While a healthy lifestyle is known to reduce the risk of stroke,the extent to which blood pressure(BP)mediates this association remains unclear.The present study aimed to quantify the mediating role of BP in the assoc...While a healthy lifestyle is known to reduce the risk of stroke,the extent to which blood pressure(BP)mediates this association remains unclear.The present study aimed to quantify the mediating role of BP in the association between combined lifestyle factors and stroke incidence.Using data from 51929 participants free of major cardiovascular diseases or cancer at baseline,we employed structural equation modeling to assess the mediating effects of systolic(SBP)and diastolic(DBP)blood pressure.During the follow-up,2811 incident stroke cases were identified.A healthy lifestyle was significantly associated with a reduced risk of stroke,with SBP mediating 44.70%(β=-0.0014,95%confidence interval[CI]:-0.0016 to-0.0012)and DBP mediating 37.81%(β=-0.0012,95%CI:-0.0015 to-0.0009)of this association.The mediating effects were attenuated but remained significant for ischemic stroke(SBP:33.21%;DBP:27.24%).In conclusion,approximately two-fifths of the protective association between a healthy lifestyle and stroke may be mediated by BP.These findings suggest that BP control may serve as an important early indicator for evaluating the effectiveness of lifestyle interventions in reducing stroke risk.展开更多
Objective Evidence suggests that depleted gut microbialα-diversity is associated with hypertension;however,whether metabolic markers affect this relationship remains unknown.We aimed to determine the potential metabo...Objective Evidence suggests that depleted gut microbialα-diversity is associated with hypertension;however,whether metabolic markers affect this relationship remains unknown.We aimed to determine the potential metabolites mediating the associations ofα-diversity with blood pressure(BP)and BP variability(BPV).Methods Metagenomics and plasma targeted metabolomics were conducted on 523 Chinese participants from the MetaSalt study.The 24-hour,daytime,and nighttime BP and BPV were calculated based on ambulatory BP measurements.Linear mixed models were used to characterize the relationships betweenα-diversity(Shannon and Chao1 index)and BP indices.Mediation analyses were performed to assess the contribution of metabolites to the observed associations.The influence of key metabolites on hypertension was further evaluated in a prospective cohort of 2,169 participants.Results Gut microbial richness(Chao1)was negatively associated with 24-hour systolic BP,daytime systolic BP,daytime diastolic BP,24-hour systolic BPV,and nighttime systolic BPV(P<0.05).Moreover,26 metabolites were strongly associated with richness(Bonferroni P<0.05).Among them,four key metabolites(imidazole propionate,2-hydroxy-3-methylbutyric acid,homovanillic acid,and hydrocinnamic acid)mediated the associations between richness and BP indices(proportions of mediating effects:14.1%–67.4%).These key metabolites were also associated with hypertension in the prospective cohort.For example,each 1-standard deviation unit increase in hydrocinnamic acid significantly reduced the risk of prevalent(OR[95%CI]=0.90[0.82,0.99];P=0.03)and incident hypertension(HR[95%CI]=0.83[0.71,0.96];P=0.01).Conclusion Our results suggest that gut microbial richness correlates with lower BP and BPV,and that certain metabolites mediate these associations.These findings provide novel insights into the pathogenesis and prevention of hypertension.展开更多
Ischemic stroke,a frequently occurring form of stroke,is caused by obstruction of cerebral blood flow,which leads to ischemia,hypoxia,and necrosis of local brain tissue.After ischemic stroke,both astrocytes and the bl...Ischemic stroke,a frequently occurring form of stroke,is caused by obstruction of cerebral blood flow,which leads to ischemia,hypoxia,and necrosis of local brain tissue.After ischemic stroke,both astrocytes and the blood–brain barrier undergo morphological and functional transformations.However,the interplay between astrocytes and the blood–brain barrier has received less attention.This comprehensive review explores the physiological and pathological morphological and functional changes in astrocytes and the blood–brain barrier in ischemic stroke.Post-stroke,the structure of endothelial cells and peripheral cells undergoes alterations,causing disruption of the blood–brain barrier.This disruption allows various pro-inflammatory factors and chemokines to cross the blood–brain barrier.Simultaneously,astrocytes swell and primarily adopt two phenotypic states:A1 and A2,which exhibit different roles at different stages of ischemic stroke.During the acute phase,A1 reactive astrocytes secrete vascular endothelial growth factor,matrix metalloproteinases,lipid carrier protein-2,and other cytokines,exacerbating damage to endothelial cells and tight junctions.Conversely,A2 reactive astrocytes produce pentraxin 3,Sonic hedgehog,angiopoietin-1,and other protective factors for endothelial cells.Furthermore,astrocytes indirectly influence blood–brain barrier permeability through ferroptosis and exosomes.In the middle and late(recovery)stages of ischemic stroke,A1 and A2 astrocytes show different effects on glial scar formation.A1 astrocytes promote glial scar formation and inhibit axon growth via glial fibrillary acidic protein,chondroitin sulfate proteoglycans,and transforming growth factor-β.In contrast,A2 astrocytes facilitate axon growth through platelet-derived growth factor,playing a crucial role in vascular remodeling.Therefore,enhancing our understanding of the pathological changes and interactions between astrocytes and the blood–brain barrier is a vital therapeutic target for preventing further brain damage in acute stroke.These insights may pave the way for innovative therapeutic strategies for ischemic stroke.展开更多
Background:Panacis Quinquefolii Radix(PQR)is known for its ability to nourish“Qi”(it serves as the driving force for the functional activities of the body’s organs and meridians,promoting and regulating various phy...Background:Panacis Quinquefolii Radix(PQR)is known for its ability to nourish“Qi”(it serves as the driving force for the functional activities of the body’s organs and meridians,promoting and regulating various physiological functions)and“Yin”(it represents the material foundation of the human body.It plays a role in nourishing,moistening,and cooling the body).Notoginseng Radix et Rhizoma(NRR)is recognized for its properties of resolving blood stasis(it refers to a pathological condition characterized by impaired or stagnant blood circulation within the body).Changes in the compatibility ratio of these herbs often lead to variations in their chemical composition and efficacy.However,the specific alterations in chemical composition and efficacy resulting from compatibility adjustments remain unclear.We aimed to compare the material basis and their effects of different compatibility ratios of PQR and NRR on“Qi”deficiency and blood stasis syndrome(QBS).Methods:This study employed UPLC-Q/TOF-MS to identify effective compounds in the compatibility of PQR and NRR and utilized UPLC-TQ-MS/MS to analyze the dissolution of 16 saponins in PQR and NRR at 9 different ratios.A rat model of QBS was established,and the efficacy of PQR and NRR in treating this syndrome was assessed using hemorheology and coagulation analyses.Results:The study results show that PQR and NRR exhibit significant efficacy,effectively reducing blood viscosity induced by platelet aggregation and lowering inflammatory markers such as IL-6,IL-10,TXB2 and ET associated with vascular injury.Moreover,this combination regulates ATP and ADP levels,enhances energy metabolism,and promotes overall health.A total of 104 compounds in the compatibility of PQR and NRR were identified.The ratios of 1:2 and 1:3 showed the highest total saponin content,but the ratio of 1:1 demonstrated a superior pharmacological effect for the treatment of QBS.Conclusion:In summary,the compatibility of PQR and NRR not only shows the complex interactions between traditional Chinese medicinal materials,but also provides a new idea and method for the treatment of QBS.展开更多
Studies have shown that chitosan protects against neurodegenerative diseases. However, the precise mechanism remains poorly understood. In this study, we administered chitosan intragastrically to an MPTP-induced mouse...Studies have shown that chitosan protects against neurodegenerative diseases. However, the precise mechanism remains poorly understood. In this study, we administered chitosan intragastrically to an MPTP-induced mouse model of Parkinson's disease and found that it effectively reduced dopamine neuron injury, neurotransmitter dopamine release, and motor symptoms. These neuroprotective effects of chitosan were related to bacterial metabolites, specifically shortchain fatty acids, and chitosan administration altered intestinal microbial diversity and decreased short-chain fatty acid production in the gut. Furthermore, chitosan effectively reduced damage to the intestinal barrier and the blood–brain barrier. Finally, we demonstrated that chitosan improved intestinal barrier function and alleviated inflammation in both the peripheral nervous system and the central nervous system by reducing acetate levels. Based on these findings, we suggest a molecular mechanism by which chitosan decreases inflammation through reducing acetate levels and repairing the intestinal and blood–brain barriers, thereby alleviating symptoms of Parkinson's disease.展开更多
Blood cell disorders are among the leading causes of serious diseases such as leukemia,anemia,blood clotting disorders,and immune-related conditions.The global incidence of hematological diseases is increasing,affecti...Blood cell disorders are among the leading causes of serious diseases such as leukemia,anemia,blood clotting disorders,and immune-related conditions.The global incidence of hematological diseases is increasing,affecting both children and adults.In clinical practice,blood smear analysis is still largely performed manually,relying heavily on the experience and expertise of laboratory technicians or hematologists.This manual process introduces risks of diagnostic errors,especially in cases with rare or morphologically ambiguous cells.The situation is more critical in developing countries,where there is a shortage of specialized medical personnel and limited access to modern diagnostic tools.High testing costs and delays in diagnosis hinder access to quality healthcare services.In this context,the integration of Artificial Intelligence(AI),particularly Explainable AI(XAI)based on deep learning,offers a promising solution for improving the accuracy,efficiency,and transparency of hematological diagnostics.In this study,we propose a Ghost Residual Network(GRsNet)integrated with XAI techniques such as Gradient-weighted Class Activation Mapping(Grad-CAM),Local Interpretable Model-Agnostic Explanations(LIME),and SHapley Additive exPlanations(SHAP)for automatic blood cell classification.These techniques provide visual explanations by highlighting important regions in the input images,thereby supporting clinical decision-making.The proposed model is evaluated on two public datasets:Naturalize 2K-PBC and Microscopic Blood Cell,achieving a classification accuracy of up to 95%.The results demonstrate the model’s strong potential for automated hematological diagnosis,particularly in resource-constrained settings.It not only enhances diagnostic reliability but also contributes to advancing digital transformation and equitable access to AI-driven healthcare in developing regions.展开更多
Erythroid cells, the predominant circulating blood cells, are essential for oxygen and carbon dioxide transport (Obeagu, 2024).Their production, erythropoiesis, involves the coordinated synthesis of globin chains and ...Erythroid cells, the predominant circulating blood cells, are essential for oxygen and carbon dioxide transport (Obeagu, 2024).Their production, erythropoiesis, involves the coordinated synthesis of globin chains and heme molecules to assemble hemoglobin(Zhang et al., 2021). The erythroid-specific enzyme δ-aminolevulinate synthase 2 (ALAS2) is a key rate-limiting factor in heme biosynthesis,with its expression increasing in late-stage erythropoiesis to meet heme demands (Sadlon et al., 1999). Zebrafish (Danio rerio) is a well-established model for studying erythropoiesis due to its genetic tractability and optical transparency (Zhang and Hamza, 2019;Zhang et al., 2021). The Tol2-mediated Gal4-UAS system has been widely applied for gene and enhancer trapping in zebrafish (Asakawa and Kawakami, 2009). However, reliable Gal4 enhancer-trap lines for erythropoiesis remain limited. Here, we report a transgenic zebrafish line with erythroid-specific Gal4FF expression under the control of the endogenous alas2 promoter, offering a more precise erythroblast labeling than the gata1a reporter line. This model provides a valuable tool for erythroid-specific investigations of blood flow dynamics and gene function.展开更多
BACKGROUND The reference ranges for biochemical parameters can fluctuate due to factors like altitude,age,gender,and socioeconomic conditions.These values are crucial for interpreting laboratory data and guide clinica...BACKGROUND The reference ranges for biochemical parameters can fluctuate due to factors like altitude,age,gender,and socioeconomic conditions.These values are crucial for interpreting laboratory data and guide clinical treatment decisions.Currently,there is no established set of reference intervals for cord blood biochemical parameters of newborns in India,particularly in Mumbai.AIM To create cord blood biochemical parameters reference intervals specifically for Mumbai,India.METHODS A cross-sectional study was conducted in an Indian tertiary care hospital.This study focused on healthy newborns with normal birth weight,born to pregnant mothers without health issues.Cord blood samples,approximately 2-3 mL in volume,were collected from 210 term neonates.These samples were divided into fluoride(glucose)and clot activator(serum)tubes and were subsequently analyzed in the institute's biochemical laboratory.The data obtained from the analysis was then subjected to statistical analysis.The result of the Shapiro-Wilk test suggested non-normality in the data distribution.Consequently,nonparametric statistics were utilized for analysis.The Mann-Whitney U test was utilized to compare parameter distributions among different factors,including the infant’s sex,delivery method,maternal age,and obstetric history.A significance level of P<0.05 was considered to indicate statistical significance.RESULTS The following represent the median figures and central 95 percentile reference intervals for biochemical parameters in umbilical cord blood of newborns:Serum direct bilirubin=(0.1-0.55)mg/dL,indirect bilirubin=(0.64-2.26)mg/dL,total bilirubin=(0.62-3.14)mg/dL,creatinine=(0.27-0.76)mg/dL,sodium=(128.19-143.26)mmol/L,chloride=(100.19-111.68)mmol/L,potassium=(1.62-9.98)mmol/L and plasma glucose=(24.75-94.23)mg/dL.Statistically significant differences were observed in serum sodium,potassium,and plasma glucose levels when comparing delivery modes.CONCLUSION This is the pioneering study in which first time,the biochemical reference intervals in cord blood for newborns are established in western India.The values are applicable for newborns from this area.Larger study throughout the country is required.展开更多
Diabetes remains one of the most pressing global metabolic disorders,necessitating regular and precise monitoring of blood glucose levels for effective disease management.In this study,we developed a rapid and reliabl...Diabetes remains one of the most pressing global metabolic disorders,necessitating regular and precise monitoring of blood glucose levels for effective disease management.In this study,we developed a rapid and reliable method for quantifying glucose in whole blood using near-infrared(NIR)spectroscopy.A diabetic rat model was established through a high-fat,high-sugar diet followed by administration of streptozotocin(STZ)over a period of 4 weeks.To construct the NIR calibration model,partial least-squares(PLS)regression was employed,with optimization tailored to spectral range,preprocessing techniques,and the number of latent variables.The optimal model was achieved within the spectral window of 7502.0-5446.2 cm^(-1),using Constant Offset Elimination for spectral pretreatment and a factor number of 10.This optimized model yielded a strong correlation coefficient(R)of 0.9621,with a root mean square error of cross-validation(RMSECV)of 0.612,a residual predictive deviation(RPD)of 3.48,and a root mean square error of prediction(RMSEP)of 0.420.Additionally,biochemical indices were evaluated across all experimental groups to validate the model’s performance.Overall,the proposed NIR-based analytical strategy demonstrated high accuracy,robustness,and reproducibility,offering a promising tool for rapid glucose assessment in whole blood.展开更多
BACKGROUND Blood glucose and serum albumin have been associated with cardiovascular disease prognosis,but the impact of admission-blood-glucose-to-albumin ratio(AAR)on adverse outcomes in critical ill coronary artery ...BACKGROUND Blood glucose and serum albumin have been associated with cardiovascular disease prognosis,but the impact of admission-blood-glucose-to-albumin ratio(AAR)on adverse outcomes in critical ill coronary artery disease(CAD)patients was not investigated.METHODS Patients diagnosed with CAD were non-consecutively selected from the MIMIC-IV database and categorized into quartiles based on their AAR.The primary outcome was 1-year mortality,and secondary endpoints were in-hospital mortality,acute kidney injury(AKI),and renal replacement therapy(RRT).A restricted cubic splines model and Cox proportional hazard models assessed the association between AAR and adverse outcomes in CAD patients.Kaplan-Meier survival analysis determined differences in endpoints across subgroups.RESULTS A total of 8360 patients were included.There were 726 patients(8.7%)died in the hospital and 1944 patients(23%)died at 1 year.The incidence of AKI and RRT was 63%and 4.3%,respectively.High AAR was markedly associated with in-hospital mortality(HR=1.587,P=0.003),1-year mortality(HR=1.502,P<0.001),AKI incidence(HR=1.579,P<0.001),and RRT(HR=1.640,P<0.016)in CAD patients in the completely adjusted Cox proportional hazard model.Kaplan-Meier survival analysis noted substantial differences in all endpoints based on AAR quartiles.Stratified analysis and interaction test demonstrated stable correlations between AAR and outcomes.CONCLUSIONS The results highlight that AAR may be a potential indicator for assessing in-hospital mortality,1-year mortality,and adverse renal prognosis in critical CAD patients.展开更多
Objective:To study the clinical value of combined detection of blood lipids,blood glucose,and liver function in non-alcoholic fatty liver disease.Methods:105 patients with non-alcoholic fatty liver disease treated in ...Objective:To study the clinical value of combined detection of blood lipids,blood glucose,and liver function in non-alcoholic fatty liver disease.Methods:105 patients with non-alcoholic fatty liver disease treated in our hospital from May 2022 to July 2024 were selected as the research subjects.All patients underwent a B-ultrasound examination.According to the severity of the disease,they were divided into group A(mild,n=35),group B(moderate,n=44),and group C(severe,n=26).Another 30 healthy residents who came to the hospital for physical examination during the same period were selected as group D.The differences in blood lipids,blood glucose,and liver function indicators between groups were compared.Results:The triglyceride(TG),total cholesterol(TC),and low-density lipoprotein cholesterol(LDL)levels in groups A,B,and C were higher than those in group D,while the high-density lipoprotein cholesterol(HDL)level was lower(P<0.05).The fasting plasma glucose(FPG)levels in groups B and C were higher than those in group D(P<0.05).The TG,LDL,and FPG levels in groups B and C were higher than those in group A(P<0.05).The TC level in group C was higher than that in group A,while the HDL level was lower(P<0.05).The TC and FPG levels in group C were higher than those in group B(P<0.05).The total bilirubin(TBil),aspartate aminotransferase(AST),and alanine aminotransferase(ALT)levels in groups A,B,and C were higher than those in group D(P<0.05).The TBil and ALT levels in groups B and C were higher than those in group A(P<0.05).The AST level in group C was higher than that in group A(P<0.05).The AST and ALT levels in group C were higher than those in group B(P<0.05).Conclusion:Patients with non-alcoholic fatty liver disease have disordered glucose and lipid metabolism.Blood lipids,blood glucose,and liver function are closely related to the severity of the disease.Strengthening exercise and dietary intervention early on can help control the progression of simple fatty liver disease and reduce the risk of severe liver diseases such as steatohepatitis and cirrhosis.展开更多
Background Hypertension is associated with an increased risk of calcific aortic valve stenosis(CAVS).However,the directionality of causation between blood pressure traits and aortic stenosis is unclear,as is the benef...Background Hypertension is associated with an increased risk of calcific aortic valve stenosis(CAVS).However,the directionality of causation between blood pressure traits and aortic stenosis is unclear,as is the benefit of antihypertensive drugs for CAVS.Methods Using genome-wide association studies(GWAS)summary statistics,we performed bidirectional two-sample univariable mendelian randomization(UVMR)to assess the causal associations of systolic blood pressure(SBP),diastolic blood pressure(DBP),and pulse pressure(PP)with CAVS.Multivariable mendelian randomization(MVMR)was conducted to evaluate the direct effect of hypertension on CAVS,adjusting for confounders.Drug target mendelian randomization(MR)and summary-level MR(SMR)were used to estimate the effects of 12 classes of antihypertensive drugs and their target genes on CAVS risk.Inverse variance weighting was the primary MR method,with sensitivity analyses to validate results.Results UVMR showed SBP,DBP,and PP have causal effects on CAVS,with no significant reverse causality.MVMR confirmed the causality between hypertension and CAVS after adjusting for confounders.Drug-target MR analyses indicated that calcium channel blockers(CCBs),loop diuretics,and thiazide diuretics via SBP lowering exerted protective effects on CAVS risk.SMR analysis showed that the CCBs target gene CACNA2D2 and ARBs target gene AGTR1 were positively associated with CAVS risk,while diuretics target genes SLC12A5 and SLC12A1 were negatively associated with aortic stenosis risk.Conclusions Hypertension has a causal relationship with CAVS.Managing SBP in hypertensive patients with CCBs may prevent CAVS.ARBs might exert protective effects on CAVS independent of blood pressure reduction.The relationship between diuretics and CAVS is complex,with opposite effects through different mechanisms.展开更多
Objective This study aimed to evaluate the relationships of white blood cell(WBC)count,platelet(PLT)count,and PLT-to-WBC ratio(PWR)with muscle mass in Chinese older adults.Methods This cross-sectional analysis involve...Objective This study aimed to evaluate the relationships of white blood cell(WBC)count,platelet(PLT)count,and PLT-to-WBC ratio(PWR)with muscle mass in Chinese older adults.Methods This cross-sectional analysis involved 4,033 Chinese older adults aged≥65 years from the Healthy Ageing and Biomarkers Cohort Study.Muscle mass and total skeletal muscle mass index(TSMI)were measured by bioelectric impedance analysis.WBC,PLT,and PWR were measured using standard methods.Multivariate linear regression was used to examine the associations of WBC count,PLT count,and PWR with TSMI.Results High WBC count,PLT count,and PWR were associated with low TSMI,with coefficients of-0.0091(95%confidence interval[CI]:-0.0142 to-0.0041),-0.0119(95%CI:-0.0170 to-0.0068),and-0.0051(95%CI:-0.0102 to-0.0001).The associations between the three inflammatory indices and TSMI were linear.Stratified analyses indicated that the relationship between inflammatory markers and TSMI was more evident in male participants and in individuals aged<80 years than in their counterparts.Conclusion Elevated WBC count,PLT count,and PWR correlated with muscle mass loss.This study highlights the importance of regular monitoring of inflammatory markers as a potential strategy for the screening and management of sarcopenia in older adults.展开更多
Background Both medication and non-medication therapies are effective approaches to control blood pressure (BP) in hypertension patients.However,the association of joint changes in antihypertensive medication use and ...Background Both medication and non-medication therapies are effective approaches to control blood pressure (BP) in hypertension patients.However,the association of joint changes in antihypertensive medication use and healthy lifestyle index (HLI)with BP control among hypertension patients is seldom reported,which needs to provide more evidence by prospective intervention studies.We examined the association of antihypertensive medication use and HLI with BP control among employees with hypertension in China based on a workplace-based multicomponent intervention program.Methods Between January 2013 and December 2014,a cluster randomized clinical trial of a workplace-based multicomponent intervention program was conducted in 60 workplaces across 20 urban areas in China.Workplaces were randomly divided into intervention (n=40) and control (n=20) groups.Basic information on employees at each workplace was collected by trained professionals,including sociodemographic characteristics,medical history,family history,lifestyle behaviors,medication status and physical measurements.After baseline,the intervention group received a 2-year intervention to achieve BP control,which included:(1) a workplace wellness program for all employees;(2) a guidelines-oriented hypertension management protocol.HLI including nonsmoking,nondrinking,adequate physical activity,weight within reference range and balanced diet,were coded on a 5-point scale (range:0-5,with higher score indicating a healthier lifestyle).Antihypertensive medication use was defined as taking drug within the last 2 weeks.Changes in HLI,antihypertensive medication use and BP control from baseline to 24 months were measured after the intervention.Results Overall,4655 employees were included (age:46.3±7.6 years,men:3547 (82.3%)).After 24 months of the intervention,there was a significant improvement in lifestyle[smoking (OR=0.65,95%CI:0.43-0.99;P=0.045),drinking (OR=0.52,95%CI:0.40-0.68;P<0.001),regular exercise (OR=3.10,95%CI:2.53-3.78;P<0.001),excessive intake of fatty food (OR=0.17,95%CI:0.06-0.52;P=0.002),restrictive use of salt (OR=0.26,95%CI:0.12-0.56;P=0.001)].Compare to employees with a deteriorating lifestyle after the intervention,those with an improved lifestyle had a higher BP control.In the intervention group,compared with employees not using antihypertensive medication,those who consistent used (OR=2.34;95%CI:1.16-4.72;P=0.017) or changed from not using to using antihypertensive medication (OR=2.24;95%CI:1.08-4.62;P=0.030) had higher BP control.Compared with those having lower HLI,participants with a same (OR=1.38;95%CI:0.99-1.93;P=0.056) or high (OR=1.79;95%CI:1.27~2.53;P<0.001) HLI had higher BP control.Those who used antihypertensive medication and had a high HLI had the highest BP control (OR=1.88;95%CI:1.32-2.67,P<0.001).Subgroup analysis also showed the consistent effect as the above.Conclusion These findings suggest that adherence to antihypertensive medication treatment and healthy lifestyle were associated with a significant improvement in BP control among employees with hypertension.展开更多
The purpose of this study is to evaluate the price and composition of blood glucose meters and blood glucose test papers in Hubei Province,so as to improve the affordability of blood glucose monitoring for diabetes pa...The purpose of this study is to evaluate the price and composition of blood glucose meters and blood glucose test papers in Hubei Province,so as to improve the affordability of blood glucose monitoring for diabetes patients.Using the standard survey method jointly developed by the World Health Organization(WHO)and Health Action International(HAI)for drug price composition analysis,central level data was collected through literature review,policy review,and interviews with key informants.Field research was conducted in Wuhan and Yichang to trace price data at various levels of the supply chain.At the central level,data shows that China has implemented multiple policies related to the management and pricing of blood glucose meters and test strips,but has not yet introduced price restrictions for blood glucose meters and test strips;At the supply chain level,data shows that the price composition of blood glucose meters and test strips in Hubei Province is mainly composed of manufacturer prices and retail markups,followed by supply chain taxes and wholesale markups.It can be seen from this that China has established a comprehensive medical device registration,sales,quality control and management standard system through a series of policies.At present,China has not issued price policies for blood glucose meters and blood glucose test papers.Therefore,we can reduce product prices by including medical insurance,government subsidies,competitive bidding,and reducing supply chain taxes,thus improving the affordability of blood glucose monitoring for diabetes patients.展开更多
Objective:To explore the accuracy and stability of the results of peripheral blood routine tests at different time points after anticoagulation and standing,providing a scientific basis for actual clinical work.Method...Objective:To explore the accuracy and stability of the results of peripheral blood routine tests at different time points after anticoagulation and standing,providing a scientific basis for actual clinical work.Methods:In this study,30 patients who visited the hospital in October 2023 were randomly selected and divided into two groups(15 cases in each group).The same collection method was used for routine blood tests.The tests were performed after anticoagulation and standing for 5 minutes,1 hour,and 5 minutes,2 hours respectively,and the routine blood test indicators at different time points were compared.Results:After comparison,there were no significant differences in the results of routine blood tests at 5 minutes after mixing,anticoagulating,and standing peripheral blood and those at 1 hour and 2 hours(P>0.05).Conclusion:The results of peripheral blood after mixing,anticoagulating,and standing for 5 minutes are stable compared with those after standing for 1 hour and 2 hours.In actual work,the pre-test turnaround time can be appropriately extended.展开更多
Objective:To analyze the distribution and blood type characteristics of unpaid blood donors in Linxia area from 2012 to 2021,provide the basis for the strategy of recruiting safe blood sources in the future,ensure suf...Objective:To analyze the distribution and blood type characteristics of unpaid blood donors in Linxia area from 2012 to 2021,provide the basis for the strategy of recruiting safe blood sources in the future,ensure sufficient and safe blood supply,and promote the sustainable development of unpaid blood donation in this area.Methods:Collect the data of unpaid blood donors in Linxia area,and make statistics,comparison and analysis based on the query information of the fourth generation safe blood transfusion standardization system and the free blood donation registration form.Results:The total number of blood donors was 151131 and the ratio of male to female blood donors was 2.61:1.People aged 18-45 were the main blood donors,accounting for 80.78%of all unpaid blood donors.37.19%of people with junior high school education or below;Farmers,other professionals and civil servants were the main subjects of blood donation,accounting for 15.74%,14.98%and 12.12%,respectively.The blood group distribution was O>B>A>AB,and the negative rate was 8.2%.Blood type O was the most common in Hezheng County(34.08%).The distribution of blood type B in Kangle County(31.99%),blood typeAin Yongjing County(29.58%),blood typeAB in Dongxiang County(10.18%).Conclusion:The unpaid blood donors in Linxia area have significant characteristics in terms of gender,age,occupation,education level,etc.to master the distribution characteristics of the unpaid blood donors and blood types in Linxia area is helpful to carry out targeted publicity and recruitment of unpaid blood donation and blood collection,and is of great significance to continuously strengthen the contingent of unpaid blood donors and fully guarantee the clinical blood demand under the new situation.展开更多
The blood–brain barrier constitutes a dynamic and interactive boundary separating the central nervous system and the peripheral circulation.It tightly modulates the ion transport and nutrient influx,while restricting...The blood–brain barrier constitutes a dynamic and interactive boundary separating the central nervous system and the peripheral circulation.It tightly modulates the ion transport and nutrient influx,while restricting the entry of harmful factors,and selectively limiting the migration of immune cells,thereby maintaining brain homeostasis.Despite the well-established association between blood–brain barrier disruption and most neurodegenerative/neuroinflammatory diseases,much remains unknown about the factors influencing its physiology and the mechanisms underlying its breakdown.Moreover,the role of blood–brain barrier breakdown in the translational failure underlying therapies for brain disorders is just starting to be understood.This review aims to revisit this concept of“blood–brain barrier breakdown,”delving into the most controversial aspects,prevalent challenges,and knowledge gaps concerning the lack of blood–brain barrier integrity.By moving beyond the oversimplistic dichotomy of an“open”/“bad”or a“closed”/“good”barrier,our objective is to provide a more comprehensive insight into blood–brain barrier dynamics,to identify novel targets and/or therapeutic approaches aimed at mitigating blood–brain barrier dysfunction.Furthermore,in this review,we advocate for considering the diverse time-and location-dependent alterations in the blood–brain barrier,which go beyond tight-junction disruption or brain endothelial cell breakdown,illustrated through the dynamics of ischemic stroke as a case study.Through this exploration,we seek to underscore the complexity of blood–brain barrier dysfunction and its implications for the pathogenesis and therapy of brain diseases.展开更多
Amyotrophic lateral sclerosis is a devastating neurodegenerative disease for which the current treatment approaches remain severely limited.The principal pathological alterations of the disease include the selective d...Amyotrophic lateral sclerosis is a devastating neurodegenerative disease for which the current treatment approaches remain severely limited.The principal pathological alterations of the disease include the selective degeneration of motor neurons in the brain,brainstem,and spinal cord,as well as abnormal protein deposition in the cytoplasm of neurons and glial cells.The biological markers under extensive scrutiny are predominantly located in the cerebrospinal fluid,blood,and even urine.Among these biomarke rs,neurofilament proteins and glial fibrillary acidic protein most accurately reflect the pathologic changes in the central nervous system,while creatinine and creatine kinase mainly indicate pathological alterations in the peripheral nerves and muscles.Neurofilament light chain levels serve as an indicator of neuronal axonal injury that remain stable throughout disease progression and are a promising diagnostic and prognostic biomarker with high specificity and sensitivity.However,there are challenges in using neurofilament light chain to diffe rentiate amyotrophic lateral sclerosis from other central nervous system diseases with axonal injury.Glial fibrillary acidic protein predominantly reflects the degree of neuronal demyelination and is linked to non-motor symptoms of amyotrophic lateral sclerosis such as cognitive impairment,oxygen saturation,and the glomerular filtration rate.TAR DNA-binding protein 43,a pathological protein associated with amyotrophic lateral sclerosis,is emerging as a promising biomarker,particularly with advancements in exosome-related research.Evidence is currently lacking for the value of creatinine and creatine kinase as diagnostic markers;however,they show potential in predicting disease prognosis.Despite the vigorous progress made in the identification of amyotrophic lateral sclerosis biomarkers in recent years,the quest for definitive diagnostic and prognostic biomarke rs remains a formidable challenge.This review summarizes the latest research achievements concerning blood biomarkers in amyotrophic lateral sclerosis that can provide a more direct basis for the differential diagnosis and prognostic assessment of the disease beyond a reliance on clinical manifestations and electromyography findings.展开更多
Allogeneic blood transfusion during liver resection for malignancies has been associated with an increased incidence of different types of complications: infectious complications, tumor recurrence, decreased survival....Allogeneic blood transfusion during liver resection for malignancies has been associated with an increased incidence of different types of complications: infectious complications, tumor recurrence, decreased survival. Even if there is clear evidence of transfusion-induced immunosuppression, it is difficult to demonstrate that transfusion is the only determinant factor that decisively affects the outcome. In any case there are several motivations to reduce the practice of blood transfusion. The advantages and drawbacks of different transfusion alternatives are reviewed here, emphasizing that surgeons and anesthetists who practice in centers with a high volume of liver resections, should be familiar with all the possible alternatives.展开更多
基金supported by grants from the National Natural Science Foundation of China(Grant Nos.82192900,82192901,82192904,81390540,and 91846303 to L.L.)the National Key Research and Development Program of China(Grant No.2016YFC0900500 to Y.G.)the Kadoorie Charitable Foundation in Hong Kong,and the Wellcome Trust in the UK(Grant/Award Nos.088158/Z/09/Z,104085/Z/14/Z,and 202922/Z/16/Z to Z.C.).
文摘While a healthy lifestyle is known to reduce the risk of stroke,the extent to which blood pressure(BP)mediates this association remains unclear.The present study aimed to quantify the mediating role of BP in the association between combined lifestyle factors and stroke incidence.Using data from 51929 participants free of major cardiovascular diseases or cancer at baseline,we employed structural equation modeling to assess the mediating effects of systolic(SBP)and diastolic(DBP)blood pressure.During the follow-up,2811 incident stroke cases were identified.A healthy lifestyle was significantly associated with a reduced risk of stroke,with SBP mediating 44.70%(β=-0.0014,95%confidence interval[CI]:-0.0016 to-0.0012)and DBP mediating 37.81%(β=-0.0012,95%CI:-0.0015 to-0.0009)of this association.The mediating effects were attenuated but remained significant for ischemic stroke(SBP:33.21%;DBP:27.24%).In conclusion,approximately two-fifths of the protective association between a healthy lifestyle and stroke may be mediated by BP.These findings suggest that BP control may serve as an important early indicator for evaluating the effectiveness of lifestyle interventions in reducing stroke risk.
基金supported by the National Science and Technology Major Program for Noncommunicable Chronic Diseases(2023ZD0503500)the National Natural Science Foundation of China(82030102,12126602,91857118)+1 种基金the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(2021-I2M-1-010,2019-I2M-2-003)the National High Level Hospital Clinical Research Funding(2022-GSP-GG-1,2022-GSP-GG-2)。
文摘Objective Evidence suggests that depleted gut microbialα-diversity is associated with hypertension;however,whether metabolic markers affect this relationship remains unknown.We aimed to determine the potential metabolites mediating the associations ofα-diversity with blood pressure(BP)and BP variability(BPV).Methods Metagenomics and plasma targeted metabolomics were conducted on 523 Chinese participants from the MetaSalt study.The 24-hour,daytime,and nighttime BP and BPV were calculated based on ambulatory BP measurements.Linear mixed models were used to characterize the relationships betweenα-diversity(Shannon and Chao1 index)and BP indices.Mediation analyses were performed to assess the contribution of metabolites to the observed associations.The influence of key metabolites on hypertension was further evaluated in a prospective cohort of 2,169 participants.Results Gut microbial richness(Chao1)was negatively associated with 24-hour systolic BP,daytime systolic BP,daytime diastolic BP,24-hour systolic BPV,and nighttime systolic BPV(P<0.05).Moreover,26 metabolites were strongly associated with richness(Bonferroni P<0.05).Among them,four key metabolites(imidazole propionate,2-hydroxy-3-methylbutyric acid,homovanillic acid,and hydrocinnamic acid)mediated the associations between richness and BP indices(proportions of mediating effects:14.1%–67.4%).These key metabolites were also associated with hypertension in the prospective cohort.For example,each 1-standard deviation unit increase in hydrocinnamic acid significantly reduced the risk of prevalent(OR[95%CI]=0.90[0.82,0.99];P=0.03)and incident hypertension(HR[95%CI]=0.83[0.71,0.96];P=0.01).Conclusion Our results suggest that gut microbial richness correlates with lower BP and BPV,and that certain metabolites mediate these associations.These findings provide novel insights into the pathogenesis and prevention of hypertension.
基金supported by the National Natural Science Foundation of China,No.U21A20400(to QW)the National Natural Science Foundation of China,No.82104560(to CL)+1 种基金the Natural Science Foundation of Beijing,No.7232279(to XW)the Project of Beijing University of Chinese Medicine,Nos.2024-JYB-JBZD-043(to CL),2022-JYB-JBZR-004(to XW)。
文摘Ischemic stroke,a frequently occurring form of stroke,is caused by obstruction of cerebral blood flow,which leads to ischemia,hypoxia,and necrosis of local brain tissue.After ischemic stroke,both astrocytes and the blood–brain barrier undergo morphological and functional transformations.However,the interplay between astrocytes and the blood–brain barrier has received less attention.This comprehensive review explores the physiological and pathological morphological and functional changes in astrocytes and the blood–brain barrier in ischemic stroke.Post-stroke,the structure of endothelial cells and peripheral cells undergoes alterations,causing disruption of the blood–brain barrier.This disruption allows various pro-inflammatory factors and chemokines to cross the blood–brain barrier.Simultaneously,astrocytes swell and primarily adopt two phenotypic states:A1 and A2,which exhibit different roles at different stages of ischemic stroke.During the acute phase,A1 reactive astrocytes secrete vascular endothelial growth factor,matrix metalloproteinases,lipid carrier protein-2,and other cytokines,exacerbating damage to endothelial cells and tight junctions.Conversely,A2 reactive astrocytes produce pentraxin 3,Sonic hedgehog,angiopoietin-1,and other protective factors for endothelial cells.Furthermore,astrocytes indirectly influence blood–brain barrier permeability through ferroptosis and exosomes.In the middle and late(recovery)stages of ischemic stroke,A1 and A2 astrocytes show different effects on glial scar formation.A1 astrocytes promote glial scar formation and inhibit axon growth via glial fibrillary acidic protein,chondroitin sulfate proteoglycans,and transforming growth factor-β.In contrast,A2 astrocytes facilitate axon growth through platelet-derived growth factor,playing a crucial role in vascular remodeling.Therefore,enhancing our understanding of the pathological changes and interactions between astrocytes and the blood–brain barrier is a vital therapeutic target for preventing further brain damage in acute stroke.These insights may pave the way for innovative therapeutic strategies for ischemic stroke.
基金funded by the Entrusted service project of Shaanxi Administration of Traditional Chinese Medicine(ZYJXG-L23001)2023 Sanqin Talent Special Support Program Innovation and Entrepreneurship Team Project,and Sci-Tech Innovation Talent System Construction Program of Shaanxi University of Chinese Medicine(2023).
文摘Background:Panacis Quinquefolii Radix(PQR)is known for its ability to nourish“Qi”(it serves as the driving force for the functional activities of the body’s organs and meridians,promoting and regulating various physiological functions)and“Yin”(it represents the material foundation of the human body.It plays a role in nourishing,moistening,and cooling the body).Notoginseng Radix et Rhizoma(NRR)is recognized for its properties of resolving blood stasis(it refers to a pathological condition characterized by impaired or stagnant blood circulation within the body).Changes in the compatibility ratio of these herbs often lead to variations in their chemical composition and efficacy.However,the specific alterations in chemical composition and efficacy resulting from compatibility adjustments remain unclear.We aimed to compare the material basis and their effects of different compatibility ratios of PQR and NRR on“Qi”deficiency and blood stasis syndrome(QBS).Methods:This study employed UPLC-Q/TOF-MS to identify effective compounds in the compatibility of PQR and NRR and utilized UPLC-TQ-MS/MS to analyze the dissolution of 16 saponins in PQR and NRR at 9 different ratios.A rat model of QBS was established,and the efficacy of PQR and NRR in treating this syndrome was assessed using hemorheology and coagulation analyses.Results:The study results show that PQR and NRR exhibit significant efficacy,effectively reducing blood viscosity induced by platelet aggregation and lowering inflammatory markers such as IL-6,IL-10,TXB2 and ET associated with vascular injury.Moreover,this combination regulates ATP and ADP levels,enhances energy metabolism,and promotes overall health.A total of 104 compounds in the compatibility of PQR and NRR were identified.The ratios of 1:2 and 1:3 showed the highest total saponin content,but the ratio of 1:1 demonstrated a superior pharmacological effect for the treatment of QBS.Conclusion:In summary,the compatibility of PQR and NRR not only shows the complex interactions between traditional Chinese medicinal materials,but also provides a new idea and method for the treatment of QBS.
基金supported by the National Natural Science Foundation of China,Nos. 32260196 (to JY), 81860646 (to ZY) and 31860274 (to JY)a grant from Yunnan Department of Science and Technology,Nos. 202101AT070251 (to JY), 202201AS070084 (to ZY), 202301AY070001-239 (to JY), 202101AZ070001-012, and 2019FI016 (to ZY)。
文摘Studies have shown that chitosan protects against neurodegenerative diseases. However, the precise mechanism remains poorly understood. In this study, we administered chitosan intragastrically to an MPTP-induced mouse model of Parkinson's disease and found that it effectively reduced dopamine neuron injury, neurotransmitter dopamine release, and motor symptoms. These neuroprotective effects of chitosan were related to bacterial metabolites, specifically shortchain fatty acids, and chitosan administration altered intestinal microbial diversity and decreased short-chain fatty acid production in the gut. Furthermore, chitosan effectively reduced damage to the intestinal barrier and the blood–brain barrier. Finally, we demonstrated that chitosan improved intestinal barrier function and alleviated inflammation in both the peripheral nervous system and the central nervous system by reducing acetate levels. Based on these findings, we suggest a molecular mechanism by which chitosan decreases inflammation through reducing acetate levels and repairing the intestinal and blood–brain barriers, thereby alleviating symptoms of Parkinson's disease.
文摘Blood cell disorders are among the leading causes of serious diseases such as leukemia,anemia,blood clotting disorders,and immune-related conditions.The global incidence of hematological diseases is increasing,affecting both children and adults.In clinical practice,blood smear analysis is still largely performed manually,relying heavily on the experience and expertise of laboratory technicians or hematologists.This manual process introduces risks of diagnostic errors,especially in cases with rare or morphologically ambiguous cells.The situation is more critical in developing countries,where there is a shortage of specialized medical personnel and limited access to modern diagnostic tools.High testing costs and delays in diagnosis hinder access to quality healthcare services.In this context,the integration of Artificial Intelligence(AI),particularly Explainable AI(XAI)based on deep learning,offers a promising solution for improving the accuracy,efficiency,and transparency of hematological diagnostics.In this study,we propose a Ghost Residual Network(GRsNet)integrated with XAI techniques such as Gradient-weighted Class Activation Mapping(Grad-CAM),Local Interpretable Model-Agnostic Explanations(LIME),and SHapley Additive exPlanations(SHAP)for automatic blood cell classification.These techniques provide visual explanations by highlighting important regions in the input images,thereby supporting clinical decision-making.The proposed model is evaluated on two public datasets:Naturalize 2K-PBC and Microscopic Blood Cell,achieving a classification accuracy of up to 95%.The results demonstrate the model’s strong potential for automated hematological diagnosis,particularly in resource-constrained settings.It not only enhances diagnostic reliability but also contributes to advancing digital transformation and equitable access to AI-driven healthcare in developing regions.
基金supported by the National Key Research and Development Plan of China (2023YFA1802000)the National Natural Science Foundation of China for Distinguished Young Scholars (31925014),the National Natural Science Foundation of China Key Program (32130033),the National Natural Science Foundation of Original Exploratory Program (32350006)+5 种基金the Key Research Program of Frontier Sciences,Chinese Academy of Sciences (ZDBS-LY-SM010)Shanghai Pilot Program for Basic Research-Chinese Academy of Sciences,Shanghai Branch (JCYJ-SHFY-2022-006)Shanghai Science Technology Innovation Action Plan for Basic Research Program (21JC1406300)Haihe laboratory of Cell Ecosystem Innovation Fund (24HHXBSS00011)CAS project for Young Scientists in Basic Research (YSBR-077)supported by Science and Technology Commission of Shanghai Municipality (Shanghai Rising-Star Program,23QA1411300)
文摘Erythroid cells, the predominant circulating blood cells, are essential for oxygen and carbon dioxide transport (Obeagu, 2024).Their production, erythropoiesis, involves the coordinated synthesis of globin chains and heme molecules to assemble hemoglobin(Zhang et al., 2021). The erythroid-specific enzyme δ-aminolevulinate synthase 2 (ALAS2) is a key rate-limiting factor in heme biosynthesis,with its expression increasing in late-stage erythropoiesis to meet heme demands (Sadlon et al., 1999). Zebrafish (Danio rerio) is a well-established model for studying erythropoiesis due to its genetic tractability and optical transparency (Zhang and Hamza, 2019;Zhang et al., 2021). The Tol2-mediated Gal4-UAS system has been widely applied for gene and enhancer trapping in zebrafish (Asakawa and Kawakami, 2009). However, reliable Gal4 enhancer-trap lines for erythropoiesis remain limited. Here, we report a transgenic zebrafish line with erythroid-specific Gal4FF expression under the control of the endogenous alas2 promoter, offering a more precise erythroblast labeling than the gata1a reporter line. This model provides a valuable tool for erythroid-specific investigations of blood flow dynamics and gene function.
文摘BACKGROUND The reference ranges for biochemical parameters can fluctuate due to factors like altitude,age,gender,and socioeconomic conditions.These values are crucial for interpreting laboratory data and guide clinical treatment decisions.Currently,there is no established set of reference intervals for cord blood biochemical parameters of newborns in India,particularly in Mumbai.AIM To create cord blood biochemical parameters reference intervals specifically for Mumbai,India.METHODS A cross-sectional study was conducted in an Indian tertiary care hospital.This study focused on healthy newborns with normal birth weight,born to pregnant mothers without health issues.Cord blood samples,approximately 2-3 mL in volume,were collected from 210 term neonates.These samples were divided into fluoride(glucose)and clot activator(serum)tubes and were subsequently analyzed in the institute's biochemical laboratory.The data obtained from the analysis was then subjected to statistical analysis.The result of the Shapiro-Wilk test suggested non-normality in the data distribution.Consequently,nonparametric statistics were utilized for analysis.The Mann-Whitney U test was utilized to compare parameter distributions among different factors,including the infant’s sex,delivery method,maternal age,and obstetric history.A significance level of P<0.05 was considered to indicate statistical significance.RESULTS The following represent the median figures and central 95 percentile reference intervals for biochemical parameters in umbilical cord blood of newborns:Serum direct bilirubin=(0.1-0.55)mg/dL,indirect bilirubin=(0.64-2.26)mg/dL,total bilirubin=(0.62-3.14)mg/dL,creatinine=(0.27-0.76)mg/dL,sodium=(128.19-143.26)mmol/L,chloride=(100.19-111.68)mmol/L,potassium=(1.62-9.98)mmol/L and plasma glucose=(24.75-94.23)mg/dL.Statistically significant differences were observed in serum sodium,potassium,and plasma glucose levels when comparing delivery modes.CONCLUSION This is the pioneering study in which first time,the biochemical reference intervals in cord blood for newborns are established in western India.The values are applicable for newborns from this area.Larger study throughout the country is required.
基金The University Key Research Projects of Henan Province(Grant No.25B360004)the Backbone Teachers Program of North Henan Medical University(Sanquan College of Xinxiang Medical University)(Grant No.SQ2025GGJS08).
文摘Diabetes remains one of the most pressing global metabolic disorders,necessitating regular and precise monitoring of blood glucose levels for effective disease management.In this study,we developed a rapid and reliable method for quantifying glucose in whole blood using near-infrared(NIR)spectroscopy.A diabetic rat model was established through a high-fat,high-sugar diet followed by administration of streptozotocin(STZ)over a period of 4 weeks.To construct the NIR calibration model,partial least-squares(PLS)regression was employed,with optimization tailored to spectral range,preprocessing techniques,and the number of latent variables.The optimal model was achieved within the spectral window of 7502.0-5446.2 cm^(-1),using Constant Offset Elimination for spectral pretreatment and a factor number of 10.This optimized model yielded a strong correlation coefficient(R)of 0.9621,with a root mean square error of cross-validation(RMSECV)of 0.612,a residual predictive deviation(RPD)of 3.48,and a root mean square error of prediction(RMSEP)of 0.420.Additionally,biochemical indices were evaluated across all experimental groups to validate the model’s performance.Overall,the proposed NIR-based analytical strategy demonstrated high accuracy,robustness,and reproducibility,offering a promising tool for rapid glucose assessment in whole blood.
基金supported by the National Nature Science Foundation of China(No.82370336&No.82330014)the Key Research and Development Plan of Heilongjiang Province(2022ZX06C23&JD2023SJ44)the Research Project of the First Affiliated Hospital of Harbin Medical University(No.2021M19).
文摘BACKGROUND Blood glucose and serum albumin have been associated with cardiovascular disease prognosis,but the impact of admission-blood-glucose-to-albumin ratio(AAR)on adverse outcomes in critical ill coronary artery disease(CAD)patients was not investigated.METHODS Patients diagnosed with CAD were non-consecutively selected from the MIMIC-IV database and categorized into quartiles based on their AAR.The primary outcome was 1-year mortality,and secondary endpoints were in-hospital mortality,acute kidney injury(AKI),and renal replacement therapy(RRT).A restricted cubic splines model and Cox proportional hazard models assessed the association between AAR and adverse outcomes in CAD patients.Kaplan-Meier survival analysis determined differences in endpoints across subgroups.RESULTS A total of 8360 patients were included.There were 726 patients(8.7%)died in the hospital and 1944 patients(23%)died at 1 year.The incidence of AKI and RRT was 63%and 4.3%,respectively.High AAR was markedly associated with in-hospital mortality(HR=1.587,P=0.003),1-year mortality(HR=1.502,P<0.001),AKI incidence(HR=1.579,P<0.001),and RRT(HR=1.640,P<0.016)in CAD patients in the completely adjusted Cox proportional hazard model.Kaplan-Meier survival analysis noted substantial differences in all endpoints based on AAR quartiles.Stratified analysis and interaction test demonstrated stable correlations between AAR and outcomes.CONCLUSIONS The results highlight that AAR may be a potential indicator for assessing in-hospital mortality,1-year mortality,and adverse renal prognosis in critical CAD patients.
文摘Objective:To study the clinical value of combined detection of blood lipids,blood glucose,and liver function in non-alcoholic fatty liver disease.Methods:105 patients with non-alcoholic fatty liver disease treated in our hospital from May 2022 to July 2024 were selected as the research subjects.All patients underwent a B-ultrasound examination.According to the severity of the disease,they were divided into group A(mild,n=35),group B(moderate,n=44),and group C(severe,n=26).Another 30 healthy residents who came to the hospital for physical examination during the same period were selected as group D.The differences in blood lipids,blood glucose,and liver function indicators between groups were compared.Results:The triglyceride(TG),total cholesterol(TC),and low-density lipoprotein cholesterol(LDL)levels in groups A,B,and C were higher than those in group D,while the high-density lipoprotein cholesterol(HDL)level was lower(P<0.05).The fasting plasma glucose(FPG)levels in groups B and C were higher than those in group D(P<0.05).The TG,LDL,and FPG levels in groups B and C were higher than those in group A(P<0.05).The TC level in group C was higher than that in group A,while the HDL level was lower(P<0.05).The TC and FPG levels in group C were higher than those in group B(P<0.05).The total bilirubin(TBil),aspartate aminotransferase(AST),and alanine aminotransferase(ALT)levels in groups A,B,and C were higher than those in group D(P<0.05).The TBil and ALT levels in groups B and C were higher than those in group A(P<0.05).The AST level in group C was higher than that in group A(P<0.05).The AST and ALT levels in group C were higher than those in group B(P<0.05).Conclusion:Patients with non-alcoholic fatty liver disease have disordered glucose and lipid metabolism.Blood lipids,blood glucose,and liver function are closely related to the severity of the disease.Strengthening exercise and dietary intervention early on can help control the progression of simple fatty liver disease and reduce the risk of severe liver diseases such as steatohepatitis and cirrhosis.
基金supported by the National Natural Science Foundation of China(82170375,U23A20395)1.3.5 project for disciplines of excellence from West China Hospital of Sichuan University(ZYGD23021,23HXF-H009)Sichuan Science and Technology Program 2023NSFSC1645。
文摘Background Hypertension is associated with an increased risk of calcific aortic valve stenosis(CAVS).However,the directionality of causation between blood pressure traits and aortic stenosis is unclear,as is the benefit of antihypertensive drugs for CAVS.Methods Using genome-wide association studies(GWAS)summary statistics,we performed bidirectional two-sample univariable mendelian randomization(UVMR)to assess the causal associations of systolic blood pressure(SBP),diastolic blood pressure(DBP),and pulse pressure(PP)with CAVS.Multivariable mendelian randomization(MVMR)was conducted to evaluate the direct effect of hypertension on CAVS,adjusting for confounders.Drug target mendelian randomization(MR)and summary-level MR(SMR)were used to estimate the effects of 12 classes of antihypertensive drugs and their target genes on CAVS risk.Inverse variance weighting was the primary MR method,with sensitivity analyses to validate results.Results UVMR showed SBP,DBP,and PP have causal effects on CAVS,with no significant reverse causality.MVMR confirmed the causality between hypertension and CAVS after adjusting for confounders.Drug-target MR analyses indicated that calcium channel blockers(CCBs),loop diuretics,and thiazide diuretics via SBP lowering exerted protective effects on CAVS risk.SMR analysis showed that the CCBs target gene CACNA2D2 and ARBs target gene AGTR1 were positively associated with CAVS risk,while diuretics target genes SLC12A5 and SLC12A1 were negatively associated with aortic stenosis risk.Conclusions Hypertension has a causal relationship with CAVS.Managing SBP in hypertensive patients with CCBs may prevent CAVS.ARBs might exert protective effects on CAVS independent of blood pressure reduction.The relationship between diuretics and CAVS is complex,with opposite effects through different mechanisms.
基金supported by the National Natural Science Foundation of China(grant nos.82025030,82222063,and 82388102)the National Key Research and Development Program of China(grant no.2023YFC3603400)。
文摘Objective This study aimed to evaluate the relationships of white blood cell(WBC)count,platelet(PLT)count,and PLT-to-WBC ratio(PWR)with muscle mass in Chinese older adults.Methods This cross-sectional analysis involved 4,033 Chinese older adults aged≥65 years from the Healthy Ageing and Biomarkers Cohort Study.Muscle mass and total skeletal muscle mass index(TSMI)were measured by bioelectric impedance analysis.WBC,PLT,and PWR were measured using standard methods.Multivariate linear regression was used to examine the associations of WBC count,PLT count,and PWR with TSMI.Results High WBC count,PLT count,and PWR were associated with low TSMI,with coefficients of-0.0091(95%confidence interval[CI]:-0.0142 to-0.0041),-0.0119(95%CI:-0.0170 to-0.0068),and-0.0051(95%CI:-0.0102 to-0.0001).The associations between the three inflammatory indices and TSMI were linear.Stratified analyses indicated that the relationship between inflammatory markers and TSMI was more evident in male participants and in individuals aged<80 years than in their counterparts.Conclusion Elevated WBC count,PLT count,and PWR correlated with muscle mass loss.This study highlights the importance of regular monitoring of inflammatory markers as a potential strategy for the screening and management of sarcopenia in older adults.
基金supported by grant 2011BAI11B01 from the Projects in the Chinese National Science and Technology Pillar Program during the 12th Five-year Plan Periodby grant 2017-I2M-1-004 from the Chinese Academy of Medical Science Innovation Fund for Medical Sciencesby the Major science and technology special plan project of Yunnan Province (202302AA310045)。
文摘Background Both medication and non-medication therapies are effective approaches to control blood pressure (BP) in hypertension patients.However,the association of joint changes in antihypertensive medication use and healthy lifestyle index (HLI)with BP control among hypertension patients is seldom reported,which needs to provide more evidence by prospective intervention studies.We examined the association of antihypertensive medication use and HLI with BP control among employees with hypertension in China based on a workplace-based multicomponent intervention program.Methods Between January 2013 and December 2014,a cluster randomized clinical trial of a workplace-based multicomponent intervention program was conducted in 60 workplaces across 20 urban areas in China.Workplaces were randomly divided into intervention (n=40) and control (n=20) groups.Basic information on employees at each workplace was collected by trained professionals,including sociodemographic characteristics,medical history,family history,lifestyle behaviors,medication status and physical measurements.After baseline,the intervention group received a 2-year intervention to achieve BP control,which included:(1) a workplace wellness program for all employees;(2) a guidelines-oriented hypertension management protocol.HLI including nonsmoking,nondrinking,adequate physical activity,weight within reference range and balanced diet,were coded on a 5-point scale (range:0-5,with higher score indicating a healthier lifestyle).Antihypertensive medication use was defined as taking drug within the last 2 weeks.Changes in HLI,antihypertensive medication use and BP control from baseline to 24 months were measured after the intervention.Results Overall,4655 employees were included (age:46.3±7.6 years,men:3547 (82.3%)).After 24 months of the intervention,there was a significant improvement in lifestyle[smoking (OR=0.65,95%CI:0.43-0.99;P=0.045),drinking (OR=0.52,95%CI:0.40-0.68;P<0.001),regular exercise (OR=3.10,95%CI:2.53-3.78;P<0.001),excessive intake of fatty food (OR=0.17,95%CI:0.06-0.52;P=0.002),restrictive use of salt (OR=0.26,95%CI:0.12-0.56;P=0.001)].Compare to employees with a deteriorating lifestyle after the intervention,those with an improved lifestyle had a higher BP control.In the intervention group,compared with employees not using antihypertensive medication,those who consistent used (OR=2.34;95%CI:1.16-4.72;P=0.017) or changed from not using to using antihypertensive medication (OR=2.24;95%CI:1.08-4.62;P=0.030) had higher BP control.Compared with those having lower HLI,participants with a same (OR=1.38;95%CI:0.99-1.93;P=0.056) or high (OR=1.79;95%CI:1.27~2.53;P<0.001) HLI had higher BP control.Those who used antihypertensive medication and had a high HLI had the highest BP control (OR=1.88;95%CI:1.32-2.67,P<0.001).Subgroup analysis also showed the consistent effect as the above.Conclusion These findings suggest that adherence to antihypertensive medication treatment and healthy lifestyle were associated with a significant improvement in BP control among employees with hypertension.
基金Hubei Provincial Medical Institutions at all levels of basic drugs and drug bridging support policy projectsResearch on the Integrated Development of Disease Prevention and Control and Medical Services in the XPCC under the Background of Healthy China (Grant No. BTJKJ2024003)。
文摘The purpose of this study is to evaluate the price and composition of blood glucose meters and blood glucose test papers in Hubei Province,so as to improve the affordability of blood glucose monitoring for diabetes patients.Using the standard survey method jointly developed by the World Health Organization(WHO)and Health Action International(HAI)for drug price composition analysis,central level data was collected through literature review,policy review,and interviews with key informants.Field research was conducted in Wuhan and Yichang to trace price data at various levels of the supply chain.At the central level,data shows that China has implemented multiple policies related to the management and pricing of blood glucose meters and test strips,but has not yet introduced price restrictions for blood glucose meters and test strips;At the supply chain level,data shows that the price composition of blood glucose meters and test strips in Hubei Province is mainly composed of manufacturer prices and retail markups,followed by supply chain taxes and wholesale markups.It can be seen from this that China has established a comprehensive medical device registration,sales,quality control and management standard system through a series of policies.At present,China has not issued price policies for blood glucose meters and blood glucose test papers.Therefore,we can reduce product prices by including medical insurance,government subsidies,competitive bidding,and reducing supply chain taxes,thus improving the affordability of blood glucose monitoring for diabetes patients.
基金Project of Guangdong Provincial Medical Science and Technology Research Fund(A2022011)Major Science and Technology Project of Shenzhen Nanshan District Health System(NSZD2023067)Sub-project of Education(Health)Science and Technology Project of Nanshan District Technology Research and Development and Creative Design Project in Shenzhen(NS2022002)。
文摘Objective:To explore the accuracy and stability of the results of peripheral blood routine tests at different time points after anticoagulation and standing,providing a scientific basis for actual clinical work.Methods:In this study,30 patients who visited the hospital in October 2023 were randomly selected and divided into two groups(15 cases in each group).The same collection method was used for routine blood tests.The tests were performed after anticoagulation and standing for 5 minutes,1 hour,and 5 minutes,2 hours respectively,and the routine blood test indicators at different time points were compared.Results:After comparison,there were no significant differences in the results of routine blood tests at 5 minutes after mixing,anticoagulating,and standing peripheral blood and those at 1 hour and 2 hours(P>0.05).Conclusion:The results of peripheral blood after mixing,anticoagulating,and standing for 5 minutes are stable compared with those after standing for 1 hour and 2 hours.In actual work,the pre-test turnaround time can be appropriately extended.
文摘Objective:To analyze the distribution and blood type characteristics of unpaid blood donors in Linxia area from 2012 to 2021,provide the basis for the strategy of recruiting safe blood sources in the future,ensure sufficient and safe blood supply,and promote the sustainable development of unpaid blood donation in this area.Methods:Collect the data of unpaid blood donors in Linxia area,and make statistics,comparison and analysis based on the query information of the fourth generation safe blood transfusion standardization system and the free blood donation registration form.Results:The total number of blood donors was 151131 and the ratio of male to female blood donors was 2.61:1.People aged 18-45 were the main blood donors,accounting for 80.78%of all unpaid blood donors.37.19%of people with junior high school education or below;Farmers,other professionals and civil servants were the main subjects of blood donation,accounting for 15.74%,14.98%and 12.12%,respectively.The blood group distribution was O>B>A>AB,and the negative rate was 8.2%.Blood type O was the most common in Hezheng County(34.08%).The distribution of blood type B in Kangle County(31.99%),blood typeAin Yongjing County(29.58%),blood typeAB in Dongxiang County(10.18%).Conclusion:The unpaid blood donors in Linxia area have significant characteristics in terms of gender,age,occupation,education level,etc.to master the distribution characteristics of the unpaid blood donors and blood types in Linxia area is helpful to carry out targeted publicity and recruitment of unpaid blood donation and blood collection,and is of great significance to continuously strengthen the contingent of unpaid blood donors and fully guarantee the clinical blood demand under the new situation.
基金supported by the grants from the Spanish Ministry of Economy and Competitiveness(SAF2017-85602-R)the Spanish Ministry of Science and Innovation(PID2020-119638RB-I00 to EGR)FPU-program(FPU17/02616 to JCG)。
文摘The blood–brain barrier constitutes a dynamic and interactive boundary separating the central nervous system and the peripheral circulation.It tightly modulates the ion transport and nutrient influx,while restricting the entry of harmful factors,and selectively limiting the migration of immune cells,thereby maintaining brain homeostasis.Despite the well-established association between blood–brain barrier disruption and most neurodegenerative/neuroinflammatory diseases,much remains unknown about the factors influencing its physiology and the mechanisms underlying its breakdown.Moreover,the role of blood–brain barrier breakdown in the translational failure underlying therapies for brain disorders is just starting to be understood.This review aims to revisit this concept of“blood–brain barrier breakdown,”delving into the most controversial aspects,prevalent challenges,and knowledge gaps concerning the lack of blood–brain barrier integrity.By moving beyond the oversimplistic dichotomy of an“open”/“bad”or a“closed”/“good”barrier,our objective is to provide a more comprehensive insight into blood–brain barrier dynamics,to identify novel targets and/or therapeutic approaches aimed at mitigating blood–brain barrier dysfunction.Furthermore,in this review,we advocate for considering the diverse time-and location-dependent alterations in the blood–brain barrier,which go beyond tight-junction disruption or brain endothelial cell breakdown,illustrated through the dynamics of ischemic stroke as a case study.Through this exploration,we seek to underscore the complexity of blood–brain barrier dysfunction and its implications for the pathogenesis and therapy of brain diseases.
文摘Amyotrophic lateral sclerosis is a devastating neurodegenerative disease for which the current treatment approaches remain severely limited.The principal pathological alterations of the disease include the selective degeneration of motor neurons in the brain,brainstem,and spinal cord,as well as abnormal protein deposition in the cytoplasm of neurons and glial cells.The biological markers under extensive scrutiny are predominantly located in the cerebrospinal fluid,blood,and even urine.Among these biomarke rs,neurofilament proteins and glial fibrillary acidic protein most accurately reflect the pathologic changes in the central nervous system,while creatinine and creatine kinase mainly indicate pathological alterations in the peripheral nerves and muscles.Neurofilament light chain levels serve as an indicator of neuronal axonal injury that remain stable throughout disease progression and are a promising diagnostic and prognostic biomarker with high specificity and sensitivity.However,there are challenges in using neurofilament light chain to diffe rentiate amyotrophic lateral sclerosis from other central nervous system diseases with axonal injury.Glial fibrillary acidic protein predominantly reflects the degree of neuronal demyelination and is linked to non-motor symptoms of amyotrophic lateral sclerosis such as cognitive impairment,oxygen saturation,and the glomerular filtration rate.TAR DNA-binding protein 43,a pathological protein associated with amyotrophic lateral sclerosis,is emerging as a promising biomarker,particularly with advancements in exosome-related research.Evidence is currently lacking for the value of creatinine and creatine kinase as diagnostic markers;however,they show potential in predicting disease prognosis.Despite the vigorous progress made in the identification of amyotrophic lateral sclerosis biomarkers in recent years,the quest for definitive diagnostic and prognostic biomarke rs remains a formidable challenge.This review summarizes the latest research achievements concerning blood biomarkers in amyotrophic lateral sclerosis that can provide a more direct basis for the differential diagnosis and prognostic assessment of the disease beyond a reliance on clinical manifestations and electromyography findings.
文摘Allogeneic blood transfusion during liver resection for malignancies has been associated with an increased incidence of different types of complications: infectious complications, tumor recurrence, decreased survival. Even if there is clear evidence of transfusion-induced immunosuppression, it is difficult to demonstrate that transfusion is the only determinant factor that decisively affects the outcome. In any case there are several motivations to reduce the practice of blood transfusion. The advantages and drawbacks of different transfusion alternatives are reviewed here, emphasizing that surgeons and anesthetists who practice in centers with a high volume of liver resections, should be familiar with all the possible alternatives.
