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Heterogeneity of chronic obstructive pulmonary disease: from phenotype to genotype

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《医学前沿（英文）》 2013年 第7卷 第4期   页码 425-432 doi: 10.1007/s11684-013-0295-x

摘要：

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity and mortality throughout the world and is mainly characterized by persistent airflow limitation. Given that multiple systems other than the lung can be impaired in COPD patients, the traditional FEV1/FVC ratio shows many limitations in COPD diagnosis and assessment. Certain heterogeneities are found in terms of clinical manifestations, physiology, imaging findings, and inflammatory reactions in COPD patients; thus, phenotyping can provide effective information for the prognosis and treatment. However, phenotypes are often based on symptoms or pathophysiological impairments in late-stage COPD, and the role of phenotypes in COPD prevention and early diagnosis remains unclear. This shortcoming may be overcome by the potential genotypes defined by the heterogeneities in certain genes. This review briefly describes the heterogeneity of COPD, with focus on recent advances in the correlations between genotypes and phenotypes. The potential roles of these genotypes and phenotypes in the molecular mechanisms and management of COPD are also elucidated.

关键词： chronic obstructive pulmonary disease     heterogeneity     phenotype     genotype     prediction    

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Exploration of Strategies for Chronic Disease Prevention and Control and Relevant System Development

Long-de Wang

《工程管理前沿（英文）》 2015年 第2卷 第1期   页码 2-12 doi: 10.15302/J-FEM-2015002

摘要： Chronic non-communicable diseases have become a major threat to humanity. International studies have shown that of 57 million deaths worldwide in 2008, 36 million (63%) were caused by chronic non-communicable diseases; of these, 29 million (80%) occurred in low and middle income countries. The WHO predicts that if the current trend continues, the annual number of deaths due to chronic non-communicable diseases will increase to 55 million by 2030. Due to acceleration of industrialization and urbanization, along with population aging and rapid changes of people’s lifestyle, the morbidity and mortality from chronic diseases are rapidly increasing in China. Therefore, dealing with the prevalence of chronic non-communicable diseases has become one of the current major health issues for China to address. On the basis of summarizing the status of major chronic diseases in China, analyzing the key issues and key factors in chronic disease prevention and control, and reviewing and summarizing the experience from the previous projects, this paper proposes the following recommendations as strategies for chronic disease prevention and control and development of relevant system, which China should adopt. All relevant government departments should formulate corresponding policies; establish a coordinated and efficient work system with rational structure and clear division of tasks and responsibilities within the system. Implementation and development of “integrated medicine” in system is necessary. Work norms and requirements will then improve the performance and efficiency in chronic disease prevention and control in China.

关键词： chronic disease prevention and control     strategy and system construction    

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Identification of differentially expressed miRNAs associated with chronic kidney disease–mineral bone

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《医学前沿（英文）》 2017年 第11卷 第3期   页码 378-385 doi: 10.1007/s11684-017-0541-8

摘要：

The purpose of this study is to characterize a meta-signature of differentially expressed mRNA in chronic kidney disease (CKD) to predict putative microRNA (miRNA) in CKD–mineral bone disorder (CKD–MBD) and confirm the changes in these genes and miRNA expression under uremic conditions by using a cell culture system. PubMed searches using MeSH terms and keywords related to CKD, uremia, and mRNA arrays were conducted. Through a computational analysis, a meta-signature that characterizes the significant intersection of differentially expressed mRNA and expected miRNAs associated with CKD–MBD was determined. Additionally, changes in gene and miRNA expressions under uremic conditions were confirmed with human Saos-2 osteoblast-like cells. A statistically significant mRNA meta-signature of upregulated and downregulated mRNA levels was identified. Furthermore, miRNA expression profiles were inferred, and computational analyses were performed with the imputed microRNA regulation based on weighted ranked expression and putative microRNA targets (IMRE) method to identify miRNAs associated with CKD occurrence. TLR4 and miR-146b levels were significantly associated with CKD–MBD. TLR4 levels were significantly downregulated, whereas pri-miR-146b and miR-146b were upregulated in the presence of uremic toxins in human Saos-2 osteoblast-like cells. Differentially expressed miRNAs associated with CKD-MBD were identified through a computational analysis, and changes in gene and miRNA expressions were confirmed with an in vitro cell culture system.

关键词： chronic kidney disease     microRNA     mineral bone disorder     uremia    

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中国慢性病防控策略和体系建设探索

王陇德

《中国工程科学》 2014年 第16卷 第10期   页码 22-30

摘要：

慢性非传染性疾病已成为当前人类的重大威胁。国际研究表明，2008 年全球5 700 万人死亡，其中的63 %（3 600 万人）死于慢性非传染性疾病；80 %的非传染性疾病所致死亡（2 900 万人）发生在低收入和中等收入国家。WHO预测，如果按目前的情况继续发展，到2030 年每年死于慢性非传染性疾病的人数将增加至5 500 万人。在中国，伴随着工业化、城镇化、老龄化进程的加快和国民生活方式的快速变迁，居民慢性病患病率、死亡率呈持续快速增长趋势。因此，慢性非传染性疾病流行的应对，是中国当前必须尽快考虑的重大问题。本文在总结中国重大慢性病流行状况、分析中国慢性病防控中存在的主要问题和关键影响因素以及总结前期项目探索经验的基础上，对中国慢性病防控应制定和采取的策略及防控体系建设工作要点提出了建议：如相关政府部门都应制定相应政策；建立结构合理、系统内任务分工明确，协调、高效的工作体系；从制度、工作规范与要求上推行“整合医学”的发展，从而提高中国慢性病防控工作效能与效益等。

关键词： 慢性病防控     策略与体系建设    

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Effects of comprehensive therapy based on traditional Chinese medicine patterns on older patients with chronicobstructive pulmonary disease: a subgroup analysis from a four-center, randomized, controlled study

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《医学前沿（英文）》 2014年 第8卷 第3期   页码 368-375 doi: 10.1007/s11684-014-0360-0

摘要：

This study aimed to evaluate the efficacy of comprehensive therapy based on traditional Chinese medicine (TCM) patterns on older patients with chronic obstructive pulmonary disease (COPD) through a four-center, open-label, randomized controlled trial. Patients were divided into the trial group treated using conventional western medicine and Bu-Fei Jian-Pi granules, Bu-Fei Yi-Shen granules, and Yi-Qi Zi-Shen granules based on TCM patterns respectively; and the control group treated using conventional western medicine. A total of 136 patients≥65 years completed the study, with 63 patients comprising the trial group and 73 comprising the control group. After the six-month treatment and the 12-month follow-up period, significant differences were observed between the trial and control groups in the following aspects: frequency of acute exacerbation (P≤0.040), duration of acute exacerbation (P = 0.034), symptoms (P≤0.034), 6-min walking distance (6MWD) (P≤0.039), dyspnea scale (P≤0.036); physical domain (P≤0.019), psychological domain (P≤0.033), social domain (P≤0.020), and environmental domain (P≤0.044) of the WHOQOL-BREF questionnaire; and daily living ability domain (P≤0.007), social activity domain (P≤0.018), depression symptoms domain (P≤0.025), and anxiety symptoms domain (P≤0.037) of the COPD-QOL. No differences were observed between the trial and control groups with regard to FVC, FEV1, and FEV1%.

关键词： chronic obstructive pulmonary disease     older adult     clinical trial     Bu-Fei Jian-Pi granules     Bu-Fei Yi-Shen granules     Yi-Qi Zi-Shen granules    

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Risk factors for chronic graft-versus-host disease after anti-thymocyte globulin-based haploidentical

Meng Lv, Xiaohui Zhang, Lanping Xu, Yu Wang, Chenhua Yan, Huan Chen, Yuhong Chen, Wei Han, Fengrong Wang, Jingzhi Wang, Kaiyan Liu, Xiaojun Huang, Xiaodong Mo

《医学前沿（英文）》 2019年 第13卷 第6期   页码 667-679 doi: 10.1007/s11684-019-0702-z

摘要： Chronic graft-versus-host disease (cGVHD) is a major complication following unmanipulated haploidentical hematopoietic stem cell transplantation (haplo-HSCT). We aimed to identify the risk factors for cGVHD in patients who underwent anti-thymocyte globulin-based haplo-HSCT for acute myeloid leukemia ( =280). The diagnosis of cGVHD was in accordance with the National Institutes of Health consensus criteria. A total of 169 patients suffered from cGVHD. The patients who had 3 loci mismatched had a higher 8-year incidence of cGVHD (total, 66.0% vs. 53.7%, =0.031; moderate to severe, 42.4% vs. 30.1%, =0.036) than the patients who had 1 to 2 loci mismatched. The patients who had maternal donors had a higher 8-year incidence of moderate to severe cGVHD (49.2% vs. 32.9%, =0.024) compared with the patients who had other donors. The patients who had grades III to IV acute GVHD (aGVHD) had higher 8-year incidence of cGVHD (total, 88.0% vs. 50.4%, <0.001; moderate to severe, 68.0% vs. 27.0%, <0.001) compared with the patients without aGVHD. In multivariate analysis, grades III to IV aGVHD was the only independent risk factor for cGVHD. Thus, further interventions should be considered in patients with severe aGVHD to prevent cGVHD.

关键词： acute graft-versus-host disease     chronic graft-versus-host disease     National Institutes of Health consensus criteria     acute myeloid leukemia     anti-thymocyte globulin    

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Association of periodontal disease with glycemic control in patients with type 2 diabetes in Indian population

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《医学前沿（英文）》 2017年 第11卷 第1期   页码 110-119 doi: 10.1007/s11684-016-0484-5

摘要：

This study aims to investigate the link between glycated hemoglobin and diabetic complications with chronic periodontitis. A total of 207 patients with type 2 diabetes and chronic periodontitis (CP) were divided according to tertiles of mean PISA (periodontal inflamed surface area) scores as low, middle and high PISA groups. Simultaneously a group of 67 periodontally healthy individuals (PH) was recruited. Periodontal examinations, including full-mouth assessment of probing depths (PPD), bleeding on probing, clinical attachment level and plaque scores were determined. Blood analyses were carried out for glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), 2 h post parandial glucose (PPG). Individuals in PH group had significantly better glycemic control than CP group. Upon one-way analysis of variance, subjects with increased PISA had significantly higher HbA1c levels, retinopathy and nephropathy (P<0.05). After controlling for age, gender, body mass index (BMI), socioeconomic status (SES), family history of diabetes and periodontitis, duration of diabetes, the mean PISA in mm2, PPD 4--6 mm (%) and PPD≥7 mm (%) emerged as significant predictors for elevated HbA1c in regression model (P<0.05). Logistic regression analysis revealed that PISA was associated with higher risk of having retinopathy and neuropathy (odds ratio). In our study, the association between glycemic control and diabetic complications with periodontitis was observed.

关键词： type 2 diabetes mellitus     hemoglobin A     glycated     chronic periodontitis    

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Associations of sleeping patterns and isotemporal substitution of other behavior with the prevalence of CKD in Chinese adults

《医学前沿（英文）》 doi: 10.1007/s11684-023-1019-5

摘要： Studies have found a U-shaped relationship between sleep duration and chronic kidney disease (CKD) risk, but limited research evaluated the association of reallocating excessive sleep to other behavior with CKD. We included 104 538 participants from the nationwide cohort of the Risk Evaluation of Cancers in Chinese Diabetic Individuals: A Longitudinal Study, with self-reported time of daily-life behavior. Using isotemporal substitution models, we found that substituting 1 h of sleeping with sitting, walking, or moderate-to-vigorous physical activity was associated with a lower CKD prevalence. Leisure-time physical activity displacement was associated with a greater prevalence reduction than occupational physical activity in working population. In stratified analysis, a lower CKD prevalence related to substitution toward physical activity was found in long sleepers. More pronounced correlations were observed in long sleepers with diabetes than in those with prediabetes, and they benefited from other behavior substitutions toward a more active way. The U-shaped association between sleep duration and CKD prevalence implied the potential effects of insufficient and excessive sleep on the kidneys, in which the pernicious link with oversleep could be reversed by time reallocation to physical activity. The divergence in the predicted effect on CKD following time reallocation to behavior of different domains and intensities and in subpopulations with diverse metabolic statuses underlined the importance of optimizing sleeping patterns and adjusting integral behavioral composition.

关键词： sleep     physical activity     chronic kidney disease     isotemporal substitution     behavioral pattern    

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Prevalence of asthma symptoms in Golestan schoolchildren aged 6–7 and 13–14 years in Northeast Iran

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《医学前沿（英文）》 2016年 第10卷 第3期   页码 345-350 doi: 10.1007/s11684-016-0462-y

摘要：

Asthma is the most common chronic disease among children, and its incidences are often imminent among elementary schoolchildren. This study aimed to examine the prevalence of asthma symptoms in Golestan schoolchildren aged 6–7 and 13–14 years in Northeast Iran. The prevalence rate was compared according to age group (aged 6–7 years vs. aged 13–14 years) and gender (male vs. female). In this cross-sectional study, 1706 Iranian schoolchildren aged 6–7 and 13–14 years in Golestan Province were enrolled. Participants completed questionnaires between February and July 2014. Asthma symptoms were assessed using the questionnaire of the International Study of Asthma and Allergies in Childhood protocol in Persian. The logistic regression model was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of the asthma symptoms for each of the gender and age groups. The prevalence rates of “current asthma” symptoms and “asthma ever” in all the children were estimated as 9.5% and 7.5%, respectively. The prevalence of asthma (“asthma ever” and “wheezing in the past 12 months”) in junior high schoolchildren (aged 13–14 years) is higher than that in elementary schoolchildren (aged 6–7 years) (P <0.05). The prevalence of the severity of wheezing in girls is lower than that in boys (OR= 1.7, 95%CI= 1.06–2.96, P = 0.02). Asthma is still a major public health problem. This study shows that the prevalence of the asthma symptoms in boys is lower than that in girls in both age groups, and the severity of asthma in girls is higher than that in boys aged 13–14 years.

关键词： asthma     asthma symptoms     epidemiology     childhood     chronic disease    

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国外重大慢性非传染性疾病防治对策研究

张祝琴,刘德培

《中国工程科学》 2017年 第19卷 第2期   页码 112-116 doi: 10.15302/J-SSCAE-2017.02.019

摘要：

重大慢性非传染性疾病包括心脑血管疾病、癌症、呼吸系统疾病、糖尿病等，其流行给全球居民健康造成了重大威胁。为进一步对慢性病进行有效预防控制，促进健康、推动经济和社会发展，2014年中国工程院立项并开展了“重大慢性非传染性疾病防治的国际对比研究”项目，对国内外慢性病预防控制情况以及可供我们借鉴的经验进行了详细分析。本文从慢性病发病概况入手，分析了各种疾病的预防控制措施，并对不同国家的慢性病预防控制体系进行比较，凝练有益经验和方法，提出了增强我国慢性病预防控制的措施和建议。

关键词： 慢性病     心脑血管疾病     癌症     呼吸系统疾病     糖尿病     疾病预防控制体系    

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New perspective on the natural course of chronic HBV infection

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《医学前沿（英文）》 2014年 第8卷 第2期   页码 129-134 doi: 10.1007/s11684-014-0339-x

摘要：

Chronic hepatitis B virus (HBV) infection is a significant threat to public health and an enormous burden on society. Mechanisms responsible for chronic HBV infection remain poorly understood. A better understanding of the natural course of chronic HBV infection may shed new light on the mechanisms underlying this disease and help in designing new antiviral strategies. Natural course of chronic HBV infection is conventionally viewed as an uninterrupted process that is usually marked by HBV e antigen (HBeAg) seroconversion or characterized by different phases associated with assumed host responses to HBV infection. However, none of these descriptions captures or highlights the core events that determine the natural course of chronic HBV infection. In this review, we briefly present the current knowledge on this subject and explain the significance and implication of events that occur during infection. A pre-core mutant becomes predominant in the viral population following elimination of the wild-type virus in duck hepatitis B virus-chronically infected animals. The coupled events in which first there is viral clearance that clears wild-type virus and then there is the reinfection of wild-type virus cleared livers with mutant virus are highly relevant to understanding of the natural course of chronic HBV infection under both treated and untreated conditions. In our new perspective, a general natural course of chronic HBV infection comprises cycles of viral clearance and reinfection, and such cycles prolong the chronic HBV infection course. Reviewing published data on the natural course of chronic HBV infection can reduce the possibility of missing important points in the initial data interpretation.

关键词： hepatitis B virus     chronic HBV infection     natural course     hepatitis B     seroconversion    

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Effect of renal function and hemodialysis on the serum tumor markers in patients with chronic kidneydisease

YU Xiaofang, XU Xialian, YE Zhibin

《医学前沿（英文）》 2007年 第1卷 第3期   页码 308-311 doi: 10.1007/s11684-007-0059-6

摘要： In patients with chronic renal failure, whether they have had hemodialysis or not, the specificity of some of the serum tumor markers for the diagnosis of the corresponding tumors is decreased while others remain as valuable as they are in patients with normal kidney function. The detection of tumor markers is extensively used for the diagnosis of corresponding tumors. It has been recently shown that some tumor markers are higher in patients with chronic kidney disease (CKD) than in the normal population. The effects of renal function and hemodialysis were examined on serum levels of some of the tumor markers including CEA, CA, CA, AFP, CA, CA, CYFRA, NSE, SCC-Ag, PSA, and fPSA. The 232 non-dialysis patients with CKD and 37 chronic uremic patients treated with maintenance hemodialysis were enrolled in this study. The 232 non-dialysis patients were divided into three groups according to their Ccr. In group 1, Ccr was ≤25 mL/min. In group 2, Ccr was between 25 and 50 mL/min. In group 3, Ccr was ≥50 mL/min. The male patients were also divided into three groups to compare the serum levels of PSA and fPSA among the three groups. Nine tumor markers in 37 uremic patients were tested. For comparison, 37 non-dialysis patients with similar Ccr of the same age and gender served as controls. There existed significant differences in serum levels of CEA, CA, CYFRA, NSE, and SCC-Ag among different Ccr groups and the markers bore a negative correlation with Ccr. There were no significant differences among the three groups in the serum concentrations of CA, AFP, CA, CA, PSA and fPSA. The serum levels of CA and NSE were significantly higher (199, CYFRA, NSE, CA and SCC-Ag for the diagnosis of the corresponding tumors was decreased while serum AFP, CA, CA, PSA and fPSA were as valuable as they were in patients with normal kidney function. Hemodialysis further increased the serum level of CA and NSE.

关键词： CKD     non-dialysis     valuable     detection     chronic    

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Acupuncture is ineffective for chronic low back pain? A critical analysis and rethinking

Xuqiang Wei, Baoyan Liu

《医学前沿（英文）》 2021年 第15卷 第5期   页码 767-775 doi: 10.1007/s11684-020-0785-6

摘要： Acupuncture is a promising treatment for relieving pain and improving lower back function in clinical practice. However, evidence from randomized clinical trials (RCTs) remains controversial. Most RCTs conclude that acupuncture procedures for chronic low back pain (CLBP) had no significant difference in efficacy and belonged to placebo. We carefully reviewed and analyzed the methodology and implementation of sham acupuncture in RCTs. Controversial evidence of acupuncture for CLBP is only a microcosm of the evaluation methodological limitation of acupuncture. Inappropriate selection of sham acupuncture controls, rigorous RCT research models, and incorrect interpretation of results may contribute to negative evidence. Evaluating and disregarding the holistic efficacy of acupuncture with an explanatory RCT model based on evaluation drugs may be unwise. Moreover, sham acupuncture is often proven to be non-inert, unreasonable, and with low fidelity. Pitfalls of the explanatory RCT model and sham acupuncture design should be avoided. Establishing a new evaluation system that is in line with the clinical characteristics of acupuncture and obtaining high-quality evidence are difficult but promising tasks.

关键词： chronic low back pain     sham acupuncture     acupuncture     methodology     therapeutic evaluation    

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Vaccine therapies for chronic hepatitis B: can we go further?

null

《医学前沿（英文）》 2014年 第8卷 第1期   页码 17-23 doi: 10.1007/s11684-014-0313-7

摘要：

Chronic hepatitis B is a major health burden worldwide. In addition to the recent progress in antiviral treatment, therapeutic vaccination is a promising new strategy for the control of chronic hepatitis B. On the basis of the major specific and non-specific immune dysregulations and defects in chronic hepatitis B patients, this paper presents the peptide and protein-based, DNA-based, cell-based, and antigen-antibody-based therapeutic vaccines, which have undergone clinical trials. The advantages, disadvantages, and future perspectives for these therapeutic vaccines are discussed.

关键词： chronic hepatitis B     therapeutic     antigen-antibody complexes     DNA     vaccine    

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Perceived resource support for chronic illnesses among diabetics in north-western China

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《医学前沿（英文）》 2016年 第10卷 第2期   页码 219-227 doi: 10.1007/s11684-016-0441-3

摘要：

A high level of social support can improve long-term diabetes self-management. Support from a single source has been evaluated. This study aims to analyze support from multiple and multilevel sources for diabetic patients by using the Chronic Illness Resources Survey (CIRS). Factors influencing the utilization of the CIRS were also evaluated. A total of 297 patients with diabetes were investigated using the CIRS and Perceived Diabetes Self-management Scale in Shihezi City, China. Descriptive statistics were used to explain demographic variables and scores of the scales. Factors affecting the utilization of chronic illness resources were determined through univariate analysis and then examined by multivariate logistic regression analysis. Of the 297 diabetic patients surveyed, 67% failed to reach the standard (more than 3 points) of utilizing chronic illness resources. Moreover, utilization of chronic illness resources was positively moderately correlated with self-management of diabetes (r = 0.75, P <0.05). According to the multivariate logistic regression analysis, age (OR, 3.42; 95%CI, 1.19–9.84) and monthly income (OR, 5.27; 95%CI, 1.86–14.90) were significantly positively associated with the CIRS score. Individuals with high school (OR, 2.61; 95%CI, 1.13–6.05) and college (OR, 3.02; 95%CI, 1.13–8.04) degrees obtained higher scores in the survey than those with elementary school education. Results indicated that utilization of resources and support for chronic illness self-management, particularly personal adjustment and organization, were not ideal among diabetics in the communities of north-western China. Improved utilization of chronic illness resources was conducive for proper diabetes self-management. Furthermore, the level of utilization of chronic illness resources increased with age, literacy level, and monthly income.

关键词： chronic illness resources survey     diabetes     community     north-western China    

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标题 作者 时间 类型 操作

Heterogeneity of chronic obstructive pulmonary disease: from phenotype to genotype

null

期刊论文

Exploration of Strategies for Chronic Disease Prevention and Control and Relevant System Development

Long-de Wang

期刊论文

Identification of differentially expressed miRNAs associated with chronic kidney disease–mineral bone

null

期刊论文

中国慢性病防控策略和体系建设探索

王陇德

期刊论文

Effects of comprehensive therapy based on traditional Chinese medicine patterns on older patients with chronicobstructive pulmonary disease: a subgroup analysis from a four-center, randomized, controlled study

null

期刊论文

Risk factors for chronic graft-versus-host disease after anti-thymocyte globulin-based haploidentical

Meng Lv, Xiaohui Zhang, Lanping Xu, Yu Wang, Chenhua Yan, Huan Chen, Yuhong Chen, Wei Han, Fengrong Wang, Jingzhi Wang, Kaiyan Liu, Xiaojun Huang, Xiaodong Mo

期刊论文

Association of periodontal disease with glycemic control in patients with type 2 diabetes in Indian population

null

期刊论文

Associations of sleeping patterns and isotemporal substitution of other behavior with the prevalence of CKD in Chinese adults

期刊论文

Prevalence of asthma symptoms in Golestan schoolchildren aged 6–7 and 13–14 years in Northeast Iran

null

期刊论文

国外重大慢性非传染性疾病防治对策研究

张祝琴,刘德培

期刊论文

New perspective on the natural course of chronic HBV infection

null

期刊论文

Effect of renal function and hemodialysis on the serum tumor markers in patients with chronic kidneydisease

YU Xiaofang, XU Xialian, YE Zhibin

期刊论文

Acupuncture is ineffective for chronic low back pain? A critical analysis and rethinking

Xuqiang Wei, Baoyan Liu

期刊论文

Vaccine therapies for chronic hepatitis B: can we go further?

null

期刊论文

Perceived resource support for chronic illnesses among diabetics in north-western China

null

期刊论文