1.Evaluation of the effectiveness of screening-intervention management in elderly population at high risk of stroke in a community in Shanghai
Peiyu XU ; Hong YU ; Zhenzhang CAI ; Haiyang ZHANG ; Zhenmao GU ; Ting ZHOU ; Jiuyi HUANG
Chinese Journal of Cerebrovascular Diseases 2024;21(10):671-677
Objective To evaluate the effectiveness of screening-intervention management program for high risk population of stroke in community.Methods Participants aged≥60 years old in Tairi Community,Fengxian District,Shanghai from May 2019 to July 2022 were selected as screening and intervention objects.The first round of stroke high-risk group screening was conducted in 2019 and 2020 in two years respectively,and the second round of stroke high-risk group screening(re-screening)was conducted in 2021 and 2022 respectively for the 2019 and 2020 screening groups,and the groups who had received stroke high-risk screening in both rounds of screening(overlapping groups)were selected as the observation objects of this study.The cerebrovascular function score was used to screen the high-risk individuals of stroke,75-100 was classified as non-high-risk,<75 were classified as high risk,among which 50-74,25-49,0-24 were light,medium and severe risk,in turn.Baseline and follow-up data were collected for all screening groups,including systolic blood pressure,diastolic blood pressure,overweight or obesity,fasting blood glucose,glycated hemoglobin,triglyceride,total cholesterol,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,and blood uric acid.After the completion of screening,the test report interpretation and first diagnosis intervention were carried out on the screening site,and the screening results were recorded into the health examination file.The first intervention includes lifestyle intervention,risk factor intervention and therapeutic intervention for high-risk individuals.Lifestyle intervention and risk factor intervention were conducted through the distribution of popular science handbook for stroke prevention and individualized face-to-face guidance.Therapeutic intervention for high-risk individuals was guided by anti-platelet aggregation drug therapy,statin therapy,and further examination and treatment of cerebral vessels according to stroke risk assessment results and the incidence of related chronic diseases.Prior to the implementation of the project,the incidence of stroke in the community in 2018 was retrospectively investigated to compare annual changes in stroke screening-intervention.In the process of implementation of intervention management,stroke incidence monitoring of the whole community registered population was carried out,and the monitoring method was to conduct stroke incidence registration once a year,and cooperate with the disease control and community police station to obtain the community stroke incidence monitoring data and death registration information provided by the police station from 2018 to 2022.Results A total of 5 188 subjects who completed both the initial screening and the follow-up screening and met the inclusion and exclusion criteria were identified,of whom 2 269 were male and 2 923 were female.The age of participants ranged from 60 to 93 years at the time of the first round of screening,with a mean age of(68±6)years.The proportions of subjects in the age groups of 60-64,65-69,70-74,and≥75 years were 30.3%,34.7%,21.1%,and 14.0%,respectively.(1)After screening and intervention,the proportion of individuals with increased systolic blood pressure,diastolic blood pressure,fasting blood glucose,triglyceride,and low-density lipoprotein cholesterol all decreased(respectively 49.4%vs.57.3%,26.6%vs.28.7%,9.6%vs.10.9%,14.7%vs.17.0%,2.4%vs.3.3%;all P<0.05),but the proportion of individuals with hyperuricemia increased(15.8%vs.13.1%,P<0.01),with statistically significant differences.(2)Before the implementation of the screening-intervention program in 2018,the stroke incidence rate in the community was 332.1/100 000.The stroke incidence rates in the community during the period from 2019 to 2022 after the implementation of the screening-intervention program were 335.0/100 000,270.8/100 000,235.0/100 000,and 193.6/100 000,respectively.The incidence rates of ischemic stroke(x2trend=8.350,P=0.004)and stroke(x2trend=9.910,P=0.002)decreased during the period from 2019 to 2022,while the incidence rate of hemorrhagic stroke did not show a decreasing trend(x2trend=1.636,P=0.201).(3)The median baseline and follow-up cerebrovascular function scores for the 5 188 elderly individuals undergoing residual stroke risk screening were 82.50(52.50,98.75)and 88.5(59.00,100.00),respectively,with stroke risk rates of 39.8%and 35.6%before and after intervention,respectively.After intervention,the follow-up cerebrovascular function scores increased compared to the baseline,and the stroke risk rate decreased.The distribution of stroke risk levels before and after screening-intervention had statistically significant differences(P<0.01).Conclusion Implementing a stroke high-risk population screening-intervention management program for the elderly in the community,combined with health examinations and family doctor team services,can significantly reduce the incidence,high-risk rate,and exposure level of risk factors for stroke in the community.
2.The design and application of foot pressure injury prevention device for bedridden stroke patients
Xiangying YANG ; Yue ZHENG ; Qian ZHANG ; Peiyu LIN ; Li NING
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care 2024;31(2):193-197
Objective To observe the clinical effect of the preventive device for foot stress injury in bedridden patients with stroke.Methods A total of 166 patients with stroke who were hospitalized in the department of intensive care unit(ICU)of Hangzhou First People's Hospital from March 2021 to March 2022 were selected as the study subjects.The experimental design of the quantitative study was adopted,and the patients were divided into the control group(ICU 4th floor patients)and the observation group(ICU 5th floor patients)according to the different ward of ICU,with 83 cases in each group.Nurses were also grouped according to this method(41 in observation group,43 in control group).Both groups received conventional treatment and nursing care to prevent pressure injury.The control group was depressurized by sponge ring or existing pillow,and the foot sagging was prevented by T-shoe lined towel.The observation group used the self-designed and developed foot pressure injury prevention device for bedridden patients.The incidence of foot stress injury and foot drop,as well as the satisfaction of patients with using the preventive device for foot stress and the satisfaction of nurses with operating the preventive device for foot stress were observed.Results The incidence of foot pressure injury and foot drop in the observation group was significantly lower than that in the control group[incidence of foot pressure injury:3.61%(3/83)vs.8.43%(7/83),the incidence of foot drop:9.64%(8/83)vs.16.87%(14/83),both P<0.05].The satisfaction of patients in the observation group was significantly higher than that in the control group[91.6%(76/83)vs.79.5%(66/83),P<0.05],and nurse satisfaction in the observation group was higher than that in the control group[95.1%(39/41)vs.86.0%(37/43)],but there was no significant difference between the two groups(P>0.05).Conclusion The foot stress injury prevention device is suitable for patients with severe stroke in bed,which can effectively reduce the incidence of stress injury and foot drop,improve the satisfaction of patients and operators,and is worthy of clinical promotion.
3.Severity assessment criteria for rosacea
Yue ZHANG ; Meng TAO ; Min LI ; Peiyu JIANG ; Yunyi LIU ; Yixuan LIU ; Ruoxin PAN ; Yang XU
Chinese Journal of Dermatology 2024;57(2):182-185
Rosacea is a chronic recurrent inflammatory skin disease, and correct assessment of clinical symptoms and severity may facilitate treatment options. This review summarizes a range of subjective, semi-subjective and objective methods currently used in the assessment of rosacea severity, in order to provide useful tools for clinical assessment of rosacea severity and give guidance on treatment modification according to the therapeutic effect.
4.Interpretation of the key points of "Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries"
Peiyu WANG ; Qi HUANG ; Shaodong WANG ; Xiankai CHEN ; Ruixiang ZHANG ; Jia ZHAO ; Mantang QIU ; Yin LI ; Xiangnan LI
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2024;31(07):933-954
"Global cancer statistics 2022" based on the latest GLOBCAN data from the International Agency for Research on Cancer (IARC) was recently released, providing a systematic analysis of the incidence and mortality of 36 types of cancer across 185 countries worldwide. The international burden of cancer is expected to continue to increase over the next 30 years, posing a severe public health and social challenge for many countries, including China. This article offers a key point interpretation of the "Global cancer statistics 2022", focusing on the evolution of cancer epidemiology and future development trends. The aim is to broaden the international perspective on cancer prevention and treatment, with the hope of providing reference and guidance for cancer prevention and treatment efforts in our country.
5.Advances in drug therapy of diabetic retinopathy
Minghao CHEN ; Peiyu LIU ; Xuan WANG ; Yixiang WU ; Yujin JIANG ; Chaoyang ZHANG ; Jingfa ZHANG
Journal of Shanghai Jiaotong University(Medical Science) 2024;44(7):822-829
Diabetic retinopathy(DR)is one of the most common microvascular complications of diabetes and has become one of the leading causes of blindness and visual impairment in diabetes patients.The pathogenesis of DR is multifaceted,involving inflammation,oxidative stress,neurovascular abnormalities,and other factors that present potential targets for disease management interventions.Currently,anti-vascular endothelial growth factor(VEGF)drugs serve as the primary treatment for advanced stages of DR when irreversible neurovascular damage and visual impairment have occurred.Additionally,some patients show poor or no response to anti-VEGF treatment.There is a lack of early intervention options for the initial phases of the disease.Therefore,there is an urgent need to develop novel local or systemic therapies based on the underlying mechanisms of DR to enable early prevention and treatment with the aim of preserving patients' vision.Medications targeting various pathways including anti-inflammatory agents(corticosteroids and nonsteroidal anti-inflammatory drugs),neurotrophic and neuroprotective drugs,drugs modulating biochemical pathways,antioxidant phytochemicals,and gene therapy can complement each other in terms of therapeutic effects to benefit a larger number of individuals affected by DR.This article reviews previous research reports on the pathogenesis,drug treatment methods,and potential therapeutic targets associated with DR in order to provide guidance for clinical practice.
6.Tofacitinib inhibits the transformation of lung fibroblasts into myofibroblasts through JAK/STAT3 pathway
Shan HE ; Xin CHEN ; Qi CHENG ; Lingjiang ZHU ; Peiyu ZHANG ; Shuting TONG ; Jing XUE ; Yan DU
Journal of Peking University(Health Sciences) 2024;56(3):505-511
Objective:To investigate the effect of tofacitinib,a pan-Janus kinase(JAK)inhibitor,on transforming growth factor-beta 1(TGF-β1)-induced fibroblast to myofibroblast transition(FMT)and to explore its mechanism.To provide a theoretical basis for the clinical treatment of connective tissue disease-related interstitial lung disease(CTD-ILD).Methods:(1)Human fetal lung fibroblast 1(HFL-1)were cultured in vitro,and 6 groups were established:DMSO blank control group,TGF-β1 in-duction group,and TGF-β1 with different concentrations of tofacitinib(0.5,1.0,2.0,5.0 μmol/L)drug intervention experimental groups.CCK-8 was used to measure the cell viability,and wound-healing assay was performed to measure cell migration ability.After 48 h of combined treatment,quantitative real-time PCR(RT-PCR)and Western blotting were used to detect the gene and protein expression levels of α-smooth muscle actin(α-SMA),fibronectin(FN),and collagen type Ⅰ(COL1).(2)RT-PCR and enzyme-linked immunosorbnent assay(ELISA)were used to detect the interleukin-6(IL-6)gene and protein expression changes,respectively.(3)DMSO carrier controls,1.0 μmol/L and 5.0 μmol/L tofacitinib were added to the cell culture media of different groups for pre-incubation for 30 min,and then TGF-β1 was added to treat for 1 h,6 h and 24 h.The phosphorylation levels of Smad2/3 and signal transducer and activator of transcription 3(STAT3)protein were detected by Western blotting.Results:(1)Tofacitinib inhibited the viability and migration ability of HFL-1 cells after TGF-β1 induction.(2)The expression of α-SMA,COL1A1 and FN1 genes of HFL-1 in the TGF-β1-induced groups was signifi-cantly up-regulated compared with the blank control group(P<0.05).Compared with the TGF-β1 in-duction group,α-SMA expression in the 5.0 μmol/L tofacitinib intervention group was significantly inhi-bited(P<0.05).Compared with the TGF-β1-induced group,FN1 gene was significantly inhibited in each intervention group at a concentration of 0.5-5.0 μmol/L(P<0.05).Compared with the TGF-β1-induced group,the COL1A1 gene expression in each intervention group did not change significantly.(3)Western blotting results showed that the protein levels of α-SMA and FN1 in the TGF-β1-induced group were significantly higher than those in the control group(P<0.05),and there was no significant difference in the expression of COL1A1.Compared with the TGF-β1-induced group,the α-SMA protein level in the intervention groups with different concentrations decreased.And the differences between the TGF-β1-induced group and 2.0 μmol/L or 5.0 μmol/L intervention groups were statistically significant(P<0.05).Compared with the TGF-β1-induced group,the FN1 protein levels in the intervention groups with different concentrations showed a downward trend,but the difference was not statistically sig-nificant.There was no difference in COL1A1 protein expression between the intervention groups com-pared with the TGF-β1-induced group.(4)After TGF-β1 acted on HFL-1 cells for 48 h,the gene ex-pression of the IL-6 was up-regulated and IL-6 in culture supernatant was increased,the intervention with tofacitinib partly inhibited the TGF-β1-induced IL-6 gene expression and IL-6 in culture supernatant.TGF-β1 induced the increase of Smad2/3 protein phosphorylation in HFL-1 cells for 1 h and 6 h,STAT3 protein phosphorylation increased at 1 h,6 h and 24 h,the pre-intervention with tofacitinib inhibited the TGF-β1-induced Smad2/3 phosphorylation at 6 h and inhibited TGF-β1-induced STAT3 phosphorylation at 1 h,6 h and 24 h.Conclusion:Tofacitinib can inhibit the transformation of HFL-1 cells into myofi-broblasts induced by TGF-β1,and the mechanism may be through inhibiting the classic Smad2/3 path-way as well as the phosphorylation of STAT3 induced by TGF-β1,thereby protecting the disease progres-sion of pulmonary fibrosis.
7.Analysis of the three-dimensional image characteristics of bone island in jaw using CBCT
Shijie YAN ; Lianfeng YANG ; Jingyan WANG ; Juan ZHANG ; Tingting ZHU ; Diya LENG ; Guangchao ZHOU ; Peiyu GU
STOMATOLOGY 2024;44(10):721-727
Objective To analyze three-dimensional(3D)radiographic characterizations of bone island(BI)in jaw using cone-beam computed tomography(CBCT).Methods CBCT data from four thousand patients were selected,reconstructed and analyzed using NNT 10.0 software.The sagittal,coronal and axial planes were used to analyze the 3D radiographic characteristics of BIs,including the localization,shape,density,boundary,the relationship between BIs and tooth and bone cortex,diameter and anatomical structures and complications involved.Their relationship with gender were analyzed.Results A total of 803 people had BIs,with the prevalence rate of 20.08%,including 338 males with 389 BIs and 465 females with 526 BIs.Both males and females had a dominant BI,and the ratio between male and female was 1∶1.38,but the difference was not statistically significant(P>0.05).The BIs of both male and female mostly occurred in the mandibular premolars and molars area,and appeared irregular in shape,dense and contact with lingual bone cortex.Mostly BIs were apical type and with unclear boundary.The mean maximum diameter of mesial/distal direction was greater than buccal/lingual direction(P<0.05).The most commonly involved anatomy structure was the inferior alveolar neural canal,cortical infil-tration and mental foramen.Conclusion There are no significant differences between males and females in the three-dimensional image characteristics of BIs in Chinese populations.CBCT can accurately and comprehensively analyze the 3D radiographic characteris-tics of BI and its relationship with the surrounding teeth and bone.
8.An interpretable machine learning method for heart beat classification
Jinbao ZHANG ; Peiyu HE ; Pian TIAN ; Jianmin CAI ; Fan PAN ; Yongjun QIAN ; Qijun ZHAO
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2023;30(02):185-190
Objective To explore the application of Tsetlin Machine (TM) in heart beat classification. Methods TM was used to classify the normal beats, premature ventricular contraction (PVC) and supraventricular premature beats (SPB) in the 2020 data set of China Physiological Signal Challenge. This data set consisted of the single-lead electro-cardiogram data of 10 patients with arrhythmia. One patient with atrial fibrillation was excluded, and finally data of the other 9 patients were included in this study. The classification results were then analyzed. Results The classification results showed that the average recognition accuracy of TM was 84.3%, and the basis of classification could be shown by the bit pattern interpretation diagram. Conclusion TM can explain the classification results when classifying heart beats. The reasonable interpretation of classification results can increase the reliability of the model and facilitate people's review and understanding.
9.Magnetic Resonance Imaging Studies of Neurodegenerative Disease: From Methods to Translational Research.
Neuroscience Bulletin 2023;39(1):99-112
Neurodegenerative diseases (NDs) have become a significant threat to an aging human society. Numerous studies have been conducted in the past decades to clarify their pathologic mechanisms and search for reliable biomarkers. Magnetic resonance imaging (MRI) is a powerful tool for investigating structural and functional brain alterations in NDs. With the advantages of being non-invasive and non-radioactive, it has been frequently used in both animal research and large-scale clinical investigations. MRI may serve as a bridge connecting micro- and macro-level analysis and promoting bench-to-bed translational research. Nevertheless, due to the abundance and complexity of MRI techniques, exploiting their potential is not always straightforward. This review aims to briefly introduce research progress in clinical imaging studies and discuss possible strategies for applying MRI in translational ND research.
Animals
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Humans
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Neurodegenerative Diseases/pathology*
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Translational Research, Biomedical
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Magnetic Resonance Imaging/methods*
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Brain/pathology*
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Head/pathology*
10.Evaluation of Chinese Food Guide Pagoda (2022)
Lili ZHANG ; Yan ZHOU ; Peiyu WANG ; Liqiang QIN
Journal of Environmental and Occupational Medicine 2023;40(9):1074-1078
Background A rational diet is the foundation of health. Dietary guidelines for Chinese residents and Chinese Food Guild Pagoda aim to provide healthy eating guidance for Chinese residents. Objective To evaluate the rationality and applicability of the "Chinese Food Guild Pagoda" (2022). Methods The energy and nutrient supplies of foods recommended by the Food Pagoda-were calculated based on the chinese food composition Table. The degree of requirement satisfaction for energy or nutrients was calculated by comparing with the recommended nutrient intake (RNI) or adequate intake (AI) for adults (≥ 18 years) with light physical activity according to the Chinese dietary reference intakes. Results The estimated energy intake was 46662.79-10062.28 kJ, which met the 6697.36-10046.04 kJ set by the Food Pagoda. We estimated that 65.74-102.78 g of protein, 59.67-82.71 g of fat, and 211.27-333.19 g of carbohydrate were provided by following the Food Pagoda. Adequate vitamins and minerals were also provided by following the Food Pagoda. However, the amounts of vitamin E was estimated to be 2.40-3.28 times and sodium was 1.59-1.75 times of AI, while selenium was 63.40%-98.15% of RNI. Conclusion The amounts of vitamin E and sodium by following the Food Pagoda may be higher and selenium may be lower than recommended intakes. Energy and other nutrients in the Food Pagoda are suitable for general adults in China.

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