1.Establishment and Evaluation of New Mouse Model of Rheumatoid Arthritis Combined with Interstitial Lung Disease
Liting XU ; Qingyu ZHAO ; Chao YANG ; Lianhua HE ; Congcong SUN ; Shuangrong GAO ; Lili WANG ; Chunfang LIU ; Na LIN
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(6):81-90
ObjectiveTo establish a mouse model of rheumatoid arthritis with interstitial lung disease (RA-ILD) in DBA/1 mice using Porphyromonas gingivalis (Pg) infection combined with collagen-induced arthritis (CIA), and to comprehensively evaluate pathological characteristics in joints, lungs, and serum. MethodsForty DBA/1 mice were randomly divided into four groups, i.e., Control, Pg infection (Pg), CIA, and Pg infection combined with CIA (Pg+CIA), with 10 mice in each group. Arthritis clinical symptoms were evaluated by recording arthritis incidence and clinical scores. Micro-CT scanning was used to assess knee joint pathology. Histopathological changes and collagen deposition in knee joints and lung tissues were analyzed using hematoxylin-eosin (HE) and Masson staining. Immunohistochemistry was performed to detect protein expression of α-smooth muscle actin (α-SMA), typeⅠ collagen (ColⅠ), and fibronectin (FN) in lung tissues. Real-time quantitative polymerase chain reaction(Real-time PCR)was used to measure mRNA expression levels of α-SMA, ColⅠ, FN, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and IL-1β in lung tissues. Enzyme-linked immunosorbent assay (ELISA) was used to detect serum levels of Pg, cyclic citrullinated peptide (CCP), and immunoglobulin G (IgG). ResultsJoint lesions: The CIA and Pg+CIA groups showed 100% arthritis incidence, with evident joint redness, swelling, and deformity. The number of affected limbs was 27 and 28, and clinical scores were 68 and 70, respectively. No obvious clinical symptoms were observed in the Pg group. Histopathological and imaging analyses showed severe joint lesions in the CIA and Pg+CIA groups, with significantly increased histopathological scores, bone mineral density, bone volume fraction, trabecular thickness, and trabecular number compared to the Control group (P<0.01). No obvious joint pathology was observed in the Pg group. Lung lesions: The Pg+CIA group exhibited marked alveolar inflammation, interstitial inflammatory cell infiltration, and alveolar wall thickening, with pronounced blue staining of collagen fibers. Histopathological scores and collagen area ratios were significantly higher than those of the Control, Pg, and CIA groups (P<0.05). Lung protein and mRNA expression levels of α-SMA, ColⅠ, and FN were markedly increased, and mRNA levels of IL-6, TNF-α, and IL-1β were significantly elevated compared to the Control group (P<0.05). Serology: The Pg+CIA group showed significantly higher levels of CCP, Pg, and IgG compared with the Control, Pg, and CIA groups (P<0.05). ConclusionDBA/1 mice subjected to Pg infection combined with CIA exhibited pronounced symptoms and pathological features of RA-ILD, along with elevated serum anti-CCP antibody levels. This model represents a novel RA-ILD mouse model, providing a valuable experimental tool for investigating RA-ILD pathogenesis and developing new therapeutics, and serves as a basis for establishing anti-cyclic citrullinated peptide antibody (ACPA)-positive RA-ILD animal models.
2.Material Basis of Entada phaseoloides Against Neuropathic Pain Based on in vitro Chemical Profiling and in vivo Absorbed Constituents
Sensen LI ; Hanxue WU ; Yuanbin LI ; Limin ZHAO ; Xiaohui SU ; Hui XIONG ; Weihua MA ; Chao WANG ; Zhaochen MA ; Na LIN
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(18):88-97
ObjectiveTo systematically characterize the in vitro chemical constituents of Entada phaseoloides and its absorbed prototype compounds and metabolites in a neuropathic pain (NP) model, thereby elucidating the potential pharmacological material basis underlying its analgesic activity. MethodsUltra-high-performance liquid chromatography coupled with quadrupole-Orbitrap high-resolution mass spectrometry (UHPLC-Q-Orbitrap HRMS) was used to analyze the constituents of the 80% methanol extract of E. phaseoloides. Thirty-six mice were divided into a blank group, low-, medium-, and high-dose E. phaseoloides extract groups (25, 50, and 100 mg·kg-1, respectively), an aspirin group (400 mg·kg-1), and a morphine group (10 mg·kg-1), with six mice in each group. The tail-flick threshold was measured. Twenty-four mice were randomly divided into a blank group and low-, medium-, and high-dose E. phaseoloides extract groups (25, 50, and 100 mg·kg-1, respectively), with six mice in each group, and motor coordination was evaluated. A spinal nerve ligation (SNL) model was established in mice. Twenty-four mice were randomly divided into a sham-operated (Sham) group, an SNL group, an SNL + E. phaseoloides extract group (750 mg·kg-1), and an SNL + pregabalin group (20 mg·kg-1), with 6 mice in each group. Mechanical allodynia and thermal hyperalgesia were evaluated. Behavioral assessments were combined to determine the optimal onset time of the analgesic effect, and plasma samples were collected at this time point. Absorbed components and metabolites were systematically identified based on accurate mass, MS/MS fragmentation patterns, retention time, and comparisons with literature data and reference standards. Meanwhile, network pharmacology, target similarity analysis, and molecular docking validation were integrated to evaluate the potential effects of absorbed components on disease intervention. ResultsCompared with the blank group, the high-dose E. phaseoloides extract group and morphine group showed significantly increased pain response thresholds (P<0.01), without affecting motor coordination in normal mice. Compared with the Sham group, the SNL group exhibited significantly decreased thresholds for mechanical allodynia and thermal hyperalgesia (P<0.01). Compared with the SNL group, the SNL + E. phaseoloides extract group and SNL + pregabalin group showed significantly increased thresholds for mechanical allodynia and thermal hyperalgesia (P<0.01). The analgesic effect of E. phaseoloides was most significant at 2 h after administration. A total of 70 constituents were identified in vitro, and 22 prototype compounds and 29 metabolites were detected in plasma. The targets of the absorbed components were mainly enriched in biological processes associated with pain signal perception and transmission and showed a high degree of overlap with disease genes related to neuropathic pain. In addition, multiple components exhibited strong binding energies with core pain-related targets. Based on integrated analysis of in vitro content, plasma exposure levels, and target associations, ketanthamide A-β-D-pyranoside and ketengzide were identified as the most representative pharmacologically active substances responsible for the analgesic effect. ConclusionThis study systematically elucidates the material basis of E. phaseoloides intervention in neuropathic pain from three aspects, including chemical constituent characteristics, in vivo behavioral characteristics, and potential targets, providing important theoretical foundations and experimental support for further studies on its pharmacological mechanism and analgesic drug development.
3.Uptake of HIV-related health services among cross-border couples in Dehong Dai and Jingpo Autonomous Prefecture
Runhua YE ; Yuanyuan HAN ; Qunbo ZHOU ; Lin LI ; Yuecheng YANG ; Lifen XIANG ; Renhai TANG ; Jibao WANG ; Yingying DING ; Na HE ; Song DUAN
Shanghai Journal of Preventive Medicine 2026;38(8):614-619
ObjectiveTo investigate the current status of HIV-related health service uptake among cross-border couples (Chinese husbands and Myanmar wives) in Dehong Dai and Jingpo Autonomous Prefecture (hereinafter referred to as Dehong Prefecture), and to provide evidence for optimizing HIV prevention and control strategies in border areas. MethodsA cross-sectional survey was conducted from September 2022 to September 2023 among 14 662 cross-border couples (Chinese husbands and Myanmar wives) in Dehong Prefecture. Data on sociodemographic characteristics, HIV/AIDS knowledge awareness, and utilization of HIV-related health services within the past year were collected. Multivariable logistic regression was used to analyze factors associated with HIV testing uptake among husbands and wives. ResultsA total of 29 324 individuals (14 662 couples) were included. The overall awareness rate of HIV/AIDS was 82.09%, with the rate among husbands significantly higher than that among wives (85.17% vs. 79.01%, P<0.001). Overall, 94.98% of participants had received at least one HIV-related health service, and the HIV testing rate in the past year was 65.52%. Multivariable logistic regression analysis showed that, compared with participants married for 0‒3 years, those married for 4‒10 years and ≥11 years were more likely to have received HIV testing. The corresponding ORs were 1.344 (95%CI: 1.187‒1.521) and 1.381 (95%CI: 1.211‒1.574) among husbands, and 1.308 (95%CI: 1.155‒1.481) and 1.344 (95%CI: 1.178‒1.533) among wives, respectively. Compared with those holding a marriage certificate, those possessing a border marriage registration certificate were positively associated with HIV testing uptake, with ORs of 1.710 (95%CI: 1.575‒1.857) among husbands and 1.700 (95%CI: 1.565‒1.847) among wives. Compared with illiterate participants, those with primary school education showed lower testing rates, with ORs of 0.738 (95%CI: 0.650‒0.837) among husbands and 0.827 (95%CI: 0.766‒0.891) among wives. Additionally, a history of sexually transmitted diseases (OR=3.656, 95%CI: 1.243‒15.589) and participation in the New Rural Cooperative Medical Scheme (OR=1.51, 95%CI: 1.179‒1.935) were independently associated with higher testing rates among husbands. ConclusionThe overall utilization of HIV-related health services among cross-border couples in Dehong Prefecture is satisfactory, but significant gender disparities exist, with foreign wives showing lower rates of knowledge awareness and lower proportions obtaining such knowledge through certain channels compared with their Chinese husbands. Couples with shorter marriage duration, those with primary school education, and those not included in the border marriage registration system are vulnerable groups with lower HIV testing uptake. Future interventions should prioritize cross-border marriage families at the early stage of entry and in the newly married period. Based on the border marriage registration management system and primary healthcare networks, health education and HIV testing services targeting foreign spouses should be strengthened to improve service accessibility and equity.
4.Predictive value of serum IL-17 combined with eotaxin-3 for poor prognosis in patients with acute exacerbation of chronic obstructive pulmonary disease
Na WANG ; Li ZHAI ; Lin ZHANG ; Jungang LYU ; Tiantian CAO ; Qing DAN ; Hui LIU
International Journal of Laboratory Medicine 2025;46(6):752-756
Objective To investigate the predictive value of serum interleukin-17(IL-17)combined with eotaxin-3 for poor prognosis in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 213 patients with AECOPD admitted to Beijing Municipal Armed Police Force Hospital from May 2018 to July 2023 were selected as the disease group.According to the prognosis of patients,they were divided into good prognosis group(133 cases)and poor prognosis group(80 cases).At the same time,205 physical examination healthy people in Beijing Municipal Armed Police Force Hospital were selected as the healthy group.The serum levels of IL-17 and eotaxin-3 were detected by enzyme-linked immu-nosorbent assay.The clinical data of poor prognosis group and good prognosis group were compared.Pearson correlation analysis was used to analyze the correlation between serum IL-17 level and eotaxin-3 in AECOPD patients.Multivariate Logistic regression analysis was used to analyze the related factors affecting the progno-sis of AECOPD patients.The receiver operating characteristic(ROC)curve was used to evaluate the predic-tive value of serum IL-17 and eotaxin-3 levels for the prognosis of AECOPD patients.Results Compared with the healthy group,the serum levels of IL-17 and eotaxin-3 were increased in the disease group(P<0.05).Compared with the good prognosis group,the poor prognosis group had significant increases in serum IL-17 and eotaxin-3 levels(P<0.05).Serum IL-17 level was positively correlated with eotaxin-3 in AECOPD pa-tients(r=0.537,P<0.001).There were significant differences in Global Initiative for Chronic Obstructive Lung Disease(GOLD)grade,blood oxygen partial pressure(PaO2)and carbon dioxide partial pressure(PaCO2)between the poor prognosis group and the good prognosis group(P<0.05).GOLD grade,PaCO2,serum IL-17 and eotaxin-3 levels were risk factors for poor prognosis in patients with AECOPD(P<0.05),and PaO2 was a protective factor for poor prognosis in patients with AECOPD(P<0.05).The area under the curve of serum IL-17 and eotaxin-3 combined to predict the prognosis of AECOPD patients was 0.885,the sensitivity was 80.00%,and the specificity was 83.46%,which was better than that of IL-17 and eotaxin-3 a-lone(Zcombiation-IL-17=4.045,P<0.001,Zcombiation-eotaxin-3=3.254,P=0.001).Conclusion The serum levels of IL-17 and eotaxin-3 are increased in AECOPD patients.The combination of IL-17 and eotaxin-3 has predictive value for the prognosis of AECOPD patients.
5.Experimental animal models for rheumatoid arthritis-associated interstitial lung disease
Qianqian YAN ; Lianhua HE ; Lili WANG ; Liting XU ; Aimin ZHOU ; Chunfang LIU ; Na LIN
Science of Traditional Chinese Medicine 2025;3(2):124-136
Background: Rheumatoid arthritis (RA) is a systemic inflammatory disease primarily affecting the joints of the limbs. As the disease progresses, it can involve multiple organ systems. Interstitial lung disease (ILD) is the most common pulmonary manifestation of RA. Reported animal models of RA-ILD include adjuvant-induced arthritis (AA), collagen-induced arthritis (CIA), and transgenic mouse arthritis. However, the establishment criteria and evaluation methods for these models lack uniform standards, and they fail to fully replicate the clinicopathological characteristics of RA-ILD. This limitation significantly hinders research into the pathogenesis and development of therapeutic drugs for RA-ILD. Objective: The aim of the study was to review literature in China and abroad on RA-ILD animal models, analyze current research progress, identify existing issues, and propose research recommendations. Methods: Literature searches were conducted using the English keywords “rheumatoid arthritis, interstitial lung disease, model” and the Chinese keywords “(rheumatoid arthritis), (interstitial lung disease), (model)” or “(rheumatoid arthritis), (lung interstitial lesions), (model).” The search was performed in PubMed, Web of Science, CNKI, Wanfang Data, and VIP (China Science and Technology Journal Database) for articles published before November 2024. A total of 41 articles were included. Results and conclusions: The CIA model and the CIA model combined with bleomycin are commonly used due to their similarities to the histopathology and disease manifestations of human RA-ILD. Additionally, these models have appropriate cost and modeling duration, along with a high success rate, making them preferable choices. Transgenic animal models exhibit pathological features similar to the nonspecific interstitial pneumonia subtype of human RA-ILD and are useful for studying the genetic effects on RA-ILD. However, they have drawbacks such as high economic costs, long modeling durations, and a low success rate in some cases. The AA model is easy to establish, requires a short modeling period, and has low experimental costs. However, it lacks the chronic pathological development characteristic of human RA and exhibits a degree of self-limitation in lesion progression. Among other models, the comprehensive HLA-DQ8 transgenic mouse model can be used to study the combined effects of genetic and environmental factors on RA-ILD. The collagen autoantibody-induced arthritis model combined with bleomycin has a short modeling period, but it does not align well with the disease course of RA-ILD. These established animal models provide valuable insights into the pathogenesis of RA-ILD, the identification of novel biomarkers, and the development of new therapeutic approaches. Future research should focus on identifying an animal model that better replicates the physiological and pathological changes of clinical RA-ILD while being more convenient, cost-effective, and comprehensive in reflecting disease progression.
6.The effect and bleeding correlation analysis of ultrasound bone knife combined with high-speed gas turbine method in mandibular impacted third molar extraction surgery
Lin SHEN ; Na ZHAO ; Tingting WANG ; Fang ZHANG ; Ming WANG
China Medical Equipment 2025;22(4):79-83
Objective:To explore the effect of ultrasound bone knife combined with high-speed gas turbine method in mandibular impacted third molar extraction surgery,and conduct relevant analysis for bleeding situation.Methods:A total of 152 patients who underwent mandibular impacted third molar extraction surgery at Beijing First Hospital of Integrated Traditional Chinese and Western Medicine from April 2023 to April 2024 were retrospectively selected.They were divided into an observation group and a control group based on the different types of used instruments during the operation,with 76 cases in each group.The observation group used ultrasound bone knife combined with high-speed gas turbine method,while the control group only used high-speed gas turbine.The general information,incidence of intraoperative complications,surgical time,visual analogue scale(VAS)for pain assessment,degree of alveolar damage,patient's satisfaction,the number of patients with postoperative complications,intraoperative bleeding volume,postoperative bleeding time,and hemostatic effect were compared between two groups.Results:The incidence of complications included loosening of adjacent tooth,fracture or displacement of adjacent tooth,root fracture,and fracture of lingual bone plate in the observation group was 11.84%,which was lower than 23.68%in the control group,and the difference was statistically significant(x2=3.958,P<0.05).Both the surgical time and VAS score of the observation group were lower than those of the control group(t=-7.875,-3.222,P<0.05),and the degree of alveolar damage and the number of patients with postoperative complications in the observation group were significantly lower than those in the control group,with statistically significant differences(t=-6.500,x2=4.417,P<0.05).The average score of patients'treatment satisfaction in the observation group was significantly higher than that in the control group(t=4.242,P<0.05).Both the intraoperatively blooding loss and the time of postoperative bleeding in the observation group were significantly lower than those in the control group(t=-3.636,-9.191,P<0.001),and the score of hemostasis effect in the observation group was also better than that in the control group(t=11.744,P<0.001).Conclusion:The effect of ultrasound bone knife combined with high-speed gas turbine method is better for mandibular impacted third molar extraction surgery,which performance is better in the amount of intraoperative bleeding loss,the time of postoperative bleeding,and hemostatic effect.
7.Ultrasonic manifestations of Ewing sarcoma in children
Na XU ; Ziyi WANG ; Luyao ZHOU ; Zhou LIN ; Xia FENG ; Haonan ZHAI ; Xiuli YUAN ; Youping WANG ; Wei SHI
Chinese Journal of Medical Imaging Technology 2025;41(4):646-650
Objective To observe conventional ultrasound and contrast-enhanced ultrasound(CEUS)manifestations of Ewing sarcoma(ES)in children.Methods Fifteen children with pathologically confirmed ES were retrospectively collected.Conventional ultrasound and CEUS characteristics of lesions were analyzed.Results Among 15 cases,ES of bone(ESB)was found in 7 cases,while extraskeletal ES(EES)was observed in the other 8 cases.Solitary tumor was noticed in 14 cases,with a median maximum diameter of 7.50 cm,while multiple abdominal masses were found in 1 case.The tumors had irregular shapes and poorly defined boundaries,with medium echogenicity in 7 cases,low echogenicity in 6 cases,while in other 2 cases present as cystic-solid lesions.CDFI showed sparse blood flow in 11 cases,abundant or slightly abundant blood flow in 2 and 1 case,respectively,while no obvious blood flow was observed in 1 case.Rapid high enhancement and rapid washout were found in all 7 cases underwent CEUS,while patchy no-enhancement areas were detected in 4 cases.Conclusion Conventional ultrasonic manifestations of ES had certain specificities,which demonstrated a rapid enhancement and rapid washout pattern during CEUS and may be accompanied by necrosis.
8.Mass Spectrometry-based Quantitative Metabolomics Analysis for Uncovering Metabolic Features in Myocardial Infarction Rats
Dan-Yang YU ; Zi-Lin XIA ; Na WANG ; Hao WU ; Lun-Zhao YI
Chinese Journal of Analytical Chemistry 2025;53(8):1311-1319,中插23-中插87
A quantitative analytical method was established for 275 kinds of metabolites in plasma based on ultra-high performance liquid chromatography-triple quadrupole mass spectrometry/multiple reaction monitoring-selected ion monitoring(UHPLC-QQQ-MS/MRM-SIM)technique.Based on UHPLC-high resolution(HRMS)/full MS-parallel reaction monitoring(PRM)technique,165 kinds of lipid metabolites in plasma were qualitatively identified and quantitatively detected to address the analytical challenges of lipid isomers.This quantitative metabolomics approach was successfully applied to a rat myocardial infarction study,identifying and quantifying 372 kinds of metabolites in total.Comparative analysis with the sham-operated group revealed significant alterations in 59 kinds of plasma metabolites in myocardial infarction rats.Key metabolic pathways,which included amino acid metabolism(alanine,aspartate,and glutamate metabolism;glycine,serine,and threonine metabolism,etc.),one-carbon unit metabolism,and tricarboxylic acid cycle,were significantly disrupted.
9.Effects of Hot Night Exposure on Human Semen Quality: A Multicenter Population-Based Study.
Ting Ting DAI ; Ting XU ; Qi Ling WANG ; Hao Bo NI ; Chun Ying SONG ; Yu Shan LI ; Fu Ping LI ; Tian Qing MENG ; Hui Qiang SHENG ; Ling Xi WANG ; Xiao Yan CAI ; Li Na XIAO ; Xiao Lin YU ; Qing Hui ZENG ; Pi GUO ; Xin Zong ZHANG
Biomedical and Environmental Sciences 2025;38(2):178-193
OBJECTIVE:
To explore and quantify the association of hot night exposure during the sperm development period (0-90 lag days) with semen quality.
METHODS:
A total of 6,640 male sperm donors from 6 human sperm banks in China during 2014-2020 were recruited in this multicenter study. Two indices (i.e., hot night excess [HNE] and hot night duration [HND]) were used to estimate the heat intensity and duration during nighttime. Linear mixed models were used to examine the association between hot nights and semen quality parameters.
RESULTS:
The exposure-response relationship revealed that HNE and HND during 0-90 days before semen collection had a significantly inverse association with sperm motility. Specifically, a 1 °C increase in HNE was associated with decreased sperm progressive motility of 0.0090 (95% confidence interval [ CI]: -0.0147, -0.0033) and decreased total motility of 0.0094 (95% CI: -0.0160, -0.0029). HND was significantly associated with reduced sperm progressive motility and total motility of 0.0021 (95% CI: -0.0040, -0.0003) and 0.0023 (95% CI: -0.0043, -0.0002), respectively. Consistent results were observed at different temperature thresholds on hot nights.
CONCLUSION
Our findings highlight the need to mitigate nocturnal heat exposure during spermatogenesis to maintain optimal semen quality.
Humans
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Male
;
Semen Analysis
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Adult
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Sperm Motility
;
Hot Temperature/adverse effects*
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China
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Middle Aged
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Spermatozoa/physiology*
;
Young Adult
10.Prevalence and associates of hyperuricemia in middle- and older-aged populations of islands and mountainous areas in Taizhou City of Zhejiang Province
Yihang GAO ; Tingting WANG ; Tailin CHEN ; Yali XIE ; Yating WANG ; Shanling WANG ; Liangyou WANG ; Haijiang LIN ; Na HE
Chinese Journal of Epidemiology 2025;46(2):226-231
Objective:To determine the prevalence and associates of hyperuricemia (HUA) among the middle- and older-aged population of the island and mountainous areas in Taizhou City of Zhejiang Province.Methods:A cross-sectional study was conducted on individuals aged 45 and above in the island and mountainous area of Taizhou City. The study included questionnaires, physical examinations, and laboratory tests. Data were primarily collected on sociodemographic characteristics, chronic disease history, lifestyle factors, waist circumference, blood pressure, and serum uric acid levels. The association between hyperuricemia and these factors was analyzed by logistic regression.Results:A total of 971 individuals were included in the study, comprising 468 from island and 503 from mountainous area. The prevalence of hyperuricemia was 17.9%, with a significantly higher prevalence in the island area (25.6%) compared to the mountainous area (10.7%). Stratified by gender and age, differences in the prevalence of hyperuricemia between island and mountainous areas were observed in males aged 55 to 64, females aged 45 to 54, 55 to 64, 75 and above (all P<0.05). Multiple logistic regression analysis showed that high intake of sea food (>3 times/week) was positively associated with hyperuricemia ( OR=2.10, 95% CI:1.33-3.34). Furthermore, separate regionally stratified logistic regression analyses showed that in the island area, male gender ( OR=3.15, 95% CI:1.78-5.66), central obesity ( OR=2.38, 95% CI:1.46-3.93), and hypertriglyceridemia ( OR=2.00, 95% CI:1.22-3.30) were positively correlated with hyperuricemia (all P<0.05). In the mountainous area, the age group of 65 and above ( OR=3.50, 95% CI:1.09-12.50), male ( OR=6.79, 95% CI:2.87-17.81), those employed in enterprises and institutions ( OR=6.57, 95% CI:1.92-23.73) and hypertension ( OR=3.68, 95% CI:1.66-8.87) were positively correlated with hyperuricemia (all P<0.05). Conclusions:The prevalence of hyperuricemia among the middle- and older-aged population in the island of Taizhou City is significantly higher than that in the mountainous areas. Targeted comprehensive behavioral interventions such as routine screening of chronic diseases, low-fat diet, alcohol control, reduced seafood intake, enhanced exercise, weight management, and blood pressure control are warranted.

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