Objective To analyze the association between glutamyl transpeptidase(GGT)and the risk of newly diagnosed diabetes mellitus(DM)in middle aged and elderly population.Methods A retrospective cohort study was conducted,with baseline data sourced from the Beijing sub center population of the"Risk Evaluation of Cancersin Chinese Diabetic Individuals:A Longitudinal Study(REACTION)".A total of 6425 non DM individuals were enrolled in this study.All the participantswere divided into four groups according to GGT levels:G1(GGT<14.6 U/L,n=1601),G2(14.6 U/L≤GGT<19.3 U/L,n=1601),G3(19.3 U/L≤GGT<27.3 U/L,n=1613)and G4(GGT≥27.3 U/L,n=1610)group.They were followed up for 3.2 years.Results During follow-up,556 new DM cases were found,with a cumulative incidence rate of 8.7%.Logistic regression analysis showed that GGT was an independent risk factor for new DM in the non DM population,the risk of new DM in the G3,G4 groups was 1.730 times(95%CI 1.321～2.265,P<0.001)and 1.960 times(95%CI 1.493～2.587,P<0.001)of G1 group,respectively.GGT is also an independent risk factor for new DM in the impaired glucose regulation(IGR),the risk of new DM was 1.530 times higher in the G3 group(95%CI 1.123～2.094,P=0.008),and 1.750 times higher in the G4 group(95%CI 1.271～2.415,P=0.001)than in the G1 group.GGT is not an independent risk factor for new DM in participants with normal glucose tolerance(P>0.05).Conclusions GGT is a risk factor for new onset DM in IGR population.

Objective To analyze the association between glutamyl transpeptidase(GGT)and the risk of newly diagnosed diabetes mellitus(DM)in middle aged and elderly population.Methods A retrospective cohort study was conducted,with baseline data sourced from the Beijing sub center population of the"Risk Evaluation of Cancersin Chinese Diabetic Individuals:A Longitudinal Study(REACTION)".A total of 6425 non DM individuals were enrolled in this study.All the participantswere divided into four groups according to GGT levels:G1(GGT<14.6 U/L,n=1601),G2(14.6 U/L≤GGT<19.3 U/L,n=1601),G3(19.3 U/L≤GGT<27.3 U/L,n=1613)and G4(GGT≥27.3 U/L,n=1610)group.They were followed up for 3.2 years.Results During follow-up,556 new DM cases were found,with a cumulative incidence rate of 8.7%.Logistic regression analysis showed that GGT was an independent risk factor for new DM in the non DM population,the risk of new DM in the G3,G4 groups was 1.730 times(95%CI 1.321～2.265,P<0.001)and 1.960 times(95%CI 1.493～2.587,P<0.001)of G1 group,respectively.GGT is also an independent risk factor for new DM in the impaired glucose regulation(IGR),the risk of new DM was 1.530 times higher in the G3 group(95%CI 1.123～2.094,P=0.008),and 1.750 times higher in the G4 group(95%CI 1.271～2.415,P=0.001)than in the G1 group.GGT is not an independent risk factor for new DM in participants with normal glucose tolerance(P>0.05).Conclusions GGT is a risk factor for new onset DM in IGR population.

Objective To evaluate the relationship between the trend of glutamyl transpeptidase(GGT)change and newly developed metabolic syndrome(MS),and to explore the relationship between GGT and MS.Methods The study was a prospective cohort study,with baseline data sourced from the Beijing subcenter population of the"REACTION"study.A total of 6482 non-MS subjects was enrolled as the study subjects,and divided into four groups using the quartile method based on GGT level:G1(GGT<14.2 U/L,n=1613),G2(14.2≤GGT<18.6 U/L,n=1602),G3(18.6≤GGT<26.1 U/L,n=1639)and G4(GGT≥26.1 U/L,n=1628)group.Follow up was conducted 3.2 years later to analyze the correlation between baseline GGT and the trend of GGT changes with the risk of new MS.Results Baseline GGT was a risk factor for newly diagnosed MS.Compared with G1 group,the relative risk(RR)(95%CI)of newly diagnosed MS at follow-up in G2,G3,G4 group were 1.480(1.220～1.780,P<0.01),2.090(1.750～2.490,P<0.01),and 2.800(2.360～3.320,P<0.01),respectively.The increase in GGT is a risk factor for newly diagnosed MS during follow-up in this population.Compared with the group with decreased GGT,the RR(95%CI)of newly diagnosed MS during follow-up was 1.410(1.320～1.510)(P<0.01)in the group with increased GGT.In stratified subgroup analysis,the incidence of new-onset MS was[1.650(1.410～1.940)vs 1.510(1.310～1.750),P<0.01]respectively in female and middle-aged people in the GGT increase group compared with the GGT decrease group.There was no statistically significant difference in the risk of developing new MS in both male and elderly populations between the GGT increasing group and the decreasing group(P>0.05).Conclusions The increase in GGT is a risk factor for newly diagnosed MS,especially in female and middle-aged populations.

Objective To analyze the association between fatty liver index(FLI)and the risk of newly diagnosed diabetes mellitus(DM)in people with different glucose metabolism.Methods A retrospective cohort study was conducted,with baseline data sourced from the Beijing sub center population of the REACTION study.The follow-up was conducted 3.2 years later.A total of 6425 non DM subjects were included in this study,and divided into four groups using the quartile method based on FLI level:Q1(FLI＜11.68,n=1608),Q2(11.68≤FLI＜24.33,n=1607),Q3(24.33≤FLI＜44.73,n=1604)and Q4(FLI≥44.73,n=1606).Results During follow-up,a total of 556 new DM patients were found,with a cumulative incidence rate of 8.7%.Logistic regression analysis showed that FLI level was an independent risk factor for new DM patients,whether in non-DM people,NGT subgroups or IGR subgroups.In non DM population,the risk of developing new DM in the Q1,Q2,Q3 is 1.650 times(95%CI 1.200～2.290,P=0.002),2.040 times(95%CI 1.420～2.940,P＜0.001),and 2.950 times(95%CI 1.860～4.670,P＜0.001)higher than that in the Q1,respectively.In the NGT population,the risk of newly diagnosed DM in the Q3,Q4 is 1.670 times higher(95%CI 1.010～2.750,P=0.045)and 2.320 times higher(95%CI 1.410～3.800,P=0.001)than that in the first quartile,respectively.FLI level is an independent risk factor for newly diagnosed DM in the IGR population(P=0.012).The risk of newly diagnosed DM in the Q2,Q3,Q4 is 1.480 times(95%CI 1.080～2.020,P=0.015),1.620 times(95%CI 1.190～2.220,P=0.002),and 1.630 times(95%CI 1.180～2.250,P=0.003)higher than that in the Q1 respectively.Conclusions FLI is significantly associated with the risk of new onset DM in both NGT and IGR populations,and is an independent risk factor for newly diagnosed DM.

Objective:To investigate the response of mandibular condylar chondroprogenitors to flow fluid shear stress(FFSS).Methods:Chondroprogenitors were in vitro cultured and stimulated with FFSS that can cause cell degeneration,and treated with sec-ond-generation high-throughput RNA sequencing.Differential gene expression was screened using DESeq2 software for gene ontology(GO)functional enrichment analysis,kyoto encyclopedia of genes and genomes(KEGG)pathway enrichment analysis and protein-protein interaction(PPI)network analysis.qRT-PCR was performed to validate the core genes screened by PPI.Results:A total of 1996 differentially expressed genes were obtained,mainly including inflammatory response and cell cycle related molecules.Among them,Actal,Atf3,Ccl2,116,Nfkbia,Ret and Vcaml were identified as the core genes.Conclusion:FFSS stimulation affects chondroprogenitor function by acting on inflammatory responses and cell cycle-related signaling pathways in chondroprogenitors.

Objective:To analyze the correlation between fatty liver index (FLI) and myocardial remodeling.Methods:For cross-sectional study, cluster sampling was used to conduct a follow-up study of “Risk evaluation of cancers in Chinese diabetic individuals: A longitudinal (REACTION) study” among communities of Gucheng and Pingguoyuan of Beijing from April 2015 to September 2015. According to the inclusion and exclusion criteria, 8 848 participants were selected. Biochemical indicators such as body mass index, waist circumference, triglycerides, and γ-glutamyl transpeptidase were detected to calculate the FLI. The correlation between FLI and myocardial remodeling was analyzed. Interventricular septal thickness (IVS), left atrial diameter (LAD), left ventricular end diastolic diameter (LVEDD), and the presence of diastolic dysfunction were measured by color doppler ultrasound. The participants were divided into Q1 group (FLI<30, 4 529 cases), Q2 group (30≤FLI<60, 2 762 cases), and Q3 group (FLI≥60, 1 557 cases) based on FLI levels. Single factor analysis of variance was used for inter-group comparison, logistic regression analysis was used to analyze the correlation between FLI and myocardial remodeling.Results:A total of 8 848 subjects were selected for the study (3 110 male and 5 738 female, mean age: 59.96 years). The IVS of Q1, Q2, and Q3 groups were (9.35±1.08), (9.73±1.22), and (10.07±1.31) mm, respectively. The LAD were (30.94±3.90), (33.37±4.12), and (34.98±4.47) mm, respectively. The LVEDD were (42.51±5.05), (44.43±5.10), and (46.06±5.52) mm, respectively. All increased with the increase of FLI (all P<0.001). FLI was an independent risk factor for IVS thickening, LAD increase, LVEDD increase, and diastolic function decrease. The respective risks for IVS thickening, LAD increase, LVEDD increase, and diastolic function decrease in a population with intermediate and higher FLI levels was 1.62 times (95% CI 1.39-1.89) and 2.53 times (95% CI 2.13-3.00); 2.71 times (95% CI 2.39-3.06) and 5.00 times (95% CI 4.12-6.08); 2.36 times (95% CI 1.85-3.00) and 4.33 times (95% CI 3.33-5.62); and 1.90 times (95% CI 1.63-2.19) and 1.95 times (95% CI 1.60-2.37) than those with lower FLI levels. Conclusion:There is a certain relevance between FLI and myocardial remodeling.

Objective:To analyze the correlation between fatty liver index (FLI) and the outcomes of individuals with high normal blood pressure.Methods:In this retrospective cohort study, data from the follow-up population of the Beijing branch of the Risk Evaluation of Cancers in Chinese Diabetic Individuals: A Longitudinal (REACTION) study conducted from December 2011 to August 2012 were selected. Obtain indicators such as height, weight, waist circumference, fasting blood glucose, 2-h postprandial blood glucose, triglycerides, high-density lipoprotein cholesterol, and glutamyl transpeptidase were measured, and the FLI was calculated. The population with high normal blood pressure was divided into the FLI<30 group (1 822 cases); 30≤FLI<60 group (1 026 cases); and FLI≥60 group (473 cases) based on FLI levels. The blood pressure outcome data from the follow-up survey of this population from April 2015 to September 2015 were collected. Single factor analysis of variance was used for intergroup comparison, and logistic regression was used to analyze the correlation between FLI and the outcome of high normal blood pressure in the population.Results:The FLI was an independent influencing factor for their conversion to normal blood pressure (all P<0.01). Among all observed populations, the likelihood of conversion to normal blood pressure in the 30≤FLI<60 group and FLI≥60 group was 0.63 (95% CI 0.51-0.78) and 0.61 (95% CI 0.45-0.82) of the FLI<30 group, respectively. In the population of 40≤age<60 years, this likelihood was 0.60 (95% CI 0.47-0.76) and 0.57 (95% CI 0.41-0.79), respectively. FLI is not an independent influencing factor for the conversion to normal blood pressure in individuals aged over 60 years ( P=0.161). FLI is an independent risk factor for hypertension (all P<0.05). Among all observed populations and population of 40≤age<60 years and age>60 years, the risk of hypertension in the 30≤FLI<60 group and FLI≥60 group was 1.49 times (95% CI 1.23-1.80) and 1.54 times (95% CI 1.19-1.98); 1.41 times (95% CI 1.13-1.75) and 1.38 times (95% CI 1.04-1.83); and 1.75 times (95% CI 1.22-2.53) and 2.10 times (95% CI 1.24-3.58) of the FLI<30 group, respectively. Conclusions:There is a correlation between FLI levels and future outcomes of individuals with normal high blood pressure. Although people with higher FLI are more likely to develop hypertension, those with higher FLI are also less likely to develop normal blood pressure in the 40≤age<60-year group.

Objective:To analyze the trend of disease burden of oral cancer attributable to smoking in China from 1990 to 2019, and predict the mortality trend of oral cancer from 2020 to 2034, providing scientific basis for formulating targeted oral cancer prevention and treatment strategy to achieve the goal of "Healthy China 2030".Methods:Using partial data on the global burden of disease in China in 2019, attributive death and disability adjusted life year (DALY) were used to describe. The trend of changes in the burden of oral cancer disease attributed to smoking was analyzed by using the Joinpoint regression model to estimate the annual average percentage change (AAPC) of age standardized mortality and DALY rates. Meanwhile, the Bayesian age-period- cohort model is used to predict oral cancer deaths and DALY trends attributed to smoking over the next 15 years.Results:The age-standardized mortality rate and DALY rate in China from 1990 to 2019 showed an overall upward trend, with an average annual increase of 1.49% (95 %CI: 1.34%-1.65%, P<0.001) and 1.41% (95 %CI: 1.24%-1.59%, P<0.001) respectively, higher than around the earth and in regions with different socio-demographic index (SDI). In 2019, 46.74% (10 584/22 642) of oral cancer deaths in China were attributed to smoking. Compared to 1990, the number of attributed deaths in 2019 increased by 293.75% (7 896/2 688), while DALY increased by 257.97% (189 039/73 280). Moreover, the growth rates of attributed deaths and DALY in males [304.95% (7 584/2 487) and 265.60% (183 349/69 033), respectively] were significantly higher than those in females [154.73% (311/201) and 133.95% (5 690/4 248), respectively] ( P<0.001). The age group results showed that the proportion of deaths and DALY gradually transitioned towards the elderly (>60 years old). The expected number of deaths would increase from 10 731 in 2020 to 14 125 in 2034, with a rise of 31.63% (3 394/10 731). Simultaneously, DALY would increase from 267 064 person years in 2020 to 326 634 person years in 2034, with a rise of 22.31% (59 570/267 064). Conclusions:From 1990 to 2019, the burden of oral cancer diseases attributed to smoking in China showed an increasing trend, with a higher growth rates than in the global and different SDI regions. There were differences in gender and age, and the burden of oral cancer diseases attributed to smoking in China would continue to increase in the next 15 years. It is necessary to educate on the adverse effects of tobacco consumption and to conduct vigilant oral self-examination among high-risk groups to help early detection and intervention at the same time.

Cognitive health is key for older adults to live independently, and exercise intervention can improve cognitive health.Exercise improves cognitive health through a variety of mechanisms, including improvement of cerebral blood perfusion, enhancement of brain capacity and connectivity, promotion of neurogenesis, and release of neurotrophic factors, miRNA and myokines.The exercise mode and dose can affect the effect of exercise intervention on cognitive health.Individualized exercise intervention with a duration of more than 12 weeks and a multi-mode combination is more conducive to improving the cognitive health of older adults.

Objective:To investigate the diagnosis, treatment and aeromedical assessment of military flying personnel with cerebral cavernous malformations (CCM).Methods:The clinical data and aeromedical assessment conclusions of military flying personnel with CCM in Air Force Medical Center from 2015 to 2021 were collected and analyzed based on reviewing the relevant aeromedical assessment cases and literatures at home and abroad.Results:A total of 10 flying personnel, all male, 20-41 years old, with an average age of 28.3 years, including 8 pilots, 2 air combat/technical personnel, with the flying hours of 110-4 000 h and the average flying hours of 1 102.0 h. The sizes of lesions were 3-12 mm, including 2 cases were smaller than 5 mm, 6 cases were 5-10 mm and 2 cases were bigger than 10 mm. All lesions were located under the cortex, including a case of occipital lobe, 4 cases of frontal lobe, 2 cases of temporal lobe and 3 cases of cerebellar hemisphere. Among the 10 flying personnel, only a case presented intracranial haemorrhage (right cerebellar hemisphere) as first symptom and was treated surgically. Three cases were temporarily grounded due to they were under the grounding observation. Other 7 flying personnel had been followed up for more than 6 months. Their reexaminations of MRI showed no change in lesions and EEG examination showed no abnormalities. Two air combat/technical personnel were qualified for flight and 1 helicopter pilot was limited to be a co-pilot, and 2 dual-seat fighter pilots were qualified (limited to dual-seat fighter) and flight-qualified respectively. Two fighter pilots were qualified for lower performance aircraft (limited to bomber, transporter or helicopter).Conclusions:For CCM military flying personnel, the aeromedical assessment conclusion should be made according to the symptoms, lesion location and size, inflight incapacitation possibility assessment, treatment effect, ground observation and follow-up results, as well as the aircraft type and occupation.