Background Existing studies suggest that cadmium exposure is associated with the occurrence of cardiovascular disease (CVD), but the current epidemiological evidence is inconsistent. Objective To systematically evaluate the relationship between cadmium exposure and CVD through meta-analysis. Methods We systematically searched PubMed, Cochrane Library, Web of Science, CNKI, Wanfang and SinoMed databases to collect observational studies on the relationship between cadmium exposure and CVD in human population published until July 30, 2024. On the basis of following predetermined inclusion and exclusion criteria, the retrieved literature was systematically screened, and the basic information of the included research was extracted, including basic participant information, research outcomes, and data results. This study used the Newcastle-Ottawa Scale and a cross-sectional study evaluation protocol (11 items) recommended by the Quality of Health Care and Research Institutions of the United States for literature quality evaluation. Meta-analysis, subgroup analysis, sensitivity analysis, and assessment of publication bias of the data were conducted using Stata16.0 software. Result A total of 15 studies (18 datasets) were included, and the quality of all the studies was graded as medium or above. Among them, there were 10593 cases of CVD and 86801 controls. The results of meta-analysis showed that the standard mean difference (SMD) of the CVD case group was 0.44 and 95% confidence interval (95%CI) was (0.30, 0.58), and the cadmium exposure level of the CVD case group was higher than that of the control group (P<0.05). The subgroup analysis showed that the cadmium exposure levels in the CVD patients from the Americas (SMD=0.46, 95%CI: 0.29, 0.63) and Europe (SMD=0.14, 95%CI: 0.09, 0.19) were higher than those in the control group (P<0.05). The cadmium levels in blood (SMD=0.52, 95%CI: 0.31, 0.73) and urine (SMD=0.34, 95%CI: 0.16, 0.52) in the CVD case group were higher than those in the control group (P<0.05). In those cross-sectional studies (SMD=0.34, 95%CI: 0.23, 0.46), the cadmium exposure level in the CVD patients was higher than that in the control group (P<0.05). The sensitivity analysis showed robust meta-analysis results and the assessment of publication bias also showed no publication bias. Conclusion Cadmium exposure may increase the risk of cardiovascular disease after multiple studies were combined by meta analysis, suggesting that the scope and level of cadmium exposure in the population should be further controlled.

OBJECTIVE To systematically evaluate the incidence of anti-tuberculosis drug-induced liver injury （ATB-DILI） and its risk factors. METHODS PubMed， Embase， the Cochrane Library， Web of Science， China Knowledge Network， VIP， Wanfang data and China Biomedical Literature Database were searched to collect cohort studies and case-control studies on the incidence and risk factors of ATB-DILI from the establishment of the database to 31 May 2024. After screening literature， extracting data and evaluating the quality of literature， meta-analysis was performed using Stata 17.0 and RevMan 5.3 software. RESULTS A total of 26 literature involving 38 971 patients were included， of which 4 106 patients suffered from ATB-DILI. Meta-analysis showed that the incidence of ATB-DILI was 12.94% [95%CI （10.82%，15.06%）， P＜0.001]； subgroup analysis showed that the incidence of ATB-DILI in cohort studies， Chinese studies and pediatric patients was higher （P＜0.001）. Age≥60 years， abnormal body mass index， alcoholism， smoking， history of liver disease， hepatitis B surface antigen positivity， extrapulmonary tuberculosis， malnutrition， hypoproteinemia， cardiovascular disease， diabetes mellitus， systemic lupus erythematosus， no prophylactic use of hepatoprotective drugs， and high baseline alanine transaminase levels were risk factors for developing ATB-DILI （P＜0.05）. Sensitivity analysis and publication bias analysis showed that the results obtained in this study were relatively robust. CONCLUSIONS The incidence of ATB-DILI in tuberculosis patients is 12.94%. Age≥60 years， abnormal body mass index， alcoholism， smoking， history of liver disease， hepatitis B surface antigen positivity， extrapulmonary tuberculosis， malnutrition， hypoproteinaemia， cardiovascular disease， diabetes mellitus， systemic lupus erythematosus， non-prophylactic use of hepatoprotective medications， and high baseline levels of alanine transaminase are the risk factors for developing ATB-DILI.

Objective　To understand the impact of early and timely treatment and initial antiviral treatment regimen on mortality and attrition of antiretroviral therapy. Methods A retrospective cohort study was conducted using download data on antiretroviral therapy for HIV-infected patients in Liuzhou City, Guangxi Province, from the database of the Basic Information System for AIDS Control and Prevention (BISAC) from 2010 to 2020. The Cox proportional risk regression model was used to analyze the influencing factors of mortality and attrition. Results A total of 15 713 infected patients were included, including 53.4% aged 18-<50 years, 69.4% male, 61.0% farmer, 75.1% CD4 count <350 cells /μL before initial antiviral treatment, the overall mortality rate was 4.30/100 person-years, and the overall attrition was 2.42/100 person-years. The results of Cox regression analysis showed that the influencing factors of mortality were pretreatment CD4 counts of 350-<500 cells/μL(AHR=0.72, 95%CI: 0.63-0.81) and ≥500 cells/μL (AHR= 0.64, 95%CI: 0.55-0.76); duration from diagnosis to initial antiviral treatment 91-180 days (AHR=1.25, 95%CI: 1.08-1.45), 181-365 days (AHR=1.26, 95%CI: 1.08-1.47), and ≥365 days (AHR=1.26, 95%CI: 1.11-1.44); initial antiviral treatment regimens of D4T+3TC+EFV/NVP (AHR=1.47, 95%CI: 1.32-1.63) and AZT/D4T/TDF+3TC+LPV/r (AHR=1.73, 95%CI: 1.50-1.99). Factors affecting attrition were pretreatment CD4 counts of 350-499 cells/μL (AHR=1.32, 95%CI: 1.16-1.50) and ≥500 cells/μL (AHR=1.28, 95%CI: 1.10-1.50); interval from HIV positivity confirmation to initial dosing ≥365 days (AHR=1.21, 95%CI: 1.04-1.40), initial antiviral treatment regimens of TDF+3TC+NVP (AHR=1.32, 95%CI: 1.13-1.55), AZT+3TC+EFV/NVP (AHR=1.43, 95%CI: 1.26-1.62) and AZT/D4T/TDF+3TC+LPV/r (AHR=1.33, 95CI%: 1.06-1.67). Conclusions　Early and timely treatment and the initial antiviral treatment regimen of TDF+3TC+EFV have good efficacy, but attention should be paid to the high risk of attrition of HIV-infected people with high CD4 count before treatment.

Objective:To conduct a scoping review on gamified exercise interventions for elderly patients with cognitive impairment to provide insights for the application of gamification design in exercise programs for this population.Methods:Guided by the scoping review framework proposed by Arksey and O'Malley, a systematic search was conducted in databases including China National Knowledge Infrastructure, Wanfang, VIP, SinoMed, PubMed, Cochrane Library, CINAHL, Web of Science, Scopus, ProQuest, and Wiley Online Library. The search covered the period from the establishment of the databases to June 12, 2024. An integrative analysis was performed on the included literature.Results:A total of 12 studies were included. The most commonly used gamification elements were achievement- and progress-oriented features, while the most frequently applied behavior change theories were behavior change techniques and social cognitive theory.Conclusions:Gamification-based exercise interventions can improve adherence to exercise programs in elderly patients with cognitive impairment, promote physical activity, and enhance cognitive function. Future research should focus on combining various theories with different gamification elements to encourage proactive exercise behavior in elderly individuals with cognitive impairment.

To prepare a lipid nanoparticle (LNP)-based subunit vaccine of Mycobacterium tuberculosis (Mtb) antigen EsxV and study its immunological characteristics, the LNP containing EsxV and c-di-AMP (EsxV: C: L) was prepared by thin film dispersion method, and its encapsulation rate, LNP morphology, particle size, surface charge and polyphase dispersion index were measured. BALB/c mice were immunized with EsxV: C: L by nasal drops. The levels of serum and mucosal antibodies, transcription and secretion of cytokines in lung and spleen, and the proportion of T cell subsets were detected after immunization. EsxV: C: L LNPs were obtained with uniform size and they were spherical and negatively charged. Compared with EsxV: C immunization, EsxV: C: L mucosal inoculation induced increased sIgA level in respiratory tract mucosa. Levels of IL-2 secreted from spleen and ratios of memory T cells and tissue-resident T cells in mice were also elevated. In conclusion, EsxV: C: L could induce stronger mucosal immunity and memory T cell immune responses, which may provide better protection against Mtb infection.
Animals ; Mice ; Mycobacterium tuberculosis ; Antigens, Bacterial ; Immunization ; Nanoparticles ; Vaccines, Subunit ; Mice, Inbred BALB C

Objective:To explore the effect of integrated nursing of special diseases on compliance of lymphoma children and psychological burden of parents.Methods:Convenient sampling method was used in this study, from January 2018 to December 2019, 44 children with lymphoma who received routine nursing intervention in Zhengzhou University Cancer Hospital (Henan Provincial Cancer Hospital) were selected as the control group, and 43 children with lymphoma who received specialized integrated nursing intervention from January 2020 to January 2022 were selected as the observation group, and both groups received four weeks of nursing. The Self-rating Anxiety Scale (SAS) score, Self-rating Depression Scale (SDS) score, Revised Piper Fatigue Scale (PFS-R) score and compliance were compared between the two groups.Results:The differences of PFS-R scores between the two groups four weeks after nursing and before nursing were statistically significant ( P<0.05) . After four weeks of nursing, the scores of SDS and SAS of parents in the observation group were lower than those in the control group, with statistically significant differences ( P<0.05) . The total compliance rate of the observation group was higher than that of the control group, with a statistically significant difference ( P<0.05) . Conclusions:The application of integrated nursing of specific disease in children with lymphoma has significant effect, which can improve the compliance of children and reduce the psychological burden of parents.

This article reviews the overview of digital integration of geriatric patients and related influencing factors, the current situation of smart outpatient service, and the aging measures of smart outpatient service, with a view to providing reference for Chinese scholars to further study digital integration of geriatric patients.

Microglia differ from macrophages with unique origin and role. In glioblastoma, microglia plays an important role in regulating tumor immune status, promoting tumor angiogenesis, destroying the blood-brain barrier, and reducing the sensitivity of treatment. Therefore, the combination of microglial therapy in the radiotherapy, chemotherapy and immunotherapy of glioblastoma has also become a clinically promising treatment.

OBJECTIVE: To estimate the social and economic burden of Downs syndrome for patients and their families residing in Changsha, China. METHODS: An 160-item self-administered questionnaire was designed and distributed to the primary caregivers of the patients in March 2020. A total of 81 eligible participants had completed the questionnaire, among which 20 were excluded for incomplete data. A patient perspective was taken to estimate the economic burden of the disease. The social impact of the disease on the patient's family was evaluated through questions adapted from the Stanford Psychological Wellbeing (PWB) Scale. RESULTS: The estimated life-course cost of a Downs syndrome patient in Changsha is 4 985 659 RMB, with the patient and caregiver's loss of income taking the greater proportion. In addition, as the majority of the patients' primary caregivers, female caregivers experienced not only considerable financial hardship caused by the care provision, but also a significant amount of psychological pressure and social discrimination. CONCLUSION Increased level of social welfare for the patients and social support for their female caregivers are essential for reducing economic burden and improving their quality of life in the area. In addition, prenatal screening and diagnosis for Downs syndrome are important for reducing both the social and economic burden of the disease by preventing its occurrence.
Caregivers ; China ; Down Syndrome ; Female ; Financial Stress ; Humans ; Quality of Life ; Social Discrimination ; Surveys and Questionnaires

Objective:To explore the molecular pathogenesis of hereditary protein C (PC) deficiency due to a p. Gly86Asp variant of the PROC gene through in vitro expression experiment.Methods:Wild type and Gly86Asp mutant expression plasmids of PC were constructed and respectively transfected into HEK 293FT cells. Total RNA was extracted from the transfected cells, and the expression of PROC gene was determined by quantitative real-time PCR (qRT-PCR). PC antigen (PC: Ag) in the supernatant of cell culture and cell lysate was determined by enzyme-linked immunosorbent assay (ELISA), and the level of PC protein was detected by Western blotting. Results:qRT-PCR has detected no significant difference in the transcription level of wild-type and mutant-type PC. Compared with the wild type, the level of mutant PC: Ag in the supernatant and cell lysate were 81.3%±2.6% and 110.0%±2.8%, respectively. No difference was detected in the molecular weight between the wild-type and mutant-type PC by Western blotting. The PC content of mutant type was higher than wild-type in cell lysate, while the opposite was found with the cell culture supernatant.Conclusion:The impaired secretion by mutant PC may be the molecular mechanism of PC deficiency caused by the p.