1.Cholesterol paradox in the community-living old adults: is higher better?
Sheng-Shu WANG ; Shan-Shan YANG ; Chun-Jiang PAN ; Jian-Hua WANG ; Hao-Wei LI ; Shi-Min CHEN ; Jun-Kai HAO ; Xue-Hang LI ; Rong-Rong LI ; Bo-Yan LI ; Jun-Han YANG ; Yue-Ting SHI ; Huai-Hao LI ; Ying-Hui BAO ; Wen-Chang WANG ; Sheng-Yan DU ; Yao HE ; Chun-Lin LI ; Miao LIU
Journal of Geriatric Cardiology 2023;20(12):837-844
OBJECTIVE:
To evaluate the associations of lipid indicators and mortality in Beijing Elderly Comprehensive Health Cohort Study.
METHODS:
A prospective cohort was conducted based on Beijing Elderly Comprehensive Health Cohort Study with 4499 community older adults. After the baseline survey, the last follow-up was March 31, 2021 with an average 8.13 years of follow-up. Cox proportional hazard model was used to estimate the hazard ratios (HR) with 95% CI for cardiovascular disease (CVD) death and all-cause death in associations with baseline lipid indicators.
RESULTS:
A total of 4499 participants were recruited, and the mean levels of uric acid, body mass index, systolic blood pressure, diastolic blood pressure, fasting plasma glucose, total cholesterol (TC), triglyceride, and low-density lipoprotein cholesterol (LDL-C) showed an upward trend with the increasing remnant cholesterol (RC) quarters (Ptrend < 0.05), while the downward trend was found in high-density lipoprotein cholesterol (HDL-C). During the total 36,596 person-years follow-up, the CVD mortality and all-cause mortality during an average 8.13 years of follow-up was 3.87% (95% CI: 3.30%-4.43%) and 14.83% (95% CI: 13.79%-15.86%) with 174 CVD death participants and 667 all-cause death participants. After adjusting for confounders, the higher level of TC (HR = 0.854, 95% CI: 0.730-0.997), LDL-C (HR = 0.817, 95% CI: 0.680-0.982) and HDL-C (HR = 0.443, 95% CI: 0.271-0.724) were associated with lower risk of CVD death, and the higher level of HDL-C (HR = 0.637, 95% CI: 0.501-0.810) were associated with lower risk of all-cause death. The higher level of RC (HR = 1.276, 95% CI: 1.010-1.613) increase the risk of CVD death. Compared with the normal lipid group, TC ≥ 6.20 mmol/L group and LDL-C ≥ 4.10 mmol/L group were no longer associated with lower risk of CVD death, while RC ≥ 0.80 mmol/L group was still associated with higher risk of CVD death. In normal lipid group, the higher levels of TC, LDL-C and HDL-C were related with lower CVD death.
CONCLUSIONS
In community older adults, higher levels of TC and HDL-C were associated with lower CVD mortality in normal lipid reference range. Higher RC was associated with higher CVD mortality, which may be a better lipid indicator for estimating the CVD death risk in older adults.
2.Relationship Between Metabolic Remodeling of Endothelial Cells and Tumor Angiogenesis Based on "Yin Fire" Theory and Intervention of Chinese Medicine
Yi LI ; Xiaoxiao ZHANG ; Bo PANG ; Baojin HUA ; Zhengtao CHEN ; Xue PAN ; Chuanlong ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(15):165-171
Endothelial cells in the inner wall of blood vessels respond to physical and chemical signals of the body by regulating vascular homeostasis, vascular tension, cell adhesion, cell proliferation, coagulation resistance and inflammatory factors, to maintain the stability of blood vessels. Angiogenesis is the key condition for tumor evolution, and the pathological mode of tumor angiogenesis provides nutrients and oxygen for tumor growth and promotes its proliferation. In recent years, endothelial cells have participated in tumor vascular infiltration and driven angiogenesis, which is considered to be the point link in tumor metastasis. By regulating metabolic remodeling, vascular endothelial cells provide the materials and energy needed in the process of tumor angiogenesis, and their abnormal metabolic characteristics facilitate their adaption to the changes of tumor microenvironment, which is often regarded as an important basis for tumor angiogenesis. The ''Yin fire'' theory in traditional Chinese medicine, originating from Huangdi's Internal Classic (Huang Di Nei Jing), originally meant Yin deficiency generates internal heat, and belonged to the category of fire of internal injury. After the deduction and changes by physicians over the ages, the pathogenesis of ''spleen and stomach Qi deficiency-Yin fire rising-Qi and fire disharmony'' was gradually formed. The pathogenesis of metabolic remodeling of endothelial cells manifests the pathological characterization of Yin fire in an objective way, which is consistent with the disease state of uncontrolled and hyperactive tumor neovascularization. Changes in spleen and stomach Qi deficiency as well as imbalance of Qi movement lead to the failure of water and food in distribution, and thus metabolic disorders occur. Long term retention turns in phlegm and blood stasis, which combat with blood vessels, and result in abnormal local environment (formation of tumor microenvironment), adverse pulse channel (imbalance of endothelial cell metabolism), and tumor neovascularization. Under the guidance of ''Yin fire'' syndrome elements and by focusing on the correlation between Qi and fire, prescriptions are made based on the treatment method of ''strengthening the body and regulating Qi'' to regulate the metabolic function of endothelial cells, thus achieving a relatively balanced state of the body and inhibiting tumor angiogenesis. As a result, this study, centering on the metabolic remodeling of endothelial cells and ''Yin fire'' theory, elucidated the academic ideas, with the purpose of providing some theoretical support for the intervention of tumor vascularization by Chinese medicine.
3.Low- and moderate-volume intracerebral hemorrhage at acute stage treated by Qufeng Tongxuan method: a multicenter, randomized, controlled study
Yan YANG ; Tianzhu LIU ; Houping XU ; Ping LIU ; Li CHEN ; Sijin YANG ; Xue BAI ; Yingjiang GU ; Yinquan YU ; Jingdong HUANG ; Bo WU ; Li LEI ; Jiang YUAN ; Zhou YU ; Kaiquan ZHUO ; Daolin PAN ; Jian LI ; Xiao CHEN ; Qin LUO ; Bille ZHAO
Chinese Journal of Neuromedicine 2023;22(3):240-247
Objective:To verify the clinical efficacy and safety of Qufeng Tongxuan method in treating low- and moderate-volume intracerebral hemorrhage at acute stage.Methods:A prospective, multicenter, randomized, double-blind, placebo-controlled study was performed; patients with low- and moderate-volume intracerebral hemorrhage at the basal ganglia and/or thalamus accepted treatment in 16 hospitals from September 2019 to April 2022 were enrolled. These patients were divided into experimental and control groups with a block randomized method by SAS software. Patients in control group were given conventional western medicine treatment; those in experimental group accepted Qufeng Tongxuan method (sequential therapy of Shexiang Huayu Xingnao granules and Zhilong Huoxue Tongyu granules) besides conventional western medicine treatment. NIHSS was used to assess neurological function before treatment and on 7 th, 14 th, 30 th, and 90 th d of treatment. Prognoses of these patients were assessed by modified Rankin scale (mRS) before treatment and on 180 th d of treatment. Brain CT was performed before treatment and on 7 th and 14 th d of treatment to calculate the hematoma volume. Before treatment and on 14 th d of treatment, changes of coagulation function, liver and kidney functions of the 2 groups were compared. Adverse reactions during treatment in the 2 groups were recorded. Results:No significant differences in NIHSS scores were noted between the 2 groups before treatment, on 7 th, 14 th, and 30 th d of treatment ( P>0.05); NIHSS scores in experimental group on 90 th d of treatment were signficantly lower than those in control group ( P<0.05); NIHSS scores in experimental group decreased gradually before treatment and on 7 th, 14 th, 30 th and 90 th d of treatment, with statistical significances ( P<0.05). No significant differences in mRS scores were noted between the 2 groups before treatment ( P>0.05); mRS scores in experimental group on 180 th d of treatment were signfciantly lower than those in control group ( P<0.05). No significant difference in hematoma volume was noted between the 2 groups before treatment and on 7 th and 14 th d of treatment ( P>0.05); both groups had gradually decreased hematoma volumes before treatment and on 7 th and 14 th d of treatment, respectively, with significant differences ( P<0.05); the volume difference of hematoma between 14 th d of treatment and before treatment in experimental group (6.42[4.10, 11.73]) was significantly higher than that in control group (4.00[1.25, 10.58], P<0.05). No significant differences in liver and kidney function indexes or coagulation function indexes were noted between the 2 groups before treatment and on 14 th d of treatment ( P>0.05). Adverse reaction incidence was 9.52% ( n=12) in experimental group and 10.34% ( n=12) in control group, without statistical difference ( P>0.05). Conclusion:Under premise of conventional western medicine treatment, Qufeng Tongxuan method can promote hematoma absorption and improve neurological deficit symptoms in low- and moderate-volume intracerebral hemorrhage at acute stage, without obvious adverse reactions.
4.Antimicrobial susceptibility of Gram-positive organisms:Results from China antimicrobial resistance surveillance trial(CARST)program,2021-2022
Yun LI ; Bo ZHENG ; Feng XUE ; Xiu-Zhen ZHANG ; Yun-Jian HU ; Yu-Fen JIN ; Jian-Hong ZHAO ; Shi-Yang PAN ; Wei GUO ; Feng ZHAO ; Yun-Song YU ; Xuan CAI ; Wen-En LIU ; De-Hua LIU ; Ying FEI ; Jia-Yun LIU ; Feng-Yan PEI ; Ling MENG ; Ping JI ; Jin TANG ; Kai XU ; Lei ZHU ; Cun-Wei CAO ; He-Ping XU ; Shan WANG ; Lan-Qing CUI ; Jia ZHANG ; Yao-Yao LIU
The Chinese Journal of Clinical Pharmacology 2023;39(23):3509-3524
Objective To investigate the Gram-positive coccus resistance in nationwide's tertiary hospitals and understand the trend of antimicrobial resistance.Methods All the clinical isolates were collected from 19 hospitals and the minimal inhibitory concentrations(MICs)were tested using agar/broth dilution method recommended.Results A total of 1 974 pathogenic Gram-positive coccus from 19 tertiary hospitals in 19 cities nationwide over the period from July 2021 to June 2022 were studied.Based on the MIC results,the prevalence of methicillin resistant Stapylococcus aureus(MRSA)and methicillin resistant Stapylococcus epidermidis(MRSE)were 36.4%and 79.9%respectively.No vancomycin insensitivity Staphylococcus was detected.Staphylococcus aureus were 100%susceptibility to linezolid and teicoplanin.Antibiotic resistance rate of Enterococcus faecalis and Enterococcus faecium to ampicillin were 3.1%and 92.9%.The detectation rate of vancomycin resistant Enterococcus(VRE)was 1.6%.Nonsusceptibility rate of Enterococcus faecalis to linezolid was 32.2%,two consecutive monitoring rises and nonsusceptibility rate of Enterococcus faecium(12.5%)was also significantly increased.The prevalence of penicillin non-susceptible Streptococcus pneumoniae(PNSSP)was 0.8%based on non-meningitis and parenteral administration criterion,decrease of nearly 30 percentage points from the previous surveillance.While for cases of oral penicillin,the rate was 71.8%,showing similar to last time.The results indicated that the number of strains with higher MIC value of penicillin(MIC ≥4 mg·L-1)decreased significantly.There were no significant differences of resistance rates of Stapylococcus aureus,Stapylococcus epidermidis,Enterococcus faecalis,Enterococcus faecium and Streptococcus pneumoniae among various groups such as different department,age,or specimen source.Conclusion VRE detection ratio stablized at a relatively low level.The number of Streptococcus pneumoniae with higher MIC value of penicillin decreased significantly compared with the previous monitoring.The increase of linezolidin-insensitive Enterococcus was noteworthy.
5.Antimicrobial susceptibility of Gram-negative organisms:Results from China antimicrobial resistance surveillance trial(CARST)program,2021-2022
Yun LI ; Bo ZHENG ; Feng XUE ; Xiu-Zhen ZHANG ; Yun-Jian HU ; Yu-Fen JIN ; Jian-Hong ZHAO ; Shi-Yang PAN ; Wei GUO ; Feng ZHAO ; Yun-Song YU ; Xuan CAI ; Wen-En LIU ; De-Hua LIU ; Ying FEI ; Jia-Yun LIU ; Feng-Yan PEI ; Ling MENG ; Ping JI ; Jin TANG ; Kai XU ; Lei ZHU ; Cun-Wei CAO ; He-Ping XU ; Shan WANG ; Lan-Qing CUI ; Jia ZHANG ; Yao-Yao LIU
The Chinese Journal of Clinical Pharmacology 2023;39(23):3525-3544
Objective To investigate the Gram-negative bacteria resistance in nationwide's tertiary hospitals and understand the trend of antimicrobial resistance.Method All the clinical isolates were collected from 19 hospitals and the minimal inhibitory concentrations(MICs)were tested using agar/broth dilution method recommended.Results A total of 4 066 pathogenic isolates from 19 tertiary hospitals in 19 cities nationwide over the period from July 2021 to June 2022 were studied.Based on the MIC results,Escherichia coli and Klebsiella pneumoniae showed extended spectrum β-lactamase(ESBLs)phenotype rates of 55.0%and 21.0%,respectively,ESBLs phenotype rate of Klebsiella pneumoniae keep going down.The ratios of carbapenems resistance Klebsiella pneumoniae increased by 5 percentage points compared with the previous monitoring.Carbapenems,moxalactam,sitafloxacin,β-lactam combination agents,fosfomycin trometamol,and amikacin displayed desirable antibacterial activity against Enterbacterales,susceptibal rates were above 75%.In addition,tigacycline,omacycline,colistin and fluoxefin maintained good antibacterial activity against their respective effective bacteria/species,and the bacterial sensitivity rates by more than 80%.Resistance rates of Pseudomonas aeruginosa and Acinetobacter baumannnii to imipenem were 26.3%and 72.1%and multidrug-resistant(MDR)detection rates were 41.1%and 77.3%,extensively drug-resistant(XDR)were 12.0%and 71.8%,respectively.Comparison of drug resistance rates from different wards,ages and specimen sources indicated that the proportion of resistance in Klebsiella pneumoniae and Acinetobacter baumannii isolated from intensive care unit(ICU)were significantly higher than non-ICU.Carbapenem resistance rates of Klebsiella pneumoniae isolated from ICU were more than 35%.Resistance rates of Haemophilus influenzae isolated in children to β-lactam,macrolide,clindamycin and ESBLs detection rate in Klebsiella pneumoniae isolated from children were more than those from adults and the old people,so bacterial resistance in children is an important problem in China.Conclusion ESBLs detection rate of Escherichia coli increased slightly after years of continuous decline.The proportion of carbapenem resistant Pseudomonas aeruginosa was stable,but the resistance rate of Klebsiella pneumoniae and Acinetobacter baumannii to carbapenems was still increased,which should be paid more attention.
6.MicroRNA-125b Accelerates and Promotes PML-RARa-driven Murine Acute Promyelocytic Leukemia.
Bo GUO ; Ran QIN ; Ji Jun CHEN ; Wen PAN ; Xue Chun LU
Biomedical and Environmental Sciences 2022;35(6):485-493
Objective:
Most acute promyelocytic leukemia cases are characterized by the PML-RARa fusion oncogene and low white cell counts in peripheral blood.
Methods:
Based on the frequent overexpression of miR-125-family miRNAs in acute promyelocytic leukemia, we examined the consequence of this phenomenon by using an inducible mouse model overexpressing human miR-125b.
Results:
MiR-125b expression significantly accelerates PML-RARa-induced leukemogenesis, with the resultant induced leukemia being partially dependent on continued miR-125b overexpression. Interestingly, miR-125b expression led to low peripheral white cell counts to bone marrow blast percentage ratio, confirming the clinical observation in acute promyelocytic leukemia patients.
Conclusion
This study suggests that dysregulated miR-125b expression is actively involved in disease progression and pathophysiology of acute promyelocytic leukemia, indicating that targeting miR-125b may represent a new therapeutic option for acute promyelocytic leukemia.
Animals
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Humans
;
Leukemia, Promyelocytic, Acute/metabolism*
;
Mice
;
MicroRNAs/genetics*
;
Oncogene Proteins, Fusion/therapeutic use*
7.Effect of Fushengong Prescription on Wnt/β-catenin Signaling Pathway in Kidney of Rats with Chronic Renal Failure
Yang ZHANG ; Xue-kuan HUANG ; Qing SHEN ; Pan TONG ; Ke XU ; Hong-yu LUO ; Jia-yu TIAN ; Bo ZOU ; Shi YIN
Chinese Journal of Experimental Traditional Medical Formulae 2020;26(24):89-95
Objective:To observe the effects of Fushengong prescription on secretory glycoprotein (Wnt)/
8.Effect of Mixed Inoculation of Arbuscular Mycorrhizal on Growth and Chemical Composition of Aucklandia lappa Seedlings
Wen-chao GU ; Wen-wu YANG ; Jie ZHANG ; Min YANG ; Bo DING ; Dong-qin GUO ; Xing-jiao PAN ; Yan-bin XUE ; Nong ZHOU
Chinese Journal of Experimental Traditional Medical Formulae 2020;26(14):173-181
Objective:To explore the synergistic effect of arbuscular mycorrhizal(AM) fungi mixed inoculation on the growth,physiological and biochemical characteristics,root biomass and terpenoid component accumulation of
9.Safety and efficacy of regional transport combined with PCI model in patients with STEMI after thrombolysis in northwest China.
Ming BAI ; Chen Liang PAN ; Jing ZHAO ; Cun Rui ZHAO ; Bo ZHANG ; Zhong Yuan MU ; Xiao Xue MENG ; Xing Hu ZHOU ; You Qi ZHU ; Zheng ZHANG
Chinese Journal of Cardiology 2020;48(8):641-647
Objective: To investigate the safety and efficacy of regional transport to percutaneous coronary intervention(PCI) hospitals from non-PCI hospitals after thrombolysis in patients with acute ST-segment elevation myocardial infarction(STEMI) in northwest China. Methods: In this retrospective study, 1 062 STEMI patients who were transferred from non-PCI hospitals within 24 hours from symptom onset, during January 2015 and January 2019 in the First Hospital of Lanzhou University, were included. According to the treatment strategy, they were divided into two groups, namely intravenous thrombolysis combined with PCI group(n=240), and primary PCI group(n=822). Observation endpoint were in-hospital adverse cardiovascular and cerebrovascular events and bleeding events, Including all-cause death, ischemic stroke, malignant arrhythmia, intracranial hemorrhage and hemorrhage with hemoglobin decrease≥50 g/L. Results: A total of 1 062 STEMI patients were included(age was (61±12) years old), with 905 males (85.2%). The proportion of grade 0 TIMI blood flow in the primary PCI group before operation was significantly higher than that in the thrombolysis combined with PCI group(63.0%(518/822) vs. 36.3%(87/240), P<0.001). Compared with primary PCI group, the time from symptom onset to first medical contact(2.11(1.00, 4.00)hours vs.3.00(1.13, 7.07)hours, P<0.001) and reperfusion in thrombolysis combined with PCI group(3.07(1.83, 4.87)hours vs. 6.92(4.07, 11.15) hours, P<0.001) were significantly shorter. The proportion of all-cause death was significantly higher in the primary PCI group than that in the thrombolysis combined with PCI group (1.8%(15/822) vs. 0, P=0.03). There was no significant difference in hemorrhage, ischemic stroke and malignant arrhythmia between the two groups(all P>0.05). Conclusions: For STEMI patients initially hospitalized in non-PCI hospitals, regional transport combined with PCI is feasible and effective. It does not significantly increase the risk of bleeding and cardiovascular and cerebrovascular events, with shorter time from symptom onset to myocardial reperfusion.
Aged
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Angioplasty, Balloon, Coronary
;
China
;
Humans
;
Male
;
Middle Aged
;
Myocardial Infarction
;
Percutaneous Coronary Intervention
;
Retrospective Studies
;
ST Elevation Myocardial Infarction/therapy*
;
Thrombolytic Therapy
;
Treatment Outcome
10.PPARs signaling pathway is involved in diabetic hepatopathy in mice
Kai-Qiang REN ; Lai XUE ; Bo HUANG ; Wen-Jing PAN ; Kun WU ; Qing-Song JIANG
Chinese Journal of Pathophysiology 2018;34(3):555-560
AIM:To investigate the role of peroxisome proliferator-activated receptors(PPARs)-inflammation signaling pathways in diabetic hepatopathy.METHODS:Diabetic mouse model was established by feeding the mice with a high-energy diet for 4 weeks combined with intraperitoneal injection of streptozotocin(STZ;40 mg· kg-1· d-1for 5 d). The hepatopathy model was confirmed by histopathological observation and the indexes of liver function, such as alanine aminotransferase(ALT),aspartate aminotransferase(AST)and alkaline phosphatase(ALP),after another 4 weeks.Mo-reover,fasting blood glucose(FBG), and serum levels of total cholesterol(TC), triglyceride(TG)and insulin were measured,and the HOMA insulin resistance index(HOMA-IR)was calculated.The mRNA and protein expression levels of PPARs and inflammation-related factors were measured by qPCR and Western blot, respectively.RESULTS: After treatment with STZ for 7 d,the FBG of mice exceeded 11.1 mmol/L,suggesting that the diabetic model was established. After 4 weeks,the structural deformation of the hepatocytes(including hepatocytes containing abundant fat vacuoles, and inflammatory cell infiltration),and the increases in the serum levels of insulin,HOMA-IR,TC,TG,ALT,AST and ALP were observed(P<0.01), indicating the occurrence and progression of hepatopathy in diabetic mice.Meanwhile, com-pared with the control group,the mRNA and protein expression of PPARα,PPARβand PPARγdecreased,but the expres-sion of nuclear factor-κB(NF-κB),cyclooxygenase 2(COX-2)and inducible nitric oxide synthase(iNOS)significantly increased in the diabetic hepatopathy mice(P <0.01).CONCLUSION: Down-regulation of PPARα, PPARβand PPARγand activation of NF-κB-COX-2/iNOS signaling pathways may be involved in the diabetic hepatopathy in mice in-duced by long-term high-energy diet feeding combined with intraperitoneal injection of STZ.

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