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1.
BMJ Open ; 14(6): e078198, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38830732

RESUMO

OBJECTIVE: This study investigated the correlation between uncertainty stress (US) and depression among healthcare professionals (HCPs) in China. DESIGN, SETTINGS AND PARTICIPANTS: A cross-sectional online survey was conducted by recruiting HCPs from three provinces in China (central, eastern and western) through purposive sampling between 29 September 2022 and 18 January 2023. US was measured using the Life Stress Questionnaire and depression was measured using the Patient Health Questionnaire-9. In total, 2976 questionnaires were deemed valid. PRIMARY AND SECONDARY OUTCOME: This study examined the prevalence of US and depression among HCPs in China; the correlating sociodemographic traits; and the correlation between US and depression. RESULTS: The prevalence of US and depression among HCPs in China was 26.54% (790 out of 2976) and 71.63% (2132 out of 2976). Binary logistic analysis revealed that individuals with graduate degrees (OR: 1.83; 95% CI 1.07 to 3.11; p<0.05), central China (OR: 1.75; 95% CI 1.36 to 2.24; p<0.01), primary medical institutes (OR: 1.33; 95% CI 1.03 to 1.72; p<0.05), secondary medical institutes (OR: 1.30; 95% CI 1.01 to 1.68; p<0.05), an annual income of less than ¥50 000 (OR: 1.85; 95% CI 1.26 to 2.73; p<0.01) and an income range of ¥50 000-¥99 999 (OR: 1.49; 95% CI 1.10 to 2.03; p<0.05) were associated with a higher likelihood of US. The adjusted logistic regression model demonstrated that HCPs with higher US had a greater likelihood of depression (adjusted OR: 5.02; 95% CI 3.88 to 6.50; p<0.01). The increase in the US score was paralleled by an increased depression score (beta (B): 1.32; 95% CI 1.25 to 1.39; p<0.01). CONCLUSION: These findings reveal a significant correlation between US and depression among HCPs and suggest that improving the management of US may help reduce the prevalence of depression among HCPs.


Assuntos
Depressão , Pessoal de Saúde , Humanos , Estudos Transversais , China/epidemiologia , Feminino , Masculino , Adulto , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , Incerteza , Depressão/epidemiologia , Pessoa de Meia-Idade , Prevalência , Inquéritos e Questionários , Estresse Psicológico/epidemiologia , Adulto Jovem , Modelos Logísticos
2.
J Clin Hypertens (Greenwich) ; 26(1): 71-83, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-38126623

RESUMO

Nocturnal hypertension is highly prevalent among Chinese and Asian populations, which is mainly attributed to high salt intake and high salt sensitivity. Nocturnal hypertension increases the risk of cardiovascular and all-cause mortality, independent of daytime blood pressure (BP). However, it can usually be detected by 24-h ambulatory BP monitoring, rather than routine office or home BP measurement, thus is often underdiagnosed in clinical practice. Currently, no specific guidance is available for the management of nocturnal hypertension in China or worldwide. Experts from the Chinese Hypertension League summarized the epidemiologic and pathophysiologic characteristics and clinical phenotype of nocturnal hypertension and provided consensus recommendations on optimal management of nocturnal hypertension, with the goal of maximally reducing the cardiovascular disease risks. In this consensus document, 24-h ABPM is recommended for screening and diagnosis of nocturnal hypertension, especially in the elderly, patients with diabetes, chronic kidney diseases, obstructive sleep apnea and other conditions prone to high nocturnal BP. Lifestyle modifications including salt intake restriction, exercise, weight loss, sleep improvement, and mental stress relief are recommended. Long-acting antihypertensive medications are preferred for nocturnal and 24-h BP control. Some newly developed agents, renal denervation, and other device-based therapy on nocturnal BP reduction are evaluated.


Assuntos
Hipertensão , Humanos , Idoso , Hipertensão/diagnóstico , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Consenso , Cloreto de Sódio na Dieta/farmacologia , Ritmo Circadiano/fisiologia , Pressão Sanguínea/fisiologia , Anti-Hipertensivos/uso terapêutico , Anti-Hipertensivos/farmacologia , Monitorização Ambulatorial da Pressão Arterial
3.
Materials (Basel) ; 16(23)2023 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-38067993

RESUMO

In order to explore the corrosion resistance of duplex stainless steel under seawater corrosion and the compressive stiffness of its reinforced concrete columns, this study first performed seawater corrosion resistance tests on HRB400 ordinary steel rebar and S32205 duplex stainless steel rebar. The effect of the corrosion product film on the corrosion behavior was investigated through polarization curve tests and electrochemical impedance spectroscopy tests. The results showed that the corrosion rate of S32205 duplex stainless steel in a seawater environment was approximately 1/15 that of the HRB400 ordinary steel rebar. The anodic polarization curve of duplex stainless steel rebars exhibited a greater slope than that of carbon steel rebars. In the simulated seawater environment, the corrosion rate of these two kinds of steel bars showed different trends. The corrosion rate of ordinary steel bar HRB400 first decreased and then increased, while that of duplex stainless steel S2205 increased steadily. Furthermore, 18 short concrete columns reinforced with ordinary and duplex stainless steel rebars were subjected to the axial compression test and stiffness analysis; the stiffness of the short columns was calculated from the test data. The theoretical values agreed with the test values, with a stiffness calculation error of less than 5%.

4.
Front Med (Lausanne) ; 10: 1155428, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37378298

RESUMO

Background: The dissemination of online health information (OHI) on medication use via WeChat Official Accounts (WOAs) is an effective way to help primary care practitioners (PCPs) address drug-related problems (DRPs) in the community. Although an increasing number of primary care institutions in China have published WOA posts on medication use, their content and quality have not yet been assessed. Objective: This study aimed to explore the general features and content of WOA posts on medication use published by community healthcare centers (CHCs) in Shanghai, China and to assess their quality of content. It also aimed to explore the factors associated with the number of post views. Methods: From June 1 to October 31, 2022, two coauthors independently screened WOA posts on medication use published throughout 2021 by the CHCs in Shanghai. Content analysis was performed to analyze their general features (format, length, and source, etc.) and content (types of medicines and diseases). The QUEST tool was used to assess the quality of the posts. We compared the differences among posts published by CHCs in central urban areas and suburban areas, and used multiple linear regression to explore the factors associated with the number of post views. Results: A total of 236 WOAs of interest published 37,147 posts in 2021, and 275 (0.74%) of them were included in the study. The median number of post views was 152. Thirty percent of the posts were reviewed by the CHCs' staff before publication and only 6% provided information on PCPs' consultations. The most commonly mentioned medicines and diseases in the posts were Chinese patent medicines (37.1%) and respiratory diseases (29.5%). The posts frequently provided information on indications (77%) and usage (56%) but rarely on follow-up (13%) and storage (11%). Of the posts, 94.9% had a total QUEST score < 17 (full score = 28). The median number of post views and total post quality scores did not significantly differ among the CHCs in central urban and suburban areas. In the multiple linear regression model, the number of post views was associated with scores of complementarity (B = 56.47, 95% CI 3.05, 109.89) and conflict of interest (B = -46.40, 95% CI -56.21, -36.60). Conclusion: The quantity and quality of WOA posts on medication use published by CHCs in China need improvement. The quality of posts may partially impact the dissemination effect, but intrinsic causal associations merit further exploration.

5.
BMC Prim Care ; 23(1): 247, 2022 09 26.
Artigo em Inglês | MEDLINE | ID: mdl-36154834

RESUMO

BACKGROUND: Unnecessary drug use can cause avoidable harm to older adults and is particularly common in primary care, but how primary care physicians (PCPs) respond to older adult requests for unnecessary drugs has not been well studied. This study is to explore PCPs' responses to requests for unnecessary drugs from older adults, and their influencing factors and potential solutions. METHODS: This qualitative study was conducted through semi-structured, in-depth interviews from January 4 to September 30, 2020 using a grounded theory methodology. A purposive sample of PCPs affiliated with community healthcare centers in Zhejiang Province and Guangdong Province, China were recruited. The face-to-face interviews were audio-recorded, transcribed verbatim, and independently coded by two investigators. Themes surrounding PCPs' responses to requests for unnecessary drugs, their influencing factors and potential solutions were analysed using a constant comparative approach. RESULTS: Of the 23 participants involved in this study, 12 (52%) were women and the mean age was 35 years. PCPs frequently declined older adults' requests for unnecessary drugs through dissuasion, and occasionally rebuffed patients or referred them to another practitioner. PCPs may fulfill requests due to physician acquiescence, patient pressure, or inadequate supervision and support. Participants recommended four potential solutions to improve the quality of prescribing, including developing professional communication skills, enhancing pharmacist-physician collaboration, improving electronic prescription systems, and strengthening prescription management. CONCLUSIONS: PCPs typically deny requests by older adults for unnecessary drugs according to three main patterns, and guidance is necessary to reduce the potential for adverse consequences. Factors contributing to request fulfillment by PCPs require attention, and the potential solutions recommended by participants deserve consideration to improve the service quality of prescribing for older adults in primary care practices.


Assuntos
Prescrição Eletrônica , Médicos de Atenção Primária , Adulto , Idoso , Serviços de Saúde Comunitária , Feminino , Humanos , Masculino , Pesquisa Qualitativa , Encaminhamento e Consulta
6.
Artigo em Inglês | MEDLINE | ID: mdl-34794961

RESUMO

OBJECTIVE: To identify factors that likely contribute to potentially inappropriate prescriptions (PIPs) among older adults in primary care settings, as well as barriers to medicines optimisation and recommended potential solutions. DESIGN: Systematic review. ELIGIBILITY CRITERIA: Quantitative studies that analysed the factors associated with PIPs among older adults (≥65 years) in primary care settings, and qualitative studies that explored perceived barriers and potential solutions to medicines optimisation for this population. INFORMATION SOURCES: PubMed, EMBASE, Scopus, CINAHL, PsycINFO, Web of Science, CNKI and Wanfang. RESULTS: Of the 13 167 studies identified, 50 were included (14 qualitative, 34 cross-sectional and 2 cohort). Nearly all quantitative studies examined patient-related non-clinical factors (eg, age) and clinical factors (eg, number of medications) and nine studies examined prescriber-related factors (eg, physician age). A greater number of medications were identified as positively associated with PIPs in 25 quantitative studies, and a higher number of comorbidities, physical comorbidities and psychiatric comorbidities were identified as patient-related clinical risk factors for PIPs. However, other factors showed inconsistent associations with the PIPs. Barriers to medicines optimisation emerged within four analytical themes: prescriber related (eg, inadequate knowledge, concerns of adverse consequences, clinical inertia, lack of communication), patient related (eg, limited understanding, patient non-adherence, drug dependency), environment related (eg, lack of integrated care, insufficient investment, time constraints) and technology related (eg, complexity of implementation and inapplicable guidance). Recommended potential solutions were based on each theme of the barriers identified accordingly (eg, prescriber-related factors: incorporating training courses into continuing medical education). CONCLUSIONS: Older adults with more drugs prescribed and comorbidities may have a greater risk of receiving PIPs in the primary care setting, but it remains unclear whether other factors are related. Barriers to medicines optimisation among primary care older adults comprise multiple factors, and evidence-based and targeted interventions are needed to address these difficulties. PROSPERO REGISTRATION NUMBER: CRD42020216258.


Assuntos
Prescrição Inadequada , Atenção Primária à Saúde , Idoso , Estudos de Coortes , Estudos Transversais , Humanos , Pesquisa Qualitativa
7.
J Gen Intern Med ; 35(11): 3278-3284, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32869200

RESUMO

BACKGROUND: The coronavirus disease 2019 (COVID-19) emerged in December 2019 and posed numerous challenges to China's health system. Almost 4 million primary care practitioners (PCPs) participated in controlling the outbreak. However, PCPs' barriers to and experience of the epidemic control remain unknown and are essential for improving countermeasures. OBJECTIVE: To better understand the barriers PCPs faced in COVID-19 epidemic control and their psychological and occupational impacts, and explore potential solutions. DESIGN: This qualitative study was conducted through semi-structured, in-depth interviews from February 12, to March 10, 2020. PARTICIPANTS: A purposive sample of frontline PCPs affiliated with either community health centers or township health centers in four provinces of China were recruited. APPROACH: Interviews were conducted by telephone, and then recorded, transcribed, and content analyzed. Themes surrounding PCPs' barriers to COVID-19 epidemic control, their experience, and potential solutions were iteratively identified using the constant comparative method. KEY RESULTS: Of the 21 PCPs interviewed, 10 (48%) were women and 5 (24%) worked in rural areas. Barriers to epidemic control in primary care included inappropriate PCP scheduling and role ambiguity, difficult tasks and inadequate capacities, and inexperienced community workers and insufficient cooperation. Some PCPs perceived respect and a sense of accomplishment and were preoccupied with the outbreak, while others were frustrated by fatigue and psychological distress. PCPs reported potential solutions for improving countermeasures, such as improving management, optimizing workflows, providing additional support, facilitating cooperation, and strengthening the primary care system. CONCLUSIONS: Due to their roles in controlling the COVID-19 epidemic, PCPs in China faced a series of barriers that affected them physically and mentally. Support for PCPs should help them to overcome these barriers and work efficiently. The current findings provide insight into the challenges and potential solutions for strengthening the preparedness and response of China's primary care system in future disease outbreaks.


Assuntos
COVID-19/terapia , Médicos de Atenção Primária/psicologia , Atenção Primária à Saúde/organização & administração , Atitude do Pessoal de Saúde , China , Controle de Doenças Transmissíveis/organização & administração , Feminino , Humanos , Masculino , Pesquisa Qualitativa , SARS-CoV-2
8.
Artigo em Inglês | MEDLINE | ID: mdl-32117049

RESUMO

Objective: The purpose of this study was to further clarify the association of Hashimoto's thyroiditis (HT) and vitamin D deficiency, and to seek the connection between them and related influencing factors. Methods: Data were obtained from subjects who underwent health examinations from January 2018 to December 2018. The diagnosis of HT was based on: antithyroid peroxidase antibody (TPO-Ab) levels >35 IU/ml and/or antithyroglobulin antibody (Tg-Ab) levels >40 IU/ml. Based on the Endocrine Society guidelines, 25-hydroxyvitamin D [25(OH)D] levels ≥30.0 ng/ml were classified as a vitamin D sufficiency; those between 20 and 29.9 ng/ml, as an insufficiency; and those <20 ng/ml, as a deficiency. All statistical analysis was performed by software R. Results: Of a total of 75,436 individuals who were physically examined, 5,656 of them had 25(OH)D levels tested at the same time; 5,230 were enrolled. The level of 25(OH)D in the non-HT group was higher than that in the HT group. Multiple regression analysis showed that HT was statistically significantly correlated with being male, body mass index (BMI), waist circumference, and thyroid-stimulating hormone (TSH). TSH levels in the insufficiency group and deficiency group were higher than those in the sufficiency group. Free triiodothyronine (FT3) and thyroxine (FT4) levels in the insufficiency group and deficiency group were lower than those in the sufficiency group. 25(OH)D increased by 1 ng/ml at the normal reference level, with an increase of 2.78 ng/dl in FT4 concentration and a decrease of 0.17 mIU/L in TSH. Conclusions: Patients with HT present with a reduced 25(OH)D level, and TSH is an independent risk factor for HT. TSH is negatively correlated with 25(OH)D level. FT3 and FT4 levels were positively correlated with 25(OH)D levels.


Assuntos
Doença de Hashimoto/sangue , Hormônios Tireóideos/sangue , Vitamina D/análogos & derivados , Adulto , Pressão Sanguínea/fisiologia , Estudos de Casos e Controles , Feminino , Doença de Hashimoto/epidemiologia , Doença de Hashimoto/fisiopatologia , Humanos , Hipertensão/sangue , Hipertensão/complicações , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Testes de Função Tireóidea , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/epidemiologia , Deficiência de Vitamina D/fisiopatologia
9.
Transl Cancer Res ; 9(3): 1670-1677, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35117515

RESUMO

BACKGROUND: To clarify the risk factors of colorectal adenomas and non-adenomatous polyps by retrospective analysis. METHODS: Data were obtained from subjects who underwent health examination in the Health Promotion Centre of Sir Run Run Shaw Hospital of Zhejiang University from January 2016 to December 2018, and all of them completed colonoscopies. Statistical analysis was performed using R software. RESULTS: A total of 721 subjects were included in the analysis, of whom 58 (8.0%) were diagnosed as non-adenomatous polyps, 115 (16.0%) as adenomas, 3 (0.4%) as neuroendocrine neoplasms or adenocarcinomas. The gender ratio and prevalence of fatty liver in the non-adenomatous polyp group were different from that in the control group, and age, body mass index (BMI), waist circumference, blood glucose, serum uric acid, triglyceride, alanine transaminase and creatinine levels were higher, while the level of high-density lipoprotein was lower than control group (P<0.05). The sex ratio in the adenoma group was different from that in the control group, age, BMI, waist circumference, glycosylated hemoglobin, serum uric acid, triglyceride and creatinine levels were higher (P<0.05). Age was a risk factor for non-adenomatous polyps. Male and age were risk factors for adenomas. CONCLUSIONS: Age, body weight, waist circumference, blood lipid and blood glucose are related to the high incidence of colorectal adenomas and non-adenomatous polyps; fatty liver is related to the high incidence of colorectal non-adenomatous polyps; age is a risk factor for non-adenomatous polyps; age and male are risk factors for colorectal adenomas.

10.
Gastroenterol Res Pract ; 2019: 3916154, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31281348

RESUMO

BACKGROUND: This study investigated the relationships among the characteristics of colon polyps and potential risk factors, including metabolic condition, CEA level, uric acid level, and Helicobacter pylori (Hp) infection status. METHOD: Clinical data from patients who received colonoscopy were collected and analyzed, including patients' gender, age, polyp pathology, metabolic syndrome (MS) status, CEA level, uric acid level, and Hp infection status. Patients were divided into a polyp group and a control group based on whether they presented with colon polyps. Then, clinical data were compared between the two groups to identify any differences between the groups and their relationships to colon polyps. RESULT: Compared with the control group, the polyp group had significant differences in patient gender, body mass index (BMI), waistline, blood pressure, fasting blood glucose level, blood lipid level, and uric acid level (p < 0.05), but there were no significant differences in LDL and CEA levels (p > 0.05). Patients with MS or a uric acid level > 340 mg/dl had a greater tendency to develop colon polyps but this was not statistically significant. CONCLUSION: The incidence of colon polyps may be associated with MS and uric acid levels, but further studies are warranted to confirm this conclusion.

11.
J Diabetes Res ; 2019: 5904264, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31360730

RESUMO

OBJECTIVE: This study adopts the method of retrospective analysis to collect general information and laboratory results of physical examination population, hoping to clarify the correlation between uric acid and thyroid hormone. METHODS: The subjects of the study were healthy subjects who underwent physical examination at the Sir Run Run Shaw Hospital affiliated to the Medical College of Zhejiang University from January 2016 to December 2018. Demographic information and medical history of all subjects were recorded through an electronic health system. Serum uric acid (SUA) was grouped by quartiles. Statistical analyses were performed with R version 3.5.1. RESULTS: A total of 48,526 subjects were included in the analysis. Gender ratio, age, BMI, waist circumference, systolic blood pressure, diastolic blood pressure, FBG, HbA1c, TG, HDL-C, ALT, AST, FT3, FT4, and TSH were significantly different among the uric acid groups. The regression coefficients of SUA in the TSH, FT3, and FT4 regression models were B = 1.000 (95% CI 1.000-1.000, p = 0.009), B = 0.999 (95% CI 0.999-0.999, p < 0.001), and B = 1.001 (95% CI 1.001-1.001, p < 0.001), respectively. There was a significant dose-dependent relationship between FT4, FT3, and SUA gradient. CONCLUSIONS: Under normal thyroid function, there were significant differences in TSH, FT3, and FT4 between groups with different uric acid levels. Uric acid levels were linearly correlated with FT3 and FT4, but not with TSH.


Assuntos
Saúde , Glândula Tireoide/fisiologia , Hormônios Tireóideos/sangue , Ácido Úrico/sangue , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Saúde/estatística & dados numéricos , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Estudos Retrospectivos , Testes de Função Tireóidea/normas , Adulto Jovem
14.
Int J Endocrinol ; 2018: 1067603, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30310390

RESUMO

OBJECTIVES: To compare the predictive ability of six anthropometric indices for identification of metabolic syndrome (MetS) and to determine their optimal cut-off points among Chinese adults. METHODS: A total of 59,029 participants were enrolled. Body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), a body shape index (ABSI), body roundness index (BRI), and conicity index (CI) were measured. Receiver-operating characteristic curves analyses were performed to determine the discriminatory power of these indices for the identification of cardiometabolic risks and diagnosis of MetS. The differences in the area under the curve (AUC) values among the indices were evaluated. The Youden index was used to determine the optimal cut-off points. RESULTS: WHtR and BRI exhibited the highest AUC values for identifying MetS and most cardiometabolic risk factors in both sexes, whereas ABSI showed the lowest AUC value. The general optimal cut-off points in women were 23.03 kg/m2 for BMI, 77.25 cm for WC, 0.490 for WHtR, and 3.179 for BRI; those in men were 24.64 kg/m2 for BMI, 87.25 cm for WC, 0.510 for WHtR, and 3.547 for BRI. The AUC values and cut-off points of the indices were also analyzed in each age and BMI category. CONCLUSIONS: In Chinese adults, WHtR and BRI showed a superior predictive power for MetS in both sexes, which can be used as simple and effective screening tools for cardiometabolic risks and MetS in clinical practice.

15.
16.
Mol Med Rep ; 17(5): 7293-7300, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29568940

RESUMO

Alzheimer's disease is one of the most common age­associated diseases that frequently leads to memory disorders, cognitive decline and dementia. Evidence suggests that nicergoline serves an important role in the apoptosis of hippocampal cells, memory recovery, cognitive function and neuronal survival. However, the signaling pathway affected by nicergoline treatment remains to be elucidated. The purpose of the present study was to investigate the role of nicergoline in the cognitive competence of a mouse model of Alzheimer's disease. The apoptosis rates of hippocampal cells were studied in mice with Alzheimer's disease treated with nicergoline compared with the negative control. Apoptosis­associated gene expression levels in hippocampal cells, and hippocampus area, were analyzed in the experimental mice. Visual attention and inhibitory control were assessed and neural counting was performed in brain regions of interest. The phosphatidylinositol 3­kinase (PI3K)/RAC­α serine/threonine­protein kinase (AKT) signaling pathway was additionally analyzed in hippocampal cells following treatment with nicergoline. The results of the present study demonstrated that nicergoline ameliorated apoptosis in hippocampal cells and hippocampus tissue in 3xTg­AD mice with Alzheimer's disease. The data indicated that apoptosis­associated genes, including caspase­3, BCL2 associated X, BH3 interacting domain death agonist and caspase­9, were downregulated in hippocampal cells isolated from nicergoline-treated experimental mice. In addition, the expression levels of inflammatory factors, in addition to oxidative stress, were decreased in hippocampal cells treated with nicergoline. Additionally, amyloid precursor protein accumulation was cleared in the hippocampal area in nicergoline­treated mice. Nicergoline inhibited neuronal loss and prevented cognitive impairment through the restoration of learning/memory ability. It was additionally demonstrated in the present study that nicergoline improved motor attention impairment and cognitive competence in hippocampal cells by acting on the PI3K/AKT signaling pathway. Therefore, memory recovery, cognitive function and neuronal survival were repaired by nicergoline via inhibition of the PI3K/AKT signaling pathway, suggesting that nicergoline may be an efficient drug for the clinical treatment of patients with Alzheimer's disease.


Assuntos
Doença de Alzheimer/tratamento farmacológico , Cognição/efeitos dos fármacos , Fármacos Neuroprotetores/uso terapêutico , Nicergolina/uso terapêutico , Nootrópicos/uso terapêutico , Fosfatidilinositol 3-Quinase/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , Doença de Alzheimer/metabolismo , Doença de Alzheimer/fisiopatologia , Animais , Modelos Animais de Doenças , Hipocampo/efeitos dos fármacos , Hipocampo/metabolismo , Hipocampo/fisiopatologia , Masculino , Camundongos , Neurogênese/efeitos dos fármacos , Fármacos Neuroprotetores/farmacologia , Nicergolina/farmacologia , Nootrópicos/farmacologia , Transdução de Sinais/efeitos dos fármacos
17.
Nature ; 553(7689): 405, 2018 01 25.
Artigo em Inglês | MEDLINE | ID: mdl-29368730
18.
Nature ; 553(7689): 405, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32094822
19.
Atherosclerosis ; 263: 263-271, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28704699

RESUMO

BACKGROUND AND AIMS: The association between anthropometric indices of body composition and arterial stiffness is inconclusive. The objective of this study was to examine the predictive ability of two new obesity indices: a body shape index (ABSI), and a body roundness index (BRI), for the identification of arterial stiffness among Chinese adults, as well as to compare the relative strength of association between the anthropometric indices and arterial stiffness. METHODS: A total of 10,197 subjects were recruited in this cross-sectional study. We tested the association between anthropometric indices (body mass index [BMI], waist circumference [WC], waist-height-ratio [WHtR], ABSI and BRI) and brachial-ankle pulse wave velocity (PWV). Receiver operating characteristic curve and area under curve (AUC) were employed to evaluate the predictive value of the anthropometric indices for identification of arterial stiffness. RESULTS: After adjusting for confounding variables, BRI (linear regression: 0.112; AUC: 0.726; OR: 1.228 for female and linear regression: 0.047; AUC: 0.631; OR: 1.173 for male) exhibited a more powerful predictive ability of arterial stiffness than ABSI (linear regression: 0.110; AUC: 0.674; OR: 1.315 for female and linear regression: 0.058; AUC: 0.610; OR: 1.150 for male) and WC (linear regression: 0.078; AUC: 0.699; logistic regression: negative for female and linear regression: negative; AUC: 0.593; logistic regression: negative for male) while having a similar predictive value to that of WHtR (linear regression: 0.113; AUC: 0.726; OR: 1.228 for female and linear regression: 0.047; AUC: 0.631; OR: 1.185 for male) among both sexes. BMI (linear and logistic regression: negative; AUC: 0.660 for female and 0.568 for male) had the lowest predictive power in both sex categories. The optimal cut-off of WHtR for detecting arterial stiffness was 0.49 in females and 0.53 in males, that of BRI was 3.19 in females and 3.89 in males. CONCLUSIONS: WHtR, ABSI and BRI were significantly associated with arterial stiffness. BRI and WHtR, rather than ABSI, showed superior predictive abilities for arterial stiffness in both sexes.


Assuntos
Adiposidade , Antropometria/métodos , Doenças Cardiovasculares/diagnóstico , Obesidade/diagnóstico , Rigidez Vascular , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice Tornozelo-Braço , Área Sob a Curva , Povo Asiático , Índice de Massa Corporal , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/fisiopatologia , Distribuição de Qui-Quadrado , China , Estudos Transversais , Feminino , Humanos , Modelos Lineares , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/fisiopatologia , Razão de Chances , Valor Preditivo dos Testes , Análise de Onda de Pulso , Curva ROC , Reprodutibilidade dos Testes , Fatores de Risco , Fatores Sexuais , Circunferência da Cintura , Razão Cintura-Estatura , Adulto Jovem
20.
Arch Med Sci ; 12(2): 334-40, 2016 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-27186177

RESUMO

INTRODUCTION: It has been shown that B type natriuretic peptide (BNP) level can indicate cardiovascular disease. However, the association between BNP and metabolic risk factors is unknown. The aim of this study was to investigate the correlation between N-terminal pro-B type natriuretic peptide (NT-proBNP) and metabolic risk factors. MATERIAL AND METHODS: A total of 11,508 subjects were selected from those who underwent health examinations in our hospital. NT-proBNP, waist circumference, blood pressure, fasting plasma glucose and lipid profile were measured. The level of NT-proBNP was measured and classified into four stratifications (BNP ≥ 20 pg/ml, ≥ 40 pg/ml, ≥ 60 pg/ml, and ≥ 80 pg/ml) to analyze the relationship between BNP and metabolic risk factors. RESULTS: B type natriuretic peptide increased gradually with increasing age (p < 0.001). The BNP levels were significantly higher in women than in men (p < 0.001). Multivariate regression analysis showed a positive association between NT-proBNP levels and systolic blood pressure (p < 0.001), fasting plasma glucose (p < 0.05), and total cholesterol (p < 0.001 in women). The NT-proBNP levels were inversely associated with diastolic blood pressure, waist circumference, triglyceride, high-density lipoprotein, and LDL cholesterol. Logistic regression analysis demonstrated a close relationship between NT-proBNP and systolic blood pressure, fasting plasma glucose, and total cholesterol. In the BNP ≥ 60 pg/ml group, odds ratio (OR) values were 1.80, 1.56 and 1.54 (female) and 3.74, 1.59 and 1.51 (male), respectively. In the BNP ≥ 80 pg/ml group, OR values were 2.45, 1.65 and 1.84 (female) and 4.61, 1.66 and 1.75 (male), respectively. CONCLUSIONS: NT-proBNP was independently associated with the main metabolic risk factors (systolic blood pressure, fasting plasma glucose, and total cholesterol). These findings suggest that the combined determination of NT-proBNP and the main metabolic risk factors could be important in assessing cardiovascular morbidity.

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