Objective To investigate the cross-sectional associations between different fatty liver classifications and cardiac structure and function in people undergo health examination. Methods A total of 6 545 adults who underwent health examinations at the Health Management Center of Zhongshan Hospital, Fudan University between January 1 and December 31, 2017, were retrospectively included. Demographic characteristics and laboratory data were collected. The hepatic steatosis was graded by ultrasonography. And patients with fatty liver were further stratified according to alanine aminotransferase (ALT) or aspartate aminotransferase (AST) levels, as well as the degree of liver fibrosis. Cardiac morphology and function were assessed by transthoracic echocardiography, and left ventricular geometric patterns were classified accordingly. Multivariate logistic regression analysis was performed to evaluate the associations between fatty liver classifications and cardiac abnormalities. Results There were 2 795 patients (42.7%) with fatty liver, of whom 832 (29.8%) had significant cardiac structural alterations and 1 500 (53.7%) had diastolic dysfunction. Severe fatty liver was risk factor for concentric remodeling and increased relative wall thickness (RWT), with odds ratios (ORs) of 1.27 (P＝0.012) and 1.27 (P＝0.009), respectively. Fatty liver accompanied by elevated ALT or AST was risk factor for concentric remodeling (OR＝1.45,1.56; P＝0.001, 0.001), increased RWT (OR＝1.48,1.57; P＜0.001, ＜0.001), and diastolic dysfunction (OR＝1.27, 1.32; P＝0.035, 0.040), respectively. Fatty liver with liver fibrosis was risk factor for concentric remodeling (OR＝1.83, P＝0.046) and diastolic dysfunction (OR＝2.64, P＝0.034). Conclusions Advanced fatty liver, including severe hepatic steatosis, accompanied by elevated liver enzymes or liver fibrosis, could increase risks of cardiac remodeling and diastolic dysfunction, while systolic function is preserved. For patients with fatty liver, it is recommended to undergo regular ultrasonography examination.

Background::The prevalence of type 2 diabetes mellitus (T2DM) has been rapidly growing in Chinese populations in recent decades, and the shift in eating habits is a key contributing factor to this increase. Eating out of home (EOH) is one of the major shifts in eating habits during this period. However, the influence of EOH on the incidence of T2DM among Chinese urban workers is unknown.Methods::The cross-sectional study involved an analysis of 13,904 urban workers recruited from 11 health examination centers in the major cities of China to explore the relationship between EOH and T2DM between 2013 September and 2016 March.Results::Average weekly EOH frequency ≥10 times was positively associated with increased incidence of T2DM in the sampled population (OR: 1.31 [1.11-1.54], p < 0.01), most notably in participants ≤45 years old (OR: 1.41[1.11-1.80], p < 0.01]) and in males (OR:1.26 [1.06-1.51], p < 0.01). An EOH frequency of 5 times/week appears as a threshold for a significant increase in the odds of T2DM. Weekly EOH frequency ≥5 times was associated with increased odds of T2DM in a dose-response manner in the total population and almost all subgroups ( poverall association < 0.05 and pnonlinearity ≤ 0.05). Conclusion::This study showed that a frequency of EOH (≥5 times/week) was associated with a frequency-dependent increase in the odds of T2DM urban workers in China. More nutrition promotion is needed to improve the eating behavior of Chinese urban workers to reduce T2DM risk.

Objective To explore the effect of transcranial direct current stimulation(tDCS)in rehabilitation of swallowing function in stroke patients.Methods A total of 86 stroke patients diagnosed and treated in Affiliated Rehabilitation Hospital of Zhejiang Chinese Medical University from December 2022 to December 2023 were selected as study objects,and they were divided into observation group and control group according to random number table method,with 43 cases in each group.The control group received routine rehabilitation programs,while the observation group received tDCS therapy on the basis of control group.The swallowing function,actual swallowing process and quality of life of two groups were compared before and after intervention.Results After the intervention,standardized swallowing assessment scores of observation group were significantly lower than those of control group(P＜0.05).The scores of oral and pharyngeal phases of observation group were higher than those of control group(P＜0.05),and there was no significant difference in esophageal phase score between two groups(P＞0.05).The quality of life score of observation group was significantly higher than that of control group(P＜0.05).Conclusion tDCS can improve the swallowing function of stroke patients and improve the quality of life,which is worthy of clinical application.

Objective:To investigate the effects and mechanisms of dendrobium officinale polysaccharides(DOP)on neural function and sleep in a rat model of ischemic stroke.Methods:Rats with ischemic stroke were modeled using middle cerebral artery occlusion(MCAO).The neurological function was assessed using the Longa scale.Sleep was monitored by electroencephalography.The hippocampal tissue damage was evaluated by TTC staining,HE staining,Nissl staining and TUNEL staining.The kits were used to detect reactive oxygen species(ROS),malondialdehyde(MDA),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),IL-1β,and IL-18 in the hippocampal tissue.West-ern blot analysis was conducted to detect the expression of microtubule-associated protein light chain 3(LC3)and Bec-lin1,NLRP3,apoptosis-associated speck-like protein containing a caspase recruitment domain(ASC),cleaved caspase-1(C-caspase-1),GSDMD-N-terminal domain(GSDMD-N),nuclear factor erythroid 2-related factor 2(Nrf2),and heme oxygenase-1(HO-1)in the hippocampal tissue.Results:DOP can improve sleep quality and neurological func-tion in rats with ischemic stroke,alleviate hippocampal tissue damage,inhibit oxidative stress and inflammation in the hippocampus,decrease the expression of Beclin1,NLRP3,ASC,C-caspase-1,GSDMD-N,cytosolic Nrf2 protein,and the LC3-Ⅱ/LC3-Ⅰ ratio in the hippocampus,while increasing the expression of HO-1 and nuclear Nrf2 protein.The Nrf2 inhibitor ML385 partially reversed the ameliorative effects of DOP.Conclusion:DOP may improve neurological function and sleep in rats with ischemic stroke by inhibiting autophagy and NLRP3 inflammasome-mediated pyroptosis through the activation of the Nrf2/HO-1 pathway,thereby alleviating oxidative stress and neuroinflammation.

Objective:To evaluate the accuracy of p53 immunohistochemistry for predicting the mutational status of TP53 in gliomas.Methods:A retrospective study was conducted on 242 diffuse gliomas diagnosed at the Department of Pathology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China from June 2022 to March 2023. All cases underwent next-generation sequencing (NGS) and p53 immunohistochemical staining. The best threshold in the percentage of p53 immunohistochemical expression was assessed as an alternative to testing for TP53 mutation.Results:Among the 242 diffuse gliomas (WHO grade 2-4), 94 cases had a TP53 mutation. The p53 immunohistochemistry results revealed a significantly increased probability of TP53 mutation when the p53 immunohistochemical positivity rate (based on strongly positive cell count) was ≥20% ( P<0.05). The sensitivity and specificity of p53 immunohistochemistry for predicting TP53 gene mutations were 75.6% and 90.4%, respectively. When p53 immunohistochemical stain was totally negative, the probability of TP53 mutation increased significantly, and the mutation ratio of TP53 gene was 6/17 in all negative cases. Conclusions:When the percentage of p53 positive cells (based on strongly positive cell count) in glioma is ≥20%, p53 immunohistochemistry can be used as a reliable alternative method for TP53 mutation detection. When p53 immunohistochemistry is completely negative, the mutation rate of TP53 gene is higher, and further gene sequencing is recommended to determine the mutation status.

Objective:To evaluate the accuracy of p53 immunohistochemistry for predicting the mutational status of TP53 in gliomas.Methods:A retrospective study was conducted on 242 diffuse gliomas diagnosed at the Department of Pathology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China from June 2022 to March 2023. All cases underwent next-generation sequencing (NGS) and p53 immunohistochemical staining. The best threshold in the percentage of p53 immunohistochemical expression was assessed as an alternative to testing for TP53 mutation.Results:Among the 242 diffuse gliomas (WHO grade 2-4), 94 cases had a TP53 mutation. The p53 immunohistochemistry results revealed a significantly increased probability of TP53 mutation when the p53 immunohistochemical positivity rate (based on strongly positive cell count) was ≥20% ( P<0.05). The sensitivity and specificity of p53 immunohistochemistry for predicting TP53 gene mutations were 75.6% and 90.4%, respectively. When p53 immunohistochemical stain was totally negative, the probability of TP53 mutation increased significantly, and the mutation ratio of TP53 gene was 6/17 in all negative cases. Conclusions:When the percentage of p53 positive cells (based on strongly positive cell count) in glioma is ≥20%, p53 immunohistochemistry can be used as a reliable alternative method for TP53 mutation detection. When p53 immunohistochemistry is completely negative, the mutation rate of TP53 gene is higher, and further gene sequencing is recommended to determine the mutation status.

Objective:To analyze the effect of precipitation on road traffic injuries (RTI) in Zhejiang Province.Methods:The RTI surveillance and meteorological data from 2009 to 2022 in Zhejiang Province were collected. Based on the time-stratified case-crossover design, the precipitation of case day and control day was compared, and the distributed lag nonlinear model was applied to analyze the correlation of precipitation and RTI. Stratified analyses were conducted to analyze the effect modification of gender, age, injury location, and temperature. An attributable fraction was used to assess the burden of RTI caused by precipitation.Results:A total of 239 970 RTIs were monitored in Zhejiang Province from 2009 to 2022, averaging 46 daily cases. The distributed lag nonlinear model showed that compared with no rain, the risk of RTI increased first and then decreased with the increase of precipitation. The risk of RTI was the highest when the precipitation was 30.99 mm ( OR=1.08, 95% CI: 1.05-1.11). The adverse effects on RTI mainly occurred on the day of precipitation, and it showed insignificant or protective effects with the extension of lag days. 1.34%(95% CI: 1.31%-1.36%) of RTI could be attributed to precipitation. Stratified analysis showed that gender, age, injury location, and temperature may modify the effect of precipitation on RTI. Precipitation caused a heavier burden on RTI in subgroups aged 18-64, females, and occurring on roads and in low temperatures. Conclusions:Precipitation can increase the risk of RTI. People aged 18-64 or females are the key groups for RTI prevention, and prevention and control efforts of precipitation-related RTI should be increased in road and low-temperature environments.

Background::The prevalence of type 2 diabetes mellitus (T2DM) has been rapidly growing in Chinese populations in recent decades, and the shift in eating habits is a key contributing factor to this increase. Eating out of home (EOH) is one of the major shifts in eating habits during this period. However, the influence of EOH on the incidence of T2DM among Chinese urban workers is unknown.Methods::The cross-sectional study involved an analysis of 13,904 urban workers recruited from 11 health examination centers in the major cities of China to explore the relationship between EOH and T2DM between 2013 September and 2016 March.Results::Average weekly EOH frequency ≥10 times was positively associated with increased incidence of T2DM in the sampled population (OR: 1.31 [1.11-1.54], p < 0.01), most notably in participants ≤45 years old (OR: 1.41[1.11-1.80], p < 0.01]) and in males (OR:1.26 [1.06-1.51], p < 0.01). An EOH frequency of 5 times/week appears as a threshold for a significant increase in the odds of T2DM. Weekly EOH frequency ≥5 times was associated with increased odds of T2DM in a dose-response manner in the total population and almost all subgroups ( poverall association < 0.05 and pnonlinearity ≤ 0.05). Conclusion::This study showed that a frequency of EOH (≥5 times/week) was associated with a frequency-dependent increase in the odds of T2DM urban workers in China. More nutrition promotion is needed to improve the eating behavior of Chinese urban workers to reduce T2DM risk.

Objective To establish the phylogenic relationships among genus Botrychium,and to develop better molecular markers,along with to gain better understanding of cytonuclear coordination patterns of RuBisCO enzyme,the current article sampled two species(e.g.Botrychium ternatum(Thunb.)Sw.and Botrychium virginianum(L.)Sw.),and applied sequencing approaches for the data mining.Methods The assembly results of chloroplast(cp)genomes from B.ternatum and B.virginianum were determined via de novo hybrid assemble approach with the help of short reads(Illumina)and long reads(PacBio and Nanopore).Then the phylogenic relationships of 18 fern species were reconstructed based on the protein coding sequences from the cp genome and the rbcS gene,which were fished out of the RNA-seq data from SRA database,respectively.Then the adaptive selection and co-evolutionary analysis were employed to investigate the evolutionary trajectories of rbcL(cp genome)and rbcS(nuclear genome)genes.Results The full length of cp genome in the two genus Botrychium species were determined as 139 063 bp(NC_060644)and 139 372 bp(OR609363).Then 92 SSR sites and 78 SSR sites were identified in the current two cp genomes,respectively.The collinearity analysis showed high relevant relationship between the current two species,and significant relationship within both species among the inverted repeats regions.The adaptation and coevolution investigations illustrated the following results:①Coevolution network exists between RBCL and RBCS subunits from the fern RuBisCO enzyme.②Positively selected sites were significantly detected among both rbcL and rbcS genes.③Two coevolutionary pair sites from the two genes(e.g.site 11 in RBCL and site 106 in RBCS)were significantly positively selected,which may demonstrate a molecular pattern for the fern species fine-tuning the RuBisCO enzyme during the long earth history via the cytonuclear coordination.Conclusion Our current research shed a new light on the phylogenetic relationship of the genus Botrychium among the fern backbone-tree and provided amount of cpSSR sites with the potential as molecular markers for further population study on B.ternatum and B.virginianum.Moreover,our adaptation and coevolution investigations on rbcL and rbcS genes might indicate that the underlying cytonuclear coordination between the organelle and nuclear in cell of fern species for fine-tuning the key photosynthesis enzyme RuBisCO to gain better fitness according to the changing environment of earth during the geologic time-scale.

Objective:To establish a deployment management mode for life-supporting equipment,so as to provide reference for healthcare institutions in deployment management for equipment in responding public health emergencies.Methods:The existed problems of healthcare institutions in facing public health emergencies were analyzed.Based on evidence-based practices from domestic and international healthcare institutions in responding public health emergencies,and combined with the experiences of West China Hospital of Sichuan University in preventing and treating epidemic infection of public health emergencies,a scheme of deployment management of life-supporting equipment,and an assessment scheme that precisely matched mode and equipment for supporting respiratory were formulated.The ventilator-related medical consumables was standardly managed.A deployment management mode for life-supporting equipment was constructed to conduct deployment management for the using 293 non-invasive ventilators and 112 high-flow non-invasive respiratory humidification devices in our hospital from December 26,2022,to January 20,2023.Results:During the period of deployment management for 293 non-invasive ventilators,a total of 7492 prescriptions of non-invasive ventilation were completed,and 3183 prescriptions of non-invasive(high-follow)ventilation of using 112 high-flow non-invasive respiratory humidification devices were completed at the same period,which better ensured the requirements of all patients in clinical treatment.The average turnaround time of equipment was shorted from 22.5 min before deployment management mode was implemented to 12.6 min after it was implemented.The accuracy rate of healthcare personnel was 100%in preparing medical consumables.Conclusion:The deployment management mode of life-supporting equipment can increase the use rate of limited life-supporting equipment at the maximum degree,and increase the turnover efficiency of equipment,and decrease turnover time and vacancy rate of equipment,and increase the accuracy rate of preparing medical consumables,and meet the requirement of clinical treatment under the premise of"overall deployment and coordinated management".