1.Mechanism by which IRF1 affects hepatic ischemia-reperfusion injury by regulating the polarization of Kupffer cells
Jingbo YANG ; Hao HUANG ; Feng ZHANG ; Liying SUN ; Liuxin ZHOU ; Haiming ZHANG ; Shipeng LI ; Zhijun ZHU ; Yamin ZHANG
Chinese Journal of Hepatobiliary Surgery 2025;31(4):290-295
Objective:To explore the molecular mechanism by which interferon regulatory factor 1 (IRF1) affects hepatic ischemia-reperfusion injury (HIRI) by regulating the polarization of Kupffer cells.Methods:Twelve male healthy C57BL/6 wild-type mice weighing 20-25 g and aged 6-8 weeks were divided into a sham operation group ( n=6) and a HIRI group ( n=6); Twelve male healthy C57BL/6 IRF1 gene knockout (IRF1 -/-) mice weighing 20-25 g and aged 6-8 weeks were divided into a sham operation IRF1 -/- group ( n=6) and a HIRI IRF1 -/- group ( n=6). The levels of serum alanine transaminase (ALT) and aspartate transaminase (AST) in mice were measured, and hematoxylin-eosin (HE) staining of liver tissues was performed for Suzuki scoring to evaluate liver injury. Fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to evaluate the mRNA levels of IRF1 and tumor necrosis factor α (TNFα) in liver tissues. Flow cytometry and qRT-PCR were used to detect the proportion and functional changes of M1/M2-type Kupffer cells in liver tissues. IRF1 was overexpressed or knocked down in the mononuclear macrophage cell line ANA1, and a co-culture and hypoxia-reoxygenation system with the hepatocyte cell line AML12 was established. Flow cytometry was used to detect the apoptosis of AML12 cells. Results:At 12 hours after hepatic ischemia-reperfusion in wild-type mice, the liver tissue injury was the most severe. Compared with the sham operation group, the levels of serum ALT [(8 073±83) U/L vs. (81±19) U/L, q=13.59] and AST [(11 170±2 890) U/L vs. (412±210) U/L, q=13.77] in the HIRI group were significantly higher, and the differences were statistically significant (both P<0.001). The Suzuki score reached 5-6 points. At 12 hours after hepatic ischemia-reperfusion in IRF1 gene knockout mice, the liver tissue injury was not obvious. There were no significant differences in the levels of serum ALT [668 (514, 2 344) U/L vs. 254 (147, 285) U/L, q=2.52, P=0.348] and AST [1 936 (1 262, 2 003) U/L vs. 628 (423, 759) U/L, q=1.22, P=0.824] between the HIRI IRF1 -/- group and the sham operation IRF1 -/- group. Compared with the HIRI group, the ratio of M1/M2-type Kupffer cells in the liver of the HIRI IRF1 -/- group decreased [(0.958±0.090) vs. (2.788±0.258), q=2.06, P<0.0001], and the mRNA expression of TNFα decreased [(4.363±0.393) vs. (12.900±5.504), q=5.59, P=0.018], and the differences between the two groups were statistically significant. In the co-culture and hypoxia-reoxygenation experiment using ANA1 cells overexpressing IRF1 and AML12 cells, the proportion of AML12 hepatocytes in late apoptosis was higher than that in the control group [(14.05±4.25) vs. (3.15±1.16), t=2.85, P=0.047], and the difference was statistically significant. In contrast, when the expression of IRF1 was knocked down, the proportion of apoptotic AML12 cells decreased [(9.26±3.04) vs. (13.36±4.64), t=2.15, P=0.098], but the difference was not statistically significant. Conclusion:The IRF1 protein can regulate the polarization of Kupffer cells into M1-type macrophages, promote the inflammatory injury of the liver tissue after ischemia-reperfusion, and increase the apoptosis of hepatocytes.
2.Lower limb coordination and variability in children with spastic cerebral palsy during flat ground walking:a vec-tor coding technique study
Chuanyi CHEN ; Liuxin QI ; Aihua LI ; Yan NI ; Wei SUN ; Jiangna WANG
Chinese Journal of Rehabilitation Theory and Practice 2025;31(5):613-620
Objective To quantify the lower limb coordination and coordination variability of children with spastic cerebral palsy(CP)during flat ground walking using vector coding technology.Methods From September to December,2023,eight children with spastic CP(patients)from Ji'nan Rehabilitation Hospi-tal and Ji'nan Special Education School,and eight healthy children(controls)from communities walked on a treadmill at a speed of 0.45 m/s.Lower limb kinematic data were collected using Vicon,a three-dimensional mo-tion capture system.Vector coding technology was used to quantify the temporal and spatial parameters of ipsilat-eral lower limb joints to calculate joint coupling angles and coupling angle variability(CAV).Results In the first and second double support phase,the hip-knee coupling angle was significantly larger in the patients than in the controls(|t|>2.317,P<0.05).In the swing phase,the hip-ankle and knee-ankle coupling angles were significantly larger in the patients(|t|>2.346,P<0.05).In the first double support phase and the single support phase,CAV of the hip-knee and hip-ankle were significantly larger in the patients(|t|>2.454,P<0.05),and they were smaller in the swing phase(t>2.560,P<0.05).In the second double support phase and the swing phase,CAV of the knee-ankle was significantly larger in the patients(|t|>2.909,P<0.05).Conclusion Coordination among hip,knee and ankle joints is poor for children with spastic CP during both the stance and swing phases of walking,and variability is more during the stance phase.
3.The Value of Fitting NRS 2002,CONUT,RDW-SD and ALB in Assessing the Risk of Venous Thromboembolism in Patients with the Pulmonary Tuberculosis Based on Lasso-Logistic Regression Model
Chunjing SHI ; Wenming LI ; Yun LUO ; Huajie ZHANG ; Liuxin HAN ; Yanhong ZHAO ; Longfen LI ; Lingjun SHEN
Journal of Kunming Medical University 2025;46(8):33-42
Objective To evaluate the relationship between nutritional parameters and the risk of venous thromboembolicism(VTE)in patients with tuberculosis so as to identify the risk factors and predictors of thrombosis and assist in the early identification of high-risk factors for VTE in patients with the pulmonary tuberculosis.Methods A total of 323 patients diagnosed with the pulmonary tuberculosis and hospitalized in Kunming Third People's Hospital from August 2021 to August 2023 were collected.According to the VTE risk assessment of non-operative patients,they were divided into the high-risk group and the low-risk group respectively with 116 and 207 in each group.The nutritional indicators with statistically significant differences between the two groups were screened by Lasso regression.Multivariate Logistic regression was used to screen the independent risk factors for high VTE risk in pulmonary tuberculosis patients,and a nomogram prediction model was constructed.The prediction model was evaluated by receiver operating characteristic curve(ROC),calibration curve,decision curve,and influence curve.Results Patients in the high-risk group were significantly older than those in the low-risk group(59 vs.41,P<0.001),hypertension,gender,and Type 2 diabetes did not differ significantly(P values were 0.084,0.724 and 0.488,respectively).9 variables were selected from the inter-group comparison and Lasso regression,including ALB,HCT,NRS2002 scores,HBDH,RDW-SD,RDW-CV,TG,CONUT scores,and NEFA.Multivariate Logistic regression analysis showed that ALB,NRS2002 scores,RDW-SD,and CONUT scores were independent influencing factors for the high risk of VTE scores in patients with tuberculosis(P<0.005).Area under the ROC curve showed that the AUC(0.892)for high-risk VTE scores in patients with the pulmonary tuberculosis was greater than that of ALB(0.803),NRS2002 score(0.735),RDW-SD(0.685),and CONUT score(0.774).Fitting prediction model:Logit(P):Y=0.433×NRS-0.136×ALB+0.411×CONUT score+0.072×RDW-SD-1.770,P=1/(1+e-Y)(Y:prediction index,P:prediction probability).Calibration curve showed that the model prediction tended to be consistent with the actual results(U:>0.05),and the decision curve and influence curve showed that the model can bring clinical benefits.Conclusion ALB,NRS2002 scores,RDW-SD,and CONUT scores are independent influencing factors for the high risk of VTE scores in patients with tuberculosis.They can guide the clinical practice,improve these indicators as soon as possible,reduce VTE scores,and reduce the thrombosis risk.At the same time,the prediction model performs well in the verification cohort,with its discrimination ability,calibration accuracy and clinical utility(decision curve analysis)all reaching a satisfactory level.
4.Characterization of lower limb coordination and cortical activation during walking in adolescents with spastic cerebral palsy
Chinese Journal of Rehabilitation Medicine 2025;40(11):1650-1659
Objective:To investigate the activation characteristics of the cerebral cortex and the coordination characteris-tics of the lower limb joints in adolescents with spastic cerebral palsy during walking,and to provide a theo-retical basis for the rehabilitation training of their gait coordination.Method:A total of eight adolescents aged 12-18 years with spastic cerebral palsy were included as the spas-tic cerebral palsy group and eight normal adolescents aged 12-18 years were included as the control group.Both groups walked on a treadmill at a fixed speed of 0.45 m/s.A Vicon infrared high-speed motion capture system and a functional near-infrared spectroscopy system were applied to collect the kinematic data and hemo-dynamic signals in the sensory-motor cortical region of the two groups while walking on the treadmill.The mean absolute value of the continuous relative phase(MACRP)and the mean of the standard deviation of the relative phase(DP)were calculated to evaluate the coupling coordination characteristics of the lower limb links.The relative concentration change of oxygenated hemoglobin(HbO2)in the cerebral cortex was calculat-ed to evaluate the activation characteristics of the cerebral cortex.Result:①Comparison results of lower limb coordination ability:During walking,the MACRP value of cou-pling coordination of hip-knee joints within the left lower limb of the spastic cerebral palsy group was signifi-cantly smaller than that of the control group(P=0.043,Cohen's d=1.113).The DP value of coupled variability within the limb of the spastic cerebral palsy group was significantly larger than that of the control group for both the hip-knee(P=0.003,Cohen's d=1.755)and knee-ankle(P=0.009,Cohen's d=1.503)joints.②Compari-son results of brain activation levels:Channels 11(P=0.025,Cohen's d=1.258)and 12(P=0.02,Cohen's d=2.310)in the supplementary motor area,channels 6(P=0.043,Cohen's d=1.112),14(P=0.006,Cohen's d=1.633),and 15(P=0.002,Cohen's d=1.886)in the precentral gyrus,channels 6(P=0.043,Cohen's d=1.112),7(P=0.002,Cohen's d=1.837),15(P=0.002,Cohen's d=1.886),and 17(P=0.002,Cohen's d=1.933)in the postcentral gyrus,channels 9(P=0.016,Cohen's d=1.363),10(P=0.045,Cohen's d=1.101)and 18(P=0.001,Cohen's d=2.221)in the superior parietal lobule,the activation levels of the above chan-nels of the spastic cerebral palsy group were significantly greater than those of the control group.Conclusion:During walking,adolescents with spastic cerebral palsy had hyperactivation of the somatosensory-motor cortical area of the brain and an unstable pattern of joint coordination within the lower limbs,with a high degree of variability.
5.Mechanism of sensory neuron TRPV1 desensitization induced by mechanical stimulation to reduce the inflammatory response of synovial fibroblasts in a knee osteoarthritis model
Li ZHANG ; Hua ZHANG ; Ping LI ; Song GAO ; Guangjuan KE ; Liuxin QU
Chinese Journal of Comparative Medicine 2025;35(9):72-81
Objective To construct a model of knee osteoarthritis(KOA)through the co-culture of dorsal root ganglia(DRG)and fibroblast-like synoviocytes(FLSs).To investigate the effects of transient receptor potential vanilloid type 1(TRPV1)desensitization of sensory neurons induced by mechanical stimulation,including the alleviation of the FLSs inflammatory response.Methods DRG neuronal cells were identified through immunofluorescence.The stress loading of DRG neurons was realized using the FX-6000T cell stress system,and the effect of mechanical strain on the activity of DRG neurons was measured using the CCK-8 method.Ca2+ion flux in DRG neurons was studied through flow cytometry.A Transwell chamber and FLSs were used to establish a co-culture system.The contents of the pro-inflammatory factors IL-1β,TNF-α,and TGF-β in the supernatant were determined by ELISA.Gene and protein expression levels of TRPV1 and its desensitizing negative regulatory proteins PP2B,CaM,IL-1β,TNF-α,TGF-β,and α-SMA in DRG neurons were evaluated using RT-qPCR and Western blot,respectively.Results The Ca2+ion flux in DRG neurons increased under inflammatory conditions,and low intensity(sinusoidal,2%,1 Hz,6 h)thumb-pressing-induced mechanical stimulation did not alter Ca2+ion flux(P>0.05).However,middle intensity(sinusoidal,4%,1 Hz,6 h)and high intensity(sinusoidal,8%,1 Hz,6 h)stimulation increased Ca2+ion flux significantly(P<0.05).Notably,high intensity stimulation did not lead to a further increase in Ca2+ion flux over that for middle intensity stimulation(P>0.05).There was no significant effect of low intensity stimulation on TRPV1,PP2B,or CaM gene or protein expression in DRG neurones,on IL-1β,TNF-α,or TGF-βconcentrations in the supernatant of co-cultured cells,or on IL-1β,TNF-α,TGF-β,or α-SMA gene or protein expression in FLSs(P>0.05).Middle and high intensity mechanical stimulation up-regulated TRPV1 at the gene and protein expression levels in DRG neurons in the inflammatory group(P<0.05)but down-regulated PP2B and CaM at the gene and protein expression levels(P<0.05).Middle and high intensity mechanical stimulation decreased IL-1β,TNF-α,and TGF-β levels in the supernatants of co-cultured cells(P<0.05)and decreased the gene and protein expression levels of IL-1β,TNF-α,TGF-β,and α-SMA in FLSs(P<0.05).Conclusions Middle and high intensity thumb-pressing-induced mechanical stimulation induced TRPV1 desensitization of rat sensory neurons,reduced the release of pain mediators,and suppressed the FLSs inflammatory response through downregulating IL-1β,TNF-α,and TGF-β.
6.Characterization of lower limb coordination and cortical activation during walking in adolescents with spastic cerebral palsy
Chinese Journal of Rehabilitation Medicine 2025;40(11):1650-1659
Objective:To investigate the activation characteristics of the cerebral cortex and the coordination characteris-tics of the lower limb joints in adolescents with spastic cerebral palsy during walking,and to provide a theo-retical basis for the rehabilitation training of their gait coordination.Method:A total of eight adolescents aged 12-18 years with spastic cerebral palsy were included as the spas-tic cerebral palsy group and eight normal adolescents aged 12-18 years were included as the control group.Both groups walked on a treadmill at a fixed speed of 0.45 m/s.A Vicon infrared high-speed motion capture system and a functional near-infrared spectroscopy system were applied to collect the kinematic data and hemo-dynamic signals in the sensory-motor cortical region of the two groups while walking on the treadmill.The mean absolute value of the continuous relative phase(MACRP)and the mean of the standard deviation of the relative phase(DP)were calculated to evaluate the coupling coordination characteristics of the lower limb links.The relative concentration change of oxygenated hemoglobin(HbO2)in the cerebral cortex was calculat-ed to evaluate the activation characteristics of the cerebral cortex.Result:①Comparison results of lower limb coordination ability:During walking,the MACRP value of cou-pling coordination of hip-knee joints within the left lower limb of the spastic cerebral palsy group was signifi-cantly smaller than that of the control group(P=0.043,Cohen's d=1.113).The DP value of coupled variability within the limb of the spastic cerebral palsy group was significantly larger than that of the control group for both the hip-knee(P=0.003,Cohen's d=1.755)and knee-ankle(P=0.009,Cohen's d=1.503)joints.②Compari-son results of brain activation levels:Channels 11(P=0.025,Cohen's d=1.258)and 12(P=0.02,Cohen's d=2.310)in the supplementary motor area,channels 6(P=0.043,Cohen's d=1.112),14(P=0.006,Cohen's d=1.633),and 15(P=0.002,Cohen's d=1.886)in the precentral gyrus,channels 6(P=0.043,Cohen's d=1.112),7(P=0.002,Cohen's d=1.837),15(P=0.002,Cohen's d=1.886),and 17(P=0.002,Cohen's d=1.933)in the postcentral gyrus,channels 9(P=0.016,Cohen's d=1.363),10(P=0.045,Cohen's d=1.101)and 18(P=0.001,Cohen's d=2.221)in the superior parietal lobule,the activation levels of the above chan-nels of the spastic cerebral palsy group were significantly greater than those of the control group.Conclusion:During walking,adolescents with spastic cerebral palsy had hyperactivation of the somatosensory-motor cortical area of the brain and an unstable pattern of joint coordination within the lower limbs,with a high degree of variability.
7.Mechanism of sensory neuron TRPV1 desensitization induced by mechanical stimulation to reduce the inflammatory response of synovial fibroblasts in a knee osteoarthritis model
Li ZHANG ; Hua ZHANG ; Ping LI ; Song GAO ; Guangjuan KE ; Liuxin QU
Chinese Journal of Comparative Medicine 2025;35(9):72-81
Objective To construct a model of knee osteoarthritis(KOA)through the co-culture of dorsal root ganglia(DRG)and fibroblast-like synoviocytes(FLSs).To investigate the effects of transient receptor potential vanilloid type 1(TRPV1)desensitization of sensory neurons induced by mechanical stimulation,including the alleviation of the FLSs inflammatory response.Methods DRG neuronal cells were identified through immunofluorescence.The stress loading of DRG neurons was realized using the FX-6000T cell stress system,and the effect of mechanical strain on the activity of DRG neurons was measured using the CCK-8 method.Ca2+ion flux in DRG neurons was studied through flow cytometry.A Transwell chamber and FLSs were used to establish a co-culture system.The contents of the pro-inflammatory factors IL-1β,TNF-α,and TGF-β in the supernatant were determined by ELISA.Gene and protein expression levels of TRPV1 and its desensitizing negative regulatory proteins PP2B,CaM,IL-1β,TNF-α,TGF-β,and α-SMA in DRG neurons were evaluated using RT-qPCR and Western blot,respectively.Results The Ca2+ion flux in DRG neurons increased under inflammatory conditions,and low intensity(sinusoidal,2%,1 Hz,6 h)thumb-pressing-induced mechanical stimulation did not alter Ca2+ion flux(P>0.05).However,middle intensity(sinusoidal,4%,1 Hz,6 h)and high intensity(sinusoidal,8%,1 Hz,6 h)stimulation increased Ca2+ion flux significantly(P<0.05).Notably,high intensity stimulation did not lead to a further increase in Ca2+ion flux over that for middle intensity stimulation(P>0.05).There was no significant effect of low intensity stimulation on TRPV1,PP2B,or CaM gene or protein expression in DRG neurones,on IL-1β,TNF-α,or TGF-βconcentrations in the supernatant of co-cultured cells,or on IL-1β,TNF-α,TGF-β,or α-SMA gene or protein expression in FLSs(P>0.05).Middle and high intensity mechanical stimulation up-regulated TRPV1 at the gene and protein expression levels in DRG neurons in the inflammatory group(P<0.05)but down-regulated PP2B and CaM at the gene and protein expression levels(P<0.05).Middle and high intensity mechanical stimulation decreased IL-1β,TNF-α,and TGF-β levels in the supernatants of co-cultured cells(P<0.05)and decreased the gene and protein expression levels of IL-1β,TNF-α,TGF-β,and α-SMA in FLSs(P<0.05).Conclusions Middle and high intensity thumb-pressing-induced mechanical stimulation induced TRPV1 desensitization of rat sensory neurons,reduced the release of pain mediators,and suppressed the FLSs inflammatory response through downregulating IL-1β,TNF-α,and TGF-β.
8.Lower limb coordination and variability in children with spastic cerebral palsy during flat ground walking:a vec-tor coding technique study
Chuanyi CHEN ; Liuxin QI ; Aihua LI ; Yan NI ; Wei SUN ; Jiangna WANG
Chinese Journal of Rehabilitation Theory and Practice 2025;31(5):613-620
Objective To quantify the lower limb coordination and coordination variability of children with spastic cerebral palsy(CP)during flat ground walking using vector coding technology.Methods From September to December,2023,eight children with spastic CP(patients)from Ji'nan Rehabilitation Hospi-tal and Ji'nan Special Education School,and eight healthy children(controls)from communities walked on a treadmill at a speed of 0.45 m/s.Lower limb kinematic data were collected using Vicon,a three-dimensional mo-tion capture system.Vector coding technology was used to quantify the temporal and spatial parameters of ipsilat-eral lower limb joints to calculate joint coupling angles and coupling angle variability(CAV).Results In the first and second double support phase,the hip-knee coupling angle was significantly larger in the patients than in the controls(|t|>2.317,P<0.05).In the swing phase,the hip-ankle and knee-ankle coupling angles were significantly larger in the patients(|t|>2.346,P<0.05).In the first double support phase and the single support phase,CAV of the hip-knee and hip-ankle were significantly larger in the patients(|t|>2.454,P<0.05),and they were smaller in the swing phase(t>2.560,P<0.05).In the second double support phase and the swing phase,CAV of the knee-ankle was significantly larger in the patients(|t|>2.909,P<0.05).Conclusion Coordination among hip,knee and ankle joints is poor for children with spastic CP during both the stance and swing phases of walking,and variability is more during the stance phase.
9.Mechanism by which IRF1 affects hepatic ischemia-reperfusion injury by regulating the polarization of Kupffer cells
Jingbo YANG ; Hao HUANG ; Feng ZHANG ; Liying SUN ; Liuxin ZHOU ; Haiming ZHANG ; Shipeng LI ; Zhijun ZHU ; Yamin ZHANG
Chinese Journal of Hepatobiliary Surgery 2025;31(4):290-295
Objective:To explore the molecular mechanism by which interferon regulatory factor 1 (IRF1) affects hepatic ischemia-reperfusion injury (HIRI) by regulating the polarization of Kupffer cells.Methods:Twelve male healthy C57BL/6 wild-type mice weighing 20-25 g and aged 6-8 weeks were divided into a sham operation group ( n=6) and a HIRI group ( n=6); Twelve male healthy C57BL/6 IRF1 gene knockout (IRF1 -/-) mice weighing 20-25 g and aged 6-8 weeks were divided into a sham operation IRF1 -/- group ( n=6) and a HIRI IRF1 -/- group ( n=6). The levels of serum alanine transaminase (ALT) and aspartate transaminase (AST) in mice were measured, and hematoxylin-eosin (HE) staining of liver tissues was performed for Suzuki scoring to evaluate liver injury. Fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to evaluate the mRNA levels of IRF1 and tumor necrosis factor α (TNFα) in liver tissues. Flow cytometry and qRT-PCR were used to detect the proportion and functional changes of M1/M2-type Kupffer cells in liver tissues. IRF1 was overexpressed or knocked down in the mononuclear macrophage cell line ANA1, and a co-culture and hypoxia-reoxygenation system with the hepatocyte cell line AML12 was established. Flow cytometry was used to detect the apoptosis of AML12 cells. Results:At 12 hours after hepatic ischemia-reperfusion in wild-type mice, the liver tissue injury was the most severe. Compared with the sham operation group, the levels of serum ALT [(8 073±83) U/L vs. (81±19) U/L, q=13.59] and AST [(11 170±2 890) U/L vs. (412±210) U/L, q=13.77] in the HIRI group were significantly higher, and the differences were statistically significant (both P<0.001). The Suzuki score reached 5-6 points. At 12 hours after hepatic ischemia-reperfusion in IRF1 gene knockout mice, the liver tissue injury was not obvious. There were no significant differences in the levels of serum ALT [668 (514, 2 344) U/L vs. 254 (147, 285) U/L, q=2.52, P=0.348] and AST [1 936 (1 262, 2 003) U/L vs. 628 (423, 759) U/L, q=1.22, P=0.824] between the HIRI IRF1 -/- group and the sham operation IRF1 -/- group. Compared with the HIRI group, the ratio of M1/M2-type Kupffer cells in the liver of the HIRI IRF1 -/- group decreased [(0.958±0.090) vs. (2.788±0.258), q=2.06, P<0.0001], and the mRNA expression of TNFα decreased [(4.363±0.393) vs. (12.900±5.504), q=5.59, P=0.018], and the differences between the two groups were statistically significant. In the co-culture and hypoxia-reoxygenation experiment using ANA1 cells overexpressing IRF1 and AML12 cells, the proportion of AML12 hepatocytes in late apoptosis was higher than that in the control group [(14.05±4.25) vs. (3.15±1.16), t=2.85, P=0.047], and the difference was statistically significant. In contrast, when the expression of IRF1 was knocked down, the proportion of apoptotic AML12 cells decreased [(9.26±3.04) vs. (13.36±4.64), t=2.15, P=0.098], but the difference was not statistically significant. Conclusion:The IRF1 protein can regulate the polarization of Kupffer cells into M1-type macrophages, promote the inflammatory injury of the liver tissue after ischemia-reperfusion, and increase the apoptosis of hepatocytes.
10.Association of stage 1 hypertension defined by the 2017 ACC/AHA guideline with cardiovascular events and mortality in Chinese adults
Qiannan GAO ; Liuxin LI ; Jingjing BAI ; Luyun FAN ; Jiangshan TAN ; Shouling WU ; Jun CAI
Chinese Medical Journal 2024;137(1):63-72
Background::The 2017 American College of Cardiology/American Heart Association (ACC/AHA) blood pressure (BP) guideline lowered the threshold defining hypertension to 130/80 mmHg. However, how stage 1 hypertension defined using this guideline is associated with cardiovascular events in Chinese adults remains unclear. This study assessed the association between stage 1 hypertension defined by the 2017 ACC/AHA guideline and clinical outcomes in the Chinese population.Methods::Participants with stage 1 hypertension ( n = 69,509) or normal BP ( n = 34,142) were followed in this study from 2006/2007 to 2020. Stage 1 hypertension was defined as a systolic blood pressure of 130–139 mmHg or a diastolic blood pressure of 80–89 mmHg. None were taking antihypertensive medication or had a history of myocardial infarction (MI), stroke, or cancer at baseline. The primary outcome was a composite of MI, stroke, and all-cause mortality. The secondary outcomes were individual components of the primary outcome. Cox proportional hazards models were used for the analysis. Results::During a median follow-up of 11.09 years, we observed 10,479 events (MI, n = 995; stroke, n = 3408; all-cause mortality, n = 7094). After multivariable adjustment, the hazard ratios for stage 1 hypertension vs. normal BP were 1.20 (95% confidence interval [CI], 1.13–1.25) for primary outcome, 1.24 (95% CI, 1.05–1.46) for MI, 1.45 (95% CI, 1.33–1.59) for stroke, and 1.11 (95% CI, 1.04–1.17) for all-cause mortality. The hazard ratios for participants with stage 1 hypertension who were prescribed antihypertensive medications compared with those without antihypertensive treatment during the follow-up was 0.90 (95% CI, 0.85–0.96). Conclusions::Using the new definition, Chinese adults with untreated stage 1 hypertension are at higher risk for MI, stroke, and all-cause mortality. This finding may help to validate the new BP classification system in China.

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