Objective:To investigate the association of urinary cadmium level with body mass index (BMI) and body circumferences among the older adults over 65 years old in 9 longevity areas of China.Methods:Subjects were older adults over 65 years old from the Healthy Aging and Biomarkers Cohort Study (HABCS) between 2017 and 2018 conducted in 9 longevity areas in China. A total of 1 968 older adults were included in this study. Information including socio-demographic characteristics, lifestyles, diet intake, and health status was collected by using questionnaires and physical examinations. Urine samples were collected to detect urinary cadmium and creatinine levels. Body circumferences included waist circumference, hip circumference and calf circumference. Subjects were divided into three groups (low:<0.77 μg/g·creatinine, middle:0.77-1.69 μg/g·creatinine, high:≥1.69 μg/g·creatinine) by tertiles of creatinine-adjusted urinary cadmium concentration. Multiple linear regression models were used to analyze the association of creatinine-adjusted urinary cadmium level with BMI and body circumferences. The dose-response relationship of creatinine-adjusted urinary cadmium concentration with BMI and body circumferences was analyzed by using restrictive cubic splines fitting multiple linear regression model.Results:The mean age of subjects was (83.34±11.14) years old. The median (Q1, Q3) concentration of creatinine-adjusted urinary cadmium was 1.13 (0.63, 2.09) μg/g·creatinine, and the BMI was (22.70±3.82) kg/m 2. The mean values of waist circumference, hip circumference, and calf circumference were (85.42±10.68) cm, (92.67±8.90) cm, and (31.08±4.76) cm, respectively. After controlling confounding factors, the results of the multiple linear regression model showed that for each increment of 1 μg/g·creatinine in creatinine-adjusted urinary cadmium, the change of BMI, waist circumference, hip circumference, and calf circumference in the high-level group was -0.28 (-0.37, -0.19) kg/m 2, -0.74 (-0.96, -0.52) cm, -0.78 (-0.96, -0.61) cm, and -0.20 (-0.30, -0.11) cm, respectively. The restrictive cubic splines curve showed a negative nonlinear association of creatinine-adjusted urinary cadmium with BMI ( Pnonlinear<0.001) and negative linear associations of creatinine-adjusted urinary cadmium with waist circumference ( Plinear<0.001), hip circumference ( Plinear<0.001), and calf circumference ( Plinear<0.001). Conclusion:Urinary cadmium level is significantly associated with decreased BMI, waist circumference, hip circumference and calf circumference among older adults over 65 years old in 9 longevity areas of China.

Objective:To investigate the association of urinary cadmium level with body mass index (BMI) and body circumferences among the older adults over 65 years old in 9 longevity areas of China.Methods:Subjects were older adults over 65 years old from the Healthy Aging and Biomarkers Cohort Study (HABCS) between 2017 and 2018 conducted in 9 longevity areas in China. A total of 1 968 older adults were included in this study. Information including socio-demographic characteristics, lifestyles, diet intake, and health status was collected by using questionnaires and physical examinations. Urine samples were collected to detect urinary cadmium and creatinine levels. Body circumferences included waist circumference, hip circumference and calf circumference. Subjects were divided into three groups (low:<0.77 μg/g·creatinine, middle:0.77-1.69 μg/g·creatinine, high:≥1.69 μg/g·creatinine) by tertiles of creatinine-adjusted urinary cadmium concentration. Multiple linear regression models were used to analyze the association of creatinine-adjusted urinary cadmium level with BMI and body circumferences. The dose-response relationship of creatinine-adjusted urinary cadmium concentration with BMI and body circumferences was analyzed by using restrictive cubic splines fitting multiple linear regression model.Results:The mean age of subjects was (83.34±11.14) years old. The median (Q1, Q3) concentration of creatinine-adjusted urinary cadmium was 1.13 (0.63, 2.09) μg/g·creatinine, and the BMI was (22.70±3.82) kg/m 2. The mean values of waist circumference, hip circumference, and calf circumference were (85.42±10.68) cm, (92.67±8.90) cm, and (31.08±4.76) cm, respectively. After controlling confounding factors, the results of the multiple linear regression model showed that for each increment of 1 μg/g·creatinine in creatinine-adjusted urinary cadmium, the change of BMI, waist circumference, hip circumference, and calf circumference in the high-level group was -0.28 (-0.37, -0.19) kg/m 2, -0.74 (-0.96, -0.52) cm, -0.78 (-0.96, -0.61) cm, and -0.20 (-0.30, -0.11) cm, respectively. The restrictive cubic splines curve showed a negative nonlinear association of creatinine-adjusted urinary cadmium with BMI ( Pnonlinear<0.001) and negative linear associations of creatinine-adjusted urinary cadmium with waist circumference ( Plinear<0.001), hip circumference ( Plinear<0.001), and calf circumference ( Plinear<0.001). Conclusion:Urinary cadmium level is significantly associated with decreased BMI, waist circumference, hip circumference and calf circumference among older adults over 65 years old in 9 longevity areas of China.

Objective: To investigate the factors affecting postpartum stress urinary incontinence (PSUI) among lying-in women at ages of 35 years and older, so as to provide insights into PSUI prevention. Methods: Lying-in women at ages of 35 years and older receiving postpartum examinations were sampled using a convenient sampling method from Hangzhou Obstetrics and Gynecology Hospital during the period from January 2021 to April 2022. Participants' demographic data, type of delivery, birth weight, diastasis recti abdominis, pelvic floor muscle strength injury, pelvic floor muscle training were collected, and the development of PSUI was evaluated using the International Consultation on Incontinence modular questionnaire. The factors affecting the development of PSUI were identified among lying-in women at ages of 35 years and older using a multivariable logistic regression model. Results: A total of 230 questionnaires were allocated, and 226 valid questionnaires were recovered, with an effective recovery rate of 98.26%. The lying-in women had a mean age of (37.30±2.11) years, and 75.66% had a pre-pregnancy body mass index (BMI) of 18.5 to 24.0 kg/m2. There were 29 women with postpartum BMI of 24.0 kg/m2 and greater (12.83%), 201 women with gestational weeks of 37 weeks and greater at delivery (88.94%), 105 women with vaginal delivery (46.46%), 20 women with neonatal birth weights of 4 000 g and higher (8.85%), 149 women with diastasis recti abdominis (65.93%), 154 women with pelvic floor muscle strength injury (68.14%). The prevalence of PSUI was 25.22% among the study subjects. Multivariable logistic regression analysis showed that vaginal delivery (OR=4.061, 95%CI: 2.124-7.763), postpartum BMI of 24 kg/m2 and higher (OR=1.903, 95%CI: 1.275-3.288), neonatal birth weight of 4 000 g and higher (OR=2.108, 95%CI: 1.420-4.135), diastasis recti abdominis (OR=1.487, 95%CI: 1.110-2.169) and pelvic floor muscle strength injury (OR=2.924, 95%CI: 1.726-4.803) were risk factors for PSUI among lying-in women at ages of 35 years and older, and pelvic floor muscle training was a protective factor for PSUI among lying-in women at ages of 35 years and older (OR=0.410, 95%CI: 0.216-0.780). Conclusions The development of PSUI correlates with the type of delivery, postpartum BMI, neonatal birth weight, diastasis recti abdominis and pelvic floor muscle strength injury among lying-in women. Reasonable weight control and active pelvic floor muscle training may facilitate the prevention of PSUI.

Objective:To analyze the influencing factors related to false-negative results of interferon-γ release assay (IGRA) QFT-GIT in patients with confirmed pulmonary tuberculosis.Methods:Clinical data of 389 patients with bacteriologically confirmed pulmonary tuberculosis who underwent QFT-GIT in Quzhou Hospital Affiliated to Wenzhou Medical University between January 1 and December 31 2020 were retrospectively analyzed. Univariate and multivariate logistic regression were used to analyze the influencing factors related to the false-negative results of QFT-GIT.Results:Among 389 confirmed patients, 347 cases had positive QFT-GIT results and 42 cases had negative results. Univariate analysis showed that the false-negative results of QFT-GIT were associated with low BMI, reduced CD4 + T lymphocyte count, decreased lymphocyte count, increased C-reactive protein, negative sputum smear, anemia, diabetes mellitus, malignant tumor and sepsis ( P<0.05 or P<0.01). Multivariate conditional logistic regression analysis showed that BMI <18.5 kg/m 2( OR=1.585, 95% CI 1.076-2.336), complicated with diabetes( OR=5.157, 95% CI 2.340-11.365), malignant tumors ( OR=5.596, 95% CI 2.048-15.295)and sepsis ( OR=4.141, 95% CI 1.042-16.459) were independent risk factors for the false-negative results of QFT-GIT ( P<0.05 or P<0.01). Conclusion:When the pulmonary tuberculosis patients are extreme emaciation, complicated with diabetes, malignant tumor or sepsis, the QFT-GIT results will be false negative.

Objective To investigate the association between heme oxygenase-1 (HO-1) gene rs2071746 polymorphism and long-term clinical outcome in patients with ischemic stroke.Methods Between July 2015 and June 2017,consecutive patients with acute ischemic stroke admitted to the Department of Neurology,the Third Affiliated Hospital of Soochow University were enrolled prospectively.TOAST classification was performed for all patients.Genotyping of the HO-1 gene rs2071746 polymorphism was performed using a modified multiplex ligase detection reaction technique.The patients were followed up.The primary endpoint events included ischemic stroke,vascular death,and myocardial infarction.Multivariate Cox proportional hazard regression model was used to analyze the independent influencing factors for primary endpoint events.Results A total of 1 698 patients with successful genotyping and follow-up information were enrolled.Genotyping showed that the frequency of rs2071746 A allelewas 44.91％.They were followed up for 15.21 ± 7.39 months,and 168 patients (9.89％) had primary endpoint events.The incidence of primary endpoint events in A allele carriers was significantly lower than that in non-A allele carriers (8.80％ vs.12.40％;P =0.018).Multivariate Cox proportional risk regression model showed that after adjusting for age,gender,hypertension,diabetes mellitus,smoking,alcohol consumption,and genotype,A allele was an independent protective factor for primary endpoint events in patients with acute ischemic stroke (hazard risk [HR] 0.693,95％ confidence interval [CI]0.506-0.949;P=0.022).Subgroup analysis showed that carrying the A allele was an independent protective factor for primary endpoint events in patients with large atherosclerotic stroke (HR 0.651,95％ CI 0.425-0.997;P=0.048),while rs2071746 polymorphism was not associated with long-term outcome in other etiological subtypes.Conclusion The HO-1 gene rs2071746 A allele may be a protective factor for the long-term outcome in patients with acute ischemic stroke and large atherosclerotic stroke.

Objective To investigate the characteristics of self perceived burden (SPB) in patients with chronic obstructive pulmonary disease (COPD) and explore the relationship between the perceived burden and self-efficacy,coping style.Methods A total of 96 cases with COPD in our hospital from January 2015 to June 2017 were enrolled in the study.The clinical data of patients were retrospectively analyzed.The patients were surveyed by self perceived burden scale,self-efficacy scale and coping style scale.The relationship between self perceived burden and self efficacy,coping style were investigated.Results The self perceived burden score of COPD patients was (33.76 ± 7.65) points with moderate level.The symptom management self-efficacy,common disease management self-efficacy score of COPD patients were (8.13 ± 1.09) and (8.22 ± 1.13) respectively with moderate self-efficacy.The total score of coping style in COPD patients was (35.09 ± 10.83) points with positive coping style.The each dimension and the total score of self perceived burden were negatively correlated with positive coping style in COPD patients (P ＜ 0.05),and positively correlated with negative coping styles (P ＜ 0.05).The total score of coping style had no significant correlation with perceived burden scores (P ＞ 0.05).The each dimension and the total score of self perceived burden were negatively correlated with the each dimension scores and total scores of self-efficacy in COPD patients (P ＜ 0.05).Conclusions There are significant correlation between SPB and self-efficacy and coping style in COPD patients.Medical staff should strengthen communication with patients,and guide them with positive coping style in the face of disease,which can effectively improve their self-efficacy and reduce the self perceived burden and promote physical and mental health.

Objective To explore the relationship between carotid plaque microcalcifcation and ischemic stroke (including transient ischemic attack) and the value of carotid microcalcification in predicting ischemic stroke.Methods Twenty-six patients in accordance with atherothrombosis models classified by Korean modified TOAST classification were enrolled in this study from November 2016 to March 2017.The microcalcification of the bilateral carotid was detected by Micropure imaging and the severity of intracranial ischemic focal lesions was evaluated by Alberta stroke programme early CT scale (ASPECT).The relation of ASPECT scores with microcalcification of the bilateral carotid was analyzed,and the value of carotid microcalcification in predicting ischemic stroke was analyzed by receiver operating characteristic curve method.Results Microcalcifition was detected in 27 of the total 52 carotids (51.92％) in 19 patients,which localized in the fibrous cap in 23 carotids (85.19％) and the basilar part of the plaque in 4 carotids (14.81％).The microcalcification surrounded the macrocalcifiation in 14 carotids (51.85％).The ASPECT scores were 10.85±1.43 in the microcalcifition side,which were significantly higher than those in the side without microcalcifition (11.80±1.19,t=2.584,P=0.013).The area under the curve was 0.673,with sensitivity of 0.667 and specificity of 0.680.Conclusion Micropure imaging maybe a new approach to detect the carotid microcalcification,and plaques with microcalcifition mav easilv cause ipsilateral ischemic stroke.

Objective To study the value of expanded-National Institutes of Health Stroke Scale (e-NIHSS) in evaluating the neurological signs of medullary infarction.Methods One hundred and thirteen patients with primary medullary infarction proved by magnetic resonance imaging were enrolled and divided into medial medullary infarction (MMI) group (n=41) and lateral medullary infarction (LMI) group (n=72).Risk factors of stroke and neurological signs evaluated by NIHSS and e-NIHSS were recorded and compared between the two groups.Results The age and prevalence of diabetes in MMI group were significantly older/higher than those in LMI group (P＜0.05).The major neurological signs of MMI were limb weakness (95.12％),dysphagia (36.59％),facial plasy (34.15％) and dysarthria (31.71％).And the major neurological signs of LMI were dysphagia (63.89％),truncal ataxia (54.17％),sensory dysfunction (50.00％) and dysarthia (48.61％).All the patients had significantly higher e-NIHSS scores than NIHSS scores (5.40±2.74 vs.2.96±2.22,P=0.000),which was similar in MMI group (e-NIHSS:5.34±3.20 vs.NIHSS:4.07±2.55,P=0.000) and in LMI group (e-NIHSS:5.43±2.47 vs.NIHSS:2.33±1.74,P=0.000).The e-NIHSS scores increased 2.57±1.99 than NIHSS scores in all the patients,which were 1.63±2.25 in MMI group and 3.10±1.62 in LMI higher than NIHSS scores;the differences were statistically significant (P＜0.05).Conclusion The e-NIHSS could improve the sensitivity of NIHSS in evaluating the neurological signs of medullary infarction,which is better in evaluating LMI than in evaluating MMI.

OBJECTIVETo determine the content of puerarin in Xiaoke pill powder rapidly by near-infrared spectroscopy.

METHODNear-infrared diffuse reflectance spectroscopy technology was used to collect NIR spectra of Xiaoke pills powder. With HPLC analysis values as reference, the fast determination method of puerarin was established with partial least squares (PLS).

RESULTThe R2, RMSECV and RPD of the calibration model for puerarin were 0.980 1, 0.131 and 7.09. The average relative deviation of the predication set was 3.2%.

CONCLUSIONThe method is accurate, fast and simple, which could be generalized to the on-line quality control of Xiaoke pill powder production.

Objective To evaluate the effectiveness of lamivudine in preventing liver damages and HBV DNA reactivation in anti-HBc positive lymphoma patients after chemotherapy.Methods Seventy-nine lymphoma patients who were negative in HBsAg and positive in anti-HBc were enrolled and were divided into lamivudine group (n=37) and control group (n=42).Both groups received chemotherapy.Liver damages and HBV reactivation were observed, and the data were analyzed with software SPSS 13.0.Results In lamivudine group, liver damages Ⅰ or Ⅱ was observed in 11 patients (11/37, 29.7%), and liver damages Ⅲ or Ⅳ was observed in 2 (2/37, 5.4%); two patients (2/37, 5.4%) developed HBV reactivation, and both of them had HBV YMDD mutations.In control group, 19 (19/42, 45.2%) patients experienced liver damages Ⅰ or Ⅱ, 7 (7/42, 16.7%) experienced liver damages Ⅲ or Ⅳ; 12 (12/42, 28.6%) patients experienced HBV reactivation, the differences between the two groups were of statistical significance (χ2=79.0, 8.7 and 79.0, P ＜ 0.05 or ＜ 0.01).Conclusion Lamivudine can reduce liver damages and HBV reactivation in HBsAg negative and anti-HBc positive patients with lymphoma during chemotherapy.