BACKGROUND: Spicy food consumption has been reported to be inversely associated with mortality from multiple diseases. However, the effect of spicy food intake on the incidence of vascular diseases in the Chinese population remains unclear. This study was conducted to explore this association. METHODS: This study was performed using the large-scale China Kadoorie Biobank (CKB) prospective cohort of 486,335 participants. The primary outcomes were vascular disease, ischemic heart disease (IHD), major coronary events (MCEs), cerebrovascular disease, stroke, and non-stroke cerebrovascular disease. A Cox proportional hazards regression model was used to assess the association between spicy food consumption and incident vascular diseases. Subgroup analysis was also performed to evaluate the heterogeneity of the association between spicy food consumption and the risk of vascular disease stratified by several basic characteristics. In addition, the joint effects of spicy food consumption and the healthy lifestyle score on the risk of vascular disease were also evaluated, and sensitivity analyses were performed to assess the reliability of the association results. RESULTS: During a median follow-up time of 12.1 years, a total of 136,125 patients with vascular disease, 46,689 patients with IHD, 10,097 patients with MCEs, 80,114 patients with cerebrovascular disease, 56,726 patients with stroke, and 40,098 patients with non-stroke cerebrovascular disease were identified. Participants who consumed spicy food 1-2 days/week (hazard ratio [HR] = 0.95, 95% confidence interval [95% CI] = [0.93, 0.97], P <0.001), 3-5 days/week (HR = 0.96, 95% CI = [0.94, 0.99], P = 0.003), and 6-7 days/week (HR = 0.97, 95% CI = [0.95, 0.99], P = 0.002) had a significantly lower risk of vascular disease than those who consumed spicy food less than once a week ( Ptrend <0.001), especially in those who were younger and living in rural areas. Notably, the disease-based subgroup analysis indicated that the inverse associations remained in IHD ( Ptrend = 0.011) and MCEs ( Ptrend = 0.002) risk. Intriguingly, there was an interaction effect between spicy food consumption and the healthy lifestyle score on the risk of IHD ( Pinteraction = 0.037). CONCLUSIONS Our findings support an inverse association between spicy food consumption and vascular disease in the Chinese population, which may provide additional dietary guidance for the prevention of vascular diseases.
Humans ; Male ; Female ; Prospective Studies ; Middle Aged ; Aged ; Vascular Diseases/etiology* ; Risk Factors ; China/epidemiology* ; Adult ; Proportional Hazards Models ; Cerebrovascular Disorders/epidemiology* ; East Asian People

Objective:To construct an estimating equation to accurately reflect the aging phenomenon of the glomerular filtration rate(GFR).Methods:Healthy subjects receiving physical examinations at the First Affiliated Hospital of Nanjing Medical University between January 2017 and April 2018 were included in the study, and the aging phenomenon of renal function indicators such as serum creatinine(Scr)was used as the reference standard to evaluate the accuracy of four Scr-based GFR equations during GFR aging, including the full age spectrum(FAS)equation, the Chronic Kidney Disease Epidemiology Collaboration(CKD-EPI)equation, the Osaka equation and the Xiangya equation.Results:Of 37 636 individuals receiving physical examinations, 6 534 met the criteria specified in this study.Scr, serum urea nitrogen, serum uric acid, and serum albumin showed a significant aging phenomenon( H=191.640, 196.693, 83.271, 414.585, P<0.001 for all).The GFR estimated by the four equations all decreased with aging, but the starting point and rate of decline were significantly different.The GFR aging phenomenon estimated by the FAS equation was closer to the trend of renal function indicators. Conclusions:The FAS equation may be more applicable to healthy people to understand the aging phenomenon of GFR.

Temporomandibular joint (TMJ) diseases are common clinical conditions. The number of patients with TMJ diseases is large, and the etiology, epidemiology, disease spectrum, and treatment of the disease remain controversial and unknown. To understand and master the current situation of the occurrence, development and prevention of TMJ diseases, as well as to identify the patterns in etiology, incidence, drug sensitivity, and prognosis is crucial for alleviating patients′suffering.This will facilitate in-depth medical research, effective disease prevention measures, and the formulation of corresponding health policies. Cohort construction and research has an irreplaceable role in precise disease prevention and significant improvement in diagnosis and treatment levels. Large-scale cohort studies are needed to explore the relationship between potential risk factors and outcomes of TMJ diseases, and to observe disease prognoses through long-term follw-ups. The consensus aims to establish a standard conceptual frame work for a cohort study on patients with TMJ disease while providing ideas for cohort data standards to this condition. TMJ disease cohort data consists of both common data standards applicable to all specific disease cohorts as well as disease-specific data standards. Common data were available for each specific disease cohort. By integrating different cohort research resources, standard problems or study variables can be unified. Long-term follow-up can be performed using consistent definitions and criteria across different projects for better core data collection. It is hoped that this consensus will be facilitate the development cohort studies of TMJ diseases.

Objective To investigate the role of the TNFRSF12A molecule in the pathogenesis of liver cancer.Methods Through comprehensive analysis of the Cancer Genome Atlas Program(TCGA)database and single-cell sequencing data,we studied the expression of TNFRSF12A in liver cancer and its correlation with prognosis.HPA database was utilized to analyze the subcellular localization of TNFRSF12A,and GO and KEGG analyses were performed by DAVID.TIME 2.0 was employed to analyze the correlation between TNFRSF12A and immune cell infiltration in liver cancer tissues.Results TNFRSF12A was found to be highly expressed in liver cancer tissues,significantly correlating with patient survival prognosis(OS:HR=1.61,P=0.007 0;RFS:HR=1.45,P=0.037 0;PFS:HR=1.30,P=0.099 0;DSS:HR=1.67,P=0.027 0),as well as age(P=0.046 7)and BCLC stage(P=0.045 6).TNFRSF12A co-expressed with tumor stem cell markers(CD24,SOX4,ANPEP),indicating a strong link to malignancy.Furthermore,molecular functional analysis unveiled that IL-2R primarily existed in the cell cytoplasm and played a role in processes such as cell apoptosis,invasion,and protein binding.Moreover,TNFRSF12A was associated with Treg cells and immune cell infiltration,further suggesting its role in tumor immune regulation.Conclusion TNFRSF12A exhibits a significant elevation within liver tumors and shows a notable correlation with patients'prognosis.Tumor cells engage in interactions with cytokines produced by Tregs,thereby reshaping the tumor microenvironment.The potential clinical significance of TNFRSF12A as a prognostic marker for tumors holds promise in offering novel avenues for personalized treatment and prognosis prediction.

Objective: To analyze the clinical epidemiological characteristics including composition of pathogens , clinical characteristics, and disease prognosis acute bacterial meningitis (ABM) in Chinese children. Methods: A retrospective analysis was performed on the clinical and laboratory data of 1 610 children <15 years of age with ABM in 33 tertiary hospitals in China from January 2019 to December 2020. Patients were divided into different groups according to age,<28 days group, 28 days to <3 months group, 3 months to <1 year group, 1-<5 years of age group, 5-<15 years of age group; etiology confirmed group and clinically diagnosed group according to etiology diagnosis. Non-numeric variables were analyzed with the Chi-square test or Fisher's exact test, while non-normal distrituction numeric variables were compared with nonparametric test. Results: Among 1 610 children with ABM, 955 were male and 650 were female (5 cases were not provided with gender information), and the age of onset was 1.5 (0.5, 5.5) months. There were 588 cases age from <28 days, 462 cases age from 28 days to <3 months, 302 cases age from 3 months to <1 year of age group, 156 cases in the 1-<5 years of age and 101 cases in the 5-<15 years of age. The detection rates were 38.8% (95/245) and 31.5% (70/222) of Escherichia coli and 27.8% (68/245) and 35.1% (78/222) of Streptococcus agalactiae in infants younger than 28 days of age and 28 days to 3 months of age; the detection rates of Streptococcus pneumonia, Escherichia coli, and Streptococcus agalactiae were 34.3% (61/178), 14.0% (25/178) and 13.5% (24/178) in the 3 months of age to <1 year of age group; the dominant pathogens were Streptococcus pneumoniae and the detection rate were 67.9% (74/109) and 44.4% (16/36) in the 1-<5 years of age and 5-<15 years of age . There were 9.7% (19/195) strains of Escherichia coli producing ultra-broad-spectrum β-lactamases. The positive rates of cerebrospinal fluid (CSF) culture and blood culture were 32.2% (515/1 598) and 25.0% (400/1 598), while 38.2% (126/330)and 25.3% (21/83) in CSF metagenomics next generation sequencing and Streptococcus pneumoniae antigen detection. There were 4.3% (32/790) cases of which CSF white blood cell counts were normal in etiology confirmed group. Among 1 610 children with ABM, main intracranial imaging complications were subdural effusion and (or) empyema in 349 cases (21.7%), hydrocephalus in 233 cases (14.5%), brain abscess in 178 cases (11.1%), and other cerebrovascular diseases, including encephalomalacia, cerebral infarction, and encephalatrophy, in 174 cases (10.8%). Among the 166 cases (10.3%) with unfavorable outcome, 32 cases (2.0%) died among whom 24 cases died before 1 year of age, and 37 cases (2.3%) had recurrence among whom 25 cases had recurrence within 3 weeks. The incidences of subdural effusion and (or) empyema, brain abscess and ependymitis in the etiology confirmed group were significantly higher than those in the clinically diagnosed group (26.2% (207/790) vs. 17.3% (142/820), 13.0% (103/790) vs. 9.1% (75/820), 4.6% (36/790) vs. 2.7% (22/820), χ²=18.71, 6.20, 4.07, all P<0.05), but there was no significant difference in the unfavorable outcomes, mortility, and recurrence between these 2 groups (all P>0.05). Conclusions: The onset age of ABM in children is usually within 1 year of age, especially <3 months. The common pathogens in infants <3 months of age are Escherichia coli and Streptococcus agalactiae, and the dominant pathogen in infant ≥3 months is Streptococcus pneumoniae. Subdural effusion and (or) empyema and hydrocephalus are common complications. ABM should not be excluded even if CSF white blood cell counts is within normal range. Standardized bacteriological examination should be paid more attention to increase the pathogenic detection rate. Non-culture CSF detection methods may facilitate the pathogenic diagnosis.
Adolescent ; Brain Abscess ; Child ; Child, Preschool ; Escherichia coli ; Female ; Humans ; Hydrocephalus ; Infant ; Infant, Newborn ; Male ; Meningitis, Bacterial/epidemiology* ; Retrospective Studies ; Streptococcus agalactiae ; Streptococcus pneumoniae ; Subdural Effusion ; beta-Lactamases

Objective:To evaluate changes in the estimate glomerular filtration rate(eGFR)with aging and the risk factors.Methods:A retrospective cross-sectional study was performed based on people receiving physical examinations at the First Affiliated Hospital of Nanjing Medical University from January 2017 to January 2018.Subjects were divided into seven subgroups according to age: 18-29, 30-39, 40-49, 50-59, 60-69, 70-79, and ≥80 years old.eGFR was estimated by the Chronic Kidney Disease Epidemiology Collaboration(CKD-EPIScr)equation.Multivariate linear regression was used to analyze the correlation between eGFR and the influencing variables.The chi-square test was used to compare the incidences of eGFR<60 ml·min -1·1.73m -2in different age groups. Results:A total of 33 824 participants were included in this study.There was a negative linear eGFR-age correlation in the subjects.The mean annual rate of decline in eGFR was 0.83 ml·min -1·1.73m -2.Furthermore, the decline was steady and accelerated from the third and seventh decade onward( F=9.51, 5.37, both P=0.000). Multiple linear regression analysis showed that aging was the most prominent factor( β=-0.604, -0.534, both P=0.000), followed by serum uric acid(BUA)( β=-0.270, -0.280, both P=0.000), fasting blood-glucose(FBG)( β=-0.064, -0.046, both P=0.000), systolic blood pressure(SBP)( β=-0.015, -0.028, both P<0.05), and diastolic blood pressure(DBP)( β=-0.010, -0.026, both P<0.05). In non-elderly subjects, eGFR was found to have negative associations with body mass index(BMI)and albumin(ALB)( β=-0.028, -0.047, all P=0.000). However, in the elderly, eGFR was positively associated with ALB( β=0.022, P=0.031). eGFR showed no statistically significant correlation with BMI, TC and LDL-C.The prevalence of eGFR<60 ml·min -1·1.73m -2increased with age, at 1.55%(523/33 824)for all subjects, of whom 73.80%(386/523)were aged over 60.The incidence obviously increased from 0.22%(14/6 453)for aged 18-29 to 22.57%(214/948)for aged 80 and above( χ2=2433.71, P=0.000). Conclusions:eGFR decreases significantly with age.The incidence of eGFR<60 ml·min -1·1.73m -2in the elderly is high; eGFR is significantly correlated with BUA, FBG, SBP, DBP, and ALB in the elderly.

Objective:To observe the effect of Jianpi Shugan decoction combined with acupuncture on the clinical symptoms of diarrhea-predominant irritable bowel syndrome (IBS-D) with liver depression and spleen deficiency and the intestinal flora. Method:Seventy patients with IBS-D with liver depression and spleen deficiency were randomly divided into two groups by the random number table. The treatment group was given Jianpi Shugan decoction combined with acupuncture for 4 weeks, the control group was treated with Pivavironium bromide for 4 weeks, and 30 healthy people were used as healthy control. The total effective rate, IBS bowel symptom severity scale (IBS-BSS), IBS quality of life questionnaire (IBS-QOL) and traditional Chinese medicine pattern curative effect scoring system (TCM-PES) were evaluated. The counts of Bacillus bifidus, B.acidi lactici, Enterobacteria, and Bacteroides in feces and the colonization resistance (CR) were observed by Real-time PCR. Result:The IBS-SSS scale showed that the TCM treatment group could reduce the scores at the 4^th, 8^th, and 12^th weeks (P<0.05), and the control group could reduce the scores at 4^th and 8^th weeks (P<0.05), the 4^th week scores of TCM treatment group were better than that of control group (P<0.05). The total effective rate of TCM treatment group was better than that of control group, with statistical difference between two groups (P<0.05). The IBS-QOL scale showed that the TCM treatment group increased the scale scores at the 4^th, 8^th, and 12^th weeks, and the control group increased the scores at the 4^th week (P<0.05). There was no statistical difference between two groups. The TCM treatment group was superior to control group (P<0.05). The counts of B.bifidus and B.acidi lactici increased after 4 weeks of TCM treatment, and the count of Enterobacteria decreased (P<0.05). However, no obvious change was observed in patients of control group before and after treatment. Compared with the control group, B. bifidus increased, while Enterobacteria decreased in the TCM treatment group (P<0.05). There was no significant regulatory effect of Bacteroides after treatment in each group. Conclusion:Jianpi Shugan decoction combined with acupuncture has a reliable curative effect on IBS-D patients with liver depression and spleen deficiency. The mechanism may be related to the regulation of intestinal flora imbalance.

Electrocardiography ; Emergency Medical Services ; Humans ; Myocardial Infarction ; Out-of-Hospital Cardiac Arrest ; therapy ; Percutaneous Coronary Intervention ; ST Elevation Myocardial Infarction ; therapy ; Treatment Outcome

Objective: To study the segment of liver according to the large amount of three-dimensional(3D) reconstructive images of normal human livers and the vascular system, and to recognize the basic functional liver unit based on the anatomic features of the intrahepatic portal veins. Methods: The enhanced CT primitive DICOM files of 1 260 normal human livers from different age groups who treated from October 2013 to February 2017 provided by 16 hospitals were analyzed using the computer-aided surgery system.The 3D liver and liver vascular system were reconstructed, and the digital liver 3D model was established.The vascular morphology, anatomical features, and anatomical distributions of intrahepatic portal veins were statistically analyzed. Results: The digital liver model obtained from the 3D reconstruction of CAS displayed clear intrahepatic portal vein vessels of level four.Perform a digital liver segments study based on the analysis of level four vascular distribution areas.As the less anatomical variation of left hepatic portal vein, the liver was classified into four types of liver segmentation mainly based on right hepatic portal vein.Type A was similar to Couinaud or Cho′s segmentation, containing 8 segments(537 cases, 42.62%). Type B contained 9 segments as there are three ramifications of right-anterior portal vein(464 cases, 36.82%). The main difference for Type C was the variation of right-posterior portal vein which was sector shape(102 cases, 8.10%). Type D contained the cases with special portal vein variations, which needs three-dimensional simulation to design individualized liver resection plan(157 cases, 12.46%). These results showed that there was no significant difference in liver segmental typing between genders(χ²=2.179, P=0.536) and did not reveal any significant difference in liver segmental typing among the different age groups(χ²=0.357, P=0.949). Conclusions The 3D digital liver model can demonstrate the true 3D anatomical structures, and its spatial vascular variations.The observation of anatomic features, distribution areas of intrahepatic portal veins and individualized liver segmentation achieved via digital medical 3D visualization technology is of great value for understand the complexity of liver anatomy and to guide the precise hepatectomy.

Objective To reduce the cancer burden in the Jinchang cohort and provide evidence for developing cancer prevention strategies and performing effectiveness evaluation in the Jinchang cohort.We are fitting thirteen years of cancer mortality data from the Jinchang cohort by using six kinds of predicting methods to compare relative fitness and to select good predicting methods for the prediction of cancer mortality trends.Methods The mortality data of cancer in Jinchnag cohort from 2001-2013 were fitted using six kinds of predicting methods:dynamic series,linear regression,exponential smoothing,autoregressive integrated moving average (ARIMA) model,grey model (GM),and Joinpoint regression.Weight coefficients of combination models were calculated by four methods:the arithmetic average method,the variance inverse method,the mean square error inverse method,and the simple weighted average method.Results The cancer mortality was fitted and compared by using six kinds of forecasting methods;the fitting precision of the Joinpoint linear regression had the highest accuracy (87.64％),followed by linear regression (87.32％),the dynamic series (86.99％),GM (1,1) (86.25％),exponential smoothing (85.72％) and ARIMA (1,0,0) (81.98％),respectively.Prediction accuracy of the combination model derived from GM (1,1) and linear regression (＞99％) was higher than that of the combination model derived from ARIMA (1,0,0) and GM (1,1).The combination model derived from the GM (1,1) and linear regression,with weight coefficients based on the arithmetic average method and the mean square error inverse method,had the best prediction effect of the four weight calculation methods.Conclusion Prediction accuracy of the combination model,with accuracy ＞95％,was higher than that of the single prediction methods.