Coronary artery calcifications (CAC) is an independent risk factor for cardiovascular disease (CVD). It has been revealed that this condition can be automatically quantified through computerize tomographic (CT) scan contained in radiotherapy plan for patients with breast cancer, with which, physicians can identify the patients with increased risk of CVD after radiotherapy prematurely and take intervention measures in advance. In this article, the current literature and research progress on the correlation between CAC and cardiotoxicity in patients with breast cancer after radiotherapy were reviewed, expecting to provide a strategy to reduce the CVD risk in patients with breast cancer after radiotherapy.

BackgroundPrevious investigations have illuminated the correlation between smoking and C-reactive protein （CRP）， but previous research findings may be influenced by other confounding factors. The causal relationship of CRP in smoking-related pathological process requires further exploration. ObjectiveTo investigate the causal relationship between smoking behavior and CRP by utilizing the cumulative statistical data from existing genome-wide association studies （GWAS）， so as to provide references for formulating relevant public health policies and smoking intervention measures. MethodsThis research utilized the GWAS summary statistics for CRP and four smoking phenotypes： age of initiation of regular smoking， smoking initiation， smoking cessation and cigarettes per day-selecting independent genetic loci correlated with smoking and CRP as instrumental variables. The study employed the inverse variance weighted method （IVW） and the weighted median approach for two-sample Mendelian randomization （MR） analysis to explore the bidirectional causal relationship between smoking and CRP. The Cochran's Q test was applied to assess heterogeneity among single nucleotide polymorphisms （SNPs）. MR pleiotropy residual sum and outlier was used to detect SNP outliers. MR-Egger intercept test examined the horizontal pleiotropy of SNPs. Leave-one-out sensitivity analysis assessed the impact of individual SNP on the Mendelian randomization results. ResultsThe MR analysis revealed a bidirectional causal relationship between CRP and smoking initiation （β=0.170， P=0.01） （with smoking initiationas the exposure）， （β=0.040， P=0.001） （with CRP as the exposure）. ConclusionSmoking may lead to alterations in CRP levels， while changes in CRP levels could also influence individual's propensity to initiate smoking.

Objective:To comprehensively understand the disease burden of liver cirrhosis and other chronic liver diseases caused by alcohol use in China from 1990 to 2019, as well as to predict the trends in disease burden from 2020 to 2030.Methods:The analysis utilized data from the Global Burden of Disease study in 2019 (GBD2019). Key indicators such as incidence rate, mortality rate, disability-adjusted life years (DALY), years of life lost due to premature mortality, and years lived with disability were selected to describe the disease burden of alcohol-related liver cirrhosis and other chronic liver diseases in China from 1990 to 2019. The estimated annual percentage change (EAPC) was used to depict the temporal trends in disease burden. Furthermore, a Bayesian age-period-cohort (BAPC) model was constructed using R software to predict the age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) of alcohol-related liver cirrhosis and other chronic liver diseases in China from 2020 to 2030.Results:From 1990 to 2019, the incidence of alcohol-related liver cirrhosis and other chronic liver diseases in China showed an upward trend, with an EAPC of 0.31% (95% CI: 0.10%-0.52%). However, the DALY declined, with an EAPC of -2.81% (95% CI: -2.92% - -2.70%). The ASMR showed a downward trend, with an EAPC of -2.55% (95% CI: -2.66% - -2.45%). The highest incidence of cirrhosis of liver caused by alcohol and other chronic liver diseases was reported in the age group of 35-49 years, while the ASMR increased gradually with age, with a significant rise after the age of 30. The age-standardized DALY rate peaked between the ages of 55 and 64. The disease burden indicators for males were consistently higher than those for females during the same period. According to the predictions of the BAPC model, from 2020 to 2030, the ASIR for cirrhosis of liver caused by alcohol and other chronic liver diseases in the entire population of China was projected to increase from 3.45/100 000 in 2020 to 3.78/100 000 in 2030, a growth of 9.57%. Conversely, the ASMR was expected to decrease from 1.45/100 000 in 2020 to 1.24/100 000 in 2030, a reduction of 14.48%. Conclusions:The disease burden of cirrhosis of liver caused by alcohol and other chronic liver diseases remained serious in China, especially in men and the middle-aged to elderly population. There is a pressing need to prioritize attention and resources towards these groups. Despite the projected decrease in ASMR, the ASIR continued to rise and is expected to persist in its upward trend until 2030.

Background and purpose:Radical surgery after neoadjuvant immunotherapy combined with chemotherapy(nICT)in patients with locally advanced esophageal squamous cell carcinoma(LAESCC)has good efficacy and safety,and it can improve the patients'pathological complete remission(pCR)rate,main pathologic response(MPR)rate and R0 resection rate.The prognosis of patients with pCR/MPR after nICT is significantly better compared with patients without pCR.The prognosis of patients achieving pCR/MPR after neoadjuvant therapy has been demonstrated to be significantly better than that of patients with non-pCR/MPR.Therefore,finding predictive factors of pCR/MPR is beneficial for us to screen out the advantageous populations for combination therapy.The aim of this study was to investigate the value of clinical data of patients with LAESCC before and after nICT in predicting the degree of remission of different pathologies after radical surgery following neoadjuvant treatment and to observe the safety of the treatment.Methods:Data of patients with locally LAESCC who underwent radical surgery after nICT from January 2019 to June 2023 at the Affiliated Hospital of Chuanbei Medical College were collected.The clinical data of all patients as well as some blood,inflammation and nutritional indexes of patients before and after neoadjuvant therapy were collected,and the patients were grouped according to the different degrees of pathological remission after neoadjuvant therapy.Data were analyzed by multi-group comparative analysis of variance(ANOVA)and LSD-t post-hoc test.We explored the factors that had an influence on the different degrees of pathological remission,and collected and recorded the patients'adverse reactions during neoadjuvant therapy as well as their eventual surgeries.Results:Data of 62 patients with LAESCC treated with nICT who underwent radical surgery were collected.Only one patient showed grade 4 myelosuppression during neoadjuvant therapy,and the rest of the patients had adverse reactions≤grade 2.The R0 resection rate of the surgery was 98.39%.The present study was compared with the previous studies of LAESCC treated with neoadjuvant chemotherapy followed by radical surgery performed in Affiliated Hospital of Chuanbei Medical College.Compared with the previous studies conducted in our center,no significant difference was observed in terms of operation time,intraoperative bleeding,postoperative hospitalization time and surgical complications.The postoperative pathologic results showed that the pCR rate was 22.58%(14/62),and the MPR rate was 40.32%(25/62).According to the different tumor regression grade(TRG)after surgery,patients were divided into 3 groups of TRG1,TRG2 and TRG3-4,and differences in the platelet distribution width(PDW)before neoadjuvant therapy and the preoperative neutrophil-to-lymphocyte ratio(NLR)after neoadjuvant therapy were statistically significant among the 3 groups(P＜0.05).Further intra-group two-by-two comparisons of PDW before neoadjuvant therapy and NLR before surgery after neoadjuvant therapy were performed for the three groups of patients,respectively,and it was found that the PDW and NLR in the TRG2 group were lower compared with the TRG3-4 group,and the differences were statistically significant(P＜0.05).Conclusion:Radical surgery after nICT treatment in patients with LAESCC can have high R0 resection rate,pCR rate,MPR rate and reliable safety,and the lower PDW of patients before neoadjuvant therapy and the lower NLR of patients before surgery after neoadjuvant therapy predict better pathological remission efficacy.

Objective:To assess the prognostic impact of frailty on elderly inpatients with heart failure.Methods:This prospective cohort study enrolled 121 in elderly patients with heart failure from Beijing Hospital, the General Hospital of the People's Liberation Army, and Beijing Tsinghua Changgung Hospital between September 2018 and April 2019.Patients were assessed for frailty using the Fried frailty phenotype and categorized into frail and non-frail groups.Follow-ups were conducted at 3-, 6-, and 12-months post-enrollment through clinic visits or phone calls to record adverse events.Composite endpoints include all-cause mortality and rehospitalization duo to deterioration of heart failure.Results:The study included 121 patients with an average age of 78.0±7.4 years, of whom 71(58.7%)were male and 57(47.1%)were classified as frail.Compared to the non-frail group, the frail group had lower estimated glomerular filtration rates[49.5±20.7 ml/(min·1.73m 2) vs.(64.0±27.1)ml/(min·1.73m 2)], lower scores in Basic Activities of Daily Living[5.0(4.0, 6.0) vs.6.0(5.0, 6.0)], Instrumental Activities of Daily Living[2.0(1.3, 7.8) vs.7.0(5.0, 8.0)], and Mini-Mental State Examination[26.0(16.0, 28.0) vs.27.0(22.3, 29.0)], all P<0.05.They also experienced longer hospital stays[10.5(6.0, 18.8)days vs.8.0(6.0, 11.8)days, P=0.008].During the follow-up period, the incidence of composite endpoint events was significantly higher in the frail group(43.9% vs.25.0%, P=0.029).Kaplan-Meier survival analysis demonstrated that the one-year incidence of composite endpoint events was significantly higher in the frail group( P=0.013).Multivariable Cox regression analysisindicated that frailty was an independent risk factor for composite endpoint events( HR=2.201, 95% CI: 1.089-4.447, P=0.028). Conclusions:Frailty is an independent risk factor for poor outcomes in elderly hospitalized patients with heart failure and should be considered a crucial factor in clinical assessment and treatment strategies.

Objective:To evaluate the association of different biomarkers with frailty in elderly hospitalized patients.Methods:In this cross-sectional study, a total of 319 elderly patients aged 65 years or older hospitalized in Beijing Hospital between September 2018 and February 2019 were enrolled.Patients had a mean age of(75.0±6.6)years and 151(47.3%)were women.Based on the Fried phenotype, patients were divided into a non-frail group(244 cases, 76.5%)and a frail group(75 cases, 23.5%). The clinical characteristics and biomarker levels of the two groups were compared.The association of different biomarkers with frailty was evaluated by using the receiver operating characteristic(ROC)curve.The Youden index was used for the optimal cutoff values and the area under the curve(AUC)were calculated.AUCs of different biomarkers were compared to assess their correlations with frailty.Results:Hemoglobin, lipid levels(triglycerides, total cholesterol and low-density lipoprotein cholesterol), and prealbumin were significantly lower in the frail group than in the non-frail group( P<0.05), while N-terminal pro-B type natriuretic peptide(NT-proBNP)and high-sensitivity C reactive protein(hsCRP)levels were significantly higher than in the non-frail group( P<0.05). Thyrotropin(TSH)and free triiodothyronine(FT3)levels were significantly lower( P<0.05)and trans-triiodothyronine(rT3)was significantly higher( P<0.05)in the frail group.The combination of six biomarkers[hemoglobin, prealbumin, hsCRP, 25-dihydroxy vitamin D3[25(OH)D3], rT3 and NT-pro BNP]had the most powerful correlation with frailty(AUC=0.705, 95% CI: 0.652-0.755), but the correlation was not significantly different from that of the combination of 3 markers(hemoglobin, rT3 and hsCRP)(ROC=0.010, 95% CI: -0.0106-0.0306, P>0.05). Either of the two combinations was significantly better than the combination of 2 markers(hemoglobin and rT3)(ROC=0.143, 95% CI: 0.0406-0.245; ROC=0.153, 95% CI: 0.0498-0.256; all P<0.01). Conclusions:Hemoglobin, lipids, prealbumin, TSH and FT3 levels decrease while NT-proBNP and hsCRP levels increase in elderly hospitalized frail patients.The 6-biomarker combination[hemoglobin, prealbumin, hsCRP, 25(OH)D3, rT3 and NT-pro BNP]and 3-biomarker combination(hemoglobin, rT3 and hsCRP)have better correlation with frailty than the 2-biomarker combination(hemoglobin and rT3).

OBJECTIVES: Low dose computed tomography (LDCT) is the best method for early diagnosis of lung cancer. Even though it has been widely used in clinic, the selection of screening objects and the management scheme of pulmonary nodules are still not unified among research institutions. This study aims to evaluate the effect of LDCT in detection effect and follow-up process for pulmonary nodules in asymptomatic participants. METHODS: A total of 1 600 asymptomatic participants (37 to 82 years old), who came from Yantian District People's Hospital, Southern University of Science and Technology, received LDCT. The lung nodules were categorized into positive nodules and semi-positive nodules, and according to the density of positive nodules they were categorized into 4 types: solid nodules (SN), partial solid nodules (pSN), pure ground glass nodules (pGGN), and pleural nodules (PN). The number, detection rate, imaging findings, follow-up change of lung nodules, and the postoperative pathological results of positive nodules were recorded and analyzed. RESULTS: Lung nodules were found in 221 cases by LDCT. The total detection rate of lung nodule was 13.8% (221/1 600), and the detection rate in positive nodules was 4.9% (79/1 600). The detected nodules were mainly single (173 cases), solid (133 cases) and semi-positive nodules (142 cases). Most of nodules (177 cases) had no change in the follow-up process. The enlargement and/or increased density of nodules (5 cases) were lung cancer. Pathological results were obtained in 10 cases, 8 cases were malignant (1 small cell lung cancer and 7 adenocarcinomas), 2 cases were benign (cryptococcal infection and alveolar epithelial dysplasia). The detection rate of lung cancer was 0.5% (8/1 600), and the proportion of early lung cancer was 75% (6/8). CONCLUSIONS LDCT screening can identify and increase the detection rate in the early lung cancer, which is an effective screening method. It is safe and feasible to take regular follow-up and re-examination for nodules with diameter less than 5 mm. When the size and or density of nodule increases, it indicates the malignant prognosis of the nodule and timely clinical intervention is needed.
Adenocarcinoma ; Adult ; Aged ; Aged, 80 and over ; Early Detection of Cancer/methods* ; Humans ; Lung Neoplasms/pathology* ; Mass Screening/methods* ; Middle Aged ; Tomography, X-Ray Computed/methods*

ObjectiveTo investigate the current situation of personality traits and job satisfaction of pediatric therapists in Jiangsu province, and to explore the correlation between them and the related factors of job satisfaction. MethodsFrom June, 2021 to February, 2022, random cluster sampling method was adopted after field investigating several pediatric hospitals and institutions in Jiangsu. Online questionnaires were sent out to pediatric therapists in different settings in eleven cities in Jiangsu. The questionnaires included Minnesota Satisfaction Questionnaire (MSQ), Eysenck Personality Questionnaire-Revised Short Scale for Chinese (EPQ-RSC) and self-made scale of demographic characteristics and working status. ResultsAll of the questionaires were taken back, in which 165 were valid (83.33%). Among the three dimensions of psychoticism, extraversion and neuroticism, the intermediate type accounted for 66.06%, 38.79% and 40.00%, respectively. The overall satisfaction of job was (3.80±0.55), the internal satisfaction was (3.88±0.53), and the external satisfaction was (3.59±0.69). There was significant difference in the satisfaction among different types of work institution, monthly incomes, levels of parental support and neuroticism (P < 0.05). Multiple linear regression showed that the internal satisfaction and overall satisfaction were related with neuroticism, monthly income and parental support (P < 0.05), while external satisfaction was related with the neuroticism and parental support (P < 0.05). The level of neuroticism was negatively correlated with the internal satisfaction, the external satisfaction and overall satisfaction (|r| > 0.337, P < 0.001), and the level of extraversion was postively correlated with the external satisfaction (r = 0.155, P < 0.05). ConclusionThe job satisfaction of pediatric therapists is fine in Jiangsu, and is ralated with the level of neuroticism, the monthly income and the level of parental support. The levels of neuroticism and extraversion correlate with the job satisfaction.

Interference with quorum sensing(QS)represents an antivirulence strategy with a significant promise for the treatment of bacterial infections and a new approach to restoring antibiotic tolerance.Over the past two decades,a novel series of studies have reported that quorum quenching approaches and the discovery of quorum sensing inhibitors(QSIs)have a strong impact on the discovery of anti-infective drugs against various types of bacteria.The discovery of QSI was demonstrated to be an appropriate strategy to expand the anti-infective therapeutic approaches to complement classical antibiotics and antimicrobial agents.For the discovery of QSIs,diverse approaches exist and develop in-step with the scale of screening as well as specific QS systems.This review highlights the latest findings in strategies and methodologies for QSI screening,involving activity-based screening with bioassays,chemical methods to seek bacterial QS pathways for QSI discovery,virtual screening for QSI screening,and other potential tools for interpreting QS signaling,which are innovative routes for future efforts to discover additional QSIs to combat bacterial infections.

Objective:To explore the value of 5G robotic remote ultrasound in the diagnosis of plateau pulmonary edema(HAPE).Methods:A total of 27 patients who quickly entered Nagqu, Tibet at an altitude of 4 600 m-5 600 m from March to December 2021 and developed one of the clinical symptoms of HAPE were collected. All patients were examined by 5G remote robotic ultrasound and lung CT respectively. Kappa test was used to analyze the consistency of the two diagnostic results, and McNemar test was used to compare the difference in diagnostic results. The ROC curve was used to analyze the sensitivity and specificity of remote lung ultrasound scores in the diagnosis of HAPE.Results:Among the 27 patients, 16 showed thickening of pleural line, increasing of B line, lung consolidation, pleural effusion, etc. Meanwhile, 11 showed no abnormality. Additionally, 8 cases had diffuse pulmonary fluid in both lungs, and 8 cases had localized pulmonary fluid. ROC curve showed that the area under the curve of lung ultrasound score for the diagnosis of HAPE was 0.947 (95% CI=0.78-0.99, P<0.001). The sensitivity and specificity were 0.933 and 0.917, respectively. Lung CT diagnosis was positive in 15 cases. Lung CT showed thickening of lung texture, ground glass, small nodular shadow, fine reticulate shadow, etc. The diagnostic results of the two techniques were in good agreement (Kappa=0.924, P<0.001), and there was no significant difference between the two methods ( P>0.05). Conclusions:5G remote robotic ultrasound has high consistency with CT in the diagnosis of HAPE and is an alternative early diagnosis method for HAPE. It may have clinical application value in scattered medical resources and remote plateau areas.