Objective:To examine frailty in residents aged over 50 in the Chengdu community, investigate the risk factors linked to frailty, and analyze the impact of exercise habits on frailty.Methods:This retrospective study utilized a stratified whole-sample method to select Chengdu residents aged over 50 from 6 communities.Relevant information was collected through face-to-face interactions using a self-developed frailty questionnaire between May 2022 and May 2023.Exercise habits were defined as engaging in physical activity more than three times a week for at least 30 minutes per session, consistently maintained for a minimum of five years prior to the survey.The frailty index(FI)was established based on the multiple-deficit cumulative model.Respondents were classified into categories of no frailty(FI<0.1), mild frailty(0.1 ≤ FI<0.2), and moderate-severe frailty(FI≥0.2).Univariate and multivariate logistic regression analyses were conducted to investigate the factors influencing frailty and to compare the prevalence and progression of frailty among individuals with and without exercise habits across different age groups.Results:A total of 999 participants, comprising 483(48.3%)males and 516(51.7%)females, were enrolled in the study.The average age of the participants was 65.70±9.61 years.Among them, 346(34.6%)were classified as having mild frailty, while 107(10.7%)had moderate-severe frailty.Univariate analysis revealed that age, gender, marital status, education, smoking, alcohol consumption, and exercise habits were potential factors influencing frailty( P<0.05).Multifactorial logistic regression models indicated that individuals aged 70-79 and 80-85 were predictors of mild and moderate-severe frailty, respectively.Being female was identified as an independent risk factor for both mild frailty( OR: 1.196; 95% CI: 1.262-3.073)and moderate-severe frailty( OR: 2.721; 95% CI: 1.282-5.774).Additionally, not engaging in regular exercise was associated with an increased risk of mild frailty( OR: 1.588; 95% CI: 1.149-2.193)and moderate-severe frailty( OR: 3.186; 95% CI: 1.819-5.583).Statistical analysis revealed significant differences in frailty distribution and frailty index changes between individuals with and without exercise habits over the age of 60( P<0.05). Conclusions:Age and gender were found to be closely associated with frailty, with the impact of exercise habits on frailty becoming more pronounced after the age of 60.Encouraging middle-aged and older individuals to adopt regular exercise routines can play a significant role in promoting healthy aging in China.

Background and Aims:Pancreatic cancer is one of the most aggressive malignancies of the digestive system and is associated with an inferior prognosis.In recent years,its incidence has shown a trend toward younger onset.Early-onset pancreatic cancer(EOPC),defined as pancreatic cancer diagnosed at≤50 years of age,has been increasing annually and may possess distinct biological and prognostic characteristics.Given the limited data from China,this study aimed to investigate the clinicopathological features and prognostic outcomes of EOPC patients.Methods:Clinical data of 113 patients with EOPC admitted to Xiangya Hospital,Central South University,from January 2017 to December 2023 were retrospectively analyzed.Variables included demographic characteristics,clinicopathological features,and survival information.Kaplan-Meier survival curves were plotted,and differences in survival between the surgical and non-surgical groups were compared.Results:The median age at diagnosis was 46(42-49)years,and males accounted for 65.49%of cases.Blood type A(40.71%)and type O(34.51%)were most common.The main presenting symptoms were abdominal pain(69.91%),weight loss(62.83%),jaundice(43.36%),and abdominal distension(36.28%).Imaging findings showed bile duct dilation in 32.74%,pancreatic duct dilation in 39.82%,vascular invasion in 59.29%,and distant metastasis in 52.21%of patients.Histopathology revealed that adenocarcinoma and ductal adenocarcinoma accounted for 93.81%of all cases,with predominantly moderate or poor differentiation(76.10%).Tumors were the most frequently located in the pancreatic head(65.42%).TNM staging showed lymph node metastasis in 77.88%and stage Ⅳ disease in 52.21%.Laboratory tests demonstrated markedly elevated CA19-9 levels.Kaplan-Meier analysis indicated a median overall survival of 18.6 months for the entire cohort,with significantly longer survival in the surgical group compared with the non-surgical group(29.4 months vs.13.8 months,P=0.001 5).Conclusion:EOPC predominantly affects males and tends to arise in the pancreatic head.It is often diagnosed at an advanced stage or with distant metastasis and is characterized by poor differentiation and strong invasiveness.Surgical resection markedly improves survival and remains the key to prolonged prognosis.Young individuals presenting with unexplained abdominal pain,weight loss,or jaundice should be carefully evaluated through imaging to enable early diagnosis and timely surgical intervention.Future multicenter,large-sample prospective studies are warranted to validate these findings further.

Background and Aims:Pancreatic cancer is one of the most aggressive malignancies of the digestive system and is associated with an inferior prognosis.In recent years,its incidence has shown a trend toward younger onset.Early-onset pancreatic cancer(EOPC),defined as pancreatic cancer diagnosed at≤50 years of age,has been increasing annually and may possess distinct biological and prognostic characteristics.Given the limited data from China,this study aimed to investigate the clinicopathological features and prognostic outcomes of EOPC patients.Methods:Clinical data of 113 patients with EOPC admitted to Xiangya Hospital,Central South University,from January 2017 to December 2023 were retrospectively analyzed.Variables included demographic characteristics,clinicopathological features,and survival information.Kaplan-Meier survival curves were plotted,and differences in survival between the surgical and non-surgical groups were compared.Results:The median age at diagnosis was 46(42-49)years,and males accounted for 65.49%of cases.Blood type A(40.71%)and type O(34.51%)were most common.The main presenting symptoms were abdominal pain(69.91%),weight loss(62.83%),jaundice(43.36%),and abdominal distension(36.28%).Imaging findings showed bile duct dilation in 32.74%,pancreatic duct dilation in 39.82%,vascular invasion in 59.29%,and distant metastasis in 52.21%of patients.Histopathology revealed that adenocarcinoma and ductal adenocarcinoma accounted for 93.81%of all cases,with predominantly moderate or poor differentiation(76.10%).Tumors were the most frequently located in the pancreatic head(65.42%).TNM staging showed lymph node metastasis in 77.88%and stage Ⅳ disease in 52.21%.Laboratory tests demonstrated markedly elevated CA19-9 levels.Kaplan-Meier analysis indicated a median overall survival of 18.6 months for the entire cohort,with significantly longer survival in the surgical group compared with the non-surgical group(29.4 months vs.13.8 months,P=0.001 5).Conclusion:EOPC predominantly affects males and tends to arise in the pancreatic head.It is often diagnosed at an advanced stage or with distant metastasis and is characterized by poor differentiation and strong invasiveness.Surgical resection markedly improves survival and remains the key to prolonged prognosis.Young individuals presenting with unexplained abdominal pain,weight loss,or jaundice should be carefully evaluated through imaging to enable early diagnosis and timely surgical intervention.Future multicenter,large-sample prospective studies are warranted to validate these findings further.

Objective:To examine frailty in residents aged over 50 in the Chengdu community, investigate the risk factors linked to frailty, and analyze the impact of exercise habits on frailty.Methods:This retrospective study utilized a stratified whole-sample method to select Chengdu residents aged over 50 from 6 communities.Relevant information was collected through face-to-face interactions using a self-developed frailty questionnaire between May 2022 and May 2023.Exercise habits were defined as engaging in physical activity more than three times a week for at least 30 minutes per session, consistently maintained for a minimum of five years prior to the survey.The frailty index(FI)was established based on the multiple-deficit cumulative model.Respondents were classified into categories of no frailty(FI<0.1), mild frailty(0.1 ≤ FI<0.2), and moderate-severe frailty(FI≥0.2).Univariate and multivariate logistic regression analyses were conducted to investigate the factors influencing frailty and to compare the prevalence and progression of frailty among individuals with and without exercise habits across different age groups.Results:A total of 999 participants, comprising 483(48.3%)males and 516(51.7%)females, were enrolled in the study.The average age of the participants was 65.70±9.61 years.Among them, 346(34.6%)were classified as having mild frailty, while 107(10.7%)had moderate-severe frailty.Univariate analysis revealed that age, gender, marital status, education, smoking, alcohol consumption, and exercise habits were potential factors influencing frailty( P<0.05).Multifactorial logistic regression models indicated that individuals aged 70-79 and 80-85 were predictors of mild and moderate-severe frailty, respectively.Being female was identified as an independent risk factor for both mild frailty( OR: 1.196; 95% CI: 1.262-3.073)and moderate-severe frailty( OR: 2.721; 95% CI: 1.282-5.774).Additionally, not engaging in regular exercise was associated with an increased risk of mild frailty( OR: 1.588; 95% CI: 1.149-2.193)and moderate-severe frailty( OR: 3.186; 95% CI: 1.819-5.583).Statistical analysis revealed significant differences in frailty distribution and frailty index changes between individuals with and without exercise habits over the age of 60( P<0.05). Conclusions:Age and gender were found to be closely associated with frailty, with the impact of exercise habits on frailty becoming more pronounced after the age of 60.Encouraging middle-aged and older individuals to adopt regular exercise routines can play a significant role in promoting healthy aging in China.

Objective:To explore the risk factors, clinical features and prognosis of traumatic cerebral infarction in patients with craniocerebral trauma.Methods:The clinical data and follow-up data of 48 patients with craniocerebral trauma and traumatic cerebral infarction (observation group) and 132 patients with craniocerebral trauma without traumatic cerebral infarction (control group) admitted to the Sanya Central Hospital from January 2021 to January 2023 were retrospectively reviewed. Statistically significant risk factors were screened out by univariate analysis and Logistic regression analysis.Results:The results of univariate analysis showed that there were no significant differences in age, sex, skull fracture, traumatic subarachnoid hemorrhage and multiple injuries between the two groups ( P>0.05). There were statistical differences in midline displacement, herniation, diffuse brain swelling, decompression of the deboned flap, hemorrhagic shock, and admission Rotterdam CT score >3( P<0.05). The results of multivariate Logistic regression analysis showed that cerebral herniation, diffuse brain swelling and hemorrhagic shock were risk factors for traumatic cerebral infarction ( P<0.05). The higher the Rotterdam CT score, the higher the incidence of traumatic cerebral infarction. In the observation group, 11 cases had good prognosis and 37 cases had poor prognosis, with an average Glasgow Prognostic Scale (GOS) of (2.45 ± 1.22) points. In the control group, 74 cases had good prognosis and 48 cases had poor prognosis, with an average GOS of (3.69 ± 1.10) points. The difference in prognosis between the two groups was statistically significant ( P<0.05). Conclusions:Cerebral herniation, diffuse cerebral swelling and hemorrhagic shock are risk factors for traumatic cerebral infarction in patients with craniocerebral trauma, and the prognosis of patients complicated by traumatic cerebral infarction is worse.

Objective:To investigate the clinicopathological, immunohistochemical and molecular genetic characteristics of TFE3-rearranged perivascular epithelioid cell tumor (PEComa).Methods:Eight cases of PEComa with TFE3 rearrangement diagnosed in the First Affiliated Hospital of Air Force Medical University from January 2014 to July 2022 were collected. Three were consultation cases and 5 were collected from our hospital; 7 cases were resection specimens and 1 case was a needle biopsy specimen. Routine histolopathological analysis, immunohistochemical staining, fluorescence in situ hybridization (FISH) and the next-generation sequencing were performed. Clinical data were collected and the prognosis was assessed.Results:The 8 patients consisted of 5 females and 3 males with a median age of 45 years (ranged from 25 to 65 years). The tumor location included 1 uterus, 1 liver, 1 urachus, 2 kidneys, 1 abdominal cavity, 1 colon, and 1 retroperitoneum (3 subsequent recurrences in the abdominal cavity, pelvis and ovary, and abdominal cavity, respectively). Morphologically, the tumor cells were uniform and epithelioid with translucent or eosinophilic cytoplasm. They were arranged in nests or sheets, most of which were separated by thin-walled blood vessels. There were no papillary structures, and no overt smooth muscle or fat components. Atypical features were seen in 3 cases, with bizarre nuclei and tumor giant cells. Large areas of necrosis were visible, and mitosis was common (up to 28/50 HPF). Melanin deposition was present in 3 cases. Immunohistochemical staining showed diffuse and strong positivity for TFE3 in 8/8 cases and for HMB45 in 6/8 cases; focal positivity for Cathepsin K and Melan-A in 6/8 cases and for SMA in 2/8 of cases. All cases were negative for CKpan, PAX8 and Desmin. TFE3 gene break-apart was detected by FISH in all 8 cases, 4 of which underwent next-generation sequencing, and it revealed that 2 cases presented with SFPQ::TFE3 fusion, 1 case with ASPSCR1::TFE3 fusion, and 1 case with no chimeric fusion. Seven cases were followed up for 4—94 months. All cases were alive; 4 cases were disease-free, 2 cases showed recurrence, and 1 case had metastasis at initial diagnosis.Conclusions:TFE3-rearranged PEComa has unique histomorphological, immunohistochemical and molecular characteristics. The biological behavior is aggressive, which could lead to recurrence and metastasis, and warrants close clinical follow-up.

Humans ; Consensus ; Pancreatic Neoplasms/therapy* ; Neuroendocrine Tumors/therapy*

Objective:To investigate the clinicopathological features,immunophenotype,and prognosis of head and neck spindle cell squamous cell carcinoma(SCSCC)to improve the understanding and diagnosis of this tumor.Methods:Clinicopathological data collected from January 2012 to December 2022 at the First Affiliated Hospital,Air Force Military Medical University from 20 patients with head and neck SCSCC were retrospectively reviewed for histological morphology and immunophenotype.In situ and fluorescence in situ hybridization were performed to detect EBV-encoded ribonucleic acid(EBER)status and MDM2 gene amplification,respectively.Results:The median age among the 20 SCSCC cases was 67 years with a male-to-female ratio of 4∶1.Tumor locations were laryngeal(35.0%)and sinonasal(30.0%).SCSCC presented as polypoid or exogenous growths(61.5%),often with surface ulceration(90.0%).Histologically,sarcomatoid growth pat-terns were exhibited in 75.0%of the patients(n=15),while the remainder showed granular tissue-like or angiosarcomatoid patterns.Most tumors(65.0%)displayed components of conventional squamous cell carcinomas,with a predominant occurrence of high to moderate dif-ferentiation(91.7%).In terms of immunohistochemistry,AE1/AE3 was expressed in 83.3%(15/18)of cases,while p63 and p40 expression rates were 62.5%and 66.7%,respectively.All cases were negative for EBER.The Ki-67 proliferation index ranged 10%-70%.Overall,33.3%(1/3)of the cases showed MDM2 gene amplification.Among these,the median follow-up time for 18 patients was 18.3 months(range:1-92 months),with 6 survivors and 12 deaths.Conclusions:Head and neck SCSCC is more prevalent among elderly male smokers,predominantly exhibits a polypoid growth pattern,and does not display human papillomavirus or Epstein-Barr virus infection.Diagnosis requires a compre-hensive evaluation of clinical and pathological features and immunophenotype.Surgical resection is the primary treatment method.

Objective:To analyze the prevalence and genotypes of human pegivirus-1 (HPgV-1) among HIV-1-infected men who have sex with men (MSM) in Zhuhai, aiming to elucidate the impact of HPgV-1 on the progression of AIDS.Methods:This study collected 934 serum specimens positive for antibodies against HIV-1 for viral RNA extraction from MSM in Zhuhai from 2012 to 2020. HPgV-1 5′UTR was amplified by nested PCR and then E gene was amplified by nested PCR and sequenced in the 5′UTR-positive specimens. A phylogenetic tree was constructed to analyze genotype distribution. The influence of HPgV-1 infection on the progression of AIDS was evaluated through analyzing HIV-1 viral load and CD4 + cell counts in patients in the early stage of AIDS before antiviral treatment. Results:The positive rate of HPgV-1 in MSM with HIV-1 infection in Zhuhai was 31.05%. A total of 273 valid sequences were obtained after amplification. The main genotype of HPgV-1 was G3 (252, 92.31%), which was highly homologous to the epidemic strains in China and Japan in recent years, followed G2 (21, 7.69%), which was highly homologous to the epidemic strains in France and America. HPgV-1 strains of G1, G4, G5, G6 and G7 genotypes were not detected. There was no significant difference in HIV-1 virus load or CD4 + cell counts between patients with HIV-1 infection alone and those with HIV-1 and HPgV-1 (G3 or G2 genotype) co-infection. Conclusions:According to the data of this study, HPgV-1 infection could not delay the progression of AIDS in MSM in the early stage of AIDS before antiviral therapy. The widespread HPgV-1 of G3 genotype in China did not have a significant impact on the progression of AIDS. Therefore, a systematic in-depth research on various genotypes of HPgV-1 and further study on the pathogenic mechanism of HPgV-1, especially in patients with HPgV-1 and HIV co-infection, were needed to understanding the interaction mechanism between different genotypes of HPgV-1 and HIV-1.

Pancreatic cancer is malignant and has a poor prognosis.At present, the treatment mode has changed from "Surgery First" to systemic therapy under multi-disciplinary team, but surgical resection is still the only way to cure pancreatic cancer. In systemic treatment of pancreatic cancer, the effect of postoperative adjuvant therapy is significant, and preoperative neoadjuvant therapy has gradually attracted widespread attention. Neoadjuvant therapy can improve the rate of R0 resection in patients with pancreatic cancer.There is a consensus on neoadjuvant therapy for patients who with borderline resectable and locally advanced, but for the patients who with resectable remains controversial.