Prevalence and risk evaluation of cardiovascular disease in the newly diagnosed prostate cancer population in China: A nationwide, multi-center, population-based cross-sectional study.

BACKGROUND: Cardiovascular disease (CVD) has emerged as the leading cause of death from prostate cancer (PCa) in recent decades, bringing a great disease burden worldwide. Men with preexisting CVD have an increased risk for major adverse cardiovascular events when treated with androgen deprivation therapy (ADT). The present study was aimed to explore the prevalence and risk evaluation of CVD among people with newly diagnosed PCa in China. METHODS: Clinical data of newly diagnosed PCa patients were retrospectively collected from 34 centers in China from 2010 to 2022 through convenience sampling. CVD was defined as myocardial infarction, arrhythmia, heart failure, stroke, ischemic heart disease, and others. CVD risk was estimated by calculating Framingham risk scores (FRS). Patients were accordingly divided into low-, medium-, and high-risk groups. χ2 or Fisher's exact test was used for comparison of categorical variables. RESULTS: A total of 4253 patients were enrolled in the present study. A total of 27.0% (1147/4253) of patients had comorbid PCa and CVD, and 7.2% (307/4253) had two or more CVDs. The enrolled population was distributed in six regions of China, and approximately 71.0% (3019/4253) of patients lived in urban areas. With imaging and pathological evaluation, most PCa patients were diagnosed at an advanced stage, with 20.5% (871/4253) locally progressing and 20.5% (871/4253) showing metastasis. Most of them initiated prostatectomy (46.6%, 1983/4253) or regimens involving ADT therapy (45.7%, 1944/4253) for prostate cancer. In the present PCa cohort, 43.1% (1832/4253) of patients had hypertension, and half of them had poorly controlled blood pressure. With FRS stratification, as expected, a higher risk of CVD was related to aging and metabolic disturbance. However, we also found that patients with treatment involving ADT presented an originally higher risk of CVD than those without ADT. This was in accordance with clinical practice, i.e., aged patients or patients at advanced oncological stages were inclined to accept systematic integrative therapy instead of surgery. Among patients who underwent medical castration, only 4.0% (45/1118) received GnRH antagonists, in stark contrast to the grim situation of CVD prevalence and risk. CONCLUSIONS: Prostate cancer patients in China are diagnosed at an advanced stage. A heavy CVD burden was present at the initiation of treatment. Patients who accepted ADT-related therapy showed an original higher risk of CVD, but the awareness of cardiovascular protection was far from sufficient.

Practice and Enlightenment of Chronic Disease Management at the County Level in China from the Perspective of Professional Integration: A Qualitative Case Study of Youxi County, Fujian Province.

Background: It is currently the most cost-effective management model to have multiple professionals from relevant institutions collaborate so as to provide integrated chronic disease management services. The "classified, color-coded, hierarchical and regionalized" chronic disease management model in Youxi County, Fujian Province is a typical case in China. However, related research is limited. This paper aims to analyze the practice measures and lessons learned in Youxi County, focusing on the professional integration of service providers. Methods: From January to March 2021, interviews with 15 key informants in Youxi County were conducted to collect qualitative data, which was analyzed by the thematic framework method as well as the policy data, using the professional integration dimension in the evaluation framework of the integrated healthcare system. Results: A series of measures were taken, such as improving the professional division and collaboration mechanism, establishing the incentive and restraint mechanism geared toward chronic disease management, formulating norms and standards of chronic disease management for patients with different color labels, and promoting the compatibility of inter-professional value and culture under the governmental institutional supply and the organizational support of the tight county healthcare alliance in Youxi County, to prompt professionals of different levels and types to collaborate in order to provide integrated chronic disease management services. However, some problems remained, such as limited capacity of primary health care, the relatively narrow range and weak effect of the incentive and restraint mechanism, inadequate implementation of the norms and standards, and so forth. Conclusions: Our findings provide reference for other regions in China and other low- and middle-income countries in exploring the integrated chronic disease management model. Long-term follow-up surveys and mixed research designs are required in the future to enrich relevant evidence.

Quantitative comparison and rapid discrimination of Panax notoginseng powder and Caulis clematidis armandii using NMR combined with pattern recognition.

BACKGROUND: The market demand for Panax notoginseng (P. notoginseng) is growing rapidly because of its useful properties in food and medicine. However, the frequent adulteration of P. notoginseng seriously affects the health of consumers and is a great challenge to food safety. In this study, low- and high-field nuclear magnetic resonance (LF/HF-NMR) were applied to detect the transverse relaxation distribution of P. notoginseng contaminated with different ratios of Caulis clematidis armandii (CCA) and the components in P. notoginseng and CCA, respectively. RESULTS: Fifty-seven kinds of major and minor components in P. notoginseng and CCA were identified and quantified from their high-resolution NMR spectra, and there were significant differences in ginsenosides, sucrose, and glucose between P. notoginseng and CCA. Furthermore, the partial least squares regression analysis results indicated that LF-NMR parameters (T21 and S21 ) changed linearly as the ratio of CCA increased, and these changes were attributed to the variations in polysaccharide and sucrose in adulterated P. notoginseng. CONCLUSION: In the relaxation time-based pattern recognition models, the authentic P. notoginseng powder could be classified with 100% accuracy from adulterated P. notoginseng when the adulteration ratio was greater than 30%, demonstrating the possibility of LF-NMR, in combination with pattern recognition, for rapid discrimination of food authenticity. © 2022 Society of Chemical Industry.

Systematic and meta-based evaluation on job satisfaction of village doctors: An urgent need for solution issue.

Background: Village doctors are the health "gatekeepers" of rural residents in most developing countries. They undertake a series of strenuous but pivotal missions, including prevention, diagnosis, and treatment of complicated diseases, sanitation services and management, and preventive healthcare and education tasks. Hence, it is of great importance to evaluate the village doctors' job satisfaction status, which is one of the most important indicators that can reflect the current working state, to provide guidelines for the healthcare policies. Methods: Literature search was conducted in 7 authoritative databases, including PubMed, EMBASE, Web of Science, and China National Knowledge Infrastructure (CNKI). Experts in the field of social medicine were consulted to achieve supplement and obtain relevant literature. China was selected as a representative of the village doctor system for the in-depth analysis. Building on the previous literature, we modified and proposed a novel strategy that can transform and integrate the outcome indicators to conduct a meta-based and quantitative assessment on job satisfaction. Results: A total of 37 publications and 23,595 village doctors were included in this research. The meta-analysis showed that the overall job satisfaction score of village doctors was 3.1858 (total score: 5.00), 95% CI: 2.9675-3.404, which represented the level of "neither satisfied nor dissatisfied." However, in the subsequent adjustment of publication bias, this score reduced to 2.7579, 95% CI: 2.5254-2.9904, which indicated a direct "dissatisfied" level. To discover the underlying causes, a holistic analysis of each dimension and influencing factors of job satisfaction was conducted, and the results demonstrated that "Financial Rewards" (2.49) was the most important factor causing dissatisfaction among village doctors, followed by "Job Security (2.52)" and "Work Stress (3.05)." Several important themes were also identified and assessed to explore the factors related to this topic. Conclusion: This study indicated that there is an urgent need to improve the working status of health workers in rural and remote areas, especially in the middle- and low-income countries. Health policy makers should not only improve the current remuneration and subsidies of village doctors but also guide the professional development and give them more job security to enhance the work stability of this group. More specifically, in the context of the COVID-19 pandemic, further surveys on job satisfaction of village doctors should be carried out to take targeted measures. Systematic review registration: [https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42021289139].

Cyclodextrin metal-organic framework as vaccine adjuvants enhances immune responses.

It is urgently needed to develop novel adjuvants for improving the safety and efficacy of vaccines. Metal-organic frameworks (MOFs), with high surface area, play an important role in drug delivery. With perfect biocompatibility and green preparation process, the γ-cyclodextrin metal-organic framework (γ-CD-MOF) fabricated with cyclodextrin and potassium suitable for antigen delivery. In this study, we modified γ-CD-MOF with span-85 to fabricate the SP-γ-CD-MOF as animal vaccine adjuvants. The ovalbumin (OVA) as the model antigen was encapsulated into particles to investigate the immune response. SP-γ-CD-MOF displayed excellent biocompatibility in vitro and in vivo. After immunization, SP-γ-CD-MOF loaded with OVA could induce high antigen-specific IgG titers and cytokine secretion. Meanwhile, SP-γ-CD-MOF also significantly improved the proliferation of spleen cells and activated and matured the bone marrow dendritic cells (BMDCs). The study showed the potential of SP-γ-CD-MOF in vaccine adjuvants and provided a novel idea for the development of vaccine adjuvants.

Synergistic Lysozyme-Photodynamic Therapy Against Resistant Bacteria based on an Intelligent Upconversion Nanoplatform.

The rapid emergence of drug-resistant bacteria has raised a great social concern together with the impetus for exploring advanced antibacterial ways. NIR-triggered antimicrobial photodynamic therapy (PDT) by lanthanide-doped upconversion nanoparticles (UCNP) as energy donor exhibits the advantages of high tissue penetration, broad antibacterial spectrum and less acquired resistance, but is still limited by its low efficacy. Now we designed a bio-inorganic nanohybrid and combined lysozyme (LYZ) with UCNP-PDT system to enhance the efficiency against resistant bacteria. Benefiting from the rapid adhesion to bacteria, intelligently bacteria-responsive LYZ release and synergistic LYZ-PDT effect, the nanoplatform achieves an exceptionally strong bactericidal capacity and conspicuous bacteriostasis on methicillin-resistant S. aureus. These findings pave the way for designing efficiently antibacterial nanomaterials and provide a new strategy for combating deep-tissue bacterial infection.

Preparation of pectin/poly(m-phenylenediamine) microsphere and its application for Pb2+ removal.

Novel pectin/poly(m-phenylenediamine) (P/PmPDA) microspheres with different content of PmPDA were prepared by assembling PmPDA on the surface of pectin microsphere. The successful preparation was confirmed by the results of Fourier Transform Infrared spectra (FTIR), scanning electron microscopy (SEM) and elemental analysis. Compared with pectin microsphere, the Pb2+ adsorption performance of P/PmPDA microspheres was significantly improved. The results of batch adsorption experiments were in good agreement with the Langmuir isotherm model for Pb2+ adsorption, indicating the adsorption was monolayer. The maximum adsorption capacity of Pb2+ was found to be 390.9 mg/g. The kinetic adsorption process was well described by the pseudo-second-order model and chemical adsorption dominated the adsorption process. The potential mechanisms of Pb2+ adsorption were speculated as ion exchange and chelation, which were supported by X-ray photoelectron spectroscopy (XPS). The P/PmPDA microspheres showed good recyclability after five adsorption/desorption cycles. All these results indicated the potential of P/PmPDA microspheres for removing Pb2+.

A new pre-gelatinized starch preparing by gelatinization and spray drying of rice starch with hydrocolloids.

Rice starch with hydrocolloids (pectin, xanthan gum, sodium alginate or ι-carrageenan) was gelatinized and subsequently spray dried to prepare pre-gelatinized rice starch (PRS) with hydrocolloids (PRS-H). The PRS-H displayed concave granular shape with amorphous structure, indicating rice starch in PRS-H was completely gelatinized. Cold paste viscosity of PRS-H was enhanced in comparison with that of PRS. Especially, xanthan and ι-carrageenan increased cold paste viscosity of PRS-H more than pectin and alginate did. Cold paste viscosity of physically mixed PRS and hydrocolloids (PRS+H), and flow behavior of hydrocolloids themselves as well as gelatinized starch-hydrocolloids without spray drying (GRS-H) indicated interactions existed between starch and hydrocolloids during the preparation. Swelling power, water solubility index, and dynamic viscoelastic properties of PRS-H were also adjusted by different hydrocolloids. These results showed that premixing hydrocolloids with starch before gelatinization in method of spray drying would be a suitable methodology for manufacture PRS with altered properties.

Selective Production of Toluene from Biomass-Derived Isoprene and Acrolein.

Toluene is a basic chemical that is currently produced from petroleum resources. In this paper, we report a new route for the effective synthesis of toluene from isoprene and acrolein, two reactants readily available from biomass, through a simple two-step reaction. The process includes Diels-Alder cycloaddition of isoprene and acrolein in a Zn-containing ionic liquid at room temperature to produce methylcyclohex-3-enecarbaldehydes (MCHCAs) as intermediates, followed by M (M=Pt, Pd, Rh)/Al2 O3 -catalyzed consecutive dehydrogenation-decarbonylation of the MCHCAs at 573 K to generate toluene with an overall yield up to 90.7 %. Model reactions indicated that a synergistic inductive effect of the C=C double bond and the aldehyde group in MCHCA plays a key role in initiating the consecutive dehydrogenation-decarbonylation, and that methyl benzaldehydes are the key intermediates in the gas-phase transformation of MCHCAs. Microcalorimetric adsorption of CO on different catalysts showed that decarbonylation of the substrate occurs more likely on the strong adsorption sites. To the best of our knowledge, it is the first report of Pt/Al2 O3 -catalyzed consecutive dehydrogenation-decarbonylation of a given compound in one reactor. This work provides a highly efficient and environmental friendly route to toluene by utilizing two compounds that can be prepared from biomass.