The surveillance data of new cases of acute myocardial infarction (AMI) from January 1, 2013, to December 31, 2021, in Tengzhou City, Shandong Province, were used to analyze the incidence rate of AMI and its change trend among residents. The age and gender standardized incidence rate was calculated based on the 7th National Population Census 2020. The Cochran-Armitage trend test was used to analyze the trend of onset time and age. From 2013 to 2021, the crude and standardized incidence rate of total AMI in Tengzhou City declined from 130.07/100 000 and 161.12/100 000 to 76.15/100 000 and 72.77/100 000 ( Z=-13.785 and -20.822, both P<0.001). The crude and standardized incidence rates of males were higher than those of females. In 2016, males aged 45-54 years old and females aged 35-64 years old increased by 33.33%, 103.65%, 106.30%, and 95.75% compared to 2015, and the differences were statistically significant ( χ2=6.512, 4.965, 25.115, and 46.004, all P<0.05). The incidence rate of AMI in men aged<35 and 35-44 years old had an upward trend. From 2013 to 2021, the incidence rate of AMI decreased by 55.15% in urban areas and 36.59% in rural areas ( Z=-8.529 and -11.235, both P<0.001).

The surveillance data of new cases of acute myocardial infarction (AMI) from January 1, 2013, to December 31, 2021, in Tengzhou City, Shandong Province, were used to analyze the incidence rate of AMI and its change trend among residents. The age and gender standardized incidence rate was calculated based on the 7th National Population Census 2020. The Cochran-Armitage trend test was used to analyze the trend of onset time and age. From 2013 to 2021, the crude and standardized incidence rate of total AMI in Tengzhou City declined from 130.07/100 000 and 161.12/100 000 to 76.15/100 000 and 72.77/100 000 ( Z=-13.785 and -20.822, both P<0.001). The crude and standardized incidence rates of males were higher than those of females. In 2016, males aged 45-54 years old and females aged 35-64 years old increased by 33.33%, 103.65%, 106.30%, and 95.75% compared to 2015, and the differences were statistically significant ( χ2=6.512, 4.965, 25.115, and 46.004, all P<0.05). The incidence rate of AMI in men aged<35 and 35-44 years old had an upward trend. From 2013 to 2021, the incidence rate of AMI decreased by 55.15% in urban areas and 36.59% in rural areas ( Z=-8.529 and -11.235, both P<0.001).

Objective:To analyze the changing trend of intracerebral hemorrhage (ICH) incidence among residents with different characteristics during 9 years of comprehensive hypertension prevention and control (hypertension prevention and control) in Tengzhou from 2013 to 2021.Methods:From January 1, 2013 to December 31, 2021, the new ICH cases collected by the Center for Disease Control and Prevention in Tengzhou City were analyzed to calculate the incidence of ICH, and the trend of its distribution was analyzed among residents with different ages, sexes, and between urban and rural areas. The registered population information came from Tengzhou Public Security Bureau. Age and sex standardized incidence was calculated based on the 7th National Population Census in 2020. The Cochran-Armitage test was used to analyze the time and age trends of the incidence.Results:The overall ICH crude and standardized incidence in Tengzhou City decreased from 97.30/100 000 to 52.13/100 000 ( Z=-9.93, P<0.001) and 119.30/100 000 to 50.69/100 000 ( Z=-15.40, P<0.001) from 2013 to 2021, and both elevated to form a single peak in 2020, with 22.58% ( χ 2=24.02, P<0.001) and 18.09% ( χ 2=17.08, P<0.001) higher than in 2019, respectively. The trends in male and female incidence over the same period were similar to the overall trends, and the incidence was higher in males than in females in all years. The incidence of ICH increased with age in all years. The difference of increase in male incidence rate in 2020 was statistically significant in three age groups ≥45 years compared with 2019 (36.29%, 23.57% and 16.18%, respectively, χ 2=6.73, 4.65, 4.00, P<0.001). The incidence of ICH decreased by 70.07% and 36.23% ( Z=18.44, 5.22, P<0.001) in urban and rural areas respectively from 2013 to 2021, whereas increased by 34.15% ( χ 2=10.88, P<0.01) and 22.08% ( χ 2=18.63, P<0.001) in 2020 compared with 2019 separately. Conclusions:The incidence of ICH in Tengzhou from 2013 to 2021 showed a significant downward trend, with the decrease in the incidence of ICH in women exceeding that in men. The decrease in the incidence of ICH in urban areas exceeded that in rural areas, and male morbidity seemingly had a younger trend.

Objective:To reevaluate the upper limit of normal (ULN) of serum alanine aminotransferase (ALT) by retrospectively analyzing the ALT levels in healthy people in Ningbo area.Methods:A total of 56 140 people who underwent health examination and detection of liver biochemical indexes in the Affiliated Hospital of Medical School of Ningbo University and Yinzhou Huamao Hospital of Ningbo from 2018 to 2020 were enrolled. After excluding relevant factors that may lead to liver injury, 11 411 people were included to compare the difference of serum ALT levels among different genders and age groups (20 to 29 years, 30 to 39 years, 40 to 49 years and 50 to 59 years) to determine the ALT ULN in different gender groups. Statistical methods were performed using two independent samples t test and analysis of variance. Results:The serum ALT of males was (19.20±7.90) U/L, which was higher than that of females ((13.75±6.17) U/L), with statistical significance ( t=41.16, P<0.001). The serum ALT ULN in males and in females were 35 U/L and 26 U/L, respectively. The serum ALT levels of 20 to 29, 30 to 39, 40 to 49 and 50 to 59 years old groups were (15.48±7.61) U/L, (16.21±7.40) U/L, (17.36±7.52) U/L and (18.77±7.57) U/L, respectively.The difference was statistically significant ( F=71.51, P<0.001). Serum ALT level in 50 to 59 years old group was higher than that in 20 to 29 years old group, and the difference was statistically significant ( t=13.11, P<0.01). In males, the ALT ULN of 20 to 29 years old was the lowest of 34.43 U/L, and highest of 35.29 U/L in 40 to 49 years old. In females, the ALT ULN in the 20 to 29 years old group was the lowest of 23.01 U/L, and the ALT ULN in the 50 to 59 years old group was the highest of 30.79 U/L. ALT ULN increased with age in females. The serum ALT of males was higher than that of females in all age groups ( t=29.55, 26.91, 13.43 and 4.62, respectively, all P<0.05). Conclusions:The serum ALT level is significantly correlated to gender and age. The serum ALT ULNs of healthy adult are 35 U/L in males and 26 U/L in females in Ningbo area.

Objective:To investigate the temporal trend of the mortality rate of intracerebral hemorrhage (ICH) among residents with different characteristics during the comprehensive prevention and control of hypertension in Tengzhou, Shandong Province from 2013 to 2021.Methods:Comprehensive prevention and control of hypertension was conducted in Tengzhou, Shandong Province from 2013 to 2021. ICH mortality rate was calculated from January 1, 2013 to December 31, 2021. ICH mortality monitoring data from Tengzhou, Shandong Province was used to analyze the temporal trend of ICH mortality among residents with different characteristics. The registered residence population came from the Public Security Bureau of Tengzhou, Shandong Province. The age and gender standardized mortality rate was calculated based on the data of China's seventh population census in 2020. The temporal and age trends of mortality were analyzed using Cochran Armitage Trend Tests.Results:From 2013 to 2021, the overall crude and standardized mortality rates of ICH in Tengzhou, Shandong Province decreased from 50.51/100 000 and 63.21/100 000 to 17.51/100 000 and 16.74/100 000, respectively ( Z=-11.013 and -15.426, P<0.001), with an average annual mortality rate decrease of 12.41% and 15.30%, respectively. The overall crude and standardized mortality rates in 2017 peaked compared to 2016, mainly due to an increase of 32.94% and 30.92% in male ICH crude and standardized mortality rates, respectively ( χ2=12.328 and 15.854, P<0.05). The mortality rate of ICH increased with age, and the decreasing trend over time became increasingly evident with age. The mortality rate of ICH in the ≥65 year old age group decreased by 77.94% over 9 years ( Z=-14.065, P<0.001). In 2017, the mortality rate of ICH in the male age group ≥65 years old and female 45-54 years old increased by 31.13% and 125.79% compared to 2016 respectively, there were statistically significant differences ( χ2=8.877 and 5.421, P<0.05). In 2021, the mortality rates of urban and rural ICH decreased by 93.22% and 46.40% compared to 2013, respectively ( Z=-13.279 and -5.393, P<0.001), with an average annual decrease of 28.56% and 7.50%, respectively. The ICH mortality rate in rural areas increased by 30.54% in 2017 compared to 2016 ( χ2=16.086, P<0.001); after 2018, the mortality rate of ICH began to be higher than that of urban areas ( χ2=33.400 and 67.305, P<0.001). Conclusions:The ICH mortality rate in Tengzhou, Shandong Province has shown a significant downward trend over time, with male mortality rate higher than female mortality rate and rural mortality rate higher than urban areas. This suggests that the key attention should be paid to both male and rural areas.

Objective:To analyze the characteristics of adverse events of active medical devices in Shandong province, as well as the impact of device use duration on the risk rate of adverse events, for reference in improving the monitoring system of active medical device adverse events in China and the level of hospital medical quality management.Methods:The data came from the adverse event reporting data of active medical devices collected by Shandong Adverse Drug Reaction Monitoring Center from January 2019 to October 2021. The R software was used to analyze the distribution, cause and severity of adverse events, and a linear regression model of adverse event risk rate(Y) and adverse event time point(X) was established.Results:A total of 35 254 adverse events of active devices were included, of which 3 059 were serious injuries. The province/municipality with the largest number of reported adverse events was Shanghai(8 006 cases), and the least was Hainan province(4 cases); The majority of adverse events were reported by hospitals, with 34 056(96.60%). The medical devices reporting a higher number of adverse events were ventilators(688 cases), monitors(4 623 cases), infusion pumps(1 079 cases), syringe infusion pumps(1 995 cases), medical electron accelerators(529 cases)and infant incubators(513 cases). In the linear regression model, the risk rate of adverse events increased with the useduration of the device when 0.00%≤ X<14.14%; the risk rate of adverse events decreased with the increase of service time when 14.14%≤ X<100.00%. Conclusions:The number of adverse events reported in each province is different, and hospitals are the main reporting units.The causes of adverse events of different medical devices indicate different correlation strengths with the product itself. The use duration of medical devices poses a great impact on the risk rate of adverse events.

Cardiomyocyte autophagy plays an important role in maintaining normal cardiac structure and function.Recent studies have shown that cardiomyocyte autophagy is decreased in the aging heart.The expression of autophagy-related genes Atg5, Atg7 and Beclin1 decreases in the aging myocardium.Decreased cardiomyocyte autophagy in the aging heart is associated with dysregulation of phosphatidylinositol-3-kinase(PI3K)/serine-threonine kinase(Akt)/mammalian target of rapamycin(mTOR), adenosine monophosphate-activated protein kinase(AMPK)and/or the SIRT1 signaling pathways.In addition, reactive oxygen species and some neural hormonal factors such as endothelin-1 can also mediate the decrease of cardiomyocyte autophagy in cardiac aging.The regulation of cardiomyocyte autophagy may provide new strategies for the prevention and treatment of cardiomyopathy in the elderly.

Objective:To investigate the differences between serum lipoprotein-associated phospholipase A2 (Lp-PLA2) and insulin resistance (IR) and the relationship between Lp-PLA2 and IR and homocysteine (Hcy) levels in patients with type H and non-type H hypertension.Methods:A total of 298 patients with essential hypertension (observation group) who visited Lu′an Hospital of Traditional Chinese Medicine in Anhui Province from January 2018 to January 2020 were selected, and 564 healthy subjects were as control group. According to age, gender and body mass index (BMI), propensity score matching was conducted, and the matching relationship was determined according to 1∶1 nearest neighbor matching method. Finally, 166 cases were included in the observation group and the control group. Type H hypertension was defined as essential hypertension with an Hcy level of > 10 mol/L.Results:The smoking proportion, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), fasting blood glucose (FPG), fasting insulin (FINS), fibrinogen (FIB), hypersensitive C reactive protein (hs-CRP), LP-PLA2, Hcy, and homeostasis model of assessment for insulin resistance index (HOMA-IR) in the observation group were higher than those in control group: 24.7% vs. 13.9%, (5.06 ± 1.65) mmol/L vs. (4.60 ± 1.42) mmol/L, (2.92 ± 0.97) mmol/L vs. (2.62 ± 0.86) mmol/L, (5.80 ± 1.03) mmol/L vs. (5.12 ± 0.94) mmol/L, (13.06 ± 5.14) U/L vs. (9.25 ± 4.67) U/L, (3.28 ± 1.16) g/L vs. (2.17 ± 1.01) g/L, (2.00 ± 1.09) mg/L vs. (0.52 ± 0.43) mg/L, (161.98 ± 86.84) mg/L vs. (126.87 ± 56.84) mg/L, (15.00 ± 5.06) mol/L vs. (11.54 ± 3.63) mol/L and 3.49 ± 1.25 vs. 2.03 ± 1.11 ( P < 0.05), and the high density lipoprotein cholesterol (HDL-C) was lower than that in control group: (1.15 ± 0.56) mmol/L vs. (1.33 ± 0.66) mmol/L ( P < 0.05). The age, BMI, smoking ratio, TC, FPG, FINS, FIB, hs-CRP and Hcy in H-type hypertension group were higher than those in non-H-type hypertension group: (56.41 ± 11.07) years old vs. (49.61 ± 10.58) years old, (27.92 ± 4.02) kg/m 2 vs. (24.23 ± 4.11) kg/m 2, 31.1% vs. 14.3, (5.32 ± 1.54) mmol/L vs. (4.63 ± 1.24) mmol/L, (5.97 ± 1.03) mmol/L vs. (5.51 ± 0.98) mmol/L, (14.29 ± 5.04) U/L vs. (11.06 ± 4.57) U/L, (3.48 ± 1.10) g/L vs. (2.95 ± 0.83) g/L, (2.48 ± 1.21) mg/L vs. (1.22 ± 1.02) mg/L, 16.13 (12.96, 23.20) mol/L vs. 7.63 (6.58, 8.35) mol/L ( P < 0.05), and the HDL-C was lower than that in non-H-type hypertension group: (1.05 ± 0.54) mmol/L vs. (1.31 ± 0.78) mmol/L ( P < 0.05). HOMA-IR was 2.27 (1.60, 3.34) and Lp-PLA2 was 61.64 (53.25, 75.47) in patients with non-H-type hypertension. HOMA-IR was 3.34 (2.63, 443) and Lp-PLA2 was 212.25 (120.35, 278.62) in patients with type H-type hypertension. Lp-PLA2 and Lp-PLA2 were higher in patients with H-type hypertension than those in patients with non-H-type hypertension ( P < 0.05). In patients with essential hypertension, there was a strong positive correlation between Hcy and HOMA-IR and Lp-PLA2 ( r = 0.655 and 0.774, P < 0.05). Age, BMI, TC, FPG, FINS, FIB, hs-CRP, HOMA-IR and LP-PLA2 were independent risk factors for Hcy increase ( P < 0.05), while HDL-C was a protective factor for Hcy increase ( P < 0.05). Conclusions:Patients with type H-hypertension have a higher HOMA-IR and an increased level of Lp-PLA2, which is correlated with an increase in Hcy.