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ObjectiveTo evaluate the efficacy of three screening questionnaires for COPD in the community residents of Songjiang District, Shanghai, and to provide a basis for selecting COPD screening questionnaire and process that are more suitable. MethodsCommunity residents aged 40 years or over were randomly selected from the Shanghai Suburban Adult Cohort and Biobank for the study with screening questionnaires and spirometry. Questionnaires included the COPD screening questionnaire (COPD-SQ), the COPD population screener (COPD-PS) and the revised COPD diagnostic questionnaire (revised-CDQ). Evaluation of the efficacy of these questionnaires was based on the area under the receiver operating characteristic curve (AUC) of the subjects. DeLong test was used to compare the accuracy of different questionnaires; Z test was used to compare the accuracy of different cut-off values for the same questionnaire. ResultsAmong 3 184 community residents, a total of 259 (8.1%) COPD patients were screened by spirometry. AUC values of these 3 screening questionnaires were >0.7 indicating that they were reliable COPD screening tools. The sensitivity and specificity of the questionnaires at the recommended cut-off values were COPD-SQ (63.7% and 72.2%), COPD-PS (12.0% and 96.1%), and revised CDQ (78.8% and 52.7%), with the COPD-SQ having the highest screening accuracy (AUC=0.754). The optimal and recommended cut-off values for the three questionnaires differed in this population, but the difference in accuracy was statistically significant only for COPD-PS. The optimal cut-off values for the three questionnaires differed between male and female, and the sensitivity and accuracy of COPD-SQ and COPD-PS improved when lower cut-off values were used for women. The AUC was greater when two questionnaires were utilized simultaneously for screening, but the differences were not statistically significant. ConclusionThe COPD-SQ is recommended for primary COPD screening; a lower cut-off value for women should be considered. The COPD screening questionnaire needs to be further improved for the early diagnosis and treatment of COPD patients.
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Background With the aging of China's population, cognitive impairment in the elderly is receiving increasing public attention. Screening and intervention of people with mild cognitive impairment (MCI) are of great significance to prevent and reduce the occurrence of cognitive impairment. Objective To understand the prevalence and explore potential influencing factors of MCI in the elderly in Songjiang District, Shanghai, and to provide scientific basis for promoting early screening of cognitive impairment and precise intervention of MCI in the elderly in this area. Methods A cross-sectional study design was adopted. From August to October 2022, using multi-stage random sampling, 1800 elderly residents aged 60 years and above were screened for cognitive impairment in 6 neighborhood/village committees in 6 towns in Songjiang District. The survey questionnaires included a sociodemographic questionnaire, a health status and lifestyle questionnaire, the Instrumental Activities of Daily Living (IADL), the Patient Health Questionnaire (PHQ-9), and the Mini-Mental State Examination (MMSE). Prevalence rates of MCI among the elderly by selected social demographic characteristics, health status, and lifestyle were estimated, and potential influencing factors of MCI were evaluated by binary logistic regression. Results A total of 209 elderly residents with MCI and 1591 healthy elderly residents were detected, and the prevalence of MCI in the elderly aged 60 and above was 11.6% in Songjiang District. Being physically active (OR=0.556, 95%CI: 0.399, 0.774) reduced the risk of MCI. Illiteracy (OR=1.810, 95%CI: 1.239, 2.644), primary school education level (OR=3.454, 95%CI: 2.342, 5.092), non-participation in social activities (OR=1.945, 95%CI: 1.360, 2.781), IADL damaged (OR=3.173, 95%CI: 2.137, 4.712), and depression (OR=1.957, 95%CI: 1.112, 3.443) increased the risk of MCI (P<0.05). Conclusion The prevalence of MCI among the elderly in Songjiang District is lower than the national average. Educational level, physical activity, participation in social activities, IADL, and depression may be the influencing factors of MCI in the elderly. It is recommended to carry out early screening, early detection, and early intervention for cognitive impairment in the elderly. Improving involvement in physical exercise and increasing participation in social activities are encouraged. Special attention should be paid to the needs of vulnerable groups such as low education level and disabled elderly during a community MCI intervention program.
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ObjectivesTo investigate characteristics and influencing factors of short-term variation of systolic blood pressure of community hypertension patients in Shanghai. MethodsBased on the standardized blood pressure measurement data of hypertensive patients in Shanghai (2018‒2021) and the noninfectious chronic disease management system database, coefficient of variation of systolic blood pressure (CV_S) was described and the influencing factors were analyzed. ResultsAmong 112 680 community hypertension patients, males accounted for 46.87% with a median age of 69 years. CV_S was 0.038 6 ± 0.035 0. Generalized linear model analysis showed the following influencing factors of CV_S: gender, females were higher than males, B=0.032, P<0.001; age group, 60‒69 years, 70‒79 years old group, and ≥80 years groups were all higher than <50 years group, B=0.042, 0.056, and 0.074 respectively with P values of 0.020, 0.002, and <0.001 respectively; smoking, smoking cessation and smoking everyday was lower than never smoking, B=-0.032 and-0.028 respectively with P values of 0.023 and 0.007 respectively; systolic blood pressure, 140‒159 mmHg group, 160‒179 mmHg group, and ≥180 mmHg group were lower then <140 mmHg group, B=-0.039, -0.091, and -0.175 respectively with P values all <0.001; and measurement season, autumn was lower than spring, (B=-0.056, P<0.001). The paired test showed that CV_S calculated from the three measurements was 1.04% higher than that calculated from the two measurements (P<0.001). ConclusionThe coefficient of variation of systolic blood pressure of community hypertension patients in Shanghai has large variation, and was influenced by many factors.
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Objective:To observe any effect of electroacupuncture applied to the Jialianquan points in treating post-stroke oropharyngeal dysphagia.Methods:Forty-five stroke survivors with oropharyngeal dysphagia were randomly divided into an electroacupuncture group ( n=15), a neuromuscular electrical stimulation group ( n=15) and a control group ( n=15). All groups received 30 minutes of routine swallowing function training 5 times a week for 3 weeks. The electroacupuncture group was additionally provided with 30 minutes of electroacupuncture applied to the Jialianquan (CV23) points, and the neuromuscular electrical stimulation group instead received 30 minutes of neuromuscular electrical stimulation over the bilateral submental muscles. Videofluoroscopic swallowing studies were performed before and after the 3 weeks of treatment. Standardized swallowing assessment was conducted producing functional oral intake scale ratings, modified barium swallow impairment profiles and the penetration-aspiration scale scores. Surface electromyography was also employed to evaluate submental muscle functioning through measuring the swallowing time, average EMG (AEMG) value and peak amplitude. Results:After the treatment, significant improvement was observed in all of the evaluations with both groups, but the average scores were significantly better in the electroacupuncture and neuromuscular electrical stimulation groups compared with the control group and significantly better in the electroacupuncture group than in the neuromuscular electrical stimulation group.Conclusion:Electroacupuncture at the Jialianquan point can significantly improve the swallowing of stroke survivors with oropharyngeal dysphagia. It is more effective than neuromuscular electric stimulation.
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ObjectiveTo determine the epidemiological characteristics and risk factors of hypertension in residents in Songjiang District of Shanghai, and provide evidence for prevention and control of hypertension. MethodsLocal residents aged between 20 and 74 years were recruited from four towns in Songjiang District from 2016 to 2017 by using a multistage sampling strategy. Questionnaire surveys were conducted, and then physical examination, blood pressure measurement, glucose test and lipid test were performed. The data was analyzed by SPSS 16.0 software. Chi-square test was used to compare the differences in the prevalence of hypertension in residents, stratified by demographics and health conditions. Risk factors were determined by multivariate logistic regression. ResultsAmong 35 759 residents with a median age of 58 years and the proportion of male being 40.67%, crude prevalence of hypertension was 54.24% (19 395/35 759) and standardized prevalence was 31.69%. In the hypertensive patients, proportion of hypertension awareness was 61.09%, with 63.67% in male and 59.10% in female. Proportion of receiving treatment was 49.00%, with 50.91% in male and 47.51% in female. Furthermore, in the hypertensive patients with treatment, proportion of effectively controlling hypertension was 40.50%, with 44.46% in male and 37.21% in female. Multivariate logistic regression showed that male (OR=1.272), senior age (40‒59 years old: OR=4.353, 60‒74 years old: OR=9.802), overweight (OR=1.823), obesity (OR=3.070), central obesity (OR=1.380), diabetes (OR=1.923), dyslipidemia (OR=1.452), and drinking (OR=1.338) were risk factors associated with hypertension. ConclusionPrevalence of hypertension is high, while the proportions of receiving treatment and effective control remain low in residents in Songjiang District. It warrants strengthening prevention and control of hypertension in targeted and young residents.
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ObjectiveTo investigate the prevalence and influencing factors of diabetes mellitus among community population in Songjiang District of Shanghai, and to provide scientific basis for prevention and treatment of diabetes mellitus. MethodsBased on the baseline data of the Shanghai Suburban Adult Cohort (2016‒2017) and local medication database, the prevalence of diabetes in the cohort was described, and the influencing factors for the prevalence of diabetes in different genders were analyzed. ResultsAmong 35 928 participants, males accounted for 40.57%, and the median age was 58 years old. There were 5 342 diabetic patients with a crude prevalence rate of 14.87% and the standardized prevalence rate of diabetes mellitus was 7.57%. The prevalence rate of diabetes in males (15.81%) was significantly higher than that in females (14.23%, P<0.001). Multivariate logistic regression analysis showed that the following factors were associated with high risk of diabetes mellitus in males: 40‒59 age group (OR=7.111,95%CI:4.900‒10.320), 60‒74 age group (OR=8.994,95%CI:6.154‒13.144), family history of diabetes (OR=3.369,95%CI:2.963‒3.83), overweight (OR=1.272,95%CI:1.123‒1.439), obesity (OR=1.912,95%CI:1.623‒2.252), hypertension (OR=1.685,95%CI:1.512‒1.877), and dyslipidemia (OR=1.396,95%CI:1.263‒1.542). In females, the high risk of diabetes was associated with: 40‒59 age group (OR=2.718,95%CI:1.838‒4.02), 60‒74 age group (OR=3.517,95%CI:2.34‒5.286), family history of diabetes (OR=3.071,95%CI:2.761‒3.416), overweight (OR=1.254,95%CI:1.125‒1.398), obesity (OR=2.018,95%CI:1.764‒2.308), central obesity (OR=1.515,95%CI:1.357‒1.692), hypertension (OR=2.128,95%CI:1.929‒2.347), dyslipidemia (OR=1.506,95%CI:1.379‒1.644), exercise (OR=1.241,95%CI:1.137‒1.355), and menopause (OR=1.967,95%CI:1.693‒2.286). ConclusionThe prevalence rate of diabetes is high in Shanghai, and the related factors are different in different gender groups.
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@#To investigate the therapeutic effect of oral vaccine based on glutamate decarboxylase 65 (GAD65) on streptozotocin (STZ) -induced type 1 diabetic (T1D) mice, the mice model of T1D was established by intraperitoneal injection of low dose multiple STZ. CTB-GADIII encapsulated with calcium alginate (Ca-Alg-GADIII) was formulated using crosslinking technology with sodium alginate and calcium chloride, and was administered intragastric to T1D mice once a week for 5 consecutive weeks.Blood glucose and body weight of the mice were recorded weekly, and pharmacodynamics against T1D of Ca-Alg-GADIII were investigated by glucose tolerance assay (OGTT) and pancreatic histopathological analysis. The levels of glutamic acid decarboxylase antibody (GADA), and insulin autoantibody (IAA) and related cytokines (IL-4, IFN-γ, TGF-β1) in serum were detected by ELISA, and the CD4 + T cell subsets were detected by flow cytometry. The immunological mechanism of oral vaccine against T1D was preliminarily discussed. The results showed that the disease-related indicators improved in immunized mice: fasting blood glucose improved, glucose tolerance and insulin secretion increased, pancreatic injury decreased, autoantibodies like GADA and IAA titers significantly decreased, and CD4 + T cell immune balance in mesenteric lymph node (MLN) and pancreatic lymph node (PLN) improved to some extent. The results suggest that oral vaccine Ca-Alg-GADIII has some therapeutic effect on STZ-induced T1D mice.
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Objective To examine the clinical effect of simultaneous intervention for heart and lung on chronic obstructive pulmonary disease (COPD) of stationary phase combined with stable angina pectoris with Qi deficiencyblood stasis-phlegm blockade syndrome.Methods Ninety-six COPD stationary phase combined with stable angina pectoris patients with Qi deficiency-blood stasis-phlegm blockade syndrome were randomized into control group,Juhong [Exocarpium Citri Rubrum] tablet group,the Tongxinluo (通心络) group and the Ju&Tong group,24 cases in each group.The control group was given western medicine routine therapy.In addition to the treatment of the control group,Juhong tablet 3.6 g was given to the Juhong tablet group orally,twice each day;Tongxinluo capsule 1.04 g was given to the Tongxinluo group orally,three times each day;Juhong tablet and Tongxinluo capsule were given to the Ju&Tong group.Each group was treated for 8 weeks.The following intems were compared before and after treatment including the scores of cough,cough up phlegm,dyspnea and St.George's Respiratory Questionnaire (SGRQ),anginal attacks,durante dolors,nitroglycerin consumption,pulmonary function [including forced expiratory volume in one second (FEV1) and forced vital capacity (FVC)],as well as the levels of serum C reactive protein (CRP),interleukin 1β (IL-1β) and interleukin 10 (IL-10).Results After treatment,the scores of cough,cough up phlegm,dyspnea and SGRQ decreased in the Juhong tablet group,the Tongxinluo group and the Ju&Tong group.FEV1 and FVC increased.Anginal attacks,durante dolors,nitroglycerin consumption,as well as the levels of serum CRP,IL-1 βand IL-10 decreased.Moreover,the effect of certain indexes in the Ju&Tong group was superior to those in the Juhong tablet group and the Tongxinluo group (P < 0.05 or P < 0.01).Conclusion Simultaneous intervention for heart and lung might improve clinical symptoms and pulmonary function of COPD stationary phase combined with stable angina pectoris with Qi deficiency-blood stasis-phlegm blockade syndrome patients.Inhibiting chronic persistent inflammation might be one of the important mechanisms.
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[ ABSTRACT] AIM:To investigate the damage in human umbilical vein endothelial cells ( HUVECs) induced by recombinant soluble human CD40 ligand (rshCD40L).METHODS:The cultured HUVECs were treated with rshCD40L for 12 h.The survival activity of the HUVECs was observed by MTS assay.The expression of E-selectin, intercellular ad-hesion molecule (ICAM)-1, tissue factor (TF) and tissue factor pathway inhibitor (TFPI) was measured by ELISA.The activity of superoxide dismutase ( SOD) and the level of malondialdehyde ( MDA) were detected by the methods of thibabi-turic acid (TBA) .RESULTS:Compared with normal group, different concentrations of rshCD40L (0.5, 1, 2, 3 mg/L) had no obvious effect on the survival activity of the HUVECs (P>0.05).rshCD40L at concentration of 0.5 mg/L promo-ted the secretion of E-selectin, sICAM-1, TF and TFPI in the HUVECs (P<0.01).rshCD40L at concentration of 0.5 mg/L also increased MDA content and reduced the activity of SOD in the HUVECs (P<0.05).CONCLUSION:0.5~3mg/L rshCD40L has no obvious effect on endothelial cell survival, but already causes endothelial dysfunction by increas-ing endothelial inflammation and exogenous coagulation reaction, inducing lipid peroxides injury and reducing antioxidant capacity.
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This study was to determine the correlation between endothelial function and neuro-endocrine-immune (NEI) network through observing the changes of NEI network under the different endothelial dysfunction models. Three endothelial dysfunction models were established in male Wistar rats after exposure to homocysteine (Hcy), high fat diet (HFD) and Hcy+HFD. The results showed that there was endothelial dysfunction in all three models with varying degrees. However, the expression of NEI network was totally different. Interestingly, treatment with simvastatin was able to improve vascular endothelial function and restored the imbalance of the NEI network, observed in the Hcy+HFD group. The results indicated that NEI network may have a strong association with endothelial function, and this relationship can be used to distinguish different risk factors and evaluate drug effects.
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Animales , Humanos , Masculino , Ratas , Dieta Alta en Grasa , Sistema Endocrino , Homocisteína , Sistema Inmunológico , Sistema Nervioso , Ratas Wistar , Factores de Riesgo , SimvastatinaRESUMEN
Objective To optimize the therapeutic dose and time window of picroside Ⅱ in treating cerebral ischemic injury in rats by orthogonal test. Methods The forebrain ischemia models were established by bilateral common carotid artery occlusion (BCCAO) method. The successful models were randomly grouped according to orthogonal experimental design and treated by injecting picroside Ⅱintraperitoneally at different ischemic time with different doses. The concentrations of MDA, NO and H2O2 in serum and brain tissue were respectively determined by thiobarbituric acid assay, nitratase reductase assay and chemiluminescence immunoassay. Results The optimized composition of the therapeutic dose and time window of picroside Ⅱ in cerebral ischemic injury were ischemia 1.5 h with 10 mg/kg, 1.5 h with 20 mg/kg and 1.5 h with 10 mg/kg body weight according to the expressions of MDA, NO and H2O2 in serum, and ischemia 1.5 h with 10 mg/kg, 1.5 h with 20 mg/kg and 1.5 h with 20 mg/kg body weight according to the expressions of MDA, NO and H2O2 in brain tissue. Conclusion On the basis of the principle of lowest therapeutic dose with longest time window, the optimized composition of the therapeutic dose and time window in cerebral ischemic injury is injecting picroside Ⅱ intraperitoneally with 10-20 mg/kg body weight at ischemia 1.5 h.
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Objective To explore the effects of different swimming training intensities on the expression of glial fibrillary acidic protein (GFAP) and basic fibroblast growth factor (bFGF) around a cerebral infarct. Methods The intraluminal thread method was applied to establish left middle cerebral artery occlusion (MCAO) for 2 h in 180 rats.They were then reperfused for 3,7 and 14 days.The rats were divided into four groups ( Ⅰ -Ⅳ) according to the intensity of the swimming training they were required to do,plus a control group and a sham operation group.The rats in training group Ⅰ swam 5 min,once daily; group Ⅱ trained for 5 min twice daily; group Ⅲ swam for 10 min once daily and group Ⅳ trained for 10 min twice daily.Neurological function was evaluated using Bederson's test,the cerebral infarction volume was calculated by tripeny tetrazolium chloride (TTC) staining.The expression of GFAP and bFGF around the infract were detected using immunohistochemistry.ResultsThe average Bederson scores of the exercise training groups on the 7th and 14th days were significantly lower than that of the control group.The infarction volumes of each exercise training group were significantly lower than that of the control group,and cells positive for GFAP and bFGF in all training groups were significantly more numerous on the 3th,7th and 14th day after MCAO,especially in training group Ⅳ.Conclusion Intensive exercise can adjust the expression of GFAP and bFGF and promote the repair of brain damage after cerebral ischemia and reperfusion.
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To investigate the effects of active ingredients of Plastrum Testudinis (PT) on serum deprivation-induced apoptosis of epidermal stem cells (ESCs).
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AIM: To observe the different changes of neuroendocrine systems between the state of sport fatigue and poverty of movement. METHODS: 60 male Wistar rats were randomly divided into three groups: normal control group, sport fatigue model group and poverty of movement model group (20 rats in each group). The sport fatigue model was established by the method of combining basal diet and loaded swimming during 2 weeks, whereas the method of restricted activities was used to establish the poverty of movement model with total experimental time of 10 weeks. By the end of experiment, the climbing pole time was determined. The contents of hypothalamus thyrotropin releasing hormone (TRH), and serum norepinephrine (NE) and epinephrine (E) in rats with different treatments were determined by ELISA. In addition, the changes of hypothalamus corticotropin release hormone (CRH), pituitary adrenocorticotropic hormone (ACTH) and thyroid stimulating hormone (TSH), and serum corticosterone (CORT), triiodothyronine (T_3), tetraiodothyronine (T_4) were determined by radioimmunoassay to evaluate the functions of adrenergic nerve-adrenomedullin system, hypothalamo-pituitary-adrenal (HPA) axis and hypothalamo-pituitary-thyroid (HPT) axis. RESULTS: Compared to control group, the climbing pole time of the animals was obviously decreased in two model group. The adrenergic nerve-adrenomedullin system and HPA axis were inhibited in sport fatigue model rats, but HPT axis was unchanged. Interestingly, the HPA axis was hyperfunctional and HPT axis was inhibited in poverty of movement model rats. However, no change in the adrenergic nerve-adrenomedullin system was observed. CONCLUSION: Sport fatigue and poverty of movement all affect neuroendocrine system and lead to the adjustment mechanism imbalance, but the target and tendency are different.
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Aim To study the regulating effect of Tongxinluo on HIF-1α,VEGF that Generated by the Human brain microvascular endothelial cells induced by β-amyloid 1-42.Methods Human brain microvascular endothelial cells were pre-incubated for 4h by Tongxinluo, then injured by β-amyloid 1-42.VEGF protein and HIF-1α were detected by Western blot.Result In the Aβ treated Human brain microvascular endothelial cells,viable cells decreased.The expression of VEGF was Reduced, and HIF-1α elevated. After the cells were treated with Tongxinluo, all the above indexes were improved.Conclusion Tongxinluo can enhance the VEGF protein expressions by the HIF-1α and protect the Human brain microvascular endothelial cells.
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OBJECTIVE: To explore the pathogenesis characteristics of variant angina pectoris (VAP) by extracting its syndrome elements and analyzing the combination and distribution regularity of the syndrome elements. METHODS: One hundred and seventy-five case files of VAP patients were collected. The extraction of syndrome elements and symptom contribution to syndrome was completed by the partition method of complex system based on entropy theory. Diagnostic threshold was established by receiver operator characteristic curve. According to the results diagnosed by diagnostic criteria for syndrome element with quantitation, the combination and distribution regularity of the syndrome elements in patients with VAP was analyzed. RESULTS: The basic syndrome elements in the patients with VAP were qi deficiency, qi stagnation, blood stasis, phlegm turbidity, phlegm-heat, stagnation-heat, yin deficiency and yang deficiency syndromes. It showed that the combination types of syndrome elements could be made up of one syndrome, two, three, four or more than four syndromes. Qi deficiency, yin deficiency, qi stagnation, blood stasis and phlegm turbidity syndromes had the higher frequency than other syndrome elements in the patients with VAP. CONCLUSION: The partition method of complex system based on entropy theory can be used in extracting the syndrome elements of the patients with VAP. It is found that VAP has complicated pathogenesis according to the combination and distribution regularity of syndrome elements. Qi deficiency, qi stagnation, blood stasis, phlegm turbidity and yin deficiency syndromes are the main syndrome elements.
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0.05). But there have extremely significant between the normal and abnormal groups.(P0.05) , but the stunting group was extremely significant with the other three groups (P
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The pathogenesy of diabetic peripheral neuropathy(DPN) is approached according to collaterals diseases theory in this study,indicated that defi ciency of both vital energy and yin is the chief pathologic foundation and obstruction of collaterals by blood stasis and phlegm is the critical element in DPN.Furthermore,highlight of differentiation of symptoms and signs,therapeutic principle and diagnosis and treatment based on differentiation are illuminated.This study has supplied a new idea for precaution and treatment of DPN.
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Through the combination of the traditional Chinese medicine and the no-linear science of complex system to approach the effective regularity of traditional Chinese medicine.To raise "Cheng Zhi Tiao Ping"—main control mechanism of life motion self-adapation and homeostasis state and compensatory adjustment of pathological injury,curing disease and the effective mechanism of integrate adjustment,which reflect the research experiment and clinical in curing vascular disease by removing obstruction in collaterals,display the target dynamic characteristic of health tendency.
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Objective:To investigate the vascular protective mechanism of different levels of herbs through detecting activity of HO-1/CO system in arterial tissues of rats with stagnancy of collateral-Qi in deficiency condition.Methods:Healthy male Wistar rats of cleanness level were randomly divided into control group,stagnancy of collateral-Qi in a deficiency condition group(SCQDC group),Renshen group,Shuangshen group,and Tongxinluo group.The ultrastructure of endothelium cells in the artery was observed.RT-PCR,Western blot,and immunohistochemical approaches were used to detect JNK,c-Jun mRNA and albumen expression in the arterial tissues.Meanwhile,the content of CO in the arterial tissue was also detected.Results:In SCQDC group,the counts of pinocytotic cells and microvili on the free surface of vascular endothelial cells were significantly decreased;most crests of mitochondria fused with membrane,some even disappeared;serious degranulation was observed in the rough surfaced endoplasmic reticulum.Immunohistochemistry showed that the HO-1 positive signals in the arterial histiocyte weakened significantly compared with the control group.The HO-1 expression was increased in the 3 treatment groups.Compared with control group,SCQDC group had decreased HO-1 mRNA and albumen expression(P