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Hypertension and altitude in community-dwelling older adults: an epidemiological study in northwest China

Por: Maimaitiwusiman · Z. · Xuekelati · S. · Wumaier · A. · Bai · X. · Ma · L. · Li · Y. · Aerken · A. · Yang · Y. · Wang · H.
Objectives

Hypertension is a major risk factor for cardiovascular and cerebrovascular diseases, and a relationship between altitude and hypertension has been demonstrated. To better characterise this relationship, this study investigated the prevalence of hypertension and its association with altitude in community-dwelling older adults living at different altitudes in Xinjiang, northwest China.

Design

A cross-sectional study.

Setting

Xinjiang, China.

Participants

50 778 community-dwelling older adults residing at varying altitudes across Xinjiang.

Measures

A multistage stratified sampling method was used to conduct an epidemiological survey from January 2019 to December 2019 among 50 778 community-dwelling older adults aged ≥60 years who were long-term residents of Kashgar (1289 m), Hami (738 m) and Turpan (35 m), Xinjiang. Logistic regression analysis was conducted to evaluate the association between altitude and hypertension risk.

Results

Mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) showed significant variations (both p

Conclusions

In community-dwelling older adults residing in lowland to mid-elevation zones (35–1289 m) of Xinjiang, the prevalence and risk of hypertension were found to be inversely associated with residential altitude. These findings may reflect an environmental gradient effect specific to mid-to-low altitude settings, and their generalisability may be limited to populations at higher altitudes (>1500 m) or regions with distinct ethnic, genetic or healthcare backgrounds. Furthermore, it should be emphasised that this association likely reflects altitude-related environmental factors rather than direct physiological effects of hypoxia. Additional studies are warranted to further elucidate these complex relationships.

Prophylactic biological mesh reinforcement during ileostomy closure surgery evaluated by the image-based deep learning model for the prevention of stoma-site incisional hernia: phase II study protocol for a single-centre, prospective, randomised controlle

Por: Liu · Z. · Dong · Z. · Zhang · Y. · Guan · Y. · Bai · L. · Gu · J. · Ni · B. · Zhang · H.-y. · Aimaiti · M. · Wang · S. · Yue · B. · Xia · X. · Zhang · Z.
Background

Prophylactic ileostomy plays a critical role in the radical resection of low rectal cancer, but the incidence of stoma site incisional hernia (SSIH) after stoma closure remains high. No study has been reported in which radiomics has been used to predict SSIH. The primary aim of this study is to evaluate the safety and efficacy of biological mesh in preventing incisional hernia in patients with high-risk incisional hernia factors, as identified by image-based deep learning model, undergoing ileostomy closure surgery.

Methods and analysis

40 patients who need to undergo ileostomy closure and have been identified with high risk factors for SSIH by image-based deep learning model will be selected for this study. Patients will be randomly assigned equally to the prophylactic biological mesh placement group and the control group, and outcomes will be tracked via clinic review at 1 month, 3 months, 6 months and 12 months postoperatively. The outcome measures are the rate of postoperative incisional hernia, local pain, incisional infection, seroma and so on. This study demonstrates that prophylactic placement of biological mesh with ileostomy closure reduces the incidence of SSIH. Furthermore, it validates the feasibility of image-based deep learning models in predicting postoperative complications and identifying high-risk SSIH patients.

Ethics and dissemination

Informed consent has been obtained from all subjects. This protocol has been approved by the Ethics Committee of Renji Hospital, Shanghai Jiao Tong University School of Medicine (KY2022-087-B). The findings will be disseminated through peer-reviewed manuscripts, reports and presentations.

Trial registration number

ChiCTR2200064995. Registration date: October 2022. Registration authority: Chinese Clinical Trial Registry.

Safety and efficacy of PD-1 antibody combined with pegylated interferon {alpha} for functional cure in nucleos(t)ide analogues-suppressed chronic hepatitis B patients: protocol for a multicentre randomised controlled trial

Por: Wang · H. · Li · X. · Lu · J. · Zhang · X. · Dang · S. · Li · Y. · He · Y. · Guo · Y. · Wang · J. · Maimaitijiang · W. · Zheng · S. · Ren · S. · Cao · H. · Zhang · W. · Zhang · X. · Ma · H. · Wang · F.-S. · Fu · J.
Introduction

The functional cure of chronic hepatitis B (CHB) is an ideal goal of therapy, as it is associated with improved long-term outcomes. Patients with low levels of HBsAg have higher rates of functional cure by pegylated interferon α (PEG-IFNα) therapy, and similar results have been observed in patients treated with PD-1 antibody. However, the combination therapy of PD-1 antibody and PEG-IFNα for promoting functional cure has not been studied. This study protocol aims to evaluate the efficacy and safety of a novel combined strategy, PD-1 antibody combined with PEG-IFNα therapy, in nucleos(t)ide analogues (NAs)-treated CHB patients.

Methods and analysis

This is a prospective, multicentre, open-label, randomised controlled study. Virologically suppressed CHB patients by NAs therapy will be recruited and randomised into PEG-IFNα group, PD-1 antibody group or PD-1 antibody combined PEG-IFNα group. PD-1 antibody will be injected intravenously once per 3 weeks for 24 weeks, and PEG-IFNα will be injected subcutaneously once a week for 48 weeks. The primary outcomes are the rate of HBsAg loss at 24 weeks. For safety analysis, adverse events in different groups will be compared.

Ethics and dissemination

This study has been approved by the Ethics Committee of the Fifth Medical Center of the Chinese PLA General Hospital (KY-2023-12-86-3). All results of the study will be submitted to a peer-reviewed journal.

Trial registration number

NCT06357806.

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