ObjectiveTo understand the death status of major chronic diseases among the registered residents in Xuhui District， Shanghai from 2007 to 2021， and to analyze the probability and trend of premature death， so as to provide an evidence for the policy-making of disease control and prevention. MethodsBased on the data from the death registration system of the registered residents in Xuhui District， Shanghai from 2007 to 2021， the mortality rate of major chronic diseases， life expectancy without cause of death， potential years of life lost （PYLL）， average years of life lost （AYLL）， and premature death rate were calculated. Joinpoint 4.8 software was used to calculate the annual percentage change （APC） of premature death rate and its trend. ResultsIn 2021， the mortality rate and standardized mortality rate of four major chronic diseases， namely cardiovascular and cerebrovascular diseases， malignant tumors， diabetes mellitus and chronic lower respiratory diseases among the registered residents in Xuhui District， Shanghai was 767.75/100 000 and 234.69/100 000， respectively， accounting for 85.63% of the total causes of death among the residents in Xuhui District， Shanghai. The PYLL， AYLL and PYLL rate were 10 710.00 person-years， 1.49 years per person， and 11.43‰， respectively. Life expectancy increased by 14.91 years after removing the four major chronic diseases. From 2007 to 2021， the premature death rate of chronic diseases among the registered residents in Xuhui District decreased from 9.38% to 7.91% （APC=-1.09%，P<0.05）. Malignant tumors had the highest rate in premature death， and the premature death rate was higher in males than that in females， with a slower rate of decline than in females. Cardiovascular and cerebrovascular diseases， malignant tumors and chronic lower respiratory diseases showed a significant decreasing trend in premature death rate （APC=-1.30%， -1.20%， -5.42%， P<0.05）， while diabetes mellitus showed a significant increasing trend in premature death rate （APC=3.20%， P<0.05）. There was a significant increasing trend in the rate of premature death from diabetes mellitus in males （APC=5.15%， P<0.05） and a decreasing trend in the rate of premature death from diabetes mellitus in females （APC=-0.76%， P<0.05）. ConclusionCardiovascular and cerebrovascular diseases， malignant tumors， diabetes mellitus and chronic lower respiratory diseases are the main causes of death among the registered residents in Xuhui District. The probability of premature death of the residents in Xuhui District from major chronic diseases is at a low level， indicating that the prevention and control of chronic diseases in Xuhui District has achieved some success， but it is still difficult to realize the goals of the Outline of the "Healthy China 2030" Plan. Therefore， it is necessary to comprehensively carry out the control of risk factors such as tobacco use， harmful alcohol consumption， salt intake， hypertension， hyperglycemia and obesity， especially to strengthen the control of risk factors for male residents， as well as early diagnosis and treatment of malignant tumors， cardiovascular and cerebral vascular diseases and diabetes mellitus， and to implement the disease management mechanism to reduce premature death.

ObjectiveTo investigate the prevalence and influencing factors of overweight， obesity and central obesity among elderly residents in Xuhui District， and to analyze the epidemiological status of central obesity in elderly people with different body mass indexes. MethodsThe third round of health status and health service utilization monitoring data in Xuhui District was used. The information collected from questionnaire survey and physical examination were analyzed. SPSS 20.0 software was used for χ² test， trend χ² test and multinominal logistic regression analysis. Results5 096 survey subjects were included. The prevalence of overweight， general obesity， and central obesity in the residents aged 60 and above in Xuhui District were 34.3%， 6.5%， and 29.2%， respectively. There was gender difference in the rates of overweight， obesity， and central obesity among the residents. The overweight and central obesity rates in males were higher than those in females， while the obesity rate was lower than that in females （P<0.05）. Multinominal logistic regression analysis showed that in comparison with the normal weight non-central obesity group drinking only at party （OR=1.729， 95%CI： 1.184‒2.525）， and hypertension （OR=1.637， 95%CI： 1.305‒2.053）， were highly associated with normal weight with central obesity. Aged 60‒ years （OR=1.589， 95%CI： 1.190‒2.120）， aged 70‒ years （OR=1.763， 95%CI： 1.327‒2.342）， male （OR=1.379， 95%CI： 1.134‒1.676）， hypertension （OR=2.231， 95%CI： 1.878‒2.649）， former smokers （OR=1.437， 95%CI： 1.027‒2.011）， drinking at party only （OR=1.491， 95%CI： 1.107‒2.006）， and drinking ≥3 times per week （OR=1.611， 95%CI： 1.116‒2.325）， were highly associated with overweight combined with central obesity. Aged 60‒ years （OR=3.817， 95%CI： 2.251‒6.474）， aged 70‒ years （OR=3.084， 95%CI： 1.838‒5.175）， hypertension （OR=3.683， 95%CI： 2.753‒4.929）， diabetes （OR=2.085， 95%CI： 1.511‒2.878）， former smokers （OR=1.835， 95%CI： 1.043‒3.226）， were highly associated with compound obesity. Central obesity was found in the elderly residents with different BMI categories， and the rate of central obesity increased with the increase of BMI grade. ConclusionThe prevalence of overweight， obesity and central obesity among the elderly aged 60 years and above in Xuhui District is not optimistic. Attention should be paid to the elderly under 80 years old who are with hypertension and/or diabetes， alcohol consumption， low educational level and not doing physical exercise. Especially for the central obesity population with normal BMI， measures should be taken to prevent and intervene the occurrence of obesity and related diseases.

OBJECTIVETo investigate the effect of Src kinase inhibitor PP2 on hypoxia/reoxygenation (H/R) injury in rat astrocytes in vitro.

METHODSIn vitro cultured rat astrocytes were exposed to hypoxia for 8 h followed by reoxygenation for 24 h with or without pretreatment with PP2 (10 µmol/L) for 24 h before H/R injury. MTT assay and flow cytometry were used to detect the viability and apoptosis of the exposed astrocytes, respectively, and the protein expressions of Src, Bax, and Bcl-2 in the cells were determined using Western blotting.

RESULTSPP2 pretreatment significantly increased the viability and decreased the apoptosis rate of rat astrocytes exposed to H/R injury (P<0.01). Western blotting showed that H/R injury caused increased expression of Src kinase, which was lowered by PP2 pretreatment. The ratio of Bax/bcl-2 in the astrocytes increased after H/R injury, and was significantly decreased by PP2 pretreatment (P<0.01).

CONCLUSIONPP2 protects rat astrocytes from H/R injury possibly by inhibiting the expression of Src kinase and activating the anti-apoptotic mechanisms in the cells.

Animals ; Apoptosis ; Astrocytes ; pathology ; Cell Hypoxia ; Cells, Cultured ; Flow Cytometry ; Pyrimidines ; pharmacology ; Rats ; src-Family Kinases ; antagonists & inhibitors

OBJECTIVETo determine the expression of connexin 43 (Cx43) protein and explore the functional modulation of gap junction intercellular communication in astrocytes.

METHODSCultured neonatal SD rat astrocytes were divided into normal control group, all-trans retinoic acid (ATRA) group (treated with 10 µmol/L ATRA for 24 h) and oleamide group (treated with 25 µmol/L oleamide for 2 h). Western blotting and immunofluorescence assay were used to detect total cellular Cx43 protein expression and Cx43 expression on the surface of the astrocytes, respectively. Parachute assay was used to evaluate the functional changes of gap junction intercellular communication of the astrocytes.

RESULTSCompared with the normal control cells, ATRA treatment resulted in a significantly increased expression of total Cx43 protein in the astrocytes (P<0.01), and oleamide significantly suppressed its expression (P<0.01). Similarly, ATRA obviously enhanced while oleamide suppressed Cx43 protein expression on the surface of the astrocytes. The gap junction intercellular communication of the astrocytes was enhanced by ATRA (P<0.01) and inhibited by oleamide (P<0.01).

CONCLUSIONATRA and oleamide can modulate gap junction intercellular communication of the astrocytes possibly by regulating the expression of Cx43 protein.

Animals ; Astrocytes ; metabolism ; Cell Communication ; drug effects ; Cells, Cultured ; Connexin 43 ; metabolism ; Gap Junctions ; metabolism ; Oleic Acids ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Tretinoin ; pharmacology

Objective To study the application effect of systematic emergency nursing process in treatment of neonatal hypoxic ischemic encephalopathy (HIE). Methods One hundred and four neonates with HIE who were treated in the First Hospital of Hebei Medical University from January 2016 to January 2018 were selected as the subjects of this study, and they were divided into a control group and a study group according to different nursing care process, with 52 cases in each group. The infants in the control group were resuscitated according to conventional traditional first aid measures, while the infants in the study group received systematic emergency nursing care process on the basis of routine first aid (including the preparation of early rescue drugs and equipment; warmth kept in the whole course, the room temperature controlled in 30 - 32 ℃; rapid assessment of maternal delivery methods and procedures, delivery of the newborn and assessment of babies general conditions; performance of preliminary resuscitation for neonate, tracheal intubation for mechanical ventilation, and external chest compression if necessary; close monitor of the vital signs of newborn; symptomatic treatment; reassessment of the baby's disease condition). The successful rescue rate, total rescue time, hospitalization time, neonatal Apgar score and quality of nursing care before and after resuscitation were compared between the two groups. Results The successful rescue rate of the study group was higher than that of the control group [96.2% (50/52) vs. 82.7% (43/52), P < 0.05], and the total rescue time (minutes: 8.9±2.1 vs. 12.4±3.2) and hospitalization time (days: 8.1±2.2 vs. 11.4±2.9) in study group were shorter than those in control group, all the differences being statistically significant (all P < 0.05). After resuscitation for 5 minutes, the Apgar scores of the newborns in the two groups were higher than those before the resuscitation (study group: 8.3±1.1 vs. 2.2±0.7, control group: 6.7±2.0 vs. 2.1±0.9), and after resuscitation for 5 minutes, the Apgar score of the study group was higher than that of the control group (8.3±1.1 vs. 6.7±2.0), the difference being statistical significant (P < 0.05). The scores of rescue technique (5.0±2.9 vs. 2.7±0.6), humanistic care (5.6±2.1 vs. 2.8±0.9), rescue efficiency (5.3±1.2 vs. 3.0±0.6), and rescue effect (5.7±1.3 vs. 2.9±0.8) in the study group were all higher than those in the control group (all P < 0.05). Conclusion The systematic emergency nursing care process can effectively elevate the successful rescue rate of neonates with HIE, shorten the total rescue time and hospitalization time, enhance the rescue effect, and improve the quality of nursing care, thus it is worthy to be widely applied clinically.

Objective To investigate the hyperglycemia rate and its correlative factors for the undiagnosed diabetes population in Xuhui District of Shanghai, and to provide the basis for early intervention of diabetes mellitus. Methods Multi-stage cluster sampling was adopted by probability proportionate to size method, and physical examination information and questionnaires were made and collected from 10 130 and 9085 people in 2010 and 2015 respectively from 5 000 households, blood-glucose being examined at the same time.Univariate analysis was made by t test and χ² test and logistic regression was used for analysis of related factors. Results In 2010 and 2015, the diabetes incidence rate was 2.21% and 1.93% respectively, and the hyperglycemia incidence rate in 2015 was higher than that in 2010 (15.28% vs. 12.63%), both increased with age and BMI value.The rate was higher in those with lower education, abnormal blood pressure, self-reported hypertension, self-reported coronary heart disease and smokers.The logistic regression analysis results showed the incidence of diabetes was positively correlated with age, BMI, abnormal blood pressure and smoking, while the incidence of hyperglycemia was positively correlated with the survey year, sex, age, BMI and abnormal blood pressure; both were negatively correlated with educational level. Conclusion The hyperglycemia incidence rate is high among the community undiagnosed diabetic population.We should focus on high-risk screening for diabetes mellitus, and key intervention of the population with low educational level, overweight and obesity, hypertension and unhealthy lifestyle.

Since the key point of prevention and control of new coronavirus infection (COVID-19) in the community is to block the spread, the centralized quarantine for close contacts with confirmed or suspected cases is the most effective way in breaking the chain of transmission. A community centralized quarantine site was set up by Fenglin Community Health Service Center for medical observation of close contacts. The detailed plan and management of the centralized quarantine site, and the implementation experiences are introduced in this article to provide reference for medical institutions involved in the prevention and control of COVID-19 epidemic.

ObjectiveTo explore the evolution principles of symptoms including deficiency， phlegm and blood stasis， and of the functional near-infrared spectroscopy （fNIRS） cerebral hemodynamic characteristics at various stages in patients of Alzheimer's disease. MethodsA total of 497 patients with complaint of memory loss were included， and were divided into subjective cognitive decline （SCD） group （198 participants）， mild cognitive impairment （MCI） group （228 participants） and dementia （AD） group （71 participants）. Neuropsychological evaluation， traditional Chinese medicine （TCM） syndrome investigation， and fNIRS data collection of prefrontal cortex were performed in each group. Descriptive statistics were used to analyze the distribution of TCM syndromes and the difference of TCM syndrome scores in each group； logistic regression was used to analyze the influence of TCM syndromes on the incidence of the patients； association rules were used to analyze the TCM syndromes of the patients； the hemodynamic characteristics of fNIRS in the prefrontal cortex of each group were compared. ResultsKidney essence deficiency syndrome was the dominant syndrome in all stages of AD. There were statistically significant differences in the distribution frequency of kidney essence deficiency， phlegm turbidity obstructing orifices， blood stasis obstructing collaterals， qi and blood deficiency， heat toxin in the interior， and fu-organ stagnation and turbidity retention syndromes among the three groups （P＜0.01）， and the scores of kidney essence deficiency syndrome among the three groups were statistically significant （P＜0.01）. Logistic regression analysis showed that kidney essence deficiency， and qi and blood deficiency syndromes were the main risk factors for the SCD group （P＜0.05）， phlegm turbidity obstructing orifices syndrome was the main risk factor for the MCI group （P＜0.05）， and heat toxin in the interior， and fu-organ stagnation and turbidity retention syndromes were the main risk factors for the AD group （P＜0.05）. The association rule analysis showed that the combination of kidney essence deficiency plus phlegm turbidity obstructing orifices had the highest support （33.33%） in the SCD group， and the combination of kidney essence deficiency plus blood stasis obstructing collaterals had the highest support （32.90% and 52.13%） in both the MCI and AD group. The prefrontal fNIRS results showed that the mean ∆HbO₂ concentration in the left dorsolateral prefrontal cortex （LDLPFC） decreased sequentially among the three groups （P＜0.05）， and the mean ∆HbO₂ concentration in the LDLPFC was negatively correlated with the MoCA score among the three groups （r = -0.142， P＜0.05）. Further analysis showed that the mean ∆HbO₂ concentration in the LDLPFC of patients with kidney essence deficiency syndrome were statistically significant differences among the three groups （P＜0.05）. ConclusionKidney deficiency is the basis of the pathogenesis of AD， and the key brain area damaged is the LDLPFC. Turbid pathogens such as phlegm and blood stasis are the pathological factors that aggravate the disease， and the syndromes of AD show the evolution law of deficiency and excess as “kidney deficiency→phlegm turbidity→blood stasis→turbid toxin”. The changes in prefrontal hemodynamics based on fNIRS are consistent with the changes in the characteristics of symptoms， which can be used to assess the degree of cognitive impairment in AD patients.

ObjectiveTo investigate the high-risk detection rate and aggregation of cardiovascular diseases（CVD） in 8 districts of Shanghai and influencing factors， and to provide scientific references for prevention and control of CVD. MethodsBased on the Cardiovascular Disease Screening and Management Program in Shanghai from 2016 to 2021， 104 685 participants aged 35 to 75 in 8 districts of Shanghai were selected for analysis. χ² test and multivariate logistic regression were used for statistical analysis of the influencing factors of CVD and aggregation of CVD. ResultsThe proportion of high-risk CVD individuals in the population was 19.17%， including the high-risk individuals with hypertension （8.65%）， dyslipidemia （6.33%）， CVD history （5.58%）， and WHO assessed risk ≥20% types （2.69%）， respectively. Old age， overweight and obesity， central obesity， smoking， drinking， farmers， unmarried， and low family income were the risk factors of CVD， while high education level was the protective factor. In the participants， 16 323 people （81.34%） were classified as CVD high-risk groups； The number of aggregation of 1， 2 and ≥3 high risk types of CVD were 16 323（81.34%）， 3 236（16.13%）， 509（2.54%）， respectively. Old age， low education level， low annual family income， farmers， unmarried， smoking， drinking， overweight， obesity and central obesity were associated with the risk of aggregation of high risk types of CVD， and the correlation strength increased with the increase of aggregation types. ConclusionThe prevention and control of CVD in Shanghai should focus on the hypertension， elderly， overweight， obesity， central obesity， smoking， drinking， low educated， low family income， farmers and unmarried people， and targeted intervention measures should be taken to reduce the risk of CVD among residents.