Pelvic organ prolapse (POP), whose etiology is influenced by genetic and clinical risk factors, considerably impacts women's quality of life. However, the genetic underpinnings in non-European populations and comprehensive risk models integrating genetic and clinical factors remain underexplored. This study constructed the first polygenic risk score (PRS) for POP in the Chinese population by utilizing 20 disease-associated variants from the largest existing genome-wide association study. We analyzed a discovery cohort of 576 cases and 623 controls and a validation cohort of 264 cases and 200 controls. Results showed that the case group exhibited a significantly higher PRS than the control group. Moreover, the odds ratio of the top 10% risk group was 2.6 times higher than that of the bottom 10%. A high PRS was significantly correlated with POP occurrence in women older than 50 years old and in those with one or no childbirths. As far as we know, the integrated prediction model, which combined PRS and clinical risk factors, demonstrated better predictive accuracy than other existing PRS models. This combined risk assessment model serves as a robust tool for POP risk prediction and stratification, thereby offering insights into individualized preventive measures and treatment strategies in future clinical practice.
Humans ; Female ; Pelvic Organ Prolapse/epidemiology* ; Middle Aged ; Risk Assessment/methods* ; China/epidemiology* ; Multifactorial Inheritance ; Aged ; Risk Factors ; Genome-Wide Association Study ; Genetic Predisposition to Disease ; Case-Control Studies ; Adult ; Polymorphism, Single Nucleotide ; Genetic Risk Score ; East Asian People

Aim To examine the pathogenesis of disul-fide death gene in vascular dementia(VD)by bioin-formatics analysis of disulfide death differentially ex-pressed genes(DEGs)combined with experimental verification.Methods The death DEGs of disulfide were screened and their correlation was analyzed.The VD patients data in the data set were analyzed by clus-tering and typing and gene set variation.The clustering risk of DEGs was tested with a nomogram model,and the optimal learning model was predicted.After the es-tablishment of VD rat model,water maze test,HE stai-ning and RT-qPCR detection were performed to verify the results of health information.Results Four DEGs including SLC7A11 were obtained,which had antago-nistic or synergistic interaction with each other.The genetic data could be divided into two subtypes with significant differences.After typing,VD disulfide DEGs were mainly concentrated in GnRH signaling pathways.The accuracy of the nomogram prediction model was high.Generalized linear was the best ma-chine learning model.Compared with the sham opera-tion group,the escape latency of rats in the model group was prolonged,the number of crossing platforms decreased,the relative mRNA expression levels of Slc3a2 and Slc7a11 decreased,and LRPPRC in-creased.Conclusions SLC7A11 and other disulfide death DEGs and its related GnRH signaling pathway may be an important part of the pathogenesis of VD di-sulfide death.SLC3A2,LRPPRC and SLC7A11 can be used as characteristic genes in the regulation of VD by disulfide death,which may affect VD progression through the regulation of disulfide death.

Aim To examine the pathogenesis of disul-fide death gene in vascular dementia(VD)by bioin-formatics analysis of disulfide death differentially ex-pressed genes(DEGs)combined with experimental verification.Methods The death DEGs of disulfide were screened and their correlation was analyzed.The VD patients data in the data set were analyzed by clus-tering and typing and gene set variation.The clustering risk of DEGs was tested with a nomogram model,and the optimal learning model was predicted.After the es-tablishment of VD rat model,water maze test,HE stai-ning and RT-qPCR detection were performed to verify the results of health information.Results Four DEGs including SLC7A11 were obtained,which had antago-nistic or synergistic interaction with each other.The genetic data could be divided into two subtypes with significant differences.After typing,VD disulfide DEGs were mainly concentrated in GnRH signaling pathways.The accuracy of the nomogram prediction model was high.Generalized linear was the best ma-chine learning model.Compared with the sham opera-tion group,the escape latency of rats in the model group was prolonged,the number of crossing platforms decreased,the relative mRNA expression levels of Slc3a2 and Slc7a11 decreased,and LRPPRC in-creased.Conclusions SLC7A11 and other disulfide death DEGs and its related GnRH signaling pathway may be an important part of the pathogenesis of VD di-sulfide death.SLC3A2,LRPPRC and SLC7A11 can be used as characteristic genes in the regulation of VD by disulfide death,which may affect VD progression through the regulation of disulfide death.

The advantages of fluorescence detection of uric acid were introduced compared to the traditional detection methods.The preparation process,detection principle and performance of organic,inorganic and organic-inorganic hybrid fluorescent probes were reviewed.The advantages and disadvantages of kinds of fluorescent probes were analyzed when used for uric acid detection,and the futural directions were pointed out for related research.[Chinese Medical Equipment Journal,2024,45(6):93-104]

ObjectiveTo introduce the basic design， development plan and objectives of a population-based birth cohort in Shanghai， and further present the main data and baseline characteristics of enrolled participants in the cohort， and to provide key information for reproductive health-related studies. MethodsThe Shanghai population-based birth cohort initiated on January 1， 2005， included newborns born in Shanghai every year and their parents， and collected information on reproductive health， reproductive treatment， birth characteristics， growth and development status， as well as the incidence， treatment and death of diseases by employing data linkage technology and investigations. This formed a birth cohort spanning the entire life cycle. ResultsAs of October 2022， a total of 2 978 538 newborns and their parents were included in the cohort. Among them， 2 905 135 （97.54%） were naturally conceived （NC）， and 73 403 （2.46%） were born through assisted reproductive technologies （ART）. The average age of parents was （32.56±4.12） years old for females and （34.62±5.34） years old for males in the ART group， which was higher than （28.02±4.71） years and （30.07±5.54） years for parents in the NC group. Among parents， females and males aged 30 and above accounted for 77.12% and 85.08%， respectively， which were higher than that of parents （35.28% for females and 49.66% for males） in the NC group. Furthermore， the percentage of parents with a college degree or above in the ART group was 73.23% for females and 73.66% for males， which were higher than those in the NC group （49.98% and 50.91%， respectively）. The multiple births rate in the ART group was 33.81%， which was higher than that in the NC group （1.88%）. The incidence of premature birth and low birth weight in the ART group were 24.47% and 19.08%， respectively， which was higher than that in the NC group （5.47% and 3.73%）. ConclusionThe comprehensive collection of reproductive health-related information in the birth cohort in Shanghai can provide essential resources to determine the influence of genetics， environment， reproductive treatment and other related factors on the health of offspring after birth.

Objective To observe the clinical efficacy and safety of montelukast tablets combined with loratadine tablets in the treatment of allergic rhinitis(AR).Methods AR patients were divided into control group and treatment group according to the cohort method.The control group was given 10 mg of loratadine tablets orally once a day.On this basis,the treatment group was given 10 mg of montelukast tablets orally once a day.Both groups were treated for 8 weeks.Clinical efficacy,nasal symptom scores,inflammation cells and mediators[eosinophil cationic protein(ECP)and eosinophil(EOS)],immunoglobulin E(IgE),inflammatory factors[interleukin-6(IL-6),interleukin-8(IL-8)and interleukin-10(IL-10)],nasal mucosal tissue growth factor[insulin growth factor-1 receptor(IGF-IR),fibrogrowth factor-2(FGF-2)],and recurrence rate were compared between the two groups.And evaluated safety.Results After treatment,the total effective rates in the treatment group and the control group were 95.10％(97 cases/102 cases)and 80.61％(79 cases/98 cases),with statistically significant difference(P＜0.05).After treatment,visual analogue scale(VAS)scores for nasal symptoms in the treatment group and the control group were 1.25±0.16 and 3.01±0.70;ECP levels were(370.18±13.34)and(457.31±17.60)ng·mL-1;EOS were(2.95±0.53)％and(3.98±1.14)％;IgE levels were(119.37±7.65)and(179.55±11.63)U·mL-1;IL-6 levels were(106.27±7.13)and(135.41±10.90)ng·L-1;IL-8 levels were(108.36±6.72)and(129.47±10.33)ng·L-1;IL-10 levels were(17.14±4.55)and(13.59±3.76)ng·L-1;IGF-IR were 3.70±0.63 and 2.47±0.51;FGF-2 were 3.93±0.72 and 2.19±0.40.There were statistically significant differences in the above indexes between the treatment group and the control group(all P＜0.05).The recurrence rates in the treatment group and the control group at 6 and 12 months after treatment were 7.84％and 17.35％,15.69％and 25.51％.The differences were statistically significant(all P＜0.05).Adverse drug reactions in the treatment group mainly included nausea,weakness,headache and diarrhea.Adverse drug reactions in the control group mainly included nausea,weakness and headache.The total incidence rates of adverse drug reactions in the treatment group and the control group were 5.88％and 4.08％,without statistically significant difference(P＞0.05).Conclusion Compared with loratadine tablets,montelukast tablets combined with loratadine tablets is more effective in the treatment of AR,without increasing adverse drug reactions.

Objective To observe the clinical efficacy and safety of montelukast tablets combined with loratadine tablets in the treatment of allergic rhinitis(AR).Methods AR patients were divided into control group and treatment group according to the cohort method.The control group was given 10 mg of loratadine tablets orally once a day.On this basis,the treatment group was given 10 mg of montelukast tablets orally once a day.Both groups were treated for 8 weeks.Clinical efficacy,nasal symptom scores,inflammation cells and mediators[eosinophil cationic protein(ECP)and eosinophil(EOS)],immunoglobulin E(IgE),inflammatory factors[interleukin-6(IL-6),interleukin-8(IL-8)and interleukin-10(IL-10)],nasal mucosal tissue growth factor[insulin growth factor-1 receptor(IGF-IR),fibrogrowth factor-2(FGF-2)],and recurrence rate were compared between the two groups.And evaluated safety.Results After treatment,the total effective rates in the treatment group and the control group were 95.10％(97 cases/102 cases)and 80.61％(79 cases/98 cases),with statistically significant difference(P＜0.05).After treatment,visual analogue scale(VAS)scores for nasal symptoms in the treatment group and the control group were 1.25±0.16 and 3.01±0.70;ECP levels were(370.18±13.34)and(457.31±17.60)ng·mL-1;EOS were(2.95±0.53)％and(3.98±1.14)％;IgE levels were(119.37±7.65)and(179.55±11.63)U·mL-1;IL-6 levels were(106.27±7.13)and(135.41±10.90)ng·L-1;IL-8 levels were(108.36±6.72)and(129.47±10.33)ng·L-1;IL-10 levels were(17.14±4.55)and(13.59±3.76)ng·L-1;IGF-IR were 3.70±0.63 and 2.47±0.51;FGF-2 were 3.93±0.72 and 2.19±0.40.There were statistically significant differences in the above indexes between the treatment group and the control group(all P＜0.05).The recurrence rates in the treatment group and the control group at 6 and 12 months after treatment were 7.84％and 17.35％,15.69％and 25.51％.The differences were statistically significant(all P＜0.05).Adverse drug reactions in the treatment group mainly included nausea,weakness,headache and diarrhea.Adverse drug reactions in the control group mainly included nausea,weakness and headache.The total incidence rates of adverse drug reactions in the treatment group and the control group were 5.88％and 4.08％,without statistically significant difference(P＞0.05).Conclusion Compared with loratadine tablets,montelukast tablets combined with loratadine tablets is more effective in the treatment of AR,without increasing adverse drug reactions.

Objective To investigate the Gram-positive coccus resistance in nationwide's tertiary hospitals and understand the trend of antimicrobial resistance.Methods All the clinical isolates were collected from 19 hospitals and the minimal inhibitory concentrations(MICs)were tested using agar/broth dilution method recommended.Results A total of 1 974 pathogenic Gram-positive coccus from 19 tertiary hospitals in 19 cities nationwide over the period from July 2021 to June 2022 were studied.Based on the MIC results,the prevalence of methicillin resistant Stapylococcus aureus(MRSA)and methicillin resistant Stapylococcus epidermidis(MRSE)were 36.4％and 79.9％respectively.No vancomycin insensitivity Staphylococcus was detected.Staphylococcus aureus were 100％susceptibility to linezolid and teicoplanin.Antibiotic resistance rate of Enterococcus faecalis and Enterococcus faecium to ampicillin were 3.1％and 92.9％.The detectation rate of vancomycin resistant Enterococcus(VRE)was 1.6％.Nonsusceptibility rate of Enterococcus faecalis to linezolid was 32.2％,two consecutive monitoring rises and nonsusceptibility rate of Enterococcus faecium(12.5％)was also significantly increased.The prevalence of penicillin non-susceptible Streptococcus pneumoniae(PNSSP)was 0.8％based on non-meningitis and parenteral administration criterion,decrease of nearly 30 percentage points from the previous surveillance.While for cases of oral penicillin,the rate was 71.8％,showing similar to last time.The results indicated that the number of strains with higher MIC value of penicillin(MIC ≥4 mg·L-1)decreased significantly.There were no significant differences of resistance rates of Stapylococcus aureus,Stapylococcus epidermidis,Enterococcus faecalis,Enterococcus faecium and Streptococcus pneumoniae among various groups such as different department,age,or specimen source.Conclusion VRE detection ratio stablized at a relatively low level.The number of Streptococcus pneumoniae with higher MIC value of penicillin decreased significantly compared with the previous monitoring.The increase of linezolidin-insensitive Enterococcus was noteworthy.

Objective To investigate the Gram-negative bacteria resistance in nationwide's tertiary hospitals and understand the trend of antimicrobial resistance.Method All the clinical isolates were collected from 19 hospitals and the minimal inhibitory concentrations(MICs)were tested using agar/broth dilution method recommended.Results A total of 4 066 pathogenic isolates from 19 tertiary hospitals in 19 cities nationwide over the period from July 2021 to June 2022 were studied.Based on the MIC results,Escherichia coli and Klebsiella pneumoniae showed extended spectrum β-lactamase(ESBLs)phenotype rates of 55.0％and 21.0％,respectively,ESBLs phenotype rate of Klebsiella pneumoniae keep going down.The ratios of carbapenems resistance Klebsiella pneumoniae increased by 5 percentage points compared with the previous monitoring.Carbapenems,moxalactam,sitafloxacin,β-lactam combination agents,fosfomycin trometamol,and amikacin displayed desirable antibacterial activity against Enterbacterales,susceptibal rates were above 75％.In addition,tigacycline,omacycline,colistin and fluoxefin maintained good antibacterial activity against their respective effective bacteria/species,and the bacterial sensitivity rates by more than 80％.Resistance rates of Pseudomonas aeruginosa and Acinetobacter baumannnii to imipenem were 26.3％and 72.1％and multidrug-resistant(MDR)detection rates were 41.1％and 77.3％,extensively drug-resistant(XDR)were 12.0％and 71.8％,respectively.Comparison of drug resistance rates from different wards,ages and specimen sources indicated that the proportion of resistance in Klebsiella pneumoniae and Acinetobacter baumannii isolated from intensive care unit(ICU)were significantly higher than non-ICU.Carbapenem resistance rates of Klebsiella pneumoniae isolated from ICU were more than 35％.Resistance rates of Haemophilus influenzae isolated in children to β-lactam,macrolide,clindamycin and ESBLs detection rate in Klebsiella pneumoniae isolated from children were more than those from adults and the old people,so bacterial resistance in children is an important problem in China.Conclusion ESBLs detection rate of Escherichia coli increased slightly after years of continuous decline.The proportion of carbapenem resistant Pseudomonas aeruginosa was stable,but the resistance rate of Klebsiella pneumoniae and Acinetobacter baumannii to carbapenems was still increased,which should be paid more attention.

This paper summarized clinical experience of treating recurrent subacute thyroiditis based on the theory of internal toxin. It is believed that the core pathogenesis of recurrent subacute thyroiditis is the accumulation of internal toxin. The dysfunction of the spleen in transportation leads to the internal retention of turbidity， which serves as the basis for the formation of toxins. The combination of fire， dampness， and toxins is the key to the disease mechanism. Prolonged accumulation of dampness and turbidity leads to the formation of phlegm， fire， and stasis， and prolonged accumulation of pathogenic factors transforms into secondary toxins. For patients with severe fire， dampness， and toxins， the treatment focuses on dispersing stagnated liver qi， invigorating spleen， and differentiation treatment of fire and water， using a self-designed Chaihu Jiedu Decoction （柴胡解毒饮）. For patients with spleen deficiency and toxin accumulation， the treatment focuses on invigorating the spleen， eliminating turbidity， and cutting off the source of toxins， using a self-designed Shiwei Baizhu Powder （十味白术散）. For patients with yang deficiency and toxin stagnation， detoxification is combined with warming yang， nourishing blood， and supporting toxin expulsion， using a self-designed Heyang Baidu powder （和阳败毒散）.