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[Application of ultrasensitive single molecule immunoassay technology in clinical biomarker detection]. [超灵敏单分子免疫测定技术在临床生物标记物检测中的应用]。
Q3 Medicine Pub Date : 2024-08-06 DOI: 10.3760/cma.j.cn112150-20231212-00431
W C Jiang, G J Zhang

Single-molecule immunoassay technology represents an ultrasensitive immunoassay method that enables the resolution and detection of individual biomolecules at the nanoscale. This article highlights various representative techniques and clinical applications of single-molecule immunoassay technology, while also discussing the current challenges and future development directions. Through multiple optimizations at both the technical and commercial levels, single-molecule immunoassay technology exhibits unique advantages in real-time detection, disease diagnosis and treatment, and medical research. This technology is poised to contribute to the advancement of precision medicine by integrating individualized detection methods into clinical practice.

单分子免疫测定技术是一种超灵敏的免疫测定方法,可在纳米尺度上分辨和检测单个生物分子。本文重点介绍了单分子免疫测定技术的各种代表性技术和临床应用,同时还讨论了当前面临的挑战和未来的发展方向。通过技术和商业层面的多重优化,单分子免疫测定技术在实时检测、疾病诊断和治疗以及医学研究方面展现出了独特的优势。通过将个体化检测方法融入临床实践,这项技术有望为精准医疗的发展做出贡献。
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引用次数: 0
[Epidemiological characteristics of human respiratory syncytial virus in influenza-like illness in Shenzhen City from 2019 to 2023]. [2019-2023年深圳市流感样病例中人呼吸道合胞病毒的流行病学特征]。
Q3 Medicine Pub Date : 2024-08-06 DOI: 10.3760/cma.j.cn112150-20240318-00223
Y Sun, W H Wu, Y L Huang, S S Fang, H Liu, M Jiang, J Meng, X Zou, X Wang

Objective: To understand the epidemiological characteristics of human respiratory syncytial virus (HRSV) among cases presenting with influenza-like illness (ILI) in Shenzhen City from 2019 to 2023. Methods: Respiratory specimens were collected from two national sentinel hospitals in Shenzhen from March 2019 to December 2023, specifically targeting cases of ILI. The real-time PCR method was used for the detection and genotyping of HRSV. Basic demographic information was collected and used for the epidemiological analysis. Results: A total of 9 278 respiratory specimens of influenza-like cases were collected and detected, with a total positive rate of 4.77% (443/9 278) for HRSV. In 2021 (8.48%, 167/1 970), the positive rate of HRSV was significantly higher than in 2019 (3.35%, 52/1 552), 2022 (1.80%, 39/2 169), and 2023 (4.49%, 133/2 960), and the difference was statistically significant (χ2=102.395, P<0.001). The prevalence of HRSV was mainly in summer and early autumn (September), and there was an abnormal increase in the positive rate of HRSV in winter 2022. The highest positive rate of HRSV was in children under five years old (9.84%, 330/335). The typing results showed that in 2022, the prevalence of HRSV-A was predominant (71.79%, 28/39), and in 2023, HRSV-A and HRSV-B subtypes coexisted. Conclusions: The prevalence of HRSV in Shenzhen from 2019 to 2023 has obvious seasonality, mainly in summer and early autumn. Children under five years old are the main population of HRSV infections.

目的了解2019-2023年深圳市流感样病例中人呼吸道合胞病毒(HRSV)的流行病学特征。研究方法收集2019年3月至2023年12月深圳市两家国家级哨点医院的呼吸道标本,主要针对ILI病例。采用实时 PCR 方法检测 HRSV 并进行基因分型。收集基本人口统计学信息并用于流行病学分析。研究结果共收集并检测了 9 278 份流感样病例的呼吸道标本,HRSV 阳性率为 4.77%(443/9 278)。2021年(8.48%,167/1 970)的HRSV阳性率明显高于2019年(3.35%,52/1 552)、2022年(1.80%,39/2 169)和2023年(4.49%,133/2 960),差异有统计学意义(χ2=102.395,PConclusions:2019-2023年深圳市HRSV流行具有明显的季节性,主要集中在夏季和初秋。5岁以下儿童是HRSV感染的主要人群。
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引用次数: 0
[Research progress on detection methods for human respiratory syncytial virus]. [人类呼吸道合胞病毒检测方法研究进展]。
Q3 Medicine Pub Date : 2024-08-06 DOI: 10.3760/cma.j.cn112150-20240108-00024
N Wang, H Li, J J Song, J H Song, Y Zhang

Human respiratory syncytial virus (HRSV) can infect individuals of all ages, with children under five years old, the elderly, and immunocompromised persons as the main high-risk groups. Although older children and adults often exhibit mild or no symptoms, they may still be potential carriers of the virus. Therefore, employing efficient, accurate, and rapid detection methods to timely identify infection sources and quickly halt transmission is an important means to curb the potential spread of the epidemic. However, the clinical manifestations of HRSV infection are difficult to distinguish from acute respiratory infections caused by other respiratory viruses, and the identification relies on the results of pathogen testing. This article summarizes four commonly used detection methods for HRSV based on detection principles: antigen detection, nucleic acid testing, antibody detection, and virus isolation. The advantages, disadvantages, principles, and applicable scenarios of these four methods are summarized and compared. Furthermore, the research progress and prospects of HRSV detection methods are reviewed.

人类呼吸道合胞病毒(HRSV)可感染所有年龄段的人,五岁以下儿童、老年人和免疫力低下者是主要的高危人群。虽然年长儿童和成年人通常表现出轻微或无症状,但他们仍可能是病毒的潜在携带者。因此,采用高效、准确、快速的检测方法,及时发现传染源并迅速阻止传播,是遏制疫情可能蔓延的重要手段。然而,HRSV 感染的临床表现很难与其他呼吸道病毒引起的急性呼吸道感染区分开来,其鉴别主要依赖于病原体检测的结果。本文根据检测原理总结了四种常用的 HRSV 检测方法:抗原检测、核酸检测、抗体检测和病毒分离。总结并比较了这四种方法的优缺点、原理和适用范围。此外,还综述了 HRSV 检测方法的研究进展和前景。
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引用次数: 0
[Component diagnosis of food allergy: precise identification of allergenic components in egg and milk]. [食物过敏的成分诊断:鸡蛋和牛奶中过敏成分的精确鉴定]。
Q3 Medicine Pub Date : 2024-08-06 DOI: 10.3760/cma.j.cn112150-20240518-00401
H M Huang, A L Li, W T Luo, J L Zhang, B Q Sun

Food allergy are triggered by an abnormal immune response to specific food components, with milk and eggs being the most common food allergens, especially in children. Food allergy can cause various symptoms such as rashes, difficulty breathing, and digestive issues. Allergen component diagnostics is a technique used to identify specific allergenic proteins, aiding doctors in providing more precise treatment and management recommendations for patients. This article analyzes the latest research developments and clinical significance of milk and egg allergen components based on the " Molecular Allergology User's Guide 2.0 (MAUG 2.0)" issued by the European Academy of Allergy and Clinical Immunology (EAACI), including their applications in clinical diagnosis, treatment, and management. This article aims to enhance healthcare professionals' understanding of milk and egg allergies, offering new perspectives and practical guidelines for research and clinical practice to promote accurate diagnosis and personalized treatment strategies.

食物过敏是由对特定食物成分的异常免疫反应引发的,其中牛奶和鸡蛋是最常见的食物过敏原,尤其是对儿童而言。食物过敏会引起各种症状,如皮疹、呼吸困难和消化问题。过敏原成分诊断是一种用于识别特定过敏原蛋白的技术,有助于医生为患者提供更精确的治疗和管理建议。本文根据欧洲过敏与临床免疫学学会(EAACI)发布的《分子过敏学用户指南 2.0(MAUG 2.0)》,分析了牛奶和鸡蛋过敏原成分的最新研究进展和临床意义,包括其在临床诊断、治疗和管理中的应用。这篇文章旨在提高医护人员对牛奶和鸡蛋过敏的认识,为研究和临床实践提供新的视角和实用指南,以促进准确诊断和个性化治疗策略。
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引用次数: 0
[Survey on the current situation of human resources of professional public health institutions in Weihai City from 2021 to 2023]. [2021-2023年威海市专业公共卫生机构人力资源现状调查]。
Q3 Medicine Pub Date : 2024-08-06 DOI: 10.3760/cma.j.cn112150-20240305-00186
K Wu, W H Wang, X Q Yu, Z H Yang

This study aims to promote the system construction of public health talent through understanding the status and identifying problems of public health human resources in Weihai City. A survey on professional public health institutions was conducted through questionnaires and interviews in Weihai City, and statistical analysis on the personnel structure, introduction, and turnover of professional public health institutions was conducted. There were 24 professional public health institutions in Weihai City, with a vacancy rate of 44.27% (1 367/3 088). Health professionals accounted for 68.09% (1 669/2 451) of the on-duty personnel. The number of health technicians in professional public health institutions in the city was 0.57 per thousand people. Among the 1 669 health professionals, the age groups≤35, 36-45, 46-54, and ≥55 accounted for 47.63% (795/1 669), 30.26% (505/1 669), 18.10% (302/1 669), and 4.01% (67/1 669), respectively. The personnel with bachelor's degrees and master's degrees accounted for 74.60% (1 245/1 669) and 8.09% (135/1 669). The personnel holding clinical medical, nursing, laboratory, and public health qualifications accounted for 61.34% (995/1 622), 28.30% (459/1 622) and 10.36% (168/1 622), respectively. Only 17.73% (296/1 669) of personnel held deputy senior or above technical titles, while 45.96% (767/1 669) held junior or below technical titles. About 70.10% (1 170/1 669) personnel held permanent positions, and 29.90% (499/1 669) held non-permanent positions. From 2021 to 2023, the employment rate of public health institutions was 65.51% (207/316), and the ratio of introduced and lost personnel was approximately 3∶2 (207/132).

本研究旨在通过了解威海市公共卫生人力资源现状、发现问题,促进公共卫生人才体系建设。通过问卷、访谈等方式对威海市专业公共卫生机构进行了调查,并对专业公共卫生机构人员结构、引进、流动等情况进行了统计分析。威海市共有 24 家专业公共卫生机构,空缺率为 44.27%(1 367/3 088)。在岗人员中,卫生专业技术人员占 68.09%(1 669/2 451)。全市专业公共卫生机构卫生技术人员数为 0.57 人/千人。在 1 669 名卫生技术人员中,年龄段≤35 岁、36-45 岁、46-54 岁、≥55 岁的分别占 47.63%(795/1 669)、30.26%(505/1 669)、18.10%(302/1 669)、4.01%(67/1 669)。拥有学士学位和硕士学位的人员分别占 74.60%(1 245/1 669)和 8.09%(135/1 669)。持有临床医学、护理、检验和公共卫生资格证书的人员分别占 61.34%(995/1 622)、28.30%(459/1 622)和 10.36%(168/1 622)。只有 17.73%(296/1 669)的人员具有副高级及以上技术职称,45.96%(767/1 669)的人员具有初级及以下技术职称。约 70.10%(1 170/1 669)的人员拥有长期职位,29.90%(499/1 669)的人员拥有非长期职位。2021 年至 2023 年,公共卫生机构就业率为 65.51%(207/316),引进与流失人员比例约为 3∶2(207/132)。
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引用次数: 0
[Application of EXODUS system combined with allosteric DNA nanoswitches in the detection of miR-107 among plasma exosomes of Parkinson's disease patients]. [EXODUS系统与异构DNA纳米开关在检测帕金森病患者血浆外泌体中miR-107中的应用]。
Q3 Medicine Pub Date : 2024-08-06 DOI: 10.3760/cma.j.cn112150-20231205-00397
X Wang, L M Cheng

This study aimed to achieve rapid detection of Parkinson's disease (PD) plasma exosome miR-107. A case-control design was used to collect ten Parkinson's disease and ten healthy control plasma samples from the Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology from December 2023 to January 2024. Exosome detection via the ultrafast-isolation system (EXODUS) was used to isolate plasma exosomes. The nanoparticle tracking analysis technology and electron microscopy were used to identify exosome particle size and morphology. The Qiagen miRNeasy Micro Kit was used to extract RNA. The microRNA-activated conditional looping of engineered switches (miRacles) was used to detect miR-107, and the relative expression was analyzed by agarose gel electrophoresis. Thermo Fisher RevertAid RT Reverse Transcription Kit was used to perform reverse transcription of RNA, and real-time PCR was used to detect miR-107. The independent samples t-test was used for comparison between groups. EXODUS system completed the isolation of exosomes from 500 μl plasma within 1.5 hours. The exosome concentration (mean±SD) was (4.82±2.02)×1010 particles/ml in the control group and (5.08±2.34)×1010 particles/ml in the PD group. There was no significant difference in exosome concentration between PD patients and healthy controls (t=-0.168, P=0.872). The morphology of exosomes was confirmed by electron microscopy. The miRacles nanoswitch could detect fM-level miR-107 and also effectively distinguish miR-107 from its family members, including miR-15a and miR-16. Agarose gel electrophoresis showed that the mean±SD of relative grey value content was 1.00±0.26 in the control group and 1.86±0.21 in the PD group. The miR-107 in the PD group was significantly higher than that in the control (t=-8.143, P<0.001), which was consistent with the result of real-time PCR. EXODUS combined with miRacles could achieve rapid, non-enzymatic and cheap detection of plasma exosomal miR-107 in PD patients.

本研究旨在实现帕金森病(PD)血浆外泌体miR-107的快速检测。研究采用病例对照设计,于2023年12月至2024年1月在华中科技大学同济医学院附属同济医院检验科采集了10份帕金森病血浆样本和10份健康对照血浆样本。通过超快速分离系统(EXODUS)进行外泌体检测,以分离血浆外泌体。利用纳米粒子跟踪分析技术和电子显微镜鉴定外泌体的粒径和形态。使用 Qiagen miRNeasy Micro Kit 提取 RNA。利用microRNA激活的条件循环工程开关(miRacles)检测miR-107,并通过琼脂糖凝胶电泳分析其相对表达量。Thermo Fisher RevertAid RT 反转录试剂盒用于反转录 RNA,实时 PCR 用于检测 miR-107。组间比较采用独立样本 t 检验。EXODUS 系统可在 1.5 小时内从 500 μl 血浆中分离出外泌体。对照组的外泌体浓度(平均值±SD)为(4.82±2.02)×1010个/毫升,而腹膜透析组的外泌体浓度(平均值±SD)为(5.08±2.34)×1010个/毫升。PD患者与健康对照组的外泌体浓度无明显差异(t=-0.168,P=0.872)。电子显微镜证实了外泌体的形态。miRacles纳米开关能检测到fM级的miR-107,还能有效区分miR-107与其家族成员,包括miR-15a和miR-16。琼脂糖凝胶电泳显示,对照组相对灰度值的平均值(±SD)为(1.00±0.26),而腹泻组为(1.86±0.21)。PD组的miR-107明显高于对照组(t=-8.143,P
{"title":"[Application of EXODUS system combined with allosteric DNA nanoswitches in the detection of miR-107 among plasma exosomes of Parkinson's disease patients].","authors":"X Wang, L M Cheng","doi":"10.3760/cma.j.cn112150-20231205-00397","DOIUrl":"10.3760/cma.j.cn112150-20231205-00397","url":null,"abstract":"<p><p>This study aimed to achieve rapid detection of Parkinson's disease (PD) plasma exosome miR-107. A case-control design was used to collect ten Parkinson's disease and ten healthy control plasma samples from the Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology from December 2023 to January 2024. Exosome detection via the ultrafast-isolation system (EXODUS) was used to isolate plasma exosomes. The nanoparticle tracking analysis technology and electron microscopy were used to identify exosome particle size and morphology. The Qiagen miRNeasy Micro Kit was used to extract RNA. The microRNA-activated conditional looping of engineered switches (miRacles) was used to detect miR-107, and the relative expression was analyzed by agarose gel electrophoresis. Thermo Fisher RevertAid RT Reverse Transcription Kit was used to perform reverse transcription of RNA, and real-time PCR was used to detect miR-107. The independent samples t-test was used for comparison between groups. EXODUS system completed the isolation of exosomes from 500 μl plasma within 1.5 hours. The exosome concentration (mean±SD) was (4.82±2.02)×10<sup>10</sup> particles/ml in the control group and (5.08±2.34)×10<sup>10</sup> particles/ml in the PD group. There was no significant difference in exosome concentration between PD patients and healthy controls (<i>t</i>=-0.168, <i>P</i>=0.872). The morphology of exosomes was confirmed by electron microscopy. The miRacles nanoswitch could detect fM-level miR-107 and also effectively distinguish miR-107 from its family members, including miR-15a and miR-16. Agarose gel electrophoresis showed that the mean±SD of relative grey value content was 1.00±0.26 in the control group and 1.86±0.21 in the PD group. The miR-107 in the PD group was significantly higher than that in the control (<i>t</i>=-8.143, <i>P</i><0.001), which was consistent with the result of real-time PCR. EXODUS combined with miRacles could achieve rapid, non-enzymatic and cheap detection of plasma exosomal miR-107 in PD patients.</p>","PeriodicalId":24033,"journal":{"name":"中华预防医学杂志","volume":"58 8","pages":"1191-1196"},"PeriodicalIF":0.0,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Vaccine development based on RNA technology platforms]. [基于 RNA 技术平台的疫苗开发]。
Q3 Medicine Pub Date : 2024-08-06 DOI: 10.3760/cma.j.cn112150-20230831-00147
X Guo, J Li, H M Wang, J Qiu, Z Li, F Huang, J Li, X D Sun

mRNA vaccine technology has made significant progress in recent years, especially with the large-scale application driven by the COVID-19 pandemic. Moderna and Pfizer/BioNTech vaccines have become central tools in the global fight against the virus, demonstrating the potential of the mRNA platform for rapid design, production, and strong immune responses. These vaccines showcase the unique advantages of rapid response and effective protection. At the same time, mRNA technology still faces challenges, such as stability and targeted delivery. Future research will focus on improving the stability and safety of mRNA vaccine and expanding its application to more infectious diseases and cancer treatments. This article reviews platforms of mRNA vaccine, vaccine design, development of delivery system, and the application of mRNA vaccines, in order to enhance the understanding of professionals and accelerate the layout of this technology in vaccine research and application in China.

mRNA 疫苗技术近年来取得了重大进展,尤其是在 COVID-19 大流行的推动下得到了大规模应用。Moderna 和辉瑞/BioNTech 公司的疫苗已成为全球抗击病毒的核心工具,展示了 mRNA 平台在快速设计、生产和强大免疫反应方面的潜力。这些疫苗展示了快速反应和有效保护的独特优势。与此同时,mRNA 技术仍然面临着稳定性和定向递送等挑战。未来的研究重点是提高 mRNA 疫苗的稳定性和安全性,并将其应用扩展到更多的传染病和癌症治疗领域。本文对mRNA疫苗的平台、疫苗设计、递送系统的开发以及mRNA疫苗的应用进行了综述,以期加深专业人士对mRNA疫苗的了解,加快该技术在中国疫苗研究和应用领域的布局。
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引用次数: 0
[Development and validation of an individual risk prediction tool for severe respiratory syncytial virus infection among children under five years in China]. [中国五岁以下儿童严重呼吸道合胞病毒感染个体风险预测工具的开发与验证]。
Q3 Medicine Pub Date : 2024-08-06 DOI: 10.3760/cma.j.cn112150-20231206-00406
B B Cong, S Y Deng, S H Ma, Y M Miao, Y Li

Objective: To construct a predictive model to assess the risk of severe respiratory syncytial virus infection among children under five years in China, conduct preliminary validation of this model by using external data, and develop an individual risk assessment tool available for their parents. Methods: The admission after RSV infection was used as a marker of severe infection. Based on the evidence of RSV hospitalization-related risk factors and real-world data, such as the prevalence of various risk factors in children under five years old in China, a Monte Carlo-based individual RSV hospitalization risk prediction model for children under five years old was constructed. Taking Suzhou City as an example, the model was externally validated, and an interactive risk prediction tool (RSV HeaRT) was developed on the WeChat mini-program platform. Results: The estimation model showed that in children under five years old in China if the population did not have any risk factors for severe RSV infection, the RSV annual hospitalization rate was 2.2/1 000 (95%CI: 0.9/1 000-7.5/1 000). Based on this baseline hospitalization rate and the prevalence of related risk factors in Suzhou, the model predicted an RSV hospitalization rate of 8.0/1 000 (95%CI: 4.6/1 000-24.4/1 000) for children under five years old annually in Suzhou, which was close to the reported RSV hospitalization rate in literature (10/1 000-20/1 000). In the developed RSV HeaRT WeChat mini-program, target users (such as parents of children) could input basic information, disease history, and social environmental factors of the child into the mini-program, and the tool could provide real-time feedback on the following predicted results: First, the relative risk of hospitalization due to RSV infection in current children compared to general children; Second, the probability of hospitalization due to RSV infection within the next year; Third, the relative risk of adverse outcomes during hospitalization in the event of RSV infection. Conclusion: This study is based on real-world evidence related to RSV hospitalization risk and constructs an RSV hospitalization risk prediction model suitable for Chinese children based on the combination of the current prevalence of risk factors in children under five years old in China. The accuracy of the prediction model results has been preliminarily demonstrated. Based on this design, the RSV HeaRT developed can facilitate parents to evaluate the hospitalization risk of children.

目的:构建一个预测模型,以评估中国五岁以下儿童感染严重呼吸道合胞病毒的风险:构建评估中国五岁以下儿童严重呼吸道合胞病毒感染风险的预测模型,利用外部数据对该模型进行初步验证,并开发供家长使用的个人风险评估工具。方法将感染 RSV 后的入院时间作为严重感染的标志。根据RSV住院相关风险因素的证据和真实世界的数据,如中国5岁以下儿童各种风险因素的流行率,构建了基于蒙特卡洛的5岁以下儿童RSV住院风险预测模型。以苏州市为例,对模型进行了外部验证,并在微信小程序平台上开发了交互式风险预测工具(RSV HeaRT)。结果显示估算模型显示,在中国,如果人群不存在任何严重RSV感染的风险因素,5岁以下儿童的RSV年住院率为2.2/1000(95%CI:0.9/1000-7.5/1000)。根据这一基线住院率和相关风险因素在苏州的流行情况,模型预测苏州 5 岁以下儿童 RSV 年住院率为 8.0/1 000(95%CI:4.6/1 000-24.4/1 000),接近文献报道的 RSV 住院率(10/1 000-20/1 000)。在开发的RSV HeaRT微信小程序中,目标用户(如患儿家长)可将患儿的基本信息、疾病史、社会环境因素等输入小程序,工具可实时反馈以下预测结果:第一,与普通儿童相比,当前儿童因感染 RSV 而住院的相对风险;第二,未来一年内因感染 RSV 而住院的概率;第三,一旦感染 RSV,住院期间不良后果的相对风险。结论:本研究基于真实世界中与 RSV 住院风险相关的证据,结合目前中国 5 岁以下儿童的风险因素流行情况,构建了适合中国儿童的 RSV 住院风险预测模型。预测模型结果的准确性已得到初步验证。基于此设计开发的RSV HeaRT可帮助家长评估儿童的住院风险。
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引用次数: 0
[Age-period-cohort analysis of the mortality trend of dementia among elderly people aged 60 to 94 years in China from 1982 to 2021]. [1982-2021年中国60-94岁老年人痴呆死亡趋势的年龄-时期-队列分析]。
Q3 Medicine Pub Date : 2024-08-06 DOI: 10.3760/cma.j.cn112150-20231204-00395
Y Wei, B Liang, J J Li, X J Yan, L J Pei

Objective: To analyze the trend of dementia mortality rate among individuals aged 60 to 94 years in China from 1982 to 2021. Methods: Utilizing data from the Global Burden of Disease Study 2021, the Joinpoint regression model was employed to analyze the trend in the dementia mortality rate among Chinese older adults from 1982 to 2021. The age-period-cohort analysis method was used to decompose the age effect, period effect and cohort effect of dementia mortality data in Chinese elderly people. Results: From 1982 to 2021, the crude mortality rate of dementia in elderly women aged 60-94 in China (133.67/100 000-214.02/100 000) was higher than that in men (70.92/100 000-119.70/100 000), and the age-standardized mortality rate of dementia in women (230.74/100 000-246.87/100 000) was also higher than that in men (132.88/100 000-140.19/100 000). The age-standardized mortality rate of dementia in both genders showed an N-shaped fluctuation trend. The average annual percent change (AAPC) of dementia mortality rate in elderly males aged 60-94 was 0.07% (95%CI: 0.01%-0.13%), and the AAPC of dementia mortality rate in elderly females was -0.01% (95%CI:-0.08%-0.07%). Age effect analysis showed that from the age of 60, the risk of dementia death in males and females increased with age, especially among elderly people aged 75-94 who experienced a rapid increase in dementia mortality rate. The period effect analysis showed that the overall risk of dementia death in elderly men and women aged 60-94 was decreasing, but it had increased from 2017 to 2021. The cohort effect analysis showed that the risk of dementia death was lower in later birth cohorts. Conclusion: From 1982 to 2021, the dementia mortality rate among Chinese older adults aged 60 to 94 years exhibited fluctuations. Particularly, there has been a notable rebound in recent years. Special attention should be directed towards female seniors and those aged 75 to 94 years.

目的分析1982-2021年中国60-94岁人群痴呆死亡率的变化趋势。方法利用《2021 年全球疾病负担研究》的数据,采用 Joinpoint 回归模型分析 1982 年至 2021 年中国老年人痴呆死亡率的变化趋势。采用年龄-时期-队列分析方法对中国老年人痴呆死亡率数据的年龄效应、时期效应和队列效应进行分解。结果显示1982-2021年,中国60-94岁女性老年痴呆粗死亡率(133.67/100 000-214.02/100 000)高于男性(70.92/100 000-119.70/100 000),女性老年痴呆年龄标准化死亡率(230.74/100 000-246.87/100 000)也高于男性(132.88/100 000-140.19/100 000)。男女老年痴呆症的年龄标准化死亡率呈 N 型波动趋势。60-94岁老年男性痴呆症死亡率的年均百分率变化(AAPC)为0.07%(95%CI:0.01%-0.13%),老年女性痴呆症死亡率的年均百分率变化(AAPC)为-0.01%(95%CI:-0.08%-0.07%)。年龄效应分析表明,从 60 岁开始,男性和女性的痴呆症死亡风险随着年龄的增长而增加,尤其是 75-94 岁的老年人,其痴呆症死亡率迅速上升。时期效应分析表明,60-94 岁老年男性和女性的痴呆死亡风险总体呈下降趋势,但从 2017 年到 2021 年有所上升。队列效应分析表明,出生较晚的队列中痴呆症死亡风险较低。结论是从1982年到2021年,中国60至94岁老年人的痴呆死亡率呈现波动趋势。特别是近年来出现了明显的反弹。应特别关注女性老年人和 75 至 94 岁的老年人。
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引用次数: 0
[Advances in the diagnosis and poor prognosis of diabetic hyperfiltration]. [糖尿病高滤过诊断和不良预后的进展]。
Q3 Medicine Pub Date : 2024-08-06 DOI: 10.3760/cma.j.cn112150-20240108-00027
R X Ma, X J Wang, D Q Peng

Glomerular hyperfiltration(GHF), as an early manifestation of prediabetes and diabetic kidney disease, occurs mainly by the mechanism of glomerular-tubular feedback and hemodynamic alterations, and the risk of hyperfiltration can be elevated in younger patients, shorter duration of the disease, poor glycemic control, and high-protein, low-salt diet. Currently, there is no recognized standard for the definition of GHF, GHF lacks typical clinical manifestations, imaging diagnostic criteria are unclear, and GHF-related laboratory markers need to be further studied. Hyperfiltration, if not diagnosed and intervened in time, can accelerate the damage of nephron and the rate of nephropathy progression, and increase the risk of complications and death. Sodium-glucose cotransporter 2 inhibitor(SGLT2i), glucagon-like peptide-1 receptor agonist(GLP-1RA)and so on can effectively reverse the hyperfiltration state. Clinical attention should be paid to the diagnosis of diabetic hyperfiltration and the prevention of its poor prognosis.

肾小球高滤过(GHF)是糖尿病前期和糖尿病肾病的早期表现,主要通过肾小球-肾小管反馈机制和血液动力学改变发生,年轻患者、病程较短、血糖控制不佳、高蛋白低盐饮食者发生高滤过的风险会升高。目前,GHF 的定义还没有公认的标准,GHF 缺乏典型的临床表现,影像学诊断标准不明确,GHF 相关的实验室指标也有待进一步研究。高滤过如果不及时诊断和干预,会加速肾小球的损伤和肾病的进展速度,增加并发症和死亡的风险。钠-葡萄糖共转运体2抑制剂(SGLT2i)、胰高血糖素样肽-1受体激动剂(GLP-1RA)等可有效逆转高滤过状态。临床上应重视糖尿病高滤过的诊断和预防其不良预后。
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中华预防医学杂志
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