Association of social capital with obesity among older adults in China: a cross-sectional analysis.

BACKGROUND: Under the global aging trend, health issues of the elderly have received more and more attention. Among them, older adults' obesity is one of the common health problems of the elderly. The association between social capital and obesity in the older adults has been analysed and discussed in previous studies but remains controversial. There are few studies on the association between social capital and obesity in the older adults in China. We examined whether social capital was associated with obesity in Chinese older adults. METHODS: The data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) -wave 8 (2017-2018) was used in this study. Totally, 10,164 respondents were included in the final analysis. Generalized trust, social participation (informal social interaction and participation of organized social activities), and social support was used as measures of social capital. Obesity status was defined by body mass index (BMI). Logistic regression analyses were used to assess associations between the social capital and obesity, adjusting for confounders. RESULTS: We found that the older adults who did not trust people around had greater odds of being overweighted/obese compared to those who trust [Adjusted Odds Ratio (AOR) 1.155, 95% CI 1.045 to 1.265]. The older adults having formal participation (participating in organized social activities) registered considerably higher BMI (AOR 1.155, 95% CI 1.041 to 1.269). The older adults who did not trust people around them had greater odds of being overweighted/obese both in males (AOR 1.172, 95% CI 1.012-1.333) and in females (AOR 1.155, 95% CI 1.004-1.306). Males having formal social participation were more likely to be overweighted/obese (AOR 1.181, 95% CI 1.024 to 1.337), but not in females. CONCLUSIONS: Generalized trust and formal social participation was associated with overweight/obesity among older adults in China. Targeted obesity interventions for older adults are needed by developing public health policies for social capital optimization.

Association between social capital and sleep duration among rural older adults in China.

OBJECTIVE: Sleep disturbances are great challenges to older adults' health promotion. The study tested gender differences in the association between different dimensions of social capital and self-reported sleep duration of Chinese rural older adults. DESIGN: The data of rural older adults were extracted from a national cross-sectional survey of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) and analyzed in this study. SETTING: CLHLS covered 23 provinces in China. PARTICIPANTS: The 6552 rural respondents aged ≥65 years old were involved. MAIN OUTCOME MEASURES: Generalized trust, informal social participation, formal social participation and social support were used to assess social capital. Self-reported sleep duration was measured as health outcome. RESULTS: Low level of generalized trust had harmful effect on insufficient sleep (AOR 1.110, 95% CI 1.018-1.324), and having no formal or informal social participation was significantly positively associated with long sleep (AORformal 1.424, 95% CI 1.007-2.013; AORinformal 1.241, 95% CI 1.016-1.516). Rural older female adults with no emotional social support had higher odds of insufficient sleep (AOR 1.502, 95% CI 1.258-1.978). Meanwhile, both informal and formal social participation showed inverse association with long sleep for females. CONCLUSIONS: This study found the relationship between social capital, sleep duration and the gender differences in Chinese rural older adults. More targeted sleep disturbance interventions could be taken in social capital of rural older adults, and gender differences should be considered when making social capital-embedded health promotion policies and interventions.

Two Dietary Patterns From China Might Benefit Kidney Function, as Indicated by Latent Profile Analysis.

OBJECTIVES: Chronic kidney disease (CKD) is highly influenced by diet. However, there is a lack of a special dietary pattern to promote kidney health; there might have been some dietary patterns that could be beneficial in preventing the decline of renal function. The aim of this study is to assess the latent friendly dietary patterns for the kidneys in the year with low incidence of CKD in China. METHODS: In this cross-sectional survey (2009), 4,267 adults no less than 18 years old without CKD, hypertension, diabetes, and so on were analyzed in the China Health and Nutrition Survey. Kidney function was reflected by 3 common indicators: uric acid, urea, and creatinine. Food intake was determined based on 3 consecutive 24-hour dietary recalls from the first day of midnight to the fourth day of midnight. Latent profile analysis was used to identify dietary patterns among participants. RESULTS: After adjusting for demographic and lifestyle characteristics, 2 dietary patterns (low animal and high plant diet and high cereal and vegetable diet) which were characterized as higher intake of plant derived food (cereals, tubers, legumes, fruits, and vegetables) from China might benefit kidney function. The median intake of foods in the first dietary pattern was cereals and cereal products 433.33 g/day, tubers and starch products 150.00 g/day, dried legumes and legume products 46.67 g/day, vegetables and vegetable products 303.33 g/day, meat and meat products 40.00 g/day, and egg and egg products 20.00 g/day. The median intake of foods in the second dietary pattern was cereals and cereal products 616.67 g/day, dried legumes and legume products 38.33 g/day, vegetables and vegetable products 700.00 g/day, meat and meat products 66.67 g/day, and egg and egg products 20.00 g/day. CONCLUSIONS: It was shown that there were two dietary patterns in China might benefit kidney function. Future studies are needed to confirm these associations and design dietary patterns specifically to promote kidney health based on these characteristics.

Winter warming rapidly increases carbon degradation capacities of fungal communities in tundra soil: Potential consequences on carbon stability.

High-latitude tundra ecosystems are increasingly affected by climate warming. As an important fraction of soil microorganisms, fungi play essential roles in carbon degradation, especially the old, chemically recalcitrant carbon. However, it remains obscure how fungi respond to climate warming and whether fungi, in turn, affect carbon stability of tundra. In a 2-year winter soil warming experiment of 2°C by snow fences, we investigated responses of fungal communities to warming in the active layer of an Alaskan tundra. Although fungal community composition, revealed by the 28S rRNA gene amplicon sequencing, remained unchanged (p > .05), fungal functional gene composition, revealed by a microarray named GeoChip, was altered (p < .05). Changes in functional gene composition were linked to winter soil temperature, thaw depth, soil moisture, and gross primary productivity (canonical correlation analysis, p < .05). Specifically, relative abundances of fungal genes encoding invertase, xylose reductase and vanillin dehydrogenase significantly increased (p < .05), indicating higher carbon degradation capacities of fungal communities under warming. Accordingly, we detected changes in fungal gene networks under warming, including higher average path distance, lower average clustering coefficient and lower percentage of negative links, indicating that warming potentially changed fungal interactions. Together, our study reveals higher carbon degradation capacities of fungal communities under short-term warming and highlights the potential impacts of fungal communities on tundra ecosystem respiration, and consequently future carbon stability of high-latitude tundra.

The histone demethylase JMJD2A promotes glioma cell growth via targeting Akt-mTOR signaling.

BACKGROUND: A number of JmjC domain-containing histone demethylases have been identified and biochemically characterized in mammalian models and humans. JMJD2A is a transcriptional co-factor and enzyme that catalyzes the demethylation of histone H3 lysine 9 and 36 (H3K9 and H3K36). Here in this study, we reported the role of JMJD2A in human glioma. METHODS: Quantitative real-time PCR and western blot were performed to analyzed JMJD2A expression in glioma. Log-rank was performed to plot the survival curve. JMJD2A was knocked or overexpressed with lentivirus. Cell proliferation and colony formation were performed to assess the effects of JMJD2A on glioma cell growth. Xenograft experiment was performed the evaluate the growth rate of glioma cells in vivo. The signaling pathway was analyzed with western blot and mTOR was inhibited with rapamycin. RESULTS: Quantitative real-time PCR and western blot experiments revealed higher expression of JMJD2A and lower levels of H3K9me3/H3K36me3 in glioma tissues than that in normal brain tissues. We showed that knockdown of JMJD2A expression attenuated the growth and colony formation in three lines of glioma cells (U251, T98G, and U87MG), whereas JMJD2A overexpression resulted in opposing effects. Furthermore, we performed in vivo xenograft experiments and our data demonstrated that JMJD2A knockdown reduced the growth of glioma T98G cells in vivo. Further mechanism study implicated that JMJD2A activated the Akt-mTOR pathway and promoted protein synthesis in glioma cells via promoting phosphoinositide-dependent kinase-1 (PDK1) expression. The activation of the Akt-mTOR pathway was also validated in human glioma tissues. Finally, we showed that inhibition of mTOR with rapamycin blocked the effects of JMJD2A on protein synthesis, cell proliferation and colony formation of glioma cells. CONCLUSIONS: These findings demonstrated that JMJD2A regulated glioma growth and implicated that JMJD2A might be a promising target for intervention.

Assessment of the abstract reporting of systematic reviews of dose-response meta-analysis: a literature survey.

BACKGROUND: There is an increasing number of published systematic reviews (SR) of dose-response meta-analyses (DRMAs) over the past decades. However, the quality of abstract reporting of these SR-DRMAs remains to be understood. We conducted a literature survey to investigate the abstract reporting of SR-DRMAs. METHODS: Medline, Embase, and Wiley online Library were searched for eligible SR-DRMAs. The reporting quality of SR-DRMAs was assessed by the modified PRISMA-for-Abstract checklist (14 items). We summarized the adherence rate of each item and categorized them as well complied (adhered by 80% or above), moderately complied (50 to 79%), and poorly complied (less than 50%). We used total score to reflect the abstract quality and regression analysis was employed to explore the potential influence factors for it. RESULTS: We included 529 SR-DRMAs. Eight of 14 items were moderately (3 items) or poorly complied (5 items) while only 6 were well complied by these SR-DRMAs. Most of the SR-DRMAs failed to describe the methods for risk of bias assessment (30.2, 95% CI: 26.4, 34.4%) and the results of bias assessment (48.8, 95% CI: 44.4, 53.1%). Few SR-DRMAs reported the funding (2.3, 95% CI: 1.2, 3.9%) and registration (0.6, 95% CI: 0.1, 1.6%) information in the abstract. Multivariable regression analysis suggested word number of abstracts [> 250 vs. ≤ 250 (estimated ß = 0.31; 95% CI: 0.02, 0.61; P = 0.039)] was positively associated with the abstract reporting quality. CONCLUSION: The abstract reporting of SR-DRMAs is suboptimal, substantial effort is needed to improve the reporting. More word number may benefit for the abstract reporting. Given that reporting of abstract largely depends on the reporting and conduct of the SR-DRMA, review authors should also focus on the completeness of SR-DRMA itself.

Risk factors of mental disorders among empty and non-empty nesters in Shanxi, China: a cross-sectional study.

BACKGROUND: China has the world's largest size of elderly population. Mental disorders of the elders deserve keen attention. This study aims to comparatively explore mental disorders and risk factors among empty and non-empty nesters. METHODS: Using the stratified random cluster sampling method, we recruited 8526 elders aged 60 years and above from 11 cities in Shanxi Province in central China, comprising 4901 empty and 3625 non-empty nesters. The mental disorders were assessed with the 12-item Chinese Health Questionnaire (CHQ-12). The binary logistic regression was performed to analyze the risk factors in the two groups. RESULTS: The prevalence of mental disorders in empty nesters was significantly higher than that in non-empty ones (26.9% vs 23.5%). Binary logistic regression showed that the empty nesters who lived alone or lived in an institution were more likely to suffer from mental disorders compared with the non-empty ones, empty nesters living with spouse showed no significant deviation. And single status, hardly or part self-care ability, having chronic diseases, having lower income, and paying less attention to daily healthy diet had positive associations with mental disorders for empty nesters, and no or partial self-care ability and having chronic diseases for non-empty nesters. CONCLUSIONS: The study indicated that empty nesters had a higher prevalence of mental disorders than non-empty ones. Empty nesters living alone, with no or partial self-care ability, chronic disease, lower income and less attention to daily healthy diet were more vulnerable to mental disorders. And the lack of self-care ability and having chronic diseases were risk factors of mental disorders for non-empty nesters.

Experimental sleep restriction effect on adult body weight: a meta-analysis.

BACKGROUND: Sleep is increasingly recognized as a potential risk for overweight and obesity. Observational studies have shown links between short sleep duration with weight gain. However, the findings from longitudinal studies in adults are conflicting. This review aimed to examine the effectiveness of experimental sleep restriction on adult body weight. METHOD: A systematic search was undertaken in MEDLINE, EMBASE, PsycINFO, and CENTRAL (Cochrane center register of controlled trials) to identify experimental studies examining the effectiveness of sleep restriction on body weight, and search period was from January 2005 to June 2018. Meta-analysis was applied by using the random model. RESULTS: A total of 275 adults from six experimental studies were included. The pooled standard mean difference in body weight and body fat was 0.44 (95% CI - 0.13 to 1.02) (Z = 1.51, p > 0.05) and 0.35 kg (95% CI - 0.19 to 0.88) (Z = 1.27, p > 0.05), respectively. The experimental sleep restriction did not result in significant differences in adult body weight or body fat. Subgroup analysis showed that there were differences in weight gain between genders and races. CONCLUSION: The finding from this review cannot support the hypothesis from observational studies that short sleep leads to weight gain.

Impacts of Blast-Induced Traumatic Brain Injury on Expressions of Hepatic Cytochrome P450 1A2, 2B1, 2D1, and 3A2 in Rats.

The hepatic cytochrome P450 (CYP450) enzyme superfamily is one of the most important drug-metabolizing enzyme systems, which is responsible for the metabolism of a large number of clinically relevant medications used in traumatic brain injury (TBI) therapy. Modification of CYP450 expression may have important influences on drug metabolism and lead to untoward effects on those with narrow therapeutic windows. However, the impact of blast-induced TBI (bTBI) on the expression of CYP450 has received little attention. The subfamilies of CYP1A, 2B, 2D, and 3A account for about 85 % of all human drug metabolism of clinical significance. Therefore, in this study, we investigated the expressions of hepatic CYP1A2, CYP2B1, CYP2D1, and CYP3A2 in rats suffering bTBI. Meanwhile, we also measured some important cytokines in serum after injury, and calculated the correlation between these cytokines and the expressions of CYP1A2, CYP2B1, CYP2D1, and CYP3A2. The results showed that bTBI could significantly reduce mRNA expressions of CYP1A2, CYP2D1, and CYP3A2 at the early stage and induce the expressions from 48 h to 1 week after injury. The protein expressions of these CYP450s had all been downregulated from 24 to 48 h post- injury, and then began to elevate at 48 h after bTBI. The cytokines, IL-1ß, IL-2, IL-6, and TNF-α, increased significantly in the early phase, and began to reduce at the delayed phase of bTBI. The serum levels of IL-1ß, IL-6, and TNF-α but not IL-2 were significantly negative correlated with the mRNA expressions of CYP2B1 and CYP2D1 and the proteins expressions of CYP1A2, CYP2B1, CYP2D1, and CYP3A2. In conclusion, our work has, for the first time, indicated that bTBI has significant impact on the expressions of CYP1A2, CYP2B1, CYP2D1, and CYP3A2, which may be related to the cytokines induced by the injury.

Myocyte enhancer factor 2D promotes tumorigenicity in malignant glioma cells.

The prognosis of patients with malignant glioma is always quite poor, and this poor prognosis is probably due to our incomplete understanding of the molecular mechanisms underlying malignant glioma. It is known that myocyte enhancer factor-2D (MEF2D) plays an oncogenic role in hepatocellular carcinoma and promotes the survival of various types of cells. However, little is known about the expression profile and function of MEF2D in malignant glioma. In this study, we investigated the function and expression of MEF2D in malignant glioma. We found that in malignant glioma, there is an aberrantly high expression of MEF2D, which leads to poor prognosis of malignant glioma. The downregulation of MEF2D suppresses the proliferation of malignant glioma cell lines by inducing delay of S and G2/M phases of cell cycle and promoting apoptosis. Furthermore, the overexpression of MEF2D in astrocytes accelerates cell proliferation by regulating cell cycle progression. Furthermore, a mouse malignant glioma model demonstrated that MEF2D deficiency blocks malignant glioma formation in vivo. We conclude that MEF2D may act as a potential oncogene in malignant glioma and thus serve as a candidate target for malignant glioma therapy.

Glioma-derived thrombospondin-1 modulates cd14+ cell tolerogenic properties.

Thrombospondin-1 (TSP1) plays a role in the immune tolerance, and is involved in the pathogenesis of glioma. This study aims to investigate the role of the glioma-derived TSP1 in the induction of the tumor immune tolerance. The results showed that the primary human glioma cells expressed high levels of TSP1. Glioma cells enhanced the expression of transforming growth factor (TGF)-ß in CD4⁺ CD16⁻ naïve monocytes (Mos). The TGF-ß⁺ Mos showed inhibitory effect on CD8⁺ T cell proliferation. We conclude that glioma cell-derived TSP1 facilitates the induction of TGF-ß in Mos. The TSP1 may be a potential therapeutic target of glioma.

Emodin inhibits inducible nitric oxide synthase in a rat model of craniocerebral explosive injury.

To investigate the effects of emodin on blast-induced traumatic brain injury (bTBI) in a rat model. Eighty rats were randomly divided into 2 groups (the control group and the emodin-treated group; N = 40 per group) and were used to establish the model of blast-induced traumatic brain injury. Ten minutes after the explosion, an isotonic saline solution (10 mg/kg) or emodin (10 mg/kg) were administered via an intraperitoneal injection to the control group and the emodin-treated group, respectively. At each time point (pre-explosion, 2, 6, 12, 24 h after explosion), 2 rats were used for the pathological assessment and 6 rats were used for the biochemical assessment. The concentration of nitric oxide (NO) and the expression and activity of inducible nitric oxide synthase (iNOS) were measured at each time point by spectrophotometry and western blot analysis. Light and electron microscopy showed that the brain damage in the emodin-treated group was less serious than that observed in the control group. The concentration of NO in the emodin-treated group was lower compared with the control group (p < 0.05). Western blot analysis showed that protein expression in the emodin-treated group was lower than the control group (p < 0.05). Emodin can alleviate brain damage after bTBI by inhibiting iNOS. These findings suggest that emodin has a protective effect against bTBI. One possible mechanism may occur by inhibiting the expression and activity of iNOS and consequently decreasing the concentration of NO.

Is cranioplasty the optimal treatment for contralateral subdural effusion after decompressive craniectomy?: a case report.

Introduction and importance: Contralateral subdural effusion (CSDE) is a rare complication secondary to decompressive craniectomy (DC), which can lead to encephalocele and neurologic deterioration. The authors report a case that confirm the existence of unidirectional membrane valve, and cranioplasty is an effective treatment for CSDE. Case presentation: The authors reported a case of 43-year-old female was diagnosed with ruptured intracranial aneurysm and treated with interventional embolization. She underwent DC because of postoperative cerebral infarction subsequently. Her conscious state deteriorated accompanied by encephalocele in postoperative 2 week. A craniocerebral computed tomography (CT) confirmed the diagnosis of CSDE with cerebral hernia. A compression bandaging of the skull defect was applicated, whereas, her conscious state progressive deteriorated. She was transferred to the author's hospital where she underwent burr-hole drainage and clinical symptom has been improved. However, a relapse of CSDE was observed after the removal of drainage tube. Continuous lumbar drainage was employed, and which was ineffective for CSDE in this case. Finally, she underwent cranioplasty, with the help of drainage of subdural effusion, CSDE was completely resolved. Clinical discussion: CSDE is occasionally observed in patients after DC. Intracranial pressure (ICP) gradient and unidirectional membrane valve are the possible mechanisms of CSDE. At present, there is no optimal therapy for CSDE. For symptomatic CSDE patients, one or more treatment measures should be applicated. Conclusion: Cranioplasty is one of the curative and optimal method to treat symptomatic CSDE patients, early cranioplasty combined with burr-hole drainage should be performed for conservative treatment failed and intractable cases.

Revealing the mechanisms of blood-brain barrier in chronic neurodegenerative disease: an opportunity for therapeutic intervention.

The brain microenvironment is tightly regulated, and the blood-brain barrier (BBB) plays a pivotal role in maintaining the homeostasis of the central nervous system. It effectively safeguards brain tissue from harmful substances in peripheral blood. However, both acute pathological factors and age-related biodegradation have the potential to compromise the integrity of the BBB and are associated with chronic neurodegenerative diseases such as Alzheimer's disease (AD) and Parkinson's disease (PD), as well as Epilepsy (EP). This association arises due to infiltration of peripheral foreign bodies including microorganisms, immune-inflammatory mediators, and plasma proteins into the central nervous system when the BBB is compromised. Nevertheless, these partial and generalized understandings do not prompt a shift from passive to active treatment approaches. Therefore, it is imperative to acquire a comprehensive and in-depth understanding of the intricate molecular mechanisms underlying vascular disease alterations associated with the onset and progression of chronic neurodegenerative disorders, as well as the subsequent homeostatic changes triggered by BBB impairment. The present article aims to systematically summarize and review recent scientific work with a specific focus on elucidating the fundamental mechanisms underlying BBB damage in AD, PD, and EP as well as their consequential impact on disease progression. These findings not only offer guidance for optimizing the physiological function of the BBB, but also provide valuable insights for developing intervention strategies aimed at early restoration of BBB structural integrity, thereby laying a solid foundation for designing drug delivery strategies centered around the BBB.

Interspecific competition affects spore germination and gametophore development of mosses.

Background: Interactions between moss species in their earliest growth stages have received little attention. To what extent interspecific competition or priority effects influence spore germination, protonemal development and gametophore emergence is unknown. We evaluated such effects in pairwise interaction between six common bryophyte species: Atrichum undulatum, Bryum argenteum, Ceratodon purpureus, Funaria hygrometrica, Hypnum cupressiforme, Leptobryum pyriforme. Methods: Interspecific interactions were assessed in vitro. Spores were sterilized and sown on agar plates in three treatments: 1) as single species cultures (controls), 2) as pairwise species cultures inoculated simultaneously, and 3) with a time lag of 20 days between species. Data on time needed for spore germination, germination rate, the time needed for gametophore differentiation, number of gametophores per germinated spore and average diameter of colonies were collected. We also performed spore germination tests in single-species cultures at the start and end of the study, as well as tests for density-dependency at spore germination and gametophore formation. Results: We observed strong pairwise interactive effects when sowing spores of different species simultaneously or with a delay of 20 days. The results indicate that spore germination is often inhibited by interspecific competition. The first species has an advantage as compared to the later colonizing species, i.e., an apparent priority effect. Interspecific interactions were also evident during gametophore development and included both inhibition and facilitation. Conclusion: We found pronounced differences in the relative performance of species in interaction with other species during spore germination and gametophore formation. Allelopathic effects are the most probable explanation for these observations. Our results under sterile lab conditions are likely to reflect processes that occur in the wild, governing biotic filtering and bryophyte community assembly during primary and secondary colonization.

Immune checkpoint inhibitor-induced pure red cell aplasia: Case series and large-scale pharmacovigilance analysis.

INTRODUCTION: Impressive advances in immunotherapy, especially immune checkpoint inhibitors (ICIs), have made great progress in treating multiple cancers. However, ICIs can also cause serious, even incurable, immune-related adverse events (irAEs), most often in patients with colitis, dermatitis, hepatitis, and thyroiditis. Rare autoimmune hematologic toxicities have been reported in the literature but are poorly described. Pure red cell aplasia (PRCA) induced by ICIs is a life-threatening autoimmune disease; however, only a few cases have been reported in the literature. OBJECTIVE: To characterize and evaluate PRCA associated with different ICI regimens in a public database and to review the relevant literature. METHODS: We described a case series of patients experiencing PRCA while on ICIs. We also mined the Food and Drug Administration's Adverse Event Reporting System (FAERS) and used reporting odds ratio (ROR), proportional reporting ratio (PRR), Bayesian confidence propagation neural network (BCPNN), and multi-item gamma Poisson shrinker (MGPS) algorithms to analyze the data of the suspected adverse events of PRCA induced by ICIs between January 2011 and June 2022. RESULTS: Fifteen patients with PRCA events while on ICIs were included in our case series. In FAERS, a total of 41 individual case safety reports (ICSRs) with different ICI regimens were retrieved, among which 28 (68.3%) were related to monotherapy and three (7.3%) involved a fatal outcome. Signals of PRCA for all four ICI monotherapies (nivolumab, pembrolizumab, durvalumab, and atezolizumab) and ICI combination therapy (ipilimumab/nivolumab) were detected. Ipilimumab/nivolumab presented a higher reporting signal than nivolumab. CONCLUSIONS: There is a significant reporting signal of PRCA with several ICI agents. Clinicians should be aware of and monitor this potentially fatal adverse event.

IgG4-associated hypophysitis coexisting with MALT lymphoma and gangliocytoma: first case report and literature review.

IgG4-related or IgG4-associated hypophysitis is a rare disease characterized by the infiltration of IgG4-positive plasma cells into pituitary gland tissue. Gangliocytomas in the sellar region are also extremely rare and are associated with pituitary adenomas in the majority of cases. Sellar mucosa-associated lymphoid tissue (MALT) lymphoma is an exceedingly rare condition. In this study, we present a case of IgG4-associated hypophysitis coexisting with MALT lymphoma and gangliocytoma. However, to elucidate the potential pathophysiological relationship, it is imperative to gather additional cases of IgG4-related hypophysitis accompanied by MALT lymphoma and gangliocytoma.

Clinical features of patients with cerebral venous sinus thrombosis at plateau areas.

OBJECTIVE: Cerebral venous sinus thrombosis (CVST) is believed to be associated with high-altitude exposure and has worse clinical prognosis in plateau areas than in plain areas, although this needs to be further verified. This retrospective study aims to compare the clinical differences of patients with CVST in plateau and plain areas and further ascertain the role of high-altitude exposure in the etiology of aggravating predisposition toward CVST. METHODS: Twenty-four symptomatic CVST patients occurring at plateau areas (altitude ≥ 4000 m), in corresponding with 24 CVST patients occurring at plain areas (altitude ≤ 1000 m), were recruited according to the inclusion and exclusion criteria from June 2020 to December 2021. The collected data and compared parameters include clinical features, neuroimaging findings, hematology profile, lipid profile, and coagulation profile within 24 h of hospital admission, as well as the treatment method and final outcome. RESULTS: There were no obvious differences of demographic characteristics, including gender, age, height, and weight between patients with CVST in plateau and plain areas, as well as medical history, neuroimaging findings, treatment protocols, and clinical outcome (all p > .05). Compared to patients with CVST at plain areas, time before hospital admission was longer and heartbeat was slower in patients with CVST at plateau areas (all p < .05). More importantly, elevated red blood cells counts, hemoglobin level, and altered coagulation function were found in patients with CVST at plateau areas (all p < .05). CONCLUSION: CVST patients in plateau areas presented with altered clinical characteristics, altered coagulation function, and aggravated predisposition toward venous thromboembolism compared with CVST patients in plain areas. Future prospective studies will be needed to further elucidate the influences of a high altitude on the pathogenesis of CVST.

Analysis of inequality in the distribution of general practitioners in China: evidence from 2012 to 2018.

AIM: This paper aims to analyze the inequalities in general practitioner (GP) distribution in China. BACKGROUND: GPs-based primary health care (PHC) has been implemented from 2011 in China, aiming to improve the accessibility and quality of basic medical and healthcare services. GPs in China, as the gatekeeper of people's health, mainly undertake integrated health services at the grass-roots level. METHODS: The number of GPs and inequality in GPs distribution from 2012 to 2018 was analyzed by the Lorenz Curve/Gini coefficient and Theil L index. Data were extracted from China Health Statistical Yearbook 2013-2019. FINDINGS: The demographic Gini coefficient of GPs changed from 2012 (0.234) to 2018 (0.167), showing high equality in China. In contrast, the Thiel L index from 2012 (0.372) to 2018 (0.345) showed less equality. The decomposition of Thiel L index implicated the inequalities within the divisions. The number of GPs in China shows a fast growth trend since the general practice system established, and the GPs distribution becomes more demographically equitable. However, the shortage of GPs and inequality in their distribution remains severe. More incentive and supportive policies need to be made to enhance the quantity, quality, and structure of GPs in China.

Knowledge, Attitudes, and Practices Associated With Diabetic Foot Prevention Among Rural Adults With Diabetes in North China.

Background: The diabetic foot is a global threat to public health because it can result in infection and amputation, as well as cause the patient to experience considerable pain and incur financial costs. The condition of patients with diabetic foot in North China is distinguished by more severe local ulcers, a worse prognosis, and a longer duration of disease than that of patients with diabetic foot in the south. Through appropriate preventive measures, the diabetic foot can be effectively avoided. This study assesses the existing knowledge, attitudes and practices associated with diabetic foot prevention among adults with diabetes living in rural areas of North China. Method: This cross-sectional survey included 1,080 rural adults from North China, cluster sampled 12 villages and surveyed diabetic patients without diabetic foot who participated in community diabetes management. The self-administered knowledge and attitude questionnaire and the Chinese version of the Nottingham Assessment of Functional Foot-care Questionnaire were used. Result: Of the 1,080 subjects, 51.6% received moderate knowledge scores, 63.9% had a positive attitude and 71.4% received poor practice scores. In terms of knowledge, parameters of knowledge about foot examinations and treatment of foot problems showed the lowest scores. In terms of practice, in line with the results of the low knowledge score, parameters of the pursuit of medical treatment for foot problems and routine foot examinations were associated with the lowest scores. Multiple regression analysis revealed that participants who were current smokers (ß: -0.049, 95% CI: -0.088 to -0.011) had lower knowledge scores than those who never smoke; participants who were current smokers (ß: -0.818, 95% CI: -1.067 to -0.569) and past smokers (ß: -0.299, 95% CI: -0.485 to -0.112) had lower attitude scores than those who had never smoked; participants who had higher knowledge scores (ß: 1.964, 95% CI: 1.572-2.356) achieved higher scores on attitudes; women had better practice scores than men (ß: 0.180, 95% CI: 0.122-0.239); patients with a long diabetes duration (6-10 years) had better practice scores than those who had a short diabetes duration (<2 years; ß: 0.072, 95% CI: 0.012-0.131). Knowledge (ß: 0.130, 95% CI: 0.001-0.258) and attitudes (ß: 0.268, 95% CI: 0.249-0.287) were significantly associated with good practices. Conclusions: Increasing knowledge regarding diabetic foot would help instill positive attitudes and cultivate better practices toward diabetic foot prevention. The results of this study may help guide future promotional resources to those groups most in need, which may help lower the incidence of diabetic foot among adults in North China.