Objective To evaluate the effects of environmental factors and microRNAs （miRNAs） （miR-126, miR-143, and miR-145） on the risk of coronary heart disease （CHD）. Methods A frequency-matched case-control study （450...Objective To evaluate the effects of environmental factors and microRNAs （miRNAs） （miR-126, miR-143, and miR-145） on the risk of coronary heart disease （CHD）. Methods A frequency-matched case-control study （450 patients, 450 controls） was conducted from April 2014 to December 2016 in Fuzhou City, China. Environmental factors were investigated using a self-administered questionnaire, and the expression levels of miR-126, rniR-143, and miR-145 were determined by quantitative real-time Polymerase Chain Reaction （PCR） in pe- ripheral blood mononuclear cells. Unconditional logistic regression models were used for statistical evaluation. Results Alcohol consumption, high-salt diets, high-intensity work, and lack of physical activity were significantly associated with increased CHD risk, whereas light diet was significantly associated with decreased risk. MiR-126, miR-143, and miR-145 were highly expressed in the CHD group compared with the control group. After adjustment for other environmental factors, unconditional logistic regression results revealed that miR-126, miR-143, and depression were the independent risk factors of CHD, and light diet was the independent protective factor of CHD. Conclusions Our data suggest that a family history of CHD, anxiety, and alcohol consumption was significantly associated with increased CHD risk, whereas light diet was significantly associated with decreased risk. Furthermore, miR-126 and miR-143 in combination with several risk factors, could play a joint role in the development of CHD. Therefore, it is necessary to manage patients with CHD in all directions and multiple level.展开更多
Siberian Pine （Pinus sibirica） is an ecologically and eco-nomically important species in pristine forests throughout northern Rus-sia. Four provenances of P. sibirica were introduced from Mongolia and Russia to the ...Siberian Pine （Pinus sibirica） is an ecologically and eco-nomically important species in pristine forests throughout northern Rus-sia. Four provenances of P. sibirica were introduced from Mongolia and Russia to the Greater Xing’an Range （the Daxing’anling）, northeast China in 1993. The aim of this research was to study genetic variation and selection of the introduced four Pinus sibirica provenances. Heights （H）, basal diameters （BD）, survival rates （SR） and crown lengths （CL） of different families were measured as primary outcomes in different growth years. Results of data analyses demonstrated high coefficients of phenotypic variation （PCV） and heritability （H2） for H, BD and CL at 18 years after introduction. PCV and H2 increased with age. Correlations of＆amp;nbsp;growth traits between any two growth years were all significantly positive, but the correlation coefficient was smaller when the growth year interval was larger. Correlations between H and the original environment factors decreased gradually, indicating that with long-term subsistence in the new environment, the influence of the source environment declined. Colligation of multiple traits to estimate provenances showed that Novosibirsk, Tomsk, and Altai Mountains had higher survival rates and biomass, and proved more suitable for introduction and plantation in the Greater Xing’an Range in China.展开更多
Background Elevated resting heart rate and hypertension independently increase the risk of mortality. However, their combined ef- fect on mortality in stages of hypertension according to updated clinical guidelines am...Background Elevated resting heart rate and hypertension independently increase the risk of mortality. However, their combined ef- fect on mortality in stages of hypertension according to updated clinical guidelines among dderly population is unclear. Methods We fol- lowed a cohort of 6100 residents （2600 males and 3500 females） of Kangwha County, Korea, ranging from 55 to 99 year-olds as of March 1985, for all-cause and cardiovascular mortality for 20.8 years until December 31, 2005. Mortality data were collected through telephone calls and visits （to 1991）, and were confirmed by death record matching with the National Statistical Office （1992-2005）. Hazard ratios were calculated for all-cause and cardiovascular mortality by resting heart rate and hypertension defined by Eighth Joint National Committee crite- ria using the Cox proportional hazard model after controlling for confounding factors. Results The hazard ratios associated with resting heart rate 〉 80 beats/min were higher in hypertensive men compared with normotensives with heart rate of 61-79 beats/rain, with hazard ratios values of 1.43 （95% CI： 1.00-1.92） on all-cause mortality for prehypertension, 3.01 （95% CI： 1.07-8.28） on cardiovascular mortality for prehypertension, and 8.34 （95% CI： 2.52-28.19） for stage 2 hypertension. Increased risk （HR： 3.54, 95% CI： 1.16-9.21） was observed among those with both a resting heart rate 〉 80 beats/rain and prehypertension on cardiovascular mortality in women. Conclusions Indi- viduals with coexisting elevated resting heart rate and hypertension, even in prehypertension, have a greater risk for all-cause and cardiovas- cular mortality compared to those with elevated resting heart rate or hypertension alone. These findings suggest that elevated resting heart rate should not be regarded as a less serious risk factor in elderly hypertensive patients.展开更多
Background Cardiac rehabilitation （CR） protocols have diversified to include home-based cardiac tele-rehabilitation （HBCTR） as an alternative to hospital-based or center-based CR. To adopt the use of home-based ca...Background Cardiac rehabilitation （CR） protocols have diversified to include home-based cardiac tele-rehabilitation （HBCTR） as an alternative to hospital-based or center-based CR. To adopt the use of home-based cardiac tele-rehabilitation, it is necessary to assess cardiac patients＇ attitudes towards acceptance of such e-health technology, especially in China where knowledge of such technology is deficient. Methods Interviews were conducted in the First Affiliated Hospital of Shantou University Medical College, Shantou, China. After percutaneous coronary interventional （PCI） surgery, patients completed the survey. Results Among the 150 patients, only 13% had ever heard of HBCTR. After an introduction of our HBCTR program, 60% of patients were willing to participate in the program. From our multivariate analysis of questionnaire data, age （OR： 0.92, 95% CI： 0.864）.98; P = 0.007）, average family monthly income （OR： 0.13, 95% CI： 0.05-0.341 P 〈 0.001）, education level （OR： 0.24, 95% CI： 0.10-0.59; P = 0.002） and physical exercise time （OR： 0.19, 95% CI： 0.06-0.56; P = 0.003） were independent predictors for acceptance of HBCTR. From the reasons for participation, patients selected： enhanced safety and independ ence （28.3%）, ability to self-monitor physical conditions daily （25 A%）, and having automatic and emergency alert （23.1%）. Reasons for refusal were： too cumbersome operation （34.3%） and unnecessary protocol （19.4%）. Conclusions Most patients lacked knowledge about HBCTR but volunteered to participate after they have learned about the program. Several personal and life-style factors influenced their acceptance of the program. These indicate that both improvement of technology and better understanding of the program will enhance active participation.展开更多
Background Hypertension is a common chronic disease among older adults, and is associated with medical complications and mor- tality. This study aimed to examine the effects of social network characteristics on the pr...Background Hypertension is a common chronic disease among older adults, and is associated with medical complications and mor- tality. This study aimed to examine the effects of social network characteristics on the prevalence, awareness, and control of hypertension among older adults. Methods The Korean Social Life, Health, and Aging Project （KSHAP） interviewed 814 〉 60-year-old residents and their spouses from a rural township between December 2011 and March 2012 （response rate： 95%）. We evaluated the data from 595 partici- pants. Multivariate logistic regression models were used to assess the effects of network characteristics on hypertension. Results We ob- served strong sex-specific network effects on the prevalence, awareness, and control of hypertension. Among older women, network density was associated with hypertension awareness [odds ratio （OR）： 2.63, 95% confidence interval （CI）： 1.03 5.37J and control （OR： 1.72; 95% CI 0.94-3.13）. Among older men, large networks were associated with a lower prevalence of hypertension （OR： 0.75; 95% CI： 0.58-0.96）. Compared to older women, older men with coarse networks exhibited better hypertension awareness （OR： 0.37; 95% CI： 0.14-0.95） and control （OR： 0.42; 95% CI： 0.19-0.91 ）. Network size interacted with density for hypertension control （P = 0.051）, with controlled hyperten- sion being associated with large and course networks. Conclusions A large network was associated with a lower risk for hypertension, and a coarse network was associated with hypertension awareness and control among older men. Older women with dense networks were most likely to exhibit hypertension awareness and control.展开更多
BACKGROUND The prevalence of heart failure(HF)increases with age,and it is one of the leading causes of hospitalization and death in older patients.However,there are little data on in-hospital mortality in patients wi...BACKGROUND The prevalence of heart failure(HF)increases with age,and it is one of the leading causes of hospitalization and death in older patients.However,there are little data on in-hospital mortality in patients with HF≥75 years in Spain.METHODS A retrospective analysis of the Spanish Minimum Basic Data Set was performed,including all HF episodes discharged from public hospitals in Spain between 2016 and 2019.Coding was performed using the International Classification of Diseases,10th Revision.Patients≥75 years with HF as the principal diagnosis were selected.We calculated:(1)the crude in-hospital mortality rate and its distribution according to age and sex;(2)the risk-standardized in-hospital mortality ratio;and(3)the association between in-hospital mortality and the availability of an intensive cardiac care unit(ICCU)in the hospital.RESULTS We included 354,792 HF episodes of patients over 75 years.The mean age was 85.2±5.5 years,and 59.2%of patients were women.The most frequent comorbidities were renal failure(46.1%),diabetes mellitus(35.5%),valvular disease(33.9%),cardiorespiratory failure(29.8%),and hypertension(26.9%).In-hospital mortality was 12.7%,and increased with age[odds ratio(OR)=1.07,95%CI:1.07–1.07,P<0.001]and was lower in women(OR=0.96,95%CI:0.92–0.97,P<0.001).The main predictors of mortality were the presence of cardiogenic shock(OR=19.5,95%CI:16.8–22.7,P<0.001),stroke(OR=3.5,95%CI:3.0–4.0,P<0.001)and advanced cancer(OR=2.6,95%CI:2.5–2.8,P<0.001).In hospitals with ICCU,the in-hospital risk-adjusted mortality tended to be lower(OR=0.85,95%CI:0.72–1.00,P=0.053).CONCLUSIONS In-hospital mortality in patients with HF≥75 years between 2016 and 2019 was 12.7%,higher in males and elderly patients.The main predictors of mortality were cardiogenic shock,stroke,and advanced cancer.There was a trend toward lower mortality in centers with an ICCU.展开更多
Objective To examine the association of atherosclerosis burden in the survivors of an asymptomatic elderly cohort study and its relationship to other coronary risk factors (specifically, age) by evaluating aortic athe...Objective To examine the association of atherosclerosis burden in the survivors of an asymptomatic elderly cohort study and its relationship to other coronary risk factors (specifically, age) by evaluating aortic atherosclerotic wall burden by magnetic resonance imaging (MRI). Methods A total of 312 participants in an ongoing observational cohort study underwent cardiac and descending thoracic aorta imaging by MRI. Maximum wall thickness was measured and the mean wall thickness calculated.Wall/outer wall ratio was used as a normalized wall index (NWI) adjusted for artery size difference among participants. Percent wall volume (PWV) was calculated as NWI ×100.Results In this asymptomatic cohort (mean age: 76 years), the mean (SD) aortic wall area andwall thicknesswere 222 ±45 mm2 and 2.7 ±0.4 mm, respectively. Maximum wall thickness was 3.4 ±0.6 mm, and PWV was 32% ±4%. Women appeared to have smaller wall area,but after correcting for their smaller artery size, had significantly higher PWV than men (P = 0.03). Older age was associatedwith larger wall area (P = 0.04 for trend) with similar PWVs. However, there were no statistically significant associations between standard risk factors,Framingham global risk, or metabolic syndrome status, therapy for cholesterol or hypertension, coronary or aortic calcium score, and the aortic wall burden. Aortic calcificationwas associated with coronary calcification. Conclusions Asymptomatic elderly in this cohort had a greater descending thoracic aortic wall volume that correlated with age, andwomen had a significantly increased PWV compared to men. In these survivors, the atherosclerotic aortic wall burden was not significantly associated with traditional risk factors or with coronary or aortic calcium scores or coronary calcium progression. Results suggest that age, or as yet unidentified risk factor(s), may be responsible for the increase in atherosclerosis.展开更多
Objective: To study the physical and chemical properties of an arginine ester hydrolase from the venom of Trimeresurus mucrosqumatus in Hunan province of China.Methods:The arginine ester hydrolase(AEH) was isolated fr...Objective: To study the physical and chemical properties of an arginine ester hydrolase from the venom of Trimeresurus mucrosqumatus in Hunan province of China.Methods:The arginine ester hydrolase(AEH) was isolated from the venom of Chinese Trimeresurus mucrosqumatus by a combination of ion-exchange chromatography on DEAE-Sephadex A-50, CM-Sepharose Cl-6B and gel filtration on Sephadex G-100.Results: The purified protein named TM-AEH,a glycoprotein with carbohydrate content of 0.5% neutral hexose and 0.75% sialic acid,a relative molecular mass of 29.0 kDa,and an isoelectric point(pI) of 5.2. It shares with an extinction coefficient(E 0.1%/cm) of 1.332 at 280 nm,consisted of 225 amino acid residues,and migrated as a band under reduced or non-reduced condition in basic PAGE.TM-AEH was a highly thermostable protein and was stable to pH changes between 5 and 9.The optimum temperature and optimum pH were 55℃ and 8.4 for its catalytic activity respectively,which was inhibited by Fe 3+ and Cu 2+.Conclusion:This protein can exhibit higher BAEE-hydrolysing activity and fibrinogenolytic activity as compared to that of whole venom.展开更多
With increasing life expectancy,neurodegenerative diseases have become one of the leading causes of illhealth in the elderly.Preventive strategies include following healthy diets,such as the Mediterranean diet,which i...With increasing life expectancy,neurodegenerative diseases have become one of the leading causes of illhealth in the elderly.Preventive strategies include following healthy diets,such as the Mediterranean diet,which is particularly rich in polyphenols,bioactive compounds with neuroprotective properties.The aim of this study was to assess the association of microbial phenolic metabolites(MPM)with cognition.This cross-sectional analysis was performed with 200 participants of the PREDIMED trial(Barcelona-Clinic recruitment center).A novel method based on liquid chromatography coupled to mass spectrometry was used to identify urinary MPM(protocatechuic acid,enterodiol glucuronide,enterolactone glucuronide,urolithin B glucuronide,and vanillic acid glucuronide),and cognitive function was evaluated with neuropsychological tests.Multivariable-adjusted ordinary least squares regression was used to assess the associations between cognitive function and MPM,and a score was calculated as the weighted sum of MPM.A higher MPM score was associated with better frontal lobe function.Among individual metabolites,vanillic acid glucuronide was correlated with frontal cognitive performance.Participants with higher concentrations of vanillic acid glucuronide and urolithin B glucuronide obtained better scores in the Color Trail Test part 2.A higher score for urinary multiMPM was associated with better frontal cognitive performance in an older Mediterranean population.展开更多
Coronary heart disease （CHD） is the leading cause of death worldwide and becomes increasingly prevalent among patients aged 65 years and older.Elderly patients are at a higher risk for complications and accelerated ...Coronary heart disease （CHD） is the leading cause of death worldwide and becomes increasingly prevalent among patients aged 65 years and older.Elderly patients are at a higher risk for complications and accelerated physical deconditioning after a cardiovascular event,especially compared to their younger counterparts.The last few decades were privy to multiple studies that demonstrated the beneficial effects of cardiac rehabilitation （CR） and exercise therapy on mortality,exercise capacity,psychological risk factors,inflammation,and obesity among patients with CHD.Unfortunately,a significant portion of the available data in this field pertains to younger patients.A viable explanation is that older patients are grossly underrepresented in these programs for multiple reasons starting with the patient and extending to the physician.In this article,we will review the benefits of CR programs among the elderly,as well as some of the barriers that hinder their participation.展开更多
Background The incidence of coronary heart disease （CHD） is higher in Northern than that in Southern China, however differences in traditional CHD risk factors do not fully explain this. No study has examined the di...Background The incidence of coronary heart disease （CHD） is higher in Northern than that in Southern China, however differences in traditional CHD risk factors do not fully explain this. No study has examined the differences in subclinical atherosclerosis that may help explain the differences in incidence. This study examined these differences in subclinical atherosclerosis using coronary computed tomography （CT） for calcification between the Northern and Southern China. Methods We selected a random sample of participants in a large multi-center ongoing epidemiologic study for coronary calcium scanning in one northern city （North） （Beijing, n = 49） and in two southern cities （South） （Shanghai, n = 50, and Guangzhou, n = 50）. Participants from the three field centers （mean age 67 years） underwent coronary risk factor evaluation and cardiac CT scanning for coronary calcium measurement using the Multi-Ethnic Study of Atherosclerosis scanning protocol. Results Adjusted log-transformed coronary artery calcium score in North China （Beijing） was 3.1 ±0.4 and in South China （Shanghai and Guangzhou） was 2.2 ＋_ 0.3 （P = 0.04）. Mean calcium score for the northern city of Beijing was three times higher than that of the southern city of Guangzhou （P = 0.01） and 2.5 times higher than for the southern city of Shanghai （P = 0.03）. Conclusions The extent of subclinical atherosclerosis is significantly higher in the northern city of Beijing than that in the two southern cities of Guangzhou and Shanghai, even after adjusting for standard cardiac risk factors. This finding suggests that standard risk factors do not fully explain north south differences in clinical CHD incidence.展开更多
Objective To explore the safety and efficacy of FFR-guided percutaneous coronary intervention (PCI) in vessels with severe diameter stenosis. Methods & Results Of 1090 patients undergoing fractional flow reserve (...Objective To explore the safety and efficacy of FFR-guided percutaneous coronary intervention (PCI) in vessels with severe diameter stenosis. Methods & Results Of 1090 patients undergoing fractional flow reserve (FFR) assessment from 2002 to 2009,we identified 167 patients in whom FFR was measured in at least one 70%–89% stenotic lesion. These patients were subdivided into an FFR-defer group (n = 49) if PCI was deferred (FFR > 0.80),and an FFR-perform group (n = 118) if PCI was performed (FFR ≤ 0.80). Comparatively,an additional 1176 patients undergoing PCI in at least one lesion with 70%–89% stenosis but without measurement of FFR served as a control (angiography- guided) group. Clinical outcomes were compared during a median follow-up of 49.0 months. The 5-year Kaplan-Meier estimated revascularization rates were 16% in the FFR-defer group and 33% in the FFR-perform group (P = 0.046). The incidence of major adverse cardiac events were comparable in these two groups (HR = 0.82,95% CI: 0.37–1.82,P = 0.63). The number of stents placed was significantly lower in the FFR-guided group (0.9 ± 0.8 vs. 1.4 ± 0.8,P < 0.001). Conclusions Functional revascularization for lesions with visually severe stenosis is clinically safe and associated with fewer stents use. This study suggests that extending the use of FFR to more severe coronary lesions may be reasonable.展开更多
Background: The European Union Training Mission Mali(EUTM MLI) is a multinational military training deployment to the Western African tropical nation of Mali. Based on routinely collected disease and non-battle injury...Background: The European Union Training Mission Mali(EUTM MLI) is a multinational military training deployment to the Western African tropical nation of Mali. Based on routinely collected disease and non-battle injury surveillance data, this study quantifies the true impact of infectious diseases for this tropical mission and potential seasonal variations in infectious disease threats.Methods: Categorized health events during the EUTM MLI mission and associated lost working days were reported using the EpiNATO-2 report. Infection-related health events were descriptively analyzed for a 4-year period from the 12 th week in 2013 to the 13 th week in 2017. Aggregated EpiNATO-2 data collected from all missions other than EUTM MLI were used as a comparator.Results: Among the infectious diseases reported by EUTM MLI, non-severe upper respiratory infections and gastrointestinal diseases dominated quantitatively, accounting for 1.65 and 1.42 consultations per 100 person-weeks, respectively. The number of recorded infectious disease-associated lost working days during the whole study interval was 723. Seasonal changes in disease frequency were detectable. More gastrointestinal infections were seen in the rainy season, and more respiratory infections occurred in the dry season; these were associated with peaks of more than 2.5 consultations per 100 person-weeks for both categories.Conclusion: Despite initial concerns focused on tropical infectious diseases during this mission in tropical Mali, upper respiratory tract and gastrointestinal infections predominate. The relatively low number of reported lost working days may indicate that these infections are at the milder end of the spectrum of infectious diseases despite a likely reporting bias.展开更多
To the Editor Cardiovascular disease （CVD） is the main cause of death in older adults. There is strong evidence that regular physical activity （PA） reduces the risk of CVD mortality in this population group. Howev...To the Editor Cardiovascular disease （CVD） is the main cause of death in older adults. There is strong evidence that regular physical activity （PA） reduces the risk of CVD mortality in this population group. However, these studies used baseline data and do not account for potential changes in PA.展开更多
Background: Pharyngeal and anorectal reservoirs of gonorrhea(GC) and chlamydia(CT) are increasingly recognized among heterosexual women. While a number of studies performed at sexually transmitted disease(STD) clinics...Background: Pharyngeal and anorectal reservoirs of gonorrhea(GC) and chlamydia(CT) are increasingly recognized among heterosexual women. While a number of studies performed at sexually transmitted disease(STD) clinics have found a high prevalence of extragenital GC/CT infection, such screening is typically not offered during routine primary care visits for women. We sought to define the prevalence of and factors associated with extragenital GC/CT among women in the U.S. Navy.Methods: We recruited servicewomen stationed in San Diego, California, between the ages of 18 and 25 who presented for an annual physical exam between January and September, 2017. Nucleic acid amplification testing was performed on swabs collected at endocervical, oropharyngeal and anorectal sites to assess the presence of GC/CT. An anonymous behavioral questionnaire was also administered to characterize sexual risk. Descriptive statistics were used to compare women with and without a prior history of any sexually transmitted infection(STI)(self-report) along with a current GC/CT diagnosis. This study was approved by the Institutional Review Board of the Uniformed Services University of Health Sciences.Results: Of the 75 patients who were approached, 60 subjects were enrolled in the study, including white 20(33.3%), black/African American 18(31.0%), Hispanic/Latina 13(21.7%) and Asian/Pacific Islander 9(15.5%) women. Among all the women, six(10.0%) were diagnosed with CT infection, all via endocervical exam. Of these, five(8.3%) had concurrent anorectal infection, including two cases(3.3%) accompanied by pharyngeal infection. Of the subjects, 15(25.0%) reported anal intercourse in their most recent sexual encounter, most of which was condomless(13/15, 86.7%). A high number of women who reported sex with a casual male partner(19/45, 42.2%) reported rarely or never using condoms;last, 41.7% consuming at least 3 drinks on a typical drinking day, and one-third of the reported drinking more than once per week.Conclusions: We found a high prevalence of anorectal CT infection, although no infections were detected without concurrent endocervical involvement. Nonetheless, the high prevalence of condomless anal intercourse reported by participants argues for further study and ongoing consideration of extragenital screening among high-risk patients. Behavioral interventions are also warranted given the high prevalence of sexual and related risk factors.展开更多
Radiologic imaging is a diagnostic tool that greatly affects patient outcomes,[1]and with the recent development of imaging technology,advanced imaging tests such as computed tomography(CT)have gained widespread acces...Radiologic imaging is a diagnostic tool that greatly affects patient outcomes,[1]and with the recent development of imaging technology,advanced imaging tests such as computed tomography(CT)have gained widespread accessibility in hospitals.In particular,CT is essential in the evaluation of patients in low-level emergency departments(EDs)because of its ability to answer clinical questions accurately and quickly.[2]展开更多
Although logistic regression is the most popular for modelling regression relationships with binary responses,many find relative risk(RR),or risk ratio,easier to interpret and prefer to use this measure of risk in reg...Although logistic regression is the most popular for modelling regression relationships with binary responses,many find relative risk(RR),or risk ratio,easier to interpret and prefer to use this measure of risk in regression analysis.Indeed,since Zou published his modified Poisson regression approach for modelling RR for cross-sectional data,his paper has been cited over 7000 times,demonstrating the popularity of this alternative measure of risk in regression analysis involving binary responses.As longitudinal studies have become increasingly popular in clinical trials and observational studies,it is imperative to extend Zou’s approach for longitudinal data.The two most popular approaches for longitudinal data analysis are the generalised linear mixed-effects model(GLMM)and generalised estimating equations(GEE).However,the parametric GLMM cannot be used for the extension within the current context,because Zou’s approach treats the binary response as a Poisson variable,which is at odds with the Bernoulli distribution for the binary response.On the other hand,as it imposes no mathematical model on data distributions,the semiparametric GEE is coherent with Zou’s modified Poisson regression.In this paper,we develop a GEE-based longitudinal model for binary responses to provide inference about RR.展开更多
文摘Objective To evaluate the effects of environmental factors and microRNAs （miRNAs） （miR-126, miR-143, and miR-145） on the risk of coronary heart disease （CHD）. Methods A frequency-matched case-control study （450 patients, 450 controls） was conducted from April 2014 to December 2016 in Fuzhou City, China. Environmental factors were investigated using a self-administered questionnaire, and the expression levels of miR-126, rniR-143, and miR-145 were determined by quantitative real-time Polymerase Chain Reaction （PCR） in pe- ripheral blood mononuclear cells. Unconditional logistic regression models were used for statistical evaluation. Results Alcohol consumption, high-salt diets, high-intensity work, and lack of physical activity were significantly associated with increased CHD risk, whereas light diet was significantly associated with decreased risk. MiR-126, miR-143, and miR-145 were highly expressed in the CHD group compared with the control group. After adjustment for other environmental factors, unconditional logistic regression results revealed that miR-126, miR-143, and depression were the independent risk factors of CHD, and light diet was the independent protective factor of CHD. Conclusions Our data suggest that a family history of CHD, anxiety, and alcohol consumption was significantly associated with increased CHD risk, whereas light diet was significantly associated with decreased risk. Furthermore, miR-126 and miR-143 in combination with several risk factors, could play a joint role in the development of CHD. Therefore, it is necessary to manage patients with CHD in all directions and multiple level.
基金supported by grants Seedling Technology Rules of Siberia pine(No.2012-LY-183)
文摘Siberian Pine （Pinus sibirica） is an ecologically and eco-nomically important species in pristine forests throughout northern Rus-sia. Four provenances of P. sibirica were introduced from Mongolia and Russia to the Greater Xing’an Range （the Daxing’anling）, northeast China in 1993. The aim of this research was to study genetic variation and selection of the introduced four Pinus sibirica provenances. Heights （H）, basal diameters （BD）, survival rates （SR） and crown lengths （CL） of different families were measured as primary outcomes in different growth years. Results of data analyses demonstrated high coefficients of phenotypic variation （PCV） and heritability （H2） for H, BD and CL at 18 years after introduction. PCV and H2 increased with age. Correlations of＆amp;nbsp;growth traits between any two growth years were all significantly positive, but the correlation coefficient was smaller when the growth year interval was larger. Correlations between H and the original environment factors decreased gradually, indicating that with long-term subsistence in the new environment, the influence of the source environment declined. Colligation of multiple traits to estimate provenances showed that Novosibirsk, Tomsk, and Altai Mountains had higher survival rates and biomass, and proved more suitable for introduction and plantation in the Greater Xing’an Range in China.
文摘Background Elevated resting heart rate and hypertension independently increase the risk of mortality. However, their combined ef- fect on mortality in stages of hypertension according to updated clinical guidelines among dderly population is unclear. Methods We fol- lowed a cohort of 6100 residents （2600 males and 3500 females） of Kangwha County, Korea, ranging from 55 to 99 year-olds as of March 1985, for all-cause and cardiovascular mortality for 20.8 years until December 31, 2005. Mortality data were collected through telephone calls and visits （to 1991）, and were confirmed by death record matching with the National Statistical Office （1992-2005）. Hazard ratios were calculated for all-cause and cardiovascular mortality by resting heart rate and hypertension defined by Eighth Joint National Committee crite- ria using the Cox proportional hazard model after controlling for confounding factors. Results The hazard ratios associated with resting heart rate 〉 80 beats/min were higher in hypertensive men compared with normotensives with heart rate of 61-79 beats/rain, with hazard ratios values of 1.43 （95% CI： 1.00-1.92） on all-cause mortality for prehypertension, 3.01 （95% CI： 1.07-8.28） on cardiovascular mortality for prehypertension, and 8.34 （95% CI： 2.52-28.19） for stage 2 hypertension. Increased risk （HR： 3.54, 95% CI： 1.16-9.21） was observed among those with both a resting heart rate 〉 80 beats/rain and prehypertension on cardiovascular mortality in women. Conclusions Indi- viduals with coexisting elevated resting heart rate and hypertension, even in prehypertension, have a greater risk for all-cause and cardiovas- cular mortality compared to those with elevated resting heart rate or hypertension alone. These findings suggest that elevated resting heart rate should not be regarded as a less serious risk factor in elderly hypertensive patients.
文摘Background Cardiac rehabilitation （CR） protocols have diversified to include home-based cardiac tele-rehabilitation （HBCTR） as an alternative to hospital-based or center-based CR. To adopt the use of home-based cardiac tele-rehabilitation, it is necessary to assess cardiac patients＇ attitudes towards acceptance of such e-health technology, especially in China where knowledge of such technology is deficient. Methods Interviews were conducted in the First Affiliated Hospital of Shantou University Medical College, Shantou, China. After percutaneous coronary interventional （PCI） surgery, patients completed the survey. Results Among the 150 patients, only 13% had ever heard of HBCTR. After an introduction of our HBCTR program, 60% of patients were willing to participate in the program. From our multivariate analysis of questionnaire data, age （OR： 0.92, 95% CI： 0.864）.98; P = 0.007）, average family monthly income （OR： 0.13, 95% CI： 0.05-0.341 P 〈 0.001）, education level （OR： 0.24, 95% CI： 0.10-0.59; P = 0.002） and physical exercise time （OR： 0.19, 95% CI： 0.06-0.56; P = 0.003） were independent predictors for acceptance of HBCTR. From the reasons for participation, patients selected： enhanced safety and independ ence （28.3%）, ability to self-monitor physical conditions daily （25 A%）, and having automatic and emergency alert （23.1%）. Reasons for refusal were： too cumbersome operation （34.3%） and unnecessary protocol （19.4%）. Conclusions Most patients lacked knowledge about HBCTR but volunteered to participate after they have learned about the program. Several personal and life-style factors influenced their acceptance of the program. These indicate that both improvement of technology and better understanding of the program will enhance active participation.
文摘Background Hypertension is a common chronic disease among older adults, and is associated with medical complications and mor- tality. This study aimed to examine the effects of social network characteristics on the prevalence, awareness, and control of hypertension among older adults. Methods The Korean Social Life, Health, and Aging Project （KSHAP） interviewed 814 〉 60-year-old residents and their spouses from a rural township between December 2011 and March 2012 （response rate： 95%）. We evaluated the data from 595 partici- pants. Multivariate logistic regression models were used to assess the effects of network characteristics on hypertension. Results We ob- served strong sex-specific network effects on the prevalence, awareness, and control of hypertension. Among older women, network density was associated with hypertension awareness [odds ratio （OR）： 2.63, 95% confidence interval （CI）： 1.03 5.37J and control （OR： 1.72; 95% CI 0.94-3.13）. Among older men, large networks were associated with a lower prevalence of hypertension （OR： 0.75; 95% CI： 0.58-0.96）. Compared to older women, older men with coarse networks exhibited better hypertension awareness （OR： 0.37; 95% CI： 0.14-0.95） and control （OR： 0.42; 95% CI： 0.19-0.91 ）. Network size interacted with density for hypertension control （P = 0.051）, with controlled hyperten- sion being associated with large and course networks. Conclusions A large network was associated with a lower risk for hypertension, and a coarse network was associated with hypertension awareness and control among older men. Older women with dense networks were most likely to exhibit hypertension awareness and control.
文摘BACKGROUND The prevalence of heart failure(HF)increases with age,and it is one of the leading causes of hospitalization and death in older patients.However,there are little data on in-hospital mortality in patients with HF≥75 years in Spain.METHODS A retrospective analysis of the Spanish Minimum Basic Data Set was performed,including all HF episodes discharged from public hospitals in Spain between 2016 and 2019.Coding was performed using the International Classification of Diseases,10th Revision.Patients≥75 years with HF as the principal diagnosis were selected.We calculated:(1)the crude in-hospital mortality rate and its distribution according to age and sex;(2)the risk-standardized in-hospital mortality ratio;and(3)the association between in-hospital mortality and the availability of an intensive cardiac care unit(ICCU)in the hospital.RESULTS We included 354,792 HF episodes of patients over 75 years.The mean age was 85.2±5.5 years,and 59.2%of patients were women.The most frequent comorbidities were renal failure(46.1%),diabetes mellitus(35.5%),valvular disease(33.9%),cardiorespiratory failure(29.8%),and hypertension(26.9%).In-hospital mortality was 12.7%,and increased with age[odds ratio(OR)=1.07,95%CI:1.07–1.07,P<0.001]and was lower in women(OR=0.96,95%CI:0.92–0.97,P<0.001).The main predictors of mortality were the presence of cardiogenic shock(OR=19.5,95%CI:16.8–22.7,P<0.001),stroke(OR=3.5,95%CI:3.0–4.0,P<0.001)and advanced cancer(OR=2.6,95%CI:2.5–2.8,P<0.001).In hospitals with ICCU,the in-hospital risk-adjusted mortality tended to be lower(OR=0.85,95%CI:0.72–1.00,P=0.053).CONCLUSIONS In-hospital mortality in patients with HF≥75 years between 2016 and 2019 was 12.7%,higher in males and elderly patients.The main predictors of mortality were cardiogenic shock,stroke,and advanced cancer.There was a trend toward lower mortality in centers with an ICCU.
文摘Objective To examine the association of atherosclerosis burden in the survivors of an asymptomatic elderly cohort study and its relationship to other coronary risk factors (specifically, age) by evaluating aortic atherosclerotic wall burden by magnetic resonance imaging (MRI). Methods A total of 312 participants in an ongoing observational cohort study underwent cardiac and descending thoracic aorta imaging by MRI. Maximum wall thickness was measured and the mean wall thickness calculated.Wall/outer wall ratio was used as a normalized wall index (NWI) adjusted for artery size difference among participants. Percent wall volume (PWV) was calculated as NWI ×100.Results In this asymptomatic cohort (mean age: 76 years), the mean (SD) aortic wall area andwall thicknesswere 222 ±45 mm2 and 2.7 ±0.4 mm, respectively. Maximum wall thickness was 3.4 ±0.6 mm, and PWV was 32% ±4%. Women appeared to have smaller wall area,but after correcting for their smaller artery size, had significantly higher PWV than men (P = 0.03). Older age was associatedwith larger wall area (P = 0.04 for trend) with similar PWVs. However, there were no statistically significant associations between standard risk factors,Framingham global risk, or metabolic syndrome status, therapy for cholesterol or hypertension, coronary or aortic calcium score, and the aortic wall burden. Aortic calcificationwas associated with coronary calcification. Conclusions Asymptomatic elderly in this cohort had a greater descending thoracic aortic wall volume that correlated with age, andwomen had a significantly increased PWV compared to men. In these survivors, the atherosclerotic aortic wall burden was not significantly associated with traditional risk factors or with coronary or aortic calcium scores or coronary calcium progression. Results suggest that age, or as yet unidentified risk factor(s), may be responsible for the increase in atherosclerosis.
文摘Objective: To study the physical and chemical properties of an arginine ester hydrolase from the venom of Trimeresurus mucrosqumatus in Hunan province of China.Methods:The arginine ester hydrolase(AEH) was isolated from the venom of Chinese Trimeresurus mucrosqumatus by a combination of ion-exchange chromatography on DEAE-Sephadex A-50, CM-Sepharose Cl-6B and gel filtration on Sephadex G-100.Results: The purified protein named TM-AEH,a glycoprotein with carbohydrate content of 0.5% neutral hexose and 0.75% sialic acid,a relative molecular mass of 29.0 kDa,and an isoelectric point(pI) of 5.2. It shares with an extinction coefficient(E 0.1%/cm) of 1.332 at 280 nm,consisted of 225 amino acid residues,and migrated as a band under reduced or non-reduced condition in basic PAGE.TM-AEH was a highly thermostable protein and was stable to pH changes between 5 and 9.The optimum temperature and optimum pH were 55℃ and 8.4 for its catalytic activity respectively,which was inhibited by Fe 3+ and Cu 2+.Conclusion:This protein can exhibit higher BAEE-hydrolysing activity and fibrinogenolytic activity as compared to that of whole venom.
基金supported by the CICYT(AGL2016-75329-R PID2020-114022RB-I00)CIBEROBN from the Instituto de Salud Carlos III,ISCIII from the Ministerio de Ciencia,Innovación y Universidades(AEI/FEDER,UE)Generalitat de Catalunya(GC)(2017SGR 196).
文摘With increasing life expectancy,neurodegenerative diseases have become one of the leading causes of illhealth in the elderly.Preventive strategies include following healthy diets,such as the Mediterranean diet,which is particularly rich in polyphenols,bioactive compounds with neuroprotective properties.The aim of this study was to assess the association of microbial phenolic metabolites(MPM)with cognition.This cross-sectional analysis was performed with 200 participants of the PREDIMED trial(Barcelona-Clinic recruitment center).A novel method based on liquid chromatography coupled to mass spectrometry was used to identify urinary MPM(protocatechuic acid,enterodiol glucuronide,enterolactone glucuronide,urolithin B glucuronide,and vanillic acid glucuronide),and cognitive function was evaluated with neuropsychological tests.Multivariable-adjusted ordinary least squares regression was used to assess the associations between cognitive function and MPM,and a score was calculated as the weighted sum of MPM.A higher MPM score was associated with better frontal lobe function.Among individual metabolites,vanillic acid glucuronide was correlated with frontal cognitive performance.Participants with higher concentrations of vanillic acid glucuronide and urolithin B glucuronide obtained better scores in the Color Trail Test part 2.A higher score for urinary multiMPM was associated with better frontal cognitive performance in an older Mediterranean population.
文摘Coronary heart disease （CHD） is the leading cause of death worldwide and becomes increasingly prevalent among patients aged 65 years and older.Elderly patients are at a higher risk for complications and accelerated physical deconditioning after a cardiovascular event,especially compared to their younger counterparts.The last few decades were privy to multiple studies that demonstrated the beneficial effects of cardiac rehabilitation （CR） and exercise therapy on mortality,exercise capacity,psychological risk factors,inflammation,and obesity among patients with CHD.Unfortunately,a significant portion of the available data in this field pertains to younger patients.A viable explanation is that older patients are grossly underrepresented in these programs for multiple reasons starting with the patient and extending to the physician.In this article,we will review the benefits of CR programs among the elderly,as well as some of the barriers that hinder their participation.
文摘Background The incidence of coronary heart disease （CHD） is higher in Northern than that in Southern China, however differences in traditional CHD risk factors do not fully explain this. No study has examined the differences in subclinical atherosclerosis that may help explain the differences in incidence. This study examined these differences in subclinical atherosclerosis using coronary computed tomography （CT） for calcification between the Northern and Southern China. Methods We selected a random sample of participants in a large multi-center ongoing epidemiologic study for coronary calcium scanning in one northern city （North） （Beijing, n = 49） and in two southern cities （South） （Shanghai, n = 50, and Guangzhou, n = 50）. Participants from the three field centers （mean age 67 years） underwent coronary risk factor evaluation and cardiac CT scanning for coronary calcium measurement using the Multi-Ethnic Study of Atherosclerosis scanning protocol. Results Adjusted log-transformed coronary artery calcium score in North China （Beijing） was 3.1 ±0.4 and in South China （Shanghai and Guangzhou） was 2.2 ＋_ 0.3 （P = 0.04）. Mean calcium score for the northern city of Beijing was three times higher than that of the southern city of Guangzhou （P = 0.01） and 2.5 times higher than for the southern city of Shanghai （P = 0.03）. Conclusions The extent of subclinical atherosclerosis is significantly higher in the northern city of Beijing than that in the two southern cities of Guangzhou and Shanghai, even after adjusting for standard cardiac risk factors. This finding suggests that standard risk factors do not fully explain north south differences in clinical CHD incidence.
基金supported by the National Institute of Health (NIH Grant HL-92954 and AG-31750 to A.L)supported by an unrestricted grant from St Jude Medical+1 种基金supported by the National Natural Science Foundation of China (No.81470491)the Beijing Municipal Natural Science Foundation (No. 7192078)
文摘Objective To explore the safety and efficacy of FFR-guided percutaneous coronary intervention (PCI) in vessels with severe diameter stenosis. Methods & Results Of 1090 patients undergoing fractional flow reserve (FFR) assessment from 2002 to 2009,we identified 167 patients in whom FFR was measured in at least one 70%–89% stenotic lesion. These patients were subdivided into an FFR-defer group (n = 49) if PCI was deferred (FFR > 0.80),and an FFR-perform group (n = 118) if PCI was performed (FFR ≤ 0.80). Comparatively,an additional 1176 patients undergoing PCI in at least one lesion with 70%–89% stenosis but without measurement of FFR served as a control (angiography- guided) group. Clinical outcomes were compared during a median follow-up of 49.0 months. The 5-year Kaplan-Meier estimated revascularization rates were 16% in the FFR-defer group and 33% in the FFR-perform group (P = 0.046). The incidence of major adverse cardiac events were comparable in these two groups (HR = 0.82,95% CI: 0.37–1.82,P = 0.63). The number of stents placed was significantly lower in the FFR-guided group (0.9 ± 0.8 vs. 1.4 ± 0.8,P < 0.001). Conclusions Functional revascularization for lesions with visually severe stenosis is clinically safe and associated with fewer stents use. This study suggests that extending the use of FFR to more severe coronary lesions may be reasonable.
文摘Background: The European Union Training Mission Mali(EUTM MLI) is a multinational military training deployment to the Western African tropical nation of Mali. Based on routinely collected disease and non-battle injury surveillance data, this study quantifies the true impact of infectious diseases for this tropical mission and potential seasonal variations in infectious disease threats.Methods: Categorized health events during the EUTM MLI mission and associated lost working days were reported using the EpiNATO-2 report. Infection-related health events were descriptively analyzed for a 4-year period from the 12 th week in 2013 to the 13 th week in 2017. Aggregated EpiNATO-2 data collected from all missions other than EUTM MLI were used as a comparator.Results: Among the infectious diseases reported by EUTM MLI, non-severe upper respiratory infections and gastrointestinal diseases dominated quantitatively, accounting for 1.65 and 1.42 consultations per 100 person-weeks, respectively. The number of recorded infectious disease-associated lost working days during the whole study interval was 723. Seasonal changes in disease frequency were detectable. More gastrointestinal infections were seen in the rainy season, and more respiratory infections occurred in the dry season; these were associated with peaks of more than 2.5 consultations per 100 person-weeks for both categories.Conclusion: Despite initial concerns focused on tropical infectious diseases during this mission in tropical Mali, upper respiratory tract and gastrointestinal infections predominate. The relatively low number of reported lost working days may indicate that these infections are at the milder end of the spectrum of infectious diseases despite a likely reporting bias.
文摘To the Editor Cardiovascular disease （CVD） is the main cause of death in older adults. There is strong evidence that regular physical activity （PA） reduces the risk of CVD mortality in this population group. However, these studies used baseline data and do not account for potential changes in PA.
基金(IDCRP-092)supported by the Infectious Disease Clinical Research Program(IDCRP)a Department of Defense(DoD)program executed through the Uniformed Services University of the Health Sciences(USUHS)+1 种基金federal funds from the National Institute of Allergy and Infectious Diseases,National Institutes of Health(NIH)under InterAgency Agreement(Y1-AI5072)
文摘Background: Pharyngeal and anorectal reservoirs of gonorrhea(GC) and chlamydia(CT) are increasingly recognized among heterosexual women. While a number of studies performed at sexually transmitted disease(STD) clinics have found a high prevalence of extragenital GC/CT infection, such screening is typically not offered during routine primary care visits for women. We sought to define the prevalence of and factors associated with extragenital GC/CT among women in the U.S. Navy.Methods: We recruited servicewomen stationed in San Diego, California, between the ages of 18 and 25 who presented for an annual physical exam between January and September, 2017. Nucleic acid amplification testing was performed on swabs collected at endocervical, oropharyngeal and anorectal sites to assess the presence of GC/CT. An anonymous behavioral questionnaire was also administered to characterize sexual risk. Descriptive statistics were used to compare women with and without a prior history of any sexually transmitted infection(STI)(self-report) along with a current GC/CT diagnosis. This study was approved by the Institutional Review Board of the Uniformed Services University of Health Sciences.Results: Of the 75 patients who were approached, 60 subjects were enrolled in the study, including white 20(33.3%), black/African American 18(31.0%), Hispanic/Latina 13(21.7%) and Asian/Pacific Islander 9(15.5%) women. Among all the women, six(10.0%) were diagnosed with CT infection, all via endocervical exam. Of these, five(8.3%) had concurrent anorectal infection, including two cases(3.3%) accompanied by pharyngeal infection. Of the subjects, 15(25.0%) reported anal intercourse in their most recent sexual encounter, most of which was condomless(13/15, 86.7%). A high number of women who reported sex with a casual male partner(19/45, 42.2%) reported rarely or never using condoms;last, 41.7% consuming at least 3 drinks on a typical drinking day, and one-third of the reported drinking more than once per week.Conclusions: We found a high prevalence of anorectal CT infection, although no infections were detected without concurrent endocervical involvement. Nonetheless, the high prevalence of condomless anal intercourse reported by participants argues for further study and ongoing consideration of extragenital screening among high-risk patients. Behavioral interventions are also warranted given the high prevalence of sexual and related risk factors.
文摘Radiologic imaging is a diagnostic tool that greatly affects patient outcomes,[1]and with the recent development of imaging technology,advanced imaging tests such as computed tomography(CT)have gained widespread accessibility in hospitals.In particular,CT is essential in the evaluation of patients in low-level emergency departments(EDs)because of its ability to answer clinical questions accurately and quickly.[2]
基金supported by the National Institutes of Health(grant UL1TR001442)of Georgia Clinical and Translational Science Alliance funding.
文摘Although logistic regression is the most popular for modelling regression relationships with binary responses,many find relative risk(RR),or risk ratio,easier to interpret and prefer to use this measure of risk in regression analysis.Indeed,since Zou published his modified Poisson regression approach for modelling RR for cross-sectional data,his paper has been cited over 7000 times,demonstrating the popularity of this alternative measure of risk in regression analysis involving binary responses.As longitudinal studies have become increasingly popular in clinical trials and observational studies,it is imperative to extend Zou’s approach for longitudinal data.The two most popular approaches for longitudinal data analysis are the generalised linear mixed-effects model(GLMM)and generalised estimating equations(GEE).However,the parametric GLMM cannot be used for the extension within the current context,because Zou’s approach treats the binary response as a Poisson variable,which is at odds with the Bernoulli distribution for the binary response.On the other hand,as it imposes no mathematical model on data distributions,the semiparametric GEE is coherent with Zou’s modified Poisson regression.In this paper,we develop a GEE-based longitudinal model for binary responses to provide inference about RR.
