Background::Copper and zinc are involved in the development of multiple malignancies; yet, epidemiological evidence on hepatocellular carcinoma (HCC) is limited. This study aimed to investigate the association between dietary intake and serum levels of copper and zinc with the risk of HCC.Methods::A total of 434 case-control pairs matched for sex and age (±1 year) were included in this study. Cases with newly diagnosed HCC were from the Guangdong Liver Cancer Cohort (GLCC) study, and healthy controls were from the Guangzhou Nutrition and Health Study (GNHS). A semi-quantitative 79-item food frequency questionnaire (FFQ) was used to assess habitual dietary intakes of copper and zinc. Serum levels of copper and zinc were measured by using inductively coupled plasma mass spectrometry. The copper (Cu)/ zinc (Zn) ratio was computed by dividing copper levels by zinc levels. Conditional logistic regression models were performed to calculate the odds ratio (OR) and 95% confidence intervals (CI) for per 1 standard deviation increase (per-SD increase) in copper and zinc levels.Results::Higher dietary intake (OR per-SD increase = 0.65, 95% CI: 0.44, 0.96, Ptrend = 0.029) and serum levels of zinc (OR per-SD increase = 0.11, 95% CI: 0.04, 0.30, Ptrend <0.001) were both associated with a lower risk of HCC. Subgroup analyses showed that the inverse association was only pronounced in men but not in women ( Pinteraction = 0.041 for dietary zinc intake and 0.010 for serum zinc levels). Serum copper levels (OR per-SD increase = 2.05, 95% CI: 1.39, 3.03, Ptrend = 0.020) and serum Cu/Zn ratio (OR per-SD increase = 6.53, 95% CI: 2.52, 16.92, Ptrend <0.001) were positively associated with HCC risk, while dietary copper intake and dietary Cu/Zn ratio were not associated with HCC risk. Conclusion::Zinc may be a protective factor for HCC, especially among men, but the effects of copper on HCC risk are not clear.

Objective:To investigate the influential factors of neonatal hypoxic ischemic encephalopathy (HIE), and compare the therapeutic effects of mild hypothermia at different time windows and between different degrees of disease severity.Methods:Eighty-two neonates with HIE who were admitted to Jiaxing Maternity and Child Health Care Hospital from January 2016 to October 2021 were included in the patient group, and 123 concurrent healthy neonates were included in the control group. The influential factors of neonatal HIE were analyzed. Sixty-five neonates who received HIE were divided into four groups according to the time length between symptom onset and hospital admission (< 6 hours and 6-12 hours) and disease severity: group I (admission time < 6 hours, mild, n = 20), group II (admission time < 6 hours, moderate to severe, n = 15), group III (admission time 6-12 hours, mild, n = 17), and group IV (admission time 6-12 hours, moderate to severe, n = 13). Amplitude-integrated electroencephalography (aGGE) score was used as the evaluation criteria. The therapeutic effects of mild hypothermia were compared between different time windows and between different degrees of HIE. Results:Multivariable logistic regression analysis results revealed that the influential factors of neonatal HIE included gestational hypertension, gestational diabetes, pregnancy examination, delivery methods, amniotic fluid contamination, abnormal fetal membranes (placenta or umbilical cord), fetal distress, and neonatal asphyxia ( P < 0.05). All 65 neonates with HIE underwent mild hypothermia treatment for 72 hours. Before treatment, aGGE score in groups I, II, III and IV was 6.02 ± 1.74 points, 2.43 ± 1.82 points, 5.23 ± 1.95 points, and 2.72 ± 1.76 points, respectively. After treatment, it was 8.13 ± 2.03 points, 6.47 ± 1.87 points, 7.86 ± 1.92 points, and 3.52 ± 1.95 points, respectively. There was significant difference in aGGE score between before and after treatment in groups I, II and III ( t = 2.87, 3.55, 3.15, all P < 0.05). aGGE score in group IV did not differ significantly between before and after treatment ( P > 0.05). Before treatment, aGGE score in children with moderate to severe HIE was lower than that in children with mild HIE. After treatment, there was no significant difference in aGGE score between groups II and III ( P > 0.05). Conclusion:Pregnant women with gestational hypertension and gestational diabetes should be given intensive monitoring and learn HIE related knowledge to increase the frequency of prenatal examinations. If amniotic fluid contamination, abnormal fetal membranes (placenta or umbilical cord), fetal distress, or neonatal asphyxia occurs, timely monitoring and corresponding interventions should be given to the fetus. Mild hypothermia therapy has a certain therapeutic effect on different degrees of HIE. For moderate to severe neonates, treatment should be started within 6 hours to ensure the therapeutic effects of mild hypothermia.

Lung cancer is the most common cancer and the leading cause of cancer-related death in China. Early screening of lung cancer proves to be effective in improving its prognosis. The National Comprehensive Cancer Network (NCCN) has updated and released version 2, 2022 NCCN clinical practice guidelines for lung cancer screening in July, 2022. Based on high-quality clinical evidence and the latest research progress, the guidelines have developed and updated criteria for lung cancer screening which have been widely recognized by clinicians around the world. Compared with Chinese lung cancer screening guidelines, this article will interpret the updated content of the brand new 2022 NCCN screening guidelines, providing some reference for the current lung cancer screening practice in our country.

Objective: Although some studies have linked Asari Radix et Rhizoma (Asari Radix) administration to hepatocellular carcinoma (HCC), few studies have examined the association between the development of HCC and use of Asari Radix among patients in mainland China. This study aimed to evaluate the real-world association between Asari Radix and HCC in patients to strengthen the understanding of Asari Radix safety. Methods: A retrospective cohort study among hepatitis B virus (HBV)-monoinfected patients and non-HBV-monoinfected patients were performed. Patients over 18 years of age were eligible for inclusion. Prescription records of inpatients and outpatients were inquired to distinguish Asari Radix users and nonusers. The risk of developing HCC among Asari Radix users and nonusers in the HBV cohort and the non-HBV cohort was analyzed. Results: There were 49 500 HBV and 133 148 non-HBV patients involved in the two cohorts. Among HBV patients (2 901 users; 46 599 nonusers), the prevalence of HCC in Asari Radix users was lower than that in nonusers (145.70 vs. 265.43 per 10

Objective To explore the association between lipid profiles and left ventricular hypertrophy in a Chinese general population. Methods We conducted a retrospective observational study to investigate the relationship between lipid markers [including triglycerides, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein (HDL) cholesterol, non-HDL-cholesterol, apolipoprotein A-I, apolipoprotein B, lipoprotein[a], and composite lipid profiles] and left ventricular hypertrophy. A total of 309,400 participants of two populations (one from Beijing and another from nationwide) who underwent physical examinations at different health management centers between 2009 and 2018 in China were included in the cross-sectional study. 7,475 participants who had multiple physical examinations and initially did not have left ventricular hypertrophy constituted a longitudinal cohort to analyze the association between lipid markers and the new-onset of left ventricular hypertrophy. Left ventricular hypertrophy was measured by echocardiography and defined as an end-diastolic thickness of the interventricular septum or left ventricle posterior wall > 11 mm. The Logistic regression model was used in the cross-sectional study. Cox model and Cox model with restricted cubic splines were used in the longitudinal cohort. Results In the cross-sectional study, for participants in the highest tertile of each lipid marker compared to the respective lowest, triglycerides [odds ratio (OR): 1.250, 95％CI: 1.060 to 1.474], HDL-cholesterol (OR: 0.780, 95％CI: 0.662 to 0.918), and lipoprotein(a) (OR: 1.311, 95％CI: 1.115 to 1.541) had an association with left ventricular hypertrophy. In the longitudinal cohort, for participants in the highest tertile of each lipid marker at the baseline compared to the respective lowest, triglycerides [hazard ratio (HR): 3.277, 95％CI: 1.720 to 6.244], HDL-cholesterol (HR: 0.516, 95％CI: 0.283 to 0.940), non-HDL-cholesterol (HR: 2.309, 95％CI: 1.296 to 4.112), apolipoprotein B (HR: 2.244, 95％CI: 1.251 to 4.032) showed an association with new-onset left ventricular hypertrophy. In the Cox model with forward stepwise selection, triglycerides were the only lipid markers entered into the final model. Conclusion Lipids levels, especially triglycerides, are associated with left ventricular hypertrophy. Controlling triglycerides level potentiate to be a strategy in harnessing cardiac remodeling but deserve to be further investigated.

Since December 2019, a novel coronavirus (2019-nCoV, SARS-CoV-2) pneumonia (COVID-19) outbreak has occurred in Wuhan, Hubei Province, and the epidemic situation has continued to spread. Such cases have also been found in other parts of the country. The spread of the novel coronavirus pneumonia epidemic has brought great challenges to the clinical practice of thoracic surgery. Outpatient clinics need to strengthen the differential diagnosis of ground glass opacity and pulmonary plaque shadows. During the epidemic, surgical indications are strictly controlled, and selective surgery is postponed. Patients planning to undergo a limited period of surgery should be quarantined for 2 weeks and have a nucleic acid test when necessary before surgery. For patients who are planning to undergo emergency surgery, nucleic acid testing should be carried out before surgery, and three-level protection should be performed during surgery. Patients who are planning to undergo emergency surgery in the epidemic area should be confirmed with or without novel coronavirus pneumonia before operation, and perform nucleic acid test if necessary. Surgical disinfection and isolation measures should be strictly carried out. Among postoperative patients, cases with new coronavirus infection were actively investigated. For the rescue of patients with novel coronavirus infection, attention needs to be paid to prevention and treatment and related complications, including mechanical ventilation-related pneumothorax or mediastinal emphysema, and injury after tracheal intubation.

Objective To investigate the distribution characteristics and risk factors of intracranial and extracranial aterial lesions in Chinese patients with ischemic stroke . Methods In this multi‐center study ,2 310 continuously inpatients with ischemic stroke diagnosed in 20 stroke screening and prevention project base hospitals from June 2015 to M ay 2016 were enrolled . Carotid ultrasonography and transcranial color‐coded sonography or transcranial Doppler were performed in all patients to confirm the presence of cerebral artery stenosis or occlusion . According to the distribution of lesions ,the subjects were divided into 2 groups :the simple intracranial artery stenosis group and the simple extracranial artery stenosis group . T he difference of risk factors between the two groups was compared . Results Of the 2 310 patients with ischemic stroke ,1 516 ( 65 .6% ) had simple intracranial artery stenosis and 794 ( 34 .4% ) had simple extracranial artery stenosis . T he incidence of anterior circulation artery stenosis was higher in the group of intracranial artery stenosis than that in the extracranial artery stenosis group ( 68 .1% vs 48 .7% , P ＜0 .001) . Posterior circulation artery stenosis and combined anterior with posterior circulation artery stenosis were more common in patients with extracranial artery stenosis group than those in intracranial artery stenosis group ( 36 .4% vs 22 .1% ,14 .9% vs 9 .8% ;all P ＜0 .001) . Univariate analysis of risk factors for stroke showed that patients with intracranial arterial stenosis had a higher prevelence of hypertension , diabetes ,obesity ,and family history of stroke ,and their systolic blood pressure ,diastolic blood pressure , body mass index ( BM I) ,fasting blood‐glucose ,glycosylated hemoglobin ,triacylglycerol ,total cholesterol , and low‐density lipoprotein cholesterol were significantly higher than those in the extracranial arterial stenosis group ( all P ＜ 0 .05 ) . T he proportion of elderly ( ≥ 65 years old ) ,male and smokers in the extracranial arterial stenosis group was significantly higher than that in the intracranial arterial stenosis group ( all P ＜0 .05) . Multivariate logistic regression analysis showed that elderly ( ≥65 years old) ,male , and smoking history were independent risk factors for extracranial arterial stenosis ( OR＝ 2 .012 ,1 .637 , 1 .325 ,respectively ;all P ＜0 .05) . While hypertension ,diabetes ,less physical activity ,and high BM I levels were independent risk factors for simple intracranial arterial disease ( OR ＝ 1 .301 ,1 .252 ,1 .248 ,1 .030 , respectively ;all P ＜0 .05) . Conclusions There are significant differences in the distribution characteristics and risk factors of intracranial and extracranial aterial lesions in patients with ischemic stroke in China .

Objective To observe the clinical effect of Qingre-Jiangni-Zhixue decoction combined with omeprazole sodium on acute non-variceal upper gastrointestinal bleeding. Methods A total of 64 patients with acute non-variceal upper gastrointestinal bleeding were divided into the observation group and control group according to random number table method, with 32 cases in each group. The control group was given the routine clinical treatment combined with omeprazole sodium, and the observation group was given Qingre-Jiangni-Zhixue decoction on the basis of the control group. After 7 days of continuous treatment, the basic clinical indexes (hemostasis time, blood transfusion volume, hospitalization time, 72 hours hemostasis rate, rebleeding rate), oxidative stress indexes (cortisol, malondialdehyde, antidiuretic hormone, blood glucose) and serum inflammatory factors (hs-CRP, TNF-α, IL-1β) were observed before and after treatment, and the clinical efficacy were evaluated. Results The total effective rate of the observation group was 90.6% (29/32), which was significantly higher than that of the control group 71.9% (23/32), with statistically significant (χ2=4.730, P=0.029). After treatment, the hemostasis time (18.86 ± 2.97 h vs. 29.12 ± 4.07 h, t=7.354),blood transfusion volume (559.32 ± 67.17 ml vs. 612.73 ± 75.81 ml, t=11.032),hospitalization time (5.43 ± 0.67 d vs. 9.26 ± 1.15 d, t=5.871) of the observation group were significantly lower than those of the control group (P<0.05). The 72 h hemostasis rate of the observation group was 3.1%, which was significantly lower than that of the control group 21.9%, with statistically significant (χ2=5.143, P<0.05). The rebleeding rate of the observation group was 96.9%, which was significantly higher than that of the control group 81.3% (χ2=4.010, P=0.045). After treatment, the cortisol level, the malondialdehyde level, blood glucose, antidiuretic hormone of the observation group were lower than those of the control group (t were 8.106, 4.976, 4.842, 5.093, all Ps<0.01). After treatment, the hs-CRP, serum TNF-α, serum IL-1β of the observation group were lower than those of the control group (t were 5.506, 4.983, 7.962, all Ps<0.01). Conclusions The application of Qingre-Jiangni-Zhixue decoction combined with omeprazole sodium can inhibit the expression of serum inflammatory cytokines in patients with acute non-variceal upper gastrointestinal bleeding, reduce the oxidative stress injury caused by bleeding, and improve the hemostatic efficiency.

Objective To observe the relationship between the peripheral blood IFN-γ secretion level and prognosis in the patients with early stage of acute cerebral hemorrhage.Methods Sixty-six inpatients with acute intracerebral hemorhage in the emergency department of this hospital from July 2015 to August 2016 were selected as the experimental group,and 60 healthy people in the physical examination center served as the blank control group.The peripheral blood mononuclear cells(PBMCs) and plasma were separated.The helper T cells(Th)1/Th2 eytokines(IFN-γ,IL-2,IL-4 and IL-10) were detected by using ELISA.The flow cytometry was used to detect intracellular cytokines;the disease condition change from 1 d of onset to 30 d in the experiment group was analyzed by using NIHSS.The relationship between the cytokines and prognosis on 30 d evaluated by NIHSS score was analyzed.Results The peripheral blood IFN-γ level had statistically significant difference between the two groups(P＜0.05),while the levels of IL-2,IL-4 and IL-10 had no statistical difference(P＞0.05).The peripheral blood IFN-γ secretion level during early stage in the experimental group was positively correlated with the prognosis(P＜0.05).Conclusion The increase of peripheral blood IFN-γ during early stage is correlated with the poor prognosis in the patients with acute intracerebral hemorrhage.

Objective To analyze the correlation between smoking and occurrence of intracranial artery stenosis.Methods From June 2015 to May 2016,a total of 10 711 inpatients with transient ischemic attack (TIA) or ischemic stroke from 20 basel hospitals of nationwide were enrolled using a cross-sectional study,76 patients with unknown smoking and smoking cessation years were excluded.Finally,a total of 10 635 patients were enrolled.Transcranial color coded sonography and/or transcranial Doppler were used evaluate the intracranial artery stenosis lesions.The basic risk factors for cerebrovascular disease (age,sex,smoking and smoking years,whether smoking cessation and years,hypertension,diabetes,hyperlipidemia,atrial fibrillation,and family history of stroke) were recorded.According to the different smoking years,the smoking years were divided into five groups:non-smoking,smoking time ≤10-year,11 to 20-year,21 to 30-year,and >30-year groups for trend chi square test.According to the different smoking cessation years in the smokers,the smoking cessation years were divided into four groups:non-cessation,cessation time 1 to 10-year,11 to 20-year,and >20-year groups for trend chi square test.The effects of different smoking years and different smoking cessation years on the occurrence of intracranial arterial stenosis were analyzed.Results The incidence of intracranial artery stenosis in the smokers (40.4%[1 433/3 547]) was significantly higher than that in the non-smoking patients (29.4%[2 085/7 088]).There was significant difference (χ2=128.850,P<0.01),and the incidence of cerebral infarction in the smokers (91.6%[3 250/3 547]) was significantly higher than the non-smokers (85.0%[6 027/7 088]).There was significant difference (χ2=92.328,P<0.01).Smoking was an independent risk factor for intracranial artery stenosis (OR,1.603;95%CI 1.456-1.765;P<0.01).With the increase of smoking years,the detection rate of intracranial arterial stenosis increased gradually (trend χ2=115.437,P<0.01).Whether giving up smoking had no significant effect on the incidence of intracranial artery stenosis in patients with ≥20 years of smoking (trend χ2=1.043,P=0.307).Conclusions Smoking is an independent risk factor for affecting intracranial artery stenosis;the risk of disease increases with the number of smoking years.Long-term smokers (≥20 years) cannot reduce the effect on intracranial artery stenosis,even if they give up smoking.