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.

Associations of polygenic risk scores with risks of stroke and its subtypes in Chinese

Background and purpose Previous studies,mostly focusing on the European population,have reported polygenic risk scores(PRSs)might achieve risk stratification of stroke.We aimed to examine the association strengths of PRSs with risks of stroke and its subtypes in the Chinese population.Methods Participants with genome-wide genotypic data in China Kadoorie Biobank were split into a potential training set(n=22191)and a population-based testing set(n=72150).Four previously developed PRSs were included,and new PRSs for stroke and its subtypes were developed.The PRSs showing the strongest association with risks of stroke or its subtypes in the training set were further evaluated in the testing set.Cox proportional hazards regression models were used to estimate the association strengths of different PRSs with risks of stroke and its subtypes(ischaemic stroke(IS),intracerebral haemorrhage(ICH)and subarachnoid haemorrhage(SAH)).Results In the testing set,during 872919 person-years of follow-up,8514 incident stroke events were documented.The PRSs of any stroke(AS)and IS were both positively associated with risks of AS,IS and ICH(p<0.05).The HR for per SD increment(HR_(SD))of PRSAS was 1.10(95%CI 1.07 to 1.12),1.10(95%CI 1.07 to 1.12)and 1.13(95%CI 1.07 to 1.20)for AS,IS and ICH,respectively.The corresponding HR_(SD) of PRS_(IS) was 1.08(95%CI 1.06 to 1.11),1.08(95%CI 1.06 to 1.11)and 1.09(95%CI 1.03 to 1.15).PRS_(ICH) was positively associated with the risk of ICH(HR_(SD)=1.07,95%CI 1.01 to 1.14).PRSS_(AH) was not associated with risks of stroke and its subtypes.The addition of current PRSs offered little to no improvement in stroke risk prediction and risk stratification.Conclusions In this Chinese population,the association strengths of current PRSs with risks of stroke and its subtypes were moderate,suggesting a limited value for improving risk prediction over traditional risk factors in the context of current genome-wide association study under-representing the East Asian population.

Quantifying trapping stability of optical tweezers with an external flow

Optical tweezers(OTs)can immobilize and manipulate objects with sizes that span between nano-and micrometer scales.The manipulating ability of OTs is traditionally characterized by stability factor(S),which can only indicate an empirical“hit-or-miss”process.Additionally,the current quantitative models for trapping stability rarely consider the influence of external flow.In this paper,a comprehensive analysis to quantify the optical trapping stability in a perturbed asymmetric potential well is presented from the perspective of statistics,especially for weak trapping scenarios.Our analytical formulation takes experimentally measurable parameters including particle size,optical power,and spot width as inputs and precisely outputs a statistically relevant mean trapping time.Importantly,this formulation takes into account general and realistic cases including fluidic flow velocity and other perturbations.To verify the model,a back-focal-plane-interferometer-monitored trapping experiment in a flow is set up and the statistical characteristics of trapping time demonstrate good agreement with theoretical predictions.In total,the model quantitatively reveals the effects of external disturbance on trapping time,which will find applications where optical trapping stability is challenged by external perturbations in weak trapping conditions.

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.

Highly efficient overall urea electrolysis via single-atomically active centers on layered double hydroxide

Anodic urea oxidation reaction(UOR)is an intriguing half reaction that can replace oxygen evolution reaction(OER)and work together with hydrogen evolution reaction(HER)toward simultaneous hydrogen fuel generation and urea-rich wastewater purification;however,it remains a challenge to achieve overall urea electrolysis with high efficiency.Herein,we report a multifunctional electrocatalyst termed as Rh/Ni V-LDH,through integration of nickel-vanadium layered double hydroxide(LDH)with rhodium single-atom catalyst(SAC),to achieve this goal.The electrocatalyst delivers high HER mass activity of0.262 A mg^(-1) and exceptionally high turnover frequency(TOF)of 2.125 s^(-1) at an overpotential of100 m V.Moreover,exceptional activity toward urea oxidation is addressed,which requires a potential of 1.33 V to yield 10 mA cm^(-2),endorsing the potential to surmount the sluggish OER.The splendid catalytic activity is enabled by the synergy of the Ni V-LDH support and the atomically dispersed Rh sites(located on the Ni-V hollow sites)as evidenced both experimentally and theoretically.The selfsupported Rh/Ni V-LDH catalyst serving as the anode and cathode for overall urea electrolysis(1 mol L^(-1) KOH with 0.33 mol L^(-1) urea as electrolyte)only requires a small voltage of 1.47 V to deliver 100 mA cm^(-2) with excellent stability.This work provides important insights into multifunctional SAC design from the perspective of support sites toward overall electrolysis applications.

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.

Ordering silver nanowires for chiroptical activity

With the development of chiral materials, remarkable progress has been made in the application fields of biology, chemistry, and physics in the past decades. Here we develop a solo-Ag-nanowire(NW)-based, bottom-up chiral construction strategy to fabricate a chiral plasmonic film with strong chiroptical activity in the purple-blue band. Finitedifference time-domain simulations predict that helical structures made by Ag NWs with certain interlayer angles possess strong chiroptical intensity. We then apply a Langmuir-Blodgett technique to construct the layered NW assemblies with both handedness via regulating interlayer angle direction. The Ag NW assemblies show the interlayer-angleand film-thickness-dependent circular dichroism, reaching the highest anisotropic factor of 0.03. These new chiral structures will serve as ideal candidates for chiral sensors thanks to their specific plasmonic properties.