Dyslipidemia Prevalence in Chinese Older Adults：a Meta-analysis

BackgroundChina has stepped into an aging society, and its aging population is rapidly increasing. Recent years have seen a notable increased dyslipidemia prevalence in older adults, which has gained growing attentions as a major risk for cardiovascular and cerebrovascular diseases in this population. There is little consistency between studies on dyslipidemia prevalence in Chinese older adults due to differences of size and features of sample, design and setting.ObjectiveTo systematically evaluate the prevalence of dyslipidemia among Chinese older adults.MethodsCross-sectional studies relevant to the prevalence of dyslipidemia among Chinese elderly population were searched in databases including CNKI, CBM, CQVIP, WanFang, PubMed, Web of Science, Embase and the Cochrane Library from inception to May 2021. Two researchers performed literature screening and data extraction, separately. The Agency for Healthcare Research and Quality methodology checklist was used to assess the risk of bias. Stata 15.1 was adopted for meta-analysis.ResultsA total of 19 cross-sectional studies were included, involving 101 931 cases, and 45 785 of them had dyslipidemia. Meta-analysis results showed that the overall prevalence of dyslipidemia among the participants was 48.0%〔95%CI (41.0%, 54.0%) 〕. Specifically, the prevalence of elevated total cholesterol (TC) , triglyceride (TG) , and low-density lipoprotein cholesterol (LDL-C) as well as lowered low high-density lipoprotein cholesterol (HDL-C) was 19.7%〔95%CI (13.8%, 25.5%) 〕, 20.8%〔95%CI (16.2%, 25.4%) 〕, 15.3%〔95%CI (10.7%, 19.8%) 〕, and 20.2%〔95%CI (7.9%, 32.4%) 〕, respectively. Sex-specific analysis found that men had higher prevalence of elevated LDL-C than women (17.2% vs 9.0%) . Women had higher overall prevalence of dyslipidemia than men (48.8% vs 39.5%) . Moreover, women also had higher prevalence of elevated TC (24.0% vs 12.9%) , and TG (23.4% vs 19.0%) , as well as lowered HDL-C (20.4% vs 14.7%) . Age-specific analysis revealed that dyslipidemia prevalence in age groups of 60-69, 70-79, and ≥80 years old was 39.9%, 31.8%, and 31.4%, respectively, showing a trend of decrease with age. The prevalence of elevated TC in 60-69 year-olds (12.9%) was higher than that of 70-79 year-olds (12.1%) or 80 year-olds and above (9.5%) . The prevalence of elevated LDL-C in 60-69 year-olds (10.0%) was higher than that of 70-79 year-olds (9.4%) or 80 year-olds and above (6.5%) . The prevalence of elevated TG in 70-79 year-olds (19.3%) was higher than that of 60-69 year-olds (16.4%) or 80 year-olds and above (15.5%) . The prevalence of lowered HDL-C in 70-79 year-olds (10.5%) was higher than that of 60-69 year-olds (9.7%) or 80 year-olds and above (9.5%) . Those aged ≥80 years had lower prevalence of various forms of dyslipidemia than 60-69 year-olds and 70-79 year-olds. Region-specific analysis indicated that compared to those from western China, participants from eastern China had higher overall prevalence of dyslipidemia (49.3% vs 36.8%) . Moreover, they also showed higher prevalence of elevated TC (23.0% vs 11.4%) , elevated LDL-C (21.3% vs 7.8%) and lowered HDL-C (13.5% vs 7.8%) . However, they had slightly lower prevalence of elevated TG (19.7% vs 20.0%) .ConclusionThe overall prevalence of dyslipidemia was high in Chinese older adults. Sex-, age group- and region-specific differences were found in the overall prevalence of dyslipidemia, and prevalence of various forms of dyslipidemia. Due to limited number and non-ideal quality of the included studies, the above conclusions need to be verified by more high-quality studies

Is knowledge retained by healthcare providers after training? A pragmatic evaluation of drug-resistant tuberculosis management in China.

OBJECTIVES: Considering the urgent need of training to improve standardised management of drug-resistant infectious disease and the lack of evidence on the impact of training, this study evaluates whether training participants' knowledge on multidrug-resistant tuberculosis (MDR-TB) is improved immediately and a year after training. SETTING AND PARTICIPANTS: The study involved 91 MDR-TB healthcare providers (HCPs), including clinical doctors, nurses and CDC staff, who attended a new MDR-TB HCP training programme in Liaoning and Jiangxi provinces, China. MAIN OUTCOME MEASURES: A phone-based assessment of participants' long-term retention of knowledge about MDR-TB management was conducted in July 2017, approximately 1 year after training. The proportion of correct responses in the long-term knowledge assessment was compared with a pretraining test and an immediate post-training test using a χ2 test. Factors influencing participants' performance in the long-term knowledge assessment were analysed using linear regression. RESULTS: Across both provinces, knowledge of definitions of drug-resistant TB, standardised MDR-TB case detection protocols and laboratory diagnosis was improved 1 year after the training by 14.5% (p=0.037), 32.4% (p<0.001) and 31% (p<0.001) relative to pretraining. However, compared with immediately after training, the knowledge of the three topics declined by 26.5% (p=0.003), 19.8% (p=0.018) and 52.7% (p<0.001) respectively in Jiangxi, while no significant decline was observed in Liaoning. Additionally, we found that obtaining a higher score in the long-term knowledge assessment was associated with longer years of clinical experience (coefficient=0.51; 95 CI% 0.02 to 0.99; p=0.041) and attending training in Liaoning (coefficient=0.50; 95% CI 0.14 to 0.85; p=0.007). CONCLUSION: Our study, the first to assess knowledge retention of MDR-TB HCPs 1 year after training, showed an overall positive long-term impact of lecture-style group training on participants' knowledge. Knowledge decline 1 year after training was observed in one province, Jiangxi, and this may be partly addressed by targeted support to HCPs with fewer years of clinical experience

Perception and willingness toward various immunization routes for COVID-19 vaccines: a cross-sectional survey in China

Conclusion: Needle-free vaccination is a promising technology for the next generation of vaccines, but we found that intramuscular injection was still the most acceptable immunization route in this survey. One major reason might be that most people lack knowledge about needle-free vaccination. We should strengthen the publicity of needle-free vaccination technology, and thus improve the acceptance and coverage of vaccination in different populations

Eff ect of a comprehensive programme to provide universal access to care for sputum-smear-positive multidrugresistant tuberculosis in China: a before-and-after study

Background China has a quarter of all patients with multidrug-resistant tuberculosis (MDRTB) worldwide, but less than 5% are in quality treatment programmes. In a before-and-after study we aimed to assess the eff ect of a comprehensive programme to provide universal access to diagnosis, treatment, and follow-up for MDRTB in four Chinese cities (population 18 million). Methods We designated city-level hospitals in each city to diagnose and treat MDRTB. All patients with smear-positive pulmonary tuberculosis diagnosed in Center for Disease Control (CDC) clinics and hospitals were tested for MDRTB with molecular and conventional drug susceptibility tests. Patients were treated with a 24 month treatment package for MDRTB based on WHO guidelines. Outpatients were referred to the CDC for directly observed therapy. We capped total treatment package cost at US$4644. Insurance reimbursement and project subsidies limited patients’ expenses to 10 (2011) to those from a retrospective survey of all patients with MDRTB diagnosed in the same cities during a baseline period (2006–09). Findings 243 patients were diagnosed with MDRTB or rifampicin-resistant tuberculosis during the 12 month programme period compared with 92 patients (equivalent to 24 per year) during the baseline period. 172 (71 243 individuals were enrolled in the programme. Time from specimen collection for resistance testing to treatment initiation decreased by 90 started on appropriate drug regimen increased 2·7 times (from nine [35 172), and follow-up by the CDC after initial hospitalisation increased 24 times (from one [4 163 [99 increased ten times (from two [8 programme period had negative cultures or clinical–radiographic improvement. Patients’ expenses for hospital admission after MDRTB diagnosis decreased by 78$796 to $174), reducing the ratio of patients’ expenses to annual household income from 17·6% to 3·5% (p<0·0001 for all comparisons between baseline and programme periods). However, 36 (15%) patients did not start or had to discontinue treatment in the programme period because of fi nancial diffi culties. Interpretation This comprehensive programme substantially increased access to diagnosis, quality treatment, and aff ordable treatment for MDRTB. The programme could help China to achieve universal access to MDRTB care but greater fi nancial risk protection for patients is needed

Perception and willingness toward various immunization routes for COVID-19 vaccines: a cross-sectional survey in China

BackgroundTo date, most vaccines, including the COVID-19 vaccine, are mainly administered by intramuscular injection, which might lead to vaccine hesitancy in some populations due to needle fear. Alternatively, needle-free immunization technology is extensively developed to improve the efficacy and acceptance of vaccination. However, there is no study to report the perception and willingness toward various immunization routes of the COVID-19 vaccine in the general population.MethodsA cross-sectional survey was conducted nationwide using an online questionnaire. Bivariate analyses were undertaken to assess variable associations among the participants who reported a hesitancy to receive the COVID-19 booster vaccination. Multivariable logistic regression with a backward step-wise approach was used to analyze the predicted factors associated with the willingness to receive the COVID-19 booster vaccination.ResultsA total of 3,244 valid respondents were included in this survey, and 63.2% of participants thought they had a good understanding of intramuscular injection, but only 20.7, 9.2, 9.4, and 6.0% of participants had a self-perceived good understanding of inhalation vaccine, nasal spray vaccine, oral vaccine, and microneedle patch vaccine. Correspondingly, there was high acceptance for intramuscular injection (76.5%), followed by oral inhalation (64.4%) and nasal spray (43.0%). Those participants who were only willing to receive an intramuscular vaccine had less vaccine knowledge (OR = 0.78; 95% CI: 0.65–0.94) than those who were willing to receive a needle-free vaccine (OR = 1.97; 95% CI: 1.52–2.57). Some factors were found to be associated with vaccine hesitancy toward booster COVID-19 vaccination.ConclusionNeedle-free vaccination is a promising technology for the next generation of vaccines, but we found that intramuscular injection was still the most acceptable immunization route in this survey. One major reason might be that most people lack knowledge about needle-free vaccination. We should strengthen the publicity of needle-free vaccination technology, and thus improve the acceptance and coverage of vaccination in different populations

Kinases Mst1 and Mst2 positively regulate phagocytic induction of reactive oxygen species and bactericidal activity

该研究成果揭示了吞噬性细胞内Hippo信号通路关键激酶Mst1和Mst2通过活化Rac家族蛋白来调节线粒体向吞噬小泡募集并释放ROS来清除病原体，这个生物学过程在天然免疫和宿主防御中发挥着重要作用。该成果解析了人的Mst1基因缺失或Rac2基因突变引发免疫缺陷综合症的致病机理，为研究人类感染性疾病提供了全新的视角。 该论文的主要工作由2012级博士生耿晶、2013级博士生孙秀峰以及王平、张世浩和王晓珍等学生共同承担，并与厦门市第一医院、台湾长庚大学、中国科学技术大学等单位合作完成，通讯作者为周大旺教授和陈兰芬教授。该研究工作获得了“青年千人计划”、国家自然科学基金委和科技部的资助。Mitochondria need to be juxtaposed to phagosomes for the synergistic production of ample reactive oxygen species (ROS) in phagocytes to kill pathogens. However, how phagosomes transmit signals to recruit mitochondria has remained unclear. Here we found that the kinases Mst1 and Mst2 functioned to control ROS production by regulating mitochondrial trafficking and mitochondrion-phagosome juxtaposition. Mst1 and Mst2 activated the GTPase Rac to promote Toll-like receptor (TLR)-triggered assembly of the TRAF6-ECSIT complex that is required for the recruitment of mitochondria to phagosomes. Inactive forms of Rac, including the human Rac2D57N mutant, disrupted the TRAF6-ECSIT complex by sequestering TRAF6 and substantially diminished ROS production and enhanced susceptibility to bacterial infection. Our findings demonstrate that the TLR-Mst1-Mst2-Rac signaling axis is critical for effective phagosome-mitochondrion function and bactericidal activity.Supported by the National Basic Research Program (973) of China (2015CB910502 to L.C.), China's 1000 Young Talents Program (D.Z. and L.C.), the 111 Projects (B12001 and B06016), the Fundamental Research Funds for the Central Universities of China-Xiamen University (CXB2014004 to J.Z.; 20720140551 to L.C.; and 2013121034 and 20720140537 to D.Z.), the National Natural Science Foundation of China (31270918, 81222030 and J1310027 to D.Z.; 81372617, 81422018 and U1405225 to L.C.; 81472229 to L.H.; and 81302529 to X.L.), the Natural Science Foundation of Fujian (2013J06011 to D.Z. and 2014D007 to X.L.), the US National Institutes of Health (RO1 CA136567 for J.A.) and institutional funds from Massachusetts General Hospital (for J.A.). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Female BMI has an effect on oocyte gene expression pattern

Purpose: To explore the mechanisms by which abnormal female BMI affects oocyte quality, particularly whether it involves the alteration of gene expression patterns and how these patterns may impact clinical outcomes. Methods: In Part 1, we performed a retrospective study to compare the clinical outcomes between the female BMI ≥25 kg/m2 and female BMI ≤20 kg/m2 groups. In Part 2, we performed the transcriptome analyses based on the GSE87201 dataset. Results: In Part 1, among the clinical outcomes, only the grade 1–2 embryo rate at day 3 of ICSI cycles was significantly different between the two BMI groups; the other outcomes were not. In Part 2, compared with the BMI ≤20 kg/m2 group, the oocyte gene expression pattern of the BMI ≥25 kg/m2 group seemed to result in better oocyte tolerance to exogenous stress, such as intracytoplasmic sperm injection (ICSI). It seemed to explain the result of Part 1 that the BMI ≥25 kg/m2 group had better day-3 embryo quality after ICSI than the BMI ≤20 kg/m2 group. Conclusions: Abnormal female BMI affects oocyte quality by altering the gene expression patterns of oocytes. While a female BMI ≥25 kg/m2 is known to have certain detrimental effects on ART, our findings suggest that it can also confer some benefits to oocytes

CDasXORNet: Change detection of buildings from bi-temporal remote sensing images as an XOR problem

The up-to-date building information is significant to urban planning and economic assessment. Automatic building change detection (BCD) from bi-temporal remote sensing images is essential for updating building status efficiently. Nevertheless, BCD remains challenging due to the complex building appearance, the diverse imaging conditions, and the building’s positional inconsistencies between the bi-temporal images. Recent convolutional neural network-based BCD methods have achieved impressive performance. However, most existing methods employed subtraction or concatenation to identify building changes. Such simple change-deciding operations ignore the spatial–temporal correlation between the bi-temporal features and cannot model the building changes effectively, resulting in overmuch misclassifications. This paper proposes a hierarchical XOR approximating network CDasXORNet to model building changes robustly. An XOR approximation operation is proposed to produce discriminative building differential features from the bi-temporal inputs. We assume that BCD and the logical XOR function have the same nature (i.e., when the two inputs are identical, the output is unchanged/False; otherwise, it is changed/True). This applies to the building change and unaltered pixels simultaneously. Thus, by approximating XOR operation, CDasXORNet can simultaneously exploit the spatial–temporal correlation and the changed and changeless information of buildings. Hierarchical XOR approximation operations are subsequently designed, which process only high-level features to mitigate the influence of substantial irrelevant spectral differences. In addition, the residual linear attention mechanism is introduced to refine the building change features further. Experiments on three publicly challenging datasets demonstrate that our method achieves promising BCD results with fewer commission errors and higher overall performance than the comparative approaches