[Promoting critical care system and capacity building in pulmonary and critical care medicine subspecialties].

The development of respiratory medicine has evolved from the prevention and treatment of tuberculosis in 1950 s to the care of chronic obstructive pulmonary disease and corpulmonale disease in 1970 s. In the past 20 years, it has further advanced into the integration of pulmonary medicine (PM) and critical care (CC), becoming a dominant form of global disciplines in respiratory medicine. The subspecialty training system of pulmonary and critical care medicine (PCCM) is a decisive measure to ensure the standardized development of respiratory medicine, and medical intensive care unit (MICU) is the most important clinical practice field for respiratory medicine in China, which plays a crucial role in promoting the substantial construction of the critical care medical system within the PCCM subspecialty, thus contributing to the development of the discipline.

[Rescue balloon pulmonary angioplasty for a patient with acute exacerbation of chronic thromboembolic pulmonary hypertension supported by extracorporeal membrane oxygenation: a case report].

A 33-year-old male patient was admitted to hospital because of "dyspnea after activity for 3 years and aggravation for 15 days". With a history of membranous nephropathy, irregular anticoagulation led to acute exacerbation of Chronic thromboembolic pulmonary hypertension(CTEPH) and acute respiratory failure, and endotracheal intubation and mechanical ventilation was given. Although treated with thrombolysis and adequate anticoagulation, the condition worsened and hemodynamics deteriorated, and then VA-ECMO was performed. Due to severe pulmonary hypertension and right heart failure,ECMO could not be weaned off, and the patient subsequently developed pulmonary infection, right lung hemorrhage, hyperbilirubinemia, coagulation dysfunction and other complications. Then the patient was transferred to our hospital by airplane, and multidisciplinary discussions were quickly arranged after admission. Considering that the patient was critically ill and complicated with multiple organ failure, pulmonary endarterectomy (PEA) could not be tolerated, rescue balloon pulmonary angioplasty (BPA) was recommended and performed on the second day after admission. The mean pulmonary artery pressure was 59 mmHg(1 mmHg=0.133 kPa) measured by right heart catheterization, and pulmonary angiography showed that the main pulmonary artery was dilated, while the right lower pulmonary artery was completely occluded, and there were multiple stenoses in the branches of the right upper lobe, middle lobe pulmonary artery and the left pulmonary artery. BPA was performed on a total of 9 pulmonary arteries. VA-ECMO was weaned off on day 6 after admission, and the mechanical ventilation was weaned off on day 41 after admission. The patient was successfully discharged on day 72 after admission. Rescue BPA was an effective treatment for severe CTEPH patients who could not be treated with PEA.

The effect of neuropilin-1 silencing on the transforming growth factor-ß1-mediated epithelial-mesenchymal transition of colon cancer SW480 cells and its effect on the proliferation and migration of colon cancer cells.

This study aimed to investigate the effect of neuropilin-1 (NRP-1) silencing on epithelial-mesenchymal transformation (EMT) mediated by transforming growth factor-ß1 (TGF-ß1) and on the proliferation and migration of colon cancer SW480 cells. After transfection of small interfering ribonucleic acid (siRNA)-NRP-1 into colon cancer SW480 cells, the messenger RNA (mRNA) and protein expression levels of NRP-1 were detected using quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot. Four EMT models were induced using 0, 2, 5, and 10 ng/mL TGF-ß1, respectively. Cell proliferation was detected using Cell Counting Kit-8, and the protein levels of EMT markers E-cadherin and vimentin were detected using Western blot. EMT was induced in the transfected SW480 cells using TGF-ß1, after which four groups were created: a negative control group (siRNA-Ncontrol), a transfection group (siRNA-NRP-1), an induction group (TGF-ß1), and a transfection + induction group (siRNA-NRP-1+TGF-ß1). Western blot was then used to detect the expression of E-cadherin and vimentin, and cell proliferation and migration were detected using cell counting kit-8 (CCK-8) and scratch assay. After transfection with siRNA-NRP-1, the mRNA and protein expression levels of SW480 cells were significantly decreased (P<0.05). After 48 hours of induction with 10 ng/mL TGF-ß1, cell proliferation was obvious, E-cadherin expression decreased, and vimentin expression significantly increased (P<0.05), indicating that EMT had been successfully induced compared with the induction group, the transfection + induction group had significantly increased E-cadherin expression after corresponding treatments (including transfection and induction alone) (P<0.05), and the proliferation and migration of colon cancer cells decreased (P<0.05). In conclusion: silencing, NRP-1 in colon cancer SW480 cells can partially reverse TGF-ß1-mediated EMT, reduce the proliferation activity of colon cancer cells, and slow their migration ability. Therefore, NRP-1 may become a new target for the treatment of colon cancer.

[Prognosis and related risk factors of acute respiratory distress syndrome in elder patients].

Objective: To study the risk factors associated with the hospital survival rate of elder patients with acute respiratory distress syndrome (ARDS) in Medical/Respiratory Intensive Care Units (MICUs/RICUs) by evaluating the prognosis, and therefore to provide insight into patient treatment strategy. Methods: Twenty MICUs/RICUs of 19 general hospitals in mainland China participated in the multicenter prospective cohort study carried out from Mar 1st, 2016 to Feb 28th, 2018. Patients who met the criteria of Berlin ARDS and older than 65 years were recruited. Baseline data, risk factors of ARDS, ventilator setup and prognosis data were collected from all patients. Univariant and multivariant regression analysis were conducted to analyze the factors associated with the prognosis. Results: 170 elder ARDS patients (age≥65 years) met the Berlin ARDS criteria, among whom 8.8% (15/170), 42.9% (73/170) and 48.2% (82/170) patients had mild, moderate and severe ARDS, respectively. The most common predisposing factor for elder ARDS was pneumonia, which was present in 134 patients (78.8%). 37.6% (64/170) patients were treated with noninvasive mechanical ventilation (NIV), but 43.8% (28/64) cases experienced treatment failure. 76.5% (130/170) patients were treated with invasive mechanical ventilation. All patients 80 years or older were given invasive mechanical ventilation. 51.8% (88/170) cases had complications of non-pulmonary organ failure. 61.8% (105/170) patients deceased during hospital stay. Multivariant logistic analysis showed that the independent risk factors for hospital survival rate in elder patients with ARDS were SOFA score (P=0.030, RR=0.725, 95% CI 0.543-0.969), oxygen index after 24 hours of ARDS diagnosis (P=0.030, RR=0.196, 95% CI 0.045-0.853), accumulated fluid balance within 7 days after diagnosis of ARDS (P=0.026, RR=1.000, 95% CI 1.000-1.000) and shock (P=0.034, RR=0.140, 95% CI 0.023-0.863). Conclusion: Among 20 ICUs, the high mortality rate of elder patients with ARDS was correlated with higher 24 hour SOFA score, lower 24 hour oxygen index after ARDS diagnosis, more positive fluid balance within 7 days and concomitant shock. The conservative fluid strategy within 7 days of ARDS diagnosis may benefit the elder ARDS patients.

[Study of abnormal lipid metabolism analysis and significance of fatty acid binding protein expression in patients with hepatocellular carcinoma].

Objective: Hepatocellular carcinoma (HCC) is the fourth most dominant cancer in the world and the second leading cause of cancer-related deaths in the China. With the increase in the incidence of metabolic syndrome (MS) in the population, the correlation between MS and HCC has gradually been recognized. MS manifests as non-alcoholic fatty liver disease (shortly known as NAFLD) in the liver. A large number of research results has shown that the development of fatty liver is closely related to the occurrence of HCC, in which lipid metabolism plays a key regulatory role, and lipid metabolism is regulated by fatty acid binding protein (FABP). This study signifies the lipid metabolism analysis and the key FABP expression conditions in HCC. Methods: Data of patients who were first diagnosed with primary HCC between January 2016 to July 2019 were collected, and were divided into two groups according to the etiology, namely the viral and non-viral hepatitis-related HCC group. The relationship between MS-related factors and HCC was analyzed by t-test and chi square test. The expressions of FABP1, FABP4 and FABP5 were detected in cancer and adjacent tissues by immunohistochemistry, and the expressions of FABP1, FABP4 and FABP5 in HCC with fatty liver were detected by immunofluorescence. Finally, the expressional characteristics of the above-mentioned FABPs in HCC patients were analyzed with different clinicopathological features. Results: There were statistically significant differences in the rate of abnormal lipid metabolism and the number of abnormalities in MS-related factors between the viral and non-viral hepatitis-related HCC group. FABP1, FABP4, and FABP5 expression in HCC tissues were lower than the corresponding adjacent tumor tissues. Compared with simple HCC, FABP1, FABP4, FABP5 expression were increased in HCC tissues with steatosis, and the expression of FABP was closely related to the clinical characteristics of patients. Conclusion: Abnormal lipid metabolism is closely related to non-viral hepatitis-related HCC. The expression of lipid metabolism regulatory proteins FABP1, FABP4, and FABP5 are down-regulated in HCC tissues, but up-regulated in HCC with fatty liver, suggesting that the relationship between MS, especially dyslipidemia, and HCC should be paid attention to in clinical practice for early intervention. FABP1, FABP4, FABP5 may regulate HCC occurrence and development.

[Effectiveness of the "14 plus 7 day quarantine" and "nucleic acid plus total antibody testing" strategy for screening imported patients with COVID-19 in Xiamen].

Objective: To analysis effectiveness of the "14 plus 7 day quarantine" and "nucleic acid plus total antibody testing" strategy (combined screening strategy) for screenin the imported patients with COVID-19 in Xiamen. Methods: The study populations were overseas travelers arriving in Xiamen from March 17 to December 31, 2020, and overseas travelers who had quarantine outside Xiamen for less than 21 days from July 18 to December 31, 2020. Data were collected and analyzed on the timing of detection, pathways, and test results of the imported patients with COVID-19 after implementing combined screening strategy. Results: A total of 304 imported patients with COVID-19 were found from 174 628 overseas travelers and 943 overseas travelers from other cities. A total of 163 cases (53.6%) were diagnosed by multitime, multisite intensive nucleic acid testing after positive finding in total antibody testing. Among them, 27 (8.9%) were first positive for nucleic acid in 14 plus 7 day quarantine and 136 were first positive for nucleic acid in 14-day quarantine. Only 8 of these individuals were tested positive for nucleic acid after positive total antibody testing. The other 128 individuals were tested positive for nucleic acid after being negative for average 2.3 times (maximum of 6 times). Aditional 155 cases might be detected by using the combined "14 plus 7 day quarantine" and " nucleic acid plus total antibody testing" strategy compared with "14-day quarantine and nucleic acid testing" strategy, accounting for 51.0% of the total inbound infections. So the combined screening strategy doubled the detection rate for imported patients with COVID-19. No second-generation case caused by overseas travelers had been reported in Xiamen as of February 26, 2021. Conclusions: Xiamen's combined screening strategy can effectively screen the imported patients with COVID-19 who were first positive for nucleic acid after 14 day quarantine. Compared with "14 day quarantine and nucleic acid testing", the combined screening strategy improved detection rate and further reduced the risk of the secondary transmission caused by the imported patients with COVID-19.

Giant magnetoresistance and topological Hall effect in the EuGa4antiferromagnet.

We report on systematic temperature- and magnetic field-dependent studies of the EuGa4binary compound, which crystallizes in a centrosymmetric tetragonal BaAl4-type structure with space groupI4/mmm. The electronic properties of EuGa4single crystals, with an antiferromagnetic (AFM) transition atTN∼ 16.4 K, were characterized via electrical resistivity and magnetization measurements. A giant nonsaturating magnetoresistance was observed at low temperatures, reaching∼7×104% at 2 K in a magnetic field of 9 T. In the AFM state, EuGa4undergoes a series of metamagnetic transitions in an applied magnetic field, clearly manifested in its field-dependent electrical resistivity. BelowTN, in the ∼4-7 T field range, we observe also a clear hump-like anomaly in the Hall resistivity which is part of the anomalous Hall resistivity. We attribute such a hump-like feature to the topological Hall effect, usually occurring in noncentrosymmetric materials known to host topological spin textures (as e.g., magnetic skyrmions). Therefore, the family of materials with a tetragonal BaAl4-type structure, to which EuGa4and EuAl4belong, seems to comprise suitable candidates on which one can study the interplay among correlated-electron phenomena (such as charge-density wave or exotic magnetism) with topological spin textures and topologically nontrivial bands.

[Etiology of severe community-acquired pneumonia in immunocompromised patients].

Objective: To analyze the etiology of severe community-acquired pneumonia (SCAP) in immunocompromised patients, and to investigate the relationship between underlying diseases and infectious microorganisms. Methods: A retrospective analysis was performed on SCAP in immunocompromised patients admitted to the Fourth Department of Respiratory and Critical Medicine (MICU) of China-Japan Friendship Hospital from January 1, 2017 to December 31, 2019. A total of 119 SCAP patients were finally enrolled, including 65 males (54.6%), with an average age of (59.3±14.5) years. The average of Sequential Organ Failure Assessment (SOFA) score was 6.7±3.6 and the acute physiology and chronic health evaluation (APACHE) Ⅱ score was 19.4±6.8. Sixty (50%) of these patients were finally improved and discharged. Long-term glucocorticoid treatment was the main risk factor for immunocompromise. The difference of pathogenic microorganisms between patients with and without structural lung diseases, and the influence of different pathogenic microorganisms on hospital mortality were calculated, respectively. P<0.05 was considered to be statistically significant. Results: In this study, 99 (83.2%) patients were identified to have positive etiological results, and the incidence of concurrent infection was 54.5%. The top three pathogens were Pneumocystis Jiroveci (55.6%), Cytomegalovirus (47.5%) and Aspergillus (23.2%). Staphylococcus aureus was the most common bacterium, followed by Pseudomonas aeruginosa and Klebsiella pneumoniae. The risk of Pneumocystis Jiroveci infection was significantly higher in patients without underlying lung diseases as compared to those with underlying lung diseases (64.3% vs. 44.2%, P = 0.046). The in-hospital mortality was not different among patients infected with different pathogens(all P>0.05), but was higher in those with mixed infections(56.7% vs. 33.9%, P=0.013). Conclusions: Pneumocystis Jiroveci and Cytomegalovirus were the most common pathogens in immunocompromised patients with severe community-acquired pneumonia, and the incidence of Pneumocystis Jiroveci was significantly higher in patients without underlying lung diseases.

Utility of Contrast-Enhanced T2 FLAIR for Imaging Brain Metastases Using a Half-dose High-Relaxivity Contrast Agent.

BACKGROUND AND PURPOSE: Efficient detection of metastases is important for patient' treatment. This prospective study was to explore the clinical value of contrast-enhanced T2 FLAIR in imaging brain metastases using half-dose gadobenate dimeglumine. MATERIALS AND METHODS: In vitro signal intensity of various gadolinium concentrations was explored by spin-echo T1-weighted imaging and T2 FLAIR. Then, 46 patients with lung cancer underwent nonenhanced T2 FLAIR before administration of half-dose gadobenate dimeglumine and 3 consecutive contrast-enhanced T2 FLAIR sequences followed by 1 spin-echo T1WI after administration of half-dose gadobenate dimeglumine. After an additional dose of 0.05 mmol/kg, 3D brain volume imaging was performed. All brain metastases were classified as follows: solid-enhancing, ≥ 5 mm (group A); ring-enhancing, ≥ 5 mm (group B); and lesion diameter of <5 mm (group C). The contrast ratio of the lesions on 3 consecutive phases of contrast-enhanced T2 FLAIR was measured, and the percentage increase of contrast-enhanced T2 FLAIR among the 3 groups was compared. RESULTS: In vitro, the maximal signal intensity was achieved in T2 FLAIR at one-eighth to one-half of the contrast concentration needed for maximal signal intensity in T1WI. In vivo, the mean contrast ratio values of metastases on contrast-enhanced T2 FLAIR for the 3 consecutive phases ranged from 63.64% to 83.05%. The percentage increase (PI) values of contrast-enhanced T2 FLAIR were as follows: PIA < PIB (P = .001) and PIA < PIC (P < .001). The degree of enhancement of brain metastases on contrast-enhanced T2 FLAIR was lower than on 3D brain volume imaging (P < .001) in group A, and higher than on 3D brain volume imaging (P < .001) in group C. CONCLUSIONS: Small or ring-enhancing metastases can be better visualized on delayed contrast-enhanced T2 FLAIR using a half-dose high-relaxivity contrast agent.

The neutrophil to lymphocyte ratio as a novel predictor of asthma and its exacerbation: a systematic review and meta-analysis.

OBJECTIVE: It is widely known that the main white blood cell populations, and neutrophil to lymphocyte ratio (NLR), are involved in systemic inflammation. The usefulness of NLR measurements has been reported in patients with asthma. We performed a systematic review and meta-analysis of studies to investigate the relationship between the NLR and asthma and its exacerbations. MATERIALS AND METHODS: We systematically searched PubMed and Embase databases for studies (published between Jan 1, 1950 and Jan 2, 2020; no language restrictions) comparing the NLR values in patients with stable asthma or asthma exacerbations to healthy controls. We assessed pooled data by use of a random-effects model. RESULTS: Of 260 identified studies, 6 were eligible and were included in our analysis (N = 2418 participants). Compared with 439 healthy controls, 743 stable asthma patients in four studies showed significantly greater NLR values (standardized mean difference, SMD, 0.567, 95% CI 0.212-0.922; p = 0.002). Furthermore, compared with 1063 stable asthma patients, 402 asthma exacerbation patients yielded significantly greater NLR values (random effects SMD 1.335, 95% CI 0.429-2.241; p < 0.001). CONCLUSIONS: Our meta-analysis showed that the NLR values are a reasonable and easy-to-use marker for asthma and its exacerbations. Further studies, with larger sample sizes and more phenotypes, are required to establish its use as a predictive parameter in asthma.

[Effect of RNA interference targeting neuropilin-2 gene on proliferation and apoptosis of colon cancer cell line HCT-8].

Objective: To investigate the effects of down-regulation of expression of neuropilin-2 (NRP-2) by RNA interference (RNAi) technique on proliferation and apoptosis of HCT-8 colon cancer cells. Methods: NRP2-siRNA and negative control (NControl)-siRNA were transferred into HCT-8 colon cancer cells by liposomes (lip2000) as transfection group and negative control group, and phosphate buffered solution (PBS) was added as blank control group. Quantitative reverse transcription PCR (RT-qPCR) and Western blot were used to detect the transfection effect. The proliferation of cells in the three groups was examined by cell counting kit (CCK) assay, colony-forming unit assay and Ki-67 protein staining assay, respectively. Moreover, the apoptosis of cells in the three groups was determined by acridine orange/propranidine iodide (AO/PI) staining method. Results: The results of RT-qPCR and Western blot showed that the relative expression of NRP-2 mRNA and the content of NRP-2 protein in the transfer group decreased (0.46±0.05 vs 0.99±0.05 and 1.00±0.06; 1.04±0.06 vs 1.73±0.09 and 1.65±0.11) (all P<0.05). The results of CCK-8 demonstrated that the optical density of transfection group was significantly lower than that of the negative control group and the blank control group(24 h: 0.53±0.04 vs 0.82±0.07 and 0.87±0.07; 48 h: 0.54±0.05 vs 1.00±0.09 and 1.17±0.05; 72 h: 0.75±0.05 vs 1.31±0.13 and 1.50±0.03; 96 h:1.05±0.04 vs 1.46±0.09 and 1.86±0.06) (all P<0.05). The results of colony-forming unit assay indicated that the proliferation ability of the cells in the transfer group was significantly lower than that in the other two groups (134.67±8.74 vs 245.33±19.14 and 300.33±14.01, P<0.05). The results of Ki-67 protein staining assay showed that compared with the negative control group and blank control group, the expression of Ki-67 protein was significantly decreased in the transfection group (5.93±0.22 vs 8.36±0.09 and 8.70±0.21, P<0.05). The results of AO/PI assay revealed that the ratio of apoptotic cells to living cells in the transfer group was significantly higher than that in the other two groups (0.43±0.07 vs 0.14±0.04 and 0.11±0.04, P<0.05). Conclusion: The proliferation ability of HCT-8 colon cancer cells decreases, and the apoptosis ability increases by decreasing the expression of NRP-2.

[The clinical characteristics of severe influenza virus pneumonia complicated with invasive pulmonary aspergillosis: a retrospective study of 15 cases].

Objective: To explore the clinical characteristics, risk factors and possible inflammatory response mechanisms in critically ill patients with influenza and invasive pulmonary aspergillosis co-infection. Methods: Sixty-four patients with severe influenza virus pneumonia were included in the RICU of the China-Japanese Friendship Hospital from November 1(st), 2017 to March 31(th), 2018. There were 33 males and 31 females, with an average age of (55±14) years. T-tests or χ(2) test were applied for comparisons between the two groups. Fifteen patients were complicated with IPA and were classified as the IPA group, while the other 49 served as the control group. The clinical characteristics, laboratory examinations, and endoscopic manifestations were compared between the two groups and the risk factors for severe influenza virus pneumonia with IPA were analyzed by multivariate logistic regression. The possible mechanisms of inflammatory response were explored by comparing the differences of plasma inflammatory factors between the two groups. Results: Seven patients (7/15, 47.7%) in the IPA group died. The percentage of wheezing in the IPA group (n=13) was significantly higher than that in the control group (n=25) (P<0.05). The values of WBC [(11.0±2.7)×10(9)/L], and the levels of blood GM [(2.46±0.80) µg/L] and BALF GM [(5.30±0.98) µg/L] in the IPA group were significantly higher than those in the control group, while PCT was lower than that in the control group[(6.1±3.3)×10(9)/L, (0.33±0.07) µg/L and (0.73±0.17) µg/L, respectively] (P<0.01). Compared with the control group, the chest CT of the IPA group showed more nodules along the bronchial bundle (n=11), massive consolidation shadow (n=9), halo sign (n=3) and cavity/air crescent sign (n=5) (control group: 8, 11, 0 and 4, respectively) (P<0.05). Airway mucosal pseudomembrane formation (n=12) and airway stenosis (n=10) were significantly higher in the IPA group than in the control group (2 and 17) (P<0.05). Multivariate logistic regression analysis suggested that the history of glucocorticoid use after ICU admission, normal PCT, multiple nodules, halo signs and pseudomembrane formation under endoscopy were risk factors for severe influenza virus pneumonia with IPA. The plasma pro-inflammatory factors IFN-γ [IPA group: 34.9 (20.6-64.0) µg/L] and IL-2 [16.2 (8.9-20.7) µg/L] were significantly lower than in patients without IPA [control group: 65.2 (43.8-124.5) µg/L and 20.4 (14.6-28.8) µg/L, respectively] (P<0.05); while the inflammatory inhibitors IL-4 [51.6 (32.7-69.7) µg/L) and IL-10 [15.7 (11.8-92.5) µg/L] were higher in IPA group [control group 8.9 (6.1-15.0) µg/L and 7.8 (3.6-21.8) µg/L] (P<0.05). SOFA scores showed a negative correlation with IFN-γ (r=-0.658, P=0.02) and IL-6 (r=-0.602, P=0.038), but a positive correlation with IL-10 (r=0.641, P=0.025) by Spearman correlation analysis. Conclusions: Some relatively specific clinical characteristics could be found in severe influenza pneumonia complicated with IPA. IPA should be highly suspected when a patient had a history of glucocorticoid use after ICU admission, high WBCs in the course of treatment without significant increase of PCT,multiple nodules along the airway distribution and the characteristic pseudomembrane formation under bronchoscopy. Influenza virus caused imbalance of immune responses, leading to a weakened pro-inflammatory response and a strengthened inflammatory suppression, which might be a possible mechanism for IPA development.

[Prevalence and risk factors of hypertension combined with diabetes in middle and elder population in Nan'an district of Chongqing].

Objective: To analyze the prevalence and risk factors of hypertension combined with diabetes in the middle to elder population in the Nan'an district of Chongqing, and to provide evidence for formulating relevant prevention and control strategies. Methods: Middle or elder adults were enrolled by a Stratified multistage cluster sampling method. Questionnaire survey and the related measurements were conducted. The epidemiology of hypertension combined with diabetes was analyzed descriptively, and the risk or protective factors were analyzed by logistic regression method. Results: A total of 24 792 people were surveyed, with 1 547 patients identified as having hypertension combined with diabetes. The overall prevalence rate appeared as 6.2%, of which 6.0% in males and 6.4% in females, respectively. The prevalence of hypertension combined with diabetes in the general population was increasing with age (χ(2)=343.766, P<0.001). Factors as age, education, smoking, marital status, exercise, BMI, triglyceride, total cholesterol, high density lipoprotein cholesterol and low density lipoprotein cholesterol were related to the prevalence of hypertension and diabetes. High density lipoprotein cholesterol appeared as a protective factor for hypertension combined with diabetes (OR=0.817, 95%CI: 0.715-0.934). Age, education, low density lipoprotein cholesterol and lack of exercise all appeared as risk factors for hypertension combined with diabetes (P<0.05), respectively. Conclusions: The prevalence rate of hypertension combined with diabetes in the middle or elder adults in Nan'an of Chongqing seemed high. Attention should be paid to the health status of people being elderly, overweight or obese, low cultural level, smoking, triglyceride abnormality, total cholesterol abnormality and high low density lipoprotein cholesterol, so as to reduce the risk on hypertension combined with diabetes.

[Research progress of microRNAs in regulation of lipid metabolism-related proteins for influencing the pathogenesis of hepatocellular carcinoma].

The incidence of metabolic syndrome gradually multiplied with the change of dietary structure of high fat- high sugar in the population, bringing it as independent risk factors for tumors. Liver is an important organ of lipid metabolism. The main manifestations of metabolic syndrome are obesity and abnormal lipid metabolism, which are closely related to hepatocellular carcinoma occurrence. MicroRNA (miRNA) is an endogenous non-coding RNA that participates in the post-transcriptional regulation of target genes by binding to the 3'-UTR of mRNA. Research studies have found that abnormal miRNA expression can influence the pathogenesis of hepatocellular carcinoma via regulating lipid metabolism-related proteins in the liver. This article reviews and discusses the characteristics and pathogenesis of lipid metabolism disorder in hepatocellular carcinoma, and the mechanism by which miRNA regulates the occurrence and development of hepatocellular carcinoma through lipid metabolism-related proteins. Furthermore, it also provides a reliable theoretical foundation for the study of the pathogenesis of hepatocellular carcinoma.