BACKGROUND: Death burden of stroke is severe with over one-third rural residents in China, but there is still a lack of specific national and high-quality reports on the urban-rural differences in stroke burden, especially for subtypes. We aimed to update the understanding of urban-rural differences in stroke deaths. METHODS: This is a descriptive observational study. Data from the national mortality surveillance system, which covers 323.8 million with 605 disease surveillance points (DSPs) across all 31 provinces, municipalities, and autonomous regions in China. All deaths from stroke as the underlying cause from 2015 to 2020 according to DSPs. Crude mortality rate and age-standardized mortality rate (ASMR) were estimated through DSPs. Average annual percentage change was used to explain the change in mortality rate. RESULTS: From 2015 to 2020, the majority of deaths from all stroke subtypes occurred in rural areas. There were significant differences between the changes of urban and rural ASMRs. On the whole, the changes in urban areas were evidently better, and the ASMR differences were basically expanding. Stroke ASMR in urban China decreased by 15.5%. The rural ASMR of ischemic stroke increased by 12.9%. The rural and urban ASMRs of intracerebral hemorrhage decreased by 24.9% and 27.4%, and those of subarachnoid hemorrhage decreased by 29.5% and 40.4%, respectively. The highest ASMRs of all stroke subtypes and the increasing trend of ischemic stroke ASMR make rural males the focus of stroke management. CONCLUSIONS The death burden of stroke varies greatly between urban and rural China. Rural residents face unique challenges.
Humans ; China/epidemiology* ; Stroke/mortality* ; Rural Population/statistics & numerical data* ; Male ; Female ; Urban Population/statistics & numerical data* ; Middle Aged ; Aged ; Aged, 80 and over ; Adult

OBJECTIVE: To study effective methods for reducing lung V₅, V₁₀, and mean lung dose (MLD) in the design of volumetric modulated arc therapy for central lung cancer by using different arc configurations and dose-limiting blocks designs. METHODS: Five groups of plans were designed for the enrolled patients. Group A used a full-arc field. Group B used a partial-arc field. Groups C, D, and E used full-arc fields with vertical-length, semi-ring, and triangular dose-limiting blocks added respectively. The dosimetric similarities of target areas and the dosimetric differences in lung V₅, V₁₀, V₂₀, and MLD among the groups were compared. RESULTS: Compared with group A, groups B, C, D, and E had decreased homogeneity and conformity of the target area, but significantly lower V₅ and V₁₀ of the whole lung. The MLD of groups C, D, and E was lower than that of group A. CONCLUSION Using a full-arc field combined with dose-limiting blocks can effectively reduce lung V₅, V₁₀, MLD, and monitor units (MU).
Lung Neoplasms/radiotherapy* ; Humans ; Radiotherapy, Intensity-Modulated/methods* ; Radiotherapy Planning, Computer-Assisted/methods* ; Radiotherapy Dosage ; Lung/radiation effects*

Objective:To analyze the external quality control assessment results of salt iodine, urine iodine, and water iodine in iodine deficiency disorders (IDD) laboratories at all levels in Shandong Province, and provide reliable quality assurance for monitoring and prevention of IDD.Methods:The external quality control assessment of salt iodine, urine iodine and water iodine in provincial, municipal and county levels IDD laboratories in Shandong Province from 2017 to 2021 were conducted, and feedback rate and qualification rate were calculated.Results:From 2017 to 2021, the feedback rates and qualification rates of external quality control assessment of salt iodine, urine iodine and water iodine at provincial and municipal levels IDD laboratories in Shandong Province were all 100.0%. The feedback rates of county level laboratories participating in the salt iodine external quality control assessment were all 100.0%. The qualification rate in 2021 was 99.3% (135/136), and the other four years were all 100.0%. The feedback rates of county level laboratories participating in the urine iodine external quality control assessment were all 100.0%. The qualification rates in 2017 and 2021 were 98.4% (122/124) and 97.1% (132/136), respectively, and the other three years were all 100.0%. In 2021, the county level laboratories in Shandong Province participated in the water iodine external quality control assessment for the first year, and the feedback rate and qualification rate of 69 laboratories were both 100.0%.Conclusion:From 2017 to 2021, the detection capacity of IDD laboratories at the provincial and municipal levels in Shandong Province remains at a high level, and the detection capacity of salt iodine and urine iodine in some county level laboratories still needs to be further improved.

Objective:To explore any effect of repeated transcranial magnetic stimulation (rTMS) on the upper limb motor function and cerebral cortex activation of stroke survivors.Methods:Sixty stroke survivors were randomly divided into an intervention group and a control group, each of 30. In addition to routine rehabilitation training (including drug therapy, comprehensive hemiplegic limb training and physical factor therapy), the intervention group received 15 minutes of rTMS daily, five days a week for 4 weeks while the control group was given false rTMS. Upper limb motor function was evaluated before and after the treatment using the Fugl Meyer upper limb motor function rating scale (FMA-UE). Functional near-infrared spectroscopy was used to detect and compare the activation (β values) of the prefrontal cortex, the motor cortex and the primary somatosensory cortex in the 2 groups. The correlation between the FMA-UE scores and the β values was quantified.Results:①There was no significant difference in the average FMA-UE scores between the two groups before the treatment. Afterward, though both groups′ average scores had increased significantly, there was significantly greater improvement in the treatment group. ②There was also no significant difference in average β value between the two groups before the experiment, but afterward the average βs of channels 27 and 13 in the intervention group were significantly higher than in the control group. Moreover, in patients with lesion in the left brain, the β-values of CH27 and CH13 were also significantly higher than the control group ( P<0.05). ③The FMA-UE scores of the intervention group were moderately correlated with the CH27 and CH13 β values, but those of the control group were only weakly correlated with the β values of CH27. Conclusion:Transcranial magnetic stimulation activates a lesioned left brain region, improving upper limb motor function. The improvement is correlated with the activation of the left prefrontal cortex and the left primary somatosensory cortex.

Dynamic changes in gut dysbiosis and metabolomic dysregulation are associated with immune-complex glomerulonephritis(ICGN).However,an in-depth study on this topic is currently lacking.Herein,we report an ICGN model to address this gap.ICGN was induced via the intravenous injection of cationized bovine serum albumin(c-BSA)into Sprague-Dawley(SD)rats for two weeks,after which mycophenolate mofetil(MMF)and losartan were administered orally.Two and six weeks after ICGN establishment,fecal samples were collected and 16S ribosomal DNA(rDNA)sequencing and untargeted metabolomic were conducted.Fecal microbiota transplantation(FMT)was conducted to determine whether gut normali-zation caused by MMF and losartan contributed to their renal protective effects.A gradual decline in microbial diversity and richness was accompanied by a loss of renal function.Approximately 18 genera were found to have significantly different relative abundances between the early and later stages,and Marvinbryantia and Allobaculum were markedly upregulated in both stages.Untargeted metabolomics indicated that the tryptophan metabolism was enhanced in ICGN,characterized by the overproduction of indole and kynurenic acid,while the serotonin pathway was reduced.Administration of losartan and MMF ameliorated microbial dysbiosis and reduced the accumulation of indoxyl conjugates in feces.FMT using feces from animals administered MMF and losartan improved gut dysbiosis by decreasing the Firmicutes/Bacteroidetes(F/B)ratio but did not improve renal function.These findings indicate that ICGN induces serous gut dysbiosis,wherein an altered tryptophan metabolism may contribute to its pro-gression.MMF and losartan significantly reversed the gut microbial and metabolomic dysbiosis,which partially contributed to their renoprotective effects.

Objective:To investigate the popularization of non-iodized salt among residents in water-borne high iodine areas and the iodine nutrition status of key populations in Shandong Province.Methods:In 2021, monitoring was conducted on a county-by-county basis in 47 counties (cities, districts, hereinafter referred to as counties) in 9 cities of Shandong Province, in accordance with the newly designated high iodine areas in the "Definition of Water Source High Iodine Areas and High Iodine Disease Areas" (GB/T 19380-2016) and historical high iodine areas. In each monitoring county, administrative villages with a median water iodine level greater than 100 μg/L were sorted by water iodine value, and a systematic sampling method was used to select 5 administrative villages as monitoring sites to investigate the water improvement situation and the iodine level of residents' drinking water. Totally 40 non boarding students aged 8 to 10 from one primary school and 20 pregnant women were selected in each village location to collect household edible salt samples and random urine samples for testing salt iodine and urine iodine levels, and the B-ultrasound method was used for thyroid examination in children.Results:A total of 364 high iodine administrative villages had been monitored, all of which had completed water improvement with a water improvement rate of 100.0%. The median iodine content in residential drinking water was 20.3 μg/L, ranging from 0.1 to 869.1 μg/L; and 11 464 edible salt samples were collected from residents' homes, with a non-iodized salt rate of 82.7% (9 481/11 464). A total of 9 197 urine samples from children and 2 335 urine samples from pregnant women were tested, with median urinary iodine levels of 219.0 and 139.0 μg/L, respectively. A total of 9 197 children were examined for thyroid, with 262 cases detected and a goiter rate of 2.8%.Conclusions:The rate of non-iodized salt in high iodine areas of Shandong Province still needs to be improved. Children's iodine nutrition is above the appropriate level, while pregnant women are at an iodine deficiency level.

Objective:To explore the radiological damage to cells induced by the delayed particles of 9C-ions for heavy ion therapy, as well as the microdosimetric distribution and biological effects of these particles on a single model of V79 Chinese hamster lung cells. Methods:The Monte Carlo program was employed to simulate the endonuclear absorbed doses of α particles with various energies (3-10 MeV) transported in cells (cell radius RC = 10 μm, nucleus radius RN = 5 μm). Then, the result were compared with the S values ( SN←N, SN←Cy, and SN←CS) derived using the medical internal radiation dose (MIRD) method to demonstrate the feasibility of Monte Carlo simulations. Finally, the energy deposition of the delayed particles of 9C-ions generated at three sites (i.e., on the surface and in the cytoplasm and nucleus of the V79 cell model) during their transport in targets was simulated, and the result ing cell surviving fraction was analyzed. Results:Monte Carlo and MIRD method yielded differences in S values of 1.91%-4.95% for SN←N (nucleus to nucleus), 1.48%-5.11% for SN←Cy (cytoplasm to nucleus), and -1.99% to 0.80% for SN←CS(surface to nucleus), indicating highly consistent S values derived using both method(differences < 6%). When a 9C-ion decayed on the surface of the V79 cell model and the produced secondary particles entered the cell, the average endonuclear absorbed dose was 10 -2 Gy orders of magnitude, with a cell surviving fraction of about 88%. In the case where decay occurred in the cytoplasm, the cell surviving fraction was about 80%. However, when the 9C ion decayed in the nucleus, α particles had short ranges and deposited most of their energy in the cell (mean endonuclear absorbed dose: 0.1 Gy). In this case, severe cell damage was induced, with the cell surviving fraction reducing to about 53%. Conclusions:9C-ions emit secondary charged particles due to decay, among which α particles cause great damage to cells when entering the nucleus and trigger evident biological effects.

Objective:To compare the clinical characteristics of patients with chronic obstructive pulmonary disease (COPD) and cardiovascular diseases between smokers and non-smokers.Methods:In this retrospective cross-sectional study, a total of 735 patients with COPD and comorbid cardiovascular disease who were hospitalized in the Department of Respiratory and Critical Care Medicine of Peking University Third Hospital from January 1, 2017 to August 1, 2022 were enrolled, and were divided into a smoking group (603 cases) and a non-smoking group (132 cases) according to whether or not they had ever smoked. Clinical data, blood counts, C-reactive protein, procalcitonin, echocardiography, comorbidities, hospitalization costs and outcomes were compared between the two groups. Propensity score matching method was used to balance the baseline information between smoking patients and non-smoking patients for further paired analysis. Data were statistically analyzed using t-test, chi-square test, and rank sum test. Results:The percentage of females was significantly higher in patients in the nonsmoking group than in those in the smoking group (65.9% vs 13.6%, P<0.001), and body mass index (BMI) was also significantly higher than in those in the smoking group [(24.4±4.7) vs (23.5±4.4) kg/m 2, P=0.022]. Inflammation indicators neutrophil-to-lymphocyte ratio (NLR) [3.8 (2.2, 8.1) vs 4.9 (2.9, 8.3), P=0.018], C-reactive protein [1.3(0.5, 8.1) vs 7.9(1.1, 35.1) mg/L, P=0.001] were lower in the non-smoking group than in the smoking group. The ratio of early transmitral flow velocity to early mitral annular velocity (E/Em) values were significantly higher in the smoking group than in the nonsmoking group [10(7, 12) vs 8(7, 10) P=0.030]. The cardiovascular disease composition was dominated by hypertension with a lower percentage of combined coronary heart disease in the nonsmoking group than in the smoking group (22.0% vs 35.0%, P=0.034). The two groups were similar in terms of cost during hospitalization and mortality indicators. Conclusions:Among patients with COPD, smokers exhibit higher levels of systemic inflammation, greater cardiac involvement, and an increased risk of ICU admission than non-smokers. Therefore, they require enhanced daily health management and management during hospitalization.

Spindle assembly checkpoint (SAC) is a protective mechanism for cells to undergo accurate mitosis. SAC prevented chromosome segregation when kinetochores were not, or incorrectly attached to microtubules in the anaphase of mitosis, thus avoiding aneuploid chromosomes in daughter cells. Aneuploidy and altered expression of SAC component proteins are common in different cancers, including lung cancer. Therefore, SAC is a potential new target for lung cancer therapy. Five small molecule inhibitors of monopolar spindle 1 (MPS1), an upstream component protein of SAC, have entered clinical trials. This article introduces the biological functions of SAC, summarizes the abnormal expression of SAC component proteins in various cancers and the research progress of MPS1 inhibitors, and expects to provide a reference for the future development of lung cancer therapeutic strategies targeting SAC components.
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Humans ; Cell Cycle Proteins/metabolism* ; Spindle Apparatus/metabolism* ; Protein Serine-Threonine Kinases/metabolism* ; M Phase Cell Cycle Checkpoints/genetics* ; Lung Neoplasms/metabolism*