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Zhang N, Hong F, Xiang Y, Zhang Y, Qian W, Zhang X, Chen L, Duoji Z, Xiao X, Zhao X. Spicy food consumption and biological aging across multiple organ systems: a longitudinal analysis from the China Multi-Ethnic cohort. Nutr J 2025; 24:86. [PMID: 40410899 PMCID: PMC12101015 DOI: 10.1186/s12937-025-01147-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2025] [Accepted: 04/30/2025] [Indexed: 05/25/2025] Open
Abstract
BACKGROUND Biological aging is a common starting point for many chronic diseases and multimorbidity. Spicy food consumption is showing a growing trend worldwide. However, the association of spicy food consumption with the comprehensive biological age (BA) and organ-specific BAs remains unclear. METHODS This study included 7874 participants from the China Multi-Ethnic Cohort (CMEC), all participating in baseline and follow-up surveys. The CMEC was located in Southwest China, which has become one of the most prominent and typical regions regarding spicy food consumption in China and the world. We constructed comprehensive BA and organ-specific BAs based on composite indicators using the widely validated Klemera-Doubal method. The frequency of intake of spicy food was obtained by an electronic questionnaire. Follow-up analyses adjusted for baseline data were then employed to assess the longitudinal associations of spicy food consumption at baseline with both the comprehensive BA and the organ-specific BAs at follow-up. RESULTS Compared with non-spicy consumers, spicy consumers showed a decrease in comprehensive BA acceleration, with adjusted β = -0.23 (- 0.60 to 0.13) for 1-2 days/week, β = -0.69 (- 1.10 to - 0.29) for 3-5 days/week and - 0.32 (- 0.63 to - 0.01) years for 6-7 days/week, respectively. Higher estimates were observed for metabolic and kidney BA accelerations than for cardiopulmonary and liver BA accelerations. Compared to non-spicy consumers, spicy consumers showed a decrease in metabolic BA acceleration (3-5 days/week: β = -0.76 (- 1.28 to - 0.24) years) and kidney BA acceleration (3-5 days/week: β = -1.89 (- 2.76 to - 1.02) years). CONCLUSION Spicy foods may have potential benefits for biological aging. Our findings highlight that spicy foods may slow comprehensive and organ-specific biological aging, especially metabolic and kidney biological aging.
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Affiliation(s)
- Ning Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Feng Hong
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Yi Xiang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yuan Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Wen Qian
- Chengdu Center for Disease Control and Prevention, Chengdu, China
| | - Xuehui Zhang
- School of Public Health, Kunming Medical University, Kunming, China
| | - Liling Chen
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | | | - Xiong Xiao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
| | - Xing Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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Chen L, Wu X, Zhang R, Tang W, Chen Y, Ding X, Wu J. Consuming spicy food and type 2 diabetes incidence in Southwestern Chinese aged 30-79: a prospective cohort study. Nutr J 2024; 23:142. [PMID: 39523341 PMCID: PMC11552132 DOI: 10.1186/s12937-024-00996-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 08/08/2024] [Indexed: 11/16/2024] Open
Abstract
BACKGROUND Capsaicin is the main component of chili peppers and is believed to have antidiabetic effects. However, the association between spicy food consumption and the incidence of diabetes remains unclear. METHODS A cohort of 20,490 Han residents aged 30-79 without diabetes at baseline were followed from enrollment to June 2, 2023. The consumption of spicy food was obtained through face-to-face surveys conducted during the baseline survey from October 2018 to February 2019. The definition of type 2 diabetes onset was based on the ICD-10 code of E11 in the diabetes case reporting system and death system; Additionally, self-reported diagnosis of diabetes by a physician in active follow-ups, or a fasting blood glucose level of ≥ 7 mmol/L or a glycated hemoglobin percentage of ≥ 6.5% found on-site during the resurvey. Both Cox proportional hazard regression and competing risk regression were used to calculate hazard ratios (HRs) and confidence intervals (CIs). RESULTS During the follow-up period (53.5 ± 3.0 months), 182 individuals (1.1%) were newly diagnosed with T2D with an incidence rate of 246.2 per 100,000 person-years. Cox regression analyses revealed that spicy food consumers had a 34% reduced risk of developing type 2 diabetes (HR: 0.66, 95% CI: 0.48, 0.91) compared to non-consumers. The HRs (95% CIs) for participants consuming spicy food 3-5 days/week, 6-7 days/week, and with weak pungency were 0.45 (95% CI: 0.25, 0.81), 0.69 (0.49, 0.98), and 0.64 (0.46, 0.90), respectively. However, little significant protective effect was observed among those who consumed spicy food for 1-2 days/week, with moderate pungency, or with strong pungency (all P > 0.05). CONCLUSIONS Consuming spicy food may lower the risk of developing type 2 diabetes, particularly at a frequency of 3-5 days/week, and with weak pungency. Further multicenter prospective studies or interventional studies are needed to confirm these findings.
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Affiliation(s)
- Liling Chen
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- Institute of Chronic Non-Communicable Disease Control and Prevention, Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Xiaomin Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Rui Zhang
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wenge Tang
- Institute of Chronic Non-Communicable Disease Control and Prevention, Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Yuxuan Chen
- School of Public Health, Research Center for Medical and Social Development, Chongqing Medical University, Chongqing, China
| | - Xianbin Ding
- Institute of Chronic Non-Communicable Disease Control and Prevention, Chongqing Center for Disease Control and Prevention, Chongqing, China.
| | - Jing Wu
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
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You D, Sun D, Zhao Z, Song M, Pan L, Wu Y, Tang Y, Lu M, Shao F, Shen S, Bai J, Yi H, Zhang R, Wei Y, Ma H, Xu H, Yu C, Lv J, Pei P, Yang L, Chen Y, Chen Z, Shen H, Chen F, Zhao Y, Li L. Spicy food consumption and risk of vascular disease: Evidence from a large-scale Chinese prospective cohort of 0.5 million people. Chin Med J (Engl) 2024:00029330-990000000-01150. [PMID: 39030074 DOI: 10.1097/cm9.0000000000003177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Indexed: 07/21/2024] Open
Abstract
BACKGROUND Spicy food consumption has been reported to be inversely associated with mortality from multiple diseases. However, the effect of spicy food intake on the incidence of vascular diseases in the Chinese population remains unclear. This study was conducted to explore this association. METHODS This study was performed using the large-scale China Kadoorie Biobank (CKB) prospective cohort of 486,335 participants. The primary outcomes were vascular disease, ischemic heart disease (IHD), major coronary events (MCEs), cerebrovascular disease, stroke, and non-stroke cerebrovascular disease. A Cox proportional hazards regression model was used to assess the association between spicy food consumption and incident vascular diseases. Subgroup analysis was also performed to evaluate the heterogeneity of the association between spicy food consumption and the risk of vascular disease stratified by several basic characteristics. In addition, the joint effects of spicy food consumption and the healthy lifestyle score on the risk of vascular disease were also evaluated, and sensitivity analyses were performed to assess the reliability of the association results. RESULTS During a median follow-up time of 12.1 years, a total of 136,125 patients with vascular disease, 46,689 patients with IHD, 10,097 patients with MCEs, 80,114 patients with cerebrovascular disease, 56,726 patients with stroke, and 40,098 patients with non-stroke cerebrovascular disease were identified. Participants who consumed spicy food 1-2 days/week (hazard ratio [HR] = 0.95, 95% confidence interval [95% CI] = [0.93, 0.97], P <0.001), 3-5 days/week (HR = 0.96, 95% CI = [0.94, 0.99], P = 0.003), and 6-7 days/week (HR = 0.97, 95% CI = [0.95, 0.99], P = 0.002) had a significantly lower risk of vascular disease than those who consumed spicy food less than once a week (Ptrend <0.001), especially in those who were younger and living in rural areas. Notably, the disease-based subgroup analysis indicated that the inverse associations remained in IHD (Ptrend = 0.011) and MCEs (Ptrend = 0.002) risk. Intriguingly, there was an interaction effect between spicy food consumption and the healthy lifestyle score on the risk of IHD (Pinteraction = 0.037). CONCLUSIONS Our findings support an inverse association between spicy food consumption and vascular disease in the Chinese population, which may provide additional dietary guidance for the prevention of vascular diseases.
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Affiliation(s)
- Dongfang You
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Dianjianyi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases, Ministry of Education, Peking University, Beijing 100191, China
| | - Ziyu Zhao
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Mingyu Song
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Lulu Pan
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Yaqian Wu
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Yingdan Tang
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Mengyi Lu
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Fang Shao
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Sipeng Shen
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Jianling Bai
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Honggang Yi
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Ruyang Zhang
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
- China International Cooperation Center for Environment and Human Health, Center for Global Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
- The Center of Biomedical Big Data and the Laboratory of Biomedical Big Data, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Yongyue Wei
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Hongxia Ma
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Hongyang Xu
- Department of Critical Care Medicine, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu 214023, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases, Ministry of Education, Peking University, Beijing 100191, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases, Ministry of Education, Peking University, Beijing 100191, China
- State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing 100191, China
| | - Pei Pei
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China
| | - Ling Yang
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford OX3 7LF, United Kingdom
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, United Kingdom
| | - Yiping Chen
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford OX3 7LF, United Kingdom
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, United Kingdom
| | - Zhengming Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, United Kingdom
| | - Hongbing Shen
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Feng Chen
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
- China International Cooperation Center for Environment and Human Health, Center for Global Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
- The Center of Biomedical Big Data and the Laboratory of Biomedical Big Data, Nanjing Medical University, Nanjing, Jiangsu 211166, China
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Yang Zhao
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
- China International Cooperation Center for Environment and Human Health, Center for Global Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
- The Center of Biomedical Big Data and the Laboratory of Biomedical Big Data, Nanjing Medical University, Nanjing, Jiangsu 211166, China
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases, Ministry of Education, Peking University, Beijing 100191, China
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Li J, Xie C, Lan J, Tan J, Tan X, Chen N, Wei L, Liang J, Pan R, Zhu T, Pei P, Sun D, Su L, Zhou L. Spicy food consumption reduces the risk of ischaemic stroke: a prospective study. Br J Nutr 2024; 131:1777-1785. [PMID: 38287709 DOI: 10.1017/s0007114524000229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Abstract
Previous studies revealed that consuming spicy food reduced mortality from CVD and lowered stroke risk. However, no studies reported the relationship between spicy food consumption, stroke types and dose–response. This study aimed to further explore the association between the frequency of spicy food intake and the risk of stroke in a large prospective cohort study. In this study, 50 174 participants aged 30–79 years were recruited. Spicy food consumption data were collected via a baseline survey questionnaire. Outcomes were incidence of any stroke, ischaemic stroke (IS) and haemorrhagic stroke (HS). Multivariable-adjusted Cox proportional hazard models estimated the association between the consumption of spicy food and incident stroke. Restricted cubic spline analysis was used to examine the dose–response relationship. During the median 10·7-year follow-up, 3967 strokes were recorded, including 3494 IS and 516 HS. Compared with those who never/rarely consumed spicy food, those who consumed spicy food monthly, 1–2 d/week and 3–5 d/week had hazard ratio (HR) of 0·914 (95 % CI 0·841, 0·995), 0·869 (95 % CI 0·758, 0·995) and 0·826 (95 % CI 0·714, 0·956) for overall stroke, respectively. For IS, the corresponding HR) were 0·909 (95 % CI 0·832, 0·994), 0·831 (95 % CI 0·718, 0·962) and 0·813 (95 % CI 0·696, 0·951), respectively. This protective effect showed a U-shaped dose–response relationship. For obese participants, consuming spicy food ≥ 3 d/week was negatively associated with the risk of IS. We found the consumption of spicy food was negatively associated with the risk of IS and had a U-shaped dose–response relationship with risk of IS. Individuals who consumed spicy food 3–5 d/week had a significantly lowest risk of IS.
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Affiliation(s)
- Jiale Li
- School of Public Health of Guangxi Medical University, 22 Shuangyong Road, Nanning, Guangxi, 530021, People's Republic of China
| | - Changping Xie
- Liuzhou Center for Disease Control and Prevention, Liuzhou, Guangxi, 545005, People's Republic of China
| | - Jian Lan
- Liuzhou Center for Disease Control and Prevention, Liuzhou, Guangxi, 545005, People's Republic of China
| | - Jinxue Tan
- Liuzhou Center for Disease Control and Prevention, Liuzhou, Guangxi, 545005, People's Republic of China
| | - Xiaoping Tan
- Liuzhou Center for Disease Control and Prevention, Liuzhou, Guangxi, 545005, People's Republic of China
| | - Ningyu Chen
- Liuzhou Center for Disease Control and Prevention, Liuzhou, Guangxi, 545005, People's Republic of China
| | - Liuping Wei
- Liuzhou Center for Disease Control and Prevention, Liuzhou, Guangxi, 545005, People's Republic of China
| | - Jiajia Liang
- Liuzhou Center for Disease Control and Prevention, Liuzhou, Guangxi, 545005, People's Republic of China
| | - Rong Pan
- Liuzhou Center for Disease Control and Prevention, Liuzhou, Guangxi, 545005, People's Republic of China
| | - Tingping Zhu
- Liuzhou Center for Disease Control and Prevention, Liuzhou, Guangxi, 545005, People's Republic of China
| | - Pei Pei
- Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing100191, People's Republic of China
| | - Dianjianyi Sun
- Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing100191, People's Republic of China
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Xueyuan Road, Haidian District, Beijing100191, People's Republic of China
| | - Li Su
- School of Public Health of Guangxi Medical University, 22 Shuangyong Road, Nanning, Guangxi, 530021, People's Republic of China
| | - Lifang Zhou
- Liuzhou Center for Disease Control and Prevention, Liuzhou, Guangxi, 545005, People's Republic of China
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Hu Q, Liu H, Wang R, Yao L, Chen S, Wang Y, Lv C. Capsaicin Attenuates LPS-Induced Acute Lung Injury by Inhibiting Inflammation and Autophagy Through Regulation of the TRPV1/AKT Pathway. J Inflamm Res 2024; 17:153-170. [PMID: 38223422 PMCID: PMC10787572 DOI: 10.2147/jir.s441141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 01/03/2024] [Indexed: 01/16/2024] Open
Abstract
Purpose Acute lung injury (ALI) is a severe pulmonary disease characterized by damage to the alveoli and pulmonary blood vessels, leading to severe impairment of lung function. Studies on the effect of capsaicin (8-methyl-N-geranyl-6-nonamide, CAP) on lipopolysaccharide (LPS)-induced ALI in bronchial epithelial cells transformed with Ad12-SV40 2B (BEAS-2B) are still limited. This study aimed to investigate the effect and specific mechanism by which CAP improves LPS-induced ALI. Methods The present study investigated the effect of CAP and the potential underlying mechanisms in LPS-induced ALI in vitro and vivo via RNA sequencing, Western blotting (WB), quantitative real-time reverse transcription PCR (qRT‒PCR), enzyme-linked immunosorbent assay (ELISA), and transmission electron microscopy (TEM). The TRPV1 inhibitor AMG9810 and the AKT agonist SC79 were used to confirm the protective effect of the TRPV1/AKT axis against ALI. The autophagy agonist rapamycin (Rapa) and the autophagy inhibitors 3-methyladenine (3-MA) and bafilomycin A1 (Baf-A1) were used to clarify the characteristics of LPS-induced autophagy. Results Our findings demonstrated that CAP effectively suppressed inflammation and autophagy in LPS-induced ALI, both in vivo and in vitro. This mechanism involves regulation by the TRPV1/AKT signaling pathway. By activating TRPV1, CAP reduces the expression of P-AKT, thereby exerting its anti-inflammatory and inhibitory effects on pro-death autophagy. Furthermore, prior administration of CAP provided substantial protection to mice against ALI induced by LPS, reduced the lung wet/dry ratio, decreased proinflammatory cytokine expression, and downregulated LC3 expression. Conclusion Taken together, our results indicate that CAP protects against LPS-induced ALI by inhibiting inflammatory responses and autophagic death through the TRPV1/AKT signaling pathway, presenting a novel strategy for ALI therapy.
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Affiliation(s)
- Qin Hu
- Emergency and Trauma College, Hainan Medical University, Haikou, People’s Republic of China
- Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, People’s Republic of China
| | - Haoran Liu
- Emergency and Trauma College, Hainan Medical University, Haikou, People’s Republic of China
- Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, People’s Republic of China
| | - Ruiyu Wang
- Emergency Medicine Center, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, People’s Republic of China
| | - Li Yao
- Emergency Medicine Center, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, People’s Republic of China
| | - Shikun Chen
- Department of Anesthesiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Yang Wang
- Emergency Medicine Center, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, People’s Republic of China
| | - Chuanzhu Lv
- Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, People’s Republic of China
- Emergency Medicine Center, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, People’s Republic of China
- Research Unit of Island Emergency Medicine, Chinese Academy of Medical Sciences (No. 2019RU013), Hainan Medical University, Haikou, People’s Republic of China
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