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BACKGROUND@#Non-communicable chronic diseases have become the leading causes of disease burden worldwide. The trends and burden of "metabolic associated fatty liver disease" (MAFLD) are unknown. We aimed to investigate the cardiovascular and renal burdens in adults with MAFLD and non-alcoholic fatty liver disease (NAFLD).@*METHODS@#Nationally representative data were analyzed including data from 19,617 non-pregnant adults aged ≥20 years from the cross-sectional US National Health and Nutrition Examination Survey periods, 1999 to 2002, 2003 to 2006, 2007 to 2010, and 2011 to 2016. MAFLD was defined by the presence of hepatic steatosis plus general overweight/obesity, type 2 diabetes mellitus, or evidence of metabolic dysregulation.@*RESULTS@#The prevalence of MAFLD increased from 28.4% (95% confidence interval 26.3-30.6) in 1999 to 2002 to 35.8% (33.8-37.9) in 2011 to 2016. In 2011 to 2016, among adults with MAFLD, 49.0% (45.8-52.2) had hypertension, 57.8% (55.2-60.4) had dyslipidemia, 26.4% (23.9-28.9) had diabetes mellitus, 88.7% (87.0-80.1) had central obesity, and 18.5% (16.3-20.8) were current smokers. The 10-year cardiovascular risk ranged from 10.5% to 13.1%; 19.7% (17.6-21.9) had chronic kidney diseases (CKDs). Through the four periods, adults with MAFLD showed an increase in obesity; increase in treatment to lower blood pressure (BP), lipids, and hemoglobin A1c; and increase in goal achievements for BP and lipids but not in goal achievement for glycemic control in diabetes mellitus. Patients showed a decreasing 10-year cardiovascular risk over time but no change in the prevalence of CKDs, myocardial infarction, or stroke. Generally, although participants with NAFLD and those with MAFLD had a comparable prevalence of cardiovascular disease and CKD, the prevalence of MAFLD was significantly higher than that of NAFLD.@*CONCLUSIONS@#From 1999 to 2016, cardiovascular and renal risks and diseases have become highly prevalent in adults with MAFLD. The absolute cardiorenal burden may be greater for MAFLD than for NAFLD. These data call for early identification and risk stratification of MAFLD and close collaboration between endocrinologists and hepatologists.
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Adulto , Humanos , Estudos Transversais , Diabetes Mellitus Tipo 2 , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Inquéritos Nutricionais , PrevalênciaRESUMO
Neuroimaging technique is a kind of significant means to explore the mechanism of cerebral plasticity after stroke. Diffusion tensor imaging can be used to describe the structure of white matter fiber bundles and evaluate the degree of damage, but it cannot reflect the functional connections between different brain regions. Task-state functional magnetic resonance (fMRI) can detect the activation of corresponding brain regions caused by specific tasks, but the test design is complex and demanding for subjects. Resting-state fMRI can analyze complex brain networks and reflect functional connections in different brain regions, but the method of data analysis is complex. Functional near-infrared spectroscopy (fNIRS) is another non-invasive method to reflect the functional activation of brain regions, in which temporal resolution is better than fMRI, but the spatial resolution is slightly lower. The combination of multiple detection methods may be an important research direction in the future.
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Objective:To explore the differences in plasticity mechanism of cortical structure between hemispheres during rehabilitation for stroke patients at subacute stage. Methods:From October 20, 2018 to February 1, 2020, 22 patients with first-onset subcortical ischemic stroke completed the assessments of MRI and clinical evaluation at admission, and after one and two months of rehabilitation. Cortical surface area, thickness, and volume were measured to evaluate cortical structure plasticity. Two-way repeated measures analyses of variance were implemented to estimate dynamic cortical morphology changes and differences between hemispheres. Results:A significant time effect occurred between admission and after one month of rehabilitation for both hemispheres. Cortical surface area, thickness and volume for most regions in both hemispheres gradually decreased, while parahippocampal gyrus thickness and volume increased. The surface area and volume of postcentral gyrus was significant between both hemispheres (F > 4.305, P < 0.05), in which ipsilesional hemisphere was lower than contralesional hemisphere. The reduction of the thickness (r = -0.474, P = 0.026) and volume (r = -0.432, P = 0.044) of postcentral gyrus in ipsilesional hemisphere was negatively correlated with the recovery rate of motor function. Conclusion:There are differences in cortical structure plasticity during stroke rehabilitation between hemispheres. Cortical morphology markedly changes in the first two months poststroke. The greater the reduction in thickness and volume of postcentral gyrus in ipsilesional hemisphere is, the worse the recovery of motor function may be.
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With the development of rehabilitation researches for post-stroke motor dysfunction, functional magnetic resonance imaging (fMRI) on nerve injury has also attracted extensive attention. Subcortical lesions of stroke affect nearby or distal brain areas, leading to motor dysfunction. Mirror neuron system therapy, repetitive transcranial magnetic stimulation and transcranial electrical stimulation can activate relevant regions of cerebral cortex in a non-invasive way, and restore the balance between cerebral hemispheres, which can regulate the whole brain network circuit. However, there is a lack of grade A evidence for the effects of transcranial electrical stimulation. Although acupuncture and moxibustion can widely regulate the topological structure of the whole brain functional network nodes, it cannot fully explain the therapeutic mechanism of acupuncture and moxibustion due to the differences of acupuncture point selection, manipulation, time, and channels. The interactive application of rehabilitation therapy and neuroimaging is becoming a new direction of stroke treatment research.
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Objective:To apply functional near-infrared spectroscopy (fNIRS) to analyze brain activity pattern of bilateral sensorimotor cortex (SMC) and premotor cortex (PMC) during complex dominant and non-dominant hand movement in healthy subjects. Methods:From August to December, 2019, 15 right-handed healthy residents were recruited. The block designed grip-release task was used in the subjects, and detected oxyhemoglobin and deoxyhemoglobin concentration with fNIRS to analyze the activation of bilateral SMC, PMC and prefontal cortex in term of activation channels and intensity. Results:For the oxyhemoglobin concentration, the number of activated channels was the same in both hemispheres during right (dominant) hand movement, and the activation of left SMC was stronger (P < 0.05); however, more channels were activated in the right hemisphere during left (non-dominant) hand movement, and the activation of right SMC was stronger (P < 0.05). For the deoxyhemoglobin concentration, more channels were activated in the contralateral hemisphere during either dominant or non-dominant hand movement, and the activation of left SMC, Channel 12 (left PMC) and Channel 26 (right PMC) were stronger during right (dominant) hand movement (P < 0.05). Conclusion:It is feasible to use fNIRS to study the activation of hand movement related brain regions during complex movement of dominant and non-dominant hand, especially with the results of oxyhemoglobin concentration.
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To establish high performance liquid chromatography(HPLC) fingerprints for crude and processed Ligustri Lucidi Fructus,and to evaluate their quality through the similarity calculation and chemical pattern recognition. The separation was performed with Syncronis C_(18) column(4.6 mm × 250 mm, 5 μm), with acetonitrile(A) and 0.1% phosphoric acid solution(B) as the mobile phase for gradient elution, and a detection wavelength of 280 nm. HPLC was used to detect 22 batches of crude and processed Ligustri Lucidi Fructus,and the Similarity Evaluation System for Chromatographic Fingerprint of Traditional Chinese Medicine(2012 Edition) was used to evaluate the similarity among 22 batches. The research on pattern recognition was conducted with cluster analysis(CA), principal component analysis(PCA), and partial least squares discriminate analysis(PLS-DA). HPLC fingerprints of crude and processed Ligustri Lucidi Fructus were established, with similarity ranging from 0.9 to 1.0. The crude and processed Ligustri Lucidi Fructus can be obviously distinguished by using CA, PCA and PLS-DA. According to the results of PLS-DA,11 constituents including hydroxytyrosol, tyrosol, specnuezhenide and oleuropein were the main marker components leading to the difference. The established fingerprint method is stable and reliable, and can provide method basis for quality control of crude and processed Ligustri Lucidi Fructus. Chemical pattern recognition is proved to be helpful in comprehensive quality control and evaluation of Ligustri Lucidi Fructus before and after the process.
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Cromatografia Líquida de Alta Pressão , Medicamentos de Ervas Chinesas , Frutas , Ligustrum , Medicina Tradicional ChinesaRESUMO
Objective To investigate the therapeutic effect and feasibility of proximate clavicle fracture treated by anatomic locking plate.Methods Seven patients with of proximate clavicle fracture who were admitted in orthopedics department of Xinhua hospital(Chongming) affiliated to medical college of Shanghai Jiao Tong University from May 2012 to May 2016 were all treated by open reduction and internal fixation with locking plate,included 1 case with floating clavicle.The therapeutic effect was observed after surgey.Results Seven patients were followed up for 12 to 24 months (with average 15.6 months).All patients had normal shoulder joint range except 1 case with discomfort feel after hard work.Postoperative imaging showed that the clavicles had all achieved good reset,the fractures got good healing,the average healing time was 3.5 months.Curative effect according to Rockwood score,excellent in 4 cases,good in 3 cases,the excellent and good rate was 100％.Conclusion The anatomic locking plate is safe and reliable for proximate clavicle fracture,which can provide good reduction and fixation,early function exercise,meanwhile it should be make appropriate adjustment according to different situation of individual patients so as to achieve the best curative effect.
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Objective To investigate the mechanism of drug resistance of sulbactam mediated by TEM-1 beta-lactamases and porin CarO in clinical strains of acinetobacter baumannii. Methods Twenty-four unrepeated clinical acinetobacter baumannii strains were divided into sensitive strain group (n=6) and insensitive strain group (n=18) by susceptibility testing to sulbactam.Antibiotics susceptibility test was carried out using the Kirby-Bauer method.BlaTEM-1and carO genes were amplified by PCR.Four blaTEM-1positive strains(A3,A5,1327 and C1)were selected,and their amplified products were sequenced.The quantitative real-time RT-PCR was used to analyze mRNA transcriptional levels of blaTEM-1 and carO genes. Results Resistant rates of the sensitive strain group for meropenem, imipenem, cefoperazone, ciprofloxacin,gentamicin and ampicillin were 1/6,2/6,3/6,1/6,5/6 and 5/6,and resistant rates of the insensitive strain group were 6/18,10/18,18/18,18/18 and 18/18.BlaTEM-1genes were amplified in 16 insensitive strains,and blaTEM-1was negative in sensitive strains. The carO genes were amplified in all 24 strains.There was no significative mutation in the 4 strains of blaTEM-1genes. The promoters of the strains A3, A5 and 1327 were P4, and C1 was P3. There was a positive correlation between the mRNA expression of blaTEM-1and the MIC value of sulbactam (rs=0.551, P=0.027). There was no difference in the mRNA expression of carO between the two groups.Conclusion The clinical strains are seriously resistant to antibiotics.The main resistance mechanism of clinical strains to sulbactam is the high mRNA expression of blaTEM-1,and the promoter may be one of the reasons of high expression of TEM-1.
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The purpose of this investigation was to describe the physiological profile of elite, senior Chinese female wrestlers. Twenty-five elite wrestlers, nationally ranked in the top 3 of their weight class, participated in this study. The subjects included Olympic and world champion medalists. The physiological profile included testing of running maximal oxygen consumption (VO2max), 3,200-m run time, 400-m run time, 30-second Wingate anaerobic power and capacity, shoulder, elbow, knee, and trunk isokinetic torque, and 1 repetition maximums (1RMs) in specified exercises. The major results (mean ± SD) were VO2max: 50.58 ± 3.33 ml·kg(-1)·min(-1); 3,200-m run: 14 minutes 1 second ± 49 seconds; 400-m run: 1 minute 11 seconds ± 4 seconds; Wingate maximal anaerobic power: 495.21 ± 79.13 W and mean power: 262.97 ± 52.39 W; 1RM deadlift: 124 ± 19 kg; 1RM deep squat: 98 ± 11 kg; 1RM prone rowing: 72 ± 8 kg; 1RM power clean: 76 ± 12 kg; and 1RM hold and squat: 109 ± 17 kg. In absolute terms in the majority of measures, the heavier weight classes had greater values than the lighter weight classes, but relative to body mass, there were few differences in measures between the weight classes. The Olympic and World Championship medalist had the best value or was at the upper end of a measure's range for the strength and power measures. The results indicate that female wrestling success is not dependent on one physiological characteristic, but that a variety of physiological profiles can result in success. These data on elite female wrestlers can be compared with other wrestlers to help determine individual weaknesses or strengths and to design training programs that result in wrestling success.
