Objective:To construct a nomogram model for predicting frailty in elderly hypertensive patients, and to evaluate the discrimination and consistency of the model.Methods:A total of 317 patients with essential hypertension who were admitted to Hebei Eighth People′s Hospital from February 2021 to June 2022 were taken, they were divided into modeling group (190 cases) and verification group (127 cases) according to the proportion of 6∶4, the patients in the modeling group were divided into the asthenic group (45 cases) and the non asthenic group (145 cases) according to whether the patients in the modeling group had asthenia. The nomograph model was constructed based on the results of Logistic analysis.Results:The age, obesity or overweight ratio, diabetes ratio and systolic blood pressure in the frail group were significantly higher than those in the non-frail group: (76.25 ± 3.64)years vs.(70.44 ± 3.82) years, 51.11%(23/45) vs. 24.83%(36/145), 46.67%(21/45) vs. 17.24%(25/145), (156.46 ± 18.64) mmHg (1 mmHg = 0.133 kPa) vs. (143.25 ± 12.38) mmHg, and the mini-nutrition assessment summary form (MNA-SF) score was significantly lower than that in the non-frail group: (11.45 ± 2.06) scores vs. (13.12 ± 1.22) scores, there were statistical differences ( P<0.05). Logistic results showed that age, body mass index, diabetes, and systolic blood pressure were the risk factors for frailty ( P<0.05). The receiver operating characteristic (ROC) curve evaluation showed that the area under the curve (AUC) in the modeling group was 0.998, and AUC in the validation group was 0.954. The Hosmer-Lemeshow goodness of fit test showed: modeling group χ2 = 6.18, P = 0.627; validation group χ2 = 6.58, P = 0.582. Conclusions:The nomogram prediction model of frailty risk in elderly hypertensive patients has good consistency and differentiation

Objective To investigate the impact of overwork on vascular endothelial barrier function in mice.Methods Thirty KM mice were randomized equally into control,overwork for 2 weeks(W2)group and 4 weeks(W4)group.In the latter two groups,the mice were subjected to continuous standing in water for 8 h followed by restraint for 3 h to simulate overwork on a daily basis for 2 and 4 weeks.After modeling,4 mice from each group were intraperitoneally injected with Evans blue dye to assess vascular permeability.In the other 6 mice,serum IL-1β levels were measured using ELISA,and arterial tissues were collected for histological examination and detection of mRNA expressions of occludin,claudin-5,ZO-1,JAM-A and VE-cadherin;immunofluorescence assay was used to detect the protein expressions of claudin-5,ZO-1,VE-cadherin,and Syndecan-1.Results The mice in W2 and W4 groups exhibited slower weight gain,hair loss,reduced activity,and significantly increased serum IL-1β levels.Vascular permeability was significantly increased in W4 group.In W2 group,the endothelial cells were swollen and dissociated,and the intima was rough and irregular;arterial intimal rupture was observed in W4 group.The mRNA expressions of occludin,claudin-5,ZO-1 and JAM-A in the arterial tissues were significantly increased in W2 group but decreased in W4 group,while VE-cadherin mRNA expression were reduced in both groups(P<0.05).The protein expressions of claudin-5,ZO-1,VE-cadherin,and Syndecan-1 were all significantly reduced in W4 group.Conclusion Prolonged overwork can cause damage of the intercellular junction complexes in arterial endothelial cells and the endothelial glycocalyx to result in impaired barrier function and increased vascular permeability in mice.

Objective To investigate the impact of overwork on vascular endothelial barrier function in mice.Methods Thirty KM mice were randomized equally into control,overwork for 2 weeks(W2)group and 4 weeks(W4)group.In the latter two groups,the mice were subjected to continuous standing in water for 8 h followed by restraint for 3 h to simulate overwork on a daily basis for 2 and 4 weeks.After modeling,4 mice from each group were intraperitoneally injected with Evans blue dye to assess vascular permeability.In the other 6 mice,serum IL-1β levels were measured using ELISA,and arterial tissues were collected for histological examination and detection of mRNA expressions of occludin,claudin-5,ZO-1,JAM-A and VE-cadherin;immunofluorescence assay was used to detect the protein expressions of claudin-5,ZO-1,VE-cadherin,and Syndecan-1.Results The mice in W2 and W4 groups exhibited slower weight gain,hair loss,reduced activity,and significantly increased serum IL-1β levels.Vascular permeability was significantly increased in W4 group.In W2 group,the endothelial cells were swollen and dissociated,and the intima was rough and irregular;arterial intimal rupture was observed in W4 group.The mRNA expressions of occludin,claudin-5,ZO-1 and JAM-A in the arterial tissues were significantly increased in W2 group but decreased in W4 group,while VE-cadherin mRNA expression were reduced in both groups(P<0.05).The protein expressions of claudin-5,ZO-1,VE-cadherin,and Syndecan-1 were all significantly reduced in W4 group.Conclusion Prolonged overwork can cause damage of the intercellular junction complexes in arterial endothelial cells and the endothelial glycocalyx to result in impaired barrier function and increased vascular permeability in mice.

Objective:To investigate the value of serum vascular endothelial growth factors (VEGF), pepsinogen ratio (PGR) combined with magnifying chromoendoscopy in the diagnosis of Epstein-Barr virus associated gastric carcinoma (EBVaGC).Methods:A retrospective case control study was conducted. The clinical data of 314 patients with gastric cancer who were confirmed by pathological examination in Baoji Central Hospital from January 2018 to January 2023 were retrospectively collected. All patients were divided into EBVaGC group (34 cases) and EB virus negative gastric cancer (EBVnGC) group (280 cases) according to the result of EB virus quantitative real time polymerase chain reaction in serum before treatment, while 50 healthy volunteers who underwent the physical examination in the same period were selected as the control group. The level of VEGF was detected by using enzyme-linked immunosorbent assay (ELISA), and serum levels of pepsinogen (PG) Ⅰ and PGⅡ were detected by using fluorescence immunochromatography. PGR was calculated by PGⅠ-to-PGⅡ ratio. Electronic magnification gastroscopy was performed, suspicious lesions were stained and the pathological state of gastric tissues was observed. Taking the pathological results of living tissues as the gold standard, the diagnostic efficacy of each index alone and the combination detection for EBVaGC was calculated. Multivariate logistic regression model was used to analyze the independent risk factors of the incidence of EBVaGC.Results:The age of patients in EBVaGC group, EBVnGC group and the healthy control group was (61±10) years, (63±12) years and (61±12) years, respectively; and there were 28 males (82.4%), 228 males (81.4%) and 41 males (82.0%), respectively. There were no statistically significant differences in age and gender among the 3 groups (all P>0.05). The serum VEGF level and the proportion of positive patients detected by endochromatography in EBVaGC group were higher than those in the EBVnGC group and the healthy control group [VEGF: (253±48) pg/ml vs. (183±38) pg/ml, (92±25) pg/ml; positive proportion: 94.1% (32/34) vs. 77.9% (218/280), 2.0% (1/50)], and the PGR in EBVaGC group was lower than that in EBVnGC group and the healthy control group (2.1±1.0 vs. 3.1±1.1, 14.1±1.9), and the differences were statistically significant (all P<0.05). The sensitivity of serum VEGF in the diagnosis of EBVaGC was higher than that of PGR [73.5% (25/34) vs. 66.9% (22/34)]. The diagnostic specificity of PGR [78.2% (219/280) vs. 69.3% (194/280)] and accuracy [76.8% (241/314) vs. 69.8% (219/314)] were higher than those of VEGF. The sensitivity [85.3% (29/34)], specificity [82.9% (232/280)] and accuracy [83.1% (261/314)] of magnifying chromoendoscopy in the diagnosis of EBVaGC were higher than those of VEGF and PGR. The sensitivity [94.1% (32/34)], specificity [95.7% (268/280)] and accuracy [95.5% (300/314)] of the 3 combined detection were higher than those of single and pairwise detection. Multivariate logistic regression analysis showed that the independent risk factors for the incidence of EBVaGC included alcoholism ( OR = 2.310, 95% CI: 1.243-3.581, P = 0.007), spicy food preference ( OR = 1.516, 95% CI: 1.084-2.142, P = 0.026), irregular diet ( OR = 1.448, 95% CI: 1.013-2.104, P = 0.043), family history of gastric cancer ( OR = 2.732, 95% CI: 1.312-4.894, P = 0.001). Conclusions:Serum VEGF and PGR combined with magnifying chromoendoscopy can improve the diagnostic efficiency of EBVaGC, and developing good eating will be helpful to prevent or slow down the progression of stomach diseases.

Objective This study is focused on ultrasound multimodality examination,which refers to the combined use of three ultrasound examination modalities,ultrasound(US),acoustic radiation force impulse(ARFI)imaging,and contrast-enhanced ultrasound(CEUS).The purpose of this study is to analyze the value of applying ultrasound multimodality examination in the differential diagnosis of benign and malignant breast non-mass-like lesions(NMLs).Methods Cases of breast NMLs were analyzed retrospectively,and the nature of all the lesions was verified by pathological examination.Based on the gray-scale ultrasound image characteristics,the cases were classified into types Ⅰto Ⅴ,and type Ⅰ and type Ⅱ were further classified into 4 subtypes,Ⅰa,Ⅰ b,Ⅱ a,and Ⅱ b,according to whether there was also calcification,and the proportion of malignant cases in each subtype was statistically analyzed.Logistic regression models of US,US+ARFI,US+CEUS,and US+ARFI+CEUS for the diagnosis of malignant cases were established,ROC curves were drawn,the area under the curve(AUC)was calculated,and comparisons were made accordingly.The detection rate of malignant NMLs without calcification(atypical malignant NMLs)by the combination examination of US,ARFI,and CEUS was analyzed.Results A total of 407 cases were included in the study.All subjects were female,aged 22 to 81 years,with the average age being(47.0±1 1.0)years.There were 220 benign cases and 187 malignant cases.Ranked from the highest to the lowest,the malignancy proportion of the different types wasⅠb＞Ⅱb＞Ⅲ＞V＞Ⅰa＞Ⅱa＞Ⅳ.The malignant proportion of the low echo area with calcification was significantly higher than that of the lesions without calcification.The AUC(95％confidence interval[CI])for diagnosing malignant cases with the logistic regression models of US,US+ARFI,US+CEUS,and US+ARFI+CEUS were 0.895(0.862-0.927),0.908(0.878-0.937),0.921(0.893-0.948),and 0.927(0.902-0.952),respectively.Comparison of the AUC of the 4 regression models showed significant differences(P＜0.001).The detection rate of US for NMLs without calcification was 80.7％.When US was used in combination with ARFI and CEUS,86.4％of the malignant NMLs lesions without calcification could be detected if the lesion CEUS score was 4 or 5 points or if shear-wave velocity(SWV)≥4.28 m/s.Conclusion Breast NMLs with calcification show high risks of malignancy,and a pathological examination is always recommended for a conclusive diagnosis.Ultrasound multimodality examination can improve the diagnostic accuracy of breast NML without calcification.

OBJECTIVES: Congenital birth defects are the main source of disease burden among children under 5 years old in China. This study aims to compare the trends in disease burden of different congenital birth defects among Chinese children under 5 years old from 1990 to 2019, and to provide a scientific basis for strengthening the comprehensive prevention and control of birth defects. METHODS: Based on data from the Global Burden Disease (GBD) in 2019, the incidence mortality rate, and disability-adjusted life years (DALYs) rate of congenital birth defects among Chinese children under 5 years old from 1990 to 2019 were selected as evaluation indicators. The Joinpoint regression model was used to analyze the trends in disease burden of different types with congenital birth defects over three decades. The study also compared the differences in disease burden of congenital birth defects among children under 5 years old by gender. RESULTS: Compared to 1990, the DALYs rates of congenital heart anomalies (1 931.91/100 000), digestive congenital anomalies (364.63/100 000), neural tube defects (277.20/100 000), congenital musculoskeletal and limb anomalies (133.33/100 000), and Down syndrome (128.22/100 000) in children under 5 years old in China in 2019 were decreased 70.78%, 71.61%, 86.21%, 36.84% and 73.65%, respectively. From 1990 to 2019, the mortality rates and DALYs rates of different congenital birth defects showed an overall downward trend, but the incidence of digestive congenital anomalies and Down syndrome showed an upward trend after 2005 and 2001, respectively. Except for congenital musculoskeletal and limb anomalies, incidence of the remaining categories of birth defects were higher in boys than that in girls. CONCLUSIONS The disease burden of congenital birth defects in children under 5 years old in China is decreased substantially from 1990 to 2019, but the burden of congenital heart anomalies is still serious and the incidence of some birth defect diseases is on the rise, and it is still crucial to strengthen the prevention and treatment for birth defects in children and propose targeted measures according to their gender characteristics.
Child, Preschool ; Female ; Humans ; Male ; China/epidemiology* ; Cost of Illness ; Down Syndrome/epidemiology* ; East Asian People ; Congenital Abnormalities/epidemiology*

Objective:To investigate the application value of molecular detection in the differential diagnosis of ovarian adult granulosa cell tumors (AGCT) by analyzing FOXL2, AKT1 and DICER1 mutations in these tumors.Methods:A total of 48 cases of ovarian sex cord-stromal tumor (SCST) were selected from July 2012 to June 2019 in Beijing Obstetrics and Gynecology Hospital, including 21 adult granulosa cell tumors (AGCT), 15 fibromas/fibrothecomas, 8 Sertoli-Leydig cell tumors (SLCT) and 4 other types of ovarian SCST. Genomic DNA was extracted from the formalin-fixed paraffin-embedded tissue sections. Polymerase chain reaction amplification for FOXL2, AKT1 and DICER1 genes was performed, followed by sequencing using capillary electrophoresis. Fisher exact test was used to compare the prevalence difference of FOXL2, AKT1 and DICER1 mutations among the groups. P<0.05 was considered significant. Results:Eighteen of the 21 (85.7%) AGCT harbored FOXL2 mutation. Compared with other SCST (13.0%, 3 of 23; including fibromas/fibrothecomas and SLCT), FOXL2 mutation was significantly higher in AGCT ( P<0.001). In addition, FOXL2 mutation was also detected in one fibrothecoma, two SLCT and two gynandroblastomas. DICER1 mutation was identified in four of eight SLCT, and these cases were moderately to poorly differentiated. FOXL2 mutation was found in one SLCT with DICER1 mutation. There was no DICER1 mutation in other ovarian SCST. No AKT1 mutation was detected in all the patients. Conclusions:FOXL2 mutation is a highly specific biomarker for adult AGCT and may be helpful to resolve problematic cases. Diagnosis should also be taken into consideration of the clinical and histological features as FOXL2 mutation is also found in other SCST. The detection of DICER1 mutation is helpful for the differential diagnosis of ovarian SLCT. Synchronous DICER1 and FOXL2 mutation in the SLCT has been observed, and its significance needs to be further studied.

Objective: To explore the effects of high-fat diet exposure on glucolipid metabolism and ovarian function in offspring of female Sprague Dawley rats. Methods: Female and male rats were mated in cages at a ratio of 2∶1. Pregnant mice were collected and randomly divided into normal feed group (control group) and high-fat and high-glucose feed group (observation group). Female offspring were selected as the research object. After the offspring entering the stage of sexual maturity, the blood was taken from abdominal aorta artery. The contents of serum related factors were determined by automatic biochemical analyzer and enzyme linked immunosorbent assay (ELISA) kit. Hematoxylin-eosin staining (HE) was used to directly observe the distribution and quantity of liver tissue and the quantity and structure of ovarian follicles. Results: Compared with the normal control group, the body weight, blood glucose, blood lipids and fat coefficient in high-fat diet rats were significantly increased (P<0.05). The secretions of estradiol (E₂), follicle stimulating hormone (FSH) and luteinizing hormone (LH) in the ovary were significantly reduced (P<0.05). HE slices showed that compared with the normal control group, there were fat vacuoles in the cytoplasm of hepatocytes, the increase of hepatocyte arrangement gap, the number of adipocytes and the diameter of fat droplets in the observation group. The quantities of primordial follicles and primary follicles in the ovary showed increasing trend in high-fat diet group, and the diameter of follicles was decreased. Conclusions High-fat and high glucose diet may cause abnormal glucolipid metabolism. It is speculated that high fat diet may cause ovary to be surrounded by fat through fat accumulation in the abdomen and buttocks of female offspring, which directly leads to dysfunction.

Objective To evaluate the effect of peiminine preconditioning on ventilator-induced lung injury (VILI) in mice.Methods Thirty-two clean healthy male BALB/c mice,aged 9-10 weeks,weighing 20-25 g,were divided into 4 groups (n=8 each) using a random number table:control group (group C),VILI group,dexamethasone group (group D) and peiminine preconditioning group (group P).Normal saline 0.2 ml was administered by intragastric gavage for 7 days in C and VILI groups,dexamethasone 10 mg/kg was administered by intragastric gavage for 7 days in group D,and peiminine 1 mg/kg was administered by intragastric gavage for 7 days in group P.VILI model (respiratory rate 80 breaths/min,tidal volume 40 ml/kg,fraction of inspired oxygen 21％,inspiratory/expiratory ratio 1 ∶ 2,for 4 h) was established on the 7th day of intragastric administration.After the end of ventilation,blood samples were collected from hearts for determination of serum interleukin-8 (IL-8) and tumor necrosis factor-α (TNF-α) concentrations (by enzyme-linked immunosorbent assay),and bilateral lung tissues were obtained for examination of the pathological changes after haematoxylin and eosin staining and for determination of contents of aquaporin 1 (AQP-1) and AQP-5 in lung tissues.Results Compared with group C,the concentrations of IL-8 and TNF-α in serum were significantly increased and the contents of AQP-1 and AQP-5 in lung tissues were decreased in group VILI (P＜0.05),and no significant change was found in the parameters mentioned above in D and P groups (P＞0.05).Compared with group VILI,the concentrations of IL-8 and TNF-α in serum were significantly decreased,the content of AQP-1 in lung tissues was increased (P＜0.05),no significant change was found in AQP-1 content (P＞0.05),and the pathological changes were significantly attenuated in D and P groups.Compared with group D,no significant change was found in concentrations of IL-8 and TNF-α in serum or contents of AQP-1 and AQP-5 in lung tissues (P＞0.05),and the pathological changes were comparable in group P.Conclusion Peiminine preconditioning can reduce VILI in mice.