Objective: To understand the characteristics and trend of the premature death rate of 4 major chronic diseases in Ji'nan from 2015 to 2020. Methods: The death cause surveillance data and population data during 2015-2020 in Ji'nan were collected, and abbreviated life table, Joinpoint regression analysis and other methods were used to analyze the characteristics and change trends of the premature death rates of 4 major chronic diseases. Results: The crude mortality rate and age standardized mortality rate changes for the 4 major chronic diseases from 2015 to 2020 range from 568.65/100 000 to 604.06/100 000 and 366.77/100 000 to 432.48/100 000, respectively. The annual premature death rate of 4 major chronic diseases declined by 3.33% averagely from 2015 to 2020 (95%CI: -6.25%--0.32%), which might be explained by the declines of the premature death rates of cardiovascular and cerebrovascular diseases [average annual percentage change (AAPC)=-3.23%, 95%CI: -6.32%--0.05%] and cancer (AAPC=-3.58%,95%CI:-6.83%--0.21%). The average decline rate in women (AAPC=-4.19%,95%CI:-7.56%- -0.70%) was higher than that in men (AAPC=-2.92%,95%CI: -5.65%--0.11%). Conclusions: The premature death rate of 4 major chronic diseases showed a downward trend in Ji'nan from 2015 to 2020. Men should be considered as a key population in the prevention and control of 4 major chronic diseases, and attention should also be paid to the non-significant declines in the premature death rates of chronic respiratory diseases and diabetes.
Cerebrovascular Disorders ; Chronic Disease ; Diabetes Mellitus ; Female ; Humans ; Male ; Mortality, Premature ; Regression Analysis

Sesquiterpene pyridine alkaloids are important components in Tripterygium plants, possessing a wide range of pharmacological activities, such as anti-inflammation immunosuppression, anti-tumor, anti-virus, and deinsectization, and are of great research value. They are composed of highly oxidized dihydro-β-furansquiterpene and pyridine dicarboxylic acid through ester bonds. According to the structural characteristics of pyridine dicarboxylic acid fragments, they can be divided into various structural subtypes. Up to now, more than 110 sesquiterpene pyridine alkaloids have been isolated and identified from Tripterygium plants. This study reviewed the structural features and spectral(i.e., UV, IR, MS, and NMR) characteristics of sesquiterpene pyridine alkaloids and summarized the structural elucidation process in detail to provide references for their further research and development.
Alkaloids/pharmacology* ; Drugs, Chinese Herbal/pharmacology* ; Molecular Structure ; Pyridines/pharmacology* ; Sesquiterpenes ; Tripterygium/chemistry*

OBJECTIVES: To investigate the distribution of body mass index (BMI) and risk factors for obesity in children with Diamond-Blackfan Anemia (DBA). METHODS: The children with DBA who attended National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, from January 2003 to December 2020 were enrolled as subjects. The related clinical data and treatment regimens were recorded. The height and weight data measured within 1 week before or after follow-up time points were collected to calculate BMI. The risk factors for obesity were determined by multivariate regression analysis in children with DBA. RESULTS: A total of 129 children with DBA were enrolled, among whom there were 80 boys (62.0%) and 49 girls (38.0%), with a median age of 49 months (range 3-189 months). The prevalence rate of obesity was 14.7% (19/129). The multivariate logistic regression analysis showed that the absence of ribosomal protein gene mutation was closely associated with obesity in children with DBA (adjusted OR=3.63, 95%CI: 1.16-11.38, adjusted P=0.027). In children with glucocorticoid-dependent DBA, obesity was not associated with age of initiation of glucocorticoid therapy, duration of glucocorticoid therapy, and maintenance dose of glucocorticoids (P>0.05). CONCLUSIONS There is a high prevalence rate of obesity in children with DBA, and the absence of ribosomal protein gene mutation is closely associated with obesity in children with DBA.
Child ; Male ; Female ; Humans ; Anemia, Diamond-Blackfan/genetics* ; Pediatric Obesity/complications* ; Glucocorticoids/therapeutic use* ; Prevalence ; Risk Factors ; Ribosomal Proteins/genetics* ; Mutation

BACKGROUND: It has been a global trend that increasing complications related to pelvic floor surgeries have been reported over time. The current study aimed to outline the development of Chinese pelvic floor surgeries related to pelvic organ prolapse (POP) over the past 14 years and investigate the potential influence of enhanced monitoring conducted by the Chinese Association of Urogynecology since 2011. METHODS: A total of 44,594 women with POP who underwent pelvic floor surgeries between October 1, 2004 and September 30, 2018 were included from 22 tertiary academic medical centers. The data were reported voluntarily and obtained from a database. We compared the proportion of each procedure in the 7 years before and 7 years after September 30, 2011. The data were analyzed by performing Z test (one-sided). RESULTS: The number of different procedures during October 1, 2011-September 30, 2018 was more than twice that during October 1, 2004-September 30, 2011. Regarding pelvic floor surgeries related to POP, the rate of synthetic mesh procedures increased from 38.1% (5298/13,906) during October 1, 2004-September 30, 2011 to 46.0% (14,107/30,688) during October 1, 2011-September 30, 2018, whereas the rate of non-mesh procedures decreased from 61.9% (8608/13,906) to 54.0% (16,581/30,688) (Z = 15.53, P < 0.001). Regarding synthetic mesh surgeries related to POP, the rates of transvaginal placement of surgical mesh (TVM) procedures decreased from 94.1% (4983/5298) to 82.2% (11,603/14,107) (Z = 20.79, P < 0.001), but the rate of laparoscopic sacrocolpopexy (LSC) procedures increased from 5.9% (315/5298) to 17.8% (2504/14,107). CONCLUSIONS: The rate of synthetic mesh procedures increased while that of non-mesh procedures decreased significantly. The rate of TVM procedures decreased while the rate of LSC procedures increased significantly. TRIAL REGISTRATION NUMBER NCT03620565, https://register.clinicaltrials.gov.
China ; Female ; Gynecologic Surgical Procedures/adverse effects* ; Humans ; Pelvic Floor/surgery* ; Pelvic Organ Prolapse/surgery* ; Surgical Mesh/adverse effects* ; Treatment Outcome ; Vagina

Objective: Several COVID-19 patients have overlapping comorbidities. The independent role of each component contributing to the risk of COVID-19 is unknown, and how some non-cardiometabolic comorbidities affect the risk of COVID-19 remains unclear. Methods: A retrospective follow-up design was adopted. A total of 1,160 laboratory-confirmed patients were enrolled from nine provinces in China. Data on comorbidities were obtained from the patients' medical records. Multivariable logistic regression models were used to estimate the odds ratio ( Results: Overall, 158 (13.6%) patients were diagnosed with severe illness and 32 (2.7%) had unfavorable outcomes. Hypertension (2.87, 1.30-6.32), type 2 diabetes (T2DM) (3.57, 2.32-5.49), cardiovascular disease (CVD) (3.78, 1.81-7.89), fatty liver disease (7.53, 1.96-28.96), hyperlipidemia (2.15, 1.26-3.67), other lung diseases (6.00, 3.01-11.96), and electrolyte imbalance (10.40, 3.00-26.10) were independently linked to increased odds of being severely ill. T2DM (6.07, 2.89-12.75), CVD (8.47, 6.03-11.89), and electrolyte imbalance (19.44, 11.47-32.96) were also strong predictors of unfavorable outcomes. Women with comorbidities were more likely to have severe disease on admission (5.46, 3.25-9.19), while men with comorbidities were more likely to have unfavorable treatment outcomes (6.58, 1.46-29.64) within two weeks. Conclusion Besides hypertension, diabetes, and CVD, fatty liver disease, hyperlipidemia, other lung diseases, and electrolyte imbalance were independent risk factors for COVID-19 severity and poor treatment outcome. Women with comorbidities were more likely to have severe disease, while men with comorbidities were more likely to have unfavorable treatment outcomes.
Adult ; Aged ; COVID-19/virology* ; China/epidemiology* ; Comorbidity ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Severity of Illness Index ; Treatment Outcome

Angiotensin Receptor Antagonists ; Angiotensin-Converting Enzyme 2 ; Betacoronavirus ; COVID-19 ; Cardiovascular Agents/pharmacology* ; Cardiovascular Diseases ; Coronavirus Infections/physiopathology* ; Humans ; Pandemics ; Peptidyl-Dipeptidase A/physiology* ; Pneumonia, Viral/physiopathology* ; SARS-CoV-2

Objective: To investigate if microRNA (miR) -23a knockdown could attenuate angiotensin Ⅱ(AngⅡ) induced cardiac hypertrophy by activating phosphatase and tensin homolog deleted on chromosome ten(PTEN) and AMP-activated protein kinase(AMPK) pathway. Methods: Rat H9c2 cells were cultured in DMEM high glucose medium and put in 5% CO(2) incubator at 37 ℃(normal group). After 48 hours of culture, H9c2 cells were stimulated with 10 nmol/L AngⅡ to establish cell hypertrophy model (AngⅡgroup). The H9c2 cells were inoculated in a 6-well cell culture plate and cultured in an incubator at 37 ℃. When the confluence degree of cell growth was about 70%, the cells were transfected with different reagents, and 24 hours after transfection, 10 nmol/L AngⅡ was used to interfere with the cells. The H9c2 cells were divided into different groups according to the reagents, namely AngⅡ+anti-miR group(transfected with miR-23a inhibitor), Ang Ⅱ+NC group(transfected with miR-23a inhibitor negative control), Ang Ⅱ+anti-miR+si-PTEN group(cotransfected with miR-23a inhibitor and PTEN small interference RNA(siRNA)), and AngⅡ+anti-miR+si-NC group(cotransfected with miR-23a inhibitor and PTEN siRNA negative control). The surface area of single cell was measured by Image J software.The mRNA expression levels of α-actin 1 (ACTA1) and β-myosin heavy chain (β-MHC) and miR-23a were detected by quantitative real-time PCR(qRT-PCR). The expression levels of PTEN and AMPK signal pathway related proteins were detected by Western blot. In order to verify whether miR-23a targets PTEN gene, double luciferase reporter gene experiment was performed. The luciferase reporter gene vector recombinant plasmids of wild type pGL-WT-PTEN and mutant pGL-MUT-PTEN were constructed and prepared after normal sequencing. H9c2 cells was inoculated into 24-well cell culture plate and cultured overnight in 37 ℃ incubator. The cells were co-transfected with miR-23a mimic or miR-23a mimic negative control and wild type or mutant reporter gene recombinant plasmid. Forty-eight hours after transfection, firefly luciferase activity and sea kidney luciferase activity were measured, and the ratio of them was recorded as relative luciferase activity. Results: Compared with the normal group, the cell surface area, the mRNA expression levels of ACTA1, β-MHC and miR-23a were significantly higher, while the protein expression levels of PTEN and p-AMPK were significantly lower in the Ang Ⅱ group(all P<0.05). The results of double luciferase reporter gene assay showed that the relative luciferase activity of cells co-transfected with miR-23a mimic and wild-type reporter gene recombinant plasmid was lower than that of miR-23a mimic negative control (P<0.05), and PTEN served as the target gene of miR-23a. In AngⅡ+anti-miR group the mRNA expression levels of miR-23a, ACTA1 and β-MHC were lower, and the cell surface area was smaller, while the protein expression levels of PTEN and p-AMPK were higher than that in AngⅡ group and AngⅡ+NC group(all P<0.05). Compared with AngⅡ+anti-miR group, the cell surface area was bigger, the expression of ACTA1 and β-MHC mRNA was up-regulated, and the protein expression levels of PTEN and p-AMPK were down-regulated in Ang Ⅱ+anti-miR+si-PTEN group(all P<0.05). Conclusion: Inhibition of miR-23a can attenuate Ang Ⅱ-induced hypertrophy in H9c2 cells through targeting PTEN and activating AMPK signaling pathway.
AMP-Activated Protein Kinases ; Angiotensin II ; Animals ; Cardiomegaly ; Cell Line ; Cell Proliferation ; MicroRNAs/genetics* ; PTEN Phosphohydrolase ; Rats ; Signal Transduction

【Objective】To assess the value of 18F-FDG PET/CT for imaging liver fibrosis.【Methods】12 male SD rats （170±10 g）were divided into model group（TAA group）and control group. In the model group，200 mg/kg thioacetamide dissolved in sterile saline was administered to rats by means of intraperitoneal injection twice a week for a total of 6 weeks. In the control group，rats were treated with the same volume of saline. At week 6 after injection，18F- FDG PET/CT imaging was performed on two groups and measurement of the liver 18F-FDG uptake in two groups was taken. After PET/ CT scans， all rats were sacrificed to observe anatomical morphological changes. Liver tissues were harvested for hematoxylin and eosin （H&E） staining，Masson staining and measurement of hydroxyproline levels. 【Results】 Liver anatomical morphology of the TAA-induced rats was roughness with brunt margins and coarse surfaces ，while control rats showed sharp margins and smooth surfaces. HE staining showed visible histological changes that hepatocyte and liver sinus area surrounded by plentiful recruited hepatocyte neutrophils in the model group. Masson staining showed that obvious proliferation of fibroblasts and deposition of collagen in liver tissues in the model group. Model group showed higher hydroxyproline content than that in the control group（P<0.001）. The results of 18F- FDG imaging indicated that apparent liver radioactivity concentration in the model group. 18F-FDG uptake value of liver tissues in the model group was higher than that in the control group（P<0.001）.【Conclusion】18F- FDG PET/CT imaging could be used for diagnosis of liver fibrosis noninvasively.

Objective: To determine the content of index components in different parts of Gardenia jasminoides (pericarp, seeds, whiskers), study the fingerprint, and compare the contents and compositions differences of different parts of G. jasminoides, in order to provide the theoretical basis for different efficacies of G. jasminoides pericarp and seeds, explore the exploitation and utilization values of G. jasminoides whiskers, and avoid waste of gardenia medicinal resources. Method: The contents of geniposide and crocetin Ⅰ was were determined by HPLC, the content of total iridoid glycosides was determined by ultraviolet spectrophotometry, and three index components in different parts of G. jasminoides were analyzed. HPLC fingerprints of different parts of G. jasminoides were collected, the common pattern of HPLC fingerprints of different parts of G. jasminoides of different origins and with different processing methods was established, and the similarity evaluation software was used for data analysis; comparative analysis on fingerprints of different parts of G. jasminoides was conducted. Result: Content change of index components in G. jasminoides pericarp and seeds from Henan, Fujian and Jiangxi were the same. Content of geniposide:Fujian > Henan > Jiangxi, the contents of three components in G. jasminoides pericarp from Fujian were much higher than those from Henan and Jiangxi, the contents of crocetin Ⅰ and total iridoid glycosides:Fujian > Jiangxi > Henan, the contents of total iridoid glycosides from Fujian, Jiangxi were much higher than those from Henan. The order of three index components in G. jasminoides whiskers from different origins from high to low, the content of geniposide and crocetin Ⅰ was Fujian > Jiangxi and Henan, the content of total iridoid glycosides was Fujian > Jiangxi > Henan.In the same part, there were 22 common peaks in the fingerprints of G. jasminoides pericarp, except for S13-S15, the similarity of other samples were more than 0.9;the fingerprints of G. jasminoides seeds had 22 common peaks, except for S22-S30, the similarities of other samples were more than 0.9;the fingerprints of G. jasminoides whiskers had 16 common peaks, except for S7-S9, the similarities of other samples were more than 0.9.In different parts, the fingerprints of G. jasminoides whiskers were significant different from those of pericarp and seeds, the number of peaks in G. jasminoides whiskers reduced, the order of height of peaks 2, 3, 5 of G. jasminoides from high to low were whiskers > gardenia > seeds. There was not peak X in the seeds, the height of peak X of gardenia in whiskers was higher than that in pericarp, except for the peak 17, the height of all peaks in seeds were higher than that in whiskers. Conclusion: There are significant differences in the contents of index components in G. jasminoides pericarp and seeds. The content of total glycosides in gardenia is high, suggesting that it can be used to extract total iridoid glycosides. The fingerprints can reflect the content difference and species distribution of different parts of G. jasminoides, so as to provide theoretical support for the studies for pharmacodynamic material basis of G. jasminoides and the scientificity and rationality of the separate application of G. jasminoides pericarp and seeds.

Objective:To investigate and compare the fingerprints of different polarity fractions (petroleumether,chloroform,ethyl acetate,n-butanol,water) of fresh Gardeniae Fructus with different fruit shapes,and further understand the content difference and distribution of its chemical composition. Method:Gardeniae Fructus was reflux extracted by water in order to obtain the water extract; water extract 0.1 g and dissolved with 50 mL water,then it was extracted by petroleum ether,chloroform,ethyl acetate and n-butanol in turn in order to obtain the different extraction phases and the water phase. Each phase was condensed to extractum. Finally,the samples were analyzed by high performance liquid chromatography (HPLC) fingerprints and the similarity evaluation software was used for data analysis. Result:Fingerprint of chloroform fraction of water extract in gardenia from different habitats can be used to distinguish Gardeniae Fructus from Fujian,Henan and Jiangxi. The differences between the water extract of Gardeniae Fructus from Fujian and those of Henan and Jiangxi were mainly manifested in the petroleum ether fraction, and the fat-soluble components of Gardeniae Fructus were more than those of Henan and Jiangxi. The differences between the water extract of Gardeniae Fructus from Henan and those of Fujian and Jiangxi were mainly manifested in the ethyl acetate fraction,and the content of iridoid glycosides was significantly higher than that in Fujian and Henan. The differences between the water extract of gardenia from Jiangxi and those of Fujian and Henan were mainly manifested in the n-butanol fraction,organic acid peak C1 not detected. The fingerprint of chloroform fraction of water extract in Gardeniae Fructus can be used to distinguish Gardeniae Fructus of six ribs and Gardeniae Fructus of seven ribs from Fujian and Henan,and the contents of all components of Gardeniae Fructus of seven ribs were more than those in Gardeniae Fructus of six ribs. The fingerprint of petroleum ether fraction of water extract in Gardeniae Fructus can be used to distinguish Gardeniae Fructus of six ribs and Gardeniae Fructus of seven ribs from Jiangxi. The Z3 peak of Gardeniae Fructus of six ribs from Henan was obviously higher than that of Gardeniae Fructus of seven ribs. The contents of all components on chloroform and ethyl acetate fractions of water extract in Gardeniae Fructus of seven ribs were significantly higher than those of Gardeniae Fructus of six ribs. Conclusion:There are significant differences on chemical constituents and content among Gardeniae Fructus from Fujian,Henan and Jiangxi. The main difference of fingerprint between Gardeniae Fructus of six ribs and Gardeniae Fructus of seven ribs is the peak height.