BACKGROUND: Premature menopause, defined as natural menopause before age 40, is associated with diminished ovarian reserve. Despite growing concerns regarding environmental pollutants, no large-scale population-based studies have systematically examined the association between urinary polycyclic aromatic hydrocarbon metabolites (UPAHMs) and premature menopause. METHODS: This cross-sectional study analyzed 2001-2020 NHANES data, including urinary levels of six PAH metabolites: 1-naphthol (1-NAP), 2-naphthol (2-NAP), 3-fluorene (3-FLU), 2-fluorene (2-FLU), 1-phenanthrene (1-PHE), and 1-pyrene (1-PYR). Premature menopause was self-reported as natural menopause occurring before age 40. Multivariable logistic regression assessed UPAHMs' association with premature menopause, with restricted cubic splines (RCS) evaluating nonlinear trends. Subgroup analyses examined demographic interactions. RESULTS: Among 2,565 participants, 662 reported premature menopause. Multivariable logistic regression showed significant associations between elevated urinary levels of 1-NAP (OR: 1.01, 95% CI: 1.00-1.02, P = 0.02), 2-NAP (OR: 1.01, 95% CI: 1.00-1.02, P = 0.02), and 3-FLU (OR: 1.03, 95% CI: 1.01-1.05, P = 0.01) and increased risk of premature menopause. RCS analysis revealed significant nonlinear relationships for 2-NAP, 3-FLU, 2-FLU, 1-PHE, and 1-PYR with premature menopause risk. White participants showed greater susceptibility to UPAHMs. CONCLUSION Elevated UPAHMs, particularly 1-NAP, 2-NAP, and 3-FLU, were linked to higher premature menopause risk, with nonlinear trends observed. White individuals demonstrated greater vulnerability, emphasizing the need for targeted interventions to reduce PAH exposure.
Humans ; Female ; Cross-Sectional Studies ; United States/epidemiology* ; Polycyclic Aromatic Hydrocarbons/urine* ; Adult ; Middle Aged ; Environmental Pollutants/urine* ; Nutrition Surveys ; Menopause, Premature/urine* ; Young Adult ; Environmental Exposure

With the rapid development of mobile internet technology, mobile health application (mHealth APP) are increasingly widely used in the field of health management and have been proven to play an important role in the management of chronic diseases. Solid organ transplant recipients face complex health management needs after surgery, including postoperative follow-up, medication management, prevention and treatment of complications and comorbidities, and lifestyle adjustment. mHealth APP can provide solid organ transplant recipients with convenient self-management tools. Although some progress has been made in this field, there are still many challenges, such as insufficient user experience, technological dependence, and data security risks. Therefore, this article discusses the development process, main functions and current application status of mHealth APP, and analyzes its advantages in improving the self-management ability of solid organ transplant recipients, promoting doctor-patient communication and reducing the incidence of complications. At the same time, based on the practical experience of author’s team in developing the “TransMate” mHealth APP, we propose the directions that mHealth APPs should focus on in the future, in order to provide more effective support and services for the health management of solid organ transplant recipients.

Objective:To evaluate the association between heatwaves and fall-related mortality.Methods:A total of 61 421 fall-related mortality from 2013 to 2022 in 7 provinces of China were included in a time-stratified case-crossover design, with daily meteorological data derived from the fifth generation European Reanalysis dataset produced by the European Centre for Medium-Range Weather Forecasts. Conditional logistic regression chimeric distributed lag nonlinear model was used to analyze the association between heatwaves and fall-related mortality and stratified analysis was conducted according to gender and age.Results:Heatwaves were associated with an increased risk of fall-related morality. The risk of fall-related mortality during heatwaves was higher than during non-heatwave periods ( OR=1.11, 95% CI: 1.05-1.18). The attributable fraction of fall-related motality due to heatwaves was 10.25% (95% CI: 4.49%-15.36%). For each 1 ℃ increase above the heatwave threshold, the risk of fall-related mortality increased by 34% ( OR=1.34, 95% CI: 1.02-1.76). The effect of heatwave duration on fall-related mortality was not statistically significant. Stratified analyses indicated that women experienced a higher risk of fall-related mortality during heatwaves ( OR=1.13, 95% CI: 1.04-1.22) compared to man ( OR=1.10, 95% CI: 1.04-1.17). Conclusions:Heatwave increases the risk of fall-related mortality, and the intensity of heatwaves modify this risk. Women are vulnerable populations.

Objective:To evaluate the impact of short-term exposure to daytime heatwaves, nighttime heatwaves, and compound heatwaves on the risk of road traffic mortality and calculate the attributable mortality burden.Methods:This study collected road traffic mortality data from the Disease Surveillance System in Guangdong, Hunan, Zhejiang, Yunnan, and Jilin Provinces from 2013 to 2018. A time-stratified case-crossover design was used in this study, with the death date for each case serving as the case day. Control days were selected from the same year, month, and day of the week as the case day. A conditional logistic regression model was employed to estimate the cumulative associations of short-term exposure to daytime heatwaves, nighttime heatwaves, and compound heatwaves on the risk of road traffic mortality (lag 0-1 day) and to calculate the attributable fractions (AF).Results:Compared to non-heatwave days, the excess risk ( ER) of road traffic mortality on daytime heatwave days, nighttime heatwave days, and compound heatwave days was 5.3% (95% CI: 0.5%-10.2%), 4.9% (95% CI: 0.5%-9.4%) and 7.5% (95% CI: 2.3%- 12.9%), with corresponding AF of 5.0% (95% CI: 0.5%-9.3%), 4.7% (95% CI: 0.5%-8.6%), and 6.9% (95% CI: 2.3%-11.4%), respectively. Stratified analysis showed that the risk of traffic mortalities caused by daytime heatwaves was higher in females ( ER=15.7%, 95% CI: 5.8%-26.5%) than in males ( ER=1.8%, 95% CI: -3.6%-7.4%). Elderly individuals over 64 years old ( ER=10.9%, 95% CI: 0.3%- 22.6%) had a higher risk of road traffic mortalities from compound heatwaves than those under 45 years old ( ER=2.6%, 95% CI: -5.4%-11.2%). The risk of road traffic injury mortality from motor vehicle accidents caused by compound heatwaves ( ER=16.6%, 95% CI:2.4%-32.7%) was higher than that from non-motor vehicle accidents ( ER=5.7%, 95% CI:0.1%-11.5%). Conclusions:Short-term exposure to daytime heatwaves, nighttime heatwaves, and compound heatwaves was associated with an increased risk of road traffic mortality, with the strongest association observed for compound heatwaves. The mortality burden attributable to compound heatwaves was higher than that for daytime and nighttime heatwaves. Heatwaves were more significantly associated with road traffic mortality risk among females, elderly individuals over 64 years old, and motor vehicle accidents.

Objective To explore the correlation between the pulmonary artery diameter(PAD),PAD/aortic diameter(AOD),right ventricular diameter(RVD),RVD/left ventricular diameter(LVD)measured on pulmonary artery CT angiography(CTPA)cross-sectional images and the degree of embolism,cardiac biomarkers in patients with medium-to-high risk acute pulmonary embolism(APE).Methods The clinical data of 53 patients with medium-to-high risk APE,who received interventional treatment at the Putian Municipal First Hospital of China From January 2021 to December 2023,were retrospectively analyzed.The PAD,PAD/AOD,RVD,and RVD/LVD were measured on CTPA cross-sectional images.The correlations of the above indexes with CT embolism index(CTEI),N terminal pro B type natriuretic peptide(NT-proBNP),and cardiac troponin Ⅰ(cTnⅠ)were analyzed.Results A weak-moderate positive correlation existed between PAD,RVD,RVD/LVD and CTEI(r=0.506,r=0.310,r=0.452 respectively,P＜0.001,P=0.024,P=0.001 respectively),while no correlation existed between PAD/AOD and CTEI(r=0.247,P=0.075).Compared with the NT-proBNP negative group,in the NT-proBNP positive group the values of PAD,PAD/AOD and RVD/LVD were higher(all P＜0.05),and there was no statistically significant difference in RVD value between the two groups(P＞0.05).A weak-moderate positive correlation existed between NT-proBNP and PAD,PAD/AOD,RVD,RVD/LVD(r=0.454,r=0.326,r=0.302,r=0.405 respectively,P=0.001,P=0.017,P=0.028,P=0.003 respectively).There were no statistically significant differences in PAD,PAD/AOD,RVD and RVD/LVD values between the cTnⅠ negative group and the cTnI positive group(all P＞0.05).No correlation existed between cTnⅠ and PAD,PAD/AOD,RVD,RVD/LVD(r=0.188,r=0.042,r=-0.021,r=0.139 respectively,and P=0.195,P=0.772,P=0.884,P=0.342 respectively).Conclusion CTPA cross-sectional quantitative indicators are helpful in evaluating the embolism degree of APE and right heart function,but it cannot be used to assess myocardial injury.

Objective:To evaluate the association between heatwaves and fall-related mortality.Methods:A total of 61 421 fall-related mortality from 2013 to 2022 in 7 provinces of China were included in a time-stratified case-crossover design, with daily meteorological data derived from the fifth generation European Reanalysis dataset produced by the European Centre for Medium-Range Weather Forecasts. Conditional logistic regression chimeric distributed lag nonlinear model was used to analyze the association between heatwaves and fall-related mortality and stratified analysis was conducted according to gender and age.Results:Heatwaves were associated with an increased risk of fall-related morality. The risk of fall-related mortality during heatwaves was higher than during non-heatwave periods ( OR=1.11, 95% CI: 1.05-1.18). The attributable fraction of fall-related motality due to heatwaves was 10.25% (95% CI: 4.49%-15.36%). For each 1 ℃ increase above the heatwave threshold, the risk of fall-related mortality increased by 34% ( OR=1.34, 95% CI: 1.02-1.76). The effect of heatwave duration on fall-related mortality was not statistically significant. Stratified analyses indicated that women experienced a higher risk of fall-related mortality during heatwaves ( OR=1.13, 95% CI: 1.04-1.22) compared to man ( OR=1.10, 95% CI: 1.04-1.17). Conclusions:Heatwave increases the risk of fall-related mortality, and the intensity of heatwaves modify this risk. Women are vulnerable populations.

Objective:To evaluate the impact of short-term exposure to daytime heatwaves, nighttime heatwaves, and compound heatwaves on the risk of road traffic mortality and calculate the attributable mortality burden.Methods:This study collected road traffic mortality data from the Disease Surveillance System in Guangdong, Hunan, Zhejiang, Yunnan, and Jilin Provinces from 2013 to 2018. A time-stratified case-crossover design was used in this study, with the death date for each case serving as the case day. Control days were selected from the same year, month, and day of the week as the case day. A conditional logistic regression model was employed to estimate the cumulative associations of short-term exposure to daytime heatwaves, nighttime heatwaves, and compound heatwaves on the risk of road traffic mortality (lag 0-1 day) and to calculate the attributable fractions (AF).Results:Compared to non-heatwave days, the excess risk ( ER) of road traffic mortality on daytime heatwave days, nighttime heatwave days, and compound heatwave days was 5.3% (95% CI: 0.5%-10.2%), 4.9% (95% CI: 0.5%-9.4%) and 7.5% (95% CI: 2.3%- 12.9%), with corresponding AF of 5.0% (95% CI: 0.5%-9.3%), 4.7% (95% CI: 0.5%-8.6%), and 6.9% (95% CI: 2.3%-11.4%), respectively. Stratified analysis showed that the risk of traffic mortalities caused by daytime heatwaves was higher in females ( ER=15.7%, 95% CI: 5.8%-26.5%) than in males ( ER=1.8%, 95% CI: -3.6%-7.4%). Elderly individuals over 64 years old ( ER=10.9%, 95% CI: 0.3%- 22.6%) had a higher risk of road traffic mortalities from compound heatwaves than those under 45 years old ( ER=2.6%, 95% CI: -5.4%-11.2%). The risk of road traffic injury mortality from motor vehicle accidents caused by compound heatwaves ( ER=16.6%, 95% CI:2.4%-32.7%) was higher than that from non-motor vehicle accidents ( ER=5.7%, 95% CI:0.1%-11.5%). Conclusions:Short-term exposure to daytime heatwaves, nighttime heatwaves, and compound heatwaves was associated with an increased risk of road traffic mortality, with the strongest association observed for compound heatwaves. The mortality burden attributable to compound heatwaves was higher than that for daytime and nighttime heatwaves. Heatwaves were more significantly associated with road traffic mortality risk among females, elderly individuals over 64 years old, and motor vehicle accidents.

Objective:To test the practical effect of the research projects outpatient strategy for application of the National Natural Science Foundation (NSFC) in a hospital of Chinese medicine.Methods:We compared the number and success rate of the National Natural Science Foundation of China grant awards before and after the implementation of the research projects outpatient strategy, and further analyzed the promotional effect of the research projects outpatient strategy on general programs and youth scientists funds through univariate analysis and multivariate Logistic regression.Results:Since the implementation of the research projects outpatient strategy, both the number of NSFC grant awards and the success rate continuously increased, indicating that the strategy played a positive role in improving the overall success rate of the hospital. However, this effect was primarily reflected in the assistance provided to applications for youth scientists funds. The main favorable factor for winning general programs was the applicant′s preliminary foundation. Applicants who have previously received NSFC funding had a higher success rate.Conclusions:The strategy of research projects outpatient can promote the winning of NSFC youth scientists funds.

Objective To analyze the epidemiological characteristics of population-based cohort of patients with the comorbidity of cardiovascular and cerebrovascular diseases and type 2 diabetes in Lingnan area,and to study the related influencing factors in the onset and progression of the disease. Methods A retrospective cohort study was used to collect data from people who underwent physical examination in the Eleventh People's Hospital of Guangzhou from May 2022 to December 2023. Data mainly included questionnaire surveys,physical examinations,and laboratory testing indicators. The 2022 was defined as the baseline to statistically analyze the occurrence and development of the comorbidity of cardiovascular and cerebrovascular diseases and type 2 diabetes in this population,and to analyze the related influencing factors of comorbidity and distribution of traditional Chinese medicine constitution in comorbidity population. Results Finally,a total of 26498 subjects were included,from which there were 359 patients with the comorbidity of cardiovascular and cerebrovascular diseases and type 2 diabetes (comorbidity group),accounting for 1.4％ of the total. Among them,290 were male,accounting for 80.8％,which is much higher than female. The mean age was(61.6±9.5)years old,which was significantly higher than that of the non-comorbidity group. The cases of comorbidity group were mainly concentrated in the age group of 45-75 years old,and no cases were found in people under 35 years old. There were 293 patients with the comorbidity of ischemic cardiovascular disease and type 2 diabetes,whose proportion (81.6％) is much higher than that of other types. Significant differences between comorbidity group and non-comorbidity group were found in terms of gender,age,age distribution,height,body mass,body mass index (BMI),smoking,alcohol consumption,marital status,exercise,and dampness syndrome (P<0.05). About 1.0％ of population at the baselined converted from non-comorbidities or single disease to comorbidities. The proportion of newly diagnosed patients with the comorbidity of ischemic cardiovascular disease and type 2 diabetes is the highest,up to 68.9％. BMI overweight or obesity,large waist circumference,smoking,dampness syndrome and exercise were the risk factors affecting the comorbidity of cardiovascular and cerebrovascular diseases and type 2 diabetes. A total of 264 cases of comorbidity group had finished evaluation of traditional Chinese medicine body constitutions. The proportion of balanced constitution was the highest (31.1％),followed by dampness-heat constitution (18.2％),yang-deficiency constitution (13.3％) and phlegm-dampness constitution (11.7％). Conclusion The incidence of the comorbidity of cardiovascular and cerebrovascular diseases and type 2 diabetes is high in Lingnan area,which may be related to dampness constitution,BMI overweight or obesity,large waist circumference,smoking,dampness syndrome and lack of exercise.

Objective To investigate the correlation between amide proton transfer-weighted(APTw)value derived from APTw imaging and Ki-67 expression in hepatocellular carcinoma.Methods Sixty patients with hepatic occupations underwent preoperative upper abdominal MRI scanning,including APTw and diffusion weighted imaging(DWI)sequences.Thirty-two patients with hepatocellular carcinoma proved by pathological results were enrolled in the prospective study.The APTw and apparent diffusion coefficient(ADC)values of the lesions were measured from the corresponding APTw and ADC images,respectively.Mann-Whitney U test or independent sample t test was used to analyze the differences in APTw and ADC values between the high and low Ki-67 expression groups.Pearson correlation analysis was used to evaluate the correlation between APTw value,ADC value and Ki-67 expression level of hepatocellular carcinoma.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of amide proton transfer(APT)parameter in differentiating high and low Ki-67 expression groups.Results The APTw values of high Ki-67 expression group(n=24)was higher than that of low Ki-67 expression group(n=8)[(1.33±0.77)％vs(0.64±0.58)％,P=0.026].There was no significant difference in ADC values between the two groups(0.82×10-3 mm2/s vs 0.86×10-3 mm2/s,P=0.679).The APTw values were positively correlated with Ki-67 expression(r=0.377,P=0.035),and the area under the curve(AUC)of APTw value＞1.24％for the diagnosis of high Ki-67 expression was 0.794,with a sensitivity of 67％and a specificity of 88％.Conclusion The APTw value of hepatocellular carcinoma is positively correlated with Ki-67 expression,which has certain diagnostic value for predicting the expression status of Ki-67.