Blood Pressure and Hypertension in Adults Permanently Living at High Altitude: A Systematic Review and Meta-Analysis.

Aryal, Nirmal, Mark Weatherall, Yadav Kumar Deo Bhatta, and Stewart Mann. Blood pressure and hypertension in adults permanently living at high altitude: a systematic review and meta-analysis. High Alt Med Biol. 17:185-193, 2016.-The objective of this study was to estimate the associations between altitude and mean blood pressure (BP) (or prevalence of hypertension [HT]) in adults who live permanently at high altitude. A literature search was conducted in December 2014 using PubMed, Scopus, and OvidSP (MedLine and EMBASE) databases to identify relevant observational studies. Inclusion criteria were reports of studies in populations permanently living at an altitude of ≥2400 m and in those 18 years or older. Meta-regression was used to estimate the association between average BP and HT and altitude. We identified 3375 articles and inclusion criteria were met for 21 reports, which included a total of 40,854 participants. Random-effects meta-regression estimated that for every 1000 m elevation the average systolic BP (SBP) (95% confidence interval [CI]) increased by 17 mmHg (0.2 to 33.8), p = 0.05 and diastolic BP (DBP) by 9.5 mmHg (0.6 to 18.4), p = 0.04 in participants with Tibetan origin. By contrast, in participants with non-Tibetan origin, average SBP decreased by 5.9 mmHg (-19.1 to 7.3), p = 0.38 and DBP by 4 mmHg (-13 to 5), p = 0.38. The odds ratios (95% CI) for the proportion of participants with HT per 1000 m increment in the altitude were 2.01 (0.37 to 11.02), p = 0.446 and 4.05 (0.07 to 244.69), p = 0.489 for Tibetan and non-Tibetan participants, respectively. Sensitivity analysis excluding two studies with older participants (≥60 years) reversed the direction of this effect in non-Tibetans with odds ratio (95% CI) of 0.10 (0.004 to 2.22) per 1000 m, p = 0.143. Overall, this review suggests weak association between BP and altitude in Tibetan origin populations

The prevalence of childhood asthma in China: a systematic review

Extent: 10p.Background: It is well known that the prevalence of asthma has been reported to increase in many places around the world during the last decades. Therefore, the aim of this study was to identify and review studies of asthma prevalence among children in China and address time trends and regional variation in asthma. Methods: A systematic literature search was performed using PubMed and China National Knowledge Infrastructure (CNKI) databases. Selected articles had to describe an original study that showed the prevalence of asthma among children aged 0−14 years. Results: A total of 74 articles met the inclusion criteria. The lifetime prevalence of asthma varied between 1.1% in Lhasa (Tibet) and 11.0% in Hong Kong in studies following the International Study of Asthma and Allergies in Childhood (ISAAC) protocol. The prevalence was 3% or lower in most articles following Chinese diagnostic criteria. One article reported the results from two national surveys and showed that the current average prevalence of asthma for the total study population had increased from 1990 to 2000 (0.9% to 1.5%). The lowest current prevalence was found in Lhasa (0.1% in 1990, 0.5% in 2000). Conclusions: The prevalence of childhood asthma was generally low, both in studies following the ISAAC and Chinese diagnostic criteria. Assessment of time trends and regional variations in asthma prevalence was difficult due to insufficient data, variation in diagnostic criteria, difference in data collection methods, and uncertainty in prevalence measures. However, the findings from one large study of children from 27 different cities support an increase in current prevalence of childhood asthma from 1990 to 2000. The lowest current prevalence of childhood asthma was found in Tibet.Yangzong Yangzong, Zumin Shi, Per Nafstad, Lise Lund Håheim, Ouzhu Luobu and Espen Bjertnes

Triptolide inhibits TGF-β-induced matrix contraction and fibronectin production mediated by human Tenon fibroblasts

AIM: To determine if triptolide influences the contractility and fibronectin production in human Tenon fibroblasts (HTFs). METHODS: HTFs were cultured in type I collagen gels with or without transforming growth factor beta (TGF-β) and/or triptolide. The diameter of the collagen gel was used to measure contraction. Immunoblot analysis was used to quantify myosin light chain (MLC) phosphorylation and integrin expression. Laser confocal fluorescence microscopy was used to monitor the formation of actin stress fibers. Fibronectin production was measured with an enzyme immunoassay. RESULTS: Triptolide inhibition of contraction in TGF-β-induced collagen gel mediated by HTFs was dose-dependent and statistically significant at 3 nmol/L (P<0.05) and maximal at 30 nmol/L and significantly time dependent at 2d (P<0.05). Triptolide reduced TGF-β-induced expression of integrins α5 and β1, phosphorylation of MLC, and formation of stress fibers in HTFs. Furthermore, the inhibition of triptolide on the attenuated TGF-β-induced production of fibronectin by HTFs was concentration-dependent and significant at 1 nmol/L (P<0.05) and maximal at 30 nmol/L. CONCLUSION: Triptolide suppress the contractility of HTFs induced by TGF-β and the production of fibronectin by these cells. It is promising that triptolide treatment may possibly inhibit scar formation after glaucoma filtration surgery

Dynamic Changes in per capita Net Income of Rural Residents in Nyingchi City of Tibet

Through an in-depth analysis of the per capita net income of rural residents in Nyingchi City, it was known that the per capita net income of rural residents in Nyingchi City was increasing at high speed in recent 10 years. However, the wage income, household operating income, and agricultural income gap constitute the major factors influencing the gap of the per capita net income of rural residents in Nyingchi City. Finally, it came up with recommendations including promoting the reasonable flow of labor to the secondary and tertiary industries, increasing the wage income and transfer income of rural residents, accelerating the construction of small towns in rural areas, promoting the development of rural cooperatives, implementing the strategy of “benefiting farmers and strengthening tourism”, promoting integration of agriculture and eco-tourism, promoting the development of modern agriculture, and expanding diversified production income of farmers

A Study on the Transfer of Rural Surplus Labor in Nyingchi City

This paper studies the surplus labor transfer in Nyingchi City, obtains the first-hand information of the surplus labor transfer through the typical survey, and analyzes the current situation and characteristics of surplus labor transfer. From "transfer channel", "transfer industry" and "transfer space", this paper analyzes the factors affecting the transfer of local surplus farming and animal husbandry labor, discusses the obstacles to surplus farming and animal husbandry labor in Nyingchi City, and finally makes some recommendations for the transfer of rural surplus labor in Nyingchi City

Genome-Wide Transcriptional Analysis Reveals the Protection against Hypoxia-Induced Oxidative Injury in the Intestine of Tibetans via the Inhibition of GRB2/EGFR/PTPN11 Pathways

The molecular mechanisms for hypoxic environment causing the injury of intestinal mucosal barrier (IMB) are widely unknown. To address the issue, Han Chinese from 100 m altitude and Tibetans from high altitude (more than 3650 m) were recruited. Histological and transcriptome analyses were performed. The results showed intestinal villi were reduced and appeared irregular, and glandular epithelium was destroyed in the IMB of Tibetans when compared with Han Chinese. Transcriptome analysis revealed 2573 genes with altered expression. The levels of 1137 genes increased and 1436 genes decreased in Tibetans when compared with Han Chinese. Gene ontology (GO) analysis indicated most immunological responses were reduced in the IMB of Tibetans when compared with Han Chinese. Gene microarray showed that there were 25-, 22-, and 18-fold downregulation for growth factor receptor-bound protein 2 (GRB2), epidermal growth factor receptor (EGFR), and tyrosine-protein phosphatase nonreceptor type 11 (PTPN11) in the IMB of Tibetans when compared with Han Chinese. The downregulation of EGFR, GRB2, and PTPN11 will reduce the production of reactive oxygen species and protect against oxidative stress-induced injury for intestine. Thus, the transcriptome analysis showed the protecting functions of IMB patients against hypoxia-induced oxidative injury in the intestine of Tibetans via affecting GRB2/EGFR/PTPN11 pathways

Effects of Climate Change and Fencing on Forage Nutrition Quality of Alpine Grasslands in the Northern Tibet

How climate change and fencing will affect forage nutrition quality of alpine grasslands is still unknown in the Northern Tibet. Here, we reported the effects of climate change and fencing on forage nutrition quality (i.e., CP: crude protein, ADF: acid detergent fiber, NDF: neutral detergent fiber, Ash: crude ash, EE: ether extract and DTS: dissolvable total sugar) in alpine grasslands across the Northern Tibet based on a transect survey dataset from 2018. Over the whole survey transect, fencing reduced the NDF content by 5.15% and the EE content by 15.79%, but did not affect forage nutrition quality (R2 = 0.04, p = 0.389). Air temperature and precipitation explained 24% and 8% of variation in the CP content under the fencing conditions, respectively. Precipitation explained 22% of variation in the NDF content under the fencing conditions. The CP content decreased and increased exponentially with increasing air temperature under the fencing and grazing conditions, respectively. The NDF content showed logarithmic and negative relationships with precipitation under the fencing and grazing conditions (−8.45 vs. −6.68lnNDF). The response of the CP content to fencing showed negative relationships with temperature and the response of AGB to fencing, but showed a positive relationship with precipitation. The CP and DTS contents showed negative relationships with AGB under the fencing and grazing conditions. In contrast, the ADF content showed a positive relationship with AGB. The response of AGB, SR and community composition to fencing explained 11%, 56% and 35% of variation in the response of forage nutrition quality to fencing, respectively. Therefore, climate change may not always have adverse effects on forage nutrition quality, whereas fencing may not always have favorable effects on forage nutrition quality. Fencing and climate change can have an interactive effect on forage nutrition quality. Fencing can alter the temperature and precipitation sensitivities of forage nutrition quality. In colder and wetter regions, the forage nutrition quality may be more responsive to fencing. There may be a trade-off between forage nutrition quality and quantity. Compared to the change in AGB caused by fencing, the changes in species α-diversity and community composition caused by fencing can have greater effects on the response of forage nutrition quality to fencing. Local climate conditions and the trade-offs between forage nutrition quality and biomass should be considered when evaluating the effects of fencing on the restoration of degraded grassland plants

Evaluation on real-time self-organization algorithm of forest cultivation, tea planting, and tea processing for sustainable ecosystem management of agricultural water resources

Agricultural water resources are water resources that can be used for agricultural production, including surface water, groundwater, and soil water. The sustainable use of water resources is of great significance to agriculture and rural economy. In the context of climate change and the increasing crisis of water resources, how to effectively use forest resources and other natural resources to achieve sustainable management of agricultural water ecosystems has become an increasingly urgent issue. Therefore, this paper proposed a real-time self-organization algorithm for forest cultivation, tea planting, and tea processing for sustainable ecosystem management of agricultural water resources. This paper described the sustainable ecosystem of agricultural water resources, carried out optimization analysis on tea planting and processing technology using the genetic optimization algorithm based on decision tree, and then carried out an experimental analysis on a tea garden. It can be seen from the data that the average monthly temperature of the tea garden cultivated by the algorithm in this paper was between 13.4 and 20.5 °C and the average annual temperature was 16.16 °C. However, the average monthly temperature of the traditional cultivation method was between 11.5 and 16.8 °C and the average annual temperature was 13.64 °C. HIGHLIGHTS A real-time self-organization algorithm for forest cultivation, tea planting, and tea processing is proposed for sustainable ecosystem management of agricultural water resources.; Optimization analysis on tea planting and processing technology is carried out using the genetic optimization algorithm based on a decision tree.; Experimental analysis is carried out on a tea garden.

Predictive model for estimating the risk of high-altitude pulmonary edema: a single-centre retrospective outcome-reporting study

Objective To develop the first prediction model based on the common clinical symptoms of high-altitude pulmonary edema (HAPE), enabling early identification and an easy-to-execute self-risk prediction tool.Methods A total of 614 patients who consulted People’s Hospital of Tibet Autonomous Region between January 2014 and April 2022 were enrolled. Out of those, 508 patients (416 males and 92 females) were diagnosed with HAPE and 106 were patients without HAPE (33 females and 72 males). They were randomly distributed into training (n=431) and validation (n=182) groups. Univariate and multivariate analysis were used to screen predictors of HAPE selected from the 36 predictors; nomograms were established based on the results of multivariate analysis. The receiver operating characteristic curve (ROC) was developed to obtain the area under the ROC curve (AUC) of the predictive model, and its predictive power was further evaluated by calibrating the curve, while the Decision Curve Analysis (DCA) was developed to evaluate the clinical applicability of the model, which was visualised by nomogram.Results All six predictors were significantly associated with the incidence of HAPE, and two models were classified according to whether the value of SpO2 (percentage of oxygen in the blood) was available in the target population. Both could accurately predict the risk of HAPE. In the validation cohort, the AUC of model 1 was 0.934 with 95% CI (0.848 to 1.000), and model 2 had an AUC of 0.889, 95% CI (0.779 to 0.999). Calibration plots showed that the predicted and actual HAPE probabilities fitted well with internal validation, and the clinical decision curve shows intervention in the risk range of 0.01–0.98, resulting in a net benefit of nearly 99%.Conclusion The recommended prediction model (nomogram) could estimate the risk of HAPE with good precision, high discrimination and possible clinical applications for patients with HAPE. More importantly, it is an easy-to-execute scoring tool for individuals without medical professionals’ support