OBJECTIVE: To investigate the relationship between physical activity and genetic risk and their combined effects on the risk of developing chronic obstructive pulmonary disease. METHODS: This prospective cohort study included 318,085 biobank participants from the UK. Physical activity was assessed using the short form of the International Physical Activity Questionnaire. The participants were stratified into low-, intermediate-, and high-genetic-risk groups based on their polygenic risk scores. Multivariate Cox regression models and multiplicative interaction analyses were used. RESULTS: During a median follow-up period of 13 years, 9,209 participants were diagnosed with chronic obstructive pulmonary disease. For low genetic risk, compared to low physical activity, the hazard ratios ( HRs) for moderate and high physical activity were 0.853 (95% confidence interval [ CI]: 0.748-0.972) and 0.831 (95% CI: 0.727-0.950), respectively. For intermediate genetic risk, the HRs were 0.829 (95% CI: 0.758-0.905) and 0.835 (95% CI: 0.764-0.914), respectively. For participants with high genetic risk, the HRs were 0.809 (95% CI: 0.746-0.877) and 0.818 (95% CI: 0.754-0.888), respectively. A significant interaction was observed between genetic risk and physical activity. CONCLUSION Moderate or high levels of physical activity were associated with a lower risk of developing chronic obstructive pulmonary disease across all genetic risk groups, highlighting the need to tailor activity interventions for genetically susceptible individuals.
Humans ; Pulmonary Disease, Chronic Obstructive/epidemiology* ; Exercise ; Male ; Female ; Middle Aged ; Prospective Studies ; Aged ; Genetic Predisposition to Disease ; Risk Factors ; United Kingdom/epidemiology* ; Incidence ; Adult

Objective:To investigate the hemodynamic characteristics of intracranial collateral circulation assessed non-invasively by TCD and their correlation with clinical prognosis in patients with severe carotid stenosis or occlusion.Methods:A retrospective cohort study design was used to include 96 patients with severe stenosis(≥70％)or occlusion of the unilateral internal carotid artery admitted from March 2021 to March 2024,who were divided into a well-compensated group(58 patients)versus a poorly-compensated group(38 patients)based on the ASITN/SIR collateral branch score.Hemodynamic parameters(PSV,EDV,MFV,PI,RI)were measured using TCD,and collateral circulation status was validated by digital subtraction angiography(DSA).Prognosis was evaluated over a 12-month follow-up.Logistic regression was used to analyze risk factors for poor prognosis.Results:The good collateral group exhibited significantly higher PSV(82.32±18.51 vs.56.45±15.32 cm/s)and MFV(56.93±12.33 vs.35.89±9.83 cm/s),and significantly lower PI(0.64±0.15 vs.0.82±0.21)and RI(0.43±0.08 vs.0.51±0.11)compared to the poor collateral group(all P＜0.001).TCD parameters showed strong correlations with ASITN/SIR grades(PSV:r=0.62;PI:r=-0.61,all P＜0.001).Multivariate analysis identified age ≥65 years(OR=1.06),hypertension(OR=3.07),PI ≥ 1.00(OR=17.25),and PSV ≤ 60 cm/s(OR=1.96)as independent risk factors for poor prognosis(all P＜0.05).Conclusion:The TCD multi-parameter model enables quantitative assessment of collateral circulation function,with PI ≥ 1.00 and PSV ≤ 60 cm/s serving as key predictors of adverse outcomes.The non-invasive and dynamic monitoring advantages of TCD provide critical insights for hemodynamic stratification and personalized intervention in patients with carotid stenosis or occlusion.

Objective To explore the protective effect and potential mechanism of propofol on acute kidney injury in septic rats.Methods A total of 84 adult SD rats were randomly divided into the sham surgery group,the model group and the treatment group.The sham surgery group only opened and closed the abdomen,while the model group underwent cecal ligation and perforation for modeling.In the treatment group,propofol(60 mg/kg)was intraperitoneally injected 30 minutes before modeling,and the same dose of propofol was intraperitoneally injected again 6 hours after modeling.The renal function and pathological changes of rats in each group were observed,24-hour survival status of rats in each group were recorded,and the 24-hour survival rate was calculated.A sepsis model was established in vitro by stimulating human renal tubular epithelial cell line with lipopolysaccharide(LPS),and the changes of apoptosis and oxidative stress of renal tubular epithelial cells were observed.The effects of propofol on oxidative stress and apoptosis of renal tubular epithelial cells stimulated by LPS were analyzed.Results The renal function of sepsis rats was decreased,the renal tissue structure was damaged,the 24-hour survival rate of rats was decreased significantly and the survival time was shortened.Propofol could effectively improve renal function,reduce renal Paller score,increase survival rate and prolong survival time in sepsis rats.LPS could induce apoptosis and oxidative stress of renal tubular epithelial cells,while propofol could inhibit oxidative stress and apoptosis of renal tubular epithelial cells.Conclusion Propofol can effectively alleviate acute kidney injury in septic rats,and its mechanism is related to the inhibition of apoptosis and oxidative stress of renal tubular epithelial cells.

Objective To describe and analyze the current status,changing trend and influencing factors of the disease burden of cervical,endometrial and ovarian cancer in China from 1990 to 2021.Methods Data on incidence,mortality,disability-adjusted life year(DALY),and other indicators for cervical,endometrial and ovarian cancer were collected from the 2021 Global Burden of Disease database.Joinpoint regression models were used to analyze time trends,and age-period-cohort(APC)models assessed their impact on incidence and mortality.Spearman correlation analysis was performed to evaluate the relationship between the sociodemographic index(SDI)and the cancer indicators.Finally,the attributable risk factors for the disease burden were analyzed.Results From 1990 to 2021,age-standardized incidence rates of cervical and endometrial cancers in China significantly increased,while ovarian cancer showed no significant change.Age-standardized mortality,DALY,and years of life lost due to premature death(YLL)decreased significantly.The disease burden was heavier in middle-aged and older groups.APC model indicated an increase in cervical cancer incidence and a decrease in mortality over time.Furthermore,the incidence risks of cervical and endometrial cancers were elevated in successive birth cohorts,whereas a lower risk was observed for ovarian cancer.Correlation analysis showed significant associations between cancer incidence and mortality with SDI.Obesity has significantly contributed to the disease burden of common gynecologic cancers in China.Conclusion Mortality rates of cervical,endometrial and ovarian cancer have declined,while the incidence of cervical and endometrial cancers has significantly increased.The trends in incidence and mortality are influenced by age,period and cohort effects.Future efforts should focus on controlling risk factors like obesity to reduce the disease burden.

Objective:This study aims to investigate the spillover effects of the Diagnosis-Related Groups payment reform on medical expenditures.Methods:Based on the medical record data of inpatients in a tertiary Grade A hospital in Wuhan,Hubei Province,the Difference-in-Differences method was applied to estimate the impact of the DRG reform on medical expenditures for non-local patients.Results:After the implementation of DRG payment,the total medical expenses(β=-0.13),out-of-pocket expenses(β=-0.22),drug expenses(β=-0.25),consumable expenses(β=-0.26)decreased significantly.Meanwhile,the reduction ranges of the level and proportion of out-of-pocket expenses for non-local inpatients were significantly larger than those for local inpatients.However,the reduction range of the proportion of drug expenses for non-local inpatients was significantly smaller than that for local inpatients.The gaps between the two groups in terms of the level of out-of-pocket expenses and the proportion of drug expenses gradually narrowed.Conclusion:The DRG payment reform has produced a significant spillover effect,leading to a decrease in the medical expense level and an improvement in the expense structure for non-local inpatients.However,the medical expenses of non-local inpatients remain relatively high.It is suggested to accelerate the inclusion of non-local inpatients in disease-specific payment management and strengthen the coordination between the hospital's internal operation management and the reform of medical insurance payment methods.

AIM:To investigate the effects of urolithin A on motor function and muscle fibrosis in dystrophin-deficient mdx mice,a model of Duchenne muscular dystrophy.METHODS:Twelve 26-week-old SPF male dystrophin gene deficient C57BL/10ScSnJNju-Dmdem3Cd4/Gpt(mdx)mice were randomly divided into model group and urolithin A treatment group,with 6 mice in each group.Additionally,six wild-type SPF male mice were selected as the normal con-trol.The motor ability of the mice was evaluated by pole climbing test,inverted suspension test,grip strength test and en-durance test.The body mass,mitochondrial relative copy number,ATP level and malondialdehyde(MDA)level were compared among the mice in different groups.Hematoxylin-eosin staining,Masson staining and immunohistochemistry were performed to analyze the atrophy and pathological changes of the gastrocnemius muscle.RESULTS:Compared with normal control group,the mdx mice in model group exhibited significantly impaired motor function,as evidenced by pro-longed pole-climbing time(P<0.01),reduced suspension time and forelimb/hindlimb grip strength(P<0.01),and in-creased number of electrical stimuli required to induce movement(P<0.01).Additionally,mitochondrial relative copy number and ATP level were significantly decreased(P<0.01),while MDA level was significantly elevated(P<0.01).Histological analysis revealed marked inflammatory cell infiltration and extensive tissue fibrosis in the gastrocnemius mus-cle.In contrast,urolithin A treatment significantly improved motor performance(P<0.01),attenuated inflammatory cell infiltration and muscle fibrosis,increased mitochondrial copy number,restored ATP level(P<0.05),and reduced MDA level(P<0.01).CONCLUSION:Urolithin A ameliorates motor dysfunction and alleviates muscle fibrosis in mdx mice,suggesting its potential therapeutic benefits for Duchenne muscular dystrophy.

Objective To design a whole-process intelligent service platform to enhance services for inpatients.Methods A whole-process intelligent service platform for inpatients was designed with an intelligentized rehabilitation assessment model based on the support vector machine algorithm,which was constructed with the hyper-converged infrastructure,designed with the B/S architecture and developed using the front-end and back-end separation mode.The front end used Vue.js and Ant Design of Vue for user interface construction and JavaScript for data interaction,and the back end was developed with Java.The platform developed was composed of three functional modules for medical service management,intelligent rehabilitation management and system management.Results The platform developed provided whole-process inpatient service before,during and after hospitalization to enhance inpatient rehabilitation.Conclusion The platform developed is able to meet the health management needs of inpatients in terms of treatment-rehabilitation-follow-up,which improve the service quality of hospitals.[Chinese Medical Equipment Journal,2025,46(6):34-41]

Objective To investigate the clinical application value of serum exosomal miR-552 and miR-221 in the diagnosis and prog-nosis of gastric cancer.Methods 133 patients diagnosed with gastric cancer in the Department of Gastrointestinal Surgery,Suqian First People's Hospital from January to December 2019 were selected as the gastric cancer group,108 patients with chronic gastritis as the benign lesion group,and 94 healthy individuals undergoing physical examination as the healthy control group.Their blood samples were collected,and serum exosomes were extracted.The expression levels of miR-552 and miR-221 in serum exosomes were detected by real-time fluorescence quantitative PCR(qRT-PCR).The receiver operating characteristics(ROC)curve was used to assess the di-agnostic efficacy of miR-552 and miR-221 alone and in combination for gastric cancer.The correlations of serum exosomal miR-552 and miR-221 levels with the clinicopathological parameters of gastric cancer patients were further analyzed,and the survival curve was used to evaluate the prognosis of gastric cancer patients.Results The expression levels of serum exosomal miR-552 and miR-221 in gastric cancer patients,benign lesion patients,and healthy controls showed statistically significant differences(FmiR-552=296.271,FmiR-221=249.638,P＜0.01)and a decreasing trend.The analysis results of the ROC curve showed that the combined detection of serum exosom-al miR-552 and miR-221 for the diagnosis of gastric cancer had an area under the ROC curve(AUCROC)of 0.901,a sensitivity of 89.50%,and a specificity of 96.90%,all significantly higher than the detection of miR-552(sensitivity of 88.7%and specificity of 87.2%)and miR-221(sensitivity of 83.5%and specificity of 85.1%)alone(P＜0.05).The expression levels of serum exosomal miR-552 and miR-221 were related to tumor size,TNM staging,invasion depth,and lymph node metastasis(P＜0.05).The analysis results of the survival curve revealed that gastric cancer patients with high expression of serum exosomal miR-552 and miR-221 had sig-nificantly shorter survival time than those with low expression(χ2miR-552=30.657,χ2miR-221=38.251,P＜0.05).Conclusion Serum exo-somal miR-552 and miR-221 have high diagnostic efficacy for gastric cancer and may serve as novel biological markers for the diagnosis and prognosis evaluation of gastric cancer.