Publications by authors named "Shuran Li"

22 Publications

  • Page 1 of 1

Homeostatic regulation of T follicular helper and antibody response to particle antigens by IL-1Ra of medullary sinus macrophage origin.

Proc Natl Acad Sci U S A 2021 Apr;118(17)

Institut Pasteur of Shanghai, Guangzhou Women and Children's Medical Center Joint Center for Infection and Immunity, Chinese Academy of Sciences, 200031 Shanghai, China;

Hepatitis B virus (HBV) vaccines are composed of surface antigen HBsAg that spontaneously assembles into subviral particles. Factors that impede its humoral immunity in 5% to 10% of vaccinees remain elusive. Here, we showed that the low-level interleukin-1 receptor antagonist (IL-1Ra) can predict antibody protection both in mice and humans. Mechanistically, murine IL-1Ra-inhibited T follicular helper (Tfh) cell expansion and subsequent germinal center (GC)-dependent humoral immunity, resulting in significantly weakened protection against the HBV challenge. Compared to soluble antigens, HBsAg particle antigen displayed a unique capture/uptake and innate immune activation, including IL-1Ra expression, preferably of medullary sinus macrophages. In humans, a unique polymorphism in the RelA/p65 binding site of IL-1Ra enhancer associated IL-1Ra levels with ethnicity-dependent vaccination outcome. Therefore, the differential IL-1Ra response to particle antigens probably creates a suppressive milieu for Tfh/GC development, and neutralization of IL-1Ra would resurrect antibody response in HBV vaccine nonresponders.
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http://dx.doi.org/10.1073/pnas.2019798118DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8092388PMC
April 2021

The role of inflammatory cytokines in anemia and gastrointestinal mucosal injury induced by foot electric stimulation.

Sci Rep 2021 Feb 4;11(1):3101. Epub 2021 Feb 4.

Key Laboratory of Ethnomedicine of Ministry of Education, School of Pharmacy, Center On Translational Neuroscience, College of Life and Environmental Sciences, Minzu University of China, No. 27, South Street of Zhongguancun, Haidian District, Beijing, 100081, China.

Foot electrical stimulation (FES) has been considered as a classic stressor that can disturb homeostasis. Acute anemia was observed in the model induced by FES. The aim of this study was to explore the role of inflammatory cytokines underlying the acute anemia and gastrointestinal (GI) mucosal injury in the FES. Twenty-four male Kunming mice (20 ± 2 g) were randomly divided into control group and experimental group. The mice were placed in a footshock chamber that can generate 0.5 mA electrical impulse periodically for 0.5 h. After the process, red blood cell count, hemoglobin concentration and hematocrit, the levels of corticotropin releasing hormone (CRH) in serum and hypothalamus, and adrenocorticotropic hormone (ACTH) in serum and pituitary were detected separately. In addition, we investigated the expressions of inflammatory cytokines (IL-1, IL-6, TNF-α, iNOS, and IL-10) in the hypothalamus and duodenum by Polymerase Chain Reaction (PCR). Results showed that this FES model induced anemia, increased CRH and ACTH activity in the serum after the FES. Moreover, the expressions of IL-1β, IL-6, TNF-α, and iNOS were significantly increased following the process, while IL-10 was not activated. These findings suggest that anemia, the inflammatory cytokines in the hypothalamus and duodenum of the mice in the model induced by FES is closely related to GI mucosal injury/bleeding. Taken together, these results underscore the importance of anemia, GI mucosal injury/bleeding and stress, future studies would be needed to translate these findings into the benefit of affected patients.
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http://dx.doi.org/10.1038/s41598-021-82604-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7862408PMC
February 2021

The complete mitochondrial genome of (Squamata: Colubridae: Pseudoxenodontinae) and its phylogeny.

Mitochondrial DNA B Resour 2020 Nov 13;5(3):3752-3753. Epub 2020 Nov 13.

College of Life and Environmental Science, Wenzhou University, Wenzhou, China.

The mitochondrial genome sequence of (Squamata: Colubridae: Pseudoxenodontinae) from Taishun County, Zhejiang Province, China, which is 18,475 bp in length and contains 25 tRNAs (including extra two tRNA-Tyr genes and extra one tRNA-Met gene), two rRNAs, 13 protein-coding genes and two identical control regions. The overall AT content of the mitogenome is 59.6% (A = 32.6%, T = 27%, C = 27%, G = 13.4%). In BI and ML phylogenetic analyses, the monophyly of the family Colubridae was well supported and was a basal clade of Colubridae.
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http://dx.doi.org/10.1080/23802359.2020.1835584DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7671704PMC
November 2020

Phenotypic consequences of maternally selected nests: a cross-fostering experiment in a desert lizard.

Integr Zool 2020 Nov 15. Epub 2020 Nov 15.

Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, China.

Despite the importance of maternally selected nests in shaping offspring phenotypes, our understanding of how the nest environment affects embryonic development and offspring traits of most non-avian reptiles is rather limited largely due to the logistical difficulty in locating their nests. To identify the relative contributions of environmental (temporal [seasonal] and spatial [nest-site]) and intrinsic (clutch) factors on embryonic development and offspring traits, we conducted a cross-fostering experiment by swapping eggs between maternally-selected nests of the toad-headed agama (Phrynocephalus przewalskii) in the field. We found that nest environment explained a large proportion of variation in incubation duration, hatching success, and offspring size and growth. In contrast, clutch only explained a small proportion of variation in these embryonic and offspring traits. More significantly, compared with spatial effects, seasonal effects explained more phenotypic variation in both embryonic development and offspring traits. Eggs laid early in the nesting season had longer incubation durations and produced smaller hatchlings with higher post-hatching growth rates than did later-laid eggs. Consequently, hatchlings from early-laid eggs reached larger body sizes prior to winter. In addition, we found that female toad-headed agama did not select nests specific to reaction norms of their own offspring because hatchlings from original or translocated nests had similar phenotypic traits. Overall, our study demonstrates the importance of seasonal variation in nest environments in determining embryonic development and offspring phenotypes, which has not been widely appreciated at least in non-avian reptiles.
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http://dx.doi.org/10.1111/1749-4877.12505DOI Listing
November 2020

Wax composition and concentration in jujube (Ziziphus jujuba Mill.) cultivars with differential resistance to fruit cracking.

J Plant Physiol 2020 Dec 8;255:153294. Epub 2020 Oct 8.

College of Horticulture, Shanxi Agricultural University, Taigu, 030801, China. Electronic address:

Fruit cracking is a key problem restricting the development of the jujube (Ziziphus jujuba) industry, and is closely related to the distribution of the wax layer on the surface of the fruit. Three jujube cultivars with different levels of cracking resistance, namely 'Popozao', 'Banzao', and 'Hupingzao', were selected for comparison. Cracks on the cuticular membrane (CM) of 'Hupingzao' widened and deepened during the coloring period. The wax level of highly cracking-resistant 'Popozao' was significantly higher than that of 'Hupingzao' during the fruit coloring period. The fruit wax composition of the three jujube cultivars were quite similar, consisting mainly of alkanes, triterpenoids, aldehydes, amines, phenols, esters, ketones, fatty acids, primary alcohols, and other, unclassified compounds. Fatty acids, primary alcohols, and alkanes were the predominant fruit wax compounds of the three cultivars. We further analyzed the carbon chain length of aliphatic compounds and found that the concentration of fatty acids in 'Popozao' was significantly lower than that in 'Banzao' and 'Hupingzao' during the coloring period. Moreover, C28-30 were the most abundant primary alcohols during fruit development. Highly cracking-resistant cultivar 'Popozao' contains more very-long-chain alkanes and aldehydes (carbon atom >20) than 'Banzao' and 'Hupingzao' during the coloring period. In addition, we assessed the expression levels of 11 genes involved in fatty acid biosynthesis, elongation, and degradation, and in wax biosynthesis. Gene expression analysis indicated that KCS1, CER1, CYP86B1, and CYP86A play crucial roles in wax formation on jujube fruit. In conclusion, fruit cracking was correlated with whether wax synthesis is coordinated with fruit enlargement and'Popozao' has a stronger ability to synthesize very-long-chain alkanes and aldehydes. Understanding the diff ;erences in the cuticular wax and the activities of the corresponding genes in jujube cultivars with different sensitivities to cracking will provide a specific way to prevent fruit cracking.
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http://dx.doi.org/10.1016/j.jplph.2020.153294DOI Listing
December 2020

Embryonic and post-embryonic responses to high-elevation hypoxia in a low-elevation lizard.

Integr Zool 2020 Jul 25;15(4):338-348. Epub 2020 May 25.

College of Life and Environmental Science, Wenzhou University, Wenzhou, China.

Low-elevation species can migrate toward higher elevations to survive in a warming world. However, animals' responses to hypoxia when migrating to high elevations have rarely been addressed. To identify the response of low-elevation lizards to high-elevation hypoxia, we collected field body temperatures (T ) and operative temperatures (T ) of lizards (Eremias argus) from a low-elevation population (1036 m) and a high-elevation population (2036 m), and then determined adult thermal physiology, embryonic development, and hatchling phenotypes after acclimating low-elevation lizards and incubating their eggs in conditions mimicking the low-elevation oxygen condition (18.5% O ) and high-elevation oxygen (hypoxic) condition (16.5% O ). Our study revealed that T and T were higher for the low-elevation population compared to the high-elevation population. We also found adults from low elevation acclimated to hypoxia preferred lower body temperatures, but did not show changes in locomotor performance or growth. In addition, hypoxia did not affect embryonic development (hatching time and success) or hatchling phenotypes (body size and locomotor performance). These results suggest that adult lizards from low elevations can respond to hypoxia-induced stress when migrating to high elevations by behaviorally thermoregulating to lower body temperatures in order to sustain normal functions. Similarly, low-elevation embryos can develop normally (with unchanged hatching success and offspring phenotypes) under the high-elevation hypoxic condition. This study highlights that low-elevation populations of a species that inhabits a range of elevations can buffer the impact of high-elevation hypoxic conditions to some degree and thus attain similar fitness to the source population.
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http://dx.doi.org/10.1111/1749-4877.12441DOI Listing
July 2020

The association between frailty and incidence of dementia in Beijing: findings from 10/66 dementia research group population-based cohort study.

BMC Geriatr 2020 04 15;20(1):138. Epub 2020 Apr 15.

Global Health Institute, King's College London, London, UK.

Background: The relationship between frailty and dementia is unclear and there are very few population-based studies regarding this issue in China. The purpose of this study is to estimate the association between frailty and incident dementia in China, and to explore different effects of frailty established by three definitions of frailty on dementia incidence.

Methods: A five-year prospective cohort study was carried out in 2022 participants aged 65 years and over in urban and rural sites in Beijing, China. The participants were interviewed by trained community primary health care workers from 2004 to 2009. Frailty was defined using modified Fried frailty phenotype, physical frailty definition, and multidimensional frailty definition. Dementia was diagnosed using the 10/66 dementia criterion for calculating cumulative incidence. Both competing risk regression models and Cox proportional hazards models were applied to examine the associations between frailty at baseline and five-year cumulative incidence of dementia.

Results: At the end of follow-up the five-year cumulative incidence rates of dementia with frailty and without frailty defined by the modified Fried frailty were 21.0% and 9.6%, those defined by the physical frailty were 19.9% and 9.0%, and those defined by the multidimensional frailty were 22.8% and 8.9%, respectively. Compared with non-frail participants, frail people had a higher risk of incident dementia using multidimensional frailty definition after adjusting covariates based on competing risk regression model (HR = 1.47, 95% CI 1.01~2.17) and Cox proportional hazards model (HR = 1.56, 95% CI 1.07~2.26). The association between frailty and incident dementia was statistically significant in participants in the upper three quartiles of age (aged 68 years and over) using the multidimensional frailty definition based on the competing risk regression model (HR = 1.61, 95% CI 1.06~2.43) and Cox proportional hazard model (HR = 1.76, 95% CI 1.19~2.61).

Conclusions: Multidimensional frailty may play an inherent role in incident dementia, especially in the people aged over 68, which is significant for distinguishing high risk people and determining secondary prevention strategies for dementia patients.
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http://dx.doi.org/10.1186/s12877-020-01539-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7158148PMC
April 2020

APOBEC3B interaction with PRC2 modulates microenvironment to promote HCC progression.

Gut 2019 10 1;68(10):1846-1857. Epub 2019 Jun 1.

Center for New Drug Safety Evaluation and Research, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, China.

Objective: APOBEC3B (A3B), a cytidine deaminase acting as a contributor to the APOBEC mutation pattern in many kinds of tumours, is upregulated in patients with hepatocellular carcinoma (HCC). However, APOBEC mutation patterns are absent in HCC. The mechanism of how A3B affects HCC progression remains elusive.

Design: A3B -promoter luciferase reporter and other techniques were applied to elucidate mechanisms of A3B upregulation in HCC. A3B overexpression and knockdown cell models, immunocompetent and immune-deficient mouse HCC model were conducted to investigate the influence of A3B on HCC progression. RNA-seq, flow cytometry and other techniques were conducted to analyse how A3B modulated the cytokine to enhance the recruitment of myeloid--derived suppressor cells (MDSCs) and tumour--associated macrophages (TAMs).

Results: A3B upregulation through non-classical nuclear factor-κB (NF-κB)signalling promotes HCC growth in immunocompetent mice, associated with an increase of MDSCs, TAMs and programmed cell death1 (PD1) exprssed CD8 T cells. A CCR2 antagonist suppressed TAMs and MDSCs infiltration and delayed tumour growth in A3B and A3B- expressing mouse tumours. Mechanistically, A3B upregulation in HCC depresses global H3K27me3 abundance via interaction with polycomb repressor complex 2 (PRC2) and reduces an occupancy of H3K27me3 on promoters of the chemokine CCL2 to recruit massive TAMs and MDSCs.

Conclusion: Our observations uncover a deaminase-independent role of the A3B in modulating the HCC microenvironment and demonstrate a proof for the concept of targeting A3B in HCC immunotherapy.
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http://dx.doi.org/10.1136/gutjnl-2018-317601DOI Listing
October 2019

Impacts of maternal characteristics and temperature on juvenile survival in the crocodile lizard: Implications for conservation.

Zoo Biol 2019 May 6;38(3):272-280. Epub 2019 Jan 6.

Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, People's Republic of China.

Captive breeding is an important conservation measure that may restore and enhance wild populations of rare and endangered species. Multiple anthropogenic hazards have brought the crocodile lizard, Shinisaurus crocodilurus, to the brink of extinction. We initiated a captive breeding program and quantified female reproductive traits, including reproductive timing, litter size, litter mass, and neonate size. To identify the internal and external factors affecting female reproductive function, we then analyzed how maternal age is related to body size, temperature, and female reproductive traits. We found that larger female crocodile lizards produced more offspring than smaller ones, as both litter size and litter mass were positively related to maternal body size. In contrast, neonate size was independent of maternal body size. Maternal reproductive output varied among different age groups. Young and old females had significantly smaller living litter size and mass than middle-aged females. Among captive females, one-third exhibited early parturition in autumn and winter instead of the following spring, a pattern probably associated with higher ambient temperatures in captivity. Although female reproductive output and neonatal body size did not differ between early- and normal-parturition females, offspring from the former group died earlier than those from the latter. Our study highlights the danger of climate change in hastening parturition, a phenomenon that could significantly hamper neonate survival and impede population recruitment.
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http://dx.doi.org/10.1002/zoo.21473DOI Listing
May 2019

A simulated heat wave shortens the telomere length and lifespan of a desert lizard.

J Therm Biol 2018 Feb;72:94-100

Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China. Electronic address:

Understanding how organisms respond to warming contributes important information to the conservation of biodiversity that is threatened by climate warming. Here, we conducted experiments on a desert agama (Phrynocephalus przewalskii) to test the hypothesis that climate warming (an increase in both mean temperature and heat waves) would induce oxidative stress, shortening telomere length, and thereby decreasing survival. Our results demonstrated that one week of exposure to a simulated heat wave significantly shortened telomere length, and decreased the overwinter survival of lizards, but mean temperature increase did not affect the survival of lizards. However, the antioxidant capacity (anti-oxidative enzyme) was not affected by the warming treatments. Therefore, heat waves might have negative impacts on the desert agama, with shortened telomeres likely causing the lifespan of lizards to decrease under climate warming.
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http://dx.doi.org/10.1016/j.jtherbio.2018.01.004DOI Listing
February 2018

Deficiency in T follicular regulatory cells promotes autoimmunity.

J Exp Med 2018 03 29;215(3):815-825. Epub 2018 Jan 29.

Institute for Immunology and School of Medicine, Tsinghua University, Beijing, China

T follicular regulatory (Tfr) cells are a new subset of regulatory T (T reg) cells localized in the germinal center to limit the humoral response. Until now, the physiological function of Tfr cells has been largely unknown. In this study, we developed a mouse to analyze the function of Tfr cells in immune and autoimmune responses. These mice exhibited enhanced immunity to influenza virus; moreover, mice developed late-onset spontaneous autoimmune diseases, affecting the salivary glands with lymphocyte infiltration and antibody deposition. In a mouse experimental Sjögren's syndrome model, ablation of in T reg cells greatly enhanced disease development. Conversely, mice were protected in the model. Thus, our study indicates that Tfr cells control autoimmune diseases and can be targeted in infectious and autoimmune disease.
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http://dx.doi.org/10.1084/jem.20170901DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839755PMC
March 2018

APOBEC3B and IL-6 form a positive feedback loop in hepatocellular carcinoma cells.

Sci China Life Sci 2017 Jun 29;60(6):617-626. Epub 2017 May 29.

State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of Drug Discovery for Metabolic Disease, Center for New Drug Safety Evaluation and Research, China Pharmaceutical University, Nanjing, 211198, China.

APOBEC3 protein families, a DNA cytidine deaminase, were up-regulated in multiple tumors. However, the relationship between Hepatocellular carcinoma (HCC) and APOBEC3B (A3B) remains unknown. It has been confirmed that interleukin-6 (IL-6) has significant impacts on oncogenesis of HCC. Here, we reported that the expression of IL-6 was substantially up-regulated by A3B in HepG2 cells. A3B induced IL-6 expression through relocating HuR to enhance the IL-6 mRNA stability. Further analysis indicated that IL-6 also increased the expression of A3B through JAK1/STAT3 signaling pathway, which formed a positive feedback to maintain the continuous expression of A3B and IL-6, and thereby promoted the prolonged non-resolving inflammation. Collectively, these findings suggest that A3B is essential for oncogenesis of HCC, and is a potential target for preventive intervention.
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http://dx.doi.org/10.1007/s11427-016-9058-6DOI Listing
June 2017

Ellagic acid protects against neuron damage in ischemic stroke through regulating the ratio of Bcl-2/Bax expression.

Appl Physiol Nutr Metab 2017 Aug 7;42(8):855-860. Epub 2017 Apr 7.

c State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100050, People's Republic of China.

An oxygen-glucose deprivation and reoxygenation model in primary cultured rat cortical neurons was developed for this study to investigate the effects of ellagic acid (EA), a low-molecular-weight polyphenol, on neuron cells and their function, and to evaluate whether EA can be safely utilized by humans as a functional food or therapeutic agent. Administration of EA significantly decreased the volume of cerebrum infarction and the neurological deficit scores of the rats; EA treatment also increased the number of Bcl-2-positive cells and the ratio of Bcl-2-positive to Bax-positive neurons in the semidarkness zone near the brain ischemic focus in the photothrombotic cerebral ischemia model. Treatment of EA resulted in increased neuron viability, cell nuclear integrity, and the ratio of Bcl-2/Bax expression in the primary cultured neuron model; EA treatment also lead to a decrease in the number of apoptotic cells. Our results therefore suggest a specific mechanism for the beneficial effects of EA, providing new insights into how it provides neuroprotection. To the best of our knowledge, these results represent new insights on the mechanisms of the brain cell protective activity of EA. Thus, EA may be used in functional foods or medicines to help treat nerve dysfunction, neurodegenerative disease, and aging.
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http://dx.doi.org/10.1139/apnm-2016-0651DOI Listing
August 2017

Calpain 2 activation of P-TEFb drives megakaryocyte morphogenesis and is disrupted by leukemogenic GATA1 mutation.

Dev Cell 2013 Dec;27(6):607-20

Department of Pathology, University of Virginia School of Medicine, Charlottesville, VA 22908, USA. Electronic address:

Megakaryocyte morphogenesis employs a "hypertrophy-like" developmental program that is dependent on P-TEFb kinase activation and cytoskeletal remodeling. P-TEFb activation classically occurs by a feedback-regulated process of signal-induced, reversible release of active Cdk9-cyclin T modules from large, inactive 7SK small nuclear ribonucleoprotein particle (snRNP) complexes. Here, we have identified an alternative pathway of irreversible P-TEFb activation in megakaryopoiesis that is mediated by dissolution of the 7SK snRNP complex. In this pathway, calpain 2 cleavage of the core 7SK snRNP component MePCE promoted P-TEFb release and consequent upregulation of a cohort of cytoskeleton remodeling factors, including α-actinin-1. In a subset of human megakaryocytic leukemias, the transcription factor GATA1 undergoes truncating mutation (GATA1s). Here, we linked the GATA1s mutation to defects in megakaryocytic upregulation of calpain 2 and of P-TEFb-dependent cytoskeletal remodeling factors. Restoring calpain 2 expression in GATA1s mutant megakaryocytes rescued normal development, implicating this morphogenetic pathway as a target in human leukemogenesis.
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http://dx.doi.org/10.1016/j.devcel.2013.11.013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3892434PMC
December 2013

Prevalence, distribution, and impact of mild cognitive impairment in Latin America, China, and India: a 10/66 population-based study.

PLoS Med 2012 Feb 7;9(2):e1001170. Epub 2012 Feb 7.

National Institute of Neurology and Neurosurgery, Autonomous National University of Mexico, Mexico City, Mexico.

Background: Rapid demographic ageing is a growing public health issue in many low- and middle-income countries (LAMICs). Mild cognitive impairment (MCI) is a construct frequently used to define groups of people who may be at risk of developing dementia, crucial for targeting preventative interventions. However, little is known about the prevalence or impact of MCI in LAMIC settings.

Methods And Findings: Data were analysed from cross-sectional surveys established by the 10/66 Dementia Research Group and carried out in Cuba, Dominican Republic, Peru, Mexico, Venezuela, Puerto Rico, China, and India on 15,376 individuals aged 65+ without dementia. Standardised assessments of mental and physical health, and cognitive function were carried out including informant interviews. An algorithm was developed to define Mayo Clinic amnestic MCI (aMCI). Disability (12-item World Health Organization disability assessment schedule [WHODAS]) and informant-reported neuropsychiatric symptoms (neuropsychiatric inventory [NPI-Q]) were measured. After adjustment, aMCI was associated with disability, anxiety, apathy, and irritability (but not depression); between-country heterogeneity in these associations was only significant for disability. The crude prevalence of aMCI ranged from 0.8% in China to 4.3% in India. Country differences changed little (range 0.6%-4.6%) after standardization for age, gender, and education level. In pooled estimates, aMCI was modestly associated with male gender and fewer assets but was not associated with age or education. There was no significant between-country variation in these demographic associations.

Conclusions: An algorithm-derived diagnosis of aMCI showed few sociodemographic associations but was consistently associated with higher disability and neuropsychiatric symptoms in addition to showing substantial variation in prevalence across LAMIC populations. Longitudinal data are needed to confirm findings-in particular, to investigate the predictive validity of aMCI in these settings and risk/protective factors for progression to dementia; however, the large number affected has important implications in these rapidly ageing settings.
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http://dx.doi.org/10.1371/journal.pmed.1001170DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3274506PMC
February 2012

Leg length, skull circumference, and the prevalence of dementia in low and middle income countries: a 10/66 population-based cross sectional survey.

Int Psychogeriatr 2011 Mar 12;23(2):202-13. Epub 2010 Aug 12.

King's College London, Institute of Psychiatry, Centre for Public Mental Health, Health Service and Population Research Department, London, UK.

Background: Adult leg length is influenced by nutrition in the first few years of life. Adult head circumference is an indicator of brain growth. There is a limited literature linking short legs and small skulls to an increased risk for cognitive impairment and dementia in late life.

Methods: One phase cross-sectional surveys were carried out of all residents aged over 65 years in 11 catchment areas in China, India, Cuba, Dominican Republic, Venezuela, Mexico and Peru (n = 14,960). The cross-culturally validated 10/66 dementia diagnosis, and a sociodemographic and risk factor questionnaire were administered to all participants, and anthropometric measures taken. Poisson regression was used to calculate prevalence ratios for the effect of leg length and skull circumference upon 10/66 dementia, controlling for age, gender, education and family history of dementia.

Results: The pooled meta-analyzed fixed effect for leg length (highest vs. lowest quarter) was 0.82 (95% CI, 0.68-0.98) and for skull circumference 0.75 (95% CI, 0.63-0.89). While point estimates varied between sites, the proportion of the variability attributable to heterogeneity between studies as opposed to sampling error (I2) was 0% for leg length and 22% for skull circumference. The effects were independent and not mediated by family history of dementia. The effect of skull circumference was not modified by educational level or gender, and the effect of leg length was not modified by gender.

Conclusions: Since leg length and skull circumference are said to remain stable throughout adulthood into old age, reverse causality is an unlikely explanation for the findings. Early life nutritional programming, as well as neurodevelopment may protect against neurodegeneration.
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http://dx.doi.org/10.1017/S1041610210001274DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5391848PMC
March 2011

A five-year community-based longitudinal survival study of dementia in Beijing, China: a 10/66 Dementia Research Group population-based study.

Int Psychogeriatr 2010 Aug 4;22(5):761-8. Epub 2010 Jun 4.

Institute of Mental Health, Peking University, Beijing, China.

Background: Despite the magnitude of dementia, little research on survival duration and prognosis of dementia has been reported in developing countries. This study was conducted to investigate survival times, identify related prognostic factors and construct a prognostic index (PI) for community-based dementia patients in Beijing, China.

Methods: This study is part of the 10/66 Dementia Research Group study in China. One hundred and thirty-seven dementia patients identified by 10/66 dementia criteria among 2162 participants and 137 referent subjects matched by age and sex were followed up for five years.

Results: Ninety-one (66.4%) dementia patients and 51 (37.2%) referent subjects died during the 5-year follow-up (p < 0.01). The median survival time of dementia patients was 4.2 years (95% CI: 3.8-4.6). Severity of dementia (severe/mild, HR: 8.765, 95% CI: 4.436-17.163), substantial disability (HR: 5.503, 95% CI: 3.017-8.135), co-morbidity (HR: 4.149, 95% CI: 2.254-7.736) and age (HR: 1.079, 95% CI: 1.048-1.110) were independent predictors of survival for patients with dementia. Using the PI calculated for each dementia patient, all dementia patients were classified into three groups: low, medium and high risk groups. The median survival times of each group were 5.2 years, 4.4 years and 1.5 years (p < 0.01), respectively.

Conclusions: Survival times of community-based dementia patients were significantly shorter than those of referent subjects. Severity of dementia, substantial disability, co-morbidity and age were independent predictors of survival. The PI derived from the four predictors can stratify the mortality risk and predict life expectancy for community-dwelled dementia patients, although further validation is needed.
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http://dx.doi.org/10.1017/S1041610210000669DOI Listing
August 2010

Chronic disease prevalence and care among the elderly in urban and rural Beijing, China - a 10/66 Dementia Research Group cross-sectional survey.

BMC Public Health 2009 Oct 21;9:394. Epub 2009 Oct 21.

Institute of Mental Health, Peking University, Key Laboratory of Mental Health, Ministry of Health (Peking University), No 51 Hua Yuan Bei Road, Haidian District, Beijing 100191, PR China.

Background: Demographic ageing is occurring at an unprecedented rate in China. Chronic diseases and their disabling consequences will become much more common. Public policy has a strong urban bias, and older people living in rural areas may be especially vulnerable due to limited access to good quality healthcare, and low pension coverage. We aim to compare the sociodemographic and health characteristics, health service utilization, needs for care and informal care arrangements of representative samples of older people in two Beijing communities, urban Xicheng and rural Daxing.

Methods: A one-phase cross-sectional survey of all those aged 65 years and over was conducted in urban and rural catchment areas in Beijing, China. Assessments included questionnaires, a clinical interview, physical examination, and an informant interview. Prevalence of chronic diseases, self-reported impairments and risk behaviours was calculated adjusting for household clustering. Poisson working models were used to estimate the independent effect of rural versus urban residence, and to explore the predictors of health services utilization.

Results: We interviewed 1002 participants in rural Daxing, and 1160 in urban Xicheng. Those in Daxing were more likely to be younger, widowed, less educated, not receiving a pension, and reliant on family transfers. Chronic diseases were more common in Xicheng, when based on self-report rather than clinical assessment. Risk exposures were more common in Daxing. Rural older people were much less likely to access health services, controlling for age and health. Community health services were ineffective, particularly in Daxing, where fewer than 3% of those with hypertension were adequately controlled. In Daxing, care was provided by family, who had often given up work to do so. In Xicheng, 45% of those needing care were supported by paid caregivers. Caregiver strain was higher in Xicheng. Dementia was strongly associated with care needs and caregiver strain, but not with medical helpseeking.

Conclusion: Apparent better health in Daxing might be explained by under-diagnosis, under-reporting or selective mortality. Far-reaching structural reforms may be needed to improve access and strengthen rural healthcare. The impact of social and economic change is already apparent in Xicheng, with important implications for future long-term care.
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http://dx.doi.org/10.1186/1471-2458-9-394DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2770493PMC
October 2009

Prevalence of dementia in Latin America, India, and China: a population-based cross-sectional survey.

Lancet 2008 Aug 25;372(9637):464-74. Epub 2008 Jul 25.

Facultad de Medicina Finley-Albarran, Medical University of Havana, Havana, Cuba.

Background: Studies have suggested that the prevalence of dementia is lower in developing than in developed regions. We investigated the prevalence and severity of dementia in sites in low-income and middle-income countries according to two definitions of dementia diagnosis.

Methods: We undertook one-phase cross-sectional surveys of all residents aged 65 years and older (n=14 960) in 11 sites in seven low-income and middle-income countries (China, India, Cuba, Dominican Republic, Venezuela, Mexico, and Peru). Dementia diagnosis was made according to the culturally and educationally sensitive 10/66 dementia diagnostic algorithm, which had been prevalidated in 25 Latin American, Asian, and African centres; and by computerised application of the dementia criterion from the Diagnostic and Statistical Manual of Mental Disorders (DSM IV). We also compared prevalence of DSM-IV dementia in each of the study sites with that from estimates in European studies.

Findings: The prevalence of DSM-IV dementia varied widely, from 0.3% (95% CI 0.1-0.5) in rural India to 6.3% (5.0-7.7) in Cuba. After standardisation for age and sex, DSM-IV prevalence in urban Latin American sites was four-fifths of that in Europe (standardised morbidity ratio 80 [95% CI 70-91]), but in China the prevalence was only half (56 [32-91] in rural China), and in India and rural Latin America a quarter or less of the European prevalence (18 [5-34] in rural India). 10/66 dementia prevalence was higher than that of DSM-IV dementia, and more consistent across sites, varying between 5.6% (95% CI 4.2-7.0) in rural China and 11.7% (10.3-13.1) in the Dominican Republic. The validity of the 847 of 1345 cases of 10/66 dementia not confirmed by DSM-IV was supported by high levels of associated disability (mean WHO Disability Assessment Schedule II score 33.7 [SD 28.6]).

Interpretation: As compared with the 10/66 dementia algorithm, the DSM-IV dementia criterion might underestimate dementia prevalence, especially in regions with low awareness of this emerging public-health problem.
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http://dx.doi.org/10.1016/S0140-6736(08)61002-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2854470PMC
August 2008

The cognitive subscale of Alzheimer's Disease Assessment Scale, Chinese version in staging of Alzheimer disease.

Alzheimer Dis Assoc Disord 2004 Oct-Dec;18(4):231-5

Department of Geriatric Psychiatry, Peking University Institute of Mental Health, Beijing, China.

This study was designed to examine the utility of the ADAS-Cog, Chinese version (ADAS-Cog-C) for staging of dementia in Alzheimer disease (AD). A total of 305 patients with AD (199 mild AD and 106 moderate AD) meeting the NINCDS-ADRDA criteria of probable AD were recruited. The ADAS-Cog-C was administered to all AD subjects. The total score of ADAS-Cog-C and each item score differed significantly between mild and moderate AD groups, with moderate AD group scoring higher. Statistical analysis showed insignificant influence of age or educational level on the ADAS-Cog-C total score. The item score of orientation and constructional praxis and the ADAS-Cog total score could classify mild and moderate AD efficiently, with a sensitivity of 78% to 82% and a specificity of 70% to 73%. The results of this study indicate that the ADAS-Cog-C can discriminate mild AD from moderate AD efficiently and be useful for staging of AD. It is recommended that the ADAS-Cog-C be introduced for monitoring the cognitive efficacy in AD drug treatment among Chinese AD patients.
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April 2005

The cognitive subscale of Alzheimer's Disease Assessment Scale, Chinese version in staging of Alzheimer disease.

Alzheimer Dis Assoc Disord 2004 Oct-Dec;18(4):231-5

Department of Geriatric Psychiatry, Peking University Institute of Mental Health, Beijing, China.

This study was designed to examine the utility of the ADAS-Cog, Chinese version (ADAS-Cog-C) for staging of dementia in Alzheimer disease (AD). A total of 305 patients with AD (199 mild AD and 106 moderate AD) meeting the NINCDS-ADRDA criteria of probable AD were recruited. The ADAS-Cog-C was administered to all AD subjects. The total score of ADAS-Cog-C and each item score differed significantly between mild and moderate AD groups, with moderate AD group scoring higher. Statistical analysis showed insignificant influence of age or educational level on the ADAS-Cog-C total score. The item score of orientation and constructional praxis and the ADAS-Cog total score could classify mild and moderate AD efficiently, with a sensitivity of 78% to 82% and a specificity of 70% to 73%. The results of this study indicate that the ADAS-Cog-C can discriminate mild AD from moderate AD efficiently and be useful for staging of AD. It is recommended that the ADAS-Cog-C be introduced for monitoring the cognitive efficacy in AD drug treatment among Chinese AD patients.
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April 2005

[Incidence of senile dementia and depression in elderly population in Xicheng District, Beijing, an epidemiologic study].

Zhonghua Yi Xue Za Zhi 2002 Aug;82(15):1025-8

Institute of Mental Health, Peking University, Beijing 100083, China.

Objective: To investigate the incidence of senile dementia and depression in the elderly and the factors correlative with these disorders.

Methods: All the non-case subjects investigated in a survey of prevalence of senile dementia and depression conducted among the elderly population in Xicheng District, Beijing in 1997 were followed up in 1999. The investigation procedure, instruments and diagnostic criteria were identical with those used in 1997 survey.

Results: The annual incidence rates of senile dementia was 0.89% in those aged 60 and over. The incidence rate of old males and that of the old females were not significantly different. The annual incidence rate of senile dementia in groups aged 60 approximately 64, 64 approximately 69, 70 approximately 74 75 approximately 79 80 approximately 84 85 approximately 89, and 90 and over were 0.15% 0.68 % 0.44% 1.32% 2.41% 5.72% and 5.13% respectively. The incidence rate in the elderly over 90 was lower than that in the group aged 85 approximately 89. The minimum annual incidence rate of depression in the elderly aged 60 and over was 1.28%. The incidence rate of depression was higher in the group with poorer health than in the group with better health. The incidence rates of moderate and severe dementia were not significantly different from those in 1989.

Conclusion: The incidence rate of senile dementia in the elderly remains rather stable during this period of 10 years in Beijing city. The incidence rate of senile dementia is closely correlated with age. The incidence rate of depression in the elderly is remarkably correlated with health status. Senile dementia and depression may coexist in the same person.
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August 2002