Objective:To investigate the association of urinary cadmium level with body mass index (BMI) and body circumferences among the older adults over 65 years old in 9 longevity areas of China.Methods:Subjects were older adults over 65 years old from the Healthy Aging and Biomarkers Cohort Study (HABCS) between 2017 and 2018 conducted in 9 longevity areas in China. A total of 1 968 older adults were included in this study. Information including socio-demographic characteristics, lifestyles, diet intake, and health status was collected by using questionnaires and physical examinations. Urine samples were collected to detect urinary cadmium and creatinine levels. Body circumferences included waist circumference, hip circumference and calf circumference. Subjects were divided into three groups (low:<0.77 μg/g·creatinine, middle:0.77-1.69 μg/g·creatinine, high:≥1.69 μg/g·creatinine) by tertiles of creatinine-adjusted urinary cadmium concentration. Multiple linear regression models were used to analyze the association of creatinine-adjusted urinary cadmium level with BMI and body circumferences. The dose-response relationship of creatinine-adjusted urinary cadmium concentration with BMI and body circumferences was analyzed by using restrictive cubic splines fitting multiple linear regression model.Results:The mean age of subjects was (83.34±11.14) years old. The median (Q1, Q3) concentration of creatinine-adjusted urinary cadmium was 1.13 (0.63, 2.09) μg/g·creatinine, and the BMI was (22.70±3.82) kg/m 2. The mean values of waist circumference, hip circumference, and calf circumference were (85.42±10.68) cm, (92.67±8.90) cm, and (31.08±4.76) cm, respectively. After controlling confounding factors, the results of the multiple linear regression model showed that for each increment of 1 μg/g·creatinine in creatinine-adjusted urinary cadmium, the change of BMI, waist circumference, hip circumference, and calf circumference in the high-level group was -0.28 (-0.37, -0.19) kg/m 2, -0.74 (-0.96, -0.52) cm, -0.78 (-0.96, -0.61) cm, and -0.20 (-0.30, -0.11) cm, respectively. The restrictive cubic splines curve showed a negative nonlinear association of creatinine-adjusted urinary cadmium with BMI ( Pnonlinear<0.001) and negative linear associations of creatinine-adjusted urinary cadmium with waist circumference ( Plinear<0.001), hip circumference ( Plinear<0.001), and calf circumference ( Plinear<0.001). Conclusion:Urinary cadmium level is significantly associated with decreased BMI, waist circumference, hip circumference and calf circumference among older adults over 65 years old in 9 longevity areas of China.

Objective:To investigate the association of urinary cadmium level with body mass index (BMI) and body circumferences among the older adults over 65 years old in 9 longevity areas of China.Methods:Subjects were older adults over 65 years old from the Healthy Aging and Biomarkers Cohort Study (HABCS) between 2017 and 2018 conducted in 9 longevity areas in China. A total of 1 968 older adults were included in this study. Information including socio-demographic characteristics, lifestyles, diet intake, and health status was collected by using questionnaires and physical examinations. Urine samples were collected to detect urinary cadmium and creatinine levels. Body circumferences included waist circumference, hip circumference and calf circumference. Subjects were divided into three groups (low:<0.77 μg/g·creatinine, middle:0.77-1.69 μg/g·creatinine, high:≥1.69 μg/g·creatinine) by tertiles of creatinine-adjusted urinary cadmium concentration. Multiple linear regression models were used to analyze the association of creatinine-adjusted urinary cadmium level with BMI and body circumferences. The dose-response relationship of creatinine-adjusted urinary cadmium concentration with BMI and body circumferences was analyzed by using restrictive cubic splines fitting multiple linear regression model.Results:The mean age of subjects was (83.34±11.14) years old. The median (Q1, Q3) concentration of creatinine-adjusted urinary cadmium was 1.13 (0.63, 2.09) μg/g·creatinine, and the BMI was (22.70±3.82) kg/m 2. The mean values of waist circumference, hip circumference, and calf circumference were (85.42±10.68) cm, (92.67±8.90) cm, and (31.08±4.76) cm, respectively. After controlling confounding factors, the results of the multiple linear regression model showed that for each increment of 1 μg/g·creatinine in creatinine-adjusted urinary cadmium, the change of BMI, waist circumference, hip circumference, and calf circumference in the high-level group was -0.28 (-0.37, -0.19) kg/m 2, -0.74 (-0.96, -0.52) cm, -0.78 (-0.96, -0.61) cm, and -0.20 (-0.30, -0.11) cm, respectively. The restrictive cubic splines curve showed a negative nonlinear association of creatinine-adjusted urinary cadmium with BMI ( Pnonlinear<0.001) and negative linear associations of creatinine-adjusted urinary cadmium with waist circumference ( Plinear<0.001), hip circumference ( Plinear<0.001), and calf circumference ( Plinear<0.001). Conclusion:Urinary cadmium level is significantly associated with decreased BMI, waist circumference, hip circumference and calf circumference among older adults over 65 years old in 9 longevity areas of China.

Artemisia annua is the main natural source of artemisinin production. In A. annua, extended drought stress severely reduces its biomass and artemisinin production while short-term water-withholding or abscisic acid (ABA) treatment can increase artemisinin biosynthesis. ABA-responsive transcription factor AabZIP1 and JA signaling AaMYC2 have been shown in separate studies to promote artemisinin production by targeting several artemisinin biosynthesis genes. Here, we found AabZIP1 promote the expression of multiple artemisinin biosynthesis genes including AaDBR2 and AaALDH1, which AabZIP1 does not directly activate. Subsequently, it was found that AabZIP1 up-regulates AaMYC2 expression through direct binding to its promoter, and that AaMYC2 binds to the promoter of AaALDH1 to activate its transcription. In addition, AabZIP1 directly transactivates wax biosynthesis genes AaCER1 and AaCYP86A1. The biosynthesis of artemisinin and cuticular wax and the tolerance of drought stress were significantly increased by AabZIP1 overexpression, whereas they were significantly decreased in RNAi-AabZIP1 plants. Collectively, we have uncovered the AabZIP1-AaMYC2 transcriptional module as a point of cross-talk between ABA and JA signaling in artemisinin biosynthesis, which may have general implications. We have also identified AabZIP1 as a promising candidate gene for the development of A. annua plants with high artemisinin content and drought tolerance in metabolic engineering breeding.

Objective: To investigate the factors affecting postpartum stress urinary incontinence (PSUI) among lying-in women at ages of 35 years and older, so as to provide insights into PSUI prevention. Methods: Lying-in women at ages of 35 years and older receiving postpartum examinations were sampled using a convenient sampling method from Hangzhou Obstetrics and Gynecology Hospital during the period from January 2021 to April 2022. Participants' demographic data, type of delivery, birth weight, diastasis recti abdominis, pelvic floor muscle strength injury, pelvic floor muscle training were collected, and the development of PSUI was evaluated using the International Consultation on Incontinence modular questionnaire. The factors affecting the development of PSUI were identified among lying-in women at ages of 35 years and older using a multivariable logistic regression model. Results: A total of 230 questionnaires were allocated, and 226 valid questionnaires were recovered, with an effective recovery rate of 98.26%. The lying-in women had a mean age of (37.30±2.11) years, and 75.66% had a pre-pregnancy body mass index (BMI) of 18.5 to 24.0 kg/m2. There were 29 women with postpartum BMI of 24.0 kg/m2 and greater (12.83%), 201 women with gestational weeks of 37 weeks and greater at delivery (88.94%), 105 women with vaginal delivery (46.46%), 20 women with neonatal birth weights of 4 000 g and higher (8.85%), 149 women with diastasis recti abdominis (65.93%), 154 women with pelvic floor muscle strength injury (68.14%). The prevalence of PSUI was 25.22% among the study subjects. Multivariable logistic regression analysis showed that vaginal delivery (OR=4.061, 95%CI: 2.124-7.763), postpartum BMI of 24 kg/m2 and higher (OR=1.903, 95%CI: 1.275-3.288), neonatal birth weight of 4 000 g and higher (OR=2.108, 95%CI: 1.420-4.135), diastasis recti abdominis (OR=1.487, 95%CI: 1.110-2.169) and pelvic floor muscle strength injury (OR=2.924, 95%CI: 1.726-4.803) were risk factors for PSUI among lying-in women at ages of 35 years and older, and pelvic floor muscle training was a protective factor for PSUI among lying-in women at ages of 35 years and older (OR=0.410, 95%CI: 0.216-0.780). Conclusions The development of PSUI correlates with the type of delivery, postpartum BMI, neonatal birth weight, diastasis recti abdominis and pelvic floor muscle strength injury among lying-in women. Reasonable weight control and active pelvic floor muscle training may facilitate the prevention of PSUI.

Objective:To explore the early clinical diagnostic indicators in patients with primary hepatocellular carcinoma (HCC) combined with macrovascular invasion.Methods:The clinical data of 180 cases of HCC diagnosed by histopathology examination in the Second Affiliated Hospital of Chongqing Medical University from 2012 to 2019 were retrospectively analyzed. The factors influencing the development of macrovascular invasion in HCC patients were analyzed. The receiver operating characteristic curve (ROC curve) was used to evaluate the sensitivity and specificity.Results:Serum C-reactive protein (CRP) level was significantly correlated with various clinical characteristics of HCC patients, including the maximum tumor diameter, tumor number, and macrovascular invasion. Further analysis of the risk factors showed that serum direct bilirubin and CRP were independent risk factors for macrovascular invasion in HCC patients, with odds ratios of 1.747 (95% CI 1.119-2.728, P = 0.014) and 2.376 (95% CI 1.495-3.775, P < 0.001). ROC curve analysis showed that serum CRP, direct bilirubin, and the combination of the both had certain diagnostic value for hepatocellular carcinoma combined with macrovascular invasion. The area under the curve, sensitivity and specificity was 0.724, 0.668, 0.743, 79.1%, 70.1%, 79.1%, and 61.9%, 62.8%, 67.3%, respectively. Conclusion:The combination of CRP with direct bilirubin can be used as an important clinical diagnostic indicator for early diagnosis and prevention of hepatocellular carcinoma combined with macrovascular invasion.

Objective:To explore the relationship among cardioversion ,cerebral infarction (CI) and N terminal pro brain natriuretic peptide (NT‐proBNP) level in patients with heart failure (HF) complicated atrial fibrillation (AF) . Methods :A total of 150 HF + AF patients received intravenous drip of amiodarone for cardioversion therapy .Ac‐cording to cardioversion results ,they were divided into cardioversion group (n=100 ) and non‐cardioversion group (n=50) ,NT‐proBNP level change was observed in two groups before and after cardioversion .According to CI on‐set or not ,patients were divided into CI group (n=20) and non‐CI group (n= 130) ,NT‐proBNP level was com‐pared between two groups before and after onset .Results :Within 48h after administration ,a total of 100 patients (66.67% ) recovered to sinus rhythm .Compared with before cardioversion ,NT‐proBNP level significantly reduced [(967.04 ± 366.16) pg/ml vs .(496.21 ± 142.54) pg/ml] after cardioversion in cardioversion group ,and was signifi‐cantly lower than that of non‐cardioversion group (996.76 ± 351.28) pg/ml , P<0.01 all . In CI group ,compared with small size CI group ,there were significant rise in NT‐proBNP level [ (784.21 ± 231.26) pg/ml vs .(1983.24 ± 32.96) pg/ml ,(3562.19 ± 1468.32) pg/ml] in medium and large size CI group , P< 0.05 or <0.01 .Conclusion:NT‐proBNP level at hospitalization possesses predictive value for drug cardioversion effect in HF + AF patients . NT‐proBNP level is related with CI onset .After acute CI ,the higher NT‐proBNP level is ,the larger infarct size is , the poorer prognosis is .

Objective To evaluate the impact of subclinical hypothyroidism (SCH) on the outcome of pregnancy and the therapeutic effect of L-T4.Methods A total of 1 786 pregnant women during the first, second, and third trimesters were enrolled for thyroid screening by determining serum free thyroxine (FT4), total thyroxine (TT4), thyrotropin (TSH), and thyroid peroxidase antibody;123 pregnant women with SCH were successfully divided into treated group (n =42) and untreated group (n =81).The treated group was treated by L-T4 based on American Thyroid Association (ATA) 2011 guideline.Collected items include obstetric outcomes and complications.Results (1) Compared to control group, the rate of spontaneous abortion in pregnant women during first trimesters was increased in SCH group (20.99％ vs 8.45％, x2 =12.96, P =0.00), with higher incidence of diabetes during second trimester (24.69％ vs 10.45％, x2 =14.11, P =0.00).The incidences of hypertension during pregnancy, premature delivery, ablatio placentae, placenta praevia, fetus growth restriction, and low birth weight showed no difference between two groups (all P ＞ 0.05).(2) Compared with the untreated group, the incidences of spontaneous abortion and diabetes were decreased in the treated group (7.14％ vs 20.99％, x2 =3.89, P =0.05;9.52％ vs 24.69％, x2 =4.05, P =0.04), while the incidences of hypertension, premature delivery, ablatio placentae, placenta praevia, fetus growth restriction, and low birth weight infant accident rate were not different between two groups (all P ＞ 0.05).Conclusions SCH during the frist trimester is a risk factor of spontaneous abortion;SCH during the middle stage of pregnancy is a risk factor of gestational diabetes mellitus.Treatment of SCH with L-T4 may be beneficial.

Objective To investigate the effect of general nursing intervention on the mental state of the patients with breast cancer undergoing chemotherapy.Methods Forty-eight breast cancer patients undergoing postoperative chemotherapy received nursing general interventions including healthy education,psychological nursing care,pantosomatous,relaxation therapy and rehabilitative exercise. All patients were evaluated by self-rating depression scale (SDS) and depression status inventory (DSI) before and after the general intervention.Result The scores of SDS and DSI after intervention were significantly lower than those before intervention (bothP<0.05).Conclusion The general nursing intervention could significantly improve patients’ psychological state and life quality,promote rehabilitation and improve their quality of life.

Objective To investigate the relationship between benign prostatic hyperplasia (BPH) and urine albumin excretion.Methods A total of 258 male inpatients aged 60 to 70 years were enrolled in this study.According to prostate volume (PV) measured by transrectal ultrasonography,patients were divided into BPH group(PV≥20 ml) and NBPH(non benign prostatic hyperplasia) group(PV＜20 ml).Urine albumin and urine creatinine concentrations were measured and urine albumin/creatinine ratio(UACR) was calculated.Fasting blood glucose(FBG) and fasting insulin(FINS) also were measured,insulin resistance index(HOMA-IR) was calculated based on the formula HOMA-IR=ln(FBG × FINS/22.5).The correlation between PV and other indicators were analyzed by Pearson correlation analysis.The risk factors for BPH were analyzed by logistic regression analysis.Results UACR was significantly higher in BPH group than in NBPH group[(163.6± 69.8) mg/g vs.(73.3 ± 55.6) mg/g,t =4.81,P＜ 0.01],and hypertension duration was longer in BPH group than in NBPH group [(9.2±6.6)years vs.(6.0±3.6)years,t=2.27,P＜0.05].The prevalence rate of BPH and PV were increased along with increasing of urine albumin excretion(x2=4.58,F=4.85,respectively,P＜0.05 or 0.01).Prostate volume was positively correlated with UACR,HOMA-IR,hypertension duration,body mass index(r=0.248,0.229,0.183,0.157,respectively,all P ＜ 0.05).Logistic regression analysis indicated that UACR,HOMA-IR and hypertension duration were the risk factors for BPH(OR=16.348,1.040,0.166,respectively,all P ＜0.05).Conclusions BPH is correlated with UACR,which indicates that there is a close relationship between atherosclerosis and BPH.Insulin resistance probably plays an important role in the progression of arteriosclerosis and BPH.

Totally 1 360 pregnant women during the first trimesters (4-12 weeks) who visited Ningbo University Affiliated Hospital and Ningbo Jiangbei Maternal Health Hospital from February 2010 to October 2011,and 216 non-pregnant healthy women,who contemporaneous by visited the hospital,were enrolled in this study.The thyroid screening was made by determining urinary iodine and serum free thyroxine,free triiodothyronine,total thyroxine,total triiodothyronine,thyrotropin,and thyroid peroxidase antibody (TPOAb).The median concentration of urinary iodine in the pregnant women was not different from that of non-pregnant women (P＞0.05) ; 1 360 pregnant women were screened,268 (19.71％) of them were identified to suffer from thyroid disorders or with positive thyroid autoantibody.29(13.43％) of non-pregnant women were identified to suffer from thyroid disorders or with positive thyroid autoantibody.There was significant difference between the 2 groups (x2 =4.40,P＜0.05).Prevalence of thyroid dysfunction may increase during early pregnancy.The screening for thyroid function and autoantibody should be recommended in that period.