Additionally, daily minimum temperature showed a more apparent association with participants' BP. The estimated increases (95% confidence interval) in SBP and DBP at lag 0 were 0.82 (0.72, 0.92) mmHg and 2.28 (2.20, 2.35) mmHg for a 1 °C decrease in daily minimum temperature, while those values were 0.11 (0.10, 0.12) mmHg and 0.25 (0.24, 0.26) mmHg for a 1 °C decrease in daily average temperature, respectively. The effects of temperature on BP were stronger among female, as well as those with young age and low body mass index. It demonstrated that short-term decreases in outdoor temperature were significantly associated with rises in BP among children and adolescents. This founding has some implications for clinical management and research of BP. Meanwhile, public health intervention should be designed to reduce the exposure to cold temperature for protecting children and adolescents' BP.

Effects of resting heart rate on blood pressure and hypertension in Chinese children: findings from blood pressure surveillance program.

The purpose of this study was to analyze the association between resting heart rate (RHR) and prevalence of hypertension in Chinese children and to identify if this association was mediated by body mass index (BMI). The data of 5445 children who participated in the Blood Pressure Surveillance Program (2011-2017) were analyzed in this study. Children were divided into four groups according to quartiles of RHR in boys and girls, respectively. Compared to those in the first quartile, boys and girls in the fourth quartile were 3.06 (95% CI 2.12, 4.41) and 4.94 (95% CI 3.21, 7.61) times more likely to have hypertension, respectively. Meanwhile, every 10 beats per minute (bpm) increase in RHR was associated with a 41% (95% CI 1.27, 1.56) and 66% (95% CI 1.49, 1.85) greater risk of hypertension in boys and girls, respectively. There were no significant interactions between RHR and BMI on the prevalence of hypertension. This study confirms the existence of a relationship between elevated RHR and increased risk of hypertension in children, independent of BMI. An elevated RHR could be considered as a risk factor for the risk assessment of hypertension, no matter from a clinical setting or a public health perspective.

Association of elevated resting pulse rate with increased risk of hypertension development in children: A prospective study in Suzhou, China.

BACKGROUND: Elevated resting heart rate (RHR) or resting pulse rate (RPR) is associated with increased risk of hypertension development. However, information is limited to adults. The purpose of this study is to analyze this association among Chinese children in a prospective design. METHODS: A total of 4861 children who participated in the Blood Pressure Surveillance Program (2011-2017) were selected in this research. To investigate the association between RPR and hypertension development, children were divided into 4 groups according to the quartiles of RPR at baseline. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using logistic regression model. RESULTS: Over a mean follow-up of 3.0 ±â€Š0.1 years, there were 384 cases of incident hypertension. Compared to boys and girls in the 1st quartile, those in the 4th quartile were 1.73 (95% CI 1.13, 2.65), 2.22 (95% CI 1.43, 3.45) times more likely to have hypertension, respectively. Every 10 bpm increase in RPR was associated with a 26% greater risk of hypertension development in boys (OR: 1.26; 95% CI 1.10, 1.44), while this risk was 1.28 (95% CI 1.13, 1.44) in girls. Baseline blood pressure (BP) and body mass index (BMI) did not have significant interactions with RPR on risk of hypertension development. CONCLUSION: This study confirms the relationship between elevated RPR and increased risk of hypertension development in children, independent of confounders including baseline BP and BMI. An elevated RPR could be considered as a risk factor for the assessment of hypertension, no matter from a clinical setting or a public health perspective.

Relation of body mass index (BMI) to the prevalence of hypertension in children: A 3years' school-based prospective study in Suzhou, China.

BACKGROUND: The prevalence of hypertension has been increasing in children and adolescents in China, which is considered to be accompanied with the epidemic of childhood overweight and obesity, but limited prospective studies have investigated the effect of body mass index (BMI) change on blood pressure among children, especially in China. METHODS: This school-based prospective study compared the blood pressure and prevalence of hypertension in students with different patterns of change in BMI between two periods (childhood and adolescence). 5465 children were followed-up since 2011(childhood) in Suzhou, China and had weight, height and blood pressure measured in 2011(childhood) and 2014(adolescence). RESULTS: Those who changed from being overweight in childhood to having normal BMI in adolescence had similar mean blood pressures to those who had a normal BMI at both two periods. In contrast, those who were overweight at both two periods or who had a normal BMI in childhood and were overweight in adolescence had higher blood pressure in adolescence than those who had a normal BMI at both two periods. Compared with students who had a normal BMI at both periods, those with combination of abnormal BMI in childhood and adolescence have higher ORs of hypertension (4.83 in boys, 3.44 in girls and 3.73 in total). CONCLUSION: These results suggest that obesity is a key determinant of blood pressure during childhood, and weight reduction may have important beneficial effects on blood pressure.

Reversal of multi-drug resistance by pSUPER-shRNA-mdr1 in vivo and in vitro.

AIM: To explore the possibility of reversing multi-drug resistance (MDR) to HepG2/mdr1 in vitro and in vivo with RNA interference (RNAi). METHODS: HepG2/mdr1 was obtained by cloning the whole gene mdr1 into HepG2 cells. shRNA targeting sequence was designed to be homologous to the P-gp encoding MDR1 mRNA consensus sequence. pSUPER-shRNA/mdr1 was constructed using the enzyme-digested technique. HepG2/mdr1 cells were transfected with vectors of pSUPER-shRNA/mdr1 to measure their efficacy by real-time PCR for mdr1 mRNA, flow cytometry (FCM) for P-gp expression, and Rhodamine efflux, MTT method for HepG2/mdr1 function, respectively. In vivo, mice tumors were treated by injecting pSUPER-shRNA/mdr1 in situ and into intra-abdominal cavity. Tumors were collected to create cell suspension and cryosections after chemotherapy with adriamycin and mytomycin. The cell suspension was incubated in RPMI-1640 supplemented with G418 to screen stable cells for appreciating the reversal of MDR. Cryosections were treated with immunohistochemistry technique to show the effectiveness of transfection and the expression of P-gp. RESULTS: pSUPER-shRNA/mdr1 was successfully constructed, which was confirmed by sequencing. The MDR phenotype of HepG2/mdr1 was decreased significantly in vitro transfection. HepG2/mdr1 showing its MDR was reversed notably in P-gp expression (11.0% vs 98.2%, P<0.01). Real-time PCR showed that mRNA/mdr1 was lower in test groups than in control groups (18.73+/-1.33 vs 68.03+/-2.21, P<0.001). Compared with HepG2, the sensitivity of HepG2/mdr1 and HepG2/mdr1-dsRNA cells to ADM was decreased by 1.64 times and 15.6 times, respectively. The accumulation of DNR in positive groups was decreased evidently. In vivo, the p-gp expression in positive groups was significantly lower than that in control groups (65.1% vs 94.1%, P<0.05). The tumor suppressing rate in test groups was 57.8%. After chemotherapy, the growth rate in test groups was lower than that in control groups (700.14+/-35.61 vs 1659.70+/-152.54, P<0.05). Similar results were also observed under fluorescence microscope, and confirmed by Image-Pro Plus 4.5 analysis. CONCLUSION: pSUPER-shRNA/mdr1 vector system allows simple, stable and durable nonviral knockdown of P-gp by RNAi in malignant cells and animals to restore their sensitivity to adriamycin.

Interferon-alpha restrains growth and invasive potential of hepatocellular carcinoma induced by hepatitis B virus X protein.

AIM: To investigate the effects of interferon-alpha (IFN-alpha) to restrain the growth and invasive potential of hepatocellular carcinoma (HCC) induced by hepatitis B virus (HBV) X protein. METHODS: The pcDNA3.1-HBx plasmid was transfected into Chang cells by Lipofectamine in vitro, and Chang/HBx was co-cultured with IFN-alpha. Cell survival growth curve and clonogenicity assay were used to test the growth potential of Chang/pcDNA3.1, Chang/HBx and IFN-alpha-Chang/HBx in vitro. Growth assay in nude mice was used to detect the growth potential of Chang/pcDNA3.1, Chang/HBx and IFN-alpha-Chang/HBx in vivo. Wound healing and transwell migration assays were used to detect the invasive ability of Chang/pcDNA3.1, Chang/HBx and IFN-alpha-Chang/HBx. RESULTS: Compared with CCL13 cells transfected with pcDNA3.1, CCL13 with stable expression of hepatitis B virus X protein showed the characteristics of malignant cells with high capability of growth and invasion by detecting their growth curves, colony forming efficiency, wound healing , transwell migration assays and growth assays in nude mice. Its capability of growth and invasion could be controlled by IFN-alpha. CONCLUSION: IFN-alpha can restrain the growth and invasive potential of HCC cells induced by HBx protein, which has provided an experimental basis for IFN-alpha therapy of HCC.