1.Predictive Modeling of Symptomatic Intracranial Hemorrhage Following Endovascular Thrombectomy: Insights From the Nationwide TREAT-AIS Registry
Jia-Hung CHEN ; I-Chang SU ; Yueh-Hsun LU ; Yi-Chen HSIEH ; Chih-Hao CHEN ; Chun-Jen LIN ; Yu-Wei CHEN ; Kuan-Hung LIN ; Pi-Shan SUNG ; Chih-Wei TANG ; Hai-Jui CHU ; Chuan-Hsiu FU ; Chao-Liang CHOU ; Cheng-Yu WEI ; Shang-Yih YAN ; Po-Lin CHEN ; Hsu-Ling YEH ; Sheng-Feng SUNG ; Hon-Man LIU ; Ching-Huang LIN ; Meng LEE ; Sung-Chun TANG ; I-Hui LEE ; Lung CHAN ; Li-Ming LIEN ; Hung-Yi CHIOU ; Jiunn-Tay LEE ; Jiann-Shing JENG ;
Journal of Stroke 2025;27(1):85-94
Background:
and Purpose Symptomatic intracranial hemorrhage (sICH) following endovascular thrombectomy (EVT) is a severe complication associated with adverse functional outcomes and increased mortality rates. Currently, a reliable predictive model for sICH risk after EVT is lacking.
Methods:
This study used data from patients aged ≥20 years who underwent EVT for anterior circulation stroke from the nationwide Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke (TREAT-AIS). A predictive model including factors associated with an increased risk of sICH after EVT was developed to differentiate between patients with and without sICH. This model was compared existing predictive models using nationwide registry data to evaluate its relative performance.
Results:
Of the 2,507 identified patients, 158 developed sICH after EVT. Factors such as diastolic blood pressure, Alberta Stroke Program Early CT Score, platelet count, glucose level, collateral score, and successful reperfusion were associated with the risk of sICH after EVT. The TREAT-AIS score demonstrated acceptable predictive accuracy (area under the curve [AUC]=0.694), with higher scores being associated with an increased risk of sICH (odds ratio=2.01 per score increase, 95% confidence interval=1.64–2.45, P<0.001). The discriminatory capacity of the score was similar in patients with symptom onset beyond 6 hours (AUC=0.705). Compared to existing models, the TREAT-AIS score consistently exhibited superior predictive accuracy, although this difference was marginal.
Conclusions
The TREAT-AIS score outperformed existing models, and demonstrated an acceptable discriminatory capacity for distinguishing patients according to sICH risk levels. However, the differences between models were only marginal. Further research incorporating periprocedural and postprocedural factors is required to improve the predictive accuracy.
2.Nutritional supply status of school meals for primary and secondary students in three cities of Henan Province
LI Shan, YANG Li, HE Qidong, CAO Linlin, CHEN Xiaolong, LIU Bingrui, FENG Yinhua, FU Pengyu
Chinese Journal of School Health 2025;46(1):50-52
Objective:
To assess the nutritional supply status of school meals for primary and secondary school students in Henan Province, so as to provide a basis for scientific guidance of school meals.
Methods:
During 2021-2023, 115 lunch and dinner samples were collected from 25 primary and secondary schools in Zhoukou, Anyang and Luoyang of Henan Province by a direct selection method, and 13 nutrients were determined for each sample. The nutrient supply was evaluated based on Nutrition Guidelines of School Meals and Reference Intake of Dietary Nutrients for Chinese Residents (2023 Edition). Mann-Whitney U test was used to compare the differences of nutritional supply between urban and rural schools.
Results:
The median values for energy (709.77 kcal,1 kcal=4.18 kJ), fat energy supply ratio (0.27) and carbohydrate energy supply ratio (0.55) in the 66 lunches and dinners from primary school were within the recommended range. The supply of protein (28.39 g) and sodium (1 464.59 mg) was excessive. The median values of zinc (2.62 mg) and dietary fiber (5.19 g) were lower than the reference values. No statistically significant differences were observed in the supply of 13 nutrients between urban and rural primary schools( U = 427.00 -633.00, P > 0.05 ). Among 49 samples from secondary schools, the median value of energy supply (930.02 kcal), carbohydrate energy ratio ( 0.54 ) and fat energy supply ratio(0.25) were within the recommended range; and the median values of protein (38.82 g) and sodium (2 556.80 mg) were higher than the standard; and the median values of calcium (250.32 mg) and vitamin B1 (0.16 mg) were lower than the standard. Additionally, the differences in the level of vitamin B2 ( U =372.00) and zinc ( U =375.00) between the urban and rural secondary schools were statistically significant ( P <0.05).
Conclusion
Nutrient supply of primary and secondary school meals in three cities of Henan Province is inadequate and imbalanced, and the recipe need to be further optimized and improved.
3.Predictive Modeling of Symptomatic Intracranial Hemorrhage Following Endovascular Thrombectomy: Insights From the Nationwide TREAT-AIS Registry
Jia-Hung CHEN ; I-Chang SU ; Yueh-Hsun LU ; Yi-Chen HSIEH ; Chih-Hao CHEN ; Chun-Jen LIN ; Yu-Wei CHEN ; Kuan-Hung LIN ; Pi-Shan SUNG ; Chih-Wei TANG ; Hai-Jui CHU ; Chuan-Hsiu FU ; Chao-Liang CHOU ; Cheng-Yu WEI ; Shang-Yih YAN ; Po-Lin CHEN ; Hsu-Ling YEH ; Sheng-Feng SUNG ; Hon-Man LIU ; Ching-Huang LIN ; Meng LEE ; Sung-Chun TANG ; I-Hui LEE ; Lung CHAN ; Li-Ming LIEN ; Hung-Yi CHIOU ; Jiunn-Tay LEE ; Jiann-Shing JENG ;
Journal of Stroke 2025;27(1):85-94
Background:
and Purpose Symptomatic intracranial hemorrhage (sICH) following endovascular thrombectomy (EVT) is a severe complication associated with adverse functional outcomes and increased mortality rates. Currently, a reliable predictive model for sICH risk after EVT is lacking.
Methods:
This study used data from patients aged ≥20 years who underwent EVT for anterior circulation stroke from the nationwide Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke (TREAT-AIS). A predictive model including factors associated with an increased risk of sICH after EVT was developed to differentiate between patients with and without sICH. This model was compared existing predictive models using nationwide registry data to evaluate its relative performance.
Results:
Of the 2,507 identified patients, 158 developed sICH after EVT. Factors such as diastolic blood pressure, Alberta Stroke Program Early CT Score, platelet count, glucose level, collateral score, and successful reperfusion were associated with the risk of sICH after EVT. The TREAT-AIS score demonstrated acceptable predictive accuracy (area under the curve [AUC]=0.694), with higher scores being associated with an increased risk of sICH (odds ratio=2.01 per score increase, 95% confidence interval=1.64–2.45, P<0.001). The discriminatory capacity of the score was similar in patients with symptom onset beyond 6 hours (AUC=0.705). Compared to existing models, the TREAT-AIS score consistently exhibited superior predictive accuracy, although this difference was marginal.
Conclusions
The TREAT-AIS score outperformed existing models, and demonstrated an acceptable discriminatory capacity for distinguishing patients according to sICH risk levels. However, the differences between models were only marginal. Further research incorporating periprocedural and postprocedural factors is required to improve the predictive accuracy.
4.Predictive Modeling of Symptomatic Intracranial Hemorrhage Following Endovascular Thrombectomy: Insights From the Nationwide TREAT-AIS Registry
Jia-Hung CHEN ; I-Chang SU ; Yueh-Hsun LU ; Yi-Chen HSIEH ; Chih-Hao CHEN ; Chun-Jen LIN ; Yu-Wei CHEN ; Kuan-Hung LIN ; Pi-Shan SUNG ; Chih-Wei TANG ; Hai-Jui CHU ; Chuan-Hsiu FU ; Chao-Liang CHOU ; Cheng-Yu WEI ; Shang-Yih YAN ; Po-Lin CHEN ; Hsu-Ling YEH ; Sheng-Feng SUNG ; Hon-Man LIU ; Ching-Huang LIN ; Meng LEE ; Sung-Chun TANG ; I-Hui LEE ; Lung CHAN ; Li-Ming LIEN ; Hung-Yi CHIOU ; Jiunn-Tay LEE ; Jiann-Shing JENG ;
Journal of Stroke 2025;27(1):85-94
Background:
and Purpose Symptomatic intracranial hemorrhage (sICH) following endovascular thrombectomy (EVT) is a severe complication associated with adverse functional outcomes and increased mortality rates. Currently, a reliable predictive model for sICH risk after EVT is lacking.
Methods:
This study used data from patients aged ≥20 years who underwent EVT for anterior circulation stroke from the nationwide Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke (TREAT-AIS). A predictive model including factors associated with an increased risk of sICH after EVT was developed to differentiate between patients with and without sICH. This model was compared existing predictive models using nationwide registry data to evaluate its relative performance.
Results:
Of the 2,507 identified patients, 158 developed sICH after EVT. Factors such as diastolic blood pressure, Alberta Stroke Program Early CT Score, platelet count, glucose level, collateral score, and successful reperfusion were associated with the risk of sICH after EVT. The TREAT-AIS score demonstrated acceptable predictive accuracy (area under the curve [AUC]=0.694), with higher scores being associated with an increased risk of sICH (odds ratio=2.01 per score increase, 95% confidence interval=1.64–2.45, P<0.001). The discriminatory capacity of the score was similar in patients with symptom onset beyond 6 hours (AUC=0.705). Compared to existing models, the TREAT-AIS score consistently exhibited superior predictive accuracy, although this difference was marginal.
Conclusions
The TREAT-AIS score outperformed existing models, and demonstrated an acceptable discriminatory capacity for distinguishing patients according to sICH risk levels. However, the differences between models were only marginal. Further research incorporating periprocedural and postprocedural factors is required to improve the predictive accuracy.
5.Diagnostic Techniques and Risk Prediction for Cardiovascular-kidney-metabolic (CKM) Syndrome
Song HOU ; Lin-Shan ZHANG ; Xiu-Qin HONG ; Chi ZHANG ; Ying LIU ; Cai-Li ZHANG ; Yan ZHU ; Hai-Jun LIN ; Fu ZHANG ; Yu-Xiang YANG
Progress in Biochemistry and Biophysics 2025;52(10):2585-2601
Cardiovascular disease (CVD), chronic kidney disease (CKD), and metabolic disorders are the 3 major chronic diseases threatening human health, which are closely related and often coexist, significantly increasing the difficulty of disease management. In response, the American Heart Association (AHA) proposed a novel disease concept of “cardiovascular-kidney-metabolic (CKM) syndrome” in October 2023, which has triggered widespread concern about the co-treatment of heart and kidney diseases and the prevention and treatment of metabolic disorders around the world. This review posits that effectively managing CKM syndrome requires a new and multidimensional paradigm for diagnosis and risk prediction that integrates biological insights, advanced technology and social determinants of health (SDoH). We argue that the core pathological driver is a “metabolic toxic environment”, fueled by adipose tissue dysfunction and characterized by a vicious cycle of systemic inflammation and oxidative stress, which forms a common pathway to multi-organ injury. The at-risk population is defined not only by biological characteristics but also significantly impacted by adverse SDoH, which can elevate the risk of advanced CKM by a factor of 1.18 to 3.50, underscoring the critical need for equity in screening and care strategies. This review systematically charts the progression of diagnostic technologies. In diagnostics, we highlight a crucial shift from single-marker assessments to comprehensive multi-marker panels. The synergistic application of traditional biomarkers like NT-proBNP (reflecting cardiac stress) and UACR (indicating kidney damage) with emerging indicators such as systemic immune-inflammation index (SII) and Klotho protein facilitates a holistic evaluation of multi-organ health. Furthermore, this paper explores the pivotal role of non-invasive monitoring technologies in detecting subclinical disease. Techniques like multi-wavelength photoplethysmography (PPG) and impedance cardiography (ICG) provide a real-time window into microcirculatory and hemodynamic status, enabling the identification of early, often asymptomatic, functional abnormalities that precede overt organ failure. In imaging, progress is marked by a move towards precise, quantitative evaluation, exemplified by artificial intelligence-powered quantitative computed tomography (AI-QCT). By integrating AI-QCT with clinical risk factors, the predictive accuracy for cardiovascular events within 6 months significantly improves, with the area under the curve (AUC) increasing from 0.637 to 0.688, demonstrating its potential for reclassifying risk in CKM stage 3. In the domain of risk prediction, we trace the evolution from traditional statistical tools to next-generation models. The new PREVENT equation represents a major advancement by incorporating key kidney function markers (eGFR, UACR), which can enhance the detection rate of CKD in primary care by 20%-30%. However, we contend that the future lies in dynamic, machine learning-based models. Algorithms such as XGBoost have achieved an AUC of 0.82 for predicting 365-day cardiovascular events, while deep learning models like KFDeep have demonstrated exceptional performance in predicting kidney failure risk with an AUC of 0.946. Unlike static calculators, these AI-driven tools can process complex, multimodal data and continuously update risk profiles, paving the way for truly personalized and proactive medicine. In conclusion, this review advocates for a paradigm shift toward a holistic and technologically advanced framework for CKM management. Future efforts must focus on the deep integration of multimodal data, the development of novel AI-driven biomarkers, the implementation of refined SDoH-informed interventions, and the promotion of interdisciplinary collaboration to construct an efficient, equitable, and effective system for CKM screening and intervention.
6.Design and baseline characteristics of a population-based birth cohort in Shanghai
Huiting YU ; Xin CUI ; Zhou LIANG ; Renzhi CAI ; Lan CHEN ; Naisi QIAN ; Weixiao LIN ; Shan JIN ; Chunfang WANG ; Chen FU
Shanghai Journal of Preventive Medicine 2024;36(1):11-15
ObjectiveTo introduce the basic design, development plan and objectives of a population-based birth cohort in Shanghai, and further present the main data and baseline characteristics of enrolled participants in the cohort, and to provide key information for reproductive health-related studies. MethodsThe Shanghai population-based birth cohort initiated on January 1, 2005, included newborns born in Shanghai every year and their parents, and collected information on reproductive health, reproductive treatment, birth characteristics, growth and development status, as well as the incidence, treatment and death of diseases by employing data linkage technology and investigations. This formed a birth cohort spanning the entire life cycle. ResultsAs of October 2022, a total of 2 978 538 newborns and their parents were included in the cohort. Among them, 2 905 135 (97.54%) were naturally conceived (NC), and 73 403 (2.46%) were born through assisted reproductive technologies (ART). The average age of parents was (32.56±4.12) years old for females and (34.62±5.34) years old for males in the ART group, which was higher than (28.02±4.71) years and (30.07±5.54) years for parents in the NC group. Among parents, females and males aged 30 and above accounted for 77.12% and 85.08%, respectively, which were higher than that of parents (35.28% for females and 49.66% for males) in the NC group. Furthermore, the percentage of parents with a college degree or above in the ART group was 73.23% for females and 73.66% for males, which were higher than those in the NC group (49.98% and 50.91%, respectively). The multiple births rate in the ART group was 33.81%, which was higher than that in the NC group (1.88%). The incidence of premature birth and low birth weight in the ART group were 24.47% and 19.08%, respectively, which was higher than that in the NC group (5.47% and 3.73%). ConclusionThe comprehensive collection of reproductive health-related information in the birth cohort in Shanghai can provide essential resources to determine the influence of genetics, environment, reproductive treatment and other related factors on the health of offspring after birth.
7. The neuroprotective effects of Haikun Shenxi capsule medicated serum on N2a/APP695 cells based on PINKl-Parkin mitophagy pathway
Yan-Hua SUN ; Jing JI ; Jiao PENG ; Shan HE ; Shan HE ; Xian-Jun FU
Chinese Pharmacological Bulletin 2024;40(3):461-468
Aim To research the neuroprotective effect of Haikun Shenxi (HKSX) medicated serum on N2a/ App695 cells and the underlying mechanism. Methods HKSX medicated serum was prepared and carbohydrate components in it was analyzed using high performance thin layer chromatography (HPTLC) . N2a/ App695 cells were intervened with HKSX medicated serum, the cytotoxicity of HKSX medicated serum was measured by MTT; AP[_
8.Pathological Mechanism of Diabetes Based on NF-κB Signaling Pathway and Traditional Chinese Medicine Intervention: A Review
Menglu WANG ; Lu SHI ; Changhao HE ; Yongcheng AN ; Yinglan LYU ; Chen WANG ; Huimin LI ; Huilin ZHANG ; Yan HUANG ; Wanxin FU ; Ziyi SHAN ; Baosheng ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(5):246-255
As people's living standards improve, the development trend of diabetes has gradually become severe. Diabetes is a chronic inflammatory disease associated with abnormal expression of nuclear factor-kappa B (NF-κB) in patients. NF-κB exists in various tissue cells and participates in the regulation of a variety of genes related to immune function and inflammation. Varieties of factors can activate NF-κB when the body is stimulated by external factors, so as to produce inflammation and other reactions. Previous studies on NF-κB mainly focus on cancer, and the pathological mechanism of the treatment of diabetes by related signaling pathways and the progress of traditional Chinese medicine (TCM) treatment have not been systematically elaborated on. By referring to the relevant literature in China and abroad, it was found that NF-κB is not isolated in the development and progression of diabetes but is associated with signal molecules related to inflammation, oxidative stress, and energy metabolism, and it is involved in mediating inflammation, pancreatic β cell apoptosis, insulin signal transduction, and other physiological functions. Therefore, blocking the transmission of NF-κB signaling pathway is beneficial to the treatment of diabetes. At present, Western medicine for the treatment of diabetes mainly includes oral hypoglycemic drugs and insulin injections, but the adverse reactions are obvious. TCM has been characterized by multi-target, extensive action, and excellent curative effects in the treatment of diabetes. TCM and its compounds with functions of tonifying Qi and promoting blood circulation, regulating qi and eliminating phlegm, clearing heat and detoxifying, and nourishing Yin and moistening dryness can effectively intervene in the abnormal expression of NF-κB signaling pathway in vivo through anti-inflammatory effects. In this paper, the association between NF-κB signaling pathway and diabetes was summarized, and the modern research progress of TCM intervention of NF-κB signaling pathway in the treatment of diabetes in the past five years was reviewed, so as to lay a laboratory foundation for the study of a new pathological mechanism of diabetes based on NF-κB signaling pathway and provide new targets and research direction for the prevention and treatment of diabetes and development of related TCM.
9.Effect and Mechanism of Water Extract of Mori Folium on Oxidative Stress in Adipose Tissue of T2DM Mice
Huilin ZHANG ; Yongcheng AN ; Changhao HE ; Yan HUANG ; Wanxin FU ; Menglu WANG ; Ziyi SHAN ; Yuhang DU ; Jiamei XIE ; Zhanhong JIA ; Baosheng ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(11):43-50
ObjectiveTo observe the effect of water extract of Mori Folium (MLE) on oxidative stress in adipose tissue of type 2 diabetes mellitus (T2DM) mice and explore its mechanism. MethodTwenty-four male db/db mice were randomly divided into model group, metformin group, low-dose MLE (MLE-L) group, and high-dose MLE (MLE-H) group according to their body weight and blood glucose, with six mice in each group, and other six C57BLKS/JGpt wild littermate mice were selected as normal group. The mice in the metformin group were given 200 mg·kg-1 metformin suspension, and the mice in the MLE-L and MLE-H groups were respectively given 2 g·kg-1 and 4 g·kg-1 MLE, while the mice in the normal group and model group were given the same dose of deionized water by daily gavage for eight weeks. Body weight, subcutaneous fat index, fasting blood glucose (FBG), and oral glucose tolerance level (OGTT) of the mice were detected, and serum superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and malondialdehyde (MDA) were measured. The expression levels of silent information regulator 1 (SIRT1) and NADPH oxidase type 4 (NOX4) protein in subcutaneous adipose tissue of the mice were detected by Western blot. ResultThe FBG level, OGTT, and subcutaneous fat index of T2DM mice were significantly decreased (P<0.05, P<0.01) after administration of MLE compared with the blank group. The contents of serum SOD and GSH were significantly increased, while the level of oxidative stress damage marker MDA was significantly decreased (P<0.05, P<0.01). The expression of SIRT1 protein in adipose tissue was significantly increased, while the expression of NOX4 protein was significantly decreased (P<0.05, P<0.01). ConclusionMLE can ameliorate T2DM by alleviating oxidative stress in adipose tissue of T2DM mice and reducing blood glucose.
10.Protective Effect and Mechanism of Mori Folium Extract on Kidney of db/db Diabetic Mice
Yan HUANG ; Huilin ZHANG ; Changhao HE ; Yongcheng AN ; Wanxin FU ; Menglu WANG ; Ziyi SHAN ; Yuhang DU ; Jiamei XIE ; Zhanhong JIA ; Baosheng ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(11):51-59
ObjectiveTo investigate the protective effects of Mori Folium extract (MLE) on the kidney of db/db diabetic mice and its mechanism. MethodTwenty-four male C57BLKS/JGpt-Leprdb/Leprdb (db/db) mice were randomly divided into model group, metformin group, low-dose group of MLE (MLE-L), and high-dose group of MLE (MLE-H) according to their fasting blood glucose (FBG), with six mice in each group, and other six C57BLKS/JGpt wild littermate (m/m) mice were selected as normal group. The mice in the drug administration groups were given corresponding drugs by gavage, and the mice in the normal group and model group were given the same dose of deionized water by gavage once a day for continuous eight weeks. Body weight, bilateral kidney weight, and FBG were measured, and an oral glucose tolerance test (OGTT) was performed. The pathological changes in the kidney tissue of mice were observed by hematoxylin-eosin (HE) and periodic acid-silver (PAS) staining, and serum creatinine (SCr) and blood urea nitrogen (BUN) levels were detected. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) in serum and urinary microalbumin (U-mAlb) of mice. The expression levels of toll-like receptor 4 (TLR4), myeloid differentiation factor 88 (MyD88), and nuclear factor-kappa B p65 (NF-κB p65) protein in kidney tissue of mice were tested by Western blot. ResultCompared with the normal group, the body weight, absolute renal weight, FBG, and the area under the curve (AUC) of OGTT of mice in the model group were significantly increased (P<0.01), and the levels of SCr, BUN, and U-mAlb, as well as TNF-α and IL-6 in serum were significantly increased (P<0.01). The glomerular basement membrane in the kidney tissue of mice was thicker, with obvious inflammatory cell infiltration. The protein expression levels of TLR4, MyD88, and NF-κB p65 in the kidney tissue of mice were increased significantly (P<0.01). Compared with the model group, there was no statistical difference in the body weight of mice in each drug administration group. The absolute renal weight of mice in the MLE-H and metformin groups was significantly reduced (P<0.05, P<0.01). The FBG levels of mice in the metformin, MLE-L, and MLE-H groups started to decrease after treatment for four to eight weeks (P<0.05, P<0.01). The AUC of mice in the MLE-H and metformin groups was significantly decreased (P<0.01). The levels of SCr, BUN, and U-mAlb of mice in the MLE-H and metformin groups were significantly decreased (P<0.01), and those of SCr and U-mAlb of mice in the MLE-L group were significantly decreased (P<0.01). The levels of TNF-α and IL-6 in the serum of mice in the MLE-H and metformin groups were significantly decreased (P<0.01). The renal tissue pathology of mice in each drug administration group was improved to varying degrees, and the protein expression levels of TLR4, MyD88, and NF-κB p65 in the MLE-H group were decreased significantly (P<0.05, P<0.01). ConclusionMLE can improve the renal structure and function of db/db diabetic mice, and its mechanism may be related to the inhibition of the TLR4/MyD88/NF-κB signaling pathway.


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