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Anthracyclines (ANTs) continue to play an irreplaceable role in oncology treatment. However, the clinical application of ANTs has been limited. In the first place, ANTs can cause dose-dependent cardiotoxicity such as arrhythmia, cardiomyopathy, and congestive heart failure. In the second place, the development of multidrug resistance (MDR) leads to their chemotherapeutic failure. Oncology cardiologists are urgently searching for agents that can both protect the heart and reverse MDR without compromising the antitumor effects of ANTs. Based on in vivo and in vitro data, we found that natural compounds, including saponins, may be active agents for other both natural and chemical compounds in the inhibition of anthracycline-induced cardiotoxicity (AIC) and the reversal of MDR. In this review, we summarize the work of previous researchers, describe the mechanisms of AIC and MDR, and focus on revealing the pharmacological effects and potential molecular targets of saponins and their derivatives in the inhibition of AIC and the reversal of MDR, aiming to encourage future research and clinical trials.

Background Although approximately 50% of Chinese with type 2 diabetes mellitus (T2DM) patients have vitamin D deficiency, studies regarding vitamin D supplementation on insulin resistance (IR) have mainly focused on non-Asians. Endurance exercise training (ET) enhances insulin-mediated glucose metabolism, which plays a critical role in T2DM prevention and control. However, the combined effects of vitamin D supplementation and ET on IR in T2DM patients are unclear. The objectives of this study is to investigate the synergistic effect of vitamin D supplementation combined with exercise training intervention on IR in T2DM patients. Methods and analysis We propose a 3-month randomized controlled trial among 60 T2DM patients aged 40–65, newly diagnosed with T2DM ≤ 1 year, and with stable HbA1c level (≤ 8.0%) in the past 3 months. The participants will be randomly allocated to the vitamin D group, vitamin D combined with exercise training group, exercise training group, and control group (CG) using a computer-generated random number sequence. At baseline, participants will undergo a medical review, anthropometric measurements, dual X-ray absorptiometry, a 75-g oral glucose tolerance test (OGTT), ankle-brachial index measurements, and physical fitness measurements and will complete related lifestyle questionnaires. Fasting blood lipid and glucose levels were also measured. In a 3-month intervention period, vitamin D intervention group will receive a dose of 1000 IU daily; exercise group will perform a 1-h endurance exercise 3 times per week (maximal heart rate, 60–80%), and the control group will receive apparently identical tablets. Additionally, all participants will be advised to maintain their normal diet and physical activities during the intervention. All measurements will be repeated at 3-month follow-up after the intervention with the primary outcome measure expressed as a change from baseline in insulin sensitivity and secretion. Secondary outcome measures will compare the changes in anthropometry, ankle-brachial index, and physical fitness factors (e.g., peak oxygen uptake, hand grip strength). Data will be managed and analyzed using the Statistical Package for the Social Sciences. Discussion This is the first study to conduct a randomized trial to clearly determine the independent and combined effects of vitamin D supplementation and endurance exercise trial on IR in Chinese T2DM patients as measured by OGTT. The findings from the proposed study will not only provide new evidences that vitamin D supplementation plays an important role in IR management but also develop a simple and efficient method to improve IR-associated metabolic diseases for T2DM patients. Trial registration Chinese Clinical Trial Registry ChiCTR1800015383, Registered on 28 March 2018

Myocardial ischemia is a disease with high morbidity and mortality, for which reperfusion is currently the standard intervention. However, the reperfusion may lead to further myocardial damage, known as myocardial ischemia/reperfusion injury (MI/RI). Oxidative stress is one of the most important pathological mechanisms in reperfusion injury, which causes apoptosis, autophagy, inflammation, and some other damage in cardiomyocytes through multiple pathways, thus causing irreversible cardiomyocyte damage and cardiac dysfunction. This article reviews the pathological mechanisms of oxidative stress involved in reperfusion injury and the interventions for different pathways and targets, so as to form systematic treatments for oxidative stress-induced myocardial reperfusion injury and make up for the lack of monotherapy.

The outbreak of a novel coronavirus disease (COVID-19, caused by the 2019-nCoV infection) in December 2019 is one of the most severe public health emergencies since the founding of People's Republic of China in 1949. Healthcare personnel (HCP) nationwide are facing heavy workloads and high risk of infection, especially those who care for patients in Hubei Province. Sadly, as of February 20, 2020, over two thousand COVID-19 cases are confirmed among HCP from 476 hospitals nationwide, with nearly 90% of them from Hubei Province. Based on literature search and interviews with some HCP working at Wuhan, capital city of Hubei, we have summarized some of the effective measures taken to reduce infection among HCP, and also made suggestions for improving occupational safety during an infectious disease outbreak. The experience and lessons learned should be a valuable asset for international health community to contain the ongoing COVID-19 epidemic around the world.

Background Physical activity (PA) and dietary intake are important modifiable factors associated with health outcomes. However, Chinese pregnant women’s PA and dietary intake are only vaguely understood. The aim of this study was to reveal the characteristics of PA and dietary intake of Chinese women in different trimesters as well as the associations between PA and dietary intake. Methods This is a cross-sectional observational study. PA, dietary intake, and demographics of 1077 Chinese pregnant women were measured. The Chi-square test, Kruskal-Wallis test, multiple logistic regression, and multiple linear regression were used for data analysis. Results About 57.1% of the participants met the international guideline for PA. Household activity and occupational activity contributed the most to the total PA, while sports/exercise contributed little. The mean energy intake of the participants was 2008 ± 748.0 kcal. Most participants had normal energy intake, but they obtained excessive energy from fat (mean = 41.7 ± 8.7%). PA was not found to be significantly associated with dietary intake. Further, the participants who were unemployed during pregnancy (OR = 0.72, 95% CI: 0.55–0.95; p 30 years) showed higher dietary intake than the younger (

Background Traditional exercise [supervised exercise (SE)] intervention has been proved to be one of the most effective ways to improve metabolic health. However, most exercise interventions were on a high-cost and small scale, moreover lacking of the long-term effect due to low engagement. On the other hand, it was noteworthy that gamification and social incentives were promising strategies to increase engagement and sustain exercise interventions effects; as well as mobile technologies such as WeChat also can provide an appropriate platform to deploy interventions on a broader, low-cost scale. Thus, we aim to develop a novel exercise intervention (‘S&G exercise intervention’) that combines SE intervention with gamification and social incentives design through WeChat, with the aim of improving metabolic health and poor behaviors among overweight and obesity children. Methods We propose a randomized controlled trial of a ‘S&G exercise intervention’ among 420 overweight and obese children who have at least one marker of metabolic syndrome. Children will be randomized to control or intervention group in a 1:1 ratio. The exercise intervention package includes intervention designs based on integrated social incentives and gamification theory, involving targeted essential volume and intensity of activity (skipping rope) as well as monitoring daily information and providing health advice by WeChat. Participants will undertake assessments at baseline, at end of intervention period, in the follow-up time at months 3,6,12. The primary outcome is outcome of metabolic health. Secondary outcomes include behavioral (e.g., diary physical activity, diet) and anthropometric measures (e.g., body fat rate and muscle mass). Discussions This will be the first study to design an exercise intervention model that combines traditional supervised exercise (SE) intervention with gamification and social incentives theory through WeChat. We believed that this study could explore a low-cost, easy-to-popularize, and effective exercise intervention model for improving metabolic health and promote healthy among obese children. Furthermore, it will also provide important evidence for guidelines to prevent and improve metabolic health and health behaviors. Trial registration 10-04-2019;Registration number: ChiCTR1900022396.

Objective:To clarify nutrient supplementation usage and primary source of information among pregnant women in China.Design:This cross-sectional study used information on nutrient supplementation and primary source of information collected via face-to-face interviews. Data on the usage of folic acid, Ca/vitamin D, Fe, vitamins, DHA and other dietary supplements were collected. Primary source of information was categorised as family/relatives, friends/co-workers, the Internet, books/magazines, television/radio, doctors, other people and oneself.Setting:Maternal and Child Health Hospital in Chengdu, China.Participants:One thousand eighty-one Chinese pregnant women aged ≥20 years with singleton pregnancies.Results:In all three trimesters of pregnancy, usage was highest and most stable for folic acid (81·7 %), followed by vitamins (vitamin A, B-group vitamins, vitamin C and multivitamins; 75·0 %), whereas Ca/vitamin D (51·4 %) and Fe (18·1 %) usage was low, potentially indicating a deficiency risk. All supplementation usage percentages increased with pregnancy duration (P < 0·05). Notably, approximately 10 % of the pregnant women in our study did not use any nutrient supplementation, and this was especially common in early pregnancy. More than 50 % of the women reported getting information on nutrient supplementation from family members, and about 30 % reported getting this information from doctors.Conclusions:Among pregnant women in China, awareness about nutrient supplementation increases as the pregnancy progresses, but some types of nutrient supplementation (such as Ca/vitamin D and Fe) remain at low levels. It is necessary to pay more attention to the health education of pregnant women in China, and the influence of family members should be emphasised.

The 2019 coronavirus disease (COVID-19) is a public health emergency of international concern. In China, all schools were shut down and students were home quarantined to prevent disease spread; these steps could have potential negative effects on mental health of adolescents. This study aimed to examine changes in depression and anxiety among Chinese adolescents during the COVID-19 epidemic, and explore factors associated with depression and anxiety. Two survey administrations were conducted among Chinese adolescents between February 20 and February 27 and between April 11 and April 19, 2020, respectively. The Center for Epidemiological Studies-Depression Scale (CES-D) and the 7-item Generalized Anxiety Disorder (GAD-7) scale were used to assess depressive symptoms and anxiety symptoms, respectively. A total of 9554 and 3886 adolescents participated in the first and second surveys. During the initial survey, the prevalence of depression was 36.6% (95% CI: 35.6–37.6%) while the prevalence of anxiety was 19% (95% CI: 18.2–19.8%). Rates of depression and anxiety increased to 57.0% (95% CI: 55.4–58.6%) and 36.7% (95% CI: 35.2–38.2%), respectively, in the second survey. Multivariable logistic regression analyses revealed that group membership in the second survey, female gender, senior secondary school enrollment, and concerns about entering a higher grade were positively associated with both depression and anxiety. Conversely, a sleep duration of ≥6 h/day, an exercise duration ≥30 min/day, having the same as typical or higher study efficiency during the COVID-19 outbreak, and living in provinces with 1000–9999 confirmed COVID-19 cases were negatively associated with depression and anxiety. In conclusion, compared to figures reported during the COVID-19 outbreak, the prevalence of depression and anxiety in Chinese adolescents significantly increased after the initial outbreak. Regular screening and appropriate interventions are urgently needed to reduce the risk for emotional disturbances among adolescents during and after the initial COVID-19 outbreaks.

Additional file 10: Checklist S1 Completed ARRIVE guidelines checklist. The checklist includes the ARRIVE Essential 10 and the Recommended Set.

Background: In the context of accelerated global aging, blood lipid levels are directly related to the health status of oldest old. The common sense is that lower serum cholesterol levels are better, as higher cholesterol levels increase the risk of cardiovascular disease. However, a growing number of researches have questioned this especially for the oldest old. The current study was to assess the association between total cholesterol and all-cause mortality in a group of people aged 85 years old and over. Methods: In this retrospective longitudinal study, we selected 903 Chinese old participants who aged ≥85 years from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) at baseline in 2012. The participants were followed up until death or until December 31, 2014. The outcome of our study was all-cause mortality. The univariate and multivariate cox regression analyses were used to estimate Hazard ratios (HRs) and 95% confidence interval values of all-cause mortality. To analyze further the relationship between total cholesterol and all-cause mortality, we stratified the participants into three groups (

Objective. We aimed to observe the impact of ginkgolic acid (GA) on the proliferation and metastasis ability of ovarian cancer (OCa) cells and to further explore whether GA affects the malignant progress of OCa via regulating the lncRNA MALAT1/JAK2 axis. Methods. OCa cells SKOV3 and CAOV3 were administered with 1 ng/ml GA, 5 ng/ml GA, 10 ng/ml GA, 20 ng/ml GA, and DSMO as control, respectively. The cell proliferation and migration ability of the abovementioned cells in each group were measured by CCK-8 test and Transwell experiments. The expression levels of lncRNA MALAT1 and JAK2 protein were examined by qRT-PCR and western blot, respectively. Subsequently, in OCa cells treated with GA, lncRNA MALAT1 overexpression vector was transfected to continue to detect the proliferation activity and migration ability of each treatment group. Finally, the regulation of GA on activity of lncRNA MALAT1/JAK2 axis in OCa cells was further explored in nude mice. Results. Our data showed that the proliferation inhibition rate of cells at each ginkgolic acid concentration was higher than that of the control group ( P < 0.05 ), suggesting that GA has an inhibitory influence on the proliferation of OCa cells, in a dose-dependent way. GA was able to inhibit the proliferation rate and migration ability of OCa cells. Administration of ginkgolic acid downregulated the levels of lncRNA MALAT1 and JAK2 protein. Overexpression of lncRNA MALAT1 partially reversed the inhibited OCa proliferative capacity caused by GA treatment. Consistent with the results observed in vitro, we also found that the OCa tumor weight and volume of nude mice injected with lncRNA MALAT1 overexpression vector were enhanced and JAK2 protein level increased remarkably in comparison to the ginkgolic acid group. Conclusions. In summary, GA may exert its inhibitory effect on the proliferative and migratory capacities of OCa cells through suppressing the activity of lncRNA MALAT1/JAK2 axis.

Ferroptosis is a programmed iron-dependent cell death characterized by accumulation of lipid peroxides (LOOH) and redox disequilibrium. Ferroptosis shows unique characteristics in biology, chemistry, and gene levels, compared to other cell death forms. The metabolic disorder of intracellular LOOH catalyzed by iron causes the inactivity of GPX4, disrupts the redox balance, and triggers cell death. Metabolism of amino acid, iron, and lipid, including associated pathways, is considered as a specific hallmark of ferroptosis. Epidemiological studies and animal experiments have shown that ferroptosis plays an important character in the pathophysiology of cardiovascular disease such as atherosclerosis, myocardial infarction (MI), ischemia/reperfusion (I/R), heart failure (HF), cardiac hypertrophy, cardiomyopathy, and abdominal aortic aneurysm (AAA). This review systematically summarized the latest research progress on the mechanisms of ferroptosis. Then we report the contribution of ferroptosis in cardiovascular diseases. Finally, we discuss and analyze the therapeutic approaches targeting for ferroptosis associated with cardiovascular diseases.

Synchrotron emission polarization is very sensitive to the magnetic field configuration. Recently, polarization of synchrotron emission with a mixed (SM) magnetic field in Gamma-ray burst (GRB) afterglow phase had been developed. Here, we apply these SM models to GRB prompt phase and compare their polarization properties with that of synchrotron emission in purely ordered (SO) magnetic field. We find that the polarization properties in a SM model are very similar to these in a corresponding SO model (e.g., synchrotron emission in a mixed magnetic field with an aligned ordered part (SMA) and synchrotron emission with a purely ordered aligned magnetic field (SOA)), only with a lower polarization degree (PD). We also discuss the statistical properties of the models. We find PDs of the simulated bursts are concentrated around $25\%$ for both SOA and synchrotron emission in a purely ordered toroidal magnetic field (SOT), while they can range from $0\%$ to $25\%$ for SMA and synchrotron emission in a mixed magnetic field with a toroidal ordered part (SMT), depending on $\xi_B$ value, i.e., the ratio of magnetic reduction of the ordered magnetic field over that of random magnetic field. From statistics, if PDs of majority GRBs are non-zero, then it favours SO and SM models. Further, if there are some bright GRBs with a prominently lower PDs than that of the majority GRBs, it favours SOT (SMT) models; if all the bright GRBs have comparable PDs with the majority ones, it favours SOA (SMA) models. Finally, we apply our results to POLAR's data and find that $\sim10\%$ time-integrated PDs of the observed bursts favor SMA and SMT models, and $\xi_B$ parameter of these bursts is constrained to be around 1.135., Comment: 23 pages, 10 figures, accepted by RAA

Besides light curves and spectra, polarization provides a different powerful tool of studying the $\gamma-$ray burst (GRB) prompt phase. Compared with the time-integrated and energy-integrated polarization, time-resolved and energy-resolved polarization can deliver more physical information about the emitting region. Here we investigate time-resolved and energy-resolved polarization of GRB prompt emission using the synchrotron models. We find that the equal arrival time surface effect is very important in shaping the PD curves when the physical conditions of emitting region changes violently with radius. Polarization properties are neither correlated with the spectral lag nor the peak energy evolution patterns. Polarization properties with a mixed magnetic field are very similar to those for a corresponding ordered magnetic field but the former has a smaller polarization degree. The emission at the MeV peak can be highly polarized for a synchrotron model while it is unpolarized as predicted by a dissipative photosphere model. Future energy-resolved polarization observations can distinguish between these two models., Comment: 20 pages, 6 figures, Accepted by ApJ

The effects of Chios mastic gum (Pistacia lentiscus var. Chia) and exercise on physical characteristics, blood lipid markers, insulin resistance, and hepatic function were investigated in healthy, non-smoking Japanese men aged ≥ 40 years. Participants were allocated to control (C, 5 g/day placebo powder, n = 7), mastic (M, 5 g/day mastic powder, n = 7), or mastic plus physical activity groups (M + PA, 5 g/day mastic powder and 30-min exercise three times/week, n = 7), and measurements were taken at baseline, 3 and 6 months. Serum triglycerides were significantly reduced at 3 months in M and M + PA compared with C (P

A central compact object (CCO, e.g. a black hole) with an accretion disk has been suggested as the common central engine of various astrophysical phenomena, such as gamma-ray bursts (GRBs), tidal disruption events (TDEs) and active galactic nuclei (AGNs). A jet powered by such a system might precess due to the misalignment of the angular momenta of the CCO and accretion disk. Some quasi-periodic behaviors observed in the light curves of these phenomena can be well interpreted within the framework of a precessing jet model. In this paper, we study the emission polarization of precessing jets in the three kinds of phenomena. The polarization angle also shows a gradual change for the synchrotron emission in both the random and toroidal magnetic field configurations with the precessing jet, while it can only change abruptly by $90^\circ$ for the non-precessing top-hat jet. Polarization properties are periodic due to the assumptions made in our model. The polarization observations are crucial to confirm the precession nature of jets in GRBs, TDEs and AGNs., 21 pages, 6 figures, accepted by ApJ

Objectives We aimed to compare the association of body mass index (BMI), waist circumference (WC), and waist‐to‐height ratio (WHtR) with risk of cardiovascular disease (CVD) among middle‐aged working Japanese men. Methods A nested case‐control study was performed among middle‐aged male employees who underwent periodic health checkup. A total of 241 CVD cases were identified and matched individually on age, gender, and worksite with 1205 controls. Data on BMI, WC, WHtR, smoking, hypertension, diabetes, and dyslipidemia collected at 4 years before the event/index date were retrieved. Associations between BMI, WC, WHtR, and CVD risk were assessed by using conditional logistic regression models. Results The strength of the association of BMI, WC, and WHtR with CVD risk was similar. The smoking‐adjusted odds ratio (95% confidence interval) for CVD was 1.60 (1.38‐1.85), 1.53 (1.33‐1.78), and 1.56 (1.35‐1.81) for a 1 SD unit increase in BMI, WC, and WHtR respectively. After further adjustment for hypertension, diabetes, and dyslipidemia, these associations were attenuated but remained statistically significant. Conclusions Measures of general (BMI) and abdominal (WC and WHtR) obesity were similarly associated with CVD in middle‐aged Japanese men.

The independent effect of sedentary behavior (SB) on maternal mental health is still unclear. The purpose of this study was to examine the different relationships of SB with maternal distress in pregnant women across the three trimesters, controlling for the confounding factors including physical activity (PA), diet and gestational weight gain.Survey data were collected from 1272 participants in different trimesters of pregnancy. The data were divided into three data sets based on trimester, and regression analysis was conducted on each data set. Both the linear and quadratic relationships between SB and mental distress were estimated.There was no significant association between SB and any mental distress symptoms in the first trimester. In the second trimester, SB was positively associated with higher mental overall distress symptoms (β=0.34, P0.001), including depress and anxiety. There is an inverted-U shaped curvilinear relationship between SB and mental distress in the third trimester, as SB-squared is significantly associated with mental overall distress (GSI: β=-0.65, P = 0.002, depression: β=-0.53, P = 0.014, anxiety: β=-0.46, P = 0.031).The data were collected from only one city in China, which may limit the generalizability of the findings for all Chinese women. This was an observational study and causality cannot be established.This study found that the relationship between SB and maternal mental distress depends on trimesters. The stage of pregnancy should be considered when designing interventions for pregnant women to change SB to reduce mental distress.

Gamification and social incentives are promising strategies to increase the effectiveness of web-based physical activity (PA) interventions by improving engagement. In this study, we designed a PA intervention integrating gamification and social incentives based on the most popular social networking service in China, WeChat. A controlled trial involving 52 Chinese undergraduate students was implemented to evaluate the effectiveness of the intervention. Subjects in the intervention group received a 7-week intervention. PA behavior and related social cognitive variables according to the theory of planned behavior were measured at the baseline and after the intervention. Daily physical activity duration was measured during the intervention. The results showed that PA-related subjective norms, perceived behavior control, and intention, as well as self-reported vigorous physical activity and moderate physical activity in the intervention group, were increased after the intervention, compared with the control group (p &lt, 0.05). During the intervention, perceived daily physical activity duration in the intervention group was on the rise, while it declined in the control group (p &lt, 0.001). The findings indicate that WeChat-based intervention integrating gamification and social incentives could effectively increase subjectively measured PA and related social cognition among Chinese undergraduate students and that it is a promising way to ameliorate the problem of insufficient PA among youths.

Gamma-ray bursts are the strongest explosions in the Universe since the Big Bang, believed to be produced either in forming black holes at the end of massive star evolution or merging of compact objects. Spectral and timing properties of gamma-ray bursts suggest that the observed bright gamma-rays are produced in the most relativistic jets in the Universe; however, the physical properties, especially the structure and magnetic topologies in the jets are still not well known, despite several decades of studies. It is widely believed that precise measurements of the polarization properties of gamma-ray bursts should provide crucial information on the highly relativistic jets. As a result there have been many reports of gamma-ray burst polarization measurements with diverse results, see, however many such measurements suffered from substantial uncertainties, mostly systematic. After the first successful measurements by the GAP and COSI instruments, here we report a statistically meaningful sample of precise polarization measurements, obtained with the dedicated gamma-ray burst polarimeter, POLAR onboard China's Tiangong-2 spacelab. Our results suggest that the gamma-ray emission is at most polarized at a level lower than some popular models have predicted; although our results also show intrapulse evolution of the polarization angle. This indicates that the low polarization degrees could be due to an evolving polarization angle during a gamma-ray burst., 34 pages, 15 figures (16 pages and 3 figures without supplementary information). Accepted for publication in Nature Astronomy, http://dx.doi.org/10.1038/s41550-018-0664-0

As the standard gamma-ray burst (GRB) prompt-emission model, the internal shock (IS) model can reproduce the fast-rise and slow-decay features of the pulses in the GRB light curve. The time- and energy-dependent polarization can deliver important physical information on the emission region and can be used to test models. Polarization predictions for the GRB prompt phase with the magnetized IS model should be investigated carefully. The magnetic field of the magnetized IS model is very likely to be mixed and decays with radius. The synchrotron emission in the presence of such a decaying magnetic field can recover the Band-like spectrum of the GRB prompt phase. We investigate the dependence of the polarization of GRB prompt emission on both time and energy in the framework of the magnetized IS model. Due to the large range of parameters, it is hard to distinguish the magnetized IS model and the magnetic-reconnection model through polarization degree (PD) curves. The energy-dependent PD could increase toward the high-energy band for the magnetized IS model, while it decreases to zero above the megaelectronvolt band for the dissipative photosphere model. Therefore, we conclude that the energy dependence of PD can be used to distinguish these two models for the GRB prompt emission. Finally, we find that, independent of the observational energy band, the profiles of the $\xi_B-PD$ curve for the time-integrated and time-resolved PDs are very similar, where $\xi_B$ is the magnetic field strength ratio of the ordered component to the random component., Comment: 7 pages, 3 figures, accepted by ApJ