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In this study, the aim is to explore whether frailty status modified the associations of serum 25(OH)D levels with all-cause and cause-specific mortality in the oldest old Chinese population.A total of 1411 participants aged at least 80 years were enrolled in the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Information on serum 25(OH)D level, frailty status, and covariates were examined at baseline. All-cause and cause-specific mortality status were ascertained during the follow-up survey conducted in 2017-2018 by using the ICD-10 codes. Cox proportional hazard models with stratified analyses were performed to evaluate potential associations. Over a median follow-up of 3.2 years, 722 (51.2%) participants were deceased, including 202 deaths due to circulatory diseases, and 520 deaths due to noncirculatory causes. After multivariable adjustment, the lowest quartile of serum 25(OH)D levels (Hazard Ratios (95% Confidence Intervals), 1.85 (1.45-2.36), 1.85 (1.45-2.36), 1.73 (1.31-2.29), respectively) and frailty (Odd Ratios (95% Confidence Intervals), 1.91 (1.60-2.29), 2.67 (1.90-3.74), 1.64 (1.31-2.05)) were associated with significantly higher risk of all-cause mortality, circulatory mortality, and noncirculatory mortality, respectively. In addition, we observed significant interactions among 25(OH)D and frailty on the risk of all-cause and cause-specific mortality (all P-interaction 0.001). Similar results were found in sensitivity analyses by excluding participants who died in the first year of follow-up and using clinical cutoffs of serum 25(OH)D levels.Low serum 25(OH)D levels were associated with higher risk of all-cause and cause-specific mortality among the oldest old of the Chinese population, and the associations were significantly stronger in individuals with frailty.

Background and aims The relationship between lipid variability and stroke among patients with hypertension were inconclusive. We aimed to investigate the association of lipid variability with ischemic stroke in hypertensive patients. Methods and results This retrospective cohort study included 4995 individuals with hypertension between 2013 and 2015, and recorded their status of ischemic stroke until the end of 2018. The variability in total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were measured using the standard deviation (SD), coefficient of variation (CV), variability independent of the mean (VIM) and average absolute difference between successive values (ASV). Multivariate Cox proportional hazards models with hazard ratios (HRs) and 95% confidence interval (CI) were performed. There were 110 cases of ischemic stroke during a median follow up of 4.2 years. The multivariable adjusted HRs and 95% CIs comparing the highest versus the lowest quartiles of SD of TC, LDL-C, HDL-C and TG were 4.429 (95% CI: 2.292, 8.560), 2.140 (95% CI: 1.264, 3.621), 1.368 (95% CI: 0.793, 2.359) and 1.421 (95% CI: 0.800, 2.525), respectively. High variability in TC and LDL-C were associated with a higher risk for ischemic stroke. Similarly, the results were consistent when calculating variability of TC and LDL-C using CV, ASV and VIM, and in various subgroup analyses. Conclusion Higher variability of TC and LDL-C associated with the risk of ischemic stroke among hypertensive patients. These findings suggest reducing variability of lipid parameters may decrease adverse outcomes.

Little was known about the effect of famine exposure on carotid intima-media thickness (cIMT). The present study aimed to explore the relationship in a Chinese population.Participants were divided into five groups: not exposed to famine, exposed to famine in fetal, early, mid or late childhood. Elevated cIMT was defined as a thickness of0.9 mm measured by carotid ultrasound. Multivariate logistic regression was performed to calculate odds ratio (OR) and confidence interval (CI) between famine exposure and cIMT. A total of 2637 (970 male, mean age 59.1 ± 3.65 years) participants were recruited, and 491 (18.62%) of them had elevated cIMT. When compared with the non-exposure group, the fully adjusted ORs for increased cIMT for exposure in fetal, early, mid to late childhood were 1.321 (95%CI: 0.872, 1.994, P = 0.186), 1.713 (95% CI: 1.188, 2.483, P = 0.004), 2.359 (95% CI: 1.674, 3.357, P 0.001) and 2.485 (95% CI: 1.773, 3.518, P 0.001), respectively. Subgroup analyses showed that the exposure to famine did not interact with body mass index, gender, smoking status, hypertension and diabetes history on its effect on cIMT.Our findings indicated that early-life exposure to the Chinese famine might be associated with an increased risk of increased cIMT in adulthood.

Purpose Pulmonary mucormycosis is a highly lethal invasive fungal infection usually found in immunocompromised patients. We report herein the case of an adult woman who developed pulmonary mucormycosis with possible systemic dissemination after recovering from acute liver failure secondary to acetaminophen overdose. Results Our case developed an invasive pulmonary mucormycosis with probable systemic dissemination. She did not suffer from any immunocompromising disease other than severe acute liver failure. She did not survive the disease, although she received appropriate antifungal treatment. We also performed a systematic review of the literature on pulmonary mucormycosis, with or without dissemination, in immunocompetent patients. We found 16 cases of pulmonary or disseminated mucormycosis in immunocompetent patients. Fifty-seven percent of them died and none occurred after an acute liver failure episode. Conclusion This case report is the first one to present an invasive pulmonary mucormycosis infection after acute liver failure in an adult patient. The clinical course of this disease is highly lethal, even in immunocompetent adults.

Manganese (Mn) may improve cardiometabolic health with its anti-oxidative ability. However, epidemiological evidence on the overall and sex-specific relationship between Mn exposure and metabolic syndrome (MetS) has been inconclusive. We evaluated the associations of urinary (n = 1713) and blood (n = 3335) Mn levels with the prevalence of MetS, its components (elevated waist circumference, impaired glucose metabolism, elevated blood pressure and dyslipidemia) and sex-dependent heterogeneities among participants in the United States National Health and Nutrition Examination Survey 2011–2016. After adjusting for multiple covariates and the levels of other metals (Arsenic, Barium, Cadmium, Mercury, Molybdenum, Tin and Uranium), urinary Mn at the third quartile associated with a lower odd of MetS (odds ratio [OR] = 0.55, 95% confidence interval [C.I.] = 0.32–0.97), elevated waist circumference (OR = 0.56, 95% C.I. = 0.36–0.86) and elevated fasting plasma glucose (OR = 0.46, 95% C.I. = 0.27–0.76) among overall participants, and lower odds of MetS (OR = 0.40, 95% C.I. = 0.16–0.99), elevated waist circumference (OR = 0.39, 95% C.I. = 0.19–0.81) and elevated fasting plasma glucose (OR = 0.44, 95% C.I. = 0.22–0.90) among men. The U-shaped dose-response relationship between urinary Mn and MetS (P non-linear = 0.008) was observed among all participants. We did not observe the significant associations of blood Mn with the prevalence of MetS. Compared with other metals, urinary Mn played a less important role in development of MetS (posterior inclusion probabilities [PIP] = 0.49 for Mn versus 0.54 to 0.91 for other metals), but the contribution of blood Mn (PIP = 0.59 versus 0.60 to 0.61) was similar to other blood metals (Cadmium, Lead, Mercury and Selenium). These findings have provided new evidence of the potential roles of Mn in cardiometabolic health, and the needs to explore how Mn interacts with multiple metals in sex-specific manner.

Background: The relationship between telomere length and blood pressure remains unclear. The aim of this study is to examine the relationship between mean telomere length and blood pressure among US adults. Methods: Our study population was from the National Health and Education National Surveys (NHANES, 1999-2002). Mean telomere length were grouped by quartiles. The mean telomere length assay was performed by using the quantitative polymerase chain reaction method to measure leukocyte telomere length relative to standard reference DNA (also known as the telomere-to-single copy gene (T/S) ratio). Coefficients (betas) and 95% confidence intervals (CIs) for mean telomere length in association with blood pressure were estimated by using multivariate linear regression analysis, subgroup stratified and interaction tests. Results: There were total 5954 participants including 2911 men and 3043 women, mean age were 45.16 ± 17.26 years. After adjusting for potential confounders a non-linear relationship was detected between mean telomere length and systolic and diabolic blood pressure, which had an inflection point of 0.79 T/S ratio and 1.02 T/S ratio, respectively. Subgroup analysis in participants without antihypertensive drugs showed that mean telomere length had a negative correlation with SBP(β=-6.44, 95%CI:-7.80, -5.08,P

The effects of mesocarbon microbeads support for platinum-ruthenium (Pt-Ru) catalysts on anode performance of the direct methanol fuel cell (DMFC) were investigated. The Pt-Ru catalyst with mesocarbon microbeads as support shows lower polarization characteristics than that with carbon black as support. The SEM of the cross-section of the catalyst layer with mesocarbon microbeads as support shows that there exist large pores and channels that are favorite for mass transfer in electrode reaction region. The effects of the cell operation temperature and the methanol concentration on the polarization curves of the anode electrode were also investigated.

Mesocarbon microbeads (MCMB) as Pt catalyst supports were characterized by X-ray electron diffraction, thermal field emission scanning electron microscope and electrochemical analysis. MCMB with different pretreatment were used as the catalyst supports. The XRD patterns show the existence of Pt and the micrograph of SEM shows Pt is absorbed uniformly on the surface of MCMB particles and the platinum grain size is ca. 3–5 nm. The effect of the pretreatment of the support on the catalyst performance of methanol electrooxidation was studied. Electrochemical analysis shows that MCMB are excellent candidates to be used as the support of catalyst for methanol electrochemical oxidation. The catalyst with MCMB boiled in KOH for 1 h as support exhibits a high catalytic activity during the electrooxidation of methanol.