OBJECTIVE:Although the potential benefits of wearable devices in enhancing the physical activity levels of the elderly have been recognized,the specific effects of these devices on this population have not yet been comprehensively and systematically assessed.The aim of this article is to systematically evaluate the effect of wearable device interventions on various physical activity-related indicators in the elderly,including moderate-to-vigorous physical activity,low-intensity physical activity,total physical activity,daily step count,and sedentary behavior.METHODS:A literature search was conducted through databases including PubMed,EMbase,Scopus,Ovid-Medline,The Cochrane Library,SPORTDiscus,CNKI,VIP,and WanFang from inception to March 10,2024,to collect randomized controlled trials on the effect of wearable device interventions on physical activity in the elderly.The methodological quality of included studies was assessed using the Cochrane Risk of Bias tool.Data synthesis,subgroup analysis,forest plot creation,sensitivity analysis,publication bias assessment,and univariate meta-regression analysis were performed using Review Manager 5.2 and Stata 12.0 software.RESULTS:(1)A total of 43 articles,encompassing 5 194 participants,were included in the final analysis.(2)Meta-analysis results indicated that wearable device interventions significantly enhanced the daily step count(SMD=0.48,95％CI:0.33-0.62,P＜0.000 01),moderate-to-vigorous physical activity(SMD=0.29,95％CI:0.20-0.38,P＜0.000 01),low-intensity physical activity(SMD=0.17,95％CI:0.02-0.32,P=0.03),and total physical activity(SMD=0.15,95％CI:0.02-0.28,P=0.02)in the elderly.However,the intervention showed no significant effect on improving sedentary behavior(SMD=-0.08,95％CI:-0.21-0.05,P=0.22).(3)Subgroup analysis revealed that comprehensive intervention strategies,interventions lasting＜12 weeks,and the use of pedometers as intervention devices were more effective in promoting low-intensity physical activity and total physical activity among the elderly.Comprehensive intervention strategies,interventions lasting＜12 weeks,and the use of accelerometers as intervention devices might be more effective in enhancing daily step count and moderate-to-vigorous physical activity.(4)Meta-regression results suggested that age(P=0.038)and health status(P=0.083)could be significant factors influencing heterogeneity in daily step count.CONCLUSION:Current evidence suggests that wearable device interventions have a positive role in promoting daily step count,moderate-to-vigorous physical activity,low-intensity physical activity,and total physical activity in the elderly.It is recommended to consider comprehensive intervention approaches,interventions lasting＜12 weeks,and the selection of appropriate devices based on intervention goals when designing wearable device intervention programs.Nevertheless,further high-quality randomized controlled trials are needed to substantiate the effectiveness of interventions aimed at reducing sedentary behavior.

Cardiovascular surgery in China has undergone leapfrog development, from learning and introducing technologies, to independent innovation, and now leading the world in some fields. Currently, the continuous decline in the birth rate, accelerated aging process, and westernization of dietary structure have profoundly reshaped the epidemiological spectrum of cardiovascular diseases, posing a " triple impact" on the development of cardiovascular surgery. This article summarizes their impacts: (1) Congenital heart disease (CHD): The reduction in newborns has led to a decrease in the absolute number of surgeries, but the popularization of prenatal diagnosis and improved treatment capabilities have relatively increased the proportion of complex CHD cases. The population of adult CHD patients is large and their management has become more complex. (2) Acquired heart disease: Aging has driven a significant increase in the volume of surgeries for coronary artery bypass grafting (CABG), valvular heart disease (especially degenerative lesions), atrial fibrillation surgery, and heart failure (heart transplantation and left ventricular assist devices). Patients are characterized by advanced age, critical conditions, and multiple comorbidities. (3) Great vessel diseases: Hypertension, atherosclerosis, and aging have caused a sharp increase in the incidence and surgical volume of aortic aneurysms/aortic dissections, with endovascular treatment becoming an important approach. To address these challenges, future development directions focus on: Technological innovation (minimally invasive surgery, interventional/hybrid techniques, mechanical circulatory support, precision medicine, and regenerative medicine); Transformation of diagnosis and treatment models (establishing full-life-cycle management of CHD, strengthening multidisciplinary heart team decision-making, and promoting enhanced recovery after surgery); Resource optimization (regional collaborative hierarchical diagnosis and treatment, capacity building at the grassroots level, and adaptation to medical insurance payment reforms); Talent training and scientific research innovation (cultivating interdisciplinary talents, strengthening clinical research, and innovating domestic medical devices). Cardiovascular surgery in China needs to actively adapt to changes in population structure and safeguard national heart health through continuous innovation and system optimization.

Objective:To analyze the clinical characteristics and treatment of patients with acute Q fever in Dali Bai Autonomous Prefecture, Yunnan Province.Methods:A total of 26 patients with acute Q fever admitted to People′s Hospital of Yunnan Dali Bai Autonomous Prefecture from October 2022 to December 2023 were enrolled. A retrospective cross-sectional study analysis was performed to analyze the demographic characteristics, epidemiology, clinical manifestations, laboratory tests and pathogen detection of these patients.Results:Of the 26 patients, 25 were male and one was female. The age ranged from 18 to 82 years with an average age of (45.6±17.2) years. All of them were sporadic cases. The neighbors of eight patients had sheep and cattle, 11 cases had a history of field work, and four cases had a history of field trip. Coxiella burnetii was detected in 26 patients by different molecular diagnostic techniques, including 21 cases by blood quantitative polymerase chain reaction (qPCR), three cases by sputum multi-pathogen targeted next-generation sequencing (tNGS), one case by alveolar lavage fluid tNGS, and one case by cerebrospinal fluid metagenomic next-generation sequencing (mNGS). Routine blood cultures of 19 cases were negative. All 26 patients presented with chills and fever, 21 cases (80.8%) with headache, 19 cases (73.1%) with fatigue, 14 cases (53.8%) with generalized aches and pains, 12 cases (46.2%) with poor appetite, and 14 cases (53.8%) with cough. Twenty-four cases had concurrent hepatitis, 12 cases had pneumonia, one had encephalitis, and 19 cases had myocardial damage. The laboratory tests showed that 23 cases (88.5%) had normal white blood cell count, eight cases (30.8%) had decreased platelet count, 25 cases (96.2%) had C-reactive protein elevated, 24 cases (92.3%) had procalcitonin elevated, 14 out of 17 cases had elevated erythrocyte sedimentation rate, and 19 cases had elevated D-dimer levels. Liver function tests showed that alanine aminotransferase increased in 24 cases (92.3%) (all less than 10 times of upper limit of normal (ULN)), aspartate aminotransferase increased in 23 cases (88.5%) (all less than 10 times of ULN), alkaline phosphatase increased in 10 cases (38.5%)(all less than two times of ULN), and γ-glutamyl transpeptidase increased in 19 cases (73.1%), which were all less than 10 times of ULN. Myocardial enzymes were detected in 21 cases, of which seven cases (33.3%) had elevated lactate dehydrogenase and 12 cases (57.1%) had elevated hydroxybutyrate dehydrogenase (all less than three times of ULN). In terms of treatment, 16 cases were treated with doxycycline alone, and nine cases were treated with doxycycline combined with azithromycin or quinolones or rifampicin, and one with tigecycline. After treatment, the conditions of patients improved. The overall length of hospital stay was (7.7±5.0) d, and that of eight patients treated with doxycycline combined with quinolones or azithromycin was 4.8 to 6.0 days. Conclusions:Acute Q fever often has no clear epidemiological history, and the clinical manifestations and laboratory tests are lack of specificity. qPCR, tNGS, mNGS can provide pathogenic diagnostic evidence for suspected cases. In terms of treatment, doxycycline is the first choice for treatment of acute Q fever, and combined treatment with azithromycin or quinolones could result in a shorter hospital stay.

OBJECTIVE:Although the potential benefits of wearable devices in enhancing the physical activity levels of the elderly have been recognized,the specific effects of these devices on this population have not yet been comprehensively and systematically assessed.The aim of this article is to systematically evaluate the effect of wearable device interventions on various physical activity-related indicators in the elderly,including moderate-to-vigorous physical activity,low-intensity physical activity,total physical activity,daily step count,and sedentary behavior.METHODS:A literature search was conducted through databases including PubMed,EMbase,Scopus,Ovid-Medline,The Cochrane Library,SPORTDiscus,CNKI,VIP,and WanFang from inception to March 10,2024,to collect randomized controlled trials on the effect of wearable device interventions on physical activity in the elderly.The methodological quality of included studies was assessed using the Cochrane Risk of Bias tool.Data synthesis,subgroup analysis,forest plot creation,sensitivity analysis,publication bias assessment,and univariate meta-regression analysis were performed using Review Manager 5.2 and Stata 12.0 software.RESULTS:(1)A total of 43 articles,encompassing 5 194 participants,were included in the final analysis.(2)Meta-analysis results indicated that wearable device interventions significantly enhanced the daily step count(SMD=0.48,95％CI:0.33-0.62,P＜0.000 01),moderate-to-vigorous physical activity(SMD=0.29,95％CI:0.20-0.38,P＜0.000 01),low-intensity physical activity(SMD=0.17,95％CI:0.02-0.32,P=0.03),and total physical activity(SMD=0.15,95％CI:0.02-0.28,P=0.02)in the elderly.However,the intervention showed no significant effect on improving sedentary behavior(SMD=-0.08,95％CI:-0.21-0.05,P=0.22).(3)Subgroup analysis revealed that comprehensive intervention strategies,interventions lasting＜12 weeks,and the use of pedometers as intervention devices were more effective in promoting low-intensity physical activity and total physical activity among the elderly.Comprehensive intervention strategies,interventions lasting＜12 weeks,and the use of accelerometers as intervention devices might be more effective in enhancing daily step count and moderate-to-vigorous physical activity.(4)Meta-regression results suggested that age(P=0.038)and health status(P=0.083)could be significant factors influencing heterogeneity in daily step count.CONCLUSION:Current evidence suggests that wearable device interventions have a positive role in promoting daily step count,moderate-to-vigorous physical activity,low-intensity physical activity,and total physical activity in the elderly.It is recommended to consider comprehensive intervention approaches,interventions lasting＜12 weeks,and the selection of appropriate devices based on intervention goals when designing wearable device intervention programs.Nevertheless,further high-quality randomized controlled trials are needed to substantiate the effectiveness of interventions aimed at reducing sedentary behavior.

Cardiovascular surgery in China has undergone leapfrog development, from learning and introducing technologies, to independent innovation, and now leading the world in some fields. Currently, the continuous decline in the birth rate, accelerated aging process, and westernization of dietary structure have profoundly reshaped the epidemiological spectrum of cardiovascular diseases, posing a " triple impact" on the development of cardiovascular surgery. This article summarizes their impacts: (1) Congenital heart disease (CHD): The reduction in newborns has led to a decrease in the absolute number of surgeries, but the popularization of prenatal diagnosis and improved treatment capabilities have relatively increased the proportion of complex CHD cases. The population of adult CHD patients is large and their management has become more complex. (2) Acquired heart disease: Aging has driven a significant increase in the volume of surgeries for coronary artery bypass grafting (CABG), valvular heart disease (especially degenerative lesions), atrial fibrillation surgery, and heart failure (heart transplantation and left ventricular assist devices). Patients are characterized by advanced age, critical conditions, and multiple comorbidities. (3) Great vessel diseases: Hypertension, atherosclerosis, and aging have caused a sharp increase in the incidence and surgical volume of aortic aneurysms/aortic dissections, with endovascular treatment becoming an important approach. To address these challenges, future development directions focus on: Technological innovation (minimally invasive surgery, interventional/hybrid techniques, mechanical circulatory support, precision medicine, and regenerative medicine); Transformation of diagnosis and treatment models (establishing full-life-cycle management of CHD, strengthening multidisciplinary heart team decision-making, and promoting enhanced recovery after surgery); Resource optimization (regional collaborative hierarchical diagnosis and treatment, capacity building at the grassroots level, and adaptation to medical insurance payment reforms); Talent training and scientific research innovation (cultivating interdisciplinary talents, strengthening clinical research, and innovating domestic medical devices). Cardiovascular surgery in China needs to actively adapt to changes in population structure and safeguard national heart health through continuous innovation and system optimization.

Objective:To analyze the clinical characteristics and treatment of patients with acute Q fever in Dali Bai Autonomous Prefecture, Yunnan Province.Methods:A total of 26 patients with acute Q fever admitted to People′s Hospital of Yunnan Dali Bai Autonomous Prefecture from October 2022 to December 2023 were enrolled. A retrospective cross-sectional study analysis was performed to analyze the demographic characteristics, epidemiology, clinical manifestations, laboratory tests and pathogen detection of these patients.Results:Of the 26 patients, 25 were male and one was female. The age ranged from 18 to 82 years with an average age of (45.6±17.2) years. All of them were sporadic cases. The neighbors of eight patients had sheep and cattle, 11 cases had a history of field work, and four cases had a history of field trip. Coxiella burnetii was detected in 26 patients by different molecular diagnostic techniques, including 21 cases by blood quantitative polymerase chain reaction (qPCR), three cases by sputum multi-pathogen targeted next-generation sequencing (tNGS), one case by alveolar lavage fluid tNGS, and one case by cerebrospinal fluid metagenomic next-generation sequencing (mNGS). Routine blood cultures of 19 cases were negative. All 26 patients presented with chills and fever, 21 cases (80.8%) with headache, 19 cases (73.1%) with fatigue, 14 cases (53.8%) with generalized aches and pains, 12 cases (46.2%) with poor appetite, and 14 cases (53.8%) with cough. Twenty-four cases had concurrent hepatitis, 12 cases had pneumonia, one had encephalitis, and 19 cases had myocardial damage. The laboratory tests showed that 23 cases (88.5%) had normal white blood cell count, eight cases (30.8%) had decreased platelet count, 25 cases (96.2%) had C-reactive protein elevated, 24 cases (92.3%) had procalcitonin elevated, 14 out of 17 cases had elevated erythrocyte sedimentation rate, and 19 cases had elevated D-dimer levels. Liver function tests showed that alanine aminotransferase increased in 24 cases (92.3%) (all less than 10 times of upper limit of normal (ULN)), aspartate aminotransferase increased in 23 cases (88.5%) (all less than 10 times of ULN), alkaline phosphatase increased in 10 cases (38.5%)(all less than two times of ULN), and γ-glutamyl transpeptidase increased in 19 cases (73.1%), which were all less than 10 times of ULN. Myocardial enzymes were detected in 21 cases, of which seven cases (33.3%) had elevated lactate dehydrogenase and 12 cases (57.1%) had elevated hydroxybutyrate dehydrogenase (all less than three times of ULN). In terms of treatment, 16 cases were treated with doxycycline alone, and nine cases were treated with doxycycline combined with azithromycin or quinolones or rifampicin, and one with tigecycline. After treatment, the conditions of patients improved. The overall length of hospital stay was (7.7±5.0) d, and that of eight patients treated with doxycycline combined with quinolones or azithromycin was 4.8 to 6.0 days. Conclusions:Acute Q fever often has no clear epidemiological history, and the clinical manifestations and laboratory tests are lack of specificity. qPCR, tNGS, mNGS can provide pathogenic diagnostic evidence for suspected cases. In terms of treatment, doxycycline is the first choice for treatment of acute Q fever, and combined treatment with azithromycin or quinolones could result in a shorter hospital stay.

Background::We previously reported that activation of the cell cycle in human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) enhances their remuscularization capacity after human cardiac muscle patch transplantation in infarcted mouse hearts. Herein, we sought to identify the effect of magnesium lithospermate B (MLB) on hiPSC-CMs during myocardial repair using a myocardial infarction (MI) mouse model.Methods::In C57BL/6 mice, MI was surgically induced by ligating the left anterior descending coronary artery. The mice were randomly divided into five groups ( n = 10 per group); a MI group (treated with phosphate-buffered saline only), a hiPSC-CMs group, a MLB group, a hiPSC-CMs + MLB group, and a Sham operation group. Cardiac function and MLB therapeutic efficacy were evaluated by echocardiography and histochemical staining 4 weeks after surgery. To identify the associated mechanism, nuclear factor (NF)-κB p65 and intercellular cell adhesion molecule-1 (ICAM1) signals, cell adhesion ability, generation of reactive oxygen species, and rates of apoptosis were detected in human umbilical vein endothelial cells (HUVECs) and hiPSC-CMs. Results::After 4 weeks of transplantation, the number of cells that engrafted in the hiPSC-CMs + MLB group was about five times higher than those in the hiPSC-CMs group. Additionally, MLB treatment significantly reduced tohoku hospital pediatrics-1 (THP-1) cell adhesion, ICAM1 expression, NF-κB nuclear translocation, reactive oxygen species production, NF-κB p65 phosphorylation, and cell apoptosis in HUVECs cultured under hypoxia. Similarly, treatment with MLB significantly inhibited the apoptosis of hiPSC-CMs via enhancing signal transducer and activator of transcription 3 (STAT3) phosphorylation and B-cell lymphoma-2 (BCL2) expression, promoting STAT3 nuclear translocation, and downregulating BCL2-Associated X, dual specificity phosphatase 2 (DUSP2), and cleaved-caspase-3 expression under hypoxia. Furthermore, MLB significantly suppressed the production of malondialdehyde and lactate dehydrogenase and the reduction in glutathione content induced by hypoxia in both HUVECs and hiPSC-CMs in vitro. Conclusions::MLB significantly enhanced the potential of hiPSC-CMs in repairing injured myocardium by improving endothelial cell function via the NF-κB/ICAM1 pathway and inhibiting hiPSC-CMs apoptosis via the DUSP2/STAT3 pathway.

Humans ; Asthma/drug therapy* ; Biological Therapy

BACKGROUND: Previous research demonstrated that a homozygous mutation of g.136372044G>A (S12N) in caspase recruitment domain family member 9 ( CARD9 ) is critical for producing Aspergillus fumigatus -induced ( Af -induced) T helper 2 (T H 2)-mediated responses in allergic bronchopulmonary aspergillosis (ABPA). However, it remains unclear whether the CARD9S12N mutation, especially the heterozygous occurrence, predisposes the host to ABPA. METHODS: A total of 61 ABPA patients and 264 controls (including 156 healthy controls and 108 asthma patients) were recruited for sequencing the CARD9 locus to clarify whether patients with this heterozygous single-nucleotide polymorphisms are predisposed to the development of ABPA. A series of in vivo and in vitro experiments, such as quantitative real-time polymerase chain reaction, flow cytometry, and RNA isolation and quantification, were used to illuminate the involved mechanism of the disease. RESULTS: The presence of the p.S12N mutation was associated with a significant risk of ABPA in ABPA patients when compared with healthy controls and asthma patients, regardless of Aspergillus sensitivity. Relative to healthy controls without relevant allergies, the mutation of p.S12N was associated with a significant risk of ABPA (OR: 2.69 and 4.17 for GA and AA genotypes, P = 0.003 and 0.029, respectively). Compared with patients with asthma, ABPA patients had a significantly higher heterozygous mutation (GA genotype), indicating that p.S12N might be a significant ABPA-susceptibility locus ( aspergillus sensitized asthma: OR: 3.02, P = 0.009; aspergillus unsensitized asthma: OR: 2.94, P = 0.005). The mutant allele was preferentially expressed in ABPA patients with heterozygous CARD9S12N , which contributes to its functional alterations to facilitate Af -induced T H 2-mediated ABPA development. In terms of mechanism, Card9 wild-type ( Card9WT ) expression levels decreased significantly due to Af -induced decay of its messenger RNA compared to the heterozygous Card9S12N . In addition, ABPA patients with heterozygous CARD9S12N had increased Af -induced interleukin-5 production. CONCLUSION Our study provides the genetic evidence showing that the heterozygous mutation of CARD9S12N , followed by allele expression imbalance of CARD9S12N , facilitates the development of ABPA.
Humans ; Aspergillosis, Allergic Bronchopulmonary/complications* ; Aspergillus fumigatus/genetics* ; Asthma/genetics* ; Aspergillus ; Mutation/genetics* ; CARD Signaling Adaptor Proteins/genetics*

Objective To investigate the effect and mechanism of Liuling Jiedu Pills on acute pharyngitis caused by Staphylococcus aureus in rats.Methods The rat model of acute pharyngitis was replicated using the method of injecting 1×109 CFU·mL-1 of Staphylococcus aureus solution into the pharynx of rats.SD rats were randomly divided into a blank group,a model group,a Lanqin Oral Solution group(5 mL·kg-1),and a low-,medium-,and high-dose group of Liuling Jiedu Pills(4.375,8.750,and 17.500 mg·kg-1),with 10 rats in each group.Rats in each group were administered the drug by gavage once a day for 7 days.The general conditions of the rats were observed and recorded every day during the modeling and drug administration periods,and the local inflammation in the pharynx was scored;histopathological changes in the pharynx of the rats were observed by hematoxylin-eosin(HE)staining;serum interleukin 1β(IL-1β),interleukin 6(IL-6),tumor necrosis factor α(TNF-α),and tumor necrosis factor-α(TNF-α)were detected by ELISA.Immunohistochemistry and Western Blot were used to detect the protein expression levels of IL-1β,IL-6 and TNF-α in rat pharyngeal tissue.Results Compared with the blank group,rats in the model group had significantly increased pharyngeal erythema,significantly higher inflammation scores(P＜0.01),significantly lower body mass on days 5-7 after modeling(P＜0.05,P＜0.01),significantly higher pathological scores(P＜0.01),significantly higher levels of the serum inflammatory factors IL-1β,IL-6,and TNF-α(P＜0.01),and significantly higher pharyngeal tissues showed significantly higher levels of IL-1β,IL-6,and TNF-α proteins(P＜0.01).Compared with the model group,the pharyngeal erythema was significantly reduced in the Lanqin Oral Solution group and the low-,medium-and high-dose groups of Liuling Jiedu Pills,and the inflammation scores were significantly reduced(P＜0.01),and the serum levels of IL-1β,IL-6,and TNF-α were significantly reduced(P＜0.01);the body mass of the rats in the Lanqin Oral Solution group,and in the medium-and high-dose groups of Liuling Jiedu Pills,were significantly increased on the seventh day of the modeling(P＜0.01);the histopathological scores and the levels of IL-1β,IL-6 and TNF-α proteins in pharyngeal tissue were significantly decreased(P＜0.05,P＜0.01).Conclusion Liuling Jiedu Pills can significantly improve the symptoms and inflammatory pathological changes of pharyngeal tissues in rats with acute pharyngitis,and its mechanism may be related to the down-regulation of the expression levels of inflammatory factors such as IL-1β,IL-6,and TNF-α.