Global burden attributable to high sodium intake from 1990 to 2019

Background and aimsHigh sodium intake is associated with a higher risk of a wide range of diseases. We aimed to estimate the pattern and trend of the global disease burden associated with high sodium intake from 1990 to 2019.Methods and resultsWe obtained numbers and rates of death and disability-adjusted life year (DALY) attributable to high sodium intake by sex, socio-demographic index, and country from the Global Burden of Disease Study 2019. We calculated the estimated annual percentage change to evaluate the age-standardized rate (ASR) of the burden attributable to high sodium intake between 1990 and 2019. We further calculated the contribution of population growth, population aging, and age-specific rates of death and DALY to the net change in the total number of deaths and DALYs attributable to high sodium intake. From 1990 to 2019, global age-standardized rates of death and DALY attributable to high sodium intake substantially decreased for both sexes. However, there were significant increases in the total numbers of deaths and DALYs attributable to high sodium intake, which were driven by population growth and population aging. The attribution of population growth and population aging varied widely across countries, with a higher contribution of population growth in most developing countries and a higher contribution of population aging in countries with slow population growth.ConclusionsAlthough the global burden attributable to high sodium intake in terms of age-standardized rate declined from 1990 to 2019, the absolute burden increased significantly, which was driven by population growth and population aging.     

不安运动阶段对早产儿运动发育结局的预测价值

目的比较全身运动质量评估(General movements assessment,GMs)不安运动阶段和Gesell发育量表(Gesell Developmental Test Scales,GDS)对早产儿运动发育结局的预测效度,及对两种评估方法和发育结局的一致性检测。方法对2011年6月-2013年6月共226例在本院儿童保健科随访的早产儿,在纠正5个月内采用GMs和GDS进行评估,在纠正12个月时临床诊断是否为脑瘫,并使用Peabody运动发育量表(Peabody Development Motor Scale 2,PDMS-2)确定其运动发育结局。对比分析两种评估方法的预测效度(包括敏感度、特异度、阳性预测值和阴性预测值),及与发育结局的相关性。结果 226例早产儿发育结局中运动发育正常176例,运动发育迟缓22例,脑瘫28例。不安运动阶段评估结果为正常者168例,异常为58例;GDS评估结果为正常者140例,异常为86例。不安运动及GDS预测脑瘫敏感度92.9%、71.4%,特异度83.8%、66.7%,阳性预测值44.8%、23.3%,阴性预测值98.8%、94.3%。不安运动及GDS预测运动发育结局敏感度88.0%、68.0%,特异度92.0%、70.4%,阳性预测值75.9%、39.5%,阴性预测值96.4%、88.6%。GDS和PDMS-2的一致性检验Kappa值0.306,P0.05,GMs和PDMS-2评估的一致性检验Kappa值0.757,P0.05,提示GMs、GDS对运动发育预测与发育结局均具有良好的一致性,GMs中不安运动阶段的预测与发育结局的一致性更高。结论 GMs的不安运动阶段能够超早期预测脑瘫等不良运动发育结局,在预测预后方面要优于GDS,能更早期的做出预测。     

Cost-effectiveness of dengue vaccination in ten endemic countries

Following publication of results from two phase-3 clinical trials in 10 countries or territories, endemic countries began licensing the first dengue vaccine in 2015. Using a published mathematical model, we evaluated the cost-effectiveness of dengue vaccination in populations similar to those at the trial sites in those same Latin American and Asian countries. Our main scenarios (30-year horizon, 80% coverage) entailed 3-dose routine vaccinations costing US$20/dose beginning at age 9, potentially supplemented by catch-up programs of 4- or 8-year cohorts. We obtained illness costs per case, dengue mortality, vaccine wastage, and vaccine administration costs from the literature. We estimated that routine vaccination would reduce yearly direct and indirect illness cost per capita by 22% (from US$10.51 to US$8.17) in the Latin American countries and by 23% (from US$5.78 to US$4.44) in the Asian countries. Using a health system perspective, the incremental cost-effectiveness ratio (ICER) averaged US$4,216/disability-adjusted life year (DALY) averted in the five Latin American countries (range: US$666/DALY in Puerto Rico to US$5,865/DALY in Mexico). In the five Asian countries, the ICER averaged US$3,751/DALY (range: US$1,935/DALY in Malaysia to US$5,101/DALY in the Philippines). From a health system perspective, the vaccine proved to be highly cost effective (ICER under one times the per capita GDP) in seven countries and cost effective (ICER 1–3 times the per capita GDP) in the remaining three countries. From a societal perspective, routine vaccination proved cost-saving in three countries. Including catch-up campaigns gave similar ICERs. Thus, this vaccine could have a favorable economic value in sites similar to those in the trials.     

促性腺激素释放激素拮抗剂对大鼠睾丸支持细胞雄激素受体和Fas配体基因表达的影响

本实验利用注射促性腺激素释放激素拮抗剂（ＧｎＲＨ Ａ）引起睾丸生精细胞程序化死亡的大鼠模型，用地高辛标记的大鼠雄激素受体和Ｆａｓ配体的ＲＮＡ探针对大鼠睾丸石蜡切片进行原位杂交，观察雄激素受体和Ｆａｓ配体基因在生精细胞凋亡中的变化。结果显示，ＧｎＲＨ Ａ处理后曲细精管有退行性变，原位杂交表明此时Ｓｅｒｔｏｌｉ细胞的雄激素受体表达明显减低，而Ｆａｓ配体表达显著升高。提示Ｆａｓ配体的表达可能与生精上皮细胞程序化死亡关系密切。     

复方二精灵多糖对谷氨酸诱导的海马神经元凋亡的保护作用

目的探讨中药复方二精灵多糖(EJL)预防阿尔茨海默病的机制。方法实验分为正常对照组、模型(100μmol.L-1谷氨酸诱导)组、阳性对照组(50μmol.L-1多奈哌齐)及EJL实验组(0.5,1.0,2.0及3.0g.L-1)。体外培养9d的海马神经元先用各药物预处理一定时间后,加入谷氨酸。采用MTT法、Hoechst 33258荧光染色、流式细胞术和Western蛋白质印迹法等方法检测细胞凋亡。结果MTT检测发现,随着EJL浓度的增加,细胞的存活率也增加;与模型组〔(59.6±4.6)%〕比较,EJL2.0及3.0g.L-1组细胞存活率明显升高〔(82.8±2.8)%和(89.4±4.1)%;n=3,P<0.05〕。荧光染色观察形态学变化发现,EJL预处理组凋亡细胞明显减少。FITC-Annexin Ⅴ和PI双染,在直方图中可以发现,模型组的凋亡率为32.33%,EJL预处理组则分别为24.33%,22.01%及12.12%。Western蛋白质印迹法结果显示,与模型组比,EJL2.0g.L-1预处理可以显著提高Bcl-2蛋白表达量,减少Bax蛋白表达量。结论EJL对海马神经元有一定的保护作用。