Objective To explore the ^“contribution^” of different exposures to cardiovascular diseases at the population level and to construct a risk prediction model for the effective allocation of prevention resources. Methods The CHNS (China Health and Nutrition Survey) database was used. In 2009, 2011 and 2015, 9 899 permanent residents aged 35 to 75 years in 10 provinces and cities in the central and eastern regions (Beijing, Liaoning, Heilongjiang, Shanghai, Shandong, Henan, Hubei, Hunan, Guangxi and Jiangsu) were selected as the research subjects. A single-factor analysis was conducted to examine the risk factors including sex, age, BMI, marital status, urban/rural area, sleep time, smoking, alcohol consumption, diabetes, education, and health insurance. The multifactor-adjusted population-attributable risk of certain risk factors was also estimated based on logistic regression analysis. The cardiovascular disease (CVD) risk prediction model was developed using a modeling group of 6 927 randomly selected individuals (70%) and a validation group of 2 974 individuals (30%). The model's differentiation and calibration were assessed using the receiver operating characteristic (ROC) curve and the Hosmer-Lemeshow goodness-of-fit test. Results The results showed that the adjusted population attributable risk and 95% confidence interval for BMI, sleep time, smoking, drinking and diabetes were 32.20% (27.67%-36.89%), 7.90% (1.68%-16.58%), 18.56% (11.35%-26.24%), 6.47% (0.11%-13.25%) and 5.73% (4.42%-7.03%). The results of multivariate adjusted population attributable risk percentage showed that BMI was the dominant cause of cardiovascular diseases, followed by smoking, sleep time, drinking and diabetes. The low-risk prevalence rate was 18.44%, the higher-risk prevalence rate was 14.19%, and the high-risk prevalence rate was 42.52%. The area under ROC curve AUC was 0.711, P<0.001, and Hosmer-Lemeshow goodness of fit test showed P=0.257. Conclusion In the future, it is important to focus on high-risk groups , control body mass index to the normal range, and reduce smoking , which is of great significance for the prevention of cardiovascular diseases. The risk prediction model has the value of good differentiation and practicability , and can provide certain prediction ability for the prevention of cardiovascular diseases.

Objective:To investigate the effects of zinc oxide nanoparticles (ZnO-NPs) on neutrophil hypoxia and pyroptosis through nucleotide binding of oligomeric domain-like receptor protein 3 (NLRP3) inflammasome, and to analyze the role of pyroptosis on respiratory tract inflammotion induced by ZnO-NPs.Methods:In October 2022, primary cultured neutrophils were obtained from the abdominal aortic blood of SPF adult healthy SD rats. The neutrophils were treated with ZnO-NPs solution (0, 5, 10, 20 μg/ml) at different concentrations, and hypoxia group (5% O 2) was set up. Hypoxia and reactive oxygen species (ROS) levels were detected by flow cytometry, and the expression levels of NLRP3, apoptosis-associated speck-like protein containing a CARD (ASC), cleaved Caspase-1 were measured by Western blot. The activity of lactic dehydrogenase (LDH) in the cell supernatant was measured by coloration, and the content of interleukin-1 beta (IL-1β) in cell culture supernatant was detected by enzyme-linked immunosorbent assay (ELISA) . Results:Compared with the control group, hypoxia and ROS levels of neutrophils in hypoxia group and ZnO-NPs groups were significantly increased ( P<0.05), and NLRP3, ASC, cleaved Caspase-1 protein expression levels, LDH activity and IL-1β content were significantly increased ( P<0.05). Compared with hypoxia group, hypoxia and ROS levels of neutrophils in 5 μg/ml and 10 μg/ml ZnO-NPs groups were significantly decreased ( P<0.05), NLRP3, ASC, cleaved Caspase-1 protein expression levels, LDH activity, and IL-1β content were decreased significantly ( P<0.05). There were no significant differences in hypoxia, ROS levels, ASC, cleaved Caspase-1 protein expression levels, LDH activity, and IL-1β content between the 20 μg/ml ZnO-NPs group and the hypoxia group ( P>0.05) . Conclusion:ZnO-NPs treatment may activate the NLRP3 inflammasome to induce pyroptosis of neutrophils which may be related to ROS and hypoxia.

Objective:To investigate the effects of zinc oxide nanoparticles (ZnO-NPs) on neutrophil hypoxia and pyroptosis through nucleotide binding of oligomeric domain-like receptor protein 3 (NLRP3) inflammasome, and to analyze the role of pyroptosis on respiratory tract inflammotion induced by ZnO-NPs.Methods:In October 2022, primary cultured neutrophils were obtained from the abdominal aortic blood of SPF adult healthy SD rats. The neutrophils were treated with ZnO-NPs solution (0, 5, 10, 20 μg/ml) at different concentrations, and hypoxia group (5% O 2) was set up. Hypoxia and reactive oxygen species (ROS) levels were detected by flow cytometry, and the expression levels of NLRP3, apoptosis-associated speck-like protein containing a CARD (ASC), cleaved Caspase-1 were measured by Western blot. The activity of lactic dehydrogenase (LDH) in the cell supernatant was measured by coloration, and the content of interleukin-1 beta (IL-1β) in cell culture supernatant was detected by enzyme-linked immunosorbent assay (ELISA) . Results:Compared with the control group, hypoxia and ROS levels of neutrophils in hypoxia group and ZnO-NPs groups were significantly increased ( P<0.05), and NLRP3, ASC, cleaved Caspase-1 protein expression levels, LDH activity and IL-1β content were significantly increased ( P<0.05). Compared with hypoxia group, hypoxia and ROS levels of neutrophils in 5 μg/ml and 10 μg/ml ZnO-NPs groups were significantly decreased ( P<0.05), NLRP3, ASC, cleaved Caspase-1 protein expression levels, LDH activity, and IL-1β content were decreased significantly ( P<0.05). There were no significant differences in hypoxia, ROS levels, ASC, cleaved Caspase-1 protein expression levels, LDH activity, and IL-1β content between the 20 μg/ml ZnO-NPs group and the hypoxia group ( P>0.05) . Conclusion:ZnO-NPs treatment may activate the NLRP3 inflammasome to induce pyroptosis of neutrophils which may be related to ROS and hypoxia.

Objective:To develop the Nurse Managers Negative Leadership Behavior Scale and test its reliability and validity.Methods:This study is a cross-sectional study. The Nurse Managers Negative Leadership Behavior Scale item pool was formed through literature review and semi-structured interviews. A total of 28 nursing management experts from Hubei Province, Beijing, Guangdong Province and other places were selected for expert consultation to form the first draft of the scale. The scale was further revised through pre-experiment and item analysis. In May 2022, 300 nurses from the Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were selected by convenient sampling for a questionnaire survey to test the reliability and validity of the scale. A total of 300 questionnaires were distributed, and 265 valid questionnaires were recovered, with an effective recovery rate of 88.33%. One week after the survey, 20 nurses were randomly selected to re-issue the questionnaire for the retest reliability test of the scale.Results:Totally, 19 experts completed two rounds of expert consultation, with expert authority coefficient of 0.880, Kendall harmony coefficient of 0.160 and 0.130 ( P<0.05) . Exploratory factor analysis extracted six factors, including neglect of needs, personal attack, right satisfaction, unpredictable behavior, slack work and improper supervision, and the cumulative variance interpretation rate was 75.125%. The confirmatory factor analysis showed that the model fitted well and the factor structure was stable. The Nurse Managers Negative Leadership Behavior Scale included six dimensions and 36 items. The total Cronbach's α coefficient of the scale was 0.880, the split-half reliability coefficient was 0.895, and the retest reliability coefficient was 0.876. The content validity index of the scale was 0.930, and the content validity index of each item was 0.800 to 1.000. Conclusions:The Nurse Managers Negative Leadership Behavior Scale has good reliability and validity, and can be used to evaluate the negative leadership behavior of head nurses in China.

Objective:To construct a quality evaluation index system for postoperative rehabilitation in children with developmental dislocation of the hip (DDH) .Methods:From August to November 2021, a quality evaluation index system for postoperative rehabilitation in children with DDH was established through literature review, group discussion, and Delphi expert consultation. The analytic hierarchy process was used to determine the weights of various indicators. The positive coefficient of experts was expressed by the effective response rate of the questionnaire. The authority level of experts was represented by the authority coefficient ( Cr) , which was determined by the expert judgment coefficient ( Ca) and the expert familiarity level ( Cs) . The degree of coordination of expert opinions was represented by the Kendall harmony coefficient (Kendall's W) . The degree of concentration of expert opinions was represented by the average score of importance assignment, coefficient of variation, and full score rate. Results:The effective response rates of the two rounds of expert consultation questionnaires were 90.00% and 100.00%, respectively. The Cr of experts in two rounds were 0.785 and 0.815, and the Kendall harmony coefficients were 0.098-0.193 and 0.147-0.212 ( P<0.05) . In the second round of expert consultation, the average scores of importance assignment for all levels of indicators were≥4.0, with coefficients of variation of 0-0.24 and a full score rate of ≥50%. The final quality evaluation index system for postoperative rehabilitation in children with DDH included 3 first-level indicators, 9 second-level indicators, and 37 third-level indicators. In the consistency test results of each indicator at all levels, all of the CI were <0.001, and all of the CR were<0.001. Conclusions:The construction process of the quality evaluation index system for postoperative rehabilitation in children with DDH is scientific, and the weight distribution of the indicators is reasonable, which can be used as an effective tool for evaluating the postoperative rehabilitation quality of DDH children.

The progressive destruction of condylar cartilage is a hallmark of the temporomandibular joint (TMJ) osteoarthritis (OA); however, its mechanism is incompletely understood. Here, we show that Kindlin-2, a key focal adhesion protein, is strongly detected in cells of mandibular condylar cartilage in mice. We find that genetic ablation of Kindlin-2 in aggrecan-expressing condylar chondrocytes induces multiple spontaneous osteoarthritic lesions, including progressive cartilage loss and deformation, surface fissures, and ectopic cartilage and bone formation in TMJ. Kindlin-2 loss significantly downregulates the expression of aggrecan, Col2a1 and Proteoglycan 4 (Prg4), all anabolic extracellular matrix proteins, and promotes catabolic metabolism in TMJ cartilage by inducing expression of Runx2 and Mmp13 in condylar chondrocytes. Kindlin-2 loss decreases TMJ chondrocyte proliferation in condylar cartilages. Furthermore, Kindlin-2 loss promotes the release of cytochrome c as well as caspase 3 activation, and accelerates chondrocyte apoptosis in vitro and TMJ. Collectively, these findings reveal a crucial role of Kindlin-2 in condylar chondrocytes to maintain TMJ homeostasis.
Aggrecans/metabolism* ; Animals ; Cartilage, Articular/metabolism* ; Chondrocytes/pathology* ; Cytoskeletal Proteins/metabolism* ; Mice ; Muscle Proteins/metabolism* ; Osteoarthritis/pathology* ; Temporomandibular Joint/pathology*

Objective:To explore the application effect of family-centered empowerment model (FCEM) in rehabilitation nursing of children with femoral shaft fractures treated by skin traction.Methods:A retrospective case-control study was conducted to analyze the clinical data of 107 children with femoral shaft fractures treated with skin traction in Anhui Children′s Hospital from April 2019 to October 2021, including 67 males and 40 females; aged 1.5-5.0 years [2.8(2.0, 3.5)years]. Fracture types included oblique fracture ( n=50), comminuted fracture ( n=26), transverse fracture ( n=14) and spiral fracture ( n=17). FCEM nursing was implemented in 55 patients (family empowerment group) and routine home rehabilitation nursing guidance was performed in 52 patients (routine nursing group). The face, legs, activity, cry, consolability (FLACC) behavioral score on admission and at days 1, 3 and 7 after skin traction, treatment compliance rate at 1 month after skin traction, complication rate at 1 month after skin traction, length of hospital stay and fracture healing time were compared between the two groups. Results:All patients were followed up for 12-18 weeks [13.4(12.7, 13.9)weeks]. There was no significant difference in FLACC behavioral score between the two groups on admission ( P>0.05). The FLACC behavioral score was (4.0±0.7)points,(3.4±0.6)points and (2.4±0.6)points in family empowerment group at days 1, 3 and 7 after skin traction, lower than (4.8±0.7)points, (3.9±0.8)points and (3.3±0.5)points in routine nursing groups (all Ρ<0.01). One month after skin traction, treatment compliance was excellent in 51 patients, good in 4, poor in 0, with treatment compliance rate of 92.7% (51/55) in family empowerment group, and was excellent in 40 patients, good in 9, poor in 3, with treatment compliance rate of 76.9% (40/52) in routine nursing group ( Ρ<0.05). The complication rate was 5.4% (3/55) in family empowerment group, lower than 21.2% (11/52) in routine nursing group ( Ρ<0.05). The length of hospital stay and fracture healing time were (15.6±0.3)days and (7.1±0.8)weeks in family empowerment group, shorter than (16.8±0.3)days and (8.2±0.4)weeks in routine nursing group (all Ρ<0.01). Conclusion:For children with femoral shaft fractures treated by skin traction, nursing using FCEM can alleviate pain, improve treatment compliance, reduce complication rate, reduce hospital stay and shorten fracture healing time.

Objective:To explore the effects of interpregnancy interval (IPI) on pregnancy outcomes of subsequent pregnancy.Methods:A multicenter retrospective study was conducted in 21 hospitals in China. Information of age, height, pre-pregnancy weight, IPI, history of diseases, complications of pregnancy, gestational age of delivery, delivery mode, and pregnancy outcomes of the participants were collected by consulting medical records of pregnant women who had two consecutive deliveries in the same hospital during 2011 to 2018. The participants were divided into 4 groups according to IPI:<18 months, 18-23 months, 24-59 months and ≥60 months. According to the WHO′s recommendation, with the IPI of 24-59 months group as a reference, to the effects of IPI on pregnancy outcomes of subsequent pregnancy were analyzed. Stratified analysis was further carried out based on age, history of gestational diabetes mellitus (GDM), macrosomia, and premature delivery, to explore the differences in the effects of IPI on pregnancy outcomes among women with different characteristics.Results:A total of 8 026 women were included in this study. There were 423, 623, 5 512 and 1 468 participants in <18 months group, 18-23 months group, 24-59 months group and ≥60 months group, respectively. (1) The age, pre-pregnancy body mass index (BMI), history of cesarean section, GDM, gestational hypertension and cesarean section delivery rate of <18 months group, 18-23 months group, 24-59 months group and ≥60 months group were gradually increased, and the differences were statistically significant ( P<0.05). (2) After adjusting for potential confounding factors, compared with women in the IPI of 24-59 months group, the risk of premature delivery, premature rupture of membranes, and oligohydramnios were increased by 42% ( OR=1.42, 95% CI: 1.07-1.88, P=0.015), 46% ( OR=1.46, 95% CI: 1.13-1.88, P=0.004), and 64% ( OR=1.64, 95% CI: 1.13-2.38, P=0.009) respectively for women in the IPI≥60 months group. No effects of IPI on other pregnancy outcomes were found in this study ( P>0.05). (3) After stratified by age and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of oligohydramnios for women with advanced age ( OR=2.87, 95% CI: 1.41-5.83, P=0.004); and <18 months could increase the risk of premature rupture of membranes for women under the age of 35 ( OR=1.59, 95% CI: 1.04-2.43, P=0.032). Both the risk of premature rupture of membranes ( OR=1.58, 95% CI: 1.18-2.13, P=0.002) and premature delivery ( OR=1.52, 95% CI: 1.07-2.17, P=0.020) were significantly increased in the IPI≥60 months group. After stratified by history of GDM and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would lead to an increased risk of postpartum hemorrhage for women with a history of GDM ( OR=5.34, 95% CI: 1.45-19.70, P=0.012) and an increased risk of premature rupture of membranes for women without a history of GDM ( OR=1.44, 95% CI: 1.10-1.90, P=0.009). After stratified by history of macrosomia and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months could increase the proportion of cesarean section for women with a history of macrosomia ( OR=4.11, 95% CI: 1.18-14.27, P=0.026) and the risk of premature rupture of membranes for women without a history of macrosomia ( OR=1.46, 95% CI: 1.12-1.89, P=0.005). After stratified by history of premature delivery and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of premature rupture of membranes for women without a history of premature delivery ( OR=1.47, 95% CI: 1.13-1.92, P=0.004). Conclusions:Both IPI≥60 months and <18 months would increase the risk of adverse pregnancy outcomes in the subsequent pregnancy. Healthcare education and consultation should be conducted for women of reproductive age to maintain an appropriate IPI when they plan to pregnant again, to reduce the risk of adverse pregnancy outcomes in the subsequent pregnancy.

Objective To observe the relation of phase angle (PA) measured by bioelectrical impedance method with nutritional status of patients with primary liver cancer, and to explore its influence on clinical outcomes. Methods We collected 120 inpatients with primary liver cancer for nutritional risk screening, patient-generated subjective nutrition assessment(PG-SGA), anthropometry, biochemical examination and body composition analysis. According to the phase angle, the patients were divided into low PA group and normal PA group. The correlation between PA and nutrition-related indicators was analyzed. The survival and complications of the two groups were compared after 1-year follow-up. Results There were 56.7% (68/120) of primary liver cancer patients with lower PA. TP, ALB, CHE, HB, AMC, GS, BCM, FFM and ASMI in low PA group were lower while ECW/TBW was higher than those in normal PA group (all P < 0.05). The correlation analysis showed that PA was negatively correlated with ECW/TBW (P < 0.05), but positively correlated with TP, ALB, CHE, HB, AMC, GS, BCM, FFM and ASMI (all P < 0.05). Low PA was significantly associated with nutritional risk, deterioration of liver function, progress of liver cancer staging and severe malnutrition (all P < 0.05). During the follow-up period, the mortality of the low PA group was higher than that of the normal PA group (P < 0.05). The risk of death in the low PA group increased by 2.738 times (OR=3.738, 95%CI: 1.465-9.535). Conclusion Phase angle is an economic and effective index to reflect the nutritional status of patients with primary liver cancer, and closely related to the risk of death. Phase angle measurement is helpful for assessing nutritional status and predicting clinical outcome of patients with primary liver cancer.

Caroli’s disease is a rare congenital disease characterized by non-obstructive dilatation of the intrahepatic bile ducts, with a prevalence of one in a million in the general population[1]. Most of it is considered to be an autosomal recessive genetic disease, but in many cases, the typical genetic family history cannot be traced back. There are two forms of Caroli’s disease: simple type (commonly called Caroli disease) and Caroli syndrome (characterized by congenital liver fibrosis and/or polycystic kidney disease). PKHD1 gene is considered to be the causative gene of Caroli’s disease, congenital liver fibrosis and/or polycystic kidney disease [2]. Here, we introduce a case of Caroli's disease confirmed by pathology, atypical symptoms and images in our hospital.