Objective: To evaluate the prognostic value of left ventricular ejection fraction (LVEF) reserve assessed by gated SPECT myocardial perfusion imaging (SPECT G-MPI) for major adverse cardiovascular event (MACE) in patients with coronary artery disease. Methods: This is a retrospective cohort study. From January 2017 to December 2019, patients with coronary artery disease and confirmed myocardial ischemia by stress and rest SPECT G-MPI, and underwent coronary angiography within 3 months were enrolled. The sum stress score (SSS) and sum resting score (SRS) were analyzed by the standard 17-segment model, and the sum difference score (SDS, SDS=SSS-SRS) was calculated. The LVEF at stress and rest were analyzed by 4DM software. The LVEF reserve (ΔLVEF) was calculated (ΔLVEF=stress LVEF-rest LVEF). The primary endpoint was MACE, which was obtained by reviewing the medical record system or by telephone follow-up once every twelve months. Patients were divided into MACE-free and MACE groups. Spearman correlation analysis was used to analyze the correlation between ΔLVEF and all MPI parameters. Cox regression analysis was used to analyze the independent factors of MACE, and the optimal SDS cutoff value for predicting MACE was determined by receiver operating characteristic curve (ROC). Kaplan-Meier survival curves were plotted to compare the difference in the incidence of MACE between different SDS groups and different ΔLVEF groups. Results: A total of 164 patients with coronary artery disease [120 male; age (58.6±10.7) years] were included. The average follow-up time was (26.5±10.4) months, and a total of 30 MACE were recorded during follow-up. Multivariate Cox regression analysis showed that SDS (HR=1.069, 95%CI: 1.005-1.137, P=0.035) and ΔLVEF (HR=0.935, 95%CI: 0.878-0.995, P=0.034) were independent predictors of MACE. According to ROC curve analysis, the optimal cut-off to predict MACE was a SDS of 5.5 with an area under the curve of 0.63 (P=0.022). Survival analysis showed that the incidence of MACE was significantly higher in the SDS≥5.5 group than in the SDS<5.5 group (27.6% vs. 13.2%, P=0.019), but the incidence of MACE was significantly lower in the ΔLVEF≥0 group than in theΔLVEF<0 group (11.0% vs. 25.6%, P=0.022). Conclusions: LVEF reserve (ΔLVEF) assessed by SPECT G-MPI serves as an independent protective factor for MACE, while SDS is an independent risk predictor in patients with coronary artery disease. SPECT G-MPI is valuable for risk stratification by assessing myocardial ischemia and LVEF.
Humans ; Male ; Middle Aged ; Aged ; Coronary Artery Disease/diagnostic imaging* ; Stroke Volume ; Myocardial Perfusion Imaging ; Retrospective Studies ; Ventricular Function, Left ; Myocardial Ischemia

OBJECTIVE: This study was aimed at investigating the carrier rate of, and molecular variation in, α- and β-globin gene mutations in Hunan Province. METHODS: We recruited 25,946 individuals attending premarital screening from 42 districts and counties in all 14 cities of Hunan Province. Hematological screening was performed, and molecular parameters were assessed. RESULTS: The overall carrier rate of thalassemia was 7.1%, including 4.83% for α-thalassemia, 2.15% for β-thalassemia, and 0.12% for both α- and β-thalassemia. The highest carrier rate of thalassemia was in Yongzhou (14.57%). The most abundant genotype of α-thalassemia and β-thalassemia was -α ^3.7/αα (50.23%) and β ^IVS-II-654/β ^N (28.23%), respectively. Four α-globin mutations [CD108 (ACC>AAC), CAP +29 (G>C), Hb Agrinio and Hb Cervantes] and six β-globin mutations [CAP +8 (C>T), IVS-II-848 (C>T), -56 (G>C), beta nt-77 (G>C), codon 20/21 (-TGGA) and Hb Knossos] had not previously been identified in China. Furthermore, this study provides the first report of the carrier rates of abnormal hemoglobin variants and α-globin triplication in Hunan Province, which were 0.49% and 1.99%, respectively. CONCLUSION Our study demonstrates the high complexity and diversity of thalassemia gene mutations in the Hunan population. The results should facilitate genetic counselling and the prevention of severe thalassemia in this region.
Humans ; beta-Thalassemia/genetics* ; alpha-Thalassemia/genetics* ; Hemoglobinopathies/genetics* ; China/epidemiology* ; High-Throughput Nucleotide Sequencing

Objective:To explore the theory and methods of integrating sports into modern health service systems. Methods:Based on the theory of World Health Organization modern health service systems and the policy guideline Rehabilitation in Health Service Systems, we analyzed how to promote the integration of sports into modern health service systems in six areas: leadership and governance capacity, financing, health human resources, service delivery, medical technology and health information systems, systematically analyzed the key elements and requirements for integrating physical education and sports into the health service system in the four segments of the health service continuum: prevention, intervention, rehabilitation and health promotion. Results:The goal of building a human-centered, cross-sectoral and multidisciplinary health service system was proposed, requiring the promotion of the integration of medicine and sports, the use of sports intervention as a method of health intervention, the development of service technologies and standards for the integration of sports and health; the training of professionals who master sports intervention and sports rehabilitation, and the development of information systems to promote the development of the integration of sports and health services. Conclusion:Sports is an important mean of health and an important part of modern health services. Starting from the components of the health service system, we can build a theoretical and methodological system for integrating sports into the modern health service system, so as to promote the realization of a health service system covering the whole population and the whole life cycle, achieve the United Nations 2030 Sustainable Development Goal 3: ensure healthy lives and promote well-being for all at all ages; and realize the goals related to "Healthy China".

Objective:To review the categories of physical activities and rehabilitation exercise for aging people based on the theory and method of the International Classification of Functioning, Disability, and Health (ICF). Methods:From the framework and coding of ICF, physical activities, rehabilitation exercise and functional improvement for the aging people were reviewed. Results:There were three typical physical activities: physical fitness, skills and sports, mainly including regular exercises, cognitive amusements, leisure sports activities, recreational sports activities, rehabilitation exercises, etc. Physical activities promoted the functioning of the aging people, including mental function (b1), pain and sensory dysfunction (b2), cardiovascular, blood, the function of the immune system and respiratory system (b4), digestion, metabolism and function of the endocrine system (b5), nerve musculoskeletal function related to movement (b7), the function of skin and related structures (b8), activity (d4), and community, social and civic life (d9), etc., especially body mass index, cardiovascular, physical fitness (muscular strength and endurance, aerobic endurance), balance, flexibility, upper and lower extremities strength, sleep, metabolic capability, cognitive function and anti-aging ability. There were more gains at individual levels, including promotion of subjective happiness, quality of life, reducing depression, risk of sarcopenia, dementia and falling, etc. The environmental and personal factors related to activity and participation in physical activities included the products and technologies (e1), natural environment and man-made changes to the environment (e3), support and interpersonal relationships (e3), attitude, service system and policy (e5), such as urban environment, building environment, street pavement behavior, weather, caregivers, accompany of family and friends, etc. Conclusion:The physical activities and rehabilitation exercise the aged joined include physical fitness activities, skills activities, and sports activities. The physical activities had effects on the rehabilitation of the aged including the function of the body(mental function, pain and sensory dysfunction, cardiovascular, blood, the function of the immune system and respiratory system, digestion, metabolism, and function of the endocrine system, nerve musculoskeletal function related to movement, the function of skin and related structures) and the participation in activities (activities, community, society and civic life). The function of the body works for the health of the aged to promote physical health, mental health, functional health, social adjustment and social well-being.

Cardiac Resynchronization Therapy ; Electrocardiography ; Heart Ventricles ; Stroke Volume ; Treatment Outcome ; Ventricular Function, Left

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

Objective:To analyze the categories and its relations of recreational physical activities and rehabilitation exercise for adult with disabilities based on the theory and method of International Classification of Functioning, Disability and Health (ICF). Methods:An evidence-based scoping review had been implemented. We had developed the framework and coding approaches for recreational physical activities, rehabilitation exercise and functional improvement for the adults with disabilities based on evidence-based literature review. The literature related to recreational physical activities and rehabilitation exercise of adult with disabilities was searched by subject retrieval method. The retrieval database in Chinese included CNKI and Wanfang database, and the retrieval database in English included PubMed and Web of Science. The retrieval time was from establishment to July 31, 2020. The authors, countries, published time, published journals, research objectives, object of the study and their ages, data collection tool, and the key findings were extracted. Results:A total of 2476 literatures were returned, and 18 of them were enrolled, which were published in 14 countries, and most were published in journals on topics related to medicine, public health, exercise and people with disabilities. They were mainly published from 2010 to 2020, and mainly used questionnaire survey, measurement and interviewing method. There were three typical recreational physical activities: physical fitness activities, skills activities and sports activities, mainly including Taiji Quan, wheelchair basketball, leisure outdoor activities, community recreational sports activities and rehabilitation exercises, etc. According to the framework of ICF, recreational physical activities promote functional rehabilitation for adults with disabilities, including physical functions (b1 mental function; b4 cardiovascular, blood, the function of the immune system and respiratory system; b5 digestion, metabolism and function of the endocrine system; and b7 nerve musculoskeletal function related to movement), and activities and participation (d1 study and application of knowledge; d2 the general tasks and requirements; d4 activity; d5 self-care; d7 interpersonal communication and interpersonal relationship; and d9 community, social and civic life). The evidences showed benefits of improvement in the fields of body mass index, body index, athletic ability, balance ability, and cognitive function. There were more gains at individual levels, including support, coping with stress, self-concept development, life satisfaction, happiness, exercise self-efficacy, health perception, etc. The environmental and personal factors had effects on the performance of activity and participation in recreational physical activities, including e1 products and technologies, e4 attitude, e3 support and interpersonal relationships, e5 service system and policy, as well as attitudes and support of family members and colleagues, interpersonal relationships, social support, transportation, equipment and facilities, and policies. Conclusion:Rehabilitation exercise is an important part of health-related services. We scoped the recreational physical activities and its functional effects for adults with disabilities. The categories and structure of recreational physical activities and rehabilitation exercises were constructed based on ICF. Aligning rehabilitation exercises and relevant factors to ICF, the recreational activities and rehabilitation exercises had been reviewed and discussed and several recommendations for further studies had been drawn.

Objective To establish an emergency care mode with fixed position and station for outpatient nurses and to evaluate the effectiveness of this mode.Methods Current problems in emergency care were analyzed,a system-improving team was formed,and the emergency care mode with fixed position and station for outpatient nurses was established.Emergency care start-up time,successful emergency rescue rate and rate of disputes and complaints caused by emergency issues were compared before and after application of the mode.Results After application,emergency care start-up time was reduced from (5.45-±1.21)min to (2.71±0.97)min;successful emergency rescue rate was increased from 82.5％ to 96.55％;rate of disputes and complaints caused by emergency issues was decreased from 12.5％ to 1.72％.All differences were statistically significant(P＜0.05).Conclusion The emergency care mode with fixed position and station for outpatient nurses can shorten emergency care start-up time,increase successful emergency rescue rate,reduce rate of disputes and complaints caused by emergency issues,and further improve general emergency system of the hospital.

Objective To explore the effects of arctigenin on inhibiting proliferation of type Ⅱ endometrial carcinoma cells , and its relationship with vascular endothelial growth factor ( VEGF).Methods The typeⅡendometrial carcinoma cells line were divided into control group , test A group and test B group.The control group were cultured for 7 days without any drugs.The test A group and test B group were treated with Arctigenin for 7 days at the concentration of 10 μmol · L-1 and 20 μmol· L-1 respectively.Cell proliferation and inhibition level were measured by cell counting kit ( CCK -8 ) and cell growth curve.The expression of mRNA and protein for VEGF were measured by reverse transcription polymerase chain reaction and Western blot.Results Comparing with the control group , the test A group and test B group have inhibitory effects on proliferation of type Ⅱendometrial carci-noma cell line ( P<0.05 ).The effect of inhibition in test B group was more obvious than in test A group ( P<0.01 ).The expression of mRNA and protein for VEGF in test A group and test B group decreased ( P<0.05 ).The expression level in test B group decreased more significantly than in test A group ( P<0.01 ).Conclusion The effect of Arctigenin on inhibiting proliferation of typeⅡendometrial carcinoma cells is implemented by down-regulating the genetic expression of VEGF.

OBJECTIVETo analyze clinical data and gene mutations in 3 Chinese patients with tyrosinemia type I, and to explore the correlation between genotypes and phenotypes.

METHODSThree patients suspected with tyrosinemia I were tested by tandem mass spectrometry for the level of tyrosine, phenylalanine and succinylacetone in the blood, and by gas chromatography-mass spectrometry to determine the level of succinylacetone and organic acid in their urine. With the diagnosis established, the FAH gene was analyzed with polymerase chain reaction (PCR) and direct sequencing.

RESULTSTwo patients had acute onset of the disease, while another had subacute onset of the disease, with features including hepatomegaly and remarkably increased tyrosine and succinylacetone in the blood. Five mutations were detected in the FAH gene, which included c.455G>A (W152X), c.520C>T (R174X), c.974_976delCGAinsGC, c.1027 G>A (G343R) and c.1100 G>A (W367X), among which c.455G>A (W152X), c.974_976delCGAinsGC and c.1100 G>A (W367X) were not reported previously.

CONCLUSIONTyrosinemia type I may be effectively diagnosed with the level of tyrosine and succinylacetone by tandem mass spectrometry and succinylacetone in the urine by gas chromatography mass spectrometry. Detection of underlying mutations mutations will be helpful for genetic counseling and further research.

Asian Continental Ancestry Group ; genetics ; Base Sequence ; China ; Female ; Humans ; Hydrolases ; genetics ; Infant ; Male ; Mutation ; Tyrosinemias ; diagnosis ; genetics