Pelvic organ prolapse (POP), whose etiology is influenced by genetic and clinical risk factors, considerably impacts women's quality of life. However, the genetic underpinnings in non-European populations and comprehensive risk models integrating genetic and clinical factors remain underexplored. This study constructed the first polygenic risk score (PRS) for POP in the Chinese population by utilizing 20 disease-associated variants from the largest existing genome-wide association study. We analyzed a discovery cohort of 576 cases and 623 controls and a validation cohort of 264 cases and 200 controls. Results showed that the case group exhibited a significantly higher PRS than the control group. Moreover, the odds ratio of the top 10% risk group was 2.6 times higher than that of the bottom 10%. A high PRS was significantly correlated with POP occurrence in women older than 50 years old and in those with one or no childbirths. As far as we know, the integrated prediction model, which combined PRS and clinical risk factors, demonstrated better predictive accuracy than other existing PRS models. This combined risk assessment model serves as a robust tool for POP risk prediction and stratification, thereby offering insights into individualized preventive measures and treatment strategies in future clinical practice.
Humans ; Female ; Pelvic Organ Prolapse/epidemiology* ; Middle Aged ; Risk Assessment/methods* ; China/epidemiology* ; Multifactorial Inheritance ; Aged ; Risk Factors ; Genome-Wide Association Study ; Genetic Predisposition to Disease ; Case-Control Studies ; Adult ; Polymorphism, Single Nucleotide ; Genetic Risk Score ; East Asian People

Objective:To evaluate the optical performance of two aspheric intraocular lenses (IOL) AcrySof IQ SN60WF and Proming A1-UV with identical negative spherical aberration values, using the optical bench OptiSpheric IOL R&D through an in vitro study. Methods:The optical performance of + 20.0 D blue-light filtering SN60WF and monofocal high-order aspheric non blue-light filtering A1-UV IOL was evaluated through cornea models with the spherical aberration of 0 μm (ISO-1) and + 0.28 μm (ISO-2) under apertures of 3.0 mm and 4.5 mm via the optical bench OptiSpheric IOL R&D.The modulation transfer function (MTF) and USAF 1951 resolution test chart were employed to measure the IOL with centering, decentration of 0.3, 0.5, 0.7, 0.9 and 1.1 mm, as well as tilt of 3°, 5°, 7°, 9° and 11°.The spectral transmittance of IOL was measured with the UV-3300 UV-VIS spectrophotometer.Results:Compared with the A1-UV IOL, the spectral transmittance of SN60WF for blue light with wavelengths of 400-500 nm was significantly reduced, which effectively reduced the passage of blue light.At an aperture of 3.0 mm, the MTF values at 100 lp/mm spatial frequency for the centered SN60WF and A1-UV were 0.576 and 0.598 under ISO-1 corneal measurement conditions, 0.564 and 0.563 under ISO-2 conditions.At an aperture of 4.5 mm, the MTF values were 0.238 and 0.404 under ISO-1 corneal measurement conditions, and 0.438 and 0.339 under ISO-2 conditions.The MTF values of A1-UV and SN60WF at 3.0 mm aperture and 100 lp/mm spatial frequency under ISO-1 corneal measurement conditions were larger than those under ISO-2 corneal measurement conditions.Under ISO-1 corneal measurement conditions with a 3.0 mm aperture, A1-UV had a better optical quality compared to SN60WF, whereas under ISO-2 corneal measurement conditions, the optical quality of both IOLs was similar.Under the 3.0 mm aperture, the MTF values of SN60WF and A1-UV at a decentration of 0.3 mm and 100 lp/mm spatial frequency were 0.414 and 0.571 under ISO-1 corneal measurement conditions, 0.438 and 0.512 under ISO-2 corneal measurement conditions, respectively.The MTF values of SN60WF and A1-UV at a tilt of 3° were 0.522 and 0.597 under ISO-1 corneal measurement conditions, and 0.532 and 0.531 under ISO-2 corneal measurement conditions.The MTF values and USAF resolution test chart of A1-UV had no significant change between the two corneal measurement conditions.When subjected to equal degrees of decentration or tilting, except for the ISO-1 corneal measurement conditions at a 4.5 mm aperture, the MTF values of A1-UV showed a gradual decline across various spatial frequencies compared to SN60WF.With the increase in aperture size, the impact of IOL decentration or tilting on MTF values and USAF 1951 resolution test chart became more notable for A1-UV relative to SN60WF.Conclusions:The SN60WF IOL effectively filters blue light within the wavelength range of 400-500 nm.However, when both IOL experience decentration greater than 0.3 mm or tilting beyond 3°, the optical quality of the IOL will decline.A1-UV has a distinct advantage over SN60WF in terms of resistance to both decentration and tilting-induced optical performance degradation in vitro.

This study aimed to investigate the incidence and risk factors for female sexual dysfunction (FSD) in urban and rural China. A prospective cohort study was conducted from February 2014 to January 2016, with follow-up from June to December 2018. Women aged ≽20 years were recruited from urban and rural areas in six provinces of China using a multistage, stratified, cluster sampling method. Sexual function was assessed using the Female Sexual Function Index questionnaire. A total of 16 827 women without sexual dysfunction at baseline participated in this study, 9489 of them (urban, 5321; rural, 4168) who had complete information from baseline to follow-up were included in the final analysis. The rate of follow-up was 68.81%, and the median follow-up time was 4.13 years. The 4-year incidence of FSD was 43.07%, with an incidence density of 12.02 per 100 person-years. In particular, the 4-year incidence and incidence density of FSD were 41.03% and 11.88 per 100 person-years in the urban group and 45.68% and 12.17 per 100 person-years in the rural group. Among women with sexual dysfunction, difficulties in sexual desire, satisfaction, and arousal were the main symptoms. In urban women, the risk factors for FSD included age ≽45 years (adjusted relative risk 1.69, 95% confidence interval 1.57-1.81), hypertension (1.31, 1.14-1.49), previous delivery (1.26, 1.13-1.41), post-menopausal status (1.20, 1.10-1.32), pelvic inflammatory disease (1.13, 1.05-1.21), and multiparity (1.11, 1.03-1.19). In the rural group, the risk factors significantly associated with FSD were age ≽45 years (1.50, 1.40-1.61), previous delivery (1.39, 1.17-1.65), hypertension (1.18, 1.06-1.30), multiparity (1.16, 1.07-1.27), and post-menopausal status (1.15, 1.07-1.23). FSD is a hidden epidemic condition in China, and the development of prevention strategies should consider the distinct risk factors present in rural and urban areas.
Humans ; Female ; China/epidemiology* ; Prospective Studies ; Risk Factors ; Adult ; Incidence ; Rural Population/statistics & numerical data* ; Middle Aged ; Urban Population/statistics & numerical data* ; Sexual Dysfunction, Physiological/epidemiology* ; Sexual Dysfunctions, Psychological/epidemiology* ; Surveys and Questionnaires ; Young Adult

Objective:To investigate the repeatability and correlation in tilt and decentration measurement of crystalline lens and intraocular lens (IOL) under non-mydriatic and mydriatic conditions using swept-source ocular coherence tomography CASIA2.Methods:A diagnostic test study was conducted.A total of 109 cataract patients (157 eyes) who received phacoemulsification with IOL implantation surgery in the Affiliated Hospital of North Sichuan Medical College from March to July 2020 were enrolled.The decentration and tilt of crystalline lens and IOL under non-mydriatic and mydriatic conditions were measured for three times by a single examiner using CASIA2 before and one week after surgery.The 0.5% compound tropicamide eye drops were used to dilate.Repeatability was evaluated by within-standard deviation, test-retest repeatability (TRT), coefficient of variation (CoV) and intraclass correlation coefficient (ICC). The correlation in decentration and tilt of crystalline lens and IOL between before and after mydriasis was assessed by Pearson correlation coefficient.This study adhered to the Declaration of Helsinki, and the study protocol was approved by an Ethics Committee of the Affiliated Hospital of North Sichuan Medical College (No.2020ER030-1). Written informed consent was obtained from all subjects before any medical examination.Results:The decentration of crystalline lens under non-mydriatic and mydriatic conditions was (0.217±0.112)mm and (0.220±0.110)mm, respectively, and the tilt was (5.017±1.422)° and (5.310±1.645)°, respectively.The decentration of IOL under non-mydriatic and mydriatic conditions was (0.245±0.136)mm and (0.250±0.145)mm, respectively, and the tilt was (5.144±1.345)° and (5.437±1.646)°, respectively.No significant difference was found between non-mydriatic and mydriatic conditions (all at P>0.05). Under both non-mydriatic and mydriatic conditions, the crystalline lenses of both eyes decentered and tilted toward the inferotemporal direction, and the IOL of right eyes decentered toward the inferior and tilted toward the inferotemporal direction, and the IOL of left eyes decentered and tilted toward the inferotemporal direction.Except the crystalline lens decentration, the measurement repeatability of crystalline lens tilt, IOL decentration and tilt in cataract patients before and after mydriasis was good, with ICC range in 0.815-0.984, TRT<50% and CoV≤14.840%.The measurement repeatability of crystalline lens decentration was poor, and the measurement repeatability of decentration axis, tilt and tilt axis of crystalline lens, and the repeatability of decentration and tilt of IOL were good in both eyes, with ICC range in 0.757-0.998, TRT<50% and CoV≤17.763%.There were good correlations in decentration, decentration axis, tilt and tilt axis of crystalline lens and IOL between non-mydriatic and mydriatic conditions (all r≥0.679, all at P<0.01). Conclusions:The measurement repeatability of decentration axis, tilt and tilt axis of crystalline lens and IOL, as well as the decentration of IOL by CASIA2 before and after mydriasis is good.The correlations of the measured parameters before and after mydriasis are good.

Objective:To explore the risk factors of urinary incontinence (UI) in China by using random forest algorithm, and to evaluate the predictive effect of each risk factor on UI.Methods:A baseline survey with a multistage stratified cluster sampling design was conducted between February 2014 and January 2016, and followed up by telephone from June to December 2018. A total of 55 477 adult women from six provinces of China participated the survey. According to the ratio of 1:1, under sampling method was used to randomly select the same number of women as UI from the non UI women. The data were randomly divided into training set and verification set according to 7:3. The training set was used to establish the random forest model, which including the candidate variables with P<0.2 in univariate analysis, and the verification set was used to verify the predictive effects. Results:A total of 30 658 patients (55.26%, 30 658/55 477) completed the follow-up, the median follow-up time was 3.7 years. Among the 24 985 women without UI at baseline, 1 757 (7.03%, 1 757/24 985) had UI at followed up, including 1 117 (4.47%, 1 117/24 985) with stress UI, 243 (0.97%, 243/24 985) with urgency UI and 397 (1.59%, 397/24 985) with mixed UI. When fixed the number of features as 2 and the number of random trees as 300 in the random forest model, the out of bag error rate estimation was the lowest; with such parameter settings, the classification accuracy was 64.3%, the sensitivity was 64.2%, and the specificity was 64.4%. The top10 predictive UI factors that screening by the variable importance measure in random forest model were obtained as follows: age, parity, delivery pattern, body mass index (BMI), menopause, history of diabetes, education level, history of pelvic surgery, regions, and marital status.Conclusion:We identified the top10 predictive UI factors that screening by the variable importance in random forest model as follows: age, parity, delivery pattern, BMI, menopause, history of diabetes, education level, history of pelvic surgery, regions, and marital status.

Objective This study aimed to explore the practice and effect of PAD Class (presentationassimilation-discussion Class) in the teaching of Medical Genetics.Methods We randomly selected a teaching class (117) for PAD Class and the other class (115) for lecture-style teaching.The two classes took the same exam in the end,with the PAD class taking an extra questionnaire on teaching conditions at the same time.The average scores of the two classes were tested by SPSS 19.0.Results The scores of the final exams for PAD and control classes were (72.21 ± 7.42) and (69.77 ± 8.89),differences were statistically significant (t=2.27,P=0.02).Questionnaire results showed that in PAD Class,68.81％ (75/109) of the students could complete homework,93.58％ (102/109) thought that PAD class had (obviously) increased their initiative and enthusiasm for learning,and 53.21％ (58/109) were very satisfied with their learning results.Conclusion PAD Class is suitable for the teaching of Medical Genetics and improves the teaching efficiency.

OBJECTIVE:To observe the clinical efficacy and safety of Kangfuxin solution combined with rhEGF solution for external use in the treatment of vitamin B12 deficiency atrophic glossitis. METHODS:Totally 94 patients with vitamin B12 deficien-cy atrophic glossitis in Xinjiang Production and Construction Corps Hospital during Jul. 2012-Jun. 2015 were divided into observa-tion group and control group according to random number table,with 47 cases in each group. Both groups received etiological treat-ment of vitamin B12 supplement. Control group was additionally given rhEGF solution for external use on tongue surface,qid. Based on control group,observation group was additionally given Kangfuxin solution and applied medical gauze saturated with liq-uid medicine to the affected area,more than 30 min each time,tid. Treatment course of 2 groups lasted for 4 week,a referral of the week. Clinical efficacies were compared between 2 groups as well as average pain indexes and lesion areas of tongue before and after treatment,and the occurrence of ADR. RESULTS:Cure rate(76.6% vs. 57.4%)and total response rate(97.9% vs. 83.0%) of observation group were significantly higher than those of control group,with statistical significance (P<0.05). Before treat-ment,there was no statistical significance in average pain indexes and lesion areas of tongue between 2 groups (P>0.05). 1-4 weeks after treatment,average pain indexes and lesion areas of tongue in 2 groups were significantly decreased,with statistical sig-nificance compared to before treatment (P<0.05). The average pain indexes of observation group were significantly lower than those of control group (3,4 weeks after treatment),and lesion areas of tongue was significantly smaller than control group (2-4 weeks after treatment),with statistical significance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:For vita-min B12 deficiency atrophic glossitis,Kangfuxin solution combined with rhEGF solution for external use can significantly improve tongue lesion and have good analgesic effect and safety.

Objective: To investigate the clinical implications of p16 gene deletion in adult Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph⁺ ALL) . Methods: Retrospective analysis of clinical, immunophenotypic, cytogenetics, molecular characteristics and prognosis of 80 newly diagnosed Ph⁺ ALL patients with p16 deletion. Results: Of 80 adult Ph⁺ ALL, the prevalence of p16 gene deletion was 31.3%. p16 gene deletion carriers frequently accompanied with high WBC counts (WBC≥30×10⁹/L) and CD20 expression. The incidence of complex chromosome abnormality in p16 gene deletion group was higher than that in non-deletion group, with alternations in chromosome 7, 8, 19 and der (22) more frequently observed. There was no difference occurred between patients with or without p16 gene deletion in complete remission (CR) rate following induction chemotherapy combined with tyrosine kinase inhibitors (TKIs) . However, after three cycles of chemotherapy, the MMR and CMR rate in the p16 gene deletion group was lower than patients with wild-type p16 gene (P=0.034, P=0.036) . The p16 gene deletion patients showed no significant differences in MMR, CMR and relapse rate between Imatinib or Dasatinib plus chemotherapy (P>0.05) . Deletion of p16 gene was significantly associated with poor outcomes including worse overall survival (OS) (37.1% vs 54.1%, P=0.037) , lower disease free-survival (DFS) (12.4% vs 45.9%, P=0.026) , and increased cumulative incidence of relapse (P=0.033) . Among the 25 patients with p16 deletion, 14 underwent allo-HSCT and the median survival was 21 months, better than that of patients received chemotherapy alone (12 months) (P=0.030) . Conclusion This study indicated that deletion of p16 was associated with poor prognosis in adult Ph⁺ ALL, and the utility of second-generation TKI (Dasatinib) does not necessarily have an edge on efficacy over Imatinib, but allo-HSCT has the potential of elongating life expectancy. It is an important significance to define the status of p16 in Ph⁺ ALL for predicting prognosis and guiding therapy decision-making.

Objective To investigate the correlation of the polymorphisms of angiotensin Ⅱtype 1 receptor (AT1R)gene A1166C and angiotensinogen(AGT)gene M235T and blood biochemical indicators with essential hypertension(EH)in the male of Yi nationality in Yunnan province. Methods 92 hypertensive and 70 normotensive of Yi people were recruited in Yunnan province. Their basic information and blood biochemical indicators were obtained by questionnaire and standardized physical examination. The genes polymorphisms were determined by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP)technique. Results(1)For the male EH patients of Yi nationality,1166C and 235T allele frequencies were 0.038 and 0.772. No significant differences in allele frequency or genotype frequency were observed between the two groups(P > 0.05).(2)The levels of TC,LDL-C and TG in EH were significantly higher than those in controls(P < 0.05). Conclusion The AT1R A1166C and AGT M235T polymorphisms were not related to the pathogenesis of EH in the male of Yi people. However,the high levels of TC,TG and LDL-C might be the risk factors of EH.

ObjectiveTo explore relationship between psychological resilience and life events of Tibetan nursing students receiving free vocational nursing education.Method The questionnaire of Symptom Checklist 90(SCL-90)and ASLEC were used in the survey among 120 nursing students to investigate the psychological resilience and life events and SPSS 17.0 was used to look into the correlations between them.Results The scores on psychological resilience of Tibetan nursing students was higher than the norm (P<0.05).There were negative correlations between life events and psychological resilience(P<0.05).Their psychological resilience was positively related to personal relations and health conditions(P<0.05)but negatively to learning pressure,punishment and losses (P<0.05).Conclusion The school and hospital should make teaching measures to psychologically support them in daily life to strengthen the abilities to handle failure and adjust to the society.