Dear Editor,Psoriasis,a chronic inflammatory cutaneous condition,is characterized by the development of red plaques with silvery scales,significantly affecting patients'quality of life and mental health[1].This co...Dear Editor,Psoriasis,a chronic inflammatory cutaneous condition,is characterized by the development of red plaques with silvery scales,significantly affecting patients'quality of life and mental health[1].This condition is thought to affect approximately 2%of the Western population,with diagnosis peaking in early adulthood[2].Vitamin D,a fat-soluble vitamin,is essential for phospho-calcium metabolism,calcium homeostasis,and bone health.展开更多
Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsist...Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsistent.It remains unclear whether these associations are causal.Methods We conducted a meta-analysis by systematically searching for observational studies on the association between IBD and dementia.Mendelian randomization(MR)analysis based on summary genome-wide association studies(GWASs)was performed.Genetic correlation and Bayesian colocalization analyses were used to provide robust genetic evidence.Results Ten observational studies involving 80,565,688 participants were included in this metaanalysis.IBD was significantly associated with dementia(risk ratio[RR]=1.36,95%CI=1.04-1.78;I2=84.8%)and VD(RR=2.60,95%CI=1.18-5.70;only one study),but not with AD(RR=2.00,95%CI=0.96-4.13;I^(2)=99.8%).MR analyses did not supported significant causal associations of IBD with dementia(dementia:odds ratio[OR]=1.01,95%CI=0.98-1.03;AD:OR=0.98,95%CI=0.95-1.01;VD:OR=1.02,95%CI=0.97-1.07).In addition,genetic correlation and co-localization analyses did not reveal any genetic associations between IBD and dementia.Conclusion Our study did not provide genetic evidence for a causal association between IBD and dementia risk.The increased risk of dementia observed in observational studies may be attributed to unobserved confounding factors or detection bias.展开更多
This paper proposes an interdisciplinary talent training model that combines foreign language education with area studies.The model aims to cultivate international ocean affairs professionals with cross-cultural commu...This paper proposes an interdisciplinary talent training model that combines foreign language education with area studies.The model aims to cultivate international ocean affairs professionals with cross-cultural communication skills,in-depth regional and country knowledge,and practical expertise in ocean affairs.Additionally,the paper presents specific training pathways and policy recommendations for implementing this model.展开更多
In modern society,the globalization of literary works is evident,with exceptional literary pieces from various countries spreading worldwide.Among these,children’s literature,due to the specificity of its target audi...In modern society,the globalization of literary works is evident,with exceptional literary pieces from various countries spreading worldwide.Among these,children’s literature,due to the specificity of its target audience,imposes distinct requirements on children’s books,compelling translators to approach the text from a child’s perspective.“The Little Prince”has renowned both within and outside of China,and a careful reading of this work can provide us with much inspiration.To this end,the present study adopts the perspective of Gideon Toury’s Descriptive Translation Studies to conduct an in-depth analysis of the different English and Chinese translations in conjunction with the original French novel.This approach aims to better guide literary research and explores translation methods for children’s literature through the analysis of translation norms and rules.展开更多
Objective:The incidence and mortality of colorectal carcinoma(CRC)continue to rise globally,highlighting the need to identify modifiable risk factors for early detection and prevention.Previous studies have demonstrat...Objective:The incidence and mortality of colorectal carcinoma(CRC)continue to rise globally,highlighting the need to identify modifiable risk factors for early detection and prevention.Previous studies have demonstrated significant associations between CRC risk and various serum metabolites as well as inflammatory cytokines;however,due to limitations in study design and potential confounding factors,the causal relationships remain unclear.This study aims to investigate the causal relationships between inflammatory cytokines,serum metabolites,and CRC risk,providing a theoretical basis for the development of novel early diagnostic biomarkers and therapeutic targets.Methods:A two-sample Mendelian randomization(MR)design was applied using summary statistics from genome-wide association studies(GWAS).Instrumental variables(IVs)were derived from:1)metabolomics GWAS data of 1400 serum metabolites(n=8299);2)cytokine GWAS data of 91 inflammatory factors(n=14824);and 3)CRC risk data from the FinnGen consortium(6847 cases and 314193 controls).The primary analysis was conducted using the inverse-variance weighted(IVW)method,with sensitivity analyses performed using MR Egger regression and the weighted median method.Effect estimates including odds ratios(OR),95%confidence intervals(CI),and false discovery rates(FDR)were calculated.Results:MR analysis indicated that higher levels of axin-1(AXIN1)(OR=0.84195%CI 0.714 to 0.991)and Fms-related tyrosine kinase 3 ligand(Flt3L)(OR=0.916,95%CI 0.844 to 0.994)were associated with a reduced risk of CRC.In contrast,higher levels of Delta/Notchlike epidermal growth factor-related receptor(DNER)(OR=1.119,95%CI 1.009 to 1.241)and vascular endothelial growth factor A(VEGF-A)(OR=1.078,95%CI 1.011 to 1.150)were associated with an increased risk of CRC(all P<0.05).Metabolomics association analysis further identified 144 serum metabolites significantly correlated with these four key inflammatory cytokines(FDR<0.05),suggesting that they may regulate CRC risk through inflammatory pathways.Conclusion:Specific inflammatory cytokines and serum metabolites have causal relationships with the risk of CRC.These findings provide insights for further exploration of potential risk factors and the development of effective prevention strategies for CRC.展开更多
In molybdenum chemistry,the oxidative addition of o-quinone or 1,2-dicarbonyl compounds to molybdenum has been widely used in Mo-catalyzed C—C bond construction.The carbonyl oxidative addition to Mo(0)or Mo(Ⅱ)is the...In molybdenum chemistry,the oxidative addition of o-quinone or 1,2-dicarbonyl compounds to molybdenum has been widely used in Mo-catalyzed C—C bond construction.The carbonyl oxidative addition to Mo(0)or Mo(Ⅱ)is the critical elementary reaction of molybdenum catalysis.However,the relevant density functional theory(DFT)studies are relatively scarce,especially regarding the rational selection of functionals.In this work,14 functionals were employed to investigate the Mo-catalyzed carbonyl oxidative addition step.A benchmark study was carried out to evaluate their performance in structure optimization and energy calculation.Analyses of mean absolute error(MAE)and mean squared error(MSE)indicated that the B3LYP-D3(BJ),TPSSh,and ωB97X-D functionals exhibited superior performance in structure optimization.Using the DLPNO-CCSD(T)functional as the reference,the M06,M06-L,and MN15-L functionals exhibited good performance for energy calculation based on the structures optimized using the B3LYP-D3(BJ)functional.In particular,MN15-L provided the best performance with the smallest MAE and MSE.展开更多
Objective:To identify the root causes of typical adverse drug events through the lens of patient experiences proposing novel strategies to mitigate preventable harm.Methods:A qualitative case study leveraging in-depth...Objective:To identify the root causes of typical adverse drug events through the lens of patient experiences proposing novel strategies to mitigate preventable harm.Methods:A qualitative case study leveraging in-depth interviews with patients and families,anchored by Interactive Patient Par ticipation Theory,to analyze 4 high-severity adverse drug events(ADE)cases.Cases were purposively sampled from 8 communities in China's National Adverse Event Monitor Center(2018-2023).Semi-structured interviews explored patient perspectives,with data analyzed via thematic coding and triangulation against clinical records.Results:Five interconnected themes emerged:(1)erosion of trust,(2)communication breakdowns,(3)information asymmetry,(4)environmental inadequacies,and(5)technological alienation.Notably,75% of participants had≤high school education,and 50% used≥7 medications daily,compounding ADE risks.Conclusions:We considered elements mentioned by theory,exploring trust,communication,information,and suppor t as the root causes.In addition,we added“adaptability to new technology”as an impor tant and necessary component.It is impor tant and necessary to analyze typical adverse drug events from the perspectives of patients.展开更多
Objective Frailty is becoming increasingly common among aging adults.Frailty transitionis shaped by biological,social,psychological,and environmental factors.This study investigated combined effects of protective fact...Objective Frailty is becoming increasingly common among aging adults.Frailty transitionis shaped by biological,social,psychological,and environmental factors.This study investigated combined effects of protective factors on frailty transition by constructing a Protection Index(PI)to guide targeted interventions.Methods Data were extracted from the 4th Sample Survey of the Aged Population in Urban and Rural China,including baseline(2017)and follow-up(2019)surveys.Frailty was assessed using the Frailty Index(FI),whereas the PI measured protective factors.Frailty transitions over 2 years were analyzed prospectively.Pearson’s correlation examined the relationship between FI and PI,and logistic regression assessed the effects of PI on frailty transitions.Results This study included 9,093 older adults.FI values increased with age and were higher in women,whereas PI values decreased with age and were higher in men.Over 2 years,56.2%of the participants showed a stable frailty status,14.2%improved,and 29.6%worsened.Negative transitions were more common than positive transitions,with transitions occurring most frequently between adjacent states.The PI was moderately negatively correlated with the FI(r=−0.349,P<0.001).A higher PI was associated with a lower risk of negative transitions among robust and prefrail individuals(OR=0.989,0.981,both P<0.05),but showed no significant effect among those with existing frailty.Conclusion Negative frailty transitions were more common with advancing age.Enhancing PI may help prevent negative frailty transitions among robust and pre-frail older adults,underscoring the value of early interventions.展开更多
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
Objective:Olfactory dysfunction(OD)is a common and persistent symptom of coronavirus disease 2019(COVID-19)for which effective treatments remain limited.Acupuncture,widely used in Chinese medicine for olfactory disord...Objective:Olfactory dysfunction(OD)is a common and persistent symptom of coronavirus disease 2019(COVID-19)for which effective treatments remain limited.Acupuncture,widely used in Chinese medicine for olfactory disorders has uncertain efficacy in post-COVID-19 OD.Therefore,in this study,we aimed to explore the feasibility and preliminary efficacy of acupuncture in patients with post-COVID-19 OD.Methods:This study was a dual-phased study.Phase I involved a systematic review conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines,encompassing eight databases.Phase II consisted of a pilot randomized controlled trial(RCT)enrolling 25 patients with moderate to severe post-COVID-19 OD.Participants were randomly assigned to receive either real(group A)or sham(group B)acupuncture.The intervention included eight sessions over 4 weeks,with assessments at baseline,post-cycle 1,2-week washout,post-cycle-2 treatment,and 2-week follow-up.The primary outcome was the change in scores on the 12-item Assessment of Self-Reported Olfactory Functioning and Quality of Life(ASOF).Secondary outcomes included the short version of the Questionnaire of Olfactory Disorders-Negative Statements(sQOD-NS)and the traditional Chinese version of the University of Pennsylvania Smell Identification Test(UPSIT-TC).Results:The systematic review identified 22 studies(15 case reports,seven RCTs)suggesting that acupuncture may positively influence olfactory function.In the pilot RCT,no significant baseline differences were observed between groups.Group A showed steady improvement across all ASOF domains during Cycle 1(SOC,mean=5.86;SRP,mean=3.26;ORQ,mean=3.98),with slight declines during cycle 2 and 2-week follow-up,though scores remained above baseline.Post-cycle 1,group A showed higher mean SOC and ORQ scores compared with group B(7.00 vs.4.67;3.98 vs.3.39).Improvements in secondary outcomes were also more pronounced in group A,whereas group B showed minimal changes.Conclusion:Acupuncture appears to be a safe and potentially effective treatment for post-COVID-19 OD,warranting validation through larger clinical trials.展开更多
AIM:To investigate the potential causal associations between 41 inflammatory cytokines and myopia using a two-sample Mendelian randomization(MR)approach.METHODS:Publicly available genome-wide association study(GWAS)da...AIM:To investigate the potential causal associations between 41 inflammatory cytokines and myopia using a two-sample Mendelian randomization(MR)approach.METHODS:Publicly available genome-wide association study(GWAS)datasets were utilized for this two-sample MR analysis.Inflammatory cytokine-related GWAS data were extracted from The University of Bristol’s Research Data Repository,and myopia-related GWAS data were obtained from the FinnGen project.Single nucleotide polymorphisms(SNPs)associated with inflammatory cytokines were systematically selected as instrumental variables(IVs)based on three rigorous criteria:relevance,independence,and exclusion of pleiotropy.Five MR methods were employed for causal inference:the inverse-variance weighted(IVW)method as the primary analysis,supplemented by MREgger regression,weighted median estimator,simple mode,and weighted mode approaches.Sensitivity analyses were performed to evaluate the robustness of the causal estimates.RESULTS:A total of 773 myopia-associated SNPs were identified.MR analysis revealed that higher levels of macrophage inflammatory protein 1-α(MIP-1α)were associated with a 17%reduced risk of myopia[odds ratio(OR)=0.83;95%confidence interval(CI):0.69-0.99;P<0.05].In contrast,elevated levels of eotaxin(OR=1.26;95%CI:1.07-1.47;P<0.01),stromal cell-derived factor-1α(SDF-1α;OR=1.68;95%CI:1.08-2.62;P<0.05),and interleukin-2 receptor subunit alpha(IL-2Rα;OR=1.25;95%CI:1.01-1.53;P<0.05)were significantly associated with an increased risk of myopia.Sensitivity analyses confirmed the reliability of these results.CONCLUSION:This study provides evidence supporting a causal relationship between specific inflammatory cytokines and myopia.MIP-1αmay act as a protective factor against myopia,while eotaxin,SDF-1α,and IL-2Rαare potential risk factors for myopia.These findings emphasize the critical role of inflammatory pathways in the pathogenesis of myopia,offering novel insights for the development of preventive and therapeutic strategies for myopia.展开更多
The development of wheat cultivars with improved nitrogen(N),phosphorus(P),and potassium(K)use efficiency is essential for sustainable agriculture.Genetic dissection and identification of causative genes underlying nu...The development of wheat cultivars with improved nitrogen(N),phosphorus(P),and potassium(K)use efficiency is essential for sustainable agriculture.Genetic dissection and identification of causative genes underlying nutrient use efficiency represent a key strategy toward this goal.We conducted an extensive genome-wide association study(GWAS)using a panel of 431 wheat cultivars,identifying 1,659 significant single-nucleotide polymorphisms(SNPs)(LOD>5)through genotyping-by-sequencing.This analysis revealed 534 quantitative trait loci(QTLs)associated with 12 nutrient use efficiency traits across five distinct environments,among which 14 QTLs were consistently detected in at least three environments.Notably,meta-QTL analysis,showed that QTL80(72.12–74.24 Mb,chr2A),QTL387(32.88–33.56 Mb,chr6A),and QTL500(535.53–540.80 Mb,chr7B)exhibit clear co-localization with MQTL-2A-2,MQTL-6A-1,and MQTL-7B-2,respectively.This overlap highlights their robustness across diverse environmental conditions.Within these regions,critical candidate genes-including members of the bZIP transcription factor family and a potassium transporter gene-were identified in relation to nutrient use efficiency.Furthermore,a novel locus,QTL234,was discovered,harboring key candidate genes such as dof zinc finger protein,Ankyrin repeat family protein,and cytochrome P450.To validate the SNP within QTL234 associated with nitrogen harvest index(NHI),we developed a dCAPS marker for AX-109095537.These findings demonstrate the effectiveness of high-resolution SNP-based GWAS in rapidly pinpointing promising candidate genes.They also establish a foundation for large-scale QTL fine mapping,candidate gene validation,and the development of functional markers essential for enhancing nutrient use efficiency in wheat breeding programs.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:Antipsychotic-induced movement disorders(AIMDs)are prevalent side effects of antipsychotics,particularly during the acute phase of treatment.This study aimed to elucidate the genetic mechanisms underlying A...Background:Antipsychotic-induced movement disorders(AIMDs)are prevalent side effects of antipsychotics,particularly during the acute phase of treatment.This study aimed to elucidate the genetic mechanisms underlying AIMDs using a genome-wide association study(GWAS).Methods:GWASs on AIMDs were conducted in three independent cohorts:a discovery cohort of 3067 patients(2016 subjects were reserved after quality control),a validation cohort of 277 patients,and a multi-ancestry validation cohort of 766 patients.Subsequent post-GWAS analyses included gene-based analyses,transcriptome-wide association studies(TWASs),and polygenic risk score(PRS)profiling.Results:Our study identified two loci located in RAB44 gene(rs116249243,P=5.98×10^(-9);rs117097482,P=1.17×10^(-8))associated with extrapyramidal symptoms(EPSs),1 locus(rs6826172,P=5.56×10^(-9))related to akathisia,and 76 loci linked to involuntary movements(11 genes were mapped).Risk loci located in CNTNAP2,LUZP2,TMEM167A,and RAB44 genes were successfully replicated in the validation cohort,whereas the locus located in RAB44 was also replicated in the multi-ancestry cohort.Gene-based analyses indicated that XRCC4 and PAIP2B reached significance at the genome-wide level in involuntary movements.Tissue expression analysis revealed that involuntary movement-related genes are predominantly expressed in the substantia nigra.Additionally,the TWAS suggested a causal relationship between XRCC4 and involuntary movement.The PRSs derived from the discovery cohort significantly predicted AIMDs in the validation cohort,with area under the receiver operating characteristic curve(AUC)values from 0.60 to 0.80.Conclusions:Our findings highlight the role of substantia nigra related gene polymorphisms in AIMDs.This study provides novel insights into the pathogenesis of AIMDs and supports the potential for personalized treatment approaches for schizophrenia.展开更多
Genetic variations are risk factors for neonatal hyperbilirubinemia(NHB),a common cause of infant hospitalization in the first postnatal week,but their contribution and long-term impacts remain unclear.This population...Genetic variations are risk factors for neonatal hyperbilirubinemia(NHB),a common cause of infant hospitalization in the first postnatal week,but their contribution and long-term impacts remain unclear.This population-based multicenter study enrolls 1780 hospitalized NHB newborns and 38,158 genetically screened newborns across 20 hospitals(2019-2022).Excluding cases with clear clinical causes,977 NHB cases are categorized into genetic variation-positive and-negative groups.Results show significantly higher NHB-related gene variants(81.63%vs.65.62%)and positive variation rates(36.29%vs.9.4%)in NHB cases than in the general newborn population(all P<0.001).Among the 977 NHB cases,325(33.3%)have positive variants,with higher rates of severe hyperbilirubinemia(16.9%vs.9.7%,P=0.001),prolonged jaundice(36.3%vs.27.6%,P=0.005),and cholestasis/hypercholanaemia(23.7%vs.14.7%,P<0.001)in the positive group.Cumulative genetic variants in bilirubin metabolism pathways exhibit dosedependent associations with increased risks of complications.Long-term follow-up reveals that UGT1A1 variants prolong jaundice up to one month,while severe SLC10A1 variants cause persistent cholestasis/hypercholanaemia beyond nine months.This large-scale evidence highlights genetic factors as key NHB determinants,with implications for neonatal care protocols to integrate genetic testing and establish longterm surveillance for variant carriers.展开更多
Biological aging is a complex physiological process characterized by a decline in tissue function and the loss of cellular capabilities,which increase an individual's risk of various diseases[1].While genetic fact...Biological aging is a complex physiological process characterized by a decline in tissue function and the loss of cellular capabilities,which increase an individual's risk of various diseases[1].While genetic factors and lifestyle are key influences on biological aging,environmental factors also play a significant role.Given the rapid aging of the global population,elucidating the factors that influence biological aging is crucial for promoting healthy aging.展开更多
BACKGROUND Solid fuel use for cooking and heating is a major environmental risk factor,yet its association with new-onset heart disease(HD)remains unclear.The aim of this study was to investigate the relationship betw...BACKGROUND Solid fuel use for cooking and heating is a major environmental risk factor,yet its association with new-onset heart disease(HD)remains unclear.The aim of this study was to investigate the relationship between solid fuel exposure and new-onset HD in a large cohort.METHODS Multivariable logistic regression models assessed associations between cooking/heating fuel types(coal,crop residue/wood,liquefied petroleum gas,natural gas,and others)and new-onset HD.Subgroup analyses explored effect modification by age,sex,education,smoking,alcohol use,and region.RESULTS A prospective cohort study included 5915 participants,with 781 participants(13.2%)developing new-onset HD.Coal use for cooking showed an initial association with new-onset HD risk(OR=1.41,95%CI:1.06–1.86,P=0.02),which attenuated after full adjustment(OR=1.28,95%CI:0.96–1.72,P=0.10).Coal use for heating demonstrated robust associations across all models(OR=1.86,95%CI:1.42–2.43,P<0.001).Crop residue/wood burning for heating was also significant(Model 2:OR=1.40,95%CI:1.06–1.86,P=0.02).Subgroup analyses revealed stronger associations among females,non-smokers,non-drinkers,and less-educated participants.Geographic stratification showed significant associations in southern but not northern regions.CONCLUSIONS Solid fuel use,particularly coal for heating,is associated with increased new-onset HD risk.Reducing solid fuel exposure is crucial for HD prevention in low-resource settings.展开更多
Objective Patients with atherosclerotic cardiovascular disease(ASCVD)following percutaneous coronary intervention(PCI)are classified as very-high-risk individuals in cardiovascular disease(CVD)risk stratification.The ...Objective Patients with atherosclerotic cardiovascular disease(ASCVD)following percutaneous coronary intervention(PCI)are classified as very-high-risk individuals in cardiovascular disease(CVD)risk stratification.The distribution pattern of traditional Chinese medicine(TCM)syndromes in this patient population,as well as its association with blood lipid profiles and clinical prognosis,remains unclear.The present prospective cohort study aims to investigate these correlations,thereby providing insights to enrich the research fields.Methods We enrolled consecutive patients with ASCVD who underwent PCI at the Integrated Cardiology Unit of China-Japan Friendship Hospital between September 1,2020 and December 31,2022.Demographics and clinical characteristics,signs and symptoms defining each TCM syndrome,and fasting venous blood samples were collected at baseline and follow up or upon major adverse cardiovascular events(MACEs).We analyzed the correlation between TCM syndromes,blood lipid profiles,and MACEs,and developed a new joint prognostic model incorporating both TCM syndromes and blood lipids using logistic regression.The analyses were based on detailed baseline and one-year follow-up data.Results A per-protocol analysis was performed on 586 patients with complete data ultimately.During the one-year follow-up,174 patients(29.69%)experienced a MACE.We performed statistical analyses on comorbidities,medication,and biochemical indicators across groups defined by TCM syndrome differentiation.When comparing different TCM syndromes,no significant differences were found in age,body mass index(BMI),history of revascularization,comorbidities,family history of CVD,smoking or drinking,or statin intensity(P>0.05).Patients with intertwined phlegm and blood stasis syndrome exhibited significantly higher levels of total cholesterol(TC,5.27±1.18 mmol/L,P<0.001),triglyceride(TG,1.96±1.33 mmol/L,P=0.008),low-density lipoprotein cholesterol(LDL-C,3.35±0.79 mmol/L,P<0.001),and high-density lipoprotein cholesterol(HDL-C,1.24±0.81 mmol/L,P<0.001)compared with those with other TCM syndromes combined.A multivariable logistic regression model was constructed to predict MACEs.The model included TCM syndrome type[with intertwined phlegm and blood stasis as a predictor,adjusted odds ratio(OR)=1.413,95%confidence interval(CI):0.517–3.864,P=0.501],age(adjusted OR=0.97,95%CI:0.955–1.001,P=0.057),male gender(adjusted OR=0.698,95%CI:0.416–1.170,P=0.173),TC(adjusted OR=1.004,95%CI:0.513–1.965,P=0.990),and LDL-C(adjusted OR=5.825,95%CI:2.214–15.326,P<0.001).This model demonstrated good discriminatory ability for MACEs in post-PCI ASCVD patients[the area under the receiver operating characteristic(ROC)curve(AUC)=0.865,95%CI:0.816–0.914].Conclusion The intertwined phlegm and blood stasis TCM syndrome is associated with a distinct atherogenic lipid profile characterized by elevated levels of TC and LDL-C.The prognostic model that incorporates this TCM syndrome type along with conventional lipid parameters(TC and LDL-C)shows good discriminatory ability for predicting MACEs in ASCVD patients after PCI,underscoring the potential clinical utility of integrating TCM syndrome differentiation into CVD risk assessment.展开更多
基金supported by the National Natural Science Foundation of China(Grant Nos.82573974 and 82373475)to Z.Y.
文摘Dear Editor,Psoriasis,a chronic inflammatory cutaneous condition,is characterized by the development of red plaques with silvery scales,significantly affecting patients'quality of life and mental health[1].This condition is thought to affect approximately 2%of the Western population,with diagnosis peaking in early adulthood[2].Vitamin D,a fat-soluble vitamin,is essential for phospho-calcium metabolism,calcium homeostasis,and bone health.
基金supported by the China Postdoctoral Science Foundation(Grant No.2021M703366)Shenzhen Science and Technology Program(Grant No.KQTD20190929172835662).
文摘Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsistent.It remains unclear whether these associations are causal.Methods We conducted a meta-analysis by systematically searching for observational studies on the association between IBD and dementia.Mendelian randomization(MR)analysis based on summary genome-wide association studies(GWASs)was performed.Genetic correlation and Bayesian colocalization analyses were used to provide robust genetic evidence.Results Ten observational studies involving 80,565,688 participants were included in this metaanalysis.IBD was significantly associated with dementia(risk ratio[RR]=1.36,95%CI=1.04-1.78;I2=84.8%)and VD(RR=2.60,95%CI=1.18-5.70;only one study),but not with AD(RR=2.00,95%CI=0.96-4.13;I^(2)=99.8%).MR analyses did not supported significant causal associations of IBD with dementia(dementia:odds ratio[OR]=1.01,95%CI=0.98-1.03;AD:OR=0.98,95%CI=0.95-1.01;VD:OR=1.02,95%CI=0.97-1.07).In addition,genetic correlation and co-localization analyses did not reveal any genetic associations between IBD and dementia.Conclusion Our study did not provide genetic evidence for a causal association between IBD and dementia risk.The increased risk of dementia observed in observational studies may be attributed to unobserved confounding factors or detection bias.
基金supported by“Dalian Maritime University Teaching Reform Research Fund 2022 Annual Project”(Fund No.XJG2022-96).
文摘This paper proposes an interdisciplinary talent training model that combines foreign language education with area studies.The model aims to cultivate international ocean affairs professionals with cross-cultural communication skills,in-depth regional and country knowledge,and practical expertise in ocean affairs.Additionally,the paper presents specific training pathways and policy recommendations for implementing this model.
文摘In modern society,the globalization of literary works is evident,with exceptional literary pieces from various countries spreading worldwide.Among these,children’s literature,due to the specificity of its target audience,imposes distinct requirements on children’s books,compelling translators to approach the text from a child’s perspective.“The Little Prince”has renowned both within and outside of China,and a careful reading of this work can provide us with much inspiration.To this end,the present study adopts the perspective of Gideon Toury’s Descriptive Translation Studies to conduct an in-depth analysis of the different English and Chinese translations in conjunction with the original French novel.This approach aims to better guide literary research and explores translation methods for children’s literature through the analysis of translation norms and rules.
基金supported by the Natural Science Foundation of Hunan Province (2022JJ30987)the Key Research and Development Project of Hunan Province (2024JK2107),China。
文摘Objective:The incidence and mortality of colorectal carcinoma(CRC)continue to rise globally,highlighting the need to identify modifiable risk factors for early detection and prevention.Previous studies have demonstrated significant associations between CRC risk and various serum metabolites as well as inflammatory cytokines;however,due to limitations in study design and potential confounding factors,the causal relationships remain unclear.This study aims to investigate the causal relationships between inflammatory cytokines,serum metabolites,and CRC risk,providing a theoretical basis for the development of novel early diagnostic biomarkers and therapeutic targets.Methods:A two-sample Mendelian randomization(MR)design was applied using summary statistics from genome-wide association studies(GWAS).Instrumental variables(IVs)were derived from:1)metabolomics GWAS data of 1400 serum metabolites(n=8299);2)cytokine GWAS data of 91 inflammatory factors(n=14824);and 3)CRC risk data from the FinnGen consortium(6847 cases and 314193 controls).The primary analysis was conducted using the inverse-variance weighted(IVW)method,with sensitivity analyses performed using MR Egger regression and the weighted median method.Effect estimates including odds ratios(OR),95%confidence intervals(CI),and false discovery rates(FDR)were calculated.Results:MR analysis indicated that higher levels of axin-1(AXIN1)(OR=0.84195%CI 0.714 to 0.991)and Fms-related tyrosine kinase 3 ligand(Flt3L)(OR=0.916,95%CI 0.844 to 0.994)were associated with a reduced risk of CRC.In contrast,higher levels of Delta/Notchlike epidermal growth factor-related receptor(DNER)(OR=1.119,95%CI 1.009 to 1.241)and vascular endothelial growth factor A(VEGF-A)(OR=1.078,95%CI 1.011 to 1.150)were associated with an increased risk of CRC(all P<0.05).Metabolomics association analysis further identified 144 serum metabolites significantly correlated with these four key inflammatory cytokines(FDR<0.05),suggesting that they may regulate CRC risk through inflammatory pathways.Conclusion:Specific inflammatory cytokines and serum metabolites have causal relationships with the risk of CRC.These findings provide insights for further exploration of potential risk factors and the development of effective prevention strategies for CRC.
基金Project supported by the Fundamental Research Funds for the Central Universities(No.2042025kf0052)。
文摘In molybdenum chemistry,the oxidative addition of o-quinone or 1,2-dicarbonyl compounds to molybdenum has been widely used in Mo-catalyzed C—C bond construction.The carbonyl oxidative addition to Mo(0)or Mo(Ⅱ)is the critical elementary reaction of molybdenum catalysis.However,the relevant density functional theory(DFT)studies are relatively scarce,especially regarding the rational selection of functionals.In this work,14 functionals were employed to investigate the Mo-catalyzed carbonyl oxidative addition step.A benchmark study was carried out to evaluate their performance in structure optimization and energy calculation.Analyses of mean absolute error(MAE)and mean squared error(MSE)indicated that the B3LYP-D3(BJ),TPSSh,and ωB97X-D functionals exhibited superior performance in structure optimization.Using the DLPNO-CCSD(T)functional as the reference,the M06,M06-L,and MN15-L functionals exhibited good performance for energy calculation based on the structures optimized using the B3LYP-D3(BJ)functional.In particular,MN15-L provided the best performance with the smallest MAE and MSE.
基金supported by the Science and Technology Fund Project of Guizhou Health Commission(gzwkj2025-163)。
文摘Objective:To identify the root causes of typical adverse drug events through the lens of patient experiences proposing novel strategies to mitigate preventable harm.Methods:A qualitative case study leveraging in-depth interviews with patients and families,anchored by Interactive Patient Par ticipation Theory,to analyze 4 high-severity adverse drug events(ADE)cases.Cases were purposively sampled from 8 communities in China's National Adverse Event Monitor Center(2018-2023).Semi-structured interviews explored patient perspectives,with data analyzed via thematic coding and triangulation against clinical records.Results:Five interconnected themes emerged:(1)erosion of trust,(2)communication breakdowns,(3)information asymmetry,(4)environmental inadequacies,and(5)technological alienation.Notably,75% of participants had≤high school education,and 50% used≥7 medications daily,compounding ADE risks.Conclusions:We considered elements mentioned by theory,exploring trust,communication,information,and suppor t as the root causes.In addition,we added“adaptability to new technology”as an impor tant and necessary component.It is impor tant and necessary to analyze typical adverse drug events from the perspectives of patients.
基金supported by grants from the National Key R&D Program of China[Grant Nos.2020YFC2003000 and 2020YFC2003001]the National High Level Hospital Clinical Research Funding(BJ-2023-074 and BJ-2023-018)+1 种基金Beijing Municipal Science&Technology Commission“AI+Health Collaborative Innovation Cultivation”Project(Z221100003522015)the Non-Profit Central Research Institute Fund of the Chinese Academy of Medical Sciences(2021-JKCS-024).
文摘Objective Frailty is becoming increasingly common among aging adults.Frailty transitionis shaped by biological,social,psychological,and environmental factors.This study investigated combined effects of protective factors on frailty transition by constructing a Protection Index(PI)to guide targeted interventions.Methods Data were extracted from the 4th Sample Survey of the Aged Population in Urban and Rural China,including baseline(2017)and follow-up(2019)surveys.Frailty was assessed using the Frailty Index(FI),whereas the PI measured protective factors.Frailty transitions over 2 years were analyzed prospectively.Pearson’s correlation examined the relationship between FI and PI,and logistic regression assessed the effects of PI on frailty transitions.Results This study included 9,093 older adults.FI values increased with age and were higher in women,whereas PI values decreased with age and were higher in men.Over 2 years,56.2%of the participants showed a stable frailty status,14.2%improved,and 29.6%worsened.Negative transitions were more common than positive transitions,with transitions occurring most frequently between adjacent states.The PI was moderately negatively correlated with the FI(r=−0.349,P<0.001).A higher PI was associated with a lower risk of negative transitions among robust and prefrail individuals(OR=0.989,0.981,both P<0.05),but showed no significant effect among those with existing frailty.Conclusion Negative frailty transitions were more common with advancing age.Enhancing PI may help prevent negative frailty transitions among robust and pre-frail older adults,underscoring the value of early interventions.
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jointly supported by Hong Kong Baptist University(SCM-2020-001)Haven of Hope—The Chinese University of Hong Kong Chinese Medicine Clinic cum Training and Research Centre(Sai Kung District)Tseung Kwan O Hospital of Hospital Authority,Hong Kong,China,for expenses and equipment.
文摘Objective:Olfactory dysfunction(OD)is a common and persistent symptom of coronavirus disease 2019(COVID-19)for which effective treatments remain limited.Acupuncture,widely used in Chinese medicine for olfactory disorders has uncertain efficacy in post-COVID-19 OD.Therefore,in this study,we aimed to explore the feasibility and preliminary efficacy of acupuncture in patients with post-COVID-19 OD.Methods:This study was a dual-phased study.Phase I involved a systematic review conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines,encompassing eight databases.Phase II consisted of a pilot randomized controlled trial(RCT)enrolling 25 patients with moderate to severe post-COVID-19 OD.Participants were randomly assigned to receive either real(group A)or sham(group B)acupuncture.The intervention included eight sessions over 4 weeks,with assessments at baseline,post-cycle 1,2-week washout,post-cycle-2 treatment,and 2-week follow-up.The primary outcome was the change in scores on the 12-item Assessment of Self-Reported Olfactory Functioning and Quality of Life(ASOF).Secondary outcomes included the short version of the Questionnaire of Olfactory Disorders-Negative Statements(sQOD-NS)and the traditional Chinese version of the University of Pennsylvania Smell Identification Test(UPSIT-TC).Results:The systematic review identified 22 studies(15 case reports,seven RCTs)suggesting that acupuncture may positively influence olfactory function.In the pilot RCT,no significant baseline differences were observed between groups.Group A showed steady improvement across all ASOF domains during Cycle 1(SOC,mean=5.86;SRP,mean=3.26;ORQ,mean=3.98),with slight declines during cycle 2 and 2-week follow-up,though scores remained above baseline.Post-cycle 1,group A showed higher mean SOC and ORQ scores compared with group B(7.00 vs.4.67;3.98 vs.3.39).Improvements in secondary outcomes were also more pronounced in group A,whereas group B showed minimal changes.Conclusion:Acupuncture appears to be a safe and potentially effective treatment for post-COVID-19 OD,warranting validation through larger clinical trials.
文摘AIM:To investigate the potential causal associations between 41 inflammatory cytokines and myopia using a two-sample Mendelian randomization(MR)approach.METHODS:Publicly available genome-wide association study(GWAS)datasets were utilized for this two-sample MR analysis.Inflammatory cytokine-related GWAS data were extracted from The University of Bristol’s Research Data Repository,and myopia-related GWAS data were obtained from the FinnGen project.Single nucleotide polymorphisms(SNPs)associated with inflammatory cytokines were systematically selected as instrumental variables(IVs)based on three rigorous criteria:relevance,independence,and exclusion of pleiotropy.Five MR methods were employed for causal inference:the inverse-variance weighted(IVW)method as the primary analysis,supplemented by MREgger regression,weighted median estimator,simple mode,and weighted mode approaches.Sensitivity analyses were performed to evaluate the robustness of the causal estimates.RESULTS:A total of 773 myopia-associated SNPs were identified.MR analysis revealed that higher levels of macrophage inflammatory protein 1-α(MIP-1α)were associated with a 17%reduced risk of myopia[odds ratio(OR)=0.83;95%confidence interval(CI):0.69-0.99;P<0.05].In contrast,elevated levels of eotaxin(OR=1.26;95%CI:1.07-1.47;P<0.01),stromal cell-derived factor-1α(SDF-1α;OR=1.68;95%CI:1.08-2.62;P<0.05),and interleukin-2 receptor subunit alpha(IL-2Rα;OR=1.25;95%CI:1.01-1.53;P<0.05)were significantly associated with an increased risk of myopia.Sensitivity analyses confirmed the reliability of these results.CONCLUSION:This study provides evidence supporting a causal relationship between specific inflammatory cytokines and myopia.MIP-1αmay act as a protective factor against myopia,while eotaxin,SDF-1α,and IL-2Rαare potential risk factors for myopia.These findings emphasize the critical role of inflammatory pathways in the pathogenesis of myopia,offering novel insights for the development of preventive and therapeutic strategies for myopia.
基金funded by the National Key R&D Program of China(2021YFD1900700)。
文摘The development of wheat cultivars with improved nitrogen(N),phosphorus(P),and potassium(K)use efficiency is essential for sustainable agriculture.Genetic dissection and identification of causative genes underlying nutrient use efficiency represent a key strategy toward this goal.We conducted an extensive genome-wide association study(GWAS)using a panel of 431 wheat cultivars,identifying 1,659 significant single-nucleotide polymorphisms(SNPs)(LOD>5)through genotyping-by-sequencing.This analysis revealed 534 quantitative trait loci(QTLs)associated with 12 nutrient use efficiency traits across five distinct environments,among which 14 QTLs were consistently detected in at least three environments.Notably,meta-QTL analysis,showed that QTL80(72.12–74.24 Mb,chr2A),QTL387(32.88–33.56 Mb,chr6A),and QTL500(535.53–540.80 Mb,chr7B)exhibit clear co-localization with MQTL-2A-2,MQTL-6A-1,and MQTL-7B-2,respectively.This overlap highlights their robustness across diverse environmental conditions.Within these regions,critical candidate genes-including members of the bZIP transcription factor family and a potassium transporter gene-were identified in relation to nutrient use efficiency.Furthermore,a novel locus,QTL234,was discovered,harboring key candidate genes such as dof zinc finger protein,Ankyrin repeat family protein,and cytochrome P450.To validate the SNP within QTL234 associated with nitrogen harvest index(NHI),we developed a dCAPS marker for AX-109095537.These findings demonstrate the effectiveness of high-resolution SNP-based GWAS in rapidly pinpointing promising candidate genes.They also establish a foundation for large-scale QTL fine mapping,candidate gene validation,and the development of functional markers essential for enhancing nutrient use efficiency in wheat breeding programs.
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supported by the National Natural Science Foundation of China(82330042,82441005 and 82301687)the National Key R&D Program of China(2023YFE0119400)+9 种基金the Capital’s Funds for Health Improvement and Research(2024-1-4111)the STI2030-Major Projects-2021ZD0200702Fundamental Research Funds for the Central Universities(Peking University Medicine Fund for world’s leading discipline or discipline cluster development,BMU2022DJXK007)the Beijing Municipal Health Commission Research Ward Programme(3rd batch)Beijing Nova Program(20230484425)the Beijing Municipal Science&Technology Commission,Administrative Commission of Zhongguancun Science Park(Z221100003522010)the China Postdoctoral Science Foundation(2024M760141 and 2022M720302)the National Postdoctoral Program for Innovative Talents(BX20240029)the Beijing Natural Science Foundation(7254462)the Peking University Medicine Sailing Program for Young Scholars’Scientific&Technological Innovation,the Fundamental Research Funds for the Central Universities(BMU2025YFJHPY044 and BMU2025YFJHPY046).
文摘Background:Antipsychotic-induced movement disorders(AIMDs)are prevalent side effects of antipsychotics,particularly during the acute phase of treatment.This study aimed to elucidate the genetic mechanisms underlying AIMDs using a genome-wide association study(GWAS).Methods:GWASs on AIMDs were conducted in three independent cohorts:a discovery cohort of 3067 patients(2016 subjects were reserved after quality control),a validation cohort of 277 patients,and a multi-ancestry validation cohort of 766 patients.Subsequent post-GWAS analyses included gene-based analyses,transcriptome-wide association studies(TWASs),and polygenic risk score(PRS)profiling.Results:Our study identified two loci located in RAB44 gene(rs116249243,P=5.98×10^(-9);rs117097482,P=1.17×10^(-8))associated with extrapyramidal symptoms(EPSs),1 locus(rs6826172,P=5.56×10^(-9))related to akathisia,and 76 loci linked to involuntary movements(11 genes were mapped).Risk loci located in CNTNAP2,LUZP2,TMEM167A,and RAB44 genes were successfully replicated in the validation cohort,whereas the locus located in RAB44 was also replicated in the multi-ancestry cohort.Gene-based analyses indicated that XRCC4 and PAIP2B reached significance at the genome-wide level in involuntary movements.Tissue expression analysis revealed that involuntary movement-related genes are predominantly expressed in the substantia nigra.Additionally,the TWAS suggested a causal relationship between XRCC4 and involuntary movement.The PRSs derived from the discovery cohort significantly predicted AIMDs in the validation cohort,with area under the receiver operating characteristic curve(AUC)values from 0.60 to 0.80.Conclusions:Our findings highlight the role of substantia nigra related gene polymorphisms in AIMDs.This study provides novel insights into the pathogenesis of AIMDs and supports the potential for personalized treatment approaches for schizophrenia.
基金supported by the Guangzhou Science and Technology Plan Project(2024B03J0191)to Hu Haothe Research Projects of the Sixth Affiliated Hospital,Sun Yat-sen University(No.2023-053 and No.2023-063)to Hu Hao.
文摘Genetic variations are risk factors for neonatal hyperbilirubinemia(NHB),a common cause of infant hospitalization in the first postnatal week,but their contribution and long-term impacts remain unclear.This population-based multicenter study enrolls 1780 hospitalized NHB newborns and 38,158 genetically screened newborns across 20 hospitals(2019-2022).Excluding cases with clear clinical causes,977 NHB cases are categorized into genetic variation-positive and-negative groups.Results show significantly higher NHB-related gene variants(81.63%vs.65.62%)and positive variation rates(36.29%vs.9.4%)in NHB cases than in the general newborn population(all P<0.001).Among the 977 NHB cases,325(33.3%)have positive variants,with higher rates of severe hyperbilirubinemia(16.9%vs.9.7%,P=0.001),prolonged jaundice(36.3%vs.27.6%,P=0.005),and cholestasis/hypercholanaemia(23.7%vs.14.7%,P<0.001)in the positive group.Cumulative genetic variants in bilirubin metabolism pathways exhibit dosedependent associations with increased risks of complications.Long-term follow-up reveals that UGT1A1 variants prolong jaundice up to one month,while severe SLC10A1 variants cause persistent cholestasis/hypercholanaemia beyond nine months.This large-scale evidence highlights genetic factors as key NHB determinants,with implications for neonatal care protocols to integrate genetic testing and establish longterm surveillance for variant carriers.
基金support from the Shenzhen Science and Technology program(grant number 202208183000115)。
文摘Biological aging is a complex physiological process characterized by a decline in tissue function and the loss of cellular capabilities,which increase an individual's risk of various diseases[1].While genetic factors and lifestyle are key influences on biological aging,environmental factors also play a significant role.Given the rapid aging of the global population,elucidating the factors that influence biological aging is crucial for promoting healthy aging.
基金supported by the Sichuan Provincial Cadre Health Research Project(ZH2024-101)the Key Natural Science Foundation of Sichuan Province(No.2025 ZNSFSC0053)。
文摘BACKGROUND Solid fuel use for cooking and heating is a major environmental risk factor,yet its association with new-onset heart disease(HD)remains unclear.The aim of this study was to investigate the relationship between solid fuel exposure and new-onset HD in a large cohort.METHODS Multivariable logistic regression models assessed associations between cooking/heating fuel types(coal,crop residue/wood,liquefied petroleum gas,natural gas,and others)and new-onset HD.Subgroup analyses explored effect modification by age,sex,education,smoking,alcohol use,and region.RESULTS A prospective cohort study included 5915 participants,with 781 participants(13.2%)developing new-onset HD.Coal use for cooking showed an initial association with new-onset HD risk(OR=1.41,95%CI:1.06–1.86,P=0.02),which attenuated after full adjustment(OR=1.28,95%CI:0.96–1.72,P=0.10).Coal use for heating demonstrated robust associations across all models(OR=1.86,95%CI:1.42–2.43,P<0.001).Crop residue/wood burning for heating was also significant(Model 2:OR=1.40,95%CI:1.06–1.86,P=0.02).Subgroup analyses revealed stronger associations among females,non-smokers,non-drinkers,and less-educated participants.Geographic stratification showed significant associations in southern but not northern regions.CONCLUSIONS Solid fuel use,particularly coal for heating,is associated with increased new-onset HD risk.Reducing solid fuel exposure is crucial for HD prevention in low-resource settings.
基金Capital Health Development Scientific Research Project(2020-2-4064)National Key Research and Development Program of China(2018YFC2002502).
文摘Objective Patients with atherosclerotic cardiovascular disease(ASCVD)following percutaneous coronary intervention(PCI)are classified as very-high-risk individuals in cardiovascular disease(CVD)risk stratification.The distribution pattern of traditional Chinese medicine(TCM)syndromes in this patient population,as well as its association with blood lipid profiles and clinical prognosis,remains unclear.The present prospective cohort study aims to investigate these correlations,thereby providing insights to enrich the research fields.Methods We enrolled consecutive patients with ASCVD who underwent PCI at the Integrated Cardiology Unit of China-Japan Friendship Hospital between September 1,2020 and December 31,2022.Demographics and clinical characteristics,signs and symptoms defining each TCM syndrome,and fasting venous blood samples were collected at baseline and follow up or upon major adverse cardiovascular events(MACEs).We analyzed the correlation between TCM syndromes,blood lipid profiles,and MACEs,and developed a new joint prognostic model incorporating both TCM syndromes and blood lipids using logistic regression.The analyses were based on detailed baseline and one-year follow-up data.Results A per-protocol analysis was performed on 586 patients with complete data ultimately.During the one-year follow-up,174 patients(29.69%)experienced a MACE.We performed statistical analyses on comorbidities,medication,and biochemical indicators across groups defined by TCM syndrome differentiation.When comparing different TCM syndromes,no significant differences were found in age,body mass index(BMI),history of revascularization,comorbidities,family history of CVD,smoking or drinking,or statin intensity(P>0.05).Patients with intertwined phlegm and blood stasis syndrome exhibited significantly higher levels of total cholesterol(TC,5.27±1.18 mmol/L,P<0.001),triglyceride(TG,1.96±1.33 mmol/L,P=0.008),low-density lipoprotein cholesterol(LDL-C,3.35±0.79 mmol/L,P<0.001),and high-density lipoprotein cholesterol(HDL-C,1.24±0.81 mmol/L,P<0.001)compared with those with other TCM syndromes combined.A multivariable logistic regression model was constructed to predict MACEs.The model included TCM syndrome type[with intertwined phlegm and blood stasis as a predictor,adjusted odds ratio(OR)=1.413,95%confidence interval(CI):0.517–3.864,P=0.501],age(adjusted OR=0.97,95%CI:0.955–1.001,P=0.057),male gender(adjusted OR=0.698,95%CI:0.416–1.170,P=0.173),TC(adjusted OR=1.004,95%CI:0.513–1.965,P=0.990),and LDL-C(adjusted OR=5.825,95%CI:2.214–15.326,P<0.001).This model demonstrated good discriminatory ability for MACEs in post-PCI ASCVD patients[the area under the receiver operating characteristic(ROC)curve(AUC)=0.865,95%CI:0.816–0.914].Conclusion The intertwined phlegm and blood stasis TCM syndrome is associated with a distinct atherogenic lipid profile characterized by elevated levels of TC and LDL-C.The prognostic model that incorporates this TCM syndrome type along with conventional lipid parameters(TC and LDL-C)shows good discriminatory ability for predicting MACEs in ASCVD patients after PCI,underscoring the potential clinical utility of integrating TCM syndrome differentiation into CVD risk assessment.
