[An interlaboratory comparison study on the detection of RUNX1-RUNX1T1 fusion transcript levels and WT1 transcript levels]

Objective: To investigate the current status and real performance of the detection of RUNX1-RUNX1T1 fusion transcript levels and WT1 transcript levels in China through interlaboratory comparison. Methods: Peking University People's Hospital (PKUPH) prepared the samples for comparison. That is, the fresh RUNX1-RUNX1T1 positive (+) bone morrow nucleated cells were serially diluted with RUNX1-RUNX1T1 negative (-) nucleated cells from different patients. Totally 23 sets with 14 different samples per set were prepared. TRIzol reagent was added in each tube and thoroughly mixed with cells for homogenization. Each laboratory simultaneously tested RUNX1-RUNX1T1 and WT1 transcript levels of one set of samples by real-time quantitative PCR method. All transcript levels were reported as the percentage of RUNX1-RUNX1T1 or WT1 transcript copies/ABL copies. Spearman correlation coefficient between the reported transcript levels of each participated laboratory and those of PKUPH was calculated. Results: ①RUNX1-RUNX1T1 comparison: 9 samples were (+) and 5 were (-) , the false negative and positive rates of the 20 participated laboratories were 0 (0/180) and 5% (5/100) , respectively. The reported transcript levels of all 9 positive samples were different among laboratories. The median reported transcript levels of 9 positive samples were from 0.060% to 176.7%, which covered 3.5-log. The ratios of each sample's highest to the lowest reported transcript levels were from 5.5 to 12.3 (one result which obviously deviated from other laboratories' results was not included) , 85% (17/20) of the laboratories had correlation coefficient ≥0.98. ②WT1 comparison: The median reported transcript levels of all 14 samples were from 0.17% to 67.6%, which covered 2.6-log. The ratios of each sample's highest to the lowest reported transcript levels were from 5.3-13.7, 62% (13/21) of the laboratories had correlation coefficient ≥0.98. ③ The relative relationship of the reported RUNX1-RUNX1T1 transcript levels between the participants and PKUPH was not always consistent with that of WT1 transcript levels. Both RUNX1-RUNX1T1 and WT1 transcript levels from 2 and 7 laboratories were individually lower than and higher than those of PKUPH, whereas for the rest 11 laboratories, one transcript level was higher than and the other was lower than that of PKUPH. Conclusion: The reported RUNX1-RUNX1T1 and WT1 transcript levels were different among laboratories for the same sample. Most of the participated laboratories reported highly consistent result with that of PKUPH. The relationship between laboratories of the different transcript levels may not be the same.

[Protective effects of berberine against exhaustion exercise induced myocardial injury in rats]

Objective: To investigate the effect and possible mechanism of berberine (Ber) on myocardial injury induced by exhaustion exercise (Ee). Methods: Forty healthy male SPF Sprague-Dawley rats were randomly divided into 5 groups using the random unit group design method: control group, Ee group and Ee plus Ber group (low: 50 mg·kg(-1)·d(-1), medium: 100 mg·kg(-1)·d(-1) and high dose: 150 mg·kg(-1)·d(-1), n=8 each). Ber (1.5 ml) or equal volume saline was given per gavage for 14 days. Rats assigned to Ee groups underwent Ee swimming once daily and rats in control group remain sedentary. After 14 days, echocardiographic measurements were performed and left ventricular ejection fraction (LVEF) and fractional shortening (LVFS), left ventricular diastolic diameter (LVIDd) and left ventricular systolic diameter (LVIDs) were obtained. The morphological structure of heart was detected by HE and Masson staining. Serum superoxide dismutase (SOD) and malondialdehyde (MDA) were measured by enzyme-linked immunosorbent assay. Cardiomyocytes apoptosis was detected by TUNEL method. The protein expression of myocardial hypertrophy marker protein B-type natriuretic peptide (BNP) and apoptotic marker protein (Bcl-2, Bax) in rat myocardial tissue was detected by Western blot. Results: (1) Both LVFS and LVEF were significantly lower, and LVIDs and LVIDd were significantly larger in Ee group than those in control group (all P<0.01). The LVFS and LVEF in medium dose of Ber and high-dose Ber groups were significantly higher, and the LVIDs and LVIDd were significantly smaller than those in Ee group (all P<0.01). (2) The results of HE staining showed that the myocardial cells in control group were closely arranged, regular, normal in morphology, clear in structure, and uniform in staining. The myocardial cells of rats in Ee group were disarranged, cell staining was uneven, and vacuoles appeared in the cytoplasm. The disorder of myocardial cell arrangement and unequal staining in the medium dose of Ber were attenuated than in Ee group. The Masson staining results showed that the myocardial cells in control group were closely arranged, regular, normal in shape, clear in structure, and rarely blue-stained (fibrosis). Myocardial cells in rats in Ee group showed obvious fibrosis. The myocardial cell fibrosis in rats with medium dose of Ber was significantly reduced than exercise group. (3) MDA content in myocardial tissue of rats in Ee group was significantly higher than that of control group, and MDA content in myocardial tissue of rats in medium dose of Ber group was significantly lower than in Ee group (P<0.01). The SOD activity of myocardial tissue in rats was significantly lower than that of control group, while that of rats with medium dose of Ber was significantly higher than that of rats in Ee group (P<0.01). (4) TUNEL staining results showed that only a small amount of apoptosis myocardial cells were seen in control group, and a large number of apoptosis myocardial cells were seen in rats in Ee group. However, the number of apoptotic cardiomyocytes in medium dose of Ber was significantly lower than that in Ee group. The AI of rat cardiomyocytes was significantly higher than that of control group (P<0.01), and the AI of rat cardiomyocytes in median dose of Ber group was significantly lower than in Ee group (P<0.01). (5) BNP and Bax protein expression in the myocardial tissues of rats in Ee group were significantly higher than in control group (P<0.01). BNP and Bax protein expression in the myocardial tissues in median dose of Ber group were significantly lower than that of Ee group (P<0.01). The myocardial protein expression level of Bax was significantly higher, and the myocardial protein level of Bcl-2 was significantly lower in Ee group than in control group (both P<0.01), treatment with median dose of Ber could partly reverse above changes (both P<0.01). Conclusion: Ber can attenuate exhaustion exercise induced myocardial injury and remodeling in rats, and the beneficial effects of Ber might possibly be mediated by reducing free radical release and cardiomyocytes apoptosis.

[Mortality attributable to inadequate intake of fruits among population aged 25 and above in China, 2013]

Objective: To assess the mortality attributable to low fruit intake among people over 25 years old in China, 2013, and its effect on life expectancy. Methods: Based on data collected from China Chronic Disease and Risk Factor Surveillance in 2013, the average fruit intake in different genders and areas were calculated. Potential impact fraction (PIF) was used to examine the impact on deaths, mortality and life expectancy. Results: The average daily fruit intake was (113.3±168.9) g among people over 25 years old, with (103.6±160.1) g for men and (122.7±176.6) g for women, in China in 2013. Fruit intake for urban residents was significantly higher than that in rural residents and higher in eastern regions than that in central or western regions. Scores that attributable to low fruit intake accounted for 15.21% of the total deaths and the population attributable fraction of inadequate intake of fruits to associated diseases was 35.00%. PIF for all the deaths in rural residents (16.50%) appeared higher than that of the urban residents (13.88%), and higher in the residents living in the eastern region (15.48%) than that in the central (16.27%) or western (13.75%) regions. Number of deaths that attributable to low fruit intake was 1.348 4 million. Deaths caused by related diseases appeared as: ischemic heart disease (472.5 thousands), hemorrhagic stroke (338.8 thousands), ischemic stroke (259.0 thousands), lung cancer (208.4 thousands), esophageal cancer (60.7 thousands), laryngeal cancer (5.4 thousands) and oral cancer (3.6 thousands). Numbers of all deaths and related diseases for urban residents were lower than that of the rural residents, with central regions (452.7 thousands) higher than that in the eastern (531.1 thousands) or western (364.6 thousands) regions. The average life expectancy loss caused by low fruit intake was 1.73 years, 1.80 years for men and 1.58 years for women, in this country. Loss of life expectancy in the rural residents was higher than that of the urban residents, and higher in central regions than that in the eastern or western regions. Conclusions: The intake of fruit was far lower than the recommended standard set for the Chinese people. Population attributable fraction was related to the associated diseases caused by inadequate intake of fruits which also made serious impact on life expectancy.

[Number of deaths that attributable to high fasting plasma glucose among population aged 25 and above and its impact on life expectancy in China, 2013]

Objective: To analyze deaths that attributable to high fasting plasma glucose and its impact on life expectancy among Chinese residents in 2013. Methods: Data from the Mortality Surveillance Programs in National Disease Surveillance Points System and the China Chronic Disease Surveillance (2013) were used. Death attributed to high fasting plasma glucose and its impact on the life expectancy of Chinese residents were estimated, based on the principle of population attributable fraction. Results: In 2013, the total number of deaths attributed to high fasting plasma glucose among aged ≥25 years old was 621 thousand, with 333 thousand males and 288 thousand females. Diseases related to the number of deaths caused by high fasting plasma glucose would include ischemic heart disease (212 thousand) as the most important one. Cerebrovascular disease appeared the 2(nd) place, with around 181 thousand cases and then followed by diabetes (145 thousand), chronic kidney disease (52 thousand) and tuberculosis (31 thousand). After removal of the effects on high blood glucose exposure, the life expectancy of Chinese residents in 2013 would have reached 76.5 years old, an average increase of 0.7 years, compared to the average life expectancy of all deaths, with men having an increase of 0.7 years and women of 0.8 years, respectively. Conclusions: High fasting plasma glucose appeared an important risk factor for mortality and life expectancy on the Chinese residents. Programs related to prevention and control of high fasting plasma glucose and related diseases should be strengthened.

[Death and impact of life expectancy attributable to smoking in China, 2013]

Objective: To analyze the death attributable to smoking and impact of life expectancy in China in 2013. Methods: According to the characteristics of different diseases, we calculated the population attributable fractions of different diseases, death and impact of life expectancy which caused by smoking, using direct method (current smoking rate as exposure levels) and indirect method (smoking impact ratio as exposure levels), based on data from both programs of death surveillance and Chinese chronic disease risk factor surveillance of 2013. Results: In 2013, smoking caused around 1.59 million deaths which accounted for 17.38% of all deaths in China. Constituent ratio of death caused by smoking in males (23.66%) was much higher than that in females (8.30%). However, in urban areas (17.24%), it was slightly lower than that in rural areas (17.51%). Constituent ratio of death caused by smoking in the eastern regions appeared the lowest (16.81%), with western regions the highest (17.91%). In 2013, lung cancer, COPD and ischemia heart disease were the top three diseases causing deaths that related to smoking, but the top three population attributable fractions were lung cancer, COPD and nasopharyngeal carcinoma in China. In 2013, smoking caused a reduction of 2.04 years of life expectancy loss in China, with males in the western regions the highest (3.05 years). Conclusion: Smoking is still an important public health problem in China. Tobacco-control-targeted programs in the heavily involved areas could reduce the number of deaths from related diseases that caused by smoking.

[Disease burden of diabetes attributable to high body mass index in China,1990-2016]

Objective: To analyze the burden of disease (BOD) on diabetes attributable to high BMI in China from 1990 to 2016. Methods: Data based on population of the 2016 Global Burden of Disease Study for China were used to analyze the attributable fractions (PAF) of BOD for diabetes attributable to high BMI. Measurements for attributable BOD of diabetes included disability adjusted life years (DALY), years of lost life (YLL), years living with disability (YLD), death number and mortality rate. The average world population from 2010 to 2035 was used as a reference. Results: In 2016, death number of diabetes attributable to high BMI was 40 310, which was significantly higher than that in 1990 (15 008). Age-standardized death rate of diabetes attributable to high BMI increased from 2.01/100 000 in 1990 to 2.60/100 000 in 2016, which showed a more significant increasing trend in both males and people aged 15-49 years. DALYs of diabetes attributable to high BMI increased from 1.09 million person years to 3.30 million person years. YLL and YLD also showed increasing trends. The highest increasing rate of YLD was in people aged 15-49 years. High BMI was responsible for 26.01% of the diabetes deaths in 2016 in China, an increase of 39.39% compared with that in 1990 (18.66%). Most provinces in China experienced a sharp increase of DALY of diabetes attributable to high BMI from 1990 to 2016. Inner Mongolia, Xinjiang, Zhejiang, Macao SAR, Sichuan and Qinghai had the most significant increase tendency in terms of DALY rate during this period. Conclusions: There was a rapid increase of the deaths and mortality rate of diabetes attributable to high BMI, causing a heavy disease burden, in China from 1990 to 2016. The BOD varied in both different age and gender groups. More attention should be paid to males and people aged 15-49 years in the prevention and control programs of diabetes.

[Disease burden on uterine fibroids in China, 1990 and 2016]

Objective: To assess the disease burden on uterine fibroids in China in 1990 and 2016. Methods: Data were extracted from the Global Burden of Disease Study 2016. Burdens of uterine fibrosis among different age groups and provinces were measured in 1990 and 2016, with key indicators including number of cases, prevalence rates, disability-adjusted life year (DALY) and the rates of DALY. The WHO world standard population, 2010-2035 was used to calculate the age- standardized rates. Results: In 1990 and 2016, there were 13 695 567 and 27 169 312 women aged 15 years and older, suffered from uterine fibrosis respectively, with prevalence rate as 2.48% and 4.10%, DALY as 146 045.05 life years and 281 976.67 life years, and the DALY rate as 26.40/100 000 and 42.50/100 000, in 1990 and 2016 respectively. Both the prevalence rate and the DALY rate increased with age, reaching the peak on the 45-49 years-old, in both 1990 and 2016. Women aged 40-54 years accounted for 55.60% (1990) and 66.74% (2016) of the total cases while 48.37% (1990) and 60.65% (2016) of the total DALY. The first three provinces with highest DALYs were Shandong (1990: 12 574.67 life year; 2016: 22 728.12 life year), Henan (1990: 10 849.29 life year; 2016: 18 454.32 life year) and Jiangsu (1990: 10 501.55 life year; 2016: 18 274.10 life year), while the three provinces with leading standardized DALY rates were Heilongjiang (1990: 48.20/100 000; 2016: 47.00/100 000), Shanxi (1990: 44.50/100 000; 2016: 47.70/100 000) and Tianjin (1990: 43.80/100 000; 2016: 46.40/100 000) in both 1990 and 2016. Compared with 1990, the number of cases with uterine fibroids increased by 13 473 745 (with rate of change as: 98.38%), standardized prevalence rate increased by 1.88%, DALY value increased by 135 931.62 life years (with the rate of change as 93.08%) and standardized DALY rate increased by 5.92% among Chinese women, in 2016. Conclusion: Menopausal women were the ones hard hit by uterine fibrosis. Compared with data from 1990, the disease burden of uterine fibrosis increased rapidly in China, in 2016.

CPP-ACP Promotes SnF2 Efficacy in a Polymicrobial Caries Model

Dental caries is associated with plaque dysbiosis, leading to an increase in the proportions of acidogenic and aciduric bacteria at the expense of alkali-generating commensal species. Stannous fluoride (SnF₂) slows the progression of caries by remineralization of early lesions but has also been suggested to inhibit glycolysis of aciduric bacteria. Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) promotes fluoride remineralization by acting as a salivary biomimetic that releases bioavailable calcium and phosphate ions, and the peptide complex has also been suggested to modify plaque composition. We developed a polymicrobial biofilm model of caries using 6 bacterial species representative of supragingival plaque that were cultured on sound human enamel and pulsed with sucrose 4 times a day to produce a high cariogenic challenge. We used this model to explore the mechanisms of action of SnF₂ and CPP-ACP. Bacterial species in the biofilms were enumerated with 16S rRNA gene sequence analyses, and mineral loss and lesion formation were determined in the enamel directly under the polymicrobial biofilms via transverse microradiography. The model tested the twice-daily addition of SnF₂, CPP-ACP, or both. SnF₂ treatment reduced demineralization by 50% and had a slight effect on the composition of the polymicrobial biofilm. CPP-ACP treatment caused a similar inhibition of enamel demineralization (50%), a decrease in Actinomyces naeslundii and Lactobacillus casei abundance, and an increase in Streptococcus sanguinis and Fusobacterium nucleatum abundance in the polymicrobial biofilm. A combination of SnF₂ and CPP-ACP resulted in a greater suppression of the acidogenic and aciduric bacteria and a significant 72% inhibition of enamel demineralization.

[Resting-state functional MRI studies of amyotrophic lateral sclerosis patients with various levels of cognitive impairment]

Objective: To characterize the brain functional changes of amyotrophic lateral sclerosis (ALS) patients with various levels of cognitive impairment as measured by resting-state functional MRI (RS-fMRI). Methods: From September 2013 to March 2017, a total of 55 patients diagnosed with ALS in Peking Union Medical College Hospital and 20 healthy controls (HCs) were included in this study, and all participants underwent neuropsychological assessments and diffusion tensor imaging scans. According to their cognitive performance, ALS patients were further subclassified into ALS with normal cognition (ALS-Cn, n=27), those with cognitive impairment (ALS-Ci, n=17) and ALS-FTD (n=11). Comparisons of fractional amplitude of low frequency fluctuation (fALFF) value and regional homogeneity (ReHo) value were conducted among the 4 subgroups. Results: The fALFF showed significant differences in bilateral frontal lobe, left temporal lobe and cingulate gyrus, (P<0.001, uncorrected) and the ReHo showed significant differences in left frontal lobe, right temporal lobe and left cingulate gyrus (P<0.001, FDR corrected). The differences mainly stemmed from that patients with ALS-FTD showed decreased fALFF and ReHo in these areas when compared to the other three groups, especially in relation to HCs, mainly locating in left prefrontal lobe and anterior cingulate cortex. The whole-brain comparisons of fALFF and ReHo between ALS-Ci, ALS-Cn and HCs revealed no significant difference (P<0.001, uncorrected). Conclusion: Hypoactivities are detected in extramotor areas in patients with ALS-FTD. RS-fMRI is helpful in investigating the pathophysiologic mechanism of cognitive impairment in ALS.

[Disease burden for gynecological disease in China, 2016]

Objective: To assess the disease burden for gynecological disease in China in 2016. Methods: Data were extracted from the global burden of disease study 2016 (GBD 2016) . The burden of gynecological disease among age groups and provinces groups was assessed by prevalence rate, mortality rate, years lived with disability (YLD) , years of life lost due to premature mortality (YLL) and disability-adjusted life years (DALY) . An average world population age-structure for the period 2010-2035 was adopted to calculate age-standardized rates. Results: In 2016, the prevalence rate of gynecological disease in women aged 15 years and above in China was 24.94%, of which was 36.71% to women of childbearing age. The number of DALY from gynecological disease was 2 727 637.82 life years in 2016, with the DALY rate was 411.12/100 000 and standardized DALY rate was 341.80/100 000. The first three gynecological diseases with highest DALY and DALY rate among Chinese women aged ≥15 years were premenstrual syndrome (815 004.64 life years, 122.84/100 000) , uterine fibroids (281 976.67 life years, 42.5/100 000) and endometriosis (154 792.89 life years, 23.33/100 000) . The DALY caused by gynecological disease in Guangdong (220 871.19 life years) , Shandong (190 968.72 life years) , Henan (171 273.92 life years) , Jiangsu (168 404.27 life years) and Sichuan (144 358.5 life years) were higher than other provinces. The standardized DALY rate attributable to gynecological disease were highest in Xinjiang Uygur Autonomous Region (404.00/100 000) , Shanghai (394.90/100 000) , Heilongjiang (382.00/100 000) , Beijing (365.70/100 000) and Jiangsu (357.50/100 000). Conclusions: Gynecological disease is a great threat to women's reproductive health. Effective measures should be taken to address the issue, especially to women of childbearing age.

[Estimation of the impact of risk factors control on non-communicable diseases mortality, life expectancy and the labor force lost in China in 2030]

Objective: To estimate the impact of risk factors control on non-communicable diseases (NCDs) mortality, life expectancy and the numbers of labor force lost in China in 2030. Methods: We used the results of China from Global Burden of Disease Study 2013, according to the correlation between death of NCDs and exposure of risk factors and the comparative risk assessment theory, to calculate population attributable fraction (PAF) and disaggregate deaths of NCDs into parts attributable and un-attributable. We used proportional change model to project risk factors exposure and un-attributable deaths of NCDs in 2030, then to get deaths of NCDs in 2030. Simulated scenarios according to the goals of global main NCDs risk factors control proposed by WHO were constructed to calculate the impact of risk factors control on NCDs death, life expectancy and the numbers of labor force lost. Results: If the risk factors exposure changed according to the trend of 1990 to 2013, compared to the numbers (8.499 million) and mortality rate (613.5/100 000) of NCDs in 2013, the death number (12.161 million) and mortality rate (859.2/100 000) would increase by 43.1% and 40.0% respectively in 2030, among which, ischemic stroke (increasing by 103.3% for death number and 98.8% for mortality rate) and ischemic heart disease (increasing by 85.0% for death number and 81.0% for mortality rate) would increase most quickly. If the risk factors get the goals in 2030, the NCDs deaths would reduce 2 631 thousands. If only one risk factor gets the goal, blood pressure (1 484 thousands NCDs deaths reduction), smoking (717 thousands reduction) and BMI (274 thousands reduction) would be the most important factors affecting NCDs death. Blood pressure control would have greater impact on ischemic heart disease (662 thousands reduction) and hemorrhagic stroke (449 thousands reduction). Smoking control would have the greatest effect on lung cancer (251 thousands reduction) and chronic obstructive pulmonary disease (201 thousands reduction). BMI control would have the greatest impact on ischemic heart disease (86 thousands reduction) and hypertensive heart disease (45 thousands reduction). If the risk factors exposure changed according to the trend of 1990 to 2013, in 2030, the life expectancy of Chinese population would reach to 79.0 years old, compared to 2013, increasing by 3.3 years old, the labor force at the age of 15-64 years old would loss 1.932 million. If the risk factors get the goals in 2030, life expectancy would increase to 81.7 years old and the number of labor force lost would decrease to 1.467 million. Blood pressure, smoking and BMI control would have much greater impact on life expectancy (4.9, 4.0 and 3.8 years old respectively) and labor force lost (630 thousands, 496 thousands and 440 thousands respectively). Conclusion: Risk factors control would play an important role in reducing NCD death, improving life expectancy of residents and reducing loss of labor force. Among them, the control of blood pressure raising, smoking and BMI raising would have a greater contribution to the improvement of population health status.

[Deaths attributable to alcohol use and its impact on life expectancy in China, 2013]

Objective: To analyze the deaths attributable to alcohol use and its impact on people's life expectancy in China in 2013. Methods: The mortality data from the Disease Surveillance Points System and alcohol use data from China Chronic Disease Surveillance (2013) were used. The deaths attributed to alcohol use and its impact on the life expectancy of Chinese residents were estimated based on the principle of comparative risk assessment by calculating population attributable fraction. Results: In 2013, alcohol use resulted in 381 200 deaths, including 97 100 hemorrhagic stroke deaths, 88 200 liver cancer deaths, 61 400 liver cirrhosis deaths and 48 700 esophageal cancer deaths, and prevented 76 500 deaths, including 68 500, 4 900 and 3 100 deaths which might be caused by ischemic heart disease, hemorrhagic stroke and diabetes respectively. If risk factor of alcohol use is removed, the people's life expectancy would rise by an average of 0.43 years, especially in western China by 0.52 years, which was 0.12 years higher than that in eastern and central China, and the life expectancy of the population in rural and urban areas would rise by 0.48 years and 0.31 years respectively. Conclusions: Although alcohol has a protective effect on reducing ischemic heart disease, stroke and diabetes deaths, alcohol use is still a risk factor influencing the mortality and life expectancy of residents in China. It is necessary to take targeted measures to reduce the health problems caused by harmful use of alcohol.

[Subnational analysis of probability of premature mortality caused by four main non-communicable diseases in China during 1990-2015 and " Health China 2030" reduction target]

Objective: To investigate the current status, temporal trend and achieving Health China 2030 reduction target of probability of premature mortality caused by four main non-communicable diseases (NCDs) including cardiovascular and cerebrovascular diseases, tumour, diabetes, and chronic respiratory disease in China both at national and provincial level during 1990 to 2015. Methods: Using the results of Global Burden of Disease study 2015 (GBD 2015), according to the method of calculating premature mortality probability recommended by WHO, the current status and temporal trend by different gender from 1990 to 2015 were calculated, analyzed, and compared. Referring to " Health China 2030" target of reduction 30% of probability of premature mortality caused by major NCDs, we evaluated the difficulty of achieving the reduction target among provinces (not including Taiwan). Results: From 1990 to 2015, the probabilities of premature mortality in cardiovascular and cerebrovascular diseases, tumour, and chronic respiratory disease were all declined consistently for both men and women in China, the total of four main NCDs decreased from 30.69% to 18.54% with higher decreasing in women (from 25.97% to 12.40%) than that in men (from 34.94% to 24.19%). In 2015, the top five provinces in terms of probability of premature mortality caused by four main NCDs were Qinghai (28.81%), Tibet (25.88%), Guizhou (24.67%), Guangxi (23.56%), and Xinjiang (23.21%) in turn, while the top five provinces with the lowest probability were Shanghai (8.40%), Beijing (9.39%), Hong Kong (10.10%), Macao (10.31%), and Zhejiang (11.70%). If achieving the " Health China 2030" target, the probabilities of premature mortality in Qinghai and Tibet with the highest probability should decline to about 20.17%, and 18.12%, respectively in 2030, while 5.88%, and 6.57% in Shanghai and Beijing, respectively. From 1990 to 2015, the probability of premature mortality of four main NCDs declined by 2.00% a year on average, the top five provinces with the fastest decline were Beijing (3.48%), Shanghai (3.24%), Zhejiang (2.81%), Fujian (2.75%), and Guangdong (2.67%), and 11 provinces including these five provinces could achieve the " Health China 2030" target by the usual rate of decline, while other 22 provinces could not achieve the target, they need greater rate of decline in order to achieve the target. Conclusion: From 1990 to 2015, the probabilities of premature mortality of four main NCDs were declined consistently in China both at national and provincial level, compared with women, the men had higher probabilities and declined slower, there were significant different in probabilities of premature mortality and their change speed among provinces. Based on the results from 1990 to 2015, there were about two thirds of the provinces, which the task of achieving the Health China 2030 target will be daunting.

[Analysis on life expectancy and healthy life expectancy in China, 1990-2015]

Objective: To understand the life expectancy (LE) and health life expectancy (HALE) of Chinese during 1990-2015. Methods: Using the results of global burden of disease study 2015 (GBD 2015), we compared the Chinese LE and HALE in 2015 with those of other countries and analyzed the differences between LE and HALE in Chinese and the changes of LE and HALE during 1990-2015 at both national level and provincial level. Results: In 2015, the LE and the HALE of Chinese were 76.2 and 68.0 years, 4.4 and 5.2 years higher than the global averages, respectively. The LE and HALE were higher in women than in men. The high LE and HALE were observed in developed provinces or areas, such as Shanghai, Beijing, Hong Kong, Macau, Zhejiang, Jiangsu, Tianjin and Guangdong, while the low LE and HALE were found in underdeveloped provinces, such as Tibet, Qinghai, Guizhou, Xinjiang and Yunnan. Between 1990 and 2015, the LE and HALE of Chinese increased substantially by 9.5 and 8.4 years, respectively. The increase of LE was greater than that of HALE at both national level and provincial level. Conclusion: LE and HALE of Chinese increased substantially from 1990 to 2015, but the differences among provinces were obvious.

[Burden of disease attributable to high- sodium diets in China, 2013]

Objective: To examine the burden of disease(BOD)attributable to high-sodium diets in China in 2013. Methods: Data were extracted from the 2013 Global Burden of Disease Study for China to examine the BOD attributable to high-sodium diets in 2013, gender, and disease composition. Measurements for attributable BOD were population attributable fraction(PAF), deaths, standardized mortality and disability-adjusted life years(DALY)(not including Taiwan, China). An average world population age-structure for the period 2000-2025 was adopted to calculate age-standardized rates. Results: In 2013, deaths attributable to high-sodium diets accounted for 12.6% of all deaths and 14.5% of chronic disease deaths. Overall, 7.8% of deaths because of neoplasms, 25.2% of cardiovascular disease deaths, and 22.9% of chronic kidney disease deaths were attributable to high-sodium diets. A total of 1 176 553 deaths were attributable to high-sodium diets and the standardized mortality was 91.5/100 000, which was higher in men than in women(121.7/100 000 and 63.0/100 000, respectively). Overall, 22.759 million DALYs were attributable to high-sodium diets. The DALY standardized rate was 1 588.0/100 000, which was higher in men than in women(2 189.7/100 000 and 993.2/100 000, respectively). When compared by province, PAF in Xinjiang(25.0%), Qinghai(23.7%), Shanxi(23.2%), Tibet(22.1%)and Shandong(20.5%)was higher than other provinces. The standardized mortality in Xinjiang(239.4/100 000), Qinghai(238.9/100 000), Tibet(221.7/100 000), Shanxi(166.2/100 000)and Hebei(149.9/100 000)were higher than other provinces. The DALY standardized rate attributable to high-sodium diets was highest in Xinjiang(4 430.8/100 000), Qinghai(4 422.5/100 000), Tibet(4 021.4/100 000), Shanxi(2 816.6/100 000), and Hebei(2 624.9/100 000). Conclusion: The BOD attributable to high-sodium diets is a serious issue in China, particularly in men and in the northern provinces. Effective measures should be taken in northern provinces to reduce sodium intake.

A new cave-dwelling loach, Triplophysa xichouensis sp. nov. (Teleostei Nemacheilidae) from Yunnan, China

A new cave-dwelling loach of the genus Triplophysa, T. xichouensis, is described from an outlet of a subterranean river in Xisa Town, Xichou County, Yunnan Province, China. It can be distinguished from its congeners by the following characters: dorsal-fin rays iii, 8; anal-fin rays ii, 6; pectoral-fin rays i, 9 or 10; pelvic-fin rays i, 5 or 6; branched caudal-fin rays 16(8+8); eyes highly degenerated to a very tiny black dot; dorsal-fin origin closer to snout tip than to caudal-fin base and anterior to vertical line of pelvic-fin origin; pectoral fin length about two-thirds the distance between pectoral-fin origin to pelvic-fin origin; caudal peduncle slender, its length about three times its depth; caudal fin emarginate; body smooth and scaleless; lateral line complete and straight; anterior chamber of air bladder wrapped in dumbbell-shaped bony capsule and the posterior one well developed, long, oval; intestine short, bending in zigzag shape behind stomach. A key for the cave-dwelling species of Triplophysa is provided. urn:lsid:zoobank.org:pub:9162FFB1-7911-47C3-AE50-6A00E9590327.

[Current status of antiarrhythmic drug use and safety assessment in Chinese patients with atrial fibrillation]

Objective: To investigate the current status of antiarrhythmic drugs (AADs) use in Chinese patients with atrial fibrillation(AF) and assess the safety of AADs in this patient cohort. Methods: From January 2011 to December 2013, a total of 4 008 AF patients treated with AADs was enrolled in this study and patients were followed up for 24 months. Detailed information of prescribed drug, the causes of drug discontinuation and side effects were recorded. Results: Amiodarone was prescribed to 64.3%(2 579 cases) and propafenone to 31.1%(1 247 cases) of the enrolled patients, only 148 patients(3.7%) were treated with sotalol and 34 patients (0.8%) were treated with moracizine. The prevalence of heart failure (4.0%(102/2 579) vs. 1.4%(17/1 247, P<0.001), coronary heart disease (13.5% (348/2 579) vs. 7.4%(93/1 247), P<0.001) and non-ischemic cardiomyopathy (3.1%(78/2 579) vs. 0.7%(9/1 247), P<0.001) was significantly higher in patients treated with amiodarone than in the patients treated with propafenone. During the follow-up period, the discontinuation rate of amiodarone, propafenone, sotalol and moracizine was 28.8%(743/2 579), 25.1%(313/1 247), 14.2%(21/148) and 32.4%(11/34) respectively. The reasons of discontinuing amiodarone were: follow physicians' decision (75.7%, 563 cases), no effect (3.0%, 22 cases), side effects (4.3%, 32 cases) and patients' own decision (17.0%, 126 cases). The side effects of amiodarone included thyroid dysfunction (56.3%, 18 cases), bradycardia (12.5%, 4 cases), interstitial pneumonitis/pulmonary interstitial fibrosis (6.2%, 2 cases) and others (gastrointestinal symptom, rash, hepatic dysfunction, etc.). Conclusions: Amiodarone and propafenone are the most common AADs used in Chinese patients with atrial fibrillation. The prescription of AADs is essentially in accordance to the guideline of AF treatment. However, the discontinuation rates of AADs are high in Chinese AF patients. Lacking of better AADs is still a major problem in AF pharmacotherapy. Clinical Trial Registry Chinese Clinical Trial Registry, ChiCTR-OCH-13003729.

Fermentation of Foc TR4-infected bananas and Trichoderma spp

Fusarium wilt (also known as Panama disease) is one of the most destructive banana diseases, and greatly hampers the global production of bananas. Consequently, it has been very detrimental to the Chinese banana industry. An infected plant is one of the major causes of the spread of Fusarium wilt to nearby regions. It is essential to develop an efficient and environmentally sustainable disease control method to restrict the spread of Fusarium wilt. We isolated Trichoderma spp from the rhizosphere soil, roots, and pseudostems of banana plants that showed Fusarium wilt symptoms in the infected areas. Their cellulase activities were measured by endoglucanase activity, β-glucosidase activity, and filter paper activity assays. Safety analyses of the Trichoderma isolates were conducted by inoculating them into banana plantlets. The antagonistic effects of the Trichoderma spp on the Fusarium pathogen Foc tropical Race 4 (Foc TR4) were tested by the dual culture technique. Four isolates that had high cellulase activity, no observable pathogenicity to banana plants, and high antagonistic capability were identified. The isolates were used to biodegrade diseased banana plants infected with GFP-tagged Foc TR4, and the compost was tested for biological control of the infectious agent; the results showed that the fermentation suppressed the incidence of wilt and killed the pathogen. This study indicates that Trichoderma isolates have the potential to eliminate the transmission of Foc TR4, and may be developed into an environmentally sustainable treatment for controlling Fusarium wilt in banana plants.

[Burden of disease attributed to high total cholesterol in 2013 in China]

Objective: To analyze the burden of disease attributed to high total cholesterol(TC)in 2013 in China. Methods: We used data from the 2013 Global Burden of Disease Study. The population attributable fraction was calculated to estimate the deaths and disability-adjusted life years(DALY)attributed to high TC. Disease burden was compared by age, gender, diseases and province(not including Taiwan, China). An average world population age structure for the period 2000- 2025 was adopted to calculate age-standardized rates. Results: In 2013, high TC caused 298 952 deaths in China, accounting for 3.3% of total deaths, and caused 6 332 thousand DALYs. DALYs attributed to high TC were highest among the 50-69 years age group(3 165 thousand person years), accounting for 50.0% of the total attributed DALYs. The DALY rate in the ≥70 years age group was 2 053.3/100 000, which was 10.3 times that of 15-49 age group(198.6/100 000). DALYs among men were 4 431 thousand person years, which was 2.3 times higher than in women(1 900 thousand person years), and the age-standardized DALY rate among men was 590.6/100 000, which was 2.3 times higher than in women(257.1/100 000). DALYs attributed to high TC were mainly caused by ischemic heart disease(IHD; 5 572 thousand person years), accounting for 88.0% of the total attributed DALYs. Deaths and DALYs attributed to high TC were highest in Shandong(31 002 and 628 thousand person years for deaths and DALYs, respectively), Henan(27 398 deaths and 587 thousand person years, respectively), Hebei(25 744 deaths and 589 thousand person years, respectively), accounting for 28.1% of total attributed deaths and 28.5% of total attributed DALYs. The number of deaths and DALY were lowest in Macao(75 deaths and 1 thousand person years, respectively)and Tibet(385 deaths and 10 thousand person years, respectively). The age standardized DALY rates were highest in Beijing(794.8/100 000), Hebei(732.7/100 000), and Jilin(709.1/100 000), and lowest in Shanghai(151.4/100 000), Zhejiang(168.1/100 000), and Hong Kong(182.0/100 000). Conclusion: The burden of disease attributed to high TC in 2013 in China was mainly the result of the IHD it causes, with greater influence among males and those aged ≥50 years, and variation among provinces.

Interrelationship between Protein Phosphatase-2A and Cytoskeletal Architecture during the Endothelial Cell Response to Soluble Products Produced by Human Head and Neck Cancer

Tumor neovascularization is necessary for the progressive development of all solid tumors, including head and neck squamous cell carcinomas (HNSCCs). The angiogenic process includes increased endothelial cell motility. Our prior studies have shown the importance of protein phos-phatase-2A (PP-2A) in restricting endothelial cell motility. Because motility is regulated by the polymerization/depolymerization of the cellular cytoskeleton, the present study defined the interrelationship between PP-2A and the cytoskeleton during endothelial cell responses to HNSCC-derived angiogenic factors. PP-2A was shown to colocalize with microtubules of unstimulated endothelial cells. However, exposure to HNSCC-derived products resulted in a more diffuse distribution of PP-2A staining and a loss of filamentous tubulin. The feasibility of pharmacologically preventing this cytoskeletal disorganization as a means of blocking tumor-induced angiogenesis was tested. This was accomplished by use of 1α,25-dihydroxyvitamin D3[1,25 (OH)2D3] and all- trans-retinoic acid to indirectly stimulate PP-2A activity through their capacity to elevated intracellular levels of the second messenger ceramide. Pretreatment of endothelial cells with either 1,25(OH)2D3or retinoic acid prevented the cytoskeletal disorganization that otherwise occurs in endothelial cells on exposure to HNSCC-derived products. These studies support the feasibility of using elevation of PP-2A to prevent the mor-phogenic component of the angiogenic process that is stimulated by HNSCC-derived factors.

[Burden of chronic obstructive pulmonary disease attributable to ambient ozone pollution in 1990 and 2013 in China]

OBJECTIVE

To investigate the burden of chronic obstructive pulmonary disease (COPD) in China attributable to ambient ozone pollution in 1990 and 2013.

METHODS

Based on the results of the China Global Burden of Disease Study (GBD) 2013, the population attributable fractions was used to analyze the deaths and disability-adjusted life years (DALY) of COPD attributable to ambient ozone pollution in all provinces (not including Taiwan, China) in 1990 and 2013, and to compare changes of the attributable disease burden in 1990 and 2013.

RESULTS

In 2013, 7.4% (95% uncertainty interval (95% UI): 6.1%-8.6%) of COPD were attributable to ambient ozone pollution, with the highest rate in Hebei province (15.0%, 95%UI: 12.0%-18.7%) and the lowest in Heilongjiang province (2.8%,95%UI: 0.9%-5.3%). In 2013, 67 485 COPD deaths in China were due to ambient ozone pollution, with the highest number in Sichuan province (11 929) and in China lowest in Macao (11). A total of 1.168 million DALYs caused by COPD were due to ambient ozone pollution, with the highest in Sichuan province (0.189 million) and lowest in Macao (257.4). In 2013, the DALY per 100 000 population caused by COPD due to ambient ozone pollution after age standardization was lowest in Heilongjiang province (21.9), Shanghai (26.7), Beijing (38.4), Tianjin (39.3), and Jilin province (39.7) and highest in Sichuan province (206.4), Qinghai province (202.5), Guizhou province (175.3), and Gansu province (171.4). DALYs caused by COPD attributable to ambient ozone pollution increased with age (0.144 million person years for ages 15-49 years, 0.43 million person years for age 50-69 years and 0.594 million person years for age 70 years and above), which were higher in men than in women (0.708 million person years for men and 0.459 million person years for women in 2013). Deaths of COPD attributable to ambient ozone pollution were 49 514 and 67 485 in 1990 and 2013, respectively. DALYs caused by COPD attributable to ozone pollution totaled 0.894 million and 1.168 million person years in 1990 and 2013, respectively. Ambient ozone pollution-related deaths and DALYs increased 36.3% and 30.6%, respectively.

CONCLUSION

Compared with 1990, the disease burden of COPD in 2013 attributed to ambient ozone pollution in China increased substantially. Ambient ozone pollution caused great losses among Chinese residents. More attention should be directed toward western provinces with a particularly high disease burden due to ambient ozone pollution.