Prevalence and risk factors associated with prehypertension: identification of foci for primary prevention of hypertension.

BACKGROUND AND RESEARCH OBJECTIVE: Prehypertension (pre-HT) has become an important public health issue in China because it identifies people at higher risk for hypertension (HT) and cardiovascular diseases. The aims of this study were to (1) examine the prevalence of pre-HT, (2) identify risk factors of pre-HT, and (3) identify factors that increase the likelihood of developing HT among the pre-HT group. SUBJECT AND METHODS: This was a cross-sectional descriptive study. Community-dwelling residents of an urban district in Wuhan, central China (obtained from stratified random sampling), aged between 35 and 74 years completed the study. Data were collected by using a structured self-reporting questionnaire and a standardized protocol for blood pressure measurement and risk screening. Blood pressure categories were defined according to the results of the seventh report of the Joint National Committee on the Prevention, Detection and Treatment of High Blood Pressure. RESULTS: Among the 1,448 participants, 618 (42.7%) had pre-HT. Multivariate logistic regression analysis revealed the risk factors of being overweight (adjusted odds ratio [aOR], 1.93; 95% confidence interval [CI], 1.26-2.98) or obese (aOR, 8.9; 95% CI, 1.14-62.3) and having above-optimal triglyceride level (aOR, 1.67; 95% CI, 1.24-2.26) were associated with pre-HT. Age and lower educational level were also associated with pre-HT risk. There was a clear trend toward an increased risk of HT among the pre-HT group with every 10-year increment in age starting from 45 years (aORs were 3.47, 6.82, and 7.58, respectively). Participants with Pre-HT currently engaging in sedentary work were also found to have a higher risk of developing HT. Other risk factors for HT included being overweight (aOR, 2.0; 95% CI, 1.50-2.68), a known family history of HT (aOR, 2.54; 95% CI, 1.98-3.26), and presence of diabetes mellitus (aOR, 2.51; 95% CI, 1.66-3.80). CONCLUSION: Prehypertension is common among residents in an urban district in central China. Findings of this study serve to identify the at-risk groups. Targeting these people early with therapeutic lifestyle changes may provide important long-term benefit for HT prevention.

Construction of air quality health index for respiratory diseases in Urumqi / 环境与职业医学

Background Air quality health index (AQHI) is derived from exposure-response coefficients calculated from air pollution and morbidity/mortality time series, which helps to understand the overall short-term health impacts of air pollution. Objective To study the effects of common air pollutants on respiratory diseases in Urumqi and to develop an AQHI for the risk of respiratory diseases in the city. Methods The daily outpatient volume data of respiratory diseases from The First Affiliated Hospital of Xinjiang Medical University, meteorological data (daily mean temperature and daily mean relative humidity), and air pollutants [fine particulate matter (PM2.5), inhalable particulate matter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon dioxide (CO), and ozone (O3)] in Urumqi City, Xinjiang, China were collected from January 1, 2017 to December 31, 2021. A distributed lag nonlinear model based on quasi-Poisson distribution was constructed by time-stratified case crossover design. Adopting zero concentration of air pollutants as reference, the exposure-response coefficient (β value) was used to quantify the impact of included air pollutants on the risk of seeking medical treatment for respiratory diseases, and the AQHI was established. The association of between AQHI and the incidence of respiratory diseases and between air quality index (AQI) and the incidence of respiratory diseases was compared to evaluate the prediction effect of AQHI. Results Each 10 µg·m−3 increase in PM10, SO2, NO2, and O3 concentrations presented the highest excess risk of seeking outpatient services at 3 d cumulative lag (Lag03) and 2d cumulative lag (Lag02), with increased risks of morbidity of 0.687% (95%CI: 0.101%, 1.276%), 17.609% (95%CI: 3.253%, 33.961%), 13.344% (95%CI: 8.619%, 18.275%), and 4.921% (95%CI: 1.401%, 8.502%), respectively. There was no statistically significant PM2.5 or CO lag effect. An AQHI was constructed based on a model containing PM10, SO2, NO2, and O3, and the results showed that the excess risk of respiratory disease consultation for the whole population, different genders, ages, or seasons for each inter-quartile range increase in the AQHI was higher than the corresponding value of AQI. Conclusion PM10, SO2, NO2, and O3 impact the number of outpatient visits for respiratory diseases in Urumqi, and the constructed AQHI for the risk of respiratory diseases in Urumqi outperforms the AQI in predicting the effect of air pollution on respiratory health.

Emodin reduces the injury of glomerular mesangial cells in lupus nephritis by targeting forkhead protein K2 through miR-96-5p / 中国临床药理学与治疗学

AIM: To investigate the injury of emodin (EMO) in reduce of glomerular mesangial cells (MCs) in lupus nephritis by targeting forkhead protein K2 (FOXK2) through miR-96-5p. METHODS: The contents of 24 h urine protein, serum urea nitrogen (BUN) and serum creatinine (Scr) in MRL / faslpr mice (lupus nephritis group) and MRL / MPJ mice (control group) were detected. MCs were separated, purified and divided into: MCs group (MCs without any treatment), L-EMO group (MCs treated with 10 μmol/L Emodin), M-EMO group (MCs treated with 25 μmol / L Emodin), H-EMO group (MCs treated with 50 μmol / L Emodin), H-EMO + miR-96-5p-NC group (MCs treated with 50 μmol / L Emodin and transfected with miR-96-5p-NC), and H-EMO + miR-96-5p-minic group (MCs treated with 50 μmol/ L Emodin and transfected with miR-96-5p-minic). Double luciferase report experiment was used to verify the targeting relationship between miR-96-5p and FOXK2. The real-time quantitative fluorescent polymerase chain reaction (qRT-PCR) was used to detect the expression of miR-96-5p. Western blot was used to detect the expression of FOXK2 and apoptosis related proteins. The enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of inflammatory factors in MCs. cell count kit 8 (CCK-8) was used to determine the activity of MCs. Annexin-V FITC/PI double staining was used to detect apoptosis of MCs. RESULTS: Compared with the control group, 24 h urinary protein content, serum BUN and Scr levels in the lupus nephritis group were significantly increased (P< 0.05). Compared with the MCs group, the miR-96-5p expression, interleukin1β (IL-1β), interleukin6 (IL-6), tumor necrosis factor-α (TNF-α), A450 value and B-lymphoblastoma-2 (Bcl-2) protein in the L-EMO group, M-EMO group and H-EMO group were significantly decreased (P<0.05), the FOXK2 level, cell apoptosis rate, Bcl-2 related X gene (Bax), aspartate specific cysteine proteinase-3 (cleaved Caspase-3) protein levels were significantly increased, respectively (P<0.05), the effect of Emodin was dose-dependent. Compared with the H-EMO group and H-EMO+miR-96-5p-NC group, H-EMO+miR-96-5p-minic group obviously increased the miR-96-5p expression, inflammatory factor levels, A450 value and Bcl-2 protein level (P<0.05), and obviously decreased FOXK2 level and cell apoptosis rate (P< 0.05). CONCLUSION: EMO can reduce the injury of lupus nephritis MCs by down-regulating miR-96-5p and then up-regulating FOXK2.

The progress of contrast-enhanced ultrasound in clinical application of breast cancer / 中国医师杂志

As a non-invasive pure blood pool imaging technology, contrast-enhanced ultrasound can be applied to the diagnosis of breast cancer, the judgment of lymph node status, the evaluation of neoadjuvant chemotherapy efficacy and prognosis, and provide more effective information for the diagnosis and treatment of breast cancer, which is conducive to the development of personalized treatment plan and avoid over treatment. This article reviews the clinical application of contrast-enhanced ultrasound in breast cancer in recent years.

Resting-state fMRI study of hippocampus in patients with Crohn′s disease / 中华全科医师杂志

Fifteen patients with Crohn′s disease (CD) in remission diagnosed at Shanghai Jing′an District Central Hospital from February 2018 to June 2019, and 26 matched healthy subjects were recruited. All participants underwent resting-state functional magnetic resonance imaging (fMRI) scans of hippocampus. The amplitude of low-frequency fluctuations (ALFF) was calculated to determine differences in the brain. Left hippocampus was selected as seeds for functional connectivity (FC) analysis, and the results were compared between two groups. The relationship between disease duration and ALFF/FC values in abnormal regions were analyzed with Pearson correlation. Compared with the controls, the ALFF of the left hippocampus (voxel size 32) of CD patients decreased [family-wise error correstion(FWE correction), cluster level P<0.05], and the ALFF of the left medial superior frontal gyrus (voxel size 126), left supplementary motor area (voxel size 126) and left anterior cingulate gyrus increased (voxel size 37) (FWE corrected, cluster level P<0.05). Using the left hippocampus as the seed point for the whole brain functional connectivity analysis, CD patients showed increased FC strength with the left superior temporal gyrus, left medial superior frontal gyrus, left inferior frontal gyrus (opercular part), and right supplementary motor area(FEW corrected, cluster level P<0.05). Correlation analysis did not show a significantly differences between ALFF/FC value of altered brain areas and the disease duration. It suggests that there are changes in spontaneous activities and functional connectivity in the left hippocampus in patients with CD.

Molecular characteristics and mechanisms in related diseases of peptidylarginine deiminase from Porphyromonas gingivalis / 中华微生物学和免疫学杂志

Porphyromonas gingivalis peptidylarginine deiminase (PPAD), an isoenzyme of animal endogenous peptidylarginine deaminase, is secreted by the Por system and catalyzes the citrullination of arginine. Recent studies have found that PPAD can affect the formation of Porphyromonas gingivalis biofilm and reduce the body′s immune defense function, which is related to the occurrence and development of many diseases such as periodontal diseases and rheumatoid arthritis. In this paper, we reviewed the molecular characteristics of PPAD, including the genetic and functional characteristics, as well as the mechanisms related to the inflammatory and autoimmune diseases. We also pointed some issues that should be pay attention to in the further study.

Analysis on the incidence trend of pulmonary tuberculosis before and after the COVID-19 in Hotan , Xinjiang , from 2015 to 2021 / 安徽医科大学学报

Objective @#To analyze the incidence characteristics and trends in pulmonary tuberculosis in the Hotan prefecture , before and after the epidemic , and to provide a reference basis for the formulation and evaluation of tuberculosis prevention and control measures in the Hotan prefecture . @*Methods @#The Hotan prefecture ’s pulmonary tuberculosis incidence data was collected between 2015 and 2021 . Joinpoint regression (JPR) model and Interrupted Time Series (ITS) model were established to explore the incidence trend of pulmonary tuberculosis , as well as the impact of COVID-19 prevention and control measures in Xinjiang on the incidence trend in Hotan , respectively. Furthermore , an analysis of variations in incidence among different age and gender subgroups was carried out. @*Results@#The results of the JPR model showed that from 2015 to 2021 , the reported incidence rate of pulmonary tuberculosis in the Hotan prefecture initially increased and then decreased , with a turning point appearing in December 2018 . The incidence rate in males was slightly higher than that in females , and the turning point and incidence trend were consistent with the overall trend . Among all age subgroups , those ≥60 age group had the highest incidence rate , with the trend also showing an initial increase followed by a decrease . A turning point in the incidence rate for the under 18 age group appeared in June 2021 , yet the trend was not statistically significant (P > 0. 05) .The turning points in the 19 - 59 age group and in those aged ≥60 were consistent with the overall trend . The results of the ITS model showed that the incidence rate of pulmonary tuberculosis in the Hotan prefecture significantly decreased since January 2020 , dropping from 319. 28 per 100 000 in 2019 to 155 . 88 per 100 000 in 2021 , a decrease of 51 . 16% year-on-year , with a monthly average reduction of 0. 049 per 100 000 .@*Conclusion @# In 2018 ,Xinjiang province integrated tuberculosis screening into the universal health checkup for the entire population ,which led to the identification of numerous cases of tuberculosis . In the Hotan prefecture , the reported incidence of pulmonary tuberculosis peaked in December 2018 and then started to decline . Under the impact of COVID-19 isolation measures in Xinjiang , the reported incidence rate showed a notable decrease starting in January 2020 . Reiterating preventive measures and remaining watchful for the possible appearance of latent tuberculosis patients is crucial as the pandemic fades .

The Research on the Construction of Medical Key Discipline Based on Application/Estimation/ Documents of Constructive Task / 中华医学科研管理杂志

Objective To determine key medical disciplines construction elements and specific contents.Methods The information of national and provincial level construction standards in medical key discipline was collected,and the key indexes and specific requirements in the standards were analyzed.Results There were 10 one-class indexes with a frequency of five and plus,including the overall situation,academic leaders,scientific research performance and support conditions which have emerged to 10 times.There are 4 first-class indexes set,4～14 second-class indexes respectively,and the frequencies of the second-class indexes were from 1 ～ 10.Conclusions Research on a number of the construction and evaluation criteria from different levels and regions was the best way to discover and identify priority disciplines and the best way to assess the contents.It is an important guidance for build a scientific,sustainable development key medical disciplines.It had important guiding significance to how to construct and develop the medical key disciplines.

The Current Situation and Countermeasures of Three Key Construction Projects in the Field of Medicine and Health in Shandong Province / 中华医学科研管理杂志

Objective To analyze the current situation and existing problems in the construction of key disciplines of medicine and health in 20 years in Shandong province and to explore the development countermeasures.Methods The data of all key disciplines of medicine and health certified by former Shandong Provincial Health Department from 1993 to 2013 were collected and analyzed.Results A total of 99 key professionals,71 key disciplines and 115 key laboratories were constructed in 20 years in the provincial medical and health institutions.The key projects in general hospitals had accounted for 74.38％.The numbers of key projects in Jinan,Qingdao,Weifang City were over the provincial average.Provincial Hospital and Qilu Hospital stayed top with 25 key projects among medical and health institutions.63.16％ of the key projects take the three grade discipline name as the standard name.There were ten discipline names emerged in the three key projects conjointly,including the names of 71 items.Conclusions The construction of three key projects of medicine and health in 20 years in Shandong province had gain the marked achievement.However,the problems of regional inequality,the lack of public health discipline,discipline name confusion and other issues still existed.To amendthe management approach,unified specification,strengthening process supervision,balanced development are the countermeasures for the constructions of key projects in Shandong Province.

Clinical observation on treatment effect of negative pressure wound therapy followed by ultrasonic debridement surgical system in patients with diabetic foot / 局解手术学杂志

Objective To evaluate the treatment effect of negative pressure wound therapy ( NPWT) followed by ultrasonic debridement surgical system ( UDSS) in patients with diabetic foot. Methods Forty-seven diabetic foot ulcer patients( WagnerⅡ~Ⅲ) were divided into two groups,of which 26 patients treated with UDSS combined NPWT,and 21 patients treated with traditional surgical debridement combined NPWT were control group. Cure rate, markedly effective rate and adverse reaction and complication were compared between two groups. Results Compared with control group,the experiment group had higher markedly effective rate in the first week(P<0. 05),and healing rates were higher in the 2th,4th,6th,12th weeks (P<0. 05). There were no differences in the adverse reactions and complications between the two groups. Conclusion UDSS combined with NPWT can accelerate wound cure,may play an important role for the treatment of diabetic foot ulcer.

Combined ultrasound-guided radiofrequency ablation and ethanol injection with a multipronged needle for the treatment of hepatocellular carcinoma ranging from 3.0 to 7.0 cm in diameter / 中华超声影像学杂志

Objective To evaluate the therapeutic efficacy and safety of radiofrequency ablation (RFA) combined with ethanol injection with a multipronged needle under ultrasound guidance for the treatment of hepatocellular carcinoma (HCC) larger than 3 cm in diameter.Methods 65 patients with 67HCC nodules ranging from 3.1 to 7.0 cm in diameter were treated percutaneously under ultrasound guidance.Tumor response and complications after treatment were observed.Results Complete ablation was achieved in 94.0％ (63/67) of HCC nodules.4 residual tumor nodules received complete ablation after additional treatment.Ablation-related major complications was occurred in 3 patients,including liver abscess in 1 case,abdominal bleeding in 1 case and massive ascites in 1 case,all were cured by conservative therapy.After a mean follow-up period of (20.0 ± 7.6) months (6.7-32.6 months),local-tumor progression was observed in 10 (14.9％) of 67 HCC nodules,and distant recurrence was observed in 32 (49.2％) of 65patients.The 1-year and 2-year survival rate were 93.1 ％ and 88.1％,respectively.Conclusions RFA combined with ethanol injetion with a multipronged needle is a safe and effective technique for the treatment of hepatocellular carcinoma larger than 3 cm,especially 3-5 cm in diameter.

Ultrasonographic diagnosis of pseudothrombophlebitis / 中华超声影像学杂志

Objective To investigate the ultrasound characteristics of pseudothrombophlebitis.Methods The ultrasound characteristics of thirty-two popliteal cyst cases with pseudothrombophlebitis which were confirmed by MRI or puncture were retrospectively analyzed.The former group was matched with a case control group of sixty-four patients with asymptomatic popliteal cysts,the ultrasound images were comparative analysis between the two groups.Results Compared to the control group,both the length and width of the case group were larger [(12.4 ± 4.7) ×(2.5±0.4)cm vs (5.3±2.9) × (1.2±0.4)cm,P ＜ 0.001],and there were 18(43.8％) cases with the cysts extension into the calf.The case group were more prone to show cyst with poor ultrasound penetration or solid-cystic echo (78.1％ vs 9.4％,P =0.000),which were diagnosed as popliteal cyst with hematoma or infection.Six cases of case group showed irregular anechoic area surrounding the inferior border of the cysts,which were diagnosed as ruptured popliteal cyst,no similar imaging detected in the control group(P =0.001).Both the two group showed septation in the cyst,but it did not differ significantly(P ＞0.05).Conclusions Ultrasonography is helpful to the diagnosis of pseudothrombophlebitis,the ultrasound characteristics include large cyst extension into the calf,cyst with poor ultrasound penetration or solid-cystic echo and irregular anechoic area surrounding the inferior border of the cysts.

Smac/DIABLO induces apoptosis in pancreatic cancer cells and increases the sensitivity of TRAIL and gemcitabine chemotherapy / 中华普通外科杂志

Objective To explore the effect of ectopic overexpression of Smac/DIABLO on the proliferation of pancreatic cancer cell line SW1990,and the sensitization to TRAIL and Gemcitabine induced apoptosis.Methods The Smac/DIABLO gene was transfected into the pancreatic cancer cell line SW1990 with the participation of Lipofectamine 2000 (SW1990/Smac).The cell line transfected with empty vector served as controls (SW1990/neo).The SW1990/neo and SW1990/Smac cells were assigned into the following treatment groups:TRAIL group,Gemcitabine group,TRAIL plus Gemcitabine group,and the control group.The SW1990 cells were treated with TRAIL and Gemcitabine in different concentrations and time.The cell growth inhibition rate (CGIR) was detected by MTT,the rate of apoptosis was measured by flow eytometry,the apoptosis morphous was observed by Heochst 33342 staining.The expressions of apoptosis-associated proteins such as Smas/DIABLO,XIAP,cytochrome C and caspase-3 were detected by Western blot.Results The cell growth of SW1990/Smac was significantly lower than growth of SW1990/ neo.The concentration of TRAIL were 200,500,1000 and 2500 ng/ml respectively.After 24 hours,the CGIR of SW1990/neo and SW1990/Smac were 11.11％,46.03％,67.08％,76.19％ and 22.11％,42.67％,56.63％,67.6％ respectively (P ＜ 0.05).The concentration of Gemcitabine were 10,20,40 and 60 μmol/L respectively.After 24 hours,the CGIR of SW1990/neo and SW1990/Smac were 15.2％,34.6％,55.16％,76.4％ and 22.65％,36.85％,55.11％,79.99％ respectively (P＜0.05).The cells of SW1990/neo and SW1990/Smac were treated by TRAIL(500 ng/ml),Gemcitabine (20 μmol/L) and combination group.The apoptosis rate were 5.64％,15.30％,27.27％ and 20.37％,23.27％,67.30％ (P ＜ 0.05) respectively.In combination group,the expressions of activators of caspase such as Smas/DIABLO,cytochrome C and caspase-3 increased significantly,while the expressions of inhibitor of apoptosis protein XIAP decreased.Conclusions Ectopic expression of Smac/DIABLO could induce the apoptosis of SW1990 cell,inhibit the cell proliferation,and enhence the sensitivity of SW1990 cell to TRAIL and Gemcitabine.The mechanism of apoptosis sensitization effect by Smac/DIABLO was associated with significant up-regulation of Smac/DIABLO,cytochrome C,down-regulation of XIAP,and the activation of caspase-3.

Comparison of enhancement pattern and differential diagnosis efficacy between contrast-enhanced ultrasound and contrast-enhanced computed tomography for gallbladder diseases / 中华超声影像学杂志

Objective To compare the enhancement characteristic of the gallbladder diseases and to evaluate the diagnostic efficacy in differential diagnosis of the gallbladder diseases between contrast-enhanced sonography (CEUS) and contrast-enhanced computed tomography (CECT).Methods Seventy-two patiens with gallbladder lesions were examined by CEUS and CECT before operation and all final diagnoses were confirmed by surgery and/or pathological diagnosis.Results 1)In early phase,84.6％ (33/39) and 79.5％ (31/39) of benign diseases showed hyper-enhancement on CEUS and CECT,and 97.0％ (32/33) and 87.9％ (29/33) of malignant diseases showed hyper-enhancement on CEUS and CECT respectively (P =0.250).In later phase,91.2％ (31/34) and 88.2％ (30/34) of benign diseases showing hypo-enhancement (P =1.000),and 100％ of the malignant diseases showing hypo-enhancement on CEUS and CECT respectively.2)The time of enhancement from hyper-to hypo in CEUS for benign and malignant diseases were (39.9 ± 15.7)s and (29.9 ± 5.6)s respectively (t =3.61,P =1.000).3)The inhomogeneous enhancement on CEUS and CECT were 41.0％ (16/39) and 53.8％ (21/39) in the benign diseases respectively (P =0.063),84.8 ％ (28/33) and 97.0 ％ (32/33) in the malignant diseases respectively(P =0.125).4)The destruction of the gallbladder wall on CEUS and CECT are 87.9％ (29/33) and 90.9％ (30/33) respectively(P =1.000).5)The accuracy,diagnostic sensitivity,specificity of CEUS and CECT were 91.7％(66/72) and 87.5％(63/72),97.0％(32/33) and 93.9％(31/33),87.2％(34/39) and 82.15％ (32/39) respectively (P =0.250,1.000,0.500).Conclusions The enhancement pattern of the gallbladder diseases on CEUS and CECT were much similar.CEUS has equal diagnostic efficacy in comparison with CECT,but CEUS can supply more diagnostic information than CECT.

Infantile Septicemia Induced by Coagulase Negative Staphylococcus / 中华医院感染学杂志

OBJECTIVE To investigate the major pathogenic bacteria and drug resistance in the infantile septicemia and to provide laboratory evidence for clinical diagnosis and treatment. METHODS The venous blood plate was used. RESULTS Totally 328 isolated strains were assayed with French Bio-Merieux API System.Of them,203 strains of coagulase negative Staphylococcus(CNS),being 61.9%.115 strains(56.6%) were(S.epidermidis).45 strains(22.1%) were S.haemolyticus,and 43 strains(21.1%) were S.lugdunensis.The isolated rate of meticillin resistant coagulase negative Staphylococcus(MRCNS) was 35.5%.The drug test for MRCNS showed multiple drug-resistance. CONCLUSIONS MRCNS is the major pathogen in infantile septicemia.The detectable rate of MRCNS is high.Glycopeptide antibiotics are the first-choice drugs for MRCNS infection.