Background: This study investigated the independent and joint impacts of the geriatric nutritional risk index (GNRI) and frailty index (FI) on all-cause and cause-specific mortality in patients with diabetes. Methods: This study included 1,790 National Health and Nutrition Examination Survey participants between 1999 and 2018. GNRI and FI were used to assess patients with diabetes, who were categorized into low GNRI and high GNRI groups, as well as low FI and high FI groups, to evaluate older adults’ nutritional status. These groups were combined into four categories. Weighted Cox proportional hazards models, Kaplan-Meier survival curves, and restricted cubic spline regression models were applied to assess the independent and joint associations of GNRI and FI with all-cause and cause-specific mortality in patients with diabetes. Results: The median follow-up period was 100 months, during which 720 deaths occurred. An independent linear dose-response relationship between GNRI, FI, and all-cause mortality risk was observed. The combination of low GNRI and high FI was significantly associated with increased risk of all-cause mortality (hazard ratio, 1.65; 95% confidence interval [CI], 1.02 to 2.68) for the low GNRI+low FI group, 2.03 (95% CI, 1.61 to 2.55) for the high GNRI+high FI group, and 3.65 (95% CI, 2.38 to 5.58) for the low GNRI+high FI group. Stratified analysis (reference: high GNRI+low FI group) showed an increased mortality risk among men in the low GNRI+high FI group. Conclusion The combination of low GNRI and high FI was independently and jointly associated with increased risk of all-cause, cardiovascular disease, diabetes, and hypertension mortality, particularly among men.

Abstract: Objective To analyze the epidemiological characteristics of a local outbreak of dengue fever caused by a construction site in Shenzhen City, evaluate the effectiveness of control measures, and explore dengue fever prevention and control strategies suitable for local characteristics. Methods Epidemiological investigations were conducted on dengue fever cases during the outbreak. Descriptive analysis methods were used to analyze the epidemiological characteristics of the outbreak. The Breteau Index method and double-layer trap method were employed to monitor mosquito density and evaluate the effectiveness of control measures. Results A total of 85 cases were reported in this outbreak, all of which were local cases. Among them, 76 cases (89.41%) were laboratory-confirmed, and 9 cases (10.59%) were clinically diagnosed. All laboratory-confirmed cases were identified as Dengue Virus Serotype 1 (DENV-1). There were 64 male and 21 female cases, with no critical or fatal cases. The age of cases ranged from 4 to 78 years old, with the highest number of cases occurring in the 31-<50 age group (43 cases, 50.59%). The majority of cases were construction workers (38 cases, 44.71%). The outbreak was mainly concentrated in Qiutou Community, Fu Hai Street, Bao'an District, accounting for 69 cases (81.18%). The median and quartile M (P25, P75) interval between onset of illness and diagnosis was 3 (2, 5) days, with construction workers having a shorter interval between onset and seeking medical attention compared to other residents. After implementing control measures such as case search, isolation and treatment, mosquito control, cleaning of mosquito breeding sites, and health education, the daily average Breteau Index decreased from the initial 12 to below 3, and the adult mosquito density remained at 0 mosquitoes (person/hour). Conclusions This outbreak was a local dengue fever outbreak initiated at a construction site. After the community staff participated in the comprehensive prevention and control measures, including case searching, mosquito elimination, clearing of breeding grounds, environmental health inspection, and education and propaganda, the epidemic was effectively contained. In addition, the continuous improvement of clinicians' diagnostic levels for dengue fever and the popularization of dengue fever antigen primary screening reagents (NS1 antigen reagents) in medical institutions may have played a crucial role in the early detection of the epidemic.

Hexanes ; Hexanones ; blood ; Humans ; Occupational Exposure

To improve the quality of postgraduate students,school of medicine of Shanghai Jiao Tong University have offered medical molecular genetics course to postgraduates and obtained good teaching efficiency. More than ten professors gave lectures on the academic foreland,leading students to find and solve academic problems and training practical and innovative ability of students. Accord-ing to the questionnaires of evaluation of the course and suggestions from postgraduates in the recent two years,some recommendations for the further teaching reform were proposed,such as using multi-plex teaching models,strengthening communication for teaching information with the students,em-ploying comprehensive evaluation methods and strengthening coordination and management of the course.