Acute mountain sickness(AMS) is an illness caused by hypoxia due to rapid ascent to altitudes above 2,500 m. Symptoms include headache,nausea, vomiting, and loss of appetite, all of which usually improve within 1 to 2...Acute mountain sickness(AMS) is an illness caused by hypoxia due to rapid ascent to altitudes above 2,500 m. Symptoms include headache,nausea, vomiting, and loss of appetite, all of which usually improve within 1 to 2 days. However,untreated AMS can progress to life-threatening conditions such as high-altitude cerebral and pulmonary edema(HACE and HAPE, respectively)^([1]).展开更多
BACKGROUND Esophageal carcinoma(EC)presents a significant public health issue in China,with its prognosis impacted by myriad factors.The creation of a reliable prog-nostic model for the overall survival(OS)of EC patie...BACKGROUND Esophageal carcinoma(EC)presents a significant public health issue in China,with its prognosis impacted by myriad factors.The creation of a reliable prog-nostic model for the overall survival(OS)of EC patients promises to greatly advance the customization of treatment approaches.AIM To create a more systematic and practical model that incorporates clinically significant indicators to support decision-making in clinical settings.METHODS This study utilized data from a prospective longitudinal cohort of 3127 EC patients treated at Chongqing University Cancer Hospital between January 1,2018,and December 12,2020.Utilizing the least absolute shrinkage and selection operator regression alongside multivariate Cox regression analyses helped pinpoint pertinent variables for constructing the model.Its efficacy was assessed by concordance index(C-index),area under the receiver operating characteristic curve(AUC),calibration curves,and decision curve analysis(DCA).RESULTS Nine variables were determined to be significant predictors of OS in EC patients:Body mass index(BMI),Karnofsky performance status,TNM stage,surgery,radiotherapy,chemotherapy,immunotherapy,platelet-to-lymphocyte ratio,and albumin-to-globulin ratio(ALB/GLB).The model demonstrated a C-index of 0.715(95%CI:0.701-0.729)in the training cohort and 0.711(95%CI:0.689-0.732)in the validation cohort.In the training cohort,AUCs for 1-year,3-year,and 5-year OS predictions were 0.773,0.787,and 0.750,respectively;in the validation cohort,they were 0.772,0.768,and 0.723,respectively,illustrating the model's precision.Calibration curves and DCA verified the model's predictive accuracy and net benefit.CONCLUSION A novel prognostic model for determining the OS of EC patients was successfully developed and validated to help clinicians in devising individualized treatment schemes for EC patients.展开更多
Triple-negative breast cancer (TNBC) is an aggressive and often fatal disease, especially since the brain metastasis of TNBC has been a particularly severe manifestation. However, brain metastasis in TNBC at early sta...Triple-negative breast cancer (TNBC) is an aggressive and often fatal disease, especially since the brain metastasis of TNBC has been a particularly severe manifestation. However, brain metastasis in TNBC at early stages often lacks noticeable symptoms, making it challenging to detect. Near-infrared II (NIR-II) fluorescence microscopic imaging obtains long wavelength, which enables reduced scattering, high spatial resolution and minimal autofluorescence, it is also a favorable imaging method for tumor diagnosis. PbS@CdS quantum dots (QDs) are one of the popular NIR-II fluorescence nanoprobes for well brightness. In this study, NIR-II emissive PbS@CdS QDs were utilized and further encapsulated with thiol-terminated poly(ethylene oxide) (SH-PEG, MW = 5000) to form PbS@CdS@PEG QDs nanoparticles (NPs). The obtained PbS@CdS@PEG QDs NPs were then characterized and further studied in detail. The PbS@CdS@PEG QDs NPs had large absorption spectra, exhibited strong NIR-II fluorescence emission at approximately 1300nm, and possessed good NIR-II fluorescence properties. Then, the mice model of early-stage brain metastases of TNBC was established, and the PbS@CdS@PEG QDs NPs were injected into the tumor-bearing mice for NIR-II fluorescence microscopic bioimaging. The brain vessels and tumors of the living mice were detected with high spatial resolution under the NIR-II fluorescence microscopic imaging system with irradiation of 808nm laser. The tumor tissues were further restricted and prepared as thin slices. The NIR-II fluorescence signals were collected from the tumor slices with high spatial resolution and signal-to-background ratio (SBR). Thus, the PbS@CdS@PEG QDs NPs-assisted NIR-II fluorescence microscopic system can effectively achieve targeting brain metastases of TNBC imaging, offering a novel and promising approach for TNBC-specific diagnosis.展开更多
BACKGROUND Few studies have specifically modeled the risk of venous thromboembolism(VTE)for postoperative hepatocellular carcinoma(HCC)patients,although HCC is the third leading cause of cancer death worldwide.This st...BACKGROUND Few studies have specifically modeled the risk of venous thromboembolism(VTE)for postoperative hepatocellular carcinoma(HCC)patients,although HCC is the third leading cause of cancer death worldwide.This study aimed to develop and validate a nomogram that accurately predicts the risk of VTE in patients after HCC surgery.AIM To develop and validate a nomogram to accurately predict the risk of VTE in postoperative HCC patients by integrating clinical and laboratory risk factors.The model seeks to provide a user-friendly tool for identifying high-risk individuals who may benefit from targeted anticoagulation therapy,thereby improving clinical decision-making and patient outcomes.METHODS Data from patients who underwent HCC surgery at Chongqing University Cancer Hospital in China were analyzed.Through univariate and multivariate logistic regression analyses,independent risk factors for VTE were identified and integrated into a nomogram.The predictive performance of the nomogram was assessed via receiver operating characteristic curves,calibration curves,decision curve analysis and other relevant metrics.RESULTS Of 905 postoperative HCC patients were included in the study.The nomogram incorporated eight independent risk factors for VTE:Karnofsky Performance Scale,base disease,cancer stage(tumor-node-metastasis),chemotherapy,D-dimer concentration,white blood cell count,hemoglobin,and fibrinogen.The C-index for the nomogram model was 0.825 in the training cohort and 0.820 in the validation cohort,indicating good discriminative ability.Calibration plots of the model revealed high concordance between the predicted probabilities and observed outcomes.CONCLUSION We developed and validated a novel nomogram that can accurately estimate the risk of VTE in individual postoperative HCC patients.This model can identify high-risk patients who may benefit from targeted anticoagulation therapy.展开更多
BACKGROUND Rectal cancer is prevalent and associated with substantial morbidity and mortality.AIM To develop a nomogram prediction model for overall survival(OS)in patients with rectal cancer by leveraging a comprehen...BACKGROUND Rectal cancer is prevalent and associated with substantial morbidity and mortality.AIM To develop a nomogram prediction model for overall survival(OS)in patients with rectal cancer by leveraging a comprehensive analysis of demographic,clinicopathological,haematological,and follow-up data to identify independent prognostic factors.METHODS We conducted a prospective cohort study in China involving rectal cancer patients and applied Cox regression and least absolute shrinkage and selection operator regression to assess the significance of various variables as independent prognostic factors for OS.The identified factors were integrated into a nomogram model,which was evaluated for predictive accuracy via the C-index,area under the curve(AUC),calibration curve,and decision curve analysis(DCA).RESULTS Multivariate analysis revealed independent predictors of OS,including the Karnofsky performance status,age,sex,TNM stage,chemotherapy,surgery,targeted therapy,β2-microglobulin,lactate dehydrogenase,and the neutrophil-to-lymphocyte ratio.The nomogram demonstrated a C-index of 0.80 for the training and validation cohorts,with AUC values indicating high predictive accuracy for 1-year,3-year,and 5-year OS.The calibration curves confirmed the model's excellent agreement with the observed survival rates,and DCA revealed the superior clinical utility of the nomogram over the TNM staging system.CONCLUSION In this study,a novel prognostic model that accurately predicts the OS of rectal cancer patients was developed.The model exhibited excellent discriminatory and calibration capabilities,thus offering a reliable tool for health care professionals to estimate patient survival.展开更多
BACKGROUND Gastrointestinal schwannomas(GIS)are rare neurogenic tumors arising from Schwann cells in the gastrointestinal tract.Studies on GIS are limited to small case reports or focus on specific tumor sites,undersc...BACKGROUND Gastrointestinal schwannomas(GIS)are rare neurogenic tumors arising from Schwann cells in the gastrointestinal tract.Studies on GIS are limited to small case reports or focus on specific tumor sites,underscoring the diagnostic and thera-peutic challenges they pose.AIM To comprehensively examine the clinical features,pathological characteristics,treatment outcomes,associated comorbidities,and prognosis of GIS.METHODS The study population included patients diagnosed with GIS at the First Affiliated Hospital,Zhejiang University School of Medicine,between June 2007 and April 2024.Data were retrospectively collected and analyzed from medical records,including demographic characteristics,endoscopic and imaging findings,treatment modalities,pathological evaluations,and follow-up information.RESULTS In total,229 patients with GIS were included,with a mean age of 56.00 years and a male-to-female ratio of 1:1.83.The mean tumor size was 2.75 cm,and most(76.9%)were located in the stomach.Additionally,6.6%of the patients had other malig-nant tumors.Preoperative imaging and endoscopy frequently misdiagnosed GIS as gastrointestinal stromal tumors.However,accurate preoperative diagnosis was achieved using endoscopic ultrasound-guided fine-needle aspiration combined with immunohistochemical analysis,in which S100 and SOX-10 markers were mostly positive.Smaller tumors were typically managed with endoscopic resection,while larger lesions were treated with surgical resection.Follow-up results showed that most patients experienced favorable outcomes.CONCLUSION Preoperative diagnosis of GIS via clinical characteristics,endoscopy,and imaging examinations remains challenging but crucial.Endoscopic therapy provides a minimally invasive and effective option for patients.展开更多
BACKGROUND Oesophageal cancer is a significant health concern worldwide,with high inci-dence and mortality rates.In China,the disease burden is particularly high,accounting for a substantial proportion of oesophageal ...BACKGROUND Oesophageal cancer is a significant health concern worldwide,with high inci-dence and mortality rates.In China,the disease burden is particularly high,accounting for a substantial proportion of oesophageal cancer cases and related deaths worldwide.AIM To explore the relationship between the mortality rate of oesophageal cancer patients and insurance type,out-of-pocket ratio,and the joint effects of insurance type and out-of-pocket ratio.METHODS The χ^(2) test was used to analyze patients’demographic and clinical characteristics.Multivariate logistic regression,the Cox proportional hazard model,and the competitive risk model were used to calculate the cumulative hazard ratios(HRs)of all-cause death and oesophageal cancer-specific death among patients with different types of insurance and out-of-pocket ratios.RESULTS Compared with patients covered by basic medical insurance for urban and rural residents,patients covered by urban employee basic medical insurance for urban workers(UEBMI)had a 23.30%increased risk of oesophageal cancer-specific death[HR=1.233,95%confidence interval(CI):1.093-1.391,P<0.005].Compared with patients in the low out-of-pocket ratio group,patients in the high out-of-pocket ratio group had a 25.80%reduction in the risk of oesophageal cancer-specific death(HR=0.742,95%CI:0.6555-0.84,P<0.005).With each 10%increase in the out-of-pocket ratio,the risk of oesophageal cancer-specific death decreased by 10.10%in patients covered by UEBMI.However,the risk of oesophageal cancer-specific death increased by 26.90%in patients in the high out-of-pocket ratio group.CONCLUSION This study reveals the relationships of the specific mortality rate of patients with oesophageal cancer with the out-of-pocket ratio and medical insurance types as well as their combined effects.This study provides practical suggestions and guidance for the formulation of relevant policies in this area.展开更多
BACKGROUND The prevalence and mortality rates of gastric carcinoma are disproportionately elevated in China,with the disease's intricate and varied characteristics further amplifying its health impact.Precise fore...BACKGROUND The prevalence and mortality rates of gastric carcinoma are disproportionately elevated in China,with the disease's intricate and varied characteristics further amplifying its health impact.Precise forecasting of overall survival(OS)is of paramount importance for the clinical management of individuals afflicted with this malignancy.AIM To develop and validate a nomogram model that provides precise gastric cancer prevention and treatment guidance and more accurate survival outcome prediction for patients with gastric carcinoma.METHODS Data analysis was conducted on samples collected from hospitalized gastric cancer patients between 2018 and 2020.Least absolute shrinkage and selection operator,univariate,and multivariate Cox regression analyses were employed to identify independent prognostic factors.A nomogram model was developed to predict gastric cancer patient outcomes.The model's predictability and discriminative ability were evaluated via receiver operating characteristic curves.To evaluate the clinical utility of the model,Kaplan-Meier and decision curve analyses were performed.RESULTS A total of ten independent prognostic factors were identified,including body mass index,tumor-node-metastasis(TNM)stage,radiation,chemotherapy,surgery,albumin,globulin,neutrophil count,lactate dehydrogenase,and platelet-to-lymphocyte ratio.The area under the curve(AUC)values for the 1-,3-,and 5-year survival prediction in the training set were 0.843,0.850,and 0.821,respectively.The AUC values were 0.864,0.820,and 0.786 for the 1-,3-,and 5-year survival prediction in the validation set,respectively.The model exhibited strong discriminative ability,with both the time AUC and time C-index exceeding 0.75.Compared with TNM staging,the model demonstrated superior clinical utility.Ultimately,a nomogram was developed via a web-based interface.CONCLUSION This study established and validated a novel nomogram model for predicting the OS of gastric cancer patients,which demonstrated strong predictive ability.Based on these findings,this model can aid clinicians in implementing personalized interventions for patients with gastric cancer.展开更多
This study introduces the type-I heavy-tailed Burr XII(TIHTBXII)distribution,a highly flexible and robust statistical model designed to address the limitations of conventional distributions in analyzing data character...This study introduces the type-I heavy-tailed Burr XII(TIHTBXII)distribution,a highly flexible and robust statistical model designed to address the limitations of conventional distributions in analyzing data characterized by skewness,heavy tails,and diverse hazard behaviors.We meticulously develop the TIHTBXII’s mathematical foundations,including its probability density function(PDF),cumulative distribution function(CDF),and essential statistical properties,crucial for theoretical understanding and practical application.A comprehensive Monte Carlo simulation evaluates four parameter estimation methods:maximum likelihood(MLE),maximum product spacing(MPS),least squares(LS),and weighted least squares(WLS).The simulation results consistently show that as sample sizes increase,the Bias and RMSE of all estimators decrease,with WLS and LS often demonstrating superior and more stable performance.Beyond theoretical development,we present a practical application of the TIHTBXII distribution in constructing a group acceptance sampling plan(GASP)for truncated life tests.This application highlights how the TIHTBXII model can optimize quality control decisions by minimizing the average sample number(ASN)while effectively managing consumer and producer risks.Empirical validation using real-world datasets,including“Active Repair Duration,”“Groundwater Contaminant Measurements,”and“Dominica COVID-19 Mortality,”further demonstrates the TIHTBXII’s superior fit compared to existing models.Our findings confirm the TIHTBXII distribution as a powerful and reliable alternative for accurately modeling complex data in fields such as reliability engineering and quality assessment,leading to more informed and robust decision-making.展开更多
The stability and evolution of human genetics depend on chromosomes and chromosome-chromosome interactions.We wish to understand the spatial location of chromosomes in dividing cells in order to understand the relatio...The stability and evolution of human genetics depend on chromosomes and chromosome-chromosome interactions.We wish to understand the spatial location of chromosomes in dividing cells in order to understand the relationship between chromosome-chromosome interactions and to further investigate the role of chromosomes and their impact on cell biological behavior.In this study,we explored the relative spatial positional relationships of chromosomes[t(9;22)and t(15;17)]in B-ALL cells by using the three-dimensional DNA fluorescent in situ hybridization(3D-FISH)method.The results showed that chromosomes[t(9;22)and t(15;17)]showed relatively stable spatial relationships.The relative stability of the spatial location of chromosomes in dividing cells may be relevant to disease.展开更多
Objective The relationship between fish consumption and stroke is inconsistent,and it is uncertain whether this association varies across predicted stroke risks.Methods A cohort study comprising 95,800 participants fr...Objective The relationship between fish consumption and stroke is inconsistent,and it is uncertain whether this association varies across predicted stroke risks.Methods A cohort study comprising 95,800 participants from the Prediction for Atherosclerotic Cardiovascular Disease Risk in China project was conducted.A standardized questionnaire was used to collect data on fish consumption.Participants were stratified into low-and moderate-to-high-risk categories based on their 10-year stroke risk prediction scores.Hazard ratios(HRs)and 95%confidence intervals(CIs)were estimated using Cox proportional hazard models and additive interaction by relative excess risk due to interaction(RERI),attributable proportion(AP),and synergy index(SI).Results During 703,869 person-years of follow-up,2,773 incident stroke events were identified.Higher fish consumption was associated with a lower risk of stroke,particularly among moderate-to-high-risk individuals(HR=0.53,95%CI:0.47-0.60)than among low-risk individuals(HR=0.64,95%CI:0.49-0.85).A significant additive interaction between fish consumption and predicted stroke risk was observed(RERI=4.08,95%CI:2.80-5.36;SI=1.64,95%CI:1.42-1.89;AP=0.36,95%CI:0.28-0.43).Conclusion Higher fish consumption was associated with a lower risk of stroke,and this beneficial association was more pronounced in individuals with moderate-to-high stroke risk.展开更多
Objective To estimate the relationship between migration and HIV risky behavior when controlling for gender, age, and educational levels and to evaluate the gender differences in migration, HIV knowledge, and HIV risk...Objective To estimate the relationship between migration and HIV risky behavior when controlling for gender, age, and educational levels and to evaluate the gender differences in migration, HIV knowledge, and HIV risky behaviors among rural youth in China. Methods A cross-sectional, anonymous, investigative questionnaire for 1710 unmarried, out-of-school rural youth, aged between 15 and 24 years, was handed out in Gongzhuling county of Jilin province, China. Results 58.5% of participants had a history of migration, irrespective of gender. There were gender differences observed in other factors such as drug abuse（4.3% for males and 5.5% for females, P〈0.01）, multiple sexual partners（24.1% for males and 44.1% for females, P〈0.01）, and HIV knowledge rate（35.2% for males and 25.5% for females, P〈0.001）. While controlling for gender, age, and educational levels, the relationships between migration and drug abuse, selling sex, and non usage of condoms during last instance of sexual activity were found to be significant. The cases of premarital sex and multiple sexual partners were both not found to be related to migration. Conclusion Among rural youth, the HIV risky behavior such as drug abuse, selling sex, and lack of condom use, is significantly related to migration, while premarital sex and multiple sexual partners seem unrelated to migration.展开更多
Drug abuse continues to be a serious public health threat worldwide.Most drug abuse prevention research has been conducted with predominantly American or European adolescent populations.Little is known about approache...Drug abuse continues to be a serious public health threat worldwide.Most drug abuse prevention research has been conducted with predominantly American or European adolescent populations.Little is known about approaches that work best to prevent the initiation of Chinese adolescent drug use.For targeting risk factors of drug initiation in Chinese adolescents,a school-based health intervention program named "Cognition-Motivation-Emotional IntelligenceResistance Skills" (CMER) was developed to enhance cognition upon drug use,to decrease motivation of drug use and to improve emotional adjusting and drug resistance skills in this study.A total of 798 students from 3 senior high schools in Wuhan,a city in central China,were assigned randomly to intervention and control groups.The intervention group received the CMER program in which knowledge,development of positive attitude and motivation towards drugs and training of peer resistance skills were basic elements.The immediate impact was compared by measuring the above mentioned elements prior to and three-month after the training session.Students from both groups were asked to complete a self-administered questionnaire.The questionnaire included demographic items,self-reported drug use behavior,cognition,attitude,and motivation associated with the initiation of drug use and resistance skills.Three months after the intervention,significant effects were found on "illegal substance use at least once" (P【0.05) between the intervention and control groups.Immediate effects of the intervention were also found on knowledge,motivation and peer resistance skills (P【0.05),but there was no clear evidence for any effects on attitude towards substance use (P】0.05).It was concluded that the CMER program,which significantly increased the knowledge of drugs and peer resistance skills,was effective in the drug abuse prevention in a sample of school students in Wuhan,China.展开更多
Introduction: Anthropometric indices are used for assessing the nutrition status of people and societies. The indices determine the growth of the child’s nutrition status, his socioeconomic status and his quality of ...Introduction: Anthropometric indices are used for assessing the nutrition status of people and societies. The indices determine the growth of the child’s nutrition status, his socioeconomic status and his quality of life. This research aims to study the anthropometric indices of elementary school children in the Iranian city of Piranshahr using the Body Mass Index (BMI) and waist circumference in the first six months of 2011. Methods: In this descriptive-analytical cross-sectional study, 1803 students aged between 7 and 11 in Piranshahr were studied. Multi-stage cluster sampling was used. The research setting was an elementary school in Piranshahr. Demographic data were collected through interviews and record in questionnaires. A Secca stadiometer was used to measure the height of each student standing without shoes (accuracy of 0.1 centimeter). The weight was measured using a spring scale with an accuracy of 0.1 kilogram with the least possible clothes on. The weight was divided by the square of height (square meter) to calculate BMI. To determine overweight and obesity, BMI percentiles of Center for Disease Control (CDC) were used. In order to use appropriate tests, the normality and equality of variances were measured by Leven and K-S tests, respectively. Results: The study found that 231 children (12.8%) were at risk of overweight and 96 children (5.3%) were overweight. Conclusion: There was a meaningful difference between boys and girls in terms of nutrition status of BMI, father’s higher education level, shortness, abdominal obesity and family history of obesity, and father’s jobs展开更多
Context: With the view to reorient both STI/HIV/AIDS prevention and adolescents pregnancies, this research study aims at evaluating cognitive and behavioral acquisitions, as well as the process of interactive sex educ...Context: With the view to reorient both STI/HIV/AIDS prevention and adolescents pregnancies, this research study aims at evaluating cognitive and behavioral acquisitions, as well as the process of interactive sex education participatory approach among adolescents in Kinshasa high schools. Methods: Based on a “pre and post” virtually experimental design, two crosswise surveys were conducted in Kinshasa, for six months in 2011-2012 on 484 high school students (pre-survey) and on 441 high school students (post-survey), whose age range from 14 - 19 years including both sexes. Two participatory educational talks (PET) “A” and “B”, covered weekly in two different schools, were compared to a control group school. The PET “A” consisted of interactive interpersonal communication sessions given by an external expert as a substitute for the life education course in one school. The PET “B” carried out in another school, included more educational talk sessions, led by the external expert and supplemented by a close follow-up of teenagers divided into small groups of 10 participants. The subjects’ assessment was based on their knowledge, attitudes and practices relating to STI/HIV/AIDS dual prevention as well as to unwanted pregnancies. Results: The subjects involved in the PET “B” displayed a better/higher performance based on their knowledge, attitudes and practices related to STI/HIV/AIDS dual prevention and unwanted pregnancies. Broadly speaking, knowledge has been improved 6 times with the PET “B” (OR = 6, 10, IC 95%) (3.24 - 11.9), and 3 times with the PET “A” (OR = 3, 45, IC 95%) (1.79 - 6.81), compared to control school. Similarly, findings on subjects’ attitudes show an improvement rated 12 times with the PET”B” (OR = 11, 99, IC 95%) (5.67 - 27.38) and 5 times for the PET “A” (OR = 5.51, IC 95%) (2.54 - 12.87). As far as the subjects’ practices are concerned, an improvement of 6 more times of protected sexual intercourses with the PET “B” compared with the control school group (OR = 6, 52, IC 95%) (3.60 - 12.0). The process assessment records a spontaneous involvement of schools enhanced by the positive contribution of Life Education and Biology teachers;add a massive participation of adolescents who requested permanent PET program. Conclusion: The results of this study suggest that school sexual education programs can be improved to increase the quality of apprenticeship. The use of interactive methods and the consideration of the adolescents’ specific needs that take into account the gender approach may bring about beneficial advantages on both educational outcomes and reproductive health of adolescents.展开更多
OBJECTIVE:To evaluate the efficacy of electroacupuncture(EA)intervention on myocardial protection and postoperative rehabilitation in patients undergoing cardiac surgery with cardiopulmonary bypass(CPB).METHODS:Eight ...OBJECTIVE:To evaluate the efficacy of electroacupuncture(EA)intervention on myocardial protection and postoperative rehabilitation in patients undergoing cardiac surgery with cardiopulmonary bypass(CPB).METHODS:Eight databases,including Pub Med,Embase,the Cochrane Library,Web of Science,Chinese Bio Medical Literature Database,China National Knowledge Infrastructure Database,Wanfang Data,China Science and Technology Journal Database,and two clinical trial registries,were searched.All randomized controlled trials(RCTs)related to EA intervention in cardiac surgery with CPB were collected.Based on the inclusion and exclusion criteria,two researchers independently screened articles and extracted data.After the quality evaluation,RevMan 5.3 software was used for analysis.RESULTS:Fourteen RCTs involving 836 patients were included.Compared with the control treatment,EA significantly increased the incidence of cardiac automatic rebeat after aortic unclamping[relative risk(RR)=1.15,95%confidence interval(CI)(1.01,1.31),P<0.05;moderate].Twenty-four hours after aortic unclamping,EA significantly increased the superoxide dismutase[standardized mean difference(SMD)=0.96,95%CI(0.32,1.61),P<0.05;low],and interleukin(IL)-2[SMD=1.33,95%CI(0.19,2.47),P<0.05;very low]expression levels and decreased the malondialdehyde[SMD=-1.62,95%CI(-2.15,-1.09),P<0.05;moderate],tumour necrosis factor-α[SMD=-1.28,95%CI(-2.37,-0.19),P<0.05;moderate],and cardiac troponin I[SMD=-1.09,95%CI(-1.85,-0.32),P<0.05;low]expression levels as well as the inotrope scores[SMD=-0.77,95%CI(-1.22,-0.31),P<0.05;high].There was no difference in IL-6 and IL-10 expression levels.The amount of intraoperative sedative[SMD=-0.31,95%CI(-0.54,-0.09),P<0.05;moderate]and opioid analgesic[SMD=-0.96,95%CI(-1.53,-0.38),P<0.05;low]medication was significantly lower in the EA group than in the control group.Moreover,the postoperative tracheal intubation time[SMD=-0.92,95%CI(-1.40,-0.45),P<0.05;low]and intensive care unit stay[SMD=-1.71,95%CI(-3.06,-0.36),P<0.05;low]were significantly shorter in the EA group than in the control group.There were no differences in the time to get out of bed for the first time,total days of antibiotic use after surgery,or postoperative hospital stay.No adverse reactions related to EA were reported in any of the included studies.CONCLUSIONS:In cardiac surgery with CPB,EA may be a safe and effective strategy to reduce myocardial ischaemia-reperfusion injury and speed up the recovery of patients after surgery.These findings must be interpreted with caution,as most of the evidence was of low or moderate quality.More RCTs with larger sample sizes and higher quality are needed to provide more convincing evidence.展开更多
Objective Previous studies on the association between lipid profiles and chronic kidney disease(CKD)have yielded inconsistent results and no defined thresholds for blood lipids.Methods A prospective cohort study inclu...Objective Previous studies on the association between lipid profiles and chronic kidney disease(CKD)have yielded inconsistent results and no defined thresholds for blood lipids.Methods A prospective cohort study including 32,351 subjects who completed baseline and follow-up surveys over 5 years was conducted.Restricted cubic splines and Cox models were used to examine the association between the lipid profiles and CKD.A regression discontinuity design was used to determine the cutoff value of lipid profiles that was significantly associated with increased the risk of CKD.Results Over a median follow-up time of 2.2(0.5,4.2)years,648(2.00%)subjects developed CKD.The lipid profiles that were significantly and linearly related to CKD included total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),TC/HDL-C,and TG/HDL-C,whereas lowdensity lipoprotein cholesterol(LDL-C)and LDL-C/HDL-C were nonlinearly correlated with CKD.TC,TG,TC/HDL-C,and TG/HDL-C showed an upward jump at the cutoff value,increasing the risk of CKD by 0.90%,1.50%,2.30%,and 1.60%,respectively,whereas HDL-C showed a downward jump at the cutoff value,reducing this risk by 1.0%.Female and participants with dyslipidemia had a higher risk of CKD,while the cutoff values for the different characteristics of the population were different.Conclusion There was a significant association between lipid profiles and CKD in a prospective cohort from Northwest China,while TG,TC/HDL-C,and TG/HDL-C showed a stronger risk association.The specific cutoff values of lipid profiles may provide a clinical reference for screening or diagnosing CKD risk.展开更多
Objective: Plant-based diets have multiple health benefits for cancers;however, little is known about the association between plant-based dietary patterns and esophageal cancer(EC).This study presents an investigation...Objective: Plant-based diets have multiple health benefits for cancers;however, little is known about the association between plant-based dietary patterns and esophageal cancer(EC).This study presents an investigation of the prospective associations among three predefined indices of plant-based dietary patterns and the risk of EC.Methods: We performed endoscopic screening for 15,709 participants aged 40-69 years from two high-risk areas of China from January 2005 to December 2009 and followed the cohort until December 31, 2022. The overall plant-based diet index(PDI), healthful plant-based diet index(h PDI), and unhealthful plant-based diet index(u PDI), were calculated using survey responses to assess dietary patterns. We applied Cox proportional hazard regression to estimate the multivariable hazard ratios(HRs) and 95% confidence intervals(95% CIs) of EC across 3plant-based diet indices and further stratified the analysis by subgroups.Results: The final study sample included 15,184 participants in the cohort. During a follow-up of 219,365person-years, 176 patients with EC were identified. When the highest quartile was compared with the lowest quartile, the pooled multivariable-adjusted HR of EC was 0.50(95% CI, 0.32-0.77) for h PDI. In addition, the HR per 10-point increase in the h PDI score was 0.42(95% CI, 0.27-0.66) for ECs. Conversely, u PDI was positively associated with the risk of EC, and the HR was 1.80(95% CI, 1.16-2.82). The HR per 10-point increase in the u PDI score was 1.90(95% CI, 1.26-2.88) for ECs. The associations between these scores and the risk of EC were consistent in most subgroups. These results remained robust in sensitivity analyses.Conclusions: A healthy plant-based dietary pattern was associated with a reduced risk of EC. Emphasizing the healthiness and quality of plant-based diets may be important for preventing the development of EC.展开更多
Scarlet fever(SF)is a common infectious disease caused by group A streptococcus(GAS)[1].During the 18th and 19th centuries,SF was a significant cause of mortality in children aged 5-15 years worldwide[2].The incidence...Scarlet fever(SF)is a common infectious disease caused by group A streptococcus(GAS)[1].During the 18th and 19th centuries,SF was a significant cause of mortality in children aged 5-15 years worldwide[2].The incidence and fatality rates of SF have decreased remarkably due to the widespread use of effective antibiotics and improvements in diet and sanitation[3].However,the recent resurgence of SF has sparked significant interest in infectious diseases[1,3].Given the insufficient understanding of the triggers that cause SF outbreaks and the absence of available vaccines to prevent GAS infection to date[1],effective prevention and control programs are needed to manage the ongoing spread of SF.展开更多
Background Educational inequalities in suicide have become increasingly prominent over the past decade.Elucidating modifiable risk factors that serve as intermediaries in the impact of low educational attainment on su...Background Educational inequalities in suicide have become increasingly prominent over the past decade.Elucidating modifiable risk factors that serve as intermediaries in the impact of low educational attainment on suicide has the potential to reduce health disparities.Aims To examine the risk factors that mediate the relationship between educational attainment and suicide attempts and quantify their contributions to the mediation effect.Methods We conducted a two-sample Mendelian randomisation(MR)analysis to estimate the causal effect of educational attainment on suicide attempts,utilising genome-wide association study summary statistics from the Integrative Psychiatric Research(iPSYCH;6024 cases and 44240 controls)and FinnGen(8978 cases and 368299 controls).We systematically evaluated 42 putative mediators within the causal pathway connecting reduced educational attainment to suicide attempts and employed two-step and multivariable MR to quantify the proportion of the mediated effect.Results In the combined analysis of iPSYCH and FinnGen,each standard deviation(SD)decrease in genetically predicted educational attainment(equating to 3.4 years of education)was associated with a 105%higher risk of suicide attempts(odds ratio(OR):2.05;95%confidence interval(Cl):1.81 to 2.31).0f the 42 risk factors analysed,the two-step MR identified five factors that mediated the association between educational attainment and suicide attempts.The respective proportions of mediation were 47%(95%Cl:29%to 66%)for smoking behaviour,36%(95%Cl:0%to 84%)for chronic pain,49%(95%Cl:36%to 61%)for depression,35%(95%Cl:12%to 59%)for anxiety and 26%(95%Cl:18%to 34%)for insomnia.Multivariable MR implicated these five mediators collectively,accounting for 68%(95%Cl:40%to 96%)of the total effect.Conclusions This study identified smoking,chronic pain and mental disorders as primary intervention targets for attenuating suicide risk attributable to lower educational levels in the European population.展开更多
文摘Acute mountain sickness(AMS) is an illness caused by hypoxia due to rapid ascent to altitudes above 2,500 m. Symptoms include headache,nausea, vomiting, and loss of appetite, all of which usually improve within 1 to 2 days. However,untreated AMS can progress to life-threatening conditions such as high-altitude cerebral and pulmonary edema(HACE and HAPE, respectively)^([1]).
文摘BACKGROUND Esophageal carcinoma(EC)presents a significant public health issue in China,with its prognosis impacted by myriad factors.The creation of a reliable prog-nostic model for the overall survival(OS)of EC patients promises to greatly advance the customization of treatment approaches.AIM To create a more systematic and practical model that incorporates clinically significant indicators to support decision-making in clinical settings.METHODS This study utilized data from a prospective longitudinal cohort of 3127 EC patients treated at Chongqing University Cancer Hospital between January 1,2018,and December 12,2020.Utilizing the least absolute shrinkage and selection operator regression alongside multivariate Cox regression analyses helped pinpoint pertinent variables for constructing the model.Its efficacy was assessed by concordance index(C-index),area under the receiver operating characteristic curve(AUC),calibration curves,and decision curve analysis(DCA).RESULTS Nine variables were determined to be significant predictors of OS in EC patients:Body mass index(BMI),Karnofsky performance status,TNM stage,surgery,radiotherapy,chemotherapy,immunotherapy,platelet-to-lymphocyte ratio,and albumin-to-globulin ratio(ALB/GLB).The model demonstrated a C-index of 0.715(95%CI:0.701-0.729)in the training cohort and 0.711(95%CI:0.689-0.732)in the validation cohort.In the training cohort,AUCs for 1-year,3-year,and 5-year OS predictions were 0.773,0.787,and 0.750,respectively;in the validation cohort,they were 0.772,0.768,and 0.723,respectively,illustrating the model's precision.Calibration curves and DCA verified the model's predictive accuracy and net benefit.CONCLUSION A novel prognostic model for determining the OS of EC patients was successfully developed and validated to help clinicians in devising individualized treatment schemes for EC patients.
基金supported by the National Natural Science Foundation of China(NSFC)under Grant Nos.62035011,82202220 and 82060326State Key Laboratory of Pathogenesis,Prevention and treat ment of High Incident Diseases in central Asia(Nos.SKL-HIDCA-2022-3 and SKL-HIDCA-2022-GJ1)+3 种基金the Xinjiang Uygur Autonomous Region Regional Collaborative Innovation Special Science and Technology Assistance Program(No.2022E02130)Xinjiang Uygur Autonomous Region Natural Sci ence Foundation Key Project(No.2022D01D40)Outstanding Youth Project(2023D01E06)Y.Gao and C.Zhang authors contributed equally to this work.
文摘Triple-negative breast cancer (TNBC) is an aggressive and often fatal disease, especially since the brain metastasis of TNBC has been a particularly severe manifestation. However, brain metastasis in TNBC at early stages often lacks noticeable symptoms, making it challenging to detect. Near-infrared II (NIR-II) fluorescence microscopic imaging obtains long wavelength, which enables reduced scattering, high spatial resolution and minimal autofluorescence, it is also a favorable imaging method for tumor diagnosis. PbS@CdS quantum dots (QDs) are one of the popular NIR-II fluorescence nanoprobes for well brightness. In this study, NIR-II emissive PbS@CdS QDs were utilized and further encapsulated with thiol-terminated poly(ethylene oxide) (SH-PEG, MW = 5000) to form PbS@CdS@PEG QDs nanoparticles (NPs). The obtained PbS@CdS@PEG QDs NPs were then characterized and further studied in detail. The PbS@CdS@PEG QDs NPs had large absorption spectra, exhibited strong NIR-II fluorescence emission at approximately 1300nm, and possessed good NIR-II fluorescence properties. Then, the mice model of early-stage brain metastases of TNBC was established, and the PbS@CdS@PEG QDs NPs were injected into the tumor-bearing mice for NIR-II fluorescence microscopic bioimaging. The brain vessels and tumors of the living mice were detected with high spatial resolution under the NIR-II fluorescence microscopic imaging system with irradiation of 808nm laser. The tumor tissues were further restricted and prepared as thin slices. The NIR-II fluorescence signals were collected from the tumor slices with high spatial resolution and signal-to-background ratio (SBR). Thus, the PbS@CdS@PEG QDs NPs-assisted NIR-II fluorescence microscopic system can effectively achieve targeting brain metastases of TNBC imaging, offering a novel and promising approach for TNBC-specific diagnosis.
文摘BACKGROUND Few studies have specifically modeled the risk of venous thromboembolism(VTE)for postoperative hepatocellular carcinoma(HCC)patients,although HCC is the third leading cause of cancer death worldwide.This study aimed to develop and validate a nomogram that accurately predicts the risk of VTE in patients after HCC surgery.AIM To develop and validate a nomogram to accurately predict the risk of VTE in postoperative HCC patients by integrating clinical and laboratory risk factors.The model seeks to provide a user-friendly tool for identifying high-risk individuals who may benefit from targeted anticoagulation therapy,thereby improving clinical decision-making and patient outcomes.METHODS Data from patients who underwent HCC surgery at Chongqing University Cancer Hospital in China were analyzed.Through univariate and multivariate logistic regression analyses,independent risk factors for VTE were identified and integrated into a nomogram.The predictive performance of the nomogram was assessed via receiver operating characteristic curves,calibration curves,decision curve analysis and other relevant metrics.RESULTS Of 905 postoperative HCC patients were included in the study.The nomogram incorporated eight independent risk factors for VTE:Karnofsky Performance Scale,base disease,cancer stage(tumor-node-metastasis),chemotherapy,D-dimer concentration,white blood cell count,hemoglobin,and fibrinogen.The C-index for the nomogram model was 0.825 in the training cohort and 0.820 in the validation cohort,indicating good discriminative ability.Calibration plots of the model revealed high concordance between the predicted probabilities and observed outcomes.CONCLUSION We developed and validated a novel nomogram that can accurately estimate the risk of VTE in individual postoperative HCC patients.This model can identify high-risk patients who may benefit from targeted anticoagulation therapy.
文摘BACKGROUND Rectal cancer is prevalent and associated with substantial morbidity and mortality.AIM To develop a nomogram prediction model for overall survival(OS)in patients with rectal cancer by leveraging a comprehensive analysis of demographic,clinicopathological,haematological,and follow-up data to identify independent prognostic factors.METHODS We conducted a prospective cohort study in China involving rectal cancer patients and applied Cox regression and least absolute shrinkage and selection operator regression to assess the significance of various variables as independent prognostic factors for OS.The identified factors were integrated into a nomogram model,which was evaluated for predictive accuracy via the C-index,area under the curve(AUC),calibration curve,and decision curve analysis(DCA).RESULTS Multivariate analysis revealed independent predictors of OS,including the Karnofsky performance status,age,sex,TNM stage,chemotherapy,surgery,targeted therapy,β2-microglobulin,lactate dehydrogenase,and the neutrophil-to-lymphocyte ratio.The nomogram demonstrated a C-index of 0.80 for the training and validation cohorts,with AUC values indicating high predictive accuracy for 1-year,3-year,and 5-year OS.The calibration curves confirmed the model's excellent agreement with the observed survival rates,and DCA revealed the superior clinical utility of the nomogram over the TNM staging system.CONCLUSION In this study,a novel prognostic model that accurately predicts the OS of rectal cancer patients was developed.The model exhibited excellent discriminatory and calibration capabilities,thus offering a reliable tool for health care professionals to estimate patient survival.
文摘BACKGROUND Gastrointestinal schwannomas(GIS)are rare neurogenic tumors arising from Schwann cells in the gastrointestinal tract.Studies on GIS are limited to small case reports or focus on specific tumor sites,underscoring the diagnostic and thera-peutic challenges they pose.AIM To comprehensively examine the clinical features,pathological characteristics,treatment outcomes,associated comorbidities,and prognosis of GIS.METHODS The study population included patients diagnosed with GIS at the First Affiliated Hospital,Zhejiang University School of Medicine,between June 2007 and April 2024.Data were retrospectively collected and analyzed from medical records,including demographic characteristics,endoscopic and imaging findings,treatment modalities,pathological evaluations,and follow-up information.RESULTS In total,229 patients with GIS were included,with a mean age of 56.00 years and a male-to-female ratio of 1:1.83.The mean tumor size was 2.75 cm,and most(76.9%)were located in the stomach.Additionally,6.6%of the patients had other malig-nant tumors.Preoperative imaging and endoscopy frequently misdiagnosed GIS as gastrointestinal stromal tumors.However,accurate preoperative diagnosis was achieved using endoscopic ultrasound-guided fine-needle aspiration combined with immunohistochemical analysis,in which S100 and SOX-10 markers were mostly positive.Smaller tumors were typically managed with endoscopic resection,while larger lesions were treated with surgical resection.Follow-up results showed that most patients experienced favorable outcomes.CONCLUSION Preoperative diagnosis of GIS via clinical characteristics,endoscopy,and imaging examinations remains challenging but crucial.Endoscopic therapy provides a minimally invasive and effective option for patients.
基金Supported by the Chongqing Science and Health Joint Medical Research Project,No.2024MSXM065.
文摘BACKGROUND Oesophageal cancer is a significant health concern worldwide,with high inci-dence and mortality rates.In China,the disease burden is particularly high,accounting for a substantial proportion of oesophageal cancer cases and related deaths worldwide.AIM To explore the relationship between the mortality rate of oesophageal cancer patients and insurance type,out-of-pocket ratio,and the joint effects of insurance type and out-of-pocket ratio.METHODS The χ^(2) test was used to analyze patients’demographic and clinical characteristics.Multivariate logistic regression,the Cox proportional hazard model,and the competitive risk model were used to calculate the cumulative hazard ratios(HRs)of all-cause death and oesophageal cancer-specific death among patients with different types of insurance and out-of-pocket ratios.RESULTS Compared with patients covered by basic medical insurance for urban and rural residents,patients covered by urban employee basic medical insurance for urban workers(UEBMI)had a 23.30%increased risk of oesophageal cancer-specific death[HR=1.233,95%confidence interval(CI):1.093-1.391,P<0.005].Compared with patients in the low out-of-pocket ratio group,patients in the high out-of-pocket ratio group had a 25.80%reduction in the risk of oesophageal cancer-specific death(HR=0.742,95%CI:0.6555-0.84,P<0.005).With each 10%increase in the out-of-pocket ratio,the risk of oesophageal cancer-specific death decreased by 10.10%in patients covered by UEBMI.However,the risk of oesophageal cancer-specific death increased by 26.90%in patients in the high out-of-pocket ratio group.CONCLUSION This study reveals the relationships of the specific mortality rate of patients with oesophageal cancer with the out-of-pocket ratio and medical insurance types as well as their combined effects.This study provides practical suggestions and guidance for the formulation of relevant policies in this area.
文摘BACKGROUND The prevalence and mortality rates of gastric carcinoma are disproportionately elevated in China,with the disease's intricate and varied characteristics further amplifying its health impact.Precise forecasting of overall survival(OS)is of paramount importance for the clinical management of individuals afflicted with this malignancy.AIM To develop and validate a nomogram model that provides precise gastric cancer prevention and treatment guidance and more accurate survival outcome prediction for patients with gastric carcinoma.METHODS Data analysis was conducted on samples collected from hospitalized gastric cancer patients between 2018 and 2020.Least absolute shrinkage and selection operator,univariate,and multivariate Cox regression analyses were employed to identify independent prognostic factors.A nomogram model was developed to predict gastric cancer patient outcomes.The model's predictability and discriminative ability were evaluated via receiver operating characteristic curves.To evaluate the clinical utility of the model,Kaplan-Meier and decision curve analyses were performed.RESULTS A total of ten independent prognostic factors were identified,including body mass index,tumor-node-metastasis(TNM)stage,radiation,chemotherapy,surgery,albumin,globulin,neutrophil count,lactate dehydrogenase,and platelet-to-lymphocyte ratio.The area under the curve(AUC)values for the 1-,3-,and 5-year survival prediction in the training set were 0.843,0.850,and 0.821,respectively.The AUC values were 0.864,0.820,and 0.786 for the 1-,3-,and 5-year survival prediction in the validation set,respectively.The model exhibited strong discriminative ability,with both the time AUC and time C-index exceeding 0.75.Compared with TNM staging,the model demonstrated superior clinical utility.Ultimately,a nomogram was developed via a web-based interface.CONCLUSION This study established and validated a novel nomogram model for predicting the OS of gastric cancer patients,which demonstrated strong predictive ability.Based on these findings,this model can aid clinicians in implementing personalized interventions for patients with gastric cancer.
基金supported and funded by the Deanship of Scientific Research at Imam Mohammad Ibn Saud Islamic University(IMSIU)(Grant Number IMSIU-DDRSP2501).
文摘This study introduces the type-I heavy-tailed Burr XII(TIHTBXII)distribution,a highly flexible and robust statistical model designed to address the limitations of conventional distributions in analyzing data characterized by skewness,heavy tails,and diverse hazard behaviors.We meticulously develop the TIHTBXII’s mathematical foundations,including its probability density function(PDF),cumulative distribution function(CDF),and essential statistical properties,crucial for theoretical understanding and practical application.A comprehensive Monte Carlo simulation evaluates four parameter estimation methods:maximum likelihood(MLE),maximum product spacing(MPS),least squares(LS),and weighted least squares(WLS).The simulation results consistently show that as sample sizes increase,the Bias and RMSE of all estimators decrease,with WLS and LS often demonstrating superior and more stable performance.Beyond theoretical development,we present a practical application of the TIHTBXII distribution in constructing a group acceptance sampling plan(GASP)for truncated life tests.This application highlights how the TIHTBXII model can optimize quality control decisions by minimizing the average sample number(ASN)while effectively managing consumer and producer risks.Empirical validation using real-world datasets,including“Active Repair Duration,”“Groundwater Contaminant Measurements,”and“Dominica COVID-19 Mortality,”further demonstrates the TIHTBXII’s superior fit compared to existing models.Our findings confirm the TIHTBXII distribution as a powerful and reliable alternative for accurately modeling complex data in fields such as reliability engineering and quality assessment,leading to more informed and robust decision-making.
文摘The stability and evolution of human genetics depend on chromosomes and chromosome-chromosome interactions.We wish to understand the spatial location of chromosomes in dividing cells in order to understand the relationship between chromosome-chromosome interactions and to further investigate the role of chromosomes and their impact on cell biological behavior.In this study,we explored the relative spatial positional relationships of chromosomes[t(9;22)and t(15;17)]in B-ALL cells by using the three-dimensional DNA fluorescent in situ hybridization(3D-FISH)method.The results showed that chromosomes[t(9;22)and t(15;17)]showed relatively stable spatial relationships.The relative stability of the spatial location of chromosomes in dividing cells may be relevant to disease.
基金supported by the Chinese Academy of Medical Sciences(CAMS)Innovation Fund for Medical Sciences(2021-I2M-1-010,2019-I2M-2-003,and 2017-I2M-1-004)the National High Level Hospital Clinical Research Funding(2022-GSPGG-1,2022-GSP-GG-2)+2 种基金the Research Unit of Prospective Cohort of Cardiovascular Diseases and Cancers,CAMS(2019RU038)the National Key Research and Development Program of China(2018YFE0115300 and 2017YFC0211700)the National Natural Science Foundation of China(82030102,12126602).
文摘Objective The relationship between fish consumption and stroke is inconsistent,and it is uncertain whether this association varies across predicted stroke risks.Methods A cohort study comprising 95,800 participants from the Prediction for Atherosclerotic Cardiovascular Disease Risk in China project was conducted.A standardized questionnaire was used to collect data on fish consumption.Participants were stratified into low-and moderate-to-high-risk categories based on their 10-year stroke risk prediction scores.Hazard ratios(HRs)and 95%confidence intervals(CIs)were estimated using Cox proportional hazard models and additive interaction by relative excess risk due to interaction(RERI),attributable proportion(AP),and synergy index(SI).Results During 703,869 person-years of follow-up,2,773 incident stroke events were identified.Higher fish consumption was associated with a lower risk of stroke,particularly among moderate-to-high-risk individuals(HR=0.53,95%CI:0.47-0.60)than among low-risk individuals(HR=0.64,95%CI:0.49-0.85).A significant additive interaction between fish consumption and predicted stroke risk was observed(RERI=4.08,95%CI:2.80-5.36;SI=1.64,95%CI:1.42-1.89;AP=0.36,95%CI:0.28-0.43).Conclusion Higher fish consumption was associated with a lower risk of stroke,and this beneficial association was more pronounced in individuals with moderate-to-high stroke risk.
基金supported by the 2006 Chinese National AIDS Prevention Social Mobilization Project 06-I-37
文摘Objective To estimate the relationship between migration and HIV risky behavior when controlling for gender, age, and educational levels and to evaluate the gender differences in migration, HIV knowledge, and HIV risky behaviors among rural youth in China. Methods A cross-sectional, anonymous, investigative questionnaire for 1710 unmarried, out-of-school rural youth, aged between 15 and 24 years, was handed out in Gongzhuling county of Jilin province, China. Results 58.5% of participants had a history of migration, irrespective of gender. There were gender differences observed in other factors such as drug abuse（4.3% for males and 5.5% for females, P〈0.01）, multiple sexual partners（24.1% for males and 44.1% for females, P〈0.01）, and HIV knowledge rate（35.2% for males and 25.5% for females, P〈0.001）. While controlling for gender, age, and educational levels, the relationships between migration and drug abuse, selling sex, and non usage of condoms during last instance of sexual activity were found to be significant. The cases of premarital sex and multiple sexual partners were both not found to be related to migration. Conclusion Among rural youth, the HIV risky behavior such as drug abuse, selling sex, and lack of condom use, is significantly related to migration, while premarital sex and multiple sexual partners seem unrelated to migration.
文摘Drug abuse continues to be a serious public health threat worldwide.Most drug abuse prevention research has been conducted with predominantly American or European adolescent populations.Little is known about approaches that work best to prevent the initiation of Chinese adolescent drug use.For targeting risk factors of drug initiation in Chinese adolescents,a school-based health intervention program named "Cognition-Motivation-Emotional IntelligenceResistance Skills" (CMER) was developed to enhance cognition upon drug use,to decrease motivation of drug use and to improve emotional adjusting and drug resistance skills in this study.A total of 798 students from 3 senior high schools in Wuhan,a city in central China,were assigned randomly to intervention and control groups.The intervention group received the CMER program in which knowledge,development of positive attitude and motivation towards drugs and training of peer resistance skills were basic elements.The immediate impact was compared by measuring the above mentioned elements prior to and three-month after the training session.Students from both groups were asked to complete a self-administered questionnaire.The questionnaire included demographic items,self-reported drug use behavior,cognition,attitude,and motivation associated with the initiation of drug use and resistance skills.Three months after the intervention,significant effects were found on "illegal substance use at least once" (P【0.05) between the intervention and control groups.Immediate effects of the intervention were also found on knowledge,motivation and peer resistance skills (P【0.05),but there was no clear evidence for any effects on attitude towards substance use (P】0.05).It was concluded that the CMER program,which significantly increased the knowledge of drugs and peer resistance skills,was effective in the drug abuse prevention in a sample of school students in Wuhan,China.
文摘Introduction: Anthropometric indices are used for assessing the nutrition status of people and societies. The indices determine the growth of the child’s nutrition status, his socioeconomic status and his quality of life. This research aims to study the anthropometric indices of elementary school children in the Iranian city of Piranshahr using the Body Mass Index (BMI) and waist circumference in the first six months of 2011. Methods: In this descriptive-analytical cross-sectional study, 1803 students aged between 7 and 11 in Piranshahr were studied. Multi-stage cluster sampling was used. The research setting was an elementary school in Piranshahr. Demographic data were collected through interviews and record in questionnaires. A Secca stadiometer was used to measure the height of each student standing without shoes (accuracy of 0.1 centimeter). The weight was measured using a spring scale with an accuracy of 0.1 kilogram with the least possible clothes on. The weight was divided by the square of height (square meter) to calculate BMI. To determine overweight and obesity, BMI percentiles of Center for Disease Control (CDC) were used. In order to use appropriate tests, the normality and equality of variances were measured by Leven and K-S tests, respectively. Results: The study found that 231 children (12.8%) were at risk of overweight and 96 children (5.3%) were overweight. Conclusion: There was a meaningful difference between boys and girls in terms of nutrition status of BMI, father’s higher education level, shortness, abdominal obesity and family history of obesity, and father’s jobs
文摘Context: With the view to reorient both STI/HIV/AIDS prevention and adolescents pregnancies, this research study aims at evaluating cognitive and behavioral acquisitions, as well as the process of interactive sex education participatory approach among adolescents in Kinshasa high schools. Methods: Based on a “pre and post” virtually experimental design, two crosswise surveys were conducted in Kinshasa, for six months in 2011-2012 on 484 high school students (pre-survey) and on 441 high school students (post-survey), whose age range from 14 - 19 years including both sexes. Two participatory educational talks (PET) “A” and “B”, covered weekly in two different schools, were compared to a control group school. The PET “A” consisted of interactive interpersonal communication sessions given by an external expert as a substitute for the life education course in one school. The PET “B” carried out in another school, included more educational talk sessions, led by the external expert and supplemented by a close follow-up of teenagers divided into small groups of 10 participants. The subjects’ assessment was based on their knowledge, attitudes and practices relating to STI/HIV/AIDS dual prevention as well as to unwanted pregnancies. Results: The subjects involved in the PET “B” displayed a better/higher performance based on their knowledge, attitudes and practices related to STI/HIV/AIDS dual prevention and unwanted pregnancies. Broadly speaking, knowledge has been improved 6 times with the PET “B” (OR = 6, 10, IC 95%) (3.24 - 11.9), and 3 times with the PET “A” (OR = 3, 45, IC 95%) (1.79 - 6.81), compared to control school. Similarly, findings on subjects’ attitudes show an improvement rated 12 times with the PET”B” (OR = 11, 99, IC 95%) (5.67 - 27.38) and 5 times for the PET “A” (OR = 5.51, IC 95%) (2.54 - 12.87). As far as the subjects’ practices are concerned, an improvement of 6 more times of protected sexual intercourses with the PET “B” compared with the control school group (OR = 6, 52, IC 95%) (3.60 - 12.0). The process assessment records a spontaneous involvement of schools enhanced by the positive contribution of Life Education and Biology teachers;add a massive participation of adolescents who requested permanent PET program. Conclusion: The results of this study suggest that school sexual education programs can be improved to increase the quality of apprenticeship. The use of interactive methods and the consideration of the adolescents’ specific needs that take into account the gender approach may bring about beneficial advantages on both educational outcomes and reproductive health of adolescents.
基金the National Natural Science Foundation of China:Mechanism of Protective Effect of Acupoint Preconditioning on Myocardial Mitochondria and Energy Metabolism in Rats with Bupivacaine Toxicity(No.81760892)。
文摘OBJECTIVE:To evaluate the efficacy of electroacupuncture(EA)intervention on myocardial protection and postoperative rehabilitation in patients undergoing cardiac surgery with cardiopulmonary bypass(CPB).METHODS:Eight databases,including Pub Med,Embase,the Cochrane Library,Web of Science,Chinese Bio Medical Literature Database,China National Knowledge Infrastructure Database,Wanfang Data,China Science and Technology Journal Database,and two clinical trial registries,were searched.All randomized controlled trials(RCTs)related to EA intervention in cardiac surgery with CPB were collected.Based on the inclusion and exclusion criteria,two researchers independently screened articles and extracted data.After the quality evaluation,RevMan 5.3 software was used for analysis.RESULTS:Fourteen RCTs involving 836 patients were included.Compared with the control treatment,EA significantly increased the incidence of cardiac automatic rebeat after aortic unclamping[relative risk(RR)=1.15,95%confidence interval(CI)(1.01,1.31),P<0.05;moderate].Twenty-four hours after aortic unclamping,EA significantly increased the superoxide dismutase[standardized mean difference(SMD)=0.96,95%CI(0.32,1.61),P<0.05;low],and interleukin(IL)-2[SMD=1.33,95%CI(0.19,2.47),P<0.05;very low]expression levels and decreased the malondialdehyde[SMD=-1.62,95%CI(-2.15,-1.09),P<0.05;moderate],tumour necrosis factor-α[SMD=-1.28,95%CI(-2.37,-0.19),P<0.05;moderate],and cardiac troponin I[SMD=-1.09,95%CI(-1.85,-0.32),P<0.05;low]expression levels as well as the inotrope scores[SMD=-0.77,95%CI(-1.22,-0.31),P<0.05;high].There was no difference in IL-6 and IL-10 expression levels.The amount of intraoperative sedative[SMD=-0.31,95%CI(-0.54,-0.09),P<0.05;moderate]and opioid analgesic[SMD=-0.96,95%CI(-1.53,-0.38),P<0.05;low]medication was significantly lower in the EA group than in the control group.Moreover,the postoperative tracheal intubation time[SMD=-0.92,95%CI(-1.40,-0.45),P<0.05;low]and intensive care unit stay[SMD=-1.71,95%CI(-3.06,-0.36),P<0.05;low]were significantly shorter in the EA group than in the control group.There were no differences in the time to get out of bed for the first time,total days of antibiotic use after surgery,or postoperative hospital stay.No adverse reactions related to EA were reported in any of the included studies.CONCLUSIONS:In cardiac surgery with CPB,EA may be a safe and effective strategy to reduce myocardial ischaemia-reperfusion injury and speed up the recovery of patients after surgery.These findings must be interpreted with caution,as most of the evidence was of low or moderate quality.More RCTs with larger sample sizes and higher quality are needed to provide more convincing evidence.
基金supported by the Municipal Science and Technology Program of Wuwei City,China(WW2202RPZ037)the Fundamental Research Funds for the Central Universities in China(Grant No.lzujbky-2018-69).
文摘Objective Previous studies on the association between lipid profiles and chronic kidney disease(CKD)have yielded inconsistent results and no defined thresholds for blood lipids.Methods A prospective cohort study including 32,351 subjects who completed baseline and follow-up surveys over 5 years was conducted.Restricted cubic splines and Cox models were used to examine the association between the lipid profiles and CKD.A regression discontinuity design was used to determine the cutoff value of lipid profiles that was significantly associated with increased the risk of CKD.Results Over a median follow-up time of 2.2(0.5,4.2)years,648(2.00%)subjects developed CKD.The lipid profiles that were significantly and linearly related to CKD included total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),TC/HDL-C,and TG/HDL-C,whereas lowdensity lipoprotein cholesterol(LDL-C)and LDL-C/HDL-C were nonlinearly correlated with CKD.TC,TG,TC/HDL-C,and TG/HDL-C showed an upward jump at the cutoff value,increasing the risk of CKD by 0.90%,1.50%,2.30%,and 1.60%,respectively,whereas HDL-C showed a downward jump at the cutoff value,reducing this risk by 1.0%.Female and participants with dyslipidemia had a higher risk of CKD,while the cutoff values for the different characteristics of the population were different.Conclusion There was a significant association between lipid profiles and CKD in a prospective cohort from Northwest China,while TG,TC/HDL-C,and TG/HDL-C showed a stronger risk association.The specific cutoff values of lipid profiles may provide a clinical reference for screening or diagnosing CKD risk.
基金supported by grants from the Beijing Nova Program (No. Z201100006820069)CAMS Innovation Fund for Medical Sciences (CIFMS, No. 2021-I2M-1-023, 2021-I2M-1-010)Talent Incentive Program of Cancer Hospital Chinese Academy of Medical Sciences (Hope Star)。
文摘Objective: Plant-based diets have multiple health benefits for cancers;however, little is known about the association between plant-based dietary patterns and esophageal cancer(EC).This study presents an investigation of the prospective associations among three predefined indices of plant-based dietary patterns and the risk of EC.Methods: We performed endoscopic screening for 15,709 participants aged 40-69 years from two high-risk areas of China from January 2005 to December 2009 and followed the cohort until December 31, 2022. The overall plant-based diet index(PDI), healthful plant-based diet index(h PDI), and unhealthful plant-based diet index(u PDI), were calculated using survey responses to assess dietary patterns. We applied Cox proportional hazard regression to estimate the multivariable hazard ratios(HRs) and 95% confidence intervals(95% CIs) of EC across 3plant-based diet indices and further stratified the analysis by subgroups.Results: The final study sample included 15,184 participants in the cohort. During a follow-up of 219,365person-years, 176 patients with EC were identified. When the highest quartile was compared with the lowest quartile, the pooled multivariable-adjusted HR of EC was 0.50(95% CI, 0.32-0.77) for h PDI. In addition, the HR per 10-point increase in the h PDI score was 0.42(95% CI, 0.27-0.66) for ECs. Conversely, u PDI was positively associated with the risk of EC, and the HR was 1.80(95% CI, 1.16-2.82). The HR per 10-point increase in the u PDI score was 1.90(95% CI, 1.26-2.88) for ECs. The associations between these scores and the risk of EC were consistent in most subgroups. These results remained robust in sensitivity analyses.Conclusions: A healthy plant-based dietary pattern was associated with a reduced risk of EC. Emphasizing the healthiness and quality of plant-based diets may be important for preventing the development of EC.
基金supported by the Key Scientific Research Project of Universities in Henan(21A330004)Supported by the Open Project Program of the First Hospital of Xinxiang Medical University(XZZX2022002).
文摘Scarlet fever(SF)is a common infectious disease caused by group A streptococcus(GAS)[1].During the 18th and 19th centuries,SF was a significant cause of mortality in children aged 5-15 years worldwide[2].The incidence and fatality rates of SF have decreased remarkably due to the widespread use of effective antibiotics and improvements in diet and sanitation[3].However,the recent resurgence of SF has sparked significant interest in infectious diseases[1,3].Given the insufficient understanding of the triggers that cause SF outbreaks and the absence of available vaccines to prevent GAS infection to date[1],effective prevention and control programs are needed to manage the ongoing spread of SF.
基金the Key Discipline of Zhejang Province in Public Health and Preventative Medicine(First Class,Category A)at the Hangzhou Medical College,China.
文摘Background Educational inequalities in suicide have become increasingly prominent over the past decade.Elucidating modifiable risk factors that serve as intermediaries in the impact of low educational attainment on suicide has the potential to reduce health disparities.Aims To examine the risk factors that mediate the relationship between educational attainment and suicide attempts and quantify their contributions to the mediation effect.Methods We conducted a two-sample Mendelian randomisation(MR)analysis to estimate the causal effect of educational attainment on suicide attempts,utilising genome-wide association study summary statistics from the Integrative Psychiatric Research(iPSYCH;6024 cases and 44240 controls)and FinnGen(8978 cases and 368299 controls).We systematically evaluated 42 putative mediators within the causal pathway connecting reduced educational attainment to suicide attempts and employed two-step and multivariable MR to quantify the proportion of the mediated effect.Results In the combined analysis of iPSYCH and FinnGen,each standard deviation(SD)decrease in genetically predicted educational attainment(equating to 3.4 years of education)was associated with a 105%higher risk of suicide attempts(odds ratio(OR):2.05;95%confidence interval(Cl):1.81 to 2.31).0f the 42 risk factors analysed,the two-step MR identified five factors that mediated the association between educational attainment and suicide attempts.The respective proportions of mediation were 47%(95%Cl:29%to 66%)for smoking behaviour,36%(95%Cl:0%to 84%)for chronic pain,49%(95%Cl:36%to 61%)for depression,35%(95%Cl:12%to 59%)for anxiety and 26%(95%Cl:18%to 34%)for insomnia.Multivariable MR implicated these five mediators collectively,accounting for 68%(95%Cl:40%to 96%)of the total effect.Conclusions This study identified smoking,chronic pain and mental disorders as primary intervention targets for attenuating suicide risk attributable to lower educational levels in the European population.
