Objective:To explore the mediating effect of unhealthy lifestyle and depressive symptom on the associations between life course factors and aging health.Methods:The study included 6 217 participants (aged ≥45 years) from the China Health and Retirement Longitudinal Study (CHARLS). We used principal component analysis (PCA) and hierarchical clustering analysis (HCA) to divide participants into six subgroups based on 70 life course factors. Five key life course factors were identified based on correlation analysis and their contribution to aging health. Physiological dysregulation (PD) was calculated by using eight biomarkers in the 2015 CHARLS biomarker dataset. Linear regression, logistic regression, and mediation models were used to explore the complex associations of life course subgroups, key factors, unhealthy lifestyle, depression symptom with PD.Results:Life course subgroups were significantly associated with PD after adjusting chronological age and gender ( β: 0.08-0.17, all P<0.05). Life-course subgroups and key factors, including adverse experiences in adulthood and lower education level, were significantly associated with unhealthy lifestyle ( β: 0.04-0.52, all P<0.05). Life-course subgroups and key factors, including childhood trauma, parental health in childhood, adverse experiences in adulthood, and lower education level, were significantly associated with depression symptom ( OR: 1.16-4.76, all P<0.05). Mediation analysis showed that unhealthy lifestyle had partial mediating effect on the association of life course subgroups and key factors, including adverse experiences in adulthood, and lower education levels, with PD (3.1%-3.6%). Depression symptom had partial mediating effect on the association of life course subgroups and key factors, including childhood trauma, adverse experience in adulthood, and lower education level, with PD (6.0%-16.2%). Conclusions:Unhealthy lifestyle and depression symptom has partial mediating effect on the impact of life course factors on aging health. It is important to pay attention to these two modifiable factors while targeting childhood trauma and adverse experience in adulthood.

ObjectiveTo compare the annual and age trends of the age-standard incidence rate （ASIR） and the age-standard mortality rate （ASMR） of lung cancer in countries with different human development index （HDI） from 1990 to 2019. MethodsThe data were collected from the global burden of disease study and GLOBOCAN 2020. The average annual percentage change （AAPC） and age trends of ASIR and ASMR in lung cancer were analyzed by the Joinpoint regression model， and the comparison between the four groups was analyzed by Kruskale-Wallis analysis. ResultsIn 2020， the incidence and mortality of lung cancer gradually increased with age and HDI grade. From 1990 to 2019， the global ASIR and ASMR of lung cancer decreased， and the ASIR of lung cancer among male decreased， while the ASIR of lung cancer among female increased. The results showed that ASIR of lung cancer in female residents in countries with very high HDI increased significantly from 1996 to 2011， resulting in an overall upward trend in female ASIR， while the other groups showed a downward trend. It was found that ASIR and ASMR of lung cancer in China and India were on the rise， while ASIR and ASMR of lung cancer in Russia and the United States were on the decline. ConclusionAlthough very high/high HDI countries face a higher burden of lung cancer occurrence and death， the accumulation of lung cancer burden is completed in the transitioning period. Therefore， lung cancer prevention measures in countries in transition are critical for global lung cancer control.

Statistics plays an important role in medical research， and the selection of appropriate statistical methods is crucial for drawing reliable and valuable conclusions. This paper provides a brief introduction to commonly used statistical analysis methods for medical data， covering descriptive analysis， parametric test， nonparametric test， correlation analysis， regression analysis， and analysis of survival data. It focuses on discussing the assumptions of multiple linear regression， logistic regression and Cox proportional risk regression， as well as how to choose the appropriate statistical methods for analyzing and interpreting medical data based on different research objectives and data types.

Clinical research reports serve as the presentation of scientific research findings and directly reflect the quality of the research. This article describes the writing of different types of clinical research reports， such as observational studies and randomized controlled trial studies， with a particular focus on randomized controlled trials. Each scientific research design has its reporting focus， and the writing of scientific research papers has uniform requirements and a specific writing format. Mastering the proper format of drafting research reports is of practical value and significant importance for conduction high-quality clinical research.

Objective:To compare the geographical differences and time trends of liver cancer incidence and mortality in different regions around the world so as to predict the future burden of liver cancer.Methods:The incidence and mortality data of liver cancer in different Human Development Index (HDI) countries from 2000 to 2020 were collected from the GLOBOCAN 2020 database. The joinpoint model and annual percent change (APC) were used to analyze the liver cancer global incidence and mortality as well as future epidemic trends from 2000 to 2020.Results:ASMR for male liver cancer was increased from 8.0/100, 000 in 2000 to 7.1/100,000 in 2015 (APC = -0.7, 95% CI: -1.2 ~ -0.3, P = 0.002), while ASMR for female liver cancer was increased from 3.0/100, 000 in 2000 to 2.8/100, 000 in 2015 (APC = -0.5, 95% CI: -0.8 ~ -0.2, P < 0.001). The ratio of male to female ASMR was 2.67:1 in 2000 and 2.51:1 in 2015, indicating a slight narrowing of the difference in mortality between men and women. In 2020, the global ASIR and ASMR for liver cancer were 9.5/100 000 and 8.7/100 000, respectively. Male ASIR and ASMR (14.1/100, 000 and 12.9/100, 000, respectively) were 2 ~ 3 times higher than females (5.2/100, 000 and 4.8/100, 000, respectively). There were significant differences between ASIR and ASMR in different HDI countries and regions ( PASIR = 0.008, PASMR < 0.001), and the distributions of ASMR and ASIR were very similar. New cases and deaths were expected to increase by 58.6% (143,6744) and 60.9% (133, 5 375) in 2040, with the number of cases and deaths increasing by 39,7003 and 37,4208 in Asia, respectively. Conclusion:ASMR due to liver cancer worldwide has had a downward trend between 2000 and 2015. However, the latest epidemiological status and predictions of liver cancer in 2020 indicate that prevention and control will still be a major challenge globally in the next 20 years.

Objective     To compare the perioperative results between uniportal and three-portal thoracoscopic lobectomy for non-small cell lung cancer (NSCLC). Methods     Electronic databases including PubMed, Web of Science, EMbase, CNKI, Wanfang were systematically searched from the establishment of each database until April 2022. Literature screening, data extraction and bias risk assessment were independently conducted by two researchers. All combined results were performed by RevMan 5.3 and Stata 16.0. The quality of the literature and the risk of bias were evaluated using the Cochrane Bias Risk Assessment Tool. Results     Eighteen eligible randomized controlled trials (1 597 patients) were identified eventually, including 800 patients undergoing uniportal thoracoscopic lobectomy and 797 patients undergoing three-portal thoracoscopic lobectomy. Meta-analysis results showed that compared to the three-portal approach, uniportal lobectomy took longer operation time (WMD=7.63, 95%CI 2.36 to 12.91, P=0.005) with less intraoperative blood loss (WMD=–28.81, 95%CI –42.54 to –15.08, P<0.001). Furthermore, patients undergoing uniportal lobectomy achieved lower visual analogue score within 24 hours after the operation (WMD=–1.60, 95%CI –2.26 to –0.94, P<0.001), less volume of drainage after the operation (WMD=–25.30, 95%CI –46.22 to –4.37, P=0.020), as well as shorter drainage duration (WMD=–0.36, 95%CI –0.72 to –0.01, P=0.040). Besides, patients undergoing uniportal lobectomy were also observed with shorter length of hospital stay (WMD=–2.28, 95%CI –2.68 to –1.88, P<0.001) and lower incidence of postoperative complications (RR=0.49, 95%CI 0.38 to 0.63, P<0.001). However, the number of lymph nodes harvested during the operation (WMD=–0.01, 95%CI –0.24 to 0.21, P=0.930) was similar between the two groups. Conclusion     Both uniportal and three-portal thoracoscopic lobectomy for NSCLC are safe and feasible. The uniportal approach is superior in reducing short-term postoperative pain, postoperative complications and shortening the length of hospital stay.

Objective:To study the intestinal flora specific differences with different lesional stages of metabolic (disorder) associated fatty liver disease (MAFLD), namely simple steatosis and steatohepatitis, so as to provide a new direction for MAFLD-related intestinal flora transplantation and targeted therapy.Methods:Mice were fed with normal diet, methionine-choline deficient diet (MCD) and a high-fat high-fructose diet (HFHF) for 12 weeks to construct simple steatosis and steatohepatitis models. HE and Sirius scarlet staining was performed to observe the liver pathological changes. The qPCR method was used to evaluate inflammation and liver fibrosis factors. A fully automatic biochemical analyzer was used to detect changes in liver transaminase and blood lipids. 16S rRNA sequencing method was used to observe the intestinal flora differences in the feces of each group of mice. The comparison of means between two groups was performed by t-test, and the comparison of means between multiple groups was performed by one-way analysis of variance. Kruskal-Wallis rank sum test was used for non-normally distributed data.Results:NAFLD scores were determined with pathological sections (HE and Sirius scarlet staining) of mice liver, which showed that the inflammation and liver fibrosis scores of the MCD and HFHF groups were 2.12 ± 0.18 and 1.06 ± 0.24, and 2.22 ± 0.16 and 0.46 ± 0.10, respectively. The degree of liver inflammation and fibrosis was significantly higher in the MCD than the HFHF group ( P < 0.001 and P < 0.01). Lipid deposition was higher in the HFHF than the MCD group ( P < 0.001), and the scores were 2.36 ± 0.17 and 1.60 ± 0.24 respectively. Simultaneously, the inflammatory [tumor necrosis factor-A (TNF-a), chemokine factor-2 (CXCL-2)] and hepatic fibrosis indicators [vascular smooth muscle actin alpha (a-SMA) and connective tissue growth factor (CTGF)] had confirmed the above-mentioned results at the transcription level. Moreover, the intestinal flora diversity was reduced ( P < 0.05) in the MCD group than the HFHF group, and the Simpson and Shannon index were 0.31 ± 0.10 and 0.42 ± 0.05, and 2.03 ± 0.33 and 1.70 ± 0.28, respectively, and the differences were significant between different intestinal flora groups. The levels of Desulfovibrio, Odoribacter, and Roseburia flora were significantly increased in the HFHF than the MCD group, and the levels of Faecalibaculum, Parasutterella, Alipis, Butyricimonas_virosa, Turicibacter_sp, and Romboutsia_ilealis were significantly increased in the MCD than the HFHF group, and the difference was statistically significant ( P < 0.05). Conclusion:There are significant differences in intestinal flora diversity between simple steatosis and steatohepatitis models. Therefore, clarifying the difference between the two may provide a new direction for the stage manner treatment of MAFLD.

Objective To study the effect of amino acid site variation of HIV-1 Nef protein on its inhibition of neuronal autophagy and explore the mechanism of Nef protein-induced central nervous system injury.Methods HIV-1 nef genes were amplified and cloned from the temporal cortex (TC) of the central nervous system in 1 case of HIV-associated dementia (HAD) H and 1 case of non-HAD AIDS patient N.The amino acid sequences were aligned by NCBI BLAST tools and MEGA6.0 software to study the variation of amino acid sites.The eukaryotic expression vectors pEGFP-N1-nef derived from H-TC and N-TC were constructed and transfected into U87 cells to observe green fluorescence.At the same time,the expression of Nef protein,LC3-Ⅱ and p62 protein in U87 cells were detected by Western blot,and the effects of different sources of Nef on autophagy of U87 cells were analyzed.Results The nef genes were amplified by PCR and clone vectors pMD-19T-nef of H-TC and N-TC were successfully constructed.The sequencing confirmed that they were HIV-1B subtypes.The amino acid sequence analysis showed that there were differences between H-TC and N-TC key amino acid sites.The recombinant plasmid pEGFP-N1-nefwas successfully constructed and expressed Nef protein in U87 cells.Western blot analysis showed that the expression of LC3-Ⅱ protein was significantly different among groups (F =11.764,P =0.001).There was no significant difference in the expression of LC3-Ⅱ between cell control and plasmid control(P=0.169).The content of LC3-Ⅱ was low in the two groups of cells,which could not be detected by Western blot.The expression of LC3-Ⅱ in H-TC,N-TC and positive control CQ group increased,compared with blank control or blank vector.The difference was statistically significant (P=0.017,P=0.039,P=0.031),and the expression of LC3-Ⅱ in H-TC group was higher than that in N-TC group (P =0.023);the expression of p62 protein in H-TC,N-TC and positive control CQ group was higher than that in blank control or blank vector group,but there was no significant difference between groups (F=2.049,P =0.163).Conclusions HIV-1 Nef amino acid sites in the central nervous system of patients with HAD and non-HAD were different,and their effects on autophagy of U87 cells were different.The expression of LC3-Ⅱ,an autophagic marker protein,was more strongly induced by Nef from H-TC.

Objective: To observe the short-term efficacy and side effects of bevacizumab combined with pemetrexed for the treat-ment of recurrent and metastatic cervical cancer. Methods: The clinical data of 32 patients with recurrent metastatic cervical cancer admitted to the Department of Oncology, Guizhou Provincial People's Hospital between January 2014 and December 2016 were retro-spectively analyzed. All patients were treated with bevacizumab plus pemetrexed. In the 21-day cycle, chemotherapy was adminis-tered for 4 to 6 cycles. The efficacy and grade of adverse reactions were evaluated. Results: Of the 32 patients with cervical cancer, 0 had complete remission, 7 (21.9%) had partial remission, 19 (59.4%) had stable disease, and 6 (18.7%) had disease progression. The ef-fective rate was 21.9% (7/32) and the disease control rate was 81.3% (26/32). The 32 patients had mild common adverse reactions, which can be tolerated. Conclusions: Bevacizumab combined with pemetrexed has good short-term effects for patients with recurrent and metastatic cervical cancer, and its side effects can be tolerated. The long-term efficacy warrants further study.

Objective To evaluate the feasibility of three-dimensional (3D) printing of mitral annulus with transesophageal echocardiographic volume images as the data source ,and to assess the accuracy of the 3D printing mitral annulus models based on three dimensional transesophageal echocardiography ( 3D-TEE) images preliminarily . Methods A retrospective study was performed in 25 patients with mild or slight mitral regurgitation and 10 patients with moderate to severe mitral regurgitation . All the subjects were underwent 3D-TEE . The 3D-TEE volume images of mitral annulus at the end diastole were post-processed by Mimics software to create images of the mitral annulus in standard tessellation language format . The STL file was output to the 3D printer and the 3D printing models of mitral annulus were obtained . The mitral annulus size parameters including the diameter between anterior and posterior ,the diameter between anterolaterior and posteromedial ,sphericity index and mitral annulus circumference were measured from 3D printing models and 3D-TEE images ,respectively . From which the absolute difference of the measurements between 3D printing models and the 3D-TEE images were calculated . Results All of the 3D-TEE images were successfully post-processed ,and the corresponding 3D printing models were acquired by high-precision 3D printer . It showed no significant difference in all the mitral annulus size parameters between 3D printing modelsand3D-TEEimages(allP >0.05) .Morever,thesizeparameterswereconcordantwellbetweenthe two methods ,all of the data points fell within the limits of agreement . It showed little absolute difference in value of the mitral annulus size parameters between the 3D printing mitral annulus models and the 3D-TEE images . Conclusions It is technically feasible to print 3D models of mitral annulus using 3D-TEE images as the data source . 3D printing mitral annulus models based on transesophageal echocardiographic volume images have high precision .