Traditional Chinese medicine shows good hypoglycemic effect with mild efficacy, long duration and few adverse reac-tions. In recent years, the researches on the hypoglycemic effect of Ruikang Hospital Affilliated to traditional Chinese medicine mainly started from the mechanism of new target protein and pathway, for example, Chinese medicine monomers or compounds including as-tragalus polysaccharide, curcumin, berberine, emodin, total saponins of momordicacharantia, total saponins of momordicacharantia, Yitangkang, Jiangtang Sanhuang tablets, Jianpixiaokefang and Tangnaikang granule can activate Adenosine monophosphate ( AMP)-activated protein kinase ( AMPK) to play hypoglycemic effect.

Objective: To investigate the impact of improved AHA cardiovascular health behavior score (CHS) on short-time systemic blood pressure variability (SBPV) in elder population.
Methods: A total of 2464 participants ≥ 60 years from 3 hospitals of Kailuan area were taken for cohort study. The participants had no cardiovascular disease, not taking anti-psychotic drug, Parkinson treatment drug, anti-depression drug and analgesic drug within 2 weeks. All participants received 24-hour ambulatory blood pressure monitoring (ABPM) and the 24-hour, day-time, night-time SBPV were deifned by the standard deviation of 24-hour, day-time, night-time systolic blood pressure. The influence of CHS on SBPV was studied by multi-linear regression analysis. Improved cardiovascular health behavior and factors implied as changing the vegetable intake amount to salt amount by American Humane Association, 2010; boundary of BMI based on《Guidelines for prevention of overweight and obesity in Chinese adults》; status of exercise was deifed as the ideal status: ≥80 min/week, general status: < 80 min/week and bad status: no exercise.
Results: Finally, 1812 participants were recruited for survey and they were divided into 3 groups according to improved CHS: Group①, CHS (0-4) points,n=56, Group②, CHS (5-9) pointsn=1600 and Group③, CHS (10-14) points,n=156. The 24-hour SBPV in Groups①,②and③were 16.02 mmHg, 14.91 mmHg and 13.18 mmHg; day-time SBPV were 15.42 mmHg, 14.50 mmHg and 13.22 mmHg; night-time SBPV were 12.68 mmHg, 11.44 mmHg and 10.16 mmHg, allP<0.05. Multi-linear regression analysis indicated that with adjusted confounding factors, with 1 point of CHS elevation, the 24 hour-, day-time, night-time SBPV would reduce for 0.20 mmHg, 0.19 mmHg and 0.37 mmHg respectively, allP<0.05.
Conclusion: CHS was negatively related to short-time SBPV in elder population.

Background::The CHA 2DS 2–VASc score was initially applied to stratify stroke risk in patients with atrial fibrillation (AF) and was found to be effective in predicting all-cause mortality outcomes. To date, it is still unclear whether circulating long non-coding RNAs (lncRNAs) as emerging biomarkers, can improve the predictive power of the CHA 2DS 2–VASc score in stroke and all-cause mortality. Methods::Candidate lncRNAs were screened by searching the literature and analyzing previous RNA sequencing results. After preliminary verification in 29 patients with AF, the final selected lncRNAs were evaluated by Cox proportional hazards regression in 192 patients to determine whether their relative expression levels were associated with stroke and all-cause mortality. The c-statistic, net reclassification improvement (NRI), and integrated discrimination improvement of the patients were calculated to evaluate the discrimination and reclassification power for stroke and all-cause mortality when adding lncRNA expression levels to the CHA 2DS 2–VASc score model. Results::Five plasma lncRNAs associated with stroke and all-cause mortality in AF patients were selected in our screening process. Patients with elevated H19 levels were found to have a higher risk of stroke (hazard ratio [HR] 3.264, 95% confidence interval [CI]: 1.364–7.813, P = 0.008). Adding the H19 expression level to the CHA 2DS 2–VASc score significantly improved the discrimination and reclassification power of the CHA 2DS 2–VASc score for stroke in AF patients. In addition, the H19 level showed a marginally significant association with all-cause mortality (HR 2.263, 95% CI: 0.889–5.760, P = 0.087), although it appeared to have no significant improvement for the CHA 2DS 2–VASc model for predicting all-cause mortality. Conclusions::Plasma expression of H19 was associated with stroke risk in AF patients and improved the discriminatory power of the CHA 2DS 2–VASc score. Therefore, lncRNA H19 served as an emerging non-invasive biomarker for stroke risk prediction in patients with AF.

Background::Given that seizures may be triggered by vaccination, this study aimed to evaluate the risk and correlative factors of seizures in patients with epilepsy (PWE) after being vaccinated against coronavirus disease 2019 (COVID-19).Methods::This study retrospectively enrolled PWE who were vaccinated against COVID-19 in the epilepsy centers of 11 hospitals in China. We divided the PWE into two groups as follows: (1) patients who developed seizures within 14 days of vaccination were assigned to the SAV (with seizures after vaccination) group; (2) patients who were seizure-free within 14 days of vaccination were assigned to the SFAV (seizure-free after vaccination) group. To identify potential risk factors for seizure reccurence, the binary logistic regression analysis was performed. Besides, 67 PWE who had not been vaccinated were also included for elucidating the effects of vaccination on seizures recurrence, and binary logistic regression analysis was performed to determine whether vaccination would affect the recurrence rate of PWE who had drug reduction or withdrawal.Results::The study included a total of 407 patients; of which, 48 (11.8%) developed seizures within 14 days after vaccination (SAV group), whereas 359 (88.2%) remained seizure-free (SFAV group). The binary logistic regression analysis revealed that duration of seizure freedom ( P < 0.001) and withdrawal from anti-seizure medications (ASMs) or reduction in their dosage during the peri-vaccination period were significantly associated with the recurrence of seizures (odds ratio= 7.384, 95% confidence interval = 1.732–31.488, P = 0.007). In addition, 32 of 33 patients (97.0%) who were seizure-free for more than three months before vaccination and had a normal electroencephalogram before vaccination did not have any seizures within 14 days of vaccination. A total of 92 (22.6%) patients experienced non-epileptic adverse reactions after vaccination. Binary logistic regression analysis results showed that vaccine did not significantly affect the recurrence rate of PWE who had the behavior of ASMs dose reduction or withdrawal ( P = 0.143). Conclusions::PWE need protection from the COVID-19 vaccine. PWE who are seizure-free for >3 months before vaccination should be vaccinated. Whether the remaining PWE should be vaccinated depends on the local prevalence of COVID-19. Finally, PWE should avoid discontinuing ASMs or reducing their dosage during the peri-vaccination period.

Objective:To describe the characteristics, etiology and patterns of outpatients and inpatients patients with moderate or severe valvular heart disease (VHD).Methods:This is a cross-sectional study. Outpatients and inpatients with moderate or severe VHD who underwent transthoracic echocardiography for first examination from 1 st January 2001 to 1 st January 2020 in Southwest Hospital, Army Medical University were enrolled. Data were collected from medical records and big data platform of Southwest Hospital. Characteristics of age and gender, etiology and types of VHD were descriptively analysed. Results:A total of 68 354 patients with moderate or severe VHD were enrolled. The age was 63 (50, 72) years. And 35 706 (52.24%) patients were female. (1) Age characteristics: There was similar age trend between male and female patients with moderate or severe VHD. The number of patients increased firstly and then decreased and reached its peak in the age group of 65-69 years old. The peak age of mitral stenosis patients was 45-49 years, which was earlier than that of whole patients with moderate or severe VHD. The median age of patients with bicuspid aortic valve was 42 years. (2) Gender characteristics: The proportion of tricuspid regurgitation, pulmonary regurgitation, mitral regurgitation, mitral stenosis and valve surgery in female patients with moderate or severe VHD were higher than those in male patients. The proportion of aortic regurgitation, aortic stenosis and bicuspid aortic valve in male patients with moderate or severe VHD were significantly higher than those in female patients (all P<0.05). (3) Etiology: The proportion of rheumatic VHD was 13.07% (8 934/68 354), which was higher than that of degenerative VHD (0.67% (458/68 354)). (4) Types of VHD: Tricuspid regurgitation made contribution to the largest proportion with 60.72% (41 503/68 354), followed by mitral regurgitation, aortic regurgitation, mitral stenosis, pulmonary regurgitation and aortic stenosis. Conclusions:There are certain regional characteristics in the prevalence of moderate or severe VHD in southwest China, suggesting different attention should be paid on the whole process of refined management of moderate or severe VHD.