Objective:To explore the relationship between the hypertensive snowbirds′ length of migratory stay and their blood pressure control and blood pressure levels.Methods:This study was a cross-sectional study. A population of snowbirds with hypertension was recruited between October and November 2022, and a structured questionnaire was used to collect their self-measured blood pressure and length of stay in Hainan Province. The blood pressure control status is determined based on self-measured blood pressure. According to the self-measured blood pressure to determine whether the blood pressure was well controlled. The associations between snowbirds′ length of stay and their blood pressure control as well as their self-measured blood pressure were analyzed using restricted cubic splines.Results:A total of 362 research subjects were included, 169(46.7%) of whom were male, and their age was (69.7±7.0) years old. The participants′ self-measured systolic blood pressure and diastolic blood pressure were (129.1±16.2) mmHg (1 mmHg=0.133 kPa) and (78.9±10.1) mmHg, respectively. Overall, 174 (48.1%) participants attained adequate blood pressure control. The median length of stay in Wuzhishan City was 7(6, 7) months. There was an inverted U-shaped association between snowbirds′ length of stay and blood pressure control (overall: P=0.023; nonlinearity: P=0.014), where participants with a length of stay of 7 months had the highest rate of blood pressure control. There is a U-shaped curve relationship between length of stay and systolic blood pressure (overall: P=0.001; nonlinearity: P=0.033), and a linear negative correlation with diastolic blood pressure ( β=-1.19, P=0.003). Conclusions:Compared with hypertensive snowbirds with too long or too short lengths of stay, snowbirds who stayed in Wuzhishan City for seven months have better blood pressure control, and systolic blood pressure is also lower.

Objective To investigate the predictive value of combined plasma gluconic acid(GA),fumaric acid(FA),and pseudouridine levels at admission for acute kidney injury(AKI)in elderly patients with acute myocardial infarction(AMI).Methods A total of 78 elderly AMI patients transferred from Emergency Department to Coronary Care Unit in Fuwai Hospital during Decem-ber 2021 and July 2022 were enrolled in this prospective study.They were divided into AKI group(40 cases)and non-AKI group(38 cases)according to whether they developed AKI during hospi-talization.Plasma levels of GA,FA and pseudouridine were quantitatively detected with liquid chromatography-tandem mass spectrometry.ROC curve was plotted to assess the predictive value of these three plasma metabolites for AKI in AMI patients.Multivariate logistic regression analy-sis was applied to analyze the clinical risk factors for AKI.Results There were no statistical differences in the plasma levels of GA,FA and pseudouridine between the AKI group and the non-AKI group(P＞0.05).ROC curve analysis revealed that the plasma levels of the three indicators had no predictive value for the development of AKI in elderly AMI patients(AUC=0.576,95％CI:0.449-0.704,P=0.246;AUC=0.595,95％CI:0.467--0.721,P=0.154;AUC=0.563,95％CI:0.435-0.692,P=0.337).Multivariate logistic regression analysis revealed that left ventricu-lar ejection fraction(LVEF)was an independent predictor for AKI development in elderly AMI patients(OR=0.923,95％CI:0.870-0.978,P=0.007).Conclusion Plasma GA,FA and pseud-ouridine cannot predict the development of AKI in elderly AMI patients,while,LVEF is an inde-pendent predictor for the development.

【Objective】 To study the clinical characteristics and treatment of patients with acute hemolytic anemia crisis induced by levofloxacin. 【Methods】 The levofloxacin antibody was detected by the microcolumn gel method and scored by the Naranjo Adverse Drug Reaction Probability Scale(APS). Patients suffered from acute hemolysis anemia induced by levofloxacin was rescued by whole blood exchange(WBE) and therapeutic plasma exchange(TPE). 【Results】 The patient was diagnosed as acute hemolysis induced by levofloxacin as levofloxacin antibody was yielded, and 7 points scored by the Naranjo APS. After WBE and TPE treatment, the patient′s clinical symptoms and signs improved rapidly. Supplemented with immunoglobulin and hormone therapy, the patient was discharged on d 10 after treatment. 【Conclusion】 Levofloxacin can induce acute hemolytic anemia crisis, and WBE and TPR are effective rescue methods.

Anemia, Aplastic ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; Humans ; Infections ; Transplantation Conditioning

OBJECTIVE: To investigate the effect of high mobility group protein box 1 (HMGB1) on apoptosis of astrocytes after oxygen glucose deprivation/reoxygenation (OGD/R), and to investigate the possible mechanism by evaluating the expression of apoptosis related protein Bcl-2 and Bax. METHODS: The cerebral cortex astrocytes of neonatal rats were divided into normal group, model group, interference group and control group. Lentivirus vector of rat HMGB1 short hairpin RNA (shRNA) was used to suppress the HMGB1 protein expression in the astrocytes. Then the detection was made after astrocytes were deprived of oxygen and glucose 6 h, reoxygenation for 24 h. The effect of RNA interference was evaluated by Western blotting. The cell survival rate was measured by MTT assay. The apoptosis of astrocytes was determined by TUNEL assay. The expressions of Bcl-2 and Bax were detected by Western blotting. RESULTS: Compared with the normal group, the protein expression of HMGB1 was significantly increased in model group after OGD/R (P<0.001), the astrocytes survival rate was decreased (P<0.001), the number of apoptotic cells labeled with TUNEL was increased (P<0.001), and the ratio of Bcl-2/Bax was decreased (P<0.001). Compared with the model group, RNA interference effectively inhibited the expression of HMGB1 in interference group (P<0.001), the astrocytes survival rate was increased (P<0.001), the number of apoptotic cells labeled with TUNEL was reduced (P<0.01), and the ratio of Bcl-2/Bax was increased (P<0.001). CONCLUSION The apoptosis of astrocytes can be induced by HMGB1 after OGD/R, and the mechanism may be related to regulating the expression of apoptosis related proteins Bcl-2 and Bax.
Animals ; Apoptosis ; Astrocytes ; Cell Hypoxia ; Cells, Cultured ; Glucose/metabolism* ; HMGB1 Protein/physiology* ; Oxygen ; Proto-Oncogene Proteins c-bcl-2 ; Rats ; Rats, Sprague-Dawley ; bcl-2-Associated X Protein/metabolism*

Objective: To understand the seasonal distribution of patient hospitalization due to asthma exacerbation in 7 geographic areas in China. Methods: This was a retrospective study which involved patients hospitalized for asthma exacerbation in 29 hospitals throughout 7 geographic areas in the mainland of China (northeast, north, central, east, south, northwest and southwest). The numbers of asthmatic patients and total inpatients of the respiratory department of each hospital were recorded. The monthly ratio of asthmatic patients to the total inpatients in every area was calculated and compared. Results: During the study period, 6 480 patients were admitted for asthma exacerbation, accounting for 3.14% of all the 206 135 patients admitted to the respiratory departments in the 29 hospitals. The ratio of asthmatic patients to total inpatients in the northeast area (5.61%) was highest, and the ratio in east area was lowest (1.97%). Statistical analysis showed that the difference among different areas was significant (P<0.000 1). In most areas, both the number and proportion of hospitalized asthmatic patients peaked in spring (February-April) and autumn (September-October). In the northeast area, east area and south area, the peaks in spring were more obvious, while in the north area and southwest area, the peaks in autumn were more obvious. In the northwest area the peaks occurred in winter (December-January) and summer (June-August), respectively. The differences in hospitalization due to asthma among different months were significant in the northeast, north, and southwest areas (P<0.005). Conclusion: The number of patients hospitalized for asthma exacerbation fluctuated with season in different areas in China. In most areas, more asthmatic patients were admitted to hospitals in spring and autumn.
Asthma ; China/epidemiology* ; Hospitalization/statistics & numerical data* ; Humans ; Retrospective Studies ; Seasons

OBJECTIVE:To investigate off-label drug use of Ambroxol hydrochloride injection,and to provide reference for further evidence-based evaluation on rationality and standardized management of off-label drug use. METHODS:All medical orders for inpatients receiving Ambroxol hydrochloride injection were selected from 10 hospitals of Guangdong province during Apr. 2014 to Mar. 2015. Situation of drug use in different categories of departments was summarized,the incidence of off-label administation route and off-label dosage were analyzed;according to drug package inserts,prescription daily dose(PDD)and drug utilization in-dex(DUI)were calculated for each category of department,and the degree of off-label dosage was evaluated. RESULTS:A total of 761 821 person·day who used Ambroxol hydrochloride injection was included. Off-label drug use occurred in each category of departments,and the incidence of off-label drug use was 62.10%. The incidence of off-label administration route was 40.51%, mainly atomization inhalation;the incidence of it was the high-est in gynecology and obstetrics department(92.70%).The in-cidence of off-label dosage was 36.30%,and the incidence of it was the highest in cardiothoracic surgery department (85.36%). Departments whose PDDs were higher than the drug package inserts were cardiothoracic surgery department,ICU,surgical department,cardiovascular medicine department,emer-gency department,department of internal medicine and pediatrics department.CONCLUSIONS:Off-label drug use of Ambroxol hy-drochloride injection is common,and the effectiveness,safety and necessity remain controversial,which need to be proved by multi-center randomized controlled prospective trial.

The cell counting kit-8 (CCK-8) proliferation assay and diameter measure of neurospheres were used to investigate the effect of high-mobility group box 1 (HMGB1) on proliferation of primary rat neural stem cells (NSCs) in vitro, and c-Jun N-terminal protein kinase (JNK) potent inhibitor SP600125 was used to study the mechanism. The results demonstrated that HMGB1 significantly increased CCK-8 absorbance values and neurosphere diameters at concentrations of 1 and 10 ng/mL at 48 h and 72 h (P < 0.05), and the other HMGB1 concentration groups (0.01, 0.1, 100 ng/mL) showed no significant difference, compared with control group (P > 0.05). HMGB1 at 10 ng/mL significantly increased the NSCs proliferation accompanied by the rising of phosphorylated JNK levels (P < 0.01), and 10 μmol/L SP600125 prevented these effects in HMGB1-cultured NSCs (P < 0.01). In conclusion, low concentration of HMGB1 (1-10 ng/mL) can increase NSCs proliferation, which may play a role by promoting JNK phosphorylation.
Animals ; Cell Proliferation ; Cells, Cultured ; HMGB1 Protein ; pharmacology ; JNK Mitogen-Activated Protein Kinases ; metabolism ; Neural Stem Cells ; cytology ; Phosphorylation ; Rats

Objective To identify the main etiologies of emergency room (ER) patients with chest pain or equivalent syndrome.Methods This was a prospective and cross-sectinal survey of ER patinets with chest pain or equivalent syndrome in 17 medical centre in Beijing,China from July to August 2009.Data was collected by structured interviews and medical record reviews.The mean follow up period was 30 days.Results A total of 5666 patients were enrolled in the study (2663 males and 3303 females) and the mean age was 58.1 ± 18.4years.Their final diagnoses were:coronary heart disease 1506 ( 27.4％ ),acute heart failure 149 ( 2.6％ ),pericarditis 4 ( 0.1％ ),pulmonary embolism 11 ( 0.2％ ),aortic dissection 8 ( 0.1％ ),acute cerebrovascular disease 431 ( 7.6％ ) and non-cardic chest pain 2538 ( 44.9％ ).Thirty-seven cased died and 275 cases hospitalized again 30 days later,4.9％ patients with cornary heart disease had symptoms at their presentation.Conclusion Special vigilance and thorough coronary artery evaluation are needed for all patients with chest discomfort or respiratory distress in the ER,even for patients without chest pain.

Objective To evaluate the effect of pitavastatin on blood glucose in patients with hypercholesterolemia,and to investigate the efficacy of pitavastatin in diabetic patients combined with hypercholesterolemia.Method This study was a 12-week,multi-center,open-label,without parallel-group comparison,phase Ⅳ clinical trail.Results Contrasting to baseline,the prevalences at week 4 and 12 post-treatment of abnormal fasting plasma glucose (FPG) and glycosylated hemoglobin Alc (HbA1c)( FPG:14.2％ vs 14.1％ and 11.0％ ; HbA1c:14.3％ vs 15.1％ and 16.1％ ) in the safety set subjects without diabetes mellitus (DM),as well as in those with DM but not taking glucose-lowering drugs (FPG:7/7 vs 4/7 and 5/7; HbAlc:5/5 vs 4/4 and 5/5) had no significant changes (all P vaules ＞0.05).Contrasting to baseline,the levels of TC [ (6.51±0.94) mmol/L vs (5.12 ±0.93) mmol/L and (4.54 ±1.00) mmol/L],LDL-C [(4.11 ±0.79)mmol/L vs (3.02 ±0.81) mmol/L and (2.51 ±0.70)mmol/L] and TG [2.10(1.53,2.54) mmol/L vs 1.62(1.26,2.00) mmol/L and 1.35(1.10,1.86)mmol/L]at week 4 and 12 post-treatment in the per protocol set 55 subjects with DM were significantly reduced (all P values ＜ 0.05 ) ; 33.3％ of subjects at high risk and 10.0％ of subjects at very high risk had achieved a TC target value; 55.6％ of subjects at high risk and 40.0％ of subjects at very high risk had achieved a LDL-C target value.Conclusion Pitavastatin has a safe effect on blood glucose and it could be used to treat diabetic patients combined with hypercholesterolemia in China.