1.Investigation and Trend Prediction of Disease Burden of Hypertensionin the Elderly Population Globally and in China from 1990 to 2021
Xiaoxiao ZHAO ; Xiaohui LU ; Lixin KE ; Wulin GAO ; Xiangran MENG ; Lili REN ; Yunhan DING ; Qiang ZHANG ; Yangqin XUN ; Jibiao WU ; Cuncun LU
Medical Journal of Peking Union Medical College Hospital 2025;16(3):647-658
		                        		
		                        			
		                        			 To analyze the disease burden of hypertension in the elderly population from 1990 to 2021 and to predict future trends in China and globally, thereby providing insights for public health decision-making regarding older adults with hypertension in China. Data on hypertension-related deaths and disability adjusted life years (DALYs) for individuals aged ≥60 years was extracted from the Global Burden of Disease (GBD)2021 database for the world, China, and five sociodemographic index (SDI) regions. Age-standardized mortality and DALYs rates for hypertension in the elderly population were calculated, and Joinpoint regression was used to assess trend changes of disease burden, with results reported as average annual percentage change (AAPC). Additionally, subgroup analyses were conducted based on age and sex. The relative impact of aging, population growth, and epidemiological changes on disease burden was analyzed using a three-factor decomposition method. Future projections for the disease burden from 2022 to 2040 were performed using a Bayesian model. From 1990 to 2021, both age-standardized mortality and DALYs rates for hypertension in the elderly population demonstrated a significant downward trend globally and in China (both AAPC values were negative, all   Although age-standardized mortality and DALYs rates for hypertension among the elderly in China have shown a downward trend over the past three decades, the absolute burden remains substantial. There is an urgent need for the formulation and implementation of more effective public health policies and clinical interventions to address this critical public health challenge.
		                        		
		                        	
2.Phacoemulsification combined with capsular tension ring and intraocular lens implantation in the treatment of high myopia with cataract
Keqing MENG ; Wulin ZHANG ; Yanhui XU ; Wei DONG ; Jianfeng XU
International Eye Science 2024;24(3):432-435
		                        		
		                        			
		                        			 AIM: To observe the efficacy of phacoemulsification combined with capsular tension ring and intraocular lens implantation in the treatment of high myopia with cataract.METHODS: Retrospective study. A total of 82 cases(82 eyes)of high myopia complicated with cataract who admitted to the cataract department of our hospital from December 2021 to April 2023 were selected as study objects, and they were divided into control group(n=39)and combination group(n=43)according to whether or not the capsular tension ring was used intraoperatively. Patients in the control group were treated with intraocular lens implantation alone, and those in the combination group were treated with phacoemulsification combined with capsular tension ring and intraocular lens implantation. The preoperative and postoperative best corrected visual acuity, central anterior chamber depth, trabecular ciliary process, visual quality and complications were compared.RESULTS: At 1 mo after surgery, the best corrected visual acuity(LogMAR)of both groups increased significantly(combination group: 0.64±0.28 vs 0.12±0.14; control group: 0.62±0.26 vs 0.23±0.25, both P<0.001). Central anterior chamber depth in both groups were higher than those before surgery(combination group: 2.57±0.56 vs 1.97±0.40 mm; control group: 2.22±0.45 vs 1.89±0.37 mm; both P<0.001), and the best corrected visual acuity and central anterior chamber depth of the combination group were significantly better than those of the control group(both P<0.05). The distance of trabecular ciliary process showed no statistical significance(combination group: 0.68±0.22 vs 0.74±0.20 mm; control group: 0.74±0.19 vs 0.78±0.17 mm, both P>0.05). The visual quality scores of the combination group were all higher than the control group at 1 mo after surgery [watching TV: 3.00±0.38 vs 2.22±0.46 points; reading books: 2.85±0.42 vs 2.21±0.44 points; night vision: 2.71±0.34 vs 2.37±0.41 points; fine operation: 2.82±0.38 vs 2.33±0.40 points, all P<0.001]. The incidence of complication in the combination group was significantly lower than that of the control group(33% vs 14%, P<0.05).CONCLUSION: Phacoemulsification combined with capsular tension ring and intraocular lens implantation can effectively promote the recovery of visual function, improve the structure of chamber angle, and reduce the incidence of complications in the treatment of patients with high myopia and cataract. 
		                        		
		                        		
		                        		
		                        	
3.Analysis of the causes of revision total knee arthroplasty
Jian JIN ; Liyi ZHANG ; Wulin KANG ; Xuan GAO ; Jianhao LIN ; Zhichang LI
Chinese Journal of Orthopaedics 2024;44(4):217-225
		                        		
		                        			
		                        			Objective:To assess causes for revision total knee arthroplasty (TKA) in China using the data of revision TKA in the past 15 years in our single center andcompare the differences in survival time, operation time and blood loss among different revision reasons.Methods:Data of 337 patients (345 knees) with revision TKAs at our institution from January 2007 to December 2021 (15 years) were retrospectively analyzed. The included population consists of 57 males and 288 females. The causes for first revision TKA were identified and compared according to the time of revision surgery as early (up to 2 years) and late revision (more than 2 years). The reason for revision before 2012 and after 2012 was also compared. Furthermore, the differences of survival time, operation time and blood loss among different revision reasons were compared.Results:The most common reasons for revision of knee joints in 345 cases were periprosthetic infection (133 knees, 38.6%), followed by aseptic loosening (97 knees, 28.1%) and joint instability (35 knees, 10.1%). Early revisions were performed in 171 knees (49.6%), while late revisions were performed in 174 knees (50.4%). Periprosthetic infection (96 knees, 56.1%) and aseptic loosening (86 knees, 49.4%) were the most common reasons for early and late revisions, respectively. There were 59 revisions performed before 2012 and 286 revisions performed after 2012, with periprosthetic infection being the main reason for revision in both groups. The percentage of revisions due to infection decreased from 64.4% before 2012 to 33.2% after 2012, and this difference was statistically significant (χ 2=18.790, P<0.001). The proportion of revisions due to aseptic loosening was 15.3% before 2012, which was significantly lower than the proportion of 30.8% after 2012 (χ 2=5.083, P=0.024). The median survival time of the prostheses in the included patients was 30 months, with shorter survival time observed in patients with stiffness, patellar complications, and periprosthetic infection, and longer survival time observed in patients with polyethylene wear and aseptic loosening. There were significant differences in operation time and blood loss among different reasons for revision ( P<0.001). Conclusion:In our specialized arthroplasty center periprosthesis infection was the most common reason for revision. Periprosthesis infection and aseptic loosening needed to be considered for early or late-stage revision. With the development of technique of total knee arthroplasty, the proportion of periprosthesis infection is decreasing, while the incidence of aseptic loosening is increasing.
		                        		
		                        		
		                        		
		                        	
4.A retrospective study on clinicopathological features and prognostic factors of 179 cases of laryngeal squamous cell carcinoma
Zhipeng MI ; Yongchun LI ; Wulin WEN ; Xueliang SHEN ; Fengxia YANG ; Meihua YANG ; Yuqiao ZHANG ; Baoli CHEN ; Ruixia MA
Chinese Archives of Otolaryngology-Head and Neck Surgery 2024;31(11):686-691
		                        		
		                        			
		                        			OBJECTIVE To analyze the clinicopathological features of laryngeal squamous carcinoma tumors and their correlation with prognosis in order to improve the understanding and diagnosis of laryngeal squamous cell carcinoma.METHODS The clinical and pathological data(including gender,age,stage,differentiation,immunohistochemistry,etc.)of 179 patients with laryngeal squamous cell carcinoma[171 males,8 females,aged 30-84(61.53±8.02)years]who were treated in Department of Otolaryngology Head and Neck Surgery,The First and Second Clinical Medical Schools of Ningxia Medical University from January 2015 to December 2022 were retrospectively studied,and the effects of various factors on prognosis were analyzed.RESULTS Among the 179 patients with laryngeal squamous cell carcinoma,the male-to-female ratio was 21.4:1,and the incidence was high in the age group of 60-79 years old(58.7%),and the youngest age of onset was 30 years old.The main clinical manifestations were hoarseness 138 cases(77.1%),sore throat 16 cases(8.9%)and pharyngeal foreign body sensation 13 cases(7.3%).Glottic type was more common in the primary site 135 cases(75.4%),and 31 cases were accompanied by cervical lymph node metastasis(17.3%).The degree of differentiation was more common in the moderately differentiated type 80 cases(44.7%).The positive rates of immunohistochemistry markers p16,EGFR(epidermal growth factor receptor),PD-1/PD-L1 and VEGF(vascular endothelial growth factor)were 20.3%,96.4%,36.4%and 77.3%,respectively.Univariate Kaplan-Meier survival analysis showed that the site of disease,lymph node metastasis,and tumor stage were significantly correlated with disease recurrence.Multivariate Cox regression analysis showed that the clinical stage of the tumor was an independent risk factor for the prognosis of the disease(HR=3.715,95%CI:1.519-9.088,P=0.04).CONCLUSION The stage of laryngeal squamous cell carcinoma,the site of the disease,and the metastasis of the lymph nodes are the main factors affecting the prognosis.The high positive expression rate of immunohistochemistry markers EGFR and VEGF is worth paying attention to Targeted therapy for patients with positive PD-1/PD-L1 testing is a promising research direction.
		                        		
		                        		
		                        		
		                        	
5.Effect of phacoemulsification combined with CTR implantation on capsule stability after cataract surgery for high myopia
Keqing MENG ; Wulin ZHANG ; Wei DONG ; Yanhui XU ; Nan LI
Tianjin Medical Journal 2024;52(10):1056-1060
		                        		
		                        			
		                        			Objective To investigate the stability of pouch in patients with high myopia cataract after phacoemulsification cataract extraction combined with capsular tension ring(CTR)implantation.Methods A total of 80 patients with high myopia complicated with cataract(80 eyes)were included and randomly divided into the experimental group and the control group.The experimental group received phacoemulsification cataract extraction combined with CTR implantation,while the control group was not combined with CTR implantation,and the other interventions were completely consistent.The naked eye visual acuity(UCVA),best corrected distant visual acuity(BCVA),corneal biomechanics,contrast sensitivity,intraocular lens inclination and anterior capsular opening area were compared between the two groups at 1,3 and 6 months after surgery.The incidence of late cataract(PCO)was measured 6 months after surgery.Results UCVA and BCVA were improved at 1,3 and 6 months after operation.There were no significant differences in postoperative corneal biomechanical parameters ARTh and SP-A between the two groups of patients(P>0.05).The Corvis biomechanical index(CBI)of the experimental group was significantly higher 3 months after surgery than that of the control group(P<0.05),and there were no significant differences at other time points between the 2 groups.There was no significant difference in contrast sensitivity at each time point after surgery between the experimental group and the control group(P>0.05).At 3 and 6 months after operation,the anterior capsule opening area was increased in the experimental group,and IOL inclination angle was decreased compared with the control group(P<0.05).At 6 months after operation,no PCO occurred in 38 eyes and PCO grade Ⅰ in 2 eyes.No PCO occurred in 35 eyes in the control group,3 eyes in grade Ⅰ,2 eyes in grade Ⅱ and 2 eyes in grade Ⅲ.Conclusion Phacoemulsification cataract extraction combined with CTR implantation has higher stability,long-term clinical effect and visual quality in patients with high myopia cataract,and is worthy of clinical application.
		                        		
		                        		
		                        		
		                        	
6.The effects of palatal spur and chincup in the early treatment of anterior open bite in patients with Angle class Ⅰ malocclusion: A Meta-analysis
Guorong ZHANG ; Zengxu WANG ; Jing XU ; Wulin YOU ; Yang ZHANG
Journal of Practical Stomatology 2019;35(1):95-99
		                        		
		                        			
		                        			Objective: To study the effects of the palatal spur and chincup in the early treatment of anterior open bite in patients with Angle class Ⅰ malocclusion. Methods: Electronic search was conducted to find studies about the effects of the palatal spur and chincup in the early treatment of anterior open bite in patients with Angle class Ⅰ malocclusion. Data extraction and risk of bias assessment of included studies were conducted. RevMan5. 3 software was used fore Meta-analysis. Results: 6 clinical trials were qualified to the Meta-analysis. Compared to the control group, there was no significant change of skeletal measurments after treatment (P> 0. 05), and no significant change in dental measurments in chincup group (P> 0. 05) . While overbite, U1-PP (mm) and L1-MP (mm) were increased (P < 0. 05), U1-NA (°) and L1-NB (°) decreased (P < 0. 05) in the 3 groups of fixed palatal crib, bonded spur associated with the chincup and the removable palatal spur associated with the chincup. Conclusion: Chincup is not effective in the early treatment of the anterior open bite in patients with Angle class I malocclusion. But chincup combined with palatal spur or crib and have a positive effect on the closure of open bite through the palatal clination and extraction of the anterior teeth without influence of molar intrusion and skeletal change.
		                        		
		                        		
		                        		
		                        	
7.Comparison Between Single-port and Three-port Video-assisted Thoracoscopic Lobectomy in the Treatment of Lung Cancer
Yu LIU ; Xuebing SONG ; Wulin ZHANG
Chinese Journal of Minimally Invasive Surgery 2018;18(3):205-208
		                        		
		                        			
		                        			Objective To compare the clinical efficacy of uniportal complete thoracoscopic and conventional three -port thoracoscopic lobectomy in the treatment of lung cancer. Methods A total of 62 cases of lung cancer from January 2012 to January 2016 received lobectomy in our hospital.According to admission sequence number, the patients were randomly divided into either single-port group(n=31)or three-port group(n=31).The single-port group was given uniportal thoracoscopic lobectomy, and the three-port group was given traditional three-port operation of VATS lobectomy.We compared the two groups with intraoperative and postoperative conditions and follow-up outcomes. Results The operations were successfully completed in both groups.There were no significant differences between the two groups in operation time[(182.3 ±77.9)min vs.(177.6 ±69.2)min, t =0.251, P=0.803],intraoperative blood loss[(207.3 ±48.4)ml vs.(226.5 ±52.3)ml,t=-1.500, P=0.139], chest tube indwelling time[(5.5 ±1.6)d vs.(5.7 ±2.0)d, t=0.435, P=0.665], postoperative hospitalization time[(8.7 ±2.7)d vs.(9.0 ± 2.8)d,t=0.925,P=0.0.372],lymph node dissection number[(11.2 ±2.8)vs.(11.7 ±3.1),t=-0.666,P=0.508]and postoperative incidence of complications[9.7%(3/31)vs.12.9%(4/31),χ2=0.000,P=1.000].The VAS scores on the first and fifth postoperative day were(3.1 ±1.1)points and(1.0 ±0.7)points in the single-port group, which were significantly lower than those in the three-port group[(3.9 ±1.4)points,t=-2.502,P=0.015;(1.5 ±0.7)points,t=-2.812,P=0.007].The 62 cases were followed up for 12-36 months(mean,18.4 ±6.4 months)without recurrence and death. Conclusion Single-port thoracoscopic lobectomy for lung cancer has good curative effect and safety as compared with traditional method,being worthy of clinical application.
		                        		
		                        		
		                        		
		                        	
8.Bioinformatic Analysis of Differentially Expressed Genes in Peripheral Blood of Human Immunodeficiency Virus/Tubercle Bacilli Co-infected Patients.
Rongqiang ZHANG ; Qiling LIU ; Na SUN ; Wulin KANG ; Puwei YUAN
Acta Academiae Medicinae Sinicae 2017;39(3):336-344
		                        		
		                        			
		                        			Objective To analyze the differentially expressed genes in peripheral blood of human immunodeficiency(HIV)/tubercle bacilli co-infected patients and explore the biological regulatory mechanism and network of key proteins,so as to provide new evidence for early diagnosis and clinical treatment of HIV/TB co-infected patients. Methods Microarray gene chip data of HIV/TB co-infected patients were downloaded from public databases GEO and imported into the analysis software GEO,STRING,PANTHER,and GenClip. The gene expression profiles,protein interaction networks,processes of molecular biology,and gene functions were analyzed. Results The expression profiles of 15 529 genes between the two groups of patients were similar,and gene expression profiles from 44 subjects were highly correlated. The 251 differentially expressed genes had good diagnostic capabilities in the differential diagnosis of HIV/TB infection. RPLP1 might be a key gene in the diagnosis of HIV/TB infection. The differentially expressed genes and positive regulators showed certain functions such as external stimuli,signal transduction pathways in cells,migration of neutrophils,and immunological and other relevant functionalities. Meanwhile,they may also be involved in free radical-related apoptosis,inflammation,and activation pathways. Conclusions A total of 251 differentially expressed genes are found to be able to distinguish simple HIV infection from HIV/TB infection. Protein-protein interaction network of top 40 differential expression genes includes RPLP1 gene,which is possibly associated with HIV/TB co-infection and may be involved in and the positive regulation of external stimuli,signal transduction pathways in cells,migration of neutrophils,and immunological functions. These findings may provide certain evidence for the diagnosis and treatment of HIV/TB infection.
		                        		
		                        		
		                        		
		                        	
9.Application of two capsular Tension ring sclera fixing methods in treatment of moderate and severe lens subluxation
Wulin ZHANG ; Keqing MENG ; Yue ZHANG ; Xiaowei XU
Recent Advances in Ophthalmology 2017;37(7):647-650
		                        		
		                        			
		                        			Objective To compare the clinical effects of one-stage modified capsular tension ring (MCTR) scleral fixation and second-stage capsular tension ring (CTR) capsular bag complex scleral fixation in the treatment of moderate and severe subluxation of lens.Methods Retrospective study.Thirty cases (43 eyes) of patients with moderate and severe subluxation of lens from January 2012 to December 2015 were collected.Those patients were treated with phacoemulsification cataract extraction and MCTR or CTR and IOL intracapsular implantation under local anesthesia.23 eyes in group A were treated with MCTR combined with IOL implantation and one-stage scleral fixation.20 eyes in group B were treated with one-phase CTR combined with IOL implantation and second-stage of CTR-capsular bag complex scleral fixation after 3 to 6 months.The best corrected visual acuity,location of the postoperative capsular bag complex and complication were observed at 6 months after surgery.Results Postoperative 6-month,the best corrected visual acuity ≥0.6 were in 87%,95% of the patients m group B,and there was no statistical significance difference (P > 0.05).All CTR and IOL were located in the capsular bag after surgery.Two eyes in group A and 1 eye in group B were observed with moderate contraction and off-center of capsular bag,there was no significant difference (P > 0.05).All groups achieved response after YAG laser anterior capsule relaxing incisions.Early complications of postoperative (1 month):3 eyes in group A and 1 eye in group B were observed with exudative membrane in anterior chamber;5 eyes in group A and 2 eyes in group B were with transient high intraocular pressure,and there was no significant difference (all P > 0.05).Long-term complications of postoperative (6 months):3 eyes in group A and 1 eye in group B were observed with after cataract,and there was no significant difference (P > 0.05).All groups conducted YAG laser posterior capsulotomy.Conclusion The location stability of the capsular complex after one-stage MCTR scleral fixation or secondstage CTR capsular bag sclera fixation is good.And the treatment is effective for moderate and severe lens dislocation.
		                        		
		                        		
		                        		
		                        	
10.Tilted implants and final fixed prostheses treatment in edentulous mandible with severely resorbed
Shuo YANG ; Yongtong GUO ; Xiangcheng ZHANG ; Qianyi WU ; Zhen ZHOU ; Yamin WANG ; Wulin HE ; Lei ZHOU ; Shulan XU
The Journal of Practical Medicine 2017;33(11):1810-1813
		                        		
		                        			
		                        			Objective To evaluate the clinical outcomes of severely resorbed edentulous mandibles with tilted implants and fixed prostheses. Methods Ten patients with severely resorbed edentulous mandibles were en-rolled. Each patient received 4 implants,two posteriors placed tilted implants. Immediate loading of tilted implants were applied in all cases using a fixed provisional prosthesis. All patients were finalized 3-4 months with fixed pros-theses. Results 40/40 implants with initial torque(>35N.cm)were followed 1-1.5 years presenting 100%surviv-al. Conclusion The method of using tilted implants and fixed prostheses in the cases of severely resorbed edentu-lous mandibles can achieve an ideal short-term and medium-term effects.
		                        		
		                        		
		                        		
		                        	
            
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