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1.
J Affect Disord ; 296: 189-197, 2021 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-34607060

RESUMO

BACKGROUND: The symptoms that patients with major depressive disorder (MDD) experience are the dominant contributing factors to its heavy disease burden. This study sought to identify key symptoms leading to disability in patients with MDD. METHODS: Subjects consisted of patients who had a 12-month MDD diagnosis based on the China Mental Health Survey (CMHS). World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) was used to assess the degree of disability. The associations between depressive symptoms and disability were analyzed using a linear regression and logistic regression with a complex sampling design. RESULTS: Of the 32,552 community residents, 655 patients were diagnosed with 12-month MDD. The disability rate due to MDD was 1.06% (95% CI: 0.85%-1.28%) among adults in Chinese community and 50.7% (95% CI: 44.3%-57.1%) among MDD patients. Depression was associated with all functional losses measured by the WHODAS. Feelings of worthlessness in life or inappropriate guilt, and psychomotor agitation or retardation were the key symptoms related to disability. Economic status, co-morbidity of physical diseases or anxiety disorders were correlates of disability scores. LIMITATIONS: The disability rate might be underestimated due to the exclusion of MDD patients living in hospitals. The effect of treatments on disability was excluded. CONCLUSIONS: Psychological symptoms, not somatic symptoms, contribute to disability in MDD patients. Disability worsens when physical diseases or anxiety disorders are present. More attention could be paid to psychological symptoms, physical diseases, and anxiety disorders in MDD patients with disabilities.

2.
BMC Psychiatry ; 21(1): 427, 2021 08 31.
Artigo em Inglês | MEDLINE | ID: mdl-34465307

RESUMO

BACKGROUND: This study aimed to describe the prevalence and lifetime criteria profiles of DSM-5 alcohol use disorder (AUD) and the transitions from alcohol use to disorder in Chifeng, China. METHODS: Face-to-face interviews were conducted using Composite International Diagnostic Interview-3.0 (CIDI-3.0) among 4528 respondents in Chifeng. RESULTS: The weighted lifetime and 12-month prevalence of DSM-5 AUD were 3.03 and 1.05%, respectively. Mild lifetime AUD was the most prevalent severity level (69.53%). The two most common criteria were "failure to quit/cutdown" and "drinking more or for longer than intended." Lifetime prevalence was 65.59% for alcohol use, and 22.97% for regular drinking. Male and domestic violence were risk factors for the transition from alcohol use to regular drinking or AUD and from regular drinking to AUD. Younger age was risk factor for the transition to AUD from alcohol use or regular drinking. Poverty (OR = 2.49) was risk factor for the transition from alcohol use to regular drinking. The earlier drinkers were more likely to develop to regular drinking (OR = 2.11). CONCLUSION: AUD prevalence in Chifeng was not as high as that in Western countries. The study revealed that multiple risk factors might contribute to the transition across different stages of alcohol use. Further research should explore the underlying mechanisms.


Assuntos
Transtornos Relacionados ao Uso de Álcool , Alcoolismo , Consumo de Bebidas Alcoólicas/epidemiologia , Transtornos Relacionados ao Uso de Álcool/diagnóstico , Transtornos Relacionados ao Uso de Álcool/epidemiologia , Alcoolismo/diagnóstico , Alcoolismo/epidemiologia , China/epidemiologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos , Masculino , Prevalência , Fatores de Risco
3.
PLoS Med ; 18(9): e1003097, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34520466

RESUMO

BACKGROUND: The World Health Organization (WHO) has reframed health and healthcare for older people around achieving the goal of healthy ageing. The recent WHO Integrated Care for Older People (ICOPE) guidelines focus on maintaining intrinsic capacity, i.e., addressing declines in neuromusculoskeletal, vitality, sensory, cognitive, psychological, and continence domains, aiming to prevent or delay the onset of dependence. The target group with 1 or more declines in intrinsic capacity (DICs) is broad, and implementation may be challenging in less-resourced settings. We aimed to inform planning by assessing intrinsic capacity prevalence, by characterising the target group, and by validating the general approach-testing hypotheses that DIC was consistently associated with higher risks of incident dependence and death. METHODS AND FINDINGS: We conducted population-based cohort studies (baseline, 2003-2007) in urban sites in Cuba, Dominican Republic, Puerto Rico, and Venezuela, and rural and urban sites in Peru, Mexico, India, and China. Door-knocking identified eligible participants, aged 65 years and over and normally resident in each geographically defined catchment area. Sociodemographic, behaviour and lifestyle, health, and healthcare utilisation and cost questionnaires, and physical assessments were administered to all participants, with incident dependence and mortality ascertained 3 to 5 years later (2008-2010). In 12 sites in 8 countries, 17,031 participants were surveyed at baseline. Overall mean age was 74.2 years, range of means by site 71.3-76.3 years; 62.4% were female, range 53.4%-67.3%. At baseline, only 30% retained full capacity across all domains. The proportion retaining capacity fell sharply with increasing age, and declines affecting multiple domains were more common. Poverty, morbidity (particularly dementia, depression, and stroke), and disability were concentrated among those with DIC, although only 10% were frail, and a further 9% had needs for care. Hypertension and lifestyle risk factors for chronic disease, and healthcare utilisation and costs, were more evenly distributed in the population. In total, 15,901 participants were included in the mortality cohort (2,602 deaths/53,911 person-years of follow-up), and 12,939 participants in the dependence cohort (1,896 incident cases/38,320 person-years). One or more DICs strongly and independently predicted incident dependence (pooled adjusted subhazard ratio 1.91, 95% CI 1.69-2.17) and death (pooled adjusted hazard ratio 1.66, 95% CI 1.49-1.85). Relative risks were higher for those who were frail, but were also substantially elevated for the much larger sub-groups yet to become frail. Mortality was mainly concentrated in the frail and dependent sub-groups. The main limitations were potential for DIC exposure misclassification and attrition bias. CONCLUSIONS: In this study we observed a high prevalence of DICs, particularly in older age groups. Those affected had substantially increased risks of dependence and death. Most needs for care arose in those with DIC yet to become frail. Our findings provide some support for the strategy of optimising intrinsic capacity in pursuit of healthy ageing. Implementation at scale requires community-based screening and assessment, and a stepped-care intervention approach, with redefined roles for community healthcare workers and efforts to engage, train, and support them in these tasks. ICOPE might be usefully integrated into community programmes for detecting and case managing chronic diseases including hypertension and diabetes.

4.
Pestic Biochem Physiol ; 173: 104770, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33771270

RESUMO

Chitin deacetylases (CDAs, EC 3.5.1.41) catalyze the N-deacetylation of chitin to produce chitosan, which is essential for insect survival. Hence, CDAs are promising targets for the development of novel insecticidal drugs. In this study, the putative Group I chitin deacetylase genes HpCDA1, HpCDA2-1 and HpCDA2-2 were identified from Holotrichia parallela. Conserved domain database search identified a chitin-binding peritrophin-A domain (ChBD), a low-density lipoprotein receptor class A domain (LDLa), and a putative CDA-like catalytic domain. RT-qPCR analysis showed that the Group I HpCDAs were expressed in various tissues and predominant in the integument. The developmental expression patterns from the first-instar to third-instar larvae showed that HpCDAs were highly expressed on the first day and gradually declined after molting. The functional characteristics of the Group I CDAs in cuticle organization were examined using RNA interference (RNAi) and transmission electron microscopy (TEM) methods. Administration of double-stranded HpCDA (dsHpCDA) through larval injection could suppress the expression levels of HpCDA1 and HpCDA2, thus resulting in abnormal or lethal phenotypes. TEM analysis revealed that RNAi of either HpCDA1 or HpCDA2 remarkably affected the cuticle integrity, as evidenced by cuticle disorganization and chitin laminae disruption, suggesting the crucial role of CDAs in chitin modification. These experimental results demonstrate the important contribution of putative key genes involved in chitin metabolism, and provide a foundation for developing new strategies to control H. parallela.


Assuntos
Besouros , Amidoidrolases/genética , Amidoidrolases/metabolismo , Animais , Quitina/metabolismo , Besouros/genética , Besouros/metabolismo , Proteínas de Insetos/genética , Proteínas de Insetos/metabolismo , Interferência de RNA
5.
Neuropsychiatr Dis Treat ; 16: 2449-2457, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33122908

RESUMO

Purpose: Previous surveys have shown an increase in the prevalence of depression among college students. However, knowledge on the incidence and risk factors of depressive symptoms in Chinese college students is limited. The aim of the present study was to determine the two-year cumulative incidence of depressive symptoms in Chinese college freshmen and identified related psychosocial risk factors. Patients and Methods: A prospective survey was used to examine the cumulative incidence and risk factors of depressive symptoms (as assessed by the Centre for Epidemiological Study-Depression Scale, CES-D) among undergraduate freshmen. Five times (baseline, 5, 12, 17, and 24 months later) of self-reported data were collected from the students. Results: Of the initial 758 non-depressed respondents at baseline, 235 developed depressive symptoms (CES-D ≥ 16) during the follow-up period. The two-year cumulative incidence was estimated to be 42% and not significantly different between males and females (χ2=3.138, df =1, p=0.077). Logistic regression model showed that female gender (OR=0.43, 95% CI (0.28-0.64)), high level of self-esteem (OR=0.67, 95% CI (0.52-0.86)), and moderate exercise (OR=0.71, 95% CI (0.55-0.92)) reduced the onset of depressive symptoms; while high levels of baseline anxiety (OR=1.48, 95% CI (1.12-1.94)), Eysenck Personality Questionnaire-Neuroticism (OR=1.40, 95% CI (1.09-1.79)), concern over mistakes (OR=1.35,95% CI (1.07-1.71)), daytime sleepiness (OR=1.28, 95% CI (1.02-1.60)), mild exercise (OR=1.25, 95% CI (1.01-1.55)) increased the new onset of depressive symptoms. Conclusion: The high two-year cumulative incidence indicates that depressive symptoms are an important mental problem in Chinese college students. The present findings on the risk factors of depressive symptoms in Chinese college students may be useful for the design of student health screening and intervention programs.

6.
BMC Public Health ; 20(1): 1330, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32873275

RESUMO

BACKGROUND: A growing number of studies have explored how features of the neighbourhood environment can be related to cognitive health in later life. Yet few have focused on low- and middle-income countries and compared the results across different settings. The aim of this study is to investigate the cross-sectional associations between neighbourhood amenities and dementia in older people from high-, middle- and low-income countries. METHODS: This study was based on two population-based cohort studies of people aged≥65: the Cognitive Function and Ageing Study II (CFAS II) in UK (N = 4955) and a subset of the 10/66 study in China, Dominican Republic and Mexico (N = 3386). In both cohorts, dementia was assessed using the Geriatric Mental State-Automated Geriatric Examination for Computer Assisted Taxonomy (GMS-AGECAT) algorithm. The 10/66 dementia diagnostic algorithm was also used as an additional criterion in the 10/66 study. Publicly accessible databases, Google Maps and Open Street Map, were used to obtain geographic information system data on distance to neighbourhood amenities, including lifestyle (cafés, libraries, movie theatres, parks), daily life (post offices, convenience stores), healthcare (hospitals, pharmacies) and percentages of local green and blue spaces within 400 and 800 m of participants' residences. Multilevel logistic regression was used to investigate the associations between these environmental features and dementia adjusting for sociodemographic factors and self-rated health. RESULTS: Living far from daily life amenities was associated with higher odds of dementia in both CFAS II (1.47; 95% CI: 0.96, 2.24) and the 10/66 study (1.53; 95% CI: 1.15, 2.04), while living far from lifestyle (1.50; 95% CI: 1.13, 1.99) and healthcare amenities (1.32; 95% CI: 0.93, 1.87) was associated with higher odds of dementia only in the 10/66 study. A high availability of local green and blue spaces was not associated with dementia in either cohort yet living far from public parks was associated with lower odds of dementia in CFAS II (0.64; 95% CI: 0.41, 1.00). CONCLUSIONS: The different relationships across cohorts may indicate a varying role for local amenities in diverse settings. Future research may investigate mechanisms related to these differences and social, cultural and historical influences on the interaction between neighbourhood amenities and older people.


Assuntos
Cognição , Demência/epidemiologia , Características de Residência/estatística & dados numéricos , Meio Social , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Estudos de Coortes , Estudos Transversais , Países Desenvolvidos , Países em Desenvolvimento , República Dominicana/epidemiologia , Feminino , Avaliação Geriátrica , Humanos , Modelos Logísticos , Masculino , Testes de Estado Mental e Demência , México/epidemiologia , Reino Unido/epidemiologia
7.
Ann Transl Med ; 8(15): 920, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32953720

RESUMO

Background: Focally recalcitrant mycosis fungoides (MF) is challenging to treat. Despite interferon (IFN)-α intralesional injection having been tested in randomized controlled trials for the treatment of patch or early plaque lesions of MF, no real-world data regarding this therapy for focally recalcitrant MF has been reported. This study aimed to evaluate the effectiveness and safety of IFN-α-2a intralesional injection in focally recalcitrant MF. Methods: Data on all cases of focally recalcitrant MF treated by IFN-α-2a intralesional injection in Peking Union Medical College Hospital from January 1, 2015 to December 31, 2019 were retrospectively retrieved. Based on clearance of injected lesions and the proportion of adverse events (AEs), the effectiveness and safety of the treatment were analyzed, respectively. Results: Of the 15 patients included, 10 (66.7%) achieved complete response (CR), and 1 (6.7%) patient had partial response. The overall response rate was 73.3%. The clearance rate of lesions in the sun-exposed areas was significantly higher than that in the non-sun-exposed areas (P<0.01). The CR rate in patients with disease duration of less than 20 years was significantly higher than that in the patients with disease duration of at least 20 years (P<0.05). Four (26.7%) patients had stable disease (SD). The median event-free survival (EFS) was 4.0 months (95% CI, 1.8-6.1 months; range, 1-28+ months). There were no severe acute or chronic side effects. Conclusions: IFN-α-2a intralesional injection is an effective and safe treatment modality for the treatment of focally recalcitrant MF.

8.
J Ultrasound Med ; 39(10): 1927-1937, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32319698

RESUMO

OBJECTIVES: This study was aimed to assess the ultrasound (US) characteristics of mycosis fungoides (MF)/Sézary syndrome (SS) and explore the value of high-frequency US in accuracy staging for classic mycosis fungoides (cMF). METHODS: A prospective study was designed. Twenty-six patients with histopathologically confirmed MF or SS were enrolled to undergo HF-US examinations. Both 50- and 20-MHz US images of the most prominent lesion of each patient were collected by a cutaneous diagnostic US system, and the US characteristics in different stages were analyzed by 2 physicians independently. The Fisher exact test was used for the statistical analysis. RESULTS: A total of 26 patients underwent this study, including 23 with cMF, 2 with folliculotropic mycosis fungoides (FMF), and 1 with SS. Among cMF, 16 patients with patches or plaques (the early-stage group) showed a subepidermal low-echogenic band, and only 3 lesions in the plaque stage partially extended to the superficial dermis. Seven patients with tumors (the advanced-stage group) showed lesions that infiltrated to the deep dermis or subcutaneous tissue. The infiltration depth (P < .001), clarity of the boundary (P = .002), and homogeneity of internal echoes (P = .001) were significantly different between the early and advanced stages. Additionally, the 2 FMF lesions and 1 SS lesion had characteristic manifestations, showing a well-defined subepidermal low-echogenic band with patchy hypoechoic regions around the hair follicles in the dermis. CONCLUSIONS: High-frequency US can be used to accurately detect the infiltration depth and morphologic features of MF/SS lesions and provide important information for tumor staging of cMF. Additionally, the characteristic US features in FMF and SS might be helpful for diagnosis.


Assuntos
Micose Fungoide , Síndrome de Sézary , Neoplasias Cutâneas , Humanos , Micose Fungoide/diagnóstico por imagem , Micose Fungoide/patologia , Estadiamento de Neoplasias , Prognóstico , Estudos Prospectivos , Síndrome de Sézary/diagnóstico por imagem , Síndrome de Sézary/patologia , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Cutâneas/patologia
9.
BMC Geriatr ; 20(1): 138, 2020 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-32293307

RESUMO

BACKGROUND: The relationship between frailty and dementia is unclear and there are very few population-based studies regarding this issue in China. The purpose of this study is to estimate the association between frailty and incident dementia in China, and to explore different effects of frailty established by three definitions of frailty on dementia incidence. METHODS: A five-year prospective cohort study was carried out in 2022 participants aged 65 years and over in urban and rural sites in Beijing, China. The participants were interviewed by trained community primary health care workers from 2004 to 2009. Frailty was defined using modified Fried frailty phenotype, physical frailty definition, and multidimensional frailty definition. Dementia was diagnosed using the 10/66 dementia criterion for calculating cumulative incidence. Both competing risk regression models and Cox proportional hazards models were applied to examine the associations between frailty at baseline and five-year cumulative incidence of dementia. RESULTS: At the end of follow-up the five-year cumulative incidence rates of dementia with frailty and without frailty defined by the modified Fried frailty were 21.0% and 9.6%, those defined by the physical frailty were 19.9% and 9.0%, and those defined by the multidimensional frailty were 22.8% and 8.9%, respectively. Compared with non-frail participants, frail people had a higher risk of incident dementia using multidimensional frailty definition after adjusting covariates based on competing risk regression model (HR = 1.47, 95% CI 1.01~2.17) and Cox proportional hazards model (HR = 1.56, 95% CI 1.07~2.26). The association between frailty and incident dementia was statistically significant in participants in the upper three quartiles of age (aged 68 years and over) using the multidimensional frailty definition based on the competing risk regression model (HR = 1.61, 95% CI 1.06~2.43) and Cox proportional hazard model (HR = 1.76, 95% CI 1.19~2.61). CONCLUSIONS: Multidimensional frailty may play an inherent role in incident dementia, especially in the people aged over 68, which is significant for distinguishing high risk people and determining secondary prevention strategies for dementia patients.


Assuntos
Demência , Idoso Fragilizado , Fragilidade , Idoso , Pequim/epidemiologia , Estudos de Coortes , Demência/complicações , Demência/epidemiologia , Feminino , Fragilidade/complicações , Humanos , Incidência , Masculino , População , Estudos Prospectivos , Pesquisa
10.
J Aging Health ; 32(5-6): 401-409, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30698491

RESUMO

Objective: The objective of this study was to estimate healthy life expectancies in eight low- and middle-income countries (LMICs), using two indicators: disability-free life expectancy (DFLE) and dependence-free life expectancy (DepFLE). Method: Using the Sullivan method, healthy life expectancy was calculated based on the prevalence of dependence and disability from the 10/66 cohort study, which included 16,990 people aged 65 or above in China, Cuba, Dominican Republic, India, Mexico, Peru, Puerto Rico, and Venezuela, and country-specific life tables from the World Population Prospects 2017. Results: DFLE and DepFLE declined with older age across all sites and were higher in women than men. Mexico reported the highest DFLE at age 65 for men (15.4, SE = 0.5) and women (16.5, SE = 0.4), whereas India had the lowest with (11.5, SE = 0.3) in men and women (11.7, SE = 0.4). Discussion: Healthy life expectancy based on disability and dependency can be a critical indicator for aging research and policy planning in LMICs.


Assuntos
Indicadores Básicos de Saúde , Expectativa de Vida , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Estudos de Coortes , Países em Desenvolvimento , Pessoas com Deficiência/estatística & dados numéricos , República Dominicana/epidemiologia , Feminino , Humanos , Índia/epidemiologia , Masculino , México/epidemiologia , Peru/epidemiologia , Prevalência , Porto Rico/epidemiologia , Venezuela/epidemiologia
11.
Int J Geriatr Psychiatry ; 35(1): 29-36, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31608478

RESUMO

OBJECTIVES: Depression and anxiety are common mental disorders in later life. Few population-based studies have investigated their potential impacts on mortality in low- and middle-income countries (LMICs). The aim of this study is to examine the associations between depression, anxiety, their comorbidity, and mortality in later life using a population-based cohort study across eight LMICs. METHODS: This analysis was based on the 10/66 cohort study including 15 991 people aged 65 years or above in Cuba, Dominican Republic, Venezuela, Mexico, Peru, Puerto Rico, China, and India, with an average follow-up time of 3.9 years. Subthreshold and clinical levels of depression were determined using EURO-D and ICD-10 criteria, and anxiety was based on Geriatric Mental State (GMS)-Automated Geriatric Examination for Computer Assisted Taxonomy (AGECAT). Cox proportional hazard modelling was used to estimate how having depression, anxiety, or both was associated with mortality adjusting for sociodemographic and health factors. RESULTS: Participants with clinical depression (hazard ratio [HR]: 1.45; 95% CI, 1.24-1.70) and subthreshold anxiety (HR: 1.26; 95% CI, 1.15-1.38) had higher risk of mortality than those without the conditions after adjusting for sociodemographic factors and health conditions. Comorbidity of depression and anxiety was associated with a 30% increased risk of mortality but the effect sizes varied across countries (Higgins I2  = 58.8%), with the strongest association in India (HR: 1.99; 95% CI, 1.21-3.27). CONCLUSIONS: Depression and anxiety appear to be associated with mortality in older people living in LMICs. Variation in effect sizes may indicate different barriers to health service access across countries. Future studies may investigate underlying mechanisms and identify potential interventions to reduce the impact of common mental disorders.


Assuntos
Ansiedade/epidemiologia , Depressão/epidemiologia , Países em Desenvolvimento/estatística & dados numéricos , Mortalidade/tendências , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Masculino
12.
ACS Appl Mater Interfaces ; 12(3): 4135-4142, 2020 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-31880903

RESUMO

A combinational effect of nanostructured crystallites and π-bonded interfaces is much attractive in solving the conflict between strength/hardness and toughness to design extrinsically superhard materials with enhanced fracture toughness and/or other properties such as tunable electronic properties. In the present work, taking the experimentally observed π-bonded interfaces in nanostructured diamond as the prototype, we theoretically investigated their stabilities, electronic structures, and mechanical strengths with special consideration of the size effect of nanocrystallites or nanolayers. It is unprecedentedly found that the π-bonded interfaces exhibit tunable electronic semiconducting properties, superior fracture toughness, and anomalously large creep-like plasticity at the cost of minor losses in strength/hardness; such unique combination is uncovered to be attributed to the ductile bridging effect of the sp2 bonds across the π-bonded interface that dominates the localized plastic flow channel. As the length scale of nanocrystallites/nanolayers is lower than a critical value, however, the first failure occurring inside nanocrystallites/nanolayers features softening and embrittling. These findings not only provide a novel insight into the unique strengthening and toughening origin observed in ultrahard nanostructured diamonds consisting of nanotwins, nanocomposites, and nanocrystallites but also highlight a unique pathway by combining the nanostructured crystallites and the strongly bonded interface to design the novel superhard materials with superior toughness.

13.
Calcif Tissue Int ; 106(2): 131-146, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31679055

RESUMO

Until recently, it remains unclear whether schizophrenia, bipolar disorder (BD), and Alzheimer's disease (AD) is associated with bone mineral density (BMD). We aimed to investigate the causal effects of schizophrenia, BD and AD on BMD with Mendelian randomization (MR) analysis. Single-nucleotide polymorphisms (SNPs) strongly associated with these three neuropsychiatric diseases as instrumental variables were selected from genome-wide association studies in the MR Base database. We analyzed the effects of these SNPs on the femoral neck BMD (FN-BMD), lumbar spine BMD (LS-BMD) and forearm BMD (FA-BMD), and evaluated the heterogeneities and pleiotropy of these genetic variants. We also evaluated the potential confounding factors in the association between these three neuropsychiatric diseases and the BMD level. It was found that none of these genetic variants were significantly associated with BMD or confounding factors. Using these genetic variants, we did not find statistically significant causal effects of per unit increase in the log-odds of having schizophrenia, BD or AD with FN-BMD, LS-BMD and FA-BMD changes (e.g. schizophrenia and FN-BMD, MR-Egger OR 0.9673, 95% CI 0.8382 to 1.1163, p = 0.6519). The MR results also revealed that directional pleiotropy was unlikely to bias the causality (e.g., schizophrenia and FN-BMD, intercept = 0.0023, p = 0.6887), and no evidence of heterogeneity was found between the genetic variants (e.g., schizophrenia and FN-BMD, MR-Egger Q = 46.1502, I2 = 0.0899, p = 0.3047). Our MR study did not support causal effects of increased risk of schizophrenia, BD and AD status with BMD level.


Assuntos
Doença de Alzheimer/epidemiologia , Transtorno Bipolar/epidemiologia , Densidade Óssea/genética , Osteoporose/epidemiologia , Esquizofrenia/epidemiologia , Doença de Alzheimer/complicações , Doença de Alzheimer/genética , Transtorno Bipolar/complicações , Transtorno Bipolar/genética , Estudos de Casos e Controles , Causalidade , Comorbidade , Conjuntos de Dados como Assunto , Frequência do Gene , Heterogeneidade Genética , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Humanos , Desequilíbrio de Ligação , Análise da Randomização Mendeliana , Osteoporose/genética , Fraturas por Osteoporose/epidemiologia , Fraturas por Osteoporose/genética , Polimorfismo de Nucleotídeo Único , Fatores de Risco , Esquizofrenia/complicações , Esquizofrenia/genética
14.
Arch Osteoporos ; 15(1): 2, 2019 12 06.
Artigo em Inglês | MEDLINE | ID: mdl-31811461

RESUMO

We performed a systematic analysis of the standardized prevalence of osteoporosis in mainland China from 1990 to 2050. INTRODUCTION: Osteoporosis is the most common bone disease. We aimed to investigate the standardized prevalence of osteoporosis in mainland China at the national and regional levels, with projections until 2050. METHODS: A comprehensive literature search was performed in PubMed, EMBASE, Cochrane Library, CNKI, Wanfang, and CBM-SinoMed. We constructed resample sets to calculate the standardized prevalence in each study. Multilevel mixed-effects logistic regression was used to estimate the age-specific and sex-specific prevalence. The United Nations Population Division (UNPD) data and regional population data from the fifth and sixth censuses in mainland China were used to estimate and project the national and regional prevalence of osteoporosis. RESULTS: The standardized prevalence of osteoporosis ranged from 5.04% (2.12~11.34%) to 7.46% (3.13~16.32%) in males aged ≥ 50 years and from 26.28% (15.38~40.40%) to 39.19% (25.74~53.95%) in females aged ≥ 50 years from 1990 to 2050. Moreover, we did not find a significant difference in the standardized prevalence among three geographic regions (Central China, West China, and East China). CONCLUSION: We found that osteoporosis is a serious public health challenge in mainland China. The findings in our study add insight into the epidemiology of osteoporosis and would be beneficial for the prevention and treatment of osteoporosis in mainland China.


Assuntos
Previsões , Osteoporose/epidemiologia , Saúde Pública/tendências , Adulto , Idoso , China/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência
15.
Cell Res ; 29(11): 942-952, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31551537

RESUMO

It has been widely accepted that mitochondria-dependent apoptosis initiates when select BH3-only proteins (BID, BIM, etc.) directly engage and allosterically activate effector proteins BAX/BAK. Here, through reconstitution of cells lacking all eight pro-apoptotic BH3-only proteins, we demonstrate that all BH3-only proteins primarily target the anti-apoptotic BCL-2 proteins BCL-xL/MCL-1, whose simultaneous suppression enables membrane-mediated spontaneous activation of BAX/BAK. BH3-only proteins' apoptotic activities correlate with affinities for BCL-xL/MCL-1 instead of abilities to directly activate BAX/BAK. Further, BID and BIM do not distinguish BAX from BAK or accelerate BAX/BAK activation following inactivation of BCL-xL/MCL-1. Remarkably, death ligand-induced apoptosis in cells lacking BH3-only proteins and MCL-1 is fully restored by BID mutants capable of neutralizing BCL-xL, but not direct activation of BAX/BAK. Taken together, our findings provide a "Membrane-mediated Permissive" model, in which the BH3-only proteins only indirectly activate BAX/BAK by neutralizing the anti-apoptotic BCL-2 proteins, and thus allowing BAX/BAK to undergo unimpeded, spontaneous activation in the mitochondrial outer membrane milieu, leading to apoptosis initiation.


Assuntos
Apoptose/fisiologia , Proteína Agonista de Morte Celular de Domínio Interatuante com BH3/fisiologia , Proteína 11 Semelhante a Bcl-2/fisiologia , Mitocôndrias/metabolismo , Membranas Mitocondriais/metabolismo , Células HCT116 , Células HEK293 , Humanos , Proteína de Sequência 1 de Leucemia de Células Mieloides/metabolismo , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Proteína Killer-Antagonista Homóloga a bcl-2/metabolismo , Proteína bcl-X/metabolismo
16.
J Transl Med ; 17(1): 189, 2019 06 04.
Artigo em Inglês | MEDLINE | ID: mdl-31164161

RESUMO

BACKGROUND: Gastric cancer (GC) is a leading cause of cancer deaths, and an increased number of GC patients adopt to next-generation sequencing (NGS) to identify tumor genomic alterations for precision medicine. METHODS: In this study, we established a hybridization capture-based NGS panel including 612 cancer-associated genes, and collected sequencing data of tumors and matched bloods from 153 gastric cancer patients. We performed comprehensive analysis of these sequencing and clinical data. RESULTS: 35 significantly mutated genes were identified such as TP53, AKAP9, DRD2, PTEN, CDH1, LRP2 et al. Among them, 29 genes were novel significantly mutated genes compared with TCGA study. TP53 is the top frequently mutated gene, and tends to mutate in male (p = 0.025) patients and patients whose tumor located in cardia (p = 0.011). High tumor mutation burden (TMB) gathered in TP53 wild-type tumors (p = 0.045). TMB was also significantly associated with DNA damage repair (DDR) genes genotype (p = 0.047), Lauren classification (p = 1.5e-5), differentiation (1.9e-7), and HER2 status (p = 0.023). 38.31% of gastric cancer patients harbored at least one actionable alteration according to OncoKB database. CONCLUSIONS: We drew a comprehensive mutational landscape of 153 gastric tumors and demonstrated utility of target next-generation sequencing to guide clinical management.


Assuntos
Biomarcadores Tumorais/genética , Análise Mutacional de DNA/métodos , Perfilação da Expressão Gênica/métodos , Genômica/métodos , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Neoplasias Gástricas/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Estadiamento de Neoplasias , Medicina de Precisão , Análise de Sequência de DNA/métodos , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/patologia , Neoplasias Gástricas/terapia , Adulto Jovem
17.
Endocrine ; 65(2): 338-347, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31175577

RESUMO

PURPOSE: It is well known that hyperthyroidism is associated with atrial fibrillation (AF); however, the relationship between hypothyroidism and AF remains controversial. METHODS: Hypothyroidism was established in rats by two methods: methimazole-induced (MMI) and thyroidectomy (TX). MMI model includes control (n = 10), MMI (n = 10), and MMI + L-thyroxine (T4, n = 10). Methimazole was given intragastrically in MMI and MMI + T4 for 12 weeks, and T4 was added intragastrically in MMI + T4 at week 5. TX model includes sham (n = 10), TX (n = 10), and TX + T4 (n = 10). Four weeks after surgery, rats in TX + T4 received T4 for 8 weeks. Triiodothyronine (T3), T4, and thyroid-stimulating hormone (TSH) were measured. Electrophysiology, tissue structure and function, and protein levels of potassium and L-type calcium channels were assessed in the atria. RESULTS: Severe changes in the atrial structure of hypothyroid rats were observed. Compared with euthyroid rats, atrial effective refractory period (AERP) in hypothyroid rats was significantly shortened; accordingly, inducibility and duration of AF were considerably increased. Protein levels of minK, Kv1.5, Kv4.2, Kv4.3, Kv7.1, and Cav1.2 were upregulated in hypothyroid rats, whereas there was only a tendency toward increased Kir2.1. Kv11.1 was statistically upregulated in the MMI model and had an increasing tendency in the TX model. Conversely, Kir3.1 and Kir3.4 were downregulated in hypothyroid rats. The above changes could be partially inhibited by T4 treatment. CONCLUSIONS: AERP shortening due to altered protein levels of ion channels and atrial structural changes increased the susceptibility to AF in hypothyroidism. Thyroid replacement therapy could prevent electrical and structural remodeling under hypothyroid condition.


Assuntos
Fibrilação Atrial/etiologia , Hipotireoidismo/complicações , Canais de Potássio/metabolismo , Animais , Fibrilação Atrial/metabolismo , Ecocardiografia , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/metabolismo , Átrios do Coração/ultraestrutura , Hipotireoidismo/diagnóstico por imagem , Hipotireoidismo/metabolismo , Hipotireoidismo/patologia , Masculino , Ratos Wistar
18.
J Affect Disord ; 253: 184-192, 2019 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-31108379

RESUMO

BACKGROUND: Meta-analyses support the efficacy of cognitive behavioural therapy (CBT) for obsessive-compulsive disorder (OCD) in Western cultures. However, there are no adequately powered multicentre studies in China. This study aimed to compare the effectiveness of treatment with CBT combined with medication and medication alone in OCD patients in China. METHODS: OCD patients (N = 167) were recruited from outpatient clinics at three large tertiary psychiatric hospitals and one general hospital in China. Participants were randomly allocated to receive either CBT combined with medication (n = 92) or medication alone (n = 75) for a 24-week treatment period. Participants' symptoms and social functioning were assessed using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Hamilton Anxiety Rating Scale (HAM-A), Global Assessment of Functioning (GAF) and Clinical Global Impression Scale for Severity (CGI-S) at 0, 4, 8, 12 and 24 weeks, and the effectiveness of the two treatments compared using linear mixed-effects models. RESULTS: At 24 weeks, both groups showed large within-group effects in all measures. Significantly more patients receiving combined therapy than medication alone had a decrease in symptom severity of at least 35% (based on Y-BOCS total score). The CGI-S and GAF scores decreased in both groups, and significant differences were found between the groups. LIMITATIONS: Study limitations included lack of consideration of medication types and dosages, and the absence of a CBT-only arm. CONCLUSIONS: CBT combined with medication may be effective in alleviating symptoms and social functioning impairment associated with OCD, and is more effective than medication alone in China, particularly for the treatment of compulsive behaviours.


Assuntos
Antipsicóticos/uso terapêutico , Terapia Cognitivo-Comportamental/métodos , Transtorno Obsessivo-Compulsivo/terapia , Adulto , China , Terapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/psicologia , Índice de Gravidade de Doença , Resultado do Tratamento
19.
Arch Osteoporos ; 14(1): 55, 2019 05 25.
Artigo em Inglês | MEDLINE | ID: mdl-31129721

RESUMO

We used statistical approaches to calculate 1-year mortality rates and reveal the relationship between age and the 1-year mortality rate after hip fracture based on data from mainland China between the years 2000 and 2018. INTRODUCTION: Data on the 1-year mortality rates after hip fracture in mainland China remain limited and localized. We aimed to analyze the 1-year mortality rates and reveal the variations in 1-year mortality by age after hip fracture based on data from mainland China. METHODS: We searched PubMed, EMBASE, Cochrane Library, CNKI, Wanfang, and CBM-SinoMed for all relevant articles in English or Chinese to estimate the 1-year mortality rates after hip fracture in mainland China. A random-effects meta-analysis model was fitted to pool the overall 1-year mortality rates. A multilevel mixed-effects meta-regression model was developed. Based on the final model, the age-specific 1-year mortality rates after hip fracture in mainland China were generated. RESULTS: The pooled estimate of the 1-year mortality rate was 13.96% after hip fracture (95% CI 12.26 to 15.86%), 17.47% after femoral intertrochanteric fracture (95% CI 14.29 to 21.20%), and 9.83% after femoral neck fracture (95% CI 6.96 to 13.72%) between the years 2000 and 2018. We found that the 1-year mortality rates ranged from 2.65% (95% CI 1.76 to 3.99%) in those aged 50~54 years to 28.91% (95% CI 24.23 to 34.30%) in those aged 95~99 years after hip fracture; ranged from 1.73% (95% CI 0.58 to 4.99%) in those aged 50~54 years to 50.11% (95% CI 46.03% to 53.97%) in those aged 95~99 years after femoral intertrochanteric fracture; and ranged from 1.66% (95% CI 1.31 to 2.11%) in those aged 60~64 years to 37.71% (95% CI 27.92 to 48.63%) in those aged 95~99 years after femoral neck fracture. CONCLUSION: In this systematic review and meta-analysis, we calculated the 1-year mortality rate after hip fracture in mainland China and found that this rate was lower than that in most countries. We also estimated the age-specific mortality rates for different age groups after hip fracture. These findings will be beneficial for the prevention and treatment of hip fracture in mainland China.


Assuntos
Fatores Etários , Fraturas do Quadril/mortalidade , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade
20.
Lancet Psychiatry ; 6(3): 211-224, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30792114

RESUMO

BACKGROUND: The China Mental Health Survey was set up in 2012 to do a nationally representative survey with consistent methodology to investigate the prevalence of mental disorders and service use, and to analyse their social and psychological risk factors or correlates in China. This paper reports the prevalence findings. METHODS: We did a cross-sectional epidemiological survey of the prevalence of mental disorders (mood disorders, anxiety disorders, alcohol-use and drug-use disorders, schizophrenia and other psychotic disorders, eating disorder, impulse-control disorder, and dementia) in a multistage clustered-area probability sample of adults from 157 nationwide representative population-based disease surveillance points in 31 provinces across China. Face-to-face interviews were done with a two-stage design by trained lay interviewers and psychiatrists with the Composite International Diagnostic Interview, the Structured Clinical Interview for DSM-IV Axis I disorders, the Community Screening Instrument for Dementia from the 10/66 dementia diagnostic package, and the Geriatric Mental State Examination. Data-quality control procedures included logic check by computers, sequential recording check, and phone-call check by the quality controllers, and reinterview check by the psychiatrists. Data were weighted to adjust for differential probabilities of selection and differential response as well as to post-stratify the sample to match the population distribution. FINDINGS: 32 552 respondents completed the survey between July 22, 2013, and March 5, 2015. The weighted prevalence of any disorder (excluding dementia) was 9·3% (95% CI 5·4-13·3) during the 12 months before the interview and 16·6% (13·0-20·2) during the participants' entire lifetime before the interview. Anxiety disorders were the most common class of disorders both in the 12 months before the interview (weighted prevalence 5·0%, 4·2-5·8) and in lifetime (7·6%, 6·3-8·8). The weighted prevalence of dementia in people aged 65 years or older was 5·6% (3·5-7·6). INTERPRETATION: The prevalence of most mental disorders in China in 2013 is higher than in 1982 (point prevalence 1·1% and lifetime prevalence 1·3%), 1993 (point prevalence 1·1% and lifetime prevalence 1·4%), and 2002 (12-month prevalence 7·0% and lifetime prevalence 13·2%), but lower than in 2009 (1-month prevalence 17·5%). The evidence from this survey poses serious challenges related to the high burdens of disease identified, but also offers valuable opportunities for policy makers and health-care professionals to explore and address the factors that affect mental health in China. FUNDING: National Health Commission of Health (Ministry of Health) and Ministry of Science and Technology of China.


Assuntos
Transtornos Mentais/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Vigilância da População , Prevalência , Distribuição por Sexo , Inquéritos e Questionários , Adulto Jovem
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