OBJECTIVE: To investigate the relationship between physical activity and genetic risk and their combined effects on the risk of developing chronic obstructive pulmonary disease. METHODS: This prospective cohort study included 318,085 biobank participants from the UK. Physical activity was assessed using the short form of the International Physical Activity Questionnaire. The participants were stratified into low-, intermediate-, and high-genetic-risk groups based on their polygenic risk scores. Multivariate Cox regression models and multiplicative interaction analyses were used. RESULTS: During a median follow-up period of 13 years, 9,209 participants were diagnosed with chronic obstructive pulmonary disease. For low genetic risk, compared to low physical activity, the hazard ratios ( HRs) for moderate and high physical activity were 0.853 (95% confidence interval [ CI]: 0.748-0.972) and 0.831 (95% CI: 0.727-0.950), respectively. For intermediate genetic risk, the HRs were 0.829 (95% CI: 0.758-0.905) and 0.835 (95% CI: 0.764-0.914), respectively. For participants with high genetic risk, the HRs were 0.809 (95% CI: 0.746-0.877) and 0.818 (95% CI: 0.754-0.888), respectively. A significant interaction was observed between genetic risk and physical activity. CONCLUSION Moderate or high levels of physical activity were associated with a lower risk of developing chronic obstructive pulmonary disease across all genetic risk groups, highlighting the need to tailor activity interventions for genetically susceptible individuals.
Humans ; Pulmonary Disease, Chronic Obstructive/epidemiology* ; Exercise ; Male ; Female ; Middle Aged ; Prospective Studies ; Aged ; Genetic Predisposition to Disease ; Risk Factors ; United Kingdom/epidemiology* ; Incidence ; Adult

Objectives: To investigated the safety and efficacy of treating patients with acute non-ST-segment elevation myocardial infarction (NSTEMI) and elevated levels of N-terminal pro-hormone B-type natriuretic peptide (NT-proBNP) with levosimendan within 24 hours of first medical contact (FMC). Methods: This multicenter, open-label, block-randomized controlled trial (NCT03189901) investigated the safety and efficacy of levosimendan as an early management strategy of acute heart failure (EMS-AHF) for patients with NSTEMI and high NT-proBNP levels. This study included 255 patients with NSTEMI and elevated NT-proBNP levels, including 142 males and 113 females with a median age of 65 (58-70) years, and were admitted in the emergency or outpatient departments at 14 medical centers in China between October 2017 and October 2021. The patients were randomly divided into a levosimendan group (n=129) and a control group (n=126). The primary outcome measure was NT-proBNP levels on day 3 of treatment and changes in the NT-proBNP levels from baseline on day 5 after randomization. The secondary outcome measures included the proportion of patients with more than 30% reduction in NT-proBNP levels from baseline, major adverse cardiovascular events (MACE) during hospitalization and at 6 months after hospitalization, safety during the treatment, and health economics indices. The measurement data parameters between groups were compared using the t-test or the non-parametric test. The count data parameters were compared between groups using the χ² test. Results: On day 3, the NT-proBNP levels in the levosimendan group were lower than the control group but were statistically insignificant [866 (455, 1 960) vs. 1 118 (459, 2 417) ng/L, Z=-1.25,P=0.21]. However, on day 5, changes in the NT-proBNP levels from baseline in the levosimendan group were significantly higher than the control group [67.6% (33.8%,82.5%)vs.54.8% (7.3%,77.9%), Z=-2.14, P=0.03]. There were no significant differences in the proportion of patients with more than 30% reduction in the NT-proBNP levels on day 5 between the levosimendan and the control groups [77.5% (100/129) vs. 69.0% (87/126), χ²=2.34, P=0.13]. Furthermore, incidences of MACE did not show any significant differences between the two groups during hospitalization [4.7% (6/129) vs. 7.1% (9/126), χ²=0.72, P=0.40] and at 6 months [14.7% (19/129) vs. 12.7% (16/126), χ²=0.22, P=0.64]. Four cardiac deaths were reported in the control group during hospitalization [0 (0/129) vs. 3.2% (4/126), P=0.06]. However, 6-month survival rates were comparable between the two groups (log-rank test, P=0.18). Moreover, adverse events or serious adverse events such as shock, ventricular fibrillation, and ventricular tachycardia were not reported in both the groups during levosimendan treatment (days 0-1). The total cost of hospitalization [34 591.00(15 527.46,59 324.80) vs. 37 144.65(16 066.90,63 919.00)yuan, Z=-0.26, P=0.80] and the total length of hospitalization [9 (8, 12) vs. 10 (7, 13) days, Z=0.72, P=0.72] were lower for patients in the levosimendan group compared to those in the control group, but did not show statistically significant differences. Conclusions: Early administration of levosimendan reduced NT-proBNP levels in NSTEMI patients with elevated NT-proBNP and did not increase the total cost and length of hospitalization, but did not significantly improve MACE during hospitalization or at 6 months.
Male ; Female ; Humans ; Aged ; Natriuretic Peptide, Brain ; Simendan/therapeutic use* ; Non-ST Elevated Myocardial Infarction ; Heart Failure/drug therapy* ; Peptide Fragments ; Arrhythmias, Cardiac ; Biomarkers ; Prognosis

Aged ; Blood Pressure ; Exercise ; Humans ; Hypertension/therapy* ; Middle Aged ; Nitric Oxide Synthase ; Tai Ji

Objective To ascertain the level and dynamic changes of environmental health hazards in the rural areas of Pukou, Nanjing, to objectively evaluate the situation of rural environmental sanitation, providing basis and support for formulating policies and measures by the higher authorities. Methods According to the requirements of the rural environmental sanitation monitoring program of Jiangsu Province in 2017, 5 streets, 20 administrative villages were selected as monitoring points and 100 families used as monitoring objects.The monitoring data were obtained through interviews, access data, field records and laboratory tests. Results Centralized water supply was realized by 20 monitoring points.The rate of collection and centralized disposal of domestic waste was 95.00%.The sewage disposal sites were mainly discharged into sewage treatment plants and harmless sanitary toilets, accounting for 41.00% and 42.00% respectively.The coverage rate of sanitary toilets was 95.54%.Those who did the work of killing rats, flies and mosquitoes accounted for 40.00% and those who did the work of killing cockroaches 25.00%.And 98.00% of the families used fuel for gas, 98.00% of the families never burned straw in the fields, 88.00% of the families did not use the film, and the membrane recycling rate was 91.67%.It was found that 100% of the households drank boiled water, and 90.00% of the respondents developed the habit of washing hands before and after meals.The detection rate of Ascaris eggs was 20.00% in 20 soil samples, and the contents of Pb, CD and Cr were all within the normal range. Conclusion Although some achievements have been made in the rural environmental sanitation in Pukou, the management of pollution of rural sewage, waste and feces should be further strengthened, and the dangerous factors that affect the health of rural residents should be decreased and four pests removal activities actively carried out.

Objective To investigate the antibacterial activity of quinu-prisitin/dalfopristin on the clinical isolates of Enterococcus faecium in vitro.Methods A total of 2217 Enterococcus faecium isolates were isola-ted from the various specimens of patients at the first affiliated hospital of Wenzhou medical university from January , 2011 to December , 2015.The susceptibility of 2217 Enterococcus faecium isolates to quinuprisitin/dalfopristin and the susceptibility of quinuprisitin/dalfopristin -non -susceptible isolates to clinically often used antimicrobials were determined by full automated Microbiology Analyzer.Results Among 2217 Entero-coccus faecium isolates, 115 (5.2%) were non -susceptible to quinu-prisitin/dalfopristin, among which 25 with quinuprisitin/dalfopristin re-sistance and 90 with quinuprisitin/dalfopristin intermediate.The rates of quinuprisitin/dalfopristin non -susceptibility among tested clinical iso-lates from 2011 to 2015 were 4.3%(25/588), 3.1%(18/581), 6.2%(22/353), 6.3%( 25/394 ) and 8.3%( 25/301 ), respectively.All non-susceptible isolates were susceptible to vancomycin , linezolid , teicoplanin and tigecycline.However , more than 80% of theses isolates were resistant to ampicllin, penicillin, levofloxacin, ciprofloxacin, moxifloxacin and erythromycin.Conclusion Quinuprisitin/dalfopristin has good antimicrobial activity in vitro against Enterococcus faecium clinical isolates.The prevalence of quinuprisitin/dalfopristin resistance remained relatively stable and low , but non-susceptible rate showed an upward trend.

OBJECTIVETo compare clinical effect of T-shaped locking internal fixation and external fixation in treating dorsal Barton's fracture,and investigate selective strategy of internal fixation.

METHODSFrom January 2008 to January 2013, 100 patients with dorsal Barton's fracture were randomly divided into two groups. In treatment group, there were 30 males and 20 females with an average age of (33.8±3.6) years old;30 cases were type B, 20 cases were type C;and treated with T-shaped locking internal fixation. In control group, there were 32 male and 18 females with an average age of (32.9±3.4) years old; 29 cases were type B, 21 cases were type C; and treated with external fixation. Volar tilt, ulnar deviation and radial height at 3 months after operation were detected and compared between two groups. Mechara functional evaluation were used to evaluate postoperative clinical effects. Clinical cure time, postoperative complications,joint mobility and function score were recorded and compared between two groups.

RESULTSIn treatment group,volar tilt was (11.9±2.7)°, ulnar deviation was (20.8+ 2.9)°,and radial height was (10.9±1.8) mm; while volar tilt was (9.1±1.6)°, ulnar deviation was (17.1±2.9)°, and radial height was (8.1±1.5) mm in control group. Treatment group was better than control group in volar tilt, ulnar deviation and radial height. Clinical cure time in treatment group was(12.0±2.3) weeks, shorter than control group (18.0±4.1) weeks. The incidence of complications in treatment group was lower than control group. According to Mehara functional evaluation,20 cases got excellent results, 25 good, 3 moderate and 2 poor in treatment group; 16 cases got excellent results, 14 good, 10 moderate and 10 poor in control group. Treatment group was better than control group in clinical effects.

CONCLUSIONT-shaped locking internal fixation with postoperative functional exercise for the treatment of dorsal Barton's fracture fits for biomechanics demands,and has advantages of stable fixation,rapid recovery, less complications and good functional recovery, it has better clinical effects.

Adult ; Bone Plates ; Case-Control Studies ; Female ; Fracture Fixation ; instrumentation ; Fracture Fixation, Internal ; instrumentation ; Humans ; Male ; Radius Fractures ; surgery ; Wrist Injuries ; surgery

Eleven flavonol glycosides were isolated from the ethanol extract of Lysimachia clethroides by a combination of various chromatographic techniques including column chromatography over silica gel, Sephadex LH-20, and reversed-phase HPLC. Their structures were identified as astragalin (1), isoquercitrin (2), isorhamnetin-3-O-β-D-glucopyranoside (3), quercetin-3-O-β-D-6"-acetylglucopyranoside (4), quercetin-7-O-β-D-glucopyranoside (5), prunin (6), 2-hydroxynaringin-5-O-β-D-glucopyranoside (7), kaempferol-3-O-rutinonoside (8), kaempferol-3-O-robinobioside (9), rutin (10) and kaempferol-3,7-di-O-β-D-glucopyranoside (11). Among them, compounds 4, 7 and 11 were obtained from the Lysimachia genus for the first time, while compounds 3, 5 and 9 were firstly reported from this plant. In the preliminary assays, compounds 2, 6 and 8 possessed significant inhibition against aldose reduc- tase, with IC50 values of 2.69, 1.00, 1.80 μmol · L(-1), respectively; none of compounds 1-11 exhibited obvious cytotoxic activity (IC50 > 10 μmol · L(-1)).
Drugs, Chinese Herbal ; chemistry ; Flavonols ; chemistry ; Glycosides ; chemistry ; Molecular Structure ; Primulaceae ; chemistry ; Spectrometry, Mass, Electrospray Ionization

OBJECTIVE: To explore the growth status of epiphysis of sternal end of clavicle using thin-section computed tomography (CT) and to study the relationship between the status and the chronological age of Sichuan Han nationality youth. METHODS: According to the Schmeling's report and the age range of our samples, the ossification status of medial clavicle epiphysis was classified as four stages. CT films of 565 patients between 15 and 25 years were studied based on the classification and analyzed statistically. RESULTS: There was no statistical difference between the sexes (P > 0.05). The calculated empiric distribution function showed that 100% of stage 1 patients were under 18 years, 75% of stage 2 patients were under 18 years, 94.5% of stage 3 patients were over 18 years, and 100% of the stage 4 patients were over 20 years, respectively. CONCLUSION The ossification of medial epiphysis of the clavicle for those around 18 years has certain regular. These characteristics can be used for forensic identification of the skeletal age, especially 18 years, which is the criminal responsibility age.
Adolescent ; Adult ; Age Determination by Skeleton/methods* ; Age Factors ; Asian People/ethnology* ; China/ethnology* ; Clavicle/growth & development* ; Epiphyses/growth & development* ; Female ; Forensic Anthropology/methods* ; Humans ; Image Processing, Computer-Assisted ; Male ; Osteogenesis ; Sex Characteristics ; Tomography, X-Ray Computed/methods* ; Young Adult

Objective To discuss the risk and strategy of dental implantation in patients with periodontal disease and type 2 diabetes.Methods Retrospective analysis was performed of dental implantation results in 248 patients with periodontal disease and type 2 diabetes from 2000 to 2008.The survival rate was evaluated and the data statistically analyzed.Results The Nobel implant system and CDIC implant system were used.The operation applied flapless and bone expanding techniques.A total of 1190 implants were inserted (333 Nobel Replace implants and 857 CDIC implants).0.5％ (6 implants) lost during the first 6 months healing stage.The l-year,5-year and 8-year survival rate were 98.4％ (1165/1184),95.3％(487/511)and 89.2％(91/102) respectively.Conclusions The patients with periodontal disease and type 2 diabetes are suitable for implant treatment with satisfactory results under the conditions that the indication and risk factors are evaluated and controlled strictly.

Objective The purpose of this study is to evaluate the in-hospital clinical outcome of patients with coronary artery disease who underwent transradial intervention (TRI) and analyze the predictors of chinical outcome. Methods From May 2004 to May 2009, there were 16 281 patients who underwent transradial intervention, as well as 5388 patients who underwent transfemoral intervention (TFI) at our institution. The clinical characteristics, procedural characteristics, and in-hospital clinical adverse events were compared between TRI and TFI groups. Multivariable logistic regression analysis was performed to determine predictors of in-hospital major adverse cardiac events ( composite of death, myocardial infarction,or target lesion revascularization) of TRI. Results The annulations time was significantly longer for TRIthan TFI (P ＜0. 01 ), fluoroscopy time, amount of contrast agent and procedural success rate (95.5% for TRI and 96. 2% for TFI) were similar between the two groups. However, the rates of vascular complications (0. 1% for TRI group and 1.3% for TFI group, P ＜0. 01 ), incidence of in-hospital major adverse cardiac events (1.6% vs. 3. 8%, P＜ 0.01) and in-hospital death (0.2% vs. 0.4%, P＜0.01) were all significantly lower in TRI group compared with TFI group. The following characteristics were identified as independent multivariate predictors of in-hospital major adverse cardiac events of TRI: age ≥65 ( OR: 1.98,95% CI: 1. 50 - 2. 61, P ＜ 0. 01 ), prior myocardial infarction ( OR:2. 14, 95% CI: 1.63 - 2. 82, P ＜0. 01 ), use of drug-eluting stent (DES) ( OR:0. 68, 95% CI:0. 47 - 0. 98, P = 0. 04 ), dissection during procedure (OR:4.08, 95%CI:2.28-7.33, P＜0.01), left main lesion (OR:2. 12, 95% CI:1.09-4. 13, P=0.03), number of implanted stents (OR:1.25, 95% CI:1.09 - 1.43, P ＜0.01), and total stented length (OR:1.01, 95% CI:1. 00 -1. 02 , P=0.03). Conclusions In this large single-centre patient cohort, the transradial intervention is superior to transfemoral intervention in terms of in-hospital safety and efficacy. Age ≥ 65, prior myocardial infarction, use of DES, dissection during procedure, left main lesion, number of implanted stents and total stented length were identified as independent multivariate predictors of in-hospital major adverse cardiac events of TRI.