ObjectiveTo investigate the association of particulate matter and ozone with the prevalence of non-alcoholic fatty liver disease (NAFLD) in a district of Shanghai, and to provide epidemiological evidence for the further identification of early health hazards of air pollution and for the prevention and control of NAFLD. MethodsBased on Songjiang Sub-cohort of Shanghai Natural Population Cohort, a cross-sectional survey design was used to recruit participants from 2016 to 2017. Annual average exposure levels to air pollution from 2009 to 2017 were matched to the participant’s residential address using a high-resolution and high-quality ambient air pollutants dataset in China. NAFLD was diagnosed according to the “Guidelines for the prevention and treatment of metabolism⁃associated (non⁃alcoholic) fatty liver disease” by the Chinese Medical Association. Multivariate logistic regression models were employed to analyze the association between air pollution and the prevalence of NAFLD, and stratified analyses were used to compare differences by age, gender, obesity, and lifestyle habits within subgroups. ResultsA total of 32 791 individuals were included in the study. The prevalence of NAFLD among community residents in suburban Shanghai was 38.88%. For every 1 μg·m^-3 increase in PM₁, PM_2.5, PM₁₀, or O₃, the risk of NAFLD increased correspongdinglt, with the odds ratios (95%CI) of 1.071 (1.043‒1.099), 1.065 (1.042‒1.089), 1.041 (1.027‒1.055), or 1.061 (1.032‒1.091), respectively. There were differences in effects across different gender, age, and obesity status subgroups. ConclusionPM₁, PM_2.5, PM₁₀, and O₃ are positively associated with an increased risk of NAFLD. Stratified analyses reveal that individuals aged 65 years old or above exhibited greater susceptibility to PM₁, PM_2.5, and O₃, whereas those aged less than 65 years old are more vulnerable to PM₁₀. Males are more sensitive to PM₁ and O₃, and females are more susceptible to PM_2.5 and PM₁₀. The association between air pollutant exposure and NAFLD risk is more pronounced among obese participants compared to that in non-obese counterparts.

Objective: To investigate the correlation between tumor size, tumor location, and prognosis in patients with early-stage endometrial cancer (EC) receiving adjuvant radiotherapy. Methods: Data of patients who had been treated for stage I–II EC from March 1999 to September 2017 in 13 tertiary hospitals in China was screened. Cox regression analysis was performed to investigate associations between tumor size, tumor location, and other clinical or pathological factors with cancer-specific survival (CSS) and distant metastasis failurefree survival (DMFS). The relationship between tumor size as a continuous variable and prognosis was demonstrated by restricted cubic splines. Prognostic models were constructed as nomograms and evaluated by Harrell’s C-index, calibration curves and receiver operating characteristic (ROC) curves. Results: The study cohort comprised 805 patients with a median follow-up of 61 months and a median tumor size of 3.0 cm (range 0.2–15.0 cm). Lower uterine segment involvement (LUSI) was found in 243 patients (30.2%). Tumor size and LUSI were identified to be independent prognostic factors for CSS. Further, tumor size was an independent predictor of DMFS. A broadly positive relationship between poor survival and tumor size as a continuous variable was visualized in terms of hazard ratios. Nomograms constructed and evaluated for CSS and DMFS had satisfactory calibration curves and C-indexes of 0.847 and 0.716, respectively. The area under the ROC curves for 3- and 5-year ROC ranged from 0.718 to 0.890. Conclusion Tumor size and LUSI are independent prognostic factors in early-stage EC patients who have received radiotherapy. Integrating these variables into prognostic models would improve predictive ability.

Objective: To investigate the correlation between tumor size, tumor location, and prognosis in patients with early-stage endometrial cancer (EC) receiving adjuvant radiotherapy. Methods: Data of patients who had been treated for stage I–II EC from March 1999 to September 2017 in 13 tertiary hospitals in China was screened. Cox regression analysis was performed to investigate associations between tumor size, tumor location, and other clinical or pathological factors with cancer-specific survival (CSS) and distant metastasis failurefree survival (DMFS). The relationship between tumor size as a continuous variable and prognosis was demonstrated by restricted cubic splines. Prognostic models were constructed as nomograms and evaluated by Harrell’s C-index, calibration curves and receiver operating characteristic (ROC) curves. Results: The study cohort comprised 805 patients with a median follow-up of 61 months and a median tumor size of 3.0 cm (range 0.2–15.0 cm). Lower uterine segment involvement (LUSI) was found in 243 patients (30.2%). Tumor size and LUSI were identified to be independent prognostic factors for CSS. Further, tumor size was an independent predictor of DMFS. A broadly positive relationship between poor survival and tumor size as a continuous variable was visualized in terms of hazard ratios. Nomograms constructed and evaluated for CSS and DMFS had satisfactory calibration curves and C-indexes of 0.847 and 0.716, respectively. The area under the ROC curves for 3- and 5-year ROC ranged from 0.718 to 0.890. Conclusion Tumor size and LUSI are independent prognostic factors in early-stage EC patients who have received radiotherapy. Integrating these variables into prognostic models would improve predictive ability.

Objective: To investigate the correlation between tumor size, tumor location, and prognosis in patients with early-stage endometrial cancer (EC) receiving adjuvant radiotherapy. Methods: Data of patients who had been treated for stage I–II EC from March 1999 to September 2017 in 13 tertiary hospitals in China was screened. Cox regression analysis was performed to investigate associations between tumor size, tumor location, and other clinical or pathological factors with cancer-specific survival (CSS) and distant metastasis failurefree survival (DMFS). The relationship between tumor size as a continuous variable and prognosis was demonstrated by restricted cubic splines. Prognostic models were constructed as nomograms and evaluated by Harrell’s C-index, calibration curves and receiver operating characteristic (ROC) curves. Results: The study cohort comprised 805 patients with a median follow-up of 61 months and a median tumor size of 3.0 cm (range 0.2–15.0 cm). Lower uterine segment involvement (LUSI) was found in 243 patients (30.2%). Tumor size and LUSI were identified to be independent prognostic factors for CSS. Further, tumor size was an independent predictor of DMFS. A broadly positive relationship between poor survival and tumor size as a continuous variable was visualized in terms of hazard ratios. Nomograms constructed and evaluated for CSS and DMFS had satisfactory calibration curves and C-indexes of 0.847 and 0.716, respectively. The area under the ROC curves for 3- and 5-year ROC ranged from 0.718 to 0.890. Conclusion Tumor size and LUSI are independent prognostic factors in early-stage EC patients who have received radiotherapy. Integrating these variables into prognostic models would improve predictive ability.

Enhancer of zeste homolog 2 (EZH2) is a catalytic subunit of polycomb repressive complex 2 (PRC2). It acts as a histone methylation transferase and plays a key role in oncogenesis, development, metastasis, and drug tolerance. Studies have found that the expression of EZH2 is regulated by a variety of carcinogenic transcription factors, anti-cancer microRNA, tumor-related non-coding RNA and post-translational modifications. Moreover, the effect of EZH2 in silencing target genes is mainly through trimethylation of histone H3 at lysine 27 (H3K27me3). This article summarizes the main regulatory roles and functions of EZH2 in tumorigenesis, and reviews the progress of target therapies based on EZH2.

Objective To investigate the diagnostic values of procalcitonin (PCT),high sensitive C-reactive protein (hs-CRP),white blood cell (WBC)and percentage of neutrocyte (NEU％)in Gramnegative and Gram-positive bacterial blood stream infection in early stage of sepsis in order to investigate the correlation between PCT and APACHE lⅡ score as well as between PCT and SOFA score,and the prognostic value in assessment of Gram-negative and Gram-positive bacterial blood stream infection.Methods Clinical data of patients admitted to ICU from January 2012 through December 2014 were retrospectively analyzed.A total of 124 sepsis patients with blood stream infection were checked with PCT,hs-CRP,WBC and NEU％ tests,and APACHE Ⅱ score and SOFA score were calculated.The differences in APACHE Ⅱ score and SOFA score were compared between Gram-negative group (n =41) and Gram-positive group (n =83).The correlation between PCT and APACHE Ⅱ score as well as between PCT and SOFA score was analyzed.The differences in diagnostic values of PCT,hs-CRP,WBC and NEU％ between Gram-negative group and Grampositive group were analyzed by using receiver operating characteristic (ROC) curve and it was plotted to assess the prognostic values of PCT,hs-CRP,WBC and NEU％ for septic patients with blood stream infection.Results Compared with Gram-positive group,the levels of PCT [.55.32 (22.01,97.11) vs.2.13 (0.27,5.27)] (P ＜0.01),hs-CRP [105.09 (69.97,186.12) vs.70.54 (42.37,138.63)] (P=0.508),NEU％ [88.30 (75.79,93.52) vs.55.32 (22.01,97.11)] (P=0.302) were higher but WBC was lower [13.59 (10.74,17.58) vs.13.73 (11.32,20.90)] (P=0.058) in Gram-negative group.The ROC curve analysis of PCT showed the area under the curve (AUC) was 0.867 (95％ CI:0.789-0.946).When the optimal cutoff point of PCT was 17.48 ng/mL,the largest Youden's index was found to be 0.661 with 76.9％ sensitivity and 89.2％ specificity.Between two groups,there were significant differences in APACHE Ⅱ score and SOFA score (27.46 ± 9.60 vs.23.67 ± 7.74,P =0.020;8.05 ±3.38 vs.6.59-±3.45,P =0.028).There was significant difference in diagnostic value between PCT and SOFA (r =0.536,P =0.036) in Gram-negative group but no significant difference in Gram-positive group.Conclusions Higher PCT levels are found in Gram-negative group and it can play a role in differntiation between the Gram-negative group and Gram-positive group rather than hs-CRP,WBC and NEU％.PCT can be a better indicator for evaluation of severity of sepsis as well as for prognosis of sepsis patients with Gram-negative bacterium infection.

Objective To analyze the effect of perioperative systemic nursing for laparoscopic radical nephrectomy patients.Methods A total of 90 patients with laparoscopic radical nephrectomy undergoing laparoscopic surgery were randomly divided into observation group and control group,with 45 cases in each group.The observation group used the perioperative whole systematic nursing,the control group traditional nursing.The therapeutic effect,postoperative pain,SAS score,SDS score and postoperative complications were compared between the two groups.Results The total effective rate of the observation group was significantly higher than that of the control group (97.78％ vs.84.44％,P ＜ 0.05);The number of patients with 0,Ⅰ pain was more,and grade Ⅱ and Ⅲ pain patients in observation group were significantly less than that in the control group (P ＜ 0.05);SAS scores and SDS scores of the two groups after treatment decreased compared with treatment before,and the observation group was significantly lower than the control group (P ＜ 0.05);The postoperative complication rate in the observation group was significantly lower than that in the control group (P ＜ 0.05).Conclusion Perioperative systemic nursing measures can improve the curative effect of laparoscopic radical nephrectomy,relieve the pain and negative mood of patients,and reduce the incidence of complications.

Objective To analyze the effect of perioperative systemic nursing for laparoscopic radical nephrectomy patients.Methods A total of 90 patients with laparoscopic radical nephrectomy undergoing laparoscopic surgery were randomly divided into observation group and control group,with 45 cases in each group.The observation group used the perioperative whole systematic nursing,the control group traditional nursing.The therapeutic effect,postoperative pain,SAS score,SDS score and postoperative complications were compared between the two groups.Results The total effective rate of the observation group was significantly higher than that of the control group (97.78％ vs.84.44％,P ＜ 0.05);The number of patients with 0,Ⅰ pain was more,and grade Ⅱ and Ⅲ pain patients in observation group were significantly less than that in the control group (P ＜ 0.05);SAS scores and SDS scores of the two groups after treatment decreased compared with treatment before,and the observation group was significantly lower than the control group (P ＜ 0.05);The postoperative complication rate in the observation group was significantly lower than that in the control group (P ＜ 0.05).Conclusion Perioperative systemic nursing measures can improve the curative effect of laparoscopic radical nephrectomy,relieve the pain and negative mood of patients,and reduce the incidence of complications.

Objective To observe the features of the changes in the whole blood N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in pregnant patients with complication of hypertensive disorders,its correlation to the severity of the illness,and to investigate the diagnostic value of point-of-care testing of NT-proBNP in patients with hypertensive disorders complicating pregnancy.Methods A prospective observation was conducted.Sixty-nine patients with hypertensive disorders complicating pregnancy admitted to Department of Critical Care Medicine of Liaocheng People's Hospital in Shandong Province from April 2013 to April 2015 were enrolled.All patients were divided into gestational hypertension group (n =16),preeclampsia group (n =30) and eclampsia group (n =23).At the same time,30 age-matched normal pregnant women were enrolled as the control group.The acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score of all patients with hypertensive disorders complicating pregnancy were calculated within 24 hours after intensive care unit (ICU) admission.NT-proBNP in venous blood at 1,3,5 days after ICU admission was determined with point-of-care testing,in order to analyze the correlation of changes in NT-proBNP value in each group and the severity of the disorder.Receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic value of NT-proBNP in the whole blood in hypertensive disorder complicating pregnancy.Results The APACHE Ⅱ score of the eclampsia group was significantly higher than that of the preeclampsia group,and it was higher than that of gestational hypertension group (15.91 ± 1.06,13.73 ± 1.09,10.31 ± 1.10,all P ＜ 0.01).The NT-proBNP in normal pregnancy group was lower than 125.00 ng/L,with a mean of 90.00 (79.75,100.00) ng/L.With the aggravation of the disease,NT-proBNP was gradually increased.On the first day in ICU,the NT-proBNP of the eclampsia gronp was significantly higher than that of the preeclampsia group,and it was higher in preeclampsia group than that of gestational hypertension group [ng/L:1960.00 (1 226.00,3 229.00),859.50 (626.75,2439.00),505.00 (171.25,604.05),P ＜ 0.05 or P ＜ 0.01].With the extension of duration of treatment,the levels of NT-proBNP (ng/L) in the eclampsia group,preeclampsia group,and gestational hypertension group was gradually decreased,and had a statistically significant difference on the fifth day as compared with that of the first day [310.00 (210.00,430.00) vs.1 960.00 (1 226.00,3 229.00) in eclampsia group,265.00 (229.50,333.25) vs.859.50 (626.75,2439.00) in preeclampsia group,and 203.00 (115.50,259.25) vs.505.00 (171.25,604.05) in gestational hypertension group,all P ＜ 0.01].APACHE Ⅱ score of the patient with hypertensive disorders complicating pregnancy was positively correlated with the level of NT-proBNP on the first day in ICU (r =0.795,P =0.000).It was shown by ROC curve analysis that the area under the ROC curve (AUC) of NT-proBNP in the whole blood for the diagnosis of the patient with hypertensive disorder complicating pregnancy was 0.986 [95％ confidence interval (95％C/) =0.753-0.924].When the cutoff value was 122.50 ng/L,the sensitivity was 97.1％,and the specificity was 100.0％.No patient died,all the 69 patients recovered and discharged.Conclusions The levels of NT-proBNP in the whole blood in the patients with hypertensive disorder complicating pregnancy,especially those with eclampsia,were significantly higher,and it was correlated with the severity of illness.After treatment,the levels were gradually lowered with the improvement of the disease.Therefore,it is concluded that the point-of-care testing of NT-proBNP in the whole blood has an excellent value for the diagnosis and evaluation of hypertensive disorder complication pregnancy.

Objective to investigate the correlation between glutathione S- transferase gene M1,t1 and P1(GStM1,GStt1 and GStP1)poly-morphism and sperm DNA fragmentation index(DFI)in male patients with idiopathic infertile. Methods the study included 246 male patients with idiopathic infertility. Polymerase chain reaction(PCR)and polymerase chain reaction restriction fragment length polymorphism(PCR-RFLP) were used to identify the genotype of GStM1,GStt1 and GStP1,respectively. Sperm DFI was analyzed by flow cytometry with acridine orange staining. Results the sperm DFI was significantly higher in GStt1 gene null type group than in GStt1 gene wild type group(P < 0.01);and there were no significant differences in GStM1 and GStP1 gene mutation type groups when comparing with the wild type group(P > 0.05). Conclusion GStt1 gene deletion was positive associated with the sperm DFI in male idiopathic infertile patients.