中国慢性病前瞻性研究:10个项目地区成年人肺功能指标水平和气流受限现患率的差异分析

目的 描述中国慢性病前瞻性研究(CKB)10个地区人群肺功能指标水平和气流受限现患率的地区差异。方法 剔除基线调查时肺功能指标异常个体后,分析10个地区512 495名30～79岁调查对象肺功能指标水平(FEV₁和FVC)和气流受限(分别采用GOLD标准和LLN标准进行判断)现患率的地区差异。结果 10个地区男性的FEV₁(2.66 L)和FVC(3.16 L)均高于女性(1.99 L和2.35 L);河南和哈尔滨人群FEV₁和FVC高于其他地区。基于GOLD标准的气流受限现患率:男性(5.13%)高于女性(3.75%);农村人群高于城市(男性:6.32% vs. 3.47%;女性:4.26% vs. 2.97%);四川人群现患率最高(男性为13.34%,女性为10.70%),其次是苏州、河南和湖南。基于LLN标准的气流受限现患率(男性为6.93%,女性为6.29%)略高于GOLD标准,但地区差异近似。结论 CKB的10个地区人群无论在肺功能指标水平和气流受限现患率上均存在明显的地区差异。     

中国10个地区成年人食物摄入频率特征差异的分析

目的 描述中国慢性病前瞻性研究(CKB)项目10个地区人群食物摄入频率特征的地区差异。方法 CKB项目于2004－2008年在城市和农村各5个地区募集自愿参加的30～79岁常住居民进入队列并完成基线调查。本研究分析10个项目地区中512 891名30～79岁队列成员12组食物的摄入频率,描述各食物组摄入频率特征的地区差异。结果 南方城市(99.0%)和南方农村(99.9%)人群每天摄入的谷类食物以大米为主,北方农村(99.0%)和北方城市如青岛(88.4%)人群则以面食为主。河南人群每天摄入杂粮人群比例最高(98.8%)。甘肃人群每天摄入新鲜蔬菜比例最低(74.0%)。在南方城市人群每天摄入新鲜水果、腌制蔬菜、肉类及其制品比例高于农村地区,北方也存在相同现象。北方城市(37.1%)和农村(14.6%)人群每天摄入蛋类及其制品高于南方城市(6.5%)和农村(6.9%)。北方城市地区人群每天摄入豆制品、乳类及其制品比例最高,其中哈尔滨人群每天摄入豆制品比例最高(10.0%),青岛人群每天摄入乳类及其制品比例最高(34.3%)。结论 CKB项目研究人群谷类食物、蛋类及其制品、豆制品摄入频率存在南北差异,肉类及其制品、家禽及其制品、水产/海产品、新鲜水果、腌制蔬菜、乳类及其制品摄入频率存在城乡差异。     

The Associations of Month of Birth With Body Mass Index,Waist Circumference,and Leg Length: Findings From the China Kadoorie Biobank of 0.5 Million Adults

Background

Season of birth (SoB) has been linked with various health outcomes. This study aimed to examine the associations between month of birth (MoB) and adult measures of leg length (LL), body mass index (BMI), and waist circumference (WC).

Methods

We analysed survey data from 10 geographically diverse areas of China obtained through the China Kadoorie Biobank. Analysis included 487 529 adults with BMI ≥ 18.5 kg/m². A general linear model was used to examine the associations between MoB and adult measures of LL, BMI, and WC, adjusted for survey site, sex, age, education level, smoking habit, alcohol consumption, physical activity level, sedentary leisure time, height (only for WC and LL), and hip circumference (only for LL).

Results

MoB was independently associated with both BMI and WC. Birth months in which participants had higher measures of adiposity were March–July for BMI and March–June for WC. The peak differences were 0.14 kg/m² for BMI and 0.47 cm for WC. The association between MoB and LL depended on survey site. Participants who were born in February–August in four sites (Harbin, Henan, Gansu, and Hunan) had the shortest LL (all P < 0.01). The peak difference in mean LL was 0.21 cm. No statistically significant association between MoB and LL was noted in the other sites (Qingdao, Suzhou, Sichuan, Zhejiang, Liuzhou, and Haikou).

Conclusions

These findings suggest that MoB is associated with variations in adult adiposity measures and LL among Chinese adults. Low exposure to ultraviolet B radiation and subsequent reduced levels of vitamin D during the late second and early third trimesters may be involved in these phenomena.Key words: month of birth, BMI, waist circumference, leg length, vitamin D deficiency     

以数据挖掘为核心的医院数据管理平台建设初探

以建设基于精细化管理的医院决策支持系统为目的,利用数据仓库等信息化技术对各业务系统数据进行采集、清洗、整合,建立数据中心进行综合管理,保证数入一门、数出一门。有效消除信息孤岛、解决数据混乱状态、缓解信息化应用瓶颈。以数据挖掘为手段以病种为核心着重分析医疗核心指标及医保的总额预付管理两个主题,通过深入分析明确管理目标、缩小管理范畴、抓住主要矛盾,提高医院科学管理水平。     

眼科诊断用接触镜的消毒现状及消毒效果比较

目的：调查国内医院对眼科诊断用接触镜的消毒现状,评估其消毒效果。方法：采用方便抽样的方法对10所医院进行调查,发现氯霉素滴眼液冲洗、75%乙醇搽拭和0.05%的二氯异氰尿酸钠( NaDCC)浸泡是目前我国临床最常用的眼科诊断用接触镜消毒方法。将被金黄色葡萄球菌、表皮葡萄球菌或铜绿假单胞菌污染的眼科检查用接触镜,用上述三种消毒剂按照以下方式进行消毒：1)擦拭;2)浸泡消毒5min;3)浸泡消毒10min,n=9.然后镜面采样,对细菌群落培养并计数以评估细菌量,观察消毒效果。同时评估消毒后镜头的清晰度。结果：细菌负荷量为1×108/mL×50μL/镜头等于5×106/镜头。 NaDCC或乙醇消毒显著降低了细菌量;擦拭消毒时,75%的乙醇和NaDCC的消毒效果与氯霉素滴眼液比较差异显著(P≤0.01),但不能达到临床消毒要求,仍然存在交叉感染的风险。浸泡消毒效果与时间正相关,75%的乙醇和NaDCC浸泡10 min最有效,能完全达到临床消毒要求,氯霉素滴眼液浸泡10 min仍然不能达到临床要求。但乙醇会影响镜头的清晰度。结论：NaDCC浸泡消毒10 min 或更长时间是一种简单有效的眼科诊断用接触镜消毒方法。     

Major Dietary Patterns in Relation to General and Central Obesity among Chinese Adults

Limited evidence exists for the association between diet pattern and obesity phenotypes among Chinese adults. In the present study, we analyzed the cross-sectional data from 474,192 adults aged 30–79 years from the China Kadoorie Biobank baseline survey. Food consumption was collected by an interviewer-administered questionnaire. Three dietary patterns were extracted by factor analysis combined with cluster analysis. After being adjusted for potential confounders, individuals following a traditional southern dietary pattern had the lowest body mass index (BMI) and waist circumference (WC); the Western/new affluence dietary pattern had the highest BMI; and the traditional northern dietary pattern had the highest WC. Compared to the traditional southern dietary pattern in multivariable adjusted logistic models, individuals following a Western/new affluence dietary pattern had a significantly increased risk of general obesity (prevalence ratio (PR): 1.06, 95% confidence interval (CI): 1.03–1.08) and central obesity (PR: 1.07, 95% CI: 1.06–1.08). The corresponding risks for the traditional northern dietary pattern were 1.05 (1.02–1.09) and 1.17 (1.25–1.18), respectively. In addition, the associations were modified by lifestyle behaviors, and the combined effects with alcohol drinking, tobacco smoking, and physical activity were analyzed. Further prospective studies are needed to elucidate the diet-obesity relationships.     

Salidroside ameliorates insulin resistance through activation of a mitochondria-associated AMPK/PI3K/Akt/GSK3β pathway

Background and Purpose

Recent reports have suggested that salidroside could protect cardiomyocytes from oxidative injury and stimulate glucose uptake in skeletal muscle cells by activating AMP-activated protein kinase (AMPK). The aim of this study was to evaluate the therapeutic effects of salidroside on diabetic mice and to explore the underlying mechanisms.

Experimental Approach

The therapeutic effects of salidroside on type 2 diabetes were investigated. Increasing doses of salidroside (25, 50 and 100 mg·kg⁻¹·day⁻¹) were administered p.o. to db/db mice for 8 weeks. Biochemical analysis and histopathological examinations were conducted to evaluate the therapeutic effects of salidroside. Primary cultured mouse hepatocytes were used to further explore the underlying mechanisms in vitro.

Key Results

Salidroside dramatically reduced blood glucose and serum insulin levels and alleviated insulin resistance. Hypolipidaemic effects and amelioration of liver steatosis were observed after salidroside administration. In vitro, salidroside dose-dependently induced an increase in the phosphorylations of AMPK and PI3K/Akt, as well as glycogen synthase kinase 3β (GSK3β) in hepatocytes. Furthermore, salidroside-stimulated AMPK activation was found to suppress the expression of PEPCK and glucose-6-phosphatase. Salidroside-induced AMPK activation also resulted in phosphorylation of acetyl CoA carboxylase, which can reduce lipid accumulation in peripheral tissues. In isolated mitochondria, salidroside inhibited respiratory chain complex I and disturbed oxidation/phosphorylation coupling and moderately depolarized the mitochondrial membrane potential, resulting in a transient increase in the AMP/ATP ratio.

Conclusions and Implications

Salidroside exerts an antidiabetic effect by improving the cellular metabolic flux through the activation of a mitochondria-related AMPK/PI3K/Akt/GSK3β pathway     

Carnosic acid induces autophagic cell death through inhibition of the Akt/mTOR pathway in human hepatoma cells

The therapeutic goal of cancer treatment is now geared towards triggering tumour‐selective cell death with autophagic cell death being required for the chemotherapy of apoptosis‐resistant cancer. In this study, Carnosic acid (CA), a polyphenolic diterpene isolated from Rosemary (Rosemarinus officinalis), significantly induced autophagic cell death in HepG2 cells. Ca treatment caused the formation of autophagic vacuoles produced an increasing ratio of LC3‐II to LC3‐I in a time‐ and dose‐dependent manner but had no effect on the levels of autophagy‐related protein ATG6 and ATG13 expression. Autophagy inhibitors, 3‐methyladenine (3‐MA), chloroquine and bafilomycin A1, or ATG genes silencing in HepG2 cells significantly inhibited CA‐induced autophagic cell death. The CA treatment decreased the levels of phosphorylated Akt and mTOR without any effects on PI3K or PTEN. Most importantly, overexpression of Akt and knockdown of PTEN attenuated autophagy induction in CA‐treated cells. Taken together, our results indicated that CA induced autophagic cell death through inhibition of the Akt/mTOR pathway in human hepatoma cells. These findings suggest that CA has a great potential for the treatment of hepatoma via autophagic induction. Copyright © 2014 John Wiley & Sons, Ltd.     

Dickkopf-1 perpetuated synovial fibroblast activation and synovial angiogenesis in rheumatoid arthritis

Clinical Rheumatology - Dickkopf-1 (Dkk-1), a regulatory molecule of the Wnt pathway, is elevated and leads to bone resorption in patients with RA. This study is aimed to investigate the...     

The clinical and laboratory features associated with cancer in patients with primary biliary cholangitis: a longitudinal survey–based study

Clinical Rheumatology - To analyze the clinical and laboratory features of primary biliary cholangitis (PBC) patients complicated with cancer, and explore the potential factors associated with...