Objective To systematically review the epidemic trend and disease burden of ischemic stroke in the Chinese population and to provide references for formulating reasonable prevention and treatment measures and allocating health resources. Methods Based on Global Burden of Disease (GBD) data, we analyzed the morbidity, mortality, disability-adjusted life year (DALY) and normalized rates for ischemic stroke in China from 1990 to 2019 and evaluated the changes in the disease burden by sex and age group. Meanwhile, joinpoint regression model was constructed to analyze the time trend change in each stage during the study period. Results Compared with 1990, the incidence, mortality and DALY rate of ischemic stroke in China increased by 171.68%, 125.60% and 98.60% in 2019, among which the incidence, mortality and DALY rate of males increased by 184.29%, 148.96% and 115.16%, respectively; the morbidity, mortality and DALY rates of females increased by 160.9%, 101.32% and 81.44%, respectively. The age-standardized incidence increased by 34.70%, while the age-standardized mortality and age-standardized DALY rate decreased by 3.33% and 4.02%, respectively; the age-standardized incidence, mortality and DALY rates of males increased by 39.52%, 8.03% and 3.68%, respectively; the age-standardized incidence rate of females increased by 31.40%, while the age-standardized mortality rate and age-standardized DALY rate decreased by 14.02% and 11.53%, respectively. In 2019, both the mortality rate and DALY rate due to ischemic stroke increased with age, and the highest rate was found in the population over 85 years old. Males over 60 years old were significantly than females. In the 55-84 age group, the incidence of ischemic stroke in females was higher than that in males, while in the 85 and above age group, the incidence of ischemic stroke in females was lower than that in males. The AAPC of age-standardized incidence, age-standardized mortality, and age-standardized DALY rates due to ischemic stroke from 1990 to 2019 were 1.06% (95%CI 1.00% to 1.11%), 0.01% (95%CI −0.45% to 0.48%) and −0.16% (95%CI −0.53% to 0.22%), respectively. All indicators of the AAPC for males were higher than those for females. ConclusionThe curvent age-standardized mortality and DALY rate of ischemic stroke in China have decreased slightly compared with 1990. The crude mortality, morbidity and disease burden have significantly increased. All indicators of the AAPC for males were higher than those for females. To reduce the epidemic trend and disease burden of ischemic stroke, reasonable prevention and treatment measures and rational allocation of health resources should be made according to sex and age.
Objective To investigate the death rate and life lost of the Xinjian district residents in Nanchang city, and to provide scientific evidence for the health administrators to formulate relevant policies and improve the life expectancy of the residents. Methods Based on the population and the death data in this area from 2011 to 2015, the mortality, the cause of death spectrum, the life expectancy, the life expectancy for death causes, the potential years of life lost (PYLL), the potential years of life lost rate (PYLLR), the average potential years of life lost (APYLL), the standardized potential years of life lost (SPYLL), the standardized potential years of life lost rate (SPYLLR) were analyzed by SPSS 20.0 software. Results From 2011 to 2015, the crude death rate of Xinjian district was 538.38/10 million, the standardized mortality rate was 563.00/10 million, the crude death rate of males is higher than that of females (χ2=788.91, P<0.01); the causes of death in the top five were follows: circulatory system diseases, tumor, respiratory system diseases, injury, endocrine, nutrition and metabolic diseases. The causes of death were in the same order whether in male or female. Mortality rates of different age groups showed that the mortality rates began to rise substantially after the age of 30, the main causes of death were different between the low age group and the high age group. The life expectancy of residents was 78.38 years, the PYLL for all causes of death was 129 087.5 years, the PYLLR was 39.84‰, the APYLL was 17.44 years, the SPYLL was 134 057.00 years, the SPYLLR was 38.61‰. The PYLL caused by injury was 46 191.5 years, the PYLLR was 14.26‰, APYLL was 33.14 years, of which were all ranked first. The SPYLL caused by tumor was 48 414.95 years, the SPYLLR was 13.94‰, of which were ranked first. Conclusion The mortality rate of Xinjian district residents is higher than that of Nanchang urban residents, but lower than the average level of Jiangxi province and the whole country. Life reduction analysis shows that chronic non-communicable diseases and injuries are the main causes of death for residents in the area. The three levels prevention is of great significance to reduce the death of residents and improve their life expectancy.
OBJECTIVE: To elongate the proliferation life-span of human umbilicus vein endothelial cell (HUVEC). METHODS: We synthesized the human telomerase reverse transcriptase mRNA (hTERT mRNA) by in vitro transcription, then transferred the hTERT mRNA into HUVEC in quicent stage by lipofect introduction. RESULTS: Telomerase expressed transiently in HUVEC, and the cell life-span was elongated for 7 population doublings. CONCLUSION: Telomerase can be reconstructed controllably and transiently in HUVEC by hTERT mRNA introduction, this method has the potential to be used to elongate the lifespan of cells cultured in vitro.
目的:应用心肌自发荧光(AF)研究心肌线粒体氧化代谢状态,监测线粒体功能改变的早期信号。方法:烟酰胺腺嘌呤(磷酸)二核苷酸［NAD(P)H］作为荧光探针,用光谱分辨的时间相关单光子计数(TCSPC)记录375nm紫外激光激发的心肌AF光谱和荧光寿命,测试影响线粒体呼吸时AF动态衰减。结果:在420~560nm光谱区域,至少需用3个荧光寿命池0.4~0.7ns,1.2~1.9ns和8.0~13.0ns描述细胞AF。线粒体呼吸阻断剂鱼藤酮可显著增加AF强度,缩短平均荧光寿命。氧化磷酸化解偶联剂二硝基酚可显著降低AF强度,在520nm处增宽荧光光谱,延长平均荧光寿命。这些结果和NADH荧光动力学离体实验(in vitro)有可比性。结论:光谱分辨的荧光寿命技术测定心肌NAD(P)H荧光有很好的重复性,在细胞水平上增加了心肌氧化代谢或线粒体功能障碍的知识,为临床诊断和治疗线粒体功能障碍开拓了新视野。
Objective To insure early detection and hence efficient prevention of allograft rejection in transplanted heart, investigate possible applications of NAD(P)H fluorescence components analysis at the level of living cardiac cells to propose new approaches for diagnosis of rejection. Methods NAD(P)H was studied for noninvasive fluorescent probing of the mitochondrial function. Human cardiomyocyte were isolated from one additional endomyocardial biopsy (EMB) of 14 pediatric patients with heart ransplantation. Rat cardiomyocyte (n=5, 13-14 week old) were also isolated by the same approach for human myocytes. Autofluorescence(AF) was recorded in living cardiomyocytes following excitation with 375 nm UVlight and detection by spectrallyresolved time correlated single photon counting (TCSPC), based on the simultaneous measurement of the fluorescence spectra and lifetimes. Rat cardiac cells were divided into four groups: normoxic condition, normoxia with Rotenone, ischemic condition and ischemia with Rotenone. Comparison of cardiomyocyte AF between human and rat; compared kinetics of rat cardiomyocytes AF in normoxic conditions to ischemiamimicking ones, induced at physiological temperatures by reducing cell pH and oxygen content; comparison of cardiomyocyte AF dynamic changes in transplanted pediatric patients presenting either no rejection (R0) or mild rejection (R1). Results We have achieved appropriate isolation of living cardiomyocytes from human biopsies, as well as from rat cardiac tissues and determined their AF. At least a 3-exponential decay with 0.5-0.7ns, 1.9-2.4 ns and 9.0-15.0 ns lifetime pools is necessary to describe human cardiomyocyte AF within 420560 nm spectral range. Rat cardiomyocyte steadystate AF in ischemiamimicking condition was significantly increased when compared normoxic ones (Plt;0.05); application of Rotenone induced a significant increase in AF intensity in ischemic and normoxic condition, however no significant difference between the two groups (Plt;0.05).Human cardiomyocyte AF was found significantly lower in comparison to experimental rat model in the same condition(Plt;0.05). A correlation between changes in steadystate NAD(P)H fluorescence and rejection grades was found when comparison of R1 to R0. R1 showed significantly increased fluorescence intensity (Plt;0.05), without change in the spectra shape, results can be comparable to the effect of ischemiamimic conditions. Conclusion Our studies clearly demonstrated that spectrallyresolved fluorescence spectral analysis coupled to fluorescence lifetime are high sensitive approaches to examine mitochondrial metabolic oxidative state directly in living human cardiomyocytes with good reproducibility. Human cardiomyocytes are more metabolically active than the rat ones, while this activity (and thus ATP production) seems lowered during rejection process. In perspective, the advantage of this method is the possibility of its combination to multiphoton confocal microscopy, which can result in the adaptation of this approach directly to tissue biopsy, as well as in vivo directly via cardiac catheterization without the necessity of cell isolation. This approach provides promising new tool for clinical diagnosis and treatment of allograft rejection, and will enhance our knowledge about cardiomyocyte oxidative metabolism and/or its dysfunction at a cellular level.
Objective To estimate healthy life expectancy of residents aged 30 and above in Jianyang, Sichuan province, and comprehensively evaluate the health status of the population, so as to provide reference and basis for the formulation of health-related public policies. Methods The population data, death data and health status data of Jianyang city in 2018 were collected, and the self-rated health life expectancy and life expectancy without chronic diseases of residents aged 30 and above were calculated by Sullivan method, and their proportion in life expectancy was calculated. Results A total of 4 482 residents aged 30 years and above were included in Jinyang city, of whom 3 989 were self-rated healthy, accounting for 89.00% of self-rated health, and 1 988 were suffering from chronic diseases, with a chronic disease prevalence rate of 44.36%. In the age group of 30-64, the self-rated health life expectancy of women was significantly higher than that of men (P<0.05), and in the age group of 40-44, the life expectancy without chronic diseases of women was significantly lower than that of men (P<0.05), and the differences were not statistically significant when comparing different genders in other age groups (P>0.05). With the increase of age, the proportion of residents’ self-rated health and the proportion of life expectancy without chronic diseases in healthy life expectancy gradually declined. Conclusions The chronic disease has become the main factor affecting the health of middle-aged and elderly population, especially female population. It is suggested that active measures should be taken to deal with chronic diseases and the elderly health support system should be strengthened to improve healthy life expectancy of residents in Jianyang city.
Objective To observate the influencing factors on circuit life during continuous renal replacement therapy (CRRT) with regional citrate anticoagulation (RCA), so as to provide data support for further optimization of RCA anticoagulation strategy. MethodsPatients who underwent CRRT with RCA in West China Hospital of Sichuan University between March 2021 and April 2022 were retrospectively selected. Analyze the basic information of patients and the impact of relevant indicators before or within 12 hours of treatment on the circuit life. Results A total of 116 patients were included. Among the included patients, a total of 225 cases were treated with CRRT for 11 051.7 hours, the median circuit life was 57.0 (25.4, 72.0) h. 142 cases (63.1%) were terminated due to coagulation, the median circuit life was 30.3 (20.5, 52.8) h. The results of multivariate Cox regression analysis showed that pH value [hazard ratio (HR)=0.002, 95% confidence interval (CI) (0.0001, 0.127), P=0.003], the maximam postfilter ionized calcium [HR=0.039, 95%CI (0.004, 0.437), P=0.008], blood flow [HR=1.051, 95%CI (1.027, 1.075), P<0.001] and catheter dysfunction [HR=5.701, 95%CI (3.777, 8.605), P<0.001] were the four influential factors affected circuit life. Kaplan Meier survival curve showed that RCA had the best effect when the postfilter ionized calcium was in the range of 0.25 ~ 0.35 mmol/L. Conclusions During CRRT treatment of RCA, pH value, postfilter ionized calcium, blood flow and catheter function are the independent influencing factors of circuit life. The above parameters should be carefully monitored and optimized in the treatment process to minimize the risk of coagulation, prolong the circuit life and maintain the continuty of CRRT treatment. The postfilter ionized calcium was recommended to be maitained at 0.25-0.35mmol/L, pH value maintained above 7.38, blood flow no more than 145 mL/min and catheter maitained patency to ensure the adequate anticoagulation.
Objective To summarize and categorize the epidemiological evaluation indicators of disease burden, and to explore and analyze the research gaps in the existing evaluation indicators of disease burden. Methods The CNKI, WanFang Data, VIP, CBM, PubMed, Embase, Web of Science and Cochrane Library databases were searched by computer to obtain qualitative studies on evaluation indicators of disease burden. The search time limit was from the establishment of the database to October 2023. CASP was used to evaluate the methodological quality of the included studies, and thematic analysis was used to summarize the evaluation indicators of disease burden by NVivo 12 software. Results A total of 19 studies were included, of which 10 studies were of high quality and 9 studies were of medium quality. The evaluation indicators of disease burden were summarized into two three-level core themes: positive indicators and negative indicators. Five second-level analytic themes were used: disease indicators, life loss indicators, life expectancy indicators, cause removal indicators and health status indicators. Twenty-nine level-1 descriptive themes. Conclusion The evaluation indicators of disease burden have their respective scopes of application and limitations. It is necessary to continue strengthening the construction of a comprehensive evaluation index system for disease burden, so that it is comparable and reliable, can adapt to local calculation weights, and covers both family burden and social burden.
ObjectiveTo analyze the trend of disease burden of colorectal cancer (CRC) in China from 1990 to 2019.MethodsData was obtained from Global Burden of Disease Study 2019 (GBD 2019). Incidence, mortality, disability-adjusted life year (DALY), years of life lost (YLL), years lived with disability (YLD), and their corresponding standardized rate and annual average percentage change (AAPC) were used to describe the changes of disease burden of colorectal cancer in Chinese population between 1990 and 2019.ResultsCompared with 1990, the number of new cases, standardized incidence, the number of deaths and standardized mortality of CRC in China in 2019 increased by 474.03%, 144.01%, 230.14%, and 36.15%, respectively. The standardized mortality and standardized incidence of CRC in China had reached and gradually exceeded the global level since 2010. From 1990 to 2019, the overall standard incidence (AAPC=3.6%, P<0.05), standard mortality rate (AAPC=1.4%, P<0.05), and the standard DALY rate (AAPC=1.2%, P<0.05) of CRC in China showed an increasing trend. The incidence, mortality and DALY rates of males were higher than those of females, and gradually increased with age. Compared with 1990, the DALY, YLL, and YLD of CRC in 2019 increased by 134.3%, 127.69%, and 445.00%, and their corresponding standardized rates increased by 30.53%, 27.03%, and 187.29%, respectively, showing an overall upward trend.ConclusionsFrom 1990 to 2019, the standardized incidence rate and standardized mortality rate of colorectal cancer in China have had a continuously increasing trend, and males and the elderly are high-risk groups. To reduce the burden of colorectal cancer in China, effective measures should be taken for prevention and management.