Background:Although atrial high-rate episode (AHRE) and atrial fibrillation (AF) cannot entirely be identical, recent studies suggest AHRE is linked to AF development and shares some characteristics with AF regarding thromboembolism. At present, there is still lack of predictive indicators for AHRE and diagnostic methods and clinical indicators for AHRE in patients without cardiac implantable electronic device (CIED). The aim of this study was thus to explore the relationship between AHRE and left atrial (LA) strain parameters with the goal of identifying high-risk populations of AHRE by LA strain characteristics.Methods:From February 2022 to May 2023, a total of 105 CIED patients were enrolled and divided into two groups based on whether AHRE had occurred: AHRE (-) group (n=65) and AHRE (+) group (n=40). Real-time three-dimensional echocardiography (RT-3DE) technique was used to obtain the LA time-volume curve. The collected dynamic images were analyzed on the Echopac 204 workstation to obtain the parameters of LA. The four-dimensional automatic LA quantitative analysis (4D Auto LAQ) technology was used to analyze the LA strain parameters: LA reservoir longitudinal strain (LASr), LA conduit longitudinal strain (LAScd), LA contraction longitudinal strain (LASct), LA reservoir circumferential strain (LASr-c), LA conduit circumferential strain (LAScd-c), LA contraction circumferential strain (LASct-c). Correlation analysis was carried out using Binary logistic regression analysis. The area under the receiver operating characteristic (ROC) curve (AUC) was used to evaluate the diagnostic performance of LASct in AHRE.Results:Body surface area (BSA) [odds ratio (OR) =8.34, 95% confidence interval (CI): 1.32-72.30, P=0.037], LASct (OR =1.20, 95% CI: 1.05-1.39, P=0.013) and LA end-systolic volume (LAESV) (OR =1.02, 95% CI: 1.00-1.04, P=0.023) were the influencing factors of AHRE. Only LASct (OR =1.18, 95% CI: 1.01-1.38, P=0.041) was found to be an independent influencing factor of AHRE. This result remained significant after adjusting for age, sex, hypertension, diabetes, and stroke history. The ROC curve showed that the cut-off for predicting AHRE was LASct =-4.125% with sensitivity of 37.5% and specificity of 87.7%.Conclusions:This cross-sectional study found that decreased LASct (absolute value) is an independent risk factor for the AHRE and has diagnostic efficacy in certain degree for the occurrence of AHRE.

Background and purpose: PPP2R5D mutations are known to cause neurodevelopmental disorders in an autosomaldominant manner. To date, the vast majority of the reported cases in the literature have been sporadic with de novo mutations. There are no data regarding PPP2R5D mutation penetrance. We aimed to unravel the underlying genetic defects in 3 generations of a family affected by intellectual disability, neurodevelopmental delay, and facial dysmorphology. Methods: We performed detailed clinical examinations and whole-exome sequencing in the family. Results: We identified a novel mutation, c.1321 C>T (p.Arg441*), in PPP2R5D. The mutation cosegregated with affected family members I-2 and II-7 but not II-3, who bears the mutation but is phenotypically healthy. Our whole-exome sequencing also excluded the involvement of pathogenic mutations in other genes known to be related to neurodevelopmental disorders. The mutation was predicted to introduce a premature stop codon at position 441, thereby truncating the 162 amino acids at the C-terminus of the encoded protein. Conclusions: We report a familial transmitted PPP2R5D-related neurodevelopmental disorder as well as a novel nonsense pathogenic mutation and its incomplete penetrance. Our study expands the mutational and phenotypic spectra of PPP2R5D-related neurodevelopmental disorders, broadens our understanding of these disorders, and will thus be valuable for mutation-based pre- and postnatal screening and genetic diagnosis of neurodevelopmental disorders.

Objective The relationship between plasma copper concentration and prevalence of diabetes in adults with hypertension is unclear. We aimed to determine the association between plasma copper concentration and prevalence of diabetes in Chinese adults with hypertension. Methods A total of 2,579 participants (697 cases and 1,882 controls) was included in this cross-sectional study. Plasma copper concentrations were determined by inductively coupled plasma mass spectrometry. Multivariable logistic regression model was used to determine the association between plasma copper concentration and prevalence of diabetes. Results According to the logistic regression analyses, the adjusted OR for the prevalence of diabetes in participants with plasma copper concentration ≥109.4 μg/dL was 1.26 (1.00, 1.58) compared with those with plasma copper concentration <109.4 μg/dL (P = 0.048). The association was no longer significant following further adjusting for serum high-density lipoprotein cholesterol (HDL-C) concentration as a potential confounder. Stratified analyses demonstrated that serum HDL-C concentration significantly modified the association between plasma copper concentration and prevalence of diabetes (P-interaction = 0.043). In the strata of serum HDL-C concentration ≥1.2 mmol/L, a 56% increased prevalence of diabetes was observed in participants with plasma copper concentration ≥109.4 μg/dL compared with those with plasma copper concentration <109.4 μg/dL (P = 0.008). No significant relationship between plasma copper concentration and prevalence of diabetes was found in other strata. Conclusion Our findings suggested that high plasma copper concentration (≥109.4 μg/dL) was associated with increased prevalence of diabetes in Chinese hypertensive adults with serum HDL-C concentration ≥1.2 mmol/L.

Manganese (Mn) is an essential trace metal element required for optimal human health. However, few studies have assessed the Mn status in hypertensive patients, especially in China. Moreover, factors associated with Mn status have not yet been thoroughly explored. Therefore, we aimed to assess the serum Mn status of adults with hypertension in China and its association with demographic factors. An observational, cross-sectional study was conducted to assess serum Mn concentrations in 14 provinces of China. A total of 2597 patients with hypertension were randomly identified by sex, age, and district, and serum Mn concentrations were quantified using inductively coupled plasma mass spectrometry (ICP-MS). In our study population, the median serum Mn levels were 1.60 (interquartile range (IQR), 0.94–2.85) µg/L for males and 1.51 (IQR, 0.86–2.69) µg/L for females. In adjusted linear regression models, significantly higher serum Mn concentrations were found in summer (compared with spring, β, 1.06 µg/L, 95

Manganese (Mn) is an essential trace metal element that is associated with diabetes; however, the results of previous studies are inconsistent. Furthermore, few studies have been conducted in a hypertensive population. The purpose of this study is to explore the relationship between manganese and diabetes in a population with hypertension. A cross‐sectional study was conducted, including 2575 hypertensive individuals from 14 provinces in China. Serum manganese concentrations were measured by the inductively coupled plasma mass spectrometry (ICP‐MS) method. And logistic regression models were used to analyze the association between serum manganese and the risk of diabetes. The prevalence of diabetes was 27.0% in this hypertensive population. In logistic regression models, the odds ratios (95% confidence interval) for diabetes in tertile subgroups were 1.40 (1.12, 1.76) and 1.32 (1.05, 1.65) for tertiles 1 and tertiles 3, respectively, compared to tertile 2 (reference). Additionally, an interaction between sex and manganese was observed. The odds ratios (95% confidence interval) for diabetes were 1.29 (0.95, 1.75) and 0.96 (0.70, 1.31) for tertiles 1 and tertiles 3 among males, and 1.44 (1.01, 2.04) and 1.81 (1.29, 2.55) for tertiles 1 and tertiles 3 among females, respectively, compared to tertile 2. In conclusion, a U‐shaped association between serum manganese and diabetes was observed in a Chinese population with hypertension, and the association was modified by sex.

Background Evidence from epidemiologic studies has been limited and inconsistent regarding the role of serum calcium in stroke incidence risk. We aimed to evaluate the association between serum albumin-corrected calcium and the risk of the first stroke in the Chinese community-dwelling population. Methods The study sample population was drawn from the “H-type Hypertension and Stroke Prevention and Control Project.” Using a nested case-control study, a total of 1,255 first-stroke cases and 1,255 controls matched for age, sex, and village were included in the final data analysis. We measured the serum calcium by inductively coupled plasma mass spectrometry and assessed the associations between serum albumin-corrected calcium and first stroke using conditional logistic regression. Results The overall mean (SD) serum albumin-corrected calcium was 8.9 (0.6) mg/dl. Compared with the middle tertile (8.7–9.1 mg/dl), the multivariate-adjusted odds ratios (95% CIs) of first total stroke associated with the lowest tertile and the highest tertile of serum albumin-corrected calcium were 1.37 (1.10, 1.70) and 1.30 (1.04, 1.62), respectively. Similar trends were observed for the first ischemic stroke. Consistently, restricted cubic spline showed a U-shaped association between serum albumin-corrected calcium and risk of total stroke and ischemic stroke. However, serum albumin-corrected calcium had no significant effect on first hemorrhagic stroke. No significant effect modification was observed in the subgroup analysis. Conclusions Our results suggested a U-shaped association between serum calcium and first stroke; both low and high serum calcium levels were associated with an increased risk of the first stroke in the Chinese population.

Background: Copper is an essential micronutrient and plasma copper plays an important role in the development of myocardial infarction and cardiovascular disease (CVD)-specific mortality. However, nationwide data on the plasma copper concentrations and determinants in Chinese adults with hypertension is limited. Aims: We aimed to assess the range of plasma copper concentrations and its associations with demographic, environmental, lifestyle and dietary factors in a nationwide cohort of Chinese adults with hypertension. Methods: A cross-sectional study including 2599 adults (1389 males and 1210 females) with hypertension was conducted from February 2017 to May 2018 in 14 provinces in China. Plasma copper concentrations were determined by inductively coupled plasma mass spectrometry (ICP-MS). Results: The mean concentration of plasma copper was 95.3 ± 18.9 μg/dL for all participants, and 90.8 ± 18.2 μg/dL in males and 100.4 ± 18.5 μg/dL in females, respectively. In adjusted linear regression models, those living in areas with daily mean temperature (Tm) < 14.5 ℃ were positively associated with plasma copper concentrations compared with those in areas with Tm ≥ 24.7 ℃ (β = 4.55, 95% CI = 2.83, 6.27; P < 0.001). Similar associations were observed in patients who were female, aged ≥ 65 years, currently smoking and currently drinking alcohol. Conclusions: The mean plasma copper concentration of Chinese adults with hypertension was 95.3 ± 18.9 μg/dL. Participants who were female, aged ≥ 65 years, living in areas with Tm < 14.5 ℃, or currently smoking or drinking alcohol were positively associated with plasma copper concentrations, indicating the potential impact of demographic, environmental, lifestyle and dietary factors on plasma copper concentrations.

Background To date, there is no clearly defined association between plasma selenium levels and first stroke. We aimed to investigate the association between baseline plasma selenium and first stroke risk in a community-based Chinese population. Methods Using a nested case-control study design, a total of 1255 first stroke cases and 1255 matched controls were analyzed. Participant plasma selenium concentrations were measured by inductively coupled plasma mass spectrometry (ICP-MS), and the association of plasma selenium with first stroke risk was estimated by conditional logistic regression models. Results Overall, a non-linear negative association between plasma selenium and first total stroke and first ischemic stroke risks was found in males but not in females. Compared with participants with lower selenium levels (tertile 1–2, < 94.1 ng/mL), participants with higher selenium levels (tertile 3, ≥ 94.1 ng/mL) had significantly lower risks of first total stroke (OR 0.63; 95% CI 0.48, 0.83) and first ischemic stroke (OR 0.61; 95% CI 0.45, 0.83) in males but not in females with first total stroke (OR 0.92; 95% CI 0.69, 1.22) and first ischemic stroke (OR 0.89; 95% CI 0.65, 1.22). Furthermore, a stronger association between plasma selenium and first total stroke was found in males with higher vitamin E levels (≥ 13.5 μg/mL vs. < 13.5 μg/mL P -interaction = 0.007). No significant association was observed between plasma selenium and first hemorrhagic stroke risk in either males or females. Conclusion Our study indicated a significant, non-linear , negative association between plasma selenium and first stroke in males but not in females. Trial registration ChiCTR1800017274 .

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BACKGROUND:Sepsis is the most common critical illness in the clinic, with a high incidence and mortality. Qingwen Baidu decoction (QWBDD) has been widely applied in the treatment of sepsis, however, there is no systematic review or meta-analysis of QWBDD in the treatment of sepsis. Hence, we provide a protocol of systematic review and meta-analysis to evaluate the efficacy and safety of QWBDD in the treatment of sepsis. METHODS:The databases including Cochrane Library, PubMed, Embase, Web of Science, Cochrane Clinical Trial Database, World Health Organization International Clinical Trial Registration Platform, CNKI, CBM, VIP, and WanFang Database will be searched from the time when the respective databases were established to January 2019. All randomized controlled trials (RTCs) published in Chinese and English assessing QWBDD for sepsis will be included. Continuity data are expressed as mean difference (MD) or standard mean difference (SMD), and dichotomous data is expressed as relative risk. Analyses will be performed by using RevMan V.5.3.5 software. RESULTS:This study will provide high-quality synthesis of current evidence of QWBDD in the treatment of sepsis from the following aspects, including 28-day mortality, mean arterial pressure (MAP), blood lactate, procalcitonin (PCT), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), hypersensitive C-reactive protein (hs-CRP), acute physiology and chronic health score (APACHE-II), intensive care unit stay, mean hospital stay, mechanical ventilation time, etc. CONCLUSION:: Our systematic review will provide evidence for judging whether QWBDD is an effective intervention for sepsis. PROSPERO REGISTRATION NUMBER:PROSPERO CRD 42019123078.

The self-help market investigation is a new kind of commerce. It encourages the massive registered Internet users to track the goods placement in the market by taking pictures and upload these photos to a platform over the Internet. Nevertheless, we should design a fair price for each task to mobilize the offline users to do it. However, the solutions adapted to the issues are absent. To solve this problem, we proposed a pricing model based on multivariate linear regression analysis. We analyzed the task density, the per capita creditworthiness of the subscribers, and the per capita GDP and proved they were three main factors that affected the tasks' price. As a result, we figured out three variables of the coefficients. Experiments showed that the significance of per capita creditworthiness of the subscribers was greater than the recognized significance threshold 0.05, while the significance of per capita GDP and the task density were both less than the well-known significance level.

Objectives To evaluate the effects of 3 months of metformin therapy on various blood lipid factors and insulin sensitivity in obese women with PCOS. Methods Seventeen obese PCOS women (body mass index (BMI) ≥24 kg/m (2)), aged 20–36 years, were included in the study from the department of infertility and sexual medicine at the Third Affiliated Hospital of Sun Yat-Sen University between February 2011 and December 2011. The hormonal and metabolic parameters, including sexual hormone levels, glucose, insulin, and fasting lipids levels, were evaluated before treatment. Metformin (1500 mg/day) was administered for 3 months. After 3 months of therapy, they were resample. Results BMI were significantly decreased after 3 months of metformin treatment (25.52±3.51 vs 22.45±3.72, p<0.05). Serum total cholesterol (5.03±0.98 vs 4.70±0.75, p<0.05), triglycerides (1.81±0.97 vs 1.68±0.78, p<0.05), and serum testosterone (2.86±0.52 vs 1.76±0.45, p<0.05) were all reduced. Insulin resistance measured by homeostasis model assessment (HOMA) method was significantly decreased (4.51±0.68 vs 4.01±0.49, p<0.05). Conclusions Metformin therapy for 3 months is effective in improving insulin sensitivity and some cardiovascular risk biomarkers in obese women with PCOS.