Objective:To construct and validate the risk prediction model of osteoporosis (OP) in the middle-aged and elderly healthy physical examination population.Methods:In this cross-sectional study, 18 030 middle-aged and elderly people with bone mineral density tested in Health Management Center of Guangxi Zhuang Autonomous Region Hospital from January 2020 to December 2022 were selected. The general data, physical examination index and biochemical blood index were collected. The subjects were divided into training set (12 621 cases) and validation set (5 409 cases) in a ratio of 7∶3 with the simple random sampling method. The variables were screened with minimum LASSO regression and logistic regression and the corresponding nomogram prediction model for the risk of osteoporosis in the middle-aged and elderly health examination population was established. The performance of the nomogram model was evaluated with the area under the receiver operating characteristic curve (ROC AUC), specificity, sensitivity, calibration curve (CAL), and decision curve (DCA).Results:The results of LASSO regression and multivariate logistic regression in training set showed that gender, age, body mass index, hip circumference, waist circumference, systolic blood pressure, total cholesterol, glutamyl transpeptidase and albumin/globulin ratio were the independent best predictors of OP risk in the middle-aged and elderly health examination population (all P<0.05). The ROC AUC-value of the training set was 0.895 (95% CI: 0.886-0.904), with a sensitivity of 87.25% and a specificity of 85.01%. The ROC AUC value of the validation set was 0.892 (95% CI: 0.886-0.898), with a sensitivity of 83.74% and a specificity of 82.46%. The CAL showed a C-index value of 0.790 in the training set and a C-index value of 0.784 in validation set. The CALs all showed deviation correction and obvious curves similar to the ideal line. DCA showed that when the OP risk threshold probability of the training set was 45%-93%, and the OP risk threshold probability of the validation set was 45%-92%, the nomogram model had better efficacy in predicting OP risk in the middle-aged and elderly physical examination population, and the two results were still relatively consistent. Both CAL and DCA showed good performance. Conclusion:This study establishes a practical prediction model for osteoporosis risk in the middle-aged and elderly population, it can provide an early warning for the timely detection of OP risk for the middle-aged and elderly people.

Objective:To construct and validate the risk prediction model of osteoporosis (OP) in the middle-aged and elderly healthy physical examination population.Methods:In this cross-sectional study, 18 030 middle-aged and elderly people with bone mineral density tested in Health Management Center of Guangxi Zhuang Autonomous Region Hospital from January 2020 to December 2022 were selected. The general data, physical examination index and biochemical blood index were collected. The subjects were divided into training set (12 621 cases) and validation set (5 409 cases) in a ratio of 7∶3 with the simple random sampling method. The variables were screened with minimum LASSO regression and logistic regression and the corresponding nomogram prediction model for the risk of osteoporosis in the middle-aged and elderly health examination population was established. The performance of the nomogram model was evaluated with the area under the receiver operating characteristic curve (ROC AUC), specificity, sensitivity, calibration curve (CAL), and decision curve (DCA).Results:The results of LASSO regression and multivariate logistic regression in training set showed that gender, age, body mass index, hip circumference, waist circumference, systolic blood pressure, total cholesterol, glutamyl transpeptidase and albumin/globulin ratio were the independent best predictors of OP risk in the middle-aged and elderly health examination population (all P<0.05). The ROC AUC-value of the training set was 0.895 (95% CI: 0.886-0.904), with a sensitivity of 87.25% and a specificity of 85.01%. The ROC AUC value of the validation set was 0.892 (95% CI: 0.886-0.898), with a sensitivity of 83.74% and a specificity of 82.46%. The CAL showed a C-index value of 0.790 in the training set and a C-index value of 0.784 in validation set. The CALs all showed deviation correction and obvious curves similar to the ideal line. DCA showed that when the OP risk threshold probability of the training set was 45%-93%, and the OP risk threshold probability of the validation set was 45%-92%, the nomogram model had better efficacy in predicting OP risk in the middle-aged and elderly physical examination population, and the two results were still relatively consistent. Both CAL and DCA showed good performance. Conclusion:This study establishes a practical prediction model for osteoporosis risk in the middle-aged and elderly population, it can provide an early warning for the timely detection of OP risk for the middle-aged and elderly people.

Objective To construct and apply a management plan for microaspiration of oropharyngeal secretions in ICU intubated patients.Methods Based on evidence summaries and expert consultation,a management plan for microaspiration of oropharyngeal secretions in ICU intubated patients was constructed,consisting of 19 items covering 7 aspects including identification of risk factors,position management,tube and cuff selection,cuff management,mechanical ventilation management,pain and sedation management,removal of oropharyngeal and subglottic secretions,and oral care.Convenience sampling was used to select 141 ICU intubated patients from a tertiary A comprehensive hospital in Suzhou from June,2022 to September,2023.Patients were divided into an experimental group(n=72)and a control group(n=69)according to the wards.The experimental group received the management plan for microaspiration of oropharyngeal secretions in ICU intubated patients.The control group received the nursing bundle for ventilator associated pneumonia(VAP).The incidence and time from intubation to microaspiration and VAP,duration of mechanical ventilation,ICU length of stay,and disease outcome were compared between the 2 groups.Results The incidence of microaspiration of oropharyngeal secretions,the duration of mechanical ventilation,time from intubation to microaspiration showed significant differences between the 2 groups(P<0.05).There were no significant differences in the incidence of ventilator associated pneumonia,ICU length of stay,and disease outcome between the 2 groups(P>0.05).The time from intubation to VAP in the experimental group was 7.5 days,and that in the control group was 3.8 days.Conclusion The application of the management plan for microaspiration of orophaiyngeal secretions in ICU intubated patients is beneficial for reducing the incidence of microaspiration,delaying the time from intubation to microaspiration and VAP,and shortening the duration of mechanical ventilation.

A 11-year old female patient with severe thalassemia, receipt a lentivirus-based cell and gene therapy (CGT) therapy in Shenzhen Children′s Hosptial on July 27th, 2021. At the two follow-up visits after discharge, patient were continuously tested positive for HIV screening through HIV Ag/Ab Combo assay (chemiluminescence Immunoassay), and the viral load results of HIV-1 nucleic acid testing (NAT) were both>5 000 copies/ml. The patient can be diagnosed with HIV infection according to the National Guideline for Detection of HIV/AIDS(2020 Revised Edition). The thorough investigation findings and supplementary experiment results indicated that the false-positive HIV-1 NAT results was caused by cross-reactivity between the target sites detected by conventional HIV-1 NAT reagents and the lentiviral vectors fragments integrated into the genome of patient′s hematopoietic stem/progenitor cells. In conclusion, it is important for laboratories to select appropriate HIV-1 NAT testing platforms which won′t cause cross-reactivity for the testing of samples from patients who have been treated with HIV-derived vectors. It is also recommended to design and develop NAT testing platforms with multiple target regions labeled by different fluorescents for HIV NAT supplementation experiment to reduce the risk of false-positive diagnoses of HIV infection.

  Objective  To study the demographic and clinical characteristics, correlation of genotype and phenotype and treatment of Blau syndrome to facilitate early diagnosis and timely treatment of Blau syndrome.  Methods  Seventy-two patients with Blau syndrome from 11 centers from May 2006 to April 2022 were retrospectively analyzed, and their general information, clinical data, laboratory examination and treatment medication were collected.  Results  The distribution of patients with Blau syndrome was uniform in geographical north and south of China, and there was no obvious gender bias. The mean age of onset was (14.30±12.81) months, and the age of diagnosis was (55.18±36.22) months. 35% of patients with Blau syndrome happened before 1 year old, and all patients developed before 5 years old. 87.50% (63/72) had granulomatous arthritis, 65.28% (47/72) had rash, 36.11% (26/72) had ocular involvement, 27.78% (20/72) had fever, and 15.28% (11/72) had pulmonary involvement. Arthritic manifestations of Blau syndrome were most at risk, followed by rash, ocular involvement, and fever.The first 25 months of the disease, the risk of developing a rash was the greatest. The risk of developing arthritis was the greatest between 25 months and 84 months. The main mutations were p.R334Q and p.R334W, and patients with p.R334Q mutation had relatively high incidence of fever (35.71%[5/14] vs. 14.29%[1/7], P=0.43) and ocular involvement (42.86%[6/14]vs. 28.57%[2/7], P=0.51). There was a relatively high incidence of rash (85.71%[6/7] vs. 64.29%[9/14], P=0.59) in patients with the p.R334W mutation. Forty-five patients(62.50%)were treated with a combina-tion of glucocorticoid and methotrexate. Twenty-two patients were treated with tumor necrosis factor antagonist in addition to glucocorticoid and methotrexate.  Conclusions  The risk of different clinical manifestations of Blau syndrome from high to low was arthritis, followed by rash, ocular involvement and fever. The main treatment was glucocorticoid combined with methotrexate, to which biological agents could be added.

Objective     To explore the role of versican (VCAN) in ESCC prognosis based on bioinformatics data. Methods    First, three RNA microarray datasets of ESCC were downloaded from GEO database, which were then integrated and used to explore differentially expressed genes (DEGs). The subsequent analysis was conducted based on the results of these DEGs: (1) The STRING database was used to construct a protein-protein interaction (PPI) network;(2) molecular complex detection software was used to analyze the modules of the PPI network, of which the most significant modules were chosen, and hub genes were the genes included in the chosen modules; (3) high-throughput RNA sequencing data from TCGA and GTEx databases were used to verify the expression of these hub genes to confirm whether they were differentially expressed; (4) the survival curve analysis of confirmed DEGs was conducted to select genes that had significant influence on the survival of ESCC; (5) TIMER database was used to analyze the relationship between the gene expression of VCAN and the abundance of tumor-infiltrating immune cells (TIICs) and gene markers in these cells; (6) Targetscan and miRDB software were used to predict the miRNAs that could regulate VCAN, and Cytoscape software was used to construct the regulatory network. Results    A total of 630 DEGs and 32 hub genes were found, of which VCAN was an up-regulated DEG, and high expression of VCAN was significantly associated with poor prognosis of ESCC. Moreover, VCAN could also play a role in the immune microenvironment of ESCC, which was mainly manifested by a significant positive correlation between the abundance of VCAN and the abundance of M2 macrophages gene markers, some of which had been reported to be associated with poor prognosis of ESCC. Finally, we also found that VCAN could be regulated by 15 miRNAs in ESCC, some of which had been reported to be associated with ESCC prognosis. Conclusion    This study provides direct and indirect comprehensive evidence for the role of VCAN in ESCC prognosis. The direct evidence is that the survival curve shows that highly expressed VCAN is significantly associated with the poor prognosis of ESCC, and the indirect evidence is that VCAN is positively related to some markers which indicate poor prognosis in the ESCC immune microenvironment, and VCAN can be regulated by some prognostic miRNAs in ESCC.

Objective:To evaluate the effect of propofol on dopaminergic neurons of mice with Parkinson′s disease (PD).Methods:Forty-eight pathogen-free healthy male C57BL/6 mice, aged 8-12 weeks, weighing 22-32 g, were divided into 3 groups ( n=16 each) using a random number table method: control group (group C), group PD and propofol group (group Pro). The neurotoxin 1-methyl-4-phenyl-1, 2, 3, 6-tetrahydropypridine (MPTP) was intraperitoneally injected for 7 consecutive days in PD and Pro groups, while the equal volume of normal saline was given for 7 consecutive days in group C. At 30 min after intraperitoneal injection of MPTP, propofol 25 mg/kg was intraperitoneally injected in group Pro, while the equal volume of normal saline was given daily in group C and group PD.At day 8 after the end of establishment of the model, gait analysis system experiment and rotarod test were used to record the step distance and retention time.The animals were sacrificed after the behavioral tests, and the brain tissues were removed for the dopamine neuron count in substantia nigra (by immunohistochemistry) and for determination of the expression of alpha-Synuclein (α-Syn) and Tyrosine hydroxylase (TH) in the substantia nigra (by Western blot). Results:Compared with group C, the step distance was significantly decreased, retention time were shortened, the dopamine neuron count in substantia nigra was decreased, the expression of TH was down-regulated, and expression of α-Syn in substantia nigra was up-regulated in group PD ( P<0.05), and no significant change was found in the parameters mentioned above in group Pro ( P>0.05). Compared with group PD, the step distance was significantly increased, retention time were prolonged, the dopamine neuron count in substantia nigra was increased, the expression of TH was up-regulated, and expression of α-Syn in substantia nigra was down-regulated in group Pro ( P<0.05). Conclusion:Propofol has protective effect on dopaminergic neurons of PD mice, and the mechanism may be related to the down-regulation of α-Syn expression in substantia nigra.

Objective:To investigate the changes of mean venous sinus pressure (MVP) and trans-stenosis pressure gradient in patients with idiopathic intracranial hypertension (IIH) under awake setting and general anesthesia.Methods:Thirty-eight patients with IIH accepted venous sinus stent implantation in our hospital from January 2010 to January 2020 were chosen in our study; their clinical data were analyzed retrospectively. The manometry results of these 38 patients were recorded under awake setting and general anesthesia before stenting; MVP and trans-stenosis pressure gradient were obtained and compared.Results:MVP in the superior sagittal sinus, torcular, transverse sinus and sigmoid sinus showed no significant difference between patients under awake setting and general anesthesia ( P>0.05). Mean trans-stenosis pressure gradient in patients under awake setting ([22.784±7.606] mmHg) was significantly higher as compared with that in patients under general anesthesia ([18.388±8.992] mmHg, P<0.05). Conclusion:Mean trans-stenosis pressure gradient in patients under awake setting is higher as compared with that in patients under general anesthesia, and selection for venous sinus stent implantation should be decided by trans-stenosis pressure gradient in patients under awake setting.

Objective:This study aimed to examine the prevalence of comorbid generalized anxiety disorder (GAD) among adult patients with major depressive disorder (MDD) in China and explore its potential risk factors.Methods:This is a multicenter, cross-sectional study, involving 1 086 patients in 9 clinical settings. The diagnosis of MDD and GAD were confirmed by the MINI. Life events were evaluated by the Life Events Scale (LES), and early life stress was assessed by the Childhood Trauma Questionnaire (CTQ). The severity of depression, social support, coping style and personality traits were assessed by Hamilton Depression Rating Scale-17 item (HAMD 17), Simplified Coping Style Questionnaire (SCSQ), and Eysenck Personality Questionnaire, short scale for China (EPQ-RSC), respectively. Pearson correlation analysis, univariate regression analysis and Logistic regression analysis were used to explore the association of clinical characteristics, life stress, social factors and comorbidity of MDD and GAD. Results:Among 1 086 MDD patients, 276 of them (25.4%) were diagnosed with comorbid GAD. Patients with comorbid GAD were more likely to report adulthood adversity then those without (60.2% （165/276） vs. 39.9%（321/810）, χ2=33.993， P<0.01). However, there was no difference in social support and coping styles between the two groups. Furthermore, patients with comorbid GAD had higher levels of neuroticism, and lower levels of extraversion. After controlling for confounders, logistic regression results showed that adulthood adversity ( OR=1.720, 95% CI 1.262-2.343, P<0.01) and higher neuroticism levels (O R=1.211, 95% CI 1.141-1.286, P<0.01) were significantly associated with comorbid GAD in patients with MDD. Conclusion:Adulthood adversity and high levels of neuroticism were potential risk factors of comorbidity of MDD and GAD. This finding provides empirical evidence for developing targeted interventions for this subgroup population with MDD.

Objective:This study aimed to examine the prevalence of comorbid generalized anxiety disorder (GAD) among adult patients with major depressive disorder (MDD) in China and explore its potential risk factors.Methods:This is a multicenter, cross-sectional study, involving 1 086 patients in 9 clinical settings. The diagnosis of MDD and GAD were confirmed by the MINI. Life events were evaluated by the Life Events Scale (LES), and early life stress was assessed by the Childhood Trauma Questionnaire (CTQ). The severity of depression, social support, coping style and personality traits were assessed by Hamilton Depression Rating Scale-17 item (HAMD 17), Simplified Coping Style Questionnaire (SCSQ), and Eysenck Personality Questionnaire, short scale for China (EPQ-RSC), respectively. Pearson correlation analysis, univariate regression analysis and Logistic regression analysis were used to explore the association of clinical characteristics, life stress, social factors and comorbidity of MDD and GAD. Results:Among 1 086 MDD patients, 276 of them (25.4%) were diagnosed with comorbid GAD. Patients with comorbid GAD were more likely to report adulthood adversity then those without (60.2% （165/276） vs. 39.9%（321/810）, χ2=33.993， P<0.01). However, there was no difference in social support and coping styles between the two groups. Furthermore, patients with comorbid GAD had higher levels of neuroticism, and lower levels of extraversion. After controlling for confounders, logistic regression results showed that adulthood adversity ( OR=1.720, 95% CI 1.262-2.343, P<0.01) and higher neuroticism levels (O R=1.211, 95% CI 1.141-1.286, P<0.01) were significantly associated with comorbid GAD in patients with MDD. Conclusion:Adulthood adversity and high levels of neuroticism were potential risk factors of comorbidity of MDD and GAD. This finding provides empirical evidence for developing targeted interventions for this subgroup population with MDD.