BACKGROUND Gastric cancer is one of the most common cancers worldwide,especially in East Asia.AIM To explore the clinical outcomes and progression-related factors of low-grade intraepithelial neoplasia(LGIN)in the gas...BACKGROUND Gastric cancer is one of the most common cancers worldwide,especially in East Asia.AIM To explore the clinical outcomes and progression-related factors of low-grade intraepithelial neoplasia(LGIN)in the gastric mucosa and provide valuable guidance for improving treatment efficacy.METHODS A total of 357 patients diagnosed with LGIN based on initial pathological examination in Anhui Provincial Hospital or three other medical consortium units between January 2022 and June 2024 were included.Among them,296 patients were followed up with endoscopic and biopsy pathology.Logistic regression was utilized to analyze the relevant risk factors for LGIN progression in the gastric mucosa.RESULTS The distribution sites of LGIN among the 357 patients were as follows:Gastric antrum(54.6%),gastric cardia(24.1%),gastric angulus(8.7%),gastric body(4.8%),gastric fundus(4.8%),and multiple sites(3.1%).Additionally,of the 357 patients with LGIN,112(31.4%)developed ulceration and 59(16.5%)experienced gastric polyps.Furthermore,231 of the 357(64.71%)patients with LGIN tested positive for Helicobacter pylori(H.pylori)infection.The H.pylori infection rates of the patients with LGIN with accompanying atrophy,intestinal metaplasia,and gastric ulcer were 51.95%,59.31%,and 28.57%,respectively.Multivariate logistic regression analysis showed that age≥60 years[odds ratio(OR)=3.063,95%confidence interval(CI):1.351-6.945,P=0.007],H.pylori infection(OR=3.560,95%CI:1.158-10.949,P=0.027),multiple locations(OR=10.136,95%CI:2.045-50.237,P=0.005),lesion size≥2 cm(OR=3.921,95%CI:1.664-9.237,P=0.002),and gastric ulcer(OR=2.730,95%CI:1.197-6.223,P=0.017)were predictive factors for LGIN progression.CONCLUSION LGIN progression is closely related to age,H.pylori positivity,multiple locations,lesion size≥2 cm,and gastric ulcer.Thus,actively identifying these risk factors in patients with LGIN may have certain clinical significance in preventing further tumor progression.展开更多
Rapid population aging has led to an increased focus on age-related conditions such as sarcopenia.causing loss of muscle mass and strength^([1,2]). Sarcopenia is associated with adverse outcomes,including falls, funct...Rapid population aging has led to an increased focus on age-related conditions such as sarcopenia.causing loss of muscle mass and strength^([1,2]). Sarcopenia is associated with adverse outcomes,including falls, functional decline, frailty, and mortality, which can lower the quality of life and shorten lifespan^([1,2]).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
BACKGROUND Attention deficit hyperactivity disorder(ADHD)affects approximately 5%of children worldwide and is associated with significant academic impairment.Parents of children with ADHD experience elevated stress an...BACKGROUND Attention deficit hyperactivity disorder(ADHD)affects approximately 5%of children worldwide and is associated with significant academic impairment.Parents of children with ADHD experience elevated stress and anxiety levels,which may further affect their children's educational outcomes.This prospective study examined the relationship between parental anxiety and academic performance of children with ADHD over a 6-year period.AIM To investigate the longitudinal impact of parental anxiety on academic performance in children with ADHD and explore the mediating and moderating factors over a 6-year follow-up period.METHODS A longitudinal cohort study was conducted from 2018 to 2024,enrolling 118 children with ADHD(aged 6-12 years)and their parents from three specialized educational centers.Parental anxiety was assessed using the Parenting Stress Index-4(PSI-4)and Parental Anxiety Scale.Children's academic performance was measured using the Academic Performance Questionnaire and standardized achievement tests.Assessments were conducted at baseline and every 6 months for 3 years.RESULTS Higher parental anxiety scores were significantly associated with poorer academic performance in children with ADHD(β=-0.42,P<0.001).Children of parents with clinically significant anxiety(PSI-4 scores>85th percentile)showed 1.2 standard deviations lower academic achievement than children of parents with normal anxiety levels.The relationship was partially mediated by parent-child interaction quality(indirect effect=-0.18,95%CI:-0.26 to-0.10)and homework supervision practices(indirect effect=-0.15,95%CI:-0.22 to-0.08).CONCLUSION Parental anxiety could significantly affect the academic outcomes of children with ADHD via multiple pathways.Interventions targeting parental mental health may improve the educational outcomes of children with ADHD.展开更多
The urinary, psychosocial, organ-specific, infection, neurological/systemic and tenderness （UPOINT） phenotype system has been validated to be an effective phenotype system in classifying patients with chronic prosta...The urinary, psychosocial, organ-specific, infection, neurological/systemic and tenderness （UPOINT） phenotype system has been validated to be an effective phenotype system in classifying patients with chronic prostatitis/chronic pelvic pain syndrome （CP/CPPS） in western populations. To validate the utility of the UPOINT system and evaluate the effect of multimodal therapy based on the UPOINT system in Chinese patients with CPICPPS, we performed this study. Chinese patients with CP/CPPS were prospectively offered multimodal therapy using the UPOINT system and re-examined after 6 months. A minimum 6-point drop in National Institutes of Health-Chronic Prostatitis Symptoms Index （NIH-CPSI） was set to be the primary endpoint. Finally, 140 patients were enrolled in the study. The percentage of patients with each domain was 59.3%, 45.0%, 49.3%, 22.1%, 37.9%, and 56.4% for the UPOINT, respectively. The number of positive domains significantly correlated with symptom severity, which is measured by total NIH-CPSI scores （r = 0.796, P 〈 0.001）. Symptom duration was associated with a greater number of positive domains （r = 0.589, P〈 0.001）. With 6 months follow-up at least, 75.0% （105/140） had at least a 6-point improvement in NIH-CPSI after taking the therapy. All NIH-CPSI scores were significantly improved from original ones： pain 10.14 ± 4.26 to 6.60 ± 3.39, urinary 6.29 ± 2.42 to 3.63 ± 1.52, quality of life 6.56 ± 2.44 to 4.06 ± 1.98, and total 22.99 ± 7.28 to 14.29 ±5.70 （all P〈 0.0001）. Our study indicates that the UPOINT system is clinically feasible in classifying Chinese patients with CP/CPPS and directing therapy.展开更多
AIM： To examine whether peanut consumption is associated with a reduced risk of colorectal cancer in a prospective cohort with a 10-year follow-up. METHODS： In 1990-1992, residents （12026 men and 11917 women aged 3...AIM： To examine whether peanut consumption is associated with a reduced risk of colorectal cancer in a prospective cohort with a 10-year follow-up. METHODS： In 1990-1992, residents （12026 men and 11917 women aged 30 to 65 years） in 7 townships, Taiwan, were interviewed and recruited into a cancerscreening cohort and annually followed up. Colorectal cancer cases in this cohort were identified from cancer registry and death certificates. Incidence rates of this disease by the end of 2001 were calculated by gender for the primary study variable and covariates. The dietary intake was assessed by means of weekly food frequency measures, including frequently consumed food groups and folk dishes including sweet potato, bean products, peanut products, pickled foodstuffs, nitrated or smoked foodstuffs. RESULTS： During the study period, 107 new colorectal cancer cases （68 men and 39 women） were confirmed. The multivariate Cox＇s proportional hazard model showed that the relative risk （RR） of peanut consumption was 0.73 [95% confidence interval （CI） = 0.44-1.21] for men and 0.42 （95% CI = 0.21-0.84） for women. However, frequent intake of pickled foodstuffs was harmful for women （RR= 2.15, 95% CI=0.99-4.65）. The risk of colorectal cancer was also elevated among cigarette smokers but not significant （P〈 0.05）.CONCLUSION： This study suggests that frequent intake of peanut and its products may reduce colorectal cancer risk in women, demonstrating the anti-proliferating effect of peanut intake.展开更多
Objective We aimed to evaluate the combined effect of a family history of cardiovascular disease（CVD） and high serum C‐reactive protein（CRP） on the stroke incidence in an Inner Mongolian population in China. Meth...Objective We aimed to evaluate the combined effect of a family history of cardiovascular disease（CVD） and high serum C‐reactive protein（CRP） on the stroke incidence in an Inner Mongolian population in China. Methods A prospective cohort study was conducted from June 2002 to July 2012, with 2,544 participants aged 20 years and over from Inner Mongolia, China. We categorized participants into four groups based on the family history of CVD and CRP levels. Results We adjusted for age; sex; smoking; drinking; hypertension; body mass index; waist circumference; and blood glucose, triglycerides, low‐density lipoprotein cholesterol, and high‐density lipoprotein cholesterol levels. Compared with the group with no family history of CVD/low CRP levels, the group with family history of CVD/high CRP levels had a hazard ratio（HR） of 1.78 [95% confidence interval（CI）, 1.03‐3.07; P = 0.039] of stroke, and an HR of 2.14（95% CI, 1.09‐4.20; P = 0.027） of ischemic stroke. The HRs of hemorrhagic stroke for the other three groups were not statistically significant（all P 〉 0.05）. Conclusion Participants with both a family history of CVD and high CRP levels had the highest stroke incidence, suggesting that high CRP levels may increase stroke risk, especially of ischemic stroke, among individuals with a family history of CVD.展开更多
BACKGROUND Although radical surgery for colorectal cancer improves the oncological outcomes,a significant portion of patients suffer from alterations in their quality of life(QoL).There are many studies investigating ...BACKGROUND Although radical surgery for colorectal cancer improves the oncological outcomes,a significant portion of patients suffer from alterations in their quality of life(QoL).There are many studies investigating the QoL of patients who have colorectal cancer but none of these focus on the QoL of spouses.AIM To compare the QoL of patients after colorectal surgery to the QoL of spouses.METHODS This prospective study consisted of patients who were married and who underwent surgery at the University of Ankara,Department of Surgery between March 2006 and November 2010.Patients’spouses were also enrolled.The study was approved by the Ethics Committee of the Faculty of Medicine,Ankara University,and all patients provided written informed consent.The study included patients who underwent curative surgery for colorectal carcinoma[n=100;abdominoperineal excision(n=33),low anterior resection(n=33),left hemicolectomy(n=34)]and their spouses(n=100).The patients and spouses completed the Medical Outcome Study 36-item Short Form Survey(SF-36)and the World Health Organization Disability Assessment Schedule II(WHODAS-II)preoperatively and at postoperative months 15 to 18.RESULTS During this 4.5-year study period,273 patients with sigmoid or rectal cancer were admitted to the hospital.Of these patients,119 were eligible and willing to participate.Eleven patients had either systemic or locally inoperable disease,three patients had a severe surgical complication,and five patients were lost to followup.Therefore,a total of 100 patients completed the follow-up period.There was a statistically significant positive correlation between the disability scores of patients and the scores of their spouses for some of the WHODAS-II subscales,such as“self-care,”“life activities,”and“participation in society,”as well as for the total WHODAS-II score.There was also a positive correlation between the QoL of patients and the QoL of their spouses in most of the SF-36 subscales.Statistically significant correlations were observed for the“bodily pain,”“general health,””vitality,”“social function,”“emotion,”“mental health,”and mental component summary score subscales of the SF-36.When gender differences were evaluated,the QoL of male patients’spouses changed more when compared with female patients’spouses for all of the WHODAS-II subscales.Colorectal cancer surgery has a significant effect on the QoL of both patients and their spouses,these effects were more significant among male patients’spouses.CONCLUSION Preoperative counseling regarding potential problems should therefore collectively address patient and their spouse as a couple rather than the patient alone,particularly for patients undergoing low anterior resection and abdominoperineal resection procedures.展开更多
BACKGROUND Manipulation under anesthesia(MUA)of the shoulder joint is a commonly used method for the treatment of adhesive capsulitis.Though it has been known to be associated with a variety of complications,there is ...BACKGROUND Manipulation under anesthesia(MUA)of the shoulder joint is a commonly used method for the treatment of adhesive capsulitis.Though it has been known to be associated with a variety of complications,there is a paucity of studies describing the arthroscopic findings after MUA.AIM To describe the arthroscopic findings in patients with idiopathic adhesive capsulitis of the shoulder after MUA.METHODS We recruited 28 patients with idiopathic adhesive capsulitis who underwent arthroscopic capsular release.Manipulation of the shoulder was performed under anesthesia in all of these patients before capsular release.Intra-articular findings were recorded during arthroscopic capsular release in these patients.RESULTS All patients showed the presence of synovitis.Twenty-seven patients showed tears in the capsule on the anterior aspect.One patient had an avulsion of the anterior rim of the glenoid and labrum following the manipulation.Four patients had partial rotator cuff tears,and one patient showed a superior labrum anterior posterior lesion,which was not diagnosed preoperatively on magnetic resonance imaging.CONCLUSION MUA leads to rupture of the capsule,which is the desired outcome.However,the site of rupture of the capsule is dependent on the maneuvers of MUA.In addition,partial tears of the rotator cuff and osteochondral fractures of the glenoid can also occur.展开更多
Objectives To study characteristics of psychosomatic symptoms related to sterilization, to find out risk factors and their roles ascribed to psychosomatic symptoms, and to establish a mathematic model for screening...Objectives To study characteristics of psychosomatic symptoms related to sterilization, to find out risk factors and their roles ascribed to psychosomatic symptoms, and to establish a mathematic model for screening out susceptible women. Methods: This study enrolled 776 women in rural area at three counties of Linxiang, Qiyang, Changsha of Hunan province in China between February 1990 and April 1992. Brief Neurosis Screening Scale (BNSS), Symptom Checklist 90 (SCL-90), sensitivity to pain, suggestibility were used to indicate subjects' psychological status. Logistic regression model and retrograde discriminant analysis were applied to develop a mathematical model. Results: Prevalence of psychosomatic reactions or symptoms was 54.8% before sterilization, 26.6% at three months and 16.4% at one year after operation respectively. Psychosomatic symptoms were verified to be the result of joint effects of multiple risk factors. The following risk factors were associated with postoperative symptoms: anger-hostility (RR=33.71), high suggestibility (RR=4.53), high neuroticism (RR=3.44), sensitivity to pain (RR=2.14) and operative sites (RR=2.05). A mathematical model to estimate the probability of developing psychosomatic symptoms in sterilization was established.Conclusions: More than half of women suffered from psychosomatic reactions before operation, and some of them did not recover after operation. The postoperative psychosomatic symptoms are the joint effect of multiple risk factors.展开更多
Objective:To observe the clinical results and therapeutic characteristics of Tongluo Shenggu Decoction in the treatment of ARCOⅡnon-traumatic femoral head necrosis.Methods:120 patients with ARCOⅡnon-traumatic femora...Objective:To observe the clinical results and therapeutic characteristics of Tongluo Shenggu Decoction in the treatment of ARCOⅡnon-traumatic femoral head necrosis.Methods:120 patients with ARCOⅡnon-traumatic femoral head necrosis from January 2016 to January 2017 were studied by prospective matched and controlled design.60 cases in the treatment group were treated with Tongluo Shenggu Formula.The control group(60 cases)received high energy extracorporeal shock wave therapy.The imaging stability rate,Harris score and SF-36 score were used as clinical efficacy indicators,followed up for 24 months,and the follow-up results were statistically analyzed.Results:Among the 120 patients,5 fell off and the rest were followed up.The imaging stability rate is heavy.The imaging stability rate of the patients in the treatment group is 78.95%,while that in the control group is 72.41%.The two groups have the same stability rate(P>0.05).In Harris score,the Harris score of the patients in the treatment group was 92.678.45 points,significantly higher than that of the control group(80.3924.65 points),the difference was statistically significant(p<0.05),and the pain degree,joint function and joint deformity score of the treatment group were better than those of the control group(p<0.05).In the SF-36 score,the scores of physiological function,physiological function,physical pain,overall health,social function and emotional function in the treatment group were significantly higher than those in the control group,the difference was statistically significant(p<0.05).the incidence of adverse events in the treatment period of the two groups was lower and the patients could relieve themselves in the later stage.Conclusion:Tongluo Shenggu prescription has definite curative effect in treating ARCOⅡnon-traumatic femoral head necrosis,especially in improving hip joint function,relieving hip joint pain and improving quality of life.To observe the clinical results and therapeutic characteristics of Tongluo Shenggu Decoction in the treatment of ARCOⅡnon-traumatic femoral head necrosis.Methods:120 patients with ARCOⅡnon-traumatic femoral head necrosis from January 2016 to January 2017 were studied by prospective matched and controlled design.60 cases in the treatment group were treated with Tongluo Shenggu Formula.The control group(60 cases)received high energy extracorporeal shock wave therapy.The imaging stability rate,Harris score and SF-36 score were used as clinical efficacy indicators,followed up for 24 months,and the follow-up results were statistically analyzed.Results:Among the 120 patients,5 fell off and the rest were followed up.The imaging stability rate is heavy.The imaging stability rate of the patients in the treatment group is 78.95%,while that in the control group is 72.41%.The two groups have the same stability rate(P>0.05).In Harris score,the Harris score of the patients in the treatment group was 92.678.45 points,significantly higher than that of the control group(80.3924.65 points),the difference was statistically significant(p<0.05),and the pain degree,joint function and joint deformity score of the treatment group were better than those of the control group(p<0.05).In the SF-36 score,the scores of physiological function,physiological function,physical pain,overall health,social function and emotional function in the treatment group were significantly higher than those in the control group,the difference was statistically significant(p<0.05).the incidence of adverse events in the treatment period of the two groups was lower and the patients could relieve themselves in the later stage.Conclusion:Tongluo Shenggu prescription has definite curative effect in treating ARCOⅡnon-traumatic femoral head necrosis,especially in improving hip joint function,relieving hip joint pain and improving quality of life.展开更多
A prospective study on the relationship between garlic and gastric cancer of 4552 subjects was made from Oct., 1980 through 1985. The volunteers, aged 50-59, were healthy males and came from different incidence areas ...A prospective study on the relationship between garlic and gastric cancer of 4552 subjects was made from Oct., 1980 through 1985. The volunteers, aged 50-59, were healthy males and came from different incidence areas of gastric cancer where they lived for long periods. The result of this study showed that the death rates of gastric cancer in < 2500 g and >500 g groups of annual garlic intake were 10.40/ 10000 and 0, respectively. The relative risk of gastric cancer was significantly much higher in the former than in the latter, and showed a dose-response relationship. Protective effect of garlic for the population equal annual garlic intake was roughly the same in different districts. It was further confirmed that garlic played important role in preventing gastric cancer and had no regional differences.展开更多
AIM:To determine the role of interferon(IFN)with or withoutribavirin in preventing or delaying hepatocellular carcinoma(HCC)development in patients with hepatitis C virus(HCV)related cirrhosis.Data on the preventive e...AIM:To determine the role of interferon(IFN)with or withoutribavirin in preventing or delaying hepatocellular carcinoma(HCC)development in patients with hepatitis C virus(HCV)related cirrhosis.Data on the preventive effect of IFN plusribavirin treatment are lacking.METHODS:A total of 101 patients(62 males and 39 females,mean age 55.1±1.4 years)with histologically proven HCVrelated liver cirrhosis plus compatible biochemistry andultrasonography were enrolled in the study.Biochemistryand ultrasonography were performed every 6 mo.Ultrasoundguided liver biopsy was performed on all detected focallesions.Follow-up lasted for 5 years.Cellular proliferation,evaluated by measuring Ag-NOR proteins in hepatocytesnuclei,was expressed as AgNOR-Proliferative index(AgNOR-PI)(cut-off=2.5).Forty-one patients(27 males,14 females)were only followed up after the end of anyearly treatment with IFN-alpha2b(old treatment controlgroup=OTCG).Sixty naive patients were stratified accordingto sex and AgNOR-PI and then randomized in two groups:30 were treated with IFN-alpha2b+ribavirin(treatmentgroup=TG),the remaining were not treated(control group=CG).Nonresponders(NR)or relapsers in the TG receivedfurther IFN/ribavirin treatments after a 6 mo of withdrawal.RESULTS:AgNOR-PI was significantly lowered by IFN(P<0.001).HCC incidence was higher in patients withAgNOR-PI>2.5(26% vs3%,P<0.01).Two NR in the OTCG,none in the TG and 9 patients in the CG developed HCCduring follow-up.The Kaplan-Mayer survival curves showedstatistically significant differences both between OTCG andCG(P<0.004)and between TG and CG(P<0.003).CONCLUSION:IFN/ribavirin treatment associated with re-treatment courses of NR seems to produce the best resultsin terms of HCC prevention.AgNOR-PI is a useful markerof possible HCC development.展开更多
Background:Many studies have shown that carotenoids are beneficial to non-alcoholic fatty liver disease(NAFLD).Therefore,we explored potential biomarkers of gut microbiota and fecal and serum metabolites linking the a...Background:Many studies have shown that carotenoids are beneficial to non-alcoholic fatty liver disease(NAFLD).Therefore,we explored potential biomarkers of gut microbiota and fecal and serum metabolites linking the association between serum carotenoids and NAFLD in adults.Methods:This 7.8-year prospective study included 2921 participants with serum carotenoids at baseline and determined NAFLD by ultrasonography(ULS-NAFLD)every 3 years.A total of 828 subjects additionally underwent magnetic resonance imaging to identify NAFLD(MRI-NAFLD).Gut microbiota was analyzed by 16S rRNA sequencing in 1,661 participants,and targeted metabolomics profiling in 893 feces and 896 serum samples was performed by ultrahigh-performance liquid chromatography-tandem mass spectrometry(UPLC-MS/MS)in the middle term.Results:A total of 2,522 participants finished follow-up visits.Of these participants,770,301,474,and 977 were categorized into NAFLD-free,improved,new-onset,and persistent NAFLD groups based on their ULS-NAFLD status changes,respectively,and 342/828 were MRI-verified NALFD.Longitudinal analyses showed an inverse association between carotenoids and NALFD risk/presence(P-trend<0.05).Multivariable-adjusted odds ratios(ORs)/hazard ratio(HR)[95%confidence intervals(CIs)]of NAFLD for quartile 4(vs.quartile 1)of total carotenoids were 0.63(0.50,0.80)for incident ULS-NAFLD,0.20(0.15,0.27)for persistent ULS-NAFLD,1.53(1.10,2.12)for improved-NAFLD,and 0.58(0.39,0.87)for MRI-NAFLD.The biomarkers in the gut-liver axis significantly associated with both serum carotenoids and NAFLD included sixteen microbial genera mainly in Ruminococcaceae and Veillonellaceae family,nineteen fecal metabolites containing medium-chain fatty acids(MCFAs),bile acids,and carnitines,and sixteen serum metabolites belonging to organic acids and amino acids.The total carotenoids-related scores of significant microbial genera,fecal and serum metabolites mediated the carotenoids-NAFLD association by 8.72%,12.30%,and 16.83%(all P<0.05)for persistent NAFLD and 9.46%,8.74%,and 15.7%for incident-NAFLD,respectively.Conclusions:Our study reveals a beneficial association of serum carotenoids and incident and persistent NAFLD.The identified gut-liver axis biomarkers provided mechanistic linkage for the epidemiological association.展开更多
BACKGROUND Excessive noise in healthcare environments—commonly described as"unwanted sound"—has been linked to a range of negative impacts on both patients and staff.In clinical settings,elevated noise lev...BACKGROUND Excessive noise in healthcare environments—commonly described as"unwanted sound"—has been linked to a range of negative impacts on both patients and staff.In clinical settings,elevated noise levels have been associated with sleep disruption,heightened cardiovascular stress,and an increased risk of delirium in patients.Among healthcare workers,noise can impair focus and cognitive performance,potentially compromising care quality.AIM To evaluate the effectiveness of educational and behavioural interventions in reducing noise levels within intensive care units(ICUs),recognizing their potential impact on patient outcomes and healthcare effectiveness.METHODS A prospective interventional study in two Singaporean teaching hospitals compared peak and average sound levels between control and intervention groups.An educational and behavioural intervention comprising talks,posters,and self-audits by nurse champions was initiated in two ICUs in one hospital on November 18,2023.Sound measurements were collected at 4 Locations within each ICU before and after intervention.Baseline measurements were taken from October 22,2023 to October 29,2023,and post-intervention measurements from December 21,2023 to December 22,2023.The hospitals served as the primary exposure variable,controlled for ICU type(medical vs surgical)and hour of the day.RESULTS Our analysis generated 48 pairs of peak and average sound level readings for each unit(control n=48 readings;intervention n=48 readings).The effect of the intervention was associated with a significant 4.8 dB decrease in average sound level(P=0.009)and a nonsignificant 4.3 dB decrease in peak sound level(P=0.104),adjusted for hour of day and type of ICU.CONCLUSION Educational and behavioural interventions successfully reduced average sound levels,emphasizing their positive impact on noise control.These findings contribute valuable insights for optimizing noise reduction efforts in critical care settings.Future studies may explore additional systemic and environmental interventions to enhance noise management strategies.展开更多
This prospective study aimed to investigate the associations of untreated cholesterol levels and their longitudinal changes,especially low levels,with all-cause and cause-specific mortality in different populations.Pa...This prospective study aimed to investigate the associations of untreated cholesterol levels and their longitudinal changes,especially low levels,with all-cause and cause-specific mortality in different populations.Participants were drawn from two Chinese cohorts and the UK Biobank,excluding those with lipid-lowering medications,coronary heart disease(CHD),stroke,cancer,clinically diagnosed chronic obstructive pulmonary disease,low body mass index(<18.5 kg·m^(-2))at baseline,and deaths within the first two years to minimize reverse causality.Individual cholesterol changes were assessed in a subset who attended the resurvey after over four years.Mortality data were linked to registries,and risks were estimated using Cox proportional hazards models.A total of 163115 Chinese and 317305 UK adults were included(mean age,49-61 years),with 43%,81%,and 44%males in Dongfeng-Tongji,Kailuan,and UK Biobank cohorts,respectively.During a median follow-up of 9.7-12.9 years,9553 and 15760 deaths were documented in the Chinese cohorts and UK Biobank,respectively.After multivariate adjustments,nonlinear relationships were observed between total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),and non-high-density lipoprotein cholesterol(non-HDL-C)levels and mortality.In both populations,high cholesterol was primarily associated with CHD mortality,while low cholesterol associated with all-cause and cancer mortality(Pnonlinear≤0.0161).The optimal levels for all-cause mortality risk in Chinese adults(TC:200 mg·dL^(-1);LDL-C:130 mg·dL^(-1);non-HDL-C:155 mg·dL^(-1))were lower than those in the UK Biobank but consistent with guideline recommendation.Additionally,decreasing cholesterol levels over four years were associated with higher all-cause and cancer mortality in the Chinese cohorts(P_(nonlinear)≤0.0100).Participants with low TC,LDL-C,or non-HDL-C levels at both baseline and resurvey experienced elevated all-cause mortality risks in both populations,as did those with low/medium baseline levels and>20%reductions over time in Chinese adults.In conclusion,higher TC,LDL-C,and non-HDL-C levels are associated with elevated CHD mortality.Importantly,low and/or longitudinally decreasing cholesterol levels are robustly associated with increased all-cause and cancer mortality,potentially serving as markers of premature death.Regular cholesterol monitoring,with attention to both high and low levels,is recommended to inform guideline updates and clinical strategies.展开更多
BACKGROUND Anxiety is a common comorbidity in patients with Crohn’s disease(CD).Data on the imaging characteristics of brain microstructure and cerebral perfusion in CD with anxiety are limited.AIM To compare the ima...BACKGROUND Anxiety is a common comorbidity in patients with Crohn’s disease(CD).Data on the imaging characteristics of brain microstructure and cerebral perfusion in CD with anxiety are limited.AIM To compare the imaging characteristics of brain microstructure and cerebral perfusion among CD patients with or without anxiety and healthy individuals.METHODS This prospective comparative study enrolled consecutive patients with active CD and healthy individuals who visited the study hospital between January 2022 and January 2023.Anxiety was measured using the Hospital Anxiety and Depression Scale-Anxiety.The imaging characteristics of brain microstructure and cerebral perfusion were measured by diffusion kurtosis imaging and intravoxel incoherent motion.RESULTSA total of 57 participants were enrolled. Among the patients with active CD, 16 had anxiety. Compared withhealthy individuals, patients with active CD demonstrated significantly lower radial kurtosis values in the rightcerebellar region 6, lower axial kurtosis (AK) values in the right insula, left superior temporal gyrus, and rightthalamus, and higher slow and fast apparent diffusion coefficients (ADCslow and ADCfast) in the bilateral frontal lobe,bilateral temporal lobe, and bilateral insular lobe (all P < 0.05). Compared with patients with CD without anxiety,patients with CD and anxiety exhibited significantly higher ADCslow values in the left insular lobe and lower AKvalues in the right insula and right anterior cuneus (all P < 0.05).CONCLUSIONThere are variations in brain microstructure and perfusion among CD patients with/without anxiety and healthyindividuals, suggesting potential use in assessing anxiety-related changes in active CD.展开更多
Introduction:Effective detection methods to distinguish between transient human papillomavirus(HPV)infection and clinically relevant high-risk HPV(hrHPV)-induced diseases are lacking,leading to excessive referrals and...Introduction:Effective detection methods to distinguish between transient human papillomavirus(HPV)infection and clinically relevant high-risk HPV(hrHPV)-induced diseases are lacking,leading to excessive referrals and overtreatment.This study evaluated the clinical performance of a host DNA sixmethylation marker panel(ASTN1,DLX1,ITGA4,RXFP3,SOX17,and ZNF671)to triage Chinese women who were hrHPV-positive.Methods:This prospective multicenter study enrolled women aged 21-65 years with positive hrHPV testing.hrHPV genotyping,cytology,colposcopy,and the six-methylation marker assay were performed.High-grade cervical lesions were defined as histologically confirmed CIN2+.Forest plots analyses were performed to assess the triage performance of the methylation assay.Results:Of the 1,806 patients recruited from 4 hospitals in China,1,659 were included.The methylation assay positivity rates were 7.5%,73.9%,88.9%,and 100%for CIN1,CIN2,CIN3,and cervical cancer,respectively.The six-methylation marker assay demonstrated sensitivities of 82.2%and 90.3%and specificities of 92.4%and 84.1%for CIN2+and CIN3+,respectively,which were higher than those of HPV genotype testing and cytology(≥ASCUS)screening;the areas under the curve for CIN3+detection were 0.87(0.84-0.90),0.68(0.64-0.72),and 0.64(0.60-0.69),respectively.The six-methylation marker assay showed the lowest colposcopy referral rate(24.2%)and required the fewest referrals for detection,with 1.32 and 2.39 referrals per CIN2+and CIN3+cases,respectively.In women aged<30 years,the six-methylation marker assay had the highest specificity for CIN2+(95.7%)and a sensitivity and specificity for CIN3+of 80.8%and 88.9%,respectively.It had the lowest referral rate(17.17%)and colposcopy referrals,with 1.24 and 2.43 per CIN2+and CIN3+cases,respectively.Conclusions:The host DNA six-methylation marker assay is a reliable triage tool for women who are hrHPV-positive,providing evidence supporting the application of methylation markers in China.展开更多
基金the Research Project of the Chinese Digestive Early Cancer Physicians’Joint Growth Program,No.GTCZ-2021-AH-34-0012.
文摘BACKGROUND Gastric cancer is one of the most common cancers worldwide,especially in East Asia.AIM To explore the clinical outcomes and progression-related factors of low-grade intraepithelial neoplasia(LGIN)in the gastric mucosa and provide valuable guidance for improving treatment efficacy.METHODS A total of 357 patients diagnosed with LGIN based on initial pathological examination in Anhui Provincial Hospital or three other medical consortium units between January 2022 and June 2024 were included.Among them,296 patients were followed up with endoscopic and biopsy pathology.Logistic regression was utilized to analyze the relevant risk factors for LGIN progression in the gastric mucosa.RESULTS The distribution sites of LGIN among the 357 patients were as follows:Gastric antrum(54.6%),gastric cardia(24.1%),gastric angulus(8.7%),gastric body(4.8%),gastric fundus(4.8%),and multiple sites(3.1%).Additionally,of the 357 patients with LGIN,112(31.4%)developed ulceration and 59(16.5%)experienced gastric polyps.Furthermore,231 of the 357(64.71%)patients with LGIN tested positive for Helicobacter pylori(H.pylori)infection.The H.pylori infection rates of the patients with LGIN with accompanying atrophy,intestinal metaplasia,and gastric ulcer were 51.95%,59.31%,and 28.57%,respectively.Multivariate logistic regression analysis showed that age≥60 years[odds ratio(OR)=3.063,95%confidence interval(CI):1.351-6.945,P=0.007],H.pylori infection(OR=3.560,95%CI:1.158-10.949,P=0.027),multiple locations(OR=10.136,95%CI:2.045-50.237,P=0.005),lesion size≥2 cm(OR=3.921,95%CI:1.664-9.237,P=0.002),and gastric ulcer(OR=2.730,95%CI:1.197-6.223,P=0.017)were predictive factors for LGIN progression.CONCLUSION LGIN progression is closely related to age,H.pylori positivity,multiple locations,lesion size≥2 cm,and gastric ulcer.Thus,actively identifying these risk factors in patients with LGIN may have certain clinical significance in preventing further tumor progression.
基金supported by the Ministry of Education Chunhui Program Collaborative Scientific Research Projects(Grant No.:HZKY20220286)Henan Province Foreign Experts Introduction Program(Grant No.:HNGD2022021)+1 种基金Natural Science Foundation of Henan Province(Grant No.:23230042151)the Foundation of the National Key Program of Research and Development of China(Grant No.:2016YFC0900803)。
文摘Rapid population aging has led to an increased focus on age-related conditions such as sarcopenia.causing loss of muscle mass and strength^([1,2]). Sarcopenia is associated with adverse outcomes,including falls, functional decline, frailty, and mortality, which can lower the quality of life and shorten lifespan^([1,2]).
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.
文摘BACKGROUND Attention deficit hyperactivity disorder(ADHD)affects approximately 5%of children worldwide and is associated with significant academic impairment.Parents of children with ADHD experience elevated stress and anxiety levels,which may further affect their children's educational outcomes.This prospective study examined the relationship between parental anxiety and academic performance of children with ADHD over a 6-year period.AIM To investigate the longitudinal impact of parental anxiety on academic performance in children with ADHD and explore the mediating and moderating factors over a 6-year follow-up period.METHODS A longitudinal cohort study was conducted from 2018 to 2024,enrolling 118 children with ADHD(aged 6-12 years)and their parents from three specialized educational centers.Parental anxiety was assessed using the Parenting Stress Index-4(PSI-4)and Parental Anxiety Scale.Children's academic performance was measured using the Academic Performance Questionnaire and standardized achievement tests.Assessments were conducted at baseline and every 6 months for 3 years.RESULTS Higher parental anxiety scores were significantly associated with poorer academic performance in children with ADHD(β=-0.42,P<0.001).Children of parents with clinically significant anxiety(PSI-4 scores>85th percentile)showed 1.2 standard deviations lower academic achievement than children of parents with normal anxiety levels.The relationship was partially mediated by parent-child interaction quality(indirect effect=-0.18,95%CI:-0.26 to-0.10)and homework supervision practices(indirect effect=-0.15,95%CI:-0.22 to-0.08).CONCLUSION Parental anxiety could significantly affect the academic outcomes of children with ADHD via multiple pathways.Interventions targeting parental mental health may improve the educational outcomes of children with ADHD.
文摘The urinary, psychosocial, organ-specific, infection, neurological/systemic and tenderness （UPOINT） phenotype system has been validated to be an effective phenotype system in classifying patients with chronic prostatitis/chronic pelvic pain syndrome （CP/CPPS） in western populations. To validate the utility of the UPOINT system and evaluate the effect of multimodal therapy based on the UPOINT system in Chinese patients with CPICPPS, we performed this study. Chinese patients with CP/CPPS were prospectively offered multimodal therapy using the UPOINT system and re-examined after 6 months. A minimum 6-point drop in National Institutes of Health-Chronic Prostatitis Symptoms Index （NIH-CPSI） was set to be the primary endpoint. Finally, 140 patients were enrolled in the study. The percentage of patients with each domain was 59.3%, 45.0%, 49.3%, 22.1%, 37.9%, and 56.4% for the UPOINT, respectively. The number of positive domains significantly correlated with symptom severity, which is measured by total NIH-CPSI scores （r = 0.796, P 〈 0.001）. Symptom duration was associated with a greater number of positive domains （r = 0.589, P〈 0.001）. With 6 months follow-up at least, 75.0% （105/140） had at least a 6-point improvement in NIH-CPSI after taking the therapy. All NIH-CPSI scores were significantly improved from original ones： pain 10.14 ± 4.26 to 6.60 ± 3.39, urinary 6.29 ± 2.42 to 3.63 ± 1.52, quality of life 6.56 ± 2.44 to 4.06 ± 1.98, and total 22.99 ± 7.28 to 14.29 ±5.70 （all P〈 0.0001）. Our study indicates that the UPOINT system is clinically feasible in classifying Chinese patients with CP/CPPS and directing therapy.
基金Supported by the Grant NSC 2000-2314-B-002-373, NSC 2001-2320-B-002-123 and NSC 2002-2320-B-002-121 from the National Science Council, Taipei, Taiwan, China
文摘AIM： To examine whether peanut consumption is associated with a reduced risk of colorectal cancer in a prospective cohort with a 10-year follow-up. METHODS： In 1990-1992, residents （12026 men and 11917 women aged 30 to 65 years） in 7 townships, Taiwan, were interviewed and recruited into a cancerscreening cohort and annually followed up. Colorectal cancer cases in this cohort were identified from cancer registry and death certificates. Incidence rates of this disease by the end of 2001 were calculated by gender for the primary study variable and covariates. The dietary intake was assessed by means of weekly food frequency measures, including frequently consumed food groups and folk dishes including sweet potato, bean products, peanut products, pickled foodstuffs, nitrated or smoked foodstuffs. RESULTS： During the study period, 107 new colorectal cancer cases （68 men and 39 women） were confirmed. The multivariate Cox＇s proportional hazard model showed that the relative risk （RR） of peanut consumption was 0.73 [95% confidence interval （CI） = 0.44-1.21] for men and 0.42 （95% CI = 0.21-0.84） for women. However, frequent intake of pickled foodstuffs was harmful for women （RR= 2.15, 95% CI=0.99-4.65）. The risk of colorectal cancer was also elevated among cigarette smokers but not significant （P〈 0.05）.CONCLUSION： This study suggests that frequent intake of peanut and its products may reduce colorectal cancer risk in women, demonstrating the anti-proliferating effect of peanut intake.
基金supported by the National Natural Science Foundation of China(grants:30972531 and 81320108026)a Project of the Priority Academic Program Development of Jiangsu Higher Education Institutions
文摘Objective We aimed to evaluate the combined effect of a family history of cardiovascular disease（CVD） and high serum C‐reactive protein（CRP） on the stroke incidence in an Inner Mongolian population in China. Methods A prospective cohort study was conducted from June 2002 to July 2012, with 2,544 participants aged 20 years and over from Inner Mongolia, China. We categorized participants into four groups based on the family history of CVD and CRP levels. Results We adjusted for age; sex; smoking; drinking; hypertension; body mass index; waist circumference; and blood glucose, triglycerides, low‐density lipoprotein cholesterol, and high‐density lipoprotein cholesterol levels. Compared with the group with no family history of CVD/low CRP levels, the group with family history of CVD/high CRP levels had a hazard ratio（HR） of 1.78 [95% confidence interval（CI）, 1.03‐3.07; P = 0.039] of stroke, and an HR of 2.14（95% CI, 1.09‐4.20; P = 0.027） of ischemic stroke. The HRs of hemorrhagic stroke for the other three groups were not statistically significant（all P 〉 0.05）. Conclusion Participants with both a family history of CVD and high CRP levels had the highest stroke incidence, suggesting that high CRP levels may increase stroke risk, especially of ischemic stroke, among individuals with a family history of CVD.
文摘BACKGROUND Although radical surgery for colorectal cancer improves the oncological outcomes,a significant portion of patients suffer from alterations in their quality of life(QoL).There are many studies investigating the QoL of patients who have colorectal cancer but none of these focus on the QoL of spouses.AIM To compare the QoL of patients after colorectal surgery to the QoL of spouses.METHODS This prospective study consisted of patients who were married and who underwent surgery at the University of Ankara,Department of Surgery between March 2006 and November 2010.Patients’spouses were also enrolled.The study was approved by the Ethics Committee of the Faculty of Medicine,Ankara University,and all patients provided written informed consent.The study included patients who underwent curative surgery for colorectal carcinoma[n=100;abdominoperineal excision(n=33),low anterior resection(n=33),left hemicolectomy(n=34)]and their spouses(n=100).The patients and spouses completed the Medical Outcome Study 36-item Short Form Survey(SF-36)and the World Health Organization Disability Assessment Schedule II(WHODAS-II)preoperatively and at postoperative months 15 to 18.RESULTS During this 4.5-year study period,273 patients with sigmoid or rectal cancer were admitted to the hospital.Of these patients,119 were eligible and willing to participate.Eleven patients had either systemic or locally inoperable disease,three patients had a severe surgical complication,and five patients were lost to followup.Therefore,a total of 100 patients completed the follow-up period.There was a statistically significant positive correlation between the disability scores of patients and the scores of their spouses for some of the WHODAS-II subscales,such as“self-care,”“life activities,”and“participation in society,”as well as for the total WHODAS-II score.There was also a positive correlation between the QoL of patients and the QoL of their spouses in most of the SF-36 subscales.Statistically significant correlations were observed for the“bodily pain,”“general health,””vitality,”“social function,”“emotion,”“mental health,”and mental component summary score subscales of the SF-36.When gender differences were evaluated,the QoL of male patients’spouses changed more when compared with female patients’spouses for all of the WHODAS-II subscales.Colorectal cancer surgery has a significant effect on the QoL of both patients and their spouses,these effects were more significant among male patients’spouses.CONCLUSION Preoperative counseling regarding potential problems should therefore collectively address patient and their spouse as a couple rather than the patient alone,particularly for patients undergoing low anterior resection and abdominoperineal resection procedures.
基金The study was approved by the institutional ethical committee(IESC/T-300/02.08.2013).
文摘BACKGROUND Manipulation under anesthesia(MUA)of the shoulder joint is a commonly used method for the treatment of adhesive capsulitis.Though it has been known to be associated with a variety of complications,there is a paucity of studies describing the arthroscopic findings after MUA.AIM To describe the arthroscopic findings in patients with idiopathic adhesive capsulitis of the shoulder after MUA.METHODS We recruited 28 patients with idiopathic adhesive capsulitis who underwent arthroscopic capsular release.Manipulation of the shoulder was performed under anesthesia in all of these patients before capsular release.Intra-articular findings were recorded during arthroscopic capsular release in these patients.RESULTS All patients showed the presence of synovitis.Twenty-seven patients showed tears in the capsule on the anterior aspect.One patient had an avulsion of the anterior rim of the glenoid and labrum following the manipulation.Four patients had partial rotator cuff tears,and one patient showed a superior labrum anterior posterior lesion,which was not diagnosed preoperatively on magnetic resonance imaging.CONCLUSION MUA leads to rupture of the capsule,which is the desired outcome.However,the site of rupture of the capsule is dependent on the maneuvers of MUA.In addition,partial tears of the rotator cuff and osteochondral fractures of the glenoid can also occur.
文摘Objectives To study characteristics of psychosomatic symptoms related to sterilization, to find out risk factors and their roles ascribed to psychosomatic symptoms, and to establish a mathematic model for screening out susceptible women. Methods: This study enrolled 776 women in rural area at three counties of Linxiang, Qiyang, Changsha of Hunan province in China between February 1990 and April 1992. Brief Neurosis Screening Scale (BNSS), Symptom Checklist 90 (SCL-90), sensitivity to pain, suggestibility were used to indicate subjects' psychological status. Logistic regression model and retrograde discriminant analysis were applied to develop a mathematical model. Results: Prevalence of psychosomatic reactions or symptoms was 54.8% before sterilization, 26.6% at three months and 16.4% at one year after operation respectively. Psychosomatic symptoms were verified to be the result of joint effects of multiple risk factors. The following risk factors were associated with postoperative symptoms: anger-hostility (RR=33.71), high suggestibility (RR=4.53), high neuroticism (RR=3.44), sensitivity to pain (RR=2.14) and operative sites (RR=2.05). A mathematical model to estimate the probability of developing psychosomatic symptoms in sterilization was established.Conclusions: More than half of women suffered from psychosomatic reactions before operation, and some of them did not recover after operation. The postoperative psychosomatic symptoms are the joint effect of multiple risk factors.
基金Science foundation for postdoctoral researches in China(2017 M613179)Studio construction project of Traumatology and orthopedics of traditional Chinese medicine Guo family genre([2018]40)
文摘Objective:To observe the clinical results and therapeutic characteristics of Tongluo Shenggu Decoction in the treatment of ARCOⅡnon-traumatic femoral head necrosis.Methods:120 patients with ARCOⅡnon-traumatic femoral head necrosis from January 2016 to January 2017 were studied by prospective matched and controlled design.60 cases in the treatment group were treated with Tongluo Shenggu Formula.The control group(60 cases)received high energy extracorporeal shock wave therapy.The imaging stability rate,Harris score and SF-36 score were used as clinical efficacy indicators,followed up for 24 months,and the follow-up results were statistically analyzed.Results:Among the 120 patients,5 fell off and the rest were followed up.The imaging stability rate is heavy.The imaging stability rate of the patients in the treatment group is 78.95%,while that in the control group is 72.41%.The two groups have the same stability rate(P>0.05).In Harris score,the Harris score of the patients in the treatment group was 92.678.45 points,significantly higher than that of the control group(80.3924.65 points),the difference was statistically significant(p<0.05),and the pain degree,joint function and joint deformity score of the treatment group were better than those of the control group(p<0.05).In the SF-36 score,the scores of physiological function,physiological function,physical pain,overall health,social function and emotional function in the treatment group were significantly higher than those in the control group,the difference was statistically significant(p<0.05).the incidence of adverse events in the treatment period of the two groups was lower and the patients could relieve themselves in the later stage.Conclusion:Tongluo Shenggu prescription has definite curative effect in treating ARCOⅡnon-traumatic femoral head necrosis,especially in improving hip joint function,relieving hip joint pain and improving quality of life.To observe the clinical results and therapeutic characteristics of Tongluo Shenggu Decoction in the treatment of ARCOⅡnon-traumatic femoral head necrosis.Methods:120 patients with ARCOⅡnon-traumatic femoral head necrosis from January 2016 to January 2017 were studied by prospective matched and controlled design.60 cases in the treatment group were treated with Tongluo Shenggu Formula.The control group(60 cases)received high energy extracorporeal shock wave therapy.The imaging stability rate,Harris score and SF-36 score were used as clinical efficacy indicators,followed up for 24 months,and the follow-up results were statistically analyzed.Results:Among the 120 patients,5 fell off and the rest were followed up.The imaging stability rate is heavy.The imaging stability rate of the patients in the treatment group is 78.95%,while that in the control group is 72.41%.The two groups have the same stability rate(P>0.05).In Harris score,the Harris score of the patients in the treatment group was 92.678.45 points,significantly higher than that of the control group(80.3924.65 points),the difference was statistically significant(p<0.05),and the pain degree,joint function and joint deformity score of the treatment group were better than those of the control group(p<0.05).In the SF-36 score,the scores of physiological function,physiological function,physical pain,overall health,social function and emotional function in the treatment group were significantly higher than those in the control group,the difference was statistically significant(p<0.05).the incidence of adverse events in the treatment period of the two groups was lower and the patients could relieve themselves in the later stage.Conclusion:Tongluo Shenggu prescription has definite curative effect in treating ARCOⅡnon-traumatic femoral head necrosis,especially in improving hip joint function,relieving hip joint pain and improving quality of life.
文摘A prospective study on the relationship between garlic and gastric cancer of 4552 subjects was made from Oct., 1980 through 1985. The volunteers, aged 50-59, were healthy males and came from different incidence areas of gastric cancer where they lived for long periods. The result of this study showed that the death rates of gastric cancer in < 2500 g and >500 g groups of annual garlic intake were 10.40/ 10000 and 0, respectively. The relative risk of gastric cancer was significantly much higher in the former than in the latter, and showed a dose-response relationship. Protective effect of garlic for the population equal annual garlic intake was roughly the same in different districts. It was further confirmed that garlic played important role in preventing gastric cancer and had no regional differences.
文摘AIM:To determine the role of interferon(IFN)with or withoutribavirin in preventing or delaying hepatocellular carcinoma(HCC)development in patients with hepatitis C virus(HCV)related cirrhosis.Data on the preventive effect of IFN plusribavirin treatment are lacking.METHODS:A total of 101 patients(62 males and 39 females,mean age 55.1±1.4 years)with histologically proven HCVrelated liver cirrhosis plus compatible biochemistry andultrasonography were enrolled in the study.Biochemistryand ultrasonography were performed every 6 mo.Ultrasoundguided liver biopsy was performed on all detected focallesions.Follow-up lasted for 5 years.Cellular proliferation,evaluated by measuring Ag-NOR proteins in hepatocytesnuclei,was expressed as AgNOR-Proliferative index(AgNOR-PI)(cut-off=2.5).Forty-one patients(27 males,14 females)were only followed up after the end of anyearly treatment with IFN-alpha2b(old treatment controlgroup=OTCG).Sixty naive patients were stratified accordingto sex and AgNOR-PI and then randomized in two groups:30 were treated with IFN-alpha2b+ribavirin(treatmentgroup=TG),the remaining were not treated(control group=CG).Nonresponders(NR)or relapsers in the TG receivedfurther IFN/ribavirin treatments after a 6 mo of withdrawal.RESULTS:AgNOR-PI was significantly lowered by IFN(P<0.001).HCC incidence was higher in patients withAgNOR-PI>2.5(26% vs3%,P<0.01).Two NR in the OTCG,none in the TG and 9 patients in the CG developed HCCduring follow-up.The Kaplan-Mayer survival curves showedstatistically significant differences both between OTCG andCG(P<0.004)and between TG and CG(P<0.003).CONCLUSION:IFN/ribavirin treatment associated with re-treatment courses of NR seems to produce the best resultsin terms of HCC prevention.AgNOR-PI is a useful markerof possible HCC development.
文摘Background:Many studies have shown that carotenoids are beneficial to non-alcoholic fatty liver disease(NAFLD).Therefore,we explored potential biomarkers of gut microbiota and fecal and serum metabolites linking the association between serum carotenoids and NAFLD in adults.Methods:This 7.8-year prospective study included 2921 participants with serum carotenoids at baseline and determined NAFLD by ultrasonography(ULS-NAFLD)every 3 years.A total of 828 subjects additionally underwent magnetic resonance imaging to identify NAFLD(MRI-NAFLD).Gut microbiota was analyzed by 16S rRNA sequencing in 1,661 participants,and targeted metabolomics profiling in 893 feces and 896 serum samples was performed by ultrahigh-performance liquid chromatography-tandem mass spectrometry(UPLC-MS/MS)in the middle term.Results:A total of 2,522 participants finished follow-up visits.Of these participants,770,301,474,and 977 were categorized into NAFLD-free,improved,new-onset,and persistent NAFLD groups based on their ULS-NAFLD status changes,respectively,and 342/828 were MRI-verified NALFD.Longitudinal analyses showed an inverse association between carotenoids and NALFD risk/presence(P-trend<0.05).Multivariable-adjusted odds ratios(ORs)/hazard ratio(HR)[95%confidence intervals(CIs)]of NAFLD for quartile 4(vs.quartile 1)of total carotenoids were 0.63(0.50,0.80)for incident ULS-NAFLD,0.20(0.15,0.27)for persistent ULS-NAFLD,1.53(1.10,2.12)for improved-NAFLD,and 0.58(0.39,0.87)for MRI-NAFLD.The biomarkers in the gut-liver axis significantly associated with both serum carotenoids and NAFLD included sixteen microbial genera mainly in Ruminococcaceae and Veillonellaceae family,nineteen fecal metabolites containing medium-chain fatty acids(MCFAs),bile acids,and carnitines,and sixteen serum metabolites belonging to organic acids and amino acids.The total carotenoids-related scores of significant microbial genera,fecal and serum metabolites mediated the carotenoids-NAFLD association by 8.72%,12.30%,and 16.83%(all P<0.05)for persistent NAFLD and 9.46%,8.74%,and 15.7%for incident-NAFLD,respectively.Conclusions:Our study reveals a beneficial association of serum carotenoids and incident and persistent NAFLD.The identified gut-liver axis biomarkers provided mechanistic linkage for the epidemiological association.
文摘BACKGROUND Excessive noise in healthcare environments—commonly described as"unwanted sound"—has been linked to a range of negative impacts on both patients and staff.In clinical settings,elevated noise levels have been associated with sleep disruption,heightened cardiovascular stress,and an increased risk of delirium in patients.Among healthcare workers,noise can impair focus and cognitive performance,potentially compromising care quality.AIM To evaluate the effectiveness of educational and behavioural interventions in reducing noise levels within intensive care units(ICUs),recognizing their potential impact on patient outcomes and healthcare effectiveness.METHODS A prospective interventional study in two Singaporean teaching hospitals compared peak and average sound levels between control and intervention groups.An educational and behavioural intervention comprising talks,posters,and self-audits by nurse champions was initiated in two ICUs in one hospital on November 18,2023.Sound measurements were collected at 4 Locations within each ICU before and after intervention.Baseline measurements were taken from October 22,2023 to October 29,2023,and post-intervention measurements from December 21,2023 to December 22,2023.The hospitals served as the primary exposure variable,controlled for ICU type(medical vs surgical)and hour of the day.RESULTS Our analysis generated 48 pairs of peak and average sound level readings for each unit(control n=48 readings;intervention n=48 readings).The effect of the intervention was associated with a significant 4.8 dB decrease in average sound level(P=0.009)and a nonsignificant 4.3 dB decrease in peak sound level(P=0.104),adjusted for hour of day and type of ICU.CONCLUSION Educational and behavioural interventions successfully reduced average sound levels,emphasizing their positive impact on noise control.These findings contribute valuable insights for optimizing noise reduction efforts in critical care settings.Future studies may explore additional systemic and environmental interventions to enhance noise management strategies.
基金supported by the National Natural Science Foundation of China(82021005,82192903,81930092)the Chief Scientist Research Project of Hubei Shizhen Laboratory(HSL2024SX0003)+1 种基金the Fundamental Research Funds for the Central Universities(2019kfyXMBZ015)the 111 Project and the Program for Changjiang Scholars and Innovative Research Team in University.
文摘This prospective study aimed to investigate the associations of untreated cholesterol levels and their longitudinal changes,especially low levels,with all-cause and cause-specific mortality in different populations.Participants were drawn from two Chinese cohorts and the UK Biobank,excluding those with lipid-lowering medications,coronary heart disease(CHD),stroke,cancer,clinically diagnosed chronic obstructive pulmonary disease,low body mass index(<18.5 kg·m^(-2))at baseline,and deaths within the first two years to minimize reverse causality.Individual cholesterol changes were assessed in a subset who attended the resurvey after over four years.Mortality data were linked to registries,and risks were estimated using Cox proportional hazards models.A total of 163115 Chinese and 317305 UK adults were included(mean age,49-61 years),with 43%,81%,and 44%males in Dongfeng-Tongji,Kailuan,and UK Biobank cohorts,respectively.During a median follow-up of 9.7-12.9 years,9553 and 15760 deaths were documented in the Chinese cohorts and UK Biobank,respectively.After multivariate adjustments,nonlinear relationships were observed between total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),and non-high-density lipoprotein cholesterol(non-HDL-C)levels and mortality.In both populations,high cholesterol was primarily associated with CHD mortality,while low cholesterol associated with all-cause and cancer mortality(Pnonlinear≤0.0161).The optimal levels for all-cause mortality risk in Chinese adults(TC:200 mg·dL^(-1);LDL-C:130 mg·dL^(-1);non-HDL-C:155 mg·dL^(-1))were lower than those in the UK Biobank but consistent with guideline recommendation.Additionally,decreasing cholesterol levels over four years were associated with higher all-cause and cancer mortality in the Chinese cohorts(P_(nonlinear)≤0.0100).Participants with low TC,LDL-C,or non-HDL-C levels at both baseline and resurvey experienced elevated all-cause mortality risks in both populations,as did those with low/medium baseline levels and>20%reductions over time in Chinese adults.In conclusion,higher TC,LDL-C,and non-HDL-C levels are associated with elevated CHD mortality.Importantly,low and/or longitudinally decreasing cholesterol levels are robustly associated with increased all-cause and cancer mortality,potentially serving as markers of premature death.Regular cholesterol monitoring,with attention to both high and low levels,is recommended to inform guideline updates and clinical strategies.
基金Ethics Committee of Affiliated Changzhou Second People’s Hospital of Nanjing Medical University(approval number KY039-01).
文摘BACKGROUND Anxiety is a common comorbidity in patients with Crohn’s disease(CD).Data on the imaging characteristics of brain microstructure and cerebral perfusion in CD with anxiety are limited.AIM To compare the imaging characteristics of brain microstructure and cerebral perfusion among CD patients with or without anxiety and healthy individuals.METHODS This prospective comparative study enrolled consecutive patients with active CD and healthy individuals who visited the study hospital between January 2022 and January 2023.Anxiety was measured using the Hospital Anxiety and Depression Scale-Anxiety.The imaging characteristics of brain microstructure and cerebral perfusion were measured by diffusion kurtosis imaging and intravoxel incoherent motion.RESULTSA total of 57 participants were enrolled. Among the patients with active CD, 16 had anxiety. Compared withhealthy individuals, patients with active CD demonstrated significantly lower radial kurtosis values in the rightcerebellar region 6, lower axial kurtosis (AK) values in the right insula, left superior temporal gyrus, and rightthalamus, and higher slow and fast apparent diffusion coefficients (ADCslow and ADCfast) in the bilateral frontal lobe,bilateral temporal lobe, and bilateral insular lobe (all P < 0.05). Compared with patients with CD without anxiety,patients with CD and anxiety exhibited significantly higher ADCslow values in the left insular lobe and lower AKvalues in the right insula and right anterior cuneus (all P < 0.05).CONCLUSIONThere are variations in brain microstructure and perfusion among CD patients with/without anxiety and healthyindividuals, suggesting potential use in assessing anxiety-related changes in active CD.
文摘Introduction:Effective detection methods to distinguish between transient human papillomavirus(HPV)infection and clinically relevant high-risk HPV(hrHPV)-induced diseases are lacking,leading to excessive referrals and overtreatment.This study evaluated the clinical performance of a host DNA sixmethylation marker panel(ASTN1,DLX1,ITGA4,RXFP3,SOX17,and ZNF671)to triage Chinese women who were hrHPV-positive.Methods:This prospective multicenter study enrolled women aged 21-65 years with positive hrHPV testing.hrHPV genotyping,cytology,colposcopy,and the six-methylation marker assay were performed.High-grade cervical lesions were defined as histologically confirmed CIN2+.Forest plots analyses were performed to assess the triage performance of the methylation assay.Results:Of the 1,806 patients recruited from 4 hospitals in China,1,659 were included.The methylation assay positivity rates were 7.5%,73.9%,88.9%,and 100%for CIN1,CIN2,CIN3,and cervical cancer,respectively.The six-methylation marker assay demonstrated sensitivities of 82.2%and 90.3%and specificities of 92.4%and 84.1%for CIN2+and CIN3+,respectively,which were higher than those of HPV genotype testing and cytology(≥ASCUS)screening;the areas under the curve for CIN3+detection were 0.87(0.84-0.90),0.68(0.64-0.72),and 0.64(0.60-0.69),respectively.The six-methylation marker assay showed the lowest colposcopy referral rate(24.2%)and required the fewest referrals for detection,with 1.32 and 2.39 referrals per CIN2+and CIN3+cases,respectively.In women aged<30 years,the six-methylation marker assay had the highest specificity for CIN2+(95.7%)and a sensitivity and specificity for CIN3+of 80.8%and 88.9%,respectively.It had the lowest referral rate(17.17%)and colposcopy referrals,with 1.24 and 2.43 per CIN2+and CIN3+cases,respectively.Conclusions:The host DNA six-methylation marker assay is a reliable triage tool for women who are hrHPV-positive,providing evidence supporting the application of methylation markers in China.
