Lifestyle improvement and the reduced risk of cardiovascular disease:the China-PAR project

BACKGROUND The benefits of healthy lifestyles are well recognized. However, the extent to which improving unhealthy lifestyles reduces cardiovascular disease(CVD) risk needs to be discussed. We evaluated the impact of lifestyle improvement on CVD incidence using data from the China-PAR project(Prediction for Atherosclerotic Cardiovascular Disease Risk in China).METHODS A total of 12,588 participants free of CVD were followed up for three visits after the baseline examination. Changes in four lifestyle factors(LFs)(smoking, diet, physical activity, and alcohol consumption) were assessed through questionnaires from the baseline to the first follow-up visit. Cox proportional hazard models were used to estimate hazard ratios(HRs) and corresponding 95% confidence intervals(CIs). The risk advancement periods(RAPs: the age difference between exposed and unexposed participants reaching the same incident CVD risk) and population-attributable risk percentage(PAR%) were also calculated.RESULTS A total of 909 incident CVD cases occurred over a median follow-up of 11.14 years. Compared with maintaining 0-1healthy LFs, maintaining 3–4 healthy LFs was associated with a 40% risk reduction of incident CVD(HR = 0.60, 95% CI: 0.45–0.79)and delayed CVD risk by 6.31 years(RAP:-6.31 [-9.92,-2.70] years). The PAR% of maintaining 3–4 unhealthy LFs was 22.0%compared to maintaining 0-1 unhealthy LFs. Besides, compared with maintaining two healthy LFs, improving healthy LFs from 2to 3–4 was associated with a 23% lower risk of CVD(HR = 0.77, 95% CI: 0.60–0.98).CONCLUSIONS Long-term sustenance of healthy lifestyles or improving unhealthy lifestyles can reduce and delay CVD risk.

Beneficial effects of moderate to vigorous physical activity on cardiovascular disease among Chinese adults

Background In China,lack of evidence remains a significant challenge for the national initiative to promote physical activity(PA).We aimed to quantify the beneficial effects of meeting or maintaining the recommended PA level[150 minutes per week(min/wk)of moderate PA or 75 min/wk of vigorous PA or an equivalent combination]on incident cardiovascular disease(CVD)among Chinese population.Methods We included 100,560 participants without history of CVD from three cohorts in the Prediction for Atherosclerotic Cardiovascular Disease Risk in China(China-PAR)project.Cox proportional hazards models were used to estimate hazard ratios(HRs)and 95%confidence intervals(CIs)for CVD events and its subtypes,including stroke,coronary heart disease,heart failure,and CVD death.Results During a median follow-up of 7.3 years(range:6–15 years),777,163 person-years and 4693 incident CVD events were observed.Compared with participants who were inactive at baseline,the multivariable adjusted HR(95%CI)of developing CVD was 0.74(0.69–0.79)for those who met recommended moderate to vigorous physical activity(MVPA)level at baseline.Furthermore,the risk of CVD incidence was reduced with increment of MVPA(Ptrend<0.001),and the HR(95%CI)of highly-active versus inactive category was 0.62(0.56–0.68).Compared with individuals who were inactive both at the baseline and follow-up,those keeping active over the period of follow-up had a substantial lower risk of incident CVD with the HR(95%CI)of 0.57(0.43–0.77).Conclusions The findings demonstrated that meeting and maintaining the recommended MVPA level could reduce the cardiovascular risk.Wider adoption of the PA recommendations would have considerable health impacts to the Chinese population.

Subclinical atherosclerosis in northern and southern China： the Chinese paradox

背景冠的心疾病(CHD ) 的发生是更高的在北比在南部的中国，然而，在传统的 CHD 的差别冒险的，解释这。没有学习在可以帮助在发生解释差别的无临床症状的动脉粥样硬化检验了差别。这研究为在北、南部的中国之间的石灰化用冠的计算断层摄影术(CT ) 在无临床症状的动脉粥样硬化检验了这些差别。我们在一个大多中心选择了参加者的一件随机的样品的方法为冠的钙在一个北城市(诺思) 里扫描的进行中的流行病的学习(北京， n = 49 ) 并且在二个南部的城市(南方) 里(上海， n = 50，并且广州， n = 50 ) 。从三个领域中心的参加者(意味着年龄 67 年) 经历了用动脉粥样硬化扫描的多种族的学习为冠的钙测量扫描的冠的风险因素评估和心脏的 CT 协议。结果调整了在诺思中国(北京) 的转变木头的冠的动脉钙 20 是 3.1 +/-0.4 并且在华南(上海和广州) 是 2.2 +/- 0.3 (P = 0.04 ) 。为北京的北城市的吝啬的钙分数比广州的南部的城市的高三倍(P = 0.01 ) 并且比为上海的南部的城市高 2.5 倍(P = 0.03 ) 。结论无临床症状的动脉粥样硬化的程度在广州和上海的二个南部的城市里比那在北京的北城市里是显著地更高的，甚至在为标准心脏的风险因素调整以后。这发现建议标准风险因素充分不在临床的 CHD 发生解释北方南方差别。

Effects of the total physical activity and its changes on incidence, progression, and remission of hypertension

OBJECTIVES Moderate to vigorous physical activity is recommended to prevent hypertension according to the current guidelines.However,the degree to which the total physical activity(TPA)and its changes benefit normotensives and hypertensives is uncertain.We aimed to examine the effects of TPA and its changes on the incidence,progression,and remission of hypertension in the large-scale prospective cohorts.METHODS A total of 73,077 participants(55,101 normotensives and 17,976 hypertensives)were eligible for TPA analyses.During a mean follow-up of 7.16 years(394,038 person-years),12,211 hypertension cases were identified.TPA was estimated as metabolic equivalents and categorized into quartiles.Cox proportional hazards regression and multivariable logistic regression were used to estimate associations of TPA and changes in TPA with incident hypertension and progression/remission of hypertension.RESULTS Compared with the lowest quartile of TPA,normotensives at the third and the highest quartile had a decreased risk of incident hypertension,with hazard ratios(HRs)of 0.86[95%confidence interval(CI):0.81−0.91]and 0.81(95%CI:0.77−0.86),respectively.Hypertensives at the highest quartile of TPA demonstrated a decreased risk of progression of hypertension[odds ratio(OR)=0.87,95%CI:0.79−0.95],and an increased probability of hypertension remission(OR=1.17,95%CI:1.05−1.29).Moreover,getting active from a sedentary lifestyle during the follow-up period could reduce 25%(HR=0.75,95%CI:0.58−0.96)risk of incident hypertension,whereas those becoming sedentary did not achieve benefit from initially being active.CONCLUSIONS Our findings indicated that increasing and maintaining TPA levels could benefit normotensives,whereas higher TPA levels were needed to effectively control progression and improve remission of hypertension.Physical activity played undoubtedly an essential role in both primary and secondary prevention of hypertension.

Investigation of gate oxide traps effect on NAND flash memory by TCAD simulation

The effects of gate oxide traps on gate leakage current and device performance of metal–oxide–nitride–oxide–silicon(MONOS)-structured NAND flash memory are investigated through Sentaurus TCAD. The trap-assisted tunneling(TAT)model is implemented to simulate the leakage current of MONOS-structured memory cell. In this study, trap position, trap density, and trap energy are systematically analyzed for ascertaining their influences on gate leakage current, program/erase speed, and data retention properties. The results show that the traps in blocking layer significantly enhance the gate leakage current and also facilitates the cell program/erase. Trap density ~10^(18) cm^(-3) and trap energy ~ 1 eV in blocking layer can considerably improve cell program/erase speed without deteriorating data retention. The result conduces to understanding the role of gate oxide traps in cell degradation of MONOS-structured NAND flash memory.

Review of 2D Bi_(2)X_(3)(X=S,Se,Te):from preparation to photodetector

Detector has become an indispensable part of human beings.The increasing demand for photodetectors with high performance has promoted the research of novel materials.At the same time,with the development of rising material system,two-dimensional(2D)materials attract a lot of attention,while the suitable option for fabricating photodetector is still limited.The prospering of bismuth chalcogenides injected new vitality for material field,thereinto,the unique topological insulator characteristics make the research on bismuth selenide(Bi_(2)X_(3))and bismuth telluride(Bi_(2)X_(3))intriguing.2D Bi_(2)X_(3)also exhibits unique features among various 2D materials,of which,the adjustable narrow energy band gap and polarization-sensitive photocurrent contribute to the promising application of high performance and broadband photodetector.In this review,from a bottom-up perspective,we summarize fundamental properties,synthesis method,photodetector performance of 2D Bi_(2)X_(3)based on the previous study,which provide an overall perspective of 2D Bi_(2)X_(3).Wherein,the section of the photodetector is specifically discu ssed with regard to pure Bi_(2)X_(3)photodetector and heterojunction photodetector.A brief summary and outlook were also explored in the end.

Association of cardiovascular diseases with milk intake among general Chinese adults

Background:The association of milk intake with cardiovascular disease(CVD)and cause-specific mortality remained controversial and evidence among the Chinese population was limited.We aimed to study the relationship between milk intake and CVDs among general Chinese adults.Methods::A total of 104,957 participants received questionnaire survey.Results of physical examination such as anthropometric measurements and biochemical tests during 2007 to 2008,demographic data and their information on milk intake were collected through standardized questionnaires.Cox proportional hazard regression models were used to calculate hazard ratios(HRs)and their corresponding 95%confidence intervals(CIs)of CVD incidence,cause-specific mortality and all-cause mortality related to milk intake.Restricted cubic splines(RCSs)were applied to examine dose-response associations.Results::Among the 91,757 participants with a median follow-up period of 5.8 years,we documented 3877 CVD cases and 4091 all-cause deaths.Compared with participants who never consumed milk,the multivariate-adjusted HRs(95%CIs)of CVD incidence for 1 to 150 g/day,151 to 299 g/day,and≥300 g/day were 0.94(0.86-1.03)(P>0.05),0.77(0.66-0.89)(P<0.05),and 0.59(0.40-0.89)(P<0.05),respectively;each 100 g increase of daily milk intake was associated with 11%lower risk of CVD incidence(HR,0.89;95%CI:0.85-0.94;P<0.001),and 11%lower risk of CVD mortality(HR,0.89;95%CI:0.82-0.97;P=0.008)after adjustment for age,sex,residential area,geographic region,education level,family history of CVD,smoking,alcohol drinking,physical activity level,body mass index,and healthy diet status(ideal or not).RCS analyses also showed a linear dose-response relationship with CVD(P for overall significance of the curve<0.001;P for non-linearity=0.979;P for linearity<0.001)and stroke(P for overall significance of the curve=0.010;P for non-linearity=0.998;P for linearity=0.002)incidence,and CVD mortality(P for overall significance of the curve=0.045;P for non-linearity=0.768;P for linearity=0.014)within the current range of daily milk intake.Conclusions::Daily milk intake was associated with lower risk of CVD incidence and mortality in a linear inverse relationship.The findings provide new evidence for dietary recommendations in CVD prevention among Chinese adults and people with similar dietary pattern in other countries.

Fasting glucose and its association with 20-year all-cause and cause-specific mortality in Chinese general population

Objective: The aim of this study was to explore the relationship between fasting glucose levels and all-cause and cause-specific mortality in Chinese population. Methods: The role of fasting blood glucose levels as a predictor of all-cause and cause-specific mortality was estimated in 9930 participants from four Chinese general populations with a 20-year follow-up. Multivariate Cox proportional hazard models were used to identify the relationship between fasting glucose and mortality. Results: There were 1471 deaths after a median follow-up of 20.2 years (a total of 187,374 person-years), including 310 cardiovascular deaths, 581 cancer deaths, and 580 other-cause deaths. After adjustment for age, sex, urban or rural, northern or southern of China, types of work, education level, physical exercise, smoking status, drinking status, body mass index, systolic blood pressure, and serum total cholesterol at baseline, the hazard ratios (HRs) and 95% confidence intervals (C/s) for all-cause mortality in the fasting blood glucose categories of <60, 60—69, 70—79, 90—99, 100—109, 110—125, and >126 mg/dl were 1.38 (1.04-1.84), 1.20 (1.01-1.43), 1.18 (1.03-1.36), 1.18 (0.99-1.41), 1.48 (1.16-1.88), 1.17 (0.84-1.62), and 2.23 (1.72—2.90), respectively, in contrast to the reference group (80—89 mg/dl). The HRs, and 95% C/s for cardiovascular disease mortality in these groups were 2.58 (1.44-4.61), 1.41 (0.95-2.10), 1.56 (1.15-2.11), 1.29 (0.88-1.89), 1.36 (0.78-2.37), 1.05 (0.52—2.11), and 2.73 (1.64—4.56), respectively. Conclusions: Both low and high fasting glucose were significantly associated with increased risk of all-cause and cardiovascular mortality in Chinese general population.