Improved surgical techniques and greater efficacy of new anti-rejection drugs have significantly improved the survival of patients undergoing orthotopic liver transplantation(OLT). This has led to an increased inciden...Improved surgical techniques and greater efficacy of new anti-rejection drugs have significantly improved the survival of patients undergoing orthotopic liver transplantation(OLT). This has led to an increased incidence of metabolic disorders as well as cardiovascular and cerebrovascular diseases as causes of morbidity and mortality in OLT patients. In the last decade, several studies have examined which predisposing factors lead to increased cardiovascular risk(i.e., age, ethnicity, diabetes, NASH, atrial fibrillation, and some echocardiographic parameters) as well as which factors after OLT(i.e., weight gain, metabolic syndrome, immunosuppressive therapy, and renal failure) are linked to increased cardiovascular mortality. However, currently, there are no available data that evaluate the development of atherosclerotic damage after OLT. The awareness of high cardiovascular risk after OLT has not only lead to the definition of new but generally not accepted screening of high risk patients before transplantation, but also to the need for careful patient follow up and treatment to control metabolic and cardiovascular pathologies after transplant. Prospective studies are needed to better define the predisposing factors for recurrence and de novo occurrence of metabolic alterations responsible for cardiovascular damage after OLT. Moreover, such studies will help to identify the timing of disease progression and damage,which in turn may help to prevent morbidity and mortality for cardiovascular diseases. Our preliminary results show early occurrence of atherosclerotic damage, which is already present a few weeks following OLT, suggesting that specific, patient-tailored therapies should be started immediately post OLT.展开更多
China has experienced rapid urbanization in recent decades along with dramatic economic growth. Previous studies have shown that urbanization has both positive and negative effects on health. However, there is a lack ...China has experienced rapid urbanization in recent decades along with dramatic economic growth. Previous studies have shown that urbanization has both positive and negative effects on health. However, there is a lack of research on the overall effects of urbanization on the epidemic transition of environmental health risks considering various pathways in China. In the present study, we studied the contributions of different aspects of urbanization in China to epidemic transitions using provincial and multi-year （1995, 2000, 2005, and 2010） panel data. Statistical models with fixed and random effects were developed to explore the impacts of different urbanization indicators on the overall epidemic tran- sition of environmental health （general model） and the changes in cause-specific mortality rates of typ- ical diseases （cause-specific models）. The results show that the impacts of non-communicable diseases continue to grow during the urbanization process in China. The ratio of communicable disease-related mortality to non-communicable disease-related mortality continues to decrease over time. The general model shows that the improved medical conditions （coefficient =-0.0011, P= 0.037）, the improved urban infrastructure （e.g., tap water supply） （coefficient = -0.00065, P 〈 0,001）, and the rise in income （coefficient = -0.00027, P = 0.047） during the urbanization process are important factors that promote this overall epidemic transition. The cause-specific models show that the mechanisms behind the general model are complicated. More attention should be paid to non-communicable diseases in urban health management. Specific health policies for different diseases should incorporate the considerations of dif- ferent impact pathwavs of urbanization,展开更多
文摘Improved surgical techniques and greater efficacy of new anti-rejection drugs have significantly improved the survival of patients undergoing orthotopic liver transplantation(OLT). This has led to an increased incidence of metabolic disorders as well as cardiovascular and cerebrovascular diseases as causes of morbidity and mortality in OLT patients. In the last decade, several studies have examined which predisposing factors lead to increased cardiovascular risk(i.e., age, ethnicity, diabetes, NASH, atrial fibrillation, and some echocardiographic parameters) as well as which factors after OLT(i.e., weight gain, metabolic syndrome, immunosuppressive therapy, and renal failure) are linked to increased cardiovascular mortality. However, currently, there are no available data that evaluate the development of atherosclerotic damage after OLT. The awareness of high cardiovascular risk after OLT has not only lead to the definition of new but generally not accepted screening of high risk patients before transplantation, but also to the need for careful patient follow up and treatment to control metabolic and cardiovascular pathologies after transplant. Prospective studies are needed to better define the predisposing factors for recurrence and de novo occurrence of metabolic alterations responsible for cardiovascular damage after OLT. Moreover, such studies will help to identify the timing of disease progression and damage,which in turn may help to prevent morbidity and mortality for cardiovascular diseases. Our preliminary results show early occurrence of atherosclerotic damage, which is already present a few weeks following OLT, suggesting that specific, patient-tailored therapies should be started immediately post OLT.
基金supported by the National Natural Science Foundation of China(71433007)the National Key Research and Development Program of China(2016YFC0207603)supported by China Scholarship Council(CSC)under the State Scholarship Fund
文摘China has experienced rapid urbanization in recent decades along with dramatic economic growth. Previous studies have shown that urbanization has both positive and negative effects on health. However, there is a lack of research on the overall effects of urbanization on the epidemic transition of environmental health risks considering various pathways in China. In the present study, we studied the contributions of different aspects of urbanization in China to epidemic transitions using provincial and multi-year （1995, 2000, 2005, and 2010） panel data. Statistical models with fixed and random effects were developed to explore the impacts of different urbanization indicators on the overall epidemic tran- sition of environmental health （general model） and the changes in cause-specific mortality rates of typ- ical diseases （cause-specific models）. The results show that the impacts of non-communicable diseases continue to grow during the urbanization process in China. The ratio of communicable disease-related mortality to non-communicable disease-related mortality continues to decrease over time. The general model shows that the improved medical conditions （coefficient =-0.0011, P= 0.037）, the improved urban infrastructure （e.g., tap water supply） （coefficient = -0.00065, P 〈 0,001）, and the rise in income （coefficient = -0.00027, P = 0.047） during the urbanization process are important factors that promote this overall epidemic transition. The cause-specific models show that the mechanisms behind the general model are complicated. More attention should be paid to non-communicable diseases in urban health management. Specific health policies for different diseases should incorporate the considerations of dif- ferent impact pathwavs of urbanization,
