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 explore the thoughts and medication rules of the contemporary inheritors of Lingnan LUO's Gynecology in differentiating and treating menopausal syndromes based on data mining technology.Methods The medical records of menopausal syndrome differentiated and treated by the contemporary inheritors of Lingnan LUO's Gynecology in clinic were collected.The Ancient and Modern Medical Records Cloud Platform(V2.3.5)was used to perform frequency statistics,association rule analysis,cluster analysis and complex network analysis of the data of medical records.Results A total of 191 medical records and 191 prescriptions were finally included,involving 160 kinds of Chinese medicinals.The statistics of four-examination information and syndrome types showed that the pathogenesis of menopausal syndrome was characterized by deficiency of the origin,which resulted in the dysfunction of healthy qi and the disturbance of the pivot,and then multiple viscera were involved;among the syndrome types,liver and kidney yin deficiency syndrome was the most common type.There were 26 high-frequency Chinese medicinals with the frequency being or over 40 times,and the top 5 Chinese medicinals were Lilii Bulbus,Codonopsis Radix,Corni Fructus,Paeoniae Radix Alba,and Rehmanniae Radix Praeparata.Most of the medicines were sweet in flavor and mild in nature,and had the meridian tropism of the liver,heart,kidney and spleen meridians.A total of 15 pairs of high-confidence drug combinations were obtained after association rule analysis.Cluster analysis of high-frequency Chinese medicinals yielded 5 core drug combinations.The complex network analysis revealed the core prescription which was composed of Rehmanniae Radix Praeparata,Corni Fructus,Cuscutae Semen,Lilii Bulbus,Ziziphi Spinosae Semen,Salviae Miltiorrhizae Radix et Rhizoma,and Margaritifera Concha.The association rule analysis showed that the drug pairs with high frequency of use were Ligustri Lucidi Fructus-Corni Fructus,Ligustri Lucidi Fructus-Salviae Miltiorrhizae Radix et Rhizoma.Conclusion For the treatment of menopausal syndrome,the contemporary inheritors of Lingnan LUO's Gynecology take the therapy of nourishing liver and kidney as the key,and also adopt the therapies of nourishing the heart and calming the mind,benefiting qi and invigorating the spleen,and harmonizing the pivot.The medicines prescribed by the inheritors mostly are sweet-light and mild tonics,and their prescription and medication rules are consistent with Professor LUO Yuan-Kai's academic thoughts.

Objective To explore the influential factors and predictive value of early femoral head collapse progression following allogeneic fibula grafting(AFG)surgery.Methods Clinical and radiological data of 68 patients(75 hips)with osteonecrosis of the femoral head(ONFH)who underwent AFG between January 2008 and December 2022 at the Orthopedics and Traumatology Department,Affiliated Hospital of Nanjing University of Chinese Medicine were retrospectively analyzed.Seventy-five hips were divided into stable(n=40)and progressive(n=35)groups based on the presence or absence of postoperative collapse progression.Age,gender,etiology,location of the lesion,Association Research Circulation Osseous(ARCO)stage,Japanese Committee of Osteonecrosis Investigation(JIC)classification,China-Japan Friendship Hospital(CJFH)classification,and Hounsfield units(HU)value of anterolateral sclerosis rim(ⅠSHU)were collected.Univariate and multivariate logistic regression analyses were used to identify the factors influencing early collapse progression after AFG.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of the identified factors influencing postoperative early collapse progression.Results Of the 75 hips,35(46.7%)had postoperative collapse progression.Univariate logistic regression analysis showed that age,ARCO stage,JIC classification,and ⅠSHU were in fluencing factors for early femoral head collapse progression after AFG(P<0.05).Multivariate logistic regression analysis showed that ARCO stage ⅢA and JIC classification C2 were independent risk factors for early femoral head collapse progression after AFG,while ⅠSHU was identified as an independent protective factor(P<0.05).The ROC curve analysis showed that the sensitivities of ARCO stage,JIC classification,ⅠSHU,and the combined predictive model were 0.850,0.725,0.800,and 0.775,the specificities were 0.486,0.657,0.743,and 0.914,and the area under the ROC curve(AUC)were 0.668,0.725,0.811,and 0.896,respectively.Conclusions ⅠSHU is associated with early collapse progression after AFG in patients with ONFH.ARCO stage ⅢA,JIC classification C2,and ⅠSHU are independent factors influencing postoperative early collapse progression and have a certain predictive value.

Cardiovascular disease(CVD)is a common complication of chronic kidney disease(CKD).CVD can be divided into two categories:one is cardiovascular disease,common as atherosclerosis;another is cardiomyopathy,leading to changes in the structure and function of the heart itself,such as ventricular hypertrophy and cardiac dila-tation.Heart failure(HF)is a common result of these processes.This article reviews the common etiology and treatment progress of HF in CKD patients.

BACKGROUND: Myocardial ischemia-reperfusion (I/R) is a serious and irreversible injury. Bone marrow-derived mesenchymal stem cells (MSCs) is considered to be a potential therapy for I/R injury due to the paracrine effects. High-mobility group box 1 (HMGB1) is a novel mediator in MSC and regulates the response of inflammation injury. Signal Transduction and Transcription Activator 3 (STAT3) is a critical transcription factor and important for release of paracrine factors. However, the relationship between HMGB1 and STAT3 in paracrine effect of MSC remains unknown. METHODS: In vitro, hypoxia/reoxygenation injury model was established by AnaeroPack System and examined by Annexin V flow cytometry, CCK8 assay and morphology observation. Detection of apoptotic proteins and protein expression of HMGB1 and STAT3 by Western blot. RESULTS: The conditioned medium of MSCs with or without LPS pretreatment was cocultured with H9C2 cells for 24 h before hypoxia treatment and MSC showed obvious cardiomyocytes protect role, as evidence by decreased apoptosis rate and improved cells viability, and LPS pretreated MSC exhibited better protect role than untreated MSC. However, such effect was abolished in HMGB1 deficiency group, silencing HMGB1 decreased the secretion of vascular endothelial growth factor (VEGF), hepatocyte growth factor (HGF), insulin growth factor (IGF), cell viability, and the expression of STAT3. Furthermore, STAT3 silence attenuated the protective effect of LPS in MSC. CONCLUSIONS These findings suggested that LPS improved MSC-mediated cardiomyocytes protection by HMGB1/STAT3 signaling.

Melatonin receptor 1B (MT2, encoded by the MTNR1B gene), a high-affinity receptor for melatonin, is associated with glucose homeostasis including glucose uptake and transport. The rs10830963 variant in the MTNR1B gene is linked to glucose metabolism disorders including gestational diabetes mellitus (GDM); however, the relationship between MT2-mediated melatonin signaling and a high birth weight of GDM infants from maternal glucose abnormality remains poorly understood. This article aims to investigate the relationship between rs10830963 variants and GDM development, as well as the effects of MT2 receptor on glucose uptake and transport in trophoblasts. TaqMan-MGB (minor groove binder) probe quantitative real-time polymerase chain reaction (qPCR) assays were used for rs10930963 genotyping. MT2 expression in the placenta of GDM and normal pregnant women was detected by immunofluorescence, western blot, and qPCR. The relationship between MT2 and glucose transporters (GLUTs) or peroxisome proliferator-activated receptor γ (PPARγ) was established by western blot, and glucose consumption of trophoblasts was measured by a glucose assay kit. The results showed that the genotype and allele frequencies of rs10830963 were significantly different between GDM and normal pregnant women (P<0.05). The fasting, 1-h and 2-h plasma glucose levels of G-allele carriers were significantly higher than those of C-allele carriers (P<0.05). Besides, the protein and messenger RNA (mRNA) expression of MT2 in the placenta of GDM was significantly higher than that of normal pregnant women (P<0.05). Melatonin could stimulate glucose uptake and GLUT4 and PPARγ protein expression in trophoblasts, which could be attenuated by MT2 receptor knockdown. In conclusion, the rs10830963 variant was associated with an increased risk of GDM. The MT2 receptor is essential for melatonin to raise glucose uptake and transport, which may be mediated by PPARγ.
Female ; Humans ; Pregnancy ; Blood Glucose/metabolism* ; Diabetes, Gestational/metabolism* ; Glucose/metabolism* ; Melatonin/metabolism* ; Polymorphism, Genetic ; PPAR gamma ; Receptor, Melatonin, MT2/genetics*

Abstract: Objective To express and purify MPT83 protein of Mycobacterium tuberculosis and evaluate its application value in immunological diagnosis of tuberculosis (TB) using clinical samples. Methods Using Mycobacterium tuberculosis (Mtb) H37Rv genome as the template, Mtb mpt83 gene was amplified by PCR and connected to PET-21a (+) to construct prokaryotic expression vector, and then transferred into E.coli DH5α. The positive colonies were picked out and retained. The recombinant plasmid pET-mpt83 of the strain with positive colony PCR was extracted, identified by double digestion, and the samples of the positive colonies were sent for sequencing. The correctly sequenced plasmids then were transferred into BL21 competent cells for induction, expression and purification with nickel column affinity chromatography. The purified products were identified by 12 alkyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and Western blotting. Mouse polyclonal antiserum was prepared by immunizing mice with purified protein. 8 patients clinically diagnosed as tuberculosis pleural effusion (TB group) and 8 adenocarcinomas patients (CA group) were enrolled and their pleural effusion and plasma were collected. 8 healthy people (HC group) were enrolled as the control group and their plasma were collected. An indirect ELISA was used to detect the level of specific antibodies recognizing MPT83 protein in the samples. Results Mtb MPT83 protein was successfully expressed and purified. The serum titer of MPT83 mouse polyclonal antibody was as high as 1∶1 280 000. The plasma levels of MPT83 antigen specific antibodies in TB group were significantly higher than those in HC group (P<0.05), while the plasma levels of MPT83 antigen specific antibodies in CA group were not significantly different from those in HC group (P>0.05). Compared with the HC group, there was no significant difference in pleural fluid in both the TB and CA groups (P>0.05). The ROC curve was used to analyze the OD values of plasma in TB group and HC group, and the area under the curve was greater than 0.7, showing high diagnostic efficacy. Conclusion　MPT83 protein has high antigen specificity and immunogenicity, which has great application value in the immunological diagnosis of tuberculosis.

Objective: To describe the epidemiological distribution characteristics of peripheral blood mosaic chromosomal alteration (mCA) in community adults aged 30-79 years in 10 regions of China. Methods: A total of 100 297 participants with complete baseline information (demographic characteristics, lifestyle, physical examination, etc.) and genotyping data of blood-derived DNA in ten regions of the China Kadoorie Biobank study were included. The mCAs were detected with the Mosaic Chromosomal Alterations pipeline, and logistic regression models were used to compare the differences in the detection rate of mCAs in different regions and populations. Results: A total of 5 810 mCA carriers were detected, with the detection rate of 5.8%. The standardized detection rate was 5.1%. The baseline detection rate of mCA increased with age, which were 3.4%, 5.0%, and 9.4% in those aged 30-, 51-, and >60 years, respectively (trend test P<0.001). A more significant proportion of mCAs were found in men (8.0%) than women (4.0%), as well as in urban areas (6.4%) than in rural areas (5.3%), the difference was significant (P<0.001). After adjusting for age and gender, the detection rate of mCA was higher in current smokers or people quitting smoking due to illness and people with low physical activity level, and the mCA detection rate was lower in obesy people (5.3%) than that in people with normal body weight (5.9%) (P=0.006). Conclusions: The detection rate of mCAs varied with region and population in community adults aged 30-79 years in 10 regions of China. The study results might contribute to the molecular identification of aging populations and guide precision prevention of age-related diseases such as cancers.
Adult ; Female ; Humans ; Male ; Middle Aged ; China/epidemiology* ; Life Style ; Risk Factors ; Smoking/epidemiology* ; Aged

Objective To summarize the palliative care consultations proposed by the Emergency Department of Peking Union Medical College Hospital. Methods A retrospective study was conducted on 22 palliative care consultations in the Emergency Department of Peking Union Medical College Hospital from January 2017 to June 2020. Results A total of 18 patients (6 males and 12 females) received palliative care consultations in the Emergency Department,with the average age of (65±8) years (36-88 years).Specifically,10 and 6 patients received once and twice consultations,respectively,and 2 patients did not complete the consultation.Of the patients receiving palliative care consultations,15 had malignant tumors and 3 had non-neoplastic diseases.The reasons for palliative care consultations included communication (61.1%,11/18) and pain relief (61.1%,11/18).In terms of the place of death,8 patients died in the hospital and 6 patients in other medical institutions. Conclusion There is a clear demand for palliative care consultation in the Emergency Department of Peking Union Medical College Hospital,and the consultation can bring help to both emergency doctors and patients.
Male ; Female ; Humans ; Middle Aged ; Aged ; Palliative Care/methods* ; Retrospective Studies ; Referral and Consultation ; Hospitals ; Emergency Service, Hospital

Blood loss and blood transfusion requirement are important quality control indicators of cardiovascular surgery and cardiovascular anesthesia. Patient blood management (PBM) is an evidence-based, multidisciplinary approach to optimizing the care of patients who may need transfusion, which encompasses anemia management, hemodilution, cell salvage, hemostatic treatment, and other approaches to reducing bleeding and minimizing blood transfusion. PBM in cardiovascular surgery is a "team sport" that involves cardiac and vascular surgeons, anesthesiologists, perfusionist, intensivists, and other health care providers. The current work provides an overview of evidence and practice of PBM at Fuwai Hospital. Implementation of PBM should also take local resource availability and cost-effectiveness of different devices, drugs, technologies, and techniques into consideration.
Humans ; Blood Transfusion/methods* ; Anemia/therapy* ; Hemorrhage ; Hospitals ; Blood Loss, Surgical