Objective To investigate the spatial patterns of the prevalence,awareness,treatment,and control rates of dyslipidemia at the provincial level in China.Methods A national and provincial representative cross-sectional s...Objective To investigate the spatial patterns of the prevalence,awareness,treatment,and control rates of dyslipidemia at the provincial level in China.Methods A national and provincial representative cross-sectional survey was conducted among 178,558 Chinese adults in 31 provinces in China's Mainland in 2018–2019,using a multi-stage,stratified,cluster-randomized sampling design.Subjects,as households,were selected,followed by a home visit to collect information.Both descriptive and linear regression procedures were applied in the analyses.Results The overall prevalence of dyslipidemia was 35.6%,and wide geographic variations of prevalence,treatment,and control rates of dyslipidemia were identified among 178,558 eligible participants with a mean age of 55.1±13.8 years.The highest-lowest difference regarding the provincial level prevalence rates were 19.7%vs.2.1%for high low-density lipoprotein cholesterol,16.7%vs.2.5%for high total cholesterol,35.9%vs.5.4%for high triglycerides,and 31.4%vs.10.5%for low high-density lipoprotein cholesterol.The treatment rate of dyslipidemia was correlated with the socio-demographic index(P<0.001),urbanization rate(P=0.01),and affordable basic technologies and essential medicines(P<0.001).Conclusion Prevailing dyslipidemia among the Chinese population and its wide geographic variations in prevalence,treatment,and control suggest that China needs both integrated and localized public health strategies across provinces to improve lipid management.展开更多
Objective Total cholesterol(TC)is an important risk factor for myocardial infarction(MI),but the effect of TC on MI in Chinese male hypertension population has not been well documented.We conducted a prospective cohor...Objective Total cholesterol(TC)is an important risk factor for myocardial infarction(MI),but the effect of TC on MI in Chinese male hypertension population has not been well documented.We conducted a prospective cohort study to determine the incidence and relative risk for MI across a wide range of TC levels in Chinese male hypertension population.Methods A cohort of 5 298 male employees aged 18-74 years recruited from Capital Steel and Iron Company in Beijing of China in 1974-1980 was followed up for an average of 20.84 years.A total of 122 incident MI cases were identified during the period of follow-up.Results The incidence of MI among participants with elevated TC and those with desirable TC in male non-hypertension population was 137.20 and 63.81 per 100 000 person-years,respectively and the corresponding incidence in male hypertension population was 279.80 and 130.96 per 100 000 person-years,respectively.After adjustment for important covariables,10.38%,16.71%,and 23.80% of MI cases were attributable to hypertension,elevated TC,and hypertension plus elevated TC,respectively.In male hypertension population,the multivariate adjusted hazard ratios of MI were 1.21,2.39,3.38,and 3.95 for participants with TC level of 5.17-5.68,5.69-6.20,6.21-6.71,and ≥6.72 mmol/L,compared with those with TC<5.17 mmol/L.The corresponding population attributable risks were 2.92%,9.20%,8.87%,and 9.84%,respectively.Conclusion Elevated TC is an important independent risk factor of MI both in male non-hypertension and hypertension populations.There is a linear association between TC level and MI incidence in Chinese male hypertension population.展开更多
Objective To investigate whether the common variants 45T/G and 276G/T in APM1 gene were associated with hypertension combined with obesity (HO) and related clinical features in Chinese Han population. Methods A case-c...Objective To investigate whether the common variants 45T/G and 276G/T in APM1 gene were associated with hypertension combined with obesity (HO) and related clinical features in Chinese Han population. Methods A case-control study design was applied. Common polymorphisms of 45T/G and 276G/T were genotyped by PCR product sequencing in 484 cases with HO and 502 controls with normal blood presure and BMI < 25. Results The genotype and allele frequencies of 45T/G, 276G/T, and haplotype defined by the two variants in cases did not differ from those in controls. The means of blood pressure, BMI and waist-hip ratio did not differ among genotypes of the two polymorphisms and haplotypes. Among lipid profiles, only serum high-density lipoprotein cholesterol (HDL-C) levels were significantly lower in T allele carriers than that in non-T carriers after adjusting possible confounding factors (1.21 vs 1.32 mmol/L, P=0.0001). Conclusion Polymorphisms of 45T/G and 276G/T in APM1 gene are not associated with hypertension or obesity, or their clinical features in Chinese Han population. Common polymorphism of 45T/G might be associated with serum HDL-C levels in Chinese.展开更多
Objective: This study aimed to evaluate Chinese tertiary hospital nurses' research output,research ability,and their related training needs regarding scientific research methodology and analyze the relations among...Objective: This study aimed to evaluate Chinese tertiary hospital nurses' research output,research ability,and their related training needs regarding scientific research methodology and analyze the relations among them.Methods: A nationwide survey was conducted in China on a large sample of tertiary hospital nurses (n =27,335) recruited from 22 provinces,autonomous regions,and municipalities.A validated,self-designed questionnaire,consisted of a common questionnaire,the Science Research Skills Self-Rating Questionnaire (SRSQ) and the Scientific Research Training Needs Questionnaire (SRTNQ) were used to assess nurses' research output,self-rated research skills and research-training needs.Results: The nurses' scientific research participation rates (with 4.13%,7.85%,5.35%,and 2.04% in research projects,research attendance,papers published,and patent,respectively) and their self-rated research skills 25.00 (12.50,37.50) were very low.However,the research training needs were relatively high 53.12(37.50,75.00).Significant differences in research participation rates (research projects,research attendance,papers published,and patent),scientific research skills,and research-training needs were determined by age,highest education level,nursing experience,employment,technical title,administrative post,and clinical tutoring experience (P< 0.05).Female and male nurses had different research participation rates (only research projects and studies published) and scientific research skills (P < 0.05).Positive correlations were observed among research output,scientific research skills,and researchtraining needs (P < 0.01).Conclusions: Nurses' scientific research participation and self-rated research ability were below the optimal despite that they had relatively high research-training needs.Nurses should be provided further research training with tailored content to their characteristics and capacity.展开更多
Objective To study the association of the apolipoprotein B gene polymorphisms with essential hypertension in Northern Chinese Han population. Methods XbaI and EcoRI polymorphisms of the apolipoprotein B (APOB) gene we...Objective To study the association of the apolipoprotein B gene polymorphisms with essential hypertension in Northern Chinese Han population. Methods XbaI and EcoRI polymorphisms of the apolipoprotein B (APOB) gene were genotyped by polymerase chain reaction (PCR) and restriction fragment-length polymorphism (RFLP) method in 503 unrelated hypertensive patients and 490 healthy controls recruited from international collaborative study of cardiovascular disease in Asia (InterAsia). Results The difference in the genotypic distributions could be neglected across the groups. The prevalence of X+ allele in healthy controls (4.8%) was less frequent in Chinese, and there was no significant difference in the frequency of the X+ allele between cases (5.7%) and controls (P=0.38). The observed E- allele frequencies were closely similar among groups (5.9% in cases vs 5.0% in controls, P=0.39). Logitstic regression analyses revealed that the lack of association still persisted after adjustment of other environmental factors. Haplotype analysis showed that X-E+ was most frequent and no haplotype could significantly contribute to essential hypertension. Conclusion The APOB gene XbaI and EcoRI polymorphisms are not associated with essential hypertension in the Northern Chinese Han population. Future studies on single nucleotide polymorphisms in larger samples are needed to further investigate the possible contribution of the APOB gene to essential hypertension.展开更多
Since December 2019,a novel type of coronavirus disease(COVID-19)in Wuhan led to an outbreak throughout China and the rest of the world.To date,there have been more than 1,260,000 COVID-19 patients,with a mortality ra...Since December 2019,a novel type of coronavirus disease(COVID-19)in Wuhan led to an outbreak throughout China and the rest of the world.To date,there have been more than 1,260,000 COVID-19 patients,with a mortality rate of approximately 5.44%.Studies have shown that coagulation dysfunction is a major cause of death in patients with severe COVID-19.Therefore,the People’s Liberation Army Professional Committee of Critical Care Medicine and Chinese Society on Thrombosis and Hemostasis grouped experts from the frontline of the Wuhan epidemic to come together and develop an expert consensus on diagnosis and treatment of coagulation dysfunction associated with a severe COVID-19 infection.This consensus includes an overview of COVID-19-related coagulation dysfunction,tests for coagulation,anticoagulation therapy,replacement therapy,supportive therapy and prevention.The consensus produced 18 recommendations which are being used to guide clinical work.展开更多
Background: Despite recent improvements in the hospital treatment of ACS, little is known about current cardiological practice in China or use of evidence-based approach in Chinese hospitals. Methods: A questionnaire ...Background: Despite recent improvements in the hospital treatment of ACS, little is known about current cardiological practice in China or use of evidence-based approach in Chinese hospitals. Methods: A questionnaire about doctor-reported hospital management of ACS was posted to the head of the cardiology department of 1397 hospitals across 30 provinces of China. Reported use of various clinical procedures and treatments were analysed and compared between different types of hospital. Results: Of the 1029 (74%) hospitals that responded, 43% were tier III (tertiary) hospitals. For STEMI, primary PCI was used as the main reperfusion therapy by 50.2% of tier III and 9.3% of tier II/I (secondary) hospitals. Most of hospitals also used various proven therapy routinely for STEMI and NSTEMI/UA, including anti-platelet therapy (98% and 93%), anticoagulant (96% and 90%), statin (97% and 94%), oral β-blockers (87% and 86%) and ACE-I (88% and 83%). However, certain therapies with little or no proven value (eg, G.I.K., magnesium and Chinese tradition medicine) remained used routinely by 25% - 40% of tier II/I hospitals. After discharge, statin, antiplatelet, β-blockers and ACE-I were reportedly used routinely by 85% - 95% of the responders for secondary prevention. Conclusions: With a few exceptions, doctor-reported hospital management of ACS in China is largely consistent with that recommended by current guidelines. Large nationwide registries are needed to assess long-term adherence to treatments after hospital discharge.展开更多
Background Anomalous origin of the left coronary artery from the pulmonary artery(ALCAPA)is associated with myocardial ischemia.This study analyzed the predictive factors associated with prolonged mechanical ventilati...Background Anomalous origin of the left coronary artery from the pulmonary artery(ALCAPA)is associated with myocardial ischemia.This study analyzed the predictive factors associated with prolonged mechanical ventilation(PMV)and prolonged duration of inotropic support(PDIS)following ALCAPA surgery with possible concomitant mitral valve surgery(MVS)in a relatively young population.展开更多
BACKGROUND Epidemiologic studies have explored the association between a single cardiovascular risk factor(CVRF)and resting heart rate(RHR),but the research on the relation of multiple risk factors with RHR remains sc...BACKGROUND Epidemiologic studies have explored the association between a single cardiovascular risk factor(CVRF)and resting heart rate(RHR),but the research on the relation of multiple risk factors with RHR remains scarce.This study aimed to explore the associations between CVRFs clustering and the risk of elevated RHR.METHODS In this cross-sectional study,adults aged 35-75 years from 31 provinces were recruited by the China PEACE Million Persons Projects from September 2015 to August 2020.We focused on seven risk factors:hypertension,diabetes mellitus,dyslipidemia,obesity,smoking,alcohol use,and low physical activity.Multivariate logistic regression was used to calculate odds ratios(OR)for elevated RHR(>80 beats/min).RESULTS Among 1,045,405 participants,the mean age was 55.67±9.86 years,and 60.4%of participants were women.The OR(95%CI)for elevated RHR for the groups with 1,2,3,4 and≥5 risk factor were 1.11(1.08-1.13),1.36(1.33-1.39),1.68(1.64-1.72),2.01(1.96-2.07)and 2.58(2.50-2.67),respectively(Ptrend<0.001).The association between the CVRFs clustering number and elevated RHR was much more pronounced in young males than in other age-sex subgroups.Clusters comprising more metabolic risk factors were associated with a higher risk of elevated RHR than those comprising more behavioral risk factors.CONCLUSIONS There was a significant positive association between the CVRFs clustering number and the risk of elevated RHR,particularly in young males.Compared clusters comprising more behavioral risk factors,clusters comprising more metabolic risk factors were associated with a higher risk of elevated RHR.RHR may serve as an indicator of the cumulative effect of multiple risk factors.展开更多
Objective To explore the variation of treatment and outcomes for NSTEMI across different-level hospitals, which potentially influenced by unbalanced economy and disparate medical care.Methods The China AMI registry co...Objective To explore the variation of treatment and outcomes for NSTEMI across different-level hospitals, which potentially influenced by unbalanced economy and disparate medical care.Methods The China AMI registry consists of 108 hospitals across three levels (province, prefecture and county) throughout China.展开更多
Background and Objective Marfan syndrome,a variable and heritable disorder of fibrous connective tissue,characterized by affecting skeletal,ocular and cardiovascular systems.With the research advancement of genetic me...Background and Objective Marfan syndrome,a variable and heritable disorder of fibrous connective tissue,characterized by affecting skeletal,ocular and cardiovascular systems.With the research advancement of genetic mechanism,the diagnosis of Marfan syndrome,based on clinical manifestations and genetic evidence,is more accurate.The aim of this study is identification of genetic pathogenesis in a Chinese family.展开更多
Background Arrhythmogenic right ventricular cardiomyopathy(ARVC)is an inherited primary cardiomyopathy characterized by myocardial degeneration with fibro-fatty replacement.Clinical and genetic features of ARVC were w...Background Arrhythmogenic right ventricular cardiomyopathy(ARVC)is an inherited primary cardiomyopathy characterized by myocardial degeneration with fibro-fatty replacement.Clinical and genetic features of ARVC were well identified in Caucasian cohorts,but seldom examined in Chinese cohort.Our aim is to examine the genetic factor,genotype-phenotype correlations,and inheritance patterns of ARVC in a Chinese cohort.展开更多
Objective There is a consensus that intervention should be advised in patients with severe,symptomatic aortic stenosis(AS).Decision to operate raises specific problems in the elderly because of the increasing operativ...Objective There is a consensus that intervention should be advised in patients with severe,symptomatic aortic stenosis(AS).Decision to operate raises specific problems in the elderly because of the increasing operative comorbidity and mortality.However,little is known regarding the proportion of Chinese patients who denied to receive intervention and the reasons leading to the denial.This study is designed to analyze factors associated with decision-making and prognosis in elderly patients with severe,symptomatic AS.展开更多
Dear editor,Post-cardiac injury syndrome(PCIS) refers to a group of syndromes characterized by inflammation of the pericardium, pleura, and lung parenchyma after various heart injuries, including cardiac surgery or tr...Dear editor,Post-cardiac injury syndrome(PCIS) refers to a group of syndromes characterized by inflammation of the pericardium, pleura, and lung parenchyma after various heart injuries, including cardiac surgery or trauma, acute myocardial infarction(AMI), radiofrequency catheter ablation, coronary intervention, pacemaker implantation and pericardiocentesis.[1-5]Although advanced PCIS is well understood after cardiac surgery and AMI, known as post-pericardiotomy syndrome and post-myocardial infarction syndrome,[6,7]early-onset cases of PCIS after coronary intervention are rarely reported in China.展开更多
Cardiovascular disease(CVD)has become the leading cause of death and disability in the global population and imposes a significant economic burden on global health systems.Prevalent cases of total CVD nearly doubled f...Cardiovascular disease(CVD)has become the leading cause of death and disability in the global population and imposes a significant economic burden on global health systems.Prevalent cases of total CVD nearly doubled from 271 million in 1990 to 523 million in 2019,and the number of CVD deaths steadily increased from 12.1 million in 1990,reaching 18.6 million in 2019.The global trends for disabilityadjusted life years and years of life lost also increased significantly,and years lived with disability doubled from 17.7 million to 34.4 million over that period.展开更多
BACKGROUND Clinical outcomes are poor if patients with acute heart failure(AHF)are discharged with residual congestion in the presence of renal dysfunction.However,there is no single indication to reflect the combined...BACKGROUND Clinical outcomes are poor if patients with acute heart failure(AHF)are discharged with residual congestion in the presence of renal dysfunction.However,there is no single indication to reflect the combined effects of the two related pathophysiological processes.We,therefore,proposed an indicator,congestion and renal index(CRI),and examined the associations between the CRI and one-year outcomes and the incremental prognostic value of CRI compared with the established scoring systems in a multicenter prospective cohort of AHF.METHODS We enrolled AHF patients and calculated the ratio of thoracic fluid content index divided by estimated glomerular filtration rate before discharge,as CRI.Then we examined the associations between CRI and one-year outcomes.RESULTS A total of 944 patients were included in the analysis(mean age 63.3±13.8 years,39.3%women).Compared with patients with CRI≤0.59 mL/min per kΩ,those with CRI>0.59 mL/min per kΩhad higher risks of cardiovascular death or HF hospitalization(HR=1.56[1.13-2.15])and all-cause death or all-cause hospitalization(HR=1.33[1.01-1.74]).CRI had an incremental prognostic value compared with the established scoring system.CONCLUSIONS In patients with AHF,CRI is independently associated with the risk of death or hospitalization within one year,and improves the risk stratification of the established risk models.展开更多
The Annual Report on Cardiovascular Health and Diseases in China(2022)intricate landscape of cardiovascular health in China.This is the first section of the report,which dissects influential factors across diverse dom...The Annual Report on Cardiovascular Health and Diseases in China(2022)intricate landscape of cardiovascular health in China.This is the first section of the report,which dissects influential factors across diverse domains.The investigation identifies tobacco use as a paramount concern,portraying China as the global epicenter of tobacco consumption.Cigarette smoking,exacerbated by second-hand smoke exposure,emerges as a critical and preventable risk factor,contributing to a surge in attributable deaths over the past three decades.In the realm of dietary nutrition,the study discerns an overall improvement,yet discerns worrisome deviations,notably an escalating fat intake surpassing recommended guidelines.The shifting dietary structure reveals diminished consumption of cereals and vegetables juxtaposed with an uptick in animal foods,while excessive intake of cooking oil and salt persists,straying substantially from endorsed levels.The exploration of physical activity patterns unfolds a nuanced narrative.Varied trends are observed among students,with concerns arising from sedentary behaviors and inadequate adherence to recommended guidelines.The analysis spans a trajectory of declining physical activity in Chinese adults,coupled with an alarming surge in sedentary leisure time,ultimately linking these factors to heightened risks of cardiovascular diseases and increased adiposity.An examination of overweight and obesity trends uncovers a relentless upward trajectory,projecting substantial prevalence by 2030.Noteworthy prevalence rates underscore the imperative for targeted interventions to curtail this burgeoning health crisis,with the anticipated prevalence extending to nearly two-thirds of the adult population.Psychological factors,notably depression,constitute an integral facet of cardiovascular health.Prevalence rates among patients with coronary artery disease and acute myocardial infarction underscore the intricate interplay between mental health and cardiovascular outcomes.Additionally,persistent depressive symptoms are shown to significantly elevate the risk of cardiovascular diseases and mortality.This first section underscores the multifaceted challenges facing cardiovascular health in China,emphasizing the imperative for tailored interventions across tobacco control,dietary habits,physical activity,obesity management,and psychological well-being to mitigate the escalating burden of cardiovascular diseases in the population.展开更多
Background:Existing evidence suggests that fruit consumption is a significant influencing factor for chronic obstructive pulmonary disease(COPD),but this is unclear in the Chinese population.We examined the associatio...Background:Existing evidence suggests that fruit consumption is a significant influencing factor for chronic obstructive pulmonary disease(COPD),but this is unclear in the Chinese population.We examined the association of fresh fruit consumption with the risk of COPD-related hospitalization and death in a nationwide,population-based prospective cohort from China.Methods:Between 2004 and 2008,the China Kadoorie Biobank recruited>0.5 million adults aged 30 to 79 years from ten diverse regions across China.After excluding individuals diagnosed with major chronic diseases and prevalent COPD,the prospective analysis included 421,428 participants.Cox regression was used to calculate the hazard ratios(HRs)for the association between fresh fruit consumption and risk of COPD-related hospitalization and death,with adjustment for established and potential confounders.Results:During a mean follow-up of 10.9 years,11,292 COPD hospitalization events and deaths were documented,with an overall incidence rate of 2.47/1000 person-years.Participants who consumed fresh fruit daily had a 22%lower risk of COPD-related hospitalization and death compared with non-consumers(HR=0.78,95%confidence interval[CI]:0.71-0.87).The inverse association between fresh fruit consumption and COPD-related hospitalization and death was stronger among non-current smokers and participants with normal body mass index(BMI)(18.5 kg/m^(2)≤BMI<24.0 kg/m^(2));the corresponding HRs for daily fresh fruit consumption were 0.78(95%CI:0.68-0.89)and 0.69(95%CI:0.59-0.79)compared with their counterparts,respectively.Conclusions:High-frequency fruit consumption was associated with a lower risk of COPD in Chinese adults.Increasing fruit consumption,together with cigarette cessation and weight control,should be considered in the prevention and management of COPD.展开更多
Background The reversibility of pulmonary arterial hypertension(PAH)in congenital heart disease(CHD)is of great importance for the operability of CHD.Proteomics analysis found that transgelin was significantly upregul...Background The reversibility of pulmonary arterial hypertension(PAH)in congenital heart disease(CHD)is of great importance for the operability of CHD.Proteomics analysis found that transgelin was significantly upregulated in the lung tissue of CHD-PAH patients,especially in the irreversible group.However,how exactly it participated in CHD-PAH development is unknown.展开更多
基金supported by National Key R&D Program of China[2018YFC1311702,2018YFC1311706]the Chinese central government[key project of public health program]+2 种基金the Fund of"Sanming"Project of Medicine in Shenzhen[SZSM201811096]Young Talent Program of the Academician FundFuwai Hospital Chinese Academy of Medical Sciences,Shenzhen[YS-2020-006]。
文摘Objective To investigate the spatial patterns of the prevalence,awareness,treatment,and control rates of dyslipidemia at the provincial level in China.Methods A national and provincial representative cross-sectional survey was conducted among 178,558 Chinese adults in 31 provinces in China's Mainland in 2018–2019,using a multi-stage,stratified,cluster-randomized sampling design.Subjects,as households,were selected,followed by a home visit to collect information.Both descriptive and linear regression procedures were applied in the analyses.Results The overall prevalence of dyslipidemia was 35.6%,and wide geographic variations of prevalence,treatment,and control rates of dyslipidemia were identified among 178,558 eligible participants with a mean age of 55.1±13.8 years.The highest-lowest difference regarding the provincial level prevalence rates were 19.7%vs.2.1%for high low-density lipoprotein cholesterol,16.7%vs.2.5%for high total cholesterol,35.9%vs.5.4%for high triglycerides,and 31.4%vs.10.5%for low high-density lipoprotein cholesterol.The treatment rate of dyslipidemia was correlated with the socio-demographic index(P<0.001),urbanization rate(P=0.01),and affordable basic technologies and essential medicines(P<0.001).Conclusion Prevailing dyslipidemia among the Chinese population and its wide geographic variations in prevalence,treatment,and control suggest that China needs both integrated and localized public health strategies across provinces to improve lipid management.
基金supported by a grant (2006BAI01A01) from the Ministry of Science and Technology, China
文摘Objective Total cholesterol(TC)is an important risk factor for myocardial infarction(MI),but the effect of TC on MI in Chinese male hypertension population has not been well documented.We conducted a prospective cohort study to determine the incidence and relative risk for MI across a wide range of TC levels in Chinese male hypertension population.Methods A cohort of 5 298 male employees aged 18-74 years recruited from Capital Steel and Iron Company in Beijing of China in 1974-1980 was followed up for an average of 20.84 years.A total of 122 incident MI cases were identified during the period of follow-up.Results The incidence of MI among participants with elevated TC and those with desirable TC in male non-hypertension population was 137.20 and 63.81 per 100 000 person-years,respectively and the corresponding incidence in male hypertension population was 279.80 and 130.96 per 100 000 person-years,respectively.After adjustment for important covariables,10.38%,16.71%,and 23.80% of MI cases were attributable to hypertension,elevated TC,and hypertension plus elevated TC,respectively.In male hypertension population,the multivariate adjusted hazard ratios of MI were 1.21,2.39,3.38,and 3.95 for participants with TC level of 5.17-5.68,5.69-6.20,6.21-6.71,and ≥6.72 mmol/L,compared with those with TC<5.17 mmol/L.The corresponding population attributable risks were 2.92%,9.20%,8.87%,and 9.84%,respectively.Conclusion Elevated TC is an important independent risk factor of MI both in male non-hypertension and hypertension populations.There is a linear association between TC level and MI incidence in Chinese male hypertension population.
文摘Objective To investigate whether the common variants 45T/G and 276G/T in APM1 gene were associated with hypertension combined with obesity (HO) and related clinical features in Chinese Han population. Methods A case-control study design was applied. Common polymorphisms of 45T/G and 276G/T were genotyped by PCR product sequencing in 484 cases with HO and 502 controls with normal blood presure and BMI < 25. Results The genotype and allele frequencies of 45T/G, 276G/T, and haplotype defined by the two variants in cases did not differ from those in controls. The means of blood pressure, BMI and waist-hip ratio did not differ among genotypes of the two polymorphisms and haplotypes. Among lipid profiles, only serum high-density lipoprotein cholesterol (HDL-C) levels were significantly lower in T allele carriers than that in non-T carriers after adjusting possible confounding factors (1.21 vs 1.32 mmol/L, P=0.0001). Conclusion Polymorphisms of 45T/G and 276G/T in APM1 gene are not associated with hypertension or obesity, or their clinical features in Chinese Han population. Common polymorphism of 45T/G might be associated with serum HDL-C levels in Chinese.
文摘Objective: This study aimed to evaluate Chinese tertiary hospital nurses' research output,research ability,and their related training needs regarding scientific research methodology and analyze the relations among them.Methods: A nationwide survey was conducted in China on a large sample of tertiary hospital nurses (n =27,335) recruited from 22 provinces,autonomous regions,and municipalities.A validated,self-designed questionnaire,consisted of a common questionnaire,the Science Research Skills Self-Rating Questionnaire (SRSQ) and the Scientific Research Training Needs Questionnaire (SRTNQ) were used to assess nurses' research output,self-rated research skills and research-training needs.Results: The nurses' scientific research participation rates (with 4.13%,7.85%,5.35%,and 2.04% in research projects,research attendance,papers published,and patent,respectively) and their self-rated research skills 25.00 (12.50,37.50) were very low.However,the research training needs were relatively high 53.12(37.50,75.00).Significant differences in research participation rates (research projects,research attendance,papers published,and patent),scientific research skills,and research-training needs were determined by age,highest education level,nursing experience,employment,technical title,administrative post,and clinical tutoring experience (P< 0.05).Female and male nurses had different research participation rates (only research projects and studies published) and scientific research skills (P < 0.05).Positive correlations were observed among research output,scientific research skills,and researchtraining needs (P < 0.01).Conclusions: Nurses' scientific research participation and self-rated research ability were below the optimal despite that they had relatively high research-training needs.Nurses should be provided further research training with tailored content to their characteristics and capacity.
基金This work was funded by the National Basic Research Program of China (No. 2006CB503805)the Ministry of Science and Technology of The People’s Republic of China (No.2006AA02Z170,2006AA020706)Beijing Natural Science Foundation (No.7061006).
文摘Objective To study the association of the apolipoprotein B gene polymorphisms with essential hypertension in Northern Chinese Han population. Methods XbaI and EcoRI polymorphisms of the apolipoprotein B (APOB) gene were genotyped by polymerase chain reaction (PCR) and restriction fragment-length polymorphism (RFLP) method in 503 unrelated hypertensive patients and 490 healthy controls recruited from international collaborative study of cardiovascular disease in Asia (InterAsia). Results The difference in the genotypic distributions could be neglected across the groups. The prevalence of X+ allele in healthy controls (4.8%) was less frequent in Chinese, and there was no significant difference in the frequency of the X+ allele between cases (5.7%) and controls (P=0.38). The observed E- allele frequencies were closely similar among groups (5.9% in cases vs 5.0% in controls, P=0.39). Logitstic regression analyses revealed that the lack of association still persisted after adjustment of other environmental factors. Haplotype analysis showed that X-E+ was most frequent and no haplotype could significantly contribute to essential hypertension. Conclusion The APOB gene XbaI and EcoRI polymorphisms are not associated with essential hypertension in the Northern Chinese Han population. Future studies on single nucleotide polymorphisms in larger samples are needed to further investigate the possible contribution of the APOB gene to essential hypertension.
文摘Since December 2019,a novel type of coronavirus disease(COVID-19)in Wuhan led to an outbreak throughout China and the rest of the world.To date,there have been more than 1,260,000 COVID-19 patients,with a mortality rate of approximately 5.44%.Studies have shown that coagulation dysfunction is a major cause of death in patients with severe COVID-19.Therefore,the People’s Liberation Army Professional Committee of Critical Care Medicine and Chinese Society on Thrombosis and Hemostasis grouped experts from the frontline of the Wuhan epidemic to come together and develop an expert consensus on diagnosis and treatment of coagulation dysfunction associated with a severe COVID-19 infection.This consensus includes an overview of COVID-19-related coagulation dysfunction,tests for coagulation,anticoagulation therapy,replacement therapy,supportive therapy and prevention.The consensus produced 18 recommendations which are being used to guide clinical work.
文摘Background: Despite recent improvements in the hospital treatment of ACS, little is known about current cardiological practice in China or use of evidence-based approach in Chinese hospitals. Methods: A questionnaire about doctor-reported hospital management of ACS was posted to the head of the cardiology department of 1397 hospitals across 30 provinces of China. Reported use of various clinical procedures and treatments were analysed and compared between different types of hospital. Results: Of the 1029 (74%) hospitals that responded, 43% were tier III (tertiary) hospitals. For STEMI, primary PCI was used as the main reperfusion therapy by 50.2% of tier III and 9.3% of tier II/I (secondary) hospitals. Most of hospitals also used various proven therapy routinely for STEMI and NSTEMI/UA, including anti-platelet therapy (98% and 93%), anticoagulant (96% and 90%), statin (97% and 94%), oral β-blockers (87% and 86%) and ACE-I (88% and 83%). However, certain therapies with little or no proven value (eg, G.I.K., magnesium and Chinese tradition medicine) remained used routinely by 25% - 40% of tier II/I hospitals. After discharge, statin, antiplatelet, β-blockers and ACE-I were reportedly used routinely by 85% - 95% of the responders for secondary prevention. Conclusions: With a few exceptions, doctor-reported hospital management of ACS in China is largely consistent with that recommended by current guidelines. Large nationwide registries are needed to assess long-term adherence to treatments after hospital discharge.
文摘Background Anomalous origin of the left coronary artery from the pulmonary artery(ALCAPA)is associated with myocardial ischemia.This study analyzed the predictive factors associated with prolonged mechanical ventilation(PMV)and prolonged duration of inotropic support(PDIS)following ALCAPA surgery with possible concomitant mitral valve surgery(MVS)in a relatively young population.
基金supported by the National Key Research and Development Program from the Ministry of Science and Technology of China(2018YFC1311205).
文摘BACKGROUND Epidemiologic studies have explored the association between a single cardiovascular risk factor(CVRF)and resting heart rate(RHR),but the research on the relation of multiple risk factors with RHR remains scarce.This study aimed to explore the associations between CVRFs clustering and the risk of elevated RHR.METHODS In this cross-sectional study,adults aged 35-75 years from 31 provinces were recruited by the China PEACE Million Persons Projects from September 2015 to August 2020.We focused on seven risk factors:hypertension,diabetes mellitus,dyslipidemia,obesity,smoking,alcohol use,and low physical activity.Multivariate logistic regression was used to calculate odds ratios(OR)for elevated RHR(>80 beats/min).RESULTS Among 1,045,405 participants,the mean age was 55.67±9.86 years,and 60.4%of participants were women.The OR(95%CI)for elevated RHR for the groups with 1,2,3,4 and≥5 risk factor were 1.11(1.08-1.13),1.36(1.33-1.39),1.68(1.64-1.72),2.01(1.96-2.07)and 2.58(2.50-2.67),respectively(Ptrend<0.001).The association between the CVRFs clustering number and elevated RHR was much more pronounced in young males than in other age-sex subgroups.Clusters comprising more metabolic risk factors were associated with a higher risk of elevated RHR than those comprising more behavioral risk factors.CONCLUSIONS There was a significant positive association between the CVRFs clustering number and the risk of elevated RHR,particularly in young males.Compared clusters comprising more behavioral risk factors,clusters comprising more metabolic risk factors were associated with a higher risk of elevated RHR.RHR may serve as an indicator of the cumulative effect of multiple risk factors.
文摘Objective To explore the variation of treatment and outcomes for NSTEMI across different-level hospitals, which potentially influenced by unbalanced economy and disparate medical care.Methods The China AMI registry consists of 108 hospitals across three levels (province, prefecture and county) throughout China.
文摘Background and Objective Marfan syndrome,a variable and heritable disorder of fibrous connective tissue,characterized by affecting skeletal,ocular and cardiovascular systems.With the research advancement of genetic mechanism,the diagnosis of Marfan syndrome,based on clinical manifestations and genetic evidence,is more accurate.The aim of this study is identification of genetic pathogenesis in a Chinese family.
文摘Background Arrhythmogenic right ventricular cardiomyopathy(ARVC)is an inherited primary cardiomyopathy characterized by myocardial degeneration with fibro-fatty replacement.Clinical and genetic features of ARVC were well identified in Caucasian cohorts,but seldom examined in Chinese cohort.Our aim is to examine the genetic factor,genotype-phenotype correlations,and inheritance patterns of ARVC in a Chinese cohort.
文摘Objective There is a consensus that intervention should be advised in patients with severe,symptomatic aortic stenosis(AS).Decision to operate raises specific problems in the elderly because of the increasing operative comorbidity and mortality.However,little is known regarding the proportion of Chinese patients who denied to receive intervention and the reasons leading to the denial.This study is designed to analyze factors associated with decision-making and prognosis in elderly patients with severe,symptomatic AS.
基金National Natural Science Foundation of China(81770365)National Clinical Research Center for Cardiovascular Diseases,Fuwai Hospital,Chinese Academy of Medical Sciences(NCRC2020013)+1 种基金Beijing United Heart Foundation(BJUHFCSOARF201901-19)Key Project of Yunnan National Regional Medical Center for Cardiovascular Diseases(202002AA310100-14).
文摘Dear editor,Post-cardiac injury syndrome(PCIS) refers to a group of syndromes characterized by inflammation of the pericardium, pleura, and lung parenchyma after various heart injuries, including cardiac surgery or trauma, acute myocardial infarction(AMI), radiofrequency catheter ablation, coronary intervention, pacemaker implantation and pericardiocentesis.[1-5]Although advanced PCIS is well understood after cardiac surgery and AMI, known as post-pericardiotomy syndrome and post-myocardial infarction syndrome,[6,7]early-onset cases of PCIS after coronary intervention are rarely reported in China.
文摘Cardiovascular disease(CVD)has become the leading cause of death and disability in the global population and imposes a significant economic burden on global health systems.Prevalent cases of total CVD nearly doubled from 271 million in 1990 to 523 million in 2019,and the number of CVD deaths steadily increased from 12.1 million in 1990,reaching 18.6 million in 2019.The global trends for disabilityadjusted life years and years of life lost also increased significantly,and years lived with disability doubled from 17.7 million to 34.4 million over that period.
基金This work was supported by the National Key Technology R&D Program(2015BAI12B02)from the Ministry of Science and Technology of China.
文摘BACKGROUND Clinical outcomes are poor if patients with acute heart failure(AHF)are discharged with residual congestion in the presence of renal dysfunction.However,there is no single indication to reflect the combined effects of the two related pathophysiological processes.We,therefore,proposed an indicator,congestion and renal index(CRI),and examined the associations between the CRI and one-year outcomes and the incremental prognostic value of CRI compared with the established scoring systems in a multicenter prospective cohort of AHF.METHODS We enrolled AHF patients and calculated the ratio of thoracic fluid content index divided by estimated glomerular filtration rate before discharge,as CRI.Then we examined the associations between CRI and one-year outcomes.RESULTS A total of 944 patients were included in the analysis(mean age 63.3±13.8 years,39.3%women).Compared with patients with CRI≤0.59 mL/min per kΩ,those with CRI>0.59 mL/min per kΩhad higher risks of cardiovascular death or HF hospitalization(HR=1.56[1.13-2.15])and all-cause death or all-cause hospitalization(HR=1.33[1.01-1.74]).CRI had an incremental prognostic value compared with the established scoring system.CONCLUSIONS In patients with AHF,CRI is independently associated with the risk of death or hospitalization within one year,and improves the risk stratification of the established risk models.
文摘The Annual Report on Cardiovascular Health and Diseases in China(2022)intricate landscape of cardiovascular health in China.This is the first section of the report,which dissects influential factors across diverse domains.The investigation identifies tobacco use as a paramount concern,portraying China as the global epicenter of tobacco consumption.Cigarette smoking,exacerbated by second-hand smoke exposure,emerges as a critical and preventable risk factor,contributing to a surge in attributable deaths over the past three decades.In the realm of dietary nutrition,the study discerns an overall improvement,yet discerns worrisome deviations,notably an escalating fat intake surpassing recommended guidelines.The shifting dietary structure reveals diminished consumption of cereals and vegetables juxtaposed with an uptick in animal foods,while excessive intake of cooking oil and salt persists,straying substantially from endorsed levels.The exploration of physical activity patterns unfolds a nuanced narrative.Varied trends are observed among students,with concerns arising from sedentary behaviors and inadequate adherence to recommended guidelines.The analysis spans a trajectory of declining physical activity in Chinese adults,coupled with an alarming surge in sedentary leisure time,ultimately linking these factors to heightened risks of cardiovascular diseases and increased adiposity.An examination of overweight and obesity trends uncovers a relentless upward trajectory,projecting substantial prevalence by 2030.Noteworthy prevalence rates underscore the imperative for targeted interventions to curtail this burgeoning health crisis,with the anticipated prevalence extending to nearly two-thirds of the adult population.Psychological factors,notably depression,constitute an integral facet of cardiovascular health.Prevalence rates among patients with coronary artery disease and acute myocardial infarction underscore the intricate interplay between mental health and cardiovascular outcomes.Additionally,persistent depressive symptoms are shown to significantly elevate the risk of cardiovascular diseases and mortality.This first section underscores the multifaceted challenges facing cardiovascular health in China,emphasizing the imperative for tailored interventions across tobacco control,dietary habits,physical activity,obesity management,and psychological well-being to mitigate the escalating burden of cardiovascular diseases in the population.
基金supported by grants from the National Key Research&Development Program of China(Nos.2016YFC0900500,2016YFC0900501,2016YFC0900504,and 2016YFC1303904)National Natural Science Foundation of China(Nos.81973125,81941018,91846303,and 91843302)
文摘Background:Existing evidence suggests that fruit consumption is a significant influencing factor for chronic obstructive pulmonary disease(COPD),but this is unclear in the Chinese population.We examined the association of fresh fruit consumption with the risk of COPD-related hospitalization and death in a nationwide,population-based prospective cohort from China.Methods:Between 2004 and 2008,the China Kadoorie Biobank recruited>0.5 million adults aged 30 to 79 years from ten diverse regions across China.After excluding individuals diagnosed with major chronic diseases and prevalent COPD,the prospective analysis included 421,428 participants.Cox regression was used to calculate the hazard ratios(HRs)for the association between fresh fruit consumption and risk of COPD-related hospitalization and death,with adjustment for established and potential confounders.Results:During a mean follow-up of 10.9 years,11,292 COPD hospitalization events and deaths were documented,with an overall incidence rate of 2.47/1000 person-years.Participants who consumed fresh fruit daily had a 22%lower risk of COPD-related hospitalization and death compared with non-consumers(HR=0.78,95%confidence interval[CI]:0.71-0.87).The inverse association between fresh fruit consumption and COPD-related hospitalization and death was stronger among non-current smokers and participants with normal body mass index(BMI)(18.5 kg/m^(2)≤BMI<24.0 kg/m^(2));the corresponding HRs for daily fresh fruit consumption were 0.78(95%CI:0.68-0.89)and 0.69(95%CI:0.59-0.79)compared with their counterparts,respectively.Conclusions:High-frequency fruit consumption was associated with a lower risk of COPD in Chinese adults.Increasing fruit consumption,together with cigarette cessation and weight control,should be considered in the prevention and management of COPD.
文摘Background The reversibility of pulmonary arterial hypertension(PAH)in congenital heart disease(CHD)is of great importance for the operability of CHD.Proteomics analysis found that transgelin was significantly upregulated in the lung tissue of CHD-PAH patients,especially in the irreversible group.However,how exactly it participated in CHD-PAH development is unknown.
