BACKGROUND: The benefits of ideal cardiovascular-health metrics (ICVHMs) in patients with renal insufficiency remain unclear. This study aimed to investigate the associations between ICVHM and prognosis in a renal insufficiency population. METHODS: The trial enrolled 29,682 participants from the US National Health and Nutrition Examination Survey (NHANES), 2007-2018, with mortality follow-up through December 31, 2019. Participants were divided into three groups based on estimated glomerular filtration rates. Cardiovascular health was assessed using new "Life's Essential 8" metrics. Cox regression analyses based on NHANES data were used to determine the associations between ICVHMs and cardiovascular mortality in patients with renal insufficiency. RESULTS: During a mean follow-up of 6.58 years, ideal cardiovascular health (hazard ratio [HR] = 0.42; 95% confidence interval [CI]; 0.25-0.70) and ideal health behavior (HR = 0.53; 95% CI; 0.39-0.73) reduced cardiovascular mortality in participants with renal insufficiency. For each one ICVHM increment, a 25% reduction in cardiovascular mortality was recorded (95% CI; 0.69-0.82). When compared with participants with normal renal function, for those with mild renal insufficiency, the HR for cardiovascular mortality gradually decreased from 1.47 (95% CI; 0.85-2.52) in those who had ≤1 ICVHMs to 0.30 (95% CI; 0.12-0.77) in participants who had >6 ICVHMs. CONCLUSIONS From an ICVHM perspective, enhanced cardiovascular benefits were observed in individuals with renal insufficiency, coupled with a reduced risk of all-cause mortality. Furthermore, when compared with individuals with normal renal function, increased ICVHMs can mitigate adverse risks associated with renal impairment.
Humans ; Male ; Female ; Nutrition Surveys ; Middle Aged ; Renal Insufficiency/physiopathology* ; Aged ; Prognosis ; Adult ; Cardiovascular Diseases/mortality* ; Glomerular Filtration Rate/physiology* ; Proportional Hazards Models

Neoplasms characterized by the expression of markers of neuroendocrine differentiation in neoplastic cells are defined as neuroendocrine neoplasms. A case of neuroendocrine carcinomas (NECs) with a small amount of papillary adenocarcinoma and significantly vacuolar nucleus at the esophagogastric junction was reported in this article. A 77-year-old male had dysphagia for one week. Endoscopy revealed early-stage esophagogastric junction carcinoma, and biopsy was diagnosed as poorly differentiated carcinoma. Endoscopic submucosal dissection was performed. Histologically, the papillary adenocarcinoma progresses from typically branching papillary structures (well-differentiated) to hyperplasia of the lining epithelium of the papilla to form a cribriform structure (moderately differentiated), to solid area lacking papillary structures (poorly differentiated). There was a continuous process, and during this process, the vacuoles in the nuclei of tumor cells showed progressive changes from mild to obvious and finally to significant vacuoles. The tumor was mainly composed of solid areas (about 95%), with single cell, large cell, round or oval to irregular nuclei, and significantly vacuolar nuclei, nuclei with larger vacuoles appeared in a loop, a few thin weakly basophilic or weakly eosinophilic fine particles could be seen in the vacuoles, and the vacuoles had rough edges. The nucleus chromatin at the outer edge of the vacuoles was fine particles, and mitosis was common (20-30/mm²), atypical mitosis could be seen, and nucleoli could be seen easily, the cytoplasm was weakly eosinophilic, and the boundaries of cells were unclear. The cells were arranged in a nested, trabecular, or diffuse sheet shape, with some arranged in a glandular tube shape. Tumor thrombus was found in the vein of submucosa; the interstitial tissue rich in capillaries within the tumor was accompanied by a large number of neutrophil infiltration. Immunohistochemical staining showed that the solid area of the tumor was positive for synaptophysin (Syn) and chromogranin A (CgA), while papillary adenocarcinoma was negative. Mucin 5AC (MUC5AC) was diffusely positive in papillary adenocarcinoma, while the proportion of positive cells in the solid area of the tumor was about 10% to 15%. In a word, this case showed the extreme situation of the vacuolar nuclear characteristics of NECs, extremely rare, in a sense, this case expanded the boundary of the morphological spectrum of NECs. Understanding the extreme vacuolar features of this nucleus is helpful to make a correct pathological diagnosis.
Humans ; Male ; Esophagogastric Junction/pathology* ; Aged ; Carcinoma, Neuroendocrine/pathology* ; Vacuoles/pathology* ; Esophageal Neoplasms/pathology* ; Cell Nucleus/pathology* ; Adenocarcinoma, Papillary/pathology* ; Stomach Neoplasms/pathology*

OBJECTIVE: To explore the relationship between the geriatric nutritional risk index (GNRI) and cognitive function. METHODS: A cross-sectional study method was conducted. People aged ≥ 60 years from the National Health and Nutrition Examination Survey (NHANES) databases from 1999 to 2002 and 2011 to 2014 were included as study subjects. The participants were divided into three groups based on their GNRI scores: a medium-high risk group (82 ≤ GNRI < 92), a low risk group (92 ≤ GNRI < 98), and a no-risk group (GNRI ≥ 98). Demographic characteristics (gender, age, race, education), chronic diseases [chronic bronchitis, emphysema, thyroid problems, coronary heart disease, angina pectoris, stroke, hypertension, diabetes mellitus, and depression score on the patient health questionnaire (PHQ-9)], lifestyle habits (history of smoking, hours of sleep), etc., were collected. Cognitive function was assessed using the consortium to establish a registry for Alzheimer's disease word learning subtest (CERAD-WL), animal fluency test (AFT), and digit symbol substitution test (DSST) for the 2011-2014 data, while only the DSST was used for the 1999-2002 data. Differences in the above information among the GNRI cohorts were compared. Factors affecting cognitive function in the population were analyzed using multifactorial Logistic regression. RESULTS: 2 653 participants from 2011 to 2014 and 2 380 participants from 1999 to 2002 were enrolled, with a total of 5 033 participants in the study. There were statistically significant differences in age, stroke, diabetes mellitus, DSST score, AFT score, CERAD score test 1 recall (Cst1), and CERAD score test 2 recall (Cst2) among the GNRI groups. Multifactorial Logistic regression analysis of data from 2011 to 2014 showed that in model 3 (DSST score, age, gender, race, marriage, education, hours of sleep, history of smoking, emphysema, thyroid problems, chronic bronchitis, coronary heart disease, angina pectoris, hypertension, diabetes mellitus, depression score on the PHQ-9, and stroke) adjusted for all covariates, GNRI was a protective factor for DSST [odds ratio (OR) = 1.03, 95% confidence interval (95%CI) was 1.00 to 1.05, P = 0.03]; Logistic regression analyse for 1999 to 2002 and 2011 to 2014 showed a significant association even after adjustment for covariates (OR = 1.02, 95%CI was 1.00 to 1.03, P = 0.02). Subgroup Logistic regression analyses of the total population from 2011 to 2014 showed a significant association between GNRI and DSST scores (OR = 1.02, 95%CI was 1.01 to 1.03, P < 0.001), with significant associations in the age subgroups of 60 to 64 years old, across gender, non-Hispanic Whites and Blacks, by education, and by marital status associations were significant (all P < 0.05). Subgroup Logistic regression analyse of the total populations from 1999 to 2002 and 2011 to 2014 showed a significant association between the GNRI and DSST score (OR = 1.01, 95%CI was 1.01 to 1.02, P < 0.001), but did not show a significant year difference (interaction P = 0.503), and the newly found in the smoking population the association was also more significant (P < 0.01). CONCLUSION The GNRI correlates with the presence of cognitive functions related to processing speed, sustained attention, and executive function, and may be able to serve as an indicator for the assessment or prediction of related cognitive functions.
Humans ; Cross-Sectional Studies ; Aged ; Middle Aged ; Nutrition Surveys ; Cognition ; Female ; Male ; Nutritional Status ; Risk Factors ; Geriatric Assessment

This study aimed to investigate the influence of anti-cross-reactive carbohydrate determinant IgE antibodies (anti-CCD IgE) on the detection of allergen-specific IgE (sIgE) antibodies, as well as the application value of anti-CCD IgE adsorbents in detecting allergen sIgE. In this cross-sectional study, a total of 2 636 test samples from patients who received treatment in West China Hospital of Sichuan University and tested allergen sIgE using the western blot method from October 2020 to May 2021 were analyzed. In these samples, 709 samples tested postive of allergen sIgE. 46 stochastic venous serum samples that tested positive in both sIgE and anti-CCD IgE and 1 serum sample that tested positive in sIgE but negative in anti-CCD IgE were collected. These samples were processed by anti-CCD IgE adsorbents, followed by allergen sIgE detection. The difference between the two detection results before and after adsorption was analyzed. The allergen test results showed that the positive rate of anti-CCD IgE in samples was 2.6% (69/2 636) during the period of sample collection. After treatment with anti-CCD IgE adsorbents, the top three allergen-sIgE of the positive rate changed from tree combination 2 (willow/poplar/elm), common ragweed and peanut to dust mite combination, cockroach and crab. The positive anti-CCD IgE results of 46 samples all turned negative and the total positive sIgE antibody dropped by 62.8%; the positive rate of sIgE antibodies with the class result ≥2 significantly decreased after treatment with anti-CCD IgE adsorbents, especially the positive rate of common ragweed dropped by 96.2%. The results of positive samples showed that multiple sIgE antibodies declined by different ranges, involving up to 11 antibodies with a maximum decline of 4 classes. Strongly positive sIgE antibodies (the class result ≥4) also had a high conversion rate of negative (25.0%-100%). The positive sIgE antibodies in about 60% of the samples decreased by more than 2, and the sIgE antibodies in 17.4% of the samples turned completely negative. There was no change in the allergen sIgE detection results of the sample with negative anti-CCD IgE after treatment. In conclusion, sIgE antibodies including targeting common ragweed, humulus, tree combination 2 (willow/poplar/elm), etc. are susceptible to false positives caused by anti-CCD IgE. Treatment of samples with anti-CCD IgE adsorbents can significantly reduce the risk of false positives caused by anti-CCD IgE. It is necessary to pretreat samples that were anti-CCD IgE positive with anti-CCD IgE adsorbents, which can make laboratory results more accurate and provide a reference for diagnosis and prevention of allergic diseases.

This study aimed to investigate the influence of anti-cross-reactive carbohydrate determinant IgE antibodies (anti-CCD IgE) on the detection of allergen-specific IgE (sIgE) antibodies, as well as the application value of anti-CCD IgE adsorbents in detecting allergen sIgE. In this cross-sectional study, a total of 2 636 test samples from patients who received treatment in West China Hospital of Sichuan University and tested allergen sIgE using the western blot method from October 2020 to May 2021 were analyzed. In these samples, 709 samples tested postive of allergen sIgE. 46 stochastic venous serum samples that tested positive in both sIgE and anti-CCD IgE and 1 serum sample that tested positive in sIgE but negative in anti-CCD IgE were collected. These samples were processed by anti-CCD IgE adsorbents, followed by allergen sIgE detection. The difference between the two detection results before and after adsorption was analyzed. The allergen test results showed that the positive rate of anti-CCD IgE in samples was 2.6% (69/2 636) during the period of sample collection. After treatment with anti-CCD IgE adsorbents, the top three allergen-sIgE of the positive rate changed from tree combination 2 (willow/poplar/elm), common ragweed and peanut to dust mite combination, cockroach and crab. The positive anti-CCD IgE results of 46 samples all turned negative and the total positive sIgE antibody dropped by 62.8%; the positive rate of sIgE antibodies with the class result ≥2 significantly decreased after treatment with anti-CCD IgE adsorbents, especially the positive rate of common ragweed dropped by 96.2%. The results of positive samples showed that multiple sIgE antibodies declined by different ranges, involving up to 11 antibodies with a maximum decline of 4 classes. Strongly positive sIgE antibodies (the class result ≥4) also had a high conversion rate of negative (25.0%-100%). The positive sIgE antibodies in about 60% of the samples decreased by more than 2, and the sIgE antibodies in 17.4% of the samples turned completely negative. There was no change in the allergen sIgE detection results of the sample with negative anti-CCD IgE after treatment. In conclusion, sIgE antibodies including targeting common ragweed, humulus, tree combination 2 (willow/poplar/elm), etc. are susceptible to false positives caused by anti-CCD IgE. Treatment of samples with anti-CCD IgE adsorbents can significantly reduce the risk of false positives caused by anti-CCD IgE. It is necessary to pretreat samples that were anti-CCD IgE positive with anti-CCD IgE adsorbents, which can make laboratory results more accurate and provide a reference for diagnosis and prevention of allergic diseases.

Objective To investigate the effect and molecular mechanism of tRF-1:30-Gln-CTG-4(tRF-1:30)on the expression of inflammatory factors in high glucose(HG)-induced renal tubular epithelial cells(RTECs).Methods RTECs were divided into the control group,the HG group,the HG+tRF-1:30 mimic group,the HG+tRF-1:30 negative control(NC)group,the HG+si-IKZF2 group and the HG+si-NC group.Real-time quantitative polymerase chain reaction(RT-qPCR)was used to detect the expression levels of tRF-1:30,tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),monocyte chemoattractant protein-1(MCP-1)and IKAROS family zinc finger protein 2(IKZF2).Enzyme-linked immunosorbent assay(ELISA)was used to detect levels of TNF-α,IL-6 and MCP-1.Protein expression of IKZF2 was detected by Western blot assay.Dual-luciferase reporter assay was used to detect the targeting relationship between tRF-1:30 and IKZF2.Results The expression levels of inflammatory factors were elevated in HG-induced RTECs,and the expression level of tRF-1:30 was decreased(P＜0.05).Overexpression of tRF-1:30 significantly decreased expression levels of inflammatory factors in HG-induced RTECs(P＜0.05),and the expression level of IKZF2 was significantly increased(P＜0.05).Further knockdown of IKZF2 can inhibit the release of inflammatory factors,and the expression level of IKZF2 was down-regulated after overexpression of tRF-1:30.Double luciferase reporting experiment further verified the possible targeting relationship between tRF-1:30 and IKZF2.Conclusion Overexpression of tRF-1:30 inhibits the expression of inflammatory factors in HG-induced RTECs by target binding and negatively regulating the expression of IKZF2.

Objective: To investigate the association of parental knowledge and skills in myopia prevention and control with healthy eye behavior in primary school children, so as to provide a basis for accurate family education. Methods: A total of 4 979 students in grades 1-5 from eight elementary schools in Pudong New Area were sampled between October and December in 2022 by using a stratified cluster sampling method. A self administered questionnaire was used to assess healthy eye behavior in primary school children and parental knowledge and skills in myopia prevention and control. The Chi squared test, independent samples t-test and Logistic regression were used to analyse the association between parental knowledge and skills in myopia prevention and control and healthy eye behaviour in primary school children. Results: Parents of primary school children with a high level of knowledge and skills in myopia prevention and control were 50.97% and 56.36%, respectively. The knowlegde entry scores for parents of lower and middle elementary school students were higher than those of parents of upper primary students with respect to their understanding, on the main causes of myopia in their children, the correct knowledge of myopia prevention and control, the role of family members in helping each other to manage and treat myopia in their children and the parents responsibility to teach their children to use their eyes correctly and scientifically (3.05±1.21, 2.97±1.20; 5.92±0.68, 5.83±0.86; 4.46±0.88, 4.40±0.93; 3.88±1.04, 3.72±1.07); all differences were statistically significant (t=2.04, 3.39, 2.00, 4.87, P<0.05). The differences in the scores of parents of primary school children in different grades for all items were statistically significant (t=2.93-7.31, P<0.05) in the skill entries. Parental knowledge levels were poor for items of full scores that assessed the following: knowing the main causes of their childrens myopia, awareness of the correct knowledge of myopia prevention and control measures, awareness of Comprehensive Prevention and Control Strategy for Children and Adolescents with Myopia, and concerning that their childrens future education and employment will be affected by myopia, understanding the responsibility of parents for guiding children to use their eyes scientifically and correctly, with 12.71%, 22.90%, 19.30%, 21.83% and 22.47% respectively. Parental skills were poor for items of full scores that assessed the following:reminding their children to rest their eyes when doing homework, reading or writing, deliberately avoiding mobile phone use when spending time with their children, the number of times which taking children to the hospital for refractive screening in the past year, and giving their children extra learning tasks, with 33.26%, 15.12%, 9.00% and 5.36% respectively. Compared to parental knowledge in myopia prevention and control, parental skills had a more pronounced effect on the four dimensions of healthy eye behavior (reading and writing, screen time, outdoor activities, and sleep duration) among students in different grades (OR=1.41-3.37, P<0.05). Conclusions Parental knowledge and skills in myopia prevention and control are still insafficient, associated with healthy eye behavior in primary school children. There is a need to strengthen accurate health education for parents on the prevention and control of myopia, to cultivate healthy eye behaviour among primary school students and reduce the incidence of myopia among them.

Atmospheric fine particulate matter (particulate matter 2.5,PM_2.5) is a major component of haze, and its potential hazards to human reproductive health have garnered widespread attention. Establishing appropriate animal models is crucial for in-depth research into the reproductive toxicity of PM_2.5 exposure and its underlying mechanisms. This paper, based on recent literature, summarizes current methods for establishing PM_2.5-exposed animal models and the evaluation criteria for reproductive toxicity research. The primary modeling methods for PM_2.5 exposure include whole-body inhalation exposure and intratracheal instillation exposure. While whole-body inhalation exposure effectively simulates real-life human inhalation environments, it requires sophisticated experimental equipment. Conversely, intratracheal instillation exposure is more cost-effective and easier to operate but faces challenges in accurately mimicking the distribution and deposition of PM_2.5 during natural inhalation. Therefore, researchers must carefully weigh these exposure methods to enhance model rigor and achieve the most realistic simulation of human exposure conditions. When summarizing the application evaluation indicators of PM_2.5-induced reproductive toxicity, this review finds that the main indicators of male reproductive toxicity include reduced sperm quality, testicular tissue damage, and hormonal imbalances. For female reproductive toxicity, the primary indicators are reduced ovarian reserve, endocrine dysfunction, endometrial damage, and adverse perinatal reactions. Additionally, this review highlights the need for detailed chemical composition analysis of PM_2.5, exploring the reproductive toxic targets and mechanisms of particles containing different chemical components, such as heavy metals and polycyclic aromatic hydrocarbons. Long-term studies are also necessary to assess the effects of PM_2.5 exposure on reproductive health and transgenerational effects, to predict potential long-term risks for humans. Additionally, interdisciplinary collaboration should be encouraged, involving cooperation between environmental science, toxicology, reproductive medicine, and other disciplines, to comprehensively assess the environmental health risks of PM_2.5 and provide scientific support for the development of integrated prevention and control strategies. This review summarizes animal modeling methods, evaluation criteria, and their applications, providing valuable methodological references for future reproductive toxicity research on PM_2.5.

The incidence of osteoporotic thoracolumbar vertebral fracture (OTLVF) in the elderly is gradually increasing. The kyphotic deformity caused by various factors has become an important characteristic of OTLVF and has received increasing attention. Its clinical manifestations include pain, delayed nerve damage, sagittal imbalance, etc. Currently, the definition and diagnosis of OTLVF with kyphotic deformity in the elderly are still unclear. Although there are many treatment options, they are controversial. Existing guidelines or consensuses pay little attention to this type of fracture with kyphotic deformity. To this end, the Lumbar Education Working Group of the Spine Branch of the Chinese Medicine Education Association and Editorial Committee of Chinese Journal of Trauma organized the experts in the relevant fields to jointly develop Clinical guidelines for the diagnosis and treatment of osteoporotic thoracolumbar vertebral fractures with kyphotic deformity in the elderly ( version 2024), based on evidence-based medical advancements and the principles of scientificity, practicality, and advanced nature, which provided 18 recommendations to standardize the clinical diagnosis and treatment.

Objective To observe the effect of nursing-led auricular acupressure therapy in improving the symptoms of peripheral neuropathy in breast cancer patients with chemotherapy of paclitaxel. Methods A total of 86 patients were randomly divided into study group and control group, with 43 cases in each group. The study group was treated with traditional western medicine and auricular acupressure, while the control group was treated with traditional western medicine alone. The clinical efficacy and scores of peripheral neuropathy symptoms were compared between the two groups. Results After treatment, the scores of limb numbness, limb pain, fatigue and tendon reflex in both groups were significantly lower than those before treatment, and the scores of the above symptoms in the study group were significantly lower than those in the control group (P < 0.05).The total effective rate of the study group was 88.4% (38/43), which was significantly higher than 74.4% (32/43) in the control group (P < 0.05). Conclusion The nursing-led auricular acupressure therapy combined with mecobalamin can improve the symptoms of peripheral neurotoxicity in breast cancer patients treated with paclitaxel, with the advantages of non-invasiveness, simplicity, safety, flexibility, cost-effectiveness, and good compliance.