Laser assisted sclerectomy and cataract extraction combined with angle separation in the treatment of angle closure glaucoma / 实用医学杂志

Objective To explore the clinical efficacy of laser-assisted sclerectomy and cataract extraction combined with angle separation in the treatment of angle-closure glaucoma.Methods A total of 162 patients with angle closure glaucoma were selected as the research subjects.Eighty-one patients in the experimental group under-went laser-assisted sclerectomy and cataract extraction combined with angle separation,and another 81 patients in the control group underwent cataract extraction combined with angle separation.The therapeutic effects of two groups of patients were observed.Results The postoperative visual acuity,BCVA,angle width,and corneal endothelial cell count of the experimental group were higher than those of the control group,but the intraocular pressure,central anterior chamber depth,and corneal thickness were all lower than those in the control group.The incidence of adverse reactions in the experimental group(6.2% )was lower than that in the control group(13.6% ).During postop-erative follow-up,there was no further increase in intraocular pressure in the two groups,while the height of filtering blebs in the control group decreased significantly when compared with that in the experimental group.One month after surgery,the BCVA and corneal endothelial cell count in the experimental group were higher than those in the control group(P<0.05),and the corneal thickness was lower than that in the control group(P<0.05),but no statistical significance was found at 3 and 6 months after surgery.The astigmatism in the experimental group was better than that in the control group 3 months after surgery,but there was no statistically significant difference at 1 month and 6 months after surgery.Conclusion Laser-assisted sclerectomy and cataract extraction combined with angle separa-tion are effective and safe in the treatment of angle closure glaucoma.

Detection of immune-related cytokines of bone marrow mesenchymal stem cells in postmenopausal osteoporosis mice by antibody chip and analysis of key differential genes / 中国组织工程研究

BACKGROUND:In recent years,research on the interaction mechanism between the immune system and the skeleton in postmenopausal osteoporosis has become a hot topic.However,the impact of changes in key immune-related cytokine expression on postmenopausal osteoporosis remains unclear and requires further exploration. OBJECTIVE:To investigate the differential expression of immune-related cytokines in bone marrow mesenchymal stem cells of mice with postmenopausal osteoporosis by bioinformatics methods. METHODS:Postmenopausal osteoporosis mouse model was established through ovariectomy.Bone marrow mesenchymal stem cells were obtained by the whole bone marrow adherence method and passaged to passage 2.RayBio L-Series Mouse Antibody Array 308 Glass Slide Kit immune-related factor antibody chip was used to detect the differentially expressed proteins in bone marrow mesenchymal stem cells from ovariectomy and sham-operation mice.Gene ontology,Kyoto Encyclopedia of Genes and Genomes enrichment analysis,and protein-protein interaction network analysis were performed to screen common Hub genes by MCC,EPC,and MNC algorithms. RESULTS AND CONCLUSION:This study identified a total of 68 differentially expressed genes.Gene ontology analysis revealed that the differentially expressed genes were enriched in terms including"immune system processes","extracellular regions",and"signal receptor binding".Kyoto Encyclopedia of Genes and Genomes pathway analysis revealed that the differentially expressed genes were mainly enriched in"cytokine-cytokine receptor interactions","tumor necrosis factor signaling pathways",and"chemokine signaling pathways".Further screening was performed by constructing a protein-protein interaction network analysis of these 68 differentially expressed genes to identify 8 Hub genes.The violin plot and correlation matrix showed that the expression levels of these 8 Hub genes were significantly down-regulated in the ovariectomy group compared to the sham-operation group.These results demonstrated that there was differential expression of immune-related factors in bone marrow mesenchymal stem cells of postmenopausal osteoporosis mice,and key genes involved in cytokine-cytokine receptor interactions,immune system-related processes,and potential targeted signaling pathways and cellular biological processes were identified,providing new promising targets for the diagnosis,treatment,and prevention of postmenopausal osteoporosis.

Human ESC-derived vascular cells promote vascular regeneration in a HIF-1α dependent manner

Hypoxia-inducible factor (HIF-1α), a core transcription factor responding to changes in cellular oxygen levels, is closely associated with a wide range of physiological and pathological conditions. However, its differential impacts on vascular cell types and molecular programs modulating human vascular homeostasis and regeneration remain largely elusive. Here, we applied CRISPR/Cas9-mediated gene editing of human embryonic stem cells and directed differentiation to generate HIF-1α-deficient human vascular cells including vascular endothelial cells, vascular smooth muscle cells, and mesenchymal stem cells (MSCs), as a platform for discovering cell type-specific hypoxia-induced response mechanisms. Through comparative molecular profiling across cell types under normoxic and hypoxic conditions, we provide insight into the indispensable role of HIF-1α in the promotion of ischemic vascular regeneration. We found human MSCs to be the vascular cell type most susceptible to HIF-1α deficiency, and that transcriptional inactivation of ANKZF1, an effector of HIF-1α, impaired pro-angiogenic processes. Altogether, our findings deepen the understanding of HIF-1α in human angiogenesis and support further explorations of novel therapeutic strategies of vascular regeneration against ischemic damage.

Are threat perceptions associated with patient adherence to antibiotics? Insights from a survey regarding antibiotics and antimicrobial resistance among the Singapore public.

BACKGROUND: Public health strategies to improve patient adherence to antibiotics rely mostly on raising awareness of the threat of antimicrobial resistance (AMR) and improving knowledge about antibiotics. We aimed to evaluate how adherence to antibiotics relates to knowledge and the threat perceptions proposed by the Protection Motivation Theory (PMT). METHOD: A cross-sectional online survey was conducted in September-December 2020 with 1002 participants aged 21-70 years in Singapore. Two items, which were reverse coded, evaluated adherence to antibiotics: 'how often do you obtain antibiotics that were left over from the previous prescription' and 'how often did you treat yourself with antibiotics in the past year'. Questions about the PMT-related constructs, and knowledge regarding antibiotics and AMR knowledge were also included. Hierarchical regression models were performed at a 5% significance level. RESULTS: Adherence to antibiotics was associated with knowledge level (ß = 0.073, p < 0.05), education level (ß = - 0.076, p < 0.01), and four of the five PMT constructs: "perceived response cost" (ß = 0.61, p < 0.01), "perceived response efficacy of adherence to antibiotic" (ß = 0.096, p < 0.01), "perceived susceptibility to AMR" (ß = 0.097, p < 0.01), and "perceived severity of AMR" (ß = - 0.069, p < 0.01). Knowledge about AMR, perceived self-efficacy in adhering to antibiotics, age, and sex were not associated with adherence. CONCLUSIONS: In Singapore, patient adherence to antibiotics appear to be driven by the perceived costs of visiting a doctor to obtain antibiotics, followed by perceptions of AMR as a threat and to a lesser extent, knowledge about antibiotics. Public health strategies to mitigate antibiotic misuse should consider these patient barriers to medical care.

Intestinal microbiota and carotid atherosclerosis / 国际脑血管病杂志

The intestinal microbiota participates in maintaining the homeostasis of the intestinal environment, and the imbalance caused by changes in its composition or distribution and activity is called intestinal microbiota imbalance. Carotid atherosclerosis, especially vulnerable carotid plaques, will increase the risk of ischemic stroke. Researches have shown that intestinal microbiota can participate in the occurrence and development of carotid artery plaques through its metabolites as signaling molecules, and targeted drugs that improve intestinal microbiota imbalance are expected to become a new treatment modality for vulnerable carotid artery plaques.

A comparative study on the efficacy and adverse reactions of nituzumab and bevacizumab combined with synchronous ra-diotherapy and chemotherapy in the treatment of locally advanced cervical cancer / 实用肿瘤学杂志

Objective The objective of this study was to compare the short-term efficacy and adverse reactions of nituzum-ab combined with synchronous radiotherapy and chemotherapy and bevacizumab combined with synchronous radiotherapy and chemo-therapy in the treatment of locally advanced cervical cancer.Methods A total of 100 locally advanced cervical cancer patients with pathological type of squamous cell carcinoma were collected from 1 September 2020 to 31 December 2021.They were divided into a control group(synchronous radiotherapy and chemotherapy group),a nituzumab group(nituzumab combined synchronous radiotherapy group)and a bevacizumab group(bevacizumab combined synchronous radiotherapy and chemotherapy group).The total effective rate of short-term treatment,changes in tumor volume before and after treatment,serum squamous cell carcinoma antigen(SCC)levels be-fore and after treatment,and adverse reactions after treatment were compared among patients of the three groups.Results The short-term total effective rates of the Nitro group,Bevar group and control group were 90.3％,87.2％and 60.0％,respectively.The total effective rates of the Nitro and Bevar groups were significantly higher than those of the control group,and the differences were statisti-cally significant(P＜0.001).There was no statistically significant difference in the total effective rates of the Nitro and Bevar groups(P＞0.05);The degree of tumor volume reduction and SCC reduction in the Nituo group and Bevac group after treatment was higher than those in the control group(P＜0.05),and there was no statistically significant difference between the two groups(P＞0.05).The incidence of hypertension in the Bevar group was 33.4％,significantly higher than that in the control group(10.0％)and the Ni-tro group(12.9％)(P＜0.05).There was no statistically significant difference in the incidence of hypertension between the Nito group and the control group(P＞0.05);There was no statistically significant difference in the incidence of adverse reactions among the three groups except hypertension(P＞0.05).Conclusion Nituzumab combined with synchronous radiotherapy and chemothera-py,as well as bevacizumab combined with synchronous radiotherapy and chemotherapy,can improve the short-term efficacy of locally advanced cervical cancer,effectively reduce tumor volume and inhibit the expression of tumor markers,both of which are superior to synchronous radiotherapy and chemotherapy alone.Compared to bevacizumab,nituzumab has fewer adverse reactions.For patients with locally advanced cervical cancer,the combination of nituzumab and concurrent radiotherapy and chemotherapy is more reliable in terms of safety.

Research progress on the bone-marrow sparing intensity-modulated radiotherapy for cervical cancer / 中华放射肿瘤学杂志

The cisplatin-based concurrent chemoradiotherapy (CCRT) has been accepted as a standard treatment for most locally advanced cervical cancer. Compared with radiation therapy alone, CCRT can increase tumor control and survival rates, whereas it also can increase the incidence of acute hematological toxicity, which results in the treatment interruption or delay, and may even affect clinical efficacy and prognosis of patients. Therefore, how to reduce the incidence and severity of acute hematological toxicity induced by CCRT is a hot spot of clinical research. Previous studies have demonstrated that the occurrence of hematological toxicity is associated with the volume and dose of irradiated pelvic bone marrow. With the development of modern radiotherapy technology, precise radiotherapy technologies, such as intensity-modulated radiotherapy (IMRT) and image-guided radiotherapy (IGRT), not only guaranteed the enough dose for tumor, but also realized the protection of normal tissues. This article will focus on the feasibility of bone marrow sparing during CCRT for cervical cancer, and summarize the research progress in recent years.

Nuclear factor-Y mediates pancreatic β-cell compensation by repressing reactive oxygen species-induced apoptosis under metabolic stress / 中华医学杂志(英文版)

BACKGROUND@#Pancreatic β-cells elevate insulin production and secretion through a compensatory mechanism to override insulin resistance under metabolic stress conditions. Deficits in β-cell compensatory capacity result in hyperglycemia and type 2 diabetes (T2D). However, the mechanism in the regulation of β-cell compensative capacity remains elusive. Nuclear factor-Y (NF-Y) is critical for pancreatic islets' homeostasis under physiological conditions, but its role in β-cell compensatory response to insulin resistance in obesity is unclear.@*METHODS@#In this study, using obese ( ob/ob ) mice with an absence of NF-Y subunit A (NF-YA) in β-cells ( ob , Nf-ya βKO) as well as rat insulinoma cell line (INS1)-based models, we determined whether NF-Y-mediated apoptosis makes an essential contribution to β-cell compensation upon metabolic stress.@*RESULTS@#Obese animals had markedly augmented NF-Y expression in pancreatic islets. Deletion of β-cell Nf-ya in obese mice worsened glucose intolerance and resulted in β-cell dysfunction, which was attributable to augmented β-cell apoptosis and reactive oxygen species (ROS). Furthermore, primary pancreatic islets from Nf-ya βKO mice were sensitive to palmitate-induced β-cell apoptosis due to mitochondrial impairment and the attenuated antioxidant response, which resulted in the aggravation of phosphorylated c-Jun N-terminal kinase (JNK) and cleaved caspase-3. These detrimental effects were completely relieved by ROS scavenger. Ultimately, forced overexpression of NF-Y in INS1 β-cell line could rescue palmitate-induced β-cell apoptosis, dysfunction, and mitochondrial impairment.@*CONCLUSION@#Pancreatic NF-Y might be an essential regulator of β-cell compensation under metabolic stress.

Single-nucleus transcriptomics reveals a gatekeeper role for FOXP1 in primate cardiac aging

Aging poses a major risk factor for cardiovascular diseases, the leading cause of death in the aged population. However, the cell type-specific changes underlying cardiac aging are far from being clear. Here, we performed single-nucleus RNA-sequencing analysis of left ventricles from young and aged cynomolgus monkeys to define cell composition changes and transcriptomic alterations across different cell types associated with age. We found that aged cardiomyocytes underwent a dramatic loss in cell numbers and profound fluctuations in transcriptional profiles. Via transcription regulatory network analysis, we identified FOXP1, a core transcription factor in organ development, as a key downregulated factor in aged cardiomyocytes, concomitant with the dysregulation of FOXP1 target genes associated with heart function and cardiac diseases. Consistently, the deficiency of FOXP1 led to hypertrophic and senescent phenotypes in human embryonic stem cell-derived cardiomyocytes. Altogether, our findings depict the cellular and molecular landscape of ventricular aging at the single-cell resolution, and identify drivers for primate cardiac aging and potential targets for intervention against cardiac aging and associated diseases.

Mechanism of white matter hyperintensity involved in hemorrhagic transformation after intravenous thrombolysis / 国际脑血管病杂志

Cerebrovascular disease is a common disease that seriously endangers the health of Chinese people. White matter hyperintensities (WMHs) are the most common in elderly patients. Intravenous thrombolysis is currently the most effective drug treatment for acute ischemic stroke. Hemorrhagic transformation (HT) is the most common serious complication after intravenous thrombolysis in patients with acute ischemic stroke. The destruction of blood-brain barrier in patients of WMHs can increase the risk of HT after intravenous thrombolysis. Matrix metalloproteinases and S100B jointly participate in the destruction process of blood-brain barrier in WMHs and HT after intravenous thrombolysis. At present, the pathogenesis of WHM and HT is not completely clear, and whether mild and moderate WMHs will aggravate HT is still controversial. Nevertheless, WMHs are still the independent risk factor for HT.

Role of blood pressure on stroke-related mortality: a 45-year follow-up study in China / 中华医学杂志(英文版)

BACKGROUND@#Hypertension is associated with stroke-related mortality. However, the long-term association of blood pressure (BP) and the risk of stroke-related mortality and the influence path of BP on stroke-related death remain unknown. The current study aimed to estimate the long-term causal associations between BP and stroke-related mortality and the potential mediating and moderated mediating model of the associations.@*METHODS@#This is a 45-year follow-up cohort study and a total of 1696 subjects were enrolled in 1976 and 1081 participants died by the latest follow-up in 2020. COX proportional hazard model was used to explore the associations of stroke-related death with baseline systolic blood pressure (SBP)/diastolic blood pressure (DBP) categories and BP changes from 1976 to 1994. The mediating and moderated mediating effects were performed to detect the possible influencing path from BP to stroke-related deaths. E value was calculated in the sensitivity analysis.@*RESULTS@#Among 1696 participants, the average age was 44.38 ± 6.10 years, and 1124 were men (66.3%). After a 45-year follow-up, a total of 201 (11.9%) stroke-related deaths occurred. After the adjustment, the COX proportional hazard model showed that among the participants with SBP ≥ 160 mmHg or DBP ≥ 100 mmHg in 1976, the risk of stroke-related death increased by 217.5% (hazard ratio [HR] = 3.175, 95% confidence interval [CI]: 2.297-4.388), and the adjusted HRs were higher in male participants. Among the participants with hypertension in 1976 and 1994, the risk of stroke-related death increased by 110.4% (HR = 2.104, 95% CI: 1.632-2.713), and the adjusted HRs of the BP changes were higher in male participants. Body mass index (BMI) significantly mediated the association of SBP and stroke-related deaths and this mediating effect was moderated by gender.@*CONCLUSIONS@#In a 45-year follow-up, high BP and persistent hypertension are associated with stroke-related death, and these associations were even more pronounced in male participants. The paths of association are mediated by BMI and moderated by gender.

Associations Between Anemia, Cognitive Impairment, and All-Cause Mortality in Oldest-Old Adults: A Prospective Population-Based Cohort Study.

Objective: To evaluate the combined effects of anemia and cognitive function on the risk of all-cause mortality in oldest-old individuals. Design: Prospective population-based cohort study. Setting and Participants: We included 1,212 oldest-old individuals (men, 416; mean age, 93.3 years). Methods: Blood tests, physical examinations, and health questionnaire surveys were conducted in 2012 were used for baseline data. Mortality was assessed in the subsequent 2014 and 2018 survey waves. Cox proportional hazards models were used to evaluate anemia, cognitive impairment, and mortality risk. We used restricted cubic splines to analyze and visualize the association between hemoglobin (Hb) levels and mortality risk. Results: A total of 801 (66.1%) deaths were identified during the 6-year follow-up. We noted a significant association between anemia and mortality (hazard ratio [HR] 1.32, 95% confidence interval [CI] 1.14-1.54) after adjusting for confounding variables. We also observed a dose-response relationship between the severity of anemia and mortality (P < 0.001). In the restricted cubic spline models, Hb levels had a reverse J-shaped association with mortality risk (HR 0.88, 95% CI 0.84-0.93 per 10 g/L-increase in Hb levels below 130 g/L). The reverse J-shaped association persisted in individuals without cognitive impairment (HR 0.88, 95% CI 0.79-0.98 per 10 g/L-increase in Hb levels below 110 g/L). For people with cognitive impairment, Hb levels were inversely associated with mortality risk (HR 0.83, 95% CI 0.78-0.89 per 10 g/L-increase in Hb levels below 150 g/L). People with anemia and cognitive impairment had the highest risk of mortality (HR 2.60, 95% CI 2.06-3.27). Conclusion: Our results indicate that anemia is associated with an increased risk of mortality in oldest-old people. Cognitive impairment modifies the association between Hb levels and mortality.

Extended SIR Prediction of the Epidemics Trend of COVID-19 in Italy and Compared With Hunan, China.

Background: Coronavirus Disease 2019 (COVID-19) is currently a global public health threat. Outside of China, Italy is one of the countries suffering the most with the COVID-19 epidemic. It is important to predict the epidemic trend of the COVID-19 epidemic in Italy to help develop public health strategies. Methods: We used time-series data of COVID-19 from Jan 22 2020 to Apr 02 2020. An infectious disease dynamic extended susceptible-infected-removed (eSIR) model, which covers the effects of different intervention measures in dissimilar periods, was applied to estimate the epidemic trend in Italy. The basic reproductive number was estimated using Markov Chain Monte Carlo methods and presented using the resulting posterior mean and 95% credible interval (CI). Hunan, with a similar total population number to Italy, was used as a comparative item. Results: In the eSIR model, we estimated that the mean of basic reproductive number for COVID-19 was 4.34 (95% CI, 3.04-6.00) in Italy and 3.16 (95% CI, 1.73-5.25) in Hunan. There would be a total of 182 051 infected cases (95%CI:116 114-274 378) under the current country blockade and the endpoint would be Aug 05 in Italy. Conclusion: Italy's current strict measures can efficaciously prevent the further spread of COVID-19 and should be maintained. Necessary strict public health measures should be implemented as soon as possible in other European countries with a high number of COVID-19 cases. The most effective strategy needs to be confirmed in further studies.

Extended SIR prediction of the epidemics trend of COVID-19 in Italy and compared with Hunan, China

BackgroundCoronavirus Disease 2019 (COVID-19) is currently a global public health threat. Outside of China, Italy is one of the most suffering countries with the COVID-19 epidemic. It is important to predict the epidemics trend of COVID-19 epidemic in Italy to help develop public health strategies. MethodsWe used time-series data of COVID-19 from Jan 22,2020 to Mar 16,2020. An infectious disease dynamic extended susceptible-infected-removed (eSIR) model, which covers the effects of different intervention measures in dissimilar periods, was applied to estimate the epidemic trend in Italy. The basic reproductive number was estimated using Markov Chain Monte Carlo methods and presented using the resulting posterior mean and 95% credible interval (CI). Hunan, with similar total number of populations in Italy, was used as a comparative item. ResultsIn the eSIR model, we estimated that the basic reproductive number for COVID-19 was respectively 4.10 (95% CI: 2.15-6.77) in Italy and 3.15(95% CI: 1.71-5.21) in Hunan. There would be totally 30 086 infected cases (95%CI:7920-81 869) under the current country blockade and the endpoint would be Apr 25 (95%CI: Mar 30 to Aug 07) in Italy. If the country blockade is imposed 5 day later, the total number of infected cases would expand the infection scale 1.50 times. ConclusionItalys current strict measures can efficaciously prevent the further spread of COVID-19 and should be maintained. Necessary strict public health measures be implemented as soon as possible in other European countries with a high number of COVID-19 cases. The most effective strategy needs to be confirmed in further studies.

Association between hypertension and carotid plaque in a physical examination population: a cross-sectional study / 中华健康管理学杂志

Objective:This study aimed to assess the association between hypertension and carotid plaque in a research population in China.Methods:The subjects of this study were selected from a population undergoing physical examination at the Fourth Medical Center of PLA General Hospital in 2017. We collected information on physical examination, physiological index test, blood pressure indicators were analyzed according as continuous variables (systolic blood pressure, diastolic blood pressure, and pulse pressure) and categorical variables (hypertension and quartile of blood pressure pulse pressure). A multivariate logistic regression model was conducted to estimate the correlation between blood pressure and carotid plaque development.Results:A total of 716 individuals were surveyed, including 321 men (44.8%) and 395 women (55.2%), and the prevalence of hypertension and carotid plaque were 40.9%(293 cases) and 40.4% (289 cases), respectively. The prevalence of carotid plaque was higher in individuals aged ≥60 years, diabetes mellitus, hypertension and increased waist circumference, systolic blood pressure, fasting blood glucose and glycosylated hemoglobin. The prevalence of carotid plaque increased with the increase of the quartile of blood pressure and pulse pressure ( Ptrend<0.05). After adjustment for age, sex, BMI, waist circumference, and total cholesterol, triglyceride, fasting blood glucose, glycosylated hemoglobin, and hemoglobin levels, every 1 mmHg increased systolic blood pressure increases the risk of carotid plaque by 1.4% (95% CI: 1.005-1.024). Compared with the control group, the risk of carotid plaque increased by 86.8% (95% CI: 1.175-2.946) and 84.8% (95% CI: 1.098-3.110) and 119.6% (95% CI: 1.165-4.142) in the group of normal high blood pressure, grade 1 hypertension and grade 2 and grade 3 hypertension, respectively; compared with the control group, the risk of carotid plaque increased by 56.2% in the group of pulse pressure difference≥60 mmHg (95% CI: 1.049-2.326), in which the risk of carotid plaque increased by 73.3% (95% CI: 1.007-2.983) in women with pulse pressure difference≥60 mmHg (1 mmHg=0.133 kPa); in the control group with pulse pressure difference of four categories Q1 (<42 mmHg), the risk of carotid plaque increased by 92.2% (95% CI: 1.173-3.149) and 95.0% (95% CI: 1.147-3.316) in Q3 (50-61 mmHg) and Q4 (≥62 mmHg), respectively. Conclusion:Increased blood pressure or pulse pressure are associated with increased prevalence of carotid plaque. Prevention of elevated blood pressure and pulse pressure might be one of the effective precautions for the prevention of carotid plaque development.

Association between hypertension and carotid plaque in a physical examination population: a cross-sectional study / 中华健康管理学杂志

Objective@#This study aimed to assess the association between hypertension and carotid plaque in a research population in China.@*Methods@#The subjects of this study were selected from a population undergoing physical examination at the Fourth Medical Center of PLA General Hospital in 2017. We collected information on physical examination, physiological index test, blood pressure indicators were analyzed according as continuous variables (systolic blood pressure, diastolic blood pressure, and pulse pressure) and categorical variables (hypertension and quartile of blood pressure pulse pressure). A multivariate logistic regression model was conducted to estimate the correlation between blood pressure and carotid plaque development.@*Results@#A total of 716 individuals were surveyed, including 321 men (44.8%) and 395 women (55.2%), and the prevalence of hypertension and carotid plaque were 40.9%(293 cases) and 40.4% (289 cases), respectively. The prevalence of carotid plaque was higher in individuals aged ≥60 years, diabetes mellitus, hypertension and increased waist circumference, systolic blood pressure, fasting blood glucose and glycosylated hemoglobin. The prevalence of carotid plaque increased with the increase of the quartile of blood pressure and pulse pressure (Ptrend<0.05). After adjustment for age, sex, BMI, waist circumference, and total cholesterol, triglyceride, fasting blood glucose, glycosylated hemoglobin, and hemoglobin levels, every 1 mmHg increased systolic blood pressure increases the risk of carotid plaque by 1.4% (95%CI: 1.005-1.024). Compared with the control group, the risk of carotid plaque increased by 86.8% (95%CI: 1.175-2.946) and 84.8% (95%CI: 1.098-3.110) and 119.6% (95%CI: 1.165-4.142) in the group of normal high blood pressure, grade 1 hypertension and grade 2 and grade 3 hypertension, respectively; compared with the control group, the risk of carotid plaque increased by 56.2% in the group of pulse pressure difference≥60 mmHg (95%CI: 1.049-2.326), in which the risk of carotid plaque increased by 73.3% (95%CI: 1.007-2.983) in women with pulse pressure difference≥60 mmHg (1 mmHg=0.133 kPa); in the control group with pulse pressure difference of four categories Q1 (<42 mmHg), the risk of carotid plaque increased by 92.2% (95%CI: 1.173-3.149) and 95.0% (95%CI: 1.147-3.316) in Q3 (50-61 mmHg) and Q4 (≥62 mmHg), respectively.@*Conclusion@#Increased blood pressure or pulse pressure are associated with increased prevalence of carotid plaque. Prevention of elevated blood pressure and pulse pressure might be one of the effective precautions for the prevention of carotid plaque development.

Application of precision nursing emergency management in emergency rescue of emergencies / 中国实用护理杂志

Objective:To explore the management effectiveness of emergency treatment management for emergencies.Methods:To establish precision nursing emergency management system, the response time, triage accuracy, receiving time, information delivery time and rescue success rate were compared before and after the application of the system.Results:After the application of the precision nursing emergency management, the emergency response time was shortened from (6.47±1.25) min to (3.56±1.38) min, and the time for admission and triage reduced from (5.15±0.54) min to (2.84±0.49) min. The time was shortened from (92.45±10.49) minutes to (72.35±13.20) minutes, and the time for information submission was shortened from (121.47±58.41) minutes to (65.23±10.72) minutes; the accuracy of triage diagnosis increased from 96.85% (277/286) to 99.27%(271/273). The rescue success rate increased from 96.15%(275/286) to 98.90%(270/273), and the differences were statistically significant ( t value was -2.920-5.587, χ2 value was 4.220, 4.317, P<0.05). Conclusions:The application of precision nursing emergency management in emergencies can improve the emergency response rate and overall level of nursing staff and ensure the safety of patients.

Association between atherogenic index of plasma and renal function impairment in patients with gout / 中华内分泌代谢杂志

Objective To study the relationship between atherogenic index of plasma ( AIP ) and renal impairment in male patients with gout. Methods A retrospective analysis of 821 male subjects was conducted to measure the relevant biochemical indicators and to calculate the AIP, endogenous creatinine-clearance rate (Ccr), and estimated glomerular filtration rate ( eGFR) . EpiData 3.1 software was used for data entry, SPSS21.0 was used for statistical analysis, and GraphPad Prism 6. 0 software was used for charts. Results Compared with control group, AIP, serum uric acid, triglyceride in gout group were significantly higher (all P<0.01), while eGFR and high density lipoprotein-cholesterol were significantly lower ( both P<0.05) . The composition ratio of renal function impairment in gout group was significantly higher (P<0.01). With the increase of AIP level, eGFR level decreased and serum creatinine level increased, but the overall difference was not statistically significant ( P>0.05) , while Ccr and serum uric acid levels gradually increased (P<0.05). Logistic regression analysis after adjusting for various confounding factors showed that AIP, triacylglycerol, and serum uric acid were risk factors for renal function damage in patients with gout (P<0.05), the relevant risk were 7.030, 1.291, 1.004 respectively, After adjusting corfounding factors, the associafions betwees triglyceride, serum uric acid and with renal function injury risk changed little, while AIP show more evident, the OR value increased from 2.629 to 6.265 and 7.030. Conclusions (1)AIP is closely related to the renal function damage of patients with gout. After adjusting various confounding factors, AIP can better reflect the renal function damage than other indicators, which is of great significance to predict the renal function damage of patients with gout. ( 2) That patients with gout with high uric acid level may suffer from renal atherosclerosis and have a higher risk of renal impairment. ( 3) Dynamic observation of AIP in gout patients is helpful for early identification of the risk of renal failure in such patients.

Association between atherogenic index of plasma and renal function impairment in patients with gout / 中华内分泌代谢杂志

Objective@#To study the relationship between atherogenic index of plasma (AIP)and renal impairment in male patients with gout.@*Methods@#A retrospective analysis of 821 male subjects was conducted to measure the relevant biochemical indicators and to calculate the AIP, endogenous creatinine-clearance rate (Ccr), and estimated glomerular filtration rate (eGFR). EpiData 3.1 software was used for data entry, SPSS21.0 was used for statistical analysis, and GraphPad Prism 6.0 software was used for charts.@*Results@#Compared with control group, AIP, serum uric acid, triglyceride in gout group were significantly higher (all P<0.01), while eGFR and high density lipoprotein-cholesterol were significantly lower (both P<0.05). The composition ratio of renal function impairment in gout group was significantly higher (P<0.01). With the increase of AIP level, eGFR level decreased and serum creatinine level increased, but the overall difference was not statistically significant (P>0.05), while Ccr and serum uric acid levels gradually increased (P<0.05). Logistic regression analysis after adjusting for various confounding factors showed that AIP, triglyceride, and serum uric acid were risk factors for renal function damage in patients with gout (P<0.05), the relevant risk were 7.030, 1.291, 1.004 respectively. After adjusting confounding factors, the associations between triglyceride, serum uric acid and renal function injury risk changed little, while AIP showed more evident, the OR value increased from 2.629 to 6.265 and 7.030.@*Conclusions@#(1)AIP is closely related to the renal function damage of patients with gout. After adjusting various confounding factors, AIP can better reflect the renal function damage than other indicators, which is of great significance to predict the renal function damage of patients with gout. (2)That patients with gout with high uric acid level may suffer from renal atherosclerosis and have a higher risk of renal impairment. (3)Dynamic observation of AIP in gout patients is helpful for early identification of the risk of renal failure in such patients.

Healthy aging and the progress in the research of geriatric epidemiology / 中华流行病学杂志

In recent years,great effort has been made in the promotion of healthy aging in China.The core indicator of a country's healthy aging is the level of body health,mental health,social adaptation and quality of life (QOL) of the elderly.This paper summarizes the concept and the progress in the research of healthy ageing and the leading role of geriatric epidemiology.Articles on column "Pay attention to function and health of elderly" analyze the basic conditions affecting the QOL of the elderly,such as disability,comorbidity and Alzheimer disease prevalence,in the elderly in China and related risk factors to describe the severity of different health problems affecting the QOL of the elderly in different areas of China and provide essential data for developing effective health approaches and conducting targeted intervention foe healthy aging.