1.Characteristics of vascular endothelial function and its relationship with coronary artery injury in children with incomplete Kawasaki disease of different ages
Ruihua LIU ; Jianwei LI ; Yunning FAN ; Guangfei SUN ; Yixuan WANG
Journal of Chinese Physician 2024;26(8):1151-1156
Objective:To explore the characteristics of endothelial function in children with incomplete Kawasaki disease (IKD) of different ages and its relationship with coronary artery lesion (CAL).Methods:A total of 200 children with IKD admitted to the Affiliated Hospital of Jining Medical University from February 2020 to May 2022 were selected as the IKD group, and another 200 healthy children who underwent physical examinations during the same period were selected as the control group. According to the age of children with IKD, infants ( n=78) were classified as those under 1 year old, infants ( n=62) were classified as those between 1-3 years old, and preschool children ( n=60) were classified as those over 3-6 years old. The endothelial function characteristics of IKD children in different age groups and normal control group children were analyzed and compared. In addition, IKD patients were divided into CAL group ( n=110) and nCAL group ( n=90) based on whether CAL was merged. The age, carotid intima-media thickness (IMT), flow-mediated-dilation (FMD), carotid stiffness index (SI), nitroglycerin-mediated dilation (NMD), tumor necrosis factor α (TNF-α), C-reactive protein (CRP), brachial artery endothelial dependent dilation function (EDD) and other clinical data were compared between the two groups. Cox proportional hazards model was used for univariate and multivariate analysis to identify the risk factors for CAL in IKD patients. A column chart prediction model was constructed and evaluated. Results:There were statistically significant differences in FMD, NMD, SI, IMT, reactive congestion index (RHI), and EDD between IKD patients and normal control group children (all P<0.05). There were statistically significant differences in FMD, NMD, SI, IMT, RHI, and EDD among three groups of IKD children of different ages (all P<0.05). There were statistically significant differences in the proportion of children aged ≤3 years, TNF-α, CRP, SI, IMT, EDD, FMD, and NMD between the nCAL and CAL groups (all P<0.05). Age ≤3 years, elevated levels of TNF-α, CRP, SI, IMT, and EDD, as well as decreased levels of FMD and NMD, were independent risk factors for CAL in children with IKD (all P<0.05). The column chart prediction model had high discrimination, and the area under the curve for predicting CAL occurrence in children with IKD was 0.868 and 0.830, respectively. Conclusions:There are significant differences in endothelial function among children with IKD of different ages, and endothelial function is closely related to the occurrence of CAL. When endothelial function is abnormal, CAL is more likely to occur.
2.Measurement and algorithm of healthy life expectancy: a scoping review
Wanqi WANG ; Jinghan QU ; Mengze LIU ; Minrui LI ; Boying ZANG ; Junwen ZHOU ; Houyu ZHAO ; Rui ZHANG ; Yunning LIU ; Lijun WANG ; Xia WAN ; Feng SUN ; Jing WU
Chinese Journal of Epidemiology 2022;43(12):1986-1994
Objective:Healthy life expectancy (HLE), which combines life expectancy with health, is an essential comprehensive measure of life length and quality. This article aimed to systematically review the methods for defining and measuring HLE and describe application studies published, providing a reference for decision makers to select and develop methods suitable for China's conditions to measure HLE.Methods:Seven Chinese and English literature databases were searched up to May 7, 2022, and several related reviews and bibliography were manually retrieved. Systematic reviews and empirical research were included concerning HLE indicators and measurement of HLE. Information including the study area, type of the study, study population, HLE index, measurement method, data sources, and results from application studies published in the last five years were extracted. The evolution of the definition of HLE, the scope of different indicators, the measurement scale of health, and measurement methods, were all collected. Results of the empirical research related to measurement methods of indicators were summarized. The study followed the scoping review framework and was written according to the PRISMA-ScR statement.Results:A total of 84 articles were included, including 13 reviews, 17 original studies related to HLE index definition, ten original studies related to index measurement, and 44 empirical studies conducted in the past five years. There were as many as 20 indicators related to HLE, and each scale had its emphasis. A total of ten methods measuring HLE were identified, which vary in the definition of health, whether using weight, and the data type. The most commonly used indicators in the past five years were disability-free life expectancy and HLE. For the method of HLE calculation, Sullivan's method was mainly used for cross-sectional data, and the multistate life table was mainly used for longitudinal data.Conclusions:There are various definitions and measurement methods of HLE, but none are suitable for all scenarios. To summarize the HLE concept, health evaluation techniques, measurement methods, and application studies published worldwide can provide a reference for the localization of HLE measurement in China.
3.A study of Tai Chi and Qigong popularity in the United States based on the NHIS data
Yunning LI ; Chunyun WANG ; Haoyue LI ; Jing ZHAO ; Hongxin CAO
International Journal of Traditional Chinese Medicine 2022;44(6):610-615
Tai Chi and Qigong (TCQ) are regarded as major therapies of complementary and alternative medicine (CAM), and welcomed by increasing practitioners worldwide for their efficacy in various health issues. To better learn about the popularity of TCQ in the United States, the related data collected from 2007, 2012 and 2017 questionnaires of the National Health Interview Survey (NHIS) were examined and analyzed. The result showed that adult TCQ practitioners in the US increased substantially from 2007-2017, the percentage of Tai Chi practitioners in adult population was 1.0% in 2007, and Qigong practitioners 0.3%; Tai Chi practitioners was 1.1% in 2012, and Qigong practitioners 0.3%; in 2017, Tai Chi practitioners was 1.5%, and Qigong practitioners 0.5%. The top three reasons for using TCQ were: 82.4% for general wellness or disease prevention, 64.6% to improve or enhance energy, and 35.1% recommended by family, friends or co-workers. The health benefits of TCQ, the demand for complementary therapies and increasing research evidences were positive factors for the growth, while there are also challenges including insufficiencies in scientific researches and lacking of standardized teaching system. To promote the future development of TCQ in the US and oversea countries, we should optimize the research methods and standardize the teaching system, encourage the exchange and training of TCQ related professionals, and promote the integration of TCQ into conventional medical system and other related industries.
4.Mangiferin ameliorates cardiac fibrosis in D-galactose-induced aging rats by inhibiting TGF-β/p38/MK2 signaling pathway
Jing CHENG ; Chaoyang REN ; Renli CHENG ; Yunning LI ; Ping LIU ; Wei WANG ; Li LIU
The Korean Journal of Physiology and Pharmacology 2021;25(2):131-137
Aging is the process spontaneously occurred in living organisms. Cardiac fibrosis is a pathophysiological process of cardiac aging. Mangiferin is a wellknown C-glucoside xanthone in mango leaves with lots of beneficial properties. In this study, rat model of cardiac fibrosis was induced by injected with 150 mg/kg/d Dgalactose for 8 weeks. The age-related cardiac decline was estimated by detecting the relative weight of heart, the serum levels of cardiac injury indicators and the expression of hypertrophic biomakers. Cardiac oxidative stress and local inflammation were measured by detecting the levels of malondialdehyde, enzymatic antioxidant status and proinflammatory cytokines. Cardiac fibrosis was evaluated by observing collagen deposition via masson and sirius red staining, as well as by examining the expression of extracellular matrix proteins via Western blot analysis. The cardiac activity of profibrotic TGF-β1/p38/MK2 signaling pathway was assessed by measuring the expression of TGF-β1 and the phosphorylation levels of p38 and MK2. It was observed that mangiferin ameliorated D-galactose-induced cardiac aging, attenuated cardiac oxidative stress, inflammation and fibrosis, as well as inhibited the activation of TGF-β1/p38/MK2 signaling pathway. These results showed that mangiferin could ameliorate cardiac fibrosis in D-galactose-induced aging rats possibly via inhibiting TGF-β/p38/MK2 signaling pathway.
6.Mangiferin ameliorates cardiac fibrosis in D-galactose-induced aging rats by inhibiting TGF-β/p38/MK2 signaling pathway
Jing CHENG ; Chaoyang REN ; Renli CHENG ; Yunning LI ; Ping LIU ; Wei WANG ; Li LIU
The Korean Journal of Physiology and Pharmacology 2021;25(2):131-137
Aging is the process spontaneously occurred in living organisms. Cardiac fibrosis is a pathophysiological process of cardiac aging. Mangiferin is a wellknown C-glucoside xanthone in mango leaves with lots of beneficial properties. In this study, rat model of cardiac fibrosis was induced by injected with 150 mg/kg/d Dgalactose for 8 weeks. The age-related cardiac decline was estimated by detecting the relative weight of heart, the serum levels of cardiac injury indicators and the expression of hypertrophic biomakers. Cardiac oxidative stress and local inflammation were measured by detecting the levels of malondialdehyde, enzymatic antioxidant status and proinflammatory cytokines. Cardiac fibrosis was evaluated by observing collagen deposition via masson and sirius red staining, as well as by examining the expression of extracellular matrix proteins via Western blot analysis. The cardiac activity of profibrotic TGF-β1/p38/MK2 signaling pathway was assessed by measuring the expression of TGF-β1 and the phosphorylation levels of p38 and MK2. It was observed that mangiferin ameliorated D-galactose-induced cardiac aging, attenuated cardiac oxidative stress, inflammation and fibrosis, as well as inhibited the activation of TGF-β1/p38/MK2 signaling pathway. These results showed that mangiferin could ameliorate cardiac fibrosis in D-galactose-induced aging rats possibly via inhibiting TGF-β/p38/MK2 signaling pathway.
8. Estimation of the impact of risk factors control on non-communicable diseases mortality, life expectancy and the labor force lost in China in 2030
Xinying ZENG ; Yichong LI ; Jiangmei LIU ; Yunning LIU ; Shiwei LIU ; Jinlei QI ; Maigeng ZHOU
Chinese Journal of Preventive Medicine 2017;51(12):1079-1085
Objective:
To estimate the impact of risk factors control on non-communicable diseases (NCDs) mortality, life expectancy and the numbers of labor force lost in China in 2030.
Methods:
We used the results of China from Global Burden of Disease Study 2013, according to the correlation between death of NCDs and exposure of risk factors and the comparative risk assessment theory, to calculate population attributable fraction (PAF) and disaggregate deaths of NCDs into parts attributable and un-attributable. We used proportional change model to project risk factors exposure and un-attributable deaths of NCDs in 2030, then to get deaths of NCDs in 2030. Simulated scenarios according to the goals of global main NCDs risk factors control proposed by WHO were constructed to calculate the impact of risk factors control on NCDs death, life expectancy and the numbers of labor force lost.
Results:
If the risk factors exposure changed according to the trend of 1990 to 2013, compared to the numbers (8.499 million) and mortality rate (613.5/100 000) of NCDs in 2013, the death number (12.161 million) and mortality rate (859.2/100 000) would increase by 43.1% and 40.0% respectively in 2030, among which, ischemic stroke (increasing by 103.3% for death number and 98.8% for mortality rate) and ischemic heart disease (increasing by 85.0% for death number and 81.0% for mortality rate) would increase most quickly. If the risk factors get the goals in 2030, the NCDs deaths would reduce 2 631 thousands. If only one risk factor gets the goal, blood pressure (1 484 thousands NCDs deaths reduction), smoking (717 thousands reduction) and BMI (274 thousands reduction) would be the most important factors affecting NCDs death. Blood pressure control would have greater impact on ischemic heart disease (662 thousands reduction) and hemorrhagic stroke (449 thousands reduction). Smoking control would have the greatest effect on lung cancer (251 thousands reduction) and chronic obstructive pulmonary disease (201 thousands reduction). BMI control would have the greatest impact on ischemic heart disease (86 thousands reduction) and hypertensive heart disease (45 thousands reduction). If the risk factors exposure changed according to the trend of 1990 to 2013, in 2030, the life expectancy of Chinese population would reach to 79.0 years old, compared to 2013, increasing by 3.3 years old, the labor force at the age of 15-64 years old would loss 1.932 million. If the risk factors get the goals in 2030, life expectancy would increase to 81.7 years old and the number of labor force lost would decrease to 1.467 million. Blood pressure, smoking and BMI control would have much greater impact on life expectancy (4.9, 4.0 and 3.8 years old respectively) and labor force lost (630 thousands, 496 thousands and 440 thousands respectively).
Conclusion
Risk factors control would play an important role in reducing NCD death, improving life expectancy of residents and reducing loss of labor force. Among them, the control of blood pressure raising, smoking and BMI raising would have a greater contribution to the improvement of population health status.
9.Acute effect of fine particulate matters on daily cardiovascular disease mortality in seven cities of China
Ruiming LIANG ; Peng YIN ; Lijun WANG ; Yichong LI ; Jiangmei LIU ; Yunning LIU ; Jinling YOU ; Jinlei QI ; Maigeng ZHOU
Chinese Journal of Epidemiology 2017;38(3):283-289
Objective To explore the effect of fime particulate matters with an aerodynamic diameter less than 2.5 μtm (PM2.5) on daily cardiovascular disease mortality in seven cities of China.Methods Daily average concentrations of PM2.5,cardiovascular disease mortality data and environmental data were collected from January 1,2013 to December 31,2015 in seven cities of China,including Shijiazhuang,Haerbin,Shanghai,Wuhan,Guangzhou,Chengdu and Xi'an.We linked generalized additive model with Quasi-Poisson distribution to evaluate the association between daily concentrations of PM2.5 and cardiovascular disease mortality at single-city level and multi-city level,after adjusting for the long-term and seasonal trend,as well as meteorological factors and the effect of "days of week".Results The single-pollutant model indicated that there were marked differences in association strength in these cities,among which the effect in Guangzhou was strongest.At multi-city level,a 10 μg/m3 increase of PM2.5 was associated with an increase of 0.315% (95%CI:0.133%-0.497%) of daily cardiovascular disease mortality.From lag0 to lag2,the effect of PM2.5 on cardiovascular disease mortality decreased,while it was strongest on lag01.In the two-pollutant model,the estimated effect decreased in all the cities with the adjustments of SO2 or NO2.The insignificant combined results suggested that PM2.5 might have combined effect with other pollutants.Each 10 μg/m3 increase of PM2.5 was associated with increases of 0.371% (95%CI:0.141%-0.600%) and 0.199% (95% CI:0.077%-0.321%) of cardiovascular disease mortality in males and females,respectively.The effect of PM2.5 on cardiovascular disease mortality increased with age and decreased with educational level,although the differences between different subgroups were insignificant.The dose-response relationship between PM2.5 and cardiovascular disease mortality was non-linear and non-threshold,with a steeper curve at lower concentrations.Conclusion The increases of PM2.5 concentration can result in the increase of daily cardiovascular mortality.
10.Life expectancy and influence on disease in China, 2013
Yue CAI ; Maigeng ZHOU ; Xiaohong LI ; Yunning LIU ; Ruixian WU ; Ming XUE
Chinese Journal of Epidemiology 2017;38(8):1001-1004
Objective To analyze the characteristics of life expectancy and influencing factors in Chinese population in different areas and provide scientific evidence for policy-making on disease managements,medical care and risk factor intervention.Methods Based on the national census data from National Bureau of Statistics and the death registration data from the National Health and Family Planning Commission,we used exponential model,under-report adjustment model and abbreviated life tables to estimate the life expectancy and influence on disease in Chinese population in 2013.Results The Chinese life expectancy was 75.8 years in 2013,1 year higher than that in 2010.The life expectancy in urban area was 77.4 years,while it was 75.1 years that in rural area with the gap between the rural area and urban area was 2.3 years.The life expectancy was 77.2 years in the eastern area,75.8 years in middle area and 73.5 years in western area,the gap between the east and west was 3.6 years.In 2013,the first 10 leading diseases causing the life expectancy lost were cerebrovascular disease,ischemic heart disease,chronic obstructive pulmonary disease,lung cancer,road injury,liver cancer,stomach cancer,hypertensive heart disease,lower respiratory infection,esophagus cancer,resulting in 7.97 years of life expectancy lost.Conclusion The life expectancy in Chinese has already reached a relative high level,while the gap between different areas still exists.Different policies on disease management,medical care and risk factor interventions targeting different areas are needed to increase the life expectancy and improve the quality of life.

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