OBJECTIVE: This study aimed to explore the association between body mass index (BMI) and mortality based on the 10-year population-based multicenter prospective study. METHODS: A general population-based multicenter prospective study was conducted at four sites in rural China between 2013 and 2023. Multivariate Cox proportional hazards models and restricted cubic spline analyses were used to assess the association between BMI and mortality. Stratified analyses were performed based on the individual characteristics of the participants. RESULTS: Overall, 19,107 participants with a sum of 163,095 person-years were included and 1,910 participants died. The underweight (< 18.5 kg/m ²) presented an increase in all-cause mortality (adjusted hazards ratio [ aHR] = 2.00, 95% confidence interval [ CI]: 1.66-2.41), while overweight (≥ 24.0 to < 28.0 kg/m ²) and obesity (≥ 28.0 kg/m ²) presented a decrease with an aHR of 0.61 (95% CI: 0.52-0.73) and 0.51 (95% CI: 0.37-0.70), respectively. Overweight ( aHR = 0.76, 95% CI: 0.67-0.86) and mild obesity ( aHR = 0.72, 95% CI: 0.59-0.87) had a positive impact on mortality in people older than 60 years. All-cause mortality decreased rapidly until reaching a BMI of 25.7 kg/m ² ( aHR = 0.95, 95% CI: 0.92-0.98) and increased slightly above that value, indicating a U-shaped association. The beneficial impact of being overweight on mortality was robust in most subgroups and sensitivity analyses. CONCLUSION This study provides additional evidence that overweight and mild obesity may be inversely related to the risk of death in individuals older than 60 years. Therefore, it is essential to consider age differences when formulating health and weight management strategies.
Humans ; Body Mass Index ; China/epidemiology* ; Male ; Female ; Middle Aged ; Prospective Studies ; Rural Population/statistics & numerical data* ; Aged ; Follow-Up Studies ; Adult ; Mortality ; Cause of Death ; Obesity/mortality* ; Overweight/mortality*

Objective To investigate the mechanism underlying gasdermin E(GSDME)-mediated pyroptosis in radiation-induced intestinal injury and to find out whether gasdermin(GSDM)family members regulate pyroptosis through similar signaling pathways.Methods Human normal colon epithelial cells(NCM460)and human colon cancer cells(HT-29)were exposed to radiation of different doses and durations before pyroptosis indicators were evaluated by observing pyroptotic bubbles,cell survival,and the cleavage of pyroptosis execution proteins.HT-29 cells overexpressing GSDME were subjected to radiation,followed by enrichment analysis of pyroptosis-related differentially expressed genes using RNA-seq.Results Radiation induced substantial pyroptosis in NCM460 cells.Overexpression of GSDME in HT-29 cells resulted in substantial radiation-induced pyroptosis.The pyroptosis state of human intestinal cells was simulated in the HT-29 model cell line.Overexpressions of GSDME-N and GSDMD-N resulted in the expression of more than 50％ of the differentially expressed genes in the pyroptosis state.Sequencing analysis showed that the genes in the pyroptosis state were mainly overrepresented in immune response,inflammatory response,and Rapl signaling pathway.Conclusion GSDME activation can mediate radiation-induced pyroptosis by producing GSDME-N fragments.GSDM family members participate in pyroptosis in a similar mode of regulation.Furthermore,radiation-induced activation of GSDME/D may regulate pyroptosis through immune response,inflammatory response,and Rap1 signaling pathway.

Abstract: Objective To investigate the prevalence and pathogenic characteristics of Yersinia enterocolitica infection in children with diarrhea under 5 years of age in western Yunnan, and to provide a basis for the prevention and treatment of infectious diarrhea in children. Methods Feces were collected from under five-year-old children with diarrhea in the First Affiliated Hospital of Dali University from 2020 to 2021. Clinical information of the cases was also collected. Yersinia enterocolitica was isolated from the samples after cold enrichment on selective culture plates, and the pathogenic characteristics of Yersinia enterocolitica were analyzed by biological type and serotype and virulence gene detection. Results A total of 397 feces were collected. Seven strains of Yersinia enterocolitica were isolated in three samples, and the prevalence of Yersinia enterocolitica infection was 0.76% (3/397). Among the three positive samples, two Yersinia frederiksenii or Yersinia intermedia were isolated in specimen No. 212 , and five Yersinia enterocolitica were detected in specimens No. 24 and 226. Two Yersinia enterocolitica isolated from one sample were biological type 1A, and the virulence gene test results were ail-/ystA-/ ystB+ /yadA-/virF-, which were non-pathogenic Yersinia enterocolitica. Three Yersinia enterocolitica isolated from the other sample were biological type 3, serotype O∶3 (rfbc+), and virulence gene detection results were ail+/ystA+/ystB-/yadA+ /virF+, which were pathogenic Yersinia enterocolitica. While pathogenic Yersinia enterocolitica was detected from feces of children with diarrhea at 11 months of age with a infection rate of 0.50%(2/397). Conclusion Sporadic infection of pathogenic Yersinia enterocolitica was found in under five-year-old children in western Yunnan Province. It is necessary to strengthen the monitoring and research of Yersinia enterocolitica.

Objective To analyze the epidemiological characteristics of pulmonary tuberculosis in the elderly people in Wuhan during 2016-2020, and to provide a basis for formulating effective prevention and control strategies and measures. Methods Using the National Tuberculosis Information Management System, a descriptive statistical analysis was performed on the medical records of elderly (≥60 years old) pulmonary tuberculosis patients registered in Wuhan from 2016 to 2020. Results A total of 9 427 elderly pulmonary tuberculosis patients were registered in Wuhan during 2016-2020, accounting for 32.07% of the total number of registrations in the whole population. The reported incidence rate of tuberculosis in the elderly was significantly higher than that in the total population, and the reported incidence rates in both the elderly and the general population showed declining trends (whole population χ²_trend=216.97, P<0.05, elderly population χ²_trend=153.57, P<0.05). The time distribution showed that more cases occurred from April to November (70.90%). The top three districts with the largest number of registered cases were far urban areas, namely Huangpi District (13.81%), Xinzhou District (11.55%), and Jiangxia District (9.82%). The ratio of male to female with pulmonary tuberculosis in elderly patients was 2.85:1. Among the elderly pulmonary tuberculosis, the most registered cases were in the age group of 60 ~ years old, followed by 65 ~ years old. The proportion of smear-positive in elderly patients with pulmonary tuberculosis retreatment was 16.83%. Conclusion From 2016 to 2020, the epidemic situation of elderly pulmonary tuberculosis showed a downward trend in Wuhan. However, the elderly population with tuberculosis registrations still accounted for a relatively high proportion of the total population. According to the epidemiological characteristics of pulmonary tuberculosis among the elderly, the city should carry out tuberculosis prevention and control work in a timely, appropriate and focused manner.

Objective To investigate the mutation characteristics of drug resistance genes of multidrug-resistant mycobacterium tuberculosis in Wuhan, and to provide evidence for molecular diagnosis of drug-resistant tuberculosis. Methods Whole-genome sequencing was performed on 149 isolates collected from Wuhan Pulmonary Hospital in 2017 to obtain the specific mutation of genotype or subtype of H37Rv and the drug-resistant gene mutation of anti-TB drugs. The correlation between major mutation types and genotypes or subtypes was analyzed. Results Among the 149 strains, the major mutation types of resistance-related genes to common anti-tuberculosis drugs were katG Ser315Thr (65.77%, isoniazid), ropB Ser450Leu (62.42%, rifampicin), rpsL Lys43Arg (46.31%, streptomycin), embB Met306Val (20.13%, ethambutol), pncA -11 T>C (3.36%, pyrazinamide), gyrA Ala90Val (10.07%, ofloxacin) , rrs -1401 A> G (4.70%, second-line injectable drugs), fabG -15C>T (14.09%, ethionamide), and folC Ile43Thr (3.36%, paza-aminosalicylate). Nine strains of ahpC-OxyR mutation (isoniazid resistance compensatory mutation) and five strains of ropC gene mutation (rifampicin resistance compensatory mutation) were found. The mutation frequency of embB Met306Ile of L4 strain was higher than that of L2, and the mutation frequency of rpsL Lys43Arg was lower than that of L2 (P < 0.05). The difference of mutation frequency of other sites was not statistically significant. The mutation frequency of thyA His75Asn in the ancient subtype was higher than that in the modern type (P<0.05). Conclusion The mutation of MDR-TB isolates in Wuhan displays genetic diversity and should be detected by whole genome sequencing rather than targeted molecular approaches, which may miss some mutations. Some mutation types of MDR-related genes are related to the genotype and subtype of the strains.

AIM:To investigate the effect of sodium hydrosulfide(NaHS)on cardiac function and activity of renin-angiotensin(Ang)-aldosterone(ALD)system(RAAS)in the rats with chronic heart failure(CHF).METHODS:The CHF rat model was established by abdominal aortic coarctation.SD rats were randomly divided into sham operation group,model group,low dose of NaHS group and high dose of NaHS group(n=6).The left ventricular end-diastolic di-ameter(LVEDD), left ventricular end-systolic diameter(LVESD)and left ventricular ejection fraction(LVEF)were measured before and after treatment by echocardiography in each group.The levels of renin,AngⅡand ALD in the plasma were measured by ELISA.The expression of angiotensin-converting enzyme(ACE)and angiotensin Ⅱ type 1 receptor (AT1R)at mRNA and protein levels in the myocardium tissues was determined by qPCR and Western blot,respectively. RESULTS:After treatment with NaHS,compared with model group and before treatment,LVEDD and LVESD in low dose of NaHS group and high dose of NaHS group were decreased significantly, while LVEF was increased significantly(P<0.05).Compared with low dose of NaHS group,LVEDD and LVESD were decreased,while LVEF was increased in high dose of NaHS group(P<0.05).Compared with sham operation group,the levels of renin,AngⅡand ALD in the plasma of model group were significantly increased(P<0.05),and the expression of ACE and AT1R at mRNA and protein levels in the myocardium tissues of model group were significantly increased(P<0.05).Compared with model group,the plas-ma levels of renin,AngⅡand ALD in low dose of NaHS group and high dose of NaHS group were significantly decreased (P<0.05),and the myocardial expression of ACE and AT 1R at mRNA and protein levels was significantly down-regulated (P<0.05).The plasma levels of renin,AngⅡand ALD,and the myocardial expression of ACE and AT 1R at mRNA and protein levels in high dose of NaHS group were significantly lower than those in low dose of NaHS group(P<0.05). CONCLUSION:NaHS inhibits the activation of RAAS,thus improving the cardiac function of CHF rats,and the effect of high-dose NaHS is better than that of low-dose NaHS.

The expression of calcium binding protein S100A8 in 30 controls of normal oral tissue and 35 cases of OSCC was detected by immunohistochemical staining and Western blot respectively. The positive expression of S100A8 protein in OSCC and the controls was 68. 5％ and 36. 7％ respectively(P ＜ 0. 05). S100A8 may play a role in the development of OSCC.

OBJECTIVETo determine the detection rate of Helicobacter pylori (Hp) in children with Meckel's diverticulum (MD) and its clinical significance among children with MD.

METHODSEighty-one children with MD were divided into two groups according to the presence (n=45) or absence (n=36) of digestive hemorrhage. The detection rates of Hp in MD tissues and stomach tissues were determined by immunohistochemistry. The detection rates of Hp were compared between the two groups and between the MD tissues with different clinical features in the hemorrhage group.

RESULTSThe detection rate of Hp in MD tissues for the hemorrhage group was 76% (34/45), which was significantly higher than that for the non-hemorrhage group (47%, 17/36) (P<0.05). The detection rate of Hp in stomach tissues for the hemorrhage group (87%, 39/45) was insignificantly higher than that for the non-hemorrhage group (67%, 24/36) (P>0.05). Among patients in the bleeding group, the detection rate of Hp in MD tissues showed no relationship with age, sex, preoperative hemorrhage frequency, amount of hemorrhage, length of MD, basal diameter of MD, and pathological type (P>0.05), but was related to location of MD, presence or absence of ulcer, and depth of ulcer (P<0.05). For the hemorrhage group, a significant positive correlation was found between the detection rates of Hp in MD tissues and stomach tissues (P<0.05), as shown by the Spearman correlation analysis.

CONCLUSIONSThe detection rate of Hp in MD tissues is increased in children with MD complicated by digestive hemorrhage. Hp infection may play some role in the hemorrhage process among children with MD.

Adolescent ; Child ; Child, Preschool ; Female ; Gastric Mucosa ; microbiology ; Gastrointestinal Hemorrhage ; etiology ; microbiology ; Helicobacter pylori ; isolation & purification ; Humans ; Immunohistochemistry ; Infant ; Male ; Meckel Diverticulum ; complications ; microbiology

China ; epidemiology ; Humans ; Patient Acceptance of Health Care ; Tuberculosis, Pulmonary ; epidemiology ; psychology

Objective To evaluate the family and economic burden of chronic Schistosomiasis japonica. Methods Relevant information on 226 chronic schistosomiasis patients from four surveillance sites in Yangxin county was collected. A questionnaire survey was conducted on 219 of them who agreed to corporate. Family burden was estimated with standard Family Burden Scale of Disease (FBS). Direct economic burden was calculated by questionnaire survey. Human capital method combined with Years Lived with Disability (YLDs) was adopted to evaluate the indirect economic burden. Results The positive rates on the dimensions of family economic burden and family entertainment were 54.8 percent and 47.0 percent respectively. The remaining dimensions were lower than 40.0 percent. Results of the questionnaire survey among 219 chronic Schistosomiasis patients showed that the total economic burden was 353 480.59 Chinese Yuan, which was 1614.07 Yuan per person. The direct and indirect economic burden were 61 679 and 291 801.59 Yuan respectively. The average direct and indirect economic burden when counted on money losses, were 281.64 and 1332.43 Yuan per person, respectively. Conclusion The family burden caused by chronic Schistosomiasis japonica was serious, economically in particular. With regard to the income level of local residents, the economic burden of chronic Schistosomiasis was heavy to every household with indirect economic burden accounted for major proportion, suggesting close attention to be paid.