BACKGROUND: While emotional distress, encompassing anxiety and depression, has been associated with negative clinical outcomes, its impact across various clinical departments and general hospitals has been less explored. Previous studies with limited sample sizes have examined the effectiveness of specific treatments (e.g., antidepressants) rather than a systemic management strategy for outcome improvement in non-psychiatric inpatients. To enhance the understanding of the importance of addressing mental health care needs among non-psychiatric patients in general hospitals, this study retrospectively investigated the impacts of emotional distress and the effects of early detection and management of depression and anxiety on hospital length of stay (LOS) and rate of long LOS (LLOS, i.e., LOS >30 days) in a large sample of non-psychiatric inpatients. METHODS: This retrospective cohort study included 487,871 inpatients from 20 non-psychiatric departments of a general hospital. They were divided, according to whether they underwent a novel strategy to manage emotional distress which deployed the Huaxi Emotional Distress Index (HEI) for brief screening with grading psychological services (BS-GPS), into BS-GPS ( n = 178,883) and non-BS-GPS ( n = 308,988) cohorts. The LOS and rate of LLOS between the BS-GPS and non-BS-GPS cohorts and between subcohorts with and without clinically significant anxiety and/or depression (CSAD, i.e., HEI score ≥11 on admission to the hospital) in the BS-GPS cohort were compared using univariable analyses, multilevel analyses, and/or propensity score-matched analyses, respectively. RESULTS: The detection rate of CSAD in the BS-GPS cohort varied from 2.64% (95% confidence interval [CI]: 2.49%-2.81%) to 20.50% (95% CI: 19.43%-21.62%) across the 20 departments, with a average rate of 5.36%. Significant differences were observed in both the LOS and LLOS rates between the subcohorts with CSAD (12.7 days, 535/9590) and without CSAD (9.5 days, 3800/169,293) and between the BS-GPS (9.6 days, 4335/178,883) and non-BS-GPS (10.8 days, 11,483/308,988) cohorts. These differences remained significant after controlling for confounders using propensity score-matched comparisons. A multilevel analysis indicated that BS-GPS was negatively associated with both LOS and LLOS after controlling for sociodemographics and the departments of patient discharge and remained negatively associated with LLOS after controlling additionally for the year of patient discharge. CONCLUSION Emotional distress significantly prolonged the LOS and increased the LLOS of non-psychiatric inpatients across most departments and general hospitals. These impacts were moderated by the implementation of BS-GPS. Thus, BS-GPS has the potential as an effective, resource-saving strategy for enhancing mental health care and optimizing medical resources in general hospitals.
Humans ; Retrospective Studies ; Male ; Length of Stay/statistics & numerical data* ; Female ; Middle Aged ; Adult ; Psychological Distress ; Inpatients/psychology* ; Aged ; Anxiety/diagnosis* ; Depression/diagnosis*

BACKGROUND: Recent studies have provided compelling evidence that exposure to brominated flame retardants (BFRs) can adversely affect human health. We aim to explore the potential impact of BFRs on adiposity and central obesity. METHODS: Data from the National Health and Nutrition Examination Surveys (NHANES) cycles conducted between 2009 and 2014 was used to study the connections between variables. After filtering, we analyzed a sample of 4,110 adults aged 20 years and above. Our goal was to examine the potential association between BFRs and consequences and investigate the part played by oxidative stress and inflammatory markers as intermediaries. To achieve this, we used advanced statistical methods such as weighted quantile sum (WQS) regression, quantile-based g-computation (QGC), and the Bayesian kernel machine regression (BKMR). RESULTS: The findings showed that among the examined chemicals, exposure to PBDE85 (weight: 41%), PBDE100 (24%), and PBB153 (23%) may be the dominant contributors to general obesity risk. Upon controlling for all variables that could impact the results, it was found that the QGC outcomes indicated a positive correlation between exposure to mixtures of brominated flame retardants and the occurrence of abdominal obesity (OR = 1.187, 95% CI: 1.056-1.334, p = 0.004). Significant contributions were made by PBDE85 (52%), PBB153 (27%), and PBDE100 (21%). Mediation analysis shows that lymphatic cells (LC) and albumin (ALB) partially mediate the link between brominated flame retardants and obesity. The results of BKMR are generally consistent with those of WQS and QGC. CONCLUSION At a population level, our research has revealed a noteworthy correlation between BFRs and obesity. However, further investigation is required through prospective cohort studies and in-depth mechanistic exploratory studies.
Humans ; Flame Retardants/adverse effects* ; Oxidative Stress/drug effects* ; Adult ; Male ; Female ; Middle Aged ; Inflammation/epidemiology* ; Obesity/chemically induced* ; Biomarkers/blood* ; Nutrition Surveys ; Mediation Analysis ; Young Adult ; United States/epidemiology* ; Environmental Exposure/adverse effects* ; Aged ; Environmental Pollutants/adverse effects* ; Halogenated Diphenyl Ethers/adverse effects*

OBJECTIVE To analyze the dynamic changes of inhalant allergen sensitization profiles in patients with allergic rhinitis,asthma and allergic rhinitis combined with asthma in the Beijing area.METHODS A retrospective study was conducted on patients with allergic rhinitis,asthma,and allergic rhinitis combined with asthma who visited the Allergy Department of Beijing Shijitan Hospital from January 2021 to December 2024.All patients underwent skin prick tests for 27 inhalant allergens.RESULTS A total of 28 454 patients were included.The overall positive rate of SPT was 74.21%,with the highest positive rate in the 10-14 age group(84.09%).Spring pollen and summer-autumn pollen were the main allergens,with higher positive rates than dust mites and molds(P<0.05).Juniperus chinensis was the main sensitization in patients with allergic rhinitis,while in patients with allergic rhinitis combined with asthma,sensitization to weeds such as Chenopodium album,Humulus scandens,and Artemisia sieversiana were more common.In recent years,the positive rates of sensitization to spring pollen,summer-autumn pollen,and molds all showed an upward trend(P<0.05),with the most significant increase in molds.CONCLUSION In the Beijing area,pollen,dust mites and mold are the main allergens in spring and autumn.In recent years,the sensitization rates of Juniperus chinensis and Artemisia sieversiana pollen have decreased,but the positive rate of mold sensitization has been on the rise,which still needs to be taken seriously.

Gastric cancer with peritoneal metastasis (GCPM) is a common and lethal manifestation of advanced gastric cancer, with a median survival of only 5-11 months. This consensus was developed by 30 experts from Asia (China, Japan, Korea, and Singapore) using the Delphi method and the GRADE evidence grading system. A total of 29 statements were formulated, covering the diagnosis and assessment of GCPM, indications for laparoscopic exploration and NIPS (normothermic intraperitoneal and systemic treatment), treatment regimens, prevention and management of complications, criteria for conversion surgery, and postoperative intraperitoneal therapy. The consensus aims to standardize clinical practice and improve the prognosis of patients with GCPM.

Recent years have witnessed significant advancements in the perioperative trea-tment of locally advanced gastric cancer (LAGC), yet numerous challenges persist. Current research focuses primarily on the precise application of immunotherapy, breakthroughs in targeted therapy, optimization of multidisciplinary comprehensive treatment models, and the selection of postopera-tive adjuvant therapy regimens. Although immunotherapy has achieved remarkable progress in the treatment of advanced gastric cancer, its application in the perioperative setting remains controver-sial, particularly regarding its long-term survival benefits. In terms of targeted therapy, the applica-tion of drugs targeting human epidermal growth factor receptor-2 and Claudin 18.2 in the periopera-tive setting for LAGC still requires further validation. Additionally, the optimization of multidisci-plinary comprehensive treatment models, such as the long-term survival benefits of neoadjuvant chemoradiotherapy combined with perioperative chemotherapy, remains unclear. There are also many disputes surrounding the selection of postoperative adjuvant therapy regimens and surgical strategies following neoadjuvant treatment, including the extent of lymph node dissection. Addres-sing these issues will help further optimize the perioperative treatment strategies for LAGC, thereby improving patient survival rates and quality of life. Therefore, the authors explore in depth the key issues and relevant strategies for perioperative treatment of LAGC.

Nucleic acid aptamers are short oligonucleotide sequences that can specifically bind to target substances with affinity comparable to or even better than protein antibodies.Due to their advantages of low cost,ease of modification,and low immunogenicity,aptamers have shown great potential in early cancer screening,diagnosis and targeted therapy.This paper systematically re-views the latest research progress on nucleic acid aptamers in immunotherapy,gene therapy,and drug delivery,discusses the current status and technical challenges of aptamers in cancer therapy and outlines future research directions.

Nucleic acid aptamers are short oligonucleotide sequences that can specifically bind to target substances with affinity comparable to or even better than protein antibodies.Due to their advantages of low cost,ease of modification,and low immunogenicity,aptamers have shown great potential in early cancer screening,diagnosis and targeted therapy.This paper systematically re-views the latest research progress on nucleic acid aptamers in immunotherapy,gene therapy,and drug delivery,discusses the current status and technical challenges of aptamers in cancer therapy and outlines future research directions.

Recent years have witnessed significant advancements in the perioperative trea-tment of locally advanced gastric cancer (LAGC), yet numerous challenges persist. Current research focuses primarily on the precise application of immunotherapy, breakthroughs in targeted therapy, optimization of multidisciplinary comprehensive treatment models, and the selection of postopera-tive adjuvant therapy regimens. Although immunotherapy has achieved remarkable progress in the treatment of advanced gastric cancer, its application in the perioperative setting remains controver-sial, particularly regarding its long-term survival benefits. In terms of targeted therapy, the applica-tion of drugs targeting human epidermal growth factor receptor-2 and Claudin 18.2 in the periopera-tive setting for LAGC still requires further validation. Additionally, the optimization of multidisci-plinary comprehensive treatment models, such as the long-term survival benefits of neoadjuvant chemoradiotherapy combined with perioperative chemotherapy, remains unclear. There are also many disputes surrounding the selection of postoperative adjuvant therapy regimens and surgical strategies following neoadjuvant treatment, including the extent of lymph node dissection. Addres-sing these issues will help further optimize the perioperative treatment strategies for LAGC, thereby improving patient survival rates and quality of life. Therefore, the authors explore in depth the key issues and relevant strategies for perioperative treatment of LAGC.

Objective To explore the effects of different phenotypes macrophages(Mφs)on the proliferation,mi-gration and osteogenic differentiation of periodontal ligament stem cells(PDLSCs).Methods PDLSCs were isola-ted and cultured by tissue block method.Tohoku Hospital Pediatrics-1(THP-1)cell line was stimulated to activate into unpolarized Mφs(M0),then induced to polarize into type Ⅰ Mφs(M1)and type Ⅱ Mφs(M2).Quantitative real-time PCR(qPCR)detected the inflammatory factors tumor necrosis factor α(TNF-α),interleukin(IL)-1 β,IL-6,IL-10 and transforming growth factor-β(TGF-β)mRNA expression level.After collecting culture superna-tants with different phenotypes,PDLSCs were stimulated,native control(NC)group did not receive the culture su-pernatant of Mφs.The effects of PDLSCs proliferation were assessed via Methylthiazolyldiphenyl-tetrazolium bro-mide(MTT)assay,while scratch assays were employed to evaluate their migration.Western blot was utilized to analyze the protein expression of Runt-related transcription factor 2(RUNX2)and alkaline phosphatase(ALP).Additionally,Alizarin Red staining was performed to investigate the deposition of calcified nodules in PDLSCs.Re-sults qPCR showed the relative expression of TNF-α,IL-1 β and IL-6 in M1 Mφs were higher than those in M0 and M2 Mφs(P＜0.05),and the relative expression of IL-10 and TGF-β in M2 Mφs were higher than those in M0 and M1 Mφs(P＜0.05);Western blot showed the expression of RUNX2 and ALP proteins in PDLSCs in M0 and M2 groups was higher than those in the NC group(P＜0.05),Alizarin Red staining showed increased calcified nodule deposition in PDLSCs in M0,M1 and M2 groups compared to the NC group;MTT assay showed the prolifer-ation of PDLSCs in the M0 and M1 groups was suppressed compared to the NC group(P＜0.05);and scratch ex-periment showed the migratory capacity of PDLSCs in the M1 and M2 groups was stronger than that in the NC group.Conclusion M0 and M1 Mφs inhibit PDLSCs proliferation,M1 and M2 Mφs promote PDLSCs migration,and all types of Mφs promote osteogenic differentiation of PDLSCs.

Objective:To analyze epidemiology of gastric cancer five-year survival distribution in Zhejiang population-based cancer registration.Methods:The follow-up data of registrated gastric cancer cases diagnosed from 2008 to 2019 in 22 national cancer registry areas of Zhejiang Province were collected and divided into three diagnostic periods: 2008-2011, 2012-2015 and 2016-2019 to calculate five-year observed survival rates (OSRs), five-year relative survival rates (RSRs) and five-year age-standardized relative survival rates (ARSRs). The distribution of population characteristics (including gender, urban/rural, age group and occupation) and clinical characteristics (including the highest diagnostic institution, sub-site, pathological type and degree of differentiation) of gastric cancer survival rates in each period were analysed.Results:51 663 new cases of gastric cancer in 2008-2019 in the cancer registration area of Zhejiang Province were included in the analysis, and the ARSR of gastric cancer in 2008-2011, 2012-2015 and 2016-2019 showed an increasing trend (39.2%, 41.3% and 44.7%, respectively). In 2016-2019, the ARSR was similar across gender and urban and rural areas (44.4% for men and 45.7% for women; 44.9% in urban areas and 44.2% in rural areas); Among people with different occupations, the ARSR was highest among business and service workers (55.3%), the agriculture, forestry, animal husbandry and fisheries, water conservancy production workers and domestic workers were lower (41.5% and 43.2%, respectively). The highest diagnostic institution was the provincial hospital with a higher gastric cancer survival rate (47.0%) than the municipal (43.4%) and district (43.6%) levels. The ARSR for gastric cancer was relatively high in the lesser curvature (59.7%), pylorus (50.4%), antrum (49.3%), and greater curvature (48.7%), and lowest in cardia (38.9%). Among the major pathological types, adenocarcinoma (NOS) had an ARSR of 48.1%, mucinous adenocarcinoma 41.3%, imprinted cell carcinoma 39.4%, and squamous carcinoma 33.4%. The ARSR for highly differentiated, moderately differentiated, poorly differentiated and undifferentiated gastric cancers were 80.6%, 57.9%, 43.2% and 36.8%, respectively.Conclusion:The 5-year survival rate of gastric cancer in Zhejiang Province is high and on the rise, with similar survival rates in different genders, urban and rural areas, and significant differences in the survival rates of gastric cancer patients with different occupational groups, highest diagnostic institutions, tumour sub-sites, pathological types and differentiation degrees.