Objective To explore the prognostic value of pre-chemotherapy serum cystatin C (Cys C) in patients with castration-resistant prostate cancer (CRPC).Methods The medical records of 48 patients with CRPC were reviewed.These patients were diagnosed and underwent docetaxel-based chemotherapy in Xinjiang Military Command General Hospital between January 2009 and January 2015.Statistical analysis was performed to identify the clinical and prognosis value of Cys C.Results Of 48 patients with CRPC,the expression of serum Cys C before chemotherapy was related with Gleason score (x2 =4.218,P =0.040) and distant metastasis(x2 =4.090,P =0.043).23 patients was in high group (Cys C ＞ 1.61 mg/L),25 in low (Cys C ≤ 1.61 mg/L).The median survival time of high group and low group were 15.6 and 25.3 months,respectively (x2 =13.876,P ＜ 0.001).Univariate analysis showed that TNM stage (x2 =6.934,P =0.018),Gleason score (x2 =7.933,P =0.005),baseline prostate specific antigen (PSA) (x2 =9.038,P =0.003),number of chemotherapy cycles (x2 =5.024,P =0.028),distant metastases (x2 =6.963,P =0.013) and serum Cys C before chemotherapy (x2 =6.976,P =0.012) were associated with overall survival of patients with CRPC.COX multivariate analysis showed that baseline PSA at diagnosis (x2 =4.257,P =0.039),number of chemotherapy cycles (x2 =6.245,P =0.017),distant metastases (x2 =5.122,P =0.028) and serum Cys C before chemotherapy (x2 =8.172,P =0.004) were independent risk factors of overall survival of patients with CRPC,especially serum Cys C before chemotherapy (HR =2.394).Conclusion The patients with high Cys C level have poor prognosis,and the pre-chemotherapy Cys C is an independent risk factor for prognosis of CRPC patients treated with docetaxel-based chemotherapy which can be used as an effective indicator to assess the prognosis of CRPC.

Objective To investigate the prevalence of dyslipidemia and the relationship between breakfast frequency and dyslipidemia in residents over 40 years old in Yiling area of Yichang City in Hubei Province. Methods A random sampling was conducted, and 10 420 inhabitants were investigated during 2011 to 2012. Results The morbidity of dyslipidemia was 64. 0%. It was significantly higher in female than in male (65. 9% vs 60. 6%). Compared with regular breakfast eaters, non-breakfast eaters had significantly higher morbidity of higher blood low density lipoprotein-cholesterol(LDL-C) and hypertriglyceridemia(P<0. 05). The risk of elevated serum LDL-C was higher in the non-breakfast eaters group(OR=2. 382, 95%CI 1. 300-4. 367, P=0. 019) after adjusted by age, sex, smoking, drinking, etc. Conclusions Compared with regular breakfast eaters, breakfast skippers had significantly higher morbidity of dyslipidemia. Eating breakfast on daily basis may have a significant protective effect on preventing dyslipidemia.

Objective To investigate the status of undergraduates′ sub-health and explore the relationship between personality traits and sub-health and the mediating role of self-harmony. Methods A total of 196 undergraduate nursing students in Tianjin University of Traditional Chinese Medicine were investigated by Sub-health Self-rating Scale (SSS), Self Consistency and Congruence Scale (SCCS) and Eysenck Personality Questionnaire Short Scale. Results The the total scores of the undergraduate nursing students′personality traits, self-harmony and sub-health were 22.71±4.90, 102.74±14.41, 182.54± 31.76. The neuroticism and extroversion of personality traits were significantly correlated with self-harmony and sub-health (P<0.01). Neuroticism had a significant prediction on self-harmony (β=0.37, P<0.01) and sub-health (β=-0.64, P<0.01), after controlling self-harmony, the prediction on sub-health was reduced, but still significant (β=-0.56, P<0.01);extroversion had a significant prediction on self-harmony (β=-0.27, P<0.01) and sub-health (β=0.54, P<0.01), after controlling self-harmony, the prediction on sub-health was reduced, but still significant (β=0.46, P < 0.01). Conclusions The sub-health status of undergraduate nursing students was not optimistic. Nursing students′ personality traits of psychoticism, extroversion, which directly impact on the health status, and through self-harmony indirectly affect their health level, self-harmony played a intermediary role between personality traits and sub-health.

Disease Progression ; Hepatic Stellate Cells ; Hepatitis B, Chronic ; Humans ; Liver Cirrhosis ; Receptors, Cannabinoid

Objective:to understand the current situation of academic research misconduct by analyzing the investigation results of a number of medical scientific research integrity cases, to strengthen the construction of scientific research integrity in medical institutions.Methods:Select the investigation and handling results of 310 medical scientific research integrity cases disclosed by the National Health Commission in 2021, and analyze the basic information of the case papers, the types and characteristics of misconduct behaviors involved, and the handling results of each institution.Results:This batch of problematic papers was widely distributed, including particular hospitals from a certain region or city level hospitals. Identified misconduct included fabrication of the research process, falsification of research data, purchasing, ghost-writing, third-party submission, and inappropriate authorship. Responsible persons were severely punished.Conclusions:Long-term mechanism for the prevention of academic misconduct should be established with collaboration among administrative department, medical institutions and research personnel, to deal with academic misconduct more systematically.

Objective To retrieve the relevant evidence of ICU nurse ventilator alarm management and summarize the best evidence to provide a reference for ICU nurse ventilator alarm management decision.Methods The clinical decision,guideline,systematic evaluation,expert consensus and all kinds of original studies related to the alarm management of ICU nurses in PubMed,CINAHL,Embase,Web of Science,VIP,CNKI and Wanfang were searched from database construction until April 22,2023.The literature quality evaluation and result extraction were performed independently by 2 investigators.Results 14 articles were finally involved,including 4 guidelines,2 international standards,2 national standards,2 expert consensuses,3 systematic evaluations and 1 randomized controlled trial;combined with professional judgment,27 pieces of the evidence were summarized,including multidisciplinary teamwork,alarm monitoring and processing,alarm setting,alarm management requirements,alarm education and training and ventilator maintenance.Conclusion This study summarizes the best evidence of ventilator alarm management for ICU nurses,which can provide evidence-based bases for clinical decisions,solve clinical ventilator alarm problems in a scientific management way,and improve the quality of management.

Objective: The aim of this study was to describe the distribution of neck-shoulder symptoms among middle school students, and to explore its influence factors. Methods: A cross-sectional survey was conducted on 24 middle schools in Shenyang, Zhengzhou and Shenzhen by purposive sampling method. In each middle school, 3 to 4 classes were selected from each grade all the students in the selected class would be recruited to the survey to investigate the demographic characteristics, neck-shoulder symptoms, physical exercise time, academic stress, screen behavior, sedentary behavior and other information by questionnaire. A total of 10 566 questionnaires were issued and 10 270 valid questionnaires were withdrawn. The prevalence of neck-shoulder symptoms among students were compared by different characteristics. Logistic regression models were applied to examine influencing factors associated with neck-shoulder symptoms. Results: The prevalence of neck-shoulder symptoms among middle school students was 19.2% (1 968/10 270), while it was 22.6% (1 137/5 039) among girls and 15.9% (831/5 231) among boys; the difference showed statistical significance (P<0.001). The prevalence of neck-shoulder symptoms was separately 13.3% (253/1 901) in seventh grade, 16.8% (326/1 942) in eighth grade, 18.5% (299/1 617) in ninth grade, 21.8% (417/1 915) in sophomore, 21.4% (345/1 611) in junior, 25.5% (328/1 284) in senior; the difference showed statistical significance (P<0.001). The multivariate logistic regression analysis showed that in the last 3 months, students who always playing mobile phone ≥40 min continuously (OR=4.66, 95%CI: 3.95-5.49), watching TV ≥40 min continuously (OR=4.01, 95%CI: 3.39-4.73), using computer ≥40 min continuously (OR=3.61, 95%CI: 3.09-4.23), doing homework ≥60 min continuously (OR=3.25, 95%CI: 2.79-3.79), the average daily sitting time ≥10 h (OR=4.95, 95%CI: 4.25-5.77), and always sitting ≥90 min continuously (OR=5.18, 95%CI: 4.42-6.06) were risk factors of neck-shoulder symptoms. Conclusion The prevalence of neck-shoulder symptoms was high among middle school students in China, especially girls in senior grades. Long time, high frequency video behaviors and sedentary behaviors were related to the occurrence of neck-shoulder symptoms among middle school students.

Objective: To examine the relationship between the prevalence of self-reported myopia and outdoor activities among middle school students and to explore the influence factors of the self-reported myopia. Methods: A total of 12 979 participants were recruited from junior and senior middle school students in in Shenzhen, Nanchang, Zhengzhou and Shenyang by random cluster sampling method between December 2015 and March 2016. All participants completed an anonymous questionnaire to collect the information of demographic characteristics, self-reported myopia, outdoor activities, etc. 12 603 out of 12 979 copies of questionnaire were valid. The prevalence of self-reported myopia was compared among middle school students with different characteristics. Logistic regression models were used to analyze the relationship between myopia and outdoor activities. Results: The prevalence of self-reported myopia among middle school students was 69.6% (8 766/12 603); which was separately 52.1% (1 216/2 335) in seventh grader, 61.6% (1 459/2 369) in eighth grader, 69.0%(1 470/2 129) in ninth grader, 80.0% (1 812/2 265) in freshmen, 79.4% (1 622/2 042) in sophomore, and 81.1%(1 187/1 463) in junior. The prevalence of self-reported myopia showed an increasing trend with the increase of grade (χ²=639.67, P<0.001). The prevalence of self-reported myopia was separately 63.5%(4 927/7 756) in non-myopic parents group, 78.0%(2 664/3 415)in either myopic parent group, and 82.1%(1 175/1 432) in both myopic parents group(χ²=328.28, P<0.001). Outdoor activities were associated with self-reported myopia. Binary logistic regression analysis showed that the risk of self-reported myopia was significantly increased by always staying at home in extracurricular time among the middle school students (OR=1.58, 95%CI: 1.36-1.82). The risk of self-reported myopia were significantly decreased by always physical exercise and recreational activities after school among middle school students: the ORs were separately 0.67 (95%CI: 0.57-0.78) for physical exercise and 0.77 (95%CI: 0.64-0.92) for recreational activities. After stratified analysis by the parents' myopia status, in non-myopic parents group, exercise and recreational activities after school among middle school students decreased the risk of myopia: the ORs were separately 0.68 (95%CI: 0.55-0.82) for physical exercise and 0.76 (95%CI: 0.61-0.95) for recreational activities; in either myopic parent group, OR(95%CI) were separately 0.65 (0.47-0.90) and 0.68 (0.47-0.98). Conclusion Outdoor activities was negatively associated with self-reported myopia among middle school students. However, the parents' myopia status may affect the protective effect.

Objective:To explore the effect of neutrophil-lymphocyte ratio (NLR) at the initial visit on the survival of children with newly diagnosed medulloblastoma (MB).Methods:This was a case-control study involving 61 children with newly diagnosed MB at the Department of Pediatrics, Beijing Shijitan Hospital, Capital Medical University from August 2018 to January 2020 .The blood cell counts, lymphocyte subsets and immunoglobulin in the periphe-ral blood were measured to calculate NLR at the initial visit.Based on the cut-off value determined by receiver opera-ting characteristic (ROC) curve, patients were divided into high NLR group (≥ 2.07, n=21) and low NLR group (<2.07, n=40). The progression-free survival (PFS) and overall survival (OS) between 2 groups were analyzed by the Kaplan-Meier method, followed by Log- rank test.The correlation between NLR at the initial visit with clinical characteristics, lymphocyte subsets and immunoglobulin of children with newly diagnosed MB was analyzed.Differences between groups were compared by the Chi- square test, Mann- Whitney U test and independent sample t test. Results:The survival analysis showed that the relapse rate (38.1% vs.10.0%, χ2=6.879, P=0.016) and mortality rate (19.0% vs.0, χ2=8.154, P=0.011) were significantly higher in high NLR group than those of low NLR group.PFS (12 months vs.19 months, χ2=9.775, P=0.002) and OS (19 months vs.20 months, χ2=8.432, P=0.004) were significantly shorter in high NLR group than those of low NLR group.No significant differences in clinical characteristics were detected between groups (all P>0.05). Compared with low NLR group, the percentage of T lymphocyte[(67.93±6.37)% vs.(73.38±8.08)%, t=2.886, df=48.865, P=0.006], T helper cells (Th)[(30.86±5.53)% vs.(34.29±7.44)%, t=2.037, df=51.981, P=0.047], and T suppressor cells (Ts)[(27.39±5.50)% vs.(30.84±6.58)%, t=2.164, df=47.581, P=0.035] were significantly lower in high NLR group.Spearman correlation analysis showed a negative correlation between NLR and T lymphocyte count ( r=-0.303, P=0.018), and Ts lymphocyte count ( r=-0.260, P=0.043). Conclusions:Children with newly diagnosed MB expressing a high level of NLR had a poor prognosis, which may be associated with T lymphocyte and Ts lymphocyte.

Background/Aims: Low educational attainment is a well-established risk factor for nonalcoholic fatty liver disease (NAFLD) in developed areas. However, the association between educational attainment and the risk of NAFLD is less clear in China. Methods: A cross-sectional study including over 200,000 Chinese adults across mainland China was conducted. Information on education level and lifestyle factors were obtained through standard questionnaires, while NAFLD and advanced fibrosis were diagnosed using validated formulas. Outcomes included the risk of NAFLD in the general population and high probability of fibrosis among patients with NAFLD. Logistic regression analysis was employed to estimate the risk of NAFLD and fibrosis across education levels. A causal mediation model was used to explore the potential mediators. Results: Comparing with those receiving primary school education, the multi-adjusted odds ratios (95% confidence intervals) for NAFLD were 1.28 (1.16 to 1.41) for men and 0.94 (0.89 to 0.99) for women with college education after accounting for body mass index. When considering waist circumference, the odds ratios (95% CIs) were 0.94 (0.86 to 1.04) for men and 0.88 (0.80 to 0.97) for women, respectively. The proportions mediated by general and central obesity were 51.00% and 68.04% for men, while for women the proportions were 48.58% and 32.58%, respectively. Furthermore, NAFLD patients with lower educational attainment showed an incremental increased risk of advanced fibrosis in both genders. Conclusions In China, a low education level was associated with a higher risk of prevalent NAFLD in women, as well as high probability of fibrosis in both genders.