1.Diagnostic value of serum Mac-2 binding protein for the severity of schistosomiasis-induced liver fibrosis
Jun WU ; Meiqun LUO ; Shuying XIE ; Ronghua ZHU ; Hui XU ; Long TANG ; Fei HU ; Sheng DING
Chinese Journal of Schistosomiasis Control 2026;38(1):38-43
Objective To evaluate the value of serum Mac-2 binding protein (M2BP) for assessment of the severity of schisto somiasis-induced liver fibrosis, so as to provide insights into non-invasive diagnosis and disease surveillance of liver fibrosis caused by schistosomiasis. Methods A total of 234 individuals with a history of Schistosoma japonicum infection were sampled from Xinhua Village, Lushan City, Jiangxi Province from 2019 to 2020, and 234 serum samples were collected from all participants. All participants received B-ultrasound examinations of the liver. Serum samples were categorized into four groups (grades 0, Ⅰ, Ⅱ and Ⅲ schistosomiasis-induced liver fibrosis groups) according to B-ultrasound examination results, and then, each group was randomly divided into a receiver operating characteristic (ROC) curve group and an efficacy assessment group at a ratio of 7∶3. Serum M2BP concentration was measured in four groups using the enzyme-linked immunosorbent assay (ELISA), and differences in serum M2BP concentrations were compared with analysis of variance and Spearman correlation analysis. Serum M2BP concentration was subjected to ROC curve analysis among individuals with different grades of schistosomiasis-induced liver fibrosis in the ROC curve group to determine the optimal diagnostic threshold of M2BP concentration at different fibrosis grades, and the area under the ROC curve (AUC) was calculated to evaluate the diagnostic performance. The diagnostic accuracy was verified by comparing the accordance rate and Kappa consistency test in the efficacy assessment group. Results Among 234 serum samples, there were 79 samples with grade 0 schistosomiasis-induced liver fibrosis, 87 samples with Grade Ⅰ, 46 samples with Grade Ⅱ and 22 samples with Grade Ⅲ according to the B-ultrasound examinations. The mean serum M2BP concentrations were (0.40 ± 0.31) [95% confidence interval (CI): (0.33, 0.47)], (0.64 ± 0.48) [95% CI: (0.53, 0.74)], (1.76 ± 0.58) [95% CI: (1.59, 1.93)] μg/mL and (2.56 ± 0.93) [95% CI: (2.14, 2.97)] μg/mL in the four groups, respectively (F = 150.796, P < 0.001), and the severity of schistosomiasis-induced liver fibrosis significantly positively correlated with serum M2BP concentration (rs = 0.715, P < 0. 001). The sample sizes of grades 0, Ⅰ, Ⅱ and Ⅲ schistosomiasis-induced liver fibrosis sera were randomly allocated as follows: 55 versus 24, 61 versus 26, 32 versus 14, and 15 versus 7 in the ROC curve and efficacy assessment groups, respectively, and the serum M2BP concentrations were (0.39 ± 0.29) μg/mL and (0.42 ± 0.36) μg/mL (F = 0.196, P > 0.05), (0.59 ± 0.47) μg/mL and (0.75 ± 0.51) μg/mL (F = 1.967, P > 0.05), (1.73 ± 0.59) μg/mL and (1.85 ± 0.57) μg/mL (F = 0.417, P > 0.05), and (2.46 ± 0.64) μg/mL and (2.76 ± 1.41) μg/mL (F = 0.491, P > 0.05), respectively. ROC curve analysis showed that the optimal diagnostic thresholds of serum M2BP concentration were 0.347 86 μg/mL (AUC = 0.635, P < 0.05), 1.188 83 μg/mL (AUC = 0.938, P < 0.000 1) and 2.021 21 μg/mL (AUC = 0.821, P < 0.000 1) for grade Ⅰ, Ⅱ and Ⅲ schistosomiasis-induced liver fibrosis. In addition, the accordance rates between the optimal diagnostic threshold of serum M2BP and B-ultrasound examinations for predicting grade Ⅰ, Ⅱ and Ⅲ schistosomiasis-induceed liver fibrosis were 69.23%, 85.71% and 71.43% (χ2 = 1.340, P > 0.05), and the overall Kappa consistency test showed moderate consistency [Kappa = 0.608, 95% CI: (0.428, 0.788); Z = 6.609, P < 0.000 1]. Conclusions Serum M2BP may serve as a potential biomarker for assessing moderate to advanced schistosomiasis-induced liver fibrosis; however, its diagnostic value for early-stage schistosomiasis-induced liver fibrosis remains limited.
2.Reactive and Enzyme-activated Probe Strategies for Imaging Acute Kidney Injury
Ru-Long CHEN ; Ting-Fei XIE ; Jin-Xin ZHANG ; Jia-Ting CHEN ; Jie LI ; Peng-Fei ZHANG ; Ji-Hong CHEN ; Lin-Tao CAI
Progress in Biochemistry and Biophysics 2026;53(6):1622-1637
Acute kidney injury (AKI) is a prevalent and life-threatening clinical syndrome characterised by a rapid decline in renal function and diverse pathological etiologies. The condition has been demonstrated to be associated with elevated mortality rates and an increased risk of progression to chronic kidney disease. At present, clinicians depend heavily on conventional functional markers, such as serum creatinine and urine output, for the diagnosis and staging of the disease. It is evident that these conventional indicators characteristically manifest a considerable temporal delay and only undergo modification subsequent to considerable tissue damage. This severely restricts the timeframe for early detection and timely therapeutic intervention. Furthermore, standard markers fail to provide specific biological information regarding the underlying cellular injury mechanisms. The utilisation of advanced probe technologies in molecular imaging offers a robust alternative to overcome these inherent diagnostic limitations.This comprehensive review systematically evaluates recent progress in the design and application of two primary categories of molecular imaging tools for acute kidney disease, specifically reactive probes and enzyme-activated probes. Reactive probes are engineered to specifically interact with redox-active chemical species, including hydrogen peroxide, peroxynitrite, hypochlorous acid, and sulfur dioxide. Because oxidative stress constitutes a primary early event in acute renal tubular damage, these probes enable researchers and clinicians to visualize early cellular injury and radical accumulation well before global renal functional decline becomes evident. We discuss the application of these reactive probes across multiple imaging modalities including fluorescence imaging, magnetic resonance imaging (MRI), positron emission tomography (PET), and photoacoustic techniques. Photoacoustic imaging combines high spatial resolution with deep tissue penetration and has successfully demonstrated the ability to provide diagnostic alerts up to 12 h before any detectable rise in serum creatinine levels. Additionally, specific reactive probes have shown promising translational potential when tested by high-throughput screening in clinical human urine samples. Enzyme-activated probes target the specific catalytic activity of disease-relevant enzymes. These include well-documented renal tubular structural biomarkers such as NAG, GGT, and ALP, along with apoptosis-related caspases and specific nitroreductases. By responding only to enzymatic cleavage, these tools provide highly specific and pathology-directed imaging readouts. Recent structural design strategies in this field have advanced significantly beyond single-enzyme detection. Researchers are now focusing on sophisticated dual-target recognition to minimize background noise, multimodal integration to cross-validate imaging signals, and theranostic applications where probes simultaneously deliver diagnostic feedback and therapeutic agents to injured tissues. Nanotechnology serves as a fundamental enabler for realizing these advanced probe functions. By precisely optimizing nanoparticle parameters such as hydrodynamic size, surface charge, and targeting ligands, researchers can achieve amplified signal output, highly precise kidney delivery, and protection against premature degradation in the systemic circulation. For example, modifying surface charges can significantly enhance the active uptake of nanoprobes by damaged renal tubular epithelial cells.While preclinical probe development has progressed rapidly, moving these technologies into routine clinical practice remains a major challenge. We analyze the translational feasibility and current obstacles from biological, technological, and regulatory perspectives. Although biological targets such as KIM-1, FAP, and ALP have been validated in extensive patient cohorts, practical barriers severely limit their immediate clinical application. These obstacles involve complex changes in in vivo pharmacokinetics. During an acute injury episode, the extreme drop in the glomerular filtration rate alters probe clearance and can cause unwanted systemic accumulation or confusing background imaging signals. Other major hurdles include a lack of comprehensive long-term toxicity data and the absence of standardized manufacturing protocols to ensure batch-to-batch consistency. Future successful translation will require rigorous multi-center clinical studies to confirm the true diagnostic value of these probes over traditional markers. Researchers must also establish strict standardization of imaging procedures and comprehensive safety evaluations. Ultimately, this review provides a thorough reference framework for designing clinically translatable molecular probes and building a precision diagnostic imaging system for acute kidney injury.
3.Cushing Disease Masquerading as Polycystic Ovary Syndrome: A Diagnostic Pitfall in Severe Hyperandrogenism
Jean Mun Cheah ; Fei Bing Yong ; K.J. Lingeswary ; Jen Hoong Oon ; Sharifah Noor Adrilla binti Long Mohd Noor Affendi ; Gayathri Devi A/P Krishnan ; Shazatul Reza binti Mohd Redzuan ; Subashini Rajoo Rajoo
Journal of the ASEAN Federation of Endocrine Societies 2026;41(S1):97-
Introduction:
Polycystic ovary syndrome (PCOS) is the most common
cause of hyperandrogenism in women of reproductive
age. However, several endocrine disorders, particularly
Cushing disease (CD), can closely mimic the clinical, biochemical, and radiological features of PCOS. This overlap
may lead to misdiagnosis and delayed recognition of
hypercortisolism, with significant metabolic and reproductive consequences.
Case:
We report a 24-year-old female with young-onset diabetes
mellitus who was referred for endocrine co-management
during admission for recurrent mons pubis and labial
abscesses with poorly controlled glycemia. She had a 5-year
history of progressive hirsutism, oligomenorrhoea, scalp
hair loss, significant weight gain, and insulin resistance,
and had previously been labelled as having PCOS during
adolescence, with subsequent default of follow-up. On
examination, she was obese (body mass index 33 kg/
m²) with plethoric facies, acanthosis nigricans, proximal
myopathy, and hirsutism (Ferriman–Gallwey score 10),
without overt virilization or acromegalic features.
Biochemical evaluation demonstrated severe hyperandrogenism with markedly elevated total testosterone
(7.05 nmol/L), suppressed gonadotropins, and adrenocorticotropic hormone (ACTH)-dependent hypercortisolism. Cortisol failed to suppress on low-dose dexamethasone testing, and 24-hour urinary free cortisol
was markedly elevated (>4,900 nmol/24 h). Pelvic ultrasonography and computed tomography imaging showed
polycystic ovarian morphology without evidence of an
ovarian mass. Pituitary magnetic resonance imaging
revealed a small right-sided pituitary microadenoma
measuring 2.6 × 3.7 mm. Inferior petrosal sinus sampling
demonstrated a central-to-peripheral ACTH gradient with
adequate prolactin ratios, confirming pituitary CD.
Conclusion
This case highlights how Cushing disease can closely
mimic PCOS, including polycystic ovarian morphology
and hyperandrogenism. Progressive symptoms, severe
biochemical androgen excess, and marked insulin
resistance should prompt evaluation for secondary causes
of hyperandrogenism, particularly hypercortisolism, to
avoid delayed diagnosis and prolonged morbidity.
Female
;
Hyperandrogenism
;
Pituitary ACTH Hypersecretion
;
Polycystic Ovary Syndrome
4.Biochemical Discordance in Acromegaly Complicated by Pituitary Apoplexy and Severe Insulin Resistance
Jean Mun Cheah ; Fei Bing Yong ; K.J. Lingeswary ; Jen Hoong Oon ; Sharifah Noor Adrilla binti Long Mohd Noor Affendi ; Gayathri Devi A/P Krishnan ; Shazatul Reza binti Mohd Redzuan ; Subashini Rajoo
Journal of the ASEAN Federation of Endocrine Societies 2026;41(S1):100-
Introduction:
Acromegaly is usually diagnosed by elevated age- and
sex-adjusted insulin-like growth factor-1 (IGF-1) levels
reflecting chronic growth hormone (GH) excess. IGF-1 is
preferred as a screening biomarker due to its longer half-life
and reduced pulsatility compared with GH. However, IGF1 levels may be disproportionately low or only modestly
elevated in certain clinical contexts, leading to diagnostic
uncertainty. Pituitary apoplexy is one such condition in
which acute tumor hemorrhage or infarction may disrupt
sustained GH secretion and attenuate IGF-1 production
Case:
A 48-year-old female with hypertension, type 2 diabetes
mellitus, and dyslipidemia presented with a 2-day history
of severe headache, vomiting, and visual disturbance, on a
background of progressive acral enlargement over 2 years.
Examination revealed coarse facial features, prognathism,
enlarged hands, and cranial nerve involvement. Magnetic
resonance imaging demonstrated an invasive sellar–
suprasellar pituitary macroadenoma with optic chiasmal
compression and cavernous sinus encasement. Intravenous
dexamethasone was initiated pre-operatively due to a
significant mass effect.
Biochemical evaluation showed markedly elevated
random GH levels (>50 ng/mL) with only mildly elevated
IGF-1 at 1.19 times the upper limit of normal, below the
threshold at which confirmatory oral glucose tolerance
testing may be omitted according to current guidelines.
Other pituitary axes suggested evolving hypopituitarism.
During admission, she developed severe hyperglycemia
with marked insulin resistance, requiring high-dose insulin
therapy (approximately 1.5 U/kg/day). She underwent
urgent transsphenoidal surgery, with histopathology
confirming a pituitary neuroendocrine tumor with extensive
hemorrhage and infarction, consistent with pituitary
apoplexy. Postoperatively, GH levels were suppressed to
<5 ng/mL, insulin requirements decreased markedly, and
hormone replacement was initiated for secondary adrenal
insufficiency and central hypothyroidism.
Conclusion
This case highlights that IGF-1 levels below conventional
diagnostic thresholds do not exclude clinically significant
acromegaly, particularly in the setting of pituitary
apoplexy. Integration of clinical phenotype, GH levels, and
imaging findings is essential to avoid diagnostic delay and
ensure timely management.
Acromegaly
;
Insulin Resistance
;
Pituitary Apoplexy
5.Hyperthyroidism and Gestational Trophoblastic Disease: A Case Report
K.J. Lingeswary ; Jean Mun Cheah ; Fei Bing Yong ; Jen Hoong Oon ; Aniqah Shamimi ; Sharifah Noor Adrilla binti Long Mohd Noor Affendi ; Gayathri Devi A/P Krishnan ; Shazatul Reza Binti Mohd Redzuan ; Subashini Rajoo
Journal of the ASEAN Federation of Endocrine Societies 2026;41(S1):118-119
Introduction:
Gestational trophoblastic disease (GTD) is an uncommon
but important cause of secondary hyperthyroidism,
termed trophoblastic hyperthyroidism, resulting from
the structural similarity between human chorionic
gonadotropin (hCG) and thyroid-stimulating hormone
(TSH). Excessively elevated hCG levels can stimulate
the TSH receptor, leading to increased thyroid hormone
production and clinically significant thyrotoxicosis. Early
recognition is essential as uncontrolled hyperthyroidism
may lead to serious perioperative complications.
Case:
We report a 50-year-old female who presented with
persistent vaginal bleeding following a prior uterine
evacuation. Clinical examination and ultrasonography
revealed a uterine mass corresponding to approximately
14 weeks’ gestation. Serum β-hCG was markedly elevated
at >1,000,000 IU/L. Histopathological evaluation confirmed
choriocarcinoma. Thyroid function tests demonstrated
severe biochemical hyperthyroidism, with suppressed TSH
and elevated free thyroxine levels. Notably, the patient did
not exhibit classic symptoms or signs of hyperthyroidism
such as palpitations, tremor, goiter, or thyroid eye signs.
She was started on beta-blockers and carbimazole for initial control. Given the underlying pathology, early definitive
surgical management was planned with multidisciplinary
input, and she subsequently underwent total abdominal
hysterectomy with bilateral salpingo-oophorectomy
successfully.
Hyperthyroidism in GTD is well described, but patients
may remain clinically asymptomatic despite significant
biochemical derangement, as seen in this case. Markedly
elevated β-hCG can mimic primary thyroid disease and
may lead to misinterpretation if the underlying cause is not
recognized. While antithyroid drugs such as carbimazole
are commonly initiated, they may have limited effect in
this setting, as the hyperthyroidism is driven by hCG rather
than intrinsic thyroid overactivity. Beta-blockers play an
important role in controlling symptoms and reducing
peripheral conversion of T4–T3. Early definitive treatment
of the underlying trophoblastic disease remains the key
to resolution.
Conclusion
Trophoblastic hyperthyroidism is a reversible condition
secondary to the underlying disease process. Treatment
of the trophoblastic tumor results in resolution of the
thyrotoxic state. Early recognition and appropriate
preoperative optimization are essential to ensure safe
patient outcomes.
Gestational Trophoblastic Disease
;
Hyperthyroidism
6.Different Exercise Modalities for Type 2 Diabetes Mellitus Complicated With Metabolic-associated Fatty Liver Disease
Bo-Zong YI ; Lei LÜ ; Yu-Xiao GUO ; Bei-Bei QIE ; Fei-Long CHEN
Progress in Biochemistry and Biophysics 2026;53(8):2053-2070
Both type 2 diabetes mellitus (T2DM) and metabolic associated fatty liver disease (MAFLD) fall within the spectrum of metabolic diseases, and they exhibit a bi-directional causal relationship and robust reciprocal association. Their shared pathological cornerstone is insulin resistance (IR), which involves the interplay of mitochondrial dysfunction and chronic inflammation, forming a cascading pathological process of “IR-mitochondrial dysfunction-inflammation”. This largely explains the notable upward trend in T2DM-MAFLD co-occurrence observed over recent years. Exercise intervention, as a safe and effective non-pharmacological approach, can improve the pathological progression of these patients at multiple levels. Following the logical framework of “pathogenesis-efficacy comparison-molecular mechanisms-clinical translation”, this article systematically compares the efficacy and molecular mechanisms of moderate-intensity continuous training (MICT), resistance exercise, high-intensity interval training (HIIT), and combined training. MICT reduces intrahepatic triglycerides by promoting lipolysis and improving cardiorespiratory fitness; resistance exercise increases muscle mass and basal metabolic rate, offering unique advantages in preserving muscle while reducing fat and improving insulin sensitivity; HIIT is a time-efficient exercise modality that enhances patients’ cardiorespiratory fitness and insulin sensitivity by alternating brief periods of vigorous exertion with recovery periods, with a prominent short-term triglyceride-lowering effect; combined training produces synergistic effects, comprehensively improving glucolipid metabolism and showing the best long-term adherence. Mechanistically, exercise exerts its beneficial effects through three common pathways: (1) AMPK-mediated lipid oxidation and mitochondrial biogenesis; (2) IRS/PI3K/Akt-mediated insulin signaling sensitization; and (3) Nrf2/ARE anti-oxidation and TGF-β/Smads anti-fibrosis regulation. Different exercise modalities activate these pathways with distinct emphases: MICT most directly and persistently activates the AMPK pathway; resistance exercise uniquely improves IRS/PI3K/Akt signaling through muscle mass gain; HIIT induces the highest AMPK activation intensity and triggers unique lactate-mediated signaling regulation; combined training integrates the above multiple mechanistic advantages. For clinical translation, multidisciplinary team collaboration is essential to ensure safety and adherence. Individualized prescriptions should be formulated according to the FITT-VP principle and patient phenotypes—frequency of 3-5 sessions/week of aerobic exercise combined with 2-3 sessions/week of resistance exercise; intensity of moderate-intensity (40%-60% heart rate reserve (HRR))aerobic exercise and 60%-80% of one-repetition maximum (1-RM) for resistance exercise; time of at least 150 min/week of moderate-intensity aerobic exercise, 30-60 min per session; type of combined training as the preferred modality; total volume of≥500-1 000 MET-min/week; and progression adjusted every 4-6 weeks—with real-time adjustments supported by wearable devices, ultimately forming a closed-loop management system from initial assessment to long-term follow-up. Notably, current studies have limitations such as small sample sizes and short intervention periods. Future research should focus on long-term follow-up, multi-omics biomarkers, and combined exercise-drug strategies. In conclusion, the systematic integration of structured, individualized, and sustainable exercise interventions into the multidisciplinary management pathway for patients with T2DM complicated by MAFLD is an urgent need in current clinical practice.
7.Aerobic Exercise and MOTS-c Ameliorate Hepatic Oxidative Stress and Metabolic Disorder in Type 2 Diabetes via The NRF2/PPARγ Axis
Fei-Long CHEN ; Zhi-Yu LI ; Tu-Tu WANG ; Yu FU ; Lei LÜ ; Cheng-Yuan XING ; Shun-Chang LI
Progress in Biochemistry and Biophysics 2026;53(8):2071-2090
ObjectiveType 2 diabetes mellitus (T2DM) often causes severe hepatic metabolic complications, dominated by metabolic associated fatty liver disease (MAFLD). Persistent hepatic steatosis and oxidative stress further trigger steatohepatitis and progressive liver damage, increasing the mortality risk of diabetic patients. Aerobic exercise effectively improves hepatic lipid metabolism and antioxidant capacity, but poor patient adherence restricts its long-term clinical application. Mitochondrial-derived mitochondrial open reading frame of the 12S rRNA type-c (MOTS-c) is a key peptide regulating insulin sensitivity and hepatic redox homeostasis. This study aimed to explore the protective mechanism of MOTS-c against T2DM-related liver injury and its combined beneficial effect with aerobic exercise via the NRF2/PPARγ signaling axis. This study aimed to investigate whether MOTS-c cooperates with aerobic exercise to alleviate T2DM-associated hepatic oxidative stress and metabolic dysfunction by activating the NRF2/PPARγ axis, and to clarify the molecular and transcriptomic characteristics of their combined intervention. MethodsStable MOTS-c overexpression and knockdown HepG2 cell lines were constructed using lentiviral transfection. An oleic acid-induced cellular lipid accumulation model and NRF2-knockout cell model were applied to verify the NRF2-dependent mechanism ofMOTS-c. Intracellular lipid deposition, triglyceride levels, antioxidant enzyme activities, and the expression of NRF2/PPARγ pathway-related genes and proteins were detected. In vivo, a T2DM rat model with obvious hepatic steatosis was established via a high-fat and high-sucrose diet combined with streptozotocin injection. Model rats received aerobic exercise, MOTS-c intraperitoneal injection, or combined intervention. We detected systemic glycolipid metabolic indicators, hepatic histopathological changes, and the expression of core proteins in the hepatic NRF2/PPARγ axis. Hepatic transcriptomic sequencing was performed to screen differentially expressed genes (DEGs) and enrich key pathways co-regulated by MOTS-c and aerobic exercise. ResultsCellular results showed that MOTS-c overexpression significantly reduced oleic acid-induced lipid deposition, enhanced antioxidant enzyme activity, and upregulated NRF2 and PPARγ expression. Conversely, MOTS-c knockdown aggravated hepatic lipid accumulation and oxidative damage and inhibited NRF2/PPARγ pathway activation. NRF2 knockout completely eliminated the protective effects of MOTS-c on lipid metabolism and redox balance, confirming its NRF2-dependent regulatory mechanism. In T2DM rats, both MOTS-c supplementation and aerobic exercise effectively improved insulin resistance, corrected glycolipid metabolic disorders, and alleviated hepatic steatosis, while consistently activating the hepatic NRF2/PPARγ axis. Compared with single intervention, the combined treatment showed a better improvement trend in hepatic metabolic and oxidative injury, without definitive synergistic effects. Transcriptomic analysis revealed that the co-regulated DEGs of MOTS-c and aerobic exercise were primarily enriched in lipid metabolism and PPAR signaling pathways, with multiple antioxidant and lipid-regulating genes significantly modulated by combined intervention. ConclusionMOTS-c exhibits obvious exercise-mimetic hepatoprotective effects in T2DM. It activates the hepatic NRF2/PPARγ axis to strengthen antioxidant defense, stabilize lipid metabolism, and relieve T2DM-associated hepatic steatosis and oxidative damage. Furthermore, MOTS-c produces additive beneficial effects with aerobic exercise, showing a superior intervention trend on diabetic liver dysfunction. This study identifies the NRF2/PPARγ axis as the core mechanism of MOTS-c-regulated hepatic protection, elucidates the transcriptomic basis of combined intervention, and provides a reliable theoretical basis and potential therapeutic target for clinical intervention in T2DM-complicated MAFLD.
8.Exploring urban versus rural disparities in atrial fibrillation: prevalence and management trends among elderly Chinese in a screening study.
Wei ZHANG ; Yi CHEN ; Lei-Xiao HU ; Jia-Hui XIA ; Xiao-Fei YE ; Wen-Yuan-Yue WANG ; Xin-Yu WANG ; Quan-Yong XIANG ; Qin TAN ; Xiao-Long WANG ; Xiao-Min YANG ; De-Chao ZHAO ; Xin CHEN ; Yan LI ; Ji-Guang WANG ; FOR THE IMPRESSION INVESTIGATORS AND COORDINATORS
Journal of Geriatric Cardiology 2025;22(2):246-254
BACKGROUND:
Atrial fibrillation (AF) is a common cardiac arrhythmia in the elderly. This study aimed to evaluate urban-rural disparities in its prevalence and management in elderly Chinese.
METHODS:
Consecutive participants aged ≥ 65 years attending outpatient clinics were enrolled for AF screening using handheld single-lead electrocardiogram (ECG) from April 2017 to December 2022. Each ECG rhythm strip was reviewed from the research team. AF or uninterpretable single-lead ECGs were referred for 12-lead ECG. Primary study outcome comparison was between rural and urban areas for the prevalence of AF. The Student's t-test was used to compare mean values of clinical characteristics between rural and urban participants, while the Pearson's chi-square test was used to compare between-group proportions. Multivariate stepwise logistic regression analysis was performed to estimate the association between AF and various patient characteristics.
RESULTS:
The 29,166 study participants included 13,253 men (45.4%) and had a mean age of 72.2 years. The 7073 rural participants differed significantly (P ≤ 0.02) from the 22,093 urban participants in several major characteristics, such as older age, greater body mass index, and so on. The overall prevalence of AF was 4.6% (n = 1347). AF was more prevalent in 7073 rural participants than 22,093 urban participants (5.6% vs. 4.3%, P < 0.01), before and after adjustment for age, body mass index, blood pressure, pulse rate, cigarette smoking, alcohol consumption and prior medical history. Multivariate logistic regression analysis identified overweight/obesity (OR = 1.35, 95% CI: 1.17-1.54) in urban areas and cigarette smoking (OR = 1.62, 95% CI: 1.20-2.17) and alcohol consumption (OR = 1.42, 95% CI: 1.04-1.93) in rural areas as specific risk factors for prevalent AF. In patients with known AF in urban areas (n = 781) and rural areas (n = 338), 60.6% and 45.9%, respectively, received AF treatment (P < 0.01), and only 22.4% and 17.2%, respectively, received anticoagulation therapy (P = 0.05).
CONCLUSIONS
In China, there are urban-rural disparities in AF in the elderly, with a higher prevalence and worse management in rural areas than urban areas. Our study findings provide insight for health policymakers to consider urban-rural disparity in the prevention and treatment of AF.
9.Effect of multi-mode pre-rehabilitation on patients undergoing Jinling procedure
Li-Yun LI ; Yang YANG ; Xiang-Hong YE ; Ting SUN ; Fei-Long GUO ; Jia-Huan LIU ; Cui-Li WU
Parenteral & Enteral Nutrition 2025;32(3):165-170
Objective:To evaluate the efficacy of multimodal prehabilitation in patients with refractory functional constipation undergoing Jinling procedure(modified Duhamel surgery).Methods:In this prospective randomized controlled trial,80 patients with refractory functional constipation scheduled for Jinling procedure at the Department of General Surgery,the General Hospital of Eastern Theater Command between January 2020 and December 2021 were enrolled.Participants were randomly assigned to either the observation group(n=40,multimodal prehabilitation)or control group(n=40,routine nursing care).Outcome measures included:time to first flatus,time to first ambulation,defecation volume on postoperative day 5,length of hospitalization,nutritional markers(hemoglobin,albumin,total protein at postoperative day 7),anxiety/depression scores(Hospital Anxiety and Depression Scale,HADS),and total complication rates.Results:Compared to controls,the first ventilation time(48.02±6.15)h,first ambulation time(49.92±5.58)h,defecation volume on the fifth day(234.50±51.03)mL,hospital stay(13.15±2.64)d,anxiety score(43.68±3.45)points,depression score(43.81±1.58)points,and the total incidence of postoperative complications(15%)were significantly lower in the observation group(all p values<0.05).By contrast,the serum levels of hemoglobin(115.60±11.60)g/l,albumin(41.19±5.79)g/L and total protein(61.64±4.94)g/L on day 7 post-operatively were significantly higher in the observation group than those in the control group(P<0.05).Conclusions:Multimodal prehabilitation enhances postoperative intestinal recovery,reduces complications,improves nutritional status,and shortens hospital stays in refractory functional constipation patients undergoing Jinling procedure,supporting its clinical adoption.
10.Bioequivalence study of desloratadine tablets in healthy Chinese subjects
Peng-fei XIE ; Yuan-lu CHEN ; Hong-di CUI ; Hui LONG ; Yong-gang ZHAO ; Qi-shan HUANG ; Peng YANG ; Yan ZHOU ; Yong-dong ZHANG
The Chinese Journal of Clinical Pharmacology 2025;41(2):220-224
Objective To explore the pharmacokinetic(PK)characteristics of desloratadine tablets and reference drugs in healthy subjects,and evaluate their bioequivalence and safety.Methods The random,open,two-period,cross-over pharmacokinetic study method was adopted,each subject received a single oral dose of desloratadine tablets test drug(T)or reference drug(R)for 5 mg.The concentrations of desloratadine and 3-hydroxy desloratadine in plasma were determined by liquid chromatography-tandem mass spectrometry(LC-MS/MS);and the PK parameters were calculated by WinNonlin 8.1 software to evaluate the bioequivalence.Results The main PK parameters of T and R of desloratadine were as follows:the fasting condition Cmax were respectively(3 809.82±1 016.54)and(3 642.36±777.07)pg·mL-1;AUC0-120h were respectively(5.75 ×104±5.03 ×104)and(5.51 × 104±4.00 × 104)pg·h·mL-1;AUC0-∞ were respectively(6.85× 104±1.03× 104)and(6.37 × 104±7.92 × 104)pg·h·mL-1.The fed condition Cmax were respectively(4 398.98±1 191.22)and(4 744.4±1 511.97)pg·mL-1;AUC0-120h were respectively(5.25 × 104±1.82 × 104)and(5.55 × 104±1.98 × 104)pg·h·mL-1;AUC0-∞ were respectively(5.37 × 104±1.86 × 104)and(5.68 × 104±2.04 × 104)pg·h·mL-1.The 90%confidence interval of Cmax,AUC0-t and AUC0-∞ of desloratadine were all within 80.00%~125.00%.Conclusion There was no significant difference in the main PK parameters between T tablets and R under fasting or high-fat postprandial conditions,and desloratadine tablets were bioequivalent,safe and well tolerated.


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