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Wang Y, Zhang Q, Qi W, Zhang N, Li J, Tse G, Li G, Wu S, Liu T. Proteinuria, Body Mass Index, and the Risk of New-Onset Heart Failure: A Prospective Cohort Study in Northern China. Curr Probl Cardiol 2023; 48:101519. [PMID: 36450329 DOI: 10.1016/j.cpcardiol.2022.101519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 11/25/2022] [Indexed: 11/29/2022]
Abstract
Some studies have reported that body-mass index (BMI) and proteinuria are risk factors for heart failure (HF). However, the combined effect of BMI and proteinuria on HF is still unclear. We aimed to investigate the association of BMI and proteinuria levels with the risk of HF in a large community-based population. A total of 61, 113 individuals aged ≥18 years from the prospective Kailuan cohort (recruited during 2006-2007) without preexisting heart failure were included. Each participant was categorized into 4 groups according to BMI (< 25 kg/m2 or ≥ 25 kg/m2) and the urine dipstick test results (negative or positive). The primary outcome was HF. We performed multivariable Cox regression analyses to identify the association between BMI and proteinuria category and incident HF. Over a mean follow-up of 9.97±0.75 years, a total of 987 individuals developed incident HF, 1.62 per 1000 person-years. Compared to BMI < 25 kg/m2 and absence of proteinuria, the risk of HF was higher for BMI ≥ 25 kg/m2 and positive proteinuria (HR 2.630, 95% CI 1.982-3.490, P < 0.0001) (P for trend < 0.0001). Degree of proteinuria in participants was associated with a significantly higher rate of incident HF in dose dependent manner. Compared to consistently negative proteinuria, the risk of HF increased by 75.0% (HR 1.750, 95% CI 1.368-2.239, P < 0.0001) and 127.0% (HR 2.270, 95% CI 1.540-3.347, P < 0.0001) in the proteinuria aggravated group and persistent positive group, respectively. Proteinuria combined with a high BMI level is associated with an increased risk for HF in the Chinese population. However, the mechanism is unknown and awaits further study.
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Affiliation(s)
- Yueying Wang
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Qingling Zhang
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Wenwei Qi
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Nan Zhang
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Jie Li
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Gary Tse
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China; Epidemiology Research Unit, Cardiovascular Analytics Group, Hong Kong, China; Kent and Medway Medical School, Canterbury, Kent, UK
| | - Guangping Li
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan City, China.
| | - Tong Liu
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China.
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AlSinan SR, Alsaigh SA, Al-Dawood KM, AbdelWahab MM. Proteinuria and its associated factors in patients attending family medicine clinics in Dammam, Saudi Arabia. J Family Community Med 2022; 29:223-229. [PMID: 36389034 PMCID: PMC9664458 DOI: 10.4103/jfcm.jfcm_133_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 06/13/2022] [Accepted: 06/23/2022] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Urinalysis is a simple, valuable, and low-cost tool for the detection of proteinuria, a significant risk factor for renal and cardiovascular diseases. The purpose of this study was to determine the rate of proteinuria and its associated risk factors in patients attending Family Medicine Clinics in Dammam, Saudi Arabia, as no study of that nature had previously been conducted. MATERIALS AND METHODS In this register-based cross-sectional study, data including urinary protein and other urinalysis components ordered between January 2018 and January 2020 were collected from electronic medical records. In addition, data regarding nationality, gender, age, blood pressure, body mass index, serum human chorionic gonadotropin, fasting glucose, hemoglobin A1c (HbA1c), 25-hydroxy Vitamin D level, blood urea nitrogen (BUN), uric acid, creatinine, estimated glomerular filtration rate (eGFR), and lipid profile was also obtained. Proteinuria was classified as negative if no or trace protein was present, and positive if protein was ≥1+, and was considered overt proteinuria. RESULTS In total, results of 2942 urinalysis tests were included. The mean age of the patients was 42.4 ± 14.5 years; majority of the patients were females (62.3%) and were Saudis (68.8%). The rate of proteinuria was 4.2%. Saudi nationality, female gender, age ≥ 40 years, high systolic blood pressure, high diastolic blood pressure, fasting glucose ≥126, HbA1c ≥6.5%, BUN >20 mg/dl, creatinine >1.3 mg/dl, low eGFR <60, and high low-density lipoproteins cholesterol were significantly associated with proteinuria based on bivariate analysis. Using a logistic regression model, a statistically significant association was observed between proteinuria and advancing age, the presence of urinary casts, elevated serum creatinine level, and Saudi nationality. CONCLUSION The only variables that were independently associated with proteinuria using the logistic regression were the presence of casts in the urine, Saudi nationality, high creatinine level, and older age. These variables should be borne in mind by treating physicians.
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Affiliation(s)
- Salma R. AlSinan
- Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Sukaynah A. Alsaigh
- Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Kasim M. Al-Dawood
- Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Moataza M. AbdelWahab
- Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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ZHANG JM, LIANG S, NIE P, LIAO Y, AI Q, YAN X, LIU H, JI Y, ZENG Z. Efficacy of Kushen decoction on high-fat-diet-induced hyperlipidemia in rats. J TRADIT CHIN MED 2022; 42:364-371. [PMID: 35610005 PMCID: PMC9924673 DOI: 10.19852/j.cnki.jtcm.20220225.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
OBJECTIVE To investigate the efficacy and underlying mechanisms of action of Kushen decoction on high-fat-diet-induced hyperlipidemia in rats using RNA-seq technology. METHODS The efficacy of a Kushen decoction, at a concentration of 1 mL/g of crude medicine prepared according to the method commonly used in clinical practice, was investigated on 24 specific pathogen-free male Sprague-Dawley rats. Liver tissues were compared using RNA-Seq technology. The differentially expressed genes were further investigated by real-time fluorescent quantitative polymerase chain reaction (qPCR and Western blot (WB). RESULTS Serum triglycerides (TG), liver low-density lipoprotein cholesterol (LDL-C), body weight, body length, and Lee's index were significantly increased in the untreated hyperlipidemia-induced group (model) compared with the control group, whereas liver high-density lipoprotein cholesterol (HDL-C) was significantly decreased. Serum TG, liver LDL-C, bodyweight, and Lee's index were decreased in the high-dose Kushen decoction group (HDKS) compared with the model group, whereas liver HDL-C was significantly increased. Similarly, liver TG tended to decline in the HDKS group. Comparison of the gene expression profiles in the livers from different groups indicated that the Kushen decoction significantly affected metabolic pathways, PPAR signalling pathway, and circadian rhythm ( ≤ 0.05), with the genes ARNTL, PER3, and CLOCK being differentially expressed. qPCR and WB analysis confirmed the differential expression of the genes discovered by transcriptomics analysis. CONCLUSION The Kushen decoction may achieve a lipid-lowering effect on hyperlipidemic rats by regulating metabolic pathways and the circadian rhythm pathway and in particular, their related genes ARNTL, PER3, and CLOCK.
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Affiliation(s)
- Jiri Mutu ZHANG
- 1 Research Center for Differention and Development of TCM Basic Theory, Jiangxi Province Key Laboratory of TCM Etiopathogenisis, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi 330006, China
- 2 Mongolian Medical College, Inner Mongolia Minzu Uaniversity, Tongliao 028000, China
| | - Shilong LIANG
- 1 Research Center for Differention and Development of TCM Basic Theory, Jiangxi Province Key Laboratory of TCM Etiopathogenisis, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi 330006, China
| | - Peng NIE
- 1 Research Center for Differention and Development of TCM Basic Theory, Jiangxi Province Key Laboratory of TCM Etiopathogenisis, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi 330006, China
| | - Yong’an LIAO
- 1 Research Center for Differention and Development of TCM Basic Theory, Jiangxi Province Key Laboratory of TCM Etiopathogenisis, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi 330006, China
| | - Qinying AI
- 1 Research Center for Differention and Development of TCM Basic Theory, Jiangxi Province Key Laboratory of TCM Etiopathogenisis, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi 330006, China
| | - Xiaojun YAN
- 1 Research Center for Differention and Development of TCM Basic Theory, Jiangxi Province Key Laboratory of TCM Etiopathogenisis, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi 330006, China
| | - Hongning LIU
- 1 Research Center for Differention and Development of TCM Basic Theory, Jiangxi Province Key Laboratory of TCM Etiopathogenisis, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi 330006, China
| | - Yanhua JI
- 1 Research Center for Differention and Development of TCM Basic Theory, Jiangxi Province Key Laboratory of TCM Etiopathogenisis, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi 330006, China
- JI Yanhua and ZENG Zhijun, Research Center for Differention and Development of TCM Basic Theory, Jiangxi Province Key Laboratory of TCM Etiopathogenisis, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi 330006, China. and
| | - Zhijun ZENG
- 1 Research Center for Differention and Development of TCM Basic Theory, Jiangxi Province Key Laboratory of TCM Etiopathogenisis, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi 330006, China
- JI Yanhua and ZENG Zhijun, Research Center for Differention and Development of TCM Basic Theory, Jiangxi Province Key Laboratory of TCM Etiopathogenisis, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi 330006, China. and
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Medeiros T, do Rosário NF, Gama NA, Mérida LAD, Storch AS, Ferraz L, de Fátima Lopes P, da Silva AA, Almeida JR. Metabolic syndrome components and estimated glomerular filtration rate based on creatinine and/or cystatin C in young adults: A gender issue? Diabetes Metab Syndr 2017; 11 Suppl 1:S351-S357. [PMID: 28284908 DOI: 10.1016/j.dsx.2017.03.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 03/03/2017] [Indexed: 10/20/2022]
Abstract
AIMS This work aims to identify correlations between estimated glomerular filtration rate (eGFR) based on creatinine and/or cystatin C (Cr, CysC) with metabolic syndrome (MS) components in young adults, according to gender. MATERIAL AND METHODS This is a cross sectional study, where young adults aged between 18 and 30 were matched by gender, age and body mass index. All subjects underwent clinical evaluation and blood sampling for laboratory measurements. MS was determined according to the JIS criteria. The eGFR was estimated using CKD-EPI equations (eGFRCr; eGFRCysC; eGFRCr-CysC). RESULTS We evaluated 78 subjects with a mean age of 24.5 years. 10.2% had MS, with higher incidence among males (15.4% ♂ vs. 5.1% ♀). Elevated waist circumference was the MS component most observed. Significant correlations (Pearson; p<0.05) between eGFR and metabolic markers were observed only in males. In addition, we observed a significant association between the increase of MS components and the decay of eGFRCr and eGFRCr-CysC (zero vs. two or more components, ANOVA, p<0.05) only among males. CONCLUSION eGFR decay associated with components of MS and insulin resistance in young male adults could represent a worrying specific risk and indicate that further studies are needed to better understand these findings.
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Affiliation(s)
- Thalia Medeiros
- Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas, Departamento de Medicina Clínica, Faculdade de Medicina, Universidade Federal Fluminense, Rio de Janeiro, Brazil.
| | - Natalia Fonseca do Rosário
- Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas, Departamento de Medicina Clínica, Faculdade de Medicina, Universidade Federal Fluminense, Rio de Janeiro, Brazil.
| | - Nycole Abreu Gama
- Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas, Departamento de Medicina Clínica, Faculdade de Medicina, Universidade Federal Fluminense, Rio de Janeiro, Brazil.
| | - Lyris Anunciata Demétrio Mérida
- Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas, Departamento de Medicina Clínica, Faculdade de Medicina, Universidade Federal Fluminense, Rio de Janeiro, Brazil.
| | - Amanda Sampaio Storch
- Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas, Departamento de Medicina Clínica, Faculdade de Medicina, Universidade Federal Fluminense, Rio de Janeiro, Brazil.
| | - Leda Ferraz
- Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas, Departamento de Medicina Clínica, Faculdade de Medicina, Universidade Federal Fluminense, Rio de Janeiro, Brazil.
| | - Patricia de Fátima Lopes
- Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas, Departamento de Medicina Clínica, Faculdade de Medicina, Universidade Federal Fluminense, Rio de Janeiro, Brazil; Departamento de Patologia, Faculdade de Medicina, Universidade Federal Fluminense, Rio de Janeiro, Brazil.
| | - Andrea Alice da Silva
- Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas, Departamento de Medicina Clínica, Faculdade de Medicina, Universidade Federal Fluminense, Rio de Janeiro, Brazil; Departamento de Patologia, Faculdade de Medicina, Universidade Federal Fluminense, Rio de Janeiro, Brazil.
| | - Jorge Reis Almeida
- Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas, Departamento de Medicina Clínica, Faculdade de Medicina, Universidade Federal Fluminense, Rio de Janeiro, Brazil; Serviço de Nefrologia, Departamento de Medicina Clínica, Faculdade de Medicina, UFF, Rio de Janeiro, Brazil.
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Ji W, Zhao M, Wang M, Yan W, Liu Y, Ren S, Lu J, Wang B, Chen L. Effects of canagliflozin on weight loss in high-fat diet-induced obese mice. PLoS One 2017; 12:e0179960. [PMID: 28665967 PMCID: PMC5493335 DOI: 10.1371/journal.pone.0179960] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Accepted: 06/07/2017] [Indexed: 02/06/2023] Open
Abstract
Canagliflozin, an inhibitor of sodium glucose co-transporter (SGLT) 2, has been shown to reduce body weight during the treatment of type 2 diabetes mellitus (T2DM). In this study, we sought to determine the role of canagliflozin in body weight loss and liver injury in obesity. C57BL/6J mice were fed a high-fat diet to simulate diet-induced obesity (DIO). Canagliflozin (15 and 60 mg/kg) was administered to DIO mice for 4 weeks. Orlistat (10 mg/kg) was used as a positive control. The body weight, liver weight, liver morphology, total cholesterol (TC) and triglyceride (TG) levels were examined. Signaling molecules, including diacylgycero1 acyltransferase-2 (DGAT2), peroxisome proliferation receptor alpha-1 (PPARα1), PPARγ1, PPARγ2 mRNA levels and the protein expression of SGLT2 were evaluated. Canagliflozin reduced body weight, especially the high-dose canagliflozin, and resulted in increased body weight loss compared with orlistat. Moreover, canagliflozin reduced the liver weight and the ratio of liver weight to body weight, lowered the serum levels of TC and TG, and ameliorated liver steatosis. During the canagliflozin treatment, SGLT2, DGAT2, PPARγ1 and PPARγ2 were inhibited, and PPARα1 was elevated in the liver tissues. This finding may explain why body weight was reduced and secondary liver injury was ameliorated in response to canagliflozin. Together, the results suggest that canagliflozin may be a potential anti-obesity strategy.
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Affiliation(s)
- Wenjun Ji
- Department of Pharmacology, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Department of Pharmacy, Taizhou People’s Hospital, Taizhou, Jiangsu, China
| | - Mei Zhao
- Department of Pharmacology, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Department of Pharmacy, 302 Military Hospital of China, Beijing, China
| | - Meng Wang
- Department of Pharmacology, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Department of Pharmacy, Shijiazhuang Maternity Hospital, Shijiazhuang, Hebei, China
| | - Wenhui Yan
- Department of Pharmacology, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Yuan Liu
- Department of Pharmacology, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Shuting Ren
- Key Laboratory of Environment and Genes Related to Diseases (Xi’an Jiaotong University), Ministry of Education, Xi’an, Shaanxi, China
- Department of Pathology, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Jun Lu
- Clinical Research Center, the First Affiliated Hospital, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Bing Wang
- Key Laboratory of Environment and Genes Related to Diseases (Xi’an Jiaotong University), Ministry of Education, Xi’an, Shaanxi, China
- Department of Pathology, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Lina Chen
- Department of Pharmacology, School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Key Laboratory of Environment and Genes Related to Diseases (Xi’an Jiaotong University), Ministry of Education, Xi’an, Shaanxi, China
- * E-mail:
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Li Z, Meng L, Huang Z, Cui L, Li W, Gao J, Wang Z, Zhang R, Zhou J, Zhang G, Chen S, Zheng X, Cong H, Gao X, Wu S. Ideal Cardiovascular Health Metrics and Incident Hyperuricemia. Arthritis Care Res (Hoboken) 2016; 68:660-6. [PMID: 26714267 DOI: 10.1002/acr.22830] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 12/09/2015] [Accepted: 12/22/2015] [Indexed: 12/22/2022]
Affiliation(s)
- Zheng Li
- Tianjin Medical University, Tianjin, China, and Chinese Medicine Hospital, North China University of Science and Technology; Tangshan China
| | - Lingmin Meng
- Kailuan Hospital, North China University of Science and Technology; Tangshan China
| | - Zhe Huang
- Kailuan Hospital, North China University of Science and Technology, Tangshan, China, and Tianjin Medical University; Tianjin China
| | - Liufu Cui
- Kailuan Hospital, North China University of Science and Technology; Tangshan China
| | - Weijuan Li
- Jacobi Medical Center, Albert Einstein College of Medicine, Morris Park; Bronx New York
| | - Jingsheng Gao
- Kailuan Hospital, North China University of Science and Technology; Tangshan China
| | | | - Rui Zhang
- Tianjin Medical University and Tianjin Chest Hospital; Tianjin China
| | - Jing Zhou
- Tianjin Medical University, Tianjin, China, and Chinese Medicine Hospital, North China University of Science and Technology; Tangshan China
| | - Ge Zhang
- Tianjin Medical University; Tianjin China
| | - Shuohua Chen
- Kailuan Hospital, North China University of Science and Technology; Tangshan China
| | - Xiaoming Zheng
- Kailuan Hospital, North China University of Science and Technology; Tangshan China
| | | | - Xiang Gao
- Xiang Gao, MD, PhD: Pennsylvania State University; University Park
| | - Shouling Wu
- Kailuan Hospital, North China University of Science and Technology; Tangshan China
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