Objective: To analyze the prevalence and risk factor of co-exiting pre-hypertension and pre-diabetes condition in middle to elder adults, and to provide the theoretical basis for preventing cardiovascular disease in relevant population in Chengdu area.
Methods: A total of 5240 middle to elder adults from (40-79) years of age in Chengdu area were enrolled for a stratiifed cluster sampling study. The blood pressure, glucose and other clinical information were collected by more than 30 medical professionals with uniifed training to investigate the prevalence of co-exiting pre-hypertension and pre-diabetes condition with the risk factors.
Results: The overall prevalence rate of coexisting pre-hypertension and pre-diabetes condition was at 12.5% in Chengdu area and the standardized prevalence was at 11.5%. The prevalence rate in urban area was 12.4% and in rural was 13.2%, P=0.47, the prevalence in male gender was 12.7% and in female was 12.4%,P=0.81. With the increased age, the prevalence trend was elevated accordingly. Multi-regression analysis indicated that the elder age, overweight or obesity (female with abdominal obesity), sibling history of hypertension, hyper-triglyceridemia, multiple childbirth and menopause had the higher risk of coexisting pre-hypertension and pre-diabetes condition, allP<0.05; the higher educational level could decrease the risk of prevalence in male gender,P<0.05 and the proper exercise could decrease the risk in female gender,P<0.05.
Conclusion: There is a high prevalence rate of coexisting pre-hypertension and pre-diabetes condition in middle to elder population in Chengdu area and the prevalence is closely related to age. It is important to prevent such condition by elevating educational level nationwide, controlling waist and body weight, adjusting diet structure with proper exercise.

To facilitate the expression of GL 7 ACA acylase gene in a recombinant E coli , a fragment of the gene, in which the signal peptide was deleted by PCR method, was inserted into a prokaryotic expression vector, pET 28a By colony PCR method screening, a recombinant plasmid pET ACY was obtained and then transformed into the expression host BL21 (DE3) The influences of induction conditions such as IPTG concentration, the time of induction and the induction temperature on the expression of the recombinant protein were investigated Under optimal condition, the enzyme activity could reach 266 U/L Finally, the recombinant GL 7 ACA acylase can be easily isolated to a purity of about 80% by a simple anion ion exchange chromatography with enzyme activity recovery of 50%

Objective:To explore the feasibilitv of stereotactic minimally invasive aspiration of small thalamic bemorrhage.Methods:Twenty-two patients with small thalamic hemowhage(5 to 10 mL)were divided into two groups:a stereotactic group(n=10)and a control group(n= 12).The patients in the stereotactic group received stereomctic minimally invasive puncture and drainage of hematomas.According to the condition,repeated infusion of urokinase(10-20 kU) into the hematoma cavities were administered 12 hours after the procedure,and the hematomas were irrigated and drained so as to removal of them completely after retaining for 2-4 hours, The appropriate symptomatic treatment was administered in the patients in both groups.National Institutes of Health Stroke Scale(NIHSS)scores were determined 14 and 30 days before and after the treatment in all the patients.The reductiom of the NIJSS scores (as compared with those before treatment)were calculated at day 14 and 30 respectively after the treatment. Results:The reductiom of the NIHSS scores in the stereotactic group at day 14 and 30 were significantly higher than those in the control group.It was suggested that the neurological functional recovery of the patients was faster after stereotmtic minimally invasive puncture and drainage of intracranial hematorna in the stereotactic group.Concision:The stereotactic minimally invasive puncture and drainage of intracranial hematoma may significantly improve the outcome in patients with small thalamic hemorrhage.

Objective:To investigate the prevalence of drinking-tea fluorosis from 2016 to 2018 in Lhasa City, Tibet, and to provide clues and basic data for preventing this disease.Methods:According to the stratified cluster sampling method, Mozhugongka County and Nimu County in 2016, Dazi District in 2017, Chengguan District, Duilongdeqing District and Qushui County of Lhasa City in 2018 were selected as survey counties (districts), each county (district) selected 1 township (town) according to the 5 directions of east, south, west, north, and middle, and each township (town) selected 1 to 2 administrative villages as survey points, and each survey point recruited villager volunteers aged ≥18 years for survey subject. All volunteers were tested for dental fluorosis (Dean method) and skeletal fluorosis (X-ray), and samples of drinking water, brick tea consumed at home and residents' urine were collected for water fluoride, tea fluoride, and urine fluoride testing.Results:A total of 30 water samples were collected, and the water fluoride content was all < 1.0 mg/L. The average fluorine content was 1 167.5 mg/kg among 314 samples of brick tea investigated in this study. The qualification rate of brick tea in each survey county was 0 - 16.7%. The daily intake of fluoride in brick tea per person was 6.4 mg. The prevalence of dental fluorosis was 18.1% (350/1 929) among all enrolled participants, 4 of the 6 survey counties (districts) had varying degrees of dental fluorosis. A total of 1 637 urine samples were collected and detected, and the urine fluorine level ranged from 0.01 to 11.01 mg/L, with a geometric mean of 1.07 mg/L. The urine fluorine levels in all investigated counties (districts) were under the standard limits (≤1.6 mg/L). Eight adults were diagnosed with skeletal fluorosis of degree Ⅰ via X-ray detection, with a detection rate of 0.4% (8/1 929). Totally 20.2% (390/1 929) of people reported suffered from two or more joint disease. Furthermore, 6 counties (districts) in Lhasa City were identified as mild drinking-tea type endemic fluorosis disease areas.Conclusion:From 2016 to 2018, the fluorine content of brick tea in Lhasa has exceeded the standard seriously, dental fluorosis is mildly prevalent in some counties (districts), and 6 counties (districts) are all mild tea-drinking fluorosis areas.

Objective: To investigate the prevalence of drinking-tea type endemic fluorosis among children in Lhasa, Tibet, and to provide basic data for the early prevention of dental fluorosis and skeletal fluorosis among children. Methods: Stratified cluster random sampling method was used to select primary school 1 991 students in 6 counties. Results: The detection rate of dental fluorosis was 27.2%, the index of dental fluorosis was 0.44, and the total severity of fluorosis prevalence was identified as very mild among 6 counties. The detection rate of dental fluorosis increased with the age of the children：male and female increased by 36.2 and 28.5 percentage points,respectively. There was no significant difference between male and female students(χ2=0.08, P> 0.05). The urine fluoride test results suggested that urine fluoride concentration among participate children was below the standard limits value(geometric mean of urinary fluorine <1.4 mg/L). Conclusion The prevalence of tea-drinking type endemic fluorosis among children in Lhasa is more serious compared with that from other regions of China. The cumulative effect of fluorine in human body makes older students more prone to dental fluorosis. It is suggested that more school-based health education programs should be carried out to prevent tea drinking type endemic fluorosis.

Objective To investigate the effect of Osthole on memory function of sleep deprivation(SD) mice. Methods Forty-eight male mice were randomly divided into 4 groups;normal control group(NC group ), large platform control group(TC group),sleep deprivation group(M group)and Osthole group(Ost group). The model of SD in mice was estabished by using improved multi platform method. The ability of learning and memory was tested by using Morris water maze test and pathological changes of hippocampal neurons in mice were observed by HE staining. The serum,hippcampus malondialdehyde(MDA)contents and superoxide dismutase(SOD)activity, so as the hippocampus No content,were detected. Results Compared with NC group and TC group,the escape la-tency of M group increased significiantly and the number of crossing platform decreased significantly. There were in-creased levels hippocampus tissue,serum MDA level,hippocampal SOD activity and NO content. After supplemen-tation of Osthole,the escape latency significantly shortened in mice. The number of crossing platform was increased while the contents of MDA both in hippocampus and serum were decreased,and the SOD activity in hippocampus re-turned to normal. However,the level of NO in hippocampus was not decreased. Conclusion Osthole can protect the memory function of SD mice by reducing the the damage of hippocampal neurons through antioxidant stress.

Objective To evaluate the evidence and recommendations of the relevant clinical practice guidelines for the prevention and treatment of stroke published in the last five years. Methods The stroke and guideline-related key words and free words domestic computer retrieval platforms(China biomedical literature database,CNKI,and Yimaitong etc.),as well as foreign platforms(PubMed,NGC,GIN,etc.) were retrieved.The retrieval time limit ranged from January 2012 to May 2017.Appraisal of Guidelines for Research and Evaluation Ⅱ(AGREE Ⅱ)was used to assess the quality of the guidelines. Results A total of 9 490 documents were retrieved preliminarily and finally 16 articles were included. The average scoring rates of the 16 guidelines in the 6 fields of AGREE Ⅱ,including the scope and purpose,participants,rigor of the formulation,clarity of expression,applicability,and independence of the editors were 66.3%, 27.4%,23.0%,53.9%,18.8%,and 0%,respectively.The different guidelines all recommend that internal endarterectomy or carotid balloon dilatation and carotid artery stenting are used to extracranial carotid stenosis,while the treatment of vertebral artery stenting is recommended for extracranial vertebral artery stenosis.However,the intravascular interventional therapy is not recommended for intracranial arterial stenosis.The perioperative period of ischemic stroke intravascular intervention need to pay attention to the application of anti-platelet aggregation,anticoagulation,blood pressure,blood glucose,blood lipid management,and postoperative monitoring. For postoperative stent restenosis,especially after vertebral artery stenting,the guidelines recommend using drug-eluting stents,however,the dosage of heparin in intraoperative anticoagulation is still controversial.The intracranial aneurysm guidelines are more recommended for interventional therapy.The cerebral hemorrhage in different regions is recommended for different surgical procedures. Conclusions The guidelines in this field can reflect the key problems in clinical practice and keep up with the international concept.However,the quality of the methodology of the guidelines development needs to be improved. Some of them need to be updated and the recommendations should refer more evidence of the Chinese population.

Background and purpose:For patients with human epidermal growth factor receptor 2(HER2)-positive metastatic breast cancer,trastuzumab treatment can prolong the overall survival and significantly improve the prognosis of patients.However,the reference original research trastuzumab(Herceptin?)is more expensive.Biosimilars have comparable efficacy and safety profiles while increasing patient access to treatment.This clinical trial aimed to evaluate the efficacy,pharmacokinetics,safety and immunogenicity of the trastuzumab biosimilar AK-HER2 compared to trastuzumab(Herceptin?)in patients with HER2-positive metastatic breast cancer.Methods:This multi-center,randomised,double-blind phase Ⅲ clinical trial was conducted in 43 subcenters in China.This study complied with the research protocol,the ethical principles stated in the Declaration of Helsinki and the quality management standards for drug clinical trials.It was approved by the hospital's medical ethics committee.The clinical trial registration agency is the State Food and Drug Administration(clinical trial approval number:2015L04224;clinical trial registration number:CTR20170516).Written informed consent was obtained from subjects before enrollment.Enrolled patients were randomly assigned to the AK-HER2 group and the control group,respectively receiving AK-HER2 or trastuzumab(initial loading dose 8 mg/kg,maintenance dose 6 mg/kg,every 3 weeks as a treatment cycle,total treatment time is 16 cycles)in combination with docetaxel(75 mg/m2,treatment duration is at least 9 cycles).The primary endpoint of this clinical trial was the objective response rate(ORR9)between the AK-HER2 group and the control group in the 9th cycle.Secondary efficacy endpoints included ORR16,disease control rate(DCR),clinical benefit rate(CBR),progression-free survival(PFS)and 1-year survival rate.In this study,100 subjects(AK-HER2 group to control group=1:1)were randomly selected for blood sample collection after the 6th cycle of medication,The collection time points were 45 minutes after infusion(the end of administration),4,8,24,72,120,168,336,and 504 hours after the end of administration.After collection,blood samples were analyzed by PK parameter set(PKPS).Other evaluation parameters included safety and immunogenicity assessment.Results:A total of 550 patients with HER2-positive metastatic breast cancer were enrolled in this clinical trial between Sep.2017 and Mar.2021.In the AK-HER2 group(n=237),129 subjects in the experimental group achieved complete response(CR)or partial response(PR),and the ORR9 was 54.4%.There were 134 subjects in the control group(n=241)who achieved CR or PR,and the ORR9 was 55.6%.The ORR9 ratio between the AK-HER2 group and the control group was 97.9%[90%confidence interval(CI):85.4%-112.2%,P=0.784],which was not statistically significant.In all secondary efficacy endpoints,no statistically significant differences were observed between the two groups.We conducted a mean ratio analysis of pharmacokinetics(PK)parameters between the AK-HER2 group and the control group,and the results suggested that the pharmacokinetic characteristics of the two drugs are similar.The incidence of treatment emergent adverse event(TEAE)leading to drug reduction or suspension during trastuzumab treatment was 3.6%(10 cases)in the AK-HER2 group and 8.1%(22 cases)in the control group.There was statistically significant difference between the two groups(P=0.027).The incidence rate was significantly lower in the AK-HER2 group than in the control group,and there was no statistically significant difference among the other groups.The differences in the positive rates of anti-drug antibodies(ADA)and neutralizing antibodies(NAB)between groups were of no statistical significance(P=0.385 and P=0.752).Conclusion:In patients with HER2-positive metastatic breast cancer,AK-HER2 was comparable to the trastuzumab(Herceptin?)in terms of drug efficacy,pharmacokinetics,safety and immunogenicity.