Objective To explore the correlation between nap frequency and sleep duration and the risk of carotid atherosclerosis(CAS)in the middle-aged and elderly people in Guangzhou.Methods A retrospective study was conducted to select 1170middle-aged and elderly patients over 50 years who were enrolled in"Guangzhou Biobank Cohort-Cardiovascular Disease Subcohort"from Sep-tember 2006 to March 2008.The general data of the subjects were collected,and the intima-media thickness of common carotid artery,CCA-IMT was measured by color Doppler ultrasound.Logistic regression analysis was used to evaluate the correlation between nap fre-quency and sleep duration and the risk of CAS.Results After adjusting for potential confounding factors such as gender,age,body mass index(BMI),waist-to-hip ratio(WHR),physical activity level,smoking,alcohol consumption,and diabetes,the study found that compared with those who never nappers,Daily nappers had a higher risk of CAS[adjusted Exp(β)=2.095,95％CI:1.823-2.407,P＜0.001].In addition,this study observed a"U-shaped"association between sleep duration and CAS prevalence.Further studies found that compared with those who slept for 6h per day,those who slept for ≤5h,8h and≥10h had a significantly increased risk of CAS(adjusted OR=1.420,95％CI:1.117-1.805,P＜0.001;OR=1.356,95％CI:1.142-1.610,P＜0.001;OR=1.537,95％CI:1.156-2.044,P＜0.01).Conclusion Daily napping and short or long sleep duration may increase the risk of CAS.It is recommen-ded to reduce the nap frequency and maintain the appropriate sleep duration in order to reduce the incidence of CAS.

Objective To explore the correlation between nap frequency and sleep duration and the risk of carotid atherosclerosis(CAS)in the middle-aged and elderly people in Guangzhou.Methods A retrospective study was conducted to select 1170middle-aged and elderly patients over 50 years who were enrolled in"Guangzhou Biobank Cohort-Cardiovascular Disease Subcohort"from Sep-tember 2006 to March 2008.The general data of the subjects were collected,and the intima-media thickness of common carotid artery,CCA-IMT was measured by color Doppler ultrasound.Logistic regression analysis was used to evaluate the correlation between nap fre-quency and sleep duration and the risk of CAS.Results After adjusting for potential confounding factors such as gender,age,body mass index(BMI),waist-to-hip ratio(WHR),physical activity level,smoking,alcohol consumption,and diabetes,the study found that compared with those who never nappers,Daily nappers had a higher risk of CAS[adjusted Exp(β)=2.095,95％CI:1.823-2.407,P＜0.001].In addition,this study observed a"U-shaped"association between sleep duration and CAS prevalence.Further studies found that compared with those who slept for 6h per day,those who slept for ≤5h,8h and≥10h had a significantly increased risk of CAS(adjusted OR=1.420,95％CI:1.117-1.805,P＜0.001;OR=1.356,95％CI:1.142-1.610,P＜0.001;OR=1.537,95％CI:1.156-2.044,P＜0.01).Conclusion Daily napping and short or long sleep duration may increase the risk of CAS.It is recommen-ded to reduce the nap frequency and maintain the appropriate sleep duration in order to reduce the incidence of CAS.

The subtype of lung cancer that presents as subsolid nodules on imaging exhibits unique biological behavior and favorable prognosis. Recently, the American Association for Thoracic Surgery (AATS) issued "The 2023 American Associationfor Thoracic Surgery (AATS) expert consensus document: Management of subsolid lung nodules". This consensus, based on the latest literature and current clinical experience, proposes updated strategies for managing subsolid nodules. It emphasizes the correlation between imaging findings and pathological classification, individualized follow-up and surgical management strategies for subsolid nodules, and multimodal treatment approaches for multiple subsolid pulmonary nodules.

To revise GBZ 188 Technical Specification for Occupational Health Surveillance based on national laws, regulations, standards, specifications and legal documents of occupational disease, and combination with the actual situation in China. The main modifications are as follows: the occupational health surveillance for workers exposed to toluene (xylene may implement by reference), bromopropane, methyl iodide, ethylene oxide, chloroacetic acid, indium and its compounds, coal tar, coal tarasphalt, asphalt, β-naphthylamine, dust of metal and its compounds(tin, iron, antimony, barium and its compounds), hard metal dust, erionite dust, low temperature, laser, tick-borne encephalitis virus, Borrelia burgdorferi, and human immunodeficiency virus, for scraper or grind operators, and underground workers using squatting or kneeling position, crawling position, side-lying position, or shoulder position for a long period of time are included. The emergency health screening for workers exposed to arsenic, fluorine and its inorganic compounds, and acrylamide are included. The occupational medical examination (OME) for workers exposed to amino and nitro compounds of benzene, phosgene, monomethylamine, organic fluorine and dimethyl sulfate has been adjusted and made mandatory, with corresponding assessments required upon leaving the job. The special occupational health surveillance for workers exposed to mycobacterium tuberculosis and hepatitis virus is removed. The OME conclusion of reexamination is removed, and standardize recheck/additional inspection requirements. The optional items in OME performed before, during and after leaving post are removed, but the optional items in emergency medical examination are retained. Additional OME items are added. The Guideline for OME Summary Reports is added as informative appendix, and so on. The revised GBZ 188 Technical Specification for Occupational Health Surveillance is more scientific and practical.

Along with the popularity of low-dose computed tomography lung cancer screening, an increasing number of early-stage lung cancers are detected. Radical lobectomy with systematic nodal dissection (SND) remains the standard-of-care for operable lung cancer patients. However, whether SND should be performed on non-metastatic lymph nodes remains controversy. Unnecessary lymph node dissection can increase the difficulty of surgery while also causing additional surgical damage. In addition, non-metastatic lymph nodes have been recently reported to play a key role in immunotherapy. How to reduce the surgical damage of mediastinal lymph node dissection for early-stage lung cancer patients is pivotal for modern concept of "minimally invasive surgery for lung cancer 3.0". The selective mediastinal lymph node dissection strategy aims to dissect lymph nodes with tumor metastasis while preserving normal mediastinal lymph nodes. Previous studies have shown that combination of specific tumor segment site, radiology and intraoperative frozen pathology characteristics can accurately predict the pattern of mediastinal lymph node metastasis. The personalized selective mediastinal lymph node dissection strategy formed from this has been successfully validated in a recent prospective clinical trial, providing an important basis for early-stage lung cancer patients to receive more personalized selective lymph node dissection with "precision surgery" strategies.

Objective: To explore the mediating effect of hemoglobin (Hb) and hematocrit (HCT) on the association between alcohol consumption and blood pressure, and provide evidence for the prevention and control of alcohol-attributed hypertension. Methods: 1 091 male (age >50 years old) participants with drinking habit were selected from the Guangzhou biobank cohort study (GBCS). Mediation analysis was used to evaluate the mediating effect of Hb and HCT on the association of alcohol consumption (unit/day) with systolic blood pressure (SBP), diastolic blood pressure(DBP), pulse pressure(PP) and mean arterial pressure (MAP). Results: After adjusting for age, body mass index, education level, personal annual income, smoking, occupation and physical activity, the associations of alcohol consumption with SBP, DBP, PP and MAP were partly mediated by Hb, the proportion of mediating effect was 11.8% (95%CI 4.8%-24.7%), 15.3% (95%CI 6.5%-32.0%), 8.4% (95%CI 2.2%-22.5%) and 13.5% (95%CI 5.9%-27.5%), respectively. The associations of alcohol consumption with SBP, DBP, and MAP were also partly mediated by HCT, the proportion of mediating effect was 6.3% (95%CI 1.0%-16.0%), 8.7% (95%CI 1.4%-21.4%), and 7.5% (95%CI 1.0%-18.6%), respectively. Conclusion There is a significant mediating effect of Hb and HCT on the association between alcohol consumption and blood pressure. Besides efforts on alcohol control, the potential effects of alcohol-induced increase on Hb and HCT, which might also increase the blood pressure, need to be considered to achieve optimal monitoring and prevention of alcohol-related hypertension.

Objective To examine the association between weight changes during early and middle adulthood and the risk of type 2 diabetes mellitus in middle aged and elderly population.Methods Based on the Guangzhou Biobank Cohort Study (GBCS),28 736 residents aged ≥50 years were included in Guangzhou.Multivariate logistic regression was used to analyze the association between body weight changes during early or middle adulthood and age when the heaviest weight reaching the threshold on the risk of type 2 diabetes mellitus in middle age or elderly population.Adjustments on age,smoking,alcohol consumption,physical activity,education level,occupation,district of residence and body mass index etc.,were made.Results The mean age was 64.3 (standard deviation=6.7) years in men and 61.0 (standard deviation=7.0) years in women,with the prevalence rates of diabetes as 13.1％ and 13.7％ in men and women,respectively.Compared to those with stable body weight,the risk of diabetes increased with weight gain during early and middle adulthood in both men and women (both P values for trend ＜0.01).Participants who gained more than 20 kg during early and middle adulthood were associated with the highest risk of diabetes in men (OR=2.83,95％ CI:1.99-4.02) and women (OR=3.13,95％CI:2.47-3.96).Compared to those who reached the highest weight at age 20,those who reaching the highest weight at 40 to 49 years were associated with the highest risk of diabetes,with OR being 5.32 (95％CI:1.92-14.8) in men and 3.41 (95％CI:2.49-4.67) in women,respectively.Weight loss in adulthood was associated with self-reported but not newly diagnosed diabetic cases in both middle and older aged men and women.Conclusion Weight gain during early and middle adulthood may increase the risk of diabetes in middle and older aged population.The detrimental effect of obesity on diabetes might become significantly visible in the next decades.

OBJECTIVETo examine the association of fasting plasma glucose (FPG) and serum uric acid (SUA) in middle and elderly Chinese.

METHODS10 413 Guangzhou residents aged ≥50 were included in the present study. Information on personal history, physical examination and biochemical parameters were collected. Subjects were grouped by the FPG level, association between FPG and SUA. Levels of hyperuricemia (HUA) were evaluated.

RESULTSThe SUA levels and the incidence of HUA showed trends of increasing, with the increasing FPG levels in women, with statistically significant differences seen among all the FPG groups (P value for trend<0.05). While the statistical differences of SUA levels and the incidence rates of HUA among diabetes group (DM group) and impaired fasting glucose (IFG) groups were non-significant (P > 0.05) but it was higher than normal FPG group in men (P < 0.05). Logistic regression models were built between various FPG groups and HUA. After adjusting for age, smoking status, drinking status, physical activity, hypertension, body mass index and the levels of triglyceride and creatin. When compared to the normal FPG group, the risk of women suffering from HUA increased by 40% (95%CI:1.19-1.64) under the FPG in the range of 6.1-6.9 mmol/L. Compared to those non-diabetic individuals, the risk of diabetic patients suffering from HUA also increased by 44% (95% CI:1.15-1.79) in women. However, the risk of suffering from HUA did not relate to the increase of FPG in men.

CONCLUSIONThe SUA level and the incidence of HUA tended to increase along with the increasing levels of FPG in middle and elderly Chinese women and the increase of FPG might also increase the risk of HUA, but not in men.

Aged ; Asian Continental Ancestry Group ; Blood Glucose ; China ; epidemiology ; Diabetes Mellitus ; epidemiology ; Fasting ; blood ; Female ; Humans ; Hyperuricemia ; epidemiology ; Incidence ; Male ; Middle Aged ; Prediabetic State ; epidemiology ; Risk Factors ; Sex Distribution ; Uric Acid ; blood

Objective To examine the association of fasting plasma glucose (FPG) and serum uric acid (SUA) in middle and elderly Chinese. Methods 10 413 Guangzhou residents aged ≥50 were included in the present study. Information on personal history,physical examination and biochemical parameters were collected. Subjects were grouped by the FPG level,association between FPG and SUA. Levels of hyperuricemia(HUA)were evaluated. Results The SUA levels and the incidence of HUA showed trends of increasing,with the increasing FPG levels in women,with statistically significant differences seen among all the FPG groups(P value for trend<0.05). While the statistical differences of SUA levels and the incidence rates of HUA among diabetes group(DM group)and impaired fasting glucose(IFG)groups were non-significant(P>0.05)but it was higher than normal FPG group in men (P<0.05). Logistic regression models were built between various FPG groups and HUA. After adjusting for age,smoking status,drinking status,physical activity, hypertension,body mass index and the levels of triglyceride and creatin. When compared to the normal FPG group,the risk of women suffering from HUA increased by 40%(95%CI:1.19-1.64) under the FPG in the range of 6.1-6.9 mmol/L. Compared to those non-diabetic individuals,the risk of diabetic patients suffering from HUA also increased by 44%(95%CI:1.15-1.79) in women. However,the risk of suffering from HUA did not relate to the increase of FPG in men. Conclusion The SUA level and the incidence of HUA tended to increase along with the increasing levels of FPG in middle and elderly Chinese women and the increase of FPG might also increase the risk of HUA,but not in men.

Objective To study the value of intraoperative neurophysiological monitoring (IONM) in microsurgical detethering of patients diagnosed as having tethered cord syndrome (TCS).Methods A retrospective analysis of the clinical data,IONM results and prognosis of 11 patients with TCS,admitted to our hospital from January 2007 to December 2010,was performed to explore the protective role of IONM in microsurgical detethering of TCS.Results IONM responses could be obtained in all patients.Postoperative deterioration of symptoms was found in two patients one day after surgery.At discharge,10 patients got improvement with only one having deterioration of symptoms.Follow-up was performed for 1.5-5.5 years; long-term deterioration of symptoms was found in only one patients.Conclusion IONM can protect the spinal cord function,prevent neurological damage,improve the safty and improve life quality of the patients.