Objective To research the effect of radiosurgery in combination of temozolomide therapy in vitro on invasion and endocrine function of rat pituitary adenoma cells.Methods Rat pituitary adenoma cell lines GH3 and MMQ were divided into control group,10 Gy irradiation group,20 Gy irradiation group,temozolomide treatment group,and radiosurgery in combination of temozolomide group;cells without exposure were used as control group,cells treated with gamma knife radiation respectively with marginal doses of 10 and 20 Gy (all to the 99％ isodose line) were used as 10 Gy irradiation group and 20 Gy irradiation group,cells treated with 250 μmol/L and 615 μmol/L temozolomide for 24 h after 20 Gy radiation were used as radiosurgery in combination of temozolomide group,and cells treated with 250 μmol/L and 615 μmol/L temozolomide for 24 h were used as temozolomide treatment group.Real time-PCR and Western blotting were employed to measure the mRNA and protein expressions of matrix metalloproteinase (MMP)-9 and vascular endothelial growth factor (VEGF);and secretion of prolactin (PRL) and growth hormone (GH) was detected by ELISA.Results As compared with the control group,the 10 Gy irradiation group and 20 Gy irradiation group had significantly lower mRNA and protein expressions of MMP-9 and VEGF,and secretion of PRL and GH (P＜0.05);and these levels in the 20 Gy irradiation group were significantly lower than those in the 10 Gy irradiation group (P＜0.05);As compared with the 10 Gy irradiation group,20 Gy irradiation group,and temozolomide treatment group,the radiosurgery in combination of temozolomide group had significantly lower mRNA and protein expressions of MMP-9 and VEGF,and secretion of PRL and GH (P＜0.05) Conclusion Gamma knife radiosurgery combined temozolomide could significantly inhibit the invasive ability and endocrine function of rat pituitary adenoma cell lines GH3 and MMQ,which has better effect than radiotherapy or temozolomide treatment alone.

Objective To investigate the epidemiological characteristics of metabolic syndrome in the elderly, and to develop scientific prevention and control measures. Methods Physical examination personnel in Xianyang district from January 2017 to January 2020 were selected by random sampling method. The prevalence and epidemiological characteristics of the patients with metabolic syndrome were calculated according to the diagnostic criteria of metabolic syndrome. Intervention measures were implemented for patients with metabolic syndrome, and changes in survival and body quality were compared before and after intervention. SPSS 20.0 software was used for T test, rank sum test and Spearman rank correlation analysis, and the test level was α=0.05. Results There were 587 cases of metabolic syndrome in Xianyang area, and the overall prevalence rate was 13.81%. Complete clinical data of 566 elderly patients with metabolic syndrome were obtained. Age of 60~69 years old, overweight, obesity, activity time <3 hours per day, sitting time ≥8 hours per day, smoking history, and drinking history were independent risk factors for metabolic syndrome (all P<0.05, all OR>1). After the intervention, scores of diet management, exercise management and cognition management in all age groups were higher than those before the intervention (P<0.05). In addition, values of triglyceride, high-density lipoprotein and BMI were better than those before the intervention (P<0.05). Conclusion Age of 60~69 years old, overweight, obesity, activity time <3 hours per day, sitting time ≥8 hours per day, smoking and alcohol consumption are the risk factors for the occurrence of metabolic syndrome in the elderly. Targeted interventions are of vital importance in helping patients to establish suitable self-management and executive ability.

Objective To investigate the association between short-term exposure to ambient air pollution and hospital admission for ischemic stroke among older adults. Methods Using clinical monitoring data from China National Health Commission, we identified 124 297 individuals from Guangzhou, Guangdong province, China who were 60 years or older and were admitted to hospital for ischemic stroke in 2016-2019. We used a time-stratified case-crossover design and employed the conditional logistic regression model to investigate the exposure-response association between short-term exposure to air pollution and hospital admission for ischemic stroke. Based on each subject's residential address and pollutant data from its neighboring air quality monitoring stations, we used an inverse distance weighting method to assess individual-level exposure to PM_2.5, PM₁₀, SO₂, NO₂, CO and O₃ on each of the case and control days. Results In single-pollutant models, each 10 µg/m₃ increase of PM_2.5, PM₁₀, SO₂, NO₂, CO and O₃ was associated with a 0.46% (95% confidence interval [CI]: 0.13-1.36%, lag 2 d), 0.66% (1.38-2.93%, lag 02 d), 3.39% (0.07-0.21%, lag 2 d), 1.47% (0.07-0.21%, lag 02 d), 0.06% (0.07-0.21%, lag 02 d) and 0.18% (0.07-0.21%, lag 3 d) increase in odds of hospital admission, respectively. The results of 2-pollutant models showed that the association of exposure to SO₂, NO₂ and O₃ with hospital admission for ischemic stroke remained stable with adjustment for each of the other air pollutants. Conclusions Short-term exposure to ambient air pollution, especially SO₂, NO₂ and O₃, was associated with increased risk of hospital admission for ischemic stroke in older adults.

Objective To analyze the changing trend of disease burden attributable to renal insufficiency in cardiovascular disease (CVD) among the elderly in China from 1990 to 2019, and to forecast the disability-adjusted life years (DALY) in the next 10 years, so as to provide a reference basis for accurate prevention and control of CVD attributable to renal insufficiency in China. Methods Data were obtained from the Global Health Data Exchange (GHDx) database to describe the current status of CVD prevalence attributable to renal insufficiency. The joinpoint model was used to estimate the annual percentage change and average annual percentage change to assess the temporal trend of CVD attributable to renal insufficiency in China. An autoregressive moving average model was created by R4.0.2 software to predict the disease burden of CVD attributable to renal insufficiency in China. Results Compared with 1990, CVD mortality and DALY rates attributed to renal insufficiency increased in the male elderly population and decreased in women. Mortality and DALY rates attributed to ischemic heart disease, ischemic stroke, and peripheral arterial disease attributed to renal insufficiency showed an increasing trend, and mortality and DALY rates for cerebral hemorrhage decreased. There was an overall increasing trend in the attribution of CVD due to renal insufficiency. Conclusion The burden of diseases attributable to renal insufficiency in Chinese elderly with CVD is relatively high, and the impact on each disease is different, which requires the attention of relevant authorities.

Objective To analyze the disease burden of multidrug-resistant tuberculosis (MDR-TB) in China and regions with different income levels in the world from 1990 to 2019. Methods Using the Global Burden of Disease Study 2019 (GBD2019) results, the changes of the disease burden of MDR-TB in China and regions with different income levels in the world were described and analyzed using the Joinpoint Regression Program 4.8.0.1 software. Results From 1990 to 2019, the age standardized incidence, mortality and DALY rates in China and other areas with different income levels in the world basically showed a trend of first rising and then decreasing at the turning point of the late 20th century and early 21st century, except for low-income areas where the age standardized incidence rate showed an overall upward trend. In 2019, the incidence rate, mortality and DALY rate of MDR-TB in China were 9 times, 6.67 times and 6.89 times higher than those in high-income areas, respectively. The incidence rate in China was 6 times lower than that in low and middle-income areas, while the mortality and DALY rate in China were 26 times and 32.53 times lower than those in low-income areas, respectively. The age standardized incidence, mortality rate and DALY rate of MDR-TB in men were higher than those in women. Risk factors for the burden of MDR-TB disease included alcohol consumption, smoking, and high fasting blood glucose. Conclusion From 1990 to 2019, there are significant regional and gender differences in the disease burden of multidrug-resistant tuberculosis in China and regions with different income levels in the world. Multidrug-resistant tuberculosis is still a major challenge for tuberculosis control in the world. It is necessary to develop more effective control strategies and health care systems to deal with multidrug-resistant tuberculosis.

Objective To investigate the characteristics and influencing factors of mental health status of permanent residents in Yichang, Hubei Province. Methods A total of 9 576 permanent residents aged 18 years and older from Yichang City were selected by a multistage random sampling method between June and October 2022. The PHQ-9 was used to assess the residents’ depressive symptoms, the GAD-7 was used to assess their anxiety symptoms, the ISI was used to assess their insomnia status, and the PCL-5 was used to assess their stress status. The influence factors of depression and anxiety were analyzed using χ2 test and logistic regression. Results A total of 9 122 valid questionnaires were completed. The detection rate of depression, anxiety, insomnia, and stress symptoms were 29.98%, 19.03%, 11.97% and 1.58%, respectively. Gender, education level, monthly family income, self-rated health status, mental health literacy level, total GAD-7 score, total ISI score, and total PCL-5 score were the main factors that caused residents' anxiety symptoms, while gender, education level, self-rated health status, total PHQ-9 score, total ISI score, and total PCL-5 score were the main factors that caused residents' anxiety symptoms. Conclusion The prevalence of depression and anxiety is high among the permanent residents in Yichang, while the situation of insomnia and stress is relatively good. Measures such as improving the level of mental health literacy can be taken to improve mental health level of residents in Yichang.

Objective To quantitatively evaluate the association of short-term exposure to ambient submicron particulate matter (PM₁) with hospital admissions for angina in older adults. Methods A case-crossover study was conducted among 46 687 older adults hospitalized for angina from 2016 to 2019 in Guangzhou medical institutions. Grid data on ambient PM₁ concentrations in Guangzhou were obtained from the ChinaHighAirPollutants (CHAP) dataset. Exposure to PM₁ was assessed according to each subject's residential addresses. Conditional logistic regression model was used to analyze the the exposure-response association between PM₁ and hospital admissions for angina. Results From 2016 to 2019, the average exposure level of PM₁ on the same day of hospital admissions (lag 0) for angina was 21.0 ± 11.5 μg/m³. The results of main model analysis showed that lag 0 day exposure to ambient PM₁ was significantly associated with a higher odds of hospital admissions for angina in older adults. Each 10 μg/m³ increase of PM₁ exposure level was significantly associated with a 1.31% (95% CI: 0.05%, 2.59%) increased odds of angina admissions. Results from a two-pollutant model adjusting for O₃ showed that the association between short-term exposure to PM₁ and odds of hospitalization for angina remained stable. According to the results of the above model, it was estimated that the excess hospitalization attributable to ambient PM₁ exposure accounted for 2.46% (95% CI: 0.09%, 4.76%) of the total admissions in Guangzhou during 2016-2019, corresponding to 1539 (95% CI: 54, 2976) admissions. No significant effect modification on the associations was observed by sex, age, or season. Conclusion Short-term exposure to ambient PM₁ was significantly associated with an increased odds of hospital admissions for angina in older adults.

Objective To investigate the accuracy of body mass index (BMI) as the evaluation standard for obesity in Miao adults in Guangxi, to find out the BMI cutoff value suitable for the evaluation standard of adult obesity, and to provide an accurate and reliable reference value for the prevention and treatment of obesity in Miao nationality adults. Methods Using a cross-sectional design, residents aged 18 years or older in the Miao villages in Rongshui Miao Autonomous County, Guangxi, were selected as the research subjects, and their body composition was measured. The percent body fat (PBF) standard was used as the ^“gold standard^” for obesity, and the BMI standard for obesity in Chinese adults was used as the positive screening standard. The accuracy of the BMI standard was evaluated, and the ROC curve analysis was used to determine the optimal BMI cutoff value for obesity in Miao adults. Results The detection rate of obesity of Miao adults in Guangxi by BMI method was lower than that by PBF method (10.3% vs 19.0%, χ²=426.62, P<0.001). The results of reliability evaluation showed that BMI was in good agreement with PBF in judging obesity (Kappa=0.59, P<0.001). BMI as a screening criterion for obesity in Miao adults showed high specificity and low sensitivity, low Yordon index, high positive predictive value and high positive likelihood ratio, and low negative predictive value and high negative likelihood ratio. When the PBF was used as the ^“gold standard^”, BMI had a good diagnostic performance for obesity in Miao adults (AUC=0.959, P<0.001). The optimal BMI cutoff points for obesity in adults of Miao nationality in Guangxi were 25.85 kg/m² and 25.55 kg/m² for men and women, respectively. Conclusion BMI is of great value for the diagnosis of obesity in Miao adults, but it should not be used as an exclusion criterion for obesity. Especially in the case of a small sample size, the risk of misclassification bias is relatively high.

Objective To understand the situation of cancer screening of community residents and its association with the knowledge of cancer core knowledge, and to provide reference for the formulation of secondary cancer prevention measures. Methods A cross-sectional survey was conducted among 2 037 residents aged 18-79 who lived in Bao 'an District, Shenzhen. Multivariate Logistic regression analysis was used to investigate the relationship between core knowledge and cancer screening behavior after adjusting for age, gender, education, marriage, occupation and smoking. Results The cancer screening rate of community residents was 28.10%, and the screening rate of middle-aged and elderly people aged 40-79 was 33.50 %.The proportion of ^“not very well understanding^”, ^“partial understanding^” and ^“basic understanding^” of the core knowledge of cancer were 43.91%, 42.33% and 13.76%, respectively, which was higher than that of the non-participants. Multivariate analysis showed that the women, the higher the level of education of college/university or above and the higher the level of knowledge of cancer prevention core knowledge, the higher the probability of participating in cancer screening was OR (95%CI ) : 2.40 (1.86-3.12), 1.65 (1.29-2.10), 1.38 (1.18 - 1.62), respectively. Conclusion The proportion of cancer screening in community residents needs to be improved, and the degree of core knowledge of cancer is closely related to cancer screening behavior. It is suggested to increase the publicity and education of the core knowledge of cancer, and at the same time, carry out the health education of secondary cancer prevention for the key population such as men and people with low education level, so as to improve the proportion of ^“early detection, early diagnosis and early treatment^” of cancer.