Risk factors for cardiovascular disease in the Chinese population:recent progress and implications

Cardiovascular disease(CVD)is the leading cause of death in both urban and rural areas of China.The current evidence regarding CVD risk factors was primarily established in Western countries,with limited generalizability to the Chinese population.In China,a growing number of population-based prospective cohort studies have emerged that have yielded substantial research data on CVD risk factors in the past five years.The research studies have covered biological risk factors(e.g.,blood lipids,blood pressure,blood glucose,adiposity),lifestyle risk factors(e.g.,smoking,alcohol,diet,physical activity),environmental risk factors(e.g.,ambient and indoor air pollution),and risk prediction.This study aimed to systematically review the research progress on CVD risk factors in the Chinese population in the past five years.Prospective studies in China have identified biological,lifestyle,and environmental risk factors for CVD and its main subtypes,along with some protective factors unique to the Chinese(e.g.,spicy food and green tea).This review aimed to provide high-quality evidence for achieving the Outline of Healthy China 2030,developing disease prevention guidelines and measures,and deepening efforts for popularization of health knowledge.

Genetic and healthy lifestyle factors in relation to the incidence and prognosis of severe liver disease in the Chinese population

Background:Severe liver disease(SLD),including cirrhosis and liver cancer,constitutes a major disease burden in China.We aimed to examine the association of genetic and healthy lifestyle factors with the incidence and prognosis of SLD.Methods:The study population included 504,009 participants from the prospective China Kadoorie Biobank aged 30-79 years.The individuals were from 10 diverse areas in China without a history of cancer or liver disease at baseline.Cox regression was used to estimate adjusted hazard ratios(HRs)for incident SLD and death after SLD diagnosis associated with healthy lifestyle factors(smoking,alcohol,physical activity,and central adiposity).Additionally,the contribution of genetic risk for hepatitis B virus(HBV,assessed by genetic variants in major histocompatibility complex,class II,DP/DQ[HLA-DP/DQ]genes)was also estimated.Results:Compared with those with 0-1 healthy lifestyle factor,participants with 2,3,and 4 factors had 12%(HR 0.88[95%confidence interval[CI]0.85,0.92]),26%(HR 0.74[95%CI:0.69,0.79]),and 44%(HR 0.56[95%CI:0.48,0.65])lower risks of SLD,respectively.Inverse associations were observed among participants with both low and high genetic risks(HR per 1-point increase 0.83[95%CI:0.74,0.94]and 0.91[95%CI:0.82,1.02],respectively;P_(interaction)=0.51),although with a non-significant trend among those with a high genetic risk.Inverse associations were also observed between healthy lifestyle factors and liver biomarkers regardless of the genetic risk.Despite the limited power,healthy lifestyle factors were associated with a lower risk of death after incident SLD among participants with a low genetic risk(HR 0.59[95%CI:0.37,0.96]).Conclusions:Lifestyle modification may be beneficial in terms of lowering the risk of SLD regardless of the genetic risk.Moreover,it is also important for improving the prognosis of SLD in individuals with a low genetic risk.Future studies are warranted to examine the impact of healthy lifestyles on SLD prognosis,particularly among individuals with a high genetic risk.

Minimal improvement in coronary artery disease risk prediction in Chinese population using polygenic risk scores:evidence from the China Kadoorie Biobank

Background:Several studies have reported that polygenic risk scores(PRSs)can enhance risk prediction of coronary artery disease(CAD)in European populations.However,research on this topic is far from sufficient in non-European countries,including China.We aimed to evaluate the potential of PRS for predicting CAD for primary prevention in the Chinese population.Methods:Participants with genome-wide genotypic data from the China Kadoorie Biobank were divided into training(n=28,490)and testing sets(n=72,150).Ten previously developed PRSs were evaluated,and new ones were developed using clumping and thresholding or LDpred method.The PRS showing the strongest association with CAD in the training set was selected to further evaluate its effects on improving the traditional CAD risk-prediction model in the testing set.Genetic risk was computed by summing the product of the weights and allele dosages across genome-wide single-nucleotide polymorphisms.Prediction of the 10-year first CAD events was assessed using hazard ratios(HRs)and measures of model discrimination,calibration,and net reclassification improvement(NRI).Hard CAD(nonfatal I21-I23 and fatal I20-I25)and soft CAD(all fatal or nonfatal I20-I25)were analyzed separately.Results:In the testing set,1214 hard and 7201 soft CAD cases were documented during a mean follow-up of 11.2 years.The HR per standard deviation of the optimal PRS was 1.26(95%CI:1.19-1.33)for hard CAD.Based on a traditional CAD risk prediction model containing only non-laboratory-based information,the addition of PRS for hard CAD increased Harrell’s C index by 0.001(-0.001 to 0.003)in women and 0.003(0.001 to 0.005)in men.Among the different high-risk thresholds ranging from 1%to 10%,the highest categorical NRI was 3.2%(95%CI:0.4-6.0%)at a high-risk threshold of 10.0%in women.The association of the PRS with soft CAD was much weaker than with hard CAD,leading to minimal or no improvement in the soft CAD model.Conclusions:In this Chinese population sample,the current PRSs minimally changed risk discrimination and offered little improvement in risk stratification for soft CAD.Therefore,this may not be suitable for promoting genetic screening in the general Chinese population to improve CAD risk prediction.

Multimorbidity patterns and association with mortality in 0.5 million Chinese adults

Background:Few studies have assessed the relationship between multimorbidity patterns and mortality risk in the Chinese population.We aimed to identify multimorbidity patterns and examined the associations of multimorbidity patterns and the number of chronic diseases with the risk of mortality among Chinese middle-aged and older adults.Methods:We used data from the China Kadoorie Biobank and included 512,723 participants aged 30 to 79 years.Multimorbidity was defined as the presence of two or more of the 15 chronic diseases collected by self-report or physical examination at baseline.Multimorbidity patterns were identified using hierarchical cluster analysis.Cox regression was used to estimate the associations of multimorbidity patterns and the number of chronic diseases with all-cause and cause-specific mortality.Results:Overall,15.8%of participants had multimorbidity.The prevalence of multimorbidity increased with age and was higher in urban than rural participants.Four multimorbidity patterns were identified,including cardiometabolic multimorbidity(diabetes,coronary heart disease,stroke,and hypertension),respiratory multimorbidity(tuberculosis,asthma,and chronic obstructive pulmonary disease),gastrointestinal and hepatorenal multimorbidity(gallstone disease,chronic kidney disease,cirrhosis,peptic ulcer,and cancer),and mental and arthritis multimorbidity(neurasthenia,psychiatric disorder,and rheumatoid arthritis).During a median of 10.8 years of follow-up,49,371 deaths occurred.Compared with participants without multimorbidity,cardiometabolic multimorbidity(hazard ratios[HR]=2.20,95%confidence intervals[CI]:2.14-2.26)and respiratory multimorbidity(HR=2.13,95%CI:1.97-2.31)demonstrated relatively higher risks of mortality,followed by gastrointestinal and hepatorenal multimorbidity(HR=1.33,95%CI:1.22-1.46).The mortality risk increased by 36%(HR=1.36,95%CI:1.35-1.37)with every additional disease.Conclusion:Cardiometabolic multimorbidity and respiratory multimorbidity posed the highest threat on mortality risk and deserved particular attention in Chinese adults.

层状双氢氧化物上的单原子活性中心调控实现高效的尿素电解

阳极尿素氧化反应(UOR)不仅可以取代析氧反应(OER)降低能耗,还可与析氢反应(HER)协同作用,同时产生氢燃料并净化富含尿素废水.然而,如何高效实现全电解尿素仍然面临挑战.本文首先将铑单原子催化剂(SAC)锚定到镍钒层状双氢氧化物(LDH)表面,以获得多功能电催化剂即Rh/NiV-LDH.该催化剂可以实现低能耗全电解尿素产氢目标.Rh/NiV-LDH在100 mV过电位下具有较高HER质量活性(0.262 A mg^(-1))和转化频率(TOF:2.125 s^(-1))此外,Rh/NiV-LDH表现出优异的UOR催化活性,仅需要1.33 V电压即可达到10 mA cm^(-2)的电流密度,表明UOR具备克服缓慢OER动力学缓慢的潜力.实验数据和理论计算证明,Rh/NiV-LDH出色的催化活性归因于NiV-LDH载体和单原子Rh位点的协同作用.将自支撑Rh/NiV-LDH分别作为尿素全电解池的阴极和阳极(1.0 mol L^(-1)KOH+0.33 mol L^(-1)尿素作为电解液),只需要1.47 V的低电压就可以提供100 mA cm^(-2)的电流密度且具有良好稳定性.这项工作从单原子精确调控的角度对全电解多功能SAC的设计具有重要指导意义.

Optical Trapping and Manipulation Using Optical Fibers

An optical trap forms a restoring optical force field to immobilize and manipulate tiny objects.A fiber optical trap is capable of establishing the restoring optical force field using one or a few pieces of optical fiber,and it greatly simplifies the optical setup by removing bulky optical components,such as microscope objectives from the working space.It also inherits other major advantages of optical fibers:flexible in shape,robust against disturbance,and highly integrative with fiber-optic sys-tems and on-chip devices.This review will begin with a concise introduction on the principle of optical trapping techniques,followed by a comprehensive discussion on different types of fiber optical traps,including their structures,functionalities and associated fabrication techniques.A brief outlook to the future development and potential applications of fiber optical traps is given at the end.

Current Progress and Challenges to Tobacco Control in China

In May 2003,the World Health Organization(WHO)Framework Convention on Tobacco Control(FCTC)was released(1),which is an event of great significance in the history of tobacco control.The FCTC was signed by China in November 2003 and entered into force in January 2006.Although some achievements in tobacco control have been made over the past 15 years,much more progress is needed.In July 2021,the WHO Report on the Global Tobacco Epidemic(Report)was released.The Report evaluates and grades implementation of the 6 most effective strategies of the Monitor,Protect,Offer,Warn,Enforce and Raise(MPOWER)tobacco control package in 61 high-income countries,105 middleincome countries,and 29 low-income countries(2)(Table 1).This article summarizes current progress and challenges to tobacco control in China with reference to the Report.

中国成人糖尿病、血糖与结直肠癌发病率:针对50万人的前瞻性研究

背景糖尿病可致结直肠癌(CRC)的发病风险升高。糖尿病病程和非糖尿病患者的血糖与CRC发病风险之间的相关性仍不清楚。方法2004至2008年前瞻性中国Kadoofe Biobank研究从10个不同地区纳入了512 713名受试者。在10年随访期间,在基线无癌症史的510 136名受试者中共记录有3 024例新发CRC病例(1 745例结肠癌,1 716例直肠癌)。应用Cox回归分析对糖尿病(入组前诊断或筛查发现的)或无糖尿病病史者随机血糖(RPG)水平与CRC发病相关性的校正风险比(HR)进行估计。结果基线时,共有5.8%的受试者患有糖尿病。糖尿病患者发生CRC的校正HR为1.18(95%可信区间1.04~1.33),且发生结肠癌与直肠癌的风险相当[1.19(1.01~1.39)比1.14(0.96~1135)]。这些患者发生CRC的HR随糖尿病病程的延长而下降(趋势P值为0.03)。在入组前无糖尿病的受试者中,其RPG水平与CRC发病呈正相关,基线RPG每升高1 mmol/L其发生CRC的校正HR为1.04(1.02~1.05),且发生结肠癌与直肠癌的风险亦相当[1.03(1.01~1.05)比1.04(1.02~1.06)]。在男性中,糖尿病和RPG与CRC发病风险的相关性高于女性,但其差异无统计学意义(异质性检验的P值分别为0.3和0.2)。讨论在中国成年人中,未诊断糖尿病者其糖尿病和升高的血糖水平与CRC发病风险升高相关。

Optical trapping using transverse electromagnetic(TEM)-like mode in a coaxial nanowaveguide

Optical traps have emerged as powerful tools for immobilizing and manipulating small particles in three dimensions.Fiber-based optical traps(FOTs)significantly simplify optical setup by creating trapping centers with single or multiple pieces of optical fibers.In addition,they inherit the flexibility and robustness of fiber-optic systems.However,trapping 10-nm-diameter nanoparticles(NPs)using FOTs remains challenging.In this study,we model a coaxial waveguide that works in the optical regime and supports a transverse electromagnetic(TEM)-like mode for NP trapping.Single NPs at waveguide front-end break the symmetry of TEM-like guided mode and lead to high transmission efficiency at far-field,thereby strongly altering light momentum and inducing a large-scale back-action on the particle.We demonstrate,via finite-difference time-domain(FDTD)simulations,that this FOT allows for trapping single 10-nm-diameter NPs at low power.

银纳米线有序化实现手性光学活性

随着数十年的研究,手性材料在生物、化学、物理等领域的应用取得了显著进展.本文报道了一种基于纯银纳米线、自下而上的手性构建策略,用以制备在紫-蓝光能带中具有较强光学活性的手性等离子体薄膜.时域有限差分模拟预测了一定层间角的银纳米线螺旋结构具有较强的手性光学活性.我们采用Langmuir-Blodgett技术通过调节层间角度和方向,构建了具有左、右旋手性的层状纳米线组装结构.银纳米线组装体的圆二色性强度与层间角和膜厚相关,其不对称因子最高可达0.03.这些新的手性结构由于特殊的等离子特性,将成为手性传感器的理想主体材料.