AIM:To investigate the influencing factors of dry eye in elderly people aged over 60 years, and to construct a risk nomogram prediction model, so as to provide a reference for the identification of high-risk individuals and the development of preventive strategies.METHODS:A convenience sampling method was used to select 301 people aged over 60 years who attended the ophthalmology outpatient clinic or were hospitalized at the Second Affiliated Hospital of Guangzhou Medical University between July 2023 and December 2023. They were divided into a dry eye group(n=173)and a non-dry eye group(n=128)based on the presence or absence of dry eye. Data from the two groups were compared and a risk prediction model was constructed.RESULTS:Gender, hypertension, meibomian gland dysfunction, frequent use of eye drops, frequent use of electronic products, and frequent exposure to dry environments were significant influencing factors for the occurrence of dry eye in people aged over 60 years(all P<0.05). The nomogram prediction model demonstrated excellent discrimination(AUC=0.86, 95% CI: 0.81-0.90). The calibration curve showed good fit with the ideal curve, indicating high predictive accuracy. The Hosmer-Lemeshow test yielded a P-value of 0.424. The sensitivity was 73% and the specificity was 86%.CONCLUSION:The nomogram predictive model for the risk of dry eye in elderly people aged over 60 years constructed in this study showed good discrimination and calibration. It can serve as an intuitive and effective clinical risk assessment tool, providing a basis for the early identification of high-risk populations and the development of individualized intervention strategies.

Objective:To examine the burden and trends of acute viral hepatitis in Guangdong Province from 1990 to 2019, and provide reference evidences for hepatitis prevention and control in the province.Methods:Data on acute viral hepatitis (hepatitis A, B, C, and E) in Guangdong from 1990 to 2019 were extracted from the Global Burden of Disease Study 2019 database. The incidence, prevalence, mortality, and disability-adjusted life years (DALY) data were analyzed by age and gender, and the estimated annual percentage change (EAPC) was calculated to describe the changing trends in disease burden.Results:From 1999 to 2019, the standardized incidence, prevalence, mortality, and DALY of acute viral hepatitis in Guangdong were higher than the national averages. In 2019, 51.43% (2 245 087/4 365 221) of acute viral hepatitis cases in Guangdong Province were mainly attributed to hepatitis B, and 77.18% (106/138) of deaths were due to acute hepatitis B. In different age groups, except for acute hepatitis B, which was more common in adults, the incidence rates of other types of viral hepatitis such as hepatitis A, B, and E showed an overall decreasing trend with age. The mortality rates of different types of acute viral hepatitis, except for the <5 age group, increased with age. The overall incidence and mortality rates of acute viral hepatitis were higher in men than in women.Conclusions:The overall burden of acute viral hepatitis in Guangdong declined in 2019, but remained higher than the national level. Further efforts are needed to strengthen hepatitis prevention and screening in different population in Guangdong Province, especially in children and the elderly.

Bioactive compounds derived from herbal medicinal plants modulate various therapeutic targets and signaling pathways associated with cardiovascular diseases (CVDs), the world's primary cause of death. Ginkgo biloba, a well-known traditional Chinese medicine with notable cardiovascular actions, has been used as a cardio- and cerebrovascular therapeutic drug and nutraceutical in Asian countries for centuries. Preclinical studies have shown that ginkgolide B, a bioactive component in Ginkgo biloba, can ameliorate atherosclerosis in cultured vascular cells and disease models. Of clinical relevance, several clinical trials are ongoing or being completed to examine the efficacy and safety of ginkgolide B-related drug preparations in the prevention of cerebrovascular diseases, such as ischemia stroke. Here, we present a comprehensive review of the pharmacological activities, pharmacokinetic characteristics, and mechanisms of action of ginkgolide B in atherosclerosis prevention and therapy. We highlight new molecular targets of ginkgolide B, including nicotinamide adenine dinucleotide phosphate oxidases (NADPH oxidase), lectin-like oxidized LDL receptor-1 (LOX-1), sirtuin 1 (SIRT1), platelet-activating factor (PAF), proprotein convertase subtilisin/kexin type 9 (PCSK9) and others. Finally, we provide an overview and discussion of the therapeutic potential of ginkgolide B and highlight the future perspective of developing ginkgolide B as an effective therapeutic agent for treating atherosclerosis.

Objective:To investigate the prognostic value of albumin (ALB), aspartate aminotransferase/alanine aminotransferase ratio (AST/ALT) in patients with acute liver failure (ALF) in hyperacute phase of sepsis which provided the basis for clinical evaluation and prognostic judgment and corresponding treatment options.Methods:A multicenter retrospective cohort study was conducted. Patients with ALF in hyperacute phase of sepsis admitted to Zhoupu Hospital Affiliated to Shanghai Health College, Shanghai Pudong New Area People's Hospital, and Shanghai Oriental Hospital from January 2019 to February 2024 were enrolled. General data such as gender and age of the patients were collected. Lactate dehydrogenase (LDH), liver function indexes [total bilirubin (TBIL), direct bilirubin (DBIL), AST, ALT, AST/ALT, ALB, total protein (TP), globulin (GLB), ALB/GLB ratio (A/G), blood amine, γ-glutamyl transpeptidase (γ-GT)], platelet count (PLT), creatinine, activated partial thromboplastin time (APTT), severity of illness scores [acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), sequential organ failure assessment (SOFA)], serum procalcitonin (PCT), N-terminal pro-brain natriuretic peptide (NT-proBNP), arterial blood lactic acid (Lac) within 24 hours after admission, and whether to use mechanical ventilation, whether to use vasoactive drugs, whether to use artificial liver treatment and prognosis during hospitalization also were collected. The differences of clinical data between patients with different prognosis were compared. The variables with statistically significant differences in univariate analysis were included in multivariate Logistic regression analysis to determine the independent risk factors for death of patients with ALF in hyperacute phase of sepsis during hospitalization. The receiver operator characteristic curve (ROC curve) was drawn to evaluate the predictive value of ALB and AST/ALT for death of patients with ALF in hyperacute phase of sepsis during hospitalization.Results:A total of 73 patients with ALF in hyperacute phase of sepsis were included, with 22 survived and 51 died during hospitalization and the mortality of 69.86%. Compared with the survival group, the patients in the death group had lower ALB, γ-GT within 24 hours after admission and proportion of artificial liver treatment, and higher AST/ALT, SOFA score, LDH and proportion of use of vasoactive drugs. The differences were statistically significant. Multivariate Logistic regression analysis showed that ALB and AST/ALT were the independent risk factors for death in patients with ALF in hyperacute phase of sepsis during hospitalization [ALB: odds ratio ( OR) = 0.856, 95% confidence interval (95% CI) was 0.736-0.996, P = 0.044; AST/ALT: OR = 2.018, 95% CI was 1.137-3.580, P = 0.016]. ROC curve analysis showed that the area under the curve (AUC) of ALB for predicting in-hospital death in patients with ALF in hyperacute phase of sepsis was 0.760 (95% CI was 0.637-0.884, P < 0.001). When ALB ≤ 29.05 g/L, the sensitivity was 68.2%, and the specificity was 76.5%. The AUC of AST/ALT for predicting in-hospital death in patients with ALF in hyperacute phase of sepsis was 0.764 (95% CI was 0.639-0.888, P < 0.001). When AST/ALT ≥ 1.26, the sensitivity was 59.1%, and the specificity was 90.2%. Conclusions:The lower the ALB level, and the higher the AST/ALT within 24 hours after admission, the worse the prognosis of patients with ALF in hyperacute phase of sepsis. ALB and AST/ALT can be used as clinical indicators to evaluate the severity and prognosis of patients with ALF in hyperacute phase of sepsis.

Objective To establish a method for measurement of ²³⁹Pu in fecal samples based on inductively coupled plasma-mass spectrometry (ICP-MS), and to provide a novel method for assessing the internal exposure of workers. Methods Fecal samples were collected from workers and labeled. The samples were pretreated with carbonization ashing and microwave digestion devices, purified on TEVA resin, and measured using ICP-MS. Results The detection limit of ²³⁹Pu in fecal samples based on ICP-MS was 1.91 × 10⁻⁴ Bq. Conclusion In the routine monitoring of class S substances characterized by a 5 μm aerodynamic diameter during 12 months, the committed effective dose corresponding to the detection limit is 0.17 mSv. This value meets the requirements of relevant national standards and ICP-MS can be used as a novel means for accurate evaluation of internal exposure for workers.

Objective To preliminarily study and establish a method for measurement of the transuranic nuclide ²⁴¹Am in fecal samples, and to provide technical support for internal radiation monitoring of staff. Methods Fecal samples were collected with a self-made stool sampler and treated with a self-made carbonization and ashing furnace. DGA resin was used to separate and purify ²⁴¹Am from fecal samples. With ²⁴³Am as the tracer, the orthogonal method was used for condition optimization. Results The optimum conditions for separation and purification were: the acidity of HNO₃ added into the column, 6 mol/L; column flow rate, 0.6 mL/min; and the volume of analytical solution,12 mL. The method based on inductively coupled plasma mass spectrometry showed a detection limit of 9.79×10⁻⁴ Bq for ²⁴¹Am in fecal samples, which was satisfactory and feasible. Conclusion This method fills the vacancy of ²⁴¹Am measurement in fecal samples to some extent, which is of practical significance for internal radiation monitoring and protection for analysts.

Objective:To explore the relationship between iodine and hypothyroidism.Methods:Patients with primary hypothyroidism (hypothyroidism group) and healthy people (control group) from Linfen City who first came to the Affiliated Hospital of Shanxi Institute for Endemic Disease Prevention and Treatment in 2017 and 2018 were selected as the research subjects. One random urine sample and fasting venous blood sample were collected from the research subjects. The levels of urinary iodine, blood iodine and serum total triiodothyronine (TT 3), total thyroxine (TT 4), free triiodothyronine (FT 3), free thyroxine (FT 4), thyroid stimulating hormone (TSH), anti-thyroglobulin antibody (TgAb) and anti-thyroid peroxidase antibody (TPOAb) were detected. According to the results of TSH level, hypothyroidism group was divided into hypothyroidism Ⅰ group (TSH≥10.00 mU/L) and hypothyroidism Ⅱ group (4.20 mU/L < TSH < 10.00 mU/L), and they were compared with control group (0.27 mU/L≤TSH≤4.20 mU/L). Results:A total of 97, 96 and 175 research subjects were included in hypothyroidism Ⅰ group, hypothyroidism Ⅱ group and control group, respectively. There was no significant difference in urinary iodine levels among the three groups ( H = 0.631, P > 0.05). The blood iodine levels [(40.70 ± 21.08), (58.59 ± 14.55), (59.50 ± 11.89) μg/L] in the three groups were significantly different ( F = 50.559, P < 0.01), and the blood iodine level in hypothyroidismⅠgroup was lower than that in hypothyroidism Ⅱ group and control group ( P < 0.01). The levels of TT 3 [median (interquartile range): 1.59 (0.99, 2.05), 2.25 (1.98, 2.59), 2.14 (1.89, 2.49) nmol/L], TT 4 [35.18 (16.06, 70.23), 105.68 (83.38, 133.19), 107.18 (89.92, 128.30) nmol/L], FT 3 [3.48 (1.94, 4.52), 5.01 (4.57, 5.50), 5.02 (4.64, 5.55) pmol/L] and FT 4 [7.14 (3.12, 10.76), 15.31 (13.87, 17.11), 16.69 (14.87, 18.20) pmol/L] in the three groups were significantly different ( H = 66.197, 142.461, 94.508, 166.557, P < 0.01). After further pairwise comparison, the levels of TT 3, TT 4, FT 3, and FT 4 in hypothyroidism Ⅰ group were significantly lower than those in hypothyroidism Ⅱ group and control group ( P < 0.01). The levels of TgAb and TPOAb in the three groups were significantly different ( H = 85.507, 101.726, P < 0.01). After further pairwise comparison, the levels of TgAb and TPOAb in hypothyroidismⅠgroup were significantly higher than those in hypothyroidism Ⅱ group and control group ( P < 0.01); and the levels of TgAb and TPOAb in hypothyroidism Ⅱ group were significantly higher than those in control group ( P < 0.01). The correlation analysis showed that urinary iodine was positively correlated with blood iodine ( r = 0.170, P < 0.05); blood iodine was positively correlated with TT 3, TT 4, FT 3, and FT 4 levels ( r s = 0.484, 0.594, 0.383, 0.509, P < 0.01), and it was negatively correlated with TSH level ( r s = - 0.373, P < 0.01). Conclusion:Hypothyroidism patients with TSH≥10.00 mU/L may have low blood iodine level.

Objective:To investigate the detection of neutrophil gelatinase related lipid carrier protein (NGAL), alpha fetoprotein (AFP), leucine aminopeptidase (LAP), alpha L fucosidase (AFU) in primary liver cancer (PHC) individually and jointly The diagnostic value of cancer (PHC).Methods:From January 2015 to December 2017, 124 patients with primary liver cancer from the third people′s Hospital of Yunnan Province were selected as PHC group, 53 patients with cirrhosis treated at the same time as benign group A, 37 patients with liver cyst as benign group B, and 64 healthy volunteers as healthy group. The serum AFU, LAP, NGAL and AFP of four groups of subjects were detected by rate method, immunoturbidimetric method and electrochemiluminescence method respectively. The diagnostic efficacy of PHC detected by different combinations of indicators was analyzed by receiver operating characteristic curve (ROC).Results:There were significant differences in serum AFP, AFU, LAP levels and positive expression rates between PHC group, benign group A, group B and healthy group( F values were 56.832, 38.209, 23.415, respectively; χ 2 values were 69.324, 72.568, 24.695, respectively; all P<0.05), and the serum AFP, AFU, LAP levels and positive expression rate were significantly higher in the PHC group than in the benign group A, group B and healthy group, the difference was statistically significant( all P<0.05); sensitivity of AFP+ AFU+ LAP combined detection(89.27% vs.72.17%, 73.52%, 76.31%, 81.35%, 80.69%, 86.87%), specificity(95.76% vs.81.58%, 82.79%, 84.16%, 86.95%, 94.23%, 93.29%) and the Yoden index (0.85 and 0.54, 0.56, 0.60, 0.68, 0.75, 0.80) are superior to their one indicator (LAP, AFU, AFP) and two indexes combined detection(LAP+ AFU, LAP+ AFP, AFU+ AFP). ROC curve analysis showed that the AUC(0.94) combined with AFP+ AFU+ LAP was greater than LAP+ AFU(0.78), LAP+ AFP(0.85) and AFU+ AFP(0.89). Conclusion:Combined detection of AFP, AFU and LAP can effectively improve the diagnosis efficiency of PHC and reduce missed diagnosis.

Objective The objective of this study was to investigate the relationship between the methylation of phosphodies-terase 4C(PDE4C)gene in peripheral blood leukocytes,and its interaction with environmental factors and the pathogenesis of breast cancer. Methods A case-control study was conducted to select 402 cases of breast cancer and 470 cancer-free controls from Octo-ber 2010 to December 2014. The specific DNA methylation-modified quantitative PCR method was used to detect the methylation of PDE4C gene. The use of crossover analysis and multivariate logistic regression was used to analyze the relationship between the level of gene methylation and its interaction with environmental factors and the pathogenesis of breast cancer. Results PDE4C methylation was not found to be significantly associated with the onset of breast cancer. High-frequency/high-intake of whole grains,vegetables, onion-based plants,poultry,milk,and regular exercise could reduce the risk of breast cancer;high-frequency/high-intake of pork, irregular menstrual cycle,and a high psychological stress index could increase the risk of breast cancer. PDE4C hypermethylation had a significant combining effect with edible onion-producing plants greater than 3 times/week,with an OR of 0. 373(95% CI:0. 208~0. 668,P=0. 001). Conclusion Hypermethylation of PDE4C is not an independent risk factor for breast cancer,and its combination with environmental factors affects the risk of breast cancer.

Objective: To explore the feasibility and clinical efficacy of serosal muscular layers incision and submucosal layers exfoliation technique in laparoscopic surgery for gastric gastrointestinal stromal tumors(GIST). Methods: 28 patients with gastric GIST underwent serosal muscular layers incision and submucosal layers exfoliation technique under laparoscopic surgery. Patients′clinicopathologic characteristics, operative outcomes, postoperative complications, and follow up results were analyzed retrospectively. Results: Surgery was successfully completed in all patients, and no one was converted to open surgery.The average operation time was (66±15) min, and the intra operative blood loss was (16±10) ml, the time of passage of gas by anus after operation was (20±10)h, the time starting liquid diet was(2.5±1.6)d, and the length of postoperative hospital stay was (7±3)d. One patient had delayed gastric emptying, one had incisional infection. All the specimen had complete pseudocapsule and negative margin. pathology was all gastric GIST. After a median 22 months followed up, no recurrence or metastasis were found. Conclusion Serosal muscular layers incision and submucosal layers exfoliation under laparoscopic surgery is a safe and feasible procedure for treating gastric GIST.