Burden of disease and risk factors among children under 5 years in China from 1990 to 2019: a perspective of international comparison / 中华预防医学杂志

Based on the Global Burden of Disease study 2019, the standardized mortality rate and disability-adjusted life years (DALYs) rate of children under 5 years old were selected as evaluation indicators to compare and analyze the current situation and differences of disease burden of children under 5 years old between China and other regions from 1990 to 2019. The change trend and difference of disease burden of children under 5 years old in China were analyzed by sexes. From 1990 to 2019, the all-cause standardized mortality rate of children under 5 years old in China decreased from 1 153.81/100 000 to 160.39/100 000, and the all-cause standardized DALY rate decreased from 104 426.40/100 000 to 16 479.01/100 000. In 2019, neonatal preterm birth, congenital heart anomalies and lower respiratory infections ranked the top three disease burden of children under 5 years old in China. Except that the disease burden of neonatal preterm birth was lower than that in North America, they were much higher than that in Western Europe and North America in the same period. The burden of unintentional injury diseases, including pulmonary aspiration and foreign body in airway and drowning, was higher than that in Western Europe and North America. The standardized mortality and DALY rate of the top ten diseases and injuries in boys and girls under 5 years old in China showed a downward trend (P<0.05), and most of them were higher in boys than girls (P<0.05). From 1990 to 2019, the disease burden of children under 5 years old in China decreased significantly. However, compared other regions, it is still necessary to strengthen the prevention and control of neonatal premature birth, birth defects and unintentional injuries, and take different sex-specific interventions to improve the overall health of children.

Application progress of artificial intelligence in diagnosis and risk stratification of coronary artery disease / 医学研究生学报

Artificial Intelligence has been widely applied in cardiovascular diseases. Coronary artery disease, one of the most familiar cardiovascular disease, relies highly on visualized functional tests in its diagnosis and risk stratification, which caters to the advantage of artificial intelligence. Recently, several inspiring results of combining artificial intelligence and related functional tests in diagnosis and risk stratification of coronary artery disease were published worldwide. This review focuses on the application progress of artificial intelligence in diagnosis and risk stratification of coronary artery disease.

Tolerance of rat bone marrow mesenchymal stem cells overexpressing human heme oxygenase 1 to ischemia/hypoxia injury / 中国组织工程研究

BACKGROUND:Under ischemia/hypoxia microenvironment,very low survival rate of transplanted bone marrow mesenchymal stem cells (BMSCs) in the host limits its efficacy in the treatment of acute myocardial infarction.OBJECTIVE:To explore the tolerance of human heme oxygenase 1 (hHO-1) gene modified rat BMSCs to ischemia/hypoxia injury.METHODS:The rat BMSCs were transfected with hHO-1 recombinant adenovirus.Western blot assay was used to determinate the optimal time of hHO-1 protein expression.hHO-1 modified rat BMSCs were cultured in hypoxia and serum-free conditions that simulated ischemia/hypoxia microenvironment in vivo.Cell counting kit-8 and trypan blue staining were performed to detect the survival rate of BMSCs at 12,24,48,72 hours after culture under the ischemia/hypoxia microenvironment.Flow cytometry was used to detect apoptosis in BMSCs at 24 hours after culture under the ischemia/hypoxia microenvironment.RESULTS AND CONCLUSION:The expression of hHO-1 protein was highest at 4 days after transfection.Under the ischemia/hypoxia microenvironment for 12,24,48,72 hours,the survival rates of transfected BMSCs were significantly higher as compared with the untransfected cells (P ＜ 0.05),shown by the cell counting kit-8 and trypan blue staining.In addition,the results from flow cytometry showed that there was a higher survival rate of transfected BMSCs than untransfected cells at 24 hours of culture under the ischemia/hypoxia microenvironment (P ＜ 0.05).To conclude,hHO-1 modified rat BMSCs have stronger tolerance to the ischemia/hvpoxia microenvironment.

Prognostic value of ultra-sensitive pregnancy associated plasma protein-A in patients with acute coronary syndrome / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the prognostic value of ultra-sensitive pregnancy associated plasma protein-A (PAPP-A) level in the early phase of acute coronary syndrome (ACS) attack.</p><p><b>METHODS</b>Patients diagnosed as ACS were enrolled and the level of circulatory PAPP-A was measured within 12 hours after ACS attack. The patients were followed at the time of 1st, 6th, and 12th months post-ACS attack in order to observe the incidence of the cardiovascular adverse events. According to the highest quintile, the patients were divided into 2 groups: high level (≥26.08 μg/L) group and low level (<26.08 μg/L) group, to evaluate the association between the level of PAPP-A and the incidence of the cardiovascular events.</p><p><b>RESULTS</b>Compared with the low level group, the incidence of the composite outcome is significantly increased in the high level group, and the values of OR are 4.76, 4.38, 3.75 for 1st, 6th, 12th months respectively (P=0.000). For myocardial infarction (MI) + cardiac death (CD) the values of OR were 9.81, 6.08, 4.12 (P<0.01). Multivariate logistic regression analysis demonstrates that PAPP-A was an independent risk factor for the cardiovascular adverse events in the early, median, and late phase of ACS (P<0.05).</p><p><b>CONCLUSION</b>In the early phase of ACS attack, the elevation of PAPP-A is an independent risk factor for the occurrence of cardiovascular adverse events.</p>

Comparison of 99Tcm-MIBI myocardial perfusion imaging and delayed enhancement MRI for patients with idiopathic dilated cardiomyopathy / 中华核医学杂志

Objective To compare 99Tcm-MIBI MPI with delayed enhancement MRI (DE-MRI) in patients with idiopathic dilated cardiomyopathy (IDCM). Methods Forty patients with IDCM were included. They underwent both rest 99Tcm-MIBI myocardial perfusion imaging and DE-MRI within 7 days. 99Tcm-MIBI MPI was performed to identify diffuse or segmental abnormal perfusion patterns including reduced or defect perfusion segments. DE-MRI images were divided into 4 categories: no delayed enhancement, septal, subendocardial and transmural delayed enhancement, x2 test was used for data analysis. Results Diffuse and segmental perfusion abnormality on 99Tcm-MIBI MPI were found in 19 (47.5%) and 21 (52.5%)patients respectively, while DE-MRI enhancement was simultaneously found in 5 patients of the former (5/19, 26.3%) and 18 (18/21, 85.7%) of the latter (x2 =14.401, P＜0. 001). For those (n=18) with both segmental perfusion abnormality and DE-MRI enhancement, the number of segments of the 4 DE-MRI respectively. A significant difference was found in the DE-MRI enhancement categories between normal and defect perfusion segments (x2 = 29. 183, P ＜0.001 ) and between reduced and defect perfusion segments as well (x2 =25. 110, P＜0. 001). Conclusions Both diffuse and segmental perfusion abnormalities on 99Tcm-MIBI MPI can be found in patients with IDCM. DE-MRI enhancement is more frequently found in patients with segmental perfusion abnormality.

Effect of angiotensin II on pregnancy-associated plasma protein A and insulin-like growth factor 1 gene expression in human umbilical artery smooth muscle cells / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the effect of angiotensin II (Ang II) on pregnancy-associated plasma protein A (PAPP-A) and insulin-like growth factor 1 (IGF-1) mRNA expressions in human umbilical artery smooth muscle cells (HUVSMCs).</p><p><b>METHODS</b>In the presence or absence of Ox-LDL, HUVSMCs were cultured with Ang II of 10(-5) mol/L for 0, 6, 12, 24, 36, and 48 h, or with Ang II at the concentrations of 10(-7), 10(-6), 10(-5), and 10(-4) mol/L for 24 h, after which the cells were then collected to detect PAPP-A and IGF-1 mRNA expressions in the cells using RT-PCR.</p><p><b>RESULTS</b>At the concentration of 10(-5) mol/L, Ang II showed a time-dependent effect in inducing PAPP-A and IGF-1 mRNA expressions, which began to increase at 12 h of culture and reaching the highest level at 24 h. Ang II also dose-dependently induced PAPP-A and IGF-1 mRNA expressions, and 10(-5) mol/L Ang II induced the highest expression levels of the two genes. Ox-LDL exposure significantly further increased the expression levels of PAPP-A and IGF-1 mRNA in the cells regardless of the Ang II concentration or duration for cell treatment (P<0.05).</p><p><b>CONCLUSION</b>Ang II can time- and dose-dependently induces PAPP-A and IGF-1 mRNA expression in HUVSMCs and is responsible for inducing platelet activity and inflammatory reaction in acute coronary syndromes, and the effects of Ang II can be enhanced by Ox-LDL.</p>

Cigarette smoking and Parkinson's disease: a population based case-control study / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the association with cigarette smoking for Parkinson's disease (PD).</p><p><b>METHODS</b>One hundred and fourteen PD cases and 205 controls matched on gender and race were recruited from ongoing PD prevalence survey and identified at the neurological clinic of Peking Union Medical College Hospital. Face to face questionnaire interview was carried out and data on smoking and alcohol consumption were analyzed in a population-based case control study.</p><p><b>RESULTS</b>With never-smokers as the reference category, we observed reduced risk for PD among ever smokers (OR = 0.49, 95% CI: 0.30 - 0.79) current smokers (OR = 0.44, 95% CI: 0.23 - 0.86) and ex-smokers (OR = 0.54, 95% CI: 0.30 - 0.96). When comparing with non-smokers, the ever smokers stratified by years of smoking had an inverse association with those whose smoking history longer than 20 years (OR = 0.35, 95% CI: 0.18 - 0.70) and an mild protective association with those who smoked less than 20 years (OR = 0.61, 95% CI: 0.35 - 1.07). Those who had quitted smoking for more than 20 years were less likely to have the disease than never smokers, and those who had quitted for less than 20 years were least likely to have PD. Those current smokers were still least likely to have the disease. Significant inverse gradient with pack-day smoker (trend P < 0.05), and the inverse association for cigarette smoking and PD were found not bing confounded by alcohol consumption.</p><p><b>CONCLUSION</b>The inverse association between PD and cigarette smoking and history of cessation was found. Further studies need to provide biochemical evidence on the relation between smoking and its protective effect on PD.</p>