Prevalence of metabolic syndrome among middle-aged and elderly adults in China: current status and temporal trends

Background: Metabolic syndrome (MetS) is a cluster of major risk factors for cardiovascular diseases. We aimed to estimate prevalence and distribution of MetS among middle-aged and elderly adults in China. Methods: The present analysis used data from a national study in 2014–2015. We defined MetS by different definitions, and compared results of the present study and previous nationally representative studies to illustrate possible temporal changes in MetS prevalence. Results: The estimated prevalence of MetS was 18.4% by the ATP III criteria, 34.0% by the revised ATP III criteria, and 26.9% by IDF criteria. The prevalence was higher in women, older adults, those with lower education level, and in economically developed regions. Contrasting with previous national studies, adults in urban areas had a lower rate of MetS than those in rural areas (odds ratio 0.94; 95% CI 0.92−0.97). Rural adults had worse deterioration or less improvement in abdominal obesity, overweight, hypertension, and high fasting plasma glucose, than urban adults, which was particularly striking for women. Conclusion: While measures to prevent and control cardiovascular diseases need to be strengthened in China, rapid increasing risk factors among rural residents and women should be prioritized in making public health policy decisions

Hydrogen Sulfide Attenuates LPS-Induced Acute Kidney Injury by Inhibiting Inflammation and Oxidative Stress

In order to investigate the protective mechanism of hydrogen sulfide (H2S) in sepsis-associated acute kidney injury (SA-AKI), ten AKI patients and ten healthy controls were enrolled. In AKI patients, levels of creatinine (Cre), urea nitrogen (BUN), tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β), and myeloperoxidase (MPO) activity as well as concentrations of malondialdehyde (MDA) and hydrogen peroxide (H2O2) were significantly increased compared with those of controls. However, plasma level of H2S decreased and was linearly correlated with levels of Cre and BUN. After that, an AKI mouse model by intraperitoneal lipopolysaccharide (LPS) injection was constructed for in vivo study. In AKI mice, H2S levels decreased with the decline of 3-MST activity and expression; similar changes were observed in other indicators mentioned above. However, the protein expressions of TLR4, NLRP3, and caspase-1 in mice kidney tissues were significantly increased 6 h after LPS injection. NaHS could improve renal function and kidney histopathological changes, attenuate LPS-induced inflammation and oxidative stress, and inhibit expressions of TLR4, NLRP3, and caspase-1. Our study demonstrated that endogenous H2S is involved in the pathogenesis of SA-AKI, and exogenous H2S exerts protective effects against LPS-induced AKI by inhibiting inflammation and oxidative stress via the TLR4/NLRP3 signaling pathway

Local experience with extracorporeal membrane oxygenation in children with acute fulminant myocarditis.

To analyze the clinical effect of extracorporeal membrane oxygenation (ECMO) in children with acute fulminant myocarditis, we retrospectively analyzed the data of five children with acute fulminant myocarditis in the intensive care unit (ICU) at the Affiliated Children's Hospital, Zhejiang University from February 2009 to November 2012. The study group included two boys and three girls ranging in age from 9 to 13 years (median 10 years). Body weight ranged from 25 to 33 kg (mean 29.6 kg). They underwent extracorporeal membrane oxygenation (ECMO) through a venous-arterial ECMO model with an average ECMO supporting time of 89.8 h (40-142 h). Extracorporeal circulation was established in all five children. After treatment with ECMO, the heart rate, blood pressure, and oxygen saturation were greatly improved in the four children who survived. These four children were successfully weaned from ECMO and discharged from hospital machine-free, for a survival rate of 80% (4/5). One child died still dependent on the machine. Cause of death was irrecoverable cardiac function and multiple organ failure. Complications during ECMO included three cases of suture bleeding, one case of acute hemolytic renal failure and suture bleeding, and one case of hyperglycemia. During the follow-up period of 4-50 months, the four surviving children recovered with normal cardiac function and no abnormal functions of other organs. The application of ECMO in acute fulminant myocarditis, even in local centers that experience low incidence of this disease, remains an effective approach. Larger studies to determine optimal timing of placement on ECMO to guide local centers are warranted

Dechlorination of Excess Trichloroethene by Bimetallic and Sulfidated Nanoscale Zero-Valent Iron

Nanoscale zerovalent iron (nZVI) likely finds its application in source zone remediation. Two approaches to modify nZVI have been reported: bimetal (Fe–Me) and sulfidated nZVI (S-nZVI). However, previous research has primarily focused on enhancing particle reactivity with these two modifications under more plume-like conditions. In this study, we systematically compared the trichloroethene (TCE) dechlorination pathway, rate, and electron selectivity of Fe-Me (Me: Pd, Ni, Cu, and Ag), S-nZVI, and nZVI with excess TCE simulating source zone conditions. TCE dechlorination on Fe-Me was primarily via hydrogenolysis while that on S-nZVI and nZVI was mainly via β-elimination. The surface-area normalized TCE reduction rate (<i>k</i>^′_SA) of Fe–Pd, S-nZVI, Fe–Ni, Fe–Cu, and Fe–Ag were ∼6800-, 190-, 130-, 20-, and 8-fold greater than nZVI. All bimetallic modification enhanced the competing hydrogen evolution reaction (HER) while sulfidation inhibited HER. Fe–Cu and Fe–Ag negligibly enhanced electron utilization efficiency (ε_e) while Fe–Pd, Fe–Ni, and S-nZVI dramatically increased ε_e from 2% to ∼100%, 69%, and 72%, respectively. Adsorbed atomic hydrogen was identified to be responsible for the TCE dechlorination on Fe–Me but not on S-nZVI. The enhanced dechlorination rate along with the reduced HER of S-nZVI can be explained by that FeS conducting major electrons mediated TCE dechlorination while Fe oxides conducting minor electrons mediated HER

The cardiac function of the 4 survivors pre-ECMO, at the time of hospital discharge and at the follow-up visits.

<p>LVEF: lefr ventricular ejection fraction; LVFS: lefe ventricular fractional shortening.</p