BACKGROUND: Neuroticism has been associated with numerous health outcomes. However, most research has focused on a single specific disorder and has produced controversial results, particularly regarding mortality risk. Here, we aimed to examine the association of neuroticism with morbidity and mortality and to elucidate how neuroticism affects trajectories from a healthy state, to one or more neuroticism-related disorders, and subsequent mortality risk. METHODS: We included 483,916 participants from the UK Biobank at baseline (2006-2010). Neuroticism was measured using the Eysenck Personality Questionnaire. Three clusters were constructed, including worry, depressed affect, and sensitivity to environmental stress and adversity (SESA). Cox proportional hazards regression and multistate models were used. Linear regression was used to examine the association between neuroticism and immune parameters and neuroimaging measures. RESULTS: High neuroticism was associated with 37 non-overlapping diseases, including increased risk of infectious, cardiometabolic, neuropsychiatric, digestive, and respiratory diseases, and decreased risk of cancer. After adjustment for sociodemographic variables, physical measures, healthy behaviors, and baseline diagnoses, moderate-to-high neuroticism was associated with a decreased risk of all-cause mortality. In multistate models, high neuroticism was associated with an increased risk of transitions from a healthy state to a first neuroticism-related disease (hazard ratio [HR] [95% confidence interval (CI)] = 1.09 [1.05-1.13], P  <0.001) and subsequent transitions to multimorbidity (1.08 [1.02-1.14], P  = 0.005), but was associated with a decreased risk of transitions from multimorbidity to death (0.90 [0.84-0.97], P for trend = 0.006). The leading neuroticism cluster showing a detrimental role in the health-illness transition was depressed affect, which correlated with higher amygdala volume and lower insula volume. The protective effect of neuroticism against mortality was mainly contributed by the SESA cluster, which, unlike the other two clusters, did not affect the balance between innate and adaptive immunity. CONCLUSION This study provides new insights into the differential role of neuroticism in health outcomes and into new perspectives for establishing mortality prevention programs for patients with multimorbidity.
Humans ; Neuroticism/physiology* ; Male ; Female ; Middle Aged ; Aged ; Proportional Hazards Models ; Surveys and Questionnaires ; Adult ; Risk Factors

Objective:To identify strain-specific features of Klebsiella pneumoniae by analyzing metagenomics next generation sequencing (mNGS) data, thereby expanding the downstream applications of mNGS. Methods:The sequences of K.pneumoniae strains were organized from both the self-built database of the long-term multi-center research cohort in China established by the Peking University People′s Hospital from 2009 to 2020 (with 2 345 sequences) and the public databases (with 19 648 sequences). The existing large-scale databases were compressed, and a set of strains representative of clonal groups were screened. A strain genome information library was constructed based on k-mer features, and the most matching representative sequences in the database were searched for the raw mNGS data. The search results of the self-built library and public library were merged and optimized to update the prediction of antimicrobial-resistance characteristics and avoid the impact of uneven data distribution on the results. A total of 314 clinical samples from patients with K.pneumoniae detected by mNGS in the Clinical Microbiology Laboratory of Peking University People′s Hospital from 2022 to 2024 were retrospectively collected, and 101 samples with positive clinical culture results were selected to validate the prediction results. The antimicrobial-resistance phenotypes were verified by clinical antimicrobial susceptibility test results. Whole-genome sequencing was performed on the culture strains of 14 samples randomly selected using random numbers to verify the genotypes. Single nucleotide polymorphism distance analysis was used to verify the occurrence of outbreak events. The χ2 test and Mann-Whitney U test were used for statistical analysis. Results:A representative strain sequence k-mer feature library containing self-built and public sub-libraries was constructed. The library construction required only about 1 hour with <3 GB storage, with a high compression ratio and low update cost. Using k-mer-based analysis, mNGS data achieved precise strain characterization within 4 minutes and and <5 GB memory occupation. There was a significant difference in the antimicrobial-resistance rates to more than half of the antibiotics between the self-built database (90.8%, 2 130/2 345) and the public database (22.7%, 4 457/19 648) ( χ2=4 634.1, P<0.001). After optimizing the search results, the mean category agreement, sensitivity, and specificity of the prediction for eight antibiotics reached 84.8% (323/381), 78.9% (131/166), and 91.2% (196/215), respectively. The target genotypes were successfully detected in 10 out of 12 samples, and two outbreak events (2 samples per event) were successfully identified. Conclusions:An independent analysis process adapted to the needs of identifying the features of K. pneumoniae strains in mNGS data was developed. This process requires minimal computational resources and processing time and can directly achieve the simultaneous analysis of the antimicrobial-resistance phenotypes of K. pneumoniae at the strain level and their corresponding genomic characteristic profiles based on the raw mNGS reads.

Objective : To investigate the relationship between the risk occurrence of rectal cancer and the single nucleotide polymorphisms(SNP) of zinc finger protein 6(ZBED6), and to provide the experimental basis for early diagnosis and treatment of rectal cancer. Methods: Polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP) technology was used to genotype the ZBED6 gene in 109 randomly selected rectal cancer patients and 110 unrelated healthy controls. To evaluate the relationship between alleles, genotypes and the risk of rectal cancer, unconditional Logistic regression analysis was used toORand 95%CI. Results: The SNP rs7552670 of ZBED6 had significant correlation with the risk of rectal cancer. Compared with the population carrying the TT genotype, those carrying the TC genotype had a 2.653 fold increased risk of rectal cancer(TTvsTC:OR=2.635, 95%CI=1.501-4.690). Other SNPs had no significant correlation with the risk of rectal cancer. Conclusion There is an interaction between the polymorphisms of ZBED6(rs7552670) and rectal cancer. The population carried ZBED6 rs7552670 TC genotype had an growing risk of rectal cancer.

Objective To analyze the distribution characteristics of infectious respiratory particles(IRPs)in hospi-tal waiting rooms,and explore the impact of indoor air environmental on the distribution characteristics of bacterial IRPs.Methods In the summer and winter of 2024,nine waiting rooms in non-infectious departments of three ter-tiary hospitals in a district of Beijing were selected for on-site investigation on basic conditions.Concentration and distribution of particle diameter of cultivable bacteria from 36 air specimens collected by the impacting method were analyzed.Cyclone method was employed to collect 36 IRPs specimens.Major respiratory pathogens were analyzed by fluorescence polymerase chain reaction(PCR).Results The median of the total bacterial count in IRPs in the waiting rooms in summer was 1 035 CFU/m3,which was higher than that in winter(295 CFU/m3),with statisti-cally significant difference(P＜0.05).The orders of medians of the total bacterial count from IRPs of different types in the waiting rooms in both summer and winter were as follows:emergency department waiting room＜re-spiratory department waiting room＜pediatric waiting room＜general outpatient waiting room.There was no sta-tistically significant difference in the total bacterial count among different waiting rooms(P＞0.05).Particle diame-ter of bacterial IRPs in the waiting rooms in summer and winter mainly distributed in the range of＜4.7 μm,ac-counting for 73.77％and 69.44％,respectively.The total number of bacteria in IRPs in the waiting rooms was positively correlated with indoor air temperature,relative humidity,PM10,and PM2.5(all P＜0.01),while nega-tively correlated with indoor wind speed(all P＜0.01).The types of respiratory infectious and non-infectious pathogens detected from IRPs in different types of waiting rooms were different between summer and winter.The pathogens detected in summer were mainly concentrated in respiratory non-infectious pathogens(Escherichia coli,Klebsiella pneumoniae,Staphylococcus aureus).In winter,respiratory infectious pathogens(virus and Mycoplas-ma pneumoniae)were detected.The types of detected pathogens in different types of waiting rooms were different.Non-infectious respiratory pathogens detected from IRPs in winter were mainly Escherichia coli,Klebsiella pneumoniae,and Staphylococcus aureus.Conclusion Particle diameter of bacterial IRPs in the waiting room is mainly＜4.7 μm.These particles can enter the lower respiratory tract of human body,and pose potential risk to health.The detection of main infectious and non-infectious respiratory pathogens from IRPs in waiting rooms suggests risk of exposure to infection for patients and healthcare workers.

Objective To analyze the distribution characteristics of infectious respiratory particles(IRPs)in hospi-tal waiting rooms,and explore the impact of indoor air environmental on the distribution characteristics of bacterial IRPs.Methods In the summer and winter of 2024,nine waiting rooms in non-infectious departments of three ter-tiary hospitals in a district of Beijing were selected for on-site investigation on basic conditions.Concentration and distribution of particle diameter of cultivable bacteria from 36 air specimens collected by the impacting method were analyzed.Cyclone method was employed to collect 36 IRPs specimens.Major respiratory pathogens were analyzed by fluorescence polymerase chain reaction(PCR).Results The median of the total bacterial count in IRPs in the waiting rooms in summer was 1 035 CFU/m3,which was higher than that in winter(295 CFU/m3),with statisti-cally significant difference(P＜0.05).The orders of medians of the total bacterial count from IRPs of different types in the waiting rooms in both summer and winter were as follows:emergency department waiting room＜re-spiratory department waiting room＜pediatric waiting room＜general outpatient waiting room.There was no sta-tistically significant difference in the total bacterial count among different waiting rooms(P＞0.05).Particle diame-ter of bacterial IRPs in the waiting rooms in summer and winter mainly distributed in the range of＜4.7 μm,ac-counting for 73.77％and 69.44％,respectively.The total number of bacteria in IRPs in the waiting rooms was positively correlated with indoor air temperature,relative humidity,PM10,and PM2.5(all P＜0.01),while nega-tively correlated with indoor wind speed(all P＜0.01).The types of respiratory infectious and non-infectious pathogens detected from IRPs in different types of waiting rooms were different between summer and winter.The pathogens detected in summer were mainly concentrated in respiratory non-infectious pathogens(Escherichia coli,Klebsiella pneumoniae,Staphylococcus aureus).In winter,respiratory infectious pathogens(virus and Mycoplas-ma pneumoniae)were detected.The types of detected pathogens in different types of waiting rooms were different.Non-infectious respiratory pathogens detected from IRPs in winter were mainly Escherichia coli,Klebsiella pneumoniae,and Staphylococcus aureus.Conclusion Particle diameter of bacterial IRPs in the waiting room is mainly＜4.7 μm.These particles can enter the lower respiratory tract of human body,and pose potential risk to health.The detection of main infectious and non-infectious respiratory pathogens from IRPs in waiting rooms suggests risk of exposure to infection for patients and healthcare workers.

Objective:To identify strain-specific features of Klebsiella pneumoniae by analyzing metagenomics next generation sequencing (mNGS) data, thereby expanding the downstream applications of mNGS. Methods:The sequences of K.pneumoniae strains were organized from both the self-built database of the long-term multi-center research cohort in China established by the Peking University People′s Hospital from 2009 to 2020 (with 2 345 sequences) and the public databases (with 19 648 sequences). The existing large-scale databases were compressed, and a set of strains representative of clonal groups were screened. A strain genome information library was constructed based on k-mer features, and the most matching representative sequences in the database were searched for the raw mNGS data. The search results of the self-built library and public library were merged and optimized to update the prediction of antimicrobial-resistance characteristics and avoid the impact of uneven data distribution on the results. A total of 314 clinical samples from patients with K.pneumoniae detected by mNGS in the Clinical Microbiology Laboratory of Peking University People′s Hospital from 2022 to 2024 were retrospectively collected, and 101 samples with positive clinical culture results were selected to validate the prediction results. The antimicrobial-resistance phenotypes were verified by clinical antimicrobial susceptibility test results. Whole-genome sequencing was performed on the culture strains of 14 samples randomly selected using random numbers to verify the genotypes. Single nucleotide polymorphism distance analysis was used to verify the occurrence of outbreak events. The χ2 test and Mann-Whitney U test were used for statistical analysis. Results:A representative strain sequence k-mer feature library containing self-built and public sub-libraries was constructed. The library construction required only about 1 hour with <3 GB storage, with a high compression ratio and low update cost. Using k-mer-based analysis, mNGS data achieved precise strain characterization within 4 minutes and and <5 GB memory occupation. There was a significant difference in the antimicrobial-resistance rates to more than half of the antibiotics between the self-built database (90.8%, 2 130/2 345) and the public database (22.7%, 4 457/19 648) ( χ2=4 634.1, P<0.001). After optimizing the search results, the mean category agreement, sensitivity, and specificity of the prediction for eight antibiotics reached 84.8% (323/381), 78.9% (131/166), and 91.2% (196/215), respectively. The target genotypes were successfully detected in 10 out of 12 samples, and two outbreak events (2 samples per event) were successfully identified. Conclusions:An independent analysis process adapted to the needs of identifying the features of K. pneumoniae strains in mNGS data was developed. This process requires minimal computational resources and processing time and can directly achieve the simultaneous analysis of the antimicrobial-resistance phenotypes of K. pneumoniae at the strain level and their corresponding genomic characteristic profiles based on the raw mNGS reads.

Objective:To evaluate the bone salt metabolism levels of patients with acute brucellosis complicated by decreased serum calcium levels.Methods:Forty patients with acute brucellosis complicated by decreased serum calcium levels diagnosed by the Disease Prevention and Control Center of Donghe District, Baotou City from January to December 2021 were selected as the low calcium acute brucellosis group, and 30 local healthy people were selected as the control group. The fully automatic chemiluminescence immunoassay analyzer was used to determine the levels of regulatory hormone indicators such as serum parathyroid hormone (PTH), 25-hydroxyvitamin D 3 [25-(OH)VD 3], and bone mineral indicators such as serum calcium, phosphorus, and magnesium. The expression difference of the above indexes between the two groups was compared. Results:Compared with the control group, the serum PTH and 25-(OH)VD 3 levels in the low calcium acute brucellosis group were lower [(23.15 ± 9.78) vs (54.34 ± 15.31) pg/ml, (16.68 ± 5.48) vs (46.23 ± 16.79) ng/L, t = 4.96, 15.03, P < 0.001]; the serum calcium level was lower [(0.94 ± 0.14) vs (1.23 ± 0.23) mmol/L, t = 6.11, P < 0.001], while the serum phosphorus and magnesium levels were higher [(2.98 ± 0.68) vs (1.90 ± 0.25) mmol/L, (1.13 ± 0.21) vs (0.90 ± 0.48) mmol/L, t = 7.51, 7.70, P < 0.001]. Conclusion:Patients with acute brucellosis complicated by decreased serum calcium levels may experience abnormal bone salt metabolism hormones.

Background/Aims: There may be many predictors of anticoagulation-related gastrointestinal bleeding (GIB), but until now, systematic reviews and assessments of the certainty of the evidence have not been published. We conducted a systematic review to identify all risk factors for anticoagulant-associated GIB to inform risk prediction in the management of anticoagulation- related GIB. Methods: A systematic review and meta-analysis were conducted to search PubMed, EMBASE, Web of Science, and Cochrane Library databases (from inception through January 21, 2022) using the following search terms: anticoagulants, heparin, warfarin, dabigatran, rivaroxaban, apixaban, DOACs, gastrointestinal hemorrhage, risk factors. According to inclusion and exclusion criteria, studies of risk factors for anticoagulation-related GIB were identified. Risk factors for anticoagulant-associated GIB were used as the outcome index of this review. Results: We included 34 studies in our analysis. For anticoagulant-associated GIB, moderate-certainty evidence showed a probable association with older age, kidney disease, concomitant use of aspirin, concomitant use of the antiplatelet agent, heart failure, myocardial infarction, hematochezia, renal failure, coronary artery disease, helicobacter pylori infection, social risk factors, alcohol use, smoking, anemia, history of sleep apnea, chronic obstructive pulmonary disease, international normalized ratio (INR), obesity et al. Some of these factors are not included in current GIB risk prediction models. such as anemia, co-administration of gemfibrozil, co-administration of verapamil or diltiazem, INR, heart failure, myocardial infarction, etc. Conclusions The study found that anemia, co-administration of gemfibrozil, co-administration of verapamil or diltiazem, INR, heart failure, myocardial infarction et al. were associated with anticoagulation-related GIB, and these factors were not in the existing prediction models. This study informs risk prediction for anticoagulant-associated GIB, it also informs guidelines for GIB prevention and future research.

Objective:To evaluate the bone salt metabolism levels of patients with acute brucellosis complicated by decreased serum calcium levels.Methods:Forty patients with acute brucellosis complicated by decreased serum calcium levels diagnosed by the Disease Prevention and Control Center of Donghe District, Baotou City from January to December 2021 were selected as the low calcium acute brucellosis group, and 30 local healthy people were selected as the control group. The fully automatic chemiluminescence immunoassay analyzer was used to determine the levels of regulatory hormone indicators such as serum parathyroid hormone (PTH), 25-hydroxyvitamin D 3 [25-(OH)VD 3], and bone mineral indicators such as serum calcium, phosphorus, and magnesium. The expression difference of the above indexes between the two groups was compared. Results:Compared with the control group, the serum PTH and 25-(OH)VD 3 levels in the low calcium acute brucellosis group were lower [(23.15 ± 9.78) vs (54.34 ± 15.31) pg/ml, (16.68 ± 5.48) vs (46.23 ± 16.79) ng/L, t = 4.96, 15.03, P < 0.001]; the serum calcium level was lower [(0.94 ± 0.14) vs (1.23 ± 0.23) mmol/L, t = 6.11, P < 0.001], while the serum phosphorus and magnesium levels were higher [(2.98 ± 0.68) vs (1.90 ± 0.25) mmol/L, (1.13 ± 0.21) vs (0.90 ± 0.48) mmol/L, t = 7.51, 7.70, P < 0.001]. Conclusion:Patients with acute brucellosis complicated by decreased serum calcium levels may experience abnormal bone salt metabolism hormones.

Objective:To understand the results of serum protein electrophoresis in patients with acute brucellosis, and to provide objective indicators for clinical diagnosis and treatment of acute brucellosis patients.Methods:Thirty acute brucellosis patients diagnosed by the Center for Disease Prevention and Control of Donghe District, Baotou City from January to June 2021 were selected as the case group, and 30 local healthy persons who took physical examination during the same period were selected as the control group. Blood samples were collected from the two groups of people, serum was separated and serum protein electrophoresis was performed. Independent sample t-tests were used to compare total protein concentrations, protein fractions (albumin, α1-globulin, α2-globulin, β-globulin and γ-globulin) and albumin/globulin (A/G) ratio. Results:The age of patients in the case group was (52.35 ± 6.74) years old, with 25 males and 5 females. The course of the disease ranged from 0.3 to 2.6 months, with an average of 1.78 months. The age of people in the control group was (52.74 ± 5.47) years old, with 25 males and 5 females. There were no statistically significant difference in age and sex distuibution between the two groups ( P > 0.05). The concentrations of total protein and α2-globulin fractions were not significantly different between the two groups ( t = 0.78, 2.04, P > 0.05, respectively). Compared with the control group, the differences in the percentage of albumin, α1-globulin, β-globulin, γ-globulin in total protein and A/G ratio were statistically significant ( t = 4.78, 4.76, 2.89, 2.20, 3.65, P < 0.05). Conclusions:The percentage of serum albumin in total protein and A/G ratio decrease in patients with acute brucellosis, while the percentage of α1-globulin, β-globulin and γ-globulin in total protein increase. The percentage of albumin, α1-globulin, β-globulin, γ-globulin in total protein and A/G ratio can be uesed as objective indicators for clinical treatment of acute brucellosis.