OBJECTIVE: To investigate the relationship between physical activity and genetic risk and their combined effects on the risk of developing chronic obstructive pulmonary disease. METHODS: This prospective cohort study included 318,085 biobank participants from the UK. Physical activity was assessed using the short form of the International Physical Activity Questionnaire. The participants were stratified into low-, intermediate-, and high-genetic-risk groups based on their polygenic risk scores. Multivariate Cox regression models and multiplicative interaction analyses were used. RESULTS: During a median follow-up period of 13 years, 9,209 participants were diagnosed with chronic obstructive pulmonary disease. For low genetic risk, compared to low physical activity, the hazard ratios ( HRs) for moderate and high physical activity were 0.853 (95% confidence interval [ CI]: 0.748-0.972) and 0.831 (95% CI: 0.727-0.950), respectively. For intermediate genetic risk, the HRs were 0.829 (95% CI: 0.758-0.905) and 0.835 (95% CI: 0.764-0.914), respectively. For participants with high genetic risk, the HRs were 0.809 (95% CI: 0.746-0.877) and 0.818 (95% CI: 0.754-0.888), respectively. A significant interaction was observed between genetic risk and physical activity. CONCLUSION Moderate or high levels of physical activity were associated with a lower risk of developing chronic obstructive pulmonary disease across all genetic risk groups, highlighting the need to tailor activity interventions for genetically susceptible individuals.
Humans ; Pulmonary Disease, Chronic Obstructive/epidemiology* ; Exercise ; Male ; Female ; Middle Aged ; Prospective Studies ; Aged ; Genetic Predisposition to Disease ; Risk Factors ; United Kingdom/epidemiology* ; Incidence ; Adult

BACKGROUND: Previous evidence showed that ambient air pollution and cardiovascular mortality are related. However, there is a lack of evidence towards the modification effect of long-term lifestyle on the association between short-term ambient air pollution and death from cardiovascular events. METHOD: A total of 14,609 death from major adverse cardiovascular events (MACE) were identified among the China Kadoorie Biobank participants from 2013 to 2018. Ambient air pollution exposure including particulate matter 2.5 (PM_2.5), SO₂, NO₂, CO, and O₃ from the same period were obtained from space-time model reconstructions based on remote sensing data. Case-crossover design and conditional logistic regression was applied to estimate the effect of short-term exposure to air pollutants on MACE mortality. RESULTS: We found MACE mortality was significantly associated with PM_2.5 (relative percent increase 2.91% per 10 µg/m³ increase, 95% CI 1.32-4.53), NO₂ (5.37% per 10 µg/m³ increase, 95% CI 1.56-9.33), SO₂ (6.82% per 10 µg/m³ increase, 95% CI 2.99-10.80), and CO (2.24% per 0.1 mg/m³ increase, 95% CI 1.02-3.48). Stratified analyses indicated that drinking was associated with elevated risk of MACE mortality with NO₂ and SO₂ exposure; physical inactivity was associated with higher risk of death from MACE when exposed to PM_2.5; and people who had balanced diet had lower risk of MACE mortality when exposed to CO and NO₂. CONCLUSIONS The study results showed that short-term exposure to ambient PM_2.5, NO₂, SO₂, and CO would aggravate the risk of cardiovascular mortality, yet healthy lifestyle conduct might mitigate such negative impact to some extent.
Humans ; Cardiovascular Diseases/epidemiology* ; China/epidemiology* ; Male ; Female ; Air Pollution/adverse effects* ; Middle Aged ; Air Pollutants/analysis* ; Particulate Matter/analysis* ; Environmental Exposure/adverse effects* ; Life Style ; Aged ; Adult ; Risk Factors ; Cross-Over Studies ; East Asian People

Objective To investigate the effect of Huangqi Shengmai Yin(HSY)on myocardial fibrosis in rats with acute myocardial infarction(AMI)by adjusting P2X purinoceptor 7(P2X7R)/NOD-like receptor protein 3(NLRP3)pathway.Methods Sixty rats were divied into a sham operation group and model group(5 groups),with 10 rats in each group.The AMI rat model was constructed by ligating the left anterior descending branch and randomly grouped into AMI group,the HSY-low group(intragastric administration of 1.6 ml/kg HSY),the HSY group(intragastric administration of 6.2 ml/kg HSY),the compound miltiorhiza group(intragastric administration of 300 mg/kg),and the HSY-high+P2X7R agonist-ATP group(intragastric administration of 6.2 ml/kg HSY,and tail vein administration of 10 mmol/L ATP).After the intervention,cardiac function,myocardial injury and inflammatory factor markers were detected.The tissue sections were prepared to examine pathological changes,myocardial fibrosis,type Ⅰ and type Ⅲ collagen(COL1A1,COL3A1).Western blotting was performed to detecte the protein expression of P2X7R,NLRP3,tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),and the expression of activated Caspase-1.Results Compared with the sham surgery group,the AMI group showed an increase in the left ventricular end diastolic diameter(LVEDD),the coatent of brain natriuretic peptide(BNP)and cardiac troponin I(cTn I),fibrosis volume fraction,the positive expression of COL1A1,COL3A1,TNF-α,IL-1β,P2X7R,NLRP3,and activated Caspase-1 proteins(P＜0.05),and a decrease in left ventricular ejection fraction(LVEF)(P＜0.05).The HSY-low group,HSY-high groups,and compound miltiorhiza group showed a decrease in LVEDD,the content of BNP and cTn I,fibrosis volume fraction,the positive expression of COL1A1 and COL3A1,TNF-α,IL-1β,P2X7R,NLRP3,and activated Caspase-1 proteins(P＜0.05),and an increase in LVEF than these in the AMI group(P＜0.05).The HSY-high+ATP group showed an increase in LVEDD,the content of BNP,cTn I,fibrosis volume fraction,the positive expression of COL1A1 and COL3A1,TNF-α,IL-1β,P2X7R,NLRP3,and activated Caspase-1 proteins(P＜0.05),and a decrease in LVEF than those in the HSY-high group(P＜0.05).Conclusion HSY inhibits P2X7R/NLRP3 pathway to alleviate myocardial fibrosis in AMI rats.

Objective To explore the protective effect and potential mechanism of propofol on acute kidney injury in septic rats.Methods A total of 84 adult SD rats were randomly divided into the sham surgery group,the model group and the treatment group.The sham surgery group only opened and closed the abdomen,while the model group underwent cecal ligation and perforation for modeling.In the treatment group,propofol(60 mg/kg)was intraperitoneally injected 30 minutes before modeling,and the same dose of propofol was intraperitoneally injected again 6 hours after modeling.The renal function and pathological changes of rats in each group were observed,24-hour survival status of rats in each group were recorded,and the 24-hour survival rate was calculated.A sepsis model was established in vitro by stimulating human renal tubular epithelial cell line with lipopolysaccharide(LPS),and the changes of apoptosis and oxidative stress of renal tubular epithelial cells were observed.The effects of propofol on oxidative stress and apoptosis of renal tubular epithelial cells stimulated by LPS were analyzed.Results The renal function of sepsis rats was decreased,the renal tissue structure was damaged,the 24-hour survival rate of rats was decreased significantly and the survival time was shortened.Propofol could effectively improve renal function,reduce renal Paller score,increase survival rate and prolong survival time in sepsis rats.LPS could induce apoptosis and oxidative stress of renal tubular epithelial cells,while propofol could inhibit oxidative stress and apoptosis of renal tubular epithelial cells.Conclusion Propofol can effectively alleviate acute kidney injury in septic rats,and its mechanism is related to the inhibition of apoptosis and oxidative stress of renal tubular epithelial cells.

Objective To describe and analyze the current status,changing trend and influencing factors of the disease burden of cervical,endometrial and ovarian cancer in China from 1990 to 2021.Methods Data on incidence,mortality,disability-adjusted life year(DALY),and other indicators for cervical,endometrial and ovarian cancer were collected from the 2021 Global Burden of Disease database.Joinpoint regression models were used to analyze time trends,and age-period-cohort(APC)models assessed their impact on incidence and mortality.Spearman correlation analysis was performed to evaluate the relationship between the sociodemographic index(SDI)and the cancer indicators.Finally,the attributable risk factors for the disease burden were analyzed.Results From 1990 to 2021,age-standardized incidence rates of cervical and endometrial cancers in China significantly increased,while ovarian cancer showed no significant change.Age-standardized mortality,DALY,and years of life lost due to premature death(YLL)decreased significantly.The disease burden was heavier in middle-aged and older groups.APC model indicated an increase in cervical cancer incidence and a decrease in mortality over time.Furthermore,the incidence risks of cervical and endometrial cancers were elevated in successive birth cohorts,whereas a lower risk was observed for ovarian cancer.Correlation analysis showed significant associations between cancer incidence and mortality with SDI.Obesity has significantly contributed to the disease burden of common gynecologic cancers in China.Conclusion Mortality rates of cervical,endometrial and ovarian cancer have declined,while the incidence of cervical and endometrial cancers has significantly increased.The trends in incidence and mortality are influenced by age,period and cohort effects.Future efforts should focus on controlling risk factors like obesity to reduce the disease burden.

Objective:To explore the effectiveness of diversified teaching methods in the clinical teaching of nurses training in extracorporeal membrane pulmonary oxygenation (ECMO) .Methods:From March 2019 to August 2023, 167 out-of-hospital nurses who furthered their knowledge of ECMO at China-Japan Friendship Hospital were selected using convenience sampling method. ECMO training and teaching team was set up, adopting a three-tier teaching management model of "nurse leader-teaching instructor-clinical instructor", and implementing a diversified teaching method that integrated nursing rounds teaching, scenario simulation teaching, and Workshop teaching. Theoretical scores before and after training, operational scores after training, application effects after returning to the hospital and satisfaction with diversified teaching were recorded for training nurses.Results:After training, the theoretical scores of the training nurses were (76.59±6.88), which were higher than the pre-training scores of (52.74±6.86), and the difference was statistically significant ( P<0.01). The post-training nurses' operational score was (94.10±3.26) and the satisfaction of the training nurses with the teaching was 95.81% (160/167). When applying ECMO back to the hospital after the training, more than 95% of the nurses believed that the degree of medical and nursing cooperation increased, the time of tube placement and the preparation time for supplies shortened, the completeness of supplies preparation improved, and they were able to respond successfully to emergency events in ECMO patients. Conclusions:Diversified teaching methods can improve the comprehensive specialty competence of ECMO training nurses and help to improve the quality of teaching in the department, which can be promoted and applied in the teaching of ECMO training.

Objective:This study aims to investigate the spillover effects of the Diagnosis-Related Groups payment reform on medical expenditures.Methods:Based on the medical record data of inpatients in a tertiary Grade A hospital in Wuhan,Hubei Province,the Difference-in-Differences method was applied to estimate the impact of the DRG reform on medical expenditures for non-local patients.Results:After the implementation of DRG payment,the total medical expenses(β=-0.13),out-of-pocket expenses(β=-0.22),drug expenses(β=-0.25),consumable expenses(β=-0.26)decreased significantly.Meanwhile,the reduction ranges of the level and proportion of out-of-pocket expenses for non-local inpatients were significantly larger than those for local inpatients.However,the reduction range of the proportion of drug expenses for non-local inpatients was significantly smaller than that for local inpatients.The gaps between the two groups in terms of the level of out-of-pocket expenses and the proportion of drug expenses gradually narrowed.Conclusion:The DRG payment reform has produced a significant spillover effect,leading to a decrease in the medical expense level and an improvement in the expense structure for non-local inpatients.However,the medical expenses of non-local inpatients remain relatively high.It is suggested to accelerate the inclusion of non-local inpatients in disease-specific payment management and strengthen the coordination between the hospital's internal operation management and the reform of medical insurance payment methods.

Objective To design a performance testing platform to evaluate the working status and performance characteristics of the ventilator proportional solenoid valve.Methods The performance testing platform had its hardware including a high-pressure gas source,a pressure regulating valve,sensors and etc,and its software designed based on PyQt5 and composed of several modules for data acquisition,parameter setting,image display,indicator computation,result output and etc.Two kinds of proportional solenoid valves(Valve 1、Valve2)were selected for static and dynamic tests to verify the performance of the platform.Results The platform developed facilitated the proportional solenoid valve to carry out accurate computation of static and dynamic indicators at real time and time domain and waveform feature extraction of sensor data by precision control and data acquisition for the proportional solenoid valve.Static tests showed that Valve 1 gained advantages over Valve 2 in static flow characteristics involving in lowered repeatability,return error and offset while enhanced stability;dynamic tests indicated Valve 2 had rapid flow variations and significant flow fluctuation impacts,Valve 1 showed smooth dynamic response changes,and Valve 2 behaved better than Valve 1 in dynamic performance.Conclusion The testing platform developed comprehensively demonstrates the performance characteristics and working performance of the ventilator proportional solenoid valve,which is of great significance to enhance the reliability and safety of the ventilator.[Chinese Medical Equipment Journal,2025,46(1):13-19]