2021 Vol. 34, No. 12

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2021, 34(12): 0-0.
2021, 34(12): 1-2.
Hypertension Prevalence, Awareness, Treatment, and Control and Their Associated Socioeconomic Factors in China: A Spatial Analysis of A National Representative Survey
WANG Wei, ZHANG Mei, XU Cheng Dong, YE Peng Peng, LIU Yun Ning, HUANG Zheng Jing, HU Cai Hong, ZHANG Xiao, ZHAO Zhen Ping, LI Chun, CHEN Xiao Rong, WANG Li Min, ZHOU Mai Geng
2021, 34(12): 937-951. doi: 10.3967/bes2021.130
  Objective  We aimed to investigate and interpret the associations between socioeconomic factors and the prevalence, awareness, treatment, and control of hypertension at the provincial level in China.   Methods  A nationally and provincially representative sample of 179,059 adults from the China Chronic Disease and Nutrition Surveillance study in 2015–2016 was used to estimate hypertension burden. The spatial Durbin error model was fitted to investigate socioeconomic factors associated with hypertension indicators.  Results  Overall, it was estimated that 29.20% of the participants were hypertensive nationwide, among whom, 34.32% were aware of their condition, 27.69% had received antihypertensive treatment, and 7.81% had controlled their condition. Per capita gross domestic product (GDP) was associated with hypertension prevalence (coefficient: −2.95, 95% CI: −5.46, −0.45) and control (coefficient: 6.35, 95% CI: 1.36, 11.34) among adjacent provinces and was also associated with awareness (coefficient: 2.93, 95% CI: 1.12, 4.74) and treatment (coefficient: 2.67, 95% CI: 1.21, 4.14) in local province. Beds of internal medicine (coefficient: 2.66, 95% CI: 1.08, 4.23) was associated with control in local province. Old dependency ratio (coefficient: −3.58, 95% CI: −5.35, −1.81) was associated with treatment among adjacent provinces and with control (coefficient: −1.69, 95% CI: −2.42, −0.96) in local province.  Conclusion  Hypertension indicators were not only directly influenced by socioeconomic factors of local area but also indirectly affected by characteristics of geographical neighbors. Population-level strategies should involve optimizing supportive socioeconomic environment by integrating clinical care and public health services to decrease hypertension burden.
Association of Serum Glucocorticoids with Various Blood Pressure Indices in Patients with Dysglycemia and Hypertension: the Henan Rural Cohort Study
XUE Yuan, MAO Zhen Xing, LIU Xue, WEI Dan Dan, LIU Chang, PANG Shan Bin, YU Song Cheng, GAO Jiao Jiao, LIN Ji Song, ZHANG Dong Dong, WANG Chong Jian, LI Wen Jie, LI Xing
2021, 34(12): 952-962. doi: 10.3967/bes2021.131
  Objective   To our knowledge, no definitive conclusion has been reached regarding the relationship between glucocorticoids and hypertension. Here, we aimed to explore the characteristics of glucocorticoids in participants with dysglycemia and hypertension, and to analyze their association with blood pressure indicators.   Methods   The participants of this study were from the Henan Rural Cohort study. A total of 1,688 patients 18–79 years of age were included in the matched case control study after application of the inclusion and exclusion criteria. Statistical methods were used to analyze the association between glucocorticoids and various indices of blood pressure, through approaches such as logistic regression analysis, trend tests, linear regression, and restricted cubic regression.   Results   The study population consisted of 552 patients with dysglycemia and hypertension (32.7%). The patients with co-morbidities had higher levels of serum cortisol (P = 0.009) and deoxycortisol (P < 0.001). The adjusted odds ratios (and 95% confidence intervals) for dysglycemia with hypertension were 1.55 (1.18, 2.04) for the highest tertile of Ln-cortisol compared with the lowest tertile. Additionally, the highest Ln-deoxycortisol levels were associated with increased prevalence of dysglycemia with hypertension by 159% (95% confidence interval: 122%, 207%).   Conclusions   Serum deoxycortisol was positively correlated with systolic blood pressure, pulse pressure, mean arterial pressure, mean blood pressure, and mean proportional arterial pressure. Glucocorticoids (deoxycortisol and cortisol) increase the risk of hypertension in people with dysglycemia, particularly in those with T2DM.
Associations of Sedentary Time and Physical Activity with Metabolic Syndrome among Chinese Adults: Results from the China Health and Nutrition Survey
BAI Jing, WANG Yun, ZHANG Xian Fan, OUYANG Yi Fei, ZHANG Bing, WANG Zhi Hong, DU Shu Fa, WANG Hui Jun
2021, 34(12): 963-975. doi: 10.3967/bes2021.132
  Objective  This study aimed to determine the independent and joint associations of sedentary time (ST) and physical activity (PA) with metabolic syndrome (MetS) and its components among Chinese adults.   Methods  The study analyzed data from 4,865 adults aged ≥ 18 years who participated in the 2009 and 2015 China Health and Nutrition Surveys (CHNS). Four types of leisure ST and three types of PA self-reported at baseline were collected. Multivariable logistic regressions were used to determine the independent and joint associations of ST and PA with the odds of MetS or its components.   Results  For independent effects, higher levels of television time and total leisure ST was associated with higher MetS risk [odds ratio (OR) 1.3, 95% confidence interval (CI) 1.1–1.6, P < 0.001; OR 1.4, 95% CI 1.2–1.8, P < 0.001, respectively]. The MetS risk in the computer time > 7 hours/week (h/w) group was higher than that in the < 7 h/w group in (OR 1.5, 95% CI 1.2–1.9). Higher levels of moderate-to-vigorous-intensity physical activity (MVPA) and total PA were associated with a lower MetS risk (OR 0.7, 95% CI 0.6–0.9, P < 0.001; OR 0.8, 95% CI 0.7–0.9, P < 0.001, respectively). For the joint effects, compared with those reporting the lowest level of total leisure ST (< 14 h/w) and the most active tertile of MVPA (≥ 61.0 MET-h/w), participants reporting the most total leisure ST (≥ 35 h/w) and the lowest level of MVPA (0 MET-h/w) had the highest odds of MetS (OR 2.0; 95% CI 1.4–2.7). Except for people reporting ST (14–21 h/w) within the most active tertile of MVPA, the associations in all other groups were significant. With the increase of TV time and decreased MVPA, the odds of MetS almost showed a curve acceleration.   Conclusions  MVPA and total PA have independent preventive effects, and sedentary behavior (mainly watching TV) has an unsafe effect on MetS and its components. Strengthening the participation of MVPA and combining the LPA to replace the TV-based ST to increase the total PA may be necessary to reduce the prevalence of MetS in Chinese adults.
Kinetic Characteristics of Neutralizing Antibody Responses Vary among Patients with COVID-19
LI Ling Hua, TU Hong Wei, LIANG Dan, WEN Chun Yan, LI An An, LIN Wei Yin, HU Ke Qi, HONG Wen Shan, LI Yue Ping, SU Juan, ZHAO San Tao, LI Wei, YUAN Run Yu, ZHOU Ping Ping, HU Feng Yu, TANG Xiao Ping, KE Chang Wen, KE Bi Xia, CAI Wei Ping
2021, 34(12): 976-983. doi: 10.3967/bes2021.133
  Objective  The coronavirus disease 2019 (COVID-19) pandemic continues to present a major challenge to public health. Vaccine development requires an understanding of the kinetics of neutralizing antibody (NAb) responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).   Methods  In total, 605 serum samples from 125 COVID-19 patients (from January 1 to March 14, 2020) varying in age, sex, severity of symptoms, and presence of underlying diseases were collected, and antibody titers were measured using a micro-neutralization assay with wild-type SARS-CoV-2.   Results  NAbs were detectable approximately 10 days post-onset (dpo) of symptoms and peaked at approximately 20 dpo. The NAb levels were slightly higher in young males and severe cases, while no significant difference was observed for the other classifications. In follow-up cases, the NAb titer had increased or stabilized in 18 cases, whereas it had decreased in 26 cases, and in one case NAbs were undetectable at the end of our observation. Although a decreasing trend in NAb titer was observed in many cases, the NAb level was generally still protective.   Conclusion  We demonstrated that NAb levels vary among all categories of COVID-19 patients. Long-term studies are needed to determine the longevity and protective efficiency of NAbs induced by SARS-CoV-2.
Factors Defining the Development of Severe Illness in Patients with COVID-19: A Retrospective Study
XIONG Yi Bai, TIAN Ya Xin, MA Yan, YANG Wei, LIU Bin, RUAN Lian Guo, LU Cheng, HUANG Lu Qi
2021, 34(12): 984-991. doi: 10.3967/bes2021.117
  Objective  Early triage of patients with coronavirus disease 2019 (COVID-19) is pivotal in managing the disease. However, studies on the clinical risk score system of the risk factors for the development of severe disease are limited. Hence, we conducted a clinical risk score system for severe illness, which might optimize appropriate treatment strategies.   Methods  We conducted a retrospective, single-center study at the JinYinTan Hospital from January 24, 2020 to March 31, 2020. We evaluated the demographic, clinical, and laboratory data and performed a 10-fold cross-validation to split the data into a training set and validation set. We then screened the prognostic factors for severe illness using the least absolute shrinkage and selection operator (LASSO) and logistic regression, and finally conducted a risk score to estimate the probability of severe illness in the training set. Data from the validation set were used to validate the score.   Results  A total of 295 patients were included. From 49 potential risk factors, 3 variables were measured as the risk score: neutrophil to lymphocyte ratio (OR, 1.27; 95% CI, 1.15–1.39), albumin (OR, 0.76; 95% CI, 0.70–0.83), and chest computed tomography abnormalities (OR, 2.01; 95% CI, 1.41–2.86) and the AUC of the validation cohort was 0.822 (95% CI, 0.7667–0.8776).   Conclusion  This report may help define the potential of developing severe illness in patients with COVID-19 at an early stage, which might be related to the neutrophil to lymphocyte ratio, albumin, and chest computed tomography abnormalities.
Positive Associations between Bilateral High-Frequency Hearing Loss and Hypertension Risk in Short-Term Occupational Noise Exposure
JIN Nan, ZHONG Hui Yun, YUAN Fang, DENG Hua Xin
2021, 34(12): 992-997. doi: 10.3967/bes2021.134
Lipid Accumulation and IL-6 Production in L02 Hepatocytes Induced by Sodium Oleate: Dose and Time Dependence
CHEN Chen, HUO Jun Sheng, ZHUO Qin, LI Yan, MA Yan, WANG Jing Bo, JIA Xu Dong
2021, 34(12): 998-1004. doi: 10.3967/bes2021.058
To explore interleukin-6 (IL-6) production and characterize lipid accumulation in L02 hepatocytes induced by sodium oleate. L02 hepatocytes were incubated with 0, 37.5, 75, 150, 300, 600, or 1,200 μmol/L sodium oleate for 24 h, and the supernatant was collected to detect the concentration of IL-6. L02 hepatocytes were incubated with 300, 150, 75, or 0 μmol/L sodium oleate for 0–24 h. The supernatant was collected for detection of IL-6 and free fatty acids. L02 hepatocytes treated with 300 μmol/L sodium oleate for 0–24 h were stained with Oil Red O. With extended sodium oleate incubation time, IL-6 levels increased, and free fatty acids decreased. After 24 h incubation, IL-6 levels increased as sodium oleate increased from 37.5 to 300 μmol/L (P < 0.05 for 37.5 μmol/L, P < 0.01 for 75 μmol/L and P < 0.001 for concentrations 150 μmol/L or higher). Lipid accumulation increased as the sodium oleate concentration and incubation time increased. Oil Red O staining intensified with incubation time extending beyond 2 h. IL-6 production and lipid accumulation in L02 hepatocytes are influenced by sodium oleate in a dose- and time-dependent manner.
Is the Trial of Labor after Two Previous Cesarean Sections Contraindicated in China?
BI Shi Lei, ZHANG Li Zi, LIANG Xin Yue, HUANG Li Jun, ZENG Shan Shan, LIANG Ying Yu, LI Yu Lian, HUANG Min Shan, JIA Jin Ping, WEN Sui Wen, FENG Ling, DU Li Li, WANG Zhi Jian, CHEN Dun Jin
2021, 34(12): 1005-1009. doi: 10.3967/bes2021.135
Application of Ginkgo biloba L. Extract at the Early Stage of Tumor Development Helps Cyclophosphamide Inhibit the Growth of Tumor Cells
YANG Jing Hui, MENG Fan Zhu, BESELER Cheryl L., LI Hao, LIU Xiao Mei, GUO Yin Pei, QIN Li Li, ZUO Ru Yue, REN Shu Ping
2021, 34(12): 1010-1014. doi: 10.3967/bes2021.136
Pterostilbene Ameliorates Renal Damage in Diabetic Rats by Suppressing Hyperglycemia with Inhibition of Inflammatory and Fibrotic Responses
DING Run Rong, HUANG Guo Yu, ZHANG Yu Jing, SUN Hua Lei, LIU Yi Ming, XU Ze, LI Wen Jie, LI Xing
2021, 34(12): 1015-1019. doi: 10.3967/bes2021.137
Molecular Detection and Identification of Candidatus Ehrlichia Hainanensis, A Novel Ehrlichia Species in Rodents from Hainan Province, China
ZHAO Hong Qing, LIU Pei Pei, XUE Feng, LU Miao, QIN Xin Cheng, LI Kun
2021, 34(12): 1020-1023. doi: 10.3967/bes2021.138
Ehrlichia (Anaplasmataceae family) are obligatory intracellular bacteria that infect humans and animals. They are hosted by mammals such as canines, bovines and wild rodents, and are vectored by ticks. In this study, we collected 121 rodent samples comprising 67 Niviventer fulvescens, 27 Rattus tanezumi, 24 Chiromyscus sp., 2 Rattus nitidus and 1 Leopoldamys edwardsi from Hainan province, which includes the second largest island in China. The presence and genetic diversity of Ehrlichia species was evaluated and characterized by amplification and sequencing of 16S rRNA, groEL and gltA genes. An Ehrlichia species was detected in 5 of the 67 Niviventer fulvescens samples (7.46%). The 16S rRNA, groEL and gltA genes showed the highest identity to known Ehrlichia sequences (99.20%, 89.87% and 83.86%, respectively). In the phylogenetic trees they formed a cluster distinct from all other species. We propose that this species is a putative novel Ehrlichia species, which we suggest be named Candidatus Ehrlichia hainanensis. Its pathogenicity to humans remains to be further researched, and molecular surveillance in local populations is needed.
Genetic Characteristics and Antimicrobial Susceptibility of Arcobacter butzleri Isolates from Raw Chicken Meat and Patients with Diarrhea in China
WANG Yuan Yuan, ZHOU Gui Lan, LI Ying, GU Yi Xin, HE Mu, ZHANG Shuang, JI Guo Qiang, YANG Jie, WANG Miao, MA Hong Mei, ZHANG Mao Jun
2021, 34(12): 1024-1028. doi: 10.3967/bes2021.139
Arcobacter is an emerging foodborne pathogen worldwide. In this study, the prevalence, antimicrobial susceptibility and genetic characteristics of Arcobacter from different sources were investigated. Eighteen A. butzleri isolates were obtained from 60 raw chicken meat samples (16/60, 27%) and 150 patients with diarrhea (2/150, 1.3%). The resistance ratios to nalidixic acid, ciprofloxacin, clindamycin, chloramphenicol, and florfenicol were 83.33% (15/18), 38.89% (7/18), 38.89% (7/18), 33.33% (6/18) and 33.33% (6/18), respectively. We performed whole genome sequencing of the 18 isolates, and we predicted antibiotic resistance genes and virulence factors by using assembled genomes through blastx analysis. Two resistance genes, blaOXA-464 and tet(H), and the C254T mutation in gyrA, were identified in the genomes of some resistant isolates. Furthermore, virulence genes, such as flgG, flhA, flhB, fliI, fliP, motA, cadF, cjl349, ciaB, mviN, pldA and tlyA, were found in all strains, whereas hecA, hecB and iroE were found in only some strains. Phylogenetic tree analysis of A. butzleri isolates on the basis of the core-genome single nucleotide polymorphisms showed that two isolates from patients with diarrhea clustered together, separately from the isolates from raw chicken and the chicken strains. This study is the first comprehensive analysis of Arcobacter isolated in Beijing.
Ulinastatin Exerts the Protective Effects of Lung by Up-Regulating Aquaporins Expression in a Two-Hit Porcine Model of Acute Respiratory Distress Syndrome
HANG Chen Chen, GUO Yu Hong, LI Chun Sheng, WANG Shuo
2021, 34(12): 1029-1032. doi: 10.3967/bes2021.140