This study investigated the impact of metabolic syndrome (MetS) and its components on prostate volume (PV) in the general Chinese population. In total, 43 455 participants in The First Medical Center of the Chinese PLA General Hospital (Beijing, China) from January 1, 2012, to December 31, 2022, undergoing health examinations were included in the study. Participants were categorized into four groups according to PV quartiles: Q1 (PV ≤24.94 ml), Q2 (PV >24.94 ml and ≤28.78 ml), Q3 (PV >28.78 ml and ≤34.07 ml), and Q4 (PV >34.07 ml), with Q1 serving as the reference group. Logistic regression analyses were used to examine the association between MetS and PV, with subgroup analyses conducted by age. Among the participants, 18 787 (43.2%) were diagnosed with MetS. In the multivariate analysis model, a significant correlation between MetS and PV was observed, with odds ratios (ORs) increasing as PV increased (Q2, OR = 1.203, 95% confidence interval [CI]: 1.139-1.271; Q3, OR = 1.300, 95% CI: 1.230-1.373; and Q4, OR = 1.556, 95% CI: 1.469-1.648). Analysis of MetS components revealed that all components were positively associated with PV, with abdominal obesity showing the most significant effect. The number of MetS components was identified as a dose-dependent risk factor for elevated PV. The impact of MetS, its components, and component count on PV exhibited a decreasing trend with advancing age. Overall, the influence of MetS, its components, and component count on PV was predominantly observed in the age groups of 40-49 years and 50-59 years. Early intervention targeting MetS can significantly alleviate the increase in PV, particularly benefiting individuals aged 40-59 years who have abdominal obesity.
Humans ; Male ; Metabolic Syndrome/complications* ; Middle Aged ; Cross-Sectional Studies ; Aged ; Prostate/diagnostic imaging* ; Adult ; Age Factors ; Organ Size ; China/epidemiology* ; Obesity, Abdominal ; Risk Factors

BACKGROUND: Based on the China-VHD database, this study sought to develop and validate a Valvular Heart Disease- specific Age-adjusted Comorbidity Index (VHD-ACI) for predicting mortality risk in patients with VHD. METHODS & RESULTS: The China-VHD study was a nationwide, multi-centre multi-centre cohort study enrolling 13,917 patients with moderate or severe VHD across 46 medical centres in China between April-June 2018. After excluding cases with missing key variables, 11,459 patients were retained for final analysis. The primary endpoint was 2-year all-cause mortality, with 941 deaths (10.0%) observed during follow-up. The VHD-ACI was derived after identifying 13 independent mortality predictors: cardiomyopathy, myocardial infarction, chronic obstructive pulmonary disease, pulmonary artery hypertension, low body weight, anaemia, hypoalbuminaemia, renal insufficiency, moderate/severe hepatic dysfunction, heart failure, cancer, NYHA functional class and age. The index exhibited good discrimination (AUC, 0.79) and calibration (Brier score, 0.062) in the total cohort, outperforming both EuroSCORE II and ACCI (P < 0.001 for comparison). Internal validation through 100 bootstrap iterations yielded a C statistic of 0.694 (95% CI: 0.665-0.723) for 2-year mortality prediction. VHD-ACI scores, as a continuous variable (VHD-ACI score: adjusted HR (95% CI): 1.263 (1.245-1.282), P < 0.001) or categorized using thresholds determined by the Yoden index (VHD-ACI ≥ 9 vs. < 9, adjusted HR (95% CI): 6.216 (5.378-7.184), P < 0.001), were independently associated with mortality. The prognostic performance remained consistent across all VHD subtypes (aortic stenosis, aortic regurgitation, mitral stenosis, mitral regurgitation, tricuspid valve disease, mixed aortic/mitral valve disease and multiple VHD), and clinical subgroups stratified by therapeutic strategy, LVEF status (preserved vs. reduced), disease severity and etiology. CONCLUSION The VHD-ACI is a simple 13-comorbidity algorithm for the prediction of mortality in VHD patients and providing a simple and rapid tool for risk stratification.

[This corrects the article DOI: 10.1016/j.apsb.2019.01.013.].

OBJECTIVES: To explore the values of materialism in medical postgraduates and its relationship with depression. METHODS: We conducted a survey among 592 postgraduates in clinical medicine using Materialism Tendency Scale (MTS) and Patient Health Questionnaire-9 (PHQ-9). Descriptive analysis, mean comparison, and correlation analysis were used for data analysis. RESULTS: The postgraduates had a mean total score of materialism of 56.36±10.44, and 11.8%, 54.1%, and 34.1% of them reported high, medium, and low levels of materialism, respectively. No significant differences were found in the total score of materialism among the postgraduates of different genders or with different family economic levels, but the postgraduates from urban families had a significantly higher level of materialism than those from rural families (P<0.001). 18.4% of the postgraduates screened positive for moderate to severe depressive symptoms. The total score of MTS was positively correlated with depression (r=0.289, P<0.001). The dimension scores of MTS for materialism obsessions, material vanity, material interest, and material pursuit were all positively correlated with depression (r=0.183-0.289, P<0.001). The depressive symptoms and their overall levels differed significantly among individuals with different levels of materialism, and higher levels of materialism were associated with severer depressive symptoms (F=18.792, P<0.001) and a higher positive rate of depression (χ²=27.528, P<0.001). CONCLUSIONS Materialistic values may increase the risk of depression among medical postgraduates.
Humans ; Depression/epidemiology* ; Surveys and Questionnaires ; Female ; Adult ; Male ; Middle Aged ; Risk Factors

Objective:To develop three tDCS protocols based on the gait-related brain networks:the frontoparietal net-work(FPN),the dorsal-attention network(DAN),and the default network(DN),with the aim of specifical-ly modulating gait speed and gait variability and improving walking function. Method:In this study,healthy adults were recruited and randomly divided into 3 groups receiving different stimulation protocols:simultaneously enhancing the excitability of FPN and suppressing the excitability of DN(i.e.,FPN+/DN-tDCS),enhancing the excitability of DAN and suppressing the excitability of DN(i.e.,DAN+/DN-tDCS),and sham stimulation(Sham group).Normal,fast and dual-task gait tests were performed immediately before/after electrical stimulation,and spatiotemporal parameters and variability indicators of gait were collected.Two-way repeated measures ANOVA was used to assess the effects of three stimulation on gait characteristics under different conditions. Result:A total of 72 subjects were included in this study,64 of whom completed all tests.There were no significant interaction effects observed on gait spatiotemporal parameters in three conditions(normal,fast,dual-task walking conditions)and gait variability in normal walking between pre-and post-intervention assessments.In the fast gait task,there were significant interaction effects observed for stride length variability(F=3.671,P=0.031)and double support time variability(F=3.879,P=0.026).In the dual-task gait task,there were signif-icant interaction effects observed for stride width variability(F=3.940,P=0.025),gait speed variability(F=3.936,P=0.025),and double support time variability(F=4.913,P=0.011). Conclusion:The DAN+/DN-tDCS protocol were effective in reducing gait variability and improving gait stabili-ty during complex tasks in healthy adults.However,the FPN+/DN-tDCS protocol did not specifically improve gait speed under different conditions.

Objective To investigate the predictive value of procalcitonin(PCT),interleukin-6(IL-6),heparin binding protein(HBP),and C-reactive protein(CRP)in cerebral infarction(CI)complicated with pulmonary infection.Methods 145 CI patients treated in Jiangning Hospital Affiliated to Nanjing Medical University from July 2022 to June 2023 were selected as the CI group.Ac-cording to whether combined with pulmonary infection,they were divided into the co-infected group(n=76)with pulmonary infection and the simple CI group(n=69)without pulmonary infection.61 healthy volunteers performed physical examination in our hospital at the same time were enrolled as the control group.The general clinical data from each group were collected and their serum biochemical indicators were compared.The multivariate Logistic regression was used to analyze the risk factors of CI complicated with pulmonary in-fection and the receiver operating characteristic(ROC)curve was constructed.The area under the ROC curve(AUCROC)was used to evaluate the diagnostic value of each index for CI complicated with pulmonary infection.Results Age,PCT,IL-6,HBP,and CRP were the independent risk factors of CI complicated with pulmonary infection(P＜0.05).The ROC curve analysis showed that each in-dex of PCT,IL-6,HBP,and CRP had a certain value in predicting CI combined with pulmonary infection.The sensitivity and specific-ity of the combination detection of PCT,IL-6,HBP,and CRP were 85.47%and 75.36%,respectively,which were significantly high-er than that of the single detection of PCT,IL-6,HBP,and CRP(P＜0.05).Conclusion The levels of serum PCT,IL-6,HBP,and CRP are highly expressed in CI patients combined with pulmonary infection.They can be used for the diagnosis of CI combined with pulmonary infection.The combination detection of the four indexes can effectively improve the diagnosis accuracy of CI complicated with pulmonary infection.

The comparison between traditional Chinese medicine Jinzhen oral liquid (JZOL) and Western medicine in treating children with acute bronchitis (AB) showed encouraging outcomes. This trial evaluated the efficacy and safety of the JZOL for improving cough and expectoration in children with AB. 480 children were randomly assigned to take JZOL or ambroxol hydrochloride and clenbuterol hydrochloride oral solution for 7 days. The primary outcome was time-to-cough resolution. The median time-to-cough resolution in both groups was 5.0 days and the antitussive onset median time was only 1 day. This randomized controlled trial showed that JZOL was not inferior to cough suppressant and phlegm resolving western medicine in treating cough and sputum and could comprehensively treat respiratory and systemic discomfort symptoms. Combined with clinical trials, the mechanism of JZOL against AB was uncovered by network target analysis, it was found that the pathways in TRP channels like IL-1β/IL1R/TRPV1/TRPA1, NGF/TrkA/TRPV1/TRPA1, and PGE2/EP/PKA/TRPV1/TRPA1 might play important roles. Animal experiments further confirmed that inflammation and the immune regulatory effect of JZOL in the treatment of AB were of vital importance and TRP channels were the key mechanism of action.

OBJECTIVE: To observe the clinical effect of electroacupuncture at acupoints of yangming meridians for sarcopenia. METHODS: A total of 60 patients with sarcopenia were randomized into an observation group and a control group, 30 cases in each group. In the control group, conventional nutrition intervention for sarcopenia was adopted. In the observation group, on the basis of the treatment in the control group, acupuncture was applied at bilateral Binao (LI 14), Quchi (LI 11), Zusanli (ST 36), Yanglingquan (GB 34), etc.,ipsilateral Quchi (LI 11) and Zusanli (ST 36) were connected to electroacupuncture, with discontinuous wave, 2 Hz in frequency, 1-10 mA in intensity, 2 times a week, with a interval of 3 days. A total of 12-week treatment was required in the two groups. Before and after treatment, the appendicular skeletal muscle mass index (ASMI), grip strength, 6 m-walking time, body fat percentage and body moisture percentage were observed in the two groups. RESULTS: Compared with those before treatment, after treatment, ASMI and grip strength were increased while 6 m-walking time was shortened in the two groups (P<0.05); body fat percentage was decreased while body moisture percentage was increased in the observation group (P<0.05). After treatment, in the observation group, ASMI, grip strength and body moisture percentage were increased (P<0.05), 6 m-walking time was shortened and body fat percentage was decreased (P<0.05) compared with those in the control group. CONCLUSION Electroacupuncture at acupoints of yangming meridians can effectively improve the skeletal muscle mass, muscle function, body fat percentage and body moisture percentage in patients with sarcopenia, and make the distribution of muscle and fat more reasonable.
Humans ; Meridians ; Acupuncture Points ; Electroacupuncture ; Sarcopenia/therapy* ; Acupuncture Therapy

Variations in the dynein axonemal heavy chain gene, dynein axonemal heavy chain 6 (DNAH6), lead to multiple morphological abnormalities of the flagella. Recent studies have reported that these deficiencies may result in sperm head deformation. However, whether DNAH6 is also involved in human acrosome biogenesis remains unknown. The purpose of this study was to investigate DNAH6 gene variants and their potential functions in the formation of defective sperm heads and flagella. Whole-exome sequencing was performed on a cohort of 375 patients with asthenoteratozoospermia from the First Affiliated Hospital of Anhui Medical University (Hefei, China). Hematoxylin and eosin staining, scanning electron microscopy, and transmission electron microscopy were performed to analyze the sperm morphology and ultrastructure. Immunofluorescence staining and Western blot analysis were conducted to examine the effects of genetic variants. We identified three novel deleterious variants in DNAH6 among three unrelated families. The absence of inner dynein arms and radial spokes was observed in the sperm of patients with DNAH6 variants. Additionally, deficiencies in the acrosome, abnormal chromatin compaction, and vacuole-containing sperm heads were observed in these patients with DNAH6 variants. The decreased levels of the component proteins in these defective structures were further confirmed in sperm from patients with DNAH6 variants using Western blot. After intracytoplasmic sperm injection (ICSI) treatment, the partner of one patient with a DNAH6 variant achieved successful pregnancy. Overall, novel variants in DNAH6 genes that contribute to defects in the sperm head and flagella were identified, and the findings indicated ICSI as an effective clinical treatment for such patients.

OBJECTIVE: To develop and validate a user-friendly risk score for older mitral regurgitation (MR) patients, referred to as the Elder-MR score. METHODS: The China Senile Valvular Heart Disease (China-DVD) Cohort Study functioned as the development cohort, while the China Valvular Heart Disease (China-VHD) Study was employed for external validation. We included patients aged 60 years and above receiving medical treatment for moderate or severe MR (2274 patients in the development cohort and 1929 patients in the validation cohort). Candidate predictors were chosen using Cox's proportional hazards model and stepwise selection with Akaike's information criterion. RESULTS: Eight predictors were identified: age ≥ 75 years, body mass index < 20 kg/m², NYHA class III/IV, secondary MR, anemia, estimated glomerular filtration rate < 60 mL/min per 1.73 m², albumin < 35 g/L, and left ventricular ejection fraction < 60%. The model displayed satisfactory performance in predicting one-year mortality in both the development cohort (C-statistic = 0.73, 95% CI: 0.69-0.77, Brier score = 0.06) and the validation cohort (C-statistic = 0.73, 95% CI: 0.68-0.78, Brier score = 0.06). The Elder-MR score ranges from 0 to 15 points. At a one-year follow-up, each point increase in the Elder-MR score represents a 1.27-fold risk of death (HR = 1.27, 95% CI: 1.21-1.34, P < 0.001) in the development cohort and a 1.24-fold risk of death (HR = 1.24, 95% CI: 1.17-1.30, P < 0.001) in the validation cohort. Compared to EuroSCORE II, the Elder-MR score demonstrated superior predictive accuracy for one-year mortality in the validation cohort (C-statistic = 0.71 vs. 0.70, net reclassification improvement = 0.320, P < 0.01; integrated discrimination improvement = 0.029, P < 0.01). CONCLUSIONS The Elder-MR score may serve as an effective risk stratification tool to assist clinical decision-making in older MR patients.