BACKGROUND: Recent studies have provided compelling evidence that exposure to brominated flame retardants (BFRs) can adversely affect human health. We aim to explore the potential impact of BFRs on adiposity and central obesity. METHODS: Data from the National Health and Nutrition Examination Surveys (NHANES) cycles conducted between 2009 and 2014 was used to study the connections between variables. After filtering, we analyzed a sample of 4,110 adults aged 20 years and above. Our goal was to examine the potential association between BFRs and consequences and investigate the part played by oxidative stress and inflammatory markers as intermediaries. To achieve this, we used advanced statistical methods such as weighted quantile sum (WQS) regression, quantile-based g-computation (QGC), and the Bayesian kernel machine regression (BKMR). RESULTS: The findings showed that among the examined chemicals, exposure to PBDE85 (weight: 41%), PBDE100 (24%), and PBB153 (23%) may be the dominant contributors to general obesity risk. Upon controlling for all variables that could impact the results, it was found that the QGC outcomes indicated a positive correlation between exposure to mixtures of brominated flame retardants and the occurrence of abdominal obesity (OR = 1.187, 95% CI: 1.056-1.334, p = 0.004). Significant contributions were made by PBDE85 (52%), PBB153 (27%), and PBDE100 (21%). Mediation analysis shows that lymphatic cells (LC) and albumin (ALB) partially mediate the link between brominated flame retardants and obesity. The results of BKMR are generally consistent with those of WQS and QGC. CONCLUSION At a population level, our research has revealed a noteworthy correlation between BFRs and obesity. However, further investigation is required through prospective cohort studies and in-depth mechanistic exploratory studies.
Humans ; Flame Retardants/adverse effects* ; Oxidative Stress/drug effects* ; Adult ; Male ; Female ; Middle Aged ; Inflammation/epidemiology* ; Obesity/chemically induced* ; Biomarkers/blood* ; Nutrition Surveys ; Mediation Analysis ; Young Adult ; United States/epidemiology* ; Environmental Exposure/adverse effects* ; Aged ; Environmental Pollutants/adverse effects* ; Halogenated Diphenyl Ethers/adverse effects*

Objective:To investigate the efficacy and safety of anlotinib combined with GP (gemcitabine+cisplatin) regimen in the treatment of advanced triple-negative breast cancer refractory to anthracyclines and taxanes chemotherapy.Methods:A retrospective cohort study was conducted. Fifty two patients with advanced triple-negative breast cancer refractory to anthracyclines and taxanes chemotherapy in Affiliated Jiangyin Hospital of Nantong University from January 2019 to June 2022 were selected. According to follow-up treatment methods, they were divided into the treatment group of anlotinib combined with GP regimen (observation group) and the treatment group of GP regimen alone (control group), with 26 cases in each group. The short-term efficacy was evaluated according to the Response Evaluation Criteria in Solid Tumors 1.1 after 2 cycles of treatment, and the adverse reactions were assessed according to the Common Terminology Criteria for Adverse Events 4.0 after each treatment cycle. Kaplan-Meier method was used for analysis of progression-free survival (PFS) and overall survival (OS), and log-rank test was performed for inter group comparison. The scores of various dimensions of SF-36 quality of life scale before and after treatment were compared.Results:All 52 enrolled patients were able to evaluate the therapeutic effect. The objective response rate (ORR) of the observation group was 38.5% (10/26), and the disease control rate (DCR) was 84.6% (22/26). The ORR of the control group was 19.2% (5/26), and the DCR was 57.7% (15/26). The ORR and DCR of the observation group were higher than those in the control group, and the differences were statistically significant ( χ2 values were 10.82 and 7.18, respectively, both P < 0.05). The PFS [median PFS time, 5.4 months (95% CI: 5.0-5.8 months) vs. 3.9 months (95% CI: 3.6-4.2 months)] and OS [median OS time, 14.0 months (95% CI: 12.1-17.8 months) vs. 9.2 months (95% CI: 7.9-11.3 months)] of the observation group were better than those of the control group, and the differences were statistically significant (both P < 0.05). Compared with the control group, the incidence of hypertension [57.7% (15/26) vs. 3.8% (1/26)] and hand-foot syndrome [23.1% (6/26) vs. 0 (0/26)] in the observation group was higher (both P < 0.05), while there was no statistically significant difference in the incidence of nausea and vomiting, neutropenia, thrombocytopenia, anemia, bleeding, hyperbilirubinemia, fatigue, oral mucositis, and alopecia between the two groups (all P > 0.05). The scores of each dimension of the SF-36 quality of life scale in both groups of patients after treatment were higher than those before treatment (all P < 0.05), and the scores of each dimension in the observation group were higher than those in the control group after treatment (all P < 0.05). Conclusions:Anlotinib combined with GP regimen is effective in the treatment of advanced triple-negative breast cancer refractory to anthracyclines and taxanes chemotherapy, this regimen will not significantly increase the adverse reactions of chemotherapy and can improve the prognosis and the quality of life of patients.

Objective To explore the effects and mechanism of Dahuang Tangluo Pills on intestinal inflammatory injury in type 2 diabetes mellitus(T2DM)rats based on TLR4/NF-κB signaling pathway.Methods Eight ZDF(fa/+)rats were used as the blank group,and 40 ZDF(fa/fa)rats were fed with high-fat diet and then randomly divided into model group,metformin group(0.18 g/kg metformin)and TCM high-,medium-and low-dosage groups(2.16,1.08,0.54 g/kg Dahuang Tangluo Pills),respectively.The medication groups were gavaged with corresponding dosages for 12 consecutive weeks.The body mass and fasting blood glucose(FBG)of rats before and after intervention were detected.After the intervention,an oral glucose tolerance test(OGTT)was performed,the serum glucose(GLU),glycosylated serum protein(GSP),triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C)and high-density lipoprotein cholesterol(HDL-C)contents were detected.ELISA was used to detect serum fasting insulin(FINS),free fatty acids(FFA)and tumor necrosis factor-α(TNF-α),interleukin(IL)-6,IL-22,lipopolysaccharide(LPS),secreted immunoglobulin A(SIgA)contents in colonic tissue.HE staining was used to observe the morphology of colonic tissue,and Western blot was used to detect the expressions of Toll like receptor 4(TLR4),nuclear factor-κB p65(NF-κB p65),p-NF-κB p65,NF-κB inhibitor α(IκBα),p-IκBα,myeloid differentiation factor 88(MyD88)and zona pellucida protein-1(ZO-1)in colonic tissue.Results Compared with the blank group,the body mass and FBG significantly increased in the model group(P<0.01),blood glucose significantly increased at all time points of OGTT(P<0.01),serum GLU,GSP,TG,TC,LDL-C,FINS,FFA and TNF-α,IL-6,IL-22,LPS contents in colonic tissue significantly increased,serum HDL-C and colonic tissue SIgA contents significantly decreased(P<0.01),with colonic tissue nuclear condensation,cytoplasmic dissolution,inflammatory cell infiltration.The protein expressions of TLR4,NF-κB p65,p-NF-κB p65,p-IκBα and MyD88 in colonic tissue significantly increased,while the protein expressions of IκBα and ZO-1 significantly decreased(P<0.01).Compared with the model group,the body mass and FBG significantly decreased in metformin group,TCM high-and medium-dosage groups(P<0.01),blood glucose decreased at different time points of OGTT,and serum GLU,GSP,TG,TC,LDL-C,FINS,FFA and TNF-α,IL-6,IL-22,LPS contents in colonic tissue significantly decreased,serum HDL-C and colonic tissue SIgA contents significantly increased(P<0.05,P<0.01),with significant improvement in colonic tissue structure and reduction in inflammatory cell infiltration.The protein expressions of TLR4,NF-κB p65,p-NF-κB p65,p-IκBα and MyD88 in colonic tissue significantly decreased,while the proteins expression of IκBα and ZO-1 significantly increased(P<0.05,P<0.01).Conclusion Dahuang Tangluo Pills may inhibit the activation of the TLR4/NF-κB signaling pathway,reduce the release of inflammatory factors,improve intestinal inflammatory injury,restore intestinal homeostasis,thereby improving glucose and lipid metabolism and exerting therapeutic effects on T2DM.

Objective:To assess the feasibility and efficacy of transperineal laser ablation(TPLA)with single laser fiber in treating benign prostatic obstruction(BPO).Methods:From April 2021 to March 2024,a total of 13 BPO patients were selected from Beijing Friendship Hospital.TPLA was performed using a single laser fiber,which was guided by transrectal biplane ultrasound.The single laser fiber was used to undergo TPLA under the guidance of trans-rectal dual-plane ultrasound.The intraoperative time,ablation time,energy consumption,indwelling time of catheter,and complications were observed.The postoperative 6 months was chosen as the cut-off point of follow-up,and the pre and postoperative changes of international prostate symptom score(IPSS),quality of life index(QoL),prostate volume(PV),residual urine volume(RUV)and the maximum urine flow rate(Qmax)were compared.Results:All 13 patients successfully underwent TPLA with single laser fiber.The average operation time was(55.1±18.3)min,and the average ablation time was(16.3±1.7)min,and average energy consumption was(3951.6±459.7)J,and the median value of indwelling time of catheter was 7(7,10)days.The number of postoperative complication was 2 cases,and both them belonged to Clavien-Dindo grade II complication.At the postoperative 6th month,the IPSS,QoL,PV,Qmax and RUV of all patients were improved,all of which were better than preoperative these indicators,and the differences were significant(t=12.102,-3.228,-3.181,-2.581,-2.936,P<0.05).Conclusion:The application of single laser fiber in conducting TPLA operation is feasibility at technical aspect,and it can achieve the therapeutic goals of improving patients'symptoms and enhancing their quality of life.Although its operational time is slightly longer than that of using multiple fibers simultaneously,it can effectively reduce the cost of expenditure for consumables.

Objective:To analyze the clinical data and results of prenatal diagnosis for fetuses with high-risk for trisomy/monosomy 13 by non-invasive prenatal testing (NIPT).Methods:Clinical data of pregnant women with fetus at a high risk for trisomy/monosomy 13 by NIPT at the First Affiliated Hospital of Zhengzhou University from May 2016 to May 2024 were reviewed, and relevant data such as Z-score, positive predictive value (PPV) and fetal fraction (FF) were analyzed to assess the correlation between them. This study was approved by the Ethics Committee of the Hospital (No. 2018-YB-08). Results:71 fetuses were found to have a high risk by NIPT, including 58 cases for trisomy 13 (T13) and 13 cases for monosomy 13 (M13). 52 women had opted invasive prenatal diagnosis and 13 cases were confirmed, which yielded a positive prediction value (PPV) of 25%. 12 fetuses were confirmed as T13 (PPV = 29.3%; 12/41), 1 was confirmed as M13 (PPV = 9.1%; 1/11). The PPV had increased along with the Z-score. Fetal faction (FF) was not correlated with the age of woman but gestational age, and was negatively correlated with the body mass index. No statistical difference was found in FF and Z-score between true- and false-positive fetuses, and there was a weak correlation between the Z-score and FF. The PPV of the NIPT could be improved by combining the results of ultrasonography. Conclusion:The high false positive rate for T13 may be related to confined placental mosaicism, PPV is related to the Z-score, which in turn is related to FF. High-risk women are strongly recommended to undergo genetic counseling and prenatal diagnosis. Clinicians should consider relevant information such as the age of women, gestational age, indication for prenatal screening, Z-score, PPV, and FF in order to accurately interpret the result of NIPT, reduce anxiety, and avoid direct termination of the pregnancy.

OBJECTIVE: To analyze the clinical data and results of prenatal diagnosis for fetuses with high-risk for trisomy/monosomy 13 by non-invasive prenatal testing (NIPT). METHODS: Clinical data of pregnant women with fetus at a high risk for trisomy/monosomy 13 by NIPT at the First Affiliated Hospital of Zhengzhou University from May 2016 to May 2024 were reviewed, and relevant data such as Z-score, positive predictive value (PPV) and fetal fraction (FF) were analyzed to assess the correlation between them. This study was approved by the Ethics Committee of the Hospital (No. 2018-YB-08). RESULTS: 71 fetuses were found to have a high risk by NIPT, including 58 cases for trisomy 13 (T13) and 13 cases for monosomy 13 (M13). 52 women had opted invasive prenatal diagnosis and 13 cases were confirmed, which yielded a positive prediction value (PPV) of 25%. 12 fetuses were confirmed as T13 (PPV = 29.3%; 12/41), 1 was confirmed as M13 (PPV = 9.1%; 1/11). The PPV had increased along with the Z-score. Fetal faction (FF) was not correlated with the age of woman but gestational age, and was negatively correlated with the body mass index. No statistical difference was found in FF and Z-score between true- and false-positive fetuses, and there was a weak correlation between the Z-score and FF. The PPV of the NIPT could be improved by combining the results of ultrasonography. CONCLUSION The high false positive rate for T13 may be related to confined placental mosaicism, PPV is related to the Z-score, which in turn is related to FF. High-risk women are strongly recommended to undergo genetic counseling and prenatal diagnosis. Clinicians should consider relevant information such as the age of women, gestational age, indication for prenatal screening, Z-score, PPV, and FF in order to accurately interpret the result of NIPT, reduce anxiety, and avoid direct termination of the pregnancy.
Humans ; Female ; Pregnancy ; Trisomy 13 Syndrome/genetics* ; Adult ; Prenatal Diagnosis/methods* ; Noninvasive Prenatal Testing/methods*

Objective To explore the relationship between plasma trimethylamine N-oxide(TMAO)level and atrial fibrillation(AF)by a clinical trial.Methods Totally 257 patients with AF were enrolled including 114 patients with paroxysmal AF and 143 with persistent AF.The control group had 122 non-AF patients;Plasma TMAO level,the demographic characteristics and clinical data of patients were collected.Regression analysis was performed to identify the association between TMAO and presence of AF.Results Plasma TMAO level of patients with AF was higher than that of patients without AF(3.9[2.4-5.9]vs.2.4[1.6-3.7]μmol/L,P＜0.001);Even after adjust-ment of confounding factors including age,hypertension,diabetes,heart failure and body mass index;Plasma TMAO level was still related to presence of AF(OR:1.290,95％CI:1.151-1.445;P＜0.001).The plasma TMAO level of patients with persistent AF was higher than that of patients with paroxysmal AF(4.4[2.8-6.8]vs.3.2[2.2-5.0]μmol/L,P＜0.01);Even after adjustment of confounding factors including age,hypertension,diabetes and heart failure and coronary heart disease;Plasma TMAO level was still related to persistent AF(OR:1.092,95％CI:1.009-1.182;P=0.029).Conclusions The level of plasma TMAO of patients with AF is higher than that of patients without AF.Elevated plasma TMAO level is related to an increased risk of AF.Elevated plasma TMAO level in patients with AF is related to an increased risk of persistent AF.

Objective:To determine the clinical issues in the Clinical practice guidelines for postoperative pain management in adults (2024 edition). Methods:A preliminary list of clinical issues for the guidelines was developed through literature review, clinical surveys, and expert interviews. This was followed by two rounds of Delphi questionnaire surveys, with quality control and statistical analysis conducted using expert positive coefficient, mean item scores, full score ratio, coefficient of variation, Cronbach′s α coefficient, and expert authority level to finalize the list of clinical issues.Results:The experts participating in the Delphi questionnaire surveys had multidisciplinary collaborative backgrounds and regional representativeness, with a high level of authority. The overall positive coefficient of expert participation in the surveys was 78.9%. Through two rounds of the Delphi method and based on the screening criteria of a mean score ≥3.5, coefficient of variation ≤30%, and full score ratio ≥30%, 17 clinical issues were ultimately included following an expert consensus meeting.Conclusions:Through the Delphi method and rigorous quality control, the clinical issues in the Clinical practice guidelines for postoperative pain management in adults (2024 edition) are determined, laying a foundation for the subsequent development of the guidelines.

Objective:To determine the clinical issues in the Clinical practice guidelines for postoperative pain management in adults (2024 edition). Methods:A preliminary list of clinical issues for the guidelines was developed through literature review, clinical surveys, and expert interviews. This was followed by two rounds of Delphi questionnaire surveys, with quality control and statistical analysis conducted using expert positive coefficient, mean item scores, full score ratio, coefficient of variation, Cronbach′s α coefficient, and expert authority level to finalize the list of clinical issues.Results:The experts participating in the Delphi questionnaire surveys had multidisciplinary collaborative backgrounds and regional representativeness, with a high level of authority. The overall positive coefficient of expert participation in the surveys was 78.9%. Through two rounds of the Delphi method and based on the screening criteria of a mean score ≥3.5, coefficient of variation ≤30%, and full score ratio ≥30%, 17 clinical issues were ultimately included following an expert consensus meeting.Conclusions:Through the Delphi method and rigorous quality control, the clinical issues in the Clinical practice guidelines for postoperative pain management in adults (2024 edition) are determined, laying a foundation for the subsequent development of the guidelines.

Objective:To study the epidemiological characteristics and clinical diagnosis of human brucellosis in Qujing City, Yunnan Province.Methods:Through the Infectious Disease Reporting Information Management System of the China Disease Prevention and Control Information System, the basic information and clinical diagnostic data of brucellosis cases reported in Qujing City from January 2008 to December 2023 were retrospectively collected. Descriptive epidemiological methods were used to analyze the epidemic profile, three distribution characteristics (time, population, region), and diagnosis of brucellosis.Results:A total of 1 417 brucellosis cases were reported in Qujing City from 2008 to 2023, with no death. The annual average incidence of brucellosis was 1.49/100 000, with no cases reported in 2009 and 2010, and the highest incidence in 2023 (7.82/100 000). The incidence of brucellosis showed an increasing trend year by year (χ 2trend = 1 874.58, P < 0.001). The number of cases from June to November accounted for 61.54% (872/1 417). The majority of brucellosis cases were in the age group of 36 - 65 years old, accounting for 67.82% (961/1 417). Among them, there were 954 males and 463 females, with a gender ratio of 2.06 ∶ 1.00. Farmers were the main occupation, accounting for 84.33% (1 195/1 417). The cases were mainly distributed in Luliang County (621 cases), Xuanwei City (282 cases) and Shizong County (137 cases), accounting for 73.39% (1 040/1 417). The median interval between onset and diagnosis was 13 days, and the cases with intervals ≤7 d, 8 - 30 d, and ≥31 d accounted for 32.11% (455/1 417), 40.16% (569/1 417), and 27.73% (393/1 417), respectively. Totally 63.94% (906/1 417) of the cases were confirmed in medical institutions in Qujing City. Conclusions:The incidence of brucellosis in Qujing City is increasing year by year, with men, middle-aged and elderly people and farmers as the main population, summer and autumn as the peak period, and Luliang County, Xuanwei City and Shizong County as the high incidence areas. Most cases have an interval of less than 30 days between onset and diagnosis, and can be diagnosed within the jurisdiction.