1.Progress and practice of objective measurement of physical behaviors in large-scale cohort research
Yuanyuan CHEN ; Yalei KE ; Jun LYU ; Dianjianyi SUN ; Lang PAN ; Pei PEI ; Huaidong DU ; Junshi CHEN ; Zhengming CHEN ; Liming LI ; Doherty AIDEN ; Canqing YU
Chinese Journal of Epidemiology 2024;45(1):35-40
Due to the limited reliability of traditional self-completed questionnaire, the accuracy of measurement of physical behaviors (physical activity, sedentary behavior and sleep) is not high. With the development of technology, wearable devices (e.g. accelerometer) can be used for more accurate measurement of physical behaviors and have great application potential in large-scale research. However, the data of objective measurement of physical behaviors from large-scale cohort research in Asian populations is still limited. Between August 2020 and December 2021, the 3 rd resurvey of China Kadoorie Biobank (CKB) project used Axivity AX3 wrist triaxial accelerometer to collect the data of participants' daily activity and sleep status. A total of 20 370 participants from 10 study areas were included in the study, in whom 65.2% were women, and the age was (65.4±9.1) years. The participants' physical activity level varied greatly in different study areas. The objective measurement of participants' physical behaviors in CKB project has provided valuable resources for the description of 24-hour patterns of physical behaviors and evaluation of the health effect of physical activity, sedentary behavior and sleep as well as their association with diseases in the elderly in China.
2.Distribution and influencing factors of lipoprotein (a) levels in non-arteriosclerotic cardiovascular disease population in China
Yalei KE ; Lang PAN ; Jun LYU ; Dianjianyi SUN ; Pei PEI ; Yiping CHEN ; Ling YANG ; Huaidong DU ; Robert CLARKE ; Junshi CHEN ; Zhengming CHEN ; Xiao ZHANG ; Ting CHEN ; Runqin LI ; Litong QI ; Liming LI ; Canqing YU
Chinese Journal of Epidemiology 2024;45(6):779-786
Objective:To describe the distribution of lipoprotein (a) [Lp(a)] levels in non-arteriosclerotic cardiovascular disease (ASCVD) population in China and explore its influencing factors.Methods:This study was based on a nested case-control study in the CKB study measured plasma biomarkers. Lp(a) levels was measured using a polyclonal antibody-based turbidimetric assay certified by the reference laboratory and ≥75.0 nmol/L defined as high Lp(a). Multiple logistic regression model was used to examine the factors related to Lp(a) levels.Results:Among the 5 870 non-ASCVD population included in the analysis, Lp(a) levels showed a right-skewed distribution, with a M ( Q1, Q3) of 17.5 (8.8, 43.5) nmol/L. The multiple logistic regression analysis found that female was associated with high Lp(a) ( OR=1.23, 95% CI: 1.05-1.43). The risk of increased Lp(a) levels in subjects with abdominal obesity was significantly reduced ( OR=0.68, 95% CI: 0.52-0.89). As TC, LDL-C, apolipoprotein A1(Apo A1), and apolipoprotein B(Apo B) levels increased, the risk of high Lp(a) increased, with OR (95% CI) for each elevated group was 2.40 (1.76-3.24), 2.68 (1.36-4.93), 1.29 (1.03-1.61), and 1.65 (1.27-2.13), respectively. The risk of high Lp(a) was reduced in the HDL-C lowering group with an OR (95% CI) of 0.76 (0.61-0.94). In contrast, an increase in TG levels and the ratio of Apo A1/Apo B(Apo A1/B) was negatively correlated with the risk of high Lp(a), with OR (95% CI) of 0.73 (0.60-0.89) for elevated triglyceride group, and OR (95% CI) of 0.60 (0.50-0.72) for the Apo A1/B ratio increase group (linear trend test P≤0.001 except for Apo A1). However, no correlation was found between Lp(a) levels and lifestyle factors such as diet, smoking, and physical activity. Conclusions:Lp(a) levels were associated with sex and abdominal obesity, but less with lifestyle behaviors.
3.Sponge forceps assisted threading with Speedbridge technique for the treatment of acute closed Achilles tendon rupture
Lin SHANG ; Fuqiang MA ; Qi LI ; Yalei WANG ; Xiaolong ZHANG ; Shiqiang SUN ; Guanghui JIA ; Xiangyu WANG ; Aiguo WANG
Chinese Journal of Trauma 2023;39(3):259-264
Objective:To explore the outcome of sponge forceps assisted threading with Speedbridge technique for the treatment of acute closed Achilles tendon rupture.Methods:A retrospective case series study was conducted on 20 patients with acute closed Achilles tendon rupture treated in Zhengzhou Orthopedic Hospital from December 2019 to December 2021. There were 18 males and 2 females, with age range of 24-43 years [(29.5±7.6)years]. All patients were with unilateral injury, involving the left side in 13 patients and right side in 7. Examinations revealed a palpable defect in the Achilles tendon and positive Thompson test. A longitudinal incision was made at the medial edge of the ruptured tendon. Three nonabsorbable sutures were passed through the proximal stump with sponge forceps, bypassed the rupture site and fixed directly into the calcaneal bone. The disrupted tendon ends were aligned by the tendon-bundle technique using 4-0 absorbable sutures. The operation time and incision length were documented. The ankle joint range of motion (dorsiflexion/plantar flexion), American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Achilles tendon total rupture score (ATRS) in the affected and healthy side were compared at 3, 6 and 12 months postoperatively. The wound healing and complications were observed.Results:All patients were followed up for 12-16 months [(13.2±2.5)months]. The operation time was 40-66 minutes [(52.0±10.3)minutes], with the incision length of 3-4 cm [(3.3±0.7)cm]. In the affected side at 3 and 6 months postoperatively, the ankle joint dorsiflexion [(5.6±1.5)°, (10.5±0.2)°] and plantar flexion [(28.4±3.2)°, (33.5±1.5)°] showed statistically significant difference compared with the healthy side (all P<0.05). The ankle joint dorsiflexion [(13.9±0.7)°] and plantar flexion [(38.3±4.4)°] in the affected side were not statistically different from that of the healthy side at 12 months postoperatively (all P>0.05). The AOFAS ankle-hindfoot score was (58.3±5.4)points, (84.9±7.1)points and (91.8±6.3)points at 3, 6 and 12 months postoperatively, showing a gradual rise (all P<0.05). The ATRS was (60.5±4.9)points, (85.5±9.0)points and (93.1±5.7)points at 3, 6 and 12 months postoperatively, showing a gradual rise (all P<0.05). All incisions were healed primarily. No patients had wound infection, nerve injury or re-rupture. Pain at the anchor insertion site occurred in 2 patients at 1 month after operation and relieved after active functional rehabilitation at 4 months after operation. Transient pain at the Achilles tendon insertion occurred in 1 patient at 6 months after operation, and relieved after 2 weeks of oral non-steroidal anti-inflammatory drugs treatment. Conclusion:For acute closed Achilles tendon rupture, sponge forceps assisted threading with Speedbridge technique can attain short operation time, small incision and good functional recovery, with few complications.
4.Human menstrual blood-derived stem cells alleviate autoimmune hepatitis via JNK/MAPK signaling pathway in vivo and in vitro.
Fen ZHANG ; Lanlan XIAO ; Ya YANG ; Menghao ZHOU ; Yalei ZHAO ; Zhongyang XIE ; Xiaoxi OUYANG ; Feiyang JI ; Shima TANG ; Lanjuan LI
Frontiers of Medicine 2023;17(3):534-548
Autoimmune hepatitis (AIH) is a severe globally distributed liver disease that could occur at any age. Human menstrual blood-derived stem cells (MenSCs) have shown therapeutic effect in acute lung injury and liver failure. However, their role in the curative effect of AIH remains unclear. Here, a classic AIH mouse model was constructed through intravenous injection with concanavalin A (Con A). MenSCs were intravenously injected while Con A injection in the treatment groups. The results showed that the mortality by Con A injection was significantly decreased by MenSCs treatment and liver function tests and histological analysis were also ameliorated. The results of phosphoproteomic analysis and RNA-seq revealed that MenSCs improved AIH, mainly by apoptosis and c-Jun N-terminal kinase/mitogen-activated protein signaling pathways. Apoptosis analysis demonstrated that the protein expression of cleaved caspase 3 was increased by Con A injection and reduced by MenSCs transplantation, consistent with the TUNEL staining results. An AML12 co-culture system and JNK inhibitor (SP600125) were used to verify the JNK/MAPK and apoptosis signaling pathways. These findings suggested that MenSCs could be a promising strategy for AIH.
Mice
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Animals
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Humans
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Hepatitis, Autoimmune/pathology*
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Signal Transduction
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Disease Models, Animal
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Stem Cells
5.Brain-computer interface technology for stroke in the past decade: a visualized analysis
Mingyue LIU ; Yalei FAN ; Meng ZHANG ; Xueyi SONG ; Zhe LI
Chinese Journal of Rehabilitation Theory and Practice 2023;29(2):223-230
ObjectiveTo conduct a visualized analysis of the research related to the use of brain-computer interface technology for stroke rehabilitation in the past ten years, and identify and predict the hot spots and hot trends in order to promote the further development of this field. MethodsThe Web of Science Core Collection database was searched for literature related to brain-computer interface technology for stroke rehabilitation from January, 2011 to October, 2022. CiteSpace 5.8.R3 was used to analyze the number of publications, countries, institutions, authors, keywords, co-citations, and grant support. Results and ConclusionA total of 592 papers were included, and the annual number of publications in this field of research showed a rapid growth trend, and the research enthusiasm continued to increase. The United States was in the leading position in this field, with the highest number of cooperative publications and the highest intermediary centrality; China had certain advantages in this field, but still needed to strengthen the exchange and cooperation with other countries/regions. Foreign institutions and authors had formed a network of close cooperative relationships, and formed a high-impact team represented by Niels Birbaumer, Cuntai Guan, Kai Keng Ang, etc.; there were poor cooperative relationships among domestic authors and institutions, and there were geographical restrictions and lack of high-impact academic groups. The keywords "motor imagery" and "recovery" formed ten major clusters and 15 prominent words with high variation rates, showing a trend of diversification in research directions. The study of the efficacy of upper limb motor rehabilitation and central mechanisms has been the hot topics in this field and will continue for some time in the future; the use of lower limb brain-computer interface systems for improving foot drop, gait and balance in stroke patients and the application of multimodal brain-computer interfaces will probably become a hot topic in the future. Finally, the use of brain-computer interface-guided neurofeedback training for cognitive and language rehabilitation in stroke also needs attention.
6.The value of different risk stratifications in the diagnosis of early gastric cancer
Pengyue Zhang ; Zhen Zhu ; Tingting Xu ; Hui Feng ; Yang Li ; Yi Cai ; Jiahui He ; Yalei Wang
Acta Universitatis Medicinalis Anhui 2023;58(3):510-514
Objective :
To compare the diagnostic efficacy of three screening methods,including the epidemiological survey and the new gastric cancer scoring system proposed in the Expert Consensus Opinion on Early Gastric Cancer Screening Process in China ( Shanghai,2017) ,and the Kyoto classification score for screening gastric in early gastric cancer diagnosis.
Methods:
Patients who underwent endoscopic submucosal dissection and were pathologically confirmed were included in the gastric cancer group,patients with non-gastric cancer in the same period were consecutively included in the control group.Questionnaires and serological tests were performed in all enrolled patients,and the endoscopic presentations was recorded according to the classification of Kyoto gastritis during gastroscopy.The risk stratification and the detection rates of gastric cancer were estimated by different screening methods,and the receiver operating characteristic curve (ROC curve) of subjects diagnosed with each screening method alone and in combination were plotted to compare the area under the ROC curve (AUC) and the diagnostic efficacy .
Results:
Among all participants,84 were patients with gastric cancer and 120 were normal people without gastric cancer.The Kyoto risk score had the highest diagnostic value (AUC = 0. 79) among the others,and its sensitivity and specificity were 72. 6% and 79. 1% ,respectively,but the combined diagnosis of different methods did not significantly improve the diagnostic efficacy.The Kyoto risk score had a more discriminative value in the medium to high-risk group delineated by the new scoring system.
Conclusion
The Kyoto risk score has high clinical value in the diagnosis of early gastric cancer and can be used in conjunction with the new scoring system for early gastric cancer risk assessment.
7.Role of frontal lobe and its related circuits involved in cognitive flexibility impairment in autism
Chengming XU ; Yalei FAN ; Zhe ZHANG ; Jiwei ZHANG ; Liguo LI ; Xianwen DONG
Chinese Journal of Behavioral Medicine and Brain Science 2023;32(11):1051-1056
Autism spectrum disorder (ASD) is a multifactorial disease, with social difficulties and repetitive behaviors as its core symptoms. With the improvement of diagnostic methods, the detection rate of ASD is increasing year by year.Cognitive flexibility impairment is very obvious in most autistic patients.More and more studies have shown that cognitive flexibility impairment is related to the occurrence and development of core symptoms. However, the mechanism of cognitive flexibility impairment in autism remains unclear. The frontal lobe plays an important role in advanced cognition, and its complete development is related to cognitive function. Recent studies have shown that frontal lobe dysfunction is closely related to cognitive flexibility deficits in autistic patients, and the abnormal changes in the frontal lobe, the associated default mode network dysfunction and frontal striatal circuit defects may be the important mechanisms of cognitive flexibility impairment. Based on the recent clinical and basic studies on cognitive flexibility in autism, this article reviews the mechanisms of frontal lobe and related circuits involved in the impairment of cognitive flexibility in autism.
8.Comparative study on physical activity and its influencing factors in patients with cardiovascular disease between China and the United Kingdom
Yalei KE ; Hongjing SHI ; Jun LYU ; Yuanyuan CHEN ; Zilun SHAO ; Liming LI ; Dianjianyi SUN ; Canqing YU
Chinese Journal of Epidemiology 2023;44(11):1709-1716
Objective:To explore the differences of physical activity levels between Chinese and British patients with cardiovascular disease (CVD) and its influencing factors.Methods:Based on the baseline survey of China Kadoorie Biobank (CKB) and United Kingdom Biobank (UKB), we identified the case and control group according to the self-reported disease history in the questionnaire. Metabolic equivalent of task, as the assessment of physical activity level, was graded according to the tertiles of specific ages and genders. Multiple logistic regression models were used to analyze the correlation between CVD status and physical activity levels.Results:We included 509 170 Chinese adults and 360 360 British adults in the analysis. After adjusting for multiple factors, we found a positive correlation between CVD patients and low physical activity levels in both CKB and UKB populations (CKB: OR=1.21, 95% CI:1.17-1.25; UKB: OR=1.24, 95% CI:1.20-1.28). There was a high correlation between the prevalence of CVD and low physical activity levels in males with CKB ( OR=1.33, 95% CI:1.27-1.40).Unlike the UKB population, as the length of CVD increased, the physical activity levels of CKB patients gradually approached that of the non-CVD population, and stroke was positively correlated with low physical activity levels ( OR=1.46, 95% CI:1.38-1.53). The decline in physical activity was more pronounced among CKB and UKB CVD patients with lower educational levels, current or former smokers or drinkers, and those with other chronic diseases. In CKB, there showed a high correlation between CVD disease and low physical activity levels in rural areas and non-retired populations. In UKB, there appeared a higher correlation between CVD disease and low physical activity levels in urban and non-working populations. Conclusions:The physical activity levels of CVD patients in both China and the UK were lower than that in non-CVD population. In addition to low-educated individuals, current or former smokers or drinkers, and those with other chronic diseases, it is critical to pay attention to the physical activity levels of rural, male, and non-retirees among Chinese patients.
9.KAP investigation and analysis of drug use safety risk of Sanjin tablets
Yalei YANG ; Chunxiao LI ; Xiao LING ; Panpan WANG ; Jing MA ; Ya ZHAO ; Hongmei ZHENG
China Pharmacy 2022;33(23):2908-2912
OBJECTIVE To investigate the awareness of the patients receiving Sanjin tablets in knowledge-attitude-practice (KAP) aspect, and its influential factors. METHODS Demographic characteristics, medication knowledge, attitude and practice of outpatients and inpatients who used Sanjin tablets in the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from June to December 2020 were investigated online and offline for questionnaire survey and scale scoring.Oneway variance analysis and multiple linear regression analysis were used to screen the influential factors for KAP of the patient receiving Sanjin tablets. RESULTS A total of 503 valid questionnaires (effective recovery rate of 99.60%) were collected in this survey. The drug use knowledge score of Sanjin tablet users was (26.74±6.82) points, the drug use attitude score was (7.82±3.75) points, and the drug use practice score was (21.72±5.56) points. The overall scores were good, excellent and good, respectively.The results of oneway variance analysis showed that there were significant differences in drug use knowledge and drug use practice scores among the patients receiving Sanjin tablets with different ages,occupations and medical insurance types (P<0.05); there were significant differences in drug use attitude scores among the patients receiving Sanjin tablets with different ages, occupations, education levels and medical insurance types (P<0.05). The results of multiple linear regression analysis showed that ages, occupations, education levels and medical insurance types were the main factors affecting the drug use knowledge and drug use attitude of the patients receiving Sanjin tablets (P<0.05); education levels and medical insurance types were the main factors affecting the drug use practice of the patients receiving Sanjin tablets (P<0.05). CONCLUSIONS Most of the patients receiving Sanjin tablets have a good attitude towards the acquisition of safe medication information, but the knowledge to drug use and the actual drug use practice still have certain hidden danger in security; it is necessary to strengthen drug use education and publicity for individual age groups, low-educational background groups and other people, carry out the drug education among the population with different vocational characteristics and medical insurance types in order to promote safe and rational drug use.
10.Development of hedgehog pathway inhibitors by epigenetically targeting GLI through BET bromodomain for the treatment of medulloblastoma.
Xiaohua LIU ; Yu ZHANG ; Yalei LI ; Juan WANG ; Huaqian DING ; Wenjing HUANG ; Chunyong DING ; Hongchun LIU ; Wenfu TAN ; Ao ZHANG
Acta Pharmaceutica Sinica B 2021;11(2):488-504
Medulloblastoma (MB) is a common yet highly heterogeneous childhood malignant brain tumor, however, clinically effective molecular targeted therapy is lacking. Modulation of hedgehog (HH) signaling by epigenetically targeting the transcriptional factors GLI through bromodomain-containing protein 4 (BRD4) has recently spurred new interest as potential treatment of HH-driven MB. Through screening of current clinical BRD4 inhibitors for their inhibitory potency against glioma-associated oncogene homolog (GLI) protein, the BRD4 inhibitor


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