Objective:To identify the trajectories of dietary choline intake in middle-aged and older population, and to analyze its longitudinal association with cognitive function.Methods:Subjects aged 55 to 79 years with at least two rounds of completed population economics, lifestyle, disease history, cognitive function, dietary assessments and physical measurements in 1997-2018 and those with at least three rounds of dietary measures in 1991-2015 were selected from the China Health and Nutrition Survey. Dietary survey was conducted using three consecutive 24-hour dietary recalls combined with a weighing inventory at the household level. Cognitive assessment was performed using part of the Telephone Interview for Cognitive Status Scale. Group-based univariate trajectory modeling was used to identify trajectory of choline intake, and three-level linear mixed-effects models or three-level logistic mixed-effects models was employed to analyze the relationship between trajectory groups and cognitive function. Subgroup analyses were conducted by gender and age at baseline.Results:Four trajectories of dietary choline intake were identified in the whole population, named as low-intake-stable group (61.0%), medium-intake-stable group (23.9%), medium-intake-slowly-declined group (11.2%), and high-intake-stable group (3.9%). Three trajectories were identified for each subgroup. Low-intake-stable group accounted for more than 60% in total population as well as each subgroup, especially in women and 55-59 years group. After adjusting for covariates, global cognitive scores were 0.54 (95% CI: 0.26-0.82), 0.77 (95% CI: 0.36-1.18), and 0.85 (95% CI: 0.21-1.48) points higher in medium-intake-stable, medium-intake- slowly-declined and high-intake-stable groups in the whole population, respectively, compared with the low-intake-stable group. The likelihoods of cognitive decline were 18.4% ( OR=0.816,95% CI: 0.709-0.939), 17.6% ( OR=0.824, 95% CI: 0.680-0.998), 24.4% ( OR=0.756, 95% CI: 0.589-0.970) and 22.4% ( OR=0.776,95% CI: 0.623-0.968) lower in medium-intake-stable group of dietary choline in the whole population, medium-intake-stable group in males, medium-intake-slightly-increased group in females and medium-intake-slowly-increased group in 55-59 years at baseline than in low-intake-stable group, respectively. Conclusions:Dietary choline intake is generally lower in the Chinese population aged 55-79 years. Long-term lower choline intake has a negative impact on cognitive function in middle-aged and older adults and may increase the risk of cognitive decline. The increment in the consumption of choline-enriched foods should be recommended.

BACKGROUND: The available evidence regarding the benefits of percutaneous coronary intervention (PCI) on patients receiving dialysis with coronary artery disease (CAD) is limited and inconsistent. This study aimed to evaluate the association between PCI and clinical outcomes as compared with medical therapy alone in patients undergoing dialysis with CAD in China. METHODS: This multicenter, retrospective study was conducted in 30 tertiary medical centers across 12 provinces in China from January 2015 to June 2021 to include patients on dialysis with CAD. The primary outcome was major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke. Secondary outcomes included all-cause death, the individual components of MACE, and Bleeding Academic Research Consortium criteria types 2, 3, or 5 bleeding. Multivariable Cox proportional hazard models were used to assess the association between PCI and outcomes. Inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were performed to account for potential between-group differences. RESULTS: Of the 1146 patients on dialysis with significant CAD, 821 (71.6%) underwent PCI. After a median follow-up of 23.0 months, PCI was associated with a 43.0% significantly lower risk for MACE (33.9% [ n  = 278] vs . 43.7% [ n  = 142]; adjusted hazards ratio 0.57, 95% confidence interval 0.45-0.71), along with a slightly increased risk for bleeding outcomes that did not reach statistical significance (11.1% vs . 8.3%; adjusted hazards ratio 1.31, 95% confidence interval, 0.82-2.11). Furthermore, PCI was associated with a significant reduction in all-cause and cardiovascular mortalities. Subgroup analysis did not modify the association of PCI with patient outcomes. These primary findings were consistent across IPTW, PSM, and competing risk analyses. CONCLUSION This study indicated that PCI in patients on dialysis with CAD was significantly associated with lower MACE and mortality when comparing with those with medical therapy alone, albeit with a slightly increased risk for bleeding events that did not reach statistical significance.
Humans ; Percutaneous Coronary Intervention/methods* ; Male ; Female ; Coronary Artery Disease/drug therapy* ; Retrospective Studies ; Renal Dialysis/methods* ; Middle Aged ; Aged ; China ; Proportional Hazards Models ; Treatment Outcome

Objective To investigate the role and molecular mechanism of ginsenoside Rb1(Rb1)in regulating neutrophil extracellular trapping networks(NETs)to intervene in atherosclerosis(AS).Methods In vivo:an AS model was constructed with ApoE knockout mice superimposed on a high-fat diet.The pathological and morphological changes of aortic root plaques were observed by HE staining and oil red O staining;Immunofluorescence labelling of neutrophils citrullinated histones(Cit-H3)and macrophages as well as IL-1β at the aortic root plaque site were used to assess the inflammatory infiltration.In vitro:NETs induced by PMA and cholesterol crystals were taken as models respectively.Direct effect of Rb1 against NETs formation assessed by Sytox staining and immunofluorescence staining with Cit-H3 and myeloperoxidase.Rb1 on ROS levels was assessed by DCFH-DA.Rb1 on histone H3 citrulline modification was assessed by Western blotting.Results In vivo:Rb1 significantly inhibited plaque formation,lipid deposition(P<0.05)and intra-plaque inflammatory infiltration(P<0.05).In vitro:Rb1 significantly inhibited NETs formation(P<0.05),neutrophil ROS levels(P<0.05),and Cit-H3 levels(P<0.05).Conclusions Rb1 significantly inhibited AS progression by inhibiting plaque NETs formation,which may be partly through the inhibition of histone H3 citrullination resulting from activation of the neutrophil oxidative stress pathway.

Objective:To identify the trajectories of dietary choline intake in middle-aged and older population, and to analyze its longitudinal association with cognitive function.Methods:Subjects aged 55 to 79 years with at least two rounds of completed population economics, lifestyle, disease history, cognitive function, dietary assessments and physical measurements in 1997-2018 and those with at least three rounds of dietary measures in 1991-2015 were selected from the China Health and Nutrition Survey. Dietary survey was conducted using three consecutive 24-hour dietary recalls combined with a weighing inventory at the household level. Cognitive assessment was performed using part of the Telephone Interview for Cognitive Status Scale. Group-based univariate trajectory modeling was used to identify trajectory of choline intake, and three-level linear mixed-effects models or three-level logistic mixed-effects models was employed to analyze the relationship between trajectory groups and cognitive function. Subgroup analyses were conducted by gender and age at baseline.Results:Four trajectories of dietary choline intake were identified in the whole population, named as low-intake-stable group (61.0%), medium-intake-stable group (23.9%), medium-intake-slowly-declined group (11.2%), and high-intake-stable group (3.9%). Three trajectories were identified for each subgroup. Low-intake-stable group accounted for more than 60% in total population as well as each subgroup, especially in women and 55-59 years group. After adjusting for covariates, global cognitive scores were 0.54 (95% CI: 0.26-0.82), 0.77 (95% CI: 0.36-1.18), and 0.85 (95% CI: 0.21-1.48) points higher in medium-intake-stable, medium-intake- slowly-declined and high-intake-stable groups in the whole population, respectively, compared with the low-intake-stable group. The likelihoods of cognitive decline were 18.4% ( OR=0.816,95% CI: 0.709-0.939), 17.6% ( OR=0.824, 95% CI: 0.680-0.998), 24.4% ( OR=0.756, 95% CI: 0.589-0.970) and 22.4% ( OR=0.776,95% CI: 0.623-0.968) lower in medium-intake-stable group of dietary choline in the whole population, medium-intake-stable group in males, medium-intake-slightly-increased group in females and medium-intake-slowly-increased group in 55-59 years at baseline than in low-intake-stable group, respectively. Conclusions:Dietary choline intake is generally lower in the Chinese population aged 55-79 years. Long-term lower choline intake has a negative impact on cognitive function in middle-aged and older adults and may increase the risk of cognitive decline. The increment in the consumption of choline-enriched foods should be recommended.

Objective To investigate the role and molecular mechanism of ginsenoside Rb1(Rb1)in regulating neutrophil extracellular trapping networks(NETs)to intervene in atherosclerosis(AS).Methods In vivo:an AS model was constructed with ApoE knockout mice superimposed on a high-fat diet.The pathological and morphological changes of aortic root plaques were observed by HE staining and oil red O staining;Immunofluorescence labelling of neutrophils citrullinated histones(Cit-H3)and macrophages as well as IL-1β at the aortic root plaque site were used to assess the inflammatory infiltration.In vitro:NETs induced by PMA and cholesterol crystals were taken as models respectively.Direct effect of Rb1 against NETs formation assessed by Sytox staining and immunofluorescence staining with Cit-H3 and myeloperoxidase.Rb1 on ROS levels was assessed by DCFH-DA.Rb1 on histone H3 citrulline modification was assessed by Western blotting.Results In vivo:Rb1 significantly inhibited plaque formation,lipid deposition(P<0.05)and intra-plaque inflammatory infiltration(P<0.05).In vitro:Rb1 significantly inhibited NETs formation(P<0.05),neutrophil ROS levels(P<0.05),and Cit-H3 levels(P<0.05).Conclusions Rb1 significantly inhibited AS progression by inhibiting plaque NETs formation,which may be partly through the inhibition of histone H3 citrullination resulting from activation of the neutrophil oxidative stress pathway.

Objective:To investigate the effect of astragaloside A (AS-A) on the photoreceptor degeneration induced by sodium iodate (NaIO 3) and its related mechanism. Methods:Sixty healthy male C57BL/6J mice, aged 6-8 weeks, were randomly divided into normal control (NC) group, NaIO 3 group, and ASA group, with twenty mice in each group. 30 min before modeling, AS-A group mice were intraperitoneally injected with 100 μl AS-A at a dose of 100 mg/kg body weight. 30 min later, mice in NaIO 3 group and AS-A group were intraperitoneally injected with 100 μl NaIO 3 at a dose of 30 mg/kg body weight. Subsequently, AS-A group mice were administered AS-A twice daily at 12 h intervals until the end of the experiment. On day 1 post-modeling, zonula occludens-1 (ZO-1) immunohistochemistry was performed to observe the structure of retinal pigment epithelium (RPE) cells; real-time quantitative polymerase chain reaction (qPCR) was conducted to detect the mRNA expression of various retinal chemokine ligand-2 ( Ccl2), interleukin-1 beta ( Il-1β), mixed lineage kinase domain-like protein ( Mlkl), receptor-interacting protein kinase 3 ( Ripk3), and tumor necrosis factor ( Tnf). On day 3 post-modeling, immunohistochemistry was performed to observe the expression of ionized calcium binding adaptor molecule 1 (Iba1) and glial fibrillary acid protein (GFAP) in the retina; TdT-mediated dUTP nick-end labeling (TUNEL) assay was used to detect photoreceptor cell death in each group. On day 4 post-modeling, fundus morphology of mice in each group was observed by fundus color photography and optical coherence tomography (OCT). Hematoxylin-eosin staining (HE) was used to observe the morphological structure of the retina in each group. Inter-group comparisons between two groups were conducted using independent samples t-test, while comparisons among three groups were performed using one-way ANOVA. Results:Fundus color photography and OCT examination showed that a large number of scattered yellow-white subretinal nodular structures in the fundus of NaIO 3 group mice, and a large number of strong reflection areas in the RPE layer. The number of strong reflection areas in the RPE layer was reduced in the AS-A group. Immunohistochemical analysis of ZO-1 showed that ZO-1 was largely lost on the RPE cell membrane in that NaIO 3 group; whereas in the AS-A group, ZO-1 was evenly distributed on the RPE cell membrane. HE staining results showed circular black deposits were visible in the RPE layer of the NaIO 3 group, and the inner and outer segments of photoreceptors were severely damaged, with a significant decrease in the number of outer nuclear layer (ONL) cell nuclei; whereas in the AS-A group, the RPE layer pigments were orderly, the inner and outer segments of photoreceptors were intact, and the number of ONL cell nuclei significantly increased. The results of TUNEL staining show that numerous TUNEL-positive cell nuclei were observed in the ONL of the retina in the NaIO 3 group, while the number of TUNEL-positive cell nuclei in the ONL of the retina was significantly reduced in the AS-A group, with statistically significant differences ( t=2.66, P<0.05). The analysis of qPCR data showed that compared with the AS-A group, the relative expression levels of Mlkl, Ripk3, Ccl2, Il-1β and Tnf mRNA in the retina were significantly increased in the NaIO 3 group, with statistically significant differences ( F=39.18, 10.66, 53.51, 41.40, 24.13; P<0.001). Immunohistochemical staining results showed that compared with NC group and AS-A group, the positive expression of GFAP in retina of NaIO 3 group was significantly increased, and the difference was statistically significant ( F=9.62, P<0.05). Conclusion:AS-A antagonizes NaIO 3-induced photoreceptor degeneration in part by inhibiting photoreceptor cell death and neuroinflammation. Meanwhile, AS-A treatment protects against NaIO 3-triggered perturbation of retinal homeostasis.

Objective:To investigate the effect of cathodic transcranial direct current stimulation (ctDCS) combined with upper limb robot therapy (RT) on the rehabilitation of upper limb motor function in stroke patients.Methods:Forty patients with stroke hemiplegia who met the enrollment criteria were randomly divided into a pseudo-stimulation group ( n = 20) and a stimulation group ( n = 20). In addition to conventional treatment in both groups, ctDCS + RT was used in the stimulation group, and sham stimulation + RT was used in the sham-stimulation group. Treatment was performed 10 times, 5 times per week, for 30 minutes each time. Patients in both groups were evaluated before, during, and after treatment using the Brunnstrom Staging Scale, the Modified Barthel Index (MBI) scale, and the Modified Ashworth Scale (MAS), respectively. Results:Compared with the same group before treatment, there were statistically significant differences in Brunnstrom’s rating grade Ⅳ for upper limbs and hands in both groups during and after treatment (all P < 0.05). Compared with the same group during treatment, there were statistically significant differences in Brunnstrom’s rating grade Ⅳ for upper limbs and hands in both groups after treatment (all P < 0.05). MBI scores were higher in two groups during and after treatment compared to the same group before treatment (all P < 0.05). MBI scores were higher in two groups after treatment compared to the same group during treatment (all P < 0.05). The MBI scores after treatment in the stimulation group were higher than those in the pseudo-stimulation group ( P < 0.05). The MAS scores of elbow flexion grade 2 and extension grade 4 and shoulder flexion grade 2, extension grade 2, adduction grade 2, and abduction grade 2 were lower in both groups after treatment compared with the same group before treatment (all P < 0.05). Conclusions:Cathodic transcranial direct current stimulation combined with robotic therapy can effectively promote upper limb motor function rehabilitation in stroke patients and is superior to upper limb robotic therapy alone.

Objective:To investigate the effect of transcranial direct current stimulation (tDCS) on the behavior and the mismatch negativity (MMN) component of the auditory evoked potential of autistic children.Methods:Thirty-four autistic children were randomly divided into an anode stimulation group ( n=19) and a pseudo-stimulation group ( n=16). Both groups were given one hour of routine rehabilitation five times a week for 4 weeks, while the anode stimulation group was additionally provided with 20 minutes of tDCS 3 times a week. Before and after the treatment, both groups′ behavior was evaluated by using autism behavior checklist (ABC) as well as any changes in MMN of the auditory evoked EEG signals. Results:There were no significant differences between the two groups in any of the measurements before the treatment. Afterwards behavior had improved significantly in both groups, with significantly greater improvement in the stimulated group. In the stimulated group the average MMN amplitude had increased significantly and the average latency had decreased significantly. However, no such significant changes were observed in the pseudo-stimulation group. There was a significant linear correlation between the changes in the incubation period of MMN components and the improvements in ABC, vestibular functioning, tactile defense and proprioception.Conclusion:Anodal tDCS combined with conventional rehabilitation therapy can effectively increase the MMN amplitude and shorten the latency in autistic children, improving their brain function.

Objective To evaluate the effect of isokinetic muscle training combined with semiconductor laser on acute knee osteoarthritis (KOA). Methods Ninety-eight KOA patients were randomly divided into 4 groups. All patients were treated with conventional rehabilitation treatment and nursing. Based on that treatment, the group 1 received semiconductor laser irradiation, the group 2 received isokinetic muscle training, and the group 3 received laser irradiation combined with isokinetic muscle training. All patients were assessed with WOMAC osteoarthritis rating scale and affected knee extensor and flexor muscles strength measurement including peak torque, peak work, average power, average work and flex/extend before and 4 weeks after the treatment. Results All of the four treatments can significantly alleviate the condition of acute KOA patients and improve the muscle condition around the ipsilateral knee joint. The isokinetic muscle training improves the knee function of KOA patients better than the laser irradiation treatment. Isokinetic strength training combined with laser irradiation can get the most significant improvement of knee joint pain, stiffness, dysfunction, muscle strength of flexors and extensors in KOA patients. Conclusions The combination of isokinetic muscle training and semiconductor laser irradiation has a significant effect on relieving pain, reducing the stiffness, improving the function of knee of the patients with KOA in the acute phase and improving the muscle strength of the affected lower extremities. That methad is superior to drug therapy, physical therapy, or exercise alone, and is better to solve the problem of relieving symptoms and enhancing function simultaneously.

The upper limb dysfunction after stroke has a high incidence,and is difficult to recovery,which seriously affects the patients' activities of daily living and the quality of life.Scholars have been exploring new and effective rehabilitation strategies for upper limb dysfunction after stroke.Transcranial direct current stimulation (tDCS),a typical form of non-invasive brain stimulation,is widely used in upper limb function rehabilitation by modulating the excitability of the cerebral cortex to improve motion performance.Some results showed that tDCS combined with repetitive rehabilitation training can significantly improve the motion function of stroke patients.Robotic therapy (RT) provides high-intensity,repetitive motion therapy that meets the training needs of patients at different levels.Therefore,tDCS combined with RT can effectively enhance the upper limb function rehabilitation effect of stroke patients.In this paper,the research status of tDCS combined with RT in the treatment of upper limb function after stroke were reviewed such as target patients,treatment methods,rehabilitation effects,combination methods,etc.The research trends and future development ideas in this field were discussed.