Objectives:To evaluate the occurrence of depression and its related factors among public health nurses(PHNs)engaged in child neglect-related abuse cases.Methods:A cross-sectional study of PHNs involved in maternal and...Objectives:To evaluate the occurrence of depression and its related factors among public health nurses(PHNs)engaged in child neglect-related abuse cases.Methods:A cross-sectional study of PHNs involved in maternal and child health or child and family welfare,and engaged in cases of child neglect-related abuse was conducted from January to March 2023 in all municipalities of 13 prefectures selected from Japan's seven regions,considering geographic diversity and major urban areas.The Patient Health Questionnaire-2 was used to screen for depression.Statistical analyses included the Chi-square test,Mann-Whitney U test,and logistic regression analysis.Results:A total of 359 provided valid responses.Among them,11.4%screened positive for depression.Significant individual factors related depression were management-stage nurses(OR=6.27,95%CI:1.63-24.18),no disability welfare experience(OR=3.49,95%CI:1.05-11.55),being assignment of highrisk cases within the past year(OR=8.28,95%CI:2.07-33.08),and lower work control(OR=0.53,95%CI:0.32-0.86).Workplace environment factors were lower perceptions and relationships within the workplace(OR=0.43,95%CI:0.29-0.65)and perceiving manpower as not secured(OR=9.07,95%CI:1.17-70.40),Conclusions:Mental health measures for PHNs should include workload management and reduced burdens through workforce enhancement,attention to burdens on managerial PHNs,promoting communication and mutual support,and opportunities to engage in disability welfare work.展开更多
Diamond combines many unique properties,including high stability,strong optical dispersion,excellent mechanical strength,and outstanding thermal conductivity.Its structure,surface groups,and electrical conductivity ar...Diamond combines many unique properties,including high stability,strong optical dispersion,excellent mechanical strength,and outstanding thermal conductivity.Its structure,surface groups,and electrical conductivity are also tunable,increasing its functional versatility.These make diamond and its related materials,such as its composites,highly promising for various applications in energy fields.This review summarizes recent advances and key achievements in energy storage and conversion,covering electrochemical energy storage(e.g.,batteries and supercapacitors),electrocatalytic energy conversion(e.g.,CO_(2)and nitrogen reduction reactions),and solar energy conversion(e.g.,photo-(electro)chemical CO_(2)and nitrogen reduction reactions,and solar cells).Current challenges and prospects related to the synthesis of diamond materials and the technologies for their energy applications are outlined and discussed.展开更多
This paper reviews the related formulas of Sugemule,introduces the advances in research of clinical application of these formulas in treating Heyi type insomnia,cardiac diseases,and renal diseases.Besides,it summarize...This paper reviews the related formulas of Sugemule,introduces the advances in research of clinical application of these formulas in treating Heyi type insomnia,cardiac diseases,and renal diseases.Besides,it summarizes pharmacological research advances regarding these formulas,including their anti-insomnia effects,cardioprotective properties,and ovarian function preservation capabilities.This study is expected to provide a reference and insight for in-depth and systematic research on classical Mongolian medicinal formulas.展开更多
Aging,mitochondria,and neurodegenerative diseases:Aging is often viewed as the buildup of changes that lead to the gradual transformations associated with getting older,along with a rising likelihood of disease and mo...Aging,mitochondria,and neurodegenerative diseases:Aging is often viewed as the buildup of changes that lead to the gradual transformations associated with getting older,along with a rising likelihood of disease and mortality.Although organis m-wide deterioration is observed during aging,organs with high metabolic demand,such as the brain,are more vulnerable.展开更多
Fear memory,a predictive and protective mechanism in potentially hostile environments,elicits defensive behavioral responses that have evolved to help organisms avoid harm and ensure survival.However,excessive fear me...Fear memory,a predictive and protective mechanism in potentially hostile environments,elicits defensive behavioral responses that have evolved to help organisms avoid harm and ensure survival.However,excessive fear memories may contribute to the onset of various psychological disorders,such as panic disorder,phobias,and post-traumatic stress disorder(PTSD).展开更多
Fear memory is crucial for survival and adaptation in complex and dynamically changing environments that enables individuals to avoid or escape from potentially dangerous situations.However,excessive fear memories can...Fear memory is crucial for survival and adaptation in complex and dynamically changing environments that enables individuals to avoid or escape from potentially dangerous situations.However,excessive fear memories can significantly contribute to emotional disabilities and mental disorders,including panic disorder,phobias,social anxiety disorder,and post-traumatic stress disorder(PTSD).展开更多
Considering the three typical phase-change related rock mechanics phenomena during drilling and production in oil and gas reservoirs,which include phase change of solid alkane-related mixtures upon heating,sand liquef...Considering the three typical phase-change related rock mechanics phenomena during drilling and production in oil and gas reservoirs,which include phase change of solid alkane-related mixtures upon heating,sand liquefaction induced by sudden pressure release of the over-pressured sand body,and formation collapse due to gasification of pore fillings from pressure reduction,this study first systematically analyzes the progress of theoretical understanding,experimental methods,and mathematical representation,then discusses the engineering application scenarios corresponding to the three phenomena and reveals the mechanical principles and application effectiveness.Based on these research efforts,the study further discusses the significant challenges,potential developmental trends,and research approaches that require urgent exploration.The findings disclose that various phase-related rock mechanics phenomena require specific experimental and mathematical methods that can produce multi-field coupling mechanical mechanisms,which will eventually instruct the control on resource exploitation,evaluation on disaster level,and analysis of formation stability.To meet the development needs of the principle,future research efforts should focus on mining more phase-change related rock mechanics phenomena during oil and gas resources exploitation,developing novel experimental equipment,and using techniques of artificial intelligence and digital twins to implement real-time simulation and dynamic visualization of phase-change related rock mechanics.展开更多
Cardiovascular damage caused by cancer treatment has become an important cause of death for tumor survivors.With the recognition of cardiovascular diseases and cancer therapy-related cardiovascular toxicity(CTR-CVT)in...Cardiovascular damage caused by cancer treatment has become an important cause of death for tumor survivors.With the recognition of cardiovascular diseases and cancer therapy-related cardiovascular toxicity(CTR-CVT)in tumor patients,noninvasive imaging technologies play pivotal roles in the risk stratification,early diagnosis,monitoring and follow-up for CTR-CVT.In recent years,the field of cardio-oncology has witnessed continual updates in diagnostic and therapeutic strategies,with several pertinent guidelines and expert consensus documents issued in China and abroad.However,there remains a conspicuous absence of systematic guidance documents on the application of imaging techniques in the clinical practice of cardio-oncology.Therefore,the Chinese Anti-Cancer Association Society of Integrative Cardio-oncology,the Ultrasound Branch of the Chinese Medical Association,and the Chinese Society of Echocardiography convened experts to formulate the"Chinese guideline for the clinical application of noninvasive imaging technology in accessing cancer therapy-related cardiovascular toxicity".Building upon the systematic evaluation of guidelines and the latest evidence-based medical research in the field of cardio-oncology domestically and abroad,and in conjunction with data derived from evidence-based medical research in China,this guideline proposes noninvasive imaging examination methods and monitoring strategies for CTR-CVT,aiming to further standardize and guide the clinical practice of multidisciplinary physicians specializing in cardio-oncology in China.展开更多
Dear Editor,I am Yuki Tanaka from Hakodate Central General Hospital,Japan.Mikulicz’s disease is characterized by symmetrical swelling of lacrimal and salivary glands.In 2012,a Japanese study group proposed comprehens...Dear Editor,I am Yuki Tanaka from Hakodate Central General Hospital,Japan.Mikulicz’s disease is characterized by symmetrical swelling of lacrimal and salivary glands.In 2012,a Japanese study group proposed comprehensive diagnostic criteria for immunoglobulin G4-related disease(IgG4-RD)^([1]).They have revealed that Mikulicz’s disease is a systemic IgG4-RD and attracted attentions of ophthalmologists.In 2014,the criteria for IgG4-related ophthalmic disease(IgG4-ROD)were established.展开更多
Colorectal cancer(CRC),ranking as the third most common malignant tumor globally,continues to have high incidence and mortality rates.In China,the incidence of CRC has been increasing in recent years,imposing a heavy ...Colorectal cancer(CRC),ranking as the third most common malignant tumor globally,continues to have high incidence and mortality rates.In China,the incidence of CRC has been increasing in recent years,imposing a heavy economic burden on society[1].Low prevalence of early screening leads to the majority of patients being diagnosed at an advanced stage.Current main treatment methods,such as surgery,chemotherapy,targeted therapy,and immunotherapy,have limited effectiveness for these patients and are prone to recurrence and metastasis.Moreover,the interplay of various pathogenic factors including genetic,environmental,and lifestyle factors increases the difficulty of CRC prevention and treatment[1].展开更多
The current quality standard for polyvinyl alcohol eye drops lacks an impurity assessment,despite the potential impact of raw material impurities on product safety.To strengthen quality control and ensure drug safety,...The current quality standard for polyvinyl alcohol eye drops lacks an impurity assessment,despite the potential impact of raw material impurities on product safety.To strengthen quality control and ensure drug safety,an investigation into the impurity profile of the formulation was conducted,and an HPLC-UV method was developed for impurity quantification.The method validation was performed using an H-type cation exchange column.A total of 116 batches of polyvinyl alcohol eye drops from four manufacturers and two batches of the innovator drug were analyzed.Formic acid was detected exclusively in 0.4 mL samples from Company A and the innovator drug,with concentrations below 0.002%in both cases.Acetic acid was identified in samples from all manufacturers,with levels not exceeding 0.1%.The method demonstrated high specificity and sensitivity,making it well-suited for the quantification of formic and acetic acids in polyvinyl alcohol eye drops.The presence of formic acid was attributed to excipients,whereas acetic acid originated from raw materials and was further generated during pH adjustment in manufacturing.Although the overall impurity levels were low and posed minimal risk to drug safety,manufacturers should remain vigilant regarding impurity control to maintain product quality.展开更多
Dentistry is a profession with a high prevalence of work-related musculoskeletal disorders(WMSDs),with symptoms often appearing very early in one’s career[1].WMSDs are conditions affecting the muscles,bones,and nervo...Dentistry is a profession with a high prevalence of work-related musculoskeletal disorders(WMSDs),with symptoms often appearing very early in one’s career[1].WMSDs are conditions affecting the muscles,bones,and nervous system due to occupational factors.In 2002,the International Labor Organization included musculoskeletal diseases in the International List of Occupational Diseases.China’s recently updated Classification and Catalog of Occupational Diseases has introduced two new categories of occupational illnesses,including occupational musculoskeletal disorders.WMSDs significantly impact the health and work of dentists,reducing their quality of life and causing economic losses.These disorders are multifactorial in nature,influenced by personal,psychosocial,biomechanical,and environmental factors.Dentists frequently maintain static or awkward postures during procedures,which leads to musculoskeletal strain and discomfort;additionally,long working hours contribute to psychological stress,further increasing the risk of WMSDs[2].展开更多
BACKGROUND Recent studies have indicated that triglyceride glucose(TyG)-waist height ratio(WHtR)and TyG-waist circumference(TyG-WC)are effective indicators for evaluating insulin resistance.However,research on the ass...BACKGROUND Recent studies have indicated that triglyceride glucose(TyG)-waist height ratio(WHtR)and TyG-waist circumference(TyG-WC)are effective indicators for evaluating insulin resistance.However,research on the association in TyG-WHtR,TyG-WC,and the risk and prognosis of major adverse cardiovascular events(MACEs)in type 2 diabetes mellitus(T2DM)cases are limited.AIM To clarify the relation in TyG-WHtR,TyG-WC,and the risk of MACEs and overall mortality in T2DM patients.METHODS Information for this investigation was obtained from Action to Control Cardiovascular Risk in Diabetes(ACCORD)/ACCORD Follow-On(ACCORDION)study database.The Cox regression model was applied to assess the relation among TyG-WHtR,TyG-WC and future MACEs risk and overall mortality in T2DM cases.The RCS analysis was utilized to explore the nonlinear correlation.Subgroup and interaction analyses were conducted to prove the robustness.The receiver operating characteristic curves were applied to analysis the additional predicting value of TyG-WHtR and TyG-WC.RESULTS After full adjustment for confounding variables,the highest baseline TyG-WHtR cohort respectively exhibited a 1.353-fold and 1.420-fold higher risk for MACEs and overall mortality,than the lowest quartile group.Similarly,the highest baseline TyG-WC cohort showed a 1.314-fold and 1.480-fold higher risk for MACEs and overall mortality,respectively.Each 1 SD increase in TyG-WHtR was significantly related to an 11.7%increase in MACEs and a 14.9%enhance in overall mortality.Each 1 SD increase in TyG-WC corresponded to an 11.5%in MACEs and a 16.6%increase in overall mortality.Including these two indexes in conventional models significantly improved the predictive power for MACEs and overall mortality.CONCLUSION TyG-WHtR and TyG-WC were promising predictors of MACEs and overall mortality risk in T2DM cases.展开更多
BACKGROUND Immunoglobulin G4-related disease(IgG4-RD)is a complex immune-mediated condition that causes fibrotic inflammation in several organs.A significant clinical feature of IgG4-RD is hypertrophic pachymeningitis...BACKGROUND Immunoglobulin G4-related disease(IgG4-RD)is a complex immune-mediated condition that causes fibrotic inflammation in several organs.A significant clinical feature of IgG4-RD is hypertrophic pachymeningitis,which manifests as inflammation of the dura mater in intracranial or spinal regions.Although IgG4-RD can affect multiple areas,the spine is a relatively rare site compared to the more frequent involvement of intracranial structures.CASE SUMMARY A 70-year-old male presented to our hospital with a two-day history of fever,altered mental status,and generalized weakness.The initial brain magnetic resonance imaging(MRI)revealed multiple small infarcts across various cerebral regions.On the second day after admission,a physical examination revealed motor weakness in both lower extremities and diminished sensation in the right lower extremity.Electromyographic evaluation revealed findings consistent with acute motor sensory neuropathy.Despite initial management with intravenous immunoglobulin for presumed Guillain-Barrésyndrome,the patient exhibited progressive worsening of motor deficits.On the 45th day of hospitalization,an enhanced MRI of the entire spine,focusing specifically on the thoracic 9 to lumbar 1 vertebral level,raised the suspicion of IgG4-related spinal pachymeningitis.Subsequently,the patient was administered oral prednisolone and participated in a comprehensive rehabilitation program that included gait training and lower extremity strengthening exercises.CONCLUSION IgG4-related spinal pachymeningitis,diagnosed on MRI,was treated with corticosteroids and a structured rehabilitation regimen,leading to significant improvement.展开更多
BACKGROUND Breast cancer is one of the most common malignant tumors in women worldwide and poses a severe threat to their health.Therefore,this study examined patients who underwent breast cancer surgery,analyzed hosp...BACKGROUND Breast cancer is one of the most common malignant tumors in women worldwide and poses a severe threat to their health.Therefore,this study examined patients who underwent breast cancer surgery,analyzed hospitalization costs and structure,and explored the impact of China Healthcare Security Diagnosis Related Groups(CHS-DRG)management on patient costs.It aimed to provide medical institutions with ways to reduce costs,optimize cost structures,reduce patient burden,and improve service efficiency.AIM To study the CHS-DRG payment system’s impact on breast cancer surgery costs.METHODS Using the CHS-DRG(version 1.1)grouping criteria,4073 patients,who underwent the radical resection of breast malignant tumors from January to December 2023,were included in the JA29 group;1028 patients were part of the CHS-DRG payment system,unlike the rest.Through an independent sample t-test,the length of hospital stay as well as total hospitalization,medicine and consumables,medical,nursing,medical technology,and management expenses were compared.Pearson’s correlation coefficient was used to test the cost correlation.RESULTS In terms of hospitalization expenses,patients in the CHS-DRG payment group had lower medical,nursing,and management expenses than those in the diagnosis-related group(DRG)non-payment group.For patients in the DRG payment group,the factors affecting the total hospitalization cost,in descending order of relevance,were medicine and consumable costs,consumable costs,medicine costs,medical costs,medical technology costs,management costs,nursing costs,and length of hospital stay.For patients in the DRG nonpayment group,the factors affecting the total hospitalization expenses in descending order of relevance were medicines and consumable expenses,consumable expenses,medical technology expenses,the cost of medicines,medical expenses,nursing expenses,length of hospital stay,and management expenses.CONCLUSION The CHS-DRG system can help control and reduce unnecessary medical expenses by controlling medicine costs,medical consumable costs,and the length of hospital stay while ensuring medical safety.展开更多
Background and objective:In northern China's cold regions,the prevalence of metabolic dysfunction-associated steatotic liver disease(MASLD)exceeds 50%,significantly higher than the national and global rates.MASLD ...Background and objective:In northern China's cold regions,the prevalence of metabolic dysfunction-associated steatotic liver disease(MASLD)exceeds 50%,significantly higher than the national and global rates.MASLD is an important risk factor for cardiovascular and cerebrovascular diseases,including coronary heart disease,stroke,and tumors,with no specific therapeutic drugs currently available.The ethanol extract of cassia seed(CSEE)has shown promise in lowering blood lipids and improving hepatic steatosis,but its mechanism in treating MASLD remains underexplored.This study aims to investigate the therapeutic effects and mechanisms of CSEE.Methods:MASLD models were established in male Wistar rats and golden hamsters using a high fat diet(HFD).CSEE(10,50,250 mg/kg)was administered via gavage for six weeks.Serum levels of total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),aspartate aminotransferase(AST),and alanine aminotransferase(ALT),as well as liver TC and TG,were measured using biochemical kits.Histopathological changes in the liver were evaluated using Oil Red O staining,Hematoxylin-eosin(H&E)staining,and transmission electron microscopy(TEM).HepG2 cell viability was assessed using the cell counting kit-8(CCK8)and Calcein-AM/PI staining.Network pharmacology was used to analyze drug-disease targets,and western blotting was used to confirm these predictions.Results:CSEE treatment significantly reduced serum levels of TC,TG,LDL-C,ALT,and AST,and improved liver weight,liver index,and hepatic lipid deposition in rats and golden hamsters.In addition,CSEE alleviated free fatty acid(FFA)-induced lipid deposition in HepG2 cells.Molecular biology experiments demonstrated that CSEE increased the protein levels of p-AMPK,p-ACC,PPARα,CPT1A,PI3K P110 and p-AKT,while decreasing the protein levels of SREBP1,FASN,C/EBPα,and PPARγ,thus improving hepatic lipid metabolism and reducing lipid deposition.The beneficial effects of CSEE were reversed by small molecule inhibitors of the signaling pathways in vitro.Conclusion:CSEE improves liver lipid metabolism and reduces lipid droplet deposition in Wistar rats and golden hamsters with MASLD by activating hepatic AMPK,PPARα,and PI3K/AKT signaling pathways.展开更多
The description in the abstract lacks clear logic and a comprehensive summary of this study, so please revise and improve it according to the design theme and main content of this study, and describe it in the order o...The description in the abstract lacks clear logic and a comprehensive summary of this study, so please revise and improve it according to the design theme and main content of this study, and describe it in the order of (research background), purpose/aim, method, results and conclusions. The introduction of the abstract and preface is rather lengthy, but the summary of the whole study and the presentation of the research background are not perfect (mainly because the logic of the context is not clear and orderly), so it will appear a bit messy. Hope to be able to modify (this has been mentioned in the preliminary opinion). Cardiovascular events (CVE) pose a significant threat to individuals with end-stage renal disease (ESRD), yet these patients are often excluded from cardiovascular clinical trials, leaving prognostic factors associated with CVE in ESRD patients largely unexplored. Recent human studies have demonstrated elevated circulating aldosterone levels in ESRD patients, correlating with left ventricular hypertrophy. Additionally, animal models have shown improvements in uremic cardiomyopathy with spironolactone therapy, prompting interest in assessing the efficacy of spironolactone or eplerenone in reducing mortality and improving cardiovascular function in dialysis patients. Clinicians have historically been cautious about prescribing mineralocorticoid receptor antagonists (MRAs) to congestive heart failure patients with chronic kidney disease (CKD) due to hyperkalemia risk. However, the emergence of finerenone, a novel MR antagonist with a favorable safety profile and lower hyperkalemia risk, has renewed interest in MRA therapy in this population. Heart disease, including coronary artery disease, hypertension, and left ventricular failure, is alarmingly prevalent in dialysis patients, contributing significantly to elevated mortality rates compared to the general population. Arterial stiffness, as indicated by pulse wave velocity (PWV), progressively worsens with advancing CKD stages, peaking in severity among ESRD patients undergoing dialysis. High PWV serves as a crucial risk stratification tool in ESRD. Elevated NT-proBNP and BNP levels in ESRD patients are well-documented, with significant associations observed between baseline peptide concentrations and cardiovascular morbidity and mortality. By incorporating finerenone into our study, we aim to investigate its potential benefits in reducing arterial stiffness, lowering blood pressure, and ultimately mitigating heart-related mortality among hemodialysis patients. This study holds substantial implications for hypertension and cardiovascular risk management in this vulnerable patient population. Eligible participants must have been on chronic hemodialysis for at least three months, with ACE inhibitors or angiotensin receptor blockers included in their therapy at maximum tolerable doses. Serum potassium levels 5.7 mmol/L, left ventricular ejection fraction 50%, and PWV higher than age-estimated values are also prerequisites for study entry. Randomized allocation will be conducted using a permuted block design, stratified by center, with allocation communicated via signed study forms during initial examinations. All steps of this research will be conducted in accordance with the principles of the Helsinki Declaration.展开更多
AIM:To examine the disparities in macular retinal vascular density between individuals with connective tissue disease-related interstitial lung disease(CTD-ILD)and healthy controls(HCs)by optical coherence tomography ...AIM:To examine the disparities in macular retinal vascular density between individuals with connective tissue disease-related interstitial lung disease(CTD-ILD)and healthy controls(HCs)by optical coherence tomography angiography(OCTA)and to investigate the changes in microvascular density in abnormal eyes.METHODS:For a retrospective case-control study,a total of 16 patients(32 eyes)diagnosed with CTD-ILD were selected as the ILD group.The 16 healthy volunteers with 32 eyes,matched in terms of age and sex with the patients,were recruited as control group.The macular retina’s superficial retinal layer(SRL)and deep retinal layer(DRL)were examined and scanned using OCTA in each individual eye.The densities of retinal microvascular(MIR),macrovascular(MAR),and total microvascular(TMI)were calculated and compared.Changes in retinal vascular density in the macular region were analyzed using three different segmentation methods:central annuli segmentation method(C1-C6),hemispheric segmentation method[uperior right(SR),superior left(SL),inferior left(IL),and inferior right(IR)],and Early Treatment Diabetic Retinopathy Study(ETDRS)methods[superior(S),inferior(I),left(L),and right(R)].The data were analyzed using Version 9.0 of GraphPad prism and Pearson analysis.RESULTS:The OCTA data demonstrated a statistically significant difference(P<0.05)in macular retinal microvessel density between the two groups.Specifically,in the SRL and DRL analyses,the ILD group exhibited significantly lower surface density of MIR and TMI compared to the HCs group(P<0.05).Furthermore,using the hemispheric segmentation method,the ILD group showed notable reductions in SL,SR,and IL in the superficial retina(P<0.05),as well as marked decreases in SL and IR in the deep retina(P<0.05).Similarly,when employing the ETDRS method,the ILD group displayed substantial drops in superficial retinal S and I(P<0.05),along with notable reductions in deep retinal L,I,and R(P<0.05).In the central annuli segmentation method,the ILD group exhibited a significant decrease in the superficial retinal C2-4 region(P<0.05),whereas the deep retina showed a notable reduction in the C3-5 region(P<0.05).Additionally,there was an observed higher positive likelihood ratio in the superficial SR region and deep MIR.Furthermore,there was a negative correlation between conjunctival vascular density and both deep and superficial retinal TMI(P<0.001).CONCLUSION:Patients with CTD-ILD exhibits a significantly higher conjunctival vascular density compared to the HCs group.Conversely,their fundus retinal microvascular density is significantly lower.Furthermore,CTD-ILD patients display notably lower superficial and deep retinal vascular density in comparison to the HCs group.The inverse correlation between conjunctival vascular density and both superficial and deep retinal TMI suggests that detecting subtle changes in ocular microcirculation could potentially serve as an early diagnostic indicator for connective tissue diseases,thereby enhancing disease management.展开更多
Context: Antiretroviral therapy (ART) helps restore the health status of people living with HIV (PLHIV). Likewise, it increases the risk of overweight/obesity and related comorbidities among the recipients. In countri...Context: Antiretroviral therapy (ART) helps restore the health status of people living with HIV (PLHIV). Likewise, it increases the risk of overweight/obesity and related comorbidities among the recipients. In countries like Botswana where ±84% of PLHIV is on ART, the paucity of data comparing overweight/obesity between HIV-positive on ART and HIV-negative patients may impede clinical and policy decision-making. This study sought to estimate and compare: i) the prevalence of overweight/obesity between HIV-positive on ART and HIV-negative patients;ii) the prevalence of hypertension (HTN), diabetes mellitus (DM)/coronary heart disease (CHD) between HIV-positive patients on ART and HIV-negative patients attending same outpatient departments of general clinics in Gaborone, Botswana. Patients and Methods: Five hundred eighty-one (581) outpatients were recruited in four major clinics of Gaborone, Botswana, between June and July 2019;294 or 51% of them were HIV-negative and 287 or 49% were HIV-positive on ART. The prevalence of overweight/obesity and of HTN and DM/CHD were calculated and examined using stratified analysis. Subgroups were compared using Chi-square analysis with Yates correction or Fisher exact test and t-student test for continuous data. Results: Major findings after stratification of the study population by HIV status were: i) the prevalence of all categories of (BMI), including overweight/obesity, were comparable between HIV-negative-patients and HIV-positive. In fact, there were 24 (8.0%) cases of underweight among HIV-negative-Patients and 15(5%) cases among HIV-positive patients, p = 0.2;145 (49%) HIV-negative-patients and 128 (45%) HIV-positive, p = 0.07 cases of normal weight;72 (25%) HIV-negative-patients and 87 (30%) HIV-positive, p = 0.08, were overweight;53 (18%) HIV-negative-patients and 57 (20%) HIV-positive, p = 0.12, were obese;125 (43%) HIV-negative patients and 144 (50%) HIV-positive, p=0.06 were overweight/obese;ii) the prevalence of HTN and DM/CHD among HIV-positive-patients were significantly lower (p < 0.05) compared to HIV-negative patients: There were 32 (10.9%) cases of HTN among HIV-negative patients compared to 18 (6.3%) cases of HTN among HIV-positive patients, p = 0.001;32 (11%) cases of DM/CHD HIV-negative patients compared to 4 (1.4%) cases of DM/CHD among HIV-positive patients, p = 0.001. Conclusion: the prevalence of overweight/obesity observed between HIV-negative and HIV-positive patients may suggest that the two groups shared the same exposure factors. That HTN and DM/CHD prevalence was lower among HIV-positive compared to HIV-negative patients, is possibly due to interplay factors of ART, HIV or the host population. Further studies are, however, recommended for clarifications.展开更多
基金funded by a Grant-in-Aid for Scientific Research(JP19K19762,JP 23K10258)from the Japan Society for the Promotion of Science,Japan.
文摘Objectives:To evaluate the occurrence of depression and its related factors among public health nurses(PHNs)engaged in child neglect-related abuse cases.Methods:A cross-sectional study of PHNs involved in maternal and child health or child and family welfare,and engaged in cases of child neglect-related abuse was conducted from January to March 2023 in all municipalities of 13 prefectures selected from Japan's seven regions,considering geographic diversity and major urban areas.The Patient Health Questionnaire-2 was used to screen for depression.Statistical analyses included the Chi-square test,Mann-Whitney U test,and logistic regression analysis.Results:A total of 359 provided valid responses.Among them,11.4%screened positive for depression.Significant individual factors related depression were management-stage nurses(OR=6.27,95%CI:1.63-24.18),no disability welfare experience(OR=3.49,95%CI:1.05-11.55),being assignment of highrisk cases within the past year(OR=8.28,95%CI:2.07-33.08),and lower work control(OR=0.53,95%CI:0.32-0.86).Workplace environment factors were lower perceptions and relationships within the workplace(OR=0.43,95%CI:0.29-0.65)and perceiving manpower as not secured(OR=9.07,95%CI:1.17-70.40),Conclusions:Mental health measures for PHNs should include workload management and reduced burdens through workforce enhancement,attention to burdens on managerial PHNs,promoting communication and mutual support,and opportunities to engage in disability welfare work.
基金西南大学中央高校基本科研业务费项目(SWU-KT22030)重庆市教育委员会科学技术研究项目(KJQN202300205)Deutsche Forschungsgemeinschaft(DFG,German Research Foundation,457444676).
文摘Diamond combines many unique properties,including high stability,strong optical dispersion,excellent mechanical strength,and outstanding thermal conductivity.Its structure,surface groups,and electrical conductivity are also tunable,increasing its functional versatility.These make diamond and its related materials,such as its composites,highly promising for various applications in energy fields.This review summarizes recent advances and key achievements in energy storage and conversion,covering electrochemical energy storage(e.g.,batteries and supercapacitors),electrocatalytic energy conversion(e.g.,CO_(2)and nitrogen reduction reactions),and solar energy conversion(e.g.,photo-(electro)chemical CO_(2)and nitrogen reduction reactions,and solar cells).Current challenges and prospects related to the synthesis of diamond materials and the technologies for their energy applications are outlined and discussed.
基金Supported by Laboratory Open Fund Project of Inner Mongolia Medical University in 2024(2024ZN20)Key Laboratory of Mongolian Medicine Open Fund Project of Inner Mongolia Autonomous Region(GX20240003)+2 种基金Inner Mongolia Medicine Collaborative Innovation Center Achievement Transformation and Cultivation Project(MYYXTPY202402)Project of Construction of Key Laboratory of Mongolian Medicine in Universities of Inner Mongolia Autonomous Region(RZ2400000451)Project of Construction of Key Laboratory of Mongolian Medicine Research Platform in Inner Mongolia Autonomous Region(DC2400000724).
文摘This paper reviews the related formulas of Sugemule,introduces the advances in research of clinical application of these formulas in treating Heyi type insomnia,cardiac diseases,and renal diseases.Besides,it summarizes pharmacological research advances regarding these formulas,including their anti-insomnia effects,cardioprotective properties,and ovarian function preservation capabilities.This study is expected to provide a reference and insight for in-depth and systematic research on classical Mongolian medicinal formulas.
文摘Aging,mitochondria,and neurodegenerative diseases:Aging is often viewed as the buildup of changes that lead to the gradual transformations associated with getting older,along with a rising likelihood of disease and mortality.Although organis m-wide deterioration is observed during aging,organs with high metabolic demand,such as the brain,are more vulnerable.
基金supported by the National Natural Science Foundation of China(82104138)the Zhejiang Provincial Natural Science Foundation of China(LY24H310003).
文摘Fear memory,a predictive and protective mechanism in potentially hostile environments,elicits defensive behavioral responses that have evolved to help organisms avoid harm and ensure survival.However,excessive fear memories may contribute to the onset of various psychological disorders,such as panic disorder,phobias,and post-traumatic stress disorder(PTSD).
文摘Fear memory is crucial for survival and adaptation in complex and dynamically changing environments that enables individuals to avoid or escape from potentially dangerous situations.However,excessive fear memories can significantly contribute to emotional disabilities and mental disorders,including panic disorder,phobias,social anxiety disorder,and post-traumatic stress disorder(PTSD).
基金Supported by the National Natural Science Foundation of China(NSFC)Major Project(51991362).
文摘Considering the three typical phase-change related rock mechanics phenomena during drilling and production in oil and gas reservoirs,which include phase change of solid alkane-related mixtures upon heating,sand liquefaction induced by sudden pressure release of the over-pressured sand body,and formation collapse due to gasification of pore fillings from pressure reduction,this study first systematically analyzes the progress of theoretical understanding,experimental methods,and mathematical representation,then discusses the engineering application scenarios corresponding to the three phenomena and reveals the mechanical principles and application effectiveness.Based on these research efforts,the study further discusses the significant challenges,potential developmental trends,and research approaches that require urgent exploration.The findings disclose that various phase-related rock mechanics phenomena require specific experimental and mathematical methods that can produce multi-field coupling mechanical mechanisms,which will eventually instruct the control on resource exploitation,evaluation on disaster level,and analysis of formation stability.To meet the development needs of the principle,future research efforts should focus on mining more phase-change related rock mechanics phenomena during oil and gas resources exploitation,developing novel experimental equipment,and using techniques of artificial intelligence and digital twins to implement real-time simulation and dynamic visualization of phase-change related rock mechanics.
基金National Key Research and Development Program of China(2022YFC 3602400)Shanghai Municipal Health Commission“Top Priority Research Center”(2023-ZZ02021)+2 种基金Shanghai Public Health Key Discipline Construction Project(GWVI-11.1-26)Shanghai Academic/Technology Research Leader(21XD1432100)Key Research and Development Program of Shandong Province(2021SFGC0503)。
文摘Cardiovascular damage caused by cancer treatment has become an important cause of death for tumor survivors.With the recognition of cardiovascular diseases and cancer therapy-related cardiovascular toxicity(CTR-CVT)in tumor patients,noninvasive imaging technologies play pivotal roles in the risk stratification,early diagnosis,monitoring and follow-up for CTR-CVT.In recent years,the field of cardio-oncology has witnessed continual updates in diagnostic and therapeutic strategies,with several pertinent guidelines and expert consensus documents issued in China and abroad.However,there remains a conspicuous absence of systematic guidance documents on the application of imaging techniques in the clinical practice of cardio-oncology.Therefore,the Chinese Anti-Cancer Association Society of Integrative Cardio-oncology,the Ultrasound Branch of the Chinese Medical Association,and the Chinese Society of Echocardiography convened experts to formulate the"Chinese guideline for the clinical application of noninvasive imaging technology in accessing cancer therapy-related cardiovascular toxicity".Building upon the systematic evaluation of guidelines and the latest evidence-based medical research in the field of cardio-oncology domestically and abroad,and in conjunction with data derived from evidence-based medical research in China,this guideline proposes noninvasive imaging examination methods and monitoring strategies for CTR-CVT,aiming to further standardize and guide the clinical practice of multidisciplinary physicians specializing in cardio-oncology in China.
文摘Dear Editor,I am Yuki Tanaka from Hakodate Central General Hospital,Japan.Mikulicz’s disease is characterized by symmetrical swelling of lacrimal and salivary glands.In 2012,a Japanese study group proposed comprehensive diagnostic criteria for immunoglobulin G4-related disease(IgG4-RD)^([1]).They have revealed that Mikulicz’s disease is a systemic IgG4-RD and attracted attentions of ophthalmologists.In 2014,the criteria for IgG4-related ophthalmic disease(IgG4-ROD)were established.
文摘Colorectal cancer(CRC),ranking as the third most common malignant tumor globally,continues to have high incidence and mortality rates.In China,the incidence of CRC has been increasing in recent years,imposing a heavy economic burden on society[1].Low prevalence of early screening leads to the majority of patients being diagnosed at an advanced stage.Current main treatment methods,such as surgery,chemotherapy,targeted therapy,and immunotherapy,have limited effectiveness for these patients and are prone to recurrence and metastasis.Moreover,the interplay of various pathogenic factors including genetic,environmental,and lifestyle factors increases the difficulty of CRC prevention and treatment[1].
基金National Drug Sampling Inspection Project(No.NMPA Drug Admin[2024]1).
文摘The current quality standard for polyvinyl alcohol eye drops lacks an impurity assessment,despite the potential impact of raw material impurities on product safety.To strengthen quality control and ensure drug safety,an investigation into the impurity profile of the formulation was conducted,and an HPLC-UV method was developed for impurity quantification.The method validation was performed using an H-type cation exchange column.A total of 116 batches of polyvinyl alcohol eye drops from four manufacturers and two batches of the innovator drug were analyzed.Formic acid was detected exclusively in 0.4 mL samples from Company A and the innovator drug,with concentrations below 0.002%in both cases.Acetic acid was identified in samples from all manufacturers,with levels not exceeding 0.1%.The method demonstrated high specificity and sensitivity,making it well-suited for the quantification of formic and acetic acids in polyvinyl alcohol eye drops.The presence of formic acid was attributed to excipients,whereas acetic acid originated from raw materials and was further generated during pH adjustment in manufacturing.Although the overall impurity levels were low and posed minimal risk to drug safety,manufacturers should remain vigilant regarding impurity control to maintain product quality.
基金supported by the 2021 Shandong Province Higher Education Institutions“Youth Innovation Talent Introduction and Cultivation Plan”(Public Health Safety Risk Assessment and Response Innovation Team)National Traditional Chinese Medicine Comprehensive Reform Demonstration Zone Science and Technology Co construction Project(No.GZYKJSSD-2024-106)Research Project of Shandong Educational Supervision Society(No.SDJYDDXH2023-2159).
文摘Dentistry is a profession with a high prevalence of work-related musculoskeletal disorders(WMSDs),with symptoms often appearing very early in one’s career[1].WMSDs are conditions affecting the muscles,bones,and nervous system due to occupational factors.In 2002,the International Labor Organization included musculoskeletal diseases in the International List of Occupational Diseases.China’s recently updated Classification and Catalog of Occupational Diseases has introduced two new categories of occupational illnesses,including occupational musculoskeletal disorders.WMSDs significantly impact the health and work of dentists,reducing their quality of life and causing economic losses.These disorders are multifactorial in nature,influenced by personal,psychosocial,biomechanical,and environmental factors.Dentists frequently maintain static or awkward postures during procedures,which leads to musculoskeletal strain and discomfort;additionally,long working hours contribute to psychological stress,further increasing the risk of WMSDs[2].
文摘BACKGROUND Recent studies have indicated that triglyceride glucose(TyG)-waist height ratio(WHtR)and TyG-waist circumference(TyG-WC)are effective indicators for evaluating insulin resistance.However,research on the association in TyG-WHtR,TyG-WC,and the risk and prognosis of major adverse cardiovascular events(MACEs)in type 2 diabetes mellitus(T2DM)cases are limited.AIM To clarify the relation in TyG-WHtR,TyG-WC,and the risk of MACEs and overall mortality in T2DM patients.METHODS Information for this investigation was obtained from Action to Control Cardiovascular Risk in Diabetes(ACCORD)/ACCORD Follow-On(ACCORDION)study database.The Cox regression model was applied to assess the relation among TyG-WHtR,TyG-WC and future MACEs risk and overall mortality in T2DM cases.The RCS analysis was utilized to explore the nonlinear correlation.Subgroup and interaction analyses were conducted to prove the robustness.The receiver operating characteristic curves were applied to analysis the additional predicting value of TyG-WHtR and TyG-WC.RESULTS After full adjustment for confounding variables,the highest baseline TyG-WHtR cohort respectively exhibited a 1.353-fold and 1.420-fold higher risk for MACEs and overall mortality,than the lowest quartile group.Similarly,the highest baseline TyG-WC cohort showed a 1.314-fold and 1.480-fold higher risk for MACEs and overall mortality,respectively.Each 1 SD increase in TyG-WHtR was significantly related to an 11.7%increase in MACEs and a 14.9%enhance in overall mortality.Each 1 SD increase in TyG-WC corresponded to an 11.5%in MACEs and a 16.6%increase in overall mortality.Including these two indexes in conventional models significantly improved the predictive power for MACEs and overall mortality.CONCLUSION TyG-WHtR and TyG-WC were promising predictors of MACEs and overall mortality risk in T2DM cases.
文摘BACKGROUND Immunoglobulin G4-related disease(IgG4-RD)is a complex immune-mediated condition that causes fibrotic inflammation in several organs.A significant clinical feature of IgG4-RD is hypertrophic pachymeningitis,which manifests as inflammation of the dura mater in intracranial or spinal regions.Although IgG4-RD can affect multiple areas,the spine is a relatively rare site compared to the more frequent involvement of intracranial structures.CASE SUMMARY A 70-year-old male presented to our hospital with a two-day history of fever,altered mental status,and generalized weakness.The initial brain magnetic resonance imaging(MRI)revealed multiple small infarcts across various cerebral regions.On the second day after admission,a physical examination revealed motor weakness in both lower extremities and diminished sensation in the right lower extremity.Electromyographic evaluation revealed findings consistent with acute motor sensory neuropathy.Despite initial management with intravenous immunoglobulin for presumed Guillain-Barrésyndrome,the patient exhibited progressive worsening of motor deficits.On the 45th day of hospitalization,an enhanced MRI of the entire spine,focusing specifically on the thoracic 9 to lumbar 1 vertebral level,raised the suspicion of IgG4-related spinal pachymeningitis.Subsequently,the patient was administered oral prednisolone and participated in a comprehensive rehabilitation program that included gait training and lower extremity strengthening exercises.CONCLUSION IgG4-related spinal pachymeningitis,diagnosed on MRI,was treated with corticosteroids and a structured rehabilitation regimen,leading to significant improvement.
基金Research Center for Capital Health Management and Policy,No.2024JD09.
文摘BACKGROUND Breast cancer is one of the most common malignant tumors in women worldwide and poses a severe threat to their health.Therefore,this study examined patients who underwent breast cancer surgery,analyzed hospitalization costs and structure,and explored the impact of China Healthcare Security Diagnosis Related Groups(CHS-DRG)management on patient costs.It aimed to provide medical institutions with ways to reduce costs,optimize cost structures,reduce patient burden,and improve service efficiency.AIM To study the CHS-DRG payment system’s impact on breast cancer surgery costs.METHODS Using the CHS-DRG(version 1.1)grouping criteria,4073 patients,who underwent the radical resection of breast malignant tumors from January to December 2023,were included in the JA29 group;1028 patients were part of the CHS-DRG payment system,unlike the rest.Through an independent sample t-test,the length of hospital stay as well as total hospitalization,medicine and consumables,medical,nursing,medical technology,and management expenses were compared.Pearson’s correlation coefficient was used to test the cost correlation.RESULTS In terms of hospitalization expenses,patients in the CHS-DRG payment group had lower medical,nursing,and management expenses than those in the diagnosis-related group(DRG)non-payment group.For patients in the DRG payment group,the factors affecting the total hospitalization cost,in descending order of relevance,were medicine and consumable costs,consumable costs,medicine costs,medical costs,medical technology costs,management costs,nursing costs,and length of hospital stay.For patients in the DRG nonpayment group,the factors affecting the total hospitalization expenses in descending order of relevance were medicines and consumable expenses,consumable expenses,medical technology expenses,the cost of medicines,medical expenses,nursing expenses,length of hospital stay,and management expenses.CONCLUSION The CHS-DRG system can help control and reduce unnecessary medical expenses by controlling medicine costs,medical consumable costs,and the length of hospital stay while ensuring medical safety.
基金The animal protocols were approved by the Ethics Committee of the Second Affiliated Hospital of Harbin Medical University(SYDW2019-258).
文摘Background and objective:In northern China's cold regions,the prevalence of metabolic dysfunction-associated steatotic liver disease(MASLD)exceeds 50%,significantly higher than the national and global rates.MASLD is an important risk factor for cardiovascular and cerebrovascular diseases,including coronary heart disease,stroke,and tumors,with no specific therapeutic drugs currently available.The ethanol extract of cassia seed(CSEE)has shown promise in lowering blood lipids and improving hepatic steatosis,but its mechanism in treating MASLD remains underexplored.This study aims to investigate the therapeutic effects and mechanisms of CSEE.Methods:MASLD models were established in male Wistar rats and golden hamsters using a high fat diet(HFD).CSEE(10,50,250 mg/kg)was administered via gavage for six weeks.Serum levels of total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),aspartate aminotransferase(AST),and alanine aminotransferase(ALT),as well as liver TC and TG,were measured using biochemical kits.Histopathological changes in the liver were evaluated using Oil Red O staining,Hematoxylin-eosin(H&E)staining,and transmission electron microscopy(TEM).HepG2 cell viability was assessed using the cell counting kit-8(CCK8)and Calcein-AM/PI staining.Network pharmacology was used to analyze drug-disease targets,and western blotting was used to confirm these predictions.Results:CSEE treatment significantly reduced serum levels of TC,TG,LDL-C,ALT,and AST,and improved liver weight,liver index,and hepatic lipid deposition in rats and golden hamsters.In addition,CSEE alleviated free fatty acid(FFA)-induced lipid deposition in HepG2 cells.Molecular biology experiments demonstrated that CSEE increased the protein levels of p-AMPK,p-ACC,PPARα,CPT1A,PI3K P110 and p-AKT,while decreasing the protein levels of SREBP1,FASN,C/EBPα,and PPARγ,thus improving hepatic lipid metabolism and reducing lipid deposition.The beneficial effects of CSEE were reversed by small molecule inhibitors of the signaling pathways in vitro.Conclusion:CSEE improves liver lipid metabolism and reduces lipid droplet deposition in Wistar rats and golden hamsters with MASLD by activating hepatic AMPK,PPARα,and PI3K/AKT signaling pathways.
文摘The description in the abstract lacks clear logic and a comprehensive summary of this study, so please revise and improve it according to the design theme and main content of this study, and describe it in the order of (research background), purpose/aim, method, results and conclusions. The introduction of the abstract and preface is rather lengthy, but the summary of the whole study and the presentation of the research background are not perfect (mainly because the logic of the context is not clear and orderly), so it will appear a bit messy. Hope to be able to modify (this has been mentioned in the preliminary opinion). Cardiovascular events (CVE) pose a significant threat to individuals with end-stage renal disease (ESRD), yet these patients are often excluded from cardiovascular clinical trials, leaving prognostic factors associated with CVE in ESRD patients largely unexplored. Recent human studies have demonstrated elevated circulating aldosterone levels in ESRD patients, correlating with left ventricular hypertrophy. Additionally, animal models have shown improvements in uremic cardiomyopathy with spironolactone therapy, prompting interest in assessing the efficacy of spironolactone or eplerenone in reducing mortality and improving cardiovascular function in dialysis patients. Clinicians have historically been cautious about prescribing mineralocorticoid receptor antagonists (MRAs) to congestive heart failure patients with chronic kidney disease (CKD) due to hyperkalemia risk. However, the emergence of finerenone, a novel MR antagonist with a favorable safety profile and lower hyperkalemia risk, has renewed interest in MRA therapy in this population. Heart disease, including coronary artery disease, hypertension, and left ventricular failure, is alarmingly prevalent in dialysis patients, contributing significantly to elevated mortality rates compared to the general population. Arterial stiffness, as indicated by pulse wave velocity (PWV), progressively worsens with advancing CKD stages, peaking in severity among ESRD patients undergoing dialysis. High PWV serves as a crucial risk stratification tool in ESRD. Elevated NT-proBNP and BNP levels in ESRD patients are well-documented, with significant associations observed between baseline peptide concentrations and cardiovascular morbidity and mortality. By incorporating finerenone into our study, we aim to investigate its potential benefits in reducing arterial stiffness, lowering blood pressure, and ultimately mitigating heart-related mortality among hemodialysis patients. This study holds substantial implications for hypertension and cardiovascular risk management in this vulnerable patient population. Eligible participants must have been on chronic hemodialysis for at least three months, with ACE inhibitors or angiotensin receptor blockers included in their therapy at maximum tolerable doses. Serum potassium levels 5.7 mmol/L, left ventricular ejection fraction 50%, and PWV higher than age-estimated values are also prerequisites for study entry. Randomized allocation will be conducted using a permuted block design, stratified by center, with allocation communicated via signed study forms during initial examinations. All steps of this research will be conducted in accordance with the principles of the Helsinki Declaration.
基金Supported by National Natural Science Foundation of China(No.82160195)Key R&D Program of Jiangxi Province(No.20223BBH80014)General Science and Technology Program of the Department of Traditional Chinese Medicine,Jiangxi Provincial Health Commission(No.2017A241).
文摘AIM:To examine the disparities in macular retinal vascular density between individuals with connective tissue disease-related interstitial lung disease(CTD-ILD)and healthy controls(HCs)by optical coherence tomography angiography(OCTA)and to investigate the changes in microvascular density in abnormal eyes.METHODS:For a retrospective case-control study,a total of 16 patients(32 eyes)diagnosed with CTD-ILD were selected as the ILD group.The 16 healthy volunteers with 32 eyes,matched in terms of age and sex with the patients,were recruited as control group.The macular retina’s superficial retinal layer(SRL)and deep retinal layer(DRL)were examined and scanned using OCTA in each individual eye.The densities of retinal microvascular(MIR),macrovascular(MAR),and total microvascular(TMI)were calculated and compared.Changes in retinal vascular density in the macular region were analyzed using three different segmentation methods:central annuli segmentation method(C1-C6),hemispheric segmentation method[uperior right(SR),superior left(SL),inferior left(IL),and inferior right(IR)],and Early Treatment Diabetic Retinopathy Study(ETDRS)methods[superior(S),inferior(I),left(L),and right(R)].The data were analyzed using Version 9.0 of GraphPad prism and Pearson analysis.RESULTS:The OCTA data demonstrated a statistically significant difference(P<0.05)in macular retinal microvessel density between the two groups.Specifically,in the SRL and DRL analyses,the ILD group exhibited significantly lower surface density of MIR and TMI compared to the HCs group(P<0.05).Furthermore,using the hemispheric segmentation method,the ILD group showed notable reductions in SL,SR,and IL in the superficial retina(P<0.05),as well as marked decreases in SL and IR in the deep retina(P<0.05).Similarly,when employing the ETDRS method,the ILD group displayed substantial drops in superficial retinal S and I(P<0.05),along with notable reductions in deep retinal L,I,and R(P<0.05).In the central annuli segmentation method,the ILD group exhibited a significant decrease in the superficial retinal C2-4 region(P<0.05),whereas the deep retina showed a notable reduction in the C3-5 region(P<0.05).Additionally,there was an observed higher positive likelihood ratio in the superficial SR region and deep MIR.Furthermore,there was a negative correlation between conjunctival vascular density and both deep and superficial retinal TMI(P<0.001).CONCLUSION:Patients with CTD-ILD exhibits a significantly higher conjunctival vascular density compared to the HCs group.Conversely,their fundus retinal microvascular density is significantly lower.Furthermore,CTD-ILD patients display notably lower superficial and deep retinal vascular density in comparison to the HCs group.The inverse correlation between conjunctival vascular density and both superficial and deep retinal TMI suggests that detecting subtle changes in ocular microcirculation could potentially serve as an early diagnostic indicator for connective tissue diseases,thereby enhancing disease management.
文摘Context: Antiretroviral therapy (ART) helps restore the health status of people living with HIV (PLHIV). Likewise, it increases the risk of overweight/obesity and related comorbidities among the recipients. In countries like Botswana where ±84% of PLHIV is on ART, the paucity of data comparing overweight/obesity between HIV-positive on ART and HIV-negative patients may impede clinical and policy decision-making. This study sought to estimate and compare: i) the prevalence of overweight/obesity between HIV-positive on ART and HIV-negative patients;ii) the prevalence of hypertension (HTN), diabetes mellitus (DM)/coronary heart disease (CHD) between HIV-positive patients on ART and HIV-negative patients attending same outpatient departments of general clinics in Gaborone, Botswana. Patients and Methods: Five hundred eighty-one (581) outpatients were recruited in four major clinics of Gaborone, Botswana, between June and July 2019;294 or 51% of them were HIV-negative and 287 or 49% were HIV-positive on ART. The prevalence of overweight/obesity and of HTN and DM/CHD were calculated and examined using stratified analysis. Subgroups were compared using Chi-square analysis with Yates correction or Fisher exact test and t-student test for continuous data. Results: Major findings after stratification of the study population by HIV status were: i) the prevalence of all categories of (BMI), including overweight/obesity, were comparable between HIV-negative-patients and HIV-positive. In fact, there were 24 (8.0%) cases of underweight among HIV-negative-Patients and 15(5%) cases among HIV-positive patients, p = 0.2;145 (49%) HIV-negative-patients and 128 (45%) HIV-positive, p = 0.07 cases of normal weight;72 (25%) HIV-negative-patients and 87 (30%) HIV-positive, p = 0.08, were overweight;53 (18%) HIV-negative-patients and 57 (20%) HIV-positive, p = 0.12, were obese;125 (43%) HIV-negative patients and 144 (50%) HIV-positive, p=0.06 were overweight/obese;ii) the prevalence of HTN and DM/CHD among HIV-positive-patients were significantly lower (p < 0.05) compared to HIV-negative patients: There were 32 (10.9%) cases of HTN among HIV-negative patients compared to 18 (6.3%) cases of HTN among HIV-positive patients, p = 0.001;32 (11%) cases of DM/CHD HIV-negative patients compared to 4 (1.4%) cases of DM/CHD among HIV-positive patients, p = 0.001. Conclusion: the prevalence of overweight/obesity observed between HIV-negative and HIV-positive patients may suggest that the two groups shared the same exposure factors. That HTN and DM/CHD prevalence was lower among HIV-positive compared to HIV-negative patients, is possibly due to interplay factors of ART, HIV or the host population. Further studies are, however, recommended for clarifications.
