: To explore the relationship between metal exposure level and blood pressure, so as to provide a scientific basis for verifying the relationship between metal exposure and elevated blood pressure among primary school students. Methods: In July 2022, a total of 555 students of second to sixth grade were selected by cluster random sampling method from two primary schools in Zhuxi County, Shiyan City, Hubei Province. A questionnaire survey was conducted to obtain the socio demographic characteristics and living habits of the participants. The height, weight, body mass index(BMI) and blood pressure were obtained by physical examination. At the same time, the urine of the subjects was collected, and the metal mass fraction in urine was detected by inductively coupled plasma mass spectrometry. The relationship between metal mass fraction in urine and blood pressure was analyzed by generalized linear regression. Results: The detection rate of elevated blood pressure in primary school students was 15.86% , and there was a statistically significant difference in the detection rate of elevated blood pressure among obese primary school students (yes:37.25%,no:13.69%, χ 2=19.28, P <0.01).There were statistically significant differences in BMI[15.80( 14.69 ， 17.92 )，17.87(15.49，20.89)kg/m 2] between the non elevated blood pressure group and the elevated blood pressure group of elementary school students ( Z =-4.67, P <0.01). The geometric mean mass fraction of zinc in urine was the highest ( 6 942.86 μg/g), titanium was the lowest (2.20 μg/g). Zinc and lead were positively correlated with elevated systolic blood pressure( β = 0.054 , 0.014), zinc and cadmium were positively correlated with elevated diastolic blood pressure ( β =0.038,0.029) ( P <0.05). Conclusions Metal zinc, lead and cadmium concentration are associated with elevated blood pressure. It is necessary to intervene and control the exposure of zinc, lead and cadmium in the environment to promote the blood pressure health of primary school students.

Objective To systematically evaluate the measurement properties and methodological quality of the liver cancer patients specific self-reported outcome assessment tools,and to provide a basis for healthcare professionals to select a high-quality scale.Methods Systematic search of PubMed,Embase,CINAHL,Web of Science,Cochrane Library,China National Knowledge Infrastructure,VIP Database,Wanfang Database,and China Biomedical Literature Database was conducted for studies related to the evaluation of the measurement properties of liver cancer specific self-reported outcome assessment tools.The search period was from the date of creation to February 1,2024,and 2 researchers independently conducted literature screening and data extraction according to the COSMIN selection criteria,and used the COSMIN Risk of Bias Inventory and Quality Criteria Scale to measure the methodological quality and measurement properties,and the final recommendations were formed.Results A total of 12 studies involving 8 specific self-reported outcome assessment tools for liver cancer patients were included.Finally,TSM-PLC was recommended at level A;EORTC QLQ-HCC18,QOL-LC,QLICP-LI were recommended at level C;FACT-HEP,MDASI-Periop-Hep,Quality of Life Scale for Liver Cancer Patients,and FHSI-8 were recommended at level B.Conclusion Compared to other scales,TSM-PLC has relatively good methodological quality and measurement properties,and is recommended for use as a priority.Due to its evaluation content mainly focusing on the patient's physical symptom distress,it can be used in conjunction with other scales to enhance the comprehensiveness of the evaluation.

Pyroptosis， an atypical new cell death mode other than apoptosis and necrosis， has been discovered in recent years. Pyroptosis depends on the cleavage of gasdermins （GSDMs） by Caspases. The activated GSDMs act on the plasma membrane to form a perforation， which results in cell lysis and triggers inflammation and immune response. Pyroptosis can be induced by four distinct signaling pathways， including canonical and non-canonical inflammasome pathways， apoptosis-associated Caspases-mediated pathway， and granzyme pathway. In these signaling pathways， GSDMs are the executors of pyroptosis. Pyroptosis is associated with the death of tumor cells and the inflammatory damage of normal tissues. Recent studies have demonstrated that moderate pyroptosis can lead to tumor cell death to exert an anti-tumor effect， and meanwhile stimulate the tumor immune microenvironment， while it can promote tumor development. Despite the good performance， drug-based anti-tumor therapies such as tumor immunotherapy， chemotherapy， and targeted therapy have some shortcomings such as drug resistance， recurrence， and damage to normal tissues. The latest research shows that a variety of natural compounds have anti-tumor effects in the auxiliary treatment of tumors by mediating the pyroptosis pathways in a multi-target and multi-pathway manner， which provide new ideas for the study of anti-tumor therapy. We reviewed the molecular mechanism of pyroptosis and the regulatory role of pyroptosis in tumors and tumor immune microenvironment， and summarized the recent research progress in the natural medicinal components regulating pyroptosis in anti-tumor therapy， with a view to providing ideas for the research on the anti-tumor therapy based on pyroptosis.

Objective: To investigate the current situation and related factors of the ecological environment and health literacy level of medical college students in Shiyan City, so as to propose relevant countermeasures and suggestions for improvement in these domains. Methods: From May to June 2023, 1 312 medical students from Hubei University of Medicine in Shiyan City were selected by accidental sampling to investigate the level and influencing factors of the ecological environment and health literacy among this population. The Chi square test and binary multivariate Logistic regression analysis were performed to analyze the different characteristics and main influencing factors of the ecological environment and health literacy levels in this population. Results: The level of the ecological environment and health literacy level among medical students in Shiyan City was 24.3%. Different levels of ecological environmental and health literacy were observed among medical students by gender, grade, major and ethnicity ( χ 2=5.13, 54.87 , 64.71, 5.99, P <0.05). Higher rates were also observed among public health major students than among students of other majors. The first three classification literacy levels consisting of basic literacy, basic knowledge, and basic skills were 4.6%, 49.5 % and 50.4%, respectively. The possession rates of six secondary classification indicators were as follows:basic cognition ( 53.2 %), basic attitudes (34.5%), scientific knowledge (3.0%), behavioral knowledge (22.5%), cognitive skills (59.5%) and operational skills (48.6%). The results of multivariate Logistic regression showed that ethnic minorities and biomedical majors were negatively correlated with medical students ecological environment and health literacy ( OR =0.61,0.52), while female students, public health majors, sophomores and seniors were positively correlated with medical students ecological environment and health literacy ( OR=1.44, 1.95, 2.16, 2.24, P <0.05). Conclusions The overall level of ecological environment and health literacy among medical students in Shiyan City is low. Schools should popularize environmental health knowledge from different perspectives in order to improve the overall literacy level of environmental health literacy among medical students.

Humans ; East Asian People ; Surveys and Questionnaires ; Vitiligo/epidemiology*

OBJECTIVE: In developed countries, midday napping and nighttime sleep duration have been linked to long-term survival; however, little is known about such effects in less developed regions. Therefore, this study aimed to assess the associations of midday napping and nocturnal sleep with mortality in middle-aged and older Chinese adults. METHODS: A nationwide cohort of 15,524 adults aged ≥ 45 years was enrolled from 28 provincial regions across mainland China and followed up from 2011 to 2018, using data from the Chinese Health and Retirement Longitudinal Study. Midday napping and nighttime sleep duration were assessed using standardized questionnaires. Cox proportional hazards models with random intercepts for the surveyed provinces were used to estimate hazard ratios ( HRs) of all-cause mortality, adjusting for sociodemographic characteristics, behavioral factors, and health status. RESULTS: A total of 1,745 deaths occurred during a median follow-up of 7.1 years, and the mean (standard deviation) age was 59 (10.1) years at baseline. Compared with non-nappers, over 60 min nappers had a higher risk of all-cause mortality [ HR: 1.35, 95% confidence interval ( CI): 1.17-1.56], while no significant associations were observed among < 30 min nappers. Compared with sleep duration of 6-8 h/night, both short (< 6 h) and long (≥ 8 h) sleep duration were significantly associated with increased mortality, with corresponding HR (95% CI) estimates of 1.21 (1.05-1.38) and 1.26 (1.10-1.44), respectively. We observed significant patterns for greater risks associated with longer nap duration, with a P _trend value < 0.001 for all-cause mortality. No significant evidence of an additive interaction was identified between midday napping and nighttime sleep. CONCLUSION Long midday napping and inappropriate nighttime sleep were independently associated with an increased risk of all-cause mortality in middle-aged and older Chinese populations. Biological studies are needed to validate our findings and clarify the mechanisms underlying this association.
Adult ; Middle Aged ; Humans ; Aged ; Longitudinal Studies ; Prospective Studies ; Sleep ; Sleep Duration ; China/epidemiology*

Objective: To investigate the incidence and treatment of perioperative anemia in patients with gastrointestinal neoplasms in Hubei Province. Methods: The clinicopathological data of 7 474 patients with gastrointestinal neoplasms in 62 hospitals in 15 cities (state) of Hubei Province in 2019 were collected in the form of network database. There were 4 749 males and 2 725 females. The median age of the patients was 62 years (range: 17 to 96 years). The hemoglobin value of the first time in hospital and the first day after operation was used as the criterion of preoperative anemia and postoperative anemia. Anemia was defined as male hemoglobin <120 g/L and female hemoglobin <110.0 g/L, mild anemia as 90 to normal, moderate anemia as 60 to <90 g/L, severe anemia as <60 g/L. The t test and χ² test were used for inter-group comparison. Results: The overall incidence of preoperative anemia was 38.60%(2 885/7 474), and the incidences of mild anemia, moderate anemia and severe anemia were 25.09%(1 875/7 474), 11.37%(850/7 474) and 2.14%(160/7 474), respectively. The overall incidence of postoperative anemia was 61.40%(4 589/7 474). The incidence of mild anemia, moderate anemia and severe anemia were 48.73%(3 642/7 474), 12.20%(912/7 474) and 0.47%(35/7 474), respectively. The proportion of preoperative anemia patients receiving treatment was 26.86% (775/2 885), and the proportion of postoperative anemia patients receiving treatment was 14.93% (685/4 589). The proportions of preoperative anemia patients in grade ⅢA, grade ⅢB, and grade ⅡA hospitals receiving treatment were 26.12% (649/2 485), 32.32% (85/263), and 29.93% (41/137), and the proportions of postoperative anemia patients receiving treatment were 14.61% (592/4 052), 22.05% (73/331), and 9.71% (20/206). The proportion of intraoperative blood transfusion (16.74% (483/2 885) vs. 3.05% (140/4 589), χ²=434.555, P<0.01) and the incidence of postoperative complications (17.78% (513/2 885) vs. 14.08% (646/4 589), χ²=18.553, P<0.01) in the preoperative anemia group were higher than those in the non-anemia group, and the postoperative hospital stay in the preoperative anemia group was longer than that in the non-anemia group ((14.1±7.3) days vs. (13.3±6.2) days, t=5.202, P<0.01). Conclusions: The incidence of perioperative anemia in patients with gastrointestinal neoplasms is high. Preoperative anemia can increase the demand for intraoperative blood transfusion and affect the short-term prognosis of patients. At present, the concept of standardized treatment of perioperative anemia among gastrointestinal surgeons in Hubei Province needs to be improved.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anemia/epidemiology* ; Blood Transfusion ; Female ; Gastrointestinal Neoplasms/surgery* ; Humans ; Length of Stay ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

This study aims to investigate the molecular mechanism of polyphyllin Ⅰ(PPⅠ) inhibiting proliferation of human breast cancer cells. Human breast cancer BT474 and MDA-MB-436 cells were treated with different concentrations of PPⅠ, and then the effect of PPⅠ on cell proliferation was detected by MTT assay, trypan blue dye exclusion assay, real-time cell analysis, and clone forming assay, respectively. The apoptosis was detected by Annexin V-FITC/PI staining and then analyzed by flow cytometry. The change of mitochondrial membrane potential was detected by flow cytometry after fluorescent probe JC-1 staining. Western blot was used to detect protein expression and phosphorylation. Molecular docking was performed to detect the binding between PPⅠ and EGFR. The affinity between PPⅠ and EGFR was determined by drug affinity responsive target stability assay. The results indicated that PPⅠ inhibited the proliferation and colony formation of BT474 and MDA-MB-436 cells in a time-and concentration-dependent manner. The PPⅠ treatment group showed significantly increased apoptosis rate and significantly decreased mitochondrial membrane potential. PPⅠ down-regulated the expression of pro-caspase-3 protein, promoted the cleavage of PARP, and significantly reduced the phosphorylation levels of EGFR, Akt, and ERK. Molecular docking showed that PPⅠ bound to the extracellular domain of EGFR and formed hydrogen bond with Gln366 residue. Drug affinity responsive target stability assay confirmed that PPⅠ significantly prevented pronase from hydrolyzing EGFR, indicating that PPⅠ and EGFR have a direct binding effect. In conclusion, PPⅠ inhibited the proliferation and induced apoptosis of breast cancer cells by targeting EGFR to block its downstream signaling pathway. This study lays a foundation for the further development of PPⅠ-targeted drugs against breast cancer.
Apoptosis ; Breast Neoplasms/genetics* ; Cell Line, Tumor ; Cell Proliferation ; Diosgenin/analogs & derivatives* ; ErbB Receptors ; Female ; Humans ; Molecular Docking Simulation

Objective:To investigate the value of BRAF V600E mutation combined with 2015 American Thyroid Association (ATA) Guidelines ultrasound (US) pattern in fine-needle aspiration (FNA) cytology of thyroid nodules with atypia of undetermined significance or follicular lesion of undetermined significance (AUS/FLUS).Methods:This study retrospectively enrolled 96 consecutive patients with 101 AUS/FLUS thyroid nodules who underwent preoperative US, FNA, and BRAF V600E mutation analysis. All AUS/FLUS nodules were classified based on US pattern-based risk stratification of 2015 ATA Guidelines. With postoperative pathology as the gold standard, the diagnostic value of BRAF V600E mutation, US pattern and the combination of two methods were compared.Results:Postoperative pathology confirmed 33 benign nodules and 68 malignant nodules. The mutation rates of BRAF V600E in AUS/FLUS nodules was 51.5%. The sensitivity, specificity, and accuracy of BRAF V600E in the diagnosis AUS/FLUS nodules were 72.1%, 90.9% and 78.2%, respectively. The ROC curve demonstrated that the best cut-off of US pattern was high suspicion. The sensitivity, specificity, and accuracy of US pattern in the diagnosis of AUS/FLUS nodules were 63.2%, 81.8% and 69.3%, respectively. The accuracy of US pattern in determining AUS/FLUS nodules without BRAF V600E mutation was 70.6%. The sensitivity, specificity, and accuracy of the combination of two methods in the differential diagnosis of AUS/FLUS nodules were 89.7%, 75.8%, and 85.1%, respectively. The combination had the highest sensitivity ( P<0.05). Conclusions:BRAF V600E mutation has a good diagnostic value for differentiating benign and malignant AUS/FLUS nodules. Combined with US pattern, the differential diagnostic value for AUS/FLUS nodules without BRAF V600E mutation can be improved, and the sensitivity can be raised.

Allografts ; COVID-19 ; China/epidemiology* ; Disease Outbreaks ; Humans ; Kidney Transplantation/adverse effects* ; SARS-CoV-2