Objective: To construct a deep learning model based on convolutional neural network(CNN)-long short term memory network(LSTM)-Attention to explore the correlation between meteorological and clinical factors and the incidence of ischemic stroke. Methods: A fusion model CNN-LSTM-Attention based on CNN, LSTM, and Attention was constructed by incorporating clinical data and meteorological data of ischemic stroke inpatients. The predictive performance of the model was evaluated by maximum prediction error and root mean square error(RMSE). The impact of different lag days on prediction performance was investigated by selecting lag periods ranging from 1 to 7 days. Results: In both short-term and long-term predictions, the CNN-LSTM-Attention fusion model(short-term: 1.5 and 0.6; long-term: 8.3 and 2.5) showed superior maximum prediction bias and RMSE compared to the LSTM model(short-term: 2.8 and 1.2; long-term: 19.5 and 5.5) and the CNN-LSTM model(short-term: 2.0 and 0.8; long-term: 11.2 and 3.3). After incorporating lag days, the maximum prediction deviation and RMSE for lags of 3 days(short-term: 0.7 and 0.4; long-term: 5.5 and 1.9) and 5 days(short-term: 0.8 and 0.3; long-term: 6.5 and 2.0) in both short-term and long-term forecasts were smaller than lags of 0 days(short-term: 1.5 and 0.6; long-term: 8.3 and 2.5). The maximum prediction deviation and RMSE in the short-term forecast were greater than lag 0 days for both lag 1 days(1.5 and 0.8) and lag 7 days(1.9 and 0.9). In the long-term forecast, the two indicators for lag 1 days(6.8 and 2.4) were lower than those for lag 0 days but higher than those for lag 3 days and 5 days. The maximum prediction deviation for lag 7 days(7.5) was lower than that for lag 0 days, but the RMSE(2.7) is higher than that for lag 0 days. Conclusion The established CNN-LSTM-Attention model demonstrates significant predictive value for the onset of ischemic stroke and can provide reference for the rational allocation of medical resources.

BACKGROUND: Hypertension is associated with stroke-related mortality. However, the long-term association of blood pressure (BP) and the risk of stroke-related mortality and the influence path of BP on stroke-related death remain unknown. The current study aimed to estimate the long-term causal associations between BP and stroke-related mortality and the potential mediating and moderated mediating model of the associations. METHODS: This is a 45-year follow-up cohort study and a total of 1696 subjects were enrolled in 1976 and 1081 participants died by the latest follow-up in 2020. COX proportional hazard model was used to explore the associations of stroke-related death with baseline systolic blood pressure (SBP)/diastolic blood pressure (DBP) categories and BP changes from 1976 to 1994. The mediating and moderated mediating effects were performed to detect the possible influencing path from BP to stroke-related deaths. E value was calculated in the sensitivity analysis. RESULTS: Among 1696 participants, the average age was 44.38 ± 6.10 years, and 1124 were men (66.3%). After a 45-year follow-up, a total of 201 (11.9%) stroke-related deaths occurred. After the adjustment, the COX proportional hazard model showed that among the participants with SBP ≥ 160 mmHg or DBP ≥ 100 mmHg in 1976, the risk of stroke-related death increased by 217.5% (hazard ratio [HR] = 3.175, 95% confidence interval [CI]: 2.297-4.388), and the adjusted HRs were higher in male participants. Among the participants with hypertension in 1976 and 1994, the risk of stroke-related death increased by 110.4% (HR = 2.104, 95% CI: 1.632-2.713), and the adjusted HRs of the BP changes were higher in male participants. Body mass index (BMI) significantly mediated the association of SBP and stroke-related deaths and this mediating effect was moderated by gender. CONCLUSIONS In a 45-year follow-up, high BP and persistent hypertension are associated with stroke-related death, and these associations were even more pronounced in male participants. The paths of association are mediated by BMI and moderated by gender.
Adult ; Blood Pressure/physiology* ; China/epidemiology* ; Follow-Up Studies ; Humans ; Hypertension ; Male ; Middle Aged ; Risk Factors ; Stroke

Objective:To investigate basic characteristics of diabetes prevalence and associated factors in centenarians in Hainan province of China.Methods:All the subjects were from China Hainan Centenarian Cohort Study. A total of 1 002 centenarians were included in the final analysis, who were divided into three groups: diabetes group, impaired fasting glucose (IFG) group, and normal glucose group according to the guideline.Results:The average age of centenarians was (102.77±2.55) years, and the proportion of females was 82.0%. There were 95 centenarians who suffered from diabetes, and the prevalence rate was 9.5%. There were 81 centenarians who had IFG, and the prevalence rate was 8.1%. The mean fasting plasma glucose (FPG) level of centenarians was (5.12±1.44) mmol/L, while 43.5% of centenarians had FPG levels ranging from 4.00 to 5.00 mmol/L and 22.1% of centenarians had the FPG levels ranging from 5.00 to 6.00 mmol/L. Increased triglyceride level and abdominal obesity might be associated with the risk for diabetes.Conclusion:The glycometabolism in centenarians in Hainan was better than that in other age groups, and no gender specific difference was observed.

Objective:To explore the blood pressure levels and the influencing factors of hypertension among Hainan centenarians, and provide basic data for the further blood pressure related studies of the centenarian population.Methods:The baseline data were from China Hainan Centenarian Cohort Study (CHCCS). This cross-sectional data, based on the community population, was a complete sample study of centenarians, including questionnaire survey, physical examination and physiological index detection. A total of 1 002 centenarians were recruited to describe the blood pressure level. According to the guidelines for the prevention and treatment of hypertension in Chinese adults in 2018, the prevalence of hypertension was analyzed.Results:The median levels of systolic blood pressure, diastolic pressure and pulse pressure were 152.0, 76.0 and 76.5 mmHg, respectively. Blood pressure level was higher in females than in males. The prevalence of hypertension was 71.9%, mainly in isolated systolic hypertension with the prevalence of 60.1%. The results of multivariate analysis showed that the risk of hypertension in women was higher than that in men ( OR=1.624, 95% CI: 1.155-2.283), and the risk of hypertension in the northern ( OR=0.625, 95% CI: 0.434-0.901) and central areas ( OR=0.586, 95% CI: 0.346-0.993) was lower than that of the Eastern. Conclusion:The prevalence of hypertension, mainly in isolated systolic hypertension, showing gender and regional distribution differences.

Objective:To explore the prevalence of lipid profile and the influencing factors of dyslipidemia in centenarians in Hainan province, and provide basic data for the study of the lipid profile in centenarians.Methods:The data of this study were from the baseline data of China Hainan Centenarian Cohort Study from June 2014 to December 2016. A total of 1 002 centenarians were recruited. According to the guidelines for the prevention and treatment of dyslipidemia in Chinese adults in 2016, the prevalence of lipid profile were described and the prevalence of dyslipidemia with different clinical classifications were compared, and the main influencing factors were analyzed.Results:The median levels of TC, TG, LDL-C and HDL-C were 4.60 mmol/L, 1.05 mmol/L, 2.77 mmol/L and 1.41 mmol/L, respectively, in centenarians in Hainan. Blood lipid profile level was higher in females than in males. With the increase of BMI, TC, TG and LDL-C increased significantly, while HDL-C decreased significantly. The total prevalence of dyslipidemia was 19.1%. Smoking, BMI and area distribution were the main influencing factors of dyslipidemia.Conclusion:The prevalence of dyslipidemia in centenarians in Hainan was at a low level compared with other countries, and the blood lipid profile level was higher in females than in males.

Objective:To analyze the association of waist circumference, BMI, waist-hip ratio, waist-height ratio, calf circumference and waist-calf circumference ratio (WCR) with depression risk in centenarians in Hainan province.Methods:A total of 1 002 centenarians in Hainan were selected by cluster sampling. GDS-15 was used to investigate the depression. Multivariate linear regression and logistic regression analyses were conducted to evaluate the correlation between anthropometric indicators and depression risk. Restricted cubic spline was used to analyze and visualize the linear relationship.Results:After adjusting demographic characteristics (gender, age, ethnic group, marital status, educational level and type of residence) and lifestyle (smoking and drinking), the standard β of BMI, WC, WHR, WHtR, calf circumference and WCR associated with GDS-15 were -0.069, -0.032,0.009, -0.009, -0.099 and 0.060, respectively, and the P values of BMI and calf circumference were <0.05. With the increase of calf circumference, the risk of depression decreased, OR value was 0.94 (95% CI:0.90-0.98), and after adjustment, the results were still significant. Classified variable analysis indicated with the decrease of calf circumference and the increase of WCR, the risk of depression increased gradually, the trend P values were 0.038 and 0.042, respectively. Conclusion:Central obesity (waist circumference and WCR) and periphery obesity (calf circumference) have differed effects on depression in centenarians, and increased calf circumference is a protective factor for depression in female centenarians, attention should be paid to the mental health of the elderly women with lower calf circumference.

Objective To investigate the effect of phenylephrine on the morphology and the expression level of Nampt mRNA in the irradiated osteoblasts of the rats,and to clarify the possible protective effects of phenylephrine on this injury.Methods The osteoblasts cultured by conventional tissue were randomly divided into control group, phenylephrine group,simple irradiation group,and phenylephrine+irradiation group.The cells in phenylephrine group were treated with 100 mmol· L-1 phenylephrine 30 min before irradiation.The cells in simple irradiation group were irradiated with 8 Gy X-ray.The osteoblasts were observed by microscope and were collected at the time points of 8,16,32 and 64 h after irradiation.The Nampt mRNA expression level in osteoblasts was examined by RT-PCR.Results There was no obviously morphological and number changes of osteoblasts in phenylephrine group compared with control group.The osteoblasts in simple irradiation group were atrophied,especially at 8 h;the number of osteoblasts in simple irradiation group was 0.82,0.37,0.24 and 0.21 times as control group respectively at 8,16,32 and 64 h. Atrophy of osteoblasts was alleviated in phenylephrine+irradiation group;at 8, 16,32 and 64 h,the number of osteoblasts was 0.91,0.83,0.72 and 0.75 times as control group,and was 1.09,2.24,3.00 and 3.60 times as simple irradiation group. The expression level of Nampt mRNA in the osteoblasts in simple irradiation group was reduced compared with control group (P < 0.01) at 8, 16, 32 and 64 h.There were significant differernces of the expression levels of Nampt mRNA in the osteoblasts between phenylephrine+irradiation group and control group (P < 0.01),and there were significant differernces between phenylephrine + irradiation group and simple irradiation group (P < 0.01 ) at the different time points. Conclusion Phenylephrine could reduce the atrophy of osteoblasts in the rats induced by irradiation and up-regulate the expression level of Nampt mRNA.Its protective effect on irradiated injury may be related to the up-regulation of the expression level of Nampt mRNA.

OBJECTIVE: To observe the changes of blood pressure and S-100B, neuron specific enolase (NSE) protein in hypertensive dogs with high fat diet after catheter-based renal sympathetic denervation. METHODS: Twelve Beagles were divided into an interventional group (n=6) and a sham-operation group (n=6). After baseline measurements, the Beagles were fed with lard oil for 3 months. After 3 months, the interventional group had renal sympathetic denervation by percutaneous catheter based radiofrequency ablation and the control group had renal angiography. The blood pressure, plasma S-100B, and NSE before the operation and 3 days, 1 week, 2 weeks, 1 month, 2 months and 3 months after the operation were measured. RESULTS: The dogs had significantly higher levels of systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MBP) compared to its baselines (P<0.05). The SBP, DBP and MBP in the interventional group were significantly lower than those in the control group 1 month and 3 months after the operation (P<0.05). Three months after the operation, renal angiography in all dogs revealed no sign of renal artery stenosis. Plasma S-100B and NSE expression in the interventional group were higher than those in the control group 3 days, 1 week and 2 weeks after the operation (P<0.05). CONCLUSION Renal sympathetic denervation can significantly reduce the SBP, DBP and MBP in hypertensive dogs. The plasma S-100B and NSE may be used as indicators for assessment of renal nerve injury after renal sympathetic denervation.
Animals ; Blood Pressure ; Catheter Ablation ; Dogs ; Hypertension ; metabolism ; Kidney ; innervation ; surgery ; Phosphopyruvate Hydratase ; metabolism ; S100 Calcium Binding Protein beta Subunit ; metabolism ; Sympathectomy

Objective To evaluate the effects and toxicities of the hyperthermic peritoneal peffusion with oxaliplatin (L-OHP) and interleukin-2 (IL-2) combined with chemotherapy for treatment malignant asci-tes. Methods 42 patients with malignant aacites from assimilation system tumor were catheterized,drained and flushed with L-OHP 85 mg/m2 in 2 000 ～2 500 ml of 5 % glucose and IL-2(2 MU),NRL-001 Double RF tumor hyperthermia system was applied to heat the abdominal part for 60 ～ 120 minutes at an intraperitoneal temperature of 41 -43 ℃ ,next day,all the patients were treated with calcium folinate(CF)0. 2 g/m2 by 2 hours intravenous infusion,5-fluorouracil (5-FU) 0. 4 g/m2 intravenously, followed by 46 hours continuous infusion of 5-FU (1 600 mg/m2), 2 weeks a cycle. Results The overall response rate was 66. 67%, including CR : 6 cases, PR:22 cases, NC:6 cases, and PD:8 cases. MST is 5.6 months. The main toxicity was impatient abdomen ache,paralysis intestinal obstruction. Conclusion Hyperthermic peritoneal perfusion with oxaliplatin and inter-leukin-2 combined with chemotherapy is efficient and safe in the treatment malignant ascites and can improve the quality of life. It is worthing wildly using and research.

Objective:To prepare dendritic cell (DC)-cytokine induced killer (CIK) tumor vaccine using DCs of patients with nonsmall-cell lung cancer (NSCLC) harboring autologous tumor antigens and to observe its inhibitory effect on autologous tumor cells in vitro. Methods: Peripheral blood mononuclear cells (PBMCs) extracted from NSCLC patients were cultured into DCs and CIKs in presence of different cytokines. Cancer cells from the patients were cultured in vitro and were used to prepare different tumor antigens: tumor cell lysates, necrotic tumor cells and normally-grown tumor cells. The DCs were stimulated by OK-432 and the phenotypes of the DCs were analyzed by flow cytometer. Then the DCs were co-cultured with CIKs. The anti-tumor effect of DC-CIK was evaluated by MTT assay. Results: Compared with the DCs harboring the antigens of necrotic tumor cells and normally-grown tumor cells, DCs pulsed with tumor cell lysates had significantly higher expression of surface molecules such as CD1a (85.1?2.7), CD80 (80.0?4.4), CD83 (75.4?5.3), and HLA-DR(80.5?7.8, all P