Current Articles

2023, 36(8)
2023, 36(8): 1-2.
Special Report
Report on Cardiovascular Health and Diseases in China 2022: an Updated Summary
The Writing Committee of the Report on Cardiovascular Health and Diseases in China
2023, 36(8): 669-701. doi: 10.3967/bes2023.106
In the past 30 years, the accessibility and quality index of medical care have made remarkable progress in China, ranking the first among middle-income countries. Many cardiovascular technologies are at or near the world's leading level, and significant progress has been achieved in China solving the problem of “treatment difficulty” of cardiovascular diseases (CVD). However, due to the prevalence of unhealthy lifestyles among Chinese residents, a huge population with CVD risk factors, accelerated population aging, and other reasons, the incidence and mortality rate of CVD are still increasing, and the turning point of the decline in disease burden has not appeared yet in China. In terms of proportions of disease mortality among urban and rural residents, CVD still ranks the first. In 2020, CVD accounted for 48.00% and 45.86% of the causes of death in rural and urban areas, respectively; two out of every five deaths were due to CVD. It is estimated that the number of current CVD patients in China is around 330 million, including 13 million stroke, 11.39 million coronary heart disease, 8.9 million heart failure, 5 million pulmonary heart disease, 4.87 million atrial fibrillation, 2.5 million rheumatic heart disease, 2 million congenital heart disease, 45.3 million peripheral artery disease, and 245 million hypertension cases. China has entered a new stage of transformation from high-speed development to high-quality development, and the prevention and control of CVD in China should also shift from previous emphasis on scale growth to strategies focusing more on strategic and key technological development in order to curb the trend of increasing incidence and mortality rates of CVD.
Original Article
Midday Napping, Nighttime Sleep, and Mortality: Prospective Cohort Evidence in China
WANG Ke, HU Lan, WANG Lu, SHU Hai Nan, WANG Yi Ting, YUAN Yang, CHENG Hong Ping, ZHANG Yun Quan
2023, 36(8): 702-714. doi: 10.3967/bes2023.073
  Objective   In developed countries, midday napping and nighttime sleep duration have been linked to long-term survival; however, little is known about such effects in less developed regions. Therefore, this study aimed to assess the associations of midday napping and nocturnal sleep with mortality in middle-aged and older Chinese adults.  Methods   A nationwide cohort of 15,524 adults aged ≥ 45 years was enrolled from 28 provincial regions across mainland China and followed up from 2011 to 2018, using data from the Chinese Health and Retirement Longitudinal Study. Midday napping and nighttime sleep duration were assessed using standardized questionnaires. Cox proportional hazards models with random intercepts for the surveyed provinces were used to estimate hazard ratios (HRs) of all-cause mortality, adjusting for sociodemographic characteristics, behavioral factors, and health status.  Results   A total of 1,745 deaths occurred during a median follow-up of 7.1 years, and the mean (standard deviation) age was 59 (10.1) years at baseline. Compared with non-nappers, over 60 min nappers had a higher risk of all-cause mortality [HR: 1.35, 95% confidence interval (CI): 1.17–1.56], while no significant associations were observed among < 30 min nappers. Compared with sleep duration of 6–8 h/night, both short (< 6 h) and long (≥ 8 h) sleep duration were significantly associated with increased mortality, with corresponding HR (95% CI) estimates of 1.21 (1.05–1.38) and 1.26 (1.10–1.44), respectively. We observed significant patterns for greater risks associated with longer nap duration, with a Ptrend value < 0.001 for all-cause mortality. No significant evidence of an additive interaction was identified between midday napping and nighttime sleep.  Conclusion   Long midday napping and inappropriate nighttime sleep were independently associated with an increased risk of all-cause mortality in middle-aged and older Chinese populations. Biological studies are needed to validate our findings and clarify the mechanisms underlying this association.
Insomnia Burden among Informal Caregivers of Hospitalized Lung Cancer Patients and Its Influencing Factors
LI Chun Yan, SONG Yu Jian, ZHAO Lan, DENG Mu Hong, LI Rui Xin, ZHANG Xiao Ling, LI Qiong Xuan, SHI Ying, LUAN Heng Yu, SUN Yuan Yuan, HU Yi, SAI Xiao Yong
2023, 36(8): 715-724. doi: 10.3967/bes2023.099
  Objective  This study aimed to reveal the insomnia burden and relevant influencing factors among informal caregivers (ICs) of hospitalized patients with lung cancer.  Methods  A cross-sectional study on ICs of hospitalized patients with lung cancer was conducted from December 31, 2020 to December 31, 2021. ICs’ burden was assessed using the Caregiver Reaction Assessment (CRA), Hospital Anxiety and Depression Scale (HADS), and Insomnia Severity Index (ISI). Linear and logistic regression models were used to identify the influencing factors.  Results  Among 289 ICs of hospitalized patients with lung cancer, 83 (28.72%), 53 (18.34%), and 14 (4.84%) ICs experienced mild, moderate, and severe insomnia, respectively. The scores concerning self-esteem, lack of family support, financial problems, disturbed schedule, and health problems were 4.32 ± 0.53, 2.24 ± 0.79, 2.84 ± 1.14, 3.63 ± 0.77, and 2.44 ± 0.95, respectively. ICs with higher Activities of Daily Living Scale (ADLS) scores were associated with a lower risk of insomnia, with an odd ratio (OR) and 95% confidence interval (CI) of 0.940 (0.898–0.983). Among the ICs, female gender (OR = 2.597), alcohol consumption (OR = 3.745), underlying medical conditions (OR = 11.765), long-term caregiving experience (OR = 37.037), and higher monthly expenses (OR = 5.714) were associated with a high risk of insomnia.  Conclusion  Of the hospitalized patients with lung cancer, 51.9% experienced insomnia. Patients’ ADL, ICs gender, alcohol consumption, underlying medical conditions, caregiving duration, and monthly expenses were influencing factors. Therefore, prompt screening and early intervention for ICs of patients with lung cancer is necessary.
Observation of the Curative Effect of the Dexamethasone Vitreous Cavity Implant for the Treatment of Irvine-Gass Syndrome
MAO Yu, GAO Li Qin, JIA Li Yun, HOU Si Meng, XIAO Yuan Yuan, JI Xi Wen, WANG Shuang
2023, 36(8): 725-731. doi: 10.3967/bes2023.084
  Objective  To investigate the clinical efficacy of dexamethasone vitreous cavity implants (Ozurdex) for the treatment of macular edema (Irvine-Gass Syndrome) after cataract surgery.   Method  Eight patients (eight eyes) with Irvine-Gass syndrome were enrolled for vitreous injections with Ozurdex. The patients included six men (six eyes) and two women (two eyes) with a mean age of 67.12 ± 11.92 years. Changes in the patients best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure were compared before and after treatment.   Result  The mean visual acuity BCVA of the patients was 0.81 ± 0.26 before implantation, which improved to 0.20 ± 0.12, 0.13 ± 0.09, and 0.15 ± 0.13 at 2 weeks, 1 month, and 3 months after implantation, respectively (P < 0.001). The patient’s mean CMT before implantation was 703.00 ± 148.88 μm, and it reduced to 258.87 ± 37.40 μm, 236.25 ± 28.74 μm, and 278.00 ± 76.82 μm at 2 weeks, 1 month, and 3 months after implantation, respectively (P < 0.001).   Conclusion  The dexamethasone vitreous cavity implant (Ozurdex) is a safe and effective treatment, which can effectively improve patient’s visual acuity and reduce macular edema associated with cataract surgery.
Causative Microorganisms Isolated from Patients with Intra-Abdominal Infections and Their Drug Resistance Profiles: An 11-Year (2011–2021) Single-Center Retrospective Study
DING Rui, MA Rui Rui, LIU Ya Li, ZHAO Ying, GUO Li Na, DOU Hong Tao, SUN Hong Li, LIU Wen Jing, ZHANG Li, WANG Yao, LI Ding Ding, YI Qiao Lian, XU Ying Chun
2023, 36(8): 732-742. doi: 10.3967/bes2023.072
  Objective  To investigate the distribution and antimicrobial susceptibility of causative microorganisms recovered from patients with intra-abdominal infections (IAIs).   Methods  A total of 2,926 bacterial and fungal strains were identified in samples collected from 1,679 patients with IAIs at the Peking Union Medical College Hospital between 2011 and 2021. Pathogenic bacteria and fungi were identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Antimicrobial susceptibility testing (AST) was performed using the VITEK 2 compact system and the Kirby–Bauer method. AST results were interpreted based on the M100-Ed31 clinical breakpoints of the Clinical and Laboratory Standards Institute.   Results  Of the 2,926 strains identified, 49.2%, 40.8%, and 9.5% were gram-negative bacteria, gram-positive bacteria, and fungi, respectively. Escherichia coli was the most prevalent pathogen in intensive care unit (ICU) and non-ICU patients; however, a significant decrease was observed in the isolation of E. coli between 2011 and 2021. Specifically, significant decreases were observed between 2011 and 2021 in the levels of extended-spectrum β-lactamase (ESBL)-producing E. coli (from 76.9% to 14.3%) and Klebsiella pneumoniae (from 45.8% to 4.8%). Polymicrobial infections, particularly those involving co-infection with gram-positive and gram-negative bacteria, were commonly observed in IAI patients. Moreover, Candida albicans was more commonly isolated from hospital-associated IAI samples, while Staphylococcus epidermidis had a higher ratio in community-associated IAIs. Additionally, AST results revealed that most antimicrobial agents performed better in non-ESBL-producers than in ESBL-producers, while the overall resistance rates (56.9%–76.8%) of Acinetobacter baumanmii were higher against all antimicrobial agents than those of other common gram-negative bacteria. Indeed, Enterococcus faecium, Enterococcus faecalis, S. epidermidis, and S. aureus were consistently found to be susceptible to vancomycin, teicoplanin, and linezolid. Similarly, C. albicans exhibited high susceptibility to all the tested antifungal drugs.   Conclusion  The distribution and antimicrobial susceptibility of the causative microorganisms from patients with IAIs were altered between 2011 and 2021. This finding is valuable for the implementation of evidence-based antimicrobial therapy and provides guidance for the control of hospital infections.
The Dual Role of Non-coding RNAs in the Development of Periodontitis
XU Xi, LANG Guang Ping, CHEN Zhong Lan, WANG Jing Le, HAN Ying Ying
2023, 36(8): 743-755. doi: 10.3967/bes2023.079
This review aims to sum up how Non-coding RNAs (ncRNAs) regulate the development of periodontitis and provides a new perspective for understanding the pathogenesis of periodontitis. We explored the ncRNA's dual role in the development of periodontitis by summarizing evidence from previous in vivo and in vitro studies as well as clinical samples. In our review, the downregulation of 18 miRNAs, 22 lncRNAs and 10 circRNAs demonstrates protective roles in periodontitis. In contrast, the expression of other 11 miRNAs, 7 lncRNAs and 6 circRNAs are upregulated in periodontitis, which promote the progression of periodontitis. These dysregulated ncRNAs exert their protective or destructive roles by mainly influencing cell proliferation, differentiation and apoptosis via cross-talking with various molecules or signaling pathways. Our findings suggested which and how ncRNAs promote or delay the progression of periodontitis, which may greatly contribute to diagnose and therapy development of periodontitis based on ncRNAs in the future.
Letter to the Editor
Hypoxic Mesenchymal Stem Cells Promote Diabetic Wound Healing in Rats by Increasing VEGF Secretion
ZHUANG Su Jing, SUN Xu Yan, LUO Meng, WANG Zhong, ZHANG Xue Juan, GAO Zong Sheng, LIU Jian, LIU Xin Ran, LIU Shi Ze, JIA Xiao Peng
2023, 36(8): 756-759. doi: 10.3967/bes2023.100
Risk of Developing Non-Alcoholic Fatty Liver Disease Over Time in a Cohort of the Elderly in Qingdao, China
LIU Li, SHAO Yu Han, FENG En Qiang, SHAO Zhu Gang, XING Dong Ming
2023, 36(8): 760-767. doi: 10.3967/bes2023.101
A Risk Assessment Model for Pancreatic Cancer Based on Cuproptosis-related Genes and Clinical Characteristics
CHEN Yi Kai, WU Si Qian, LIU Wen Jun
2023, 36(8): 768-772. doi: 10.3967/bes2023.102
Exploring Gender Differences in Adolescent Dissociative Symptoms via A Structural Equation Model
CHENG Qing Lin, DENG Yuan Yuan, ZHAO Gang, CHEN Jun Fang, XIE Li, WANG Le
2023, 36(8): 773-778. doi: 10.3967/bes2023.103
A Campylobacteriosis Outbreak Caused by One Asymptomatic Food Handler Carrier
YAN Ai Xia, ZHOU Gui Lan, GAO Peng, KANG Ying, LI Shou Fei, WANG Yuan Yuan, WANG Feng Shuang, WANG Hai Rui, LI Ying, ZHANG Mao Jun
2023, 36(8): 779-782. doi: 10.3967/bes2023.105
In August 2021, three students with diarrhea from the same school visited a local hospital in the S district of Beijing. An epidemic investigation showed that there were more students with diarrhea in the same school and they had one meal together. Campylobacter jejuni was isolated from both patients with diarrhea and asymptomatic food handlers; however, the latter also carried Campylobacter coli. Phylogenomic analysis showed that there was a campylobacteriosis outbreak among the students, and the asymptomatic food handler may have been the source of the infection. Routine inspection and surveillance for Campylobacter is needed for the food producing staff, particularly those cooking in the cafeteria in schools or other public food services.
The China Cardiovascular Health Index 2023 was Grandly Released
2023, 36(8): 783-783. doi: 10.3967/bes2023.107
Method for Folate Deficiency Screening
2023, 36(8): 784-784. doi: 10.3967/bes2023.108
Method for Vitamin D Deficiency Screening
2023, 36(8): 785-785. doi: 10.3967/bes2023.109