Objective To systematically analyze the characteristics of the disease burden of hypertensive heart disease (HHD) in the elderly (≥60 years) globally and in China from 1990 to 2021, and to predict its future trends from 2022 to 2040, with the aim of providing data support for optimizing comprehensive prevention and control strategies for HHD. Methods Based on the Global Burden of Disease (GBD) 2021 database, the number of prevalent cases and disability-adjusted life years (DALYs) of HHD in the elderly were extracted for the world, China, and five regions categorized by sociodemographic index (SDI). Joinpoint regression was used to analyze the temporal trends of age-standardized prevalence rate and age-standardized DALYs rate of HHD in the elderly. A three-factor decomposition method was applied to evaluate the relative contributions of aging, population growth, and epidemiological changes to the variations in the elderly HHD burden. Additionally, a Bayesian age-period-cohort model was used to predict the elderly HHD burden from 2022 to 2040. Results In 2021, the number of prevalent elderly HHD cases reached 10 283 000 globally and 3 412 400 in China, representing increases of 179.20% and 159.20% respectively, compared with 1990. The DALYs of elderly HHD were 18 812 700 person-years globally and 4 731 400 person-years in China, rising by 76.08% and 29.45% respectively from 1990. Meanwhile, the growth rates of the number of prevalent cases and DALYs of elderly HHD varied across different SDI regions. From 1990 to 2021, the age-standardized prevalence rate of elderly HHD in China, as well as the age-standardized DALYs rate of elderly HHD both globally and in China, showed significant downward trends (all average annual percentage changes<0, all P<0.001). In 2021, the 70-74 years age group accounted for the highest proportion of prevalent cases and DALYs of elderly HHD, both globally and in China. Decomposition analysis revealed that population growth was the dominant factor driving the increase in the elderly HHD burden across all regions. The prediction model results indicated that the number of prevalent cases and DALYs of elderly HHD would continue to rise globally and in China from 2022 to 2040, with the growth rate of the elderly HHD burden in China between 2021 and 2040 expected to exceed the global average. Conclusion Over the past 32 years, although the age-standardized disease rates of elderly HHD have mainly shown a downward trend globally and in China, the absolute number of the disease burden has increased substantially. The projection model indicates a continued upward trajectory, with the growth rate in China higher than the global average. Therefore, there is an urgent need to implement precise prevention and control strategies to effectively mitigate the disease burden of elderly HHD.

Immunotherapy has emerged as a revolutionary approach to treat immune-related diseases. Dendritic cells (DCs) play a pivotal role in orchestrating immune responses, making them an attractive target for immunotherapeutic interventions. Modulation of gene expression in DCs using genome editing techniques, such as the CRISPR-Cas system, is important for regulating DC functions. However, the precise delivery of CRISPR-based therapies to DCs has posed a significant challenge. While lipid nanoparticles (LNPs) have been extensively studied for gene editing in tumor cells, their potential application in DCs has remained relatively unexplored. This study investigates the important role of cholesterol in regulating the efficiency of BAMEA-O16B lipid-assisted nanoparticles (BLANs) as carriers of CRISPR/Cas9 for gene editing in DCs. Remarkably, BLANs with low cholesterol density exhibit exceptional mRNA uptake, improved endosomal escape, and efficient single-guide RNA release capabilities. Administration of BLAN_mCas9/gPD-L1 results in substantial PD-L1 gene knockout in conventional dendritic cells (cDCs), accompanied by heightened cDC1 activation, T cell stimulation, and significant suppression of tumor growth. The study underscores the pivotal role of cholesterol density within LNPs, revealing potent influence on gene editing efficacy within DCs. This strategy holds immense promise for the field of cancer immunotherapy, offering a novel avenue for treating immune-related diseases.

OBJECTIVES: To analyze bone mass distribution and the factors affecting bone mass in a general Chinese Han cohort undergoing physical examinations at our center. METHODS: We retrospectively collected the data of bone mineral density (BMD) measurements from 30 599 healthy Han Chinese adults (age≥20 years) who underwent dual-energy X-ray absorptiometry scans at our hospital from July, 2013 to July, 2023. Basic parameters including height, body weight, and gender were recorded, and descriptive statistics and correlation analyses were performed using R software. RESULTS: In this cohort, the male individuals had a mean peak BMD of 1.00±0.12 g/cm² in the lumbar vertebrae, 0.94±0.14 g/cm² in the femoral neck, and 0.99±0.13 g/cm² in the total hip, significantly higher than the values in the female individuals [0.99±0.12 g/cm² in the lumbar vertebrae (P=0.022), 0.79±0.11 g/cm² in the femoral neck (P<0.001), and 0.88±0.11 g/cm² in the total hip (P<0.001)]. In the overall cohort, the BMD values of the lumbar spine and femur decreased with age after reaching their peak levels. There was a positive correlation between BMD value and body mass index (BMI) in both male and female individuals. The 2013-2014 period recorded the lowest BMD values in the lumbar, hip, and femoral neck, which tended to increase steadily in the following years (2015-2023). CONCLUSIONS Our data suggest that the BMD values vary among different populations, and future multi-center studies using more accurate BMD detection technology are warranted to capture the variation patterns of BMD with demographic characteristics of specific populations.
Humans ; Bone Density ; Absorptiometry, Photon ; Male ; Female ; Retrospective Studies ; Osteoporosis/diagnostic imaging* ; Adult ; Middle Aged ; Lumbar Vertebrae/diagnostic imaging* ; China/epidemiology* ; Femur Neck/diagnostic imaging* ; Aged ; Beijing/epidemiology* ; Young Adult

Objective To investigate the diagnostic value of plasma short stature homeobox 2(SHOX2),Ras association domain family 1A(RASSF1A)and prostaglandin E receptor 4(PTGER4)gene methylation detection combined with low-dose CT(LDCT)for malignant pulmonary nodules.Methods A total of 153 hospitalized patients with pulmonary nodules scheduled for surgi-cal treatment were selected as study subjects.The Ct values of the target genes SHOX2,RASSF1A,PTGER4 and the internal reference gene ACTB in the patients' plasma were detected,and the ΔCt values(ΔCttarget gene-Ctinternal reference gene)and the three-gene fitting positive index(PI)of each gene were further calculated.The sensitivity and specificity of ΔCt values and the three-gene fitting PI as methylation-positive diagnostic criteria for malignant pulmonary nodules were analyzed.Receiver op-erating characteristic(ROC)curves were plotted to evaluate the diagnostic value of LDCT combined with gene methylation detection for malignant pulmonary nodules.Results According to the pathological results,the patients were divided into benign pulmonary nodule group(47 cases)and malignant nodule group(106 cases).The sensitivity and specificity of the three-gene fitting PI for diagnosing malig-nant pulmonary nodules were 58.49％and 70.21％,respectively.The sensitivities of ΔCtSHOX2,ΔCtRASSF1A and ΔCtPTGER4 values for diagnosing malignant pulmonary nodules alone and their combina-tion were 33.96％,43.40％,49.06％and 75.47％,respectively,and the specificities were 87.23％,72.34％,80.85％and 100.00％,respectively.Compared with the three-gene fitting PI,ΔCt values were more suitable for the differential diagnosis of benign and malignant pulmonary nodules.Based on the pathological diagnosis results,there was a statistically significant difference in the positive rates of malignant pulmonary nodules between LDCT diagnosis and gene methylation combined with LDCT diagnosis(P＜0.001).ROC curve analysis showed that the areas under the curves(AUCs)for diagnosing malignant pulmonary nodules using plasma SHOX2,RASSF1A,PTGER4 gene methylation ΔCt values,LDCT alone,and their combination were 0.604,0.582,0.629,0.668 and 0.981,respectively.The diagnostic value of the combined indicators was higher than that of single indicators.Conclusion LDCT combined with plasma SHOX2,RASSF1A,PTGER4 gene methylation detection has high diagnostic efficacy for malignant pulmonary nodules and can significantly reduce the false-positive rate of LDCT in early screening of lung cancer.

Objective: To investigate the trends in incidence and epidemiological characteristics of notifiable infectious diseases in Huzhou City, Zhejiang Province from 2005 to 2023, so as to provide insights into optimizing infectious disease surveillance and control. Methods: Data of notifiable infectious disease cases in Huzhou City from 2005 to 2023 were collected from the Infectious Disease Report Information System of Chinese Disease Prevention and Control Information System. Trends in incidence were analyzed using annual percent change (APC) and average annual percent change (AAPC). The population distribution and seasonal characteristics were descriptively analyzed. Results: From 2005 to 2023, a total of 504 283 cases of notifiable infectious diseases were reported in Huzhou City, with an annual crude incidence rate of 892.65/105 and a standardized incidence rate of 989.21/105. The incidence rate of notifiable infectious diseases in Huzhou City showed an upward trend (AAPC=8.886%, P<0.05), of which there was an obvious upward trend from 2021 to 2023 (APC=95.996%, P<0.05). After the removal of COVID-19 incidence, the incidence trend was basically unchanged (AAPC=7.970%, P<0.05). From 2005 to 2023, the incidence rate of class A and B notifiable infectious diseases showed no obvious trend (P>0.05), and the incidence rate of class A and B respiratory infectious diseases showed an upward trend (AAPC=6.958%, P<0.05). After the removal of COVID-19 incidence, the two showed a downward trend (AAPC=-7.680% and -8.660%, both P<0.05). The incidence rate of class A and class B intestinal infectious diseases, blood-borne and sexually transmitted infectious diseases showed a downward trend (AAPC=-14.849% and -5.977%, both P<0.05), while the incidence rates of natural and insect-borne infectious diseases did not show a significant trend (P>0.05). The overall incidence rate of class C infectious diseases showed an upward trend (AAPC=13.058%, P<0.05). The incidence rate ratio (IRR) of notifiable infectious diseases between males and females was 1.26 (95%CI: 1.25-1.27). A total of 204 043 cases under 10 years were reported, accounting for 40.46%. The peak incidence of class A and B respiratory infectious diseases was in January, May and June, while that of class A and B intestinal infectious diseases was from June to October. The peak incidence of class C respiratory infectious diseases was in January, March, April and December, while that of class C intestinal infectious diseases was from May to August and from November to December. Conclusions The incidence rate of notifiable infectious diseases in Huzhou City showed an upward trend from 2005 to 2023, which was more obvious from 2021 to 2023. Men and children under 10 years were the high-risk population. The incidence of respiratory and intestinal infectious diseases had obvious seasonal characteristics.

Objective: To investigate the epidemilogical characteristics of pulmonary tuberculosis in Huzhou City, Zhejiang Province from 2014 to 2023, so as to provide the basis for formulating prevention and control measures for the construction of "TB-free city". Methods: The data of pulmonary tuberculosis cases in Huzhou City from 2014 to 2023 was collected through the Infectious Disease Reporting Management System of Chinese Disease Prevention and Control Information System. The onset time, region, and population distribution characteristics of the cases were described. Results: A total of 11 598 cases of pulmonary tuberculosis were reported in Huzhou City from 2014 to 2023, with an average annual incidence of 37.42/105. The reported incidence decreased from 47.50/105 in 2014 to 28.36/105 in 2023 (P<0.05), with an annual decline rate of 5.57%. There were 6 304 etiological positive cases, accounting for 54.35%. The peak season for pulmonary tuberculosis cases was from March to September, with the highest seasonal ratio of 112.48% in May. The average annual reported incidence rates in Anji County and Changxing County were relatively high (46.14/105 and 41.15/105). The reported incidence rate of pulmonary tuberculosis in Huzhou City increased with age (P<0.05), peaking at 97.36/105 in the group aged 75 to <80 years. There were 7 991 male pulmonary tuberculosis cases and 3 607 female cases, with a male-to-female ratio of 2.22∶1. The average annual incidence rates of pulmonary tuberculosis was higher in males than in females (50.39/105 vs. 23.87/105). Farmers were the primary occupation affected, with 6 350 cases accounting for 54.75%. Conclusions The reported incidence rate of pulmonary tuberculosis in Huzhou City decreased from 2014 to 2023, with a high incidence in spring and summer. The incidence rates in Anji County and Changxing County were higher than Huzhou City's average. Male, elderly residents and farmers were the key populations for pulmonary tuberculosis prevention and control.

AIM: To investigate the pharmacokinetic properties of the main active components of Dalitong extract in SD rats after oral administration using UPLC-MS / MS. METHODS: An UPLC-MS / MS method was established to simultaneously detect tetrahydropalmatine, nobiletin and costunolide in the plasma and tissues of SD rats. The method was applied to investigate the pharmacokinetic characteristics and tissue distribution. RESULTS: After a single oral administration, the three active components were rapidly absorbed into the body, with a peak concentration (Cmax) of (13.73 ± 7.50), (27.01 ± 17.69) and (6.73 ± 29.94) ng / mL for tetrahydropalmatine, nobiletin, and costunolide, respectively. The time to reach the peak concentration (Tmax) was (1.40 ± 0.93), (0.63 ± 0.28) and (2.38 ± 8.81) h, respectively. The area under the curve (AUC) was (80.43±40.03), (41.30±28.69) and (303.90 ± 136.69) ng · h · mL

Objective : To understand the epidemiological characteristics of notifiable respiratory infectious diseases in Huzhou City, Zhejiang Province from 2017 to 2022, so as to provide insights into formulation of respiratory infectious disease prevention and control strategies. Methods: The data pertaining to notifiable respiratory infectious disease in Huzhou City from 2017 to 2022 were collected through the Infectious Disease Report Information System of Chinese Disease Prevention and Control Information System. Epidemiological characteristics of notifiable respiratory infectious disease was analyzed using a descriptive epidemiological method. : Results Conclusions: A total of 31 314 cases of notifiable respiratory infectious diseases were reported in Huzhou City from 2017 to 2022, with an average annual reported incidence of 169.12/105. The reported incidence of notifiable respiratory infectious diseases appeared a tendency towards a rise in Huzhou City from 2017 to 2022 (P<0.05). The top six reported diseases in terms of case numbers were influenza (20 048 cases), tuberculosis (6 920 cases), COVID-19 (1 893 cases), mumps (1 413 cases), pertussis (475 cases) and scarlet fever (442 cases), accounting for 99.61% of the total cases. The incidence of influenza, COVID-19 and pertussis showed a tendency towards a rise, the incidence of mumps and tuberculosis showed a tendency towards a decline (all P<0.05), and scarlet fever remained at a low-level incidence (P>0.05). Respiratory infectious diseases were mainly reported in winter (January, February and December), with 14 644 cases accounting for 46.77%. There were 15 068 cases reported in schools and kindergartens, accounting for 48.12%. The incidence showed a U-shaped variation with age, with the highest incidence in residents at ages of 10 years and below (987.68/105), and showing a tendency towards a rise in residents at ages of 60 years and above. The incidence of respiratory infectious diseases in Huzhou City from 2017 to 2022 increased significantly. Influenza, tuberculosis, COVID-19, mumps and pertussis are key notifiable respiratory infectious diseases. Residents at ages of 10 years and below and 60 years and above should be given a high priority for respiratory infectious disease control.

Objective To investigate the value of eclampsia risk prediction combined with umbilical artery peak systolic velocity/end diastolic velocity(S/D)ratio in predicting pregnancy outcomes in patients with gestational diabetes mellitus.Methods Select 60 cases of gestational diabetes mellitus(GDM)patients admitted to ourhospital's obstetrics outpatient department from January 2021 to January 2023 as the gestational diabetes group.At the same time,select 30healthy pregnant women who received regular prenatal check-ups in ourhospital's obstetrics outpatient department as the control group.Determination of placental growth factor(PIGF)in serum by magnetic particle chemiluminescence.The ratio of S/D ratio to was measured by ultrasound.At the same time,they were divided into good pregnancy outcome group and bad pregnancy outcome group according to whether combined with adverse pregnancy outcome,and the PIGF and S/D ratio were compared.We performed a predictive analysis using receiver operating characteristic(ROC)curve analysis to assess the predictive value of PIGF combined with the S/D ratio for the pregnancy outcomes in GDM patients.Results Compared with the control group,patients in the gestational diabetes mellitus(GDM)group showed a decrease in PIGF levels and an increase in the S/D ratio of systolic to diastolic velocities(S/D ratio)(P＜0.05).The incidence of adverse pregnancy outcomes was 46.67% in the GDM group,significantlyhigher than the 20.00% in the control group(P＜0.05).Compared with the group with favorable pregnancy outcomes,the GDM group with adverse pregnancy outcomeshad lower PIGF levels andhigher S/D ratio(P＜0.05).ROC curve analysis showed that both PIGF and S/D ratio were sensitive markers for predicting adverse pregnancy outcomes in GDM patients,with S/D ratio having ahigher diagnostic efficacy than PIGF alone,but the combination of both markers yielded greater accuracy.Conclusion The decrease of PIGF level and the increase of S/D ratio in patients with gestational diabetes mellitus are correlated with adverse pregnancy outcomes,and PIGF combined with S/D ratiohas thehighest diagnostic efficacy in patients with adverse pregnancy outcomes.

Objective To compare the efficacy of double filtration plasmapheresis(DFPP),centrifugal therapeutic plasma exchange(cTPE)and centrifugation-filtration plasmapheresis(CFPP)in improving renal insufficiency after kidney transplantation,as well as the differences in inducing plasma exchange-related adverse reactions.Methods Clinical data from 46 patients who underwent plasma exchange after renal transplantation in our hospital were retrospectively collected,and patiens were divided into DFPP group(n=33),cTPE group(n=7)and CFPP group(n=6).Changes in peripheral blood creatinine,albumin,hemoglobin,platelets,fibrinogen levels and urine volume before and after TPE were compared and analyzed among the three groups.Results Among the DFPP group,cTPE group and CFPP group,the creatinine after TPE decreased by(31.40±25.38)%,(58.91±19.75)%and(39.44±28.64)%,respectively,with cTPE group significant-ly higher than the DFPP group(P＜0.05),but no significant differences between the DFPP group and cTPE group(P＞0.05);the urine volume after TPE increased by(49.33±30.03)%,(54.62±39.32)%and(68.89±23.00)%,showing no significant differences(P＞0.05);the hemoglobin after TPE decreased by(11.97±5.94)%,(20.17±5.75)%and(9.65±8.75)%,respectively,with the cTPE group significantly higher than the DFPP group and CFPP group(P＜0.05),but no significant difference between the DFPP group and CFPP group(P＞0.05).The platelet count after TPE decreased by(37.88±18.39)%,(24.56±12.36)%and(21.40±12.51)%,respectively,with no significant differences between the three groups(P＞0.05);the fibrinogen after TPE decreased by(0.57±0.20)%,(0.14±0.06)%and(0.26±0.22)%,re-spectively,with the DFPP group significantly higher than the cTPE group(P＜0.05),but the CFPP group had no significant difference with cTPE group or DFPP group(P＞0.05);the albumin after TPE decreased by(11.41±5.97)%,(14.67±6.52)%and(25.18±5.10)%,respectively,with cTPE group and DFPP group significantly lower than the CFPP group(P＜0.05,P＜0.001),but with no significant difference between the DFPP group and cTPE group(P＞0.05).Conclusion The effect of three plasma exchange methods varies on renal function,anemia and coagulation function of patients after kid-ney transplantation.It is necessary to consider the the patient's disease characteristics and treatment needs,as well as the laboratory′s technical conditions and plasma supply when selecting TPE methods.