Objective:To evaluate the diagnostic value of gene testing in familial hypercholesterolemia (FH) in patients with premature myocardial infarction(PMI).Methods:This study was a single center cross-sectional study. A retrospective analysis was made on PMI patients who visited the People′s Hospital of Peking University from May 1, 2015 to March 31, 2017. Clinical data of patients was collected and gene testing of FH related genes low density lipoprotein receptor (LDLR), proprotein convertase subtilisin/kexin type 9 (PCSK9), apolipoprotein B(APOB) and low density lipoprotein receptor adaptor protein 1(LDLRAP1) was carried out. Clinical diagnosis of FH patients was performed using Simon Broome criteria, DLCN criteria, and FH Chinese expert consensus.Results:There were 188 males (83.6%) among 225 PMI patients, and the age of the first myocardial infarction was (46.6±7.2) years old. Ten patients carried FH pathogenic or possibly pathogenic mutations (4.4%). Compared with Simon Broome standard, DLCN standard and FH Chinese expert consensus, gene testing increased the diagnostic rate of FH by 53.3%, 33.3% and 42.1% respectively.Conclusion:Gene testing is helpful to improve the diagnosis of FH, and it is important to start the standard treatment of FH as early as possible in patients with premature myocardial infarction.

  Objective  To promote the development of high-quality health standards in China and summarize the characteristics of global health standards management systems and development processes.  Methods  We conducted a systematic search of relevant databases and the websites of standardization institutions. A descriptive method was used to analyze the basic characteristics of the standard management systems and development processes.  Results  The majority of the investigated countries and organizations primarily implement voluntary standards, with the exception of Chinese and the European Committee for Standardization that enforce compulsory standards. All countries and organizations have health standards at the national, group, and enterprise levels. In China and Japan, standards authorities are subordinate to the government, while in other countries or organizations, they operate as independent civil societies. The development process for health standards generally involves five stages: "Project/Proposal → Draft → Enquiry → Review → Publication". However, the specific steps in the development of health standards vary across different countries and organizations. Furthermore, China ranks high in the number of both standards and health standards issued, but the proportion of health standards is only 2.06%.  Conclusions  There are significant differences between China and other countries in terms of the management system and development process of health standards. To promote the management and development of high-quality health standards in China, we recommend promoting the coordination mechanism for standard development, increasing efforts to publicize standards and evaluate the implementation effect, strengthening the construction of personnel for the development of health standards, optimizing the efficiency of standard development and improving the internationalization level of health standards.

National health standards involve all kinds of technical requirements formulated and numbered in accordance with the procedures and formats stipulated in the standardisation system for the implementation of national health and hygiene laws, regulations and policies, and the protection of human health. The establishment of health standards in China should align with our legal framework, including laws, regulations, departmental rules, and health and hygiene policies. During the development of these standards, a comprehensive approach is advocated, encompassing in-depth investigations, rigorous demonstrations, and extensive stakeholder engagement. However, the process of standard formulation may suffer from insufficient research evidence. The evidence-based concept emphasizes the significance of evidence. Therefore, integrating evidence-based concept into the process of developing health standards can enhance the quality and scientific basis of these standards. This article systematically elucidates the current status and development process of health standards in China, explores the necessity and feasibility of incorporating evidence-based concept into the development of these standards, analyzes the challenges and opportunities, and presents reflections and suggestions.

Humans ; Hypertension/therapy* ; Publications ; Research Design

Objective:To investigate the predictive value of atherogenic index of plasma (AIP) in the assessment of acute pancreatitis (AP).Methods:598 patients diagnosed with AP admitted to the Affiliated Hospital of Yangzhou University between January 2016 and December 2020 were recruited and divided into severe acute pancreatitis group (SAP group, n=57) and non-severe acute pancreatitis group (non SAP group, n=541) according to the Atlanta Classification (2012 revision). General clinical data and related biochemical indicators of all enrolled patients were collected, and Bedside Index of Acute Pancreatitis Severity (BISAP) score, Ranson score and CT Severity Index (CTSI) score were performed. The risk factors of SAP were analyzed by logistic regression. Receiver operating characteristic (ROC) curve was used to analyze the evaluation value of AIP and various scoring systems on the severity of pancreatitis. Results:The AIP, white blood cell (WBC), neutrophil count (NEUT), fasting blood glucose (FBG), serum total cholesterol (TC) level, proportion of hyperlipidemia, proportion of diabetes, Ranson score, BISAP score, CTSI score of patients in SAP group were higher than those in non SAP group, and the difference was statistically significant (all P<0.05). Multivariate logistic regression analysis showed that AIP was an independent risk factor for SAP ( P<0.05). ROC curve showed that the are under the curve (AUC) of SAP predicted by AIP was 0.706(95% CI: 0.631-0.782, P<0.001). Conclusions:AIP is an independent risk factor for SAP, which helps to assess the severity of AP.

Objective : To investigate the cross⁃sectional associations of serum interleukin( IL) Ⅳ18 with cartilage volume , cartilage defects , bone marrow lesions ( BML) and biomarkers of cartilage degradation in patients with knee osteoarthritis (OA) , and to provide new ideas and new methods for clinical diagnosis and treatment. Methods: The study included 151 patients with knee OA , a general questionnaire survey was conducted , and the knee strucral was photographed by magnetic resonance imaging (MRI) . The cartilage volume was measured by OsiriX software in 3D⁃FLASH sequence , and cartilage defect and BML were determined in T2⁃weighted sequence. Serum IL-18 and matrix metalloproteinase ( MMP) Ⅳ3 , 13 levels were measured by enzyme⁃linked immunosorbent assay(ELISA) . SPSS software was used for statistical analysis. Results : In multivariable analyses , serum IL⁃18 level was consistent at divided part of joint (femorotibial joint and the patella femoral joint , all P < 0. 05) . Serum IL⁃18 level was positively associated with cartilage defect and BML at media femorotibial area (all P < 0. 01) . Serum IL⁃18 level was positively associated with MMP⁃3 (β = 0. 31 , 95% CI:0. 001 - 0. 010) and MMP⁃13 (β = 0. 86 , 95% CI:0. 08 - 0. 10 , all P < 0. 01) . CI:0. 08 - 0. 10 , all P < 0. 01) . Conclusion Serum IL⁃18 level is negatively associated with cartilage volume and Serum IL⁃18 level is negatively associated with cartilage volume and positively associated with cartilage defect , BML , MMP⁃3 and MMP⁃13 , suggesting IL⁃18 may play a significant role duce the injury of article cartilage in patients with knee OA and delay the progression of disease.

Objective:To explore the influence of multidimensional integration and 360° support on the function of family and marriage, and quality of life in women patients with systemic lupus erythematosus.Methods:Totally 196 patients with systemic lupus erythematosus from Department of Rheumatology and Immunology, The Second Affiliated Hospital of the Air Force Medical University from August 2016 to November 2017 were included. According to random number table method, these patients were divided into observation group and control group as 98 cases each. Conventional care and hospital discharge were used for control group. On the basis of this, multidimensional integration and 360° support were used for patients of observation group. The function of family and marriage, quality of life in patients were assessed before and after 3 months of the intervention. The treatment adherence was evaluated in 3 months and 6 months after intervention.Results:Before intervention, the marriage family function score, marital satisfaction, conflict resolution methods and the relationship with friends and family, husband and wife exchange scores of the observation group were (2.3 ± 0.5), (24.6 ± 6.1), (25.7 ± 7.1), (28.2 ± 6.9), (28.8 ± 6.9) points, respectively. Three months after intervention, these scores were (2.5 ± 0.7), (31.6 ± 5.0), (31.7 ± 5.3), (28.1 ± 6.8), (29.0 ± 7.1) points, respectively. There was statistically significant difference between before and after the intervention ( t values were -2.371 - 8.631, P < 0.01). These scores of control group before the intervention were (2.3 ± 0.6), (24.5 ± 6.2), (25.2 ± 7.2), (32.5 ± 6.0), (33.9 ± 6.3) points, respectively. Three months after intervention, these scores were (2.3 ± 0.4), (24.5 ± 6.2), (26.1 ± 6.9), (29.1± 4.8), (28.5 ± 7.2) points. Significant differeces were found between before and after the intervention in control group ( t values were -3.878-6.323, P < 0.05 or 0.01). There was statistically significant difference between the two groups after the intervention ( t values were 2.675-8.631, P<0.01). As for observation group, planning (62.8 ± 27.2 vs. 75.5 ± 25.4) and intimate relationship (62.8 ± 25.2 vs. 78.2± 24.9) in quality of life were obviously difference before and after 3 months of intervention ( t values were 3.050, 3.639, P < 0.01). As for control group, planning (62.5 ± 27.6 vs. 65.7 ± 24.9) and intimate relationship (65.8 ±25.2 vs. 63.5 ± 23.8) in quality of life were obviously difference before and after 3 months of intervention ( t values were 2.375, 3.132, P < 0.01). There was statistically significant difference between the two groups after the intervention ( t values were 3.050, 3.639, P < 0.01). The treatment adherence of observation group was significant better than control group. After 6 months intervention, the treatment adherece of observation group was 83.67% (82/98), while the treatment adherece of control group was 44.89% (44/98), significant differences were found btween the two groups ( χ2 value was 0.511, P < 0.01). Conclusion:Multidimensional integration and 360° support obviously improved function of family and marriage, improved the understanding of disease, and self-management ability of patients. Therefore, it can increase the treatment adherence and improve quality of life in SLE patients.

Objective: To study the effects of three different granular fats on proliferation, differentiation and migration of adipose-derived stem cells. Methods: Ten patients were selected for lumbar liposuction. The adipose tissue was obtained with different sized side-hole fat aspiration devices: 10 ml of Macrofat (n=10), 10 ml of Microfat (n=10) and 10 ml of Nanofat (n=10). Enzyme digestion method was used to separate and extract adipose-derived stem cells(ADSCs). The differences of vascular matrix components in these 3 kinds of fat sources were analyzed. XTT assay was used to detect proliferation and growth ability. The migration ability of the cell injury model was observed in vitro, and the multi-directional differentiation ability was compared by the analysis of adipogenic and osteogenic induction. The experimental data were analyzed using SPSS 13.0 software. One-Way ANOVA was used to compare the difference of multiple groups. P<0.05 was considered as statistically significant. Results: The detection of adipose-derived stem cells was by flow cytometry and it showed Macrofat, Microfat and Nanofat was(4.23±0.37)×10⁵, (2.29±0.33)×10⁵ and(1.56±0.16)×10⁵. The content of fat-derived stem cells in Macrofat was the highest, followed by Microfat, and the content of Nanofat was the least (F=209.533, P<0.001). XTT assay showed that the proliferative ability of adipose-derived stem cells in the first two generations of Macrofat was the highest, followed by Microfat, while the proliferation of Nanofat was the lowest (the absorbance in 3 groups increased in a time-dependent manner). There was no significant difference in the proliferative capacity of the third generation of 3 groups (the absorbance of these 3 groups were compared at each time point). The cellular trauma model showed that the first generation of Macrofat-derived stem cells had the best migration ability, followed by Microfat, while the Nanofat had the weakest migration ability(Compared with the remaining area of wounds at 0 h, 12 h, 24 h point between the three groups, F=306.370, 1409.907, P<0.001). From the second generation, the migration ability of each group of ADSCs gradually self-repaired, and the migration ability at 12 h was similar to that of the first generation (F=11.410, P<0.001), but there was no significant difference in 24 h (F=0.070, P=0.933). Oil red O and alizarin red staining showed that the first generation of Macrofat and Microfat had better fat-forming and osteogenic differentiation ability than Nanofat(F=523.532, 620.022, P<0.001). However, there was no significant change after the second generation (F=2.144, 0.866, P=0.137, 0.432). Conclusions In the process of adipose tissue extraction of Nanofat, the production and activity of adipose-derived stem cells was impacted. However, in the process of culture and passage, the cell activity, proliferation ability, migration ability and differentiation ability can be achieved through self-repair, evenclose to the level of Macrofat or Microfat.

Objective To investigate the effect of adipose-derived stem cells (ADSCs) on pho toaging skin after laser pretreatment with GaAlAs.Methods ADSCs were isolated from healthy wistar rats,ADSCs were isolated and cultured to establish an adipose-derived stem cell culture system.ADSCs were pretreated with GaAlAs laser at a wavelength of 650 nm 4 J/cm2.A rat model of pho toaging aging was established.Different doses of ADSCs and low energy laser ADSCs were pretreated with ADSCs for the treatment of photoaging skin,and the morphological changes of epidermis and dermis were observed before and after treatment with low energy laser pretreatment.Results When the concentration of ADSCs was 103/100 μl,there was no significant difference in epidermal thickness and dermal thickness between ADSCs treated group and GaAlAs pretreatment group (P＞0.05).The thickness of epidermis in the GaAlAs pretreatment group was significantly lower than that in the ADSCs group (P＜0.05) at 104/100 μl.When the concentration of ADSCs was 5 × 104/100 μl,the epidermal thickness of the GaAlAs pretreatment group decreased significantly and the thickness of the dermis increased significantly,which was significantly different from that of the ADSCs group (P ＜ 0.05).Conclusions GaAlAs laser pretreatment can enhance ADSCs anti-skin photoaging ability.

Objective To determine the influencing factors on informed consent associated with decline or delay of primary percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods This study was conducted in Peking University People′s Hospital from 1 August, 2014 to 31 March, 2016, with 229 consecutive cases of acute STEMI enrolled in the study.Data were collected by reviewing medical records and STEMI treatment time records.180 patients with ischemic symptoms ≤12 hours were included in the final analysis.Patients were divided into the consent group and the refusal group according to the final decision.For patients who received primary PCI, they were further categorized into two groups based on the 30min cut-off time.Results Among the 180 STEMI patients reviewed, 139 patients agreed to primary PCI and the remaining 41 patients refused primary PCI.Multivariate logistic analysis showed that symptom relief (OR 5.532, 95% CI 1.165-26.278, P=0.031) and history of chronic kidney disease (OR 4.786, 95% CI 1.346-17.011, P=0.016) were predictors of dissent of primary PCI.Self-rated symptoms severity (OR 0.094, 95% CI 0.034-0.260, P<0.001)was predictor of consent to primary PCI.106 patients had complete time point records of informed consent in the consent group (n=139).Among these patients, the median informed consent delay was 24 min.64 patients made a decision within 30 minutes, and the other 42 patients had their decision made beyond 30 minutes.Symptom-to-door time ≥4 hours (OR 4.563,95% CI 1.682-12.385, P=0.003) was independent predictor of informed consent delay.Conclusions Patients with resolved symptoms, self-rated mild symptoms or renal insufficiency were more inclined to refuse primary PCI.For patients who eventually received primary PCI, symptom-to-door time ≥4 hours was the independent predictor of informed consent delay.