OBJECTIVE: To evaluate the prospective association between cumulative resting heart rate (cumRHR) and rapid renal function decline (RRFD) in a cohort of individuals aged 60 and older. METHODS: In the Tianjin Chronic Kidney Disease Cohort Study, the individuals who underwent three consecutive physical examinations between 2014 and 2017, with estimated glomerular filtration rate (eGFR) greater than 60 mL/min per 1.73 m² and aged 60 years or older were enrolled. A total of 27,564 patients were prospectively followed up from January 1, 2017 to December 31, 2020. The 3-year cumRHR was calculated. The primary outcome was RRFD, defined as an annualized decline in eGFR of 5 mL/min per 1.73 m² or greater. Logistic and restricted spline regression models and subgroup analysis were used to investigate the association of cumRHR with RRFD after adjusting for all confounders. RESULTS: During a median follow-up of 3.2 years, a total of 4,347 (15.77%) subjects developed RRFD. In fully-adjusted models, compared with the lowest quartile of cumRHR, the odds ratio (OR) for the highest was 1.44 (1.28-1.61), P < 0.001. Furthermore, each 1-standard deviation (27.97 beats/min per year) increment in cumRHR was associated with a 17% (P < 0.001) increased risk of RRFD, with a linear positive correlation (P for non-linear = 0.803). Participants with a 3-year cumRHR ≥ 207 (beats/min) * year (equivalent to ≥ 69 beats/min per year in 3 years) were found to be at a higher risk of RRFD. CONCLUSIONS The cumRHR is significantly associated with a higher risk of RRFD among older adults. These results might provide an effective goal for managing and delaying the decline of renal function in the older adults.

Objective: To investigate the associations between adverse childhood experiences (ACE) and substance use behaviors among lesbians to provide a scientific basis for high-risk population identification and formulation of targeted intervention measures. Methods: Lesbians who participated in routine AIDS voluntary counseling, testing services, activities, and peer recommendations were recruited from July to December 2018, with the help of LesPark in Beijing. Convenient sampling method was used. Demographic characteristics, ACE, and substance use behaviors of subjects were investigated using an online platform powered by www.wjx.cn. Subsequently, the associations between ACE and adulthood substance use behaviors were evaluated using the logistic regression model. The SPSS 22.0 was used for statistical analysis. Results: A total of 294 lesbians were recruited in the study, 81.3% (239/294) of them were lesbians, and 18.7% (55/294) were bisexuals. Besides, 55.8% (164/294) of subjects reported they had had ACE, with proportions of lesbians experiencing abuse, neglect, and family dysfunction as 33.3% (98/294), 24.5% (72/294), and 32.7% (96/294), respectively. 55.1% (162/294) of the lesbians reported they had smoked in the past 30 days, 11.2% (33/294) reported having drug-use behavior in the past three months, and 22.8% (67/294) claimed drinking alcohol weekly. Multivariate logistic regression analysis showed that lesbians with ACE were at high risks to smoke (OR=1.87, 95%CI: 1.13-3.08), drink (OR=2.13, 95%CI: 1.18-3.84), and use drugs (OR=3.33, 95%CI: 1.29-8.61) in adulthood. Moreover, lesbians with childhood family dysfunction were at higher risk of smoking cigarettes (OR=2.60, 95%CI: 1.46-4.62) and drinking alcohol (OR=2.65, 95%CI: 1.44-4.87). At the same time, those with abuse experience were at higher risk of drug use (OR=3.17, 95%CI: 1.26-7.96). Conclusions: Substance use behaviors, including cigarette smoking, drinking alcohol, and drugs use, were common among lesbians. Positive associations were found between ACE and adulthood substance use behaviors.
Adult ; Adverse Childhood Experiences ; Child ; Child Abuse/psychology* ; Female ; Humans ; Risk Factors ; Sexual and Gender Minorities ; Substance-Related Disorders/psychology*

Objective: The study aims to predict 10-year cardiovascular disease (CVD) risk and explore its association with sleep duration among Chinese urban adults. Methods: We analyzed part of the baseline data of a cohort that recruited adults for health screening by cluster sampling. The simplified Pittsburgh Sleep Quality Index (PSQI) and Framingham 10-year risk score (FRS) were used to measure sleep duration and CVD risk. Demographic characteristics, personal history of chronic diseases, lifestyle factors were collected using a questionnaire. Height, weight, total cholesterol (TC), and high-density lipoprotein cholesterol (HDL-C) were also measured. Multiple logistic regression models were performed to explore the association of sleep duration with the predicted CVD risk. Results: We included 31, 135 participants (median age 44 years, 53.02% males) free of CVD, cerebral stroke, and not taking lipid-lowering agents. Overall, 14.05%, and 25.55% of participants were at medium and high predicted CVD risk, respectively. Short sleep was independently associated with increased odds of medium to high risk of predicted 10-year CVD among males ( Conclusion A substantial number of adults free of CVD were at high 10-year CVD risk. Short sleep was associated with increased odds of predicted CVD risk.
Adult ; Aged ; Aged, 80 and over ; Cardiovascular Diseases/etiology* ; China/epidemiology* ; Female ; Humans ; Male ; Middle Aged ; Risk Factors ; Sleep Quality ; Young Adult

Antineoplastic Combined Chemotherapy Protocols ; Bortezomib/therapeutic use* ; Dexamethasone ; Humans ; Multiple Myeloma/drug therapy* ; Treatment Outcome

Objective To classify and identify several kinds of basic graphics in medicine, and to explore the practical application.Methods The method combining angular points and minimum inertia axis was applied to execute the study.The necessity to draw a minimum inertia axis through the centroid was determined based on the number of the angular points,and the category of the target graphic was judged by comparing its perimeter and area with the theoretical value of the known graphics. Results The method had high recognition rates for simulation and actual graphics, and was irrelevant to the position,scale and rotation of the graphic.Conclusion The method based on angular points and minimum inertia axis gains advantages when used to recognize the tablet and capsule on the platform.

Objective The role of BMI1 gene in the development of gastrointestinal stromal tumor (GIST) has not yet been clarified. This study aimed to explore the expression of BMI1 gene in gastrointestinal stromal tumor,and analyze its relationship with clinical pathological features of GIST. Methods The clinical data of 68 GIST patients treated in The First People's Hospital of Nan-ning from August 2012 to October 2015 were analyzed retrospectively. The expression of BMI1 in normal gastrointestinal tissues and GIST tissues were detected with immunohistochemistry method,and analyzed the relationship between various clinicopathological pa-rameters of GIST and BMI1. The expression of BMI1 protein was detected by Western blot. Results The positive rate of BMI1 was much higher in GIST group than in non-GIST (76.47% vs 36.84%,P<0.05). The difference in the expression of BMI1 protein between the different risk groups was statistically significant (P<0.05). The positive expression rate was the highest in the high-risk group (93.75%),but had no statistically significant difference among different genders,age,locations,histological types and whether me-tastasis (P>0.05). Expression of proliferation genes such as PCNA,CyclinD1 mRNA in BMI1 positive group were higher than those in BMI1 negative group,the expression of Pro-apoptotic genes such as Caspase-7,Smac mRNA were lower than those in BMI1 negative group,the expression of anti-apoptosis genes such as Livin,p53,Bcl-2 mRNA were higher than those in BMI1 negative group (P<0.05). Conclusion The expression of BMI1 protein was increased in GIST tissue. It is correlated with the risk classification,and is an important factor affecting the prognosis of patients.

BackgroundShensong Yangxin Capsule (SSYX), traditional Chinese medicine, has been used to treat arrhythmias, angina, cardiac remodeling, cardiac fibrosis, and so on, but its effect on cardiac energy metabolism is still not clear. The objective of this study was to investigate the effects of SSYX on myocardium energy metabolism in angiotensin (Ang) II-induced cardiac hypertrophy.

MethodsWe used 2 μl (10 mol/L) AngII to treat neonatal rat cardiomyocytes (NRCMs) for 48 h. Myocardial α-actinin staining showed that the myocardial cell volume increased. Expression of the cardiac hypertrophic marker-brain natriuretic peptide (BNP) messenger RNA (mRNA) also increased by real-time polymerase chain reaction (PCR). Therefore, it can be assumed that the model of hypertrophic cardiomyocytes was successfully constructed. Then, NRCMs were treated with 1 μl of different concentrations of SSYX (0.25, 0.5, and 1.0 μg/ml) for another 24 h. To explore the time-depend effect of SSYX on energy metabolism, 0.5 μg/ml SSYX was added into cells for 0, 6, 12, 24, and 48 h. Mitochondria was assessed by MitoTracker staining and confocal microscopy. mRNA and protein expression of mitochondrial biogenesis-related genes - Peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α), energy balance key factor - adenosine monophosphate-activated protein kinase (AMPK), fatty acids oxidation factor - carnitine palmitoyltransferase-1 (CPT-1), and glucose oxidation factor - glucose transporter- 4 (GLUT-4) were measured by PCR and Western blotting analysis.

ResultsWith the increase in the concentration of SSYX (from 0.25 to 1.0 μg/ml), an increased mitochondrial density in AngII-induced cardiomyocytes was found compared to that of those treated with AngII only (0.25 μg/ml, 18.3300 ± 0.8895 vs. 24.4900 ± 0.9041, t = 10.240, P < 0.0001; 0.5 μg/ml, 18.3300 ± 0.8895 vs. 25.9800 ± 0.8187, t = 12.710, P < 0.0001; and 1.0 μg/ml, 18.3300 ± 0.8895 vs. 24.2900 ± 1.3120, t = 9.902, P < 0.0001; n = 5 per dosage group). SSYX also increased the mRNA and protein expression of PGC-1α (0.25 μg/ml, 0.8892 ± 0.0848 vs. 1.0970 ± 0.0994, t = 4.319, P = 0.0013; 0.5 μg/ml, 0.8892 ± 0.0848 vs. 1.2330 ± 0.0564, t = 7.150, P < 0.0001; and 1.0 μg/ml, 0.8892 ± 0.0848 vs. 1.1640 ± 0.0755, t = 5.720, P < 0.0001; n = 5 per dosage group), AMPK (0.25 μg/ml, 0.8872 ± 0.0779 vs. 1.1500 ± 0.0507, t = 7.239, P < 0.0001; 0.5 μg/ml, 0.8872 ± 0.0779 vs. 1.2280 ± 0.0623, t = 9.379, P < 0.0001; and 1.0 μg/ml, 0.8872 ± 0.0779 vs. 1.3020 ± 0.0450, t = 11.400, P < 0.0001; n = 5 per dosage group), CPT-1 (1.0 μg/ml, 0.7348 ± 0.0594 vs. 0.9880 ± 0.0851, t = 4.994, P = 0.0007, n = 5), and GLUT-4 (0.5 μg/ml, 1.5640 ± 0.0599 vs. 1.7720 ± 0.0660, t = 3.783, P = 0.0117; 1.0 μg/ml, 1.5640 ± 0.0599 vs. 2.0490 ± 0.1280, t = 8.808, P < 0.0001; n = 5 per dosage group). The effect became more obvious with the increasing concentration of SSYX. When 0.5 μg/ml SSYX was added into cells for 0, 6, 12, 24, and 48 h, the expression of AMPK (6 h, 14.6100 ± 0.6205 vs. 16.5200 ± 0.7450, t = 3.456, P = 0.0250; 12 h, 14.6100 ± 0.6205 vs. 18.3200 ± 0.9965, t = 6.720, P < 0.0001; 24 h, 14.6100 ± 0.6205 vs. 21.8800 ± 0.8208, t = 13.160, P < 0.0001; and 48 h, 14.6100 ± 0.6205 vs. 23.7400 ± 1.0970, t = 16.530, P < 0.0001; n = 5 per dosage group), PGC-1α (12 h, 11.4700 ± 0.7252 vs. 16.9000 ± 1.0150, t = 7.910, P < 0.0001; 24 h, 11.4700 ± 0.7252 vs. 20.8800 ± 1.2340, t = 13.710, P < 0.0001; and 48 h, 11.4700 ± 0.7252 vs. 22.0300 ± 1.4180, t = 15.390; n = 5 per dosage group), CPT-1 (24 h, 15.1600 ± 1.0960 vs. 18.5800 ± 0.9049, t = 6.048, P < 0.0001, n = 5), and GLUT-4 (6 h, 10.2100 ± 0.9485 vs. 12.9700 ± 0.8221, t = 4.763, P = 0.0012; 12 h, 10.2100 ± 0.9485 vs. 16.9100 ± 0.8481, t = 11.590, P < 0.0001; 24 h, 10.2100 ± 0.9485 vs. 19.0900 ± 0.9797, t = 15.360, P < 0.0001; and 48 h, 10.2100 ± 0.9485 vs. 14.1900 ± 0.9611, t = 6.877, P < 0.0001; n = 5 per dosage group) mRNA and protein increased gradually with the prolongation of drug action time.

ConclusionsSSYX could increase myocardial energy metabolism in AngII-induced cardiac hypertrophy. Therefore, SSYX might be considered to be an alternative therapeutic remedy for myocardial hypertrophy.

Angiotensin II ; metabolism ; Animals ; Cardiomegaly ; drug therapy ; Energy Metabolism ; Medicine, Chinese Traditional ; Myocardium ; Myocytes, Cardiac ; drug effects ; Rats

Objective To understand the treatment circumstance of ST-elevation myocardial Infarction (STEMI) patients at public hospitals in Shenzhen.Methods Directed by Public Hospital Administration at Shenzhen Municipality (PHASM) and led by Chest Pain Treatment Quality Control Center at Shenzhen People's Hospital (CPTQCC-SZ),25 public hospitals in Shenzhen, including 15 PCI-capable hospitals and 10 non-PCI-capable hospitals,we investigated on the overall treatment conditions and the STEMI patient treatment situations from October to December 2015 in these hospitals. A regression analysis was performed between a few factors and the success rate of STEMI treatment was reviewed. Results 383 STEMI cases twere registered between October to December 2015 in the 25 public hospitals in Shenzhen,with 324 case treated in PCI-capable hospitals and 59 cases in non-PCI-capable hospitals. There were statistical differences between the PCI-capable hospitals and non-PCI-capable hospital in fields of total number of senior cardiologists (work year ≥ 3 year),total number of beds in general cardiology beds and number of beds in cccu(all P<0.01). There was no difference in the time of obtaining the first ECG at patient arrival between hospitals(P=0.052).Time for laboratory results availability for troporin was significantly shorter in PCI-capable hospital[(25.0±4.2)min vs.(58.0±2.8)min,P=0.002] .Among the PCI-capable hospitals,the mean D-to-B time was 320 minutes, and mean F-to-B time was 380 minutes. In non-PCI-capable hospitals,D-to-N time ranged from 20 to 350 minutes and F-to-N time ranged from 25 to 380 minutes. Conclusions There are gaps among the overall conditions of the public hospitals in Shenzhen. The overall conditions and chest pain treatment conditions of non-PCI-capable hospitals had bigger gaps with PCI-capable hospitals.

OBJECTIVE: To evaluate the effect of herceptin(trastuzumab) plus adjuvant chemotherapy on the prognosis of patients with human epithelial growth factor receptor 2 (HER2) positive early-stage breast cancer by Meta-analysis. METHODS: Search all of randomized clinical trials (RCTs) on herceptin plus adjuvant chemotherapy for HER2 positive early-stage breast cancer in MEDLINE, EMBase, Cochrane library, Clinical Trails, ASCO Conference data, CHKD, Wanfang Database, VIP information, scholar.google.com and SIGLE. A Meta-analysis was carried out by collecting information based on the inclusion and exclusion criteria from all papers available. RESULTS: The Meta-analysis included 4 trials. A total of 9116 patients were included in the analysis(4555 in the study group and 4561 in the control group). There were statistical differences between the study group(herceptin plus adjuvant chemotherapy) and the control group(adjuvant chemotherapy) in the disease-free survival rate [relative risk(RR)=1.08, 95% CI, 1.06-1.09, P<0.001], the overall survival rate(RR=1.01, 95% CI, 1.01-1.02, P=0.0003), the distant recurrence rate(RR=0.49, 95% CI, 0.42-0.57, P<0.001), and the cardiac events rate (RR=3.93,95% CI, 1.03-15.06, P=0.05). CONCLUSION Herceptin plus adjuvant chemotherapy can improve the disease-free survival rate and the overall survival rate, decrease distant recurrence rate of patients with HER2 positive early-stage breast cancer, but may cause heart toxicity, especially when combined with anthracycline (doxorubicin).
Antibodies, Monoclonal, Humanized ; therapeutic use ; Breast Neoplasms ; drug therapy ; genetics ; metabolism ; Chemotherapy, Adjuvant ; Female ; Humans ; Prognosis ; Receptor, ErbB-2 ; genetics ; Trastuzumab

OBJECTIVETo investigate the association between the polymorphism of HLA-DQA1 alleles and type 2 diabetes in Yi nationality of Yunnan.

METHODSPolymerase chain reaction with sequence-specific primers (PCR-SSP) genotyping method was conducted in 58 ethnic Yi patients with type 2 diabetes mellitus and 82 ethnically matched controls from Chuxiong of Yunnan. Then a study was made on the association between the polymorphism of HLA-DQA1 alleles and type 2 diabetes mellitus.

RESULTSThe frequency of HLA-DQA1*0301 allele in the patients with type 2 diabetes mellitus was significantly higher than that in the healthy controls (P=0.002, RR=3.097), and the frequency of HLA-DQA1*0601 in the patients was significantly lower (P=0.025, RR=0.429).

CONCLUSIONIn Yi nationality of Yunnan, HLA-DQA1*0301 allele may be a susceptible gene and the HLA-DQA1*0601 allele may protect individuals from the risk of diabetes mellitus.

Adult ; Aged ; Aged, 80 and over ; China ; Diabetes Mellitus, Type 2 ; genetics ; Female ; Genetic Predisposition to Disease ; genetics ; HLA-DQ Antigens ; genetics ; HLA-DQ alpha-Chains ; Humans ; Male ; Middle Aged ; Polymerase Chain Reaction ; Polymorphism, Genetic