Globally, individuals with chronic diseases now consume over 80% of all healthcare resources. Set against this depressing projection is decades of epidemiologic work demonstrating that 80%-90% of cardiovascular disease can be prevented via lifestyle and dietary interventions. How can we reconcile such contrasting views toward the future of cardiovascular health in human populations? Herein, we review available sources of evidence that can be used to answer these challenging questions of how and why. In particular, we submit that analytical framework incorporating the 6P (prediction, precision, personalization, prevention, population, and policy)-3G (good food, good environment, and good behavior)-4I (interpretation, integration, implementation, and innovation) will allow us to focus resource towards the development of multi-level approaches for the betterment of population

Objective To clarify the effec.t of smoking and related factors in symptomatic osteoarthritis disease,and explore the method to analyze the osteoarthritis (OA) risks.Methods Based on the investigation of 7 126 rural residents in Shanxi province,according to whether patients had related factors of symptomatic osteoarthritis in longitudinal axis arthrosis,the single factor and multiple factors logistic regression analysis were adopted to reveal the interaction between risk factors,and the interaction on multiplicative scale and the interaction on additive scale were both analyzed;interaction on multiplicative scale was estimated by OR,the interaction on additive scale was estimated by the relative excess risk due to interact (RERI),the attributableproportion due to interaction (AP),and the synergy index (S).Results The survey included 7 126 residents,in which 1 480 cases osteoarthritis patients in vertical axis joint with the prevalence of 20.8％.By multiple logistic regression analysis,the whole samples by enter level 0.05 level was stepwisely filtered.The results showed that gender,body mass inlex (BMI),smoking,age,heatable adobe,picky eater,working under coal mine were main influencing factors for the symptomatic arthritis.Balance other influence factors,passive smoking had an effect on arthritis.Aftcr adjusting for weight,smoking was not included in the final model.In the stratified interaction analysis,there was interaction on multiplicative scale between smoking and weight (OR=0.32,P=0.03),and the interaction on additive scale between passive smoking and gender or weight exists [RERI (95％CI) 0.41 (0.01,0.81)＞0,AP(95％CI) 0.25(0.01,0.51)＞0,S=3.04＞ 1].Conclusion The influence of smoking on osteoarthritis is so weak that it could not be a risk factor and its influence on osteoarthritis is initiated via body.

Objective To investigate the factor that affecting the prevalence of osteoarthritis in rural areas of Shanxi, China. Methods All the residents above 16-year-old from the villages chosen by multi-stage stratified cluster sampling in Yangcheng County and Pianguan County in Shanxi Province were investigated by COPCORD procedure of WHO. All respondents signed the informed consent forms. Chi-square test and multivariable logistic regression analysis were used for the risk factor analysis. Results Seven thousand one hundred and twenty-six permanent residents in the two counties were investigated, of which 1734 cases of patients with osteoarthritis were identified. Take with or without osteoarthritis as response variables, statistically significant variables in the univariate analysis were substituted into the logistic regression model. Forward method was used for the variable selection. The inclusion criteria set as 0.10. The results showed that, age, room heating and ventilation, marital status, occupation, education, engaged in coal mine work, accompanied cardiovascular disease were the risk factors for osteoarthritis disease. Conclusion There were many factors that affect the prevalence of osteoarthritis in Shanxi rural communities, in which lifestyle may play an important role. Early intervention on risk factors may have a significant effect on reducing the prevalence.

Objective: To investigate the relationship between blood pressure variability and ambulatory arterial stiffness index (AASI) in both normal subjects and hypertensive patients.
Methods: A total of 280 consecutive subjects without antihypertensive medication were studied. All subjects received ambulatory blood pressure monitoring (ABPM) and AASI was calculated as 1 minus the regression slope of diastolic blood pressure value vs systolic blood pressure value according to ABPM recording.
Results: ① There were 161 subjects with male gender, 138 patients with hypertension, and the average age was (50.4 ± 13.3) years.②Pearson analysis indicated that AASI was related to age (r=0.272, P<0.001), 24-hour mean pulse pressure (r=0.504, P<0.001) , nocturnal diastolic blood pressure dipping (r=-0.334, P<0.001) and standard deviation of 24-hour diastolic blood pressure (r=-0.520, P<0.001).③AASI in anti-dipper hypertensive patients was higher than that in dipper patients, P<0.05;while AASI between dipper and non-dipper patients, dipper and extreme-dipper patients were similar, P>0.05 respectively.④Multiple linear regression analysis demonstrated that with adjusted age, gender, BMI and blood pressure, AASI was independently related to 24-hour mean pulse pressure (β=0.003, P<0.001), nocturnal diastolic blood pressure dipping (β=-0.001, P<0.05), standard deviations of 24-hour systolic blood pressure (β=0.032, P<0.001) and 24-hour diastolic blood pressure (β=-0.064, P<0.001), standard deviation of 24-hour heart rate (β=0.006, P<0.001).
Conclusion:AASI is closely related to blood pressure variability, it’s a comprehensive index for arterial stiffness and blood pressure variability.

Objective:Combined with the hospital's optimization of expenditure management measures, this paper discusses how to enable scientific research personnel with appropriate discretion right to use scientific research funds and further improve the efficiency of the use of scientific research funds under the background of the reform of Release, manage and service.Methods:Through the implementation of information management system, policy revision, reconstruction of the approval process of expenditure, integration of multi department management resources and other ways, the efficiency of expenditure has been improved.Results:After optimizing the management of expenditure, the management efficiency and the efficiency of scientific research personnel is improved, the burden of scientific research personnel is reduced, and the expected effect of expenditure management is achieved.Conclusions:The optimization of expenditure management can improve the efficiency of expenditure to some extent, but more reform is still needed to promote the development of scientific research.

Objective:This stndy aims to analyze the influence of ChatGPT on medical research and give suggestions on GhatGPT.Methods:This paper expounded the background of ChatGPT, analyze the connection between ChatGPT and medical research management, application and threats of ChatGPT , and gave suggestions to avoid GhatGPT′s damage.Results:Technology will promote the evolution of medical research management. It is recommended to strengthen the supervision of the ChatGPT and research integrity education.Conclusions:It is urgent to establish a scientific management mechanism to take usage the advantages of GhatGPT.

Objective:To construct a scientific research performance evaluation index system for specialized hospitals based on disciplinary development.Methods:Building a preliminary evaluation index framework of scientific research performance through literature review and expert consultation meetings, combined with the strategic goals of strengthening specialization and weakening generalization; Delphi method was adopted to conduct two rounds questionnaires survey to collect the importance scores for each index, which confirmed the content of the index system; finally, applied the analytic hierarchy process to calculate the weight coefficient of each index.Results:The responding rates of the two rounds questionnaire survey reached 95%, and the authoritative coefficients were 0.75 and 0.76, respectively. The research results were reliable. The coordination coefficients of all levels of the two surveys were greater than 0.1, according to the significance testing, the P values were less than 0.05, and the expert opinions were well coordinated. Finally, we developed a three-level scientific research performance evaluation system under the guidance of disciplinary development, which including 3 first-level indicators, 20 second-level indicators, as well as 56 third-level indicators. Conclusions:A scientific research performance evaluation system was constructed based on scientific theories. This system combined relevant indicators, such as the development of special disciplinary of specialized hospitals with scientific validity and operability. Besides, it could serve as a tool to evaluate the scientific research performance of specialized hospitals taking into account of the practical application value for guiding scientific research development and disciplinary improvement.

As the first cyclin-dependent kinases 4 and 6 inhibitors, palbociclib significantly improved the survival of the patients with the hormone receptor-positive and human epidermal growth factor receptor-2 negative breast cancer. Palbociclib is a crucial landmark in the development history of antineoplastic drugs. This article reviews the mechanism of palbociclib, and summarizes the clinical trials, side effects, and the application of palbociclib.

Diabetic patients with poor glycemic control are exposed to media containing mold spores, and spores enter the body, which may lead to refractory infections. This article combines case and literature reviews, proposes the diagnosis and treatment method of mold infection, and provides some guidances for subjects who long-term exposure to mold groups such as farmers and immunocompromised people.

BACKGROUNDS: Cardiovascular disease (CVD) remains the leading cause of deaths nationwide. However, little is understood about its temporal trend and corresponding influence on longevity improvements. We aimed to describe the updated tendency in CVD mortality and to quantify its impact on life expectancy (LE) increase in China. METHODS: All-cause mortality rates were calculated with population sizes from the National Bureau of Statistics and death counts from the National Health Commission. We estimated CVD mortality rates by allocating age- and sex-based mortality envelopes to each CVD subtype based on its proportion derived from the Disease Surveillance Points system. The probability of CVD premature deaths and LE were calculated with life tables and we adopted Arriaga's method to quantitate age- and cause-specific contributions to LE gains. RESULTS: During 2013 to 2018, the age-standardized mortality rate of CVD decreased from 289.69 (95% confidence interval [CI]: 289.03, 290.35)/100,000 to 272.37 (95%CI: 271.81, 272.94)/100,000, along with a decline in probability of CVD premature deaths from 9.05% (95%CI: 9.02%, 9.09%) to 8.13% (95%CI: 8.10%, 8.16%). The gap in CVD mortality across sexes expanded with more remarkable declines in females, especially for those aged 15 to 64 years. Among major subtypes, the probability of premature deaths from hemorrhage stroke declined fastest, while improvements of ischemic stroke and ischemic heart disease were limited, and there was an increase in stroke sequelae. LE in China reached 77.04 (95%CI: 76.96, 77.12) years in 2018 with an increase of 1.38 years from 2013. Of the total LE gains, 21.15% (0.29 years) were attributed to reductions of CVD mortality in the overall population, mostly driven by those aged >65 years. CONCLUSIONS The general process in reducing CVD mortality has contributed to longevity improvements in China. More attention should be paid to prevention and control of atherosclerotic CVD and stroke sequelae, especially for the elderly. Working-age males also deserve additional attention due to inadequate improvements.
Aged ; Male ; Female ; Humans ; Cardiovascular Diseases ; Life Expectancy ; China/epidemiology* ; Disease Progression ; Stroke ; Cause of Death