Objective To investigate the effects of emotions(subjective well-being,depressed effect,worry,and guilt)on cancer(colorectal cancer,hepatic cancer,thyroid cancer,lung cancer,and breast cancer).Methods Two-sample bi-directional Mendelian randomization(MR)method was adopted.All data were based on summary data from genome-wide association studies(GWAS).Inverse variance weighting(IVW)was used to generate the main results,and weighted median(WM)and MR-Egger methods were employed to calculate supplementary results.The outcome measure was odds ratio(OR),and sensitivity analysis was conducted.Results For depressed effect,a significant association with lung cancer(OR=1.005,95％CI:1.001-1.009,P=0.015)was found.For worry,a significant association with breast cancer(OR=1.199,95％CI:1.011-1.423,P=0.038)was observed.For guilt,a significant association with thyroid cancer(OR=2.083,95％CI:1.080-4.017,P=0.029)was identified.After removing all potentially pleiotropic SNPs detected by MR PRESSO,the association between worry and breast cancer showed no statistical difference(P=0.064),while the association between worry and colorectal cancer remained significant(OR=0.739,95％CI:0.571-0.956,P=0.021).No causal relationship was found between cancer and emotions.Conclusion There is a causal relationship between depression and increased lung cancer incidence,guilt and increased thyroid cancer incidence,as well as anxiety and decreased colorectal cancer incidence.

[Objective] To analyze the correlation of the distribution and morphological characteristics of breast calcification with the risk of breast malignant tumors, so as to further reveal the important value of the calcification in diagnosis of breast malignant tumors. [Methods] A total of 108 patients who had received concurrent puncture biopsy and surgical treatment of breast calcification at The Second Affiliated Hospital of Xi’an Jiaotong University from January 1, 2019 to December 31, 2019 were recruited, and their imaging data and postoperative pathological results were analyzed. We divided the distribution of breast X calcification into two categories based on segmental/linear calcification and regional/diffuse calcification. We classified the morphology of breast X calcification into punctate, small branching, polymorphic, amorphous, and coarse ones. We then explored the distribution, morphology, and BI-RADS classification of tumor calcification under breast X-ray, and its correlation with the occurrence, age, menopausal status, hormone receptors, and molecular typing of breast malignant tumors. [Results] Among the 108 patients enrolled in the study, 21 cases were malignant and 87 cases were benign. The results showed that the distribution of calcification was segmental/linear (χ²=11.2, P=0.003) and the calcification morphology was of small branching calcification (χ²=9.3, P=0.046). The detection rate in malignant tumors was significantly higher than that in benign tumors. The distribution and morphology of calcification were not significantly correlated with ER, PR, HER2, Ki67, pathological type, or molecular typing (P>0.05). Logistic regression analysis showed that , calcification distribution was segmental/linear [OR=19.94(3.061-129.9), P=0.002], calcification morphology was small branching [OR=3.906(1.141-13.37), P=0.030], and B-RADS classification was 4 grade and above [OR=39.99(2.703-591.7), P=0.007], which were closely related to the occurrence of malignant tumors. [Conclusion] For patients with breast tumors in which calcification can be detected under mammography, their imaging characteristics are closely related to the occurrence of malignant tumors. The distribution of calcification is segmental/linear, and the morphology of calcification is small branching/amorphous, which is more likely to be a malignant tumor and closely related to the occurrence of breast cancer.

Objective:To explore the measurement method and its diagnostic performance based on MRI and CT measurement of vertebral bone density in patients to predict proximal junctional kyphosis after degenerative scoliosis surgery.Methods:Retrospectively included patients who underwent long-segment fixation and fusion surgery at the Department of Orthopedics, West China Hospital of Sichuan University from January 2010 to December 2020 and had complete preoperative whole-spine X-rays, CT, MRI and other imaging examination results, and were followed up on schedule. 68 cases of adult degenerative scoliosis, 16 male, 52 women, aged 66.87±6.65 years (range, 54-80 years). The patients were measured based on preoperative lumbar spine MRI T 1WI bone quality score (vertebral bone quality score, VBQ) and CT-based Hounsfield (HU) value, and the patients were divided into postoperative proximal junction kyphosis group or non-proximal junction kyphosis group based on the results of postoperative imaging examinations. The age, gender, BMI, comorbidities, lumbar spine VBQ score, L 1 CT HU value and various imaging parameters before and after surgery were compared between the two groups of patients, including pelvic incident, lumbar lordosis, sagittal vertical axis, pelvic tilt, sacral slope, pelvic incidence-lumbar lordosis, T 1 pelvic angle, Upper instrumented vertebrae screw angle, etc. The receiver operating characteristic curve (ROC) was drawn to analyze the diagnostic efficacy, sensitivity and specificity of VBQ score, HU value and their combined indicators. Results:Seventeen cases were included in the PJK group and 51 cases in the non-PJK group. The preoperative VBQ and HU values of the PJK group were 3.10±0.43 and 99.76±16.34 respectively, while those of the non-PJK group were 2.62±0.37 and 115.27±13.46 respectively. The differences were statistically significant ( t=3.896, P<0.001; t=4.482, P<0.001). The area under curve (AUC) of VBQ was 0.773 [95% CI(0.633, 0.914)], the sensitivity and specificity are 82.4% and 70.6% respectively, the AUC of HU value was 0.814 [95% CI(0.680, 0.949)], the sensitivity and specificity are 76.5% and 76.5% respectively. The AUC of the two combined indicators was 0.895 [95% CI(0.795, 0.995)], and the sensitivity and specificity were 94.1% and 82.4% respectively. The maximum Youden index and the critical value were respectively, VBQ value 0.530, 2.895, HU value 0.530, 110.0, the combined index 0.765, 0.734. Conclusion:Both VBQ and L 1 HU value can accurately predict proximal junctional kyphosis after degenerative scoliosis surgery. The accuracy of HU value was slightly higher than that of VBQ value. The diagnosis accuracy of the combined index was the highest.

β-thalassemia is a common monogenic inherited blood disorder caused by mutations of β-globin gene which results to synthesis obstacles or abnormal structure of β-globin.Gene therapy mediated by lentiviral vector(LVV)is divided into gene-integration strategies using LVV to add fully functional β-hemoglobin(HBB)genes to chromosomes and gene-editing strategies using LVV to deliver specific ribozymes to hematopoietic stem cells for in situ repair of HBB genes.Improving viral titration and transduction efficiency,reducing target loss and advancing clinical trials are the main targets of these two strategies.

Background Air pollution is a major public health concern. Air Quality Health Index (AQHI) is a very important air quality risk communication tool. However, AQHI is usually constructed by single-pollutant model, which has obvious disadvantages. Objective To construct an AQHI based on the joint effects of multiple air pollutants (J-AQHI), and to provide a scientific tool for health risk warning and risk communication of air pollution. Methods Data on non-accidental deaths in Yunnan, Guangdong, Hunan, Zhejiang, and Jilin provinces from January 1, 2013 to December 31, 2018 were obtained from the corresponding provincial disease surveillance points systems (DSPS), including date of death, age, gender, and cause of death. Daily meteorological (temperature and relative humidity) and air pollution data (SO₂, NO₂, CO, PM_2.5, PM₁₀, and maximum 8 h O₃ concentrations) at the same period were respectively derived from China Meteorological Data Sharing Service System and National Urban Air Quality Real-time Publishing Platform. Lasso regression was first applied to select air pollutants, then a time-stratified case-crossover design was applied. Each case was matched to 3 or 4 control days which were selected on the same days of the week in the same calendar month. Then a distributed lag nonlinear model (DLNM) was used to estimate the exposure-response relationship between selected air pollutants and mortality, which was used to construct the AQHI. Finally, AQHI was classified into four levels according to the air pollutant guidance limit values from World Health Organization Global Air Quality Guidelines (AQG 2021), and the excess risks (ERs) were calculated to compare the AQHI based on single-pollutant model and the J-AQHI based on multi-pollutant model. Results PM_2.5, NO₂, SO₂, and O₃ were selected by Lasso regression to establish DLNM model. The ERs for an interquartile range (IQR) increase and 95% confidence intervals (CI) for PM_2.5, NO₂, SO₂ and O₃ were 0.71% (0.34%–1.09%), 2.46% (1.78%–3.15%), 1.25% (0.9%–1.6%), and 0.27% (−0.11%–0.65%) respectively. The distribution of J-AQHI was right-skewed, and it was divided into four levels, with ranges of 0-1 for low risk, 2-3 for moderate risk, 4-5 for high health risk, and ≥6 for severe risk, and the corresponding proportions were 11.25%, 64.61%, 19.33%, and 4.81%, respectively. The ER (95%CI) of mortality risk increased by 3.61% (2.93–4.29) for each IQR increase of the multi-pollutant based J-AQHI , while it was 3.39% (2.68–4.11) for the single-pollutant based AQHI . Conclusion The J-AQHI generated by multi-pollutant model demonstrates the actual exposure health risk of air pollution in the population and provides new ideas for further improvement of AQHI calculation methods.

Objective:To identify the threshold of a health warning system based on the association of apparent temperature and years of life lost (YLL).Methods:Daily mortality records and meteorological data were collected from 364 Chinese counties for 2006-2017. Distributed lag nonlinear model and multivariate Meta-analyses were applied to estimate the association between the apparent temperature and YLL rate. A regression tree model was employed to estimate the warning thresholds of the apparent temperature. Stratified analyses were further conducted by age and cause of death.Results:The daily YLL rate was 23.6/10 5. The mean daily apparent temperature was 15.7 ℃. U-shaped nonlinear associations were observed between apparent temperature and YLL rate. The actual temperature-caused YLL rate for the elderly was higher than the young population. The daily excess deaths rate increased with the higher effect levels. Conclusions:Regression tree model was employed to define the warning threshold for meteorological health risk. The present study provides theoretical support for the weather-related health warning system.

Objective To investigate the influencing factors of stereopsis and ocular position changes before and after intermittent exotropia sur-gery. Methods A total of 70 cases diagnosed with intermittent exotropia(squint angle>15△and<85△)and treated in the Department of Ophthal-mology,the First Hospital of China Medical University from January 2010 to December 2014,were enrolled for the study. Operation methods was designed according to the pre-operative apparent distant strabismus ,and operations should be taken on the non-dominant eyes to lateral rectus re-cession combined with medial rectus shortening or lateral rectus recession. Patients were divided into different groups according to age ,age of exo-tropia onset,the angle of squint. The outcomes included best corrected visual acuity of eyes,refractive status,stereopsis,squint angle position of eye with intermittent exotropia after surgery. Results Compared with preoperative status,the stereopsis symptom was significantly improved after surgery(P<0.05). Stereopsis recovery and orthophoric rate were significantly increased according to the surgery age in children below 9 years old compared with those over 9 years old(P<0.05). Compared with the group of age≤9 years old,the rate of recovery of stereopsis and the rate of or-thophoria were not statistically significant(P>0.05). There was no statistical difference in the recovery rate of stereopsis and the orthostatic rate of eyes between the groups of 45△and more than 45△. Conclusion Intermittent exotropia surgery can effectively improve the stereopsis and eye po-sition,and the outcomes of surgery are related to the age of surgery. The recovery rate of stereopsis is higher in the patients with intermittent exotro-pia during the visual development period. Regardless of the size of the angle of squint ,early surgery is benefit to the recovery of stereopsis.

Objective To understand the prevalence of senile dementia in the elderly aged ≥ 60 years in China between 2000 and 2015.Methods Publications between 2000 and 2015 were retrieved from China National Knowledge Infrastructure (CNKI),Wanfang Databases,Chinese Science and Technology Journal Databases (VIP) and PubMed.Observational studies on prevalence of senile dementia were included.Meta-analysis was carried out by using R software.Results A total of 25 papers were included in this study.The total number of participants investigated was 76 980,with 4 295 dementia cases identified.The prevalence of senile dementia in the elderly was 5.15％ (95％CI:4.21％-6.09％);Subgroup analysis showed that the women had a higher prevalence (6.08％) than the men (4.10％);and the prevalence was significant increased with age (The senile dementia prevalence was 1.01％ in age groups 60-64 years,but 23.60％ in age group ≥85 years).The prevalence of Alzheimer's disease (3.56％) was higher than that of cerebral vascular dementia (1.11％).The senile dementia prevalence in the illiterate was 8.74％,higher than 3.17％ in the literate.The prevalence of senile dementia in the unmarried was 6.83％,higher than that in the married (3.95％).Conclusion The prevalence of senile dementia was high in the population aged ≥60 years in China.Age,sex,education level and marital status might influence the prevalence of senile dementia.

Objective To evaluate the efficacy of transarterial chemoembolization (TACE) and percutaneous cryosurgery sequential therapy for unresectable hepatocellular carcinoma (HCC).Methods Four hundred and twenty patients with unresectable HCC were divided into sequential TACE-cryosurgery sequential (sequential) group (n=290) and cryosurgery alone (cryoalone) group (n = 130). TACE was performed with the routine operation; the percutaneous cryosurgery was conducted 2 to 4 weeks after TACE. The patients were followed up at the first month and once every 2 to 3 month later. Liver ultrasound or both computer tomography and alpha fetal protein were examined during follow-up. Results During a mean follow-up of (42±17) months (range from 24 to 70 months), the local recurrence rate of ablated lesion was 17% for all the patients, 11% and 24% for patients in sequential group and cryoalone groups respectively (P=0. 001). The overall 1-, 2-, 3-, 4-and 5-year survival rate was 72%, 57%, 47%, 39% and 31%, respectively. The 1- and 2-year survival rates (71% and 61 % ) in sequential group were similar to those (73 % and 54 % ) in cryo-alone group (P=0.69 and 0. 147), while the 4- and 5-year survival rates were higher in sequential group (49 % and 39 % ) than those (29 % and 23 % ) in cryo-alone group (P= 0.001). Eighteen patients with large HCC (＞5 cm in diameter) in sequential group survived for more than 5 years while no one in cryo-alone group. Complication rate was 24% in all patients, 21% and 26% for the sequential and cryo-alone groups respectively (P=0. 06). The incidence of hepatic bleeding was higher in cryo-alone group than in sequential group (P=0. 02). Liver crack occurred in two patients of the cryoalone group. Conclusions Pre-cryosurgical TACE increased the cryoablation efficacy and decrease its complications, especially hepatic bleeding. TACE and cryosurgery sequential therapy may be a better treatment for unresectable HCC, especially for large HCC.