Objectives Incident ischaemic stroke(IS)risk may increase not only with lipids concentration but also with longer duration of exposure.This study aimed to investigate the impact of cumulative burden of lipid profiles ...Objectives Incident ischaemic stroke(IS)risk may increase not only with lipids concentration but also with longer duration of exposure.This study aimed to investigate the impact of cumulative burden of lipid profiles on risk of incident IS.Methods A total of 43836 participants were enrolled who participated in four surveys during 2006-2013.Individual cumulative lipid burden was calculated as number of years(2006-2013)multiplied by the levels of low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),non-HDL C and triglyceride(TG),respectively.The primary outcome was defined as the incident IS during 2012-2017.Results During 4.67 years(±0.70 years)follow-up on average,we identified 1023(2.33%)incident IS.Compared with respective reference groups,the HRs(95%CIs)of the upper tertile in cumulative TG burden,cumulative LDL-C burden,cumulative TC burden and cumulative non-HDL C burden were 1.26 mmol/L(1.02-1.55 mmol/L),1.47 mmol/L(1.25-1.73 mmol/L),1.33 mmol/L(1.12-1.57 mmol/L)and 1.51 mmol/L(1.28-1.80 mmol/L)for incidence of IS,respectively.However,this association was not significant in cumulative HDL-C burden and IS(HR:1.09;95%CI:0.79 to 1.52),after adjustment for confounding variables.Among 16600 participants with low cumulative LDL-C burden,HRs(95%CI)for TC,TG,non-HDL C and HDL-C with IS were 1.63 mmol/L(1.03-2.57 mmol/L),1.65 mmol/L(1.19-2.31 mmol/L),1.57 mmol/L(1.06-2.32 mmol/L)and 0.98 mmol/L(0.56-1.72 mmol/L),respectively.Conclusions We observed the correlation between cumulative burden of lipid profiles,except for cumulative burden of HDL-C,with the risk of incident IS.Cumulative burden of TC,TG and non-HDL C may still predict IS in patients with low cumulative LDL-C burden.Trial registration number ChiCTR-TNRC 11001489.展开更多
Objectives To establish a new ambulatory blood pressure(ABP)parameter(24-hour ABP profile)and evaluated its performance on stroke outcome in ischaemic stroke(IS)or transient ischaemic attack(TIA)patients.Methods The p...Objectives To establish a new ambulatory blood pressure(ABP)parameter(24-hour ABP profile)and evaluated its performance on stroke outcome in ischaemic stroke(IS)or transient ischaemic attack(TIA)patients.Methods The prospective cohort consisted of 1996 IS/TIA patients enrolled for ABP monitoring and a 3-month follow-up for stroke recurrence as outcome.Profile groups of systolic blood pressure(SBP)were identified via an advanced functional clustering method,and the associations of the profile groups and conventional ABP parameters with stroke recurrence were examined in a Cox proportional hazards model.Results Three discrete profile groups(n=604,781 and 611 in profiles 1,2 and 3,respectively)in 24-hour ambulatory SBP were identified.Profile 1 resembled most to the normal diurnal blood pressure pattern;profile 2 also dropped at night,but climbed earlier and with higher morning surge;while profile 3 had sustained higher nocturnal SBP without significant nocturnal SBP decline.The incidence of stroke recurrence was 2.9%,3.9%and 5.5%in profiles 1,2 and 3,respectively.After adjustment for covariates,profile 3 was significantly associated with higher risk of stroke recurrence with profile 1 as reference(HR 1.76,95%CI:1.00 to 3.09),while no significant difference was observed between profiles 2 and 1(HR 1.22,95%CI:0.66 to 2.25).None of conventional ABP parameters showed significant associations with the outcome.Conclusions Ambulatory 24-hour SBP profile is associated with short-term stroke recurrence.Profiles of ABP may help improve identification of stroke recurrence by capturing the additive effects of individual ABP parameters.展开更多
Background and purpose The Treat Stroke to Target trial has confirmed the benefit of targeting low-density lipoprotein cholesterol(LDL-C)of<1.8 mmol/L in patients who had an ischaemic stroke(IS).However,haemorrhagi...Background and purpose The Treat Stroke to Target trial has confirmed the benefit of targeting low-density lipoprotein cholesterol(LDL-C)of<1.8 mmol/L in patients who had an ischaemic stroke(IS).However,haemorrhagic risk brought by this target level(<1.8 mmol/L)or even lower level(<1.4 mmol/L)of LDL-C should also be concerned.In this study,we aimed to demonstrate whether low LDL-C could increase the intracranial haemorrhage risk following IS.Methods Patients who had an IS from China Stroke Center Alliance programme with complete baseline information were prospectively enrolled.793572 patients who had an IS were categorised into 6 groups according to LDL-C level(<1.40 mmol/L,1.40-1.79 mmol/L,1.80-2.59 mmol/L,2.60-2.99 mmol/L,3.00-4.89 mmol/L,≥4.90 mmol/L).The study outcome was defined as intracranial haemorrhage identified during hospitalisation.Logistic regression model was used to examine the association between different LDL-C levels and risk of intracranial haemorrhage.Results Compared with patients of LDL-C=1.80-2.59 mmol/L,both subgroups of LDL-C<1.40 mmol/L and LDL-C=1.40-1.79 mmol/L showed significantly higher risk of intracranial haemorrhage(OR=1.26,95%CI=1.18 to 1.35;OR=1.22,95%CI=1.14 to 1.30,respectively).Interaction effect was found to exist between the subgroups of intravenous thrombolytic therapy(p=0.04),rather than the subgroups of age,sex and body mass index.Moreover,the sensitivity analyses indicated that even patients who had an IS with minor stroke still suffered from the increased intracranial haemorrhage risk related to low LDL-C level.Conclusions Among patients who had an IS,the low LDL-C level(<1.4 mmol/L or<1.8 mmol/L)at baseline is associated with increased risk of intracranial haemorrhage during acute stage.While actively lowering LDL-C level for patients who had an IS,clinicians should also concern about the haemorrhagic risk associated with low LDL-C level.展开更多
High-throughput sequencing of 16S rRNA gene amplicons was conducted to characterize the changing patterns of bacterial community and potential pathogens in full-scale drinking water treatment and distribution systems....High-throughput sequencing of 16S rRNA gene amplicons was conducted to characterize the changing patterns of bacterial community and potential pathogens in full-scale drinking water treatment and distribution systems.Results showed that Actinobacteria was the predominant phylum in source water,while Proteobacteria dominated after chlorine disinfection and its relative abundance increased from 40.88%±9.45%to 67.86%±27.10%.The genera Pseudarthrobacter,Arenimonas,and Limnohabitans were effectively removed by chlorination,while Phreatobacter,Undibacterium,Pseudomonas,and Sphingomonas within the Proteobacteria phylum were greatly enriched after chlorination.Metagenomic analyses revealed the occurrence of 56 species of potential pathogenic bacteria within 17 genera in drinking water,mainly including Pseudomonas fluorescens and five mycobacteria species,which were also persistent in tap water samples.The bacteria were found to be involved in various pathways,among which considerable groups were related to human diseases,including infectious diseases and even cancers.展开更多
基金This work was supported by a grant from National Key R&D programme of China(2017YFC1310902).
文摘Objectives Incident ischaemic stroke(IS)risk may increase not only with lipids concentration but also with longer duration of exposure.This study aimed to investigate the impact of cumulative burden of lipid profiles on risk of incident IS.Methods A total of 43836 participants were enrolled who participated in four surveys during 2006-2013.Individual cumulative lipid burden was calculated as number of years(2006-2013)multiplied by the levels of low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),non-HDL C and triglyceride(TG),respectively.The primary outcome was defined as the incident IS during 2012-2017.Results During 4.67 years(±0.70 years)follow-up on average,we identified 1023(2.33%)incident IS.Compared with respective reference groups,the HRs(95%CIs)of the upper tertile in cumulative TG burden,cumulative LDL-C burden,cumulative TC burden and cumulative non-HDL C burden were 1.26 mmol/L(1.02-1.55 mmol/L),1.47 mmol/L(1.25-1.73 mmol/L),1.33 mmol/L(1.12-1.57 mmol/L)and 1.51 mmol/L(1.28-1.80 mmol/L)for incidence of IS,respectively.However,this association was not significant in cumulative HDL-C burden and IS(HR:1.09;95%CI:0.79 to 1.52),after adjustment for confounding variables.Among 16600 participants with low cumulative LDL-C burden,HRs(95%CI)for TC,TG,non-HDL C and HDL-C with IS were 1.63 mmol/L(1.03-2.57 mmol/L),1.65 mmol/L(1.19-2.31 mmol/L),1.57 mmol/L(1.06-2.32 mmol/L)and 0.98 mmol/L(0.56-1.72 mmol/L),respectively.Conclusions We observed the correlation between cumulative burden of lipid profiles,except for cumulative burden of HDL-C,with the risk of incident IS.Cumulative burden of TC,TG and non-HDL C may still predict IS in patients with low cumulative LDL-C burden.Trial registration number ChiCTR-TNRC 11001489.
文摘Objectives To establish a new ambulatory blood pressure(ABP)parameter(24-hour ABP profile)and evaluated its performance on stroke outcome in ischaemic stroke(IS)or transient ischaemic attack(TIA)patients.Methods The prospective cohort consisted of 1996 IS/TIA patients enrolled for ABP monitoring and a 3-month follow-up for stroke recurrence as outcome.Profile groups of systolic blood pressure(SBP)were identified via an advanced functional clustering method,and the associations of the profile groups and conventional ABP parameters with stroke recurrence were examined in a Cox proportional hazards model.Results Three discrete profile groups(n=604,781 and 611 in profiles 1,2 and 3,respectively)in 24-hour ambulatory SBP were identified.Profile 1 resembled most to the normal diurnal blood pressure pattern;profile 2 also dropped at night,but climbed earlier and with higher morning surge;while profile 3 had sustained higher nocturnal SBP without significant nocturnal SBP decline.The incidence of stroke recurrence was 2.9%,3.9%and 5.5%in profiles 1,2 and 3,respectively.After adjustment for covariates,profile 3 was significantly associated with higher risk of stroke recurrence with profile 1 as reference(HR 1.76,95%CI:1.00 to 3.09),while no significant difference was observed between profiles 2 and 1(HR 1.22,95%CI:0.66 to 2.25).None of conventional ABP parameters showed significant associations with the outcome.Conclusions Ambulatory 24-hour SBP profile is associated with short-term stroke recurrence.Profiles of ABP may help improve identification of stroke recurrence by capturing the additive effects of individual ABP parameters.
基金supported by grants from the Ministry of Science and Technology of the People’s Republic of China(2016YFC0901002,2016YFC0901001,2017YFC1310901,2017YFC1307905,2018YFC1312903)grants from Beijing Municipal Administration of Hospitals’Mission Plan(SML20150502)+1 种基金grants from Beijing Municipal Science&Technology Commission(D171100003017002,D151100002015003)grants from National Science and Technology Major Project(2017ZX09304018).
文摘Background and purpose The Treat Stroke to Target trial has confirmed the benefit of targeting low-density lipoprotein cholesterol(LDL-C)of<1.8 mmol/L in patients who had an ischaemic stroke(IS).However,haemorrhagic risk brought by this target level(<1.8 mmol/L)or even lower level(<1.4 mmol/L)of LDL-C should also be concerned.In this study,we aimed to demonstrate whether low LDL-C could increase the intracranial haemorrhage risk following IS.Methods Patients who had an IS from China Stroke Center Alliance programme with complete baseline information were prospectively enrolled.793572 patients who had an IS were categorised into 6 groups according to LDL-C level(<1.40 mmol/L,1.40-1.79 mmol/L,1.80-2.59 mmol/L,2.60-2.99 mmol/L,3.00-4.89 mmol/L,≥4.90 mmol/L).The study outcome was defined as intracranial haemorrhage identified during hospitalisation.Logistic regression model was used to examine the association between different LDL-C levels and risk of intracranial haemorrhage.Results Compared with patients of LDL-C=1.80-2.59 mmol/L,both subgroups of LDL-C<1.40 mmol/L and LDL-C=1.40-1.79 mmol/L showed significantly higher risk of intracranial haemorrhage(OR=1.26,95%CI=1.18 to 1.35;OR=1.22,95%CI=1.14 to 1.30,respectively).Interaction effect was found to exist between the subgroups of intravenous thrombolytic therapy(p=0.04),rather than the subgroups of age,sex and body mass index.Moreover,the sensitivity analyses indicated that even patients who had an IS with minor stroke still suffered from the increased intracranial haemorrhage risk related to low LDL-C level.Conclusions Among patients who had an IS,the low LDL-C level(<1.4 mmol/L or<1.8 mmol/L)at baseline is associated with increased risk of intracranial haemorrhage during acute stage.While actively lowering LDL-C level for patients who had an IS,clinicians should also concern about the haemorrhagic risk associated with low LDL-C level.
基金supported by the National Natural Science Foundation of China(52025102 and 51908274)Nanjing University Excellent Research Program(ZYJH005)State Key Laboratory of Pollution Control and Resource Reuse Foundation(PCRRF20004).
文摘High-throughput sequencing of 16S rRNA gene amplicons was conducted to characterize the changing patterns of bacterial community and potential pathogens in full-scale drinking water treatment and distribution systems.Results showed that Actinobacteria was the predominant phylum in source water,while Proteobacteria dominated after chlorine disinfection and its relative abundance increased from 40.88%±9.45%to 67.86%±27.10%.The genera Pseudarthrobacter,Arenimonas,and Limnohabitans were effectively removed by chlorination,while Phreatobacter,Undibacterium,Pseudomonas,and Sphingomonas within the Proteobacteria phylum were greatly enriched after chlorination.Metagenomic analyses revealed the occurrence of 56 species of potential pathogenic bacteria within 17 genera in drinking water,mainly including Pseudomonas fluorescens and five mycobacteria species,which were also persistent in tap water samples.The bacteria were found to be involved in various pathways,among which considerable groups were related to human diseases,including infectious diseases and even cancers.
