Analysis of the relationship between 24-hour sodium and blood pressure and the dietary status based on mobile phone APP in the high-risk population of hypertension in Haikou

Objective:To understand the dietary intake of high-risk population with hypertension in Haikou,and to analyze the relationship between dietary intake and blood pressure,especially the relationship between sodium intake and blood pressure,so as to provide a scientific basis for salt reduction.Methods:A multi-stage cluster sampling 2021 was used from July to December to collect 3-4 cscs from each of the four districts in Haikou.A total of 15 cscs were collected,295 permanent residents aged 55-74 were recruited from 15 community service centers,with 20 eligible subjects from each community.The subjects underwent general physical examination,laboratory tests,and a dietary survey using the self-developed Android phone APP“Nutrition Assistant”(registration number:2021SR1547832).SPSS 21.0 was used 2 for t test,x^(2) test and multiple Regression analysis.Result:In Haikou,69.4%of the subjects had energy intake above energy requirement,and 44.8%had fat intake above the acceptable range of macronutrients.There were only differences in energy,carbohydrate,vitamin B 6 and sodium intake(t=-2.174,-1.990,2.333,-5.442,P=0.031,0.048,0.021,<0.001,respectively).There were significant differences in BMI,family history of chronic diseases,systolic blood 2 pressure and diastolic blood pressure(f value or x^(2) value were 4.260,19.045,139.916,36.864,P value were 0.015,<0.001,<0.001,<0.001,respectively).Multiple Regression analysis analysis showed that 24h sodium excretion was significantly correlated with systolic and diastolic blood pressure(t=12.964,P<0.001),systolic and diastolic blood pressure increased by 0.135 mmhg and 0.068 mmhg,respectively.Conclusion:The dietary intake of the middle-aged and elderly people at high risk of hypertension in the Haikou community was unbalanced,and the intake of sodium salt was strongly correlated with blood pressure,it is necessary to continue to promote salt reduction as one of the key ways to prevent and control hypertension.

Association between PPARG genetic polymorphisms and ischemic stroke risk in a northern Chinese Han population: a case-control study

Two common polymorphisms of the peroxisome proliferator-activated receptor gamma(PPARG) gene, rs1801282 and rs3856806, may be important candidate gene loci affecting the susceptibility to ischemic stroke. This case-control study sought to identify the relationship between these two single-nucleotide polymorphisms and ischemic stroke risk in a northern Chinese Han population. A total of 910 ischemic stroke participants were recruited from the First Hospital of China Medical University, Shenyang, China as a case group, of whom 895 completed the study. The 883 healthy controls were recruited from the Health Check Center of the First Hospital of China Medical University, Shenyang, China. All participants or family members provided informed consent. The study protocol was approved by the Ethics Committee of the First Hospital of China Medical University, China on February 20, 2012(approval No. 2012-38-1). The protocol was registered with the Chinese Clinical Trial Registry(registration number: ChiCTR-COC-17013559). Plasma genomic DNA was extracted from all participants and analyzed for rs1801282 and rs3856806 single nucleotide polymorphisms using a SNaPshot Multiplex sequencing assay. Odds ratios(ORs) and 95% confidence intervals(CIs) were calculated using unconditional logistic regression to estimate the association between ischemic stroke and a particular genotype. Results demonstrated that the G allele frequency of the PPARG gene rs1801282 locus was significantly higher in the case group than in the control group(P < 0.001). Individuals carrying the G allele had a 1.844 fold increased risk of ischemic stroke(OR = 1.844, 95% CI: 1.286–2.645, P < 0.001). Individuals carrying the rs3856806 T allele had a 1.366 fold increased risk of ischemic stroke(OR = 1.366, 95% CI: 1.077–1.733, P = 0.010). The distribution frequencies of the PPARG gene haplotypes rs1801282-rs3856806 in the control and case groups were determined. The frequency of distribution in the G-T haplotype case group was significantly higher than that in the control group. The risk of ischemic stroke increased to 2.953 times in individuals carrying the G-T haplotype(OR = 2.953, 95% CI: 2.082–4.190, P < 0.001). The rs1801282 G allele and rs3856806 T allele had a multiplicative interaction(OR = 3.404, 95% CI: 1.631–7.102, P < 0.001) and additive interaction(RERI = 41.705, 95% CI: 14.586–68.824, AP = 0.860;95% CI: 0.779–0.940;S = 8.170, 95% CI: 3.772–17.697) on ischemic stroke risk, showing a synergistic effect. Of all ischemic stroke cases, 86% were attributed to the interaction of the G allele of rs1801282 and the T allele of rs3856806. The effect of the PPARG rs1801282 G allele on ischemic stroke risk was enhanced in the presence of the rs3856806 T allele(OR = 8.001 vs. 1.844). The effect of the rs3856806 T allele on ischemic stroke risk was also enhanced in the presence of the rs1801282 G allele(OR = 2.546 vs. 1.366). Our results confirmed that the G allele of the PPARG gene rs1801282 locus and the T allele of the rs3856806 locus may be independent risk factors for ischemic stroke in the Han population of northern China, with a synergistic effect between the two alleles.

Associations between thromboxane A synthase 1 gene polymorphisms and the risk of ischemic stroke in a Chinese Han population

Thromboxane A synthase 1 （TBXAS1） catalyses the synthesis of thromboxane A2 （TXA2）, which plays an important role in the pathogenesis of ischemic stroke. Thus, the TBXAS1 gene was investigated as a candidate gene involved in the formation of atherosclerosis. This case-control study collected peripheral blood specimens and clinical data of 370 ischemic stroke patients and 340 healthy controls in the Northern Chinese Han population from October 2010 to May 2011. Two TBXAS1 single-nucleotide polymorphisms, rs2267682 and rs10487667, were analyzed using a SNaPshot Multiplex sequencing assay to explore the relationships between the single-nucleotide polymorphisms in TBXAS1 and ischemic stroke. The TT genotype frequency and T allele frequency of rs2267682 in the patients with ischemic stroke were significantly higher than those in the controls （P 〈 0.01 and P = 0.02）. Furthermore, compared with the GG ＋ GT genotype, the TT rs2267682 genotype was associated with increased risk of ischemic stroke （odds ratio （OR） = 1.80, 95% confidence interval （CI）： 1.16–2.79, P 〈 0.01）. Multivariate logistic analysis with adjustments for confounding factors revealed that rs2267682 was still associated with ischemic stroke （OR = 1.94,95% CI ： 1.13–3.33, P = 0.02）. The frequency of the T-G haplotype in the patients was significantly higher than that in the controls according haplotype analysis （OR = 1.49, 95% CI： 1.10–2.00, P 〈 0.01）. These data reveal that the rs2267682 TBXAS1 polymorphism is associated with ischemic stroke. The TT genotype of TBXAS1 and T allele of rs2267682 increase susceptibility to ischemic stroke in this Northern Chinese Han population. The protocol has been registered with the Chinese Clinical Trial Registry （registration number： ChiCTR-COC-17013559）.

Association of G-protein coupled purinergic receptor P2Y2 with ischemic stroke in a Han Chinese population of North China

The G-protein-coupled purinergic receptor P2Y2(P2RY2) plays an important role in the mechanism of atherosclerosis, which is relevant to ischemic stroke. This retrospective case-control study aimed to assess the relationship between P2RY2 gene polymorphisms and ischemic stroke risk in the northern Han Chinese population. In this study, clinical data and peripheral blood specimens were collected from 378 ischemic stroke patients and 344 controls. The ischemic stroke participants were recruited from the First Affiliated Hospital of China Medical University and the First Affiliated Hospital of Liaoning Medical University. The controls were recruited from the Health Check Center at the First Affiliated Hospital of China Medical University. Ischemic stroke patients were divided into two subgroups according to the Trial of ORG 10172 in Acute Stroke Treatment(TOAST) classification: large-artery atherosclerosis(n = 178) and small-artery occlusion(n = 200) strokes. All subjects were genotyped for three single nucleotide polymorphisms(rs4944831, rs1783596, and rs4944832) in the P2RY2 gene using peripheral venous blood samples. The distribution of the dominant rs4944832 phenotype(GG vs. GA+AA) differed significantly between small-artery occlusion patients and control subjects(odds ratio(OR) = 1.720, 95% confidence interval(CI): 1.203–2.458, P < 0.01). Multivariable logistic regression analysis revealed that the GG genotype of rs4944832 was significantly more prevalent in small-artery occlusion patients than in control subjects(OR = 1.807, 95% CI: 1.215–2.687, P < 0.01). The overall distribution of the haplotype established by rs4944831-rs1783596-rs4944832 was significantly different between ischemic stroke patients and controls(P < 0.01). In ischemic stroke patients, the frequency of the G-C-G haplotype was significantly higher than in control subjects(P = 0.028), whereas the frequency of the T-C-A haplotype was lower than in control subjects(P = 0.047). These results indicate that the G-C-G haplotype of P2RY2 is a susceptibility haplotype for ischemic stroke. In addition, the GG genotype of rs4944832 may be associated with the development of small-artery occlusion in the northern Han Chinese population. The study protocol was approved by the Ethics Committee of the First Affiliated Hospital of China Medical University on February 20, 2012(No. 2012-38-1) and the First Affiliated Hospital of Liaoning Medical University, China, on March 1, 2013(No. 2013-03-1). All participants gave their informed consent. This trial was registered with the ISRCTN Registry(ISRCTN11439124) on October 24, 2018. Protocol version(1.0).

Age scope of high-risk population for esophageal cancer in Ci county

AIM: To define the age scope of high-risk population for esophageal cancer (EC) in Ci county. METHODS: The results of endoscopic examination of 2 013 subjects, cytological screening of 16 763 persons and records of 9 265 patients with EC were analyzed by Ridit methods, the standard age group was 45-49 year group. RESULTS: The average age of patients with moderate esophageal epithelium dysplasia by endoscopic examination was 53.5 years, of severe esophageal epithelium dysplasia, 51.4 years, early EC, 55.6 years. The average age of stage one severe epithelium dysplasia (SEEDⅠ) by cytological screening was 51.2 years, of stage two severe epithelium esophageal dysplasia (SEED Ⅱ) 51.6 years, of advanced EC 61.7 years. In the group of 40-year olds, the value of Ridit by pathological diagnosis was 0.46, 95% CI, 0.45-0.47, that by cytological diagnosis was 0.45, 95% CI, 0.43-0.47. As the age increased at five-year intervals, the value of Ridit increased significantly. CONCLUSION: In Ci county of a high incidence area of EC, the age definition of high-risk population should be above 45 years.

Living with liver disease in the era of COVID-19-the impact of the epidemic and the threat to high-risk populations

The cardinal symptoms of severe acute respiratory syndrome coronavirus 2 infection as the pandemic began in 2020 were cough,fever,and dyspnea,thus characterizing the virus as a predominantly pulmonary disease.While it is apparent that many patients presenting acutely to the hospital with coronavirus disease 2019(COVID-19)infection have complaints of respiratory symptoms,other vital organs and systems are also being affected.In fact,almost half of COVID-19 hospitalized patients were found to have evidence of some degree of liver injury.Incidence and severity of liver injury in patients with underlying liver disease were even greater.According to the Centers of Disease Control and Prevention,from August 1,2020 to May 31,2022 there have been a total of 4745738 COVID-19 hospital admissions.Considering the gravity of the COVID-19 pandemic and the incidence of liver injury in COVID-19 patients,it is imperative that we as clinicians understand the effects of the virus on the liver and conversely,the effect of underlying hepatobiliary conditions on the severity of the viral course itself.In this article,we review the spectrum of novel studies regarding COVID-19 induced liver injury,compiling data on the effects of the virus in various age and high-risk groups,especially those with preexisting liver disease,in order to obtain a comprehensive understanding of this disease process.We also provide an update of the impact of the new Omicron variant and the changing nature of COVID-19 pathogenesis.

Large Population Screening Identified the Main Risk Factors of Stroke in Shashi District of Jingzhou City

Objective: This paper aims to screen and analyze the current status of high-risk stroke patients in Shashi District of Jingzhou City and the exposure levels of related risk factors, and provides suggestions as the references for prevention and treatment of stroke. Methods: Using cluster sampling, on-site investigations were conducted on 1060 permanent residents aged 40 years and over at 3 townships and 2 communities in Shashi District of Jingzhou City from January 2018 to December 2018. Risk assessment of stroke is based on the stroke risk screening form. Statistical analysis was performed by using SPSS 22.0 software. Results: After making a stroke risk assessment, a total of 313 high-risk stroke patients were screened, and the detection rate was 29.53%. The exposure rate of risk factors from high to low was hypertension (70.93%), dyslipidemia (46.33%), less physical exercise (46.01%), diabetes (36.10%), overweight (33.55%), smoking (33.23%), family history of stroke (24.92%), atrial fibrillation or valvular heart disease (7.35%). There are statistically significant differences among all risk factors between the high-risk group and middle and low-risk groups (P Conclusion: The detection rate of high-risk stroke patients in Shashi District of Jingzhou City is high. Hypertension, dyslipidemia and less physical exercise are the main risk factors of stroke occurrence and recurrence in the region. The prevention and treatment of risk factors for stroke should be strengthened to control the incidence and recurrence rate of stroke.

Genetic polymorphisms in pri-let-7a-2 are associated with ischemic stroke risk in a Chinese Han population from Liaoning, China: a case-control study

Ischemic stroke is a complicated disease, and its pathogenesis has been attributed to the occurrence of genetic polymorphisms.Evidence has suggested that the microRNA let-7a is involved in the pathogenesis of ischemic stroke.Pri-miRNA is the primary transcript, which undergoes several processing steps to generate pre-miRNA and, later, mature miRNAs.In this case-control study, we analyzed the distribution of prilet-7a-2 variants in patients at a high risk for ischemic stroke and the interactions of pri-let-7a-2 variants and environmental factors.Blood samples and clinical information were collected from 1086 patients with ischemic stroke and 836 healthy controls between December 2013 and December 2015 at the First Affiliated Hospital of China Medical University.We found that the rs1143770 CC genotype and the C allele were associated with a decreased risk of ischemic stroke, whereas the rs629367 CC genotype was associated with an increased risk for ischemic stroke.Moreover, these two single-nucleotide polymorphisms were in linkage disequilibrium in this study sample.We analyzed gene-environment interactions and found that rs1143770 exerted a combined effect on the pathogenesis of ischemic stroke, together with alcohol use, smoking, and a history of hypertension.Therefore, the detection of pri-let-7a-2 polymorphisms may increase the awareness of ischemic stroke risk.This study was approved by the Institutional Ethics Committee of the First Affiliated Hospital of China Medical University, China(approval No.2012-38-1) on February 20, 2012, and was registered with the Chinese Clinical Trial Registry(registration number: ChiCTR-COC-17013559) on December 27, 2017.

The Use of Lipoprotein-Associated Phospholipase A2 in a Chinese Population to Predict Cardiovascular Events

Objective To explore associations between lipoprotein-associated phospholipase A2(Lp-PLA2)and the risk of cardiovascular events in a Chinese population,with a long-term follow-up.Methods A random sample of 2,031 participants(73.6%males,mean age=60.4 years)was derived from the Asymptomatic Polyvascular Abnormalities Community study(APAC)from 2010 to 2011.Serum Lp-PLA2 levels were determined by enzyme-linked immunosorbent assay(ELISA).The composite endpoint was a combination of first-ever stroke,myocardial infarction(MI)or all-cause death.Lp-PLA2 associations with outcomes were assessed using Cox models.Results The median Lp-PLA2 level was 141.0 ng/m L.Over a median follow-up of 9.1 years,we identified 389 events(19.2%),including 137 stroke incidents,43 MIs,and 244 all-cause deaths.Using multivariate Cox regression,when compared with the lowest Lp-PLA2 quartile,the hazard ratios with95%confidence intervals for developing composite endpoints,stroke,major adverse cardiovascular events,and all-cause death were 1.77(1.24–2.54),1.92(1.03–3.60),1.69(1.003–2.84),and 1.94(1.18–3.18)in the highest quartile,respectively.Composite endpoints in 145(28.6%)patients occurred in the highest quartile where Lp-PLA2(159.0 ng/m L)was much lower than the American Association of Clinical Endocrinologists recommended cut-off point,200 ng/m L.Conclusion Higher Lp-PLA2 levels were associated with an increased risk of cardiovascular event/death in a middle-aged Chinese population.The Lp-PLA2 cut-off point may be lower in the Chinese population when predicting cardiovascular events.

Detection of Asymptomatic Carotid Artery Stenosis in High-Risk Individuals of Stroke Using a Machine-Learning Algorithm

Objective Asymptomatic carotid stenosis(ACS)is closely associated to the incidence of severe cerebrovascular diseases.Early identifying the individuals with ACS and its associated risk factors could be beneficial for primary prevention of stroke.This study aimed to investigate a machine-learning algorithm for the detection of ACS among high-risk population of stroke based on the associated risk factors.Methods A novel model of machine learning was utilized to screen the associated predictors of ACS based on 30 potential risk factors.The algorithm of this model adopted a random forest pattern based on the training data and then was verified using the testing data.All of the original data were retrieved from the China National Stroke Screening and Prevention Project(CNSSPP),including demographic,clinical and laboratory characteristics.The individuals with high risk of stroke were enrolled and randomly divided into a training group and a testing group at a ratio of 4:1.The identification of carotid stenosis by carotid artery duplex scans was set as the golden standard.The receiver operating characteristic(ROC)curve and the area under the curve(AUC)was used to evaluate the efficacy of the model in detecting ACS.Results Of 2841 high risk individual of stroke enrolled,326(11.6%)were diagnosed as ACS by ultrasonography.The top five risk fectors contributing to ACS in this model were identified as family history of dyslipidemia,high level of lowdensity lipoprotein cholesterol(LDL-c),low level of high-density lipoprotein cholesterol(HDL-c),aging,and low body.

Identification of Common Variants within KCNK17 in Chinese Han Population

KCNK17 is a member of the acid-sensitive subfamily of tandem pore K+ channels,which are open at all membrane potentials and contribute to cellular resting membrane potential.Recent genome-wide study(GWA)has shown that variants within KCNK17 confer genetic susceptibility for increasing ischemic stroke.In an effort to discover additional polymorphism(s),we scrutinized the genetic polymorphisms in the KCNK17.By direct DNA sequencing in 32 individuals,we identified nine sequence variants within the 16kb of whol...

Angiotensin-converting enzyme gene polymorphism and middle cerebral artery stenosis in a Chinese Han population

The angiotensin-converting enzyme gene is a candidate gene of stroke. The present study involved 62 healthy volunteers and 148 patients with middle cerebral artery stenosis as confirmed by brain color ultrasound from a Han population in North China, and determined the peripheral blood angiotensin-converting enzyme genotype using PCR-restriction fragment length polymorphism analysis. The results showed that the frequencies of the DD genotype and D allele were increased in patients with middle cerebral artery stenosis, but the difference was not statistically significant compared with healthy controls. The findings of this study on the relationship between stroke genes and middle cerebral artery stenosis indicate no significant correlation between the frequencies of the DO genotype and D allele of angiotensin-converting enzyme and middle cerebral artery stenosis in this Han population from North China. In the future, studies will be carried out to investigate correlations between multiple stroke candidate gene synergy and middle cerebral artery stenosis to provide a foundation for the development of gene therapy.

Alzheimer’s Disease among American Minority Populations: An Eco­logical Exploratory Study

A significant public health concern with regards to increasing rates of Alzheimer’s is that it disproportionately affects minority groups in the United States.The present ecological exploratory study uses secondary aggregate data from the fifty United States in the year of 2019.The pur­pose of this study was to address the disparities in Alzheimer’s in minori­ty populations in the US and explore associated factors.The“minority”populations considered were African American and Hispanic populations,and the“majority”population was referred to as“white”.The data were extracted from the United States Census Bureau,the CDC National Cen­ter for Health Statistics,and the Behavioral Risk Factor Surveillance Sys­tem(BRFSS)Dataset.The prevalence rates of Alzheimer’s disease are greatest in both older Hispanic(12.2%)and African Americans(13.8%),compared to older whites(10.3%)in the investigated time period.Our results showed that being over 65 years old(p=.009),with a below-av­erage($62,843)median household income(p=.024),history of stroke(p=.029),and being a part of the Hispanic population(p=.036),were significantly associated with Alzheimer’s mortality rates in the United States.By identifying disparities in access to Alzheimer’s healthcare and at-risk communities,more comprehensive intervention strategies can be developed to promote change and advocate for more Alzheimer’s educa­tion and resource allocation for minority populations.

中国中老年人群脑卒中发病的影响因素探索及列线图模型构建

[目的]探讨中国中老年人群脑卒中发病的相关影响因素,并构建列线图预测模型,以期为脑卒中的防治提供更为个性化的参考依据。[方法]本研究共包括13 063名来源于中国健康与养老追踪调查项目的参与对象。该项目通过多阶段抽样,于2011年对全国28个省(自治区、直辖市)的150个县、450个社区(村)的45岁以上的中老年人进行横断面调查,并详细收集了参与者的社会人口学特征、体格测量资料、健康状况、医疗保健情况、家庭收入和消费状况。分别于2013年、2015年和2018年随访了研究对象脑卒中的发病情况。采用单因素和多因素Cox回归筛选与脑卒中发病有关的影响因素,并构建列线图预测模型。[结果]随访过程中,新发脑卒中774人。多因素Cox回归结果显示,高龄(HR=1.028,95%CI:1.019~1.038)、单身(HR=1.295,95%CI:1.031~1.626)、吸烟(HR=1.264,95%CI:1.074~1.489)、体质指数异常(HR=1.204,95%CI:1.020~1.420)、高血压(HR=2.200,95%CI:1.855~2.609)和糖尿病(HR=1.483,95%CI:1.117~1.970)是影响脑卒中发病的危险因素,高水平的家庭人均年支出(HR=0.783,95%CI:0.642~0.953)是脑卒中发病的拮抗因素。基于以上因素构建的列线图具有较好的预测性能,其曲线下面积(AUC)约为0.700。[结论]高龄、单身、吸烟、体质指数异常、高血压和糖尿病是脑卒中发病的独立危险因素,基于这些因素构建的列线图有助于预测脑卒中的发病率。

基于临床基线特征与颈动脉超声参数构建脑卒中高危人群颈动脉易损斑块模型

背景:研究表明,颈动脉斑块的易损性和弹性与斑块内新生血管的存在及形成程度有关。超声作为筛查和评价颈动脉易损斑块的首选检查手段,具有无创、操作便捷、可重复性高和无辐射等的特点。目的:基于临床基线特征与颈动脉超声参数,探讨脑卒中高危人群颈动脉易损斑块的影响因素,基于独立危险因素构建并验证风险列线图(Nomogram)预测模型。方法:回顾性选取2021年11月到2023年11月于抚州市第一人民医院行脑卒中筛查确定为脑卒中高危人群的180例患者作为研究对象,将180例患者按7∶3比例分为建模集(n=126)和验证集(n=54),根据颈动脉超声检查结果将建模集研究对象分为易损斑块组(n=54)和非易损斑块组(n=72)。通过多因素Logistic回归得出独立危险因素,构建Nomogram模型,并使用R语言绘制决策曲线以评估模型的临床效益。采用受试者工作特征曲线和校准曲线检验模型的预测效能,同时分析验证集的病例数据进行外部验证。结果与结论:①多因素Logistic回归结果显示,年龄、脑卒中家族史、颈动脉斑块最大厚度值、颈动脉斑块数量、尿微量白蛋白和尿微量白蛋白/肌酐均与脑卒中高危人群颈动脉易损斑块有关(P<0.05)。②构建的Nomogram模型受试者工作特征曲线下面积为0.917,灵敏度和特异度分别为79.6%和91.7%;决策曲线结果显示,该模型的潜在临床获益可观,可用性较高;校准曲线结果提示,模型具备较好的预测准确性;验证集结果显示,模型的外部预测性能良好。③结果说明,脑卒中高危人群颈动脉易损斑块受年龄、脑卒中家族史、颈动脉斑块最大厚度值等因素影响,基于各独立危险因素构建的风险Nomogram预测模型的预测性能良好,可为临床上治疗此类高危人群提供有力的参考依据。

Development and validation of a prediction model for early screening of people at high risk for colorectal cancer

BACKGROUND Colorectal cancer(CRC)is a serious threat worldwide.Although early screening is suggested to be the most effective method to prevent and control CRC,the current situation of early screening for CRC is still not optimistic.In China,the incidence of CRC in the Yangtze River Delta region is increasing dramatically,but few studies have been conducted.Therefore,it is necessary to develop a simple and efficient early screening model for CRC.AIM To develop and validate an early-screening nomogram model to identify individuals at high risk of CRC.METHODS Data of 64448 participants obtained from Ningbo Hospital,China between 2014 and 2017 were retrospectively analyzed.The cohort comprised 64448 individuals,of which,530 were excluded due to missing or incorrect data.Of 63918,7607(11.9%)individuals were considered to be high risk for CRC,and 56311(88.1%)were not.The participants were randomly allocated to a training set(44743)or validation set(19175).The discriminatory ability,predictive accuracy,and clinical utility of the model were evaluated by constructing and analyzing receiver operating characteristic(ROC)curves and calibration curves and by decision curve analysis.Finally,the model was validated internally using a bootstrap resampling technique.RESULTS Seven variables,including demographic,lifestyle,and family history information,were examined.Multifactorial logistic regression analysis revealed that age[odds ratio(OR):1.03,95%confidence interval(CI):1.02-1.03,P<0.001],body mass index(BMI)(OR:1.07,95%CI:1.06-1.08,P<0.001),waist circumference(WC)(OR:1.03,95%CI:1.02-1.03 P<0.001),lifestyle(OR:0.45,95%CI:0.42-0.48,P<0.001),and family history(OR:4.28,95%CI:4.04-4.54,P<0.001)were the most significant predictors of high-risk CRC.Healthy lifestyle was a protective factor,whereas family history was the most significant risk factor.The area under the curve was 0.734(95%CI:0.723-0.745)for the final validation set ROC curve and 0.735(95%CI:0.728-0.742)for the training set ROC curve.The calibration curve demonstrated a high correlation between the CRC high-risk population predicted by the nomogram model and the actual CRC high-risk population.CONCLUSION The early-screening nomogram model for CRC prediction in high-risk populations developed in this study based on age,BMI,WC,lifestyle,and family history exhibited high accuracy.

宜宾市城乡人群脑卒中危险因素的暴露水平分析

目的了解宜宾市40岁以上城乡常住居民的脑卒中患病情况及城乡之间脑卒中危险因素暴露水平的差异,为脑卒中的预防制定合适的防控措施提供依据。方法凭借国家卫生健康委员会脑卒中防治工程项目,对宜宾市2个抽样选中的乡镇/社区中40岁以上常住居民开展脑卒中调查问卷、查体及辅助检查,应用SPSS22.0软件进行数据分析,包括一般性描述分析和单因素χ^(2)检验。结果本次研究共调查40岁及以上常住居民4621例,脑卒中患者112例,患病率为2.42%。其中,城市人群中高危人群576例,中危人群778例,均显著高于乡镇人群,而城市人群中既往有脑卒中病史69例,也显著多于乡镇人群。宜宾市城市地区脑卒中危险因素暴露水平前3位依次为高血压、血脂异常、运动缺乏。宜宾市乡镇地区脑卒中危险因素暴露水平前3位依次为血脂异常、高血压、吸烟史。结论宜宾市脑卒中患病率和省内水平相似,但城乡人群之间的危险因素暴露水平存在差异,城乡共同主要危险因素包括高血压、糖尿病、血脂异常、吸烟、运动缺乏和脑卒中家族史等。

健康体检人群心脏代谢指数与脑血管功能积分值的相关性分析

目的探讨健康体检人群心脏代谢指数(CMI)与脑血管功能积分值(CVHI)的相关性。方法本研究为横断面研究,选取2023年1-7月在新疆医科大学第一附属医院健康管理中心参加健康体检的1636例体检人员为研究对象。收集一般资料,完成相关体格检查和实验室检查。根据CVHI积分值的最佳截断点(75分)分为CVHI正常组和CVHI异常组,采用Logistic回归分析探讨影响CVHI积分值的因素,受试者工作特征(ROC)曲线下面积(AUC)评估CMI对CVHI积分值的预测价值。结果在1636例体检人员中,使用脑血管功能检测仪筛检出脑卒中风险高危人群419例(25.6%)。CVHI正常组与异常组在年龄、性别、高血压、糖尿病、血脂异常、运动缺乏等方面比较,差异有统计学意义(P均<0.05)。CVHI异常组的收缩压、舒张压、体质指数、腰围、腰臀比、腰高比、总胆固醇、甘油三酯、空腹血糖、尿酸、肌酐、尿素、心脏代谢指数均高于CVHI正常组(P<0.05)。年龄、高血压、糖尿病、收缩压、尿酸、CMI是CVHI积分值的影响因素(P<0.05)。CMI预测CVHI积分值<75人群的ROC曲线下面积为0.602。CVHI积分值随着CMI水平的增高而降低(P<0.05),CMI≥0.4918的CVHI积分值异常率(31.0%)明显高于CMI<0.4918的CVHI积分值异常率(18.7%)(P<0.05)。CVHI积分值与CMI呈负相关(r=-0.143,P<0.05)。结论随着CMI的增加,CVHI积分值逐渐降低,筛选出脑卒中高危人群的风险逐步增加,这对脑卒中高危人群的筛检具有一定的参考价值。

国内外脑卒中高危人群相关研究的可视化分析

目的对脑卒中高危人群相关研究现状进行可视化分析,探讨研究热点及未来研究趋势。方法检索建库至2023年4月中国知网(CNKI)和Web of Science核心数据库中脑卒中高危人群相关文献,利用CiteSpace6.2软件从文章作者、机构、国家、关键词等方面进行知识图谱分析。结果共纳入1479篇文献,其中中文1169篇,英文310篇。除主题相关关键词外,国内高频关键词有危险因素、筛查、高血压等。国外高频关键词有risk factors、cerebral infarction、atrial fibrillation等。结论脑卒中高危人群研究领域目前的研究热度较高,其中开发和利用脑卒中危险因素监测或预测工具,将研究方向从人群调查转变为个体预防健康管理值得未来关注。

中医院单中心心房颤动住院患者分布特征及其卒中风险分析

目的分析中医类医院单中心心房颤动(房颤)住院患者的分布特征及卒中的风险因素,从而指导房颤的防治工作。方法回顾性分析中国房颤中心数据填报平台中广东省中医院海南医院2020年10月至2022年9月填报的667例住院患者的临床资料,包括住院信息、诊断与治疗、人口学信息、欧洲心律学会(EHRA)症状评分、健康评估等相关数据,采用描述流行病学方法分析不同性别患者的分布特征,并以脑卒中危险CHA2DS2-VASc评分为因变量,采用多因素Logistic回归模型分析影响男性与女性非瓣膜性房颤患者发生卒中的危险因素。结果房颤患者中瓣膜性房颤占5.85%(39/667),非瓣膜性房颤占94.15%(628/667),以持续性房颤为主65.52%(437/667);患者构成男性高于女性(1.22∶1),平均年龄为(75.14±11.23)岁,以71~80岁和81~90岁为主,分别占33.28%(222/667)和28.78%(192/667);临床症状以心悸和胸部不适为主,分别占51.27%和45.43%,EHRA症状评级<Ⅱ级者占79.01%(527/667),≥Ⅲ级者占20.99%(140/667);房颤合并疾病中高血压的患病率最高〔占64.62%(431/667)〕,其次为慢性心力衰竭(心衰)〔占36.43%(243/667)〕;CHA2DS2-VASc评分中卒中高危人群构成比明显高于卒中中、低危人群〔89.17%(560/628)比10.83%(68/628)〕;HAS-BLED评分出血低风险者的构成比明显高于出血高风险人群〔69.27%(462/667)比30.73%(205/667)〕。将628例非瓣膜性房颤患者按性别进行单因素分析,结果显示,279例女性患者以CHA2DS2-VASc评分是否≥3分为因变量,单因素分析表明,两组患者的年龄及是否患有高血压、冠心病、心肌病、慢性心衰、脑血管疾病和甲状腺疾病差异均有统计学意义(均P<0.05);349例男性患者以CHA2DS2-VASc评分是否≥2分为因变量,经单因素分析表明,两组年龄、文化程度、EHRA评级及是否患有高血压、冠心病、慢性心衰、脑血管疾病和甲状腺疾病差异均有统计学意义(均P<0.05)。多因素Logistic回归分析表明,卒中高危因素中女性为年龄、收缩压、患有甲状腺疾病和脑血管疾病〔女性年龄>75岁:优势比(OR)=42.270,95%可信区间(95%CI)为9.130~195.800;收缩压>160 mmHg(1 mmHg≈0.133 kPa):OR=3.530,95%CI为1.420~8.760;患有甲状腺疾病:OR=0.140,95%CI为0.040~0.460;患有脑血管疾病:OR=9.400,95%CI为2.130~41.440;均P<0.05〕;男性为年龄、文化程度、收缩压和患有慢性心衰、甲状腺疾病及脑血管疾病(男性年龄>75岁:OR=81.270,95%CI为27.730~238.210;文化程度:OR=0.250,95%CI为0.120~0.530;收缩压>160 mmHg:OR=14.110,95%CI为7.250~27.460;患有慢性心衰:OR=23.780,95%CI为7.850~71.970;患有甲状腺疾病:OR=0.240,95%CI为0.110~0.540;患有脑血管疾病:OR=0.580,95%CI为0.360~0.940;均P<0.05)。结论广东省中医院海南医院房颤中心住院人群男性多于女性、以老年人为主,其平均年龄大于近期报告水平,且其卒中风险更突出,尤其是高龄和患有高血压、慢性心衰、脑血管疾病和甲状腺疾病的人群风险大,应强化其针对性防治。