BACKGROUND Gastrointestinal endoscopy technology has significantly improved the diagnostic accuracy and the successful treatment of gastrointestinal diseases.However,a series of ethical issues have emerged,such as exp...BACKGROUND Gastrointestinal endoscopy technology has significantly improved the diagnostic accuracy and the successful treatment of gastrointestinal diseases.However,a series of ethical issues have emerged,such as expanding treatment indications,which affect the fair distribution of medical resources.There is limited research on ethical issues in the field of digestive endoscopy.AIM To investigate the level of ethical awareness among gastrointestinal endoscopy practitioners and analyze the ethical issues involved in gastrointestinal endoscopy technology.METHODS A questionnaire survey was performed to collect relevant data(gender,age,degree of education,professional title,personnel category,the level of understanding medical ethical principles,ethics training and its learning pathways)from gastrointestinal endoscopy practitioners at the Second Hospital of Dalian Medical University and Dalian Friendship Hospital,including licensed physicians and nurses(including trainees and graduate students).RESULTS The majority of gastrointestinal endoscopy practitioners have received training on ethics,but there is still considerable room for improvement in their ethical awareness.Different learning pathways may affect the mastery of ethical principles, and understanding of ethical principles is more easily achieved through hospital ethics institutions.CONCLUSIONTo address the ethical issues in gastrointestinal endoscopy technology, it is necessary to enhance the humanisticeducation of gastrointestinal endoscopy practitioners, incorporate ethical standards into the technology assessmentprocess, and establish a patient-centered diagnostic and treatment model to improve the ethical awareness of practitionersand achieve a balance between technology and ethics.展开更多
Existing evidence suggests residential greenness is beneficial to human,while no research to date explored the associations of greenness with age-related macular degeneration(AMD).To evaluate the association of greenn...Existing evidence suggests residential greenness is beneficial to human,while no research to date explored the associations of greenness with age-related macular degeneration(AMD).To evaluate the association of greenness with AMD,modification and mediation effect of air pollution,we conducted this prospective study.We con-structed weighted quantile sum(WQS)index as co-exposure to nitrogen oxides(NO_(x)),particulate matter<2.5μm(PM_(2.5)),particulate matter<10μm(PM10).Stratified Cox regression models were applied to test the effect of exposure.Effect modification of air pollution was assessed.Stratified Cox models through the indirect method and Aalen additive risk models were used in mediation analysis.Over median follow-up of 11.67 years,4596 AMD events were ascertained.Hazard ratios(HRs)and 95%confidence intervals(95%CIs)of incident AMD for pollution per interquartile range(IQR)increment were 1.10(1.04–1.16)for nitrogen dioxide(NO_(2)),1.09(1.03–1.15)for NO_(x),1.14(1.05–1.24)for PM_(2.5),1.13(1.05–1.21)for PM10.The HR(95%CI)of AMD associated with greenness 1000 m buffer per IQR increment was 0.91(0.86–0.97),300 m buffer was 0.94(0.89–0.99).The as-sociation between greenness 1000 m and AMD was 28.59%,44.77%,35.59%,32.31%and 27.08%mediated by the decreased WQS index,NO_(2),NO_(x),PM_(2.5) and PM10,respectively.Increased greenness was associated with lower AMD incidence,and air pollution partly mediate it,which implies that interventions aimed at improving air quality and increasing greenness could have a dual benefit in mitigating AMD risk.展开更多
Background:Despite highly effective vaccines against SARS-CoV-2,COVID-19 vaccine hesitancy persisted in some populations in England during the pandemic,with rates and motivations for hesitancy varying by demographic g...Background:Despite highly effective vaccines against SARS-CoV-2,COVID-19 vaccine hesitancy persisted in some populations in England during the pandemic,with rates and motivations for hesitancy varying by demographic group.Addressing the drivers of vaccine hesitancy through targeted interventions in hesitant groups is a public health priority for better and more rapid control of disease spread.We aimed to characterise the determinants and subtypes of vaccine hesitancy and identify more persistent forms of hesitancy via analysis of vaccine uptake in a large cross-sectional cohort with linked National Health Service(NHS)data.展开更多
Background:To determine whether initiating a glucagon-like peptide-1 receptor agonist(GLP-1 RA)within 3 months of type 2 diabetes(T2DM)diagnosis alters the subsequent risk of overall and site-specific cancer and wheth...Background:To determine whether initiating a glucagon-like peptide-1 receptor agonist(GLP-1 RA)within 3 months of type 2 diabetes(T2DM)diagnosis alters the subsequent risk of overall and site-specific cancer and whether this association differs by baseline body-mass index(BMI).Methods:This retrospective cohort study used electronic health records from the TriNetX U.S.research network.Adults aged 20 years or older diagnosed with T2DM between 2016 and 2024 were included if they received any hypoglycemic agents within 3 months before and after diagnosis.Following 1:1 propensity score matching,both the GLP-1 RA user and non-user groups included 183,264 patients.The study outcome was defined as a diagnosis of malignant neoplasms.Hazard ratios(HRs)for overall and site-specific cancer risk were estimated using Cox proportional hazards models.Kaplan–Meier analysis and stratified analysis by BMI were performed.Results:Early GLP-1 RA use demonstrated a modest but significant association with reduced overall cancer risk(HR 0.93;95%CI:0.90–0.96).Reduced risks were noted for cancers of the digestive(HR 0.81),respiratory(HR 0.66),and female genital(HR 0.87)systems.In stratified analysis,benefits were more pronounced in patients with BMI≥30,particularly for pancreatic and colorectal cancers.Conclusion:Early initiation of GLP-1 receptor agonists in patients with diagnosed T2DM was associated with a modest reduction in overall cancer risk,particularly among individuals with obesity.These findings highlight the dual metabolic and oncologic value of prompt GLP-1 RA therapy.展开更多
BACKGROUND Helicobacter pylori(H.pylori)infection is a prevalent disease encountered in military internal medicine and recognized as the main cause of dyspepsia,gastritis,and peptic ulcer,which are common diseases in ...BACKGROUND Helicobacter pylori(H.pylori)infection is a prevalent disease encountered in military internal medicine and recognized as the main cause of dyspepsia,gastritis,and peptic ulcer,which are common diseases in military personnel.Current guidelines in China state all patients with evidence of active infection with H.pylori are offered treatment.However,the prevalence of H.pylori infection and its regional distribution in the military population remain unclear,which hinders effective prevention and treatment strategies.Understanding the prevalence of H.pylori infection in the military population will aid in the development of customized strategies to better manage this infectious disease.AIM To investigate the prevalence of H.pylori infection in the Chinese military population in different geographic areas.METHODS This multicenter,retrospective study included 22421 individuals from five tertiary hospitals located in north,east,southwest,and northwest cities of China.H.pylori infection was identified using the urea breath test,which had been performed between January 2020 and December 2021.RESULTS Of the 22421 military service members,7416(33.1%)were urea breath test-positive.The highest prevalence of H.pylori was in the 30-39 years age group for military personnel,with an infection rate of 34.9%.The majority of infected subjects were younger than 40-years-old,accounting for 70.4%of the infected population.The individuals serviced in Lanzhou and Chengdu showed a higher infection prevalence than those in Beijing,Nanjing,and Guangzhou,with prevalence rates of 44.3%,37.9%,29.0%,31.1%,and 32.3%,respectively.CONCLUSION H.pylori infection remains a common infectious disease among military personnel in China and has a relatively high prevalence rate in northwest China.展开更多
Objective The relationship between non-high-density lipoprotein(NHDL)cholesterol to high-density lipoprotein cholesterol(HDL-C)ratio(NHHR)and stoke remains unknown.This study aimed to evaluate the association between ...Objective The relationship between non-high-density lipoprotein(NHDL)cholesterol to high-density lipoprotein cholesterol(HDL-C)ratio(NHHR)and stoke remains unknown.This study aimed to evaluate the association between the adult NHHR and stroke occurrence in the United States of America(USA).Methods To clarify the relationship between the NHHR and stroke risk,this study used a multivariable logistic regression model and a restricted cubic spline(RCS)model to investigate the association between the NHHR and stroke,and data from the National Health and Nutrition Examination Survey(NHANES)from 2005 to 2018.Subgroup and sensitivity analyses were conducted to test the robustness of the results.Results This study included 29,928 adult participants,of which 1,165 participants had a history of stroke.Logistic regression analysis of variables demonstrated a positive association between NHHR and stroke(OR 1.24,95%CI:1.03-1.50,P=0.026).Compared with the lowest reference group of NHHR,participants in the second,third,and fourth quartile had a significantly increased risk of stroke after full adjustments(OR:1.35,95%CI:1.08-1.69)(OR:1.83,95%CI:1.42-2.36)(OR:2.04,95%CI:1.50-2.79).In the total population,a nonlinear dose-response relationship was observed between the NHHR and stroke risk(P non-linearity=0.002).This association remained significant in several subgroup analyses.Further investigation of the NHHR may enhance our understanding of stroke prevention and treatment.Conclusion Our findings suggest a positive correlation between the NHHR and an increased prevalence of stroke,potentially serving as a novel predictive factor for stroke.Timely intervention and management of the NHHR may effectively mitigate stroke occurrence.Prospective studies are required to validate this association and further explore the underlying biological mechanisms.展开更多
OBJECTIVE:To investigate the difference in gut microbiota between population with damp-heat constitution(DHC)and balanced constitution(BC).METHODS:A multi-centered cross-sectional casecontrol study was conducted,which...OBJECTIVE:To investigate the difference in gut microbiota between population with damp-heat constitution(DHC)and balanced constitution(BC).METHODS:A multi-centered cross-sectional casecontrol study was conducted,which included 249 participants with damp-heat constitution or balanced constitution.Baseline information of participants was collected,and stool samples were collected for gut microbiota analysis.Principal coordinate analysis,linear discriminant analysis effect size analysis,receiver operating characteristic,random forest model,and phylogenetic investigation of communities by reconstruction of unobserved states methods were used to reveal the relationship between gut microbiota and the damp-heat constitution.RESULTS:Compared to those in the BC group,the richness and diversity of the microbiota,specifically those of several short-chain fatty acid producing genera such as Barnesiella,Coprobacter,and Butyricimonas,were significantly decreased in the DHC group.Regarding biological functions,flavonoid biosynthesis,propanoate metabolism,and nucleotide sugar metabolism were suppressed,while arachidonic acid metabolism and glutathione metabolism were enriched in the DHC group.Finally,a classifier based on the microbiota was constructed to discriminate between the DHC and BC populations.CONCLUSION:The gut microbiota of the DHC population exhibits significantly reduced diversity and is closely related to inflammation,metabolic disorders,and liver steatosis,which is consistent with clinical observations,thus serving as a potential diagnostic tool for traditional Chinese medicine constitution discrimination.展开更多
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
BACKGROUND Although the link between cardiovascular disease(CVD)and various cancers is well-established,the relationship between CVD risk and colorectal cancer(CRC)remains underexplored.AIM To elucidate the relationsh...BACKGROUND Although the link between cardiovascular disease(CVD)and various cancers is well-established,the relationship between CVD risk and colorectal cancer(CRC)remains underexplored.AIM To elucidate the relationship between CVD risk scores and CRC incidence.METHODS In this population-based cohort study,participants from the 2009 National Health Checkup were followed-up until 2020.The cardiovascular(CV)risk score was calculated as the sum of risk factors(age,family history of coronary artery disease,hypertension,smoking status,and high-density lipoprotein levels)with high-density lipoprotein(≥60 mg/dL)reducing the risk score by one.The primary outcome was incidence of newly diagnosed CRC.RESULTS Among 2526628 individuals,30329 developed CRC during a mean follow-up of 10.1 years.Categorized by CV risk scores(0,1,2,and≥3).CRC risk increased with higher CV risk scores after adjusting for covariates[(hazard ratio=1.155,95%confidence interval:1.107-1.205)in risk score≥3,P<0.001].This association individuals not using statins.Moreover,even in participants without diabetes,a higher CV risk was associated with an increased CRC risk.CONCLUSION Increased CV risk scores were significantly associated with higher CRC risk,especially among males,younger populations,and non-statin users.Thus,males with a higher CV risk score,even at a younger age,are recommended to control their risk factors and undergo individualized CRC screening.展开更多
Objective:Postpartum nutrition plays a critical role in maternal recovery and long-term health.However,the nutritional status of working mothers in the postpartum period remains understudied.This study aimed to assess...Objective:Postpartum nutrition plays a critical role in maternal recovery and long-term health.However,the nutritional status of working mothers in the postpartum period remains understudied.This study aimed to assess the dietary quality of postpartum women in urban Beijing,identify occupational-related factors influencing their diet,and explore potential interventions to improve maternal nutrition during the postpartum period.Methods:In this cross-sectional analysis,554 women one year after delivery were recruited from ten community health centers.Sociodemographic,occupational and postpartum care variables were collected via questionnaire.Dietary intake over the preceding year was assessed using a food frequency questionnaire.The modified dietary balance index for postpartum women were used for dietary quality assessment.Results:The study revealed severe dietary imbalances among postpartum women,characterized by excessive consumption of cereals,eggs,and meats,while their intake of vegetables,fruits,and dairy products was inadequate.According to dietary balance index for postpartum women,66.25%of mothers showed varying degrees of excessive intake.45.31%of mothers experienced varying levels of insufficient intake,with only 19.86%of participants having a relatively balanced diet.Occupational differences were observed,with women in the commercial employment group showing higher levels of excessive food intake.The analysis of influencing factors showed that family monthly income,maternity leave,and postpartum care significantly affected the dietary quality.Conclusions:Postpartum women in Beijing experience widespread dietary imbalances,with both excesses and deficiencies.Occupational context and related factors significantly shape diet quality.These findings highlight the need for targeted nutritional interventions tailored to the specific challenges of different occupational groups.展开更多
Objective To investigate the association between ABO blood types and gestational diabetes mellitus(GDM)risk.Methods A prospective birth cohort study was conducted.ABO blood types were determined using the slide method...Objective To investigate the association between ABO blood types and gestational diabetes mellitus(GDM)risk.Methods A prospective birth cohort study was conducted.ABO blood types were determined using the slide method.GDM diagnosis was based on a 75-g,2-h oral glucose tolerance test(OGTT)according to the criteria of the International Association of Diabetes and Pregnancy Study Groups.Logistic regression was applied to calculate the odds ratios(ORs)and 95%confidence intervals(CIs)between ABO blood types and GDM risk.Results A total of 30,740 pregnant women with a mean age of 31.81 years were enrolled in this study.The ABO blood types distribution was:type O(30.99%),type A(26.58%),type B(32.20%),and type AB(10.23%).GDM was identified in 14.44%of participants.Using blood type O as a reference,GDM risk was not significantly higher for types A(OR=1.05)or B(OR=1.04).However,women with type AB had a 19%increased risk of GDM(OR=1.19,95%CI=1.05–1.34;P<0.05),even after adjusting for various factors.This increased risk for type AB was consistent across subgroup and sensitivity analyses.Conclusion The ABO blood types may influence GDM risk,with type AB associated with a higher risk.Incorporating it—either as a single risk factor or in combination with other known factors—could help identify individuals at risk for GDM before or during early pregnancy.展开更多
Objective: We aim to analyze the surgical nursery of abdominal wall hernias in adults between two poorly fitted medical environments, the Regional Hospital Center of Tsévié (RHC-T) and the Prefectural Hospit...Objective: We aim to analyze the surgical nursery of abdominal wall hernias in adults between two poorly fitted medical environments, the Regional Hospital Center of Tsévié (RHC-T) and the Prefectural Hospital Center of Kpalimé (PHC-K) in Togo. Methodology: It was a retrospective, descriptive and comparative study carried out over five years (2018-2022) focusing on abdominal wall hernias in adults. Information was gathered from the patients’clinical notes and registers on the frequency of hernias, the anatomo-clinical forms of hernias, the type of anesthesia, the hernia repair technique and the postoperative evolution. Results: Of the 1022 and 1026 operations performed, 312 and 412 were hernial repairs, representing 30.5% and 41.2% of operations at RHC-T and PHC-K respectively (p = 0.001). The inguinal hernia was the most often found in 83.7% (n = 261) at RHC-T versus 76.6% (n = 324) at PHC-K. Herniorrhaphy was the most frequently used repair method, in 93.6% (n = 292) of patients at RHC-T and in 91.3% (n = 376) at PHC-K (p = 0.11). Postoperative complications were noted in 5.1% of cases (n = 16) at RHC-T versus 3.5% of cases (n = 15) at PHC-K (p = 0.307). These complications included scrotal hematomas, surgical areas infections, and orchitis. We recorded 1.3% (n = 4) and 0.8% (n = 3) deaths at RHC-T and PHC-K respectively (p = 0.496). Conclusion: There is homogeneity in the treatment of hernia in these two hospitals in Togo.展开更多
Background: Pancreatic cancer is one of the most lethal malignancies, with postoperative recurrence severely affecting patient survival and prognosis. This study aims to develop and validate a clinical prediction mode...Background: Pancreatic cancer is one of the most lethal malignancies, with postoperative recurrence severely affecting patient survival and prognosis. This study aims to develop and validate a clinical prediction model for postoperative recurrence in pancreatic cancer patients, incorporating multiple preoperative, intraoperative, and postoperative factors to assist clinical decision-making. Methods: A retrospective study was conducted on 216 patients who underwent surgical treatment for pancreatic malignancy at the First Affiliated Hospital of Chongqing Medical University between January 2015 and January 2023. An independent external validation cohort of 76 patients from the Second Affiliated Hospital of Chongqing Medical University was used to validate the model. Seven independent risk factors for postoperative recurrence were identified through univariate and multivariate Cox regression analyses. The model’s performance was evaluated using the concordance index (C-index) and ROC curves, and its accuracy and clinical value were assessed using calibration curves and decision curve analysis (DCA). Results: The predictive model demonstrated good discriminatory power, with a C-index of 0.72 in the training cohort and 0.66 in the validation cohort. The ROC curves for predicting recurrence at 3, 6, and 12 months postoperatively showed AUC values ranging from 0.72 to 0.83, indicating strong predictive value. Calibration curves and DCA confirmed the model’s accuracy and clinical utility. Conclusion: This study successfully developed and validated a clinical prediction model that incorporates seven independent risk factors for postoperative recurrence in pancreatic cancer. The model provides a useful tool for predicting recurrence risk, aiding in the identification of high-risk patients, and informing clinical decision-making.展开更多
OBJECTIVE The emergence of evolving variants of Coronavirus disease 2019(COVID-19)has fostered the need for change of newer and adaptive treatments for these infections.During the COVID-19 pandemic and persists,tradit...OBJECTIVE The emergence of evolving variants of Coronavirus disease 2019(COVID-19)has fostered the need for change of newer and adaptive treatments for these infections.During the COVID-19 pandemic and persists,traditional Chinese medicine(TCM)herbs exhibit significant bioactivity and therapeutic effect.This study is aimed to evaluate the efficacy of four TCM preparations on 28-day mortality risk of patients and changes of the laboratory indicators.METHODS The retrospective cohort study included patients with COVID-19 who were admitted to the Jiangsu Province Hospital of Chinese Medicine from December 15,2022 to January 15,2023,and those died within 48 hours of admission or cannot be tracked for outcomes were excluded.The primary outcome was survival status in 28 days(death or survival)starting from the day of admission.The second outcomes were laboratory indicators,including absolute lymphocyte count,lactate dehydrogenase,creatinine,and blood urea nitrogen.Binary logistic regressions were used to estimate the effect of TCM preparations on the primary and secondary outcomes in main analysis.Meanwhile,heterogeneity and robustness of results from main analysis were assessed by subgroup analyses and multiple sensitivity analyses.RESULTS 1816 eligible patients were included in analysis dataset,including 573 patients received standard care(control group)and 1243 patients received TCM preparations(hospital preparation group).The 28-day mortality rate of hospital preparation group was lower than that of control group(4.75%vs.14.83%),and the difference was statistically significant(χ^(2)=54.666,P<0.001).The risk of 28-day mortality was 0.535 times lower in the hospital preparation group as compared with the control group(OR=0.46,95%CI:0.305-0.708,P<0.001)showed by multivariable binary logistic regressions.Subgroup analyses showed that taking TCM preparations reduced the 28-day mortality risk.Sensitivity analyses demonstrated that the results of the main analysis for primary outcomes were robust.For secondary outcomes,the risk of abnormal absolute lymphocyte counts at discharge in the hospital preparation group decreased by 0.284 times(OR=0.703,95%CI:0.515-0.961,P=0.027).CONCLUSION Compared with standard of care,taking four hospital preparations including Kanggan Heji,Feining Heji,Qishen Gubiao Keli,and Qianghuo Qushi Qingwen Heji decreased risk of 28-day mortality among hospitalized COVID-19 patients.TCM therapy achieves adequate therapeutic effects in COVID-19.展开更多
Background Clinical brain-computer interface(BCI)for mental disorders is an emerging interdisciplinary research field,posing new ethical concerns and challenges,yet lacking practical ethical governance guidelines for ...Background Clinical brain-computer interface(BCI)for mental disorders is an emerging interdisciplinary research field,posing new ethical concerns and challenges,yet lacking practical ethical governance guidelines for stakeholders and the entire community.Aims This study aims to establish a multidisciplinary consensus of principles for ethical governance of clinical BCI research for mental disorders and offer practical ethical guidance to stakeholders involved.Methods A systematic literature review,symposium and roundtable discussions,and a pre-Delphi(round 0)survey were conducted to form the questionnaire for the three-round modified Delphi study.Two rounds of surveys,followed by a third round of independent interviews of 25 experts from BCI-related research domains,were involved.We conducted quantitative analysis of responses and agreements among experts to reveal the consensus and differences regarding the ethical governance of mental BCI research from a multidisciplinary perspective.Results The Delphi panel emphasised important concerns of ethical review practices and ethical principles within the BCI context,identified qualified and highly influential institutions and personnel in conducting and advancing clinical BCI research,and recognised prioritised aspects in the risk-benefit evaluation.Experts expressed diverse opinions on specific ethical concerns,including concerns about invasive technology,its impact on humanity and potential social consequences.Agreement was reached that the practices of ethical governance of clinical BCI for mental disorders should focus on patient voluntariness,autonomy,long-term effects and related assessments of BCI interventions,as well as privacy protection,transparent reporting and ensuring that the research is conducted in qualified institutions with strong data security.Conclusions Ethical governance of clinical research on BCI for mental disorders should include interdisciplinary experts to balance various needs and incorporate the expertise of different stakeholders to avoid serious ethical issues.It requires scientifically grounded approaches,continuous monitoring and interdisciplinary collaboration to ensure evidence-based policies,comprehensive risk assessments and transparency,thereby promoting responsible innovations and protecting patient rights and well-being.展开更多
Lung cancer, the leading cause of cancer deaths worldwide and in China, has a 19.7% five-year survival rate due to terminal-stage diagnosis^([1-3]).Although low-dose computed tomography(CT) screening can reduce mortal...Lung cancer, the leading cause of cancer deaths worldwide and in China, has a 19.7% five-year survival rate due to terminal-stage diagnosis^([1-3]).Although low-dose computed tomography(CT) screening can reduce mortality, high false positive rates can create economic and psychological burdens.展开更多
Thermally activated delayed fluorescence(TADF)molecules have outstanding potential for applications in organic light-emitting diodes(OLEDs).Due to the lack of systematic studies on the correlation between molecular st...Thermally activated delayed fluorescence(TADF)molecules have outstanding potential for applications in organic light-emitting diodes(OLEDs).Due to the lack of systematic studies on the correlation between molecular structure and luminescence properties,TADF molecules are far from meeting the needs of practical applications in terms of variety and number.In this paper,three twisted TADF molecules are studied and their photophysical properties are theoretically predicted based on the thermal vibrational correlation function method combined with multiscale calculations.The results show that all the molecules exhibit fast reverse intersystem crossing(RISC)rates(kRISC),predicting their TADF luminescence properties.In addition,the binding of DHPAzSi as the donor unit with different acceptors can change the dihedral angle between the ground and excited states,and the planarity of the acceptors is positively correlated with the reorganization energy,a property that has a strong influence on the non-radiative process.Furthermore,a decrease in the energy of the molecular charge transfer state and an increase in the kRISC were observed in the films.This study not only provides a reliable explanation for the observed experimental results,but also offers valuable insights that can guide the design of future TADF molecules.展开更多
Objective: This study assessed the effects of consuming acetic acid bacteria (Gluconacetobacter hansenii GK-1) for 12 weeks on fatigue induced by temporary mental stress. Methods: This randomized, double-blind, placeb...Objective: This study assessed the effects of consuming acetic acid bacteria (Gluconacetobacter hansenii GK-1) for 12 weeks on fatigue induced by temporary mental stress. Methods: This randomized, double-blind, placebo-controlled, parallel-group study included 100 healthy male and female adults aged 20 - 64 years. Participants consumed either the G. hansenii GK-1 supplement (9 × 10⁹ cells/day) or a placebo daily for 12 weeks. The impact of temporary mental stress on fatigue in G. hansenii GK-1 was assessed using a Visual Analog Scale (VAS) before the study began and after 12 weeks of supplementation. Results: Subjective fatigue measured by Visual Analog Scale (VAS) showed a significant decrease in fatigue induced by temporary mental stress after 12 weeks of consumption in the G. hansenii GK-1 group compared with the placebo group. No adverse events were attributed to G. hansenii GK-1. These findings confirm that continuous oral ingestion of G. hansenii GK-1 by healthy Japanese adults reduces feelings of fatigue caused by temporary mental stress.展开更多
Objective:To explore the association between acupuncture during controlled ovarian hyperstimulation(COH)and the live birth rate(LBR)using different propensity score methods.Methods:In this retrospective cohort study,e...Objective:To explore the association between acupuncture during controlled ovarian hyperstimulation(COH)and the live birth rate(LBR)using different propensity score methods.Methods:In this retrospective cohort study,eligible women who underwent a COH were divided into acupuncture and non-acupuncture groups.The primary outcome was LBR,as determined by propensity score matching(PSM).LBR was defined as the delivery of one or more living infants that reached a gestational age over 28 weeks after embryo transfer.The propensity score model encompassed 16 confounding variables.To validate the results,sensitivity analyses were conducted using three additional propensity score methods:propensity score adjustment,inverse probability weighting(IPW),and IPW with a"doubly robust”estimator.Results:The primary cohort encompassed 9751 patients(1830[18.76%]in the acupuncture group and7921[81.23%]in the non-acupuncture group).Following 1:1 PSM,a higher LBR was found in the acupuncture cohort(41.4%[755/1824]vs 36.4%[664/1824],with an odds ratio of 1.23[95%confidence interval,1.08-1.41]).Three additional propensity score methods produced essentially similar results.The risk of serious adverse events did not significantly differ between the two groups.Conclusion:This retrospective study revealed an association between acupuncture and an increased LBR among patients undergoing COH,and that acupuncture is a safe and valuable treatment option.展开更多
On May 26,40 teachers and students from the graduating class of the Buddhist Academy of Xizang in Lhasa embarked on a teaching practice and national condition study tour in Zhejiang and Shanghai.
文摘BACKGROUND Gastrointestinal endoscopy technology has significantly improved the diagnostic accuracy and the successful treatment of gastrointestinal diseases.However,a series of ethical issues have emerged,such as expanding treatment indications,which affect the fair distribution of medical resources.There is limited research on ethical issues in the field of digestive endoscopy.AIM To investigate the level of ethical awareness among gastrointestinal endoscopy practitioners and analyze the ethical issues involved in gastrointestinal endoscopy technology.METHODS A questionnaire survey was performed to collect relevant data(gender,age,degree of education,professional title,personnel category,the level of understanding medical ethical principles,ethics training and its learning pathways)from gastrointestinal endoscopy practitioners at the Second Hospital of Dalian Medical University and Dalian Friendship Hospital,including licensed physicians and nurses(including trainees and graduate students).RESULTS The majority of gastrointestinal endoscopy practitioners have received training on ethics,but there is still considerable room for improvement in their ethical awareness.Different learning pathways may affect the mastery of ethical principles, and understanding of ethical principles is more easily achieved through hospital ethics institutions.CONCLUSIONTo address the ethical issues in gastrointestinal endoscopy technology, it is necessary to enhance the humanisticeducation of gastrointestinal endoscopy practitioners, incorporate ethical standards into the technology assessmentprocess, and establish a patient-centered diagnostic and treatment model to improve the ethical awareness of practitionersand achieve a balance between technology and ethics.
基金supported by the High-level Talents Introduction Plan from Central South University(No.502045003)the National Natural Science Foundation of China(No.42277438)Hunan Provincial Natural Science Foundation for Distinguished Young Scholars(No.2024JJ2082)to Fang Xiao,and the Postgraduate Independent Exploration and Innovation Project of Central South University,China(Nos.2024ZZTS0557 and 2023ZZTS0993)。
文摘Existing evidence suggests residential greenness is beneficial to human,while no research to date explored the associations of greenness with age-related macular degeneration(AMD).To evaluate the association of greenness with AMD,modification and mediation effect of air pollution,we conducted this prospective study.We con-structed weighted quantile sum(WQS)index as co-exposure to nitrogen oxides(NO_(x)),particulate matter<2.5μm(PM_(2.5)),particulate matter<10μm(PM10).Stratified Cox regression models were applied to test the effect of exposure.Effect modification of air pollution was assessed.Stratified Cox models through the indirect method and Aalen additive risk models were used in mediation analysis.Over median follow-up of 11.67 years,4596 AMD events were ascertained.Hazard ratios(HRs)and 95%confidence intervals(95%CIs)of incident AMD for pollution per interquartile range(IQR)increment were 1.10(1.04–1.16)for nitrogen dioxide(NO_(2)),1.09(1.03–1.15)for NO_(x),1.14(1.05–1.24)for PM_(2.5),1.13(1.05–1.21)for PM10.The HR(95%CI)of AMD associated with greenness 1000 m buffer per IQR increment was 0.91(0.86–0.97),300 m buffer was 0.94(0.89–0.99).The as-sociation between greenness 1000 m and AMD was 28.59%,44.77%,35.59%,32.31%and 27.08%mediated by the decreased WQS index,NO_(2),NO_(x),PM_(2.5) and PM10,respectively.Increased greenness was associated with lower AMD incidence,and air pollution partly mediate it,which implies that interventions aimed at improving air quality and increasing greenness could have a dual benefit in mitigating AMD risk.
文摘Background:Despite highly effective vaccines against SARS-CoV-2,COVID-19 vaccine hesitancy persisted in some populations in England during the pandemic,with rates and motivations for hesitancy varying by demographic group.Addressing the drivers of vaccine hesitancy through targeted interventions in hesitant groups is a public health priority for better and more rapid control of disease spread.We aimed to characterise the determinants and subtypes of vaccine hesitancy and identify more persistent forms of hesitancy via analysis of vaccine uptake in a large cross-sectional cohort with linked National Health Service(NHS)data.
基金financial support fromthe Chung Shan Medical University Hospital,Taiwan(CSH-2022-A-009).
文摘Background:To determine whether initiating a glucagon-like peptide-1 receptor agonist(GLP-1 RA)within 3 months of type 2 diabetes(T2DM)diagnosis alters the subsequent risk of overall and site-specific cancer and whether this association differs by baseline body-mass index(BMI).Methods:This retrospective cohort study used electronic health records from the TriNetX U.S.research network.Adults aged 20 years or older diagnosed with T2DM between 2016 and 2024 were included if they received any hypoglycemic agents within 3 months before and after diagnosis.Following 1:1 propensity score matching,both the GLP-1 RA user and non-user groups included 183,264 patients.The study outcome was defined as a diagnosis of malignant neoplasms.Hazard ratios(HRs)for overall and site-specific cancer risk were estimated using Cox proportional hazards models.Kaplan–Meier analysis and stratified analysis by BMI were performed.Results:Early GLP-1 RA use demonstrated a modest but significant association with reduced overall cancer risk(HR 0.93;95%CI:0.90–0.96).Reduced risks were noted for cancers of the digestive(HR 0.81),respiratory(HR 0.66),and female genital(HR 0.87)systems.In stratified analysis,benefits were more pronounced in patients with BMI≥30,particularly for pancreatic and colorectal cancers.Conclusion:Early initiation of GLP-1 receptor agonists in patients with diagnosed T2DM was associated with a modest reduction in overall cancer risk,particularly among individuals with obesity.These findings highlight the dual metabolic and oncologic value of prompt GLP-1 RA therapy.
文摘BACKGROUND Helicobacter pylori(H.pylori)infection is a prevalent disease encountered in military internal medicine and recognized as the main cause of dyspepsia,gastritis,and peptic ulcer,which are common diseases in military personnel.Current guidelines in China state all patients with evidence of active infection with H.pylori are offered treatment.However,the prevalence of H.pylori infection and its regional distribution in the military population remain unclear,which hinders effective prevention and treatment strategies.Understanding the prevalence of H.pylori infection in the military population will aid in the development of customized strategies to better manage this infectious disease.AIM To investigate the prevalence of H.pylori infection in the Chinese military population in different geographic areas.METHODS This multicenter,retrospective study included 22421 individuals from five tertiary hospitals located in north,east,southwest,and northwest cities of China.H.pylori infection was identified using the urea breath test,which had been performed between January 2020 and December 2021.RESULTS Of the 22421 military service members,7416(33.1%)were urea breath test-positive.The highest prevalence of H.pylori was in the 30-39 years age group for military personnel,with an infection rate of 34.9%.The majority of infected subjects were younger than 40-years-old,accounting for 70.4%of the infected population.The individuals serviced in Lanzhou and Chengdu showed a higher infection prevalence than those in Beijing,Nanjing,and Guangzhou,with prevalence rates of 44.3%,37.9%,29.0%,31.1%,and 32.3%,respectively.CONCLUSION H.pylori infection remains a common infectious disease among military personnel in China and has a relatively high prevalence rate in northwest China.
文摘Objective The relationship between non-high-density lipoprotein(NHDL)cholesterol to high-density lipoprotein cholesterol(HDL-C)ratio(NHHR)and stoke remains unknown.This study aimed to evaluate the association between the adult NHHR and stroke occurrence in the United States of America(USA).Methods To clarify the relationship between the NHHR and stroke risk,this study used a multivariable logistic regression model and a restricted cubic spline(RCS)model to investigate the association between the NHHR and stroke,and data from the National Health and Nutrition Examination Survey(NHANES)from 2005 to 2018.Subgroup and sensitivity analyses were conducted to test the robustness of the results.Results This study included 29,928 adult participants,of which 1,165 participants had a history of stroke.Logistic regression analysis of variables demonstrated a positive association between NHHR and stroke(OR 1.24,95%CI:1.03-1.50,P=0.026).Compared with the lowest reference group of NHHR,participants in the second,third,and fourth quartile had a significantly increased risk of stroke after full adjustments(OR:1.35,95%CI:1.08-1.69)(OR:1.83,95%CI:1.42-2.36)(OR:2.04,95%CI:1.50-2.79).In the total population,a nonlinear dose-response relationship was observed between the NHHR and stroke risk(P non-linearity=0.002).This association remained significant in several subgroup analyses.Further investigation of the NHHR may enhance our understanding of stroke prevention and treatment.Conclusion Our findings suggest a positive correlation between the NHHR and an increased prevalence of stroke,potentially serving as a novel predictive factor for stroke.Timely intervention and management of the NHHR may effectively mitigate stroke occurrence.Prospective studies are required to validate this association and further explore the underlying biological mechanisms.
基金National Nonprofit Institute Research Grant for the Institute of Basic Theory for Chinese Medicine,China Academy of Chinese Medical Sciences:Mechanism of Regulating Phlegm-Dampness Constitution to Prevent Metabolic Diseases based on Gut Microbiota-host DNA Methylation(No.YZ-202151)。
文摘OBJECTIVE:To investigate the difference in gut microbiota between population with damp-heat constitution(DHC)and balanced constitution(BC).METHODS:A multi-centered cross-sectional casecontrol study was conducted,which included 249 participants with damp-heat constitution or balanced constitution.Baseline information of participants was collected,and stool samples were collected for gut microbiota analysis.Principal coordinate analysis,linear discriminant analysis effect size analysis,receiver operating characteristic,random forest model,and phylogenetic investigation of communities by reconstruction of unobserved states methods were used to reveal the relationship between gut microbiota and the damp-heat constitution.RESULTS:Compared to those in the BC group,the richness and diversity of the microbiota,specifically those of several short-chain fatty acid producing genera such as Barnesiella,Coprobacter,and Butyricimonas,were significantly decreased in the DHC group.Regarding biological functions,flavonoid biosynthesis,propanoate metabolism,and nucleotide sugar metabolism were suppressed,while arachidonic acid metabolism and glutathione metabolism were enriched in the DHC group.Finally,a classifier based on the microbiota was constructed to discriminate between the DHC and BC populations.CONCLUSION:The gut microbiota of the DHC population exhibits significantly reduced diversity and is closely related to inflammation,metabolic disorders,and liver steatosis,which is consistent with clinical observations,thus serving as a potential diagnostic tool for traditional Chinese medicine constitution discrimination.
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.
文摘BACKGROUND Although the link between cardiovascular disease(CVD)and various cancers is well-established,the relationship between CVD risk and colorectal cancer(CRC)remains underexplored.AIM To elucidate the relationship between CVD risk scores and CRC incidence.METHODS In this population-based cohort study,participants from the 2009 National Health Checkup were followed-up until 2020.The cardiovascular(CV)risk score was calculated as the sum of risk factors(age,family history of coronary artery disease,hypertension,smoking status,and high-density lipoprotein levels)with high-density lipoprotein(≥60 mg/dL)reducing the risk score by one.The primary outcome was incidence of newly diagnosed CRC.RESULTS Among 2526628 individuals,30329 developed CRC during a mean follow-up of 10.1 years.Categorized by CV risk scores(0,1,2,and≥3).CRC risk increased with higher CV risk scores after adjusting for covariates[(hazard ratio=1.155,95%confidence interval:1.107-1.205)in risk score≥3,P<0.001].This association individuals not using statins.Moreover,even in participants without diabetes,a higher CV risk was associated with an increased CRC risk.CONCLUSION Increased CV risk scores were significantly associated with higher CRC risk,especially among males,younger populations,and non-statin users.Thus,males with a higher CV risk score,even at a younger age,are recommended to control their risk factors and undergo individualized CRC screening.
基金supported by an Innovation Fund for Medical Sciences of the Chinese Academy of Medical Sciences (Grant No.2019-I2M-2-007).
文摘Objective:Postpartum nutrition plays a critical role in maternal recovery and long-term health.However,the nutritional status of working mothers in the postpartum period remains understudied.This study aimed to assess the dietary quality of postpartum women in urban Beijing,identify occupational-related factors influencing their diet,and explore potential interventions to improve maternal nutrition during the postpartum period.Methods:In this cross-sectional analysis,554 women one year after delivery were recruited from ten community health centers.Sociodemographic,occupational and postpartum care variables were collected via questionnaire.Dietary intake over the preceding year was assessed using a food frequency questionnaire.The modified dietary balance index for postpartum women were used for dietary quality assessment.Results:The study revealed severe dietary imbalances among postpartum women,characterized by excessive consumption of cereals,eggs,and meats,while their intake of vegetables,fruits,and dairy products was inadequate.According to dietary balance index for postpartum women,66.25%of mothers showed varying degrees of excessive intake.45.31%of mothers experienced varying levels of insufficient intake,with only 19.86%of participants having a relatively balanced diet.Occupational differences were observed,with women in the commercial employment group showing higher levels of excessive food intake.The analysis of influencing factors showed that family monthly income,maternity leave,and postpartum care significantly affected the dietary quality.Conclusions:Postpartum women in Beijing experience widespread dietary imbalances,with both excesses and deficiencies.Occupational context and related factors significantly shape diet quality.These findings highlight the need for targeted nutritional interventions tailored to the specific challenges of different occupational groups.
基金supported by the Capital’s Funds for Health Improvement and Research(No.2024-2G-2118)the National Key Research and Development Program of China(2016YFC1000101)+2 种基金the Leading Talents in the Construction Project of High-Level Public Health Technical Talents in Beijing(2022-1-003)the“Green Seedling”Youth Program by the Beijing Hospitals Authority(QML20231402)the Young Elite Scientist Sponsorship Program by the Beijing Association for Science and Technology(BYESS2022200)。
文摘Objective To investigate the association between ABO blood types and gestational diabetes mellitus(GDM)risk.Methods A prospective birth cohort study was conducted.ABO blood types were determined using the slide method.GDM diagnosis was based on a 75-g,2-h oral glucose tolerance test(OGTT)according to the criteria of the International Association of Diabetes and Pregnancy Study Groups.Logistic regression was applied to calculate the odds ratios(ORs)and 95%confidence intervals(CIs)between ABO blood types and GDM risk.Results A total of 30,740 pregnant women with a mean age of 31.81 years were enrolled in this study.The ABO blood types distribution was:type O(30.99%),type A(26.58%),type B(32.20%),and type AB(10.23%).GDM was identified in 14.44%of participants.Using blood type O as a reference,GDM risk was not significantly higher for types A(OR=1.05)or B(OR=1.04).However,women with type AB had a 19%increased risk of GDM(OR=1.19,95%CI=1.05–1.34;P<0.05),even after adjusting for various factors.This increased risk for type AB was consistent across subgroup and sensitivity analyses.Conclusion The ABO blood types may influence GDM risk,with type AB associated with a higher risk.Incorporating it—either as a single risk factor or in combination with other known factors—could help identify individuals at risk for GDM before or during early pregnancy.
文摘Objective: We aim to analyze the surgical nursery of abdominal wall hernias in adults between two poorly fitted medical environments, the Regional Hospital Center of Tsévié (RHC-T) and the Prefectural Hospital Center of Kpalimé (PHC-K) in Togo. Methodology: It was a retrospective, descriptive and comparative study carried out over five years (2018-2022) focusing on abdominal wall hernias in adults. Information was gathered from the patients’clinical notes and registers on the frequency of hernias, the anatomo-clinical forms of hernias, the type of anesthesia, the hernia repair technique and the postoperative evolution. Results: Of the 1022 and 1026 operations performed, 312 and 412 were hernial repairs, representing 30.5% and 41.2% of operations at RHC-T and PHC-K respectively (p = 0.001). The inguinal hernia was the most often found in 83.7% (n = 261) at RHC-T versus 76.6% (n = 324) at PHC-K. Herniorrhaphy was the most frequently used repair method, in 93.6% (n = 292) of patients at RHC-T and in 91.3% (n = 376) at PHC-K (p = 0.11). Postoperative complications were noted in 5.1% of cases (n = 16) at RHC-T versus 3.5% of cases (n = 15) at PHC-K (p = 0.307). These complications included scrotal hematomas, surgical areas infections, and orchitis. We recorded 1.3% (n = 4) and 0.8% (n = 3) deaths at RHC-T and PHC-K respectively (p = 0.496). Conclusion: There is homogeneity in the treatment of hernia in these two hospitals in Togo.
文摘Background: Pancreatic cancer is one of the most lethal malignancies, with postoperative recurrence severely affecting patient survival and prognosis. This study aims to develop and validate a clinical prediction model for postoperative recurrence in pancreatic cancer patients, incorporating multiple preoperative, intraoperative, and postoperative factors to assist clinical decision-making. Methods: A retrospective study was conducted on 216 patients who underwent surgical treatment for pancreatic malignancy at the First Affiliated Hospital of Chongqing Medical University between January 2015 and January 2023. An independent external validation cohort of 76 patients from the Second Affiliated Hospital of Chongqing Medical University was used to validate the model. Seven independent risk factors for postoperative recurrence were identified through univariate and multivariate Cox regression analyses. The model’s performance was evaluated using the concordance index (C-index) and ROC curves, and its accuracy and clinical value were assessed using calibration curves and decision curve analysis (DCA). Results: The predictive model demonstrated good discriminatory power, with a C-index of 0.72 in the training cohort and 0.66 in the validation cohort. The ROC curves for predicting recurrence at 3, 6, and 12 months postoperatively showed AUC values ranging from 0.72 to 0.83, indicating strong predictive value. Calibration curves and DCA confirmed the model’s accuracy and clinical utility. Conclusion: This study successfully developed and validated a clinical prediction model that incorporates seven independent risk factors for postoperative recurrence in pancreatic cancer. The model provides a useful tool for predicting recurrence risk, aiding in the identification of high-risk patients, and informing clinical decision-making.
文摘OBJECTIVE The emergence of evolving variants of Coronavirus disease 2019(COVID-19)has fostered the need for change of newer and adaptive treatments for these infections.During the COVID-19 pandemic and persists,traditional Chinese medicine(TCM)herbs exhibit significant bioactivity and therapeutic effect.This study is aimed to evaluate the efficacy of four TCM preparations on 28-day mortality risk of patients and changes of the laboratory indicators.METHODS The retrospective cohort study included patients with COVID-19 who were admitted to the Jiangsu Province Hospital of Chinese Medicine from December 15,2022 to January 15,2023,and those died within 48 hours of admission or cannot be tracked for outcomes were excluded.The primary outcome was survival status in 28 days(death or survival)starting from the day of admission.The second outcomes were laboratory indicators,including absolute lymphocyte count,lactate dehydrogenase,creatinine,and blood urea nitrogen.Binary logistic regressions were used to estimate the effect of TCM preparations on the primary and secondary outcomes in main analysis.Meanwhile,heterogeneity and robustness of results from main analysis were assessed by subgroup analyses and multiple sensitivity analyses.RESULTS 1816 eligible patients were included in analysis dataset,including 573 patients received standard care(control group)and 1243 patients received TCM preparations(hospital preparation group).The 28-day mortality rate of hospital preparation group was lower than that of control group(4.75%vs.14.83%),and the difference was statistically significant(χ^(2)=54.666,P<0.001).The risk of 28-day mortality was 0.535 times lower in the hospital preparation group as compared with the control group(OR=0.46,95%CI:0.305-0.708,P<0.001)showed by multivariable binary logistic regressions.Subgroup analyses showed that taking TCM preparations reduced the 28-day mortality risk.Sensitivity analyses demonstrated that the results of the main analysis for primary outcomes were robust.For secondary outcomes,the risk of abnormal absolute lymphocyte counts at discharge in the hospital preparation group decreased by 0.284 times(OR=0.703,95%CI:0.515-0.961,P=0.027).CONCLUSION Compared with standard of care,taking four hospital preparations including Kanggan Heji,Feining Heji,Qishen Gubiao Keli,and Qianghuo Qushi Qingwen Heji decreased risk of 28-day mortality among hospitalized COVID-19 patients.TCM therapy achieves adequate therapeutic effects in COVID-19.
基金funded by the Shanghai Philosophy and Social Science Planning Project (2021BZX008)the National Social Science Foundation of China (23BZX110)the National Office for Philosophy and Social Science (20&ZD045).
文摘Background Clinical brain-computer interface(BCI)for mental disorders is an emerging interdisciplinary research field,posing new ethical concerns and challenges,yet lacking practical ethical governance guidelines for stakeholders and the entire community.Aims This study aims to establish a multidisciplinary consensus of principles for ethical governance of clinical BCI research for mental disorders and offer practical ethical guidance to stakeholders involved.Methods A systematic literature review,symposium and roundtable discussions,and a pre-Delphi(round 0)survey were conducted to form the questionnaire for the three-round modified Delphi study.Two rounds of surveys,followed by a third round of independent interviews of 25 experts from BCI-related research domains,were involved.We conducted quantitative analysis of responses and agreements among experts to reveal the consensus and differences regarding the ethical governance of mental BCI research from a multidisciplinary perspective.Results The Delphi panel emphasised important concerns of ethical review practices and ethical principles within the BCI context,identified qualified and highly influential institutions and personnel in conducting and advancing clinical BCI research,and recognised prioritised aspects in the risk-benefit evaluation.Experts expressed diverse opinions on specific ethical concerns,including concerns about invasive technology,its impact on humanity and potential social consequences.Agreement was reached that the practices of ethical governance of clinical BCI for mental disorders should focus on patient voluntariness,autonomy,long-term effects and related assessments of BCI interventions,as well as privacy protection,transparent reporting and ensuring that the research is conducted in qualified institutions with strong data security.Conclusions Ethical governance of clinical research on BCI for mental disorders should include interdisciplinary experts to balance various needs and incorporate the expertise of different stakeholders to avoid serious ethical issues.It requires scientifically grounded approaches,continuous monitoring and interdisciplinary collaboration to ensure evidence-based policies,comprehensive risk assessments and transparency,thereby promoting responsible innovations and protecting patient rights and well-being.
基金supported by the National Natural Science Foundation of China(grant numbers 82204127 and 72204172)。
文摘Lung cancer, the leading cause of cancer deaths worldwide and in China, has a 19.7% five-year survival rate due to terminal-stage diagnosis^([1-3]).Although low-dose computed tomography(CT) screening can reduce mortality, high false positive rates can create economic and psychological burdens.
文摘Thermally activated delayed fluorescence(TADF)molecules have outstanding potential for applications in organic light-emitting diodes(OLEDs).Due to the lack of systematic studies on the correlation between molecular structure and luminescence properties,TADF molecules are far from meeting the needs of practical applications in terms of variety and number.In this paper,three twisted TADF molecules are studied and their photophysical properties are theoretically predicted based on the thermal vibrational correlation function method combined with multiscale calculations.The results show that all the molecules exhibit fast reverse intersystem crossing(RISC)rates(kRISC),predicting their TADF luminescence properties.In addition,the binding of DHPAzSi as the donor unit with different acceptors can change the dihedral angle between the ground and excited states,and the planarity of the acceptors is positively correlated with the reorganization energy,a property that has a strong influence on the non-radiative process.Furthermore,a decrease in the energy of the molecular charge transfer state and an increase in the kRISC were observed in the films.This study not only provides a reliable explanation for the observed experimental results,but also offers valuable insights that can guide the design of future TADF molecules.
文摘Objective: This study assessed the effects of consuming acetic acid bacteria (Gluconacetobacter hansenii GK-1) for 12 weeks on fatigue induced by temporary mental stress. Methods: This randomized, double-blind, placebo-controlled, parallel-group study included 100 healthy male and female adults aged 20 - 64 years. Participants consumed either the G. hansenii GK-1 supplement (9 × 10⁹ cells/day) or a placebo daily for 12 weeks. The impact of temporary mental stress on fatigue in G. hansenii GK-1 was assessed using a Visual Analog Scale (VAS) before the study began and after 12 weeks of supplementation. Results: Subjective fatigue measured by Visual Analog Scale (VAS) showed a significant decrease in fatigue induced by temporary mental stress after 12 weeks of consumption in the G. hansenii GK-1 group compared with the placebo group. No adverse events were attributed to G. hansenii GK-1. These findings confirm that continuous oral ingestion of G. hansenii GK-1 by healthy Japanese adults reduces feelings of fatigue caused by temporary mental stress.
基金funded by the National Natural Science Foundation of China(No.81973966)。
文摘Objective:To explore the association between acupuncture during controlled ovarian hyperstimulation(COH)and the live birth rate(LBR)using different propensity score methods.Methods:In this retrospective cohort study,eligible women who underwent a COH were divided into acupuncture and non-acupuncture groups.The primary outcome was LBR,as determined by propensity score matching(PSM).LBR was defined as the delivery of one or more living infants that reached a gestational age over 28 weeks after embryo transfer.The propensity score model encompassed 16 confounding variables.To validate the results,sensitivity analyses were conducted using three additional propensity score methods:propensity score adjustment,inverse probability weighting(IPW),and IPW with a"doubly robust”estimator.Results:The primary cohort encompassed 9751 patients(1830[18.76%]in the acupuncture group and7921[81.23%]in the non-acupuncture group).Following 1:1 PSM,a higher LBR was found in the acupuncture cohort(41.4%[755/1824]vs 36.4%[664/1824],with an odds ratio of 1.23[95%confidence interval,1.08-1.41]).Three additional propensity score methods produced essentially similar results.The risk of serious adverse events did not significantly differ between the two groups.Conclusion:This retrospective study revealed an association between acupuncture and an increased LBR among patients undergoing COH,and that acupuncture is a safe and valuable treatment option.
文摘On May 26,40 teachers and students from the graduating class of the Buddhist Academy of Xizang in Lhasa embarked on a teaching practice and national condition study tour in Zhejiang and Shanghai.
