In the context of the digital transformation of vocational education,a quality evaluation index system has been constructed.Based on a questionnaire survey conducted among higher vocational colleges and enterprises in...In the context of the digital transformation of vocational education,a quality evaluation index system has been constructed.Based on a questionnaire survey conducted among higher vocational colleges and enterprises in Hainan Province,it has been found that the quality of vocational education generally depends on the talent training program and professional construction at the macro level.At the meso level,the teacher level and teaching environment are critical,while at the micro level,the evaluation of talent training quality cannot be underestimated.Strategies for quality improvement in vocational education are proposed from the perspectives of talent training programs,major construction,teacher development,teaching environment,and talent training quality,all under the lens of digital transformation.展开更多
BACKGROUND The diagnosis of gastric carcinoma(GC)is essential for improving clinical outcomes.However,the biomarkers currently used for GC screening are not ideal.AIM To explore the diagnostic implications of the neut...BACKGROUND The diagnosis of gastric carcinoma(GC)is essential for improving clinical outcomes.However,the biomarkers currently used for GC screening are not ideal.AIM To explore the diagnostic implications of the neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and systemic immune-inflammatory index(SII)for GC.METHODS The baseline data of 133 patients with GC and 134 patients with precancerous gastric conditions admitted between January 2022 and December 2023 were retrospectively analyzed.The information on peripheral blood platelet,neutrophil,and lymphocyte counts in each patient was collected,and the NLR,PLR,and SII levels of both groups were calculated.Additionally,multivariate logistic regression analysis was conducted,and the diagnostic implications of NLR,PLR,and SII in differentiating patients with precancerous gastric conditions,compared with those with GC,were analyzed through receiver operating characteristic(ROC)curves.RESULTS The data indicated that NLR,PLR,and SII had abnormally increased levels in the patients with GC.Gender and body mass index were risk factors for the occurrence of GC.ROC data revealed that the areas under the curve of three patients with precancerous gastric conditions,who were differentiated from those with GC,were 0.824,0.787,and 0.842,respectively.CONCLUSION NLR,PLR,and SII are all abnormally expressed in GC and have diagnostic implications,especially when used as joint indicators,in distinguishing patients with precancerous gastric conditions from those with GC.展开更多
BACKGROUND Anastomotic leakage(AL)is a serious complication following rectal cancer surgery and is associated with increased recurrence,mortality,extended hospital stays,and delayed chemotherapy.The Onodera prognostic...BACKGROUND Anastomotic leakage(AL)is a serious complication following rectal cancer surgery and is associated with increased recurrence,mortality,extended hospital stays,and delayed chemotherapy.The Onodera prognostic nutritional index(OPNI)and inflammation-related biomarkers,such as the neutrophil-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR),have been studied in the context of cancer prognosis,but their combined efficacy in predicting AL remains unclear.AIM To investigate the relationships between AL and these markers and developed a predictive model for AL.METHODS A retrospective cohort study analyzed the outcomes of 434 patients who had undergone surgery for rectal cancer at a tertiary cancer center from 2016 to 2023.The patients were divided into two groups on the basis of the occurrence of AL:One group consisted of patients who experienced AL(n=49),and the other group did not(n=385).The investigation applied logistic regression to develop a risk prediction model utilizing clinical,pathological,and laboratory data.The efficacy of this model was then evaluated through receiver operating characteristic curve analysis.RESULTS In the present study,11.28%of the participants(49 out of 434 participants)suffered from AL.Multivariate analysis revealed that preoperative levels of the OPNI,NLR,and PLR emerged as independent risk factors for AL,with odds ratios of 0.705(95%CI:0.641-0.775,P=0.012),1.628(95%CI:1.221-2.172,P=0.024),and 0.994(95%CI:0.989-0.999,P=0.031),respectively.These findings suggest that these biomarkers could effectively predict AL risk.Furthermore,the proposed predictive model has superior discriminative ability,as demonstrated by an area under the curve of 0.910,a sensitivity of 0.898,and a specificity of 0.826,reflecting its high level of accuracy.CONCLUSION The risk of AL in rectal cancer surgery patients can be effectively predicted by assessing the preoperative levels of serum nutritional biomarkers and inflammatory indicators,emphasizing their importance in the preoperative evaluation process.展开更多
ACKGROUND The hemoglobin glycation index(HGI)represents the discrepancy between the glucose management indicator(GMI)based on mean blood glucose levels and laboratory values of glycated hemoglobin(HbA1c).The HGI is a ...ACKGROUND The hemoglobin glycation index(HGI)represents the discrepancy between the glucose management indicator(GMI)based on mean blood glucose levels and laboratory values of glycated hemoglobin(HbA1c).The HGI is a promising indicator for identifying individuals with excessive glycosylation,facilitating personalized evaluation and prediction of diabetic complications.However,the factors influencing the HGI in patients with type 1 diabetes(T1D)remain unclear.Autoimmune destruction of pancreaticβcells is central in T1D pathogenesis,yet insulin resistance can also be a feature of patients with T1D and their coexistence is called“double diabetes”(DD).However,knowledge regarding the relationship between DD features and the HGI in T1D is limited.AIM To assess the association between the HGI and DD features in adults with T1D.METHODS A total of 83 patients with T1D were recruited for this cross-sectional study.Laboratory HbA1c and GMI from continuous glucose monitoring data were collected to calculate the HGI.DD features included a family history of type 2 diabetes,overweight/obesity/central adiposity,hypertension,atherogenic dyslipidemia,an abnormal percentage of body fat(PBF)and/or visceral fat area(VFA)and decreased estimated insulin sensitivity.Skin autofluorescence of advanced glycation end products(SAF-AGEs),diabetic complications,and DD features were assessed,and their association with the HGI was analyzed.RESULTS A discrepancy was observed between HbA1c and GMI among patients with T1D and DD.A higher HGI was associated with an increased number of SAF-AGEs and a higher prevalence of diabetic microangiopathy(P=0.030),particularly retinopathy(P=0.031).Patients with three or more DD features exhibited an eight-fold increased risk of having a high HGI,compared with those without DD features(adjusted odds ratio=8.12;95%confidence interval:1.52-43.47).Specifically,an elevated PBF and/or VFA and decreased estimated insulin sensitivity were associated with high HGI.Regression analysis identified estimated insulin sensitivity and VFA as factors independently associated with HGI.CONCLUSION In patients with T1D,DD features are associated with a higher HGI,which represents a trend toward excessive glycosylation and is associated with a higher prevalence of chronic diabetic complications.展开更多
BACKGROUND Gastric cancer(GC)is the fifth most common cancer and the third leading cause of cancer-related deaths in China.Many patients with GC frequently experience symptoms related to the disease,including anorexia...BACKGROUND Gastric cancer(GC)is the fifth most common cancer and the third leading cause of cancer-related deaths in China.Many patients with GC frequently experience symptoms related to the disease,including anorexia,nausea,vomiting,and other discomforts,and often suffer from malnutrition,which in turn negatively affects perioperative safety,prognosis,and the effectiveness of adjuvant therapeutic measures.Consequently,some nutritional indicators such as nutritional risk index(NRI),prognostic nutritional index(PNI),and systemic immune-inflammatorynutritional index(SIINI)can be used as predictors of the prognosis of GC patients.AIM To examine the prognostic significance of PNI,NRI,and SIINI in postoperative patients with GC.METHODS A retrospective analysis was conducted on the clinical data of patients with GC who underwent surgical treatment at the Guangxi Medical University Cancer Hospital between January 2010 and December 2018.The area under the receiver operating characteristic(ROC)curve was assessed using ROC curve analysis,and the optimal cutoff values for NRI,PNI,and SIINI were identified using the You-Review-HTMLden index.Survival analysis was performed using the Kaplan-Meier method.In addition,univariate and multivariate analyses were conducted using the Cox proportional hazards regression model.RESULTS This study included a total of 803 patients.ROC curves were used to evaluate the prognostic ability of NRI,PNI,and SIINI.The results revealed that SIINI had superior predictive accuracy.Survival analysis indicated that patients with GC in the low SIINI group had a significantly better survival rate than those in the high SIINI group(P<0.05).Univariate analysis identified NRI[hazard ratio(HR)=0.68,95%confidence interval(CI):0.52-0.89,P=0.05],PNI(HR=0.60,95%CI:0.46-0.79,P<0.001),and SIINI(HR=2.10,95%CI:1.64-2.69,P<0.001)as prognostic risk factors for patients with GC.However,multifactorial analysis indicated that SIINI was an independent risk factor for the prognosis of patients with GC(HR=1.65,95%CI:1.26-2.16,P<0.001).CONCLUSION Analysis of clinical retrospective data revealed that SIINI is a valuable indicator for predicting the prognosis of patients with GC.Compared with NRI and PNI,SIINI may offer greater application for prognostic assessment.展开更多
The Dst index has been commonly used to measure the geomagnetic effectiveness of magnetic storm events for several decades.Based on Burton’s empirical Dst model and the global magneto-hydrodynamic(MHD)simulation of E...The Dst index has been commonly used to measure the geomagnetic effectiveness of magnetic storm events for several decades.Based on Burton’s empirical Dst model and the global magneto-hydrodynamic(MHD)simulation of Earth’s magnetosphere,here we proposed a semi-empirical model to forecast the Dst index during geomagnetic storms.In this model,the ring current contribution to the Dst index is derived from Burton’s model,while the contributions from other current systems are obtained from the global MHD simulation.In order to verify the model accuracy,a number of recent magnetic storm events are tested and the simulated Dst index is compared with the observation through the correlation coefficient(CC),prediction efficiency(PE),root mean square error(RMSE)and central root mean square error(CRMSE).The results indicate that,in the context of moderate and intense geomagnetic storm events,the semi-empirical model performs well in global MHD simulations,showing relatively higher CC and PE,and lower RMSE and CRMSE compared to those from the empirical model.Compared with the physics-based ring current models,this model inherits the advantage of fast processing from the empirical model,and easy implementation in a global MHD model of Earth’s magnetosphere.Therefore,it is suitable for the Dst estimation under a context of a global MHD simulation.展开更多
Extreme weather events,such as floods and droughts,are expected to rise significantly worldwide as a result of climate change.Investigating future drought patterns is therefore a key approach for elaborating anticipat...Extreme weather events,such as floods and droughts,are expected to rise significantly worldwide as a result of climate change.Investigating future drought patterns is therefore a key approach for elaborating anticipatory water resources management responses to climate change.In this paper,future meteorological drought conditions are investigated based on the SPEI(Standardised Precipitation Evapotranspiration Index).This study makes use of observed and projected data.The simulated data were retrieved from the CMIP6(Coupled Model Intercomparison Project Phase 6)over the period 2025-2050,and the Delta change method was adopted to remove the bias in the dataset.Then SPEI at various scales has been estimated under four future scenarios(SSP1-2.6,SSP2-4.5,SSP3-7.0 and SSP5-8.5).The trend analysis of the projected SPEI was performed at p<0.05 using the MMK(Modified Mann-Kendall)test in order to detect the statistically significant trend of the drought against the null hypothesis of no trend.Results show large variability in the magnitude of drought in the past and future.Based on SPEI at 24 months accumulation,the result shows that under SSP1-2.6,the basin will experience a wet period during the first decade(SPEI=0.60),the second decade will be dry(SPEI24=-0.43).The remaining years will be also dry(SPEI=-0.34).Under SSP2-4.5,SSP3-7.0 and SSP5-8.5 scenarios,the district will experience a wet period during the first two decades with SPEI ranging from 0.38 to 0.59.This wet period will be followed by a dry period under these scenarios ranging from-0.14 to-0.06.Overall,under SSPs scenarios,two main periods characterized by a rainfall recovery spanning from followed by a moderately prolonged drought are identified within the study area.The findings of this study may provide valuable information for developing proactive measures to reduce water insecurity in Fada N’Gourma through effective drought mitigation.展开更多
BACKGROUND Acute kidney injury(AKI)is a frequent complication after liver transplantation(LT).How to realize the early diagnosis of AKI,perform active intervention,and reduce the mortality of post-LT patients is an ur...BACKGROUND Acute kidney injury(AKI)is a frequent complication after liver transplantation(LT).How to realize the early diagnosis of AKI,perform active intervention,and reduce the mortality of post-LT patients is an urgent problem to be solved.AIM To investigate the accuracy of hepatorenal index(HRI)and renal resistive index(RRI)in monitoring of early AKI after LT.METHODS This observational study included adult deceased-donor LT recipients at our center between February 2022 and February 2023 with no preoperative renal dysfunction.The HRI and RRI were recorded once per day in the postoperative period through to postoperative day(POD)7.We followed up with the patients at 1 month after LT.The patients were divided into the AKI and non-AKI groups according to the Kidney Disease Improving Global Outcomes criteria.RESULTS Of 121 patients were included in the study(mean age:50.18±8.88years;female:17.36%).AKI developed in 53 patients(43.80%).The AKI and non-AKI groups were similar in terms of their baseline characteristics.An HRI of≤1.12 on POD 1 detected AKI with a sensitivity of 62.30%and a specificity of 87.80%[area under the receiver operating characteristic curve(AUC)=0.801,P<0.01].An RRI of≥0.65 on POD 1 detected AKI with a sensitivity of 87.80%and a specificity of 67.60%(AUC=0.825,P<0.01).The HRI combined with the RRI was more effective at detecting AKI than either the HRI or RRI alone(AUC=0.890,P<0.01).The HRI increased as AKI resolved while the RRI decreased as AKI resolved.CONCLUSION The HRI and RRI are non-invasive bedside indices that can identify the occurrence and recovery of early AKI after LT.展开更多
The statistics of the China natural gas industry prosperity index showed that the China natural gas industry prosperity index was 357.68 in the 2nd quarter of 2025,up 3.1% from the 1st quarter of 2025,a stably prosper...The statistics of the China natural gas industry prosperity index showed that the China natural gas industry prosperity index was 357.68 in the 2nd quarter of 2025,up 3.1% from the 1st quarter of 2025,a stably prosperous state in the short term and a very prosperous state in the medium to long term;the prosperity index of natural gas production companies was 542.01 in the 2nd quarter of 2025,up 4.8% from the 1st quarter of 2025,an increasingly prosperous state in the short term and a very prosperous state in the medium to long term;the prosperity index of natural gas sales companies was 209.06 in the 2nd quarter of 2025,up 0.4% from the 1st quarter of 2025,an increasing prosperity in the short term and a prosperous state in the medium to long term;the prosperity trend index of the natural gas industry in the coming year for the 2nd quarter of 2025 was 765.70,up 4.1% from the 1st quarter of 2025,a very prosperous state,indicating that natural gas industry experts are optimistic about the natural gas industry’s prosperity trend in the coming year.See Fig.1 and Table 1 for details.展开更多
On June 12th, 2024, Clarivate Analytics officially notified that the journal of Chinese Medicine and Culture (CMC) met the necessary selection criteria, and has been included in the Emerging Sources Citation Index(ESC...On June 12th, 2024, Clarivate Analytics officially notified that the journal of Chinese Medicine and Culture (CMC) met the necessary selection criteria, and has been included in the Emerging Sources Citation Index(ESCI) database. The journal is expected to receive its first Impact Factor(IF) in 2025, marking a new stage of its development.展开更多
This paper investigates the performance of a simultaneous wireless information and power transfer(SWIPT)enabled two-way one-relay(TWOR)system based on generalized carrier index differential chaos shift keying(GCI-DCSK...This paper investigates the performance of a simultaneous wireless information and power transfer(SWIPT)enabled two-way one-relay(TWOR)system based on generalized carrier index differential chaos shift keying(GCI-DCSK).We derive the expressions for the proposed scheme’s bit error rate(BER),considering both additive white Gaussian noise(AWGN)and multipath Rayleigh fading channels.The simulation results demonstrate that the proposed SWIPT-enabled GCI-DCSK TWOR system performs slightly worse than the DCSK TWOR system without SWIPT at the same distance.However,a notable advantage of the proposed system is that the relay node is self-sustainable,which is particularly significant considering the challenges associated with battery replacement in relay nodes.Furthermore,we derive the outage probability and validate the accuracy of the derived formulas using simulation results.展开更多
BACKGROUND The correlation between geriatric nutritional risk index(GNRI)and the prognosis of patients with osteoporosis or osteopenia has not been studied.This study aims to explore the relationship between GNRI and ...BACKGROUND The correlation between geriatric nutritional risk index(GNRI)and the prognosis of patients with osteoporosis or osteopenia has not been studied.This study aims to explore the relationship between GNRI and the cardiovascular disease(CVD)and all-cause mortality rates in elderly patients with osteoporosis or osteopenia.METHODS This study included 4756 patients with osteoporosis and osteopenia from five cycles of the National Health and Nutrition Examination Survey(NHANES).We used multivariable Cox regression and subgroup analyses to investigate the correlation between GNRI and mortality rates.The restricted cubic spline analysis was used to assess the dose-response relationship between GNRI and mortality risk.Mediation analysis was conducted to examine the mediating effect of chronic kidney disease on the relationship between nutritional risk and mortality.RESULTS During a median follow-up period of 114 months,a total of 1241 deaths(26.09%)occurred,including 300 deaths due to CVD(6.31%).In the fully adjusted Model 3,compared to the no-risk group,the risk group showed significantly increased all-cause mortality risk(HR=2.05,95%CI:1.74–2.40)and CVD mortality risk(HR=1.88,95%CI:1.30–2.71).The restricted cubic spline analysis indicated a non-linear association between GNRI and all-cause mortality risk as well as CVD mortality risk.The mediation analysis results indicated that chronic kidney disease mediates 16.9%of the effect of nutritional risk on all-cause mortality and 25.3%on CVD mortality risk.CONCLUSIONS GNRI can serve as a predictive factor for all-cause and CVD mortality rates in elderly patients with osteoporosis or osteopenia.展开更多
BACKGROUND Primary liver cancer,particularly hepatocellular carcinoma(HCC),ranks as the sixth most prevalent cancer globally and the third major cause of cancerassociated mortality.Despite the available immunotherapie...BACKGROUND Primary liver cancer,particularly hepatocellular carcinoma(HCC),ranks as the sixth most prevalent cancer globally and the third major cause of cancerassociated mortality.Despite the available immunotherapies and combined immunotherapy and targeted therapy,the prognosis for many patients remains dismal.Accurately identifying the appropriate patient cohorts is crucial for improving treatment outcomes.AIM To investigate the prognostic value of the triglyceride-glucose(TyG)index-a novel,accessible marker of insulin resistance-in predicting therapeutic outcomes among patients with hepatitis B virus(HBV)-related HCC treated with camrelizumab and lenvatinib.METHODS In this study,we conducted a retrospective review of 278 patients diagnosed with stage B/C HBV-related HCC who underwent combination therapy.Based on their TyG index,patients were categorized into high and low TyG index groups.A nomogram prediction model was developed based on independent prognostic factors for overall survival(OS)and validated using the C-index and calibration curves.RESULTS Of the 278 patients enrolled in the study,144 were assigned to the high TyG index group,while the remaining 134 were classified into the low index group.Importantly,patients with a low TyG index demonstrated a significantly prolonged median progression-free survival and OS relative to those with a high index.Additionally,the objective response rate and disease control rate were 22.39%and 64.18%in the low TyG index group,whereas they were 12.50%and 51.39%in the high TyG index group,respectively.Moreover,the incidence of hypertension was higher in the high TyG index group than in the low TyG index group.The incidence of other adverse effects did not differ significantly between the groups.Multivariate regression analysis identified independent prognostic factors for OS,including the Barcelona Clinic Liver Cancer stage,alpha-fetoprotein level,Eastern Cooperative Oncology Group score,distant metastasis,and the TyG index.The risk ratio of the TyG index was 0.48(95%confidence interval:0.31-0.72,P<0.001).CONCLUSION The TyG index is a reliable long-term predictor of response to combined immunotherapy and targeted therapy in patients with HBV-related HCC.Patients with a low TyG index tend to experience better clinical outcomes.展开更多
Background:Although the prognostic nutritional index(PNI)may predict surgical outcomes in certain cancers,the impact of PNI on surgical prognosis in patients undergoing pylorus-preserving pancreati-coduodenectomy(PPPD...Background:Although the prognostic nutritional index(PNI)may predict surgical outcomes in certain cancers,the impact of PNI on surgical prognosis in patients undergoing pylorus-preserving pancreati-coduodenectomy(PPPD)is unclear.This study aimed to investigate the impact of preoperative PNI on mortality rate and cancer recurrence rate in patients who underwent PPPD.Methods:A total of 718 patients who were diagnosed with periampullary or pancreatic cancer and un-derwent PPPD between January 2012 and December 2016 were analyzed.Patients were categorized into two groups using the optimal cut-offvalue for PNI,determined by calculating the receiver operating characteristic(ROC)curve and the Youden index.We performed propensity score matching(PSM)anal-ysis to compare the mortality rate and cancer recurrence rate between the two groups.In addition,Cox regression analyses were performed to examine the association of PNI with mortality rate and cancer recurrence rate.Results:Using the 1-year mortality as an endpoint,the area under the ROC curve for PNI was 0.620(opti-mal cut-offvalue:41.7).We observed significant differences in 1-year(P=0.001),5-year(P=0.002),and overall(P=0.001)mortality;1-year(P=0.013),5-year(P=0.032),and overall(P=0.017)cancer re-currence between groups after PSM.High PNI was significantly associated with reduced 1-year[adjusted hazard ratio(HR)=0.44,95%confidence interval(CI):0.26-0.74,P=0.020],5-year(HR=0.66,95%CI:0.52-0.84,P<0.001),and overall(HR=0.71,95%CI:0.57-0.88,P=0.002)mortality;1-year(HR=0.70,95%CI:0.52-0.93,P=0.016),5-year(HR=0.78,95%CI:0.62-0.97,P=0.027)and overall(HR=0.78,95%CI:0.63-0.97,P=0.024)cancer recurrence.Conclusions:Preoperative PNI may serve as an independent factor for short-and long-term surgical prog-nosis in cancer patients undergoing PPPD.展开更多
Objective This study aimed to explore the association between body mass index(BMI)and mortality based on the 10-year population-based multicenter prospective study.Methods A general population-based multicenter prospe...Objective This study aimed to explore the association between body mass index(BMI)and mortality based on the 10-year population-based multicenter prospective study.Methods A general population-based multicenter prospective study was conducted at four sites in rural China between 2013 and 2023.Multivariate Cox proportional hazards models and restricted cubic spline analyses were used to assess the association between BMI and mortality.Stratified analyses were performed based on the individual characteristics of the participants.Results Overall,19,107 participants with a sum of 163,095 person-years were included and 1,910 participants died.The underweight(<18.5 kg/m^(2))presented an increase in all-cause mortality(adjusted hazards ratio[aHR]=2.00,95%confidence interval[CI]:1.66–2.41),while overweight(≥24.0 to<28.0 kg/m^(2))and obesity(≥28.0 kg/m^(2))presented a decrease with an aHR of 0.61(95%CI:0.52–0.73)and 0.51(95%CI:0.37–0.70),respectively.Overweight(aHR=0.76,95%CI:0.67–0.86)and mild obesity(aHR=0.72,95%CI:0.59–0.87)had a positive impact on mortality in people older than 60 years.All-2 cause mortality decreased rapidly until reaching a BMI of 25.7 kg/m(aHR=0.95,95%CI:0.92–0.98)and increased slightly above that value,indicating a U-shaped association.The beneficial impact of being overweight on mortality was robust in most subgroups and sensitivity analyses.Conclusion This study provides additional evidence that overweight and mild obesity may be inversely related to the risk of death in individuals older than 60 years.Therefore,it is essential to consider age differences when formulating health and weight management strategies.展开更多
A D-type photonic crystal fiber(PCF) sensor based on surface plasmon resonance(SPR) principle is designed.In order to excite the SPR effect,a gold film is plated on the open-loop channel of the sensor,the free electro...A D-type photonic crystal fiber(PCF) sensor based on surface plasmon resonance(SPR) principle is designed.In order to excite the SPR effect,a gold film is plated on the open-loop channel of the sensor,the free electrons in a metal are resonated with photons.The structural parameters are fine-tuned and the sensing performance of the sensor is studied.The results show that the maximum spectral sensitivity reaches 18 000 nm/RIU in the refractive index range of 1.24—1.32,and the maximum resolution is 5.56×10^(-6) RIU.The novel structure with high sensitivity and low refractive index provides a new perspective for fluid density detection.展开更多
Advanced gastric cancer(GC)remains a high-mortality malignancy despite progress in diagnosis and treatment,including immunotherapy.Reliable prognostic markers are essential for better patient stratification.The trigly...Advanced gastric cancer(GC)remains a high-mortality malignancy despite progress in diagnosis and treatment,including immunotherapy.Reliable prognostic markers are essential for better patient stratification.The triglycerideglucose(TyG)index,a marker of insulin resistance,has shown promise in various cancers,but its role in GC remains unclear.Yao et al investigated its prognostic value in 300 patients with advanced GC receiving immunotherapy and chemotherapy.Their model,which integrates the TyG index,programmed death-ligand 1 expression,and Eastern Cooperative Oncology Group performance status,underscores the impact of metabolic dysfunction on immune response and treatment efficacy.This letter examines the TyG index’s potential as a prognostic tool in GC and its implications for treatment strategies guided by metabolic and immune factors,as demonstrated in Yao et al research.展开更多
This paper focuses on the optimization of the evaluation index system for the value of transportation infrastructure assets.It analyzes the shortcomings of the current system and explores the directions for optimizing...This paper focuses on the optimization of the evaluation index system for the value of transportation infrastructure assets.It analyzes the shortcomings of the current system and explores the directions for optimizing the index system from the perspectives of functionality,economy,social impact,environmental impact,and sustainability.The paper also discusses the application of the optimized index system in practical evaluation and the measures to ensure its effectiveness.The research aims to enhance the evaluation mechanism for the value of transportation infrastructure assets,providing a more scientific basis for decision-making,addressing challenges in asset management,improving the level of asset management in transportation infrastructure,and meeting the demands of high-quality development in the transportation sector in the new era.展开更多
Objective The geriatric nutritional risk index(GNRI)is widely used for nutritional assessment.Poor nutritional status is associated with complications and poor survival in cirrhotic patients.We aimed to investigate th...Objective The geriatric nutritional risk index(GNRI)is widely used for nutritional assessment.Poor nutritional status is associated with complications and poor survival in cirrhotic patients.We aimed to investigate the value of the GNRI in predicting outcomes in cirrhotic patients.Methods This retrospective study included 420 cirrhotic patients from three centers between 2013 and 2017.Patients were divided into the high GNRI group(≥92)and low GNRI group(<92).Overall survival(OS)in the two groups was evaluated via the Kaplan‒Meier method.Cox proportional hazards model was used to estimate the value of the GNRI in predicting outcomes.Restricted cubic spline model was used to intuitively display the dose‒response associations between the GNRI and OS.A nomogram was constructed to predict OS.Results During the 2-year follow-up period,58(13.81%)patients died,and 262(62.38%)patients experienced episodes of complications.Compared with patients in the low GNRI group,those in the high GNRI group had lower mortality rates(18.73%vs.5.23%,P<0.001).The GNRI was an independent predictor of OS(hazard ratio[HR]=0.958,95%confidence interval[CI]0.929–0.988,P=0.007).The GNRI was associated with the cumulative incidence of ascites(HR=0.954,95%CI 0.940–0.969,P<0.001),spontaneous bacterial peritonitis(HR=0.928,95%CI 0.891–0.966,P<0.001),hepatic encephalopathy(HE;HR=0.944,95%CI 0.920–0.968,P<0.001),and hepatorenal syndrome(HRS)(HR=0.916,95%CI 0.861–0.974,P=0.005).Furthermore,6 independent factors were included to construct the nomogram for OS prediction,including GNRI,age,total bilirubin,serum sodium,history of HE and HRS.The C statistics of our model were 0.83(95%CI 0.75–0.90)and 0.80(95%CI 0.73–0.86)at 1 and 2 years,respectively.Patients whose GNRI score decreased within 3 and 6 months had poorer outcomes(P<0.001).Conclusions The lower GNRI score was associated with the higher cumulative incidence of complications and poorer OS of cirrhotic patients.The GNRI could be a helpful tool for assessing nutritional status and prognosis of these patients.展开更多
文摘In the context of the digital transformation of vocational education,a quality evaluation index system has been constructed.Based on a questionnaire survey conducted among higher vocational colleges and enterprises in Hainan Province,it has been found that the quality of vocational education generally depends on the talent training program and professional construction at the macro level.At the meso level,the teacher level and teaching environment are critical,while at the micro level,the evaluation of talent training quality cannot be underestimated.Strategies for quality improvement in vocational education are proposed from the perspectives of talent training programs,major construction,teacher development,teaching environment,and talent training quality,all under the lens of digital transformation.
文摘BACKGROUND The diagnosis of gastric carcinoma(GC)is essential for improving clinical outcomes.However,the biomarkers currently used for GC screening are not ideal.AIM To explore the diagnostic implications of the neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and systemic immune-inflammatory index(SII)for GC.METHODS The baseline data of 133 patients with GC and 134 patients with precancerous gastric conditions admitted between January 2022 and December 2023 were retrospectively analyzed.The information on peripheral blood platelet,neutrophil,and lymphocyte counts in each patient was collected,and the NLR,PLR,and SII levels of both groups were calculated.Additionally,multivariate logistic regression analysis was conducted,and the diagnostic implications of NLR,PLR,and SII in differentiating patients with precancerous gastric conditions,compared with those with GC,were analyzed through receiver operating characteristic(ROC)curves.RESULTS The data indicated that NLR,PLR,and SII had abnormally increased levels in the patients with GC.Gender and body mass index were risk factors for the occurrence of GC.ROC data revealed that the areas under the curve of three patients with precancerous gastric conditions,who were differentiated from those with GC,were 0.824,0.787,and 0.842,respectively.CONCLUSION NLR,PLR,and SII are all abnormally expressed in GC and have diagnostic implications,especially when used as joint indicators,in distinguishing patients with precancerous gastric conditions from those with GC.
基金Supported by Natural Science Foundation of Xinjiang Uygur Autonomous Region,No.2022D01C297.
文摘BACKGROUND Anastomotic leakage(AL)is a serious complication following rectal cancer surgery and is associated with increased recurrence,mortality,extended hospital stays,and delayed chemotherapy.The Onodera prognostic nutritional index(OPNI)and inflammation-related biomarkers,such as the neutrophil-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR),have been studied in the context of cancer prognosis,but their combined efficacy in predicting AL remains unclear.AIM To investigate the relationships between AL and these markers and developed a predictive model for AL.METHODS A retrospective cohort study analyzed the outcomes of 434 patients who had undergone surgery for rectal cancer at a tertiary cancer center from 2016 to 2023.The patients were divided into two groups on the basis of the occurrence of AL:One group consisted of patients who experienced AL(n=49),and the other group did not(n=385).The investigation applied logistic regression to develop a risk prediction model utilizing clinical,pathological,and laboratory data.The efficacy of this model was then evaluated through receiver operating characteristic curve analysis.RESULTS In the present study,11.28%of the participants(49 out of 434 participants)suffered from AL.Multivariate analysis revealed that preoperative levels of the OPNI,NLR,and PLR emerged as independent risk factors for AL,with odds ratios of 0.705(95%CI:0.641-0.775,P=0.012),1.628(95%CI:1.221-2.172,P=0.024),and 0.994(95%CI:0.989-0.999,P=0.031),respectively.These findings suggest that these biomarkers could effectively predict AL risk.Furthermore,the proposed predictive model has superior discriminative ability,as demonstrated by an area under the curve of 0.910,a sensitivity of 0.898,and a specificity of 0.826,reflecting its high level of accuracy.CONCLUSION The risk of AL in rectal cancer surgery patients can be effectively predicted by assessing the preoperative levels of serum nutritional biomarkers and inflammatory indicators,emphasizing their importance in the preoperative evaluation process.
基金Supported by the National Key R D Program of China,No.2022YFC2010102Natural Science Foundation of Hunan Province,No.2021JC0003+1 种基金National Natural Science Foundation of China,No.82070812the Sinocare Diabetes Foundation,No.LYF2022039.
文摘ACKGROUND The hemoglobin glycation index(HGI)represents the discrepancy between the glucose management indicator(GMI)based on mean blood glucose levels and laboratory values of glycated hemoglobin(HbA1c).The HGI is a promising indicator for identifying individuals with excessive glycosylation,facilitating personalized evaluation and prediction of diabetic complications.However,the factors influencing the HGI in patients with type 1 diabetes(T1D)remain unclear.Autoimmune destruction of pancreaticβcells is central in T1D pathogenesis,yet insulin resistance can also be a feature of patients with T1D and their coexistence is called“double diabetes”(DD).However,knowledge regarding the relationship between DD features and the HGI in T1D is limited.AIM To assess the association between the HGI and DD features in adults with T1D.METHODS A total of 83 patients with T1D were recruited for this cross-sectional study.Laboratory HbA1c and GMI from continuous glucose monitoring data were collected to calculate the HGI.DD features included a family history of type 2 diabetes,overweight/obesity/central adiposity,hypertension,atherogenic dyslipidemia,an abnormal percentage of body fat(PBF)and/or visceral fat area(VFA)and decreased estimated insulin sensitivity.Skin autofluorescence of advanced glycation end products(SAF-AGEs),diabetic complications,and DD features were assessed,and their association with the HGI was analyzed.RESULTS A discrepancy was observed between HbA1c and GMI among patients with T1D and DD.A higher HGI was associated with an increased number of SAF-AGEs and a higher prevalence of diabetic microangiopathy(P=0.030),particularly retinopathy(P=0.031).Patients with three or more DD features exhibited an eight-fold increased risk of having a high HGI,compared with those without DD features(adjusted odds ratio=8.12;95%confidence interval:1.52-43.47).Specifically,an elevated PBF and/or VFA and decreased estimated insulin sensitivity were associated with high HGI.Regression analysis identified estimated insulin sensitivity and VFA as factors independently associated with HGI.CONCLUSION In patients with T1D,DD features are associated with a higher HGI,which represents a trend toward excessive glycosylation and is associated with a higher prevalence of chronic diabetic complications.
基金Supported by the Scientific Research Project of Hospital Pharmacy of Guangxi Pharmaceutical Association in 2022,No.GXYXH1-202202.
文摘BACKGROUND Gastric cancer(GC)is the fifth most common cancer and the third leading cause of cancer-related deaths in China.Many patients with GC frequently experience symptoms related to the disease,including anorexia,nausea,vomiting,and other discomforts,and often suffer from malnutrition,which in turn negatively affects perioperative safety,prognosis,and the effectiveness of adjuvant therapeutic measures.Consequently,some nutritional indicators such as nutritional risk index(NRI),prognostic nutritional index(PNI),and systemic immune-inflammatorynutritional index(SIINI)can be used as predictors of the prognosis of GC patients.AIM To examine the prognostic significance of PNI,NRI,and SIINI in postoperative patients with GC.METHODS A retrospective analysis was conducted on the clinical data of patients with GC who underwent surgical treatment at the Guangxi Medical University Cancer Hospital between January 2010 and December 2018.The area under the receiver operating characteristic(ROC)curve was assessed using ROC curve analysis,and the optimal cutoff values for NRI,PNI,and SIINI were identified using the You-Review-HTMLden index.Survival analysis was performed using the Kaplan-Meier method.In addition,univariate and multivariate analyses were conducted using the Cox proportional hazards regression model.RESULTS This study included a total of 803 patients.ROC curves were used to evaluate the prognostic ability of NRI,PNI,and SIINI.The results revealed that SIINI had superior predictive accuracy.Survival analysis indicated that patients with GC in the low SIINI group had a significantly better survival rate than those in the high SIINI group(P<0.05).Univariate analysis identified NRI[hazard ratio(HR)=0.68,95%confidence interval(CI):0.52-0.89,P=0.05],PNI(HR=0.60,95%CI:0.46-0.79,P<0.001),and SIINI(HR=2.10,95%CI:1.64-2.69,P<0.001)as prognostic risk factors for patients with GC.However,multifactorial analysis indicated that SIINI was an independent risk factor for the prognosis of patients with GC(HR=1.65,95%CI:1.26-2.16,P<0.001).CONCLUSION Analysis of clinical retrospective data revealed that SIINI is a valuable indicator for predicting the prognosis of patients with GC.Compared with NRI and PNI,SIINI may offer greater application for prognostic assessment.
基金supported by NNSFC grants 42150101,42188105,42304189National Key R&D program of China No.2021YFA-0718600the Pandeng Program of National Space Science Center,Chinese Academy of Sciences.
文摘The Dst index has been commonly used to measure the geomagnetic effectiveness of magnetic storm events for several decades.Based on Burton’s empirical Dst model and the global magneto-hydrodynamic(MHD)simulation of Earth’s magnetosphere,here we proposed a semi-empirical model to forecast the Dst index during geomagnetic storms.In this model,the ring current contribution to the Dst index is derived from Burton’s model,while the contributions from other current systems are obtained from the global MHD simulation.In order to verify the model accuracy,a number of recent magnetic storm events are tested and the simulated Dst index is compared with the observation through the correlation coefficient(CC),prediction efficiency(PE),root mean square error(RMSE)and central root mean square error(CRMSE).The results indicate that,in the context of moderate and intense geomagnetic storm events,the semi-empirical model performs well in global MHD simulations,showing relatively higher CC and PE,and lower RMSE and CRMSE compared to those from the empirical model.Compared with the physics-based ring current models,this model inherits the advantage of fast processing from the empirical model,and easy implementation in a global MHD model of Earth’s magnetosphere.Therefore,it is suitable for the Dst estimation under a context of a global MHD simulation.
文摘Extreme weather events,such as floods and droughts,are expected to rise significantly worldwide as a result of climate change.Investigating future drought patterns is therefore a key approach for elaborating anticipatory water resources management responses to climate change.In this paper,future meteorological drought conditions are investigated based on the SPEI(Standardised Precipitation Evapotranspiration Index).This study makes use of observed and projected data.The simulated data were retrieved from the CMIP6(Coupled Model Intercomparison Project Phase 6)over the period 2025-2050,and the Delta change method was adopted to remove the bias in the dataset.Then SPEI at various scales has been estimated under four future scenarios(SSP1-2.6,SSP2-4.5,SSP3-7.0 and SSP5-8.5).The trend analysis of the projected SPEI was performed at p<0.05 using the MMK(Modified Mann-Kendall)test in order to detect the statistically significant trend of the drought against the null hypothesis of no trend.Results show large variability in the magnitude of drought in the past and future.Based on SPEI at 24 months accumulation,the result shows that under SSP1-2.6,the basin will experience a wet period during the first decade(SPEI=0.60),the second decade will be dry(SPEI24=-0.43).The remaining years will be also dry(SPEI=-0.34).Under SSP2-4.5,SSP3-7.0 and SSP5-8.5 scenarios,the district will experience a wet period during the first two decades with SPEI ranging from 0.38 to 0.59.This wet period will be followed by a dry period under these scenarios ranging from-0.14 to-0.06.Overall,under SSPs scenarios,two main periods characterized by a rainfall recovery spanning from followed by a moderately prolonged drought are identified within the study area.The findings of this study may provide valuable information for developing proactive measures to reduce water insecurity in Fada N’Gourma through effective drought mitigation.
基金Supported by the Clinical+X Scientific Research Project of Affiliated Hospital of Qingdao University,No.QYFY+X202101060Natural Science Foundation of Shandong Province,No.ZR2023MH240.
文摘BACKGROUND Acute kidney injury(AKI)is a frequent complication after liver transplantation(LT).How to realize the early diagnosis of AKI,perform active intervention,and reduce the mortality of post-LT patients is an urgent problem to be solved.AIM To investigate the accuracy of hepatorenal index(HRI)and renal resistive index(RRI)in monitoring of early AKI after LT.METHODS This observational study included adult deceased-donor LT recipients at our center between February 2022 and February 2023 with no preoperative renal dysfunction.The HRI and RRI were recorded once per day in the postoperative period through to postoperative day(POD)7.We followed up with the patients at 1 month after LT.The patients were divided into the AKI and non-AKI groups according to the Kidney Disease Improving Global Outcomes criteria.RESULTS Of 121 patients were included in the study(mean age:50.18±8.88years;female:17.36%).AKI developed in 53 patients(43.80%).The AKI and non-AKI groups were similar in terms of their baseline characteristics.An HRI of≤1.12 on POD 1 detected AKI with a sensitivity of 62.30%and a specificity of 87.80%[area under the receiver operating characteristic curve(AUC)=0.801,P<0.01].An RRI of≥0.65 on POD 1 detected AKI with a sensitivity of 87.80%and a specificity of 67.60%(AUC=0.825,P<0.01).The HRI combined with the RRI was more effective at detecting AKI than either the HRI or RRI alone(AUC=0.890,P<0.01).The HRI increased as AKI resolved while the RRI decreased as AKI resolved.CONCLUSION The HRI and RRI are non-invasive bedside indices that can identify the occurrence and recovery of early AKI after LT.
文摘The statistics of the China natural gas industry prosperity index showed that the China natural gas industry prosperity index was 357.68 in the 2nd quarter of 2025,up 3.1% from the 1st quarter of 2025,a stably prosperous state in the short term and a very prosperous state in the medium to long term;the prosperity index of natural gas production companies was 542.01 in the 2nd quarter of 2025,up 4.8% from the 1st quarter of 2025,an increasingly prosperous state in the short term and a very prosperous state in the medium to long term;the prosperity index of natural gas sales companies was 209.06 in the 2nd quarter of 2025,up 0.4% from the 1st quarter of 2025,an increasing prosperity in the short term and a prosperous state in the medium to long term;the prosperity trend index of the natural gas industry in the coming year for the 2nd quarter of 2025 was 765.70,up 4.1% from the 1st quarter of 2025,a very prosperous state,indicating that natural gas industry experts are optimistic about the natural gas industry’s prosperity trend in the coming year.See Fig.1 and Table 1 for details.
文摘On June 12th, 2024, Clarivate Analytics officially notified that the journal of Chinese Medicine and Culture (CMC) met the necessary selection criteria, and has been included in the Emerging Sources Citation Index(ESCI) database. The journal is expected to receive its first Impact Factor(IF) in 2025, marking a new stage of its development.
基金support provided by the National Natural Science Foundation of China(No:62361012)the Guizhou Science and Technology Department Foundation(ZK[2021]302)the invaluable backing from the Intelligent Evaluation and Early Warning Innovation Team for the Quality of Electric Power Equipment Manufacturing in Higher Education Institutions in Guizhou Province(QJJ[2023]064).
文摘This paper investigates the performance of a simultaneous wireless information and power transfer(SWIPT)enabled two-way one-relay(TWOR)system based on generalized carrier index differential chaos shift keying(GCI-DCSK).We derive the expressions for the proposed scheme’s bit error rate(BER),considering both additive white Gaussian noise(AWGN)and multipath Rayleigh fading channels.The simulation results demonstrate that the proposed SWIPT-enabled GCI-DCSK TWOR system performs slightly worse than the DCSK TWOR system without SWIPT at the same distance.However,a notable advantage of the proposed system is that the relay node is self-sustainable,which is particularly significant considering the challenges associated with battery replacement in relay nodes.Furthermore,we derive the outage probability and validate the accuracy of the derived formulas using simulation results.
文摘BACKGROUND The correlation between geriatric nutritional risk index(GNRI)and the prognosis of patients with osteoporosis or osteopenia has not been studied.This study aims to explore the relationship between GNRI and the cardiovascular disease(CVD)and all-cause mortality rates in elderly patients with osteoporosis or osteopenia.METHODS This study included 4756 patients with osteoporosis and osteopenia from five cycles of the National Health and Nutrition Examination Survey(NHANES).We used multivariable Cox regression and subgroup analyses to investigate the correlation between GNRI and mortality rates.The restricted cubic spline analysis was used to assess the dose-response relationship between GNRI and mortality risk.Mediation analysis was conducted to examine the mediating effect of chronic kidney disease on the relationship between nutritional risk and mortality.RESULTS During a median follow-up period of 114 months,a total of 1241 deaths(26.09%)occurred,including 300 deaths due to CVD(6.31%).In the fully adjusted Model 3,compared to the no-risk group,the risk group showed significantly increased all-cause mortality risk(HR=2.05,95%CI:1.74–2.40)and CVD mortality risk(HR=1.88,95%CI:1.30–2.71).The restricted cubic spline analysis indicated a non-linear association between GNRI and all-cause mortality risk as well as CVD mortality risk.The mediation analysis results indicated that chronic kidney disease mediates 16.9%of the effect of nutritional risk on all-cause mortality and 25.3%on CVD mortality risk.CONCLUSIONS GNRI can serve as a predictive factor for all-cause and CVD mortality rates in elderly patients with osteoporosis or osteopenia.
文摘BACKGROUND Primary liver cancer,particularly hepatocellular carcinoma(HCC),ranks as the sixth most prevalent cancer globally and the third major cause of cancerassociated mortality.Despite the available immunotherapies and combined immunotherapy and targeted therapy,the prognosis for many patients remains dismal.Accurately identifying the appropriate patient cohorts is crucial for improving treatment outcomes.AIM To investigate the prognostic value of the triglyceride-glucose(TyG)index-a novel,accessible marker of insulin resistance-in predicting therapeutic outcomes among patients with hepatitis B virus(HBV)-related HCC treated with camrelizumab and lenvatinib.METHODS In this study,we conducted a retrospective review of 278 patients diagnosed with stage B/C HBV-related HCC who underwent combination therapy.Based on their TyG index,patients were categorized into high and low TyG index groups.A nomogram prediction model was developed based on independent prognostic factors for overall survival(OS)and validated using the C-index and calibration curves.RESULTS Of the 278 patients enrolled in the study,144 were assigned to the high TyG index group,while the remaining 134 were classified into the low index group.Importantly,patients with a low TyG index demonstrated a significantly prolonged median progression-free survival and OS relative to those with a high index.Additionally,the objective response rate and disease control rate were 22.39%and 64.18%in the low TyG index group,whereas they were 12.50%and 51.39%in the high TyG index group,respectively.Moreover,the incidence of hypertension was higher in the high TyG index group than in the low TyG index group.The incidence of other adverse effects did not differ significantly between the groups.Multivariate regression analysis identified independent prognostic factors for OS,including the Barcelona Clinic Liver Cancer stage,alpha-fetoprotein level,Eastern Cooperative Oncology Group score,distant metastasis,and the TyG index.The risk ratio of the TyG index was 0.48(95%confidence interval:0.31-0.72,P<0.001).CONCLUSION The TyG index is a reliable long-term predictor of response to combined immunotherapy and targeted therapy in patients with HBV-related HCC.Patients with a low TyG index tend to experience better clinical outcomes.
基金supported by a grant from the National Re-search Foundation of Korea(grant number:RS-2022-00165755).
文摘Background:Although the prognostic nutritional index(PNI)may predict surgical outcomes in certain cancers,the impact of PNI on surgical prognosis in patients undergoing pylorus-preserving pancreati-coduodenectomy(PPPD)is unclear.This study aimed to investigate the impact of preoperative PNI on mortality rate and cancer recurrence rate in patients who underwent PPPD.Methods:A total of 718 patients who were diagnosed with periampullary or pancreatic cancer and un-derwent PPPD between January 2012 and December 2016 were analyzed.Patients were categorized into two groups using the optimal cut-offvalue for PNI,determined by calculating the receiver operating characteristic(ROC)curve and the Youden index.We performed propensity score matching(PSM)anal-ysis to compare the mortality rate and cancer recurrence rate between the two groups.In addition,Cox regression analyses were performed to examine the association of PNI with mortality rate and cancer recurrence rate.Results:Using the 1-year mortality as an endpoint,the area under the ROC curve for PNI was 0.620(opti-mal cut-offvalue:41.7).We observed significant differences in 1-year(P=0.001),5-year(P=0.002),and overall(P=0.001)mortality;1-year(P=0.013),5-year(P=0.032),and overall(P=0.017)cancer re-currence between groups after PSM.High PNI was significantly associated with reduced 1-year[adjusted hazard ratio(HR)=0.44,95%confidence interval(CI):0.26-0.74,P=0.020],5-year(HR=0.66,95%CI:0.52-0.84,P<0.001),and overall(HR=0.71,95%CI:0.57-0.88,P=0.002)mortality;1-year(HR=0.70,95%CI:0.52-0.93,P=0.016),5-year(HR=0.78,95%CI:0.62-0.97,P=0.027)and overall(HR=0.78,95%CI:0.63-0.97,P=0.024)cancer recurrence.Conclusions:Preoperative PNI may serve as an independent factor for short-and long-term surgical prog-nosis in cancer patients undergoing PPPD.
基金supported by the CAMS Innovation Fund for Medical Sciences(CIFMS)[grant number 2021-I2M-1-037]the National Natural Science Foundation of China[grant numbers 82373647,and 82473697].
文摘Objective This study aimed to explore the association between body mass index(BMI)and mortality based on the 10-year population-based multicenter prospective study.Methods A general population-based multicenter prospective study was conducted at four sites in rural China between 2013 and 2023.Multivariate Cox proportional hazards models and restricted cubic spline analyses were used to assess the association between BMI and mortality.Stratified analyses were performed based on the individual characteristics of the participants.Results Overall,19,107 participants with a sum of 163,095 person-years were included and 1,910 participants died.The underweight(<18.5 kg/m^(2))presented an increase in all-cause mortality(adjusted hazards ratio[aHR]=2.00,95%confidence interval[CI]:1.66–2.41),while overweight(≥24.0 to<28.0 kg/m^(2))and obesity(≥28.0 kg/m^(2))presented a decrease with an aHR of 0.61(95%CI:0.52–0.73)and 0.51(95%CI:0.37–0.70),respectively.Overweight(aHR=0.76,95%CI:0.67–0.86)and mild obesity(aHR=0.72,95%CI:0.59–0.87)had a positive impact on mortality in people older than 60 years.All-2 cause mortality decreased rapidly until reaching a BMI of 25.7 kg/m(aHR=0.95,95%CI:0.92–0.98)and increased slightly above that value,indicating a U-shaped association.The beneficial impact of being overweight on mortality was robust in most subgroups and sensitivity analyses.Conclusion This study provides additional evidence that overweight and mild obesity may be inversely related to the risk of death in individuals older than 60 years.Therefore,it is essential to consider age differences when formulating health and weight management strategies.
基金supported by the Natural Science Foundation of Tianjin City (No.19JCYBJC17000)the National Natural Science Foundation of China (No.11905159)。
文摘A D-type photonic crystal fiber(PCF) sensor based on surface plasmon resonance(SPR) principle is designed.In order to excite the SPR effect,a gold film is plated on the open-loop channel of the sensor,the free electrons in a metal are resonated with photons.The structural parameters are fine-tuned and the sensing performance of the sensor is studied.The results show that the maximum spectral sensitivity reaches 18 000 nm/RIU in the refractive index range of 1.24—1.32,and the maximum resolution is 5.56×10^(-6) RIU.The novel structure with high sensitivity and low refractive index provides a new perspective for fluid density detection.
文摘Advanced gastric cancer(GC)remains a high-mortality malignancy despite progress in diagnosis and treatment,including immunotherapy.Reliable prognostic markers are essential for better patient stratification.The triglycerideglucose(TyG)index,a marker of insulin resistance,has shown promise in various cancers,but its role in GC remains unclear.Yao et al investigated its prognostic value in 300 patients with advanced GC receiving immunotherapy and chemotherapy.Their model,which integrates the TyG index,programmed death-ligand 1 expression,and Eastern Cooperative Oncology Group performance status,underscores the impact of metabolic dysfunction on immune response and treatment efficacy.This letter examines the TyG index’s potential as a prognostic tool in GC and its implications for treatment strategies guided by metabolic and immune factors,as demonstrated in Yao et al research.
文摘This paper focuses on the optimization of the evaluation index system for the value of transportation infrastructure assets.It analyzes the shortcomings of the current system and explores the directions for optimizing the index system from the perspectives of functionality,economy,social impact,environmental impact,and sustainability.The paper also discusses the application of the optimized index system in practical evaluation and the measures to ensure its effectiveness.The research aims to enhance the evaluation mechanism for the value of transportation infrastructure assets,providing a more scientific basis for decision-making,addressing challenges in asset management,improving the level of asset management in transportation infrastructure,and meeting the demands of high-quality development in the transportation sector in the new era.
基金supported by grants from the Joint Tackling Project of Pudong Health Committee of Shanghai(PW2022D08)Medical Discipline Construction Project of Pudong Health Committee of Shanghai(PWZxq2022-6)+1 种基金Health and Family Planning Research Project of Pudong Health Committee of Shanghai(PW2021A-38)Youth Scientific Research Cultivation Fund Project of Shanghai Oriental Hospital(DFPY2022020).
文摘Objective The geriatric nutritional risk index(GNRI)is widely used for nutritional assessment.Poor nutritional status is associated with complications and poor survival in cirrhotic patients.We aimed to investigate the value of the GNRI in predicting outcomes in cirrhotic patients.Methods This retrospective study included 420 cirrhotic patients from three centers between 2013 and 2017.Patients were divided into the high GNRI group(≥92)and low GNRI group(<92).Overall survival(OS)in the two groups was evaluated via the Kaplan‒Meier method.Cox proportional hazards model was used to estimate the value of the GNRI in predicting outcomes.Restricted cubic spline model was used to intuitively display the dose‒response associations between the GNRI and OS.A nomogram was constructed to predict OS.Results During the 2-year follow-up period,58(13.81%)patients died,and 262(62.38%)patients experienced episodes of complications.Compared with patients in the low GNRI group,those in the high GNRI group had lower mortality rates(18.73%vs.5.23%,P<0.001).The GNRI was an independent predictor of OS(hazard ratio[HR]=0.958,95%confidence interval[CI]0.929–0.988,P=0.007).The GNRI was associated with the cumulative incidence of ascites(HR=0.954,95%CI 0.940–0.969,P<0.001),spontaneous bacterial peritonitis(HR=0.928,95%CI 0.891–0.966,P<0.001),hepatic encephalopathy(HE;HR=0.944,95%CI 0.920–0.968,P<0.001),and hepatorenal syndrome(HRS)(HR=0.916,95%CI 0.861–0.974,P=0.005).Furthermore,6 independent factors were included to construct the nomogram for OS prediction,including GNRI,age,total bilirubin,serum sodium,history of HE and HRS.The C statistics of our model were 0.83(95%CI 0.75–0.90)and 0.80(95%CI 0.73–0.86)at 1 and 2 years,respectively.Patients whose GNRI score decreased within 3 and 6 months had poorer outcomes(P<0.001).Conclusions The lower GNRI score was associated with the higher cumulative incidence of complications and poorer OS of cirrhotic patients.The GNRI could be a helpful tool for assessing nutritional status and prognosis of these patients.
