OBJECTIVE To predict biomarkers of type 2 inflammation in chronic rhinosinusitis with nasal polyps(CRSwNP)by employing peripheral blood indicators.METHODS CRSwNP patients admitted to the Rhinology Department of Beijing Tongren Hospital from June 2020 to May 2022 were enrolled and their basic clinical data were collected.The blood percentage of eosinophils(Eos%),Eos count,periostin and total IgE,as well as mucosal interleukin-5(IL-5)and Staphylococcus aureus enterotoxin-immunoglobulin E(SE-IgE)were tested.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of each blood indicator for positive mucosal expression of IL-5/SE-IgE.The logistic regression was employed to screen multiple blood indicators with predictive value for positive mucosal expression of IL-5/SE-IgE in order to construct a nomogram model.RESULTS The proportion of asthma,blood Eos%,periostin and total IgE in CRSwNP patients showed statistical differences between IL-5/SE-IgE positive and negative subgroups.ROC univariate analysis demonstrated that blood Eos%,Eos count,periostin and total IgE could predict mucosal IL-5 positivity with AUC ranging from 0.655 to 0.784,and mucosal SE-IgE positivity with AUC ranging from 0.721-0.802.The logistic regression confirmed that blood Eos%and total IgE,as well as blood periostin and total IgE were independent predictors for mucosal IL-5 and SE-IgE positivity,respectively.The nomogram models were constructed for predicting IL-5/SE-IgE positivity in CRSwNP mucosa,with consistency incides(C-index)of 0.804 and 0.81,indicating good predictive accuracy.CONCLUSION The nomograms constructed based on blood Eos%and total IgE,as well as blood periostin and total IgE,could have good predictive value for the positive mucosal expression of IL-5 and SE-IgE in the CRSwNP,which help to predict the severity of endotype and phenotype of CRSwNP.

Objective·To analyze the epidemiological characteristics of risk factors for cardiovascular diseases and malignant tumors based on the Shanghai community elderly cohort.Methods·The study subjects were selected from the Shanghai community elderly cohort established from February to August 2019,with a total of 17 948 people.The study subjects were divided into 4 groups according to self-reported presence or absence of tumors and/or cardiovascular diseases during the baseline survey:tumor-free and non-cardiovascular disease group,single cardiovascular disease group,single tumor group and tumor cardiovascular disease co-occurrence group.The differences among the four groups of subjects were collected and compared in terms of demographic characteristics and physiological indicators,daily living habits(smoking,drinking tea,drinking coffee,drinking carbonated drink,drinking alcohol,sedentary time,physical activity level and sleep quality),past medical history,psychological status(depression and anxiety)and dietary compliance.Results·Among the study subjects,60.1%of tumor patients were complicated with cardiovascular diseases.The differences among the four groups of subjects in age,gender,educational level,pre-retirement occupation,waist circumference,hip circumference and body mass index were statistically significant(all P<0.05).Compared with the tumor-free and non-cardiovascular disease group,the single cardiovascular disease group,single tumor group and tumor cardiovascular disease co-occurrence group all exhibited lower proportions of smoking and high physical activity levels(all P<0.05),and higher proportion of sedentary time exceeding 4 h/d and poor sleep quality(all P<0.05);the proportion of subjects with past medical histories including hyperlipidemia,peripheral vascular disease,endocrine system disease,respiratory system disease,urinary system disease and digestive system disease of the single cardiovascular disease group and the tumor cardiovascular disease co-occurrence group was higher(all P<0.05),and the proportion of subjects with depression and anxiety was also higher(all P<0.05).Furthermore,compared with the tumor-free and non-cardiovascular disease group,the single cardiovascular disease group had lower compliance rates of poultry,fish,fruit and liquid milk(all P<0.05).Among the four groups,only the compliance rate of vegetable intake exceeded 50%,while the compliance rates of poultry,fish,fruit,liquid milk and tubers were all below 20%.Conclusion·In the elderly population of Shanghai communities,over half of malignant tumor patients are concomitant with cardiovascular diseases.Unhealthy daily habits are prevalent among those with cardiovascular diseases,tumors and tumor-cardiovascular disease co-occurrence.The intake of many foods in the elderly of the community do not reach the levels recommended by Chinese Dietary Guidelines.

Autologous ozonized blood transfusion(AOBT) is a therapy of re-transfusion of 100-200 mL of autologous blood after shaking and agitation with appropriate amount of oxygen-ozone in vitro. The oxidation of blood through the strong oxidation of ozone can enhance the non-specific immune response of the body, regulate the internal environment and promote health. This therapy has been increasingly applied in clinical practice, while no unified standard for the operation process in terms of ozone concentration, treatment frequency and treatment course had been established. This operation process of AOBT is primarily explored in order to standardize the operation process and ensure its safety and efficacy.

Objective:To investigate the specific types of lateral meniscus injury in Schatzker type II tibial plateau fractures and its potential correlation with CT features of the lateral plateau.Methods:The data of 213 patients with Schatzker II tibial plateau fractures from August 2014 to June 2021 were retrospectively analyzed, including 132 males and 81 females, aged from 29 to 61 years, with an average of 44.9 years. All patients underwent arthroscopic evaluation of fracture reduction immediately after open reduction and internal fixation (ORIF). According to the actual situation during the operation, the types and locations of lateral meniscus injury were determined and the patients were divided into the meniscus injury group and non-injury group. By measuring lateral plateau depression (LPD) and lateral plateau widening (LPW) of the lateral tibial plateau on CT images, the correlation of which and lateral meniscus injury was analyzed. The optimal critical values of LPD and LPW for predicting lateral meniscus injury were obtained by drawing the relevant receiver operating characteristic (ROC) curves.Results:The meniscus injury group (109 patients) mainly showed injuries involving the mid-body and posterior horn of lateral meniscus (98.2%, 107/109) and LPD was 13.1±3.2 mm; while the LPD of 104 patients without meniscus injury was 9.1±3.0 mm with a statistical difference ( t=3.98, P<0.001). The LPW of meniscus injury group and non-injury groups was 8.0±1.3 mm and 6.7±1.6 mm, respectively, and the difference was statistically significant ( t=2.68, P=0.011). The optimal predictive critical point of LPD and LPW was 7.6 mm (sensitivity 90.3%, specificity 64.7%, area under the curve 0.834) and 7.3 mm (sensitivity 80.5%, specificity 58.8%, area under the curve 0.722). Conclusion:Schatzker II tibial plateau fractures combined with lateral meniscus injury is usually characterized by meniscus-joint capsule separation, rupture and longitudinal fracture. The mid-body and posterior horn of lateral meniscus injury is more likely to occur when LPD> 7.6 mm and/or LPW> 7.3 mm on coronal CT images.

Osteoarthritis (OA) is a prevalent degenerative joint disease characterized by cartilage loss and accounts for a major source of pain and disability worldwide. However, effective strategies for cartilage repair are lacking, and patients with advanced OA usually need joint replacement. Better comprehending OA pathogenesis may lead to transformative therapeutics. Recently studies have reported that exosomes act as a new means of cell-to-cell communication by delivering multiple bioactive molecules to create a particular microenvironment that tunes cartilage behavior. Specifically, exosome cargos, such as noncoding RNAs (ncRNAs) and proteins, play a crucial role in OA progression by regulating the proliferation, apoptosis, autophagy, and inflammatory response of joint cells, rendering them promising candidates for OA monitoring and treatment. This review systematically summarizes the current insight regarding the biogenesis and function of exosomes and their potential as therapeutic tools targeting cell-to-cell communication in OA, suggesting new realms to improve OA management.
Apoptosis ; Cartilage/pathology* ; Cartilage, Articular/metabolism* ; Cell Communication ; Chondrocytes/metabolism* ; Exosomes/pathology* ; Humans ; Osteoarthritis/therapy*

Purpose: The goal of this study was to describe the current status of oncology nurses' behaviors toward end of life (EOL) care in China and to explore the factors associated with oncology nurses’ behaviors toward EOL care. Methods: A cross-sectional design was applied and a convenience sample of 1038 oncology nurses from 22 grade A hospitals were recruited into this study. A general social demographic data questionnaire was administered, and the Chinese version of Nurses’ Behaviors of Caring for Dying Patients Scale was used to assess nurse behavior toward EOL care. The total score ranges from 40 to 200 points. Data were analyzed with SPSS 26.0 software. Results: Chinese oncology nurses' average score of holistic EOL care behaviors was 2.97 ± 0.59. Oncology nurses provide physical care most (3.81 ± 0.76), followed by family care (3.02 ± 0.86), and spiritual care (2.37 ± 0.67). Multiple regression analysis showed that a higher frequency of sharing EOL care experience with colleagues, in-service palliative care education, higher level of head nurse support for EOL patient care, more cases of EOL care, higher working position, and nurse's perceived high level of support were positively associated with behavior toward EOL care. These six factors explained 16.2% of the total variance. Conclusions The results may help provide a basis for converting behavior for EOL care among oncology nurses and design interventions to better improve quality of life for EOL patients with cancer in China.

Objective:To investigate sensitization rate of cow′s milk in children, and explore its clinical features.Methods:This study enrolled a total of 818 patients under 18 years old with suspected food allergy who were admitted to the Allergy department in Beijing Shijitan Hospital during June 2018 to November 2020. The ImmunoCAP fluorescent enzyme-linked immunoassay system was used to quantify cow milk-specific immunoglobulin E (sIgE). Mild sensitization to cow′s milk was defined as Radio-Allergo-Sorbent-Test (RAST) class 1, moderate sensitization was defined as class 2-3 and severe sensitization was class 4-6. Statistical methods such as χ 2 test, independent sample t-test, one-way analysis of variance, and Spearman correlation analysis were used to retrospectively clarify differences of cow′s milk sensitization rate between ages of children and elaborate its clinical features. Results:Overall sensitization rate of cow′s milk reached 25.7% (210/818). Positive rate of cow milk sensitization (39.2%), cow milk sIgE levels [0.93 (0.52, 2.62)] kU/L, and moderate to severe sensitization rate (23.5%) were highest in infants aged between 0-3 years old. The sensitization rate and severity of sensitization declined with age. Most common clinical manifestation of cow milk sensitization was skin symptoms (50.0%), followed by respiratory symptoms (38.9%) and gastrointestinal symptoms (36.1%). Skin symptoms were the most common manifestation in 0-3 year-old group (47.3%), and respiratory symptoms were more common in 4-6 and 7-18 year-old groups (58.7%, 56.0%). Multiple-sensitization rate of patients with moderate to severe cow milk sensitization was 74.1%, most of which (70.4%) were co-sensitized by other food allergens, and 31.5% were co-sensitized by inhaled allergens.Conclusions:In population with age under 18 years old, infants aged between 0-3 years old suffered highest cow milk sensitization rate and increased sensitization severity. Then the severity decreased with age increasing. Patients with cow milk sensitization manifested skin symptoms most.

Objective:To investigate sensitization rate of cow′s milk in children, and explore its clinical features.Methods:This study enrolled a total of 818 patients under 18 years old with suspected food allergy who were admitted to the Allergy department in Beijing Shijitan Hospital during June 2018 to November 2020. The ImmunoCAP fluorescent enzyme-linked immunoassay system was used to quantify cow milk-specific immunoglobulin E (sIgE). Mild sensitization to cow′s milk was defined as Radio-Allergo-Sorbent-Test (RAST) class 1, moderate sensitization was defined as class 2-3 and severe sensitization was class 4-6. Statistical methods such as χ 2 test, independent sample t-test, one-way analysis of variance, and Spearman correlation analysis were used to retrospectively clarify differences of cow′s milk sensitization rate between ages of children and elaborate its clinical features. Results:Overall sensitization rate of cow′s milk reached 25.7% (210/818). Positive rate of cow milk sensitization (39.2%), cow milk sIgE levels [0.93 (0.52, 2.62)] kU/L, and moderate to severe sensitization rate (23.5%) were highest in infants aged between 0-3 years old. The sensitization rate and severity of sensitization declined with age. Most common clinical manifestation of cow milk sensitization was skin symptoms (50.0%), followed by respiratory symptoms (38.9%) and gastrointestinal symptoms (36.1%). Skin symptoms were the most common manifestation in 0-3 year-old group (47.3%), and respiratory symptoms were more common in 4-6 and 7-18 year-old groups (58.7%, 56.0%). Multiple-sensitization rate of patients with moderate to severe cow milk sensitization was 74.1%, most of which (70.4%) were co-sensitized by other food allergens, and 31.5% were co-sensitized by inhaled allergens.Conclusions:In population with age under 18 years old, infants aged between 0-3 years old suffered highest cow milk sensitization rate and increased sensitization severity. Then the severity decreased with age increasing. Patients with cow milk sensitization manifested skin symptoms most.

Objective: To understand the incidence of stroke in the population of Jinchang Cohort and the relationship between metabolic diseases and stroke, and provide scientific evidence for the prevention and treatment of stroke in the population. Methods: The epidemiological investigation data and physical examination data of the 33 042 follow-up participants in Jinchang Cohort were collected for a prospective cohort study. Restricted cubic splines functions was used to analyze the dose-response relationship between metabolic indexes and the risk of stroke incidence. Results: 1) The incidence rate of stroke in Jinchang Cohort was 1.59%, and the standardized incidence rate was 3.99%. 2) Hypertension (male HR=2.20, female HR=4.45) and dyslipidemia (male HR=1.49, female HR=1.79) were the risk factors of stroke incidence in the population and diabetes had influence on the incidence of stroke only in the males (HR=1.79), while obesity had influence only in the females (HR=1.64). The more kinds of metabolic diseases, the higher risk of stroke incidence was. 3) Systolic blood pressure had a non-linear dose-response correlation with the risk of stroke incidence, while diastolic blood pressure had a positive linear correlation with the risk of stroke incidence. Conclusions The incidence of stroke in Jinchang Cohort population was high compared with both domestic level and oversea level. The patients with metabolic diseases were the population at high-risk for stroke, and more attention should be paid to them in the prevention and treatment of stroke. Diastolic blood pressure might be more closely related to stroke.

Objective: To explore the effects of temperature on the daily cases of varicella. Methods: The data of daily cases of varicella was collected during 2008 to 2016 in Lanzhou from National Notifiable Disease Report System, and the meteorological data at the same period was integrated from Gansu Meteorological Administration. Distributed lag nonlinear model was fitted to reveal the relationship between the daily mean temperature and the daily cases of varicella and susceptible population. The minimum morbidity temperature was defined as the reference for the estimation of RRs in different temperature level (-5.2 ℃, 1.7 ℃, 20.1 ℃ and 25.4 ℃). Results: The total of 21 254 cases were reported from 2008 to 2016, of which the ratio of male to female was 1.28 (11 951/9 303) and people aged 6-14 years accounted for 52.87%. The relationship between the daily mean temperature and the daily cases of varicella was M type. For all subjects, the accumulative effects of temperature had statistical significance from lag 0-14 d when temperatures was at -5.2 ℃, 1.7 ℃ and 20.1 ℃,while the RRs (95%CI) were 1.87 (1.64-2.12) , 1.33 (1.10-1.62) ,1.60 (1.38-1.86) ,while from lag 0-7 d when temperatures was at 25.4 ℃,and the RR (95%CI) was 2.51 (1.93-3.27) . The RR value of accumulative effects was 6.23(95%CI: 4.38-8.86) on lag 7 d when temperatures was at -5.2 ℃, which was the highest value at different temperature during lag days. The cumulative effects trends of different temperatures were similar for different gender population or different age subjects. However, the cumulative effects of was highest for children aged 6-14 years among all subjects, and the value of RR was 6.12 (95%CI:3.71-10.10) on lag 5d when temperatures was at -5.2 ℃. Conclusion We conclude that the increasing risk of varicella is associative with low and high temperature in Lanzhou. The effects of low temperature are stronger than those of high temperature. The children aged 6-14 years belong to the high-risk population of varicella.